bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation of Wave-Breaking Index by Learning Nonlinear Relation Using Multilayer Neural Network
Authors: Yun Miyoung , Kim Jinah , Do Kideok
Published: January 2022

Estimating wave-breaking indexes such as wave height and water depth is essential to understanding the location and scale of the breaking wave. Therefore, numerous wave-flume laboratory experiments have been conducted to develop empirical wave-breaking formulas. However, the nonlinearity between the parameters has not been fully incorporated into the empirical equations. Thus, this study proposes a multilayer neural network utilizing the nonlinear activation function and backpropagation to extract nonlinear relationships. Existing laboratory experiment data for the monochromatic regular wave are used to train the proposed network. Specifically, the bottom slope, deep-water wave height and wave period are plugged in as the input values that simultaneously estimate the breaking-wave height and wave-breaking location. Typical empirical equations employ deep-water wave height and length as input variables to predict the breaking-wave height and water depth. A newly proposed model directly utilizes breaking-wave height and water depth without nondimensionalization. Thus, the applicability can be significantly improved. The estimated wave-breaking index is statistically verified using the bias, root-mean-square errors, and Pearson correlation coefficient. The performance of the proposed model is better than existing breaking-wave-index formulas as well as having robust applicability to laboratory experiment conditions, such as wave condition, bottom slope, and experimental scale.
Robust Adaptive Neural Cooperative Control for the USV-UAV Based on the LVS-LVA Guidance Principle
Authors: Li Jiqiang , Zhang Guoqing , Li Bo
Published: January 2022

Around the cooperative path-following control for the underactuated surface vessel (USV) and the unmanned aerial vehicle (UAV), a logic virtual ship-logic virtual aircraft (LVS-LVA) guidance principle is developed to generate the reference heading signals for the USV-UAV system by using the “virtual ship” and the “virtual aircraft”, which is critical to establish an effective correlation between the USV and the UAV. Taking the steerable variables (the main engine speed and the rudder angle of the USV, and the rotor angular velocities of the UAV) as the control input, a robust adaptive neural cooperative control algorithm was designed by employing the dynamic surface control (DSC), radial basic function neural networks (RBF-NNs) and the event-triggered technique. In the proposed algorithm, the reference roll angle and pitch angle for the UAV can be calculated from the position control loop by virtue of the nonlinear decouple technique. In addition, the system uncertainties were approximated through the RBF-NNs and the transmission burden from the controller to the actuators was reduced for merits of the event-triggered technique. Thus, the derived control law is superior in terms of the concise form, low transmission burden and robustness. Furthermore, the tracking errors of the USV-UAV cooperative control system can converge to a small compact set through adjusting the designed control parameters appropriately, and it can be also guaranteed that all the signals are the semi-global uniformly ultimately bounded (SGUUB). Finally, the effectiveness of the proposed algorithm has been verified via numerical simulations in the presence of the time-varying disturbances.
Carbon and Nitrogen Contents Driven by Organic Matter Source within Pichavaram Wetland Sediments
Authors: Naidu Sathy A. , Kathiresan Kandasamy , Simonson Jeffrey H. , Blanchard Arny L. , Sanders Christian J. , Pérez Alexander , Post Ruth M. , Subramoniam Thanumalaya , Naidu Raj A. , Narender Rajendran
Published: January 2022

Differences in grain size, total organic carbon (OC), total nitrogen (TN), OC/TN ratios, and stable isotope (δ13C and δ15N) were assessed in sediments from areas covered by mangrove and saltmarsh vegetation within Pichavaram estuary (Southeast India). The mean percentage contents of silt and clays (70 vs. 19%), OC (5.7 vs. 2.0%), and TN (0.39 vs. 0.14%) were consistently higher in the mangrove as compared to those observed in the saltmarsh tidal zone. These differences may obey the higher deposition and retention of fine particles in the presence of a mangrove root system that may facilitate the accumulation and preservation of organic matter within these sedimentary systems. Further, higher OC and TN contents were associated to higher terrestrial or mangrove-derived organic matter contribution with lighter δ13C signatures (−26.0‰) in both sedimentary tidal zones, whereas lower OC and TN contents were associated to heavier δ13C signatures. This study is in agreement with previous studies which indicate that the presence of wetland vegetation may increase the carbon and nutrient storage capacity within estuarine ecosystems, highly relevant information for the establishment of further conservation strategies for blue carbon ecosystems at global scales.
Study on the Motion Stability of the Autonomous Underwater Helicopter
Authors: Lin Yuan , Guo Jin , Li Haonan , Zhu Hai , Huang Haocai , Chen Ying
Published: January 2022

The hydrodynamic performance of a novel hovering autonomous underwater vehicle, the autonomous underwater helicopter (AUH), with an original disk-shaped hull (HG1) and an improved fore–aft asymmetric hull (HG3), is investigated by means of computational fluid dynamics with the adoption of overlapping mesh method. The hydrodynamic performance of the two hull shapes in surge motion with variation of the angle of attack is compared. The results show that HG3 has less resistance and higher motion stability compared to HG1. With the angle of attack reaching 10 degrees, both HG1 and HG3 achieve the maximum lift-to-drag ratio, which is higher for HG3 compared to HG1. Furthermore, based on the numerical simulation of the plane motion mechanism test (PMM) and according to Routh’s stability criterion, the horizontal movement and vertical movement stability indexes of HG1 and HG3 (GHHG1=1.0, GVHG1=49.7, GHHG2=1.0, GVHG3=2.1) are obtained, which further show that the AUH has better vertical movement stability than the torpedo-shaped AUV. Furthermore, the scale model tail velocity experiment indirectly shows that HG3 has better hydrodynamic performance than HG1.
A New Species of Diaphus Associated with Seamounts of the Emperor Chain, North-Western Pacific Ocean (Teleostei: Myctophiformes: Myctophidae)
Authors: Prokofiev Artem M. , Emelyanova Olga R. , Orlov Alexei M. , Orlova Svetlana Y.
Published: January 2022

A new species, Diaphus balanovi, is described based on 35 specimens collected over the Emperor Seamount Chain in the north-western Pacific Ocean. It belongs to the D. fulgens species complex and is most similar to D. kuroshio both morphologically and genetically. Nevertheless, the new species can be distinguished from D. kuroshio by its higher gill-rakers count, large luminous scale at PLO, large Dn, somewhat higher position of SAO3, otolith shape, and larger absolute size. The CO1 mtDNA sequence of D. balanovi differs by 16 substitutions from that of D. kuroshio. Diaphus balanovi may represent a benthopelagic derivate of D. kuroshio endemic to the Emperor Seamounts.
Adaptive Integral Sliding Mode Based Course Keeping Control of Unmanned Surface Vehicle
Authors: González-Prieto José Antonio , Pérez-Collazo Carlos , Singh Yogang
Published: January 2022

This paper investigates the course keeping control problem for an unmanned surface vehicle (USV) in the presence of unknown disturbances and system uncertainties. The simulation study combines two different types of sliding mode surface based control approaches due to its precise tracking and robustness against disturbances and uncertainty. Firstly, an adaptive linear sliding mode surface algorithm is applied, to keep the yaw error within the desired boundaries and then an adaptive integral non-linear sliding mode surface is explored to keep an account of the sliding mode condition. Additionally, a method to reconfigure the input parameters in order to keep settling time, yaw rate restriction and desired precision within boundary conditions is presented. The main strengths of proposed approach is simplicity, robustness with respect to external disturbances and high adaptability to static and dynamics reference courses without the need of parameter reconfiguration.
Water and Salt Transports in the Hengsha Channel of Changjiang Estuary
Authors: Ma Rui , Zhu Jianrong
Published: January 2022

In a multilevel bifurcated estuary, the channels between the bifurcated branches play important roles in the exchanges of water and salt. In the Changjiang Estuary, the Hengsha Channel (HC) connects the North Channel (NC) and the North Passage (NP). In this paper, based on a two-way nesting unstructured quadrilateral grid, finite-differencing, three-dimensional estuarine and coastal ocean model, the tidal and seasonal variations in the water and salt transports in the HC were simulated, and their dynamic mechanism was analyzed. The residual water and salt transports in the HC both flow southward from the NC to the NP. In wet season, the residual water transport in the HC is 677 m3/s during neap tide and 245 m3/s during spring tide, and the residual salt transport is 0. In dry season, the residual water and salt transports in the HC are 1278 m3/s and 0.38 t/s during neap tide, respectively, and 1328 m3/s and 12.61 t/s during spring tide. Affected by the northerly wind and the southeastward baroclinic gradient force, the water and salt fluxes in dry season are much larger than those in wet season. The dynamic mechanism responsible for the water transport in the HC was numerically simulated and analyzed.
Variable Gain Prescribed Performance Control for Dynamic Positioning of Ships with Positioning Error Constraints
Authors: Gong Chenglong , Su Yixin , Zhang Danhong
Published: January 2022

In this paper, a variable gain prescribed performance control law is proposed for dynamic positioning (DP) of ships with positioning error constraints, input saturation and unknown external disturbances. The error performance index functions are designed to preset the prescribed performance bounds and the error mapping functions are constructed to incorporate the prescribed performance bounds into the DP control design. The variable gain technique is used to limit the output amplitude of the control law to avoid input saturation of the system by dynamically adjusting the control gain of the DP control law according to the positioning errors, and the error mapping function replaces the positioning error as a recursive sliding-mode surface to realize the prescribed performance control of the system and guarantee the stability of the closed-loop system with variable control gains. It has been proved that the proposed DP control law can make the uniformly ultimately boundedness of all signals in the DP closed-loop control system. The numerical simulation results illustrate that the proposed control law can make the ship’s position and heading maintain at the desired value with positioning error constraints, enhance the non-fragility of the DP control law to the perturbation of system’s parameters and improve the system’s rejection ability to external disturbances.
Prevalence of Pneumocystosis in Sub-Saharan Africa and Helminth Immune Modulation
Authors: Fonte Luis , Ginori María , Calderón Enrique J. , de Armas Yaxsier
Published: January 2022

Sub-Saharan Africa is the region of the world with the highest prevalence of helminth infections. To protect themselves from the defensive mechanisms of their respective hosts, helminths modulate their immune responses. This modulation has relevant clinical and epidemiological consequences, including the inhibition of inflammatory processes that characterize infection by other microorganisms. Severe Pneumocystis pneumonia is characterized by an intense inflammatory reaction that can lead to death. Acquired immunodeficiency syndrome is the main predisposing factor to the development of pneumocystosis. Although the introduction of highly active antiretroviral therapy has led to a notable decline in the incidence of acquired immunodeficiency syndrome-associated complications, pneumocystosis continues to be an important global health problem. Despite the high incidence of human immunodeficiency virus infection in the sub-Saharan region, the prevalence of Pneumocystis pneumonia there has been lower than expected. Several factors, or combinations thereof, may contribute to this evolution. Here, we hypothesize the possible role of helminth immune modulation as an important issue at play. On the other hand, and looking ahead, we believe that the immune modulation achieved by helminths may be an important factor to consider during the design and evaluation processes of vaccines against Pneumocystis jirovecii to be used in Sub-Saharan Africa. The requirements of a balanced triggering of different types of immune responses for controlling the infection produced by this microorganism, as observed during experiments in animal models, support this final consideration.
Variation in Fungal Community in Grapevine (Vitis vinifera) Nursery Stock Depends on Nursery, Variety and Rootstock
Authors: Lade Sarah B. , Štraus Dora , Oliva Jonàs
Published: January 2022

Grapevine trunk diseases (GTDs) are caused by cryptic complexes of fungal pathogens and have become a growing problem for new grapevine (Vitis vinifera) plantations. We studied the role of the nursery, variety, and rootstock in the composition of the fungal communities in root collars and graft unions of planting material in Catalonia (NE Spain). We compared necrosis and fungal communities in graft unions and root collars at harvest, and then after three months of cold storage. We evaluated combinations of eleven red and five white varieties with four common rootstocks coming from six nurseries. Fungal communities were characterized by isolation and metabarcoding of the ITS2 region. Our data suggests that nursery followed by rootstock and variety had significant effects on necrosis and fungal community structure in graft and root tissues. Within the plant, we found large differences in terms fungal community distribution between graft and root tissues. Graft unions housed a significantly higher relative abundance of GTD-related Operational Taxonomic Units (OTUs) than root collars. More severe necrosis was correlated with a lower relative abundance of GTD-related OTUs based on isolation and metabarcoding analyses. Our results suggest that nurseries and therefore their plant production practices play a major role in determining the fungal and GTD-related fungal community in grapevine plants sold for planting. GTD variation across rootstocks and varieties could be explored as a venue for minimizing pathogen load in young plantations.
Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019
Authors: Wu Chi-Jung , Cia Cong-Tat , Wang Hsuan-Chen , Chen Chang-Wen , Lin Wei-Chieh , Lee Jen-Chieh , Chen Po-Sheng , Hsieh Chih-Cheng , Li Wei-Ting , Su Po-Lan , Liao Xin-Min , Hsieh Ming-I , Choi Pui-Ching , Ko Wen-Chien
Published: January 2022

This study delineated the characteristics of 24 (11.2%) culture-positive, influenza-associated pulmonary aspergillosis (IAPA) patients out of 215 patients with severe influenza during 2016–2019 in a medical center in southern Taiwan. Twenty (83.3%) patients did not have EORTC/MSG-defined host factors. The mean time from influenza diagnosis to Aspergillus growth was 4.4 days, and 20 (83.3%) developed IAPA within seven days after influenza diagnosis. All patients were treated in intensive care units and all but one (95.8%) received mechanical ventilation. Aspergillus tracheobronchitis was evident in 6 (31.6%) of 19 patients undergoing bronchoscopy. Positive galactomannan testing of either serum or bronchoalveolar lavage was noted in all patients. On computed tomography imaging, IAPA was characterized by peribronchial infiltrates, multiple nodules, and cavities superimposed on ground-glass opacities. Pure Aspergillus growth without bacterial co-isolation in culture was found in 17 (70.8%) patients. A. fumigatus (15, 62.5%), A. flavus (6, 25.0%), and A. terreus (4, 16.7%) were the major causative species. Three patients had mixed Aspergillus infections due to two species, and two had mixed azole-susceptible and azole-resistant A. fumigatus infection. All patients received voriconazole with an all-cause mortality of 41.6%. Of 14 survivors, the mean duration of antifungal use was 40.5 days. In conclusion, IAPA is an early and rapidly deteriorating complication following influenza that necessitates clinical vigilance and prompt diagnostic workup.
Whole-Genome Sequencing and Annotation of the Yeast Clavispora santaluciae Reveals Important Insights about Its Adaptation to the Vineyard Environment
Authors: Franco-Duarte Ricardo , Čadež Neža , Rito Teresa , Drumonde-Neves João , Dominguez Yazmid Reyes , Pais Célia , Sousa Maria João , Soares Pedro
Published: January 2022

Clavispora santaluciae was recently described as a novel non-Saccharomyces yeast species, isolated from grapes of Azores vineyards, a Portuguese archipelago with particular environmental conditions, and from Italian grapes infected with Drosophila suzukii. In the present work, the genome of five Clavispora santaluciae strains was sequenced, assembled, and annotated for the first time, using robust pipelines, and a combination of both long- and short-read sequencing platforms. Genome comparisons revealed specific differences between strains of Clavispora santaluciae reflecting their isolation in two separate ecological niches—Azorean and Italian vineyards—as well as mechanisms of adaptation to the intricate and arduous environmental features of the geographical location from which they were isolated. In particular, relevant differences were detected in the number of coding genes (shared and unique) and transposable elements, the amount and diversity of non-coding RNAs, and the enzymatic potential of each strain through the analysis of their CAZyome. A comparative study was also conducted between the Clavispora santaluciae genome and those of the remaining species of the Metschnikowiaceae family. Our phylogenetic and genomic analysis, comprising 126 yeast strains (alignment of 2362 common proteins) allowed the establishment of a robust phylogram of Metschnikowiaceae and detailed incongruencies to be clarified in the future.
Development of PCR-Based Race-Specific Markers for Differentiation of Indian Fusarium oxysporum f. sp. cubense, the Causal Agent of Fusarium Wilt in Banana
Authors: Thangavelu Raman , Edwinraj Esack , Gopi Muthukathan , Pushpakanth Periyasamy , Sharmila Kotteswaran , Prabaharan Manivasakan , Loganathan Murugan , Uma Subbaraya
Published: January 2022

Fusarium wilt caused by Fusarium oxysporum f. sp. cubense (Foc), is the most lethal soil-borne fungal pathogen infecting bananas. Foc race 1 (R1) and 4 (R4) are the two most predominant races affecting the economically important Cavendish group of bananas in India. A total of seven vegetative compatibility groups (VCGs) from three pathogenic races were isolated during our field survey and were found to be highly virulent towards cv. Grande Naine. According to comparative genome analyses, these Indian Foc VCGs were diverse in genomic organization and effector gene profiles. As a result, false-positive results were obtained with currently available molecular markers. In this context, the study has been initiated to develop PCR-based molecular markers for the unambiguous identification of Indian Foc R1 and R4 isolates. Whole-genome sequences of Foc R1 (GCA_011316005.3), Foc TR4 (GCA_014282265.3), and Foc STR4 (GCA_016802205.1), as well as the reference genomes of Foc (ASM799451v1) and F. oxysporum f. sp. lycopersici (Fol; ASM14995v2), were aligned to identify unique variable regions among the Foc races. Using putative chromosome and predicted gene comparison, race-specific unique Foc virulence genes were identified. The putative lineage-specific identified genes encoding products secreted in xylem (SIX) that may be necessary for disease development in the banana. An in silico analysis was performed and primers were designed from a region where sequences were dissimilar with other races to develop a specific marker for Foc R1, R4, TR4, and STR4. These race-specific markers allowed target amplification in the characterized highly virulent Foc isolates, and did not show any cross-amplification to any other Foc races, VCGs or banana pathogens, Fusarium species, and non-pathogenic Fusarium oxysporum isolates. The study demonstrated that the molecular markers developed for all the three Foc races of India could detect the pathogen in planta and up to 0.025 pg µL−1 DNA levels. Thus, the markers developed in this study are novel and could potentially be useful for the accurate diagnosis and detection of the Indian Foc races which are important for the effective management of the disease.
The Gβ-like Protein AfCpcB Affects Sexual Development, Response to Oxidative Stress and Phagocytosis by Alveolar Macrophages in Aspergillus fumigatus
Authors: Lim Joo-Yeon , Kim Yeon-Ju , Park Hee-Moon
Published: January 2022

G-protein signaling is important for signal transduction, allowing various stimuli that are external to a cell to affect its internal molecules. In Aspergillus fumigatus, the roles of Gβ-like protein CpcB on growth, asexual development, drug sensitivity, and virulence in a mouse model have been previously reported. To gain a deeper insight into Aspergillus fumigatus sexual development, the ΔAfcpcB strain was generated using the supermater AFB62 strain and crossed with AFIR928. This cross yields a decreased number of cleistothecia, including few ascospores. The sexual reproductive organ-specific transcriptional analysis using RNAs from the cleistothecia (sexual fruiting bodies) indicated that the CpcB is essential for the completion of sexual development by regulating the transcription of sexual genes, such as veA, steA, and vosA. The ΔAfcpcB strain revealed increased resistance to oxidative stress by regulating genes for catalase, peroxiredoxin, and ergosterol biosynthesis. The ΔAfcpcB strain showed decreased uptake by alveolar macrophages in vitro, decreased sensitivity to Congo red, decreased expression of cell wall genes, and increased expression of the hydrophobin genes. Taken together, these findings indicate that AfCpcB plays important roles in sexual development, phagocytosis by alveolar macrophages, biosynthesis of the cell wall, and oxidative stress response.
Fungal Infections Other Than Invasive Aspergillosis in COVID-19 Patients
Authors: Basile Kerri , Halliday Catriona , Kok Jen , Chen Sharon C-A.
Published: January 2022

Invasive fungal disease (IFD) associated with Coronavirus Disease 2019 (COVID-19) has focussed predominantly on invasive pulmonary aspergillosis. However, increasingly emergent are non-Aspergillus fungal infections including candidiasis, mucormycosis, pneumocystosis, cryptococcosis, and endemic mycoses. These infections are associated with poor outcomes, and their management is challenged by delayed diagnosis due to similarities of presentation to aspergillosis or to non-specific features in already critically ill patients. There has been a variability in the incidence of different IFDs often related to heterogeneity in patient populations, diagnostic protocols, and definitions used to classify IFD. Here, we summarise and address knowledge gaps related to the epidemiology, risks, diagnosis, and management of COVID-19-associated fungal infections other than aspergillosis.
Predication of the Effector Proteins Secreted by Fusarium sacchari Using Genomic Analysis and Heterogenous Expression
Authors: Huang Zhen , Li Huixue , Zhou Yuming , Bao Yixue , Duan Zhenzhen , Wang Caixia , Powell Charles A. , Chen Baoshan , Zhang Muqing , Yao Wei
Published: January 2022

One of the causative agents of pokkah boeng disease (PBD), which affects sugarcane crops globally, is the fungus Fusarium sacchari. These fungal infections reduce sugar quality and yield, resulting in severe economic losses. Effector proteins play important roles in the interactions between pathogenic fungi and plants. Here, we used bioinformatic prediction approaches to identify 316 candidate secreted effector proteins (CSEPs) in the complete genome of F. sacchari. In total, 95 CSEPs contained known conserved structures, representing 40 superfamilies and 18 domains, while an additional 91 CSEPs contained seven known motifs. Of the 130 CSEPs containing no known domains or motifs, 14 contained one of four novel motifs. A heterogeneous expression system in Nicotiana benthamiana was used to investigate the functions of 163 CSEPs. Seven CSEPs suppressed BAX-triggered programmed cell death in N. benthamiana, while four caused cell death in N. benthamiana. The expression profiles of these eleven CSEPs during F. sacchari infection suggested that they may be involved in sugarcane-F. sacchari interaction. Our results establish a basis for further studies of the role of effector molecules in pathogen–sugarcane interactions, and provide a framework for future predictions of pathogen effector molecules.
Fake News Explosion in Portugal and Brazil the Pandemic and Journalists’ Testimonies on Disinformation
Authors: Canavilhas João , Jorge Thaïs de Mendonça
Published: January 2022

Orchestrated manipulations spread lies and can create an environment of uncertainty in society, leading to concerns from politicians, scholars, educators, and journalists, among others. In this paper we explore what the emergence of fake news (understood as false news) represents for journalists, trying to answer the following question: Does false news pose a threat to the credibility of good journalism, causing a disruption of the traditional work? To answer it, we interviewed a sample of journalists from various media organizations in Portugal and Brazil. Among the main findings, journalists are aware that fake news is a problem to be faced, as the blame for the dissemination of false news erroneously lies with the profession. They are conscious that something must be done and agree that the best way to fight against fake news is to invest in media literacy. Most of the journalists of our sample think they must be also more cautious to check sources for veracity and for political motivations. The results show that there is a resolve to reinforce the role of journalism in society.
Agreement and Reliability Analysis of Machine Learning Scaling and Wireless Monitoring in the Assessment of Acute Proximal Weakness by Experts and Non-Experts: A Feasibility Study
Authors: Park Eunjeong , Lee Kijeong , Han Taehwa , Nam Hyo Suk
Published: January 2022

Assessing the symptoms of proximal weakness caused by neurological deficits requires the knowledge and experience of neurologists. Recent advances in machine learning and the Internet of Things have resulted in the development of automated systems that emulate physicians’ assessments. The application of those systems requires not only accuracy in the classification but also reliability regardless of users’ proficiency in the real environment for the clinical point-of-care and the personalized health management. This study provides an agreement and reliability analysis of using a machine learning-based scaling of Medical Research Council (MRC) proximal scores to evaluate proximal weakness by experts and non-experts. The system trains an ensemble learning model using the signals from sensors attached to the limbs of patients in a neurological intensive care unit. For the agreement analysis, we investigated the percent agreement of MRC proximal scores and Bland-Altman plots of kinematic features between the expert- and non-expert scaling. We also analyzed the intra-class correlation coefficients (ICCs) of kinematic features and Krippendorff’s alpha of the observers’ scaling for the reliability analysis. The mean percent agreement between the expert- and the non-expert scaling was 0.542 for manual scaling and 0.708 for autonomous scaling. The ICCs of kinematic features measured using sensors ranged from 0.742 to 0.850, whereas the Krippendorff’s alpha of manual scaling for the three observers was 0.275. The autonomous assessment system can be utilized by the caregivers, paramedics, or other observers during an emergency to evaluate acute stroke patients.
Stakeholder Perspectives on Navigating Evidentiary and Decision Uncertainty in Precision Oncology
Authors: Pollard Samantha , Dunne Jessica , Costa Sarah , Regier Dean A.
Published: January 2022

(1) Background: Precision oncology has the potential to improve patient health and wellbeing through targeted prevention and treatment. Owing to uncertain clinical and economic outcomes, reimbursement has been limited. The objective of this pan-Canadian qualitative study was to investigate barriers to precision oncology implementation from the perspectives of health system stakeholders. (2) Methods: We conducted 32 semi-structured interviews with health technology decision makers (n = 14) and clinicians (n = 18) experienced with precision oncology. Participants were recruited using a purposive sampling technique. Interviews were analyzed using thematic analysis. Recruitment continued until two qualitative analysts reached agreement that thematic saturation was reached. (3) Results: While cautiously optimistic about the potential for enhanced therapeutic alignment, participants identified multiple decisional challenges under conditions of evidentiary uncertainty. Decision makers voiced concern over resource requirements alongside small benefitting patient populations and limited evidence supporting patient and health system impacts. Clinicians were comparatively tolerant of evidentiary uncertainty guiding clinical decision-making practices. Clinicians applied a broader definition of patient benefit, focusing on the ability to assist patients making informed clinical decisions. (4) Conclusions: Sustainable precision oncology must balance demand with evidence demonstrating benefit. We show that clinicians and decision makers vary in their tolerance for evolving knowledge, suggesting a need to establish evidentiary standards supporting precision oncology reimbursement decisions.
Intersections between Copper, β-Arrestin-1, Calcium, FBXW7, CD17, Insulin Resistance and Atherogenicity Mediate Depression and Anxiety Due to Type 2 Diabetes Mellitus: A Nomothetic Network Approach
Authors: Al-Hakeim Hussein Kadhem , Hadi Hadi Hasan , Jawad Ghoufran Akeel , Maes Michael
Published: January 2022

Type 2 diabetes mellitus (T2DM) is frequently accompanied by affective disorders with a prevalence of comorbid depression of around 25%. Nevertheless, the biomarkers of affective symptoms including depression and anxiety due to T2DM are not well established. The present study delineated the effects of serum levels of copper, zinc, β-arrestin-1, FBXW7, lactosylceramide (LacCer), serotonin, calcium, magnesium on severity of depression and anxiety in 58 men with T2DM and 30 healthy male controls beyond the effects of insulin resistance (IR) and atherogenicity. Severity of affective symptoms was assessed using the Hamilton Depression and Anxiety rating scales. We found that 61.7% of the variance in affective symptoms was explained by the multivariate regression on copper, β-arrestin-1, calcium, and IR coupled with atherogenicity. Copper and LacCer (positive) and calcium and BXW7 (inverse) had significant specific indirect effects on affective symptoms, which were mediated by IR and atherogenicity. Copper, β-arrestin-1, and calcium were associated with affective symptoms above and beyond the effects of IR and atherogenicity. T2DM and affective symptoms share common pathways, namely increased atherogenicity, IR, copper, and β-arrestin-1, and lowered calcium, whereas copper, β-arrestin-1, calcium, LacCer, and FBXW7 may modulate depression and anxiety symptoms by affecting T2DM.
COVID-19 Follow-App. Mobile App-Based Monitoring of COVID-19 Patients after Hospital Discharge: A Single-Center, Open-Label, Randomized Clinical Trial
Authors: Marquez-Algaba Ester , Sanchez Marc , Baladas Maria , España Claudia , Dallo Hermes Salvatore , Requena Manuel , Torrella Ariadna , Planas Bibiana , Raventos Berta , Molina Carlos , Ribo Marc , Almirante Benito , Len Oscar
Published: January 2022

Introduction: In the midst of a pandemic, apps can be used to provide close follow-up, ensure that patients are monitored at home, avoid excessive pressure on medical facilities, prevent the movement of people (both patients and health professionals), and reduce the risk of infection. Objective: To adapt and validate the use of a smartphone application for outpatient follow-up of COVID-19 patients after hospital discharge. Methods: We conducted an open-label clinical trial at Hospital Universitari Vall d’Hebron in Barcelona, Spain. Patients were randomly assigned in a 1:1 ratio to be followed by the Farmalarm app or by their primary care center. The primary endpoint was the reduction in the need for in-person return visits. Results: From 31 March to 4 May 2020, 150 patients were enrolled in the study at hospital discharge: 74 patients were randomized to the experimental group, and 76 to the control group. All patients in the control group and all except for six in the experimental group completed the study. During hospitalization, before study inclusion, all but 4 (97.3%) had viral pneumonia, 91 (60.7%) required supplemental oxygen, and 16 (10.7%) required intensive care unit (ICU) admission. COVID-19–related return visits to the emergency department were significantly higher in the control group (7.9% vs. 0%; p = 0.028) in the per-protocol analysis. Telephone consultations with the emergency department were performed by 12 (15.8%) patients in the control group and 0 (0%) in the experimental group (p < 0.001). Satisfaction with outpatient monitoring was rated higher by the experimental group (5 vs. 4 points; p < 0.001). Conclusions: Following COVID-19 hospital discharge, home follow-up via a mobile app was effective in reducing in-person return visits without undermining patient satisfaction or perception of health, compared with standard follow-up.
Predictive Value of Ambulatory Objective Movement Measurement for Outcomes of Levodopa/Carbidopa Intestinal Gel Infusion
Authors: Kilinçalp Gökçe , Sjöström Anne-Christine , Eriksson Barbro , Holmberg Björn , Constantinescu Radu , Bergquist Filip
Published: January 2022

Patients with Parkinson’s disease that may benefit from device-assisted therapy can be identified with guidelines like Navigate PD. The decision to offer advanced treatment and the choice of treatment modality are, however, not straightforward, and some patients respond less favorably to a chosen therapy. Measurements with the Parkinson Kinetigraph (PKG) can detect motor fluctuations and could therefore predict patients that respond better or worse to intestinal levodopa/carbidopa gel infusion (LCIG). In a retrospective analysis of 45 patients that had been selected to start LCIG between 2014 and 2020, the effects of baseline PKG and clinical characteristic on the outcome were determined with ordinal regression. Although all patients had been found to have handicapping medication-related symptom fluctuations, patients without clear objective off fluctuations in the baseline PKG had low odds ratio for success. Lower odds for success were also found with increasing age, whereas gender, medication intensity and baseline PKG summary scores (median bradykinesia and dyskinesia scores, fluctuation dyskinesia score and percent time with tremor) had no significant effect. Absence of easily identified off-periods in the PKG has a negative prognostic value for the effect of LCIG and could prompt noninvasive infusion evaluation before surgery.
Network Analysis-Based Disentanglement of the Symptom Heterogeneity in Asian Patients with Schizophrenia: Findings from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics
Authors: Choi Joonho , Yoon Hyung-Jun , Park Jae Hong , Nakagami Yukako , Kubota Chika , Inada Toshiya , Kato Takahiro A. , Yang Shu-Yu , Lin Sih-Ku , Chong Mian-Yoon , Avasthi Ajit , Grover Sandeep , Kallivayalil Roy Abraham , Tanra Andi Jaylangkara , Chee Kok Yoon , Xiang Yu-Tao , Sim Kang , Javed Afzal , Tan Chay Hoon , Sartorius Norman , Kanba Shigenobu , Shinfuku Naotaka , Park Yong Chon , Park Seon-Cheol
Published: January 2022

The symptom heterogeneity of schizophrenia is consistent with Wittgenstein’s analogy of a language game. From the perspective of precision medicine, this study aimed to estimate the symptom presentation and identify the psychonectome in Asian patients, using data obtained from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics. We constructed a network structure of the Brief Psychiatric Rating Scale (BPRS) items in 1438 Asian patients with schizophrenia. Furthermore, all the BPRS items were considered to be an ordered categorical variable ranging in value from 1–7. Motor retardation was situated most centrally within the BPRS network structure, followed by depressive mood and unusual thought content. Contrastingly, hallucinatory behavior was situated least centrally within the network structure. Using a community detection algorithm, the BPRS items were organized into positive, negative, and general symptom clusters. Overall, DSM symptoms were not more central than non-DSM symptoms within the symptom network of Asian patients with schizophrenia. Thus, motor retardation, which results from the unmet needs associated with current antipsychotic medications for schizophrenia, may be a tailored treatment target for Asian patients with schizophrenia. Based on these findings, targeting non-dopamine systems (glutamate, γ-aminobutyric acid) may represent an effective strategy with respect to precision medicine for psychosis.
Cognitive Reserve in Early Manifest Huntington Disease Patients: Leisure Time Is Associated with Lower Cognitive and Functional Impairment
Authors: Migliore Simone , D’Aurizio Giulia , Scaricamazza Eugenia , Maffi Sabrina , Ceccarelli Consuelo , Ristori Giovanni , Romano Silvia , Castaldo Anna , Fichera Mario , Curcio Giuseppe , Squitieri Ferdinando
Published: January 2022

We focused on Cognitive Reserve (CR) in patients with early Huntington Disease (HD) and investigated whether clinical outcomes might be influenced by lifetime intellectual enrichment over time. CR was evaluated by means of the Cognitive Reserve Index questionnaire (CRIq), an internationally validated scale which includes three sections: education, working activity, and leisure time. The clinical HD variables were quantified at three different time points (baseline-t0, 1 year follow up-t1 and 2 years follow up-t2) as per the Unified Huntington’s Disease Rating Scale (UHDRS), an internationally standardized and validated scale including motor, cognitive, functional and behavioral assays. Our sample consisted of 75 early manifest patients, withclinical stage scored according to the Total Functional Capacity (TFC) scale. Our correlational analysis highlighted a significant inverse association between CRIq leisure time (CRIq_LA) and longitudinal functional impairment (namely, the differential TFC score between t2 and t0 or ΔTFC) (p < 0.05), and the multidimensional progression of HD as measured by the composite UHDRS (cUHDRS, p < 0.01). CRIq_LA was significantly and positively associated with better cognitive performances at all time points (p < 0.05). Our results suggest that higher is the CRIq_LA, milder is the progression of HD in terms of functional, multidimensional and cognitive outcome.
Chronic Kidney Disease Patients Visiting Various Hospital Departments: An Analysis in a Hospital in Central Tokyo, Japan
Authors: Fukui Akira , Takeshita Kohei , Nakashima Akio , Maruyama Yukio , Yokoo Takashi
Published: January 2022

To further improve care for chronic kidney disease (CKD) patients, healthcare providers’ awareness of CKD must be raised. Proteinuria testing is essential for CKD care, and collaboration with specialists is recommended for advanced cases. We reviewed data from the electronic medical records of outpatients at our hospital to analyze the clinical departments visited by CKD patients, and the frequency of proteinuria testing and referrals to nephrologists. We defined CKD as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or a urine protein concentration (U-pro) ≥ +1. We found that 31.1% of the CKD tests in September 2021 were performed in clinical departments other than internal medicine. Furthermore, within 1 year, 68.0% of CKD patients identified in September 2020 underwent a urine dipstick test, and 33.7% underwent a quantitative test for urinary protein or albumin. Additionally, 27.5% of individuals with an eGFR < 30 mL/min/1.73 m2 or U-pro ≥ +1 identified by non-nephrology departments in September 2020 visited the nephrology department within 1 year. Repeated assessments of these quality indicators may be useful for progress management in improving CKD care. Because CKD patients visited various departments in our hospital, campaigns to raise CKD awareness must reach a wide range of healthcare providers in hospitals.
Differentiation between Germinoma and Craniopharyngioma Using Radiomics-Based Machine Learning
Authors: Chen Boran , Chen Chaoyue , Zhang Yang , Huang Zhouyang , Wang Haoran , Li Ruoyu , Xu Jianguo
Published: January 2022

For the tumors located in the anterior skull base, germinoma and craniopharyngioma (CP) are unusual types with similar clinical manifestations and imaging features. The difference in treatment strategies and outcomes of patients highlights the importance of making an accurate preoperative diagnosis. This retrospective study enrolled 107 patients diagnosed with germinoma (n = 44) and CP (n = 63). The region of interest (ROI) was drawn independently by two researchers. Radiomic features were extracted from contrast-enhanced T1WI and T2WI sequences. Here, we established the diagnosis models with a combination of three selection methods, as well as three classifiers. After training the models, their performances were evaluated on the independent validation cohort and compared based on the index of the area under the receiver operating characteristic curve (AUC) in the validation cohort. Nine models were established and compared to find the optimal one defined with the highest AUC in the validation cohort. For the models applied in the contrast-enhanced T1WI images, RFS + RFC and LASSO + LDA were observed to be the optimal models with AUCs of 0.91. For the models applied in the T2WI images, DC + LDA and LASSO + LDA were observed to be the optimal models with AUCs of 0.88. The evidence of this study indicated that radiomics-based machine learning could be potentially considered as the radiological method in the presurgical differential diagnosis of germinoma and CP with a reliable diagnostic performance.
Invasive Candidiasis in Hospitalized Patients with Major Burns
Authors: Lin Yi-Ling , Chen I-Chen , Yen Jung-Hsing , Lai Chih-Sheng , Tsai Yueh-Chi , Lu Chun-Te , Wu Cheng-Yeu , Lin Wei-Szu , Lin Ching-Heng , Huang Yung-Chieh
Published: January 2022

Background: Invasive candidiasis (IC) is a major cause of morbidities and mortality in patients hospitalized with major burns. This study investigated the incidence of IC in this specific population and analyzed the possible risk factors. Materials and Methods: We retrospectively analyzed data from the National Health Insurance Research Database (NHIRD) of Taiwan. We identified 3582 patients hospitalized with major burns on over 20% of their total body surface area (TBSA) during 2000–2013; we further analyzed possible risk factors. Result: IC was diagnosed in 452 hospitalized patients (12.6%) with major burns. In the multivariate analysis, patients older than 50 years (adjusted odds ratio (OR) = 1.96, 95% confidence interval (CI) 1.36–2.82), those of female sex (adjusted OR = 1.33, 95% CI 1.03–1.72), those with burns on the head (adjusted OR = 1.33, 95% CI 1.02–1.73), and those with burns over a greater TBSA had higher risks of IC. Conclusion: Treating IC is crucial in healthcare for major burns. Our study suggests that several risk factors are associated with IC in patients hospitalized with major burns, providing reliable reference value for clinical decisions.
Impact of 5-Year Endoscopic Surveillance Intervals with Biopsy following Endoscopic Papillectomy for Ampullary Adenoma
Authors: So Hoonsub , Ko Sung Woo , Shin Seung Hwan , Kim Eun Ha , Park Do Hyun
Published: January 2022

Background: Endoscopic snare papillectomy (ESP) has been established as a safe and effective treatment for ampullary adenomas. However, little is known about the optimal post-procedure follow-up period and the role of routine endoscopic surveillance biopsy following ESP. We aimed to evaluate patient adherence to a 5-year endoscopic surveillance and routine biopsy protocol after ESP of ampullary adenoma. Methods: We reviewed our prospectively collected database (n = 98), all members of which underwent ESP for ampullary lesions from January 2011 to December 2016, for the evaluation of long-term outcomes. The primary outcome was the rate of patient adherence to 5-year endoscopic surveillance following ESP. The secondary outcomes were the diagnostic yield of routine endoscopic biopsy, recurrence rate, and adverse events after endoscopic surveillance in the 5-year follow-up (3-month, 6-month, and every 1 year). Results: A total of 19 patients (19.4%) experienced recurrence during follow-up, all of these patients experienced recurrence within 3 years of the procedure (median 217 days, range 69–1083). The adherence rate for patients with sporadic ampullary adenoma were 100%, 93.5%, and 33.6% at 1, 3, and 5 years after ESP, respectively. The diagnostic yield of routine endoscopic biopsy without macroscopic abnormality was 0.54%. Pancreatitis occurred in four patients (4%, 3 mild, 1 moderate) after surveillance endoscopic biopsy without macroscopic abnormality. Conclusions: Given the low 5-year adherence rate and diagnostic yield of routine endoscopic biopsy with risk of pancreatitis, optimal surveillance intervals according to risk stratification (low grade vs. high grade adenoma/intramucosal adenocarcinoma) may be required to improve patient adherence, and routine biopsy without macroscopic abnormality may not be recommended.
ICBrainDB: An Integrated Database for Finding Associations between Genetic Factors and EEG Markers of Depressive Disorders
Authors: Ivanov Roman , Kazantsev Fedor , Zavarzin Evgeny , Klimenko Alexandra , Milakhina Natalya , Matushkin Yury G. , Savostyanov Alexander , Lashin Sergey
Published: January 2022

In this study, we collected and systemized diverse information related to depressive and anxiety disorders as the first step on the way to investigate the associations between molecular genetics, electrophysiological, behavioral, and psychological characteristics of people. Keeping that in mind, we developed an internet resource including a database and tools for primary presentation of the collected data of genetic factors, the results of electroencephalography (EEG) tests, and psychological questionnaires. The sample of our study was 1010 people from different regions of Russia. We created the integrated ICBrainDB database that enables users to easily access, download, and further process information about individual behavioral characteristics and psychophysiological responses along with inherited trait data. The data obtained can be useful in training neural networks and in machine learning construction processes in Big Data analysis. We believe that the existence of such a resource will play an important role in the further search for associations of genetic factors and EEG markers of depression.