bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the O/P ratio on the optical properties and structures of fluoride–phosphate glass
Authors: Yoshimoto Kohei , Ueda Motoi , Yamamoto Yuya , Mizuguchi Masafumi
Published: December 2022

Ca(PO3)2–AlF3–CaF2–BaF2–BaO glasses were prepared by the melt quenching method, and the effects of the O/P ratio on the optical properties and glass structure were investigated. The bandgap energy showed no significant change at O/P = 3.0–3.4 but drastically decreased with the increase in the O/P from 3.6 to 4.0. In addition, the refractive index dispersion was analyzed based on the Lorentz model, and it was found that the decrease in the resonance frequency in the ultraviolet region with the increase in the O/P ratio resulted in an increase in the refractive index and dispersion. Analysis of the infrared absorption and Raman scattering spectra revealed that the phosphate chains were broken, and isolated Q0 units were generated with the increase in the O/P ratio from 3.6 to 4.0. Based on the structural change of the glass, the origin of the nonlinear dependence of the optical properties on the O/P ratio was discussed.
The effect of a telehealth exercise intervention on balance in adults with Down syndrome
Authors: Guerrero Kristina , Umagat Alexandria , Barton Mark , Martinez Andrew , Ho Kai‐Yu , Mann Sarah , Hilgenkamp Thessa
Published: December 2022

Background

People with Down syndrome often present with balance deficits, which compromise safety during daily activity. While evidence shows that exercise can improve balance in the Down syndrome population, it is unclear if a telehealth method will elicit similar benefits. We aimed to examine the effects of a virtual exercise program on balance in adults with Down syndrome.

Methods

Eighteen low‐active participants with Down syndrome completed a 12‐week telehealth exercise program based on the Mann Method. Balance testing took place before and after the intervention, which included: TUG, MCTSIB, FICSIT‐4, and FRT. This study was registered as a clinical trial on ClinicalTrials.gov, identifier: NCT04647851.

Results

Significant improvement was seen in the TUG (p = .043), FICSIT‐4 (p = .019) and FRT (p = .019). All participants achieved maximum scores on the MCTSIB in pre‐ and post‐testing.

Conclusions

Balance in low‐active adults with Down syndrome significantly improved following the telehealth exercise program, which we attribute to the tailored exercises that address visual/vestibular deficits and hip muscle weakness.
Protecting our youth: Advocating for family services in the juvenile justice system
Authors: Tadros Eman , Vlach Alyssa
Published: December 2022

Juveniles are entering the justice system at exceptional rates. Nearly 700,000 minors were arrested in 2019 in the United States, calling for a social justice movement. This paper explores the zero‐tolerance policies being implemented in school systems, grades K‐12, across the U.S. Schools began implementing zero‐tolerance policies in an attempt to control drug‐war crimes, regulate firearm activity, and control gang‐related activity in the 1980s. However, they are still in place today and are being used for minor infractions. Zero‐tolerance policies make up the school‐to‐prison pipeline because they force youth out of the school systems via expulsion or suspension and into the criminal justice system. Zero‐tolerance policies focus on punitive actions, including incarceration, rather than social and restorative justice, disproportionately targeting racial minority groups. The article offers clinical implications for working in the juvenile justice system through a restorative justice and incarcerated informed lens.
Primary care patterns among dual eligibles with Alzheimer's disease and related dementias
Authors: Potter Andrew J. , Wright Brad , Akiyama Jill , Stehlin Grace G. , Trivedi Amal N. , Wolinsky Fredric D.
Published: December 2022

Background

Primary care is essential for persons with Alzheimer's disease and related dementias (ADRD). Prior research suggests that the propensity to provide high‐quality, continuous primary care varies by provider setting, but the settings used by Medicare‐Medicaid dual‐eligibles with ADRD have not been described at the population level.

Methods

Using 2012–2018 Medicare data, we identified dual‐eligibles with ADRD. For each person‐year, we identified primary care visits occurring in six settings. We calculated descriptive statistics for beneficiaries with a majority of visits in each setting, and conducted a k‐means cluster analysis to determine utilization patterns, using the standardized count of primary care visits in each setting.

Results

Each year from 2012 to 2018, at least 45.6% of dual‐eligibles with ADRD received a majority of their primary care in nursing facilities, while at least 25.2% did so in physician offices. Over time, the share relying on nursing facilities for primary care decreased by 5.2 percentage points, offset by growth in Federally Qualified Health Centers (FQHCs) and miscellaneous settings (2.3 percentage points each). Dual‐eligibles relying on nursing facilities had more annual primary care visits (16.1) than those relying on other settings (range: 6.8–10.7 visits). Interpersonal care continuity was also higher in nursing facilities (97.0%) and physician offices (87.9%) than in FQHCs (54.2%), rural health clinics (RHCs, 46.6%), or hospital‐based clinics (56.8%). Among dual‐eligibles without care continuity, 82.7% were assigned to a cluster with few primary care visits.

Conclusions

A trend toward care in different settings likely reflects improved access to patient‐centered primary care. Low rates of interpersonal care continuity in FQHCs, RHCs, and physician offices may warrant concern, unless providers in these settings function as a care team. Nonetheless, every healthcare system encounter presents an opportunity to designate a primary care provider for dual‐eligibles with ADRD who use little or no primary care.
Reappraising the public health benefits conferred by environmental policy: Considerations for an aging society
Authors: Festa Natalia , Hsu John , Hammitt James K. , Gill Thomas M.
Published: December 2022

Although addressing environmental pollution and unprecedented societal aging are concurrent public health challenges, rarely is the relationship between the two considered. Current approaches to valuing the public health benefits conferred by environmental policy may be ill‐suited to aging populations. We describe the limitations of the age‐invariant approach used by the United States Environmental Protection Agency to estimate the public health benefits corresponding to environmental regulation. These include the poor age‐representativeness of the samples informing the valuation of mortality risk reduction, the exclusion of age‐related outcomes from valuation, and the omission of age‐related third‐party expenditures. We offer an empirical framework that could address these limitations. Our recommendations could improve the calibration of environmental regulatory analysis to the changing age distribution of the United States population.
Optical properties, biaxial flexural strength, and reliability of new‐generation lithium disilicate glass‐ceramics after thermal cycling
Authors: Diken Türksayar Almira Ada , Demirel Münir , Donmez Mustafa Borga
Published: December 2022

Purpose

To investigate the color stability, translucency, biaxial flexural strength (BFS), and reliability of nano‐lithium disilicate and fully crystallized lithium disilicate after thermal cycling and to compare with those of a commonly used lithium disilicate.

Materials and methods

Three lithium disilicate glass‐ceramics were used to prepare disk‐shaped specimens (ø:12 mm, thickness: 1.2 mm) from A2 shaded HT blocks (Amber Mill, AM; Initial LiSi Block, IN; IPS e.max CAD, EX). AM and EX specimens were crystallized, and all specimens were polished with a polishing paste (Diamond Polish Mint). A spectrophotometer (CM‐26d) was used to measure color coordinates before and after thermal cycling. BFS test was performed after thermal cycling. Color differences (ΔE00) and relative translucency parameter (RTP) values were calculated. One‐way analysis of variance (ANOVA) (ΔE00 and BFS), two‐way ANOVA followed by Tukey's HSD tests (RTP), and chi‐square tests (Weibull modulus and characteristic strength) were used for the statistical analyses (α = 0.05).

Results

No significant differences were observed among the ΔE00 values of tested materials (df = 2, F = 2.933, p = 0.070). RTP values were only affected by material type (p < 0.001) as AM had the highest RTP (p < 0.001), whereas IN and EX had similar values (p ≥ 0.165). BFS values varied among tested materials (df = 2, F = 21.341, p < 0.001). AM and EX had similar BFS values (p = 0.067) that were higher than that of IN (p ≤ 0.001). Weibull moduli of the materials were similar (p = 0.305), whereas EX had the highest and IN had the lowest characteristic strength values (p < 0.001)

Conclusions

Although nano‐lithium disilicate had the highest translucency, all materials had imperceptible color and translucency changes after thermal cycling when reported threshold values were considered. Newly introduced lithium disilicate glass–ceramics had adequate flexural strength as compared to the precursor material.
Trust in public performance information: The effect of data accessibility and data source
Authors: Schmidthuber Lisa , Willems Jurgen , Krabina Bernhard
Published: December 2022

Building on transparency literature, we theorize that information characteristics such as accessibility of raw data and data source provision influence citizens' trust in public performance information. Next to the question of whether providing a data source matters, we argue that information provision from a non‐government actor can compensate for the information asymmetry between citizens and public sector organizations due to a stronger symmetric data exchange relationship. Integrating and elaborating these theoretical assumptions of principal‐agent theory with bureaucratic reputation theory, the organization's reputation, rather than the stakeholder group the information provider is belonging to, may explain varying trust. We conduct eight online experiments in large‐N data collections in Austria and Germany and find that data accessibility and source provision increase trust in performance information. Whereas citizens have more trust in government‐provided data compared to data provided by other citizens, source reputation matters dominantly for building trust in performance information.
The pandemic of ocular surface disease in brachycephalic dogs: The brachycephalic ocular syndrome
Authors: Sebbag Lionel , Sanchez Rick F.
Published: December 2022

Brachycephalic dog breeds are popular around the world, yet many brachycephalic dogs are affected by numerous health problems, including several head‐related diseases that are directly linked to their conformation. In addition to the well‐recognized disorders associated with the respiratory system (brachycephalic obstructive airway syndrome, i.e.,BOAS), brachycephalic dogs have a concerningly high prevalence of ocular surface disorders that can cause chronic discomfort, loss of the globe, and/or require long‐term, daily therapy. This review offers a summary of the physiological and anatomical features of brachycephalic ocular syndrome (BOS) that predispose brachycephalic dogs to develop ocular surface disease, followed by a concise description of common ocular diseases associated with BOS. It ends with an overview of evidence‐based guidelines and animal welfare legislation that some in the veterinary community have already implemented but that requires a wider, international effort in order to reduce the prevalence of BOS‐associated disorders and improve the ocular health of affected dogs.
Gauged U(1)Lμ−Lτ symmetry and two-zero textures of inverse neutrino mass matrix in light of muon (g − 2)
Authors: Singh Labh , Kashav Monal , Verma Surender
Published: December 2022

In the framework of anomaly free [Formula: see text] model, singlet scalar field with nonzero [Formula: see text] charge gives rise to massive gauge boson [Formula: see text] through spontaneous symmetry breaking. [Formula: see text] leads to one loop contribution to the muon anomalous magnetic moment. These scalar fields may, also, appear in the structure of right-handed neutrino mass matrix, thus, connecting the possible explanation of muon [Formula: see text] and low-energy neutrino phenomenology through vevs associated with the scalar fields. In this work, we consider textures of inverse neutrino mass matrix [Formula: see text] wherein any two elements of the mass matrix are zero. In this ansatz, with Dirac neutrino mass matrix diagonal, the zero(s) of right-handed Majorana neutrino mass matrix correspond to zero(s) in the low-energy effective neutrino mass matrix (within Type-I seesaw). We have realized two such textures of [Formula: see text] accommodating the muon [Formula: see text] and low-energy neutrino phenomenology. The requirement of successful explanation of muon [Formula: see text], further, constrains the allowed parameter space of the model and results in sharp correlations amongst neutrino mixing angles and CP invariants. The model explains muon [Formula: see text] for [Formula: see text] in the range (0.035–0.100 GeV) and [Formula: see text] which is found to be consistent with constraints coming from the current experiments CCFR, COHERENT, BABAR while being within sensitivities of future experiments such as NA62 and NA64.
A numerical study of the micropolar nanofluid flow containing aluminum alloy nanoparticles over a variable thickened stretching sheet
Authors: Dawar Abdullah , Islam Saeed , Shah Zahir , Alshehri Ahmed , Mahmuod S. R.
Published: December 2022

Aluminum alloys are used to make wheels that are suitable for aeroplanes and automobiles, as well as all types of ground vehicles and watercraft. Aluminum alloys are made through melting, sintering (assembly of formed parts utilizing metal particles that melt together at intense temperatures), or mechanical braiding. Aluminum alloys have had a major impact on aeroplane manufacturing. Aluminum alloys like AA7075 and AA7072 are especially useful in transportation applications including maritime, aviation, and automotive, and are also utilized in the construction of bicycles, glider rock climbing equipment, and planes. This attempt sheds light on the magnetically influenced methanol-based micropolar nanofluid containing aluminum alloy nanoparticles (AA7075) over a variable thickened stretching sheet. A variable magnetic field is applied normal to the flow direction. The flow is considered at a stagnation point. Also, the Joule heating impact is considered in this analysis. The similarity transformations are used for the transformation of partial differential equations into ordinary differential equation. The authors have chosen to solve the proposed model with the help of NDSolve technique which can handle a wide range of ordinary and partial differential equations (ODEs and PDEs). The results showed that, as the volume fraction of AA7075 nanoparticles grows the velocity profile of the AA7075–methanol nanofluid decreases, while the microrotation and temperature profiles of the AA7075–methanol nanofluid increases. The velocity profile of the AA7075–methanol nanofluid reduces, while the microrotation and temperature profiles of the AA7075–methanol nanofluid increase with the increasing magnetic parameter. The growing micropolar parameter augments the velocity and temperature profiles of the AA7075–methanol nanofluid, whereas a dual impact of the micropolar parameter is found against the microrotation profile of the AA7075–methanol nanofluid. The growing variable wall thickness factor augments the velocity, microrotation and temperature profiles of the AA7075–methanol nanofluid. It is found that the embedded factors highly affected the AA7075–methanol nanofluid as compared to methanol fluid.
I Shop Therefore I Am: The Artificial Consumer
Authors: Manzotti Riccardo
Published: December 2022

Can Artificial Intelligence replace humans not only as producers of goods and content, but also as consumers of commodities? AI agents have so far been associated mainly with the production of goods and content—that is, supply—which is only one side of economic processes. The other side is consumption, which drives demand. Is an Artificial Consumer (AC) conceivable? Can artificial consumers support a human–artificial hybrid artificial economy? Could such an economy help increase GDP? Such questions require exploration of the connection between consciousness, consumption, value, economics, and AI. This admittedly speculative paper discusses the potential consequences of introducing artificial consumers. What place would be left in the economic system for humans if AI took over both supply and demand? The final frontier for AI could be our economy: I shop therefore I am.
Optimizing Adaptive Disturbance Rejection Control Models Using the Chimp Optimization Algorithm for Ships’ Hybrid Renewable Energy Systems
Authors: Amlashi Ali Goudarzi , Rezvani Mohammad , Radmehr Mehdi , Ghafouri Alireza
Published: December 2022

Hybrid renewable energy systems are becoming widely prevalent in warships due to their reliability and acceptability. However, the uncertainty caused by using renewable energy resources is one of the primary challenges. Therefore, this paper investigates the implementation of a dynamic voltage restorer (DVR) with a new control strategy in a hybrid solar power generation system, including photovoltaic (PV) panels, diesel generators, battery storage, and conventional and sensitive loads. Furthermore, a new metaheuristic-based active disturbance rejection control (ADRC) strategy for fast and accurate DVR control is proposed. In this regard, a novel chimp optimization algorithm (ChOA)-based (i.e., ChOA-ADRC) strategy is suggested to increase the stability and robustness of the aforementioned hybrid system. The ADRC controller’s parameters are updated in real-time using the ChOA approach as an automatic tuning mechanism. In order to evaluate the performance of the proposed control strategy, the model is evaluated under two and three-phase fault case scenarios. Also, a comparison with the conventional PI controller has been performed to further evaluate the proposed method. Simulation findings reveal the suggested control strategy’s remarkable effectiveness in correcting fault-caused voltage drop and maintaining sensitive load voltage. Additionally, the results show that ChOA-ADRC presents a better dynamic response compared to conventional control strategies and increases the reliability of the hybrid power generation system.
Using Machine Learning Approaches for Food Quality Detection
Authors: Han Junming , Li Tong , He Yun , Gao Quan
Published: December 2022

Food quality detection is an important method for ensuring food safety. Efficient quality detection methods can improve the efficiency of food circulation and reduce storage and labor costs. Traditional methods use instrumentation, testing reagents, or manual labor. These methods take a long time to detect, are time-consuming and labor-intensive, and require professionals to operate. Fruit, as a high-value food that provides essential nutrition for human beings, is susceptible to spoilage during packaging, transportation, and sales, so the freshness and safety assurance of fruit are a hot and difficult area of current research. Therefore, for the detection of fruit freshness, this paper proposes an efficient and nondestructive way to detect fruit freshness by using the machine learning algorithm convolutional neural network (CNN). This paper shows that convolutional neural networks have good performance in identifying the freshness of fruits through extensive experimental results and discusses the overfitting of machine learning based on the experimental results.
Zhuangzi and Particularism
Authors: Fraser Chris
Published: December 2022

The Zhuangzi rejects the use of invariant general norms to guide action, instead stressing the importance of contextual factors in determining the apt course to take in particular situations. This stance might seem to present a variety of moral particularism, the view that general norms play no fundamental role in moral thought and judgment. I argue against interpreting the Zhuangzi as committed to particularism and thus denying that dao rests on, is shaped by, or comprises general patterns or norms. Instead, I contend, the text presents a combination of contextualism about the factors that determine appropriate responses to particular situations and pluralism about defeasible general norms or standards. The target of criticism is not generalism, the view that general patterns and relations play a role in determining and explaining appropriate courses of action. It is the monolithic application of fixed norms without regard for context.
Looking Back to Look Forward
Authors: Devasar Nitasha
Published: December 2022

India is the second-largest book market in the world for English-language content. Indian publishing, predominantly educational and 75 per cent in English, is growing at a compound annual growth rate. Tracing the business’s 75-year journey, this article highlights key phases and players that have shaped the way this industry looks today. Family businesses and international publishers have been an intrinsic part of the local publishing scene from the start. A large textbook market and growing general books market sustain them as new players continue to appear on the scene. The book-publishing ecosystem has historically included bookselling, distribution, and printing and in more recent times has expanded to edtech and telecoms. The COVID-19 experience has enhanced the need for collaborations in this ecosystem to sustain Indian publishing. Although the books market remains 90 per cent print, its sustainability requires e-resources that enhance, support, and test learning from these printed books. Finding suitable pricing models in a historically price-sensitive market is one of the key challenges. Government policy plays a key role in the direction and growth of Indian publishing. Tax, copyright, and education policies can pave the way for Indian publishing to be a research and skilling hub for this youthful nation.
After Midnight
Authors: Abraham Thomas
Published: December 2022

A whirlwind historical tour of the trade publishing (in English) landscape in India from the start of printing down to the present day, 75 years after Independence. The piece attempts to be a capsule history surveying the evolution of the trade book market through the multiple perspectives of authors, booksellers, genres, publishers, and market data. This is intended primarily as a quick introduction to the beginner and practitioner alike and is not intended to be an exhaustive narrative either by chronology or by genre or market information. It is a quick one-stop reference point for those who would like to see when and how the foundations for trade publishing were late, the key historical imperatives, early writing movements, the earliest booksellers, the beginnings of a formalized and sustained market through imports and distribution, and looks at the evolution of local Indian English publishing and how that has matured into a significant industry; and concludes by taking stock of current market realities and assays forward initiatives needed to reach the next level of stable development.
The Story of India’s Educational Publishing Market
Authors: Khan Manzar
Published: December 2022

Manzar Khan has been a part of India’s educational publishing industry since 1978 and has worked with Orient Longman, Oxford University Press and his current entrepreneurial venture Headword. The educational books market in the country started to expand in the 1990s with economic liberalization and growth, more private schools, and increasing demand for learning in English. This also attracted foreign publishers to set up local operations. Digital resources started to become relevant from the early 2000s, and publishers started to provide ebooks and teacher support materials digitally. Publishers who have good quality content continue to exist and grow through print along with digital support. Covid had a major impact, and it will take publishers at least another season or two to recover the losses incurred. Though operating in a low-price market, private publishers in India have the freedom to develop books and promote these directly to private schools and compete for adoptions. There is scope to continue investing in the educational business.
National Book Trust, India
Authors: Vikram Kumar
Published: December 2022

The journey of National Book Trust, India (NBT, in short) is the journey of the exploration, development and promotion of Indian content through Indian languages in the post-independence era. For NBT, there was no hierarchy of languages and scholarship as it sourced content for all age groups in all languages to be translated into other languages – hence the emphasis on developing ‘common’ books to read from regardless of the initial language of creation. Established and visualized as the national body for both book publishing and promotion, NBT’s ambit naturally extends to creating platforms to promote the culture of reading and book-mindedness. Interactive and pioneering platforms like the New Delhi World Book Fair have helped build a visible book-reading tradition in the country, which is being taken forward with renewed fervour while meeting the challenges of the post-Covid era.
Geopolitical Influences and Language Contacts of the Ukrainian Speech Community of the Chelm and Podlachia Regions in the Kingdom of Poland (1815–1912)
Authors: Matsyuk Halyna
Published: December 2022

This paper explores language contacts, unrecorded in Ukrainian-language texts, which occurred during a period of history when Ukrainian was a minority language. In order to reconstruct language contacts, I applied the theoretical framework of the social history of language. The database was constructed using metalinguistic evidence from secondary sources. The characterization of the macro-level of language contacts from the standpoint of the sociology of language was provided through the inductive method and the method of metalinguistic evidence interpretation. The findings of the article on the variable transition of native speakers from Ukrainian as a colloquial code to oral and written forms of Polish, Russian and (occasionally) to the written form of Ukrainian are relevant for studying language contacts in subsequent periods of the social history of Ukrainian, using the linguistic evidence available from the Ukrainian-language sources.
Extraordinary Example of Media–Minority Relations: The Polish Minority in the Turkish Media
Authors: Karaköse Gizem
Published: December 2022

Adampol / Polonezköy is a Polish village located on the Asian side of İstanbul, founded due to the efforts of Prince Adam Czartoryski in the nineteenth century. The village is an extraordinary example of a Catholic minority in a Muslim environment, making the community and its representation in the media particularly interesting. This research-based study focuses on how the Polish minority is represented in the Turkish media in the light of van Dijk’s critical discourse analysis. The study evaluates how texts and photographs have been structured in newspapers by examining news stories about Adampol / Polonezköy from the Milliyet newspaper and the haberler.com and adampolpolonezkoy websites.
Polish–Romanian Bilingualism: An Individual and Social Process
Authors: Krasowska Helena
Published: December 2022

The aim of this article is to present issues pertaining to Polish–Romanian bilingualism, based on the example of two speakers who can be seen as representative of both the geographical area in focus and of their respective language communities. The interviewees were born in the 1950s and they have lived in Romania, with Romanian as the official language, all their lives. The common denominator of their cases is the family domain and the domain of religion. Both interviewees were born in Polish families in which the home language was Polish.
The language experience of the interviewees has been different: one of them played with Romanian- and Ukrainian-speaking children, while the other grew up in the environment of the Polish dialect of Bukovinian highlanders in Solonețu Nou (Pol. Nowy Sołoniec). However, neither of them spoke a language other than Polish on a daily basis during their preschool period. Their language repertoire was enriched with Romanian during their school period and the following periods of their lives mainly involved the use of Romanian. Their retirement has been a time of great change, including the rebirth of the life of the Polish minority. One of the interviewees is the leader of the local Polish association while the other is a member of a folk group of Polish Bukovinian highlanders and is involved in the life of the local Polish community and the activities of the Polish Cultural Centre (Dom Polski) in Suceava. In the domestic sphere, one of them still speaks Polish, while in the case of the other the language of the domestic sphere is Romanian. Both informants have a very high sense of Polish identity and appreciate the language codes they use: Polish and Romanian.
Interpretable generalized neural additive models for mortality prediction of COVID-19 hospitalized patients in Hamadan, Iran
Authors: Moslehi Samad , Mahjub Hossein , Farhadian Maryam , Soltanian Ali Reza , Mamani Mojgan
Published: December 2022

Background

The high number of COVID-19 deaths is a serious threat to the world. Demographic and clinical biomarkers are significantly associated with the mortality risk of this disease. This study aimed to implement Generalized Neural Additive Model (GNAM) as an interpretable machine learning method to predict the COVID-19 mortality of patients.

Methods

This cohort study included 2181 COVID-19 patients admitted from February 2020 to July 2021 in Sina and Besat hospitals in Hamadan, west of Iran. A total of 22 baseline features including patients' demographic information and clinical biomarkers were collected. Four strategies including removing missing values, mean, K-Nearest Neighbor (KNN), and Multivariate Imputation by Chained Equations (MICE) imputation methods were used to deal with missing data. Firstly, the important features for predicting binary outcome (1: death, 0: recovery) were selected using the Random Forest (RF) method. Also, synthetic minority over-sampling technique (SMOTE) method was used for handling imbalanced data. Next, considering the selected features, the predictive performance of GNAM for predicting mortality outcome was compared with logistic regression, RF, generalized additive model (GAMs), gradient boosting decision tree (GBDT), and deep neural networks (DNNs) classification models. Each model trained on fifty different subsets of a train-test dataset to ensure a model performance. The average accuracy, F1-score and area under the curve (AUC) evaluation indices were used for comparison of the predictive performance of the models.

Results

Out of the 2181 COVID-19 patients, 624 died during hospitalization and 1557 recovered. The missing rate was 3 percent for each patient. The mean age of dead patients (71.17 ± 14.44 years) was statistically significant higher than recovered patients (58.25 ± 16.52 years). Based on RF, 10 features with the highest relative importance were selected as the best influential features; including blood urea nitrogen (BUN), lymphocytes (Lym), age, blood sugar (BS), serum glutamic-oxaloacetic transaminase (SGOT), monocytes (Mono), blood creatinine (CR), neutrophils (NUT), alkaline phosphatase (ALP) and hematocrit (HCT). The results of predictive performance comparisons showed GNAM with the mean accuracy, F1-score, and mean AUC in the test dataset of 0.847, 0.691, and 0.774, respectively, had the best performance. The smooth function graphs learned from the GNAM were descending for the Lym and ascending for the other important features.

Conclusions

Interpretable GNAM can perform well in predicting the mortality of COVID-19 patients. Therefore, the use of such a reliable model can help physicians to prioritize some important demographic and clinical biomarkers by identifying the effective features and the type of predictive trend in disease progression.
Risk factors for failed back surgery syndrome following open posterior lumbar surgery for degenerative lumbar disease
Authors: Xu Wenbo , Ran Bingbing , Zhao Jianhui , Luo Wenqi , Gu Rui
Published: December 2022

Background

With the growing number of traditional posterior open surgery, the incidence of failed back surgery syndrome (FBSS) increases gradually. We aimed to investigate the incidence and risk factors for FBSS following open posterior lumbar surgery for degenerative lumbar disease (DLD).

Method

A multivariable regression analysis was performed for 333 consecutive patients to identify potential risk factors for FBSS. Clinical outcomes were evaluated by the validated North American Spine Society (NASS) Questionnaire and numerical rating scale (NRS) for pain. Demographics, diagnostic characteristics, surgical data, radiographic parameters for each patient were analyzed.

Result

16.8% of the included patients were classified as FBSS. Univariate analysis showed that age, hypertension, symptom location, intermittent claudication, preoperative pain NRS-leg, HIZ, Modic changes (MCs), surgical strategy and postoperative rehabilitation were related to FBSS. Multivariable logistic regression analysis demonstrated that preoperative NRS-leg (OR:0.80, 95%CI:0.71–0.91, P = 0.001), hypertension (OR: 2.22, 95%CI: 1.10–4.51, P = 0.027), intermittent claudication with waking distance > 100 m (OR: 4.07, 95%CI: 1.75–9.47, P = 0.001) and waking distance ≤ 100 m (OR: 12.43, 95%CI: 5.54–27.92, P < 0.001), HIZ (OR: 8.26, 95%CI: 4.00–17.04, P < 0.001), MCs (OR: 3.41, 95%CI: 1.73–6.71, P < 0.001), postoperative rehabilitation (OR: 2.63, 95%CI: 1.13–6.12, P = 0.024) were risk factors for FBSS.

Conclusion

Open posterior lumbar surgery is an effective treatment for DLD which provides pain reduction and lumbar curve improvement with a considerable satisfaction rate. Lower preoperative NRS-leg, hypertension, intermittent claudication, HIZ, MCs and postoperative rehabilitation are risk factors for FBSS, which can serve as a tool for clinicians to identify at-risk population and provide more effective management to mitigate the doctor-patient contradictions and further occupation of medical resources.
Genetic profiling of different phenotypic subsets of breast cancer stem cells (BCSCs) in breast cancer patients
Authors: Zekri Abdel-Rahman N. , Bahnassy Abeer , Mourad Magda , Malash Ibrahim , Ahmed Ola , Abdellateif Mona S.
Published: December 2022

Background

Breast cancer stem cells (BCSCs) have a crucial role in breast carcinogenesis, development, and progression. The aim of the current study is to characterize the BCSCs through the genetic profiling of different BCSCs phenotypic subsets to determine their related genetic pathways.

Methods

Fresh tumor tissue samples were obtained from 31 breast cancer (BC) patients for (1) Mammosphere culture. (2) Magnetic separation of the BCSCs subsets using CD24, CD44, and CD326 Microbeads. (3) Flow cytometry (FCM) assay using CD44, CD24, and EpCAM. (4) RT-PCR profiler Arrays using stem cell (SC) panel of 84 genes for four group of cells (1) CD44+/CD24−/EpCAM− BCSCs, (2) CD44+/CD24− /EpCAM+ BCSCs, (3) mammospheres, and (4) normal breast tissues.

Results

The BCSCs (CD44+/CD24−/EpCAM−) showed significant downregulation in 13 genes and upregulation in 15, where the CD44, GJB1 and GDF3 showed the maximal expression (P = 0.001, P = 0.003 and P = 0.007); respectively).

The CD44+/CD24−/EpCAM+ BCSCs showed significant upregulation in 28 genes, where the CD44, GDF3, and GJB1 showed maximal expression (P < 0.001, P = 0.001 and P = 0.003; respectively). The mammospheres showed significant downregulation in 9 genes and a significant upregulation in 35 genes. The maximal overexpression was observed in GJB1 and FGF2 (P = 0.001, P = 0.001; respectively).

The genes which achieved significant overexpression in all SC subsets were CD44, COL9A1, FGF1, FGF2, GDF3, GJA1, GJB1, GJB2, HSPA9, and KRT15. While significant downregulation in BMP2, BMP3, EP300, and KAT8.

The genes which were differentially expressed by the mammospheres compared to the other BCSC subsets were CCND2, FGF3, CD4, WNT1, KAT2A, NUMB, ACAN, COL2A1, TUBB3, ASCL2, FOXA2, ISL1, DTX1, and DVL1.

Conclusion

BCSCs have specific molecular profiles that differ according to their phenotypes which could affect patients’ prognosis and outcome.
Expansion of regulatory T cells by CD28 superagonistic antibodies attenuates neurodegeneration in A53T-α-synuclein Parkinson’s disease mice
Authors: Badr Mohammad , McFleder Rhonda L. , Wu Jingjing , Knorr Susanne , Koprich James B. , Hünig Thomas , Brotchie Jonathan M. , Volkmann Jens , Lutz Manfred B. , Ip Chi Wang
Published: December 2022

Background

Regulatory CD4+CD25+FoxP3+T cells (Treg) are a subgroup of T lymphocytes involved in maintaining immune balance. Disturbance of Treg number and impaired suppressive function of Treg correlate with Parkinson’s disease severity. Superagonistic anti-CD28 monoclonal antibodies (CD28SA) activate Treg and cause their expansion to create an anti-inflammatory environment.

Methods

Using the AAV1/2-A53T-α-synuclein Parkinson’s disease mouse model that overexpresses the pathogenic human A53T-α-synuclein (hαSyn) variant in dopaminergic neurons of the substantia nigra, we assessed the neuroprotective and disease-modifying efficacy of a single intraperitoneal dose of CD28SA given at an early disease stage.

Results

CD28SA led to Treg expansion 3 days after delivery in hαSyn Parkinson’s disease mice. At this timepoint, an early pro-inflammation was observed in vehicle-treated hαSyn Parkinson’s disease mice with elevated percentages of CD8+CD69+T cells in brain and increased levels of interleukin-2 (IL-2) in the cervical lymph nodes and spleen. These immune responses were suppressed in CD28SA-treated hαSyn Parkinson’s disease mice. Early treatment with CD28SA attenuated dopaminergic neurodegeneration in the SN of hαSyn Parkinson’s disease mice accompanied with reduced brain numbers of activated CD4+, CD8+T cells and CD11b+microglia observed at the late disease-stage 10 weeks after AAV injection. In contrast, a later treatment 4 weeks after AAV delivery failed to reduce dopaminergic neurodegeneration.

Conclusions

Our data indicate that immune modulation by Treg expansion at a timepoint of overt inflammation is effective for treatment of hαSyn Parkinson’s disease mice and suggest that the concept of early immune therapy could pose a disease-modifying option for Parkinson’s disease patients.
Effects of syphilis infection among HIV-1-positive individuals on suppressive antiretroviral therapy
Authors: Chan Phillip , Tang Tommy H. C. , Kwong Ruby T. S. , Chan Lawrence , Chan Helen S. Y. , Lam K. W. , Ting W. M. , Yung S. K. , Lam Emily C. T. , Chu M. Y. , Lam Wilson , Wu T. C. , Li Patrick , Lee M. P.
Published: December 2022

Introduction

Incident syphilis leads to changes in plasma HIV-1 RNA and CD4 + T-cell level in people with HIV (PWH) with viraemia. Its effect in PWH on suppressive antiretroviral therapy (ART) is less clear.

Methods

PWH on suppressive ART (plasma HIV-1 RNA < 50copies/mL) followed at the Queen Elizabeth Hospital, Hong Kong, China were regularly screened for syphilis. Their plasma HIV-1 RNA, CD4 + and CD8 + T-cell, and total lymphocyte levels before syphilis, during syphilis, and after successful treatment were compared.

Results

Between 2005 and 2020, 288 syphilis episodes from 180 individuals were
identified; 287 episodes were related to male, with a median age of 41 at
diagnosis; 221 (77%) were syphilis re-infection. The rates of plasma HIV-1
suppression were statistically unchanged across the time-points (97% pre-syphilis,
98% during syphilis, and 99% post-treatment).

Total lymphocyte, CD4+ and CD8+ T-cell levels decreased during
incident syphilis (p<0.01), and rebounded post-treatment (p<0.01). VDRL
titre was associated with declines in CD4+ T-cell (p=0.045), CD8+ T-cell
(p=0.004), and total lymphocyte levels (p=0.021). Pre-syphilis CD4/CD8 ratio
was associated with increases in CD8+ T-cell (p=0.001) and total lymphocyte
levels (p=0.046) during syphilis. Syphilis re-infection was associated with an
increase in total lymphocyte level (p=0.037). In the multivariable analysis,
only pre-syphilis CD4/CD8 ratio was independently associated with increases in CD8+
T-cell (p=0.014) and total lymphocyte levels (p=0.039) during syphilis.

Conclusions

Among virally-suppressed PWH, total lymphocyte, CD4+, and CD8+ T-cell
levels declined during
incident syphilis but rebounded post-treatment. The status of plasma HIV suppression
was unaffected
by syphilis.
Mechanism of autophagy induced by activation of the AMPK/ERK/mTOR signaling pathway after TRIM22-mediated DENV-2 infection of HUVECs
Authors: Wu Ning , Gou Xiaoqin , Hu Pan , Chen Yao , Ji Jinzhong , Wang Yuanying , Zuo Li
Published: December 2022

Background

Dengue virus type 2 (DENV-2) was used to infect primary human umbilical vein endothelial cells (HUVECs) to examine autophagy induced by activation of the adenosine monophosphate-activated protein kinase (AMPK)/extracellular signal-regulated kinase (ERK)/mammalian target of rapamycin (mTOR) signaling pathway following tripartite motif-containing 22 (TRIM22)-mediated DENV-2 infection to further reveal the underlying pathogenic mechanism of DENV-2 infection.

Methods

Quantitative real-time polymerase chain reaction (qRT-PCR) was used to screen putative interference targets of TRIM22 and determine the knockdown efficiency. The effect of TRIM22 knockdown on HUVEC proliferation was determined using the CCK8 assay. Following TRIM22 knockdown, transmission electron microscopy (TEM) was used to determine the ultrastructure of HUVEC autophagosomes and expression of HUVEC autophagy and AMPK pathway-related genes were measured by qRT-PCR. Moreover, HUVEC autophagy and AMPK pathway-related protein expression levels were determined by western blot analysis. Cell cycle and apoptosis were assessed by flow cytometry (FCM) and the autophagosome structure of the HUVECs was observed by TEM.

Results

Western blot results indicated that TRIM22 protein expression levels increased significantly 36 h after DENV-2 infection, which was consistent with the proteomics prediction. The CCK8 assay revealed that HUVEC proliferation was reduced following TRIM22 knockdown (P < 0.001). The TEM results indicated that HUVEC autolysosomes increased and autophagy was inhibited after TRIM22 knockdown. The qRT-PCR results revealed that after TRIM22 knockdown, the expression levels of antithymocyte globulin 7 (ATG7), antithymocyte globulin 5 (ATG5), Beclin1, ERK, and mTOR genes decreased (P < 0.01); however, the expression of AMPK genes (P < 0.05) and P62 genes (P < 0.001) increased. FCM revealed that following TRIM22 knockdown, the percentage of HUVECs in the G2 phase increased (P < 0.001) along with cell apoptosis. The effect of TRIM22 overexpression on HUVEC autophagy induced by DENV-2 infection and AMPK pathways decreased after adding an autophagy inhibitor.

Conclusions

In HUVECs, TRIM22 protein positively regulates autophagy and may affect autophagy through the AMPK/ERK/mTOR signaling pathway. Autophagy is induced by activation of the AMPK/ERK/mTOR signaling pathway following TRIM22-mediated DENV-2 infection of HUVECs.
Experiences of mothers of NICU preterm infants in milk management out of the hospital: a qualitative study
Authors: Yang Rui , Chen Danqi , Wang Hua , Xu Xinfen
Published: December 2022

Background

Human milk is important for the health and development of preterm infants. China’s neonatal intensive care units (NICUs) have adopted the management system of maternal–infant separation. Human milk received and used by NICUs is managed by the infants’ families in the out-of-hospital environment. There is scant publication on mothers’ opinions on out-of-hospital human milk management. This study aimed to explore the experiences of Chinese mothers providing their infants in the NICUs with human milk expressed outside of the hospital.

Methods

Semi-structured interviews were conducted with 23 participants recruited from June 2020 to November 2020, who transported their human milk to the human milk bank of Women’s Hospital School of Medicine Zhejiang University during the hospitalization of their preterm infants. This study adopted a qualitative research approach with thematic analysis.

Results

Three main themes were identified: 1) awareness of human milk management and a willingness to adopt it; 2) lack of standardization regarding expressing, storing, and transporting expressed human milk; and 3) the need for more external support. Theme 2 additionally has three sub-themes: I) differentiation of preparations before human milk expression; II) differentiation of devices for human milk expression; and III) insufficient knowledge and understanding.

Conclusions

In this study, all participants who received health education showed enthusiasm for participating in out-of-hospital human milk management. However, most participants had questions during the implementation process. Medical staff should provide professional and continuous external support to support mothers in implementing human milk management.
Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastia
Authors: Rashad Manal Mohamed , Abdelhay Anas Ahmed
Published: December 2022

Background

Nerve block reduces anesthetics requirement, allows faster recovery, and reduces postoperative pain. The modified pectoral plane block (PECS II) and the erector spinae plane block (ESP) have been proposed for nerve block in men undergoing breast surgery for gynecomastia.

This study aimed to compare the efficacy of PECS II and ESP for perioperative analgesia in men undergoing surgical treatment of gynecomastia.

We conducted a randomized clinical trial on 46 males (with ASA I and II, age range from 18 to 25 years) undergoing surgical gynecomastia treatment in a tertiary medical center. Patients were randomly allocated to receive nerve blocks with either PECS II or ESP in addition to the general anesthesia. The postoperative opioid requirement, analgesic doses, pain intensity on the VAS score, hemodynamic parameters throughout the operation, and complications were recorded and compared for both groups.

Results

PECS II group had more favorable outcomes compared to the ESP group, evident by the significantly less total morphine consumption in 24 h (6.09 vs. 14.26 mg, P ≤ 0.001) and the significantly higher effective analgesic time (6.57 vs. 4.91 h, P ≤ 0.001). In addition, there were no intraoperative or postoperative complications recorded in both groups.

Conclusions

For men undergoing elective surgical treatment of gynecomastia, the ultrasound-guided modified PECS II is superior to the ESP in terms of opioid requirement, analgesic doses, and pain intensity.