bluuebunny/crossref_metadata_2025 huggingface dataset:
Outlier analysis of sloshing impact loads on liquid ship cargo
Authors: Kim Sang-Yeob , Kim Yonghwan , Ahn Yang-Jun
Published: January 2022

This paper introduces an outlier analysis which can improve the convergence of the statistical analysis results of sloshing model test data. The paper classify possible outliers in the sloshing model test into three categories and present a treatment method for each outlier. The developed outlier analysis is adapted to the model test results for the cargo of the liquefied-natural-gas (LNG) carrier in operation. The results of the present new method are compared with those of the conventional procedure, particularly focusing on long-term sloshing prediction. Through this study, the effectiveness of the present method is observed, and it is found that the present method provides is robust and reliable results in the application of experimental data for load prediction.
Urban scale digital twins in data-driven society: Challenging digital universalism in urban planning decision-making
Authors: Charitonidou Marianna
Published: January 2022

The article examines the impact of the virtual public sphere on how urban spaces are experienced and conceived in our data-driven society. It places particular emphasis on urban scale digital twins, which are virtual replicas of cities that are used to simulate environments and develop scenarios in response to policy problems. The article also investigates the shift from the technical to the socio-technical perspective within the field of smart cities. Despite the aspirations of urban scale digital twins to enhance the participation of citizens in the decision-making processes relayed to urban planning strategies, the fact that they are based on a limited set of variables and processes makes them problematic. The article aims to shed light on the tension between the real and the ideal at stake during this process of abstracting sets of variables and processes in the case of urban scale digital twins.
Continuous renal replacement therapy in patients receiving extracorporeal membrane oxygenation therapy
Authors: Raja Meera , Leal Ricardo , Doyle James
Published: January 2022

Methods of continuous renal replacement therapy (CRRT) in extracorporeal membrane oxygenation (ECMO) patients include dedicated central venous cannula (CVC) (vCRRT), in-series with filter connected to ECMO circuit (eCRRT) or in-line with haemodiafilter incorporated within ECMO circuit. We assessed the efficacy and safety of eCRRT versus vCRRT in 20 ECMO-CRRT patients. Average filter lifespan was 42 vs 28 hours and filter runs completing 72hours were 40% vs 13.8% (eCRRT vs vCRRT, respectively). One incidence of ECMO circuit air embolus occurred (vCRRT). eCRRT achieved adequate filtration and increased filter lifespan, and has become our default for ECMO-CRRT if a pre-existing dialysis CVC is not present.
The Intersection of Candidate Gender and Ethnicity: How Voters Respond to Campaign Messages from Latinas
Authors: Santia Martina , Bauer Nichole M.
Published: January 2022

Despite the recent surge of women of color in elected political office in the U.S., the representation of Latinas is strikingly low. Past research offers unclear conclusions as to whether Latina political candidates face biases due to the intersection of their identities as women and as ethnic minorities, and how Latinas can navigate such biases. In this study, we identify how Latinas draw on their intersectional identities as both women and ethnic minorities to develop strategic campaign messages and how voters respond to such messages. Through an analysis of campaign advertising data and an original survey experiment, we show that Latina candidates do not face an automatic disadvantage based in gender and ethnic biases, but they can benefit from the intersection of these two identities, especially among female minority voters. These results are consequential because they offer insights into how to improve the descriptive and substantive representation of marginalized groups in the U.S.
Augmented Reality-Assisted Spine Surgery: An Early Experience Demonstrating Safety and Accuracy with 218 Screws
Authors: Bhatt Fenil R. , Orosz Lindsay D. , Tewari Anant , Boyd David , Roy Rita , Good Christopher R. , Schuler Thomas C. , Haines Colin M. , Jazini Ehsan
Published: January 2022

Study Design

Prospective cohort study.

Objectives

In spine surgery, accurate screw guidance is critical to achieving satisfactory fixation. Augmented reality (AR) is a novel technology to assist in screw placement and has shown promising results in early studies. This study aims to provide our early experience evaluating safety and efficacy with an Food and Drug Administration-approved head-mounted (head-mounted device augmented reality (HMD-AR)) device.

Methods

Consecutive adult patients undergoing AR-assisted thoracolumbar fusion between October 2020 and August 2021 with 2 -week follow-up were included. Preoperative, intraoperative, and postoperative data were collected to include demographics, complications, revision surgeries, and AR performance. Intraoperative 3D imaging was used to assess screw accuracy using the Gertzbein-Robbins (G-R) grading scale.

Results

Thirty-two patients (40.6% male) were included with a total of 222 screws executed using HMD-AR. Intraoperatively, 4 (1.8%) were deemed misplaced and revised using AR or freehand. The remaining 218 (98.2%) screws were placed accurately. There were no intraoperative adverse events or complications, and AR was not abandoned in any case. Of the 208 AR-placed screws with 3D imaging confirmation, 97.1% were considered clinically accurate (91.8% Grade A, 5.3% Grade B). There were no early postoperative surgical complications or revision surgeries during the 2 -week follow-up.

Conclusions

This early experience study reports an overall G-R accuracy of 97.1% across 218 AR-guided screws with no intra or early postoperative complications. This shows that HMD-AR-assisted spine surgery is a safe and accurate tool for pedicle, cortical, and pelvic fixation. Larger studies are needed to continue to support this compelling evolution in spine surgery.
Cervical Myelopathy Caused by Non-Rheumatic Retro-Odontoid Pseudotumor: An Investigation of Underlying Mechanisms and Optimal Surgical Strategy
Authors: Takahata Masahiko , Hyakkan Ryota , Oshima Shigeki , Oda Itaru , Kanayama Masahiro , Hyakumachi Takahiko , Fujita Ryo , Endo Tsutomu , Kajino Tomomichi , Iwasaki Norimasa
Published: January 2022

Study Design

Retrospective case-control study.

Objective

This study aimed to identify the underlying pathologies of non-rheumatic retro-odontoid pseudotumors (NRPs), which would help establish an appropriate surgical strategy for myelopathy caused by NRP.

Methods

We identified 35 patients with myelopathy caused by NRP who underwent surgery between 2006 and 2017. An age- and sex-matched control group of 70 subjects was selected from patients with degenerative cervical myelopathy. Radiographic risk factors for NRP were compared between cases and controls. We also assessed surgical outcomes following occipital-cervical (O-C) fusion, atlantoaxial (C1-2) fusion, or C1 laminectomy.

Results

Patients with NRP had significantly lower C1 sagittal inner diameter, C2-7 range of motion (ROM), C2-7 Cobb angle, and C7 tilt, as well as significantly higher C1-2 ROM, atlantodental interval (ADI), and C1-2 to O-C7 ROM ratio. Multivariate regression analysis revealed that ADI, C2-7 ROM, and C7 tilt were independent risk factors for NRP. Neurological recovery and pseudotumor size reduction were comparable among surgical procedures, whereas post-operative cervical spine function was significantly lower in the O-C fusion group than in the other groups.

Conclusion

Non-rheumatic retro-odontoid pseudotumor was associated with an increase in ADI, suggesting that spinal arthrodesis surgery is a reasonable strategy for NRP. C1-2 fusion is preferable over O-C fusion because of the high prevalence of ankylosis in the subaxial cervical spine. Given that 29% of patients with NRP have C1 hypoplasia, such cases can be treated by posterior decompression alone. Our study highlights the need to select appropriate surgical procedures based on the underlying pathology in each case.
Household Income as a Predictor for Surgical Outcomes and Opioid Use After Spine Surgery in the United States
Authors: Barrie Umaru , Montgomery Eric Y. , Ogwumike Erica , Pernik Mark N. , Luu Ivan Y. , Adeyemo Emmanuel A. , Christian Zachary K. , Edukugho Derrek , Johnson Zachary D. , Hoes Kathryn , El Tecle Najib , Hall Kristen , Aoun Salah G. , Bagley Carlos A.
Published: January 2022

Study Design

Cross-Sectional Study

Objectives

Socioeconomic status (SES) is a fundamental root of health disparities, however, its effect on surgical outcomes is often difficult to capture in clinical research, especially in spine surgery. Here, we present a large single-center study assessing whether SES is associated with cause-specific surgical outcomes.

Methods

Patients undergoing spine surgery between 2015 and 2019 were assigned income in accordance with the national distribution and divided into quartiles based on the ZIP code-level median household income. We performed univariate, chi-square, and Analysis of Variance (ANOVA) analysis assessing the independent association of SES, quantified by household income, to operative outcomes, and multiple metrics of opioid consumption.

Results

1199 patients were enrolled, and 1138 patients were included in the analysis. Low household income was associated with the greatest rates of 3-month opioid script renewal (OR:1.65, 95% CI:1.14-2.40). In addition, low-income was associated with higher rates of perioperative opioid consumption compared to higher income including increased mean total morphine milligram equivalent (MME) 252.25 (SD 901.32) vs 131.57 (SD 197.46) (P < .046), and inpatient IV patient-controlled analgesia (PCA) MME 121.11 (SD 142.14) vs 87.60 (SD 86.33) (P < .023). In addition, household income was independently associated with length of stay (LOS), and emergency room (ER) revisits with low-income patients demonstrating significantly longer postop LOS and increasing postoperative ER visits.

Conclusions

Considering the comparable surgical management provided by the single institution, the associated differences in postoperative outcomes as defined by increased morbidities and opioid consumption can potentially be attributed to health disparities caused by SES.
Proteomic identification of proliferation and progression markers in human polycythemia vera stem and progenitor cells
Authors: Tan Ge , Wolski Witold E. , Kummer Sandra , Hofstetter Mara , Theocharides Alexandre P. A. , Manz Markus G. , Aebersold Ruedi , Meier-Abt Fabienne
Published: January 2022

Polycythemia vera (PV) is a stem cell disorder characterized by hyperproliferation of the myeloid lineages and the presence of an activating JAK2 mutation. To elucidate mechanisms controlling PV stem and progenitor cell biology, we applied a recently developed highly sensitive data-independent acquisition mass spectrometry workflow to purified hematopoietic stem and progenitor cell (HSPC) subpopulations of patients with chronic and progressed PV. We integrated proteomic data with genomic, transcriptomic, flow cytometry, and in vitro colony formation data. Comparative analyses revealed added information gained by proteomic compared with transcriptomic data in 30% of proteins with changed expression in PV patients. Upregulated biological pathways in hematopoietic stem and multipotent progenitor cells (HSC/MPPs) of PV included mammalian target of rapamycin (MTOR), STAT, and interferon signaling. We further identified a prominent reduction of clusterin (CLU) protein expression and a corresponding activation of nuclear factor-κB (NF-κB) signaling in HSC/MPPs of untreated PV patients compared with controls. Reversing the reduction of CLU and inhibiting NF-κB signaling decreased proliferation and differentiation of PV HSC/MPPs in vitro. Upon progression of PV, we identified upregulation of LGALS9 and SOCS2 protein expression in HSC/MPPs. Treatment of patients with hydroxyurea normalized the expression of CLU and NF-κB2 but not of LGALS9 and SOCS2. These findings expand the current understanding of the molecular pathophysiology underlying PV and provide new potential targets (CLU and NF-κB) for antiproliferative therapy in patients with PV.
Combined driving: task-specific position impacts grip strength of equestrian athletes
Authors: Keener Michaela M. , Tumlin Kimberly I. , Heebner Nicholas R.
Published: January 2022

Background

Loss of hand strength is a predictor of mortality in aging populations. Despite reliance on the hands to participate in equestrian driving activity, no existing studies focus on associations of hand strength to athletic performance. Therefore, this study 1) established baseline handgrip of equestrian combined drivers in standing and task-specific positions, 2) determined endurance of task-specific handgrip, 3) compared handgrip strength to normative data, and 4) evaluated associations of handgrip and equestrian-specific variables.

Methods

There were 51 combined drivers (9 males, 42 females) ages 21–78 who completed a survey, standing handgrip, and grip strength and endurance in a task-specific position. Sixty-three percent of participants were 50 years or older. The dynamometer grip bar was normalized by hand size for standing tests; to duplicate sport-specific tasks, the bar was set to the closest setting. Significances were determined at p < 0.05.

Results

Drivers with more than 30 years of experience demonstrated highest summed standing (73.1 ± 5.2 kg) and summed sitting (59.9 ± 6.3 kg) grip strength. Females 60-years and older had greater handgrip endurance (Χ2 = 8.323, df = 2, p = .0156) in non-dominant (left) hands. Males (60%) reported more cold weather fatigue than females. Glove wearing was associated with bilateral endurance balance; a higher proportion of endurance balance between dominant and non-dominant (49% high-high and 29% low-low; Χ2 = 11.047, df = 1, p = .0009) was realized. There were no associations of handgrip and prior injury.

Conclusions

Our results have implications in understanding task-specific and normative grip strengths in aging equestrian populations. Bilateral balance in handgrip strength and endurance is important particularly in maintaining strength in non-dominant hands over time. Equestrian driving sport promotes greater endurance in older females. Strength can be improved by participating in combined driving, and engagement in this sport over several years’ benefits hand strength over time. This cohort of equestrian participants provides evidence that participating in hand-specific activities promotes greater strength, which has been previously shown to improve aging outcomes.
Premorbid functional status as an outcome predictor in intensive care patients aged over 85 years
Authors: Pietiläinen Laura , Bäcklund Minna , Hästbacka Johanna , Reinikainen Matti
Published: January 2022

Background

Poor premorbid functional status (PFS) is associated with mortality after intensive care unit (ICU) admission in patients aged 80 years or older. In the subgroup of very old ICU patients, the ability to recover from critical illness varies irrespective of age. To assess the predictive ability of PFS also among the patients aged 85 or older we set out the current study.

Methods

In this nationwide observational registry study based on the Finnish Intensive Care Consortium database, we analysed data of patients aged 85 years or over treated in ICUs between May 2012 and December 2015. We defined PFS as good for patients who had been independent in activities of daily living (ADL) and able to climb stairs and as poor for those who were dependent on help or unable to climb stairs.

To assess patients’ functional outcome one year after ICU admission, we created a functional status score (FSS) based on how many out of five physical activities (getting out of bed, moving indoors, dressing, climbing stairs, and walking 400 m) the patient could manage. We also assessed the patients’ ability to return to their previous type of accommodation.

Results

Overall, 2037 (3.3% of all adult ICU patients) patients were 85 years old or older. The average age of the study population was 87 years. Data on PFS were available for 1446 (71.0%) patients (good for 48.8% and poor for 51.2%). The one-year mortalities of patients with good and those with poor PFS were 29.2% and 50.1%, respectively, p < 0.001. Poor PFS increased the probability of death within 12 months, adjusted odds ratio (OR), 2.15; 95% confidence interval (CI) 1.68–2.76, p < 0.001. For 69.5% of survivors, the FSS one year after ICU admission was unchanged or higher than their premorbid FSS and 84.2% of patients living at home before ICU admission still lived at home.

Conclusions

Poor PFS doubled the odds of death within one year. For most survivors, functional status was comparable to the premorbid status.
Systemic sclerosis complicated with renal thrombotic microangiopathy: a case report and literature review
Authors: Kong Weiwei , Wang Yaomin , Wang Huiping , Zhou Qin , Chen Jianghua , Han Fei
Published: January 2022

Background

Systemic sclerosis (SSc) may overlap with other connective tissue diseases, which is named overlap syndrome. Scleroderma renal crisis (SRC) is a rare but severe complication of SSc. SSc related thrombotic microangiopathy (SSc-TMA) is an infrequent pathology type of SRC, while SSc-TMA accompanied by overlap syndrome is very rare.

Case presentation

This study reported a case of acute kidney injury (AKI) accompanied with overlap syndrome of SSc, systemic lupus erythematosus (SLE) and polymyositis (PM). The renal pathology supported the diagnosis of SSc-TMA but not SLE or PM-related renal injury, characterized by renal arteriolar thrombosis, endothelial cells edema, little cast in tubules and mild immune complex deposition. The primary TMA related factors (ADAMTS13 and complement H factor) were normal. Thus, this case was diagnosed as secondary TMA associated with SSc. The patient was treated with renin angiotensin system inhibitors, sildenafil, supportive plasma exchange/dialysis, and rituximab combined with glucocorticoids. After 2 months of peritoneal dialysis treatment, her renal function recovered and dialysis was stopped.

Conclusion

This study presented a case of SSc-TMA with overlap syndrome. Rituximab can be used as a treatment option in patients with high SRC risk or already manifesting SRC.
Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia
Authors: Nyemba Dorothy C. , Kalk Emma , Vinikoor Michael J. , Madlala Hlengiwe P. , Mubiana-Mbewe Mwangelwa , Mzumara Maureen , Moore Carolyn Bolton , Slogrove Amy L. , Boulle Andrew , Davies Mary-Ann , Myer Landon , Powis Kathleen
Published: January 2022

Background

Infants born HIV-exposed yet remain uninfected (HEU) are at increased risk of poorer growth and health compared to infants born HIV-unexposed (HU). Whether maternal antiretroviral treatment (ART) in pregnancy ameliorates this risk of poorer growth is not well understood. Furthermore, whether risks are similar across high burden HIV settings has not been extensively explored.

Methods

We harmonized data from two prospective observational studies conducted in Cape Town, South Africa, and Lusaka, Zambia, to compare weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length (WLZ) Z-scores between infants who were HEU and HU, converting infant anthropometric measures using World Health Organisation Growth Standards adjusted for age and sex. Linear mixed effects models were fit to identify risk factors for differences in anthropometrics at 6–10 weeks and 6 months by infant HIV exposures status and by timing of exposure to maternal ART, either from conception or later in gestation.

Results

Overall 773 mother-infant pairs were included across two countries: women living with HIV (WLHIV), 51% (n = 395) with 65% on ART at conception and 35% initiating treatment in pregnancy. In linear mixed effects models, WAZ and WLZ at 6–10 weeks were lower among infants who were HEU vs HU [β = − 0.29 (95% CI: − 0.46, − 0.12) and [β = − 0.42 (95% CI: − 0.68, − 0.16)] respectively after adjusting for maternal characteristics and infant feeding with a random intercept for country. At 6 months, LAZ was lower [β = − 0.28 CI: − 0.50, − 0.06)] among infants who were HEU, adjusting for the same variables, with no differences in WAZ and WLZ. Within cohort evaluations identified different results with higher LAZ among infants who were HEU from Zambia at 6–10 weeks, [β = + 0.34 CI: + 0.01, + 0.68)] and lower LAZ among infants who were HEU from South Africa [β = − 0.30 CI: − 0.59, − 0.01)] at 6 months, without other anthropometric differences at either site.

Conclusion

Infant growth trajectories differed by country, highlighting the importance of studying contextual influences on outcomes of infants who were HEU.
Exploring drug cost and disease outcome in rheumatoid arthritis patients treated with biologic and targeted synthetic DMARDs in Norway in 2010–2019 – a country with a national tender system for prescription of costly drugs
Authors: Brkic Alen , Diamantopoulos Andreas P. , Haavardsholm Espen Andre , Fevang Bjørg Tilde Svanes , Brekke Lene Kristin , Loli Liz , Zettel Camilla , Rødevand Erik , Bakland Gunnstein , Mielnik Pawel , Haugeberg Glenn
Published: January 2022

Background

In Norway, an annual tender system for the prescription of biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) has been used since 2007. This study aimed to explore annual b/tsDMARDs costs and disease outcomes in Norwegian rheumatoid arthritis (RA) patients between 2010 and 2019 under the influence of the tender system.

Methods

RA patients monitored in ordinary clinical practice were recruited from 10 Norwegian centers. Data files from each center for each year were collected to explore demographics, disease outcomes, and the prescribed treatment. The cost of b/tsDMARDs was calculated based on the drug price given in the annual tender process.

Results

The number of registered RA patients increased from 4909 in 2010 to 9335 in 2019. The percentage of patients receiving a b/tsDMARD was 39% in 2010 and 45% in 2019. The proportion of b/tsDMARDs treated patients achieving DAS28 remission increased from 42 to 67%. The estimated mean annual cost to treat a patient on b/tsDMARDs fell by 47%, from 13.1 thousand euros (EUR) in 2010 to 6.9 thousand EUR in 2019. The mean annual cost to treat b/tsDMARDs naïve patients was reduced by 75% (13.0 thousand EUR in 2010 and 3.2 thousand EUR in 2019).

Conclusions

In the period 2010–2019, b/tsDMARD treatment costs for Norwegian RA patients were significantly reduced, whereas DAS28 remission rates increased. Our data may indicate that the health authorities’ intention to reduce treatment costs by implementing a tender system has been successful.
The timed up and go test in idiopathic normal pressure hydrocephalus: a Nationwide Study of 1300 patients
Authors: Sundström Nina , Rydja Johanna , Virhammar Johan , Kollén Lena , Lundin Fredrik , Tullberg Mats
Published: January 2022

Background

The aim of this study was to describe the outcome measure timed up and go (TUG) in a large, nationwide cohort of patients with idiopathic normal pressure hydrocephalus (iNPH) pre- and post-operatively. Furthermore, to compare the TUG test to the 10-m walk test (10MWT), the iNPH scale, the modified Rankin scale (mRS) and the Mini Mental State Examination (MMSE), which are commonly applied in clinical assessment of iNPH.

Methods

Patients with iNPH (n = 1300), registered in the Swedish Hydrocephalus Quality Registry (SHQR), were included. All data were retrieved from the SHQR except the 10MWT, which was collected from patient medical records. Clinical scales were examined pre- and 3 months post-operatively. Data were dichotomised by sex, age, and preoperative TUG time.

Results

Preoperative TUG values were 19.0 [14.0–26.0] s (median [IQR]) and 23 [18–30] steps. Post-operatively, significant improvements to 14.0 [11.0–20.0] s and 19 [15–25] steps were seen. TUG time and steps were higher in women compared to men (p < 0.001) but there was no sex difference in improvement rate. Worse preoperative TUG and younger age favoured improvement. TUG was highly correlated to the 10MWT, but correlations of post-operative changes were only low to moderate between all scales (r = 0.22–0.61).

Conclusions

This study establishes the distribution of TUG in iNPH patients and shows that the test captures important clinical features that improve after surgery independent of sex and in all age groups, confirming the clinical value of the TUG test. TUG performance is associated with performance on the 10MWT pre- and post-operatively. However, the weak correlations in post-operative change to the 10MWT and other established outcome measures indicate an additional value of TUG when assessing the effects of shunt surgery.
LINC00885 promotes cervical cancer progression through sponging miR-3150b-3p and upregulating BAZ2A
Authors: Liu Yeling , Chen Jingrui , Zhou Lizhong , Yin Chunhua
Published: January 2022

Background

Cervical cancer (CC) is one of the most common malignancies affecting female worldwide. Long non-coding RNAs (lncRNAs) are increasingly indicated as crucial participants and promising therapeutic targets in human cancers. The main objective of this study was to explore the functions and mechanism of LINC00885 in CC.

Methods

RT-qPCR and western blot were used to detect RNA and protein levels. Functional and mechanism assays were respectively done for the analysis of cell behaviors and molecular interplays.

Results

Long intergenic non-coding RNA 885 (LINC00885) was discovered to be upregulated in CC tissues and cell lines through bioinformatics analysis and RT-qPCR. Overexpression of LINC00885 promoted proliferation and inhibited apoptosis, whereas its silence exerted opposite effects. The cytoplasmic localization of LINC00885 was ascertained and furthermore, LINC00885 competitively bound with miR-3150b-3p to upregulate BAZ2A expression in CC cells. Rescue assays confirmed that LINC00885 regulated CC proliferation and apoptosis through miR-3150b-3p/BAZ2A axis. Finally, we confirmed that LINC00885 aggravated tumor growth through animal experiments.

Conclusions

LINC00885 exerted oncogenic function in CC via regulating miR-3150b-3p/BAZ2A axis. These findings suggested LINC00885 might serve as a potential promising therapeutic target for CC patients.
The short-term effect of vitamin D supplementation on the response to muscle and liver damages indices by exhaustive aerobic exercise in untrained men: a quasi-experimental study
Authors: Mastali Vahid Parvizi , Hoseini Rastegar , Azizi Mohammad
Published: January 2022

Background

Exercise-induced muscle damage typically caused by unaccustomed exercise results in pain, soreness, inflammation, and muscle and liver damages. Antioxidant supplementation might be a useful approach to reduce myocytes and hepatocytes damages. Therefore, the present study was conducted to investigate the effect of short-term vitamin D (Vit D) supplementation on the response to muscle and liver damages indices by Exhaustive Aerobic Exercise (EAE) in untrained men.

Methods

In this clinical trial, 24 untrained men were randomly divided into experimental (Exp; n = 12) and control (C; n = 12) groups. Exp received 2000 IU of Vit D daily for six weeks (42 days), while C daily received a lactose placebo with the same color, shape, and warmth percentage. Two bouts of EAE were performed on a treadmill before and after six weeks of supplementation. Anthropometric characteristics (Bodyweight (BW), height, Body Fat Percentage (BFP), Body Mass Index (BMI), waist to hip ratio (WHR)) were measured at the Pre 1 and Pre 2. Blood samples were taken to measure the Creatine Kinase (CK), Lactate Dehydrogenase (LDH), Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Gamma-Glutamyl Transferase (GGT), Alkaline Phosphatase (ALP), and Vit D levels at four stages: Pre 1 (before the first EE session), Post 1 (after the first EE session), Pre 2 (before the second EE session), and Post 2 (after the second EE session). The data were analyzed using repeated-measures ANOVA, Bonferroni's post hoc test, independent t test, and dependent t-test at the significant level of P < 0.05 using SPSS version 26.

Results

The results show significant differences between Exp and C in alterations of BW (P = 0.039), BMI (P = 0.025), BFP (P = 0.043), and WHR (P = 0.035). The results showed that EAE increased muscle and liver damage indices and Vit D (P < 0.05). Compared with C, the results of the independent t-test showed significantly lower ALT (P = 0.001; P = 0.001), AST (P = 0.011; P = 0.001), GGT (P = 0.018; P = 0.001), and ALP (P = 0.001; P = 0.001); while significantly higher Vit D (P = 0.001, P = 0.001) in the Exp in both Pre 2 and Post 2; receptivity. The independent t test showed significantly lower ALT (P = 0.001; P = 0.001), AST (P = 0.011; P = 0.001), GGT (P = 0.018; P = 0.001), and ALP (P = 0.001; P = 0.001) and considerably greater Vit D (P = 0.001, P = 0.001) in the Exp in both Pre 2 and Post 2 compared to C. The results of an independent t test showed that LDH and CK levels in the Exp were significantly lower than those in the Post 2 (P = 0.001).

Conclusions

Short-term Vit D supplementation could prevent myocytes and hepatocytes damage induced by EAE.
Forgone healthcare and financial burden due to out-of-pocket payments in Bangladesh: a multilevel analysis
Authors: Rahman Md. Mizanur , Islam Md. Rashedul , Rahman Md. Shafiur , Hossain Fahima , Alam Ashraful , Rahman Md. Obaidur , Jung Jenny , Akter Shamima
Published: January 2022

Background

Ensuring access to health services for all is the main goal of universal health coverage (UHC) plan. Out-of-pocket (OOP) payment still remains the main source of funding for healthcare in Bangladesh. The association between barriers to accessing healthcare and over-reliance on OOP payments has not been explored in Bangladesh using nationally representative household survey data. This study is a novel attempt to examine the burden of OOP payment and forgone healthcare in Bangladesh, and further explores the inequalities in catastrophic health expenditures (CHE) and forgone healthcare at the national and sub-national levels.

Methods

This study used data from the most recent nationally representative cross-sectional survey, Bangladesh Household Income and Expenditure Survey, conducted in 2016–17 (N = 39,124). In order to identify potential determinants of CHE and forgone healthcare, multilevel Poisson regression was used. Inequalities in CHE and forgone healthcare were measured using the slope index of inequality.

Results

Around 25% of individuals incurred CHE and 14% of the population had forgone healthcare for any reasons. The most common reasons for forgone healthcare were treatment cost (17%), followed by none to accompany or need for permission (5%), and distance to health facility (3%). Multilevel analysis indicated that financial burden and forgone care was higher among households with older populations or chronic illness, and those who utilize either public or private health facilities. Household consumption quintile had a linear negative association with forgone care and positive association with CHE.

Conclusion

This study calls for incorporation of social safety net in health financing system, increase health facility, and gives priority to the disadvantaged population to ensure access to health services for all.
Multiple ratiometric nanothermometry using semiconductor BiFeO3 nanowires and quantitative validation of thermal sensitivity
Authors: Prashanthi K. , Krishna Mohan K. , Antić Željka , Ahadi Kaveh , Dramicanin Miroslav D.
Published: January 2022

Here, we report a very sensitive, non-contact, ratio-metric, and robust luminescence-based temperature sensing using a combination of conventional photoluminescence (PL) and negative thermal quenching (NTQ) mechanisms of semiconductor BiFeO3(BFO) nanowires. Using this approach, we have demonstrated the absolute thermal sensitivity of ~ 10 mK−1over the 300–438 K temperature range and the relative sensitivity of 0.75% K−1at 300 K. Further, we have validated thermal sensitivity of BFO nanowires quantitatively using linear regression and analytical hierarchy process (AHP) and found close match with the experimental results. These results indicated that BFO nanowires are excellent candidates for developing high‐performance luminescence-based temperature sensors.

Graphical abstract
Cultural heritage preservation by using blockchain technologies
Authors: Trček Denis
Published: January 2022

Ubiquitous digitization enables promising options for cultural heritage preservation. Therefore, a new approach is presented that considers deployment scenarios by linking heritage science to tourism. Such an approach is necessary because neither technology nor society views can be treated separately to obtain deployable solutions of a wider social, and even national importance. Clearly, while the traditional approaches to cultural heritage preservation will remain a gold standard, they will be increasingly complemented by digital preservation techniques. Thus, based on practical implementations and lessons learnt in other areas, this multidisciplinary framework paper analyses existing disruptive information technologies deployments. In line with the findings it presents a novel technological architecture tailored to the needs of cultural heritage preservation that deploys an open blockchain architecture. The architecture preserves the advantages of traditional blockchains, which made this technology so important, while enabling energy efficient implementations that can be deployed in mobile applications. By additionally using the contribution-ware principle it links it to tourism, where the identification of users focused incentives and business models play a central role. It is obvious that tourism is a good candidate in such preservation efforts due to the organic links between it and cultural heritage and can support further developments in the heritage preservation domain.
Addressing big data variety using an automated approach for data characterization
Authors: Vranopoulos Georgios , Clarke Nathan , Atkinson Shirley
Published: January 2022

The creation of new knowledge from manipulating and analysing existing knowledge is one of the primary objectives of any cognitive system. Most of the effort on Big Data research has been focussed upon Volume and Velocity, while Variety, “the ugly duckling” of Big Data, is often neglected and difficult to solve. A principal challenge with Variety is being able to understand and comprehend the data. This paper proposes and evaluates an automated approach for metadata identification and enrichment in describing Big Data. The paper focuses on the use of self-learning systems that will enable automatic compliance of data against regulatory requirements along with the capability of generating valuable and readily usable metadata towards data classification. Two experiments towards data confidentiality and data identification were conducted in evaluating the feasibility of the approach. The focus of the experiments was to confirm that repetitive manual tasks can be automated, thus reducing the focus of a Data Scientist on data identification and thereby providing more focus towards the extraction and analysis of the data itself. The origin of the datasets used were Private/Business and Public/Governmental and exhibited diverse characteristics in relation to the number of files and size of the files. The experimental work confirmed that: (a) the use of algorithmic techniques attributed to the substantial decrease in false positives regarding the identification of confidential information; (b) evidence that the use of a fraction of a data set along with statistical analysis and supervised learning is sufficient in identifying the structure of information within it. With this approach, the issues of understanding the nature of data can be mitigated, enabling a greater focus on meaningful interpretation of the heterogeneous data.
Acute superior mesenteric artery occlusion associated with COVID-19 pneumonia: a case report
Authors: Sukegawa Masahiro , Nishiwada Satoshi , Terai Taichi , Kuge Hiroyuki , Koyama Fumikazu , Nakagawa Kenji , Nagai Minako , Sho Masayuki
Published: January 2022

Background

The novel 2019 coronavirus disease (COVID-19), which is caused by infection with the severe acute respiratory syndrome coronavirus 2, has spread rapidly around the world and has caused many deaths. COVID-19 involves a systemic hypercoagulable state and arterial/venous thrombosis which induces unfavorable prognosis. Herein, we present a first case in East Asia where an acute superior mesenteric artery (SMA) occlusion associated with COVID-19 pneumonia was successfully treated by surgical intervention.

Case presentation

A 70-year-old man presented to his local physician with a 3-day history of cough and diarrhea. A real-time reverse transcriptase-polymerase chain reaction test showed positive for COVID-19, and he was admitted to the source hospital with the diagnosis of moderate COVID-19 pneumonia. Eight days later, acute onset of severe abdominal pain appeared with worsening respiratory condition. Contrast CT showed that bilateral lower lobe/middle lobe and lingula ground glass opacification with distribution suggestive of COVID-19 pneumonia and right renal infarction. In addition, it demonstrated SMA occlusion with intestinal ischemia suggesting extensive necrosis from the jejunum to the transverse colon. The patient underwent an emergency exploratory laparotomy with implementing institutional COVID-19 precaution guideline. Upon exploration, the intestine from jejunum at 100 cm from Treitz ligament to middle of transverse colon appeared necrotic. Necrotic bowel resection was performed with constructing jejunostomy and transverse colon mucous fistula. We performed second surgery to close the jejunostomy and transverse colon mucous fistula with end-to-end anastomosis on postoperative day 22. The postoperative course was uneventful and he moved to another hospital for rehabilitation to improve activities of daily living (ADLs) on postoperative day 45. As of 6 months after the surgery, his ADLs have completely improved and he has returned to social life without any intravenous nutritional supports.

Conclusions

Intensive treatment including surgical procedures allowed the patient with SMA occlusion in COVID-19 pneumonia to return to social life with completely independent ADLs. Although treatment for COVID-19 involves many challenges, including securing medical resources and controlling the spread of infection, when severe abdominal pain occurs in patients with COVID-19, physicians should consider SMA occlusion and treat promptly for life-saving from this deadly combination.
Lessons from the design, development and implementation of a three-dimensional (3D) neonatal resuscitation training smartphone application: Life-saving Instruction for Emergencies (LIFE app)
Authors: Wanyama Conrad , Nagraj Shobhana , Muinga Naomi , Tuti Timothy , Edgcombe Hilary , Geniets Anne , Winters Niall , English Mike , Rossner Jakob , Paton Chris
Published: January 2022

Neonatal mortality remains disproportionately high in sub-Saharan Africa partly due to insufficient numbers of adequately trained and skilled front-line health workers. Opportunities for improving neonatal care may result from upskilling frontline health workers using innovative technological approaches. This practice paper describes the key steps involved in the design, development and implementation of an innovative smartphone-based training application using an agile, human-centred design approach. The Life-saving Instruction for Emergencies (LIFE) app is a three-dimension (3D) scenario-based mobile app for smartphones and is free to download. Two clinical modules are currently included with further scenarios planned. Whilst the focus of the practice paper is on the lessons learned during the design and development process, we also share key learning related to project management and sustainability plans, which we hope will help researchers working on similar projects.
Assessing mortality registration in Kerala: the MARANAM study
Authors: Gupta Aashish , Mani Sneha Sarah
Published: January 2022

Complete or improving civil registration systems in sub-national areas in low- and middle-income countries provide several opportunities to better understand population health and its determinants. In this article, we provide an assessment of vital statistics in Kerala, India. Kerala is home to more than 33 million people and is a comparatively low-mortality context. We use individual-level vital registration data on more than 2.8 million deaths between 2006 and 2017 from the Kerala MARANAM (Mortality and Registration Assessment and Monitoring) Study. Comparing age-specific mortality rates from the Civil Registration System (CRS) to those from the Sample Registration System (SRS), we do not find evidence that the CRS underestimates mortality. Instead, CRS rates are smoother across ages and less variable across periods. In particular, the CRS records higher death rates than the SRS for ages, where mortality is usually low and for women. Using these data, we provide the first set of annual sex-specific life tables for any state in India. We find that life expectancy at birth was 77.9 years for women in 2017 and 71.4 years for men. Although Kerala is unique in many ways, our findings strengthen the case for more careful attention to mortality records within low- and middle-income countries, and for their better dissemination by government agencies.
Beyond the beauty of occlusion: medical masks increase facial attractiveness more than other face coverings
Authors: Hies Oliver , Lewis Michael B.
Published: January 2022

The sanitary-mask effect (Miyazaki and Kawahara in Jpn Psychol Res 58(3):261–272, 2016) is the finding that medical face masks prompt an image of disease and thus result in lower ratings of facial attractiveness of the wearer. However, during the COVID-19 pandemic, medical masks have been found to increase attractiveness (Patel et al. in Plast Reconstruct Surg Glob Open 8(8), 2020) although this could have been a general effect of occlusion. To further explore this issue, female participants were presented with a series of male faces of low or high attractiveness that were occluded with a medical mask, cloth mask, book or not occluded and asked to rate them on attractiveness. The results show that faces were considered as most attractive when covered by medical masks and significantly more attractive when occluded with cloth masks than when not occluded. Contrary to expectation, base attractiveness did not interact with the type of occlusion, suggesting that this is not simply due to occlusion of negative features. The present findings are contrary to the sanitary-mask effect and explanations in terms of social desirability, and the association of medical masks with caregiving professions is explored.
Face mask use in healthcare settings: effects on communication, cognition, listening effort and strategies for amelioration
Authors: Lee Emily , Cormier Kayla , Sharma Anu
Published: January 2022

Aim

To investigate mask use and the difficulties it may pose during communication in healthcare settings.

Methods

A survey utilizing a series of Likert scales was administered. Mask use challenges between clinicians and their patients were examined in the domains of communication, listening effort, cognition, and rehabilitation.

Results

Across 243 participants, mask use significantly increased listening effort, with hearing loss having an additive effect on listening effort. Listening effort was also significantly associated with more trouble understanding conversation, decreased interest in conversation, more difficulty connecting with patients, changes in cognition for both providers and patients, and changes in the clinical efficiency of providers. Hearing loss had an additive effect for trouble understanding conversations and changes in clinical efficiency.

Conclusion

These results provide information about the clinical strain introduced from mask use in healthcare settings. Overall, results show that in healthcare settings there is increased cognitive load and listening effort for both patients and providers, as well as changes in clinical efficiency for providers when utilizing masks. These effects are often greater with hearing loss. Results showed that patients reported written and visual instructions would be most beneficial to include in appointments among the other rehabilitative strategies which are discussed.
Case series of intravenous thrombolysis for acute ischemic stroke in confirmed COVID-19 patients: single-centre experience
Authors: Alwahdy Ahmad Sulaiman , Margaretha Ika Yulieta , Pramesti Kenyo Sembodro , Hamro Nailaufar , Yuzella Viska , Nasution Fitriani , Mappalilu Arfan
Published: January 2022

Background

Coronavirus disease 2019 (COVID-19) not only caused a large surge of respiratory infections, it also had a potential association with and increases the risk of stroke. The pandemic has certainly provided new challenges and opportunities in the management of acute ischemic stroke (AIS); however, data regarding outcomes of intravenous tissue plasminogen activator (IV TPA) administration in stroke patients with COVID-19 remains limited.

Case presentation

Three AIS patients with confirmed COVID-19 treated using IV tPA. One case had excellent outcome, while the other cases showed unfavorable results. The risk–benefit ratio of IV TPA in COVID-19 remains unclear.

Conclusion

In this article, we discuss the possible explanation behind these different outcomes. Although IV tPA could not cure COVID-19, we suggest that its administration should not be delayed in AIS patients with COVID-19.
Is lumbar erector spinae plane block (L-ESPB) a lumbar plexus block?: a case report of three cases
Authors: Jadon Ashok , Sahoo Rajendra Kumar , Sharma Santosh Kumar
Published: January 2022

Background

Lumbar erector spinae plane block (L-ESPB) is being used in fractured hip patients for the postoperative pain relief and as a sole anesthetic technique. Various clinical and cadaveric studies have differences of opinion about its mechanism of action and pathways of local anesthetic spread; however, the role of lumbar plexus (LP) in the mechanism of action is still not considered. In our clinical experience, we observed that the action on LP could be a pathway for the analgesic action of local anesthetic along with paravertebral spread.

Case presentation

We report here three cases of the fractured hip who were given L-ESPB for postoperative pain management. The radiological examination was done after injection of non-ionic contrast to know the spread of local anesthetic. In two cases, the contrast spread was seen towards LP and in one case spread of contrast was observed towards the paravertebral area.

Conclusions

Effect of local anesthetic on the lumbar plexus is one of the plausible pathways in L-ESPB for its analgesic mechanism of action.