bluuebunny/crossref_metadata_2025 huggingface dataset:
The vernacularisation of global rights discourses and social protection in regional African arena
Authors: Seekings Jeremy
Published: December 2020

International organisations have increasingly advocated a rights-based approach to social protection, especially in Africa, despite persistent criticisms from some African scholars that the globally dominant discourse of human rights reflects a specifically ‘western’ ideology. Regional African inter-governmental organisations have occupied a frontline between international organisations and national governments in ‘vernacularising’ global rights, that is, incorporating some ‘African’ norms and values into the universal claims of the dominant global discourse. This has entailed an emphasis on broadly communitarian responsibilities and obligations (including but not limited to the family and kin) alongside individual claims. The process of vernacularisation has been limited, however, in that it entails the adaptation of exogenous statements about rights. These tend to overlook the specific needs and claims of poor farmers and fail to recognise the full extent to which communitarian norms and values in Africa challenge the predominant global discourse.
Bayesian uncertainty quantification for guided-wave-based multidamage localization in plate-like structures using Gibbs sampling
Authors: Zhao Meijie , Huang Yong , Zhou Wensong , Li Hui
Published: December 2020

In this article, a new Bayesian approach for guided-wave-based multidamage localization by employing Gibbs sampling is proposed. By using the information of time-of-flight (ToF) embedded in guided wave signals, the posterior probability distributions of three parameter groups, that is, the horizontal and vertical coordinates of the multidamage locations (x, y) and wave velocity v, are characterized using Gibbs sampling samples. To obtain the analytical form of the conditional posterior probability density function of each parameter group conditional on the other two and the available ToF data, a first-order Taylor expansion of the nonlinear ToF-based damage localization model with respect to each parameter group is performed. Two Gibbs sampling algorithms are proposed, which differ in their strategies to address the posterior uncertainty of the prediction error parameter; however, both algorithms iteratively sample from conditional posterior probability density functions of three parameter groups. Therefore, the effective number of dimensions for Gibbs sampling is always three, regardless of the number of defects. The final damage localization results are obtained by grouping all ToFs and then comparing the posterior uncertainty of localization results of each grouping scheme to obtain the most reliable sampling results among all candidates. The proposed method not only identifies the group velocity but also localizes multiple defects by sharing the same characteristics of damage localization. Furthermore, this method can quantify the uncertainty of multidamage localization to automatically find the most reliable damage locations. The effectiveness and robustness of the proposed algorithms are validated by both numerical and experimental examples.
Investigation of some weathering impacts on tearing properties of PVC-coated fabrics used for architectural purposes
Authors: Dobilaitė Vaida , Jucienė Milda , Bliūdžius Raimondas , Šveikauskaitė Loreta
Published: December 2020

This paper reports the comprehensive experimental study of the tearing behaviour of PES/PVC-coated architectural membranes exposed to different accelerated aging conditions. Coated fabrics intended as building envelopes are constantly exposed to the environmental impacts, therefore, it is important to determine the influence of these factors on changes of mechanical properties, and the tear strength was considered to be one of the essential characteristics associated with the life span of a tensioned membrane structures. An accelerated aging model was developed based on the analysis of the aging factors significantly relevant to the building operation. The effect of abrasion, higher temperature and humidity as well as set of these aging factors on tear performance were investigated. The results show that in most cases the tear strength of architectural membranes changes marginally within the limits after exposure to artificial aging. The biggest contributor to tearing changes was high temperature, which could be the dominant component in the aging model. The study provides a better understanding of tearing performance of PVC-coated fabrics in real environmental conditions.
“Normally I Try and Capture a Moment, and With This I Had to Create a Moment”: Implications of Anonymous Photography Protocols in Photovoice Research with People Who Inject Drugs
Authors: Carlberg-Racich Suzanne
Published: December 2020

Photovoice collaborations are designed to promote critical consciousness and advocate for change. People who inject drugs (PWID) are systematically silenced from advocacy for fear of being “outed.” Photovoice protocols that prohibit identifying photography provide a safer alternative; however, it is not known how these protections affect participant experience. This study examined how human subjects’ protections affect PWID experience in a Photovoice research project. A purposeful sample of PWID ( N = 25) was recruited from a Photovoice study and engaged in semi-structured interviews. Interview transcripts were coded and analyzed for key themes. The majority of participants understood the protections while also explaining the difficulty in achieving their vision. Creativity played a significant role in overcoming the restrictions. A vocal minority voiced strong objections to the restrictive protocol. Allowing only anonymous photography posed certain challenges, but PWID valued the inherent privacy. Creative approaches may aid in overcoming restraints and achieving a balance.
Shook Ones: Understanding the Intersection of Nonfatal Violent Firearm Injury, Incarceration, and Traumatic Stress Among Young Black Men
Authors: Richardson Joseph B. , Wical William , Kottage Nipun , Bullock Che
Published: December 2020

Violent injury is a leading cause of death and disability among young Black men, with the highest rates occurring in low-income urban populations. Hospital-based violence intervention programs (HVIPs) offer a promising opportunity to address the biopsychosocial factors that adversely affect this population. However, there are major gaps between the needs of young Black male survivors of violent injury and the forms of care provided by HVIPs. Patient-centered outcomes research provides a useful mode of inquiry to develop strategies to decrease these differences. Care for survivors, including treatment for traumatic stress disorders, must be reconceptualized to center the lived experiences of young Black men. This paper qualitatively explores how these survivors of gun violence express symptoms of traumatic stress and the ways in which their narratives can inform the implementation of the biopsychosocial model in HVIPs. A phenomenological variant ecological systems theory framework was used to analyze participant narratives to aid in understanding their symptoms of traumatic stress and post-injury affective changes as both psychologically and socially important experiences. Such insight may inform changes to HVIP practice to address persistent health disparities related to violence.
The Diagnosis and Treatment of Lichen Sclerosus and Bulbous Urethral Squamous Cell Carcinoma: A Case Report
Authors: Wang Jun , Zhang Wei , Li Xiaodong
Published: December 2020

Lichen sclerosus (LS) is a rare disease with malignant potential and has been identified by the European Society of Urology Guidelines as a risk factor for penile squamous cell carcinoma (SCC) cancer. LS combined with urethral squamous cell carcinoma (USCC) is extremely rare. There has been only one case report of this combination in China over the last decade. The prevalence of this combination in East Asian population is unclear. In this report, a 49-year-old patient with the presence of LS, perineal masses, and abscesses was hospitalized. He underwent anti-infectious therapy, meatotomy, perineal abscess incision, and drainage and debridement of the perineal wound. USCC was diagnosed following a series of biopsies and treated with radiation therapy. The patient remains well and alive with no recurrence of USCC 13 months after radiation treatment.
A discretization method for predicting the equivalent elastic parameters of the graded lattice structure
Authors: Zhao Cun , Li Guoxi , Zhang Meng , Luo Weipeng
Published: December 2020

In recent years, cellular materials have been widely studied and applied in aerospace and other fields due to the advantages of lightweight and multi-function. However, it is difficult to predict the equivalent elastic properties of the graded lattice structure and other non-uniform cellular materials because of the complex configuration and non-uniformity. A new discretization method for predicting the equivalent elastic parameters of the graded lattice structure is proposed based on the strain energy equivalent method and the discretization method in this paper. The graded lattice structure is discretized into lattice cells, the equivalent elastic properties are predicted by calculating the global equivalent elastic parameters with the parameters of lattice cells, and the calculation formulas are derived. After that, taking edge cube, face-centered cubic and body-centered cubic lattice as examples, the effectiveness and accuracy of the method are verified by theoretical calculation, numerical analysis, and experiment. The results show that the calculation errors of equivalent elastic parameters are between 4.5%–9.7%, and the errors can be significantly improved by reducing the graded factor. It proves that the proposed discretization method can predict the equivalent elastic parameters of the graded lattice structure effectively, and is suitable for different lattice structures.
The impact of high-risk and chronic opioid use among commercially insured endometriosis patients on health care resource utilization and costs in the United States
Authors: Estes Stephanie J , Soliman Ahmed M , Zivkovic Marko , Chopra Divyan , Zhu Xuelian
Published: December 2020

Objectives:

Evaluate all-cause and endometriosis-related health care resource utilization and costs among newly diagnosed endometriosis patients with high-risk versus low-risk opioid use or patients with chronic versus non-chronic opioid use.

Methods:

A retrospective analysis of IBM MarketScan® Commercial Claims data from 2009 to 2018 was performed for females aged 18 to 49 with newly diagnosed endometriosis (International Classification of Diseases, Ninth Edition code: 617.xx; International Classification of Diseases, Tenth Edition code: N80.xx). Two sub-cohorts were identified: high-risk (⩾1 day with ⩾90 morphine milligram equivalents per day or ⩾1-day concomitant benzodiazepine use) or chronic opioid utilization (⩾90-day supply prescribed or ⩾10 opioid prescriptions). High-risk or chronic utilization was evaluated during the 12-month assessment period after the index date. Index date was the first opioid prescription within 12 months following endometriosis diagnosis. All outcomes were assessed over 12-month post-assessment period while adjusting for demographic and clinical characteristics.

Results:

Out of 61,019 patients identified, 18,239 had high-risk opioid use and 5001 chronic opioid use. Health care resource utilization drivers were outpatient visits and pharmacy fills, which were higher among high-risk versus low-risk patients (outpatient visits: 17.49 vs 15.51; pharmacy fills: 19.58 vs 16.88, p < 0.0001). Chronic opioid users had a higher number of outpatient visits (19.53 vs 15.00, p < 0.0001) and pharmacy fills (23.18 vs 16.43, p < 0.0001) compared to non-chronic opioid users. High-risk opioid users had significantly higher all-cause health care costs compared to low-risk opioid users (US$16,377 vs US$13,153; p < 0.0001). Chronic opioid users also had significantly higher all-cause health care costs compared to non-chronic opioid users (US$20,930 vs US$12,272; p < 0.0001). Similar patterns were observed among endometriosis-related HCRU, except pharmacy fills among high-risk and chronic sub-cohorts.

Conclusion:

This analysis demonstrates significantly higher all-cause and endometriosis-related health care resource utilization and total costs for high-risk opioid users compared to low-risk opioid users among newly diagnosed endometriosis patients over 1 year. Similar trends were observed for comparing chronic opioid users with non-chronic opioid users, except for endometriosis-related pharmacy fills and associated costs.
Modified and simplified clinically important deterioration: multidimensional indices of short-term disease trajectory to predict future exacerbations in patients with chronic obstructive pulmonary disease
Authors: Zhao Yi-yang , Liu Cong , Zeng Yu-qin , Zhou Ai-yuan , Duan Jia-xi , Cheng Wei , Sun Tian , Li Xin , Ma Li-bing , Liu Qi-mi , Zhu Ying-qun , Chen Ming , Zhou Mei-ling , Chen Ping
Published: December 2020

Background and aims:

Various prediction indices based on the single time point observation have been proposed in chronic obstructive pulmonary disease (COPD), but little was known about disease trajectory as a predictor of future exacerbations. Our study explored the association between disease trajectory and future exacerbations, and validated the predictive value of the modified and simplified short-term clinically important deterioration (CID).

Methods:

This study was a multicenter, prospective observational study. Patients with COPD were recruited into our study and followed up for 18 months. The modified CID (CID-C) was defined as a decrease of 100 mL in forced expiratory volume in 1 second (FEV1), or suffering exacerbations, or increase of 2 units in COPD Assessment Test (CAT) during the first 6 months follow-up. Simplified CID was defined when excluding CAT from the CID-C model.

Results:

A total of 127 patients were enrolled in our final analysis. Compared with patients without exacerbations during the period of the 6th to the 18th month, patients with exacerbations were more likely to have frequent short-term exacerbations in the first 6 months (2.14 versus 0.21, p < 0.001). The short-term exacerbations were the best predictor for future exacerbations [odds ratio (OR): 13.25; 95% confidence interval: 5.62–34.67; p < 0.001], followed by the history of exacerbation before study entry, short-term changes in FEV1 and CAT. CID-C and Simplified CID were both significantly associated with exacerbations (OR: 7.14 and 9.74, both p < 0.001). The receiver operating characteristic curves showed that the Simplified CID had slightly better predictive capacity for future exacerbation than CID-C (0.754 versus 0.695, p = 0.02).

Conclusion:

Disease trajectory, including both the CID-C and the Simplified CID had significant predictive value for future exacerbations. The reviews of this paper are available via the supplemental material section.
Multi-response optimization of chromium/gold-based nanofilm Kretschmann-based surface plasmon resonance glucose sensor using finite-difference time-domain and Taguchi method
Authors: Mohamad Najmiah Radiah , Wee Mohd Farhanulhakim Mohd Razip , Mohamed Mohd Ambri , Hamzah Azrul Azlan , Menon P Susthitha
Published: December 2020

Kretschmann-based surface plasmon resonance sensor utilizing chromium and gold nanofilms is ideal for label-free biomedical sensing. In this work, Taguchi’s L9 orthogonal array method was used to optimize the effects of three control factors and noise factor, which are the incident optical wavelength, chromium and gold nanofilm thicknesses, and their root-mean-square surface roughness, on the performance of the Kretschmann-based surface plasmon resonance sensor. The control factors were varied at three levels for a novel multi-response optimization of the Kretschmann-based surface plasmon resonance sensor for the minimum reflectivity, the full-width-at-half-maximum, and the sensitivity of 3% glucose detection, executed using Lumerical’s two-dimensional finite-difference time-domain method. Using Taguchi method, the best control factor setting in air was A3B2C2 corresponding to 785 nm optical wavelength, 0.5 nm chromium, and 50 nm gold layer thickness, respectively, with minimum reflectivity of 0.0017%, full-width-at-half-maximum of 0.4759°, and glucose-sensing sensitivity of 106.73°·RIU−1. The detection accuracy and quality factor were 0.01 and 224.26 RIU−1, respectively. It was also indicated that chromium nanofilm thickness of 0.5–3 nm and its root-mean-square surface roughness has a negligible factor effect compared to other control factors. Taguchi method’s factor effect analysis showed that for chromium layer thickness of 1–3 nm, the minimum reflectivity values are predominantly determined by the gold layer thickness with 75% factor effect, followed by optical wavelength with 11%. Factor effect of full-width-at-half-maximum is determined by optical wavelength (57%), followed by gold layer thickness (38%). Sensitivity is 88% determined by optical wavelength and 10% determined by gold layer thickness. The Kretschmann-based surface plasmon resonance glucose sensor with the best glucose-sensing sensitivity was at optical wavelength of 632.8 nm with a higher sensitivity value of 163.415°·RIU−1 but lower detection accuracy and quality factor values of 0.001 and 24.86 RIU−1, respectively, compared to near-infrared wavelength of 785 nm. In conclusion, finite-difference time-domain and Taguchi method is suitable for multi-response optimization of control and noise factors of Kretschmann-based surface plasmon resonance sensors.
Architecture and Mental Disorders: A Systematic Study of Peer-Reviewed Literature
Authors: Aljunaidy Mais M. , Adi Mohamad Nadim
Published: December 2020

Objectives:

To perform a systematic study about the contribution of architecture and interior design researchers in studying the effect of physical environment on mental disorders.

Background:

Mental disorders are a major health problem worldwide and related to severe distress, functional disabilities, and heavy economical burdens. Studies propose that physical environment design can trigger or reduce mental disorder symptoms. However, there is a lack of knowledge about the extent of architectural design research contribution to all types of mental disorder prevention or intervention.

Methods:

A team of cross-disciplinary researchers gathered information from peer-reviewed manuscripts about the effect of architectural design on enhancing or reducing mental disorder symptoms. Data were collected from manuscripts published between 2008 and 2020 (research related to the topic became clearer in quality and quantity then). Keywords including architecture, interior design, physical environment, and mental disorders were used in the systematic search. Databases were collected using online resources. Numerical data collected from quantitative studies were organized in tables.

Results:

Our data showed that there were a lot of studies about dementia and autism; few studies about schizophrenia, anxiety, stress-related disorders, and depressive disorders; and no studies about the rest of the mental disorders. General environment followed by housing facility design were the most assessed physical environments for mental disorders.

Conclusions:

As all mental disorders can have a significant impact on the society, we conclude that architectural studies should focus more on improving or preventing the symptoms of all types of mental disorders through the design of physical environments.
Intracranial brain parenchymal spread of mucormycosis through olfactory tract: a diffusion-weighted imaging-based concept
Authors: Sandron J. , Hantson Ph. , Duprez T.
Published: December 2020

Mucormycosis is an opportunistic fungal infection involving among others the paranasal sinuses, nasal fossa and brain parenchyma. Mucor can invade the brain parenchyma by either contiguous spread from the paranasal sinuses or through vascular invasion. We report a case of fatal rhino-cerebral mucormycosis in whom cytotoxic edema at magnetic resonance diffusion-weighted imaging was symmetrically restricted to both neocortical and paleocortical primary areas of olfactory projection at earliest phase of the disease process. Shortly later tissue damage extended into the whole brain. This undescribed observation raised the hypothesis of preferential way of brain invasion by Mucor through the olfactory tract.
How Family Physicians Practice the Principle of Remission Along the Glycemic Continuum
Authors: Fulleborn Stephanie T. , Crawford Paul F. , Jackson Jeremy T. , Ledford Christy J.W.
Published: December 2020

Introduction

Recent evidence reveals that diabetes and prediabetes (preDM) can be reversed to normal glucose regulation (NGR) through significant weight loss, but how physicians clinically identify the principles of partial and complete remission of diabetes is largely unknown.

Methods

As part of the cross-sectional omnibus survey conducted in March 2019 at a professional annual meeting in the United States, physician participants answered case scenario questions about the diagnosis and documentation of patients with preDM and type 2 diabetes (T2DM).

Results

Of the registered conference attendees, 387 (72.7%) responded. When presented with the initial case of preDM, 201 physicians (70.8%) selected R73.03 Prediabetes. In a follow-up encounter with improved lab results, 118 physicians (58.7%) indicated that they would not chart any diabetes-related code and 62 (30.8%) would chart preDM again. When presented with the case of T2DM, 256 physicians (90.1%) indicated E11.0–E11.9 Type 2 Diabetes. In the follow-up encounter, only 38 (14.8%) coded a diagnosis reflecting remission from T2DM to prediabetes and 211 (82.4%) charted T2DM.

Conclusion

Physicians may be reluctant to document diabetes regression as there is little evidence for long-term outcomes and “downgrading” the diagnosis in the medical record may cause screenings to be missed. Documenting this regression in the medical record should communicate the accurate point on the continuum of glucose intolerance with both the patient and the care team.
Supplementing Clinical Practice in Nursing Homes With Simulation Training: A Qualitative Study of Nursing Students’ Experiences
Authors: Olaussen Camilla , Aase Ingunn , Jelsness-Jørgensen Lars-Petter , Tvedt Christine Raaen , Steindal Simen A.
Published: December 2020

Introduction

Limited access to nurse supervisors, insufficient learning support and staff with high workloads are well documented in the research literature as barriers to nursing students´ learning in clinical practice in nursing homes. Due to these barriers nursing students may benefit from additional learning support from nurse educators during their clinical practice period.

Objective

The study aimed to explore nursing students’ experiences of supplementary simulation training as a tool to support learning during clinical practice in nursing homes.

Methods

A descriptive qualitative design was used. Twenty-seven first-year nursing students from a university college in Norway were interviewed after attending a seven-week practice period in nursing homes with supplementary simulation training. Three semi-structured focus group interviews were audio recorded, transcribed, and analysed using systematic text condensation.

Findings

Three categories of student experiences were identified: enhancing the reasoning behind care, transferring knowledge and experiences between the learning environments and enhancing the sense of mastery.

Conclusion

The supplementary simulation training seemed to complement clinical practice by consolidating the students’ learning during the clinical practice period, enhance the students’ motivation and sense of mastery, and consequently their efforts to seek out new challenges, explore and learn both in the clinical and the simulated environment.
A two-dimensional propensity score matching method for longitudinal quasi-experimental studies: A focus on travel behavior and the built environment
Authors: Zhong Haotian , Li Wei , Boarnet Marlon G
Published: December 2020

The lack of longitudinal studies of the relationship between the built environment and travel behavior has been widely discussed in the literature. This paper discusses how standard propensity score matching estimators can be extended to enable such studies by pairing observations across two dimensions: longitudinal and cross-sectional. Researchers mimic randomized controlled trials and match observations in both dimensions to find synthetic control groups that are similar to the treatment group and to match subjects across before- and after-treatment periods. We call this a two-dimensional propensity score matching method. This method demonstrates superior performance for improving treatment effect estimation based on Monte Carlo evidence. A near-term opportunity for such matching is identifying the treatment effect of transportation infrastructure on travel behavior.
Exploring the MaaS market with systematic analysis
Authors: Esztergár-Kiss Domokos , Kerényi Tamás , Mátrai Tamás , Aba Attila
Published: December 2020

Mobility as a Service (MaaS) is a new transport concept which integrates, manages, and distributes private and public mobility alternatives by using intelligent digital technologies. Recently, research and implementations have been widely conducted. In order to reveal future implications, it is crucial to analyze the available MaaS services by using systematic methodology. Cluster analysis was applied to create typical groups of MaaS services and to define the common features of the systems, which may highlight future trends. In order to identify the most relevant MaaS initiatives, the typical parameters of the services were taken into account and a dataset was developed. More than 30 MaaS services from 14 countries were investigated, and the features and the functionalities of these services were analyzed. The findings demonstrate that there is potential for the development of the applications in terms of their payment features, their personalization, and the provision of all attainable elements of MaaS. The number of operators is constantly increasing. However, it is uncertain whether public or private MaaS operators will be dominant on the market. Three cluster groups were created with specific features and directions of development. The Route planners group involves a few modes of transport, but it provides an extensive service. While the Third parties group has primarily private MaaS operators, the Public systems group usually includes public MaaS operators. This comprehensive study might be useful to MaaS operators and regulators for understanding the typical features and the development directions of the market.
Learning to detect the onset of slow activity after a generalized tonic–clonic seizure
Authors: Vance Carroll , Kim Yejin , Zhang Guoqiang , Lhatoo Samden , Tao Shiqiang , Cui Licong , Li Xiaojin , Jiang Xiaoqian
Published: December 2020

Background

Sudden death in epilepsy (SUDEP) is a rare disease in US, however, they account for 8–17% of deaths in people with epilepsy. This disease involves complicated physiological patterns and it is still not clear what are the physio-/bio-makers that can be used as an indicator to predict SUDEP so that care providers can intervene and treat patients in a timely manner. For this sake, UTHealth School of Biomedical Informatics (SBMI) organized a machine learning Hackathon to call for advanced solutions https://sbmi.uth.edu/hackathon/archive/sept19.htm.

Methods

In recent years, deep learning has become state of the art for many domains with large amounts data. Although healthcare has accumulated a lot of data, they are often not abundant enough for subpopulation studies where deep learning could be beneficial. Taking these limitations into account, we present a framework to apply deep learning to the detection of the onset of slow activity after a generalized tonic–clonic seizure, as well as other EEG signal detection problems exhibiting data paucity.

Results

We conducted ten training runs for our full method and seven model variants, statistically demonstrating the impact of each technique used in our framework with a high degree of confidence.

Conclusions

Our findings point toward deep learning being a viable method for detection of the onset of slow activity provided approperiate regularization is performed.
Categorisation of EEG suppression using enhanced feature extraction for SUDEP risk assessment
Authors: Mier Juan C. , Kim Yejin , Jiang Xiaoqian , Zhang Guo-Qiang , Lhatoo Samden
Published: December 2020

Background

Sudden Unexpected Death in Epilepsy (SUDEP) has increased in awareness considerably over the last two decades and is acknowledged as a serious problem in epilepsy. However, the scientific community remains unclear on the reason or possible bio markers that can discern potentially fatal seizures from other non-fatal seizures. The duration of postictal generalized EEG suppression (PGES) is a promising candidate to aid in identifying SUDEP risk. The length of time a patient experiences PGES after a seizure may be used to infer the risk a patient may have of SUDEP later in life. However, the problem becomes identifying the duration, or marking the end, of PGES (Tomson et al. in Lancet Neurol 7(11):1021–1031, 2008; Nashef in Epilepsia 38:6–8, 1997).

Methods

This work addresses the problem of marking the end to PGES in EEG data, extracted from patients during a clinically supervised seizure. This work proposes a sensitivity analysis on EEG window size/delay, feature extraction and classifiers along with associated hyperparameters. The resulting sensitivity analysis includes the Gradient Boosted Decision Trees and Random Forest classifiers trained on 10 extracted features rooted in fundamental EEG behavior using an EEG specific feature extraction process (pyEEG) and 5 different window sizes or delays (Bao et al. in Comput Intell Neurosci 2011:1687–5265, 2011).

Results

The machine learning architecture described above scored a maximum AUC score of 76.02% with the Random Forest classifier trained on all extracted features. The highest performing features included SVD Entropy, Petrosan Fractal Dimension and Power Spectral Intensity.

Conclusion

The methods described are effective in automatically marking the end to PGES. Future work should include integration of these methods into the clinical setting and using the results to be able to predict a patient’s SUDEP risk.
Clinical outcomes in patients with atrial fibrillation and frailty: insights from the ENGAGE AF-TIMI 48 trial
Authors: Wilkinson Chris , Wu Jianhua , Searle Samuel D. , Todd Oliver , Hall Marlous , Kunadian Vijay , Clegg Andrew , Rockwood Kenneth , Gale Chris P.
Published: December 2020

Background

Atrial fibrillation (AF) is common in older people with frailty and is associated with an increased risk of stroke and systemic embolism. Whilst oral anticoagulation is associated with a reduction in this risk, there is a lack of data on the safety and efficacy of direct oral anticoagulants (DOACs) in people with frailty. This study aims to report clinical outcomes of patients with AF in the Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation–Thrombolysis in Myocardial Infarction 48 (ENGAGE AF-TIMI 48) trial by frailty status.

Methods

Post hoc analysis of 20,867 participants in the ENGAGE AF-TIMI 48 trial, representing 98.8% of those randomised. This double-blinded double-dummy trial compared two once-daily regimens of edoxaban (a DOAC) with warfarin. Participants were categorised as fit, living with pre-frailty, mild-moderate, or severe frailty according to a standardised index, based upon the cumulative deficit model. The primary efficacy endpoint was stroke or systemic embolism and the safety endpoint was major bleeding.

Results

A fifth (19.6%) of the study population had frailty (fit: n = 4459, pre-frailty: n = 12,326, mild-moderate frailty: n = 3722, severe frailty: n = 360). On average over the follow-up period, the risk of stroke or systemic embolism increased by 37% (adjusted HR 1.37, 95% CI 1.19–1.58) and major bleeding by 42% (adjusted HR 1.42, 1.27–1.59) for each 0.1 increase in the frailty index (four additional health deficits). Edoxaban was associated with similar efficacy to warfarin in every frailty category, and a lower risk of bleeding than warfarin in all but those living with severe frailty.

Conclusions

Edoxaban was similarly efficacious to warfarin across the frailty spectrum and was associated with lower rates of bleeding except in those with severe frailty. Overall, with increasing frailty, there was an increase in stroke and bleeding risk. There is a need for high-quality, frailty-specific population randomised control trials to guide therapy in this vulnerable population.

Trial registration

ClinicalTrials.gov NCT00781391. First registered on 28 October 2008
Amyloid-β misfolding as a plasma biomarker indicates risk for future clinical Alzheimer’s disease in individuals with subjective cognitive decline
Authors: Stockmann Julia , Verberk Inge M. W. , Timmesfeld Nina , Denz Robin , Budde Brian , Lange-Leifhelm Julia , Scheltens Philip , van der Flier Wiesje M. , Nabers Andreas , Teunissen Charlotte E. , Gerwert Klaus
Published: December 2020

Background

We evaluated Aβ misfolding in combination with Aβ42/40 ratio as a prognostic tool for future clinical progression to mild cognitive impairment (MCI) or dementia due to Alzheimer’s disease (AD) in individuals with subjective cognitive decline (SCD).

Methods

Baseline plasma samples (n = 203) from SCD subjects in the SCIENCe project and Amsterdam Dementia Cohort (age 61 ± 9 years; 57% male, mean follow-up time 2.7 years) were analyzed using immuno-infrared-sensor technology. Within 6 years of follow-up, 22 (11%) individuals progressed to MCI or dementia due to AD. Sensor readout values > 1646 cm− 1 reflected normal Aβ folding; readouts at ≤ 1646 cm− 1 reflected low and at < 1644 cm− 1 high misfolding. We used Cox proportional hazard models to quantify Aβ misfolding as a prognostic biomarker for progression to MCI and dementia due to AD. The accuracy of the predicted development of MCI/AD was determined by time-dependent receiver operating characteristic (t-ROC) curve analyses that take individual follow-up and conversion times into account. Statistical models were adjusted for age, sex, and APOEε4 status. Additionally, plasma Aβ42/40 data measured by SIMOA were statistically analyzed and compared.

Results

All 22 patients who converted to MCI or AD-dementia within 6 years exhibited Aβ misfolding at baseline. Cox analyses revealed a hazard ratio (HR) of 19 (95% confidence interval [CI] 2.2–157.8) for future conversion of SCD subjects with high misfolding and of 11 (95% CI 1.0–110.1) for those with low misfolding. T-ROC curve analyses yielded an area under the curve (AUC) of 0.94 (95% CI 0.86–1.00; 6-year follow-up) for Aβ misfolding in an age, sex, and APOEε4 model. A similar model with plasma Aβ42/40 ratio yielded an AUC of 0.92 (95% CI, 0.82–1.00). The AUC increased to 0.99 (95% CI, 0.99–1.00) after inclusion of both Aβ misfolding and the Aβ42/40 ratio.

Conclusions

A panel of structure- and concentration-based plasma amyloid biomarkers may predict conversion to clinical MCI and dementia due to AD in cognitively unimpaired subjects. These plasma biomarkers provide a noninvasive and cost-effective alternative for screening early AD pathological changes. Follow-up studies and external validation in larger cohorts are in progress for further validation of our findings.
Anisotropic dynamic and static mechanical properties of organic-rich shale: The influence of stress
Authors: Wang Yang , Zhao Luanxiao , Han De-hua , Mitra Abhijit , Li Hui , Aldin Samir
Published: December 2020

Understanding the relationship between dynamic and static mechanical properties of organic-rich shales is crucial for successful in situ stress profile prediction and hydraulic fracturing stimulation in unconventional reservoirs. However, the relationship between dynamic and static properties remains ambiguous, considering the complex rock microstructure and subsurface stress environment. We have reported pseudotriaxial tests on a pair of outcrop Eagle Ford shale plugs, with the axial load applied perpendicular and parallel to bedding planes, to investigate the effects of intrinsic anisotropy and anisotropic stress on dynamic-static relationships. The bedding-parallel Young’s modulus is larger than the bedding-normal one dynamically and statically, whereas there exist complex relations among three static Poisson’s ratios, which are attributed to the intrinsic anisotropy induced by the lenticular texture and finely laminated alignment of kerogen. Along with a stress increment, static tests respond to superpositions of the elastic, viscoelastic, and nonelastic properties, whereas dynamic tests, with more than two orders of magnitude smaller strain amplitude, only reflect the elastic properties of rocks. As a result, the static properties characteristically exhibit more stress dependence than the dynamic properties. Moreover, the evolutions of static properties, especially two static Poisson’s ratios in the horizontal plug, are significantly influenced by the applied stress orientation with respect to the bedding plane. Lastly, we calculate four independent stiffnesses using the five static mechanical parameters with the assumption of transverse isotropy to compare with those calculated from ultrasonic velocities at different stress levels. Finally, when the deviatoric stress is approximately 20 MPa, static parameters derived from stress loading, unloading, and reloading almost intersect together. At this stress level, dynamic and static stiffnesses demonstrate a reasonable correlation with the fitting coefficient of approximately 1.4.
Impacto do Programa Academia da Saúde sobre gastos com internações hospitalares por doenças cerebrovasculares
Authors: Lima Rita de Cássia Franciele , Rodrigues Bárbara Letícia Silvestre , Farias Shirlley Jackllanny Martins de , Lippo Bruno Rodrigo Da Silva , Guarda Flávio Renato Barros da
Published: December 2020

O objetivo deste artigo é avaliar o impacto do Programa Academia da Saúde (PAS) sobre os gastos com internações hospitalares por doenças cerebrovasculares no estado de Pernambuco. Trata-se de uma avaliação de impacto de políticas públicas, desenvolvida através de uma abordagem quase-experimental que consiste na aplicação do método do pareamento por escore de propensão, tomando como referência os anos de 2010 e 2018. Para tanto, utilizou-se dados socioeconômicos, demográficos e epidemiológicos de 89 municípios que implantaram o programa (tratados) e de outros 52 que não implantaram (controles). Os dados foram obtidos no Departamento de Informática do Sistema Único de Saúde, Instituto Brasileiro de Geografia e Estatística e outras bases. O total de internações por doenças cerebrovasculares em 2010 foi de 6.091 e 10.595 em 2018. Os municípios que implantaram o PAS gastaram em média R$ 1.258,61 a menos com internações por doenças cerebrovasculares (p < 0,05) para cada grupo de 10 mil habitantes. O modelo econométrico proposto mostrou-se adequado para explicar o impacto do PAS sobre os gastos com internações hospitalares por doenças cerebrovasculares. A relação entre a implantação PAS e a diminuição do gasto nos permite inferir que essa intervenção tem cumprido com a sua diretriz de constituir-se como programa de referência para a promoção da saúde, prevenção e controle de doenças crônicas, e alcançado o seu objetivo específico de aumentar o nível de atividade física da população dos municípios beneficiários.
Technical Note—A Note on the Equivalence of Upper Confidence Bounds and Gittins Indices for Patient Agents
Authors: Russo Daniel
Published: December 2020

This note gives a short, self-contained proof of a sharp connection between Gittins indices and Bayesian upper confidence bound algorithms. I consider a Gaussian multiarmed bandit problem with discount factor [Formula: see text]. The Gittins index of an arm is shown to equal the [Formula: see text]-quantile of the posterior distribution of the arm's mean plus an error term that vanishes as [Formula: see text]. In this sense, for sufficiently patient agents, a Gittins index measures the highest plausible mean-reward of an arm in a manner equivalent to an upper confidence bound.
Role of cats in human toxocarosis
Authors: Castro Pablo David Jimenez , Sapp Sarah GH
Published: December 2020

Toxocara cati, the feline ascarid, is ubiquitous in domestic cats globally and is increasingly recognised as an important zoonotic species. In the definitive host, infections with the adult ascarid usually do not present any clinical signs; if clinical signs do appear, it is usually in kittens infected with T. cati, especially by the trans-mammary route. Diseases may include cachexia, a pot-bellied appearance, respiratory disorders, diarrhoea, vomiting, among other signs, and these may present as early as 3 weeks of age. However, infections with Toxocara spp. larvae in paratenic hosts (including humans and many other animals), can result in serious complications from the migration of larvae. Historically, there has been an assumption that Toxocara canis was the most likely cause of Toxocara spp.-related disease; while it is probably true that T. canis is responsible for the majority of infections, it is important that those caused by T. cati are accurately identified so that the contribution of this parasite to human disease can be established and then handled appropriately. Overall, the detection of infections in cats and the control of parasite stages in the environment are essential to minimise the infection risk to other animals or humans.
An Analysis of Errors and Misconceptions in the Study of Quadratic Equations
Authors: Tendere Jane , Mutambara Lillias H. N.
Published: December 2020

This study attempts to investigate the errors and misconception that form three students reveal using symbolic equation and word-problem representations. The participants were thirty form three students, from a high school in Zimbabwe. Three mathematics teachers from the same school also took part. Data was collected from the students through a questionnaire, a test, follow up interviews and semi-structured interviews. Semi structured interviews were also conducted with the three mathematics teachers. In data analysis, the students’ written responses and data from questionnaire were qualitatively analysed to determine the nature of the students’ errors when solving quadratic equations. The results revealed that the students had difficulties in solving symbolic quadratic equations by the factorisation method as well as the use of the quadratic formula such that many misconceptions were exposed. The following types of errors were revealed: conceptual, procedural and technical. It was found out that it is an advantage for teachers to teach students with the knowledge of these errors in an effort to eliminate them.
Effectiveness of maggot extractions and secretion (E/S) of Lucilia sericata in reducing wound surface in experimental scalding burn injury
Authors: Zahra Sadat Amiri  , Akbarzadeh Kamran , Douraghi Masoumeh , Abdi Khosrou M , Abbas Aghaei Afshar  , Jasem ghaffari  , Razieh shabani Kordshouli  , Akbari Morteza , Rafinejad Javad
Published: December 2020

Abstract. Amiri ZS, Akbarzadeh K, Douraghi M, Abdi KM, Afshar AA, Ghaffari J, Kordshouli RS, Akbari M, Rafinejad J. 2021. Effectiveness of maggot extractions and secretion (E/S) of Lucilia sericata in reducing wound surface in an experimental scalding burn injury. Nusantara Bioscience 13: 11-15. Lucilia sericata larvae have been successfully used as medicinal larvae for wound healing. This study was performed to evaluate the therapeutic effects of the primary ointment made from excretory-secretory substances of L.sericata larvae on experimental burn wounds on rabbits under laboratory conditions. Extraction of ES from the third stage of L.sericata larvae and antibiogram testing was done. Four rabbits were randomly divided into four groups; three standard third-grade burn wounds were created on the back of each rabbit for intervention groups (B, D) of wounds were used respectively from the original ointment made from ES and ES without accompanying material. Nitrofurazone ointment was used for the positive (C) and placebo ointment was used for the negative (A). On the 21st day, all scars of wounds in groups B and D were separated and the wound was free of infectious tissue, whereas in groups A and C that the scars were clinging to the base. The level of the ulcer was significantly lower in the E/S intervention group and the infectious tissue was not observed during the treatment of group B and D wounds. Methicillin-resistant Staphylococcus aureus (MRSA) did not show resistance to excretory-secretory substances of L. sericata larvae. The debridement and recovery process was faster in the ES-treated group and the initial ointment than in the control group. The results showed that maggot extractions and secretion (E/S) of L. sericata in reducing wound healing is appropriate for treatment.
Experimental analysis of the measurement precision of spectral water-leaving radiance in different water types
Authors: Wei Jianwei , Wang Menghua , Lee Zhongping , Ondrusek Michael , Zhang Shuai , Ladner Sherwin
Published: December 2020

The on-water radiometric approach employs a unique provision to obtain water-leaving radiance from nadir (Lw(λ)) which can be used for the calibration of ocean color satellites. In this effort, we address the measurement precision associated with Lw(λ) from a single on-water instrument, which is an important aspect of measurement uncertainty. First, we estimated the precision as the ratio of the standard deviation of the means of repeated measurements to the mean of these measurements. We show that the measurement precision for Lw(λ) is within 2.7–3.7% over 360–700 nm. The corresponding remote sensing reflectance spectra (Rrs(λ)) from the same instrument also exhibit a high precision of 1.9–2.8% in the same spectral domain. These measured precisions of radiance and reflectance over the 360–700 nm range are independent of the optical water type. Second, we quantified the consistency of on-water Lw(λ) and Rrs(λ) from two collocated systems for further insight into their measurement repeatability. The comparison reveals that Lw(λ) measurements in the 360–700 nm agree with each other with an absolute percentage difference of less than 3.5%. The corresponding Rrs(λ) data pairs are subjected to increased differences of up to 8.5%, partly due to variable irradiance measurements (Es(λ)). The evaluation of measurement precision corroborates the reliability of the on-water acquisition of radiometric data for supporting satellite calibration and validation.