bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the Safety Impact of Segment- and Intersection-Level Bicycle Treatments on Bicycle–Motorized Vehicle Crashes
Authors: Deliali Aikaterini , Fournier Nicholas , Christofa Eleni , Knodler Michael
Published: August 2022

Bicycle treatments are installed to elevate motorists’ awareness of the presence of bicyclists and to enhance bicycle safety and mobility. To date, no studies have compared the safety benefits of sharrows and protected- and conventional bike lanes, or intersection-level treatments like bike boxes and intersection-crossing pavement markings. One factor that limits bicycle safety research is the lack of adequate bicycle exposure data. For this study, a crowdsource app was used for estimating networkwide bicycle demand data for Portland, OR. Crash prediction models were developed for road segments and signalized intersections to associate bicycle treatment presence and type with crash frequency. Compared with the “no treatment” case, protected bike lanes (odds ratio [OR] = 0.032), sharrows (OR = 0.211), and conventional bike lanes (OR = 0.552) were safer for road segments. Signalized intersections where segment-level bicycle treatments exist at more than one of the intersecting roads were associated with higher crash frequency. Specifically, for signalized intersections with one conventional bike lane, with two conventional bike lanes, or with a conventional- and a protected bike lane, the respective CMFs were 1.94, 2.07, and 3.38. Signalized intersections with at least one bike box or intersection-crossing pavement markings experienced higher crash frequency than intersections with no treatments, however not necessarily in the approach where the treatment was located. The respective Crash Modification Factors (CMFs) were 1.39 and 1.76. The findings could guide practitioners in selecting bicycle treatments for segments, whereas the models for signalized intersections could identify intersections with high crash frequency that need safety improvements.
Methodology for Conflating Large-Scale Roadway Networks
Authors: Zhang Xu , Chen Mei
Published: August 2022

Transportation agencies are increasingly integrating third-party traffic data into their core business function areas such as system performance monitoring, project programming, traffic incident management, and safety analysis. However, linking private-sector data with agency asset inventory data has been a major challenge because the networks typically have different referencing systems, segmentation schemes, and representations of travel directions. This paper presents an effective conflation algorithm that associates spatial features between large-scale road networks. Instead of breaking lines into smaller pieces, which is a common technique in transportation applications, we use an intersection-based approach that leverages the inherent topological similarities between networks. The underlying uncertainty and imprecision in network geometries and road names are addressed through application of a fuzzy logic inference technique. We then implement an effective mechanism to handle differences in representations of divided roadways and travel directions in the two networks. The algorithm was tested on Kentucky statewide roadway networks and achieved a matching accuracy of over 99%. This approach has been successfully applied by the Kentucky Transportation Cabinet in its project identification and prioritization process.
Insidious Nonetheless: How Small Effects and Hierarchical Norms Create and Maintain Gender Disparities in Organizations
Authors: Du Yuhao , Nordell Jessica , Joseph Kenneth
Published: August 2022

The term glass ceiling is applied to the well-established phenomenon in which women and people of color are consistently blocked from reaching the uppermost levels of the corporate hierarchy. Focusing on gender, we present an agent-based model that explores how empirically established mechanisms of interpersonal discrimination coevolve with social norms at both the organizational (meso) and societal (macro) levels to produce this glass ceiling effect for women. Our model extends the understanding of how the glass ceiling arises and why it can be resistant to change. We do so by synthesizing existing psychological and structural theories of discrimination into a mathematical model that quantifies explicitly how complex organizational systems can produce and maintain inequality. We discuss implications of our findings for both intervention and future empirical analyses and provide open-source code for those wishing to adapt or extend our work.
Differential expression analysis of mRNAs, lncRNAs, and miRNAs expression profiles and construction of ceRNA networks in PEDV infection
Authors: Shi Xiaojie , Zhang Qi , Wang Jingjing , Zhang Yuting , Yan Yuchao , Liu Yi , Yang Naling , Wang Quanqiong , Xu Xingang
Published: August 2022

Background

Porcine Epidemic Diarrhea Virus (PEDV) is a coronavirus that seriously affects the swine industry. MicroRNAs and long noncoding RNAs are two relevant non-coding RNAs (ncRNAs) class and play crucial roles in a variety of physiological processes. Increased evidence indicates a complex interaction between mRNA and ncRNA. However, our understanding of the function of ncRNA involved in host-PEDV interaction is limited.

Results

A total of 1,197 mRNA transcripts, 539 lncRNA transcripts, and 208 miRNA transcripts were differentially regulated at 24 h and 48 h post-infection. Gene ontology (GO) and KEGG pathway enrichment analysis showed that DE mRNAs and DE lncRNAs were mainly involved in biosynthesis, innate immunity, and lipid metabolism. Moreover, we constructed a miRNA-mRNA-pathway network using bioinformatics, including 12 DE mRNAs, 120 DE miRNAs, and 11 pathways. Finally, the target genes of DE miRNAs were screened by bioinformatics, and we constructed immune-related lncRNA-miRNA-mRNA ceRNA networks. Then, the selected DE genes were validated by qRT-PCR, which were consistent with the results from RNA-Seq data.

Conclusions

This study provides the comprehensive analysis of the expression profiles of mRNAs, lncRNAs, and miRNAs during PEDV infection. We characterize the ceRNA networks which can provide new insights into the pathogenesis of PEDV.
Identification of HM13 as a prognostic indicator and a predictive biomarker for immunotherapy in hepatocellular carcinoma
Authors: Zhang Genhao , Lv Xianping , Yang Qiankun , Liu Hongchun
Published: August 2022

Background

Histocompatibility minor 13 (HM13) is a signal sequence stubbed intramembrane cleavage catalytic protein that is essential for cell signaling, intracellular communication, and cancer. However, the expression of HM13 and its prognostic value, association with tumor-infiltrating immune cells (TIICs) in the microenvironment, and potential to predict immunotherapeutic response in HCC are unknown.

Methods

The HM13 expression, clinicopathology analysis, and its influence on survival were analyzed in multiple public databases and further verified in collected HCC and normal tissues by qRT-PCR and immunohistochemistry staining assay (IHC). Furthermore, the lentivirus vector encoding HM13-shRNA to manipulate HM13 expression was selected to investigate whether HM13 could influence the malignant growth and metastasis potential of HCC cells. Finally, significant impacts of HM13 on the HCC tumor microenvironment (TME) and reaction to immune checkpoint inhibitors were analyzed.

Results

Upregulated HM13 was substantially correlated with poor prognosis in patients with HCC, and could facilitate the proliferation and migratory potential of HCC cells. Additionally, patients with high HM13 expression might be more sensitive to immunotherapy.

Conclusions

HM13 might be a prognostic biomarker and potential molecular therapeutic target for HCC.
Universal health coverage and the poor: to what extent are health financing policies making a difference? Evidence from a benefit incidence analysis in Zambia
Authors: Rudasingwa Martin , De Allegri Manuela , Mphuka Chrispin , Chansa Collins , Yeboah Edmund , Bonnet Emmanuel , Ridde Valéry , Chitah Bona Mukosha
Published: August 2022

Background

Zambia has invested in several healthcare financing reforms aimed at achieving universal access to health services. Several evaluations have investigated the effects of these reforms on the utilization of health services. However, only one study has assessed the distributional incidence of health spending across different socioeconomic groups, but without differentiating between public and overall health spending and between curative and maternal health services. Our study aims to fill this gap by undertaking a quasi-longitudinal benefit incidence analysis of public and overall health spending between 2006 and 2014.

Methods

We conducted a Benefit Incidence Analysis (BIA) to measure the socioeconomic inequality of public and overall health spending on curative services and institutional delivery across different health facility typologies at three time points. We combined data from household surveys and National Health Accounts.

Results

Results showed that public (concentration index of − 0.003; SE 0.027 in 2006 and − 0.207; SE 0.011 in 2014) and overall (0.050; SE 0.033 in 2006 and − 0.169; SE 0.011 in 2014) health spending on curative services tended to benefit the poorer segments of the population while public (0.241; SE 0.018 in 2007 and 0.120; SE 0.007 in 2014) and overall health spending (0.051; SE 0.022 in 2007 and 0.116; SE 0.007 in 2014) on institutional delivery tended to benefit the least-poor. Higher inequalities were observed at higher care levels for both curative and institutional delivery services.

Conclusion

Our findings suggest that the implementation of UHC policies in Zambia led to a reduction in socioeconomic inequality in health spending, particularly at health centres and for curative care. Further action is needed to address existing barriers for the poor to benefit from health spending on curative services and at higher levels of care.
Apical region correction and global balance: a 3-rods surgical strategy for the treatment of severe and rigid scoliosis
Authors: Jiao Yang , Tan Haining , Feng Erwei , Wang Zhen , Lin Youxi , Zhao Junduo , Shen Jianxiong
Published: August 2022

Background

The treatment of severe and rigid scoliosis is challenging. We developed a surgical strategy for severe and rigid scoliosis since 2014. This study aimed to retrospectively analyze the safety and efficacy of apical region correction and global balance with 3 rods as a surgical strategy for the treatment of severe and rigid scoliosis.

Methods

A retrospective study was performed for patients with severe and rigid scoliosis who underwent one-stage posterior corrective operation using the apical region correction and global balance with 3 rods surgical strategy between February 2014 and April 2020. The inclusion criteria were as follows: [1] Cobb angle > 90°; [2] flexibility < 30%; [3] a minimum 2-year follow-up. Patients were excluded if they had a history of traction or spinal surgery. Coronal and sagittal parameters, including Cobb angle, flexibility, apex vertebra translation, trunk shift (TS), thoracic kyphosis, lumbar lordosis, and sagittal vertical axis (SVA) were measured preoperatively, postoperatively and at the final follow-up. The Scoliosis Research Society 22-item questionnaire was administered preoperatively and at the final follow-up. During the operation, one slightly-bent short rod was placed into the concave side of apical region and correction was achieved by rod-rotation and distraction. Two pre-bent long rods were placed into both sides of the scoliosis and global balance was improved by leveling the proximal thoracic vertebrae and distal lumbar vertebrae.

Results

A total of 41 patients were included, with an average age of 20 years (range, 12–49 years) and follow-up of 34 months (range, 24–58 months). Postoperative correction rate was 53% for scoliosis. There were 14 patients with normal kyphosis before surgery, and 28 patients with normal kyphosis at the last follow-up. 88% of the patients (23/26) with preoperative coronal imbalance (TS > 20 mm) restored coronal balance at the final follow-up. 87% of the patients (14/16) with preoperative sagittal imbalance (SVA > 40 mm) restored sagittal balance at the final follow-up. The mean operation time and blood loss were 286 min and 941 mL, respectively. No patients had neurological complications or implant failure.

Conclusion

The surgical strategy of apical region correction and global balance with 3 rods is a safe and effective alternative for the surgical treatment of severe and rigid scoliosis.
Do pregnancy outcomes of women with false-positive early gestational diabetes mellitus differ from those of women with normal glucose tolerance?
Authors: Nakanishi Sayuri , Aoki Shigeru , Shindo Ryosuke , Obata Soichiro , Kasai Junko , Miyagi Etsuko
Published: August 2022

Background

To investigate whether false-positive early gestational diabetes mellitus (GDM) women can be managed similarly as normal glucose tolerance (NGT) women.

Methods

This retrospective study was conducted at a tertiary care center in Japan. Pregnancy and neonatal outcomes of 67 singleton pregnancies with false-positive early GDM and 1774 singleton pregnancies with NGT who delivered after 22 weeks of gestation were compared. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria (patients having one or more of the following: fasting plasma glucose ≥ 92 mg/dL and a 75 g oral glucose tolerance test (OGTT) value ≥ 180 mg/dL at 1 h, or ≥ 153 mg/dL at 2 h). Pregnant women diagnosed with GDM in early pregnancy who did not meet the diagnostic criteria on the second OGTT were defined as having false-positive early GDM. Women with false-positive early GDM did not receive any therapeutic intervention during gestation.

Results

Maternal age, pre-pregnancy body mass index, and gestational weight gain were significantly higher in the false-positive GDM group than in the NGT group. No significant differences were found in pregnancy outcomes, including gestational age, birth weight, large for gestational age rate, and cesarean delivery rate. Except for a higher neonatal hypoglycemia rate in the false-positive early GDM group, no significant differences were found in neonatal outcomes.

Conclusions

There were no clinically significant differences between early GDM false-positive women exhibiting GDM patterns only during early pregnancy and NGT women. False-positive early GDM women can be managed similarly as NGT women, suggesting that World Health Organization diagnostic guidelines, applying the IADPSG criteria during early pregnancy, need revision.
Role of PI3K/AKT pathway in squamous cell carcinoma with an especial focus on head and neck cancers
Authors: Ghafouri-Fard Soudeh , Noie Alamdari Ali , Noee Alamdari Yashar , Abak Atefe , Hussen Bashdar Mahmud , Taheri Mohammad , Jamali Elena
Published: August 2022

PI3K/AKT pathway is an important pathway in the carcinogenesis since it has central impacts in the regulation of metabolic pathways, cell proliferation and survival, gene expression and protein synthesis. This pathway has been reported to be dysregulated in several types of cancers. In the current review, we summarize the role of this signaling pathway in squamous cell carcinomas (SCCs) originated from different parts of body cervix, oral cavity, head and neck and skin. The data presented in the current review shows the impact of dysregulation of PI3K/AKT pathway in survival of patients with SCC. Moreover, targeted therapies against this pathway have been found to be effective in reduction of tumor burden both in animal models and clinical settings. Finally, a number of molecules that regulate PI3K/AKT pathway can be used as diagnostic markers for different types of SCCs.
A prospective short-term study to evaluate methodologies for the assessment of disease extent, impact, and wound evolution in patients with dystrophic epidermolysis bullosa
Authors: Paller Amy S. , Pope Elena , Rudin Dan , Malyala Anna , Ramsdell Deborah , Johnson Ramsey , Landy Hal , Murrell Dedee F. ,   the DEB Investigators
Published: August 2022

Background

Standardized assessments for dystrophic epidermolysis bullosa (DEB) are needed. This prospective, multicenter, 4-week, observational study was designed to evaluate DEB assessments for suitability as clinical trial endpoints.

Methods

Patients with confirmed DEB diagnosis and ≥ 5 measurable wounds were included. The primary outcome was change from baseline in wound surface area (WSA) of 5 selected wounds by 3-dimensional imaging. Secondary endpoints were change from baseline in clinician global assessment (CGA) of WSA, wound characteristics, disease-related questionnaires and instruments (disease severity, quality of life [QoL], pain and disability, and itch), and tolerability of procedures.

Results

Of 30 enrolled patients, 29 completed the study (of whom, 28 had recessive DEB). Median age was 17.8 years (range, 3.8–58.7). All patients developed new or recurrent wounds during the 4-week study. Of the wounds selected at baseline, 45/150 (30.0%) healed by week 2; an additional 38 healed by week 4, while 8 of those healed at week 2 had recurred by week 4 for a total of 75/150 (50.0%) healed wounds at week 4. Mean values for WSA, CGA, and disease-related questionnaire and instrument scores remained steady during this 4-week observational study. Of the 10 disease-related questionnaires and instruments assessed, the scores for the Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI) and the Instrument for Scoring Clinical Outcomes for Research of Epidermolysis Bullosa (iscorEB) did not substantially overlap between moderate and severe disease. Between mild and moderate disease, only the EBDASI scores did not substantially overlap.

Conclusions

These results stress the dynamic nature of wounds, even during a 4-week period of observation, and suggest that a combination of clinician-assessed outcomes and patient-/caregiver-reported outcomes is needed to provide a comprehensive assessment of DEB severity and impact. In addition, these results support the use of EBDASI and iscorEB to monitor disease severity as both produced scores that did not substantially overlap between disease severity strata.

Clinical trial registration ClinicalTrials.gov, NCT02178969. Registered 4 June 2014, https://clinicaltrials.gov/ct2/show/NCT02178969.
Patterns and determinants of adherence to resistance and endurance training during cancer treatment in the Phys-Can RCT
Authors: Brooke Hannah L. , Mazzoni Anne-Sophie , Buffart Laurien M. , Berntsen Sveinung , Nordin Karin , Demmelmaier Ingrid
Published: August 2022

Background

Knowledge regarding adherence is necessary to improve the specificity of exercise interventions during cancer treatment. We aimed to determine adherence to resistance and endurance training interventions in parallel; identify subgroups with similar adherence characteristics; and examine determinants of these subgroups.

Methods

In the Phys-Can randomised controlled trial, participants (n = 577, 81% women, mean(SD) age 59(12) years, and 50% with BMI ≥ 25 kg/m2) starting (neo-) adjuvant treatment for breast, colorectal or prostate cancer were randomized to 6-month of high (HI) or low-to-moderate intensity (LMI) supervised, group-based resistance training and individual home-based endurance training, with or without behavior change support. Adherence was calculated as performed exercise volume as a proportion of prescribed exercise volume (0–100%), overall (HI and LMI groups) and for frequency, intensity, type and time (FITT principles) (HI group). Adherence to resistance training was plotted against adherence to endurance training overall and for each FITT principle. K-means cluster analysis was used to identify subgroups with similar adherence characteristics. Potential determinants of subgroup membership were examined using multinomial logistic regression.

Results

We found a positive curvilinear correlation between adherence to resistance and endurance training overall. A similar correlation was seen for adherence to frequency of resistance vs. endurance training in the HI group. In the HI group, adherence to resistance training intensity and time was > 80% for almost all participants. For endurance training adherence ranged from 0 to 100% for each of the FITT principles. Three clusters were identified, representing low, mixed, and high adherence to resistance and endurance training overall. Participants with higher age (Relative risk ratio [95% CI]; LMI: 0.86[0.77–0.96], HI: 0.83[0.74–0.93]), no behaviour change support (LMI: 0.11[0.02–0.56], HI: 0.20[0.05–0.85]), higher cardiorespiratory fitness (LMI: 0.81[0.69–0.94], HI: 0.80[0.69–0.92]), more fatigue (according to the reduced activity subscale of the MFI questionnaire) (LMI: 0.48[0.31–0.73], HI: 0.69[0.52–0.93]) or higher quality of life (LMI: 0.95[0.90–1.00], HI: 0.93[0.88–0.98]) were less likely to be in the low than the high adherence cluster whether randomised to LMI or HI training. Other determinants were specific to those randomised to LMI or HI training.

Conclusions

In an exercise intervention during cancer treatment, adherence to resistance and endurance training were positively correlated. Personalisation of interventions and additional support for some subgroups of participants may improve adherence.

Trial registrationNCT02473003 (clinicaltrials.gov, Registered 16/06/2015).
Sourcing of human peripheral blood-derived myeloid angiogenic cells under xeno-free conditions for the treatment of critical limb ischemia
Authors: Wong Christy Wing Tung , Sawhney Apurva , Wu Yalan , Mak Yi Wah , Tian Xiao Yu , Chan Hon Fai , Blocki Anna
Published: August 2022

Background

Critical limb ischemia (CLI) is the most severe form of peripheral artery disease and exhibits a high risk of lower extremity amputations. As even the most promising experimental approaches based on mesenchymal stem cells (MSCs) demonstrated only moderate therapeutic effects, we hypothesized that other cell types with intrinsic roles in angiogenesis may exhibit a stronger therapeutic potential. We have previously established a protocol to source human peripheral blood-derived angiogenic cells (BDACs). These cells promoted revascularization and took perivascular location at sites of angiogenesis, thus resembling hematopoietic pericytes, which were only described in vivo so far. We thus hypothesized that BDACs might have a superior ability to promote revascularization and rescue the affected limb in CLI.

Methods

As standard BDAC sourcing techniques involve the use of animal-derived serum, we sought to establish a xeno- and/or serum-free protocol. Next, BDACs or MSCs were injected intramuscularly following the ligation of the iliac artery in a murine model. Their ability to enhance revascularization, impair necrosis and modulate inflammatory processes in the affected limb was investigated. Lastly, the secretomes of both cell types were compared to find potential indications for the observed differences in angiogenic potential.

Results

From the various commercial media tested, one xeno-free medium enabled the derivation of cells that resembled functional BDACs in comparable numbers. When applied to a murine model of CLI, both cell types enhanced limb reperfusion and reduced necrosis, with BDACs being twice as effective as MSCs. This was also reflected in histological evaluation, where BDAC-treated animals exhibited the least muscle tissue degeneration. The BDAC secretome was enriched in a larger number of proteins with pro-angiogenic and anti-inflammatory properties, suggesting that the combination of those factors may be responsible for the superior therapeutic effect.

Conclusions

Functional BDACs can be sourced under xeno-free conditions paving the way for their safe clinical application. Since BDACs are derived from an easily accessible and renewable tissue, can be sourced in clinically relevant numbers and time frame and exceeded traditional MSCs in their therapeutic potential, they may represent an advantageous cell type for the treatment of CLI and other ischemic diseases.
Intra-amniotic transplantation of brain-derived neurotrophic factor-modified mesenchymal stem cells treatment for rat fetuses with spina bifida aperta
Authors: Ma Wei , Wei Xiaowei , Gu Hui , Liu Dan , Luo Wenting , Cao Songying , Jia Shanshan , He Yiwen , Chen Lizhu , Bai Yuzuo , Yuan Zhengwei
Published: August 2022

Background

Spina bifida aperta (SBA) is a relatively common clinical type of neural tube defect. Although prenatal fetal surgery has been proven to be an effective treatment for SBA, the recovery of neurological function remains unsatisfactory due to neuron deficiencies. Our previous results demonstrated that intra-amniotic transplanted bone marrow mesenchymal stem cells (BMSCs) could preserve neural function through lesion-specific engraftment and regeneration. To further optimize the role of BMSCs and improve the environment of defective spinal cords so as to make it more conducive to nerve repair, the intra-amniotic transplanted BMSCs were modified with brain-derived neurotrophic factor (BDNF-BMSCs), and the therapeutic potential of BDNF-BMSCs was verified in this study.

Methods

BMSCs were modified by adenovirus encoding a green fluorescent protein and brain-derived neurotrophic factor (Ad-GFP-BDNF) in vitro and then transplanted into the amniotic cavity of rat fetuses with spina bifida aperta which were induced by all-trans-retinoic acid on embryonic day 15. Immunofluorescence, western blot and real-time quantitative PCR were used to detect the expression of different neuron markers and apoptosis-related genes in the defective spinal cords. Lesion areas of the rat fetuses with spina bifida aperta were measured on embryonic day 20. The microenvironment changes after intra-amniotic BDNF-BMSCs transplantation were investigated by a protein array with 90 cytokines.

Results

We found that BDNF-BMSCs sustained the characteristic of directional migration, engrafted at the SBA lesion area, increased the expression of BDNF in the defective spinal cords, alleviated the apoptosis of spinal cord cells, differentiated into neurons and skin-like cells, reduced the area of skin lesions, and improved the amniotic fluid microenvironment. Moreover, the BDNF-modified BMSCs showed a better effect than pure BMSCs on the inhibition of apoptosis and promotion of neural differentiation.

Conclusion

These findings collectively indicate that intra-amniotic transplanted BDNF-BMSCs have an advantage of promoting the recovery of defective neural tissue of SBA fetuses.
Shallow and deep feature fusion for digital audio tampering detection
Authors: Wang Zhifeng , Yang Yao , Zeng Chunyan , Kong Shuai , Feng Shixiong , Zhao Nan
Published: August 2022

Digital audio tampering detection can be used to verify the authenticity of digital audio. However, most current methods use standard electronic network frequency (ENF) databases for visual comparison analysis of ENF continuity of digital audio or perform feature extraction for classification by machine learning methods. ENF databases are usually tricky to obtain, visual methods have weak feature representation, and machine learning methods have more information loss in features, resulting in low detection accuracy. This paper proposes a fusion method of shallow and deep features to fully use ENF information by exploiting the complementary nature of features at different levels to more accurately describe the changes in inconsistency produced by tampering operations to raw digital audio. Firstly, the audio signal is band-pass filtered to obtain the ENF component. Then, the discrete Fourier transform (DFT) and Hilbert transform are performed to obtain the phase and instantaneous frequency of the ENF component. Secondly, the mean value of the sequence variation is used as the shallow feature; the feature matrix obtained by framing and reshaping of the ENF sequence is used as the input of the convolutional neural network; the characteristics of the fitted coefficients are obtained by curve fitting. Then, the local details of ENF are obtained from the feature matrix by the convolutional neural network, and the global information of ENF is obtained by fitting coefficient features through deep neural network (DNN). The depth features of ENF are composed of ENF global information and local information together. The shallow and deep features are fused using an attention mechanism to give greater weights to features useful for classification and suppress invalid features. Finally, the tampered audio is detected by downscaling and fitting with a DNN containing two fully connected layers, and classification is performed using a Softmax layer. The method achieves 97.03% accuracy on three classic databases: Carioca 1, Carioca 2, and New Spanish. In addition, we have achieved an accuracy of 88.31% on the newly constructed database GAUDI-DI. Experimental results show that the proposed method is superior to the state-of-the-art method.
A method for mixed additive and multiplicative random error models with inequality constraints in geodesy
Authors: Wang Leyang , Chen Tao
Published: August 2022

In the geodetic data processing field, most methods for dealing with inequality constraints model are based on additive random error (ARE) models, and there have been few studies on mixed additive and multiplicative random error (MAAMRE) models with inequality constraints. To address this problem, a MAAMRE model with inequality constraints is first established based on the definition of inequality constraint equations, and then, a corresponding parameter estimation algorithm is proposed based on the idea of an exhaustive search method. In addition, considering a MAAMRE model for an ill-posed problem, an iterative regularization solution for an ill-posed MAAMRE model is first derived, and then, a specific parameter estimation algorithm for an ill-posed MAAMRE model with inequality constraints is further proposed by applying the exhaustive search approach. Finally, the feasibility and advantages of the proposed algorithms are verified by global positioning system (GPS) elevation fitting model and digital terrain model (DTM) examples.

Graphical Abstract
Optimal bispectral index level of sedation and cerebral oximetry in traumatic brain injury: a non-invasive individualized approach in critical care?
Authors: Froese Logan , Gomez Alwyn , Sainbhi Amanjyot Singh , Batson Carleen , Slack Trevor , Stein Kevin Y. , Mathieu Francois , Zeiler Frederick A.
Published: August 2022

Background

Impaired cerebral autoregulation has been linked with worse outcomes, with literature suggesting that current therapy guidelines fail to significantly impact cerebrovascular reactivity. The cerebral oximetry index (COx_a) is a surrogate measure of cerebrovascular reactivity which can in theory be obtained non-invasively using regional brain tissue oxygen saturation and arterial blood pressure. The goal of this study was to assess the relationship between objectively measured depth of sedation through BIS and autoregulatory capacity measured through COx_a.

Methods

In a prospectively maintained observational study, we collected continuous regional brain tissue oxygen saturation, intracranial pressure, arterial blood pressure and BIS in traumatic brain injury patients. COx_a was obtained using the Pearson’s correlation between regional brain tissue oxygen saturation and arterial blood pressure and ranges from − 1 to 1 with higher values indicating impairment of cerebrovascular reactivity. Using BIS values and COx_a, a curve-fitting method was applied to determine the minimum value for the COx_a. The associated BIS value with the minimum COx_a is called BISopt. This BISopt was both visually and algorithmically determined, which were compared and assessed over the whole dataset.

Results

Of the 42 patients, we observed that most had a parabolic relationship between BIS and COx_a. This suggests a potential “optimal” depth of sedation where COx_a is the most intact. Furthermore, when comparing the BISopt algorithm with visual inspection of BISopt, we obtained similar results. Finally, BISopt % yield (determined algorithmically) appeared to be independent from any individual sedative or vasopressor agent, and there was agreement between BISopt found with COx_a and the pressure reactivity index (another surrogate for cerebrovascular reactivity).

Conclusions

This study suggests that COx_a is capable of detecting disruption in cerebrovascular reactivity which occurs with over-/under-sedation, utilizing a non-invasive measure of determination and assessment. This technique may carry implications for tailoring sedation in patients, focusing on individualized neuroprotection.
Towards green biomanufacturing of high-value recombinant proteins using promising cell factory: Chlamydomonas reinhardtii chloroplast
Authors: Ma Ke , Deng Lei , Wu Haizhen , Fan Jianhua
Published: August 2022

Microalgae are cosmopolitan organisms in nature with short life cycles, playing a tremendous role in reducing the pressure of industrial carbon emissions. Besides, microalgae have the unique advantages of being photoautotrophic and harboring both prokaryotic and eukaryotic expression systems, becoming a popular host for recombinant proteins. Currently, numerous advanced molecular tools related to microalgal transgenesis have been explored and established, especially for the model species Chlamydomonas reinhardtii (C. reinhardtii hereafter). The development of genetic tools and the emergence of new strategies further increase the feasibility of developing C. reinhardtii chloroplasts as green factories, and the strong genetic operability of C. reinhardtii endows it with enormous potential as a synthetic biology platform. At present, C. reinhardtii chloroplasts could successfully produce plenty of recombinant proteins, including antigens, antibodies, antimicrobial peptides, protein hormones and enzymes. However, additional techniques and toolkits for chloroplasts need to be developed to achieve efficient and markerless editing of plastid genomes. Mining novel genetic elements and selectable markers will be more intensively studied in the future, and more factors affecting protein expression are urged to be explored. This review focuses on the latest technological progress of selectable markers for Chlamydomonas chloroplast genetic engineering and the factors that affect the efficiency of chloroplast protein expression. Furthermore, urgent challenges and prospects for future development are pointed out.
Efficient synthesis 1,4-cyclohexanedicarboxaldehyde by an engineered alcohol oxidase
Authors: Cheng Yaqi , Song Wei , Chen Xiulai , Gao Cong , Liu Jia , Guo Liang , Zhu Meng , Liu Liming , Wu Jing
Published: August 2022

In this study, we selected and engineered a flavin adenine dinucleotide (FAD)-dependent alcohol oxidase (AOX) to produce 1,4-cyclohexanedicarboxaldehyde (CHDA), an initial raw material for spiral compounds, from 1,4-cyclohexanedimethanol (CHDM). First, the structure of alcohol oxidase from Arthrobacter cholorphenolicus (AcCO) was analyzed, and the mechanism of AcCO-catalyzed primary alcohol oxidation was elucidated, demonstrating that the energy barrier of the hydride (H−) transfer (13.4 kcal·mol−1 and 20.4 kcal·mol−1) decreases the catalytic efficiency of the primary alcohol oxidation reaction. Therefore, we designed a protein engineering strategy to adjust the catalytically active conformation to shorten the distance of hydride (H−) transfer and further decreased the core energy barrier. Following this strategy, variant W4 (S101A/H351V/N378S/Q329N) was obtained with 112.5-fold increased catalytic efficiency to produce CHDA compared to that of the wild-type strain. The 3 L scale preparation of CHDA reached a titer up to 29.6 g·L−1 with a 42.2% yield by an Escherichia coli whole-cell catalyst, which demonstrates the potential of this system for industrial application.

Graphical Abstract
The Clinical Utility of the Child SCAT5 for Acute Concussion Assessment
Authors: Erdman Nicholas K. , Kelshaw Patricia M. , Hacherl Samantha L. , Caswell Shane V.
Published: August 2022

Background

The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5) was developed to evaluate children between 5 and 12 years of age for a suspected concussion. However, limited empirical evidence exists demonstrating the value of the Child SCAT5 for acute concussion assessment. Therefore, the purpose of our study was to examine differences and assess the diagnostic properties of Child SCAT5 scores among concussed and non-concussed middle school children on the same day as a suspected concussion.

Methods

Our participants included 34 concussed (21 boys, 13 girls; age = 12.8 ± 0.86 years) and 44 non-concussed (31 boys, 13 girls; age = 12.4 ± 0.76 years) middle school children who were administered the Child SCAT5 upon suspicion of a concussion. Child SCAT5 scores were calculated from the symptom evaluation (total symptoms, total severity), child version of the Standardized Assessment of Concussion (SAC-C), and modified Balance Error Scoring System (mBESS). The Child SCAT5 scores were compared between the concussed and non-concussed groups. Non-parametric effect sizes ($$r=\frac{Z}{\sqrt{n}}$$

r
=

Z

n

) were calculated to assess the magnitude of difference for each comparison. The diagnostic properties (sensitivity, specificity, diagnostic accuracy, predictive values, likelihood ratios, and diagnostic odds ratio) of each Child SCAT5 score were also calculated.

Results

Concussed children endorsed more symptoms (p < 0.001, $$r$$
r
=0.45), higher symptom severity (p < 0.001, $$r$$
r
=0.44), and had higher double leg (p = 0.046, $$r$$
r
=0.23), single leg (p = 0.035, $$r$$
r
=0.24), and total scores (p = 0.022, $$r$$
r
=0.26) for the mBESS than the non-concussed children. No significant differences were observed for the SAC-C scores (p’s ≥ 0.542). The quantity and severity of endorsed symptoms had the best diagnostic accuracy (AUC = 0.76–0.77), negative predictive values (NPV = 0.84–0.88), and negative likelihood ratios (-LR = 0.22–0.31) of the Child SCAT5 scores.

Conclusions

Clinicians should prioritize interpretation of the symptom evaluation form of the Child SCAT5 as it was the most effective component for differentiating between concussed and non-concussed middle school children on the same day as a suspected concussion.
Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol
Authors: Khazanov Gabriela Kattan , Jager-Hyman Shari , Harrison Joseph , Candon Molly , Buttenheim Alison , Pieri Matteo F. , Oslin David W. , Wolk Courtney Benjamin
Published: August 2022

Background

Primary care is an ideal setting to connect individuals at risk for suicide to follow-up care; however, only half of the patients referred from the primary care attend an initial mental health visit. We aim to develop acceptable, feasible, low-cost, and effective new strategies to increase treatment initiation among at-risk individuals identified in primary care.

Methods

We will conduct a multi-phase, mixed-methods study. First, we will conduct a chart review study by using administrative data, including medical records, to identify characteristics of primary care patients at risk for suicide who do or do not attend an initial mental health visit following a referral. Second, we will conduct a mixed methods study by using direct observations and qualitative interviews with key stakeholders (N = 65) to understand barriers and facilitators to mental health service initiation among at-risk individuals. Stakeholders will include patients with suicidal ideation referred from primary care who do and do not attend a first mental health visit, primary care and behavioral health providers, and individuals involved in the referral process. We also will collect preliminary self-report and behavioral data regarding potential mechanisms of behavior change (i.e., self-regulation and social support) from patients. Third, we will leverage these findings, relevant frameworks, and the extant literature to conduct a multi-arm, non-randomized feasibility trial. During this trial, we will rapidly prototype and test strategies to support attendance at initial mental health visits. Strategies will be developed with subject matter experts (N = 10) and iteratively pilot tested (~5 patients per strategy) and refined. Research will be completed in the Penn Integrated Care Program (PIC), which includes fourteen primary care clinics in Philadelphia that provide infrastructure for electronic referrals, patient communication, and data access.

Discussion

We will leverage frameworks and methods from behavioral economics and implementation science to develop strategies to increase mental health treatment initiation among individuals at risk for suicide identified in primary care. This project will lead to an evaluation of these strategies in a fully powered randomized trial and contribute to improvements in access to and engagement in mental health services for individuals at risk for suicide.

Trial registration

ClinicalTrials.gov Identifier: NCT05021224
Postoperative delirium does not affect cardiopulmonary exercise testing in aged patients undergoing cardiac valve surgery
Authors: Shimomoto Yuta , Mukaiyama Kana , Hori Takashi , Inaki Yuichirou , Masai Takafumi , Hayashi Yukio
Published: August 2022

Background

The effect of delirium on cardiopulmonary exercise testing (CPX) is unknown. This retrospective study was to examine the effect of delirium on CPX at discharge in aged patients undergoing cardiac surgery.

Methods

This study included seventy patients aged 70 or older undergoing cardiac valve surgery, who entered our ICU and were discharged from our hospital between June 2016 and July 2018. All patients received active exercise by our rehabilitation team from the first postoperative day and were performed a CPX on a cycle ergometer before discharge. The anaerobic threshold oxygen uptake and the slope of the relationship between carbon dioxide output and minute ventilation were examined. We obtained the patient’s data, including patient’s characteristics, cardiac function, anesthesia data, laboratory data, ICU data, and length of ICU and hospital stay. Data were analyzed by unpaired t test or Fisher’s exact test. P < 0.05 was considered statistically significant.

Results

Of the 70 patients, 21 patients experienced delirium during ICU stay. The delirium group needed longer administration of sedatives and longer ICU stay and showed higher CRP value and lower renal function but similar cardiopulmonary function before discharge from our hospital compared with the non-delirium group.

Conclusions

Patients with a history of delirium during ICU showed higher CRP value and lower renal function before discharge, but the CPX values at discharge were not significantly affected by delirium.
Performance evaluation of resin wafer electrodeionization for cooling tower blowdown water reclamation
Authors: Tseng Po-Chih , Lin Zhan-Zhao , Chen Tse-Lun , Lin Yupo , Chiang Pen-Chi
Published: August 2022

The complicated nexus between water resource and energy consumption poses the problems of water scarcity, safety, affordability and carbon emissions. In the industrial and commercial buildings, the cooling tower is an inevitable system and has been considered to contribute water-energy consumption. Therefore, the high energy efficiency of water recovery technology should be practically developed to minimize the freshwater usage with lower energy consumption. In this study, a robust ion-exchange resin-wafer electrodeionization (RW-EDI) technology was used to demonstrate the desalination of cooling tower blowdown wastewater. Immobilizing the conventional ion-exchange resin into porous material between compartment can enhance ion transportation and significantly reduce the service labor for assembling and maintenance. The removal efficiency for blowdown water reclamation using RW-EDI was evaluated along with energy consumption, productivity, and current efficiency by investigating the key operating parameters including applied voltage and superficial velocity. The experimental design was based on the response surface methodology to statistically elucidate the optimal conditions. Results show that the energy consumption was 0.28 kWh m− 3 and productivity 23.4 L h− 1 m− 2 with around 90% removal of hardness to meet the standard of make-up water for blowdown water reclamation.
Linkage of pipeline blockage to coagulation-flocculation process: effect of anionic polymer and pH
Authors: Praptiwi Rosalina Eka , Syu Jyun-Cyuan , Cheng Hai-Hsuan , Yu Tsung-Hsiung , Wu Yu-Charng , Whang Liang-Ming
Published: August 2022

This study investigated the frequent blockages observed in the discharge pipeline in the chemical mechanical polishing wastewater treatment plant. Preliminary analyses indicated that blockages were predominantly consisted of residual organically-bounded Al due to overdosage of polyaluminum chloride (PACl) and anionic polymer during coagulation-flocculation process. To minimize the recurrence of blockage, jar test experiments were conducted in this study to identify optimum dosages of PACl and anionic polymer as well as optimum pH value. According to the model derived from jar tests, the optimum PACl dosage was dependent on the soluble Cu concentration of wastewater with low initial turbidity [< 1000 nephelometry turbidity units (NTU)]. The PACl dosage would require more than 5 mg L−1 when soluble copper below 20 mg L−1, while PACl is not necessary when more than 20 mg L−1 of soluble copper in the wastewater. On the other hand, optimal PACl dosage was dependent on the initial turbidity of wastewater with high initial turbidity (> 1000 NTU), while the optimal PACl dosage was 30 mg L−1 when initial turbidity around 7000 NTU. The change of pH in the range of 8 to 9.5 did not significantly affect the turbidity or Cu removal, however, higher pH increased the deposition of residual monomeric Al species which might lead to blockage. In summary, controlling PACl dosage at optimum dosage under the conditions of pH 8.5 ± 0.5 and 1 mg L−1 polymer could reduce the blockage occurrence as well as maintain the effluent quality to meet the standards.