bluuebunny/crossref_metadata_2025 huggingface dataset:
Alamandine: Potential Protective Effects in SARS-CoV-2 Patients
Authors: Soltani Hekmat Ava , Javanmardi Kazem
Published: November 2021

Coronavirus disease 2019 (COVID-19) can occur due to contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has no confined treatment and, consequently, has high hospitalization and mortality rates. Moreover, people who contract COVID-19 present systemic inflammatory spillover. It is now known that COVID-19 pathogenesis is linked to the renin-angiotensin system (RAS). COVID-19 invades host cells via the angiotensin-converting enzyme 2 (ACE2) receptor—as such, an individual’s susceptibility to COVID-19 increases alongside the upregulation of this receptor. COVID-19 has also been associated with interstitial pulmonary fibrosis, which leads to acute respiratory distress, cardiomyopathy, and shock. These outcomes are thought to result from imbalances in angiotensin (Ang) II and Ang-(1-7)/alamandine activity. ACE2, Ang-(1-7), and alamandine have potent anti-inflammatory properties, and some SARS-CoV-2 patients exhibit high levels of ACE2 and Ang-(1-7). This phenomenon could indicate a failing physiological response to prevent or reduce the severity of inflammation-mediated pulmonary injuries. Alamandine, which is another protective component of the RAS, has several health benefits owing to its antithrombogenic, anti-inflammatory, and antifibrotic characteristics. Alamandine alleviates pulmonary fibrosis via the Mas-related G protein-coupled receptor D (MrgD). Thus, a better understanding of this pathway could uncover novel pharmacological strategies for altering proinflammatory environments within the body. Following such strategies could inhibit fibrosis after SARS-CoV-2 infection and, consequently, prevent COVID-19.
Research on College English Multimedia Teaching Model Driven by Wireless Communication Network Environment
Authors: Li Xinguo , Zhang Hua
Published: November 2021

English teaching has also gradually introduced computer network‐assisted teaching methods. Compared with other subjects, English teaching has many constraints, including lower teacher‐student interaction time, lack of English speaking training environment, single learning method, and other problems leading to the phenomenon that English teaching tends to emphasize theory but not practice. In terms of the current practical situation, the development and research of computer network multimedia courses are still far from meeting the actual needs of English network teaching. English network teaching mainly involves the transmission and use of video streams on the network, but the current video stream transmission conditions are not very ideal. Therefore, this paper focuses on the practical development of computer‐assisted teaching in English teaching based on the browser/server (B/S) architecture mode of network multimedia teaching system, so that the teaching reform of English network courses can be further improved and developed. The research content of this paper is based on the development technology of the B/S mode, theoretical study and research on the production method of the English network teaching system, and practical evaluation and development application of this teaching system. A comparison of the educational effects of computer network education models and traditional education models is carried out to determine the implementation and effectiveness of web‐based English multimedia education systems. Based on a web browser‐based network education model, the Internet is used as a means of transmitting media education content with synchronised English and playback lessons as well as related online tests and online question and answer sessions on the Internet, enabling timely and efficient educational activities. The teaching system is also evaluated and applied. The research results show that the network multimedia teaching system provides a variety of forms of materials, making the original more abstract content a more vivid image and concrete. Changing the original traditional teaching mode of English makes students’ English learning change from simple memory to concrete understanding; increasing students’ initiative to information not only improves the utilization of time but also changes the monotonous information exchange from teachers to students, providing a large number of English environment materials, which is conducive to students’ oral practice and promotes the successful completion of teaching tasks.
Promotion of VR Technology in Taijiquan Multimedia Edge Computing Technology
Authors: Xiao Jie , Guo Mingang
Published: November 2021

Taijiquan is a representative sport in my country’s traditional sports. It occupies an important position in China’s traditional sports. It has been rated as my country’s intangible cultural heritage. Widespread and promotion of Taijiquan can promote my country’s traditional culture. Using the unique advantages of Tai Chi and better development prospects, the method and path of VR technology are combined to create a new cultural atmosphere, and the active spread and promotion of Tai Chi culture are gradually carried out. VR technology is an augmented reality technology based on sensors and computers that can provide a strong visual experience. Playing the role of multimedia edge computing technology and combining VR technology with the advantages of Tai Chi itself are beneficial to change the traditional teaching methods and the spread of the Tai Chi movement. The purpose of this article is to solve some of the problems China faces in the promotion of Taijiquan and explore the role of VR technology in the spread and promotion of Taijiquan. This article uses methods such as searching literature, questionnaires, and experimental comparisons. The students in the 24-style Taijiquan elective course are the research objects, using VR technology as the teaching method of Taijiquan, scoring teaching efficiency, learning enthusiasm, students’ sensory effects, the attractiveness of Taijiquan, and statistics and analysis of relevant data. The research results show that the combination of VR technology and Taijiquan teaching can increase the visual and auditory effects of students in the learning process by 28.4%, the overall improvement of students’ learning enthusiasm by 25.3%, and the overall increase of learning efficiency by 34.8%, while greatly improving Taijiquan’s performance attractive. Therefore, it can be seen that the application of VR technology to Tai Chi is feasible.
Placement of Unilateral Cortical Bone Trajectory Screws in Previously Instrumented Pedicle without Removal of Existing Hardware for Adjacent Segment Disease
Authors: Melikian Rojeh , Yeremian Sofia
Published: November 2021

Adjacent segment disease (ASD) in the lumbar spine is a possible consequence in segments adjacent to a fusion. As the number of lumbar fusions in the United States increases, the rates of ASD will continue to climb. There are several treatment options for ASD with open decompression and extension of the fusion being common. However, need for exposure and removal of existing instrumentation can lead to increased operative times resulting in increasing blood loss and infection risk. The purpose of this paper is to describe a case report for unilateral cortical trajectory screw instrumentation, allowing for posterior instrumentation without having to remove the existing pedicle screws in the setting of ASD. Our technique can be done with standard c-arm fluoroscopy without the need for navigation.
Prolonged SARS-CoV-2 Infection in Patients with Lymphoid Malignancies
Authors: Lee Christina Y. , Shah Monika K. , Hoyos David , Solovyov Alexander , Douglas Melanie , Taur Ying , Maslak Peter , Babady N. Esther , Greenbaum Benjamin , Kamboj Mini , Vardhana Santosha A.
Published: November 2021

Coronavirus disease 2019 (COVID-19) infection results in both acute mortality and persistent and/or recurrent disease in patients with hematologic malignancies, but the drivers of persistent infection in this population are unknown. We found that B-cell lymphomas were at particularly high risk for persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity. Further analysis of these patients identified discrete risk factors for initial disease severity compared with disease chronicity. Active therapy and diminished T-cell counts were drivers of acute mortality in COVID-19–infected patients with lymphoma. Conversely, B cell–depleting therapy was the primary driver of rehospitalization for COVID-19. In patients with persistent SARS-CoV-2 positivity, we observed high levels of viral entropy consistent with intrahost viral evolution, particularly in patients with impaired CD8+ T-cell immunity. These results suggest that persistent COVID-19 infection is likely to remain a risk in patients with impaired adaptive immunity and that additional therapeutic strategies are needed to enable viral clearance in this high-risk population.

Significance:

We describe the largest cohort of persistent symptomatic COVID-19 infection in patients with lymphoid malignancies and identify B-cell depletion as the key immunologic driver of persistent infection. Furthermore, we demonstrate ongoing intrahost viral evolution in patients with persistent COVID-19 infection, particularly in patients with impaired CD8+ T-cell immunity.

This article is highlighted in the In This Issue feature, p. 1
Corpos Kõkamõu: uma relação simétrica entre indígena e não indígena na tríade corpo-cultura-aldeia/cidade
Authors: Gonçalves Luiz Davi Vieira
Published: November 2021

Este artigo apresenta uma reflexão sobre os afetos construídos na relação kõkamõu – juntos(as) –, entre indígenas e não indígenas na tríade, corpo-cultura-aldeia/cidade. Um olhar simétrico para o corpo e cultura Yanonami da Região de Maturacá, Alto Rio Negro (Amazonas), transmutando as barreiras preestabelecidas do campo da pesquisa científica, o que previa um distanciamento para análise.
Empedramento corporificado: reflexão acerca do processo urbano de imunização a partir da relação entre corpo e pedra
Authors: Donnianni Maeza de Vasconcelos
Published: November 2021

A discussão é dedicada a refletir sobre como são moldadas as relações na multidão contemporânea, ressaltando os modos de atuação do biopoder na urbanidade, que objetivam a imunização da comunidade. Para tanto, relacionamos os modos como a pedra e o corpo na cidade, são ordenados de maneiras semelhantes no sistema. Em um jogo de corpo que empedra e pedra que move, a propomos um olhar para os desvios, os tropeços como possibilidade de ruptura dessa lógica opressora da potência de vida.
Geometrias do corpo: entre o Butô e a arquitetura
Authors: Habib Ian Guimarães , Vaillant André Bambirra
Published: November 2021

Este artigo propõe um contraponto entre as noções de corpo e espacialidade desenvolvidas tradicionalmente na arquitetura e no urbanismo e aquelas da dança, em particular o Butô. Para tanto, são brevemente analisadas as formas de representação, a morfologia e a história da arquitetura clássica, propondo-se os conceitos de corpoespaço e espaçotempo na dança de Min Tanaka e no Butô. Dessa comparação pretende-se depreender novas possibilidades de percepção e interação entre espaço e corpo no movimento e no projeto arquitetônico.
Beyond Divisive Categorization in Young Adult Fiction: Lessons from Divergent
Authors: Cronshaw Darren
Published: November 2021

Veronica Roth’s Divergent is a young adult fiction and movie franchise that addresses issues of political power, social inequity, border control, politics of fear, gender, ethnicity, violence, surveillance, personal authenticity and mind control. It is possible a large part of the popularity of the series is its attention to these issues which young Western audiences are concerned about. The narrative makes heroes of protagonists who become activists for justice and struggle against oppressive social-political systems. What follows is a literary analysis of Divergent, evaluating its treatment of public theology and social justice themes, and discussing implications for Christian activism, especially for youth and young adults. It affirms the ethos in the books of resisting oppression, and questions assumptions about gender and abuse, violence and imperial control, personal authenticity and categorization, and difference and sameness.
Quasi-Naturalism and the Problem of Alternative Normative Concepts
Authors: Golub Camil
Published: November 2021

The following scenario seems possible: a community uses concepts that play the same role in guiding actions and shaping social life as our normative concepts, and yet refer to something else. As Eklund (2017) argues, this apparent possibility poses a problem for any normative realist who aspires to vindicate the thought that reality itself favors our ways of valuing and acting. How can realists make good on this idea, given that anything they might say in support of the privileged status of our normative concepts can be mirrored by the imagined community? E.g., the realist might claim that using our concepts is what we ought to do if we are to describe normative facts correctly, but members of the other community can claim the same about their concepts, using their own concept of ought. A promising approach to this challenge is to try to rule out the possibility of alternative normative concepts, by arguing that any concepts that have the same normative role must share a reference as well. (Eklund calls this referential normativity.) In this paper I argue that normative quasi-naturalism, a view that combines expressivism about normative discourse with a naturalist metaphysics of normativity, supports referential normativity and solves the problem of alternative normative concepts.
Ebogotermes raphaeli, new genus and new species, an African soldierless termite described from the worker caste (Isoptera, Termitidae, Apicotermitinae)
Authors: SCHEFFRAHN RUDOLF H. , ROISIN YVES , AKAMA PIERRE DIEUDONNÉ , ŠOBOTNÍK JAN
Published: November 2021

Ebogotermes raphaeli gen. n. sp. n., is described from workers collected in Cameroon. This soil-feeding termite is the largest soldierless termite from central Africa and aligns with the Anoplotermes subgroup. The enteric valve armature is weakly armed and, as with most apicotermitine species, is uniquely diagnostic.
3. Burns’s Song
Authors: Grant Morag Josephine
Published: November 2021

This chapter explores the contribution made to the modern song by Robert Burns, from his first mention of it in a letter to his correspondent Frances Dunlop, to his versions of the song as published by his collaborators, the editors James Johnson and George Thomson. It discusses the differences between the five extant versions of the song in Burns’s own hand, and compares these to the earlier songs discussed in Chapter 2. It deals both with the tune to which Burns set Auld Lang Syne, and with which his version was first published in 1796, and the different tune that appeared when the song was republished by George Thomson in 1799—the most familiar tune today. The chapter offers a variety of possible explanations for why Thomson changed the tune, including through looking at his correspondence with the two composers he commissioned to arrange Auld Lang Syne, Leopold Koželuch and Ludwig van Beethoven. It discusses various theories on this new tune’s provenance, and its relationship to William Shield’s comic opera Rosina. The chapter concludes by looking at the continuing legacy, into at least the early twentieth century, of the songs that predated Burns’s version, and looks at other songs on “auld lang syne” that were contemporary with Burns’s, including one by Susannah Blamire and one variously attributed to John Skinner and Anna Brown.
9. Take Leave, Brothers
Authors: Grant Morag Josephine
Published: November 2021

In the first of two chapters on the international and foreign-language reception of the song, this chapter uses Germany as an in-depth case-study. It begins by looking at settings of the song in the German art music tradition, including a choral setting of the text by Robert Schumann, before considering the evidence for the use of the song in other settings. The chapter demonstrates that, despite the great popularity of Burns’s poems and songs in the Romantic period and beyond, there is little evidence for the adoption of the song into German repertoires before the mid-twentieth century. This changes in the second half of twentieth century, for reasons related in part to the post-war cultural history of Germany. A significant role is played here by a further fraternal-type organisation: the Scouts. The chapter looks at the adoption of the song and its traditional use as a song of parting in Scouting, and the impact internationally, including in Germany, of foreign-language versions of the song created primarily for this purpose. This finding thus ultimately provides further evidence for this book’s main thesis: that the song’s popularity and longevity has everything to do with the traditions and rituals with which it has become connected; active rather than passive reception is key.
Effect of Medialization on Dyspnea Index in Unilateral Vocal Fold Paralysis
Authors: Hoffman Matthew R. , Vandiver Beau , Derise Natalie , Hapner Edie R. , Leverson Glen , Simpson C. Blake
Published: November 2021

Objective

Patients with unilateral vocal fold paralysis commonly report dysphonia and dysphagia. Dyspnea also occurs, with studies on treatment‐related change producing mixed results. Studies including patient‐reported outcomes have focused on single‐question global scales. The Dyspnea Index (DI) includes 10 questions, is specific to upper airway–related dyspnea, and may better capture these patients’ symptoms. We evaluated change in DI after treatment.

Study Design

Retrospective review.

Setting

Academic medical center.

Methods

Forty‐three patients with unilateral vocal fold paralysis underwent injection augmentation (n = 25) or framework surgery (n = 18). DI was recorded preprocedure, 2 to 4 weeks afterward, and at approximately 3 months afterward in 19 patients. Voice Handicap Index–10, Glottal Function Index, Cough Severity Index, and Eating Assessment Tool–10 were also recorded. Change in parameters and correlations were assessed. Obesity, cardiac disease, pulmonary disease, and procedure (injection vs framework surgery) were evaluated for effect on DI.

Results

Twenty‐four patients had an abnormal baseline DI (>10). DI decreased from 14.9 ± 13.8 to 6.5 ± 9.3 after treatment (P <. 001; 95% CI, 4.7‐12.1). Twenty‐eight scores decreased, 9 remained unchanged, and 6 increased. Change in DI was influenced by the presence of cardiac disease. Decreased DI persisted at 3‐month follow‐up. Voice Handicap Index–10, Glottal Function Index, Cough Severity Index, and Eating Assessment Tool–10 scores decreased and were correlated with change in DI.

Conclusion

Upper airway–related dyspnea is common in unilateral vocal fold paralysis, occurring in half of this cohort. Correcting glottic insufficiency may alleviate symptoms. Treatment decision making should consider postprocedural change in dyspnea, especially in patients for whom dyspnea is a motivating factor for seeking treatment.
Depression and Anxiety: Considerations for Interpretation of the SNOT‐22 (22‐Item Sinonasal Outcome Test)
Authors: Phillips Katie M. , Sedaghat Ahmad R.
Published: November 2021

Objective

The objective of this study was to determine whether depression and anxiety symptoms affect and confound scoring on the 22‐item Sinonasal Outcome Test (SNOT‐22), a commonly used outcome measure for chronic rhinosinusitis.

Study Design

Prospective cross‐sectional.

Setting

Tertiary care academic center.

Methods

240 participants completed the SNOT‐22, from which nasal, sleep, ear/facial pain, and emotional subdomain scores were calculated. They also completed the 8‐item Patient Health Questionnaire (PHQ‐8) as a reflection of depression symptoms and 7‐item Generalized Anxiety Disorder (GAD‐7) questionnaire as a reflection of anxiety symptoms. Correlations were calculated between the 4 SNOT‐22 subdomains and the PHQ‐8 and GAD‐7. Additionally, the predictive ability of subdomains and individual items of the SNOT‐22 to predict depression and anxiety was calculated.

Results

The SNOT‐22 sleep and emotional subdomains most strongly correlated with the PHQ‐8 and the GAD‐7. The emotional and sleep subdomain scores were predictive of having depression or anxiety. An emotional subdomain score ≥4 had 62.5% sensitivity and 90.1% specificity for detecting depression and 78.8% sensitivity and 88.9% specificity for detecting anxiety. A sleep subdomain score ≥21 had 81.2% sensitivity and 71.4% specificity for detecting depression and 87.9% sensitivity and 68.6% specificity for detecting anxiety. The emotional subdomain item related to sadness and the sleep subdomain items related to functional impairment were most predictive of depression and anxiety.

Conclusion

The SNOT‐22 emotional and sleep subdomain scores may be used to predict active depression and anxiety symptoms, especially when items related to sadness or functional impairment are scored with moderate burden.
Difficulties detaching psychologically from work among German teachers: prevalence, risk factors and health outcomes within a cross-sectional and national representative employee survey
Authors: Varol Yasemin Z. , Weiher Gerald M. , Wendsche Johannes , Lohmann-Haislah Andrea
Published: November 2021

Background

Teachers often face high job demands that might elicit strong stress responses. This can increase risks of adverse strain outcomes such as mental and physical health impairment. Psychological detachment has been suggested as a recovery experience that counteracts the stressor-strain relationship. However, psychological detachment is often difficult when job demands are high. The aims of this study were, first, to gain information on the prevalence of difficulties detaching from work among German teachers, second, to identify potential person-related/individual (i.e., age, sex), occupational (e.g., tenure, leadership position), and work-related (e.g., overload, cognitive, emotional, and physical demands) risk factors and, third, to examine relationships with mental and physical health impairment and sickness absence.

Methods

A secondary analysis of cross-sectional data from a national and representative survey of German employees was conducted (BIBB/BAuA Employment Survey 2018). For the analyses data from two groups of teachers (primary/secondary school teachers: n = 901, other teachers: n = 641) were used and compared with prevalence estimates of employees from other occupations (n = 16,266).

Results

Primary/secondary school teachers (41.5%) and other teachers (30.3%) reported more difficulties detaching from work than employees from other occupations (21.3%). Emotional demands and deadline/performance pressure were the most severe risk factors in both groups of teachers. In the group of primary/secondary school teachers multitasking demands were further risk factors for difficulties to detach from work whereas support from colleagues reduced risks. In both groups of teachers detachment difficulties can be linked to an increase in psychosomatic and musculoskeletal complaints and, additionally, to a higher risk of sickness absence among primary/secondary school teachers.

Conclusions

Difficulties detaching from work are highly prevalent among German teachers. In order to protect them from related risks of health impairment, interventions are needed which aim at optimizing job demands and contextual resources (i.e., work-directed approaches) or at improving coping strategies (i.e., person-directed approaches).
Clinical analysis of the “small plateau” sign on the flow-volume curve followed by deep learning automated recognition
Authors: Wang Yimin , Chen Wenya , Li Yicong , Zhang Changzheng , Liang Lijuan , Huang Ruibo , Liang Jianling , Gao Yi , Zheng Jinping
Published: November 2021

Background

Small plateau (SP) on the flow-volume curve was found in parts of patients with suspected asthma or upper airway abnormalities, but it lacks clear scientific proof. Therefore, we aimed to characterize its clinical features.

Methods

We involved patients by reviewing the bronchoprovocation test (BPT) and bronchodilator test (BDT) completed between October 2017 and October 2020 to assess the characteristics of the sign. Patients who underwent laryngoscopy were assigned to perform spirometry to analyze the relationship of the sign and upper airway abnormalities. SP-Network was developed to recognition of the sign using flow-volume curves.

Results

Of 13,661 BPTs and 8,168 BDTs completed, we labeled 2,123 (15.5%) and 219 (2.7%) patients with the sign, respectively. Among them, there were 1,782 (83.9%) with the negative-BPT and 194 (88.6%) with the negative-BDT. Patients with SP sign had higher median FVC and FEV1% predicted (both P < .0001). Of 48 patients (16 with and 32 without the sign) who performed laryngoscopy and spirometry, the rate of laryngoscopy-diagnosis upper airway abnormalities in patients with the sign (63%) was higher than those without the sign (31%) (P = 0.038). SP-Network achieved an accuracy of 95.2% in the task of automatic recognition of the sign.

Conclusions

SP sign is featured on the flow-volume curve and recognized by the SP-Network model. Patients with the sign are less likely to have airway hyperresponsiveness, automatic visualizing of this sign is helpful for primary care centers where BPT cannot available.
The impact of external academic accreditation of undergraduate medical program on students’ satisfaction
Authors: Al-Eyadhy Ayman , Alenezi Shuliweeh
Published: November 2021

Background

The external academic accreditation is a quality assurance and auditing process that focuses on the structure, process, and outcome of the education. It is an interrupting and highly demanding process in terms of effort, time, financial, and human resources. However, it is unclear in the literature how much of these external quality assurance practices impeded in the accreditation processes would reflect on the other end of the learning pathway, including student satisfaction.

Methods

A retrospective quantitative secondary data analysis, with a before-after comparison research design, was performed to evaluate external accreditation’s impact on students’ mean satisfaction score within two accreditation cycles at King Saud University (KSU)-Bachelor of Medicine, Bachelor of Surgery (MBBS) program.

Results

The overall average students’ satisfaction scores pre-and-post the first accreditation cycle were 3.46/5 (±0.35), 3.71 (±0.39), respectively, with a P-value of < 0.001. The effect of post first accreditation cycle was sustainable for a couple of years, then maintained above the baseline of the pre-first accreditation cycle until the pre-second accreditation cycle. Similarly, the overall average students’ satisfaction scores pre-and-post the second accreditation cycles were 3.57/5 (±0.30) and 3.70 (±0.34), respectively, with a P-value of 0.04. Compared to the first accreditation cycle, the improvement of the mean score of students’ satisfaction rates was not sustained beyond the year corresponding to the post-second accreditation cycle.

Conclusion

Both accreditation cycles were associated with an increased score in students’ satisfaction. The preparatory phase activities and navigation through the self-study assessment while challenging the program’s competencies are essential triggers for quality improvement practices associated with accreditation.
Offspring's risk for suicidal behaviour in relation to parental death by suicide: systematic review and meta-analysis and a model for familial transmission of suicide
Authors: Calderaro Mara , Baethge Christopher , Bermpohl Felix , Gutwinski Stefan , Schouler-Ocak Meryam , Henssler Jonathan
Published: November 2021

Background

Exposure to parental suicide has been associated with increased risk for suicide and suicide attempts, although the strength of this association is unclear as evidence remains inconsistent.

Aims

To quantify this risk using meta-analysis and identify potential effect modifiers.

Method

A systematic search in PubMed, PsycInfo and Embase databases to 2020 netted 3614 articles. Inclusion criteria were: observation of history of parental death by suicide, comparison with non-exposed populations and definition of suicide and suicide attempt according to standardised criteria. We focused on population-based studies. The primary outcome was the pooled relative risk (RR) for incidence of suicide attempt and suicide in offspring of a parent who died by suicide compared with offspring of two living parents. Additionally, we compared the RR for attempted and completed suicide after parental suicide with the RR for attempted and completed suicide after parental death by other causes.

Results

Twenty studies met our inclusion criteria. Offspring exposed to parental suicide were more likely to die by suicide (RR = 2.97, 95% CI 2.50–3.53) and attempt suicide (RR = 1.76, 95% CI 1.58–1.96) than offspring of two living parents. Furthermore, their risk of dying by or attempting suicide was significantly higher compared with offspring bereaved by other causes of death.

Conclusions

The experience of losing a parent to suicide is a strong and independent risk factor for suicidal behaviour in offspring. Our findings highlight the need for prevention strategies, outreach programmes and support interventions that target suicide-related outcomes in the exposed population.
Machine Learning Applied to Electronic Health Records: Identification of Chemotherapy Patients at High Risk for Preventable Emergency Department Visits and Hospital Admissions
Authors: Peterson Dylan J. , Ostberg Nicolai P. , Blayney Douglas W. , Brooks James D. , Hernandez-Boussard Tina
Published: November 2021

PURPOSE

Acute care use (ACU) is a major driver of oncologic costs and is penalized by a Centers for Medicare & Medicaid Services quality measure, OP-35. Targeted interventions reduce preventable ACU; however, identifying which patients might benefit remains challenging. Prior predictive models have made use of a limited subset of the data in the electronic health record (EHR). We aimed to predict risk of preventable ACU after starting chemotherapy using machine learning (ML) algorithms trained on comprehensive EHR data.

METHODS

Chemotherapy patients treated at an academic institution and affiliated community care sites between January 2013 and July 2019 who met inclusion criteria for OP-35 were identified. Preventable ACU was defined using OP-35 criteria. Structured EHR data generated before chemotherapy treatment were obtained. ML models were trained to predict risk for ACU after starting chemotherapy using 80% of the cohort. The remaining 20% were used to test model performance by the area under the receiver operator curve.

RESULTS

Eight thousand four hundred thirty-nine patients were included, of whom 35% had preventable ACU within 180 days of starting chemotherapy. Our primary model classified patients at risk for preventable ACU with an area under the receiver operator curve of 0.783 (95% CI, 0.761 to 0.806). Performance was better for identifying admissions than emergency department visits. Key variables included prior hospitalizations, cancer stage, race, laboratory values, and a diagnosis of depression. Analyses showed limited benefit from including patient-reported outcome data and indicated inequities in outcomes and risk modeling for Black and Medicaid patients.

CONCLUSION

Dense EHR data can identify patients at risk for ACU using ML with promising accuracy. These models have potential to improve cancer care outcomes, patient experience, and costs by allowing for targeted, preventative interventions.
Association of Race With Cancer-Related Financial Toxicity
Authors: Panzone John , Welch Christopher , Morgans Alicia , Bhanvadia Sumeet K. , Mossanen Matthew , Shenhav-Goldberg Rachel , Chandrasekar Thenappan , Pinkhasov Ruben , Shapiro Oleg , Jacob Joseph M. , Basnet Alina , Bratslavsky Gennady , Goldberg Hanan
Published: November 2021

PURPOSE:

We investigated the association between race and FT among previous patients with cancer. Studies show that patients with cancer experience financial toxicity (FT) because of their cancer treatment.

METHODS:

Data on individuals with a cancer history were collected in this cross-sectional study during 2012, 2014, and 2017, from the US Health Information National Trends Survey. This survey is conducted by mail with monetary compensation as an incentive. We specifically assessed responses to two questions: Has cancer hurt you financially? Have you been denied health insurance because of cancer? Multivariable logistic regression analyses were used to assess the associations between these questions and race.

RESULTS:

Of 10,592 individuals participating, 1,328 men and women (12.5%) with a cancer history were assessed. Compared with Blacks, Whites were found to have a higher rate of insurance (95.4% v 90.0%), were more likely to receive cancer treatment (93.9% v 85%), and had a higher rate of surgical treatment than Blacks (77% v 60%), Hispanics (55%), and others (77%, 60%, 55%, and 74.2%, respectively, P < .001). On multivariable analysis, Blacks were more than five times as likely to be denied insurance (odds ratio, 5.003; 95% CI, 2.451 to 10.213; P < .001) and more than twice as likely to report being hurt financially because of cancer (odds ratio, 2.448; 95% CI, 1.520 to 3.941; P < .001) than Whites. Of all cancer groups analyzed (genitourinary, gynecologic, gastrointestinal, and breast), genitourinary malignancies were the only group in which the rate of reporting being hurt financially varied in a statistically significant manner (Whites 36.7%, Hispanics 62.5%, and Blacks 59.3%, P = .004).

CONCLUSION:

Our data suggest that race is significantly associated with FT because of cancer. Awareness of racial inequality with regards to FT should be raised among health care workers.
COVID Vaccination in Athletes & Updated Interim Guidance on the Preparticipation Physical Examination during the SARS-CoV-2 Pandemic
Authors: Narducci Dusty Marie , Diamond Alex B. , Bernhardt David T. , Roberts William O.
Published: November 2021

The American Medical Society for Sports Medicine (AMSSM) convened an expert panel to address the current evidence, knowledge gaps, and recommendations surrounding the COVID vaccination in athletes during the SARS-CoV-2 pandemic. The group held a series of meetings beginning in July 2021 and reviewed the available literature while using an iterative process and expert consensus to finalize this guidance statement. This document is intended to provide clinicians with suggestions on how to incorporate the COVID vaccination during the preparticipation physical examination for athletes in all levels of training and competition. The statement is not intended to address treatment, infection control principles, safety, ethical discussion, or public health issues related to SARS-CoV-2. The AMSSM task force acknowledges the clinical uncertainty, evolving public health objectives, and the limited data currently available to create this guidance statement.
A case of hepatic intraductal papillary neoplasm of the bile duct
Authors: Mukaida Eisuke , Tamura Akio , Nishiya Masao , Katoh Kenichi , Sugai Tamotsu , Yoshioka Kunihiro
Published: November 2021

In this report, we present a 57-year-old female with a history of mild alcoholic liver disease during a medical check-up. Abdominal computed tomography and magnetic resonance imaging showed a multicystic mass with a solid enhancing mural nodule in the right lobe of the liver. Subsequently, laparoscopic right liver lobectomy was performed and pathological findings revealed intraductal papillary neoplasm of the bile duct (IPNB) with an associated invasive carcinoma. IPNB is a relatively rare disease that should be considered in the differential diagnosis of hepatic cystic tumours. Our case report highlights the importance of capturing image findings of the IPNB as this disease has a high potential for malignancy.
Introduction to the Special Issue on Artificial Intelligence for Smart Cities and Industries
Authors: Sharma Ashutosh , Singh Pradeep Kumar , Hong Wei-Chiang , Dhiman Gaurav , Slowik Adam
Published: November 2021

Smart Cities and Artificial Intelligence offers an intensive evaluation of how the smart city establishments are made at different scales through automated thinking headways, for instance, geospatial information, data examination, data portrayal, clever related things, and quick natural frameworks handiness. Progressing propels in electronic thinking attract us closer to making a persistent reproduced model of human-made and trademark structures, from urban regions to transportation establishments to utility frameworks. This continuous living model empowers us to all the bound to manage and improve these working structures, making them dynamically watchful. Keen Cities and Artificial Intelligence gives a multidisciplinary, joined procedure, using speculative and applied bits of information, for the evaluation of savvy city situations. This special issue shows how the mechanized and physical universes are associated inside this organic framework, and how nonstop data arrangement is changing the possibility of our urban as well as industrial condition. It gives a fresh sweeping perspective on the natural framework designing, advances, and parts that include the masterminding and execution of sharp city and industry establishments. This special issue also shows how the computerized and physical universes are connected inside this biological system, and how continuous information assortment is changing the idea of our urban and industry condition. It gives a crisp all-encompassing viewpoint on the biological system engineering, advances, and parts that involve the arranging and execution of keen city and industry foundations. After following double blind peer review for all the submitted manuscripts across the globe, and after the rigorous review process, revision and based on final recommendations of the reviewers and editorial team, finally 17 manuscripts have been accepted for publication.
Steroid osteoporosis within the framework of the Itsenko-Cushing drug syndrome: demonstration of a clinical case
Authors: Fleyshman A. , Belyaeva Elena
Published: November 2021

A case of severe systemic osteoporosis complicated by multiple fractures of the ribs and vertebrae in a young patient with late diagnosis of Still's disease as a result of independent long-term uncontrolled use of corticosteroids is presented. Lack of medical supervision, taking a high dose (35 mg / day) of prednisolone without recommendation and control of treatment led to untimely recognition and treatment of the underlying disease and the development of irreversible disabling transformations of the skeleton.
MODERN EVALUATION CRITERIA AND CLASSIFICATION BREAST CYST (literature review)
Authors: Odincov V. , Guseynov Arif , Val'kova L. , Val'kov M.
Published: November 2021

Breast cysts represent a difficult problem in mammology in terms of diagnosis and choice of treatment tactics. The introduction of a system for interpreting and logging the results of ultrasound examination of the mammary glands according to the BI-RADS scale into the daily practice of an ultrasound diagnostic doctor makes it possible to systematize the results obtained, to determine the tactics of optimal examination and management of patients with breast neoplasms, and ensures continuity in the conduct of medical and diagnostic measures.
ELECTROMAGNETIC RADIATION IN REHABILITATION (a brief review of the publications of scientists of the TulSU Medical Institute for 10 years)
Authors: Ivanov D. , Valentinov B. , Belyaeva Elena , Borisova Ol'ga
Published: November 2021

. The brief review provides information about the publications of scientists of the Tula Scientific School in the field of the development of rehabilitation and restorative electro-magnetic technologies in the interests of clinical medicine. Low-intensity laser radiation, laserophoresis, extreme high-frequency, ultrahigh-frequency, electrolaser exposure - electrolaser myostimulation - provided significant clinical effect in various diseases, in improving athletic performance in athletes of various sports.
MANUFACTURING METHOD OF THE MORPHING WING STRUCTURE FOR UAV BY CFRP WITH APPLYING THE ELECTROFORMED RESIN MOLDING METHOD
Authors: KATAGIRI KAZUAKI , PARK CHOONG SIK , YAMAGUCHI SHIMPEI , KAWAKITA SONOMI , DAEKWI KIM , HONDA SHINYA , SASAKI KATSUHIKO , TAMAYAMA MASATO
Published: November 2021

Aircraft flight control usually requires driving flaps and ailerons. However, the air drags increase significantly due to the corners of flaps and aileron. Especially, the gap between mother wing and flap / aileron causes a drag increase. Therefore, studies are being conducted on morphing wings that smoothly and greatly deform the wing surface. For aircraft wing, it is needless to say that strength is important to sustain lift and drag for the aircraft during the flight. For morphing wings, in addition, actuators must be mounted inside the wing to enable the morphing deformation. Moreover, for the aircraft wing, weight is quite important. Therefore, carbon fiber reinforced plastic (CFRP) is currently most suitable for aircraft wing structural materials. However, it is difficult to mold CFRP so that it has sufficient strength and can be morphed. In this study, by using CFRP, the morphing wing structure was prototyped with targeting a small unmanned aerial vehicle (UAV) weighing 3 kg. The CFRP lattice structure that enables morphing deformation was designed and manufactured by applying the electrodeposition resin molding (ERM) method which was developed by the authors. In the ERM method, firstly, the carbon fiber was fixed with a jig according to the designed morphing wing structure, and immersed in the electrodeposition solution. Secondly, the epoxy polymer particle in the solution were electrophoresed and impregnated between carbon fibers. After thermal curing, the morphing wing structure was fabricated. Further, the loading-unloading torsion and bending tests of the morphing wing structure were carried out. Smooth morphing deformation and sufficient strength were confirmed.
A NOVEL, SCALABLE PRODUCTION OF MULTIFUNCTIONAL NANOCOMPOSITE POLYMER FILAMENTS FOR ADDITIVE MANUFACTURING
Authors: CARROLA MIA , ASADI AMIR
Published: November 2021

Though a revolutionary process, additive manufacturing (AM) has left more to be desired from printed parts, specifically, improved interlayer strength and minimal defects such as porosity. To overcome these common issues, nanocomposites have become one of the most popular materials used in AM, with various nanoparticles used to achieve a variety of characteristics. The use of these technologies together allows for both to synergistically enhance the final printed parts by improving the process and products simultaneously. Here, we introduce a novel, scalable technique to coat ABS pellets with cellulose nanocrystal (CNC) bonded carbon nanotubes (CNT), to improve the adhesion between layers as well as the mechanical properties of printed parts. An aqueous suspension of CNT-CNC is used to coat ABS pellets before they are dried and extruded into filament for printing. The filament produced using this manufacturing method showed an increase in tensile and interlayer strength as well as improved thermal conductivity. This process uses water as solvent and pristine nanoparticles without the need for any functionalization or surfactants, promoting its scalability. This process has the potential to be used with various polymers and nanoparticles, which allows the materials to be specifically tailored to the end application, (i.e. strength, conductivity, antibacterial, etc.). These nanocomposite filaments have the potential to revolutionize the way that additive manufacturing is utilized in a variety of industries.
MODELLING COMPACTION BEHAVIOR OF TOUGHENED PREPREG DURING AUTOMATED FIBRE PLACEMENT
Authors: SARTHAK MAHAPATRA SARTHAK MAHAPATRA , BELNOUE JONATHAN , KRATZ JAMES , IVANOV DMITRY S. , HALLETT STEPHEN R.
Published: November 2021

One of the most widely used automated manufacturing processes for composite parts is automated fibre placement (AFP). The deposition process involves the simultaneous warming, lay-up and consolidation of prepreg consisting of multitude of process parameters. Currently, AFP process parameters that ensure part conformance are derived by expensive and time-consuming trial-and-error approaches. The aim of this study is to demonstrate how physics-based finite element simulations that can predict the as manufactured geometry of a preform deposited by AFP can help reduce some of the empiricism associated with current industry practices. Here we particularly focus on the consolidation behaviour of toughened prepregs during the deposition process. An isothermal roller compaction model with thermal properties derived from an independent simplified thermo-mechanical model of the AFP head is used. Additionally, a fully characterised viscoelastic material definition is used for the prepreg tape along with a hyperelastic material for the compaction roller to accurately represent the physical parts. Various lay-up speeds, heater powers and compaction forces are simulated. To reduce the empiricism present in the manufacturing process, the viability of incorporating the numerical models into existing statistical relationships between process parameters and manufactured geometry is examined.
DESIGN AND ANALYSIS OF AN INTEGRATED THREE- BAY THERMOPLASTIC COMPOSITE WINGBOX
Authors: OLIVERI VINCENZO , ZUCCO GIOVANNI , ROUHI MOHAMMAD , COSENTINO ENZO , O’HIGGINS RONAN , YOUNG TREVOR M. , WEAVER PAUL M.
Published: November 2021

The design of a multi-part aerospace structural component, such as a wingbox, is a challenging process because of the complexity arising from assembly and integration, and their associated limitations and considerations. In this study, a design process of a stiffeners-integrated variable stiffness three-bay wingbox is presented. The wingbox has been designed for a prescribed buckling and post-buckling performance (a prescribed real testing scenario) and made from thermoplastic composite material system (Carbon-PEEK) with the total length of three meters. The stiffeners and spars are integrated into the top and bottom panels of the wingbox resulting a single-piece blended structure with no fasteners or joints. The bottom skin also has an elliptical cut-out for access purposes. The composite tows are steered around this cutout for strain concentration reduction purposes. The fiber/tow steering in the top skin bays (compression side) has also been considered for improved compression-induced buckling load carrying capacity. The proposed design has been virtually verified via high fidelity finite element analysis.