bluuebunny/crossref_metadata_2025 huggingface dataset:
Individual Changes in Respiratory Compliance Upon Immersion May Predict Susceptibility to Immersion Pulmonary Edema
Authors: Castagna Olivier , Druelle Arnaud , Michoud Guillaume , Prevautel Thibaut , Lacour Jean-René
Published: June 2023

Background

Immersion pulmonary edema (IPE) is a frequent diving accident, and it is the primary cause of hospitalization for young military divers during training. The objective of this study was to identify immersion-induced parameters predicting individual susceptibility to IPE.

Methods

Eighteen experienced male divers having completed at least 100 dives were recruited. Eight divers had previously been hospitalized for IPE (IPE), and the other ten had never developed IPE (non-IPE). The two groups were matched for age, BMI, and number of dives performed. Ventilatory function and overall compliance of the respiratory system (Crs) were measured on land and during head-out-of-water immersion. Subjects also performed 30 min of fin swimming in a channel at 33 m min−1. Following this exercise, the presence of extravascular lung water, revealed by ultrasound lung comets (ULC), was assessed.

Results

In the whole group, the decrease in Crs upon immersion correlated with the immersion-induced alterations to expiratory reserve volume, ERV (r2 = 0.91; p < 0.001), inspiratory reserve volume, IRV (r2 = 0.94; p < 0.001), and tidal volume, Vt, changes (r2 = 0.43; p < 0.003). The number of ULC correlated strongly with immersion-induced changes in ventilatory function (r2 = 0.818; p < 0.001 for ERV, r2 = 0.849; p < 0.001 for IRV, r2 = 0.304; p = 0.0164 for Vt) and reduced Crs (r2 = 0.19; p < 0.001).

The variations of ERV, IRV, and Crs at rest induced by head-out-of-water immersion and the number of ULC measured after swimming for 30 min were significantly greater in IPE subjects.

Conclusion

In the face of similar immersion stresses, the extent of alterations to ventilatory function and the number of ULCs were very different between individuals but remained statistically correlated. These parameters were significantly greater in divers with a history of IPE. Alterations to pulmonary function and, in particular, to pulmonary compliance induced by head-out-of-water immersion, through their effects on work of breathing appear to allow the identification of divers with a greater susceptibility to developing IPE. Measurement of these parameters could therefore be proposed as a predictive test for the risk of developing IPE.
Modeling and performance analysis of solar parabolic trough collectors for hybrid process heat application in Kenya’s tea industry using system advisor model
Authors: Akello Philip O. O. , Saoke Churchil O. , Kamau Joseph N. , Ndeda Jared O. H.
Published: June 2023

Among the Concentrated Solar Collector (CSC) technologies, Parabolic Trough Collector (PTC) is the most mature and commercialized CSC technology today. Currently, solar PTC technology is mainly used for electricity generation despite its huge potential for heating, especially in industrial process heat (IPH) applications. Though the technology is well-developed and successfully used in many developed countries, there is barely any development in Kenya. This paper studies the techno-economic feasibility of a solar PTC-assisted tea drying process in one tea factory that currently relies on biomass for process heat, in the tea producing area of Kericho, Kenya. The plant integrating parabolic troughs is modelled and a yearly simulation performed using System Advisor Model (SAM) software. The weather data are derived from ground measurements at Kericho meteorological weather station. SAM is used to model the impact of the principal design parameters, i.e., solar multiple (SM), thermal energy storage (TES) and hybridization percentages, on solar–biomass plant configurations, and to reveal the optimum case. The studied impacts are linked to the annual energy production and the optimal size which minimizes the levelized cost of heat (LCOH). Analysis of monthly variations of energy production by the solar PTC reveals that even when the solar system is designed to its maximum capacity (SM of 3 and TES of 24 h), some months will still require hybridisation with biomass to fully meet the energy demand. TES must also be incorporated in the solar PTC design to maximise on energy production. The hybrid solar–biomass plant with TES provides optimal performance when SM is 1.8 and TES is 24 h. This results in LCOH of 1.85 US cents/kWh, which is 25% cheaper than using biomass only as is the current practice. Furthermore, integration of solar PTC has a positive impact on carbon footprint and considerably reduces annual greenhouse gas (GHG) emissions by 9817 tons of CO2-eq, and annual fuel wood consumption by 16,462 m3 (equivalent to 23.51 acres of mature grown trees).
A global network of scholars? The geographical concentration of institutes in migration studies and its implications
Authors: Piccoli Lorenzo , Ruedin Didier , Geddes Andrew
Published: June 2023

The study of international migration and responses to it has experienced rapid growth in the last three decades: an institutionalisation of migration studies. This paper identifies and specifies infrastructural and semantic elements of institutionalisation by establishing a global Directory of Migration Research Institutions identifying 282 institutes focused on migration research that were operative between 1945 and 2020. We observe a clear geographical concentration in the Americas and Europe and find that most institutes are in countries with higher economic development (GDP) and net immigration (not emigration). Using this evidence, we suggest that the institutionalisation of migration studies is driven by concerns and ideas produced in high-income ‘destination’ countries. We thus show that uneven knowledge production in migration studies is not only caused by exclusive categories, language, or journal policies, but also by a structural problem at an earlier stage: because of fewer resources invested in the creation of institutionalised academic knowledge structures, lower income countries have fewer possibilities to shape the semantic features of the field of migration studies, by which we mean the identification of subjects of interest, concepts, narratives, and priorities.
Feasibility, credence, and usefulness of out-of-office cuffless blood pressure monitoring using smartwatch: a population survey
Authors: Jang Yongjun , Seo Jong-Mo , Ihm Sang-Hyun , Lee Hae Young ,   on behalf of the Korean Society of Hypertension
Published: June 2023

Background

Cuffless blood pressure (BP) measurement, enabled by recent advances in wearable devices, allows for BP monitoring in daily life. This study aims to evaluate the feasibility, cresdence, and usefulness of cuffless BP monitoring through a population survey.

Methods

During the "Daily BP Measurement with Your Galaxy Watch" campaign held by the Korean Society of Hypertension, participants were asked to share their experiences with cuffless BP measurement using a smartwatch application through an online survey. The questionnaire included questions about age, underlying medical conditions, smartwatch utilization, experience with BP calibration, the reliability of BP values measured by a smartwatch, and willingness to use the BP monitoring function in the future.

Results

A total of 1071 participants responded to the survey. The largest age group (decile) was 50-59 years old (33.3%), followed by 40-49 years old (29.9%). Although nearly half of the participants (47.5%) had no chronic diseases, 40.1% reported having hypertension. BP monitoring was the most frequently utilized smartwatch function (95.8%), followed by heart rate measurement (87.1%). 31.8% of participants reported that BP values measured by the smartphone application were "very accurate and helpful," while 63.5% rated them as "slightly lower (44.4%)" or "higher (19.1%)" compared to the standard home BP monitoring device. 93% of the participants reported utilizing the BP monitoring function at least once a week. Regarding the BP calibration process, most participants (93.9%) calibrated the BP measurement application themselves, and 50.8% rated the difficulty level as "very easy."

Conclusion

Cuffless BP measurement using a smartwatch application was feasible in the general population, including the self-calibration process. However, the satisfaction level in terms of accuracy is still modest, indicating a need for further development.
PRO-Act: a healthcare provider workshop outlining the added value of implementing PROs in routine HIV practice
Authors: Antunes António , Racha-Pacheco Ricardo , Esteves Catarina , Tavares Ana , Mendez Josefina , Pacheco Patrícia , Short Duncan
Published: June 2023

Patient Reported Outcomes (PROs) are an evidenced way of adding value to routine clinical care. As a source of unique information on the effect of a medical condition and its treatment from the patients’ perspective (Mercieca-Bebber et al. in Patient Relat Outcome Meas 9: 353–367,https://doi.org/10.2147/PROM.S156279, 2018), PROs allow for an improved assessment in routine clinical care of symptoms, side effects, functional outcomes (physical, sexual, social, emotional, cognitive functioning), and health-related quality of life (HRQoL). By helping to align healthcare providers’ interventions with what matters most to the patient, PROs contribute to the individualized choice of Anti-Retroviral Therapy (Carfora et al. in PLoS ONE 17(4): e0267030,https://doi.org/10.1371/journal.pone.0267030, 2022) as a paramount component of tailored and person-centred care management, in routine clinical practice. This article outlines a practical framework and process tested in Portugal to raise awareness of PROs’ added value, and to help guide first steps in the implementation and seamless integration of PROs, in routine HIV care.
Evaluation of symptoms in respiratory syncytial virus infection in adults: psychometric evaluation of the Respiratory Infection Intensity and Impact Questionnaire™ symptom scores
Authors: Osborne Richard H. , Nelson Lauren M. , Fehnel Sheri , Williams Nicole , Bender Randall H. , Ziemiecki Ryan , Gymnopoulou Efi , De Paepe Els , Vandendijck Yannick , Norcross Lindsey , Heijnen Esther , Ispas Gabriela , Comeaux Christy , Callendret Benoit , Chan Eric K. H. , Scott Jane A.
Published: June 2023

Background

The Respiratory Infection Intensity and Impact Questionnaire (RiiQ™) is a patient-reported outcome measure designed to assess symptoms and impacts of respiratory syncytial virus (RSV) infection. This study evaluated the construct validity, reliability, and responsiveness of the RiiQ™ Respiratory and Systemic Symptoms Scale scores.

Methods

Prospective data were analyzed from a total of 1795 participants, including from non-hospitalized patients with acute respiratory infection (ARI) and no coinfections enrolled in a Phase 2b RSV vaccine study (RSV-positive: n = 60; RSV-negative: n = 1615), and two observational studies of patients hospitalized with RSV (n = 20; n = 100). Descriptive statistics, confirmatory factor analysis (CFA), test–retest intraclass correlation coefficients (ICCs), construct validity correlations (between a clinician-assessed clinical questionnaire and the RiiQ™ symptoms scale), known-groups validity, and responsiveness (correlations of change scores) were evaluated.

Results

Mean patient age ranged from 66.5 to 71.5 years and the majority of patients were female. Initial assessments in the vaccine trial (ARI Day 1) were suggestive of less severe illness than in the observational studies with hospitalized patients. CFA loadings (> 0.40) supported summary scores. ICCs exceeding the recommended threshold of 0.70 supported test–retest reliability for Respiratory and Systemic Symptoms, except in the small observational study. At the scale level, correlations were moderate to strong (|r| ≥ 0.3) and positive between the Respiratory Symptoms Scale and the related clinical questionnaire scores, reflecting measurement of similar symptoms in support of convergent validity. Correlations with change in Patient Global Impression of Severity > 0.30 supported responsiveness.

Conclusions

Psychometric tests applied to the RiiQ™ Symptoms scales provide evidence of its reliability, construct validity, discriminating ability, and responsiveness for use in clinical studies to assess the onset and severity of RSV symptoms.
Potential health risk assessment through the consumption of arsenic-contaminated groundwater in parts of the middle Gangetic plain
Authors: Jha Maya , Kumar Suresh , Singh T. B. N. , Srivastava S. K. , Azad Gajendra Kumar , Yasmin Shahla
Published: June 2023

Background

Arsenic toxicity in humans is well recognized. It has been classified as a class I human carcinogen by the International Agency of Research on Cancer. Arsenic enters the human body mainly through drinking water, dermal contact, food chain, and inhalation. The Gangetic belt of India is considered as one of the most arsenic-affected sites in India. Health risk assessment of the human population exposed to arsenic in drinking water is important. The present study was conducted to assess the groundwater quality and associated health risks on the people of Samastipur district in the middle Gangetic belt of Bihar. Groundwater samples from 40 different study sites were collected and analyzed for various physico-chemical properties of water.

Results

Arsenic (> 0.01 mg/L) was present in 33% of the water samples analyzed. Subsequently, an assessment for carcinogenic risk and non-carcinogenic health risk (HQ) for children, females, and males in the study area was performed. Risk assessment showed that 100% of the population may be at carcinogenic health risk and 35% may be at non-carcinogenic health risk, and among these, children were at maximum risk. Furthermore, the computational assessment of the arsenic–protein interactome revealed the enrichment of cancer-related pathways.

Conclusions

It is recommended to provide arsenic-free alternate sources of water in the study area.
PosFuzz: augmenting greybox fuzzing with effective position distribution
Authors: Zou Yanyan , Zou Wei , Zhao JiaCheng , Zhong Nanyu , Zhang Yu , Shi Ji , Huo Wei
Published: June 2023

Mutation-based greybox fuzzing has been one of the most prevalent techniques for security vulnerability discovery and a great deal of research work has been proposed to improve both its efficiency and effectiveness. Mutation-based greybox fuzzing generates input cases by mutating the input seed, i.e., applying a sequence of mutation operators to randomly selected mutation positions of the seed. However, existing fruitful research work focuses on scheduling mutation operators, leaving the schedule of mutation positions as an overlooked aspect of fuzzing efficiency. This paper proposes a novel greybox fuzzing method, PosFuzz, that statistically schedules mutation positions based on their historical performance. PosFuzz makes use of a concept of effective position distribution to represent the semantics of the input and to guide the mutations. PosFuzz first utilizes Good-Turing frequency estimation to calculate an effective position distribution for each mutation operator. It then leverages two sampling methods in different mutating stages to select the positions from the distribution. We have implemented PosFuzz on top of AFL, AFLFast and MOPT, called Pos-AFL, -AFLFast and -MOPT respectively, and evaluated them on the UNIFUZZ benchmark (20 widely used open source programs) and LAVA-M dataset. The result shows that, under the same testing time budget, the Pos-AFL, -AFLFast and -MOPT outperform their counterparts in code coverage and vulnerability discovery ability. Compared with AFL, AFLFast, and MOPT, PosFuzz gets 21% more edge coverage and finds 133% more paths on average. It also triggers 275% more unique bugs on average.
Extent of routine diagnostic cardiac work-up at certified German stroke units participating in the prospective MonDAFIS study
Authors: Olma Manuel C. , Tütüncü Serdar , Grittner Ulrike , Kunze Claudia , Jawad-Ul-Qamar Muhammad , Kirchhof Paulus , Röther Joachim , Thomalla Götz , Veltkamp Roland , Laufs Ulrich , Nabavi Darius G. , Heuschmann Peter U. , Endres Matthias , Haeusler Karl Georg
Published: June 2023

Background

About 25% of all ischaemic strokes are related to cardio-embolism, most often due to atrial fibrillation (AF). Little is known about the extent and standardization of routine cardiac diagnostic work-up at certified stroke-units in Germany.

Methods

The MonDAFIS study included non-AF patients with acute ischaemic stroke or transient ischaemic attack (TIA) at 38 certified stroke-units in Germany. Here, we analysed routine diagnostic work-up and disregarded study-related Holter-ECG monitoring. We compared duration of stroke-unit stay, number of 24-h Holter-ECGs, and echocardiography performed between university-based comprehensive stroke centres (UCSC, 12 hospitals, 1606 patients), non university-based comprehensive stroke centres (nUCSC, 14 hospitals, 892 patients), and primary stroke centres at non-university hospitals (PCS, 12 hospitals, 933 patients) using multivariable mixed regression analyses. Detection of a first AF episode in-hospital was also compared between hospitals of different stroke-unit levels.

Results

In 3431 study patients (mean age 66.2 years, 39.5% female, median NIHSS = 2 on admission), median duration of the stroke-unit stay was 72 h (IQR 42–86). Stroke-unit stay was longer (categorised ≤ 24/ > 24- ≤ 72/ > 72 h) for patients with severe stroke (NIHSS score ≥ 5/ < 5: OR = 1.6, 95%CI 1.3–2.0) and for patients with ischaemic stroke vs. TIA (OR = 1.7, 95%CI 1.4–2.1). Overall, 2149/3396 (63.3%) patients underwent at least one additional 24-h Holter-ECG (median 1 [IQR 0–1], range 0–7). Holter-ECG rate was 47% in UCSC, 71% in nUCSC, and 84% in PCS. Compared to PCS, AF was less often detected in-hospital in UCSC (OR = 0.65, 95%CI 0.45–0.93) and nUCSC (OR = 0.69, 95%CI 0.46–1.04). Transoesophageal echocardiography (TEE) only was performed in 513/3391 (15.1%) study patients, transthoracic echocardiography (TTE) only in 1228/3391 (36.2%), and TEE combined with TTE in 1020/3391 (30.1%) patients. Patients younger than 60 years (vs. ≥ 60 years) underwent TEE more often than those older than 60 years (OR = 3.44, 95%CI 2.67–4.42). TEE (IQR 34–65%) and TTE rate (IQR 40–85%) varied substantially among study centres. Echocardiography rate (TTE and/or TEE) was 74.0% in UCSC, 85.4% in nUCSC, and 90.3% in PSC, respectively.

Conclusions

In the MonDAFIS study, the routine use of echocardiography and Holter-ECG monitoring varied in participating stroke centres and at stroke-unit level, if grouped according to stroke-unit certification grade and hospitals´ university status.

Trial registration Clinical Trials, NCT02204267. Registered 30 July 2014, https://clinicaltrials.gov/ct2/show/NCT02204267.
Design and implementation of ParkinsonAKTIV: an interventional study to evaluate the effectiveness of a novel online platform to guide quickcard-based treatment decisions
Authors: Achtert Katharina , Huchtemann Tessa , Altendorf Maria , Kerkemeyer Linda , Haring Malte , Lummer Carina , Frenz Lena , Becking Theresa , Friedmann Jonas , Mildner Philip , Schwarze Katharina , Steinhaus Lars , Amelung Volker , Warnecke Tobias
Published: June 2023

Introduction

Patients with Parkinson’s Disease (PD) require an all-encompassing and individualized care including pharmacological as well as non-pharmacological treatment approaches, such as physical therapy, occupational therapy and speech and swallowing therapy. ParkinsonAKTIV is an innovative, multidisciplinary, and comprehensive approach to guide this non-pharmacological PD treatment in northwestern Germany. Its online communication platform called JamesAKTIV has been developed to enhance and standardize PD healthcare professionals’ communication. The implementation of ParkinsonAKTIV and JamesAKTIV is accompanied through a detailed process evaluation and to gather evidence on the impact on patient-related outcomes, such as health-related quality of life and healthcare costs for people with PD through an effectiveness evaluation.

Methods

The study design contains two parts: (1) first, a quantitative effectiveness evaluation is conducted utilizing a prospective quasi-experimental approach with a control group which examines PD patient’s health-related quality of life and physician-assessed PD patient’s health status (Unified Parkinson Disease Rating Scale). Moreover, a health economic evaluation of the ParkinsonAKTIV intervention is conducted using patient-reported outcomes and cost data as well as routine data from a statutory health insurance. (2) Second, a mixed-methods process evaluation among healthcare professionals, which examines the feasibility and potential barriers and facilitators of ParkinsonAKTIV for routine care, is performed. Quantitative results from a social network analysis and a survey among healthcare professionals will be triangulated with data from qualitative stakeholder interviews and focus group discussions.

Perspective

Findings are expected to provide evidence of an increase in quality of life of patients with PD, less severe PD symptoms, and a better ability to participate in activities of daily living. ParkinsonAKTIV has the potential of increasing PD patients’ quality of care through sufficient and more tailored prescription of non-pharmacological therapies. It is anticipated that ParkinsonAKTIV will improve communication among health professionals. Results from the ParkinsonAKTIV study will provide first practice-oriented evidence and a roadmap for implementation of an online tool for a comprehensive, multidisciplinary care PD network for patients and their caregivers in routine care in Germany.

Trial registration ClinicalTrials.gov: registration number NCT05251298 (retrospectively registered: https://clinicaltrials.gov/ct2/show/record/NCT05251298).
Effect of cartilaginous rings in tracheal flow with stenosis
Authors: Bocanegra Evans Humberto , Segnini Jose Montoya , Doosttalab Ali , Cordero Joehassin , Castillo Luciano
Published: June 2023

Background

In respiratory fluid dynamics research, it is typically assumed that the wall of the trachea is smooth. However, the trachea is structurally supported by a series of cartilaginous rings that create undulations on the wall surface, which introduce perturbations into the flow. Even though many studies use realistic Computer Tomography (CT) scan data to capture the complex geometry of the respiratory system, its limited spatial resolution does not resolve small features, including those introduced by the cartilaginous rings.

Results

Here we present an experimental comparison of two simplified trachea models with Grade II stenosis (70% blockage), one with smooth walls and second with cartilaginous rings. The use a unique refractive index-matching method provides unprecedented optical access and allowed us to perform non-intrusive velocity field measurements close to the wall (e.g., Particle Image Velocimetry (PIV)). Measurements were performed in a flow regime comparable to a resting breathing state (Reynolds number ReD = 3350). The cartilaginous rings induce velocity fluctuations in the downstream flow, enhancing the near-wall transport of momentum flux and thus reducing flow separation in the downstream flow. The maximum upstream velocity in the recirculation region is reduced by 38%, resulting in a much weaker recirculation zone— a direct consequence of the cartilaginous rings.

Conclusions

These results highlight the importance of the cartilaginous rings in respiratory flow studies and the mechanism to reduce flow separation in trachea stenosis.
Bacterial symbiont diversity in Arctic seep Oligobrachia siboglinids
Authors: Sen Arunima , Tanguy Gwenn , Galand Pierre E. , Andersen Ann C. , Hourdez Stéphane
Published: June 2023

Background

High latitude seeps are dominated by Oligobrachia siboglinid worms. Since these worms are often the sole chemosymbiotrophic taxon present (they host chemosynthetic bacteria within the trophosome organ in their trunk region), a key question in the study of high latitude seep ecology has been whether they harbor methanotrophic symbionts. This debate has manifested due to the mismatch between stable carbon isotope signatures of the worms (lower than -50‰ and usually indicative of methanotrophic symbioses) and the lack of molecular or microscopic evidence for methanotrophic symbionts. Two hypotheses have circulated to explain this paradox: (1) the uptake of sediment carbon compounds with depleted δC13 values from the seep environment, and (2) a small, but significant and difficult to detect population of methanotrophic symbionts. We conducted 16S rRNA amplicon sequencing of the V3-V4 regions on two species of northern seep Oligobrachia (Oligobrachia webbi and Oligobrachia sp. CPL-clade), from four different high latitude sites, to investigate the latter hypothesis. We also visually checked the worms’ symbiotic bacteria within the symbiont-hosting organ, the trophosome, through transmission electron microscopy.

Results

The vast majority of the obtained reads corresponded to sulfide-oxidizers and only a very small proportion of the reads pertained to methane-oxidizers, which suggests a lack of methanotrophic symbionts. A number of sulfur oxidizing bacterial strains were recovered from the different worms, however, host individuals tended to possess a single strain, or sometimes two closely-related strains. However, strains did not correspond specifically with either of the two Oligobrachia species we investigated. Water depth could play a role in determining local sediment bacterial communities that were opportunistically taken up by the worms. Bacteria were abundant in non-trophosome (and thereby symbiont-free) tissue and are likely epibiotic or tube bacterial communities.

Conclusions

The absence of methanotrophic bacterial sequences in the trophosome of Arctic and north Atlantic seep Oligobrachia likely indicates a lack of methanotrophic symbionts in these worms, which suggests that nutrition is sulfur-based. This is turn implies that sediment carbon uptake is responsible for the low δ13C values of these animals. Furthermore, endosymbiotic partners could be locally determined, and possibly only represent a fraction of all bacterial sequences obtained from tissues of these (and other) species of frenulates.
Diversity of Indonesian offal-based dishes
Authors: Prastowo Indro , Nurusman Arief Abdillah , Moro Hendro Kusumo Eko Prasetyo , Rizkianti  , Dewi Cyntia
Published: June 2023

Indonesia is a home to diverse ethnicities and cultures that have influenced its culinary tradition. Moreover, Indonesian culinary tradition is shaped by the country’s wealth of natural resources, one of which is offal (including tripe, lung, intestine, liver, and so on). The utilization of offal has created myriad recipes of offal-based dishes (OBDs), resulting in a culinary diversity across the nation. Therefore, this article aimed to identify and create a culinary profile of Indonesian OBDs based on geographical distribution. To strengthen this culinary profile, historical creations of Indonesian OBDs were also elucidated. For centuries, Indonesian OBDs have been shaped by several factors, such as natural resources, history, religio-cultural, and economic backgrounds. For instance, specialties such asmomoh(braised offal) from Central Java andpallubasa(coconut milk-based offal soup) from South Sulawesi were developed due to religio-cultural and economic reasons, respectively. Although 139 Indonesian OBDs are widely distributed across 23 Indonesian provinces, the foods are mostly concentrated in West Sumatra (31 dishes), Central Java (18 dishes), and East Java (14 dishes). Furthermore, intestine, liver, and tripe are the most commonly used types of offal as utilized in over 40 dishes; while cattle, water buffalo, and chicken are the most utilized sources of offal. Meanwhile, pig offal is only used in the non-Muslim regions of Indonesia. The creation of Indonesian OBDs is also influenced by foreign cultures. For example,gulai tambusu(intestine curry) from West Sumatra,rabeg(Bantenese-styled mutton curry) from Banten,babat gongso(stir-fried cattle tripe) from Central Java, and the ubiquitoussop buntut(oxtail soup) demonstrate Indian, Arabian, Chinese, and colonial influences, respectively. However, OBD such assaksang(pork stewed in pig blood), which originated from Batak ethnic group, retains the native culinary features. Additionally, OBDs recipes involve several spices, herbs, and other ingredients that can maintain and improve their organoleptic attributes.
Predicting 30-day readmission following total knee arthroplasty using machine learning and clinical expertise applied to clinical administrative and research registry data in an Australian cohort
Authors: Gould Daniel J. , Bailey James A. , Spelman Tim , Bunzli Samantha , Dowsey Michelle M. , Choong Peter F. M.
Published: June 2023

Background

Thirty-day readmission is an increasingly important problem for total knee arthroplasty (TKA) patients. The aim of this study was to develop a risk prediction model using machine learning and clinical insight for 30-day readmission in primary TKA patients.

Method

Data used to train and internally validate a multivariable predictive model were obtained from a single tertiary referral centre for TKA located in Victoria, Australia. Hospital administrative data and clinical registry data were utilised, and predictors were selected through systematic review and subsequent consultation with clinicians caring for TKA patients. Logistic regression and random forest models were compared to one another. Calibration was evaluated by visual inspection of calibration curves and calculation of the integrated calibration index (ICI). Discriminative performance was evaluated using the area under the receiver operating characteristic curve (AUC-ROC).

Results

The models developed in this study demonstrated adequate calibration for use in the clinical setting, despite having poor discriminative performance. The best-calibrated readmission prediction model was a logistic regression model trained on administrative data using risk factors identified from systematic review and meta-analysis, which are available at the initial consultation (ICI = 0.012, AUC-ROC = 0.589). Models developed to predict complications associated with readmission also had reasonable calibration (ICI = 0.012, AUC-ROC = 0.658).

Conclusion

Discriminative performance of the prediction models was poor, although machine learning provided a slight improvement. The models were reasonably well calibrated, meaning they provide accurate patient-specific probabilities of these outcomes. This information can be used in shared clinical decision-making for discharge planning and post-discharge follow up.
An understanding of falling bodies across schooling and experience based on the conceptual prevalence framework
Authors: Potvin Patrice , Chastenay Pierre , Thibault François , Riopel Martin , Ahr Emmanuel , Brault Foisy Lorie-Marlène
Published: June 2023

In this article, we describe a study conducted online with 953 participants of varying levels of education and, when applicable, science/physics teaching experience. These participants were asked to solve a cognitive task in which many different pairs of objects were presented and to identify which, if any, would touch the ground first when dropped (in atmospheric or non-atmospheric environments). Recorded accuracies and response times allowed us to conduct an analysis based on the conceptual prevalence framework, which posits that the coexistence of conceptual and/or misconceptual resources can produce interference in response production. The results show that the influence of some of them decreases or, more surprisingly, increases with training. In fact, secondary and college physics teachers seem to cultivate some of them, and most likely have contributed to their spread. The implications for teaching and research are discussed.
Added value of dynamic MRI in assessment of cervical spondylodegenerative diseases
Authors: Abdalhak Menna Ahmad Mohamed , Sakr Hossam Mousa , Shalaby Mennatallah Hatem , El diasty Shaimaa Elmetwally
Published: June 2023

Background

Magnetic resonance imaging (MRI) is an effective imaging tool for diagnosing spinal disorders. With a high degree of sensitivity and specificity, it gives vital information on the spinal cord, nerve roots, intervertebral discs, and ligamentous structures inside the spine. Dynamic MRI may image patients in flexed and extended postures, showing abnormalities undetected by static MRI studies. It allows for a more complete investigation of each patient and a better knowledge of the real nature of the pathology. Imaging the spine in extension and flexion, or putting the spine in pain, may help spine surgeons improve their diagnostic accuracy. We aimed to assess the diagnostic value of flexion–extension sagittal T2 (Dynamic MRI) for patients with cervical spondylodegenerative diseases.

Results

We found that more spinal canal stenosis levels were detected on extension position MRI compared to a neutral position (128 vs. 133 MUHLE classification system grade 0, 38 vs. 63 MUHLE grade 1, 31 vs. 13 MUHLE grade 2, 13 vs. 1 MUHLE grade 3), which was statistically significant according to MUHLE among total disc levels, with p value < 0.05. While more spinal canal stenosis levels were detected on flexion position MRI than in neutral position (134 vs. 133 MUHLE grade 0, 49 vs. 63 MUHLE grade 1, 23 vs. 13 MUHLE grade 2, 4 vs. 1 MUHLE grade 3), which was statistically insignificant according to MUHLE among total disc levels (p value > 0.05).

Conclusions

Flexion and extension MR imaging demonstrates additional information using a non-invasive technique concerning the dynamic factors in the pathogenesis of cervical spondylodegenerative diseases. DMRI identifies a significant percentage of increased spinal stenosis especially at extension position more than at neutral and flexion positions. So, we recommend to include extension DMRI in investigations for diagnosis and management plans of cervical spondylodegenerative diseases.
An experimental study to show the effect of forced vertical vibrations on the thermal heat transfer coefficient of a flat plate
Authors: Idan Mahmoud Fadhel , Ramadhan Amer Abbas
Published: June 2023

The objective of this study is to conduct an experiment that considers the influence of vertical oscillations on the heat transfer coefficient of free convection in an aluminum flat plate component measuring 3 × 100 × 300 mm. The plate is subject to a steady-state heat transfer; whereby it experiences a sustained heat flux ranging from (250–1500) W/m2. The orientation of the flat plate can be either horizontal or inclined at particular angles, specifically at 0°, 30°, 45°, 60°, and 90°. The experimental tests conducted were characterized by an expanded frequency spectrum ranging from 2 to 16 Hz, a variable amplitude range spanning from 1.63 to 7.16 mm, and a range of Rayleigh number values upon activation of the system, with minimum and maximum thresholds of 138.991 and 487.275, respectively. The impact of vibration frequency upon both the amplitude and velocity of vibrations for a heat flow of 250 W/m2, situated at an angle of θ = 0°, was examined. The impact of the Reynolds number upon the total vibrational heat transfer coefficient, as well as the total Nusselt number, was investigated with and without the presence of angle vibration θ = 0°, across diverse degrees of heat flux. This study investigates the impact of the Rayleigh number on the overall Nusselt number under varying conditions of thermal flux, with and without the application of vibration at angles of θ = 30°, 45°, 60°, and 90°. The findings of this analysis demonstrate that there exists a discernible correlation between the incremental amplitude of vibration and the coefficient of heat transfer, manifesting as a negative slope within the range of 0° to 60°. Such correlation reaches its optimal magnitude of 13.2894% under the condition of flat vibration mode, whereas the coefficient of heat transfer declines progressively as vertical vibration is augmented, culminating in a maximum decline of 7.6475%. The present study reports a decrease in the overall vibrational heat transfer coefficient with increasing vibrational Reynolds number. The total Nusselt number was found to increase with or without vibration as the Rayleigh number increased.
Evaluating the effectiveness of barbed reposition palatopharyngoplasty compared to uvulopalatopharyngoplasty for treatment of obstructive sleep apnea
Authors: Kamel Ahmed Ahmed , Tabbakh Hossam Atia El , Dewidar Hazem Raghib , Fouly Mahmoud Sayed El
Published: June 2023

Background

The majority of obstructive sleep apnea cases involve the oropharynx. The hypercollapsibility of the upper airway walls (UAWs) was the cause of obstructive sleep apnea syndrome (OSAS), which most often manifested itself at the retropalatal and/or retrolingual level. Modular and adaptable barbed snore surgery (BSS) is a novel treatment for retropalatal OSA (based on the anatomy and findings of drug-induced sleep endoscopy (DISE).

Objectives

To compare between the outcomes of uvulopalatopharyngoplasty and the barbed reposition palatopharyngoplasty technique, and to establish if there is indeed a significant variance in post-operative results among both types of surgeries.

Patients and methods

This was a prospective randomized clinical trial conducted on Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, and it was carried out on 50 patients (28 males and 22 females) suffering from OSAS. They were randomly distributed into two groups: group A and group B.

Results

There was a substantial distinction among the two groups regarding to post-operative data, comparison between values of all domains of Sleep Apnea Quality of Life Index (SAQLI) and bleeding and nasal regurgitation after surgery. There was no substantial distinction among the two groups in terms of age, sex, body mass index (BMI), smoking, hypertension, and diabetes mellitus.

Conclusion

Barbed reposition pharyngoplasty is superior to traditional uvulopalatopharyngoplasty in terms of results of Apnea Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), and in Sleep Apnea Quality of Life Index (SAQLI) in addition to producing less post-operative complications as well as being easy to learn.
Fragility analysis of bridge structures: a global perspective & critical review of past & present trends
Authors: Thakkar Kanan , Rana Anshum , Goyal Harsh
Published: June 2023

Bridges are vital to modern transportation infrastructure, providing convenient and efficient access to different locations. However, these structures are susceptible to forces that can cause significant damage and pose a hazard in the event of seismic activity. A country's economy relies heavily on its bridge infrastructure, but many older bridges built before 1970 are showing signs of deterioration due to climate change and other factors. At the time of their construction, seismic design codes did not provide sufficient guidance on proper design and detailing to ensure ductility and capacity, resulting in deficient bridges. This paper provides a brief overview of the literature on the seismic behaviour of bridges and the analytical methods used to evaluate their performance. Various factors that influence the behaviour of different types of bridges are also discussed. This paper aims to establish a theoretical foundation for selecting appropriate methods to analyze bridge structures, prioritizing retrofitting, pre-earthquake planning, and loss measurement tools. The seismic design philosophies and analytical methods are elaborated in-depth, including the methodology to develop fragility curves. The paper also discusses the fragility analysis of retrofitted bridges.
Microplastic paint particle production for spiking experiments; silicone rubber as application material provide high yield with low effort
Authors: Tagg Alexander S.
Published: June 2023

Paint particles are a highly-important but as-yet overlooked type of microplastic commonly found in coastal sediment, although research interest is growing. There is a need for paint particles as laboratory standards for spiking experiments, however, given paint is generally only available for purchase in liquid form, a new method is needed to reliable produce laboratory-grade paint particles. The main distinguishing issue with paint particle production (as opposed to other microplastic production) is the paint must be applied to a surface in layers before then being decoupled to be processed into particles. Since paints, and especially primers, are designed specifically to strongly adhere to surfaces, using the right application material is highly important. This study tests the time and material efficiency of 2 different application materials; laboratory wax film (i.e. Parafilm®) and silicone rubber sheets (i.e. silicone baking sheets). Silicone rubber was on average 36 × more time-efficient than laboratory wax and was also 8 × more material-efficient (8 × more paint particles were produce per liquid paint used). Indeed, silicone rubber provided an essentially-perfect decoupling process, as the paint could be easily peeled away in a solid and complete layer. As such, for the future production of paint particles for laboratory purposes, silicone rubber is highly recommended as an application material.
Localized amyloidoma of the chest wall: diagnostic and surgical perspectives
Authors: Kawakami Toru , Atsumi Jun , Shimoda Kiyomi , Hiramatsu Miyako , Oka Teruaki , Shiraishi Yuji
Published: June 2023

Background

An amyloidoma is defined as a solitary, localized, tumor-like deposit of amyloid in the absence of systemic amyloidosis. Amyloidomas occur most frequently in the bladder, followed by the lungs, trachea and bronchi, larynx and vocal cords, tonsils, conjunctivae, orbits, lymph nodes, gastrointestinal tract, and skin. It is extremely rare for an amyloidoma to present in the chest wall. Indeed, only 5 cases of chest wall amyloidoma have been reported. Moreover, all reported lesions were > 10 cm in size and involved the ribs. Herein, we report our experience with a patient who had a chest wall amyloidoma 3 cm in diameter without rib involvement.

Case presentation

A 3.1 × 1.5-cm tumor situated in the fifth intercostal space of the chest wall was found in an 83-year-old male during a routine health checkup. Chest magnetic resonance imaging showed a mass of intermediate intensity on T1-weighted imaging and low intensity on T2-weighted imaging with heterogeneous contrast enhancement. The tumor was resected during video-assisted thoracoscopic surgery. No adhesions were observed between the tumor and the lung. The tumor was white, hard, elastic, and located in the extrapleural fat without bone involvement. The tumor was removed in a piecemeal fashion because the tumor was fragile and the surgical margin was unclear. A wide resection was achieved, including the intercostal muscle. Pathologic examination of the tumor using Dylon and Congo red staining confirmed amyloid deposition with tumor spread from the fat to the intercostal muscle and vascular walls but no pleural invasion. Without clear evidence of systemic amyloidosis, this patient was diagnosed with an amyloidoma of the chest wall. The postoperative course was uneventful, and he is doing well 1 year after surgery.

Conclusion

Amyloidoma of the chest wall can present in various ways. An amyloidoma can be a small tumor, as in our patient, or the amyloidoma can be a large, destructive mass with rib involvement. Diagnosis of an amyloidoma should be kept in mind when patients present with chest wall tumors because an amyloidoma can be characterized by invasion within the chest wall independent of size.
In memory of Louise Pellerin
Authors: Knight Rosemary , Alumbaugh David
Published: June 2023

Louise Pellerin
Estimated Glucose Disposal Rate Predicts Renal Progression in Type 2 Diabetes Mellitus: A Retrospective Cohort Study
Authors: Peng Juan , Li Aimei , Yin Liangqingqing , Yang Qi , Pan Jinting , Yi Bin
Published: June 2023

Context

Insulin resistance is a feature of type 2 diabetes mellitus (T2DM). The estimated glucose disposal rate (eGDR), a validated marker for insulin resistance, is associated with complications of diabetes, but few studies have explored the relationship between eGDR and renal outcomes in T2DM.

Objective

This study investigated the value of eGDR in predicting renal progression in T2DM.

Methods

A total of 956 T2DM patients with a baseline estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and 5 years of follow-up were enrolled. Primary outcomes were rapid eGFR decline, eGFR <60 mL/min/1.73 m2, and composite renal endpoint consisting of 50% eGFR decline, doubling of serum creatinine, or end-stage renal disease. A continuous scale with restricted cubic spline curves and a generalized linear model were applied to evaluate the associations between eGDR and primary outcomes.

Results

Rapid eGFR decline was experienced by 23.95% of patients, 21.97% with eGFR <60 mL/min/1.73 m2, and 12.13% with the composite renal endpoint. The eGDR showed a relationship with follow-up eGFR and percentage change in eGFR (P < .001). An eGDR <6.34 mg/kg/min was an independent risk factor for rapid eGFR decline, eGFR < 60 mL/min/1.73 m2, or the composite renal endpoint(P < .05). Compared with eGDR of 5.65∼6.91 mg/kg/min, eGDR levels >8.33 mg/kg/min decreased the risk of rapid eGFR decline by 75%, eGFR < 60 mL/min/1.73 m2 by 60%, and the composite renal endpoint by 61%. Subgroup analysis was performed by sex, age, and diabetes duration, which showed that eGDR was associated with primary outcomes.

Conclusion

Lower eGDR is a predictive factor for renal deterioration in T2DM patients.
Efficacy and Safety of Leuprolide Acetate 6-Month Depot for the Treatment of Central Precocious Puberty: A Phase 3 Study
Authors: Klein Karen O , Mauras Nelly , Nayak Sunil , Sunil Bhuvana , Martinez-Placencia Blanca M , Dragnic Sanja , Ballina Mayra , Zhou Qing , Kansra Alvina R
Published: June 2023

Context

Treatment options for central precocious puberty (CPP) are important for individualization of therapy.

Objective

We evaluated the efficacy and safety of 6-month 45-mg leuprolide acetate (LA) depot with intramuscular administration.

Methods

LA depot was administered at weeks 0 and 24 to treatment-naïve (n = 27) or previously treated (n = 18) children with CPP in a phase 3, multicenter, single-arm, open-label study (NCT03695237). Week 24 peak-stimulated luteinizing hormone (LH) suppression (<4 mIU/mL) was the primary outcome. Secondary/other outcomes included basal sex hormone suppression (girls, estradiol <20 pg/mL; boys, testosterone <30 ng/dL), suppression of physical signs, height velocity, bone age, patient/parent-reported outcomes, and adverse events.

Results

All patients (age, 7.8 ± 1.27 years) received both scheduled study doses. At 24 weeks, 39/45 patients (86.7%) had LH suppressed. Six were counted as unsuppressed; 2 because of missing data, 3 with LH of 4.35−5.30 mIU/mL and 1 with LH of 21.07 mIU/mL. Through 48 weeks, LH, estradiol, and testosterone suppression was achieved in ≥86.7%, ≥97.4%, and 100%, respectively (as early as week 4 for LH and estradiol and week 12 for testosterone). Physical signs were suppressed at week 48 (girls, 90.2%; boys, 75.0%). Mean height velocity ranged 5.0 to 5.3 cm/year post-baseline in previously treated patients and declined from 10.1 to 6.5 cm/year at week 20 in treatment-naïve patients. Mean bone age advanced slower than chronological age. Patient/parent-reported outcomes remained stable. No new safety signals were identified. No adverse event led to treatment discontinuation.

Conclusion

Six-month intramuscular LA depot demonstrated 48-week efficacy with a safety profile consistent with other GnRH agonist formulations.