bluuebunny/crossref_metadata_2025 huggingface dataset:
A Secure Traffic Police Remote Sensing Approach via a Deep Learning-Based Low-Altitude Vehicle Speed Detector through UAVs in Smart Cites: Algorithm, Implementation and Evaluation
Authors: Moshayedi Ata Jahangir , Roy Atanu Shuvam , Taravet Alireza , Liao Liefa , Wu Jianqing , Gheisari Mehdi
Published: February 2023

Nowadays, the unmanned aerial vehicle (UAV) has a wide application in transportation. For instance, by leveraging it, we are able to perform accurate and real-time vehicle speed detection in an IoT-based smart city. Although numerous vehicle speed estimation methods exist, most of them lack real-time detection in different situations and scenarios. To fill the gap, this paper introduces a novel low-altitude vehicle speed detector system using UAVs for remote sensing applications of smart cities, forging to increase traffic safety and security. To this aim, (1) we have found the best possible Raspberry PI’s field of view (FOV) camera in indoor and outdoor scenarios by changing its height and degree. Then, (2) Mobile Net-SSD deep learning model parameters have been embedded in the PI4B processor of a physical car at different speeds. Finally, we implemented it in a real environment at the JXUST university intersection by changing the height (0.7 to 3 m) and the camera angle on the UAV. Specifically, this paper proposed an intelligent speed control system without the presence of real police that has been implemented on the edge node with the configuration of a PI4B and an Intel Neural Computing 2, along with the PI camera, which is armed with a Mobile Net-SSD deep learning model for the smart detection of vehicles and their speeds. The main purpose of this article is to propose the use of drones as a tool to detect the speeds of vehicles, especially in areas where it is not easy to access or install a fixed camera, in the context of future smart city traffic management and control. The experimental results have proven the superior performance of the proposed low-altitude UAV system rather than current studies for detecting and estimating the vehicles’ speeds in highly dynamic situations and different speeds. As the results showed, our solution is highly effective on crowded roads, such as junctions near schools, hospitals, and with unsteady vehicles from the speed level point of view.
Development and Optimization of Erythromycin Loaded Transethosomes Cinnamon Oil Based Emulgel for Antimicrobial Efficiency
Authors: Abdallah Marwa H. , Elghamry Hanaa A. , Khalifa Nasrin E. , Khojali Weam M. A. , Khafagy El-Sayed , Shawky Seham , El-Horany Hemat El-Sayed , El-Housiny Shaimaa
Published: February 2023

Erythromycin (EM) is a macrolide antibiotic that is frequently used to treat skin bacterial infections. It has a short half-life (1–1.5 h), instability in stomach pH, and a low oral bioavailability. These foregoing factors limit its oral application; therefore, the development of topical formulations loaded with erythromycin is an essential point to maximize the drug’s concentration at the skin. Accordingly, the current study’s goal was to boost the antimicrobial activity of EM by utilizing the advantages of natural oils such as cinnamon oil. Erythromycin-loaded transethosomes (EM-TE) were generated and optimized using a Box–Behnken design employing, phospholipid concentration (A), surfactant concentration (B), and ethanol content (C) as independent variables. Their effects on entrapment efficiency, EE, (Y1) and the total amount of erythromycin that penetrated the skin after 6 h, Q6h (Y2), were assessed. The optimized transethosome showed a particle size of 256.2 nm, EE of 67.96 ± 0.59%, and Q6h of 665.96 ± 5.87 (µg/cm2) after 6 h. The TEM analysis revealed that, the vesicles are well-known packed structures with a spherical shape. The optimized transethosomes formulation was further transformed into a cinnamon oil-based emulgel system using HPMC as a gelling agent. The generated EM-TE-emulgel was characterized by its physical features, in vitro, ex vivo studies, and antimicrobial activities. The formulation showed sufficient characteristics for effective topical application, and demonstrated a great stability. Additionally, EM-TE-Emulgel had the highest transdermal flux (120.19 μg/cm2·h), and showed considerably (p < 0.05) greater antimicrobial activity, than EM-TE-gel and placebo TE-Emulgel. The action of EM was subsequently augmented with cinnamon oil, which eventually showed a notable effect against bacterial growth. Finally, these results demonstrate that the transethosomes-loaded cinnamon oil-based emulgel is an alternative way to deliver erythromycin for the treatment of topical bacterial infections.
Delineating the Spectrum of Genetic Variants Associated with Bardet-Biedl Syndrome in Consanguineous Pakistani Pedigrees
Authors: Rao Ali Raza , Nazir Aamir , Imtiaz Samina , Paracha Sohail Aziz , Waryah Yar Muhammad , Ujjan Ikram Din , Anwar Ijaz , Iqbal Afia , Santoni Federico A. , Shah Inayat , Gul Khitab , Baig Hafiz Muhammad Azhar , Waryah Ali Muhammad , Antonarakis Stylianos E. , Ansar Muhammad
Published: February 2023

This study aimed to find the molecular basis of Bardet-Biedl syndrome (BBS) in Pakistani consanguineous families. A total of 12 affected families were enrolled. Clinical investigations were performed to access the BBS-associated phenotypes. Whole exome sequencing was conducted on one affected individual from each family. The computational functional analysis predicted the variants’ pathogenic effects and modeled the mutated proteins. Whole-exome sequencing revealed 9 pathogenic variants in six genes associated with BBS in 12 families. The BBS6/MKS was the most common BBS causative gene identified in five families (5/12, 41.6%), with one novel (c.1226G>A, p.Gly409Glu) and two reported variants. c.774G>A, Thr259LeuTer21 was the most frequent BBS6/MMKS allele in three families 3/5 (60%). Two variants, c.223C>T, p.Arg75Ter and a novel, c. 252delA, p.Lys85STer39 were detected in the BBS9 gene. A novel 8bp deletion c.387_394delAAATAAAA, p. Asn130GlyfsTer3 was found in BBS3 gene. Three known variants were detected in the BBS1, BBS2, and BBS7 genes. Identification of novel likely pathogenic variants in three genes reaffirms the allelic and genetic heterogeneity of BBS in Pakistani patients. The clinical differences among patients carrying the same pathogenic variant may be due to other factors influencing the phenotype, including variants in other modifier genes.
Opening the Black Box of Imputation Software to Study the Impact of Reference Panel Composition on Performance
Authors: Dekeyser Thibault , Génin Emmanuelle , Herzig Anthony F.
Published: February 2023

Genotype imputation is widely used to enrich genetic datasets. The operation relies on panels of known reference haplotypes, typically with whole-genome sequencing data. How to choose a reference panel has been widely studied and it is essential to have a panel that is well matched to the individuals who require missing genotype imputation. However, it is broadly accepted that such an imputation panel will have an enhanced performance with the inclusion of diversity (haplotypes from many different populations). We investigate this observation by examining, in fine detail, exactly which reference haplotypes are contributing at different regions of the genome. This is achieved using a novel method of inserting synthetic genetic variation into the reference panel in order to track the performance of leading imputation algorithms. We show that while diversity may globally improve imputation accuracy, there can be occasions where incorrect genotypes are imputed following the inclusion of more diverse haplotypes in the reference panel. We, however, demonstrate a technique for retaining and benefitting from the diversity in the reference panel whilst avoiding the occasional adverse effects on imputation accuracy. What is more, our results more clearly elucidate the role of diversity in a reference panel than has been shown in previous studies.
Association of Functional Polymorphism in TPH2 Gene with Alcohol Dependence and Personality Traits: Study in Cloninger’s Type I and Type II Alcohol-Dependent Inpatients
Authors: Konjevod Marcela , Rešetar Mirta , Matošić Ana , Čičin-Šain Lipa , Štefulj Jasminka
Published: February 2023

Alcohol dependence (AD) is a complex disorder with a poorly understood etiology. In this study, we investigated the relationship between genetic variation in the TPH2 gene, which encodes the enzyme responsible for serotonin synthesis in the brain, and both AD and personality traits, with attention to Cloninger’s types of AD. The study included 373 healthy control subjects, 206 inpatients with type I AD, and 110 inpatients with type II AD. All subjects were genotyped for the functional polymorphism rs4290270 in the TPH2 gene, and AD patients completed the Tridimensional Personality Questionnaire (TPQ). The AA genotype and the A allele of the rs4290270 polymorphism were more frequent in both patient groups compared with the control group. In addition, a negative association was found between the number of A alleles and TPQ scores for harm avoidance in patients with type II, but not type I, AD. These results support the involvement of genetic variations of the serotonergic system in the pathogenesis of AD, especially type II AD. They also suggest that in a subset of patients, genetic variation of TPH2 could potentially influence the development of AD by affecting the personality trait of harm avoidance.
Characterization of the Complete Mitochondrial Genome of a Flea Beetle Luperomorpha xanthodera (Coleoptera: Chrysomelidae: Galerucinae) and Phylogenetic Analysis
Authors: Li Jingjing , Yan Bin , He Hongli , Xu Xiaoli , Ruan Yongying , Yang Maofa
Published: February 2023

In this study, the mitochondrial genome of Luperomorpha xanthodera was assembled and annotated, which is a circular DNA molecule including 13 protein-coding genes (PCGs), 22 transfer RNA (tRNA) genes, 2 ribosomal RNA genes (12S rRNA and 16S rRNA), and 1388 bp non-coding regions (A + T rich region), measuring 16,021 bp in length. The nucleotide composition of the mitochondrial genome is 41.3% adenine (A), 38.7% thymine (T), 8.4% guanine (G), and 11.6% cytosine (C). Most of the protein-coding genes presented a typical ATN start codon (ATA, ATT, ATC, ATG), except for ND1, which showed the start codon TTG. Three-quarters of the protein-coding genes showed the complete stop codon TAR (TAA, TAG), except the genes COI, COII, ND4, and ND5, which showed incomplete stop codons (T- or TA-). All the tRNA genes have the typical clover-leaf structure, except tRNASer1 (AGN), which has a missing dihydrouridine arm (DHU). The phylogenetic results determined by both maximum likelihood and Bayesian inference methods consistently supported the monophyly of the subfamily Galerucinae and revealed that the subtribe Luperina and genus Monolepta are polyphyletic groups. Meanwhile, the classification status of the genus Luperomorpha is controversial.
Advances in Ophthalmic Epigenetics and Implications for Epigenetic Therapies: A Review
Authors: Moore Spencer M. , Christoforidis John B.
Published: February 2023

The epigenome represents a vast molecular apparatus that writes, reads, and erases chemical modifications to the DNA and histone code without changing the DNA base-pair sequence itself. Recent advances in molecular sequencing technology have revealed that epigenetic chromatin marks directly mediate critical events in retinal development, aging, and degeneration. Epigenetic signaling regulates retinal progenitor (RPC) cell cycle exit during retinal laminar development, giving rise to retinal ganglion cells (RGCs), amacrine cells, horizontal cells, bipolar cells, photoreceptors, and Müller glia. Age-related epigenetic changes such as DNA methylation in the retina and optic nerve are accelerated in pathogenic conditions such as glaucoma and macular degeneration, but reversing these epigenetic marks may represent a novel therapeutic target. Epigenetic writers also integrate environmental signals such as hypoxia, inflammation, and hyperglycemia in complex retinal conditions such as diabetic retinopathy (DR) and choroidal neovascularization (CNV). Histone deacetylase (HDAC) inhibitors protect against apoptosis and photoreceptor degeneration in animal models of retinitis pigmentosa (RP). The epigenome represents an intriguing therapeutic target for age-, genetic-, and neovascular-related retinal diseases, though more work is needed before advancement to clinical trials.
Talking about Meaning and Loss with Relatives of Persons with Dementia: An Ethnographic Study in a Nursing Home
Authors: Couprie Caroline , van der Steen Jenny T.
Published: February 2023

Advance care planning (ACP) can help prepare for future losses and decisions to be taken. However, relatives of persons with dementia may wait for healthcare professionals to initiate ACP conversations which may not adequately address their individual information needs. To evaluate inducing and enhancing conversations about meaning and loss, we conducted an ethnographic study on nurse-led ACP conversations using a question prompt list (QPL) on six dementia wards of a nursing home in the Netherlands from January to September 2021. Staff received training in using the QPL, with information and sample questions to inspire relatives to ask their questions, in particular on meaning and loss. Thematic analysis was applied to transcribed interviews and memos of observations. Nursing staff in particular was concerned about having to be available to answer questions continuously. Relatives used the study as an opportunity to get in touch with professionals, and they saw the QPL as an acknowledgement of their needs. There was a mismatch in that staff wished to discuss care goals and complete a care plan, but the relatives wanted to (first) address practical matters. A QPL can be helpful to conversations about meaning and loss, but nursing staff need dedicated time and substantial training. Joint agenda setting before the conversation may help resolve a mismatch in the preferred topics and timing of conversations.
Listen to the Whispers before They Become Screams: Addressing Black Maternal Morbidity and Mortality in the United States
Authors: Njoku Anuli , Evans Marian , Nimo-Sefah Lillian , Bailey Jonell
Published: February 2023

Black women in the United States (U.S.) disproportionately experience adverse pregnancy outcomes, including maternal mortality, compared to women of other racial and ethnic groups. Historical legacies of institutionalized racism and bias in medicine compound this problem. The disproportionate impact of COVID-19 on communities of color may further worsen existing racial disparities in maternal morbidity and mortality. This paper discusses structural and social determinants of racial disparities with a focus on the Black maternal mortality crisis in the United States. We explore how structural racism contributes to a greater risk of adverse obstetric outcomes among Black women in the U.S. We also propose public health, healthcare systems, and community-engaged approaches to decrease racial disparities in maternal morbidity and mortality.
Early Surfactant Therapy for Respiratory Distress Syndrome in Very Preterm Infants
Authors: Cucerea Manuela , Moscalu Mihaela , Moldovan Elena , Santa Reka , Gall Zsuzsanna , Suciu Laura Mihaela , Simon Marta
Published: February 2023

Background: It is currently considered that early initiation of nasal continuous positive airway pressure, using a less invasive exogenous surfactant administration and avoiding mechanical ventilation as much as possible to minimize lung damage, may reduce mortality and/or the risk of morbidities in preterm infants. The aim of our study was to quantify our experience and compare different strategies of surfactant administration, to investigate which method is associated with less morbidity. Materials and Methods: A total of 135 preterm infants with early rescue surfactant administration for respiratory distress syndrome were included in the study. The infants were treated in an academic, Level III Neonatal Intensive Care Unit over a 3-year period between 1 December 2018 and 1 December 2021. Patients were separated into three groups: those with standard surfactant administration; those with Less Invasive Surfactant Administration—LISA; and those with Intubation Surfactant Administration Extubation—INSURE. As a primary outcome, we followed the need for intubation and mechanical ventilation within 72 h, while the secondary outcomes were major neonatal morbidities and death before discharge. Results: The surfactant administration method was significantly associated with the need for mechanical ventilation within 72 h after the procedure (p < 0.001). LISA group infants needed less MV (OR = 0.538, p = 0.019) than INSURE group infants. We found less morbidities (OR = 0.492, p = 0.015) and deaths before discharge (OR = 0.640, p = 0.035) in the LISA group compared with the INSURE group. The analysis of morbidities found in infants who were given the surfactant by the LISA method compared with the INSURE method showed lower incidence of pneumothorax (3.9% vs. 8.8%), intraventricular hemorrhage (17.3% vs. 23.5%), intraventricular hemorrhage grade 3 and 4 (3.9% vs. 5.9%), sepsis/probable sepsis (11.5% vs. 17.7%) retinopathy of prematurity (16.7% vs. 26.7%) and deaths (3.9% vs. 5.9%). There were no significant differences between groups in frequencies of bronchopulmonary dysplasia, necrotizing enterocolitis and patent ductus arteriosus. Conclusions: Less invasive surfactant administration methods seem to have advantages regarding early need for mechanical ventilation, decreasing morbidities and death rate. In our opinion, the LISA procedure may be a good choice in spontaneously breathing infants regardless of gestational age.
Lower Limb Muscles’ Activation during Ascending and Descending a Single Step-Up Movement: Comparison between In water and On land Exercise at Different Step Cadences in Young Injury-Free Adults
Authors: So Billy C. L. , Kwok Manny M. Y. , Lee Nakita W. L. , Lam Andy W. C. , Lau Anson L. M. , Lam Allen S. L. , Chan Phoebe W. Y. , Ng Shamay S. M.
Published: February 2023

(1) Background: Forward step-up (FSU) simulates the stance phase in stair ascension. With the benefits of physical properties of water, aquatic FSU exercise may be more suitable for patients with lower limb weakness or pain. The purpose of this study is to investigate the effect of progressive steps per min on the surface electromyography (sEMG) of gluteus maximus (GM), biceps femoris (BF), rectus femoris (RF), and gastrocnemius (GA), when performing FSU exercise with different steps per min in water and on land. (2) Methods: Participants (N = 20) were instructed to perform FSU exercises at different steps per min (35, 60, and 95 bpm) in water and on land. The sEMG of the tested muscles were collected. The percentage maximum voluntary isometric contraction (%MVIC) of GM, RF, GA and BF at different environments and steps per min was compared. (3) Result: There was a statistically significant difference of %MVIC of RF at all steps per min comparisons regardless of the movement phases and environments (p < 0.01, except for descending phases of 35 bpm vs. 60 bpm). All tested muscles showed a statistically significant lower muscle activation in water (p < 0.05) (4) Conclusion: This study found that the %MVIC of the tested muscle in both investigated environments increase as steps per minute increases. It is also found that the movement pattern of FSU exercise activates RF the most among all the tested muscles. Muscle activation of all tested muscles is also found to be smaller in water due to buoyancy property of water. Aquatic FSU exercise might be applicable to patients with lower limb weakness or knee osteoarthritis to improve their lower limb strength.
The Associations between Erythropoietic Response with Inflammation Markers and Perfluorinated Chemicals in Hemodialysis Patients
Authors: Liu Wen-Sheng , Lin Chien-Hung , Tan Ann Charis , Lai Yen-Ting , Liu Tsung-Yun , Chan Hsiang-Lin , Li Szu-Yuan , Chen Chun-Fan , Chen Yung-Tai , Chen Tz-Heng , Chen Fan-Yu , Ho Yang , Tsou Han-Hsing , Lin Chih-Ching
Published: February 2023

Erythropoiesis-stimulating agents (ESA) are used to treat anemia in hemodialysis (HD) patients. We investigated the role of inflammation and accumulation of environmental toxins (perfluorinated chemicals (PFCs), such as perfluorooctanoic acid and perfluorooctane sulfonate) in the erythropoietic response of HD patients who receive a fixed monthly continuous erythropoietin receptor activator (CERA) dosage. Forty-five patients underwent three successive phases of ESA treatment for two months each (phase one: 100 µg CERA once monthly; phase two: 50 µg CERA twice monthly; phase three: 100 µg CERA once monthly). Patient data were collected to determine the association of various factors with erythropoietic response (change in hematocrit). Liquid chromatography-tandem mass spectrometry was used to analyze perfluorinated chemicals. Twenty-eight patients exhibited a poor erythropoietic response that was significantly associated with: age > 80 years, initial hematocrit > 36%, glucose > 200 mg/dL, alanine aminotransferase > 21 U/L, c-reactive protein > 1 mg/dL, interleukin−6 > 10 ng/mL, lactate dehydrogenase ≤ 190 U/L, and chloride ≤ 93 mEq/L. There was also a borderline significant association between inflammation and PFCs, although PFCs failed to show any impact on ESA response. Age, glucose, chloride, liver function, and inflammation may be associated with cost-effective fixed CERA dosage administered at an increased frequency.
Computer-Based Cognitive Training vs. Paper-and-Pencil Training for Language and Cognitive Deficits in Greek Patients with Mild Alzheimer’s Disease: A Preliminary Study
Authors: Georgopoulou Eleni-Nefeli , Nousia Anastasia , Siokas Vasileios , Martzoukou Maria , Zoupa Elli , Messinis Lambros , Dardiotis Efthimios , Nasios Grigorios
Published: February 2023

The purpose of the present study was to explore whether Computer-Based Cognitive Training (C-BCT) versus Paper-Pencil Cognitive Training (P-PCT) is more beneficial in improving cognitive and language deficits in Greek patients living with Alzheimer’s disease (pwAD). Twenty pwAD were assigned to two groups: (a) the C-BCT group, receiving a computer-based cognitive training program using the RehaCom software, and (b) the P-PCT group, which received cognitive training using paper and pencil. The cognitive training programs lasted 15 weeks and were administered twice a week for approximately one hour per session. The analyses of each group’s baseline versus endpoint performance demonstrated that the P-PCT group improved on delayed memory, verbal fluency, attention, processing speed, executive function, general cognitive ability, and activities of daily living. In contrast, the C-BCT group improved on memory (delayed and working), naming, and processing speed. Comparisons between the two groups (C-BCT vs. P-PCT) revealed that both methods had significant effects on patients’ cognition, with the P-PCT method transferring the primary cognitive benefits to real-life activities. Our findings indicate that both methods are beneficial in attenuating cognitive and language deficits in pwAD. The need for large-scale neurobehavioral interventions to further clarify this issue, however, remains a priority.
Delivering Prognostic News to Older People with Chronic Disease: What Format Preference and Level of Involvement in Decision Making? A Hospital Survey
Authors: Lewis Ebony T. , Hammill Kathrine , Culbert Rebekah , van der Merwe Madeleen , Sahay Ashlyn , Turner Robin , Cardona Magnolia
Published: February 2023

Shared decision making near end of life is a balancing act of communicating prognosis to patients and their surrogates/families and engaging them in considering value-concordant management choices. This cross-sectional survey aimed to determine the format in which older patients with chronic illnesses would prefer to receive prognostic information on their treatment options and disease progression, and their desired level of engagement in decision making. With a 60% participation rate, 139 inpatients in two hospitals and five surrogates were presented with six hypothetical scenarios with a randomly assigned sequence: verbal and written summary, graph, table, photo, video, and pamphlet. The majority (76%) of respondents chose the traditional verbal communication of prognosis by their doctor with a written summary as a reference and to share with family; the second choice was a condition-specific pamphlet (63%). Many found the graph and photo to be distressing (36% and 42%, respectively). Most (71%) wanted to know everything about their condition trajectory, and 63% chose shared decision making rather than completely autonomous or full delegation to clinicians or family. There were no gender differentials between wanting to know it all, supporting shared decision making or the preferred format for breaking news (p > 0.05). Older hospitalized patients with chronic conditions are willing to discuss end-of-life issues, learn about their prognosis, and be involved in shared decision making. Innovative formats such as graphs, videos, or photos were not welcome as part of the prognostic discussion.
An Examination of the Number of Adolescent Scoliotic Curves That Are Braceable at First Presentation to a Scoliosis Service
Authors: Hartley Laura , Jones Conor , Lui Darren , Bernard Jason , Bishop Timothy , Herzog Jan , Chan Daniel , Stokes Oliver , Gardner Adrian
Published: February 2023

Adolescent idiopathic scoliosis (AIS) affects between 0.5% and 5.2% of adolescents and is progressive in two-thirds of cases. Bracing is an effective non-operative treatment for AIS and has been shown to prevent up to 72% of curves from requiring surgery. This paper explores the presentation of AIS in the UK and identifies who would be suitable for bracing, as per guidelines published by the Scoliosis Research Society (SRS) and British Scoliosis Society (BSS), through curve severity and skeletal maturity at presentation. There were 526 patients with AIS eligible for inclusion across three tertiary referral centres in the UK. The study period was individualised to each centre, between January 2012 and December 2021. Only 10% were appropriate for bracing via either SRS or BSS criteria. The rest were either too old, skeletally mature or had a curve size too large to benefit. By the end of data collection, 38% had undergone surgery for their scoliosis. In the UK, bracing for AIS is only suitable for a small number at presentation. Future efforts to minimise delays in specialist review and intervention will increase the number of those with AIS suitable for bracing and reduce the number and burden of operative interventions for AIS in the UK.
A Deep Learning Approach to Predict Chronological Age
Authors: Lahza Husam , Alsheikhy Ahmed A. , Said Yahia , Shawly Tawfeeq
Published: February 2023

Recently, researchers have turned their focus to predicting the age of people since numerous applications depend on facial recognition approaches. In the medical field, Alzheimer’s disease mainly depends on patients’ ages. Multiple methods have been implemented and developed to predict age. However, these approaches lack accuracy because every image has unique features, such as shape, pose, and scale. In Saudi Arabia, Vision 2030, concerning the quality of life, is one of the twelve initiatives that were launched recently. The health sector has gained increasing attention as the government has introduced age-based policies to improve the health of its elderly residents. These residents are urgently advised to vaccinate against COVID-19 based on their age. In this paper, proposing a practical, consistent, and trustworthy method to predict age is presented. This method uses the color intensity of eyes and a Convolutional Neural Network (CNN) to predict age in real time based on the ensemble of CNN. A segmentation algorithm is engaged since the approach takes its input from a video stream or an image. This algorithm extracts data from one of the essential parts of the face: the eyes. This part is also informative. Several experiments have been conducted on MATLAB to verify and validate results and relative errors. A Kaggle website dataset is utilized for ages 4 to 59. This dataset includes over 270,000 images, and its size is roughly 2 GB. Consequently, the proposed approach produces ±8.69 years of Mean Square Error (MSE) for the predicted ages. Lastly, a comparative evaluation of relevant studies and the presented algorithm in terms of accuracy, MSE, and Mean Absolute Error (MAE) is also provided. This evaluation shows that the approach developed in the current study outperforms all considered performance metrics since its accuracy is 97.29%. This study found that the color intensity of eyes is highly effective in predicting age, given the high accuracy and acceptable MSE and MAE results. This indicates that it is helpful to utilize this methodology in real-life applications.
Fabry Disease: Switch from Enzyme Replacement Therapy to Oral Chaperone Migalastat: What Do We Know Today?
Authors: Perretta Fernando , Jaurretche Sebastián
Published: February 2023

Fabry disease is a lysosomal storage disorder caused by the deficiency of the α-galactosidase-A enzyme. The result is the progressive accumulation of complex glycosphingolipids and cellular dysfunction. Cardiac, renal, and neurological involvement significantly reduces life expectancy. Currently, there is increasing evidence that clinical response to treatment improves with early and timely initiation. Until a few years ago, treatment options for Fabry disease were limited to enzyme replacement therapy with agalsidase alfa or beta administered by intravenous infusion every 2 weeks. Migalastat (Galafold®) is an oral pharmacological chaperone that increases the enzyme activity of “amenable” mutations. The safety and efficacy of migalastat were supported in the phase III FACETS and ATTRACT studies, compared to available enzyme replacement therapies, showing a reduction in left ventricular mass, and stabilization of kidney function and plasma Lyso-Gb3. Similar results were confirmed in subsequent extension publications, both in patients who started migalastat as their first treatment and in patients who were previously on enzyme replacement therapy and switched to migalastat. In this review we describe the safety and efficacy of switching from enzyme replacement therapy to migalastat in patients with Fabry disease and “amenable” mutations, referring to publications available to date.
Perspectives on Emotional Care: A Qualitative Study with Cancer Patients, Carers, and Health Professionals
Authors: Krishnasamy Meinir , Hassan Heidi , Jewell Carol , Moravski Irene , Lewin Tennille
Published: February 2023

The emotional consequences of a cancer diagnosis are well documented and range from emotional distress, defined as suffering associated with feelings such as shock, fear, and uncertainty, through to psychological distress that may manifest as depression, anxiety, feelings of hopelessness, or heightened risk of suicide. This study set out to explore the assumption that the provision of emotional care should be the platform upon which all other aspects of cancer care are delivered and, that without attention to emotional care, no other aspects of cancer care can be fully realized. Utilizing qualitative focus groups and in-depth interviews with 47 patients, carers, and health professionals, emotional care was shown to be (1) fundamental to the provision of comprehensive cancer care, (2) essential to easing the burden of a cancer diagnosis and demands of treatment, (3) everyone’s business, and (4) a component of cancer care at any time and every time. Future studies are needed to test interventions to enhance provision of intentional, purposeful, and individualized emotional care to help patents achieve the best health outcomes possible.
Development Pattern of Medical Device Technology and Regulatory Evolution of Cataract Treatment
Authors: Kim Heejung , Jeong Harry , Shin Kwangsoo
Published: February 2023

To prevent regulation from becoming an obstacle to healthcare technological innovation, regulation should evolve as new healthcare technologies are developed. Although regulation is closely related to healthcare technology development, there are few studies that view healthcare technological advances from the multi-layered perspective of papers, patents, and clinical research and link this with regulatory evolution. Therefore, this study tried to develop a new method from a multi-layer perspective and draw regulatory implications based on it. This study applied this method to intraocular lens (IOLs) for cataract treatment and detected four major healthcare technologies and two recent healthcare technologies. Moreover, it discussed how current regulations evaluate these technologies. The findings provide implications for healthcare technological advances and the evolutionary direction of regulation through the example of IOLs for cataract treatment. This study contributes to the development of theoretical methods for co-evolution with regulations based on healthcare technology innovation.
Seasonal Pattern of Cerebrovascular Fatalities in Cancer Patients
Authors: Shivarov Velizar , Shivarov Hristo , Yordanov Angel
Published: February 2023

Cancer patients are at increased risk of cerebrovascular events. The incidence of those events and the associated mortality are known to follow a seasonal pattern in the general population. However, it is unclear whether cerebrovascular mortality in cancer patients has seasonal variation. To address this question, we performed a retrospective analysis of the seasonality of deaths due to the fact of cerebrovascular diseases among patients with first primary malignancy registered between 1975 and 2016 in the SEER database. The presence of seasonality in death rates was modeled using the cosinor approach assuming a circa-annual pattern. A significant seasonal pattern with a peak in the first half of November was identified in all patient groups. The same peak was observed in almost all subgroups of patients defined based on demographic characteristics. However, not all entity-defined subgroups showed a seasonal pattern, which might be explained by the different pathologic processes affecting the circulatory system in each cancer type. Based on our findings, one can propose that the active monitoring of cancer patients for cerebrovascular events from the late autumn and during the winter can help in the reduction of mortality in this patient population.
Leveraging Responsible, Explainable, and Local Artificial Intelligence Solutions for Clinical Public Health in the Global South
Authors: Kong Jude Dzevela , Akpudo Ugochukwu Ejike , Effoduh Jake Okechukwu , Bragazzi Nicola Luigi
Published: February 2023

In the present paper, we will explore how artificial intelligence (AI) and big data analytics (BDA) can help address clinical public and global health needs in the Global South, leveraging and capitalizing on our experience with the “Africa-Canada Artificial Intelligence and Data Innovation Consortium” (ACADIC) Project in the Global South, and focusing on the ethical and regulatory challenges we had to face. “Clinical public health” can be defined as an interdisciplinary field, at the intersection of clinical medicine and public health, whilst “clinical global health” is the practice of clinical public health with a special focus on health issue management in resource-limited settings and contexts, including the Global South. As such, clinical public and global health represent vital approaches, instrumental in (i) applying a community/population perspective to clinical practice as well as a clinical lens to community/population health, (ii) identifying health needs both at the individual and community/population levels, (iii) systematically addressing the determinants of health, including the social and structural ones, (iv) reaching the goals of population’s health and well-being, especially of socially vulnerable, underserved communities, (v) better coordinating and integrating the delivery of healthcare provisions, (vi) strengthening health promotion, health protection, and health equity, and (vii) closing gender inequality and other (ethnic and socio-economic) disparities and gaps. Clinical public and global health are called to respond to the more pressing healthcare needs and challenges of our contemporary society, for which AI and BDA can help unlock new options and perspectives. In the aftermath of the still ongoing COVID-19 pandemic, the future trend of AI and BDA in the healthcare field will be devoted to building a more healthy, resilient society, able to face several challenges arising from globally networked hyper-risks, including ageing, multimorbidity, chronic disease accumulation, and climate change.
Critical Issues in the Management of Agitation, Aggression, and End-of-Life in Delusional Disorder: A Mini-Review
Authors: González-Rodríguez Alexandre , Seeman Mary V. , Román Eloïsa , Natividad Mentxu , Pagés Carmen , Ghigliazza Camila , Ros Laura , Monreal José A.
Published: February 2023

Background: Compared to other psychotic disorders, there is little information about staging care in delusional disorder (DD). Unlike schizophrenia, this is a disorder that begins in middle age, a time at which chronic medical comorbidities have already begun to impact global functioning. With age, the combination of psychological and somatic conditions leads to new behaviours, e.g., agitation, aggression, and behaviours that require specific preventive and interventive measures. With further age, knowledgeable end-of-life care becomes necessary for this population. Aim: The aim of this article was to review existing evidence on the management of these successive phases. Methods: We conducted a narrative review using PubMed and ClinicalTrials.gov and searched for the following terms: (agitation OR aggressivity OR aggression OR palliative OR “end-of-life”) AND (“delusional disorder”). Results: We found that the literature was sparse. Existing evidence suggests that medical causes are frequently at the root of agitation and aggression. With respect to management, de-escalation strategies are generally preferred over pharmacotherapy. Specific delusional syndromes, e.g., de Clérambault, Othello, Capgras, Fregoli, as well as folie à deux, are associated with aggression. The somatic subtype of DD is the one most often requiring palliative care at the end of life. Conclusions: We conclude that insufficient attention has been given to the care needs of the accelerated aging process in DD.
The Effect of a Nurse-Led Family Involvement Program on Anxiety and Depression in Patients with Advanced-Stage Hepatocellular Carcinoma
Authors: Klankaew Sukhuma , Temthup Suthisa , Nilmanat Kittikorn , Fitch Margaret I.
Published: February 2023

Psychological distress is commonly reported in patients with advanced cancer. Family is considered a psychological supporter for patients during their cancer journey. This study aimed to examine the effect of a nurse-led family involvement program on anxiety and depression in patients with advanced hepatocellular cancer. This is a quasi-experimental study with a two-group, pre–post-test design. Forty-eight participants were recruited at a male medical ward in a university hospital in Southern Thailand, and assigned to either the experimental or the control group. The experimental group received the nurse-led family involvement program, while the control group received only conventional care. Instruments included a demographic data form, clinical data form, and the Hospital Anxiety and Depression Scale. Data analyses were performed using descriptive statistics, chi-square, Fisher’s exact test, and t-test. The results revealed that the mean scores of anxiety and depression in the experimental group at post-test were significantly lower than on the pretest and significantly lower than those of the control group. The results indicate that a nurse-led family involvement program has a short-term effect on the reduction of anxiety and depression in male patients with advanced HCC. The program can be useful for nurses to encourage family caregivers to engage in patient care during hospitalization.
The Relationship between Short Video Flow, Addiction, Serendipity, and Achievement Motivation among Chinese Vocational School Students: The Post-Epidemic Era Context
Authors: Nong Weiguaju , He Zhen , Ye Jian-Hong , Wu Yu-Feng , Wu Yu-Tai , Ye Jhen-Ni , Sun Yu
Published: February 2023

Since the COVID-19 outbreak, people have been spending more time in the online world because of restrictions on face-to-face communication due to epidemic prevention controls. This has also brought the issue of Internet addiction, including the overuse and negative effects of short videos, to the forefront of attention. Past research has found that Internet addiction has a negative impact on well-being. However, there is a special concept of positive emotion called “serendipity” (小确幸). Serendipity provides a small, fleeting but positive experience, yet it is often associated with negative perceptions from an outside perspective. However, the relationship between short video addiction and serendipity is not yet known. Based on this, a theoretical model was developed in the context of the I-PACE model. To understand the relationship between short video addiction and serendipity among college students, in this study, we conducted snowball sampling and distributed online questionnaires using the Wenjuanxing platform. The target population of the questionnaire distribution was vocational college students in China, of whom 985 valid study participants responded, yielding a valid return rate of 82.1%. Of the respondents, 410 (41.6%) were male and 575 (58.4%) were female. The results were as follows: a. short video flow had a positive relationship with serendipity, a negative relationship with achievement motivation, and a positive effect on short video addiction; b. short video addiction had a positive effect on serendipity and a negative effect on achievement motivation; and c. serendipity had a negative impact on achievement motivation. This shows that short video addiction, like other Internet addictions, can have a negative impact on students’ learning.
Self-Rated Health of US Older Adults in the General Social Survey (GSS) 1972–2021: Complexity of the Associations of Education and Immigration
Authors: Siddiq Hafifa , Darvishi Mona , Najand Babak
Published: February 2023

Background: Multiple studies have shown a link between high education and better self-rated health (SRH). However, recent studies have suggested that immigrants may experience a weaker association between education and SRH than native-born individuals. Aim: Using a national sample of US older adults, this investigation studied whether there is an inverse association between education and SRH and whether immigration status moderates this association. Methods: This study is based on marginalized diminished returns (MDRs) that argues socioeconomic status (SES) resources, such as education, may generate less favorable health outcomes for marginalized groups. Data were from the General Social Survey (GSS) 1972–2021, a cross-sectional survey in the US. A total of 7999 participants who were 65+ years old were included. The independent variable was education, measured as years of schooling and treated as a continuous variable. The dependent variable was poor/fair (poor) SRH. Immigration status was the moderator. Age, sex, and race were control variables. Logistic regressions were used for data analysis. Results: We found that higher levels of education were protective against poor SRH. However, this effect was weaker for immigrants than for US-born individuals. Conclusions: This study found that native-born US older individuals are more likely to experience the protective effect of their education against poor SRH compared to their immigrants. Eliminating health inequality between immigrant and US-born individuals needs policies that go beyond socioeconomic status (SES) equality and address barriers that hinder highly-educated immigrants.
The Health-Seeking Behavior of the Elderly with Non-Communicable Diseases in Coastal Areas of Vietnam
Authors: Duy Ho Minh , Lee Jakyoung , Han Whiejong , Rajaguru Vasuki , Jang Suk-Yong
Published: February 2023

This study aimed to analyze the utilization of health care facilities and the health-seeking behavior of elderly people with non-communicable diseases and find the factors that affect them. A cross-sectional study was conducted in seven coastal areas of the Thua Thien Hue province, Vietnam, using a sample of 370 elderly people aged over 60 years. Chi-square and multiple logistic regression analyses were used to examine the factors associated with the utilization of health care services. The participants’ average age was 69.70 (SD), and 18% of them reported having ≥ two non-communicable diseases (NCDs). The results of the study showed that 69.8% of the total participants exhibited health-seeking behaviors. The findings also revealed that elderly people living alone, and those with an average or above-average income, had higher utilization of health care services. Participants with multiple NCDs exhibited more health-seeking behaviors than those with only one (OR: 9.24, 95% CI: 2.66–32.15, p = <0.001). The presence of health insurance and the need for health care counseling were also relevant ([OR: 4.16, 95% CI: 1.30–13.31, p = 0.016], [OR: 3.91, 95% CI: 2.04–7.49, p < 0.001], respectively). Health-seeking behavior is one of the most important positive implications for the aged population, as it encompasses one’s physical, mental, and psychological wellbeing. Future studies can aim at gaining an in-depth understanding of the same results, helping improve the health-seeking behavior of elderly people, and enhancing their quality of life.
The Effects of Art Therapy on Anxiety and Distress for Korean–Ukrainian Refugee: Quasi-Experimental Design Study
Authors: Kim Soo-Yeon , Lee Jenny Seongryung , Choi Han
Published: February 2023

Since Russia invaded Ukraine in February 2022, there has been an urgent need to provide mental healthcare and share various practices for Ukrainian war refugees. This study urgently focuses on the need for art therapy to support the mental health of Ukrainian refugees, Koryo-saram, who are staying in the Republic of Korea due to the wartime emergency. It also examines the impact of art therapy intervention on anxiety and subjective stress. The single-session art therapy with the 54 Koryo-saram refugees aged 13-68 showed the effectiveness of the art therapy intervention. The results indicate that GAD-7 (t = 3.092, p = 0.003) and SUDs (t = 3.335, p = 0.002) were statistically significant within the intervention group. In addition, satisfaction assessments of the qualitatively analyzed participants showed that Ukrainian Koryo-saram had a positive experience of art therapy. Therefore single-session art therapy in this study demonstrated the efficacy of art therapy for the anxiety and subjective distress of Ukrainian Koryo-saram refugees. This result suggests that the intervention of art therapy as immediate mental healthcare for refugees facing war could benefit the mental health of Koryo-saram refugees.