bluuebunny/crossref_metadata_2025 huggingface dataset:
Broadband radar cross section reduction by an absorptive metasurface based on a magnetic absorbing material
Authors: Leung Shuwai , Liang Cheng-peng , Tao Xiu-feng , Li Fei-fei , Poo Yin , Wu Rui-xin
Published: September 2021

A highly feasible approach to achieve a broadband radar cross section (RCS) reduction using a simple magnetic metasurface is presented. A magnetic absorbing material (MAM) with high permittivity and magnetic loss is introduced into the metasurface design instead of the more common dielectric material to considerably reduce its thickness. The metasurface is composed of an optimized two-dimensional array of MAM meta-atoms and a metal plate in back. The meta-atoms share a simple square ring shape but with variable geometrical parameters, forming strong absorption in different frequency bands with large reflection phase differences. By hybridizing the absorption and phase-cancelation technique, a 10-dB RCS reduction from 3.4 to 18 GHz is achieved at a thickness of only 4 mm. Further experimental measurements are provided to evaluate the performance. Our work provides a promising way to broaden the bandwidth of RCS reduction with low density, reduced thickness, and stable performance, which can be utilized in harsh physical and chemical environments.
Cryptographic analysis on an optical random-phase-encoding cryptosystem for complex targets based on physics-informed learning
Authors: Wu Huazheng , Li Qi , Meng Xiangfeng , Yang Xiulun , Liu Shoupei , Yin Yongkai
Published: September 2021

Optical cryptanalysis based on deep learning (DL) has grabbed more and more attention. However, most DL methods are purely data-driven methods, lacking relevant physical priors, resulting in generalization capabilities restrained and limiting practical applications. In this paper, we demonstrate that the double-random phase encoding (DRPE)-based optical cryptosystems are susceptible to preprocessing ciphertext-only attack (pCOA) based on DL strategies, which can achieve high prediction fidelity for complex targets by using only one random phase mask (RPM) for training. After preprocessing the ciphertext information to procure substantial intrinsic information, the physical knowledge DL method based on physical priors is exploited to further learn the statistical invariants in different ciphertexts. As a result, the generalization ability has been significantly improved by increasing the number of training RPMs. This method also breaks the image size limitation of the traditional COA method. Optical experiments demonstrate the feasibility and the effectiveness of the proposed learning-based pCOA method.
Time-resolved optical probing of the non-equilibrium supercritical state in molecular media under ns laser-plasma impact
Authors: Mareev Evgenii , Minaev Nikita , Epifanov Evgenii , Tsymbalov Ivan , Sviridov Alexander , Gordienko Vyacheslav
Published: September 2021

We proposed a complex method based on a combination of shadow photography and time-resolved Raman spectroscopy to observe the non-stationary laser-induced supercritical state in molecular media. Shadow photography is applied for retrieving pressure values, while Raman spectroscopy with molecular dynamics for temperature estimation. Time resolution of 0.25 ns is achieved by varying the delay between the pump (creating an extreme energy delivery) and the probe laser pulses by the self-made digital delay electronic circuit . The proposed method was employed in liquid carbon dioxide and water. Under nanosecond laser pulse impact, the estimated temperatures and pressures (∼700 K and ∼0.5 GPa) achieved in media are higher than the critical parameters of the samples.
Causes of death after biannual azithromycin treatment: A community-level randomized clinical trial
Authors: Bloch Evan M. , Mrango Zakayo , Weaver Jerusha , Munoz Beatriz , Lietman Thomas M. , West Sheila K.
Published: September 2021

The MORDOR study, a masked, community-level randomized clinical trial conducted in Niger, Malawi and Tanzania (2015 to 2017), showed that biannual administration of single-dose azithromycin to preschool children reduced all-cause mortality. We sought to evaluate its impact on causes of death in children aged 1–59 months in Tanzania. A random sampling of 614 communities was conducted in Kilosa District, Tanzania, with simple random assignment of communities to receive either azithromycin or placebo. In these communities, a census was carried out every 6 months and children aged 1–59 months received biannual (every 6 months), single-dose azithromycin (~20mg/kg) or placebo depending on community assignment, over a 2-year period. Mortality was determined at the time of the biannual census. For child deaths, a verbal autopsy was performed to ascertain the cause using a standardized diagnostic classification. A total of 190- (0.58 /100 person-years) and 200 deaths (0.59/100 person-years) were reported in the azithromycin and placebo arms, respectively. Malaria, pneumonia and diarrhea, accounted for 71% and 68% of deaths in the respective arms. Overall, the mortality was not different by treatment arm, nor were the distribution of causes of death after adjusting for community clustering. The cause-specific mortality for diarrhea/pneumonia was no different over time. In children aged 1–5 months, 32 deaths occurred in the placebo arm and 25 deaths occurred in the azithromycin arm; 20 (62.5%) deaths in the placebo- and 10 (40%) in the azithromycin arm were attributed to diarrhea or pneumonia. Neither differences in the number of deaths nor the diarrhea/pneumonia attribution was statistically significant after adjusting for community clustering. In conclusion, azithromycin was not associated with a significant decline in deaths by specific causes compared to placebo. The non-significant lower rates of diarrhea or pneumonia in children <6 months who received azithromycin merit further investigation in high-mortality settings.

Trial registration: NCT02048007.
The pattern of orthopedic fractures and visceral injury in road traffic crash victims, Addis Ababa, Ethiopia
Authors: Mengistu Zuriyash , Ali Ahmed , Abegaz Teferi
Published: September 2021

Background

Road Traffic crash injury is one of the main public health problems resulting in premature death and disability particularly in low-income countries. However, there is limited evidence on the crash fractures in Ethiopia.

Objective

The study was conducted to assess the magnitude of road traffic crash fractures and visceral injuries.

Methods

A hospital-based cross-sectional study was conducted on 420 fracture patients. Participants were randomly selected from Addis Ababa City hospitals. The study was carried out between November 2019 and February 2020. Data were collected using a questionnaire and record of medical findings. Multilevel logistic regression analysis was carried out. Ethical clearance was obtained from the Addis Ababa University, College of Health Sciences Institutional Review Board. Confidentiality of participants’ information was maintained.

Results

The study found out that the majority 265 (63. 1%) of fracture cases were younger in the age group of 18 to 34 years. Males were more affected—311(74.0%). The mortality rate was 59(14.1%), of those 50(85.0%) participants were males. The major road traffic victims were pedestrians—220(52.4%), mainly affected by simple fracture type -105(53.3%) and compound fracture type—92(46. 7%). Drivers mainly suffered from compound fracture type -23 (59.0%). One hundred eighty-two (43.3%) of fracture patients had a visceral injury. Homeless persons who sit or sleep on the roadside had a higher risk of thoracic visceral injury compared to traveler pedestrians (AOR = 4.600(95%CI: 1.215–17.417)); P = 0.025.

Conclusion

Visceral injury, simple and compound fractures were the common orthopedic injury types reported among crash victims. Males, pedestrians, and young age groups were largely affected by orthopedic fracture cases. Homeless persons who sited or slept on the roadside were significant factors for visceral injury. Therefore, preventing a harmful crash and growing fracture care should be considered to reduce the burden of crash fracture.
Combined effect of olive pruning residues and spent coffee grounds on Pleurotus ostreatus production, composition, and nutritional value
Authors: Abou Fayssal Sami , El Sebaaly Zeina , Alsanad Mohammed A. , Najjar Rita , Böhme Michael , Yordanova Milena H. , Sassine Youssef N.
Published: September 2021

No previous study assessed the combined effect of olive pruning residues (OLPR) and spent coffee grounds (SCG) on P. ostreatus production and nutritional value. The aim of this study was to determine the capacity of P. ostreatus to degrade lignocellulosic nature of combined OLPR and SCG as well as their resultant nutrient composition. A complete randomized design was adopted with five treatments: S1:100%wheat straw (WS) (control), S2:33%WS+33%SCG+33%OLPR,S3:66%WS+17%SCG+17%OLPR,S4:17%WS+66%SCG+17%OLPR, and S5:17%WS+17%SCG+66%OLPR, and ten replicates per treatment. Substrate’s and mushroom’s composition were analyzed on chemical scale, including fatty acids and heavy metals profiles, following international standards. Only S1, S2, and S3 were productive, with comparable biological yield, economical yield, and biological efficiency. Organic matter loss decreased with increasing proportions of OLPR and SCG. Percentage lignin loss was higher in S1 than in S2 and S3 (53.51, 26.25, and 46.15% respectively). Mushrooms of S3 had some enhanced nutritional attributes compared to control: decrease in fat, increase in protein, increase in monounsaturated fatty acids, and lower zinc accumulation. Lead was less accumulated in S2 than S1 mushrooms. Sodium content of mushroom decreased in S2 and S3. The latter substrates yielded mushrooms with lower polyunsaturated fatty acids (PUFA) and higher saturated fatty acids (SFA) contents. All mushrooms had a valuable PUFA/SFA. This study suggests using OLPR and SCG in low proportions as nutritional supplements to the commercial wheat straw.
eARDS: A multi-center validation of an interpretable machine learning algorithm of early onset Acute Respiratory Distress Syndrome (ARDS) among critically ill adults with COVID-19
Authors: Singhal Lakshya , Garg Yash , Yang Philip , Tabaie Azade , Wong A. Ian , Mohammed Akram , Chinthala Lokesh , Kadaria Dipen , Sodhi Amik , Holder Andre L. , Esper Annette , Blum James M. , Davis Robert L. , Clifford Gari D. , Martin Greg S. , Kamaleswaran Rishikesan
Published: September 2021

We present an interpretable machine learning algorithm called ‘eARDS’ for predicting ARDS in an ICU population comprising COVID-19 patients, up to 12-hours before satisfying the Berlin clinical criteria. The analysis was conducted on data collected from the Intensive care units (ICU) at Emory Healthcare, Atlanta, GA and University of Tennessee Health Science Center, Memphis, TN and the Cerner® Health Facts Deidentified Database, a multi-site COVID-19 EMR database. The participants in the analysis consisted of adults over 18 years of age. Clinical data from 35,804 patients who developed ARDS and controls were used to generate predictive models that identify risk for ARDS onset up to 12-hours before satisfying the Berlin criteria. We identified salient features from the electronic medical record that predicted respiratory failure among this population. The machine learning algorithm which provided the best performance exhibited AUROC of 0.89 (95% CI = 0.88–0.90), sensitivity of 0.77 (95% CI = 0.75–0.78), specificity 0.85 (95% CI = 085–0.86). Validation performance across two separate health systems (comprising 899 COVID-19 patients) exhibited AUROC of 0.82 (0.81–0.83) and 0.89 (0.87, 0.90). Important features for prediction of ARDS included minimum oxygen saturation (SpO2), standard deviation of the systolic blood pressure (SBP), O2 flow, and maximum respiratory rate over an observational window of 16-hours. Analyzing the performance of the model across various cohorts indicates that the model performed best among a younger age group (18–40) (AUROC = 0.93 [0.92–0.94]), compared to an older age group (80+) (AUROC = 0.81 [0.81–0.82]). The model performance was comparable on both male and female groups, but performed significantly better on the severe ARDS group compared to the mild and moderate groups. The eARDS system demonstrated robust performance for predicting COVID19 patients who developed ARDS at least 12-hours before the Berlin clinical criteria, across two independent health systems.
Remote monitoring of COVID-19 positive high-risk patients in domestic isolation: A feasibility study
Authors: Wurzer David , Spielhagen Paul , Siegmann Adonia , Gercekcioglu Ayca , Gorgass Judith , Henze Simone , Kolar Yuron , Koneberg Felix , Kukkonen Sari , McGowan Hannah , Schmid-Eisinger Stefanie , Steger Alexander , Dommasch Michael , Haase Hans Ulrich , Müller Alexander , Martens Eimo , Haller Bernhard , Huster Katharina M. , Schmidt Georg
Published: September 2021

Background

If a COVID-19 patient develops a so-called severe course, he or she must be taken to hospital as soon as possible. This proves difficult in domestic isolation, as patients are not continuously monitored. The aim of our study was to establish a telemonitoring system in this setting.

Methods

Oxygen saturation, respiratory rate, heart rate and temperature were measured every 15 minutes using an in-ear device. The data was transmitted to the Telecovid Centre via mobile network or internet and monitored 24/7 by a trained team. The data were supplemented by daily telephone calls. The patients´ individual risk was assessed using a modified National Early Warning Score. In case of a deterioration, a physician initiated the appropriate measures. Covid-19 Patients were included if they were older than 60 years or fulfilled at least one of the following conditions: pre-existing disease (cardiovascular, pulmonary, immunologic), obesity (BMI >35), diabetes mellitus, hypertension, active malignancy, or pregnancy.

Findings

153 patients (median age 59 years, 77 female) were included. Patients were monitored for 9 days (median, IQR 6–13 days) with a daily monitoring time of 13.3 hours (median, IQR 9.4–17.0 hours). 20 patients were referred to the clinic by the Telecovid team. 3 of these required intensive care without invasive ventilation, 4 with invasive ventilation, 1 of the latter died. All patients agreed that the device was easy to use. About 90% of hospitalised patients indicated that they would have delayed hospitalisation further if they had not been part of the study.

Interpretation

Our study demonstrates the successful implementation of a remote monitoring system in a pandemic situation. All clinically necessary information was obtained and adequate measures were derived from it without delay.
Development of a novel ALK rearrangement screening test for non–small cell lung cancers
Authors: Chen Yi-Lin , Chen Wan-Li , Cheng Yi-Chia , Lin Ming-Ching , Yang Shu-Ching , Tsai Hung-Wen , Lin Chien‐Chung , Su Wu-Chou , Chow Nan-Haw , Ho Chung-Liang
Published: September 2021

Approximately 5–7% of non–small cell lung cancer (NSCLC) cases harbor an anaplastic lymphoma kinase (ALK) fusion gene and may benefit from ALK inhibitor therapy. To detect ALK fusion genes, we developed a novel test using reverse transcription polymerase chain reaction (RT-PCR) for the ALK kinase domain (KD). Since ALK expression is mostly silenced in the adult with the exception of neuronal tissue, the normal lung tissue, mesothelial lining, and inflammatory cells are devoid of ALK transcript, making ALK KD RT-PCR an ideal surrogate test for ALK fusion transcripts in lung or pleural effusion. The test was designed with a short PCR product (197 bp) to work for both malignant pleural effusion (MPE) and formalin-fixed, paraffin-embedded (FFPE) NSCLC samples. Using ALK IHC as a reference, the sensitivity of the test was 100% for both MPE and FFPE. The specificity was 97.6% for MPE and 97.4% for FFPE. Two false positive cases were found. One was a metastatic brain lesion which should be avoided in the future due to intrinsic ALK expression in the neuronal tissue. The other one resulted from ALK gene amplification. Due to potential false positivity, subsequent confirmation tests such as fluorescence in situ hybridization or multiplex PCR would be preferable. Nevertheless, the test is simple and inexpensive with no false negativity, making it a desirable screening test. It also offers an advantage over multiplex RT-PCR with the capability to detect novel ALK fusions. Indeed through the screening test, we found a novel ALK fusion partner (sperm antigen with calponin homology and coiled-coil domains 1 like gene, SPECC1L) with increased sensitivity to crizotinib in vitro. In summary, a novel RNA-based ALK KD analysis was developed for ALK rearrangement screening in MPE and FFPE specimens of NSCLC. This simple inexpensive test can be implemented as routine diagnostics.
Influence of environmental change, harvest exposure, and human disturbance on population trends of greater sage-grouse
Authors: Dinkins Jonathan B. , Lawson Kirstie J. , Beck Jeffrey L.
Published: September 2021

Hunter harvest of greater sage-grouse (Centrocercus urophasianus; hereafter “sage-grouse”) has been regulated by wildlife agencies during most of the past century. Hunting season regulations were maintained with the intention of providing sustainable hunting opportunities. Sage-grouse populations oscillate over time, and population growth can be influenced by seasonal weather and habitat disturbance. From 1995–2013, we compared sage-grouse lek trends from 22 relatively distinct sage-grouse population segments in 9 western U.S. states and 2 Canadian provinces. We stratified these populations into 3 broad categories (non-hunted [n = 8], continuously hunted [n = 10], and hunting season discontinued between 1996–2003 [n = 4]) with 8 different regulation histories to evaluate the potential impact of harvest on sage-grouse populations. Concomitantly, we assessed the effects of proportion burned, forested and cropland habitat; winter, spring, and summer precipitation; and human population, road, and oil and gas well densities on initial and time-varying lek counts. Density-dependent models fit lek trend data best for all regulation histories. In general, higher proportions of burnt, forested, and cropland habitat; and greater human population and oil and gas well densities were associated with lower equilibrium abundance (K). We found mixed results regarding the effect of hunting regulations on instantaneous growth rate (r). The cessation of harvest from 1996–2001 in approximately half of the largest sage-grouse population in our analysis was associated with higher r. Continuously harvested sage-grouse populations with permit hunting seasons had higher r during years with higher proportion of area exposed to permitted hunting rather than general upland game seasons. However, more liberal hunting regulations were positively associated with higher r in populations continuously harvested under general upland game hunts. Our results suggest that discontinuing harvest in the largest population resulted in greater population growth rates; however, this was not consistently the case for smaller populations. To no surprise, not all sage-grouse populations were influenced by the same environmental change or human disturbance factors. Our results will assist managers to understand factors associated with K, which provides the best targets for conservation efforts.
Noise robustness of persistent homology on greyscale images, across filtrations and signatures
Authors: Turkeš Renata , Nys Jannes , Verdonck Tim , Latré Steven
Published: September 2021

Topological data analysis is a recent and fast growing field that approaches the analysis of datasets using techniques from (algebraic) topology. Its main tool, persistent homology (PH), has seen a notable increase in applications in the last decade. Often cited as the most favourable property of PH and the main reason for practical success are the stability theorems that give theoretical results about noise robustness, since real data is typically contaminated with noise or measurement errors. However, little attention has been paid to what these stability theorems mean in practice. To gain some insight into this question, we evaluate the noise robustness of PH on the MNIST dataset of greyscale images. More precisely, we investigate to what extent PH changes under typical forms of image noise, and quantify the loss of performance in classifying the MNIST handwritten digits when noise is added to the data. The results show that the sensitivity to noise of PH is influenced by the choice of filtrations and persistence signatures (respectively the input and output of PH), and in particular, that PH features are often not robust to noise in a classification task.
HB-HTA as an implementation problem in Polish health policy
Authors: Gałązka-Sobotka Małgorzata , Frączkiewicz-Wronka Aldona , Kowalska-Bobko Iwona , Kelm Hanna , Szymaniec-Mlicka Karolina
Published: September 2021

Hospital Based Health Technology Assessment (HB-HTA) is a new policy implemented in Poland to allow for a more practical and contextualized assessment related to the use of specific medical procedures, devices, or equipment. It requires changes in governance relating to the healthcare sector. One of the forms of governance improvement is to involve society in the process of creating public services. This can be implemented, e.g., by applying the pragmatic model of public responsiveness. The aim of this research was to identify and analyze forces which will shape a dynamic process in determining the implementation of HB-HTA. The results obtained in the Gioia analysis led to the identification of the main forces driving and restraining the implementation of HB-HTA. The grouping and interpretation allowed for the twelve most important dimensions to be distinguished, which were recognized as conceptual categories necessary to build theories that describe the studied phenomenon. This study contributes to the development of the idea of responsiveness in public management theory and in health care services, and ultimately helps to better enable the adjustment of health services to the dynamically changing needs of Polish society.
Global research priorities for COVID-19 in maternal, reproductive and child health: Results of an international survey
Authors: Etti Melanie , Alger Jackeline , Salas Sofía P. , Saggers Robin , Ramdin Tanusha , Endler Margit , Gemzell-Danielsson Kristina , Alfvén Tobias , Ahmed Yusuf , Callejas Allison , Eskenazi Deborah , Khalil Asma , Le Doare Kirsty ,   On behalf of the Maternal, Newborn and Child Health Working Group of the COVID-19 Clinical Research Coalition
Published: September 2021

Background

The World Health Organization’s “Coordinated Global Research Roadmap: 2019 Novel Coronavirus” outlined the need for research that focuses on the impact of COVID-19 on pregnant women and children. More than one year after the first reported case significant knowledge gaps remain, highlighting the need for a coordinated approach. To address this need, the Maternal, Newborn and Child Health Working Group (MNCH WG) of the COVID-19 Clinical Research Coalition conducted an international survey to identify global research priorities for COVID-19 in maternal, reproductive and child health.

Method

This project was undertaken using a modified Delphi method. An electronic questionnaire was disseminated to clinicians and researchers in three different languages (English, French and Spanish) via MNCH WG affiliated networks. Respondents were asked to select the five most urgent research priorities among a list of 17 identified by the MNCH WG. Analysis of questionnaire data was undertaken to identify key similarities and differences among respondents according to questionnaire language, location and specialty. Following elimination of the seven lowest ranking priorities, the questionnaire was recirculated to the original pool of respondents. Thematic analysis of final questionnaire data was undertaken by the MNCH WG from which four priority research themes emerged.

Results

Questionnaire 1 was completed by 225 respondents from 29 countries. Questionnaire 2 was returned by 49 respondents. The four priority research themes which emerged from the analysis were 1) access to healthcare during the COVID-19 pandemic, 2) the direct and 3) indirect effects of COVID-19 on pregnant and breastfeeding women and children and 4) the transmission of COVID-19 and protection from infection.

Conclusion

The results of these questionnaires indicated a high level of concordance among continents and specialties regarding priority research themes. This prioritized list of research uncertainties, developed to specifically highlight the most urgent clinical needs as perceived by healthcare professionals and researchers, could help funding organizations and researchers to answer the most pressing questions for clinicians and public health professionals during the pandemic. It is hoped that these identified priority research themes can help focus the discussion regarding the allocation of limited resources to enhance COVID-19 research in MNCH globally.
Elevated serum galectin-1 concentrations are associated with increased risks of mortality and acute kidney injury in critically ill patients
Authors: Chou Ruey-Hsing , Tsai Chuan-Tsai , Lu Ya-Wen , Guo Jiun-Yu , Lu Chi-Ting , Tsai Yi-Lin , Wu Cheng-Hsueh , Lin Shing-Jong , Lien Ru-Yu , Lu Shu-Fen , Yang Shang-Feng , Huang Po-Hsun
Published: September 2021

Background

Galectin-1 (Gal-1), a member of the β-galactoside binding protein family, is associated with inflammation and chronic kidney disease. However, the effect of Gal-1 on mortality and acute kidney injury (AKI) in critically-ill patients remain unclear.

Methods

From May 2018 to March 2020, 350 patients admitted to the medical intensive care unit (ICU) of Taipei Veterans General Hospital, a tertiary medical center, were enrolled in this study. Forty-one patients receiving long-term renal replacement therapy were excluded. Serum Gal-1 levels were determined within 24 h of ICU admission. The patients were divided into tertiles according to their serum Gal-1 levels (low, serum Gal-1 < 39 ng/ml; median, 39–70 ng/ml; high, ≥71 ng/ml). All patients were followed for 90 days or until death.

Results

Mortality in the ICU and at 90 days was greater among patients with elevated serum Gal-1 levels. In analyses adjusted for the body mass index, malignancy, sepsis, Sequential Organ Failure Assessment (SOFA) score, and serum lactate level, the serum Gal-1 level remained an independent predictor of 90-day mortality [median vs. low: adjusted hazard ratio (aHR) 2.11, 95% confidence interval (CI) 1.24–3.60, p = 0.006; high vs. low: aHR 3.21, 95% CI 1.90–5.42, p < 0.001]. Higher serum Gal-1 levels were also associated with a higher incidence of AKI within 48 h after ICU admission, independent of the SOFA score and renal function (median vs. low: aHR 2.77, 95% CI 1.21–6.34, p = 0.016; high vs. low: aHR 2.88, 95% CI 1.20–6.88, p = 0.017). The results were consistent among different subgroups with high and low Gal-1 levels.

Conclusion

Serum Gal-1 elevation at the time of ICU admission were associated with an increased risk of mortality at 90 days, and an increased incidence of AKI within 48 h after ICU admission.
Understanding risk factors for disordered eating symptomatology in athletes: A prospective study
Authors: Stoyel Hannah , Stride Chris , Shanmuganathan-Felton Vaithehy , Serpell Lucy
Published: September 2021

Disordered eating and eating disorders have huge impact on athletic health and performance. Understanding risk factors for disordered eating development is paramount to protecting the health and performance of these athletes. This project tested a model longitudinally to test whether body dissatisfaction (mediated by negative affect) and societal pressures (mediated by internalisation) predicted bulimic symptomatology at 1 year. The study recruited 1017 male and female athletes in a range of sports at three time points over a year. Cross-lag meditation modelling in MPLUS was utilised to test the hypothesised model. Results indicated that societal pressures mediated by general internalisation led to bulimic symptomatology and that gender and sport type do moderate the relationships. However, measurement issues indicate that scales not originally created for athletes may not reliably measure athletes’ experience. This research highlights how understanding how to better assess risk factors and disordered eating related concepts in athletes is a key next step. The study is unique in its longitudinal design and in its sampling of a wide range of sports in both male and female athletes.
Exploring menstrual products: A systematic review and meta-analysis of reusable menstrual pads for public health internationally
Authors: van Eijk Anna Maria , Jayasinghe Naduni , Zulaika Garazi , Mason Linda , Sivakami Muthusamy , Unger Holger W. , Phillips-Howard Penelope A.
Published: September 2021

Background

Girls and women need effective, safe, and affordable menstrual products. Single-use menstrual pads and tampons are regularly provided by agencies among resource-poor populations. Reusable menstrual pads (RMPs: fabric layers sewn together by an enterprise for manufacture of menstrual products) may be an effective alternative.

Methods

For this review (PROSPERO CRD42020179545) we searched databases (inception to November 1, 2020) for quantitative and qualitative studies that reported on leakage, acceptability, or safety of RMPs. Findings were summarised or combined using forest plots (random-effects meta-analysis). Potential costs and environmental savings associated with RMPs were estimated.

Results

A total of 44 studies were eligible (~14,800 participants). Most were conducted in low- and middle-income countries (LMIC, 78%), and 20% in refugee settings. The overall quality of studies was low. RMP uptake in cohort studies ranged from 22–100% (12 studies). One Ugandan trial among schoolgirls found leakage with RMPs was lower (44.4%, n = 72) compared to cloths (78%, n = 111, p<0.001). Self-reported skin-irritation was 23.8% after 3 months among RMP-users in a Ugandan cohort in a refugee setting (n = 267), compared to 72.8% at baseline with disposable pad use. There were no objective reports on infection. Challenges with washing and changing RMP were reported in LMIC studies, due to lack of water, privacy, soap, buckets, and sanitation/drying facilities. Among 69 brands, the average price for an RMP was $8.95 (standard deviation [sd] $5.08; LMIC $2.06, n = 10, high-income countries [HIC] $10.11), with a mean estimated lifetime of 4.3 years (sd 2.3; LMIC 2.9, n = 11; HIC 4.9 years, n = 23). In 5-year cost-estimates, in LMICs, 4–25 RMPs per period would be cheaper (170–417 US$) than 9–25 single-use pads, with waste-savings of ~600–1600 single-use pads. In HICs, 4–25 RMPs would be cheaper (33–245 US$) compared to 20 single-use tampons per period, with waste-savings of ~1300 tampons.

Conclusion

RMPs are used internationally and are an effective, safe, cheaper, and environmentally friendly option for menstrual product provision by programmes. Good quality studies in this field are needed.
A simple method for ex vivo honey bee cell culture capable of in vitro gene expression analysis
Authors: Watanabe Kazuyo , Yoshiyama Mikio , Akiduki Gaku , Yokoi Kakeru , Hoshida Hiroko , Kayukawa Takumi , Kimura Kiyoshi , Hatakeyama Masatsugu
Published: September 2021

Cultured cells are a very powerful tool for investigating biological eventsin vitro; therefore, cell lines have been established not only in model insect species, but also in non-model species. However, there are few reports on the establishment of stable cell lines and development of systems to introduce genes into the cultured cells of the honey bee (Apis mellifera). We describe a simpleex vivocell culture system for the honey bee. Hemocyte cells obtained from third and fourth instar larvae were cultured in commercial Grace’s insect medium or MGM-450 insect medium for more than two weeks maintaining a normal morphology without deterioration. After an expression plasmid vector bearing theenhanced green fluorescent protein(egfp) gene driven by the immediate early 2 (IE2) viral promoter was transfected into cells, EGFP fluorescence was detected in cells for more than one week from one day after transfection. Furthermore, double-stranded RNA corresponding to a part of theegfpgene was successfully introduced into cells and interfered withegfpgene expression. A convenient and reproducible method for anex vivocell culture that is fully practicable for gene expression assays was established for the honey bee.
Risk factors for inadvertent intraoperative hypothermia in patients undergoing laparoscopic surgery: A prospective cohort study
Authors: Chen Huai-Ying , Su Li-Jing , Wu Hang-Zhou , Zou Hong , Yang Rong , Zhu Yi-Xia
Published: September 2021

Background

Inadvertent intraoperative hypothermia is frequent during open surgeries; however, few studies on hypothermia during laparoscopic abdominal surgery have been reported. We aimed to investigate the incidence and risk factors for hypothermia in patients undergoing laparoscopic abdominal surgery.

Methods

This single-center prospective cohort observational study involved patients undergoing laparoscopic surgery between October 2018 and June 2019. Data on core body temperature and potential variables were collected. A multivariate logistic regression analysis was performed to identify the risk factors associated with hypothermia. A Cox regression analysis was used to verify the sensitivity of the results.

Results

In total, 690 patients were included in the analysis, of whom 200 (29.0%, 95% CI: 26%−32%) had a core temperature < 36°C. The core temperature decreased over time, and the incident hypothermia increased gradually. In the multivariate logistic regression analysis, age (OR = 1.017, 95% CI: 1.000–1.034,P= 0.050), BMI (OR = 0.938, 95% CI: 0.880–1.000;P= 0.049), baseline body temperature (OR = 0.025, 95% CI: 0.010–0.060;P <0.001), volume of irrigation fluids (OR = 1.001, 95% CI: 1.000–1.001,P= 0.001), volume of urine (OR = 1.001, 95% CI: 1.000–1.003,P= 0.070), and duration of surgery (OR = 1.010, 95% CI: 1.006–1.015,P< 0.001) were significantly associated with hypothermia. In the Cox analysis, variables in the final model were age, BMI, baseline body temperature, volume of irrigation fluids, blood loss, and duration of surgery.

Conclusions

Inadvertent intraoperative hypothermia is evident in patients undergoing laparoscopic surgeries. Age, BMI, baseline body temperature, volume of irrigation fluids, and duration of surgery are significantly associated with intraoperative hypothermia.
Immunohistochemical comparison of three programmed death-ligand 1 (PD-L1) assays in triple-negative breast cancer
Authors: Yoshikawa Katsuhiro , Ishida Mitsuaki , Yanai Hirotsugu , Tsuta Koji , Sekimoto Mitsugu , Sugie Tomoharu
Published: September 2021

Background

Triple-negative breast cancer (TNBC) is the most aggressive type of breast cancer. A recent study demonstrated the efficacy of anti-PD-L1 (anti-programmed death ligand-1) immunotherapy in patients with TNBC. However, the identification of TNBC patients who may benefit from immunotherapy is a critical issue. Several assays have been used to evaluate PD-L1 expression, and a few studies comparing PD-L1 expression using various primary antibodies in TNBC tissues have been reported. However, the expression profiles of the PD-L1 using the 73–10 assay have not yet been analyzed in TNBC tissues.

Methods

We analyzed the PD-L1 immunohistochemical profiles of 62 women with TNBC using the 73–10, SP142 (companion diagnostic for atezolizumab), and E1L3N assays. PD-L1 expression on immune cells (ICs) and tumor cells (TCs) was also evaluated, and PD-L1 positivity was defined as a PD-L1-expressing ICs or TCs ≥ 1%.

Results

The expression rates of PD-L1 were 79.0%, 67.7%, and 46.8% on ICs, and 17.7%, 6.5%, and 12.9% on TCs using the 73–10, SP142, and E1L3N assays, respectively. The concordance rates between the 73–10 and SP142 assays were 85.5% (on ICs) and 88.7% (on TCs), respectively, and substantial agreement on ICs (coefficient 0.634) and moderate agreement (coefficient 0.485) on TCs were noted. Sample age and tumor diameter did not influence the ratio of PD-L1 expression among the assays.

Conclusions

The positive rate on ICs and TCs of the 73–10 assay was higher than that of the SP 142 and E1L3N assays. Although substantial agreement on ICs and moderate agreement on TCs between the 73–10 and SP142 assays was noted in the present cohort, further studies are needed to clarify the PD-L1 expression status using various primary antibodies in a larger patient population. This would lead to the establishment of an effective evaluation method to assess the predictive value of anti-PD-L1 immunotherapy.
Impact of the COVID-19 pandemic on ophthalmic specialist training in Poland
Authors: Konopińska Joanna , Obuchowska Iwona , Lisowski Łukasz , Dub Natalia , Dmuchowska Diana Anna , Rękas Marek
Published: September 2021

The aim of this study was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on ophthalmology residency training in Poland. An anonymous self-administered online survey involving polish ophthalmology residents was conducted between February 15 and 28, 2021. Of the 126 residents who completed the survey, 88.9% (n = 112) and 89.7% (n = 113) felt that the COVID-19 pandemic had negatively impacted their surgical training and overall training programs, respectively. Trainees providing care to patients with COVID-19 and female trainees indicated a greater negative impact of the pandemic on the implementation of the specialization program (p = 0.008 and p = 0.015, respectively) and on the acquisition of practical skills (p = 0.014 and p = 0.021, respectively). Approximately 94% (n = 118) of the residents surveyed participated in virtual training during the pandemic, and 99.2% (n = 124) positively assessed the content and usefulness of online teaching in everyday clinical practice. The most common platforms used for online meetings were Zoom (62.7%, n = 79) and Microsoft Teams (50.8%, n = 64). Approximately 79% (n = 99) of residents believed that, after the pandemic is over, at least some of the training courses and conferences should be conducted online. In addition, 13.5% (n = 17) of residents reported that they would like to undergo training and specialization courses in virtual form only after the pandemic is over. In summary, the present findings indicate that the COVID-19 pandemic negatively impacted the implementation of the ophthalmology specialization program in Poland, with the greatest impact on surgical training. Trainees providing care to patients with COVID-19 are more likely to negatively assess the impact of the pandemic on the training process. Replacing traditional training with virtual methods was positively received by residents and considered very useful, and most residents reported a desire to maintain virtual training in ophthalmology in the future.
Does seniority always correlate with simulated intubation performance? Comparing endotracheal intubation performance across medical students, residents, and physicians using a high-fidelity simulator
Authors: Yau Sze-Yuen , Chang Yu-Che , Wu Meng-Yu , Liao Shu-Chen
Published: September 2021

Background

Endotracheal intubation is crucial in emergency medical care and anaesthesia. Our study employed a high-fidelity simulator to explore differences in intubation success rate and other skills between junior and senior physicians.

Methods

We examined the performance of 50 subjects, including undergraduate students (UGY), postgraduate trainees (PGY), residents (R), and attending physicians (VS). Each participant performed 12 intubations (i.e. 3 devices x 4 scenarios) on a high-fidelity simulator. Main outcome measures included success rate, time for intubation, force applied on incisor and tongue, and Cormack Lehane grades.

Results

There was no primary effect of seniority on any outcome measure except success rate and Cormack Lehane grades. However, VS demonstrated shorter duration than medical students using Glidescope and direct laryngoscopy, whereas VS and R applied significantly more force on the incisor in the normal airway and rigid neck scenario respectively.

Discussion

Seniority does not always correlate with skill perfection in detailed processes. Our study suggests that the use of video laryngoscopy enhances the intubation success rate and speed, but the benefit only accrues to senior learners, whereby they applied more force on the incisor at a single peak under difficult scenarios. These findings are discussed in terms of psychological and cognitive perspectives.

Conclusion

Speed and safety are essential for high quality critical medical procedures. A tool should be designed and implemented to educate junior physicians with an emphasis on practice and efficiency, which should also contribute to updating senior physicians’ knowledge and competence by providing instant feedback on their performance. This type of fine-grained feedback could serve as a complement to traditional training and provide a sustainable learning model for medical education.
Phagocytes produce prostaglandin E2 in response to cytosolic Listeria monocytogenes
Authors: McDougal Courtney E. , Morrow Zachary T. , Christopher Tighe , Kim Seonyoung , Carter Drake , Stevenson David M. , Amador-Noguez Daniel , Miller Mark J. , Sauer John-Demian
Published: September 2021

Listeria monocytogenesis an intracellular bacterium that elicits robust CD8+T-cell responses. Despite the ongoing development ofL.monocytogenes-based platforms as cancer vaccines, our understanding of howL.monocytogenesdrives robust CD8+T-cell responses remains incomplete. One overarching hypothesis is that activation of cytosolic innate pathways is critical for immunity, as strains ofL.monocytogenesthat are unable to access the cytosol fail to elicit robust CD8+T-cell responses and in fact inhibit optimal T-cell priming. Counterintuitively, however, activation of known cytosolic pathways, such as the inflammasome and type I IFN, lead to impaired immunity. Conversely, production of prostaglandin E2(PGE2) downstream of cyclooxygenase-2 (COX-2) is essential for optimalL.monocytogenesT-cell priming. Here, we demonstrate that vacuole-constrainedL.monocytogeneselicit reduced PGE2production compared to wild-type strains in macrophages and dendritic cellsex vivo.In vivo, infection with wild-typeL.monocytogenesleads to 10-fold increases in PGE2production early during infection whereas vacuole-constrained strains fail to induce PGE2over mock-immunized controls. Mice deficient in COX-2 specifically in Lyz2+or CD11c+cells produce less PGE2, suggesting these cell subsets contribute to PGE2levelsin vivo, while depletion of phagocytes with clodronate abolishes PGE2production completely. Taken together, this work demonstrates that optimal PGE2production by phagocytes depends onL.monocytogenesaccess to the cytosol, suggesting that one reason cytosolic access is required to prime CD8+T-cell responses may be to facilitate production of PGE2.
Characterization of changes in the hemagglutinin that accompanied the emergence of H3N2/1968 pandemic influenza viruses
Authors: West Johanna , Röder Juliane , Matrosovich Tatyana , Beicht Jana , Baumann Jan , Mounogou Kouassi Nancy , Doedt Jennifer , Bovin Nicolai , Zamperin Gianpiero , Gastaldelli Michele , Salviato Annalisa , Bonfante Francesco , Kosakovsky Pond Sergei , Herfst Sander , Fouchier Ron , Wilhelm Jochen , Klenk Hans-Dieter , Matrosovich Mikhail
Published: September 2021

The hemagglutinin (HA) of A/H3N2 pandemic influenza viruses (IAVs) of 1968 differed from its inferred avian precursor by eight amino acid substitutions. To determine their phenotypic effects, we studied recombinant variants of A/Hong Kong/1/1968 virus containing either human-type or avian-type amino acids in the corresponding positions of HA. The precursor HA displayed receptor binding profile and high conformational stability typical for duck IAVs. Substitutions Q226L and G228S, in addition to their known effects on receptor specificity and replication, marginally decreased HA stability. Substitutions R62I, D63N, D81N and N193S reduced HA binding avidity. Substitutions R62I, D81N and A144G promoted viral replication in human airway epithelial cultures. Analysis of HA sequences revealed that substitutions D63N and D81N accompanied by the addition of N-glycans represent common markers of avian H3 HA adaptation to mammals. Our results advance understanding of genotypic and phenotypic changes in IAV HA required for avian-to-human adaptation and pandemic emergence.
Salmonella Typhimurium impairs glycolysis-mediated acidification of phagosomes to evade macrophage defense
Authors: Gutiérrez Saray , Fischer Julia , Ganesan Raja , Hos Nina Judith , Cildir Gökhan , Wolke Martina , Pessia Alberto , Frommolt Peter , Desiderio Vincenzo , Velagapudi Vidya , Robinson Nirmal
Published: September 2021

Regulation of cellular metabolism is now recognized as a crucial mechanism for the activation of innate and adaptive immune cells upon diverse extracellular stimuli. Macrophages, for instance, increase glycolysis upon stimulation with pathogen-associated molecular patterns (PAMPs). Conceivably, pathogens also counteract these metabolic changes for their own survival in the host. Despite this dynamic interplay in host-pathogen interactions, the role of immunometabolism in the context of intracellular bacterial infections is still unclear. Here, employing unbiased metabolomic and transcriptomic approaches, we investigated the role of metabolic adaptations of macrophages uponSalmonella entericaserovar Typhimurium (S. Typhimurium) infections. Importantly, our results suggest thatS. Typhimurium abrogates glycolysis and its modulators such as insulin-signaling to impair macrophage defense. Mechanistically, glycolysis facilitates glycolytic enzyme aldolase A mediated v-ATPase assembly and the acidification of phagosomes which is critical for lysosomal degradation. Thus, impairment in the glycolytic machinery eventually leads to decreased bacterial clearance and antigen presentation in murine macrophages (BMDM). Collectively, our results highlight a vital molecular link between metabolic adaptation and phagosome maturation in macrophages, which is targeted byS. Typhimurium to evade cell-autonomous defense.
From environmental degradation to the waste economy of postcolonial desire: Ecocritical footprints in Touki Bouki and Hyenas
Authors: Diop El Hadji
Published: September 2021

There is a tendency, among Mambety critics, to overemphasize his formal innovations and parodic contents, his virtuosic collages and subtle nods to auteur and genre cinema, at the expense of a sustained engagement with the acute environmental sensibility running through all his films, notably at the start of a film career that is contemporaneous with the Great Sahel Drought of the late 1960s and early 1970s. This article focuses on the ecocritical edge neatly blended into the narrative structures and visual aesthetics of the classicTouki BoukiandHyenas. The point is, through a minute analysis of the tropes and metaphors of lack, scarcity and abundance, to cast a sharp light on the deep-ecological angst informing Mambety’s cinematic gaze.