bluuebunny/crossref_metadata_2025 huggingface dataset:
SNPE-SRGAN: Lightweight Generative Adversarial Networks for Single-Image Super-Resolution on Mobile Using SNPE Framework
Authors: Tampubolon Hendrik , Setyoko Aji , Purnamasari Fanindia
Published: June 2021

An image resulting from a low-resolution (LR) camera on the mobile phone has lower quality than a high-resolution(HR) camera on a DSLR. Meanwhile, the HR camera is pricing if compared with the LR camera. How to achieve a single-image quality on LR camera likewise on HR camera becomes essential research in the past years. Addressing this issue can be done by upscaling a single LR image. Recently, the super-resolution generative adversarial network (SRGAN) model is one of the state-of-the-art super-resolution(SR)models employed on single-image SR. However, implementing a deep learning model like SRGAN on a mobile device is challenging in computation power and resources. This study aims to develop a smaller and lower resources model while preserving single-image SR quality on mobile devices. To meet these objectives, we convert, quantize, and compress the SRGAN model on Snapdragon Neural Processing Engine (SNPE) as an example. We then validate the SRGAN on the DIV2K dataset on which improves the model performances. Besides, we conduct experiments on GPU, DSP environment. The experimental result confirmed that SNPE-SRGAN capable of achieves not only HR images’ quality but also low latency by 0.06 second and smaller model by 1.7 Mb size running on DSP. Also, the SRGAN-DLC-Quantized running on GPU has a smaller size by 1.7 Mb and lower latency by 1.151 seconds compared with Non-quantized SRGAN-TensorFlow by 9.1 Mb and 1.608 seconds latency.
Classification of Facial Expression Recognition using Machine Learning Algorithms
Authors: Abinaya D , Priyanka C , Rocky Stefinjain M , Prasanna Venkatesan G.K. D , Kamalraj S.
Published: June 2021

Face is the reflection of brain facial expressions are the discernible consequences of moving a facial muscle. In the perception of human articulations, the facial expression like Sad, Happy, Anger, Disgust, Fear is assumes a fundamental part. The objective of this research focuses on facial expression recognition which related to machine learning and optimization algorithms. Here, we proposed Hybrid Adaptive Kernel based Extreme Learning Machine (HAKELM) algorithm to identify the human facial expression based on certain image processing technique. Thus, the obtained results shown the proposed HAKELM scheme achieved 10% more accuracy, sensitivity and specificity than existing algorithms like Principal Component Analysis (PCA) and Support Vector Machine (SVM).
A Systematic Review on Lumbar Alignment Device’s Mechanism Using Sensor Fusion Technology
Authors: Jerome Christhudass A. , Manimegalai P. , Leo A. , Kumara Pillai K. , Thanga Helina S.
Published: June 2021

Good posture reflects a proper state of mind which let anyone get away with anything but people nowadays, is experiencing loads of work burden that are resulting in a bad posture. In this work the role of sensors in posture corrector devices are reviewed. Multiple techniques with different applications are used to detect, identify, and classify the lower lumbar spine movement. In the review multiple sensors employed in posture correctors are reviewed. Each sensor has a different working principle, its own advantages and disadvantages in this review, each paper had different methods and sensors. They are used in the devices according to their functions to get the exact expected output.
Block Chain for Efficient Indian Health Care System Implementation
Authors: Clement Sudhahar J. , Amudha R.
Published: June 2021

Health care is undergoing a major transformation worldwide due to technological advancements and increase in number of diseases. In the wake of current pandemic Covid ‘19 impact across the Globe, stresses the need to overhaul the Health Management system in a large country like India. A country with two-thirds of population living in rural setting, their access to quality Health System is dubious. In Urban setting also the availability of affordable and accessible health care also left a lot to be of concern. Block Chain Technology integration in all the facets of Health care management can cut costs and dramatically improve accessibility and affordability for all segments of people in India. Suggested Block Chain Modules integration and implementation measures emanating from this study in delivering different medicines and paramedics support aims at rendering efficiency to this strained system. Hence this study acclaims on the key performance metrics on health care system to be integrated with the efficient block chain implementation in India.
A Novel Reversible Carry Look Ahead Adder for Bio-Medical Applications
Authors: Sharmila Devi S , Bhanumathi V
Published: June 2021

Reversible logic is becoming more important in VLSI architecture in order to minimize power dissipation. In computational technologies like digital signal processing, nanotechnology, low-power CMOS, etc., this logic is used. If it comprises an equal count of inputs and an equal count of outputs that provide mapping, it is said to be reversible. This research work shows the realization of a Carry Look ahead Adder (CLA) using Reversible Partial Adder (RPA) and Peres Gate (PG) that achieves speed through parallel carry computations. By comparing the introduced research to previous work, the adder circuit’s output is measured. The simulation results indicate that the proposed reversible CLA achieves better area, power and delay reduction. The adder circuit can be incorporated as a useful feature in the low power design for biomedical devices because it is energy efficient and highly durable.
Early Detection of Diabetic Foot Ulcer
Authors: Sangam V. G. , Hema Priyadarshini S. , Anand Nishita , Prathibha P , Purohit Payal , Nalamitha Reeth
Published: June 2021

A lesion or wound that occurs in the foot due to diabetic complications like Neuropathy and Peripheral Vascular Disease, is known as a diabetic foot ulcer. Diabetic Foot Ulceration (DFU) can cause amputation in up to 85% of the cases. In gait and podiatric research, and orthotic applications to prevent foot ulceration, foot pressure is vital parameter. The disadvantage of traditional systems is, it is tedious and expensive. In this paper, we look in to the early detection of diabetic foot ulcer using a device consisting of a sensor array used to assess various parameters. Plantar pressure, temperature and PPG are the main parameters viewed in this paper.
Variety of structure and changes in the properties of building composites over time
Authors: Korobko O , Urazmanova N , Grynyova I , Dudnik L
Published: June 2021

The potential possibility of increasing the level of mechanical properties of composites on mineral binders remains during the long period. The initial structures hereditarily determine the change of the properties of the finished material in time. It can be assumed that an increase in the structural diversity of concretes should lead to such the organization of a structure that will guarantee the preservation or increase of the level of quality indicators at long terms of hardening (up to 720 days). The conducted researches showed that concrete of long hardening with the structure organized at selective adhesion of a cement matrix to the surface of dense or porous aggregates differed are more resistant to external influences. That is, those concretes, organization of structure which happened under the conditions of diversity of interphase interactions at the level of a macrostructure. This was ensured by the use of aggregates with various condition of a surface. The directed change of a ratios of adhesive-cohesive bonding forces at the surfaces of partition between a cement part and the surface of an aggregates provided structures, which caused increase the compressive strength of concrete by 18% and the module of elasticity by 24% at reducing the water by 29-36% and the open capillary pore volume by 44%. The structure of concrete organized at selective adhesion was the densest in comparison with of concrete of other structures. At the same time, the damage of material by technological cracks and inner surfaces of partition has grown more for concrete, the structure of which was provided by a variety of conditions of interactions between the cement matrix and aggregates. Favourable change of the parameters of these elements, along with the processes of hydration of relict binder grains, causes an improvement in time of indicators of the mechanical and deformative properties of concrete. Thus, structural diversity determines the potential changes of the concrete structure at long-hardening that must be taken into account at designing compositions and technology of the concrete, intended for difficult operating conditions.
Internal surface roughness measurement of metal additively manufactured samples via x-ray CT: the influence of surrounding material thickness
Authors: Lifton Joseph John , Liu Yuchan , Tan Zheng Jie , Mutiargo Bisma , Goh Xue Qi , Malcolm Andrew Alexander
Published: June 2021

X-ray computed tomography (XCT) can be used to measure the internal and external surfaces of an object non-destructively and with micron-level spatial resolution. XCT is therefore an appealing method for measuring and characterising the internal surface roughness of additively manufactured parts that cannot be accessed by traditional tactile and optical surface roughness instruments. In this work, an additively manufactured aluminium spherical surface roughness sample is designed, fabricated and its surface roughness measured via a focus variation microscope, the sample is then XCT scanned when embedded in varying thicknesses of surrounding material. A quantitative and qualitative comparison between the optical and XCT surface roughness measurements is made; the results show that the Sa of the XCT-based surface roughness measurements increases as a function of surrounding material thickness.
Comparison between patient-specific deep brain stimulation simulations and commercial system SureTune3
Authors: Johansson Johannes D , Zsigmond Peter
Published: June 2021

Objective. Software to visualize estimated volume of tissue activated (VTA) in deep brain stimulation assuming a homogeneous tissue surrounding such as SureTune3 has recently become available for clinical use. The objective of this study is to compare SureTune3 with homogeneous and heterogeneous patient-specific finite element method (FEM) simulations of the VTA to elucidate how well they coincide in their estimates. Approach. FEM simulations of the VTA were performed in COMSOL Multiphysics and compared with VTA from SureTune3 with variation of voltage and current amplitude, pulse width, axon diameter, number of active contacts, and surrounding homogeneous grey or white matter. Patient-specific simulations with heterogeneous tissue were also performed. Main results. The VTAs corresponded well for voltage control in homogeneous tissue, though with the smallest VTAs being slightly larger in SureTune3 and the largest VTAs being slightly larger in the FEM simulations. In current control, FEM estimated larger VTAs in white matter and smaller VTAs in grey matter compared to SureTune3 as grey matter has higher electric conductivity than white matter and requires less voltage to reach the same current. The VTAs also corresponded well in the patient-specific cases except for one case with a cyst of highly conductive cerebrospinal fluid (CSF) near the active contacts. Significance. The VTA estimates without taking the surrounding tissue into account in SureTune3 are in good agreement with patient-specific FEM simulations when using voltage control in the absence of CSF-filled cyst. In current control or when CSF is present near the active contacts, the tissue characteristics are important for the VTA and needs consideration. Clinical. trial ethical approval: Local ethics committee at Linköping University (2012/434-31).
Spatial variation in the intensity of interactions via heterospecific pollen transfer may contribute to local and global patterns of plant diversity
Authors: Arceo-Gómez Gerardo
Published: June 2021

Background

Studies that aim to understand the processes that generate and organize plant diversity in nature have a long history in ecology. Among these, the study of plant–plant interactions that take place indirectly via pollinator choice and floral visitation has been paramount. Current evidence, however, indicates that plants can interact more directly via heterospecific pollen (HP) transfer and that these interactions are ubiquitous and can have strong fitness effects. The intensity of HP interactions can also vary spatially, with important implications for floral evolution and community assembly.

Scope

Interest in understanding the role of heterospecific pollen transfer in the diversification and organization of plant communities is rapidly rising. The existence of spatial variation in the intensity of species interactions and their role in shaping patterns of diversity is also well recognized. However, after 40 years of research, the importance of spatial variation in HP transfer intensity and effects remains poorly known, and thus we have ignored its potential in shaping patterns of diversity at local and global scales. Here, I develop a conceptual framework and summarize existing evidence for the ecological and evolutionary consequences of spatial variation in HP transfer interactions and outline future directions in this field.

Conclusions

The drivers of variation in HP transfer discussed here illustrate the high potential for geographic variation in HP intensity and its effects, as well as in the evolutionary responses to HP receipt. So far, the study of pollinator-mediated plant–plant interactions has been almost entirely dominated by studies of pre-pollination interactions even though their outcomes can be influenced by plant–plant interactions that take place on the stigma. It is hence critical that we fully evaluate the consequences and context-dependency of HP transfer interactions in order to gain a more complete understanding of the role that plant–pollinator interactions play in generating and organizing plant biodiversity.
Effects of noninherited ancestral genotypes on offspring phenotypes†
Authors: Cullen Sean M , Hassan Nora , Smith-Raska Matthew
Published: June 2021

It is well established that environmental exposures can modify the profile of heritable factors in an individual’s germ cells, ultimately affecting the inheritance of phenotypes in descendants. Similar to exposures, an ancestor’s genotype can also affect the inheritance of phenotypes across generations, sometimes in offspring who do not inherit the genetic aberration. This can occur via a variety of prenatal, in utero, or postnatal mechanisms. In this review, we discuss the evidence for this process in mammals, with a focus on examples that are potentially mediated through the germline, while also considering alternate routes of inheritance. Noninherited ancestral genotypes may influence descendant’s disease risk to a much greater extent than currently appreciated, and focused evaluation of this phenomenon may reveal novel mechanisms of inheritance.
Bayesian multiregional clinical trials using model averaging
Authors: Bean Nathan W , Ibrahim Joseph G , Psioda Matthew A
Published: June 2021

Multiregional clinical trials (MRCTs) provide the benefit of more rapidly introducing drugs to the global market; however, small regional sample sizes can lead to poor estimation quality of region-specific effects when using current statistical methods. With the publication of the International Conference for Harmonisation E17 guideline in 2017, the MRCT design is recognized as a viable strategy that can be accepted by regional regulatory authorities, necessitating new statistical methods that improve the quality of region-specific inference. In this article, we develop a novel methodology for estimating region-specific and global treatment effects for MRCTs using Bayesian model averaging. This approach can be used for trials that compare two treatment groups with respect to a continuous outcome, and it allows for the incorporation of patient characteristics through the inclusion of covariates. We propose an approach that uses posterior model probabilities to quantify evidence in favor of consistency of treatment effects across all regions, and this metric can be used by regulatory authorities for drug approval. We show through simulations that the proposed modeling approach results in lower MSE than a fixed-effects linear regression model and better control of type I error rates than a Bayesian hierarchical model.
Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables
Authors: Back E , Häggström J , Holmgren K , Haapamäki M M , Matthiessen P , Rutegård J , Rutegård M
Published: June 2021

Background

A permanent stoma after anterior resection for rectal cancer is common. Preoperative counselling could be improved by providing individualized accurate prediction modelling.

Methods

Patients who underwent anterior resection between 2007 and 2015 were identified from the Swedish Colorectal Cancer Registry. National Patient Registry data were added to determine presence of a stoma 2 years after surgery. A training set based on the years 2007–2013 was employed in an ensemble of prediction models. Judged by the area under the receiving operating characteristic curve (AUROC), data from the years 2014–2015 were used to evaluate the predictive ability of all models. The best performing model was subsequently implemented in typical clinical scenarios and in an online calculator to predict the permanent stoma risk.

Results

Patients in the training set (n = 3512) and the test set (n = 1136) had similar permanent stoma rates (13.6 and 15.2 per cent). The logistic regression model with a forward/backward procedure was the most parsimonious among several similarly performing models (AUROC 0.67, 95 per cent c.i. 0.63 to 0.72). Key predictors included co-morbidity, local tumour category, presence of metastasis, neoadjuvant therapy, defunctioning stoma use, tumour height, and hospital volume; the interaction between age and metastasis was also predictive.

Conclusion

Using routinely available preoperative data, the stoma outcome at 2 years after anterior resection for rectal cancer can be predicted fairly accurately.
Flexible sodium-ion batteries using electrodes from Samanea saman tree leaf-derived carbon quantum dots decorated with SnO2 and NaVO3
Authors: Thangaraj Baskar , Chuangchote Surawut , Wongyao Nutthapon , Solomon Pravin Raj , Roongraung Kamonchanok , Chaiworn Wachira , Surareungchai Werasak
Published: June 2021

Carbonaceous materials with large interlayer spacing and disordered structure are considered suitable as electrodes in sodium-ion batteries so as to overcome the problem encountered in conventional electrodes. In this study, carbon quantum dots (CQDs) decorated with SnO2 and NaVO3 are used as electrodes in the fabrication of flexible Na-ion batteries. CQDs are prepared from dead leaves of the Samanea saman tree through alkaline-peroxide treatment and hydrothermal carbonization. As-prepared CQDs exhibit a quantum yield of 21.03% at an excitation wavelength of 360 nm. Various separators such as indium-doped tin oxide/polyoxyethylene tridecyl ether (ITO/PTE), rice paper (RP), silicone with three big holes (SIL BH), silicone with many small holes (SIL SH) and cellulose paper (CP) have been tried in flexible Na-ion batteries. SIL SH achieved higher specific capacitance (881 F g–1) than other separators due to the function of many small holes on the surface of the silicone. The SIL SH separator delivered higher discharge capacities of 141 and 114 mC g–1 at 1.5 and 2.5 V than SIL BH. The RP separator delivered specific discharge capacities of 1087 and 347 mC g–1 in the 1st and 50th cycles, respectively, at 1 V. The RP separator delivered a high initial specific discharge capacity of 698 mC g–1 at 2 V and maintained a good discharge capacity of 222 mC g–1 in the 50th cycle. As compared to RP, SIL SH delivered high specific discharge capacity of 4246 in 1st cycle at 2 V but maintained a capacity of 71 mC g–1 in the 50th cycle. This study reveals the scope of developing flexible Na-ion batteries with high capacity and cyclability using carbonaceous materials derived from the leaves of the S. saman tree.

Carbon quantum dots (CQDs)-decorated with SnO2 and NaVO3 are used as electrodes in the fabrication of flexible Na-ion batteries. CQDs exhibit a quantum yield of 21% at the excitation wavelength of 360 nm. The electrochemical performances of fabricated batteries are investigated by cyclic voltammetry.
Local anesthetics for the Nephrologist
Authors: Uppal Nupur N , Jhaveri Mital , Hong Susana , Shore-Lesserson Linda , Jhaveri Kenar D , Izzedine Hassan
Published: June 2021

Several specialists in medicine use local anesthetics. In patients with kidney disease, these agents are used during catheter insertions for hemodialysis and peritoneal dialysis, arteriovenous fistula and graft procedures, kidney transplantation, parathyroidectomy, kidney biopsies, and dental and skin procedures. Patients on chronic hemodialysis use a topical application prior to use of needles for arteriovenous fistula cannulation before starting dialysis. They are also used to manage acute and chronic pain conditions, in regional nerve blockade and in multi-modal enhanced recovery protocols. Despite their frequent use by both physicians and patients, data on the use of local anesthetics in patients with kidney impairment are not well reported. This review will summarize the use of local anesthetics in chronic kidney disease, describe their pharmacology and the impact of lower estimated glomerular filtration rate on their pharmacokinetics, and suggest dose regulation in those with kidney dysfunction.
Association between computed tomography-derived tricuspid annular dimensions and prognosis: insights from whole-beat computed tomography assessment
Authors: Hirasawa Kensuke , Fortuni Federico , van Rosendael Philippe J , Ajmone Marsan Nina , Bax Jeroen J , Delgado Victoria
Published: June 2021

Aims

Tricuspid regurgitation (TR) has been associated with outcome in patients treated with transcatheter aortic valve implantation (TAVI). Tricuspid annulus (TA) dimensions are associated with TR. However, the TA is highly dynamic during the cardiac cycle, and the interaction between the TA dimensions, TR, and patient prognosis has never been evaluated. This study aimed to characterize the dynamics of the TA along with the cardiac cycle and its association with prognosis in patients undergoing TAVI.

Methods and results

Patients with severe aortic stenosis who underwent whole-beat computed tomography (n = 393, mean age 80 ± 7 years, 53% male) were included. The ratio between anterior-posterior (AP) and septal-lateral (SL) diameter of the TA was calculated at end-systole (ES), mid-diastole (MD), and end-diastole (ED) to characterize the TA shape throughout the cardiac cycle. The primary endpoint was all-cause mortality. During a median follow-up of 3.6 (1.7–5.5) years, 146 patients died. While all the TA parameters at ES and MD were not associated with all-cause mortality, a low AP/SL ratio at ED (more circular geometry) was independently related with all-cause mortality (hazard ratio: 4.717, 95% confidence interval: 1.481–15.152; P = 0.009). In addition, a more circular TA shape at ED (AP/SL ratio < 1.20) was also associated with more right atrial and ventricular dilation, more frequently significant TR, and a higher prevalence of atrial fibrillation.

Conclusion

Circular remodelling of the TA shape at ED is associated with more right atrial and ventricular dilation, and a higher long-term mortality after TAVI. The evaluation of the TA shape at ED may be a useful parameter in the risk stratification of patients undergoing TAVI.
Management of rheumatic aortic valve disease using the Ozaki procedure with autologous pericardium: a case report
Authors: Asif Ashar , Benedetto Umberto , Ofoe Victor , Caputo Massimo
Published: June 2021

Background

Rheumatic valve disease (RVD) is the most common cause of cardiovascular death in low-middle income nations. Surgical aortic valve (AV) interventions for RVD, especially in children, have proven problematic with graft failure, relapse, and poor compliance with anticoagulation. A novel technique involving neocuspidization of the aortic annulus using autologous pericardium to construct new AV leaflets (the Ozaki procedure) has shown promising outcomes in children with congenital AV disease; however, there are no previous recorded cases using this technique in children with RVD.

Case summary

We present the case of a 15-year-old male presenting with exertional angina and dyspnoea with a background of previous rheumatic fever. Echocardiography had shown a regurgitant tricuspid AV, left ventricular dilatation with mitral valve leaflet tethering. The patient underwent the Ozaki procedure for his AV regurgitation and was discharged following an uneventful post-operative recovery. The patient had full resolution of symptoms following the procedure and remains well 3 years following his operation.

Discussion

This case highlights that good outcomes with the Ozaki procedure in RVD are possible 3-years post-operatively and should prompt future studies to evaluate the procedure as a surgical option for paediatric patients in this clinical context. Additionally, the Ozaki procedure may also provide a cost-effective surgical technique requiring minimal additional operative resources and reduced follow-up demand, which would be critical in low-resource clinical settings where RVD is prevalent.
The role of signal production and transduction in induced resistance of harvested fruits and vegetables
Authors: Wang Bin , Bi Yang
Published: June 2021

Postharvest diseases are the primary reason causing postharvest loss of fruits and vegetables. Although fungicides show an effective way to control postharvest diseases, the use of fungicides is gradually being restricted due to safety, environmental pollution, and resistance development in the pathogen. Induced resistance is a new strategy to control postharvest diseases by eliciting immune activity in fruits and vegetables with exogenous physical, chemical, and biological elicitors. After being stimulated by elicitors, fruits and vegetables respond immediately against pathogens. This process is actually a continuous signal transduction, including the generation, transduction, and interaction of signal molecules. Each step of response can lead to corresponding physiological functions, and ultimately induce disease resistance by upregulating the expression of disease resistance genes and activating a variety of metabolic pathways. Signal molecules not only mediate defense response alone, but also interact with other signal transduction pathways to regulate the disease resistance response. Among various signal molecules, the second messenger (reactive oxygen species, nitric oxide, calcium ions) and plant hormones (salicylic acid, jasmonic acid, ethylene, and abscisic acid) play an important role in induced resistance. This article summarizes and reviews the research progress of induced resistance in recent years, and expounds the role of the above-mentioned signal molecules in induced resistance of harvested fruits and vegetables, and prospects for future research.
Effect of raspberry extract on wound healing
Authors: Lu Wenjing , Xu Meng , Yuan Youwei , Zhang Xuemei , Tan Jianxin , He Junping , Tian Yiling
Published: June 2021

The main purpose of this study was to investigate the effect of raspberry extract on wound healing and compare it with that of ellagic acid. The elimination of excess free radicals was the key to preventing wound inflammation; cellular antioxidation activity was evaluated using an oxidative stress damage cell model. Cell proliferation ability was measured using the WST-1 assay, and the migration capacity was determined using the wound scratch assay. A mouse wound model was used to verify the effect of raspberry extract on wound healing. The cellular antioxidant activity of the extract ((50.31±3.17) μg/mL) was slightly lower than that of ellagic acid ((44.59±2.38) μg/mL). The results of a cell proliferation assay showed that both raspberry extract and ellagic acid at 5 μg/mL could significantly (P<0.01) promote the proliferation of HaCaT cells. After culturing for 24 h and 48 h, the cell healing rates of the extract were (41.11±0.38) per cent and (68.88±2.51) per cent, respectively, whereas the corresponding rates of ellagic acid were (39.01±2.40) per cent and (70.33±0.89) per cent; hence, there were no significant differences between them (P>0.05). The wound areas of mice fed low, medium, and high doses of raspberry extract for 14 days were 1.66, 1.41, and 1.24 mm2, respectively, which were significantly lower than that of the blank control group, 2.18 mm2 (P<0.05). These findings indicate that raspberry extract and ellagic acid exhibit similar antioxidant capacities and equivalent cell proliferation-promoting capabilities. In the mouse test, raspberry extract effectively promoted a reduction in wound area. This work demonstrates the potential of raspberry extract in wound healing, suggesting a promising application of raspberry resources in the fields of functional foods, cosmetics, and medicine.
Future magnitude 7.5 earthquake offshore Martinique: spotlight on the main source features controlling ground motion prediction
Authors: Oral Elif , Satriano Claudio
Published: June 2021

The eastern offshore of Martinique is one of the active areas of the Lesser Antilles Subduction Zone (LASZ). Although its seismicity is moderate compared to other subduction zones, LASZ is capable of generating a M 7+ interplate earthquake and recent studies and historical events, such as the M 8 1839 and M 7–7.5 1946 earthquakes, confirm this possibility. Given the high risk that Martinique can face in case of unpreparedness for such a M 7+ earthquake, and the lack of a regional seismic hazard study, we investigated through numerical modelling how ground motion can vary for a hypothetical Mw 7.5 interplate earthquake. Our main objective is to highlight the major factors related to earthquake source that can cause the highest variation in ground motion at four broad-band seismic stations across Martinique. For this purpose, we generated 320 rupture scenarios through a fractal kinematic source model, by varying rupture directivity, source dimension, slip distribution. We computed the broad-band ground motion (0.5–25 Hz) by convolution of source–time functions with empirical Green’s functions (EGFs), that we selected from the analysis of moderate events (M 4–4.5) recorded in the area of interest since 2016 by the West Indies network. We found that the fault geometry and the spatial extension of the largest slip patch are the most influential factors on ground motion. The significance of the variation of the predicted ground motion with respect to ground motion prediction equations (GMPEs) depends on the evaluated frequency of ground motion and on the station. Moreover, we concluded that the EGF selection can be another significant factor controlling the modelled ground motion depending on station. Our results provide a new insight for the seismic source impact on ground motion across Martinique and can guide future blind seismic hazard assessment studies in different regions.
Artificial intelligence in the fertility clinic: status, pitfalls and possibilities
Authors: Riegler M A , Stensen M H , Witczak O , Andersen J M , Hicks S A , Hammer H L , Delbarre E , Halvorsen P , Yazidi A , Holst N , Haugen T B
Published: June 2021

In recent years, the amount of data produced in the field of ART has increased exponentially. The diversity of data is large, ranging from videos to tabular data. At the same time, artificial intelligence (AI) is progressively used in medical practice and may become a promising tool to improve success rates with ART. AI models may compensate for the lack of objectivity in several critical procedures in fertility clinics, especially embryo and sperm assessments. Various models have been developed, and even though several of them show promising performance, there are still many challenges to overcome. In this review, we present recent research on AI in the context of ART. We discuss the strengths and weaknesses of the presented methods, especially regarding clinical relevance. We also address the pitfalls hampering successful use of AI in the clinic and discuss future possibilities and important aspects to make AI truly useful for ART.
Legal Consequences of and Approaches to the Question of Recognition of a Government of a State: Disputes involving Venezuela
Authors: Rees-Evans Laura , Carvosso Rhys
Published: June 2021

This article examines the ongoing dispute over the presidency of Venezuela as a case study on the state of international law relating to the recognition of governments. Since the beginning of the presidential deadlock in Venezuela in 2019, ICSID tribunals and ad hoc Committees, as well as the courts of England and Wales, have found themselves embroiled in the dispute over the Venezuelan presidency between the rival Maduro and Guaidó administrations. ICSID tribunals and committees have had to determine whose legal representatives are entitled to represent Venezuela in proceedings before them, while the English courts have been called upon to determine which administration has control over Venezuelan gold and other assets held in the UK. These disputes have brought renewed arbitral and judicial attention to the concepts of ‘effective control’ and recognition. This article examines how each of the courts and tribunals has addressed these concepts, and what their decisions tell us about the legal consequences of recognition as a matter of international and domestic law.
Metrics for evaluating antibiotic use and prescribing in outpatient settings
Authors: Leung Valerie , Langford Bradley J , Ha Rita , Schwartz Kevin L
Published: June 2021

Antimicrobial stewardship interventions in outpatient settings are diverse and a variety of outcomes have been used to evaluate these efforts. This narrative review describes, compares and provides specific examples of antibiotic use and other prescribing measures to help antimicrobial stewards better understand, interpret and implement metrics for this setting. A variety of data have been used including those generated from drug sales, prescribing and dispensing activities, however data generated closest to when an individual patient consumes an antibiotic is usually more accurate for estimating antibiotic use. Availability of data is often dependent on context such as information technology infrastructure and the healthcare system under consideration. While there is no ideal antibiotic use or prescribing metric for evaluating antimicrobial stewardship activities in the outpatient setting, the intervention of interest and available data sources are important factors. Common metrics for estimating antimicrobial use include DDD per 1000 inhabitants per day (DID) and days of therapy per 1000 inhabitants/day (DOTID). Other prescribing metrics such as antibiotic prescribing rate (APR), proportion of prescriptions containing an antibiotic, proportion of prolonged antibiotic courses prescribed, estimated appropriate APR and quality indicators are used to assess specific aspects of antimicrobial prescribing behaviour such as initiation, selection, duration and appropriateness. Understanding the context of prescribing practices helps to ensure feasibility and relevance when implementing metrics and targets for improvement in the outpatient setting.
Concordance of Umbilical Cord Drug Screening in Multiple Births: Experience from a Reference Laboratory and Academic Medical Center
Authors: Nelson Heather A , Wood Kelly E , McMillin Gwendolyn A , Krasowski Matthew D
Published: June 2021

The objective of this study was to review the results of umbilical cord drug screening in twins and triplets (multiples) to compare the detected drug(s) and/or drug metabolite(s). Results that did not agree between multiples were considered mismatched and investigated. A retrospective analysis was conducted using de-identified data from a national reference laboratory, and results were compared with data from an academic medical center, where detailed medical chart review was performed. Umbilical cord was analyzed for stimulants, sedatives, opioids and other drugs and metabolites. For the reference laboratory dataset, 23.3% (n = 844) of 3,616 umbilical cords from twins (n = 3,550) or triplets (n = 66) were positive for one or more drugs and/or metabolites. Of these, mismatched results were identified for 37 sets of twins (2.1%) and no sets of triplets. The most frequent mismatches were found in opioids (n = 24), with morphine (n = 5) being the most mismatched of any single analyte in the panel. Mismatches for the marijuana metabolite 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (9-COOH-THC) in the reference laboratory dataset occurred in 6 of 737 sets of twins (0.8%) and no triplets. For the academic medical center dataset, 21.9% (n = 57) of 260 umbilical cords tested positive for one or more drugs and/or metabolite(s). Of these, four mismatches (3.2%) were identified, including 9-COOH-THC (n = 2), phentermine (n = 1) and oxycodone (n = 1), all involving twins. All involved cases where the discrepant analyte was likely present in the negative twin but either slightly below the reporting cutoff threshold or failed analytical quality criteria. Mismatched results of umbilical cord drug screening occur in less than 4% of twins and most often occur when the analyte is slightly above the reporting cutoff in just one infant.
An ensemble soft weighted gene selection-based approach and cancer classification using modified metaheuristic learning
Authors: Tavasoli Niloofar , Rezaee Khosro , Momenzadeh Mohammadreza , Sehhati Mohammadreza
Published: June 2021

Hybrid algorithms are effective methods for solving optimization problems that rarely have been used in the gene selection procedure. This paper introduces a novel modified model for microarray data classification using an optimized gene subset selection method. The proposed approach consists of ensemble feature selection based on wrapper methods using five criteria, which reduces the data dimensions and time complexity. Five feature ranking procedures, including receiver operating characteristic curve, two-sample T-test, Wilcoxon, Bhattacharyya distance, and entropy, are used in the soft weighting method. Besides, we proposed a classification method that used the support vector machine (SVM) and metaheuristic algorithm. The optimization of the SVM hyper-parameters for the radial basis function (RBF) kernel function is performed using a modified Water Cycle Algorithm (mWCA). The results indicate that the ensemble performance of genes-mWCA SVM (EGmWS) is considered an efficient method compared to similar approaches in terms of accuracy and solving the uncertainty problem. Five benchmark microarray datasets, including leukemia, MicroRNA-Breast, diffuse large B-cell lymphoma, prostate, and colon, are employed for experiments. The highest and lowest numbers of genes are related to prostate with 12 533 genes and MicroRNA-Breast with 1926 genes, respectively. Besides, the highest and lowest numbers of samples are MicroRNA-Breast with 132 samples and colon with 62 samples, respectively. The results of classifying all data by applying effective genes of the EF-WS yielded high accuracies in microarray data classification. In addition to the robustness and simplicity of the proposed method, the model’s generalizability is another crucial aspect of the method that can be further developed to increase the accuracy while reducing classification error.
Unusual apical femoral head deformity treated by hip arthroscopy and tunnel drilling through femoral head: a case report
Authors: Morattel Boris , Bonin Nicolas
Published: June 2021

Femoro-acetabular impingement (FAI), is the result of an abnormal morphology of the hip joint. On the femoral side, asphericity of the head can be highlighted by an alpha angle measurement >50° on computed tomography or MRI. However, some particular cephalic asphericities can make it difficult to measure the alpha angle, leading to a diagnostic pitfall. While in the classic cam effect, the deformity is peripheral and can be treated by arthroscopic femoroplasty, an apical head deformity remains a therapeutic challenge. We present the case of a 17-year-old male patient with a femoral head deformity, corresponding to an ISHA zone 6 overhang, significantly improved in everyday and sports life by arthroscopic trapdoor technique to resect the focal central deformity while enabling concomitant treatment of central compartment pathology, in this case, a hypertrophic ligamentum teres and femoral head chondral flap. Etiology of this femoral head deformity remains uncertain but could be a particular cam deformity, sequelae to pediatric disease or instability with repeated traction of the ligament teres on the femoral head apical insertion during cephalic growth.
Sharing genetic test results of germline pathogenic variants of hereditary cancer with relatives: A single-center cross-sectional study
Authors: Fukuzaki Naomi , Kiyozumi Yoshimi , Higashigawa Satomi , Horiuchi Yasue , Mizuguchi Maki , Matsubayashi Hiroyuki , Nishimura Seiichiro , Mori Keita , Notsu Akifumi , Suishu Izumi , Ohnami Sumiko , Kusuhara Masatoshi , Yamaguchi Ken , Doorenbos Ardith Z , Takeda Yuko
Published: June 2021

Objective

This study aimed to determine whether Japanese cancer patients share test results of germline pathogenic variants of hereditary cancer with their relatives.

Methods

This single-center cross-sectional study enrolled 21 Japanese patients who received results of germline pathogenic variants of hereditary cancer at least 6 months prior.

Results

All patients shared their test results with at least one relative, with the following sharing rates: 85.7% for first-degree relatives, 10% for second-degree relatives and 8.3% for third-degree relatives. Patients most commonly shared the information with their children aged >18 years (86.7%), followed by their siblings (73.6%), spouses (64.7%) and parents (54.5%). Three categories were extracted from qualitative analysis: ‘characteristics of my cancer’, ‘knowledge and caution about inheritability’ and ‘utilization of medical care.’

Conclusions

The rate of test result sharing with first-degree relatives was comparable with those in Europe and the USA. Patients with germline pathogenic variants also tended to share their test results more with their children and siblings than with their parents. Informing their relatives of the results was suggestive of the motivation to influence their relatives’ health outcome and contribute to the well-being of their children and siblings.
Armed Groups and Public Health Emergencies: A Cross-Country Look at Armed Groups’ Responses to Covid-19
Authors: Breslawski Jori
Published: June 2021

In public health emergencies that take place in violent contexts, which non-state armed groups engage in public health interventions, and what do those interventions consist of? While a growing literature on rebel governance has increased our understanding of how these armed groups govern civilian populations day to day, less understood is how armed groups respond to emergencies, such as natural disasters or pandemics. In a world defined by an increasing number of unpredictable crises, it is important to understand the ways in which armed groups respond. The Covid-19 pandemic provides an unprecedented opportunity to examine how armed groups respond to crises across conflicts. Drawing upon new data from Geneva Call on armed groups’ responses to Covid-19, the article offers a descriptive analysis of the types of actions armed groups take and the characteristics of armed groups taking action.
Right-sided patent ductus arteriosus with bovine aortic arch, tetralogy of Fallot, dextrocardia and situs inversus
Authors: Sayuti Khairil Amir , Shamsuddin Ahmad Mahir , Mamat Ahmad Zuhdi , Zain Mohd Rizal Mohd , Ramli Noraida , Mokhtar Ariffin Marzuki , Ali Saedah
Published: June 2021

A neonate with cyanosis at birth was found to have a rare type of tetralogy of Fallot. Echocardiography showed dextrocardia, left aortic arch with constricting and tortuous patent ductus arteriosus (PDA). Computed tomography angiography thorax revealed visceroatrial situs inversus, mirror image dextrocardia, tetralogy anatomy and tortuous right PDA arising from bovine brachiocephalic artery. In view of severe cyanosis, emergency division of PDA and modified right Blalock-Taussig shunt through median sternotomy were performed under cardiopulmonary bypass. Post-operatively, the sternum was left open and he developed pulmonary overcirculation requiring prolonged ICU stay. He was discharged well at Day 26 post surgery. This case highlights a rare association tetralogy of Fallot, dextrocardia and situs inversus, with concomitant unilateral right PDA and bovine aortic arch.
The Politics of International Refugee Law and Protection
Authors: Hamlin Rebecca
Published: June 2021

This chapter evaluates how politics and power dynamics permeate the story of international refugee law and protection. Historically, scholars of politics have been more likely to study the causes of displacement; there have been fewer studies focused on the politics of reception, that is, how displaced people are treated, processed, and categorized when they flee. Part of the explanation for this puzzling feature of the scholarly literature is that the discipline of political science has tended to study immigration politics as part of domestic politics, assuming immigrants are economically motivated, and bracketing refugees as a niche foreign policy issue. A further explanation is that international refugee protection is often assumed to be simply a legal matter, not shaped by politics. The chapter argues that the global refugee regime looks the particular way it does because powerful political forces and dynamics have shaped and constrained it. In order to understand the politics of international refugee law and protection, one cannot just look at the law itself. To understand what the law means in practice, one must examine protection law in the context of both international geopolitics and the domestic politics of border control, state formation, and ongoing nation-building. The chapter then outlines seven key facets of the politics of international refugee law and protection.
Human Trafficking and Refugees
Authors: Briddick Catherine , Stoyanova Vladislava
Published: June 2021

This chapter assesses the interactions between the international trafficking regime and international refugee and human rights law. In practical terms, refugees and other forced migrants can fall victim to trafficking when they travel irregularly in search of protection, or when they seek livelihoods while lacking legal rights, as may arise when they await the outcome of protracted status determination, or live without the right to work. The chapter takes a feminist approach, highlighting the gendered nature of trafficking and the responses thereto. Women and girls are more likely than men and boys to be trafficked, and are also more likely to be trafficked for particular forms of exploitation. The chapter studies the international trafficking regime, a complex and multilayered regime with diverse legal sources; it explores its links with the suppression of mobility and compares the limited rules that protect some refugees and trafficked persons from criminalization. It also highlights the links between trafficking and refugee recognition and looks at the protections provided to both refugees and trafficking victims by ‘general’ international human rights law and the specialist legal regimes concerned with discrimination and violence against women.