bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness and safety of prehospital analgesia with nalbuphine and paracetamol versus morphine by paramedics - an observational study
Authors: Deslandes Marvin , Deicke Martin , Grannemann Julia Johanna , Hinkelbein Jochen , Hoyer Annika , Kalmbach Matthias , Kobiella André , Strickmann Bernd , Plappert Thomas , Jansen Gerrit
Published: May 2024

Background

Despite the development of various analgesic concepts, prehospital oligoanalgesia remains very common. The present work examines prehospital analgesia by paramedics using morphine vs. nalbuphine + paracetamol.

Methods

Patients with out-of-hospital-analgesia performed by paramedics from the emergency medical services of the districts of Fulda (morphine) and Gütersloh (nalbuphine + paracetamol) were evaluated with regards to pain intensity at the beginning and the end of prehospital treatment using the Numeric-Rating-Scale for pain (NRS), sex, age, and complications. The primary endpoint was achievement of adequate analgesia, defined as NRS < 4 at hospital handover, depending on the analgesics administered (nalbuphine + paracetamol vs. morphine). Pain intensity before and after receiving analgesia using the NRS, sex, age and complications were also monitored.

Results

A total of 1,808 patients who received out-of-hospital-analgesia were evaluated (nalbuphine + paracetamol: 1,635 (90.4%), NRS-initial: 8.0 ± 1.4, NRS-at-handover: 3.7 ± 2.0; morphine: 173(9.6%), NRS-initial: 8.5 ± 1.1, NRS-at-handover: 5.1 ± 2.0). Factors influencing the difference in NRS were: initial pain intensity on the NRS (regression coefficient (RK): 0.7276, 95%CI: 0.6602–0.7950, p < 0.001), therapy with morphine vs. nalbuphine + paracetamol (RK: -1.2594, 95%CI: -1.5770 - -0.9418, p < 0.001) and traumatic vs. non-traumatic causes of pain (RK: -0.2952, 95%CI: -0.4879 - -0.1024, p = 0.002). Therapy with morphine (n = 34 (19.6%)) compared to nalbuphine + paracetamol (n = 796 (48.7%)) (odds ratio (OR): 0.274, 95%CI: 0.185–0.405, p < 0.001) and the initial NRS score (OR:0.827, 95%CI: 0.771–0.887, p < 0.001) reduced the odds of having an NRS < 4 at hospital handover. Complications occurred with morphine in n = 10 (5.8%) and with nalbuphine + paracetamol in n = 35 (2.1%) cases. Risk factors for complications were analgesia with morphine (OR: 2.690, 95%CI: 1.287–5.621, p = 0.008), female sex (OR: 2.024, 95%CI: 1.040–3.937, p = 0.0379), as well as age (OR: 1.018, 95%CI: 1.003–1.034, p = 0.02).

Conclusions

Compared to morphine, prehospital analgesia with nalbuphine + paracetamol yields favourable effects in terms of analgesic effectiveness and a lower rate of complications and should therefore be considered in future recommendations for prehospital analgesia.
Single-cell transcriptomic analysis of decidual immune cell landscape in the occurrence of adverse pregnancy outcomes induced by Toxoplasma gondii infection
Authors: Fu Tianyi , Wang Xiaohui , Zhao Xiaoyue , Jiang Yuzhu , Liu Xianbing , Zhang Haixia , Ren Yushan , Li Zhidan , Hu Xuemei
Published: May 2024

Background

Toxoplasma gondii is an obligate intracellular parasite that can lead to adverse pregnancy outcomes, particularly in early pregnancy. Previous studies have illustrated the landscape of decidual immune cells. However, the landscape of decidual immune cells in the maternal–fetal microenvironment during T. gondii infection remains unknown.

Methods

In this study, we employed single-cell RNA sequencing to analyze the changes in human decidual immune cells following T. gondii infection. The results of scRNA-seq were further validated with flow cytometry, reverse transcription-polymerase chain reaction, western blot, and immunofluorescence staining.

Results

Our results showed that the proportion of 17 decidual immune cell clusters and the expression levels of 21 genes were changed after T. gondii infection. Differential gene analysis demonstrated that T. gondii infection induced the differential expression of 279, 312, and 380 genes in decidual NK cells (dNK), decidual macrophages (dMφ), and decidual T cells (dT), respectively. Our results revealed for the first time that several previously unknown molecules in decidual immune cells changed following infection. This result revealed that the function of maternal–fetal immune tolerance declined, whereas the killing ability of decidual immune cells enhanced, eventually contributing to the occurrence of adverse pregnancy outcomes.

Conclusions

This study provides valuable resource for uncovering several novel molecules that play an important role in the occurrence of abnormal pregnancy outcomes induced by T. gondii infection.

Graphical Abstract
Seasonal change and influence of environmental variables on host-seeking activity of the biting midge Culicoides sonorensis at a southern California dairy, USA
Authors: Zhang Xinmi , Li Jun , Gerry Alec C.
Published: May 2024

Background

As a primary vector of bluetongue virus (BTV) in the US, seasonal abundance and diel flight activity of Culicoides sonorensis has been documented, but few studies have examined how time of host-seeking activity is impacted by environmental factors. This knowledge is essential for interpreting surveillance data and modeling pathogen transmission risk.

Methods

The diel host-seeking activity of C. sonorensis was studied on a California dairy over 3 years using a time-segregated trap baited with CO2. The relationship between environmental variables and diel host-seeking activity (start, peak, and duration of activity) of C. sonorensis was evaluated using multiple linear regression. Fisher’s exact test and paired-sample z-test were used to evaluate the seasonal difference and parity difference on diel host-seeking activity.

Results

Host-seeking by C. sonorensis began and reached an activity peak before sunset at a higher frequency during colder months relative to warmer months. The time that host-seeking activity occurred was associated low and high daily temperature as well as wind speed at sunset. Colder temperatures and a greater diurnal temperature range were associated with an earlier peak in host-seeking. Higher wind speeds at sunset were associated with a delayed peak in host-seeking and a shortened duration of host-seeking. Parous midges reached peak host-seeking activity slightly later than nulliparous midges, possibly because of the need for oviposition by gravid females before returning to host-seeking.

Conclusions

This study demonstrates that during colder months C. sonorensis initiates host-seeking and reaches peak host-seeking activity earlier relative to sunset, often even before sunset, compared to warmer months. Therefore, the commonly used UV light-baited traps are ineffective for midge surveillance before sunset. Based on this study, surveillance methods that do not rely on light trapping would provide a more accurate estimate of host-biting risk across seasons. The association of environmental factors to host-seeking shown in this study can be used to improve modeling or prediction of host-seeking activity. This study identified diurnal temperature range as associated with host-seeking activity, suggesting that Culicoides may respond to a rapidly decreasing temperature by shifting to an earlier host-seeking time, though this association needs further study.

Graphical Abstract
Structural basis for pathogenic variants of GJB2 and hearing levels of patients with hearing loss
Authors: Namba Kazunori , Mutai Hideki , Matsunaga Tatsuo , Kaneko Hiroki
Published: May 2024

Objectives

The crystal structure of the six protomers of gap junction protein beta 2 (GJB2) enables prediction of the effect(s) of an amino acid substitution, thereby facilitating investigation of molecular pathogenesis of missense variants of GJB2. This study mainly focused on R143W variant that causes hearing loss, and investigated the relationship between amino acid substitution and 3-D structural changes in GJB2.

Methods

Patients with nonsyndromic hearing loss who appeared to have two GJB2 pathogenic variants, including the R143W variant, were investigated. Because the X-ray crystal structure of the six protomers of the GJB2 protein is known, R143W and structurally related variants of GJB2 were modeled using this crystal structure as a template. The wild-type crystal structure and the variant computer-aided model were observed and the differences in molecular interactions within the two were analyzed.

Results

The predicted structure demonstrated that the hydrogen bond between R143 and N206 was important for the stability of the protomer structure. From this prediction, R143W related N206S and N206T variants showed loss of the hydrogen bond.

Conclusion

Investigation of the genotypes and clinical data in patients carrying the R143W variant on an allele indicated that severity of hearing loss depends largely on the levels of dysfunction of the pathogenic variant on the allele, whereas a patient with the homozygous R143W variant demonstrated profound hearing loss. We concluded that these hearing impairments may be due to destabilization of the protomer structure of GJB2 caused by the R143W variant.
Cerebrospinal fluid α-synuclein adds the risk of cognitive decline and is associated with tau pathology among non-demented older adults
Authors: Liu Wenying , Li Wenwen , Liu Zhaojun , Li Yan , Wang Xuechu , Guo Mengmeng , Wang Shiyuan , Wang Shuheng , Li Yan , Jia Jianping
Published: May 2024

Background

The role of α-synuclein in dementia has been recognized, yet its exact influence on cognitive decline in non-demented older adults is still not fully understood.

Methods

A total of 331 non-demented individuals were included in the study from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Participants were divided into two distinct groups based on their α-synuclein levels: one with lower levels (α-synuclein-L) and another with higher levels (α-synuclein-H). Measurements included neuropsychiatric scales, cerebrospinal fluid (CSF) biomarkers, and blood transcriptomics. The linear mixed-effects model investigated the longitudinal changes in cognition. Kaplan-Meier survival analysis and the Cox proportional hazards model were utilized to evaluate the effects of different levels of α-synuclein on dementia. Gene set enrichment analysis (GSEA) was utilized to investigate the biological pathways related to cognitive impairment. Pearson correlation, multiple linear regression models, and mediation analysis were employed to investigate the relationship between α-synuclein and neurodegenerative biomarkers, and their potential mechanisms affecting cognition.

Results

Higher CSF α-synuclein levels were associated with increased risk of cognitive decline and progression to dementia. Enrichment analysis highlighted the activation of tau-associated and immune response pathways in the α-synuclein-H group. Further correlation and regression analysis indicated that the CSF α-synuclein levels were positively correlated with CSF total tau (t-tau), phosphorylated tau (p-tau) 181, tumor necrosis factor receptor 1 (TNFR1) and intercellular cell adhesion molecule-1 (ICAM-1). Mediation analysis further elucidated that the detrimental effects of CSF α-synuclein on cognition were primarily mediated through CSF t-tau and p-tau. Additionally, it was observed that CSF α-synuclein influenced CSF t-tau and p-tau181 levels via inflammatory pathways involving CSF TNFR1 and ICAM-1.

Conclusions

These findings elucidate a significant connection between elevated levels of CSF α-synuclein and the progression of cognitive decline, highlighting the critical roles of activated inflammatory pathways and tau pathology in this association. They underscore the importance of monitoring CSF α-synuclein levels as a promising biomarker for identifying individuals at increased risk of cognitive deterioration and developing dementia.
Association between untreated and treated blood pressure levels and cognitive decline in community-dwelling middle-aged and older adults in China: a longitudinal study
Authors: Li Haibin , Wang Man , Qian Frank , Wu Zhiyuan , Liu Weida , Wang Anxin , Guo Xiuhua
Published: May 2024

Background

Optimal blood pressure (BP) levels to reduce the long-term risk of cognitive decline remains controversial. We aimed to investigate the association between BP and anti-hypertensive treatment status with cognitive decline in older adults.

Methods

This study used data from the China Health and Retirement Longitudinal Study. Cognitive function was assessed at year 2011, 2013, 2015, and 2018. Global cognitive Z-score was calculated as the average score of episodic memory and mental intactness. BP were measured at the first and second wave. Pulse pressure (PP) was calculated as systolic BP (SBP) minus diastolic BP. Cumulative BP was calculated as the area under the curve using BP measurements from 2011 to 2013. Linear mixed models were used to assess the longitudinal association between BP-related measurements and cognitive decline.

Results

We included 11,671 participants (47.3% men and mean age 58.6 years). Individual with BP > 140/90 mm Hg or taking anti-hypertensive medication were independently associated with accelerated cognitive decline (β=-0.014, 95% CI: -0.020 to -0.007). Individuals with anti-hypertensive medication use, but with controlled SBP to less than 120 mm Hg did not have a significantly increased risk of cognitive decline compared with normotension (β=-0.003, 95% CI: -0.021 to 0.014). Individuals on anti-hypertensive treatment with PP of more than 70 mm Hg had a significantly higher risk of cognitive decline (β=-0.033, 95% CI: -0.045 to -0.020). Regardless of anti-hypertensive treatment status, both elevated baseline and cumulative SBP and PP were found to be independently associated with accelerated cognitive decline.

Conclusions

Cumulatively elevated SBP, PP and uncontrolled BP were associated with subsequent cognitive decline. Effectively controlling BP with anti-hypertensive treatment may be able to preserve cognitive decline in older adults.
Proteo-transcriptomic profiles reveal key regulatory pathways and functions of LDHA in the ovulation of domestic chickens (Gallus gallus)
Authors: Nie Ruixue , Zhang Wenhui , Tian Haoyu , Li Junying , Ling Yao , Zhang Bo , Zhang Hao , Wu Changxin
Published: May 2024

Background

In poultry, the smooth transition of follicles from the preovulatory-to-postovulatory phase impacts egg production in hens and can benefit the poultry industry. However, the regulatory mechanism underlying follicular ovulation in avians is a complex biological process that remains unclear.

Results

Critical biochemical events involved in ovulation in domestic chickens (Gallus gallus) were evaluated by transcriptomics, proteomics, and in vitro assays. Comparative transcriptome analyses of the largest preovulatory follicle (F1) and postovulatory follicle (POF1) in continuous laying (CL) and intermittent laying (IL) chickens indicated the greatest difference between CL_F1 and IL_F1, with 950 differentially expressed genes (DEGs), and the smallest difference between CL_POF1 and IL_POF1, with 14 DEGs. Additionally, data-independent acquisition proteomics revealed 252 differentially abundant proteins between CL_F1 and IL_F1. Perivitelline membrane synthesis, steroid biosynthesis, lysosomes, and oxidative phosphorylation were identified as pivotal pathways contributing to ovulation regulation. In particular, the regulation of zona pellucida sperm-binding protein 3, plasminogen activator, cathepsin A, and lactate dehydrogenase A (LDHA) was shown to be essential for ovulation. Furthermore, the inhibition of LDHA decreased cell viability and promoted apoptosis of ovarian follicles in vitro.

Conclusions

This study reveals several important biochemical events involved in the process of ovulation, as well as crucial role of LDHA. These findings improve our understanding of ovulation and its regulatory mechanisms in avian species.
Gut microbiota, blood metabolites, and left ventricular diastolic dysfunction in US Hispanics/Latinos
Authors: Luo Kai , Taryn Alkis , Moon Eun-Hye , Peters Brandilyn A. , Solomon Scott D. , Daviglus Martha L. , Kansal Mayank M. , Thyagarajan Bharat , Gellman Marc D. , Cai Jianwen , Burk Robert D. , Knight Rob , Kaplan Robert C. , Cheng Susan , Rodriguez Carlos J. , Qi Qibin , Yu Bing
Published: May 2024

Background

Left ventricular diastolic dysfunction (LVDD) is an important precursor of heart failure (HF), but little is known about its relationship with gut dysbiosis and microbial-related metabolites. By leveraging the multi-omics data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a study with population at high burden of LVDD, we aimed to characterize gut microbiota associated with LVDD and identify metabolite signatures of gut dysbiosis and incident LVDD.

Results

We included up to 1996 Hispanic/Latino adults (mean age: 59.4 years; 67.1% female) with comprehensive echocardiography assessments, gut microbiome, and blood metabolome data. LVDD was defined through a composite criterion involving tissue Doppler assessment and left atrial volume index measurements. Among 1996 participants, 916 (45.9%) had prevalent LVDD, and 212 out of 594 participants without LVDD at baseline developed incident LVDD over a median 4.3 years of follow-up. Using multivariable-adjusted analysis of compositions of microbiomes (ANCOM-II) method, we identified 7 out of 512 dominant gut bacterial species (prevalence > 20%) associated with prevalent LVDD (FDR-q < 0.1), with inverse associations being found for Intestinimonas_massiliensis, Clostridium_phoceensis, and Bacteroide_coprocola and positive associations for Gardnerella_vaginali, Acidaminococcus_fermentans, Pseudomonas_aeruginosa, and Necropsobacter_massiliensis. Using multivariable adjusted linear regression, 220 out of 669 circulating metabolites with detection rate > 75% were associated with the identified LVDD-related bacterial species (FDR-q < 0.1), with the majority being linked to Intestinimonas_massiliensis, Clostridium_phoceensis, and Acidaminococcus_fermentans. Furthermore, 46 of these bacteria-associated metabolites, mostly glycerophospholipids, secondary bile acids, and amino acids, were associated with prevalent LVDD (FDR-q < 0.1), 21 of which were associated with incident LVDD (relative risk ranging from 0.81 [p = 0.001, for guanidinoacetate] to 1.25 [p = 9 × 10−5, for 1-stearoyl-2-arachidonoyl-GPE (18:0/20:4)]). The inclusion of these 21 bacterial-related metabolites significantly improved the prediction of incident LVDD compared with a traditional risk factor model (the area under the receiver operating characteristic curve [AUC] = 0.73 vs 0.70, p = 0.001). Metabolite-based proxy association analyses revealed the inverse associations of Intestinimonas_massilliensis and Clostridium_phoceensis and the positive association of Acidaminococcus_fermentans with incident LVDD.

Conclusion

In this study of US Hispanics/Latinos, we identified multiple gut bacteria and related metabolites linked to LVDD, suggesting their potential roles in this preclinical HF entity.
Co-localization of antibiotic resistance genes is widespread in the infant gut microbiome and associates with an immature gut microbial composition
Authors: Li Xuanji , Brejnrod Asker , Trivedi Urvish , Russel Jakob , Thorsen Jonathan , Shah Shiraz A , Vestergaard Gisle Alberg , Rasmussen Morten Arendt , Nesme Joseph , Bisgaard Hans , Stokholm Jakob , Sørensen Søren Johannes
Published: May 2024

Background

In environmental bacteria, the selective advantage of antibiotic resistance genes (ARGs) can be increased through co-localization with genes such as other ARGs, biocide resistance genes, metal resistance genes, and virulence genes (VGs). The gut microbiome of infants has been shown to contain numerous ARGs, however, co-localization related to ARGs is unknown during early life despite frequent exposures to biocides and metals from an early age.

Results

We conducted a comprehensive analysis of genetic co-localization of resistance genes in a cohort of 662 Danish children and examined the association between such co-localization and environmental factors as well as gut microbial maturation. Our study showed that co-localization of ARGs with other resistance and virulence genes is common in the early gut microbiome and is associated with gut bacteria that are indicative of low maturity. Statistical models showed that co-localization occurred mainly in the phylum Proteobacteria independent of high ARG content and contig length. We evaluated the stochasticity of co-localization occurrence using enrichment scores. The most common forms of co-localization involved tetracycline and fluoroquinolone resistance genes, and, on plasmids, co-localization predominantly occurred in the form of class 1 integrons. Antibiotic use caused a short-term increase in mobile ARGs, while non-mobile ARGs showed no significant change. Finally, we found that a high abundance of VGs was associated with low gut microbial maturity and that VGs showed even higher potential for mobility than ARGs.

Conclusions

We found that the phenomenon of co-localization between ARGs and other resistance and VGs was prevalent in the gut at the beginning of life. It reveals the diversity that sustains antibiotic resistance and therefore indirectly emphasizes the need to apply caution in the use of antimicrobial agents in clinical practice, animal husbandry, and daily life to mitigate the escalation of resistance.
Long-term survival rates of tapered self-tapping bone-level implants after immediate placement: a positional effective rationale
Authors: Aung Yoon Thu , Eo Mi Young , Sodnom-Ish Buyanbileg , Kim Myung Joo , Kim Soung Min
Published: May 2024

Background

Immediate implant placement has gained popularity due to its several advantages. However, immediate placement has its challenges, including concerns about primary stability and bone formation around the implant. The aim of the present study is to evaluate the clinical outcomes of tapered, sand-blasted, and acid-etched internal submerged dental implants in various regions of the jaw bones and to provide a positional rationale for immediate implant placement.

Methods

Between 2009 and 2018, a single surgeon at Seoul National University Dental Hospital in Seoul, Korea, immediately inserted 49 dental implants with tapered bone-level design after extraction, in a total of 34 patients. The clinical outcomes were collected and evaluated, focusing on location of implant placement and marginal bone loss (MBL), with consideration of other parameters such as implant diameter and length.

Results

Of 49 immediately installed Luna® (Shinhung Co., Seoul, Korea) dental implants, 23 were placed in the mandible, and 26 were set in the maxilla. The mean age of patients at the time of installation was 65.91 years, ranging from 40 to 86 years. The average follow-up period was 7.43 years, with a range of 5 to 14 years. After a 5-year retrospective evaluation of tapered, sand-blasted, and acid-etched internal submerged dental implants for immediate implant placement, the cumulative survival rate was 93.88%, with 100% survival rate in the mandible and premolar region of both the maxilla and mandible.

Conclusions

After a 5-year evaluation, tapered, sand-blasted, and acid-etched internal submerged dental implants demonstrated good efficacy for immediate placement in various locations within the dental arches, exhibiting effective clinical performance.
The Value of Support: STEM Intervention Programs Impact Student Persistence and Belonging
Authors: Shortlidge Erin E. , Gray MacKenzie J. , Estes Suzanne , Goodwin Emma C.
Published: May 2024

STEM Intervention Programs (SIPs) can influence student persistence in science. A survey measured multiple persistence factors among STEM students at one non-traditional university and focus groups triangulated nuances of the student experience. Overall, students in SIPs are more likely to persist and experience belonging.
Biomechanics of biting in loggerhead shrikes: jaw-closing force, velocity and an argument for power
Authors: Sustaita Diego , Laurin Mason A.
Published: May 2024

Differences in the physical and behavioral attributes of prey are likely to impose disparate demands of force and speed on the jaws of a predator. Because of biomechanical trade-offs between force and speed, this presents an interesting conundrum for predators of diverse prey types. Loggerhead shrikes (Lanius ludovicianus) are medium-sized (∼50 g) passeriform birds that dispatch and feed on a variety of arthropod and vertebrate prey, primarily using their beaks. We used high-speed video of shrikes biting a force transducer in lateral view to obtain corresponding measurements of bite force, upper and lower bill linear and angular displacements, and velocities. Our results show that upper bill depression (about the craniofacial hinge) is more highly correlated with bite force, whereas lower bill elevation is more highly correlated with jaw-closing velocity. These results suggest that the upper and lower jaws might play different roles for generating force and speed (respectively) in these and perhaps other birds as well. We hypothesize that a division of labor between the jaws may allow shrikes to capitalize on elements of force and speed without compromising performance. As expected on theoretical grounds, bite force trades-off against jaw-closing velocity during the act of biting, although peak bite force and jaw-closing velocity across individual shrikes show no clear signs of a force–velocity trade-off. As a result, shrikes appear to bite with jaw-closing velocities and forces that maximize biting power, which may be selectively advantageous for predators of diverse prey that require both jaw-closing force and speed.
Guided Diverse Concept Miner (GDCM): Uncovering Relevant Constructs for Managerial Insights from Text
Authors: Lee Dokyun “DK” , Cheng Zhaoqi “ZQ” , Mao Chengfeng , Manzoor Emaad
Published: May 2024

The Guided Diverse Concept Miner (GDCM) is an innovative deep learning algorithm tailored for the extraction of managerially relevant concepts from textual data, emphasizing the autonomy in discovering insights without predefined labels or guidance. This tool stands out by embedding words, documents, and concepts within the same vector space, which simplifies the interpretation of unearthed concepts and ensures their alignment with managerial outcomes. Central to GDCM’s methodology is its capacity to focus on concepts that are highly correlated with user-specified managerial outcomes, termed guiding variables, thereby enhancing the relevance and application of extracted insights in decision-making processes. The algorithm’s design inherently promotes the diversity of the recovered concepts, ensuring a broad spectrum of insights. Through practical application in analyzing customer reviews related to online purchases, GDCM not only identified key concepts influencing conversion rates but also validated its findings against established theories and prior causal research. This validation underscores GDCM’s utility in generating actionable, diverse insights tailored to specific managerial contexts, marking a significant advancement in how businesses leverage textual data for strategic decisions.
Congressional Apportionment: A Multiobjective Optimization Approach
Authors: Shechter Steven M.
Published: May 2024

Two events, with major implications for U.S. voters, occur after each decennial census. First, congressional “apportionment” takes place, followed by congressional “districting.” Apportionment determines how to allocate the 435 seats in the House of Representatives across the 50 states, whereas districting determines the geographic boundaries assigned to representatives within each state. Although districting and the practice of gerrymandering often receive great attention in the media and courts, the best way to apportion representatives across states has been debated for nearly 250 years. Historical methods (including the current method) each satisfy some desirable optimality criteria that the others are not guaranteed to satisfy. Moreover, none are guaranteed to optimize certain reasonable fairness measures (e.g., minimum range, minimum bias). To our knowledge, we are the first to formulate and analyze a multiobjective optimization approach to apportionment, allowing policymakers to identify Pareto-optimal allocations and quantify their trade-offs between several competing criteria. Some of these models can be formulated and solved as mixed-integer linear programs, whereas others require the solution of mixed-integer, nonconvex, quadratically constrained quadratic programs. We take advantage of recent software advances that allow one to solve these problems with optimality guarantees. Policy implications of our work include Pareto curves from historical censuses and simulations, which suggest opportunities for improvement in some objectives at little sacrifice to others.

This paper was accepted by David Simchi-Levi, operations management.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2023.02472 .
CAN WE PREDICT DAIR FAILURE IN PJI? EXTERNAL VALIDATION OF THE KLIC AND CRIME80 SCORES
Authors: Hoffman Tom , Knudsen Joshua , Jesani Satyen , Clark Helen
Published: May 2024

Introduction

Debridement, antibiotics irrigation and implant retention (DAIR) is a common management strategy for hip and knee prosthetic joint infections (PJI). However, failure rates remain high, which has led to the development of predictive tools to help determine success. These tools include KLIC and CRIME80 for acute-postoperative (AP) and acute haematogenous (AH) PJI respectively. We investigated whether these tools were applicable to a Waikato cohort.

Method

We performed a retrospective cohort study that evaluated patients who underwent DAIR between January 2010 and June 2020 at Waikato Hospital. Pre-operative KLIC and CRIME80 scores were calculated and compared to success of operation. Failure was defined as: (i) need for further surgery, (ii) need for suppressive antibiotics, (iii) death due to the infection. Logistic regression models were used to calculate the area under the curve (AUC).

Results

117 eligible patients underwent DAIR, 53 in the AP cohort and 64 in the AH cohort. Failure rate at 2 years post-op was 43% in the AP cohort and 59% in the AH cohort. In the AP cohort a KLIC score of <4 had a DAIR failure rate of 28.6%, while those who scored ³4 had a failure rate of 72.2% (p=0.002). In the AH cohort a CRIME80 score of <3 had a DAIR failure rate of 48% while those who scored ³3 had a 100% failure rate (p<0.001).

Discussion

This study represents the first external validation of the KLIC and CRIME80 scores for predicting DAIR failure in an Australasian population. The results indicate that both KLIC and CRIME80 scoring tools are valuable aids for the clinician seeking to determine the optimal management strategy in patients with AP or AH PJI.
IN VIVO ACCURACY OF A NEW ROBOTICALLY ASSISTED SYSTEM FOR TOTAL KNEE ARTHROPLASTY: A PROSPECTIVE COHORT STUDY
Authors: Zaidi F. , Goplen C. M. , Fitz-Gerald C. , Bolam S. M. , Hanlon M. , Munro J. , Monk A. P.
Published: May 2024

Introduction

Recent technological advancements have led to the introduction of robotic-assisted total knee arthroplasty to improve the accuracy and precision of bony resections and implant position. However, the in vivo accuracy is not widely reported. The primary objective of this study is to determine the accuracy and precision of a cut block positioning robotic arm.

Method

Seventy-seven patients underwent total knee arthroplasty with various workflows and alignment targets by three arthroplasty-trained surgeons with previous experience using the ROSA® Knee System. Accuracy and precision were determined by measuring the difference between various workflow time points, including the final pre-operative plan, validated resection angle, and post-operative radiographs. The mean difference between the measurements determined accuracy, and the standard deviation represented precision.

Results

The accuracy and precision for all angles comparing the final planned resection and validated resection angles was 0.90° ± 0.76°. The proportion within 3° ranged from 97.9% to 100%. The accuracy and precision for all angles comparing the final intra- operative plan and post-operative radiographs was 1.95 ± 1.48°. The proportion of patients within 3° was 93.2%, 95.3%, 96.6%, and 71.4% for the distal femur, proximal tibia, femoral flexion, and tibial slope angles when the final intra-operative plan was compared to post-operative radiographs. No patients had a postoperative complication requiring revision at the final follow-up.

Conclusions

This study demonstrates that the ROSA Knee System has accurate and precise coronal plane resections with few outliers. However, the tibial slope demonstrated decreased accuracy and precision were measured on post-operative short-leg lateral radiographs with this platform.
A new construction of quadratic double circulant LCD codes
Authors: Yadav Shikha , Prakash Om
Published: May 2024

Let $GF(l)$ be the Galois field with $l=p^m$ elements where $p$ is a prime number and integer $m\geq 1$. Here, we present three constructions for linear codes over $GF(l)$ (depending on the parity of $l$) by using the quadratic residue approach and obtain some sufficient conditions for these codes to be LCD with respect to the Euclidean and Hermitian inner products, respectively. Furthermore, several examples of codes, including optimal and near to optimal codes, are provided to support our study.
On the structure of monomial codes and their generalizations
Authors: Ouazzou Hassan , Najmeddine Mustapha , Mouatadid Lhoussain , Kabbouch Oussama
Published: May 2024

In this paper, we are interested in monomial codes with associated vector $a=(a_0, a_1,\ldots, a_{n-1}),$ introduced in \cite{Maria2017}, and more generally in linear codes invariant under a monomial matrix $M=\diag(a_0, a_1,\ldots, a_{n-1}) P_{\sigma}$ where $\sigma$ is a permutation and $P_{\sigma}$ its associated permutation matrix.We discuss some connections between monomial codes and codes invariant under an arbitrary monomial matrix $M$. Next, we identify monomial codes with associated vector $a=(a_0,a_2,\ldots, a_{n-1})$ by the ideals of the polynomial ring $ R_{_{q,n}}:= \quot{{\Fq[x]}}{{\langle x^{n}-\prod_{i=0}^{n-1}a_i \rangle}},$ via a special isomorphism $\varphi_{_{\overline{a}}}$ which preserves the Hamming weight and differs from the classical isomorphism used in the case of cyclic codes and their generalizations. This correspondence leads to some basic characterizations of monomial codes such as generator polynomials, parity check polynomials, and others. Next, we focus on the structure of $\ell-$quasi-monomial ( $\ell-$QM) codes of length $n=m\ell,$ where on the one hand, we characterize them by the $ R_{_{q,m}}-$submodules of $ R_{_{q,m}}^{\ell}.$ On the other hand, $\ell-$QM codes are seen as additive monomial codes over the extension $\mathbb{F}_{q^{\ell}}/\Fq.$ So, as in the case of quasi-cyclic codes \cite{Guneri2018}, we characterize those codes that have $\mathbb{F}_{q^{\ell}}-$linear images with respect to a basis of the extension $ \mathbb{F}_{q^{\ell}}/\Fq,$ based on the CRT decomposition. Finally, we show that $\ell-$QM codes and additive monomial codes are asymptotically good.
As Used by the Augusta: The Creation of Livia's Imperial Persona Through Endorsement of Pharmaceutical Recipes
Authors: Connolly Serena
Published: May 2024

Abstract: Scribonius Largus, in his collection of pharmaceutical recipes ( Compositiones ), describes ten as having been used by members of the imperial family, including Livia. A model from the field of modern consumer research reveals that Livia used such endorsements to create a persona of discernment and intellectualism, qualities hitherto largely overlooked. Réesumé: Dans sa collection de recettes pharmaceutiques ( Compositiones ), Scribonius Largus en décrit une dizaine comme ayant été utilisées par les membres de la famille impériale eux-mêmes, dont Livie. Un modèle tiré de la recherche actuelle sur les consommateurs révèle que Livie s'est servie de ce type de recommandation pour asseoir sa réputation de discernement et d'intellectualisme, des qualités qui ont jusqu'ici été largement négligées.
Compact multichannel reconfigurable mode demultiplexer enabled by phase change material
Authors: An Yongxian , Ruan Jiakai , Gao Yixiao , Wang Teng , Liu Bowen , Zhang Wei , Xu Peipeng , Xu Tiefeng
Published: May 2024

The reconfigurable mode demultiplexer is a crucial component for flexibly routing modes into different channels in on-chip multimode photonic systems with enhanced information processing capabilities. In this paper, we present a multichannel reconfigurable mode demultiplexer enabled by ultralow-loss phase-changing Sb2Se3. By harnessing the phase-change-mediated mode coupling in asymmetric directional couplers (ADCs), one or more of the higher-order modes including TE1, TE2 and TE3 modes could be selectively dropped from the bus waveguide with low losses. With an optimized ADCs structure, the proposed mode demultiplexer demonstrates insertion loss less than 0.227 dB in the ON (amorphous) state and the extinction ratios large than 23.28 dB over the C-band. By coupling the access waveguides of the higher-order mode in parallel on both sides of the bus waveguide, the device size can be compact with a footprint of ∼ 7 × 75 µm2, and this design approach can be further extended to enable more higher-order mode multiplexing.
Increased ER Stress and Unfolded Protein Response Activation in Epithelial and Inflammatory Cells in Hypersensitivity Pneumonitis
Authors: Cabrera Sandra , García-Vicente Ángeles , Gutiérrez Pamela , Sánchez Andrea , Gaxiola Miguel , Rodríguez-Bobadilla Carolina , Selman Moisés , Pardo Annie
Published: May 2024

Several types of cytotoxic insults disrupt endoplasmic reticulum (ER) homeostasis, cause ER stress, and activate the unfolded protein response (UPR). The role of ER stress and UPR activation in hypersensitivity pneumonitis (HP) has not been described. HP is an immune-mediated interstitial lung disease that develops following repeated inhalation of various antigens in susceptible and sensitized individuals. The aim of this study was to investigate the lung expression and localization of the key effectors of the UPR, BiP/GRP78, CHOP, and sXBP1 in HP patients compared with control subjects. Furthermore, we developed a mouse model of HP to determine whether ER stress and UPR pathway are induced during this pathogenesis. In human control lungs, we observed weak positive staining for BiP in some epithelial cells and macrophages, while sXBP1 and CHOP were negative. Conversely, strong BiP, sXBP1- and CHOP-positive alveolar and bronchial epithelial, and inflammatory cells were identified in HP lungs. We also found apoptosis and autophagy markers colocalization with UPR proteins in HP lungs. Similar results were obtained in lungs from an HP mouse model. Our findings suggest that the UPR pathway is associated with the pathogenesis of HP:
Increasing coverage and uptake of voluntary family planning in Uganda’s emerging municipalities and secondary cities: An implementation research study protocol
Authors: Kananura Rornald Muhumuza , Birabwa Catherine , Ssanyu Jacquellyn Nambi , Kizito Felix , Kagaha Alexander , Namutanba Sarah , Kyangwa Moses , Kakaire Othman , Waiswa Peter
Published: May 2024

Introduction

While urban areas are often perceived to have better access to healthcare services, including modern family planning (FP) services, urban dwellers including those with better socioeconomic status are faced with multidimensional challenges that shape their access to appropriate FP services. In Uganda’s urban spaces, there is currently a lack of understanding among service providers, civil society organizations, and individuals/communities regarding the implementation of interventions that promote informed choice and voluntary use of family planning services. This knowledge gap has profound implications for reproductive rights. This study seeks to enhance existing efforts towards increasing coverage and uptake of Voluntary Family Planning (VFP) in Jinja City and Iganga Municipality, central eastern Uganda. Our primary question is, “What interventions can effectively be packaged and delivered to increase the uptake of VFP among different segments of urban residents?”

Methods

We propose to use the Human-Centered Design (HCD) approach to understand the needs and challenges of users and community capabilities in ensuring access to VFP services. Co-creating with stakeholders’ engagement and a data-driven-centric approach will steer design and adaptation that respond to the different population segments within the urban space. As such, the study will be implemented in three phases: formative assessment, design and implementation, and implementation monitoring and evaluation. The implementation process will incorporate robust monitoring, learning, and adaptation mechanisms. The primary focus of these mechanisms will be to utilize gathered information effectively to inform the design of the implementation and facilitate continuous learning throughout the process. The study will apply a process monitoring and evaluation approach to address questions related to what package of FP interventions work, for whom, under what circumstances and why.

Discussion

Guided by strong learning and implementation flexibility, we hypothesize that our implementation will provide segmentation-specific high-impact interventions in an urban context.

Registration

This implementation research protocol has been registered on the Open Science Framework (OSF) repository Registries (https://osf.io/vqxu9; DOI: 10.17605/OSF.IO/VQXU9).
The effects of co-designed physical activity interventions in older adults: A systematic review and meta-analysis
Authors: Zacharuk Amanda , Ferguson Alison , Komar Chelsea , Bentley Nicole , Dempsey Alexandra , Louwagie Michelle , O’Hoski Sachi , D’Amore Cassandra , Beauchamp Marla
Published: May 2024

Background

Physical activity (PA) declines with age despite the knowledge that physical inactivity is a leading cause of disease, death, and disability worldwide. To better tailor PA interventions to older adults, researchers are turning to the collaborative principles of co-design. The purpose of this systematic review was to compare the effectiveness of co-designed PA interventions and standard care for increasing PA and other health outcomes (i.e., physical function, quality of life, mental health, functional independence, attendance and attrition rates) in older adults.

Methods

A search was conducted in MEDLINE, AgeLine, CINAHL, Embase, and SPORTDiscus. Records were screened by independent pairs of reviewers. Primary research studies conducted among community-dwelling older adults (age 60+) comparing co-designed PA interventions to standard care were considered for inclusion. Controls included wait-list control, usual care, sham interventions, PA interventions without the use of co-design, and no intervention. A random effects meta-analysis was conducted, and the standardized mean difference (SMD) was used to report effect estimates. Quality of evidence was rated using GRADE.

Results

Of 16,191 studies screened, eight (N = 16,733) were included in this review. Most studies reported results favouring the effect of co-design on physical activity; however, only two studies (N = 433) could be pooled for meta-analysis resulting in a SMD of 0.28, (95% CI = -0.13 to 0.69; p = 0.19; I2 = 56%) immediately post-intervention. The GRADE quality of evidence was very low. The quantitative analysis of three studies reported improved physical function.

Conclusion

This review did not demonstrate that co-designed PA interventions are more effective than standard care for increasing PA in older adults; however, evidence was limited and of very low quality. Further well-designed trials are warranted to better understand the impacts of co-designed PA interventions and how to best implement them into practice.

Trial registration

PROSPERO registration number:

CRD42022314217.
Determinants of post-acute COVID-19 syndrome among hospitalized severe COVID-19 patients: A 2-year follow-up study
Authors: Elias Tamrat Petros , Gebreamlak Tsegaye Wesenseged , Gebremeskel Tigist Tesfaye , Adde Binyam Lukas , Abie Abraham Sisay , Elias Bitaniya Petros , Argaw Abel Mureja , Tenaw Addis Aschenek , Belay Biruk Mulugeta
Published: May 2024

Background

Post-acute COVID-19 syndrome is a condition where individuals experience persistent symptoms after the acute phase of the COVID-19 infection has resolved, which lowers their quality of life and ability to return to work. This study assessed the prevalence and associated risk factors of post-acute COVID-19 syndrome (PACS) among severe COVID-19 patients who were discharged from Millennium COVID-19 Care Center, Addis Ababa, Ethiopia.

Methods

A cross-sectional study using data collected from patient charts and a follow-up telephone interview after two years of discharge. Systematic random sampling was used to select a total of 400 patients. A structured questionnaire developed from the case report form for PACS of the World Health Organization (WHO) was used. Frequency and cross-tabulation were used for descriptive statistics. Predictor variables with a p-value <0.25 in bivariate analyses were included in the logistic regression.

Result

Out of the 400 patients, 20 patients were dead, 14 patients refused to give consent, and 26 patients couldn’t be reached because their phones weren’t working. Finally, 340 were included in the study. The majority (68.5%) were males and the mean age was 53.9 (±13.3 SD) years. More than a third (38.1%) of the patients reported the persistence of at least one symptom after hospital discharge. The most common symptoms were fatigue (27.5%) and Cough (15.3%). Older age (AOR 1.04, 95% CI 1.02–1.07), female sex (AOR 1.82, 95% CI 1.00–3.29), presence of comorbidity (AOR 2.38, 95% CI 1.35–4.19), alcohol use (AOR 3.05, 95% CI 1.49–6.26), fatigue at presentation (AOR 2.18, 95% CI 1.21–3.95), and longer hospital stay (AOR 1.06, 95% CI 1.02–1.10) were found to increase the odds of developing post-acute COVID-19 syndrome. Higher hemoglobin level was found to decrease the risk of subsequent post-acute COVID-19 syndrome (AOR 0.84, 95% CI 0.71–0.99).

Conclusion

The prevalence of post-acute COVID-19 syndrome is high, with a wide range of persistent symptoms experienced by patients. COVID-19 survivors with the identified risk factors are more susceptible to post-acute COVID-19 and require targeted monitoring and care in a multidisciplinary approach.