bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the impact of private land conservation with synthetic control design
Authors: Sharma Roshan , Jones Simon , Robinson Doug , Gordon Ascelin
Published: July 2023

Programs to protect biodiversity on private land are increasingly being used worldwide. To understand the efficacy of such programs, it is important to determine their impact: the difference between the program's outcome and what would have happened without the program. Typically, these programs are evaluated by estimating the average program‐level impact, which readily allows comparisons between programs or regions, but masks important heterogeneity in impact across the individual conservation interventions. We used synthetic control design, statistical matching, and time‐series data to estimate the impact of individual protected areas over time and combined individual‐level impacts to estimate program‐level impact with a meta‐analytic approach. We applied the method to private protected areas governed by conservation covenants (legally binding on‐title agreements to protect biodiversity) in the Goldfields region of Victoria, Australia using woody vegetation cover as our outcome variable. We compared our results with traditional approaches to estimating program‐level impact based on a subset of covenants that were the same age. Our results showed an overall program‐level impact of a 0.3–0.8% increase in woody vegetation cover per year. However, there was significant heterogeneity in the temporal pattern of impact for individual covenants, ranging from −4 to +7% change in woody vegetation cover per year. Results of our approach were consistent with results based on traditional approaches to estimating program‐level impact. Our study provides a transparent and robust workflow to estimate individual and program‐level impacts of private protected areas.
Fighting the COVID‐19 pandemic: A socio‐cultural insight into Pakistan
Authors: Shekhani Sualeha Siddiq , Moazam Farhat , Jafarey Aamir
Published: July 2023

During the COVID‐19 pandemic, healthcare professionals around the world were driven by universal values of solidarity and duty to provide care. However, local societal norms and existing healthcare systems influenced interactions among physicians, and with patients and their families. An exploratory qualitative study design using in‐depth interviews was undertaken with physicians working at two public sector hospitals in Karachi, Pakistan. Using the constant comparison method of data analysis, several key themes were identified highlighting norms of kinship and interdependencies characteristic of collectivistic societies that influenced professional interactions. The role of seniors in the hierarchical society of Pakistan played a major role in provision of care. Physicians reported numerous challenges in dealing with patients and their families amidst public denial fueled due to ill‐formed government policies. This included interruption of funeral rites which undermined public trust. The study provides insights into the local moral world of two healthcare institutions in Pakistan.
Digital transformation in healthcare using eagle perching optimizer with deep learning model
Authors: Thilagavathy R. , Jagadeesan J. , Parkavi A. , Radhika M. , Hemalatha S. , Galety Mohammad Gouse
Published: July 2023

The COVID‐19 epidemic accelerated the digital change of several services, including healthcare, and increased access to telemedicine. As a result, an increasing number of web tools were introduced to meet patient needs. A safe database can be created in the healthcare industry as a result of digital transformation. This database can be used to protect, store, and share private patient data with healthcare workers, labs, and medical specialists. Designing efficient decision‐making tools for COVID‐19 diagnostics is now possible thanks to recent developments in information technology and deep learning (DL) models. In this paper, a novel method for diagnosing COVID‐19 using deep learning‐enhanced eagle perching optimizer (DTH‐EPODL) model is presented. With the help of the IoT and the presented DTH‐EPODL model, patient information can be gathered and analysed for illness detection. The DTH‐EPODL model uses the Gaussian filtering (GF) method to remove noise in the initial step. Additionally, MixNet, a deep convolutional neural network‐based method, is used for feature extraction. Using the deep autoencoder (DAE) algorithm, COVID‐19 detection and categorization are accomplished. Finally, the DAE approach's associated hyperparameters can be best adjusted using the EPO method, which enhances categorization results. Benchmark chest x‐ray datasets can be used to evaluate the experimental validity of the DTH‐EPODL method. The experimental results showed that the DTH‐EPODL technique outperformed more modern methods.
Prediction of CO pollutant in Mashhad metropolis, Iran: Using multiple linear regression
Authors: Rahnama Mohammad Rahim , Abkooh Shirin Sabaghi
Published: July 2023

Given the importance of carbon monoxide (CO) in acute health threats, studies have been conducted in different countries and cities (272 cities in China and 337 cities on a global scale) on the relationship between daily mortality and CO while the spatial analysis of factors affecting CO pollutant in cities, especially in developing countries, has rarely been done. Accordingly, this research has measured the effect of five environmental‐social variables (ESVs) on the spatial distribution of CO pollutants in the metropolis of Mashhad, Iran. CO concentration data were collected in 23 air pollutant monitoring stations in an area of 356 km2 in 2019. Then, the relationship between five variables and CO pollutant were measured using linear and multiple regression by Sentinel 2A and 3 satellite images in ArcGIS and TerrSet software. The results show that the mean CO concentration averages at 1.56 ppm in the whole city. But its range varies between 0.171 and 2.907 ppm, which is a low figure compared with presented standards and does not indicate a critical situation. The results of multiple regression indicate that 42% of the variance in CO concentration is explained by independent variables. Among five independent variables, the beta value of the land surface temperature (LST) and digital elevation model (DEM) variables is negative and positive for the other three variables, including population density, normalised difference vegetation index (NDVI) and normalised difference built‐up index (NDBI). It should be noted that the strongest correlating variable is population density. Prediction of the spatial distribution of CO pollutants shows the division of the city into three areas: (1) the south and southwest slopes of the city with a low concentration; (2) central areas with a medium concentration; and (3) northern and northeastern areas of the city with a high concentration where low‐income groups reside and there are more worn‐out vehicles, motorcycles and industrial workshops. Areas with high CO concentration need more attention from urban managers.
Oral frailty five‐item checklist to predict adverse health outcomes in community‐dwelling older adults: A Kashiwa cohort study
Authors: Tanaka Tomoki , Hirano Hirohiko , Ikebe Kazunori , Ueda Takayuki , Iwasaki Masanori , Shirobe Maki , Minakuchi Shunsuke , Akishita Masahiro , Arai Hidenori , Iijima Katsuya
Published: July 2023

Aim

To enable easy assessment of oral frailty; that is, an overlapping slight decline in multifaceted oral function, in any setting, we developed the oral frailty five‐item checklist (OF‐5), and examined its predictive validity for increased risks of physical frailty, physical disability and mortality among community‐dwelling older adults.

Methods

This population‐based cohort study randomly selected 2044 residents in Kashiwa, Japan, with no long‐term care needs. Baseline data were collected in 2012, and follow‐up data were collected in 2013, 2014, 2016, 2018 and 2021. The OF‐5 includes five measures: fewer teeth, difficulty in chewing, difficulty in swallowing, dry mouth and low articulatory oral motor skills. Physical frailty was defined according to the Cardiovascular Health Study criteria. Physical disability and mortality determined from the long‐term care insurance receipt database were followed for 9 years.

Results

Of 2031 eligible participants (mean age 73.1 ± 5.6 years; 51.1% women), 39.3% individuals with ≥2 OF‐5 points had significantly increased prevalence and new‐onset rate of physical frailty. After adjusting for potential confounders, oral frailty, defined as ≥2 OF‐5 points, was associated with increased risks of physical disability (adjusted hazard ratio 1.40; 95% confidence interval 1.14–1.72) and mortality (adjusted hazard ratio 1.44; 95% confidence interval 1.11–1.87). The highest adjusted hazard ratios were observed in older adults with coexisting physical and oral frailty.

Conclusions

The OF‐5 showed strong predictive validity for physical frailty, physical disability and mortality in Japanese older adults. This assessment tool can be implemented in various settings and foster comprehensive prevention through interprofessional collaboration. Geriatr Gerontol Int 2023; 23: 651–659.
Factors influencing normal blood pressure maintenance in young adults
Authors: Li Man , Zhao Lei , Zhang Li , Li Peng , Zhang Xiaoling , Wang Chong , Li Xinyuan , Wu Shouling , Sun Lixia
Published: July 2023

Despite an alarming increase in the prevalence of hypertension among Chinese young adults, longitudinal studies investigating factors that affect the maintenance of normal blood pressure (BP) in this population are lacking. Our study aimed to address this knowledge gap. A total of 7100 participants from the Kailuan Study who had normal BP and were aged <30 years at their first physical examination between 2006 and 2016 were included in this study. Cox proportional hazards regression models were used to assess hazard ratios (HR), and 95% confidence intervals (CI) were calculated to assess the associations between influencing factors and the maintenance of normal BP in young adults. Analyses were stratified by sex. During the follow‐up period (mean, 7.98 years), 1921 participants (27.06%) maintained normal BP. Higher education levels (HR, 1.11; 95% CI, 1.00–1.22), low salt intake (HR, 1.25; 95% CI, 1.04–1.51), being underweight (HR, 1.16; 95% CI, 1.02–1.31), and having normal weight (HR, 1.19; 95% CI, 1.01–1.39), normal blood glucose (HR, 1.22; 95% CI, 1.02–1.46), and no family history of hypertension (HR, 1.65; 95% CI, 1.41–1.92) at baseline were found to be associated with maintaining normal BP. Compared with female smokers, female non‐smokers had 1.68 times higher odds of maintaining normal BP. This study identified factors that influence the maintenance of normal BP in the young population in China. This information can assist clinicians in establishing comprehensive and effective primary prevention measures for hypertension.
PRMT5activatesKLF5by methylation to facilitate lung cancer
Authors: Zhou Hai , Chang Jing , Zhang Jingjian , Zheng Hongzhen , Miao Xiang , Mo Huimin , Sun Jie , Jia Qin , Qi Guangsheng
Published: July 2023

The highly expressed oncogenic factor Krüppel‐like factor 5 (KLF5) promotes various cancerous processes, such as cell growth, survival, anti‐apoptosis, migration and metastasis, particularly in lung cancer. Nevertheless, the modifications to KLF5 after translation are poorly understood. Protein arginine methyltransferase 5 (PRMT5) is considered as an oncogene known to be involved in different types of carcinomas, including lung cancer. Here, we show that the expression levels of PRMT5 and KLF5 are highly expressed lung cancer. Moreover, PRMT5 interacts with KLF5 and facilitates the dimethylation of KLF5 at Arginine 41 in a manner that depends on methyltransferase activity. Downregulation or pharmaceutical suppression of PRMT5 reduces the expression of KLF5 and its downstream targets both in vitro and in vivo. Mechanistically, the dimethylation of KLF5 by PRMT5 promotes the maintenance and proliferation of lung cancer cells at least partially by stabilising KLF5 via regulation of the Akt/GSK3β signalling axis. In summary, PRMT5 methylates KLF5 to prevent its degradation, thereby promoting the maintenance and proliferation of lung cancer cells. These results suggest that targeting PRMT5/KLF5 axis may offer a potential therapeutic strategy for lung cancer.
A case of ovarian carcinosarcoma with a germline pathogenic variant of BRCA2 involving a perforated appendix with an abscess
Authors: Saito Ayaka , Yamashita Eiko , Sakurai Urara , Hirasawa Akira , Tanioka Maki , Tamura Kazuya , Umezawa Satoshi
Published: July 2023

We report a case of rare and aggressive ovarian carcinosarcoma with a germline pathogenic BRCA2 variant. A patient with a history of breast cancer who developed an inflammatory ovarian tumor with peritonitis carcinomatosis involving the appendix suffered from cachexia. Following three cycles of weekly paclitaxel and carboplatin chemotherapy, emergency surgery was required owing to sepsis. Bilateral salpingo‐oophorectomy, total hysterectomy, appendectomy, and small intestine adhesiolysis were performed. Histologically, the tumor comprised an admixture of carcinomatous and sarcomatous components, with involvement of the appendix, which had caused perforation and abscess formation. The final diagnosis was ovarian carcinosarcoma with a germline pathogenic BRCA2 variant, c.658_659del (p.Val220fs). The patient responded completely to adjuvant chemotherapy. A combination of chemotherapy and surgery might be beneficial to patients with ovarian carcinosarcoma and germline pathogenic BRCA2 variants with a poor general condition. This is the first report of ovarian carcinosarcoma with a germline pathogenic BRCA2 variant that responded favorably to chemotherapy.
Whole exome sequencing identifies a novel homozygous missense mutation of LHCGR gene in primary infertile women with empty follicle syndrome
Authors: Xu Yang , Wang Enhua , Liu Tianfeng , Wang Surong , Wu Fengxia , Zhao Xiangyu , Wang Ancong
Published: July 2023

Aim

The genetic basis of empty follicle syndrome (EFS) is largely unknown, and the aim of this study was to investigate the genetic causes of EFS in primary infertile women.

Methods

Four affected women diagnosed with anovulation were recruited, and whole exome sequencing (WES) was requested for the genetic diagnosis of the cases. One hundred healthy controls were verified by Sanger sequencing.

Results

A novel homozygous variant of the LHCGR gene (NM_000233:c.1847C>A) was revealed in one affected individual by WES. Trios analysis of the mutation revealed an autosomal recessive pattern. This LHCGR variant was absent in 100 healthy controls and predicted to be highly damaging to the function of LHCGR.

Conclusions

The novel variant extends the mutational spectrum of the LHCGR gene associated with female sterility, which promotes the prognostic value of testing for LHCGR mutations in infertile women with EFS.
Development of a multiplex RT‐RPA assay for simultaneous detection of three viruses in cucurbits
Authors: Jailani A. Abdul Kader , Paret Mathews L.
Published: July 2023

Begomoviruses and criniviruses, vectored by whiteflies (Bemisia tabaci), are important threats to crops worldwide. In recent years, the spread of cucurbit leaf crumple virus (CuLCrV), cucurbit yellow stunting disorder virus (CYSDV) and cucurbit chlorotic yellows virus (CCYV) on cucurbit crops has been reported to cause devastating crop losses in many regions of the world. In this study, a multiplex recombinase polymerase amplification (RPA) assay, an isothermal technique for rapid and simultaneous detection of DNA and RNA viruses CuLCrV, CYSDV and CCYV was developed. Highly specific and sensitive multiplex RPA primers for the coat protein region of these viruses were created and evaluated. The sensitivity of the multiplex RPA assay was examined using serially diluted plasmid containing the target regions. The results demonstrated that multiplex RPA primers have high sensitivity with a detection limit of a single copy of the viruses. The multiplex RPA primers were specific to the target as indicated by testing against other begomoviruses, potyviruses and an ilarvirus, and no nonspecific amplifications were noted. The primers simultaneously detected mixed infection of CCYV, CYSDV and CuLCrV in watermelon and squash crude extracts. This study is the first report of a multiplex RPA assay for simultaneous detection of mixed infection of DNA and RNA plant viruses.
Insights into the pathological basis of dementia from population‐based neuropathology studies
Authors: Wharton Stephen B. , Simpson Julie E. , Ince Paul G. , Richardson Connor D. , Merrick Richard , Matthews Fiona E. , Brayne Carol ,   CFAS
Published: July 2023

The epidemiological neuropathology perspective of population and community‐based studies allows unbiased assessment of the prevalence of various pathologies and their relationships to late‐life dementia. In addition, this approach provides complementary insights to conventional case–control studies, which tend to be more representative of a younger clinical cohort. The Cognitive Function and Ageing Study (CFAS) is a longitudinal study of cognitive impairment and frailty in the general United Kingdom population. In this review, we provide an overview of the major findings from CFAS, alongside other studies, which have demonstrated a high prevalence of pathology in the ageing brain, particularly Alzheimer's disease neuropathological change and vascular pathology. Increasing burdens of these pathologies are the major correlates of dementia, especially neurofibrillary tangles, but there is substantial overlap in pathology between those with and without dementia, particularly at intermediate burdens of pathology and also at the oldest ages. Furthermore, additional pathologies such as limbic‐predominant age‐related TDP‐43 encephalopathy, ageing‐related tau astrogliopathy and primary age‐related tauopathies contribute to late‐life dementia. Findings from ageing population‐representative studies have implications for the understanding of dementia pathology in the community. The high prevalence of pathology and variable relationship to dementia status has implications for disease definition and indicate a role for modulating factors on cognitive outcome. The complexity of late‐life dementia, with mixed pathologies, indicates a need for a better understanding of these processes across the life‐course to direct the best research for reducing risk in later life of avoidable clinical dementia syndromes.
Feminine leadership and juvenile justice outcomes: The Florida experience
Authors: Jackson William T. , Neshkova Milena I. , Newman Meredith A.
Published: July 2023

In this paper, we ask whether female top law enforcement officials can steer justice provision on the ground. While prior research has documented that female street‐level bureaucrats advance the interests of their female clients, we know little about how female leaders influence the distribution of street‐level outcomes. This study draws on juvenile justice and inquires whether youth arrests and prosecutions vary as a function of the sheriff's and state attorney's sex. We expect counties and circuits led by female sheriffs and state attorneys to experience fewer youth arrests and prosecutions than those led by men, especially among female and minority offenders. Data from Florida's 67 counties between 2015 and 2020 reveal that women's leadership is associated with less severe outcomes for all young offenders, not just females. We also find that gender and feminine leadership theories hold more explanatory power in this context than representative bureaucracy and gendered organizational socialization.
Whither ethics in research? Randomized controlled trials at the nexus of technocratization and Eurocentrism
Authors: Chamola Bikalp
Published: July 2023

The use of randomized controlled trials (RCTs) as a methodological approach has become ubiquitous across disciplines, particularly in development economics. Building on the existing scholarship critiquing the widespread deployment of RCTs, this paper argues that the lack of a nuanced engagement with the concept of objectivity creates fertile grounds for the technocratization of social science research. The technocratic discourse that shapes the use of RCTs makes them susceptible to two potential dangers: perpetuating politics of partner organizations and Eurocentrism. To illustrate these issues, this paper utilizes a recently published RCT titled ‘Randomizing Religion’ as a case study. Two important conclusions are drawn by analyzing the case. First, a lack of engagement with the worldviews and assumptions from which causal mechanisms are drawn leads to a normative imposition of a Eurocentric social reality onto the marginalized communities in the Global South. Second, participation in the activities of a partner organization during the conduct of the RCT requires researchers to reflect on the organization's politics and its ramifications for marginalized communities. Finally, this paper contributes to an ongoing conversation about including strong reflexivity in the conduct of research in economics.
Repair of femoral fractures in calves via external skeletal fixator with intramedullary pin tie‐in
Authors: Hilliard Rachel L. , Livesey Michael A. , De Gasperi Diego
Published: July 2023

Objective

To describe the success rate and associated complications of external skeletal fixator/intramedullary pin tie‐in for calf femoral fracture fixation.

Study Design

Clinical retrospective.

Animals

Ten calves, less than 30 days old, with diaphyseal/metaphyseal femoral fractures.

Methods

Medical records were reviewed from the University of Wisconsin from 2000 to 2020. Fractures were repaired using open reduction and fixation. An intramedullary Steinman pin was placed, exiting near the greater trochanter, and utilized for fracture reduction. Bicortical transfixation pins were placed distal and proximal to the fracture site. Poly(methyl methacrylate) (PMMA)‐filled tubing connected the transfixation pins and proximal intramedullary pin, creating a Type 1a external skeletal fixator (ESF) tie‐in. Follow up was obtained via medical records and phone interviews.

Results

Short‐term survival rate was 7/10 (70%). Postanesthetic death occurred once. Postoperative complications occurred in all remaining cases. The most common findings were transfixation pin tract lucency and lameness (6/9 cases), implant dysfunction (5/9 cases), and infection (4/9 cases). Three of five cases with long‐term follow up survived; all went on to productive careers.

Conclusion

Although patients were prone to postoperative complications, short‐term survival was comparable to previous reports.

Clinical Significance

The external skeletal fixator/intramedullary (ESF/IM) pin tie‐in is less expensive and offers comparable success rates to other methods, providing a lower cost option for calf femoral fracture repair.
Control of Heracleum mantegazzianum with pyrolysis liquid products
Authors: Hyvönen Terho T. , Hagner Marleena M. , Hurme Timo K. , Lindqvist Bengt E. , Ojanen Hannu J.
Published: July 2023

Heracleum mantegazzianum is an invasive environmental weed that is widely distributed in Europe and whose distribution is continually expanding. Novel management methods are required to address its impacts and spread. We studied the use of pyrolysis liquids (PL) as a component of biodegradable mulch and as biobased herbicide to control H. mantegazzianum. A five‐year field experiment was conducted to compare pyrolysis liquid peat mulch (PLM) with plastic PE–mulch, biobased Ökolys® mulch and glyphosate. Application of PL biobased herbicide after stem cutting was studied in a one‐year field experiment. We established that PLM does not control the growth or reproduction of mature H. mantegazzianum effectively in contrast with the other mulching materials and glyphosate. The coverage of H. mantegazzianum differed only in 1 year between application of PLMs and the control. The number of flower stems increased in PLM treatments and in the control, indicating that PLM failed to control reproduction and spread of H. mantegazzianum. PL treatment of cut H. mantegazzianum stems was more effective than application of acetic acid alone. The results suggest that biobased control methods do not provide as effective control of H. mantegazzianum as widely used current methods (plastic mulches and glyphosate). If biobased methods are to be more widely used for controlling H. mantegazzianum, lower control efficacy must be accepted, and they should be used in an integrated approach with other methods.
Acoustic Levitation-Assisted Contactless Printing of Microdroplets for Biomedical Applications
Authors: Tang Tengteng , Joralmon Dylan , Anyigbo Tochukwu , Li Xiangjia
Published: July 2023

The cell is a microcapsule system wherein biological materials are encapsulated by a thin membrane, which provides valuable information on the metabolism, morphology, development, and signal transduction pathways of the studied cell. The cell-inspired microdroplet has the characteristics of efficient nanoscale substance transportation, self-organization, and morphological adaptation. However, it is extremely difficult to manufacture such systems. Mostly vesicles such as liposomes, polymersomes, and microcapsules are first produced by a high-pressure homogenizer and microfluidizer as an emulsion and then encapsulated microcapsules by the drop or emulsion method. Currently, acoustic levitation opens entirely new possibilities for creating bioinspired microdroplets because of its ability to suspend tiny droplets in an antigravity and noncontact manner. Herein, we propose contactless printing of single-core or multi-core cell-inspired microdroplets via acoustic levitation. First, the oscillation mode and microscopic morphology of the droplets under different ultrasonic vibration frequencies are shown by simulation, and the curing characteristics of the shell structure under different ultraviolet illumination conditions are quantitatively measured. The feasibility of manufacturing multi-core microdroplets and manufacturing submillimeter-scale particles based on oil trapping is extensively studied. To explore the morphological adaptability of microdroplets, ferromagnetic Fe3O4 nanoparticles are used to give magnetic-responsive properties to cells, and the microscopic deformation and motion in microfluidic channels under the magnetic field are characterized. Finally, the proposed printing method proves the versatility of in-space contactless printing of complex 3D beam structures and provides a powerful platform for developing biomedical devices and microrobots and studying morphogenesis and synthetic biological systems.
A Pointwise-Optimal Ensemble of Surrogate Models
Authors: Liang Pengwei , Zhang Shuai , Pang Yong , Li Jianji , Song Xueguan
Published: July 2023

The ensemble of surrogate models is commonly used to replace computationally expensive simulations due to their superior prediction accuracy and robustness compared to individual models. This paper proposes a new pointwise ensemble of surrogate models, namely, a pointwise-optimal ensemble of surrogate models (POEMs). To address the limitations of the cross-validation (CV) error in evaluating the performance of regression surrogate models, this paper introduces the compensated cross-validation error, which is more reliable in selecting better individual surrogate models and improving the accuracy of surrogate model ensembles. To overcome the limitations of CV error in calculating pointwise weight factors, this paper designs and solves an optimization problem at training points to obtain corresponding pointwise weight factors. Additionally, this paper proposes two weight calculation methods to be applied in the interpolation and extrapolation regions, respectively, to reduce the instability of ensembles caused by extrapolation. Thirty test functions are employed to investigate the appropriate hyperparameters of POEM and the Friedman test is used to verify the rationality of the α value. The thirty test functions are also used to examine the performance of POEM and compare it with state-of-the-art ensemble surrogate models. Furthermore, POEM is applied to a large-aperture mirror holder optimization case to verify its superiority. The results demonstrate that POEM presents better accuracy and robustness than individual surrogates and other compared ensembles of surrogate models.
Single-Actuated Camshaft Robot With Multiple Sequential Motions
Authors: Yan Peng , Huang Hailin , Wang Sen , Li Bing , Zhang Zhifeng
Published: July 2023

Pipeline inspection in unknown environments is challenging for robots, and various in-pipe crawling robots have been developed in recent years to perform pipeline inspection. Most of these robots comprise multiple parts and require multiple actuators to realize the pipeline locomotion, resulting in complicated system composition and large energy consumption. In this paper, inspired by the crawling principles of earthworm locomotion, we propose a single-actuated camshaft robot that can realize multiple sequential motions for pipeline crawling. The proposed single-actuated camshaft robot contains one actuator and three parts: head anchoring, body elongation, and rear anchoring part. The multiple sequential motions of these three parts are realized based on the cam mechanisms. Umbrella-shaped elastic rubbers are circumferentially around the head and rear anchoring parts. Each part contains a cam bracket. The camshaft’s rotatory motion pushes the cam brackets to generate the axial translational motion, resulting in the umbrella-shaped elastic rubbers being expanded or contracted. The proposed camshaft robot’s expansion and contraction motion are sequentially realized by the phase deviation of the camshafts. First, the structures of the proposed robot are designed. Then, the cam curves are modeled, the expansion/contraction ratio of the rear/head anchoring part is calculated, the phase deviation of the camshafts is determined, and multiple sequential motions of the proposed robot are simulated. Finally, we fabricate the proposed camshaft robot and carry out crawling experiments in pipelines with different shapes and diameters.
Whole-genome sequence of an
Aspergillus parasiticus
strain isolated from Kenyan soil
Authors: Schamann Alexandra , Geisen Rolf , Schmidt-Heydt Markus
Published: July 2023

Aspergillus parasiticus
is an important aflatoxigenic fungus, frequently found in soil samples. Here, we report the sequencing of
A. parasiticus
strain MRI410 using Illumina MiSeq and Oxford Nanopore platforms. This strain was isolated from soil of a Kenyan maize field.
Improved paediatric antimicrobial prescribing with a smartphone application: a before and after interventional study
Authors: Primhak Sarah , Pool Natasha , Sam Michelle Shien Yee , Duffy Eamon , Ritchie Stephen R , Webb Rachel , Wilson Elizabeth , Voss Lesley , Best Emma J
Published: July 2023

Introduction

Children have a high consumption of antimicrobials that require complicated decision-making by prescribers. Despite this, antimicrobial stewardship (AMS) interventions are often not translated into paediatric medicine. Script is a smartphone application (app) launched in Auckland, New Zealand to support decision-making for antimicrobial prescribers. The aim was to improve adherence to existing local clinical guidelines for both adult and paediatric infections.

Methods

Inpatient and emergency department antimicrobial prescriptions were prospectively collected and evaluated for guideline adherence. Baseline prescribing data were collected and compared with prescribing at 4 months and 1 year after the app was launched. Prescriptions were graded as ‘appropriate’ or ‘inappropriate’ by investigators. Grading was done blinded to timing of the prescription relative to the intervention.

Results

Following the launch of the Script app, guideline adherence significantly increased from 241 of 348 (69%) antimicrobial prescriptions graded as appropriate during the baseline period to 301 of 359 (83%) after 4 months (p<0.0001). This improvement from baseline was sustained at 1 year with 263 of 323 (81%) adherence (p<0.001). At 1 year, this improvement could be demonstrated separately for medical, surgical and emergency department prescriptions.

Conclusion

There was a significant and sustained improvement in adherence to paediatric antimicrobial guidelines following the introduction of a prescribing support app. The need to seek guidance for antimicrobial doses due to the age-based and weight-based calculations in paediatrics may mean that AMS interventions such as decision support and prescribing tools are particularly well suited to paediatric prescribing.
Study protocol for investigating the clinical performance of an automated blood test for glial fibrillary acidic protein and ubiquitin carboxy-terminal hydrolase L1 blood concentrations in elderly patients with mild traumatic BRAIN Injury and reference values (BRAINI-2 Elderly European study): a prospective multicentre observational study
Authors: Lagares Alfonso , Payen Jean-François , Biberthaler Peter , Poca M Antonia , Méjan Odile , Pavlov Vladislav , Viglino Damien , Sapin Vincent , Lassaletta Aurora , de la Cruz Javier
Published: July 2023

Introduction

Two blood brain-derived biomarkers, glial fibrillar acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), can rule out intracranial lesions in patients with mild traumatic brain injury (mTBI) when assessed within the first 12 hours. Most elderly patients were excluded from previous studies due to comorbidities. Biomarker use in elderly population could be affected by increased basal levels. This study will assess the performance of an automated test for measuring serum GFAP and UCH-L1 in elderly patients to predict the absence of intracranial lesions on head CT scans after mTBI, and determine both biomarkers reference values in a non-TBI elderly population.

Methods and analysis

This is a prospective multicentre observational study on elderly patients (≥65 years) that will be performed in Spain, France and Germany. Two patient groups will be included in two independent substudies. (1) A cohort of 2370 elderly patients (1185<80 years and 1185≥80 years; BRAINI2-ELDERLY DIAGNOSTIC AND PROGNOSTIC STUDY) with mTBI and a brain CT scan that will undergo blood sampling within 12 hours after mTBI. The primary outcome measure is the diagnostic performance of GFAP and UCH-L1 measured using an automated assay for discriminating between patients with positive and negative findings on brain CT scans. Secondary outcome measures include the performance of both biomarkers in predicting early (1 week) and midterm (3 months) neurological status and quality of life after trauma. (2) A cohort of 480 elderly reference participants (BRAINI2-ELDERLY REFERENCE STUDY) in whom reference values for GFAP and UCHL1 will be determined.

Ethics and dissemination

Ethical approval was obtained from the Institutional Review Boards of Hospital 12 de Octubre in Spain (Re#22/027) and Southeast VI (Clermont Ferrand Hospital) (Re# 22.01782.000095) in France. The study’s results will be presented at scientific meetings and published in peer-review publications.

Trial registration number

NCT05425251.
Traditional and novel risk factors for incident aortic stenosis in community-dwelling older adults
Authors: Massera Daniele , Bartz Traci M , Biggs Mary L , Sotoodehnia Nona , Reiner Alexander P , Semba Richard D , Gottdiener John S , Psaty Bruce M , Owens David S , Kizer Jorge R
Published: July 2023

Objectives

Calcific aortic stenosis (AS) is the most common valvular disease in older adults, yet its risk factors remain insufficiently studied in this population. Such studies are necessary to enhance understanding of mechanisms, disease management and therapeutics.

Methods

The Cardiovascular Health Study is a population-based investigation of older adults that completed adjudication of incident AS over long-term follow-up. We evaluated traditional cardiovascular risk factors or disease, as well as novel risk factors from lipid, inflammatory and mineral metabolism pathways, in relation to incident moderate or severe AS (including AS procedures) and clinically significant AS (severe AS, including procedures).

Results

Of 5390 participants (age 72.9±5.6 years, 57.6% female, 12.5% black), 287 developed moderate or severe AS, and 175 clinically significant AS, during median follow-up of 13.1 years. After full adjustment, age (HR=1.66 per SD (95% CI=1.45, 1.91)), male sex (HR=1.41 (1.06, 1.87)), diabetes (HR=1.53 (1.10, 2.13)), coronary heart disease (CHD, HR=1.36 (1.01, 1.84)), lipoprotein-associated phospholipase-A2(LpPLA2) activity (HR=1.21 per SD (1.07, 1.37)) and sCD14 (HR=1.16 per SD (1.01, 1.34)) were associated with incident moderate/severe AS, while black race demonstrated an inverse association (HR=0.40 (0.24, 0.65)), and creatinine-based estimated glomerular filtration rate (eGFRcr) showed a U-shaped relationship. Findings were similar for clinically significant AS, although CHD and sCD14 fell short of significance, but interleukin-(IL) 6 showed a positive association.

Conclusion

This comprehensive evaluation of risk factors for long-term incidence of AS identified associations for diabetes and prevalent CHD, LpPLA2activity, sCD14 and IL-6, and eGFRcr. These factors may hold clues to biology, preventive efforts and potential therapeutics for those at highest risk.
Artificial intelligence-assisted interpretation of systolic function by echocardiogram
Authors: Yamaguchi Natsumi , Kosaka Yoshitaka , Haga Akihiko , Sata Masataka , Kusunose Kenya
Published: July 2023

Objective

Precise and reliable echocardiographic assessment of left ventricular ejection fraction (LVEF) is needed for clinical decision-making. Recently, artificial intelligence (AI) models have been developed to estimate LVEF accurately. The aim of this study was to evaluate whether an AI model could estimate an expert read of LVEF and reduce the interinstitutional variability of level 1 readers with the AI-LVEF displayed on the echocardiographic screen.

Methods

This prospective, multicentre echocardiographic study was conducted by five cardiologists of level 1 echocardiographic skill (minimum level of competency to interpret images) from different hospitals. Protocol 1: Visual LVEFs for the 48 cases were measured without input from the AI-LVEF. Protocol 2: the 48 cases were again shown to all readers with inclusion of AI-LVEF data. To assess the concordance and accuracy with or without AI-LVEF, each visual LVEF measurement was compared with an average of the estimates by five expert readers as a reference.

Results

A good correlation was found between AI-LVEF and reference LVEF (r=0.90, p<0.001) from the expert readers. For the classification LVEF, the area under the curve was 0.95 on heart failure with preserved EF and 0.96 on heart failure reduced EF. For the precision, the SD was reduced from 6.1±2.3 to 2.5±0.9 (p<0.001) with AI-LVEF. For the accuracy, the root-mean squared error was improved from 7.5±3.1 to 5.6±3.2 (p=0.004) with AI-LVEF.

Conclusions

AI can assist with the interpretation of systolic function on an echocardiogram for level 1 readers from different institutions.
Predictors of worse outcome after postponing non-emergency cardiac interventions during the COVID-19 pandemic
Authors: Andreß Stefanie , Felbel Dominik , Mack Alex , Rattka Manuel , d’Almeida Sascha , Buckert Dominik , Rottbauer Wolfgang , Imhof Armin , Stephan Tilman
Published: July 2023

Objective

Deferral of non-emergency cardiac procedures is associated with increased early emergency cardiovascular hospitalisation. This study aimed to identify predictors of worse clinical outcome after deferral of non-emergency cardiovascular interventions.

Methods

This observational case-control study included consecutive patients whose non-emergency cardiac intervention has been postponed during COVID-19-related lockdown between 19 March and 30 April 2020 (n=193). Cox regression was performed to identify predictors of the combined 1-year end point emergency cardiovascular hospitalisation and death. All patients undergoing non-emergency interventions in the corresponding time period 2019 served as control group (n=216).

Results

The combined end point of death and emergency cardiovascular hospitalisation occurred in 70 (36.3%) of 193 patients with a postponed cardiovascular intervention. The planned intervention was deferred by a median of 23 (19–36) days. Arterial hypertension (HR 2.27; 95% CI 1.00 to 5.12; p=0.049), chronic kidney disease (HR 1.89; 95% CI 1.03 to 3.49; p=0.041) as well as severe valvular heart disease (HR 3.08; 95% CI 1.68 to 5.64; p<0.001) were independent predictors of death or emergency hospitalisation. Kaplan-Maier estimators of the combined end point were 31% in patients with arterial hypertension, 56% in patients with severe valvular heart disease and 77% with both risk factors (HR 12.4, 95% CI 3.8 to 40.7; p<0.001) and only 9% in patients without these risk factors (log rank p<0.001). N-terminal pro-B-type natriuretic peptide (NT-proBNP) cut-point of ≥1109 pg/mL best predicts the occurrence of primary end point event in deferred patients (area under the curve 0.71; p<0.001; sensitivity 63.8%, specificity 69.4%).

Conclusion

Our results suggest that patients with either arterial hypertension, chronic kidney or severe valvular heart disease are at very high risk for emergency hospitalisation and increased mortality in case of postponed cardiac interventions even in supposed stable clinical status. Risk seems to be even higher in patients suffering from a combination of these conditions. If the ongoing or future pandemics force hospitals again to postpone cardiac interventions, the biomarker NT-proBNP is an applicable parameter for outpatient monitoring to identify those at risk for adverse cardiovascular events.
Delivery of essential pediatric congenital surgical care within Brazil’s universal health coverage system: a national survey of pediatric surgeons
Authors: Truche Paul R , Naus Abbie E , Botelho Fabio , Ferreira Julia , Bowder Alexis , Caddell Luke , Zimmerman Kathrin , de Freitas Faria Isabella Maria , Lopes Bellisa Caldas , Costa Eduardo Corrêa , Dantas Fernanda Lage Lima , Cavalcante Augusto J S A , Carvalho Carlos A L B , Abib Simone , Mooney David P , Alonso Nivaldo
Published: July 2023

Objective

In this study, we assess the delivery of congenital pediatric surgical care under Brazil’s system of universal health coverage and evaluate differences in delivery between public and private sectors.

Methods

A cross-sectional national survey of pediatric surgeons in Brazil was conducted. Participants were asked which of 23 interventions identified through theDisease Control Priorities 3 (Surgical Interventions for Congenital Anomalies)they perform and to report barriers faced while providing surgical care. Responses were weighted by state and stratified by sector (public vs private).

Results

A sample of 352 responses was obtained and weighted to represent 1378 practicing pediatric surgeons registered in Brazil during the survey time. 73% spend the majority of their time working in the public sector (‘Sistema Único de Saúde’ and Foundation hospitals), and most of them also work in the private sector. Generally, Brazilian pediatric surgeons have the expertise to provide thoracic, abdominal, and urologic procedures. Surgeons working mostly in the public sector were more likely to report a lack of access to essential medications (25% vs 9%, p<0.01) and a lack of access to hospital beds for surgical patients (52% vs 32%, p<0.01).

Conclusions

Brazilian pediatric surgeons routinely perform thoracic, abdominal, and urologic surgery. Those working in government-financed hospitals face barriers related to infrastructure, which may impact Brazilians who rely on Brazil’s universal health coverage system. Policies that support pediatric surgeons working in the public sector may promote the workforce available to provide congenital pediatric surgical care.
The Adoption of Artificial Intelligence in Bureaucratic Decision-making: A Weberian Perspective
Authors: Cetina Presuel Rodrigo , Martinez Sierra Jose M.
Published: July 2023

This work questions AI´s role in bureaucratic decision-making. The Weberian conception of bureaucracy, based around the concept of an ideal bureaucracy in which authority is distributed, delegated, clearly delimited and hierarchical and that enshrines the following of formal rules, task specialization through division of labor, legal certainty and a predilection for efficiency in recordable and accountable decisions can serve as a framework to orient how governments should approach the adoption of artificial intelligence (AI) given the many problems associated with its careless deployment. Using theoretical analysis, this work explains Weberian ideas of bureaucracy and contrasts them with real-life cases of implementation of AI in bureaucratic decision-making, often with detrimental results for society. After identifying and framing issues related to AI, e.g., lack of transparency, attempts to shift accountability from humans to technology, the exacerbation of bias and potential for systemic discrimination, the paper proposes Weberian prescriptions that should help public administration make careful decisions about the adoption of AI and the consequences of its implementation. The article also engages with Weber critically, rejecting the notion that public administrators do not engage in politics and asserting that AI decision-making is necessarily political as well, as it entails exercising power over citizens.
Exploring the Photoluminescence Property, Photocatalytic Efficiency, and Antibacterial Activity of Eu-Doped ZnO/SnO2 Heterostructure
Authors: Palai Amrita , Panda Nihar Ranjan , Sahu Dojalisa
Published: July 2023

In this study, nanocomposites of ZnO–SnO2 doped with Eu ions were synthesized by sol-gel method. The samples show the co-existence of hexagonal ZnO and tetragonal SnO2 crystallographic phases as observed from X-ray diffractometry studies. Eu doping facilitates the grain growth as the average grain size is found to increase with the increase in Eu dopant concentration. Surface morphology of the samples also gets altered with Eu doping with EDAX measurement giving the confirmation of existence of elements like Zn/Sn/Eu. FTIR measurement specifies the appearance of peaks linked with functional groups like Zn–O, Sn–O and O–H. Photoluminescence study shows the evolution of characteristic emissions of Eu ions (5D0→ 7F1, 5D0→ 7F2 and 5D0→ 7F3). Photodegradation of toxic environmental dyes like Congo red and methylene blue was executed and the efficiency of degradation was estimated under visible light illumination. The presence of Eu3+ ions in ZnO/SnO2 helps to enhance the degradation efficiency by facilitating to form Z- scheme heterojunctions between ZnO and SnO2. This allows the delay in recombination rate of the photoinduced electron/hole pairs. The antibacterial behavior of the prepared nanocomposites against E. coli and S. aureus has also been studied in detail which demonstrates improved antibacterial efficiency of the samples.
Hepatic and intestinal manganese excretion are both required to regulate brain manganese during elevated manganese exposure
Authors: Hutchens Steven , Jursa Thomas P. , Melkote Ashvini , Grant Stephanie M. , Smith Donald R. , Mukhopadhyay Somshuvra
Published: July 2023

This article shows that, in contrast with expectations from prior studies and physiological conditions, excretion of manganese by the intestines and liver is equally important in controlling brain manganese during human-relevant manganese exposure. The results provide foundational insights about the interorgan mechanisms that control brain manganese homeostasis at the organism level and have important implications for the development of therapeutics to treat manganese-induced neurological disease.