bluuebunny/crossref_metadata_2025 huggingface dataset:
Does coprescribing nonsteroidal anti‐inflammatory drugs and oral anticoagulants increase the risk of major bleeding, stroke and systemic embolism?
Authors: Penner Leonie S. , Gavan Sean P. , Ashcroft Darren M. , Peek Niels , Elliott Rachel A.
Published: April 2022

Aims: To examine the risk of gastrointestinal (GI) bleeding, major bleeding, stroke and systemic embolism associated with prescribing nonsteroidal anti‐inflammatory drugs (NSAIDs) to adults receiving oral anticoagulant (OAC) therapy.

Methods: We conducted a population‐based cohort study in adults receiving OAC therapy using linked primary care (Clinical Practice Research Datalink GOLD) and hospital (Hospital Episodes Statistics) electronic health records. We used cause‐specific Cox regression models with time‐dependent NSAID treatment in a propensity score matched population to estimate the increased risk of GI bleeding, stroke, major bleeding and systemic embolism associated with NSAID use.

Results: The matched cohort contained 3177 patients with OAC therapy alone and 3177 with at least 1 concomitant NSAID prescription. Compared with OAC therapy alone, concomitant prescription of NSAIDs with OACs was associated with increased risk of GI bleeding (hazard ratio [HR] 3.01, 95% confidence interval [CI] 1.63 to 5.55), stroke (HR 2.71, 95% CI 1.48 to 4.96) and major bleeding (HR 2.77, 95% CI 1.84 to 4.19). The association with systemic embolism did not reach statistical significance (HR 3.02, 95% CI 0.82 to 11.07). Sensitivity analyses indicated that the results were robust to changes in exclusion criteria and the choice of potential confounding variables.

Conclusion: When OACs are coprescribed with NSAIDs, the risk of adverse bleeding events increases and, simultaneously, the protective effect of OACs to prevent strokes reduces. There is a need for interventions that reduce hazardous prescribing of NSAIDs in people receiving OAC therapy.
Plant‐based diet index and erectile dysfunction in the Health Professionals Follow‐Up Study
Authors: Yang Heiko , Breyer Benjamin N. , Rimm Eric B. , Giovannucci Edward , Loeb Stacy , Kenfield Stacey A. , Bauer Scott R.
Published: April 2022

Objective

To evaluate the longitudinal association between plant‐based diet index (PDI) score and incident erectile dysfunction (ED).

Materials and Methods

We conducted a prospective analysis of 21 942 men aged 40 to 75 years who were enrolled in the Health Professionals Follow‐Up Study. ED was assessed with questionnaires every 4 years starting in 2000. Dietary data were collected via validated food frequency questionnaires completed every 4 years and were used to calculate total PDI scores, as well as healthy (hPDI) and unhealthy (uPDI) subscores. Multivariable Cox proportional hazards models were used to compute hazard ratios (HRs) for incident ED. All models were stratified by age (<60, 60 to <70, ≥70 years).

Results

Among men aged 60 to <70 years, hPDI was inversely associated with incident ED. Those in the highest quintile of hPDI in that age group had an 18% lower risk of ED (HR 0.82, 95% confidence interval (CI) 0.73–0.91; P‐trend <0.001) compared to those in the lowest quintile. Conversely, uPDI was positively associated with ED in men aged <60 years (HR 1.27, 95% CI 1.01–1.60; P‐trend = 0.02).

Conclusions

Encouraging a healthy plant‐based diet may be an environmentally sustainable intervention for men interested in maintaining erectile function.
Inflammatory reflex disruption in COVID‐19
Authors: Hajiasgharzadeh Khalil , Jafarlou Mahdi , Mansoori Behzad , Dastmalchi Narges , Baradaran Behzad , Khabbazi Alireza
Published: April 2022

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) was identified in Wuhan, China, in late 2019 and caused coronavirus disease 2019 (COVID‐19), which is still a global pandemic. In most infected people, SARS‐CoV‐2 only causes moderate symptoms, whereas in other patients, it leads to severe illness and eventually death. Although the main clinical manifestation of COVID‐19 is often seen in the lungs, this disease affects almost all body organs. The excessive and prolonged release of inflammatory cytokines that might occur in COVID‐19 patients, known as cytokine storms, stimulates undesired immune responses and can cause various tissues damage. In the current review article, we focus on the potential advantages of the intrinsic cholinergic anti‐inflammatory pathway as the efferent arm of the inflammatory reflex in COVID‐19 management. Considering this endogenous protective mechanism against chronic inflammation, we focused on the effects of SARS‐CoV‐2 in the destruction of this anti‐inflammatory system. Several studies showed the interaction of SARS‐CoV‐2 with the alpha‐7 subtype of the nicotinic acetylcholine receptor as the effector molecule of the inflammatory reflex. In contrast, neurological manifestations have increasingly been identified as significant extrapulmonary manifestations of COVID‐19. The rational connection between these findings and COVID‐19 pathogenesis might be an important issue in both our understanding of and dealing with this disease. COVID‐19 is deeply rooted in our daily life and requires an urgent need for the establishment of effective therapeutic options, and all the possible treatments must be considered for the control of such inflammatory conditions.
Spatiotemporal variation in costs of managing protected areas
Authors: Le Bouille Diane , Fargione Joseph , Armsworth Paul R.
Published: April 2022

Funding for protected areas is limited and recurrent costs associated with managing these sites must be considered in planning their acquisition. However, most conservation planning studies either ignore management costs or use snapshot estimates, even though they vary through time. We surveyed expenditures on management made over 15 years for 37 protected areas in the Appalachians that were established by a large land trust (TNC). These management costs varied greatly through both time and space. We explored what ecological and socioeconomic characteristics explain this variation. Management costs increased with site area but exhibited economies of scale. They were also greater for sites presenting a more rugged terrain and surrounded by a denser combination of roads and urban areas. Prescribed burns were strong drivers of expenditures in the years they occur, while acquisition costs were negatively correlated to subsequent expenditures on management. Land managers felt that protected areas that received less management effort were in worse condition and tended to spend more on areas with greater estimated species richness. Better accounting of how management costs vary in space and time can help conservation organizations allocate their limited resources effectively and to evaluate the likely long‐term cost implications of expanding protected area networks.
A Call for Support from The Mystetski Arsenal National Art and Culture Museum Complex in Kyiv
Authors:   Mystetski Arsenal Team
Published: April 2022

This public domain content is reprinted verbatim from a post by The Mystetski Arsenal Team Appeal, dated on or near February 24, 2022, as a historical records and to ensure duplicate content remains on the web in the event of cyber‐attack or interference with the current website.
Statement on Ukraine
Authors:   International Coalition of Sites of Conscience
Published: April 2022

This statement was posted by the International Coalition of Sites of Conscience on their website to draw attentions to the falsehoods and fallacies used by the Kremlin to justify their unprovoked assault on a sovereign nation. It draws attention to the historical memory of past aggressions and political interference, memorialized in museums located in Ukraine, and highlights all the oppressions, the violations of human rights that flow from such actions, and the necessity of memorializing these atrocities to ensure honesty and transparency will guide the future. The article is republished here with permission.
Liver Fibrosis‐4 index indicates atrial fibrillation in acute ischemic stroke
Authors: Fandler‐Höfler Simon , Kneihsl Markus , Stauber Rudolf E. , Bisping Egbert , Mangge Harald , Wünsch Gerit , Haidegger Melanie , Fabisch Linda , Hatab Isra , Fickert Peter , Werring David , Enzinger Christian , Gattringer Thomas
Published: April 2022

Background

Non‐alcoholic fatty liver disease and particularly liver fibrosis are related to cardiovascular disease and may indicate an increased risk for atrial fibrillation (AF), but this association has not yet been systematically investigated in a cohort of ischemic stroke patients.

Methods

We analyzed data from a prospective single‐center study enrolling all consecutive ischemic stroke patients admitted to our stroke unit over a 1‐year period. All patients received a thorough etiological workup. For evaluation of liver fibrosis, we determined the Fibrosis‐4 (FIB‐4) index, a well‐established noninvasive liver fibrosis test. Laboratory results were analyzed from a uniform blood sample taken at stroke unit admission.

Results

Of 414 included patients (mean age 70.2 years, 57.7% male), FIB‐4 indicated advanced liver fibrosis in 92 (22.2%). AF as the underlying stroke mechanism was present in 28.0% (large vessel disease: 25.6%, small vessel disease: 11.4%, cryptogenic: 29.2%). Patients with FIB‐4 ≥ 2.67 had higher rates of AF (53.3% vs. 20.8%, p < 0.001), and this association remained significant after correction for established AF risk factors (odds ratio 2.53, 95% confidence interval 1.44–4.46, p = 0.001). FIB‐4 was further associated with worse functional outcome 3 months (p < 0.001) and higher mortality 4 years post‐stroke (p < 0.02), but these relationships were no longer present after correction for age and initial stroke severity. Moreover, FIB‐4 was not associated with long‐term recurrent vascular events.

Conclusions

Liver fibrosis assessed by the FIB‐4 index is independently associated with AF in acute ischemic stroke patients. Further studies should evaluate whether adding the FIB‐4 index to AF risk scores increases their precision.
Dental caries experience and its relationship to demographic factors in 2‐ to 6‐year‐old children in Fars—Iran in 2018
Authors: Mirahmadizadeh Alireza , Zahmatkesh Soraya , Mahizadeh Hojjat , Mokhtari Ali Mohammad , Vali Mohebat , Abedinzade Arefe
Published: April 2022

Purpose

Among oral conditions, tooth decay is the most common chronic childhood disease. Children's dental caries are influenced by several factors, among which diet is one of the most highlighted ones. The present study was conducted to examine the decayed, missing and filled teeth in primary dentition (dmft) and caries‐free (CF) indexes as well as the impact of nutrition and demographic factors on oral health of 2‐ to 6‐year‐old children in Fars Province.

Methods

A cross‐sectional study was conducted on children aged 2–6 years old to evaluate dmft and CF indices according to the latest WHO standards as well as their demographic characteristics in 2018. A questionnaire was used for data collection.

Results

A total of 2220 children were recruited. The mean dmft was 1.37 ± 2.69. The components of the dmft score included decay (1.23 ± 2.6), missing (0.03 ± 0.11) and filling (0.11 ± 0.7) in primary dentition, and the prevalence of caries‐free children was 66.5%. The results showed that dmft had a significant positive relationship with breastfeeding termination time, maternal education level and maternal age. Birth weight, consumption of iron, vitamin A and D supplements, age at onset of complementary feeding and maternal occupation had no significant relationship with dmft.

Conclusions

The tooth decay index of 2‐ to 6‐year‐old children in Fars Province is very different from WHO global standards. Therefore, educating mothers about the duration of breastfeeding is important to achieve standard values for the dental caries index.
Nanoscale composition fluctuations and crystallization process: Case study in Li2O–SiO2‐based glasses
Authors: Komatsu Takayuki , Honma Tsuyoshi
Published: April 2022

Nanoscale composition fluctuations in Li2O–SiO2‐based glasses were analyzed and discussed from the data on the structure and crystallization process reported so far to enter deeply into the medium‐range ordered structure of multicomponent oxide glasses. Li2O is proposed to have a strong tendency for dynamical heterogeneous structure, that is, the formation of fragile Li2O‐rich regions with small SiO2 contents, resulting in the initial crystallization of metastable Li2SiO3 prior to the formation of stable Li2Si2O5 in Li2O–2SiO2‐based glasses. Li2O–Ga2O3/Nb2O5–SiO2 glasses are proposed to have nanoscale composition fluctuations of Li2O–Ga2O3/Nb2O5‐rich regions, resulting in the initial formation of LiGa5O8 and LiNbO3 nanocrystals. In Li2O–Al2O3–SiO2 glasses, the distribution width of composition fluctuations is proposed to be narrow, resulting in the initial crystallization of metastable β‐quartz solid solutions Li2O·Al2O3·nSiO2 (n = 6–8). Additive P2O5 and NiO leading to an enhanced nucleation are proposed to be present in fragile Li2O‐rich regions.
Treating equivalent cases differently: A comparative analysis of substance use disorder and type 2 diabetes in Norwegian treatment guidelines
Authors: Moe Fredrik D. , Berg Henrik
Published: April 2022

Background

Substance use disorder (SUD) is often understood as a chronic illness. Aims: This paper investigates whether SUD is treated as a chronic illness.

Method

To this aim, we have used World Health Organizations (WHO's) definition of chronic illness to conduct a comparative analysis of SUD and type 2 diabetes (T2D), which is another chronic illness.

Results

When analysing Norwegian treatment guidelines, we found that only the T2D guideline reflects the WHO's conceptualization of chronic illnesses. We argue that this discrepancy implies that SUD is understood as a moral and legal problem, while T2D is conceptualized as a somatic illness. We discuss how social, political and historical conditions of the possibility for understanding SUD are interwoven with normative presumptions about the clinician, patient, treatment guidelines and drug policies in a way that may impede the development of continuing care.

Conclusion

The paper concludes that the delivery of treatment services is inequitable as SUD is not treated as a chronic illness.
Management of post‐surgical faecal incontinence due to anorectal malformations by pelvic floor rehabilitation
Authors: Sharifi‐Rad Lida , Ladi‐Seyedian Seyedeh‐Sanam , Ashjaei Bahar
Published: April 2022

Aim

Many patients with anorectal malformations (ARM) experience a long‐lasting problem with faecal incontinence (FI). We assessed the effectiveness of a pelvic floor rehabilitation program including transcutaneous functional electrical stimulation (TFES) in combination with pelvic floor muscle (PFM) exercises on post‐surgical FI in children with ARM.

Methods

Data of 40 children at the age of 4 years or older who had undergone surgical correction for ARM and suffered from persistent FI referring for pelvic floor rehabilitation were analysed respectively. Patients underwent TFES and PFM exercises for 20 sessions. TFES was applied for 20‐min during each session, two times a week. A paediatric FI score questionnaire and a bowel habit diary were completed both before and after the treatment for all children. We completed a FI quality of life questionnaire before the therapy and again after treatment for all patients.

Results

Twenty‐two out of 40 (55%) patients responded completely to the treatment (100% reduction in FI episodes) after the completion of treatment sessions, sustained in 19/40 (47.5%) patients after 6 months. Mean ± SD of FI score was 4.9 ± 3.6 at baseline that significantly reduced to 2.4 ± 1.3 and 2.4 ± 1.8 after completion of treatment sessions and 6 months later, respectively (P < 0.05).

Conclusions

Our results show that TFES and PFM exercises have a considerable beneficial impact on post‐surgical FI in children with ARM.
Kamzori: Aging, Care, and Alienation in the Post‐pastoral Himalaya
Authors: Simpson Nikita
Published: April 2022

As the Gaddi community of Himalayan India transition from agro–pastoralism to waged labor, configurations of kinship and care have shifted. Such shifts have introduced relational tensions, especially between elderly women, who have labored in the house and fields, expecting care in old age, and younger generations, who experience their own pressures of class aspiration. This article examines how the myriad tensions of the post‐pastoral economy are experienced in the bodies of elderly women. It presents insights onkamzori, bodily weakness that is experienced by women who feel that their contribution of labor and care is unreciprocated by their kin or wider milieu. It recuperates alienation as a concept that captures distressed social relations. Alienation might be used by anthropologists studying aging, care, and debility to envisage the body in scalar relation to people, things and places, and illness or distress as disruption of such relations.[weakness, aging, care, gender, alienation]
Microbiological analysis of oral biofilms in patients admitted to intensive care unit: Pilot study
Authors: De Medeiros Raphael Florentino Souza Barbalho , da Silva Régia Carla Medeiros , Marinho Liliane Cristina Nogueira , Silva Davi Neto de Araújo , Tavares Isabelle Lisiany de Lima , de Lima Camila Alfrida Cabral Nascimento Rocha Antunes , de Melo Maria Celeste Nunes , Sales Roberta Correia , de Medeiros Domingos Sávio Barbalho , Bezerra Beatriz , da Silveira Ericka Janine Dantas , de Aquino Martins Ana Rafaela Luz
Published: April 2022

Aim

To identify Pseudomonas aeruginosa and Staphylococcus aureus in oral biofilms of intubated and non‐intubated patients admitted to an Intensive Care Unit (ICU).

Methods

This was a cross‐sectional study, with 30 biofilm sites sampled. S. aureus and P. aeruginosa were identified by conventional biochemical assays. Antimicrobial susceptibility was tested by disk‐diffusion.

Results

Of 30 sites, 50% contained P. aeruginosa and 3.33% S. aureus. P. aeruginosa was detected in similar amounts in all 3 sample sites, with 5 colonized sites (50%). S. aureus colonized a single supragingival site (3.33%). There was resistance to multiple antimicrobial agents of P. aeruginosa in 7 sites (100%) and S. aureus in 1 (100%).

Conclusions

This study revealed an important relationship between P. aeruginosa and S. aureus colonization at supragingival, subgingival and lingual sites and intubation, thus revealing antimicrobial resistant bacteria colonization of medical interest, which may contribute to the therapy choice directed to these microorganisms.
Mechanical ventilation in Duchenne muscular dystrophy: A pilot project in Ukraine
Authors: Tsarenko Anatolii , Trofimov Igor , Shatillo Andriy , Kostiukova Dariia , Kobylinskyi Sergii , Melnyk Svitlana , Riiatchenko Svitlana , Berdykova Yuliia , Morozova Mariana , Marichuk Mykola , Bondarenko Stanislav , Gutarev Andriy , Toussaint Michel ,   the Ukraine HMV Consortium
Published: April 2022

Background

Home mechanical ventilation (HMV) prolongs survival in patients with Duchenne muscular dystrophy (DMD) until ±35 years of age. This study evaluates the implementation of a HMV pilot project in children with DMD in Ukraine.

Methods

Children with DMD were invited to Kirovograd Regional Children’s Clinical Hospital, Kropyvnytskyi, Ukraine, for 5 days’ training with non‐invasive ventilation. Donated equipment comprised second‐hand Covidien PB560 ventilators from Belgium. Due to the absence of carbon dioxide pressure and pulse oximetry monitoring, indications for HMV included sleep‐related symptoms, restrictive lung function test, loss of ambulation for more than 1 year, or age greater than 17 years. Master class lectures on HMV were conducted for Ukrainian doctors in conjunction with patient training.

Results

Twelve Ukrainian physicians took part in face‐to‐face master classes and 50 Ukrainian physicians participated in online master classes. Simultaneously, eight Duchenne inpatients, mean age 15.4 (SD: 1.8) years and body mass index 25.8 (SD: 4.0), were included in the study. All patients chose nasal masks and volume‐pressure‐assisted control mode. After 6 weeks, one patient stopped HMV, two others used HMV partially during sleep, and 5/8 used nocturnal HMV increasingly with few complaints. Follow up via phone call was organized after hospitalization.

Conclusions

Implementation of HMV is feasible in DMD inpatients in Ukraine. In the short term, the Ukrainian parliament should recognize official centers for HMV, and define the funding policy of equipment for HMV, and its maintenance. Local distributors should deliver equipment for HMV and devices for monitoring carbon dioxide pressure and pulse oximetry in specialized centers for HMV.
COVID‐19 test‐kit trade and trade policy: Implications for developing countries
Authors: Vo Long Hai , Le Thai‐Ha
Published: April 2022

At the centre of the multi‐dimensional impact of the COVID‐19 pandemic, the shortage of medical supplies in countries with weaker healthcare systems significantly reduced the effectiveness of national and international public health interventions. Using a database of test‐kit trade flows and barriers, we estimate the price responsiveness of test‐kit demand in a global sample of countries. These estimates allow us to investigate the degree to which import tariffs by leading producers could result in a disruption in global supply chains, price increases, and welfare loss. Simulation experiments indicate that the combination of rising demand for test kits and import dependence magnifies the impact of trade barriers on consumer welfare and this impact is more profound for developing countries.
María de Nazaret: algunas reflexiones desde la teología feminista
Authors: Novoa Palacios Amparo , Pirela Morillo Johann
Published: April 2022

La superación del excesivo reduccionismo dogmático y el rescate de María de Nazaret como sujeto ineludible en la construcción de la historia de la salvación es la premisa que guía el ejercicio de escritura que se devela en este texto, proponiendo miradas que se distancian de los criterios de racionalidad teológica que han predominado en el análisis de su papel como figura esencial, en torno de la cual se estructuran narrativas fundamentales para entender la participación activa de las mujeres en el contexto de las sagradas Escrituras.Frente a ello se recurrió a una propuesta de análisis polifónico que considera las complejas y dinámicas dimensiones de María como mujer, madre y paradigma de vida. Para tratar de solventar estos vacíos, se consideraron los aportes de la teología feminista, que permitieron descentrarse de los discursos que solo la ven como madre y sujeto silencioso que se difumina en la opacidad producto de los análisis hegemónicos. De este modo, se posicionó a María como mujer histórica en la que confluyen los referentes de representación de su papel como lideresa que forjó un ethos familiar y la figura de Jesús, con una experiencia de Dios afincada en el sentido a la vida; que invita a trascender el paradigma de madre desde la función biológica y ampliar así la perspectiva hacia lo que da sentido a la misma después de la concepción.Para tal fin, se plantea un marco de ética de la igualdad que asume la idea de equilibrio de poder e igualdad recíproca. Esto constituye un valor que apela al reconocimiento del otro en su poder, es decir, igualdad de poder como equipotencia, para cuya explicación se requiere entender que los sujetos y ciudadanos son iguales y comparten cada uno su rol como actores que ayudan a configurar sociedades y colectividades.
Air-to-Liquid Heat Exchanger Fabricated Using Deposition-Based Additive Manufacturing Processes
Authors: Boxleitner Jake , Mulholland Tom , Nellis Gregory
Published: April 2022

This work describes the use of deposition-based additive manufacturing (AM) techniques to fabricate air-cooled, two-fluid heat exchangers. The project focused on a Heating, Ventilation and Air Conditioning application and used an industry-standard copper/aluminum heat exchanger manufactured with conventional technology as the basis for assessing performance. The manufacturing constraints associated with using deposition-based AM technology for this application include the need for a continuous tool path within each build layer that allows uninterrupted extrusion and therefore defect-free water channel walls that correspond to a reliably leak-tight heat exchanger. A geometry that respects these constraints was developed, simulated, optimized and finally manufactured and tested. The material used was a composite of polymer filled with conductive flakes in order to provide high conductivity in the direction that heat must flow in this heat exchanger, across the wall separating the fluids. The measured performance for several test coupons matched the predicted performance and the test coupons exhibited performance that approach and in some cases exceeds conventional technology
Extremely fast-charging lithium ion battery enabled by dual-gradient structure design
Authors: Lu Lei-Lei , Lu Yu-Yang , Zhu Zheng-Xin , Shao Jia-Xin , Yao Hong-Bin , Wang Shaogang , Zhang Tian-Wen , Ni Yong , Wang Xiu-Xia , Yu Shu-Hong
Published: April 2022

Extremely fast-charging lithium-ion batteries are highly desirable to shorten the recharging time for electric vehicles, but it is hampered by the poor rate capability of graphite anodes. Here, we present a previously unreported particle size and electrode porosity dual-gradient structure design in the graphite anode for achieving extremely fast-charging lithium ion battery under strict electrode conditions. We develop a polymer binder–free slurry route to construct this previously unreported type particle size-porosity dual-gradient structure in the practical graphite anode showing the extremely fast-charging capability with 60% of recharge in 10 min. On the basis of dual-gradient graphite anode, we demonstrate extremely fast-charging lithium ion battery realizing 60% recharge in 6 min and high volumetric energy density of 701 Wh liter
−1
at the high charging rate of 6 C.
Machine learning reveals distinct gene signature profiles in lesional and nonlesional regions of inflammatory skin diseases
Authors: Martínez Brittany A. , Shrotri Sneha , Kingsmore Kathryn M. , Bachali Prathyusha , Grammer Amrie C. , Lipsky Peter E.
Published: April 2022

Analysis of gene expression from cutaneous lupus erythematosus, psoriasis, atopic dermatitis, and systemic sclerosis using gene set variation analysis (GSVA) revealed that lesional samples from each condition had unique features, but all four diseases displayed common enrichment in multiple inflammatory signatures. These findings were confirmed by both classification and regression tree analysis and machine learning (ML) models. Nonlesional samples from each disease also differed from normal samples and each other by ML. Notably, the features used in classification of nonlesional disease were more distinct than their lesional counterparts, and GSVA confirmed unique features of nonlesional disease. These data show that lesional and nonlesional skin samples from inflammatory skin diseases have unique profiles of gene expression abnormalities, especially in nonlesional skin, and suggest a model in which disease-specific abnormalities in “prelesional” skin may permit environmental stimuli to trigger inflammatory responses leading to both the unique and shared manifestations of each disease.
Management of cauda equina syndrome during pregnancy and postpartum
Authors: Vakos Amanda , Dean Kathryn , Reeder Callie , Louis-Jacques Adetola
Published: April 2022

Cauda equina syndrome (CES) is a rare condition that occurs from multiple nerve root compression. It is considered a surgical emergency because it can lead to permanent neurological damage. There is limited literature regarding management and prognosis of CES for pregnant patients, leaving providers with many questions when encountering patients with this condition. We describe the case of a patient who developed CES during pregnancy. She presented at 30 weeks gestation and successfully underwent surgical decompression in prone position. She later delivered via elective caesarean at term. This case highlights management considerations for pregnant patients with CES, including positioning during surgery and use of regional anaesthesia.
Gemella morbillorummitral valve endocarditis in a patient with a history of mitral valve annuloplasty
Authors: Liu Charles Ruohua , Heid Christopher A , Chandra Raghav , Hauptmann Edward , Brickner Mary Elizabeth , Hwang Michael , Wait Michael A
Published: April 2022

A woman with a history of congenital heart disease status post multiple valve operations including mitral valve repair presented with 2 months of low back pain and general malaise. Blood cultures returned positive for Gram-positive cocci. While transthoracic echocardiography did not identify vegetations, transoesophageal echocardiography visualised vegetations on the patient’s mitral valve, which had previously undergone repair with annuloplasty. The patient was found to have infectious endocarditis (IE), caused byGemella morbillorum. The patient was treated with over 6 weeks of intravenous antibiotics. Cases ofGemella-associated IE are rare and largely relegated to case reports. This report aims to contribute to the literature regarding this subject, and to further characterise the presentation and treatment ofGemella-associated IE. Additionally, this report emphasises the importance of maintaining a high suspicion of IE in a patient with non-specific malaise in the setting of prior cardiac valve operation.
Hypercalcaemia to hypocalcaemia: tetany as a side effect of intravenous bisphosphonate treatment
Authors: Bounds Lauren , McGrath Felix , Taubert Mark
Published: April 2022

A woman in her 40s with advanced bladder cancer was admitted to hospital with hypercalcaemia of malignancy. Initially, she presented with non-specific symptoms of malaise, fatigue and general deterioration. She was treated with intravenous fluids and zoledronic acid in order to bring her calcium levels down, but subsequently developed significant hypocalcaemia. This manifested as tetany in the hands in the form of bilateral carpopedal spasm. She also reported perioral paraesthesia. Bloods during her admission revealed deranged electrolytes, and her vitamin D level was on the lower scale of normal (25 nmol/L). The patient’s symptoms improved with electrolyte replacement and oral baclofen for her symptomatically distressing wrist and hand muscle spasms. This case report is a reminder that bisphosphonates can cause significant hypocalcaemia with symptoms of tetany, even when they are given for initial hypercalcaemia. Baclofen worked well to improve symptoms.
Interesting presentation of postnatal depression and infant failure to thrive
Authors: Murgan Nevani , Harrison Beate
Published: April 2022

This case report is of a woman in her 30s, 10 months post partum who was referred to Mother Baby Unit at a tertiary hospital with depressive symptoms including lowered mood, reduced self-care and motivation despite initiation of escitalopram 3 months earlier. In addition, her infant had non-organic failure to thrive mediated by decreased feeding and non-initiation of solids. On admission, her cognitive difficulties, blurred vision and reported loss of smell led to further neurological assessment and investigation with an MRI. Diagnosis of a frontal meningioma was made on the basis of the MRI finding of a 7 cm meningioma in the anterior cranial fossa. Surgical removal was successful which led to resolution of her depressive symptoms and improved parenting functioning. This case highlights the importance of considering organic causes of depression and non-organic causes of failure to thrive in infants.
RNA sequencing uncovers clinically actionable germline intronicMSH2variants in previously unresolved Lynch syndrome families
Authors: Fulk Kelly , Turner Morgan , Eppolito Amanda , Krukenberg Rebekah
Published: April 2022

Despite advances in genetic testing for Lynch syndrome, nearly one quarter of mismatch repair-deficient (MMRd) colorectal and endometrial cancers remain unexplained. When added to germline DNA testing, RNA sequencing can increase diagnostic yield, improve variant classification and reduce variants of uncertain significance. Here, we describe two cases where RNA sequencing uncovered likely pathogenicMSH2variants in families with MMRd tumours that were initially unexplained following comprehensive genetic testing for Lynch syndrome.
Survival of off-host Dermacentor albipictus (Acari: Ixodidae) adult females and larvae underwater
Authors: Sullivan C.F. , Parker B.L. , Skinner M.
Published: April 2022

The winter tick ( Dermacentor albipictus (Packard, 1869); Acari: Ixodidae) significantly affects the health and productivity of North American moose ( Alces alces (Linnaeus, 1758); Artiodactyla: Cervidae). Survival of off-host stages of Ixodid ticks depends on microclimate driven in part by extrinsic factors resulting from weather, such as temperature, humidity, drought, and floods. The impact of some of these abiotic factors is unclear for D. albipictus. The effect of water submergence on biological parameters of engorged, adult, females, and unfed larvae was assessed in the laboratory. Survival of adult females after submergence for 3 days was 88% with significant effects on their ability to oviposit. After 5 weeks, 63% of larvae (1-month-old) survived submergence in water, whereas survival of larvae (3-month-old) was reduced to 23% after 7 days. The off-host stages of D. albipictus have variable tolerance to periods of submergence that may influence the number of larvae available on the landscape for recruitment to moose in autumn.
Anisotropy of the gravitational-wave standard sirens and its cosmological applications
Authors: Chen Lin , Xu Lixin , Liu Jinyi , Qiao Ling , Du Minghui
Published: April 2022

We analyze the anisotropic factors present in the gravitational wave signal, such as the peculiar velocity of the observer and the inhomogeneous distribution of matter in the universe. We model the gravitational wave source as a standard siren, extract the anisotropic part of its luminosity distance $$d_L$$

d
L

, and obtain the Hubble parameter H(z) by direct calculation instead of integration. Finally, we derive the equation of state $$w_\mathrm{DE}(z)$$

w
DE

(
z
)

for the dark energy by both model-dependent and model-independent methods, and further investigate the cosmological significance of the simulated H(z) measurements. The advantage of this approach is that it makes full use of the anisotropic part of the $$d_L$$

d
L

data, which directly gives the value of H(z) at certain redshifts. This approach is sensitive to the local features of H(z) and does not depend on the cosmological model.
Isospin asymmetry and quantum statistical interpretation of nucleons
Authors: Sohaily Sozha , Vaziri Mohammad
Published: April 2022

In this paper, a statistical model introducing analytical expressions of [Formula: see text] dependent quantum statistical parton distributions is presented to explore proton and neutron structures. A merely theoretical maximum entropy method is applied to obtain thermodynamical variables determining parton distributions accurately. This study provides considering proton and neutron isospin asymmetry in order to improve the consistency of the framework achievements with the experimental results. The presented approach is extended to evaluate modified neutron structure in an [Formula: see text]-[Formula: see text] state. Also, the uniqueness of gluon distribution in proton and neutron is surveyed for both cases of lonely nucleon and [Formula: see text]-[Formula: see text] system. Eventually, the predicted unpolarized structure functions and the spin structure functions, only based on the maximum entropy method, are compared to CERN, HERMES, SLAC and the other data sets. Finally, the correlation of the obtained distributions with the experimental observations confirms the proposed statistical model.
Temporal Sequence of Data Fluctuation-Based Approach for Tor Program Classification
Authors: Zhang Hao , Zhang Weidong , Zhao Wei , Wu Xuangou
Published: April 2022

With the continuous development of encryption technology, the share of encrypted traffic in the network is increasing, which brings great challenges to the traditional methods of rule-based traffic identification. Deep learning is becoming an inspiring methodology to solve the problem. Previous studies have confirmed that time characteristics play an important role in Tor traffic classification. We find that there is a similarity of time characteristics among different programs. This paper proposes an end-to-end classification framework: the temporal sequence of data fluctuation network (TSDFN). It first extracts the temporal sequence of data fluctuation in the original flow and then uses the GRU network to learn the hidden temporal features. Experiments on public data sets validate the effectiveness of our proposal over other methods.
Application Optimization of Cloud Management Mode in Information Technology in Sudden Social Security Incidents
Authors: Huang Haining , Xu Lihua , Lu Haomin , Lin Zhencheng , Yan Wei
Published: April 2022

With the change of social structure and management mode, emergency social security incidents have become the focus of social security management. In order to solve the problems of insufficient overall performance and low security in the practical application of cloud management mode in traditional social security emergencies. With the use of improved pick-KX load balancing algorithm and RSA encryption algorithm, this paper optimizes the cloud computing model and applies it to the cloud management mode of emergent social security events. Then the optimized cloud management model is simulated and evaluated by the multi-level fuzzy comprehensive evaluation model. The simulation results reflect that the proposed cloud management model in this paper is able to effectively improve the management effect of social security events.
The Industrial Internet of Things (IIoT): An Anomaly Identification and Countermeasure Method
Authors: Tariq Usman , Ahanger Tariq Ahamed , Ibrahim Atef , Bouteraa Yassine Saleh
Published: April 2022

Networked devices benefit enterprises to gain far-reaching control over their industrial processes, which encourages them to conduct routine operations in a smart manner. Rapidly expanding interconnected sensor devices are eligible to aggregate, process and disseminate wide-ranging data. This paper proposed an extended anomaly discovery and response framework. We argued the prospective security anomalies to the IoT equipped industrial-floor and examined the numerous attacks that are conceivable on the modules in the Industrial Internet of Things (IIoT) architecture. IIoT service layer architecture was designed in consideration of high-volume device connectivity, management and security enforcement. Collection of geospatial service and device data aided the proposed framework to bridge the gap between anomaly identification and context-aware node behavior. Framework evaluation considered design principles such as node interpretability, decentralization, real-time data relay, modularity and required service alignment. Emulation outcomes specify that the malware discovery performance is better if the anomaly recognition model used the applied utility for the yield layer.
An extended study of k-restricted edge connectivity: Another approach to Tait’s coloring theorem
Authors: Suresh Singh G , Chandran Athira
Published: April 2022

For a graph [Formula: see text], an edge connectivity [Formula: see text] is the minimum number of edges whose removal disconnects G. In this paper, we define property restricted edge connectivity. Then we appraise its particular case, more precisely k-restricted edge connectivity. Some of the basic properties of k-restricted edge connectivity are considered. We also discuss how k-restricted edge connectivity associates with graph coloring. In particular, we try to study how k-restricted edge connectivity relates with Tait’s coloring theorem and thereby the famous Four-color conjecture.
A Review on Silver and Zinc Oxide Nanoparticles as Antimicrobial Agents in Water Treatment Technologies
Authors: Aravindakshan Pranav , Krishnamoorthy Anand , Pal Chandrika , Chang Yoon-Young , Tan Noel Peter Bengzon
Published: April 2022

Metal and metal oxide nanoparticles are active materials used in water treatment technologies. The emergence of these nanomaterials is due to the increasing demand for clean water supply. Among these nanoscale materials, Silver (Ag) and Zinc oxide (ZnO) are famous for having shown good antibacterial properties, essential in water purification technologies. Aside from its pure metal form, its composites have also been explored due to their synergistic effects with some polymeric matrices. Chitosan, for example, is an abundant natural material for its biodegradability, non-toxicity, and water purification properties. In this review, syntheses of Ag and ZnO nanoparticles together with their composites are discussed. Furthermore, its antibacterial properties, along with its water purification efficiencies, are further analyzed. The authors also give an outlook on the possible directions of nanomaterials in water remediation and the inevitable challenges ahead.
From One Language to the Next: Applications of Analogical Transfer for Programming Education
Authors: Kao Yvonne , Matlen Bryan , Weintrop David
Published: April 2022

The 1980s and 1990s saw a robust connection between computer science education and cognitive psychology as researchers worked to understand how students learn to program. More recently, academic disciplines such as science and engineering have begun drawing on cognitive psychology research and theories of learning to create instructional materials and teacher professional development materials based on theories of learning, to some success. In this paper, we follow a similar approach by highlighting common areas of interest between computer science education and cognitive psychology–specifically theories of analogical transfer–and discuss how cross-pollination of theoretical constructs between disciplines can support research on the teaching and learning of multiple programming languages. We will also discuss areas where computing education research can adapt the existing theories from cognitive psychology to develop domain-specific theories of knowledge transfer in computing and feed back into cognitive psychology research to inform larger debates about the nature of cognition and learning.
Effects of Explanations in AI-Assisted Decision Making: Principles and Comparisons
Authors: Wang Xinru , Yin Ming
Published: April 2022

Recent years have witnessed the growing literature in empirical evaluation of
explainable AI (XAI)
methods. This study contributes to this ongoing conversation by presenting a comparison on the effects of a set of established XAI methods in AI-assisted decision making. Based on our review of previous literature, we highlight three desirable properties that ideal AI explanations should satisfy — improve people’s understanding of the AI model, help people recognize the model uncertainty, and support people’s calibrated trust in the model. Through three randomized controlled experiments, we evaluate whether four types of common model-agnostic explainable AI methods satisfy these properties on two types of AI models of varying levels of complexity, and in two kinds of decision making contexts where people perceive themselves as having different levels of domain expertise. Our results demonstrate that many AI explanations do not satisfy any of the desirable properties when used on decision making tasks that people have little domain expertise in. On decision making tasks that people are more knowledgeable, the feature contribution explanation is shown to satisfy more desiderata of AI explanations, even when the AI model is inherently complex. We conclude by discussing the implications of our study for improving the design of XAI methods to better support human decision making, and for advancing more rigorous empirical evaluation of XAI methods.
Synthesizing fine-grained synchronization protocols for implicit monitors
Authors: Ferles Kostas , Sepanski Benjamin , Krishnan Rahul , Bornholt James , Dillig Işil
Published: April 2022

A monitor is a widely-used concurrent programming abstraction that encapsulates all shared state between threads. Monitors can be classified as being either implicit or explicit depending on the primitives they provide. Implicit monitors are much easier to program but typically not as efficient. To address this gap, there has been recent research on automatically synthesizing explicit-signal monitors from an implicit specification, but prior work does not exploit all paralellization opportunities due to the use of a single lock for the entire monitor. This paper presents a new technique for synthesizing fine-grained explicit-synchronization protocols from implicit monitors. Our method is based on two key innovations: First, we present a new static analysis for inferring safe interleavings that allow violating mutual exclusion of monitor operations without changing its semantics. Second, we use the results of this static analysis to generate a MaxSAT instance whose models correspond to correct-by-construction synchronization protocols. We have implemented our approach in a tool called Cortado and evaluate it on monitors that contain parallelization opportunities. Our evaluation shows that Cortado can synthesize synchronization policies that are competitive with, or even better than, expert-written ones on these benchmarks.
Linear types for large-scale systems verification
Authors: Li Jialin , Lattuada Andrea , Zhou Yi , Cameron Jonathan , Howell Jon , Parno Bryan , Hawblitzel Chris
Published: April 2022

Reasoning about memory aliasing and mutation in software verification is a hard problem. This is especially true for systems using SMT-based automated theorem provers. Memory reasoning in SMT verification typically requires a nontrivial amount of manual effort to specify heap invariants, as well as extensive alias reasoning from the SMT solver. In this paper, we present a hybrid approach that combines linear types with SMT-based verification for memory reasoning. We integrate linear types into Dafny, a verification language with an SMT backend, and show that the two approaches complement each other. By separating memory reasoning from verification conditions, linear types reduce the SMT solving time. At the same time, the expressiveness of SMT queries extends the flexibility of the linear type system. In particular, it allows our linear type system to easily and correctly mix linear and nonlinear data in novel ways, encapsulating linear data inside nonlinear data and vice-versa. We formalize the core of our extensions, prove soundness, and provide algorithms for linear type checking. We evaluate our approach by converting the implementation of a verified storage system (about 24K lines of code and proof) written in Dafny, to use our extended Dafny. The resulting system uses linear types for 91% of the code and SMT-based heap reasoning for the remaining 9%. We show that the converted system has 28% fewer lines of proofs and 30% shorter verification time overall. We discuss the development overhead in the original system due to SMT-based heap reasoning and highlight the improved developer experience when using linear types.