bluuebunny/crossref_metadata_2025 huggingface dataset:
Expert insights on Malaysia’s residential solar-energy policies: shortcomings and recommendations
Authors: Lau Lin-Sea , Choong Yuen-Onn , Ching Suet-Ling , Wei Chooi-Yi , Senadjki Abdelhak , Choong Chee-Keong , Seow Ai-Na
Published: July 2022

Malaysia has a long way before achieving the 20% renewable-energy penetration by 2025. Currently, merely 2% of the country’s electricity is generated by renewable energy sources including solar power. Unlike the abundant literature about solar energy, qualitative studies that focus on experts’ opinions on the weaknesses of residential solar-energy policies have received less attention, particularly in the context of Malaysia. Understanding the flaws in the existing policies would lead to creating a better policy framework for solar-energy development. Thus, this study aims to identify the shortcomings of the current government initiatives and policies that deter solar photovoltaic adoption among households from experts’ perspectives. Experts also provide recommendations for better future policy design and implementation. This study employs a qualitative research approach (via semi-structured interviews) in collecting experts’ viewpoints. Key concerns emerging from the interviews include insufficient financial support, lack of awareness programmes and subsidized electricity tariffs. Also, interviewed experts suggest sufficient financial incentives, increased public awareness programmes and comprehensive legislation aimed at safeguarding consumer interests as a means to raising solar-energy adoption in the country. This underlines the need for policymakers to create public awareness, provide financial support and develop regulatory measures aimed at managing solar companies for the sake of solar development in Malaysia.
Clinical Outcomes in a Randomized Controlled Trial Comparing Point-of-Care With Standard Human Immunodeficiency Virus (HIV) Viral Load Monitoring in Nigeria
Authors: Chang Charlotte , Agbaji Oche , Mitruka Kiren , Olatunde Bola , Sule Halima , Dajel Titus , Zee Aaron , Ahmed Mukhtar L , Ahmed Isah , Okonkwo Prosper , Chaplin Beth , Kanki Phyllis
Published: July 2022

Background

Point-of-care (POC) viral load (VL) tests provide results within hours, enabling same-day treatment interventions. We assessed treatment outcomes with POC vs standard-of-care (SOC) VL monitoring.

Methods

We implemented a randomized controlled trial at an urban and rural hospital in Nigeria. Participants initiating antiretroviral therapy (ART) were randomized 1:1 for monitoring via the POC Cepheid Xpert or SOC Roche COBAS (v2.0) HIV-1 VL assays. Viral suppression (VS) and retention in care at 12 months were compared via intention-to-treat (ITT) and per-protocol (PP) analyses. Post-trial surveys for POC patients and healthcare workers (HCWs) evaluated acceptability.

Results

During April 2018–October 2019, 268 SOC and 273 POC patients enrolled in the trial. Viral suppression at <1000 copies/mL at 12 months was 59.3% (162/273) for POC and 52.2% (140/268) for SOC (P = .096) in ITT analysis and 77.1% (158/205) for POC and 65.9% (137/208) for SOC (P = .012) in PP analysis. Retention was not significantly different in ITT analysis but was 85.9% for POC and 76.9% for SOC (P = .02) in PP analysis. The increased VS in the POC arm was attributable to improved retention and documentation of VL results. POC monitoring was preferred over SOC by 90.2% (147/163) of patients and 100% (15/15) of HCWs thought it facilitated patient care.

Conclusions

POC VL monitoring did not improve 12-month VS among those with results but did improve retention and VS documentation and was preferred by most patients and HCWs. Further research can inform best POC implementation conditions and approaches to optimize patient care.

Clinical Trials Registration

NCT03533868.
Centrality measures in interval-weighted networks
Authors: Alves Hélder , Brito Paula , Campos Pedro
Published: July 2022

Centrality measures are used in network science to assess the centrality of vertices or the position they occupy in a network. There are a large number of centrality measures according to some criterion. However, the generalizations of the most well-known centrality measures for weighted networks, degree centrality, closeness centrality and betweenness centrality have solely assumed the edge weights to be constants. This article proposes a methodology to generalize degree, closeness and betweenness centralities taking into account the variability of edge weights in the form of closed intervals (interval-weighted networks, IWN). We apply our centrality measures approach to two real-world IWN. The first is a commuter network in mainland Portugal, between the 23 NUTS 3 Regions. The second focuses on annual merchandise trade between 28 European countries, from 2003 to 2015.
Swimming performance of a pelagic species in the Yangtze River under different exposure modes of the total dissolved gas supersaturation
Authors: Ji Qianfeng , Li Kefeng , Wang Yuanming , Liang Ruifeng , Feng Jingjie , Li Ran , Zhu David Z
Published: July 2022

During flood discharges of upstream dams in the Yangtze River, the pelagic fish have a stress risk from total dissolved gas (TDG) supersaturation in the river water. This study took the silver carp as the object and systematically evaluated the effects of TDG supersaturation levels and exposure time on their critical swimming speed (Ucrit) at different temperatures. The external symptoms of gas bubble disease were found when TDG levels exceeded 130%. Both exposure time and TDG level did not significantly impact the Ucrit of fish under 6 days of non-lethal exposure (110%, 120%, 130% TDG) with lower or higher water temperature. Significant differences in Ucrit were found among different exposure times at 11.0 ± 1.0°C under 10 hours of lethal exposure (135%, 140%, 150% TDG) and the Ucrit reduced by 59.88%, 83.32%, and 92.40%, respectively. TDG level had a significant impact on the Ucrit at 21.0 ± 1.0°C when exposure time exceeded 8 hours. Ucrit at 21.0 ± 1.0°C water were significantly greater than those at 11.0 ± 1.0°C water where conditions had the same TDG supersaturation and exposure time. Differences in Ucrit between temperatures ranged from 3.24 to 6.12 BL/s under non-lethal exposure and from 6.38 to 13.88 BL/s under lethal exposure. The results of this study can provide a reference for fish conservation during flood discharge.
Patient-reported Outcomes: the ICHOM Standard Set for Inflammatory Bowel Disease in Real-life Practice Helps Quantify Deficits in Current Care
Authors: Wong Darren , Matini Lawrence , Kormilitzin Andrey , Kantschuster Ramona , Simadibrata Daniel Martin , Lyden Sara , Wilson Jean , Brain Oliver A , Palmer Rebecca , Ambrose Tim , Satsangi Jack , South Matthew , Geddes John , Bodger Keith , Travis Simon P L , Walsh Alissa
Published: July 2022

Background

Patient-reported outcome measures [PROMs] are key to documenting outcomes that matter most to patients and are increasingly important to commissioners of health care seeking value. We report the first series of the ICHOM Standard Set for Inflammatory Bowel Disease [IBD].

Methods

Patients treated for ulcerative colitis [UC] or Crohn’s disease [CD] in our centre were offered enrolment into the web-based TrueColours-IBD programme. Through this programme, e-mail prompts linking to validated questionnaires were sent for symptoms, quality of life, and ICHOM IBD outcomes.

Results

The first 1299 consecutive patients enrolled [779 UC, 520 CD] were studied with median 270 days of follow-up (interquartile range [IQR] 116, 504). 671 [52%] were female, mean age 42 years (standard deviation [sd] 16), mean body mass index [BMI] 26 [sd 5.3]. At registration, 483 [37%] were using advanced therapies. Median adherence to fortnightly quality of life reporting and quarterly outcomes was 100% [IQR 48, 100%] and 100% [IQR 75, 100%], respectively. In the previous 12 months, prednisolone use was reported by 229 [29%] patients with UC vs 81 [16%] with CD, p <0.001; 202 [16%] for <3 months; and 108 [8%] for >3 months. An IBD-related intervention was reported by 174 [13%] patients, and 80 [6%] reported an unplanned hospital admission. There were high rates of fatigue [50%] and mood disturbance [23%].

Conclusions

Outcomes reported by patients illustrate the scale of the therapeutic deficit in current care. Proof of principle is demonstrated that PROM data can be collected continuously with little burden on health care professionals. This may become a metric for quality improvement programmes or to compare outcomes.
Longer leukocyte telomere length is associated with myeloid inflammation and increased mortality after transcatheter aortic valve replacement
Authors: Hoffmann Jedrzej , Tabata Noriaki , Mas-Peiro Silvia , Spyridopoulos Ioakim , Sinning Jan-Malte , Berkowitsch Alexander , Martin-Ruiz Carmen , Al-Kassou Baravan , Herrmann Eva , Dimmeler Stefanie , Zeiher Andreas M , Vasa-Nicotera Mariuca
Published: July 2022

Aims

Inflammatory activation of leukocytes may limit prognosis of patients (pts) with severe aortic valve stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). Leukocyte telomere length (LTL) is a marker of proliferative capacity and inflammatory responsiveness but the impact of LTL on the prognosis in AS remains elusive. The aim of this study was to analyse the association of LTL with inflammatory markers and prognosis of pts undergoing TAVR.

Methods and results

LTL was analysed using quantitative real-time PCR in 285 consecutive pts (median age 82 years) undergoing TAVR and correlated with 18-month all-cause mortality. C-reactive protein was significantly elevated in pts with the longest LTL (P = 0.017), paralleled by increased procalcitonin (PCT) serum levels (P = 0.0006). This inflammatory reaction was accompanied by increased myeloid cells in the highest LTL tertile, mainly a rise in circulating neutrophils (P = 0.0025) and monocytes (P = 0.01). Multivariate analysis revealed LTL (HR 2.6, 95%CI 1.4–5.1,  P= 0.004) and PCT levels (HR 4.3, 95%CI 1.7–11.0, P = 0.003) as independent predictors of mortality.

Conclusions

Longer LTL is associated with increased mortality after TAVR. This might be explained by enhanced proliferative capacity of cells resulting in myeloid and systemic inflammation. Our findings suggest that targeting the specific inflammation pathways could present a novel strategy to augment survival in selected patients with degenerative aortic stenosis.
Molecular Mechanisms of the Convergent Adaptation of Bathypelagic and Abyssopelagic Fishes
Authors: Bo Jing , Xu Han , Lv Wenqi , Wang Cheng , He Shunping , Yang Liandong
Published: July 2022

Harsh environments provide opportunities to study how different species adapt, at the molecular level, to similar environmental stressors. High hydrostatic pressure, low temperature, and absence of sunlight in the deep-sea environment are challenging conditions for gene expression, cell morphology and vision. Adaptation of fish to this environment appears independently in at least 22 orders of fish, but it remains uncertain whether these adaptations represent convergent evolution. In this study, we performed comparative genomic analysis of 80 fish species to determine genetic evidences for adaptations to the deep-sea environment. The 80 fishes were divided into six groups according to their order. Positive selection and convergent evolutionary analysis were performed and functional enrichment analysis of candidate genes was performed. Positively selected genes (pik3ca, pik3cg, vcl and sphk2) were identified to be associated with the cytoskeletal response to mechanical forces and gene expression. Consistent signs of molecular convergence genes (grk1, ednrb, and nox1) in dark vision, skin color, and bone rarefaction were revealed. Functional assays of Grk1 showed that the convergent sites improved dark vision in deep-sea fish. By identifying candidate genes and functional profiles potentially involved in cold, dark, and high-pressure responses, the results of this study further enrich the understanding of fish adaptations to deep-sea environments.
Sequencing Bait: Nuclear and Mitogenome Assembly of an Abundant Coastal Tropical and Subtropical Fish,Atherinomorus stipes
Authors: Drown Melissa K , DeLiberto Amanda N , Flack Nicole , Doyle Meghan , Westover Alexander G , Proefrock John C , Heilshorn Sandra , D’Alessandro Evan , Crawford Douglas L , Faulk Christopher , Oleksiak Marjorie F
Published: July 2022

Genetic data from nonmodel species can inform ecology and physiology, giving insight into a species’ distribution and abundance as well as their responses to changing environments, all of which are important for species conservation and management. Moreover, reduced sequencing costs and improved long-read sequencing technology allows researchers to readily generate genomic resources for nonmodel species. Here, we apply Oxford Nanopore long-read sequencing and low-coverage (∼1x) whole genome short-read sequencing technology (Illumina) to assemble a genome and examine population genetics of an abundant tropical and subtropical fish, the hardhead silverside (Atherinomorus stipes). These fish are found in shallow coastal waters and are frequently included in ecological models because they serve as abundant prey for commercially and ecologically important species. Despite their importance in sub-tropical and tropical ecosystems, little is known about their population connectivity and genetic diversity. Our A. stipes genome assembly is about 1.2 Gb with comparable repetitive element content (∼47%), number of protein duplication events, and DNA methylation patterns to other teleost fish species. Among five sampled populations spanning 43 km of South Florida and the Florida Keys, we find little population structure suggesting high population connectivity.
A role for the Saccharomyces cerevisiae Rtt109 histone acetyltransferase in R-loop homeostasis and associated genome instability
Authors: Cañas Juan Carlos , García-Rubio María Luisa , García Alicia , Antequera Francisco , Gómez-González Belén , Aguilera Andrés
Published: July 2022

The stability of the genome is occasionally challenged by the formation of DNA–RNA hybrids and R-loops, which can be influenced by the chromatin context. This is mainly due to the fact that DNA–RNA hybrids hamper the progression of replication forks, leading to fork stalling and, ultimately, DNA breaks. Through a specific screening of chromatin modifiers performed in the yeast Saccharomyces cerevisiae, we have found that the Rtt109 histone acetyltransferase is involved in several steps of R-loop-metabolism and their associated genetic instability. On the one hand, Rtt109 prevents DNA–RNA hybridization by the acetylation of histone H3 lysines 14 and 23 and, on the other hand, it is involved in the repair of replication-born DNA breaks, such as those that can be caused by R-loops, by acetylating lysines 14 and 56. In addition, Rtt109 loss renders cells highly sensitive to replication stress in combination with R-loop-accumulating THO-complex mutants. Our data evidence that the chromatin context simultaneously influences the occurrence of DNA–RNA hybrid-associated DNA damage and its repair, adding complexity to the source of R-loop-associated genetic instability.
A Model of Care to Improve Survival of Older Trauma Patients: Geriatrics Comanagement
Authors: Neupane Iva , Mujahid Nadia , Zhou Eric P , Filipe Goncalves Monteiro Joao , Lueckel Stephanie , Cizginer Sevdenur , Yildiz Ferhat , Raza Sakeena , Singh Mriganka , Gravenstein Stefan , McNicoll Lynn
Published: July 2022

Background

Trauma patients older than 80 years of age have higher mortality rates compared to younger peers. No studies have investigated the effectiveness of geriatrics comanagement on mortality in general trauma.

Methods

A retrospective cohort study from 2015 to 2016 comparing overall and inpatient mortality in a geriatrics trauma comanagement (GTC) program versus usual care (UC). Demographic and outcome measures were obtained from the trauma registry at an 11-bed trauma critical care unit within a 719-bed Level 1 Trauma Center. One thousand five hundred and seventy two patients, 80 years and older, with an admitting trauma diagnosis were evaluated. Primary outcome was in-hospital mortality and overall mortality (defined as inpatient death or discharge to hospice). Secondary outcomes included hospital length of stay (LOS), Intensive Care Unit (ICU) LOS, discharge location, and medical complications.

Results

Three hundred and forty six patients (22%) were placed in the GTC program. Overall mortality was lower in the GTC (4.9%) when compared with UC (11.9%), representing a 57% reduction (95% odds ratio [OR] confidence interval [CI] 0.24–0.75, p value = .0028). There was a 7.42% hospital mortality rate in the UC group compared to 2.6% in the GTC group (95% CI 0.21–0.92, p value = .0285), representing a 56% decrease in in-hospital mortality. GTC patients had a longer mean LOS (6.4 days vs 5.3 days, p value < .0001). More GTC patients were sent to inpatient rehabilitation facilities or skilled nursing facilities (80% vs 60%, p value < .0001).

Conclusion

Geriatrics trauma comanagement of trauma patients above the age of 80 may reduce mortality and deserves formal study.
Moving the Brazilian ischaemic stroke pathway to a value-based care: introduction of a risk-adjusted cost estimate model for stroke treatment
Authors: Etges Ana Paula Beck da Silva , Marcolino Miriam Allein Zago , Ogliari Leonardo Alves , de Souza Ana Claudia , Zanotto Bruna Stella , Ruschel Renata , Safanelli Juliana , Magalhães Pedro , Diegoli Henrique , Weber Karina Tavares , Araki Ana Paula , Nunes Altacílio , Ponte Neto Octávio Marques , Nabi Junaid , Martins Sheila Ouriques , Polanczyk Carisi Anne
Published: July 2022

The unsustainable increases in healthcare expenses and waste have motivated the migration of reimbursement strategies from volume to value. Value-based healthcare requires detailed comprehension of cost information at the patient level. This study introduces a clinical risk- and outcome-adjusted cost estimate model for stroke care sustained on time-driven activity-based costing (TDABC). In a cohort and multicentre study, a TDABC tool was developed to evaluate the costs per stroke patient, allowing us to identify and describe differences in cost by clinical risk at hospital arrival, treatment strategies and modified Rankin Score (mRS) at discharge. The clinical risk was confirmed by multivariate analysis and considered patients’ National Institute for Health Stroke Scale and age. Descriptive cost analyses were conducted, followed by univariate and multivariate models to evaluate the risk levels, therapies and mRS stratification effect in costs. Then, the risk-adjusted cost estimate model for ischaemic stroke treatment was introduced. All the hospitals collected routine prospective data from consecutive patients admitted with ischaemic stroke diagnosis confirmed. A total of 822 patients were included. The median cost was I$2210 (interquartile range: I$1163–4504). Fifty percent of the patients registered a favourable outcome mRS (0–2), costing less at all risk levels, while patients with the worst mRS (5–6) registered higher costs. Those undergoing mechanical thrombectomy had an incremental cost for all three risk levels, but this difference was lower for high-risk patients. Estimated costs were compared to observed costs per risk group, and there were no significant differences in most groups, validating the risk and outcome-adjusted cost estimate model. By introducing a risk-adjusted cost estimate model, this study elucidates how healthcare delivery systems can generate local cost information to support value-based reimbursement strategies employing the data collection instruments and analysis developed in this study.
Control and optimization of workforce outsourcing decisions
Authors: Nilakantan Kannan
Published: July 2022

With outsourcing of work having become ubiquitous, and more importantly, given its potential to become controversial, the need for such outsourcing decisions to be drafted carefully, managed effectively and controlled accurately cannot be underscored. In this context, this paper has constructed a mathematical model of organizations with ‘outsource’ employees to study the problem of the monitoring and control of the extent of outsourcing, and the number and distribution of outsource manpower. Control policies for maintaining desired blends of internal and outsource manpower have been mathematically derived, thereby obviating the need for further statistical validation. The cost savings that could be expected to accrue due to outsourcing, as also the problem of optimal outsourcing have been investigated and illustrated with numerical examples. This paper thereby studies a problem of contemporary relevance and importance, and organizations could use the suggested models as a decision-making tool, to generate alternative trade-off scenarios between cost savings due to outsourcing on the one hand, and the need to restrict the extent of outsourcing on the other.
Pursuing Quantum Difference Equations II: 3D mirror symmetry
Authors: Kononov Yakov , Smirnov Andrey
Published: July 2022

Let $\textsf {X}$ and $\textsf {X}^{!}$ be a pair of symplectic varieties dual with respect to 3D mirror symmetry. The $K$-theoretic limit of the elliptic duality interface is an equivariant $K$-theory class $\mathfrak {m} \in K(\textsf {X}\times \textsf {X}^{!})$. We show that this class provides correspondences $$ \begin{align*} & \Phi_{\mathfrak{m}}: K(\textsf{X}) \leftrightarrows K(\textsf{X}^{!}) \end{align*}$$mapping the $K$-theoretic stable envelopes to the $K$-theoretic stable envelopes. This construction allows us to relate various representation theoretic objects of $K(\textsf {X})$, such as action of quantum groups, quantum dynamical Weyl groups, $R$-matrices, etc., to those for $K(\textsf {X}^{!})$. In particular, we relate the wall $R$-matrices of $\textsf {X}$ to the $R$-matrices of the dual variety $\textsf {X}^{!}$. As an example, we apply our results to $\textsf {X}=\textrm {Hilb}^{n}({{\mathbb {C}}}^2)$—the Hilbert scheme of $n$ points in the complex plane. In this case, we arrive at the conjectures of Gorsky and Negut from [10].
When AI moderates online content: effects of human collaboration and interactive transparency on user trust
Authors: Molina Maria D , Sundar S Shyam
Published: July 2022

Given the scale of user-generated content online, the use of artificial intelligence (AI) to flag problematic posts is inevitable, but users do not trust such automated moderation of content. We explore if (a) involving human moderators in the curation process and (b) affording “interactive transparency,” wherein users participate in curation, can promote appropriate reliance on AI. We test this through a 3 (Source: AI, Human, Both) × 3 (Transparency: No Transparency, Transparency-Only, Interactive Transparency) × 2 (Classification Decision: Flagged, Not Flagged) between-subjects online experiment (N = 676) involving classification of hate speech and suicidal ideation. We discovered that users trust AI for the moderation of content just as much as humans, but it depends on the heuristic that is triggered when they are told AI is the source of moderation. We also found that allowing users to provide feedback to the algorithm enhances trust by increasing user agency.
Indebted Impunity and Violence in a Lesser State: Ethno-Racial Capitalism in Sri Lanka
Authors: Xavier Sujith , Bhatia Amar , Smith Adrian A
Published: July 2022

This article examines the relationship between colonialism, capitalism, and violence in Sri Lanka through the combined lenses of international economic law (IEL) and transitional justice. We argue that colonialism instantiates vicious cycles in the histories of violence of ethno-racial capitalism through the creation of states with debts that can never be repaid. This system of ‘indebted impunity’ persists even under ‘new’ Southern sovereigns. We illustrate how IEL and transitional justice are co-constitutive in maintaining international law’s racial hierarchies, while pursuing the construction of racial hierarchies that precipitate ethno-racial capitalist formations, and violence, in Sri Lanka. We first attend to the emergence of international law with racial capitalism as a story of sustained violence, where offshoots like IEL and transitional justice remain tied to the foundational violence in ways that cannot be reformed away. The final section examines the colonial transformation of Sri Lanka, focusing on the British Empire’s role in configuring ethno-racial communities, to consider how IEL and transitional justice work together to maintain this cycle. We observe that indebted impunity persists as a structural condition even when the ‘white’ colonial masters have formally departed, and ‘brown’ differentially racialized compatriots become the ones in charge.
Contributions of CO2-Baited Malaise-Type Traps to the Knowledge of Hematophagous and Oestrid Flies (Diptera: Oestridae) Parasitizing Cervid Hosts
Authors: Anderson John R
Published: July 2022

This review describes an innovative and efficient modification of a type of Malaise trap meme overlooked in a recent review of such insect traps. It further identifies the large variety of dipteran parasites of vertebrates caught in the traps when CO2 was added as an attractant that otherwise rarely were caught in unbaited traps. Baited trap catches of parasitic flies mimicked those caught attacking cervid hosts. This review particularly focuses on comprehensive studies of: 1) several hematophagous species of largely unknown snipe flies (Diptera: Rhagionidae: Symphoromyia [Artiodactyla: Cervidae]) found host specific for Columbian black-tailed deer (Odocoileus hemionus columbianus Richardson), and 2) the biology of oestrid fly (Diptera: Oestridae) parasites of black-tailed deer and caribou/reindeer [Rangifer tarandus (L.) (Artiodactyla: Cervidae)], after it was discovered that the non-hematophagous females are guided to their vertebrate hosts by tracking a source of CO2, as done by many hematophagous flies.
Sociodemographic Survival Disparities for Lung Cancer in the United States, 2000-2016
Authors: Brouwer Andrew F , Engle Jason M , Jeon Jihyoun , Meza Rafael
Published: July 2022

Background

Understanding the impact of patient and tumor characteristics on lung cancer survival can help build personalized prognostic models and identify health disparities.

Methods

We identified 557 555 patients aged 25 years and older diagnosed with lung or bronchus carcinoma from the Surveillance, Epidemiology, and End Results database, 2000-2016. We estimated hazard ratios (HR) for demographic (sex, age, race and ethnicity), tumor (stage, histology, year of diagnosis), and geographic characteristics (census tract–level urbanicity, socioeconomic status [SES]), as well as selected interactions, on the rate of lung cancer–specific death using multivariable proportional hazards models.

Results

Women had a higher survival (lower hazard) of lung cancer–specific death than men (HR = 0.83, 95% confidence interval [CI] = 0.82 to 0.83). Hazards differed by race and ethnicity. Regional (HR = 2.41, 95% CI = 2.37 to 2.44) and distant (HR = 6.61, 95% CI = 6.53 to 6.69) tumors were associated with a lower survival (higher hazard) than localized tumors. Small cell tumors were associated with a lower survival (HR = 1.19, 95% CI = 1.18 to 1.20) than non–small cell tumors. Patients diagnosed after 2009 had lower hazards (HR = 0.86, 95% CI = 085 to 0.86) than those diagnosed 2000-2009. Lung cancer–specific survival did not depend on urbanicity after adjusting for census tract–level SES, but survival decreased with decreasing census tract–level SES. Differences in survival between non-Hispanic Black and White patients were greater for younger patients and localized tumors and increased with census tract–level SES. Differences by sex were greatest for young patients and localized tumors.

Conclusions

Disparities in survival after lung cancer diagnosis remain, with intersectional patterns suggesting differential access to and quality of care. Efforts are needed to ensure that high-risk groups receive guideline-concordant treatment.
Eplerenone reduces renal ischaemia/reperfusion injury by modulating Klotho, NF-κB and SIRT1/SIRT3/PGC-1α signalling pathways
Authors: Barati Alireza , Rahbar Saadat Yalda , Meybodi Seyed Mohammadmahdi , Nouraei Sana , Moradi Kimia , Kamrani Moghaddam Farid , Malekinejad Zahra , Hosseiniyan Khatibi Seyed Mahdi , Zununi Vahed Sepideh , Bagheri Yasin
Published: July 2022

Objectives

Acute kidney injury (AKI) is a sudden impairment in kidney function that is associated with high morbidity and mortality. Inflammation, oxidative stress, mitochondrial impairment and energy depletion, along with organ dysfunction are hallmarks of AKI. This study aimed to evaluate the effects of Eplerenone, an aldosterone receptor antagonist, on the kidney injury caused by ischaemia/reperfusion (I/R).

Methods

Male Wistar rats (n = 24) were randomly allocated into four groups: sham, IR, Eplerenone and Eplerenone+IR. Rats in the two last groups 1 h before I/R induction, were treated with Eplerenone (100 mg/kg) via intraperitoneal injection. Protein levels of Klotho, heat shock protein 70 (HSP70), sirtuin1 (SIRT1), SIRT3 and peroxisome proliferator-activated receptor-gamma coactivator 1-α (PGC-1α) along with antioxidant, apoptotic (caspase 3, Bax and Bcl2) and inflammatory [nuclear factor kappa-B (NF-κB) p65, Interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α) and cyclooxygenase-2 (COX-2)] factors were evaluated in the kidney tissues of the experimental groups.

Key findings

Eplerenone pre-treatment significantly could improve IR-induced pathological changes and kidney function and increase the renal antioxidant factors compared to the IR group (P < 0.05). Furthermore, in the Eplerenone + IR group, significant elevation of the Klotho, SIRT1, SIRT3 and PGC-1α at the protein level was identified compared to the IR group. Eplerenone pretreatment could not only downregulate NF-κB signalling and its downstream inflammatory factors (IL-6, COX-2 and TNF-α) but also could decrease apoptotic factors (P ≤ 0.01).

Conclusions

The results recommended that Eplerenone exerts a protective effect against kidney IR injury by up-regulating Klotho, HSP70, sirtuins and PGC-1α to preserve mitochondrial function and cell survival. Moreover, it hinders renal inflammation by suppressing NF-κB signalling. These results offer insight into the prevention or treatment of AKI in the future.
Topological magnetoelectric response in ferromagnetic axion insulators
Authors: Wan Yuhao , Li Jiayu , Liu Qihang
Published: July 2022

The topological magnetoelectric effect (TME) is a hallmark response of the topological field theory, which provides a paradigm shift in the study of emergent topological phenomena. However, its direct observation is yet to be realized due to the demanding magnetic configuration required to gap all surface states. Here, we theoretically propose that axion insulators with a simple ferromagnetic configuration, such as the MnBi2Te4/(Bi2Te3)n family, provide an ideal playground to realize the TME. In the designed triangular prism geometry, all the surface states are magnetically gapped. Under a vertical electric field, the surface Hall currents give rise to a nearly half-quantized orbital moment, accompanied by a gapless chiral hinge mode circulating in parallel. Thus, the orbital magnetization from the two topological origins can be easily distinguished by reversing the electric field. Our work paves the way for direct observation of the TME in realistic axion-insulator materials.
Non-contact real-time detection of trace nitro-explosives by MOF composites visible-light chemiresistor
Authors: Deng Wei-Hua , Yao Ming-Shui , Zhang Min-Yi , Tsujimoto Masahiko , Otake Kenichi , Wang Bo , Li Chun-Sen , Xu Gang , Kitagawa Susumu
Published: July 2022

To create an artificial structure to remarkably surpass the sensitivity, selectivity and speed of the olfaction system of animals is still a daunting challenge. Herein, we propose a core-sheath pillar (CSP) architecture with a perfect synergistic interface that effectively integrates the advantages of metal–organic frameworks and metal oxides to tackle the above-mentioned challenge. The sheath material, NH2-MIL-125, can concentrate target analyte, nitro-explosives, by 1012 times from its vapour. The perfect band-matched synergistic interface enables the TiO2 core to effectively harvest and utilize visible light. At room temperature and under visible light, CSP (TiO2, NH2-MIL-125) shows an unexpected self-promoting analyte-sensing behaviour. Its experimentally reached limit of detection (∼0.8 ppq, hexogeon) is 103 times lower than the lowest one achieved by a sniffer dog or all sensing techniques without analyte pre-concentration. Moreover, the sensor exhibits excellent selectivity against commonly existing interferences, with a short response time of 0.14 min.
Dinitrogen cleavage and hydrogenation to ammonia with a uranium complex
Authors: Xin Xiaoqing , Douair Iskander , Zhao Yue , Wang Shuao , Maron Laurent , Zhu Congqing
Published: July 2022

The Haber–Bosch process produces ammonia (NH3) from dinitrogen (N2) and dihydrogen (H2), but requires high temperature and pressure. Before iron-based catalysts were exploited in the current industrial Haber–Bosch process, uranium-based materials served as effective catalysts for production of NH3 from N2. Although some molecular uranium complexes are known to be capable of combining with N2, further hydrogenation with H2 forming NH3 has not been reported to date. Here, we describe the first example of N2 cleavage and hydrogenation with H2 to NH3 with a molecular uranium complex. The N2 cleavage product contains three uranium centers that are bridged by three imido μ2-NH ligands and one nitrido μ3-N ligand. Labeling experiments with 15N demonstrate that the nitrido ligand in the product originates from N2. Reaction of the N2-cleaved complex with H2 or H+ forms NH3 under mild conditions. A synthetic cycle has been established by the reaction of the N2-cleaved complex with trimethylsilyl chloride. The isolation of this trinuclear imido-nitrido product implies that a multi-metallic uranium assembly plays an important role in the activation of N2.
Occupational recovery of Dutch workers with low back pain
Authors: Brus I , Speklé E , Kuijer P P , Hardenberg M , Coenen P
Published: July 2022

Background

Low back pain (LBP) is a world leading cause of disability and has substantial impact on individuals and society as a whole. The largest part of the societal burden of LBP is caused by indirect costs, including sick leave.

Aims

We aimed to describe occupational recovery and associated costs for workers consulting an occupational physician (OP) with LBP, and to determine to what extent this differs by diagnoses: non-specific favourable LBP, non-specific unfavourable LBP, lumbosacral radicular syndrome (LRS) and specific LBP.

Methods

We analysed longitudinal dynamic cohort data from an occupational health service, representing ~1.2 million workers from various companies and sectors throughout the Netherlands. The OP registered data on sick leave and LBP diagnoses. A survival analysis was performed on sick leave duration to determine recovery and a linear regression analysis on cost per episode, adjusting for sex, age and working hours.

Results

We analysed 5951 LBP episodes from 5472 workers who consulted an OP, with a median and mean duration sick leave of 95 and 151 days, respectively. The probability of not recovering was 82% at 30 days and 10% at 1 year. The mean cost per episode was €15 350. Specific LBP (€22 999; beta (95% confidence interval [CI]): 16 278 (13 325–19 165)) and LRS (€20 111; beta (95% CI): 13 589 (12 527–14 659)) had the longest and most costly episodes, compared to non-specific favourable LBP (€6745; reference group).

Conclusions

With LRS and non-specific unfavourable LBP accounting for over 83% of LBP-associated sick leave costs, the work-directed care of workers with these two diagnoses deserves increased attention.
Missed Opportunity: The Unseen Driver for Low Coronavirus Disease 2019 Vaccination Rates in Underserved Patients
Authors: Campagnoli Tania , Mohan Geetika , Taddese Nigist , Santhiraj Yaveen , Margeta Natasa , Alvi Saad , Jabbar Umair , Bobba Aniesh , Alharash Jihad , Hoffman Michael J
Published: July 2022

Background

Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus have been available since December 2020. Vaccination rates among hospitalized patients at our institution remained low at approximately 40%, thus we sought to understand the drivers of vaccine hesitancy in our patient population.

Methods

All unvaccinated adult patients admitted to our hospital were asked to participate in a survey to assess coronavirus disease 2019 (COVID-19) vaccine hesitancy. Updated vaccination status was collected at the end of the study.

Results

Ninety-seven patients agreed to participate, 34% of which were SARS-CoV-2 positive based on results from polymerase chain reaction tests. Of the 64 participants eligible to receive the vaccine, 57.8% were agreeable but only 27% received the vaccine before discharge.

Conclusion

Many patients are willing to receive the vaccine, and hospitalization provides a unique opportunity to interact with patients who have been otherwise unaware, unable, or unwilling to pursue vaccination outside of the hospital.
Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment
Authors: Clague Madison , Kim Carla , Zucker Jason , Green Daniel A , Sun Yifei , Whittier Susan , Thakur Kiran T
Published: July 2022

Background

Herpes simplex virus–1 is the most common cause of sporadic encephalitis worldwide and requires prompt antiviral treatment. Traditionally, herpes simplex virus–1 (HSV-1) cerebrospinal fluid (CSF) testing is conducted using standalone polymerase chain reaction (PCR). The BioFire CSF FilmArray Meningitis/Encephalitis Panel (BioFire ME Panel) was introduced in 2015 at our institution, providing an alternative method of HSV-1 CSF testing. This study assesses the impact of the BioFire ME Panel on duration of intravenous acyclovir treatment.

Methods

A retrospective review of electronic medical records between 2010 and 2019 was performed. Information on intravenous acyclovir treatment and HSV-1 CSF testing was collected and analyzed. Our descriptive analysis included Mann-Whitney tests, 2 proportion Z-tests, and logistic regression.

Results

Our CSF HSV-1-negative cohort included 524 BioFire patients (125 pediatric, 399 adult) and 287 standalone PCR patients (115 pediatric, 172 adult). Across both pediatric and adult groups, patients who were tested for HSV-1 with the BioFire ME Panel had shorter average (SD) durations of intravenous acyclovir treatment (pediatric: 2.00 [5.71] days; adult: 3.26 [6.59] days) compared with patients tested with standalone PCR (pediatric: 4.83 [8.62] days; adult: 4.93 [8.46] days; P < .001). Time from lumbar puncture collection to HSV-1 results was additionally faster on average for the BioFire ME Panel than the standalone PCR (P < .001).

Conclusions

The implementation of the BioFire ME Panel shortened CSF HSV-1 PCR result time and intravenous acyclovir duration. The shortened treatment and testing times from the BioFire ME Panel implementation may reduce hospital treatment costs and unnecessary use of antiviral treatments.
Energy status-promoted growth and development of Arabidopsis require copper deficiency response transcriptional regulator SPL7
Authors: Schulten Anna , Pietzenuk Björn , Quintana Julia , Scholle Marleen , Feil Regina , Krause Marcus , Romera-Branchat Maida , Wahl Vanessa , Severing Edouard , Coupland George , Krämer Ute
Published: July 2022

Copper (Cu) is a cofactor of around 300 Arabidopsis proteins, including photosynthetic and mitochondrial electron transfer chain enzymes critical for adenosine triphosphate (ATP) production and carbon fixation. Plant acclimation to Cu deficiency requires the transcription factor SQUAMOSA PROMOTER-BINDING PROTEIN-LIKE7 (SPL7). We report that in the wild type (WT) and in the spl7-1 mutant, respiratory electron flux via Cu-dependent cytochrome c oxidase is unaffected under both normal and low-Cu cultivation conditions. Supplementing Cu-deficient medium with exogenous sugar stimulated growth of the WT, but not of spl7 mutants. Instead, these mutants accumulated carbohydrates, including the signaling sugar trehalose 6-phosphate, as well as ATP and NADH, even under normal Cu supply and without sugar supplementation. Delayed spl7-1 development was in agreement with its attenuated sugar responsiveness. Functional TARGET OF RAPAMYCIN and SNF1-RELATED KINASE1 signaling in spl7-1 argued against fundamental defects in these energy-signaling hubs. Sequencing of chromatin immunoprecipitates combined with transcriptome profiling identified direct targets of SPL7-mediated positive regulation, including Fe SUPEROXIDE DISMUTASE1 (FSD1), COPPER-DEFICIENCY-INDUCED TRANSCRIPTION FACTOR1 (CITF1), and the uncharacterized bHLH23 (CITF2), as well as an enriched upstream GTACTRC motif. In summary, transducing energy availability into growth and reproductive development requires the function of SPL7. Our results could help increase crop yields, especially on Cu-deficient soils.
Radiofrequency Ablation of the Infrapatellar Branch of the Saphenous Nerve for the Treatment of Chronic Anterior Inferomedial Knee Pain
Authors: Beckwith Margaret , Cushman Daniel , Clark Tyler , Park Peter K , Burnham Taylor , Burnham Robert , McCormick Zachary L , Conger Aaron
Published: July 2022

Intro. Genicular nerve radiofrequency ablation (GNRFA) is an effective treatment for chronic knee pain related to osteoarthritis. It is often utilized when conservative management has failed and patients wish to avoid arthroplasty, are poor surgical candidates due to comorbid medical conditions, or in those suffering from persistent pain after arthroplasty. The classic targets for GNRFA include the superior lateral genicular nerve, superior medial genicular nerve, and inferior medial genicular nerve but multiple anatomic studies have demonstrated additional sensory innervation to the knee. Objective. In this research article, we propose an image-guided technique that can safely target the infrapatellar branch of the saphenous nerve which also provides sensory innervation to the anterior capsule. Proposal. The proposed technique includes variations for conventional bipolar radiofrequency ablation, cooled radiofrequency ablation, dual-tined bipolar radiofrequency ablation, and monopolar radiofrequency ablation using a long axis approach. The described technique is based on updated anatomic studies and takes into account safety concerns such as thermal risk to the skin and/or pes anserine tendons and breaching of the synovial cavity. Conclusion. Future clinical research should be performed to confirm the safety and effectiveness of this specific approach.
The Pain Clinic for Older People
Authors: Chen Nancy , Farrell Michael , Kendall Sarah , Levy Leah , Mehan Robert , Katz Benny
Published: July 2022

Objective

Multidisciplinary pain clinics have an established role in the management of persistent pain, but there is little evidence to support this approach in an older population. This study describes the characteristics and pain outcomes of patients attending a pain clinic designed exclusively for older people.

Methods

A retrospective audit was performed of outcomes of the Pain Clinic for Older People (PCOP) in 2015–2019. Response to treatment was determined by change in Brief Pain Inventory (BPI) scores at initial attendance and after a treatment program. Clinically meaningful improvement was defined by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) consensus criteria of ≥30% improvement in average pain and one-point improvement in pain interference. Results were compared with the national benchmark collated by the electronic Persistent Pain Outcomes Collaboration (ePPOC), which reports the combined results from 67 participating Australian and New Zealand pain services.

Results

Patients attending the PCOP had a mean age of 80.5 years and had high rates of frailty (84%), cognitive impairment (30%), and multimorbidity. Significant reductions in BPI average pain and BPI pain interference scores were achieved. Clinically meaningful improvement in BPI average pain was achieved in 63% of patients attending the PCOP who were 65–74 years of age and in 46% of patients who were ≥75 years of age, which met the national benchmark set by ePPOC of 40% for both age groups. Clinically meaningful improvement in BPI pain interference was achieved in 69% of those attending the PCOP who were 65–74 years of age and in 66% of those who were ≥75 years of age, comparable to the ePPOC benchmark of 71% and 65% for the respective age groups.

Conclusion

PCOP clients achieved significant and meaningful improvements in their pain outcomes that satisfied the national benchmark. Advanced age, cognitive impairment, frailty and multimorbidity should not be regarded as barriers to benefit from a pain clinic specifically designed for older people.
Quantifying navigation complexity in transportation networks
Authors: Jiang Zhuojun , Dong Lei , Wu Lun , Liu Yu
Published: July 2022

The complexity of navigation in cities has increased with the expansion of urban areas, creating challenging transportation problems that drive many studies on the navigability of networks. However, due to the lack of individual mobility data, large-scale empirical analysis of the wayfinder’s real-world navigation is rare. Here, using 225 million subway trips from three major cities in China, we quantify navigation difficulty from an information perspective. Our results reveal that (1) people conserve a small number of repeatedly used routes and (2) the navigation information in the subnetworks formed by those routes is much smaller than the theoretical value in the global network, suggesting that the decision cost for actual trips is significantly smaller than the theoretical upper limit found in previous studies. By modeling routing behaviors in growing networks, we show that while the global network becomes difficult to navigate, navigability can be improved in subnetworks. We further present a universal linear relationship between the empirical and theoretical search information, which allows the two metrics to predict each other. Our findings demonstrate how large-scale observations can quantify real-world navigation behaviors and aid in evaluating transportation planning.