bluuebunny/crossref_metadata_2025 huggingface dataset:
Participatory Media Cultures: Virality, Humour, and Online Political Contestations in Kenya
Authors: Mukhongo Lynete Lusike
Published: November 2020

The increase in access to affordable mobile technologies has created an interesting, sometimes complicated, relationship between Internet users and the Kenyan government. On the one hand, the latter is committed to building information and communications technology infrastructure and encouraging technological innovation. On the other, citizens are becoming digitally literate, civically engaged, and more likely to hold the government accountable. The article seeks to discuss varied forms of citizen engagement in the era of Internet viral cultures, ranging from (1) the use of social media for online protest, characterised by political contestation and fleeting outbursts of anger and backlash in the Twittersphere, to (2) the appropriation of protest messages into humorous viral memes (often oversimplified, ignoring the complexities of the situation and more focused on humour rather than underlying core problems). Four select hashtags during the 2017 Kenyan elections are analysed as frames for collective action within the context of playful participation and “spreadable” media.
We Might ‘Overcome Someday': West Tennessee’s Rural Freedom Movement
Authors: Ballantyne Katherine
Published: November 2020

After white landowners evicted black sharecroppers in late 1960 for registering to vote, activists in Fayette and Haywood Counties organized ‘Tent Cities' in a bid to focus national media attention on their plight. Over the decade, it developed into a wide-reaching campaign for desegregation in public accommodations and education, welfare reform, voting rights, and sustained community improvement measures. This little-known episode significantly advances scholarly understanding of rural civil rights activism. Notably this story reveals complex dualities including: a local grassroots movement bolstered by a national framework of organizations and social networks; leadership on national, state and local levels; collaboration despite tensions along race, age, class and gender lines; coexistence of nonviolent strategies and armed self-defense; and varied initiatives demonstrating activists’ focus on local needs.
Key Elements of Gingival Epithelial Homeostasis upon Bacterial Interaction
Authors: Lee J.S. , Yilmaz Ö.
Published: November 2020

Epithelia are structurally integral elements in the fabric of oral mucosa with significant functional roles. Similarly, the gingival epithelium performs uniquely critical tasks in responding to a variety of external stimuli and dangers through the regulation of specific built-in molecular mechanisms in a context-dependent fashion at cellular levels. Gingival epithelial cells form an anatomic architecture that confers defense, robustness, and adaptation toward external aggressions, most critically to colonizing microorganisms, among other functions. Accordingly, recent studies unraveled previously uncharacterized response mechanisms in gingival epithelial cells that are constructed to rapidly exert biocidal effects against invader pathobiotic bacteria, such as Porphyromonas gingivalis, through small danger molecule signaling. The host-adapted bacteria, however, have developed adroit strategies to 1) exploit the epithelia as privileged growth niches and 2) chronically target cellular bactericidal and homeostatic metabolic pathways for successful bacterial persistence. As the overgrowth of colonizing microorganisms in the gingival mucosa can shift from homeostasis to dysbiosis or a diseased state, it is crucial to understand how the innate modulatory molecules are intricately involved in antibacterial pathways and how they shape susceptibility versus resistance in the epithelium toward pathogens. Thus, in this review, we highlight recent discoveries in gingival epithelial cell research in the context of bacterial colonizers. The current knowledge outlined here demonstrates the ability of epithelial cells to possess highly organized defense machineries, which can jointly regulate host-derived danger molecule signaling and integrate specific global responses against opportunistic bacteria to combat microbial incursion and maintain host homeostatic balance. These novel examples collectively suggest that the oral epithelia are equipped with a dynamically robust and interconnected defense system encompassing sensors and various effector molecules that arrange and achieve a fine-tuned and advanced response to diverse bacteria.
COVID-19 and Immigrant Essential Workers: Bhutanese and Burmese Refugees in the United States
Authors: Zhang Mengxi , Gurung Ashok , Anglewicz Philip , Yun Katherine
Published: November 2020

Objectives

Immigrants are believed to be at high risk of infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). A leading suspected risk factor is their role in the essential workforce. We aimed to describe COVID-19–related risk factors among Bhutanese and Burmese refugees in the United States.

Methods

We administered an anonymous online survey in May 2020 among community leaders of Bhutanese and Burmese refugees. Using a snowball sampling strategy, we invited community leaders to complete the survey and share the link with others who met inclusion criteria (English proficient, aged ≥18, currently living in the United States). We compared respondents with and without recent COVID-19 and identified risk factors for infection.

Results

Of 218 refugees in 23 states who completed the survey from May 15 through June 1, 2020, fifteen (6.9%) reported infection with COVID-19. Being an essential worker during the pandemic (odds ratio [OR] = 5.25; 95% CI, 1.21-22.78), having an infected family member (OR = 26.92; 95% CI, 5.19-139.75), and being female (OR = 5.63; 95% CI, 1.14-27.82) were risk factors for infection. Among 33 infected family members, 23 (69.7%) were essential workers.

Conclusion

Although we had a small snowball sample, we found that working in essential industries was associated with an increased risk of COVID-19 infection among Bhutanese and Burmese refugees. We call for larger studies that include Asian immigrant subgroups, as well as immediate attention to protecting immigrant essential workers during the COVID-19 pandemic.
China Pushed the Pink Tide and the Pink Tide Pulled China: Intertwining Economic Interests and Ideology in Ecuador and Bolivia (2005–2014)
Authors: Ganchev Ivo
Published: November 2020

This article examines the rise of leftist ideology in Ecuador and Bolivia in light of their deepening economic relations with China from 2005 to 2014. First, it reveals that market trends account for trade fluctuations but fail to explain Chinese investment in, and some loan deals with, Ecuador as well as loans to Bolivia. Second, it demonstrates how these forms of funding provided alternatives to U.S.-led international institutions, enabling Rafael Correa and Evo Morales to steer away from Western influence. Third, it contends that four factors led to a cyclic reinforcement of Chinese economic interests and the rise of leftist ideology in Ecuador and Bolivia, namely: mutual complementarity between China’s demand for energy/natural resource supply diversification and Pink Tide development agendas; U.S.–China geopolitical competition for influence in Latin America; China’s experience in engaging with leftist governments from developing countries; and anti-Americanism shaping national identity in Ecuador and Bolivia.
Policy Versus Praxis: Has the European Union Failed to Respond to the Refugee Crisis?
Authors: Eylemer Sedef , Söylemez Nagihan
Published: November 2020

This study analyzes the effects of supranational governance on the refugee crisis in the European Union (EU). The main argument is that the supranational institutions of the EU have often failed to adequately manage the refugee crisis according to its foundational principles of fair burden sharing and solidarity. This failure has gradually discredited the Union’s basic normative principles such as solidarity, hospitality, and respect for human rights. We show that the gaps between certain policies adopted at the Union level and the practices at the national level have widened, and this has led to a familiar defeat of the normative domain by realpolitik, following some central tenets of classical realism. We aim to show that in several areas of EU policy, as well as how individual states have responded to them, national interests and burden shirking, rather than sharing, have unfortunately prevailed.
DelNido cardioplegia versus St Thomas cardioplegia solution in double valve replacement: a single centre experience
Authors: Sharma Anil , Dixit Sunil , Mittal Sourabh , Sharma Mohit , Sharma Dhruva , Mawar K K
Published: November 2020

Introduction:

The role of cardioplegia cannot be underrated in cardiac surgery. St Thomas solution is the most widely used cardioplegic, but needs repeated dosing. Del Nido solution provides long duration of asystole with adequate protection; but has been used mainly in paediatric patients. This study was aimed to compare Del Nido cardioplegia with St Thomas cardioplegia in adult cardiac surgeries, requiring double valve replacement and compare the outcomes.

Methodology:

This retrospective, observational, descriptive study was conducted over a time period spanning from January 2016 to December 2019. A total of 209 patients were included and were separated in two groups DC group (n = 114) and BC group (n = 95) on the basis of cardioplegic solution used. Del Nido solution was administered as single dose. Parameters noted were CPB time, cross clamp time, wean off bypass time, DC shocks given, inotropic support required, ventilation duration, duration of ICU and hospital stay.

Results:

There was significantly shorter aortic cross clamp time (72.6 ± 10.2 vs. 98.2 ± 9.2), CPB time (92.1 ± 12.3 vs.129.5 ± 11) and wean off bypass time (19.4 ± 5.9 vs. 31.3 ± 7.6) and less requirement of DC shocks (21.2% vs. 65.9%) in DC group. Inotropic requirement in immediate post-operative period was significantly less in DC group both on day of surgery (5.35 ± 1.44 vs. 7.52 ± 3.8) and 24 hours later (3.4 ± 2.12 vs. 2.18 ± 0.72). There was no significant difference in duration of ventilation, ICU and hospital stay.

Conclusion:

Del Nido can be used safely in long duration adult cardiac surgeries and in a single dose with better intra operative and immediate post-operative outcomes as compared to St Thomas solution.
Multiple metastases after surgery for a rare vulvar malignant melanoma combined with immunotherapy: a case report
Authors: Li Wenjing , Song Jingzhi , Sun Yiming , Cui Zhumei
Published: November 2020

We herein describe the preoperative and postoperative clinical data of a patient with a rare case of vulvar malignant melanoma and discuss her clinical characteristics and prognosis. After surgical resection and immunotherapy, the patient’s illness continued to worsen. She then received local vulvar radiotherapy. However, further treatment was discontinued because of intolerable complications of radiotherapy, and the patient died about 18 months postoperatively. Management of vulvar malignant melanoma is challenging. No unified, effective, and standardized diagnostic and treatment plan has been established for this disease. Surgery remains the primary treatment modality for locally resectable vulvar malignant melanoma. Radiation therapy and chemotherapy do not benefit survival. Encouragingly, however, immunotherapy and targeted therapy have shown clinical efficacy in metastatic vulvar malignant melanoma.
Canine Tonsillar Polyps: Characteristics, Classification, and Review of the Pathogenesis
Authors: Molín Jéssica , Vilafranca Miquel , Suárez-Bonnet Alejandro , Altimira Jaume , Ramírez Gustavo A.
Published: November 2020

Canine tonsillar polyps are uncommon. We describe 14 tonsillar polyps in dogs and review their classification and pathogenesis. All dogs were adult (3–13 years old). Females (10/14) were more affected than males (4/14). Most of the lesions were asymptomatic (10/14). All lesions were unilateral, pedunculated (9/14), or sessile (5/14), with a smooth (12/14) or papillary/verrucous surface (2/14). Histologically, polyps consisted of benign proliferation of lymphatic vessels, blood vessels, fibrous tissue, and lymphoid tissue in variable proportions, with occasional adipose tissue (4/14). According to the main stromal components, polyps were categorized as lymphangiomatous (5/14), lymphangiolipomatous (2/14), lymphangiofibromatous (2/14), angiofibromatous (1/14), angiofibrolipomatous (1/14), lymphoid (2/14), and myxomatous (1/14). As the pathogenesis of these polyps remains unclear, we propose to replace the term inflammatory tonsillar polyp by a morphological diagnosis based on the stromal characteristics of the lesions. Simple surgical excision was curative in the 9 cases with available follow-up information.
Prediction of Design Hourly Volume on Rural Roads
Authors: Petković Miloš , Tubić Vladan , Stepanović Nemanja
Published: November 2020

Design hourly volume (DHV) represents one of the most significant parameters in the procedures of developing and evaluating road designs. DHV values can be accurately and precisely calculated only on the road sections with the implemented automatic traffic counters (ATCs) which constantly monitor the traffic volume. Unfortunately, many road sections do not contain ATCs primarily because of the implementation costs. Consequently, for many years, the DHV values have been defined on the basis of occasional counting and the factors related to traffic flow variability over time. However, it has been determined that this approach has significant limitations and that the predicted values considerably deviate from the actual values. Therefore, the main objective of this paper is to develop a model which will enable DHV prediction on rural roads in cases of insufficient data. The suggested model is based on the correlation between DHVs and the parameters defining the characteristics of traffic flows, that is, the relationship between the traffic volumes on design working days and non-working days, and annual average daily traffic. The results of the conducted research indicate that the application of the proposed model enables the prediction of DHV values with a significant level of data accuracy and reliability. The coefficient of determination (R2) shows that more than 98% of the variance of the calculated DHVs was explained by the observed DHV values, while the mean error ranged from 4.86% to 7.84% depending on the number of hours for which DHV was predicted.
Parametric and non-parametric tests for the evaluation of interlaminar fracture toughness of polymer composites
Authors: Yavuz Hande , Utku Durdu Hakan
Published: November 2020

This study is based on the statistical analysis of interlaminar fracture toughness of various laminated polymer composites used in aerospace applications through parametric and non-parametric tests. Tukey’s, Dunkan’s, two-sample t-test, and Kolmogorov–Smirnov tests are used to analyze tensile mode interlaminar fracture toughness of various fiber-reinforced polymer composites obtained by beam theory, modified beam theory, and modified compliance calibration method. Among the studied composite samples, modified compliance calibration method provided the highest average interlaminar fracture toughness, whereas the modified beam theory showed the lowest one. Room temperature cured carbon fiber-reinforced composite samples exhibited higher interlaminar fracture toughness than the autoclave cured samples. Two-sample t-test show that all methods are found coherent with each other in terms of being significantly different. On the contrary, Kolmogorov–Smirnov test revealed no significant difference. Besides, Tukey’s and Duncan’s tests exhibited almost the same results in regard to significant differences except those obtained by the modified compliance calibration method. Two-sample t-test method should have to be performed in order to observe significant relations rather than Kolmogorov–Smirnov test, since the results of Tukey’s and Duncan’s tests are only consistent with each other for the beam theory and modified beam theory method.
Comparison of various gating systems for investment casting of hydraulic retarder impeller with complex geometry
Authors: Li Fei , Wang Yingchun , Wang Donghong , Zhao Yanjie , Qi Chengkang , Sun Baode
Published: November 2020

Due to the complex structure and thin thickness of the guide vane edge of the hydraulic retarder impeller, the casting defects such as shrinkage porosity and misrun are usually formed during casting, which have a close relationship with the filling and solidification process. In this work, the filling and solidification processes of impeller in various gating systems, named case 1 to 3, were simulated and the distribution characteristics of potential shrinkage porosity defects were predicted by ProCAST software based on the mathematical models, boundary conditions, and parameters of investment casting. The simulation results show that the aim of complete filling of the impeller can be achieved by using all of the three gating systems. However, only the case 3 gating system consisted with one sprue riser and four feeding risers can provide the impeller with suitable feeding channel in melt solidification process. Therefore, no predicted shrinkage porosities form in the impeller because the defects can transfer to the gating system during solidification. The optimized gating system have been verified by experiment, and the rapid casting of the impeller has been realized by using 3D printed polystyrene patterns. The results of visual and X-ray inspections show that both the misrun and shrinkage porosity defects were eliminated in the actually final cast, which matched well with the numerical simulation results for the investment casting of the impeller. Many experiment results of the new product show that these optimization gating system are very helpful to reduce the casting defect and to improve the product quality.
Anterior and Posterior Arthroscopic Treatment of Primary Synovial Chondromatosis of the Ankle
Authors: Bojanić Ivan , Plečko Mihovil , Mataić Ana , Dimnjaković Damjan
Published: November 2020

Background:

Primary synovial chondromatosis (PSC) is a progressive disorder of unknown etiology resulting in formation of multiple loose bodies. If left untreated, it may lead to degenerative changes or malignant transformation to chondrosarcoma.

Methods:

Seventeen patients who underwent combined posterior and anterior ankle arthroscopy within the same operative session and had histologically confirmed PSC were included in this retrospective study. American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score was used to evaluate ankle function preoperatively and at a final follow-up. A 3-question survey was used to evaluate patient’s satisfaction at the final follow-up.

Results:

In 14 patients, loose bodies were found in both compartments of the ankle, in 2 only in the anterior compartment, and in 1 only in the posterior compartment. All patients had evident signs of synovial inflammation in both compartments. The AOFAS Ankle-Hindfoot score increased from the preoperative median score of 65 (range, 29-90) to 95 (range, 65-100) at the final follow-up. Fourteen patients reported they were extremely satisfied with the outcome, 1 was moderately satisfied, and 2 were dissatisfied. No cases of recurrence of synovitis or loose body formation were noted, nor any signs of malignant transformation during the follow-up period.

Conclusion:

We believe the risk of recurrence of PSC, which is in close relation to malignant transformation, can be minimized by performing a complete synovectomy of the ankle. Our experience and review of literature makes us believe that ankle PSC should be regarded as a whole joint disorder. Performing a combined posterior and anterior arthroscopic procedure within the same operative session should always be considered in patients with ankle PSC.

Level of Evidence:

Level IV, retrospective case series.
Safety Assessment of Silk Protein Ingredients as Used in Cosmetics
Authors: Johnson Wilbur , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Gill Lillian J. , Heldreth Bart
Published: November 2020

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of Hydrolyzed Silk and 9 other silk protein ingredients, which function primarily as skin and hair conditioning agents and bulking agents in cosmetic products. The Panel reviewed relevant data relating to the safety of these ingredients and concluded that 8 ingredients are safe in the present practices of use and concentration in cosmetics, as described in this safety assessment, but that the available data are insufficient for determining the safety of 2 silk protein ingredients in cosmetic products, MEA-Hydrolyzed Silk and Silkworm Cocoon Extract.
Air quality effect on the hotel industry
Authors: Wang Liang-Ju , Chen Ming-Hsiang , Lu Lu
Published: November 2020

This article makes an original contribution to the hospitality research literature. It proposes a curvilinear impact of air quality (AQ) on hotel sales (HS) and then empirically tests this nonlinear effect using data from 26 major tourist cities in China from 2002 to 2016. The results of dynamic panel regression test based on estimations of the system generalized method of moments reveal an inverse U-shaped impact of AQ (measured by concentrations of the fine particulate matter, i.e. PM2.5) on HS and thus validate the proposal. Empirical findings offer valuable policy implications for hotel business owners and tourism authorities and policymakers.
Boronate probe-based hydrogen peroxide detection with AlGaN/GaN HEMT sensor
Authors: Mahaboob Isra , Reinertsen Roger J , McEwen Benjamin , Hogan Kasey , Rocco Emma , Melendez J Andres , Cady Nathaniel C , Shahedipour-Sandvik F
Published: November 2020

The results from this study demonstrate the potential of an AlGaN/GaN high electron mobility transistor sensor for the detection of reactive and transient biological molecules such as hydrogen peroxide. A boronate-based fluorescent probe was used with this device to detect the presence of micromolar levels of hydrogen peroxide typically associated with intracellular processes. The real-time electrical response of the high electron mobility transistor sensor showed a gradual decrease in the two-dimensional electron gas current as the reaction proceeded over time. A corresponding increase in the emission intensity was measured from the fluorescent probe with the progression of the reaction. The fluorescence from the boronate probe was used as an indicator to confirm the detection of hydrogen peroxide. These results demonstrate the dynamic measurement capability of AlGaN/GaN high electron mobility transistor sensors in monitoring real-time reactions of reactive oxygen species such as hydrogen peroxide.
Outcomes of Degenerative Cervical Myelopathy From The Perspective of Persons Living With the Condition: Findings of a Semistructured Interview Process With Partnered Internet Survey
Authors: Davies Benjamin M. , Munro Colin , Khan Danyal Z. , Fitzpatrick Siobhan M. , Hilton Bryn , Mowforth Oliver D. , McNair Angus G. K. , Sadler Iwan , Kotter Mark R. N.
Published: November 2020

Study Design:

Mixed-methods cross-sectional study.

Objectives:

Degenerative cervical myelopathy (DCM) is a common and disabling condition. While classically, assessment and diagnosis has focused on neuromuscular symptoms, many other disabilities have been linked. The aim of this study was to explore the consequences of DCM for those with lived experience, producing a long list to inform the development of a core outcome set for DCM research.

Methods:

A 2-stage process was used: a focus group session of people with DCM (PwCM) and their supporters (n = 8) discussed the impact of DCM. This was used to develop a preliminary list of consequences, which were then placed into a survey of an online community of DCM sufferers (n = 224). Survey participants were asked to tick the consequences that they had experienced and given the opportunity to submit additional. Additional consequences were reviewed by a group of healthcare professionals and PwCM and included if not already represented. Demographic information including disease severity, age, and sex were captured for sampling comparison.

Results:

A total of 52 outcomes were identified from the focus group and nominally divided into 2 categories; symptoms (36 outcomes) and handicaps (18 outcomes), and further evaluated using a survey. All outcomes were recognized by at least 5% of respondents. A further 16 outcomes were added following the survey.

Conclusions:

A list of DCM consequences has been defined from the perspective of PwCM. This will now be evaluated as part of AO Spine RECODE-DCM, an international multistakeholder collaboration to establish a core outcome set for research.
Clinical Effects of Anterior Cervical Spondylolisthesis on Cervical Spondylotic Myelopathy After Posterior Decompression Surgery: A Retrospective Multicenter Study of 732 Cases
Authors: Ninomiya Ken , Yamane Junichi , Aoyama Ryoma , Suzuki Satoshi , Shiono Yuta , Takahashi Yuichiro , Fujita Nobuyuki , Okada Eijirou , Tsuji Osahiko , Yagi Mitsuru , Watanabe Kota , Iga Takahito , Nakamura Masaya , Matsumoto Morio , Ishii Ken , Nagoshi Narihito
Published: November 2020

Study Design:

Multicenter retrospective study.

Objectives:

We aim to investigate features of cervical spondylotic myelopathy (CSM) associated with anterior cervical spondylolisthesis (ACS) during posterior decompression surgery.

Methods:

A total of 732 patients with CSM were enrolled, who underwent posterior decompression surgery between July 2011 and November 2015 at 17 institutions. The patients with ACS (group A), defined as an anterior slippage of ≥2 mm on plain radiographs, were compared with those without ACS (group non-A). Also, the characteristics of patients with ACS progression (group P), defined as postoperative worsening of ACS ≥2 mm or newly developed ACS, were investigated. Moreover, kyphosis was defined as C2-C7 angle in neutral position ≤−5°. The Japanese Orthopedic Association (JOA) scoring system was used for clinical evaluation.

Results:

Group A consisting of 62 patients (8.5%) had worse preoperative clinical status but comparable surgical outcomes to group non-A. Furthermore, ACS was associated with greater age, and the degree of slippage did not affect myelopathy grades. Seventeen patients (2.3%) were observed in group P, and preoperative ACS was a significant predisposing factor for the progression without clinical impact. Among the patients in group A, preoperative cervical kyphosis was a risk factor for lower JOA recovery rate.

Conclusions:

Although the presence of ACS increases the risk of postoperative progression, it is not a contraindication for posterior decompression. However, surgeons need to consider the indication of fusion surgery for the patients who have ACS accompanied by kyphosis because of the poor surgical outcomes.
Use of Autologous Stem Cells in Lumbar Spinal Fusion: A Systematic Review of Current Clinical Evidence
Authors: Buser Zorica , Hsieh Patrick , Meisel Hans-Joerg , Skelly Andrea C. , Brodt Erika D. , Brodke Darrel S. , Park Jong-Beom , Yoon S. Tim , Wang Jeffrey ,   AO KF Degenerative
Published: November 2020

Study design:

Systematic review.

Objectives:

To systematically review, critically appraise and synthesize evidence on use of autologous stem cells sources for fusion in the lumbar spine.

Methods:

A systematic search of PubMed/MEDLINE, EMBASE and ClinicalTrials.gov through February 20, 2020 was conducted comparing autologous cell grafts to other biologics for lumbar spine fusion. The focus was on studies comparing distinct patient groups.

Results:

From 343 potentially relevant citations, 15 studies met the inclusion criteria set a priori. Seven studies compared distinct patient groups, with BMA being used in combination with allograft or autograft not as a standalone material. No economic evaluations were identified. Most observational studies were at moderately high risk of bias. When used for primary lumbar fusion, no statistical differences in outcomes or complications were seen between BMA+autograft/or +allograft compared to autograft/allograft alone. Compared with allograft, data from a RCT suggested statistically better fusion and lower complication rates with concentrated BMA+allograft. When used in revisions, no differences in outcomes were seen between BMA+allograft and either autograft or rh-BMP-2 but fusion rates were lower with BMA+allograft, leading to additional revision surgery.

Conclusions:

There was substantial heterogeneity across studies in patient populations, sample size, biologic combinations, and surgical characteristics making direct comparisons difficult. The overall quality of evidence for fusion rates and the safety of BMA in lumbar fusion procedures was considered very low, with studies being at moderately high or high risk of bias.
A multi-label classification model for full slice brain computerised tomography image
Authors: Li Jianqiang , Fu Guanghui , Chen Yueda , Li Pengzhi , Liu Bo , Pei Yan , Feng Hui
Published: November 2020

Background

Screening of the brain computerised tomography (CT) images is a primary method currently used for initial detection of patients with brain trauma or other conditions. In recent years, deep learning technique has shown remarkable advantages in the clinical practice. Researchers have attempted to use deep learning methods to detect brain diseases from CT images. Methods often used to detect diseases choose images with visible lesions from full-slice brain CT scans, which need to be labelled by doctors. This is an inaccurate method because doctors detect brain disease from a full sequence scan of CT images and one patient may have multiple concurrent conditions in practice. The method cannot take into account the dependencies between the slices and the causal relationships among various brain diseases. Moreover, labelling images slice by slice spends much time and expense. Detecting multiple diseases from full slice brain CT images is, therefore, an important research subject with practical implications.

Results

In this paper, we propose a model called the slice dependencies learning model (SDLM). It learns image features from a series of variable length brain CT images and slice dependencies between different slices in a set of images to predict abnormalities. The model is necessary to only label the disease reflected in the full-slice brain scan. We use the CQ500 dataset to evaluate our proposed model, which contains 1194 full sets of CT scans from a total of 491 subjects. Each set of data from one subject contains scans with one to eight different slice thicknesses and various diseases that are captured in a range of 30 to 396 slices in a set. The evaluation results present that the precision is 67.57%, the recall is 61.04%, the F1 score is 0.6412, and the areas under the receiver operating characteristic curves (AUCs) is 0.8934.

Conclusion

The proposed model is a new architecture that uses a full-slice brain CT scan for multi-label classification, unlike the traditional methods which only classify the brain images at the slice level. It has great potential for application to multi-label detection problems, especially with regard to the brain CT images.
ClusterM: a scalable algorithm for computational prediction of conserved protein complexes across multiple protein interaction networks
Authors: Wang Yijie , Jeong Hyundoo , Yoon Byung-Jun , Qian Xiaoning
Published: November 2020

Background

The current computational methods on identifying conserved protein complexes across multiple Protein-Protein Interaction (PPI) networks suffer from the lack of explicit modeling of the desired topological properties within conserved protein complexes as well as their scalability.

Results

To overcome those issues, we propose a scalable algorithm—ClusterM—for identifying conserved protein complexes across multiple PPI networks through the integration of network topology and protein sequence similarity information. ClusterM overcomes the computational barrier that existed in previous methods, where the complexity escalates exponentially when handling an increasing number of PPI networks; and it is able to detect conserved protein complexes with both topological separability and cohesive protein sequence conservation. On two independent compendiums of PPI networks from Saccharomyces cerevisiae (Sce, yeast), Drosophila melanogaster (Dme, fruit fly), Caenorhabditis elegans (Cel, worm), and Homo sapiens (Hsa, human), we demonstrate that ClusterM outperforms other state-of-the-art algorithms by a significant margin and is able to identify de novo conserved protein complexes across four species that are missed by existing algorithms.

Conclusions

ClusterM can better capture the desired topological property of a typical conserved protein complex, which is densely connected within the complex while being well-separated from the rest of the networks. Furthermore, our experiments have shown that ClusterM is highly scalable and efficient when analyzing multiple PPI networks.
Anatomically induced changes in rice leaf mesophyll conductance explain the variation in photosynthetic nitrogen use efficiency under contrasting nitrogen supply
Authors: Gao Limin , Lu Zhifeng , Ding Lei , Xie Kailiu , Wang Min , Ling Ning , Guo Shiwei
Published: November 2020

Background

The ratio of CO2 mesophyll conductance (gm) to Ribulose-1, 5-bisphosphate carboxylase/oxygenase (Rubisco) content has been suggested to positively affect photosynthetic nitrogen use efficiency (PNUE). The anatomical basis of gm has been quantified, but information on the relationship between cell-level anatomies and PNUE is less advanced. Here, hydroponic experiments were conducted in rice plants supplied with ammonium (NH4+) and nitrate (NO3−) under three N levels (low, 0.71 mM; intermediate, 2.86 mM; high, 7.14 mM) to investigate the gas exchange parameters, leaf anatomical structure and PNUE.

Results

The results showed a lower PNUE in plants supplied with high nitrogen and NH4+, which was positively correlated with the gm/Rubisco ratio. A one-dimensional within-leaf model revealed that the resistance to CO2 diffusion in the liquid phase (rliq) dominated the overall mesophyll resistance (rm), in which CO2 transfer resistance in the cell wall, cytoplasm and stroma were significantly affected by nitrogen supply. The chloroplast surface area exposed to intercellular space (Sc) per Rubisco rather than the gm/Sc ratio was positively correlated with PNUE and was thus considered a key component influencing PNUE.

Conclusion

In conclusion, our study emphasized that Sc was the most important anatomical trait in coordinating gm and PNUE with contrasting N supply.
Preoperative sedentary behavior is neither a risk factor for perioperative neurocognitive disorders nor associated with an increase in peripheral inflammation, a prospective observational cohort study
Authors: Saxena Sarah , Rodts Christopher , Nuyens Vincent , Lazaron Juliette , Sosnowski Victoria , Verdonk Franck , Seidel Laurence , Albert Adelin , Boogaerts Jean , Kruys Veronique , Maze Mervyn , Vamecq Joseph
Published: November 2020

Background

Surgical interventions result in a postoperative rise in circulating inflammatory cytokines and high molecular group box protein 1 (HMGB1). Herein, the impact of a sedentary lifestyle and other age-related factors on the development of perioperative neurocognitive disorders (PND) following non-cardiac surgical procedures was assessed in an older (55–75 years-old) surgical population.

Methods

Prior to surgery, patients were asked questions regarding their sedentary behavior and daily habits. They also passed the Mini Mental State Examination (MMSE) and their blood circulating interleukin 6 (IL-6) and HMGB1 levels were assayed by ELISA. IL-6 and HMGB1 measurements were repeated respectively 6 and 24 h after surgery. MMSE was re-evaluated 6 weeks and whenever possible 3 months after surgery.

Results

Thirty-eight patients were enrolled in the study from January until July 2019. The study identified self-sufficiency, multilinguism, and overall health score on the geriatric depression scale, as protectors against PND. No other demographic (age, sex), environmental (solitary/non-solitary housing, professional and physical activities, smoking, alcohol drinking), comorbidity (antipsychotic drug uptake, diabetic state) and type of surgery (orthopedic, general, genitourinary) influenced the development of PND. Although some factors (surgery type and age) influenced the surgery-induced rise in the circulating IL-6 levels, they did not impact HMGB1.

Conclusion

Inflammaging, reflected by the greater increment of surgery-induced IL-6 in patients with advanced age, was present. As trauma-induced release of HMGB1 was not similarly affected by age, we surmise that HMGB1, rather than circulating cytokines, is the key driver of the trauma-induced inflammatory cascade leading to PND.

Trial registration

Clinicaltrials.gov identifier: NCT03805685.
PreAnaesThesia computerized health (PATCH) assessment: development and validation
Authors: Osman Tarig , Lew Eileen , Lum Elaine Pooi-Ming , van Galen Louise , Dabas Rajive , Sng Ban Leong , Car Josip
Published: November 2020

Background

Technological advances in healthcare have enabled patients to participate in digital self-assessment, with reported benefits of enhanced healthcare efficiency and self-efficacy. This report describes the design and validation of a patient-administered preanaesthesia health assessment digital application for gathering medical history relevant to preanaesthesia assessment. Effective preoperative evaluation allows for timely optimization of medical conditions and reduces case cancellations on day of surgery.

Methods

Using an iterative mixed-methods approach of literature review, surveys and panel consensus, the study sought to develop and validate a digitized preanaesthesia health assessment questionnaire in terms of face and criterion validity. A total of 228 patients were enrolled at the preoperative evaluation clinic of a tertiary women’s hospital. Inclusion criteria include: age  ≥ 21 years, scheduled for same-day-admission surgery, literacy in English and willingness to use a digital device. Patient perception of the digitized application was also evaluated using the QQ10 questionnaire. Reliability of health assessment questionnaire was evaluated by comparing the percentage agreement of patient responses with nurse assessment.

Results

Moderate to good criterion validity was obtained in 81.1 and 83.8% of questions for the paper and digital questionnaires respectively. Of total 3626 response-pairs obtained, there were 3405 (93.4%) concordant and 221 (6.1%) discrepant response-pairs for the digital questionnaire. Discrepant response-pairs, such as ““no/yes” and “unsure/yes”, constitute only 3.7% of total response-pairs. Patient acceptability of the digitized assessment was high, with QQ10 value and burden scores of 76 and 30%, respectively.

Conclusions

Self-administration of digitized preanaesthesia health assessment is acceptable to patients and reliable in eliciting medical history. Further iteration should focus on improving reliability of the digital tool, adapting it for use in other languages and incorporating clinical decision tools.
Racial and ethnic patterns and differences in health care expenditures among Medicare beneficiaries with and without cognitive deficits or Alzheimer’s disease and related dementias
Authors: Park Sungchul , Chen Jie
Published: November 2020

Background

Numerous studies have documented racial and ethnic differences in the prevalence and incidence of Alzheimer’s disease and related dementias (ADRD). Less is known, however, about racial and ethnic differences in health care expenditures among older adults at risk for ADRD (cognitive deficits without ADRD) or with ADRD. In particular, there is limited evidence that racial and ethnic differences in health care expenditures change over the trajectory of ADRD or differ by types of service.

Methods

We examined racial and ethnic patterns and differences in health care expenditures (total health care expenditures, out-of-pocket expenditures, and six service-specific expenditures) among Medicare beneficiaries without cognitive deficits, those with cognitive deficits without ADRD, and those with ADRD. Using the 1996–2017 Medical Expenditure Panel Survey, we performed multivariable regression models to estimate expenditure differences among racial and ethnic groups without cognitive deficits, those with cognitive deficits without ADRD, and those with ADRD. Models accounted for survey weights and adjusted for various demographic, socioeconomic, and health characteristics.

Results

Black, Asians, and Latinos without cognitive deficits had lower total health care expenditures than whites without cognitive deficits ($10,236, $9497, $9597, and $11,541, respectively). There were no racial and ethnic differences in total health care expenditures among those with cognitive deficits without ADRD and those with ADRD. Across all three groups, however, Blacks, Asians, and Latinos consistently had lower out-of-pocket expenditures than whites (except for Asians with cognitive deficits without ADRD). Furthermore, service-specific health care expenditures varied by racial and ethnic groups.

Conclusions

Our study did not find significant racial and ethnic differences in total health care expenditures among Medicare beneficiaries with cognitive deficits and/or ADRD. However, we documented significant differences in out-of-pocket expenditures and service-specific expenditures. We speculated that the differences may be attributable to racial and ethnic differences in access to care and/or preferences based on family structure and cultural/economic factors. Particularly, heterogeneous patterns of service-specific expenditures by racial and ethnic groups underscore the importance of future research in identifying determinants leading to variations in service-specific expenditures among racial and ethnic groups.
Time-trend of hospitalizations for anogenital warts in Veneto region in the HPV vaccination era: a cross sectional study (2007–2018)
Authors: Cocchio S. , Prandi G. M. , Furlan P. , Bertoncello C. , Fonzo M. , Saia M. , Baldovin T. , Baldo V.
Published: November 2020

Background

Human papillomavirus (HPV) is a common sexually transmitted pathogen and the cause of several cancers and of anogenital warts. With this study, we estimated the trend of hospitalizations for anogenital warts (AGWs) in the Veneto region (Italy) from 2007 to 2018.

Methods

The analysis included all the hospital discharge records of public and accredited private hospitals occurred in Veneto residents in the timespan 2007–2018. The ICD9-CM code 078.11 considered were those associated with condyloma acuminatum and those associated with surgical interventions for vulval/vaginal warts, penile warts anal warts. Annual total and sex- and age-specific hospitalization rates and trends were calculated and correlated with the different HPV vaccine coverage over the study period.

Results

We observed an overall reduction of hospitalization rates for AGWs: from 15.0 hospitalizations every 100,000 Veneto residents in years 2007–08 to 10.9 hospitalizations every 100,000 Veneto residents in year 2017–18 (− 37.4%; p < 0.05). Reduction has been caused by a drop in hospitalizations in females - from a rate of 20.4/100,000 in 2007–2008 to a rate of 10.8/100,000 in 2017–18 (AAPC: -7.1; 95%CI: − 10.6;-3.4); while in males, we observed a slight - but not statistically significant - increase in hospitalization rates.

Conclusion

The marked decline in hospitalization rates for AGWs in Veneto Region is probably attributable to the high coverage rates of HPV vaccination programs implemented since 2008.
Novel MYO15A variants are associated with hearing loss in the two Iranian pedigrees
Authors: Khatami Somayeh , Askari Masomeh , Bahreini Fatemeh , Hashemzadeh-Chaleshtori Morteza , Hematian Saeed , Asgharzade Samira
Published: November 2020

Background

Clinical genetic diagnosis of non-syndromic hearing loss (NSHL) is quite challenging. With regard to its high heterogeneity as well as large size of some genes, it is also really difficult to detect causative mutations using traditional approaches. One of the recent technologies called whole-exome sequencing (WES) has been thus developed in this domain to remove the limitations of conventional methods.

Methods

This study was a report on a research study of two unrelated pedigrees with multiple affected cases of hearing loss (HL). Accordingly, clinical evaluations and genetic analysis were performed in both families.

Results

The results of WES data analysis to uncover autosomal recessive non-syndromic hearing loss (ARNSHL) disease-causing variants was reported in the present study. Initial analysis identified two novel variants of MYO15A i.e. c.T6442A:p.W2148R and c.10504dupT:p.C3502Lfs*15 correspondingly which were later confirmed by Sanger validations and segregation analyses. According to online prediction tools, both identified variants seemed to have damaging effects.

Conclusion

In this study, whole exome sequencing were used as a first approach strategy to identify the two novel variants in MYO15A in two Iranian families with ARNSHL.
Assessment of serum electrolytes and kidney function test for screening of chronic kidney disease among Ethiopian Public Health Institute staff members, Addis Ababa, Ethiopia
Authors: Molla Meseret Derbew , Degef Maria , Bekele Abebe , Geto Zeleke , Challa Feyissa , Lejisa Tadesse , Getahun Tigist , Sileshi Meron , Tolcha Yosef , Ashebir Genet , Seifu Daniel
Published: November 2020

Background

Chronic kidney disease (CKD), which is characterized by its asymptomatic nature until an end stage, is one of the most common public health problems in the world. Thus, a regular checkup, especially for those individuals with high risk groups is inevitably important, and the screening has been done with laboratory findings. However, in developing countries, including Ethiopia screening for CKD are rarely done, and it is becoming common to hear sudden death from the kidney failure. Therefore, we aimed to screen serum electrolyte levels and estimated glomerular filtration rate (eGFR) among Ethiopian Public Health Institute (EPHI) staff members for an early detection of CKD and to identify the factors associated with it.

Methods

A cross-sectional study was conducted from July 1 to October 28, 2018 among EPHI staff members. The level of serum creatinine and electrolytes were measured using COBAS 6000 analyzer. Then, eGFR was calculated using MDRD and CKD-EPI equations. Data analysis were done using SPSS version 20, and the factors associated with the outcome variable were assessed using logistic regression. P values < 0.05 were considered as statistically significant.

Results

This study found that 3.6 and 1.9% of the study participants were at CKD stage II by MDRD and CKD-EPI equations, respectively. Out of the total study participants, 9.5% had hyperkalemia (serum potassium level > 5.0 mmol/L) and 8.5% had hypocalcemia (serum calcium level < 2.15 mmol/L). An older age (P = 0.006), high BMI (P = 0.045) and previous history of CVDs (P = 0.033) were found to be significantly associated factors with reduced glomerular filtration rate. Nine percent of the study participants were obese, 6.1% had family history of kidney failure, 18% self-reported history of hypertension, 3.4% diabetic and 5.3% had CVDs. About 51.2% of the study participants were males, and the majorities, (66%) of the study participants were found to be alcohol consumers.

Conclusions

The prevalence of a stage II kidney disease was relatively low and none of the participants was under serious kidney disease (GFR < 60 mmol/min/1.73m2). An older age, high BMI and previous history of CVDs were significantly associated with reduced GFR. Hyperkalemia and hypokalemia were the major electrolyte disorders in the study participants.