bluuebunny/crossref_metadata_2025 huggingface dataset:
Gaussian class-conditional simplex loss for accurate, adversarially robust deep classifier training
Authors: Ali Arslan , Migliorati Andrea , Bianchi Tiziano , Magli Enrico
Published: March 2023

In this work, we present the Gaussian Class-Conditional Simplex (GCCS) loss: a novel approach for training deep robust multiclass classifiers that improves over the state-of-the-art in terms of classification accuracy and adversarial robustness, with little extra cost for network training. The proposed method learns a mapping of the input classes onto Gaussian target distributions in a latent space such that a hyperplane can be used as the optimal decision surface. Instead of maximizing the likelihood of target labels for individual samples, our loss function pushes the network to produce feature distributions yielding high inter-class separation and low intra-class separation. The mean values of the learned distributions are centered on the vertices of a simplex such that each class is at the same distance from every other class. We show that the regularization of the latent space based on our approach yields excellent classification accuracy. Moreover, GCCS provides improved robustness against adversarial perturbations, outperforming models trained with conventional adversarial training (AT). In particular, our model learns a decision space that minimizes the presence of short paths toward neighboring decision regions. We provide a comprehensive empirical evaluation that shows how GCCS outperforms state-of-the-art approaches over challenging datasets for targeted and untargeted gradient-based, as well as gradient-free adversarial attacks, both in terms of classification accuracy and adversarial robustness.
A reinforcement learning-based sleep scheduling algorithm for compressive data gathering in wireless sensor networks
Authors: Wang Xun , Chen Hongbin , Li Shichao
Published: March 2023

Compressive data gathering (CDG) is an adequate method to reduce the amount of data transmission, thereby decreasing energy expenditure for wireless sensor networks (WSNs). Sleep scheduling integrated with CDG can further promote energy efficiency. Most of existing sleep scheduling methods for CDG were formulated as centralized optimization problems which introduced many extra control message exchanges. Meanwhile, a few distributed methods usually adopted stochastic decision which could not adapt to variance in residual energy of nodes. A part of nodes were prone to prematurely run out of energy. In this paper, a reinforcement learning-based sleep scheduling algorithm for CDG (RLSSA-CDG) is proposed. Active nodes selection is modeled as a finite Markov decision process. The mode-free Q learning algorithm is used to search optimal decision strategies. Residual energy of nodes and sampling uniformity are considered into the reward function of the Q learning algorithm for load balance of energy consumption and accurate data reconstruction. It is a distributed algorithm that avoids large amounts of control message exchanges. Each node takes part in one step of the decision process. Thus, computation overhead for sensor nodes is affordable. Simulation experiments are carried out on the MATLAB platform to validate the effectiveness of the proposed RLSSA-CDG against the distributed random sleep scheduling algorithm for CDG (DSSA-CDG) and the original sparse-CDG algorithm without sleep scheduling. The simulation results indicate that the proposed RLSSA-CDG outperforms the two contrast algorithms in terms of energy consumption, network lifetime, and data recovery accuracy. The proposed RLSSA-CDG reduces energy consumption by 4.64% and 42.42%, respectively, compared to the DSSA-CDG and the original sparse-CDG, prolongs life span by 57.3%, and promotes data recovery accuracy by 84.7% compared to the DSSA-CDG.
Keloid treatments: an evidence-based systematic review of recent advances
Authors: Walsh Laura A. , Wu Ellen , Pontes David , Kwan Kevin R. , Poondru Sneha , Miller Corinne H. , Kundu Roopal V.
Published: March 2023

Background

Keloids are pathologic scars that pose a significant functional and cosmetic burden. They are challenging to treat, despite the multitude of treatment modalities currently available.

Objective

The aim of this study was to conduct an evidence-based review of all prospective data regarding keloid treatments published between 2010 and 2020.

Methods

A systematic literature search of PubMed (National Library of Medicine), Embase (Elsevier), and Cochrane Library (Wiley) was performed in November of 2020. Search strategies with the keywords “keloid” and “treatment” were performed by a medical librarian. The search was limited to prospective studies that were peer-reviewed, reported on clinical outcomes of keloid therapies, and were published in the English language between January 1, 2010, and November 24, 2020.

Results

A total of 3462 unique citations were identified, of which 108 studies met inclusion criteria. Current literature supports silicone gel or sheeting with corticosteroid injections as first-line therapy for keloids. Adjuvant intralesional 5-fluorouracil (5-FU), bleomycin, or verapamil can be considered, although mixed results have been reported with each. Laser therapy can be used in combination with intralesional corticosteroids or topical steroids with occlusion to improve drug penetration. Excision of keloids with immediate post-excision radiation therapy is an effective option for recalcitrant lesions. Finally, silicone sheeting and pressure therapy have evidence for reducing keloid recurrence.

Conclusions

This review was limited by heterogeneity of subject characteristics and study outcome measures, small sample sizes, and inconsistent study designs. Larger and more robust controlled studies are necessary to further understand the variety of existing and emerging keloid treatments, including corticosteroids, cryotherapy, intralesional injections, lasers, photodynamic therapy, excision and radiation, pressure dressings, and others.
The move towards living systematic reviews and living guidelines in healthcare: consideration of the possibilities and challenges for living qualitative evidence syntheses
Authors: Carmona Chris , Carroll Christopher , Baxter Susan
Published: March 2023

Over the past decade qualitative evidence synthesis (QES), a range of methods for synthesising qualitative research evidence, has become a valued form of evidence for guideline producers who wish to understand more about patient preference and acceptability of treatments. The surge in interest in living systematic reviews and the appearance of living guidelines as a response to the COVID-19 pandemic potentially weaken the value and usability of QES.

There are currently no published methods for producing living QES, and if QES are to remain of worth to guideline producers then methods for the rapid, frequent updating of them will need to be developed. We discuss some of the similarities and differences between qualitative and quantitative evidence syntheses and highlight areas where development is needed if reviewers are to progress with living approaches to QES.
The nature of properly human mathematics
Authors: Ruelle David
Published: March 2023

We claim that human mathematics is only a limited part of the consequences of the chosen basic axioms. Properly human mathematics varies with time but appears to have universal features which we try to analyse. In particular, the functioning of the human brain privileges concept naming and short formulations. This leads to organising mathematical knowledge structurally. We consider briefly the problem of non-mathematical sciences.
Cost-based hierarchy genetic algorithm for service scheduling in robot cloud platform
Authors: Yin Lei , Liu Jin , Zhou Fengyu , Gao Ming , Li Ming
Published: March 2023

Service robot cloud platform is effective method to improve the intelligence of robots. An efficient cloud service scheduling algorithm is the basis of ensuring service quality and platform concurrency. In this paper, Hierarchy Genetic Algorithm of robot service(RHGA) is presented to solve the scheduling problem with the crucial constraints. Firstly, the limitations and attributes of the cloud service robots and cloud services are presented and boiled down to an important optimization goal. Secondly, three factors (i.e. evolutionary factor, hunting factor and parent similarity) are integrated with RHGA to promote the efficiency of small-scale service invocations and improve the performance of large-scale service invocations on the platform. Finally, a series of experiments are conducted on several service scheduling algorithms, including four traditional efficient algorithms and two state-of-art algorithms. The experimental results demonstrate that the RHGA can enhance the performance on small-scale service scheduling and ensure its excellent ability in large-scale service scheduling. Moreover, the empirical studies also prove that our proposal has a better performance in service scheduling completion time and cost-savings with comparison to other methods.
An artificial intelligence lightweight blockchain security model for security and privacy in IIoT systems
Authors: Selvarajan Shitharth , Srivastava Gautam , Khadidos Alaa O. , Khadidos Adil O. , Baza Mohamed , Alshehri Ali , Lin Jerry Chun-Wei
Published: March 2023

The Industrial Internet of Things (IIoT) promises to deliver innovative business models across multiple domains by providing ubiquitous connectivity, intelligent data, predictive analytics, and decision-making systems for improved market performance. However, traditional IIoT architectures are highly susceptible to many security vulnerabilities and network intrusions, which bring challenges such as lack of privacy, integrity, trust, and centralization. This research aims to implement an Artificial Intelligence-based Lightweight Blockchain Security Model (AILBSM) to ensure privacy and security of IIoT systems. This novel model is meant to address issues that can occur with security and privacy when dealing with Cloud-based IIoT systems that handle data in the Cloud or on the Edge of Networks (on-device). The novel contribution of this paper is that it combines the advantages of both lightweight blockchain and Convivial Optimized Sprinter Neural Network (COSNN) based AI mechanisms with simplified and improved security operations. Here, the significant impact of attacks is reduced by transforming features into encoded data using an Authentic Intrinsic Analysis (AIA) model. Extensive experiments are conducted to validate this system using various attack datasets. In addition, the results of privacy protection and AI mechanisms are evaluated separately and compared using various indicators. By using the proposed AILBSM framework, the execution time is minimized to 0.6 seconds, the overall classification accuracy is improved to 99.8%, and detection performance is increased to 99.7%. Due to the inclusion of auto-encoder based transformation and blockchain authentication, the anomaly detection performance of the proposed model is highly improved, when compared to other techniques.
Enhancement of an IoT hybrid intrusion detection system based on fog-to-cloud computing
Authors: Mohamed Doaa , Ismael Osama
Published: March 2023

Nowadays, with the proliferation of internet of things-connected devices, the scope of cyber-attacks on the internet of things has grown exponentially. So, it makes it a necessity to develop an efficient and accurate intrusion detection system that should be fast, dynamic, and scalable in an internet of things environment. On the other hand, Fog computing is a decentralized platform that extends Cloud computing to deal with the inherent issues of the Cloud computing. As well, maintaining a high level of security is critical in order to ensure secure and reliable communication between Fog nodes and internet of things devices. To address this issue, we present an intrusion detection method based on artificial neural networks and genetic algorithms to efficiently detect various types of network intrusions on local Fog nodes. Through this approach, we applied genetic algorithms to optimize the interconnecting weights of the network and the biases associated with each neuron. Therefore, it can quickly and effectively establish a back-propagation neural network model. Moreover, the distributed architecture of fog computing enables the distribution of the intrusion detection system over local Fog nodes with a centralized Cloud, which achieves faster attack detection than the Cloud intrusion detection mechanism. A set of experiments were conducted on the Raspberry Pi4 as a Fog node, based on the UNSW-NB15 and ToN_IoT data sets for binary-class classification, which showed that the optimized weights and biases achieved better performance than those who used the neural network without optimization. The optimized model showed interoperability, flexibility, and scalability. Furthermore, achieving a higher intrusion detection rate through decreasing the neural network error rate and increasing the true positive rate is also possible. According to the experiments, the suggested approach produces better outcomes in terms of detection accuracy and processing time. In this case, the proposed approach achieved an 16.35% and 37.07% reduction in execution time for both data sets, respectively, compared to other state-of-the-art methods, which enhanced the acceleration of the convergence process and saved processing power.
Food insecurity status and its contributing factors in slums’ dwellers of southwest Iran, 2021: a cross-sectional study
Authors: Joulaei Hassan , Keshani Parisa , Foroozanfar Zohre , Afrashteh Sima , Hosseinkhani Zahra , Mohsenpour Mohammad Ali , Moghimi Ghasem , Homayouni Meymandi Arash
Published: March 2023

Background

One major factor causing food insecurity is believed to be poverty. Approximately 20 million Iranians live in slums with a vulnerable socioeconomic context. The outbreak of COVID-19, on top of the economic sanctions against Iran, has increased this vulnerability and made its inhabitants prone to food insecurity. The current study investigates food insecurity and its associated socioeconomic factors among slum residents of Shiraz, southwest Iran.

Methods

Random cluster sampling was used to select the participants in this cross-sectional study. The heads of the households completed the validated Household Food Insecurity Access Scale questionnaire to assess food insecurity. Univariate analysis was utilized to calculate the unadjusted associations between the study variables. Moreover, a multiple logistic regression model was employed to determine the adjusted association of each independent variable with the food insecurity risk.

Results

Among the 1227 households, the prevalence of food insecurity was 87.20%, with 53.87% experiencing moderate and 33.33% experiencing severe food insecurity. A significant relationship was observed between socioeconomic status and food insecurity, indicating that people with low socioeconomic status are more prone to food insecurity (P < 0.001).

Conclusions

The current study revealed that food insecurity is highly prevalent in slum areas of southwest Iran. The socioeconomic status of households was the most important determinant of food insecurity among them. Noticeably, the coincidence of the COVID-19 pandemic with the economic crisis in Iran has amplified the poverty and food insecurity cycle. Hence, the government should consider equity-based interventions to reduce poverty and its related outcomes on food security. Furthermore, NGOs, charities, and governmental organizations should focus on local community-oriented programs to make basic food baskets available for the most vulnerable households.
Challenges connected with the energy choice and transition in bakeries of Abidjan, Côte d'Ivoire
Authors: Berte Salimata , Adou Djané Dit Fatogoma
Published: March 2023

Background

The great dependence on fuelwood due to demographic factors, logging, agricultural expansion and the repercussions of political instability, is presented for Côte d'Ivoire, as a contributor to forest degradation and deforestation. Faced with this situation, the country has been trying for many years, through the promotion of alternative energy sources to firewood, to put in place a policy to protect the environment. However, the findings from the urban bakery industry question the social logic behind the choice of energy used. The bakery industry is considered as one of the main contributors to the erosion of the country's main forest due to its propensity to use firewood for cooking. Despite the recommendation of the Ivorian government to use butane and the promotion of “clean” energies, firewood is still the most used energy source in Abidjan. Against this background, the social determinants of the continued use of firewood in those bakeries should be critically assessed.

Methods

The study relied on a qualitative approach using semi-structured interviews and direct observation for data collection. Interviews were conducted with state and non-state actors selected using a "snowball" sampling method. Data collected were subject to thematic content analysis.

Results

The energy transition in the bakery sub-sector in Abidjan is hampered by the plurality of actors and the lack of clarity in energy management. It has led to a higher consumption of firewood and other sources of energy in the production of bread.

Conclusion

Three elements shape the adoption of clean energies in bakeries in Abidjan. These are the politics of the government, its bilateral and multilateral partners, the immediate social pressure linked to wood resources and the availability of infrastructure.
Evolution of seasonal land surface temperature trend in pond-breeding newt (Neurergus derjugini) in western Iran and eastern Iraq
Authors: Karami Peyman , Tavakoli Sajad , Esmaeili Mina
Published: March 2023

Background

Temperature, as one of the effective environmental stimuli in many aspects of species life and ecosystems, can affect amphibians in many ways. Knowing and predicting temperature change and its possible effects on the habitat suitability and movements of amphibians have led many researchers to use climate change scenarios and species distribution models (SDMs). One of the important remote-sensing products that received less attention of conservation biologists is the land surface temperature (LST). Due to the small difference between LST and air temperature, this component can be used to investigate and monitor the daily and seasonal changes of habitats. This study aims to investigate the seasonal trend of LST in the habitat suitability and connectivity of the critically endangered newt (Neurergus derjugini) in its small distribution range, using the MODIS LST time series (2003 to 2021) and with the help of SDMs, Mann–Kendall (MK) and Pettitt non-parametric tests.

Results

In the last decade, the increasing trend of LST versus its decreasing trends is obvious. Based on MK and Pettitt tests, in the winter and spring, with the decrease in latitude of 35.45° and increase in longitude of 46.14°, the core populations which are located in the southeast have experienced an increase in temperature. Considering the period time of breeding and overwintering, the continuity of winter and spring can be effective on the survival of adult newts as well as larvae in the microclimate. Linkages with the highest current flow between core populations in the winter and summer are the most likely to be vulnerable. At the level of habitat, the increase in LST is proportional to the trend of thermal landscape changes, and all seasons have had an increase in LST, but in winter and summer, the largest area of the habitat has been involved. By continuing the current trend, many high-altitude southern habitats in Iran will be endangered, and the species will be at risk of local extinction.

Conclusion

The increasing trend of temperature in all seasons such as winter will affect many adaptations of the species and these effects are mostly evident in the southern parts of its distribution range therefore, captive breeding and reintroduction are recommended for the populations of these areas.
Measuring financial satisfaction of Indonesian young adults: a SEM-PLS analysis
Authors: Nabila Farizka Shafa , Fakhri Mahendra , Pradana Mahir , Kartawinata Budi Rustandi , Silvianita Anita
Published: March 2023

People in Indonesia, particularly members of Generation Z, frequently struggle to manage their financial situation both now and in the future. The problem is brought on by a lack of understanding of financial investments. The purpose of this study is to ascertain the financial standing of Generation Z. A questionnaire with 100 respondents was employed in this investigation. In this study, financial attitudes serve as the independent variable, financial management serves as the intervention variable, and financial satisfaction serves as the dependent variable. A Likert scale was utilized as the measurement in the quantitative research technique. In this work, structural equation modeling (SEM) and SmartPLS software were utilized to process the data. The financial attitude variable has a positive and significant impact on financial happiness that is mediated by financial management. We also offer some recommendations and future research directions related to this topic.
A note on the effects of start-up competitions: experience from the Czech Business Plan Contest “Idea of the Year”
Authors: Dvouletý Ondřej
Published: March 2023

The study contributes to the scholarly discussion on the effects of business plan competitions by assessing the survival and performance of the entrepreneurial teams participating in the Czech Business Plan Contest “Idea of the Year” during the years 2010–2015. The implemented research design followed up with the finalists, receiving financial and non-financial rewards 5 years after participating in the contest. The implemented scientific methods include mainly survival analysis and applied statistical techniques, such as cross-tabulations, tests of association, t-tests and correlation analysis. The obtained results allowed us to empirically support a hypothesis assuming that participation in the business plan contest positively relates to new venture creation, start-up survival, and performance. The study provides a series of recommendations for the contest’s organizers, especially in terms of evaluation and monitoring and encouraging the projects’ diversity. The added value for the international scholarship is that the article utilizes a complex theoretical framework combining various types of entrepreneurial capital that may be well used in future studies aiming to assess the impacts of start-up competitions.
Enhancing competitiveness through technology transfer and product quality: the mediation and moderation effects of location and asset value
Authors: Rambe Patient , Khaola Peter
Published: March 2023

The direct effects of technology transfer and innovation on the productivity and competitiveness of economies and businesses are well established. However, research is yet to establish the explanatory variables and the boundary conditions within which these relationships exist. This study examines the extent to which product quality mediates the relationship between technology transfer and competitiveness of small-scale agricultural businesses (SSABs). Moreover, the study explores the extent to which the geographical location moderates the technology transfer–business competitiveness relationship, including whether asset value moderates the product quality–competitiveness relationship. A cross-sectional survey was conducted on 400 SSAB owners and managers in the Free State and Mashonaland Central Provinces of South Africa and Zimbabwe, respectively. Of the 400 questionnaires distributed, 268 usable questionnaires (67%) were returned for analysis. The results suggest that product quality partially mediated the relationship between technology transfer and competitiveness of SSABs. The results demonstrate further that the relationship between product quality and competitiveness was moderated by asset value such that at low levels of product quality, SSABs with larger asset values became more competitive than those with smaller asset values. However, as product quality increased, SSABs with smaller asset values became increasingly competitive until the competitive advantage of those with larger asset values was eliminated. SSABs in South Africa reported higher product quality and competitiveness than those in Zimbabwe. The relationship between the location in which the SSAB was situated and competitiveness was direct, and location did not moderate the relationship between technology transfer and competitiveness. The study illuminates the critical importance of product quality for SSABs, especially those with small asset values. It also demonstrates that while technology transfer may influence the competitiveness of SSABs directly, the influence of quality products cannot be underestimated. The study is one-of-a-kind that simultaneously considers explanatory and moderated effects of technology transfer–competitiveness nexus in SSABs, in the context of South Africa and Zimbabwe.
Safety profile of a multimodal fail-safe model to minimize postoperative complications in oncologic colorectal resections—a cohort study
Authors: Khadem Shahram , Herzberg Jonas , Honarpisheh Human , Jenner Robert Maximilian , Guraya Salman Yousuf , Strate Tim
Published: March 2023

Background

Despite innovations in surgical techniques, major complications following colorectal surgery still lead to a significant morbidity and mortality. There is no standard protocol for perioperative management of patients with colorectal cancer. This study evaluates the effectiveness of a multimodal fail-safe model in minimizing severe surgical complications following colorectal resections.

Methods

We compared major complications in patients with colorectal cancers who underwent surgical resections with anastomosis during 2013–2014 (control group) with patients treated during 2015–2019 (fail-safe group). The fail-safe group had preoperative bowel preparation and a perioperative single dose of antibiotics, on-table bowel irrigation and early sigmoidoscopic assessment of anastomosis in rectal resections. A standard surgical technique for tension-free anastomosis was adapted in the fail-safe approach. The chi-square test measured relationships between categorical variables, t-test estimated the probability of differences, and the multivariate regression analysis determined the linear correlation among independent and dependent variables.

Results

A total of 924 patients underwent colorectal operations during the study period; however, 696 patients had surgical resections with primary anastomoses. There were 427 (61.4%) laparoscopic and 230 (33.0%) open operations, while 39 (5.6%) laparoscopic procedures were converted. Overall, the rate of major complications (Dindo-Clavien grade IIIb–V) significantly reduced from 22.6% for the control group to 9.8% for the fail-safe group (p < 0.0001). Major complications mainly occurred due to non-surgical reasons such as pneumonia, heart failure, or renal dysfunction. The rates of anastomotic leakage (AL) were 11.8% (22/186) and 3.7% (n = 19/510) for the control and fail-safe groups, respectively (p < 0.0001).

Conclusion

We report an effective multimodal fail-safe protocol for colorectal cancer during the pre-, peri-, and postoperative period. The fail-safe model showed less postoperative complications even for low rectal anastomosis. This approach can be adapted as a structured protocol during the perioperative care of patients for colorectal surgery.

Trial registration

This study was registered in the German Clinical Trial Register (Study ID: DRKS00023804).
Patient and ward related risk factors in a multi-ward nosocomial outbreak of COVID-19: Outbreak investigation and matched case–control study
Authors: Leal Jenine , O’Grady Heidi M. , Armstrong Logan , Dixit Devika , Khawaja Zoha , Snedeker Kate , Ellison Jennifer , Erebor Joyce , Jamieson Peter , Weiss Amanda , Salcedo Daniel , Roberts Kimberley , Wiens Karen , Croxen Matthew A. , Berenger Byron M. , Pabbaraju Kanti , Lin Yi-Chan , Evans David , Conly John M.
Published: March 2023

Background

Risk factors for nosocomial COVID-19 outbreaks continue to evolve. The aim of this study was to investigate a multi-ward nosocomial outbreak of COVID-19 between 1st September and 15th November 2020, occurring in a setting without vaccination for any healthcare workers or patients.

Methods

Outbreak report and retrospective, matched case–control study using incidence density sampling in three cardiac wards in an 1100-bed tertiary teaching hospital in Calgary, Alberta, Canada. Patients were confirmed/probable COVID-19 cases and contemporaneous control patients without COVID-19. COVID-19 outbreak definitions were based on Public Health guidelines. Clinical and environmental specimens were tested by RT-PCR and as applicable quantitative viral cultures and whole genome sequencing were conducted. Controls were inpatients on the cardiac wards during the study period confirmed to be without COVID-19, matched to outbreak cases by time of symptom onset dates, age within ± 15 years and were admitted in hospital for at least 2 days. Demographics, Braden Score, baseline medications, laboratory measures, co-morbidities, and hospitalization characteristics were collected on cases and controls. Univariate and multivariate conditional logistical regression was used to identify independent risk factors for nosocomial COVID-19.

Results

The outbreak involved 42 healthcare workers and 39 patients. The strongest independent risk factor for nosocomial COVID-19 (IRR 3.21, 95% CI 1.47–7.02) was exposure in a multi-bedded room. Of 45 strains successfully sequenced, 44 (97.8%) were B.1.128 and differed from the most common circulating community lineages. SARS-CoV-2 positive cultures were detected in 56.7% (34/60) of clinical and environmental specimens. The multidisciplinary outbreak team observed eleven contributing events to transmission during the outbreak.

Conclusions

Transmission routes of SARS-CoV-2 in hospital outbreaks are complex; however multi-bedded rooms play a significant role in the transmission of SARS-CoV-2.
Predictive value of gut microbiota in long-term blood pressure control: a cross-sectional study
Authors: Kang Guobin , He Hongtao , Miao Huawei , Zhang Tiejun , Meng Zongde , Li Xia
Published: March 2023

Objectives

To investigate the prediction of long-term blood pressure control using the intestinal flora of patients with hypertension.

Methods

A total of 125 patients with primary grade-2 hypertension who attended the cardiovascular department of Hebei Province Hospital of Chinese Medicine between April 2021 and April 2022 were enrolled; these included 65 patients with substandard long-term blood pressure control (the uncontrolled group) and 60 patients with standard long-term blood pressure control (the controlled group). General clinical data and data on morning stools and diet were recorded for all the enrolled patients. The 16 s rDNA sequencing of faecal intestinal flora was also performed to analyse the differences in intestinal flora between the two groups of patients and to investigate the relationship between blood pressure compliance and the presence of flora.

Results

The intestinal flora of the two groups of patients differed in terms of the Firmicutes–Bacteroidetes ratio (F/B), α-diversity analysis (Chao1, ACE and Shannon) results and β-diversity analysis results. At the genus level, the number of Streptococcus and Paraprevotella in patients in the uncontrolled group was greater than that of the controlled group, and the level of Akkermansia and Bifidobacterium was lower than that in the controlled group. A logistic regression analysis of the difference factors found differences in ACE, F/B, Streptococcus, Paraprevotella and Akkermansia in the two groups; these differences remained after correcting for age, gender and body mass index. The receiver operating characteristic curves revealed the following: ACE (area under the curve [AUC] = 85.282), Streptococcus (AUC = 82.705), Akkermansia (AUC = 77.333), Paraprevotella (AUC = 66.154) and F/B (AUC = 60.436).

Conclusions

There were significant differences in the intestinal flora of the patients in the controlled blood group compared with that of the uncontrolled group. Therefore, the ACE, genus levels of Streptococcus and Akkermansia could provide some prediction of late blood pressure compliance or non-compliance in patients with hypertension.
Surgical bleeding in patients undergoing posterior lumbar inter-body fusion surgery: a randomized clinical trial evaluating the effect of two mechanical ventilation mode types
Authors: Hajijafari Mohammad , Ziloochi Mohammad Hossein , Salimian Manoochehr , Fakharian Esmaeil
Published: March 2023

Background

The purpose of the study was to compare the effect of using volume-controlled ventilation (VCV) versus pressure-controlled ventilation (PCV) on blood loss in patients undergoing posterior lumbar inter-body fusion (PLIF) surgery.

Methods

In a randomized, single-blinded, parallel design, 78 patients, candidates for PLIF surgery, were randomly allocated into two groups of 39 to be mechanically ventilated using VCV or PCV mode. All the patients were operated in prone position by one surgeon. Amount of intraoperative surgical bleeding, transfusion requirement, surgeon satisfaction, hemodynamic parameters, heart rate, and blood pressure were measured as outcomes.

Results

PCV group showed slightly better outcomes than VCV group in terms of mean blood loss (431 cc vs. 465 cc), transfusion requirement (0.40 vs. 0.43 unit), and surgeon satisfaction (82.1% vs. 74.4%); however, the differences were not statistically significant. Diastolic blood pressure 90 and 105 min after induction were significantly lower in PCV group (P = 0.043–0.019, respectively); however, blood pressure at other times, hemoglobin levels, and mean heart rate were similar in two groups.

Conclusions

In patients undergoing posterior lumbar inter-body fusion surgery, mode of ventilation cannot make significant difference in terms of blood loss; however, some minor benefits in outcomes may lead to the selection of PCV rather than VCV. More studies with larger sample size, and investigating more factors may be needed.
Gestational diabetes mellitus and its associated factors in Ethiopia: a systematic review and meta-analysis
Authors: Beyene Fentahun Yenealem , Kassa Bekalu Getnet , Mihretie Gedefaye Nibret , Ayele Alemu Degu
Published: March 2023

Background

In Ethiopia, gestational diabetes mellitus (GDM) is a significant public health issue and a risk to maternal and child health. Understanding the prevalence and factors of GDM in Ethiopia may also help determine the best interventions. Therefore, we tried to review gestational diabetes and its factors in Ethiopia.AQ: Please check and confirm the edit made to the article title.yes i have checked and confirm

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) instrument was used to conduct the review. In order to report on the prevalence and contributing factors of gestational diabetes mellitus, the following databases were used: Google Scholar, PubMed, EMBASE, Scopus, Web of Sciences, and Grey literature. Pilo-tests were conducted using a standardized data gathering form in research using a random sample. All statistical analyses were performed using STATA version 16 software for Windows and the random-effects meta-analysis method. The results are presented using texts, tables, and forest plots, along with measure of effect and a 95% confidence interval.Affiliations: Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author Given name: [Fentahun Yenealem], Last name [Beyene], Given name: [Bekalu Getnet], Last name [Kassa], Given name: [Gedefaye Nibret], Last name [Mihretie], Given name: [Alemu Degu], Last name [Ayele].yes checked and corrected AQ: Is this word Pilo-tests spelled correctly throughout the article?Thank you the correction Affiliations: Please check and confirm whether the city name is correctly identified for the affiliation 2.yes checked and corrected 

Results

Out of 1755 records, 10 studies with 6525 participants that fully satisfy the inclusion criteria were included for the meta-analysis. The pooled prevalence of gestational diabetes mellitus in Ethiopia was 12.04% [95% CI (8.17%, 15.90%)]. Inadequate dietary diversity, high body mass index, having a family history of DM, history of having macrosomic neonate, low physical activity, and previous history of GDM were statistically significant.AQ: Please note that the sentence Inadequate dietary diversity, high body mass index… is repeated under the below heading Conclusion.yes checked and corrected 

Conclusion

The pooled prevalence of gestational diabetes mellitus is high in Ethiopia. Inadequate dietary diversity, high body mass index, having a family history of DM, history of having macrosomic neonate, low physical activity and previous history of GDM were statically significant variables. Emphasize on early screening, prenatal care and all women having risk factors and trying to get pregnant should get screens for diabetes to improve the maternal and child health at large.AQ: Please check the clarity of the sentence Emphasize on early screening, prenatal…it is clear and easly understand the readers
Clinical predictors of early surgical intervention in patients with venomous snakebites
Authors: Lu Hsiao-Yu , Mao Yan-Chiao , Liu Po-Yu , Lai Kuo-Lung , Wu Cheng-Yeu , Tsai Yueh-Chi , Yen Jung-Hsing , Chen I.-Chen , Lai Chih-Sheng
Published: March 2023

Background

Venomous snakebites induce tissue destruction and secondary infection; however, the optimal timing of surgical intervention for these complications remains unknown. This study assessed the clinical predictors of early surgical intervention in patients with snakebites.

Methods

This retrospective study included 63 patients (45 men and 18 women) with venomous snakebites. In addition to the snake species, the demographics, affected body parts, clinical characteristics, and ultrasound findings of the patients in the surgical (32 patients) and nonsurgical (31 patients) groups were analyzed and compared.

Results

A higher incidence of acute compartment syndrome, local ecchymosis, skin necrosis, bullae, blisters, and fever was found in the surgical group than in the nonsurgical group, and ultrasound findings of the absence of Doppler flow were more frequently noted in the surgical group than in the nonsurgical group. After adjustment using a multivariate logistic regression model, only advanced age, Naja atra bite, local ecchymosis, and bulla or blister formation remained significant factors for surgical intervention. Furthermore, comparison of the outcomes of patients who received early (≤ 24 h) and late (> 24 h) surgical intervention revealed that the duration of continuous negative pressure wound therapy (6 vs. 15 days; P = 0.006), duration of hospital stay (13 vs. 26 days; P = 0.002), and duration of outpatient follow-up (15 vs. 36 days; P < 0.001) were significantly lower in patients who received early surgical intervention. The final reconstructive surgery was simple among the patients who received surgical intervention within 24 h of being bitten (P = 0.028).

Conclusion

In patients with snakebites, advanced age, high-risk clinical manifestations (e.g., local ecchymosis and bulla or blister formation), and Naja atra envenomation are predictors of surgical intervention within 24 h.
Modulating arousal to overcome gait impairments in Parkinson’s disease: how the noradrenergic system may act as a double-edged sword
Authors: Tosserams Anouk , Bloem Bastiaan R. , Ehgoetz Martens Kaylena A. , Helmich Rick C. , Kessels Roy P. C. , Shine James M. , Taylor Natasha L. , Wainstein Gabriel , Lewis Simon J. G. , Nonnekes Jorik
Published: March 2023

In stressful or anxiety-provoking situations, most people with Parkinson’s disease (PD) experience a general worsening of motor symptoms, including their gait impairments. However, a proportion of patients actually report benefits from experiencing—or even purposely inducing—stressful or high-arousal situations. Using data from a large-scale international survey study among 4324 people with PD and gait impairments within the online Fox Insight (USA) and ParkinsonNEXT (NL) cohorts, we demonstrate that individuals with PD deploy an array of mental state alteration strategies to cope with their gait impairment. Crucially, these strategies differ along an axis of arousal—some act to heighten, whereas others diminish, overall sympathetic tone. Together, our observations suggest that arousal may act as a double-edged sword for gait control in PD. We propose a theoretical, neurobiological framework to explain why heightened arousal can have detrimental effects on the occurrence and severity of gait impairments in some individuals, while alleviating them in others. Specifically, we postulate that this seemingly contradictory phenomenon is explained by the inherent features of the ascending arousal system: namely, that arousal is related to task performance by an inverted u-shaped curve (the so-called Yerkes and Dodson relationship). We propose that the noradrenergic locus coeruleus plays an important role in modulating PD symptom severity and expression, by regulating arousal and by mediating network-level functional integration across the brain. The ability of the locus coeruleus to facilitate dynamic ‘cross-talk’ between distinct, otherwise largely segregated brain regions may facilitate the necessary cerebral compensation for gait impairments in PD. In the presence of suboptimal arousal, compensatory networks may be too segregated to allow for adequate compensation. Conversely, with supraoptimal arousal, increased cross-talk between competing inputs of these complementary networks may emerge and become dysfunctional. Because the locus coeruleus degenerates with disease progression, finetuning of this delicate balance becomes increasingly difficult, heightening the need for mental strategies to self-modulate arousal and facilitate shifting from a sub- or supraoptimal state of arousal to improve gait performance. Recognition of this underlying mechanism emphasises the importance of PD-specific rehabilitation strategies to alleviate gait disability.
Farmers' preferences for East African highland cooking banana 'Matooke' hybrids and local cultivars
Authors: Madalla Noel A. , Swennen Rony , Brown Allan , Carpentier Sebastien , Van den Bergh Inge , Crichton Rhiannon , Marimo Pricilla , Weltzien Eva , Massawe Cornel , Shimwela Mpoki , Mbongo Daud , Kindimba Grace , Kubiriba Jerome , Tumuhimbise Robooni , Okurut Asher W. , Cavicchioli Martina , Ortiz Rodomiro
Published: March 2023

Background

An understanding of farmers' preferences of new banana cultivars and their characteristics is critical for developing and selecting cultivars that meet consumer needs. Therefore, phenotypic selection in a genetically variable population remains an important aspect of plant breeding.

Methods

The participatory varietal selection approach for preference ranking was used on 31 'Matooke' secondary and primary triploid hybrids and local banana cultivars evaluated between 2016 and 2019 in Uganda and Tanzania to investigate how farmers' preference attributes could help breeders identify superior cultivars. The quantitative data were analyzed using the Statistical Package for Social Sciences (SPSS). The qualitative data from farmers' focus group discussions (FGDs) were described using content analysis. The Mann–Whitney U test and Wilcoxon's signed-rank test were used to confirm the difference in farmers' preferences between groups.

Results

Farmers' approaches for defining characteristics were multivariate, and their preferences varied by site and country. Large fruit, a large bunch, market acceptability of the banana bunch, a sturdy stem, and an attractive appearance of the banana plant were the characteristics most preferred by farmers in Tanzania and Uganda. Tanzanian farmers preferred large bunches over other characteristics like bunch marketability and robust stem. Large fruit, drought tolerance, a strong stem, and phenotypic similarity to local cultivars were prioritized by Ugandan farmers. Both men and women farmers were more concerned with production-related characteristics, but the former valued marketing-related characteristics more, while the latter preferred use-related characteristics. Their preferences did not differ statistically, but the relative importance assigned by each group to the selected attributes was different.

Conclusion

Farmers' varietal preferences are frequently based on some assumed requirements, resulting in cultivar rejection or non-adoption. Therefore, determining the value attributed to each characteristic by various farmer groups is crucial in developing 'Matooke' banana cultivars with desired attributes that will boost the rate of adoption on-farms. Breeding initiatives that establish a system of integrated approaches and rely on thorough diagnosis of both production and consumption characteristics will best serve farmers' diverse preferences. To accomplish this, planning for varietal improvement initiatives at various levels—including internationally, regionally, nationally, and locally—would require a strong participatory structure that is gender inclusive.
Recent evolution of wine exports in a turbulence period: a multiregional input–output analysis
Authors: Carrasco Inmaculada , Castillo-Valero Juan Sebastián , Carchano Marcos , Córcoles Carmen
Published: March 2023

This study focuses on analysing the economic impact (in value-added terms) generated by Spanish wine exports during the period 2018–2020, characterized by significant geopolitical changes and market shocks produced by Brexit, the entry into force of the Federal Law on Viticulture and Winemaking in the Russian Federation, the imposition of tariffs by the USA and the COVID-19 pandemic. For this purpose, the multiregional input–output model was used to identify the overall effects (direct and indirect) in different countries deriving from the changes in final demand. The paper shows that both the world wine trade and Spanish wine exports have been negatively affected by the recent changes in the analysed period. It is estimated that the accumulated losses since 2018 as a result of the decrease in the value-added generated by Spanish wine exports exceed 300 million euros. In addition, the results suggest that the negative effects of COVID-19 are greater than the effects caused by the rest of the geopolitical changes.