bluuebunny/crossref_metadata_2025 huggingface dataset:
Remote ischemic preconditioning protects against spinal cord ischemia–reperfusion injury in mice by activating NMDAR/AMPK/PGC-1α/SIRT3 signaling
Authors: Gu Changjiang , Kong Fanqi , Zeng Junkai , Geng Xiangwu , Sun Yanqing , Chen Xiongsheng
Published: March 2023

Background

To study the protective effects of delayed remote ischemic preconditioning (RIPC) against spinal cord ischemia–reperfusion injury (SCIRI) in mice and determine whether SIRT3 is involved in this protection and portrayed its upstream regulatory mechanisms.

Methods

In vivo, WT or SIRT3 global knockout (KO) mice were exposed to right upper and lower limbs RIPC or sham ischemia. After 24 h, the abdominal aorta was clamped for 20 min, then re-perfused for 3 days. The motor function of mice, number of Nissl bodies, apoptotic rate of neurons, and related indexes of oxidative stress in the spinal cord were measured to evaluate for neuroprotective effects. The expression and correlation of SIRT3 and NMDAR were detected by WB and immunofluorescence. In vitro, primary neurons were exacted and OGD/R was performed to simulate SCIRI in vivo. Neuronal damage was assessed by observing neuron morphology, detecting LDH release ratio, and flow cytometry to analyze the apoptosis. MnSOD and CAT enzyme activities, GSH and ROS level were also measured to assess neuronal antioxidant capacity. NMDAR-AMPK-PGC-1α signaling was detected by WB to portray upstream regulatory mechanisms of RIPC regulating SIRT3.

Results

Compared to the SCIRI mice without RIPC, mice with RIPC displayed improved motor function recovery, a reduced neuronal loss, and enhanced antioxidant capacity. To the contrary, the KO mice did not exhibit any effect of RIPC-induced neuroprotection. Similar results were observed in vitro. Further analyses with spinal cord tissues or primary neurons detected enhanced MnSOD and CAT activities, as well as increased GSH level but decreased MDA or ROS production in the RIPC + I/R mice or NMDA + OGD/R neurons. However, these changes were completely inhibited by the absence of SIRT3. Additionally, NMDAR-AMPK-PGC-1α signaling was activated to upregulate SIRT3 levels, which is essential for RIPC-mediated neuroprotection.

Conclusions

RIPC enhances spinal cord ischemia tolerance in a SIRT3-dependent manner, and its induced elevated SIRT3 levels are mediated by the NMDAR-AMPK-PGC-1α signaling pathway. Combined therapy targeting SIRT3 is a promising direction for treating SCIRI.
Aging aggravates acetaminophen-induced acute liver injury and inflammation through inordinate C/EBPα-BMP9 crosstalk
Authors: Liu Rui , Xu Wentao , Zhu He , Dong Zijian , Dong Huke , Yin Shi
Published: March 2023

Background

Previous studies have shown that bone morphogenetic protein 9 (BMP9) is almost exclusively produced in the liver and reaches tissues throughout the body as a secreted protein. However, the mechanism of BMP9 action and its role in aging-associated liver injury and inflammation are still unclear.

Results

Aging significantly aggravates acetaminophen (APAP)-induced acute liver injury (ALI). Increased expression of CCAAT/enhancer binding protein α (C/EBPα) and BMP9 was identified in aged livers and in hepatocytes and macrophages (MФs) isolated from aged mice. Further analysis revealed that excess BMP9 was directly related to APAP-induced hepatocyte injury and death, as evidenced by activated drosophila mothers against decapentaplegic protein 1/5/9 (SMAD1/5/9) signaling, an increased dead cell/total cell ratio, decreased levels of ATG3 and ATG7, blocked autophagy, increased senescence‐associated beta‐galactosidase (SA‐β‐Gal) activity, and a higher rate of senescence‐associated secretory phenotype (SASP) acquisition. In contrast, Bmp9 knockout (Bmp9−/−) partially alleviated the aforementioned manifestations of BMP9 overexpression. Moreover, BMP9 expression was found to be regulated by C/EBPα in vitro and in vivo. Notably, BMP9 also downregulated autophagy through its effect on autophagy-related genes (ATG3 and ATG7) in MΦs, which was associated with aggravated liver injury and SASP acquisition.

Conclusions

In summary, the present study highlights the crucial roles played by C/EBPα-BMP9 crosstalk and provides insights into the interrelationship between hepatocytes and MΦs during acute liver injury.
Trends and correlated outcomes in population-level prescription opioid and transdermal fentanyl use in Israel
Authors: Shapira Barak , Berkovitz Ronny , Haklai Ziona , Goldberger Nehama , Lipshitz Irena , Rosca Paola
Published: March 2023

Background

In the last twenty years, there was a documented increase in prescription opioid procurement in Israel. However, there is still little evidence of the association between opioid procurement rates, health service utilisation in secondary care, and enrollment rates to substance use disorder treatment programmes. In this study, we show trends in the reports of opioid-related hospitalisations, emergency department visits, enrollment to community-based outpatient treatment for Prescription Opioid Use Disorder and opioid-related mortality rates. Additionally, we examine potential correlations between these health service utilisation rates and prescription opioid procurement rates at the population level, with a focus on transdermal fentanyl.

Methods

A longitudinal study at the population level. We used seven-year data on indicators of opioid-related morbidity, prescription opioid procurement data for 2015–2021, and six-year opioid-related mortality data for 2015–2020. We measure the correlation between procurement rates of prescription opioids in Oral Morphine Equivalent per capita, and aggregated rates obtained from hospital administrative data for hospitalisations, emergency department visits, and patient enrolment in specialised prescription opioid use disorder outpatient treatment in the community setting.

Results

Between 2015 and 2021, procurement rates in primary care per capita for all prescription opioids increased by 85%, while rates of transdermal fentanyl procurement increased by 162%. We found a significant positive correlation at the population level, between annual opioid procurement rates, and rates per population of opioid-related visits to emergency departments (r = 0.96, p value < 0.01, [CI 0.74–0.99]), as well as a positive correlation with the rates per population of patient enrolment in specialised prescription opioid use disorder outpatient treatment (r = 0.93, p value = 0.02, [CI 0.58–0.99]). Opioid-related mortality peaked in 2019 at 0.31 deaths per 100,000 but decreased to 0.20 deaths per 100,000 in 2020.

Conclusion

Data shows that all-opioid and transdermal fentanyl procurement has increased yearly between 2015 and 2021. This increase is positively correlated with a growing demand for community-based Prescription Opioid Use Disorder outpatient treatment. Efforts to reduce opioid-related morbidity may require effective approaches toward appropriate prescribing, monitoring, and further increasing access to prescription opioid outpatient treatment.
Association between body condition score, testicular haemodynamics and echogenicity, nitric oxide levels, and total antioxidant capacity in rams
Authors: El-Sherbiny Hossam R. , El-Shalofy Amr S. , Samir Haney
Published: March 2023

Higher body fatness adversely affects metabolic and hormonal homeostasis. The present work aimed to evaluate the association between body condition score (BCS) and haemodynamic pattern and echogenic appearence of the testes as well as nitric oxide (NO) levels and total antioxidant capacity (TAC). For that, fifteen Ossimi rams were blocked according to their BCS into a lower BCS group (L-BCS:2–2.5; n = 5), medium BCS group (M-BCS:3–3.5; n = 5), and higher BCS group (H-BCS:4–4.5; n = 5). Rams were examined for testicular haemodynamics (TH; Doppler ultrasonography), testicular echotexture (TE; B-mode image software analysis), and serum levels of NO and TAC (colorimetric). Results are presented as means ± standard error of the mean. There was a significant (P < 0.05) difference in the resistive index and pulsatility index means among the groups under experimentation, being the least in the L-BCS group (0.43 ± 0.02 and 0.57 ± 0.04, respectively) compared to the M-BCS (0.53 ± 0.03 and 0.77 ± 0.03, respectively) and H-BCS rams (0.57 ± 0.01 and 0.86 ± 0.03, respectively). Among blood flow velocity measurements [peak systolic, end-diastolic (EDV), and time-average maximum], only EDV showed significant (P < 0.05) higher values in the L-BCS group (17.06 ± 1.03 cm/s) compared to M-BCS (12.58 ± 0.67 cm/s) and H-BCS (12.51 ± 0.61 cm/s) groups. Regarding the TE results, there were no significant differences among the examined groups. There were significant differences (P < 0.01) in the concentrations of TAC and NO among the groups under experimentation, in which the L-BCS rams had the highest levels of TAC and NO in their sera (0.90 ± 0.05 mM/L and 62.06 ± 2.72 μM/L, respectively) than the M-BCS (0.058 ± 0.05 mM/L and 47.89 ± 1.49 μM/L, respectively) and H-BCS rams (0.45 ± 0.03 mM/L and 49.93 ± 3.63 μM/L, respectively). In conclusion, body condition score is associated with both testicular hemodynamic and the antioxidant capacity in rams.
ASBL: low-cost, small-sized AUV remote guidance method and experimental verification
Authors: Shi Yang , Han Xiao , Ma Lin , Guo Lin
Published: March 2023

The low-cost, small-sized autonomous underwater vehicle (AUV) is the preferred carrier for seabed operations. As all know, the inertial navigation system (INS) error drifts over time. Three or more seafloor datum signals are required when error-correcting the INS using the long baseline (LBL). Typically, a seafloor datum has an acoustic ranging capability of 15 km. However, the positioning ability of the conventional LBL is limited and cannot play the role of remote guidance when there is only a single datum. The paper proposes the Acoustic Synthetic Baseline (ASBL) positioning technology, which can achieve target positioning through multi-frame acoustic distance estimates between the measured target and the underwater datum. Firstly, the positioning principle of the ASBL is introduced, and the error distribution is analyzed in the paper. Secondly, a small-sized AUV is used to carry out the verification on the lake test, and the result shows that the ASBL positioning technology can play a guiding role. According to the statistics of the positioning results, the detection probability of less than 5% positioning error can reach more than 83%. The ASBL technology can reduce the dependence on the number of seafloor datums that convenience and operation efficiency can improve only by a single datum.
Deep learning-based wave digital modeling of rate-dependent hysteretic nonlinearities for virtual analog applications
Authors: Massi Oliviero , Mezza Alessandro Ilic , Giampiccolo Riccardo , Bernardini Alberto
Published: March 2023

Electromagnetic components greatly contribute to the peculiar timbre of analog audio gear. Indeed, distortion effects due to the nonlinear behavior of magnetic materials are known to play an important role in enriching the harmonic content of an audio signal. However, despite the abundant research that has been devoted to the characterization of nonlinearities in the context of virtual analog modeling over the years, the discrete-time simulation of circuits exhibiting rate-dependent hysteretic phenomena remains an open challenge. In this article, we present a novel data-driven approach for the wave digital modeling of rate-dependent hysteresis using recurrent neural networks (RNNs). Thanks to the modularity of wave digital filters, we are able to locally characterize the wave scattering relations of a hysteretic reluctance by encapsulating an RNN-based model into a single one-port wave digital block. Hence, we successfully apply the proposed methodology to the emulation of the output stage of a vacuum-tube guitar amplifier featuring a nonlinear transformer.
Analysis of scalable channel estimation in FDD massive MIMO
Authors: Zhang Xing , Sabharwal Ashutosh
Published: March 2023

One of the key ideas for reducing downlink channel acquisition overhead for FDD massive MIMO systems is to exploit a combination of two assumptions: (i) the dimension of channel models in propagation domain may be much smaller than the next-generation base-station array sizes (e.g., 64 or more antennas), and (ii) uplink and downlink channels may share the same low-dimensional propagation domain. Our channel measurements demonstrate that the two assumptions may not always hold, thereby impacting the predicted performance of methods that rely on the above assumptions. In this paper, we analyze the error in modeling the downlink channel using uplink measurements, caused by the mismatch from the above two assumptions. We investigate how modeling error varies with base-station array size and provide both numerical and experimental results. We observe that modeling error increases with the number of base-station antennas, and channels with larger angular spreads have larger modeling error. Utilizing our modeling error analysis, we then investigate the resulting beamforming performance rate loss. Accordingly, we observe that the rate loss increases with the number of base-station antennas, and channels with larger angular spreads suffer from higher rate loss.
A monopole broadband circularly polarized antenna with coupled disc and folded microstrip stub lines
Authors: Ma Zhonghua , Chen Jiaxiang , Li Chen , Jiang Yanfeng
Published: March 2023

A broadband circularly polarized (CP) printed monopole antenna which fed by coplanar waveguide (CPW) is proposed in the paper. The structure of the novel antenna includes a quarter circular disc radiating monopole, a coupled circular patch, and a bent L-shaped microstrip stub line. The L-shaped microstrip stub line is used to widen the impedance bandwidth and generate a horizontal component of the electromagnetic wave. The adoption of the asymmetric ground coplanar waveguide structure with the single-feed technology and the coupled circular patch, simultaneously achieve wide impedance bandwidth and wide axial ratio (AR) bandwidth. The structure parameters and the surface current of the designed antenna are analysed. The simulation and the measurement are conducted, showing good characterizations of the designed antenna. The 10-dB impedance bandwidth is 7.57 GHz, the fractional bandwidth from 6.05 to 13.62 GHz is 76.9%, the 3-dB axial ratio bandwidth is 3.01 GHz, and the fractional bandwidth from 6.05 to 9.06 GHz is 39.8%. The antenna can generate right/left hand circularly polarized waves in the direction of ± z axis. The designed antenna has wide applications in the fields of Internet of Things (IoT), broadband dual-CP communication systems and polarization diversity systems, wireless personal area network and other advanced communication systems.
A flower bud-shaped flexible UWB antenna for healthcare applications
Authors: Karad Kailash V. , Hendre Vaibhav S.
Published: March 2023

Remote surveillance of the elderly and others with health difficulties is becoming increasingly important in these epidemic days. To address these issues, low-cost, lightweight, and portable wearable devices are in huge demand. This paper realizes the design and analysis of a flexible ultra-wideband (UWB) antenna for healthcare applications. The proposed hexagonal microstrip antenna encompasses two cuts on the top left and right side of the hexagon which looks like a flower bud. The antenna is fabricated using a flexible foam substrate with a dielectric constant of 1.07 and has a dimension of$$38 \times 30 \times 1.7\,{\text{mm}}^{3}$$38×30×1.7mm3. With a unique patch shape and corner cut in the partial ground, the present design strives to optimize the antenna structure to accommodate UWB (3.1 to 10.6 GHz) operating spectrum from 2.6 to 11.3 GHz. The proposed antenna has achieved an FBW of 125.17% with a total gain of 5.24 dB. The antenna is also evaluated on the line of bending and SAR over a tissue of 1 g and 10 g. The antenna operated admirably, with an average SAR value below the safety limits of 1.6 W/kg and 2 W/kg for the tissues, respectively.
How does HbA1c predict mortality and readmission in patients with heart failure? A protocol for systematic review and meta-analysis
Authors: Xu Jun-Peng , Zeng Rui-Xiang , Mai Xiao-Yi , Pan Wen-Jun , Zhang Yu-Zhuo , Zhang Min-Zhou
Published: March 2023

Background

Accumulating evidence suggests that HbA1c levels, a common clinical indicator of chronic glucose metabolism over the preceding 2–3 months, are independent risk factors for cardiovascular disease, including heart failure. However, conflicting evidence obscures clear cutoffs of HbA1c levels in various heart failure populations. The aim of this review is to assess the possible predictive value and optimal range of HbA1c on mortality and readmission in patients with heart failure.

Methods

A systematic and comprehensive search will be performed using PubMed, Embase, CINAHL, Scopus, and the Cochrane Library databases before December 2022 to identify relevant studies. All-cause mortality is the prespecified primary endpoint. Cardiovascular death and heart failure readmission are secondary endpoints of interest. We will only include prospective and retrospective cohort studies and place no restrictions on the language, race, region, or publication period. The ROBINS-I tool will be used to assess the quality of each included research. If there were sufficient studies, we will conduct a meta-analysis with pooled relative risks and corresponding 95% confidence intervals to evaluate the possible predictive value of HbA1c for mortality and readmission. Otherwise, we will undertake a narrative synthesis. Heterogeneity and publication bias will be assessed. If heterogeneity was significant among included studies, a sensitivity analysis or subgroup analysis will be used to explore the source of heterogeneity, such as diverse types of heart failure or patients with diabetes and non-diabetes. Additionally, we will conduct meta-regression to examine the time-effect and treatment-effect modifiers on all-cause mortality compared between different quantile of HbA1c levels. Finally, a restricted cubic spline model may be used to explore the dose-response relationship between HbA1c and adverse outcomes.

Discussion

This planned analysis is anticipated to identify the predictive value of HbA1c for mortality and readmission in patients with heart failure. Improved understanding of different HbA1c levels and their specific effect on diverse types of heart failure or patients with diabetes and non-diabetes is expected to be figured out. Importantly, a dose-response relationship or optimal range of HbA1c will be determined to instruct clinicians and patients.

Systematic review registration

PROSPERO registration details: CRD42021276067
Effects of armed conflicts on childhood undernutrition in Africa: a systematic review and meta-analysis
Authors: Azanaw Melkalem Mamuye , Anley Denekew Tenaw , Anteneh Rahel Mulatie , Arage Getachew , Muche Achenef Asmamaw
Published: March 2023

Background

Undernutrition is defined as not consuming enough nutrients and energy to meet one’s needs for maintaining good health. It is exacerbated by armed conflict. Individuals cannot stick to jobs because of a lack of safety during conflicts, which has an impact on families’ ability to purchase food. However, there is a paucity of evidence on pooled evidence on the impact of armed conflict on childhood undernutrition among children aged 6 to 59 months in Africa. Therefore, this review aimed to examine the effects of armed conflict on the magnitude of undernutrition, particularly stunting, underweight, and wasting among children in Africa.

Methods

A comprehensive literature search was conducted using electronic databases (PubMed, Hinari, and Google Scholar database) to locate potential studies. Heterogeneity between studies was checked using Cochrane Q test statistics and I2 test statistics. Small-study effects were checked using Egger’s statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence and associated factors of undernutrition among children aged 6–59 months in Africa.

Results

Of a total of 585 articles retrieved from the databases, 12 studies met our inclusion criteria. The pooled prevalence of wasting, stunting, and being underweight among conflict-affected African countries was 20.25% (95%CI = 15.08–25.43), 34.18% (95% CI = 26.34–42.02), and 24.00% (95%CI = 16.35–31.65), respectively. The most consistent factors associated with childhood stunting, wasting, and being underweight in Africa were low mother’s education, prolonged duration of armed conflict, and rural place of residence.

Conclusion

The severity of malnutrition crises will be assisted by a better understanding of the variables associated with child malnutrition, which will improve the effectiveness of development and humanitarian responses. We urge that health planners, policymakers, and the general public prioritize children with acute malnutrition in Africa’s conflict-affected areas.

Systematic review registration

PROSPERO CRD42022367487
A comprehensive introductory course on systematic review and meta-analysis simultaneously delivered in-person and online in Cameroon
Authors: Bigna Jean Joel , Kamgang Willy Steven , Nguefack-Tsague Georges
Published: March 2023

The global increased on research outputs around health research in general and systematic reviews has not left Sub-Saharan Africa indifferent, and Cameroon in particular. Research projects have not only increased in number but also in complexity with a record proportion of systematic review projects. This indicates that there is an unprecedented need to increase knowledge and expertise on systematic reviews and meta-analyses for high-quality evidence synthesis. We plan on associating local and international expertise to strengthen the planning, conduct and reporting of systematic reviews—in and out of academia—through an integrative learning program delivered both in English and French, the official languages in the country. The general of this introductory course was to assess the feasibility of our learning program as well as the extent to which the target audience would be willing to adhere to the program. Overall, there were 148 attendees, with 51 in-person and 97 online. Forty percent of in-person attendees were university lecturers at medical schools in Cameroon. Overall, we noted that the attendees were impressed with the quality of the presentation and the general organization of this pedagogical event, and are looking forward to participating in future courses.
On extensions of the Jack and open-door lemmas
Authors: Alavi R. , Shams S. , Aghalary R. , Cho N. E.
Published: March 2023

In the present paper, we apply the theory of differential subordination to extend the famous Jack lemma for analytic functions. Also, using this extension we will produce new versions of the open-door lemma for analytic functions, and utilizing them some simple conditions for starlikeness of analytic and meromorphic functions are obtained. Our results improve and extend the earlier results investigated in the literature.
Nodal solution for critical Kirchhoff-type equation with fast increasing weight in $\mathbb{R}^{2}$
Authors: Qin Qin , Jie Guo , Suo Hongmin
Published: March 2023

In this paper, we investigate the existence of a least-energy sign-changing solutions for the following Kirchhoff-type equation: $$ - \biggl(1+b \int _{\mathbb{R}^{2}} K(x) \vert \nabla u \vert ^{2}\,dx \biggr) \operatorname{div} \bigl(K(x)\nabla u \bigr)=K(x)f(u),\quad x\in \mathbb{R}^{2}, $$
−

(
1
+
b

∫

R
2

K
(
x
)
|
∇
u

|
2

d
x
)

div

(
K
(
x
)
∇
u
)

=
K
(
x
)
f
(
u
)
,

x
∈

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2

,
where f has exponential subcritical or exponential critical growth in the sense of the Trudinger–Moser inequality. By using the constrained variational methods, combining the deformation lemma and Miranda’s theorem, we prove the existence of a least-energy sign-changing solution. Moreover, we also prove that this sign-changing solution has exactly two nodal domains.
Identification of the bulk modulus coefficient in the acoustic equation from boundary observation: a sentinel method
Authors: Elhamza Billal , Hafdallah Abdelhak
Published: March 2023

In this paper, we consider an acoustic equation with incomplete data, where the bulk modulus coefficient and initial conditions are partially known. Our goal is to get information about the bulk modulus coefficient independently of the initial conditions from boundary observations. To achieve this goal, we apply the sentinel method introduced by J.L. Lions, which is a functional that links the solution to the given problem with a control function and a state observation. We prove that the existence of the sentinel functional is equivalent to a boundary-null controllability problem with constraints on the control. We use the Hilbert uniqueness method to study this controllability problem to establish the control of minimal norm.
Existence and uniqueness criterion of a periodic solution for a third-order neutral differential equation with multiple delay
Authors: Taie R. O. A. , Bakhit D. A. M.
Published: March 2023

In this paper, we study the existence and uniqueness of a periodic solution for a third-order neutral delay differential equation (NDDE) by applying Mawhin’s continuation theorem of coincidence degree and analysis techniques. An illustrative example is given as an application to support our results. To confirm the accuracy of our results, we also present a plot of the behavior of the periodic solution.
Nonexistence results of solutions of parabolic-type equations and systems on the Heisenberg group
Authors: Shi Wei
Published: March 2023

In this paper, we present necessary conditions for the existence of weak solution of the parabolic-type equations and systems on the Heisenberg group. The main technique for proving the results relies on the method of test functions.
A kinetic model of rotating galaxies
Authors: Strauss Walter A.
Published: March 2023

Although I had not previously been aware of Jean Ginibre’s work on random matrices, beginning in 1978 I became an admirer of his many papers on nonlinear waves in collaboration with Giorgio Velo. Their papers were amazingly profound and inspirational. I subsequently met Jean and Giorgio many times. I especially remember the pleasant time Jean and I spent together at a meeting in 2001 at Hokkaido University dedicated to the memory of the great Tosio Kato. The present announcement is a very brief summary of some of my recent mathematical work, joint with Yilun Wu, concerning a simple model of galaxies.
Enriching computing simulators by generating realistic serverless traces
Authors: Sallo Dilshad Hassan , Kecskemeti Gabor
Published: March 2023

Serverless computing is stepping forward to provide a cloud environment that mainly focuses on managing infrastructure, resources and configurations on the behalf of a user. Research in this field can’t rely on commercial providers such as AWS and Azure, as their inflexibility and cost often limits the required levels of reproducibility and scalability. Therefore, simulators have been opted as an alternative solution by the research community. They offer a reduced-cost and easy-setup environment. To get respectable precision, simulators use real traces collected and offered by commercial providers. These traces represent comprehensive information of executed tasks that reflect user behaviour. Due to serverless computing’s recency, typical workload traces employed by IaaS simulators are not well adoptable to the new computing model.

In this paper, we propose an approach for generating realistic serverless traces. We enhance our previous generator approach that was based on the Azure Functions dataset. Our new, genetic algorithm based approach improves the statistical properties of the generated traces. We also enabled arbitrary scaling of the workload, while maintaining real users’ behaviour. These advances further support reproducibility in the serverless research community. We validated the results of our generator approach using the coefficient of determination ($$R^2$$

R
2

), which shows that our generated workload closely matches the original dataset’s characteristics in terms of execution time, memory utilisation as well as user participation percentage. To demonstrate the benefits of the reusability of the generated traces, we applied them with a diverse set of simulators and shown that they offer reproducible results independently of the simulator used.
Towards a sense of urgency for innovation realization: a case study on complacency asymmetries in interorganizational relations
Authors: Mitcheltree Christina Marie
Published: March 2023

This paper seeks to explore the concept of complacency as a barrier to the sense of urgency within product innovation, by investigating the concept on behalf of interfirm project partners. More specifically, the study aims to understand complacency within the context of an industrial research project in Norway subject to material substitution of an energy transmission tower. As such, the study seeks to give a contextual understanding of complacency for innovation realization (e.g., innovation speed) from a single case study. The study identified different complacency mechanism asymmetries on behalf of the actors, as well as the varying reasons (drivers) to why urgency gaps may occur among actors. The urgency gaps were found to impact a sense of urgency and thus innovation speed negatively. The asymmetries are presented from the drivers: role understanding, competence, project intent, risk and trust. Moreover, the urgency gaps’ implications for interorganizational project collaboration, and how they contribute to theory on industrial product innovation, are explained. The findings contribute with new insights on important mechanisms for how a sense of urgency may be enhanced in research projects subject to interorganizational innovation. Theoretical contributions thus relate to enhanced understanding of complacency asymmetry in product innovation collaboration, and how trust is an important dimension for urgency creation.
Knowledge of surgical informed consent and associated factors among patients undergone obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Ethiopia, 2020: an institutional based cross-sectional study
Authors: Kebede Belete Fenta , Tesfa Tsegaw Biyazin , Hiwot Aynalem Yetwale , Genie Yalemtsehay Dagnaw
Published: March 2023

Introduction

Informed consent is the process whereby a patient makes a voluntary decision about their medical and surgical care with knowledge of the benefits and potential risks. Poor informed consent processes may increase potential for medical errors and malpractice. Little is known of the knowledge of surgical informed consent with regard to their surgical treatment in Ethiopia. Therefore, this study aimed to assess the knowledge of surgical informed consent and associated factors among patients who underwent obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Ethiopia.

Methods and materials

An institution-based cross-sectional study was conducted from April 1 to May 30, 2020, among 404 women undergo obstetric and gynecologic surgery at Jimma Medical Center. Data were collected through a face-to-face interview using a structured questionnaire. The collected data were coded, entered into Epi data version 3.1, and analyzed using SPSS version 25. Bivariate and multivariate regression analyses were performed to determine the association between an outcome variable and an independent variable. Tables, pie-charts, and texts were used to report the result.

Results

Of 404 patients sampled, only 372 women were agreed and participated in the study and gave response rate of 92.1%. The respondent satisfaction level (AOR 1.823 (95%CI 1.061–3.134)) and patient to provider relationship (AOR 0.472 (CI 1.217–3.697)) were associated with knowledge of surgical informed consent.

Conclusion

The overall level of knowledge regarding informed consent for surgerywas significantly lower than that of other national and international figures. Patient satisfaction and patientto provider relationships were associated with knowledge of surgical informed consent. Adequate information should provide before surgery to improve patients’ knowledge regarding surgical informed consent and to improve the consent process to make it better suited to fit the needs of all patients.
Disinfection of incubators in neonatal intensive care units: impact of steam pulverization on bacterial colonization
Authors: Reboux Marion , Chavignon Marie , Tristan Anne , Plaisant Franck , Laurent Frédéric , Butin Marine
Published: March 2023

Background

In neonatal intensive care units (NICUs), neonates requiring medical care after birth, including very vulnerable preterm infants, are housed in incubators. Previous studies have reported that the standard chemical disinfection measures used to disinfect these incubators are insufficient to eradicate contaminating bacteria, leading to a worrying infectious risk for preterm neonates. This study aimed to evaluate the efficacy of a disinfection method based on steam pulverization to eradicate the persistent bacterial contamination in such incubators.

Methods

In a tertiary NICU, 20 incubators were monitored qualitatively for bacterial contamination at five different sites (the rubber grommet, the left door handles, the temperature adjustment button, the mattress and the scale) using a culture method at three times: before and after steam pulverization then 24 h after turning on and housing a new neonate. Clinical data of neonates housed in each incubator were retrieved from the medical records to identify potential occurrence of late onset sepsis (LOS).

Results

Just after steam pulverization, only two incubators were free from bacteria. Before disinfection 87% of all the samples were contaminated compared to 61% after disinfection. After 24 h, the proportion of contaminated samples reached 85%. Mattresses and scales were the most frequently contaminated incubator sites with respectively 90% and 80% positive samples after disinfection compared to 100% and 90% before disinfection. Coagulase-negative staphylococci, Enterococcus, Enterobacteria and Bacillus resisted disinfection and were identified on respectively 90%, 20%, 5% and 45% of incubators just after disinfection. Three preterm neonates developed LOS after being housed in a disinfected incubator but the bacterial species involved have not been identified in their incubator after disinfection. In two cases, the bacterium had been isolated from the mattress 24 h after housing the infected patient.

Conclusion

Steam pulverization is not sufficient to eradicate bacterial contamination of incubators. These results highlight the urgent need for an effective disinfection method, especially for mattresses that are in constant contact with patients. In parallel, new incubator designs and mattress protections must be developed.
Multi-omics to predict acute radiation esophagitis in patients with lung cancer treated with intensity-modulated radiation therapy
Authors: Zheng Xiaoli , Guo Wei , Wang Yunhan , Zhang Jiang , Zhang Yuanpeng , Cheng Chen , Teng Xinzhi , Lam Saikit , Zhou Ta , Ma Zongrui , Liu Ruining , Wu Hui , Ge Hong , Cai Jing , Li Bing
Published: March 2023

Purpose

The study aimed to predict acute radiation esophagitis (ARE) with grade  ≥ 2 for patients with locally advanced lung cancer (LALC) treated with intensity-modulated radiation therapy (IMRT) using multi-omics features, including radiomics and dosiomics.

Methods

161 patients with stage IIIA−IIIB LALC who received chemoradiotherapy (CRT) or radiotherapy by IMRT with a prescribed dose from 45 to 70 Gy from 2015 to 2019 were enrolled retrospectively. All the toxicity gradings were given following the Common Terminology Criteria for Adverse Events V4.0. Multi-omics features, including radiomics, dosiomics (including dose−volume histogram dosimetric parameters), were extracted based on the planning CT image and three-dimensional dose distribution. All data were randomly divided into training cohorts (N = 107) and testing cohorts (N = 54). In the training cohorts, features with reliably high outcome relevance and low redundancy were selected under random patient subsampling. Four classification models (using clinical factors (CF) only, using radiomics features (RFs) only, dosiomics features (DFs) only, and the hybrid features (HFs) containing clinical factors, radiomics and dosiomics) were constructed employing the Ridge classifier using two-thirds of randomly selected patients as the training cohort. The remaining patient was treated as the testing cohort. A series of models were built with 30 times training–testing splits. Their performances were assessed using the area under the ROC curve (AUC) and accuracy.

Results

Among all patients, 51 developed ARE grade  ≥ 2, with an incidence of 31.7%. Next, 8990 radiomics and 213 dosiomics features were extracted, and 3, 6, 12, and 13 features remained after feature selection in the CF, DF, RF and DF models, respectively. The RF and HF models achieved similar classification performance, with the training and testing AUCs of 0.796 ± 0.023 (95% confidence interval (CI [0.79, 0.80])/0.744 ± 0.044 (95% CI [0.73, 0.76]) and 0.801 ± 0.022 (95% CI [0.79, 0.81]) (p = 0.74), respectively. The model performances using CF and DF features were poorer, with training and testing AUCs of 0.573 ± 0.026 (95% CI [0.56, 0.58])/ 0.509 ± 0.072 (95% CI [0.48, 0.53]) and 0.679 ± 0.027 (95% CI [0.67, 0.69])/0.604 ± 0.041 (95% CI [0.53, 0.63]) compared with the above two models (p < 0.001), respectively.

Conclusions

In LALC patients treated with CRT IMRT, the ARE grade  ≥ 2 can be predicted using the pretreatment radiotherapy image features. To predict ARE, the multi-omics features had similar predictability with radiomics features; however, the dosiomics features and clinical factors had a limited classification performance.
Seroprevalence of hepatitis C virus in Jinan, China, 2008–2020
Authors: Xu Mingjie , Liu Fang , Zhao Qianqian , Zhou Yunying , Zhuang Yuanmei , Ji Mingyu
Published: March 2023

Background

The updated estimates of hepatitis C virus (HCV) seroprevalence are critical for developing strategies to manage or eliminate HCV infection.

Methods

A comprehensive study on HCV seroprevalence was conducted among 365,210 patients at Jinan Central Hospital, China, from 2008 to 2020. The patients were tested for anti-HCV, HCV core antigen, hepatitis B surface antigen, syphilis antibody, human immunodeficiency virus antigen + antibody, antihepatitis A virus IgM, and antihepatitis E virus IgM.

Results

HCV seroprevalence was 0.79% and was related to age. HCV seropositivity was lower in children (aged  < 18 years) than in adults (aged  ≥ 18 years) (0.15% vs. 0.81%). High HCV prevalence was reported in adults aged  ≥ 41 years, and HCV seropositivity in those aged 41–80 years accounted for 74.56% of all seropositive individuals. Notably, the rate of HCV–HIV coinfection was 0. HCV seroprevalence was considerably higher in patients at the Kidney Disease Unit and Dialysis Department than in those at other departments (inpatient or outpatient).

Conclusions

HCV seroprevalence was lower in Jinan region but higher in patients at the Kidney Disease Unit and Dialysis Department, especially in those undergoing hemodialysis.
Impact of intensified contact precautions while treating hematopoietic stem cell transplantation recipients during aplasia
Authors: Böing Christian , Reicherts Christian , Froböse Neele , Mellmann Alexander , Schaumburg Frieder , Lenz Georg , Kampmeier Stefanie , Stelljes Matthias
Published: March 2023

Background

Bacterial infections are a major complication for patients undergoing allogeneic hematopoietic stem cell transplantation (HCT). Therefore, protective isolation is considered crucial to prevent nosocomial infections in this population. Here, the impact of intensified contact precautions on environmental contamination and the occurrence of bloodstream infections (BSI) in patients on a HCT unit were compared between two contact precaution measures.

Methods

A 2-year retrospective observational study was performed. In the first year, strict contact precaution measures were applied (i.e., protective isolation, the use of sterile personal protective equipment (PPE) by healthcare workers and visitors and sterilization of linen and objects that entered the patient’s room). After one year, contact precautions were reduced (i.e., no use of sterile PPE, no sterilization of linen and objects that entered the patient’s room). Environmental contamination in randomly selected patient rooms was monitored by sampling six standardized environmental sites in the respective patient treatment units. In a before-and-after study, the number of BSI episodes of those patients, who were accommodated in the monitored rooms was compared.

Results

In total, 181 treatment units were monitored. No significant difference in the contamination of anterooms and patient’s rooms between both groups was found. A total of 168 patients were followed for the occurrence of BSI during the entire study period (before: 84 patients, after: 84 patients). The total count of patients with BSI episodes showed a higher incidence in the period with reduced contact precautions (30/84 vs. 17/84, p = 0.039). The cause of this increasing number of BSI can be traced back to BSI episodes with common commensal bacteria (17/84 vs. 5/84, p = 0.011).

Conclusions

The implementation of maximal barrier measures did not reduce the bacterial contamination of the patients’ environment. The impact on the patients’ outcomes remain controversial. Further research is needed to investigate the impact of infection prevention measures on the clinical outcome of patients undergoing HCT.
Association between spinal muscular atrophy type and delayed diagnosis and the risk of spinal deformity in Indonesian patients
Authors: Sari Dian Marta , Biben Vitriana , Wiwaha Guswan , Hilmanto Dany
Published: March 2023

Background

Spinal muscular atrophy (SMA) is a genetic disease that causes muscle weakness and atrophy. Delayed diagnosis can lead to loss of motoric functions, which may then progress to deformities such as thoracolumbar scoliosis, pelvic obliquity, and hip subluxation/dislocation. The lack of information or limited experience among healthcare providers and costly genetic tests can cause delayed diagnosis. The current study aimed to assess the characteristics of patients with SMA. Moreover, the association between SMA type and delayed diagnosis and the risk of spinal deformity in the Indonesian SMA Community was evaluated.

Methods

This was a cross-sectional study performed on 53 patients diagnosed with SMA. Data about patients’ characteristics were obtained from the Indonesian SMA Community using a questionnaire in August 2019. The information included age, sex, SMA type, age at suspicion and definite diagnosis of SMA, and presence of spinal deformities. Then, descriptive analysis and logistic regression analysis were performed, and the Kruskal–Wallis test and the Chi-square test were utilized.

Results

The median age of patients suspected of SMA was 24 months. A definitive diagnosis of SMA was obtained at 36 months. Further, 43% of patients presented with SMA type 2 and 58% with spinal deformities. Results showed a positive correlation between time interval between suspicion and definite diagnosis of SMA and the risk of spinal deformities (B = 0,07; p > 0.05). Delayed diagnosis was more common in SMA type 3 than in SMA types 1 and 2, and SMA type 2 was correlated with a twofold risk of spinal deformities (p = 0.03; prevalence ratio = 2.09).

Conclusions

SMA type 2 is associated with a twofold risk of spinal deformities. Delayed diagnosis is more common in SMA type 3 than in SMA types 1 and 2. Moreover, there was an association between the time interval between suspicion and definite diagnosis of SMA and the risk of spinal deformities in patients with SMA.
Seed amplification assay of nasal swab extracts for accurate and non-invasive molecular diagnosis of neurodegenerative diseases
Authors: Duan Suying , Yang Jing , Cui Zheqing , Li Jiaqi , Zheng Honglin , Zhao Taiqi , Yuan Yanpeng , Liu Yutao , Zhao Lu , Wang Yangyang , Luo Haiyang , Xu Yuming
Published: March 2023

Nasal swabs are non-invasive testing methods for detecting diseases by collecting samples from the nasal cavity or nasopharynx. Dysosmia is regarded as an early sign of coronavirus disease 2019 (COVID-19), and nasal swabs are the gold standard for the detection. By nasal swabs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acids can be cyclically amplified and detected using real-time reverse transcriptase-polymerase chain reaction after sampling. Similarly, olfactory dysfunction precedes the onset of typical clinical manifestations by several years in prion diseases and other neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, dementia with Lewy bodies, and multiple system atrophy. In neurodegenerative diseases, nasal swab tests are currently being explored using seed amplification assay (SAA) of pathogenic misfolded proteins, such as prion, α-synuclein, and tau. These misfolded proteins can serve as templates for the conformational change of other copies from the native form into the same misfolded form in a prion-like manner. SAA for misfolded prion-like proteins from nasal swab extracts has been developed, conceptually analogous to PCR, showing high sensitivity and specificity for molecular diagnosis of degenerative diseases even in the prodromal stage. Cyclic amplification assay of nasal swab extracts is an attractive and feasible method for accurate and non-invasive detection of trace amount of pathogenic substances for screening and diagnosis of neurodegenerative disease.

Graphical Abstract
Rapid spilled oil analysis using direct analysis in real time time-of-flight mass spectrometry
Authors: Tikkisetty Krishnaja , McCallum Paige , Filewood Taylor , Yan Jeffrey , Kwok Honoria , Brunswick Pamela , Cody Robert , Shang Dayue
Published: March 2023

Background

The biomarker diagnostic ratio analysis outlined by the European Committee for Standardization is considered the current gold standard in oil forensic analysis. However, it has a major limitation as an emergency response procedure in the case of a large scale oil spill due to the high number of samples collected, long GC/MS instrument run time, and the time-consuming data processing required. This current study utilized direct analysis in real time time-of-flight mass spectrometry to develop a rapid spilled oil screening method. An exploratory search of biomarkers and synthetic additives was conducted on reference oil samples of various types. To build a robust yet swift procedure for oil typing, specific heat maps were built with extensive reference sample modelling. These heat maps were then used to select relevant ions from which principal component analysis and discriminant analysis of principal component models were constructed to result in defensible oil classifications.

Results

The initial exploratory search of biomarkers and additives in the various reference oil samples resulted in promising preliminary matches. The heat map and multivariate statistical analysis oil typing method was applied to three unknown samples, all of which were classified accurately.

Conclusion

The merit of direct analysis in real time time-of-flight mass spectrometry on oil forensic was confirmed with the detected biomarkers compound class starting members and lubricating additives along with the successful application of heat maps and multivariate statistical analysis, providing a swift yet reliable screening tool for oil spill environmental monitoring and impact surveying.