bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric adrenal incidentaloma as a rare and difficult to diagnose finding - review
Authors: Pałac Dominika , Ostrowska Magdalena , Grześk-Kaczyńska Magdalena , Kaczyński Szymon
Published: August 2022

Adrenal incidentaloma (AI) is an asymptomatic mass localized in the adrenal gland, usually detected during diagnostic imaging performed due to other health issues than the suspected adrenal disease. It occurs in 2% of adults and 0,2% of children. Pediatric AI may cause many difficulties in the diagnostic processes. Neuroblastoma is one of the most common malignant tumors in children. Usually, it is localized in the medulla of the adrenal gland. Many patients do not have any symptoms, but some may present with fever, weariness, weight loss, pain, enlarging mass, etc. The majority of cases are high- risk and the survival rate is less than 50%. The diagnostic protocol consists of laboratory tests and radiological imagining. Treatment depends on the risk group that the patient is assigned to. Pheochromocytoma is a rare catecholamine-secreting tumor in children originating in the adrenal medulla. Most pediatric patients present with sustained hypertension. 60% of pheochromocytoma cases are sporadic. The surgical removal of the tumor through adrenalectomy is a standard procedure. To the group of pediatric adrenocortical tumors (ACT), benign adrenocortical adenoma (ACA) and malignant adrenocortical carcinoma (ACC) are included. ACA is found in only 20% of cases of ACT. Most of the patients present with signs of virilization, Cushing Syndrome, or both. The 5-years survival rate of ACC in the pediatric population is 46-55%. An adrenal incidentaloma is an unpredictable and possibly dangerous disorder in the pediatric population. Due to the rarity of the finding and their variety, there is not much data and clear recommendations about AI management. Doctors need to know about the prevalence of different types of adrenal tumors in the pediatric population based on age.
Learning strategies and entrepreneurial attitudes: A predictive model of entrepreneurship intention in Peruvian undergraduate students
Authors: Bustos Varinia , Martínez-Gregorio Sara , Galiana Laura , Oliver Amparo , Olivos Mariella
Published: August 2022

This study aims to empirically test how learning strategies would fit into an undergraduate entrepreneur’s profile. The design is cross-sectional with a sample of 527 Peruvian undergraduate students. A structural equation model was specified, estimated, and tested in Mplus 8.4. The model hypothesized direct effects of the different learning strategies on a factor of entrepreneurial attitudes (considering proactivity, professional ethics, empathy, innovation, autonomy, and risk-taking dimensions) which, in turn, explained two indicators of entrepreneurship intention as outcomes. The tested structural model adequately fits the data. It provided helpful information on learning strategies and entrepreneurial attitudes accounting for up to 20% of variance of entrepreneurship intention. The learning strategies most related to entrepreneurial attitudes are those related to creativity, transference, and assessment of one's own performance. This paper provides for the first time evidence about the predictive power of several learning strategies on the entrepreneurial attitudes in connection with entrepreneurship intention (willingness and likelihood). This work increases our understanding of entrepreneurs’ learning strategies, so that we can improve the design and implementation of educational resources to promote entrepreneurs’ careers in emerging markets.
Distributionally Robust Stochastic Optimization with Wasserstein Distance
Authors: Gao Rui , Kleywegt Anton
Published: August 2022

Distributionally robust stochastic optimization (DRSO) is an approach to optimization under uncertainty in which, instead of assuming that there is a known true underlying probability distribution, one hedges against a chosen set of distributions. In this paper, we first point out that the set of distributions should be chosen to be appropriate for the application at hand and some of the choices that have been popular until recently are, for many applications, not good choices. We next consider sets of distributions that are within a chosen Wasserstein distance from a nominal distribution. Such a choice of sets has two advantages: (1) The resulting distributions hedged against are more reasonable than those resulting from other popular choices of sets. (2) The problem of determining the worst-case expectation over the resulting set of distributions has desirable tractability properties. We derive a strong duality reformulation of the corresponding DRSO problem and construct approximate worst-case distributions (or an exact worst-case distribution if it exists) explicitly via the first-order optimality conditions of the dual problem. Our contributions are fourfold. (i) We identify necessary and sufficient conditions for the existence of a worst-case distribution, which are naturally related to the growth rate of the objective function. (ii) We show that the worst-case distributions resulting from an appropriate Wasserstein distance have a concise structure and a clear interpretation. (iii) Using this structure, we show that data-driven DRSO problems can be approximated to any accuracy by robust optimization problems, and thereby many DRSO problems become tractable by using tools from robust optimization. (iv) Our strong duality result holds in a very general setting. As examples, we show that it can be applied to infinite dimensional process control and intensity estimation for point processes.
Assessing the experiences of care of children and young people in mental distress in acute care settings: a survey
Authors: Williams Sophia , Walker Dawn-Marie
Published: August 2022

Background/Aims

To date, literature may not be fully representative of the views of all children and young people experiencing mental ill health concerning their experience of attending an acute care setting with mental distress. Research highlights opinions of children and young people known to community mental health services; however, it is estimated that 65–75% of children and young people experience mental health problems are undiagnosed and untreated ( Care Quality Commission, 2018 ). The aim of this study was to compare experiences of patients presenting to emergency settings both known (group 1) and unknown (group 2) to community mental health services.

Methods

A survey was distributed to children and young people experiencing mental distress. Survey responses were categorised into two patient groups: participants known to community children and adolescent mental health services and accessing support (group 1) and those not currently known or receiving support from any children and adolescent mental health services (group 2). Responses were categorised into ‘environment rating’, ‘nurse rating’ and overall ‘acute care rating’.

Results

Disparities were identified between groups 1 and 2. Group 1 had negative acute care ratings, mainly resulting from environmental factors. Both groups reported negatively when nurses spoke to parents or carers instead of the young person themselves.

Conclusions

Further research is needed into experiences of children and young people not meeting criteria for community mental health support, as there is a data gap. Paediatric nurses must directly communicate with children and young people experiencing mental distress, rather than speaking to parents or carers.
Addressing the unmet need in alcohol service provision: outpatient clinics and a new model of treatment for alcohol dependency
Authors: Fernandez Jeff , Ryan Jennifer
Published: August 2022

This article highlights that a reconfiguration of existing services can lead to a more relevant treatment plan for patients with alcohol dependency. It focuses on how an outpatients service at a teaching hospital has been redesigned to accommodate patients who are reluctant to access mainstream services. This article demonstrates that simple changes can result in positive patient outcomes.
Research skills in practice
Authors: Folliard Kelda , Sanders Ruth
Published: August 2022

Kelda Folliard and Ruth Sanders discuss facilitating the conceptual leap for student midwives towards embedding evidence-based practice and research in midwifery
First-time fathers' experiences attending labour and birth: a descriptive cross-sectional study
Authors: Dodel Khadijeh , Ozgoli Giti , Mobarakabadi Sedigheh Sedigh , Nasiri Malihe , Pazandeh Farzaneh
Published: August 2022

Background

It is now more common for fathers to participate in labour and childbirth in Iran. As such, it is essential to examine their experiences in order to empower maternal care specialists to meet fathers' and mothers' needs more effectively. This study aimed to examine first-time fathers' experiences attending labour and birth.

Methods

This descriptive cross-sectional study recruited 200 first-time fathers in Tehran, Iran. Self-reported data were collected on participants' experiences of labour and birth. Descriptive and inferential statistics, as well as multivariate linear regression analysis were used to analyse the data.

Results

First-time fathers' overall experiences were significantly affected by their partner's education, insurance coverage for hospital charges, pregnancy care provision by an obstetrician-gynaecologist, preparedness for childbirth and whether the childbirth experience fit the father's expectations.

Conclusions

Counseling programmes based on fathers' needs should be developed to improve their experiences, allay concerns and adjust factors that shape their experiences in order to encourage fathers' participation in labour and birth.
Pregnant women's knowledge of venous thromboembolism in Malaysia
Authors: Fen Lim Suk , Shet Duangta , Zain Norhasmah Mohd , Keng Soon Lean
Published: August 2022

Background

Venous thromboembolism is an acute condition resulting in maternal morbidity and death.

Aims

This study aimed to assess venous thromboembolism knowledge among pregnant women in Malaysia.

Methods

A cross-sectional study was conducted among 143 pregnant women recruited via convenience sampling. Data gathered included demographic characteristics and knowledge of venous thromboembolism. The Fisher exact test examined the association between knowledge and outcome factors.

Results

Of the 143 pregnant women, 95.8% had low knowledge about venous thromboembolism. A significant association was found between level of knowledge and employment status (P=0.003) and monthly household income (P<0.001).

Conclusion

The study's participants demonstrated a deficit of knowledge of venous thromboembolism among pregnant women in Malaysia. Healthcare policymakers and maternal health services should put in place policies to improve pregnant women's knowledge of the danger of venous thromboembolism and its associated risk factors.
Plasmonic internal-photoemission-based Si photodetector design suitable for optical communication
Authors: Alihosseini Faramarz , Zali Aref Rasoulzadeh , Pakizeh Tavakol , Zandi Hesam
Published: August 2022

We propose a high-performance plasmonic photodetector based on the internal photoemission (IPE) process for the C-band communication wavelength. This photodetector takes advantage of an embedded nanohole array in Schottky metal. Owing to localized surface plasmon resonance, the absorption of the active metal layer increases, which results in the generation of more hot carriers and subsequently compensates for the low efficiency of IPE-based photodetectors. Simulations show that for the proposed photodetector with 2-nm-thick Au, Cu, and Ag Schottky contacts, the absorptance dramatically enhances to 95.1%, 93.2%, and 98.2%, respectively, at the wavelength of 1.55 µm. For the detector based on Au, the highest external quantum efficiency of 25.3% and responsivity of 0.32 A/W are achieved at a reverse bias voltage of 1 V. Furthermore, the 3 dB bandwidth can exceed 369 GHz owing to the low capacitance of the structure and the fast transit time of carriers from the thin p-Si layer. Finally, by studying the current–voltage characteristics of the photodetector, it is shown that under the reverse bias voltage of 1 V, the dark current is 665 nA at room temperature, and by reducing the temperature to 200 K, it improves three orders of magnitude and decreases to 810 pA.
Subwavelength dielectric grating structures with tunable higher order resonance for achromatic augmented reality display
Authors: Shi Xiaogang , Shen Hong , Xue Zhenghui , Wang Bingjie
Published: August 2022

Color non-uniformities caused by a dispersion effect can seriously affect the image quality for a diffractive waveguide display system. In this work, we propose a subwavelength multilayered dielectric grating structure by a rigorous coupled wave analysis as a novel coupling grating, to the best of our knowledge, for waveguide-based near-eye displays to overcome the “rainbow” effect. Such a grating structure exhibits a tunable high-efficiency resonance in first-order diffraction due to resonant coupling of incident light with the grating structure. A further analysis of the resonant behaviors helps us get a clear understanding of the underlying physics for the mode excitation and resonant coupling process. The first-order resonance with a diffraction efficiency of more than 60% can be achieved with the resonant angle continuously shifted to get a large field of view. The resonant angle, diffraction efficiency, and spectral linewidth can be easily tuned by the geometrical parameters of the grating structure.
Three-dimensional stitching of stereo-deflectometry based on marker points
Authors: Wei Xiaoxiao , Zhang Hao , Zou Tianmei , Wang ZhenLei
Published: August 2022

As a non-contact and three-dimensional (3D) mirror surface measurement method, stereo-deflectometry has been developing rapidly in recent years. For solving the problem of the measurement of large surface inclination with traditional stereo-deflectometry, 3D stitching of stereo-deflectometry based on marker points is proposed. In this method, the 3D points in the subregions under different perspectives were measured. Meanwhile, the 3D coordinates of the marker points on the sample table, which were calculated by binocular stereo vision, were used for coarse stitching, and the ICP algorithm was used for fine stitching. In order to verify the 3D stitching algorithm, we built a measurement system for the freeform surface of an ultra-short lens with a diameter of about 100 mm and a steepness of 52.6°. The spherical fitting error of the reflective bowl after stitching is within 60 mm. The experimental results verify the feasibility of the method, leading to potential mass application of stereo-deflectometry in 3D measurement of complex optical surfaces with a large aperture and high steepness.
Influence of detection noise on the maximum likelihood estimation of atmospheric turbulence fading parameters
Authors: Chen Dan , Gao Yue , Wang Huiqin , Liu Yuan , Cao Yeqin
Published: August 2022

Free space optical system design and performance analysis are highly related to channel statistics obtained by the channel parameter estimation. The accurate estimation of the channel parameters and scintillation index needs to consider the photoelectric detection noise at the receiving end. We propose a maximum likelihood (ML) method for estimating the parameters of a gamma–gamma fading channel affected by photoelectric detection noise. The Newton–Raphson method and expectation maximization (EM) algorithm are developed to compute the ML estimates of atmospheric turbulence fading parameters and variance of the detection noise. We also derive the Cramer–Rao bound for the unknown parameters. By way of the mean square estimation errors, our estimation technique performance is compared with existing methods of the estimation which ignore detection noise. Based on the measured channel and detection noise data under three weather conditions, it is verified that the proposed EM algorithm, considering the influence of detection noise, can significantly improve the estimation accuracy of atmospheric turbulence fading parameters.
Narrow laser-linewidth measurement using short delay self-heterodyne interferometry
Authors: Zhao Zhongan , Bai Zhenxu , Jin Duo , Qi Yaoyao , Ding Jie , Yan Bingzheng , Wang Yulei , Lu Zhiwei , Mildren Richard P.
Published: August 2022

Delayed self-heterodyne interferometry is a commonly used technique for the measurement of laser linewidth. It typically requires the use of a very long delay fiber when measuring narrow linewidth (especially linewidths in the kHz-range) lasers. The use of long fibers can result in system losses and the introduction of 1/f noise that causes spectral line broadening. In this paper, we present a calculation method for processing the output of a delayed self-heterodyne setup using a short length of delay fiber, to determine laser linewidth. The method makes use of pairs of data points (corresponding to adjacent maxima and/or minima) in the signal generated from the self-heterodyne setup to determine the laser linewidth. Here, the power ratio or amplitude difference of the signal at these data points is of importance. One of the key benefits of this method is that it avoids 1/f noise which would otherwise be introduced into the measurement through the application of long fibers. The experimental results highlight that the method has a high calculation accuracy. Furthermore, the capacity for the method to utilize different pairs of data points in the self-heterodyne output to determine the laser linewidth, imparts a high degree of flexibility and usability to the technique when applied to real-world measurements.
Analysis of the multilayer organization of a sunflower leaf during dehydration with terahertz time-domain spectroscopy
Authors: Abautret Yannick , Coquillat Dominique , Lequime Michel , Zerrad Myriam , Amra Claude
Published: August 2022

We apply reverse engineering techniques (RET) to analyze the dehydration process of a sunflower leaf with terahertz time-domain spectroscopy. The multilayer structure of the leaf is extracted with accuracy during the entire process. Time variations of thickness and the complex index are emphasized for all leaf layers (2 cuticules, 2 epiderms, and 2 mesophylls). The global thickness of the sunflower leaf is reduced by up to 40% of its initial value.
Short-wave infrared computed tomography
Authors: Wang Zhengxin , Yang Tong , Cheng Quhan , Kong Deling , Gong Cheng , Liu Weiwei
Published: August 2022

We demonstrate a short-wave infrared computed tomography method. It uses a fiber-coupled 1.44µm super-luminescent diode as light source, a PbSe photodiode as infrared detector, and an electronically controlled rotation and translation stage for high-speed Radon scanning. It is a safe and low power nondestructive testing method that can be used for the detection of plastic polymers, biological tissue and other materials that visible light cannot penetrate. We analyze the theoretical resolution of the method and build a short-wave infrared computed tomography system, which realizes the tomography and 3D reconstruction of black plastic bottles and artificial blood vessels. The measured resolution reaches10µm.
Polarization spectroscopy of high-order harmonic generation in gallium arsenide
Authors: Kaassamani Shatha , Auguste Thierry , Tancogne-Dejean Nicolas , Liu Xu , Boutu Willem , Merdji Hamed , Gauthier David
Published: August 2022

An interesting property of high harmonic generation in solids is its laser polarization dependent nature which in turn provides information about the crystal and band structure of the generation medium. Here we report on the linear polarization dependence of high-order harmonic generation from a gallium arsenide crystal. Interestingly, we observe a significant evolution of the anisotropic response of above bandgap harmonics as a function of the laser intensity. We attribute this change to fundamental microscopic effects of the emission process comprising a competition between intraband and interband dynamics. This intensity dependence of the anisotropic nature of the generation process offers the possibility to drive and control the electron current along preferred directions of the crystal, and could serve as a switching technique in an integrated all-solid-state petahertz optoelectronic device.
Engineering a strong and stable ultraviolet chiroptical effect in a large-area chiral plasmonic shell
Authors: Huang Shanshan , Yang Xiu , Liang Xiaotong , Wu Xuannan , Yang Cheng , Du Jinglei , Hou Yidong
Published: August 2022

Ultraviolet chiral metamaterials (UCM) are highly desired for their strong interaction with the intrinsic resonance of molecules and ability in manipulating the polarization state of high energy photons, but rarely reported to date due to their small feature size and complex geometry. Herein, we design and fabricate a kind of novel ultraviolet chiral plasmonic shell (UCPS) by combing the stepwise Al deposition and colloid-sphere assembled techniques. The cancellation effect originated from the disorder lattices of micro-domains in the colloid monolayer has been successfully overcome by optimizing the deposition parameters, and a strong CD signal of larger than 1 deg in the UV region is demonstrated both in simulation and experiment. This strong ultraviolet chiroptical resonances mainly come from the surface chiral lattice resonance mode, the whispering gallery mode and also the interaction between neighbor shells, and can be effectively tuned by changing structural parameters, for example, the sphere diameter, or even slightly increasing the deposition temperature in experiment. To improve the stability, the fabricated UCPSs are protected by N2 in the deposition chamber and then passivated by UV-ozone immediately after each deposition step. The formed UCPS show an excellent stability when exposing in the atmospheric environment. The computer-aided geometrical model, electromagnetic modes, and the tunable chiroptical resonance modes have been systematically investigated.
High-sensitive MEMS Fabry-Perot pressure sensor employing an internal-external cavity Vernier effect
Authors: Dai Xiaoshuang , Wang Shuang , Jiang Junfeng , Yang Haokun , Tan Ke , Li Zhiyuan , Liu Tiegen
Published: August 2022

In this paper, a high sensitivity pressure sensor employing an internal-external cavity Vernier effect is innovatively achieved with the microelectromechanical systems (MEMS) Fabry-Perot (FP) interferometer. The sensor consists of silicon cavity, vacuum cavity, and silicon-vacuum hybrid cavity, which is fabricated by direct bonding a silicon diaphragm with an etched cylindrical cavity and a silicon substrate. By rationally designing the optical lengths of the silicon cavity and silicon-vacuum hybrid cavity to match, the internal-external cavity Vernier effect will be generated. The proposed cascaded MEMS FP structure exhibits a pressure sensitivity of -1.028 nm/kPa by tracking the envelope evolution of the reflection spectrum, which is 58 times that of the silicon-vacuum hybrid cavity. What’s more, it owns a minimal temperature sensitivity of 0.041 nm/°C for the envelope spectrum. The MEMS FP sensor based on internal-external cavity Vernier effect as the promising candidate provides an essential guideline for high sensitivity pressure measurement under the characteristic of short FP sensing cavity length, which demonstrates the value to the research community.
High-performance laser power converts for direct-energy applications
Authors: Gou Yudan , Wang Hao , Wang Jun , Niu Ruijun , Chen Xiangliu , Wang Bangguo , Xiao Yao , Zhang Zhicheng , Liu Wuling , Yang Huomu , Deng Guoliang
Published: August 2022

Six-junction GaAs laser power converts (LPCs) were designed and fabricated. Each subcell is vertically connected by p++-AlGaAs: C/n++-AlGaAs: Si: Te (1:2) tunnel junction with good thermal stability and a record peak tunneling current density of 1867 A/cm2. The I-V characteristics of LPCs with an aperture of 10×10 mm2 were investigated as a function of laser power and temperature. Maximum conversion efficiency and output power of 57.7% and 15.4 W, respectively, and a continuous stable operation at 22.9 W for over 550 hours were demonstrated. The temperature coefficient of conversion efficiency and open-circuit voltage were -0.197%abs/°C and -8.15 mV/°C, respectively, under 808 nm laser illumination of 21.0 W. Furthermore, an array of 100 large-scale (41×46 mm2) LPCs with an output power of 179 W under 1 kW laser irradiation at 20 m wireless transmission was developed.
Holographic optical elements with a large adjustable focal length and an aberration correction
Authors: Xu Yuan , Lv Zhenlv , Xu Liangfa , Yang Yan , Liu Juan
Published: August 2022

Holographic optical element (HOE) has the advantages of light weight, small volume and multiple functions, but the fixed focal length limits its application. The current methods of adjusting focal length suffer from the disadvantages of small adjustable range and the introduction of aberration. This paper proposes a design method for HOE, and it can compensate the aberrations of the reconstructed image for each distance in a large adjustable range. The focal length of HOE is adjusted by modulating the incident light through the wavefront modulator, and the aberration of the reconstructed image is corrected by optimizing the phase distribution of HOE and superimposing different compensation phases for different reconstruction distances. The reconstructed image experimentally moves without aberration in a large range, which demonstrates the feasibility of the proposed method. It is expected to be widely used in various optical fields where the focal length of HOE needs to be dynamically tuned.
Actively Q switched radially polarized Ho:YAG laser with an intra-cavity laser-written S-waveplate
Authors: Barber Matthew J. , Shardlow Peter C. , Lei Yuhao , Kazansky Peter G. , Andrew Clarkson W.
Published: August 2022

Nanosecond Q switched pulses and radial polarization are established stand-alone techniques for enhanced laser materials processing applications, but are generally challenging to achieve simultaneously at high average power levels. Here, we demonstrate a 20.6 W radially polarized Ho:YAG rod laser which has been actively Q switched in order to generate

515
 

μ

J, 210 ns pulses at 2097 nm. By utilizing an ultra-low-loss spatially variant birefringent wave plate (S-waveplate) inside the laser cavity, the linearly polarized fundamental mode has been converted to a radially polarized donut-shaped beam with very high conversion efficiency.
Sub-nanometer misalignment sensing for lithography with structured illumination
Authors: Wang Nan , Li Yi , Sha Feng , He Yu
Published: August 2022

Lithography for the next generation of integrated-circuit manufacturing at the 3 nm node requires sub-1-nm misalignment measurement accuracy, which is almost impossible for existing systems due to the optical diffraction limit. Herein, we propose a misalignment sensing strategy based on structured illumination. By virtue of the distinctive modulation effect of a Talbot diffractive illuminated field on moiré fringes, the measurement signals can pass unhindered through the optical system and be used for sensing. Experiments are used to demonstrate that the proposed method can implement real-time-lapse (100 Hz) misalignment sensing with an accuracy of sub-1-nm (0.31 nm @ 3σ), making it suitable for various lithography techniques (e.g., proximity, x ray, projective, and nanoimprint lithography) and fields requiring advanced precision measurement (e.g., quantum measurement, gravitational wave detection, and molecular biology).
The links of fine airborne particulate matter exposure to occurrence of cardiovascular and metabolic diseases in Michigan, USA
Authors: Shamsa El Hussain , Song Zhenfeng , Kim Hyunbae , Shamsa Falah , Hazlett Linda D. , Zhang Kezhong
Published: August 2022

Air pollutants, particularly airborne particulate matter with aerodynamic diameter < 2.5μm (PM2.5), have been linked to the increase in mortality and morbidity associated with cardiovascular and metabolic diseases. In this study, we investigated the dose-risk relationships between PM2.5 concentrations and occurrences of cardiovascular and metabolic diseases as well as the confounding socioeconomic factors in Michigan, USA, where PM2.5 levels are generally considered acceptable. Multivariate linear regression analyses were performed to investigate the relationship between health outcome and annual ground-level PM2.5 concentrations of 82 counties in Michigan. The analyses revelated significant linear dose-response associations between PM2.5 concentrations and cardiovascular disease (CVD) hospitalization. A 10 μg/m3 increase in PM2.5 exposure was found to be associated with a 3.0% increase in total CVD, 0.45% increase in Stroke, and a 0.3% increase in Hypertension hospitalization rates in Medicare beneficiaries. While the hospitalization rates of Total Stroke, Hemorrhagic Stroke, and Hypertension in urbanized counties were significantly higher than those of rural counties, the death rates of coronary heart disease and ischemic stroke in urbanized counties were significantly lower than those of rural counties. These results were correlated with the facts that PM2.5 levels in urbanized counties were significantly higher than that in rural counties and that the percentage of the population with health insurance and the median household income in rural counties were significantly lower. While obesity prevalence showed evidence of a weak positive correlation (ρ = 0.20, p-value = 0.078) with PM2.5 levels, there was no significant dose-response association between county diabetes prevalence rates and PM2.5 exposure in Michigan. In summary, this study revealed strong dose-response associations between PM2.5 concentrations and CVD incidence in Michigan, USA. The socioeconomic factors, such as access to healthcare resources and median household income, represent important confounding factors that could override the impact of PM2.5 exposure on CVD mortality.
An improved strabismus screening method with combination of meta-learning and image processing under data scarcity
Authors: Huang Xilang , Lee Sang Joon , Kim Chang Zoo , Choi Seon Han
Published: August 2022

Purpose

Considering the scarcity of normal and strabismic images, this study proposed a method that combines a meta-learning approach with image processing methods to improve the classification accuracy when meta-learning alone is used for screening strabismus.

Methods

The meta-learning approach was first pre-trained on a public dataset to obtain a well-generalized embedding network to extract distinctive features of images. On the other hand, the image processing methods were used to extract the position features of eye regions (e.g., iris position, corneal light reflex) as supplementary features to the distinctive features. Afterward, principal component analysis was applied to reduce the dimensionality of distinctive features for integration with low-dimensional supplementary features. The integrated features were then used to train a support vector machine classifier for performing strabismus screening. Sixty images (30 normal and 30 strabismus) were used to verify the effectiveness of the proposed method, and its classification performance was assessed by computing the accuracy, specificity, and sensitivity through 5,000 experiments.

Results

The proposed method achieved a classification accuracy of 0.805 with a sensitivity (correct classification of strabismus) of 0.768 and a specificity (correct classification of normal) of 0.842, whereas the classification accuracy of using meta-learning alone was 0.709 with a sensitivity of 0.740 and a specificity of 0.678.

Conclusion

The proposed strabismus screening method achieved promising classification accuracy and gained significant accuracy improvement over using meta-learning alone under data scarcity.
Intergroup attitudes and contact between Spanish and immigrant-background adolescents using network analysis
Authors: Sánchez-Castelló María , Navas Marisol , Rojas Antonio J.
Published: August 2022

This study aimed to analyze the relationship among different evaluative reactions of the intergroup attitudes and contact in Spanish adolescents evaluating different ethnic minorities and in immigrant-background adolescents evaluating Spanish youth. This study was based on psychosocial models of great impact in the study of intergroup relations such as the Stereotype Content Model and the Behaviors from Intergroup Affect and Stereotypes Map, and incorporated a new approach to the study of attitudes: psychological networks. In total, 1122 Spanish adolescents and 683 adolescents with an immigrant background (Moroccan, Romanian or Ecuadorian origin) participated in the study, aged from 12 to 19 years. They answered a questionnaire with measures of stereotype dimensions (morality, immorality, sociability and competence), emotions (positives and negative), behavioral tendencies (facilitation and harm) and contact (quantity and quality). The results show similar structural patterns in the six studied groups, with emotions acting as links between stereotypes and behavioral tendencies. Moreover, positive and negative stereotype dimensions appeared as independent dimensions that were part of different processes: sociability and morality, and competence to a lesser extent, were related to facilitation behaviors through positive emotions, while immorality was related to harm behaviors through negative emotions. This could indicate that, to achieve successful intergroup relations involving cooperation and the development of friendly relationships, it would be appropriate to intervene in parallel in these two pathways. Due to the centrality of positive emotions (and sociability and immorality) and, therefore, their capacity to affect the entire network, focusing interventions on these variables could be an appropriate strategy to achieve overall positive attitudes.
Development and validation of a new prognostic index for mortality risk in multimorbid adults
Authors: Gastens Viktoria , Chiolero Arnaud , Anker Daniela , Schneider Claudio , Feller Martin , Bauer Douglas C. , Rodondi Nicolas , Del Giovane Cinzia
Published: August 2022

Context

Multimorbidity is highly prevalent among older adults and associated with a high mortality. Prediction of mortality in multimorbid people would be clinically useful but there is no mortality risk index designed for this population. Our objective was therefore to develop and internally validate a 1-year mortality prognostic index for older multimorbid adults.

Methods

We analysed data of the OPERAM cohort study in Bern, Switzerland, including 822 adults aged 70 years or more with multimorbidity (3 or more chronic medical conditions) and polypharmacy (use of 5 drugs or more for >30 days). Time to all-cause mortality was assessed up to 1 year of follow-up. We performed a parametric Weibull regression model with backward stepwise selection to identify mortality risk predictors. The model was internally validated and optimism corrected using bootstrapping techniques. We derived a point-based risk score from the regression coefficients. Calibration and discrimination were assessed by the calibration slope and C statistic.

Results

805 participants were included in the analysis. During 1-year of follow-up, 158 participants (20%) had died. Age, Charlson-Comorbidity-Index, number of drugs, body mass index, number of hospitalizations, Barthel-Index (functional impairment), and nursing home residency were predictors of 1-year mortality in a multivariable model. Using these variables, the 1-year probability of dying could be predicted with an optimism-corrected C statistic of 0.70. The optimism-corrected calibration slope was 0.93. Based on the derived point-based risk score to predict mortality risk, 7% of the patients classified at low-risk of mortality, 19% at moderate-risk, and 37% at high-risk died after one year of follow-up. A simpler mortality score, without the Charlson-Comorbidity-Index and Barthel-Index, showed reduced discriminative power (optimism-corrected C statistic: 0.59) compared to the full score.

Conclusion

We developed and internally validated a mortality risk index including for the first-time specific predictors for multimorbid adults. This new 1-year mortality prediction point-based score allowed to classify multimorbid older patients into three categories of increasing risk of mortality. Further validation of the score among various populations of multimorbid patients is needed before its implementation into practice.
Tolerability and pharmacokinetic evaluation of inhaled dry powder hydroxychloroquine in healthy volunteers
Authors: de Reus Y. A. , Hagedoorn P. , Sturkenboom M. G. G. , Grasmeijer F. , Bolhuis M. S. , Sibum I. , Kerstjens H. A. M. , Frijlink H. W. , Akkerman O. W.
Published: August 2022

Rationale

Inhaled antimicrobials enable high local concentrations where needed and, compared to orally administration, greatly reduce the potential for systemic side effects. In SARS-CoV-2 infections, hydroxychloroquine sulphate (HCQ) administered as dry powder via inhalation could be safer than oral HCQ allowing higher and therefore more effective pulmonary concentrations without dose limiting toxic effects.

Objectives

To assess the local tolerability, safety and pharmacokinetic parameters of HCQ inhalations in single ascending doses of 5, 10 and 20 mg using the Cyclops dry powder inhaler.

Methods

Twelve healthy volunteers were included in the study. Local tolerability and safety were assessed by pulmonary function tests, electrocardiogram and recording adverse events. To estimate systemic exposure, serum samples were collected before and 0.5, 2 and 3.5 h after inhalation.

Results and discussion

Dry powder HCQ inhalations were well tolerated by the participants, except for transient bitter taste in all participants and minor coughing irritation. There was no significant change in QTc-interval or drop in FEV1 post inhalation. The serum HCQ concentration remained below 10 μg/L in all samples.

Conclusion

Single doses of inhaled dry powder HCQ up to 20 mg are safe and well tolerated. Our data support that further studies with inhaled HCQ dry powder to evaluate pulmonary pharmacokinetics and efficacy are warranted.
Development and validation of a PLE scale from academic administrative perspective (PLES-AA) in tertiary education: A pilot study in China
Authors: Xu Xiaoshu , Kolletar-Zhu Kimberly , Liu Jia , Zhang YunFeng , Cai Na
Published: August 2022

The study aims to construct and validate a rubric to assess the effectiveness of PLEs from an academic administrative perspective (PLER-AA) in tertiary education in China. A qualitative-quantitative sequential mixed-method design was used for the scale validation. A total of 206 teachers and administrative staff participated in the Confirmative Factor Analysis (CFA), which supported the 4-dimensional scale, with policy (n = 4), program design (n = 4), curriculum/instruction (n = 4), and capacity (n = 4). Meanwhile, another 189 teachers and administrative staff participated in the current sequence of PLE applications in higher education surveys, revealing a developing phase in China. Consequently, the rubric can be used as a benchmark that provides insight to educators and administrators in developing PLEs in tertiary education in China and worldwide.
AAF-Net: Scene text detection based on attention aggregation features
Authors: Chen Mengmeng , Ibrayim Mayire , Hamdulla Askar
Published: August 2022

With the advent of the era of artificial intelligence, text detection is widely used in the real world. In text detection, due to the limitation of the receptive field of the neural network, most existing scene text detection methods cannot accurately detect small target text instances in any direction, and the detection rate of mutually adhering text instances is low, which is prone to false detection. To tackle such difficulties, in this paper, we propose a new feature pyramid network for scene text detection, Cross-Scale Attention Aggregation Feature Pyramid Network (CSAA-FPN). Specifically, we use a Attention Aggregation Feature Module (AAFM) to enhance features, which not only solves the problem of weak features and small receptive fields extracted by lightweight networks but also better handles multi-scale information and accurately separate adjacent text instances. An attention module CBAM is introduced to focus on effective information so that the output feature layer has richer and more accurate information. Furthermore, we design an Adaptive Fusion Module (AFM), which weights the output features and pays attention to the pixel information to further refine the features. Experiments conducted on CTW1500, Total-Text, ICDAR2015, and MSRA-TD500 have demonstrated the superiority of this model.
Identification of differentially expressed genes for Pseudomonas sp. Cr13 stimulated by hexavalent chromium
Authors: Pang Bingbing , Yu Hongling , Zhang Jin , Ye Fengcai , Wu Haifeng , Shang Changhua
Published: August 2022

Over exploitation of mineral resources has increasingly caused serious heavy metal contamination such as chromium (Cr). Cr(VI), the pathogenicity factor, is one of common environmental contaminants and widely known health hazards to living organisms. Therefore, it is urgent to control the polluted soil. Up to now, little is known about the regulatory mechanisms of Cr response in Pseudomonas sp. Cr13. In this study, transcriptome and differentially expressed genes in Pseudomonas sp. Cr13 strain was characterized by a comparison between Cr(VI)-treated sample and control sample using transcriptome sequencing approach. In total, 2974 genes were annotated, including 1245 (1154 down-regulated genes and 91 up-regulated genes) differentially expressed genes (DEGs). All DEGs could be assigned to 29 pathways, of which pathways related to amino acid metabolism, carbohydrate metabolism, energy metabolism and signal transduction mechanism were significantly enriched in Pseudomonas sp. Cr13. A possible mechanism for Cr toxicity response might be an active efflux which utilized a heavy metal translocating P-type ATPase to lower the intracellular Cr concentration. The down-regulated genes related to the antioxidant defense system had a key role in Cr reduction, such as SodA, Gst, osmC, BtuE, KatE, csdA and AhpC. The proteins that were visibly up-regulated, were likely to involve in alleviating Cr(VI) stress, and the significantly down-regulated genes such as MarR, Lrp, FhlA, GntR, HrcA, LysR family genes, were likely to reduce Cr(VI) induced oxidative stress. In addition, real-time quantitative PCR was used to analyze the expression patterns of some Cr responsive genes. This study reported the first identification of Cr responsive genes, and inferred the underlying regulatory mechanisms of response to Cr(VI) stress in Pseudomonas sp. Cr13.
Intensity simulation of photic effects after cataract surgery for off-axis light sources
Authors: Omidi Pooria , Cayless Alan , Langenbucher Achim
Published: August 2022

Photopsia is a photic phenomenon that can be associated with intraocular lenses after cataract surgery. To calculate the relative light intensity of photic effects observed after cataract surgery at the foveal region as the most sensitive region of the retina, photopsia was simulated using the ZEMAX optical design software. The simulations are based on the Liou-Brennan eye model with a pupil diameter of 4.5 mm and incorporating implanted IOLs. The hydrophilic IOLs implanted in the eye model have a power of 21 diopter (D) with an optic diameter of 6 mm and 7 mm. Four different intensity detectors are located in specific regions of the eye in this simulation. The ray-tracing analysis was carried out for variations of incident ray angle of 0° to 90° (temporally) in steps of 1°. Depending on the range of incident ray angle, the light intensity was detected at detectors located on the fovea, nasal side of the retina, or the edge surface of the IOLs. Some portion of the input light was detected at specific incident angles in the foveal region. By altering the IOLs edge design to a fully reflective or anti-reflective surface, the range over which the light intensity is detected on the fovea can be shifted. Additionally, with the absorbing edge design, no intensity was detected at the foveal region for incident ray angles larger than 5°. Therefore an absorbing edge design can make photic effects less disturbing for patients.
Clinical performance of the Roche Cobas 4800 HPV test for primary cervical cancer screening in a Chinese population
Authors: Liu Stephanie S. , Chan Karen K. L. , Wei Tina N. , Tse Ka Yu , Ngu Siew F. , Chu Mandy M. Y. , Lau Lesley S. K. , Cheung Annie N. Y. , Ngan Hextan Y. S.
Published: August 2022

High-risk human papillomavirus (HR-HPV) testing has become an increasing important strategy in primary cervical cancer screening in recent years. It warrants the evaluation of molecular-based HPV tests for accuracy and efficacy of screening. The performance of Roche Cobas 4800 HPV test was validated and compared with Digene Hybrid Capture 2 (HC2) high-risk HPV DNA test for primary screening in a large Chinese screening cohort. Of 6345 women screened, overall agreement between Cobas and HC2 was 92.23% (95% CI: 91.57–92.89). The inter-assay agreement was correlated with the severity of underlying biology, with an increasing concordance found in samples with more severe abnormalities. Most of the discordant samples had the test signal strength closer to the test limits of the detection than concordant samples, reflecting a low viral load and infection of a cluster of low-risk HPV in these samples. The Cobas test demonstrated significantly higher specificity in identifying CIN2+/CIN3+ cases than HC2 test (66.46% vs 43.67% and 65.42% vs 42.86%, p<0.001), with comparable sensitivity in clinical evaluation. Increased specificity of Cobas test would accent women having the highest risk of developing CIN2+, with the potential to reduce unnecessary colposcopy referral in a screening population.
Regularidades discursivas e processos de in/exclusão de pessoas com deficiência na escola
Authors: Cozzani Marcia Valéria , Milanez Nilton
Published: August 2022

Este artigo teve como objetivo analisar as regularidades e deslocamentos discursivos na área de Educação Especial e as relações com os processos de in/exclusão de pessoas com deficiência na escola. Buscamos a noção de normalização de Foucault e Canguilhem como forma de revelar as formas de exercício do poder na constituição de saberes no contexto escolar em relação às pessoas com deficiência. Analisamos a Política Nacional de Educação Especial na Perspectiva da Educação Inclusiva de 2008 e pareceres pedagógicos de professores que atuam no serviço de apoio de Atendimento Educacional Especializado (AEE). Os resultados revelaram um entrecruzamento de séries enunciativas em dois movimentos: um deslocamento discursivo da noção de deficiência a partir da afirmação da educação inclusiva na política de educação especial e outro movimento de regularidade discursiva em que a noção de deficiência é marcada por saberes do campo médico/clínico que reforçam processos de normalização dos alunos público-alvo da Educação Especial.