bluuebunny/crossref_metadata_2025 huggingface dataset:
Severe acute malnutrition’s recovery rate still below the minimum standard: predictors of time to recovery among 6- to 59-month-old children in the healthcare setting of Southwest Ethiopia
Authors: Eyi Seyum Ebissa , Debele Gebiso Roba , Negash Efrem , Bidira Kebebe , Tarecha Debela , Nigussie Kabtamu , Hajure Mohammedamin , Ahmed Mohammedjud Hassen , Kefeni Bilisumamulifna Tefera
Published: November 2022

Background

Despite currently available, scientifically proven treatments and national guideline, the SAM recovery rate is still considerably behind expectations, and it continues to have a devastating impact on under-five children. Identifying predictors of time to recovery might help to reach the minimal criterion established by the WHO and the national Sphere which decreases child mortality. Therefore, the current study assessed time to recovery and its predictors among children aged 6–59 months admitted with SAM in the Healthcare Setting of Southwest Ethiopia, 2021.

Methods

An institutional-based multicenter retrospective follow-up study was conducted on 486 children aged 6 to 59 months admitted with SAM cases. Data were entered into Epi-Data version 4.6 and exported to Stata version 14 for further analysis. Cox–Snell residual plot was used to assess the final model’s overall goodness of fit. Finally, a significant predictor of time to recovery was identified using Weibull survival regression model, at 0.05 significance level.

Result

Overall, 68.72 (95% CI 64.8, 73) of the children recovered and 4.32% died. The overall incidence density was 3.35/100-person day. Independent predictors of time to recovery were, starting complementary feeding at six months (AHR = 1.44; 95%, CI 1.073, 1.935), pneumonia at baseline (AHR = 1.33, 95%, CI 1.049, 1.696), amoxicillin (AHR = 1.31, 95%, CI 1.021, 1.685), and folic acid supplementation (AHR = 1.82, 95% CI 1,237, 2.665).

Conclusion

The recovery from SAM at study area after a maximum of 60 days of treatment was below the accepted minimum standard. Complementary feeding, pneumonia, treated by amoxicillin, and folic acid supplementation were predictors of time to recovery. Therefore, providing folic acid and amoxicillin for those in need as well as the earliest possible treatment of concomitant conditions like pneumonia is highly recommended.
Radiolabeling and quality control of therapeutic radiopharmaceuticals: optimization, clinical implementation and comparison of radio-TLC/HPLC analysis, demonstrated by [177Lu]Lu-PSMA
Authors: Hooijman Eline L. , Ntihabose Carolline M. , Reuvers Thom G. A. , Nonnekens Julie , Aalbersberg Else A. , van de Merbel Jordy R. J. P. , Huijmans Judith E. , Koolen Stijn L. W. , Hendrikx Jeroen J. M. A. , de Blois Erik
Published: November 2022

Background

Radiopharmaceuticals are considered as regular medicinal products and therefore the same regulations as for non-radioactive medicinal products apply. However, specific aspects should be considered due to the radiochemical properties. Radiopharmaceutical dedicated monographs are developed in the European Pharmacopoeia to address this. Currently, different quality control methods for non-registered radiopharmaceuticals are utilized, often focusing on radio-TLC only, which has its limitations. When the radiochemical yield (RCY) is measured by radio-TLC analysis, degradation products caused by radiolysis are frequently not detected. In contrast, HPLC analysis defines the radiochemical purity (RCP), allowing for detection of peak formation related to radiolysis. During the introduction and optimization phase of therapeutic radiopharmaceuticals, significant percentages of impurities, like radiolysed construct formation, may have consequential impact on patient treatment. Since more hospitals and institutes are offering radiopharmaceutical therapies, such as [177Lu]Lu-PSMA with an in-house production, the demand for adequate quality control is increasing. Here we show the optimization and implementation of a therapeutic radiopharmaceutical, including the comparison of ITLC and HPLC quality control.

Results

Downscaled conditions (74 MBq/μg) were in concordance to clinical conditions (18 GBq/250 µg, 5 mL syringe/100 mL flacon); all results were consistent with an > 98% RCY (radio-TLC) and stability of > 95% RCP (HPLC). Radio-TLC did not identify radiolysis peaks, while clear identification was performed by HPLC analysis. Decreasing the RCP with 50%, reduced the cell-binding capacity with 27%.

Conclusion

This research underlines the importance of the radiolabeling and optimization including clinical implementation and clarifies the need for cross-validation of the RCY and RCP for quality control measurements. Only HPLC analysis is suitable for identification of radiolysis. Here we have proven that radiolysed [177Lu]Lu-PSMA has less binding affinity and thus likely will influence treatment efficacy. HPLC analysis is therefore essential to include in at least the validation phase of radiopharmaceutical implementation to ensure clinical treatment quality.
Long-Term Outcomes in Survivors of Childhood Cancer: A 30-Year Experience From India
Authors: Prasad Maya , Goswami Savita , Chinnaswamy Girish , Banavali Shripad D. , Kurkure Purna A.
Published: November 2022

PURPOSE

Despite an increasing number of survivors of childhood cancer (CCS) in low- and middle-income countries, survivorship care is in its nascent stages. We describe the spectrum of late effects seen, challenges faced, and lessons learnt over three decades of a late effects program in India.

METHODS

We describe the demographics and profile of late effects of all CCS survivors enrolled in our After Completion of Treatment Clinic from February 5, 1991 (inception) to February 4, 2021. We analyzed the trends by the decade of diagnosis.

RESULTS

There were 3,067 CCS survivors, the median age was 18 years (range, 3-57 years), and the median follow-up was 11 years (range, 2-46 years). Two thirds (62.4%) had either no or mild late effects, 480 (15.6%), 497 (16.2%), and 162 (5.3%) had grades 2, 3, and 4 late effects, with 67 deaths reported. Notable late effects were chronic viral hepatitis (7.8%), thyroid dysfunction (7.5%), other endocrine issues (13.6%), psychosocial issues (57%), neurocognitive impairment (4.1%), and metabolic syndrome (4%). The cumulative incidence and severity of late effects showed a consistent decline by the decade of diagnosis. Twenty-two percent of survivors are lost to follow-up.

CONCLUSION

Survivors of childhood cancer treated on contemporary treatment protocols have a significantly lower side-effect profile. Attrition to long-term follow-up and psychosocial issues are significant concerns. Understanding the unique spectrum of late effects and establishing a holistic support system go a long way in ensuring the long-term physical and mental health and psychosocial concerns of childhood cancer survivors in low- and middle-income countries.
Geographic Distribution of Cancer Care Providers in the Philippines
Authors: Eala Michelle Ann B. , Maslog Ethan Angelo S. , Dee Edward Christopher , Ting Frederic Ivan L. , Toral Jean Anne B. , Dofitas Rodney B. , Co Henri Cartier S. , Cañal Johanna Patricia A.
Published: November 2022

PURPOSE

In the Philippines, a lower middle-income country in Southeast Asia, 6 of 10 Filipinos die without seeing a doctor. To ensure universal access to cancer care, providers must be equitably distributed. Therefore, we evaluated the distribution of oncologists across all 17 regions in the Philippines.

METHODS

We gathered data from the official websites of national medical societies on their members' regional area of practice: Philippine Society of Medical Oncology, Philippine Radiation Oncology Society, Surgical Oncology Society of the Philippines, Society of Gynecologic Oncologists of the Philippines, and Philippine Society of Hospice and Palliative Medicine. We compared this with the regional census to determine the number of board-certified oncologists per 100,000 Filipinos.

RESULTS

For a population of almost 110 million, the Philippines has a total of 348 medical oncologists, 164 surgical oncologists, 99 radiation oncologists, 142 gynecologic oncologists, and 35 hospice and palliative medicine (HPM) specialists. This translates to 0.32 medical oncologists, 0.15 surgical oncologists, 0.09 radiation oncologists, 0.13 gynecologic oncologists, and 0.03 HPM specialists for every 100,000 Filipinos. The number of oncologists is highest in the National Capital Region in Luzon and lowest in the Bangsamoro Autonomous Region in Muslim Mindanao. All regions have at least one medical and gynecologic oncologist. Two regions (12%) have no surgical oncologists, five regions (29%) have no radiation oncologists, and eight regions (47%) have no HPM specialists.

CONCLUSION

Efforts are needed to increase the number of oncologists and improve equity in their distribution to ensure universal access to cancer care in the Philippines.
Tissue-dependent transcriptional and bacterial associations in primary sclerosing cholangitis-associated inflammatory bowel disease
Authors: Ilott Nicholas E. , Neyazi Mastura ,   Oxford Translational Gastroenterology Unit Investigators, Arancibia-Cárcamo Carolina V. , Powrie Fiona , Geremia Alessandra
Published: November 2022

Background: Patients with primary sclerosing cholangitis (PSC) frequently have co-ocurring ulcerative colitis (UC) and develop colorectal cancer. Colorectal cancer risk in patients with PSC-associated ulcerative colitis (PSC/UC) is elevated relative to patients with ulcerative colitis (UC) alone, reasons for which remain obscure. Understanding the molecular and microbial basis for differences between these two patient groups and how these vary across intestinal sites is important for the development of therapies to prevent colorectal cancer development in at-risk individuals.  

Methods: We employed ribonucleic acid sequencing (RNA-seq) analysis of biopsy samples across three intestinal tissue locations (ileum, caecum and rectum) in patients with PSC/UC (ileum n = 7, caecum n = 7, rectum n = 7), UC (ileum n = 9, caecum n = 10, rectum n = 10) and healthy controls (ileum n = 11, caecum n = 9, rectum n = 12) to determine tissue-dependent transcriptional alterations in PSC/UC. We also performed 16S ribosomal RNA (rRNA) amplicon sequencing to determine bacterial associations with PSC/UC.

Results: Tissue-defining transcriptional signatures revealed that the ileum was enriched for genes involved in lipid and drug metabolism, the caecum for activated immune cells and the rectum for enteric neurogenesis. Transcriptional alterations relative to healthy control samples were largely shared between patients with PSC/UC or UC although were distinct across tissue locations. Nevertheless, we observed reduced expression of gamma-glutamyl transferase 1 (GGT1) specifically in the ileum and caecum of patients with PSC/UC.

Analysis of the bacterial component of the microbiome revealed high inter-individual variability of microbiome composition and little evidence for tissue-dependency. We observed a reduction in Parabacteroides relative abundance in the rectum of patients with PSC/UC.

Conclusions: The role of gamma-glutamyl transferase in maintaining the redox environment through the glutathione salvage pathway makes our observed alterations a potential pathway to PSC-associated colorectal cancer.
Reference spectrophotometric values for glucose-6-phosphate dehydrogenase activity in two-to six-month-old infants on the Thailand-Myanmar border
Authors: Bancone Germana , Poe Day Day , Gornsawun Gornpan , Htway Phyu Phyu , Gilder Mary Ellen , Archasuksan Laypaw , Chotivanich Kesinee , McGready Rose , Nosten Francois
Published: November 2022

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency represents a barrier to the full deployment of anti-malarial drugs for vivax malaria elimination and of first-line antibiotics. Lack of established reference ranges for G6PD activity in breast-fed infants puts them at risk of drug-induced haemolysis and restricts access to safe treatment of their mothers.  

Methods: The present work was undertaken to establish age-specific G6PD normal values using the gold standard spectrophotometric assay to support the future clinical use of tafenoquine in lactating women and safer antibiotic treatment in infants.  

Results: Spectrophotometric results from 78 healthy infants between the ages of 2 and 6 months showed a trend of decreased enzymatic activity with increasing age and provided a reference normal value of 100% activity for infants 2-6 months old of 10.18IU/gHb.  

Conclusions: Normal reference G6PD activity in 2–6-month-old infants was approximately 140% of that observed in G6PD normal adults from the same population. Age specific G6PD activity thresholds should be used in paediatric populations to avoid drug-induced haemolysis.
The Role of Social Media in the Corporate Bond Market: Evidence from Twitter
Authors: Bartov Eli , Faurel Lucile , Mohanram Partha
Published: November 2022

Prior studies document the role social media information plays in the stock market and the important dissimilarities between the bond and stock markets. Bridging these two types of literature, we examine the role of social media information in the corporate bond market. Analyzing a broad sample of messages by Twitter individual users, posted just prior to earnings announcements, containing bond, credit risk, and fundamental information, we find that aggregate Twitter opinion (OPI) predicts upcoming announcement bond returns and changes in credit default swap (CDS) spreads, and is associated with future changes in bond yield spreads and credit ratings, thereby providing economically important information to the bond market. This interpretation is bolstered by results from a variety of cross-sectional analyses. Finally, we document an association between OPI and future changes in default risk, which casts light on the nature of the Twitter information underlying our findings. Overall, our findings demonstrate that Twitter appears to disseminate potentially economically important information to even the presumably sophisticated bond and CDS investors, as well as information intermediaries.

This paper was accepted by Suraj Srinivasan, accounting.

Funding: P. Mohanram acknowledges financial support from the Social Sciences and Humanities Research Council (SSHRC) of Canada.

Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2022.4589 .
Contextual Search in the Presence of Adversarial Corruptions
Authors: Krishnamurthy Akshay , Lykouris Thodoris , Podimata Chara , Schapire Robert
Published: November 2022

Contextual search is a generalization of binary search, which captures settings such as feature-based dynamic pricing. In this paradigm, a decision maker repeatedly interacts with a set of agents; in the pricing example, the decision maker first observes the context/ features of an item, then sets a feature-dependent price, and the agent responds by either buying or not. Standard formulations of this problem assume that agents act in accordance with a specific homogeneous response model. In practice, however, some responses may be adversarially corrupted (e.g., when some agents exhibit outlier behavior). Existing algorithms heavily depend on the assumed response model being (approximately) accurate for all agents and have poor performance in the presence of even a few such outliers. We initiate the study of contextual search in the presence of such adversarial corruptions. Our algorithms’ performance is near-optimal in the absence of outliers and degrades gracefully with their number.
Patient satisfaction with telephone consultations at a community mental health service: a descriptive survey
Authors: Naik Kshipra Vissucanta , Allen Lucy , Gnanavel Muthukkumaar
Published: November 2022

Background/Aims

Research has demonstrated that there are several models of teleconsultation, and that these can be effective and acceptable to patients. At the start of the COVID-19 pandemic, there was a sudden shift to phone consultations in community mental health services. This study assessed the impact of this change from the patient perspective and thus determined how this mode of delivery can be optimised going forwards.

Method

Data were collected using a semi-structured, self-reporting patient satisfaction questionnaire with 17 items, which was sent to 200 patients who had received both an in-person and telephone consultation from a community mental health team in Wales. The themes covered in the questionnaire were communication, interpersonal manner, technical quality, convenience and general satisfaction. A total of 114 respondents rated their agreement with the items on a 5-point Likert scale, and free-text boxes were provided for suggestions and comments. Quantitative data were summarised using descriptive statistics and free-text comments were analysed thematically.

Results

The majority of the patients gave positive responses, with 70–94% either agreeing or strongly agreeing with the positive statements regarding the communication, interpersonal manner, technical quality and length of consultation that they experienced. Overall, 74% agreed or strongly agreed that they were generally satisfied. However, only 52% believed that telephone consultations were more convenient than in-person hospital appointments, and nearly one-quarter (24%) did not want to continue with telephone consultations in the future. Suggested improvements included the use of video consultations, provision of extra time for consultations and a general increase in the services available.

Conclusions

Telephone consultations were generally perceived as acceptable, useful and effective, helping patients to access ongoing mental health care. This suggests that telephone consultations could be an effective method of care delivery in the future. However, there is a need for further research and development in the remote delivery of mental health services.
Using quality improvement to deliver a systematic organisational approach to enjoying work in healthcare
Authors: Aurelio Marco , Ballingall Nicola , Chitewe Auzewell , Heaney Catherine , Shah Amar
Published: November 2022

Staff wellbeing is increasingly linked to good outcomes for service users in healthcare. Therefore, it is important for organisations to find ways to focus on wellbeing and staff experience at work. This article shares learning from 5 years of using the Institute for Healthcare Improvement's joy in work framework, coupled with quality improvement methods to enhance staff experience and wellbeing. This demonstrates how teams were brought together in a collaborative learning system to apply quality improvement to enhance joy in work. Key steps are shared for other organisations wanting to undertake this work, including the application of improvement methods to empower teams locally to develop, design and test change ideas, and measure their impact. The design of systems and structures required to meaningfully bring teams together and the type of leadership that enhances this work are also considered. Key learning points for other organisations include the need for improvement principles to iterate the organisational approach, make measurement simple, encourage a bias to action and make the work fun.
The influence of psychiatric comorbidities on the duration of compulsory nasogastric tube feeding of children and adolescents with restrictive eating disorders
Authors: Fuller Sarah J , Falcoski Paola Moraes Sarmento Freitas , Hudson Lee D , Tan Jacinta OA
Published: November 2022

Background/aims

The authors' clinical experience found that some patients required the intervention of compulsory nasogastric tube feeding for a significantly longer amount of time than others. The aim of this study was to identify whether different psychiatric comorbidities are associated with different durations of nasogastric tube feeding under restraint in children and young people with restrictive eating disorders.

Methods

A retrospective case-note analysis was conducted in 2018. Data were collected from electronic medical records and hospital incident forms, focusing on diagnosis, length of stay and on the number of episodes of nasogastric tube feeding under restraint.

Results

A total of nine patients required nasogastric tube feeding under restraint, of which four patients had psychiatric comorbidities (emerging emotionally unstable personality disorder, autism spectrum disorder and complex trauma). Length of stay was not significantly greater in patients with psychiatric comorbidities (median=302 vs 241 days, Mann-Witney U=16.00, P=0.20). However, the number of episodes of nasogastric tube feeding under restraint was significantly greater in those with psychiatric comorbidities (median=31.00 vs 2 episodes, Mann-Whitney U=20.00, P=0.02) than those without.

Conclusions

This study suggests that psychiatric comorbidities are associated with more prolonged episodes of nasogastric tube feeding under restraint and therefore patients with these comorbidities will have greater treatment planning needs.
Sizing of Rooftop PV Array and Community-Run Battery Storage for an Energy Cooperative in Prosumer Cluster
Authors: Sujikannan M. , Kumar A. Rakesh , Daniel S. Arul
Published: November 2022

A standalone system can address the problem of uncovered electricity from the grid. The cost of energy storage for installing renewable energy systems is one of the issues of such a system. This paper introduces and investigates the optimal capacity of a novel energy cooperative system with prosumer clusters and a community battery bank as typical energy storage. The system’s function is formulated to minimize the investor’s annual expenditure. The proposed energy cooperative system uses actual annual solar insolation data and the electric load demand of houses in the optimization process. The model, as mentioned above, is applied to two system configurations – energy cooperative without and with Prosumer to Prosumer (P2P) energy sharing. The reliability factor Loss of Power Supply Probability (LPSP) from the Cooperative Energy Sharing algorithm is taken as a constraint in the formulation. The comparison of the two configurations brings out the importance of P2P energy sharing in a standalone Energy Cooperative system. Particle Swarm Optimization (PSO) algorithm is used to achieve this optimization. The PSO results show that the proposed Energy Cooperative configurations are promising to facilitate the system’s reliability.
A Fault and Islanding Detection Scheme using Differential Positive Sequence Power Angle for a Microgrid
Authors: Ansari Salauddin , Gupta Om Hari
Published: November 2022

Implementation of distributed generation (DG) fault and islanding detection in a microgrid are two difficult jobs to complete. Efforts by many researchers to develop solutions to these a kind of challenges are ongoing. Still, there is hardly any scheme that can detect and distinguish both the fault and islanding events. To detect and differentiate between fault and islanding events, this article presents a Differential Positive Sequence Power Angle (DPSPA)-based protection technique. The scheme is widely examined considering different working conditions of a microgrid such as DG disconnection, DG penetration, different fault parameters like fault type, fault resistance, fault location, fault inception angle, fault during single-pole tripping (STP), simultaneous faults, and evolving faults. Tests were also performed for non-fault cases like load switching, capacitor switching, sectional cut-off, DG disconnection, and impact of noise and sampling frequency. Furthermore, the scheme’s outcomes have been compared to that of recent protection schemes. Finally, using the OP4510 real-time simulator, the proposed approach is validated in an online environment. The results show that the proposed DPSPA-based scheme can be a notable scheme to protect a microgrid in a wide variety of situations.
Management of Femoral Neck Fracture in Above Knee Amputee with Femoral Neck System: A Case Report
Authors: Gruhonjic Imran , West Derek
Published: November 2022

Introduction: Femoral neck fractures in patients with a history of above knee amputation present as a strain for orthopedic surgeons due to the difficulty of positioning and handling of the limb for proper reduction. Surgical treatment options typically involve open reduction internal fixation versus arthroplasty depending on patient factors such as age, surgeon skill, and available equipment. Case Report: We present a case of a femoral neck fracture (OTA 31-B2) in a relatively active 89-year-old Caucasian male after a ground level fall that has been ambulating with a prosthesis since his teenage years. In this report, we describe the patient positioning, technique used to treat a femoral neck fracture (OTA 31-B2) using the femoral neck system, and the successful outcome of our patient 1 year from the injury. Conclusion: We conclude that using the femoral neck system (FNS) is a viable option for patients with a high above knee amputation where, due to the length of the limb and potentially the lack of appropriately sized implants, dislocating and reducing the hip for total hip arthroplasties and hemiarthroplasties provide a challenge.
Extra-Articular Corrective Osteotomy for Malunion of Intra-Articular Fracture of the Elbow in a Child: A Case Report
Authors: Shibayama Hiroki , Kawamura Daisuke , Iwasaki Norimasa
Published: November 2022

Introduction: Malunion of intra-articular fracture of the elbow in children is uncommon and may be difficult to treat. Intra-articular corrective osteotomies are still not commonly performed in children, and the main reason is the concern regarding the risk of osteonecrosis. We present a case of extra-articular corrective osteotomy for malunion after open reduction and internal fixation for fracture dislocation of the elbow. Case Report: An 8-year-old boy was injured by a fall and he underwent an operation the day after the injury with diagnosis of lateral condyle fracture of the right humerus. He was referred to our department 4 months after the operation due to restricted range of motion. His elbow exhibited cubitus varus, and range of motion was 80° of flexion, −30° of extension, 55° of pronation, and 85° of supination. Plain radiographs showed malunion, a Baumann angle of 3°, and a tilting angle of 5°. We diagnosed this injury not as lateral condyle fracture but as posterolateral dislocation with Milch type 1 lateral condyle fracture associated with osteochondral flap fracture of the coronoid process with computed tomography images at the time of injury. Because the patient was only 8 years old, we decided to perform an extra-articular corrective osteotomy to encourage bone remodeling and improve the flexion range of motion. After the operation, the range of motion improved as 130° of flexion, −30° of extension, 85° of pronation, and 90° of supination 4 years after the operation. Plain radiographs showed that the epiphysis of the capitellum was closed, and the trochlea presented a fishtail deformity. Conclusion: We obtained relatively good outcomes with extra-articular corrective osteotomy, and long-term follow-up is necessary. Especially in the elbow, the injury itself may cause fishtail deformity due to avascular necrosis of the trochlea, and if an additional osteotomy is performed, the risk increases. Although there is concern about the occurrence of secondary osteoarthritis, we expect that the intra-articular deformity would be remodeled due to the patient’s young age if normal elbow movement could be obtained.
A Rare Case of an Intertrochanteric Hip Fracture Combined with an Ipsilateral Incomplete Atypical Femoral Fracture Treated with a Long Gamma Intramedullary Nail
Authors: Georgiadis Georgios F , Chatzopoulos Stamatios Theodoros D , Maniatis Konstantinos A , Begka Dimitrios G
Published: November 2022

Introduction: Osteoporotic hip fractures can occur at the femoral neck and intertrochanteric area, with the peritrochanteric fracture being responsible for half of these fractures in the geriatric population. Atypical femoral fractures have been associated in the literature with long-term use of bisphosphonates or denosumab. However, few cases with the characteristics of these fractures have been reported in the past in patients not receiving antiresorptive drugs. To date, no combination of an intertrochanteric fracture with an impending incomplete atypical fracture of the ipsilateral femoral diaphysis has been previously reported in the literature. Case Report: We present a rare case of a 97-year-old female patient with an intertrochanteric femoral fracture, with a preexisting focal cortical thickening along the lateral aspect of the ipsilateral proximal femoral diaphysis which is a warning sing for an incomplete atypical femoral fracture. A long gamma nail was used to fix the intertrochanteric fracture and simultaneously to stabilize and protect the area of the atypical femoral fracture. Conclusion: Any patient with a peritrochanteric hip fracture who was under long-term treatment with antiresorptive agents against osteoporosis, or has other risk factors predisposing to atypical femoral fracture, should undergo a thorough radiological examination of the ipsilateral femur, to exclude the possibility of simultaneous presence of both of the above pathologies. In any such case, the use of a long hip cephalomedullary nail seems to be the best treatment option, because it can treat both fractures at the same time.
Human Rights Bulletin
Authors: Rosenthal Eric , Kurylo Halyna , Ciric Milovanovic Dragana , Ahern Laurie , Rodriguez Priscila
Published: November 2022

This bulletin considers the situation of children with disabilities in Ukraine, who at the time of the onset of the armed conflict were living in institutional care. DRI investigations have revealed that despite abundant international assistance, the government of Ukraine and international relief agencies have failed to ensure the safety and protect the lives of these children within institutions – or to ensure their safe return to families in the community.
Devising genuine cross-spectral densities by randomization of coherent fields
Authors: Charnotskii Mikhail
Published: November 2022

We propose a concept of devising the authentic cross spectral densities (CSDs) of
partially coherent beam waves by averaging the second moment of a
coherent field over a certain number of random parameters. Several CSD
examples created by randomization are presented. We discuss
application of randomization to generation of twisted Gaussian Schell
model beams and show that compound randomization leads to a new, more
general class of twisted beams. We revisit the necessary nonnegative
definiteness condition of Opt. Lett. 34, 1399
(2009)OPLEDP0146-959210.1364/OL.34.001399 and show that the
two-dimensional space of parameters is necessary.
Demonstration of a high-density alkali-metal atomic magnetometer based on the frequency-symmetrical detuning effect of two pumping lights
Authors: Ma Ning , Duan Lihong , Ma Danyue , Lu Jixi , Xing Bozheng , Li Jin , Han Bangcheng
Published: November 2022

The existence of an approximately uniform and unsaturated electron spin polarization distribution within a high-density alkali-metal vapor is considered of great importance for significantly improving the response amplitude and sensitivity properties of an atomic magnetometer. However, when a high-density alkali-metal vapor is formed, the optical depth is much larger than the value of one, resulting in the electron spin polarization gradient. In this work, it was demonstrated from both numerical simulations and experimental points of view, that by replacing the resonant pumping light with two off-resonant pumping light sources, the signal amplitude of the magnetometer can be doubled. By using this approach, the electron spin polarization gradient can be significantly suppressed and the sensitivity can be improved by more than 10%. The proposed scheme is generally applicable to various optical pumping high-density alkali-metal vapor systems, where a uniform electron spin polarization distribution is required, such as optical pumping co-magnetometers and atomic gyroscopes.
Vertical stack integration of blue and yellow InGaN micro-LED arrays for display and wavelength division multiplexing visible light communication applications
Authors: Wang Zhou , Jin Zuxin , Lin Runze , Zhu Shijie , Shan Xinyi , Stepniak Grzegorz , Cui Xugao , Tian Pengfei
Published: November 2022

In this work, we demonstrated a convenient and reliable method to realize the vertical stack integration of the blue and yellow InGaN micro-LED arrays. The standard white and color-tunable micro-light sources can be achieved by adjusting the current densities injection of the micro-LEDs. The spectra cover violet, standard white, cyan, etc., showing an excellent color-tunable property. And the mixed standard white light can be separated into red-green-blue three primary colors through the color filters to realize full-color micro-LED display with a color gamut of 75% NTSC. Besides, the communication capability of the integrated micro-LED arrays as visible light communication (VLC) transmitters is demonstrated with a maximum total data rate of 2.35 Gbps in the wavelength division multiplexing (WDM) experimental set-up using orthogonal frequency division multiplexing modulation. In addition, a data rate of 250 Mbps is also realized with the standard white light using on-off keying (OOK) modulation. This integrated device shows great potential in full-color micro-LED display, color-tunable micro-light sources, and high-speed WDM VLC multifunctional applications.
Towards optimization of photonic-crystal surface-emitting lasers via quantum annealing
Authors: Inoue Takuya , Seki Yuya , Tanaka Shu , Togawa Nozomu , Ishizaki Kenji , Noda Susumu
Published: November 2022

Photonic-crystal surface-emitting lasers (PCSELs), which utilize a two-dimensional (2D) optical resonance inside a photonic crystal for lasing, feature various outstanding functionalities such as single-mode high-power operation and arbitrary control of beam polarizations. Although most of the previous designs of PCSELs employ spatially uniform photonic crystals, it is expected that lasing performance can be further improved if it becomes possible to optimize the spatial distribution of photonic crystals. In this paper, we investigate the structural optimization of PCSELs via quantum annealing towards high-power, narrow-beam-divergence operation with linear polarization. The optimization of PCSELs is performed by the iteration of the following three steps: (1) time-dependent 3D coupled-wave analysis of lasing performance, (2) formulation of the lasing performance via a factorization machine, and (3) selection of optimal solution(s) via quantum annealing. By using this approach, we discover an advanced PCSEL with a non-uniform spatial distribution of the band-edge frequency and injection current, which simultaneously enables higher output power, a narrower divergence angle, and a higher linear polarization ratio than conventional uniform PCSELs. Our results potentially indicate the universal applicability of quantum annealing, which has been mainly applied to specific types of discrete optimization problems so far, for various physics and engineering problems in the field of smart manufacturing.
Generating multiple vortex beams simultaneously and independently in different directions by elaborately splicing multiple transmissive metasurfaces featuring polarization isolation
Authors: Xu Peng , Li Ruijie , Liu Haixia , Zhang Kunyi , Wang Xin , Li Long
Published: November 2022

In this paper, by elaborately splicing multiple transmissive metasurfaces (MSs) featuring polarization isolation, multiple linear polarized (LP) vortex beams are generated simultaneously and independently in different directions. Specifically, by carefully optimizing the radius of the array and the distance between the MS and array, each MS generates a well-performed deflection vortex beam with a low side-lobe level and little diffraction, resulting in a minor effect on other deflection vortex beams. Subsequently, four transmissive MSs are elaborately spliced, showing the polarization isolation characteristic between the adjacent MS, and thereby each MS is only illuminated by the respective antenna array. In addition, each MS only generates the desired LP vortex beam, and the corresponding cross-polarization is suppressed. Finally, the simulation and measurement results show that multiple LP vortex beams carrying different orbital angular momentum (OAM) modes are generated simultaneously and independently in different directions, verifying the effectiveness of the proposed method.
Inferring parameters of cancer evolution in chronic lymphocytic leukemia
Authors: Lee Nathan D. , Bozic Ivana
Published: November 2022

As a cancer develops, its cells accrue new mutations, resulting in a heterogeneous, complex genomic profile. We make use of this heterogeneity to derive simple, analytic estimates of parameters driving carcinogenesis and reconstruct the timeline of selective events following initiation of an individual cancer, where two longitudinal samples are available for sequencing. Using stochastic computer simulations of cancer growth, we show that we can accurately estimate mutation rate, time before and after a driver event occurred, and growth rates of both initiated cancer cells and subsequently appearing subclones. We demonstrate that in order to obtain accurate estimates of mutation rate and timing of events, observed mutation counts should be corrected to account for clonal mutations that occurred after the founding of the tumor, as well as sequencing coverage. Chronic lymphocytic leukemia (CLL), which often does not require treatment for years after diagnosis, presents an optimal system to study the untreated, natural evolution of cancer cell populations. When we apply our methodology to reconstruct the individual evolutionary histories of CLL patients, we find that the parental leukemic clone typically appears within the first fifteen years of life.
Variations in long-term care home resident hospitalizations before and during the COVID-19 pandemic in Ontario
Authors: Jones Aaron , Mowbray Fabrice I. , Falk Lindsey , Stall Nathan M. , Brown Kevin A. , Malikov Kamil , Malecki Sarah L. , Lail Sharan , Jung Hae Young , Costa Andrew P. , Verma Amol A. , Razak Fahad
Published: November 2022

Objectives

To examine how the COVID-19 pandemic affected the demographic and clinical characteristics, in-hospital care, and outcomes of long-term care residents admitted to general medicine wards for non-COVID-19 reasons.

Methods

We conducted a retrospective cohort study of long-term care residents admitted to general medicine wards, for reasons other than COVID-19, in four hospitals in Toronto, Ontario between January 1, 2018 and December 31, 2020. We used an autoregressive linear model to estimate the change in monthly admission volumes during the pandemic period (March-December 2020) compared to the previous two years, adjusting for any secular trend. We summarized and compared differences in the demographics, comorbidities, interventions, diagnoses, imaging, psychoactive medications, and outcomes of residents before and during the pandemic.

Results

Our study included 2,654 long-term care residents who were hospitalized for non-COVID-19 reasons between January 2018 and December 2020. The crude rate of hospitalizations was 79.3 per month between March-December of 2018–2019 and 56.5 per month between March-December of 2020. The was an adjusted absolute difference of 27.0 (95% CI: 10.0, 43.9) fewer hospital admissions during the pandemic period, corresponding to a relative drop of 34%. Residents admitted during the pandemic period had similar demographics and clinical characteristics but were more likely to be admitted for delirium (pandemic: 7% pre-pandemic: 5%, p = 0.01) and were less likely to be admitted for pneumonia (pandemic: 3% pre-pandemic: 6%, p = 0.004). Residents admitted during the pandemic were more likely to be prescribed antipsychotics (pandemic: 37%, pre-pandemic: 29%, p <0.001) and more likely to die in-hospital (pandemic:14% pre-pandemic: 10%, p = 0.04)

Conclusions and implications

Better integration between long-term care and hospitals systems, including programs to deliver urgent medical care services within long-term care homes, is needed to ensure that long-term care residents maintain equitable access to acute care during current and future public health emergencies.
Iterative deep neural networks based on proximal gradient descent for image restoration
Authors: Lv Ting , Pan Zhenkuan , Wei Weibo , Yang Guangyu , Song Jintao , Wang Xuqing , Sun Lu , Li Qian , Sun Xiatao
Published: November 2022

The algorithm unfolding networks with explainability of algorithms and higher efficiency of Deep Neural Networks (DNN) have received considerable attention in solving ill-posed inverse problems. Under the algorithm unfolding network framework, we propose a novel end-to-end iterative deep neural network and its fast network for image restoration. The first one is designed making use of proximal gradient descent algorithm of variational models, which consists of denoiser and reconstruction sub-networks. The second one is its accelerated version with momentum factors. For sub-network of denoiser, we embed the Convolutional Block Attention Module (CBAM) in previous U-Net for adaptive feature refinement. Experiments on image denoising and deblurring demonstrate that competitive performances in quality and efficiency are gained by compared with several state-of-the-art networks for image restoration. Proposed unfolding DNN can be easily extended to solve other similar image restoration tasks, such as image super-resolution, image demosaicking, etc.
Mobile robot path planning with reformative bat algorithm
Authors: Xin Gongfeng , Shi Lei , Long Guanxu , Pan Weigang , Li Yiming , Xu Jicun
Published: November 2022

Mobile robot path planning has attracted much attention as a key technology in robotics research. In this paper, a reformative bat algorithm (RBA) for mobile robot path planning is proposed, which is employed as the control mechanism of robots. The Doppler effect is applied to frequency update to ameliorate RBA. When the robot is in motion, the Doppler effect can be adaptively compensated to prevent the robot from prematurely converging. In the velocity update and position update, chaotic map and dynamic disturbance coefficient are introduced respectively to enrich the population diversity and weaken the limitation of local optimum. Furthermore, Q-learning is incorporated into RBA to reasonably choose the loudness attenuation coefficient and the pulse emission enhancement coefficient to reconcile the trade-off between exploration and exploitation, while improving the local search capability of RBA. The simulation experiments are carried out in two different environments, where the success rate of RBA is 93.33% and 90%, respectively. Moreover, in terms of the results of success rate, path length and number of iterations, RBA has better robustness and can plan the optimal path in a relatively short time compared with other algorithms in this field, thus illustrating its validity and reliability. Eventually, by the aid of the Robot Operating System (ROS), the experimental results of real-world robot navigation indicate that RBA has satisfactory real-time performance and path planning effect, which can be considered as a crucial choice for dealing with path planning problems.
Total neoadjuvant therapy versus standard therapy in locally advanced rectal cancer: A systematic review and meta-analysis of 15 trials
Authors: Zhang Xiping , Ma Shujie , Guo Yinyin , Luo Yang , Li Laiyuan
Published: November 2022

Background

Neoadjuvant chemoradiotherapy (nCRT) before total mesorectal excision (TME) and followed systemic chemotherapy is widely accepted as the standard therapy for locally advanced rectal cancer (LARC). This meta-analysis was to evaluate the current evidence regarding nCRT in combination with induction or consolidation chemotherapy for rectal cancer in terms of oncological outcomes.

Methods

A systematic search of medical databases (PubMed, EMBASE and Cochrane Library) was conducted up to the end of July 1, 2021. This meta-analysis was performed to evaluate the efficacy of TNT in terms of pathological complete remission (pCR), nCRT or surgical complications, R0 resection, local recurrence, distant metastasis, disease-free survival (DFS) and overall survival (OS) in LARC.

Results

Eight nRCTs and 7 RCTs, including 3579 patients were included in the meta-analysis. The rate of pCR was significantly higher in the TNT group than in the nCRT group, (OR 1.85, 95% CI 1.39–2.46, p < 0.0001), DFS (HR 0.80, 95% CI 0.69–0.92, p = 0.001), OS (HR 0.75, 95% CI 0.62–0.89, p = 0.002), nCRT complications (OR 1.05, 95% CI 0.77–1.44, p = 0.75), surgical complications (OR 1.02, 95% CI 0.83–1.26, p = 0.83), local recurrence (OR 1.82, 95% CI 0.95–3.49, p = 0.07), distant metastasis (OR 0.77, 95% CI 0.58–1.03, p = 0.08) did not differ significantly between the TNT and nCRT groups.

Conclusion

TNT appears to have advantages over standard therapy for LARC in terms of pCR, R0 resection, DFS, and OS, with comparable nCRT and postoperative complications, and no increase in local recurrence and distant metastasis.
Association between circulating SerpinB1 levels and insulin sensitivity in Japanese with type 2 diabetes: A single-center, cross-sectional, observational study
Authors: Kyohara Mayu , Miyashita Daisuke , Inoue Ryota , Nishiyama Kuniyuki , Tsuno Takahiro , Okuyama Tomoko , Togashi Yu , Terauchi Yasuo , Shirakawa Jun
Published: November 2022

Plasma and liver SerpinB1 levels are elevated in mice with insulin resistance and promote β-cell proliferation in human islets. We measured serum SerpinB1 levels in Japanese subjects with or without type 2 diabetes (T2DM). We enrolled 12 normal glucose tolerance (NGT) and 51 T2DM subjects. There was no difference in serum SerpinB1 levels between the 2 groups (T2DM, 1.3 ± 0.9 ng/mL vs. NGT, 1.8 ± 1.7 ng/mL; P = 0.146). After adjusting for age and sex, the serum SerpinB1 levels were positively correlated with HOMA2-%S (β = 0.319, P = 0.036), and negatively correlated with fasting blood glucose (β = -0.365, P = 0.010), total cholesterol (β = -0.396, P = 0.006), low-density lipoprotein (LDL) cholesterol (β = -0.411, P = 0.004), triglycerides (β = -0.321, P = 0.026), and γGTP (β = -0.322, P = 0.026) in subjects with T2DM. Thus, circulating SerpinB1 is possibly associated with insulin sensitivity and better blood glucose level in Japanese subjects with T2DM.

Trial registration: UMIN Clinical Trials Registry, UMIN000020453.
A supervised topic embedding model and its application
Authors: Xu Weiran , Eguchi Koji
Published: November 2022

We propose rTopicVec, a supervised topic embedding model that predicts response variables associated with documents by analyzing the text data. Topic modeling leverages document-level word co-occurrence patterns to learn latent topics of each document. While word embedding is a promising text analysis technique in which words are mapped into a low-dimensional continuous semantic space by exploiting the local word co-occurrence patterns within a small context window. Recently developed topic embedding benefits from combining those two approaches by modeling latent topics in a word embedding space. Our proposed rTopicVec and its regularized variant incorporate regression into the topic embedding model to model each document and a numerical label paired with the document jointly. In addition, our models yield topics predictive of the response variables as well as predict response variables for unlabeled documents. We evaluated the effectiveness of our models through experiments on two regression tasks: predicting stock return rates using news articles provided by Thomson Reuters and predicting movie ratings using movie reviews. Results showed that the prediction performance of our models was more accurate in comparison to three baselines with a statistically significant difference.