bluuebunny/crossref_metadata_2025 huggingface dataset:
What are the perceptions and concerns of people living with diabetes and National Health Service staff around the potential implementation of AI-assisted screening for diabetic eye disease? Development and validation of a survey for use in a secondary care screening setting
Authors: Willis Kathryn , Chaudhry Umar A R , Chandrasekaran Lakshmi , Wahlich Charlotte , Olvera-Barrios Abraham , Chambers Ryan , Bolter Louis , Anderson John , Barman S A , Fajtl Jiri , Welikala Roshan , Egan Catherine , Tufail Adnan , Owen Christopher G , Rudnicka Alicja
Published: November 2023

Introduction

The English National Health Service (NHS) Diabetic Eye Screening Programme (DESP) performs around 2.3 million eye screening appointments annually, generating approximately 13 million retinal images that are graded by humans for the presence or severity of diabetic retinopathy. Previous research has shown that automated retinal image analysis systems, including artificial intelligence (AI), can identify images with no disease from those with diabetic retinopathy as safely and effectively as human graders, and could significantly reduce the workload for human graders. Some algorithms can also determine the level of severity of the retinopathy with similar performance to humans. There is a need to examine perceptions and concerns surrounding AI-assisted eye-screening among people living with diabetes and NHS staff, if AI was to be introduced into the DESP, to identify factors that may influence acceptance of this technology.

Methods and analysis

People living with diabetes and staff from the North East London (NEL) NHS DESP were invited to participate in two respective focus groups to codesign two online surveys exploring their perceptions and concerns around the potential introduction of AI-assisted screening.

Focus group participants were representative of the local population in terms of ages and ethnicity. Participants’ feedback was taken into consideration to update surveys which were circulated for further feedback. Surveys will be piloted at the NEL DESP and followed by semistructured interviews to assess accessibility, usability and to validate the surveys.

Validated surveys will be distributed by other NHS DESP sites, and also via patient groups on social media, relevant charities and the British Association of Retinal Screeners. Post-survey evaluative interviews will be undertaken among those who consent to participate in further research.

Ethics and dissemination

Ethical approval has been obtained by the NHS Research Ethics Committee (IRAS ID: 316631). Survey results will be shared and discussed with focus groups to facilitate preparation of findings for publication and to inform codesign of outreach activities to address concerns and perceptions identified.
What is fair? Ethical analysis of triage criteria and disability rights during the COVID-19 pandemic and the German legislation
Authors: Göttert Elena Ana Francesca
Published: November 2023

This essay discusses the ethical challenges and dilemmas in allocating scarce medical resources during the COVID-19 pandemic, using the German legislative process as a starting point. It is guided by the right to non-discrimination of people with disability and generally contrasts utilitarian and rights-based principles of allocation. Three approaches that were suggested in the German discussion, are presented, the lottery principle, the first come first served principle and the probability to survive principle. Arguments in favour and against each principle are discussed. The focus is on the utilitarian probability to survive principle, which was adopted in German legislation in 2022, and its discriminatory potential against people with disability. The essay suggests ways to mitigate the concerns of discrimination related to the probability to survive principle. It concludes that resolving the triage dilemma requires a balanced approach between utilitarian and rights-based concerns, which promotes both maximising the number of patients surviving and the right not to be discriminated against and be treated equally. It calls for a further debate on how many ethical values such as equity, fairness and non-discrimination we are willing to sacrifice for a higher number of survivors and when we are willing to sacrifice survivors to secure ethical values.
06 Did Julius Caesar have a brain disorder that impaired his judgment?
Authors: Yorston Graeme , Leon Ewelina De
Published: November 2023

Aims and Hypothesis

This poster presents an analysis of historical sources of information on the life and medical history of Julius Caesar and critically examines previously suggested modern diagnoses.

Background

Gaius Julius Caesar was born in 100 BCE to a noble but not particularly wealthy family. He had to work hard to move up the ranks in Roman society – he was known for his political shrewdness, public speaking and ability to win over the common man. His determination, ability to plan ahead, clear thinking and decisiveness paved the way for his slow but inexorable rise to the position of dictator perpetuus, or dictator for life. But after just a few weeks, ignoring warnings that his life was in danger and dismissing his guards, he walked out alone and was stabbed to death by a conspiracy of senators. This poster will attempt to answer whether this final act was the hubris of a man accustomed to victory or the impaired judgment of someone with a serious brain disorder?

Methods

There are descriptions of Julius Caesar having attacks of the falling sickness in the (almost) contemporary accounts of his life. These will be examined along with modern proposals regarding diagnosis, including: epilepsy, Meniere’s disease, celiac disease, malaria, cerebrovascular disease, AV Malformation, cerebral tuberculosis, neurocysticercosis (tape worm larva) and brain tumour.

Results

The evidence for and against each diagnosis will be presented.

Conclusions

We will never be certain what caused Julius Caesar’s falling sickness, but there is a strong case for him having epilepsy – either familial or secondary to another brain disorder. What is even less certain, however, is why he ignored concerns for his safety and walked out to his death on the Ides of March 45BCE.
19 Direct neural recordings from human bed nucleus of stria terminalis link alpha activity in empathy and affect evaluation tasks with depression severity
Authors: Sonkusare Saurabh , Qiong Ding , Zhao Yijie , Zhang Yingying , Feng Yashu , Wang Linbin , Yang Ruoqi , Zhang Chencheng , Sun Bomin , Zhan Shikun , Voon Valerie
Published: November 2023

Objectives/Aims

The bed nucleus of the stria terminalis (BNST), considered a part of ‘extended amygdala’ and located in the basomedial forebrain, is characterized by its connections with other limbic structures, hypothalamic and brainstem nuclei. With these crucial connections, it plays a key role in emotional processing and modulation of autonomic physiological and behavioural responses. Consequently, its dysfunction is implicated in many human psychiatric illnesses including depression thus positioning it as a target for neuromodulation with deep brain stimulation (DBS) and investigations of its direct neural activity.

Methods

Here, in a cross-sectional design, we acquired task-induced neuronal recordings from BNST from fifteen treatment resistant depressed patients undergoing DBS surgery in a clinical trial. We employed two tasks: 1) empathy induction with painful and non-painful pictures, 2) affect task with emotionally valenced pictures (positive, neutral and negative). We first characterised task induced spectral dynamics and subsequently using permutation testing to assess condition differences. Time- frequency clusters which showed condition differences were then tested for their association with behavioural ratings and depression scores.

Results

Empathy and affect task both showed task induced responses with condition differences predominantly in theta-alpha range. For empathy task, alpha activity also predicted the painful and non-painful behavioural ratings. Furthermore, alpha activity for non-painful pictures were also significantly associated with depression scores. Affect task showed condition differences in activity for positive and negatives pictures when compared to neutral pictures. Alpha activity of negative pictures (when compared to neutral pictures) were also positively correlated with depression scores.

Conclusions

Overall, from direct BNST recordings, we thus show the spectral signatures of BNST in evaluation of empathy and affect pictures. Furthermore, alpha activity in these tasks also predicted depression scores thus highlighting its role as a potential biomarker for depression severity.
Evaluating robustness of harvest control rules to climate-driven variability in Pacific sardine recruitment
Authors: Wildermuth Robert P. , Tommasi Desiree , Kuriyama Peter , Smith James , Kaplan Isaac
Published: November 2023

Climate-driven changes in ocean temperatures, currents, or plankton dynamics may disrupt pelagic forage fish recruitment. Being responsive to such impacts enables fisheries management to ensure continued sustainable harvest of forage species. We conducted a management strategy evaluation to assess the robustness of current and alternative Pacific sardine harvest control rules under a variety of recruitment scenarios representing potential projections of future climate conditions in the California Current. The current environmentally informed control rule modifies the harvest rate for the northern sardine subpopulation based on average sea surface temperatures measured during California Cooperative Oceanic Fisheries Investigations field cruises. This rule prioritizes catch at intermediate biomass levels but may increase variability in catch and closure frequency compared to alternative control rules, especially if recruitment is unrelated to ocean temperatures. Fishing at maximum sustainable yield and using dynamically estimated reference points reduced the frequency of biomass falling below 150 000 mt by up to 17%, while using survey index-based biomass estimates resulted in a 14% higher risk of delayed fishery closure during stock declines than when using assessment-based estimates.
Sealed (zero gas flow) resistive plate chambers
Authors: Blanco Alberto , Fonte Paulo , Lopes Luis , Pimenta Mario
Published: November 2023

The phase-out of hydro-fluorocarbons, due to their high Global Warming Potential (GWP), affecting the main gas used in Resistive Plate Chambers (RPCs), tetrafluoroethane C$$_2$$

2

H$$_2$$

2

F$$_4$$

4

, has increased pressure on existing systems and imposes strong restrictions on its use in new systems. A possible solution to the problem is the substitution of this gas by others with a much lower GWP. Another possibility would be sealed RPCs, i.e., RPCs that do not require a continuous gas flow for their operation. This paper shows the construction structure and test results of a sealed multi-gap RPC operated without gas flow for about 1 year. The results show a stable efficiency of more than 95% and a streamer percentage of less than 1%. The spatial distribution of the hits, the mean charge and the probability of streamers do not reveal significant structures. Similarly, they do not seem to be dependent on operating time.
Mutual entity authentication of quantum key distribution network system using authentication qubits
Authors: Park Hojoong , Park Byung Kwon , Woo Min Ki , Kang Min-Sung , Choi Ji-Woong , Kang Ju-Sung , Yeom Yongjin , Han Sang-Wook
Published: November 2023

Entity authentication is crucial for ensuring secure quantum communication as it helps confirm the identity of participants before transmitting any confidential information. We propose a practical entity authentication protocol for quantum key distribution (QKD) network systems that utilizes authentication qubits. In this protocol, authentication qubits that are encoded with pre-shared information are generated and exchanged to verify the legitimacy of each entity. By using the authentication qubit, participants can identify each other with enhanced security level through the quantum channel. The proposed protocol can be easily integrated with existing QKD systems without the need for additional hardware. In this study, we demonstrated the efficacy of the proposed scheme using a 1xN QKD network system and verified its stable operation over a deployed fiber network. Additionally, a security analysis of the proposed entity authentication protocol and architecture is provided.
AN EMPIRICAL ANALYSIS OF THE RELATIONSHIP BETWEEN ECONOMIC GROWTH AND POPULATION AGING IN MALAYSIA
Authors: YIP TIEN-MING , LAI SIOW-LI , LAU WEE-YEAP
Published: November 2023

Malaysia is approaching the aging society status, raising concern about whether population aging is a challenge or an opportunity for Malaysia to attain higher economic growth. Using state-level data from 2011 to 2021, the results show that population aging is negatively associated with economic growth. The economic impact of population aging is substantial and larger than the conventional determinant of economic growth. Further analysis reveals that the growth-deteriorating effect of population aging is transmitted through the labor force and productivity growth channels. The findings urge policymakers to recognize the scope of the new demographic reality and adjust policies to address the economic implications of population aging.
The Schrödinger representation and 3D gauge theories
Authors: Nair V. P.
Published: November 2023

In this paper, we consider the Hamiltonian analysis of Yang–Mills theory and some variants of it in three space–time dimensions using the Schrödinger representation. This representation, although technically more involved than the usual covariant formulation, may be better suited for some nonperturbative issues. Specifically for the Yang–Mills theory, we explain how to set up the Hamiltonian formulation in terms of manifestly gauge-invariant variables and set up an expansion scheme for solving the Schrödinger equation. We review the calculation of the string tension, the Casimir energy and the propagator mass and compare with the results from lattice simulations. The computation of the first set of corrections to the string tension, string breaking effects, extensions to the Yang–Mills–Chern–Simons theory and to the supersymmetric cases are also discussed. We also comment on how entanglement for the vacuum state can be formulated in terms of the BFK gluing formula. This paper concludes with a discussion of the status and prospects of this approach.
Computational study of flow and heat transfer analysis of Ellis fluid model in complicated divergent channel
Authors: Asghar Zeeshan , Khalid Usman , Nazeer Mubbashar , Rasheed H. S. , Kausar A.
Published: November 2023

The current theoretical analysis reports the flow and heat transfer rate in the peristaltic flow of an Ellis fluid through the complex wavy divergent channel under the impact of the electro-osmotic phenomena and viscous dissipation. The governing equations of the current flow are based on the continuity equation, Cauchy’s momentum equations, Poisson–Boltzmann equation, and the heat equation. The momentum equation is updated with the addition of the Poisson equation to introduce the electro-osmotic effects on the given flow field. The energy equation is upgraded under the addition of the viscous dissipation term to capture the effects of the Brinkman number. The Poisson equation is linearized by adopting the Debye–Hückel approximation. The problem is transformed into a dimensionless form and solved analytically to present the analytical solution of the current flow problem. The analytical expression of longitudinal velocity, temperature field, and stream function is presented by using the symbolic mathematical software MATHEMATICA 12.0. The computational results reveal that the heat transfer rate is strongly affected by the power law index [Formula: see text] and dimensionless material parameter [Formula: see text]. The longitudinal velocity is diminishing against the power law index. The power law index parameter produces the trapping bolus inside the divergent channel for [Formula: see text].
Missing Data Imputation Using Socio-hawk Optimization-based Deep Neural Network
Authors: Ghongade Trupti G. , Khobragade R. N.
Published: November 2023

Missing data remain the common issue experienced in the real-world environment, which leads to deviation in data analysis and mining. Therefore, in order to lessen the consequences of missing data caused by human mistake, missing data imputation must be used in data processing. The traditional imputation model fails to satisfy the evaluation requirement due to its poor stability and low accuracy. Further, these models compromise the imputation accuracy of the increasing number of missing information. Hence, in this research, an optimized missing data imputation model is proposed using the Socio-hawk optimization Deep Neural Network (DNN). In this research, the DNN extracts the important features from the data, in which the missing data are estimated with an arbitrary missing pattern. It is stated that whenever the hyperparameters are tuned properly, the DNN’s performance is improved. The key here is the efficient training of DNN using the suggested Socio-hawk optimization, which improves the imputation model’s accuracy. To determine how well the suggested imputation model imputes missing data, it is compared to other methods. As a result, the paper’s primary contribution is to effectively train DNN using the suggested Socio-hawk optimization that reduces the error rate of the imputation model. The experimental evaluation shows that the proposed missing data imputation model attains a high performance at 90%, which provides 1.0595, 1.9919, and 0.9421 of MAE, MSE, and MAPE.
Deterministic particle approximation of aggregation diffusion equations with nonlinear mobility
Authors: Daneri Sara , Radici Emanuela , Runa Eris
Published: November 2023

We consider a class of aggregation–diffusion equations on unbounded one-dimensional domains with Lipschitz nonincreasing mobility function. We show strong [Formula: see text]-convergence of a suitable deterministic particle approximation to weak solutions of a class aggregation–diffusion PDEs (coinciding with the classical ones in the no vacuum regions) for any bounded initial data of finite energy. In order to prove well-posedness and convergence of the scheme with no BV or no vacuum assumptions and overcome the issues posed in this setting by the presence of a mobility function, we improve and strengthen the techniques introduced in [S. Daneri, E. Radici and E. Runa, Deterministic particle approximation of aggregation–diffusion equations on unbounded domains, J. Differential Equations 312 (2020) 474–517].
Resolution of singular fibers of an S1-manifold
Authors: Wang Yi-Sheng
Published: November 2023

In this paper, we present a resolution of discrete singular fibers of a closed 5-manifold equipped with a locally free S1-action, and prove its compatibility with the resolution of cyclic surface singularities in the quotient orbifold by the S1-action.
Predicted variable river response at high and low flows due to groundwater abstraction changes in Chalk catchments
Authors: Taylor Adam B. , Yarker Daniel R. , Karapanos Ilias
Published: November 2023

Improving low flows in Chalk streams by relocating groundwater abstraction further downstream is an idea that has become popular in the UK in recent years. Simulations using the Environment Agency's Hertfordshire Chalk Groundwater Model predict that reducing groundwater abstraction close to ephemeral or intermittent Chalk streams is more likely to increase river flows during high-flow conditions than during low flows. This finding helps to explain the apparent lack of observed benefit to river flows during drought periods in catchments where abstractions have been reduced. If abstraction reductions are predicted to result in more of an increase to high river flows than to low flows, they may risk contributing to increased flood likelihood downstream, without providing significant habitat protection during low flows.

Conversely, it has also been found that, under certain circumstances, preferential benefits can be predicted for low flows. Simulations show that such benefits are most likely to manifest by relocating abstraction to downstream locations where groundwater levels are already below the base of the riverbed (e.g. due to existing abstraction or artificial channel modifications). Here, the varying degree of hydraulic connection between groundwater and river can result in preferential benefits to downstream low flows and reduced downstream flood risk.

Thematic collection:
This article is part of the Karst: Characterization, Hazards & Hydrogeology collection available at:
https://www.lyellcollection.org/topic/collections/karst
Unveiling the Threat: Investigating Distributed and Centralized Backdoor Attacks in Federated Graph Neural Networks
Authors: Xu Jing , Koffas Stefanos , Picek Stjepan
Published: November 2023

Graph neural networks (GNNs) have gained significant popularity as powerful deep learning methods for processing graph data. However, centralized GNNs face challenges in data-sensitive scenarios due to privacy concerns and regulatory restrictions. Federated learning has emerged as a promising technology that enables collaborative training of a shared global model while preserving privacy. Although federated learning has been applied to train GNNs, no research focuses on the robustness of Federated GNNs against backdoor attacks.

This article bridges this research gap by investigating two types of backdoor attacks in Federated GNNs: centralized backdoor attack (CBA) and distributed backdoor attack (DBA). Through extensive experiments, we demonstrate that DBA exhibits a higher success rate than CBA across various scenarios. To further explore the characteristics of these backdoor attacks in Federated GNNs, we evaluate their performance under different scenarios, including varying numbers of clients, trigger sizes, poisoning intensities, and trigger densities. Additionally, we explore the resilience of DBA and CBA against two defense mechanisms. Our findings reveal that both defenses cannot eliminate DBA and CBA without affecting the original task. This highlights the necessity of developing tailored defenses to mitigate the novel threat of backdoor attacks in Federated GNNs.
Simultaneous Detection of CO and NO2 Gases using Interaction Analysis of SnS2 Sensor Array Response
Authors: Kanaparthi Srinivasulu , Singh Shiv Govind
Published: November 2023

Developing a multi-analyte gas sensing system that simultaneously detects trace levels of CO and NO2 at low temperatures is necessary for the Internet of Things (IoT) based air quality monitoring applications. Nevertheless, gas sensors operating at low temperatures are nonspecific and rarely detect target gases at lower ppb levels in the air. Herein, an array of two SnS2 sensors with different bias voltages has been developed and characterized upon exposure to individual and binary mixtures of CO and NO2 gases at different concentrations. The developed gas sensors array achieved the lower detection limit of 45 ppb for NO2 and 150 ppb for CO. Further, co-adsorption-induced interaction analysis was carried out to predict the target gas concentration in the binary mixture using the mixed gas response. The mean absolute percentage error of 7.86% is observed in predicting the target gas concentrations in the binary mixture, which indicates the high prediction accuracy of proposed method. As a minimal resource intensive approach, the proposed method can be used in air quality monitoring applications that require low-power and low-cost sensors.
Cortical microglia dynamics are conserved during voluntary wheel running
Authors: Strohm Alexandra O. , O’Connor Thomas N. , Oldfield Sadie , Young Sala , Hammond Christian , McCall Matthew , Dirksen Robert T. , Majewska Ania K.
Published: November 2023

We demonstrate the first use of chronic in vivo imaging of microglia over time during physical exercise. We found that microglia movement, morphology, and process motility were remarkably stable during voluntary wheel running (VWR). Additionally, microglia in running mice respond similarly to laser ablation injury compared to sedentary mice. These findings indicate that VWR does not induce changes in microglia dynamics in healthy adults. Exercise may elicit positive effects on the brain through other mechanisms.
Exposure to passive heat and cold stress differentially modulates cerebrovascular-CO2 responsiveness
Authors: Skinner Bethany D. , Lucas Rebekah A. I. , Lucas Samuel J. E.
Published: November 2023

This study demonstrates that thermoregulatory-driven perfusion pressure changes, from either cold or heat stress, impact cerebrovascular responsiveness to hypercapnia. Compared with cold stress, heat stress poses a greater challenge to the maintenance of cerebral perfusion during hypocapnia, challenging cerebrovascular reserve capacity while increasing cerebrovascular-CO2 responsiveness. This likely exacerbates cerebral hypoperfusion during heat stress since hyperthermia-induced hyperventilation results in hypocapnia. No regional differences in middle and posterior cerebral artery responsiveness were found with thermal stress.
Phosphodiesterase in heart and vessels: from physiology to diseases
Authors: Fu Qin , Wang Ying , Yan Chen , Xiang Yang K.
Published: November 2023

Phosphodiesterases (PDEs) are a superfamily of enzymes that hydrolyze cyclic nucleotides, including cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). Both cyclic nucleotides are critical secondary messengers in the neurohormonal regulation in the cardiovascular system. PDEs precisely control spatiotemporal subcellular distribution of cyclic nucleotides in a cell- and tissue-specific manner, playing critical roles in physiological responses to hormone stimulation in the heart and vessels. Dysregulation of PDEs has been linked to the development of several cardiovascular diseases, such as hypertension, aneurysm, atherosclerosis, arrhythmia, and heart failure. Targeting these enzymes has been proven effective in treating cardiovascular diseases and is an attractive and promising strategy for the development of new drugs. In this review, we discuss the current understanding of the complex regulation of PDE isoforms in cardiovascular function, highlighting the divergent and even opposing roles of PDE isoforms in different pathogenesis.
The Link between Overweight/Obesity and Noncommunicable Diseases in Ethiopia: Evidences from Nationwide WHO STEPS Survey 2015
Authors: Ejigu Bedilu Alamirie , Tiruneh Fentanesh Nibret
Published: November 2023

Background. Noncommunicable diseases (NCDs) are the leading cause of death worldwide. Each year, 15 million adults die from NCDs; more than 85% of these premature deaths occur in low- and middle-income nations. Evidence indicates that overweight and obesity are the main risk factors for NCDs. Although the literature indicates that the burden of NCDs is increasing in Ethiopia, no research has been conducted to demonstrate a link between overweight/obesity and NCDs. Therefore, the aim of this study is to examine the association between overweight/obesity and the common NCDs while adjusting for other important factors. Methods. We analysed data from the 2015 Ethiopia WHO STEPS survey, which was conducted in 2015. A total weighted sample of 9,800 participants (15–69 years) was included. The relationship between nutritional status and NCDs was assessed using bivariate and multivariable logistic regression models while adjusting for covariates. Results. Among the 9,800 participants, 2053 (21% with (95% CI: 19.8–22.1) had hypertension and 1368 (14% with (95% CI: 13.1–15.0) had high cholesterol levels. According to the multivariable logistic regression analysis, being overweight/obese (AOR = 2.0; 95% CI: 1.7–2.3), alcohol consumption, received lifestyle advice, being female, living in urban areas, increased age, having government occupation, and living in SNNP region were positively associated with hypertension. While being underweight (AOR = 0.6; 95% CI: 0.5–0.7), living in the Afar, Somali, and Tigray regions were negatively associated with hypertension. Being overweight/obese (AOR = 1.4; 95% CI: 1.1–1.7), being female, having older age, and living in Somali region were positively associated with a high cholesterol level. Whereas being underweight (AOR = 0.7; 95% CI: 0.6–0.9), received lifestyle advice, reside in rural areas, being farmer, student, and housewife, and living in Gambela region were negatively associated with a high cholesterol level. Conclusion. This study found a statistically positive association between the common NCDs, namely, overweight/obesity, hypertension, and high cholesterol levels. Our findings imply that there is a need for effective interventions to prevent overweight/obesity by encouraging people to increase physical activity, minimize sedentary behavior, and maintain a healthy dietary pattern in order to reduce the risk of hypertension and high cholesterol levels.
Motion Control of a Mobile Robot Using the Hedge–Algebras-Based Controller
Authors: Nguyen Sy-Tai , Mac Thi-Thoa , Bui Hai-Le
Published: November 2023

Hedge–algebras (HA) theory provides a useful mathematical tool for modeling the linguistic values of a linguistic variable. These values are quantified by real numbers between 0 and 1. Therefore, the HA-based controller (HAC) has many advantages over the traditional fuzzy set theory-based controller (FC) in setup steps, control efficiency, computation time, and optimization. This study aims to control the avoidance of obstacles in the workspace and move to the destination of an autonomous robot using HAC, in which the HAC is optimized using the balancing composite motion optimization (BCMO) to return the optimal path. In which the investigated model is inherited from a reference. The HAC is established and optimized to minimize the traveling distance of the mobile robot and help it to avoid obstacles simultaneously. Simulations include one and two obstacle environments. Design variables, when optimizing, include the fuzzy parameters of linguistic variables and the reference range of state variables. This work is the first study in motion control of mobile robots based on the HA theory. The simulation data show that the proposed control rule base suits the mobile robot models. Therefore, the control efficiency of HAC is higher than that of a FC both in terms of the traveling distance of the robot and computation time (CPU time). Also, the establishment steps of the HAC controller show that HAC is more explicit, easier to optimize, and simpler to operate than FC. Research results in the present work also indicate that HAC can be developed and applied in motion control problems for different robot models with the advantages of a smaller traveling distance and faster computation time.
Optical Solitons for the Fokas-Lenells Equation with Beta and M-Truncated Derivatives
Authors: Al-Askar Farah M.
Published: November 2023

The Fokas-Lenells equation (FLE) including the M-truncated derivative or beta derivative is examined. Using the modified mapping method, new elliptic, hyperbolic, rational, and trigonometric solutions are created. Also, we extend some previous results. Since the FLE has various applications in telecommunication modes, quantum field theory, quantum mechanics, and complex system theory, the solutions produced may be used to interpret a broad variety of important physical process. We present some of 3D and 2D diagrams to illustrate how M-truncated derivative and the beta derivative influence the exact solutions of the FLE. We demonstrate that when the derivative order decreases, the beta derivative pushes the surface to the left, whereas the M-truncated derivative pushes the surface to the right.
Knowledge and Willingness to Utilize Hepatitis B Preventive Measures among Pregnant Women in Ado-Ekiti, Southwest, Nigeria
Authors: Ade-Ojo Idowu Pius , Babatola Adefunke Olarinre , Ojo Temitope Olumuyiwa , Ogundare Ezra Olatunde , Agbesanwa Tosin , Adeniyi Adewuyi Temidayo , Alao Omolola , Olatunya Oladele Simeon , Fadare Joseph Olusesan
Published: November 2023

Introduction. Mother-to-child transmission remains an important mode of transmission of hepatitis B infection particularly in endemic areas. The knowledge and practices of pregnant women about mother-to-child transmission (MTCT) of hepatitis B virus (HBV) may influence the uptake of strategies to reduce mother-to-child transmission of infection. Objectives. This study assessed the knowledge and willingness to uptake hepatitis B virus infection preventive services among pregnant women in Ado-Ekiti, Nigeria. Methods. This was a cross-sectional study that involved 373 pregnant women at the Ekiti State University Teaching Hospital (EKSUTH) and Maternal Child Specialist Clinics, Ado-Ekiti, Nigeria. A structured questionnaire was used to assess their knowledge, practices, and perceptions about MTCT of hepatitis B infection. Results. Only 52.5% (196) of the respondents had good knowledge, although the majority 290 (77.7%) had heard of hepatitis B infection prior to the survey. Only 147 (39.4%) of the respondents had ever had hepatitis B screening. More persons with professional jobs had good knowledge about hepatitis B infection compared with other occupations (

p
<
0.001

). However, more respondents aged 30–34 years had poor knowledge about hepatitis B infection compared with other age groups (

p
=
0.045

). Respondents with good knowledge about hepatitis B infection were willing to uptake hepatitis B infection prevention services (

p
<
0.001

) Conclusion. This study showed that respondents with professional jobs had good knowledge about hepatitis B infection and those who had good knowledge about the infection were willing to utilize hepatitis B preventive measures. Awareness of MTCT of HBV did not translate into good practice as only few respondents had screened for hepatitis B. There is a need to intensify education about modes of transmission of hepatitis B infection with an emphasis on promoting good preventive practices.
A Mathematical Model for Transmission of Hantavirus among Rodents and Its Effect on the Number of Infected Humans
Authors: Supriatna Asep K. , Napitupulu Herlina , Ndii Meksianis Z. , Ghosh Bapan , Kon Ryusuke
Published: November 2023

In this paper, we present a mathematical model for the transmission of hantavirus among rodents and its effect on the number of hantavirus‐infected human population. We investigate the model and present a standard analysis in mathematical epidemiology, such as determining the equilibria of the system and their stability analysis, together with the relationship to the basic reproduction number. It is found that the endemic equilibrium exists and is locally asymptotically stable when the basic reproduction number is greater than one; otherwise, the disease‐free equilibrium is stable. Later on, we also show that by constructing a suitable Lyapunov function, the endemic equilibrium is globally asymptotically stable whenever it exists. Based on the basic reproduction number, we present a critical level of intervention to control the spread of the disease to humans. We found a significant finding from the present model that if the basic reproduction number is greater than one, then it is impossible to completely eliminate hantavirus disease in the system by solely focusing on any intervention for humans, like vaccination and curative action, without paying any attention to interventions for rodent populations. However, we can still decrease the density of infected humans with those interventions. Hence, we suggest that a combination of several interventions is needed to obtain effective control in eliminating the hantavirus. This information is useful for further study in finding an optimal control strategy to reduce or eliminate the transmission of hantavirus to humans.
Reducing Dietary Protein Content by Increasing Carbohydrates Is More Beneficial to the Growth, Antioxidative Capacity, Ion Transport, and Ammonia Excretion of Nile Tilapia (Oreochromis niloticus) under Long-Term Alkalinity Stress
Authors: Liu Wei , Xu Chang , Li Zhao , Chen Liqiao , Wang Xiaodan , Li Erchao
Published: November 2023

Alkalinity stress is the main stress experienced by aquatic animals in saline–alkali water, which hinders the aquaculture development and the utilization of water resources. The two-factor (2 × 3) test was adopted to study the influence of dietary protein to carbohydrate ratios on the energy metabolism of Nile tilapia (Oreochromis niloticus) under different alkalinity stress levels. Three diets with different protein-carbohydrate ratios (P27/C35, P35/C25, and P42/C15) were fed to fish cultured in freshwater (FW, 1.3 mmol/L carbonate alkalinity) or alkaline water (AW, 35.7 mmol/L carbonate alkalinity) for 50 days. Ambient alkalinity decreased tilapia growth performance. Although ambient alkalinity caused oxidative stress and enhanced ion transport and ammonia metabolism in tilapia, tilapia fed the P27/C35 diet showed better adaptability than fish fed the other two diets in alkaline water. Further metabolomic analysis showed that tilapia upregulated all the pathways enriched in this study to cope with alkalinity stress. Under alkalinity stress, tilapia fed the P27/C35 diet exhibited enhanced pyruvate metabolism and purine metabolism compared with tilapia fed the P42/C15 diet. This study indicated that ambient alkalinity could significantly decrease growth performance and cause oxidative stress and osmotic regulation. However, reducing dietary protein content by increasing carbohydrates could weaken stress and improve growth performance, ion transport, and ammonia metabolism in tilapia under long-term hyperalkaline exposure.
Prevalence and Mortality Rates of Acute Kidney Injury among Critically Ill Patients: A Retrospective Study
Authors: Farah Randa I. , Alfuqaha Othman A. , Younes Ali R. , Mahmoud Hasan A. , Al-Jboor Alhareth M. , Karajeh Mohammad M. , Al-Masadeh Mohammad Z. , Murad Omar I. , Obeidat Nathir
Published: November 2023

Acute kidney injury (AKI) poses a significant challenge in critically ill patients. To determine the prevalence, risk factors, and mortality rate of AKI among nonsurgical critically ill patients in Jordan University Hospital, we conducted a retrospective study using a consecutive sampling method, including 457 nonsurgical critically ill patients admitted to the medical intensive care unit (MICU) from January to June 2021. The mean age was 63.8 ± 18 years, with 196 (42.8%) developing AKI during their stay in the MICU. Among AKI nonsurgical patients, pulmonary diseases (n = 52; 34.5%) emerged as the primary cause for admission, exhibiting the highest prevalence, followed by sepsis (n = 40; 20.4%). Furthermore, we found that older age (adjusted OR (AOR): 1.04; 95% confidence interval (CI): 1.04–1.06; p = 0.003), preadmission use of diuretics (AOR: 2.12; 95% CI: 1.06–4.25; p = 0.03), use of ventilators (2.19; 95% CI: 1.12–2.29; p = 0.02), and vasopressor use during MICU stay (AOR: 4.25; 95% CI: 2.1308.47; p = 0.001) were observed to have higher mortality rates. Prior utilization of statins before admission exhibited a significant association with reduced mortality rate (AOR: 0.42; 95% CI: 0.2–0.85; p = 0.02). Finally, AKI was associated with a higher mortality rate during MICU stay (AOR: 2.44; 95% CI: 1.07–5.56; p = 0.03). The prevalence of AKI among nonsurgical patients during MICU stay is higher than what has been reported previously in the literature, which highlights the nuanced importance of identifying more factors contributing to AKI in developing countries, and hence providing preventive measures and adhering to global strategies are recommended.
Avoiding Extinction: Cancer-Associated Fibroblasts Help Triple-Negative Breast Cancer Outrun Chemotherapy
Authors: Wall Steven W. , Echeverria Gloria V.
Published: November 2023

Neoadjuvant chemotherapy is a staple of triple-negative breast cancer (TNBC) treatment. Predicated on the principle of fractional cell killing, chemotherapy regimens are typically cycles of short drug exposure followed by a period of recovery from the toxic side effects. However, many patients experience chemotherapy resistance for a variety of reasons, resulting in tumors that are not sufficiently reduced with treatment. Response to chemotherapy prior to surgical resection is a strong predictor of patient prognosis; therefore, finding ways to improve efficacy is a critical need. Tremendous effort has gone into understanding the relationship between the tumor microenvironment and treatment sensitivity in many tumor types. In this issue of Cancer Research, Miroshnychenko and colleagues investigate how the well-characterized phenomenon of cancer-associated fibroblast (CAF)–induced proliferation of tumor cells allows TNBC to evade extinction after multiple cycles of cytotoxic chemotherapies. Their findings imply CAF-promoted tumor cell proliferation allows tumor cells to push through stressful conditions caused by treatment and to avoid tumor elimination. This mechanism of ‘indirect’ chemoresistance contrasts with the dogma that tumor cell proliferation enhances chemosensitivity. This study opens the door for the discovery of mechanisms and therapeutic targets to limit the ability of CAFs to rescue tumor cells from the brink of extinction.

See related article by Miroshnychenko et al., p. 3681
Detection of Recurrence through microRNA-371a-3p Serum Levels in a Follow-up of Stage I Testicular Germ Cell Tumors in the DRKS-00019223 Study
Authors: Belge Gazanfer , Dumlupinar Cansu , Nestler Tim , Klemke Markus , Törzsök Peter , Trenti Emanuela , Pichler Renate , Loidl Wolfgang , Che Yue , Hiester Andreas , Matthies Cord , Pichler Martin , Paffenholz Pia , Kluth Luis , Wenzel Mike , Sommer Jörg , Heinzelbecker Julia , Schriefer Philipp , Winter Alexander , Zengerling Friedemann , Kramer Mario Wolfgang , Lengert Marie , Frey Jana , Heidenreich Axel , Wülfing Christian , Radtke Arlo , Dieckmann Klaus-Peter
Published: November 2023

Purpose:

Surveillance of clinical stage I (CSI) testicular germ cell tumors (GCT) is hampered by low sensitivity and specificity of current biomarkers for detecting relapses. This study evaluated if serum levels of microRNA371a-3p (M371 test) can: (i) Accurately detect relapses, (ii) detect relapses earlier than conventional technology, and (iii) if elevated postoperative M371 levels may predict relapse.

Experimental Design:

In a multicentric setting, 258 patients with testicular CSI GCT were prospectively followed by surveillance for a median time of 18 months with serial measurements of serum M371 levels, in addition to standard diagnostic techniques. Diagnostic characteristics of M371 for detecting relapses were calculated using ROC curve analysis.

Results:

Thirty-nine patients recurred (15.1%), all with elevated M371 levels; eight without relapse had elevations, too. The test revealed the following characteristics: area under the ROC curve of 0.993, sensitivity 100%, specificity 96.3%, positive predictive value 83%, negative predictive value 100%. Earlier relapse detection with the test was found in 28%, with non-significant median time gain to diagnosis. Postoperative M371 levels did not predict future relapse.

Conclusions:

The sensitivity and specificity of the M371 test for detecting relapses in CSI GCTs are much superior to those of conventional diagnostics. However, post-orchiectomy M371 levels are not predictive of relapse, and there is no significant earlier relapse detection with the test. In all, there is clear evidence for the utility of the M371 test for relapse detection suggesting it may soon be ready for implementation into routine follow-up schedules for patients with testicular GCT.
Developing and Validating a Multivariable Prognostic-Predictive Classifier for Treatment Escalation of Oropharyngeal Squamous Cell Carcinoma: The PREDICTR-OPC Study
Authors: Mehanna Hisham , Rapozo Davy , von Zeidler Sandra V. , Harrington Kevin J. , Winter Stuart C. , Hartley Andrew , Nankivell Paul , Schache Andrew G. , Sloan Philip , Odell Edward W. , Thavaraj Selvam , Hunter Keith D. , Shah Ketan A. , Thomas Gareth J. , Long Anna , Amel-Kashipaz Rasoul , Brown Rachel M. , Conn Brendan , Hall Gillian L. , Matthews Paul , Weir Justin , Yeo Yen , Pring Miranda , West Catharine M.L. , McCaul James , Golusinski Pawel , Sitch Alice , Spruce Rachel , Batis Nikolaos , Bryant Jennifer L. , Brooks Jill M. , Jones Terence M. , Buffa Francesca , Haider Syed , Robinson Max
Published: November 2023

Purpose:

While there are several prognostic classifiers, to date, there are no validated predictive models that inform treatment selection for oropharyngeal squamous cell carcinoma (OPSCC).

Our aim was to develop clinical and/or biomarker predictive models for patient outcome and treatment escalation for OPSCC.

Experimental Design:

We retrospectively collated clinical data and samples from a consecutive cohort of OPSCC cases treated with curative intent at ten secondary care centers in United Kingdom and Poland between 1999 and 2012. We constructed tissue microarrays, which were stained and scored for 10 biomarkers. We then undertook multivariable regression of eight clinical parameters and 10 biomarkers on a development cohort of 600 patients. Models were validated on an independent, retrospectively collected, 385-patient cohort.

Results:

A total of 985 subjects (median follow-up 5.03 years, range: 4.73–5.21 years) were included. The final biomarker classifier, comprising p16 and survivin immunohistochemistry, high-risk human papillomavirus (HPV) DNA in situ hybridization, and tumor-infiltrating lymphocytes, predicted benefit from combined surgery + adjuvant chemo/radiotherapy over primary chemoradiotherapy in the high-risk group [3-year overall survival (OS) 63.1% vs. 41.1%, respectively, HR = 0.32; 95% confidence interval (CI), 0.16–0.65; P = 0.002], but not in the low-risk group (HR = 0.4; 95% CI, 0.14–1.24; P = 0.114). On further adjustment by propensity scores, the adjusted HR in the high-risk group was 0.34, 95% CI = 0.17–0.67, P = 0.002, and in the low-risk group HR was 0.5, 95% CI = 0.1–2.38, P = 0.384. The concordance index was 0.73.

Conclusions:

We have developed a prognostic classifier, which also appears to demonstrate moderate predictive ability. External validation in a prospective setting is now underway to confirm this and prepare for clinical adoption.