bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel lung radiomics feature for characterizing resting heart rate and COPD stage evolution based on radiomics feature combination strategy
Authors: Yang Yingjian ,   College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China, Li Wei , Kang Yan , Guo Yingwei , Yang Kai , Li Qiang , Liu Yang , Yang Chaoran , Chen Rongchang , Chen Huai , Li Xian , Cheng Lei ,   Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China,   Engineering Research Centre of Medical Imaging and Intelligent Analysis, Ministry of Education, Shenyang 110169, China,   Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University, Shenzhen 518001, China,   The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518001, China,   Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China,   Shenzhen Happy-Growing Intelligent CO., Ltd, Shenzhen 518118, China
Published: February 2022

The resting HR is an upward trend with the development of chronic obstructive pulmonary disease (COPD) severity. Chest computed tomography (CT) has been regarded as the most effective modality for characterizing and quantifying COPD. Therefore, CT images should provide more information to analyze the lung and heart relationship. The relationship between HR variability and PFT or/and COPD has been fully revealed, but the relationship between resting HR variability and COPD radiomics features remains unclear. 231 sets of chest high-resolution CT (HRCT) images from "COPD patients" (at risk of COPD and stage I to IV) are segmented by the trained lung region segmentation model (ResU-Net). Based on the chest HRCT images and lung segmentation images, 231 sets of the original lung parenchyma images are obtained. 1316 COPD radiomics features of each subject are calculated by the original lung parenchyma images and its derived lung parenchyma images. The 13 selected COPD radiomics features related to the resting HR are generated from the Lasso model. A COPD radiomics features combination strategy is proposed to satisfy the significant change of the lung radiomics feature among the different COPD stages. Results show no significance between COPD stage Ⅰ and COPD stage Ⅱ of the 13 selected COPD radiomics features, and the lung radiomics feature Y1-Y4 (P > 0.05). The lung radiomics feature F2 with the dominant selected COPD radiomics features based on the proposed COPD radiomics features combination significantly increases with the development of COPD stages (P < 0.05). It is concluded that the lung radiomics feature F2 with the dominant selected COPD radiomics features not only can characterize the resting HR but also can characterize the COPD stage evolution.
Factors Affecting the Deployment of Learning Analytics in Developing Countries: Case of Egypt
Authors: Mahmoud Mai , Dafoulas Georgios , Abd ElAziz Rasha , Saleeb Noha
Published: February 2022

The higher education institutions in developing countries such as Egypt are challenged with the high enrollment student rates, crowded classes, and inability to track the progress of each student individually which increased the demand to find a solution that can redeem those problems. Although the usage of learning analytics is an expanding solution to support different educational challenges from performance tracking to detecting students at risk, learning analytics’ developments concentrated on addressing solutions for developed countries. Accordingly, the discipline still requires a broader and in-depth interpretation of its contextual usage in developing countries, especially Egypt. A research model has been constructed based on literature and tested for its validity and reliability. A questionnaire has been distributed to 148 university students. The study used smart-PLS to interpret and analyze the collected data. The study revealed that organizational culture, data accessibility, trustworthiness, visualization has a positive effect on awareness, while lack of ability has a negative effect on awareness. both infrastructure and awareness have a significant positive effect on learning analytics impact. The research indicates high learning analytics awareness and a high perceived impact on Egyptian higher education. More evidence should be extracted with the collection of more insights from students, faculty members, and decision-makers.
Infrastructure Capacity Planning in Digitalization of Educational Services
Authors: Petrov Pavel , Radev Mihail , Dimitrov Georgi , Simeonidis Dimitrios
Published: February 2022

Capacity planning of the infrastructure is a difficult task performed during the virtualization of the IT infrastructure. It is the planning of the necessary hardware to which the existing systems will be transferred, and later the future systems that will work in a virtualized environment. Infrastructure capacity planning in digitalization of educational services is a process in which the IT infrastructure is needed to meet not only the current workload but also the future workload and to follow further requirements. In case the process of planning is well performed, it could more fully support the development of emerging technologies in learning. The traditional IT infrastructure, bound by the physical limitations of the devices, does not meet the requirements for flexible changes, for quick recovery after a problem. This leads to difficult management, to weaknesses in the implementation of educational processes. Virtualization could solve most of these problems for modern IT infrastructures. It provides highly efficient and reliable operation of operating systems and applications that do not depend on the computer system.
Recommendation of Online Learning Resources for Personalized Fragmented Learning Based on Mobile Devices
Authors: Xu Shuoyan
Published: February 2022

Fragmented learning aims to fully utilize fragmented time slices to learn and accumulate fragmented knowledge. The current mobile online learning apps fail to fully consider the preferences, demands, and adaptability of users. The content and difficulty of the recommended resources are not in match with user features. Therefore, this paper explored the issue of the recommendation of personalized online learning resources for fragmented learning based on mobile devices. Firstly, the authors developed an architecture for the adaptive recommendation model of online learning resources, modeled the learners and fragmented learning resources. Next, the recommendation model was constructed for personalized online learning resources, the flow of the recommendation engine was detailed, and the degrees of resource recommendation and matching were calculated. The proposed model was proved valid through experiments.
RESIDENTIAL ARCHITECTURE IN A POST-PANDEMIC WORLD: IMPLICATIONS OF COVID-19 FOR NEW CONSTRUCTION AND FOR ADAPTING HERITAGE BUILDINGS
Authors: Spennemann Dirk HR
Published: February 2022

COVID-19 has highlighted the disruptive, cross-sectorial effects a sudden-onset pandemic has on a globally interconnected world. A particularly insidious component is the high percentage of asymptomatic cases allowing the virus to seed undetected. The design of residential architecture will need to adapt to the new reality that COVID-19 will not be the last coronavirus epidemic. This paper discusses the implications of COVID-19 for new residential construction. It argues for a containment space, separating the largely uncontrollable external environment from the internal threat-reduced residential space, for a separation of visitor entertainment areas and private sleeping areas, as well as the design of a spatially separated master bedroom that can double as a self-isolation space if the need arises. The implications of this new design on existing housing stock are also discussed. The advocated concepts are novel and advance the design considerations for future residential developments.
« Cantonards » et « communeux ». La révolution cantonale espagnole dans l’ombre de la Commune (1873)
Authors: Moisand Jeanne
Published: February 2022

Pendant l’été 1873, de nombreuses Républiques municipales sont proclamées en Espagne. La plus durable s’établit à Carthagène, où elle défie pendant six mois la République modérée établie à Madrid. Cet article s’interroge sur les liens entre cet événement (la révolution dite « cantonale ») et les Communes françaises de 1871. À l’inverse de l’historiographie établie, il montre que les deux révolutions étaient non seulement comparables mais qu’elles furent en outre liées entre elles. Restée dans l’ombre de sa voisine française, l’insurrection espagnole n’en possédait pas moins une grande autonomie et une puissance propre.
Le communalisme naît-il de la Commune ?
Authors: Cossart Paula
Published: February 2022

La Commune de Paris, référence récurrente des diverses expériences se réclamant du communalisme ou du municipalisme, constitue paradoxalement un modèle faible, voire un contre-modèle, pour le principal théoricien du communalisme, Murray Bookchin. Nous analysons ici la critique que ce dernier élabore du centralisme de l’expérience de 1871 et de sa célébration par Marx, et cherchons à comprendre pourquoi, par contraste, la Commune n’en reste pas moins une source d’inspiration importante pour les promoteurs actuels du néo-municipalisme. Pour interroger plus avant l’apport possible de la Commune de Paris aux traditions communalistes ou municipalistes, nous revenons ensuite à ce que les travaux historiques permettent d’affirmer quant à la réalité de l’expérience communarde. Si elle exprime bel et bien une volonté d’instaurer une République démocratique et sociale adossée au communalisme, il faut dépasser la seule échelle du Conseil de la Commune et de ses commissions, pour constater l’existence d’une démocratie directe de quartier, fondée sur les assemblées des organisations populaires.
La Commune avant Haussmann. Ville et Cité dans le Grand Paris du xixe siècle
Authors: Frondizi Alexandre
Published: February 2022

Dans leur récent bilan commun des interprétations sociologiques de la Commune de Paris, Jacques Rougerie et Robert Tombs appellent à enrichir par des enquêtes micro-analytiques le travail de Roger Gould sur les rapports entre haussmannisation, réseaux sociaux et identités révolutionnaires. L’article répond à l’invitation en soumettant le film historiographique de « la reconquête de la Ville par la Ville » à un jeu d’échelles et de temporalités qui en décortique la chrono-logie et discute la centralité accordée aux effets des opérations urbaines du Second Empire sur les motivations, les formes de mobilisation et la géographie du mouvement communaliste de 1871. L’appréhension dans une plus longue durée du lien entre urbanisation et révolution, entre « grande ville » et « grande cité », révèle la vitalité préhaussmannienne de la politisation des communes périphériques du Grand Paris du xixe siècle et conduit alors à la formulation de nouvelles pistes de recherche.
Circulation des idées : dynamiques sociales et conceptuelles dans le transfert des doctrines socialistes de la France à la Pologne (1831-1848)
Authors: Kuligowski Piotr
Published: February 2022

D’abord formulées en Grande-Bretagne et en France, les idées socialistes sont progressivement exportées jusqu’à la périphérie orientale du continent européen dès la première moitié du XIXe siècle, notamment en Pologne, Roumanie et Russie. Ce transfert n’est pas sans soulever de nombreuses interrogations : comment ces constructions idéologiques, conditionnées par des enjeux historiques nouveaux, spécifiques à l’Europe occidentale (industrialisation, urbanisation, etc.), ont-t-elle pu s’adapter au contexte culturel de territoires majoritairement agricoles et ruraux, très différents sur le plan économique, social et politique ? Cet article entend contribuer à résoudre cette énigme en présentant les principaux déterminants qui conduisirent au transfert des idées socialistes françaises en Pologne au cours de la période 1831-1848.
The Geography of the COVID-19 Outbreak in Namibia
Authors: Tubulingane Booysen Sabeho , Mwewa Lameck , Dittmann Andreas
Published: February 2022

Spatial analysis of COVID-19 spread is an important tool for public health management, as a Geographic Information System (GIS) platform can support the entire process of infectious disease surveillance, preparedness and response. Consequently, this study applied regression analysis using r software and QGIS mapping to evaluate how COVID-19 infections are impacted by population dynamics, urbanisation, area temperature and tourism activities in Namibia. Study results revealed that, COVID-19 transmission is positively associated with urbanisation and negatively associated with temperature. Area population size is not associated with COVID-19 transmission. To reduce COVID-19 infections in Namibia, efforts need to be directed at minimising social and economic contact activities, particularly in urban areas. The Namibia society is also encouraged to adhere to the recommended COVID-19 public health measures such as social distancing of 1.5 meters apart and wearing of face masks in public spaces.
A Geospatial Assessment Framework of Seismic and Landslide Risk Using GIS
Authors: Konti Christina , Vatalis Konstantinos I.
Published: February 2022

Region of Epirus located in NW Greece, is an area, that many landslides are recorded every year and earthquakes had impact in the infrastructures and human’s life in the past. In order to assess the seismic and the landslide risk, a susceptibility map was created and validated based on the landslide recordings, using the Rock Engineering System (RES) method, buffer zones were also created for each fault that was selected and calculations using empirical mathematical formulas were used to examine the potential as well as the maximum and the average ground displacement and finally a geodatabase was developed. The landslide susceptibility map and buffer zones were examined in relation to the proximity of the settlements, the road network and the cultural monuments of the area and many useful conclusions were exported, as an initial effort of recording the built environment that could potentially be vulnerable and affected.
Clustering Patterns and Hot Spots of Opioid Overdoses in Louisville, Kentucky
Authors: Hess Gregory S. , Zhang Charlie H.
Published: February 2022

Using data obtained from the Louisville Metro Emergency Medical Services, this article examined the spatial and temporal patterns of opioid overdoses in Louisville, Kentucky. We aggregated opioid overdoses to street segments and applied the optimized hot spot analysis to identify areas with significant high overdose rates. Multiple spatial regression models were used to explore the ecological risk factors potentially associated with the spatial variations of the epidemic. The results suggest an overall clustered pattern of opioid overdoses with all overdose incidents concentrated in less than 8% of all the street segments. The consecutive hot spots largely overlapped with the most disadvantaged inner-city neighborhoods in Louisville. Regression results provided statistical evidence regarding the effects of socioeconomic correlates including uninsured, vacancy rates, and criminal activity. The spatial discrepancy between the overdose hot spots and lack of medical facilities or hospitals in the disadvantaged neighborhoods points to the critical issue of health inequity.
Defining Success in a Language MOOC From Learner Perspectives
Authors: Jitpaisarnwattana Napat , Darasawang Pornapit , Reinders Hayo
Published: February 2022

Despite their popularity, there remains a challenge as to how success should be measured in Language MOOCs. Although traditional metrics such as completion rates have often been adopted, they have failed to take into account the fact that learners enrol in LMOOCs with different learning goals. This study examined how success is perceived in an LMOOC on English presentations from learners’ perspectives. Data were collected through 137 questionnaire responses and 22 semi-structured interviews. The quantitative results showed that the majority of learners who completed the course, as well as those who dropped out, thought that they were successful in learning in this LMOOC. Qualitative results showed that course completion was not the primary reason for their perceived success. Rather, they attributed their success to learning specific aspects of the course, language development, applications of the content to their work or study and achieving their learning goals. The authors conclude with suggestions and implications as to how success can be measured in future LMOOC implementation.
A Case Study of Technology-Assisted Flipped Learning in Enhancing Learner Translation Capabilities and Its Mitigated Challenges
Authors: Nguyen Nhat Quang , Lee Kean Wah , Szabo Csaba Zoltan , Nguyen Dung Ngoc Phuong
Published: February 2022

This study presents a flipped classroom approach tailored to provide dynamic instructional learning of one translation module in Vietnam. The model took consideration of relevant factors of Activity theory (instruments, rules, community and division of labour) to (1) investigate how it could re-orientate learners’ translation habits, and (2) find out the mitigated challenges encountered by Vietnamese learners. 39 junior students at a public university in Vietnam participated in the study. The research implemented a case study design, using semi-structured interviews to examine in depth the benefits of this flipped setting and its actual challenges. The collected findings revealed that this approach could not only bridge the gaps in the relevant literature of flipped learning, but also could improve learners’ habits to use appropriate translation strategies. Finally, challenges faced by learners during the implementation were minimised, thanks to the systematic structure of the flipped classroom procedure and Activity theory.
The Effect of Serious Mobile Games on Student English Vocabulary Acquisition and Attitude Toward English
Authors: Kara Nuri
Published: February 2022

The main aim of this study was to explore the effect of the serious mobile game Jumo the Jumper on the vocabulary acquisition of primary school English as a Foreign Language (EFL) students and their attitudes toward an EFL course. The main research design of the study was a quasi-experimental design with nonequivalent control groups that included pre-test and post-test control groups. Twenty students in the experimental group played the serious mobile game aimed at teaching English vocabulary about the “animals” unit for four weeks, while 20 students in the control group received traditional, curriculum-based tuition. Based on the analysis of the independent sample t-test, the use of the serious mobile game Jumo the Jumper in primary school classrooms had a significant effect on the vocabulary acquisition of the students compared to traditional instruction. On the other hand, the serious mobile game did not have a significant effect on the students’ attitudes toward the EFL course.
Enablers and Challenges for E-Health Services
Authors: Kumari Ranjani , Singh Alok Kumar , Verma Rajeev , Fetais Abdulla Hamad M. A.
Published: February 2022

The purpose of the paper is to systematically review the literature of enablers and challenges for implementation and adoption e-health service. The review aims to identify the most critical success factors and barriers related with the development and growth of the e-health services under different circumstances. A total 68 relevant publications related to enablers and challenges of e-health services were selected from a total 694 research papers. These publications were thoroughly reviewed to find out the critical factors influencing the e-health services. The findings indicate that there are five broad factors viz. technological, environmental, organizational, social and economical along with four major stakeholders’ viz. citizens, patients, caregivers and service providers which influence the e-health services. These factors act as enablers as well as challenges for proper implementation and adoption of e-health services in different situations. On the basis of the findings of the review, a conceptual diamond model of e-health services adoption has been proposed.
An Exploration of Trust as an Antecedent of Unified Payment Interface Usage
Authors: Saha Poulami , Kiran K.B.
Published: February 2022

Introduction of UPI has revolutionized the Indian banking system and since then dynamics of payment ecosystem has noted a major transformation. UPI has proved to be a boon in the pandemic situation by facilitating contactless and remote transactions. Thus it is crucial to study user acceptance of payments using UPI and factors influencing its usage. The present paper extended UTAUT3 (Unified Theory of Acceptance and Use of Technology) with an additional construct called 'trust'. Studies on behavioral intention are not rare. But behavioral intention towards UPI usage is not yet explored. What makes this study unique is its attempt to use both SEM and Neural Network to analyze data. It will guide future researchers to pursue technology adoption studies using this multi-method technique. The novelty also resides in the fact that trust, the newly added construct, has proved to be the most important antecedent of behavioral intention towards UPI usage.
Early Detection of Alzheimer's Disease Using Bottleneck Transformers
Authors: Jaiswal Arunima , Sadana Ananya
Published: February 2022

Early detection of Alzheimer's disease (AD) and its prodromal state, mild cognitive impairment (MCI), is crucial for providing suitable treatment and preventing the disease from progressing. It can also aid researchers and clinicians in identifying early biomarkers and ministering new treatments that have been a subject of extensive research. The application of deep learning techniques on structural magnetic resonance imaging (MRI) has shown promising results in diagnosing the disease. In this research, the authors intend to introduce a novel approach of using an ensemble of the self-attention-based bottleneck transformers with a sharpness-aware minimizer for early detection of Alzheimer's disease. The proposed approach has been tested on the widely accepted ADNI dataset and evaluated using accuracy, precision, recall, F1 score, and ROC-AUC score as the performance metrics.
A Novel Approach for Band Selection Using Virtual Dimensionality Estimate and Principal Component Analysis for Satellite Image Classification
Authors: Sehgal Smriti , Ahuja Laxmi , Bindu M. Hima
Published: February 2022

Images, being around us in every aspect of life, have become an emerging field of research. Extensive image analysis has been done on binary as well as coloured images, which has led various researchers to explore images having deep spectral knowledge about a particular area of interest. High resolution images, having more than three spectral bands, capture minute details of an object in various spectral bands resulting in high computational complexity. In this paper, the authors have tried to reduce the complexity of multispectral image by selecting only the relevant bands need to reconstruct an image. Traditional principal component analysis technique is used for band selection of true color bands and classification-assessed results of both the images; original and dimensionality reduced images are compared using partitioning clustering technique. Experimental results show that compressed image after reduction of bands by PCA yields better classification results than the original image.
The Good, Bad, and Ugly of Remote Work During COVID-19
Authors: Nobles Calvin , Nichols Kenneth W. , Burrell Darrell Norman , Reaves April
Published: February 2022

The emergence of COVID-19 in the U.S. forced organizations to make unprecedented changes at a record pace to include a sharp uptick in the number of employees working remotely. The researchers aimed to explore what factors influenced positive remote working experiences. Data collection consisted of capturing the lived experiences of remote working employees from various industries who conducted electronic journaling and semi-structured interviews with open-ended questions. Data analysis involved qualitative content analysis that resulted in the five themes classified into two categories: (a) business-driven factors and (b) individual-based factors. The business-driven factors include (a) social factors, (b) organizational factors, (c) technological factors. The individual-based elements consist of (a) personal factors and (b) professional factors. From the data analysis, the researchers developed a Conceptual Framework: COVID-19 Remote Working Model. The conceptual model illustrates the potentiality of enhancing positive remote working experiences based on the conducted research.
Control Supply Chain Risks in Digital Transformation
Authors: Gao Yang , Leng Yubing , Shan Biaoan
Published: February 2022

Digital transformation contributes to enterprise supply chain resilience, but how to control the risks involved and whether this control contributes to supply chain resilience remains to be explored. This paper aims to clarify the relationship between risk control and resilience in the process of digital transformation and to construct a digital transformation supply chain risk (DTSCR) control process system. In this paper, we first use the SLRs method to retrieve 469 papers to construct a dimensional system of DTSCR from the theoretical perspective; we then test whether DTSCR control helps supply chain resilience through a structural equation model; finally, based on the case study of the institute of building materials of China Academy of Building Research, we use a Bayesian believe network to construct a risk control system. Our research contributes to existing literature by improving supply chain resilience from a risk perspective, and the risk control system innovatively constructed in this paper is also of significance for enterprises to carry out DTSCR control in practice.
Developing Competence in Tooth Extractions during Undergraduate Dental Education – A Qualitative Study
Authors: Ali K. , Siddiqi K. M. , Qazi H. S.
Published: February 2022

Purpose: To gain a deeper understanding of factors which contribute to development of competence in tooth extractions during undergraduate dental education. Methods: A qualitative approach was used to explore the perceptions and experiences of a range of stakeholders. Purposive sampling was used to recruit the participants which included undergraduate dental students, new graduates, dental academic staff, and clinical supervisors. The focus groups were transcribed verbatim, and data were imported into NVivo 12. Data were analyzed thematically using an inductive approach. Results: Two focus groups were conducted. Ten undergraduate students participated in the Student Focus Group while eight dental academics and clinical supervisors participated in the Staff Focus Group. Participants expressed their views on a range of issues related to teaching and training of tooth extractions. The key themes cantered on structured teaching underpinned by patient safety; focus on breadth of clinical experience; and constructive feedback to enhance reflective practice amongst students to enhance the learning experiences of students. Conclusions: This study provides useful insights into how undergraduate dental students develop competence in tooth extractions as perceived by the participants and may help dental educators to reflect of their teaching model.
IL-10 Receptor Blockade Delivered Simultaneously with Bacillus Calmette–Guérin Vaccination Sustains Long-Term Protection against Mycobacterium tuberculosis Infection in Mice
Authors: Dwivedi Varun , Gautam Shalini , Headley Colwyn A , Piergallini Tucker , Torrelles Jordi B , Turner Joanne
Published: February 2022

Mycobacterium bovis bacillus Calmette–Guérin (BCG) immunization still remains the best vaccination strategy available to control the development of active tuberculosis. Protection afforded by BCG vaccination gradually wanes over time and although booster strategies have promise, they remain under development. An alternative approach is to improve BCG efficacy through host-directed therapy. Building upon prior knowledge that blockade of IL-10R1 during early Mycobacterium tuberculosis infection improves and extends control of M. tuberculosis infection in mice, we employed a combined anti–IL-10R1/BCG vaccine strategy. An s.c. single vaccination of BCG/anti–IL10-R1 increased the numbers of CD4+ and CD8+ central memory T cells and reduced Th1 and Th17 cytokine levels in the lung for up to 7 wk postvaccination. Subsequent M. tuberculosis challenge in mice showed both an early (4 wk) and sustained long-term (47 wk) control of infection, which was associated with increased survival. In contrast, protection of BCG/saline-vaccinated mice waned 8 wk after M. tuberculosis infection. Our findings demonstrate that a single and simultaneous vaccination with BCG/anti–IL10-R1 sustains long-term protection, identifying a promising approach to enhance and extend the current BCG-mediated protection against TB.
Targeting IFN-λ Signaling Promotes Recovery from Central Nervous System Autoimmunity
Authors: Manivasagam Sindhu , Williams Jessica L , Vollmer Lauren L , Bollman Bryan , Bartleson Juliet M , Ai Shenjian , Wu Gregory F , Klein Robyn S
Published: February 2022

Type III IFNs (IFNLs) are newly discovered cytokines, acting at epithelial and other barriers, that exert immunomodulatory functions in addition to their primary roles in antiviral defense. In this study, we define a role for IFNLs in maintaining autoreactive T cell effector function and limiting recovery in a murine model of multiple sclerosis (MS), experimental autoimmune encephalomyelitis. Genetic or Ab-based neutralization of the IFNL receptor (IFNLR) resulted in lack of disease maintenance during experimental autoimmune encephalomyelitis, with loss of CNS Th1 effector responses and limited axonal injury. Phenotypic effects of IFNLR signaling were traced to increased APC function, with associated increase in T cell production of IFN-γ and GM-CSF. Consistent with this, IFNL levels within lesions of CNS tissues derived from patients with MS were elevated compared with MS normal-appearing white matter. Furthermore, expression of IFNLR was selectively elevated in MS active lesions compared with inactive lesions or normal-appearing white matter. These findings suggest IFNL signaling as a potential therapeutic target to prevent chronic autoimmune neuroinflammation.
Endothelial dysfunction in COVID-19 patients assessed with Endo-PAT2000
Authors: Cimino Giuliana , Vizzardi Enrico , Calvi Emiliano , Pancaldi Edoardo , Pascariello Greta , Bernardi Nicola , Cersosimo Angelica , Amore Ludovica , Inciardi Riccardo M. , Raddino Riccardo , Metra Marco
Published: February 2022

It has been widely reported that the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) attaches human cells by using the Angiotensin Converting Enzyme 2 (ACE2) receptor, but vascular impairment described during coronavirus disease 2019 (COVID-19) infection is primarily due to the direct involvement of the endothelial cells by the virus or secondarily to the inflammatory host response is currently unknown. We therefore aimed to demonstrate in vivo the presence of endothelial dysfunction in six COVID-19 patients without cardiovascular risk factors or pre-existing cardiac condition, using the Endo-PAT 2000, a device able to measure endothelial vasodilation function in a rapid and non-invasive way. Four patients were positive for endothelial dysfunction, with RHI values between 1.13-1.56 (average value 1.32, normal values >1.67); in one of the two negative patients the reported RHI value was slightly above the cutoff (1.72). Our findings confirm that COVID-19 patients are at higher risk of developing endothelial dysfunction. In addition, our results demonstrate that endothelial impairment may occur even in the absence of cardiovascular risk factors.
Modulation of SIRT1 expression improves erectile function in aged rats
Authors: Yu Wen , Wang Jing , Dai Yu-Tian , Wang Bin , Xu Yang , Gao Qing-Qiang , Xu Zhi-Peng
Published: February 2022

Silent information regulator 2-related enzyme 1 (SIRT1) is an aging-related protein activated with aging. Herein, we evaluated the role of SIRT1 in aging-related erectile dysfunction. The expression of SIRT1 was modulated in aged Sprague-Dawley rats following intragastric administration of resveratrol (Res; 5 mg kg−1), niacinamide (NAM; 500 mg kg−1) or Res (5 mg kg−1) + tadalafil (Tad; phosphodiesterase-5 [PDE5] inhibitor; 5 mg kg−1) for 8 weeks. Then, we determined erectile function by the ratio of intracavernosal pressure (ICP)/mean systemic arterial pressure (MAP). Cavernosal tissues were extracted to evaluate histological changes, cell apoptosis, nitric oxide (NO)/cyclic guanosine monophosphate (cGMP), the superoxide dismutase (SOD)/3,4-methylenedioxyamphetamine (MDA) level, and the expression of SIRT1, p53, and forkhead box O3 (FOXO3a) using immunohistochemistry, terminal deoxynucleotidyl transferase (TdT)-mediated 2’-deoxyuridine 5’-triphosphate (dUTP) nick-end labeling (TUNEL), enzyme-linked immunosorbent assays, and western blot analysis. Compared with the control, Res treatment significantly improved erectile function, reflected by an increased content of smooth muscle and endothelium, NO/cGMP and SOD activity, and reduced cell apoptosis and MDA levels. The effect of Res was improved by adding Tad. In addition, the protein expression of SIRT1 was increased in the Res group, accompanied by decreased p53 and FOXO3a levels. In addition, inhibition of SIRT1 by NAM treatment resulted in adverse results compared with Res treatment. SIRT1 activation ameliorated aging-related erectile dysfunction, supporting the potential of SIRT1 as a target for erectile dysfunction treatment.
Prevalence of vitamin D deficiency and persistent hyperparathyroidism in an Egyptian cohort of renal transplant recipients
Authors: Gawish Rasha I. Abd Elrazek , Hatab Ahmed Abd E.A. , Zeid Montaser M.
Published: February 2022

Background

Vitamin D metabolism might be influenced by impaired allograft function and by persistently elevated parathyroid hormone (PTH) and fibroblast growth factor 23 levels as well. Hyperparathyroidism is a frequent and sometimes severe complication following renal transplantation.

Purpose

The primary objective was to measure the prevalence of vitamin D deficiency in renal transplant recipients in a single center (Almowasah Hospital). The secondary objective was to determine predictors of low 25-hydroxyvitamin D levels using patient characteristics to identify patients at a higher risk of vitamin D deficiency.

Patients and methods

A retrospective cross-sectional study was conducted on 55 renal transplant recipients for whom 25-hydroxyvitamin D was measured. Intact PTH was measured as well and compared with pretransplant values.

Results

The majority of the patients, representing ∼81.8%, were vitamin D deficient, whereas 14.5% had insufficient serum vitamin D level. A minority of the patients (3.6%) showed sufficient vitamin D level. The mean vitamin D level was 15.13±7.03 ng/ml. Approximately 38.2% of the patients showed evidence of persistent hyperparathyroidism. The median PTH level was higher in the pretransplant period, with a value of 308.0 pg/ml, compared with the posttransplant period (121.0 pg/ml). The difference was statistically significant (P<0.001). Serum PTH level showed a reduction in its level by ∼55.79% after transplantation.

Conclusion

Vitamin D deficiency is highly prevalent in renal transplant recipients. It is also more prevalent in early than late transplant recipients, and there is a statistically significant inverse correlation between vitamin D and PTH.
Trends and Outcomes of Coronary Artery Bypass Grafting in Patients with Major Depressive Disorder
Authors: Del Re Andrew , Rivera Perla Krissia M. , Aghagoli Ghazal , Bellam Krishna , Sellke Frank W , Ehsan Afshin
Published: February 2022

Purpose:

Coronary artery disease is a major cause of morbidity and mortality in the United States, representing the highest proportion of deaths due to cardiovascular disease. Treatment of coronary artery disease ranges from prevention to intervention, with the latter warranting a decision between surgical versus percutaneous revascularization. Medical optimization before coronary artery bypass grafting (CABG) is an important step in the care continuum. While the optimization of many risk factors such as smoking has been studied extensively, the inclusion of mental health conditions in preoperative health assessment is not yet standard of care. Major depressive disorder (MDD) is the most prevalent mental health disorder and has been shown to affect physiological processes that are critical in recovery after cardiac surgery.

Methods:

We queried the national inpatient sample from 2000 to 2017 for patients ≥18 years undergoing CABG with and without MDD. Patients who left against medical advice were excluded. Patients with a diagnosis of MDD were compared against those without. Our primary outcomes were in-hospital mortality, favorable discharge (home or home with services), and length of stay. Multivariable models were used for the various outcomes and each model adjusted for confounding variables.

Results:

A total of 2,988,997 met clinical criteria for inclusion including 108,782 with an MDD diagnosis. Most patients were male (n = 2,135,804, 71.46%), White (n = 2,417,216, 80.87%), and the average age was 66.3 years (standard deviation = 10.8 years). After adjustment, patients with a diagnosis of MDD were found to have lower odds of in-hospital mortality (odds ratio [OR] [95% confidence interval {CI}] 0.64 [0.56–0.73], P < 0.001) and had decreased odds of home discharge (OR = 0.66 [0.63–0.69], P < 0.001) after CABG. Overall, length of stay was similar between the groups, with MDD patients having a slightly longer length of stay (β-coefficient = 1.03 [1.03–1.04], P < 0.001). Patients with a diagnosis of MDD were also found to have lower odds of acute kidney injury (OR = 0.70 [0.61–0.81], P < 0.001), cardiogenic shock (OR = 0.75 [0.68–0.83], P < 0.001), infection (OR = 0.78 [0.69–0.89], P < 0.001), transient ischemic attack/stroke (OR = 0.75 [0.63–0.89], P = 0.001), acute liver injury (OR = 0.45 [0.34–0.61], P < 0.001), and acute limb ischemia (OR = 0.57 [0.40–0.82], P = 0.003).

Conclusions:

Patients with a diagnosis of MDD have decreased odds of postoperative morbidity and mortality after CABG in addition to having lower odds of home discharge. The present study suggests a need for prospective investigations on the impact of MDD diagnosis and outcomes after CABG to further understand this relationship.
The frequency, related cause of disease, and treatment of hepatitis B virus infection
Authors: Kalvandi Gholamreza , Abangah Ghobad , Veisani Yousef , Nourmohammadi Hassan , Golitaleb Mohamad , Tavan Hamed
Published: February 2022

Background:

Hepatitis B virus (HBV) is one of the most dreadful viruses causing high mortality rates and serious damages to hepatocytes. The aim of this study was to assess the frequency, related causes/risk factors, and treatments of HBV infection in Iran by systematic review and meta-analysis.

Materials and Methods:

The data were obtained by a literature search in the PubMed, Scopus, SID, and Web of Sciences databases. Keywords included prevalence, risk factors, causes, treatment, and HBV. The Persian equivalents of these keywords were also searched. The time span included 2004 to2021. The Q and I
2 statistics were used to check heterogeneity among studies. The data were analyzed using Stata (version 14).

Results:

The frequencies of HBV infection and its pharmaceutical therapy were P = 6% (95% confidence interval [CI]: 4–9, I
2 = 95.2%, P < 0.001) and 19% (95% CI: 18%–30%, I
2 = 98.9%, P < 0.001), respectively. The most common risk factors/causes of HBV were narcotic consumption, blood-related factors, and transmission from infected individuals with the respective frequencies of 27% (95% CI: 16%–38%, I
2 = 88.7%, P < 0.001), 32% (95% CI: 11%–53%, I
2 = 99.8%, P < 0.001), 25% (95% CI: 10%–41%, I
2 = 99.3%, P < 0.001), and 15% (95% CI: 7%–22%, I
2 = 98.4%, P < 0.001), respectively.

Conclusion:

The most important causes of HBV infection were transmission from infected people, narcotic consumption, and blood-related factors. The main therapeutic intervention for HBV was pharmaceutical therapy.
A new ratio derived from inflammasome markers can serve as a marker of assessment of glycemic index in children with Type 1 diabetes
Authors: Dezayee Zhian M I , Al-Nimer Marwan S M
Published: February 2022

Background:

Mature inflammasome markers play a role in the development of Type 1 diabetes (T1D). This cross-sectional study aimed to derive ratios from the serum levels of interleukins (ILs): IL-1β and IL-18 and to relate their values with glycemic index and anti-inflammatory markers (IL-4 and IL-10) in children with T1D.

Materials and Methods:

This study was conducted at Hawler Medical University in Erbil-Iraq from April to July 2018. Healthy subjects (Group I, n = 40) and patients (Group II, n = 76) were recruited from primary schools and the Center of Diabetes in Erbil, respectively. Glycemic indices (including fasting serum glucose, insulin, glycosylated hemoglobin, and peptide C) and pro- and anti-inflammatory markers (including high-sensitivity C-reactive protein, IL-1β, IL-18, IL-4, and IL-10 and the ratio of neutrophil or platelet to lymphocyte) were determined.

Results:

Cutoff values of 105 pg/mL, 85 pg/mL, and 1.235 for serum IL-1β, IL-18, and IL-1β to IL-18 ratio, respectively, were found to be significant discriminators of glycemic index and anti-inflammatory markers with respect to the calculated area under the curve.

Conclusion:

A ratio of IL-1β to IL-18 adjusted to 1.235 can serve as a useful marker of assessment of glycemic index. This ratio does not discriminate the status of anti-inflammatory markers (IL-4 and IL-10) in children with T1D.
Validation of Self-Assessed Form of Diagnostic Criteria for Psychosomatic Research Adapted from Diagnostic Criteria for Psychosomatic Research - Structured Interview
Authors: Goli Farzad , Roohafza Hamidreza , Khani Azam , Afshar Hamid
Published: February 2022

Background:

As the diagnostic criteria for psychosomatic research-structured interview (DCPR-SI) is a rater-assessed questionnaire, it has not been used vastly in community-based studies and clinics. Describing and investigating self-assessed form of DCPR are an attempt to apply it easier and more worthwhile for medical settings. The aim of this study was to describe and present self-assessed form of DCPR self-assessed (DCPR-SA) and test its validity and reliability.

Materials and Methods:

The DCPR-SI was translated to Persian according to the best practice methodology and the guideline for adaptation of self-report measures. In this cross-sectional study, 540 patients and healthy individuals were recruited and answered DCPR-SA and some related questionnaires. Inter-rater (test–interview) and test–retest reliability were determined. Construct, concurrent, discriminant, and known-group validity were tested.

Results:

The kappa coefficients were expressed substantial and almost perfect agreement (0.617–0.784, P ≤ 0.05). In addition, phi correlation coefficients were indicated adequate test–retest reliability for each cluster (0.548–0.754, P ≤ 0.05). Three domains (anxiety-related symptoms, functional symptoms, and dysfunctional traits and emotional patterns) were confirmed by factor analysis. The results of the discriminate validity analysis were promising.

Conclusion:

The findings show that the DCPR-SA is valid and reliable and can be used by medical professionals as a psychosomatic screening tool and can be used properly in Persian-speaking population.
Diaphragm-Protective Mechanical Ventilation: Saving the Diaphragm from the Detrimental Effects of Mechanical Ventilation
Authors: Shi Zhonghua , Zhou Jian-Xin , Heunks Leo
Published: February 2022

Abstract

Diaphragm weakness develops in up to 80% of the critically ill patients, and is associated with adverse clinical outcomes. Mechanical ventilation has been proposed to play a role in the development of diaphragm weakness in critically ill patients, especially by ventilator under-assist or ventilator over-assist. Therefore, in addition to the concept of lung-protective ventilation to protect the lung, diaphragm-protective ventilation has been recently proposed to limit the development of diaphragm weakness. In this concise review, we will discuss the current evidence for diaphragm-protective ventilation and the clinical consequences.
Measuring the breath of life
Authors: Lund Valerie J.
Published: February 2022

The inability to breathe freely and clearly is a major source of concern to patients and a common symptom in many sinonasal conditions (1). There are of course some semantic diﬀerences between terms such as ‘obstruction’, congestion’ and ‘blockage’, which have to be clariﬁed when taking a clinical history as the presence of inﬂammation may produce the sensation of congestion without actually being associated with mechanical obstruction to airﬂow (2). Notwthstanding this, nasal obstruction is the commonest complaint in chronic rhinosinusitis with and without nasal polyps (3) and is a major feature of conditions from the common cold and acute bacterial rhinosinusitis to allergic and non-allergic rhinitis, septal deformity or a tumour. Paradoxically, many people, myself included, go through life largely oblivious to a signiﬁcant septal deﬂection. It therefore begs the question as to why an individual with a long-standing anatomical variant such as this, suddenly presents with the symptom of nasal blockage and it is important that we do not simply focus on the septum (or turbinate) but rather ask ourselves ‘Why now?’ instead of simply listing the patient for septal surgery.
Extending borders
Authors: Fokkens Wytske J.
Published: February 2022

The last 20 years of the last century, that sounds long ago but was actually the time that many of us already practiced in Rhinology or received their training, was I think the time of endoscopic sinus surgery. We learned all the possibilities of the endoscope, first mainly in limited inflammatory disease but later also because of the development of new technical possibilities like debriders, lens cleaners and probably most important curved drills more extensive surgery (1-4). Since the beginning of the 21ste century it is the time of endoscopic treatment of skull base tumours. In 2010 this Journal already produced an extensive overview in the European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base (5). In the mean time a number of papers on skull base surgery has been published in Rhinology (3, 6-11). With the rhinologist involvement in more and more complex benign and malignant sinus and skull base tumours we became part of endoscopic skull base teams.