bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Criteria For Acute Headache Attributed To Ischemic Stroke And For Sentinel Headache Before Ischemic Stroke.
Authors: Lebedeva Elena R , Ushenin Anton V. , Gurary Natalia M. , Gilev Denis V. , Olesen Jes
Published: November 2021

Background: Defining the relationship between a headache and stroke is essential. The current diagnostic criteria of the ICHD-3 for acute headache attributed to ischemic stroke are based primarily on the opinion of experts rather than on published clinical evidence based on extensive case-control studies in patients with first-ever stroke. Diagnostic criteria for sentinel headache before ischemic stroke do not exist. The present study aimed to develop explicit diagnostic criteria for headache attributed to ischemic stroke and for sentinel headache.Methods: This prospective case-control study included 550 patients (mean age 63,1, 54% males) with first-ever ischemic stroke and 192 control patients (mean age 58.7, 36% males) admitted to the emergency room without any acute neurological deficits or severe disorders. Standardized semi-structured interview forms were used to evaluate past and present headaches during face-to-face interviews by a neurologist on admission to the emergency room in both groups of patients. All headaches were diagnosed according to the ICHD-3. We tabulated the onset of different headaches before a first-ever ischemic stroke and at the time of onset of stroke. We divided them into three groups: a new type of headache, the previous headache with altered characteristics and previous unaltered headaches. The same was done for headaches in control patients within one week before admission to the hospital and at the time of entry. These data were used to create and test diagnostic criteria for acute headache attributed to stroke and sentinel headache. Results: Our previous studies showed that headache at onset of ischemic stroke was present in 82 (14.9%) of 550 patients, and 81 (14.7%) patients had sentinel headache within the last week before a stroke. Only 60% of the headaches at stroke onset fulfilled the diagnostic criteria of ICHD-3. Therefore, we proposed alternative criteria with a sensitivity of 100% and specificity of 97%. Besides, we developed diagnostic criteria for sentinel headache for the first time with a specificity of 98% and a sensitivity of 100%. Conclusion: We suggest alternative criteria for acute headache attributed to ischemic stroke and new diagnostic criteria for sentinel headache with high sensitivity and specificity.
Three-Dimensional Reconstruction of Maize Plants and Extraction of Phenotypic Parameters Based On Laser Point Cloud Data
Authors: Ju Chengxin , Zhao Yuanyuan , Wu Fengfeng , Li Rui , Yang Tianle , Zhong Xiaochun , Yan Feng , Liu Tao , Sun Chengming
Published: November 2021

Background: Three-dimensional (3D) laser scanning technology could rapidly extract the surface geometric features of maize plants to achieve non-destructive monitoring of maize phenotypes. However, extracting the phenotypic parameters of maize plants based on laser point cloud data is challenging.Methods: In this paper, a rotational scanning method was used to collect the data of potted maize point cloud from different perspectives by using a laser scanner. Maize point cloud data were grid-reconstructed and aligned based on greedy projection triangulation algorithm and iterative closest point (ICP) algorithm, and the random sampling consistency algorithm was used to segment the stem and leaf point clouds of single maize plant to obtain the plant height and leaf parameters.Results: The results showed that the R2 between the predicted plant height and the measured plant height was above 0.95, and the R2 of the predicted leaf length, leaf width and leaf area were 0.938, 0878 and 0.956 respectively when compared with the measured values.Conclusions: The 3D reconstruction of maize plants using the laser scanner showed a good performance, and the phenotypic parameters obtained based on the reconstructed 3D model had high accuracy. The results were helpful to the practical application of plant 3D reconstruction and provided guidance for plant parameter acquisition and theoretical methods for intelligent agricultural research.
Morphology and Microcirculation Changes of Optic Nerve Head Between Simple High Myopia and Pathologic Myopia
Authors: Tang Wenquan , Duan Xuanchu , Ouyang Junyi , Luo YuLin , Wang Xilang
Published: November 2021

This study explored morphology and microcirculation changes of optic nerve head (ONH) in simple high myopia(SHM) and pathologic myopia(PM), in order to evaluate and identify ONH changes in the development of PM. We divided 193 right eyes of 193 patients into SHM and PM according to the retinopathy. We found that ONH is one of the earliest pathological changes in myopia, and its morphology changes were also the most obvious. PM is closely linked to the reduction of choroidal perfusion and structural changes of ONH. Microcirculation showed a significant priority changes in myopia. Further research should address whether these fndings are associated with future disease development in highly myopic eyes.
In vitro validation of the immunogenicity of the predicted neoepitopes from high-risk estrogen receptor-positive breast cancer
Authors: Choe Yun-jeong , Kim Eunyoung , Oh Jooyeon , Jang Miran , Fu Weixan , Lee Hann , Chung Minho , Pyo Kyung-Ho , Synn Chung-Bong , Kim Sora , Yang Yohan , Kim Ahyeon , Cho Byung Chul , Kim Han Sang , Kim Sangwoo , Carreno Beatriz , Kim Jee Ye , Paik Soonmyung
Published: November 2021

Whether estrogen receptor-positive (ER+) breast cancer (BC) can be a target for therapeutic neoepitope vaccination is not clear due to its low mutation burden. We tested the immunogenicity of predicted neoepitopes from exome and RNA-seq data from three ER+/luminal B subtype BC samples using IFN-γ ELISpot assays of HLA-matched donor PBMCs. As a control, three ER- BC and three lung cancers were tested. The ensemble of Neopepsee and pVACseq pipelines predicted 93 neoepitopes from 299 SNVs in three ER+ BCs. Among them, 90 could be tested with ELISpot, and 14 (15.6%) were immunogenic (1, 5, and 10 for each tumor). In three ER- BC samples, 52 neoepitopes were predicted from 271 SNVs, and 12 (25.0%) of 48 tested were immunogenic (2, 4, and 8 for each tumor). Of the three lung cancers, 53 of 72 predicted neoepitope candidates were tested, and 10 of them were immunogenic (18.9%) (0, 1, and 11 for each tumor). These differences were not statistically significant. We conclude that luminal B subtype BCs express neoepitopes and can be a candidate for therapeutic neoepitope vaccination.
Robot-Assisted Partial Nephrectomy for Renal Pelvic Urothelial Carcinoma Complicated with Renal Insufficiency: A Case Report
Authors: Chen Shikai , Li Ping , Song Shizhang , Hou Sichuan
Published: November 2021

Background Primary malignant tumors of the renal pelvis are relatively few in urinary tumors, with a high degree of malignancy and a relatively poor prognosis. Most of the pathological results are urothelial carcinoma. The standard surgical operation is full-length resection of the kidney and ureter and sleeve resection of the bladder. However, for patients with renal insufficiency or solitary kidney, clinicians find it terribly difficult to make the decision on the surgical resection and protection of the renal function. A patient with renal pelvis malignant tumor complicated with renal insufficiency was treated in our hospital.Case presentation: A 77-year-old Chinese female with a more than 5-year history of renal dysfunction,was hospitalized due to "painless gross hematuria found for 4 months". The patient had no other significant discomfort. CT discovered that the volume of both kidneys is small, and the soft tissue density shadow was exactly at the right ureteropelvic junction. Therefore we consider the diagnosis was tumor of right renal pelvis. Patient did not accept radical surgical resection and was required to preserve the kidney. So the patient underwent robot-assisted partial nephrectomy for right renal pelvic , and the operation was successful. After surgery chemotherapy drugs were instilled into the renal pelvis through a single J-tube infusion. During nearly three years of follow-up, the patient regularly reviewed ureteroscopy and MRI/CT, no significant abnormalities were seen. Postoperative creatinine control was better and no hemodialysis was performed. The curative effect is acceptable.Conclusions Partial nephrectomy for renal pelvic is also an option for patients with malignant tumor of renal pelvis who need to preserve their kidneys.
Rapid Prototyping For Series of Tasks in Atypical Environment: Robotic System With Reliable Program-Based and Flexible Learning-Based Approaches
Authors: Ito Hiroshi , Nakamura Satoshi
Published: November 2021

We propose a novel robotic system that combines both a reliable programming-based approach and a highly generalizable learning-based approach. How to design and implement a series of tasks in an atypical environment is a challenging issue. If all tasks are implemented using a programming-based approach, the development costs will be huge. However, if a learning-based approach is used, reliability is an issue. In this paper, we propose novel design guidelines that focus on the respective advantages of programming-based and learning-based approaches and select them so that they complement each other. We use a program-based approach for actions that are dynamic and require safety and reliability and a learning-based approach for actions that have a limited working area and are difficult to achieve with a program. Our learning approach can easily and rapidly accomplish a series of tasks consisting of various motions because it does not require a computational model of an object to be designed in advance. We demonstrate a series of tasks in which randomly arranged parts are assembled using an actual robot.
Strengthening Institutions for Public Health Education: Results of a SWOT Analysis From India to Inform Global Best Practices
Authors: Miller Emily , Reddy Megha , Banerjee Preetika , Brahmbhatt Haley , Majumdar Piyusha , Mangal DK , Gupta Shiv Dutt , Zodpey Sanjay , Shet Anita , Schleiff Meike
Published: November 2021

Background: Developing public health educational programs that provide workers prepared to adequately respond to health system challenges is an historical dilemma. In India, the focus on public health education has been mounting in recent years. The COVID-19 pandemic is a harbinger of the increasing complexities surrounding public health challenges and the overdue need to progress public health education around the world. This paper aims to explore strengths and challenges of public health educational institutions in India, and elucidate unique opportunities to emerge as a global leader in reform. Methods: To capture the landscape of public health training in India, we initiated a web-based desk review of available offerings and categorized by key descriptors and program qualities. We then undertook a series of in-depth interviews with representatives from a purposively sample of institutions and performed a qualitative SWOT analysis. Results: We found that public health education exists in many formats in India. Although Master of Public Health (MPH) and similar programs are still the most common type of public health training outside of community medicine programs, other postgraduate pathways exist including PhDs, certificates and executing trainings. The strengths of public health education institutions include research capacities, financial accessibility, and innovation, yet there is a need to improve collaborations and harmonize training with career pathways. Growing attention to the sector, improved technologies and community engagement all hold exciting potential for public health education, whilst externally held misconceptions can threaten institutional efficacy and potential. Conclusions: The timely need for and attention to public health education in India present a critical juncture for meaningful reform. India may also be well-situated to contextualize and scale the types of trainings needed to address complex challenges and serve as a model for other countries and the world.
A Misleading Apical Periodontitis Like Symptoms Post COVID-19 Vaccine
Authors: Alzahrani Mohammed
Published: November 2021

BackgroundAdverse effects of vaccines are common, yet the reaction to vaccines widely varies between people. Companies provide an adverse effects list of their products. Adverse reactions might indicate the effectiveness of vaccines and that the immune system is responding. Case presentationIn this study, we present unusual side effects of the Pfizer/BioN-Tech vaccine. The patient had severe continuous pain related to the lower left first molar after the second dose of the Pfizer/BioN-Tech vaccine. The symptoms are typically resembling symptomatic apical periodontitis cases.ConclusionPfizer/BioN-Tech vaccine might lead to symptoms that mimic symptomatic apical periodontitis. The patient who develops such symptoms shortly after the covid -19 vaccine without an apparent cause should be assured and kept under observation for one to two weeks. A tentative diagnosis and treatment plan should be considered in the follow-up visit.
Detection of emerging ibrutinib resistance by flow cytometry in patients with chronic lymphocytic leukemia
Authors: Takács Ferenc , Kotmayer Lili , Czeti Ágnes , Szalóki Gábor , Tamás László , Mikala Gábor , Márk Ágnes , Masszi András , Farkas Péter , Plander Márk , Weisinger Júlia , Demeter Judit , Fekete Sándor , Szaleczki Erika , Borbényi Zita , Szerafin László , Deák Beáta , Sulák Adrienn , Barna Gabor
Published: November 2021

Background: Bruton ’ s tyrosine kinase inhibitor ibrutinib has revolutionized the treatment of chronic lymphocytic leukemia (CLL). Although ibrutinib is a highly effective drug, continuous treatment is required to maintain remission, which may lead to acquired ibrutinib resistance. Early detection of acquired resistance preceding clinical disease progression is an important issue. This is why our aim was to investigate several phenotypic markers on CLL cells to reveal changes in their expression during ibrutinib treatment in sensitive and clinically resistant patients. Materials and methods: In our study 28 (treatment naive, ibrutinib sensitive, clinically ibrutinib resistant) peripheral blood (PB), and 6 paired PB and bone marrow (BM) samples from CLL patients were examined. The expression of several surface markers (CD69, CD184, CD86, CD185, CD27) was assessed by flow cytometry in each sample. Furthermore, the presence of the BTK C481S resistance mutation was tested using digital droplet PCR (ddPCR) in samples from ibrutinib sensitive and resistant cases. In addition, we investigated the changes of CLL cells ’ phenotype during ibrutinib treatment in one patient with acquired ibrutinib resistance. Results: We found that the expression of CD27 decreased during ibrutinib therapy but increased again at the onset of clinical resistance. Expressions of CD69 and CD86 were also elevated at the onset of clinical ibrutinib resistance. Furthermore, the expression of CD86 showed correlation between PB and BM samples. Relapsed cases with high CD86 expression were positive for BTK C481S mutation. In addition, our prospective study showed that the increases in the expression of CD27, CD69 and CD86 were detectable up to several months before the onset of clinical resistance. Conclusion: Our research suggests that the flow cytometric measurements of certain markers, especially CD86, may predict development of ibrutinib resistance, however, confirmatory experiments are still required. Monitoring CD86 expression on peripheral blood CLL cells during ibrutinib treatment may become a potential new method to detect acquired ibrutinib resistance in the near future.
Impact of Whole-Genome Sequencing of Mycobacterium Tuberculosis On Treatment Outcomes for MDR-TB/ XDR-TB: A Systematic Review Protocol
Authors: Hazra Druti , Lam Connie , Dhyani Vijay Shree , V Bhumika T , Chawla Kiran , Sintchenko Vitali
Published: November 2021

Background
The emergence of drug-resistant tuberculosis (DR-TB) is a persistent threat to public health. The detection of DR-TB requires culture-based drug susceptibility testing (DST) or rapid molecular assays for targeted genes. The recent advances in Whole-genome sequencing (WGS) technology have offered a new capacity to identify resistance-conferring mutations in Mycobacterium tuberculosis (MTB). This study reviews and quantifies the emerging evidence on the association between genomic markers of drug resistance in MTB identified by WGS and treatment outcomes for DR-TB.
Methods
A literature search will be conducted in NCBI PubMed, Scopus, Cochrane Library, Web of Science, and CINAHL (Ebsco) to retrieve all the relevant original reports from 2000 onwards. Clinical trials and observational studies describing different applications of WGS to genotypic resistance testing for TB and detection of MDR-TB/ XDR-TB as well as treatment outcomes of the patients will be included. Two primary reviewers will separately screen and select papers for data extraction, risk of bias, and assess the quality. Any disagreement between the reviewers' will be clarified by a third reviewer. The I2 statistics will be used to assess the heterogeneity of the included studies and if the data are sufficiently homogenous, a meta-analysis will be performed. The Egger's test and visual representation of the funnel plot will be used to monitor for publication bias. Narrative data synthesis will be conducted for all the included studies if performing meta-analysis is not possible.
Discussion
This systematic review will examine the evidence on the feasibility and added value of WGS in improving treatment outcomes in DR-TB patients. The rapid detection of drug-resistance conferring mutations and selection of appropriate drug regimens is likely to improve the cure rates while minimizing adverse events and treatment costs. Hence, the outcome of this systematic review will inform policy-making and will guide clinical laboratory practice to improve drug resistance diagnostic capacity and treatment outcomes.
Systematic review registration:
PROSPERO CRD42020197099.
Subclones of Bone Marrow CD34+ Cells in Acute Myeloid Leukemia at Diagnosis Confer Responses of Patients to Induction Chemotherapy
Authors: Jia Ruinan , Ji Min , Li Guosheng , Xia Yuan , Guo Shouhui , Li Peng , Sun Yanping , Lu Fei , Zhang Jingru , Zang Shaolei , Yan Shuxin , Ye Jingjing , Xue Fuzhong , Ma Daoxin , Sun Tao , Ji Chunyan
Published: November 2021

BackgroundAcute myeloid leukemia (AML) is a fatal hematopoietic malignancy which has a prognosis that varies with genetic heterogeneity of its hematopoietic stem/progenitor cells(HSCPs). Intensive induction chemotherapy with cytarabine and anthracycline has been the standard of care for newly diagnosed AML, but about 30% of patients have no response to this regimen. The resistance mechanisms require deeper understanding. Methods In our study, using 10× Genomics, a high-throughput single cell RNA sequencing (scRNA-seq) platform, we analyzed the cellular heterogeneity of bone marrow CD34+ cells from newly diagnosed AML patients who were then divided into sensitive and resistant groups according to their responses to induction chemotherapy with cytarabine and anthracycline. ScRNA-seq data for healthy controls were obtained from the GEO database. We verified our findings by the TCGA database, GEO datasets and the multiparameter flow cytometry.ResultsFrom the integrative analysis of 60,402 cells, we established a landscape for single-cell CD34+ cells in AML patients and identified the hematopoietic stem/progenitor cell types based on the lineage signature genes. Interestingly, through recognizing the malignant-like clusters and comparing “resistant group” with “sensitive group”, we found a cell population with specific gene signatures (CRIP1highLGALS1highS100Ashigh) showing features of granulocyte-monocyte progenitors (GMP) was associated with poor prognosis of AML. And two cell populations of AML CD34+ cells marked by CD52+ or CD74+DAP12+ were related to good response of patients to induction therapy, showing characteristics of hematopoietic stem cell (HSC). ConclusionOur study indicates the heterogeneity of AML CD34+ cells confers for outcomes of AML and provides possible biomarkers to predict the response of AML patients to induction chemotherapy.
Exploring a Novel Method For Optimising the Implementation of a Colorectal Cancer Risk Prediction Tool Into Primary Care: A Qualitative Study
Authors: Milton Shakira , Emery Jon D , Rinaldi Jane , Kinder Joanne , Bickerstaffe Adrian , Saya Sibel , Jenkins Mark , McIntosh Jennifer
Published: November 2021

BackgroundWe developed a colorectal cancer risk prediction tool (‘CRISP’) to provide individualised risk-based advice for colorectal cancer screening. Using known environmental, behavioural, and familial risk factors, CRISP was designed to facilitate tailored screening advice to patients aged 50 to 74 years in general practice. In parallel to a randomised controlled trial of the CRISP tool, we developed and evaluated an evidence-based implementation strategy.MethodsQualitative methods were used to explore the implementation of CRISP in general practice. Using one general practice in regional Victoria, Australia as a ‘laboratory’, we tested ways to embed CRISP into routine clinical practice. General practitioners, nurses, and a practice manager co-designed the implementation methods with researchers, focussing on existing practice processes that would be sustainable. Researchers interviewed the staff regularly to assess the successfulness of the strategies employed, and implementation methods were adapted throughout the study period in response to feedback from qualitative interviews.The Consolidated Framework for Implementation Research (CFIR) underpinned the development of the interview guide and intervention strategy. Coding was inductive and themes were developed through consensus between the authors. Emerging themes were mapped onto the CFIR domains and a fidelity checklist was developed to ensure CRISP was being used as intended.Results Between December 2016 and September 2019, eleven interviews were conducted, both face-to-face and via videoconferencing (Zoom). All interviews were transcribed verbatim and coded. Themes were mapped onto the following CFIR domains: 1. ‘characteristics of the intervention’: CRISP was valued but time consuming; 2. ‘inner setting’: the practice was open to changing systems; 3. ‘outer setting’: CRISP helped facilitate screening; 4. ‘individual characteristics’: the practice staff were adaptable and able to facilitate adoption of new clinical processes; and 5. ‘processes’: fidelity checking and education was important.ConclusionsThese results describe a novel method for exploring implementation strategies for a colorectal cancer risk prediction tool in the context of a parallel RCT testing clinical efficacy. The study identified successful and unsuccessful implementation strategies using an adaptive methodology over time. This method emphasised the importance of co-design input to make an intervention like CRISP sustainable for use in other practices and with other risk tools.Trial registrationN/A
Optimal Combined Anteversion Range for Obtaining a Wider Range of Motion without Prosthetic Impingement after Total Hip Arthroplasty: A Three-dimensional Analysis Study
Authors: hidaka Ryo , Matsuda Kenta , Nakamura Masaki , Nakamura Shigeru , Kawano Hirotaka
Published: November 2021

Background: Obtaining a larger theoretical range of motion (ROM) is crucial to avoid prosthetic impingement after total hip arthroplasty (THA); however, no reports have examined the permissible range values of combined anteversion (CA) satisfying targeted ROM without prosthetic impingement. This retrospective study aimed to evaluate the possible postoperative CA extent that would allow meeting target ROM criteria according to Yoshimine’s theory using computed tomography (CT)-based three-dimensional motion analysis after THA.Methods: This study included 114 patients (133 hips) who underwent cementless primary THA using a CT-based navigation system and implants (oscillation angle ≥135°). Implant positions were determined using Yoshimine's CA formula. Postoperative evaluation was conducted using a three-dimensional templating software for CT data. The postoperative Yoshimine’s and Widmer’s CA was calculated, and the difference between the target and postoperative values was defined as the error of Yoshimine’s CA and Widmer’s CA. Prosthetic ROM was assessed by Yoshimine’s stringent criteria for activities of daily living. Based on fulfilling these criteria, all patients were divided into the ROM (+) and ROM (-) groups. Evaluation items were compared between the two groups.Results: There were 111 and 22 hips in the ROM (+) and ROM (-) groups, respectively. A significant difference was noted in the absolute error of Yoshimine’s and Widmer’s CA between the two groups. Using receiver operating characteristic analysis, threshold values of 6.0 (higher values indicate greater disability; sensitivity 90.9%, specificity 72.1%) for the absolute Yoshimine’s CA difference (area under the curve [AUC] 0.87, P<0.01) and 6.9 (higher values indicate greater disability; sensitivity 68.2%, specificity 88.3%) for the absolute Widmer’s CA difference (AUC 0.83, P<0.01) were predictors in the ROM (-) group.Conclusions: The target range of Yoshimine’s CA (90.8°±6.0°) and Widmer’s CA values (37.3°±6.9°) was crucial in implant orientation for obtaining theoretical ROM without prosthetic impingement after THA.
A comparison of mixed-variables Bayesian optimization approaches
Authors: Ramirez Jhouben Janyk Cuesta , Riche Rodolphe Le , Roustant Olivier , Perrin Guillaume , Durantin Cedric , Gliere Alain
Published: November 2021

Most real optimization problems are defined over a mixed search space where the variables are both discrete and continuous. In engineering applications, the objective function is typically calculated with a numerically costly black-box simulation. General mixed and costly optimization problems are therefore of a great practical interest, yet their resolution remains in a large part an open scientific question.
In this article, costly mixed problems are approached through Gaussian processes where the discrete variables are relaxed into continuous latent variables. The continuous space is more easily harvested by classical Bayesian optimization techniques than a mixed space would. Discrete variables are recovered either subsequently to the continuous optimization, or simultaneously with an additional continuous-discrete compatibility constraint that is handled with augmented Lagrangians.
Several possible implementations of such Bayesian mixed optimizers are compared. In particular, the reformulation of the problem with continuous latent variables is put in competition with searches working directly in the mixed space. Among the algorithms involving latent variables and an augmented Lagrangian, a particular attention is devoted to the Lagrange multipliers for which a local and a global estimation techniques are studied.
The comparisons are based on the repeated optimization of three analytical functions and a beam design problem.
Examining Barriers and Facilitators of Pediatric Enhanced Recovery Protocol Implementation
Authors: Davis Teaniese L. , Schäfer Willemijn , Blake Sarah C. , Close Sharron , Balbale Salva N. , Perry Joseph E. , Zarate Raul Perez , Ingram Martha , Strople Jennifer , Johnson Julie , Holl Jane L. , Raval Mehul V.
Published: November 2021

Background: Enhanced Recovery Protocols (ERPs) are an evidence-based intervention to optimize post-surgical recovery. Several studies have demonstrated that use of an ERP for gastrointestinal surgery results in decreased length of stay, shortened time to regular diet, and fewer administered opioids, while also trending toward lower complication and 30-day readmission rates. Yet, implementation of ERPs in pediatric surgery is lagging compared to adult surgery. The purpose of this study was to conduct a theory-guided evaluation of barriers and facilitators to ERP implementation at US hospitals with a pediatric surgery service.Methods: We conducted semi-structured interviews at 18 hospitals with 48 participants, including pediatric surgeons, anesthesiologists, gastroenterologists, nurses, and physician assistants. Interviews were conducted online, audio-recorded, and transcribed verbatim. To identify barriers and facilitators to ERP implementation, we conducted a thematic analysis using combined inductive as well as deductive logics based on the National Implementation Research Network’s Five Active Implementation Frameworks (AIFs). Results: Framed by the 5AIFs, factors serving as barriers and facilitators to ERP implementation included: fidelity to and operationalization of ERP elements and measurement of outcomes (usable innovations); establishing and standardizing ERP protocols (stages); organizational support, institutional and electronic health record capacity to track patients getting ERP, training on protocol implementation, education on benefits of ERP use and how to adhere to ERPs (implementation drivers); and team, patient, and family buy-in and engagement early in the ERP implementation process (teams). Applying the implementation framework facilitated the identification of potential strategies to support effective practices (evidence-based ERPs and implementation tools), effective implementation (local team infrastructure support including team member roles and responsibilities; a learning collaborative for pediatric surgery groups with monthly support, coaching and training by topic experts, tools to engage key stakeholders), and enabling contexts (a toolkit to support implementation, sustainability assessments, quarterly data-driven feedback sessions, and access to a QI expert on the implementation teams), to achieve the desired outcomes.Conclusions: Comprehensive and systematic application of the 5AIFs allowed organization of the identified barriers and facilitators. Future steps are to apply and evaluate these strategies in a stepped-wedge, cluster randomized trial to increase implementation of ERPs at these 18 hospitals.
Optimal Design and Noise Analysis of High-Performance DBR-Integrated Lateral Germanium (Ge) Photodetectors for SWIR Applications
Authors: Kumar Harshvardhan , Pandey Ankit Kumar , Lin Chu-Hsuan
Published: November 2021

This work presents the high-performance Si/SiO2distributed Bragg reflector (DBR)-integrated lateral germanium (Ge) p-i-n photodetectors (PDs) for atmospheric gas sensing and fiber-optic telecommunication networks in the short-wave infrared (SWIR) regime. In addition, this study also proposes an opto-electronic compact small-signal noise equivalent circuit model (SSNECM) of the designed device to compute the signal-to-noise ratio (SNR) at the output of the detector. Various figure-of merits including current under dark and illumination, responsivity, detectivity, 3dB bandwidth, and the SNR of the proposed device are estimated at the room-temperature (RT) for an incident optical power of 0.5 μW. Furthermore, the impact of scaling of rib waveguide (WG) width and height on dark current, responsivity, and 3dB bandwidth are investigated to optimize the proposed device. The validation of the proposed model is done by comparing various parameters including dark current, responsivity, and detectivity of the designed device with other Ge PDs. The estimated results show the reduced trade-off between responsivity and 3dB bandwidth of the designed device. At λ=1550 nm, the proposed device achieves the high detectivity and SNR of >2X1011 Jones and 120 dB (up to 3 THz), respectively, with the bias voltage of -2V. These encouraging results pave the path for the future development of low noise and high-speed detectors for SWIR applications.
The Cumulative Therapeutic Effect of Acupuncture Treatment in Patients With Migraine Without Aura: Evidence From Dynamic Alterations of Intrinsic Brain Activity and Effective Connectivity Analysis
Authors: Chen Yilei , Kang Yingjie , Luo Shilei , Liu Shanshan , Wang Bo , Gong Zhigang , Huang Yanwen , Wang Hui , Tan WenLi , Zhan Songhua
Published: November 2021

Background: The underlying neurological mechanism of acupuncture treatment in migraine without aura (MwoA) remains unclear. Therefore, we explored the dynamic alterations of intrinsic brain activity and effective connectivity in patients with MwoA after acupuncture treatment.Methods:The fMRI scans were separately obtained at baseline, after the first and after the 12th acupuncture sessions in 40 patients with MwoA. The acupuncture treatments were finished within 6 weeks as twice a week. 36 matched healthy controls (HCs) were recruited and performed once fMRI scan. The dynamic amplitude of low-frequency fluctuation (dALFF) and dynamic granger causality analysis(GCA) were used to analyze the difference of different time points in patients with MwoA. The correlation analyses were performed in dALFF variability, dynamic effective connectivity (DEC) variability with clinical variables in patients with MwoA.Results:Compared with HCs, Patients with MwoA at baseline showed decreased dALFF variability in regions within rostral ventromedial medulla (RVM), the superior lobe of left cerebellum (Cerebelum_Crus1_L), the right inferior frontal gyrus, triangular part (IFGtriang.R), the right median cingulate and paracingulate gyri (DCG.R), the right precuneus (PCUN.R), and the left inferior parietal, supramarginal and angular gyri (IPL.L), increased dALFF variability only in the left inferior occipital gyrus (IOG.L). After acupuncture treatment, the decreased dALFF variability of the RVM, Cerebelum_Crus1_L , and PCUN.R progressively recovered, the RVM revealed gradually increased DEC variability to the right middle frontal gyrus (MFG.R), the left insula (INS.L), the right precentral gyrus (PreCG.R), and the right supramarginal gyrus (SMG.R). And enhanced DEC variability from the right fusiform gyrus (FFG.R) to RVM. Furthermore, the increased DEC variability were found from Cerebelum_Crus1_L to the left middle occipital gyrus (MOG.L) and the left precentral gyrus (PreCG.L), from PCUN.R to the right thalamus (THA.R). These dALFF variabilities were significantly positive correlated with frequency of migraine attack and negative correlated with disease duration at baseline, dynamic GCA coefficients were significantly positive correlated with Migraine-Specific Quality of Life Questionnaire (MSQ) score, negative correlated with frequency of migraine attack and visual analog scale (VAS) score postacupuncture treatment.Conclusions:Our results provide insight into dynamic alterations from the perspective of dynamic local brain activity and effective connectivity for the understanding mechanisms of cumulative therapeutic effect of acupuncture in patients with MwoA.Trial registration: ChiCTR, ChiCTR1900023105. Registered 11 May 2019, http://www.chictr.org.cn/showproj.aspx?proj=36959.
A thermodynamic origin for the Cohen-Kaplan-Nelson bound
Authors: Ramakrishna Satish
Published: November 2021

The Cohen-Kaplan-Nelson bound is imposed on the grounds of logical consistency (with classical General Relativity) upon local quantum field theories. This paper puts the bound into the context of a thermodynamic principle applicable to a field with a particular equation of state in an expanding universe. This is achieved without overtly appealing to either a decreasing density of states or a minimum coupling requirement, though they might still be consistent with the results described. The paper establishes that the holographic principle applied to cosmology is consistent with minimizing the free energy of the universe in the canonical ensemble, upon the assumption that the ultraviolet cutoff is a function of the causal horizon scale.
Mutability of Druggable Kinases and Pro-inflammatory Cytokines by Their Proximity to Telomeres and A+T Content
Authors: McKnight Ian , Raines Regan , Hunter White , Nosoudi Nasim , Lee Peter H.U. , Shim Joon W.
Published: November 2021

Mutations of protein kinases are common and can cause cancer and other diseases. However, our understanding of the mutability in genes encoding kinases remains rudimentary. Given previously proposed factors associated with high mutation rates, we analyzed how many genes encoding druggable kinases match with (i) proximity to telomeres or (ii) high A+T content. We extracted genomic information using National Institute of Health Genome Data Viewer. Among 129 druggable human kinase genes studied, 106 genes satisfied either factors (i) or (ii), resulting in an 82% match. A similar 85% match rate was found in 73 genes encoding pro-inflammatory cytokines of multisystem inflammatory syndrome in children. As we further compared these two factors in 20 de novo mutations of mice exposed to space-like ionizing radiation, however, 10 of 20 murine genetic loci met (i) or (ii), leading to only a 50% match. When compared with the top selling approved drugs, the data suggest that matching rate analysis on factor-druggable genome is feasible to systematically prioritize the relative mutability of the novel druggable candidates. These two factors not only predict how mutations of the disease phenotype are attributed to genetic and/or environmental factors but also sort out druggable proteins by their relative mutability.
Discrete Optimization on Unsteady Pressure Fluctuation of a Centrifugal Pump Using ANN and Modified GA
Authors: Wang Wenjie , Deng Qifan , Pei Ji , Chen Jinwei , Gan Xingcheng
Published: November 2021

Pressure fluctuation due to the rotor-stator interaction in turbomachinery is unavoidable, inducing strong vibration and even shortening the lifecycle. The investigation on optimization method of an industrial centrifugal pump was carried out to reduce the pressure fluctuation intensity. Considering the time-consuming transient calculation of unsteady pressure, a novel optimization strategy was proposed by discretizing design variables and genetic algorithm. Four highly related design parameters were chosen, and 40 transient sample cases were generated and simulated using an automatic simulation program. Furthermore, a modified discrete genetic algorithm (MDGA) was proposed to reduce the optimization cost by unsteady simulation. For the benchmark test, the proposed MDGA showed a great advantage over the original genetic algorithm in terms of searching speed and could deal with the discrete variables effectively. After optimization, an improvement in terms of the performance and stability of the inline pump was achieved.
Inter-Comparison of Two Regional Climate Models (RegCM and WRF) in Downscaling CFSv2 For the Seasonal Prediction of Indian Summer Monsoon
Authors: Mohanty Manas Ranjan , Mohanty Uma Charan
Published: November 2021

The efficacy of two latest versions of regional climate models (RegCM and WRF) for simulating the Indian summer monsoon (JJAS) is tested in this study. The CFSv2 hindcast outputs are downscaled over the Indian monsoon domain for 11 contrasting monsoon seasons using the regional models. The April start ensembles of the CFSv2 are averaged to generate the initial and lateral boundary conditions for driving the WRF and RegCM. The regional models perform better in simulating the Indian summer monsoon features better than the parent CFSv2 model. The rainfall pattern as well as the intensities are improved with the dynamical downscaling and the errors in the rainfall are minimized over the GCM hindcast. On comparing the two regional models, the RegCM overestimates the rainfall during the excess and normal monsoon seasons. The RCMs improve the skill of rainfall prediction as compared to the GCM and WRF shows better skill in particular. One peculiar finding of this study is that the daily rainfall biases averaged over all the years of simulation shows that the two RCMs show similar biases with RegCM showing stronger biases occasionally. It may be implied that the errors from GCM in the form of the ICBC might be influencing the simulation in the RCMs. The upper air and surface parameters analysis shows that the WRF performs better in representing the semi-permanent features of the Indian summer monsoon which may be helping in improving the rainfall over the RegCM. The wind pattern as well as the relative humidity along the vertical column of the atmosphere are captured better in the WRF model. Diagnostics of CAPE & vertically integrated moisture transport supports the finding of the rainfall being simulated better in the WRF model.
Serum Cystatin C, Kidney Injury Molecule-1, Neutrophil Gelatinase-Associated Lipocalin, Klotho and Fibroblast Growth Factor-23 in The Early Prediction of Acute Kidney Injury Associated With Sepsis in a Chinese Emergency Cohort Study
Authors: Pei Yuanyuan , Zhou Guangping , Wang Pengfei , Shi Fang'e , Ma Xiaolu , Zhu Jihong
Published: November 2021

Background: Acute kidney injury (AKI) was a common and critical complication of sepsis, and is associated with unacceptable morbidity and mortality. Current diagnostic criteria for AKI was insensitive for early detection. Novel biomarkers included cystatin C, KIM-1, NGAL, klotho and FGF-23 which can predict AKI earlier may allow immediate interventions. We aimed to determine the diagnostic performance of these biomarkers for detecting AKI in sepsis patients.Methods: This prospective observational study was conducted from May 2018 and November 2020, enrolling sequential 162 sepsis patients. AKI’s definition was according to 2012 KDIGO criteria and we divided patients into non-AKI (n=102) and AKI (n=60) groups. Serum levels of several AKI biomarkers were detected by ELISA. The relationship between biomarker levels on admission of AKI were analyzed and discrimination performances comparison were performed.Results: AKI incidence was up to 37.0% (60/162) during hospitalization. Compared with non-AKI group, both serum cystatin C, KIM-1, NGAL and FGF-23 were significantly elevated at admission in septic AKI patients. The areas under the receiver operating curves demonstrated that serum cystatin C had modest discriminative powers for predicting AKI after sepsis, and cystatin C combined with serum creatinine in the prediction of septic AKI increased the diagnostic sensitivity prominently.Conclusion: Serum cystatin C, KIM-1, NGAL and FGF-23 levels are both increased in septic AKI patients. Our study provides reliable evidence that cystatin C solely and combined with serum creatinine may accurately and sensitively predict septic AKI when patients on admission.
The Effects of Media and Peers on Negative Body Images of Chinese College Students: Multiple Mediating Effects of Appearance Comparison and Internalization of the Thin-Ideal
Authors: Shen Jianting , Chen Jinjun , Tang Xiwen , Bao Shangfei
Published: November 2021

Background

Negative body image is a common psychological phenomenon among Chinese college students, which should arouse our attention. Peers and media are important factors that influence personal negative body image. This study explores the mechanism of media and peers on the negative body image of Chinese college students.
Methods

461 college students (173 identifying as male, 234 identifying as female) were investigated by using the Revised Social and Cultural Attitude Questionnaire of Appearance, Appearance Comparison Scale, Peer Impact Scale and Negative Body Image Scale.
Results

The results are as follows: (1) Correlation analysis shows that except media attention is not significantly correlated with negative body images, all other variables are significantly positively correlated; (2) Path analysis shows that the direct effect of media attention on negative body image is not significant, while the direct effect of peer impact is significant, and both of them have indirect effects through the mediate role of appearance comparison and internalization of the thin-ideal. Additionally, appearance comparison and internalization of the thin-ideal act as a chain mediation between negative body image and media attention, peer impact.
Conclusions

The research shows just paying attention to the information of the perfect body in the media will not produce negative body image, but paying attention to the media and peer talks about the body may cause college students to compare appearances and internalize the standards for a good shape, leading to their negative evaluation of themselves.
Compressed Sensing Based Dynamic MR Image Reconstruction By Using 3D-Total Generalized Variation and Tensor Decomposition: k-t TGV-TD
Authors: Zhang Jucheng , Han Lulu , Sun Jianzhong , Wang Zhikang , Xu Wenlong , Xia Ling , Jiang Mingfeng
Published: November 2021

Purpose: Compressed Sensing Magnetic Resonance Imaging (CS-MRI) is a promising technique to accelerate dynamic cardiac MR imaging (DCMRI). For DCMRI, the CS-MRI usually exploits image signal sparsity and low-rank property to reconstruct dynamic images from the undersampled k-space data. In this paper, a novel CS algorithm is investigated to improve dynamic cardiac MR image reconstruction quality under the condition of minimizing the k-space recording.Methods: The sparse representation of 3D cardiac magnetic resonance data is implemented by synergistically integrating 3D TGV algorithm and high order singular value decomposition (HOSVD) based Tensor Decomposition, termed as k-t TGV-TD method. In the proposed method, the low rank structure of the 3D dynamic cardiac MR data is performed by the HOSVD method, and the localized image sparsity is achieved by the 3D TGV method. Moreover, the Fast Composite Splitting Algorithm (FCSA) method, combining the variable splitting with operator splitting techniques, is employed to solve the low-rank and sparse problem. Two different cardiac MR datasets (cardiac cine and cardiac perfusion MR data) are used to evaluate the performance of the proposed method.Results: Compared with the state-of-art methods, such as the k-t SLR method, 3D TGV method and HOSVD based tensor decomposition method, the proposed method can offer improved reconstruction accuracy in terms of higher signal-to-error ratio (SER).Conclusions: This work proved that the k-t TGV-TD method was an effective sparse representation way for DC-MRI, which was capable of significantly improving the reconstruction accuracy with different reduction factor.