bluuebunny/crossref_metadata_2025 huggingface dataset:
Received power modelling in ultra‐dense networks
Authors: Prado‐Alvarez Danaisy , Antón Alejandro , Calabuig Daniel , Monserrat Jose F. , Bazzi Samer , Xu Wen
Published: April 2022

In received power modelling for system level simulations, the relative orientation of the transmitter and receiver antennas are not generally considered. By doing that, a constant gain of the receiver antenna, independently of the angle of arrival, is implicitly assumed. This is usually of minor relevance for small or low‐dense scenarios. However, in ultra‐dense deployments, especially those based on cell‐free massive multiple‐input–multiple‐output architectures where users interact with all access points, the consideration of the antennas relative orientation comes to the forefront. In this paper, the impact of whether to take the receiver antenna gain into account or not for ultra‐dense indoor environments with ceiling‐mounted antennas are studied. A simple approach to take this gain into account using the antenna effective area is provided. Finally, this approach is compared with that based on antenna radiation patterns.
Fast matrix inversion based on Chebyshev acceleration for linear detection in massive MIMO systems
Authors: Berra Salah , Dinis Rui , Shahabuddin Shahriar
Published: April 2022

To circumvent the prohibitive complexity of linear minimum mean square error detection in a massive multiple‐input multiple‐output system, several iterative methods have been proposed. However, they can still be too complex and/or lead to non‐negligible performance degradation. In this letter, a Chebyshev acceleration technique is proposed to overcome the limitations of iterative methods, accelerating the convergence rates and enhancing the performance. The Chebyshev acceleration method employs a new vector combination, which combines the spectral radius of the iteration matrix with the receiver signal, and also the optimal parameters of Chebyshev acceleration have also been defined. A detector based on iterative algorithms requires pre‐processing and initialisation, which enhance the convergence, performance, and complexity. To influence the initialisation, the stair matrix has been proposed as the first start of iterative methods. The performance results show that the proposed technique outperforms state‐of‐the‐art methods in terms of error rate performance, while significantly reducing the computational complexity.
A 86%‐efficiency CMOS rectifier with an internal threshold voltage cancellation (IVC) scheme
Authors: Kim Byeongseol , Bae Joonsung
Published: April 2022

In this letter, the authors present a high‐efficiency AC‐to‐DC rectifier for a wireless power transmission system with an internal threshold voltage cancellation (IVC) scheme to improve power conversion efficiency (PCE) and voltage conversion ratio (VCR). The rectifier with the IVC scheme implemented in 0.18‐μm CMOS technology achieves a power efficiency of 86% at a resistive load of 510 Ω when a 13.56‐MHz AC signal with a 6‐V amplitude is applied. In contrast, a previous scheme shows a 58% PCE under the same condition.
TrendRank method for evaluating the importance of power grid nodes considering information network
Authors: Su Qingyu , Chen Cong , Li Jian
Published: April 2022

To ensure the stable operation of power systems, critical nodes need to be identified for key protection. The LeaderRank algorithm is a fast and accurate algorithm for identifying key nodes, but it has obvious inappropriateness when targeting the power system. For this reason, this paper considers the scheduling function of the information network and the power flow betweenness of the power grid. A TrendRank algorithm is proposed to identify key nodes in complex power grids. TrendRank values can be computed iteratively by a weighted distribution strategy of internally linked nodes and then ranked. The performance of the TrendRank method has been fully tested and benchmarked on IEEE39 and IEEE118. The comparison of four performance metrics fully validates the effectiveness and superiority of the method. The TrendRank algorithm provides an idea in protecting the power system, which makes the economic cost of protecting the power system lower.
NHNet: A non‐local hierarchical network for image denoising
Authors: Zhang Jiahong , Cao Lihong , Wang Tian , Fu Wenlong , Shen Weiheng
Published: April 2022

With the fast development of deep learning models, hierarchical convolutional neural networks have achieved great success in image denoising tasks. To further boost the performance of image denoising, a novel non‐local hierarchical network (NHNet) is proposed. Unlike existing U‐Net‐based hierarchical methods, which mainly focus on downsampling operations, NHNet adopts an initial resolution path and a high resolution path. Specifically, the high‐resolution features are obtained through upsampling, where the non‐local mechanism is adopted to capture the self‐similarity properties, which contribute to a better denoising performance. Cross connections and channel attention layers are added between the two paths to integrate features in different resolutions. Compared with other U‐Net‐based hierarchical networks, NHNet requires fewer parameters. Experiments show that NHNet achieves state‐of‐the‐art performance in Gaussian denoising tasks and gets competitive results when dealing with real image denoising.
Active flow control using deep reinforcement learning with time delays in Markov decision process and autoregressive policy
Authors: Mao Yiqian , Zhong Shan , Yin Hujun
Published: April 2022

Classical active flow control (AFC) methods based on solving the Navier–Stokes equations are laborious and computationally intensive even with the use of reduced-order models. Data-driven methods offer a promising alternative for AFC, and they have been applied successfully to reduce the drag of two-dimensional bluff bodies, such as a circular cylinder, using deep reinforcement-learning (DRL) paradigms. However, due to the onset of weak turbulence in the wake, the standard DRL method tends to result in large fluctuations in the unsteady forces acting on the cylinder as the Reynolds number increases. In this study, a Markov decision process (MDP) with time delays is introduced to model and quantify the action delays in the environment in a DRL process due to the time difference between control actuation and flow response along with the use of a first-order autoregressive policy (ARP). This hybrid DRL method is applied to control the vortex-shedding process from a two-dimensional circular cylinder using four synthetic jet actuators at a freestream Reynolds number of 400. This method has yielded a stable and coherent control, which results in a steadier and more elongated vortex formation zone behind the cylinder, hence, a much weaker vortex-shedding process and less fluctuating lift and drag forces. Compared to the standard DRL method, this method utilizes the historical samples without additional sampling in training, and it is capable of reducing the magnitude of drag and lift fluctuations by approximately 90% while achieving a similar level of drag reduction in the deterministic control at the same actuation frequency. This study demonstrates the necessity of including a physics-informed delay and regressive nature in the MDP and the benefits of introducing ARPs to achieve a robust and temporal-coherent control of unsteady forces in active flow control.
Investigating Gender Differences in Canadian Plastic Surgery Online Patient Education
Authors: Chawla Sahil , Mazhar Leena , Ding Jeffrey , Faheem Sarim , Haq Ahmed Farhan , Khosa Faisal
Published: April 2022

Background

The public interest and demand for cosmetic surgery is growing in North America. As practices continue to advertise cosmetic procedures, male consumers must also be given fair consideration in a market targeted mostly towards women.

Objectives

This study investigated the advertising trends of plastic surgery clinics to assess for prevailing gender differences among online Canadian plastic surgery practice advertising.

Methods

The 2021 College of Physicians and Surgeons directory for each province and territory was utilized to identify all practicing plastic surgeons. A systematic search with Google (Mountain View, CA) was conducted to analyze the websites of Canadian plastic surgery centers in the following manner: “[physician name] [province of practice].”

Results

A total of 209 websites and 13,838 images were identified and analyzed. Of these images, 12,386 (90%) were female and 1452 (10%) were male patients or models. Although only 20% had a male services page, 62% of all centers offered gynecomastia procedures. The most common procedures targeting men were blepharoplasty (95%), liposuction (93%), and abdominoplasty (93%). The Prairies region had significantly fewer websites with male-only pages compared with all other Canadian regions.

Conclusions

Despite the increase in cosmetic surgery procedures for males, the market for cosmetic surgery procedures targeted towards males remains insignificant. An increase in the advertising of in-demand male cosmetic procedures can allow for a broader consumer market and a subsequent increase in benefits for plastic surgeons.
Minimal Incision Lower Augmentation Blepharoplasty: 3 Simple Steps to Facial Mid-Term Rejuvenation
Authors: Pérez Willis Wilder Antonio , Pérez Soto Wilder Armin
Published: April 2022

Background

The practice of removing skin and fatty tissue from the lower eyelid does not accommodate the different forms of facial aging. Therefore, techniques that encompass the recovery of facial volumes are common. Currently, when isolated lower blepharoplasty is performed, it does not take into account that mid-face rejuvenation is simultaneously possible. Furthermore, it is not always necessary to make incisions along the entire lash line, because this may be minimal in good candidates.

Objectives

This article presents a selection of patients who underwent augmentation lower blepharoplasty for the rejuvenation of the middle third of the face associated with the periorbital area, which is a modified traditional lower blepharoplasty technique performed with minimal incisions and fat grafting.

Methods

A retrospective study was conducted on 160 patients who underwent lower augmentation blepharoplasty performed by the authors from July 2017 to March 2021. The small incision utilized is approximately 15 to 18 mm and does not reach the ends or edges of the lower eyelid. The procedure is accompanied by fat grafting in the area of the middle third of the face. Finally, a Likert test was conducted to assess satisfaction.

Results

The patients presented a noticeable improvement, obtaining more attractive and youthful results from the middle third of the face. There were no major complications, and the patient outcomes were satisfactory.

Conclusions

Augmentation lower blepharoplasty with minimal incisions can be a useful alternative for selected patients who seek to jointly rejuvenate the middle third of the face.

Level of Evidence: 4
Infralimbic YTHDF1 is necessary for the beneficial effects of acute mild exercise on auditory fear extinction retention
Authors: Li Song-Ji , Zhang Lin-Xuan , Zou Guang-Jing , Ma Min-Hui , Zhou Shi-Fen , Lu Xiao-Yu , Li Fang , Li Chang-Qi
Published: April 2022

Exposure therapy is the most effective approach of behavioral therapy for anxiety and post-traumatic stress disorder (PTSD). But fear is easy to reappear even after successful extinction. So, identifying novel strategies for augmenting exposure therapy is rather important. It was reported that exercise had beneficial effects on cognitive and memory deficits. However, whether exercise could affect fear memory, especially for fear extinction remained elusive. Here, our results showed that exposure to acute mild exercise 1 or 2 h before extinction training can augment recent fear extinction retention and 2 h for the remote fear extinction retention. These beneficial effects could be attributed to increased YTHDF1 expression in medial prefrontal cortex (mPFC). Furthermore, by using an AAV-shRNA-based approach to silence YTHDF1 expression via stereotactic injection in prelimbic cortex (PL) or infralimbic cortex (IL), respectively, we demonstrated that silence YTHDF1 in IL, but not in PL, blunted augmentation of exposure therapy induced by acute mild exercise and accompanied with decreased NR2B and GluR1 expression. Moreover, YTHDF1 modulated dendritic spines remodeling of pyramidal neuron in IL. Collectively, our findings suggested that acute mild exercise acted as an effective strategy in augmenting exposure therapy with possible implications for understanding new treatment underlying PTSD.
Furazolidone and Nitrofurazone Metabolic Studies in Crucian Carp by Ultra-Performance Liquid Chromatography Tandem Mass Spectrometry
Authors: Zhang Shuai , Yang Zuisu , Yu Haixia , Chen Yan , Yuan Falei , Zhang Xiaojun , Fang Shuangqi
Published: April 2022

In this work, the detection of the furazolidone (FZD) and nitrofurazone (NFZ) metabolites residuals in crucian carp are focused. Crucian carps of identical size were exposed to the mixed nitrofuran antibiotics under optimized bath conditions at a concentration of 50 mg/L, 26 ± 0.5°C for 24 h. Then, liquid chromatography-electrospray ionization-triple quadrupole mass spectrometry (LC–ESI–MSMS) was performed after the drug exposure experiments when the nitrofuran metabolites were enriched in organisms. During the period of 0–144 h, residue levels of the 3-amino-2-oxazolidinone (AOZ) gradually decreased with a prolonged sampling time. The changing trend in semicarbazide (SEM) with the sample collection duration is divided into two stages, and its concentration showed a trend of rising first and then falling. The metabolite concentration–time curve demonstrates that 24 h was used as a sampling time, and fish muscle was selected as tissue samples in the further quantitative study. A novel crucian carp-enrichment procedure coupled to LC–ESI–MSMS quantitative method was further explored based on much metabolite data. According to the exponential curve of the SEM-to-AOZ concentration ratio at a precisely designed FZD-to-NFZ mass ratio, the final FZD content of the veterinary NFZ antibiotics was 0.069 ± 0.005% (in terms of mass).
Evaluation of inter-user variability in indocyanine green fluorescence angiography to assess gastric conduit perfusion in esophageal cancer surgery
Authors: Hardy Niall P , Joosten Johanna J , Dalli Jeffrey , Hompes Roel , Cahill Ronan A , van Berge Henegouwen Mark I
Published: April 2022

Indocyanine Green Fluorescence Angiography (ICGFA) has been deployed to tackle malperfusion-related anastomotic complications. This study assesses variations in operator interpretation of pre-anastomotic ICGFA inflow in the gastric conduit. Utilizing an innovative online interactive multimedia platform (Mindstamp), esophageal surgeons completed a baseline opinion-practice questionnaire and proceeded to interpret, and then digitally assign, a distal transection point on 8 ICGFA videos of esophageal resections (6 Ivor Lewis, 2 McKeown). Annotations regarding gastric conduit transection by ICGFA were compared between expert users versus non-expert participants using ImageJ to delineate longitudinal distances with Shapiro Wilk and t-tests to ascertain significance. Expert versus non-expert correlation was assessed via Intraclass Correlation Coefficients (ICC). Thirty participants (13 consultants, 6 ICGFA experts) completed the study in all aspects. Of these, a high majority (29 participants) stated ICGFA should be used routinely with most (21, including 5/6 experts) stating that 11–50 cases were needed for competency in interpretation. Among users, there were wide variations in dosing (0.05–3 mg/kg) and practice impact. Agreement regarding ICGFA video interpretation concerning transection level among experts was ‘moderate’ (ICC = 0.717) overall but ‘good’ (ICC = 0.871) among seven videos with Leave One Out (LOO) exclusion of the video with highest disagreement. Agreement among non-experts was moderate (ICC = 0.641) overall and in every subgroup including among consultants (ICC = 0.626). Experts choose levels that preserved more gastric conduit length versus non-experts in all but one video (P = 0.02). Considerable variability exists with ICGFA interpretation and indeed impact. Even adept users may be challenged in specific cases. Standardized training and/or computerized quantitative fluorescence may help better usage.
Disruption of the brain–esophagus axis in obese patients with heartburn
Authors: Ribeiro Marcelo , Forcelini Cassiano Mateus , Navarini Daniel , Soder Ricardo Bernardi , Fornari Fernando
Published: April 2022

Obesity is a risk factor for gastroesophageal reflux disease. Studies addressing the brain–esophagus axis in obese are lacking. In obese with and without heartburn, we assessed: (i) the brain responses to esophageal acid perfusion during functional brain imaging; (ii) esophageal impedance baseline before and after acid perfusion; and (iii) abdominal fat distribution. In this exploratory study, 26 obese underwent functional magnetic resonance imaging (fMRI) of the brain combined with esophageal acid perfusion. Esophageal impedance baseline was determined before and after fMRI, followed by tomographic quantification of the abdominal fat. Among 26 obese (54% men, 39.7 years old, 33.5 kg/m2), there were 17 with heartburn and 9 without heartburn. Before fMRI, the esophageal impedance baseline was lower in obese with heartburn than without heartburn (median 1187 vs. 1890 Ω; P = 0.025). After acid perfusion, impedance baseline decreased in obese with heartburn (from 1187 to 899 Ω; P = 0.011) and was lower in this group than in obese without heartburn (899 vs. 1614 Ω; P = 0.001). fMRI task-residual analysis showed that obese with heartburn presented higher functional connectivity in several brain regions than obese without heartburn. Abdominal fat area did not differ between obese with and without heartburn either for total (72.8 ± 4.4% vs. 70.3 ± 6.0%; P = 0.280), subcutaneous (42.2 ± 9.0% vs. 37.4 ± 9.0%; P = 0.226), or visceral (30.6 ± 7.9% vs. 33.0 ± 7.8%; P = 0.484). In subjects with obesity, the brain–esophagus axis is disrupted centrally with higher functional brain connectivity and peripherally with decreased esophageal mucosa integrity in the presence of heartburn.
Network Analysis of Inflammatory Bowel Disease Research: Towards the Interactome
Authors: Fernandez M Emilia , Nazar F Nicolas , Moine Luciana B , Jaime Cristian E , Kembro Jackelyn M , Correa Silvia G
Published: April 2022

Background and Aims

Modern views accept that inflammatory bowel diseases [IBD] emerge from complex interactions among the multiple components of a biological network known as the ‘IBD interactome’. These diverse components belong to different functional levels including cells, molecules, genes and biological processes. This diversity can make it difficult to integrate available empirical information from human patients into a collective view of aetiopathogenesis, a necessary step to understand the interactome. Herein, we quantitatively analyse how the representativeness of components involved in human IBD and their relationships ha ve changed over time.

Methods

A bibliographic search in PubMed retrieved 25 971 abstracts of experimental studies on IBD in humans, published between 1990 and 2020. Abstracts were scanned automatically for 1218 IBD interactome components proposed in recent reviews. The resulting databases are freely available and were visualized as networks indicating the frequency at which different components are referenced together within each abstract.

Results

As expected, over time there was an increase in components added to the IBD network and heightened connectivity within and across functional levels. However, certain components were consistently studied together, forming preserved motifs in the networks. These overrepresented and highly linked components reflect main ‘hypotheses’ in IBD research in humans. Interestingly, 82% of the components cited in reviews were absent or showed low frequency, suggesting that many aspects of the proposed IBD interactome still have weak experimental support in humans.

Conclusions

A reductionist and fragmented approach to the study of IBD has prevailed in previous decades, highlighting the importance of transitioning towards a more integrated interactome framework.
Deciphering the RNA universe in sperm in its role as a vertical information carrier
Authors: Kretschmer Miriam , Gapp Katharina
Published: April 2022

The inheritance of neurophysiologic and neuropsychologic complex diseases can only partly be explained by the Mendelian concept of genetic inheritance. Previous research showed that both psychological disorders like post-traumatic stress disorder and metabolic diseases are more prevalent in the progeny of affected parents. This could suggest an epigenetic mode of transmission. Human studies give first insight into the scope of intergenerational influence of stressors but are limited in exploring the underlying mechanisms. Animal models have elucidated the mechanistic underpinnings of epigenetic transmission. In this review, we summarize progress on the mechanisms of paternal intergenerational transmission by means of sperm RNA in mouse models. We discuss relevant details for the modelling of RNA-mediated transmission, point towards currently unanswered questions and propose experimental considerations for tackling these questions.
Comorbidities may offset expected improved survival after transcatheter aortic valve replacement
Authors: Lantelme Pierre , Aubry Matthieu , Peng Jacques Chan , Riche Benjamin , Souteyrand Géraud , Jaafar Philippe , Rabilloud Muriel , Harbaoui Brahim , Muller Olivier , Cosset Benoit , Pagnoni Mattia , Manigold Thibaut
Published: April 2022

Aims

After transcatheter aortic valve replacement (TAVR), cardiovascular and non-cardiovascular comorbidities may offset the survival benefit from the procedure. We aimed to describe the relationships between that benefit and patient comorbidities.

Methods and results

The study pooled two European cohorts of patients with severe aortic stenosis (AS-pooled): one with patients who underwent (cohort of AS patients treated by TAVR, N = 233) and another with patients who did not undergo TAVR (cohort of AS patients treated medically; N = 291). The investigators collected the following: calcification prognostic impact (CAPRI) and Charlson scores for cardiovascular and non-cardiovascular comorbidities, activities of daily living (ADL)/instrumental activities of daily living (IADL) scores for frailty as well as routine Society of Thoracic Surgeons (STS) score and Logistic Euroscore. Unlike ADL/IADL scores, CAPRI and Charlson scores were found to be independent predictors of 1-year all-cause death in the AS-pooled cohort, with and without adjustment for STS score or Logistic Euroscore; they were thus retained to define a three-level prognostic scale (good, intermediate, and poor). The survival benefit from TAVR—vs. no TAVR—was stratified according to these three prognosis categories. The beneficial effect of TAVR on 1-year all-cause death was significant in patients with good and intermediate prognosis, hazard ratio (95% confidence interval): 0.36 (0.18; 0.72) and 0.32 (0.15; 0.67). That effect was reduced and not statistically significant in patient with poor prognosis [0.65 (0.22; 1.88)].

Conclusion

The study showed that, beyond a given comorbidity burden (as assessed by CAPRI and Charlson scores), the probability of death within a year was high and poorly reduced by TAVR. This indicates the futility of TAVR in patients in the poor prognosis category.
High fibrosis-4 index predicts the new onset of ischaemic heart disease during a 10-year period in a general population
Authors: Higashiura Yukimura , Tanaka Marenao , Mori Kazuma , Mikami Takuma , Hosaka Itaru , Ohnishi Hirofumi , Hanawa Nagisa , Furuhashi Masato
Published: April 2022

Aims

The fibrosis-4 (FIB-4) index, calculated using age, platelet count, and levels of aspartate aminotransferase and alanine aminotransferase, is a non-invasive indicator for the detection of liver fibrosis. Advanced hepatic fibrosis is associated with morbidity and mortality in patients with non-alcoholic fatty liver disease. However, the relationship between liver fibrosis and the development of ischaemic heart disease (IHD) has not fully been addressed.

Methods and results

We investigated the association between the FIB-4 index and the new onset of IHD during a 10-year period in a general population of subjects who received annual health examinations (n = 28 990). After exclusion of subjects with missing data and those with a history of IHD at baseline, a total of 13 448 subjects (men/women: 8774/4674, mean age: 48 years) were included. During the 10-year period, 378 men (4.3%) and 77 women (1.6%) had a new onset of IHD. Multivariable Cox proportional hazard models with a restricted cubic spline showed that hazard risk for the development of IHD increased with a higher FIB-4 index at baseline after adjustment of age, sex, fatty liver (FL) determined by ultrasonography, estimated glomerular filtration rate, habits of current smoking and alcohol drinking, family history of IHD, and diagnosis of hypertension, diabetes mellitus and dyslipidaemia. When divided by FL, the FIB-4 index becomes an independent predictor for the development of IHD in subjects with FL but not in those without FL. The addition of the FIB-4 index to traditional risk factors for IHD significantly improved the discriminatory capability.

Conclusion

A high level of the FIB-4 index predicts the new onset of IHD during a 10-year period.
Treatment of the aortic root in acute aortic dissection type A: insights from the German Registry for Acute Aortic Dissection Type A
Authors: Kallenbach Klaus , Büsch Christopher , Rylski Bartosz , Dohle Daniel-Sebastian , Krüger Tobias , Holubec Tomas , Brickwedel Jens , Pöling Jochen , Noack Thilo , Hagl Christian , Jawny Philipp , Böning Andreas , Chalabi Khaled , Karck Matthias , Arif Rawa
Published: April 2022

OBJECTIVES

Surgery of the aortic root in acute aortic dissection type A (AADA) remains a topic of vague evidence since the extend of dissection and surgeons’ capability and interpretation of the disease vary remarkably. We aimed to interpret root operation strategies in the German Registry for Acute Aortic Dissection cohort.

METHODS

German Registry for Acute Aortic Dissection collected the data of 56 centres between July 2006 and June 2015. A total of 3382 patients undergoing operations for AADA were included and divided into 3 groups according to aortic root procedure types: supracommissural replacement (SCR), conduit replacement (CR) and valve sparing root replacement (VSRR).

RESULTS

Patients in SCR (2425, 71.7%) were significantly older than CR (681, 20.1%) and VSRR (276, 8.2%) (63.4 vs 57.5 vs 54.2 years; P < 0.001), more female (38.9% vs 32.0% vs 26.1%; P < 0.001) and presented with less aortic regurgitation (26.3% vs 57.1% vs 56.5%; P < 0.001). VSRR presented with slightly less multiple organ malperfusion (11.6% vs 12.0% vs 10.9%; P = 0.045) and were more often diagnosed for Marfan syndrome (2.4% vs 5.1% vs 9.1%; P < 0.001). Thirty-day mortality was lower for VSRR (11.6%) compared to SCR (16.1%) and CR (19.8%; P = 0.010). Despite longer procedural times, multivariable regression showed no influence of total arch replacement for VSRR on mortality compared to CR (odds ratio 0.264; 95% confidence interval, 0.033–2.117; P = 0.21).

CONCLUSIONS

SCR remains the procedure of choice in elderly and compromised patients. Extended root preservation techniques may be applied even in combination with extended aortic arch surgery for selected patients for AADA with promising early outcomes.
Advancing quality and safety of perinatal services in India: opportunities for effective midwifery integration
Authors: Vedam Saraswathi , Titoria Reena , Niles Paulomi , Stoll Kathrin , Kumar Vishwajeet , Baswal Dinesh , Mayra Kaveri , Kaur Inderjeet , Hardtman Pandora
Published: April 2022

India has made significant progress in improving maternal and child health. However, there are persistent disparities in maternal and child morbidity and mortality in many communities. Mistreatment of women in childbirth and gender-based violence are common and reduce women’s sense of safety. Recently, the Government of India committed to establishing a specialized midwifery cadre: Nurse Practitioners in Midwifery (NPMs). Integration of NPMs into the current health system has the potential to increase respectful maternity care, reduce unnecessary interventions, and improve resource allocation, ultimately improving maternal–newborn outcomes. To synthesize the evidence on effective midwifery integration, we conducted a desk review of peer-reviewed articles, reports and regulatory documents describing models of practice, organization of health services and lessons learned from other countries. We also interviewed key informants in India who described the current state of the healthcare system, opportunities, and anticipated challenges to establishing a new cadre of midwives. Using an intersectional feminist theoretical framework, we triangulated the findings from the desk review with interview data to identify levers for change and recommendations. Findings from the desk review highlight that benefits of midwifery on outcomes and experience link to models of midwifery care, and limited scope of practice and prohibitive practice settings are threats to successful integration. Interviews with key informants affirm the importance of meeting global standards for practice, education, inter-professional collaboration and midwifery leadership. Key informants noted that the expansion of respectful maternity care and improved outcomes will depend on the scope and model of practice for the cadre. Domains needing attention include building professional identity; creating a robust, sustainable education system; addressing existing inter-professional issues and strengthening referral and quality monitoring systems. Public and professional education on midwifery roles and scope of practice, improved regulatory conditions and enabling practice environments will be key to successful integration of midwives in India.
Histological Indices and Risk of Recurrence in Crohn’s Disease: A Retrospective Study of a Cohort of Patients in Endoscopic Remission
Authors: Lirsac Marion , Biron Amélie , Djerada Zoubir , Cadiot Guillaume , Morcos-Sauvain Elise , Brixi Hedia , Le Saint Margaux , Marchal Aude , Boulagnon-Rombi Camille
Published: April 2022

Background

Although histological healing is raising interest in ulcerative colitis to predict recurrence, its meaning in Crohn’s disease (CD) remains unknown. We aimed to study the performances of different histological indices to predict recurrence of CD patients with mucosal healing.

Methods

Crohn’s disease patients with mucosal healing diagnosed between 2010 and 2018 were included if there was available clinical and endoscopical data. Nancy Histological index (NHI), Geboes score (GS), Robarts Histopathology index (RHI), Global Histological Disease Activity Score (GHAS), and Inflammatory Bowel Disease—Distribution Chronicity Activity score (IBD-DCA) were independently assessed by 3 pathologists.

Results

Eighty-eight patients were included, of which 28 relapsed (32%) within 30.5 months. All 4 histological indices were associated with recurrence, with significant relapse risk (NHI, odds ratio [OR], 1.67; GHAS, OR, 2.33; RHI, OR, 1.19; GS, OR, 2.09; and IBD-DCA, OR, 2.14). Microscopic activity was significantly associated with relapse only with the IBD-DCA score. Predicting performances of all these scores were poor. Calibration curves indicate that the GHAS and IBD-DCA are the closest to the ideal predicted probability curve and thus could better predict recurrence than the other scores. Interobserver agreement varied from poor for GHAS (k = .39) to good for RHI (k = .68).

Conclusions

Histological scores are valuable indicators to predict recurrence. Histological assessment of activity seems insufficient to predict CD course with most of the score evaluated, highlighting the need for new indices or adaptation of actual scores to CD specificities.
An efficient matheuristic algorithm for bi-objective sustainable closed-loop supply chain networks
Authors: Ade Irawan Chandra , Dan-Asabe Abdulrahman Muhammad , Salhi Said , Luis Martino
Published: April 2022

This paper develops an optimization model for a sustainable closed-loop supply chain network with two conflicting objectives, namely, the minimization of the total logistic costs and the total amount of carbon emissions. The first objective relates to financial benefits, whereas the second represents the wider goal of guaranteeing cleaner air and hence a greener and healthier planet. The problem is first modelled as a mixed integer linear programming based-model. The aim is to determine the location of distribution centres and recycling centres, their respective numbers and the type of vehicles assigned to each facility. Vehicle type consideration, not commonly used in the literature, adds another dimension to this practical and challenging logistic problem. A matheuristic using compromise programming is put forward to tackle the problem. The proposed matheuristic is evaluated using a variety of newly generated datasets which produces compromise solutions that demonstrate the importance of an appropriate balance of both objective functions. The robustness analysis considering fluctuations in customer demand is assessed using Monte Carlo simulation. The results show that if the standard deviation of the demand falls within 10% of its average, the unsatisfied demand is insignificant, thus demonstrating the stability of supply chain configuration. This invaluable information is key towards helping senior management make relevant operational and strategic decisions that could impact on both the sustainability and the resilience of their supply chain networks.
Management Implications for the Nantucket Pine Tip Moth From Temperature-Induced Shifts in Phenology and Voltinism Attributed to Climate Change
Authors: Cassidy V A , Asaro C , McCarty E P
Published: April 2022

Forest insect pest phenology and infestation pressure may shift as temperatures continue to warm due to climate change, resulting in greater challenges for sustainable forest management . The Nantucket pine tip moth (NPTM) (Rhyacionia frustrana Comstock) (Lepidoptera: Tortricidae) is a native forest regeneration pest in the southeastern U.S. with multiple generations per year. Changes in NPTM voltinism may result from temperature-induced shifts in NPTM phenology. Degree-day models have been used to develop optimal spray dates (OSDs) for NPTM. The 2000 Spray Timing Model (STM), based on temperature data from 1960 to 2000, provided generation-specific 5-d OSDs to effectively time applications of contact insecticides. An updated degree-day model, the 2019 STM, is based on temperature data from 2000 to 2019 and was used to detect changes in voltinism as well as shifts in phenology and OSDs. Based on the model, increased voltinism occurred at 6 of the 28 study locations (21%). Changes in voltinism occurred in the Piedmont and Coastal Plain of Georgia, U.S., with shifts from three to four or four to five generations a year, depending on location. The OSDs from the 2019 STM were compared to the 2000 STM OSDs. Over half (57%) of the OSDs differed by 5–15 d, with the majority (66%) resulting in earlier spray dates. The 2019 STM will help growers adapt NPTM control tactics to temperature-induced phenology shifts. NPTM serves as an example of temperature-induced changes attributed to climate change in a forest insect pest with important implications to forest management.
Classification based on skeletal muscle mass and the severity of lung emphysema impacts on clinical outcomes after anatomical resection for lung cancer
Authors: Tsubokawa Norifumi , Mimura Takeshi , Tadokoro Kazuki , Yamashita Yoshinori
Published: April 2022

Objectives

Both sarcopenia and lung emphysema are prognostic factors in lung cancer and can be easily assessed using the psoas muscle index and Goddard score, respectively. We investigated the clinical significance of the classification based on psoas muscle index and Goddard score in non-small cell lung cancer.

Methods

A total of 303 consecutive patients who underwent anatomical resection for non-small cell lung cancer were retrospectively analyzed. The psoas muscle at the level of the third lumbar vertebrae and Goddard score were measured on preoperative computed tomography. The psoas muscle was adjusted by height as the psoas muscle index (cm2/m2). We divided patients into three groups: low-, middle- and high-risk, using cut-off values of psoas muscle index < 6.36 cm2/m2 for males and 3.92 cm2/m2 for females and Goddard score higher than 7. The predictors of postoperative complications and prognosis were examined.

Results

High-, middle- and low-risk were present in 30 (10%), 164 (54%) and 109 (36%) patients, respectively. High risk was significantly associated with male sex, low pulmonary function, more comorbidities and increased postoperative complications. High-risk patients showed poorer overall survival than middle- and low-risk patients (P < 0.001). Multivariable analysis revealed that high risk was an independent risk factor for postoperative complications and unfavorable prognostic factors (P = 0.011, P = 0.014, respectively).

Conclusions

Classification based on psoas muscle index and Goddard score is significantly associated with short- and long-term outcomes in patients with lung cancer. This method can be easily assessed for patients and may help select patients for nutritional support and rehabilitation before surgery.
Initial screening by immunohistochemistry is effective in universal screening for Lynch syndrome in endometrial cancer patients: a prospective observational study
Authors: Tsuruta Tomohiko , Todo Yukiharu , Yamada Ryutaro , Kuwahara Ken , Kurosu Hiroyuki , Minowa Kaoru , Minoura Yuko , Minobe Shinichiro , Suzuki Hiroaki , Kato Hidenori
Published: April 2022

Background

Few prospective reports of universal screening for Lynch syndrome exist for patients with endometrial cancer. In this study, we performed immunohistochemical staining for DNA mismatch repair-related genes (MLH1, MSH2, MSH6 and PMS2), to determine the extent to which Lynch syndrome can be diagnosed in endometrial cancer patients through universal screening.

Methods

We recruited 116 consecutive patients assumed to have uterine corpus malignancy from October 2019 to February 2021 in a prospective observational study. We performed immunohistochemical for mismatch repair-related proteins on samples from 100 patients who had surgicopathologically confirmed diagnoses of endometrial cancer. Samples with missing immunohistochemical results for any of the proteins had subsequent universal screening tests for microsatellite instability, DNA methylation of the MLH1 promoter region and mismatch repair genetics.

Results

We identified 19 (19.0%) patients with lost results for any of the proteins. All 19 patient samples had subsequent screening tests. We identified the microsatellite instability-high phenotype in 84.2% (16/19) of these patients and MLH1 methylation in 57.9% (11/19). Mismatch repair genetic testing detected two pathological variants, in MSH2 and MSH6, which indicated that the prevalence of Lynch syndrome was 2.0% in our cohort. Two cases of unclassified variant (MSH6) and one case of benign variant (PMS2) were also detected.

Conclusions

Initial screening by immunohistochemical is an effective method in universal screening for Lynch syndrome in endometrial cancer patients.
Israeli Public Opinion on the Use of Nuclear Weapons: Lessons From Terror Management Theory
Authors: Horschig Doreen
Published: April 2022

When do people become more willing to endorse a nuclear strike against a foreign country? Utilizing interdisciplinary theoretical insights from international relations and social psychology as well as original experimental survey data from Israel, this work aims to answer this question. Influential strands of scholarship argue that both the public and the political elites have internalized antinuclear norms. Critics, however, assert that the moral nuclear taboo lacks robustness. The work joins this debate by offering a novel theoretical framework informed by terror management theory (TMT) and suggests that people are more likely to support extreme forms of warfare (e.g., nuclear strikes) when reminded of their own mortality. Thus, consequentialist factors, such as perceived utility, and psychological factors, such as moral foundations theory and TMT, can be causal mechanisms in the support for nuclear weapons. In an age of populism characterized by the rise of nationalist leaders with authoritarian tendencies, the main finding is a source of significant concern.
Melatonin enhances stem strength by increasing lignin content and secondary cell wall thickness in herbaceous peony
Authors: Zhao Daqiu , Luan Yuting , Shi Wenbo , Tang Yuhan , Huang Xingqi , Tao Jun
Published: April 2022

Cut flower quality is severely restrained by stem bending due to low stem strength. Melatonin has been shown to function in many aspects of plant growth and development, yet whether it can enhance stem strength, and the corresponding underlying mechanisms remain unclear. We investigated the role of melatonin in enhancement of stem strength in herbaceous peony (Paeonia lactiflora Pall.) by applying exogenous melatonin and changing endogenous melatonin biosynthesis. Endogenous melatonin content positively correlated with lignin content and stem strength in various P. lactiflora cultivars. Supplementation with exogenous melatonin significantly enhanced stem strength by increasing lignin content and the S/G lignin compositional ratio, up-regulating lignin biosynthetic gene expression. Moreover, overexpression of TRYPTOPHAN DECARBOXYLASE GENE (TDC) responsible for the first committed step of melatonin biosynthesis in tobacco, significantly increased endogenous melatonin, which further increased the S/G ratio and stem strength. In contrast, silencing PlTDC in P. lactiflora decreased endogenous melatonin, the S/G ratio and stem strength. Finally, manipulating the expression of CAFFEIC ACID O-METHYLTRANSFERASE GENE (COMT1), which is involved in both melatonin and lignin biosynthesis, showed even greater effects on melatonin, the S/G ratio and stem strength. Our results suggest that melatonin has a positive regulatory effect on P. lactiflora stem strength.
Variation of photosynthesis during plant evolution and domestication: implications for improving crop photosynthesis
Authors: Huang Guanjun , Peng Shaobing , Li Yong
Published: April 2022

Studies investigating the mechanisms underlying the variation of photosynthesis along plant phylogeny and especially during domestication are of great importance, and may provide new insights to further improve crop photosynthesis. In the present study, we compiled a database including 542 sets of data of leaf gas exchange parameters and leaf structural and chemical traits in ferns and fern allies, gymnosperms, non-crop angiosperms, and crops. We found that photosynthesis was dramatically improved from ferns and fern allies to non-crop angiosperms, and further increased in crops. The improvement of photosynthesis during phylogeny and domestication was related to increases in carbon dioxide diffusional capacities and, to a lesser extent, biochemical capacity. Cell wall thickness rather than chloroplast surface area facing intercellular airspaces drives the variation of mesophyll conductance. The variation of the maximum carboxylation rate was not related to leaf nitrogen content. The slope of the relationship between mass-based photosynthesis and nitrogen was lower in crops than in non-crop angiosperms. These findings suggest that the manipulation of cell wall thickness is the most promising approach to further improve crop photosynthesis, and that an increase of leaf nitrogen will be less efficient in improving photosynthesis in crops than in non-crop angiosperms.
Evaluation of Intra- and Interlaboratory Variations in SARS-CoV-2 Real-Time RT-PCR Through Nationwide Proficiency Testing
Authors: Park Kuenyoul , Sung Heungsup , Chun Sail , Min Won-Ki
Published: April 2022

Objective

This study aimed to examine the intra- and interlaboratory variations of cycle threshold (Ct) values using the nationwide proficiency testing for SARS-CoV-2.

Methods

Triplicated strong-positive contrived samples duplicated weak-positive contrived samples, and 2 negative samples were transported to participating laboratories in October 2021.

Results

A total of 232 laboratories responded. All except 4 laboratories correctly answered. Six false-negative results, including 2 false-negatives with Ct values beyond the threshold and 1 clerical error, were noted from weak-positive samples. Intralaboratory variations of Ct values of weak-positive and strong-positive samples were not acceptable (Ct > 1.66) in 17 and 7 laboratories, respectively. High interlaboratory variations of Ct values (up to 7 cycles) for the 2 commonly used polymerase chain reaction (PCR) reagents were observed.

Conclusion

The overall qualitative performance was acceptable; intralaboratory variation was acceptable. However, interlaboratory variations of Ct values were remarkable even when the same PCR reagents were used.
Seasonal Variation of Ferritin among Swedish Blood Donors
Authors: Saldeen Johan , Carlsson Lena , Larsson Anders
Published: April 2022

Objective

Several biomarkers have been reported to exhibit a seasonal variation, which might also be associated with the seasonality observed for certain disorders, such as cardiovascular disease. Ferritin is a marker of iron stores but may be influenced by other factors including inflammation. The aim of this study was to determine whether there is a seasonal variation for plasma ferritin.

Methods

The study included all ferritin tests performed on blood donors between November 2009 and November 2016 in the county of Uppsala, Sweden.

Results

Median ferritin values were found to be highest in August to October (autumn) and lowest in April to May and December. The differences between the highest and lowest median values were 6 µg/L for males and 5 µg/L for females. This corresponds to approximately 12% difference for males and 15% difference for females.

Conclusion

A modest but statistically significant seasonal periodicity for ferritin was shown for blood donors.
Revisiting the relation between the number of globular clusters and galaxy mass for low-mass galaxies
Authors: Zaritsky Dennis
Published: April 2022

Using a new method to estimate total galaxy mass (MT) and two samples of low-luminosity galaxies containing measurements of the number of globular clusters (GCs) per galaxy (NGC), we revisit the NGC–MT relation using a total of 203 galaxies, 157 of which have MT ≤ 1010 M⊙. We find that the relation is nearly linear, NGC ∝ MT0.92 ± 0.08 down to at least MT ∼ 108.75 M⊙. Because the relationship extends to galaxies that average less than one GC per galaxy and to a mass range in which mergers are relatively rare, the relationship cannot be solely an emergent property of hierarchical galaxy formation. The character of the radial GC distribution in low-mass galaxies, and the lack of mergers at these galaxy masses, also appears to challenge models in which the GCs form in central, dissipatively concentrated high-density, high-pressure regions and are then scattered to large radius. The slight difference between the fitted power-law exponent and a value of one leaves room for a shallow MT-dependent variation in the mean mass per GC that would allow the relation between total mass in GCs and MT to be linear.