bluuebunny/crossref_metadata_2025 huggingface dataset:
An open-source, low-cost voluntary running activity tracking tool for in vivo rodent studies
Authors: Deitzler Grace E. , Bira Nicholas P. , Davidson Joseph R. , David Maude M.
Published: September 2022

In vivo rodent behavioral and physiological studies often benefit from measurement of general activity. However, many existing instruments necessary to track such activity are high in cost and invasive within home cages, some even requiring extensive separate cage systems, limiting their widespread use to collect data. We present here a low-cost open-source alternative that measures voluntary wheel running activity and allows for modulation and customization, along with a reproducible and easy to set-up code pipeline for setup and analysis in Arduino IDE and R. Our robust, non-invasive scalable voluntary running activity tracker utilizes readily accessible magnets, Hall effect sensors, and an Arduino microcontroller. Importantly, it can interface with existing rodent home cages and wheel equipment, thus eliminating the need to transfer the mice to an unfamiliar environment. The system was validated both for accuracy by a rotating motor used to simulate mouse behavior, and in vivo. Our recorded data is consistent with results found in the literature showing that the mice run between 3 to 16 kilometers per night, and accurately captures speed and distance traveled continuously on the wheel. Such data are critical for analysis of highly variable behavior in mouse models and allow for characterization of behavioral metrics such as general activity. This system provides a flexible, low-cost methodology, and minimizes the cost, infrastructure, and personnel required for tracking voluntary wheel activity.
Associations of lifetime concussion history and repetitive head impact exposure with resting-state functional connectivity in former collegiate American football players: An NCAA 15-year follow-up study
Authors: Walton Samuel R. , Powell Jacob R. , Brett Benjamin L. , Yin Weiyan , Kerr Zachary Yukio , Liu Mingxia , McCrea Michael A. , Guskiewicz Kevin M. , Giovanello Kelly S.
Published: September 2022

The objective of this study was to examine associations of lifetime concussion history (CHx) and an advanced metric of lifetime repetitive head impact exposure with resting-state functional connectivity (rsFC) across the whole-brain and among large-scale functional networks (Default Mode; Dorsal Attention; and Frontoparietal Control) in former collegiate football players. Individuals who completed at least one year of varsity collegiate football were eligible to participate in this observational cohort study (n= 48; aged 36–41 years; 79.2% white/Caucasian; 12.5±4.4 years of football played; all men). Individuals were excluded if they reported history/suspicion of psychotic disorder with active symptoms, contraindications to participation in study procedures (e.g., MRI safety concern), or inability to travel. Each participant provided concussion and football playing histories. Self-reported concussion history was analyzed in two different ways based on prior research: dichotomous “High” (≥3 concussions;n= 28) versus “Low” (<3 concussions;n= 20); and four ordinal categories (0–1 concussion [n= 19]; 2–4 concussions [n= 8]; 5–7 concussions [n= 9]; and ≥8 concussions [n= 12]). The Head Impact Exposure Estimate (HIEE) was calculated from football playing history captured via structured interview. Resting-state fMRI and T1-weighted MRI were acquired and preprocessed using established pipelines. Next, rsFC was calculated using the Seitzman et al., (2020) 300-ROI functional atlas. Whole-brain, within-network, and between-network rsFC were calculated using all ROIs and network-specific ROIs, respectively. Effects of CHx and HIEE on rsFC values were examined using separate multivariable linear regression models, with a-prioriαset to 0.05. We observed no statistically significant associations between rsFC outcomes and either CHx or HIEE (ps ≥ .12). Neither CHx nor HIEE were associated with neural signatures that have been observed in studies of typical and pathological aging. While CHx and repetitive head impacts have been associated with changes in brain health in older former athletes, our preliminary results suggest that associations with rsFC may not be present in early midlife former football players.
Economic issues of Severe Acute Respiratory Infections for influenza in Mexican children attended in a tertiary public hospital
Authors: Reyes-Lopez Alfonso , Moreno-Espinosa Sarbelio , Hernandez- Olivares Yosef Olaf , Rodolfo Norberto Jimenez-Juarez
Published: September 2022

Background

Influenza cause a clinical and economic burden for health systems and society. It is necessary to know the cost of the disease in order to perform cost-effectiveness assessments of preventive or treatment interventions.

Objective

Assess the costs of the care of children with influenza in a third level hospital in Mexico.

Methods

Longitudinal retrospective study based on the review of clinical files of children hospitalized with influenza. The use of resources used during their hospitalization in the emergency room, general ward, or PICU was logged, and the amount of supplies were multiplied by their corresponding prices to calculate the direct medical expenses. Descriptive statistics were used, and a GLM was adjusted in order to assess the effect of the clinical characteristics of the patients on the cost. Goodness of fit tests were performed.

Results

132 files were reviewed, out of which 95% were of subjects who had comorbidities. Subjects admitted at the PICU generates the highest cost (mean $29,608.62 USD), when analyzing the total cost summarizing the three clinical areas (Emergency room, general ward and PICU) by age group, the highest cost was for patients over age 10 (mean $49,674.53 USD). Comorbidities increase the cost of hospitalization by $10,000.00 USD.

Conclusions

Influenza causes a significant financial burden on the health system. Children with comorbidities increase the costs and children over 10 years uses a significant amount of resources and they are not a priority in immunization program. It is necessary to perform studies on the use of resources in the first and second attention levels, which represent the highest incidence of the disease.
The impact of violence on women’s health. The present as a reflection of the past: A qualitative study
Authors: García-Montes Rebeca , Fares-Medina Sandra , Diaz-Caro Isabel , Corral-Liria Inmaculada , García-Gómez-Heras Soledad
Published: September 2022

The objective of the study is to analyze the impact of violence on women’s health and the feelings generated during the period of exposure to violence. This is a qualitative study with an interpretative phenomenological design in which 16 women participated—4 through interviews and 12 through stories. The data obtained were analyzed using the Colaizzi approach. The results were structured into 3 themes according to how the women interpreted their experiences. The themes were physical consequences: visible traces; psychological consequences: stormy days and sunny days; and social consequences: from loneliness to a new world. In conclusion, the women in this study considered all those (very diverse) physical pathologies to be important. They encompassed a series of psychological disorders that lasted over time, causing considerable suffering and complicating the participants’ ability to relate to the rest of society, especially men. Similarly, the participants identified a series of positive consequences when they left the traumatic situation empowered after overcoming gender-based violence.
An LED-Based structured illumination microscope using a digital micromirror device and GPU accelerated image reconstruction
Authors: Aydın Musa , Uysallı Yiğit , Özgönül Ekin , Morova Berna , Tiryaki Fatmanur , Firat-Karalar Elif Nur , Doğan Buket , Kiraz Alper
Published: September 2022

When combined with computational approaches, fluorescence imaging becomes one of the most powerful tools in biomedical research. It is possible to achieve resolution figures beyond the diffraction limit, and improve the performance and flexibility of high-resolution imaging systems with techniques such as structured illumination microscopy (SIM) reconstruction. In this study, the hardware and software implementation of an LED-based super-resolution imaging system using SIM employing GPU accelerated parallel image reconstruction is presented. The sample is illuminated with two-dimensional sinusoidal patterns with various orientations and lateral phase shifts generated using a digital micromirror device (DMD). SIM reconstruction is carried out in frequency space using parallel CUDA kernel functions. Furthermore, a general purpose toolbox for the parallel image reconstruction algorithm and an infrastructure that allows all users to perform parallel operations on images without developing any CUDA kernel code is presented. The developed image reconstruction algorithm was run separately on a CPU and a GPU. Two different SIM reconstruction algorithms have been developed for the CPU as mono-thread CPU algorithm and multi-thread OpenMP CPU algorithm. SIM reconstruction of 1024 × 1024 px images was achieved in 1.49 s using GPU computation, indicating an enhancement by ∼28 and ∼20 in computation time when compared with mono-thread CPU computation and multi-thread OpenMP CPU computation, respectively.
The effect of poor vision on economic farm performance: Evidence from rural Cambodia
Authors: Sagemüller Frederik , Bruns Selina , Mußhoff Oliver
Published: September 2022

Roughly one-fifth of the global population is affected by poor visual acuity. Despite the fact that inhabitants of rural areas in low-income countries are most distressed by this, no prior research has studied the impact of poor visual acuity on the economic performance of farms. We conduct a standardized eye test with 288 farm managers in rural Cambodia and find that around 30 percent of our sample suffers from poor visual acuity in terms of nearsightedness (myopia). Our analyses indicate a statistically significant and economically meaningful association of poor visual acuity with economic farm performance. Our results show that gross margins for cropping activities per year could be, on average, around 630 USD higher if farm managers were able to correct for poor vision. Our results suggest that poor visual acuity impairs farm managers from tapping the full potential of their business, which in turn decreases their chance to break the vicious cycle of poverty.
Association between retinitis pigmentosa and an increased risk of primary angle closure glaucoma: A population-based cohort study
Authors: Hung Man-Chen , Chen Yu-Yen
Published: September 2022

Background

Retinitis pigmentosa (RP) is the most frequent retinal hereditary dystrophy and result in blindness if progresses. Several case reports have revealed the possible association between RP and primary angle-closure glaucoma (PACG). We conducted a population-based study to explore whether RP significantly increased the risk of PACG development.

Methods

Using the Taiwan National Health Insurance Research Database, we enrolled patients with RP into the RP group from 2001 to 2013 and included a comparison group of 1:4 age- and sex-matched individuals without RP. We performed a Cox regression analysis to estimate the crude and adjusted hazard ratios (HRs) of RP for PACG after adjustment for hypertension, diabetes, hyperlipidaemia, chronic kidney disease, and lens subluxation.

Results

We enrolled 6223 subjects with RP and 24892 subjects for comparison. The mean age of the cohort was 49.0 ± 18.1 years. The RP group had significantly higher percentages of diabetes mellitus, hypertension, and hyperlipidaemia. The cumulative incidence of PACG in patients with RP was 1.61%, which was significantly higher than that in the comparison group (0.81%, p < 0.0001). According to the univariate Cox regression analysis, the hazard of PACG development was significantly greater in the RP group, with an unadjusted HR of 2.09 (95% confidence interval [CI], 1.64–2.65). The increased risk persisted after adjusting for confounders (adjusted HR = 2.18; 95% CI, 1.76–2.72).

Conclusion

This nationwide population-based cohort study showed that people with RP are at a significantly greater risk of developing PACG than individuals without RP.
PUMA screening tool to detect COPD in high-risk patients in Chinese primary care–A validation study
Authors: Au-Doung Phillip Lung Wai , Wong Carmen Ka Man , Chan Dicken Cheong Chun , Chung Joseph Wai Ho , Wong Samuel Yeung Shan , Leung Maria Kwan Wa
Published: September 2022

The early stage of chronic obstructive pulmonary disease (COPD) is not easily recognized. Screening tools can help to identify high-risk patients in primary care settings for spirometry and may be helpful in the early detection in COPD and management. This study aims to validate the PUMA questionnaire for use in Chinese primary care settings. This cross-sectional study recruited participants (≥40 years old, current or former smoker with ≥10 packs of cigarette per year) in primary health care clinics in Hong Kong. The Chinese version of the PUMA questionnaire was administered by trained research staff to participants awaiting consultation. COPD diagnosis was confirmed by spirometry (post-bronchodilator FEV1/FVC <0.70). A total 377 patients were recruited of which 373 completed the spirometry. The percentage of participants diagnosed with COPD (post-bronchodilator FEV1/FVC <0.70) was 27.1%. A higher PUMA score was more likely to have an advanced stage of GOLD classification (P = 0.013). The area under the ROC curve of the PUMA score was 0.753 (95%CI 0.698–0.807). The best cut-point according to Youden’s index for PUMA score was ≥6 with sensitivity 76.5%, specificity 63.3% and negative predictive value (NPV) 63.3%. A cut-off point of PUMA score ≥5 was selected due to higher sensitivity of 91.2%, specificity of 42.6% and high NPV of 92.7%. PUMA score performed better than CDQ and COPD-PS in the area under the ROC curve (0.753 versus 0.658 and 0.612 respectively), had higher sensitivity than COPD-PS (91.2% versus 61%) and had higher specificity than CDQ (42.6% versus 13.1%). The use of PUMA as a screening tool was feasible in Chinese primary care and can be conducted by trained staff and health professionals. The validation results showed high sensitivity and high NPV to identify high risk patient with COPD at cut-off point of ≥5. It can be useful for early detection and management of COPD.
Prevalence and consequences of non-adherence to an evidence-based approach for incidental pulmonary nodules
Authors: Wayne Max T. , Prescott Hallie C. , Arenberg Douglas A.
Published: September 2022

Importance

Distinguishing benign from malignant pulmonary nodules is challenging. Evidence-based guidelines exist, but their impact on patient-centered outcomes is unknown.

Objective

To understand if the evaluation of incidental pulmonary nodules that follows an evidence-based management strategy is associated with fewer invasive procedures for benign lesions and/or fewer delays in cancer diagnosis.

Design

Retrospective cohort study.

Setting

Large academic medical center.

Participants

Adults (≥18 years age) with an incidental pulmonary nodule discovered between January 2012 and December 2014. Patients with calcified nodules, prior nodules, prior diagnosis of cancer, high suspicion for pulmonary metastasis, or limited life expectancy were excluded.

Exposure

Nodule management strategy (pre-specified based on evidence-based practices).

Outcome

Composite of any invasive procedure for a benign nodule or delay in diagnosis in patients with cancer (>3 month delay once probability of cancer was >15%).

Results

Of 314 patients that met inclusion criteria, median age was 61, 46.5% were men, and 66.5% had current or former tobacco use. The mean nodule size was 10.3 mm, mean probability of cancer was 11.8%, and 14.3% of nodules were malignant. Evaluation followed an evidence-based strategy in 245 patients (78.0%), and deviated in 69 patients (22%). The composite outcome occurred in 26 (8.3%) patients. Among patients whose nodule evaluation was concordant with an evidence-based evaluation, 6.1% (15/245) experienced the composite outcome versus 15.9% (11/69) of patients with an evaluation that deviated from evidence-based recommendations (P<0.01).

Conclusions and relevance

At a large academic medical center, more than 1 in 5 patients with an incidental pulmonary nodule underwent evaluation that deviated from evidence-based practice recommendations. Nodule evaluation that deviated from an evidence-based strategy was associated with biopsy of benign lesions and delays in cancer diagnosis, suggesting a need to improve guideline uptake.
Are total omega-3 and omega-6 polyunsaturated fatty acids predictors of fatal stroke in the Adventist Health Study 2 prospective cohort?
Authors: Cupino Alan , Fraser Gary , Knutsen Synnøve , Knutsen Raymond , Heskey Celine , Sabaté Joan , Shavlik David
Published: September 2022

Introduction

The effects of omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFA) on cerebrovascular disease remain unsettled. However, most studies have focused on marine sourced n-3 PUFA rather than total n-3 PUFA, of which the majority in the American diet is plant derived. This study therefore intended to investigate these effects in a cohort for which the vegetarian diet was more prevalent than the general public.

Methods

Cox proportional hazards with fatal stroke as the outcome was performed on the approximately 96,000 subject Adventist Health Study 2 prospective cohort. Stratification by race and sex was performed on models with a priori covariables, comparing 90thto 10thpercentile daily intakes of energy-adjusted total n-3 PUFA, total n-6 PUFA, and the n-6 / n-3 PUFA ratio as variables of interest.

Results

For the main analytical group (78,335 subjects), the hazard ratio (95% confidence interval) for total n-3 PUFA was 0.65 (0.51–0.83), and for total n-6 PUFA was 1.37 (1.02–1.82), while adjusting for both fatty acids in the model. The n-6 / n-3 PUFA ratio was harmful with a HR of 1.40 (1.16–1.69), whereas the inclusion of total n-3 PUFA slightly attenuated the HR to 1.33(1.02–1.74). Effects were similar for the non-black sex-combined and sex-specific analyses.

Conclusion

In most analytic groups, subjects with greater total n-3 PUFA intakes have lower risk of fatal stroke, and those with a higher n-6 / n-3 PUFA ratio had higher risk. However, the n-6 / n-3 PUFA ratio remains statistically significant even after adjusting for total n-3 PUFA or total n-6 PUFA, suggesting that the ratio is of epidemiologic interest for cerebrovascular disease research.
Geolocation of multiple sociolinguistic markers in Buenos Aires
Authors: Kellert Olga , Matlis Nicholas H.
Published: September 2022

Analysis of language geography is increasingly being used for studying spatial patterns of social dynamics. This trend is fueled by social media platforms such as Twitter which provide access to large amounts of natural language data combined with geolocation and user metadata enabling reconstruction of detailed spatial patterns of language use. Most studies are performed on large spatial scales associated with countries and regions, where language dynamics are often dominated by the effects of geographic and administrative borders. Extending to smaller, urban scales, however, allows visualization of spatial patterns of language use determined by social dynamics within the city, providing valuable information for a range of social topics from demographic studies to urban planning. So far, few studies have been made in this domain, due, in part, to the challenges in developing algorithms that accurately classify linguistic features. Here we extend urban-scale geographical analysis of language use beyond lexical meaning to include other sociolinguistic markers that identify language style, dialect and social groups. Some features, which have not been explored with social-media data on the urban scale, can be used to target a range of social phenomena. Our study focuses on Twitter use in Buenos Aires and our approach classifies tweets based on contrasting sets of tokens manually selected to target precise linguistic features. We perform statistical analyses of eleven categories of language use to quantify the presence of spatial patterns and the extent to which they are socially driven. We then perform the first comparative analysis assessing how the patterns and strength of social drivers vary with category. Finally, we derive plausible explanations for the patterns by comparing them with independently generated maps of geosocial context. Identifying these connections is a key aspect of the social-dynamics analysis which has so far received insufficient attention.
Effects of human disturbance on habitat and fish diversity in Neotropical streams
Authors: Larentis Crislei , Kotz Kliemann Bruna Caroline , Neves Mayara Pereira , Delariva Rosilene Luciana
Published: September 2022

Human pressures have been intensely modifying freshwater ecosystems worldwide. We assessed the effects of human pressure on habitat diversity and primary productivity to understand the consequences on fish fauna in 25 tropical and subtropical streams of two globally important ecoregions: Iguassu and Upper Paraná. We hypothesized that the increased human pressure (urbanization and agriculture) on stream environments, both at the local and catchment scales, directly decreases habitat diversity. We also hypothesized that increased human pressure triggers changes in primary productivity and fish fauna composition and structure. We evaluated the human pressure intensity using the Integrated Disturbance Index and the Rapid Habitat Diversity Assessment protocol, which combines information about land use, land cover and environmental characteristics of the stream catchment and sampling sites. Streams with increased human disturbance had lower habitat diversity, higher primary productivity, and high non-native species abundance. Fish compositional turnover was associated with increased human disturbance. Native and degradation-sensitive fish species, especially endemic ones, were associated with streams with higher habitat diversity and forested cover. Degradation-resistant fishes, mostly non-native species, were associated with streams with higher human disturbance and urban land use. Although human pressure did not affect species richness, Shannon diversity, and Simpson dominance, there were significant effects on numerical abundance and fish species equitability. In this study, human pressure directly affected habitat structure, with indirect consequences for fish fauna, increasing the potential for local extirpation of rare species.
A retrospective review of oral cephalosporins versus fluoroquinolones for the treatment of pyelonephritis
Authors: Lin Kevin , Zahlanie Yorgo , Ortwine Jessica K. , Wei Wenjing , Mang Norman S. , Prokesch Bonnie C.
Published: September 2022

Background

The current Infectious Diseases Society of America guidelines for the treatment of acute uncomplicated pyelonephritis (AUP) advise caution when using oral beta-lactams due to concern for potentially inferior efficacy compared to fluoroquinolones (FQs) and trimethoprim-sulfamethoxazole; however, studies specifically evaluating the efficacy of oral cephalosporins (CPs) in AUP are limited.

Objective

To assess the safety and efficacy of oral CPs versus FQs for the treatment of AUP.

Design, setting and participants

This is a retrospective, chart review study conducted at a single-center, tertiary care hospital.

Measurements

The primary endpoint was treatment failure within 30 days, defined as a change in antibiotic or return to ED or clinic due to persistent symptoms. Secondary endpoints included adverse drug reactions (ADRs) and C. difficile infection (CDI) within 30 days.

Results

Of the 343 patients included in the study, treatment failure occurred in 54/338 (16.0%) patients and was similar between oral CPs and FQs (35/229 [15.3%] vs. 19/109 [17.4%]). A higher percentage of treatment failures were observed for third generation (3GC) and first generation (1GC) CPs compared to second generation CPs (2GC) (3GC: 15/65 [23.4%]; 1GC: 11/49 [22.4%]; 2GC: 9/115 [7.8%]). Documented ADRs were low (6/343 [1.7%]) and no cases of CDI were documented.

Conclusions

Oral CPs appear to be as safe and effective as FQs for the treatment of AUP. Fewer treatment failures were noted with 2GCs as compared to 3GCs and 1GCs.
Discussing prognosis and the end of life with patients with advanced cancer or COPD: A qualitative study
Authors: Owusuaa Catherine , van Lent Liza G. G. , van ‘t Spijker Adriaan , van der Rijt Carin C. D. , van der Heide Agnes
Published: September 2022

Objectives

To explore patients’ experiences and recommendations for discussions about their prognosis and end of life with their physicians.

Methods

Patients with advanced cancer or advanced chronic obstructive pulmonary disease (COPD) were enrolled in qualitative interviews, which were analyzed with a phenomenological and thematic approach.

Results

During interviews with fourteen patients (median age 64 years), we identified the following themes for discussion about prognosis and the end of life: topics discussed, the timing, the setting, physician–patient relationship, responsibilities for clinicians, and recommendations. Patients preferred the physician to initiate such discussion, but wanted to decide about its continuation and content. The discussions were facilitated by an established physician–patient relationship or attendance of relatives. Patients with cancer had had discussions about prognosis at rather clear-cut moments of deterioration than patients with COPD. Patients with COPD did not consider end-of-life discussions a responsibility of the pulmonologist. Patients recommended an understandable message, involvement of relatives or other clinicians, sufficient time, and sensitive non-verbal communication.

Conclusions

Patients appreciated open, sensitive, and negotiable discussions about prognosis and the end of life.

Practice implications

Patients’ recommendations could be used for communication training. Possible differences in the need for such discussions between patients with cancer or COPD warrant further research.
Effects of cultural adaptation resilience promotion program for mothers-in-law in multicultural families
Authors: Lee Sang-Hwa , Kim Dong-Hee , Kang Kyoungrim
Published: September 2022

Mothers-in-law in multicultural families tend to experience psychological burden. This study aimed to verify the effects of the cultural adaptation promotion resilience program (CAPRP) on resilience, acculturation stress, depression, and quality of life among mothers-in-law in multi-cultural families. Forty-two participants from multicultural family support centres in the metropolitan city A were assigned to either the intervention group or the control group. The CAPRP was performed for 60 minutes, twice a week for four weeks. The intervention group showed a significant decrease in the acculturation stress (p = .002), and depression (p = .006), while resilience (p < .001) and quality of life (p < .001) significantly increased compared to the control group. The intervention group reported significant improvements in resilience, acculturation stress, depression, and quality of life in comparison with the control group. The results indicated that the CAPRP, developed based on positive cognitive appraisal, was an efficient nursing intervention for mothers-in-law in multicultural families.
Cardiovascular disease risk profile and management among people 40 years of age and above in Bo, Sierra Leone: A cross-sectional study
Authors: Odland Maria Lisa , Gassama Khadija , Bockarie Tahir , Wurie Haja , Ansumana Rashid , Witham Miles D. , Oyebode Oyinlola , Hirschhorn Lisa R. , Davies Justine I.
Published: September 2022

Introduction

Access to care for cardiovascular disease risk factors (CVDRFs) in low- and middle-income countries is limited. We aimed to describe the need and access to care for people with CVDRF and the preparedness of the health system to treat these in Bo, Sierra Leone.

Methods

Data from a 2018 household survey conducted in Bo, Sierra Leone, was analysed. Demographic, anthropometric and clinical data on CVDRF (hypertension, diabetes mellitus or dyslipidaemia) from randomly sampled individuals 40 years of age and above were collected. Future risk of CVD was calculated using the World Health Organisation–International Society of Hypertension (WHO-ISH) calculator with high risk defined as >20% risk over 10 years. Requirement for treatment was based on WHO package of essential non-communicable (PEN) disease guidelines (which use a risk-based approach) or requiring treatment for individual CVDRF; whether participants were on treatment was used to determine whether care needs were met. Multivariable regression was used to test associations between individual characteristics and outcomes. Data from the most recent WHO Service Availability and Readiness Assessment (SARA) were used to create a score reflecting health system preparedness to treat CVDRF, and compared to that for HIV.

Results

2071 individual participants were included. Most participants (n = 1715 [94.0%]) had low CVD risk; 423 (20.6%) and 431 (52.3%) required treatment based upon WHO PEN guidelines or individual CVDRF, respectively. Sixty-eight (15.8%) had met-need for treatment determined by WHO guidelines, whilst 84 (19.3%) for individual CVDRF. Living in urban areas, having education, being older, single/widowed/divorced, or wealthy were independently associated with met need. Overall facility readiness scores for CVD/CVDRF care for all facilities in Bo district was 16.8%, compared to 41% for HIV.

Conclusion

The number of people who require treatment for CVDRF in Sierra Leone is substantially lower based on WHO guidelines compared to CVDRF. CVDRF care needs are not met equitably, and facility readiness to provide care is low.
Saving the sea cucumbers: Using population genomic tools to inform fishery and conservation management of the Fijian sandfish Holothuria (Metriatyla) scabra
Authors: Brown Kelly T. , Southgate Paul C. , Hewavitharane Chinthaka A. , Lal Monal M.
Published: September 2022

The sea cucumber Holothuria (Metriatyla) scabra, known as sandfish, is a high-value tropical echinoderm central to the global bêche-de-mer (BDM) trade. This species has been heavily exploited across its natural range, with overharvesting and ineffective fishery management leaving stocks in the Pacific region heavily depleted. In Fiji, sandfish stocks have not recovered since a 1988 harvest ban, with surveys reporting declining populations and recruitment failure. Therefore, to inform fishery management policy for the wild sandfish resource and to guide hatchery-based restocking efforts, a high-resolution genomic audit of Fijian populations was carried out. A total of 6,896 selectively-neutral and 186 putatively-adaptive genome-wide SNPs (DArTseq) together with an independent oceanographic particle dispersal model were used to investigate genetic structure, diversity, signatures of selection, relatedness and connectivity in six wild populations. Three genetically distinct populations were identified with shallow but significant differentiation (average Fst = 0.034, p≤0.05), comprising (1) Lakeba island (Lau archipelago), (2) Macuata (Vanua Levu), and (3) individuals from Yasawa, Ra, Serua island and Kadavu comprising the final unit. Small reductions in allelic diversity were observed in marginal populations in eastern Fiji (overall mean A = 1.956 vs. Lau, A = 1.912 and Macuata, A = 1.939). Signatures of putative local adaptation were also discovered in individuals from Lakeba island, suggesting that they be managed as a discrete unit. An isolation-by-distance model of genetic structure for Fijian sandfish is apparent, with population fragmentation occurring towards the east. Hatchery-based production of juveniles is promising for stock replenishment, however great care is required during broodstock source population selection and juvenile releases into source areas only. The successful use of genomic data here has the potential to be applied to other sea cucumber species in Fiji, and other regions involved in the global BDM trade. While preliminary insights into the genetic structure and connectivity of sandfish in Fiji have been obtained, further local, regional and distribution-wide investigations are required to better inform conservation efforts, wild stock management and hatchery-based restocking interventions for this valuable invertebrate.
Uncovering nasopharyngeal carcinoma from chronic rhinosinusitis and healthy subjects using routine medical tests via machine learning
Authors: Liu Qi , Du Jinyang , Li Yuge , Peng Guiyuan , Wang Xuefang , Zhong Yong , Du Ruxu
Published: September 2022

Nasopharyngeal carcinoma (NPC) is one of the most common types of cancers in South China and Southeast Asia. Clinical data has shown that early detection is essential for improving treatment effectiveness and survival rate. Unfortunately, because the early symptoms of NPC are rather minor and similar to that of diseases such as Chronic Rhinosinusitis (CRS), early detection is a challenge. This paper proposes using machine learning methods to detect NPC using routine medical test data, namely Random Forest (RF), Support Vector Machine (SVM), and Artificial Neural Network (ANN), k-Nearest-Neighbor (KNN) and Logistic Regression (LR). We collected a dataset containing 523 newly diagnosed NPC patients before treatment, 501 newly diagnosed CRS patients before treatment as well as 600 healthy controls. The routine medical test data including age, gender, blood test features, liver function test features, and urine sediment test features. For comparison, we also used data from Epstein-Barr Virus (EBV) antibody tests, which is a specialized test not included among routine medical tests. In our first test, all four methods were tested on classifying NPC vs CRS vs controls; RF gives the best overall performance. Using only routine medical test data, it gives an accuracy of 83.1%, outperforming LR by 12%. In our second test, using only routine medical test data, when classifying NPC vs non-NPC (i.e. CRS or controls), RF achieves an accuracy of 88.2%. In our third test, when classifying NPC vs. controls, RF using only routine test data achieves an accuracy significantly better than RF using only EBV antibody data. Finally, in our last test, RF trained with NPC vs controls, using routine test data only, continued to perform well on an entirely separate dataset. This is a promising result because preliminary NPC detection using routine medical data is easy and inexpensive to implement. We believe this approach will play an important role in the detection and treatment of NPC in the future.
Experimental study of water migration characteristics in compacted loess subjected to rainfall infiltration
Authors: Zhang Shibin , Han Tielin , Lu Yani , Huang Chengzhi , Zhao Peng
Published: September 2022

In order to study the effect of the rainfall infiltration on water migration in compacted loess, a model device was developed for testing water migration in the soil under rainfall conditions. In this study, the volumetric water content and resistivity of soil were introduced into the model test device. This model test device was applied to the study of water migration characteristics in compacted loess under different rainfall conditions. The results show that the resistivity decreases with the increase of the volumetric water content at the same depth of the loess column. In this way, the characteristics of the water migration can also be reflected from the change of the resistivity. There is an intimate relationship between the resistivity and volumetric water content, dry density. The volumetric water content and dry density are normalized by saturation of loess, arriving the equation of saturation against the resistivity. The characteristics of rainfall infiltration in compacted loess show a particular pattern, which demonstrates that, with the increase of dry density of the loess column, the rainfall infiltration line present “Y”, “D” and “Λ” shape distribution respectively, under light rain, heavy rain and rainstorm.
The value conflict between freedom and security: Explaining the variation of COVID-19 policies in democracies and autocracies
Authors: Saam Nicole J. , Friedrich Carmen , Engelhardt Henriette
Published: September 2022

In the name of health security, individual freedoms were constrained in an unprecedented way in many countries, democratic or authoritarian, all over the world during the COVID-19 pandemic. Yet the constraints have not been consistent across countries, which motivates this paper to examine the relevance of value preferences towards freedom or security in the society for COVID-19 policies. Based on data for 40 democratic and authoritarian countries, the analyses show that the variation in the stringency of COVID-19 policies can be explained by value preferences of the population only in autocracies. In democracies, however, we do not find such a relationship. Governments in democratic political systems, we argue, are responsive to their constitutions and face prosecution by the judiciary if they violate the law or provisions of the constitution, limiting their capacity to implement strong COVID-19 policies. Nevertheless, their COVID-19 policies restricted citizens’ freedoms and liberties, which means that these policies were rather not responsive to citizens’ preferences for freedom, democratic rights and liberties. By highlighting how autocracies respond to their citizens’ value preferences for security, this paper contributes to a better understanding of how autocracies might gain legitimacy in times of crises.
Simulating the effects of mobility restrictions in the spread of SARS-CoV-2 in metropolitan areas in Portugal
Authors: Oliveira Sandra , Ribeiro Ana Isabel , Nogueira Paulo , Rocha Jorge
Published: September 2022

Commuting flows and long-distance travel are important spreading factors of viruses and particularly airborne ones. Therefore, it is relevant to examine the association among diverse mobility scenarios and the spatial dissemination of SARS-CoV-2 cases. We intended to analyze the patterns of virus spreading linked to different mobility scenarios, in order to better comprehend the effect of the lockdown measures, and how such measures can be better informed. We simulated the effects of mobility restrictions in the spread of SARS-CoV-2 amongst the municipalities of two metropolitan areas, Lisbon (LMA) and Porto (PMA). Based on an adapted SEIR (Suscetible-Exposed-Infected-Removed) model, we estimated the number of new daily infections during one year, according to different mobility scenarios: restricted to essential activities, industrial activities, public transport use, and a scenario with unrestricted mobility including all transport modes. The trends of new daily infections were further explored using time-series clustering analysis, using dynamic time warping. Mobility restrictions resulted in lower numbers of new daily infections when compared to the unrestricted mobility scenario, in both metropolitan areas. Between March and September 2020, the official number of new infections followed overall a similar timeline to the one simulated considering only essential activities. At the municipal level, trends differ amongst the two metropolitan areas. The analysis of the effects of mobility in virus spread within different municipalities and regions could help tailoring future strategies and increase the public acceptance of eventual restrictions.
Body mass index and physical frailty among older Mexican Americans: Findings from an 18-year follow up
Authors: Rutherford Megan , Downer Brian , Li Chih-Ying , Chou Lin-Na , Al Snih Soham
Published: September 2022

Purposes

The relationship between body mass index (BMI) and frailty in older Mexican Americans has not been previously studied. The objective of this study was to examine the relationship between BMI and frailty among non-frail older Mexican Americans at baseline over 18 years of follow up.

Methods

Longitudinal population-based study of 1,648 non-institutionalized Mexican Americans aged ≥ 67 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/96-2012/13). Frailty phenotype was defined as meeting three or more of the following: unintentional weight loss of >10 pounds, weakness, self-reported exhaustion, low physical activity, and slow walking speed. BMI (kg/m2) was classified as underweight (<18.5), normal weight (18.5-<25), overweight (25-< 30), obesity category I (30-<35), and obesity category II/morbid obesity (≥35). Covariates included socio-demographics, comorbidities, cognitive function, and depressive symptoms. Generalized Estimating Equation models were performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of frailty as a function of BMI category.

Results

Participants with underweight or obesity category II/ morbid obesity had greater odds of frailty over time compared to those with normal weight (OR = 2.39, 95% CI = 1.29–4.44 and OR = 1.62, 95% CI = 1.07–2.44, respectively) after controlling for all covariates. Participants with BMIs in the overweight or category I obesity were at lower odds of frailty over time.

Conclusions

Mexican American older adults with BMIs in the underweight or obesity category II/morbid obesity were at higher odds of frailty over time. This indicates that maintaining a healthy weight in this population may prevent future frailty.
Wavelet subband-specific learning for low-dose computed tomography denoising
Authors: Kim Wonjin , Lee Jaayeon , Kang Mihyun , Kim Jin Sung , Choi Jang-Hwan
Published: September 2022

Deep neural networks have shown great improvements in low-dose computed tomography (CT) denoising. Early algorithms were primarily optimized to obtain an accurate image with low distortion between the denoised image and reference full-dose image at the cost of yielding an overly smoothed unrealistic CT image. Recent research has sought to preserve the fine details of denoised images with high perceptual quality, which has been accompanied by a decrease in objective quality due to a trade-off between perceptual quality and distortion. We pursue a network that can generate accurate and realistic CT images with high objective and perceptual quality within one network, achieving a better perception-distortion trade-off. To achieve this goal, we propose a stationary wavelet transform-assisted network employing the characteristics of high- and low-frequency domains of the wavelet transform and frequency subband-specific losses defined in the wavelet domain. We first introduce a stationary wavelet transform for the network training procedure. Then, we train the network using objective loss functions defined for high- and low-frequency domains to enhance the objective quality of the denoised CT image. With this network design, we train the network again after replacing the objective loss functions with perceptual loss functions in high- and low-frequency domains. As a result, we acquired denoised CT images with high perceptual quality using this strategy while minimizing the objective quality loss. We evaluated our algorithms on the phantom and clinical images, and the quantitative and qualitative results indicate that ours outperform the existing state-of-the-art algorithms in terms of objective and perceptual quality.
Outdoor residual spraying for malaria vector-control in Kayin (Karen) state, Myanmar: A cluster randomized controlled trial
Authors: Chaumeau Victor , Kajeechiwa Ladda , Kulabkeeree Thithiworada , Sawasdichai Sunisa , Haohankhunnatham Warat , Inta Aritsara , Phanaphadungtham Monthicha , Girond Florian , Herbreteau Vincent , Delmas Gilles , Nosten François
Published: September 2022

Outdoor and early biting by mosquitoes challenge the efficacy of bed nets and indoor residual spraying against malaria in the Greater Mekong Subregion. The objective of this study was to assess the efficacy of outdoor residual spraying (ORS) for malaria vector-control in this region. A cluster randomized controlled trial was conducted between July 2018 and April 2019 in twelve villages in Karen (Kayin) state, Myanmar. Villages were randomly assigned to receive either a single round of ORS with a capsule suspension of lambda-cyhalothrin for two days in October or no intervention (six villages per group). The primary endpoint was the biting rate of malaria mosquitoes assessed with human-landing catch and cow-baited trap collection methods, and was analyzed with a Bayesian multi-level model. In the intervention villages, the proportion of households located within the sprayed area ranged between 42 and 100% and the application rate ranged between 63 and 559 g of active ingredient per hectare. At baseline, the median of Anopheles biting rate estimates in the twelve villages was 2 bites per person per night (inter-quartile range [IQR] 0–5, range 0–48) indoors, 6 bites per person per night (IQR 2–16, range 0–342) outdoors and 206 bites per cow per night (IQR 83–380, range 19–1149) in the cow-baited trap. In intention-to-treat analysis, it was estimated that ORS reduced biting rate by 72% (95% confidence interval [CI] 63–79) from Month 0 to Month 3 and by 79% (95% CI 62–88) from Month 4 to Month 6, considering control villages as the reference. In conclusion, ORS rapidly reduces the biting rates of malaria mosquitoes in a Southeast Asian setting where the vectors bite mostly outdoors and at a time when people are not protected by mosquito bed nets.
Combining epidemiology and economics to assess control of a viral endemic animal disease: Porcine Reproductive and Respiratory Syndrome (PRRS)
Authors: Valdes-Donoso Pablo , Jarvis Lovell S.
Published: September 2022

Porcine reproductive and respiratory syndrome (PRRS) is an extremely contagious disease that causes great damage to the U.S. pork industry. PRRS is not subject to official control in the U.S., but most producers adopt control strategies, including vaccination. However, the PRRS virus mutates frequently, facilitating its ability to infect even vaccinated animals. In this paper we analyze how increased vaccination on sow farms reduces PRRS losses and when vaccination is profitable. We develop a SIR model to simulate the spread of an outbreak between and within swine farms located in a region of Minnesota. Then, we estimate economic losses due to PRRS and calculate the benefits of vaccination. We find that increased vaccination of sow farms increases the private profitability of vaccination, and also transmits positive externalities to farms that do not vaccinate. Although vaccination reduces industry losses, a low to moderate vaccine efficacy implies that large PRRS losses remain, even on vaccinated farms. Our approach provides useful insight into the dynamics of an endemic animal disease and the benefits of different vaccination regimens.