bluuebunny/crossref_metadata_2025 huggingface dataset:
Data-driven CAD-CAM vs traditional total contact custom insoles: A novel quantitative-statistical framework for the evaluation of insoles offloading performance in diabetic foot
Authors: D’Amico Moreno , Kinel Edyta , Roncoletta Piero , Gnaldi Andrea , Ceppitelli Celeste , Belli Federico , Murdolo Giuseppe , Vermigli Cristiana
Published: March 2021

Background

Elevated plantar pressures represent a significant risk factor for neuropathic diabetic foot (NDF) ulceration. Foot offloading, through custom-made insoles, is essential for prevention and healing of NDF ulcerations. Objective quantitative evaluation to design custom-made insoles is not a standard method. Aims: 1) to develop a novel quantitative-statistical framework (QSF) for the evaluation and design of the insoles’ offloading performance through in-shoe pressure measurement; 2) to compare the pressure-relieving efficiency of traditional shape-based total contact customised insoles (TCCI) with a novel CAD-CAM approach by the QSF.

Methods

We recruited 30 neuropathic diabetic patients in cross-sectional study design. The risk-regions of interest (R-ROIs) and their areas with in-shoe peak pressure statistically ≥200kPa were identified for each patients’ foot as determined on the average of peak pressure maps ascertained per each stance phase. Repeated measures Friedman test compared R-ROIs’ areas in three different walking condition: flat insole (FI); TCCI and CAD-CAM insoles.

Results

As compared with FI (20.6±12.9 cm2), both the TCCI (7±8.7 cm2) and the CAD-CAM (5.5±7.3 cm2) approaches provided a reduction of R-ROIs mean areas (p<0.0001). The CAD-CAM approach performed better than the TCCI with a mean pressure reduction of 37.3 kPa (15.6%) vs FI.

Conclusions

The CAD-CAM strategy achieves better offloading performance than the traditional shape-only based approach. The introduced QSF provides a more rigorous method to the direct 200kPa cut-off approach outlined in the literature. It provides a statistically sound methodology to evaluate the offloading insoles design and subsequent monitoring steps. QSF allows the analysis of the whole foot’s plantar surface, independently from a predetermined anatomical identification/masking. QSF can provide a detailed description about how and where custom-made insole redistributes the underfoot pressure respect to the FI. Thus, its usefulness extends to the design step, helping to guide the modifications necessary to achieve optimal offloading insole performances.
Effect of Yttrium-90 transarterial radioembolization in patients with non-surgical hepatocellular carcinoma: A systematic review and meta-analysis
Authors: Lemieux Simon , Buies Alex , F. Turgeon Alexis , Hallet Julie , Daigle Gaétan , Côté François , Provencher Steeve
Published: March 2021

Background

Recently, the use of Yttrium-90 transarterial radioembolization in non-surgical hepatocellular carcinoma was suggested but the evidence supporting its use is unclear.

Methods

We searched Medline, Embase, Web of Science and Cochrane CENTRAL from inception up to April 14, 2020 for randomized controlled trials comparing Y90-TARE to standard of care in non-surgical HCC patients. Our primary outcome was overall survival (OS). Our secondary outcomes were progression-free survival, time to progression, disease control rate, grade ≥3 adverse events and rates of gastro-intestinal ulcers. Hazard ratios (HR) and risk ratios (RR) with random-effects model were used for our analyses. The risk of bias of the included studies was assessed using Cochrane’s RoB 2 tool.

Results

Of 1,604 citations identified, eight studies (1,439 patients) were included in our analysis. No improvement in overall survival were noted when Yttrium-90 transarterial radioembolization was compared to standard treatments (HR 0.99 [95% CI 0.81–1.21], 6 studies, I2 = 77.6%). However, Yttrium-90 transarterial radioembolization was associated with fewer grade ≥3 adverse events (RR 0.64 [95% CI 0.45–0.92], 7 studies, I2 = 66%). No difference was observed on other secondary outcomes.

Discussion

In non-surgical HCC patients, Yttrium-90 transarterial radioembolization was not associated with significant effect on survival, progression-free survival, time to progression, disease control rate and the incidence of gastro-intestinal ulcers but was however associated with significantly lower rates of grade ≥3 adverse events. Further randomized controlled trials are warranted to better delineate optimal treatment.
Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown
Authors: Xue Baowen , McMunn Anne
Published: March 2021

Objective

To describe how men and women divided childcare and housework demands during the height of the first Covid-19 lockdown in the UK, and whether these divisions were associated with worsening mental health during the pandemic.

Background

School closures and homeworking during the Covid-19 crisis have resulted in an immediate increase in unpaid care work, which draws new attention to gender inequality in divisions of unpaid care work.

Methods

Data come from the wave 9 (2017–19) of Understanding Society and the following April (n = 15,426) and May (n = 14,150) waves of Understanding Society Covid-19 study. Psychological distress was measured using the General Health Questionnaire (GHQ) at both before and during the lockdown, and unpaid care work was measured during the lockdown. Linear regression models were used.

Results

Women spent much more time on unpaid care work than men during lockdown, and it was more likely to be the mother than the father who reduced working hours or changed employment schedules due to increased time on childcare. Women who spent long hours on housework and childcare were more likely to report increased levels of psychological distress. Working parents who adapted their work patterns increased more psychological distress than those who did not. This association was much stronger if he or she was the only member in the household who adapted their work patterns, or if she was a lone mother. Fathers increased more psychological distress if they reduced work hours but she did not, compared to neither reducing work hours.

Conclusion

There are continued gender inequalities in divisions of unpaid care work. Juggling home working with homeschooling and childcare as well as extra housework is likely to lead to poor mental health for people with families, particularly for lone mothers.
Construction, characterization, and immunization of nanoparticles that display a diverse array of influenza HA trimers
Authors: Cohen Alexander A. , Yang Zhi , Gnanapragasam Priyanthi N. P. , Ou Susan , Dam Kim-Marie A. , Wang Haoqing , Bjorkman Pamela J.
Published: March 2021

Current influenza vaccines do not elicit broadly protective immune responses against multiple strains. New strategies to focus the humoral immune response to conserved regions on influenza antigens are therefore required for recognition by broadly neutralizing antibodies. It has been suggested that B-cells with receptors that recognize conserved epitopes would be preferentially stimulated through avidity effects by mosaic particles presenting multiple forms of a variable antigen. We adapted SpyCatcher-based platforms, AP205 virus-like particles (VLPs) and mi3 nanoparticles (NPs), to covalently co-display SpyTagged hemagglutinin (HA) trimers from group 1 and group 2 influenza A strains. Here we show successful homotypic and heterotypic conjugation of up to 8 different HA trimers to both VLPs and NPs. We characterized the HA-VLPs and HA-NPs by cryo-electron tomography to derive the average number of conjugated HAs and their separation distances on particles, and compared immunizations of mosaic and homotypic particles in wild-type mice. Both types of HA particles elicited strong antibody responses, but the mosaic particles did not consistently elicit broader immune responses than mixtures of homotypic particles. We conclude that covalent attachment of HAs from currently-circulating influenza strains represents a viable alternative to current annual influenza vaccine strategies, but in the absence of further modifications, is unlikely to represent a method for making a universal influenza vaccine.
The prognostic value of serum albumin levels and respiratory rate for community-acquired pneumonia: A prospective, multi-center study
Authors: Zhao Lili , Bao Jing , Shang Ying , Zhang Ying , Yin Lu , Yu Yan , Xie Yu , Chen Li , Zheng Yali , Xu Yu , Gao Zhancheng
Published: March 2021

Community-acquired pneumonia (CAP) is a respiratory disease frequently requiring hospital admission, and a significant cause of death worldwide. This study aimed to investigate the prognostic value of clinical indicators. A prospective, multi-center study was conducted (January 2017–December 2018) where patient demographic and clinical data were recorded (N = 366). The 30-day mortality rate was 5.46%. Cox Regression analyses showed that serum albumin (ALB) and respiratory rate (RR) were independent prognostic variables for 30-day survival in patients with CAP. Albumin negatively correlated with the Pneumonia Severity Index (PSI) and CURB-65 scores using Pearson and Spearman tests. Survival curves showed that a RR >24 breaths/min or ALB ≤30 g/L were associated with a significantly higher risk of mortality. The area-under-the-curve (AUC) for predicting 30-day mortality in patients with CAP was 0.762, 0.763, 0.790, and 0.784 for ALB, RR, PSI, and CURB-65, respectively. The AUC for the prediction of 30-day mortality using ALB combined with PSI, CURB-65 scores, and RR was 0.822 (95% CI 0.731–0.912), 0.847 (95% CI 0.755–0.938), and 0.847 (95% CI 0.738–0.955), respectively. Albumin and RR were found to be reliable prognostic factors for CAP. This combination showed equal predictive value when compared to adding ALB assessment to PSI and CURB-65 scores, which could improve their prognostic accuracy.
Egg recognition: The importance of quantifying multiple repeatable features as visual identity signals
Authors: Gómez Jesús , Gordo Oscar , Minias Piotr
Published: March 2021

Brood parasitized and/or colonial birds use egg features as visual identity signals, which allow parents to recognize their own eggs and avoid paying fitness costs of misdirecting their care to others’ offspring. However, the mechanisms of egg recognition and discrimination are poorly understood. Most studies have put their focus on individual abilities to carry out these behavioural tasks, while less attention has been paid to the egg and how its signals may evolve to enhance its identification. We used 92 clutches (460 eggs) of the Eurasian cootFulica atrato test whether eggs could be correctly classified into their corresponding clutches based only on their external appearance. Using SpotEgg, we characterized the eggs in 27 variables of colour, spottiness, shape and size from calibrated digital images. Then, we used these variables in a supervised machine learning algorithm for multi-class egg classification, where each egg was classified to the best matched clutch out of 92 studied clutches. The best model with all 27 explanatory variables assigned correctly 53.3% (CI = 42.6–63.7%) of eggs of the test-set, greatly exceeding the probability to classify the eggs by chance (1/92, 1.1%). This finding supports the hypothesis that eggs have visual identity signals in their phenotypes. Simplified models with fewer explanatory variables (10 or 15) showed lesser classification ability than full models, suggesting that birds may use multiple traits for egg recognition. Therefore, egg phenotypes should be assessed in their full complexity, including colour, patterning, shape and size. Most important variables for classification were those with the highest intraclutch correlation, demonstrating that individual recognition traits are repeatable. Algorithm classification performance improved by each extra training egg added to the model. Thus, repetition of egg design within a clutch would reinforce signals and would help females to create an internal template for true recognition of their own eggs. In conclusion, our novel approach based on machine learning provided important insights on how signallers broadcast their specific signature cues to enhance their recognisability.
Diffusion-weighted magnetic resonance imaging for the assessment of liver fibrosis in chronic viral hepatitis
Authors: Charatcharoenwitthaya Phunchai , Sukonrut Kamonthip , Korpraphong Pornpim , Pongpaibul Ananya , Saiviroonporn Pairash
Published: March 2021

Background

Accurate noninvasive methods for the assessment of liver fibrosis are urgently needed. This prospective study evaluated the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) for the staging of liver fibrosis and proposed a diagnostic algorithm using DWI to identify cirrhosis in patients with chronic viral hepatitis.

Methods

One hundred twenty-one treatment-naïve patients with chronic hepatitis B or C were evaluated with DWI followed by liver biopsy on the same day. Breath-hold single-shot echo-planar DWI was performed to measure the apparent diffusion coefficient (ADC) of the liver and spleen. Normalized liver ADC was calculated as the ratio of liver ADC to spleen ADC.

Results

There was an inverse correlation between fibrosis stage and normalized liver ADC (p<0.05). For the prediction of fibrosis stage ≥2, stage ≥3, and cirrhosis, the area under the receiver-operating curve of normalized liver ADC was 0.603, 0.704, and 0.847, respectively. The normalized liver ADC value ≤1.02×10−3 mm2/s had 88% sensitivity, 81% specificity, 25% positive predictive value (PPV), and 99% negative predictive value (NPV) for the diagnosis of cirrhosis. Using a sequential approach with the Fibrosis-4 index followed by DWI, normalized liver ADC ≤1.02×10−3 mm2/s in patients with Fibrosis-4 >3.25 yielded an 80% PPV for cirrhosis, and a 100% NPV to exclude cirrhosis in patients with Fibrosis-4 between 1.45 and 3.25. Only 15.7% of patients would require a liver biopsy. This sequential strategy can reduce DWI examinations by 53.7%.

Conclusion

Normalized liver ADC measurement on DWI is an accurate and noninvasive tool for the diagnosis of cirrhosis in patients with chronic viral hepatitis.
Land snail biogeography and endemism in south-eastern Africa: Implications for the Maputaland-Pondoland-Albany biodiversity hotspot
Authors: Perera Sandun J. , Herbert David G. , Procheş Şerban , Ramdhani Syd
Published: March 2021

Invertebrates in general have long been underrepresented in studies on biodiversity, biogeography and conservation. Boundaries of biodiversity hotspots are often delimited intuitively based on floristic endemism and have seldom been empirically tested using actual species distributions, and especially invertebrates. Here we analyse the zoogeography of terrestrial malacofauna from south-eastern Africa (SEA), proposing the first mollusc-based numerical regionalisation for the area. We also discuss patterns and centres of land snail endemism, thence assessing the importance and the delimitation of the Maputaland-Pondoland-Albany (MPA) biodiversity hotspot for their conservation. An incidence matrix compiled for relatively well-collected lineages of land snails and slugs (73 taxa in twelve genera) in 40 a priori operational geographic units was subjected to (a) phenetic agglomerative hierarchical clustering using unweighted pair-group method with arithmetic means (UPGMA), (b) parsimony analysis of endemicity (PAE) and biotic element analysis (BEA). Fulfilling the primary objective of our study, the UPGMA dendrogram provided a hierarchical regionalisation and identified five centres of molluscan endemism for SEA, while the PAE confirmed six areas of endemism, also supported by the BEA. The regionalisation recovers a zoogeographic province similar to the MPA hotspot, but with a conspicuous westward extension into Knysna (towards the Cape). The MPA province, centres and areas of endemism, biotic elements as well as the spatial patterns of species richness and endemism, support the MPA hotspot, but suggest further extensions resulting in a greater MPA region of land snail endemism (also with a northward extension into sky islands—Soutpansberg and Wolkberg), similar to that noted for vertebrates. The greater MPA region provides a more robustly defined region of conservation concern, with centres of endemism serving as local conservation priorities.
Development of a novel index to characterise arterial dynamics using ultrasound imaging
Authors: Ward Joel , Cheng Xinghao , Xiao Yingyi , Lapolla Pierfrancesco , Chandrashekar Anirudh , Handa Ashok , Cleveland Robin A. , Lee Regent
Published: March 2021

Abdominal aortic aneurysms (AAA) are associated with systemic inflammation and endothelial dysfunction. We previously reported flow mediated dilatation (FMD) of the brachial artery as a predictor of AAA growth. We hence hypothesised that other physical characteristics of the brachial artery correlate with AAA growth. Using a prospectively cohort of AAA patients, we devised a ‘brachial artery relaxation index’ (BARI) and examined its role as a biomarker for AAA growth. However, no correlation between BARI and future aneurysm growth was observed (p = 0.45). Therefore, our investigations did not substantiate the hypothesis that other physical characteristics of the brachial artery predicts AAA growth.
Oral health care professionals recommending and administering the HPV vaccine: Understanding the strengths and assessing the barriers
Authors: Guadiana Denise , Kavanagh Nolan M. , Squarize Cristiane H.
Published: March 2021

Introduction

Head and neck cancer is a deadly cancer that ranks among the six most common cancers worldwide. The HPV vaccine has been used to prevent head and neck cancer of the oropharynx, and changes in health policies and state law are impacting the role of dental professionals in HPV vaccination. However, relatively little is known about dental professionals’ attitudes regarding the vaccine.

Objectives

Our study assesses dental professionals’ willingness to administer the HPV vaccine, their confidence discussing HPV with patients, beliefs about the vaccine’s efficacy, perceived barriers to administering it, and sites of referral.

Methods

We surveyed 623 dental professionals, including dentists, hygienists, dental students, and hygiene students across Michigan. Attitudes toward the vaccine and predictive characteristics were evaluated by logistic regression, ANOVAs, and t-tests.

Results

The majority of the respondents (51% of dentists, 63% of hygienists, 82% of dental students, and 71% of hygiene students) were willing to administer the HPV vaccine if allowed by law. The role of dental and dental hygiene students would be one of advocacy, educating and recommending the vaccine, and the dental students administering it once licensed. Dental professionals were variably confident discussing HPV with patients and generally believed it enhanced patients’ health. Stronger confidence and beliefs were associated with greater willingness to administer the vaccine. Barriers among professionals opposing the HPV vaccine included lack of knowledge on the subject, liability concerns, and personal beliefs.

Conclusion

Dental professionals can become leaders in preventing HPV-related cancers. Training and continuing education courses could enhance their confidence and willingness to recommend and administer the HPV vaccine.

Policy implications

Legislation that permits dental professionals to administer the vaccine could increase the vaccine’s accessibility to patients, improve vaccination rates, and population health.
Radon-220 diffusion from 224Ra-labeled calcium carbonate microparticles: Some implications for radiotherapeutic use
Authors: Napoli Elisa , Bønsdorff Tina B. , Jorstad Ida Sofie , Bruland Øyvind S. , Larsen Roy H. , Westrøm Sara
Published: March 2021

Alpha-particle emitting radionuclides continue to be the subject of medical research because of their high energy and short range of action that facilitate effective cancer therapies. Radium-224 (224Ra) is one such candidate that has been considered for use in combating micrometastatic disease. In our prior studies, a suspension of224Ra-labeled calcium carbonate (CaCO3) microparticles was designed as a local therapy for disseminated cancers in the peritoneal cavity. The progenies of224Ra, of which radon-220 (220Rn) is the first, together contribute three of the four alpha particles in the decay chain. The proximity of the progenies to the delivery site at the time of decay of the224Ra-CaCO3microparticles can impact its therapeutic efficacy. In this study, we show that the diffusion of220Rn was reduced in labeled CaCO3suspensions as compared with cationic224Ra solutions, both in air and liquid volumes. Furthermore, free-floating lead-212 (212Pb), which is generated from released220Rn, had the potential to be re-adsorbed onto CaCO3microparticles. Under conditions mimicking anin vivoenvironment, more than 70% of the212Pb was adsorbed onto the CaCO3at microparticle concentrations above 1 mg/mL. Further, the diffusion of220Rn seemed to occur whether the microparticles were labeled by the surface adsorption of224Ra or if the224Ra was incorporated into the bulk of the microparticles. The therapeutic benefit of differently labeled224Ra-CaCO3microparticles after intraperitoneal administration was similar when examined in mice bearing intraperitoneal ovarian cancer xenografts. In conclusion, both the release of220Rn and re-adsorption of212Pb are features that have implications for the radiotherapeutic use of224Ra-labeled CaCO3microparticles. The release of220Rn through diffusion may extend the effective range of alpha-particle dose deposition, and the re-adsorption of the longer lived212Pb onto the CaCO3microparticles may enhance the retention of this nuclide in the peritoneal cavity.
Vegetative cells may perform nitrogen fixation function under nitrogen deprivation in Anabaena sp. strain PCC 7120 based on genome-wide differential expression analysis
Authors: He Hongli , Miao Runyu , Huang Lilong , Jiang Hongshan , Cheng Yunqing
Published: March 2021

Nitrogen assimilation is strictly regulated in cyanobacteria. In an inorganic nitrogen-deficient environment, some vegetative cells of the cyanobacteriumAnabaenadifferentiate into heterocysts. We assessed the photosynthesis and nitrogen-fixing capacities of heterocysts and vegetative cells, respectively, at the transcriptome level. RNA extracted from nitrogen-replete vegetative cells (NVs), nitrogen-deprived vegetative cells (NDVs), and nitrogen-deprived heterocysts (NDHs) inAnabaenasp. strain PCC 7120 was evaluated by transcriptome sequencing. Paired comparisons of NVs vs. NDHs, NVs vs. NDVs, and NDVs vs. NDHs revealed 2,044 differentially expressed genes (DEGs). Kyoto Encyclopedia of Genes and Genomes enrichment analysis of the DEGs showed that carbon fixation in photosynthetic organisms and several nitrogen metabolism-related pathways were significantly enriched. Synthesis ofGvp(Gas vesicle synthesis protein gene) in NVs was blocked by nitrogen deprivation, which may causeAnabaenacells to sink and promote nitrogen fixation under anaerobic conditions; in contrast, heterocysts may perform photosynthesis under nitrogen deprivation conditions, whereas the nitrogen fixation capability of vegetative cells was promoted by nitrogen deprivation. Immunofluorescence analysis of nitrogenase iron protein suggested that the nitrogen fixation capability of vegetative cells was promoted by nitrogen deprivation. Our findings provide insight into the molecular mechanisms underlying nitrogen fixation and photosynthesis in vegetative cells and heterocysts at the transcriptome level. This study provides a foundation for further functional verification of heterocyst growth, differentiation, and water bloom control.
The unfolded protein response plays dual roles in rice stripe virus infection through fine-tuning the movement protein accumulation
Authors: Li Chenyang , Xu Yi , Fu Shuai , Liu Yu , Li Zongdi , Zhang Tianze , Wu Jianxiang , Zhou Xueping
Published: March 2021

The movement of plant viruses is a complex process that requires support by the virus-encoded movement protein and multiple host factors. The unfolded protein response (UPR) plays important roles in plant virus infection, while how UPR regulates viral infection remains to be elucidated. Here, we show that rice stripe virus (RSV) elicits the UPR in Nicotiana benthamiana. The RSV-induced UPR activates the host autophagy pathway by which the RSV-encoded movement protein, NSvc4, is targeted for autophagic degradation. As a counteract, we revealed that NSvc4 hijacks UPR-activated type-I J-domain proteins, NbMIP1s, to protect itself from autophagic degradation. Unexpectedly, we found NbMIP1 stabilizes NSvc4 in a non-canonical HSP70-independent manner. Silencing NbMIP1 family genes in N. benthamiana, delays RSV infection, while over-expressing NbMIP1.4b promotes viral cell-to-cell movement. Moreover, OsDjA5, the homologue of NbMIP1 family in rice, behaves in a similar manner toward facilitating RSV infection. This study exemplifies an arms race between RSV and the host plant, and reveals the dual roles of the UPR in RSV infection though fine-tuning the accumulation of viral movement protein.
Speaking with Suhasini Mulay: A short story about a long strife
Authors: Mukherjee Madhuja
Published: March 2021

This article is connected to my project concerning the Indian film industry, questions of work and women’s labour; and, this interview-based article grows from my ongoing audio-visual documentary work tentatively titled The Shadow and The Arc Light. It enables me to reflect upon my previous book project, and takes shape in the light of contemporary feminist historiography. Suhasini Mulay began her career as an actor with Bhuvan Shome (Mrinal Sen 1969), and thereafter, shifted to filmmaking and obtained technical training from McGill University, Montreal. Upon her homecoming she initially worked with the International Film Festival of India, and later assisted Satyajit Ray (for Jana Aranya [1975]) and Mrinal Sen (for Mrigayaa [1976]). While Mulay has made documentaries, and also acted in Bhavni Bhavai (Ketan Mehta 1980), she eventually resumed full-time acting in 1999. As narrated by her, she endured hierarchical, gendered and precarious work conditions, which inform us about the arduous production milieu. Through such conversations, I propose gender as a lens for studying film history, and underscore filmmaking as labour; as well, analyse the nature of filmic work. I aspire to demonstrate how women involved in various capacities, negotiate networks of media forms and capital, and persist perilously.
Az intellektuális tőke mérésének és értékelésének különválasztása értékelő függvények alkalmazásával
Authors: Jónás Tamás , Dombi József , Tóth Zsuzsanna Eszter
Published: March 2021

A tanulmány alapgondolata az intellektuális tőke mérésének és értékelésének különválasztása értékelő és abból származtatott hasznosság függvények alkalmazásával az intellektuális tőkeelemek mutatószámrendszer alapú méréseiből kiindulva. A szerzők megközelítése lehetővé teszi, hogy a mérőrendszer által szolgáltatott mértékeket felülértékeljék a vállalat értékrendjét megtestesítő értékelő függvények segítségével. Ez utóbbi paramétereinek megfelelő kalibrálásával a vállalat intellektuális tőkeelemekre vonatkozó preferenciái jutnak kifejezésre, ezért a felülértékelés eredményeként az intellektuális tőkeelemek vállalati értékének egy jobb közelítését eredményezik.
Kommunikációs és kapcsolati tényezők jelentősége az egészségügyi szolgáltatások minőségében
Authors: Vajda Beáta
Published: March 2021

A tanulmány célja, hogy egy szekunder kutatásra alapozva áttekintetést adjon az orvos-beteg kommunikáció elméleti hátteréről, a kommunikáció és az egészségügyi (pácienshez kapcsolódó) kimenetek közvetlen, valamint az együttműködés és az észlelt minőség által összekötött közvetett kapcsolatáról. Ez azért fontos, mert a kapcsolat a kommunikáció és az objektíven mérhető kimenetek (például egészségügyi állapot javulása) között – amelyeknek komoly gazdasági következményei is vannak – alátámasztja azt a feltételezést, hogy az orvos-beteg kommunikáció kutatására szükség van az egészségügy berkein kívül is. A felvázolt elméleti háttér segítségével pedig olyan modell kialakítása a cél, amely alapul szolgálhat egy későbbi primer kutatásnak.
Aplicação do índice de qualidade de aterros nos locais de disposição final dos resíduos sólidos urbanos na Bacia do Alto Taquari
Authors: Santos Cleiton Oliveira dos , Carelli Maeli Machado do Nascimento
Published: March 2021

O gerenciamento adequado dos resíduos sólidos é uma preocupação crescente dos órgãos ambientais, pois o volume de resíduos produzidos pelas diferentes atividades antrópicas, sem destinação adequada, compromete a qualidade do meio ambiente. No Brasil, é recente a preocupação com o tratamento e a disposição final dos resíduos sólidos. Este trabalho aplicou o Índice de Qualidade de Aterros de Resíduos nos municípios da bacia do Alto Taquari no estado de Mato Grosso do Sul e a partir dos resultados, propor ações para melhoria das situações inadequadas. A aplicação do Índice de Qualidade de Aterro de Resíduos (IQR) desenvolvido pela Companhia de Tecnologia de Saneamento Ambiental do Estado de São Paulo (CETESB) foi realizada por meio de visitas nos locais de disposição final e a partir da avaliação foi perceptível que a grande maioria dos municípios ainda utilizam lixões como local de disposição final, esse fato repercutiu no baixo índice em oito cidades e apenas um aterro apresentou índice alto.
Antiviral Therapy Reduces Risk of Cirrhosis in Noncirrhotic HBV Patients Among 4 Urban Safety-Net Health Systems
Authors: Wong Robert J. , Jain Mamta K. , Therapondos George , Niu Bolin , Kshirsagar Onkar , Thamer Mae
Published: March 2021

INTRODUCTION:

To evaluate the impact of chronic hepatitis B virus infection (CHB) treatment on risk of cirrhosis, liver-related outcomes, and death among a diverse CHB cohort with a large proportion of African Americans.

METHODS:

Adults with noncirrhotic CHB without human immunodeficiency virus from 2010 to 2018 were retrospectively evaluated across 4 US safety-net health systems. CHB was identified with International Classification of Diseases, Ninth Revision/Tenth Revision diagnosis coding and confirmatory laboratory data. Propensity-score matching, Kaplan-Meier methods, and adjusted Cox proportional hazards models were used to evaluate impact of CHB treatment on risk of cirrhosis, hepatocellular carcinoma (HCC), death, and composite of cirrhosis, HCC, or death.

RESULTS:

Among 4,064 CHB patients (51.9% female, 42.0% age <45 years, 31.6% African American, 26.6% Asian, 26.7% Hispanic), 23.2% received CHB antiviral therapy and 76.8% did not. Among the propensity score–matched cohort (428 treated and 428 untreated), CHB treatment was associated with lower risk of cirrhosis (hazards ratio 0.65, 95% confidence interval 0.46–0.92, P = 0.015) and composite of cirrhosis, HCC, or death (hazards ratio 0.67, 95% confidence interval 0.49–0.94, P = 0.023). Females vs males and African Americans vs non-Hispanic whites had significantly lower risk of cirrhosis. When treatment effects were stratified by age, sex, and ethnicity, the benefits of antiviral therapies in reducing risk of cirrhosis were seen primarily in CHB patients who were females, age <45 years, and of Asian ethnicity.

DISCUSSION:

Our propensity score–matched cohort of noncirrhotic CHB patients demonstrated significant reductions in risk of cirrhosis due to CHB treatment.
The Three Villages of Hepatic Encephalopathy
Authors: Bajaj Jasmohan S.
Published: March 2021

Hepatic encephalopathy (HE) affects numerous stakeholders from a clinical, psychosocial, and financial perspective. The multilayered impact of HE is threefold and affects different groups or, for the purpose of this commentary, villages. The first village mediates HE development, including genetics, microbiome, and disease severity. The second village consists of those affected by HE-related consequences, including the patient, caregivers, society, and medical system. The third village required to manage HE includes a multidisciplinary team of inpatient and outpatient providers, mental health experts, physical therapists, and dietary specialists. Understanding and integration of these three villages can encourage individualized care for patients and families affected by hepatic encephalopathy.
Craft and Artisan Initiatives of the Salvadoran Civil War (1980–1992)
Authors: Velis Emilio , Samson Kate , Robles Isaac , Rodríguez Daniel
Published: March 2021

This article describes the testimonies of two arts and crafts collectives during the Salvadoran Civil War in the 1980s. These collectives, open to victims and refugees of the war, emerged as creative spaces during a time of significant social unrest. As participants learned to make and produce arts and crafts, these activities encouraged individual expression and allowed them to heal traumatic experiences. By describing the aspects that motivated and discouraged the involvement of participants over time, we show how the individual and collective aspects of making are important for the sustained participation of the people who engage in maker culture. We draw comparisons between the struggles of these historical movements and of current embodiments of the maker culture, in order to draw conclusions regarding how making can be a personal catalyst in the face of social hardship, the importance of economic sustainability in maker initiatives and how unjust gender dynamics take place in these spaces. The ability to compare and learn from these historical initiatives serves to unpack maker culture as a social asset that can be described beyond the mere use of digital tools and to repurpose it as a more inclusive concept that takes into account narratives from a broader range of expressions of making.
From Hacking to Making
Authors: Cuartielles Ruiz David , García Sáez César
Published: March 2021

This article explores the history of contemporary Spanish Do-It- Yourself (DIY) spaces (hacklabs, hackerspaces, fab labs, makerspaces and after-school academies) and the growth of each type since the 1990s. The development of these types of spaces is reflected against the commodification and commoditisation of DIY in Spain. The article argues that the removal of the political layer of the early Spanish DIY techno-tactical movements allowed a higher degree of dissemination within society in general, while reducing the emancipatory potential of these new spaces. However, the analysis of the degree of commodification and commoditisation of types of spaces in relation to the amount of spaces per type shows an anomaly for makerspaces. The authors reflect upon this anomaly and whether a data set enlargement could correct it. For their analysis, the authors constructed a data set of events of the Spanish DIY history through the design of an ad hoc mixed method. Tracing events and spaces could not be done in a simple way due to the long time span of the study: older spaces existed in the pre-social network days, and new ones exist only in dedicated platforms for niche communities of practice. This method of tracing events and spaces is another contribution of the article as it could be used to make similar causality analyses of historical data in other case studies.
Renal elastography measurements in children with acute glomerulonephritis
Authors: Yoǧurtçuoǧlu Burak , Damar Çaǧrı
Published: March 2021

Purpose: The aim of this study was to compare the acoustic radiation force impulse elastography (ARFI-e) values of the renal cortical parenchyma in children with acute glomerulonephritis (AGN) and healthy children, and to determine a cut-off point for the diagnosis of AGN.Methods: This prospective study included 30 children with biopsy-proven AGN and 30 healthy children. All the children underwent renal ARFI-e measurements. Values were obtained from the upper, middle, and lower zones of the right kidney parenchyma. A total of nine ARFI-e measurements (three from each zone) were made. Statistical analyses were conducted of the mean elastography values (MEVs) of the children in both groups.Results: In the patient group, the MEVs measured from the upper, middle and lower zones of the right kidney were 3.42±0.42 m/s, 3.45±0.45 m/s, and 3.39±0.39 m/s (average, 3.42±0.34 m/s), respectively. In the healthy control group, the MEVs measured from the upper, middle, and lower zones of the right kidney were 2.85±0.63 m/s, 2.85±0.68 m/s, and 2.86±0.66 m/s (average, 2.85±0.57 m/s), respectively. The MEVs in all zones were significantly higher in the patient group than in the healthy group (P<0.001). The cut-off values determined to predict AGN in the upper, middle, and lower zones of the kidney were 2.74 m/s (sensitivity, 96.67%; specificity, 46.67%), 2.71 m/s (sensitivity, 96.67%; specificity, 53.33%), and 2.81 m/s (sensitivity, 93.33%; specificity, 56.67%), respectively.Conclusion: The ARFI-e technique can be considered as a non-invasive, easily applicable, auxiliary method for the early diagnosis of AGN.
Actualización y manejo clínico de los anticuerpos anti-ácido desoxirribonucleico
Authors: González Rodríguez Concepción , Aparicio Hernández M. Belén , Alarcón Torres Inmaculada
Published: March 2021

Los anticuerpos contra el ácido desoxirribonucleico [DNA] en el laboratorio clínico, están íntimamente ligados al diagnóstico y monitorización del lupus eritematoso sistémico [LES]; no obstante, las características de los métodos analíticos y las propiedades de los propios anticuerpos son heterogéneas Revisar la definición y propiedades de los anticuerpos anti-DNA de doble cadena [anti-dsDNA], la adecuación de los métodos analíticos y los requerimientos clínicos para este biomarcador. A través de PubMed se investiga la bibliografía existente con los términos anti-dsDNA, editorial, review, guideline, meta-analysis y LES. La última búsqueda, anti-dsDNA y LES restringuida a los últimos dos años. Se amplía información a través de artículos relacionados y los publicados en organismos oficiales estatales relacionados con anti-dsDNA y LES. Se analizan los métodos del laboratorio clínico para el análisis de los anti-dsDNA y sus características. Se revisa la utilidad clínica de los anti-dsDNA en sus aspectos diagnóstico, de asociación clínica y seguimiento del LES. Existe una amplia variabilidad en los métodos analíticos y persisten déficits en la estandarización. Forman parte de los criterios actuales clasificatorios de LES y se utilizan como marcadores en el seguimiento de la enfermedad. La utilidad diagnóstica mejora cuando se determinan en pacientes con ANA positivos. En el seguimiento, es interesante la cuantificación, preferiblemente con el mismo método analítico (dado los déficits de estandarización).
Prozesskomposition in verteilten Automatisierungssystemen
Authors: Schweizer Hartmut , Braunisch Nico , Alt Raphael , Schmitz Katharina , Wollschlaeger Martin
Published: March 2021

Die aktuellen Entwicklungen in der Automation führen zu einer zunehmenden Dezentralisierung der Steuerung und Organisation der eingesetzten Maschinen bzw. Komponenten. Dies betrifft auch die an der Fertigung beteiligten Prozesse und stellt neue Ansprüche an deren Ablauforganisation in einer flexibel zusammengeschalteten Komponenten-Struktur. Der vorliegende Beitrag stellt hierzu einen Ansatz auf Basis der IEC-62264-Implementierung B2MML vor. Mittels Verwaltungsschalen wurde basierend auf diesem Ansatz innerhalb des Projektes „Funktionsnachweis der Interoperabilität von fluidtechnischen Komponenten am Beispiel von Plug-and-Produce“ die automatisierte Inbetriebnahme eines pneumatischen Handling-Systems realisiert.
Expressing uncertainty in neural networks for production systems
Authors: Multaheb Samim Ahmad , Zimmering Bernd , Niggemann Oliver
Published: March 2021

The application of machine learning, especially of trained neural networks, requires a high level of trust in their results. A key to this trust is the network’s ability to assess the uncertainty of the computed results. This is a prerequisite for the use of such networks in closed-control loops and in automation systems. This paper describes approaches for enabling neural networks to automatically learn the uncertainties of their results.
Using machine learning to identify clotted specimens in coagulation testing
Authors: Fang Kui , Dong Zheqing , Chen Xiling , Zhu Ji , Zhang Bing , You Jinbiao , Xiao Yingjun , Xia Wenjin
Published: March 2021

Objectives

A sample with a blood clot may produce an inaccurate outcome in coagulation testing, which may mislead clinicians into making improper clinical decisions. Currently, there is no efficient method to automatically detect clots. This study demonstrates the feasibility of utilizing machine learning (ML) to identify clotted specimens.

Methods

The results of coagulation testing with 192 clotted samples and 2,889 no-clot-detected (NCD) samples were retrospectively retrieved from a laboratory information system to form the training dataset and testing dataset. Standard and momentum backpropagation neural networks (BPNNs) were trained and validated using the training dataset with a five-fold cross-validation method. The predictive performances of the models were then assessed based on the testing dataset.

Results

Our results demonstrated that there were intrinsic distinctions between the clotted and NCD specimens regarding differences in the testing results and the separation of the groups (clotted and NCD) in the t-SNE analysis. The standard and momentum BPNNs could identify the sample status (clotted and NCD) with areas under the ROC curves of 0.966 (95% CI, 0.958–0.974) and 0.971 (95% CI, 0.9641–0.9784), respectively.

Conclusions

Here, we have described the application of ML algorithms in identifying the sample status based on the results of coagulation testing. This approach provides a proof-of-concept application of ML algorithms to evaluate the sample quality, and it has the potential to facilitate clinical laboratory automation.
Evaluation of the performance of immunoblot and immunodot techniques used to identify autoantibodies in patients with autoimmune diseases
Authors: EL Hassouni Youssef , Bourhia Mohammed , Bari Ahmed , Ullah Riaz , Mahmood Hafiz Majid , Ali Syed Saeed , Ibenmoussa Samir , Brahim Admou
Published: March 2021

Autoimmune diseases are pathological conditions in which the immune system mistakenly attacks its own tissues. This study evaluates the performance of two techniques, which are identifiers of autoantibody specifics: immunoblot and immunodot. This study was conducted in 300 patients of whom 62 were tested positive for antinuclear antibodies. The patients were initially screened for antinuclear antibodies using indirect immunofluorescence. Then, the identification of specific autoantibodies such as anti-extractable nuclear antigens (ENAs) was carried out using the immunoblot and immunodot techniques. The results showed that immunoblot and immunodot did not present a significant difference in their sensitivity against anti-SSA/52, SSB, CENP-B, PCNA, U1-snRNP, Jo-1, Pm-scl, and Mi-2 (p > 0.05). However, the two techniques showed a significant difference in their sensitivity toward autoantibodies anti-DNAn, anti-histone, anti-SmD1, and anti-ds-DNA (p < 0.05). The immunoblot data were in complete accordance with the immunodot data (100%) regarding the detection of autoantibodies such as anti SSA/52, SSB, CENP-B, PCNA, U1-snRP, Jo-1, Pm-scl, and Mi-2, 80% regarding SmD1, and 75% concerning ds-DNA. We should certainly pay closer attention to the efficiency of the techniques used in the diagnosis of autoimmune diseases.
Full spectrum and genetic algorithm-selected spectrum-based chemometric methods for simultaneous determination of azilsartan medoxomil, chlorthalidone, and azilsartan: Development, validation, and application on commercial dosage form
Authors: Darwish Hany W. , Al Majed Abdulrahman A. , Al-Suwaidan Ibrahim A. , Darwish Ibrahim A. , Bakheit Ahmed H. , Al-Shehri Hassan H.
Published: March 2021

Five various chemometric methods were established for the simultaneous determination of azilsartan medoxomil (AZM) and chlorthalidone in the presence of azilsartan which is the core impurity of AZM. The full spectrum-based chemometric techniques, namely partial least squares (PLS), principal component regression, and artificial neural networks (ANN), were among the applied methods. Besides, the ANN and PLS were the other two methods that were extended by genetic algorithm procedure (GA-PLS and GA-ANN) as a wavelength selection procedure. The models were developed by applying a multilevel multifactor experimental design. The predictive power of the suggested models was evaluated through a validation set containing nine mixtures with different ratios of the three analytes. For the analysis of Edarbyclor® tablets, all the proposed procedures were applied and the best results were achieved in the case of ANN, GA-ANN, and GA-PLS methods. The findings of the three methods were revealed as the quantitative tool for the analysis of the three components without any intrusion from the co-formulated excipient and without prior separation procedures. Moreover, the GA impact on strengthening the predictive power of ANN- and PLS-based models was also highlighted.
Triplets, quads and quints: Estimating disaggregate trade elasticities with different odds ratios
Authors: Bohlmann Adrienne Margarete
Published: March 2021

Trade elasticities are a crucial variable for research on international trade. Caliendo and Parro (2015) provide a novel method to estimate trade elasticities which is based on odds ratio triplets calculated from structural gravity equations. We find that these odds ratios can be set up not only as triplets, but also e. g. as quadruplets (quads) and quintuples (quints). We estimate trade elasticities from triplets, quads and quints for the two digit level of ISIC Rev.3. The corresponding estimates show certain differences, but the results are generally robust. Because the different odds ratios are all theoretically validated, we suggest using them for checking robustness. Benefits could also arise because larger odds ratios might be able to provide more reliable estimates.
An application of continuous flow microreactor in the synthesis and extraction of rabeprazole
Authors: Duan Zhenya , Wang Yan , Zhang Ling , Cao Xing , Fu Lihua , Li Zhenjiang , Zhang Junmei
Published: March 2021

The oxidation of rabeprazole sulfide is a key step in the synthesis of rabeprazole, a drug for the treatment of stomach acid-related disorders. The current rabeprazole production process adopts one pot batch process, which has low reaction efficiency and poor stability. A continuous process can greatly improve the production efficiency and solve the above problems. Therefore, the reaction parameters of rabeprazole in microreactor were explored through laboratory experiments to explore the possibility of continuous production of rabeprazole. Rabeprazole sodium was synthesized by using rabeprazole thioether as a raw material and sodium hypochlorite solution as the oxidant. Oxidation, quenching, acid-base regulation and extraction were completed continuously in the microreactor. Rabeprazole solution with a purity of 98.78% (±0.13%) can be obtained continuously in 56 s, whereas intermittent production lasted for at least 2 h. Thus, the microreactor can effectively improve the oxidation synthesis efficiency of rabeprazole, and provide reference for the realization of other reactions in the microreactor.
Foam drainage enhancement in foam fractionation for dye removal: process optimization by Taguchi methodology and grey relational analysis
Authors: Bharadwaj Tarun , Gupta Kaushal Naresh
Published: March 2021

The isolation of dye (methylene blue) by employing a foam fractionation technique with the assistance of a surfactant (sodium dodecyl sulfate) has been dealt with in this paper. This study also incorporated the comparison between contrasted and experimental columns. Taguchi methodology and grey relational analysis techniques were used to ascertain optimal conditions at which the column should be operated to achieve maximum percentage removal and enrichment ratio, for both the columns. The analysis of variance study suggested dye concentration to be the most influencing parameter. The relationship between dye concentration in the bulk phase and the foam phase was also deduced.