bluuebunny/crossref_metadata_2025 huggingface dataset:
Refined balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension: a prospective multicenter registry
Authors: Zhou Y-P , Wei Y-P , Yang Y-J , Peng F-H , Wu B-X , Hong C , Tong Q , Cui X-P , Zhang G-C , Cao Y-S , Wang D-L , Xu X-Q , Jiang X , Jing Z-C
Published: February 2022

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): the National Key Research and Development Program of China

Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening disease with a poor prognosis if left untreated. Pulmonary endarterectomy is the standard treatment for CTEPH, but around 40% of CTEPH patients are non-eligible for surgery.

Purpose To investigate the efficacy and safety of refined balloon pulmonary angioplasty (BPA) for inoperable CTEPH in a prospective multicenter registry from China.

Methods We conducted a prospective multicenter cohort study using the data from National Rare Disease Registry System of China. Total 140 consecutive patients with inoperable CTEPH who completed BPA between Jan 2016 and Dec 2020 were enrolled. The key efficacy outcomes were changes from baseline to re-evaluation in mean pulmonary arterial pressure, pulmonary vascular resistance, and six-minute walking distance. The safety outcomes were procedure-related complications. The survival outcome was all-cause mortality.

Results Among the 140 patients who completed BPA, the mean age at diagnosis was 58 ± 14 years and 60.0% were female. At re-evaluation, the least-squares mean change from baseline was -18.3 mm Hg (95% confidence interval [CI], -19.9 to -16.6, P < 0.001) in mean pulmonary arterial pressure, -5.3 Wood U (95% CI, -5.9 to -4.6, P < 0.001) in pulmonary vascular resistance, and 87 meters (95% CI, 74 to 101, P < 0.001) in six-minute walking distance. BPA procedure-related complications occurred in 109 of 650 BPA sessions (16.8%), but severe complications requiring noninvasive positive pressure ventilation only occurred in 4 (0.6%) BPA sessions. During a mean follow-up time of 32 ± 14 months, 4 patients died, including 2 peri-procedural deaths, contributing to the survival rates of 97.8% (95% CI, 93.4 to 99.3) at 1 year and 96.9% (95% CI, 91.9 to 98.8) at 3 and 5 years.

Conclusion Refined BPA appears to be an effective therapeutic option for inoperable CTEPH patients with acceptable safety profiles. Abstract Figure. Images of BPA Efficacy in a Patient  Abstract Figure. Efficacy outcomes of BPA
Clinical significance of epicardial fat in suspected angina pectoris: an observational study
Authors: Dadarwal A , Garg N , Kapoor A , Tewari S , Kumar S , Khanna R , Sahu A , Goel P K
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Epicardial adipose tissue (EAT) is the visceral fat between pericardium and visceral epicardium and is the source of several endocrine and inflammatory mediators. It also has paracrine affects in the neighboring coronary arteries.

Objective

 To evaluate the association of EAT with subclinical atherosclerosis (carotid intima media thickness & flow mediated vasodilation), ultrasonic and anthropometric measures of abdominal fat, metabolic syndrome and coronary artery disease (CAD) concurrently.

Material and methods

Patients who underwent computed tomography (CT) coronary angiography for suspected CAD were prospectively included. All underwent anthropometric measurements, laboratory investigations, ultrasonic measurement of liver fat grade & B-mode hepatorenal ratio, carotid intima media thickness (CIMT), flow mediated vasodilation (FMD), CT measurement of epicardial fat thickness (EFT) & epicardial fat volume (EFV) along with CT coronary angiography. Study population was divided into 2 groups on the basis of presence or absence of CAD and were compared. The relationship between risk factors and presence of CAD was assessed by logistic regression analysis. To define EFT and EFV value predictive of the presence of significant CAD, the area under (AUC) the receiver operating characteristic (ROC) curve was calculated. Correlation between EFT as well as EFV with anthropometric and laboratory parameters, CIMT and FMD were assessed by Pearson correlation coefficient.

Results

Total 54 patients were included in study. Mean age was 54 years, 66% were diabetic and 33% were hypertensive. Mean CIMT, FMD, EFT and EFV were 0.70 + 0.27 cm; 5.64 + 2.64%; 5.51 + 2.50 mm and 60.6 + 28.6 cc, respectively. Total 34 (62.96%) patients were detected to have CAD. EFT as well as EFV were significantly higher in CAD group (3.31 + 2.34 vs 6.24 + 1.91mm; p= <0.001, 72.5 + 22.3 vs 40.4 + 27.1cc; p= <0.001); in patients with metabolic syndrome (83.3 + 18.4 vs 49.2 + 26.1cc; p < 0.001, 7.13 + 1.49 vs 4.16 + 2.32mm; p < 0.001). Both, EFV & EFT were significantly correlated with the abdominal fat, CIMT and FMD. Smoking, age and EFV were the independent predictors for CAD.  EFV >31.65cc predicted the presence of CAD (sensitivity 91.25%, specificity 60%, AUC = 0.798, 95% CI = 0.665-0.930) and EFT >2.85mm predicted the presence of CAD (sensitivity 94.1%, specificity 65%, AUC= 0.820, 95% CI= 0.687-0.953).

Conclusions

Epicardial fat is significantly associated with presence of CAD, metabolic syndrome, visceral fat, CIMT and FMD. CT measured epicardial fat may be included with CT based CAD lesion assessment and CT coronary calcium score to screen the patients of suspected angina pectoris. Abstract Figure. Epicardial adipose tissue  Abstract Figure. EFV and CAD
Comorbidity and quality of life in older patients with chronic cardiorenal syndrome and obstructive sleep apnea
Authors: Efremova E , Shutov A M , Serov V A , Igonina N V
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Comorbidity increases with age, including the presence of cardiovascular disease, chronic kidney disease (CKD) and obstructive sleep apnea (OSA). OSA is considered as a risk factor for the progression of CKD.

The aim of this study was to investigate сomorbidity and quality of life in older patients with chronic cardiorenal syndrome and obstructive sleep apnea.

Materials and methods

80 older patients with stable cardiovascular disease and CKD (43 males, mean age was 67.6 ± 6.1 years) were studied. CKD was diagnosed and classified according to the KDIGO guidelines (2012). OSA was observed according to Clinical Guidelines for Obstructive Sleep Apnea and Insomnia (U.S., 2020). Berlin Questionnaire and Epworth Sleepiness Scale, cardiorespiratory monitoring for screening and diagnosis of OSA were used. Charlson comorbidity index (CCI) was estimated. The patients" quality of life (EQ-5D-5L), the presence of anxiety and depression (Hospital Anxiety and Depression Scale), psychological defense mechanisms were assessed.

Results

Chronic kidney disease was observed in 48 (60%) patientswith stable cardiovascular disease. OSA was first diagnosed in 31 (64.5%) older patients with CKD. Рatients with CKD had a high comorbidity independently of OSA: CCI was 8 (7; 8) points in patients with OSAS and 7 (7; 8) points in patients without OSAS (p = 0.51). There was a direct relationship between CKD and the severity of daytime sleepiness (r = 0.30, p = 0.02), as well as complaints about the quality of sleep (r = 0.31, p = 0.01) in patients with CKD. Severity of anxiety and depressive reactions, disturbance of habitual activity, increased pain and discomfort, decrease QOL index (EQ-5D-5L) in the presence of disturbed sleep quality and daytime sleepiness were observed. With a Older patients with CKD and decrease in the quality of sleep less commonly used mature mechanisms of psychological defense, such as «рrojection» (r = -0.39, p = 0.04) and «rationalization» (r = -0.41, p = 0.03). There was association between the severity of sleep disorders and the tension of the primitive mechanism of psychological defense «regression» (r = 0.41, p = 0.008), which contributes to the impairment of adaptation in older patients with CKD.

Conclusion

Older patients with CKD and OSA have a high comorbidity, including cardiovascular comorbidity. There were no differences in the structure of comorbidity in older patients with  chronic cardiorenal syndrome, depending on the presence of OSA. Sleep impairment, daytime sleepiness were associated with the severity of anxiety and depression, a decrease in the quality of life, and maladjustment.
Rapid adoption of electronic health record and health information exchange among assisted living communities, 2010–2018
Authors: Lin Sunny C , Tunalilar Ozcan
Published: February 2022

Adoption of electronic health records (EHRs) and health information exchange (HIE) is a key tool to improving the quality of care in assisted living communities (ALC). We examined whether EHRs were being used in ALC to support HIE in 2010 and 2018. We found that adoption of EHR and HIE functions increased substantially over the study period. However, adoption of HIE functions lagged significantly behind EHR functions in both 2010 and 2018 and was accompanied by growing disparities in the adoption of EHR functions among smaller, nonchain, and for-profit communities. To improve the quality of care for this important and growing population, targeted policies are needed to support the adoption of both EHR and HIE functions in ALC.
Liver abscess secondary to fishbone ingestion: case report and review of the literature
Authors: Grayson Niamh , Shanti Hiba , Patel Ameet G
Published: February 2022

We report a rare silent migration of a fishbone into the liver and review the relevant literature. A 56-year-old man presented with a 2-day history of dull epigastric pain and raised inflammatory markers. Computerized tomography scan revealed a 4-cm abscess in the left lobe of the liver, with a linear radio-dense foreign body within the collection. At laparoscopy the hepatogastric fistula was disconnected. The fishbone was retrieved from the liver. Gastrostomy was closed with an omental patch. The patient had an uneventful recovery. Fifty-two cases of liver abscess secondary to enterohepatic fishbone migration were reported with over two-thirds presenting with a left-lobe abscess. There was marked variability in the management of liver abscess in the setting of fishbone migration-summarized in table. We believe that laparoscopic drainage of the abscess and extraction of the foreign body offer control of the source of sepsis and diminishes recurrence, whilst having a low-risk profile.
Predictors of Death, Survival, Need for Intubation, and Need for Oxygen Support Among Admitted COVID-19 Patients of the Veterans Affairs Greater Los Angeles Healthcare System
Authors: Yang Hong-Ho , Wu Tara J , Yu Alice C , Wells Christine , Orshansky Greg , Lee Jivianne T
Published: February 2022

Introduction

While risk factors for severe COVID-19 infections have been well explored among the public, population-specific studies for the U.S. Veteran community are limited in the literature. By performing a comprehensive analysis of the demographics, comorbidities, and symptomatology of a population of COVID-19 positive Veterans Affairs (VA) patients, we aim to uncover predictors of death, survival, need for intubation, and need for nasal cannula oxygen support among this understudied community.

Materials and Methods

A retrospective review was conducted of 124 COVID-19 Veteran patients who were admitted from March to October 2020 to the VA Greater Los Angeles Healthcare System (IRB#2020-000272). Chi-square and Fisher’s exact tests were employed to assess differences in baseline demographic and clinical variables between Veterans who survived COVID-19 versus those who succumbed to COVID-19 illness. Multivariate logistic regression and Cox regression analyses were employed to assess predictors of outcome variables, including death, survival, need for intubation, and need for oxygen support (via nasal cannula). Covariates included a wide range of demographic, comorbidity-related, symptom-related, and summary index variables.

Results

Our study population consisted of primarily senior (average age was 73) Caucasian and African American (52.5% and 40.7%, respectively) Veterans. Bivariate analyses indicated that need for intubation was significantly associated with mortality (P = 0.002). Multivariate analyses revealed that age (P < 0.001, adjusted odds ratio (OR) = 1.16), dyspnea (P = 0.015, OR = 7.73), anorexia (P = 0.022, OR = 16.55), initial disease severity as classified by WHO (P = 0.031, OR = 4.55), and having more than one of the three most common comorbidities (hypertension, diabetes, and cardiac disease) and symptoms (cough, fever, and dyspnea) among our sample (P = 0.009; OR = 19.07) were independent predictors of death. Furthermore, age (P < 0.001, hazard ratio (HR) = 1.14), cerebrovascular disease (P = 0.022, HR = 3.76), dyspnea (P < 0.001, HR = 7.71), anorexia (P < 0.001, HR = 16.75), and initial disease severity as classified by WHO (P = 0.025, HR = 3.30) were independent predictors of poor survival. Finally, dyspnea reliably predicted need for intubation (P = 0.019; OR = 29.65).

Conclusions

Several independent predictors of death, survival, and need for intubation were identified. These risk factors may provide guidelines for risk-stratifying Veterans upon admission to VA hospitals. Additional investigations of COVID-19 prognosis should be conducted on the larger U.S. Veteran population to confirm our findings and add to the current body of literature.
Optimal timing of radiotherapy following brain metastases surgery
Authors: Yaghi Nasser K , Radu Stephanie , Nugent Joseph G , Mazur-Hart David J , Pang Brandi W , Bowden Stephen G , Murphy Blair , Han Seunggu J
Published: February 2022

Background

There is growing evidence supporting the need for a short time delay before starting radiotherapy (RT) treatment postsurgery for most optimal responses. The timing of RT initiation and effects on outcomes have been evaluated in a variety of malignancies, but the relationship remains to be well established for brain metastasis.

Methods

Retrospective study of 176 patients (aged 18–89 years) with brain metastases at a single institution (March 2009 to August 2018) who received RT following surgical resection. Time interval (≤22 and >22 days) from surgical resection to initiation of RT and any potential impact on patient outcomes were assessed.

Results

Patients who underwent RT >22 days after surgical resection had a decreased risk for all-cause mortality of 47.2% (95% CI: 8.60, 69.5%). Additionally, waiting >40 days for RT after surgical resection more than doubled the risk of tumor progression; adjusted hazard ratio 2.02 (95% CI: 1.12, 3.64).

Conclusions

Findings indicate that a short interval delay (>22 days) following surgical resection is required before RT initiation for optimal treatment effects in brain metastasis. Our timing of RT postsurgical resection data adds definition to current heterogeneity in RT timing, which is especially important for standardized clinical trial design and patient outcomes.
How can South Africa advance a new energy paradigm? A mission-oriented approach to megaprojects
Authors: Andreoni Antonio , Creamer Kenneth , Mazzucato Mariana , Steyn Grové
Published: February 2022

Green transition is a ‘wicked’ problem in that it is complex, systemic, interconnected, and urgent. In this paper we advance a ‘mission-oriented’ approach to reconceptualize energy megaprojects within a systemic, cross-sectoral, and challenge-driven policy framework for energy transition. This approach is operationalized through a discussion of project-level policy instruments including directional public finance, public procurement, and several types of conditionality. These instruments are geared towards shaping markets and industrial supply chains for green transition, and managing risks and rewards associated with energy megaprojects. We also look at the opportunities offered by a more decentralized energy system and the importance of building up state capacity and green coalitions supporting energy transition. We discuss this mission-oriented approach through a deep dive on the South African experience of energy megaprojects with a focus on the restructuring of its public utility, Eskom, as well as opportunities for sustainable industrialization.
Examining the Effects of a Universal Cash Transfer on Fertility
Authors: Cowan Sarah K , Douds Kiara Wyndham
Published: February 2022

Childbearing is at once deeply personal and shaped by social structure. It is also a site of profound inequality in the United States. Income inequality is an upstream cause of childbearing inequality, yet the evidence of the effect of income on reproduction is inconclusive. Previously, scholars primarily examined the introduction of means-tested relief to families with children. This limits analysis to families in poverty and provides insight only into the presence or absence of a policy. We analyze the Alaska Permanent Fund Dividend, which has provided all Alaskan residents with a substantial annual cash payment since 1982. The amount of the payment varies annually and is exogenous to individual Alaskans’ behavior and the state’s economy. We examine the effect of the cash transfers on fertility and abortion among a large and diverse population that has received varying amounts of money over time. We find the payments increase short-term fertility rates 1 and 2 years after disbursement, particularly among socioeconomically disadvantaged populations. Standardized to the 2010 household size distribution, two average payments relative to two minimum payments would result in a predicted fertility rate increase from 80.03 to 86.53 per 1,000 women age 15–44. The effect is largest for first births. The payments have no effect on the abortion rate. These results indicate the additional income removes economic constraints to reproductive health and autonomy and reduces reproductive inequality.
The nutrient requirements of horses: historical perspectives
Authors: Lawrence Laurie
Published: February 2022

The National Research Council (NRC) published the Recommended Nutrient Allowances for Horses in 1949. The subsequent publication was renamed the Nutrient Requirements of Horses and the 6th revised edition was published in 2007. The document has increased in size and scope from the initial publication in 1949 that contained 29 pages to the most recent version with 341 pages. Several formats for expressing requirements (dietary concentrations or daily amounts) have been utilized. In addition, a variety of methods have been employed to determine the nutrient requirements of horses since 1949. Many of the requirement estimates are based on research studies with the target class of horse. However, some estimates have been derived from practical experience or extrapolated from other species and there is ample opportunity for future research related to many nutrients. Equine nutritionists may also explore additional methods to express the recommended daily nutrient intakes of horses.
When Should I Worry That I Might Be Depressed?
Authors: Rottenberg Jonathan
Published: February 2022

How can people determine when they are
depressed? This chapter offers the reader clues from the kinds of symptoms and
experiences that distinguish normal sadness from an episode of clinical depression.
Barriers to diagnosing depression are discussed, including problems that accompany a
self-diagnosis. Some problems that accompany self-diagnosis are magnified by the overuse
of self-tests, which are frequently pushed beyond their originally intended purpose.
Specific kinds of diagnostic errors that arise when assessing depression are enumerated.
Specific procedures that can be used to minimize diagnostic errors are recommended for
people who want an accurate diagnosis in themselves or a loved one.
Depression Over Time
Authors: Rottenberg Jonathan
Published: February 2022

Depression sufferers and their loved ones
commonly ask, “Will this depression end? Will this depression come back later in life?”
This chapter considers the epidemiology of depression, offering an overview of what is
known about recurrent versus non-recurrent forms of depression, including the major risk
factors for recurrent depression. After the concept of chronic depression is defined,
scientific efforts to understand why some individuals experience depression that is
sustained over many years are discussed. Clinical examples illustrate these concepts and
dramatize the challenges of using research on recurrence and chronicity to make clinical
decisions. The chapter closes with a consideration of the concept of a depressive
personality, including the evidence for and the evidence against this concept.
Why is There an Epidemic of Depression?
Authors: Rottenberg Jonathan
Published: February 2022

This chapter explores the contemporary
depression epidemic in more detail, explaining it from the perspective of mood science.
There is an epidemic of depression because there is an epidemic of low mood. Major
environmental factors adversely affecting mood in the modern environment are reviewed,
such as low levels of sunlight exposure, disruptions to sleep routines, and harmful use
of social media platforms. Poor mood at the population level may also be fueled by
changing cultural expectations about what people should feel, leading to a “happiness
gap” or distance between what people feel and what people want to feel. These trends may
have special application to adolescents, a group that is now at the epicenter of the
contemporary depression epidemic. Finally, whether or not the depression epidemic will
continue in the future is considered.
What Are My Treatment Options?
Authors: Rottenberg Jonathan
Published: February 2022

This chapter reviews the three main empirically
supported treatments for depression: cognitive–behavioral therapy, interpersonal
therapy, and antidepressant drugs. These therapies and their supportive data are
described, including the principles behind each therapy modality and what a depressed
person can expect from each. Less well-established but emerging biological treatments,
such as transcranial magnetic stimulation and ketamine derivatives, are also considered.
What is known from treatment research has practical value to a person who is considering
treatment for depression. Based on current knowledge, there are several positive
arguments for undergoing formal treatment for depression. Practical advice for selecting
a treatment modality and for choosing a treatment provider is also offered in this
chapter.
How Civil Resistance Works
Authors: Chenoweth Erica
Published: February 2022

This chapter addresses the question of how people build social and political power from below,
how civil resistance succeeds, and whether there are conditions under which civil resistance is
impossible. It emphasizes the crucial point that civil resistance campaigns succeed when they
become large and diverse enough to reflect a serious challenge to the status quo and when they
begin to create defections from their opponent's side. It explains why nonviolent revolutions
have succeeded more often than violent revolutions. The chapter shows why mass participation,
defections, tactical innovation, and resilience against repression have helped people to
overcome long odds and succeed using civil resistance. It elaborates how nonviolent movements
succeed, and whether there are situations in which nonviolent resistance is impossible.
What is sustainability?
Authors: Thompson Paul B. , Norris Patricia E.
Published: February 2022

This chapter introduces the systems thinking approach to sustainability. We review alternative
ways of defining or interpreting sustainability and discuss points on which people differ in
their understanding of the concept. A systems approach implies that sustainability is not
limited to environmental considerations and that environmental, economic, and social
sustainability cannot be viewed as distinct spheres. A systems approach to sustainability is
also useful in analyzing practices or processes that should not be sustained. Activists and
interest groups pursue political objectives under the banner of sustainability, and even
non-partisan analysis of sustainability suggests policy directives, especially with respect to
climate. Nevertheless, the concept of sustainability should not be identified with any
particular political ideology or policy agenda. The idea of sustainability is used in managing
renewable resources and became influential in economic development following the publication of
the World Commission on Environment and Development report in 1987.
Sustainability and Environmental Quality
Authors: Thompson Paul B. , Norris Patricia E.
Published: February 2022

Pollution damage and resource depletion cause hardship, disease, and distress for human beings
and other living things by threatening important ecosystem services. Limiting and reversing
these damages is a key aim for sustainability. These goals are pursued by identifying
environmental indicators that allow managers and policy makers to monitor the overall quality of
the biophysical environment and to test the effectiveness of interventions to improve it.
Representative indicators for water quality, climate change, and other environmental concerns
are discussed, and the reasons for controversy over indicators are reviewed.
Sustainability and Social Justice
Authors: Thompson Paul B. , Norris Patricia E.
Published: February 2022

Ways of thinking about justice and its role in political ideology are described. Social justice
is linked to views on access to and distribution of resources crucial for thriving societies.
Ideas for connecting sustainability and social justice include environmental justice, food
sovereignty, climate justice, and social sustainability. Principles of sustainability are
applied to analyze why some forms of injustice are so persistent and resist efforts of change.
Features such as structural racism can be understood as highly resilient systems that are too
sustainable.
Sustainable Governance
Authors: Thompson Paul B. , Norris Patricia E.
Published: February 2022

What governments can do to promote sustainability is limited by the systemic interactions that
support government itself. The chapter places government action within a larger social system of
governance. Economic injustice and political repression can weaken the sustainability of
governance processes and limit governments' ability to deliver social services. Governments fail
when dissent or power inequality makes them consistently unable to perform the functions of
governance. The sustainability of governance systems can be strengthened through measures that
increase participation in governance processes and that redress structural injustice.
Sustainability in Science, Education, Religion, and the Arts
Authors: Thompson Paul B. , Norris Patricia E.
Published: February 2022

Science, education, religion, and the arts are mediums for discovery and dissemination about
sustainability. Scientific methods and organization, in particular, have changed significantly
as scientists work toward sustainability. These changes include the rise of interdisciplinary
and participatory methods and the emergence of wicked problems as a framework for approaching
sustainability challenges. These developments in science have sparked change in college level
education programs, as well. Religion and the arts have added engagement with environmental
issues to the longstanding focus on social issues within religious organizations and creative
activities.
Sustainability
Authors: Thompson Paul B. , Norris Patricia E.
Published: February 2022

The book concludes with a review of ways to conjoin humility and patience with systems thinking
in the evaluation of day-to-day activities. Examples include household conservation activities
and choosing consumable goods that pose less threat to ecological and social systems. We discuss
the impact of purchasing products represented as environmentally or socially sustainable.
Contributions of collective action in the social and political sphere go beyond any individual's
ability to promote sustainability when acting on their own. Yet people should not be intolerant
of others who fail to agree with or follow any particular vision of sustainability.
Robots are Here
Authors: Husbands Phil
Published: February 2022

This chapter provides an overview of robots. Since the
turn of the millennium, new robotic breeds have started to appear at an accelerating pace. It is
these mobile, intelligent robots that are now sparking great interest. Robots are not completely
ubiquitous yet or particularly smart or threatening, but, just like computers, the internet, and
networked mobile devices before them, there appears to be such momentum behind the development
of robot technology that its spread is inevitable. All over the world, government and corporate
R&D funds are being poured into artificial intelligence (AI) and robotics. Thus, it is
important to have some kind of understanding of the state-of-the-art of these machines and to
think about how they should be used and regulated now and in the future. Mobile, physical,
autonomous devices that share our domestic and working lives could potentially have a much
bigger impact on the world than their predecessor technologies. In the future, they could be
seen as the crowning glory of twenty-first-century applied science and engineering, or as tools
of social inequality and economic oppression.
Robot Fantasies
Authors: Husbands Phil
Published: February 2022

This chapter focuses on the depiction of robots in
popular culture. The word robot came from literature, specifically Karel Čapek's 1921 play
R.U.R. (Rossum's Universal Robots). But perhaps the first
literary appearance of robot-like machines was in H.G. Wells' celebrated novel The War
of The Worlds, originally published in 1898. Wells' outrageously imaginative
visions of walking and crawling machines influenced later generations of science fiction writers
and film makers. These fictions in turn influenced late-twentieth-century roboticists as they
experimented with designs for walking machines. Meanwhile, Fritz Lang's 1927 silent film
Metropolis was very influential in embedding the image of mechanical humans
built from steel and electronic circuits. The most extreme version of factory- or
laboratory-created humanoids comes in Aldous Huxley's classic 1932 novel Brave New
World. The chapter then assesses how plausible mainstream fictional portrayals of
robots are, looking at Charlie Brooker's science fiction TV show Black Mirror,
as well as video and computer games. It also asks whether imaginary robots can help us think
about the potential implications of technology, considering Isaac Asimov's stories; Alex
Garland's 2014 film Ex Machina; and Stanley Kubrick's 1968 classic
2001: A Space Odyssey.
Intelligence, Super-Intelligence, and Cyborgs
Authors: Husbands Phil
Published: February 2022

This chapter addresses machine intelligence. It begins
by explaining the notion of the technological singularity, which claims that there may come a
point at some time in the future when such relentless technological advances force a fundamental
change in the way human societies function; the old ways would no longer make sense, and human
life would be forever altered. Contrary to the claims of a few so-called futurologists,
speculators, and provocateurs, who warn that it is an imminent existential threat, there is no
convincing evidence at all that the singularity is near. Progress in artificial intelligence
(AI) and robotics has been steady, with some bursts of accelerated developments, but the
distance from where we are now to the capabilities needed for human-level intelligence—never
mind super-human intelligence—is still enormous. The chapter then considers cyborgs and robotic
cyborg enhancements, looking at artificial limbs, brain computer interfaces (BCIs), robotic
exoskeletons, and artificial implants.
Robot Ethics
Authors: Husbands Phil
Published: February 2022

This chapter studies robot ethics. Now that a new
generation of robots—particularly autonomous, primitively intelligent robots—are starting to
appear on roads and in homes, and are being used by the military, big ethical, legal, and
philosophical questions are suddenly very pertinent. Robots intended to integrate into everyday
and work lives must be designed to follow the moral codes accepted by society, the ethical norms
of the day. One of the first attempts to provide ethical rules for intelligent robots was Isaac
Asimov's Three Laws of Robotics, which featured in his 1942 story Runaround.
However, robots will only behave ethically if people make them that way. Hence, it is incumbent
on roboticists to engage with the ethics issues and act responsibly in both robot development
and the uses of robotics they help enable. The chapter then considers the first-ever explicit
ethical standard for robotics, published by the British Standards Institution as BS8611: A Guide
to the Ethical Design and Application of Robots and Robotic Systems. It also looks at the use of
ethical robots in an unethical way, reflecting on issues related to privacy and data protection,
as well as crime. Bound up with the problems of ethics is the issue of how socially acceptable
robots are.
Augmented Reality Spine Surgery Navigation
Authors: Felix Brent , Kalatar Seyed Babak , Moatz Bradley , Hofstetter Christoph , Karsy Michael , Parr Ryan , Gibby Wendell
Published: February 2022

Study Design.

Collectively, seven cadavers were instrumented with 124 thoracolumbar pedicle screws using VisAR augmented reality/guidance. Sixty-five screws were inserted into four donors using open dissection spine surgery. Fifty-nine screws were positioned in three donors with a minimally invasive spine surgery (MISS) procedure. For both open and MISS, VisAR was used exclusively for pedicle screw navigation.

Objective.

The objective of this study was to determine the accuracy of pedicle screw placement using VisAR for open spine and MISS procedures.

Summary of Background Data.

Pedicle screw placement can be challenging depending on anatomical location and a surgeon's experience. AR may minimize fluoroscopy use and speed screw insertion.

Methods.

Prior to computed tomography (CT) a series of four image visible April Tag optical fiducials were attached to the backs’ of the donors. Resulting images were used preoperatively for planned virtual pedicle screw pathways including entry point, trajectory, and depth. The study link was encrypted on a quick response (QR) code, printed, and viewed in the operating room (OR) by the surgeon using VisAR (HoloLens 2 headset). Viewing the code wirelessly uploads and launches the study, converting the DICOM data to holographic images which register to the fiducials on the donor's back. The annotated pathways for each pedicle were called up by voice command and the surgeon positioned each screw by aligning with the virtual guidance hologram.

Results.

Overall, 124 pedicle screws were inserted with VisAR navigation with 96% accuracy (Gertzbein-Robbins grades A and B). The combined angle of error was 2.4° and the distance error was 1.9 mm.

Conclusion.

Augmented reality is a highly accurate, emerging technology for navigating both open and minimally invasive spine surgery techniques with off-the-shelf headset hardware.

Level of Evidence.

N/A
The Impact of Antimicrobial Stewardship in Children in Low- and Middle-income Countries
Authors: Abo Yara-Natalie , Freyne Bridget , Kululanga Diana , Bryant Penelope A.
Published: February 2022

Background:

Antimicrobial stewardship (AMS) is central to the World Health Organisation Global Action Plan against antimicrobial resistance (AMR). If antibiotics are used without restraint, morbidity and mortality from AMR will continue to increase. In resource-rich settings, AMS can safely reduce antibiotic consumption. However, for children in low- and middle-income countries (LMIC), the impact of different AMS interventions is unknown.

Aim:

To determine the impact of different AMS interventions on antibiotic use and clinical and microbiologic outcomes in children in LMIC.

Methods:

MEDLINE, Embase and PubMed were searched for studies of AMS interventions in pediatric population in LMIC settings. Controlled trials, controlled before-and-after studies and interrupted time series studies were included. Outcomes assessed were antibiotic use, multidrug-resistant organism (MDRO) rates, clinical outcomes and cost.

Results:

Of 1462 studies, 34 met inclusion criteria including a total population of >5,000,000 in 17 countries. Twenty were in inpatients, 2 in ED, 10 in OPD and 2 in both. Seven studies were randomized controlled trials. All types of interventions reported a positive impact on antibiotic prescribing. AMS bundles with education, and clinical decision tools appeared more effective than guidelines alone. AMS interventions resulted in significantly decreased clinical infections (4/4 studies) and clinical failure (2/2) and reduced MDRO colonization rate (4/4). There was no concomitant increase in mortality (4/4 studies) or length of stay (2/2).

Conclusion:

Multiple effective strategies exist to reduce antibiotic consumption in LMIC. However, marked heterogeneity limit conclusions regarding the most effective approach, particularly regarding clinical outcomes. Overall, AMS strategies are important tools in the reduction of MDRO-related morbidity in children in LMIC.
Proteome remodeling and organelle clearance in mammalian terminal erythropoiesis
Authors: Ren Kehan , Li Ermin , Ji Peng
Published: February 2022

Purpose of review

The differentiation from colony forming unit-erythroid (CFU-E) cells to mature enucleated red blood cells is named terminal erythropoiesis in mammals. Apart from enucleation, several unique features during these developmental stages include proteome remodeling and organelle clearance that are important to achieve hemoglobin enrichment. Here, we review the recent advances in the understanding of novel regulatory mechanisms in these processes, focusing on the master regulators that link these major events during terminal erythropoiesis.

Recent findings

Comprehensive proteomic studies revealed a mismatch of protein abundance to their corresponding transcript abundance, which indicates that the proteome remodeling is regulated in a complex way from transcriptional control to posttranslational modifications. Key regulators in organelle clearance were also found to play critical roles in proteome remodeling.

These studies demonstrate that the complexity of terminal erythropoiesis is beyond the conventional transcriptomic centric perspective. Posttranslational modifications such as ubiquitination are critical in terminal erythroid proteome remodeling that is also closely coupled with organelle clearance.
Ambient air pollution is associated with vascular disease in Ugandan HIV-positive adolescents
Authors: Toe Sophia , Nagy Matthew , Albar Zainab , Yu Jiao , Sattar Abdus , Nazzinda Rashida , Musiime Victor , Etajak Samuel , Walyawula Felix , McComsey Grace A. , Atuyambe Lynn M. , Dirajlal-Fargo Sahera
Published: February 2022

Objective:

In this study, we aim to investigate the relationship between particulate matter, a common proxy indicator for air pollution, and markers of inflammation, monocyte activation, and subclinical vascular disease.

Design:

A cross-sectional study.

Methods:

Adolescents with perinatally acquired HIV (PHIV) and HIV-uninfected adolescents between 10 and 18years living near Kampala, Uganda were included. Daily ambient concentrations of particulate matter (PM2.5) were measured from the Eastern Arica GEOHealth Hub. Outcome variables measured were carotid intima-media thickness (IMT), as well as plasma markers of systemic inflammation, oxidized lipids, and gut integrity. Multivariable quantile regression models were used to explore the relationship between PM2.5 and IMT.

Results:

One hundred and nineteen participants (69 PHIV, 50 HIV-uninfected) were included. The median (Q1, Q3) age was 12.7 (11.4,14.2) years, 55% were girls. Median daily PM2.5 exposure was 29.08 μg/m3 (23.40, 41.70). There was no significant difference in exposure of PM2.5 between groups (P 
= 0.073). PM2.5 significantly correlated with intestinal permeability (zonulin; r = 0.43, P < 0.001), monocyte activation (soluble CD163: r 
= 0.25, P = 0.053), and IMT (r 
= 0.35, P = 0.004) in PHIV but not in HIV-uninfected (P ≥ 0.05). In multivariable quantile regression, after adjusting for age, sex, poverty level, soluble CD163, and zonulin, daily PM2.5 concentrations remained associated with IMT [β 
= 0.005, 95% CI (0.0003–0.010), P = 0.037] in adolescents with PHIV.

Conclusion:

Adolescents in urban Uganda are exposed to high levels of air pollution. Both PM2.5 and HIV have independently been observed to contribute to atherosclerotic disease, and our findings suggest the combined effects of HIV and air pollution may amplify the development of cardiovascular disease.
Influence of Experimental Skull Defects on Brain
Authors: Bin Peng , Run-Ming Qu , Guo-Hua Wang , Li-Hua Xu , Zheng-Lin Jiang
Published: February 2022

This study was aimed to observe the effects of skull defects on the brain in rats and further to investigate its underlying pathophysiological. Three different sizes of skull were removed in rats to produce models of skull defect, and then the behavioral changes were detected using a grip strength meter and neurobehavioral severity scale scores. The authors further examined the levels of cell apoptosis and autophagy, the cerebral blood flow with immunoblotting, and immunofluorescence micro-ultrasound system, respectively. The authors found that the sensory function but not the grip was impaired on the 6th day after a 5 × 10 mm defect while the motor function was on the 2nd day. In addition, the authors found an increment in B-cell lymphoma-2/BCL2-Associated X (Bcl2/Bax) and LC3 II/I expression, a maker of apoptosis and autophagy, respectively, in the defective hemisphere especially at the edge of the defective area. Importantly, the blood flow of internal carotid artery began to decline at 2 hours, and reached minimum on the 4th day, but began to recover on the 6th day in the hemi-defect group. In conclusion, a larger skull defect could impair the cognitive function but not the motor function and its underlying pathophysiology were mainly related to a decrease in cerebral flow.
Comparative analysis of cell-cell communication at single-cell resolution
Authors: Wilk Aaron J. , Shalek Alex K. , Holmes Susan , Blish Catherine A.
Published: February 2022

Inference of cell-cell communication (CCC) from single-cell RNA-sequencing data is a powerful technique to uncover putative axes of multicellular coordination, yet existing methods perform this analysis at the level of the cell type or cluster, discarding single-cell level information. Here we present Scriabin – a flexible and scalable framework for comparative analysis of CCC at single-cell resolution. We leverage multiple published datasets to show that Scriabin recovers expected CCC edges and use spatial transcriptomic data, genetic perturbation screens, and direct experimental manipulation of receptor-ligand interactions to validate that the recovered edges are biologically meaningful. We then apply Scriabin to uncover co-expressed programs of CCC from atlas-scale datasets, validating known communication pathways required for maintaining the intestinal stem cell niche and revealing species-specific communication pathways. Finally, we utilize single-cell communication networks calculated using Scriabin to follow communication pathways that operate between timepoints in longitudinal datasets, highlighting bystander cells as important initiators of inflammatory reactions in acute SARS-CoV-2 infection. Our approach represents a broadly applicable strategy to leverage single-cell resolution data maximally toward uncovering CCC circuitry and rich niche-phenotype relationships in health and disease.
EMoMiS: A Pipeline for Epitope-based Molecular Mimicry Search in Protein Structures with Applications to SARS-CoV-2
Authors: Stebliankin Vitalii , Baral Prabin , Balbin Christian , Nunez-Castilla Janelle , Sobhan Masrur , Cickovski Trevor , Mondal Ananda Mohan , Siltberg-Liberles Jessica , Chapagain Prem , Mathee Kalai , Narasimhan Giri
Published: February 2022

Motivation

Epitope-based molecular mimicry occurs when an antibody cross-reacts with two different antigens due to structural and chemical similarities. Molecular mimicry between proteins from two viruses can lead to beneficial cross-protection when the antibodies produced by exposure to one also react with the other. On the other hand, mimicry between a protein from a pathogen and a human protein can lead to auto-immune disorders if the antibodies resulting from exposure to the virus end up interacting with host proteins. While cross-protection can suggest the possible reuse of vaccines developed for other pathogens, cross-reaction with host proteins may explain side effects. There are no computational tools available to date for a large-scale search of antibody cross-reactivity.

Results

We present a comprehensive Epitope-based Molecular Mimicry Search (EMoMiS) pipeline for computational molecular mimicry searches. EMoMiS, when applied to the SARS-CoV-2 Spike protein, identified eight examples of molecular mimicry with viral and human proteins. These findings provide possible explanations for (a) differential severity of COVID-19 caused by cross-protection due to prior vaccinations and/or exposure to other viruses, and (b) commonly seen COVID-19 side effects such as thrombocytopenia and thrombophilia. Our findings are supported by previously reported research but need validation with laboratory experiments. The developed pipeline is generic and can be applied to find mimicry for novel pathogens. It has applications in improving vaccine design.

Availability

The developed Epitope-based Molecular Mimicry Search Pipeline (EMoMiS) is available from https://biorg.cs.fiu.edu/emomis/.

Contact

giri@cs.fiu.edu
Food insecurity disparities and mental health impacts among cancer survivors during the COVID-19 pandemic
Authors: Camacho-Rivera Marlene , Islam Jessica Yasmine , Rodriguez Diane R. , Vidot Denise C. , Bailey Zinzi
Published: February 2022

Food insecurity can negatively impact adherence and receipt of high-quality cancer care. The purpose of the study was to (1) compare the prevalence of COVID-19 associated food insecurity by cancer history and (2) examine determinants associated with COVID-19 related food insecurity among cancer survivors.

We used nationally-representative data from the COVID-19 Household Impact Survey (n = 10,760), collected at three time points: April 20-26, May 4-10, and May 30th -June 8th of 2020. Our primary exposure was cancer survivor status, based on participant’s self-report of a cancer diagnosis (n=854, 7.1%). Primary outcomes of food insecurity were categorized on how often participants reported the following: “We worried our food would run out before we got money to buy more” or “The food that we bought just didn’t last, and we didn’t have money to get more”; Respondents were categorized as food insecure if they chose often true or sometimes true. Multivariable Poisson regression was used to identify demographic determinants of food insecurity among cancer survivors.

Thirty-two percent of cancer survivors were food insecure. Cancer survivors aged 30-44 years and those aged ≥60 were more likely to report being food insecure compared to respondents without a history of cancer in the same age categories (30-44 years, 59.9% versus 41.2% p = 0.01, ≥60 years 27.2% versus 20.2%, p = 0.01). Cancer survivors without a high school diploma were more likely to report food insecurity compared to adults with no history of cancer (87.0% versus 64.1%, p = 0.001). In multivariable models, uninsured cancer survivors (adjusted Prevalence Ratio (aPR) aPR: 2.39, 95% CI: 1.46-3.92) and those on Medicaid (aPR: 2.10, 95% CI: 1.40-3.17) were also more likely to report being food insecure.

Food insecurity during the COVID-19 pandemic is vast but disparities persist. Among cancer survivors, differences in food insecurity were observed by age and SES.