bluuebunny/crossref_metadata_2025 huggingface dataset:
Transition technologies towards 6G networks
Authors: Raddo Thiago R. , Rommel Simon , Cimoli Bruno , Vagionas Chris , Perez-Galacho Diego , Pikasis Evangelos , Grivas Evangelos , Ntontin Konstantinos , Katsikis Michael , Kritharidis Dimitrios , Ruggeri Eugenio , Spaleniak Izabela , Dubov Mykhaylo , Klonidis Dimitrios , Kalfas George , Sales Salvador , Pleros Nikos , Tafur Monroy Idelfonso
Published: April 2021

The sixth generation (6G) mobile systems will create new markets, services, and industries making possible a plethora of new opportunities and solutions. Commercially successful rollouts will involve scaling enabling technologies, such as cloud radio access networks, virtualization, and artificial intelligence. This paper addresses the principal technologies in the transition towards next generation mobile networks. The convergence of 6G key-performance indicators along with evaluation methodologies and use cases are also addressed. Free-space optics, Terahertz systems, photonic integrated circuits, softwarization, massive multiple-input multiple-output signaling, and multi-core fibers, are among the technologies identified and discussed. Finally, some of these technologies are showcased in an experimental demonstration of a mobile fronthaul system based on millimeter 5G NR OFDM signaling compliant with 3GPP Rel. 15. The signals are generated by a bespoke 5G baseband unit and transmitted through both a 10 km prototype multi-core fiber and 4 m wireless V-band link using a pair of directional 60 GHz antennas with 10° beamwidth. Results shown that the 5G and beyond fronthaul system can successfully transmit signals with both wide bandwidth (up to 800 MHz) and fully centralized signal processing. As a result, this system can support large capacity and accommodate several simultaneous users as a key candidate for next generation mobile networks. Thus, these technologies will be needed for fully integrated, heterogeneous solutions to benefit from hardware commoditization and softwarization. They will ensure the ultimate user experience, while also anticipating the quality-of-service demands that future applications and services will put on 6G networks.
Research on task-offloading decision mechanism in mobile edge computing-based Internet of Vehicle
Authors: Cheng Jun , Guan Dejun
Published: April 2021

As a technology integrated with Internet of things, mobile edge computing (MEC) can provide real-time and low-latency services to the underlying network and improve the storage and computation ability of the networks instead of central cloud infrastructure. In mobile edge computing-based Internet of Vehicle (MEC-IoV), the vehicle users can deliver their tasks to the associated MEC servers based on offloading policy, which improves the resource utilization and computation performance greatly. However, how to evaluate the impact of uncertain interconnection between the vehicle users and MEC servers on offloading decision-making and avoid serious degradation of the offloading efficiency are important problems to be solved. In this paper, a task-offloading decision mechanism with particle swarm optimization for MEC-IoV is proposed. First, a mathematical model to calculate the computation offloading cost for cloud-edge computing system is defined. Then, the particle swarm optimization is applied to convert the offloading of task into the process and obtain the optimal offloading strategy. Furthermore, to avoid falling into local optimization, the inertia weight factor is designed to change adaptively with the value of the objective function. The experimental results show that the proposed offloading strategy can effectively reduce the energy consumption of terminal devices while guarantee the service quality of users.
Existence of radial solutions for a $p(x)$-Laplacian Dirichlet problem
Authors: Ragusa Maria Alessandra , Razani Abdolrahman , Safari Farzaneh
Published: April 2021

In this paper, using variational methods, we prove the existence of at least one positive radial solution for the generalized$p(x)$p(x)-Laplacian problem$$ -\Delta _{p(x)} u + R(x) u^{p(x)-2}u=a (x) \vert u \vert ^{q(x)-2} u- b(x) \vert u \vert ^{r(x)-2} u $$−Δp(x)u+R(x)up(x)−2u=a(x)|u|q(x)−2u−b(x)|u|r(x)−2uwith Dirichlet boundary condition in the unit ball in$\mathbb{R}^{N}$RN(for$N \geq 3$N≥3), wherea,b,Rare radial functions.
An efficient HILIC-MS/MS method for the trace level determination of three potential genotoxic impurities in aripiprazole active drug substance
Authors: Mullangi Sumanth , Ravindhranath Kunta , Panchakarla Ravi Kiran
Published: April 2021

A sensitive and selective hydrophilic interaction liquid chromatography-tandem mass spectrometry (HILIC-MS/MS) method was developed and validated for trace analysis of potential genotoxic impurities (PGIs): 2,3-dichloroaniline (PGI-1), bis(2-chloroethyl) amine (PGI-2), and 2-chloroethylamine (PGI-3), in aripiprazole (APZ) active drug substance. Separation of analytes was achieved on ACE HILIC–N Column (HILN-5-1046U, 100 × 4.6 mm, 5 μm) in gradient elution mode with mobile phase A [acetonitrile:ammonium formate buffer (95:5 v/v)] and mobile phase B [acetonitrile:ammonium formate buffer (50:50 v/v)] at a flow rate of 0.8 mL/min. Developed method was linear in the concentration range of 8–100 ppm for PGI-1, 11–100 ppm for PGI-2, and 12.5–100ppm for PGI-3 with R2 > 0.996. The developed method was accurate for quantification of each PGI with percent recoveries greater than 96% and RSD (%) not more than 5%. The developed method was precise for quantification of PGIs in aripiprazole with RSD (%) of not more than 4% for any of the PGIs. There was no interference of diluent peaks at the retention time of the PGIs and APZ in the method. All the PGIs and sample solutions were found to be stable at ambient laboratory temperature (25 ± 5 °C) and refrigerated condition (2–8 °C) for a period of 48 h. The developed HILIC-MS/MS method can be used for trace quantification of PGIs in aripiprazole drug in quality control laboratories of the pharmaceutical industry.
Death after discharge: prognostic model of 1-year mortality in traumatic brain injury patients undergoing decompressive craniectomy
Authors: Cui Wenxing , Ge Shunnan , Shi Yingwu , Wu Xun , Luo Jianing , Lui Haixiao , Zhu Gang , Guo Hao , Feng Dayun , Qu Yan
Published: April 2021

Background

Despite advances in decompressive craniectomy (DC) for the treatment of traumatic brain injury (TBI), these patients are at risk of having a poor long-term prognosis. The aim of this study was to predict 1-year mortality in TBI patients undergoing DC using logistic regression and random tree models.

Methods

This was a retrospective analysis of TBI patients undergoing DC from January 1, 2015, to April 25, 2019. Patient demographic characteristics, biochemical tests, and intraoperative factors were collected. One-year mortality prognostic models were developed using multivariate logistic regression and random tree algorithms. The overall accuracy, sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs) were used to evaluate model performance.

Results

Of the 230 patients, 70 (30.4%) died within 1 year. Older age (OR, 1.066; 95% CI, 1.045–1.087; P < 0.001), higher Glasgow Coma Score (GCS) (OR, 0.737; 95% CI, 0.660–0.824; P < 0.001), higher d-dimer (OR, 1.005; 95% CI, 1.001–1.009; P = 0.015), coagulopathy (OR, 2.965; 95% CI, 1.808–4.864; P < 0.001), hypotension (OR, 3.862; 95% CI, 2.176–6.855; P < 0.001), and completely effaced basal cisterns (OR, 3.766; 95% CI, 2.255–6.290; P < 0.001) were independent predictors of 1-year mortality. Random forest demonstrated better performance for 1-year mortality prediction, which achieved an overall accuracy of 0.810, sensitivity of 0.833, specificity of 0.800, and AUC of 0.830 on the testing data compared to the logistic regression model.

Conclusions

The random forest model showed relatively good predictive performance for 1-year mortality in TBI patients undergoing DC. Further external tests are required to verify our prognostic model.
Methylation as a critical epigenetic process during tumor progressions among Iranian population: an overview
Authors: Akhlaghipour Iman , Bina Amir Reza , Abbaszadegan Mohammad Reza , Moghbeli Meysam
Published: April 2021

Cancer is one of the main health challenges and leading causes of deaths in the world. Various environmental and genetic risk factors are associated with tumorigenesis. Epigenetic deregulations are also important risk factors during tumor progression which are reversible transcriptional alterations without any genomic changes. Various mechanisms are involved in epigenetic regulations such as DNA methylation, chromatin modifications, and noncoding RNAs. Cancer incidence and mortality have a growing trend during last decades among Iranian population which are significantly related to the late diagnosis. Therefore, it is required to prepare efficient molecular diagnostic panels for the early detection of cancer in this population. Promoter hyper methylation is frequently observed as an inhibitory molecular mechanism in various genes associated with DNA repair, cell cycle regulation, and apoptosis during tumor progression. Since aberrant promoter methylations have critical roles in early stages of neoplastic transformations, in present review we have summarized all of the aberrant methylations which have been reported during tumor progression among Iranian cancer patients. Aberrant promoter methylations are targetable and prepare novel therapeutic options for the personalized medicine in cancer patients. This review paves the way to introduce a non-invasive methylation specific panel of diagnostic markers for the early detection of cancer among Iranians.
3D rock minerals by correlating XRM and automated mineralogy and its application to digital rock physics for elastic properties
Authors: Hao Jin , Li Guoliang , Su Jiao , Yuan Yuan , Du Zhongming , Niu Suyun , Yang Jijin
Published: April 2021

Digital rock physics (DRP) is an emerging technique that has rapidly become an indispensable tool to estimate elastic properties. The success of DRP mainly depends on three factors: acquiring a 3D rock structure image, accurately identifying 3D minerals, and using a proper numerical simulation method. Shales present a substantial challenge for DRP owing to their heterogeneous structure, composition, and properties from micron to centimeter scale. To obtain a sufficiently large field-of-view (FOV) image of a sample that reflects the detailed and representative internal structure and composition, we have developed a new DRP workflow to obtain large-FOV high-resolution digital rocks with 3D mineralogical information. Using the “divide-and-stitch” technique, a long shale sample is divided into several subunits, imaged separately by high-resolution X-ray microscopy (XRM), and then stitched to obtain a large-FOV 3D digital rock. An FOV of a rock cylinder (736 μm in diameter, 2358 μm in height, and 1 μm resolution) is used as an example. By correlating XRM and automated mineralogy, a large-FOV 3D mineral digital rock is obtained from a shale sample. Six mineral phases are identified and verified by automated mineralogy, and four laminae are detected according to the grain size, which offer a new perspective to study sedimentary processes and heterogeneities at the millimeter scale. The finite-difference method is used to compute the elastic properties of the large-FOV 3D mineral digital rock, and the results of Young’s modulus are within the limit of the Voigt/Reuss bounds. It also reveals that there is a difference in simulated elastic properties in the four laminae. The large-FOV 3D mineral digital rock offers the potential to explore the relationship between elastic properties and mineral phases, as well as the heterogeneities of elastic properties at the millimeter scale.
Q least-squares reverse time migration based on the first-order viscoacoustic quasidifferential equations
Authors: Qu Yingming , Wang Yixin , Li Zhenchun , Liu Chang
Published: April 2021

Seismic wave attenuation caused by subsurface viscoelasticity reduces the quality of migration and the reliability of interpretation. A variety of Q-compensated migration methods have been developed based on the second-order viscoacoustic quasidifferential equations. However, these second-order wave-equation-based methods are difficult to handle with density perturbation and surface topography. In addition, the staggered grid scheme, which has an advantage over the collocated grid scheme because of its reduced numerical dispersion and enhanced stability, works in first-order wave-equation-based methods. We have developed a Q least-squares reverse time migration method based on the first-order viscoacoustic quasidifferential equations by deriving Q-compensated forward-propagated operators, Q-compensated adjoint operators, and Q-attenuated Born modeling operators. In addition, our method using curvilinear grids is available even when the attenuating medium has surface topography and can conduct Q-compensated migration with density perturbation. The results of numerical tests on two synthetic and one field data set indicate that our method improves the imaging quality with iterations and produces better imaging results with clearer structures, higher signal-to-noise ratio, higher resolution, and more balanced amplitude by correcting the energy loss and phase distortion caused by Q attenuation. It also suppresses the scattering and diffracted noise caused by the surface topography.
Development of a Pediatric Relative Bioavailability/Bioequivalence Database and Identification of Putative Risk Factors Associated With Evaluation of Pediatric Oral Products
Authors: Pawar Gopal , Wu Fang , Zhao Liang , Fang Lanyan , Burckart Gilbert J. , Feng Kairui , Mousa Youssef M. , Naumann Franci , Batchelor Hannah K.
Published: April 2021

Generally, bioequivalence (BE) studies of drug products for pediatric patients are conducted in adults due to ethical reasons. Given the lack of direct BE assessment in pediatric populations, the aim of this work is to develop a database of BE and relative bioavailability (relative BA) studies conducted in pediatric populations and to enable the identification of risk factors associated with certain drug substances or products that may lead to failed BE or different pharmacokinetic (PK) parameters in relative BA studies in pediatrics. A literature search from 1965 to 2020 was conducted in PubMed, Cochrane Library, and Google Scholar to identify BE studies conducted in pediatric populations and relative BA studies conducted in pediatric populations. Overall, 79 studies covering 37 active pharmaceutical ingredients (APIs) were included in the database: 4 bioequivalence studies with data that passed BE evaluations; 2 studies showed bioinequivalence results; 34 relative BA studies showing comparable PK parameters, and 39 relative BA studies showing differences in PK parameters between test and reference products. Based on the above studies, common putative risk factors associated with differences in relative bioavailability (DRBA) in pediatric populations include age-related absorption effects, high inter-individual variability, and poor study design. A database containing 79 clinical studies on BE or relative BA in pediatrics has been developed. Putative risk factors associated with DRBA in pediatric populations are summarized.
Two UV-sensitive targets in dorsoanterior specification of frog embryos
Authors: Elinson Richard P. , Pasceri Peter
Published: April 2021

Previous work has shown that ultraviolet (UV) irradiation of fertilized frog eggs yields embryos that lack dorsal and anterior structures. The eggs fail to undergo the cortical/cytoplasmic rotation that specifies dorsoventral polarity, and they lack an array of parallel microtubules associated with the rotation. These eggs can be rescued by tilting with respect to gravity, and normal dorsoanterior development occurs. We find here that UV irradiation of Xenopus prophase I oocytes or Rana metaphase I oocytes also causes the dorsoanterior deficient syndrome, but the UV target is different from that in fertilized eggs. Tilting eggs, irradiated as oocytes, with respect to gravity, does not rescue dorsoanterior development, although lithium treatment does. The UV dose required to produce dorsoanterior deficiency for Rana metaphase I oocytes is much less than that for fertilized eggs, and the oocytes can form the array of parallel microtubules and undergo the cortical/ cytoplasmic rotation after fertilization. Despite these features of normal development, no dorsoanterior structures form. While the UV target in fertilized eggs is thought to be the parallel microtubules (Elinson & Rowning, 1988; Devi Biol. 128, 185–197), the UV target in the oocytes may be a dorsal determinant.
Utility of first order MRI-Texture analysis parameters in the prediction of histologic grade and muscle invasion in urinary bladder cancer: a preliminary study
Authors: Razik Abdul , Das Chandan J , Sharma Raju , Malla Sundeep , Sharma Sanjay , Seth Amlesh , Srivastava Deep Narayan
Published: April 2021

Objective:

To explore the utility of first-order MRI-texture analysis (TA) parameters in predicting histologic grade and muscle invasion in urinary bladder cancer (UBC).

Methods:

After ethical clearance, 40 patients with UBC, who were imaged on a 3.0-Tesla scanner, were retrospectively included. Using the TexRADTM platform, two readers placed freehand ROI on the sections demonstrating the largest dimension of the tumor, evaluating only one tumor per patient. Interobserver reproducibility was assessed using the intraclass correlation coefficient (ICC). Mann–Whitney U test and ROC curve analysis were used to identify statistical significance and select parameters with high class separation capacity (AUC >0.8), respectively. Pearson’s test was used to identify redundancy in the results.

Results:

All texture parameters showed excellent ICC. The best parameters in differentiating high and low-grade tumors were mean/ mean of positive pixels (MPP) at SSF 0 (AUC: 0.897) and kurtosis at SSF 5 (AUC: 0.828) on the ADC images. In differentiating muscle invasive from non-muscle invasive tumors, mean/ MPP at SSF 0 on the ADC images showed AUC >0.8; however, this finding resulted from the confounding effect of high-grade histology on the ADC values of muscle invasive tumors.

Conclusion:

MRI-TA generated few parameters which were reproducible and useful in predicting histologic grade. No independent parameters predicted muscle invasion.

Advances in knowledge:

There is lacuna in the literature concerning the role of MRI-TA in the prediction of histologic grade and muscle invasion in UBC. Our study generated a few first-order parameters which were useful in predicting high-grade histology.
Current progress and quality of radiomic studies for predicting EGFR mutation in patients with non-small cell lung cancer using PET/CT images: a systematic review
Authors: Abdurixiti Meilinuer , Nijiati Mayila , Shen Rongfang , Ya Qiu , Abuduxiku Naibijiang , Nijiati Mayidili
Published: April 2021

Objectives:

To assess the methodological quality of radiomic studies based on positron emission tomography/computed tomography (PET/CT) images predicting epidermal growth factor receptor (EGFR) mutation status in patients with non-small cell lung cancer (NSCLC).

Methods:

We systematically searched for eligible studies in the PubMed and Web of Science datasets using the terms “radiomics”, “PET/CT”, “NSCLC”, and “EGFR”. The included studies were screened by two reviewers independently. The quality of the radiomic workflow of studies was assessed using the Radiomics Quality Score (RQS). Interclass correlation coefficient (ICC) was used to determine inter rater agreement for the RQS. An overview of the methodologies used in steps of the radiomics workflow and current results are presented.

Results:

Six studies were included with sample sizes of 973 ranging from 115 to 248 patients. Methodologies in the radiomic workflow varied greatly. The first-order statistics were the most reproducible features. The RQS scores varied from 13.9 to 47.2%. All studies were scored below 50% due to defects on multiple segmentations, phantom study on all scanners, imaging at multiple time points, cut-off analyses, calibration statistics, prospective study, potential clinical utility, and cost-effectiveness analysis. The ICC results for majority of RQS items were excellent. The ICC for summed RQS was 0.986 [95% confidence interval (CI): 0.898–0.998].

Conclusions:

The PET/CT-based radiomics signature could serve as a diagnostic indicator of EGFR mutation status in NSCLC patients. However, the current conclusions should be interpreted with care due to the suboptimal quality of the studies. Consensus for standardization of PET/CT-based radiomic workflow for EGFR mutation status in NSCLC patients is warranted to further improve research.

Advances in knowledge:

Radiomics can offer clinicians better insight into the prediction of EGFR mutation status in NSCLC patients, whereas the quality of relative studies should be improved before application to the clinical setting.
Quantification of penile fat infiltration using the mDIXON Quant sequence: a pilot study on the correlation with penis hardness and erectile dysfunction
Authors: Yang Fei , Li Qing-Ling , Wen Hui-Quan , Xie Wen-Jun , Shen Li-Shan , Luo Xiao-Wen , Zhang Yu-Feng , Guo Ruo-Mi
Published: April 2021

Objective:

The purpose of this study was to determine fat/water signal ratios using the mDIXON Quant sequence, quantitatively assess fat infiltration in the penis, and explore its possible relationship with penile hardness and erectile dysfunction.

Methods:

Routine pelvic MRI with the mDIXON Quant sequence was performed in 62 subjects, including 22 people in the normal group, 20 people in the normal erectile hardness group, and 20 people in the erectile dysfunction (ED) group. The fat/water signal ratio in the penis was measured using the mDIXON Quant sequence. Shear wave elastography was used to evaluate the hardness of the corpus cavernosa of the penis.

Results:

The fat/water signal ratio of the corpus spongiosum was significantly lower than that of the corpus cavernosa in the normal group (p = 0.03) and ED group (p < 0.01). There was no significant difference in the fat/water signal ratios between the normal group and the normal erectile hardness group. Fat infiltration was significantly lower, and erectile hardness was significantly higher in the normal erectile hardness group than in the ED group, and the fat infiltration in the left and right corpus cavernosa was inversely proportional to the erectile hardness of the penis.

Conclusion:

This study suggests that mDIXON Quant can be used as a non-invasive, quantitative, and objective method for evaluating penile fat infiltration. This method could help diagnose penile fat infiltration in patients with erectile dysfunction and varying body mass indexes. Our results could also allow for a more accurate diagnosis and monitoring of erectile hardness function by quantitatively measuring penile fat infiltration.

Advances in knowledge:

(1) The proton density fat fraction technology is a new tool for the objective, quantitative and non-invasive evaluation of penile fat infiltration. (2) The quantitative measurement of fat infiltration in the corpora cavernosa might help diagnose and monitor penile erection hardness and its function more accurately.
Comparison of prostate imaging reporting and data system v2.1 and 2 in transition and peripheral zones: evaluation of interreader agreement and diagnostic performance in detecting clinically significant prostate cancer
Authors: Urase Yasuyo , Ueno Yoshiko , Tamada Tsutomu , Sofue Keitaro , Takahashi Satoru , Hinata Nobuyuki , Harada Kenichi , Fujisawa Masato , Murakami Takamichi
Published: April 2021

Objective:

To evaluate the interreader agreement and diagnostic performance of the Prostate Imaging Reporting and Data System (PI-RADS) v. 2.1, in comparison with v. 2.

Methods:

Institutional review board approval was obtained for this retrospective study. 77 consecutive patients who underwent a prostate multiparametric magnetic resonance imaging at 3.0 T before radical prostatectomy were included. Four radiologists (two experienced uroradiologists and two inexperienced radiologists) independently scored eight regions [six peripheral zones (PZ) and two transition zones (TZ)] using v. 2.1 and v. 2. Interreader agreement was assessed using κ statistics. To evaluate diagnostic performance for clinically significant prostate cancer (csPC), area under the curve (AUC) was estimated.

Results

228 regions were pathologically diagnosed as positive for csPC. With a cut-off ≥3, the agreement among all readers was better with v. 2.1 than v. 2 in TZ, PZ, or both zones combined (κ-value: TZ, 0.509 vs 0.414; PZ, 0.686 vs 0.568; both zones combined, 0.644 vs 0.531). With a cut-off ≥4, the agreement among all readers was also better with v. 2.1 than v. 2 in the PZ or both zones combined (κ-value: PZ, 0.761 vs 0.701; both zones combined, 0.756 vs 0.709). For all readers, AUC with v. 2.1 was higher than with v. 2 (TZ, 0.826–0.907 vs 0.788–0.856; PZ, 0.857–0.919 vs 0.853–0.902).

Conclusion:

Our study suggests that the PI-RADS v. 2.1 could improve the interreader agreement and might contribute to improved diagnostic performance compared with v. 2.

Advances in knowledge:

PI-RADS v. 2.1 has a potential to improve interreader variability and diagnostic performance among radiologists with different levels of expertise.
Scatter-to-primary ratio in dentomaxillofacial cone-beam CT: effect of field of view and beam energy
Authors: Pauwels Ruben , Pittayapat Pisha , Sinpitaksakul Phonkit , Panmekiate Soontra
Published: April 2021

Objective:

The aim of this study was to evaluate the effect of field of view (FOV) and beam energy on the scatter-to-primary ratio (SPR) in dental cone-beam CT (CBCT).

Methods:

An anthropomorphic phantom representing an adult male (ATOM Max 711-HN, Norfolk, VA, USA) was scanned using the 3D Accuitomo 170 CBCT (J. Morita, Kyoto, Japan) using 11 FOVs. During each scan, half of the X-ray beam was blocked. Each scan was performed at three exposure settings with varying beam energy and equal radiation dose: 90 kV 5 mA, 77 kV 7.5 mA and 69 kV 10 mA. The SPR was estimated by measuring the grey values in the blocked and non-blocked regions of the RAW data. The effect of FOV on SPR was evaluated using Dunn’s multiple comparison test, and the effect of the exposure settings was compared using a Wilcoxon signed rank test.

Results:

Larger FOVs showed increased scatter. FOVs with a shorter isocenter-detector distance showed a particularly high SPR. Most intercomparisons between FOVs were statistically significant. The largest difference was found between 17 × 12 cm and 6 × 6 cm (lower jaw), with the former showing a 4.9-fold higher SPR. The effect of beam energy was relatively small and varied between FOV sizes and positions.

Conclusion:

While the choice of FOV size and position is determined by the diagnostic region of interest, the image quality deterioration for large FOVs due to scatter provides another incentive to limit the FOV size as much as possible.
Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study
Authors: Abrar Saida , Mohsin Raheela , Saleem Huda
Published: April 2021

Objectives: To assess the effect of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) on various domains of female sexual functions in patients before and after reconstructive surgery for these pelvic floor disorders.

Methods: We conducted a quasi-experimental study of 126 women aged 25-65 years, presenting with POP / SUI, from January 1st 2019 to December 31st 2019 at Aga Khan University Hospital. POP surgery was performed only in patients with symptomatic POP ≥ stage 2 according to POP-Q (quantification). Sexual functions were assessed using Female Sexual Function Index (FSFI) questionnaire, among sexually active women at baseline and 18 months after surgery.

Results: Mean age of the participants was 51.6, with a mean parity of four. Out of 126 patients, 31 patients underwent vaginal hysterectomy, pelvic floor repair and mid-urethral sling (MUS), 55 had vaginal hysterectomy with pelvic floor repair, 12 women had only pelvic floor repair and 10 patients had uterine suspension surgery for prolapse, while 18 patients underwent MUS operation alone for SUI. There was a statistically significant difference in female sexual functions after surgery for POP and/or SUI (p<0.01). This improvement was observed in both total and individual scores of each domain of FSFI with an overall improvement in sexual function from a mean of 18.5 pre-surgery to 20.8 post-surgery.

Conclusions: This study reveals that women sexual functions are affected by POP and SUI and improve remarkably after reconstructive surgeries for these pelvic floor disorders.

doi: https://doi.org/10.12669/pjms.37.4.3892

How to cite this:Abrar S, Mohsin R, Saleem H. Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study. Pak J Med Sci. 2021;37(4):1099-1103. doi: https://doi.org/10.12669/pjms.37.4.3892

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Morphometric evaluations based on Voxel Based Morphometry on adolescents with autism spectrum disorders.
Authors: Bryńska Anita , Wolak Tomasz , Naumczyk Patrycja , Srebnicki Tomasz , Wolańczyk Tomasz
Published: April 2021

Cel pracy

Cel: ocena zmian w zakresie objętości istoty szarej w grupie adolescentów z ASD, spełniających kryteria dla zespołu Aspergera.

Metoda

Materiał i metoda: Badania morfometryczne oparte o pomiar voksela (Voxel Based Morphometry) wykonano u 37 nastolatków płci męskiej, w wieku od 12 do 19 lat (śr. 14,3 ± 2,0), z zaburzeniami ze spektrum autyzmu, którzy spełniali kryteria DSM-IV-TR dla zespołu Aspergera oraz 15 prawidłowo rozwijających się nastolatków dobranych pod względem wieku. Analizy statystyczne przeprowadzono na poziomie p<0,05 z korekcją FWE (family-wise error) oraz p<0,007 bez korekcji FWE.

Wyniki

Wyniki: w grupie ASD wykazano zmniejszenie objętości istoty szarej w zakręcie przedśrodkowym i zaśrodkowym, górnym i środkowym zakręcie czołowym, górnym i dolnym płaciku ciemieniowym, przedklinku, przedniej i tylnej korze obręczy, zakręcie wrzecionowatym, zakręcie parahipokampalnym, zakręcie językowatym, środkowym obszarze potylicznym, klinku i zakręcie kątowym, okolicach bruzd ostrogowych oraz móżdżku; większość zmian była zlokalizowana obustronnie.

Wnioski

Wnioski: zmniejszenie objętości istoty szarej w grupie osób z ASD w obszarach kory mózgowej, które funkcjonalnie można powiązać z charakterem deficytów obserwowanych w zaburzeniach ze spektrum autyzmu, podkreśla rolę nieprawidłowej budowy licznych struktur OUN w powstawaniu objawów obserwowanych w sferze poznawczej i behawioralnej.
Management of dystonia in patients with hypersensitivity to anticholinergics
Authors: Sarangi Ashish , Lance Mwangi  , Domingo-Johnson E.L. , Arham Siddiqui
Published: April 2021

Abstract
Background: Anticholinergics are one of the first-line treatment for patients with dystonia. However, there are few practical guidelines for patients with dystonia who have developed hypersensitivity to anticholinergics.
Methods and Findings: This update was developed to provide clinicians with specific alternatives if patients are hypersensitive to anticholinergics but require management of dystonia. Recommendations were based upon literature review and expert opinion. We addressed several topics, including 1) the prevalence of hypersensitivity to anticholinergics, 2) anticholinergics and age-associated changes, 3) the Anticholinergic Cognitive Behavioral Scale, 4) the Anticholinergic Drug Scale,5) over the counter supplement use with anticholinergics, hypersensitivity to antihistamines, and management of dystonia. However, currently there is limited evidence supporting pharmacotherapy and non-pharmacologic treatments in patients with hypersensitivity to anticholinergics.
Conclusions: We provide the guidance on patients with dystonia who are hypersensitive to anticholinergics, based on the literature and our clinical experience. We propose personalized dystonia treatment approaches when anticholinergic hypersensitivity arises. Gaps in the existing literature and future directions in the treatment of anticholinergic hypersensitive patients being treated for dystonia are also highlighted.
Hydralazine use for the management of hypertensive crises in a medical intensive care unit
Authors: Satheeshkumar Anudeeksha , Atkins Hunter , Suchartlikitwong Sakolwan , Islam Ebtesam
Published: April 2021

Background: Hypertensive crises, including emergent or urgent hypertension, are rare but life-threatening complications of uncontrolled hypertension. Hydralazine is one of several antihypertensive medications available for treatment of hypertensive crises. Major United States guidelines on hypertension recommend conservative use of hydralazine – only for situations of preeclampsia or eclampsia with pregnancy – due to significant adverse effects and unpredictability in the dose response.
Methods: A retrospective chart review was conducted on patients admitted to the medical intensive care unit at University Medical Center in Lubbock, Texas, with urgent or emergent hypertension between January 1, 2017, and June 30, 2017. Demographic information - age and gender - and records of which antihypertensive medication(s) and route used were collected. Systolic blood pressure before and 2 hours after hydralazine administration - and whether it was given after an initial dose of another antihypertensive medication - was recorded. Patient comorbidities and contraindications for use were noted.
Results: Thirty-five patients were included in this study (1 patient result was excluded from certain calculations due to missing data). Mean age of patients was 53.4 ± 12.5 years. Range was 22-74 years. Eight patients had initial treatment with hydralazine, and 29 out of 35 patients were given hydralazine when considering combination treatment. IV hydralazine was preferred over PO hydralazine (23 patients vs. 6 patients). Sixteen patients had comorbidities and/or contraindications for hydralazine use, but 12 patients received IV hydralazine and one patient received PO hydralazine.
Conclusion: Hydralazine was not used in a guideline-directed manner in the medical intensive care unit at our hospital. Physicians should regularly evaluate patients for the presence or absence of end-organ damage concurrent with a blood pressure >180/120 mmHg before considering which
antihypertensive medication to use. Hydralazine should be reserved for special situations involving pregnancy.
Keywords: hydralazine, emergent hypertension, urgent hypertension, intensive medical care unit
Assessment of geriatrics outcomes in the cardiac intensive care unit
Authors: Fabrizio Carly , Langston Matthew , Subedi Keshab , Wimmer Neil , Choudhry Usman , Urrutia Luis
Published: April 2021

Objective: Critically ill older adults greater than or equal to 80 years old are routinely admitted to contemporary cardiac intensive care units (CICU). Little has been reported about their outcomes when compared to the general CICU population. The primary aim of this study was to compare the mortality, length-of-stay, and disposition outcomes of elderly patients (greater or equal to 80 years old) admitted to the CICU with a younger cohort (less than 80 years old).
Methods and Results: A single-center, retrospective cohort study was conducted including 6,194 adult patients admitted to a cardiovascular intensive care unit in Newark, Delaware, from July 1, 2012, to June 30, 2019. Coronary intensive care unit (CICU) mortality, CICU length-of-stay and discharge disposition were compared between elderly patients (greater than or equal to 80 years old) and younger patients (less than 80 years old), adjusted for comorbidities.
We observed increased mortality for elderly patients (OR 1.686, CI 1.361-2.090, p<0.001) compared with patients less than 80 years old, even after adjusting for comorbidities. Median length of stay was not statistically different between the two groups. However, the elderly patients were significantly more likely to be discharged to a facility, such as a skilled nursing facility, than those less than 80 years old (26.8% versus 12.5%, respectively, p<0.001).
Conclusions: Among patients admitted to the CICU, elderly patients have higher mortality rates than those less than 80 years old. Advanced age (greater or equal to 80 years old) was not a reliable predictor of outcome in the CICU. A large proportion of elderly patients are not able to live independently at home after CICU admissions.
Key Words: octogenarians, nonagenarians, cardiac intensive care unit, elderly, ICU mortality
Abstract Supplement
Authors: Nugent Kenneth
Published: April 2021

Editor’s note: Please see the abstract supplement on the right-hand side of the journal home page. This supplement includes abstracts created by first year medical students during the 2020 summer research program.
We Cannot Direct the Wind, but We Can Adjust the Sails: Prosocial Ventures’ Responses to Potential Resource Threats
Authors: Mittermaier Alexandra , Shepherd Dean A. , Patzelt Holger
Published: April 2021

One of entrepreneurs’ key tasks is mobilizing resources from external resource holders. Although we know how entrepreneurial ventures gain initial access to resources, we do not yet fully understand how they maintain their resource mobilization, particularly in the face of potential threats. During our 11-month study of prosocial ventures that emerged to alleviate the suffering of refugees in Germany, four attacks on the European public occurred that were allegedly committed by refugees. These attacks disrupted the German welcoming culture for refugees, potentially threatening the legitimacy of the prosocial ventures’ core activities. Thus, the attacks provide a starting point for examining how new prosocial ventures are able to maintain access to resources in the face of the potential withdrawal of resource holders. Theorizing from our data, we identify three distinct approaches to explain how prosocial ventures responded to the potential threat undermining the legitimacy of their activities to maintain access to resources. These approaches differ in their initial resource mobilization (i.e., based on the venture’s goal for alleviating suffering), threat appraisals, and responses to maintain resource mobilization in the face of the potential delegitimization of their core activities. Our model provides novel insights into resource mobilization and prosocial venturing.
Artificial Intelligence Approach for Analyzing Anaemia Prevalence in Children and Adolescents in BRICS Countries: A Review
Authors: Dukhi Natisha , Sewpaul Ronel , Derrick Sekgala Machoene , Olawale Awe Olushina
Published: April 2021

Anemia prevalence, especially among children and adolescents, is a serious public health burden in the BRICS countries. This article gives an overview of the current anaemia status in children and adolescents in three BRICS countries, as part of a study that utilizes an artificial intelligence approach for analyzing anaemia prevalence in children and adolescents in South Africa, India and Russia. It posits that the use of machine learning in this area of health research is still novel. The weightage assessment of the crosslink between anaemia risk indicators using a machine learning approach will assist policy makers in identifying the areas of priority to intervene in the BRICS participating countries. Health interventions utilizing artificial intelligence and more specifically, machine learning techniques, remains nascent in LMICs but could lead to improved health outcomes.
Mid-infrared optical parametric oscillator pumped by a high-pulse-energy, Q-switched Ho3+:YAG laser
Authors: Griesbeck Michael , Büker Hendrik , Eitner Madeleine , Goth Katharina , Braesicke Peter , Eichhorn Marc , Kieleck Christelle
Published: April 2021

A high-pulse-energy mid-infrared light source is presented, based on a zinc–germanium–phosphide optical parametric oscillator (ZGP OPO) pumped by an actively

Q

-switched high-pulse-energy

H
o

3
+

:

Y
A
G

laser. The

H
o

3
+

:

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pump laser source is capable of generating a pulse energy of 15 mJ from a single

H
o

3
+

:

Y
A
G

rod at room temperature at a pulse repetition frequency (PRF) of 700 Hz. A maximum power of 20.1 W at a central wavelength of 2090 nm can be obtained in continuous operation, with a slope efficiency of 45.1%. A good beam quality with an

M

2

better than 1.3 was achieved in

Q

-switched operation. The presented laser architecture was used as a suitable pump source for a ZGP-based OPO. Operated at a PRF of 2 kHz and pumped with a pulse energy of 8 mJ, a low conversion threshold of 1.5 W and a maximum total output power of 6.3 W could be obtained in a linear ZGP-based OPO. At maximum power, the peak power of the generated mid-infrared radiation exceeded 120 kW, while the beam quality was affected by the strong gain lens building inside the nonlinear material as a consequence of the high-energy pump pulses.
Compact chirped-pulse amplification systems based on highly Tm3+-doped germanate fiber
Authors: Ren Zhengqi , ben Slimen Fedia , Lousteau Joris , White Nicholas , Jung Yongmin , Price Jonathan H. V. , Richardson David J. , Poletti Francesco
Published: April 2021

We report the fabrication of a dual cladding large mode area thulium-doped germanate fiber (TDGF). The fiber has a core diameter of 20 µm, a high

T
m

3
+

ion concentration of

3

c
m

3

×

10

20

/

c
m

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, and a hexagonal inner cladding to enhance pump absorption when cladding-pumped. Using a short fiber length, we demonstrate a compact 300 fs chirped-pulse amplification system operating at 1925 nm, investigating both core- and cladding-pumped implementations. By cladding pumping a 65 cm long fiber we produced an average power of 14.1 W (limited by thermally induced damage) and a peak power of 2.17 MW at a pulse repetition rate of 15.7 MHz. Core pumping a 19 cm length of TDGF produced 2.3 W of average-power and 16 MW peak-power pulses at 0.39 MHz. The performance is already comparable to the state-of-the-art success achieved with flexible silica fibers. Considering the rapid improvements in glass quality and the scope for further increasing the doping concentration, this fiber type holds great potential for pulsed fiber lasers in the 1.5–3 µm wavelength region.
Characterizing microring resonators using optical frequency domain reflectometry
Authors: Zhang Xiaopei , Yin Yuexin , Yin Xiaojie , Wen Yongqiang , Zhang Xiaolei , Liu Xiaoping , Lv Haibin
Published: April 2021

A novel, to the best of our knowledge, method to extract optical microring resonators’ loss characteristics is proposed and demonstrated using optical frequency domain reflectometry (OFDR). Compared with the traditional optical transmission measurement method, the spatial-resolved backscattering optical signals obtained from the OFDR can clearly show the resonance mode’s increased optical path length due to its circulation inside the resonator. By further processing the backscattered optical signals, loaded

Q

-factors of several resonators can be accurately determined. A calculation model is proposed to derive the resonance mode’s intrinsic

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-factor from OFDR measurements of a series of loaded resonators.
The influence of algorithms on political and dating decisions
Authors: Agudo Ujué , Matute Helena
Published: April 2021

Artificial intelligence algorithms are ubiquitous in daily life, and this is motivating the development of some institutional initiatives to ensure trustworthiness in Artificial Intelligence (AI). However, there is not enough research on how these algorithms can influence people’s decisions and attitudes. The present research examines whether algorithms can persuade people, explicitly or covertly, on whom to vote and date, or whether, by contrast, people would reject their influence in an attempt to confirm their personal freedom and independence. In four experiments, we found that persuasion was possible and that different styles of persuasion (e.g., explicit, covert) were more effective depending on the decision context (e.g., political and dating). We conclude that it is important to educate people against trusting and following the advice of algorithms blindly. A discussion on who owns and can use the data that makes these algorithms work efficiently is also necessary.
A guilt-free strategy increases self-reported non-compliance with COVID-19 preventive measures: Experimental evidence from 12 countries
Authors: Daoust Jean-François , Bélanger Éric , Dassonneville Ruth , Lachapelle Erick , Nadeau Richard , Becher Michael , Brouard Sylvain , Foucault Martial , Hönnige Christoph , Stegmueller Daniel
Published: April 2021

Studies of citizens’ compliance with COVID-19 preventive measures routinely rely on survey data. While such data are essential, public health restrictions provide clear signals of what is socially desirable in this context, creating a potential source of response bias in self-reported measures of compliance. In this research, we examine whether the results of a guilt-free strategy recently proposed to lessen this constraint are generalizable across twelve countries, and whether the treatment effect varies across subgroups. Our findings show that the guilt-free strategy is a useful tool in every country included, increasing respondents’ proclivity to report non-compliance by 9 to 16 percentage points. This effect holds for different subgroups based on gender, age and education. We conclude that the inclusion of this strategy should be the new standard for survey research that aims to provide crucial data on the current pandemic.
The belief that politics drive scientific research & its impact on COVID-19 risk assessment
Authors: McLaughlin Danielle M. , Mewhirter Jack , Sanders Rebecca
Published: April 2021

We use survey data collected from 12,037 US respondents to examine the extent to which the American public believes that political motives drive the manner in which scientific research is conducted and assess the impact that such beliefs have on COVID-19 risk assessments. We find that this is a commonly held belief and that it is negatively associated with risk assessments. Public distrust in scientists could complicate efforts to combat COVID-19, given that risk assessments are strongly associated with one’s propensity to adopt preventative health measures.