bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving surface roughness of polylactic acid (PLA) products manufactured by 3D printing using a novel slurry impact technique
Authors: Heshmat Mahmoud , Abdelrhman Yasser
Published: August 2021

Purpose

Fused deposition modeling (FDM) is one of the most adopted additive manufacturing techniques to produce prototypes and/or final parts regardless of geometrical complexity restrictions. One of the most challenging aspects of this technology is the attainable roughness. The purpose of this study is to evaluate the capability of the slurry impacts to improve the surface roughness of parts fabricated using FDM. Moreover, a regression model for predicting the values of surface roughness was developed.

Design/methodology/approach

The developed technique imposes a silica–water mixture which softens the staircase on the surface and leaves it smoother. The process introduces three main factors: building orientation; layer thickness; and impact angle of the slurry particles. Experimentally, a test rig was used to evaluate the effect of these factors on surface roughness. Statistically, Analysis of variance (ANOVA) and regression analysis were conducted to study the contribution of the individual factors on the roughness.

Findings

The results reveal that the effect of slurry impacts has a good impact on surface roughness, and the three factors have significant effect on surface roughness.

Originality/value

This paper contributes to new knowledge by providing a new technique for enhancing the surface roughness of FDMed products. ANOVA and regression analysis is a useful tool to parametrically study the surface roughness in terms of building and testing factors.
Effects of extruder temperatures and raster orientations on mechanical properties of the FFF-processed polylactic-acid (PLA) material
Authors: Arifvianto Budi , Wirawan Yuris Bahadur , Salim Urip Agus , Suyitno Suyitno , Mahardika Muslim
Published: August 2021

Purpose

The purpose of this study is to investigate the influences of extruder temperatures and raster orientations on the mechanical properties of polylactic-acid (PLA) material processed by using fused filament fabrication (FFF).

Design/methodology/approach

In this research, the PLA specimens were first printed with nozzle or extruder temperatures of 205°C, 215°C and 225°C and then evaluated in terms of their physical, chemical and mechanical properties. An appropriate extruder temperature was then selected based on this experiment and used for the printing of the other PLA specimens having various raster orientations. A series of tensile tests were carried out again to investigate the influence of raster orientations on the tensile strength, tensile strain and elastic modulus of those FFF-processed PLA materials. In the end, the one-way ANOVA was applied for the statistical analysis and the Mohr’s circle was established to aid in the analysis of the data obtained in this experiment.

Findings

The result of this study shows that the chemistry, porosity, degree of crystallinity and mechanical properties (tensile strength, strain and elastic modulus) of the PLA material printed with a raster angle of 0° were all insensitive to the increasing extruder temperature from 205°C to 225°C. Meanwhile, the mechanical properties of such printed PLA material were obviously influenced by its raster orientation. In this case, a PLA material with a raster orientation parallel to its loading axis, i.e. those with a raster angle of θ = 0°, was found as the strongest material. Meanwhile, the raster configuration-oriented perpendicular to its loading axis or θ = 90° yielded the weakest PLA material. The results of the tensile tests for the PLA material printed with bidirectional raster orientations, i.e. θ = 0°/90° and 45°/−45° demonstrated their strengths with values falling between those of the materials having unidirectional raster θ = 0° and 90°. Furthermore, the result of the analysis by using a well-known Mohr’s circle confirmed the experimental tensile strengths and the failure mechanisms of the PLA material that had been printed with various raster orientations.

Originality/value

This study presented consistent results on the chemistry, physical, degree of crystallinity and mechanical properties of the FFF-processed PLA in responding to the increasing extruder temperature from 205°C to 225°C applied during the printing process. Unlike the results of the previous studies, all these properties were also found to be insensitive to the increase of extruder temperature. Also, the result of this research demonstrates the usability of Mohr’s circle in the analysis of stresses working on an FFF-processed PLA material in responding to the changes in raster orientation printed in this material.
Interaction between social enterprises and key actors shaping the field: experiences from the social and health sectors in Hungary
Authors: Kiss Julianna , Krátki Noémi , Deme Gábor
Published: August 2021

Purpose

In Hungary, as in other Central and Eastern European countries, the concept of social enterprise (SE) has attracted increased attention in recent years, with certain key actors shaping the organisational field. This growing interest is largely because of the availability of European Union funds focussing on the work integration of disadvantaged groups but ignoring other possible roles of SEs. This study aims to consider a seldom examined and underfunded area: SEs’ institutional environment and organisational activities in the social and health sectors.

Design/methodology/approach

Based on neoinstitutional theory, the paper uses desk research and qualitative case studies. It presents the experiences of SEs providing social and health services for specific disadvantaged groups.

Findings

This paper identified the key actors influencing the everyday operation of SEs and examined their connections, interactions and partnerships. Based on the findings, SEs primarily depend on the central state, public social and health institutions and local governments. At the same time, their connections with private customers, networks, development and support organisations, third sector organisations and for-profit enterprises are less significant. The key actors have a relevant impact on the legal form, main activities and the financial and human resources of SEs. SEs, however, have little influence on their institutional environment.

Originality/value

The paper contributes to understanding the opportunities and barriers of SEs in Hungary and, more generally, in Central and Eastern Europe, especially regarding their place in social and health services.
Fostering sustainable businesses: understanding sustainability-driven entrepreneurial intention among university students in Pakistan
Authors: Waris Idrees , Barkat Waseem , Ahmed Adeel , Hameed Irfan
Published: August 2021

Purpose

The purpose of this research paper is to predict sustainability-driven entrepreneurship intention among university students in the developing market (Pakistan).

Design/methodology/approach

The target population of this study was university students in Pakistan. According to UNDP (2017) report, Pakistan has the largest youth population. More than 64% of the total population (210 million) is below 30 years of age. If trained properly, this huge chunk of the population could become a source of intellectual capital for the development of the nation. The quota based on age sampling technique was used to collect the data from university students in Karachi because more than 64% of the Pakistan population is below 30 years of age.

Findings

The findings reveal that university entrepreneurial support has a strong influence on attitude toward sustainable entrepreneurship and entrepreneurial self-efficacy.

Research limitations/implications

The role of university entrepreneurial support, environmental concern and students’ entrepreneurial self-efficacy are vital factors in sustainability-driven entrepreneurship. This study enriches the literature of green entrepreneurship helping to understand university students’ intention for sustainable entrepreneurship. The outcome of this study would help strategists and environmental academicians to guide university students regarding the launch of sustainable ventures.

Originality/value

To the best of authors’ knowledge, this is one of the first studies to explore the effects of environmental concern on entrepreneurial intention among university students in the context of a developing country – Pakistan.
Factors that influence non‐word repetition performance in children with and without persistent speech sound disorders
Authors: Farquharson Kelly , Hogan Tiffany P. , Fox Annie B.
Published: August 2021

Background

Nonword repetition (NWR) is a common phonological processing task that is reported to tap into many cognitive, perceptual, and motor processes. For this reason, NWR is often used in assessment batteries to aid in verifying the presence of a reading or language disorder.

Aims

To examine the extent to which child‐ and item‐level factors predict the probability of a correct response on a non‐word repetition (NWR) task in a sample of children with persistent speech sound disorders (P‐SSDs) compared with their typically developing peers.

Methods & Procedures

A total of 40 American‐English‐speaking children were tested on an NWR task for which the stimuli were manipulated for phonological neighbourhood density and list length. Additional measures of vocabulary and word reading were also administered.

Outcomes & Results

Children who were typically developing were 1.82 times more likely than children with P‐SSD to respond correctly. The item‐level factor of phonological neighbourhood density influenced performance, but only for the P‐SSD group, and only at certain list lengths. Vocabulary and word‐reading ability also influenced NWR task performance.

Conclusions & Implications

Children with P‐SSD present as a complex and heterogeneous group. Multiple factors contribute to their ability to perform phonological tasks such as NWR. As such, attention to the item‐level factors in screenings and assessments is necessary to ensure that appropriate decisions are made regarding diagnosis and subsequent treatment.

What this paper adds

What is already known on the subject?

Good expressive vocabulary is important for children with speech sound disorders; it can aid in their performance on phonological processing tasks like NWR.

Nonword repetition may be a helpful test/ subtest to add to assessment batteries when evaluating children with speech sound disorders.

What this paper adds to existing knowledge?

Vocabulary and word reading abilities must also be measured for children with SSDs, to observe the bigger picture of their linguistic abilities.

What are the potential or actual clinical implications of this work?

The relation between word reading and speech sound production influences performance on phonological processing tasks.
Is CT thorax, abdomen and pelvis a useful test in patients with weight loss?
Authors: O’Cearbhaill Roisin M , Leonard Carol , O’Neill Damien , Morrin Martina M , Lee Michael J
Published: August 2021

Introduction

Unintentional weight loss is an important clinical problem. The role of CT is not firmly established in the workup of these patients. The aim of this study is to determine the diagnostic yield of CT Thorax, Abdomen and Pelvis (CT TAP) in patients with unexplained weight loss and to determine whether clinical or laboratory variables are associated with positive CT findings.

Methods

A retrospective review was performed of CT TAP examinations over 12 months with weight loss as an indication. Patients’ electronic records and radiology reports were reviewed. Clinical and laboratory variables were assessed for correlation with positive findings on CT.

Results

461 CT TAP studies with weight loss as the primary indication were identified. 124 were excluded; 82 due to a recent history of malignancy, 41 because CT TAP was used for staging of a new malignancy and one study was incomplete. This left 337 eligible examinations. 217 studies had findings of no clinical relevance, 50 studies were normal, 40 studies identified a possible cause of weight loss and 30 studies identified a definite cause. Of the 40 where a possible cause was identified, further work up led to a diagnosis which explained the weight loss in 13 patients. The diagnostic yield of CT TAP was 12.8%. Age, abdominal symptoms, degree of weight loss, anaemia, tumour markers and LDH did not significantly correlate with positive findings on CT.

Conclusion

CT TAP is a helpful investigation in patients with unexplained weight loss with a diagnostic yield of 12.8%.
Predictive model for diagnosing central lesions in emergency department patients with isolated dizziness who undergo diffusion‐weighted magnetic resonance imaging
Authors: Han Eunah , Kim Ji Hoon , You Je Sung , Son Won Jeong , Beom Jin Ho
Published: August 2021

Objectives

Only 5% to 10% of patients who visit the emergency department (ED) with isolated dizziness without neurologic abnormalities may have central lesions; however, it is important to distinguish central lesions through brain imaging. This study was conducted to create a nomogram to provide an objective medical basis for selectively performing magnetic resonance imaging (MRI) among patients with isolated dizziness.

Methods

This retrospective observational study enrolled patients who visited the ED of a tertiary hospital with isolated dizziness and underwent diffusion‐weighted MRI and subsequently consulted with the departments of neurology, neurosurgery, or otorhinolaryngology. Multivariable logistic regression analysis was performed to identify risk factors in patients diagnosed with central lesions to create a nomogram with the significant variables.

Results

Of the 1,078 patients who were screened, 119 were diagnosed with central lesions. Significant variables in the multivariable logistic regression analysis were albumin levels (odds ratio [OR] = 0.339, 95% confidence interval [CI] = 0.188 to 0.610, p = 0.0003), inorganic phosphate levels (OR = 0.891, 95% CI = 0.832 to 0.954, p = 0.0010), history of ischemic stroke (OR = 3.170, 95% CI = 1.807 to 5.560, p < 0.0001), presyncope (OR = 3.152, 95% CI = 1.184 to 8.389, p = 0.0216), and nystagmus (OR = 0.365, 95% CI = 0.237 to 0.561, p < 0.0001). The area under the receiver operating characteristic curve of the nomogram created with these variables was 0.7315 (95% CI = 0.6842 to 0.7788, p < 0.0001).

Conclusions

Albumin, inorganic phosphate, previous stroke, presyncope, and nystagmus were associated with the predictive diagnosis of central lesions among patients admitted to the ED with isolated dizziness. The novel nomogram created using these variables can help in objectively determining the need for MRI in patients presenting with isolated dizziness to the ED.
The effect of COVID‐19 on the global stock market
Authors: Chatjuthamard Pattanaporn , Jindahra Pavitra , Sarajoti Pattarake , Treepongkaruna Sirimon
Published: August 2021

This paper investigates the effect of COVID‐19 on the global stock market. Specifically, we test whether the growth in the number of confirmed cases/deaths affects market quality, measured by return, realised volatility, jumps and co‐jumps for 43 stock indices around the world. We find that an increase in the growth rate of the number of confirmed cases increases volatility and jumps while reducing return. Further, we explore whether economic, financial and political risks play any significant role in the relation between the number of confirmed cases/deaths and market quality. Overall, we find the risk from COVID‐19 overshadows these risks.
Size variation in wild Bactrocera tryoni (Diptera: Tephritidae): only a small amount is related to the host fruit
Authors: Newman Jaye D , Merkel Katharina , Clarke Anthony R
Published: August 2021

Body size is an indicator of fitness in fruit flies (Diptera: Tephritidae), with larger males and females having increased mating success and egg production, respectively. Based on laboratory studies, the larval diet and its nutritional composition are considered the most important factors influencing juvenile growth and subsequent adult body size. However, a very limited literature is less clear on the importance of larval diet as an adult size modifier of wild fruit flies. Bactrocera tryoni (Froggatt) is a polyphagous species with larvae feeding within the fruit of over 200 plant species. To test the impact of larval host on adult size in wild individuals of this species, we collected naturally infested fruit from the field and then reared out adults in the laboratory. The wing length and dry body weight of emergent flies were measured. Linear mixed models were used to analyse the difference in size depending on fruit type, larval density, sex and their interactions. Separate measurements of body size, wing length and dry body weight were significantly influenced by the larval host fruit collected from the field. However, only 7% and 24% of the variation of the wing discal–medial cell length and dry body weight, respectively, could be explained by larval host fruit type with high individual body size variation both within and between host fruit types. Fruit protein content was positively correlated, and water content negatively correlated, to wing discal–medial cell length. Unexpectedly, the parameters of wing length and dry body weight were only weakly correlated with each other. The results support the large body of laboratory‐based fruit fly diet work, which identifies protein as a key component of the larval diet, but do not support a general assumption that larval host is the key driver of adult body size variation in wild frugivorous tephritids. Rather, and in agreement with a small number of laboratory‐based trials, the importance of larval diet to adult fitness appears to become less important as the larval feeding environment becomes more complex.
Substance use treatment services utilization and outcomes among probationers in drug courts compared to a matched cohort of probationers in traditional courts
Authors: Rodriguez‐Monguio Rosa , Montgomery Barrett , Drawbridge Dara , Packer Ira , Vincent Gina M.
Published: August 2021

Background and Objectives

Drug courts provide an array of substance use treatments and community‐based services for probationers struggling with substance use disorders. We assessed substance use treatment services utilization and related expenditures and relapse and recidivism outcomes and identified predictors of cost of provision of substance use treatment services in a matched cohort of Massachusetts probationers in drug courts and traditional courts.

Methods

This was an observational quasi‐experimental study with 542 propensity‐score‐matched probationers initiating drug court between August 1, 2015 and February 28, 2018 and a minimum 6‐month follow‐up period.

Results

A significantly greater proportion of probationers in drug courts were female, self‐reported opioids as their primary drug of choice, had a history of substance use treatment, and a high and very high risk of recidivism than their counterparts in traditional courts. We estimated that the provision of substance use treatment services was $1498 more expensive for probationers in drug courts than traditional courts (p = .054). There were no statistically significant differences in relapse or recidivism rates between court systems.

Discussion and Conclusions

Probationer's age, gender, risk of recidivism at court intake, and enrollment length were strong predictors of expenditures on substance use treatment services.

Scientific Significance

This was the first study to assess substance use treatment services utilization and outcomes among probationers in drug courts and traditional courts. Drug courts served the needs of probationers disproportionally impacted by nonserious drug‐related offenses struggling with substance use disorders who were at a high and very high risk of recidivism at court intake.
Reduced alcohol use in patients prescribed pioglitazone
Authors: Dieperink Eric , Hauser Peter , Dockter Kathryn , Miranda Juan , Evenson Meredith , Thuras Paul
Published: August 2021

Background and Objectives

Alcohol use disorder (AUD) is common and causes significant morbidity and mortality. Currently approved medications are moderately effective. Novel medications are needed to address AUD. Preliminary data suggests pioglitazone may reduce alcohol use.

Methods

Veterans seen at the Minneapolis VA Health Care System, who were prescribed pioglitazone for diabetes between October 1, 2015 and September 30, 2016, were identified using a national VA database (N = 49). Further chart review was performed to identify all Alcohol Use Disorder Identification Test—Consumption (AUDIT‐C) scores prior to starting pioglitazone. Hierarchical Linear models were used to compare all AUDIT‐C scores on and off pioglitazone and compare the change in AUDIT‐C scores over time before and during pioglitazone was prescribed. AUDIT‐C scores were nested within subject with fixed effects for pioglitazone and random intercept and slope for time.

Results

Forty‐nine patients were prescribed pioglitazone and had AUDIT‐C scores of 3 or more. The estimated mean AUDIT‐C score prior to receiving pioglitazone was 3.98 (95% confidence interval [CI]: 3.51–4.44) and this was reduced to 2.89 (95% CI: 2.46‐3.32), reflecting a significant change F(1, 323) = 43.3, p < .001 in the score. The primary reduction occurred within the first year of the pioglitazone prescription. This effect remained significant after controlling for age.

Conclusion and Scientific Significance

This is the first study of pioglitazone used in a clinical sample focused on alcohol use outcome. The data show that pioglitazone may reduce alcohol use in patients with heavy drinking. Clinical trials of pioglitazone are warranted in patients with AUD.
Blame it on the rain: Rainfall variability, consumption smoothing, and subjective well‐being in rural Ethiopia
Authors: Alem Yonas , Colmer Jonathan
Published: August 2021

How does income uncertainty affect individual well‐being? Combining individual‐level panel data from rural Ethiopia with high‐resolution meteorological data, we estimate that mean‐preserving increases in rainfall variability are associated with reductions in objective consumption and subjective well‐being. Mediation analysis suggests that the estimated reduction in consumption does not fully explain the total effect on individual well‐being. Increased rainfall variability also has a large direct effect on individual well‐being. These findings suggest that the gains from further consumption smoothing are likely greater than estimates based solely on observed consumption fluctuations.
Methods of identification of parathyroid glands in thyroid surgery: A literature review
Authors: Tjahjono Richard , Nguyen Kevin , Phung Daniel , Riffat Faruque , Palme Carsten E.
Published: August 2021

Intra‐operative identification and preservation of parathyroid glands is an important but challenging aspect of thyroid surgery. Failure to do so may lead to transient or permanent hypocalcaemia, where the latter represents a serious complication causing life‐long morbidity. It would be beneficial, therefore, if a simple and reliable modality can be developed to assist in the identification of parathyroid glands intra‐operatively. The aim of this literature review is to provide an overview of intra‐operative modalities used to identify parathyroid glands with a particular focus on near‐infrared autofluorescence (NIRAF). Twenty‐seven studies were considered relevant in this literature review. Several modalities have been used to aid parathyroid gland identification, including Raman spectroscopy, indocyanine green angiography, and NIRAF. NIRAF technology allows parathyroid glands to spontaneously give off light (autofluorescence) when exposed to near‐infrared light at a wavelength of 785 nm, creating a contrast between tissues to allow intra‐operative differentiation. Studies utilising NIRAF technology were able to identify 76.3%–100% of parathyroid glands intra‐operatively. Furthermore, two randomised controlled trials comparing NIRAF and white light showed that the use of NIRAF was able to significantly increase the mean number of parathyroid glands detected and reduce the incidence of post‐operative hypocalcaemia. NIRAF is an emerging tool that has been shown to increase the number of intra‐operative parathyroid gland identification and reduce the rate of post‐operative hypocalcaemia in a safe and reproducible manner. Future trials are needed to evaluate the real‐life impact of NIRAF technology in outcomes of patients following thyroid surgery.
Synchron receives FDA approval to begin early feasibility study of their endovascular, brain‐computer interface device
Authors: Han Jason J.
Published: August 2021

Stentrode by Synchron is an endovascularly implanted brain computer interface platform that can relay the activities from the motor cortices of paralyzed patients, potentially offering a relatively noninvasive option for more than five million people in the United States alone.
Relative growth and sexual dimorphism in the hermit crab Clibanarius signatus Heller, 1861 (Anomura, Diogenidae) from the northern coast of the Persian Gulf, Iran
Authors: Ahmadi Mahdieh , Noori Ahmad , Kalvani Neitali Bita , Antonio Amaro Pinheiro Marcelo
Published: August 2021

The purpose of this study was to investigate the relative growth and sexual dimorphism in the hermit crab Clibanarius signatus. The evaluation was done with 955 specimens (494 males, 251 females, and 210 intersexes) captured in Persian Gulf (Iran) during January to December 2015. Animals were submitted to measurements related to weight (BW, total wet weight) and body size related to cephalic shield (SW, width; and SL, length) and propodus of both chelipeds (CPL, length; and CPW, width). Males were larger and heavier than females and intersexes. Both males and females showed a negative allometric growth for the SL–BW and SL–SW relationships, but a positive allometric growth to intersex specimens. To SL–CPL relationship, a negative allometric growth was confirmed in males and females independent of the laterality of the CPL, whereas a contrast was verified in intersexes, with a positive allometric growth occurred for both hands. To SL–CPW relationship, a negative allometric growth (b < 1) occurred in females, independent of the laterality of the CPW, while in males, a positive allometric pattern was confirmed. In intersexes, this relationship was positive except for the right CPW which was isometric. Sexual dimorphism was evident in Clibanarius signatus, with males being the largest and females the smallest specimens in the population.
Is platelet responsiveness to clopidogrel attenuated in overweight or obese patients and why? A reverse translational study in mice
Authors: Jiang Li‐Ping , Ji Jin‐Zi , Ge Peng‐Xin , Zhu Ting , Mi Qiong‐Yu , Tai Ting , Li Yi‐Fei , Xie Hong‐Guang
Published: August 2021

Background and Purpose

Overweight or obese patients exhibit poorer platelet responses to clopidogrel. However, the mechanisms behind this phenotype remain to be elucidated. Here, we sought to discover whether and why obesity could affect the metabolic activation of and/or platelet response to clopidogrel in obese patients and high‐fat diet‐induced obese mice.

Experimental Approach

A post hoc stratified analysis of an observational clinical study was performed to investigate changes in residual platelet reactivity with increasing body weight in patients taking clopidogrel. Furthermore, high‐fat diet‐induced obese mice were used to reveal alterations in systemic exposure of clopidogrel thiol active metabolite H4, ADP‐induced platelet activation and aggregation, the expression of genes involved in the metabolic activation of clopidogrel, count of circulating reticulated and mature platelets, and proliferation profiles of megakaryocytes in bone marrow. The relevant genes and potential signalling pathways were predicted and enriched according to the GEO datasets available from obese patients.

Key Results

Obese patients exhibited significantly attenuated antiplatelet effects of clopidogrel. In diet‐induced obese mice, systemic exposure of clopidogrel active metabolite H4 was reduced but that of its hydrolytic metabolite was increased due to down‐regulation of certain P450s but up‐regulation of carboxylesterase‐1 in the liver. Moreover, enhanced proliferation of megakaryocytes and elevated platelet count also contributed.

Conclusion and Implications

Obesity attenuated metabolic activation of clopidogrel and increased counts of circulating reticulated and mature platelets, leading to impaired platelet responsiveness to the drug in mice, suggesting that clopidogrel dosage may need to be adjusted adequately in overweight or obese patients.
Urinary albumin creatinine ratio associated with postoperative delirium in elderly patients undergoing elective non‐cardiac surgery: A prospective observational study
Authors: Guan Hui‐Lian , Liu He , Hu Xiao‐Yi , Abdul Mannan , Dai Ming‐Sheng , Gao Xing , Chen Xue‐Fen , Zhou Yang , Sun Xun , Zhou Jian , Li Xiang , Zhao Qiu , Zhang Qian‐Qian , Wang Jun , Han Yuan , Cao Jun‐Li
Published: August 2021

Introduction

The blood‐brain barrier (BBB) disruption contributes to postoperative delirium, but cost‐effective and non‐invasive assessment of its permeability is not practicable in the clinical settings. Urine albumin to creatinine ratio (UACR), reflecting systemic vascular endothelial dysfunction, may be a prognostic and predictive factor associated with postoperative delirium. The aim was to analyze the relationship between UACR and postoperative delirium in elderly patients undergoing elective non‐cardiac surgery.

Materials and methods

Through stratified random sampling, a cohort of 408 individuals aged 60 years and older scheduled for elective non‐cardiac surgery were included between February and August 2019 in the single‐center, prospective, observational study. The presence of delirium was assessed using the Confusion Assessment Method (CAM) or Confusion Assessment Method for the ICU (CAM‐ICU) on the day of surgery, at 2 h after the surgery ending time and on the first 3 consecutive days with repeated twice‐daily, with at least 6‐h intervals between assessments. Urine samples were collected on one day before surgery, and 1st day and 3rd day after surgery. The primary outcome was the presence of postoperative delirium, and association of the level of UACR with postoperative delirium was evaluated with unadjusted/adjusted analyses and multivariable logistic regression.

Results

Postoperative delirium was observed in 26.75% (107 of 400) of patients within 3 days post‐surgery. UACR‐Pre (OR, 1.30; 95% CI, 1.14–1.49, p < 0.001), UACR‐POD1 (OR, 1.20; 95% CI, 1.13–1.27, p < 0.001), and UACR‐POD3 (OR, 1.14; 95% CI, 1.08–1.20, p < 0.001) between the delirium and non‐delirium groups show a significant difference, even after adjusting for age, education levels, and other factors.

Conclusion

As the marker of endothelial dysfunction, the high perioperative UACR value may be linked to the postoperative delirium in elderly patients undergoing elective non‐cardiac surgery.
Large variability in plasma efavirenz concentration in Papua New Guinea HIV/AIDS patients associated with high frequency of CYP2B6 516T allele
Authors: Bordin Andriguetti Natália , Van Schalkwyk Helena Katherina , Barratt Daniel Thomas , Tucci Joseph , Pumuye Paul , Somogyi Andrew Alexander
Published: August 2021

Papua New Guinea (PNG) has a high HIV/AIDS prevalence and very high frequency of the CYP2B6 c.516G>T (rs3745274) variant. We have conducted the first investigation of the impact of c.516G>T and patient demographics on plasma efavirenz (EFV) and 8‐hydroxyefavirenz (8OH‐EFV) concentrations, metabolic ratio (8OH‐EFV/EFV) (MR), and their association with adverse effects, in PNG patients with HIV/AIDS. For 156 PNG patients with HIV/AIDS taking EFV 600 mg/day (for 3–156 months), plasma EFV and 8OH‐EFV concentrations were quantified, CYP2B6 c.516G>T genotyped, and demographic and self‐reported adverse effects data recorded. Genotype differences in EFV and 8OH‐EFV concentrations, MR, and percent within therapeutic range (1000–4000 ng/ml) were examined, in addition to EFV and 8OH‐EFV concentration differences between patients experiencing adverse effects. CYP2B6 c.516T allele frequency was 53%. Plasma EFV (p < 0.0001), 8OH‐EFV (p < 0.01), and MR (p < 0.0001) differed significantly between genotypes, with genotype explaining 38%, 10%, and 50% of variability, respectively. Plasma EFV concentrations were significantly higher in T/T (median = 5168 ng/ml) than G/G (1036 ng/ml, post hoc p < 0.0001) and G/T (1502 ng/ml, p < 0.0001) genotypes, with all patients above therapeutic range (n = 23) being T/T genotype (p < 0.0001). EFV and 8OH‐EFV concentrations were not significantly higher in patients experiencing adverse effects. In PNG HIV/AIDS population where the 516T frequency is very high, it explains a substantial portion of variability (38%) in EFV disposition; however, at least for the patients receiving EFV long term, this does not translate into significant side effects.
First episode of psychosis in Guam: The role of ethnicity and neighbourhood factors
Authors: Rosenfarb Irwin Ford , Sharma‐Gopinath Rita , Bhavsar Vishal
Published: August 2021

Objective

Ethnicity, neighbourhood ethnic density, and four additional neighbourhood factors (urbanicity, crime, voting, and poverty) were examined in relation to the incidence of first episode of psychosis (FEP) in the Pacific Island of Guam.

Methods

All first contact patients seen at the Guam Department of Mental Health and Substance Abuse (DMHSA) between January 2005 and December 2007 that met DSM‐IV criteria for the diagnosis of a psychotic disorder were included. At the time of the study, DMHSA was the only psychiatric facility in Guam.

Results

After controlling for age and gender, Chamorros, the indigenous people of Guam, had a standardized incidence rate (IR = 151/100 000 person‐years, 95%CI = 129–173) of FEP over twice that of Whites (IR = 66/100 000 person‐years, 95%CI = 34–99). Individuals from Palau had the highest standardized incidence rate (IR = 832/100 000 person‐years, 95%CI = 581–1083). Increased neighbourhood Chamorro density was associated with decreased incidence of FEP among Chamorro individuals (IRR = 0.11, 95%CI = 0.03–0.43). After controlling for age, gender, ethnicity, and other neighbourhood factors, urbanicity (IRR = 3.82, 95%CI = 1.86–7.81), voting (IRR = 2.06, 95%CI = 1.32–3.20), poverty (IRR = 1.94, 95%CI = 1.40–2.67), and crime (IRR = 1.18, 95%CI = 1.00–1.40) remained statistically associated with FEP incidence.

Conclusions

The findings add to prior research that suggests that rates of mental health problems are higher in indigenous than in settler communities and are highest for indigenous people who live in neighbourhoods with few other indigenous individuals. Findings also suggest that even on a small island, with only ~150 000 people, urbanicity is associated with FEP. Finally, results are consistent with other research suggesting that the reduction of crime and social adversity can play a positive role in reducing the incidence of first episode psychosis.
A potential role for restricted intertactical heritability in preventing intralocus conflict
Authors: Gamble Madilyn M. , Calsbeek Ryan G.
Published: August 2021

Intralocus sexual conflict, which arises when the same trait has different fitness optima in males and females, reduces population growth rates. Recently, evolutionary biologists have recognized that intralocus conflict can occur between morphs or reproductive tactics within a sex and that intralocus tactical conflict might constrain tactical dimorphism and population growth rates just as intralocus sexual conflict constrains sexual dimorphism and population growth rates. However, research has only recently focused on sexual and tactical intralocus conflict simultaneously, and there is no formal theory connecting the two. We present a graphical model of how tactical and sexual conflict over the same trait could constrain both sexual and tactical dimorphisms. We then use Coho salmon (Oncorhynchus kisutch), an important species currently protected under the Endangered Species Act, to investigate the possibility of simultaneous sexual and tactical conflict. Larger Coho males gain access to females through fighting while smaller males are favored through sneaking tactics, and female reproductive success is positively correlated with length. We tested for antagonistic selection on length at maturity among sexes and tactics and then used parent–offspring regression to calculate sex‐ and tactic‐specific heritabilities to determine whether and where intralocus conflict exists. Selection on length varied in intensity and form among tactics and years. Length was heritable between dams and daughters (h2 ± 95% CI = 0.361 ± 0.252) and between fighter males and their fighter sons (0.867 ± 0.312), but no other heritabilities differed significantly from zero. The lack of intertactical heritabilities in this system, combined with similar selection on length among tactics, suggests the absence of intralocus conflict between sexes and among tactics, allowing for the evolution of sexual and tactical dimorphisms. Our results suggest that Coho salmon populations are unlikely to be constrained by intralocus conflict or artificial selection on male tactic.
A study on specific learning algorithms pertaining to classify lung cancer disease
Authors: Saminathan Malavika , Ramachandran Manikandan , Kumar Ambeshwar , Rajkumar Kulandaivel , Khanna Ashish , Singh Prakashkumar
Published: August 2021

Lung cancer is a worldwide precarious disease and it is encouraged by the abnormal growth of cells in bronchi. Spotting the cancer cells is unknown until it leads to respiration issues and the muddling of organs working. Due to problems, limited or incorrect selection of hypothesis space, and dropping into local minima, single learners often give erratic output in an existing approach. The ensemble method accomplished a dataset that is free and composed of computed tomography (CT) images. The annotation process reveals observed lung lesions and provides a degree of malignancy for each lesion. Detection of benign and malignant nodules is recognized using deep convolutional frameworks AlexNet, SqueezeNet, GoogleNet, ResNet, and Inception ResNet, achieves higher accuracy (93%) than other convolutional neural networks (CNNs). Eight machine learning methods are involved for achieving better performance. The prediction probability obtained from CNN is applied as input to support vector machines (SVM), K‐nearest neighbours (KNN), naive Bayes (NB), multi‐layer perceptron (MLP), decision trees (DT), gradient boosted regression trees (GBRT), and adaptive boosting. The composition of GoogleNet model and AdaBoost classifier reached the most coherent classification accuracy as 99%. This is one of the best ways to analyse early detection and it increases the survival rate. Therefore, the result from the proposed deep CNN and ML technique achieves better precision than sputum cytology, X‐Ray process, and earlier detection of lung cancer.
The data‐collection on adverse effects of anti‐HIV drugs (D:A:D) model for predicting cardiovascular events: External validation in a diverse cohort of people living with HIV
Authors: Anikpo Ifedioranma , Agovi Afiba Manza‐A. , Cvitanovich Matthew J. , Lonergan Frank , Johnson Marc , Ojha Rohit P.
Published: August 2021

Objectives

Little is known about the external validity of the Data‐collection on Adverse Effects of Anti‐HIV Drugs (D:A:D) model for predicting cardiovascular disease (CVD) risk among people living with HIV (PLWH). We aimed to evaluate the performance of the updated D:A:D model for 5‐year CVD risk in a diverse group of PLWH engaged in HIV care.

Methods

We used data from an institutional HIV registry, which includes PLWH engaged in care at a safety‐net HIV clinic. Eligible individuals had a baseline clinical encounter between 1 January 2013 and 31 December 2014, with follow‐up through to 31 December 2019. We estimated 5‐year predicted risks of CVD as a function of the prognostic index and baseline survival of the D:A:D model, which were used to assess model discrimination (C‐index), calibration and net benefit.

Results

Our evaluable population comprised 1029 PLWH, of whom 30% were female, 50% were non‐Hispanic black, and median age was 45 years. The C‐index was 0.70 [95% confidence limits (CL): 0.64–0.75]. The predicted 5‐year CVD risk was 3.0% and the observed 5‐year risk was 8.9% (expected/observed ratio = 0.33, 95% CL: 0.26–0.54). The model had a greater net benefit than treating all or treating none at a risk threshold of 10%.

Conclusions

The D:A:D model was miscalibrated for CVD risk among PLWH engaged in HIV care at an urban safety‐net HIV clinic, which may be related to differences in case‐mix and baseline CVD risk. Nevertheless, the HIV D:A:D model may be useful for decisions about CVD intervention for high‐risk patients.
Exploring the relationship between Ln leaching and Ln–O binding energy in monazite (Nd, Sm, Eu)
Authors: Zhao Xiaofeng , Li Yuxiang , Teng Yuancheng , Liu Hang , Zheng Xiayu , He Hongni , Wang Shanlin , Ahuja Rajeev
Published: August 2021

Understanding the chemical durability of waste forms is important for the long‐term deep geological disposal of actinides. However, in‐depth investigations on the leaching mechanism of monazite ceramic waste forms remain to be poorly understand. Inspired by the degradation process of Ce‐monazite controlled by the fracture of Ce–O bond of (010) surface under the action of permeable water molecules, the relationship between Ln leaching and Ln–O binding energy in LnPO4 (Ln = Nd, Sm, Eu) monazites is investigated by combining dissolution experiments and first‐principles calculations. The dissolution experiments are performed in 0.001 mol/L HCl solutions at 363 K. Before and after leaching, the phase compositions of specimens are carefully investigated by refined XRD and GIXRD, and the results confirm that the dissolved phases in contact with the leachate are LnPO4 monazite. Some specific issues are discussed in detail by first‐principles calculations, such as the bond length, charge transfer, electron localization function, and chemical bond properties. Moreover, the boundary conditions of crystal‐growing of LnPO4 monazite are investigated to define the chemical potential that is used to calculate the defect formation energy () of Ln vacancy in (010) surface. Importantly, the results show the difficulty order of forming a vacancy defect of Ln on (010) surface is Eu > Sm > Nd, which is consistent with the leaching stability of Ln in LnPO4 (Ln = Nd, Sm, Eu) monazite.
Phase equilibria in the ZrO2–Ta2O5–Nb2O5 system: Experimental studies and thermodynamic modeling
Authors: Luo Peide , Wu Xiang , Xiao Wenhui , Zhang Fan , Wang Yao , Huang Dandan , Du Yong
Published: August 2021

The phase relations in the ZrO2–Ta2O5–Nb2O5 system were experimentally investigated, and thermodynamic modeling was consequently performed in the present work. Samples with the selected compositions were synthesized using coprecipitation method, and then separately equilibrated at 1573 and 1673 K. The microstructural characterizations and phase analyses were carried out with the support of the X‐ray diffraction (XRD) and scanning electron microscopy (SEM/EDX). The phase transformations were measured through differential thermal analysis (DTA). No ternary compounds exist, while Ta2O5 and Nb2O5 phases substantially extend into the ternary system. Moreover, binary Ta2Zr6O17 and Nb2Zr6O17 phases form a continuous solid solution (A2Zr6O17) in the ternary system. A three‐phase equilibrium region β‐Ta2O5 + A2Zr6O17 + Nb2O5 was speculated. Based on the available literature, the ZrO2–Nb2O5, ZrO2–Ta2O5, and Nb2O5–Ta2O5 binary systems were critically evaluated and optimized by means of the CALPHAD (CALculation of PHAse Diagram) method. Combining with thermodynamic parameters of the binary systems, phase relations in the ternary system were extrapolated. However, the extrapolation cannot reproduce our experimental results, especially for the ternary solubilities of ZrO2 in the Ta2O5 and Nb2O5 phases and the melting behavior of selected samples. Finally, the ternary mixing parameters were introduced, and our experimental data were well reproduced by the improved thermodynamic descriptions.
Assessing the effectiveness of a game‐based phonics intervention for first and second grade English language learners in India: A randomized controlled trial
Authors: Patel Priyanka , Torppa Minna , Aro Mikko , Richardson Ulla , Lyytinen Heikki
Published: August 2021

Background

In 2018, it was found that only a quarter of Grade 3 children in India were reading at grade level. A growing demand for English education has further limited children's literacy achievement. Despite a strong evidence base in favour of using systematic phonics for building English literacy skills, many teachers in India continue to use rote‐methods of literacy instruction.

Objectives

We aimed to examine the efficacy of GraphoLearn (GL) English Rime, a computer‐assisted reading intervention, in improving the foundational literacy skills of 1st and 2nd grade students who were attending an English medium school in India.

Methods

A total of 136 students across 6 classrooms were randomly allocated to play either GL or a control math game over a 5‐week intervention period. Students were pre‐ and post‐tested on various English literacy skills using tasks built into the GL software as well as through oral and paper‐based tasks.

Results and Conclusions

Students who played GL showed significantly greater and faster development on in‐game measures of letter‐sound knowledge, rime unit recognition, and word recognition as compared to students who did not play GL. In addition, GL resulted in greater effects on these measures for students with stronger English literacy skills prior to the start of the intervention. No differences were found between groups on the oral and paper‐based tasks.

Implications

GL was able to quickly and effectively teach critical sub‐skills for reading. However, a lack of effects on the out‐of‐game measures opens the door for further discussion on the successful implementation of such interventions.