bluuebunny/crossref_metadata_2025 huggingface dataset:
Forsythiaside A ameliorates sepsis-induced acute kidney injury via anti-inflammation and antiapoptotic effects by regulating endoplasmic reticulum stress
Authors: Chen Yi , Wei Wei , Fu Jingnan , Zhang Teng , Zhao Jie , Ma Tao
Published: February 2023

Ethnopharmacological relevance

Sepsis is a systemic inflammatory response syndrome caused by an infection in the body, and accompanying acute kidney injury (AKI) is a common complication of sepsis. It is associated with increased mortality and morbidity. Forsythia Fructus, the dried fruit of Forsythia suspensa (Thunb.) Vahl, is a commonly used traditional Chinese medicine.

Aims of the study

This study aimed to elucidate the protective effect of Forsythiaside A (FTA) on sepsis-induced AKI by downregulating inflammatory and apoptotic responses, and exploring its underlying mechanism.

Methods

Septic AKI was induced through intraperitoneal injection of LPS (10 mg/kg) using male C57BL/6 mice and pretreated with FTA or control saline. First, we assessed the degree of renal injury by creatinine, blood urea nitrogen measurement, and HE staining of renal tissue; secondly, the inflammation and apoptosis were measured byELISA, qPCR, and TUNEL immunofluorescence; finally, the mechanism was explored by computer molecular docking and Western blot.

Results

Our data showed that FTA markedly attenuated pathological kidney injuries, alleviated the elevation of serum BUN and Creatinine, suggesting the renal protective effect of FTA. Notably, FTA significantly inhibited the renal expression of proinflammatory cytokine IL-1β, IL-6, and TNF-α both at protein and mRNA levels and attenuated cell apoptosis in the kidney, as measured by caspase-3 immunoblot and TUNEL assay, indicating its anti-Inflammation and antiapoptotic properties. Mechanistically, administration of LPS resulted in robust endoplasmic reticulum (ER) stress responses in the kidney, evidenced by glucose-regulated protein 78(GRP78) upregulation, protein kinase RNA–like endoplasmic reticulum kinase (PERK) activation, eukaryotic initiation factor 2 alpha (elF2α) phosphorylation and C/EBP homologous protein (CHOP) overexpression, which could be significantly blocked by FTA pretreatment. Dynamic simulation and molecular docking were performed to provide further insight.

Conclusions

Collectively, our data suggest that FTA ameliorates sepsis-induced acute kidney injury via its anti-inflammation and antiapoptotic properties by regulating PERK signaling dependent ER stress responses.
Aluminum-based metal–organic framework nanoparticles as pulmonary vaccine adjuvants
Authors: Stillman Zachary S. , Decker Gerald E. , Dworzak Michael R. , Bloch Eric D. , Fromen Catherine A.
Published: February 2023

The adoption of pulmonary vaccines to advantageously provide superior local mucosal protection against aerosolized pathogens has been faced with numerous logistical and practical challenges. One of these persistent challenges is the lack of effective vaccine adjuvants that could be well tolerated through the inhaled route of administration. Despite its widespread use as a vaccine adjuvant, aluminum salts (alum) are not well tolerated in the lung. To address this issue, we evaluated the use of porous aluminum (Al)-based metal–organic framework (MOF) nanoparticles (NPs) as inhalable adjuvants. We evaluate a suite of Al-based MOF NPs alongside alum including DUT-4, DUT-5, MIL-53 (Al), and MIL-101﻿-NH2 (Al). As synthesized, MOF NPs ranged between ~ 200 nm and 1 µm in diameter, with the larger diameter MOFs matching those of commercial alum. In vitro examination of co-stimulatory markers revealed that the Al-based MOF NPs activated antigen presenting cells more effectively than alum. Similar results were found during in vivo immunizations utilizing ovalbumin (OVA) as a model antigen, resulting in robust mucosal humoral responses for all Al MOFs tested. In particular, DUT-5 was able to elicit mucosal OVA-specific IgA antibodies that were significantly higher than the other MOFs or alum dosed at the same NP mass. DUT-5 also was uniquely able to generate detectable IgG2a titers, indicative of a cellular immune response and also had superior performance relative to alum at equivalent Al dosed in a reduced dosage vaccination study. All MOF NPs tested were generally well-tolerated in the lung, with only acute levels of cellular infiltrates detected and no Al accumulation; Al content was largely cleared from the lung and other organs at 28 days despite the two-dose regime. Furthermore, all MOF NPs exhibited mass median aerodynamic diameters (MMADs) of ~ 1.5–2.5 µm when dispersed from a generic dry powder inhaler, ideal for efficient lung deposition. While further work is needed, these results demonstrate the great potential for use of Al-based MOFs for pulmonary vaccination as novel inhalable adjuvants.

Graphical Abstract
Erroneous detection of desensitization doses in the prevention of hypersensitivity reactions
Authors: Stan Razvan Costin
Published: February 2023

Background

Desensitization protocols have empirically established their efficacy and safety in eliminating most of the hypersensitivity reactions to drugs and other allergens. Without such procedures, the offending drugs can otherwise be lethal, for some patients, when singularly administered at therapeutic doses. These binding events and the subsequent signaling cascades have been extensively modulated by different desensitization methods, without any clear explanation as to why it is necessary to use increasing allergen doses.

Purpose

To use a novel theoretical approach in order to model the desensitization algorithms currently in practice, that seeks to shed light on the mechanism behind their clinical efficacy.

Method

An approach using signal processing concepts is applied in this work to introduce aliasing as the erroneous detection of higher drug doses responsible for the efficacy of desensitization procedures.

Results

Available experimental data is modeled and correct predictions as to the efficacy of the drug treatment procedures are produced.

Conclusions

Desensitization algorithms may benefit from using concepts from signal processing theory in order to avoid hypersensitivity reactions.
On a class of obstacle problem for Hessian equations on Riemannian manifolds
Authors: Liu Jinxuan , Wang Yong
Published: February 2023

In this paper, we establish the a priori$C^{2}$

C
2

estimates for solutions of a class of obstacle problem for Hessian equations on Riemannian manifolds. Some applications are also discussed. The main contribution of this paper is the boundary estimates for second-order derivatives.
Infection prevention and control in Indonesian hospitals: identification of strengths, gaps, and challenges
Authors: Supriadi Indri Rooslamiati , Haanappel Cynthia P. , Saptawati Leli , Widodo Nani H. , Sitohang Gortap , Usman Yuslely , Anom Ida Bagus , Saraswati Ratih Dian , Heger Michal , Doevendans Pieter A. , Satari Hindra Irawan , Voor in ‘t holt Anne F. , Severin Juliëtte A.
Published: February 2023

Background

Infection prevention and control (IPC) in hospitals is key to safe patient care. There is currently no data regarding the implementation of IPC in hospitals in Indonesia. The aim of this study was to assess the existing IPC level in a nationwide survey, using the World Health Organization (WHO) IPC assessment framework tool (IPCAF), and to identify strengths, gaps, and challenges.

Methods

A cross-sectional study was conducted from July to November 2021. Of all general hospitals in Indonesia, 20% (N = 475) were selected using stratified random sampling based on class (A, B, C and D; class D with a maximum of 50 beds and class A with ≥ 250 beds) and region. The IPCAF was translated into Indonesian and tested in four hospitals. Questions were added regarding challenges in the implementation of IPC. Quantitative IPCAF scores are reported as median (minimum–maximum). IPC levels were calculated according to WHO tools.

Results

In total, 355 hospitals (74.7%) participated in this study. The overall median IPCAF score was 620.0 (535.0–687.5). The level of IPC was mostly assessed as advanced (56.9% of hospitals), followed by intermediate (35.8%), basic (7.0%) and inadequate (0.3%). In the eastern region of the country, the majority of hospitals scored intermediate level. Of the eight core components, the one with the highest score was IPC guidelines. Almost all hospitals had guidelines on the most important topics, including hand hygiene. Core components with the lowest score were surveillance of healthcare-associated infections (HAIs), education and training, and multimodal strategies. Although > 90% of hospitals indicated that surveillance of HAIs was performed, 57.2% reported no availability of adequate microbiology laboratory capacity to support HAIs surveillance. The most frequently reported challenges in the implementation of IPC were communication with the management of the hospitals, followed by the unavailability of antimicrobial susceptibility testing results and insufficient staffing of full-time IPC nurses.

Conclusion

The IPC level in the majority of Indonesian hospitals was assessed as advanced, but there was no even distribution over the country. The IPCAF in combination with interviews identified several priority areas for interventions to improve IPC in Indonesian hospitals.
Multivariate analysis of structural and functional properties of fibres from apple pomace using different extraction methods
Authors: Fidriyanto Rusli , Singh Brij Pal , Manju K. M. , Widyastuti Yantyati , Goel Gunjan
Published: February 2023

In recent years, diets rich in fibres have become more popular due to their well-documented beneficial health effects. This has driven exploration of novel dietary fibres from various bioresources. Apple pomace, an industrial waste rich in fibres was used in this study to extract the insoluble dietary fibres. The effect of various extraction methods (hot water, acid, and alkali) on the physico-chemical, structural and functional properties, and prebiotic activity of dietary fibres was evaluated. Hot water extraction resulted in highest yield of dietary fibres in comparison to other methods (p < 0.05). All the fractions resulted in different organization of fibrous components as depicted by scanning electron micrographs, Fourier Transform Infrared spectroscopy (FTIR), X-Ray Diffraction (XRD) pattern and Thermo Gravimetric Analysis (TGA). The acid extracted fibre fraction was observed to be amorphous with loose and porous structure whereas the alkali extracted fraction was more thermal stable based on TGA profile. Among the functional properties, acid extracted dietary fibres fraction possessed highest water and oil holding capacity (p < 0.05). The hot water extracted dietary fraction resulted in maximum increase in viable cell count of standard probiotic strains Lactobacillus sporogenes and Streptococcus faecalis. The Principal Component Analysis revealed that acid extracted fraction possessed better functional activity which also correlates with the structural properties whereas for prebiotic activities, the fibre obtained from hot water extraction method served the best method. These results indicate that dietary fibres extracted through hot water can be employed as a potential prebiotic substrate for the probiotic cultures and could be further explored in foods to improve textural, functional, and bioactive properties of foods.

Graphical Abstract
Finite element analysis of reinforced concrete curved box-girder bridges
Authors: Agarwal Preeti , Pal Priyaranjan , Mehta Pradeep Kumar
Published: February 2023

The study presents the design forces of simply supported single-cell reinforced concrete (RC) curved box-girder bridges using a finite element method (FEM) based CSiBridge v.20 software. An existing model has been used to validate the present modelling approach. Models subjected to vertical loading, i.e., dead load (DL) and Indian road congress live load (LL), are considered for investigation. An intensive parametric study examines the maximum values of bending moment (BM), shear force (SF), torsional moment (TM), and vertical deflection (VD) in both girders of bridges. The influences of curve angle and span are considered in the study. The effect of curve angle, up to 12°, is negligible on forces and deflections, and thus such bridges can be analysed as a straight one. Finally, non-dimensional equations are derived for evaluating forces and deflections, so that one may predict these quantities for curved bridges based on straight bridge’s results. Engineers and designers may consider present work valuable in analysing, and designing curved box-girder bridges.
Policy Recommendations for Improving Rural Cancer Services in the United States
Authors: Lent Adrienne B. , Derksen Daniel , Jacobs Elizabeth T. , Barraza Leila , Calhoun Elizabeth A.
Published: February 2023

Compared with urban residents, rural Americans have seen slower declines in cancer deaths, have lower incidence but higher death rates from cancers that can be prevented through screening, have lower screening rates, are more likely to present with later-stage cancers, and have poorer cancer outcomes and lower survival. Rural health provider shortages and lack of cancer services may explain some disparities. The literature was reviewed to identify factors contributing to rural health care capacity shortages and propose policy recommendations for improving rural cancer care. Uncompensated care, unfavorable payer mix, and low patient volume impede rural physician recruitment and retainment. Students from rural areas are more likely to practice there but are less likely to attend medical school because of lower graduation rates, grades, and Medical College Admission Test (MCAT) scores versus urban students. The cancer care infrastructure is costly and financially challenging in rural areas with high proportions of uninsured and publicly insured patients. A lack of data on oncology providers and equipment impedes coordinated efforts to address rural shortages. Graduate Medical Education funding greatly favors large, urban, tertiary care teaching hospitals over residency training in rural, critical access and community-based hospitals and clinics. Policies have the potential to transform rural health care. This includes increasing advanced practice provider postgraduate oncology training opportunities and expanding the scope of practice; improving health workforce and services data collection and aggregation; transforming graduate medical education subsidies to support rural student recruitment and rural training opportunities; and expanding federal and state financial incentives and payments to support the rural cancer infrastructure.
The Artificial Pancreas and Type 1 Diabetes
Authors: Nwokolo Munachiso , Hovorka Roman
Published: February 2023

Diabetes technologies represent a paradigm shift in type 1 diabetes care. Continuous subcutaneous insulin infusion (CSII) pumps and continuous glucose monitors (CGM) improve glycated hemoglobin (HbA1c) levels, enhance time in optimal glycemic range, limit severe hypoglycemia, and reduce diabetes distress. The artificial pancreas or closed-loop system connects these devices via a control algorithm programmed to maintain target glucose, partially relieving the person living with diabetes of this constant responsibility. Automating insulin delivery reduces the input required from those wearing the device, leading to better physiological and psychosocial outcomes. Hybrid closed-loop therapy systems, requiring user-initiated prandial insulin doses, are the most advanced closed-loop systems commercially available. Fully closed-loop systems, requiring no user-initiated insulin boluses, and dual hormone systems have been shown to be safe and efficacious in the research setting. Clinical adoption of closed-loop therapy remains in early stages despite recent technological advances. People living with diabetes, health care professionals, and regulatory agencies continue to navigate the complex path to equitable access. We review the available devices, evidence, clinical implications, and barriers regarding these innovatory technologies.
Primary Hyperparathyroidism in a Patient With Bilateral Pheochromocytoma and a Mutation in the Tumor Suppressor MAX
Authors: Charoenngam Nipith , Mannstadt Michael
Published: February 2023

Rare heterozygous loss-of-function mutations of the MAX gene are associated with autosomal dominant hereditary pheochromocytoma-paraganglioma syndrome. In addition, evidence suggests that pathogenic MAX mutation may predispose to the development of other tumors, including endocrine and nonendocrine tumors, although the number of reported cases is small. We report a 67-year-old man with bilateral pheochromocytoma, primary hyperparathyroidism, prostate cancer, neurofibroma, and abdominal wall lipoma who tested positive for a heterozygous pathogenic germline MAX mutation. The patient has a history of bilateral norepinephrine-producing pheochromocytomas, for which he underwent left and right adrenalectomy in his 20s and 30s, respectively. His long-standing primary hyperparathyroidism was first documented when he was 40 years old and complicated by recurrent bilateral calcium oxalate nephrolithiasis and early-onset osteoporosis. Genetic testing revealed a heterozygous pathogenic deletional frameshift mutation of the exon 4 of the MAX gene (c.183_195del; p.Gln62Lysfs*104). This report, together with 3 previously reported cases, suggests that germline MAX mutation may contribute to the development of primary hyperparathyroidism and may be considered in suspected genetic forms of this disease.
Long-Term Hearing Outcome After Radiosurgery for Vestibular Schwannoma: A Systematic Review and Meta-Analysis
Authors: Balossier Anne , Tuleasca Constantin , Delsanti Christine , Troude Lucas , Thomassin Jean-Marc , Roche Pierre-Hugues , Régis Jean
Published: February 2023

BACKGROUND:

Stereotactic radiosurgery (SRS) is one of the main treatment options in the management of small to medium size vestibular schwannomas (VSs), because of high tumor control rate and low cranial nerves morbidity. Series reporting long-term hearing outcome (>3 years) are scarce.

OBJECTIVE:

To perform a systematic review of the literature and meta-analysis, with the aim of focusing on long-term hearing preservation after SRS.

METHODS:

Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we reviewed articles published between January 1990 and October 2020 and referenced in PubMed or Embase. Inclusion criteria were peer-reviewed clinical study or case series of VSs treated with SRS (single dose), reporting hearing outcome after SRS with a median or mean audiometric follow-up of at least 5 years. Hearing preservation, cranial nerves outcomes, and tumor control were evaluated.

RESULTS:

Twenty-three studies were included. Hearing preservation was found in 59.4% of cases (median follow-up 6.7 years, 1409 patients). Main favorable prognostic factors were young age, good hearing status, early treatment after diagnosis, small tumor volume, low marginal irradiation dose, and maximal dose to the cochlea. Tumor control was achieved in 96.1%. Facial nerve deficit and trigeminal neuropathy were found in 1.3% and 3.2% of patients, respectively, both significantly higher in Linear Accelerator series than Gamma Knife series (P < .05).

CONCLUSION:

Long-term hearing preservation remains one of the main issues after SRS, with a major impact on health-related quality of life. Our meta-analysis suggests that hearing preservation can be achieved in almost 60% of patients after a median follow-up of 6.7 years, irrespective of the technique.
Comparison of Clinical Outcomes of Cervical Laminoplasty for Cervical Spondylotic Myelopathy: Double-Door With Lamina Staple, Single-Door With Miniplate, and Double-Door With Spacer—A 2-Year Follow-Up Study
Authors: Li Chao , Wang Zheng , Tang Juan , Li Donglai , Tian Yonghao , Yuan Suomao , Wang Lianlei , Liu Xinyu
Published: February 2023

BACKGROUND:

There were few studies to compare the outcomes of different types of cervical laminoplasties.

OBJECTIVE:

To compare the clinical outcomes of double-door cervical laminoplasty with lamina staple (double-door staple), single-door cervical laminoplasty with miniplate (single-door miniplate), and double-door cervical laminoplasty with spacer (double-door spacer).

METHODS:

The study involved 166 patients with cervical spondylotic myelopathy (CSM). Fifty-two patients underwent double-door staple, 63 patients underwent single-door miniplate, and 51 patients underwent double-door spacer. The clinical outcomes were measured.

RESULTS:

There was no significant difference in Japanese Orthopedic Association score among the 3 groups (P > .05). The operation time was significantly shorter in double-door staple and single-door miniplate groups than in the double-door spacer group (P < .005). The estimated blood loss was significantly more in the single-door miniplate group than in double-door staple and double-door spacer groups (P < .005). The expansion ratio of cervical intraspinal cross-sectional area decreased in the order of double-door staple > double-door spacer > single-door miniplate. There were no significant differences in the expansion ratio of dural sac cross-sectional area among the 3 groups.

CONCLUSION:

Double-door staple, double-door spacer, and single-door miniplate can achieve favorable clinical outcomes for CSM. The blood loss of double-door staple is less than that of single-door miniplate, and the operation time of double-door staple is shorter than that of double-door spacer. The mean expansion ratio of cervical intraspinal cross-sectional area decreased in the order of double-door staple > double-door spacer > single-door miniplate. Overall, double-door staple is a safe and innovative alternative choice for treatment of CSM.
Altered Neural Pathways and Related Brain Remodeling: A Rat Study Using Different Nerve Reconstructions
Authors: Xiang Yun-Ting , Xing Xiang-Xin , Hua Xu-Yun , Zhang Yu-Wen , Xue Xin , Wu Jia-Jia , Zheng Mou-Xiong , Wang He , Xu Jian-Guang
Published: February 2023

BACKGROUND:

Function recovery is related to cortical plasticity. The brain remodeling patterns induced by alterations in peripheral nerve pathways with different nerve reconstructions are unknown.

OBJECTIVE:

To explore brain remodeling patterns related to alterations in peripheral neural pathways after different nerve reconstruction surgeries.

METHODS:

Twenty-four female Sprague-Dawley rats underwent complete left brachial plexus nerve transection, together with the following interventions: no nerve repair (n = 8), grafted nerve repair (n = 8), and phrenic nerve transfer (n = 8). Resting-state functional MR images of brain were acquired at the end of seventh month postsurgery. Amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and functional connectivity (FC) were compared among 3 groups. Behavioral observation and electromyography assessed nerve regeneration.

RESULTS:

Compared with brachial plexus injury group, ALFF and ReHo of left entorhinal cortex decreased in nerve repair and nerve transfer groups. The nerve transfer group showed increased ALFF and ReHo than nerve repair group in left caudate putamen, right accumbens nucleus shell (AcbSh), and right somatosensory cortex. The FC between right somatosensory cortex and bilateral piriform cortices and bilateral somatosensory cortices increased in nerve repair group than brachial plexus injury and nerve transfer groups. The nerve transfer group showed increased FC between right somatosensory cortex and areas including left corpus callosum, left retrosplenial cortex, right parietal association cortex, and right dorsolateral thalamus than nerve repair group.

CONCLUSION:

Entorhinal cortex is a key brain area in recovery of limb function after nerve reconstruction. Nerve transfer related brain remodeling mainly involved contralateral sensorimotor areas, facilitating directional “shifting” of motor representation.
Cre recombinase microinjection for single-cell tracing and localised gene targeting
Authors: Sendra Miquel , de Dios Hourcade Juan , Temiño Susana , Sarabia Antonio J. , Ocaña Oscar H. , Domínguez Jorge N. , Torres Miguel
Published: February 2023

Tracing and manipulating cells in embryos are essential to understand development. Lipophilic dye microinjections, viral transfection and iontophoresis have been key to map the origin of the progenitor cells that form the different organs in the post-implantation mouse embryo. These techniques require advanced manipulation skills and only iontophoresis, a demanding approach of limited efficiency, has been used for single-cell labelling. Here, we perform lineage tracing and local gene ablation using cell-permeant Cre recombinase (TAT-Cre) microinjection. First, we map the fate of undifferentiated progenitors to the different heart chambers. Then, we achieve single-cell recombination by titrating the dose of TAT-Cre, which allows clonal analysis of nascent mesoderm progenitors. Finally, injecting TAT-Cre to Mycnflox/flox embryos in the primitive heart tube revealed that Mycn plays a cell-autonomous role in maintaining cardiomyocyte proliferation. This tool will help researchers identify the cell progenitors and gene networks involved in organ development, helping to understand the origin of congenital defects.
Review of single-cell RNA-seq data clustering for cell-type identification and characterization
Authors: Zhang Shixiong , Li Xiangtao , Lin Jiecong , Lin Qiuzhen , Wong Ka-Chun
Published: February 2023

In recent years, the advances in single-cell RNA-seq techniques have enabled us to perform large-scale transcriptomic profiling at single-cell resolution in a high-throughput manner. Unsupervised learning such as data clustering has become the central component to identify and characterize novel cell types and gene expression patterns. In this study, we review the existing single-cell RNA-seq data clustering methods with critical insights into the related advantages and limitations. In addition, we also review the upstream single-cell RNA-seq data processing techniques such as quality control, normalization, and dimension reduction. We conduct performance comparison experiments to evaluate several popular single-cell RNA-seq clustering approaches on simulated and multiple single-cell transcriptomic data sets.
Cardiogenic shock associated with acute norovirus gastroenteritis: what is needed to prove causality?
Authors: Evans Abbie , Benjanuwattra Juthipong , Mora Barbara , Abdelnabi Mahmoud
Published: February 2023

Acute myocarditis is a well-recognized condition attributable to a variety of viral illnesses. Common viral aetiologies include enteroviruses including coxsackie, adenovirus, influenza, echovirus, parvovirus B19 and herpesvirus. A high index of suspicion, early diagnosis, and prompt management with supportive anti-failure measures, and in selected cases immunosuppressive therapies including high-dose steroids, might be considered for better outcomes. The authors report a case of sudden onset of acute heart failure complicated by cardiogenic shock caused by viral myocarditis in a patient who initially presented with norovirus gastroenteritis. She had no previous cardiac history or significant cardiovascular risk factors. Prompt medical management for cardiogenic shock for norovirus-induced myocarditis was started, her symptoms gradually improved, and she was discharged safely on regular follow-up.
Scabies: an update for community nurses
Authors: Nazarko Linda
Published: February 2023

Community nurses may encounter scabies in homeless people, those living in prisons, people living at home or in people living in care homes. Scabies is more prevalent in older adults and there is evidence that this infection is becoming more prevalent and difficult to treat. The community nurse can help reduce such risks. This article aims to enable the community nurse to be aware of the clinical features of scabies and how it is treated.
Logarithmic-Product-Cum-Ratio Type Estimator for Estimating Finite Population Coefficient of Variation
Authors: Yunusa Mojeed Abiodun , Audu Ahmed , Adejumobi Awwal
Published: February 2023

Estimation of population parameters have been a challenging aspect in sample survey for sometimes and many efforts have been made to enhance the exactness of the parameters of these estimators. We suggested the logarithmic-product-cum-ratio type estimator. Expression of the MSE of the intended estimator originated using the Taylor series technique. A numerical illustration was conducted and the results revealed that the modified work is ameliorated than sample means with other estimators observed.
Multicore fiber interconnects for multi-terabit spine-leaf datacenter network topologies
Authors: Luis Ruben S. , Puttnam Benjamin J. , Rademacher Georg , Shinada Satoshi , Hayashi Tetsuya , Nakanishi Tetsuya , Saito Yuki , Morishima Tetsu , Furukawa Hideaki
Published: February 2023

This work demonstrates the use of spatial division multiplexing (SDM) to implement spine-leaf datacenter network topologies. We consider two possible scenarios, with the first consisting of the direct use of high-capacity multicore fiber interconnects. This was implemented with an 8-core multicore fiber to support 64×200Gb/s SDM wavelength division multiplexing (WDM) lanes and combined throughput of 12.8 Tb/s. We also demonstrate a scenario in which each multicore fiber interconnect is used to establish multiple connections between pairs of spin-leaf switches. An optical circuit switch is used between the spine and leaf layers to establish core-selective connections, which significantly reduces the number of cables required to implement the network. We demonstrate this approach with a commercial optical circuit switch and 8-core and 4-core multicore fiber interconnects.
Suppressing the Mechanochromism of Flexible Photonic Crystals
Authors: Kraft Fabio , Harwardt Katharina , Schardt Jan , Nowotka Dirk , Gerken Martina
Published: February 2023

Photonic crystal slabs (PCS) are a promising platform for optical biosensing. Yet, flexible applications based on PCS for biosensing have been limited, as the mechanical properties influence the optical ones. Here, we show the suppression of the mechanochromism effect for flexible PCS. We obtained flexible photonic crystal slabs by sputtering of a dielectric 100 nm Nb2O5 high refractive index layer onto a flexible nanostructured polydimethylsiloxane (PDMS) substrate with 370 nm grating period. The PCS exhibit a guided mode resonance at around 650 nm. We demonstrate that these flexible photonic crystal slabs show less than 0.5 nm resonance shift for 4% strain and call them stabilized PCS (sPCS). We compare this to a resonance shift of ~21 nm for ~4% strain of a flexible photonic crystal with a flexible nanoparticle high index layer (mechanochromatic PCS, mPCS). This high resonance shift is expected from the Bragg equations, where 4 % grating period change correspond to approximately 4 % change of the resonance wavelength (i.e., ~26 nm at a resonance wavelength of 650 nm), if changes in the mode effective refractive index are neglected. In a stretch series we obtain color-to-strain dependencies of 4.79 nm/% strain for mPCS and 0.11 nm/% strain for our stabilized sPCS. We analyze the suppression of the mechanochromism with detailed microscopy results. We observe that fissures and fractures form in the rigid waveguiding layer of the sPCS upon mechanical stress. An algorithm based on Holistically-Nested Edge Detection (HED) is used for automated counting of cracks. Rigid photonic crystal cells with sizes on the order of 10 µm to 100 µm are formed that explain the stable optical properties. Even more stable optical properties with less than 0.03 nm wavelength shift per 1% strain are demonstrated for sPCS with an additional dielectric 100 nm SiO2 low index layer beneath the Nb2O5 waveguide layer decoupling the waveguide further from the flexible PDMS substrate
High power Nd:YLF four-level lasers with 68% slope efficiency
Authors: Prado Felipe , Franco Tomás , Vieira Tárcio , Wetter Niklaus
Published: February 2023

Three laser resonators are demonstrated emitting at 1053 nm and pumped at 797nm by VBG equipped diodes, achieving the highest reported efficiencies for Nd:YLF in a four-level system. A peak output power of 880 W is achieved by pumping the crystal with a diode-stack of 1.4 kW peak pump power.
High-speed rendering pipeline for polygon-based holograms
Authors: Wang Fan , Ito Tomoyoshi , Shimobaba Tomoyoshi
Published: February 2023

As an important three-dimensional (3D) display technology, computer-generated holograms (CGHs) have been facing challenges of computational efficiency and realism. The polygon-based method, as the mainstream CGH algorithm, has been widely studied and improved over the past 20 years. However, few comprehensive and high-speed methods have been proposed. In this study, we propose an analytical spectrum method based on the principle of spectral energy concentration, which can achieve a speedup of nearly 30 times and generate high-resolution (8 K) holograms with low memory requirements; Based on the Phong illumination model and the sub-triangles method, we propose a shading rendering algorithm to achieve a very smooth and realistic reconstruction with only a small increase in computational effort. Benefiting from the idea of triangular subdivision and octree structures, the proposed original occlusion culling scheme can closely crop the overlapping areas with almost no additional overhead, thus rendering a 3D parallax sense. With this, we built a comprehensive high-speed rendering pipeline of polygon-based holograms capable of computing any complex 3D object. Numerical and optical reconstructions confirmed the generalizability of the pipeline.
Design and simulation of a dynamically tunable 1× 2 power splitter using MZI configuration in telecom regime
Authors: Arik Kamalodin , Akbari Mahmood , Khavasi Amin
Published: February 2023

We propose an ultra-broadband, ultra-compact and a dynamically tunable 1×2 power splitter on silicon on Insulator (SOI) platform with 220 nm thick silicon light-guiding layer, using two multimode interference (MMI) couplers connected with graphene-based waveguides as phase-tuning section through a Mach-Zehnder Interferometer (MZI) configuration. First, we theoretically present and demonstrate a novel design for the MMI couplers by combining the plane wave expansion method (PWEM) and the mode expansion conjecture concept. To verify the proposed theory, a center-fed 1×2 MMI coupler and a 2×2 MMI coupler, respectively, as the input and output sections of our proposed device, are designed and simulated. The simulation results achieved by Lumerical FDTD show good agreement with the design theory. Then, a highly tunable graphene-embedded silicon waveguide, for highly efficient modulation of effective mod index (EMI), is duly designed using Lumerical Mode Solutions. As the two MZI arms, a pair of the proposed waveguides is introduced into the middle of the cascaded MMI couplers. Accordingly, the integration properties of the analytically designed MMI couplers and the numerically designed waveguide is demonstrated through our proposed device for the aim of achieving any wanted power splitting ratio. To this end, we consider the case that the real part of the EMI of the waveguide in the lower MZI arm is modulated by varying the graphene Fermi level values, being the same for all the layers belong to the same waveguide, while that of the upper arm is constant. The corresponding power splitting ratio can be dynamically tuned in the range of 0.5:0.5-0.85:0.15. All reported results assume TE polarization. The
designed MZI-based splitter possesses a bandwidth of 400nm over the wavelength range from 1.35μm to 1.75μm for various power splitting ratios, maintaining the averaged insertion loss and the averaged power imbalance, respectively, below as low as 0.39dB and 0.48. The overall footprint of the proposed device is also highly small, i.e., about 58μm × 3.5μm.
Injury patterns of non-fatal accidents related to ice hockey, an analysis of 7 years of admission to a Level-1 Emergency Centre in Switzerland
Authors: Gilardi Viola , Kotsaris Spyridon , Exadaktylos Aristomenis , Klukowska-Rötzler Jolanta
Published: February 2023

Objective

This study was carried out to identify the frequency and types of injuries in adult ice hockey, in order to better understand injury patterns and identify potential areas for injury prevention.

Methods

We conducted a retrospective database review of acute injuries reported in ice hockey in patients presenting to a Level-1 adult Emergency Centre in Switzerland. Patients between January 1, 2013 and December 31, 2019 and over 16 years of age were identified in our computerised patient database. Each consultation was reviewed to derive information on demographics, playing level and the features of the injury, including location, type, mechanism and consequences. Different age groups were compared, as were amateur and professional players. A statistical analysis was performed.

Results

A total of 230 patients were identified. The most common diagnoses were fracture (28.3%), contusion/abrasion (23.9%), laceration (12.6%) and concussion (10.4%). The most commonly affected body parts were the face (31.3%), the shoulder/clavicle (13.0%) and the head (12.2%). Most lesions were caused by player-player contact (37.4%), contact with the puck (24.3%) and falls (10.9%). In comparison to the younger cohorts, patients >36 years of age more frequently suffered injuries caused by falls, (p < 0.001) and were less frequently injured by player-player contact (p = 0.01813). In amateur players, significantly more injuries were caused by stick contact (OR 0, 95% CI (0.00–0.83), p = 0.02) and surgery was more rarely performed (OR 2.35, 95% CI 0.98–5.46, p = 0.04).

Conclusions

Injuries continue to play a major role in ice hockey, especially in the face and due to player-player contact. Future investigations should focus on player-player contact and possible effective preventive measures. Players must be encouraged to employ face protection and to wear a mouth guard at all times.
4E analysis of a two-stage refrigeration system through surrogate models based on response surface methods and hybrid grey wolf optimizer
Authors: Ahmed Rasel , Mahadzir Shuhaimi , Mota-Babiloni Adrián , Al-Amin Md , Usmani Abdullah Yousuf , Ashraf Rana Zaid , Yassin Hayati , Shaik Saboor , Hussain Fayaz
Published: February 2023

Refrigeration systems are complex, non-linear, multi-modal, and multi-dimensional. However, traditional methods are based on a trial and error process to optimize these systems, and a global optimum operating point cannot be guaranteed. Therefore, this work aims to study a two-stage vapor compression refrigeration system (VCRS) through a novel and robust hybrid multi-objective grey wolf optimizer (HMOGWO) algorithm. The system is modeled using response surface methods (RSM) to investigate the impacts of design variables on the set responses. Firstly, the interaction between the system components and their cycle behavior is analyzed by building four surrogate models using RSM. The model fit statistics indicate that they are statistically significant and agree with the design data. Three conflicting scenarios in bi-objective optimization are built focusing on the overall system following the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) and Linear Programming Technique for Multidimensional Analysis of Preference (LINMAP) decision-making methods. The optimal solutions indicate that for the first to third scenarios, the exergetic efficiency (EE) and capital expenditure (CAPEX) are optimized by 33.4% and 7.5%, and the EE and operational expenditure (OPEX) are improved by 27.4% and 19.0%. The EE and global warming potential (GWP) are also optimized by 27.2% and 19.1%, where the proposed HMOGWO outperforms the MOGWO and NSGA-II. Finally, the K-means clustering technique is applied for Pareto characterization. Based on the research outcomes, the combined RSM and HMOGWO techniques have proved an excellent solution to simulate and optimize two-stage VCRS.
Alarm-assisted urotherapy for daytime urinary incontinence in children: A meta-analysis
Authors: Wall Liesbeth L. de , Nieuwhof-Leppink Antje J. , Schappin Renske
Published: February 2023

Objectives

Wearable alarm systems are frequently used tools added to urotherapy for children with both daytime and nighttime urinary incontinence. For functional daytime incontinence (DUI) specifically, the effect of alarm interventions has not been systematically reviewed. This study systematically evaluates, summarizes, reviews, and analyzes existing evidence about the effect of wearable alarm systems in urotherapy for children with functional DUI.

Study design

We completed a comprehensive literature search in August 2022 using MEDLINE/PUBMED, EMBASE, PsycINFO, Cochrane Library, Web of Science, Google Scholar, conference abstracts, and citation tracking. Clinical controlled trials at controlled-trials.com and clinicaltrials.gov were consulted, as was the National health Service Center For Reviews And Dissemination. Eligible studies including the use of noninvasive wearable alarm systems as (part of) treatment for functional DUI in children were included. The main outcome was continence after treatment. Three independent reviewers extracted data. Risk of bias was assessed using Cochrane and National Heart, Lung and Blood Institute quality assessment tools.

Results

A total of 10 studies out of 1,382 records were included. Meta-analysis revealed a nonsignificant risk ratio of 1.4 (95% CI: 0.8–2.6) for the use of alarm systems. Urotherapy with alarm systems resulted in a 48% (95% CI: 33–62%) continence rate after treatment.

Conclusions

Alarm systems might be helpful as part of urotherapy for functional DUI in select cases. Adherence is problematic, and the optimal duration of the use of alarm systems is to be determined. Overall, the risk of bias was high in all studies.
Association between enrolment with a Primary Health Care provider and amenable mortality: A national population-based analysis in Aotearoa New Zealand
Authors: Silwal Pushkar , Lopez Maite Irurzun , Pledger Megan , Cumming Jacqueline , Jeffreys Mona
Published: February 2023

Introduction

In Aotearoa New Zealand, being enrolled with a Primary Health Care (PHC) provider furnishes opportunities for lower cost access to PHC, preventative care and secondary health care services, and provides better continuity of care. We examine the characteristics of populations not enrolled, and whether enrolment is associated with amenable mortality.

Method

We retrieved records of all deaths registered 2008 to 2017 in Aotearoa New Zealand, which included demographic and primary cause of death information. Deaths were classified as premature (aged under 75 years) or not, and amenable to health care intervention or not. The Primary Health Organisation (PHO) Enrolment Collection dataset provided the PHC enrolment status. Logistic regression was used to estimate the risk of amenable deaths by PHO enrolment status, adjusted for the effects of age, sex, ethnicity and deprivation.

Results

A total of 308,628 mortality records were available. Of these, 38.2% were premature deaths, and among them 47.8% were amenable deaths. Cardiovascular diseases made up almost half of the amenable deaths. Males, youths aged 15–24 years, Pacific peoples, Māori and those living in the most socio-economically deprived areas demonstrated a higher risk of amenable mortality compared to their respective reference category. One in twenty (4.3%) people who had died had no active enrolment status in any of the calendar years in the study. The adjusted odds of amenable mortality among those not enrolled in a PHO was 39% higher than those enrolled [Odds Ratio = 1.39, 95% Confidence Interval 1.30–1.47].

Implications

Being enrolled in a PHC system is associated with a lower level of amenable mortality. Given demonstrated inequities in enrolment levels across age and ethnic groups, efforts to improve this could have significant benefits on health equity.
Sustainable Insurance and Professional Liability: An Empirical Analysis
Authors: Tsintsadze Asie , Ivanishvili Maia
Published: February 2023

Professional liability insurance combines types of property insurance for several categories of individuals who may cause material harm to third parties as a result of their professional activities. As market rivalry has strengthened with the development of a market economy, the demand for insurance protection has increased, and the presence of a professional liability insurance policy boosts the prestige and confidence of a professional in the eyes of his clients and business partners.

In many nations throughout the world, professional liability insurance is a burgeoning insurance industry that brings profit to insurance firms and helps professionals maintain their activity and business stability.

Given that professional liability insurance is becoming a strategically significant area of insurance, it is pertinent to examine the problems and prospects of its development, which largely determined the research task: empirical analysis determined the level of influence of factors affecting the development of professional liability; based on the analysis of the state of professional responsibility in the insurance market, the problems of the development of the sub-sectors were identified.

Keywords: professional risk, insurance, object of insurance, professionalism, factor analysis
Prospection of the Factors Impacting the Sustainability of the Moroccan Pension Scheme
Authors: Outlioua Said , Fazouane Abdesselam
Published: February 2023

The objective of this study is to identify the factors impacting the sustainability of the Moroccan pension system. To this end, an adapted literature review and a study of the history and current diagnosis of the Moroccan pension system were conducted. Thus, variables appropriate to the factors identified in the literature review were selected to analyze their effects on the sustainability of the Moroccan pension system. This analysis revealed the impact of economic and demographic factors on the sustainability of the Moroccan pension system, and that over the last decade, the financial factor has also had a significant impact. Furthermore, between the 1990s and the 2000s, factors related to pension legislation and to management of the pension scheme had a significant impact on the sustainability of Moroccan pension plans. The article also discusses the efforts made by the Moroccan government to make the national pension system sustainable, some of which are in perfect harmony with the results obtained.

 Keywords: Sustainability, Pension scheme, Morocco, pension reform.

JEF classification: H55, H75.