bluuebunny/crossref_metadata_2025 huggingface dataset:
Current Trends and Future Directions of Large Scale Image and Video Annotation: Observations From Four Years of BIIGLE 2.0
Authors: Zurowietz Martin , Nattkemper Tim W.
Published: December 2021

Marine imaging has evolved from small, narrowly focussed applications to large-scale applications covering areas of several hundred square kilometers or time series covering observation periods of several months. The analysis and interpretation of the accumulating large volume of digital images or videos will continue to challenge the marine science community to keep this process efficient and effective. It is safe to say that any strategy will rely on some software platform supporting manual image and video annotation, either for a direct manual annotation-based analysis or for collecting training data to deploy a machine learning–based approach for (semi-)automatic annotation. This paper describes how computer-assisted manual full-frame image and video annotation is currently performed in marine science and how it can evolve to keep up with the increasing demand for image and video annotation and the growing volume of imaging data. As an example, observations are presented how the image and video annotation tool BIIGLE 2.0 has been used by an international community of more than one thousand users in the last 4 years. In addition, new features and tools are presented to show how BIIGLE 2.0 has evolved over the same time period: video annotation, support for large images in the gigapixel range, machine learning assisted image annotation, improved mobility and affordability, application instance federation and enhanced label tree collaboration. The observations indicate that, despite novel concepts and tools introduced by BIIGLE 2.0, full-frame image and video annotation is still mostly done in the same way as two decades ago, where single users annotated subsets of image collections or single video frames with limited computational support. We encourage researchers to review their protocols for education and annotation, making use of newer technologies and tools to improve the efficiency and effectivity of image and video annotation in marine science.
Oil Spill Detection Using Fluorometric Sensors: Laboratory Validation and Implementation to a FerryBox and a Moored SmartBuoy
Authors: Pärt Siim , Kankaanpää Harri , Björkqvist Jan-Victor , Uiboupin Rivo
Published: December 2021

A large part of oil spills happen near busy marine fairways. Presently, oil spill detection and monitoring are mostly done with satellite remote sensing algorithms, or with remote sensors or visual surveillance from aerial vehicles or ships. These techniques have their drawbacks and limitations. We evaluated the feasibility of using fluorometric sensors in flow-through systems for real-time detection of oil spills. The sensors were capable of detecting diesel oil for at least 20 days in laboratory conditions, but the presence of CDOM, turbidity and algae-derived substances substantially affected the detection capabilities. Algae extract was observed to have the strongest effect on the fluorescence signal, enhancing the signal in all combinations of sensors and solutions. The sensors were then integrated to a FerryBox system and a moored SmartBuoy. The field tests support the results of the laboratory experiments, namely that the primary source of the measured variation was the presence of interference compounds. The 2 month experiments data did not reveal peaks indicative of oil spills. Both autonomous systems worked well, providing real-time data. The main uncertainty is how the sensors' calibration and specificity to oil, and the measurement depth, affects oil detection. We recommend exploring mathematical approaches and more advanced sensors to correct for natural interferences.
The Oceans’ Biological Carbon Pumps: Framework for a Research Observational Community Approach
Authors: Claustre Hervé , Legendre Louis , Boyd Philip W. , Levy Marina
Published: December 2021

A recent paradigm explains that the downward pumping of biogenic carbon in the ocean is performed by the combined action of six different biological carbon pumps (BCPs): the biological gravitational pump, the physically driven pumps (Mixed Layer Pump, Eddy Subduction Pump and Large-scale Subduction Pump), and the animal-driven pumps (diurnal and seasonal vertical migrations of zooplankton and larger animals). Here, we propose a research community approach to implement the new paradigm through the integrated study of these BCPs in the World Ocean. The framework to investigate the BCPs combines measurements from different observational platforms, i.e., oceanographic ships, satellites, moorings, and robots (gliders, floats, and robotic surface vehicles such as wavegliders and saildrones). We describe the following aspects of the proposed research framework: variables and processes to be measured in both the euphotic and twilight zones for the different BCPs; spatial and temporal scales of occurrence of the various BCPs; selection of key regions for integrated studies of the BCPs; multi-platform observational strategies; and upscaling of results from regional observations to the global ocean using deterministic models combined with data assimilation and machine learning to make the most of the wealth of unique measurements. The proposed approach has the potential not only to bring together a large multidisciplinary community of researchers, but also to usher the community toward a new era of discoveries in ocean sciences.
Analysis of Biaxial Mechanical Properties and Failure Criterion of Self-Compacting Concrete
Authors: Zhang Jun , Li Chen , Zhu Congxiang , Zhao Zhiqing
Published: December 2021

Biaxial compression-compression, biaxial tension-compression and compression-shear tests were carried out on self-compacting concrete (SCC) using the rock true triaxial machine and compression-shear hydraulic servo machine to explore the biaxial mechanical properties of SCC. The failure modes and stress-strain curves of SCC under different loading conditions were obtained through experiment. Based on the comparison with the biaxial loading test data of ordinary concrete, the following conclusions are drawn: the failure modes and failure mechanisms under biaxial compression-compression and biaxial tension-compression are similar between SCC and ordinary concrete. Under compression-shear loading, the oblique cracks formed on the lateral surface of the specimen parallel to the shear direction gradually increased and the friction marks on the shear failure section were gradually deepened with the increase of axial compression ratio. The development trend of the stress-strain curve in the principal stress direction was not related to the lateral stress. Under the influence of lateral compressive stress, the principal compressive stress of SCC was increased by 55.78% on average; under biaxial tension-compression, the principal tensile stress of SCC had a maximum reduction of 62.79%; and under the compression-shear action, the shear stress of SCC had a maximum increase of 3.35 times. Compared with the biaxial stress test data of ordinary concrete, it can be seen that the lateral compressive stress had a more significant effect on the principal stress of SCC under biaxial loading. Subsequently, the strength criterion equations of SCC under biaxial loading were proposed based on the principal stress space and octahedral space stress respectively, which have shown good applicability in practice.
CxNy: New Carbon Nitride Organic Photocatalysts
Authors: López-Salas Nieves , Albero Josep
Published: December 2021

The search for metal-free and visible light-responsive materials for photocatalytic applications has attracted the interest of not only academics but also the industry in the last decades. Since graphitic carbon nitride (g-C3N4) was first reported as a metal-free photocatalyst, this has been widely investigated in different light-driven reactions. However, the high recombination rate, low electrical conductivity, and lack of photoresponse in most of the visible range have elicited the search for alternatives. In this regard, a broad family of carbon nitride (CxNy) materials was anticipated several decades ago. However, the attention of the researchers in these materials has just been awakened in the last years due to the recent success in the syntheses of some of these materials (i.e., C3N3, C2N, C3N, and C3N5, among others), together with theoretical simulations pointing at the excellent physico-chemical properties (i.e., crystalline structure and chemical morphology, electronic configuration and semiconducting nature, or high refractive index and hardness, among others) and optoelectronic applications of these materials. The performance of CxNy, beyond C3N4, has been barely evaluated in real applications, including energy conversion, storage, and adsorption technologies, and further work must be carried out, especially experimentally, in order to confirm the high expectations raised by simulations and theoretical calculations. Herein, we have summarized the scarce literature related to recent results reporting the synthetic routes, structures, and performance of these materials as photocatalysts. Moreover, the challenges and perspectives at the forefront of this field using CxNy materials are disclosed. We aim to stimulate the research of this new generation of CxNy-based photocatalysts, beyond C3N4, with improved photocatalytic efficiencies by harnessing the striking structural, electronic, and optical properties of this new family of materials.
Hybrid Bandgaps in Mass-coupled Bragg Atomic Chains: Generation and Switching
Authors: Xu Shao-Feng , Xu Zhu-Long , Chuang Kuo-Chih
Published: December 2021

In this work, without introducing mass-in-mass units or inertial amplification mechanisms, we show that two Bragg atomic chains can form an acoustic metamaterial that possesses different types of bandgaps other than Bragg ones, including local resonance and inertial amplification-like bandgaps. Specifically, by coupling masses of one monatomic chain to the same masses of a diatomic or triatomic chain, hybrid bandgaps can be generated and further be switched through the adjustment of the structural parameters. To provide a tuning guidance for the hybrid bandgaps, we derived an analytical transition parameter (p-value) for the mass-coupled monatomic/diatomic chain and analytical discriminants for the mass-coupled monatomic/triatomic chain. In our proposed mass-coupled monatomic/triatomic chain system, each set of analytical discriminants determines a hybrid bandgap state and a detailed examination reveals 14 different bandgap states. In addition to bandgap switching, the analytical p-value and discriminants can also be used as a guide for designing the coupled-chain acoustic metamaterials. The relations between the mass-coupled monatomic/triatomic chain system and a three-degree-of-freedom (DOF) inertial amplification system further indicate that the band structure of the former is equivalent to that of the latter through coupling masses by negative dynamic stiffness springs.
NiVCe-Layered Double Hydroxide as Multifunctional Nanomaterials for Energy and Sensor Applications
Authors: Gonçalves Josué M. , Lima Irlan S. , Azeredo Nathália F. B. , Rocha Diego P. , de Siervo Abner , Angnes Lúcio
Published: December 2021

Multifunctional nanomaterials have been attracting increasing attention as solutions to the existing challenges in energy systems and sensing technologies. In this regard, multifunctional NiVCe-layered double hydroxide (NiVCe-LDH) nanoparticles were synthesized by the modified sol-gel method. The analysis of this material demonstrated excellent potential for its utilization as electrode materials for hybrid supercapacitor, oxygen evolution reaction (OER), and sensor applications. The NiVCe-LDH nanoparticles delivered a specific charge of 740 C g−1 at 10 A g−1 and decent rate performance (charge retention of 68.7% at 100 A g−1), showing excellent prospects as electrode material for hybrid energy storage devices. In addition, NiVCe-LDH nanoparticles have also been successfully applied as a proof-of-concept for OER, as confirmed by their low Tafel slope of 47 mV dec−1. Finally, trimetallic NiVCe-LDH-based screen-printed electrodes were developed for the sensing of hydrogen peroxide directly in a real complex mouthwash sample, achieving a satisfactory recovery value of around 98% using a fast and simple batch injection analysis procedure. These results allow us to predict the great potential of this trimetallic hydroxide for building electrochemical sensors with good perspectives as electroactive material for OER processes and energy storage technologies.
Synergistic Excitation Mechanism of CaO-SiO2-Al2O3-SO3 Quaternary Active Cementitious System
Authors: Niu Fusheng , An Yukun , Zhang Jinxia , Chen Wen , He Shengtao
Published: December 2021

In this study, the influence of steel slag (SS) content on the strength of the cementitious materials was investigated. The quaternary active cementitious material (CaO-SiO2-Al2O3-SO3) was prepared using various proportions of steel slag (SS), granulated blast furnace slag (BFS), and desulfurized gypsum (DG). The mechanism of synergistic excitation hydration of the cementitious materials was examined using various techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM) and Fourier transform infrared spectrometry (FTIR). The strength of the mortar test block was initially increased and decreased later with the increase of the SS content. Mortar test block with 20% steel slag, 65% granulated blast furnace slag, and 15% desulfurized gypsum with 0.35 water-binder ratio showed the highest compressive strength of 57.3 MPa on 28 days. The free calcium oxide (f-CaO) in the SS reacted with water and produced calcium hydroxide (Ca(OH)2) which created an alkaline environment. Under the alkaline environment, the alkali-activated reaction occurred with BFS. In the early stage of hydration reaction, calcium silicate hydrate (C-S-H) gel and fibrous hydration product ettringite (AFt) crystals were formed, which provided early strength to the cementitious materials. As the hydration reaction progressed, the interlocked growth of C-S-H gel and AFt crystals continued and promoted the increase of the strength of the cementitious system.
Non-linear Methods Predominant in Fetal Heart Rate Analysis: A Systematic Review
Authors: Ribeiro Maria , Monteiro-Santos João , Castro Luísa , Antunes Luís , Costa-Santos Cristina , Teixeira Andreia , Henriques Teresa S.
Published: December 2021

The analysis of fetal heart rate variability has served as a scientific and diagnostic tool to quantify cardiac activity fluctuations, being good indicators of fetal well-being. Many mathematical analyses were proposed to evaluate fetal heart rate variability. We focused on non-linear analysis based on concepts of chaos, fractality, and complexity: entropies, compression, fractal analysis, and wavelets. These methods have been successfully applied in the signal processing phase and increase knowledge about cardiovascular dynamics in healthy and pathological fetuses. This review summarizes those methods and investigates how non-linear measures are related to each paper's research objectives. Of the 388 articles obtained in the PubMed/Medline database and of the 421 articles in the Web of Science database, 270 articles were included in the review after all exclusion criteria were applied. While approximate entropy is the most used method in classification papers, in signal processing, the most used non-linear method was Daubechies wavelets. The top five primary research objectives covered by the selected papers were detection of signal processing, hypoxia, maturation or gestational age, intrauterine growth restriction, and fetal distress. This review shows that non-linear indices can be used to assess numerous prenatal conditions. However, they are not yet applied in clinical practice due to some critical concerns. Some studies show that the combination of several linear and non-linear indices would be ideal for improving the analysis of the fetus's well-being. Future studies should narrow the research question so a meta-analysis could be performed, probing the indices' performance.
Segmentation of Cerebral Small Vessel Diseases-White Matter Hyperintensities Based on a Deep Learning System
Authors: Shan Wei , Duan Yunyun , Zheng Yu , Wu Zhenzhou , Chan Shang Wei , Wang Qun , Gao Peiyi , Liu Yaou , He Kunlun , Wang Yongjun
Published: December 2021

Objective: Reliable quantification of white matter hyperintensities (WHMs) resulting from cerebral small vessel diseases (CSVD) is essential for understanding their clinical impact. We aim to develop and clinically validate a deep learning system for automatic segmentation of CSVD-WMH from fluid-attenuated inversion recovery (FLAIR) imaging using large multicenter data.

Method: A FLAIR imaging dataset of 1,156 patients diagnosed with CSVD associated WMH (median age, 54 years; 653 males) obtained between September 2018 and September 2019 from Beijing Tiantan Hospital was retrospectively analyzed in this study. Locations of CSVD-WMH on the FLAIR scans were manually marked by two experienced neurologists. Using the manually labeled data of 996 patients (development set), a U-shaped novel 2D convolutional neural network (CNN) architecture was trained for automatic segmentation of CSVD-WMH. The segmentation performance of the network was evaluated with per pixel and lesion level dice scores using an independent internal test set (n = 160) and a multi-center external test set (n = 90, three medical centers). The clinical suitability of the segmentation results, classified as acceptable, acceptable with minor revision, acceptable with major revision, and not acceptable, was analyzed by three independent neuroradiologists. The inter-neuroradiologists agreement rate was assessed by the Kendall-W test.

Results: On the internal and external test sets, the proposed CNN architecture achieved per pixel and lesion level dice scores of 0.72 (external test set), and they were significantly better than the state-of-the-art deep learning architectures proposed for WMH segmentation. In the clinical evaluation, neuroradiologists observed the segmentation results for 95% of the patients were acceptable or acceptable with a minor revision.

Conclusions: A deep learning system can be used for automated, objective, and clinically meaningful segmentation of CSVD-WMH with high accuracy.
Advanced Endoscopic Imaging and Interventions in GERD: An Update and Future Directions
Authors: Mann Rupinder , Gajendran Mahesh , Perisetti Abhilash , Goyal Hemant , Saligram Shreyas , Umapathy Chandraprakash
Published: December 2021

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases encountered in primary care and gastroenterology clinics. Most cases of GERD can be diagnosed based on clinical presentation and risk factors; however, some patients present with atypical symptoms, which can make diagnosis difficult. An esophagogastroduodenoscopy can be used to assist in diagnosis of GERD, though only half of these patients have visible endoscopic findings on standard white light endoscopy. This led to the development of new advanced endoscopic techniques that enhanced the diagnosis of GERD and related complications like squamous cell dysplasia, Barrett's esophagus, and early esophageal adenocarcinoma. This is conducted by improved detection of subtle irregularities in the mucosa and vascular structures through optical biopsies in real-time. Management of GERD includes lifestyle modifications, pharmacological therapy, endoscopic and surgical intervention. Minimally invasive endoscopic intervention can be an option in selected patients with small hiatal hernia and without complications of GERD. These endoscopic interventions include endoscopic fundoplication, endoscopic mucosal resection techniques, ablative techniques, creating mechanical barriers, and suturing and stapling devices. As these new advanced endoscopic techniques are emerging, data surrounding the indications, advantages and disadvantages of these techniques need a thorough understanding.
Medical Facilities for Refugees in Europe: Creating a Consultation for Resettled Syrian Families
Authors: El Ghaziri Nahema , Blaser Jeremie , Malebranche Mary , Pahud-Vermeulen Brigitte , Gyuriga Teresa , Suris Joan-Carles , Gehri Mario , Bodenmann Patrick
Published: December 2021

The wave of migration that has hit Europe in recent years has led to several changes in the organization of asylum systems and medical care provided to migrants. Previous studies indicate that asylum seekers and refugees face multiple barriers in accessing health care. For that reason, adapted structures are needed. In this context, a family consultation service was implemented in our medical center in Lausanne, Switzerland. It aimed at addressing the unique health care needs of recently resettled families from Syria, which has been the leading source country for refugees since 2014. This intervention, developed through collaboration between the University Center for Primary Care and Public Health (Unisanté) and the Children's Hospital of Lausanne (HEL) involved a multidisciplinary team comprising a pediatrician, a general practitioner and a pediatric nurse. Bringing together a multidisciplinary team optimized care coordination, facilitated communication between care providers and enabled a more global vision of the family system with the aim of enhancing quality of care.
Stem Cells Therapy for COVID-19: A Systematic Review and Meta-Analysis
Authors: Arabpour Erfan , Khoshdel Sina , Tabatabaie Negin , Akhgarzad Ali , Zangiabadian Moein , Nasiri Mohammad Javad
Published: December 2021

Introduction: Vaccination seems to be a good solution for preventing and controlling coronavirus disease (COVID-19) pandemic, but still there are some challenges in COVID-19 vaccination. Investigating new therapeutic options for COVID-19 is necessary. The current study aimed to evaluate the safety and efficacy of stem cells in treating patients with COVID-19.

Methods: We reviewed the relevant scientific literature published up to April 1, 2021. The pooled risk ratio (RR) with 95% CI was assessed using a fixed or random-effect model. We considered P < 0.05 as statistically significant for publication bias. Data were analyzed by Comprehensive Meta-Analysis software, Version 2.0 (Biostat, Englewood, NJ).

Results: After reviewing 1,262 records, we identified 10 studies that met the inclusion criteria. The analysis showed that stem cell therapy could significantly reduce the mortality rate (RR 0.471, 95% CI: 0.270–0.821) and morbidity (RR 0.788, 95% CI: 0.626–0.992) in patients with COVID-19; compared with the control group.

Conclusions: The present study suggests that stem cell therapy has a remarkable effect on reducing mortality and morbidity of patients with COVID-19. Further large-scale studies are needed to approve these results. Defining a protocol for stem cell therapy in patients with COVID-19 can lead to achieving the best clinical outcomes.
Screening Referable Diabetic Retinopathy Using a Semi-automated Deep Learning Algorithm Assisted Approach
Authors: Wang Yueye , Shi Danli , Tan Zachary , Niu Yong , Jiang Yu , Xiong Ruilin , Peng Guankai , He Mingguang
Published: December 2021

Purpose: To assess the accuracy and efficacy of a semi-automated deep learning algorithm (DLA) assisted approach to detect vision-threatening diabetic retinopathy (DR).

Methods: We developed a two-step semi-automated DLA-assisted approach to grade fundus photographs for vision-threatening referable DR. Study images were obtained from the Lingtou Cohort Study, and captured at participant enrollment in 2009–2010 (“baseline images”) and annual follow-up between 2011 and 2017. To begin, a validated DLA automatically graded baseline images for referable DR and classified them as positive, negative, or ungradable. Following, each positive image, all other available images from patients who had a positive image, and a 5% random sample of all negative images were selected and regraded by trained human graders. A reference standard diagnosis was assigned once all graders achieved consistent grading outcomes or with a senior ophthalmologist's final diagnosis. The semi-automated DLA assisted approach combined initial DLA screening and subsequent human grading for images identified as high-risk. This approach was further validated within the follow-up image datasets and its time and economic costs evaluated against fully human grading.

Results: For evaluation of baseline images, a total of 33,115 images were included and automatically graded by the DLA. 2,604 images (480 positive results, 624 available other images from participants with a positive result, and 1500 random negative samples) were selected and regraded by graders. The DLA achieved an area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy of 0.953, 0.970, 0.879, and 88.6%, respectively. In further validation within the follow-up image datasets, a total of 88,363 images were graded using this semi-automated approach and human grading was performed on 8975 selected images. The DLA achieved an AUC, sensitivity, and specificity of 0.914, 0.852, 0.853, respectively. Compared against fully human grading, the semi-automated DLA-assisted approach achieved an estimated 75.6% time and 90.1% economic cost saving.

Conclusions: The DLA described in this study was able to achieve high accuracy, sensitivity, and specificity in grading fundus images for referable DR. Validated against long-term follow-up datasets, a semi-automated DLA-assisted approach was able to accurately identify suspect cases, and minimize misdiagnosis whilst balancing safety, time, and economic cost.
IL 33 Correlates With COVID-19 Severity, Radiographic and Clinical Finding
Authors: Markovic Sofija Sekulic , Jovanovic Marina , Gajovic Nevena , Jurisevic Milena , Arsenijevic Nebojsa , Jovanovic Marina , Jovanovic Milan , Mijailovic Zeljko , Lukic Snezana , Zornic Nenad , Vukicevic Vladimir , Stojanovic Jasmina , Maric Veljko , Jocic Miodrag , Jovanovic Ivan
Published: December 2021

Objective: The increased level of interleukin (IL)-33 is considered as a predictor of severe coronavirus disease 2019 (COVID-19) infection, but its role at different stages of the disease is still unclear. Our goal was to analyze the correlation of IL-33 and other innate immunity cytokines with disease severity.

Methods: In this study, 220 patients with COVID-19 were included and divided into two groups, mild/moderate and severe/critical. The value of the cytokines, clinical, biochemical, radiographic data was collected and their correlation with disease severity was analyzed.

Results: Most patients in the severe/critical group were male (81.8%) and older (over 64.5 years). We found a statistically significant difference (p < 0.05) in these two groups between clinical features (dyspnea, dry cough, fatigue, and auscultatory findings); laboratory [(neutrophil count, lymphocyte count, monocyte count, hemoglobin, plasma glucose, urea, creatinine, total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), albumin (ALB), lactate dehydrogenase (LDH), creatinine kinase (CK), D-dimer, C-reactive protein (CRP), procalcitonin (PCT), Fe, and Ferritin)], arterial blood gases (oxygen saturation-Sa02, partial pressure of oxygen -p02), and chest X-rays (CXR) lung findings (p = 0.000). We found a significantly higher serum concentration (p < 0.05) of TNF-α, IL-1β, IL-6, IL-12, IL-23, and IL-33 in patients with COVID-19 with severe disease. In the milder stage of COVID-19, a positive correlation was detected between IL-33 and IL-1β, IL-12 and IL-23, while a stronger positive correlation between the serum values of IL-33 and TNF-α, IL-1β, IL-6, and IL-12 and IL-23 was detected in patients with COVID-19 with severe disease. A weak negative correlation (p < 0.05) between pO2 and serum IL-1β, IL-12, and IL-33 and between SaO2 and serum IL-33 was noted. The positive relation (p < 0.05) between the serum values of IL-33 and IL-12, IL-33 and IL-6, and IL-6 and IL-12 is proven.

Conclusion: In a more progressive stage of COVID-19, increased IL-33 facilitates lung inflammation by inducing the production of various innate proinflammatory cytokines (IL-1β, IL-6, TNF-α, IL-12, and IL-23) in several target cells leading to the most severe forms of the disease. IL-33 correlates with clinical parameters of COVID-19 and might represent a promising marker as well as a therapeutic target in COVID-19.
17-Alpha-Hydroxyprogesterone vs. Placebo for Preventing of Recurrent Preterm Birth: A Systematic Review and Meta-Analysis of Randomized Trials
Authors: Almutairi Abdulaali R. , Aljohani Hadir I. , Al-fadel Nouf S.
Published: December 2021

Background: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.

Objective: To estimate the effect of 17-alpha-hydroxyprogesterone caproate (17-OHPC) compared to placebo in singleton gestations for reducing the risk of recurrent PTB and neonatal morbidity and mortality.

Work Design: Systematic review and meta-analysis.

Search Strategy: Searching MEDLINE, Embase, Web of Science, SCOPUS, Cochrane Library, and clinical trial registries.

Selection Criteria: Randomized controlled trials of singleton gestations with a history of PTB and treated with a weekly intramuscular injection of 17-OHPC or placebo.

Data Collection and Analysis: A random meta-analysis model was performed for the PTB outcomes (<32, <35, and <37 weeks) and neonatal outcomes (neonatal death, grade 3 or 4 intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and sepsis). Effect estimates were measured by relative risk ratio (RR) with a 95% confidence interval (CI).

Main Results: Six works were included. There were no statistically significant reductions in the PTB risk following the use of 17-OHPC at <32 weeks (RR = 0.61, 95% CI: 0.13–2.77, and I2 = 39%), <35weeks (RR = 0.60, 95% CI: 0.10–3.67, and I2 = 51%), and <37 weeks (RR = 0.68, 95% CI: 0.46–1, and I2 = 75%). Furthermore, all the neonatal outcomes were statistically similar between the two groups.

Conclusion: Treatment with 17-OHPC is not associated with reducing the risk of PTB or neonatal outcomes compared to placebo.
Meibomian Gland Morphology Changes After Cataract Surgery: A Contra-Lateral Eye Study
Authors: Chang Pingjun , Qian Shuyi , Xu Zhizi , Huang Feng , Zhao Yinying , Li Zhangliang , Zhao Yun-e
Published: December 2021

Purpose: To evaluate the morphology changes of meibomian glands (MGs) after cataract surgery.

Setting: Hangzhou Branch of the Eye Hospital of Wenzhou Medical University, Zhejiang, China.

Methods: In this contra-lateral eye study, 40 patients received unilateral cataract surgery for age-related cataract. All the patients underwent the evaluation of non-invasive break-up time (NIBUT) and lower tear meniscus height (TMH) before the surgery and 6 months post-operatively. The MGs were evaluated via ImageJ and Meibomian Gland Bio-image Analyzer. MG dropout, length, width, area, gland diameter deformation index (DI), and gland signal index (SI) were recorded.

Results: MG length, width, area, DI, and SI were significantly decreased after cataract surgery in the study group (operated eyes, P < 0.001, P = 0.003, P < 0.001, P = 0.001, and P < 0.001, respectively) and showed no significant changes in the control group (non-operated eyes) (all P > 0.05). MG loss increased more in the study group (P = 0.030), and the changes in TMH and NIBUT were not significantly different between the two eyes (both P > 0.05).

Conclusion: Cataract surgery aggravated meibomian gland morphology, such as MG loss, MG length, width, area, and SI, and produced no change in NIBUT and TMH at 6 months post-operatively.
Long-Lasting Immunity Against SARS-CoV-2: Dream or Reality?
Authors: Gussarow Daniel , Bonifacius Agnes , Cossmann Anne , Stankov Metodi V. , Mausberg Philip , Tischer-Zimmermann Sabine , Gödecke Nina , Kalinke Ulrich , Behrens Georg M. N. , Blasczyk Rainer , Eiz-Vesper Britta
Published: December 2021

Since its declaration as a pandemic in March 2020, SARS-CoV-2 has infected more than 217 million people worldwide and despite mild disease in the majority of the cases, more than 4.5 million cases of COVID-19-associated death have been reported as of September 2021. The question whether recovery from COVID-19 results in prevention of reinfection can be answered with a “no” since cases of reinfections have been reported. The more important question is whether during SARS-CoV-2 infection, a protective immunity is built and maintained afterwards in a way which protects from possibly severe courses of disease in case of a reinfection. A similar question arises with respect to vaccination: as of September 2021, globally, more than 5.2 billion doses of vaccines have been administered. Therefore, it is of utmost importance to study the cellular and humoral immunity toward SARS-CoV-2 in a longitudinal manner. In this study, reconvalescent COVID-19 patients have been followed up for more than 1 year after SARS-CoV-2 infection to characterize in detail the long-term humoral as well as cellular immunity. Both SARS-CoV-2-specific T cells and antibodies could be detected for a period of more than 1 year after infection, indicating that the immune protection established during initial infection is maintained and might possibly protect from severe disease in case of reinfection or infection with novel emerging variants. Moreover, these data demonstrate the opportunity for immunotherapy of hospitalized COVID-19 patients via adoptive transfer of functional antiviral T cells isolated from reconvalescent individuals.
Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients
Authors: Lattanzio Fabrizia , Corigliano Valentina , Soraci Luca , Fumagalli Alessia , Onder Graziano , Volpato Stefano , Cherubini Antonio , Ruggiero Carmelinda , Cozza Annalisa , Guarasci Francesco , Corsonello Andrea
Published: December 2021

Background: Hospitalized older patients are particularly exposed to adverse health outcomes.

Objective: In this study, we aimed at investigating the prognostic interactions between disability in basic activities of daily living (BADL), cognitive impairment, low handgrip strength, anticholinergic cognitive burden (ACB), and depression on 1-year mortality.

Setting and Subjects: Our series consisted of 503 older patients discharged from acute care hospitals.

Methods: Disability in at least one BADL, ACB, depression, cognitive impairment, and low handgrip strength was considered in the analysis. One-year mortality was investigated by Cox regression analysis and prognostic interactions among study variables were assessed by survival tree analysis.

Results: Basic activities of daily living disability, ACB, cognitive impairment, and low handgrip strength were significantly associated with 1-year mortality. Survival tree analysis showed that patients with BADL disability and high ACB carried the highest risk of poor survival [hazard ratio (HR): 16.48 (2.63–74.72)], followed by patients with BADL disability and low ACB (HR: 8.43, 95% CI: 1.85–38.87). Patients with cognitive impairment and no BADL disability were characterized by a lower but still significant risk of mortality (HR: 6.61, 95% CI: 1.51–28.97) and those with high ACB scores and good cognitive and functional performance (HR: 5.28, 95% CI: 1.13–24.55).

Conclusion: Basic activities of daily living dependency, cognitive impairment, and ACB score were the three main predictors of 1-year mortality among patients discharged from acute care hospitals; the interaction between BADL dependency and ACB score was

found to significantly affect survival. Early identification of such high-risk patients may help tailor targeted interventions to counteract their detrimental effects on prognosis.
Prognostic Value of Volume-Based Parameters Measured by SSTR PET/CT in Neuroendocrine Tumors: A Systematic Review and Meta-Analysis
Authors: Hou Jiale , Yang Yi , Chen Na , Chen Dengming , Hu Shuo
Published: December 2021

Purpose: A meta-analysis was conducted to investigate the value of the volume parameters based on somatostatin receptor (SSTR)-positron emission tomography (PET) in predicting the prognosis in patients with neuroendocrine tumors (NETs).

Material: PUBMED, EMBASE, Cochrane library, and Web of Knowledge were searched from January 1990 to May 2021 for studies evaluating prognostic value of volume-based parameters of SSTR PET/CT in NETs. The terms used were “volume,” “positron emission tomography,” “neuroendocrine tumors,” and “somatostatin receptor.” Pooled hazard ratio (HR) values were calculated to assess the correlations between volumetric parameters, including total tumor volume (TTV) and total-lesion SSTR expression (TL-SSTR), with progression-free survival (PFS) and overall survival (OS). Heterogeneity and subgroup analysis were performed. Funnel plots, Begg's and Egger's test were used to assess possible underlying publication bias.

Results: Eight eligible studies involving 593 patients were included in the meta-analysis. In TTV, the pooled HRs of its prognostic value of PFS and OS were 2.24 (95% CI: 1.73–2.89; P < 0.00001) and 3.54 (95% CI, 1.77–7.09; P = 0.0004), respectively. In TL-SSTR, the pooled HR of the predictive value was 1.61 (95% CI, 0.48–5.44, P = 0.44) for PFS.

Conclusion: High TTV was associated with a worse prognosis for PFS and OS in with patients NETs. The TTV of SSTR PET is a potential objective prognosis predictor.
Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment
Authors: Liu Zhanhe , Bible Joe , Petersen Lydia , Roy-Chaudhury Prabir , Geissler Judy , Brouwer-Maier Deborah , Singapogu Ravikiran
Published: December 2021

Lack of cannulation skill during hemodialysis treatments results in poor clinical outcomes due to infiltration and other cannulation-related trauma. Unfortunately, training of patient care technicians and nurses, specifically on the “technical” aspects of cannulation, has traditionally not received much attention. Simulators have been successfully deployed in many medical specialties for assessment and training of clinical skills. However, simulators have not been as widely used in nursing, especially in the context of training clinical personnel in the dialysis unit. We designed a state-of-the-art simulator for quantifying skill for hemodialysis cannulation. In this study, 52 nurses and patient care technicians with varying levels of clinical experience performed 16 cannulations on the simulator with different fistula properties. We formulated a composite metric for objectively measuring overall success of cannulation and compared this metric with subjective assessment by experts. In addition, we examined if years of clinical experience correlated with objective and subjective scores for cannulation skill. Results indicated that, while subjective and objective metrics generally correlated with each other, the objective metric was more precise and better suited for quantifying cannulation skill. Further, the simulator-based objective metric provides several advantages over subjective ratings, including providing fine-grained assessment of skill, consistency in measurement unaffected by subjective biases, and basing assessment on a more complete evaluation of performance. Years of clinical experience, however, demonstrated little correlation with either method of skill assessment. The methods presented for cannulation skill assessment in this study, if widely applied, could result in improved cannulation skill among our PCTs and nurses, which could positively impact patient outcomes in a tangible way.
Anticoagulant Therapy Is Associated With Decreased Long-Term Mortality in Splenic Infarction Patients: A Multicenter Study
Authors: Yen Chieh-Ching , Wang Chih-Kai , Chaou Chung-Hsien , Chen Shou-Yen , Lin Jhe-Ping , Ng Chip-Jin
Published: December 2021

Background: Patients with splenic infarction (SI) are associated with a prothrombotic state and are vulnerable to subsequent thromboembolic complications. However, due to its rarity, there is no established treatment modality in this population. We aimed to examine the effect of anticoagulant therapy in SI patients.

Methods: We performed a multicenter retrospective cohort study of 86 SI patients. Patients were categorized as anticoagulant users and anticoagulant non-users. The associations between anticoagulant therapy, all-cause mortality, thromboembolic events and bleeding events were evaluated.

Results: Forty-five patients (52.3%) received anticoagulant therapy during the follow-up periods. The all-cause mortality rate was 6.86 per 100 patient-years. Anticoagulant therapy was associated with 94% improved survival (HR = 0.06; Cl 0.007–0.48; p = 0.008), while the risk factors for all-cause mortality were prior stroke (HR = 13.15; Cl 2.39–72.27; p = 0.003) and liver cirrhosis (HR = 8.71; Cl 1.29–59.01; p = 0.027). Patients with anticoagulant therapy had a higher event-free survival curve for thromboembolic complications (p = 0.03) but did not achieve a significant difference after adjustment using the Cox regression model as a time-dependent covariate (HR = 0.57; Cl 0.13–2.45; p = 0.446). There was no significant difference in the risk of bleeding events between the groups (p = 0.728).

Conclusions: Anticoagulant therapy in patients with SI was associated with better survival and was not related to an increased bleeding risk.
In vitro Activity of Allicin Alone and in Combination With Antifungal Drugs Against Microsporum canis Isolated From Patients With Tinea Capitis
Authors: Zhou Ya Bin , Xiao Yuan Yuan , Chao Jin Jing , Ma Lin
Published: December 2021

The checkerboard broth method based on the Clinical and Laboratory Standards Institute M38-A3 document was used in this study to evaluate the in vitro activity of allicin alone and in combination with the antifungal drugs (griseofulvin, fluconazole, itraconazole and terbinafine) against Microsporum canis isolated from patients with tinea capitis. When allicin was used alone, only weak anti-M. canis effects were found. The MIC50, MIC90 and geometric mean (GM) of terbinafine were the lowest among the compounds tested. Synergism was observed for the combinations of allicin with itraconazole and terbinafine. Only indifference was observed for the combinations of allicin with griseofulvin and fluconazole. Our study illustrated the synergism of allicin in combination with itraconazole and terbinafine, which could be a reference for the treatment of tinea capitis due to M. canis.
Association of Cholecystectomy With Liver Fibrosis and Cirrhosis Among Adults in the USA: A Population-Based Propensity Score-Matched Study
Authors: Xie Zhi-Qin , Li Hong-Xia , Tan Wen-Liang , Yang Lei , Ma Xiao-Wu , Li Wen-Xin , Wang Qing-Bin , Shang Chang-Zhen , Chen Ya-Jin
Published: December 2021

Background and Aims: Cholecystectomy is the “gold standard” for treating diseases of the gallbladder. In addition, non-alcoholic fatty liver disease (NAFLD), liver fibrosis or cirrhosis, are major causes of morbidity and mortality across the world. However, the association between cholecystectomy and these diseases is still unclear. We assessed the association among US adults and examined the possible risk factors.

Methods: This cross-sectional study used data from 2017 to 2018 National Health and Nutrition Examination Survey, a population-based nationally representative sample of US. Liver fibrosis and cirrhosis were defined by median stiffness, which was assessed by transient elastography. Furthermore, patients who had undergone cholecystectomy were identified based on the questionnaire. In addition, Propensity Score Matching (PSM, 1:1) was performed based on gender, age, body mass index (BMI) and diabetes.

Results: Of the 4,497 included participants, cholecystectomy was associated with 60.0% higher risk of liver fibrosis (OR:1.600;95% CI:1.278–2.002), and 73.3% higher risk of liver cirrhosis (OR:1.733, 95% CI:1.076–2.792). After PSM based on age, gender, BMI group and history of diabetes, cholecystectomy was associated with 139.3% higher risk of liver fibrosis (OR: 2.393;95% CI: 1.738–3.297), and 228.7% higher risk of liver cirrhosis (OR: 3.287, 95% CI: 1.496–7.218).

Conclusions: The present study showed that cholecystectomy is positively associated with liver fibrosis and cirrhosis in US adults. The discovery of these risk factors therefore provides new insights on the prevention of NAFLD, liver fibrosis, and cirrhosis.
Case Report: Syphilitic Hepatitis–A Rare and Underrecognized Etiology of Liver Disease With Potential for Misdiagnosis
Authors: Al Dallal Hiba A. , Narayanan Siddharth , Alley Hanah F. , Eiswerth Michael J. , Arnold Forest W. , Martin Brock A. , Shandiz Alaleh E.
Published: December 2021

Syphilitic hepatitis (SH) in adults is a rare condition that can be easily misdiagnosed. Clinical and histopathologic manifestations of SH can mimic other infectious and non-infectious conditions, and the diagnosis should be considered in all at-risk patients with abnormal liver function tests. We present an unusual case of SH presenting with seizures and multiple liver lesions. This case report, in line with other newly published reports, promotes awareness of SH as a rare manifestation of treponemal infection and highlights the importance of including SH in the differential diagnosis for patients at risk for sexually transmitted infections and presenting with liver enzyme abnormalities. From a hospital quality control and socioeconomic perspective, our case adds to the growing body of evidence that demonstrates an increasing incidence of patients suffering from venereal diseases and injection drug use disorders, and the burden these conditions place on the healthcare system. Recognition of the clinicopathologic features of SH is required to prevent missed diagnosis and to foster systematic crosstalk between healthcare staff and public health personnel managing this problem.
Calculation and Interpretation of Substrate Assimilation Rates in Microbial Cells Based on Isotopic Composition Data Obtained by nanoSIMS
Authors: Polerecky Lubos , Eichner Meri , Masuda Takako , Zavřel Tomáš , Rabouille Sophie , Campbell Douglas A. , Halsey Kimberly
Published: December 2021

Stable isotope probing (SIP) combined with nano-scale secondary ion mass spectrometry (nanoSIMS) is a powerful approach to quantify assimilation rates of elements such as C and N into individual microbial cells. Here, we use mathematical modeling to investigate how the derived rate estimates depend on the model used to describe substrate assimilation by a cell during a SIP incubation. We show that the most commonly used model, which is based on the simplifying assumptions of linearly increasing biomass of individual cells over time and no cell division, can yield underestimated assimilation rates when compared to rates derived from a model that accounts for cell division. This difference occurs because the isotopic labeling of a dividing cell increases more rapidly over time compared to a non-dividing cell and becomes more pronounced as the labeling increases above a threshold value that depends on the cell cycle stage of the measured cell. Based on the modeling results, we present formulae for estimating assimilation rates in cells and discuss their underlying assumptions, conditions of applicability, and implications for the interpretation of intercellular variability in assimilation rates derived from nanoSIMS data, including the impacts of storage inclusion metabolism. We offer the formulae as a Matlab script to facilitate rapid data evaluation by nanoSIMS users.