bluuebunny/crossref_metadata_2025 huggingface dataset:
Swept Source-Optical Coherence Tomography Angiography for Management of Secondary Choroidal Neovascularization in Punctate Inner Choroidopathy
Authors: Stattin Martin , Forster Julia , Ahmed Daniel , Krepler Katharina , Ansari-Shahrezaei Siamak
Published: April 2021

The purpose was to demonstrate the diagnostic and therapeutic feasibility of swept source-optical coherence tomography angiography (SS-OCTA) by picturing neovascular changes secondary to a rare white dot syndrome following long-term intravitreal ranibizumab (IVR). A 28-year-old Caucasian myopic female presented with visual loss in her right eye only. The clinical examination and multimodal imaging including spectral domain (SD)-OCT, blue-peak autofluorescence, fluorescein, and indocyanine green angiography (HRA Spectralis, Heidelberg Engineering; Heidelberg, Germany) as well as SS-OCTA (DRI Triton, Topcon; Tokyo, Japan) led to the diagnosis of idiopathic punctate inner choroidopathy with secondary subfoveal choroidal neovascularization (CNV). In addition to oral corticosteroids, a pro re nata regimen with IVR was initiated and guided by repeated SD-OCT and SS-OCTA. Six IVR were administered based on functional SS-OCTA en face scans illustrating vessel transformation and downsizing of the CNV area while SD-OCT B-scans were inconclusive as indirect signs of activity were absent throughout the follow-up period. SS-OCTA provided new possibilities for monitoring vessel development. IVR was managed based on vessel density as displayed by SS-OCTA.
Peripapillary Choroidal Neovascular Membrane Secondary to Sarcoidosis-Related Panuveitis: Treatment with Aflibercept and Ranibizumab with a 50-month Follow-Up
Authors: Matsou Artemis , Dermenoudi Maria , Tzetzi Despina , Rotsos Tryfon , Makri Olga , Anastasopoulos Eleftherios , Symeonidis Chrysanthos
Published: April 2021

A case of peripapillary choroidal neovascular membrane (PCNM) secondary to sarcoidosis-related panuveitis successfully treated with anti-vascular endothelial growth factor (anti-VEGF) agents and systemic immunomodulatory therapy is reported. Diagnosis and follow-up were based on fundoscopic, optical coherence tomography as well as fluorescein angiography findings. A 45-year-old female patient presented with sudden onset bilateral blurring of vision. Fundoscopy revealed bilateral granulomatous panuveitis with solitary peripheral granuloma in the right eye and PCNM in the left eye. Diagnostic work-up including conjunctival biopsy confirmed the diagnosis of sarcoidosis. Topical and systemic corticosteroids controlled the inflammation. Within 4 weeks, PCNM showed rapid enlargement (best-corrected visual acuity [BCVA]: 6/60) with foveal involvement. Monthly intravitreal aflibercept injections and systemic methotrexate were administered. After 5 aflibercept injections, anatomical and functional improvement was noted (BCVA: 6/6). Due to aflibercept unavailability, further treatment included ranibizumab injections. During a 50-month follow-up period, every anti-VEGF injection was followed by total NV regression and 6/6 BCVA. Both aflibercept and ranibizumab appear to be effective in the treatment of PCNM secondary to sarcoidosis.
Mitochondrial Neurogastrointestinal Encephalopathy Disease: A Rare Disease Diagnosed in Siblings with Double Vision
Authors: Farahvash Armin , Kassardjian Charles D. , Micieli Jonathan A.
Published: April 2021

Mitochondrial neurogastrointestinal encephalopathy disease (MNGIE) is a rare autosomal recessive condition characterized by gastrointestinal dysmotility, external ophthalmoplegia, leukoencephalopathy, and sensorimotor neuropathy. A 31-year-old man was referred for a 1-year history of horizontal diplopia related to a large exotropia from chronic progressive external ophthalmoplegia. MRI revealed a diffuse leukoencephalopathy and his 3-year history of chronic intermittent diarrhea, cachexia, and diffuse sensory more than motor peripheral neuropathy led to a unifying clinical diagnosis of MNGIE. This was later confirmed with genetic testing, which revealed a homozygous pathogenic mutation in the thymidine phosphorylase (TYMP) gene. His younger brother had an identical clinical syndrome and was similarly diagnosed. MNGIE diagnosis is important to establish to avoid unnecessary invasive testing for gastrointestinal, ophthalmological, and neurological symptoms and to ensure patients receive appropriate nutritional and genetic counselling. Gene therapy offers a potential future therapy for patients with this condition.
A Rare Case of Thyroid Carcinoma Showing Thymus-Like Differentiation in a Young Adult
Authors: Kimura Eri , Enomoto Keisuke , Kono Masamitsu , Tamagawa Shunji , Takeda Saori , Kumashiro Naoko , Hirayama Shun , Kimura Takahito , Hotomi Muneki
Published: April 2021

Thyroid carcinoma showing thymus-like differentiation (CASTLE) is thought to originate from ectopic thymic tissue or remnants of the developing thymus within or adjacent to the thyroid. This case report describes a mass located on the left thyroid of a 28-year-old man. Fine-needle aspiration cytology revealed a number of lymphoid cells without atypia that were similar to those seen in a malignant lymphoma of the thyroid, and surgery was performed. Based on additional histopathological findings, the tumor was finally diagnosed as a CASTLE. It is difficult to diagnose this neoplasm using fine-needle aspiration cytology. However, it is possible to differentially diagnose CASTLE based on its histological features. CD5 is useful for diagnosing CASTLE with immunohistochemical staining.
Neuroprotective Effects of Long-Term Metformin Preconditioning on Rats with Ischemic Brain Injuries
Authors: Wang Lu , Wang Aqian , Guo Hongtao , Zhang Zhenxian , Wang Shenghai , Pei Tengbo , Liu Zhiyong , Yang Dandan , Liu Yong , Ruan Cailian
Published: April 2021

Introduction: This study is to analyze the neuroprotective effects of long-term metformin (Met) preconditioning on rats with ischemic brain injuries and the related mechanisms. Methods: Twenty-five Sprague-Dawley rats were randomly divided into 5 groups: sham group, middle cerebral artery occlusion (MCAO) group, normal saline + MCAO group, pre- Met + MCAO group, and 3-MA + Met + MCAO group. Pathological changes of brain were observed by hematoxylin-eosin staining. Neurobehavior scores were calculated. Infarct area was assessed by 2,3,5-triphenyltetrazolium chloride staining. Apoptosis of neurons was detected by TdT-mediated dUTP Nick-End Labeling (TUNEL). Western blot tested the expression of LC3 (microtubule-associated protein 1 light chain 3), Beclin-1, adenosine 5′-monophosphate ([AMP]-activated protein kinase [AMPK]), and p-AMPK in hippocampal CA1 region. Results: Compared with the sham group, the MCAO group induced severe pathological changes in the brain. The neurobehavior scores and infarct area in the brain were increased in the MCAO group than in the sham group. The apoptosis level in the MCAO group was also higher than in the sham group. However, after pretreatment with Met, the pathological changes in the brain were attenuated. Compared with the MCAO group, the pre-Met + MCAO group also had decreased neurobehavior scores and infarct area in the brain. Additionally, the apoptosis level in the pre-Met + MCAO group was lower than in the MCAO group. Moreover, the MCAO group had increased levels of LC3 and Beclin-1 than in the sham group. In the pre-Met + MCAO group, their levels were decreased than in the MCAO group. The p-AMPK level in the pre-Met + MCAO group was also increased than in the MCAO group, suggesting activation of p-AMPK by Met. Conclusion: Long-term Met pretreatment has neuroprotective effect on ischemic brain injury, which may be related to the regulation of autophagy-related protein expression and apoptosis.
Using Patient-Reported Measures to Improve Outcomes in Kidney Disease
Authors: Mclaren Sofia , Jhamb Manisha , Unruh Mark
Published: April 2021

Patients with CKD and ESRD are vulnerable to increased mortality rates and other poor outcomes. Among those with ESRD, their health-related quality of life (HRQOL) is shown little to no improvement as they undergo treatments such as dialysis and providers concurrently manage other health issues that complicate their already vulnerable state. This review synthesizes evidence demonstrating that a focus on measuring and monitoring patient-reported outcomes (PRO) such as pain and depression can improve HRQOL. Patient-centered care has the potential to create an efficient way for clinicians to address specific challenges facing patients. While there is an emerging literature assessing the use of PROs in kidney research, by examining relevant research in other disciplines it is possible to generate better ways to use PROs in this high-risk population. Electronic health records as well as various other electronic methods of communication between the clinician and patient may serve to accelerate the trajectory toward patient-centered care using PROs.
Neumonía por COVID-19 en niños: De su etiología a su manejo
Authors: Parisi Giuseppe Fabio , Indolfi Cristiana , Decimo Fabio , Leonardi Salvatore , Miraglia del Giudice Michele
Published: April 2021

El COVID-19 es menos serio en niños que en adultos. Sin embargo, las afecciones respiratorias dominan el cuadro clínico de pacientes hospitalizados por COVID-19, aun en niños. En algunas series de casos, el deterioro del estado clínico, donde la disnea, la cianosis y el inicio del síndrome de dificultad respiratoria aguda (SDRA) emergieron ∼8–10 días después del inicio de la infección por SARS-CoV-2, pudo progresar rápidamente hasta la falla multiorgánica y la muerte. Esta revisión tiene como objetivo evaluar las características de la neumonía por COVID-19 en poblaciones pediátricas, comenzando con su etiología y sus mecanismos patológicos, para cerrar con su manejo clínico.
Insektengiftallergie: Anaphylaxie besser verstehen
Authors: Wieczorek Dorothea
Published: April 2021

Background:Venom-induced anaphylaxis (VIA) is a common, potentially life-threatening hypersensitivity reaction associated with (1) a specific symptom profile, (2) specific cofactors, and (3) specific management. Identifying the differences in phenotypes of anaphylaxis is crucial for future management guidelines and development of a personalized medicine approach. Objective:This study aimed to evaluate the phenotype and risk factors of VIA. Methods:Using data from the European Anaphylaxis Registry (12,874 cases), we identified 3,612 patients with VIA and analyzed their cases in comparison with sex- and age-matched anaphylaxis cases triggered by other elicitors (non-VIA cases [n = 3, 605]). Results:VIA more frequently involved more than 3 organ systems and was associated with cardiovascular symptoms. The absence of skin symptoms during anaphylaxis was correlated with baseline serum tryptase level and was associated with an increased risk of a severe reaction. Intramuscular or intravenous epinephrine was administered significantly less often in VIA, in particular, in patients without a history of anaphylaxis. A baseline serum tryptase level within the upper normal range (8–11.5 ng/mL) was more frequently associated with severe anaphylaxis. Conclusion:Using a large cohort of VIA cases, we have validated that patients with intermediate baseline serum tryptase levels (8–11 ng/mL) and without skin involvement have a higher risk of severe VIA. Patients receiving β-blockers or angiotensin-converting enzyme inhibitors had a higher risk of developing severe cardiovascular symptoms (including cardiac arrest) in VIA and non-VIA cases. Patients experiencing VIA received epinephrine less frequently than did cases with non-VIA.
Hallazgos similares al COVID-19 en un caso fatal de neumonía intersticial descamativa asociada con glomerulonefritis por IgA en una niña de 13 meses de edad
Authors: Gurzu Simona , Satala Catalin-Bogdan , Melit Lorena Elena , Streinu-Cercel Adrian , Otelea Dan , Capalna Brandusa , Puiac Claudiu Ioan , Szederjesi Janos , Jung Ioan
Published: April 2021

En la era del COVID-19, es usual sospechar que cualquier paciente con síndrome respiratorio agudo grave (SARS) esté asociado con una infección por SARS-CoV-2. El objetivo de este artículo es presentar un caso de neumonía similar al COVID, con evolución fatal. Los aspectos clínicos se correlacionan con los hallazgos en la autopsia y se discuten en el contexto de los datos más recientes en la literatura médica. Una niña de 13 meses de edad ingresó a la sala de emergencias con dificultad respiratoria aguda y opacidades pulmonares bilaterales con apariencia de vidrio molido, además del pulmón izquierdo casi completamente opacificado. El estado de la paciente se deterioró súbitamente, y se confirmó la muerte 3 h después de la admisión. En la autopsia se diagnosticó neumonía intersticial descamativa grave, y se asoció con glomerulonefritis por IgA, un hallazgo poco usual. No se detectó infección por SARS-CoV-2 en el parénquima pulmonar mediante RT-PCR. Éste es un caso muy inusual de deterioro rápido de un infante con neumonía intersticial descamativa (NID) idiopática y afectación multiorgánica. Con base en tinciones inmunohistoquímicas, proponemos la hipótesis de que, en la NID, las membranas hialinas surgen de neumocitos descamados necrotizantes. En la era de COVID-19, tales casos son extremadamente difíciles de diagnosticar, y pueden semejar las lesiones pulmonares inducidas por el SARS-CoV-2. Esta pauta de formación de membrana hialina podría explicar la falta de respuesta a la terapia con oxígeno. El presente caso resalta la importancia de la autopsia en estos casos complicados.
Tratamiento médico exitoso de neumonía necrotizante en un paciente pediátrico
Authors: Uinarni Herlina , Nike Felicia , Bahagia Andi Dwi
Published: April 2021

La neumonía necrotizante es una complicación grave pero poco frecuente de la neumonía en niños. Presentamos el caso de una niña de 20 meses de edad con dificultad respiratoria, que más adelante se diagnosticó como neumonía necrotizante. En este artículo subrayamos el papel de estudios de imagen como la radiografía torácica, la TC torácica y la ultrasonografía pulmonar para el diagnóstico, y la importancia de la terapia intravenosa con antibióticos para un mejor resultado.
Efficient TCAM design based on dual port SRAM on FPGA
Authors: Nguyen Triet , Ngo Kiet , Trinh Nguyen , Bui Bao , Tran Linh , Trang Hoang
Published: April 2021

Ternary content addressable memory (TCAM) is a memory that allows high speed searching for data. Not only it is acknowledged as associative memory/storage but also TCAM can compare input searching content (key) against a collection of accumulated data and return the matching address which compatible with this input search data. SRAM-based TCAM utilizes and allocates blocks RAM to perform application of TCAM on FPGA hardware. This paper presents a design of 480×104 bit SRAM-based TCAM on altera cyclone IV FPGA. Our design achieved lookup rate over 150 millions input search data and update speed at 75 million rules per second. The architecture is configurable, allowing various performance trade-offs to be exploited for different ruleset characteristics.
Design and implementation of a stability control system for TCP/AQM network
Authors: Shneen Salam Waley , Sulttan Mohammed Qasim , Oudah Manal Kadhim
Published: April 2021

In this work, we used a new approach as active queue management (AQM) to avoid data congestion in TCP/IP networks. The new approach is PSO-PI controller which use the proportional-integral controller as a control unit and particle swarm optimization (PSO) algorithm as an optimization technique to improve the performance of the PI controller and therefore improving the performance of TCP/IP networks as a required goal. The optimization control (PSO-PI) is characterized by access to design and choosing the optimal parameters of (K_1 and K_p) to reach optimal solutions in a short way (fewer iterations). The implementation of the PSO algorithm is achieving by using the mathematical system model and M-file and SIMULINK in Mathlab program. Simulation results show good congestion management performance with PSO-PI controller better than the PI controller as AQM in TCP networks, and the proposed method was very fast and required few iterations.
Classification of rice plant nitrogen nutrient status using k-nearest neighbors (k-NN) with light intensity data
Authors: Muliady Muliady , Tien Sze Lim , Voon Chet Koo , Patra Suhadra
Published: April 2021

Crop management including the efficient use of nitrogen (N) fertilizer is important to ensure crop productivity. Human error in judging the leaf greenness when using the leaf color chart (LCC) to estimate the rice plant N nutrient status has encouraged numerous researchers to implement a machine-learning algorithm but experienced some issues in calibration and lighting. The datasets are created at 6.00-7.00AM (consistent lighting) and including light intensity, so each dataset contains RGB value and light intensity as inputs, and LCC value as a target. A system consists of a smartphone with an application that prevents user from taking an image if the light intensity is not in 2000-3500 lux, and a computer for preprocessing and classification purposes were developed. The preprocessing included cropping, splitting the rice leaf images, and calculating the average RGB values. A k-NN classifier is implemented and by using a cross-validation method is found k=5 gives the best accuracy of 97,22%. The in-site test of the system also works with an accuracy of 96.40%. 
Methodology to improve the accuracy of the model in photovoltaic systems
Authors: Galarza Jose
Published: April 2021

The present research proposes a methodology to improve the estimation of the unknown parameters of the unitary diode model of the photovoltaic panel. To check the accuracy, a comparison with other methodologies known in the scientific literature is made. Through an iterative process, the best value of the series resistance and the ideality factor for different temperature and irradiance conditions are identified. The objective is to determine a simplified model that accurately estimates the power supplied by a photovoltaic installation. To check the effectiveness of the methodology, a comparison was made between the power estimated by the model and the power measurements of an experimental photovoltaic installation. The results based on statistical indicators show that the proposed methodology determines a simplified model of the unitary diode with a better capacity and accuracy with respect to the known methodologies.
Design and monitoring body temperature and heart rate in humans based on WSN using star topology
Authors: Budiyanto Setiyo , Artadima Silaban Freddy , Medriavin Silalahi Lukman , Kurniawan Selamet , I. M. Fajar Rahayu , Darusalam Ucuk , Andryana Septi
Published: April 2021

Electronic health (E-health) uses information and communication technology including electronics, telecommunications, computers, and informatics to process various types of medical information, to carry out clinical services (diagnosis or therapy). Health is the most important asset in human life, therefore maintaining health is a top priority and serious attention needed. Heart rate and body temperature are vital signs that the hospital routinely checks for clinical signs and are useful for strengthening the diagnosis of a disease. In this research monitoring heart rate and body temperature with the wireless sensor network (WSN) method that uses NodeMCU 1.0 as a controller module and wireless as communication between nodes, the wireless network used in this research Wi-Fi network. As a data taker, a DS18b20 temperature sensor and a heart rate sensor (pulse sensor) are needed, which will be displayed by the ThingSpeak web and smartphones. From the test results, the success rate of the system in detecting heart rates is 97.17%. Whereas in detecting body temperature the success rate of the system is 99.28%. For data transmission, the system can send data smoothly at a maximum distance of 15 meters with a barrier.
Particle swarm optimization for airlines fleet assignment
Authors: Abouzeid Abdallah A. , Mohei Eldin Mostafa , Abdel Razek Mohammed
Published: April 2021

Airline fleet assignment is the process of assigning aircraft types to scheduled flight legs in order to minimize operating cost and achieve maximize revenue, while satisfying a set of constraints. This paper formulate the fleet assignment problem for airlines that optimization goal is to minimize the total assignment cost. Particle swarm optimization proposed to solve this model. The model successfully applied to Egyptair airline dataset using the particle swarm optimization and mixed integer programming. The proposed method compared with mixed integer programming and current Egyptair assignment methodology. The results showed that the particle swarm optimization is the best method for the Egyptair fleet assignment process. The solution quality is better than mixed integer programming and Egyptair assignment methodology where we saw a daily cost reduction with a percentage of 14.6% and 19.3% respectively.
Energy audit: types, scope, methodology and report structure
Authors: Sharma Pankaj , Reddy Salkuti Surender , Kim Seong-Cheol
Published: April 2021

The objective of this paper is to study various methods adopted during the energy audit. Many countries are focusing on energy, not only enhancing the tenable power generation sources but also on utilizing the power more proficiently for economic utilization. The energy audit is an important parameter for all the developing and developed countries and they focus on energy efficiency, energy quality, and energy intensity. In the industrial, residential, and commercial sectors the top operating expense is found to be are material, machine, manpower, and energy. Identification of the energy-consuming sector is the prior attention to look for the energy-saving potential and quality improvement. Implementation of an energy audit can enhance the efficiency, quality of power, reduce the tariff of bills, and reduces the wastage of energy. The need for energy audits, different types of energy audits, various types of software used, and the energy audit report structure were presented in this paper.
Models of improved multilink reverse charging network by utilizing the bit error rate QoS attribute
Authors: Maya Puspita Fitri , Rohania Rohania , Yuliza Evi , Herlina Wenny , Yunita Yunita
Published: April 2021

In this paper, a modification model for single-link reverse charging of internet is formed on a multi-link wireless network. The pricing scheme also takes into account the base costs and quality of services provided by the service provider. Bit error rate (BER) was utilized as one of the well-known quality of service (QoS) attribute that can guarantee best performance for internet service provider (ISP) and users. The base price is determined as a decision variable to help ISP to maximize profit. This optimization model can be solved using the LINGO 13.0 program to gain optimal values. The computational results show that by setting costs as constants and service quality as variables, optimal results are obtained for ISPs. This can make ISP considerations in determining the base price that can benefit the ISP and according to the services provided.
Analysis of sales levels of pharmaceutical products by using data mining algorithm C45
Authors: Sovia Rini , Muhammad Abulwafa , Arlis Syafri , Guslendra Guslendra , Defit Sarjon
Published: April 2021

This research was conducted to analyze the level of sales of pharmaceutical products at a Pharmacy. This is done to find out the types of products that have high and low sales levels. This study uses the C45 Data Mining Algorithm concept that will produce a conclusion on the prediction of sales of pharmaceutical products through data processing obtained from sales transactions at pharmacies. This C45 algorithm will form a decision tree that provides users with knowledge about products that are in great demand by consumers based on sales data and predetermined variables. The final result of the C45 algorithm produces a number of rules that can identify the inheritance of a type of medicinal product. C45 algorithm is able to produce 20 types of categories that will be labeled goals based on the number of pharmaceutical products, since it can be concluded that C45 successfully defines 55% of the existing objective categories.
Web-based document certification system with advanced encryption standard digital signature
Authors: Indriyawati Henny , Winarti Titin , Vydia Vensy
Published: April 2021

Web-based degree document certification system with a digital signature in Semarang University has a purpose to support academic to do online document certification through a system. The main problem which occurs in academic administration is a long document certification process that causes an ineffective and inefficient certification process. To solve the problem, a system that can encrypt a document for better security is required. This system is built with the advanced encryption standard algorithm with a 128-bit sized key to encrypt confidential information inside the document. During the encryption process, this algorithm operates using 4x4 bit array blocks and passing many encryption processes for at least 10 (ten) times. The application is analyzed with object-oriented analysis and modeled with Unified modeling language. The result of this research is a system which can secure document with AES algorithm with a 256-bit sized key. The security element in this algorithm will make easier to identify the owner of the document. The secured document is easily accessible through PHP-based web or available QR code. When decrypting the document, the application will activate the camera function and decrypt the information document.
A state-of-the-art survey on semantic similarity for document clustering using GloVe and density-based algorithms
Authors: M. Mohammed Shapol , Jacksi Karwan , R. M. Zeebaree Subhi
Published: April 2021

Semantic similarity is the process of identifying relevant data semantically. The traditional way of identifying document similarity is by using synonymous keywords and syntactician. In comparison, semantic similarity is to find similar data using meaning of words and semantics. Clustering is a concept of grouping objects that have the same features and properties as a cluster and separate from those objects that have different features and properties. In semantic document clustering, documents are clustered using semantic similarity techniques with similarity measurements. One of the common techniques to cluster documents is the density-based clustering algorithms using the density of data points as a main strategic to measure the similarity between them. In this paper, a state-of-the-art survey is presented to analyze the density-based algorithms for clustering documents. Furthermore, the similarity and evaluation measures are investigated with the selected algorithms to grasp the common ones. The delivered review revealed that the most used density-based algorithms in document clustering are DBSCAN and DPC. The most effective similarity measurement has been used with density-based algorithms, specifically DBSCAN and DPC, is Cosine similarity with F-measure for performance and accuracy evaluation.
e-SimNet: a visual similar product recommender system for E-commerce
Authors: Addagarla Ssvr Kumar , Amalanathan Anthoniraj
Published: April 2021

Visual similarity recommendations have an immense role in E-commerce portals. Fetching the appropriate similar products and suggesting to the buyers based on the product image's visual features is complex. Here in our research, we presented an efficient E-commerce similar product network model (e-SimNet) for visually similar recommendations. To achieve our objective, we have performed image feature extraction and generating embeddings using deep learning techniques and built an Index tree using the approximate nearest neighbor oh yeah (ANNOY) algorithm. Further, we have fetches top-N the near similar items using distance measure. We have benchmarked our model in terms of accuracy, error rate, and results show that better than other state-of-the-art approaches with 96.22% of accuracy.
Smart ambulance using IoT for blood transfer facilities
Authors: A. Torad Mohamed , H. Hossamel-din Yahia
Published: April 2021

In case of an accident occurrence, ambulance try to transport wounded and injured people to the nearest hospital, but if the injured persons need an urgent blood transfer, the emergency reception (ER) can check the availability of the needed blood type and quantity. If it is available, the emergency reception accepts the injured person, but if it is not available, the reception reroutes the ambulance to the nearest hospital which have the required blood type and quantity. So, a system created that save that wasted time to save injured people life as possible.  So, we create a system that save that wasted time to save injured people life as possible. So, the main contribution in this paper is selecting and determining the nearest hospital that own the proper blood types to save injurjed people lives using dijkstra algorithm. In this study, we use an android application at the ambulance which permit the paramedic to login and select the required blood type and quantity needed after determining the injured person’s blood type and the android application automatically determine the nearest hospital using the best shortest path algorithm (SPA) after checking the database and generate a pin code for the paramedic to deliver it with injured person to the ER and get the needed blood. This process will consequently decrease the used blood quantity from the database.
Divergent Functions of Tissue-Resident and Blood-Derived Macrophages in the Hemorrhagic Brain
Authors: Chang Che-Feng , Goods Brittany A. , Askenase Michael H. , Beatty Hannah E. , Osherov Artem , DeLong Jonathan H. , Hammond Matthew D. , Massey Jordan , Landreneau Margaret , Love J. Christopher , Sansing Lauren H.
Published: April 2021

Background and Purpose:

Brain tissue-resident microglia and monocyte-derived macrophages (MDMs) are innate immune cells that contribute to the inflammatory response, phagocytosis of debris, and tissue repair after injury. We have previously reported that both microglia and MDMs transition from proinflammatory to reparative phenotypes over days after an intracerebral hemorrhage (ICH). However, their individual functional properties in the brain remain largely unknown. Here we characterized the differences between microglia and MDMs and further elucidate their distinct activation states and functional contributions to the pathophysiology and recovery after ICH.

Methods:

Autologous blood injection was used to model ICH in mice. Longitudinal transcriptomic analyses on isolated microglia and MDMs from mice at days 1, 3, 7 and 10 after ICH and naive controls identified core transcriptional programs that distinguish these cells. Imaging flow cytometry and in vivo phagocytosis assays were used to study phagocytic ability of microglia and MDMs. Antigen presentation was evaluated by ovalbumin-OTII CD4 T-cell proliferation assays with bone marrow–derived macrophages and primary microglia cultures.

Results:

MDMs had higher phagocytic activity and higher erythrophagocytosis in the ICH brain. Differential gene expression revealed distinct transcriptional signatures in the MDMs and microglia after ICH. MDMs had higher expression of MHCII (major histocompatibility complex class II) genes than microglia at all time points and greater ability to induce antigen-specific T-cell proliferation.

Conclusions:

The different ontogeny of microglia and MDMs lead to divergent responses and functions in the inflamed brain as these 2 cell populations differ in phagocytic functions and antigen-presenting capabilities in the brain after ICH.
Pseudostaurosira crateri sp. nov. (Fragilariaceae, Bacillariophyta), a new small araphid, fossil diatom species from the Pleistocene (Atlantic Forest, Brazil)
Authors: MARQUARDT GISELE C. , BICUDO DENISE C. , BICUDO CARLOS E. DE M. , LEDRU MARIE-PIERRE , ECTOR LUC , WETZEL CARLOS E.
Published: April 2021

Pseudostaurosira crateri sp. nov. is described from fossil material analyzed from a Quaternary sediment core retrieved from the Colônia basin (located in the Brazilian Coastal Plain, Atlantic Forest, São Paulo Metropolitan Region). Light and scanning electron microscopy revealed its morphology and enabled its comparison with morphologically similar species from European and African rivers and lakes. The new species features wide and short vimines, a particular characteristic of the genus Pseudostaurosira, in addition to many other exclusive features that distinguish it from any other species in the genus reported to date. Some of these characteristics are: (i) apical pore fields composed of small poroids placed within cavernous troughs carved deep into the valve, (ii) absence of blisters or depositions along the valve mantle edge, (iii) small-sized valve, (iv) presence of incipient or rudimentary spines located on raised virgae at the valve face/mantle junction, and (v) internal accumulations of siliceous material on the volae appearing as concentric discs partially occluding the depression into which the areolae open internally. We further discuss the morphological features of similar species ascribed to the genera Pseudostaurosira, Pseudostaurosiropsis, Staurosirella, Frankophila, and Popovskayella based on literature information. Finally, this study contributes to the knowledge on diatom diversity and its biogeography, especially those from tropical regions, in addition to providing a taxonomical basis for its use as biological markers for paleoenvironmental reconstruction.
ADABBOY: African Dust And Biomass Burning Over Yucatan
Authors: Raga Graciela B. , Ladino Luis A. , Baumgardner Darrel , Ramirez-Romero Carolina , Córdoba Fernanda , Alvarez-Ospina Harry , Rosas Daniel , Amador Talib , Miranda Javier , Rosas Irma , Jaramillo Alejandro , Yakobi-Hancock Jacqueline , Kim Jong Sung , Martínez Leticia , Salinas Eva , Figueroa Bernardo
Published: April 2021

Biomass burning (BB) emissions and African dust (AD) are often associated with poor regional air quality, particularly in the tropics. The Yucatan Peninsula is a fairly pristine site due to predominant trade winds, but occasionally BB and AD plumes severely degrade its air quality. The African Dust And Biomass Burning Over Yucatan (ADABBOY) project (January 2017–August 2018) was conducted in the Yucatan Peninsula to characterize physical and biological properties of particulate pollution at remote seaside and urban sites. The 18-month-long project quantified the large interannual variability in frequency and spatial extent of BB and AD plumes. Remote and urban sites experienced air quality degradation under the influence of these plumes, with up to 200% and 300% increases in coarse particle mass under BB and AD influence, respectively. ADABBOY is the first project to systematically characterize elemental composition of airborne particles as a function of these sources and identify bioaerosol over Yucatan. Bacteria, actinobacteria (both continental and marine), and fungi propagules vary seasonally and interannually and revealed the presence of very different species and genera associated with different sources. A novel contribution of ADABBOY was the determination of the ice-nucleating abilities of particles emitted by different sources within an undersampled region of the world. BB particles were found to be inefficient ice-nucleating particles at temperatures warmer than −20°C, whereas both AD and background marine aerosol activated ice-nucleating particles below −10°C.
How Does Vertical Wind Shear Influence Entrainment in Squall Lines?
Authors: Mulholland Jake P. , Peters John M. , Morrison Hugh
Published: April 2021

The influence of vertical wind shear on updraft entrainment in squall lines is not well understood. To address this knowledge gap, a suite of high-resolution idealized numerical model simulations of squall lines were run in various vertical wind shear (hereafter “shear”) environments to study the effects of shear on entrainment in deep convective updrafts. Low-level horizontal mass flux into the leading edge of the cold pool was strongest in the simulations with the strongest low-level shear. These simulations consequently displayed wider updrafts, less entrainment-driven dilution, and larger buoyancy than the simulations with comparatively weak low-level shear. An analysis of vertical accelerations along trajectories that passed through updrafts showed larger net accelerations from buoyancy in the simulations with stronger low-level shear, which demonstrates how less entrainment-driven dilution equated to stronger updrafts. The effects of upper-level shear on entrainment and updraft vertical velocities were generally less pronounced than the effects of low-level shear. We argue that in addition to the outflow boundary-shear interactions and their effect on updraft tilt established by previous authors, decreased entrainment-driven dilution is yet another beneficial effect of strong low-level shear on squall-line updraft intensity.
Centennial-scale variability of terrestrial near-surface wind speed over China from reanalysis
Authors: Shen Cheng , Zha Jinlin , Wu Jian , Zhao Deming
Published: April 2021

Investigations of variations and causes of near-surface wind speed (NWS) further understanding of the atmospheric changes and improve the ability of climate analysis and projections. NWS varies on multiple temporal scales; however, the centennial-scale variability in NWS and associated causes over China remains unknown. In this study, we employ the European Centre for Medium-Range Weather Forecasts (ECMWF) twentieth century reanalysis (ERA-20C) to study the centennial-scale changes in NWS from 1900–2010. Meanwhile, a forward stepwise regression algorithm is used to reveal the relationships between NWS and large-scale ocean-atmosphere circulations. The results show three unique periods in annual mean NWS over China from 1900–2010. The annual mean NWS displayed a decreasing trend of -0.87% decade-1 and -11.75% decade-1 from 1900–1925 and 1957–2010, respectively, which were caused by the decreases in the days with strong winds, with trends of -6.64 and -4.66 days decade-1, respectively. The annual mean NWS showed an upward trend of 55.47% decade-1 from 1926–1956, which was caused by increases in the days with moderate (0.43 days decade-1) and strong winds (23.55 days decade-1). The reconstructed wind speeds based on forward stepwise regression algorithm matched well with the original wind speeds; therefore, the decadal changes in NWS over China at centennial-scale were mainly induced by large-scale ocean-atmosphere circulations, with the total explanation power of 66%. The strongest explanation power was found in winter (74%), and the weakest explanation power was found in summer (46%).
The numerical implementation of land models: Problem formulation and laugh tests
Authors: Clark Martyn P. , Zolfaghari Reza , Green Kevin R. , Trim Sean , Knoben Wouter J. M. , Bennett Andrew , Nijssen Bart , Ireson Andrew , Spiteri Raymond J.
Published: April 2021

The intent of this paper is to encourage improved numerical implementation of land models. Our contributions in this paper are two-fold. First, we present a unified framework to formulate and implement land model equations. We separate the representation of physical processes from their numerical solution, enabling the use of established robust numerical methods to solve the model equations. Second, we introduce a set of synthetic test cases (the laugh tests) to evaluate the numerical implementation of land models. The test cases include storage and transmission of water in soils, lateral sub-surface flow, coupled hydrological and thermodynamic processes in snow, and cryosuction processes in soil. We consider synthetic test cases as “laugh tests” for land models because they provide the most rudimentary test of model capabilities. The laugh tests presented in this paper are all solved with the Structure for Unifying Multiple Modeling Alternatives model (SUMMA) implemented using the SUite of Nonlinear and DIfferential/Algebraic equation Solvers (SUNDIALS). The numerical simulations from SUMMA/SUNDIALS are compared against (1) solutions to the synthetic test cases from other models documented in the peer-reviewed literature; (2) analytical solutions; and (3) observations made in laboratory experiments. In all cases, the numerical simulations are similar to the benchmarks, building confidence in the numerical model implementation. We posit that some land models may have difficulty in solving these benchmark problems. Dedicating more effort to solving synthetic test cases is critical in order to build confidence in the numerical implementation of land models.
The COVID Connection: Pandemic Anxiety, COVID-19 Comprehension, and Digital Confidence
Authors: Robinson Laura , Schulz Jeremy , Wiborg Øyvind N. , Johnston Elisha
Published: April 2021

This article presents logistic models examining how pandemic anxiety and COVID-19 comprehension vary with digital confidence among adults in the United States during the first wave of the pandemic. As we demonstrate statistically with a nationally representative data set, the digitally confident have lower probability of experiencing physical manifestations of pandemic anxiety and higher probability of adequately comprehending critical information on COVID-19. The effects of digital confidence on both pandemic anxiety and COVID-19 comprehension persist, even after a broad range of potentially confounding factors are taken into account, including sociodemographic factors such as age, gender, race/ethnicity, metropolitan status, and partner status. They also remain discernable after the introduction of general anxiety, as well as income and education. These results offer evidence that the digitally disadvantaged experience greater vulnerability to the secondary effects of the pandemic in the form of increased somatized stress and decreased COVID-19 comprehension. Going forward, future research and policy must make an effort to address digital confidence and digital inequality writ large as crucial factors mediating individuals’ responses to the pandemic and future crises.
Survey of Anesthesiologists on Topical Vasoconstrictors and Intravenous Tranexamic Acid for Endoscopic Sinus Surgery
Authors: Feng Max , Lao Veronica F. , Choby Garret , Bolton Patrick B. , Marino Michael J. , Weingarten Toby N. , Humphreys Ian M. , Dhillon Sabrina K. , Choi Byeong Y. , Fernandez Roman A. , Mehter Najma S. , Chen Philip G.
Published: April 2021

Objectives:

Topical vasoconstrictors and intravenous tranexamic acid (IV TXA) are safe and efficacious to decrease bleeding and improve the surgical field during endoscopic sinus surgery (ESS). The purpose of this study was to investigate practice patterns, awareness of clinical evidence, and comfort levels among anesthesia providers regarding these hemostatic agents for ESS.

Methods:

A total of 767 attending anesthesiologists, residents, and certified registered nurse anesthetists (CRNAs) at 5 United States academic centers were invited to participate in a survey regarding their experience with IV TXA and 3 topical vasoconstrictor medications (oxymetazoline, epinephrine, and cocaine) during ESS.

Results:

330 (47%) anesthesia providers responded to the electronic survey. 113 (97%) residents, 92 (83%) CRNAs, and 52 (68%) attendings managed 5 or fewer ESS cases per month. Two-thirds of providers had not reviewed efficacy or safety literature for these hemostatic agents. Oxymetazoline was perceived safest, followed by epinephrine, IV TXA, and cocaine. Respondents considered potential side effects over surgical field visibility when selecting agents. The majority of providers had no formal training on these agents for ESS, but indicated interest in educational opportunities.

Conclusion:

Many anesthesia providers are unfamiliar with safety and efficacy literature regarding agents used to improve hemostasis for ESS, highlighting a need for development of relevant educational resources. Rhinologic surgeons have an opportunity to communicate with anesthesia colleagues on the use of hemostatic agents to improve the surgical field during ESS.
Head Over Wheels: Traumatic Head and Neck Injuries Secondary to Mountain Biking
Authors: Kshirsagar Rijul S. , Xiao Chris , Chou David W. , Krishnan Srikanth , Christian Ashton B. , Labadie Kevin P. , Brodsky Merrick A. , Liang Jonathan
Published: April 2021

Objectives:

The popularity of mountain biking (MTB) in the United States has risen in recent years. We sought to identify the prevalence and distribution of MTB associated head and neck injuries presenting to emergency departments across the U.S. and identify risk factors for hospital admission in this patient population.

Methods:

The National Electronic Injury Surveillance System (NEISS) was queried for MTB related injuries of the head and neck from 2009 to 2018, with analysis for incidence, age, gender, anatomic site, and diagnoses.

Results:

A total of 486 cases were identified, corresponding to an estimated 18 952 head and neck MTB related ED visits. Patients were predominantly male (80.7%) and white (69.8%) with a median age of 35 years (interquartile range, 21-46 years). A majority (88.4%) of patients were released from the ED, but a significant proportion of patients were admitted (9.2%) or transferred (1.2%). The most common facial fractures were facial/not specified (35%), nasal bone (29%), mandible (15%), orbit (12%), and zygomaxillary complex (9%). The greatest predictors of hospital admission/transfer were injury to the mouth or neck and avulsion-type injury ( P < .001).

Conclusions:

MTB results in a significant number of traumatic head and neck injuries nationwide. Patients are primarily adult, white males. The majority of injuries result in discharge from the ED, however a small amount of these patients experience significant morbidity necessitating hospital admission. Understanding the distribution of MTB head and neck injuries may aid in the clinical evaluation of these patients.

Level of Evidence:

4
Student Experience Outcomes in Racially Integrated Schools: Looking Beyond Test Scores in Six Districts
Authors: Schneider Jack , Piazza Peter , White Rachel S. , Carey Ashley
Published: April 2021

In this study, we examine eight social and emotional outcomes (e.g., student engagement, sense of belonging) analyzing differences for students who attend racially diverse schools. Drawing on survey responses from roughly 26,000 students, we find that racially diverse schools are associated with more positive social and emotional outcomes for all students. Strikingly, we find that these outcomes are most uniformly positive among white students, whose families have long represented the strongest opposition to systematic racial desegregation. In light of these results, this study has implications for educators, advocates, researchers, and policy makers during a time of renewed attention to school integration.
A magnetically controlled series compensation-fault current limiter
Authors: Yao Lei , Wang Ruixin
Published: April 2021

This paper presents a magnetically controlled series compensation-fault current limiter (MCSC-FCL) which is composed of a magnetically controlled reactor (MCR) and a compensation capacitor. The device is improved from the traditional thyristor-controlled series compensation (TCSC), which has the characteristics of small output harmonics and simple control. The traditional saturated iron-core reactor is improved to increase the adjustable range of output reactance. During the fault, the MCR is connected to the grid alone to limit fault current; when the grid is normal, MCR and capacitor are used in series compensation mode. It effectively improves the utilization rate of the traditional current limiter MCR. In order to verify the effectiveness of the proposed MCSC-FCL, this paper analyzes the control characteristics of reactor models with different air gap structures by JMAG finite element analysis software, and verifies the voltage regulation characteristics and fault current limitation capabilities on MATLAB/Simulink platform.