bluuebunny/crossref_metadata_2025 huggingface dataset:
Remoción de metales en agua por residuos orgánicos
Authors:   , Milla Luna Deyanira
Published: March 2023

La siguiente revisión da referencia a la problemática de los residuos orgánicos que se generan mundialmente, dando énfasis a los residuos agroindustriales y la normativa correspondiente a su control y manejo; también se da a conocer los impactos negativos que se generan por su mala disposición. Por ello, se presentan alternativas de tratamiento y aplicación, donde nos enfocamos en el tratamiento térmico y químico, puesto que hay diferentes estudios que señalan que los residuos tratados térmicamente en presencia de medios ácidos presentan mayor eficiencia en la remoción de metales en aguas contaminadas, así también se describe el sustento químico y físico de este fenómeno llamado adsorción. Por otro lado, se comenta sobre la contaminación del agua en el Perú y las incidencias que se dieron en el sector salud junto con la normativa vigente. Se expone las incidencias ambientales con relación a la división tradicional de las tres regiones que son costa, sierra y selva, que nos permita visualizar mejor los tipos de residuos que se generan en el sector agroindustrial y las mejores propuestas a utilizar para la remoción de metales.
Percepción de los trabajadores sobre la identidad corporativa de la Municipalidad Distrital de San Bartolo, Lima, 2019
Authors:   , Parinango Carlos Diego Miguel
Published: March 2023

Este trabajo tiene la finalidad de identificar la percepción de los trabajadores de la Municipalidad Distrital de San Bartolo en la que, a través de herramientas de investigación, se reflejará su nivel de conocimiento sobre la Identidad corporativa de la misma entidad. A su vez, se estaría evidenciando la eficacia de sus procesos comunicacionales y su interiorización de cada mensaje en la capacitación que se les brinde al público interno.
Relación entre el estado nutricional y las condiciones gingivales en niños de 3 a 5 años de edad que acuden al P.S. La Esperanza - Huánuco 2018
Authors:   , Vargas Palomino Katherinne Elizabeth
Published: March 2023

Objetivo: Determinar la relación entre el estado nutricional y las condiciones gingivales en niños de 3 a 5 años que acuden al Puesto de Salud La Esperanza - Huánuco, 2018. Materiales y Métodos: Este estudio es de tipo descriptivo, observacional, prospectivo, transversal y analítico. La muestra estuvo constituida por 118 niños de 3 a 5 años que acudieron al P.S. La Esperanza-Huánuco durante 2018; se utilizaron el Índice de Inflamación Gingival (IG) para determinar mediante una evaluación clínica la condición gingival de los niños, todos estos datos se recolectaron en una ficha estomatológica. El estado nutricional del niño se determinó del último control CRED registrado en su historia clínica. Resultados: La desnutrición aguda fue el estado nutricional más prevalente y significativo (p<0,05) cuando los niños presentaron inflamación gingival severa (92.9%). Conclusiones: Existe relación entre el estado nutricional y la inflamación gingival en niños de 3 a 5 años de edad.
Frecuencia en la aparición de la osteoesclerosis idiopática y la osteítis condensante en maxilares inferiores en radiografías panorámicas
Authors:   , Pflücker Ballon Sylvia Lorena
Published: March 2023

Objetivo: Determinar la frecuencia de la osteoesclerosis idiopática (OI) y la osteítis condensante (OC) en radiografías panorámicas. Materiales y métodos: investigación descriptiva con diseño transversal y de campo; se empleó una muestra de 1500 radiografías panorámicas digitales de pacientes consultantes de un centro radiológico privado, de ambos sexos, con edades cronológicas entre 20 y 88 años, obtenidas entre julio de 2013 a diciembre del 2018. Se identificó la presencia de las condensaciones óseas (CO), distribución de acuerdo a la edad, sexo, localización, relación con los dientes, y si eran solitarias o múltiples. Se obtuvieron estadísticos descriptivos y un test Chi-cuadrado fue empleado para verificar diferencias posibles entre los valores encontrados. Resultados: se observaron 183 CO, presentando una prevalencia 11, 53%, de éstas CO, 112 se observaron en el sexo femenino (63,93%) y 66 en el masculino (36,06%). La OI fue evidenciada en 127 sujetos (8,5% del total de la muestra), mientras que 56 presentaron OC (3,7%). La OI fue más frecuente entre la tercera y cuarta década de la vida, mientras que se verificó un mayor número de OC por encima de los 40 años de edad (p=0,002); en cuanto al sexo, ambos tipos de CO fueron más frecuentes en las mujeres, lo que fue estadísticamente significativo (p=0,005). Las CO se localizaron con mayor frecuencia en la zona molar derecha, seguida de la zona molar izquierda y premolar derecha; en cuanto a la relación con los dientes, las mismas fueron observadas en un número más alto en apical, separadas y en la zona apical e interradicular. La presentación única de las CO fue más prevalente considerando el sexo o el grupo etario.
La incidencia de los factores globales en el rendimiento de la Bolsa de Valores de Lima en el periodo de 2000-2019
Authors:   , Barrera Zapata Lucero Isabel , Chahua Villegas Lina Jamely
Published: March 2023

Esta investigación determina la incidencia del precio de los principales commodities (petróleo, oro y cobre), los índices bursátiles (S&P 500 y VIX) y el índice de Incertidumbre de Política Económica de Estados Unidos (EPU) en la Bolsa de Valores de Lima durante el periodo 2000-2019, considerando los escenarios del mercado: bajista, normal y alcista. La muestra utilizada es de 33600 observaciones, considera precios de cierres de periodicidad diaria a partir del 4 de enero del 2000 al 30 de diciembre del 2019. El método empleado fue el modelo de regresión por cuantiles definida por los cuantiles 0.05, 0.10, 0.25, 0.50, 0.75, 0.90 y 0. 95. Además, se incluyó una variable dummy para analizar el efecto de la crisis financiera del 2008. Los resultados muestran que las variables explicativas inciden de forma significativa a excepción del índice EPU. La relación entre los factores globales y el mercado bursátil peruano es asimétrica, debido a que la intensidad de incidencia es distinta para los cuantiles inferiores y superiores. Por último, se analiza el grado de incidencia después de la crisis financiera del 2008, en la cual se concluye que no existe incidencia significativa de los factores globales a excepción del S&P 500.
Actividad antagonista de actinobacterias aisladas del tracto digestivo de Mugil cephalus (Lisa) frente a cepas bacterianas de origen clínico
Authors:   , Gaviño Alva Jenny Alexandra
Published: March 2023

Objetivos. Evaluar la capacidad inhibitoria de los metabolitos secundarios extraídos de cepas de actinobacterias aisladas del tracto digestivo de Mugil cephalus (Lisa) frente cepas clínicas resistentes a antibióticos. Materiales y métodos. Un total de 22 cepas de actinobacterias marinas fueron previamente aisladas del tracto digestivo de Mugil cephalus y se evaluó la capacidad antagonista de los extractos crudos frente a 11 cepas clínicas de Escherichia coli y Klebsiella pneumoniae que presentan perfiles de resistencia a los antibióticos. En base a su gran capacidad antagonista en pruebas in vitro frente a la mayoría de cepas patógenas, la cepa RFE02 fue seleccionada para extraer metabolitos secundarios utilizando solventes orgánicos como acetato de etilo, el mismo extracto también fue utilizado para calcular la concentración mínima inhibitoria (CMI). Adicionalmente, cultivos de la cepa RFE02 se sometieron a pruebas de estimulación con la finalidad de incrementar la producción de compuestos bioactivos. Resultados. Del total de cepas evaluadas 13 mostraron actividad antagonista frente a la mayoría de las cepas clínicas, siendo la cepa RFE02 la que demostró un mayor potencial inhibitorio frente a todas las cepas clínicas con las que se enfrentó. Los extractos orgánicos preparados a partir de la cepa RFE02 cultivada en medio conteniendo glucosa a una concentración de 25% mostraron un incremento en la formación de los halos de inhibición de 12 a 18 mm con una misma tendencia para la CMI de 7.01 y 14.02µg/ml. Conclusiones. La microbiota de los peces marinos podría representar un nicho inexplorado como una fuente alternativa de microorganismos con capacidad de producir compuestos bioactivos capaces de inhibir cepas clínicas resistentes a los antibióticos de uso común.
El impacto de la gestión administrativa gubernamental en la calidad del gasto en las contrataciones públicas a nivel de la Municipalidad Metropolitana de Lima durante el periodo 2019
Authors:   , Alvear Zapatel Gustavo Ernesto , Rafael Andia Renzo Yvan
Published: March 2023

El estudio investigativo presenta como principal objetivo el determinar el impacto de la gestión administrativa gubernamental en la calidad del gasto en las contrataciones públicas a nivel de la Municipalidad Metropolitana de Lima, durante el período 2019, para lo cual se investigó el cumplimiento de metas como parte de la eficiencia y eficacia del gasto en las contrataciones públicas; así como la percepción acerca del nivel de gestión administrativa, dentro de personal administrativo que labora en los departamentos de finanzas y planificación de la entidad. En el capítulo 1, se desarrolla un estudio de la situación problemática estableciendo la significancia del problema dentro del entorno local, regional y mundial; además de la exposición de la problemática a nivel institucional, para luego formular las interrogantes de investigación, tanto general como específicas. Seguidamente, se expone la justificación, a nivel práctico y valorativo; las limitaciones a nivel temporal y especial; así como la viabilidad de la investigación. En el segundo capítulo se referencian los estudios anteriores relacionados con el tema de la investigación, así como la fundamentación teórica concerniente a la gestión administrativa, entre ellas la estrategia organizacional, el proceso de gestión estratégica y sus dimensiones, gestión pública y la importancia de su control, el control de riesgos en el estado; así como las referentes a los elementos relacionados a la calidad del gasto púbico, considerando la eficiencia y eficacia y las contrataciones públicas. De igual manera, se describen los conceptos y definiciones relacionados con el argumento planteado en el estudio. Seguidamente, se plantean los objetivos, tanto general como específicos, basados en las interrogantes de investigación anteriormente descritas, así como de la hipótesis general y específicas, con base en dichos objetivos.
Face Detection Based on Cascaded Multivariate Branches Convolutional Neural Networks
Authors: Xu Ziming , Wang Tongxi , Shi Zhan
Published: March 2023

To improve MTCNN’s face detection accuracy, this paper proposes multivariate branches block (MBB) and dilated convolutional block (DCB), and we design a cascaded multivariate branch convolutional neural network model(MB-MTCNN) based on these two structural blocks. First, the model consists of three subnetworks, and we replace the first convolutional block of each subnetwork with a dilated convolutional block. Second, replace the second convolutional block of the second and third subnetworks with MBB. In addition, we add a BN layer after each convolutional layer to accelerate the training speed of the model. Finally, we introduce a structural re-parameterization method to reduce the model’s overhead in inference. Experimental results show that our model increases the True Positive Rate (TPR) by 4.48% on the FDDB datasets, improves the average accuracy by 8.08%, 8.65%, and 10.29% on the three levels of validation sets of Wider Face datasets, 8.31% and 2.08% on the AFW and CelebA datasets, respectively. Moreover, based on structural re-parameterization, the model parameters during inference are 14.68% lower than training. This model is suitable for scenarios that require accurate detection of faces, such as crowded stations and traffic arteries.
Performance Analysis of Cooperative Spectrum Sensing using Regression Algorithms
Authors: reddy Lakshmikanth , M Meena
Published: March 2023

Recently, cooperative spectrum sensing (CSS) became an emerging technology due to its advantages in using the spectrum efficiently. In this paper CSS is integrated with the Machine Learning (ML) algorithms to improve the sensing of users which is possible with ML algorithms only in estimating the channel status. Further, the various popular machine learning models for regression are discussed with relevant mathematical analysis such as Linear Regression, Nonlinear Regression, Gaussian Process Regression (GPR), Support Vector Machine Regression (SVM), Generalized Linear Model, Regression Tree, Shallow Neural Network, Deep Neural Network and Regression Tree Ensembles. In this paper, 20 primary users are assumed with different energy levels by maintaining a maximum energy of 20 units and a threshold value of 4 units is fixed for all four scenarios and obtained results are analyzed. In this regard, we concluded a best fit line to extract the features such that the linear regression has been chosen. In addition, various transformations also applied for further improvement in regression to obtain the best results.
Analysis on Energy Efficient Clustering-Based Data Aggregation Technique for Heterogeneous Network in WSN
Authors: Kaur Amanjot , AULAKH INDERDEEP KAUR , MALHOTRA MEENAKSHI
Published: March 2023

Every field is challenging same as with WSN. In the past few years, WSN is becoming more popular by reason of its features like scalability, adaptability, etc. but it is also facing various configuration problems but energy exhaustion is a serious issue in WSN. A number of protocols are introduced to save energy and maximize the network's lifetime. Hierarchical cluster-based protocols are considered as most energy-efficient protocols of all. The energy-efficient protocols provide healthier data aggregation and select one node as cluster head to communicate on behalf of other nodes to BS when an immense amount of data is transmitted from many nodes to the base station. In this paper, the data aggregation technique-based clustering protocol for a heterogeneous network is proposed. In this technique, a two-level approach for a heterogeneous network is used to divide nodes into two groups refined nodes and regular nodes. Initially, refined nodes have double energy in comparison to regular nodes. The proposed technique chooses the most energy efficient node as CH from refined nodes and regular nodes to increase the network’s lifetime. CH collects data from sensor nodes and aggregates data at the cluster level and forward it to BS. The proposed technique is compared with various existing routing protocols to measure its performance. MATLAB simulator is used to measure the performance of the proposed technique.
Re-distribution of volatiles on the airless surface of the C-type carbonaceous asteroid Ryugu.
Authors: Matsumoto Toru , Noguchi Takaaki , Miyake Akira , Igami Yohei , Haruta Mitsutaka , Seto Yusuke , Miyahara Masaaki , Tomioka Naotaka , Saito Hikaru , Hata Satoshi , Harries Dennis , Takigawa Aki , Nakauchi Yuusuke , Tachibana Shogo , Nakamura Tomoki , Matsumoto Megumi , Ishii Hope , Bradley John , Ohtaki Kenta , Dobrică Elena , Leroux Hugues , Guillou Corentin Le , Jacob Damien , Peña Francisco de la , Laforet Sylvain , Marinova Maya , Langenhorst Falko , Beck Pierre , Phan Thi , Rebois Rolando , Abreu Neyda , Gray Jennifer , Zega Thomas , Zanetta Pierre-Marie , Thompson Michelle , Stroud Rhonda , Burgess Katherine , Cymes Brittany , Bridges John , Hicks Leon , Lee Martin , Daly Luke , Bland Phil , Zolensky Michael , Frank David , Martinez James , Tsuchiyama Akira , Yasutake Masahiro , Matsuno Junya , Okumura Shota , Mitsukawa Itaru , Uesugi Kentaro , Uesugi Masayuki , Takeuchi Akihisa , Sun Mingqi , Enju Satomi , Michikami Tatsuhiro , Yurimoto Hisayoshi , Okazaki Ryuji , Yabuta Hikaru , Naraoka Hiroshi , Sakamoto Kanako , Yada Toru , Nishimura Masahiro , Nakato Aiko , Miyazaki Akiko , Yogata Kasumi , Abe Masanao , Okada Tatsuaki , Usui Tomohiro , Yoshikawa Makoto , Saiki Takanao , Tanaka Satoshi , Terui Fuyuto , Nakazawa Satoru , Watanabe Sei-ichiro , Tsuda Yuichi
Published: March 2023

Volatile components are abundant in carbonaceous asteroids and can be important tracers for the evolution of asteroid surfaces interacting with the space environment, but their behavior on airless surfaces is poorly understood. Samples from the C-type carbonaceous asteroid Ryugu show dehydration of phyllosilicate, indicating ongoing surface modifications on the aqueously-altered asteroid. Here we report the analysis of Ryugu samples showing selective liberation of carbon, oxygen, and sulfur from iron-rich oxide, sulfide, and carbonate, which are major products of aqueous alteration. These mineral surfaces are decomposed to metallic iron, iron nitride, and magnesium-iron oxide. The modifications are most likely caused by solar wind implantation and micrometeorite impacts and are distinct indicators of surface space exposure over 103 years. Nitridation of metallic iron may require micrometeorites rich in solid nitrogen compounds, which implies that the amount of nitrogen available for planetary formation in the inner solar system is larger than previously recognized.
Critical appraisal in rapid systematic reviews of COVID-19 studies: implementation of the Quality Criteria Checklist (QCC)
Authors: Duval Daphne , Pearce-Smith Nicola , Palmer Jennifer C , Sarfo-Annin Jason Kwasi , Rudd Paul , Clark Rachel
Published: March 2023

In this letter we briefly describe how we selected and implemented the quality criteria checklist (QCC) as a critical appraisal tool in rapid systematic reviews conducted to inform public health advice, guidance and policy during the COVID-19 pandemic. As these rapid reviews usually included a range of study designs, it was key to identify a single tool that would allow for reliable critical appraisal across most experimental and observational study designs and applicable to a range of public health topics. After carefully considering a number of existing tools, the QCC was selected as it had good interrater agreement between three reviewers (Fleiss kappa coefficient: 0.639) and was found to be easy and fast to apply once familiar with the tool. The QCC consists of 10 questions, with sub-questions to specify how it should be applied to a specific study design. Four of these questions are considered as critical (on selection bias, group comparability, intervention/exposure assessment and outcome assessment) and the rating of a study (high, moderate or low methodological quality) depends on the responses to these four critical questions. Our results suggest that the QCC is an appropriate critical appraisal tool to assess experimental and observational studies in systematic or rapid reviews and that it can be used in a range of public health topics.
Early Detection of Deterioration in COVID-19 Patients by Continuous Ward Respiratory Rate Monitoring: A Pilot Prospective Cohort Study
Authors: Rivas Eva , López-Baamonde Manuel , Sanahuja Josep , Rio Elena Del , Ramis Tomeu , Recasens Anna , López Antonio , Arias Marilyn , Kampakis Stylianos , Lauteslager Timo , Awara Osama , Mascha Edward J. , Soriano Alex , Badía Joan Ramon , Castro Pedro , Sessler Daniel I.
Published: March 2023

Background
Tachypnea is among the earliest signs of pulmonary decompensation. Contactless continuously respiratory rate monitoring might beuseful in isolated COVID-19 patients admitted in wards. We aim to determine whether continuous untethered ward respiratory rate patterns in hospitalized COVID-19 identify patients who require escalation of pulmonary management 24 hours ahead of time.
Methods
Single-center pilot prospective cohort study in COVID-19 patients who were cared for in routine wards. COVID-19 patients who has at least one escalation of pulmonary management were matched to 3 non-escalated patients. Contactless Breathing Monitoring was instituted after patients enrolled, and continued for 15 days unless hospital discharge, initiation of invasive mechanical ventilation, or death occurred. Respiratory rate data from the continuous monitor was not available to clinicians. The exposures were respiratory features over rolling periods of 30 min, 24 hours, and 72 hours before respiratory care escalation. The primary outcome was escalation in the pulmonary care beyond Venturi-mask.
Results
Among 125 included patients, 13 exhibited at least one escalation and were each matched to 3 non-escalated patients. A total of 28 escalation events were matched to 84 non-escalation episodes. The 30-min mean respiratory rate in escalated patients was 23 breaths per minute (bpm) ranging from 13 to 40 bpm, similar to the 22 bpm in non-escalated patients, although with less variability (range 14 to 31 bpm). However, higher respiratory rate variability, especially skewness over 1 day, was associated with higher incidence of an escalation event. Our overall model, based on continuous data, had a moderate accuracy with an AUC 0.81 (95%CI:0.73,0.88) and a good specificity 0.93 (95%CI:0.87,0.99).
Conclusions
Our pilot observational study suggests that continuous respiratory monitoring and respiratory rate variability are associated with the need for care escalation 24 hours in advance. ur results suggest that continuous respiratory monitoring is a valuable increment over intermittent monitoring.
A195V mutation identified in sudden cardiac death decreases membrane localization and activation current density and abolishes cAMP sensitivity of HCN4 channels
Authors: Wu Qiuping , Zhang Kai , Yue Jiacheng , Hu Bingjie , Cheng Jianding
Published: March 2023

Mutation A195V in hyperpolarization-activated cyclic nucleotide-gated channel 4 (HCN4) channel was identified to be genetically associated with sudden unexplained nocturnal death syndrome (SUNDS) and sudden infant death syndrome (SIDS) by us and other group, respectively. However, the underlying mechanism by which this rare variant causes SUNDS and SIDS remains unknow. In this study, HEK293 cells were transfected with wild type or mutant A195V HCN4 plasmid. qPCR, western blot and confocal analysis were conducted to analyze the expression of HCN4 channels. Whole cell clamp was used to analyze the activation current and tail current of HCN4 channels with and without cAMP stimulation. The results showed that A195V decreased the expression and membrane localization of HCN4 channels. Consistent with this, A195V also decreased the activation current density of HCN4 channels under − 140mV to -100mv and under − 50mV to -40mV. The present study was the first to clarify the decreased expression of HCN4 protein and the decreased activation current density and abolished cAMP sensitivity of HCN4 channels caused by A195V, which biophysically confirmed HCN4 A195V as the pathogenic variation for SUNDS and SIDS.
Controlled synthetic chirality in macroscopic assemblies of carbon nanotubes
Authors: Doumani Jacques , Lou Minhan , Dewey Oliver , Hong Nina , Fan Jichao , Baydin Andrey , Yomogida Yohei , Yanagi Kazuhiro , Pasquali Matteo , Saito Riichiro , Kono Junichiro , Gao Weilu
Published: March 2023

There is an emerging recognition that successful utilization of chiral degrees of freedom can bring new scientific and technological opportunities to diverse research areas. Hence, methods are being sought for creating artificial matter with controllable chirality in an uncomplicated and reproducible manner. Here, we report the development of two straightforward methods for fabricating wafer-scale chiral architectures of ordered carbon nanotubes (CNTs) with tunable and giant circular dichroism (CD). Both methods employ simple approaches, (i) mechanical rotation and (ii) twist-stacking, based on controlled vacuum filtration and do not involve any sophisticated nanofabrication processes. We used a racemic mixture of CNTs as the starting material, so the intrinsic chirality of chiral CNTs is not responsible for the observed chirality. In particular, by controlling the stacking angle and handedness in (ii), we were able to maximize the CD response and achieve a record-high deep-ultraviolet ellipticity of 40 ± 1 mdeg/nm. Our theoretical simulations using the transfer matrix method reproduce the salient features of the experimentally observed CD spectra and further predict that a film of twist-stacked CNTs with an optimized thickness will exhibit an ellipticity as high as 150 mdeg/nm. The created wafer-scale objects represent a new class of synthetic chiral matter consisting of ordered quantum wires whose macroscopic properties are governed by nanoscopic electronic signatures such as van Hove singularities. These artificial structures with engineered chirality will not only provide playgrounds for uncovering new chiral phenomena but also open up new opportunities for developing high-performance chiral photonic and optoelectronic devices.
Opioid Free Versus Opioid Based Anesthesia in Major Spine Surgery: A Prospective, Randomized, Controlled Clinical Trial
Authors: Barakat Hanane , Gholmieh Linda , Nader Jessy Abou , Karam Vanda Yazbeck , Nawwar Rony Al
Published: March 2023

Background:The aim of this study is to compare the intraoperative opioid free anesthesia approach to the conventional opioid based anesthesia in patients undergoing multilevel spinal fusion surgery, and its impact on postoperative pain, opioid consumption, and related side effects.Methods:Forty-eight patients undergoing elective major spine surgery were randomly allocated to two groups. The Opioid-Free Anesthesia (OFA) group received dexmedetomidine 0.5mcg/kg/hr and lidocaine 1mg/kg/hr as continuous intravenous (IV) infusion for 10 minutes before anesthesia induction, followed by dexmedetomidine 0.3 mcg/kg/hr and lidocaine 1.5mg/kg/hr as continuous IV infusion intraoperatively. The Opioid-Based Anesthesia (OBA) group received fentanyl 2mcg/kg during anesthesia induction and remifentanil 0.2-0.3 mcg/kg/min continuous IV infusion intraoperatively. All patients received ketamine 0.15mg/kg, propofol 2 mg/kg and rocuronium 0.6 mg/kg for anesthesia induction and ketamine 0.15 mg/kg/hr with sevoflurane for anesthesia maintenance. All patients received a Patient Controlled Analgesia (PCA) device set to deliver IV morphine ready for use directly after discharge from the Post Anesthesia Care Unit (PACU) for 48 hours after surgery. Postoperative pain was measured using Verbal Analogue Scale (VAS). Opioid side effects were documented when present.Results: The OFA group required less morphine consumption in the first 24 hours post-surgery (17.28 ± 12.25 mg versus 27.96 ± 19.75 mg, p < 0.05). The incidence of nausea and vomiting was significantly lower in the OFA group. There was no significant difference in the hemodynamic changes intraoperatively among the two groups. However, more patients in the OFA group required antihypertensive medications compared to patients in the OBA group (p< 0.05). In the PACU, OFA patients had a significantly longer stay than OBA patients (114.1± 49.33 min versus 89.96 ± 30.71 min, p<0.05), yet there was no significant difference in the morphine consumption.Conclusion: OFA can be an alternative to OBA in patients undergoing multilevel spine fusion surgery. OFA use resulted in reduced need for analgesics for the first 24 hours and less postoperative nausea and vomiting.Trial registration:The study was conducted after receiving approval from local Institutional Review Board, Lebanese American University, Institutional Review Board (LAU IRB) (LAUMCRH.HB1.11/01/2018): and was registered with ClinicalTrials.gov (registration number: NCT03417193) and posted on 31/01/2018.
Asymptomatic Arbovirus, Campylobacter but no Hepatitis E Infections in German Travelers to Asia
Authors: Dammermann Werner , Haller Isabel-Elena , Singethan Katrin , Pischke Sven , Vinnemeyer Christof , Lüth Stefan , Hentschel Florian
Published: March 2023

Purpose: Transmission of infectious travel diseases is increasing, especially in travelers from developed to developing countries. Still, the incidence of many travel diseases is not known, because retrospective surveillance systems do not detect asymptomatic infections.
Methods: We took medical history and blood samples of 81 German travelers before and after travelling to South and Southeast Asia. IgG, IgM, and if possible IgA antibody titers were measured for Dengue virus (DENV), Chikungunya virus (CHIKV), Zika virus (ZIKV), Hepatitis E virus (HEV), and Camphylobacter jejuni (C.jejuni) using commercial ELISA kits. Additionally, we tested for Cytomegalovirus and Helicobacter pylori.
Results: No symptoms were reported. Still, we found one anti-ZIKV and two anti-DENV IgG seroconversions. For CHIKV, we found three individuals who were IgG-positive before travel and negative afterwards. We found five IgG seroconversions for C.jejuni and zero for HEV. We also found one IgG seroconversion for CMV, and zero for H.pylori. Calculated incidences were between zero and 6.5%.
Conclusion: Using serological analyses, we found a small but significant number of travel infections that would have gone unnoticed by retrospectively asking for symptoms alone. This suggests that the risk for these infections may be higher than previously estimated.
Mimicking Wagyu Beef Fat in Cultured Meat: Progress in Edible Bovine Adipose Tissue Production with Controllable Fatty Acid Composition
Authors: MATSUSAKI Michiya , Louis Fiona , Furuhashi Mai , Yoshinuma Haruka , Takeuchi Shoji
Published: March 2023

Since the current process of livestock meat production has significant effects on the global environment, leading to high emissions of greenhouse gases, cultured meat has recently attracted attention as a suitable alternative way to acquire animal proteins. However, while most of the published studies on cell-cultured meat have only focused on muscle tissue culture, fat production which is an important component of the process, was often neglected from this technology, despite the fact that it can enhance the meat final taste, aroma, tenderness, texture, and palatability. In this study, we particularly added data on the bovine muscle part reconstruction by monitoring and optimizing the possible expansion rate of isolated primary bovine adipose stem cells and their adipogenesis differentiation in a fully edible way for cultured meat application. From the data, after around 100 days of serial passages, the isolated bovine adipose derived stem cells doubled 57 ± 5 times in the edible cell culture medium condition. It means that from around 10 g of fat muscle tissue, at least 2.9x1022 cells can be obtained by culturing and amplifying them. Their adipogenesis differentiation ability was then found possible up to at least 12 passages and the final lipid composition has been controlled by adjusting the fatty acids composition of the culture medium during the differentiation, up to reaching organoleptic features similar to real fat muscle composition, especially the cis isomer oleic acid percentage, an important part of the specific high-grade Japanese Wagyu meat. These characteristics of the primary bovine adipose derived stem cells proliferation and adipogenesis differentiation provide valuable insights into the production of meat alternatives in vitro.
Angiographic findings in unstable angina and prediction of 1-year risk of recurrent acute coronary syndrome or death: A Nationwide Machine Learning Study
Authors: Råmunddal Truls , Rawshani Araz , Redfors Björn , Petursson Petur , Angerås Oskar , Hirleka Geir , Ioanes Dan , Odenstedt Jacob , Dworeck Christian , Völz Sebastian , Myredal Anna
Published: March 2023

Background
We studied whether machine learning could predict survival, risk of future acute coronary syndrome (ACS) and coronary angiographic (CAG) findings in patients with unstable angina (UA). We also studied whether high-sensitivity troponin levels within normal range can predict the presence of obstructive coronary lesions, risk of future ACS and death.
Methods
We used the SWEDEHEART registry to include patients admitted to the coronary care unit due to chest pain, with normal high-sensitivity cardiac troponin T or I (hs-cTnI, hs-cTnT), who underwent CAG and did not receive a final diagnosis of acute myocardial infarction (AMI). We studied CAG findings on segmental level, developed machine learning models predicting the risk of ACS or death within 1-year, and angiographic findings. The latter model predicted CAG resulting in interventions (any) or eliciting further assessments after CAG. Models for ACS and death included 130 candidate predictors and models for angiographic findings included 110 predictors.
Results
We included 9’314 patients; 1-year rate of death was 0.9% (n=78) and ACS was 2.7% (n=251). A total of 5455 (61.5%) of CAG resulted in no intervention and no further assessment afterwards, with 40% without significant stenosis. There was a strong association between hs-cTnI (within normal range) and severity of coronary atherosclerosis; e.g 32.4% in patients with hs-cTnI 26-35 ng/L had >50% stenosis in segment 6, as compared with 12.6% in those with hs-cTnI 0-5 ng/L. All segments displayed similar associations with troponin levels. Among 17 predictors for atherosclerosis, hs-cTnI was the strongest predictor of having >50% stenosis in the left anterior descending artery (LAD). Mortality increased at hs-cTnI levels above 10 ng/L for men, but not women. Age and sex adjusted hazard ratio for hs-cTnI 25-35 vs hs-TnI 0-5 was 5.73 (2.14-15.35) for 1-year mortality. No association was noted for hs-cTnT. The strongest predictors of 1-year mortality were C-reactive protein, body mass index, estimated glomerular filtration rate.
Conclusion
Troponin levels within normal range exhibit a strong association with obstructive CAD and survival.
Clinicopathological characteristics and prognosis of uterine sarcoma: A retrospective 10-year single-center study in China
Authors: Wang Jin-feng , Li Chen , Yang Zhe , Yang Jing-yi , Wang Yue-ling , Ji Jing
Published: March 2023

Background: Uterine sarcoma is rare and heterogeneous gynecological malignancies characterized by aggressive progression and poor prognosis. The current study aimed to investigate the clinicopathological characteristics and prognosis of uterine sarcoma in Chinese patients.
Methods: In this single-center, retrospective study, we reviewed the medical records of 75 patients with histologically verified uterine sarcoma treated at the First Affiliated Hospital of Xi’an Jiaotong University between 2011 and 2020. Information on clinical characteristics, treatments, pathology, and survival was recorded.
Results: The histopathological types included 36 endometrial stromal sarcoma (ESS), 33 leiomyosarcoma (LMS), and 6 adenosarcoma. The mean age at diagnosis was 50.2±10.7 years. Stage I and low histologic grade accounted for the majority. There were 26 recurrences and 25 deaths at the last follow-up. The mean progression-free survival (PFS) and overall survival (OS) were 89.41 (95% CI: 76.07-102.75) and 94.03 (95% CI: 81.67-106.38) months, respectively. Univariate analysis showed that >50 years, post-menopause, advanced stage, ≥1/2myometrial invasion, lymphovascular space invasion, and high gradewere associated with shorter survival of uterine sarcoma (P<0.05). Ultrasonic blood flow signals of the tumor were associated with shorter PFS in the LMS group (P=0.046). The ESS group had longer PFS than the LMS group (99.56 vs 76.05 months, P=0.043). The multivariate analysis showed that post-menopause and advanced stage were independent risk factors of both PFS and OS in the total patients and in the LMS group. In the ESS group, diagnosis age >50 years and high histologic grade were independent risk factors of PFS, while high histologic grade and lymphovascular space invasion were independent risk factors of OS.
Discussion: In Chinese patients with uterine sarcoma, post-menopause, and advanced stages are associated with a significantly poorer prognosis. The prognosis of ESS is better than LMS.
Total keratometry is not better than standard keratometry: An IOL refractive prediction outcome evaluation for cataract surgery
Authors: Zhao He , Chen Xu , Liu Bo , Liu Xi , Liu Yong
Published: March 2023

Purpose
To evaluate if total keratometry (TK) is better than standard keratometry (K) for predicting an accurate intraocular lens (IOL) refractive outcome for cataract surgery in four IOL power calculation formulas.
Methods
449 eyes that underwent monofocal intraocular lens implantation were enrolled in this study. IOLMaster 700 was used for optical biometry. Median absolute prediction error (MedAE), mean absolute error (MAE), median absolute prediction error (MedAE), proportions of eyes within ± 0.25 diopters (D), ± 0.50 D, ± 0.75 D, ± 1.00 D, ± 2.00 D adjusted prediction error, and formula performance index (FPI) were calculated for each K- and TK-based formula.
Results
Overall, the accuracy of each TK and K formula was comparable. The MAEs and MedAEs showed no difference between the K-based and the TK-based formula. The percent of eyes within ± 0.25 D for TK was not significantly different from that for K. The analysis of PE across various optical dimensions revealed that TK had no effect on the refractive results in eyes with different preoperative axial length, anterior chamber depth, keratometry, and lens thickness. K-based Barrett Universal II formula performed showed the leading FPI score and had the best refractive prediction outcomes among the four formulas.
Conclusion
In all investigated formulas, the predictive accuracy of TK-based formulas is not superior than that of standard K-based formulas. TK cannot substitute K for IOL power calculation in monofocal IOL implantation cataract surgery.
Screening for the High-Need Population Using Single Institution Versus State-Wide Admissions Discharge Transfer Feed
Authors: Balucan Francis Salvador , French Benjamin , Shi Yaping , Kripalani Sunil , Vasilevskis Eduard E.
Published: March 2023

Background
Access to programs for high-needs patients depending on single-institution electronic health record data (EHR) carries risks of biased sampling. We investigate a statewide admissions, discharge, transfer feed (ADT), in assessing equity in access to these programs.
Methods
This is a retrospective cross-sectional study. We included high-need patients at Vanderbilt University Medical Center (VUMC), who were 18 years or older, with minimum three emergency visits (ED) or hospitalizations in Tennessee from January 1 to June 30, 2021, including at least one at VUMC. We used the Tennessee ADT database to identify high-need patients with at least one VUMC ED/hospitalization, then compared this population with high-need patients identified using VUMC’s Epic® EHR database. The primary outcome was the sensitivity of VUMC-only criteria for identifying high-need patient when compared to statewide ADT reference standard.
Results
We identified 2549 patients that had at least one ED/hospitalization and were assessed to be high-need based on the statewide ADT. Of those, 2100 had VUMC-only visits, and 449 had VUMC and non-VUMC visits. VUMC-only visit screening criteria showed high sensitivity (99.1%, 95% CI: 98.7% - 99.5%), indicating that the high-needs patients admitted to VUMC infrequently access alternative systems. Results demonstrated no meaningful difference in sensitivity when stratified by patient’s race or insurance.
Conclusions
ADT allows examination for potential selection bias when relying upon single-institution utilization. In VUMC’s high-need patients, there’s minimal selection bias when relying upon same-site utilization. Further research needs to understand how biases may vary by site, and durability over time.
Thalidomide use in dermatological diseases in Brazil
Authors: Miranda Giuliana Angelucci , Martins Eduardo Lacaz , Paschoal Francisco Macedo , Barbosa Caio Parente
Published: March 2023

This prospective study on the use of thalidomide in dermatological diseases was conducted at the Dermatology Outpatient Clinic of the ABC Medical School and its main goal was to describe and analyze the epidemiological profile of patients using the drug. Given the diversity of diagnoses made in this reference service in Dermatology in Brazil, this study evaluated the variety of dermatological diseases whose improvement is associated with the use of thalidomide, also describing their side effects when reported. Of the 29 patients who used thalidomide for dermatological diseases, 89.6% (26 patients) reported improvement of the lesions and symptoms associated with the dermatological diagnosis, 13.7% (4 patients) reported side effects resulting from the use of the medication and requested suspension of thalidomide. For one of the patients diagnosed with dimorphic Virchowian leprosy and recalcitrant erythema nodosum, the diagnosis of reactional neuritis or neuropathic pain resulting from the use of thalidomide was questioned, and they chose to discontinue the medication. Despite the significant improvement after the use of thalidomide in dermatological diseases in patients of the Dermatology Outpatient Clinic of ABC Medical School, it is worth highlighting that, due to the known adverse effects, particularly teratogenicity and neurotoxicity, there is still much controversy surrounding the use of this drug. In this sense, its clinical use must be carefully evaluated and carefully considered regarding the risk-benefit ratio, especially in cases of patients with prior neuropathy and in women of childbearing age.
Structuring the relationship between subjective well-being and psychological factors in Japan and the United States
Authors: Kitashima Chiho , Kunitomo Takashi , Maeno Takashi
Published: March 2023

Background
The purpose of this study was to clarify the structure of subjective well-being in post-COVID-19 and to provide baseline information for future studies. To this end, we clarified the structure of subjective well-being (SWB) based on psychological factors that affect SWB. The Japanese and English versions of the scale were developed, and the scale and the SWB were also used to determine the cultural characteristics of the Japanese and U.S. participants.
Methods and Results
In Study 1, we administered a questionnaire to 1721 participants in Japan (aged 20–79 years). A total of 107 psychological factors that were shown to influence SWB in previous studies were selected, and factor analysis was conducted on items that showed an association with SWB. The results revealed four relevant factors: 1) Accepting what is, 2) Grateful for connections, 3) Ikigai/Life fulfillment, and 4) Love for self. In Study 2, we developed Japanese and English versions of the four-factor well-being scale that was clarified in Study 1 and administered them to participants in Japan and the U.S. In Study 3, we identified comparative cultural trends in SWB and the four-factor well-being in Japan and the U.S. (Japan: n = 2628; U.S.: n = 2617).
Conclusions
This novel study is the first cohort study to capture the characteristics of contemporary SWB during the COVID-19 pandemic. Through this study, we provide a new perspective on the structural elements of SWB in people living today.
Design and Evaluation of Crowd-sourcing Platforms Based on Users’ Confidence Judgments
Authors: Ahmadabadi Samin Nili , Haghifam Maryam , Shah-Mansouri Vahid , Ershadmanesh Sara
Published: March 2023

Crowd-sourcing deals with solving problems by assigning them to a large number of non-experts called crowd using their spare time. In these systems, the final answer to the question is determined by summing up the votes obtained from the community. The popularity of using these systems has increased by facilitation of access to community members through mobile phones and the Internet.
One of the issues raised in crowd-sourcing is how to choose people and how to collect answers. Usually, the separation of users is done based on their performance in a pre-test. Designing the pre-test for performance calculation is challenging; The pre-test questions should be chosen in a way that they test the characteristics in people related to the main questions. One of the ways to increase the accuracy of crowd-sourcing systems is to pay attention to people's cognitive characteristics and decision-making model to form a crowd and improve the estimation of the accuracy of their answers to questions. People can estimate the correctness of their responses while making a decision. The accuracy of this estimate is determined by a quantity called metacognition ability. Metacoginition is referred to the case where the confidence level is considered along with the answer to increase the accuracy of the solution1. In this paper, by both mathematical and experimental analysis, we would answer the following question: Is it possible to improve the performance of the crowd-sourcing system by knowing the metacognition of individuals and recording and using the users' confidence in their answers?
Inter-species metabolic interactions in cheese flavour
formation
Authors: Melkonian Chrats , Zorrilla Francisco , Kjærbølling Inge , Blasche Sonja , Machado Daniel , Junge Mette , Soerensen Kim , Andersen Lene , Patil Kiran , Zeidan Ahmad
Published: March 2023

Cheese fermentation and flavour formation are governed by complex biochemical reactions driven by polymicrobial activity. While the compositional dynamics of cheese microbiomes is relatively well mapped, the mechanistic role of microbial interactions in flavour formation is yet unknown. We microbially and metabolically characterised a year-long Cheddar cheese process using a commonly used starter culture containing Streptococcus thermophilus and Lactococcus strains. By using an experimental strategy whereby certain strains were left out from the starting mixture, we identified the critical role of S. thermophilus in boosting Lactococcus growth and in shaping flavour compound profile. Controlled milk fermentations with systematic exclusion of single Lactococcus strains, combined with genomics, genome-scale metabolic modelling, and metatranscriptomics, indicated that proteolytic activity of S. thermophilus relieves nitrogen limitation for Lactococcus and boosts de novo nucleotide biosynthesis. While S. thermophilus had large contribution to the flavour profile, L. cremoris also played a role by limiting diacetyl and acetoin formation which leads to off-flavour when in excess. This off-flavour control could be attributed to different metabolic re-routing of citrate between L. cremoris and other L. lactis strains. Further, closely related L. lactis strains exhibited different interaction patterns with S. thermophilus highlighting the importance of strain-specificity in cheese-making. Overall, our results bring forward the critical role of competitive and cooperative microbial interactions shaping cheese flavour profile.
An Obstetrics & Gynecology resident education program to address gaps in the knowledge, screening, and treatment of Postpartum Mood and Anxiety Disorder (PMAD)
Authors: McNally Stephanie , Miller Jack , Patel Vidhi , Hy Jonathan , Shrivastava Sneha , Pekmekzaris Renee
Published: March 2023

Introduction: Prenatal mood and anxiety disorders has been shown to cause significant problems for caregivers, their newborn and children. Despite this widespread issue, only 55% of healthcare providers assess for these symptoms/disorders. Methods: We implemented a program designed to educate Obstetrics & Gynecology resident physicians about the symptoms of prenatal mood and anxiety disorders as well as interventions for validated screening and treatment modalities. Results: A total of 49 residents participated in this training program. This resulted in an improvement in foundational knowledge, notably the recognition of postpartum blues versus depression, as well as understanding how to screen for postpartum depression. Conclusions: The program increased resident confidence in recognizing and treating prenatal mood and anxiety disorders.