bluuebunny/crossref_metadata_2025 huggingface dataset:
The Study of Ranong Metakaolin-Based Porous Geopolymers as Insulating Materials for Construction
Authors:   Ceramics and Construction Materials Research Group, National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani 12120, Thailand, Henpraserttae Pimpun , Supothina Sitthisuntorn ,   Ceramics and Construction Materials Research Group, National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani 12120, Thailand, Timakul Patthamaporn ,   Ceramics and Construction Materials Research Group, National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathumthani 12120, Thailand
Published: February 2022

An increased concern of global warming has driven an increased demand of thermal-insulating materials, particularly in a construction industry. Traditional thermal-insulating construction materials are porous ceramic and light-weight cement brick which have high porosity and heat resistance. However, the manufacturing of cement is a major carbon dioxide (CO2) emission as it has been reported that 0.73-0.85 tons of CO2 were released from every single ton of cement production. Geopolymer is one of the alternatives to replace the cement-based materials. The present study aims to improve the properties of Ranong metakaolin-based porous geopolymers prepared by mixing the metakaolin in an alkaline activator at a weight ratio of metakaolin: activator of 55:45. A 3-μm Al powder employed as pore former was added into the geopolymer mixtures, and the samples were cured at 27-60°C for 24 h followed by aging at room temperature for 28 days. The addition of 0.1-0.4 wt.% Al powder resulted in porous structures having bulk densities in a range of 0.58-0.93 g/cm3, thermal conductivities in a range of 0.172-0.390 W/m∙K and compressive strengths in a range of 3.1-22.4 MPa. The properties of the fabricated porous geopolymers satisfy the TIS 1510-2541 standard and the CIBSE Guide A, indicating potential application as green thermal-insulating materials for building and construction.
Physical-Functional Properties and Characterization of Green Leaves in Nalgonda District, Telangana State: Nontimber Forest Products
Authors: Soujanya Kanneboina , Kumari B. Anila , Jyothsna E. , Kiran V. Kavitha
Published: February 2022

Naturally grown green leafy vegetables contribute nutrients, fiber, antioxidants, dietary diversity, household food security, income, and livelihood to rural people. Due to their good vitamin, mineral, and fiber properties, green leaves are considered to be protective foods. The physical-functional properties of four fresh and dried (Aerva lanata, Corchorus olitorius, Celosia argentea, and Leucas aspera) uncultivated green leafy vegetables available in Nalgonda District of Telangana State, India, were analyzed and compared. The results of the study reported that fresh Aerva lanata has high pH and fresh Corchorus olitorius has highest relative reconstitution capacity. It was found that fresh Celosia argentea has high shrinkage and dehydration ratio, and the leaves of Leucas aspera had high rehydration capacity. Dried leaf powder of Aerva lanata has high flowability, cohesiveness, pH, total soluble solids, water-retention capacity, and oil-retention capacity. Dried Corchorus olitorius was found to have high bulk density, tapped density, and rehydration capacity on dried weight basis. Leucas aspera powder had a high water absorption index and hydrophilic-lipophilic index. It was found that water activity of all the leaf powders is below 0.5 so they can be stored at room temperature. Physical and functional properties of uncultivated greens powders help in development of value-added products, product-specific equipment, and behavior of leaf powders at processing and packing levels.
The effect of crack characteristics on the mechanical properties and energy characteristics of coal-rock composite structure
Authors: Li Tan
Published: February 2022

With the gradual increase of coal mining intensity, many coal pillars need to be left near the stope. The stability of the composite structure of coal pillars and their overlying strata determines the safety of the whole stope and the surface. This paper conducts uniaxial compression tests on coal-rock composite structures with the same lithology and the same coal-rock height ratio and finds the coal-rock composite structure’s mechanical properties and failure characteristics have greater discreteness. Combining the CT images of rock and coal, it is concluded that the main reason for the discreteness of the composite structure test results is the different crack characteristics in the rock specimen and the coal specimen. Therefore, this paper uses the PFC numerical simulation software to analyzes the influence of the crack characteristics on the mechanical properties, failure characteristics, and impact energy index of the coal-rock composite structure. The sensitivity factors are used to analyze the influence of crack angle, crack length, crack number and crack position on the peak stress, total crack number, and impact energy index of the coal-rock composite structure. The research results can provide a theoretical basis and guidance for preventing the instability and failure of the coal pillar-roof composite structure.
Femtosecond Er-doped fiber laser source tunable from 872 to 1075 nm for two-photon vision studies in humans
Authors: Stachowiak Dorota , Marzejon Marcin , Bogusławski Jakub , Łaszczych Zbigniew , Komar Katarzyna , Wojtkowski Maciej , Soboń Grzegorz
Published: February 2022

We report the development of a widely-tunable femtosecond fiber laser system and its application for two-photon vision studies. The source is based on an Er-doped fiber laser with spectral shift up to 2150 nm, followed by a second harmonic generation module to generate a frequency-doubled beam tunable from 872 to 1075 nm. The source delivers sub-230 fs pulses with nearly-constant duration over the entire tuning range, with output powers between 0.68–1.24 mW, which corresponds to a pulse energy of 13.2–24.1 pJ. Such pulse energy is sufficient for employing a system for measurements of two-photon scotopic spectral sensitivity of two-photon vision in humans. The laser parameters allow for very efficient and safe two-photon stimulation of the human visual system, as proved by a good separation between one- and two-photon thresholds for wavelengths below 950 nm, which we have confirmed for 3 healthy subjects.
Terahertz multimode modulator based on tunable triple-plasmon-induced transparency in monolayer graphene metamaterials
Authors: Zhuo Shanshan , Zhou Fengqi , Liu Yanli , Liu Zhimin , Zhang Xiao , Luo Xin , Qin Yipeng , Yang Guangxin , Ji Cheng , Zhou Zizhuo , Sun Liwen , Liu Ting
Published: February 2022

A simple monolayer graphene metamaterial based on silicon/silica substrates is proposed, and typical triple-plasmon-induced transparency (PIT) is realized in the terahertz band. The physical mechanism is analyzed by coupled mode theory (CMT), and the results of CMT agree well with the finite-difference time-domain simulation. A multimode electro-optical switch can be designed by dynamic tuning, and the modulation degrees of its resonant frequencies are 84.0%, 87.3%, 83.0%, 88.1%, and 76.7%. In addition, triple-PIT gradually degenerates into dual-PIT with a decrease in the length of one bright mode. Interestingly, the group index can reach 770 at

E
f

=

0.8

e
V

, which shows that it can be designed as a slow light device with extraordinary ability. Therefore, the results of this paper are of great significance to the research and design of electro-optical switches and slow light devices in the terahertz band.
Analytical solution of the radiative transfer theory for the coherent backscattering from two-dimensional semi-infinite media
Authors: Hank Philipp , Liemert André , Kienle Alwin
Published: February 2022

An analytical solution for coherent backscattering (CBS) in two dimensions was derived by solving the radiative transfer equation. Particularly, the single scattered radiance from a semi-infinite medium containing perpendicularly illuminated cylinders was obtained. At the boundary, a refractive index mismatch was taken into account. Furthermore, the link between the radiance and the CBS was shown in the small angle approximation. An excellent agreement was found between Monte Carlo simulations and the analytical solution. Additionally, it was shown that the often applied solution in the spatial frequency domain for quantifying the CBS delivered significantly different results compared to the derived exact analytical solution.
Ultra-bright green InGaN micro-LEDs with brightness over 10M nits
Authors: Zhanghu Mengyuan , Hyun Byung-Ryool , Jiang Fulong , Liu Zhaojun
Published: February 2022

An investigation of electrical and optical properties of InGaN micro-scale light-emitting diodes (micro-LEDs) emitting at ∼530 nm is carried out, with sizes of 80, 150, and 200 µm. The ITO as a current spreading layer (CSL) provides excellent device performance. Over 10% external quantum efficiency (EQE) and wall-plug efficiency (WPE), and ultra-high brightness (> 10M nits) green micro-LEDs are realized. In addition, it is observed that better current spreading in smaller devices results in higher EQE and brightness. Superior green micro-LEDs can provide an essential guarantee for a variety of applications.
Control of the acoustic waves generated by intense laser filamentation in water
Authors: Jukna V. , Albert S. , Millon C. , Mahieu B. , Guillermin R. , Rabau G. , Fattaccioli D. , Mysyrowicz A. , Couairon A. , Houard A.
Published: February 2022

Experiments and simulations are performed to study filamentation and generation of acoustic waves in water by loosely focused multi-millijoules laser pulses. When the laser pulse duration is increased from femtosecond to nanosecond duration, a transition is observed from a filamentary propagation with extended and low energy density deposition to a localized breakdown, related to high energy density deposition. The transition suggests that Kerr self-focusing plays a major role in the beam propagation dynamics. As a result, the shape, the amplitude and the spectrum of the resulting pressure wave present a strong dependence on the laser pulse duration.
Compact fiber-integrated scattering device based on mixed-phase TiO2 for speckle spectrometer
Authors: Zhu Runze , Lei Yu , Wan Shengjie , Xiong Yifeng , Wang Yushu , Chen Ye , Xu Fei
Published: February 2022

A universal, repeatable, and controllable integration of single-mode optical fiber and mixed-phase TiO2 is used to manufacture a compact fiber-integrated scattering device. Based on the device, we achieve a high-performance and compact fiber-based speckle spectrometer, which has a resolution of 20 pm over a bandwidth of 15 nm, in the 1550 nm range. We test the capability of our proposed spectrometer to reconstruct narrow linewidth and broadband optical spectrums, and compare the performance with that of a traditional optical spectrum analyzer.
Mapping the gene network landscape of Alzheimer’s disease through integrating genomics and transcriptomics
Authors: Rosenthal Sara Brin , Wang Hao , Shi Da , Liu Cin , Abagyan Ruben , McEvoy Linda K. , Chen Chi-Hua
Published: February 2022

Integration of multi-omics data with molecular interaction networks enables elucidation of the pathophysiology of Alzheimer’s disease (AD). Using the latest genome-wide association studies (GWAS) including proxy cases and the STRING interactome, we identified an AD network of 142 risk genes and 646 network-proximal genes, many of which were linked to synaptic functions annotated by mouse knockout data. The proximal genes were confirmed to be enriched in a replication GWAS of autopsy-documented cases. By integrating the AD gene network with transcriptomic data of AD and healthy temporal cortices, we identified 17 gene clusters of pathways, such as up-regulated complement activation and lipid metabolism, down-regulated cholinergic activity, and dysregulated RNA metabolism and proteostasis. The relationships among these pathways were further organized by a hierarchy of the AD network pinpointing major parent nodes in graph structure including endocytosis and immune reaction. Control analyses were performed using transcriptomics from cerebellum and a brain-specific interactome. Further integration with cell-specific RNA sequencing data demonstrated genes in our clusters of immunoregulation and complement activation were highly expressed in microglia.
Positive-case follow up for lymphatic filariasis after a transmission assessment survey in Haiti
Authors: Hast Marisa A. , Javel Alain , Denis Eurica , Barbre Kira , Rigodon Jonas , Robinson Keri , Brant Tara A. , Wiegand Ryan , Gass Katherine , Telfort Marc Aurèle , Dubray Christine
Published: February 2022

Background

Lymphatic filariasis (LF) has been targeted for global elimination as a public health problem since 1997. The primary strategy to interrupt transmission is annual mass drug administration (MDA) for ≥5 years. The transmission assessment survey (TAS) was developed as a decision-making tool to measure LF antigenemia in children to determine when MDA in a region can be stopped. The objective of this study was to investigate potential sampling strategies for follow-up of LF-positive children identified in TAS to detect evidence of ongoing transmission.

Methodology/Principle findings

Nippes Department in Haiti passed TAS 1 with 2 positive cases and stopped MDA in 2015; however, 8 positive children were found during TAS 2 in 2017, which prompted a more thorough assessment of ongoing transmission. Purposive sampling was used to select the closest 50 households to each index case household, and systematic random sampling was used to select 20 households from each index case census enumeration area. All consenting household members aged ≥2 years were surveyed and tested for circulating filarial antigen (CFA) using the rapid filarial test strip and for Wb123-specific antibodies using the Filaria Detect IgG4 ELISA. Among 1,927 participants, 1.5% were CFA-positive and 4.5% were seropositive. CFA-positive individuals were identified for 6 of 8 index cases. Positivity ranged from 0.4–2.4%, with highest positivity in the urban commune Miragoane. Purposive sampling found the highest number of CFA-positives (17 vs. 9), and random sampling found a higher percent positive (2.4% vs. 1.4%).

Conclusions/Significance

Overall, both purposive and random sampling methods were reasonable and achievable methods of TAS follow-up in resource-limited settings. Both methods identified additional CFA-positives in close geographic proximity to LF-positive children found by TAS, and both identified strong signs of ongoing transmission in the large urban commune of Miragoane. These findings will help inform standardized guidelines for post-TAS surveillance.
Roll eccentricity extraction and compensation based on MPSO-WTD and ITD
Authors: Gao Shanfeng , Xu Lei , Li Yongkang , Ji Jiwen
Published: February 2022

To meet the high thickness accuracy requirements in cold-rolling processes, a roll eccentricity signal extraction method based on modified particle swarm optimization and wavelet threshold denoising (MPSO-WTD) with intrinsic time-scale decomposition (ITD) is proposed. The strong denoising ability of the wavelet is combined with the decomposition and recognition attributes of ITD for non-stationary signals. Periodic disturbances in strip thickness caused by roll eccentricity are actively compensated. First, the wavelet is used to denoise the signal and the MPSO algorithm is applied to determine a rational threshold and improve the calculation efficiency. Then, the denoised signal is decomposed into proper rotational components (PRCs) using the ITD method, and an appropriate PRC component representing the eccentricity signal is extracted. Finally, the eccentricity compensation signal is applied in the automatic gauge control (AGC) system of the cold rolling mill. During the rolling process, the rolling speed is not constant and will directly affect the frequency of the roll eccentricity signal. To solve this problem, an encoder is installed at the end of the roll and the compensation frequency of the roller eccentricity signal is determined in the roller eccentricity compensation system according to the pulse number output. The results of simulations and experiments show that roll eccentricity signals extracted using the proposed method can effectively remove the influence of interference signals. An average improvement of 62.3% in the roll eccentricity compensation effect was achieved under the stable rolling condition in the finishing rolling stage.
Do windy areas have more wind turbines: An empirical analysis of wind installed capacity in Native tribal nations
Authors: Evans Laura E. , Dolšak Nives , Prakash Aseem
Published: February 2022

The decarbonization of the electricity sector is leading to a substantial increase in the demand for wind energy. Will tribal nations, which account for 7.8% of utility-scale wind capacity, benefit from this policy shift? To examine why tribal nations vary in translating wind energy potential into wind installed capacity, we have constructed an original dataset of the potential as well as the location of wind turbines across tribal nations. Our statistical analysis of 286 tribal nations suggests that wind energy potential is not associated with wind installed capacity. Instead, casino square footage, a proxy for tribal nation’s administrative capacity and business acumen, is associated with wind installed capacity. Political orientation plays a role as well: tribal nations are more likely to have wind installed capacity when they value tribal sovereignty. While tribes suffering from natural disasters do not install more wind turbines, those receiving federal grants for wind energy projects, and located in states that already have a substantial number of wind turbines, are more apt to have wind turbines. Surprisingly, tribes located in states with renewable portfolio standards do not show an association with installed wind turbines capacity.
Proteomic analysis of the umbilical cord in fetal growth restriction and preeclampsia
Authors: Conrad Matthew S. , Gardner Miranda L. , Miguel Christine , Freitas Michael A. , Rood Kara M. , Ma’ayeh Marwan
Published: February 2022

Fetal growth restriction (FGR) is associated with adverse perinatal outcomes. Pre-eclampsia (PreE) increases the associated perinatal morbidity and mortality. The structure of the umbilical cord in the setting of FGR and PreE is understudied. This study aimed to examine changes in the umbilical cord (UC) composition in pregnancies complicated by FGR and FGR with PreE. UC from gestational age-matched pregnancies with isolated FGR (n = 5), FGR+PreE (n = 5) and controls (n = 5) were collected, and a portion of the UC was processed for histologic and proteomic analysis. Manual segmentation analysis was performed to measure cross-section analysis of umbilical cord regions. Wharton’s Jelly samples were analyzed on a tims-TOF Pro. Spectral count and ion abundance data were analyzed, creating an intersection dataset from multiple mass spectrometry search and inference engines. UCs from FGR and FGR with PreE had lower cross-sectional area and Wharton’s Jelly area compared with control (p = 0.03). When comparing FGR to control, 28 proteins were significantly different in abundance analysis and 34 in spectral count analysis (p < 0.05). Differential expression analysis between PreE with FGR vs controls demonstrated that 48 proteins were significantly different in abundance and 5 in spectral count. The majority of changes occurred in proteins associated with extracellular matrix, cellular process, inflammatory, and angiogenesis pathways. The structure and composition of the UC is altered in pregnancies with FGR and FGR with PreE. Future work in validating these proteomic differences will enable identification of therapeutic targets for FGR and FGR with PreE.
Prevalence of bacterial vaginosis and aerobic vaginitis and their associated risk factors among pregnant women from northern Ethiopia: A cross-sectional study
Authors: Yalew Gebrehiwet Tesfay , Muthupandian Saravanan , Hagos Kiflom , Negash Letemichael , Venkatraman Gopinath , Hagos Yemane Mengsteab , Meles Hadush Negash , Weldehaweriat Hagos Haileslasie , Al-Dahmoshi Hussein O. M. , Saki Morteza
Published: February 2022

This study aimed to determine the prevalence of bacterial vaginosis (BV) and aerobic vaginitis (AV) and their associated risk factors among pregnant women from Ethiopia. Also, this study investigated the bacterial pathogens and their antibiotic resistance in AV cases. A total of 422 pregnant women from northern Ethiopia were participated in this study. Socio-demographic and clinical data were recorded. Vaginal swabs were collected and used for wet mount and Gram stain methods to evaluate the AV and BV scores according to the Nugent’s and Donder’s criteria, respectively. In AV cases the bacterial pathogens and their antibiotic resistance were determined using standard methods. The possible risk factors for AV and BV in pregnant women were investigated. The prevalence rates of BV and AV were 20.1% (85/422) and 8.1% (34/422), respectively. BV was more common in symptomatic vs. asymptomatic people (P< 0.001), and in second trimester vs. first trimester samples (P= 0.042). However, AV was more common in secondary school vs. primary and those who were unable to read and write (P= 0.021) and in housewife women vs. employee (P= 0.013). A total of 44 bacterial strains were isolated from AV cases, of which the coagulase-negative staphylococci (CoNS) (38.6%) andStaphylococcus aureus(29.5%) were the most predominant bacteria, respectively. The highest resistance rate was observed against penicillin (100.0%) in staphylococci, while 86.7% of them were sensitive to ciprofloxacin. The resistance rate ofEnterobacteriaceaeranged from 0.0% for ciprofloxacin and chloramphenicol to 100.0% against amoxicillin/clavulanate. The prevalence of BV was higher than AV in pregnant women. This higher prevalence of BV suggests that measures should be taken to reduce the undesired consequences related to BV in the pregnancy. The circulation of drug-resistant bacteria in vaginal infections requires a global surveillance to reduce the risks to pregnant mothers and infants.
Detection of maxillary sinus fungal ball via 3-D CNN-based artificial intelligence: Fully automated system and clinical validation
Authors: Kim Kyung-Su , Kim Byung Kil , Chung Myung Jin , Cho Hyun Bin , Cho Beak Hwan , Jung Yong Gi
Published: February 2022

Background

This study aims to develop artificial intelligence (AI) system to automatically classify patients with maxillary sinus fungal ball (MFB), chronic rhinosinusitis (CRS), and healthy controls (HCs).

Methods

We collected 512 coronal image sets from ostiomeatal unit computed tomography (OMU CT) performed on subjects who visited a single tertiary hospital. These data included 254 MFB, 128 CRS, and 130 HC subjects and were used for training the proposed AI system. The AI system takes these 1024 sets of half CT images as input and classifies these as MFB, CRS, or HC. To optimize the classification performance, we adopted a 3-D convolutional neural network of ResNet 18. We also collected 64 coronal OMU CT image sets for external validation, including 26 MFB, 18 CRS, and 20 HCs from subjects from another referral hospital. Finally, the performance of the developed AI system was compared with that of the otolaryngology resident physicians.

Results

Classification performance was evaluated using internal 5-fold cross-validation (818 training and 206 internal validation data) and external validation (128 data). The area under the receiver operating characteristic over the internal 5-fold cross-validation and the external validation was 0.96 ±0.006 and 0.97 ±0.006, respectively. The accuracy of the internal 5-fold cross-validation and the external validation was 87.5 ±2.3% and 88.4 ±3.1%, respectively. As a result of performing a classification test on external validation data from six otolaryngology resident physicians, the accuracy was obtained as 84.6 ±11.3%.

Conclusions

This AI system is the first study to classify MFB, CRS, and HC using deep neural networks to the best of our knowledge. The proposed system is fully automatic but performs similarly to or better than otolaryngology resident physicians. Therefore, we believe that in regions where otolaryngology specialists are scarce, the proposed AI will perform sufficiently effective diagnosis on behalf of doctors.
Updated cost-effectiveness of MDMA-assisted therapy for the treatment of posttraumatic stress disorder in the United States: Findings from a phase 3 trial
Authors: Marseille Elliot , Mitchell Jennifer M. , Kahn James G.
Published: February 2022

Background

Severe posttraumatic stress disorder (PTSD) is a prevalent and debilitating condition in the United States. and globally. Using pooled efficacy data from six phase 2 trials, therapy using 3,4-methylenedioxymethamphetamine (MDMA) appeared cost-saving from a payer’s perspective. This study updates the cost-effectiveness analysis of this novel therapy using data from a new phase 3 trial, including the incremental cost-effectiveness of the more intensive phase 3 regimen compared with the shorter phase 2 regimen.

Methods

We adapted a previously-published Markov model to portray the costs and health benefits of providing MDMA-assisted therapy (MDMA-AT) to patients with chronic, severe, or extreme PTSD in a recent phase 3 trial, compared with standard care. Inputs were based on trial results and published literature. The trial treated 90 patients with a clinician administered PTSD scale (CAPS-5) total severity score of 35 or greater at baseline, and duration of PTSD symptoms of 6 months or longer. The primary outcome was assessed 8 weeks after the final experimental session. Patients received three 90-minute preparatory psychotherapy sessions, three 8-hour active MDMA or placebo sessions, and nine 90-minute integrative psychotherapy sessions. Our model calculates the per-patient cost of MDMA-AT, net all-cause medical costs, mortality, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). We reported results from the U.S. health care payer’s perspective for multiple analytic time horizons, (base-case is 30 years), and conducted extensive sensitivity analyses. Costs and QALYs were discounted by 3% annually. Costs were adjusted to 2020 U.S. dollars according to the medical component of the U.S. Bureau of Labor Statistics’ Consumer Price Index (CPI).

Results

MDMA-AT as conducted in the phase 3 trial costs $11,537 per patient. Compared to standard of care for 1,000 patients, MDMA-AT generates discounted net health care savings of $132.9 million over 30 years, accruing 4,856 QALYs, and averting 61.4 premature deaths. MDMA-AT breaks even on cost at 3.8 years while delivering 887 QALYs. A third MDMA session generates additional medical savings and health benefits compared with a two-session regimen. Hypothetically assuming no savings in health care costs, MDMA-AT has an ICER of $2,384 per QALY gained.

Conclusions

MDMA-AT provided to patients with severe or extreme chronic PTSD is cost-saving from a payer’s perspective, while delivering substantial clinical benefit.
Outcomes of hospitalized patients with COVID-19 during the course of the pandemic in a fully integrated health system
Authors: Lam Brian , Stepanova Maria , Venkatesan Chapy , Garcia Ivan , Reyes Mary , Mannan Ashiq , Groves Soleyah , Desai Mehul , Racila Andrei , Kolacevski Andrej , Henry Linda , Gerber Lynn H. , Younossi Zobair M.
Published: February 2022

Background

Given the rapid spread of COVID-19 and its associated morbidity and mortality, healthcare providers throughout the world have been forced to constantly update and change their care delivery models.

Objective

To assess the outcomes of COVID-19 hospitalized patients during the course of the pandemic in a well-integrated health system.

Methods

The study used data from the electronic health medical records to assess trends in clinical profile and outcomes of hospitalized adult COVID-19 patients hospitalized in our 5-hospital health system from March 2020-May 2021 (n = 6865). Integration of the health system began in February 2020 and was fully actualized by March 30, 2020.

Results

Mortality decreased from 15% during first peak (March-May 2020; the rate includes 19% in March-April and 10% in May 2020) to 6% in summer-fall 2020, increased to 13% during the second peak (November 2020-January 2021), and dropped to 7% during the decline period (February-May 2021) (p<0.01). Resource utilization followed a similar pattern including a decrease in ICU use from 35% (first peak) to 16% (decline period), mechanical ventilation from 16% (first peak, including 45% in March 2020) to 9–11% in subsequent periods (p<0.01). Independent predictors of inpatient mortality across multiple study periods included older age, male sex, higher multi-morbidity scores, morbid obesity, and indicators of severe illness on admission such as oxygen saturation ≤90% and high qSOFA score (all p<0.05). However, admission during the first peak remained independently associated with increased mortality even after adjustment for patient-related factors: odds ratio = 1.8 (1.4–2.4) (p<0.0001).

Conclusions

The creation of a fully integrated health system allowed us to dynamically respond to the everchanging COVID-19 landscape. In this context, despite the increasing patient acuity, our mortality and resource utilization rates have improved during the pandemic.
Evaluation of left ventricular diastolic function in patients operated for aortic stenosis
Authors: Hultkvist Henrik , Nylander Eva , Tamás Éva , Svedjeholm Rolf , Engvall Jan , Holm Jonas , Maret Eva , Vánky Farkas
Published: February 2022

Background

Left ventricular diastolic dysfunction is common in patients with aortic valve stenosis (AS) and reportedly affects prognosis after surgical aortic valve replacement (SAVR). Here we investigated whether and how diastolic function (assessed following the most recent guidelines) was affected by SAVR, and whether preoperative diastolic function affected postoperative outcome. We also examined whether long-term mortality was associated with preoperative NT-proBNP and postoperative heart failure (PHF).

Methods

We performed a prospective observational study of 273 patients with AS who underwent AVR with or without concomitant coronary artery bypass surgery. Of these patients, 247 were eligible for assessment of left ventricular (LV) filling pressure. Preoperatively and at the 6-month postoperative follow-up, we measured N-terminal pro-B type natriuretic peptide (NT-proBNP) in serum and assessed diastolic function with Doppler echocardiography. PHF was diagnosed using prespecified criteria. Multivariable logistic regression was performed to explore variables associated with high LV filling pressure. Cox regression was performed to explore variables associated with mortality, accounting for timeto-event.

Results

At the time of surgery, 22% (n = 54) of patients had diastolic dysfunction expressed as high LV filling pressure. Of these 54 patients, 27 (50%) showed postoperative diastolic function improvement. Among the 193 patients with preoperative low LV filling pressure, 24 (12%) showed postoperative diastolic function deterioration. Increased long-term mortality was associated with PHF and high preoperative NT-proBNP, but not with preoperative or postoperative diastolic dysfunction. Cox regression revealed the following independent risk factors for long-term mortality: diabetes, renal dysfunction, preoperative NT-proBNP>960 ng/L, age, and male gender.

Conclusions

Surgery for aortic stenosis improved diastolic function in patients with high LV filling pressure in 50% of the patients. Our results could not confirm the previously suggested role of diastolic dysfunction as a marker for poor long-term survival after SAVR. Our findings showed that both PHF and high preoperative NT-proBNP were associated with long-term mortality.
Vaccination status and factors associated among children age 12–23 months in Ethiopia, based on 2016 EDHS: Logit based multinomial logistic regression analysis
Authors: Enyew Ermias Bekele , Tareke Abiyu Abadi
Published: February 2022

Background

Childhood immunization is one of the most cost-effective prevention measures for children’s mortality and morbidity, saving 2–3 million lives per year. In Ethiopia, under-five mortality rates, about 190,000 children die each year. Different research conducted in Ethiopia on childhood vaccination have focused on either vaccination coverage of individual vaccine or complete and incomplete vaccination. As far as my literature searching, studies separated the vaccination status into non-vaccinated, partially vaccinated and full vaccinated and assorted factors among children age 12–23 month in Ethiopia were limited. Therefore, the aim of this study was to identify factors associated with vaccination status among children 12–23 months of age in Ethiopia.

Method

A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A total weighted sample of 1911 children age 12–23 months of age were included in the study. Logit based Multinomial logistic regression analysis was computed to distinguish factors associated with routine vaccination of children aged 12–23 months. P-value less than 0.05 was used to declare statistical significance of each independent variables, and adjusted odd ratio (AOR) with 95% confidence interval were used to present the result and STATA 14 was utilized for data management and analysis.

Result

Overall the prevalence of full vaccinated children was 35%, while 49% of children were partially vaccinated and 16% were non-vaccinated. In multinomial analysis, having focused ANC (at least four visits) contrasted to no ANC visits at all had 9.7 higher odd of being fully vaccinated than not vaccinated [AOR = 9.74, 95% CI = 3.52–26.94], and 5 times higher odd of being partially vaccinated than not vaccinated [AOR = 4.97, 95% CI = 2.00–12.33].

Conclusion

The present study found that childhood full vaccination status was low compared with the World Health Organization targets. Frequency of ANC visit and visited by field worker were significantly associated both partially and full vaccination whereas, visited health facility last 12 months and wealth status were significantly associated with childhood full vaccination.
Novel prognostic determinants of COVID-19-related mortality: A pilot study on severely-ill patients in Russia
Authors: Rubina Kseniya , Shmakova Anna , Shabanov Aslan , Andreev Yulii , Borovkova Natalia , Kulabukhov Vladimir , Evseev Anatoliy , Popugaev Konstantin , Petrikov Sergey , Semina Ekaterina
Published: February 2022

COVID-19 pandemic has posed a severe healthcare challenge calling for an integrated approach in determining the clues for early non-invasive diagnostics of the potentially severe cases and efficient patient stratification. Here we analyze the clinical, laboratory and CT scan characteristics associated with high risk of COVID-19-related death outcome in the cohort of severely-ill patients in Russia. The data obtained reveal that elevated dead lymphocyte counts, decreased early apoptotic lymphocytes, decreased CD14+/HLA-Dr+ monocytes, increased expression of JNK in PBMCs, elevated IL-17 and decreased PAI-1 serum levels are associated with a high risk of COVID-19-related mortality thus suggesting them to be new prognostic factors. This set of determinants could be used as early predictors of potentially severe course of COVID-19 for trials of prevention or timely treatment.
Does attention bias modification reduce anxiety in socially anxious college students? An experimental study of potential moderators and considerations for implementation
Authors: Neophytou Klavdia , Panayiotou Georgia
Published: February 2022

According to cognitive models, preferential attention to social threat contributes to maintenance of social anxiety. Socially anxious individuals are known to show attention biases to threatening stimuli, although there is inconsistency in the literature with regards to the type of attentional biases they present. This study examines the effect of attention bias modification (ABM) for social anxiety in non-treatment-seeking college students meeting social anxiety disorder criteria, taking into consideration previous mixed results regarding its effectiveness. Attention bias levels and types (i.e. vigilance vs avoidance) at baseline were examined and considered as potential moderators of ABM effects. Sixty-eight socially anxious individuals were randomly allocated to ABM vs placebo groups. A structured interview and self-report assessment were completed at pre-treatment and post-treatment. Results showed half of the participants presented few attention biases at baseline, and the rest presented either vigilance or avoidance. Participants with low attention biases scored higher in social anxiety than those showing avoidance and there was no difference between those showing vigilance vs avoidance. No significant effects from pre to post treatment were observed in attention biases, self-report or structured interview of anxiety in the ABM group. Baseline attention biases did not moderate these effects. Results are discussed with regards to implications for future research towards the creation of more effective protocols, based on the needs of heterogeneous social anxiety sub-groups.
Relationship between HbA1c, fructosamine and clinical assessment of glycemic control in dogs
Authors: Norris Olga , Schermerhorn Thomas
Published: February 2022

Background

Serum fructosamine is a routine test used for clinical monitoring of diabetes mellitus (DM) but the usefulness of HbA1c for this purpose has not been extensively studied.

Hypothesis

The study aimed to compare the ability of blood HbA1c and serum fructosamine tests to correctly classify DM control determined using a clinically-based assessment.

Animals

28 client-owned dogs with naturally-occurring diabetes mellitus.

Methods

Cross-sectional observational study. Ability of fructosamine and HbA1c tests to classify diabetes control in dogs was determined.

Results

Clinical assessment classified 50% of dogs as having good diabetic control and 82% as having acceptable diabetic control. Analysis using Cohen’s kappa test showed that agreements between fructosamine and HbA1c results and the clinical assessment ranged from poor to fair. Fructosamine and HbA1c results from each dog showed a moderate correlation. Overall, the HbA1c test showed the best agreement with the clinical assessment when diabetes control was considered either acceptable or unacceptable, although the strength of agreement was considered fair (kappa = 0.27).

Conclusions and clinical importance

The HbA1c concentration was found to be more consistent with clinical evaluation of diabetes control than was the serum fructosamine concentration. The HbA1c level is a useful tool for assessment of glycemic status in diabetic dogs but should be used alongside other tests for outpatient monitoring of clinically stable diabetic dogs.
Factor analysis, sparse PCA, and Sum of Ranking Differences-based improvements of the Promethee-GAIA multicriteria decision support technique
Authors: Abonyi János , Czvetkó Tímea , Kosztyán Zsolt T. , Héberger Károly
Published: February 2022

The Promethee-GAIA method is a multicriteria decision support technique that defines the aggregated ranks of multiple criteria and visualizes them based on Principal Component Analysis (PCA). In the case of numerous criteria, the PCA biplot-based visualization do not perceive how a criterion influences the decision problem. The central question is how the Promethee-GAIA-based decision-making process can be improved to gain more interpretable results that reveal more characteristic inner relationships between the criteria. To improve the Promethee-GAIA method, we suggest three techniques that eliminate redundant criteria as well as clearly outline, which criterion belongs to which factor and explore the similarities between criteria. These methods are the following: A) Principal factoring with rotation and communality analysis (P-PFA), B) the integration of Sparse PCA into the Promethee II method (P-sPCA), and C) the Sum of Ranking Differences method (P-SRD). The suggested methods are presented through an I4.0+ dataset that measures the Industry 4.0 readiness of NUTS 2-classified regions. The proposed methods are useful tools for handling multicriteria ranking problems, if the number of criteria is numerous.
Assessment of need for hemostatic evaluation in patients taking valproic acid: A retrospective cross-sectional study
Authors: Post Demi S. , van der Veer Arian , Schijns Olaf E. M. G. , Klinkenberg Sylvia , Rijkers Kim , Wagner G. Louis , van Kranen-Mastenbroek Vivianne H. J. M. , Willems Paul C. P. H. , Verhezen Paul W. M. , Beckers Erik A. M. , Heubel-Moenen Floor C. J. I. , Henskens Yvonne M. C.
Published: February 2022

Introduction

Valproic acid (VPA) is a frequently prescribed anti-epileptic drug. Since its introduction side effects on hemostasis are reported. However, studies show conflicting results, and the clinical relevance is questioned. We aimed to determine the coagulopathies induced by VPA in patients who undergo high-risk surgery. The study results warrant attention to this issue, which might contribute to reducing bleeding complications in future patients.

Methods

Between January 2012 and August 2020, 73 consecutive patients using VPA were retrospectively included. Extensive laboratory hemostatic assessment (including platelet function tests) was performed before elective high-risk surgery. Patient characteristics, details of VPA treatment, and laboratory results were extracted from medical records.

Results

46.6% of the patients using VPA (n = 73) showed coagulopathy. Mainly, platelet function disorder was found (36.4%). Thrombocytopenia was seen in 9.6% of the patients. Data suggested that the incidence of coagulopathies was almost twice as high in children as compared to adults and hypofibrinogenemia was only demonstrated in children. No association was found between the incidence of coagulopathies and VPA dosage (mg/kg/day).

Conclusion

A considerable number of patients using VPA were diagnosed with coagulopathy, especially platelet function disorder. Further prospective studies are needed to confirm the need for comprehensive laboratory testing before elective high-risk surgery in these patients.
Infantile subdural hematoma in Japan: A multicenter, retrospective study by the J-HITs (Japanese head injury of infants and toddlers study) group
Authors: Akutsu Nobuyuki , Nonaka Masahiro , Narisawa Ayumi , Kato Mihoko , Harada Atsuko , Park Young-Soo
Published: February 2022

Objective

Subdural hematoma in infants or toddlers has often been linked to abuse, but it is not clear how many cases actually occur and how many are suspected of abuse. The purpose of this study was to investigate subdural hematoma in infants and toddlers in Japan.

Methods

This multicenter, retrospective study reviewed the clinical records of children younger than 4 years with head trauma who were diagnosed with any finding on head computed tomography (CT) and/or magnetic resonance imaging (MRI), such as skull fracture and/or intracranial injury. A total of 452 children were included. The group suspected to have been abused was classified as nonaccidental, and the group considered to have been caused by an accident was classified as accidental. Subdural hematoma and other factors were examined on multivariate analysis to identify which factors increase the risk of nonaccidental injuries.

Results

Of the 452 patients, 158 were diagnosed with subdural hematoma. Subdural hematoma was the most common finding intracranial finding in head trauma in infants and toddlers. A total of 51 patients were classified into the nonaccidental group, and 107 patients were classified into the accidental group. The age of patients with subdural hematoma showed a bimodal pattern. The mean age of the accidental group with subdural hematoma was significantly older than that in the nonaccidental group (10.2 months vs 5.9 months, respectively. p < 0.001). Multivariate analysis showed that patients under 5 months old, retinal hemorrhage, and seizure were significant risk factors for nonaccidental injury (odds ratio (OR) 3.86, p = 0.0011; OR 7.63, p < 0.001; OR 2.49, p = 0.03; respectively). On the other hand, the odds ratio for subdural hematoma was 1.96, and no significant difference was observed (p = 0.34).

Conclusions

At least in Japanese children, infantile subdural hematoma was frequently observed not only in nonaccidental but also in accidental injuries. In infants with head trauma, age, the presence of retinal hemorrhage, and the presence of seizures should be considered when determining whether they were abused. Subdural hematoma is also a powerful finding to detect abuse, but care should be taken because, in some ethnic groups, such as the Japanese, there are many accidental cases.
Pediatric growth hormone treatment in Italy: A systematic review of epidemiology, quality of life, treatment adherence, and economic impact
Authors: Orso Massimiliano , Polistena Barbara , Granato Simona , Novelli Giuseppe , Di Virgilio Roberto , La Torre Daria , d’Angela Daniela , Spandonaro Federico
Published: February 2022

Objectives

This systematic review aims to describe 1) the epidemiology of the diseases indicated for treatment with growth hormone (GH) in Italy; 2) the adherence to the GH treatment in Italy and factors associated with non-adherence; 3) the economic impact of GH treatment in Italy; 4) the quality of life of patients treated with GH and their caregivers in Italy.

Methods

Systematic literature searches were performed in PubMed, Embase and Web of Science from January 2010 to March 2021. Literature selection process, data extraction and quality assessment were performed by two independent reviewers. Study protocol has been registered in PROSPERO (CRD42021240455).

Results

We included 25 studies in the qualitative synthesis. The estimated prevalence of growth hormone deficiency (GHD) was 1/4,000–10,000 in the general population of children; the prevalence of Short Stature HOmeoboX Containing gene deficiency (SHOX-D) was 1/1,000–2,000 in the general population of children; the birth prevalence of Turner syndrome was 1/2,500; the birth prevalence of Prader-Willi syndrome (PWS) was 1/15,000. Treatment adherence was suboptimal, with a range of non-adherent patients of 10–30%. The main reasons for suboptimal adherence were forgetfulness, being away from home, pain/discomfort caused by the injection. Economic studies reported a total cost for a complete multi-year course of GH treatment of almost 100,000 euros. A study showed that drug wastage can amount up to 15% of consumption, and that in some Italian regions there could be a considerable over- or under-prescribing. In general, patients and caregivers considered the GH treatment acceptable. There was a general satisfaction among patients with regard to social and school life and GH treatment outcomes, while there was a certain level of intolerance to GH treatment among adolescents. Studies on PWS patients and their caregivers showed a lower quality of life compared to the general population, and that social stigma persists.

Conclusion

Growth failure conditions with approved GH treatment in Italy constitute a significant burden of disease in clinical, social, and economic terms. GH treatment is generally considered acceptable by patients and caregivers. The total cost of the GH treatment is considerable; there are margins for improving efficiency, by increasing adherence, reducing drug wastage and promoting prescriptive appropriateness.