bluuebunny/crossref_metadata_2025 huggingface dataset:
Highly Sensitive Low-Frequency-Detectable Acoustic Sensor Using a Piezoresistive Cantilever for Health Monitoring Applications
Authors: Okamoto Yuki , Nguyen Thanh-Vinh , Takahashi Hidetoshi , Takei Yusuke , Okada Hironao , Ichiki Masaaki
Published: January 2023

This study investigates a cantilever-based pressure sensor that can achieve a signal-to-noise ratio (SNR) of approximately 80 dB or a resolution of approximately 0.1 mPa, over the frequency range of 0.1 to 250 Hz. A piezoresistive cantilever with ultra-high acoustic compliance is used as the sensing element in the proposed pressure sensor. We achieved a cantilever with a sensitivity of approximately 40 times higher than that of the previous cantilever device by realizing an ultrathin (340-nm thick) structure with large pads and narrow hinges. Based on the measurement results, the proposed pressure sensor can measure acoustic signals with frequencies as low as 0.1 Hz. The proposed pressure sensor can be used to measure low-frequency pressure and sound, which is crucial for various applications, including photoacoustic-based gas/chemical sensing and monitoring of physiological parameters and natural disasters. We demonstrate the measurement of heart sounds with a high SNR of 58 dB. We believe the proposed microphone will be used in various applications, such as wearable health monitoring, monitoring of natural disasters, and realization of high-resolution photoacoustic-based gas sensors. We successfully measured the systolic and diastolic beats in the heat sound with frequencies of 7-100 Hz and 20-45 Hz, respectively.
Seasonal rainfall patterns modify summer energy balance and nutritional condition of grazing sheep via vegetation communities
Authors: yoshihara yu , tanaka chisato , Choijilsuren Buyantogtokh , Tserendorj Javzandolgor , Byambajav Bilguun , Umemura Kazuhiro , Kinugasa Toshihiko , Shinoda Masato
Published: January 2023

Recent spring and summer rainfall patterns in Mongolian grasslands have shown high annual fluctuations and are thought to affect sheep energy balance and nutritious condition via plant community changes. To test this, we obtained climatic and vegetation data in Mongolian semi-arid grasslands from spring to summer for 3 years. Sheep energy intake and expenditure were calculated, and the energy balance and nutrition indicators were compared among years with different seasonal rainfall patterns. In 2019 and 2022, rainfall patterns were characterized by the presence or absence of an early summer drought, respectively. Compared to 2019, plants were tall and abundant in 2022, and thus mean bite size, energy intake, and body weights were greater. Estimated energy intake and expenditure were 4.56 and 2.10 Mcal in 2019, and 6.75 and 1.63 in 2022, respectively, demonstrating that rainfall timing and amount affected vegetation assemblage, plant height, herbage nutrition, grazing behavior, animal energy balance, and nutrition conditions. Insufficient rainfall events before early summer in semi-arid grazing lands resulted in low energy intake and balance, and the delayed body weight gain could not be recovered. The findings can inform management of grazing land to ensure optimal livestock condition.
Single-tuned passive filter (STPF) for mitigating harmonic in a 3-phase power system
Authors: Ishaya Meshack Magaji , Adegboye Oluwatayomi Rereloluwa , Agyekum Ephraim Bonah , Elnaggar Mohamed F. , Kamel Salah
Published: January 2023

Harmonics constitutes multiple integrals of the fundamental frequency found in power systems or electric circuitry systems, are primarily caused by non-linear loads that draw current intermittently or have an impedance that changes each cycle of the AC voltage. This can lead to overheating of the system, loss of original waveform, and damage to equipment or system leading to extra expense economically to the consumer. Since harmonics cause distortion in the system and cannot be eliminated from the system, various methods of mitigating to an acceptable level are introduced, use of filters is one of these methods. An STPF adjusted to the 5th, 7th, 11th, 13th, 17th, and 19th harmonic order was employed in this paper in a power system and analyzed. Data was measured on the point of common coupling (PCC) panel using the power quality analyzer tool, and the system was designed on MATLAB/Simulink environment without the filter applied readings were made, and after the STPF was added, both were compared to the IEE 519-1992 standard for which the STPF totally mitigated the harmonics in the system within the standard required.
Fe-modified fly ash/cotton stalk biochar composites for efficient removal of phosphate in water: mechanisms and green-reuse potential
Authors: Hao Mengqi , Wu Wei , Habibul Nuzahat , Chai Guang , Ma Xiaoli , Ma Xiaoqian
Published: January 2023

Excessive phosphate content input into natural water can lead to the waste of resource and eutrophication. Biochar is a kind of low-cost adsorbents. However, its adsorption capacity for phosphate is low. In order to solve this problem, Fe compounds modified fly ash/cotton stalk biochar composites (Fe-FBC) were prepared through co-pyrolyzed fly ash and cotton stalk at 800oC, followed by infiltration of FeSO4 solution. The samples were characterized by Scanning electron microscopy, Brunauer-Emmett-Teller, X-ray diffraction, Fourier-transform infrared spectroscopy, and zeta potential. After modification, the hydrophilicity and polarity of Fe-FBC increased. In addition, the pore volume, specific surface area, and surface functional groups were significantly improved. The adsorption process of Fe-FBC for phosphate in water can be well fitted by the pseudo-second-order kinetic and Sips isotherm adsorption model, with a maximum adsorption capacity of 47.91 mg/g. Fe-FBC maintained a high adsorption capacity in the pH range of 3–10. The coexisting anions (NO3-, SO42-, and Cl-) had negligible effects on phosphate adsorption. The adsorption mechanisms of Fe-FBC include electrostatic attraction, ligand exchange, surface complexation, ion exchange, chemical precipitation and hydrogen bonding. Moreover, the desorption dynamic process of phosphate was investigated, indicating that the phosphate-saturated Fe-FBC could use as slow-release phosphate fertilizer. This study proposed a potentially environmental protection and recycling economy approach, which consists of recycling resources and treating wastes with wastes.
Mental Health Problems in Flood-Hit People in Punjab Pakistan: Mediating role of social support
Authors: Abid Mueen , Riaz Maryam , Husain Nusart
Published: January 2023

The objective of current study was two-folds. First objective was to identify mental health problems (Anxiety, Depression and Stress) in flood effected people in Punjab, Pakistan. Second objective was to explore predictive effects of social support on mental health problems. Convenient sampling method was used to find the sample of 600 participants (Male = 40%, Female = 60%). Study tool covers four parts. First part included an agreement form, second part was about demographic outline, third part was Depression, Anxiety and Stress scale (DASS-21) while Perceived Social Support Scale was the last part of the research tool. Data was analysed using SPSS 23.0 version (Statistical Package for Social Sciences). Descriptive statistics used to abridge the raw data. The inferential statistics such as regression, correlation and t-test were used to determine the outcomes according to study aim. Results specified that 38%, 20% and 43% individuals were experiencing Depression, Anxiety and Stress respectively due to flood distaster. Furthermore, findings of linear regression analysis demonstrated that social support significantly predicts mental health problems [R²=.716; F = 61.223, p < .01] and 71% variation in mental health problems is due to the social support. This study suggested that policy manufacturers must establish and implement some essential platforms, support packeges and mental health interventions to prevent and cure people from overwhelming psychological and mental health costs of flood distruction on priority basis.
MicroRNA-222 carried by plasma-derived exosomes as an earlier biomarker to alert the abnormal phosphorylation of Tau caused by shRNA-PCSK9 and its correlation with Aβ1-42Ab.
Authors: Wang Lei , Liu Linna , Jiang Qian , Wang Hong , Yuan Ling , Lv Nan , Hao Di , Cui Xiaoxue , Wang Zi
Published: January 2023

The clinical adverse reaction monitoring data of Human subtilisin converting enzyme 9 gene (proprotein converting enzyme subtilisin/kexin type 9, PCSK9) inhibitors showed that there were neurocognitive adverse events. In order to early warning of the potential danger of PCSK9 inhibitors to cognitive impairment in the process of regulating lipid homeostasis, this study aimed to explore the microscopic effects of plasma exosomes. MicroRNA-222 (miR-222) as an early warning marker for shRNA-PCSK9-induced cognitive impairment. The hypercholesterolemia mouse model (high-fat diet, HFD-model group) was prepared by feeding with high-fat diet. The HFD-models were then divided into shRNA control group (HFD-shRNA-control group) and shRNA PCSK9 group (HFD-shRNA-PCSK9 group). The shRNA-PCSK9 was constructed, injected intravenously into the body, and the expression of PCSK9 mRNA was detected by real-time PCR (RT-PCR) and immunohistochemistry (IHC). Tau protein and phosphorylation in brain tissue were observed by IHC. Western blot(WB)was used to detect Tau protein and P-Tau protein. Serum amyloid Aβ1-42Ab levels were determined by enzyme-linked immunosorbent assay (ELISA). The kits extract plasma exosomes step by step, identify the exosome morphology by negative staining electron microscopy, and determine the size of exosomes by NTA technology. RT-PCR technique was used to detect the expression level of miR-222 carried in plasma exosomes. The HFD-model model was prepared by feeding a high-fat diet for 13 weeks, and the serum total cholesterol (TC) and low-density lipoprotein (LDL-C) contents were significantly increased. At the same time, the expression of PCSK9 mRNA in the brain tissue of HFD-model mice was significantly increased. After shRNA-PCSK9 lentivirus interference, PCSK9 mRNA expression was inhibited, and IHC observed that shRNA-PCSK9 induced abnormal expression and hyperphosphorylation of Tau protein in brain tissue, indicating that the pathological changes of neurofibrillary tangles have occurred. However, at this time, serum Aβ1-42Ab has not been significantly increased, and it has not yet been of significance for the diagnosis of cognitive impairment. The microRNA in plasma exosomes was extracted, and RT-PCR results showed that the expression of miR-222 carried in the exosomes of the HFD-shRNA-PCSK9 group was significantly lower than that of the HFD-shRNA-control group. At the same time, MiR-222 levels in plasma-derived exosomes were inversely correlated with Aβ1-42Ab in serum. MiR-222 carried by plasma-derived exosomes provides an early warning marker for shRNA-PCSK9-induced cognitive impairment.
Highly Uniform AuPt Bimetallic Nanoplates and Nanorings with Tunable Optical Properties and Enhanced Photothermal Conversion Performance in NIR-II Window
Authors: Yang Yang , Long Xiang , Zhang Feng-Yuan , Yan Hang-Yu , Li Guo-Wei , Luoshan Meng-Dai , Huang Chu-Yun , Zhou Li
Published: January 2023

Highly asymmetric bimetal nanostructures, such as Au-Pt nanorings and Au-Ag nanoplates possess superior plasmonic properties owing to various synergistic effects between different components and diversified morphologies. Herein, we report a controllable growth of asymmetric Pt-Au nanoplates and Au@Pt nanorings with excellent photothermal conversion efficiency. Hexagonal Au nanoplates are used as templates, which is achieved through a transformation reaction from Au nanotriangles. Pt-Au nanoplates is prepared by a site-selective growth of Pt on the rim of obtained hexagonal Au nanoplates. Subsequently, Pt nanorings is obtained by a selective etching of Au, and a regrowth of Au on the Pt nanorings leads to bimetallic Au@Pt nanorings. The evolution of extinction spectra during the whole process is carefully studied. Under irradiation by 1064 nm laser located in the second near-infrared bio-window, the Pt-Au nanoplates exhibit excellent photothermal conversion, better than that of initial Au nanotriangles and hexagonal Au nanoplates with same mass concentration. The improvement of photothermal effect can be ascribed to the strong surface plasmon resonances and coupling between Au and Pt.
Dynamical swinging between the insulating and metallic phases induced by the coherent amplitude mode excitation in 1T-TaS2
Authors: Ren Qianhui , Suzuki Takeshi , Kanai Teruto , Itatani Jiro , Shin Shik , Okazaki Kozo
Published: January 2023

We investigate the nonequilibrium electronic structure of 1T-TaS2 by time- and angle-resolved photoemission spectroscopy. We observe that strong photo excitation induces the collapse of the Mott gap, leading to the photo-induced metallic phase. It is also found that the oscillation of photoemission intensity occurs as a result of the excitations of coherent phonons corresponding to the amplitude mode of the charge density wave (CDW). To study the dynamical change of the band dispersions modulated by the CDW amplitude mode, we perform analyses by using frequency-domain angle-resolved photoemission spectroscopy. We find that two different peak structures exhibit anti-phase oscillation with respect to each other. They are attributed to the minimum and maximum band positions in energy, where the single band is oscillating between them synchronizing with the CDW amplitude mode. We further find that the flat band constructed as a result of CDW band folding survives with the collapse of the Mott gap. Our results strongly suggest the CDW phase is more robust than the Mott insulating phase, and the lattice modulation corresponding to the CDW amplitude mode dynamically modulates the Mott gap.
Long-Term Care status for the Elderly with Different Levels of Physical Ability: a cross-sectional investigation in first-tier cities of China
Authors: Zhou Mingchao , Zha Fubing , Liu Fang , Zhou Jing , Liu Xiangxiang , Li Jiehui , Yang Qingqing , Zhang Zeyu , Xiong Feng , Hou Dianrui , Weng Hongyun , Wang Yulong
Published: January 2023

Background: Long term care (LTC) services providing support to functional impaired senior citizens are considered a viable solution to the aging society. However, what are the clinical characteristics, who is eligible and what should be covered remains unclear in China. Therefore, we aim to investigate the elderly population who require LTC and explore the LTC status of the elderly.
Methods: This is a cross-sectional study conducted in two of four first-tier cities in China. Residents aged 65 and over were recruited from a nursing home and primary hospitals. Participants were divided into three groups (bedridden, domestic and community) then six grades (grade one to six) according to Longshi Scale, and their functional ability was assessed using Modified Barthel Index (MBI). Information such as diseases, complications, daily care needs were collected. Nursing staff were invited to indicate patients’ needs for care.
Results: Participants in the bedridden group accounted for 69.3% of all participants (1157). The most common diagnosis stroke (71.4%), and complication, pulmonary infection (25.2%), suffered by all participants should be focused in LTC. Participants in Longshi Scale grade one to three had higher demand for assistance in daily activities may be the ones eligible for LTC. In the nursing assessment, basic health care, disease care, mobility care, complication prevention care and psychosocial care were summarized as the five main aspects of LTC for the elderly. Feeding, bathing, drinking, bowel management and bladder management were identified as basic care which fulfills participants’ basic physical needs in each Longshi group. Mouth care, artificial airway management, body reposition which can prevent immobility complications were highly demanded by bedridden elderly.
Conclusions: The elderly in grade one to three are the ones in need of LTC most. The content of LTC for elderly should includecare for disease, mobility and psychosocial needs, specially basic care which fulfills their basic physical needs and complicationcare which can prevent immobility complications.
Trial registration: The study design was registered in the Chinese Clinical Trial Registry (ChiCTR-2000034067, Registered 22 Jun 2020, http://www.chictr.org.cn/showproj.aspx?proj=54770)
Knowledge, Attitude, and Intended Practice of Abortion among Pharmacology Students in Thailand after the Amendment of the Thai Abortion Law
Authors: Rongkapich Ratthapong , Poolkumlung Rada , Sinthuchai Natchanika , Limsirorat Phobsan , Chiemchaisri Nattaporn , Santibenchakul Somsook , Jaisamrarn Unnop
Published: January 2023

Background
The recently amended Thai abortion law allows pregnant women to undergo abortions up to the gestational age of 12 weeks. Medical abortion is significant because it has revolutionized access to safe abortion care—abortion medicine can now be safely and effectively administered outside of a healthcare facility to women in early pregnancy. This contribution supports the pharmacists’ role in interprofessional safe abortion teamwork. Adequate knowledge of the current laws regarding safe abortion services will increase pharmacists’ competence in providing services. However, safe abortions as a subject has not been formally incorporated into the curriculum for Thai pharmacology students. Therefore, this study aimed to evaluate the knowledge, attitude, and intended practice of fifth-year pharmacology students at Chulalongkorn University.
Methods
A cross-sectional study was conducted using an electronic self-administered questionnaire adapted from previously published studies to evaluate participants’ knowledge of the recently amended Thai abortion law, attitude toward abortion, and intended practices. The participants were fifth-year pharmacology students at Chulalongkorn University.
Results
Among the 150 participants, 104 (69.3%) completed the questionnaires. Only a third of the students had good knowledge scores. Most participants answered questions incorrectly regarding the gestational age limit for legal abortion. Although most participants disagreed with pro-choice statements, 87.5% agreed that abortion was a woman’s right. Good knowledge scores were statistically associated with a higher intention to provide abortion care. Furthermore, favorable attitudes were statistically associated with a higher intention to provide abortion care. A positive attitude toward abortion affects the intention to perform an abortion under socioeconomic conditions.
Conclusion
Most pharmacology students lacked knowledge on the amended abortion law, especially on the gestational limits of abortion. Students with higher knowledge scores and favorable attitudes toward abortion tended to be more liberal regarding safe abortion services.
A Meditation Based Cognitive Therapy (HMBCT) for Primary Insomnia: A treatment feasibility pilot study
Authors: Behera Chandan Kumar , Reddy Tharun Kumar , Behera Laxmidhar , Birbaumer Niels , Ika Krishna
Published: January 2023

Previous evidence suggests a critical need for alternative therapies which are cost-effective and can add to the list of well-established treatments for insomnia. This pilot study evaluates a novel therapy for treating insomnia. It comprises a randomized controlled trial with two groups. Prior to Simple randomization, the participants are included/excluded based on research diagnostic criteria (RDC) for insomnia (Edinger et al., 2004) by the American Academy of Sleep Medicine (AASM). Participants (belonging to Hindu, Muslim and Christian faiths) were assigned to either the therapy group (Hare Krishna Mantra Based Cognitive Therapy: HMBCT) or non-therapy group (control with relaxing music) (other conventional aspects of CBT: Stimulus Control, Sleep Restriction, Sleep Hygiene etc. being common to both the groups) for a 6 weeks treatment procedure (6-sessions were conducted in 6 weeks, each on an average of 45-minute duration in the evening and in addition, the participants who underwent sleep quality behavioral measures, sleep logs and Polysomnography recording were asked to practice therapy in the evening of the day of sleep recording). For a week, before and after the 6 weeks duration, no treatment is provided. HMBCT produced significant improvements in sleep quality measures, like ESS (Epworth Sleepiness Scale) (a reduction of 61% post treatment) and ISI (Insomnia Severity Index) (a reduction of 80% post treatment) scores. The participants abstained from taking any sleep-inducing medication during this study. We conclude that the addition of mantra chanting to CBT may add to the improvement of sleep quality.
3D computational fluid dynamics of Newtonian and non-Newtonian blood flow in coronary arteries with implanted stents
Authors: Ahadi Fatemeh , Azadi Mohammad , Biglari Mojtaba , Bodaghi Mahdi
Published: January 2023

This study introduces and compares computational fluid dynamics of Newtonian and non-Newtonian blood flow in coronary arteries with and without considering stents for the first time. Three blood flow models, including Newtonian, Carreau, and non-Newtonian power-law models, have been simulated to investigate their effect, and the solution algorithm includes drawing the geometry, creating the desired mesh, and then simulating Newtonian and non-Newtonian blood flow different models and comparing them with each other, is presented in the article. A Newtonian fluid model is commonly used in the simulation of blood flow, whereas blood has non-Newtonian properties due to the nature of a solution containing suspended particles. Our goal in this research is to investigate the differences between the models built with Newtonian and non-Newtonian fluid assumptions. Moreover, a stent has been designed and its effect has been investigated in all blood flow models. Stents are medical devices that can be placed in arteries to open up blood flow in a blocked vessel. In this regard, a lot of computational modeling and simulation has been done as an important tool to predict the performance of stents. The distribution of velocity, pressure, and wall shear stress in all blood flow models with and without considering the effect of stents have been investigated and finally compared. A comparison of Newtonian and non-Newtonian flows showed that in the case of the Carreau non-Newtonian model, the wall shear stress is higher. In addition, in the results of the geometric model with a stent effect compared to the geometric model without a stent effect, it is evident that there is a higher velocity and wall shear stress.
Small Files Access Efficiency in Hadoop Distributed File System a Case Study performed on British Library .rtf files
Authors: Alange Neeta , Sagar P. Vidya
Published: January 2023

In today’s world storing a large amount of data, large datasets, handling data in various forms is a challenging task. Data is getting produced rapidly with major small sized files. Hadoop is the solution for the big data problem except few limitations. This method is suggested to provide a better one for small file sizes in terms of storage, access effectiveness, and time. In contrast to the current methods, such as HDFS sequence files, HAR, and NHAR, a revolutionary strategy called VFS-HDFS architecture is created with the goal of optimizing small-sized files access problems. The existing HDFS architecture has been wrapped with a virtual file system layer in the proposed development. However, the research is done without changing the HFDS architecture. Using this proposed system, better results are obtained in terms of access efficiency of small sized files in HDFS. A case study is performed on the British Library datasets on .txt and .rtf files. The proposed system can be used to enhance the library if the catalogue is categorized as per their category in a container reducing the storage, improving the access efficiency at the cost of memory.
Prokineticin2 as a potential biomarker for the diagnosis of Kawasaki disease
Authors: Zeng Li , Wang Cai , Song Zhixin , Liu Qian , Chen Dapeng , Yu Xiaoyan
Published: January 2023

Objective: Kawasaki disease is a pressing acute self-limiting inflammatory disorder disease which lack of specific biomarkers. Our research aims to investigate the serum expression of a novel immune regulator PK2 in children with Kawasaki disease, and to evaluate the ability of PK2 to predict Kawasaki disease.
Methods: A total of 70 children with Kawasaki disease in the Children's Hospital of Chongqing Medical University who were first diagnosed, 20 children with common fever admitted to hospital due to bacterial infection during the same period, and 31 children underwent physical examination were included in this study. Venous blood was collected for complete blood count, CRP, ESR, PCT, and PK2 before clinical intervention. The predictive potential of PK2 as a biomarker for the diagnosis of Kawasaki disease was judged by correlation analysis, the receiver operating characteristic (ROC) and combined score.
Results: Compared with healthy children and children with common fever, children diagnosed with Kawasaki disease had significantly lower serum PK2 concentrations (median 28503.7208 ng/ml, 26242.5484 ng/ml, 16890.2452 ng/ml, respectively, Kruskal-Wallis test: p<0.0001). Analysis of the existing indicators in other laboratories showed that WBC (Kruskal-Wallis test: p<0.0001), PLT (Kruskal-Wallis test: p=0.0018), CRP (Mann-Whitney U: p<0.0001), ESR (Mann-Whitney U: p=0.0092), NLR (Kruskal-Wallis test: p<0.0001) and other indicators were significantly increased compared with healthy children and children with common fever, RBC (Kruskal-Wallis test: p<0.0001) and Hg (Kruskal-Wallis test: p<0.0001) were significantly decreased in children with Kawasaki disease conversely. Analysis of the Spearman correlation, it was found that serum PK2 concentration and NLR ratio were significantly negatively correlated in children with Kawasaki disease (rs= -0.2613, p=0.0301). Analysis of the ROC curves, it was found that the area under the PK2 curve was 0.782 (95% confidence interval:0.683 - 0.862; p<0.0001), the ESR was 0.697 (95% confidence interval: 0.582 - 0.796; p=0.0120), and the CRP was 0.601 (95% confidence interval: 0.683 - 0.862; p=0.1805) and NLR 0.735 (95% confidence interval:0.631 - 0.823; p=0.0026). PK2 can significantly predict Kawasaki disease independently of CRP and ESR (p<0.0001). The combined score of PK2 and ESR can significantly improve the diagnostic performance of PK2 (AUC=0.827, 95%CI: 0.724-0.903, p<0.0001). The sensitivity was 87.50%, the sensitivity was 75.81%, the positive likelihood ratio was 6.0648, and the Youden index was 0.6331.
Conclusion: PK2 has the potential to be a biomarker for early diagnosis of Kawasaki disease, and the combined use of ESR can further improve its diagnostic performance. Our study identifies PK2 as an important biomarker for Kawasaki disease and provides a potential new diagnostic strategy for Kawasaki disease.
Use of artificial intelligence as a diagnostic support tool for skin lesions in primary care: feasibility study in clinical practice
Authors: Escalé-Besa Anna , Yélamos Oriol , Vidal-Alaball Josep , Fuster-Casanovas Aïna , Catalina Queralt Miró , Börve Alexander , Aguilar Ricardo Ander-Egg , Fustà-Novell Xavier , Cubiró Xavier , R Mireia Esquius , López-Sanchez Cristina , Marin-Gomez Francesc X
Published: January 2023

Background
Dermatological conditions are a relevant health problem. Machine learning (ML) models are increasingly being applied to dermatology as a diagnostic decision support tool using image analysis, especially for skin cancer detection and disease classification.
Objective
The objective of this study was to perform a prospective validation of an image analysis ML model, which is capable of screening 44 skin diseases, comparing its diagnostic accuracy with that of General Practitioners (GPs) and teledermatology (TD) dermatologists in a real-life setting.
Methods
Prospective, diagnostic accuracy study including 100 consecutive patients with a skin problem who visited a participating GP in central Catalonia, Spain, between June 2021 and October 2021.
The skin issue was first assessed by the GPs. Then an anonymised skin disease picture was taken and uploaded to the ML application, which returned a list with the Top-5 possible diagnosis in order of probability. The same image was then sent to a dermatologist via TD for diagnosis, as per clinical practice. The GPs Top-3, ML model’s Top-5 and dermatologist’s Top-3 assessments were compared to calculate the accuracy, sensitivity, specificity and diagnostic accuracy of the ML models.
Results
The overall Top-1 accuracy of the ML model (39%) was lower than that of GPs (64%) and dermatologists (72%). When the analysis was limited to the diagnoses on which the algorithm had been explicitly trained (n=82), the balanced Top-1 accuracy of the ML model increased (48%) and in the Top-3 (75%) was comparable to the GPs Top-3 accuracy (76%). The Top-5 accuracy of the ML model (89%) was comparable to the dermatologist Top-3 accuracy (90%).
For the different diseases, the sensitivity of the model (Top-3 87% and Top-5 84%) is higher than that of the clinicians (Top-3 GPs 76% and Top-3 dermatologists 84%) only in the benign tumour pathology group, being on the other hand the most prevalent category (n=53).
About the satisfaction of professionals, 92% of the GPs considered it as a useful diagnostic support tool (DST) for the differential diagnosis and in 60% of the cases as an aid in the final diagnosis of the skin lesion.
Conclusions
The overall diagnostic accuracy of the model in this study under real conditions is lower than that of both GPs and dermatologists, a fact that is consistent with the few existing prospective studies under real conditions. These results highlight the potential of the ML models to assist GPs as a DST for skin conditions especially in the differential diagnosis. However, external testing in real conditions is essential for data validation and regulating these AI diagnostic models, in order to deploy ML models in a Primary Care setting.
Standoff detection of bacterial spores by field deployable coherent Raman spectroscopy.
Authors: Coluccelli Nicola , Galzerano Gianluca , Laporta Paolo , Kurtis Kelly , Lonsdale Claire , Padgen Debbie , Howle Chris , Cerullo Giulio
Published: January 2023

Vibrational spectroscopies offer great potential for standoff detection of chemical and biological warfare agents, avoiding contamination to the operator and equipment. Among them, particularly promising is Coherent anti-Stokes Raman scattering (CARS) spectroscopy, using synchronized pump/Stokes laser pulses to set up a vibrational coherence of target molecules at a laser focus, which is read by further interaction with a probe pulse, resulting in the emission of a coherent beam detectable at a distance. CARS has previously demonstrated the capability to detect bacterial spores based on the Raman spectrum of the characteristic molecule calcium dipicolinate (CaDPA); however, a complex and bulky laser technology, which is only suitable for a laboratory environment, was employed. Here we develop a broadband CARS setup based on a compact, industrial grade ytterbium laser system. We demonstrate high signal-to-noise ratio detection of Bacillus atrophaeus spores at a concentration of 10^5 cfu/mm2, at a standoff distance of 1 m, and an acquisition time of 1 s. Our system, which combines chemical specificity and sensitivity along with improved ruggedness and portability, paves the way to a new generation of instruments for real-world standoff detection of chemical and biological threats.
Cerebrospinal Fluid Lipidomic Fingerprint of Obstructive Sleep Apnoea in Alzheimer’s Disease
Authors: Dakterzada Farida , Benítez Iván D. , Targa Adriano , Carnes Anna , Pujol Montse , Jové Mariona , Mínguez Olga , Vaca Rafi , Sánchez-de-la-Torre Manuel , Barbé Ferran , Pamplona Reinald , Piñol-Ripoll Gerard
Published: January 2023

Background: Obstructive sleep apnoea (OSA) has a high prevalence in patients with Alzheimer's disease (AD). Both conditions have been shown to be associated with lipid dysregulation. However, the relationship between OSA severity and alterations in lipid metabolism in the brains of patients with AD has yet to be fully elucidated. In this context, we examined the cerebrospinal fluid (CSF) lipidome of patients with suspected OSA to identify potential diagnostic biomarkers and to provide insights into the pathophysiological mechanisms underlying the effect of OSA on AD.
Methods: The study included 91 consecutive AD patients who underwent overnight polysomnography (PSG) to diagnose severe OSA (apnoea-hypopnea index ≥30/h). The next morning, CSF samples were collected and analysed by liquid chromatography coupled to mass spectrometry in an LC-ESI-QTOF-MS/MS platform.
Results: The CSF levels of 11 lipid species were significantly different between AD patients with and without severe OSA. Five lipids were significantly correlated with specific PSG measures of OSA severity related to sleep fragmentation and hypoxemia. Our analyses revealed a 4-lipid signature (including oxidized ceramide OxCer(40:6)) and three unknown lipids) that provided an accuracy of 0.80 (95% CI: 0.71–0.89) in the detection of severe OSA. These lipids increased the discriminative power of the STOP-Bang questionnaire in terms of the area under the curve (AUC) from 0.61 (0.50-0.74) to 0.85 (0.71-0.93).
Conclusions: Our results reveal a CSF lipidomic fingerprint that allows the identification of AD patients with severe OSA. Our findings suggest that an increase in central nervous system lipoxidation may be the principal mechanism underlying the association between OSA and AD.
A Prospective Study of Chronic Postsurgical Pain in Elderly Patients: Prevalence, Characteristics and Risk factors
Authors: Jin Juying , Zhang Ting , Xiong Xianwei , Chen Huan , Jiang Yiling , He Shuangyu
Published: January 2023

Background Considering the continued growth of surgical procedures in older adults and the significant impact of chronic postsurgical pain (CPSP), it is crucial to improve our understanding of the occurrence of CPSP as well as the appropriate prevention and treatment. We therefore conducted this study to determine the prevalence, characteristics and risk factors of CPSP in elderly patients at both 3 and 6 months after surgery.
Methods Elderly patients (aged ≥ 60 years) undergoing elective surgery in our institution between April 2018 and March 2020 were prospectively enrolled in this study. Data on demographics, preoperative psychological well-being, intraoperative surgical and anesthesia management, and acute postoperative pain intensity were collected. At 3 and 6 months after surgery, patients received telephone interview and completed the questionnaires regarding chronic pain characteristics, analgesic consumption, and interference of the pain with activities of daily living (ADL).
ResultsA total of 1165 elderly patients were followed up for 6 postoperative months and included in final analysis. At 3 and 6 months after operation, the prevalence of CPSP was 35.6% and 21.5 %, respectively. CPSP cause negative impacts on patient’s ADL and most particularly on mood. Neuropathic pain was found in 45.1% of the patients with CPSP at 3 months. At 6 months, 31.0% of those with CPSP reported that the pain had neuropathic features. Preoperative anxiety, preoperative depression, orthopedic surgery, higher pain severity on movement within postoperative 24 h predicted CPSP independently at both 3 and 6 months after surgery.
Conclusions CPSP is a common postoperative complication in elderly surgical patients. Predictors for CPSP in the elderly included preoperative anxiety and depression, orthopedic surgery, and greater intensity of acute postoperative pain on movement.
Application of the NCCN-distress thermometer in pediatric patients during autologous and allogeneic HSCT and relationship to blood parameters of the stress axis
Authors: Malaval Carmen Isolde , Stanchi Karin Melanie Cabanillas , Werle Dustin , Thiel Stefanie , Gansel Melanie , Lang Peter , Handgretinger Rupert , Svaldi Jennifer , Döring Michaela
Published: January 2023

Purpose
Hematopoietic stem cell transplantations (HSCT) are extremely stressful procedures for pediatric patients. The activation of the Hypothalamic pituitary adrenocortical axis (HPA) can influence the immune system negatively and therefore the overall outcome. A screening instrument should be established to detect elevated stress levels.
Methods
In this prospective study, a distress thermometer with attached problem list was used in 40 pediatric patients and their parents. The patients were aged 10 to 18 years and received a HSCT. Furthermore, the patients' cortisol, thyroid stimulating hormone, free triiodothyronine and Thyroxine levels were measured regularly during the inpatient stay.
Results
After admission to the hospital, the stress levels of the pediatric patients and their parents increased and reached their maximum on the day of HSCT. The overall stress values of the parents were higher than those of the children, with a significant difference on the day of HSCT. The mean cortisol values of the pediatric patients also increased after admission, reaching significant elevated levels above the upper norm limit one week after HSCT and on discharge day. While the pediatric patients experienced mainly exhaustion, especially on the day of transplantation, their parents mainly felt worry and anxiety. Interestingly, the rate of worry among children increased in the posttransplant period and reached its maximum on the day of discharge.
Conclusions
These results confirm the need for early and continuous psycho-oncological intervention with the pediatric patients and their parents, especially up to the day of HSCT.
The radiotherapy planning CT-based multi-omics for predicting the radiation pneumonitis in lung cancer patients: A multi-center study
Authors: Niu Lishui , Chu Xianjing , Yang Xianghui , Zhao Hongxiang , Chen Liu , Deng Fuxing , Liang Zhan , Jing Di , Zhou Rongrong
Published: January 2023

Background
To predict the risk of radiation pneumonitis (RP), deep learning (DL) models were built to stratify lung cancer patients. Our study also investigated the impact of RP on survival.
Methods
This study retrospectively collected 100 RP and 99 matched non-RP lung cancer patients treated with radiotherapy from two independent centers. These patients were randomly divided into training (n = 175) and validation cohorts (n = 24). The radiomics and dosiomics features were extracted from radiation planning computed tomography (CT). Clinical information was retrospectively collected from the electronic medical record database. All features were screened by LASSO cox regression. A multi-omics prediction model was developed by the optimal algorithm and estimated the area under the receiver operating characteristic curve (AUC). Overall survival (OS) between RP, non-RP, mild-RP, and severe-RP groups was analyzed by the Kaplan-Meier method.
Results
There were eventually selected 16 radiomics features, 2 dosiomics features, and 1 clinical feature to build the best multi-omics model. GLRLM_Gray Level Non Uniformity Normalized and GLCM_MCC from PTV were essential dosiomics features, and T stage was a paramount clinical feature. The optimal performance for predicting RP was the AUC of testing set [0.94, 95% confidence interval (CI) (0.939-1.000)] and the AUC of external validation set [0.92, 95% CI (0.80-1.00)]. All RP patients were divided into mild-RP and severe-RP group according to RP grade (≤ 2 grade and > 2 grade). The median OS was 31 months (95% CI, 28–39) for non-RP group compared with 49 months (95% CI, 36-NA) for RP group (HR = 0.53, P = 0.0022). Among RP subgroup, the median OS was 57months (95% CI, 47-NA) for mild-RP and 25 months (95% CI, 29-NA) for severe-RP, and mild-RP group exhibited a longer OS (HR = 3.72, P < 0.0001).
Conclusion
The multi-omics model contributed to improvement in the accuracy of the RP prediction. Interestingly, this study also demonstrated that compared with non-RP patients, RP patients displayed longer OS, especially mild-RP.
Clinical characteristics of uterine metastasis in epithelial ovarian cancer
Authors: Wang TianMei , Li Cong
Published: January 2023

Purpose

Ovarian epithelial malignant tumor spreads directly and easily spreads to the serous surface of the uterus. However, whether invasion and metastasis occur in the uterine parenchyma is unknown. Its metastasis rate and its related clinical characteristics reveal that ovarian cancer surgery with uterus preservation provides objective data support.

Methods

The data of patients with ovarian cancer who underwent hysterectomy from January 1, 2017, to March 31, 2022, were collected retrospectively, and the distribution of actual uterine metastasis and possible factors related to clinical characteristics were analyzed.

Results

A total of 464 patients were included, and the uterine metastasis rate was 38.58%, with 29.09% confirmed by pathology, including 4.96% of myometrial metastasis and 1.51% of endometrial metastasis. The occurrence of metastasis is positively related to the Ca125, HE4, unilateral or bilateral ovarian lesions, diameter of the ovarian tumor, clinical stage, whether the fallopian tube is metastatic, pathological type, pathological grade, degree of differentiation, ascites/ peritoneal washout evidence, the timing of surgery, and whether there is extrauterine organ metastasis in the pelvic cavity, and negatively related to whether there is endometriosis.

Conclusion

The incidence of uterine myometrial metastasis of ovarian cancer is 4.96%. The assessment of risk factors, such as unilateral or bilateral ovarian lesions, oviduct metastasis and pelvic metastasis may provide assistance to patients undergoing fertility-preserving surgical treatment.
Trial registration number:2020-636
Improving breastfeeding support through the implementation of the baby friendly hospital and community initiatives: a scoping review
Authors: Walsh Aisling , Pieterse Pieternella , Mishra Nita , Chirwa Ellen , Chikalipo Maria , Msowoya Chimwemwe , Cheitin Ciara Ni , Matthews Anne
Published: January 2023

Background
Improved breastfeeding practices have the potential to save the lives of over 823,000 children under 5 years old globally every year. The Baby-Friendly Hospital Initiative (BFHI) is a global campaign by the World Health Organization and the United Nations Children's Fund, which promotes best practice to support breastfeeding in maternity services. The Baby-Friendly Community Initiative (BFCI) grew out of step 10, with a focus on community-based implementation. The aim of this scoping review is to map and examine the evidence relating to the implementation of BFHI and BFCI globally.
Methods
This scoping review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. Inclusion criteria followed the Population, Concepts, Contexts approach. All articles were screened by two reviewers, using Covidence software. Data were charted according to: country, study design, setting, study population, BFHI steps, study aim and objectives, description of intervention, summary of results, barriers and enablers to implementation, evidence gaps, and recommendations. Qualitative and quantitative descriptive analyses were undertaken.
Results
A total of 279 articles were included in the review. Patterns identified were: i) national policy and health systems: effective and visible national leadership is needed, demonstrated with legislation, funding and policy; ii) hospital policy is crucial, especially in becoming breastfeeding friendly and neonatal care settings iii) implementation of specific steps; iv) the BFCI is implemented in only a few countries and government resources are needed to scale it; v) health worker breastfeeding knowledge and training needs strengthening to ensure long term changes in practice; vi) educational programmes for pregnant and post-partum women are essential for sustained exclusive breastfeeding. Evidence gaps include study design issues and need to improve the quality of breastfeeding data and to perform prevalence and longitudinal studies.
Conclusion
At a national level, political support for BFHI implementation supports expansion of Baby friendly hospitals. Ongoing quality assurance is essential, as is systematic (re)assessment of BFHI designated hospitals. Baby friendly hospitals should provide breastfeeding support that favours long-term healthcare relationships across the perinatal period. These results can help to support and further enable the effective implementation of BFHI and BFCI globally.
Biomes of the world under climate change scenarios: increasing aridity and higher temperatures lead to significant shifts in natural vegetation
Authors: Bonannella Carmelo , Hengl Tomislav , Parente Leandro , de Bruin Sytze
Published: January 2023

The global potential distribution of biomes (natural vegetation) was modelled using 8959 training points from the BIOME 6000 dataset and a stack of 72 environmental covariates representing terrain and the current climatic conditions based on historical long term averages (1979–2013). An ensemble machine learning model based on stacked regularization was used, with multinomial logistic regression as the meta-learner and spatial blocking (100 km) to deal with spatial autocorrelation of the training points. Results of spatial cross-validation for the BIOME 6000 classes show an overall accuracy of 0.67 and R2logloss of 0.61, with ”tropical evergreen broadleaf forest” being the class with highest gain in predictive performances (R2logloss = 0.74) and ”prostrate dwarf shrub tundra” the class with the lowest (R2logloss = -0.09) compared to the baseline. Temperature-related covariates were the most important predictors, with the mean diurnal range (BIO2) being shared by all the base-learners (i.e. random forest, gradient boosted trees and generalized linear models). The model was next used to predict the distribution of future biomes for the periods 2040–2060 and 2061–2080 under three climate change scenarios (RCP 2.6, 4.5 and 8.5). Comparisons of predictions for the three epochs (present, 2040–2060 and 2061–2080) show that increasing aridity and higher temperatures will likely result in significant shifts in natural vegetation in the tropical area (shifts from tropical forests to savannas up to 1.7 × 105 km2 by 2080) and around the Arctic Circle (shifts from tundra to boreal forests up to 2.4 × 105 km2 by 2080). Projected global maps at 1 km spatial resolution are provided as probability and hard classes maps for BIOME 6000 classes and as hard classes maps for the IUCN classes (6 aggregated classes). Uncertainty maps (prediction error) are also provided and should be used for careful interpretation of the future projections.