bluuebunny/crossref_metadata_2025 huggingface dataset:
Urinary pH is An Independent Predictor of Upper Tract Recurrence in Non-Muscle-Invasive Bladder Cancer Patients with a Smoking History
Authors: Ide Hiroki , Kikuchi Eiji , Ogihara Koichiro , Niwa Naoya , Shigeta Keisuke , Masuda Tsukasa , Baba Yuto , Mizuno Ryuichi , Oya Mototsugu
Published: August 2021

Limited information is currently available on predictors of upper tract urothelial carcinoma (UTUC) recurrence in non-muscle-invasive bladder cancer (NMIBC) patients according to smoking history, although smoking probably contributes to urothelial carcinogenesis. Therefore, the present study aimed to identify independent predictors of UTUC recurrence in all patients and those with a smoking history. Our study population comprised 1190 NMIBC patients who underwent transurethral resection of bladder tumor. UTUC developed in 43 patients during the follow-up. A history of bacillus Calmette-Guérin (BCG) therapy was independently associated with a lower incidence of UTUC (HR=0.43; P=0.011). In a subgroup of NMIBC patients with a smoking history, concomitant carcinoma in situ (CIS) and a lower urinary pH (<6) were independently associated with a higher incidence of UTUC recurrence (HR=3.34, P=0.006 and HR=3.73, P=0.008, respectively). Among patients with a longer smoking duration (≥20 years) or larger smoking intensity (≥20 cigarettes per day), those with lower urinary pH (<6) had a significantly higher UTUC recurrence rate than their counterparts. These results suggest that BCG instillation may prevent UTUC recurrence in NMIBC patients, while a lower urinary pH and concomitant CIS increase the risk of UTUC recurrence in those with a smoking history.
Impact of Radial Compression Protocols on Radial Artery Occlusion and Hemostasis Time
Authors: Takamatsu Sachiko , Kagiyama Nobuyuki , Sone Naohiko , Tougi Kiyotaka , Yamauchi Shuichiro , Yuri Takuya , Ii Nobuhisa , Sugimoto Tomoko , Masutani Motomaru , Hirohata Atsushi
Published: August 2021

Protocols for hemostasis after trans-radial approach (TRA) vary depending on the institute as there is no established evidence-based protocol. This study aimed to investigate the clinical implications of radial compression protocols. Consecutive patients who underwent outpatient invasive catheter angiography before and after April 2018 were treated with traditional and new protocols, respectively. Using the same hemostasis band, the amount and timing of deflation were fixed in the traditional protocol, whereas the air was removed as much as possible every 30 min in the new protocol. A total of 1,842 patients (71±10 years old, 77% male) were included. Compared with the traditional protocol group (n=1,001), the new protocol group (n=841) had a significantly lower rate of dual antiplatelet therapy (24% vs. 35%, p<0.001). The time required for complete hemostasis was approximately one-third with the new protocol (66±32 min vs. 190±16 min, p<0.001) with no clinically relevant bleeding. The incidence of radial artery occlusion (RAO) was 9.8% and 0.9% in the traditional and new protocol groups, respectively (p<0.001). After adjusting for covariates, the new protocol was associated with a shorter hemostasis time (odds ratio 0.01, p<0.001) and a reduced risk of RAO (odds ratio 0.09, p<0.001). Our new protocol for hemostasis after TRA was strongly associated with a shorter hemostasis time and a lower rate of RAO.
Intraseasonal variability of global land monsoon precipitation and recent change
Authors: Liu Fei , Wang Bin , Ouyang Yu , Wang Hui , Qiao Shaobo , Chen Guosen , Dong Wenjie
Published: August 2021

Accurate prediction of global land monsoon rainfall on a subseasonal (2–8 weeks) time scale has become a worldwide demand. However, the current forecasts of weekly-mean rainfall in most monsoon regions have limited skills beyond two weeks. Given that two-thirds of the world’s population lives in the monsoon regions, this challenge calls for a more profound understanding of monsoon intraseasonal variability (ISVs). We show that the high-frequency (HF; 8–20 days) ISV, crucial for the Week 2 and Week 3 predictions, accounts for about 53–70% of the total (8–70 days) ISV in various land monsoon regions. The low-frequency (LF; 20–70 days) ISV has a relatively high contribution over Australia (47%), South Asia (43%), and South America (40%). The leading modes of HFISVs in Northern Hemisphere monsoons primarily originate from convectively coupled equatorial Rossby waves (Asia), mixed Rossby-gravity waves (North America), and Kelvin waves (West Africa), while in Southern Hemisphere monsoons, from mid-latitude wave trains. The Madden-Julian Oscillation (MJO) directly regulates LFISVs in the Asian-Australian monsoon while affecting the American and African monsoons by exciting Kelvin waves and mid-latitude teleconnections. During the past four decades, the HF (LF) ISVs have considerably intensified over the Asian (Asian-Australian) monsoon but weakened over the American (South American) monsoon. The presented characteristics of the ISV in each monsoon region are helpful for empirical subseasonal prediction and for identifying models’ strengths and weaknesses in reproducing regional monsoon ISVs. The results suggest an urgent need to improve the simulation of convectively coupled equatorial waves and two-way interactions between regional monsoon ISVs and mid-latitude processes and between MJO and regional monsoons.
Van der Pol Model in Two-Delay Differential Equation Representation
Authors: Elfouly M. A. , Sohaly M. A.
Published: August 2021

The Van der Pol equation is the mathematical model of a second-order ordinary differential equation with cubic nonlinearity. In this paper, the differential equation of the Van der Pol model and RLC (resistor - inductor-capacitor) circuit are deduced from a delay differential equation. The Van der Pol delay model contains two delays, which opens the way for the re-use of its applications. Also, the model for Parkinson's disease modification is described as the Van der Pol model.
Controllable Chiral Self-sorting and Guest Recognition of Ultra-stable Axially Chiral Porous Aromatic Cages
Authors: Cui Dongxu , Geng Yun , Kou Junning , SHAN Guogang , Sun Chun-Yi , Wang Xinlong , Su Zhong-Min
Published: August 2021

The synthesis of ultra-stable chiral porous organic cages (POCs) and their controllable chiral self-sorting at the molecular and supramolecular level is still a daunting challenge. Herein, we report the design and synthesis of a serial of axially chiral porous aromatic cages (1-S and 1-R) with exceptional chemical stability. The theoretical and experimental studies on chiral self-sorting reveal that the exclusive self-recognition on cage formation is an enthalpy-driven process while the chiral narcissistic and social self-sorting on supramolecular assembly of racemic cages can be precisely regulated by π–π and C–H…π interactions from different solvents. Moreover, the crystallinity of 1 can be preserved under various harsh conditions including boiling water, and high-concentrated acid and alkali solutions. Further investigations on chiral sensing show that 1 possesses high enantioselectivity toward axially chiral aromatic racemates.
cPLA2 Blockade Attenuates S100A7-Mediated Breast Tumorigenicity by Inhibiting the Immunosuppressive Tumor Microenvironment
Authors: MISHRA SANJAY , Charan Manish , Shukla Rajni Kant , Agarwal Pranay , Misri Swati , Verma Ajeet K , Ahirwar Dinesh K , Siddiqui Jalal , Kaul Kirti , Sahu Neety , Vyas Kunj , Garg Ayush Arpit , Khan Anum , Miles Wayne O , Song Jonathan W , Bhutani Nidhi , Ganju Ramesh K
Published: August 2021

Background: Metastasis is the major cause of mortality in breast cancer; however, the molecular mechanisms remain elusive. In our previous study, we demonstrated that S100A7/RAGE mediates breast cancer growth and metastasis by recruitment of tumor-associated macrophages. However, the downstream S100A7-mediated inflammatory oncogenic signaling cascade that enhances breast tumor growth and metastasis by generating the immunosuppressive tumor microenvironment (iTME) has not been studied. In this present study, we aimed to investigate the S100A7 and cPLA2 cross-talk in enhancing tumor growth and metastasis through enhancing the iTME.Methods: Human breast cancer tissue and plasma samples were used to analyze the expression of S100A7, cPLA2, and PGE2 titer. S100A7-overexpressing or downregulated human metastatic breast cancer cells were used to evaluate the S100A7-mediated downstream signaling mechanisms. Bi-transgenic mS100a7a15 overexpression, TNBC C3(1)/Tag transgenic, and humanized patient-derived xenograft mouse models and cPLA2 inhibitor (AACOCF3) were used to investigate the role of S100A7/cPLA2/PGE2 signaling in tumor growth and metastasis. Additionally, CODEX, a highly advanced multiplexed imaging was employed to delineate the effect of S100A7/cPLA2 inhibition on the recruitment of various immune cells.Results: S100A7 and cPLA2 are highly expressed and positively correlated in malignant breast cancer patients. S100A7/RAGE upregulates cPLA2/PGE2 axis in aggressive breast cancer cells. Furthermore, S100A7 is positively correlated with PGE2 in breast cancer patients. Moreover, cPLA2 pharmacological inhibition suppressed S100A7-mediated tumor growth and metastasis in multiple pre-clinical models. Mechanistically, S100A7-mediated activation of cPLA2 enhances the recruitment of immunosuppressive myeloid cells by increasing PGE2 to fuel breast cancer growth and its secondary spread. We revealed that cPLA2 inhibitor mitigates S100A7-mediated breast tumorigenicity by suppressing the iTME. Furthermore, CODEX imaging data showed that cPLA2 inhibition increased the infiltration of CD4+/CD8+ T cells in the TME. Analysis of metastatic breast cancer samples revealed a positive correlation between S100A7/cPLA2 with CD163+ tumor-associated M2-macrophages.Conclusions: Our study shows that cross-talk between S100A7 and cPLA2 plays an important role in enhancing breast tumor growth and metastasis by generating an immunosuppressive tumor microenvironment and reducing infiltration of T cells. Furthermore, S100A7 could be used as a novel non-invasive prognostic marker and cPLA2 inhibitors as promising drugs against S100A7-overexpressing metastatic breast cancer.
Numerical Simulation and Rapid Centrifugal Casting of Large Complex Thin-Walled Titanium Alloy Intermediate Casing Based on 3D Printed Pattern
Authors: Li Shurong , Wang Yingchun , Zhang Xiao , Xian Quangang , Zhao Yanjie , Qi Chengkang , Li Zhihui , Lai Junhua , Li Fei
Published: August 2021

Titanium alloy intermediate casing is a typical large casting, with many thin-walled and complex structures. It is a high cost and time-consuming process in the trial stage to manufacturing the wax pattern of the intermediate casing by metal mold. Rapid investment casting based on 3D printed patterns is the development direction of casting technology which integrates digitization and intelligence. In this study, selective laser sintering (SLS) technology was used to realize the rapid prototyping of polystyrene pattern in the precision casting of intermediate casing. A numerical simulation method was used to predict the filling process, solidification and casting defects of the intermediate casing. The simulation results show that the gating system for the casting of intermediate casting was reasonable, the number and size of gating risers met the open design requirements, and a sequential solidification of the casting could be realized. The titanium alloy intermediate casing with excellent metallurgical quality and size accuracy CT7 was successfully produced using centrifugal rapid casting technology.
Secretory pathway Ca-ATPase 2 (SPCA2) gene knockout results in mouse mammary gland changes and a secretory defect
Authors: Reinhardt Timothy , Lippolis John , Palmer Mitchell
Published: August 2021

Calcium influx into the basolateral mammary cell is thought to be due partly to an unconventional partnering of SPCA2 and the calcium channel protein ORAI1 in vitro. ORAI1’s role in mammary secretory cell calcium influx, in support of milk calcium, has been confirmed in ORAI1 knockout (KO) mice. We examine the role of SPCA2 on mammary cell calcium influx in support of milk calcium concentration in SPCA2 KO mice. The SPCA2 KO resulted in a significant 40% reduction in milk calcium and a 57% reduction in milk manganese concentrations. The loss of SPCA2 was associated with a significant 55% increase in SPCA1, which may be compensatory. The expression of other calcium transporters/channels such as PMCA2/NHERF1, ORAI1, NCX1, and TMEM165 were not affected by the loss of SPCA2. Histologically SPCA2 KO mammary glands showed increased adiposity and altered structure. Milk production was significantly down in SPCA2 KO mice, but milk fat, protein, and lactose were unaffected. The significant decline in milk calcium in SPCA2 KO mice indirectly supports the SPCA2 role as an ORAI1 partner in calcium influx into mammary tissue. Further, studies will be required to clarify this relationship between SPCA2, ORAI1, and STIM1 on mammary calcium influx in vivo.
An Autophagy-related lncRNA Prognostic Risk Model for Thyroid Cancer
Authors: Shan Yanan , He Ran , Yang Xiaowei , Zang Siwen , Yao Shan , Gao Min , Li Sixuan , Yin Zhihua
Published: August 2021

Thyroid cancer (TC) is the most common malignancy of the endocrine system and its incidence is gradually rising. Research has demonstrated a close link between autophagy and thyroid cancer. We constructed a prognostic model of autophagy-related long noncoding RNA (lncRNA) in thyroid cancer and explored its prognostic value. A total of 14,142 lncRNAs and 212 autophagy-related genes (ATGs) were obtained from the Cancer Genome Atlas (TCGA) database and the Human Autophagy Database (HADb), respectively. We performed lncRNA-ATGs correlation analysis and finally obtained 1166 autophagy-associated lncRNAs. Subsequently we conducted univariate Cox regression analysis and multivariate Cox regression analysis, a nine-autophagy-related lncRNAs (AC092279.1, AC096677.1, DOCK9-DT, LINC02454, AL136366.1, AC008063.1, AC004918.3, LINC02471, AL162231.2) significantly associated with prognosis was identified. Based on these autophagy-related lncRNAs, a risk model was constructed. The area under the curve (AUC) of the risk score was 0.905, proving that the accuracy of risk signature was superior. In addition, multiple regression analysis showed that risk score was a significant independent prognostic risk factor for thyroid cancer. In this study, a nine autophagy-related lncRNAs in thyroid cancer were established to predict the prognosis of thyroid cancer patients.
Effect of Clonal Testing on the Efficiency of Genomic Evaluation in Forest Tree Breeding
Authors: Stejskal Jan , Klápště Jaroslav , Čepl Jaroslav , El-Kassaby Yousry A. , Lstibůrek Milan
Published: August 2021

Through stochastic simulations, accuracies of breeding values and response to selection were assessed under traditional pedigree- (BLUP) and genomic-based evaluation methods (GBLUP) in forest tree breeding. The latter provides a methodological foundation for genomic selection. We evaluated the impact of clonal replication in progeny testing on the response to selection realized in seed orchards under variable marker density and target effective population sizes. We found that clonal replication in progeny trials boosted selection accuracy, thus provided additional genetic gains under BLUP. While a similar trend was observed for GBLUP, however, the added gains did not surpass those under BLUP. Therefore, breeding programs deploying extensive progeny testing with clonal propagation might not benefit from the deployment of genomic information. These findings could be helpful in the context of operational breeding programs.
Cenozoic Relative Movements of Greenland and North America by Closure of the North Atlantic-arctic Plate Circuit: the Labrador Sea, Davis Strait and Baffin Bay
Authors: Causer Annabel , Eagles Graeme , Pérez-Díaz Lucía , Adam Jürgen
Published: August 2021

The processes that accommodated plate divergence between Greenland and North America are most confidently interpretable from a short-lived (61-42 Ma) sequence of magnetic isochrons in the Labrador Sea. Understanding of the preceding and following periods is impeded by the lack of clear isochrons in the basin’s continent-ocean transition and axial zones. By closing the regional plate circuit, we build and interpret a detailed plate motion model for Greenland and North America that is applicable in, but unaffected by data uncertainty from, the Labrador Sea, Davis Strait, and Baffin Bay. Among our findings, we show the Labrador Sea initially opened during a ~8.3-16.5 Myr-long period of focused extension culminating in continental breakup no earlier than 74-72 Ma, and experienced a ~80° change in spreading direction around 56 Ma. We describe some possible implications for the accommodation of strain prior to continental breakup and during extreme spreading obliquity.
Shaping the future of temperate forests in Europe: why outdoor recreation matters
Authors: Giergiczny Marek , Jacobsen Jette , Glenk Klaus , Meyerhoff Jürgen , Abildtrup Jens , Agimass Fitalew , Czajkowski Mikołaj , Faccioli Michela , Gajderowicz Tomasz , Getzner Michael , Lundhede Thomas , Mayer Marius , McVittie Alistair , Olschewski Roland , Ščasný Milan , Strange Niels , Valasiuk Sviataslau
Published: August 2021

Forests play a fundamental role in the economy, in climate change mitigation and in halting the loss of biodiversity. The economic value of goods and services provided to the societies by forests, including forest-based recreation, is highly dependent on the way in which forests are managed. On a European scale, forests are diverse and managed in many ways. Yet there has been no large-scale assessment to date of the economic value of forests recreation across Europe. In this paper we systematically apply stated and revealed preference-based valuation methods to investigate public preferences for forest visits in ten European countries (Austria, Belarus, Czech Republic, Denmark, France, Germany, Poland, Slovakia, Scotland, Switzerland). We observe substantial recreational value measured by the consumer surplus ranging from €55 to €648 per person per year (PPP adjusted, 2017). Compared to the gross value added of forestry and timber production, gross recreational benefits are, except for Belarus, on par or larger. Additionally, we find that forests of particular characteristics – more complex forest structures and forests with taller and older trees – are preferred and generate higher recreational values. These results provide a robust basis for evaluating the societal consequences of future forest management policies in Europe and the design of its forest landscapes.
Impacts of Offshore Wind Farms On The Atmospheric Environment Over Taiwan Strait During An Extreme Weather Typhoon Event
Authors: Lee Tsung-Yu , Wu Yu-Ting , Lin Chuan-Yao , Lin Yi-Ying , Sheng Yang-Fan
Published: August 2021

Wind energy is one of the cleanest renewable resources. Through the “Thousand Wind Turbines Project”, Taiwan is planning to increase the proportion of power generation from renewable energy and has set a target of 5.7 GW for offshore wind by 2025. However, the effects of future offshore wind farms (OWFs) over the Taiwan Strait on the atmospheric environment have not been evaluated. This study examined the potential effects of proposed OWFs on the atmospheric environment if the OWFs had existed during Tropical Storm Haitang (July 30–31, 2017) by using the Weather Research and Forecasting (WRF) model. As Tropical Storm Haitang made landfall in southern Taiwan and moved northward, wake effects formed at downstream of the OWFs and weather parameters were affected at the coastal area of western Taiwan. A significant reduction (as high as 6.1 %) in 24-hour accumulated precipitation was found over the western plain of Taiwan. Concurrently, the divergence increased, corresponding to a reduction in wind speed, vertical velocity, moisture flux, reflectivity and precipitable water–vapor (PWV), whereas a slight warming of near-surface air occurred. Sensitivity simulations demonstrated that the influence of OWF location and wind turbine density should not be ignored.
Research on Attitudes Toward Ageing, Social Participation, and Depressive Symptoms Among Older Adults in China
Authors: Mao Shan , Zeng Yue , Lu Nan
Published: August 2021

Depressive symptoms are one of the most common mental health problems in later life. Although previous studies examined the social determinants of depressive symptoms, older adults’ attitudes toward ageing and the underlying mechanisms are understudied, especially in developing country contexts such as China. The objective of this study was to examine the mediator role of attitudes toward ageing on the relationship between social participation and depressive symptoms among older Chinese adults. The data were drawn from the 2014 baseline wave of China longitudinal Ageing Social Survey, and a total of 8568 respondents aged 60 years and older were included in this study. Path analysis was used to test the hypotheses. The results indicated that both psychological loss and psychological growth (i.e., two types of attitudes toward ageing) had direct effect on depressive symptoms. In addition, attitudes toward ageing were found to play significant mediator roles on the relationship between social participation and depressive symptoms among older adults. In conclusion, this study implicated the importance of older adults’ attitudes toward ageing in reducing depressive symptoms, and engaging in social activities could modify attitudes toward ageing and further reduce the risk of depressive symptoms.
Enhanced effects of reducing agent on oxalate chelated Fe(II) catalyzed percarbonate system for benzene degradation
Authors: Fu Xiaori , Wei Xinyan , Zhang Wei , Yan Wupeng , Wei Peng , Lyu Shuguang
Published: August 2021

The addition of hydroxylamine hydrochloride (HAH), ascorbic acid (ASC), sodium ascorbate (SAS) to the OA-Fe(II)/SPC system could promote the generation of HO• by accelerating Fe(II)/Fe(III) recycles and H2O2 decomposition. The enhancement of HAH on HO• generation surpasses ASC and SAS in the OA-Fe(II)/SPC system. The generation of O2•− was also enhanced by HAH, ASC and SAS, and more significant promotion of O2•− generation was observed with ASC and SAS addition. More effective benzene removal was achieved in an OA-Fe(II)/SPC system with suitable HAH, ASC and SAS addition, compared to the parent system. Excessive HAH, ASC or SAS had a negative effect on benzene removal. Results of scavenger tests showed that HO• is indeed the dominant free radical for benzene removal in every system, but the addition of HAH, ASC and SAS increased the contribution of O2•− to benzene degradation. HAH, ASC and SAS enhanced OA-Fe(II)/SPC systems could be well utilized to acidic and neutral conditions, while HCO3−, high concentration of HA and alkaline conditions were not favorable to benzene removal. Moreover, the addition of HAH, ASC and SAS are conducive to benzene removal in actual groundwater, and HAH was the optimal reducing agent for the enhancement of the OA-Fe(II)/SPC system.
Facile synthesis of highly active Ti/Sb-SnO2 electrode by sol-gel spinning technique for landfill leachate treatment
Authors: Zhang Shuchi , Chen Xu , Du Shuwen , Wang Jingli , Tan Mengyu , Dong Jiayu , Wu Donglei
Published: August 2021

Highly active Ti/Sb–SnO2 electrodes were fabricated using sol-gel spin coating procedure, which exhibited a rough, uniform and multilayer coating structure. The effects of different Sb-SnO2 film layers on the physiochemical, electrochemical properties and pollutant degradability of electrodes and the mechanism were evaluated on a systematic basis. The electrodes with more active layers exhibited higher electro-catalytic performance. Upon exceeding 8 layers, the promotion effect of the coating was reduced. Considering various factors, this paper recommends preparing Ti/Sb–SnO2 electrodes coated with 8 layers to obtain higher electro-catalytic ability in landfill leachate treatment. The specific number of coating layers should be determined according to the electrode requirements. This work provided a theoretical basis and technical support for the preparation of Ti-SnO2 electrodes with high electro-catalytic activity and stability, while it still remains a great challenge to achieve an excellent balance between performance and stability before Ti/Sb-SnO2 electrodes can be implemented on a large scale in wastewater treatment.
Mental Health Promotion and Stigma Reduction Among University Students Using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) Framework: Protocol for a Mixed Methods Study (Preprint)
Authors: Fung Kenneth , Cheng Sheng-Li , Ning Xuan , Li Alan Tai-Wai , Zhang Jingxuan , Liu Jenny Jing-Wen , Hilario Carla T , Cheng Xiaojing , Yu Miao , Jia Cun-Xian , Gao Jianguo , Wong Josephine Pui-Hing
Published: August 2021

BACKGROUND

Rapid urbanization, academic pressures, and developmental life transition stressors contribute to mental health stress for postsecondary students in China. Effective prevention, early identification, and timely intervention are challenged by stigma, a lack of mental health literacy, and inadequate mental health resources.

OBJECTIVE

Our implementation science (IS) research project is aimed at evaluating the use of an evidence-informed mental health promotion intervention named Acceptance and Commitment to Empowerment – Linking Youth and ‘Xin’ (hearts) (ACE-LYNX) to promote university student mental health in Jinan, China.

METHODS

We will engage and collaborate with Shandong Mental Health Center, the provincial mental health center, and six local universities in different regions of Jinan. The ACE-LYNX intervention aims to reduce social stigma against mental illness, enhance mental health literacy, and improve access to quality mental health care by increasing interdisciplinary collaboration and forming a mental health network. It is based on two evidence-based approaches, Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP), and it will be delivered through online learning and in-person group training. The project will train 90 interdisciplinary professionals using the model. They will in turn train 15 professionals and 20 students at each university. The project will adopt the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework, which provides a structure to examine the process and outcomes of implementation using mixed methods comprising quantitative and qualitative approaches along five dimensions: reach, efficacy, adoption, implementation, and maintenance.

RESULTS

Over the course of the project, 720 champions will be directly trained. They will contribute to developing a formal and informal mental health network, strengthened by student-led mental health initiatives and professional-led initiatives to promote collaborative care and facilitated care pathways. We anticipate that our project will reach out to 11,000 to 18,000 students.

CONCLUSIONS

This IS protocol will outline our unique intervention model and key steps to contextualize, implement, and evaluate community-based mental health intervention.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/25592
Identifying Communities at Risk for COVID-19–Related Burden Across 500 US Cities and Within New York City: Unsupervised Learning of the Coprevalence of Health Indicators (Preprint)
Authors: Deonarine Andrew , Lyons Genevieve , Lakhani Chirag , De Brouwer Walter
Published: August 2021

BACKGROUND

Although it is well-known that older individuals with certain comorbidities are at the highest risk for complications related to COVID-19 including hospitalization and death, we lack tools to identify communities at the highest risk with fine-grained spatial resolution. Information collected at a county level obscures local risk and complex interactions between clinical comorbidities, the built environment, population factors, and other social determinants of health.

OBJECTIVE

This study aims to develop a COVID-19 community risk score that summarizes complex disease prevalence together with age and sex, and compares the score to different social determinants of health indicators and built environment measures derived from satellite images using deep learning.

METHODS

We developed a robust COVID-19 community risk score (COVID-19 risk score) that summarizes the complex disease co-occurrences (using data for 2019) for individual census tracts with unsupervised learning, selected on the basis of their association with risk for COVID-19 complications such as death. We mapped the COVID-19 risk score to corresponding zip codes in New York City and associated the score with COVID-19–related death. We further modeled the variance of the COVID-19 risk score using satellite imagery and social determinants of health.

RESULTS

Using 2019 chronic disease data, the COVID-19 risk score described 85% of the variation in the co-occurrence of 15 diseases and health behaviors that are risk factors for COVID-19 complications among ~28,000 census tract neighborhoods (median population size of tracts 4091). The COVID-19 risk score was associated with a 40% greater risk for COVID-19–related death across New York City (April and September 2020) for a 1 SD change in the score (risk ratio for 1 SD change in COVID-19 risk score 1.4; P<.001) at the zip code level. Satellite imagery coupled with social determinants of health explain nearly 90% of the variance in the COVID-19 risk score in the United States in census tracts (r2=0.87).

CONCLUSIONS

The COVID-19 risk score localizes risk at the census tract level and was able to predict COVID-19–related mortality in New York City. The built environment explained significant variations in the score, suggesting risk models could be enhanced with satellite imagery.
Design of Cancer Pain Management App Modules: Using a Modified Delphi Process (Preprint)
Authors: Liu Maobai , Lin Wanglong , Weng Lizhu , Han Sijie , Yang Jianhui , Lin Xiuxian , Yang Jing
Published: August 2021

BACKGROUND

Cancer pain is a significant public health issue. Mobile health offers improved and cost-effective care to people with cancer pain. However, the efficiency of engagement strategies and modules of this technology need to be reviewed and standardized according to expert perspectives. The use of applications (apps) for cancer pain management has increased over recent years. However, evidence regarding the efficacy and safety of these apps remains lacking. This study used the modified Delphi process on the design of cancer pain management apps.

OBJECTIVE

The study aimed to design the most agreed-upon modules for cancer pain management mobile apps.

METHODS

This study recruited experts in the domain of cancer pain management and applied a modified Delphi method to design the most relevant app modules.
We used the positive coefficient and authority of expert indexes, such as the degree of coordination with expert opinions and other modules to test the reliability of the consultation. Cronbach’s α coefficient, content validity index (CVI), were used for data analysis.

RESULTS

A total of 23 experts with a mean age of 42.3 years (SD 5.7) consented to participate in the study. All of them had worked more than 10 years in the cancer pain management field. Overall, five app modules were generated. The Cronbach’s a coefficient was 0.81 for the overall scale.The scale-level CVI was 0.78.

CONCLUSIONS

This study is the first in China to recruit a local panel of experts from the cancer pain management field. We used an iterative process to combine the experts’ opinions into a group consensus. The results of this study could benefit developers of health apps and inform future decision making on cancer pain management.
Hybrid-Pattern Recognition Modeling with Arrhythmia Simulation for Ubiquitous Health Management System (Preprint)
Authors: Lin Hsueh-Chun , Hsiao Wei-Ting , Kan Yao-Chiang , Kuo Chin-Chi , Chai Sin-Kuo
Published: August 2021

BACKGROUND

Ubiquitous health management (UHM) services are getting used to working with intelligent medical technology. People expect to track their daily electrocardiogram (ECG) signals at home with AI-enabled computing for assessing arrhythmias, such as atrial premature atrial complex (APC), atrial fibrillation (AFib), ventricular premature complex (VPC), and ventricular tachycardia (VT), versus normal sinus rhythm (NSR).

OBJECTIVE

We established a uHealth management system prototype “ECG4UHM” with coupled machine learning models to recognize hybrid arrhythmia ECG patterns via online AI-computation.

METHODS

We coupled analytical modeling with machine-learning methods, such as multiple layer perceptron (MLP), random forest (RF), support vector machine (SVM), and naïve Bayes (NB), to recognize the hybrid patterns of four arrhythmia symptoms. The data pre-processing used Hilbert-Huang transform (HHT) with empirical mode decomposition to calculate ECG’s intrinsic mode functions (IMFs). The area centroids of the marginal Hilbert spectrum for the first three-order IMFs were suggested as the features. A strategy of simulative dataset modeling was conducted in the few-data resource analysis for comparison. The modeling was compiled to the modules “MMLCA” and “ECGHHT” for implementation. We engaged the MATLAB compiler and runtime server in the web-based ECG4UHM to build the recognition modules in the Java class library “HHTFeature” and drive the AI-computation to identify the arrhythmia symptoms, respectively.

RESULTS

The crucial datasets were extracted from the MIT-BIH arrhythmia open database in the modeling, which also derived the simulative datasets based on the features’ means and standard deviations. Four arrhythmia symptoms were studied, including the premature pattern (APC, VPC) and the fibril-rapid pattern (AFib, VT) against NSR. With 5-fold cross-validation, the RF model performed the best accuracy of 0.99 for the both patterns due to the crucial dataset. The test dataset evaluated the model and reached the area under the curve (AUC) of receiver operating characteristic about 0.99. The models for all hybrid patterns, excluding VPC versus AFib and VT, achieved an average accuracy of around 90%. With the prediction test, the respective AUCs of the NSR & APC versus the AFib, VPC, & VT were 0.94 and 0.93 for the RF and SVM on average. The average accuracy and the AUC of MLP, RF, and SVM models for APC-VT reached the value of 0.98 due to both crucial and simulative datasets. The feasible models for the hybrid patterns were installed in ECG4UHM to recognize four arrhythmia symptoms online for the UHM.

CONCLUSIONS

The self-developed system involved the AI-enabled modeling in recognizing hybrid patterns of the multiple arrhythmia symptoms in practice. The modeling can be extended to serve the UHM and home-isolated care in the future.
Exploring Post COVID-19 Outbreak Intradaily Mobility Pattern Change in College Students: a GPS-focused Smartphone Sensing Study (Preprint)
Authors: Wu Congyu , Fritz Hagen , Craddock Cameron , Kinney Kerry , Castelli Darla , Schnyer David M
Published: August 2021

UNSTRUCTURED

With the outbreak of the COVID-19 pandemic in 2020, most colleges and universities move to restrict campus activities, reduce indoor gatherings and move instruction online. These changes required that students adapt and alter their daily routines accordingly. To investigate patterns associated with these behavioral changes, we collected smartphone sensing data using the Beiwe platform from two groups of undergraduate students at a major North American university, one from January to March of 2020 (74 participants), the other from May to August (52 participants), to observe the differences in students' daily life patterns before and after the start of the pandemic. In this paper, we focus on the mobility patterns evidenced by GPS signal tracking from the students' smartphones and report findings using several analytical methods including principal component analysis, circadian rhythm analysis, and predictive modeling of perceived sadness levels using mobility-based digital metrics. Our findings suggest that compared to the pre-COVID group, students in the mid-COVID group generally (1) registered a greater amount of midday movement than movement in the morning (8-10am) and in the evening (7-9pm), as opposed to the other way around; (2) exhibited significantly less intradaily variability in their daily movement, and (3) had a significant lower correlation between their mobility patterns and negative mood.
Utilization of a Smart Sock for the Remote Monitoring of Patients With Peripheral Neuropathy: Cross-sectional Study of a Real-world Registry (Preprint)
Authors: Scholten Henk Jan , Shih Chia-Ding , Ma Ran , Malhotra Kara , Reyzelman Alexander M
Published: August 2021

BACKGROUND

Remote patient monitoring (RPM) devices are increasingly being used in caring for patients to reduce risks of complications. Temperature monitoring specifically has been shown in previous studies to provide a useful signal of inflammation that may help prevent foot ulcers.

OBJECTIVE

In this cross-sectional study, we evaluated utilization data for patients who were prescribed smart socks as remote temperature monitoring devices.

METHODS

This study evaluated data from a patient registry from January to July 2021. The utilization data, which were collected starting from the first full month since patients were prescribed the smart socks, were evaluated along with retention over time, the average time that the socks were worn, and the number of days that the socks were worn per month and per week.

RESULTS

A total of 160 patients wore the smart sock RPM device for 22 to 25 days per month on average. The retention rate was 91.9% (147/160) at the end of the 7-month period; a total of 13 patients were lost to follow-up during this period. The average number of days that the socks were worn per week was 5.8. The percentage of patients with a utilization rate of >15 days ranged from 79.7% (106/133) to 91.9% (125/136) each month.

CONCLUSIONS

This study shows a high level of utilization for a smart sock RPM device and a high compliance rate. A future prospective study on the clinical outcomes after the use of the smart socks may further solidify the idea of conducting temperature monitoring for foot ulcer prevention.
Design and Evaluation of a Smartphone Medical Guidance App for Outpatients of Large-Scale Medical Institutions: Retrospective Observational Study (Preprint)
Authors: Teramoto Kei , Kuwata Shigeki
Published: August 2021

BACKGROUND

The greatest stressor for outpatients is the waiting time before an examination. If the patient is able to use their smartphone to check in with reception, the patient can wait for their examination at any location, and the burden of waiting can be reduced.

OBJECTIVE

This study aimed to report the system design and postintroductory outcomes of the Tori RinRin (TR2) system that was developed to reduce outpatient burden imposed by wait times before examination.

METHODS

The TR2 system was introduced at Tottori University Hospital, a large medical facility that accepts a daily average of 1500 outpatients. The system, which links the hospital’s electronic medical record database with patients’ mobile devices, has the following functions: (1) GPS-based examination check-in processing and (2) sending appointment notification messages via a cloud notification service. In order to evaluate the usefulness of the TR2 system, we surveyed the utilization rate of the TR2 system among outpatients, implemented a user questionnaire, and polled the average time required for patients to respond to call notifications about their turn.

RESULTS

The 3-month average of TR2 users 9 months after the TR 2 system introduction was 17.9% (14,536/81,066). In an investigation of 363 subjects, the mean examination call message response time using the TR2 system was 31 seconds (median 14 seconds). Among 166 subjects who responded to a user survey, 86.7% (144/166) said that the system helped reduce the burden of waiting time.

CONCLUSIONS

The app allowed 17.9% of outpatients at a large medical facility to check in remotely and wait for examinations anywhere. Hence, it is effective in preventing the spread of infection, especially during pandemics such as that of coronavirus disease. The app reported in this study is beneficial for large medical facilities striving to reduce outpatient burden imposed by wait times.
Characterizing Anchoring Bias in Vaccine Comparator Selection Due to Health Care Utilization With COVID-19 and Influenza: Observational Cohort Study (Preprint)
Authors: Ostropolets Anna , Ryan Patrick B , Schuemie Martijn J , Hripcsak George
Published: August 2021

BACKGROUND

Observational data enables large-scale vaccine safety surveillance but requires careful evaluation of the potential sources of bias. One potential source of bias is the index date selection procedure for the unvaccinated cohort or unvaccinated comparison time (“anchoring”).

OBJECTIVE

Here, we evaluated the different index date selection procedures for 2 vaccinations: COVID-19 and influenza.

METHODS

For each vaccine, we extracted patient baseline characteristics on the index date and up to 450 days prior and then compared them to the characteristics of the unvaccinated patients indexed on (1) an arbitrary date or (2) a date of a visit. Additionally, we compared vaccinated patients indexed on the date of vaccination and the same patients indexed on a prior date or visit.

RESULTS

COVID-19 vaccination and influenza vaccination differ drastically from each other in terms of the populations vaccinated and their status on the day of vaccination. When compared to indexing on a visit in the unvaccinated population, influenza vaccination had markedly higher covariate proportions, and COVID-19 vaccination had lower proportions of most covariates on the index date. In contrast, COVID-19 vaccination had similar covariate proportions when compared to an arbitrary date. These effects attenuated, but were still present, with a longer lookback period. The effect of day 0 was present even when the patients served as their own controls.

CONCLUSIONS

Patient baseline characteristics are sensitive to the choice of the index date. In vaccine safety studies, unexposed index event should represent vaccination settings. Study designs previously used to assess influenza vaccination must be reassessed for COVID-19 to account for a potentially healthier population and lack of medical activity on the day of vaccination.
Del cielo a la tierra:
Authors: Reyes Valdez Jorge Antonio , García Salido Gabriela
Published: August 2021

El presente trabajo analiza un discurso que se pronuncia en la ceremonia conocida como xiotalh entre los tepehuanos del sur de Durango. Desde una perspectiva de la antropología lingüística se destacan aspectos indexicales sobre la deixis de persona y espacio. El objetivo es mostrar que, para tener una plena comprensión del texto ritual, es necesario conocer tanto el contexto de enunciación, como la cosmovisión del pueblo tepehuano.Metodológicamente, se entabla una relación entre el análisis formal del texto y las acciones rituales. Deeste modo, se establece cómo, a través del uso de demostrativos de distancia corta, media o distal, el orador determina la posición espacial, social y cosmológica entre los participantes. En este sentido, los integrantes del ritual pueden ser humanos y no-humano (dioses), visibles e invisibles, actuales o ancestrales.
Habitando la liminalidad:
Authors: Paredes Marín Verónica Haydee , Peña Sánchez Edith Yesenia
Published: August 2021

Este artículo tiene como objetivo el análisis de la vinculación que tiene el territorio con las condiciones de salud de los habitantes fronterizos asentados en las laderas del Volcán Tacaná, en Yalú, Guatemala y la codependencia que sostiene con Unión Juárez, Chiapas, México. El trabajo etnográfico, realizado entre 2014 y 2019,  permitió generar un panorama sobre dinámicas de frontera que inciden en la búsqueda o mantenimiento del bienestar comunitario, a partir de la creación o fortalecimiento de vínculos sociales propios de territorios liminales y que se expresan a partir de la circularidad, la codependencia comunitaria y las estrategias de aprovechamiento de la laxidad normativa en ausencia del Estado en el tema de la salud.
La diversificación de estrategias socioambientales en la familia campesina: mecanismo de resiliencia ante la crisis del café en Chiapas
Authors: Venegas Sandoval Andrea , Soto Pinto Lorena , Álvarez Gordillo Guadalupe , Alayón Gamboa Armando , Díaz Nigenda Emmanuel
Published: August 2021

*Texto recibido antes de la modificación de criterios editoriales de la revista
Las familias campesinas productoras de café se han enfrentado a una serie de problemáticas recurrentes. Ante esta situación, las familias implementaron estrategias que les permiten recuperarse y persistir buscando su bienestar. El objetivo de este estudio fue analizar la diversificación como un mecanismo que opera en el sistema socioambiental de café y que determina el establecimiento de estrategias familiares para lidiar con las amenazas. Para ello, se analizó la información de 100 entrevistas que se realizaron en 28 localidades en la región de la Sierra Madre del Sur de Chiapas. Se identificaron cinco estrategias principales de diversificación que pueden fortalecer la resiliencia del sistema socioambiental.
Virtual Private Network: Encryption Methodologies and Distinctive Categories
Authors: Patil Abhay
Published: August 2021

Abstract: A VPN association camouflages your information traffic on the web and shields it from outside access. The decoded information can be seen by any individual who has network access and needs to see it. With a VPN, programmers and cyber criminals can't bypass this information. The proposed paper portrays the methodology of the working of Virtual Private Network-to-network associations along with its different types based on the deployments. The encryption is discussed which are essentially required during the creation of the safe passaging/tunnelling. Keywords: VPN, ISP, VPDN, Tunnelling, Authentication
Smishing Detection: Using Artificial Intelligence
Authors: Shravasti Samyak Sadanand
Published: August 2021

Abstract: Phishing occurs when people's personal information is stolen via email, phone, or text communications. In Smishing Short Message Service (SMS) is used for cyber-attacks, Smishing is a type of theft of sensitive information. People are more likely to give personal information such as account details and passwords when they receive SMS messages. This data could be used to steal money or personal information from a person or a company. As a result, Smishing is a critical issue to consider. The proposed model uses an Artificial Intelligence to detect smishing. Analysing a SMS and successfully detecting Smishing is possible. Finally, we evaluate and analyse our proposed model to show its efficacy. Keywords: Phishing, Smishing, Artificial Intelligence, LSTM, RNN