bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-effectiveness analysis of a shifted completely connected network for massively parallel computer systems
Authors: Ali Mohammed N. M. , Rahman M. M. Hafizur
Published: February 2024

The Cost-Effectiveness Analysis (CEA) is one of the most important measures to compare the effect of the newly invented technologies to their costs. CEA is used to evaluate the cost of two or more new products based on the benefits that have been obtained from them. Thus, it is crucial to analyze the cost-effectiveness (CE) of any new element before starting the production process. Taking a broad view of costs and benefits is important to make a perfect CEA that provide an evaluation for the long-term effects of the new creations. CEA is applicable to be used in evaluating all new products and technologies in all sectors including computer science. In this paper, the CE of a proposed parallel computer system built by using a shifted completely connected network (SCCN) will be analyzed. This system is composed of multiple levels, the cost of creating each level will be compared to the obtained benefits of this level. Besides, each level will be compared also to other networks with almost the same number of processing elements (PEs). To evaluate this network, three parameters will be calculated including the cost-effectiveness factor (CEF), time cost-effectiveness factor (TCEF), and static-cost-effectiveness analysis. Each level of SCCN showed the lowest cost-effectiveness analysis over the two-dimensional networks, however, it has a little bit higher value of CEA compared to the three-dimensional networks.
Strategies for scaling up pre-ART advanced HIV disease screening at a secondary referral hospital - Malawi: a qualitative study
Authors: Mithi Brany , Sambala Evanson Z , Bula Agatha , Jere Ziliro , Kumilonde Emily , Gondwe Grant , Chikuse Marion M , Manda Simion , Muula Adamson
Published: February 2024

Background
Implementation of the World Health Organization (WHO) recommended Advanced HIV Disease screening package, remains poor in most settings with limited resources compared with centers of excellence in Malawi. More than 50% of newly diagnosed-HIV clients are missed on screening as a result of implementation barriers. It is important to mitigate the existing barriers and leverage enablers’ inorder to maximize uptake of the advanced HIV disease screening in resource limited settings. This study aimed to co-design strategies for scaling up implementation of advanced HIV disease screening among newly HIV-diagnosed clients in pre-ART phase using a Consolidated Framework for Implementation Research-Expert Recommendation for Implementing Change (CFIR-ERIC) guiding tool.
Methods
A qualitative study was conducted at Rumphi district hospital in Malawi (August – September, 2023). In-depth interviews and stakeholders’ meetings were facilitated to identify and co-design specific strategies for mitigating implementation barriers to advanced HIV disease screening. Participants comprised healthcare providers, purposively selected from key hospital departments. Transcripts and other information were analyzed using Nvivo software followed by mapping of barriers and specific strategies using CFIR-ERIC Matching tool version 1.0.
Findings:
Ten In-depth interviews and 2 stakeholders meetings comprising 25 participants were conducted. Overall, 6 Level 1 strategies (≥ 50% expert endorsement score) and 11 Level 2 strategies (≥ 20%, ≤ 49% expert endorsement score) were identified, targeting barriers associated with availability of resources, intervention complexity, access to knowledge and information, communication and networks; and implementation leads. Most of the reported strategies were cross-cutting and aimed at enhancing clinical knowledge of the intervention (train & educate stakeholders, develop training materials, educational meetings), developing stakeholders interrelations (network weaving, visits to site of Excellency) as well as improving clinical workflow (physical and work structure). Use of evaluative and iterative strategies (identification of barriers, audit & feedback) were also recommended as part of continuous improvement.
Conclusion
Through the involvement of key stakeholders and the use of CFIR-ERIC matching tool, this study has identified cross-cutting strategies that if well implemented, can help to mitigate contextual barriers and leverage enablers for an improved delivery of AHD screening package.
Clinical features and outcomes in kidney transplant recipients with COVID-19 pneumonia: a single center retrospective cohort study
Authors: Xu liang , Chen Xiu xiu , Yang Xuying , Chen Song , Yang Meng , Yuan Zehua , Chen Rentian , Wang Jianli , Jiang Hongtao , Xu Jian , Wang Yi
Published: February 2024

Objective
This retrospective cohort study aimed to assess the clinical characteristics, treatment outcomes, and short-term prognosis of kidney transplant recipients (KTRs) with concurrent coronavirus disease 2019 (COVID-19) pneumonia.
Methods
KTRs with COVID-19 pneumonia who were admitted to our hospital from December 28, 2022, to March 28, 2023 were included in the study, and their clinical symptoms, response to antiviral medications, and short-term prognosis were analyzed.
Results
A total of 64 KTRs with initial diagnosis of COVID-19 pneumonia were included in this study. The primary symptoms were fever, cough, and myalgia, with an incidence of 79.7%, 89.1%, and 46.9%, respectively. The administration of antiviral drugs (paxlovid or molnupiravir) within 1–5 days and for over 5 days demonstrated a statistically significant reduction in viral shedding time compared to the group without antiviral medication (P = 0.002). Both the paxlovid and molnupiravir treatment groups exhibited a significantly shorter duration of viral shedding time in comparison to the group without antiviral drugs (P = 0.002). After 6 months of recovery, there was no significantly negative impact on transplant kidney function (P = 0.294).
Conclusion
Fever, cough, and myalgia remain common initial symptoms of concurrent COVID-19 pneumonia in KTRs. The earlier use of antiviral drugs (the paxlovid or molnupiravir) is associated with better therapeutic outcomes. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had limited impact on short-term renal function of the KTRs with concurrent moderate or severe COVID-19 pneumonia.
DFTGL: Domain Filtered and Target Guided Learning for Few-Shot Anomaly Detection
Authors: Zhang Jiajun , Song Yanzhi , Yang Zhouwang
Published: February 2024

This paper addresses cross-domain challenges in few-shot anomaly detection, where utilizing various source domains leads to diminished representations and compromised detection in the target domain. To tackle this, we propose Domain Filtering and Target-Guided Learning (DFTGL). Initially, we measure domain gaps and retain source domains with smaller disparities. We introduce a limited number of target domain samples to create an intermediate domain for better feature transfer during training. Additionally, we employ category-prior-based augmentation to refine feature distribution estimation while ensuring image registration. Experimental results demonstrate significant improvements in image-level AUROC compared to the baseline: 5.1%, 5.9%, and 4.1% (2-shot, 4-shot, and 8-shot settings) on MVTec and 6.9%, 2.1%, and 2.5% on ViSA datasets. This pioneering research effectively narrows domain gaps, enabling proficient feature transfer, and holds promise for early anomaly detection in industries like product inspection and medical diagnostics.
Comparative analysis of coping methods used by patients with diabetes mellitus: a qualitative inquiry in a Ghanaian district hospital
Authors: Korsah Kwadwo Ameyaw , Achempim-Ansong Gloria , Ampomah Menford Owusu , Ansu-Frimpong Samuel , Danso Emmanuel
Published: February 2024

Background
Many studies have been conducted on coping approaches used by patients with chronic diseases such as diabetes in both developed and low- and middle-income economies, focusing on the distressful nature of the condition. Nevertheless, the classic distinction of unique coping methods used by males and females with diabetes mellitus has not been investigated or reported in Ghana. This study aimed to analyse coping strategies employed by patients with diabetes mellitus based on their differential groupings.
Method
The study focused on an exploratory descriptive design. The researchers set off to explore the unique coping methods of men and women living with diabetes mellitus using a one-on-one interview approach for data collection. Participants were purposively sampled. The data analysis was performed using a content analysis approach tied to the participants’ age, sex, and education levels.
Results
Eight (8) remarkable findings were identified and aligned with the eight (8) main distinctive groupings of males and females with diabetes mellitus. The participants reported diverse coping methods, which included confrontation coping approaches, the use of surrogates in coping, the use of humor, medical coping, the use of prayers, spiritual fasting, the use of alcohol, and suicidal ideations as ways of coping.
Conclusions
Health professionals need to be aware of patients’ beliefs without changing patients’ world outlook while also being supportive of patients’ use of suitable interventions, including coping styles for the overall management of diabetes mellitus.
A geodecisional method based in Analytical Hierarchy Process and Geographic Information System to the flood susceptibility mapping of the Sidi Bel Abbes Territory (NW of Algeria)
Authors: Chehibi Oussama , Hamidi Mansour , Roukh Zine El Abidine
Published: February 2024

Floods are one of the most common natural hazards in the world, causing a lot of damage and loss of life every year. In Algeria, many events have caused serious damage over several decades, recorded at the national level; among them, the flood of Mohammedia 1881, Mostaganem 1927, Oued R’hiou 1993 and Bab el Oued (Algiers) 2001. In northwestern of Algeria, the Wilaya of Sidi Bel Abbes, several floods are frequently recorded, with high to catastrophic levels, causing serious damage associated with significant loss of human life. In this work, we propose an approach to evaluate the rate of susceptibility to flooding of the territory of Sidi Bel Abbes by a geodecisional analysis under the GIS environment. A total of nine factors influencing flooding phenomena such as, distance to rivers, slope, streams density, altitude, flow accumulation, rainfall, soil type, geology and land use are integrated in the flood susceptibility calculation. Based on semi-quantitative statistical approach namely, Analytical Hierarchic Process (AHP), the weighting of each parameter is calculated. The Flood Susceptibility Global Index (FSGI) is evaluated using the weighted linear combination of the whole parameters used in this analysis. As a result, the flood susceptibility map is established by the classification of the envisaged index into five classes. The outcome of this analysis indicates that 41% of the study area characterized by very low susceptibility, 28% of the total area characterized by low susceptibility, 19% for the moderate flood susceptibility zones, 09% and 3% for the high and very high flood susceptibility areas, respectively. The establishment of the flood susceptibility map enabled us to understand the distribution of flood-prone areas and to better explain the preventive aspect of potential floods to local and/or regional communities in order to minimize the fatal effects of the hydrological risk.
Developing a fully applicable machine learning (ML) based sex classification model using linear cranial dimensions
Authors: Bašić Željana , Jerković Ivan , Anđelinović Šimun , Krešić Elvira , Jerković Nika , Dolić Krešimir , Čavka Mislav , Bedalov Ana , Kružić Ivana
Published: February 2024

Recent advances in AI and ML applications have elevated accomplishments in various scientific fields, primarily those that benefit the economy and society. Contemporary threats, such as armed conflicts, natural and man-made disasters, and illegal migrations, often require fast and innovative but reliable identification aids, in which forensic anthropology has a significant role. However, forensic anthropology has not exploited new scientific advances yet but instead relies on traditionally used methods. The rare studies that employ AI and ML in developing standards for sex and age estimation did not go beyond the conceptual solutions and did not apply to real cases. In this study, on the example of Croatian populations’ cranial dimensions, we demonstrated the methodology of developing sex classification models using ML in conjunction with field knowledge, resulting in sex estimation accuracy of more than 95%. To illustrate the necessity of applying scientific results, we developed a web app, CroCrania, that can be used for sex estimation and method validation.
Diagnosis and Management of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review
Authors: Njei Basile , Ameyaw Prince , Al-Ajlouni Yazan A. , Njei Lea-Pearl , Boateng Sarpong
Published: February 2024

Background Lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) challenges traditional perceptions of fatty liver diseases, occurring in non-obese individuals. The shift in nomenclature from non-alcoholic fatty liver disease to metabolic dysfunction-associated steatotic liver disease reflects a broader understanding of its pathophysiology, emphasizing the intricate interplay of metabolic components beyond obesity. Despite its clinical relevance, the diagnosis and management of Lean MASLD pose unique challenges due to historical associations with obesity and limited awareness of its distinctive features. Methods A comprehensive systematic literature search was conducted on December 4th, 2023, in six databases using specific criteria. Only peer-reviewed studies in the English language, focusing on either diagnosis or management of lean MASLD. were included. This study is registered with PROSPERO (CRD42023489308) Results Following PRISMA guidelines, a total of 95 studies were included, with 43 studies focusing on diagnosis and surveillance of MASLD, while 52 studies focused on management of MASLD. The findings provide insights into the challenges associated with diagnosing Lean MASLD. Emphasis is placed on the evolving diagnostic criteria, acknowledging the limitations of traditional markers and exploring advanced imaging modalities. Management strategies are explored, including lifestyle interventions and potential pharmacological treatments, considering the unique metabolic characteristics of this patient population. Conclusion The findings underscore the need for heightened clinical awareness, regular monitoring, and tailored therapeutic approaches in lean MASLD. Further research is essential to refine diagnostic criteria and develop targeted treatments, paving the way for improved care for individuals with Lean MASLD.
The Genetic Interface of Immunity and COVID-19: Insights from a Two-Sample Mendelian Randomization Approach
Authors: Huang Lei , Huang Ying
Published: February 2024

Introduction
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged as a global public health emergency since late 2019. Immune cells are crucial for host defense against viral infection and disease progression. However, the specific immune cell characteristics that influence susceptibility to COVID-19 remain unclear. This study aimed to investigate the causal relationship between immune cell signatures and COVID-19 using MR analysis.
Materials and Methods
This study utilized publicly available genetic datasets from the COVID-19 Host Genetics Initiative and the Blueprint Consortium and applied a two-sample Mendelian randomization approach to examine the association between 731 immune cell signatures and the risk of COVID-19. We included four types of immune signatures: median fluorescence intensity (MFI), relative cell count (RC), absolute cell count (AC), and morphological parameter (MP) data. We used the inverse-variance weighted (IVW) method as the primary analysis and performed several sensitivity analyses to test the robustness of the results.
Results
Our analysis revealed 30 distinct immune cell characteristics that were directly associated with the risk of COVID-19, including CD4 + regulatory T cells (CD4 + Treg cells), CCR2 + CD14- CD16 + monocytes, CD86 + plasmacytoid DC AC, CCR2 + plasmacytoid DC (CCR2 + pDC), CCR2 + CD62L + plasmacytoid DC (CCR2 + CD62L + pDC), and CD80 + CD62L + plasmacytoid DC (CD80 + pDC). However, among these findings, only the expression of CCR2 on CD14-CD16 + monocytes had a significant impact (P = 0.0249, OR = 1.0427, 95% CI=[1.0053, 1.0814]) on immune cell attributes in the context of COVID-19. Sensitivity analyses confirmed the validity of the IVW results and ruled out the possibility of horizontal pleiotropy.
Conclusion
Through two-sample Mendelian randomization analysis, we demonstrated a significant causal relationship between specific immune cell characteristics and the risk of COVID-19. These findings provide important genetic evidence for the development of future vaccines and treatment strategies.
Geometric Design of Electric Motors Using Adjoint-based Shape Optimization
Authors: Scotzniovsky Luca , Xiang Ru , Cheng Zeyu , Rodriguez Gabriel , Kamensky David , Mi Chris , Hwang John
Published: February 2024

Interest in electric aircraft has increased due to developments in electric propulsion technology and concerns regarding aircraft carbon emissions. The emerging urban air mobility (UAM) industry aims to provide convenient short-range air travel using electric aircraft. An important factor in the design of electric aircraft is the modeling and design of electric motors. The many degrees of freedom in electric motor design makes it a complex design problem. To mitigate this complexity, we have developed a novel adjoint-based electric motor design methodology using finite-element electromagnetic analysis and PDE-based mesh warping with exact derivatives. This paper highlights the approach and details of the proposed method and presents results from its application to a representative motor design problem. The optimization results in a 35\% decrease in motor mass and a 3\% increase in efficiency in comparison to the baseline design. These results demonstrate the efficacy of an adjoint-based optimization approach with exact analytical derivatives for electric motor design.
Aged mice show a reduction in 5-HT neurons and less cellular activation in the dentate gyrus when exposed to acute running
Authors: Silva Josiane do Nascimento , Rodrigues Bianca Andrade , Kawamoto Elisa Mitiko
Published: February 2024

Serotonin (5-HT) is an important neurotransmitter for cognition and neurogenesis. However, possible changes in brain 5-HT function due to aging process remain to be investigated. We evaluated whether elderly animals would present changes in the number of 5-HT neurons in regions such as the dorsal (DRN) and median (MRN) nucleus of the raphe, and possible changes in the rate of cell activation in the dentate gyrus (DG) in response to acute running. This research was carried out on adult (3 months) and elderly (19 months), male and female mice. Immunohistochemistry, microscopic analysis and treadmill running were performed. The data showed that in elderly mice there was a reduction in the number of 5-HT neurons in the DRN and MRN of males and females. In the DRN region, the reduction was even greater for females. Furthermore, elderly animals showed a lower rate of c-Fos labeling in the DG when stimulated by acute running. The data indicate that aging can culminate in the reduction of 5-HT neurons in raphe nuclei. Furthermore, the region responsible for hippocampal neurogenesis would be affected in aging, since the stimulus promoted by acute running evokes a lower rate of neuronal activation in these individuals.
Effect of Nutrition Education and Iron-folic acid supplementation on anemia among Pregnant Women: A quasi-experimental study
Authors: Anato Anchamo , Reshid Mensur
Published: February 2024

Background
The aim of this study was to assess the effect of nutrition education and counseling using health belief health model constructs along with iron-folic acid supplementation on hemoglobin level and adherence to IFAs during pregnancy
Methods
The study was a three months quasi-experimental study design in Butajira town, Ethiopia. Community-based nutrition education and counseling sessions using Health belief model, and IFAS for six weeks were given to the pregnant women. Baseline data and hemoglobin levels were measured at the time of enrollment. Maternal adherence to iron-folic acid tablets (IFA) was assessed using pill count based on the number of remaining pills in the retained prescribed bottles or strips. End-line data were collected from 97 intervention and 96 control group of pregnant women after 6 weeks of nutrition education intervention. Analysis of effect of intervention was done using Difference-In-Difference and a Generalized Estimation Equation (GEE) approaches.
Results
At the end of the nutrition education intervention, there was a significant drop in the proportion of anemia in the intervention group compared to the control group. The prevalence of anemia among intervention group declined from 27.8% at the baseline to 7.2% after intervention. The change in the knowledge score regarding IFAS and maternal adherence to IFAS were significantly higher in the intervention group as compared to the control group (p < 0.001). In this study, the odds of adherence to IFA supplementation were 2.26 (95% CI 1.55 to 3.29) times higher among those who received nutrition education intervention as compared to control group.
Conclusion
Implementation of community-based nutrition education and counseling along with IFAS improved the hemoglobin level and adherence to IFAS among pregnant women. Therefore, there is need to integrate community-based nutrition education approach by using HBM constructs with antenatal IFAS distribution to improve supplementation and hemoglobin level.
Additives Depletion by Water Contamination and its Influences on Engine Oil Performance
Authors: Omar A. Al Sheikh , Salehi F. Motamen , Farooq U. , Morina A.
Published: February 2024

Water enters engine oil in different ways and moves in the lubrication system causing an increase in wear, oil degradation and additive depletion. It has been proposed that water in the lubricants can transfer from dissolved to free phase leading to additive depletion in the oil. Different additives in the lubricants can easily latch to water molecules forming reverse micelles. The separation of reverse micelles from the oil causes additive depletion. This experimental and analytical study aims to investigate how the separation of free water above the saturation level can diminish the efficiency of additives in engine oils. The effect of varied levels of water on oil performance and its additives was investigated in this study. A new saturation method was used to determine the water saturation level in engine oil at different temperatures. The results reveal a decrease in additive concentration with increased separation of free water from the oil. Free water separation from engine oil is expected to reclaim the tribological performance, however the results demonstrate that tribological performance after the separation of free water from the oil has been affected. The results prove that two main mechanisms influence oil performance expressed as additive depletion by free water and remaining dissolved water.
A case of Abiotrophia defectiva endophthalmitis with retinal vasculitis
Authors: Lu Xiaojie , Wang Weiwei
Published: February 2024

Introduction
Endophthalmitis is a severe, vision-threatening intraocular infection that may follow various ophthalmic surgeries, with varying microbial etiologies. Abiotrophia defectiva, a less commonly implicated pathogen, is better recognized for its association with endocarditis rather than intraocular infections.
Case presentation
A 50-year-old man was diagnosed with endophthalmitis after trabeculectomy for open-angle glaucoma. In the outpatient clinic, he had visual acuity of 20/160, conjunctival congestion, mild anterior chamber inflammation, and preretinal bleeding. In the hours that followed, the condition worsened dramatically. He underwent urgent anterior chamber irrigation, vitreous tap, and intravitreal injection. As the symptoms did not improve, a vitrectomy was performed. The results of postoperative culture were positive for Abiotrophia defectiva. After timely and effective treatment, the patient's visual acuity increased to 20/125. At a one-year follow-up, the patient's visual acuity improved to 20/32.
Conclusion
This report delineates a rare case of endophthalmitis caused by Abiotrophia defectiva following trabeculectomy, emphasizing the need for prompt recognition and treatment of atypical pathogens in postoperative ocular infections to enhance visual outcomes.
Advancing Social Care Integration in Health Systems with Community Health Workers: an Implementation Evaluation based in Bronx, New York
Authors: Fiori Kevin P. , Levano Samantha , Haughton Jessica , Whiskey Renee , Telzak Andrew , Muleta Hemen , Vani Kavita , Chambers Earle C. , Racine Andrew
Published: February 2024

Background
In recent years, health systems have expanded the focus on health equity to include health-related social needs (HRSNs) screening. Community health workers (CHWs) are positioned to address HRSNs by serving as linkages between health care provider systems, social services, and the community. This study describes a health system’s 12-month experience integrating CHWs to navigate HRSNs among primary care patients in Bronx County, NY.
Methods
We organized process and outcome measures using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) implementation framework domains to evaluate a CHW intervention of the Community Health Worker Institute (CHWI). We used descriptive and inferential statistics to assess RE-AIM outcomes and socio-demographic characteristics of patients who self-reported at least 1 HRSN and were referred to and contacted by CHWs between October 2022 and September 2023.
Results
There were 4,420 patients who self-reported HRSNs in the standardized screening tool between October 2022 and September 2023. Of these patients, 1,245 were referred to a CHW who completed the first outreach attempt during the study period. An additional 1,559 patients self-reported HRSNs directly to a clinician or CHW without being screened and were referred to and contacted by a CHW. Of the 2,804 total patients referred, 1,939 (69.2%) were successfully contacted and consented to work with a CHW for HRSN navigation. Overall, 78.1% (n = 1,515) of patients reported receiving social services. Adoption of the CHW clinician champion varied by clinical team (median 22.2%; IQR 13.3–39.0%); however, there was no difference in referral rates between those with and without a clinician champion (p = 0.50). Implementation of CHW referrals via an electronic referral order appeared successful (73.2%) and timely (median 11 days; IQR 2–26 days) compared to standard CHWI practices. Median annual cost per household per CHW for the intervention was determined to be $184.02 (IQR $134.72 – $202.12).
Conclusions
We observed a significant proportion of patients reporting successful receipt of social services following engagement with an integrated CHW model. There are additional implementation factors that require further inquiry and research to understand barriers and enabling factors to integrating CHWs within clinical teams.
Comparison of natural abundance and enriched 15-N methods to quantify nitrogen fertilizer recovery in maize under field conditions
Authors: Manandhar Sarita , Bell Michael , Dalal Ram Chandra , Menzies Neal , Martinez Cristina
Published: February 2024

Aims
This study aims to compare the ability of natural abundance (NA) and 15N-enrichment (EN) methods to quantify N dynamics in a No-Till legume/non-legume maize crop rotation under field conditions; and deliver precise estimates of fertilizer N recovery across both rotations.
Methods
A field experiment was established on a Vertisol by sowing a legume (Vicia faba) or non-legume (Triticum aestivum) grain crop. The following maize crop was fertilized using either urea or 15N-enriched (5 atom%) urea, at five rates (0, 62.5, 125, 187.5, and 250 kg N ha− 1) in spatially separated subplots in each field plot.
Results
The proportional recovery of fertilizer N in grain (%Ndff) showed that EN method provided higher estimates than that determined by NA method, with differences greatest in the wheat-maize rotation. The NA method was better able to quantify residual benefits of fixed N from faba beans in a following maize crop. Unfortunately, different biomass and grain sampling times necessitated by the size of fertilised plots used for each isotopic method confounded comparisons of N derived from fertilizer in crop biomass and grain yields.
Conclusion
While larger plot sizes able to be used in the cheaper NA method provided better estimates of crop and grain biomass and N content, and enabled quantification of recovery of atmospheric N2-fixed legume N (%Ndfa) in a following maize crop, the EN method was better able to estimate fertilizer N recovery by maize in the field. The reasons for differences in %Ndff between methods and crop histories require further investigation.
Diagnostic Value of the Derived Neutrophil-to-Lymphocyte Ratio for Acute Appendicitis
Authors: Moreno-Alfonso Julio César , Caballero Ada Molina , Martínez Alberto Pérez , Irazábal María Concepción Yárnoz
Published: February 2024

Purpose
The diagnosis of appendicitis in children can present several challenges, leading to an increased risk of complications. Herein, we aimed to evaluate the diagnostic value of the derived neutrophil-to-lymphocyte ratio (dNLR) as a novel adjunctive diagnostic tool for appendicitis.
Methods
This diagnostic study included patients with appendicitis and non-surgical abdominal pain (AP), who were admitted to our hospital between 2020 and 2022. White blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), and dNLR were compared between the two groups of patients.
Results
In total, 202 patients were enrolled, including 101 with acute appendicitis (69% male, age 9.9 years) and 101 with non-surgical AP (56% male, age 9.4 years). WBC, NLR, and dNLR were significantly higher in patients in the appendicitis group than in those in the non-surgical AP group (16.47 vs. 11.18 × 103 cells/mm3, p ≤ 0.0001; 9.5 vs. 3.3 p ≤ 0.0001; and 5.2 vs. 2.3 p ≤ 0.0001, respectively). The sensitivity, specificity, positive predictive value, negative predictive value, area under the receiver operating characteristic curve, and cutoff point of dNLR for the diagnosis of acute appendicitis were 71%, 74%, 73%, 72%, 0.811, and 3.78, respectively. The positive likelihood ratios for WBC count, NLR, and dNLR were 1.95, 2.05, and 2.77, respectively.
Conclusions
dNLR is a novel and noninvasive biomarker with high accuracy for diagnosing appendicitis. Its inclusion as an additional diagnostic tool in clinical practice may aid in determining the need for further studies in cases with ambiguous presentations and a dNLR value ≥ 3.78.
Assessment of Plant Diversity in Forest, Agroforest and Social Forestrty in the Degraded Madhupur Sal Forest of Bangladesh
Authors: Shafiqe Shoumika Binte , Ashraf S. M. Kamran , Rana Md Tanbheer , Ripta Saleha Khatun , Afroz Mst. Sohela , Urmi S. M. Sanjida Tasnim , Asha Sumaiya Binte Rahman , Rahat Al , Islam Kazi Kamrul
Published: February 2024

The rich plant biodiversity found in tropical regions faces significant threats due to extensive human activities. Factors such as deforestation, habitat deterioration, human settlement, excessive resource exploitation, the introduction of invasive species, pollution, and the interconnected effects of global climate change collectively contribute to a substantial negative impact on biodiversity in these areas. The study aimed to assess plant diversity in Madhupur Sal Forest, Bangladesh, comparing agroforestry, social forestry, and natural Sal Forest sites. Using 90 random 10 × 10 m² plots, 47 species were recorded, including 31 trees, 5 shrubs, 6 herbs, and 5 climbers. Anacardiaceae, Arecaceae, Euphorbiaceae, and Fabaceae were prominent families, each with a species richness of 3. Agroforestry exhibited the highest species richness (14), Shannon-Wiener index (1.37), and Simpson's index (2.41) among plantation sites, surpassing social forestry. Social forestry, however, showed higher tree stand density (1673 trees/ha), tree basal area (28.67 m²/ha), and species evenness (0.67) than agroforestry. The natural Sal Forest site displayed the highest species richness (33), tree basal area (41.21 m²/ha), Shannon-Wiener index (2.15), and species evenness (0.78). Overlapping species occurred between agroforestry and social forestry (5 species), and agroforestry and natural Sal Forest (1 species), resulting in a higher similarity index (19%) for the former. No species overlapped between social forestry and natural Sal Forest. The study concluded that natural Sal Forest exhibited the highest diversity (2.15), while agroforestry proved beneficial for biodiversity compared to bare land.
Prediction-based Reactive-Greedy Routing Protocol for Flying Ad Hoc Networks
Authors: Li Xianfeng , Sun Haoran
Published: February 2024

Routing of Flying Ad Hoc Networks (FANETs) is more challenging than traditional Mobile Ad Hoc Networks (MANETs) due to the high mobility of Unmanned Aerial Vehicles (UAVs). Reactive protocols that adjust routing according to the location and speed of UAVs are widely researched. In this work, a more aggressive routing protocol that is not only reactive, but also predictive, is proposed. It is based on the salient fact that both the trajectory and change of speed are smooth in most cases, and the recent movement history of UAVs provides valuable information for predicting the change of network topology. Driven by this observation, a Link-stability Prediction-based Adaptive Routing (LPAR) protocol is proposed. LPAR predicts link stability over a period of time, and makes routing decisions that are expected to last for a longer duration. In case of link breakage, LPAR can switch to a greedy forwarding mode to reduce dropping packets. Evaluated with NS3 simulation, LPAR achieves better performance than several existing reactive routing protocols in terms of packet delivery ratio (PDR), end-to-end delay, and overhead by 20.58%, 15.72% and 37.22% on average.
Multi-parametric MRI-based machine learning model for prediction of pathological grade of renal injury in a rat kidney cold ischemia-reperfusion injury model
Authors: chen lihua , ren yan , Yuan Yizhong , Xu Jipan , Wen Baole , Xie Shuangshuang , Zhu Jinxia , Li Wenshuo , Gong Xiaoli , Shen Wen
Published: February 2024

Background Renal cold ischemia-reperfusion injury (CIRI), a pathological process during kidney transplantation, may result in delayed graft function and negatively impact graft survival and function. There is a lack of an accurate and non-invasive tool for evaluating the degree of CIRI. Multi-parametric MRI has been widely used to detect and evaluate kidney injury. The machine learning algorithms introduced the opportunity to combine biomarkers from different MRI metrics into a single classifier.
Objective To evaluate of the performance of multi-parametric magnetic resonance imaging for grading renal injury in a rat model of renal cold ischemia-reperfusion injury using a machine learning approach.
Methods Eighty male SD rats were selected to establish a renal cold ischemia -reperfusion model, and all performed multiparametric MRI scans (DWI, IVIM, DKI, BOLD, T1mapping and ASL), followed by pathological analysis. A total of 25 parameters of renal cortex and medulla were analyzed as features.The pathology scores were divided into 3 groups using K-means clustering method. Lasso regression was applied for the initial selecting of features. The optimal features and the best techniques for pathological grading were obtained. Multiple classifiers were used to construct models to evaluate the predictive value for pathology grading.
Results All rats were categorized into mild, moderate, and severe injury group according the pathologic scores. The 8 features that correlated better with the pathologic classification were medullary and cortical Dp, cortical T2*, cortical Fp, medullary T2*, ∆T1, cortical RBF, medullary T1. The accuracy(0.83, 0.850, 0.81, respectively) and AUC (0.95, 0.93, 0.90, respectively) for pathologic classification of the logistic regression, SVM, and RF are significantly higher than other classifiers. The logistic and combining logistic, RF and SVM model different techniques for pathology grading, the stable and perform are both well. Based on logistic regression, IVIM has the highest AUC (0.93) for pathological grading, followed by BOLD(0.90).
Conclusion The multi-parametric MRI-based machine learning model could be valuable for noninvasive assessment of the degree of renal injury.
Education Gradients in Parental Time Investment and Subjective Well-being
Authors: Kalil Ariel , Mayer Susan , Delgado William , Gennetian Lisa
Published: February 2024

College-educated mothers spend substantially more time in intensive childcare than less educated mothers despite their higher opportunity cost of time and working more hours. Using data from the 2010–2013 and 2021 waves of the Well-being Module of the American Time Use Survey, we investigate this puzzle by testing the hypothesis that college-educated mothers enjoy childcare more. We find that among all mothers, spending time in childcare is associated with higher positive feelings compared to spending time in other activities. However, college-educated mothers experience no more positive feelings and no fewer negative feelings during intensive childcare than other mothers. Moreover, college-educated mothers report substantially fewer positive feelings for time spent in management activities and substantially more negative feelings for time spent in educational activities with their child. Findings are robust to controlling for a rich set of covariates, mother fixed effects, and simulations to account for selection into intensive childcare.
JEL codes: D13, J13, J22
Influence of fibre arrangement on the shear behaviour of continuous carbon fibre composites and consequences on the estimation of their axial compressive strength
Authors: Méchin Pierre-Yves , Borras Anastasia , Keryvin Vincent
Published: February 2024

Axial compressive strength is a key design parameter for CFRP structures.One of its limiting factors is the non-linear shear behaviour of the unidirectional ply.We investigate the estimation of this behaviour from those of its constituents by computational homogenisation with an hexagonal unit cell and different random microstructures with smooth and clustered fibre distributions.A random microstructure without clusterings predicts the shear modulus most closely.However, the modelled shear responses converge at higher loadings so that an hexagonal model is sufficient to estimate the non-linear shear behaviour and in turn give accurate estimations of measured compressive strength
Ensuring the Safety of Indian Herbal Drugs: A Comprehensive Assessment of Heavy Metal Contaminations with Emphasis on Lead, Arsenic and Cadmium
Authors: Ibrahim Munir , Detroja Asmita , Bhimani Avani , Bhatt Tirth Chetankumar , Koradiya JayKumar , Sanghvi Gaurav , Bishoyi Ashok Kumar
Published: February 2024

Background
This study addresses the critical concern of heavy metal contamination in medicinal plants, with potential health risks such as renal failure and chronic toxicity. The World Health Organization advocates stringent control of heavy metals, including lead (Pb), arsenic (As), and cadmium (Cd), in herbal medicines to ensure safety, with recommended limits emphasizing their toxicity even at low concentrations (Pb: 10 mg/kg, As: 10 mg/kg, Cd: 0.3 mg/kg).
Methods and Results
Focusing on Shatavari (Asparagus racemosus), Ashoka (Saraca asoca), Ashwagandha (Withania somnifera), and Safed Musli (Chlorophytum borivilianum), this research, utilizing ICP-MS for heavy metals analysis, revealed Pb concentrations within safe limits across all samples, and As was absent in Shatavari and Ashoka samples. Cd concentrations in all drugs were below the 0.080 mg/kg limit of detection, highlighting the method's sensitivity.
Conclusion
The study affirms that heavy metal concentrations in the studied herbal drugs are within acceptable limits, reinforcing their safety. This research provides vital insights, emphasizing the necessity for ongoing monitoring and adherence to international standards in comprehensive pharmacological and toxicological evaluations, ensuring the well-being of consumers.
Menopausal status-dependent alterations in the transcript levels of genes encoding ERα, ERβ, PR and HER2 in breast tumors with different receptor status
Authors: Berkel Caglar
Published: February 2024

Breast cancer has distinct causes and prognoses in patients with premenopausal and postmenopausal status. The expression status of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) are analyzed by immunohistochemistry to classify molecular subtypes of breast cancer among which huge differences in prognosis exist. In this study, I analyzed the mRNA expression of ESR1 (encoding ERα), ESR2 (encoding ERβ), PGR (encoding PR) and ERBB2 (encoding HER2) based on menopausal status (pre- vs post-menopausal) in breast cancer patients with different receptor status. I found that, in ER-positive or PR-positive or HER2-negative breast tumors, ESR1 transcript levels are higher in tumors from postmenopausal women than those from premenopausal women; in contrast, ESR2 transcript levels are lower in tumors from postmenopausal women than those from premenopausal women. Furthermore, PGR mRNA expression were lower in breast tumors from postmenopausal women than those from premenopausal women, only in those with ER + or PR + status. I also analyzed the expression of these genes between tumors from pre- and post-menopausal patients with breast cancer based on the combination of status of three receptors. Together, the results suggest that mRNA expression of ESR1, ESR2 and PGR might differ depending on menopausal status in breast tumors with certain receptor status. More importantly, the change in the expression of ESR1 and ESR2 following menopause is in the opposite directions in breast cancer patients, pointing to the need to identify molecular mechanisms regulating the expression of ER isoforms post-menopause in breast cancer patients, considering the clinical importance of these receptors on the prognosis of patients.
Identifying quality and inequality in prehabilitation services before cancer surgery: a Delphi study informed by lived and professional experience
Authors: Wareing Laura , Hirst Yasemin , Shelton Cliff , Gaffney Christopher , Partridge Andrea , Rycroft-Malone Jo , Smith Andrew , Ashmore Lisa
Published: February 2024

Background
Preoperative cancer prehabilitation interventions have been described as the practice of enhancing a patient’s functional capacity before surgery, aiming to improve postoperative outcomes. Internationally, it is increasingly recommended for implementation in clinical practice to improve patients’ functional and psychological wellbeing before cancer surgery. There is a gap in evidence on how and where it is delivered, what patients want from interventions and how inequalities in access and resources are addressed. In this study, both people with lived experience of cancer and healthcare professionals created criteria for quality and equitable preoperative cancer prehabilitation.
Methods
A modified Delphi technique was implemented over three rounds of online questionnaires with prehabilitation professionals (experts by profession) and people with lived experience of cancer (experts by experience). The criteria statements included in the first round of the questionnaire were suggested and developed in a series of co-design workshops. In each Delphi round, participants were asked to rank the statements on a 5-point Likert scale and make suggestions for refinement or additional statements. The consensus rate was defined as at least 75% of participants voting to indicate agreement on each statement.
Results
A total of 22 participants voted in Delphi questionnaire with a 76% response rate. 63.6% of the participants were ‘experts by experience’ and 36.4% were ‘experts by profession’. The questionnaire started with 54 statements and 60 statements reached consensus. The criteria cover seven themes including developing and delivering prehabilitation, (covering prehabilitation definitions, safety and evaluation processes and interactions with patients), emotional health, nutritional, physical and multi-modal interventions, integrating community-based care and addressing inequalities.
Conclusions
To the authors’ knowledge, this is the first study that has developed criteria to guide the evaluation and design of prehabilitation interventions before cancer surgery with an emphasis on addressing inequalities, which have been developed by both experts by experience and profession.
The criteria enhance the evidence base on patient and healthcare professional preferences for quality and equitable access to prehabilitation interventions. The results will be of interest to researchers, healthcare professionals and service providers interested in designing, evaluating and delivering prehabilitation before cancer surgery.
Facial expression associates with longitudinal multi-organ failure: an ICU cohort study
Authors: Cox Eline G.M. , Bussel Bas C.T. van , Llamazares Nerea Campillo , Sels Jan-Willem E.M. , Onrust Marisa , Horst Iwan C.C. van der , Koeze Jacqueline , Group SICS Study
Published: February 2024

Background
Facial expression, at least unconsciously, may affect clinical decisions and treatments in the ICU. However, the association between objective clinical measurement of facial expression and multi-organ failure remains unknown. The aim of this study was to examine whether facial expression at admission is associated with longitudinal measurement of multi-organ failure.
Methods
This was a sub-study of the Simple Intensive Care Studies-II, a prospective observational cohort study. All adult patients acutely admitted to the ICU between March 26, 2019, and July 10, 2019, were included. Facial expression was assessed within three hours of ICU admission using predefined pictograms. The SOFA score was serially measured each day for the first seven days after ICU admission. The association between eye opening and facial color with longitudinal Sequential Organ Failure Assessment (SOFA) scores were investigated using generalized estimation equations.
Results
SOFA scores were measured in 228 patients. Clinical gestalt scored by the degree of eye opening was associated with a higher SOFA score at admission and follow-up (unadjusted 0.7 points per step (95%CI 0.5 to 0.9)). Facial color was not associated with worse SOFA score over time. However, patients with slinked or closed eyes combined with blushed skin had a lower SOFA score than patients with a pale or normal skin color (P-interaction < 0.1).
Conclusions
The patient's face revealed integrated cues regarding the disease state of critically ill patients, as scored by the degree of eye opening and facial color. Incorporating clinical gestalt using more advanced facial recognition techniques is promising to support future intensive care.