bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring the up-to-date quality of online food delivery: formative index construction
Authors: Chan Janelle , Gao Yixing Lisa
Published: October 2021

Purpose

This study aims to fill this paucity of knowledge by exploring and formulating a formative index to measure the up-to-date quality of online food delivery (DEQUAL). The quality measurements for online food delivery have not been well recognized and even little is known after the COVID-19 outbreak. This study fills this paucity of knowledge by exploring and formulating a formative index to measure the up-to-date quality of online food delivery (DEQUAL).

Design/methodology/approach

Owing to the explorative nature and the lack of developed quality theory under the unprecedented COVID-19 pandemic, DEQUAL is conceptualized as a formative construct. This study adopts a mixed-method approach including expert interviews and online surveys to ascertain the underlying structure of DEQUAL.

Findings

Using partial least squares structural equation modeling as the analytical method, the results support that DEQUAL is a formative construct with 32 indicators. This study provides a measurement index with robust psychometric properties to assist practitioners in evaluating DEQUAL.

Research limitations/implications

This study contributes a theoretical and empirical-based conceptualization of DEQUAL as a multi-dimensional construct. Supplementing the past studies which commonly applied the reflective approach, this study evinces that the formative approach is also appropriate and thence furnishes the relevance of the formative index in the service management theories.

Practical implications

Practitioners are suggested to apply the validated indicators for service audit and customer relationship management. By systematically monitoring and measuring the online food delivery service quality, restaurants can improve customer satisfaction and loyalty.

Originality/value

This study offers various insights to the service quality literature in the food delivery service context.
Patient engagement in system redesign teams: a process of social identity
Authors: Atkinson Mariam Krikorian , Benneyan James C. , Phillips Russell S. , Schiff Gordon D. , Hunt Lindsay S. , Singer Sara J.
Published: October 2021

Purpose

Studies demonstrate how patient roles in system redesign teams reflect a continuum of involvement and influence. This research shows the process by which patients move through this continuum and effectively engage within redesign projects.

Design/methodology/approach

The authors studied members of redesign teams, consisting of 5–10 members: clinicians, systems engineers, health system staff and patient(s), from three health systems working on separate projects in a patient safety learning lab. Weekly team meetings were observed, January 2016–April 2018, 17 semi-structured interviews were conducted and findings through a patient focus group were refined. Grounded theory was used to analyze field notes and transcripts.

Findings

Results show how the social identity process enables patients to move through stages in a patient engagement continuum (informant, partner and active change agent). Initially, patient and team member perceptions of the patient's role influence their respective behaviors (activating, directing, framing and sharing). Subsequently, patient and team member behaviors influence patient contributions on the team, which can redefine patient and team member perceptions of the patient's role.

Originality/value

As health systems grow increasingly complex and become more interested in responding to patient expectations, understanding how to effectively engage patients on redesign teams gains importance. This research investigates how and why patient engagement on redesign teams changes over time and what makes different types of patient roles valuable for team objectives. Findings have implications for how redesign teams can better prepare, anticipate and support the changing role of engaged patients.
On the design and manufacturing of topologically optimized wings
Authors: Proença Tiago , Afonso Frederico , Lau Fernando , Policarpo Hugo , Lourenço João
Published: October 2021

Purpose

The purpose of this paper is to evaluate the impact of different Additive Manufacturing (AM) orientations on the structural behavior of topologically optimized wings for Unmanned Aerial Systems (UAS), which might enable lightweight and low cost, yet complex, wing structural designs.

Design/methodology/approach

Based on an aerodynamic load, a two dimensional NACA0012 airfoil is topologically optimized considering PolyLatic Acid (PLA), several volume fractions and different manufacturing orientations. Then, the resulting topologies are post-processed to allow for manufacturing and extrude to three dimensional wing geometries with constant cross-sections. These wings are then manufactured using Fusion Deposition Modeling (FDM) technology and their dynamic structural behavior analyzed by means of Experimental Modal Analysis (EMA) in the linear elastic region.

Findings

Volume fraction increase is observed to improve the structural performance without increasing the manufacturing time. Despite manufacturing the wing from the leading edge to the trailing edge can reduce manufacturing time using FDM technology, it is found to be more difficult to build.

Originality/value

This research is a contribution toward the design and built of lightweight and low cost wings for UAS.
Histopathological examination of the ectocervical biopsy in non‐transplanted uteri: A study contributing to the provisional scoring system of subclinical graft rejection after uterus transplantation
Authors: Balko Jan , Novackova Marta , Skapa Petr , Pastor Zlatko , Chmel Roman , Zamecnik Josef , Chmel Roman
Published: October 2021

Introduction

Uterus transplantation is a causal treatment for absolute uterine factor infertility. Assessing rejection signs using a histopathological examination of the ectocervical biopsy from the transplanted uterus is common practice in all human uterus transplants worldwide to date. A provisional scoring system was used for the histopathological assessment of subclinical rejection signs in uterus recipients. Here we hypothesized that histopathological and immunohistochemical findings in the normal uteri would differ from the borderline category of subclinical rejection in uterine transplants.

Material and methods

This prospective observational study included ectocervical biopsies of 54 women who underwent hysterectomy for benign reasons. All biopsy samples were assessed histopathologically and immunohistochemically.

Results

Most of the ectocervical biopsies showed clustering lymphocytic infiltrates affecting the stromal–epithelial interface with the epithelial influx of lymphocytes, primarily CD45RO‐positive activated T‐cells with CD8 T‐lymphocyte predominance. CD4‐positive T‐lymphocytes and B‐cells were rarely detected in the ectocervix. These morphological findings and immunoprofiles of lymphocytic populations overlapped with the so‐called borderline changes defined in the provisional scoring system for rejection in the transplanted uteri. The immunoprofiles of ectocervical and endocervical lymphocytic populations differed, with strikingly prominent B‐cell participation in the endocervix vs the rare detection of B‐cells in the ectocervix.

Conclusions

The histopathological and immunohistochemical findings in the uteri of premenopausal women were similar to the borderline category of the currently used provisional scoring system of subclinical uterine rejection utilized in all uterine transplant studies. However, future similar studies are required to validate our findings.
Ontogenetic spatial constraints of sub‐arctic marine fish species
Authors: Ciannelli Lorenzo , Neuheimer Anna B. , Stige Leif C. , Frank Kenneth T. , Durant Joel M. , Hunsicker Mary , Rogers Lauren A. , Porter Steve , Ottersen Geir , Yaragina Natalia A.
Published: October 2021

Marine species may respond and adapt to climate change through shifting spatial distributions, but options may be limited by the occupancy of essential habitats which are anchored in space. Limited knowledge of when spatial constraints are most likely to occur in marine fish life cycles has impeded the development of realistic distribution forecasts. In this study, we develop and implement analytical techniques to identify spatial constraints, defined by both the consistency through which a particular geographic area is used year after year, and by the extent of such area with respect to the entire population range. This approach is applied to simulated data and to ten case‐studies including six groundfish species from three subarctic marine systems. Our analyses illustrate that the early phase of the species’ life cycle is more spatially constrained than older life stages. We detected significant species‐specific variability in both the degree to which species are anchored in space throughout their life cycle, and the ontogenetic changes in the geographic association. There is an indication that this variability can be explained by the species life history strategy, highlighting the need to extend similar analyses to other species and regions. The presence of ontogenetic spatial constraints, particularly during early life stages, indicates restrictions exist to changes in spatial distribution and questions the assertion that global warming will uniformly result in an increase in abundance and harvest at higher latitudes and decreases at lower latitudes. Our study develops ecological and analytical insights that are critical for accurate projections of species distributions under different climate change scenarios.
The determinants of open interest in option markets
Authors: Harris Jeffrey H. , Shafer Michael
Published: October 2021

Open interest, the supply of options created, is driven by proxies for asymmetric information and theta (since option writers benefit from theta). Open interest increases with the magnitude of stock return momentum, especially for short‐sale constrained equities with negative return momentum. Moreover, open interest is positively related to firm risk (i.e., option writers respond to hedging demand), but the elasticity of supply decreases toward expiration when adverse selection costs become more salient. Open interest is also informative—we document that increases in open interest significantly presage seasoned equity offerings (SEOs), reflecting informed trading that is not evident with volume metrics.
Strong genotype‐by‐genotype interactions between aphid‐defensive symbionts and parasitoids persist across different biotic environments
Authors: Gimmi Elena , Vorburger Christoph
Published: October 2021

The dynamics of coevolution between hosts and parasites are influenced by their genetic interactions. Highly specific interactions, where the outcome of an infection depends on the precise combination of host and parasite genotypes (G × G interactions), have the potential to maintain genetic variation by inducing negative frequency‐dependent selection. The importance of this effect also rests on whether such interactions are consistent across different environments or modified by environmental variation (G × G × E interaction). In the black bean aphid, Aphis fabae, resistance to its parasitoid Lysiphlebus fabarum is largely determined by the possession of a heritable bacterial endosymbiont, Hamiltonella defensa, with strong G × G interactions between H. defensa and L. fabarum. A key environmental factor in this system is the host plant on which the aphid feeds. Here, we exposed genetically identical aphids harbouring three different strains of H. defensa to three asexual genotypes of L. fabarum and measured parasitism success on three common host plants of A. fabae, namely Vicia faba, Chenopodium album and Beta vulgaris. As expected, we observed the pervasive G × G interaction between H. defensa and L. fabarum, but despite strong main effects of the host plants on average rates of parasitism, this interaction was not altered significantly by the host plant environment (no G × G × E interaction). The symbiont‐conferred specificity of resistance is thus likely to mediate the coevolution of A. fabae and L. fabarum, even when played out across diverse host plants of the aphid.
Overtreatment: Is a solution possible?
Authors: Hubbeling Dieneke
Published: October 2021

Screening is a useful tool for identifying potential health issues; however, it can also lead to overtreatment. Consequently, patients are sometimes harmed by unnecessary treatments and there are cost implications. Overtreatment can also occur in other areas of medicine besides screening and sometimes medical interventions are used to improve performance rather than to treat disease. In this paper, a distinction is made between the perspectives of the patient and the government. For patients, autonomy is important, and they can refuse life‐saving treatments, assuming they have decision‐making capacity. They can also choose to be treated to avoid a very small risk or to improve their performance. For a government with limited funds, it is important to focus on outcomes and fund those screening programmes and other medical interventions that can potentially save the most lives or prevent severe disability. Governments also have the power to legislate to enable a level playing field by prohibiting medications that improve performance, but there is no general consensus about this, and regulations can only be applied to specific, well‐defined activities. The problem with overtreatment results from the different interests involved: autonomy is the guiding idea for patients and outcome is the guiding measure for societies. A general solution will not be possible because of these inherent conflicting interests. However, medical research may improve the identification and predictions surrounding any anomalies detected during scans and reduce the problem in practice for specific conditions.
What happens to diet quality in people newly diagnosed with type 2 diabetes? The 3D case‐series study
Authors: Burch Emily , Williams Lauren T. , Thalib Lukman , Ball Lauren
Published: October 2021

Background

Diet quality plays an important role in the prevention of diabetes‐related complications in people with type 2 diabetes mellitus (T2DM). However, evidence is scarce on how diet quality typically changes over time after diagnosis. The present study aimed to describe how the diet quality of individuals newly diagnosed with T2DM changes over a 12‐month period and to identify factors associated with diet quality changes.

Methods

A 12‐month prospective, observational case‐series study was undertaken. Two‐hundred and twenty‐five Australian adults (56% men) newly diagnosed with T2DM were recruited from the Diabetes Australia national database. Participants completed five interviewer‐administered surveys over 12 months: baseline, 3, 6, 9 and 12 months. Demographic, physical and health characteristics, and dietary intake data were collected at each timepoint. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) scoring tool. To assess changes in DASH, energy, fruit and vegetable intake over time, repeated measure analyses of variance were used. Multivariate repeated measures models investigated characteristics associated with these dietary changes.

Results

The mean DASH score of the sample remained stable at 24.0 across the 12 months. Very few participants (6.8%) improved diet quality consistently across the study period. No associations between DASH, energy, fruit or vegetable intake over time and characteristics were observed.

Conclusions

This observational study suggests that without dedicated interventions (the natural course), most people newly diagnosed with T2DM will not achieve meaningful diet quality change. The development of cost‐effective interventions to achieve sustained diet quality change early after diagnosis are warranted.
Geopolitics and regionalism: A Latin American perspective
Authors: Rivarola Puntigliano Andrés
Published: October 2021

The issue of regional integration has been widely analyzed and debated for a long time. Yet, there is still a limited connection between regional integration issues and geopolitical perspectives. With an analysis focused on Latin America, this study aims to map out theory and practice on this subject. In doing so, the study explores different points of view in relation to regions and geopolitics, and how these two elements are combined in the specific topic of regional integration. This article shows that, in Latin America, there are specific contributions, such as the so‐called ‘geopolitics of integration’. Different variations across time and states are identified, as well as common elements such as the search for ‘autonomy’ and ‘development’ as related to issues such as ‘nationalism’ and ‘resistance’ toward imperialism.
Right ventricular end‐diastolic volume and outcomes in exacerbations of COPD
Authors: Leong Paul , Osadnik Christian R. , King Paul T. , MacDonald Martin I. , Ko Brian S. , Lau Kenneth K. , Joosten Simon A. , Kathriachchige Gayan , Chua Alexander , Hamza Kais , Kuganesan Ahilan , Troupis John M. , Bardin Philip G.
Published: October 2021

Background and objective

Right ventricular (RV) volumes are crucial outcome determinants in pulmonary diseases. Little is known about the associations of RV volumes during hospitalized acute exacerbations of chronic obstructive pulmonary disease (AECOPD). We aimed to ascertain associations of RV end‐diastolic volume indexed to body surface area (RVEDVI) during hospitalized AECOPD and its relationship with mortality in long‐term follow‐up.

Methods

This is a prospective observational cohort study (December 2013–November 2019, ACTRN12617001562369) using dynamic retrospective ECG‐gated computed tomography during hospitalized AECOPD. RVEDVI was defined as normal or high using Framingham Offspring Cohort values. Cox regression determined the prognostic relevance of RVEDVI for death.

Results

A total of 148 participants (70 ± 10 years [mean ± SD], 88 [59%] men) were included, of whom 75 (51%) had high RVEDVI. This was associated with more frequent hospital admissions in the 12 months before admission (52/75 [69%] vs. 38/73 [52%], p = 0.04) and higher breathlessness (modified Medical Research Council score, 2.9 ± 1.3 vs. 2.4 ± 1.2, p = 0.007). During follow‐up, high RVEDVI was associated with greater mortality (log‐rank p = 0.001). In univariable Cox regression, increasing RVEDVI was associated with higher mortality (hazard ratio [HR]: 1.02 per ml/m2; 95% CI: 1.01, 1.03; p = 0.001). In multivariable Cox regression, RVEDVI was independently associated with mortality (HR: 1.01 per ml/m2; 95% CI: 1.00, 1.03; p = 0.050) at a borderline significance level. Adding RVEDVI to three COPD mortality prediction systems improved model fit (pooled chi‐square test [BODE: p = 0.05, ADO: p = 0.04, DOSE: p = 0.02]).

Conclusion

In patients with hospitalized AECOPD, higher RV end‐diastolic volume was associated with worse acute clinical parameters and greater mortality.
AI‐enhanced soil management and smart farming
Authors: Chen Qianyu , Li Lanyu , Chong Clive , Wang Xiaonan
Published: October 2021

Soil and crop management are facing challenges, in particular an increasing pressure to feed a growing population and improve food safety. Smart farming assists in dealing with these issues by incorporating information and communication technologies into farming practice. The Multiponics Vertical Farming (MVF) system is a very promising concept in smart farming that saves space, transportation cost and delivery time. Complicated systems and messy data can be processed by advanced technologies to achieve greater accuracy and efficiency in modelling and computing. For dynamic and complex problems, Artificial Intelligence (AI) provides rapid evaluation and aids in designing effective solutions. This study discusses how AI is adopted in soil management and MVF for tasks including classification, detection and forecasting. Three categories of AI and machine learning techniques, Support Vector Machine (SVM), Decision Tree (DT) and Neural Network (NN)‐based models, that are widely used will be presented. Future perspectives on urban farming are also discussed.
Synergy of a Small Modular Reactor for Addressing Remote Communities Non-Nuclear Waste
Authors: Harvel Glenn
Published: October 2021

Small modular reactors (SMRs) are a popular topic with a significant number of designs with a wide range of sizes. The motivation of this type of work is to find alternative uses for the SMRs so that the thermal energy is more effectively used and hence the SMR is more economical. This work is similar in that it studies the synergy that might exist between a remote community and the SMR. Most work for SMRs is related to remote communities with the impact as one-way, that is the benefit of the SMR to the community yet the SMR is a separate plant. The consideration here is that the SMR could be used to burn the nonnuclear waste products of the community and return useful products. An example is the plastics generated by the community can be converted into usable synthetic fuel, such as kerosene, by using the heat energy of the SMR. The SMR then has a dependency on the community waste stream. In this manner, the environmental load of the community is reduced yet the community also obtains a locally produced fuel that could be used for heating or transport outside of the community. Considering that diesel fuel costs can be extremely high in remote communities, methods to reduce the fuel costs, including the manufacture of their own fuel, can result in a synergistic or symbiotic relationship between the community and the SMR and the community can then have a centralized energy area for supporting neighboring communities.
Surface wetting on micromilled and laser-etched aluminum with ion-beam postprocessing
Authors: Misiiuk Kirill , Lowrey Sam , Blaikie Richard , Juras Josselin , Sommers Andrew , Leveneur Jérôme
Published: October 2021

In this work, micromilling and laser-etching microfabrication techniques are trialed for mimicking the super water repellence of the lotus leaf and the directional water droplet control of the Namib desert beetle. To further alter the surface wetting properties, subsequent ion-beam surface modification techniques are used. Ion-beam postprocessing is used to create an additional nanoroughness on a microstructure as well as a controllable Gibbs surface free energy change of the substrate material. The in-plane spreading for control (smooth) surfaces are compared to the micropatterned surfaces and combined micropatterned and ion-beam processed surfaces. Combined microscale surface engineering via milling or laser etching and ion-beam surface modification allows engineering both hydrophobic and mass-transport properties directly from a bulk material rather than involving a coating. Such surfaces have potential applications in advanced heat-exchanger technology (increasing the condensation heat transfer coefficient), wind turbine technologies (delaying or eliminating ice/frost formation under extreme weather conditions), as well as for atmospheric water harvesting and condensation control on industrial heat exchangers.
Effects of Whole-Body Vibration Training on Knee Muscle Strength After Anterior Cruciate Ligament Reconstruction: A Critically Appraised Topic
Authors: Sogut Bensu , Ozsoy Habib , Baloglu Recep , Harput Gulcan
Published: October 2021

Clinical Scenario: Knee muscle strength weakness after anterior cruciate ligament (ACL) reconstruction is the most commonly seen impairment. Whole-body vibration (WBV) training has been shown to improve muscle strength in both healthy and injured individuals. However, it is not clear yet if WBV training has a beneficial effect in knee muscle strength recovery after ACL reconstruction. Clinical Question: Is adding WBV training to conventional rehabilitation more effective than conventional rehabilitation at improving quadriceps and hamstring muscles strength in individuals who have undergone ACL reconstruction? Summary of Key Findings: After the literature was reviewed, 4 randomized controlled trials met the inclusion criteria and were included in this critically appraised topic. Clinical Bottom Line: There is moderate- to high-quality evidence to support that adding WBV to conventional rehabilitation programs can result in better improvement in knee muscle strength after ACL reconstruction. Strength of Recommendation: Findings from 4 randomized controlled trials indicate that there is level B evidence supporting that WBV is effective for knee muscle strength recovery in patients who had undergone ACL reconstruction.
Effectiveness of non-pharmacological interventions for reducing postpartum fatigue: a systematic review protocol
Authors: Qian Jialu , Sun Shiwen , Liu Lu , Yu Xiaoyan
Published: October 2021

Introduction

Postpartum fatigue is a common symptom among new mothers after their pregnancy. It has a considerable negative impact on women’s functional and mental status as well as the development of babies. Identifying effective interventions to prevent or reduce postpartum fatigue is meaningful to improve the quality of life and avoid adverse outcomes of this vulnerable population. This systematic review aims to synthesise non-pharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperas.

Methods and analysis

This review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will systematically search the Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases to identify clinical trials implementing non-pharmacological interventions conducted during 0–78 weeks postpartum for fatigue reduction. An additional search of OpenGrey will be conducted to identify grey literature. The search will be performed on 30 March 2021 without restrictions on time and language. Two independent reviewers will be responsible for study selection, data extraction and study quality assessment. The Cochrane risk-of-bias tool will be adopted to evaluate the risk biases of the included randomised controlled trials, and the Risk of Bias in Non-randomised Studies of Interventions will be applied to evaluate non-randomised controlled trials. Any disagreements will be referred to a third reviewer to reach a consensus. Findings will be qualitatively synthesised, and a meta-analysis will be conducted for the statistical combination if outcome data are sufficient and available.

Ethics and dissemination

This systematic review will not involve the collection of primary data and will be based on published data. Therefore, ethics approval is not required. The final findings will be disseminated through peer-reviewed journals and academic conferences.

PROSPERO registration number

CRD42021234869
Health and social interventions to restore physical function of older adults post-hip fracture: a scoping review
Authors: Omar Abeer , Cumal Alexia , Vellani Shirin , Krassikova Alexandra , Lapenskie Julie , Bayly Melanie , Welch Vivian A , Ghogomu Elizabeth , Iaboni Andrea , McGilton Katherine S
Published: October 2021

Objectives

Despite inpatient rehabilitation, many older adults post-hip fracture have difficulty returning to their prefracture levels of function and activity. This scoping review aims to identify interventions for community-dwelling older adults discharged from inpatient rehabilitation and examine the function and activity outcomes associated with these interventions.

Design

This scoping review followed Arksey and O’Malley’s five-stage framework.

Data sources

We searched MEDLINE, CINAHL, PsycINFO, EMBASE and Ageline electronic databases for English-language articles published between January 1946 and January 2020.

Eligibility criteria

We included studies with health and social interventions involving community-dwelling older adults and their caregivers after hip fracture and inpatient rehabilitation. The interventions were selected if initiated within 60 days post-hip fracture surgery.

Data extraction and synthesis

Two independent reviewers screened abstracts and full texts and extracted the data based on the inclusion criteria. A third reviewer adjudicated any disagreement and collated the extracted data.

Results

Of the 24 studies included in the review, most studies (79%) used exercise-based interventions, over half (63%) included activities of daily living training and/or home assessment and environment modification as intervention components, and three studies used social intervention components. Over half of the interventions (58%) were initiated in the inpatient setting and physiotherapists provided 83% of the interventions. Only seven studies (29%) involved tailored interventions based on the older adults’ unique needs and progress in exercise training. Six studies (25%) enrolled patients with cognitive impairment, and only one study examined caregiver-related outcomes. Exercise-based interventions led to improved function and activity outcomes. 29 different outcome measures were reported.

Conclusion

While exercise-based multicomponent interventions have evidence for improving outcomes in this population, there is a paucity of studies, including social interventions. Further, studies with standardised outcome measures are needed, particularly focusing on supporting caregivers and the recovery of older adults with cognitive impairment.
Harnessing the full potential of hospital-based data to support surgical quality improvement
Authors: Leung Sean Nicholas , Al-Omran Mohammed , Greco Elisa , Hughes Bertha , Qadura Mohammad , Wheatcroft Mark , Murray Joshua , Mamdani Muhammad , de Mestral Charles
Published: October 2021

Surgical departments commonly rely on third-party quality improvement registries. As electronic health data become increasingly integrated and accessible within an institution, alternatives to these platforms arise. We present the conceptualization and implementation of an in-house quality improvement platform that provides real-time reports, is less onerous on clinicians and is tailored to an institution’s priorities of care.
Immune landscape in vulvar cancer-draining lymph nodes indicates distinct immune escape mechanisms in support of metastatic spread and growth
Authors: Heeren Anne Marijne , Rotman Jossie , Samuels Sanne , Zijlmans Henry J M A A , Fons Guus , van de Vijver Koen K , Bleeker Maaike C G , Kenter Gemma G , Jordanova Ekaterina J , de Gruijl Tanja D
Published: October 2021

Background

Therapeutic immune intervention is highly dependent on the T-cell priming and boosting capacity of tumor-draining lymph nodes (TDLN). In vulvar cancer, in-depth studies on the immune status of (pre)metastatic TDLN is lacking.

Methods

We have phenotyped and enumerated various T-cell and myeloid subsets in tumor-free (LN−, n=27) and metastatic TDLN (LN+, n=11) using flow cytometry. Additionally, we studied chemokine and cytokine release profiles and assessed expression of indoleamine 2,3-dioxygenase (IDO) in relation to plasmacytoid dendritic cell (pDC) or myeloid subsets.

Results

Metastatic involvement of TDLN was accompanied by an inflamed microenvironment with immune suppressive features, marked by hampered activation of migratory DC, increased cytokine/chemokine release, and closely correlated elevations of pDC and LN-resident conventional DC (LNR-cDC) activation state and frequencies, as well as of terminal CD8+ effector-memory T-cell (TemRA) differentiation, regulatory T-cell (Treg) rates, T-cell activation, and expression of cytotoxic T-lymphocyte protein-4 (CTLA-4) and programmed cell death protein-1 (PD-1) immune checkpoints. In addition, high indoleamine 2,3-dioxygenase (IDO) expression and increased frequencies of monocytic myeloid-derived suppressor cells (mMDSC) were observed. Correlation analyses with primary and metastatic tumor burden suggested respective roles for Tregs and suppression of inducible T cell costimulator (ICOS)+ T helper cells in early metastatic niche formation and for CD14+ LNR-cDC and terminal T-cell differentiation in later stages of metastatic growth.

Conclusions

Metastatic spread in vulvar TDLN is marked by an inflamed microenvironment with activated effector T cells, which are likely kept in check by an interplay of suppressive feedback mechanisms. Our data support (neoadjuvant) TDLN-targeted therapeutic interventions based on CTLA-4 and PD-1 blockade, to reinvigorate memory T cells and curb early metastatic spread and growth.
Toward Responsible AI: An Overview of Federated Learning for User-centered Privacy-preserving Computing
Authors: Yang Qiang
Published: October 2021

With the rapid advances of Artificial Intelligence (AI) technologies and applications, an increasing concern is on the development and application of responsible AI technologies. Building AI technologies or machine-learning models often requires massive amounts of data, which may include sensitive, user private information to be collected from different sites or countries. Privacy, security, and data governance constraints rule out a brute force process in the acquisition and integration of these data. It is thus a serious challenge to protect user privacy while achieving high-performance models. This article reviews recent progress of federated learning in addressing this challenge in the context of privacy-preserving computing. Federated learning allows global AI models to be trained and used among multiple decentralized data sources with high security and privacy guarantees, as well as sound incentive mechanisms. This article presents the background, motivations, definitions, architectures, and applications of federated learning as a new paradigm for building privacy-preserving, responsible AI ecosystems.
Toward High Performance All Solid-State Na Batteries: Investigation of Electrolytes Comprising NaPF6, Poly(ethylene oxide) and TiO2
Authors: Peta Gayathri , Bublil Shaul , Alon-Yehezkel Hadas , Breuer Ortal , Elias Yuval , Shpigel Nethanel , Fayena-Greenstein Miryam , Golodnitsky Diana , Aurbach Doron
Published: October 2021

Solid electrolytes based on polyethylene oxide (PEO) have been studied for decades, owing to their facile and low-cost processing, good electrochemical stability, and excellent complexation with alkali metal salts. Complexes of PEO with appropriate sodium salts are well known for ionic conduction. Here, pristine NaPF6:P(EO)16 and a composite solid electrolyte containing TiO2 nanowires were investigated as candidates for rechargeable solid-state sodium batteries. Comprehensive electrochemical characterizations were carried out, including ionic conductivity, transference number, and structural stability. At elevated temperatures, the specific capacity of an all-solid-state Na3Ti2(PO4)3 (Na/NTP) sodium battery was 110 mAh g−1, higher than room-temperature cells with liquid electrolyte solutions. We attribute this behavior to increased conductivity of the polymer electrolyte, induced by the ceramic nanofiller, combined with enhanced electronic conductivity of the NTP cathode.
The Teledentistry, Impact, Current Trends, and Application in Dentistry: A Global Study
Authors: Maqsood Afsheen , Sadiq Muhammad Shahrukh Khan , Mirza Daud , Ahmed Naseer , Lal Abhishek , Alam Mohammad Khursheed , Halim Mohamad Syahrizal Bin
Published: October 2021

Objective. The present study was aimed at assessing the impact of teledentistry, its application, and trends in uplifting dental practice and clinical care around the world. Material and Methods. The present observational study comprised of an electronic survey distributed among dental professionals around the globe. The validated survey form consisted of a total 26 questions with 5‐point Likert scale response. The questionnaire used was divided into four domains: usefulness of teledentistry for patients, its usefulness in dental practice, its capacity to improve the existing practice, and the concerns attached to its use. The statistical analysis was performed using SPSS‐25. ANOVA test was used to assess the effect of independent variables on dependent variables. A p value of ≤0.05 was taken as statistically significant. Results. A total of 506 dental professionals participated in the study with the response rate of 89.39%. More than half of the participants (50‐75%) endorsed that teledentistry is a useful tool for improving clinical practice as well as patient care. Two‐thirds of the participants (69.96%) considered that teledentistry would reduce cost for the dental practices. On the other hand, about 50‐70% of dental professionals expressed their concerns regarding the security of the data and consent of patients. The most preferred communication tool for teledentistry was reported to be videoconference followed by phone. The majority of participants recommended the use of teledentistry in the specialty of oral medicine, operative dentistry, and periodontics. There was a significant difference between the age, experience of dentists, and their qualifications with domains of teledentistry. Conclusions. The overall impact of dental professionals towards teledentistry was positive with adequate willingness to incorporate this modality in their clinical practice. However, the perceived concerns pertaining to teledentistry are significant impediments towards its integration within the oral health system. An in‐depth study of its business model and cost‐benefit needs of time, especially in the context of developing countries, in order to avail the optimum benefits of teledentistry.
Study on Connectivity Mechanism and Robustness of Three-Dimensional Pore Network of Sandstone
Authors: Liu Guannan , Pei Xiaopeng , Ye Dayu , Gao Feng , Zhou Zongqing , Gao Chenglu
Published: October 2021

As one of the most prevalent porous media, rock contains a large number of pore throats of varying size and shape. It is essential to analyze the complex pore network structure and to define the network structural features to reveal the microscopic mechanism of the rock permeability. In this paper, based on the complex network theory and CT scanning technology, sandstone is used as an example to study the structural characteristics of the rock network with different porosities. The results show that the structural characteristics of the sandstone seepage network are consistent with BA scale-free network, whose average path length increases with the size of the network. At the same time, the porosity of the sandstone is strongly influenced by the number of throat in the rock pore network. Furthermore, our analysis concludes that a few pores with a large number of connections contribute significantly to the overall connectivity of the sandstone seepage network. Removing the ‘hub’ pores increased the average path length of the entire network by 27.63-37.26%, which could not be achieved by randomly removing method. While the sandstone seepage network has better fault tolerance and robustness to external random attacks, this study provides a new approach to study the mechanisms of fluid storage and migration in porous media.
Chiral Resolution, Absolute Configuration Assignment, and Genotoxicity Evaluation of Racemic 3,4-Dihydroquinazoline as a Novel Anticancer Agent
Authors: Ahn Junseong , Ko Dohyeong , Yang Seyoung , Moon Kwang H. , Woo Jiwon , Yoo Ho , Ahn Joohoon , Lee Jeong H. , Chung Kyung S. , Lee Kyung-T. , Lee Jae Y.
Published: October 2021

If a new drug candidate will be a mixture of enantiomers, both enantiomers should be separately studied for at least latent genotoxicity as early as possible since the thalidomide tragedy. Our group has recently reported that KCP-10043F (OZ-001) as a racemate (±)-3,4-dihydroquinazoline derivative strongly represses the proliferation of human A549 lung cancer cells by caspase-mediated apoptosis via STAT3 inactivation. To investigate the possible teratological effects of the two enantiomers of a racemic KCP-10043F, therefore chiral resolution of (±)-KCP-10043F was performed and subsequently followed by a series of chemical processes to afford the corresponding chiral diastereomers. By using 1H NMR anisotropy method, the absolute configuration (+)-KCP-10043F and (−)-KCP-10043F could be assigned as S and R configuration, respectively. The bacterial reverse mutation test (Ames test) for racemate (±)-KCP-10043F and its two enantiomers exhibited that all three stereoisomers were found to be nongenotoxic against five bacterial strains with/without metabolic activation. In addition, (R)-(−)-KCP-10043F displayed almost equal anticancer activity to (S)-(+)-KCP-10043F against three cancer cell lines. Based on these overall results, racemate KCP-10043F (OZ-001) could be used for our ongoing preclinical and clinical studies without the expensive asymmetric process and/or chiral separation.
Identifying Factors Associated with Barriers in the Number of Antenatal Care Service Visits among Pregnant Women in Rural Parts of Ethiopia
Authors: Suleman Hassen Sali , Mulatu Teshale Belete , Abate Adulo Lema
Published: October 2021

Background. Antenatal care visit is the service given to pregnant women to have a safe pregnancy and a healthy baby. The main objective of this study was to identify potential factors for the barriers in the number of antenatal care visits. Methods. Data for this study was taken from the 2016 Ethiopian demographic health survey. All childbearing women from rural parts of Ethiopia were considered in this study, and the count regression model was used to explore the major risk factors for the barriers in the number of antenatal care service visits. Results. Nearly 42% of pregnant mothers did not visit antenatal care services, and only 1% of the mothers attended antenatal care service visits eight times and above. From hurdle Poisson regression model results, women having previous pregnancy complication (AOR = 1.16;

P
≤
0.001

); husbands with primary education (AOR = 1.02;

P
=
0.004

), secondary education (AOR = 1.117;

P
≤
0.0001

), and higher education (AOR = 1.191;

P
≤
0.001

); middle wealth index (AOR = 1.08;

P
=
0.006

); richer wealth index (AOR = 1.10;

P
≤
0.001

); maternal age 35–49 (AOR = 0.690;

P
≤
0.001

); being exposed to media access (AOR = 1.745;

P
=
0.019

); having distance problem (AOR = 0.75;

P
=
0.013

); planned pregnancy (AOR = 1.42;

P
=
0.002

); and mothers with primary education (AOR = 1.85;

P
≤
0.001

) and secondary (AOR = 2.387;

P
≤
0.001

) were statistically associated with barriers in the number of ANC service visits. Conclusion. As indicated in the findings, there is underutilization of the antenatal care service visits regarding rural women in Ethiopia. Having a low education level, no media access, distance problem from the health facility, and not planned pregnancy decrease the rate of antenatal care service visits. To fill this discrepancy, the concerned bodies including government and nongovernmental organizations should work on the identified factors in the rural parts of the country to save children and mothers.
Serum IL-18 Is a Potential Biomarker for Predicting Severe Dengue Disease Progression
Authors: Nanda Josephine Diony , Jung Chiau-Jing , Satria Rahmat Dani , Jhan Ming-Kai , Shen Ting-Jing , Tseng Po-Chun , Wang Yung-Ting , Ho Tzong-Shiann , Lin Chiou-Feng
Published: October 2021

Background. Dengue virus (DENV) infection is the most common arboviral disease that affects tropical and subtropical regions. Based on the clinical hallmarks, the different severities of patients range from mild dengue fever (MDF) to severe dengue diseases (SDDs) and include dengue hemorrhagic fever or dengue shock syndrome. These are commonly associated with cytokine release syndrome (CRS). The types and levels of cytokines/chemokines, which are suppressed or enhanced, are varied, indicating CRS’s pathogenic and host defensive effects. Principal Finding. In this study, we created an integrated and precise multiplex panel of cytokine/chemokine assays based on our literature analysis to monitor dengue CRS. A 24-plex panel of cytokines/chemokines was evaluated to measure the plasma levels of targeting factors in dengue patients with an MDF and SDD diagnosis without or with comorbidities. As identified in sixteen kinds of cytokines/chemokines, ten were significantly (P<0.05) (10/16) increased, one was significantly (P<0.01) (1/16) decreased, and five were potentially (5/16) altered in all dengue patients (n=30) in the acute phase of disease onset. Compared to MDF, the levels of IL-8 (CXCL-8) and IL-18 in SDD were markedly (P<0.05) increased, accompanied by positively increased IL-6 and TNF-α and decreased IFN-γ and RANTES. With comorbidities, SDD significantly (P<0.01) portrayed elevated IL-18 accompanied by increased IL-6 and decreased IFN-α2 and IL-12. In addition, decreased platelets were significantly (P<0.05) associated with increased IL-18. Significance. These results demonstrate an efficient panel of dengue cytokine/chemokine assays used to explore the possible level of CRS during the acute phase of disease onset; also, we are the first to report the increase of IL-18 in severe dengue with comorbidity compared to severe dengue without comorbidity and mild dengue.
Effects of Compound Danshen Injection Combined with Magnesium Sulfate on Pregnancy-Induced Hypertension Syndrome under the Guidance of Empirical Mode Decomposition Algorithm-Based Ultrasound Image
Authors: Zhao Xia , Wang Hongbin , Gao Yanan , Wang Yanan
Published: October 2021

Objective. The study focused on the separation effects of ultrasound blood flow signal detection, based on empirical mode decomposition (EMD) algorithm, and the clinical efficacy of Compound Danshen injection and magnesium sulfate in the treatment of pregnancy-induced hypertension (PIH) syndrome. Methods. The empirical mode decomposition (EMD) algorithm was optimized first and compared with other algorithms for the accuracy and stability in separation of blood flow signals. 80 patients with PIH syndrome undergoing ultrasound examination were selected as the research subjects and randomly divided into control group and observation group according to the actual treatment methods. 40 cases in the observation group were treated with Compound Danshen injection + magnesium sulfate, and 40 cases in the control group were treated with magnesium sulfate. After the treatment, the clinical indicators of the two groups of patients were analyzed. Results. The accuracy and stability in separating blood flow signal of the optimized EMD algorithm were better than those of other algorithms. After treatment, the total effective rate and blood pressure control of the observation group were significantly better than those of the control group, and the incidence of adverse maternal and infant outcomes was significantly lower than that of the control group. After treatment, the endothelin-1 (ET-1), C-reactive protein (CRP), and homocysteine (Hcy) indexes of the two groups of patients decreased significantly, and the decrease level of the observation group was significantly greater than that of the control group (

P

 < 0.05). The prothrombin time (PT), fibrinogen (FIB), activated partial thromboplastin time (APTT), and plasma thrombin time (TT) levels of the two groups after treatment were better than those before treatment, and the observation group was better than the control group (

P

 < 0.05). Conclusion. The optimized EMD algorithm is of great value for the separation of ultrasound blood flow signals. For patients with PIH syndrome, Compound Danshen injection combined with magnesium sulfate can be used as a treatment plan, which can improve maternal and infant outcomes; control blood pressure; reduce 24 h urine protein and serum ET-1, Hcy, and CRP levels; and improve coagulation function. It is worthy of promotion.