bluuebunny/crossref_metadata_2025 huggingface dataset:
Policymakers’ perceived barriers and facilitators in the use of research evidence in oral health policies and guidelines: a qualitative study protocol
Authors: Verdugo-Paiva Francisca , Bonfill Xavier , Ortuño Duniel , Glick Michael , Carrasco-Labra Alonso
Published: February 2023

Introduction

Evidence-informed oral health policies are crucial to improving patient and population outcomes, but policymakers and organisational leaders infrequently systematically incorporate research evidence. Although there is indirect evidence regarding challenges in other healthcare sectors, the use of evidence-informed oral health policies remains unstudied in oral health. This study aims to assess policymakers’ perceived needs, barriers and facilitators in using research evidence to inform policies in oral health.

Methods and analysis

This is a qualitative study situated within a phenomenological paradigm. We will conduct semistructured interviews with policymakers (5–10) affiliated with key organisations conducting guidance, policy statements, guidelines or any knowledge transfer deliverables in oral health. Organisations will be sampled purposively and with no geographical restrictions. All interviews will be recorded, and an audio transcript will be generated. Subsequently, a researcher will review and validate the transcripts. Data will be analysed using thematic analysis supported by ATLAS.ti software.

Ethics and dissemination

Ethical approval was not sought because the study protocol met the criteria for exemption from such review according to the Clinical Research Ethics Committee of the Hospital de la Santa Creu i Sant Pau and the Spanish legislation (Law 14/2007 of 3 July, on biomedical research). Informed consent will be obtained from all subjects involved in this study. The findings of this study will be shared with participating organisations for feedback, disseminated in conferences and published in a peer-reviewed journal adopting open science practices.

Study registration

Open Science Framework (DOI:10.17605/OSF.IO/W4KG7).
Implementation of the national Getting it Right First Time orthopaedic programme in England: a qualitative case study analysis
Authors: Aspinal Fiona , Ledger Jean , Jasim Sarah , Mehta Raj , Raine Rosalind , Fulop Naomi J , Barratt Helen
Published: February 2023

Objective

To describe the implementation and impact of the Getting it Right First Time (GIRFT) national orthopaedic improvement programme at the level of individual National Health Service (NHS) Trusts.

Design

Qualitative case studies conducted at six NHS Trusts, as part of a mixed-methods evaluation of GIRFT.

Setting

NHS elective orthopaedic surgery in England.

Participants

59 NHS staff.

Intervention

Improvement bundle, including bespoke routine performance data and improvement recommendations for each organisation, delivered via ‘deep-dive’ visits to NHS Trusts by a senior orthopaedic clinician.

Results

Although all case study sites had made improvements to care, very few of these were reportedly a direct consequence of GIRFT. A range of factors, operating at three different levels, influenced their ability to implement GIRFT recommendations: at the level of the orthopaedic team (micro—eg, how individuals perceived the intervention); the wider Trust (meso—eg, competition for theatre/bed space) and the health economy more broadly (macro—eg, requirements to form local networks). Some sites used GIRFT evidence to support arguments for change which helped cement and formalise existing plans. However, where GIRFT measures were not a Trust priority because of more immediate demands—for example, financial and bed pressures—it was less likely to influence change.

Conclusion

Dynamic relationships between the different contextual factors, within and between the three levels, can impact the effectiveness of a large-scale improvement intervention and may account for variations in implementation outcomes in different settings. When designing an intervention, those leading future improvement programmes should consider how it sits in relation to these three contextual levels and the interactions that may occur between them.
Global, regional and national prevalence of copper, selenium and zinc deficiencies in women of childbearing age: protocol for systematic review and meta-analysis
Authors: Costa Priscila Ribas , Carvalho Thais , Pitangueira Jacqueline Costa Dias , Santana Mônica Leila Portela , Kinra Sanjay , Potvin Louise
Published: February 2023

Introduction

Micronutrient deficiencies are common in low-income and middle-income countries and are usually related to inadequate food intake, poor diet quality and low bioavailability. Copper, selenium and zinc are essential minerals in several enzymatic reactions and their deficiencies are associated with worse prognosis in pregnancy, compromising maternal health as well as her offspring. Thus, the objective of the present systematic review will be to describe the prevalence of copper, selenium and zinc deficiencies in women of childbearing age.

Methods and analysis

The search will be performed by independent reviewers. The bases used will be PubMed/MEDLINE, Science direct, Lilacs, Adolec, Scopus, EMBASE, CINAHL, Web of Science, CENTRAL, IMSEAR, PAHOS, WPRIM, IMEMR, AIM for grey literature OpenGrey and OVID. National data will be searched in BDTD. A first search will be performed and a second search will be performed just before submission. Risk of bias assessment will be performed using the Joanna Briggs group prevalence study checklist. Combinable studies will be performed meta-analysis. Heterogeneity will be tested using Cochran’s Q test and quantified by the inconsistency test (I²). In the presence of high heterogeneity, meta-analysis will be performed using the random effects model with Stata metaprop. Summary prevalence will be generated for each outcome, presented in Forest plot figures.

Ethics and dissemination

This systematic review will be solely based on published and retrievable literature, no ethics approval will be obtained. Our dissemination strategy will involve the presentation in scientific meetings, as well as the publication of article(s), posters and presentations in congresses.

PROSPERO registration number

CRD42020165352.
Improving diagnostic antimicrobial stewardship in respiratory tract infections: a protocol for a scoping review investigating point-of-care testing programmes in community pharmacy
Authors: Saha Sajal K , Promite Shukla , Botheras Carly L , Manias Elizabeth , Mothobi Nomvuyo , Robinson Suzanne , Athan Eugene
Published: February 2023

Introduction

Diagnostic uncertainty regarding the cause of respiratory tract infections (RTIs) multiplies the problem of unnecessary use of antibiotics and antimicrobial resistance in primary care. Point-of-care testing (POCT) programmes have been recognised as a potential stewardship strategy to optimise antimicrobial use in primary care. There is a need for greater understanding of community pharmacy-based POCT programmes in reducing the unnecessary use of antimicrobials in patients with RTIs. This review systematically maps out evidence around the effectiveness, feasibility and implementation challenges of POCT programmes in community pharmacy to improve safe antimicrobial use in RTIs.

Methods and analysis

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and the Arksey and O’Malley methodology framework will guide the reporting of this review. We will systematically review studies with either randomised controlled trial, non-randomised controlled trial, before–after study, observational study or pilot feasibility study design. Medline, Emcare, PubMed, Health Technology Assessment, Cochrane Central Register of Controlled Trials and Google Scholar databases will be used to search for articles. Three reviewers will independently screen, review and select studies with POCT programmes involving community pharmacists for antimicrobial stewardship in RTIs. Summary statistics and random effects model, if data permit, will be used to summarise the effectiveness, feasibility and cost-effectiveness of the POCT programme. The Consolidated Framework for Implementation Research will capture POCT implementation drivers.

Ethics and dissemination

This review study does not require research ethics approval. Findings will be disseminated through national and international conferences, seminars and publication in a peer-reviewed journal.
Fibroblast growth factor 23 in children with or without heart failure: a prospective study
Authors: Elzayat Rania Salah , Bahbah Wael Abbas , Elzaiat Reham Salah , Elgazzar Basim Abdelfattah
Published: February 2023

Background

Elevated fibroblast growth factor 23 (FGF23) levels have been associated with mortality in adults with heart failure (HF), but data on FGF23 levels in paediatric HF are limited. In this prospective cohort study, we aimed to assess the prognostic value of FGF23 in children with chronic HF.

Methods

We prospectively enrolled 40 children with chronic HF and 20 matched healthy controls. In each patient, a complete diagnostic workup was performed, including transthoracic echocardiography to evaluate cardiac systolic and diastolic functions. Serum FGF23, renal function tests, parathyroid hormone, serum calcium and phosphate were measured in patients and controls. N-terminal probrain natriuretic peptide (NT-proBNP) was measured in patients. The severity of symptoms was assessed using the modified Ross HF classification for children. Patients were followed for 1 year, and clinical worsening events such as death and HF hospitalisation were recorded.

Results

Patients with HF had significantly higher FGF23 levels compared with controls (355.68±97.27 pg/mL and 60.20±11.04 pg/mL, respectively; p<0.001). Three patients died and 11 were admitted with HF. In comparison with patients without clinical worsening events, these 14 patients exhibited significantly higher FGF23 levels (320.04±89.56 pg/mL and 421.86±75.50 pg/mL, respectively; p<0.001). FGF23 was positively correlated with NT-proBNP and left ventricular end-diastolic diameter and negatively correlated with ejection fraction and fractional shortening. The ability of FGF23 to predict clinical worsening events in patients was analysed using a receiver operating characteristic curve. The optimal cut-off point was 375 pg/mL, with 85.71% sensitivity, 84.62% specificity, positive predictive value of 75.0, negative predictive value of 91.7 and area under the curve (AUC) of 0.878. Multivariable regression analysis revealed that FGF23 is the only independent predictor of clinical worsening events in children with chronic HF.

Conclusion

FGF23 levels were elevated in children with chronic HF and increased significantly as Ross score class increased. FGF23 levels increased in patients who experienced clinical worsening events.
Long COVID in the Belgian Defence forces: prevalence, risk factors and impact on quality of daily functioning
Authors: Mazibas Hava , Speybroeck N , Dhondt E , Lambrecht S , Goorts K
Published: February 2023

Introduction

Long COVID (LC) is a medical condition first described and documented through anecdotes on social media by patients prior to being recognised by WHO as a disease. Although >50 prolonged symptoms of LC have been described, it remains a diagnostic challenge for military providers and therefore threatens operational readiness.

Methods

On 9 September 2021, an online survey was emailed to 2192 Belgian Defence personnel who had previously tested PCR positive for SARS-CoV-2 between 17 August 2020 and 31 May 2021. A total of 718 validated responses were received.

Descriptive analyses determined the prevalence of LC and 10 most common symptoms and their duration following infection. In the explanatory analyses, risk factors related to LC were identified. To establish the health-related impact of LC on quality of life (HRQoL), we used the results from the EuroQol 5 Dimension 5 Level questionnaire.

Results

The most frequent symptoms that were reported for >3 months were fatigue, lack of energy and breathing difficulties.

47.35% of the respondents reported at least one persistent symptom, while 21.87% reported more than 3 symptoms lasting for at least 3 months after the initial COVID-19 infection. Most patients with LC suffered from symptoms of a neuropsychiatric nature (71.76%).

LC was significantly associated with obesity; pre-existing respiratory disease and blood or immune disorders. Physical activity of >3 hours per week halved the risk of LC.

The total QoL is reduced in patients with LC. Considering the five dimensions of the questionnaire, only the self-care dimension was not influenced by the presence of LC.

Conclusions

Almost half of Belgian Defence personnel developed LC after a confirmed COVID-19 infection, similar to numbers found in the Belgian population. Patients with LC would likely benefit from a multidisciplinary rehabilitation approach that addresses shortness of breath, fatigue and mood disturbance.
Adipokine profile in long-term juvenile dermatomyositis, and associations with adipose tissue distribution and cardiac function: a cross-sectional study
Authors: Marstein Henriette Schermacher , Witczak Birgit Nomeland , Godang Kristin , Olarescu Nicoleta Christina , Schwartz Thomas , Flatø Berit , Molberg Øyvind , Bollerslev Jens , Sjaastad Ivar , Sanner Helga
Published: February 2023

Objectives

In long-term juvenile dermatomyositis (JDM), altered adipose tissue distribution and subclinical cardiac dysfunction have been described. Our aims were to compare adipokine levels in patients with JDM after long-term disease with controls, and explore associations between adipokines and (1) adipose tissue distribution and (2) cardiac function.

Methods

The study cohort included 59 patients with JDM (60% female, mean age 25.2 years, mean disease duration 16.9 years), and 59 age/sex-matched controls. Updated Pediatric Rheumatology International Trials Organization criteria for clinically inactive JDM were used to stratify patients into active (JDM-active) or inactive (JDM-inactive) disease groups. Lipodystrophy was clinically assessed in all patients. In all study participants, we measured adipose tissue distribution by dual-energy X-ray absorptiometry and cardiac function by echocardiography. Serum adipokines (adiponectin, apelin-12, lipocalin-2, leptin, visfatin and resistin) were analysed using ELISA.

Results

Patients with JDM had higher leptin levels compared with controls (p≤0.01). In JDM-active, apelin-12 and visfatin were higher compared with JDM-inactive (p≤0.05). In JDM-total and JDM-active, lower adiponectin correlated with lipodystrophy and total fat mass. Also, systolic dysfunction correlated with: lower adiponectin in JDM-total, JDM-inactive and JDM-active, and with lower apelin-12 in JDM-total and JDM-active and resistin in JDM-active (all p≤0.05). Lower adiponectin correlated with diastolic dysfunction in JDM-total and JDM-active.

Conclusion

After long-term disease, leptin levels were unfavourably regulated in patients with JDM compared with controls, and apelin-12 and visfatin in JDM-active versus JDM-inactive. We found associations between adipokines and both adipose tissue distribution and cardiac systolic function in all patients with JDM, which was most prominent in patients with active disease.
SEAL: Integrating Program Analysis and Repository Mining
Authors: Sattler Florian , Böhm Sebastian , Schubert Philipp Dominik , Siegmund Norbert , Apel Sven
Published: February 2023

Software projects are complex technical and organizational systems involving large numbers of artifacts and developers. To understand and tame software complexity, a wide variety of
program analysis
techniques have been developed for bug detection, program comprehension, verification, and more. At the same time,
repository mining
techniques aim at obtaining insights into the inner socio-technical workings of software projects at a larger scale. While both program analysis and repository mining have been successful on their own, they are largely isolated, which leaves considerable potential for synergies untapped. We present SEAL, the first
integrated
approach that combines low-level program analysis with high-level repository information. SEAL maps repository information, mined from the development history of a project, onto a low-level intermediate program representation, making it available for state-of-the-art program analysis. SEAL’s integrated approach allows us to efficiently address software engineering problems that span multiple levels of abstraction, from low-level data flow to high-level organizational information. To demonstrate its merits and practicality, we use SEAL to determine which code changes modify central parts of a given software project, how authors interact (indirectly) with each other through code, and we demonstrate that putting static analysis’ results into a socio-technical context improves their expressiveness and interpretability.
Understanding the Impact of Peer Instruction in CS Principles Teacher Professional Development
Authors: Hamlen Mansour Karla , Jackson Debbie K. , Bievenue Lisa , Voight Adam , Sridhar Nigamanth
Published: February 2023

In a nationwide initiative to increase computer science Education in K-12, many teachers were recruited to CS teaching positions but without adequate preparation, which can lead to lack of confidence and feelings of isolation [
35
,
54
]. In response to these issues, the purpose of this study was to determine the effectiveness of a newly developed summer professional development program with follow-up support with the goal of improving teacher confidence and informing teacher beliefs about computer science. This training featured peer instruction and an emphasis on computer science principles. It took place over three years, and was used to prepare teachers from over 50 schools across a midwestern state. Using Hierarchical Linear Modeling, data analysis from 57 teachers and 871 students showed that teacher confidence and content knowledge increased significantly, and to a greater extent for those who began with the lowest levels of confidence. Students also made significant knowledge gains from before to after taking the class. Student gains were higher for those whose teachers were more confident in their ability to teach computer science.
Virtual Reality at a Prehistoric Museum: Exploring the Influence of System Quality and Personality on User Intentions
Authors: Pratisto Eko Harry , Thompson Nik , Potdar Vidyasagar
Published: February 2023

Virtual Reality (VR)promises many benefits for the tourism industry. However, a review of tourism-related VR research shows that the roles of system quality and user personality remain largely unexplored. This study examines the causal relation underlying VR quality (information quality, interactivity, and visual attractiveness) and the user's personality (openness to experience, conscientiousness, and social influence) in conjunction with usability, attitude, and behavioural intention. We collected user data from a VR tourism experience of the Sangiran museum at Surakarta, Indonesia using a Head Mounted Device VR. The Sangiran museum is an archaeological excavation site recognised as a world heritage site by UNESCO. Two hundred eighteen valid responses were analysed using Structural Equation Modelling. The result suggests that only visual attractiveness positively impacts usability from a VR quality perspective, while openness to experience and social influence show significant positive evidence of attitude. These findings are discussed based on the practical and theoretical implications, including future research opportunities into VR tourism.
A Mapping Method Tolerating SAF and Variation for Memristor Crossbar Array Based Neural Network Inference on Edge Devices
Authors: Ma Yu , Zheng Linfeng , Zhou Pingqiang
Published: February 2023

There is an increasing demand for running neural network inference on edge devices.
Memristor crossbar array (MCA)
based accelerators can be used to accelerate neural networks on edge devices. However, reliability issues in memristors, such as
stuck-at faults (SAF)
and variations, lead to weight deviation of neural networks and therefore have a severe influence on inference accuracy. In this work, we focus on the reliability issues in memristors for edge devices. We formulate the reliability problem as a 0–1 programming problem, based on the analysis of
sum weight variation (SWV)
. In order to solve the problem, we simplify the problem with an approximation - different columns have the same weights, based on our observation of the weight distribution. Then we propose an effective mapping method to solve the simplified problem. We evaluate our proposed method with two neural network applications on two datasets. The experimental results on the classification application show that our proposed method can recover 95% accuracy considering SAF defects and can increase by up to 60% accuracy with variation σ =0.4. The results of the neural rendering application show that our proposed method can prevent render quality reduction.
Health Behaviours among Travellers Regarding Risk Compensation Following COVID-19 Vaccination in Taizhou, China
Authors: Yang Meng-Ge , Wang Li-Jun , Xu Lu-Yin , Ke Mang , Sun Liang-Xue
Published: February 2023

Background. During the COVID-19 pandemic, public transport was restricted in many countries because of the transmission risk. According to the risk compensation theory, travellers post-COVID-19 vaccination may encounter higher risks; however, no real-world studies provide such evidence. Therefore, we conducted a survey to assess whether risk compensation would occur among travellers’ health-related behaviours after COVID-19 vaccination, potentially aggravating the transmission of the virus. Materials and Methods. A self-administered online survey was designed and distributed over WeChat to identify the difference in health behaviours before and after COVID-19 vaccination among travellers at a train station in Taizhou, China, from 13 February to 26 April 2022. Results. A total of 602 individuals completed the questionnaire. The results revealed no statistical difference between the health behaviours reported by the vaccinated and unvaccinated groups. Participants who received the first dose of the vaccine earlier showed no statistical difference in harmful health behaviours (hand washing frequency decreased by 4.1%

P
=
0.145

) and the duration of public transport travel increased by 3.4%

P
=
0.437

)), but showed better protective health behaviours (mask-wearing duration increased by 24.7%

P
=
0.014

)). Compared to those vaccinated less than three times, participants vaccinated against COVID-19 three times showed no statistical differences in harmful health behaviours mask-wearing duration decreased by 7.0%

P
=
0.927

), their hand washing frequency decreased by 4.8%

P
=
0.905

), and the duration of public transport travel increased by 2.5%

P
=
0.287

). After vaccination, when compared to themselves before vaccination, participants exhibited better health behaviours (increased hand washing frequency and mask-wearing duration, and decreased duration of public transport travel) to some extent. Conclusion. In conclusion, this study found no evidence of risk compensation among travellers. After being vaccinated, health behaviours partly improved among travellers.
Physical Treatment of Diabetic Foot Ulcers—Preliminary Study for Topical Application of Oxygen or Ozone Auxiliary Treatment of Diabetic Foot Ulcers
Authors: Pasek Jarosław , Szajkowski Sebastian , Cieślar Grzegorz
Published: February 2023

Diabetes mellitus is one of the most common metabolic diseases in which one of the most serious complications is the diabetic foot ulcer (DFU). The aim of the study was to compare the efficacy of two physical therapeutic methods: topical oxygen therapy and topical ozone therapy in the treatment of DFU with the calculation of the financial costs for both applied physical methods. The study included 85 patients, 47 male (55.2%) and 38 female (44.7%) in age range between 40 and 90 years (mean age: 67.82 ± 12.42 years) with hard to heal diabetic foot ulcers. The mean diabetic foot ulcer duration was 3.6 ± 1.23 years. Patients were randomized into two study groups not significantly different in terms of age, body mass index (BMI) value, and baseline ulcer surface area value, who underwent topical oxygen therapy (group I) and topical ozone therapy (group II), respectively. Both the groups underwent a total of 30 daily treatments lasting 30 minutes, in 2 sessions of 15 treatments with a 14‐day break between sessions. Progress in wound healing was evaluated by computerized planimetry and the pain intensity was assessed with use of a VAS scale. After the treatment, the ulcer area in group I decreased by an average of 33.25 ± 10.97% and by an average of 28.67 ± 14.47% in group II (p = 0.030). On the other hand, the intensity of pain ailments after the treatment was statistically significantly decreased in group I by an average of 57.13 ± 16.24% while in group II by an average of 40.21 ± 14.53% (p  < 0.001). After application of topical oxygen therapy and topical ozone therapy in the treatment of diabetic foot ulcers a statistically significant reduction in the surface area of treated ulcers in objective planimetric assessment was observed, with local oxygen therapy showing only a slight advantage in this regard. Both compared methods also caused a statistically significant reduction in the pain intensity, while local oxygen therapy shows statistically significantly better analgesic effectiveness. Due to the calculated moderate cost, both applied methods appeared to be cost‐effective.
An Energy Efficient, Robust, Sustainable, and Low Computational Cost Method for Mobile Malware Detection
Authors: Chopra Rohan , Acharya Saket , Rawat Umashankar , Bhatnagar Roheet
Published: February 2023

Android malware has been rising alongside the popularity of the Android operating system. Attackers are developing malicious malware that undermines the ability of malware detecting systems and circumvents such systems by obfuscating their disposition. Several machine learning and deep learning techniques have been proposed to retaliate to such problems; nevertheless, they demand high computational power and are not energy efficient. Hence, this article presents an approach to distinguish between benign and malicious malware, which is robust, cost-efficient, and energy-saving by characterizing CNN-based architectures such as the traditional CNN, AlexNet, ResNet, and LeNet-5 and using transfer learning to determine the most efficient framework. The OAT (of-ahead time) files created during the installation of an application on Android are examined and transformed into images to train the datasets. The Hilbert space-filling curve is then used to transfer instructions into pixel locations of the 2-D image. To determine the most ideal model, we have performed several experiments on Android applications containing several benign and malicious samples. We used distinct datasets to test the performance of the models against distinct study questions. We have compared the performance of the aforementioned CNN-based architectures and found that the transfer learning model was the most efficacious and computationally inexpensive one. The proposed framework when used with a transfer learning approach provides better results in comparison to other state-of-the-art techniques.
Factors Impacting Users’ Negative Interaction Behaviors When They Enjoy Short Videos on TikTok
Authors: Li Yazheng , Qian Jin , Guo Lu
Published: February 2023

Short video media has become an essential new media channel for Chinese people to obtain information daily. However, an interesting negative interaction phenomenon exists, such as many users canceling likes after giving likes to a video, hiding their likes and following list. Our article aims to explore the factors impacting users’ negative interaction behaviors that may lead to short video media burnout. The structural equation modeling method was used to analyze 423 valid responses in a survey from TikTok users in the Chinese mainland. The results indicate that information redundancy concerns, social image concerns, information disclosure concerns, and content value deviation are the main potential variables that affect users’ negative interactions when they enjoy short videos on TikTok. We concluded that privacy concern is critical for users’ negative interaction behaviors compared to the video content dimension. This article extends short video users’ engagement behavior research by first investigating the influence factors of TikTok users’ negative behaviors. This article also provides practical and managerial implications for app designers on stimulating users’ active interaction and participation through the innovative design of privacy management functions.
Eight Aging-Related Genes Prognostic Signature for Cervical Cancer
Authors: Yin Meilin , Weng Yanhua
Published: February 2023

This study searched for aging-related genes (ARGs) to predict the prognosis of patients with cervical cancer (CC). All data were obtained from Molecular Signatures Database, Cancer Genome Atlas, Gene Expression Integration, and Genotype Organization Expression. The R software was used to screen out the differentially expressed ARGs (DE-ARGs) between CC and normal tissues. A protein–protein interaction network was established by the DE-ARGs. The univariate and multivariate Cox regression analyses were conducted on the first extracted Molecular Complex Detection component, and a prognostic model was constructed. The prognostic model was further validated in the testing set and GSE44001 dataset. Prognosis was analyzed by Kaplan–Meier curves, and accuracy of the prognostic model was assessed by receiver operating characteristic area under the curve analysis. An independent prognostic analysis of risk score and some clinicopathological factors of CC was also performed. The copy-number variant (CNV) and single-nucleotide variant (SNV) of prognostic ARGs were analyzed by the BioPortal database. A clinical practical nomogram was established to predict individual survival probability. Finally, we carried out cell experiment to further verify the prognostic model. An eight-ARG prognostic signature for CC was constructed. High-risk CC patients had significantly shorter overall survival than low-risk patients. The receiver operating characteristic (ROC) curve validated the good performance of the signature in survival prediction. The Figo_stage and risk score served as independent prognostic factors. The eight ARGs mainly enriched in growth factor regulation and cell cycle pathway, and the deep deletion of FN1 was the most common CNV. An eight-ARG prognostic signature for CC was successfully constructed.
Risk Factors for Mortality in Sepsis Patients without Lactate Levels Increasing Early
Authors: He Miao , Huang Jialin , Li Xingxing , Liang Shunda , Wang Qing , Zhang Hong
Published: February 2023

Objectives. Our purpose was to investigate the influencing factors for mortality in sepsis patients without lactate levels increasing in the early stage. Methods. We conducted a retrospective observational study involving 830 adult sepsis patients admitted to ICU. We calculated time-weighted lactate (LacTW), a dynamic value that incorporates both the magnitude of change and the time interval of such change, to represent lactate levels in the first 24 hours. ROC curve was used to find the cutoff of LacTW for predicting mortality, and the influencing factors for lactate levels and mortality in the low lactate group were further studied. The primary outcome was hospital mortality. Results. Among 830 patients, LacTW > 1.975 mmo/L was found to be the cutoff threshold for predicting mortality (AUC = 0.646,

P

 < 0.001). The following indexes related to organ dysfunction influenced LacTW: acute physiology and chronic health evaluation II (APACHE II) score (

P

 < 0.001), activated partial thromboplastin time (APTT) (

P

 = 0.002), total bilirubin (

P

 = 0.012), creatinine (

P

 = 0.037), with hypotension (

P

 < 0.001), chronic kidney disease (

P

 = 0.013), and required continuous renal replacement therapy (CRRT) (

P

 < 0.001). Of the 394 patients in the low lactate group, age (

P

 = 0.002), malignancy (

P

 < 0.001), lactate dehydrogenase (

P

 = 0.006), required treatment such as mechanical ventilation (

P

 < 0.001), CRRT (

P

 < 0.001), vasoactive drugs (

P

 < 0.001), and glucocorticoid (

P

 < 0.001), and failure to reach the target fluid resuscitation of 30 ml/kg within 6 hours (

P

 = 0.003) were independently associated with hospital mortality. Conclusions. Due to the lower incidence of early organ dysfunction, lactate levels are not increased or delayed in some septic shock patients in the early stage, thus affecting the alertness of clinicians and the timeliness and adequacy of fluid resuscitation, and finally affects the prognosis.
A Challenging Case of Refractory Hepatic Encephalopathy in a Postliver Retransplant Patient with Thrombosed Portal Vein: A Shunt for a Shunt
Authors: Salama Fady , Leyson Anna Christina , Shah Malay , Galuppo Monticelli Roberto
Published: February 2023

Hepatic encephalopathy (HE) is a frequent and serious complication of chronic liver disease. The mechanism of hepatic encephalopathy is not entirely clear. Hepatic encephalopathy is defined as brain dysfunction caused by liver insufficiency and/or portal-systemic blood shunting. It manifests as a wide spectrum of neurological or psychiatric abnormalities, ranging from subclinical alterations, detectable only by neuropsychological or neurophysiological assessment, to coma. Liver transplant (LT) is the definitive treatment for refractory hepatic encephalopathy. In this case, we present a challenging case of refractory hepatic encephalopathy in a postliver transplant patient with portal vein thrombosis and a splenorenal shunt treated with a novel technique to address his complex anatomy.
New Personal Model for Forecasting the Outcome of Patients with Histological Grade III-IV Colorectal Cancer Based on Regional Lymph Nodes
Authors: Yang Jun , Jin Wei , Lin Zhuoqun , Li Shaotang
Published: February 2023

Background. Metastases at regional lymph nodes could easily occur in patients with high-histological-grade colorectal cancer (CRC). However, few models were built on the basis of lymph nodes to predict the outcome of patients with histological grades III-IV CRC. Methods. Data in the Surveillance, Epidemiology, and End Results databases were used. Univariate and multivariate analyses were performed. A personalized prediction model was built in accordance with the results of the analyses. A nomogram was tested in two datasets and assessed using a calibration curve, a consistency index (C-index), and an area under the curve (AUC). Results. A total of 14,039 cases were obtained from the database. They were separated into two groups (9828 cases for constructing the model and 4211 cases for validation). Logistic and Cox regression analyses were then conducted. Factors such as log odds of positive lymph nodes (LODDS) were utilized. Then, a personalized prediction model was established. The C-index in the construction and validation groups was 0.770. The 1-, 3-, and 5-year AUCs were 0793, 0.828, and 0.830 in the construction group, respectively, and 0.796, 0.833, and 0.832 in the validation group, respectively. The calibration curves showed well consistency in the 1-, 3- and 5-year OS between prediction and reality in both groups. Conclusion. The nomogram built based on LODDS exhibited considerable reliability and accuracy.
The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication
Authors: Siahaan Selma , Rukmini Rukmini , Roosihermiatie Betty , Andarwati Pramita , Handayani Rini S. , Tarigan Ingan U. , Rosita Tita , Rustika Rustika , Usman Yuslely , Kristiana Lusi
Published: February 2023

An effective strategy for combatting AMR in Indonesia is to make the use of antibiotics in hospitals more rational with the help of an Antimicrobial Resistance Control Program (AMR-CP). This study aims to analyze the implementation of the AMR-CP in hospitals by conducting in-depth interviews with health professionals from ten hospitals and health officers of ten provincial health offices in ten different provinces and observation towards its documents. The sample location was selected by purposive sampling. Informants at the hospitals were hospital directors, chairmen of the AMR-CP team, chairmen of the medical committee, persons in charge of the microbiology laboratory, clinicians, nurses, clinical pharmacists, and those program managers at the provincial health offices who are responsible for administering antibiotics. Information is first collected and then a thematic analysis is applied along with triangulation to confirm the validity of information from multiple sources, including document observation results. The analysis is adapted to the framework of the system (i.e., input, process, and output). Results show that hospitals in Indonesia already have the resources to implement AMR-CP, including AMR-CP team and microbiology laboratories. Six hospitals examined also have clinicians trained in microbiology. Though hospital leadership and its commitment to implementing AMR-CP are favorable, there is room for improvement. AMR-CP teams organize routine activities for socialization and training, develop standard operating procedures (SOPs) for antibiotic use, antibiotic patterns surveillance, and bacterial mapping. Some obstacles to implementing AMR-CP policies are posed by the human resources, facilities, budget, antibiotics and reagent shortages, and clinician compliance with SOPs. The study concludes that there was an improvement in antibiotic sensitivity patterns, rational use of antibiotics, use of microbiological laboratories, and cost-efficiency. It recommends the government and healthcare providers continue to improve AMR-CP in hospitals and promote AMR-CP policy by making the regional health office of the hospital a representative of the regional government.
Not Just Pictures: Utility of Camera Trapping in the Context of African Swine Fever and Wild Boar Management
Authors: Palencia Pablo , Vada Rachele , Zanet Stefania , Calvini Mara , De Giovanni Andrea , Gola Giacomo , Ferroglio Ezio
Published: February 2023

African swine fever (ASF) is a highly contagious disease affecting all suids and wild boar (Sus scrofa). Since 2007, ASF has spread to more than 30 countries in Europe and Asian regions, and the most recent outbreak has been in mainland Italy (reported on January 2022). When the genotype II of the ASF virus infects a population, a mortality rate close to 90% is usually reported. This drop in wild boar abundance produces a cascade effect in the entire ecosystem. In this context, effective monitoring tools for deriving management parameters are a priority aspect, and the utility of camera trapping could have been overlooked. Here, sampling the infected area in north Italy, we showed the utility of camera traps in the context of ASF infection. Specifically, we used 43 camera traps randomly distributed to (i) estimate movement parameters and population density of wild boar, roe deer (Capreolus capreolus), and wolf (Canis lupus); (ii) quantify wild boar recruitment; and (iii) assess whether the human restriction rules are being met. On the first spring after the outbreak detection, our results for wild boar indicated a density of 0.27 ind·km−2 ± 0.11 (standard error, SE), a daily activity level of 0.49 ± 0.07 (i.e., 11.76 h·day−1), a daily distance travelled of 9.07 ± 1.80 km·day−1, a litter size of 1.72 piglets·group−1, and a 72% of pregnant females. Despite human outdoor activities being restricted in the infected zone, we recorded human presence in 19 camera traps. The wide range of parameters estimated from the camera trap data, together with some intrinsic and practical advantages of this tool, allows us to conclude that camera traps are well positioned to be a reference approach to monitor populations affected by ASF. The population-specific parameters are of prime importance for optimizing ASF control efforts.
Influence of Depth and Position of Vibration-Isolating Slot on Damping Effect of Blasting Vibration
Authors: Li Xiao , Wang Xinquan , Diao Hongguo , Zhang He , Zhu Chun
Published: February 2023

The blasting vibration has an impact on the rock and soil around the blasting hole and the nearby structures. The vibration-isolating slot is one of the methods to reduce the damage of blasting vibration. In this paper, the influences of the depth and position of the vibration isolation slot on the PPV (peak particle velocity) attenuation characteristics of the ground vibration and blasting vibration damping effect of the vibration isolation slot at different measuring points are studied systematically by LS-DYNA numerical models. The results show that the damping effect of the vibration isolation slot is realized by reflecting the blasting vibration wave and increasing the propagation paths of the blasting vibration wave. When the measuring points are 5 m∼45 m far away from the vibration-isolating slot, the average vibration damping effect of the vibration-isolating slot is more than 30% and the deeper the depth of the vibration isolation slot, the better the vibration damping effect when the measuring points are 5 m∼15 m far away from the vibration isolation slot. However, when the measuring points are 15 m∼45 m far away from the vibration isolation slot, the vibration damping effect is best when the depth of the vibration isolation slot is 15 m. The vibration damping effect of blasting vibration at the same measuring point is different due to different positions of vibration isolation slot. For the measuring points M3 and M5, with the increasing of the distance between the vibration-isolating slot and the explosion source, the vibration damping effect of the vibration-isolating slot shows an increasing-decreasing-increasing trend; however, it shows a decreasing-increasing-decreasing trend for the measuring point M4.
Distributed Fixed Time Control for DC Microgrid with Input Delay
Authors: Feng Yi Wei , Liu Jia Li
Published: February 2023

This paper develops a distributed fixed-time quadratic coordinated control strategy for isolated DC microgrids with time delays. The proposed control scheme based on the droop control strategy is intended to realize bus voltage recovery and current balance distribution under time delays. We first model the isolated DC microgrids as a single integrator system with input delays by the Artstein’s transform. The current balance and voltage recovery are achieved by using fixed time control, which does not depend on the initial state of the system. Based on the Lyapunov functional method, the stability analysis criterion of the system is derived. In order to verify the effectiveness of the proposed control method, the DC microgrid system is simulated in Matlab/Simulink.
Parameter Design of Half-Bridge Converter Series Y-Connection Microgrid Grid-Connected Filter Based on Improved PSO-LSSVM
Authors: Wang Xinggui , Li Jinjian , Guo Qun , Wang Hailiang , Ding Yingjie
Published: February 2023

The half-bridge converter series Y-connection microgrid (HCSY-MG) is a new type of series microgrid. In order to reduce the harmonic content in HCSY-MG grid-connected current and at the same time simplify the parameter design process of the LCL filter, this study proposed an LCL filter parameter design method based on an improved particle swarm optimization-least squares support vector machine (PSO-LSSVM) by analyzing the harmonic characteristics of the HCSY-MG grid-connected current. In addition, to enhance the convergence speed of PSO-LSSVM, the inertia factor during its parameters’ update is made to adjust adaptively according to the direction of two consecutive parameter changes to constitute an improved PSO-LSSVM. Through simulation and comparative analysis, it is demonstrated that the improved PSO-LSSVM can enhance the convergence speed; the proposed filter parameter design method can effectively reduce the harmonic content in the HCSY-MG grid-connected current and is simpler and more comprehensive than the existing design method.
Dynamics of Serological and Mucosal Antibody Responses against African Swine Fever Viruses in Experimentally Infected Pigs
Authors: Xie Qingyun , Bai Yun , Wang Wan , Chen Rong , Xing Huixuan , Wu Yuzi , Shao Guoqing , Bu Zhigao , Zhao Dongming , Feng Zhixin
Published: February 2023

African swine fever virus (ASFV) is a lethal swine pathogen, and there is no effective vaccine or treatment available for ASFV infection. Recently, the occurrence of ASFV genotype I and genotype II natural mutants that manifest as subacute, longer-incubation, or persistent infections poses threats to preventing ASFV infection. The dynamics of antibody responses to ASFV are still completely unrevealed, especially the secretion of mucosal antibodies in oral fluid. Here, a systematic analysis was performed of serological and mucosal antibody secretion against 6 ASFV antigens after direct or indirect infection with four different ASFV strains or genotypes, namely, the field virulent genotype II isolate ASFV HLJ/18, the artificially attenuated genotype II strain HLJ/18-7GD, the naturally attenuated genotype II isolate HLJ/HRB1/20, and genotype I isolate SD/DY-I/21. Severe clinical signs of HLJ/18 infection were observed in pigs from 4 days postinoculation. However, no clinical signs were observed in HLJ/18-7GD-infected pigs. The contact pigs cohoused with the pigs intramuscularly infected with the isolate SD/DY-I/21 or HLJ/HRB1/20 only showed chronic clinical signs. Interestingly, the oral fluid sIgA responses to all the selected antigens were significantly stronger and earlier than the serum IgG responses in both HLJ/18- and HLJ/18-7GD-challenged pigs. Although significant fluctuations and individual differences appeared in oral swab sIgA responses in the contact transmission group, they were earlier than the corresponding serological IgG responses. Moreover, according to the comparative analysis of the three infection groups, P54 was proposed to be a dominant target for serological IgG diagnosis, while P30, CD2v, P54, P22, and P10 were more advantageous as mucosal sIgA diagnosis targets. These results highlight the important role of mucosal antibodies in the early diagnosis of ASFV infection and can provide references to screen appropriate targets for ASFV detection.