bluuebunny/crossref_metadata_2025 huggingface dataset:
MuSK-antibodies are associated with worse outcome in myasthenic crisis requiring mechanical ventilation
Authors: König Nicole , Stetefeld Henning R. , Dohmen Christian , Mergenthaler Philipp , Kohler Siegfried , Schönenberger Silvia , Bösel Julian , Lee De-Hyung , Gerner Stefan T. , Huttner Hagen B. , Schneider Hauke , Reichmann Heinz , Fuhrer Hannah , Berger Benjamin , Zinke Jan , Alberty Anke , Kleiter Ingo , Schneider-Gold Christiane , Roth Christian , Dunkel Juliane , Steinbrecher Andreas , Thieme Andrea , Schlachetzki Felix , Linker Ralf A. , Angstwurm Klemens , Meisel Andreas , Neumann Bernhard ,   for The German Myasthenic Crisis Study Group, Fuchs Kornelius , Schalke Berthold , Vidal Amelie , Brachaczek Izabela , Maidhof Jana , Wenke Arno , Hagen Manuel , Rahmig Jan , Schimmel Eik , Niesen Wolf , Fahrendorf Christine
Published: May 2021

Myasthenic crisis (MC) is a life-threatening condition for patients with myasthenia gravis (MG). Muscle-specific kinase-antibodies (MuSK-ABs) are detected in ~ 6% of MG, but data on outcome of MuSK-MCs are still lacking. We made a subgroup analysis of patients who presented with MC with either acetylcholine-receptor-antibody positive MG (AchR-MG) or MuSK-MG between 2006 and 2015 in a retrospective German multicenter study. We identified 19 MuSK-AB associated MCs in 15 patients and 161 MCs in 144 patients with AchR-ABs only. In contrast to patients with AchR-AB, MuSK-AB patients were more often female (p = 0.05, OR = 2.74) and classified as Myasthenia Gravis Foundation of America-class IV before crisis (p = 0.04, OR = 3.25). MuSK-AB patients suffer more often from multiple chronic disease (p = 0.016, OR = 4.87) and were treated more invasively in terms of plasma exchanging therapies (not significant). The number of days of mechanical ventilation (MV) (43.0 ± 53.1 vs. 17.4 ± 18; p < 0.0001), days on an intensive care unit (ICU) (45.3 ± 49.5 vs. 21.2 ± 19.7; p < 0.0001), and hospital-length of stay (LOS) (55.9 ± 47.6 vs. 28.8 ± 20.9 days; p < 0.0001) were significantly increased in MuSK-MC. Remarkable is that these changes were mainly due to patients with MusK-ABs only, whereas patients’ outcome with both antibodies was similar to AchR-MCs. Furthermore, our data showed a shortened duration of MV after treatment with plasma exchanging therapies compared to treatment with intravenous immunoglobulin in MuSK-MCs. We conclude that MuSK-AB-status is associated with a longer need of MV, ICU-LOS, and hospital-LOS in MC, and therefore recommend early initiation of a disease-specific therapy.
The use of electronic PROMs provides same outcomes as paper version in a spine surgery registry. Results from a prospective cohort study
Authors: Langella Francesco , Barletta Paolo , Baroncini Alice , Agarossi Matteo , Scaramuzzo Laura , Luca Andrea , Bassani Roberto , Peretti Giuseppe M. , Lamartina Claudio , Villafañe Jorge H. , Berjano Pedro
Published: May 2021

Background and Purpose

Patient-Reported Measured Outcomes (PROMs) are essential to gain a full understanding of a patient’s condition, and in spine surgery, these questionnaires are of help when tailoring a surgical strategy. Electronic registries allow for a systematic collection and storage of PROMs, making them readily available for clinical and research purposes. This study aimed to investigate the reliability between the electronic and paper form of ODI (Oswestry Disability Index), SF-36 (Short Form Health Survey 36) and COMI-back (Core Outcome Measures Index for the back) questionnaires.

Methods

A prospective analysis was performed of ODI, SF-36 and COMI-back questionnaires collected in paper and electronic format in two patients’ groups: Pre-Operatively (PO) or at follow-up (FU). All patients, in both groups, completed the three questionnaires in paper and electronic form. The correlation between both methods was assessed with the Intraclass Correlation Coefficients (ICC).

Results

The data from 100 non-consecutive, volunteer patients with a mean age of 55.6 ± 15.0 years were analysed. For all of the three PROMs, the reliability between paper and electronic questionnaires results was excellent (ICC: ODI = 0.96; COMI = 0.98; SF36-MCS = 0.98; SF36-PCS = 0.98. For all p < 0.001).

Conclusions

This study proved an excellent reliability between the electronic and paper versions of ODI, SF-36 and COMI-back questionnaires collected using a spine registry. This validation paves the way for stronger widespread use of electronic PROMs. They offer numerous advantages in terms of accessibility, storage, and data analysis compared to paper questionnaires.
Oceanic islands and climate: using a multi-criteria model of drivers of change to select key conservation areas in Galapagos
Authors: Escobar-Camacho Daniel , Rosero Paulina , Castrejón Mauricio , Mena Carlos F. , Cuesta Francisco
Published: May 2021

The unique marine and terrestrial ecosystems of the Galapagos Islands are highly vulnerable to human-based drivers of change, including the introduction of invasive species, unsustainable tourism, illegal fishing, overexploitation of ecosystem services, and climate change. These drivers can interact with climate-based drivers such as El Niño-Southern Oscillation (ENSO) at multiple temporal and spatial scales, exacerbating their negative impacts on already fragile ecosystems and the socioeconomic system of the Archipelago. In this review, we performed a literature review based on published literature from 1945 to 2020 and local and global climate databases to analyze drivers of change in the Galapagos. We developed and applied a spatial impact assessment model to identify high-ecological value areas with high sensitivity and exposure scores to environmental change drivers. We identified 13 priority HEVA that encompass ca. 23% (14,715 km2) of the Galapagos Archipelago, distributed in nearly 3% of the Galapagos Marine Reserve and 20% Galapagos National Park. Current and future impacts are likely to concentrate on the inhabited islands’ highlands, whereas marine impacts concentrate along most of the Galapagos Islands’ shorelines. These results are important for guiding the design and implementation of adaptation measures aimed at increasing ecosystem resilience and human adaptive capacity in the face of global environmental change. Overall, these results will be valuable in their application for preserving Galapagos biota, securing the provision of vital ecosystem services for resident human populations, and sustaining the nature-based tourism industry.
Tyrophagus putrescentiae (Sarcoptiformes: Acaridae) in the in vitro cultures of slime molds (Mycetozoa): accident, contamination, or interaction?
Authors: Michalczyk-Wetula Dominika , Jakubowska Monika , Felska Magdalena , Skarżyński Dariusz , Mąkol Joanna , Płonka Przemysław M.
Published: May 2021

Tyrophagus putrescentiae(Schrank), commonly known as the cereal mite, cheese mite, or ham mite, is a cosmopolitan species reported from various environments in the wild, including soil, plant material and vertebrate nests. It has also been recognized as a common pest of food storages, mycological collections as well as plant and invertebrate laboratory cultures. Laboratory observations indicate thatT. putrescentiaefeeds on a large range of dermatophytes, yeasts and molds. We have observed the interspecific relation between this mite and several species of true slime molds (Mycetozoa) under laboratory conditions, which confirms the very broad spectrum of feeding habits ofT. putrescentiae. Mycetozoans were grown in semi-sterile in vitro cultures and fed with oat flour or oat flakes.Tyrophagus putrescentiaedisplayed affinity to all macroscopically identifiable stages of the life cycle ofFuligo septica(L.) F.H. Wigg,Physarum polycephalumSchwein and theDidymiumsp. complex [Didymium iridis(Ditmar) Fr.,Didymium nigripes(Link) Fr. andDidymium bahienseGottsb.]: live, decaying or dead plasmodia, sporangia, aethalia, spores and sclerotia. The relation carrying symptoms of various types of interspecific interaction, is hypothesized to form an evolutionarily young phenomenon, which not only identifies a new aspect of mycetozoal biology, but also presents the cereal mite as a species of high adaptive potential.
A Randomised Comparison of Values and Goals, Versus Goals Only and Control, for High Nonclinical Paranoia
Authors: Davies M. , Ellett L. , Kingston J.
Published: May 2021

Background

Paranoia is common in the general population. Focusing on values and enhancing value-based acts may attenuate it. This study compared three brief (30-min, self-directed) online conditions: focusing on values and value-based goal setting (n = 30), goal setting only (n = 32) and non-values/goals control (n = 32) in a high paranoia sample.

Methods

Participants were randomly assigned to condition. State paranoia (primary outcome) and positive and negative self-views following a difficult interpersonal experience (secondary outcome) were assessed at baseline and two-weeks.

Results

Intention-to-treat: state paranoia was significantly lower following the values condition as compared to non-values/goals control (ηp2 = .148) and goals only (ηp2 = .072). Only the former comparison was significant. Per-protocol: groups did not significantly differ (p = .077). Within-group effect sizes: values and value-based goal setting (intention-to-treat d = .82, per-protocol d = .78), goals only (intention-to-treat d = .41, per-protocol d = .42) non-values/goals control (intention-to-treat d = .25, per-protocol d = .24). Positive self-views increased in all conditions. The increase was largest for the values condition, but not significantly so.

Limitations

Reliance on self-report, brief follow-up, predominantly White female sample.

Conclusions

The values condition was most effective at reducing non-clinical paranoia. The values condition appeared to increase positive self-views more so than comparison groups, but the sample was small and the difference was non-significant.
Creative reconstruction: a structured literature review of the early empirical research on the COVID-19 crisis and entrepreneurship
Authors: Kuckertz Andreas , Brändle Leif
Published: May 2021

The COVID-19 crisis triggered by the novel coronavirus (SARS-CoV-2) and the infection control measures taken have extended beyond affecting health issues to impact economic activity worldwide. In this structured literature review, the focus is specifically on how the crisis has impacted entrepreneurial activity. The review focuses on the early empirical literature that primarily relied on data collected during the first wave of the pandemic. These empirical results are synthesized in a thematic literature review. The entrepreneurship research on the COVID-19 crisis is marked by three perspectives: the uncertainty perspective, the resilience perspective, and the opportunity perspective. To obtain a complete picture of the effects of the crisis on entrepreneurship, these three perspectives should be considered in combination. We provide implications for future research, policymakers, and entrepreneurs discussing how the interplay of the reviewed perspectives provides paths toward creative reconstruction, that is, the opportunity to move beyond pre-crisis levels of innovation and entrepreneurial action.
Uptake and bio-transformation of telmisartan by cress (Lepidium sativum) from sewage treatment plant effluents using high-performance liquid chromatography/drift-tube ion-mobility quadrupole time-of-flight mass spectrometry
Authors: Lang Tamara , Himmelsbach Markus , Mlynek Franz , Buchberger Wolfgang , Klampfl Christian W.
Published: May 2021

In the present study, the uptake and metabolization of the sartan drug telmisartan by a series of plants was investigated. Thereby for seven potential metabolites, modifications on the telmisartan molecule such as hydroxylation and/or glycosylation could be tentatively identified. For two additional signals detected at accurate masses m/z 777.3107 and m/z 793.3096, no suggestions for molecular formulas could be made. Further investigations employing garden cress (Lepidium sativum) as a model plant were conducted. This was done in order to develop an analytical method allowing the detection of these substances also under environmentally relevant conditions. For this reason, the knowledge achieved from treatment of the plants with rather high concentrations of the parent drug (10 mg L−1) was compared with results obtained when using solutions containing telmisartan in the μg - ng L−1 range. Thereby the parent drug and up to three tentative drug-related metabolites could still be detected. Finally cress was cultivated in water taken from a local waste water treatment plant effluent containing 90 ng L−1 of telmisartan and harvested and the cress roots were extracted. In this extract, next to the parent drug one major metabolite, namely telmisartan-glucose could be identified.
Man’s best friend in life and death: scientific perspectives and challenges of dog brain banking
Authors: Sándor Sára , Czeibert Kálmán , Salamon Attila , Kubinyi Enikő
Published: May 2021

Biobanking refers to the systematic collection, storage, and distribution of pre- or post-mortem biological samples derived from volunteer donors. The demand for high-quality human specimens is clearly demonstrated by the number of newly emerging biobanking facilities and large international collaborative networks. Several animal species are relevant today in medical research; therefore, similar initiatives in comparative physiology could be fruitful. Dogs, in particular, are gaining increasing attention in translational research on complex phenomena, like aging, cancer, and neurodegenerative diseases. Therefore, biobanks gathering and storing dog biological materials together with related data could play a vital role in translational and veterinary research projects. To achieve these aims, a canine biobank should meet the same standards in sample quality and data management as human biobanks and should rely on well-designed collaborative networks between different professionals and dog owners. While efforts to create dog biobanks could face similar financial and technical challenges as their human counterparts, they can widen the spectrum of successful collaborative initiatives towards a better picture of dogs’ physiology, disease, evolution, and translational potential. In this review, we provide an overview about the current state of dog biobanking and introduce the “Canine Brain and Tissue Bank” (CBTB)—a new, large-scale collaborative endeavor in the field.
Oxide Evolution During the Solidification of 316L Stainless Steel from Additive Manufacturing Powders with Different Oxygen Contents
Authors: Yang Xinliang , Tang Fengzai , Hao Xinjiang , Li Zushu
Published: May 2021

The oxide evolution during the solidification of 316L stainless steel from additive manufacturing powders with different oxygen contents is studied by in situ observation of the melting and solidification of the powder materials, advanced characterization of the solidified materials, and non-equilibrium thermodynamic analysis. An oxide evolution map is established for the 316L powders with different oxygen contents. It reveals the relationship between the surface oxidation in the reused powder and its expected oxide species and morphology in the as-solidified component. For the 316L powder with oxygen content higher than ~ 0.039 pct, the liquid oxide formed first from the steel melt and then crystallized to certain oxide phases during solidification, while for the powder with lower oxygen, oxide phases are suggested to directly form from the steel melt. The oxide species in the as-solidified sample was predicted by the Scheil–Gulliver cooling calculation and verified by the TEM-based phase identification. The oxides formed in the melt of low O 316L alloy (0.0355 pct O) are predicted to be (Mn, Cr)Cr2O4 spinel and SiO2 oxide. In the high O (0.4814 pct O) 316L melt solidification, the final oxides formed are (Mn, Cr)Cr2O4 spinel, SiO2 oxide, and Cr2O3 corundum. As an important characteristic of powder materials, the oxygen pick-up due to the powder surface oxidation significantly influences the inclusion evolution in the powder fusion process.
Natural Quinone Dyes: A Review on Structure, Extraction Techniques, Analysis and Application Potential
Authors: Dulo Benson , Phan Kim , Githaiga John , Raes Katleen , De Meester Steven
Published: May 2021

Synthetic dyes are by far the most widely applied colourants in industry. However, environmental and sustainability considerations have led to an increasing efforts to substitute them with safer and more sustainable equivalents. One promising class of alternatives is the natural quinones; these are class of cyclic organic compounds characterized by a saturated (C6) ring that contains two oxygen atoms that are bonded to carbonyls and have sufficient conjugation to show color. Therefore, this study looks at the potential of isolating and applying quinone dye molecules from a sustainable source as a possible replacement for synthetic dyes. It presents an in-depth description of the three main classes of quinoid compounds in terms of their structure, occurrence biogenesis and toxicology. Extraction and purification strategies, as well as analytical methods, are then discussed. Finally, current dyeing applications are summarised. The literature review shows that natural quinone dye compounds are ubiquitous, albeit in moderate quantities, but all have a possibility of enhanced production. They also display better dyeability, stability, brightness and fastness compared to other alternative natural dyes, such as anthocyanins and carotenoids. Furthermore, they are safer for the environment than are many synthetic counterparts. Their extraction, purification and analysis are simple and fast, making them potential substitutes for their synthetic equivalents.

Graphic Abstract
Decontamination of cadmium(II) from synthetic wastewater onto shea fruit shell biomass
Authors: Bayuo Jonas
Published: May 2021

Shea fruit shells being an agricultural waste material was utilized to test its novelty as an inexpensive biosorbent for the elimination of Cd(II) from synthetic wastewater using the batch method. A batch study was employed to probe the impact of pH of the solution, contact time, temperature and initial concentration on the depollution of Cd(II) ions using unmodified Shea fruit shells biomass. The decontamination of Cd(II) by the unmodified Shea fruit shells biomass was found to be dependent on these adsorption parameters. The equilibrium data best represented Freundlich isotherm by a correlation coefficient (R2) of 0.9691. The kinetic models analyzed suggest pseudo-second-order ($${R}^{2} = 0.9515$$

R

2

=
0.9515

) as the best fit model signifying that the removal of Cd(II) ions was on account of chemisorption. The positive values of the thermodynamic parameters, ΔH° and ΔS° reveal endothermic and increase of disorder of the process while the negative charge of ΔG° shows spontaneity of the system.
Dynamic Quantum Games
Authors: Kolokoltsov Vassili N.
Published: May 2021

Quantum games represent the really twenty-first century branch of game theory, tightly linked to the modern development of quantum computing and quantum technologies. The main accent in these developments so far was made on stationary or repeated games. In this paper, we aim at initiating the truly dynamic theory with strategies chosen by players in real time. Since direct continuous observations are known to destroy quantum evolutions (so-called quantum Zeno paradox), the necessary new ingredient for quantum dynamic games must be the theory of non-direct observations and the corresponding quantum filtering. Apart from the technical problems in organizing feedback quantum control in real time, the difficulty in applying this theory for obtaining mathematically amenable control systems is due partially to the fact that it leads usually to rather non-trivial jump-type Markov processes and/or degenerate diffusions on manifolds, for which the corresponding control is very difficult to handle. The starting point for the present research is the remarkable discovery (quite unexpected, at least to the author) that there exists a very natural class of homodyne detections such that the diffusion processes on projective spaces resulting by filtering under such arrangements coincide exactly with the standard Brownian motions (BM) on these spaces. In some cases, one can even reduce the process to the plain BM on Euclidean spaces or tori. The theory of such motions is well studied making it possible to develop a tractable theory of related control and games, which can be at the same time practically implemented on quantum optical devices.
Abstracts voorjaarsvergadering NVU, 21 mei 2021
Authors:   Bohn Stafleu van Loghum
Published: May 2021

Samenvatting

De EAU-richtlijn adviseert om geen confirmatory prostaatbiopten tijdens active surveillance te verrichten bij patiënten die gediagnosticeerd zijn met een upfront MRI (strength rating: weak). In deze studie analyseren we de uitkomst van confirmatory biopten om te bepalen wie wel of niet gebaat is bij dit type biopten.
Self-sampling versus health care professional-guided swab collection for SARS-CoV-2 testing
Authors: Würstle Silvia , Spinner Christoph D. , Voit Florian , Hoffmann Dieter , Hering Svenja , Weidlich Simon , Schneider Jochen , Zink Alexander , Treiber Matthias , Iakoubov Roman , Schmid Roland M. , Protzer Ulrike , Erber Johanna
Published: May 2021

Purpose

To evaluate the diagnostic reliability and practicability of self-collected oropharyngeal swab samples for the detection of SARS-CoV-2 infection as self-sampling could enable broader testing availability and reduce both personal protective equipment and potential exposure.

Methods

Hospitalized SARS-CoV-2-infected patients were asked to collect two oropharyngeal swabs (SC-OPS1/2), and an additional oropharyngeal swab was collected by a health care professional (HCP-OPS). SARS-CoV-2 PCR testing for samples from 58 participants was performed, with a 48-h delay in half of the self-collected samples (SC-OPS2). The sensitivity, probability of concordance, and interrater reliability were calculated. Univariate and multivariate analyses were performed to assess predictive factors. Practicability was evaluated through a questionnaire.

Results

The test sensitivity for HCP-OPS, SC-OPS1, and SC-OPS2 was 88%, 78%, and 77%, respectively. Combining both SC-OPS results increased the estimated sensitivity to 88%. The concordance probability between HCP-OPS and SC-OPS1 was 77.6% and 82.5% between SC-OPS1 and SC-OPS2, respectively. Of the participants, 69% affirmed performing future self-sampling at home, and 34% preferred self-sampling over HCP-guided testing. Participants with both positive HCP-OPS1 and SC-OPS1 indicating no challenges during self-sampling had more differences in viral load levels between HCP-OPS1 and SC-OPS1 than those who indicated challenges. Increasing disease duration and the presence of anti-SARS-CoV-2-IgG correlated with negative test results in self-collected samples of previously confirmed SARS-CoV-2 positive individuals.

Conclusion

Oropharyngeal self-sampling is an applicable testing approach for SARS-CoV-2 diagnostics. Self-sampling tends to be more effective in early versus late infection and symptom onset, and the collection of two distinct samples is recommended to maintain high test sensitivity.
Testing telediagnostic thyroid ultrasound in Peru: a new horizon in expanding access to imaging in rural and underserved areas
Authors: Marini T. J. , Weiss S. L. , Gupta A. , Zhao Y. T. , Baran T. M. , Garra B. , Shafiq I. , Oppenheimer D. C. , Egoavil M. S. , Ortega R. L. , Quinn R. A. , Kan J. , Dozier A. M. , Tamayo L. , Carlotto C. , Castaneda B.
Published: May 2021

Purpose

Thyroid ultrasound is a key tool in the evaluation of the thyroid, but billions of people around the world lack access to ultrasound imaging. In this study, we tested an asynchronous telediagnostic ultrasound system operated by individuals without prior ultrasound training which may be used to effectively evaluate the thyroid and improve access to imaging worldwide.

Methods

The telediagnostic system in this study utilizes volume sweep imaging (VSI), an imaging technique in which the operator scans the target region with simple sweeps of the ultrasound probe based on external body landmarks. Sweeps are recorded and saved as video clips for later interpretation by an expert. Two operators without prior ultrasound experience underwent 8 h of training on the thyroid VSI protocol and the operation of the telemedicine platform. After training, the operators scanned patients at a health center in Lima. Telediagnostic examinations were sent to the United States for remote interpretation. Standard of care thyroid ultrasound was performed by an experienced radiologist at the time of VSI examination to serve as a reference standard.

Results

Novice operators scanned 121 subjects with the thyroid VSI protocol. Of these exams, 88% were rated of excellent image quality showing complete or near complete thyroid visualization. There was 98.3% agreement on thyroid nodule presence between VSI teleultrasound and standard of care ultrasound (Cohen’s kappa 0.91,P < 0.0001). VSI measured the thyroid size, on average, within 5 mm compared to standard of care. Readers of VSI were also able to effectively characterize thyroid nodules, and there was no significant difference in measurement of thyroid nodule size (P = 0.74) between VSI and standard of care.

Conclusion

Thyroid VSI telediagnostic ultrasound demonstrated both excellent visualization of the thyroid gland and agreement with standard of care thyroid ultrasound for nodules and thyroid size evaluation. This system could be deployed for evaluation of palpable thyroid abnormalities, nodule follow-up, and epidemiological studies to promote global health and improve the availability of diagnostic imaging in underserved communities.
Testing the Integrity of the Middle and Later Stone Age Cultural Taxonomic Division in Eastern Africa
Authors: Grove Matt , Blinkhorn James
Published: May 2021

The long-standing debate concerning the integrity of the cultural taxonomies employed by archaeologists has recently been revived by renewed theoretical attention and the application of new methodological tools. The analyses presented here test the integrity of the cultural taxonomic division between Middle and Later Stone Age assemblages in eastern Africa using an extensive dataset of archaeological assemblages. Application of a penalized logistic regression procedure embedded within a permutation test allows for evaluation of the existing Middle and Later Stone Age division against numerous alternative divisions of the data. Results suggest that the existing division is valid based on any routinely employed statistical criterion, but that is not the single best division of the data. These results invite questions about what archaeologists seek to achieve via cultural taxonomy and about the analytical methods that should be employed when attempting revise existing nomenclature.
Fuzzy particle swarm optimization (FPSO) based feature selection and hybrid kernel distance based possibilistic fuzzy local information C-means (HKD-PFLICM) clustering for churn prediction in telecom industry
Authors: Praseeda C. K. , Shivakumar B. L.
Published: May 2021

Customer churn has been considered as one of the key issues in the operations of the corporate business sector, as it influences the turnover directly. In particular, the telecom industries are seeking to develop new approaches to predict potential customer to churn. So, it needs the appropriate algorithms to overcome the increasing problem of churn. This work proposed a churn prediction model that employs both strategies of classification and clustering, that helps in recognizing the churn consumers and giving the reasons after the churning of subscribers in the industry of telecom. The process of information gain and fuzzy particle swarm optimization (FPSO) has been executed by the method of feature selection, besides the divergence kernel-based support vector machine (DKSVM) classifier is employed in categorizing churn customers in the proposed approach. In this way, the compelling guidelines on retention have generated since the process plays a vital role in customer relationship management (CRM) to suppress the churners. After the classification process, the churn customers are divided into clusters through the process of fragmenting the data of churning customer. The cluster-based retention offers have provided by the clustering algorithm of hybrid kernel distance-based possibilistic fuzzy local information C-means (HKD-PFLICM), whereas the measurement of distance have accomplished through the kernel functions such as the hyperbolic tangent kernel and Gaussian kernel. The results reveal that proposed churn prediction model (FPSO- DKSVM) produced better churn classification results compared to other existing algorithms such as K-means, flexible K-Medoids, fuzzy local information C-means (FLICM),possibilistic  FLICM (PFLICM) and entropy weighting FLICM (EWFLICM).

Article highlights

Customer churn is a major concern in most of the companies as it influences the turnover directly.

The performance of churn prediction has been improved by applying artificial intelligence and machine learning techniques.

Churn prediction plays a crucial role in telecom industry, as they are in the position to maintain their precious customers and organize their Customer Relationship Management.
Preparing for the Nordic Skiing Events at the Beijing Olympics in 2022: Evidence-Based Recommendations and Unanswered Questions
Authors: Sandbakk Øyvind , Solli Guro Strøm , Talsnes Rune Kjøsen , Holmberg Hans-Christer
Published: May 2021

At the 2022 Winter Olympics in Beijing, the XC skiing, biathlon and nordic combined events will be held at altitudes of ~ 1700 m above sea level, possibly in cold environmental conditions and while requiring adjustment to several time zones. However, the ongoing COVID-19 pandemic may lead to sub-optimal preparations. The current commentary provides the following evidence-based recommendations for the Olympic preparations: make sure to have extensive experience of training (> 60 days annually) and competition at or above the altitude of competition (~ 1700 m), to optimize and individualize your strategies for acclimatization and competition. In preparing for the Olympics, 10–14 days at ~ 1700 m seems to optimize performance at this altitude effectively. An alternative strategy involves two–three weeks of training at > 2000 m, followed by 7–10 days of tapering off at ~ 1700 m. During each of the last 3 or 4 days prior to departure, shift your sleeping and eating schedule by 0.5–1 h towards the time zone in Beijing. In addition, we recommend that you arrive in Beijing one day earlier for each hour change in time zone, followed by appropriate timing of exposure to daylight, meals, social contacts, and naps, in combination with a gradual increase in training load. Optimize your own individual procedures for warming-up, as well as for maintaining body temperature during the period between the warm-up and competition, effective treatment of asthma (if necessary) and pacing at  ~ 1700 m with cold ambient temperatures. Although we hope that these recommendations will be helpful in preparing for the Beijing Olympics in 2022, there is a clear need for more solid evidence gained through new sophisticated experiments and observational studies.
Correction to: Bayesian Topology Learning and noise removal from network data
Authors: Ramezani-Mayiami Mahmoud , Hajimirsadeghi Mohammad , Skretting Karl , Dong Xiaowen , Blum Rick S. , Poor H. Vincent
Published: May 2021

A correction to this paper has been published: https://doi.org/10.1007/s43926-021-00013-8
Drones as internet of video things front-end sensors: challenges and opportunities
Authors: Chen Chang Wen
Published: May 2021

Internet of Video Things (IoVT) has become an emerging class of IoT systems that are equipped with visual sensors at the front end. Most of such visual sensors are fixed one whereas the drones are considered flying IoT nodes capable of capturing visual data continuously while flying over the targets of interest. With such a dynamic operational mode, we can imagine significant technical challenges in sensor data acquisition, information transmission, and knowledge extraction. This paper will begin with an analysis on some unique characteristics of IoVT systems with drones as its front end sensors. We shall then discuss several inherent technical challenges for designing drone-based IoVT systems. Furthermore, we will present major opportunities to adopt drone-based IoVT in several contemporary applications. Finally, we conclude this paper with a summary and an outlook for future research directions.
The utility of paired upper and lower respiratory tract sampling for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in patients with artificial airways
Authors: Kitt Eimear M. , Davis Daniela H. , Kerman Caryn , Sammons Julia S. , Handy Lori K. , Gallagher Elizabeth , O’Callaghan Kevin , Harris Rebecca M. , Coffin Susan E. , Bell Louis M. , Chiotos Kathleen
Published: May 2021

Early in the coronavirus disease 2019 (COVID-19) pandemic, the CDC recommended collection of a lower respiratory tract (LRT) specimen for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) testing in addition to the routinely recommended upper respiratory tract (URT) testing in mechanically ventilated patients. Significant operational challenges were noted at our institution using this approach. In this report, we describe our experience with routine collection of paired URT and LRT sample testing. Our results revealed a high concordance between the 2 sources, and that all children tested for SARS-CoV-2 were appropriately diagnosed with URT testing alone. There was no added benefit to LRT testing. Based on these findings, our institutional approach was therefore adjusted to sample the URT alone for most patients, with LRT sampling reserved for patients with ongoing clinical suspicion for SARS-CoV-2 after a negative URT test.
University students and study habits
Authors: Clarke C. , Mullin M. , McGrath D. , Farrelly N.
Published: May 2021

Objectives:

The objective of this study was to understand the variables or study habits that inform study in undergraduate and postgraduate students attending Trinity College Dublin.

Methods:

A descriptive, cross-sectional anonymous online survey was used to gather data to explore student study habits. Survey 1 was completed by participants in April 2019 and survey 2 was completed by participants in April 2020, during the COVID-19 restrictions.

Results:

A total of 1557 participants completed survey 1 in 2019, and 1793 participants completed survey 2 in 2020. In both surveys a majority reported using caffeine, library study, sleep pattern adjustment and excercise to aid academic performance. Survey 2 participants reported COVID-19 resulted in increased difficulty studying (91%). In particular loss of structure and routine was negatively impacted by the pandemic (92%), and increased feelings of stress were reported (75%).

Conclusions:

Our study suggests a potential role of the college environment as a target for the implementation of interventions to promote student learning, healthy study habits and well-being. The global pandemic has resulted in additional challenging demands for universities to serve an essential role in supporting college students study habits.
Changes in mental health and help-seeking among young Australian adults during the COVID-19 pandemic: a prospective cohort study
Authors: Upton Emily , Clare Philip J. , Aiken Alexandra , Boland Veronica C. , Torres Clara De , Bruno Raimondo , Hutchinson Delyse , Kypri Kypros , Mattick Richard , McBride Nyanda , Peacock Amy
Published: May 2021

Background

Young people may have elevated risk for poorer mental health during the coronavirus disease 2019 (COVID-19) pandemic, yet longitudinal studies documenting this impact are lacking. This study assessed changes in mental health and help-seeking since COVID-19 restrictions in young Australians, including gender differences.

Methods

Data were drawn from a recent subsample (n = 443; 60% female; Mage = 22.0) of a prospective cohort originally recruited in secondary school to complete annual surveys. The subsample completed an additional COVID-19 survey during COVID-19 restrictions (May–June 2020), which was compared to responses from their latest annual survey (August 2019–March 2020). Mixed effect models with time and gender as the primary predictors were conducted for: (i) scores on the Patient Health Questionnaire Depression 9-item (PHQ-9) and Generalised Anxiety Disorder 7-item (GAD-7) modules assessed before and during COVID-19 restrictions, and (ii) self-reported help-seeking from a health professional in February 2020, and the month preceding May–June 2020.

Results

Mean symptom scores increased from before to during COVID-19 restrictions on the PHQ-9 (coefficient: 1.29; 95% CI 0.72–1.86) and GAD-7 (0.78; 95% CI 0.26–1.31), but there was no increase in help-seeking over time (odds ratio 0.50; 95% CI 0.19–1.32). There was no evidence of differential changes by gender.

Conclusions

This study found increases in depression and anxiety symptoms but not greater help-seeking among young Australian adults during the first wave of the pandemic. Increasing availability and awareness of accessible treatment options and psychoeducation is critical, as well as further research into risk and protective factors to help target treatment to this vulnerable age group.
Expression of steroidogenic enzymes and TGFβ superfamily members in follicular cells of prepubertal gilts with distinct endocrine profiles
Authors: Hoyos-Marulanda Veronica , Haas Cristina S. , Goularte Karina L. , Rovani Monique T. , Mondadori Rafael G. , Vieira Arnaldo D. , Gasperin Bernardo G. , Lucia Thomaz
Published: May 2021

Regulation of the transforming growth factor beta (TGFβ) superfamily by gonadotrophins in swine follicular cells is not fully understood. This study evaluated the expression of steroidogenic enzymes and members of the TGFβ superfamily in prepubertal gilts allocated to three treatments: 1200 IU eCG at D −3 (eCG); 1200 IU eCG at D −6 plus 500 IU hCG at D −3 (eCG + hCG); and the control, composed of untreated gilts. Blood samples and ovaries were collected at slaughter (D0) and follicular cells were recovered thereafter. Relative gene expression was determined by real-time PCR. Serum progesterone levels were greater in the eCG + hCG group compared with the other groups (P < 0.01). No differences were observed in the expression of BMP15, BMPR1A, BMPR2, FSHR, GDF9, LHCGR and TGFBR1 (P > 0.05). Gilts from the eCG group presented numerically greater mean expression of CYP11A1 mRNA than in the control group that approached statistical significance (P = 0.08) and greater expression of CYP19A1 than in both the eCG and the control groups (P < 0.05). Expression of BMPR1B was lower in the eCG + hCG treatment group compared with the control (P < 0.05). In conclusion, eCG treatment increased the relative expression of steroidogenic enzymes, whereas treatment with eCG + hCG increased serum progesterone levels. Although most of the evaluated TGFβ members were not regulated after gonadotrophin treatment, the downregulation of BMPR1B observed after treatment with eCG + hCG and suggests a role in luteinization regulation.
Clinical Pharmacology of Hyperammonemia by Sodium Valproate and Carbamazepine in People Living with HIV
Authors: Mazzoglio y Nabar Martin J. , Muñoz Santiago , Muñiz Milagros , Mejías Alexis , Montivero Christian , Schraier Gabriel
Published: May 2021

Introduction

Hyperammonaemia (HA) is observed in decompensated liver disease. The picture of hyperammonemic encephalopathy in non-cirrhotic patients was reported mostly associated with valproic acid. There are few reports of hyperammonemia in people living with human immunodeficiency virus (PLHIV) and they are associated with other comorbidities and few with antiretrovirals (HAART), but not as adverse drug reactions associated with psychotropic drugs associated with the virus.

Objective

Report of cases of PLHIV in HARRT with hyperammonemia, its clinical impact and ammonium levels.

Materials and Methods

We report 67 PLHIV in treatment with HAART, negative viral loads, psychopharmacological treatment with valproic acid (n=45) or carbamazepine (n=22). Exclusion criteria were = HCV, HBV and alcohol consumption disorder (current or recent history) and decompensated liver pathology. We apply scales to evaluate side effects (UKU), subjective adherence (DAI), daily life activities (Barthel Index), liver severity (Child-Pugh Classification) and degrees of hepatic encephalopathy (West Haven Scale). The ethical-legal requirements were met. Results: 26.86% presented hyperammonemia, among which 38.88% was symptomatic. The clinical presentation was heterogeneous with a higher prevalence of gastrointestinal and cognitive alterations; the most severe cases presented alterations of the sensorium and 1 case of convulsions. We recorded a greater symptomatic severity with carbamazepine (average ammonia =104.4 pmol/L), but a higher prevalence of non-symptomatic hyperammonemia with valproic acid (62.3 pmol/L). The time of onset of symptoms was lower with carbamazepine, but the time until its decrease was higher with valproic acid.

Conclusions

We observed a higher prevalence of hyperammonemia and associated symptomatology in PLHIV with HAART medicated with carbamazepine. The significant percentage of this adverse drug reaction suggests a biochemical, perhaps preventive, control.
A Novel Real-Time PCR Assay for Detection of HLA-A*31:01 in Individuals Being Considered for Carbamazepine Therapy
Authors: Krause David S. , Davis Kathleen , Dowd Daniel , Robbins David J.
Published: May 2021

Background

Carbamazepine, an anticonvulsant also used as a mood stabilizer and for trigeminal neuralgia, is associated with serious, sometimes fatal cutaneous adverse drug reactions, including Stevens Johnson Syndrome and toxic epidermal necrolysis1. Current literature demonstrates a genetic predisposition linked to specific class I and II human leukocyte antigen (HLA) types in various ethnic populations2. HLA-A*31:01 is one such HLA type, and is routinely identified by the tag SNP rs1061235. However, rs1061235 has poor specificity for HLA*31:01 due to interference of HLA-A*33 types3. We investigated the false positive rate in our population and developed a novel real-time PCR assay that distinguishes HLA-A*31:01 from other HLA-A types including HLA-A*33.

Methods

120 unique samples were tested in triplicate during the validation of this assay and were sent to a reference lab for HLA next generation sequencing (NGS) typing, including 89 in-house samples and 31 Coriell samples with documented HLA typing results. The results from our real-time PCR assay were compared to the HLA typing results. HLA typing results were also compared to the tag SNP rs1061235 results to calculate the false positive rate.

Results

There was 100% concordance between our real-time PCR results and expected results based on HLA typing. 89 sample results for tag SNP rs1061235 were compared to HLA typing results. 75/89 samples had a rs1061235 variant, but 31/75 (41%) samples did not have the HLA-A*31:01 type, thus defining the false positive rate of the tag SNP for our population. We theorized there would be a small subset of rare HLA-A types that would interfere with the assay and we tested the three types available to us. We confirmed that 3 of the HLA types (HLA-A*31:04, 31:12, and 31:16) result falsely positive due to sequence homology with 31:01. There is no known literature indicating whether these rare HLA-A*31 subtypes are associated with cutaneous adverse reactions. These 3 HLA types and the other suspected interfering HLA types have limited frequency data sets and are expected to occur rarely in our patient population; we expect these HLA types make up less than 0.003% of the our population. Our assay specificity for the validation is >99%.

Conclusions

Our custom real-time PCR assay for detection of HLA-A*31:01 is significantly more specific than the commonly used tag SNP rs1061235. Clinicians considering carbamazepine therapy for their patients will have a better understanding of cutaneous adverse reaction risk and can make improved personalized treatment decisions. This quick, cost effective assay allows more patients in need of carbamazepine treatment to benefit from its use.

Funding

Genomind, Inc.
Can Low Dose Sertraline Cause Serotonin Syndrome in Pediatric Patients? 2 Case Reports
Authors: Jahan Sultana
Published: May 2021

Background

Serotonin syndrome is a potentially life-threatening condition associated with increased serotonergic activity in the central nervous system. Serotonin syndrome is underreported complication of pharmacotherapy. The Hunter Criteria for serotonin syndrome (SS) are fulfilled if the patient has taken a serotonergic agent and has one of the following symptoms: 1) spontaneous clonus, 2) inducible clonus and agitation or diaphoresis, 3) ocular clonus and agitation or diaphoresis, 4) tremor and hyperreflexia, 5) hypertonia, or 6) temperature above 38 C and ocular clonus or inducible clonus.

Method

Patient A was a 16-year-old Caucasian male with history of major depressive disorder, social anxiety and OCD who presented to the emergency room with multiple complaints: twitching of bilateral cheeks, intermittent tremor of his hands and feet, mental fogginess/confusion, stuttering when attempting to speak, agitation, profuse sweating and headache. 3 weeks prior, his sertraline dose was increased from 25mg daily to 50 mg daily. His physical exam was remarkable for elevated blood pressure and heart rate as well as hyperreflexia noted on patellar reflex testing. No significant abnormalities were noted on routine labs. He was told his symptoms were likely due to medication side effects. The patient was discharged with instructions to decrease his sertraline dose from 50 mg to 25 mg daily and follow up with his outpatient psychiatrist. 2 days later the patient was seen at the outpatient child psychiatry clinic and he was advised to taper off sertraline completely by taking 12.5mg daily for 3 days before cessation. After stopping the medication, the patient’s symptoms resolved.

Patient B was a 16-year-old female with generalized anxiety disorder and major depressive disorder who presented to the general pediatric clinic with progressively worsening hand tremors and body shaking since her Zoloft dose was increased from 25mg to 50mg daily. She also felt it was more difficult to hold objects. At the physical exam she had an elevated heart rate to 93 and elevated blood pressure to 182/75. Her deep tendon reflexes were 4+ bilaterally. Upon consultation with child psychiatry, the patient was recommended to taper off sertraline. After the discontinuation of sertraline, her symptoms resolved.

Result

These 2 patients developed mild to moderate symptoms of serotonin syndrome with low doses of sertraline. Symptoms resolved after the discontinuation of the SSRI.

Discussion

In the pediatric patient population, serotonin syndrome can develop even with lower doses of an SSRI. To avoid a missed diagnosis, clinicians should familiarize themselves with the Hunter Criteria for serotonin syndrome. It is also vital to educate parents and caregivers about the toxicities of SSRIs, including serotonin syndrome, so they may monitor treatment and take appropriate action if needed.