bluuebunny/crossref_metadata_2025 huggingface dataset:
The structural evolution, optical gap, and thermoelectric properties of the RbPb2Br5 layered halide, prepared by mechanochemistry
Authors: Abia Carmen , López Carlos A. , Gainza Javier , Rodrigues João Elias F. S. , Ferrer Mateus M. , Nemes N. M. , Dura Oscar J. , Martínez José L. , Fernández-Díaz María T. , Álvarez-Galván Consuelo , Németh Gergely , Kamarás Katalin , Fauth François , Alonso José A.
Published: March 2022

RbPb2Br5 was studied by SXRD and NPD data from 15 to 573 K, yielding information on Rb–Br and Pb–Br chemical bonds. The electron lone pair of Pb2+ is visualized. Photoluminescence excitation and emission spectra suggest applications in photovoltaics.
Improving thermal stability of LiNbO3 based electro‐optical electric field sensor by depositing a TiO2 film
Authors: Wang She , Wang Hai , Li Chanxiao , Zhuang Chijie , Zeng Rong
Published: March 2022

Electro‐optic electric field sensors based on LiNbO3 are widely used for the measurement of electric fields or transient voltages. However, the working bias of the sensor is influenced by the temperature due to the thermo‐optic effect of LiNbO3. An athermal electro‐optic electric field sensor was demonstrated by coating a thin layer of TiO2 film which has a negative thermo‐optic coefficient, on the common‐path interferometer based sensor to compensate LiNbO3's positive thermo‐optic coefficient. Both calculation and experimental studies were conducted. The experimental results reasonably agree well with the calculated values, and the results show the sensor coated with a 640 nm thick TiO2 film has a much smaller temperature dependence of 0.011°/°C compared to the initial value of 0.1°/°C.
Complications, Length of Hospital Stay, and Cost of Care after Surgery for Pyogenic Spondylodiscitis
Authors: Abboud Tammam , Melich Patrick , Scheithauer Simone , Rohde Veit , Schatlo Bawarjan
Published: March 2022

Background Infectious Spondylodiscitis is a heterogeneous disease usually affecting a fragile patient population with multiple comorbidities. Therefore, surgical and medical complications are important considerations before initiating treatment.

Methods This retrospective analysis included data of 218 patients who underwent surgical treatment for pyogenic Spondylodiscitis between 2008 and 2016. Groups were divided into length of hospital stay (LOS) (group I ≤21 days and group II>21 days). Analysis included patient age, gender, Charlson comorbidity index, smoking, obesity, osteoporosis, colonization with multidrug-resistant bacteria, preoperative neurologic deficit, pre- and postoperative inflammation markers (CRP and WBC), duration of surgery, number of operated segments, vertebrectomy, and postoperative medical and surgical complications. The case value for each patient expressed in Euro was retrieved from hospital records and included in the analysis.

Results Duration of stay after surgical treatment of Spondylodiscitis was ≤21 days (range: 4–21 days; mean: 16 days) in 41% of patients and >21 days (range: 22–162 days; mean: 41 days) in 59% of the patients. Multivariate analysis showed that both medical complications (odds ratio [OR]: 2.62; 95% confidence interval [CI]: 1.24–5.56; p=0.012) and surgical site infection (OR: 6.04; 95% CI: 2.35–15.51; p<0.001) were independently associated with a long hospital stay. Case values averaged at €21,667±1,579 (minimum: €2,888; maximum: €203,802) and correlated significantly with the length of hospital stay (Pearson's correlation coefficient: 0.681; p<0.05). The occurrence of a postoperative complication increased the cost of care significantly from €17,790 to 24,527 on average (p=0.025).

Conclusions This study provides benchmark data for patients treated surgically for Spondylodiscitis. Surgical site infection and medical complications are the main drivers of prolonged hospital stays and cost of care.
Physiologic Osseous Remodeling of the Anterior Wall of the Spinal Canal after Anterior Cervical Corpectomy and Fusion: A Retrospective Observational Study
Authors: Ni Haofei , Mao Wei , Li Hailong , Dong Youhai
Published: March 2022

Background Anterior cervical corpectomy and fusion (ACCF) has been widely used in the treatment of cervical spondylotic myelopathy (CSM), ossification of posterior longitudinal ligament (OPLL), cervical trauma, and other cervical diseases, but few studies have reported the osseous and physiologic remodeling of the anterior wall of the spinal canal following ACCF. In this study, we analyze that remodeling process and its influence on titanium mesh cage (TMC) subsidence.

Methods We performed a clinical and radiologic analysis of consecutive patients treated with ACCF. Growth rates (GRs) reflecting the extent of remodeling of the remnants of the resected vertebral bodies were measured. We compared the computed tomography (CT) scans taken immediately and at least 1 year after surgery, and a literature review was conducted.

Results In all, 48 patients underwent ACCF at a mean age of 61.5 ± 12.0 years. The median follow-up was 36 months, and 159 CT images were analyzed. The GR values of the remnants of the vertebral bodies on CT images immediately and 1 year after surgery were 0.505 ± 0.077 and 0.650 ± 0.022 (p < 0.001), respectively, and the GR value at ≥4 years was 1. Axial CT scans showed that remodeling starts from the lateral remnants of the resected vertebral bodies, finally reaching the center. When fusion of the vertebral bodies and the titanium cage was complete during the first year after ACCF, osteogenesis and remodeling were initiated in the osseous anterior wall of the spinal canal. The remodeling of the osseous anterior wall of the spinal canal was completed at the fourth year after surgery, without recompressing the spinal cord, as seen on both axial and lateral CT scans. According to the literature review, there was no TMC subsidence at more than 4 years after surgery.

Conclusion The anterior wall of the spinal canal undergoes osseous remodeling after ACCF. The process is complete in the fourth year after surgery and prevents TMC subsidence.
A Data-Driven Assessment of the U.S. Health Informatics Programs and Job Market
Authors: Patel Jay S. , Vo Hoa , Nguyen An , Dzomba Bari , Wu Huanmei
Published: March 2022

Background Health Informatics (HI) is an interdisciplinary field, integrating health sciences, computer science, information science, and cognitive science to assist health information management, analysis, and utilization. As the HI field is broad, it is impossible that a student will be able to master all the diverse HI topics. Thus, it is important to train the HI students based on the offering of the various HI programs and needs of the current market. This project will study the U.S. HI programs, training materials, HI job market, the skillset required by the employers, competencies taught in HI programs, and comparisons between them.

Methods We collected the training information for the 238 U.S. universities that offered MS, PhD, or postbaccalaureate certificate programs in HI or related professions. Next, we explored the HI job market by randomly checking 200 jobs and their required skillsets and domain knowledge. Then, we compared these skillsets with those offered by the HI programs and identified the gaps and overlaps for program enhancements.

Results Among the 238 U.S. universities, 94 universities offer HI programs: 92 universities with MS (Master of Science), 43 with doctoral, 42 with both MS and doctoral, and 54 with certificate programs. The most offered HI courses are related to practicum, data analytics, research, and ethics. For the HI job postings, the three most technical skillsets required in HI job posting are data analysis, database management, and knowledge of electronic health records. However, only 58% of HI programs offer courses in database management and analytics. Compared with American Medical Informatics Association's recommended 10 fundamental domains, the HI curriculum generally lacks training in socio-technical systems, social-behavioral aspects of health, and interprofessional collaborative practice.

Conclusion There are gaps between the industry expectations of HI and the training received in HI programs. Advance level technical courses are needed in HI programs to meet industry expectations.
What really brings you here today? Applying McWhinney’s Taxonomy of Patient Behaviour between the first waves of COVID-19
Authors: Liberatti Barros Ana Carolina , de Souza Lucio Donavan
Published: March 2022

Introduction Dr Ian McWhinney argued that the behaviour of patients should be classified in parallel with the taxonomy of disease. Therefore, he proposed a Taxonomy of Patient Behaviour, taking the doctor–patient contact as the reference point. Aim To assess McWhinney’s Taxonomy of Patient Behaviour and explore its associations with patient age and gender, type, modality and the weekday of the appointment, in the context of the coronavirus disease 2019 (COVID-19) pandemic. Methods This was a cross-sectional study in a Community Health Centre in Florianópolis, Brazil. We retrospectively collected data from electronic medical records and analysed 4 consecutive weeks of our clinical encounters where every appointment had the patient’s motivation for seeking their medical appointment coded as: ‘limit of tolerance’, ‘limit of anxiety’, ‘heterothetic’, ‘administrative’, or ‘no illness’. Results There were 647 appointments. The frequencies of the taxonomic classifications were: 27.8% ‘administrative’, 26.6% ‘limit of tolerance’, 21.8% ‘limit of anxiety’, 18.1% ‘no illness’, and 5.7% ‘heterothetic’. Female patients had more consultations classified as ‘heterothetic’ and ‘limit of anxiety’. ‘Limit of tolerance’ and ‘heterothetic’ were more frequent in face-to-face appointments than in remote (on-line) consultations, and most of the ‘limit of anxiety’ consultations were same-day appointments. The average patient age was slightly higher on appointments classified as ‘heterothetic’ and lower on ‘limity of anxiety’ appointments. Discussion The COVID-19 pandemic may have influenced the higher ‘administrative’ and ‘limit of anxiety’ frequency presentations. We hope to encourage other family doctors to adopt this system during their consultations and teaching functions and, perhaps, inspire more complex investigations.
Perceived impacts of short-term rentals in the local community in the UK.
Authors: Miguel Cristina , Lutz Christoph , Alonso-Almeida María del Mar , Jones Brian , Majetić Filip , Perez-Vega Rodrigo
Published: March 2022

This study explores the perceived impacts of short-term rentals (STRs) in the UK through a quantitative analysis. A 57-item questionnaire covering sociocultural, economic, political, environmental and technological impacts of STRs was distributed online among guests, hosts and aware non-users. Apart from descriptive statistics, the data analysis included a principal component analysis to explore the dimensionality of the perceived impacts, and an analysis of variance (ANOVA) to assess differences in the community-related dimensions among the included groups. The results reveal that: (i) STRs are perceived relatively ambivalently but slightly more positively than negatively; (ii) environmental care, urban transformation, social capital and lifestyle, housing, infrastructure and events, and antisocial behaviour and crime are the key dimensions of the perceived impact; and (iii) stakeholder groups who were more involved in STRs perceived the impact of such rentals positively. We discuss the findings in the light of the literature on community resilience.
Reframing rurality: the impact of Airbnb on second-home communities in Wales and Sweden.
Authors: Adie Bailey Ashton , de Bernardi Cecilia , Amore Alberto
Published: March 2022

This chapter presents evidence from two established second-home destinations (Snowdonia in the UK and the Dalarna region in Sweden), where the proliferation of properties listed on Airbnb is currently contributing to the reframing of the existing rural landscape. This study suggests that there is a separate but connected layer of spatial interaction inherent in these rural environments, which is mediated by the perceptions of rural space of the three user groups: (i) primary residents; (ii) second homeowners; and (iii) Airbnb users. This chapter argues that the influence of peer-to-peer (P2P) platforms within these mixed-use communities injects an additional level of spatial interaction and conceptualization of rurality. Based on the findings from this study, it is noted that Airbnb guests' perceptions of rurality are similar to those of other rural tourists, but this is also influenced by the local hosts and wider rural community. Understanding how these users perceive the rural space is essential to the development of resilient rural communities as consensus is critical for resilience planning.
Assessment of milk fermentation process at three temperatures using laser speckle technique
Authors: Koley Chhanda , Nirala Anil Kumar
Published: March 2022

This research work contains information on speckle activity at different stages of the milk fermentation process at temperatures of 24 °C, 32 °C and 40 °C, using the dynamic laser speckle technique for the first time, to the best of our knowledge. Image processing algorithms such as inertia moment (IM), the absolute value of differences, the probability mass function of regular difference, spatial-temporal speckle correlation and 3D graphs of spectral images have been applied to show the speckle activity of the samples. All the methods show that the speckle activity of the sample is higher at the semisolid stage than at the liquid stage of the sample. Also, higher speckle activity of the curd has been observed at 40 °C (11 576.18 using IM) than at 32 °C (8550.92 using IM), followed by that at 24 °C (4855.88 using IM). At 40 °C, the thermal motion of curd particles is higher than that of the curd particles at the other two temperatures, and are responsible for the higher speckle activity. The preparation time for curd at 40 °C (5 h) is lower in comparison to the curds at 24 °C (10 h) and 32 °C (6 h). The lowest value for the titratable acidity of the curd prepared at 24 °C shows a lower % lactic acid than the curd at 32 °C and that at 40 °C. The lowest value of susceptibility to syneresis of the curd at 40 °C (30.00) represents a more compact curd than the curds at 32 °C (37.50) and 24 °C (45.00). The horizontal speckle grain size of the curd has been calculated using an autocovariance function; the highest is for curd fermented at 40 °C (12.34 μm), followed by that at 32 °C (11.59 μm), then that at 24 °C (10.96 μm).
Tight focusing of high-order polarized anomalous vortex beam
Authors: Xu Menghua , Qin Yali , Ji Kailai , Zhang Hongshun
Published: March 2022

Based on the vector Debye theory, the tight focusing properties of a high-order polarized anomalous vortex (HPAV) beam are studied. The corresponding mathematical expressions of the HPAV beam are derived theoretically. We accomplish the inner and outer gear shapes of the focusing intensity where the number of the gear tooth can be modulated by polarization order. The results show that the focusing gear intensity can be flexibly modulated by initial polarization azimuth which may determine the trapping effects. Various charming focusing field patterns can be used to capture two kinds of different refractive indices particles simultaneously. The compactness of the intensity distribution can be freely adjusted by the HPAV beam topological charges and polarization order. The focal spot size, which is far beyond the Rayleigh diffraction limitation can be achieved. It may be expected to have potential applications in optical microscopy, imaging, optical telecommunication and other fields.
Identifying the origins of Tianhuang stones based on Raman spectroscopy and pattern recognition algorithms
Authors: Liu Tianyuan , Kong Lili , Lin Lulu , Xu Huidi , Zhou Zhengyu , Huang Meizhen
Published: March 2022

In this paper, a non-destructive and efficient method for identifying gemstones of the same species based on Raman spectroscopy and pattern recognition algorithms was developed. Tianhuang stones from different origins (Shoushan (SS), Changhua (CH), and Laos (LA)) with similar composition and structure were investigated and analyzed. Raman spectra were collected by a self-developed portable Raman spectrometer. Combined with pattern recognition methods, the subtle differences between the three types of Tianhuang stones were comprehensively analyzed. Principal component analysis–latent Dirichlet allocation was used to predict the feasibility of distinguishing SS, CH, and LA Tianhuang stones by Raman spectra. Random forest analysis method was applied to establish SS/CH and SS/LA models to distinguish SS from CH and LA. The selection of characteristic variables and determination of the number of growing trees was discussed. Also, the accuracy, sensitivity, and specificity of the two models were calculated. The potential of this method for rapid and non-destructive identification of Tianhuang stones was proved. The feasibility and effectiveness of Raman spectroscopy combined with the pattern recognition method in identifying gemstones of the same species with similar composition were proved.
Quantum simulation of the photodissociation cross section of the NaH molecule
Authors: Guo Qianqian , Hu Jin-Wei , Qi Jianjun , Yu Jie , Han Yong-Chang
Published: March 2022

The photodissociation cross section of the NaH molecule from the ground state X1Σ+ to the excited state B1Π is calculated by solving the time-dependent Schrödinger equation with the consideration of two sets of potential energy curves (PECs). It is found that by using PECs, the maximum photodissociation cross section, the corresponding photon energy, and the effective range of photon energy which can result in the cross section greater than 0.1 Å2 all vary significantly. These differences are ascribed to the variations of the PECs, the vertical excitation energy, the vibrational wavefunction of the X1Σ+ state, and the Franck–Condon factors, etc. These findings provide a deep insight into the spectrum of the NaH molecule and are expected to inspire further relevant investigations in experiment and theory.
Reliability analysis for the power system of the nuclear ship Savannah
Authors: Jiang H , Peng C H , Xiao J
Published: March 2022

The power system, including the power transmission, distribution, and support system, is one of the largest and most complex systems established by humans. In addition to the normal considerations of power plants on board, the design of nuclear power merchant ships is also based on the need for uninterruptible power supplies. Based on the relevant data of the nuclear power ship “Savannah,” the qualitative and quantitative analysis is performed using the fault tree analysis method to analyze the reliability of its power system. The probability of basic events in certain accident conditions is evaluated according to the literature survey. In addition, this study also examines the common cause failure of diesel generators in the power system, as well as the analysis of sensitivity and importance of basic events. The installation of primary, auxiliary, and emergency power stations, the use of automated equipment for generator synchronization and power conversion, and the application of special internal communication and alarm systems unique to nuclear-powered ships can effectively eliminate the possibility of complete power outages for Savannah.
Study on soot oxidation activity of ethylene/methane laminar diffusion flame
Authors: Gu M Y , Zhu Y H , Cheng B , Zhang F , Wang Y , Lin Y Y
Published: March 2022

the soot oxidation characteristics and oxidation mechanism of ethylene flame with different methane mixing ratios were studied by thermogravimetric analyzer and oxidation reaction kinetics analysis. The conclusions are as follows: in the process of programmed temperature rise, there is almost no loss in the quality of soot particles below 450 °C; With the increasing temperature, the mass of soot particles began to decrease when the temperature exceeded 500 °C; When the temperature exceeds 750 °C, the mass of soot particles is close to zero; With the increase of flame height, the thermogravimetric curve of soot first shifts to high temperature and then to low temperature; The activation energy of soot is closely related to its oxidation process, and decreases first and then increases with the deepening of soot oxidation; The mixing of methane promotes the rise of soot ignition temperature and burnout temperature, and the minimum activation energy of soot decreases at low flame height and increases at high flame height.
Ignoring variation in wood density drives substantial bias in biomass estimates across spatial scales
Authors: Sæbø Jørgen S , Socolar Jacob B , Sánchez Edicson P , Woodcock Paul , Bousfield Christopher G , Uribe Claudia A M , Edwards David P , Haugaasen Torbjørn
Published: March 2022

Rapid development of remote sensing and Light Detection and Ranging (LiDAR) technology has refined estimates of tree architecture and extrapolation of biomass across large spatial scales. Yet, current biomass maps show significant discrepancies and mismatch to independent ground data. A potential obstacle to accurate biomass estimation is the loss of information on wood density, which can vary at local and regional scales, in the extrapolation process. Here we investigate if variation in wood specific gravity (WSG) substantially impacts the distribution of above-ground biomass (AGB) across a range of scales from local plots to large regions. We collected wood cores and measured tree volume in 341 forest sites across large altitudinal and climatic gradients in Colombia. At all spatial scales, variation in WSG was substantial compared to variation in volume. Imputing study-wide average values of WSG induced regional biases in AGB estimates of almost 30%, consequently undervaluing the difference between forest areas of low and high average wood density. Further, neither stem size nor climate usefully predicted WSG when accounting for spatial dependencies among our sampling plots. These results suggest that remote sensing- and LiDAR-based projections to biomass estimates can be considerably improved by explicitly accounting for spatial variation in WSG, necessitating further research on the spatial distribution of WSG and potential environmental predictors to advance efficient and accurate large-scale mapping of biomass.
The hypersimplex canonical forms and the momentum amplituhedron-like logarithmic forms
Authors: Łukowski Tomasz , Stalknecht Jonah
Published: March 2022

In this paper we provide a formula for the canonical differential form of the hypersimplex Δ
k,n
for all n and k. We also study the generalization of the momentum amplituhedron

M

n
,
k

to m = 2, which has been conjectured to share many properties with the hypersimplex, and we provide counterexamples for these conjectures. Nevertheless, we find interesting momentum amplituhedron-like logarithmic differential forms in the m = 2 version of the spinor helicity space, that have the same singularity structure as the hypersimplex canonical forms.
The potency of fern stem as the carbon material for clay-based ceramic filter
Authors: Ciawi Yenni , Made Alit Karyawan Salain I , Agung Gede Sutapa Anak
Published: March 2022

The provision of clean water is still a very serious problem in some places. Many times, water is available in abundant quantities but the quality does not meet human needs. On the other hand, there is a lot of locally available raw materials available for producing ceramic filters which in turn can be used to produce clean water from polluted water. The wild and domesticated fern grows widely in Southeast Asia. The stem can be used as the carbon material for producing filters. This study aims to utilize the fern stem as indigenous material to produce an affordable, easy to use, robust clay base water filter for the less advantaged communities. Chopped fern stem mixed with clay in several compositions (50%, 60%, 70%, 80%, 90% clay), shaped to produce 2 cm thick biscuits with 10 cm diameter, and dried for one week at room temperature and then fired at 9000C overnight. It was found that biscuits with 50% and 60% clay can be used as filters and filter with 50% clay produced filtrate with a better quality which meets the Indonesian standards for class two water which is water for drinking but not potable water. Therefore the fernstem is a potential raw material for ceramic filter production.
Analysis of non-ionized substance losses in experiments on plasma mass separation
Authors: USMANOV R A , ANTONOV N N , GAVRIKOV A V , LIZIAKIN G D , MELNIKOV A D , OILER A P , SMIRNOV V P , TIMIRKHANOV R A , VOLKOV L S , VORONA N A
Published: March 2022

Plasma mass separation requires a lot of diagnostic techniques that not only demonstrate the separation effect but also show the efficiency of the process. During the test experiments, plasma flux to be separated may contain neutral particles that avoid the separation process due to their insensitivity to electromagnetic field. We present the diagnostics of the lost substance in experiments on plasma mass separation. The obtained data of the diagnostics helps determine the law of particle evaporation from the plasma source. We show that neutral flux is unable to distort the result of separation diagnostics. The presented approach can be used in experiments aimed at enhancing the separation effect and achieving target productivity for industry applications.
Landis-type conjecture for the half-Laplacian
Authors: Kow Pu-Zhao , Wang Jenn-Nan
Published: March 2022

In this paper, we study the Landis-type conjecture, i.e., unique continuation property from infinity, of the fractional Schrödinger equation with drift and potential terms. We show that if any solution of the equation decays at a certain exponential rate, then it must be trivial. The main ingredients of our proof are the Caffarelli-Silvestre extension and Armitage’s Liouville-type theorem.
Drainage reversal with no lineage expansion, a case of competitive exclusion? The genetics ofGalaxias maculatusin two connected trans-Andean systems
Authors: Tymoshuk Kristen M , Delgado M Lisette , Mccracken Gregory R , Alonso Marcelo , Górski Konrad , Habit Evelyn , Ruzzante Daniel E
Published: March 2022

Understanding how historical and contemporary processes lead to genetic differentiation among populations is a fundamental goal of evolutionary and conservation biology. This study focuses on Galaxias maculatus, a widely distributed fish exhibiting diadromous and freshwater resident forms. We examine the genetic differentiation among resident populations from the Manso River System, a trans-Andean system which thus went through drainage reversal following the Last Glacial Maximum (LGM), and resident and diadromous populations from the connected Puelo River that drains into the Pacific Ocean. Single nucleotide polymorphic (SNP) markers revealed that resident populations from the Manso River System are genetically distinguishable from the diadromous and resident populations from the Puelo River. This suggests that G. maculatus from the Manso River System likely colonized the area from a glacial refugium east of the Andes and did not expand downstream during drainage reversal, whereas the populations from the Puelo River colonized the area from glacial refugia west of the Andes. The populations from the Manso River exhibited lower genetic diversity than the Puelo River populations. Galaxias maculatus resident populations in Patagonia are decreasing due to anthropogenic factors. The Manso River System resident populations are susceptible to these factors and may show further decreases in genetic diversity.
Surgery due to Inflammatory Bowel Disease During Pregnancy: Mothers and Offspring Outcomes From an ECCO Confer Multicentre Case Series [Scar Study]
Authors: Chaparro María , Kunovský Lumír , Aguas Mariam , Livne Moran , Rivière Pauline , Bar-Gil Shitrit Ariella , Myrelid Pär , Arroyo Maite , Barreiro-de Acosta Manuel , Bautista Michelle , Biancone Livia , Biron Irit Avni , Boysen Trine , Carpio Daniel , Castro Beatriz , Dragoni Gabriele , Ellul Pierre , Holubar Stefan D , de Jorge Miguel Ángel , Leo Eduardo , Manceñido Noemí , Moens Annick , Molnár Tamás , Ramírez de la Piscina Patricia , Ricanek Petr , Sebkova Ladislava , Sempere Laura , Teich Niels , Gisbert Javier P , Julsgaard Mette
Published: March 2022

Aims

i] To evaluate the evolution of pregnancies and offspring after inflammatory bowel disease [IBD] surgery during pregnancy; and ii] to describe the indications, the surgical techniques, and the frequency of caesarean section concomitant with surgery.

Methods

Patients operated on due to IBD during pregnancy after 1998 were included. Participating clinicians were asked to review their databases to identify cases. Data on patients’ demographics, IBD characteristics, medical treatments, IBD activity, pregnancy outcomes, surgery, delivery, and foetal and maternal outcomes, were recorded.

Results

In all, 44 IBD patients were included, of whom 75% had Crohn’s disease; 18% of the surgeries were performed in the first trimester, 55% in the second, and 27% in the third trimester. One patient had complications during surgery, and 27% had postsurgical complications. No patient died. Of deliveries, 70% were carried out by caesarean section. There were 40 newborns alive. There were four miscarriages/stillbirths [one in the first, two in the second, and one in the third trimester]; two occurred during surgery, and another two occurred 2 weeks after surgery; 14% of the surgeries during the second trimester and 64% of those in the third trimester ended up with a simultaneous caesarean section or vaginal delivery. Of the 40 newborns, 61% were premature and 47% had low birth weight; 42% of newborns needed hospitalisation [25% in the intensive care unit].

Conclusions

IBD surgery during pregnancy remains an extremely serious situation. Therefore, surgical management should be performed in a multidisciplinary team, involving gastroenterologists, colorectal surgeons, obstetricians, and neonatal specialists.
A computationally grounded logic of awareness
Authors: Lorini Emiliano , Song Pengfei
Published: March 2022

We introduce a multi-agent logic of explicit, implicit belief and awareness with a semantics using belief bases. The novelty of our approach is that an agent’s awareness is not a primitive but is directly computed from the agent’s belief base. We prove soundness and completeness of the logic relative to the belief base semantics. Furthermore, we provide a polynomial embedding of the logic of propositional awareness into it and a polynomial embedding of our logic into the logic of general awareness. Thanks to the latter embedding, we show that the satisfiability checking problem for our logic is PSPACE complete. Finally, we extend it by the notions of public announcement and private belief expansion.
Physical and financial impacts caused by the COVID-19 pandemic exacerbate knee pain: A longitudinal study of a large-scale general population
Authors: Morita Yugo , Ito Hiromu , Kawaguchi Shuji , Nishitani Kohei , Nakamura Shinichiro , Kuriyama Shinichi , Sekine Yoshihiro , Tabara Yasuharu , Matsuda Fumihiko , Matsuda Shuichi
Published: March 2022

Objectives

This study aimed to evaluate the changes in knee pain, a dominant cause of physical disability, following the coronavirus disease (COVID-19) pandemic, and to identify factors affecting the changes in knee pain.

Methods

We analysed the pre- and post-COVID-19 longitudinal data set of the Nagahama Study. Knee pain was assessed using the Knee Society Score (KSS). The estimated KSS from the age and sex using regression model in the pre- and post-COVID-19 data set was compared. Factors including the activity score, educational level, and various impacts of COVID-19 were analysed for correlation analyses with changes in KSS.

Results

Data collected from 6409 participants showed statistically significant differences in KSS, pre- (mean = 22.0; SD = 4.4) and post-COVID-19 (mean = 19.5; SD = 6.4). Low activity score (p = .008), low educational level (p < .001), and undesirable financial impact (p = .030) were independently associated with knee pain exacerbation.

Conclusion

The harmful effects of the COVID-19 pandemic on knee pain were suggested. People should be encouraged to engage in physical activities, such as walking, despite the state of emergency. Furthermore, social support for economically disadvantaged groups may improve healthcare access, preventing the acute exacerbations of knee pain.
Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed?
Authors: Boccia Ralph , Glaspy John , Crawford Jeffrey , Aapro Matti
Published: March 2022

Neutropenia and febrile neutropenia (FN) are common complications of myelosuppressive chemotherapy. This review provides an up-to-date assessment of the patient and cost burden of chemotherapy-induced neutropenia/FN in the US, and summarizes recommendations for FN prophylaxis, including the interim guidance that was recommended during the coronavirus disease 2019 (COVID-19) pandemic. This review indicates that neutropenia/FN place a significant burden on patients in terms of hospitalizations and mortality. Most patients with neutropenia/FN presenting to the emergency department will be hospitalized, with an average length of stay of 6, 8, and 10 days for elderly, pediatric, and adult patients, respectively. Reported in-hospital mortality rates for neutropenia/FN range from 0.4% to 3.0% for pediatric patients with cancer, 2.6% to 7.0% for adults with solid tumors, and 7.4% for adults with hematologic malignancies. Neutropenia/FN also place a significant cost burden on US healthcare systems, with average costs per neutropenia/FN hospitalization estimated to be up to $40 000 for adult patients and $65 000 for pediatric patients. Evidence-based guidelines recommend prophylactic granulocyte colony-stimulating factors (G-CSFs), which have been shown to reduce FN incidence while improving chemotherapy dose delivery. Availability of biosimilars may improve costs of care. Efforts to decrease hospitalizations by optimizing outpatient care could reduce the burden of neutropenia/FN; this was particularly pertinent during the COVID-19 pandemic since avoidance of hospitalization was needed to reduce exposure to the virus, and resulted in the adaptation of recommendations to prevent FN, which expanded the indications for G-CSF and/or lowered the threshold of use to >10% risk of FN.
DOSE-RATE EFFECT OF RADIATION ON RAT MAMMARY CARCINOGENESIS AND AN EMERGING ROLE FOR STEM CELL BIOLOGY
Authors: Imaoka Tatsuhiko , Nishimura Mayumi , Daino Kazuhiro , Hosoki Ayaka , Kudo Ken-ichi , Iizuka Daisuke , Nagata Kento , Takabatake Masaru , Nishimura Yukiko , Kokubo Toshiaki , Morioka Takamitsu , Doi Kazutaka , Shimada Yoshiya , Kakinuma Shizuko
Published: March 2022

The uncertain cancer risk of protracted radiation exposure at low dose rates is an important issue in radiological protection. Tissue stem/progenitor cells are a supposed origin of cancer and may contribute to the dose-rate effect on carcinogenesis. The authors have shown that female rats subjected to continuous whole body γ irradiation as juveniles or young adults have a notably reduced incidence of mammary cancer as compared with those irradiated acutely. Experiments using the mammosphere formation assay suggested the presence of radioresistant progenitor cells. Cell sorting indicated that basal progenitor cells in rat mammary gland were more resistant than luminal progenitors to killing by acute radiation, especially at high doses. Thus, the evidence indicates a cell-type-dependent inactivation of mammary cells that manifests only at high acute doses, implying a link to the observed dose-rate effect on carcinogenesis.
Left/Right Judgment Task for the Chest Region, Part 2: Evidence for Mental Maneuvering in Performance During Chest Versus Shoulder Regions
Authors: Boyd Benjamin S. , Smoot Betty J. , Nee Robert J.
Published: March 2022

Background:

Left/right judgment tasks (LRJTs) theoretically require mental maneuvering one's body to reorient and match a viewed image. Mental maneuvering strategies may include spatial transformation and/or motor imagery. LRJT performance outcomes do not inherently distinguish between mental maneuvering strategies used to accomplish the task. Orientation difference (OD) describes the difference between the observer's position and the body orientation within an image. Evaluating whether LRJTs elicit mental maneuvering has traditionally been based upon the premise of an inverse linear relationship between LRJT performance and OD (“exact match” hypothesis). If true, larger ODs should lead to slower LRJT performance.

Objectives:

To evaluate the relationship between OD and chest and shoulder LRJT performance.

Design:

Observational, cohort study.

Method:

Associations between OD and LRJT accuracy and response time were evaluated in women with and without a history of unilateral breast cancer. Images from chest and shoulder LRJTs were categorized by various OD methods that assume more efficient (shortest path: OD(shortest path)) or less efficient (rotation by dimensions: (OD(rotation by dimensions)) participant mental maneuvering. Shoulder analyses also incorporated the angle between the arm and trunk (OD(shortest path + arm angle) and OD(rotation by dimensions + arm angle)).

Results:

Chest LRJT response time was most associated with OD(shortest path) (R
2 = 0.510). Shoulder LRJT response time was most associated with OD(rotation by dimensions + arm angle) (R
2 = 0.807). Both relationships were nonlinear.

Discussion:

Strong relationships between chest and shoulder LRJT and different OD models suggest these are discrete tasks that elicit mental maneuvering. The nonlinear nature of these relationships does not support the “exact match” hypothesis. Factors that can explain the remaining variance in LRJT performance need to be identified.
Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings
Authors: Todic´ Jelena , Cook Scott C. , Spitzer-Shohat Sivan , Williams James S. , Battle Brenda A. , Jackson Joel , Chin Marshall H.
Published: March 2022

Achieving optimal health for all requires confronting the complex legacies of colonialism and white supremacy embedded in all institutions, including health care institutions. As a result, health care organizations committed to health equity must build the capacity of their staff to recognize the contemporary manifestations of these legacies within the organization and to act to eliminate them. In a culture of equity, all employees—individually and collectively—identify and reflect on the organizational dynamics that reproduce health inequities and engage in activities to transform them. The authors describe 5 interconnected change strategies that their medical center uses to build a culture of equity. First, the medical center deliberately grounds diversity, equity, and inclusion efforts (DEI) in critical theory, aiming to illuminate social structures through critical analysis of power relations. Second, its training goes beyond cultural competency and humility to include critical consciousness, which includes the ability to critically analyze conditions in the organizational and broader societal contexts that produce health inequities and act to transform them. Third, it works to strengthen relationships so they can be change vehicles. Fourth, it empowers an implementation team that models a culture of equity. Finally, it aligns equity-focused culture transformation with equity-focused operations transformation to support transformative praxis. These 5 strategies are not a panacea. However, emerging processes and outcomes at the medical center indicate that they may reduce the likelihood of ahistorical and power-blind approaches to equity initiatives and provide employees with some of the critical missing knowledge and skills they need to address the root causes of health inequity.
nnU-Net Deep Learning Method for Segmenting Parenchyma and Determining Liver Volume From Computed Tomography Images
Authors: Pettit Rowland W. , Marlatt Britton B. , Corr Stuart J. , Havelka Jim , Rana Abbas
Published: March 2022

Background:

Recipient donor matching in liver transplantation can require precise estimations of liver volume. Currently utilized demographic-based organ volume estimates are imprecise and nonspecific. Manual image organ annotation from medical imaging is effective; however, this process is cumbersome, often taking an undesirable length of time to complete. Additionally, manual organ segmentation and volume measurement incurs additional direct costs to payers for either a clinician or trained technician to complete. Deep learning-based image automatic segmentation tools are well positioned to address this clinical need.

Objectives:

To build a deep learning model that could accurately estimate liver volumes and create 3D organ renderings from computed tomography (CT) medical images.

Methods:

We trained a nnU-Net deep learning model to identify liver borders in images of the abdominal cavity. We used 151 publicly available CT scans. For each CT scan, a board-certified radiologist annotated the liver margins (ground truth annotations). We split our image dataset into training, validation, and test sets. We trained our nnU-Net model on these data to identify liver borders in 3D voxels and integrated these to reconstruct a total organ volume estimate.

Results:

The nnU-Net model accurately identified the border of the liver with a mean overlap accuracy of 97.5% compared with ground truth annotations. Our calculated volume estimates achieved a mean percent error of 1.92% + 1.54% on the test set.

Conclusions:

Precise volume estimation of livers from CT scans is accurate using a nnU-Net deep learning architecture. Appropriately deployed, a nnU-Net algorithm is accurate and quick, making it suitable for incorporation into the pretransplant clinical decision-making workflow.
Do Inflammatory Cytokines Affect Patient Outcomes After ACDF?
Authors: Karamian Brian A. , Levy Hannah A. , Boere Payton , Yalla Goutham R. , Canseco Jose A. , Chang Michael , Divi Srikanth N. , Fang Taolin , Millhouse Paul W. , Lendner Mayan , Hilibrand Alan S. , Vaccaro Alexander R. , Kepler Christopher K. , Markova Dessislava Z. , Schroeder Gregory D.
Published: March 2022

Study Design:

Prospective cohort study.

Objective:

The aim was to determine the relationship between serum inflammatory mediators, preoperative cervical spine disease severity, and clinical outcomes after anterior cervical discectomy and fusion (ACDF).

Summary of Background Data:

Given the role of the inflammatory cascade in spinal degenerative disease, it has been hypothesized that inflammatory markers may serve as a predictor of patient outcomes after surgery.

Materials and Methods:

All patients over age 18 who underwent ACDF for cervical spondylosis with associated radiculopathy and/or myelopathy between 2015 and 2017 from a single institution were prospectively recruited. Preoperative serum inflammatory markers including interleukin (IL)-6, IL-8, tumor necrosis factor-α, high-mobility group box-1 (HMGB1), and white blood cells were measured and correlated to patient demographics, surgical characteristics, duration of symptoms, previous opioid use, and preoperative and 1-year postoperative patient-reported outcomes measures (PROMs) including the neck disability index (NDI), visual analog scale neck pain, visual analog scale arm pain, and Physical and Mental Component Scores of the Short Form-12 (PCS and MCS, respectively) using spearman’s rho coefficient.

Results:

A total of 77 patients were enrolled with follow-up PROMs available for 62% (n=48) of patients at a minimum of 1-year after ACDF. The absolute concentrations of IL-6 and tumor necrosis factor-α were found to be weakly correlated with one another (ρ=0.479). Preoperative symptoms lasting <1-year were weakly correlated with elevation in HMGB1 (ρ=0.421). All other patient demographics exhibited negligible correlation with the preoperative inflammatory markers. Lower preoperative PCS (ρ=0.355) and higher preoperative NDI (ρ=0.336) were weakly correlated with elevated HMGB1. Lower MCS (ρ=0.395) and higher NDI (ρ=0.317) preoperatively were weakly correlated with elevated white blood cells. Postoperative improvement in MCS (ρ=0.306) and MCS recovery ratio (ρ=0.321) exhibited a weakly positive correlation with IL-6.

Conclusion:

Preoperative cytokine levels demonstrated minimal correlation with preoperative symptoms or clinical improvement, suggesting that profiling of patient cytokines has limited utility in predicting outcomes after ACDF.

Level of Evidence:

Level III.
Methods for Phenotyping Adult Patients in Sepsis and Septic Shock: A Scoping Review
Authors: Li Han , Markal Asena , Balch Jeremy A. , Loftus Tyler J. , Efron Philip A. , Ozrazgat-Baslanti Tezcan , Bihorac Azra
Published: March 2022

OBJECTIVE:

Despite its heterogeneous phenotypes, sepsis or life-threatening dysfunction in response to infection is often treated empirically. Identifying patient subgroups with unique pathophysiology and treatment response is critical to the advancement of sepsis care. However, phenotyping methods and results are as heterogeneous as the disease itself. This scoping review evaluates the prognostic capabilities and treatment implications of adult sepsis and septic shock phenotyping methods.

DATA SOURCES:

Medline and Embase.

STUDY SELECTION:

We included clinical studies that described sepsis or septic shock and used any clustering method to identify sepsis phenotypes. We excluded conference abstracts, literature reviews, comments, letters to the editor, and in vitro studies. We assessed study quality using a validated risk of bias tool for observational cohort and cross-sectional studies.

DATA EXTRACTION:

We extracted population, methodology, validation, and phenotyping characteristics from 17 studies.

DATA SYNTHESIS:

Sepsis phenotyping methods most frequently grouped patients based on the degree of inflammatory response and coagulopathy using clinical, nongenomic variables. Five articles clustered patients based on genomic or transcriptomic data. Seven articles generated patient subgroups with differential response to sepsis treatments. Cluster clinical characteristics and their associations with mortality and treatment response were heterogeneous across studies, and validity was evaluated in nine of 17 articles, hindering pooled analysis of results and derivation of universal truths regarding sepsis phenotypes, their prognostic capabilities, and their associations with treatment response.

CONCLUSIONS:

Sepsis phenotyping methods can identify high-risk patients and those with high probability of responding well to targeted treatments. Research quality was fair, but achieving generalizability and clinical impact of sepsis phenotyping will require external validation and direct comparison with alternative approaches.
Immune Checkpoint Inhibitor Exposure in Pregnancy: A Scoping Review
Authors: Salehi Iman , Porto Ludmila , Elser Christine , Singh Jessica , Saibil Samuel , Maxwell Cynthia
Published: March 2022

Since their approval, immune checkpoint inhibitors (ICIs) have become the standard of care for multiple malignancies. ICIs enhance tumor destruction by blocking important immunomodulatory pathways that regulate T-cell activation. These pathways include programmed cell death protein-1 and its ligands (programmed cell death protein-1 and programmed death ligand-1, respectively) and cytotoxic T-lymphocyte–associated protein 4. While blocking these pathways can enhance tumor destruction, these pathways are critical for the development of maternal tolerance towards the fetus. Therefore, if ICIs disrupt these immunomodulatory pathways, there could be a maternal immune response against the fetus, as was found in animal studies. With few reported cases of human pregnancy exposure to ICIs, the effects of ICIs on human pregnancy remain largely unknown. Here, we review and summarize the 6 cases of maternal exposure to immunotherapy that have been published before the present study. To add to the evidence, we present a case series of 2 patients who have been exposed to immunotherapy in pregnancy.