bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulation of pedestrian dynamics based withemantic trajectory segmentation
Authors: Rahmanov Mikhail , Shishkin Andrey , Komkov Vladimir , Alpackaya Irina
Published: January 2023

The article analyzes the existing methods of information processing necessary for the functioning of the system of intelligent control over unregulated pedestrian crossings based on aggregation and data processing by means of IOT. The state space model of the switching Kalman filter is considered, the development of mathematical software for the analysis and processing of information based on the results of intelligent control over unregulated pedestrian crossings, in particular with semantic segmentation of trajectories using agent-based models, is carried out. An MDA (Markov Decision Process) state space model is presented, a Hidden Markov Model (HMM) which has discrete hidden variables. The developments for the development of the following subsystems are presented: activity detector subsystem. Receives video frames as input, supports the static object model (background model) and returns the hotspot mask for the current frame; subsystems for detecting and tracking objects (pedestrians and cars). Based on the video frame and hotspot mask, it detects and accompanies objects of a given class, returning their coordinates; trajectory analysis subsystem. Analyzing the history of movement of pedestrians and cars, returns the facts of traffic violations.
Features meaningfulness of life among students with different attitudes to the time perspective as a component of sustainable social development
Authors: Abakumova Irina , Selezneva Yulya , Komerova Natalia , Pronenko Evgeny
Published: January 2023

The article is aimed at analyzing the features of life style and meaningfulness of life among students depending on different attitudes to time. The analysis of modern studies of time perspective as a category of psychology is presented; the main components of meaning-life orientations, locus-control of the Ego are described. The object of the study was university students from 18 to 21 years old in the number of 294 people. The following methods were used: F. Zimbardo's time perspective questionnaire; D.A. Leontiev's "Life Orientations" test; Kellerman-Plutchik Lifestyle Index questionnaire, Mann-Whitney U statistical criterion; Spearman rank correlation. It is proved that depending on the respondents' attitude to the time perspective, both the level of meaningfulness of life and the strategy of behavior in stressful situations change. It is concluded that respondents with a focus on the future have a greater meaningfulness of life, they also are more tend to setting life goals. Moreover, the leading types of life styles statistically differ, depending on the the responders’ attitude to time.
Coronaviruses of synantropic bats: an unexplored threat
Authors: Lipilkina Tatyana , Popov Ilia , Kitsenko Karina , Popov Igor , Ermakov Alexey
Published: January 2023

More than 60% of human viral pathogens are of zoonotic origin, resulting from accidental or frequent animal infections. Bats are reservoirs of various viruses, pathogens in humans of varying severity from mild asymptomatic forms to severe lethal outcomes. And are associated with the spread of various viruses (Marburg virus, Ebola virus) and, above all, coronaviruses. Since the 2000s, three independent outbreaks of coronaviruses with the emergence of new zooanthroponotic human coronaviruses (Betacoronavirus) with epidemic and pandemic potential have been registered. The first outbreak was reported in 2002 (SARS), caused by SARS-CoV, in the PRC (Guangdong Province). The second outbreak occurred in 2012 (MERS, MERS), associated with MERS-CoV, Saudi Arabia. The third occurred in 2019 PRC (Hubei Province), this case evolved into a COVID-19 pandemic caused by SARS-CoV-2. These cases seem to be independent, but the literature reports that the emergence of all these viruses is related to evolutionary processes driven by environmental and genetic aspects. It is assumed that the coronavirus causative agent of severe acute respiratory syndrome-2 (SARS-CoV-2) originated from a coronavirus-infected bat of the genus Rhinolophus. After initial emergence, due to the host vector. SARS-CoV-2 is now transmitted worldwide through human-to-human transmission. Data from experimental studies show that animal species such as cats, ferrets, raccoon dogs, Javanese macaques, rhesus macaques, white-tailed deer, rabbits, Egyptian fruit bats and Syrian hamsters are susceptible to SARS-CoV-2 infection. However, natural SARS-CoV-2 infections have only been reported in domestic dogs and cats, tigers, lions, snow leopards, cougars and gorillas in zoos, and farm-raised mink and ferrets. Although human-to-animal transmission has been reported in several cases, animal-to-human transmission of SARS-CoV-2 has been reported only from mink to humans on mink farms.
Energy performance of commercial c-Si PV modules in accordance with IEC 61853-1, -2 and impact on the annual specific yield
Authors: Monokroussos Christos , Zhang Yating , Lee Eleanor W. , Xu Frank , Zhou Allen , Zhang Yichi , Herrmann Werner
Published: January 2023

As energy yields of photovoltaic modules are highly related to local climate and ambient conditions, it is necessary to assess the energy-yield performance of PV modules under various operating conditions. This work compares commercial crystalline silicon (c-Si) based PV modules (including mono c-Si Al BSF, mono c-Si PERC, multi-crystalline (mc-Si) Al BSF, and n-type c-Si solar cells) sampled from 27 PV module manufacturers located in the Asia-Pacific region between 2016 and 2022. Several test items were compared including: (i) light-induced degradation (LID), (ii) irradiance-temperature-efficiency (GTE) matrix, (iii) angular response and (iv) temperature coefficients, which are correspondingly performed according to IEC 61215-1, -1-1, -2 and IEC 61853-1, -2. The coefficient of variation (CoV) was calculated to express the module-to-module differences within similar technology types. Benefiting from the technological innovation of c-Si based PV modules, emerging PV modules feature better performance in some extreme ambient conditions, such as low irradiance, high ambient temperature, and high ratio of diffuse irradiance. The analysis of CoV indicates that the difference of irradiance-dependent and thermal behavior between modules within the same technology may exceed the differences between different technologies. Using synthetic hourly meteorological data of 5 sites from MeteoNorm in PVsyst, the annual specific yield of four technology groups of PV modules were simulated and compared. Overall, it is shown that the maximum differences as large as 7.34% in terms of PV module's specific yield are expected within same PV technology, which exceeds the maximum difference of 2.16% obtained for specific yields of different PV technologies.
A computed tomographic evaluation of femoral and tibial rotational reference axes in total knee arthroplasty
Authors: Panicker Johncy , Thilak Jai
Published: January 2023

Introduction: The surgical trans epicondylar axis (sTEA) is considered the gold standard for optimum rotation of the femoral component; however, no consensus exists on tibial component positioning. The objectives of this study were to determine the relationship of sTEA to various femoral and tibial reference axes in varus osteoarthritis (OA) knees and (ii) to study the intra-observer and inter-observer variability of the axis relationships. Materials and methods: The study was done on preoperative computerised tomogram (CT) scans of 110 varus knees to assess the rotational relationships respectively of femoral side sTEA with whitesides line (WSL), posterior condylar axis (PCA), clinical trans epicondylar axis (cTEA) and on the tibial side sTEA with posterior tibial margin (PTM), anterior condylar axis (ACA), Akagi’s line and line from the geometric centre of the tibial plateau to 1/3rd tibial tubercle (line GC 1/3rd TT). Results: On the femoral side the mean angles of sTEA with WSL, PCA, cTEA were 95.64° ± 2.85°, 1.77° ± 1.88°, 4.19° ± 0.99° respectively. On the tibial side, the mean angles of sTEA with, PTM, ACA, Akagi’s line, and line GC 1/3rd TT were 1.10° ± 4.69°, 11.98° ± 4.51°, 2.43° ± 4.35°, 16.04° ± 5.93° respectively. Conclusion: Contrary to the generalization, TEA has variable relationships. The surgical trans epicondylar axis was not at the assumed 3° of external rotation to PCA in 85% of knees, nor perpendicular to WSL in >95% of knees. Of the four tibial axes, Akagi’s line was the least variable with sTEA. Furthermore, surgeons should also be aware of the multiple reference axes and the range of deviation from sTEA to optimize the rotational alignment of components.
Transconjunctival Lower Eyelid Blepharoplasty with Volume Augmentation for Correction of the Lower Eyelid and Cheek Junction
Authors: Asaria Jamil
Published: January 2023

Aesthetic surgical management of the inferior periorbital region should include an approach to volume augmentation of the midface and infraorbital hollow, reduction of fat pseudoherniation in the lower eyelids, and treatment of the overlying skin. A combined approach using volume augmentation with fat grafting, a transconjunctival approach to the lower eyelid fat pads, and conservative management of the lower eyelid skin can produce optimal aesthetic results while minimizing complications. Fat harvest from the thigh and abdominal region allows for ample grafting material to the lateral cheek, midface, and orbital rim. The treatment paradigm is to restore volume optimally while minimizing fat resection in the lower eyelids. Volume augmentation is used to restore youthful contours, as well as to counter deflation and laxity in the periorbital and midfacial regions.
Mechanisms of Thrombosis in Heparin-Induced Thrombocytopenia and Vaccine-Induced Immune Thrombotic Thrombocytopenia
Authors: Selvadurai Maria V. , Favaloro Emmanuel J. , Chen Vivien M.
Published: January 2023

Heparin-induced thrombocytopenia (HIT) and vaccine-induced immune thrombotic thrombocytopenia (VITT) are rare, iatrogenic immune-mediated conditions with high rates of thrombosis-related morbidity and mortality. HIT is a long-recognized reaction to the administration of the common parenterally administered anticoagulant heparin (or its derivatives), while VITT is a new, distinct syndrome occurring in response to adenovirus-based vaccines against coronavirus disease 2019 and potentially other types of vaccines. A feature of both HIT and VITT is paradoxical thrombosis despite a characteristic low platelet count, mediated by the presence of platelet-activating antibodies to platelet factor 4. Several additional factors have also been suggested to contribute to clot formation in HIT and/or VITT, including monocytes, tissue factor, microparticles, endothelium, the formation of neutrophil extracellular traps, complement, procoagulant platelets, and vaccine components. In this review, we discuss the literature to date regarding mechanisms contributing to thrombosis in both HIT and VITT and explore the pathophysiological similarities and differences between the two conditions.
Quantum dots: Another choice to sensitize organic transformations
Authors: Ye Chen , Zhang De-Shan , Chen Bin , Tung Chen-Ho , Wu Li-Zhu
Published: January 2023

Photochemical reactions are among the most important reactions in both theoretical studies and practical applications, since they utilize photon energy as the primary driving force. The sensitizer species is the key component connecting photons and the chemical materials of the reaction, which is conventionally among organic dyes or metal complex molecules. Semiconductor quantum dots (QDs), widely used in optoelectronic materials, and fluorescence sensing can be also applied to organic transformations due to their inherent physical and chemical properties. The similar functionalities and special photophysical features make QDs an ideal sensitizer and promote the efficient progress of the photochemical reactions. Moreover, the booming of QD photocatalysis reveals the excellent potential of interdisciplinary development between nano-materials science and organic chemistry QDs. Hence, a systematical explanation of the reaction principle of QDs in photocatalytic processes is necessary. In this review, we analyze the structural and optical properties of the QDs and illustrate how QDs participate in and facilitate organic reactions belonging to different pathways. We also present an outlook on the development of QD photocatalysis.
Study on the precipitation mechanisms of TiC particles in steel matrix composites fabricated by eutectic solidification
Authors: Huang Long , Liu Jia , Deng Xiangtao , Wang Zhaodong
Published: January 2023

The precipitation mechanisms of TiC eutectic particles in steel matrix composites prepared by eutectic solidification are studied through thermodynamic calculations and experimental analyses. The results indicate that the eutectic TiC particles begin to precipitate when the concentrations of Ti and C in the residual molten steel reach a eutectic point during the solidification process. The mass fractions of Ti and C in SMCs play significant roles in the precipitation time, particle characteristics and precipitation mechanism characteristics of TiC eutectic particles. When the mass fractions of Ti and C in SMC are low, TiC particles precipitate in the form of divorced eutectic solidification, showing strip, block and irregular shapes that are mainly distributed on the grain boundaries. When the mass fractions of Ti and C are high, TiC particles precipitate in the form of eutectic solidification, showing flake and dendritic shapes that are distributed on the grain boundaries and also in the grains. There are orientation relationships between the eutectic particles and the matrix.
Low power paper electronics based wearable radiation detector using hybrid halide perovskite (MAPbBr3): A real time monitoring of gamma ray
Authors: Maity Avisek , Siraj Sohel , Raychaudhuri A K , Saha Abhijit , Ghosh Barnali
Published: January 2023

In this report we demonstrate that a paper based flexible gamma ray detector can be made using hybrid halide perovskite methyl ammonium lead bromide (CH3NH3PbBr3 or MAPB). The wearable paper based detector is solution processed and works at room temperature. It detects gamma ray by a direct method by change of its resistance on exposure to gamma ray and uses IDE (interdigitated electrodes) for boosting current response. This detector grown on a substrate like a paper with large active area, shows a maximum calibrated sensitivity of 5.26 μC Gy−1 cm−2 and a reasonable mobility—life time product (

μ
τ

) ∼2 × 10−5 cm2 V−1. The detector can be operated in a wide range of gamma photon energy between 100 KeV to 1100 KeV and can detect radiation down to 0.01 μCi activity, which is noise limited. The paper detector shows a good shelf life of more than 6 months and a fast response time of a few seconds. The detector has a high degree of sustenance under exposure to high dose of Gamma radiation and was tested for a cumulative dose of minimum 1.6 KGy. The detector has low power consumption with can operate down to 1 V direct current (DC) bias and with a detector current of ∼1nA. The sensitivity increases with bias and shows saturation beyond 40 V bias. Such a low power flexible gamma detector is expected to have application potential in areas like health care and point of use quick radiation detection.
Analysis of fluid-structure interaction in a directional permeability membrane in pressure-driven flow
Authors: Bayat Hamid , Krueger Paul S , Willis David A
Published: January 2023

Finite volume and finite element analysis of fluid-structure interaction is performed to understand the behavior of a directional permeability membrane in pressure-driven flow. The membrane is comprised of two flexible porous sheets separated by a spacer. The porous sheets each have a different thickness with pores that are offset from each other. The design allows flow when the thicker sheet is on the high pressure side, but prevents flow if the pressure gradient is reversed. Flow through the membrane is studied for a pressure range of 0.01–0.1 m H2O in forward flow to understand the complex fluid motion and dependence of membrane deformation on sheet thickness, downstream pore diameter, and initial gap between the sheets. In forward flow, maximum mass flow rate of 0.2 g s−1 (or flow rate of 12.024 ml min−1) can be obtained at 0.1 m H2O pressure head. Reverse flow conditions are modeled to study the effect of design parameters on the required closing pressure, indicating that as little as 0.0325 m H2O of pressure head is required for closing.
Waning of 2-Dose BNT162b2 and mRNA-1273 Vaccine Effectiveness Against Symptomatic SARS-CoV-2 Infection Accounting for Depletion-of-Susceptibles Bias
Authors: Andrejko Kristin L , Pry Jake M , Myers Jennifer F , Mehrotra Megha , Lamba Katherine , Lim Esther , Fukui Nozomi , DeGuzman Jennifer L , Openshaw John , Watt James , Jain Seema , Lewnard Joseph A , COVID-19 Case-Control Study Team on behalf of the California
Published: January 2023

Concerns about the duration of protection conferred by coronavirus disease 2019 (COVID-19) vaccines have arisen in postlicensure evaluations. “Depletion of susceptibles,” a bias driven by differential accrual of infection among vaccinated and unvaccinated individuals, may obscure vaccine effectiveness (VE) estimates, hindering interpretation. We enrolled California residents who received molecular SARS-CoV-2 tests in a matched, test-negative design, case-control study to estimate VE of mRNA-based COVID-19 vaccines between February 23 and December 5, 2021. We analyzed waning protection following 2 vaccine doses using conditional logistic regression models. Additionally, we used data from a population-based serological study to adjust for “depletion-of-susceptibles” bias and estimated VE for 3 doses, by time since second dose receipt. Pooled VE of BNT162b2 and mRNA-1273 against symptomatic SARS-CoV-2 infection was 91.3% (95% confidence interval (CI): 83.8, 95.4) at 14 days after second-dose receipt and declined to 50.8% (95% CI: 19.7, 69.8) at 7 months. Adjusting for depletion-of-susceptibles bias, we estimated VE of 53.2% (95% CI: 23.6, 71.2) at 7 months after primary mRNA vaccination series. A booster dose of BN162b2 or mRNA-1273 increased VE to 95.0% (95% CI: 82.8, 98.6). These findings confirm that observed waning of protection is not attributable to epidemiologic bias and support ongoing efforts to administer additional vaccine doses to mitigate burden of COVID-19.
Invited Commentary: Undiagnosed and Undertreated—the Suffocating Consequences of the Use of Racially Biased Medical Devices During the COVID-19 Pandemic
Authors: Plaisime Marie V
Published: January 2023

While medical technology is typically considered neutral, many devices rely upon racially biased algorithms that prioritize care for White patients over Black patients, who may require more urgent medical attention. In their accompanying article, Sudat et al. (Am J Epidemiol. 2023;XXX(XX):XXX–XXX) document striking inaccuracies in pulse oximeter readings among Black patients, with significant clinical implications. Their findings suggest that this resulted in racial differences in delivery of evidence-based care during the coronavirus disease 2019 (COVID-19) pandemic, affecting admissions and treatment protocols. Despite the medical community’s growing awareness of the pulse oximeter’s significant design flaw, the device is still in use. In this article, I contextualize Sudat et al.’s study results within the larger history of racial bias in medical devices by highlighting the consequences of the continued underrepresentation of diverse populations in clinical trials. I probe the implications of racially biased assessments within clinical practice and research and illustrate the disproportionate impact on patients of color by examining 2 medical tools, the pulse oximeter and pulmonary function tests. Both cases result in the undertreatment and underdiagnosis of Black patients. I also demonstrate how the social underpinnings of racial bias in medical technology contribute to poor health outcomes and reproduce health disparities, and propose several recommendations for the field to rectify the harms of racial bias in medical technology.
Associations between hidradenitis suppurativa and dermatological conditions in adults: a national cross-sectional study
Authors: Brown Isabelle D , Adawi Waleed , Saal Ryan , Perkins-Holtsclaw Kala , Roberts Alice
Published: January 2023

Hidradenitis suppurativa (HS) is a chronic, inflammatory condition associated with numerous comorbidities, but there has been no broad-spectrum investigation into the dermatological comorbidities that are associated with HS using nationally representative data. We therefore analysed the 2016–2018 National Inpatient Sample for adult patients with and without HS and used multivariable logistic regression to determine correlations between HS and 25 dermatological conditions, adjusting for age, ethnicity and race, sex and insurance type. As seen previously, HS is more likely to affect women and Black people. The prevalence of having any of the 25 dermatological conditions was higher in patients with HS than without (24.60% vs. 5.30%, P < 0.001) and HS was specifically associated with 18 of the 25 dermatological conditions. This research confirms anecdotal disease relationships and identifies novel correlations between HS and dermatological conditions using a national patient population.
Alfred Marshall, Allyn Young and business size
Authors: Chandra Ramesh
Published: January 2023

Many prominent thinkers such as Karl Marx and Joseph Schumpeter thought that monopoly capitalism would eventually replace competitive capitalism. Several subsequent economists like Antoine Cournot and Piero Sraffa also maintained that increasing returns are incompatible with competition. This paper examines Alfred Marshall’s and Allyn Young’s views on whether monopoly capitalism is inevitable and whether increasing returns are incompatible with competition. Both Marshall and Young took their data from real life and were of the view that the economy was dominated not by big but small and medium firms. Both built on Adam Smith’s analysis of the division of labour and thought that the dominant tendency in the system was that of industrial specialisation and differentiation. Even if some firms producing standardised products such as steel or raw materials became big, most specialised firms remained small, and both small and big firms coexisted in a framework of effective competition. Advent of imperfect competition did not mean absence of competition but rather its imperfect working.
Polycomb response elements reduce leaky expression of Cas9 under temperature-inducible Hsp70Bb promoter in Drosophila melanogaster
Authors: Warsinger-Pepe Natalie , Chang Carly , Desroberts Connor R , Akbari Omar S
Published: January 2023

Heat-shock-inducible expression of genes through the use of heat-inducible promoters is commonly used in research despite leaky expression of downstream genes of interest without targeted induction (i.e. heat shock). The development of non-leaky inducible expression systems is of broad interest for both basic and applied studies, to precisely control gene expression. Here we characterize the use of Polycomb response elements and the inducible Heat-shock protein 70Bb promoter, previously described as a non-leaky inducible system, to regulate Cas9 endonuclease levels and function in Drosophila melanogaster after varying both heat-shock durations and rearing temperatures. We show that Polycomb response elements can significantly reduce expression of Cas9 under Heat-shock protein 70Bb promoter control using a range of conditions, corroborating previously published results. We further demonstrate that this low transcript level of heat-induced Cas9 is sufficient to induce mutant mosaic phenotypes. Incomplete suppression of an inducible Cas9 system by Polycomb response elements with no heat-shock suggests that further regulatory elements are required to precisely control Cas9 expression and abundance.
Impact of the First COVID-19 Pandemic Wave on Hospitalizations and Deaths Caused by Geriatric Syndromes in France: A Nationwide Study
Authors: Torres Marion J , Coste Joël , Canouï-Poitrine Florence , Pouchot Jacques , Rachas Antoine , Carcaillon-Bentata Laure
Published: January 2023

Background

The fear of contracting coronavirus disease 2019 (COVID-19) and the preventive measures taken during the health crisis affected both people’s lifestyles and the health system. This nationwide study aimed to investigate the impact of the first wave of the COVID-19 pandemic on hospitalizations and mortality related to geriatric syndromes (GS) in older adults in France.

Methods

The French National Health Data System was used to compare hospital admissions (excluding the main diagnosis of COVID-19) and mortality rates (using multiple-cause and initial-cause analyses, and both including or excluding confirmed/probable COVID-19) related to 10 different GS (dementia, other cognitive disorders and symptoms, delirium/disorientation, depression, undernutrition/malnutrition, dehydration, pressure ulcer, incontinence, fall/injury and femoral neck fracture) from January to September 2020 to rates observed in previous years. Analyses were stratified by age, sex, place of residence or place of death, and region.

Results

Hospitalization rates for all GS decreased during the first lockdown compared to the same periods in 2017-19 (from −59% for incontinence to −13% for femoral neck fractures). A dose–response relationship was observed between reduced hospitalizations and COVID-19-related mortality rates. Conversely, for almost all GS studied, excess mortality without COVID-19 was observed during this lockdown compared to 2015-17 (from +74% for delirium/disorientation to +8% for fall/injury), especially in nursing homes and at home.

Conclusions

In France, during the first lockdown, a substantial decrease in hospitalizations for GS was accompanied by excess mortality. This decline in the use of services, which persisted beyond lockdown, may have a mid- and long-term impact on older adults’ health.
The Longitudinal Association Between Frailty, Cognition, and Quality of Life in Older Europeans
Authors: Hu Wei , Chu Jiadong , Zhu Yixian , Chen Xuanli , Sun Na , Han Qiang , Li Tongxing , Feng Zhaolong , He Qida , Wu Jun , Shen Yueping
Published: January 2023

Objectives

Evidence on the association between frailty and quality of life (QoL) is mostly limited to cross-sectional studies. Thus, the temporal order and potential mechanisms of this association are largely unknown. Our study examines both the directionality of this association and the role of cognition in this association in longitudinal data.

Methods

Cross-lagged panel models were employed to examine the temporal relationship between frailty and QoL, as well as cognition’s role among 19,649 older adults in Europe. Frailty, QoL, and cognition were assessed using the health deficit index, CASP-12, and 3 standard cognitive tests, respectively.

Results

We observed a bidirectional association between frailty and QoL and their dynamics. High initial levels of frailty predicted poorer QoL later and vice versa (β = −0.151 and −0.052, p < .001). The early change in frailty predicted the late change in QoL, and vice versa (β = −0.093 and −0.061, p < .001). Frailty or its early change drives this interrelationship. Cognition at Wave 5 partially mediated frailty’s effect at Wave 4 on QoL at Wave 6 (indirect effect: β = −0.005, 95% confidence interval = −0.006, −0.004).

Discussion

Our findings supported that early prevention of frailty and its risk factors may have more influential protective effects on later physical and mental health, as well as the need for ongoing screening for mental health in aging population. Also, the maintenance of good cognitive performance may help interrupt this possible vicious cycle linking frailty and QoL decline.
Suicide Risk Help-Seeking Among Middle- to Old-Age Adults: A Systematic Review
Authors: Wang Xiaochuan , Beltran Susanny , Burns Rachael , Hamel Marie , Gray Sydney , Gryglewicz Kim
Published: January 2023

Background and Objectives

Suicide has become a major public health concern worldwide and in the United States. Rates of suicide increase during the life course and are highest among middle- to old-age adults. Help-seeking represents a crucial coping mechanism that can mitigate suicide risk. Yet, less is known about suicide risk help-seeking, especially among these age groups. To address this knowledge gap, a systematic review of existing literature was performed to obtain a refined understanding of help-seeking for suicide risk among middle- to old-age adults.

Research Design and Methods

Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, electronic databases and key journals with suicide and/or gerontology focuses were searched to identify peer-reviewed publications in English between 2010 and 2020. A total of 4 732 unduplicated publications were screened for relevance based on titles and abstracts, of which 52 were reviewed in full text.

Results

Twenty-four articles met inclusion criteria and were included in the qualitative synthesis. These articles discussed a range of topics, including the prevalence of service utilization, service use prior to a suicide death, and correlates of help-seeking. In general, the prevalence of service utilization was low and varied by suicidal history (eg, higher prevalence among individuals with a history of suicide attempts than those with suicide ideation only). Key facilitators (eg, current or history of suicidal thoughts, plans, or attempts) and barriers (eg, stigma) for service use and help-seeking were also identified.

Discussion and Implications

Findings highlight the need for future studies and tailored services to improve age-appropriate and culturally responsive suicide prevention and intervention strategies for middle- to old-age adults.
POTENTIAL EFFECTS OF FOOD ON A NOVEL DRUG DELIVERY SYSTEM (DDS) TO DELIVER A THERAPEUTIC COMPOUND IN THE COLON
Authors: Lee Shaoying Nikki , Stork Cheryl , Razag Ghesal , Quintana Nelson , Wahl Chris , Singh Sharat
Published: January 2023

The clinical remission rate in moderate to severe ulcerative colitis (UC) and Crohn’s disease (CD) has plateaued at ~15-20% despite the approval of multiple therapeutics. Research has shown that an inadequate amount of drug at the disease site in the colon may be responsible for limited clinical benefit. The Drug Delivery System (DDS) is an ingestible electronic targeted delivery device containing a localization system to autonomously identify colon entry based on gastrointestinal (GI) anatomy, independent of the variable GI physiological conditions, and deliver a bolus of a liquid drug formulation to the colon mucosa to improve efficacy and reduce systemic toxicity. In this study, we aim to evaluate the safety, tolerability, and functionality of the DDS devices in fasted and fed states in normal healthy volunteers (NHV).

NHV were enrolled and administered a single DDS device at each week in either the fasted state or in 1 of 3 possible fed schedules over ~ 4 weeks. Subjects were fasted overnight and were dosed in the morning (fasted schedule) or fasted overnight and consumed a light breakfast with equivalent calories and protein/fat content of egg-beater meal either immediately before administration of DDS device (fed schedule #1), 30 minutes post-dose (fed schedule #2), or 2 hours pre-dose (fed schedule #3). Devices were recovered from the feces, and data were extracted from the capsule to confirm the function of the colon entry call and activation of payload release.

A total of twelve NHV (N=12) were enrolled in this study. Eleven subjects completed all four fasted/fed dosing schedules over 4 weeks, while one subject was withdrawn due to non-compliance with device recovery. Overall, the DDS device was well-tolerated in all enrolled subjects with a total of 46 devices dosed in this study. Mild AEs were reported as possibly related to the device in two subjects, including vomiting (N=1) and nausea (N=1) following device administration which was resolved on the same day. No other device-related AEs were reported in this study.

Out of 44 devices administered to 11 subjects, 43 were successfully recovered, and device data was successfully recovered from 39 devices for device function evaluation. Thirty-nine devices for which data was recovered (100%) had successfully identified colon entry calls (S4) and activated H2 gas cells for delivery in all fasted/fed schedules (Table 1). Thirty-eight (38) out of 39 recovered devices (97.4%) had successfully activated the payload release function, and one did not (Table 1).

The results from this study demonstrated that the DDS device was well-tolerated and functioned as intended in NHV subjects in these four fasted/fed dosing schedules and confirmed that the potential food effect of a light breakfast meal on the device function of the DDS device is minimal.
EVALUATION OF CLINICAL VARIABLES, RADIOLOGICAL VISUAL ANALOG SCORING, AND RADIOMICS FEATURES ON CT ENTEROGRAPHY FOR CHARACTERIZING SEVERE INFLAMMATION AND FIBROSIS IN STRICTURING CROHN’S DISEASE
Authors: Sleiman Joseph , Chirra Prathyush , Gandhi Namita , Gordon Ilyssa , Viswanath Satish , Rieder Florian
Published: January 2023

PURPOSE

25% of patients with Crohn’s disease (CD) develop severe stricturing disease which is non-responsive to standard-of-care medication. Early and non-invasive determination of the extent of inflammation and fibrosis within the stricture via CT enterography (CTE) could facilitate the selection of targeted therapy or earlier surgical resection to improve patient outcomes; but currently there is no validated and reliable approach for this differentiation. We present initial results for machine-reader evaluation of severe inflammation and fibrosis in CD strictures via quantitative radiomic features and expert radiologist scoring on CTE.

METHODS AND MATERIALS

IRB approved, retrospective, single center study. 100 patients (n=66 for discovery; n=34 for hold-out validation) confirmed with stricturing CD on histopathology and CTE within 15 weeks of surgery. Histopathological Stenosis Therapy & Research (STAR) scoring of specimens (range 0-100, scores > 50 =severe) used as reference standard for inflammation and fibrosis each. An expert radiologist annotated the resected strictures on CTE and provided a global assessment of inflammation and chronic non-inflammatory findings (fibrosis) using a 0-100 visual analog score (VAS). Radiomics features to capture severe inflammation and fibrosis were separately extracted from the annotated strictures. Radiomics models and VAS scores evaluated against pathology-defined severe inflammation and fibrosis, via ROC analysis.

RESULTS

Two distinct sets of radiomic features capturing textural heterogeneity (patterns, wavelets, local entropy) within strictures were significantly associated (p<0.01) with severe inflammation and severe fibrosis; across both discovery (AUC=0.69, 0.69) and hold-out validation (AUCs =0.72,0.67). Radiological VAS had an AUC=0.64 for identifying severe inflammation and AUC =0.62 for identifying severe fibrosis (Figure 1). Clinical variables including sex, age, Montreal classification and stricture type were not significantly associated with severe inflammation or fibrosis, across discovery and validation groups (Table 1).

CONCLUSIONS

Radiomic analysis shows improved performance in identifying severe inflammation and severe fibrosis in CD strictures on CTE compared to radiological visual assessment scoring. Supplementing radiological visual assessment with quantitative radiomics could enable more accurate phenotyping of CD strictures potentially improving outcomes by personalizing treatment pathways.
YIELD OF SERIAL TESTING FOR TUBERCULOSIS EXPOSURE IN THE STUDY OF A PROSPECTIVE ADULT RESEARCH COHORT WITH INFLAMMATORY BOWEL DISEASES (SPARC IBD)
Authors: Lapp Sean , Bewtra Meena , Lewis James
Published: January 2023

BACKGROUND

More than 2 million Americans have Inflammatory Bowel Diseases (IBD), including Crohn’s Disease or Ulcerative Colitis. Although tuberculosis is uncommon in the United States, patients with IBD are at an increased risk for active tuberculosis infection due to the immunosuppressant therapies used to treat IBD. Due to this risk, testing for latent tuberculosis is recommended prior to and intermittently throughout administration of most IBD medications. The utility of this practice in a country with a low incidence and prevalence of tuberculosis is unknown. We aimed to determine the proportion of initial and subsequent tuberculosis tests that are positive, negative, or indeterminate.

METHODS

Data were acquired from SPARC IBD, a component of the Crohn’s & Colitis Foundation’s IBD Plexus research platform. SPARC IBD is a prospective cohort study conducted at 18 centers throughout the USA and includes more than 4,000 patients. Data are collected from SPARC IBD case report forms and the IBD Smartform, diagnoses, test results and prescriptions within the linked electronic medical records. Patients with one or more interferon gamma release assay (IGRA) test for latent tuberculosis were included in this study. The outcome investigated was a positive, negative, or indeterminate lab result. The proportion of positive and indeterminate tests were computed with 95% confidence intervals (CI). Fisher’s exact test was used to detect a change in positive test proportions following a negative test compared to initial lab results.

RESULTS

A total of 687 patients with one or more IGRA test were identified. The median age was 37 (IQR 27-50) with 54% female patients. Of the initial lab results, 644 tests were negative (93.7%, 95% CI, 91.7, 95.4), 37 were indeterminate (5.4%, 95% CI, 3.8, 7.3), and six were positive (0.9%, 95% CI, 0.3, 1.9). Following an initial negative result, 269 patients received a second test, of which five were positive (1.9%, 95% CI, 0.6, 4.3). Following two consecutive negative results, 142 patients received an additional IGRA test, of which one was positive (0.7%, 95% CI, 0.02, 3.9). The proportion of positive tests was not significantly lower following one negative (p = 0.20) or two consecutive negative tests (p > 0.99).

POTENTIAL LIMITATIONS

Many patients only had one test for latent tuberculosis, and it is unclear if the initial IGRA labs in our dataset were their first latent tuberculosis tests.

CONCLUSIONS

Based on the findings of this study, there appears to be value in continued serial testing following a negative result even in the United States, despite the overall low incidence of tuberculosis.
ERGOGENIC AID USE IN ADOLESCENTS AND YOUNG ADULTS WITH INFLAMMATORY BOWEL DISEASE AND MEDICAL PROFESSIONAL COMFORTABILITY IN NUTRITIONAL EDUCATION
Authors: Diefendorf Caitlin , Blatter Michelle , Modiano Nir , Rdesinski Rebecca , Hunter Anna
Published: January 2023

BACKGROUND

There is concern for the lack of data regarding the efficacy and negative effects of ergogenic aids (sport supplements) in patients with Inflammatory Bowel Disease (IBD). This is a prospective research project designed to determine which ergogenic aids are used in pediatric and young adult populations with IBD, the reasons patients use these products, and medical professional comfortability in discussing nutritional concerns with patients.

METHODS

IRB approval was granted by Oregon Health and Science University prior to patient recruitment. A survey was distributed to patients with IBD, ages 10-35. Recruitment occurred through MyChart. A second survey was distributed among medical students, residents, and fully trained professionals of the gastrointestinal healthcare team (fellows, physicians, dieticians, physician assistants, nurse practitioners, and gastrointestinal psychologists). Recruitment occurred via email. SPSS Statistics and RedCap were utilized for chi-square tests and logistic regression in determining significance. Patients were compensated for their participation with gift cards.

RESULTS

Patient total was n=124; Female 46%; Male 52%; Non-binary 2.1%; Crohn’s Diagnosis 69%; Ulcerative Colitis Diagnosis 31%. There was a significant difference in the number of patients who reported having used at least one ergogenic aid compared to none (n=77, 62%, p-value=<0.001). Excluding caffeine, majority of respondents utilized at least one other ergogenic aid (n=69, 56%). Specific ergogenic aid usage is detailed in Figure 1. Reasons for choosing to use ergogenic aids are detailed in Figure 2.

Medical professional response total was n=157, medical students=93, residents=21, fully trained=43. Majority of medical professionals reported they had not received adequate nutritional training during their didactic curriculum (n=126, 80%) and would have preferred additional nutritional training during their didactic courses (n=135, 86%). Increased comfortability discussing nutrition with patients correlated with an increased level of professional training, p-value=<0.001.

CONCLUSIONS

A statistically significant majority of surveyed IBD patients reported having used ergogenic aids (62%). The most utilized ergogenic aids are detailed in Figure 1. Primary reasons for using ergogenic aids are detailed in Figure 2. Majority of medical professionals reported they had not received adequate nutritional training during their medical school curriculum and were not comfortable discussing nutrition with their patients. This study highlights the prevalence of ergogenic aid usage among pediatric and young adult IBD patients, as well as the importance of improving both IBD patient and medical professional education regarding ergogenic aid safety and effectiveness. We are currently expanding to include a control of healthy patients, ages 10-35.
FOOD ACCESS AND MENTAL HEALTH IN PEDIATRIC INFLAMMATORY BOWEL DISEASE
Authors: Zeky Nicole , LeBlanc Colleen , McDonough Elizabeth , Moulton Dedrick
Published: January 2023

PURPOSE

It has been estimated that about 25% of patients with inflammatory bowel disease (IBD) are diagnosed before the age of 18. Food insecurity, limited or lack of access to enough food, has been associated with poor outcomes in childhood health including mental health problems. United States Department of Agriculture (USDA) defines a food desert as a census tract that meets criteria for low access to a grocery store and low income. Depression and anxiety have been well documented in pediatric patients with IBD. Functional Disability Inventory (FDI) is a measure of limitations in both physical and psychosocial functioning secondary to physical health. Our hypothesis is that patients in low access areas to healthy food will have more evidence of depression, anxiety and higher disability scores.

METHODS

This study is a retrospective chart review of patients diagnosed with Crohn's Disease (CD) or ulcerative colitis (UC) between 2019 to 2022. Patient’s addresses were entered into the USDA food access atlas to determine if they lived in an area of low access. Psychology screening included depression screening (PHQ-9), anxiety screening (GAD-7), and functional disability inventory (FDI). Screening questionnaires including PHQ-9, GAD-7, FDI were completed if patients were 12 years of age or old. If 11 years of old or less, parents completed FDI screening forms.

RESULTS

Our study consisted of 57 patients with an average age of 12.8 years at diagnosis. Thirty-three patients (58%) were non-Hispanic white, 19 (33%) were African American, and 3 were Hispanic (5%). Depression screening was positive in 22 patients (48%) and anxiety screening was positive in 25 patients (60%). Of those living in low access areas, 45% met criteria for depression, 53% met criteria for anxiety. There were comparable rates of depression between the low access group compared to the adequate access group (45% vs 50%, respectively) and rates of anxiety (53% vs. 61%, respectively). Patients in areas of low access had higher disability scores (9.88±11.9) than those in adequate access (5.88±6.1). When considering those who lived in a food desert (11 total), 8 patients were African American, 2 were non-Hispanic white, and 1 was self-described as other. Patients in the food desert group had higher rates of depression (78%) and anxiety (70%) compared to the low access group. Patients in the food desert group had the highest FDI scores (12.7 ±9.7).

CONCLUSION

Pediatric IBD patients had higher rate of depression and anxiety; However, there was no relationship between food access and depression or anxiety. When considering those in a food desert, the rate of depression increased to 78% and anxiety increased to 70%. Patients living in a food desert had the highest FDI scores. More information is needed on how multiple psychosocial factors might affect depression in children with IBD.
AN OBSERVATIONAL STUDY DEMONSTARTING THE MEASUREMENT, CHARACTERIZATION AND VALIDATION OF EXPRESSIONS OF CALPROTECTIN IN HUMAN SWEAT THROUGH A SWEAT WEARABLE
Authors: Prasad Shalini , Jagannath Badrinath , Lin Kai-chun , Muthukumar Sriram , Shahub Sarah , Sardesai Abha
Published: January 2023

BACKGROUND

Inflammatory bowel diseases (IBD) comprising Crohn’s disease (CD) and ulcerative colitis (UC) are typically characterized by chronic episodes of inflammation within and through the gastrointestinal (GI) tract. In many inflammatory conditions including IBD, Calprotectin (CP) is well-studied (systemic and fecal) and employed by clinicians due to assay stability and low cost to effectively guide diagnostic and therapeutic decisions. While, accessing fecal CP is non-invasive, there is significant resistance to continuous fecal CP testing from patient-use and patient enablement aspects due to the challenges is sample collection, hence there is a current unmet need to access CP in a completely non-invasive manner.

METHODS

The sweat sensor device and reference ELISA was used to investigate and quantify CP levels in sweat. The immunoassay on the sweat sensor was developed by immobilizing specific capture probe antibody to capture CP in sweat. The sensor response was measured using impedance spectroscopy. Sweat samples from seven healthy and one IBD subject were collected and correlation analysis between the sweat sensor device and ELISA was performed to evaluate CP levels in sweat.

RESULTS

The sweat sensor device demonstrated a wide dynamic range of 0.1- 10 μg/mL with a limit of detection of 0.1 μg/mL. The sensor was also specific to CP and demonstrated negligible to no response for non-specific inflammatory markers such as C-reactive protein, interleukin-6. Excellent correlation was achieved between ELISA and the sweat sensor device with Pearson’s r>0.95. Human subject studies demonstrated that elevated basal levels in IBD subject (500 ng/mL) as compared to healthy cohort (~ 350 ng/mL). Further, 3 times increase in CP levels was observed due to flare-up in the IBD subject with a mean concentration ~1300 ng/mL as compared to the basal levels.

CONCLUSION

This work is the first demonstration of CP in sweat. The pre-clinical results of elevated CP levels will be of significant interest to clinicians as it provides a non-invasive and non-intrusive tracking flare-ups in IBD patients and can aid in better management of the disease.