bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurses’ perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: a qualitative study
Authors: Banda Zione , Simbota Mirriam , Mula Chimwemwe
Published: June 2022

Background

The Malawi health system has taken numerous actions to reduce high nurse workloads, despite this, shortage of nurses especially in critical care settings still persists due to lack of prioritisation of critical care. Therefore, it is important to understand the effects of high nursing workload in Intensive Care Unit (ICU). This study aimed at exploring the perceptions of nurses regarding the effects of high nursing workload on patient care in ICU at Queen Elizabeth Central Hospital.

Methods

This qualitative descriptive study was conducted in a general ICU at Queen Elizabeth Central Hospital in Blantyre, Malawi. A purposive sample of 12 nurses working in the ICU was selected. Participants included full-time nurses working in the ICU. A total of 10 In-depth interviews were conducted to collect data upon which data saturation was reached. A semi-structured interview guide was used for data collection. Data was analysed manually using thematic analysis method by Braun & Clarke.

Results

Study findings indicated that high nursing workload compromises the delivery of quality nursing care to critically ill patients, compromises patient safety and has negative impact on nurses’ wellbeing.

Conclusion

The study findings portray that nurses are aware of the negative effects that high nursing workload has on patient care. The study findings support the need for more ICU nurses in order to reduce nurse workloads and the need for nurse managers and policy makers to develop strategies to manage nurse workloads and its effects on patient care.
The adverse effect of the COVID-19 pandemic on health service usage among patients with type 2 diabetes in North Karelia, Finland
Authors: Inglin Laura , Wikström Katja , Lamidi Marja-Leena , Laatikainen Tiina
Published: June 2022

Aims

The COVID-19 pandemic has challenged health systems and their capacity to deliver essential health services while responding to COVID-19. This study examines the pandemic’s impact on health service usage among patients with type 2 diabetes in the North Karelia region, in Finland.

Methods

This retrospective cohort study used electronic health records of 11,458 type 2 diabetes patients, comprising all primary and specialised care contacts in 2019 and 2020. We analysed diabetes and dental healthcare contacts to primary care nurses, doctors and dentists and all emergency visits in specialised care. We compared healthcare usage in three different periods in 2020 (pre-lockdown [1 January–15 March], lockdown [16 March–31 May], post-lockdown [1 June–31 December]) with the equivalent period in 2019.

Results

During the lockdown period, the number of diabetes-related contacts decreased significantly but quickly increased again to nearly the same level as in 2019. Overall, healthcare usage was lower in the pandemic year, with proportionally 9% fewer contacts per person (mean 2.08 vs 2.29) and a proportionally 9% lower proportion of patients making any contact (59.9% vs 65.8%). The proportion of remote consultations was similar in both years in the pre-lockdown period (56.3–59.5%) but then increased to 88.0% during the 2020 lockdown. Patterns were similar when analysed by age group and gender. Emergency visits went down significantly at the beginning of the lockdown period, but a “rebound effect” was observed, so after the lockdown, the number of emergency visits in 2020 exceeded the numbers of the previous year.

Conclusion

Despite the COVID-19 pandemic, diabetes care was continuous, and even elderly patients aged ≥70 years accessed the health services. The delivery of many essential services was facilitated by processes that strongly relied on telemedicine already before the pandemic.
Preparing for colorectal surgery: a qualitative study of experiences and preferences of patients in Western Canada
Authors: Wang Rebecca , Yao Christopher , Hung Stanley H. , Meyers Logan , Sutherland Jason M. , Karimuddin Ahmer , Campbell Kristin L. , Conklin Annalijn I.
Published: June 2022

Objectives

The burden and costs of abdominal surgery for chronic conditions are on the rise, but could be reduced through self-management support. However, structured support to prepare for colorectal surgery is not routinely offered to patients in Canada. This study aimed to describe experiences and explore preferences for multimodal prehabilitation among colorectal surgery patients.

Methods

A qualitative descriptive study using three focus groups (FG) was held with 19 patients who had a surgical date for abdominal surgery (April 2017-April 2018) and lived close (≤ 50 km radius) to a tertiary hospital in Western Canada (including a Surgical Lead for the British Columbia Enhanced Recovery After Surgery (ERAS) Collaborative). FGs were audio-taped and verbatim transcribed with coding and pile-and-sort methods performed by two independent reviewers, confirmed by a third reviewer, in NVivo v9 software; followed by thematic analysis and narrative synthesis.

Results

Four themes emerged: support, informed decision-making, personalization of care, and mental/emotional health, which patients felt was particularly important but rarely addressed. Patient preferences for prehabilitation programming emphasised regular support from a single professional source, simple health messages, convenient access, and flexibility.

Conclusions

There is an unmet need for structured preoperative support to better prepare patients for colorectal surgery. Future multimodal prehabilitation should be flexible and presented with non-medical information so patients can make informed decisions about their preoperative care and surgical outcomes. Healthcare providers have an important role in encouraging healthy lifestyle changes before colorectal surgery, though clearer communication and accurate advice on self-care, particularly mental health, are needed for improving patient outcomes.
CircSTX6 promotes pancreatic ductal adenocarcinoma progression by sponging miR-449b-5p and interacting with CUL2
Authors: Meng Lingdong , Zhang Yihan , Wu Pengfei , Li Danrui , Lu Yichao , Shen Peng , Yang Taoyue , Shi Guodong , Chen Qun , Yuan Hao , Ge Wanli , Miao Yi , Tu Min , Jiang Kuirong
Published: June 2022

Background

circular RNAs (circRNAs) have been reported to play crucial roles in the biology of different cancers. However, little is known about the function of circSTX6 (hsa_circ_0007905) in pancreatic ductal adenocarcinoma (PDAC).

Methods

circSTX6, a circRNA containing exons 4, 5, 6 and 7 of the STX6 gene, was identified by RNA sequencing and detected by quantitative reverse transcription PCR (qRT–PCR). The biological function of circSTX6 was assessed in vitro and in vivo. The relationship between circSTX6 and miR-449b-5p was confirmed by biotin-coupled circRNA capture, fluorescence in situ hybridization (FISH) and luciferase reporter assays. The interaction of circSTX6 with Cullin 2 (CUL2) was verified by RNA–protein RNA pull-down, RNA immunoprecipitation (RIP) and western blotting assays.

Results

circSTX6 was frequently upregulated in PDAC tissues, and circSTX6 overexpression promoted tumor proliferation and metastasis both in vitro and in vivo. Furthermore, circSTX6 expression was associated with tumor differentiation and N stage. Mechanistically, circSTX6 regulated the expression of non-muscle myosin heavy chain 9 (MYH9) by sponging miR-449b-5p. Moreover, circSTX6 was confirmed to participate in the ubiquitin-dependent degradation of hypoxia-inducible factor 1-alpha (HIF1A) by interacting with CUL2 and subsequently accelerating the transcription of MYH9.

Conclusions

Our findings indicate that circSTX6 facilitates proliferation and metastasis of PDAC cells by regulating the expression of MYH9 through the circSTX6/miR-449b-5p axis and circSTX6/CUL2/HIF1A signaling pathway. Therefore, circSTX6 could serve as a potential therapeutic target for the treatment of PDAC.
Kinematics of the head and associated vertebral artery length changes during high-velocity, low-amplitude cervical spine manipulation
Authors: Gorrell Lindsay M. , Kuntze Gregor , Ronsky Janet L. , Carter Ryan , Symons Bruce , Triano John J. , Herzog Walter
Published: June 2022

Background

Cervical spine manipulation (CSM) is a frequently used treatment for neck pain. Despite its demonstrated efficacy, concerns regarding the potential of stretch damage to vertebral arteries (VA) during CSM remain. The purpose of this study was to quantify the angular displacements of the head relative to the sternum and the associated VA length changes during the thrust phase of CSM.

Methods

Rotation and lateral flexion CSM procedures were delivered bilaterally from C1 to C7 to three male cadaveric donors (Jan 2016–Dec 2019). For each CSM the force–time profile was recorded using a thin, flexible pressure pad (100–200 Hz), to determine the timing of the thrust. Three dimensional displacements of the head relative to the sternum were recorded using an eight-camera motion analysis system (120–240 Hz) and angular displacements of the head relative to the sternum were computed in Matlab. Positive kinematic values indicate flexion, left lateral flexion, and left rotation. Ipsilateral refers to the same side as the clinician's contact and contralateral, the opposite. Length changes of the VA were recorded using eight piezoelectric ultrasound crystals (260–557 Hz), inserted along the entire vessel. VA length changes were calculated as D = (L1 − L0)/L0, where L0 = length of the whole VA (sum of segmental lengths) or the V3 segment at CSM thrust onset; L1 = whole VA or V3 length at peak force during the CSM thrust.

Results

Irrespective of the type of CSM, the side or level of CSM application, angular displacements of the head and associated VA length changes during the thrust phase of CSM were small. VA length changes during the thrust phase were largest with ipsilateral rotation CSM (producing contralateral head rotation): [mean ± SD (range)] whole artery [1.3 ± 1.0 (− 0.4 to 3.3%)]; and V3 segment [2.6 ± 3.6 (− 0.4 to 11.6%)].

Conclusions

Mean head angular displacements and VA length changes were small during CSM thrusts. Of the four different CSM measured, mean VA length changes were largest during rotation procedures. This suggests that if clinicians wish to limit VA length changes during the thrust phase of CSM, consideration should be given to the type of CSM used.
Interobserver agreement on the sonographic severity grading of shoulder impingement syndrome
Authors: Bacha Raham , Gilani Syed Amir , Hanif Asif , Manzoor Iqra
Published: June 2022

Background

Shoulder impingement syndrome is the painful entrapment of the soft tissues between the acromion and the humeral head. The severity of shoulder impingement could be graded according to the limitation of shoulder joint moment. The reliability of sonographic findings in the grading of shoulder impingement severity grading is required to be evaluated by the consistency of findings between the observers.

Purpose

To assess the interobserver agreement in the sonographic severity grading of shoulder impingement syndrome with the help of a ratio between acromion-to-greater tuberosity distance in the abduction and neutral arm position.

Material and methods

Patients were examined by two independent observers in the coronal approach with neutral arm position. Acromion-to-greater tuberosity distance was measured in abduction and neutral shoulder position. The ratios of the distances in the abduction and neutral position were calculated to grade the severity of shoulder impingement syndrome.

Results

A total of 78 shoulders were included in this study. A strong agreement was found for the grading of shoulder impingement severity grading between the two independent observers with Kappa value of 0.94. And correlation between the results of the two observers for the severity grading of shoulder impingement syndrome was significant at 0.01 level.

Conclusion

Severity grading of the shoulder impingement syndrome was performed based on the ratio of acromion-to-greater tuberosity distance in abduction and neutral arm position. However, the sonographic findings were consistent and a strong interobserver agreement was seen in this sonographic severity grading.
Cross-sectional study on relationships between physical function and psychological readiness to return to sport after anterior cruciate ligament reconstruction
Authors: Aizawa Junya , Hirohata Kenji , Ohji Shunsuke , Ohmi Takehiro , Mitomo Sho , Koga Hideyuki , Yagishita Kazuyoshi
Published: June 2022

Background

Information about specific factors of physical function that contribute to psychological readiness is needed to plan rehabilitation for a return to sports. The purpose of this study was to identify specific physical functions related to the psychological readiness of patients aiming to return to sports 6 months after reconstruction. We hypothesized that the knee strength is a factor related to the Anterior Cruciate Ligament–Return to Sport after Injury scale (ACL-RSI) cutoff score for a return to sports.

Methods

This was a cross-sectional study. Fifty-four patients who had undergone primary reconstruction using hamstring tendon participated in this study. Psychological readiness was measured using the ACL-RSI in patients at 6 months after reconstruction. To identify specific physical functions related to the ACL-RSI score, participants were divided into groups with ACL-RSI scores of ≥ 60 or < 60. Non-paired t-tests or the Mann–Whitney test were performed to analyze group differences in objective variables in physical function: (1) knee strength in both legs; (2) leg anterior reach distance on both sides; and (3) single-leg hop (SLH) distances in three directions for both legs.

Results

Significant differences between groups were identified in knee flexion strength (60°/s) for the uninvolved limb, hamstring-to-quadriceps ratio (60°/s) for the uninvolved limb, knee flexion strength (180°/s) for the involved limb, limb symmetry index (LSI) of leg anterior reach distance, the ratio of the distance to the height of the patient and LSI of SLH distances in lateral and medial directions.

Conclusion

This study revealed that at 6 months after reconstruction, increased knee flexion strength (ratio of peak torque measured to body mass of the patient), hamstring-to-quadriceps ratio, leg anterior reach distance LSI, and lateral and medial SLH appear important to exceed the ACL-RSI cutoff for a return to sports. The present results may be useful for planning post-operative rehabilitation for long-term return to sports after reconstruction.
Effect of age and gender on pre-operative cardiovascular risk assessment
Authors: Chehab Omar , Eldirani Mahmoud , Tamim Hani , Mailhac Aurelie , Makki Maha , Dakik Habib A.
Published: June 2022

Background

The AUB-HAS2 Cardiovascular Risk Index is a recently published tool for pre-operative cardiovascular evaluation. It is based on six data elements: history of heart disease, symptoms of angina or dyspnea, age ≥ 75 years, hemoglobin < 12 mg/dl, vascular surgery, and emergency surgery. The objective of this study is to study the effect of age and gender on the performance of the AUB-HAS2 Index in pre-operative cardiovascular risk assessment.

Methods

The study population consisted of 1,167,414 non-cardiac surgeries registered in the ACS NSQIP database. The population was stratified by age (≥ 40 and < 40 years old) and by gender (men and women). Each patient was given an AUB-HAS2 score of 0, 1, 2, 3, or > 3 based on the number of data elements s/he has. The outcome measure was all-cause mortality, myocardial infarction (MI), or stroke at 30 days after surgery.

Results

The overall 30-day event rate was higher in patients ≥ 40 years compared to those < 40 years (2.5% vs 0.3%, P < 0.0001) and in men compared to women (2.7% vs 1.8%, P < 0.0001). In both age and gender subgroups, there was a gradual and significant increase in the outcome measure (death, MI, or stroke) as the AUB-HAS2 score increased: from ≤ 0.5% in those with a score of 0 to more than 15% in those with a score > 3 (P < 0.0001). The AUB-HAS2 Index was able to stratify risk in all subgroups into low, intermediate, and high (P < 0.0001). Receiver operating characteristic curves showed the AUB-HAS2 Index has very good discriminatory power in both age (area under the curve (AUC) of 0.81 and 0.78) and gender (AUCs of 0.79 and 0.84) subgroups.

Conclusion

This study extends the validation of the newly derived AUB-HAS2 Cardiovascular Risk Index to different age and gender subgroups with very good discriminative power.
COVID-19 2022 update: transition of the pandemic to the endemic phase
Authors: Biancolella Michela , Colona Vito Luigi , Mehrian-Shai Ruty , Watt Jessica Lee , Luzzatto Lucio , Novelli Giuseppe , Reichardt Juergen K. V.
Published: June 2022

COVID-19, which is caused by the SARS-CoV-2, has ravaged the world for the past 2 years. Here, we review the current state of research into the disease with focus on its history, human genetics and genomics and the transition from the pandemic to the endemic phase. We are particularly concerned by the lack of solid information from the initial phases of the pandemic that highlighted the necessity for better preparation to face similar future threats. On the other hand, we are gratified by the progress into human genetic susceptibility investigations and we believe now is the time to explore the transition from the pandemic to the endemic phase. The latter will require worldwide vigilance and cooperation, especially in emerging countries. In the transition to the endemic phase, vaccination rates have lagged and developed countries should assist, as warranted, in bolstering vaccination rates worldwide. We also discuss the current status of vaccines and the outlook for COVID-19.
Nalbuphine alleviates inflammation by down-regulating NF-κB in an acute inflammatory visceral pain rat model
Authors: Ruan Dijiao , Wang Yuanyuan , Li Sisi , Zhang Chao , Zheng Wenwen , Yu Cong
Published: June 2022

Introduction

Nalbuphine can relieve patients’ inflammation response after surgery compared to other opioid drugs. However, its molecular mechanism has not been clear. Activation of NF-κB signaling pathway under oxidative stress and inflammation can maintain pain escalation.

Methods

We firstly investigated the effect of nalbuphine on writhing test and mechanical allodynia using a rat model of inflammatory visceral pain (acetic acid (AA) administrated). Cytokines (including tumor necrosis factor (TNF)-α, Interleukin (IL)-1β, IL-2, and IL-6 in plasma were tested with ELISA technology. Expression levels of TNF-α, IκBα and p-NF-κB p65 at the spinal cord (L3–5) were measured by western blot or RT-qPCR.

Results

We found that the paw withdrawal threshold (PWT) values of rats were reduced in the model group, while the numbers of writhing, levels of IL-1β, IL-2, IL-6, and TNF-α in plasma, and p-NF-κB protein and its gene expressions in the lumbar spinal cord were up-regulated. Subcutaneously injection of nalbuphine (10 μg/kg) or PDTC (NF-κB inhibitor) attenuated acetic acid-induced inflammatory pain, and this was associated with reversal of up-regulated IL-1β, IL-2, IL-6, and TNF-α in both plasma and spinal cord. Furthermore, acetic acid increased p-NF-κB and TNF-α protein levels in the white matter of the spinal cord, which was attenuated by nalbuphine. These results suggested that nalbuphine can significantly ameliorate inflammatory pain via modulating the expression of NF-κB p65 as well as inflammation factors level in the spinal cord.

Conclusion

In conclusion, nalbuphine inhibits inflammation through down-regulating NF-κB pathway at the spinal cord in a rat model of inflammatory visceral pain.
Cost-effectiveness analysis of olanzapine in four-drug antiemetic therapy in Japanese patients treated with highly emetogenic cisplatin-containing chemotherapy
Authors: Kondo Yu , Tachi Tomoya , Sakakibara Takayoshi , Kato Jun , Mizuno Takahito , Miyake Yoshio , Teramachi Hitomi
Published: June 2022

Background

Olanzapine has been shown to have an additive effect on the three-drug antiemetic therapy consisting of aprepitant, palonosetron, and dexamethasone, in a highly emetogenic cisplatin-containing chemotherapy. Although olanzapine may be more economical than aprepitant or palonosetron, an adequate cost-efficacy analysis has not been conducted.

Methods

We conducted a cost-utility analysis to evaluate the cost-effectiveness of olanzapine use in four-drug antiemetic therapy among Japanese patients. We simulated model patients treated with highly emetogenic cisplatin-containing chemotherapy and developed a decision-analytical model of patients receiving triple antiemetic therapy with or without olanzapine in an inpatient setting. The cost and probabilities of each treatment were calculated from the perspective of the Japanese healthcare payer. The probabilities, utility value, and other costs were obtained from published sources. One-way and probabilistic sensitivity analyses were conducted to examine the influence of each parameter on the model and the robustness of a base-case analysis. Threshold analysis was conducted to determine the cost of olanzapine that would make the incremental cost-effectiveness ratio (ICER) equivalent to the threshold ICER). The threshold incremental cost-effectiveness ratio was set at 5 million Japanese Yen (JPY) per quality-adjusted life-year (QALY) gained.

Results

The cost was 10,238 JPY in the olanzapine regimen and 9719 JPY in the non-olanzapine regimen. The QALY gained were 0.01065 QALYs and 0.01029 QALYs in the olanzapine and non-olanzapine regimen, respectively. The incremental cost of the olanzapine regimen relative to the non-olanzapine regimen was 519 JPY, and the incremental QALYs were 0.00036 QALY, resulting in an ICER of 1,428,675 JPY per QALY gained. In the one-way sensitivity analysis, the results were most sensitive to the utility value of incomplete control. The probabilistic sensitivity analysis revealed the probability that the ICER was below the willingness-to-pay, and the incremental QALYs was positive was 96.2%. The calculated cost of olanzapine per 5 mg that would make the incremental cost-effectiveness ratio equivalent to the threshold incremental cost-effectiveness ratio was calculated to be 475 JPY.

Conclusions

Olanzapine was cost-effective in the four-drug antiemetic therapy for Japanese patients treated with highly emetogenic cisplatin-containing chemotherapy.
Development and validation of a questionnaire to evaluate the knowledge, attitude and practices regarding travel medicine amongst physicians in an apex tertiary hospital in Northern India
Authors: Kumar Arvind , Rajendran Anand , Usman Mohd , Ahuja Jatin , Samad Sameer , Mittal Ankit , Garg Prerna , Baitha Upendra , Ranjan Piyush , Wig Naveet
Published: June 2022

Objectives

Travel medicine focuses primarily on pre-travel preventive care and the conditions and diseases acquired during or after travel. There is a paucity of validated tools to assess the knowledge, attitude and practises of physicians with regard to travel medicine. We attempted to develop a tool to assess existing expertise among Medicine and Infectious Diseases resident doctors with respect to travel medicine.

Methods

Item level content validity index (I-CVI) and scale level content validity index (S-CVI/Ave) were estimated for each of the items to establish the content validity. Refined measures of inter-rater agreement (Brennan and Prediger Agreement Coefficient and Gwet’s Agreement Coefficient) were estimated for the tool.

Results

The final version of the questionnaire had satisfactory content validity (I-CVI > 0∙6 and S-CVI/Ave > 0∙9) and possessed high agreement among the raters (Brennan and Prediger AC > 0∙7, p < 0∙01 and Gwet's AC > 0∙8, p < 0∙01) with regard to necessity, clarity and relevance of the scale.

Conclusions

This tool covers a wide range of questions and is scientifically validated. The final version of the tool can be used largely for the assessment of knowledge, attitude and practices among medical practitioners. This is instrumental to build targeted intervention programs to enhance the knowledge regarding travel medicine among health care providers.
Contribution of researchers in Arab countries to scientific publications on neglected tropical diseases (1971 – 2020)
Authors: Sweileh Waleed M.
Published: June 2022

Background

The neglected tropical diseases (NTDs) are endemic in several Arab countries. The purpose of the current study was to assess the contribution of researchers in Arab countries to the knowledge base on NTDs using bibliometric indicators.

Methods

Keywords related to all 20 NTDs were obtained from previously published bibliometric studies and were combined with the names of Arab countries listed as country affiliation. the search strategy was implemented in the Scopus database and bibliometric indicators were generated for the study period from 1971 to 2020

Results

The search strategy generated 6542 documents; representing less than 4% of the global research in the field. Scientific research on NTDs from researchers in Arab countries (a) has experienced slow growth; (b) generated a relatively inadequate number of publications over the study period; (c) was disseminated mainly through journals in the field of parasitology or tropical medicine; (d) was contributed by researchers from the 22 Arab countries, but mainly by researchers from Egypt, Saudi Arabia, and Sudan; (e) has fragmented author networks with weak collaboration between active authors in the field; (f) was characterized by strong cross-country research collaboration with researchers in the US and the UK; (g) has focused on three main diseases, specifically, schistosomiasis, leishmaniasis, and onchocerciasis, and (h) showed less emphasis on soil-transmitted helminthiasis infections despite high prevalence.

Conclusions

Arab countries cannot achieve the 2030 global agenda without control and elimination of prevalent NTDs. Researchers in Arab countries need to establish strong research networks to exchange expertise on all NTDs.
Toward just and equitable micro-credentials: an Australian perspective
Authors: Desmarchelier Renee , Cary Lisa J.
Published: June 2022

The current historic COVID-19 Pandemic moment has thrown into sharp relief the need for flexible and rigorous higher education that meets upskilling and reskilling needs of global workforces. Discussions of micro-credentialing predate the Pandemic but have received increased focus as potentially assisting in addressing perceived skills gaps. However, not all commentators have been complimentary about the possibilities inherent in micro-credentialing. In this paper we discuss Ralston (Postdigital Science and Education 3:83–101, 2021) criticism of the “microcredentialing craze” as provocation to consider how equitable, thoughtful and just educative aims may be met. We address Ralston’s argument that micro-credentials present an educative “moral hazard” by arguing that micro-credentialing will allow universities to respond quickly to changing worker educational needs rather than only offering full degrees that may not be economically viable or personally desirable for individuals. Rather, we suggest, the potential of micro-credentials lies in their pathways and potential to enhance lifelong learning and suggest that micro-credentials do not stand outside of the pedagogical ethical imperative that learning experiences should be positive and inclusive.
A flexible approach for cyber threat hunting based on kernel audit records
Authors: Yang Fengyu , Han Yanni , Ding Ying , Tan Qian , Xu Zhen
Published: June 2022

Hunting the advanced threats hidden in the enterprise networks has always been a complex and difficult task. Due to the variety of attacking means, it is difficult for traditional security systems to detect threats. Most existing methods analyze log records, but the amount of log records generated every day is very large. How to find the information related to the attack events quickly and effectively from massive data streams is an important problem. Considering that the knowledge graph can be used for automatic relation calculation and complex relation analysis, and can get relatively fast feedback, our work proposes to construct the knowledge graph based on kernel audit records, which fully considers the global correlation among entities observed in audit logs. We design the construction and application process of knowledge graph, which can be applied to actual threat hunting activities. Then we explore different ways to use the constructed knowledge graph for hunting actual threats in detail. Finally, we implement a LAN-wide hunting system which is convenient and flexible for security analysts. Evaluations based on the adversarial engagement designed by DARPA prove that our platform can effectively hunt sophisticated threats, quickly restore the attack path or assess the impact of attack.
An overview of inertia requirement in modern renewable energy sourced grid: challenges and way forward
Authors: Ayamolowo Oladimeji Joseph , Manditereza Patrick , Kusakana Kanzumba
Published: June 2022

As the world strives toward meeting the Paris agreement target of zero carbon emission by 2050, more renewable energy generators are now being integrated into the grid, this in turn is responsible for frequency instability challenges experienced in the new grid. The challenges associated with the modern power grid are identified in this research. In addition, a review on virtual inertial control strategies, inertia estimation techniques in power system, modeling characteristics of energy storage systems used in providing inertia support to the grid, and modeling techniques in power system operational and expansion planning is given. Findings of this study reveal that adequate system inertia in the modern grid is essential to mitigate frequency instability, thus, considering the inertia requirement of the grid in operational and expansion planning model will be key in ensuring the grid’s stability. Finally, a direction for future research has been identified from the study, while an inertial constant of between 4 and 10 s is recommended to ensure frequency stability in modern power grid.
President's Page: Looking into the world of medical imaging from the perspective of a geophysicist
Authors: Zhang Jie
Published: June 2022

I have worked in the geophysical industry and in academia as a geophysicist for 25 years. During the same time frame, I have also worked for 24 years in the medical industry. I founded a geophysical imaging company in 1998, and a year later I cofounded a medical imaging company. During the last seven years, I have led two biomedical companies to develop treatment solutions for bacterial infections and cancers. My career path offers me a unique insight into the world of medical imaging from the perspective of a geophysicist. In the following, I would like to share some of my observations, based on that unique perspective.
Synthetic seismic data generation for automated AI-based procedures with an example application to high-resolution interpretation
Authors: Vizeu Fernando , Zambrini Joao , Tertois Anne-Laure , da Graça e Costa Bruno de Albuquerque , Fernandes André Queiroz , Canning Anat
Published: June 2022

This paper discusses the generation of synthetic 3D seismic data for training neural networks to solve a variety of seismic processing, interpretation, and inversion tasks. Using synthetic data is a way to address the shortage of seismic data, which are required for solving problems with machine learning techniques. Synthetic data are built via a simulation process that is based on a mathematical representation of the physics of the problem. In other words, using synthetic data is an indirect way to teach neural networks about the physics of the problem. An important incentive for using synthetic data to solve problems with artificial intelligence methods is that with real seismic data the ground truth is always unknown. When generating synthetic seismic data, we first build the model and then calculate the data, so the answer (model) is always known and always exact. We describe a methodology for generating on-the-fly simulated postmigration (1D modeling) synthetic data in 3D, which are high resolution and look similar to real data. A wide range of models is covered by generating an unlimited number of data examples. The synthetic data are built from impedance models that are constructed through geostatistical simulation of real well logs. With geostatistical simulation, we can describe various geologic variance models in 3D and obtain realistic images. To cover a broad range of scenarios, we need to generalize the seismic data story by randomly perturbing many parameters including structures, conformity styles, dip-strike directions, variograms, measured input logs, frequencies, phase spectra, etc.
Discussion: Comments on Fresnel zone binning — Can it be used to determine maximum allowable holes in coverage of long offsets?
Authors: Vermeer Gijs J. O.
Published: June 2022

This paper comments on two publications by Monk on Fresnel zone binning (FZB). The first one was published in the Round Table department of The Leading Edge in 2009, and the second one is chapter 3 in the 2020 Distinguished Instructor Short Course (DISC) book. The main message of these two papers is captured by the following assertion from the DISC book: “the point is that adequate interpolation is only possible if the Fresnel zone is well sampled at the beginning.” This assertion, if true, would form a new law in geophysics; therefore, it deserves rigorous proof. Unfortunately, such a proof has not been provided. Instead, an assessment of its validity is provided by the results of one data set with considerable feathering of the long offsets acquired in an area with moderate dip. For this data set, FZB predicts that interpolation can be applied successfully. Indeed, there is no significant difference between the data set after interpolation and the data set after infill shooting. However, these results do not prove the validity of FZB; they only show the power of the interpolation technique. Even if the assertion would be true, to prove it would require a theoretical derivation of the validity of the method. Confidence in the method may also be built by successful application of the idea to several seismic data sets in areas with complex geology, while not losing any high frequencies and with accurate amplitude retrieval.
The effects of neighbourhood social cohesion on preventing depression and anxiety among adolescents and young adults: rapid review
Authors: Breedvelt Josefien J. F. , Tiemeier Henning , Sharples Evelyn , Galea Sandro , Niedzwiedz Claire , Elliott Iris , Bockting Claudi L.
Published: June 2022

Background

Research suggests that increasing neighbourhood social cohesion can prevent mental health problems, including depression and anxiety. However, it is unknown whether this is the case for adolescents and young adults.

Aims

To investigate whether neighbourhood social cohesion can prevent depression and anxiety, and identify interventions that can increase neighbourhood cohesion in young people.

Method

We conducted a rapid review for an overview of the available literature. PubMed, Campbell Collaboration, KSR Ltd and grey literature databases were searched from inception up to 10 July 2020. When synthesising the results, we applied a hierarchy of evidence, prioritising study designs that allowed for the most ability to infer causality. Risk of bias was assessed with the ROBIS tool and Joanna Briggs Institute risk-of-bias assessment. A narrative review and two workshops with young people were conducted to inform what future interventions may look like.

Results

Forty-two peer-reviewed publications, including two systematic reviews, 13 longitudinal studies and 27 cross-sectional studies, were identified. Prospective longitudinal studies found that neighbourhood social cohesion factors (safety, trust, positive social connections, helping others and a lack of crime and violence) were associated with fewer depressive symptoms. Future interventions to increase neighbourhood cohesion should involve creating safe and attractive community centres, accessible and safe outdoor spaces, community activity groups and online communities.

Conclusions

Neighbourhood social cohesion has the potential to protect mental health. The next step is to conduct intervention studies to evaluate the effects on onset prevention. Clinicians should consider the impact cohesion can have on mental health, and signpost to community initiatives.
Toward Improved Outcomes for Patients With Lung Cancer Globally: The Essential Role of Radiology and Nuclear Medicine
Authors: Mikhail Lette Miriam N. , Paez Diana , Shulman Lawrence N. , Guckenberger Mathias , Douillard Jean-Yves , Oyen Wim J.G. , Giammarile Francesco , Rangarajan Venkatesh , Ginsberg Michelle , Pellet Olivier , Liao Zhongxing , Abdel Wahab May
Published: June 2022

PURPOSE

Key to achieving better population-based outcomes for patients with lung cancer is the improvement of medical imaging and nuclear medicine infrastructure globally. This paper aims to outline why and spark relevant health systems strengthening.

METHODS

The paper synthesizes the global lung cancer landscape, imaging referral guidelines (including resource-stratified ones), the reliance of TNM staging upon imaging, relevant multinational health technology assessments, and precisely how treatment selection and in turn patient outcomes hinge upon imaging findings. The final discussion presents data on current global gaps in both diagnostics (including imaging) and therapies and how, informed by such data, improved population-based outcomes are tangible through strategic planning.

RESULTS

Imaging findings are central to appropriate lung cancer patient management and can variably lead to life-prolonging interventions and/or to life-enhancing palliative measures. Early-stage lung cancer can be treated with curative intent but, unfortunately, most patients with lung cancer still present at advanced stages and many patients lack access to both diagnostics and therapies. Furthermore, half of lung cancer cases occur in low- and middle-income countries. The role of medical imaging and nuclear medicine in lung cancer management, as outlined herein, may help inform strategic planning.

CONCLUSION

Lung cancer is the number one cancer killer worldwide. The essential role that medical imaging and nuclear medicine play in early diagnosis and disease staging cannot be overstated, pivotal in selecting the many patients for whom measurably improved outcomes are attainable. Prevention synergized with patient-centered, compassionate, high-quality lung cancer management provision mandate that strategic population-based planning, including universal health coverage strategies, should extend well beyond the scope of disease prevention to include both curative and noncurative treatment options for the millions afflicted with lung cancer.
BRAF-Mutated Advanced Colorectal Cancer: A Rapidly Changing Therapeutic Landscape
Authors: Ciombor Kristen K. , Strickler John H. , Bekaii-Saab Tanios S. , Yaeger Rona
Published: June 2022

BRAF-mutated advanced colorectal cancer is a relatively small but critical subset of this tumor type on the basis of prognostic and predictive implications. BRAF alterations in colorectal cancer are classified into three functional categories on the basis of signaling mechanisms, with the class I BRAF V600E mutation occurring most frequently in colorectal cancer. Functional categorization of BRAF mutations in colorectal cancer demonstrates distinct mitogen-activated protein kinase pathway signaling. On the basis of recent clinical trials, current standard-of-care therapies for patients with BRAF V600E -mutated metastatic colorectal cancer include first-line cytotoxic chemotherapy plus bevacizumab and subsequent therapy with the BRAF inhibitor encorafenib and antiepidermal growth factor receptor antibody cetuximab. Treatment regimens currently under exploration in BRAF V600E-mutant metastatic colorectal cancer include combinatorial options of various pathway-targeted therapies, cytotoxic chemotherapy, and/or immune checkpoint blockade, among others. Circumvention of adaptive and acquired resistance to BRAF-targeted therapies is a significant challenge to be overcome in BRAF-mutated advanced colorectal cancer.
Point/Counterpoint: Is It Time for Universal Germline Genetic Testing for All GI Cancers?
Authors: Hampel Heather , Yurgelun Matthew B.
Published: June 2022

Use of germline genetic testing among patients with cancer is increasing because of (1) the availability of multigene panel tests that include multiple cancer susceptibility genes in a single test, (2) decreased costs of these tests and improvements in insurance coverage, and (3) US Food and Drug Administration–approval of genotype-directed therapies such as poly(ADP-ribose) polymerase inhibitors for individuals with certain cancers and pathogenic germline variants in BRCA1 and BRCA2 (with possible benefits with other genes in the homologous repair deficiency pathway). In addition, National Comprehensive Cancer Network guidelines have already endorsed germline genetic testing for all patients with certain cancer types (epithelial ovarian cancer, exocrine pancreatic cancer, and high-grade/metastatic prostate cancer), regardless of age or personal/family history of cancer. Herein, we debate the pros and cons of offering germline multigene panel testing to all patients diagnosed with any GI cancer. The authors agree that it may just be a matter of time before germline multigene panel testing is offered to all patients with cancer; however, this article will highlight some of the benefits, risks, and limitations of this approach so that research can help fill some of the gaps to ensure that genetic medicine continues to be implemented in ways that improve real-world patient care and outcomes.
A new theoretical performance landscape for suction feeding reveals adaptive kinematics in a natural population of reef damselfish
Authors: Holzman Roi , Keren Tal , Kiflawi Moshe , Martin Christopher H. , China Victor , Mann Ofri , Olsson Karin H.
Published: June 2022

Understanding how organismal traits determine performance and, ultimately, fitness is a fundamental goal of evolutionary eco-morphology. However, multiple traits can interact in non-linear and context-dependent ways to affect performance, hindering efforts to place natural populations with respect to performance peaks or valleys. Here, we used an established mechanistic model of suction-feeding performance (SIFF) derived from hydrodynamic principles to estimate a theoretical performance landscape for zooplankton prey capture. This performance space can be used to predict prey capture performance for any combination of six morphological and kinematic trait values. We then mapped in situ high-speed video observations of suction feeding in a natural population of a coral reef zooplanktivore, Chromis viridis, onto the performance space to estimate the population's location with respect to the topography of the performance landscape. Although the kinematics of the natural population closely matched regions of high performance in the landscape, the population was not located on a performance peak. Individuals were furthest from performance peaks on the peak gape, ram speed and mouth opening speed trait axes. Moreover, we found that the trait combinations in the observed population were associated with higher performance than expected by chance, suggesting that these combinations are under selection. Our results provide a framework for assessing whether natural populations occupy performance optima.
The Impact of Low Skeletal Muscle Mass on Short- and Long-Term Outcomes After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Authors: Dietz Michelle V. , van Kooten Job P. , van Vugt Jeroen L. A. , Brandt-Kerkhof Alexandra R. M. , Verhoef Cornelis , Madsen Eva V. E.
Published: June 2022

Background

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a potentially curative treatment for peritoneal metastases from colorectal cancer (CRC) or pseudomyxoma peritonei (PMP). Because of the considerable morbidity of this treatment, optimal patient selection is key. This study aimed to assess the impact of low skeletal muscle mass (SMM) on outcomes after CRS-HIPEC.

Methods

Patients who underwent CRS-HIPEC between 2014 and 2020 at a tertiary center were included. SMM was measured on computed tomography by means of the L3 muscle index. Postoperative complications and survival outcomes were compared between groups by use of logistic regression and Kaplan-Meier survival analyses.

Results

Of 284 included patients, 149 had low SMM. Occurrence of severe postoperative complications did not differ between groups (28.9% for patients with low vs. 34.1% for patients with normal SMM). Low SMM was not associated with postoperative complications (p = 0.344). For CRC patients, no significant differences were observed in disease-free (DFS) or overall survival (OS) between patients with low (median DFS 7 months [IQR 4–14], median OS 33 months [IQR 14–NR]) and patients with normal SMM (median DFS 8 months [IQR 5–20], median OS 35 months [IQR 18–NR]). Regarding PMP, survival outcomes did not significantly differ between groups (3-year DFS 47.3% for patients with low SMM vs. 54.5% for patients with normal SMM, p = 0.676; 3-year OS 70.8% vs. 90.9% respectively, p = 0.172).

Conclusions

Low SMM could not be identified as a predictor of severe complications or survival outcomes after CRS-HIPEC.
The Liquidity Sensitivity of Healthcare Consumption: Evidence from Social Security Payments
Authors: Gross Tal , Layton Timothy J. , Prinz Daniel
Published: June 2022

Insurance is typically viewed as a mechanism for transferring resources from good to bad states. However, insurance may also transfer resources from high-liquidity periods to low-liquidity periods. We test for this type of transfer from health insurance by studying the distribution of Social Security checks among Medicare recipients. When Social Security checks are distributed, prescription fills increase by 6–12 percent among recipients who pay small copayments. We find no such pattern among recipients who face no copayments. The results demonstrate that more complete insurance allows recipients to consume healthcare when they need it rather than only when they have cash. (JEL D82, G22, H55, I13, I18, L65)
Robust Predictions in Coasian Bargaining
Authors: Liu Heng
Published: June 2022

This paper studies robust predictions when players may have additional information in an otherwise standard seller-offer bargaining with private values. Players’ extra information gives rise to higher-order uncertainties about the underlying surplus. We show that the equilibrium outcomes in the frequent-offer limit depend critically on the nature of second-order uncertainty: (i) when the seller’s beliefs about the buyer’s values are public, the limiting equilibrium outcomes are efficient and any surplus division is possible; (ii) when the seller’s beliefs are private, any feasible and individually rational payoffs can be the limiting equilibrium payoffs.(JEL C78, D82, D83)