bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Use of Raman Spectroscopy Improves Diagnostic Accuracy for Indeterminate Thyroid Nodules
Authors: Palermo Andrea , Sodo Armida , Naciu Anda Mihaela , Di Gioacchino Michael , Paolucci Alessio , di Masi Alessandra , Maggi Daria , Crucitti Pierfilippo , Longo Filippo , Perrella Eleonora , Taffon Chiara , Verri Martina , Ricci Maria Antonietta , Crescenzi Anna
Published: September 2022

Background and Objective

Molecular analysis of thyroid fine-needle aspiration (FNA) specimens is believed to improve the management of indeterminate nodules. Raman spectroscopy (RS) can differentiate benign and malignant thyroid lesions in surgically removed tissues, generating distinctive structural profiles. Herein, the diagnostic performance of RS was tested on FNA biopsies of thyroid gland.

Design

Prospective, blinded, and single-center study.

Methods

We enrolled 123 patients with indeterminate or more ominous cytologic diagnoses (TIR3A-low-risk indeterminate lesion, TIR3B-high-risk indeterminate lesion, TIR4-suspicious of malignancy, TIR5-malignant). All subjects were surgical candidates (defined by international guidelines) and submitted to FNA procedures for RS analysis. We compared RS data, cytologic findings, and final histologic assessments (as reference standard) using various statistical techniques.

Results

The distribution of our study population was as follows: TIR3A:37, TIR3B:32, TIR4:16, and TIR5:38. In 30.9% of patients, histologic diagnoses were benign. For predicting thyroid malignancy in FNA samples, the overall specificity of RS was 86.8%, with 86.5% specificity in indeterminate cytologic categories. In patients with high-risk ultrasound categories, the specificity of RS increased to 87.5% for TIR3A, reaching 100% for TIR3B. Benign histologic diagnoses accounted for 72.9% of patients classified as TIR3A and 31.3% of those classified as TIR3B. Based on positive RS testing, unnecessary surgery was reduced to 7.4% overall (TIR3A-33.3%, TIR3B-6.7%).

Conclusions

This premier use of RS for thyroid cytology confirms its role as a valuable diagnostic tool and a valid alternative to molecular studies, capable of improving the management of indeterminate nodules and reducing unnecessary surgery.
Suboccipital Craniectomy for an Anterior Foramen Magnum Meningioma—Optimization of Resection Using Intraoperative Augmented Reality: 2-Dimensional Operative Video
Authors: Matsoukas Stavros , Oemke Holly , Lopez Laura Salgado , Gilligan Jeffrey , Tabani Halima , Bederson Joshua B.
Published: September 2022

Foramen magnum meningiomas represent a challenge in skull base surgery because they frequently implicate the lower cranial nerves, brainstem, and posterior cerebral circulation, including the anterior spinal arteries.
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The use of virtual reality allows for surgical rehearsal based on patient-specific anatomy, thus increasing the surgeon's confidence and assists with bone opening planning by generating navigation-integrated templates.
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In this 2-dimensinal operative video, the authors demonstrate the importance of augmented reality (AR) template for the resection of a large intradural anterior foramen magnum meningioma in a 68-year-old patient. Preoperative MRI and virtual reality were used to delineate and define the extent of the tumor, as well as its relationship with nearby vital structures. The lesion measured 4.5 by 2 by 3 cm in the craniocaudal, anteroposterior and transverse axes, respectively, and was causing significant mass effect on the brainstem and spinal cord. Both vertebral arteries had a very close relationship with the tumor. After performing a bilateral craniectomy with a right side far lateral extension, debulking started at the inferior and continued toward the middle portion of the tumor. The most challenging part of the operation was to identify and protect the anterior spinal arteries, for which the AR-assisted preview of the surgical microscope proved of paramount importance. Following the heads-up display of the AR, the lateral portion of the tumor, which was adherent to the ventral surface of the vertebral artery, and then the uppermost portion of the tumor were removed, achieving a gross total resection. Appropriate consent was obtained.

Images at 4:10 used with permission. Left from Matsushima T,
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©2015; Right from Dhandapani et al,
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©2014.
Hypoxia induces an early primitive streak signature, enhancing spontaneous elongation and lineage representation in gastruloids
Authors: López-Anguita Natalia , Gassaloglu Seher Ipek , Stötzel Maximilian , Bolondi Adriano , Conkar Deniz , Typou Marina , Buschow René , Veenvliet Jesse V. , Bulut-Karslioglu Aydan
Published: September 2022

The cellular microenvironment, together with intrinsic regulators, shapes stem cell identity and differentiation capacity. Mammalian early embryos are exposed to hypoxia in vivo and appear to benefit from hypoxic culture in vitro. Yet, how hypoxia influences stem cell transcriptional networks and lineage choices remain poorly understood. Here, we investigated the molecular effects of acute and prolonged hypoxia on embryonic and extra-embryonic stem cells as well as the functional impact on differentiation potential. We find a temporal and cell type-specific transcriptional response including an early primitive streak signature in hypoxic embryonic stem cells mediated by HIF1α. Using a 3D gastruloid differentiation model, we show that hypoxia-induced T expression enables symmetry breaking and axial elongation in the absence of exogenous WNT activation. When combined with exogenous WNT activation, hypoxia enhances lineage representation in gastruloids, as demonstrated by highly enriched signatures of gut endoderm, notochord, neuromesodermal progenitors and somites. Our findings directly link the microenvironment to stem cell function and provide a rationale supportive of applying physiological conditions in models of embryo development.
Combating COVID-19 in Ghana using socio-pedagogical methods: educational campaign through children’s arts
Authors: Manful Esmeranda , Gyasi-Boadu Nelson , Osei Mavis , Laezer Katrin Luise
Published: September 2022

Background: This brief report presents an action research project that was conducted in 2020 to contribute to approaches to ensure adherence to COVID-19 health protocols by children in Ghana. The research was on the basis that when adults allow children to share the burden of finding effective measures to the adherence of COVID-19 health protocols, the spread of the virus will be contained, which would also ensure the safety of children.

Method: The action research was designed to be socially engaging, therefore a qualitative approach using Arts-Based-Research was adopted. Arts, as a socio-pedagogical method, was used as a tool to engage 189 children, between the ages of 4 and 15 years, in art workshops in Kumasi, Ghana’s second-largest city. The children, from different socioeconomic backgrounds, were aided by Art Assistants to handle the different art materials.

Results: The different artistic depiction of children on COVID-19 suggests that the awareness created had reached many children irrespective of their socioeconomic background. However, how it was portrayed by the child participants introduced a fun aspect enabling the art materials to be used for advocacy.

Conclusion: The medium, children’s art, used was innovative and caught the attention of children and adults alike, hence the art materials were effective advocacy materials. Also, the flexibility of the project design enabled the researchers to adapt the outputs to suit the rapidly evolving COVID-19 issues in the country to make the project more effective.
THE PERFORMANCE OF PNEUMATIC GUN LAUNCHING SPHERICAL PROJECTILE
Authors: LU HAI-TAO , LI WEI-BING , CUI BIN
Published: September 2022

Pneumatic guns can fire spherical projectiles of multiple materials, and some pneumatic guns can be modified and replaced with barrels. In order to clarify the impact of the pneumatic launching structure and the physical characteristics of the projectile on the launching ability of the pneumatic guns, an internal ballistic analysis model was built to describing the process of launching projectile of the gun, which accounted the process of charging and discharging, and the feasibility of the model was verified by a trial calculation with a certain pneumatic gun structure parameter Based on the model, the influence of gun/projectile characteristics on the firing ability of pneumatic guns was analyzed. The research shows that the firing ability of pneumatic guns is related to the pneumatic firing structure. Under the same conditions, the higher density of the projectile, the higher specific kinetic energy could be acquired, and the ratio of the specific kinetic energy of the higher density projectile to low density projectile is less than the density ratio; under the condition that the barrel can be modified and replaced, the barrel caliber is changed, the smaller caliber, the higher specific kinetic energy that the projectile can obtain, and the change of barrel caliber length does not affect the ratio of specific kinetic energy obtained by projectiles of different densities.
Do Prime Brokers Matter in the Search for Informed Hedge Fund Managers?
Authors: Aragon George O. , Chung Ji-Woong , Kang Byoung Uk
Published: September 2022

Using the setting of funds of hedge funds (FoFs), we show that prime brokers (PBs) facilitate investors’ search for informed hedge fund managers. We find that FoFs exhibit PB bias, a disproportionate preference for hedge funds serviced by their connected PBs. This PB bias is stronger when the cost of hedge fund due diligence is higher relative to capital and when the FoF’s management firm generates higher prime brokerage fees. PB bias also predicts FoF performance: the highest PB-bias quartile outperforms the rest by 2.08%–2.45% per annum after adjusting for differences in their risks.

This paper was accepted by Victoria Ivashina, finance.

Funding: Chung and Kang acknowledge funding support from Korea University (the Asian Institute of Corporate Governance and the Insung Research Grant) and Hong Kong Polytechnic University [Grant G-YBTG], respectively.

Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2022.4536 .
Overbooking with Bounded Loss
Authors: Freund Daniel , Zhao Jiayu (Kamessi)
Published: September 2022

We study a classic problem in revenue management: quantity-based, single-resource revenue management with no-shows. In this problem, a firm observes a sequence of T customers requesting a service. Each arrival is drawn independently from a known distribution of k different types, and the firm needs to decide irrevocably whether to accept or reject requests in an online fashion. The firm has a capacity of resources B and wants to maximize its profit. Each accepted service request yields a type-dependent revenue and has a type-dependent probability of requiring a resource once all arrivals have occurred (or be a no-show). If the number of accepted arrivals that require a resource at the end of the horizon is greater than B, the firm needs to pay a fixed compensation for each service request that it cannot fulfill. With a clairvoyant that knows all arrivals ahead of time, as a benchmark, we provide an algorithm with a uniform additive loss bound, that is, its expected loss is independent of T. This improves upon prior works achieving [Formula: see text] guarantees.

Funding: The authors gratefully acknowledge generous support by the Sloan School of Management at MIT.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/moor.2022.1293 .
Corporate Hierarchy and Organizational Learning: Member Turnover, Code Change, and Innovation in the Multiunit Firm
Authors: Joseph John , Rhee Luke , Wilson Alex James
Published: September 2022

This study examines how recombinant innovation is affected by member turnover and organizational learning within a corporate hierarchy. Prior work has overlooked the role of organizational structure in organizational learning, focusing instead on the knowledge provided by individual new hires or on the disruption caused by individual departures. We address this gap by applying March’s [March JG (1991) Exploration and exploitation in organizational learning. Organ. Sci. 2(1):71–87.] mutual learning model to a corporate hierarchy. In doing so, we theorize how the contributions of corporate staff to socializing new employees and to learning from the organizational code may differ from those of the organization’s subunit members. Empirically, we examine the learning effects of aggregate corporate and subunit arrivals and departures on novel recombinant innovation by subunits. Using 24 years of Motorola company directories, we construct membership turnover measures for corporate and subunit employees and exploit patent data to capture recombinant innovation. Our results suggest that, whereas the influx of new ideas through arrivals may be critical, breaking the pattern of inertial behavior through departures is more important for recombinant innovation. Corporate departures matter most for recombinant innovation, a result that reflects not only corporate staff’s slower individual learning from the organizational code but also its ability to update that code more quickly. In supplementary analyses, we find different effects for technical and nontechnical staff and internal and external arrivals, as well as demonstrate the mutual learning mechanism using internal corporate documents to capture code change. Our study has strong implications for theories of organizational learning, strategic human capital, organization design, and innovation.

Supplemental Material: The online appendices are available at https://doi.org/10.1287/orsc.2022.1618 .
Air Quality Assessment with Human Health Effects for Kota Metropolis, Rajasthan India.
Authors: Kamboj Kuldeep , Mathur Anil Kumar
Published: September 2022

Bad air quality is the number one environmental concern globally due to its severe impact on animals, plant life, humans and property. This study has assessed air quality and health impact on humans in Kota metropolis, Rajasthan (India), to increase the understanding of the relation between health and pollutant sources, emission characteristics, topography, and meteorological conditions. AQI and EF are also calculated to determine the pollution category and critical level of pollutants, respectively. The health effects of particulate matter on inhabitants are estimated with the AirQ+ software. The annual concentration of PM10 and PM2.5 were more than prescribed limits by CPCB, while SO2 and NO2 are well below the prescribed limits. The maximum concentrations of pollutants were detected in Winter, followed by Summer and Rainy seasons. AQI varies from satisfactory to inferior category. EF was more than 1 for all monitoring stations for PM10 and PM2.5 exhibiting High pollution, 0.5-.09 indicates Moderate pollution for NO2, while less than .5 for SO2 shows Low pollution. Particulate matter is the primary cause of air pollution. The PM2.5 induced ENACs (Estimated Number of Attributable Cases) for all causes of mortality, COPD, ALRI, LC, IHD, and stroke were 4546, 435, 255, 806,1958, and 1772, respectively. The ENACs for post neonatal infant mortality, the prevalence of bronchitis, and chronic bronchitis due to PM10 increased by 326006, 716, and 13700, respectively. This study carries useful findings and suggestions for stakeholders and policymakers to control and mitigate the decrement in air quality.
Modelling the impact of Urban Heat Island mitigation strategies on Urban Air Quality
Authors: Dave Neha M. , Vasani Rupesh P. , Chhasiya Parmit
Published: September 2022

Increasing urban sprawl has caused many severe problems like surge in pollution, rapid climatical variations, and the intensification of temperature in the urban areas, termed Urban Heat Islands (UHI). Population density has caused theconversion of most land areas into cities, and cities have expanded vastly. UHI phenomenon has caused temperature rise in the cities. Most of the metropolitan regions of India are experiencing consequences of UHI and the severity of pollution formation, which is a crucial research area. Since the rising temperature has a direct linkage with urban air pollution; the mitigation measures for UHI are also linked with urban air pollution mitigation; efficacy of mitigation measures of UHI phenomenon in correlation with urban air quality is being studied extensively, which emphasizesthescientific approach and planning concerns of implementation agency to consider the same into urban design and planning aspects. Ahmedabad is one of the growing metropolitan regions of India. The city has grown economically and physically by expanding its boundaries in a radial pattern. This study has attempted temporal assessment of remote sensing data to derive the UHI and the city's growth, and its changing land uses. Assessment has been performed from2008 to 2018 from Landsat data for temperature profile at surface level and type of usage of land of the study area. The spatial profile of Particulate Matter (PM2.5 and PM10) has been generated based on data from the state pollution control board. Four variables, LST, PM2.5, PM10, and LULC, are taken to establish the relationship between all variables present in different layers withthehelp of regression statistical analysis. A strong positive correlation between PM2.5, PM10, and LST has been discovered, which was eventually used to assess the impact of mitigation strategies of UHI, specifically urban greening and a white roof to particulate matter concentrations.
Biosynthesis of Silver Nanoparticles and its Utilization in Dye Decomposition for a Clean Environment: A Step Towards Sustainable Development
Authors: Ghosh Tatan
Published: September 2022

The tremendous interest of silver nanoparticles for the scientific community has cultivated due to its wide range of industrial applications including biomedicine. Silver (Ag) nanoparticles (NPs) are also being applied as an anti-carcinogen. Enumerable modes are available on its various synthesizing strategies which causes an adverse effect on environment. But green synthesis method which is either plant mediated or microbe mediated, a precious gift to the environment dedicated by the researchers. Here an eco-friendly approach for the preparation of Ag NPs by using aqueous extract of Neem leaves is reported. The formations of silver nanoparticle were confirmed by optical absorption spectra showing a broad absorption peaks at ~420 nm. This peak arises due to the absorption of incident light by the free electrons in the surface of the nanoparticles when they excited by an appropriate electromagnetic excitation. Material identification and crystallinity were dealt with X-ray diffraction spectra. The particles are found to be highly crystalline with face-centred cubic structure. The size of the particle was estimated by transmission electron microscope and found in the nanometer (10-9 m) scale. The synthesized nanoparticles showed a strong photocatalytic activity through the degradation of methylene blue dye under sunlight illumination. After four hours of sunlight irradiation the dye degradation was found to be 88%. The biosynthesized silver nanoparticles can be used in waste water treatment in a cost-effective way.
Spatial-Temporal Distribution and Trend Analysis of Groundwater Level at Ghazipur District, Uttar Pradesh, India.
Authors: Kumar Pushpendra , Krishan Gopal , Nema Anupam Kumar , Lohani Anil Kumar , Thakur Aradhana
Published: September 2022

The present study has analysed the Spatial-temporal distribution of groundwater level (GWL) in the Ghazipur district has been calculated using statistical and graphical methods for the period 1998, 2008 and 2018. In the present study, the GWL trend was analysed using the non-parametric Modified Mann-Kendall (MMK) test for the 39 locations of the Ghazipur district of UP, India. The trend analysis has been tested at a 5 % significance level. The mean, minimum and maximum GWL during the pre-monsoon season(PRM) ranged from 3.16 m to 12.71 m. However, in the post-monsoon (PTM) season, it ranges from 1.76 m to 9.09 m. The GWL trends have been estimated using the non-parametric tests, MMK during the period 1998 to 2018 at 39 locations in the Ghazipur district of Uttar Pradesh, India. From the analysis, The GWL trend analysis has revealed negative magnitudes for 8 locations that covered 20 % portion of total area and positive magnitudes for 31 locations spread in 80 % area in the PRM season. However, in the PTM season, 9 locations spread in 10 % area showed negative trends and 30 locations covering major area which is 90 % of total area showed positive trends. The changes in the GWL trends in two different seasons (PRM and PTM) can be included in the recharge by rainfall in the PTM season. This study reveals the behaviour of GWL over the study area. This study will help in providing valuable information about the long-term behaviour of groundwater levels for ensuring sustainable groundwater management in the Ghazipur district, Uttar Pradesh.
Characteristic of fixed abrasive polishing for KDP in an anhydrous environment
Authors: Qian Yuan , Yang Wei , Yu Xiaoluo , Chen Chaoxu
Published: September 2022

High grade optical components are rapidly being employed in a wide range of applications due to their great performance. Among these, KDP (potassium dihydrogen phosphate) is the preferred choice for frequency doubling components because to its large non-linear optical technique and high laser damage threshold. In this research, KDP is treated employing fixed polishing in an anhydrous environment. Copper oxide is utilized as abrasive, and toner and phenolic resin are combined to form pellets for KDP polishing. Calculation of the temperature field on the surface of the workpiece based on the relationship of the movement. The ideal polishing parameters are also determined from the findings of the temperature field and the optimum process parameters are 5kPa pressure, 150rpm and 8mm eccentricity. A new material removal model is presented and based on this, a unique processing technique to increase the material removal depth is provided. Interestingly, with this form of polishing, the surface roughness of the workpiece remains about Ra 20nm after a quick shift and does not alter with re-pressing.
A normative model of peripersonal space encoding as performing impact prediction
Authors: Straka Zdenek , Noel Jean-Paul , Hoffmann Matej
Published: September 2022

Accurately predicting contact between our bodies and environmental objects is paramount to our evolutionary survival. It has been hypothesized that multisensory neurons responding both to touch on the body, and to auditory or visual stimuli occurring near them—thus delineating our peripersonal space (PPS)—may be a critical player in this computation. However, we lack a normative account (i.e., a model specifying how we ought to compute) linking impact prediction and PPS encoding. Here, we leverage Bayesian Decision Theory to develop such a model and show that it recapitulates many of the characteristics of PPS. Namely, a normative model of impact prediction (i) delineates a graded boundary between near and far space, (ii) demonstrates an enlargement of PPS as the speed of incoming stimuli increases, (iii) shows stronger contact prediction for looming than receding stimuli—but critically is still present for receding stimuli when observation uncertainty is non-zero—, (iv) scales with the value we attribute to environmental objects, and finally (v) can account for the differing sizes of PPS for different body parts. Together, these modeling results support the conjecture that PPS reflects the computation of impact prediction, and make a number of testable predictions for future empirical studies.
Testing microbiome associations with survival times at both the community and individual taxon levels
Authors: Hu Yingtian , Li Yunxiao , Satten Glen A. , Hu Yi-Juan
Published: September 2022

Background

Finding microbiome associations with possibly censored survival times is an important problem, especially as specific taxa could serve as biomarkers for disease prognosis or as targets for therapeutic interventions. The two existing methods for survival outcomes, MiRKAT-S and OMiSA, are restricted to testing associations at the community level and do not provide results at the individual taxon level. An ad hoc approach testing each taxon with a survival outcome using the Cox proportional hazard model may not perform well in the microbiome setting with sparse count data and small sample sizes.

Methods

We have previously developed the linear decomposition model (LDM) for testing continuous or discrete outcomes that unifies community-level and taxon-level tests into one framework. Here we extend the LDM to test survival outcomes. We propose to use the Martingale residuals or the deviance residuals obtained from the Cox model as continuous covariates in the LDM. We further construct tests that combine the results of analyzing each set of residuals separately. Finally, we extend PERMANOVA, the most commonly used distance-based method for testing community-level hypotheses, to handle survival outcomes in a similar manner.

Results

Using simulated data, we showed that the LDM-based tests preserved the false discovery rate for testing individual taxa and had good sensitivity. The LDM-based community-level tests and PERMANOVA-based tests had comparable or better power than MiRKAT-S and OMiSA. An analysis of data on the association of the gut microbiome and the time to acute graft-versus-host disease revealed several dozen associated taxa that would not have been achievable by any community-level test, as well as improved community-level tests by the LDM and PERMANOVA over those obtained using MiRKAT-S and OMiSA.

Conclusions

Unlike existing methods, our new methods are capable of discovering individual taxa that are associated with survival times, which could be of important use in clinical settings.
Antibiotic susceptibility patterns of pathogens isolated from laboratory specimens at Livingstone Central Hospital in Zambia
Authors: Mwansa Thresa N. , Kamvuma Kingsley , Mulemena John Amos , Phiri Christopher Newton , Chanda Warren
Published: September 2022

Background

Multidrug resistance (MDR) is a global problem that require multifaceted effort to curb it. This study aimed to evaluate the antibiotic susceptibility patterns of routinely isolated bacteria at Livingstone Central Hospital (LCH).

Methods

A retrospective study was performed on all isolated organisms from patient specimens that were processed from January 2019 to December 2021. Specimens were cultured on standard media and Kirby-Bauer disc diffusion method was employed for susceptibility testing following the Clinical and Laboratory Standard Institute’s recommendations.

Results

A total of 765 specimens were processed and only 500 (65.4%) met the inclusion criteria. Of the 500, 291(58.2%) specimens were received from female and from the age-group 17–39 years (253, 50.6%) and 40–80 years (145, 29%) in form of blood (331, 66.2%), urine (165, 33%) and sputum (4, 0.8%). Amongst the bacterial isolates, Staphylococcus aureus (142, 28.4%) was the commonest followed by Escherichia coli (91, 18.2%), and Enterobacter agglomerans (76, 15.2%), and Klebsiella pneumoniae (43, 8.6%). The resistance pattern revealed ampicillin (93%) as the least effective drug followed by oxacillin (88%), penicillin (85.6%), co-trimoxazole (81.5%), erythromycin (71.9%), nalidixic acid (68%), and ceftazidime (60%) whereas the most effective antibiotics were imipenem (14.5%), and piperacillin/tazobactam (16.7%). The screening of methicillin resistant Staphylococcus aureus (MRSA) with cefoxitin showed 23.7% (9/38) resistance.

Conclusion

Increased levels of MDR strains and rising numbers of MRSA strains were detected. Therefore, re-establishing of the empiric therapy is needed for proper patient management, studies to determine the levels of extended spectrum beta lactamase- and carbapenemase-producing bacteria are warranted.
Weaning period and growth patterns of captive Sunda pangolin (Manis javanica) cubs
Authors: Yan Dingyu , Zeng Xiangyan , Jia Miaomiao , Guo Xiaobing , Que Tengcheng , Tao Li , Li Mingzhe , Li Baocai , Chen Jinyan , Xu Shanghua , Hua Yan , Wu Shibao , Zeng Peng , Li Shousheng , Wei Yongjie
Published: September 2022

This study tracked and recorded the weight changes of 13 captive Sunda pangolin cubs from lactation to maturity to explored the appropriate weaning time and reveal the rules of its weight growth. SPSS 25.0 was used to build a cubic equation model to fit the body weight change rules of 4 individuals who nonvoluntarily ingested artificial feed (NIAF) at 127 days after birth and 5 individuals who voluntarily ingested artificial feed (VIAF) at 86–108 days after birth. The body weight of NIAF cubs aged 0–120 days and VIAF cubs aged 0–150 days were estimated according to the fitting model. An independent sample T-test was performed on the mean body weight of the two groups during the late lactation period. The results showed that at 105 days after birth, the body weight of the VIAF group was significantly higher than that of the NIAF group (P = 0.049), and the body weight of the VIAF group was extremely significantly higher than that of the NIAF group at 114 days (P = 0.008); The peak cumulative body weight of the NIAF cubs during lactation appeared around 130 days of age (n = 3); The mortality rate was 66.7% (n = 3) after about 150 days if the feed was continuously consumed nonvoluntarily. It was concluded that the milk secretion period of the mother is about 0–5 months after giving birth; the weaning period of the cubs should be 4–5 months after birth. If the cubs don’t follow the mother to eat artificial feed for 3 months after birth, it can start be induced with artificial diet which adds termites, and the time point cannot be later than 130 days, otherwise it is not conducive to the survival of the cubs; When sexually mature, the body length and body weight of female cubs account for about 84% and 60% of the adult, respectively; the body maturity and body weight of female cubs tend to be stable about 15.3 months and 16.4 months, respectively. Finally, a special needle-shaped nipples and nursing patterns of female Sunda pangolins were also recorded in this study. These findings play an important role in guiding the nursing of captive Sunda pangolin cubs and other pangolin cubs. It is expected to improve the survival rate of the cubs by exploring the appropriate weaning time and the rules of weight growth. By scientifically planning the reproductive cycle of the female Sunda pangolins, our goal is to expand the population size and eventually release to the wild, meanwhile improving knowledge of this critically endangered species.
Quantifying protocols for safe school activities
Authors: Genari Juliano , Goedert Guilherme Tegoni , Lira Sérgio H. A. , Oliveira Krerley , Barbosa Adriano , Lima Allysson , Silva José Augusto , Oliveira Hugo , Maciel Maurício , Ledoino Ismael , Resende Lucas , dos Santos Edmilson Roque , Marchesin Dan , Struchiner Claudio J. , Pereira Tiago
Published: September 2022

By the peak of COVID-19 restrictions on April 8, 2020, up to 1.5 billion students across 188 countries were affected by the suspension of physical attendance in schools. Schools were among the first services to reopen as vaccination campaigns advanced. With the emergence of new variants and infection waves, the question now is to find safe protocols for the continuation of school activities. We need to understand how reliable these protocols are under different levels of vaccination coverage, as many countries have a meager fraction of their population vaccinated, including Uganda where the coverage is about 8%. We investigate the impact of face-to-face classes under different protocols and quantify the surplus number of infected individuals in a city. Using the infection transmission when schools were closed as a baseline, we assess the impact of physical school attendance in classrooms with poor air circulation. We find that (i) resuming school activities with people only wearing low-quality masks leads to a near fivefold city-wide increase in the number of cases even if all staff is vaccinated, (ii) resuming activities with students wearing good-quality masks and staff wearing N95s leads to about a threefold increase, (iii) combining high-quality masks and active monitoring, activities may be carried out safely even with low vaccination coverage. These results highlight the effectiveness of good mask-wearing. Compared to ICU costs, high-quality masks are inexpensive and can help curb the spreading. Classes can be carried out safely, provided the correct set of measures are implemented.
Veterinary consumption of highest priority critically important antimicrobials and various growth promoters based on import data in Pakistan
Authors: Umair Muhammad , Orubu Samuel , Zaman Muhammad Hamid , Wirtz Veronika J. , Mohsin Mashkoor
Published: September 2022

Background

Antimicrobial resistance (AMR) is a global public health emergency driven by the indiscriminate use of antimicrobial agents in humans and animals. Antimicrobial consumption surveillance guides its containment efforts. In this study, we estimated, for the first time, veterinary consumption of Critically Important Antimicrobials with Highest Priority (CIA-HtP) for Pakistan.

Methods

The study used an export/import database which provided imports data collected from the Pakistan Customs Authority. We investigated imports of 7 CIA-HtP and various poultry feed additives/growth promoters (FAs/GPs) identified from a survey of 10 poultry and dairy farms in Punjab province in Pakistan and a previously published study, over a three-year period of 2017–2019. Antimicrobial consumption was estimated in mg/kg of country’s animal biomass.

Findings

Imports, in tonnes, for these 7 CIA-HtP were for the years 2017–19: tylosin 240.84, enrofloxacin 235.14, colistin 219.73, tilmicosin 97.32, spiramycin 5.79, norfloxacin 5.55, ceftiofur 1.02 for a total 805.39 tonnes. The corresponding antimicrobial consumption was 10.05 mg/kg of animal biomass. The poultry FAs/GPs contained: zinc bacitracin, enramycin, bacitracin methylene disalicylate, tylosin, tiamulin, colistin, lincomycin, streptomycin, flavophospholipol, tilmicosin, and penicillin with a total antimicrobial chemical compound (ACC) import volume of 577.18 tonnes for the years 2017–2019; and an estimated consumption of 96.53 mg/kg of poultry biomass.

Interpretation

These antimicrobials were a mix of macrolides, quinolones, polymyxins and cephalosporins, among which are some also on the Watch or Reserve list by the WHO, indicating the need for stewardship and to conserve essential antimicrobials to contain AMR. The finding that a yearly average of 192.39 tonnes of the ACC imported were FAs/GPs further highlight the need for stronger regulation and enforcement.
Presepsin cut-off value for diagnosis of sepsis in patients with renal dysfunction
Authors: Arakawa Kimika , Saeki Ayako , Ide Reo , Matsushita Yoshiteru
Published: September 2022

Presepsin is used as a marker for diagnosing sepsis, but its serum concentration is affected by renal function. We investigated the effect of the estimated glomerular filtration rate (eGFR) determined by creatinine on the diagnostic accuracy of presepsin to identify the optimal cut-off value in patients with renal dysfunction. A total of 834 patients aged ≥18 years with serum presepsin and creatinine measured on the same day over a period of 1 year were included. Sepsis was diagnosed in three ways: sepsis-1, sepsis-3, and clinical diagnosis (Sep-C). Presepsin showed a significant negative correlation with eGFR (r = −0.55, p<0.01), with median and interquartile ranges of presepsin values for patients in each eGFR category as follows: ≥90, 263 (169–460); ≥60–<90, 309 (205–578); ≥45–<60, 406 (279–683); ≥30–<45, 605 (379–1109); ≥15–<30, 1027 (675–1953); <15, 1977 (1199–3477); and on hemodialysis, 3964 (2343–6967). In receiver operating characteristic (ROC) analysis, the area under the curve (AUC) for sepsis-1 was the lowest (0.64 ± 0.02), while Sep-C (0.80± 0.03) and sepsis-3 (0.75 ± 0.03) were moderately accurate. Comparing AUCs after dividing patients into eGFR ≥60 and <60 showed that the AUC of Sep-C was lower in the eGFR ≥60 group, while the AUC of sepsis-3 was ≥ 0.7 in both groups. The following cut-offs were obtained by ROC analysis for sepsis-3: 466 pg/mL in the ≥60 group and 960 pg/mLin the < 60 group. Presepsin facilitated diagnosis sepsis based on sepsis-3 criteria regardless of renal function. We found that the optimal cut-offs for patients in this study were 500 pg/mL for eGFR ≥ 60 and 1000 pg/mL for < 60. However, future prospective diagnostic studies on sepsis-3 are needed to determine the cut-offs for patients with renal dysfunction.
An assessment of organisational culture in Australian hospitals using employee online reviews
Authors: Pavithra Antoinette , Westbrook Johanna
Published: September 2022

The aim of this study was to analyse the content of online reviews posted by hospital employees on job websites for themes of organisational culture. 103 anonymous online reviews across three job websites, posted by hospital employees of four hospitals within an Australian health network were extracted. Reviews had been posted across a period of six years, from 2014 to early 2020. Sentiment rating based on user-allotted ratings on the selected websites was calculated. The sentiment score was validated against the textual content of the review to confirm employee recommendation and sentiment. Sentiment was coded as neutral, positive, or negative. Significant keywords, associations, and usage within the context of identified sentiment were deductively coded and clustered manually against eight pre-determined safety culture themes. These themes were derived from the most used assessment tools for self-reported measures of occupational health and safety, and safety culture in healthcare. Workers across clinical roles (n = 49) and non-clinical roles (n = 50) were evenly represented in the dataset. 35.9% of commenters (n = 37) reported their length of employment in the hospitals that they reviewed. Most online employee reviews addressed broad themes related to perceptions of management (n = 98), safety climate (n = 97), teamwork climate (n = 91) and working conditions (n = 98). A significant set of reviews addressed themes related to job satisfaction (n = 49) and learning, training, and development (n = 41). 72.8% of online reviews (n = 75) expressed positive sentiment towards their employer. Reviews expressing negative sentiment were largely posted by former employees and indicated areas of discontent that reflected organisational and systemic factors. Online employee reviews posted by hospital workers on job sites provide valuable insights into healthcare organisational culture. Therefore, employee online reviews could be used as a supplementary source of data to inform organisational employee engagement initiatives.
Heart rate and diastolic arterial pressure in cardiac arrest patients: A nationwide, multicenter prospective registry
Authors: Han Chul , Lee Jae Hoon ,   on behalf of the Korean Hypothermia Network Investigators
Published: September 2022

Background

Guidelines have recommended monitoring mean arterial pressure (MAP) and systolic arterial pressure (SAP) in cardiac arrest patients, but there has been relatively little regard for diastolic arterial pressure (DAP) and heart rate (HR). We aimed to determine the prognostic significance of hemodynamic parameters at all time points during targeted temperature management (TTM).

Methods

We reviewed the SAP, DAP, MAP, and HR data in out-of-hospital cardiac arrest (OHCA) survivors from the prospective multicenter registry of 22 teaching hospitals. This study included 1371 patients who underwent TTM among 10,258 cardiac arrest patients. The hemodynamic parameters were recorded every 6 hours from the return of spontaneous circulation (ROSC) to 4 days. The risks of those according to time points during TTM were compared.

Results

Of the included patients, 943 (68.8%) had poor neurological outcomes. The predictive ability of DAP surpassed that of SAP and MAP at all time points, and among the hemodynamic variables HR/DAP was the best predictor of the poor outcome. The risks in patients with DAP < 55 to 70 mmHg and HR > 70 to 100 beats/min were steeply increased for 2 days after ROSC and correlated with the poor outcome at all time points. Bradycardia showed lower risks only at 6 hours to 24 hours after ROSC.

Conclusion

Hemodynamic parameters should be intensively monitored especially for 2 days after ROSC because cardiac arrest patients may be vulnerable to hemodynamic instability during TTM. Monitoring HR/DAP can help access the risks in cardiac arrest patients.
Impact of COVID-19 on out-of-hospital cardiac arrest: A registry-based cohort-study from the German Resuscitation Registry
Authors: Ristau Patrick , Wnent Jan , Gräsner Jan-Thorsten , Fischer Matthias , Bohn Andreas , Bein Berthold , Brenner Sigrid , Seewald Stephan
Published: September 2022

Introduction

The global COVID-19 pandemic effects people and the health system. Some international studies reported an increasing number of out-of-hospital cardiac arrest (OHCA). Comparable studies regarding the impact of COVID-19 on incidence and outcome of OHCA are not yet available for Germany.

Materials and methods

This epidemiological study from the German Resuscitation Registry (GRR) compared a non-pandemic period (01.03.2018–28.02.2019) and a pandemic period (01.03.2020–28.02.2021) regarding the pandemic-related impact on OHCA care.

Results

A total of 18,799 cases were included. The incidence of OHCA (non-pandemic 117.9 vs. pandemic period 128.0/100,000 inhabitants) and of OHCA with resuscitation attempted increased (66.0 vs. 69.1/100,000). OHCA occurred predominantly and more often at home (62.8% vs. 66.5%, p<0.001). The first ECG rhythm was less often shockable (22.2% vs. 20.3%, p = 0.03). Fewer cases of OHCA were observed (58.6% vs. 55.6% p = 0.02). Both the bystander resuscitation rate and the proportion of telephone guided CPR remained stable (38.6% vs. 39.8%, p = 0.23; and 22.3% vs. 22.5%, p = 0.77). EMS arrival times increased (08:39 min vs. 09:08 min, p<0.001). Fewer patients reached a return of spontaneous circulation (ROSC) (45.4% vs. 40.9%, p<0.001), were admitted to hospital (50.2% vs. 45.0%, p<0.001), and discharged alive (13.9% vs. 10.2%, p<0.001).

Discussion

Survival after OHCA significantly decreased while the bystander resuscitation rate remained stable. However, longer EMS arrival times and fewer cases of witnessed OHCA may have contributed to poorer survival. Any change to EMS systems in the care of OHCA should be critically evaluated as it may mean a real loss of life—regardless of the pandemic situation.
Plasma treatment effects on destruction and recovery of Porphyromonas gingivalis biofilms
Authors: Hong Qing , Sun Hongmin , Chen Meng , Zhang Shaoping , Yu Qingsong
Published: September 2022

The objective of this study was to investigate the treatment effects of non-thermal atmospheric gas plasmas (NTAP) on destruction and the recovery (or re-colonization) of Porphyromonas gingivalis (P. gingivalis) in biofilms. P. gingivalis is a well-known keystone periodontal pathogen strongly associated with periodontal diseases, especially periodontitis. P. gingivalis biofilms were formed on stainless steel coupons and treated for 1, 2, and 5 minutes by NTAP of pure argon gas and argon+oxygen gas mixture. MTT assay, colony forming unit (CFU) counting assay and confocal laser scanning microscopy (CLSM) were used to assess the destruction efficiency. In addition, the plasma treated biofilms were re-cultured in the medium supplemented with antibiotics and oxidative stress sources to determine the synergy of the NTAP with other antimicrobial agents. The results showed the plasma treatment could result in 2.7 log unit reduction in bacterial load. The recovered biofilm CFU with NTAP treatment combined with sub minimal inhibition concentration of amoxicillin was 0.33 log units less than the biofilm treated with amoxicillin alone. The recovered biofilm CFU in NTAP groups was about 2.0 log units less than that in the untreated controls under H2O2 treatment. There was approximately 1.0 log unit reduction of biofilm CFU in plasma treated biofilm compared with untreated control under paraquat treatment. The plasma treated biofilms exhibited less resistance to amoxicillin and greater susceptibility to hydrogen peroxide (H2O2) and paraquat, suggesting that NTAP may enhance biofilm susceptibility to host defense. These in vitro findings suggested that NTAP could be a novel and effective treatment method of oral biofilms that cause periodontal diseases.
Association of sleep quality with temperament among one-month-old infants in The Japan Environment and Children’s Study
Authors: Kikuchi Kimiyo , Michikawa Takehiro , Morokuma Seiichi , Hamada Norio , Suetsugu Yoshiko , Nakahara Kazushige , Kato Kiyoko , Sanefuji Masafumi , Shibata Eiji , Tsuji Mayumi , Shimono Masayuki , Kawamoto Toshihiro , Ohga Shouichi , Kusuhara Koichi ,   The Japan Environment and Children’s Study Group
Published: September 2022

This study aimed to examine the association between infant sleep quality and temperament in one-month-old infants using a large cohort study data. We used data from the Japan Environment and Children’s Study, a cohort study which follows around 100,000 women from pregnancy until their children’s development. The mothers were asked about their infants’ sleep and temperament using a structured questionnaire. Frequent crying (adjusted odds ratio [AOR]: 1.05, 95% confidence interval [CI]: 1.00–1.10) and intense crying (AOR: 1.19, 95% CI: 1.13–1.25) were positively associated with longer sleep periods during the day than at night. Female infants with longer daytime sleep periods than that at nighttime were more likely to cry frequently (AOR: 1.11, 95% CI: 1.04–1.20). Parous women with infants who had frequent night awakening believed their infants cried more intensely (AOR: 1.17, 95% CI: 1.03–1.31). The study demonstrated a specific association between sleep quality and temperament in one-month-old infants. Based on the results of this study, further sleep intervention studies are required to improve infant temperament.
deconstrucción del texto corporal
Authors: Borges Carreras Cintia
Published: September 2022

En el discurso narrativo de la danza, el cuerpo se convierte en una entidad rizomática desde la que se articulan los sentidos simbólicos del propio movimiento. La semántica literaria es un recurso utilizado para hacer del lenguaje coreográfico una mímesis de las palabras, reconfiguradas a un vocabulario que, aún siendo no verbal, se presenta análogo a la acción poética. Si la obra coreográfica toma el relato literario como referente desde el que ilustrar su propia dramaturgia, la escritura dinámica del movimiento, significante y discursivo, se ocupa de una deconstrucción del textomás allá de transformar los mecanismos inherentes del contar. La conceptualización de este tipo de escritura coreográfica sobresale cuando el texto literario es la génesis del texto corporal. Por ello, hacia una epistemología de lo narrado a través del cuerpo, se indaga en el manejo de teorías y en la concreción de conceptos, aplicables a la danza como cimientos indispensables para gestionar una hermenéutica del lenguaje coreográfico.