bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of utilisation of specialist care after SARS-Cov-2 infection: a retrospective cohort study
Authors: Formoso Giulio , Marino Massimiliano , Formisano Debora , Grilli Roberto
Published: March 2023

Objective

To explore the pattern of health services utilisation of people who had had a documented SARS-Cov-2 infection.

Design

Retrospective cohort study.

Setting

The Italian province of Reggio Emilia.

Participants

36 036 subjects who recovered from SARS-CoV-2 infection during the period September 2020–May 2021. These were matched for age, sex and Charlson Index with an equal number of subjects never found positive at the SARS-Cov-2 swab test over the study period.

Main outcome measures

Hospital admissions for all medical conditions and for respiratory or cardiovascular conditions only; access to emergency room (for any cause); outpatient specialist visits (pneumology, cardiology, neurology, endocrinology, gastroenterology, rheumatology, dermatology, mental health) and overall cost of care.

Results

Within a median follow-up time of 152 days (range 1–180), previous exposure to SARS-Cov-2 infection was always associated with higher probability of needing access to hospital or ambulatory care, except for dermatology, mental health and gastroenterology specialist visits. Post-COVID subjects with Charlson Index≥1 were hospitalised more frequently for heart disease and for non-surgical reasons than subjects with Charlson index=0, whereas the opposite occurred for hospitalisations for respiratory diseases and pneumology visits. A previous SARS-CoV-2 infection was associated with 27% higher cost of care compared with people never infected. The difference in cost was more evident among those with Charlson Index>1. Subjects who had anti-SARS-CoV-2 vaccination had lower probability of falling in the highest cost quartile.

Conclusions

Our findings reflect the burden of post-COVID sequelae, providing some specific insight on their impact on the extra-use of health services according to patients’ characteristics and vaccination status. Vaccination is associated with lower cost of care following SARS-CoV-2 infection, highlighting the favourable impact of vaccines on the use of health services even when they do not prevent infection.
Protocol for the PLAY Study: a randomised controlled trial of an intervention to improve infant development by encouraging maternal self-efficacy using behavioural feedback
Authors: Prioreschi Alessandra , Pearson Rebecca , Richter Linda , Bennin Fiona , Theunissen Helene , Cantrell Sarah J , Maduna Dumsile , Lawlor Deborah , Norris Shane A
Published: March 2023

Introduction

The early infant caregiving environment is crucial in the formation of parent–child relationships, neurobehavioural development and thus child outcomes. This protocol describes the Play Love And You (PLAY) Study, a phase 1 trial of an intervention designed to promote infant development through encouraging maternal self-efficacy using behavioural feedback, and supportive interventions.

Methods and analysis

210 mother–infant pairs will be recruited at delivery from community clinics in Soweto, South Africa, and individually randomised (1:1) into two groups. The trial will consist of a standard of care arm and an intervention arm. The intervention will start at birth and end at 12 months, and outcome assessments will be made when the infants are 0, 6 and 12 months of age. The intervention will be delivered by community health helpers using an app with resource material, telephone calls, in person visits and behavioural feedback with individualised support. Every 4 months, mothers in the intervention group will receive rapid feedback via the app and in person on their infant’s movement behaviours and on their interaction styles with their infant. At recruitment, and again at 4 months, mothers will be screened for mental health risk and women who score in the high-risk category will receive an individual counselling session from a licensed psychologist, followed by referral and continued support as necessary. The primary outcome is efficacy of the intervention in improving maternal self-efficacy, and the secondary outcomes are infant development at 12 months, and feasibility and acceptability of each component of the intervention.

Ethics and dissemination

The PLAY Study has received ethical approval from the Human Research Ethics Committee of the University of the Witwatersrand (M220217). Participants will be provided with an information sheet and required to provide written consent prior to being enrolled. Study results will be shared via publication in peer-reviewed journals, conference presentation and media engagement.

Trial registration number

This trial was registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za) on 10 February 2022 (identifier: PACTR202202747620052).
Association between exposure to secondhand aerosol from heated tobacco products and respiratory symptoms among current non-smokers in Japan: a cross-sectional study
Authors: Yoshioka Takashi , Shinozaki Tomohiro , Hori Ai , Okawa Sumiyo , Nakashima Kei , Tabuchi Takahiro
Published: March 2023

Objectives

To investigate the association between secondhand-aerosol exposure from heated tobacco products (HTPs) and respiratory symptoms among current non-smokers.

Design

Cross-sectional study.

Setting

Internet survey conducted between 8 and 26 February 2021 in Japan.

Participants

Non-smoking respondents at the survey aged 15–80 years.

Exposure

Self-reported secondhand-aerosol exposure.

Primary and secondary outcomes

We defined asthma/asthma-like symptoms as a primary outcome and persistent cough as a secondary outcome. We examined the association between secondhand-aerosol exposure from HTPs and respiratory symptoms (asthma attacks/asthma-like symptoms and persistent cough). The prevalence ratio (PR) and 95% CI were calculated by using weighted, multivariable ‘modified’ Poisson regression models.

Results

Of the 18 839 current non-smokers, 9.8% (95% CI 8.2% to 11.7%) and 16.7% (95% CI 14.8% to 18.9%) of those who were exposed to secondhand aerosols reported asthma attacks/asthma-like symptoms and persistent cough, whereas 4.5% (95% CI 3.9% to 5.2%) and 9.6% (95% CI 8.4% to 11.0%) of those who were not, respectively. Secondhand-aerosol exposure was associated with respiratory symptoms (asthma attacks/asthma-like symptoms: PR 1.49, 95% CI 1.21 to 1.85; persistent cough: PR 1.44, 95% CI 1.21 to 1.72) after adjusting for covariates.

Conclusion

Secondhand-aerosol exposure from HTPs was associated with both asthma attacks/asthma-like symptoms and persistent cough. These results provide policymakers with meaningful information in the regulation of HTP use for the protection of current non-smokers.
Effects of school-level and area-level socio-economic factors on elementary school student COVID-19 infections: a population-based observational study
Authors: Srivastava Prachi , Lau Nathan T T , Ansari Daniel , Thampi Nisha
Published: March 2023

Objectives

To estimate the variability of the cumulative incidence of SARS-CoV-2 infections among elementary school students attributable to individual schools and/or their geographic areas, and to ascertain whether socio-economic characteristics of school populations and/or geographic areas may be predictive of this variability.

Design

Population-based observational study of SARS-CoV-2 infections among elementary school children.

Setting

3994 publicly funded elementary schools in 491 forward sortation areas (designated geographic unit based on first three characters of Canadian postal code), Ontario, Canada, September 2020 to April 2021.

Participants

All students attending publicly funded elementary schools with a positive molecular test for SARS-CoV-2 reported by the Ontario Ministry of Education.

Main outcome measures

Cumulative incidence of laboratory-confirmed elementary school student SARS-CoV-2 infections in Ontario, 2020–21 school year.

Results

A multilevel modelling approach was used to estimate the effects of socio-economic factors at the school and area levels on the cumulative incidence of elementary school student SARS-CoV-2 infections. At the school level (level 1), the proportion of the student body from low-income households was positively associated with cumulative incidence (β=0.083, p<0.001). At the area level (level 2), all dimensions of marginalisation were significantly related to cumulative incidence. Ethnic concentration (β=0.454, p<0.001), residential instability (β=0.356, p<0.001) and material deprivation (β=0.212, p<0.001) were positively related, while dependency (β=-0.204, p<0.001) was negatively related. Area-related marginalisation variables explained 57.6% of area variability in cumulative incidence. School-related variables explained 1.2% of school variability in cumulative incidence.

Conclusions

The socio-economic characteristics of the geographic area of schools were more important in accounting for the cumulative incidence of SARS-CoV-2 elementary school student infections than individual school characteristics. Schools in marginalised areas should be prioritised for infection prevention measures and education continuity and recovery plans.
Impact of minimally invasive surgery on surgeon health (ISSUE) study: protocol of a single-arm observational study conducted in the live surgery setting
Authors: Amirthanayagam Anumithra , Zecca Massimiliano , Barber Shaun , Singh Baljit , Moss Esther L
Published: March 2023

Introduction

The rapid evolution of minimally invasive surgery has had a positive impact on patient outcomes; however, it is reported to be associated with work-related musculoskeletal symptoms (WMS) in surgeons. Currently there is no objective measure to monitor the physical and psychological impact of performing a live surgical procedure on the surgeon.

Methods and analysis

A single-arm observational study with the aim of developing a validated assessment tool to quantify the impact of surgery (open/laparoscopic/robotic-assisted) on the surgeon. Development and validation cohorts of major surgical cases of varying levels of complexity performed by consultant gynaecological and colorectal surgeons will be recruited. Recruited surgeons wear three Xsens DOT monitors (muscle activity) and an Actiheart monitor (heart rate). Salivary cortisol levels will be taken and questionnaires (WMS and State-Trait Anxiety Inventory) completed by the participants preoperatively and postoperatively. All the measures will be incorporated to produce a single score that will be called the 'S-IMPACT' score.

Ethics and dissemination

Ethical approval for this study has been granted by the East Midlands Leicester Central Research Ethics Committee REC ref 21/EM/0174. Results will be disseminated to the academic community through conference presentations and peer-reviewed journal publications. The S-IMPACT score developed within this study will be taken forward for use in definitive multicentre prospective randomised control trials.
Prediction of cardiovascular death and non-fatal cardiovascular events by the Kidney age–Chronological age Difference (KCD) score in men and women of different ages in a community-based cohort
Authors: Campbell Duncan J , Magliano Dianna J , Shaw Jonathan E
Published: March 2023

Objective

We examined the utility of the Kidney age–Chronological age Difference (KCD) score, an age-adapted measure of kidney function, to identify increased cardiovascular (CV) death or non-fatal CV event risk in participants of the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab), a community-based cohort aged 23–95 years.

Design

Cohort study.

Setting

Community.

Participants

11205 randomly selected participants from urban and nonurban areas across Australia.

Outcome measures

Mortality status and underlying and contributory causes of death obtained from the Australian National Death Index, and non-fatal CV events from adjudicated hospital records. The association of CV death or non-fatal CV event risk with KCD score was examined using penalised spline curve analysis.

Results

Of 11 180 participants with serum creatinine measurement at baseline and 5-year outcome data, there were 308 CV deaths or non-fatal CV events after 5 years. Penalised spline curve analysis showed similar progressive increase in CV death or non-fatal CV event risk with increasing KCD score in men and women, and participants aged <50 years to ≥80 years. Receiver operating characteristic curve analysis showed optimal discrimination at a KCD score ≥20 years (KCD20) for all participants. Among 148 participants aged<70 years with CV death or non-fatal CV event, KCD20 identified 24 (16%) participants, whereas estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2identified 8 (5%) participants (p=0.0001), with specificities of 95% and 99%, respectively (p<0.0001).

Conclusion

KCD20 predicted CV death or non-fatal CV event risk similarly in men and women of different ages in this population-based cohort. The higher sensitivity for prediction of CV death or non-fatal CV event risk in participants aged <70 years by KCD20 than by eGFR <60 mL/min/1.73 m2offers opportunity for earlier renoprotective therapy in individuals with eGFR-associated increased CV death or non-fatal CV event risk.
Use of tranexamic acid (TXA) to reduce preterm birth and other adverse obstetrical outcomes among pregnant individuals with placenta previa: a systematic review protocol
Authors: Seguin Niève , Visintini Sarah , Muldoon Katherine A , Walker Mark
Published: March 2023

Introduction

Placenta previa is a placental implantation pathology where the placenta overlies the internal endocervical os. Placenta previa affects approximately 4 per 1000 pregnancies and increases the risk of antepartum bleeding, emergent preterm labour and emergency caesarean sections. Currently, placenta previa is managed through expectant management. Guidelines primarily revolve around the mode and timing of delivery, in-hospital admissions and surveillance. However, the methods to prolong pregnancy have not proven to be clinically effective. Tranexamic acid (TXA), an antifibrinolytic agent, is effectively used to prevent and treat postpartum haemorrhage as well as menorrhagia, with limited adverse effect, and may prove to be an effective treatment for placenta previa. The objective of this systematic review protocol is to review and synthesise the evidence of TXA use for antepartum haemorrhage in placenta previa.

Methods and analysis

Preliminary searches were conducted on 12 July 2022. We will search MEDLINE, EMBASE, CINAHL, Scopus and the Cochrane Central Register of Controlled Trials. Grey literature resources such as clinical trials registries (ClinicalTrials.gov and the WHO’s International Clinical Trials Registry) and preprint servers (Europe PMC and Open Science Framework) will also be searched. The search terms will comprise of index headings and keyword searches related to TXA and the placenta or antepartum bleeding. Cohort and randomised and non-randomised trials will be considered. The target population is pregnant people, of any age, with placenta previa. The intervention is TXA given in the antepartum period. The main outcome of interest is preterm birth before 37 weeks, however, all perinatal outcomes will be collected. Title and abstract will be screened by two reviewers and any conflict will be discussed and evaluated by a third reviewer. The literature will be summarised in narrative form.

Ethics and dissemination

No ethics approval is required for this protocol. Findings will be disseminated through peer-review publication, lay summaries and conference presentations.

PROSPERO registration number

CRD42022363009).
Acceptability and usability of a paediatric HIV screening tool in high-volume outpatient settings in Malawi, perspectives from caregivers and healthcare workers
Authors: Katirayi Leila , Maphosa Thulani , Kudiabor Kwashie , Kayira Dumbani , Gross Jessica , Hrapcak Susan , Chamanga Rachel , Nkhoma Harrid , Puleni Paul , Maida Alice , Ahimbisibwe Allan , Woelk Godfrey
Published: March 2023

Background

Using an HIV pretest screening tool to identify children most at risk for HIV infection may be a more efficient and cost-effective approach to identify children living with HIV in resource-limited settings. These tools seek to reduce overtesting of children by increasing the positive predictive value while ensuring a high negative predictive value for those screened for HIV.

Methods

This qualitative study in Malawi evaluated acceptability and usability of a modified version of the Zimbabwe HIV screening tool to identify children aged 2–14 years most-at-risk. The tool included additional questions about previous hospitalisations due to malaria and prior documented diagnoses. Sixteen interviews were conducted with expert clients (ECs), trained peer-supporters, which administered the screening tool and 12 interviews with biological and non-biological caregivers of screened children. All interviews were audiorecorded, transcribed and translated. Transcripts were analysed manually using a short-answer analysis, compiling responses for each question by study participant group. Summary documents were generated, identifying common and outlier perspectives.

Results

The HIV paediatric screening tool was generally accepted by caregivers and ECs, with both groups seeing the benefit of the tool and promoting its use. The ECs who were primarily responsible for implementing the tool initially struggled with acceptance of the tool but started to accept it after additional training and mentorship was provided. Overall, caregivers accepted having their children tested for HIV, although non-biological caregivers expressed hesitancy in giving consent for HIV testing. ECs reported challenges with the ability for non-biological caregivers to answer some questions.

Conclusion

This study found general acceptance of paediatric screening tools in children in Malawi and identified some minor challenges that raise important considerations for tool implementation. These include the need for a thorough orientation of the tools for the healthcare workers and caregivers, appropriate space at the facility, and adequate staffing and commodities.
On modelling relative risks for longitudinal binomial responses: implications from two dueling paradigms
Authors: Lin Tuo , Zhao Rongzhe , Tu Shengjia , Wu Hao , Zhang Hui , Tu Xin M
Published: March 2023

Although logistic regression is the most popular for modelling regression relationships with binary responses, many find relative risk (RR), or risk ratio, easier to interpret and prefer to use this measure of risk in regression analysis. Indeed, since Zou published his modified Poisson regression approach for modelling RR for cross-sectional data, his paper has been cited over 7 000 times, demonstrating the popularity of this alternative measure of risk in regression analysis involving binary responses. As longitudinal studies have become increasingly popular in clinical trials and observational studies, it is imperative to extend Zou’s approach for longitudinal data.

The two most popular approaches for longitudinal data analysis are the generalised linear mixed-effects model (GLMM) and generalised estimating equations (GEE). However, the parametric GLMM cannot be used for the extension within the current context, because Zou’s approach treats the binary response as a Poisson variable, which is at odds with the Bernoulli distribution for the binary response. On the other hand, as it imposes no mathematical model on data distributions, the semiparametric GEE is coherent with Zou’s modified Poisson regression. In this paper, we develop a GEE-based longitudinal model for binary responses to provide inference about RR.
Interaction between tumor cell TNFR2 and monocyte membrane-bound TNF-α triggers tumorigenic inflammation in neuroblastoma
Authors: Tomolonis Julie A , Xu Xin , Dholakia Kshiti H , Zhang Chunchao , Guo Linjie , Courtney Amy N , Wang Siyue , Balzeau Julien , Barragán Gabriel A , Tian Gengwen , Di Pierro Erica J , Metelitsa Leonid S
Published: March 2023

Background

Tumor progression and resistance to therapy in children with neuroblastoma (NB), a common childhood cancer, are often associated with infiltration of monocytes and macrophages that produce inflammatory cytokines. However, the mechanism by which tumor-supportive inflammation is initiated and propagated remains unknown. Here, we describe a novel protumorigenic circuit between NB cells and monocytes that is triggered and sustained by tumor necrosis factor alpha (TNF-α).

Methods

We used NB knockouts (KOs) of TNF-α andTNFRSF1AmRNA (TNFR1)/TNFRSF1BmRNA (TNFR2) and TNF-α protease inbitor (TAPI), a drug that modulates TNF-α isoform expression, to assess the role of each component in monocyte-associated protumorigenic inflammation. Additionally, we employed NB-monocyte cocultures and treated these with clinical-grade etanercept, an Fc-TNFR2 fusion protein, to neutralize signaling by both membrane-bound (m) and soluble (s)TNF-α isoforms. Further, we treated NOD/SCID/IL2Rγ(null) mice carrying subcutaneous NB/human monocyte xenografts with etanercept and evaluated the impact on tumor growth and angiogenesis. Gene set enrichment analysis (GSEA) was used to determine whether TNF-α signaling correlates with clinical outcomes in patients with NB.

Results

We found that NB expression of TNFR2 and monocyte membrane-bound tumor necrosis factor alpha is required for monocyte activation and interleukin (IL)-6 production, while NB TNFR1 and monocyte soluble TNF-α are required for NB nuclear factor kappa B subunit 1 (NF-κB) activation. Treatment of NB-monocyte cocultures with clinical-grade etanercept completely abrogated release of IL-6, granulocyte colony-stimulating factor (G-CSF), IL-1α, and IL-1β and eliminated monocyte-induced enhancement of NB cell proliferation in vitro. Furthermore, etanercept treatment inhibited tumor growth, ablated tumor angiogenesis, and suppressed oncogenic signaling in mice with subcutaneous NB/human monocyte xenografts. Finally, GSEA revealed significant enrichment for TNF-α signaling in patients with NB that relapsed.

Conclusions

We have described a novel mechanism of tumor-promoting inflammation in NB that is strongly associated with patient outcome and could be targeted with therapy.
Evaluation of tumor antigen-specific antibody responses in patients with metastatic triple negative breast cancer treated with cyclophosphamide and pembrolizumab
Authors: Routh Eric D , Woodcock Mark G , Beckabir Wolfgang , Vensko Steven P , Serody Jonathan S , Vincent Benjamin G
Published: March 2023

The role of B cells in antitumor immunity is becoming increasingly appreciated, as B cell populations have been associated with response to immune checkpoint blockade (ICB) in patients with breast cancer and murine models of breast cancer. Deeper understanding of antibody responses to tumor antigens is needed to clarify the function of B cells in determining response to immunotherapy. We evaluated tumor antigen-specific antibody responses in patients with metastatic triple negative breast cancer treated with pembrolizumab following low-dose cyclophosphamide therapy using computational linear epitope prediction and custom peptide microarrays. We found that a minority of predicted linear epitopes were associated with antibody signal, and signal was associated with both neoepitopes and self-peptides. No association was observed between signal presence and subcellular localization or RNA expression of parent proteins. Patient-specific patterns of antibody signal boostability were observed that were independent of clinical response. Intriguingly, measures of cumulative antibody signal intensity relative to immunotherapy treatment showed that the one complete responder in the trial had the greatest increase in total antibody signal, which supports a potential association between ICB-dependent antibody boosting and clinical response. The antibody boost in the complete responder was largely driven by increased levels of IgG specific to a sequence of N-terminal residues in native Epidermal Growth Factor Receptor Pathway Substrate 8 (EPS8) protein, a known oncogene in several cancer types including breast cancer. Structural protein prediction showed that the targeted epitope of EPS8 was in a region of the protein with mixed linear/helical structure, and that this region was solvent-exposed and not predicted to bind to interacting macromolecules. This study highlights the potential importance of the humoral immune response targeting neoepitopes as well as self epitopes in shaping clinical response to immunotherapy.
Role of optical coherence tomography in pipeline embolization device for the treatment of vertebral–basilar artery dissecting aneurysms
Authors: Ma Yongjie , Ji Zhe , Yang Wanxin , Li Li , Han Liqiang , Liu Yu , Guo Yuanhao , Dmytriw Adam A , He Chuan , Li Guilin , Zhang Hongqi
Published: March 2023

Background

Vertebral–basilar artery dissecting aneurysms (VADAs) are an uncommon phenomenon in all fields of cerebrovascular disease. The flow diverter (FD) can be used as an endoluminal reconstruction device that promotes neointima formation at the aneurysmal neck and preserves the parent artery. To date, imaging examinations such as CT angiography, MR angiography, and DSA are the main methods used to evaluate the vasculature of patients. However, none of these imaging methods can reveal the situation of neointima formation, which is of great importance in evaluating occlusion of VADAs, especially those treated with a FD.

Methods

Three patients were included in the study from August 2018 to January 2019. All patients underwent preprocedural, postprocedural, and follow-up evaluations with high resolution MRI, DSA, and optical coherence tomography (OCT), as well as the formation of intima on the surface of the scaffold at the 6 month follow-up.

Results

Preprocedural, postoperative, and follow-up high resolution MRI, DSA, and OCT of all three cases successfully evaluated occlusion of the VADAs and occurrence of in stent stenosis from different views of intravascular angiography and neointima formation.

Conclusions

OCT was feasible and useful to further evaluate VADAs treated with FD from a near pathological perspective, which may contribute toward guiding the duration of antiplatelet medication and early intervention of in stent stenosis.
Characterization of length of stay after minimally invasive endoscopic intracerebral hemorrhage evacuation
Authors: Ali Muhammad , Smith Colton , Vasan Vikram , Downes Margaret , Schuldt Braxton R , Odland Ian , Murtaza-Ali Muhammad , Dullea Jonathan , Rossitto Christina P , Schupper Alexander J , Hardigan Trevor , Asghar Nek , Liang John , Mocco J , Kellner Christopher P
Published: March 2023

Background

Minimally invasive evacuation may help ameliorate outcomes after intracerebral hemorrhage (ICH). However, hospital length of stay (LOS) post-evacuation is often long and costly.

Objective

To examine factors associated with LOS in a large cohort of patients who underwent minimally invasive endoscopic evacuation.

Methods

Patients presenting to a large health system with spontaneous supratentorial ICH qualified for minimally invasive endoscopic evacuation if they met the following inclusion criteria: age ≥18, premorbid modified Rankin Scale (mRS) score ≤3, hematoma volume ≥15 mL, and presenting National Institutes of Health Stroke Scale (NIHSS) score ≥6. Demographic, clinical, radiographic, and operative characteristics were included in a multivariate logistic regression for hospital and ICU LOS dichotomized into short and prolonged stay at 14 and 7 days, respectively.

Results

Among 226 patients who underwent minimally invasive endoscopic evacuation, the median intensive care unit and hospital LOS were 8 (4–15) days and 16 (9–27) days, respectively. A greater extent of functional impairment on presentation (OR per NIHSS point 1.10 (95% CI 1.04 to 1.17), P=0.007), concurrent intraventricular hemorrhage (OR=2.46 (1.25 to 4.86), P=0.02), and deep origin (OR=per point 2.42 (1.21 to 4.83), P=0.01) were associated with prolonged hospital LOS. A longer delay from ictus to evacuation (OR per hour 1.02 (1.01 to 1.04), P=0.007) and longer procedure time (OR per hour 1.91 (1.26 to 2.89), P=0.002) were associated with prolonged ICU LOS. Prolonged hospital and ICU LOS were in turn longitudinally associated with a lower rate of discharge to acute rehabilitation (40% vs 70%, P<0.0001) and worse 6-month mRS outcomes (5 (4–6) vs 3 (2–4), P<0.0001).

Conclusions

We present factors associated with prolonged LOS, which in turn was associated with poor long-term outcomes. Factors associated with LOS may help to inform patient and clinician expectations of recovery, guide protocols for clinical trials, and select suitable populations for minimally invasive endoscopic evacuation.
Radiative and viscid dissipative flowing influences on heat and mass transfer in MHD Casson fluid employing Galerkin finite element style
Authors: Shankar Gollapalli , Sheri Siva Reddy , Jamshed Wasim , Ibrahim Rabha W. , Eid Mohamed R. , Guedri Kamel
Published: March 2023

This work employs a numerical calculation to investigate the heat and mass transfer process of a hydromagnetic radiative Casson fluid flowing through a vertical plate in the presence of heat generation, viscid dissipation and chemical processes. The governing dimensional partial differential equations (PDE) for considered Casson fluid are first converted into dimensionless PDE utilizing proper variables. The obtained system is then computed using Galerkin finite element method (G-FEM). The approximated results for different parameters are shown through curves and tables. The impact of dimensionless parameters is visualized on fluid velocity, fluid temperature, fluid concentration, Nusselt number and skin friction. The heat transmission mechanism of Casson fluid is superior to that of the Newtonian liquid. In the limited scenario, the study findings are in excellent accord with the existing literature.
UNREADABLE OFFLINE HANDWRITING SIGNATURE VERIFICATION BASED ON GENERATIVE ADVERSARIAL NETWORK USING LIGHTWEIGHT DEEP LEARNING ARCHITECTURES
Authors: MAJIDPOUR JAFAR , ÖZYURT FATIH , ABDALLA MOHAMMED HUSSEIN , CHU YU MING , ALOTAIBI NAIF D.
Published: March 2023

Today, it is known that there are great difficulties and problems in signature and signature examinations, which have a very important place in both our private life and business and commercial life. The major issue arises when the manuscript’s signature is so illegible and unclear that it is difficult, if not impossible, to authenticate it with the human eye. Researchers have proposed traditional deep learning techniques to solve or improve this challenge. However, the results are not satisfactory. In this study, a new use of Generative Adversarial Network (GAN) model is proposed as a high-quality data synthesis method to address the unreadable data problem on signature verification. A unique signature verification method based on Lightweight deep learning architecture is also proposed. The suggested data synthesizing approach is evaluated using three frequently used Convolutional Neural Network (CNN) methods: MobileNet, SqueezeNet, and ShuffleNet. In addition, in preprocessing phase, we added three different types of high-intensity noise, including Salt & Pepper (S&P), Gaussian, and Gaussian Blur, to the images to make the signature unreadable. We utilized Indic scripts dataset to train GAN and CNN models in our approach. The great quality of images generated by GAN model, as well as the signature verification of the generated images, point to the suggested model’s strong performance.
TWO DISCRETE MEMRISTIVE CHAOTIC MAPS AND ITS DSP IMPLEMENTATION
Authors: HAN XINTONG , MOU JUN , LU JINSHI , BANERJEE SANTO , CAO YINGHONG
Published: March 2023

In this paper, a discrete model of memristor is adopted and analyzed. The new discrete maps are built by introducing this discrete memristor model into a two-dimensional discrete map. Interestingly, introducing this discrete memristor model from different locations can lead to two new chaotic map models. The dynamical behaviors of the two maps are studied by means of bifurcation diagrams, phase diagrams and Lyapunov exponential spectra (LEs). The simulation results show that both chaotic systems have rich dynamical behaviors. In addition, they are experimentally found to have multi-stable properties, where the M-XM map has infinite attractors coexistence. Finally, we complete the hardware implementation of the two maps based on Digital Signal Processing (DSP) platform for the application of discrete chaotic systems.
Recent developments in corrole radicals
Authors: Gao Hu , Wu Fan , Wang Kai , Shen Zhen
Published: March 2023

Corrole is a tetrapyrrolic ring-contracted porphyrin analog with one direct pyrrole-pyrrole link. The corrole macrocycle is electron-rich and easily stabilized in its one electron oxidized radical state, especially when coordinated to some specific metal ions. The corrole radicals and their complexes have demonstrated excellent air stability, amphoteric redox properties, and diversified spin configurations. Herein, we summarize the recent developments in the synthesis and properties of various corrole radicals, including [Formula: see text]-monoradicals, antiferromagnetically and ferromagnetically coupled metal radicals, and [Formula: see text]-diradicals. The regulation of spin, redox, and optical properties of corrole radicals by modifications to their periphery substituents, coordinated metals, and axial ligands is highlighted, which demonstrates their promising application prospects in spintronics, electronics, and energy-conversion materials.
Effect of bovine serum albumin on the water solubility of hydrophobic corrinoids
Authors: Dereven’kov Ilia A. , Dzvinkas Ilya I. , Osokin Vladimir S. , Makarov Sergei V.
Published: March 2023

Medicinal effects of hydrophobic derivatives of vitamin [Formula: see text] have been insignificantly investigated primarily due to their low solubility in aqueous solutions. One of the ways to increase their water solubility is the complexation with proteins. Here, we report the results of the studies of the reactions between aquacyano cobyrinic acid or monocyano cobesters (i.e., heptamethyl, heptaethyl, heptapropyl, and heptabutyl cobyrinates) and bovine serum albumin (BSA). The weakest binding is observed between aquacyano cobyrinic acid and BSA. In the case of monocyano heptaethyl cobyrinate, one BSA molecule is capable of binding up to six corrinoid molecules preventing its precipitation. Moreover, the pronounced effect of BSA on the solubility in water was observed in the case of monocyano heptapropyl cobyrinate. The absence of the precipitation of monocyano heptabutyl cobyrinate was observed only in the presence of high excess of BSA. BSA modification by diethyl pyrocarbonate, a chemical predominantly reactive toward imidazole motifs, indicated that a major fraction of BSA is bound with monocyano heptaethyl, heptapropyl, and heptabutyl cobyrinates via histidine residues. We showed that nitrosyl complexes of heptaethyl and heptapropyl cobyrinates can be stabilized from precipitation in aqueous solutions using BSA.
Tackling the Environment: Xi Jinping and the Pursuit of a ‘Beautiful China’
Authors: Sullivan Lawrence R.
Published: March 2023

Focus of the article is the pursuit by President Xi Jinping (2013–2021) of an aggressive policy of environmental protection and preservation with the ambitious goal of creating a ‘beautiful China’. Article begins with a summary of the rise to national leadership by Xi Jinping from a local and provincial leader to national prominence, and then examines the creation of central and local bureaucracies for policy implementation on the environment along with such initiatives as the system of ‘river chiefs’ to address the serious problem of waterway pollution. By tracing the transition to more environmentally friendly economic and industrial policies, government efforts are also described to foster greater environmental consciousness on the part of the Chinese public. The article concludes by weighing the accomplishments of the new policies along with various economic, institutional, and structural obstacles to achieving a ‘beautiful China’.
Green Synthesis and Scale-Up of MOFs for Water Harvesting from Air
Authors: Zheng Zhiling , Alawadhi Ali H. , Yaghi Omar M.
Published: March 2023

The synthetic scalability of water harvesting metal–organic frameworks (MOFs) is crucial for making these promising materials accessible and widely available for use in household devices. Herein, we present a facile, sustainable, and high-yield synthesis method to produce a series of water-harvesting MOFs, including MOF-303, CAU-23, MIL-160, MOF-313, CAU-10, and Al-fumarate. Using readily available reactants and water as the only solvent, we were able to synthesize these materials at the kilogram scale in a 200 L batch reactor with yields of 84–96% and space-time yields of 238–305 kg/day/m3 under optimized reaction conditions. We also show that our procedure preserves framework crystallinity, porosity, and water-harvesting performance of the MOFs synthesized at scale.
Assessing the Optical Properties of 2D MoS2 Nanosheets Synthesized Using Facile Two-Step Sequential Process
Authors: Shweta  , Singh Vinamrita , Kumar Kaushal , Yarramaneni Sridharbabu , Kumar Arun
Published: March 2023

Among 2D Transition Metal Dichalcogenides (TMDs), ultrathin molybdenum disulfide (MoS2) nanosheets are well researched in terms of synthesis, characterization and applications owing to its unique properties in contrast to the bulk material. Here, 2D MoS2 suspensions are prepared via grinding-assisted liquid phase exfoliation. The processing parameters like initial concentration of MoS2 powder, grinding hours, solvent and high-power sonication are optimized for efficient and scalable production of MoS2 nanosheets. The suspensions are characterized for their optical and structural properties and are compared to analyze the effect of synthesis conditions on the properties of the obtained samples. The bandgap of the synthesized MoS2 lies above 2.0 eV in contrast with a bandgap of 1.57 eV for bulk sample. The difference between the peaks corresponding to in-plane and out-of-plane vibration modes is lower than bulk sample depicting the formation of mono to few-layered MoS2. It is found that grinding-assisted sonication in NMP solvent is the most efficient method to produce low-dimensional nanosheets. The well dispersed MoS2 nanoflakes can be blended with other nanomaterials to prepare hybrid dispersions and can thus be explored for optoelectronic applications.
Ameliorating liver disease in an autosomal recessive polycystic kidney disease mouse model
Authors: Yanda Murali K. , Zeidan Adi , Cebotaru Liudmila
Published: March 2023

ARPKD is a multiorgan genetic disorder resulting in newborn morbidity and mortality. There is a critical need for new therapies to treat this disease. We show that persistent cholangiocytes proliferation occurs in a mouse model of ARPKD along with mislocalized CFTR and misregulated heat shock proteins. We found that VX-809, a CFTR modulator, inhibits proliferation and limits bile duct malformation. The data provide a therapeutic pathway for strategies to treat ADPKD.
Role of the microbiota-gut-brain axis in postacute COVID syndrome
Authors: Gareau Mélanie G. , Barrett Kim E.
Published: March 2023

The COVID-19 pandemic has resulted in the infection of hundreds of millions of individuals over the past 3 years, coupled with millions of deaths. Along with these more acute impacts of infection, a large subset of patients has developed symptoms that collectively comprise “postacute sequelae of COVID-19” (PASC, also known as long COVID), which can persist for months and maybe even years. In this review, we outline the current knowledge on the role of impaired microbiota-gut-brain (MGB) axis signaling in the development of PASC and the potential mechanisms involved, which may lead to a better understanding of disease progression and treatment options in the future.
Atrophy signaling pathways in respiratory and limb muscles of guinea pigs exposed to chronic cigarette smoke: role of soluble guanylate cyclase stimulation
Authors: Peinado Víctor Ivo , Guitart Maria , Blanco Isabel , Tura-Ceide Olga , Paul Tanja , Barberà Joan Albert , Barreiro Esther
Published: March 2023

Skeletal muscle dysfunction in chronic obstructive pulmonary disease (COPD) is characterized by a significant reduction in muscle strength and endurance. Preclinical studies show that stimulation of the soluble guanylate cyclase (sGC)-cGMP pathway attenuates muscle mass loss and prevents cigarette smoke-induced oxidative stress, indicating that pharmacological activation of the guanylyl cyclase pathway in COPD may provide a beneficial therapeutic strategy that reaches beyond the lung. In this study, conducted in an animal model of COPD, we first set out to assess the effect of cigarette smoke (CS) on biomarkers of muscle fatigue, such as protein degradation and its transcriptional regulation, in two types of muscles with different energy demands, i.e., the diaphragm and the gastrocnemius muscle of the limbs. Second, we evaluated the administration of an sGC stimulator on these markers to study the potential efficacy of such treatment in the recovery of skeletal muscle function. Exposure to CS led to weight loss, which was associated in the gastrocnemius with increased levels of proteolytic markers of muscle atrophy (MURF-1, Atrogin-1, proteasome C8 subunit 20 s, and total protein ubiquitination), whereas the size of fast-twitch muscle fibers decreased significantly. Long-term treatment with the sGC stimulator BAY 41-2272 resulted in a significant reduction in gastrocnemius levels of the aforementioned proteolytic markers, concomitant with a weight recovery and increased cGMP levels. Remarkably, levels of some of the analyzed biomarkers differed between respiratory and limb muscles. In conclusion, targeting sGC might exert beneficial effects on muscle alterations in patients with COPD.
Terpenoids and Bio-Functions of Essential Oils Hydrodistilled Differently from Freshly Immature and Mature Blumea balsamifera Leaves
Authors: Jirakitticharoen Sirinapha , Wisuitiprot Wudtichai , Jitareerat Pongphen , Wongs-Aree Chalermchai
Published: March 2023

The volatiles and antioxidant capacity of essential oils (EOs) extracted from freshly immature and mature leaves of Blumea balsamifera at various hydrodistillation times were investigated. Seven major terpenoids were identified: two monoterpenes, camphor and L-borneol, and five sesquiterpenes, silphiperfol-5-ene, 7-epi-silphiperfol-5-ene, ß-caryophyllene, ɤ-eudesmol, and α-eudesmol. The quantity and terpenoid composition of the EOs were impressed by leaf maturity and hydrodistillation times. The yield of EOs from the immature leaves was 1.4 times that of mature leaves, with 73% of the yield acquired within the first 6 hours (hrs) of hydrodistillation. Approximately 97% of camphor and L-borneol, 80% of ß-caryophyllene, silphiperfolene, and 7-epi-silphiperfolene, 32% of ɤ-eudesmol, and 54% α-eudesmol were collected in the first 6 hrs of hydrodistillation. More ß-caryophyllene, ɤ-eudesmol, and α-eudesmol were found in the mature leaf EOs. The antioxidant capacity of the EOs was proportionally related to their terpenoid contents. The EOs extracted from immature leaves at 0–6 hrs of hydrodistillation demonstrated distinctive antibacterial activity against Staphylococcus aureus, with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of 0.5 mg/mL and 1 mg/mL, respectively.
Seismic Reduction Performance of Wrap Rope Connection Devices for Continuous Girder Bridges
Authors: Liu Yanfang , Zhang Wenxue , Du Xiuli , Bao Weigang
Published: March 2023

In this article, wrap rope connection device (WRCD), which considers the relative acceleration of piers and beam as a control variable, is proposed for improving the current situation of continuous girder bridges whose bearing force of a single pier is along the longitudinal direction and based on the synergy principle. The WRCD device, which meets the slow displacement requirements of temperature and vehicle load under normal operation, is implemented and used to improve the performance of the sliding bearing pier. During earthquakes, because of the amplification effect of the wrap rope, the instantaneous large stiffness state in the longitudinal force can be achieved. Based on the shaking table test of a typical continuous girder bridge for examining the performance of the WRCD during earthquakes, the dynamic characteristics, structural acceleration, displacement, and strain responses of the structure under different frequency spectra, and seismic input intensities are analyzed and the seismic reduction performance of the WRCD is demonstrated. This analysis demonstrated that, by activating WRCD, the ratio of the acceleration response of the fixed bearing pier to the sliding bearing pier increased from 10% to 57%; moreover, the force on each pier appeared more uniform. Furthermore, with an increase in the input intensity of the earthquake, the displacement of the primary beam and the seismic response of the fixed pier bottom considerably decreased and the synergy effect of each pier was more prominent. Under certain site conditions, the WRCD can effectively improve the synergy effect between the sliding bearing piers and fixed bearing pier; however, the improvement in the obtained result is directly associated with the seismic input characteristics. The design parameters of the WRCD should be determined as per different site conditions and the optimum application range of the WRCD.
Single-Cell and Transcriptome-Based Immune Cell-Related Prognostic Model in Clear Cell Renal Cell Carcinoma
Authors: Wu Guanlin , Guo Weiming , Zhu Shuai , Fan Gang
Published: March 2023

Traditional studies mostly focus on the role of single gene in regulating clear cell renal cell carcinoma (ccRCC), while it ignores the impact of tumour heterogeneity on disease progression. The purpose of this study is to construct a prognostic risk model for ccRCC by analysing the differential marker genes related to immune cells in the single-cell database to provide help in clinical diagnosis and targeted therapy. Single-cell data and ligand-receptor relationship pair data were downloaded from related publications, and ccRCC phenotype and expression profile data were downloaded from TCGA and CPTAC. Based on the DEGs of each cluster acquired from single-cell data, immune cell marker genes, and ligand-receptor gene data, we constructed a multilayer network. Then, the genes in the network and the genes in TCGA were used to construct the WGCNA network, which screened out prognosis-associated genes for subsequent analysis. Finally, a prognostic risk scoring model was obtained, and CPTAC data showed that the effectiveness of this model was good. A nomogram based on the predictive model for predicting the overall survival was established, and internal validation was performed well. Our findings suggest that the predictive model built and based on the immune cell scRNA-seq will enable us to judge the prognosis of patients with ccRCC and provide more accurate directions for basic relevant research and clinical practice.