bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of depression, anxiety and stress disorders among medical students in Alexandria Faculty of Medicine during COVID-19 pandemic
Authors: Hemead Hanan M. , Hemead Sarah , Shaheen Ahmed , Shaheen Nour , Elrewany Ehab , Sheshtawy Hesham Adel
Published: June 2021

Aims

We aimed to assess the impact of the current pandemic on the mental well-being of undergraduate medical students of Alexandria Faculty of Medicine, Egypt.

Method

We designed a structured anonymous online questionnaire and encourage students to fill it in on social platforms. The questionnaire is composed of seven parts, each one includes multiple choice questions aimed to measure the impact of the pandemic on different aspect of daily activities namely: academic performance, social and family relationship, eating and smoking habits, sleep pattern, physical activity and the Depression, anxiety and stress scale (DASS-21). The last part was an open question where participants can state their comments about the experiences during the quarantine and how they affected their mental health.

Result

A total of 1181 students from the six academic grades responded. Females and students in the third academic year showed the highest prevalence of depression, anxiety and stress. Overall, most respondents reported that the current pandemic had negative impacts on their academic performance (71%) and social relationship (67.5 %). The majority of the students stated that they became less physically active (74.6%) and 52.2% experienced a weight gain. Despite that 60% of the studied population rated their sleeping quality as ‘’very good’’ and ‘’fairly good’’, 45.3% and 39.6% suffered from increased sleeping hours and disturbed sleep respectively. Based on students’ responses of the DASS-21, over half of the participants (62.2%) were experiencing moderate to extremely severe stress and over 33% were consistent with symptoms of extremely severe anxiety. In respect of depression, nearly half of the sample (46.4%) can be described as having extremely severe depression according to the cut-off points of the DASS-21.

Conclusion

The current pandemic has increased the challenges and burdens on undergraduate medical students. These impacts can be more profound in developing countries such as Egypt. The levels of psychiatric symptoms are alarming compared to previous local and international studies. These unprecedented consequences should be addressed promptly through students’ counselling and psychiatric assistance. To date, this is the largest psychiatric and survey-based study conducted on Alexandria Faculty of Medicine.

Financial disclosure: The study was not funded by any organization, the authors did not receive any financial aids.
Alcohol use disorder and its association with personal well-being and life satisfaction
Authors: Lim Chau Sian , Lew Zhen Wei , Ng Yoke Chiang , Peh Lai Huat , Ong Hatta Santoso
Published: June 2021

Aims

This study aims to find out how alcohol use disorder (AUD) correlates to personal well-being and life satisfaction.

Background

AUD is prevalent and leads to significant physical, physiological, and social-occupational impairment. Mental well-being involves the overall positive psychological state of a person – being well adjusted, socially engaged, and emotionally healthy. Despite the paradigm shift from purely treating mental illness to promoting positive mental health, there is limited literature describing the relationship between alcohol use disorder and mental well-being.

Method

This cross-sectional study was conducted in a general hospital in Singapore. Patients admitted across a span of two years were screened for possible alcohol use disorder. Patients were included if they were male, aged 21 years and above, and had the mental capacity to give consent. They were excluded if they had illicit drug use, acute mental illness, inability or refusal to give consent, or if they were already receiving intervention for addiction issues. Participants were administered the Alcohol Use Disorders Identification Test (AUDIT). Those who scored 8 or above were classified as being at risk for AUD, while those who scored 7 or less were classified as at low risk. They were also administered the Personal Wellbeing Index (PWI) and the “Satisfaction with Life as a Whole” question. The PWI measures individuals’ subjective well-being across seven domains. The “Satisfaction with Life as a Whole” question measures, on an eleven-point Likert scale, how satisfied the respondent feels with life in general. Demographic data were also collected and STATA v. 12.1 was used for statistical analysis.

Result

Among a total of 134 participants, 25 of them scored ≥8 on the AUDIT and 109 scored 7 or less. On the PWI, the group at risk scored significantly lower at 71.3 (95% CI: 66.0–76.7) compared to the group not at risk at 77.9 (95% CI: 75.8–79.9), p < 0.01. The results were similar on the “Satisfaction with Life as a Whole” item. The group at risk had a mean of 6.72 (95% CI: 6.03–7.41) while the group not at risk had a mean of 7.67 (95% CI: 7.41–7.93), both p < 0.01. The differences between the high risk and low risk groups remained statistically significant even after adjusting for differences in age, race, education level, and employment status.

Conclusion

This study demonstrated a statistically significant association between AUD and personal well-being as well as satisfaction with life among males.
Dissection of neuroinflammation in schizophrenia
Authors: Muratib Fizah , Mizuno Yuya , Figueiredo Ines Carreira , Howes Oliver , Marques Tiago Reis
Published: June 2021

Aims

Schizophrenia is notoriously becoming one of the world's most debilitating mental disorders, affecting 1 in 100 people. There is increasing evidence that neuroinflammation plays a part in the pathogenesis of schizophrenia and other psychotic disorders; microglial activity acting as a marker for neuroinflammatory reactions in the brain. Furthermore, cannabis is an illicit substance that also evokes a similar response in the neuroimmune activity. This project explores how cannabis exposure influences an elevation in neuroinflammatory responses through TSPO levels, and whether this information can help us determine if cannabis use and increased TSPO levels can be associated with a risk factor for developing psychosis.

Method

55 participants (36 males and 19 females) were recruited from the community by the IRIS (Inflammatory Reaction in Schizophrenia) team at the IoPPN, King's College London, from which 34 patients with a diagnosis of schizophrenia and 21 healthy controls took part in the study. The eligible participants underwent clinical assessments and PET scanning, from which cannabis use history and PET data were collected. Participant neuroinflammatory levels are represented by [18F]DPA-714 volume and different regions of grey matter in the brain were analysed through multivariate analyses, the confounding variables being age and TSPO genotype.

Result

A statistically significant association is shown between participants who have had exposure to cannabis and participants who have not had any exposure in their lifetime. The differences across the prioritised brain regions of interest were robust, the association appearing more apparent and statistically significant in the total (p = .00) and temporal grey matter (p = .00) regions of the brain. This may suggest that cannabis exposure influences the [18F]DPA-714 VT in the significant regions of interest. However, a negative association is seen with current use, the quantity of use, and the frequency of use.

Conclusion

The initial findings for cannabis exposure show us a positive association with increased TSPO levels, however, limitations must be taken into account. Although we cannot readily establish that elevated TSPO levels in cannabis users can presently act as a risk factor marker for developing psychosis from this particular study, we can utilise this data to continue our research in disclosing a new system to predict the occurrence of psychosis.
Pilot study of the use of handheld 6-lead ECG for patients on acute general adult mental health wards who refuse traditional 12-lead ECG
Authors: Briley Paul M , Lankappa Sudheer
Published: June 2021

Aims

To assess patient and clinician acceptability of handheld 6-lead ECG, for obtaining information about cardiac rhythm and electrical intervals, in acute general adult mental health ward inpatients who refuse traditional 12-lead ECG.

Background

In a previous audit of patients admitted to four acute general adult mental health wards, we found that 1 in 4 patients refused 12-lead ECG for at least two weeks, with 1 in 6 refusing throughout their entire stay. ECG refusers were significantly more likely to have a psychotic illness than non-refusers and were thus more likely to benefit from medications that carry a risk of prolonging the QT interval. Less invasive, handheld, 6-lead ECG, which includes measurement of lead II (the lead used to define traditional QT-interval cut-off values) is available on the NHS supply chain. Whilst not providing the full range of information that 12-lead ECG is able to provide, handheld 6-lead ECG might be an acceptable alternative in patients who would otherwise never have any form of ECG performed.

Method

We developed a Standard Operating Procedure for use of handheld 6-lead ECG and provided training for junior doctors on the four wards that were the subject of our original audit. These doctors were then able to offer the device to patients on their wards who refused 12-lead ECG. Doctors completed a short feedback form each time a handheld ECG was offered.

Result

So far, handheld 6-lead ECGs have been offered to 17 patients who refused 12-lead ECGs. Mean age (± SD) was 36.1 (± 12.6) years, and 4 of these patients were female. 13 patients (76%) accepted a handheld ECG. One of these attempts failed due to patient agitation. Attempts took a mean of 7 (± 5.4) minutes. 54% of recordings were described as “very easy” by clinicians, whereas 15%, 23% and 8% were described as “somewhat easy”, “intermediate”, and “somewhat difficult”, respectively. Clinician difficulties focussed on patient movement with impact on electrode contact and trace quality. Where answered (N = 10), 90% of patients stated they would recommend a handheld ECG to others. Patients liked the speed of the process, that it felt “less scary”, and that it was less invasive and did not involve removing clothing.

Conclusion

Our initial findings from this pilot suggest that handheld 6-lead ECG may be acceptable, both to clinicians and patients, as a means of obtaining information on cardiac rhythm and electrical intervals for patients who refuse 12-lead ECGs.
Combination of Mitotane and Locoregional Treatments in Low-volume Metastatic Adrenocortical Carcinoma
Authors: Boilève Alice , Mathy Elise , Roux Charles , Faron Matthieu , Hadoux Julien , Tselikas Lambros , Al Ghuzlan Abir , Hescot Ségolène , Leboulleux Sophie , de Baere Thierry , Lamartina Livia , Deschamps Frédéric , Baudin Eric
Published: June 2021

Context

European and French guidelines for ENSAT stage IV low tumor burden or indolent adrenocortical carcinoma (ACC) recommend a combination of mitotane and locoregional treatments (LRT) as first-line treatment. Nevertheless, the benefit of LRT in combination with mitotane has never been evaluated in this selected group of patients.

Objective

This work aimed to evaluate the therapeutic strategy of LRT combined with mitotane in patients with low tumor burden stage IVA ACC.

Methods

A retrospective chart review was performed from 2003 to 2018 of patients with stage IV ACC with 2 or fewer tumoral organs who received mitotane in our center. The primary end point was the delay between mitotane initiation and first systemic chemotherapy. Secondary end points were progression-free survival (PFS) and overall survival (OS) from mitotane initiation. Adjusted analyses were performed on the main prognostic factors.

Results

Out of 79 included patients, 48 (61%) patients were female and the median age at stage IVA diagnosis was 49.8 years (interquartile range [IQR], 38.8-60.0 years). Metastatic sites were mainly lungs (76%) and liver (48%). Fifty-eight (73%) patients received LRT including adrenal bed radiotherapy (14 patients, 18%), surgery (37 patients, 47%), and/or interventional radiology (35 patients, 44%). Median time between mitotane initiation and first chemotherapy administration was 9 months (IQR, 4-18 months). Median PFS1 (first tumor-progression) was 6.0 months (95% CI, 4.5-8.6). Median OS was 46 months (95% CI, 41-68). PFS1, PFS2, and OS were statistically longer in the mitotane plus LRT group compared to the mitotane-only group (hazard ratio [HR] = 0.39; 95% CI, 0.22-0.68; HR = 0.35; 95% CI, 0.20-0.63; and HR = 0.27; 95% CI, 0.14-0.50, respectively). Ten (13%) patients achieved complete response (CR), all from the mitotane plus LRT group.

Conclusion

Our results endorse European and French guidelines for stage IV ACC with 2 or fewer tumor organs and favor the combination of mitotane and LRT as first-line treatment. For the first time, a significant number of CRs were observed. Prospective studies are expected to confirm these findings.
Modeling Mental Qualities
Authors: Lee Andrew Y.
Published: June 2021

Conscious experiences are characterized by mental qualities, such as those involved in seeing red, feeling pain, or smelling cinnamon. The standard framework for modeling mental qualities represents them via points in multidimensional spaces, where distances between points inversely correspond to degrees of phenomenal similarity. This article argues that the standard framework is structurally inadequate and develops a new framework that is more powerful and flexible. The core problem for the standard framework is that it cannot capture precision structure: for example, consider the phenomenal contrast between seeing an object as crimson in foveal vision versus merely as red in peripheral vision. The solution the article proposes is to model mental qualities using regions, rather than points. The article explains how this seemingly simple formal innovation not only provides a natural way of modeling precision but also yields a variety of further theoretical fruits: it enables one to formulate novel hypotheses about the space and structures of mental qualities, formally differentiate two dimensions of phenomenal similarity, generate a probabilistic model of the phenomenal sorites, and deploy a new theoretical tool in the empirical investigation of consciousness. A noteworthy consequence of this new framework is that the structure of the mental qualities of conscious experiences is fundamentally different from the structure of the perceptible qualities of external objects.
Avian color expression and perception: is there a carotenoid link?
Authors: Toomey Matthew B. , Ronald Kelly L.
Published: June 2021

Carotenoids color many of the red, orange and yellow ornaments of birds and also shape avian vision. The carotenoid-pigmented oil droplets in cone photoreceptors filter incoming light and are predicted to aid in color discrimination. Carotenoid use in both avian coloration and color vision raises an intriguing question: is the evolution of visual signals and signal perception linked through these pigments? Here, we explore the genetic, physiological and functional connections between these traits. Carotenoid color and droplet pigmentation share common mechanisms of metabolic conversion and are both affected by diet and immune system challenges. Yet, the time scale and magnitude of these effects differ greatly between plumage and the visual system. Recent observations suggest a link between retinal carotenoid levels and color discrimination performance, but the mechanisms underlying these associations remain unclear. Therefore, we performed a modeling exercise to ask whether and how changes in droplet carotenoid content could alter the perception of carotenoid-based plumage. This exercise revealed that changing oil droplet carotenoid concentration does not substantially affect the discrimination of carotenoid-based colors, but might change how reliably a receiver can predict the carotenoid content of an ornament. These findings suggest that, if present, a carotenoid link between signal and perception is subtle. Deconstructing this relationship will require a deeper understanding of avian visual perception and the mechanisms of color production. We highlight several areas where we see opportunities to gain new insights, including comparative genomic studies of shared mechanisms of carotenoid processing and alternative approaches to investigating color vision.
Formulation of Diffraction Intensity of Ionic Plastic Crystal and Its Application to Trimethylethylammonium Bis(fluorosulfonyl)amide
Authors: Nishikawa Keiko , Yamada Taisei , Fujii Kozo , Masu Hyuma , Tozaki Ken-ichi , Endo Takatsugu
Published: June 2021

An ionic plastic crystal (IPC) is defined as a phase of material in which the orientation orders of constituent ions are melted but the gravity centers are ordered. It is formed by near-globular ions, which are violently rotated or largely disordered. Because of the rotation or disorder, structural analysis of an IPC cannot be performed in the same routine fashion as that of an ordinary ordered crystal. Therefore, we formulated diffraction intensities of IPCs consisting of ions which are regarded as statistically spherical, by introducing the structure factor of the components with rotational disorder. The method was applied to the structural study of the IPC phase of trimethylethylammonium bis(fluorosulfonyl)amide ([N1112][FSA]), which is an ionic liquid prototype. As a result, we found that the [FSA]− and the [N1112]+ can be regarded as statistically spherical owing to independent rotation or large disorder around each N atom. In addition, they are arranged in the CsCl-type structure. This model explained well not only the diffraction pattern but also the intensities. This is probably the first report on the diffraction intensity analysis of IPC.
Ru(0)-Catalyzed Synthesis of Borylated-Conjugated Triene Building Blocks by Cross-Dimerization and Their Use in Cross-Coupling Reactions
Authors: Kuramochi Ayumi , Komine Nobuyuki , Kiyota Sayori , Hirano Masafumi
Published: June 2021

Borylated-conjugated polyenes are used widely as synthetic building blocks for the preparation of many biologically active molecules. Nevertheless, access to these building blocks has been limited. In this study, borylated-conjugated trienes were synthesized by Ru-catalyzed cross-dimerizations for use in cross-coupling reactions. A reaction of diphenylacetylene with (E)-butadien-1-ylboronic acid pinacol ester catalyzed by [Ru(naphthalene)(1,5-cod)] (10 mol %) at r.t., in benzene produced (1E,3E,5Z)-5,6-diphenylhexa-1,3,5-trien-1-yl boronic acid pinacol ester within 10 min in 93% yield. A similar treatment using pent-1-yn-1-yl boronic acid diisopropyl ester with methyl (E)-pentadienoate afforded methyl (2E,4E,6E)-7-(diisopropyloxyboraneyl)-6-propylhexa-2,4,6-trienoate in 89% yield. A series of mono- and diborylated-conjugated trienes were synthesized by cross-dimerization and assessed for their potential use in cross-coupling reactions. Using this protocol, the total synthesis of navenone B, a sea slug pheromone, was achieved in only three steps in 45% total yield.
Ελευθερία και δικαιοσύνη στο πλαίσιο της Ανοικτής Κοινωνίας
Authors: Κωστέας Βασίλειος
Published: June 2021

Η διατριβή αυτή αποτελεί μία μελέτη πολιτικής επιστημολογίας και κοινωνιολογίας της επιστήμης, απαντώντας στο επιστημολογικό πρόβλημα του σχετικισμού και του αρνητισμού, το οποίο συνυφαίνεται με συγκεκριμένα πολιτικά και κοινωνικά προβλήματα της εποχής, αντλώντας επιχειρήματα από το ποππεριανό επιστημολογικό πρόγραμμα.
Bayes Lines Tool (BLT): a SQL-script for analyzing diagnostic test results with an application to SARS-CoV-2-testing
Authors: Aukema Wouter , Malhotra Bobby Rajesh , Goddek Simon , Kämmerer Ulrike , Borger Peter , McKernan Kevin , Klement Rainer Johannes
Published: June 2021

The performance of diagnostic tests crucially depends on the disease prevalence, test sensitivity, and test specificity. However, these quantities are often not well known when tests are performed outside defined routine lab procedures which make the rating of the test results somewhat problematic. A current example is the mass testing taking place within the context of the world-wide SARS-CoV-2 crisis. Here, for the first time in history, laboratory test results have a dramatic impact on political decisions. Therefore, transparent, comprehensible, and reliable data is mandatory. It is in the nature of wet lab tests that their quality and outcome are influenced by multiple factors reducing their performance by handling procedures, underlying test protocols, and analytical reagents. These limitations in sensitivity and specificity have to be taken into account when calculating the real test results. As a resolution method, we have developed a Bayesian calculator, the Bayes Lines Tool (BLT), for analyzing disease prevalence, test sensitivity, test specificity, and, therefore, true positive, false positive, true negative, and false negative numbers from official test outcome reports. The calculator performs a simple SQL (Structured Query Language) query and can easily be implemented on any system supporting SQL. We provide an example of influenza test results from California, USA, as well as two examples of SARS-CoV-2 test results from official government reports from The Netherlands and Germany-Bavaria, to illustrate the possible parameter space of prevalence, sensitivity, and specificity consistent with the observed data. Finally, we discuss this tool’s multiple applications, including its putative importance for informing policy decisions.
Ocimum basilicum (kemangi) intervention on powder and microencapsulated Spirulina platensis and its bioactive molecules
Authors: Yuliani Y , Riyadi Putut Har , Dewi Eko Nurcahya , Jaswir Irwandi , Agustini Tri Winarni
Published: June 2021

Background: Spirulina platensis contains several bioactive molecules such as phenol, flavonoid and phycocyanin pigments. This study unveils total phenol, flavonoid, antioxidant activity, phycocyanin content and evaluated encapsulation efficiency from Ocimum basilicum intervention on S. platensis. O. basilicum intervention aims to reduce unpleasant odors from S. platensis that will increase consumption and increase bioactive compounds.  

Methods: The intervention was carried out by soaking a S. platensis control sample (SP) in O. basilicum with a ratio of 1:4 (w/v) and it was then dried (DSB) and microencapsulated by freeze drying methods (MSB) using a combination of maltodextrin and gelatin. Total flavonoid and phenolic analysis with curve fitting analysis used a linear regression approach. Antioxidant activity of samples was analysed with the 2,2’-azino-bis-3-3thylbenzthiazoline-6-sulphonic acid (ABTS) method. Data were analysed using ANOVA at significance level (p < 0.05) followed by Tukey test models using SPSS v.22. 

Results: The result of this study indicated that O. basilicum intervention treatment (DSB) has the potential to increase bioactive compounds such as total phenol, antioxidant activity and phycocyanin, and flavonoid content. Intervention of O. basilicum on S. platensis (DSB) significantly increases total phenol by 48.7% and phycocyanin by 40.7%. This is due to the phenol and azulene compounds in O. basilicum which have a synergistic effect on phenol and phycocyanin in S. platensis. Microencapsulation using a maltodexrin and gelatin coating is effective in phycocyanin protection with an encapsulation efficiency value of 71.58%.  

Conclusion: The intervention of O. basilicum on S. platensis improved the total phenol and phycocyanin content and there is potential for a pharmaceutical product.
Decoupling control algorithm based on numerical orthogonal polynomials for a woofer-tweeter adaptive optics system
Authors: Kong Lingxi , Cheng Tao , Yang Ping , Wang Shuai , Yang Chao , Zhao Mengmeng
Published: June 2021

To resolve cooperative control issues of dual wavefront correctors in generalized irregular pupil regions, we propose a decoupling control algorithm based on numerical orthogonal polynomials (NOP). The proposed algorithm firstly deduces NOP from Zernike polynomials in generalized irregular pupil regions. Then, according to wavefront restoration, different spatial frequency aberrations to different wavefront correctors are assigned precisely. Finally, the algorithm calculates and eliminates the cross-coupling between dual wavefront correctors. As observed in numerical simulations and experiments based on a typical woofer-tweeter (W-T) adaptive optics system, NOP decoupling control algorithm restrains the cross-coupling between woofer and tweeter in generalized irregular pupil regions. Moreover, there are obvious advantages over Zernike polynomials decoupling control algorithm in cross-coupling suppression for various scenarios in irregular pupil regions and restoration orders.
Geometric phase with full-wedge and half-wedge rotation in nonlinear frequency conversion
Authors: Zhao Feiyan , Lü Jiantao , He Hexiang , Zhou Yangui , Fu Shenhe , Li Yongyao
Published: June 2021

When the quasi-phase matching (QPM) parameters of the χ(2) nonlinear crystal rotate along a closed path, geometric phase will be generated in the signal and idler waves that participate in the nonlinear frequency conversion. In this paper, we study two rotation schemes, full-wedge rotation and half-wedge rotation, of the QPM parameters in the process of fully nonlinear three-wave mixing. These two schemes can effectively suppress the uncertainty in creating the geometric phase in the nonlinear frequency conversion process when the intensity of the pump is depleted. The finding of this paper provides an avenue toward constant control of the geometric phase in nonlinear optics applications and quantum information processing.
Birefringence phase-matched direct third-harmonic generation in a ridge optical waveguide based on a KTiOPO4 single crystal
Authors: Vernay Augustin , Boutou Véronique , Félix Corinne , Jegouso David , Bassignot Florent , Chauvet Mathieu , Boulanger Benoit
Published: June 2021

Birefringence phase-matched third-harmonic generation at 1594 nm is performed for the first time in a KTiOPO4 single crystal micrometric ridge waveguide. The energy conversion efficiency reaches 3.4% for a pump energy as low as 2 µJ over a pulse duration of 15 ps at a repetition rate of 10 Hz. Strong agreements between theory and experiments for both phase-matching and conversion efficiency is obtained, which let us envision future triple photon generation quantum experiments.
Terahertz anisotropic response of additively manufactured one-dimensional photonic crystals
Authors: Park Serang , Stinson V. Paige , Boreman Glenn D. , Hofmann Tino
Published: June 2021

A polymer-based, one-dimensional photonic crystal exhibiting anisotropic responses was demonstrated in the terahertz frequency range. The photonic crystal was composed of alternating compact and low-density polymethacrylate layers. The low-density layers consisted of sub-wavelength sized columns, which were slanted 45° with respect to the substrate surface normal to achieve form-birefringence. Normal incidence polarized terahertz transmission measurements were carried out for characterization of the fabricated photonic crystals in the range from 82 to 125 GHz. The experimental data revealed a 2 GHz shift in the center frequency of the photonic bandgap as a function of in-plane orientation, well demonstrating the anisotropic behavior of the fabricated crystal. The transmission data were analyzed using stratified optical layer model calculations. A good agreement was found between the relevant model parameters and the corresponding design parameters.
Non-Hermitian metasurfaces for the best of plasmonics and dielectrics
Authors: Yang Frank , Hwang Alexander , Doiron Chloe , Naik Gururaj V.
Published: June 2021

Materials and their geometry make up the tools for designing nanophotonic devices. In the past, the real part of the refractive index of materials has remained the focus for designing novel devices. The absorption, or imaginary index, was tolerated as an undesirable effect. However, a clever distribution of imaginary index of materials offers an additional degree of freedom for designing nanophotonic devices. Non-Hermitian optics provides a unique opportunity to take advantage of absorption losses in materials to enable unconventional physical effects. Typically occurring near energy degeneracies called exceptional points, these effects include enhanced sensitivity, unidirectional invisibility, and non-trivial topology. In this work, we leverage plasmonic absorption losses (or imaginary index) as a design parameter for non-Hermitian, passive parity-time symmetric metasurfaces. We show that coupled plasmonic-photonic resonator pairs, possessing a large asymmetry in absorptive losses but balanced radiative losses, exhibit an optical phase transition at an exceptional point and directional scattering. These systems enable new pathways for metasurface design using phase, symmetry, and topology as powerful tools.
Statistical image analysis and escort histograms in characterization of articular cartilage repair in a skeleton animal model
Authors: Tomaszewski Ryszard , Dajka Jerzy
Published: June 2021

Statistical image analysis of an ensemble of digital images of histological samples is performed as an auxiliary investigation a result of the recently proposed method of articular cartilage repair utilizing growth plate chondrocytes in a skeleton animal model. A fixed–shift model of maximal likelihood estimates of image histograms applied for monochromatic (grayscale) images or their RGB components confirms the statistically significant effect of the previously proposed medical treatment. The type of staining used to prepare images of histological samples is related to the visibility of the effectiveness of medical treatment. Hellinger distance of escort distributions for maximal likelihood estimates of image histograms of medically treated and control samples is investigated to identify grayscale (or RGB) intensities responsible for statistically significant difference of the estimates. A difference of Shannon entropy quantifying informational content of the histograms allows one to identify staining and image colors which are most suitable to visualize cluster formation typical for articular cartilage repair processes.
Shadowing and shielding: Effective heuristics for continuous influence maximisation in the voting dynamics
Authors: Romero Moreno Guillermo , Chakraborty Sukankana , Brede Markus
Published: June 2021

Influence maximisation, or how to affect the intrinsic opinion dynamics of a social group, is relevant for many applications, such as information campaigns, political competition, or marketing. Previous literature on influence maximisation has mostly explored discrete allocations of influence, i.e. optimally choosing a finite fixed number of nodes to target. Here, we study the generalised problem of continuous influence maximisation where nodes can be targeted with flexible intensity. We focus on optimal influence allocations against a passive opponent and compare the structure of the solutions in the continuous and discrete regimes. We find that, whereas hub allocations play a central role in explaining optimal allocations in the discrete regime, their explanatory power is strongly reduced in the continuous regime. Instead, we find that optimal continuous strategies are very well described by two other patterns: (i) targeting the same nodes as the opponent (shadowing) and (ii) targeting direct neighbours of the opponent (shielding). Finally, we investigate the game-theoretic scenario of two active opponents and show that the unique pure Nash equilibrium is to target all nodes equally. These results expose fundamental differences in the solutions to discrete and continuous regimes and provide novel effective heuristics for continuous influence maximisation.
Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension
Authors: Arrieta Alejandro , Woods John , Wozniak Gregory , Tsipas Stavros , Rakotz Michael , Jay Stephen
Published: June 2021

Previous research indicates that patient self-measured blood pressure (SMBP) is a cost-effective strategy for improving hypertension (HTN) diagnosis and control. However, it is unknown which specific uses of SMBP produce the most value. Our goal is to estimate, from an insurance perspective, the return-on-investment (ROI) and net present value associated with coverage of SMBP devices when used (a) only to diagnose HTN, (b) only to select and titrate medication, (c) only to monitor HTN treatment, or (d) as a bundle with all three uses combined. We employed national sample of claims data, Framingham risk predictions, and published sensitivity-specificity values of SMBP and clinic blood-pressure measurement to extend a previously-developed local decision-analytic simulation model. We then used the extended model to determine which uses of SMBP produce the most economic value when scaled to the U.S. adult population. We found that coverage of SMBP devices yielded positive ROIs for insurers in the short-run and at lifetime horizon when the three uses of SMBP were considered together. When each use was evaluated separately, positive returns were seen when SMBP was used for diagnosis or for medication selection and titration. However, returns were negative when SMBP was used exclusively to monitor HTN treatment. When scaled to the U.S. population, adoption of SMBP would prevent nearly 16.5 million false positive HTN diagnoses, thereby improving quality of care while saving insurance plans $254 per member. A strong economic case exists for insurers to cover the cost of SMBP devices, but it matters how devices are used.
Nonameric structures of the cytoplasmic domain of FlhA and SctV in the context of the full-length protein
Authors: Kuhlen Lucas , Johnson Steven , Cao Jerry , Deme Justin C. , Lea Susan M.
Published: June 2021

Type three secretion is the mechanism of protein secretion found in bacterial flagella and injectisomes. At its centre is the export apparatus (EA), a complex of five membrane proteins through which secretion substrates pass the inner membrane. While the complex formed by four of the EA proteins has been well characterised structurally, little is known about the structure of the membrane domain of the largest subunit, FlhA in flagella, SctV in injectisomes. Furthermore, the biologically relevant nonameric assembly of FlhA/SctV has been infrequently observed and differences in conformation of the cytoplasmic portion of FlhA/SctV between open and closed states have been suggested to reflect secretion system specific differences. FlhA has been shown to bind to chaperone-substrate complexes in an open state, but in previous assembled ring structures, SctV is in a closed state. Here, we identify FlhA and SctV homologues that can be recombinantly produced in the oligomeric state and study them using cryo-electron microscopy. The structures of the cytoplasmic domains from both FlhA and SctV are in the open state and we observe a conserved interaction between a short stretch of residues at the N-terminus of the cytoplasmic domain, known as FlhAL/SctVL, with a groove on the adjacent protomer’s cytoplasmic domain, which stabilises the nonameric ring assembly.
Factors influencing clinical symptoms and treatment of patients with traffic accident injuries: A retrospective chart review with a questionnaire survey
Authors: Kim Kwanghwi , Kwon Ohhoon , Kim Taeyeon , Lee Taegeol , Choi Kihoon , Cho Hyun Woo , Kim Doori , Park Kyoung Sun , Lee Jinho , Shin Byung-Cheul , Ha In-Hyuk
Published: June 2021

This study analyzed factors influencing clinical symptoms and treatment of patients with traffic accident injuries. It used a retrospective chart review and questionnaire survey obtained from 560 patients (266 men and 294 women). It also conducted follow-up observations of progress after car insurance settlements and investigated the usefulness of and patient satisfaction with integrative Korean medicine treatment for traffic accident injuries. Retrospective data of patients admitted for traffic accident injury were obtained. A questionnaire survey was conducted to collect data regarding the degree of traffic accident damage, severity of pain at settlement, any treatment after settlement and duration and cost of such treatment, and patient satisfaction with car insurance services and Korean medicine treatment for traffic accident injury. The results showed no significant association between pain and the degree of damage to the car at the time of traffic accident (P = 0.662), although the degree of damage to the car was more significantly associated with time to reach a car insurance settlement than severity of pain in the patient (P = 0.003). There was no significant association between the degree of damage to the car in a traffic accident and pain after a traffic accident. Greater severity of pain at the time of the car insurance settlement was associated with greater cost and longer time spent in treatment after the car insurance settlement.
Use of comorbidity indices in patients with any cancer, breast cancer, and human epidermal growth factor receptor-2-positive breast cancer: A systematic review
Authors: Salas Maribel , Henderson Mackenzie , Sundararajan Meera , Tu Nora , Islam Zahidul , Ebeid Mina , Horne Laura
Published: June 2021

Objective

To identify comorbidity indices that have been validated in cancer populations, with a focus on breast cancer and human epidermal growth factor receptor-2-positive (HER2+) breast cancer.

Study design and setting

A systematic review of the literature on the use of comorbidity indices in any cancer, breast cancer, and HER2+ breast cancer using Ovid and PubMed.

Results

The final data set comprised 252 articles (252 any cancer, 39 breast cancer, 7 HER2+ breast cancer). The most common cancers assessed were hematologic and breast, and the most common comorbidity index used was the Charlson Comorbidity Index (CCI) or a CCI derivative. Most validity testing of comorbidity indices used predictive validity based on survival outcomes. Hazard ratios for survival outcomes generally found that a higher comorbidity burden (measured by CCI) increased mortality risk in patients with breast cancer. All breast-cancer studies that validated comorbidity indices used CCI-based indices. Only one article validated a comorbidity index in HER2+ breast cancer.

Conclusion

CCI-based indices are the most appropriate indices to use in the general breast-cancer population. There is insufficient validation of any comorbidity index in HER2+ breast cancer to provide a recommendation, indicating a future need to validate these instruments in this population.
Identification and analysis of genes associated with epithelial ovarian cancer by integrated bioinformatics methods
Authors: Gui Ting , Yao Chenhe , Jia Binghan , Shen Keng
Published: June 2021

Background

Though considerable efforts have been made to improve the treatment of epithelial ovarian cancer (EOC), the prognosis of patients has remained poor. Identifying differentially expressed genes (DEGs) involved in EOC progression and exploiting them as novel biomarkers or therapeutic targets is of great value.

Methods

Overlapping DEGs were screened out from three independent gene expression omnibus (GEO) datasets and were subjected to Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses. The protein-protein interactions (PPI) network of DEGs was constructed based on the STRING database. The expression of hub genes was validated in GEPIA and GEO. The relationship of hub genes expression with tumor stage and overall survival and progression-free survival of EOC patients was investigated using the cancer genome atlas data.

Results

A total of 306 DEGs were identified, including 265 up-regulated and 41 down-regulated. Through PPI network analysis, the top 20 genes were screened out, among which 4 hub genes, which were not researched in depth so far, were selected after literature retrieval, including CDC45, CDCA5, KIF4A, ESPL1. The four genes were up-regulated in EOC tissues compared with normal tissues, but their expression decreased gradually with the continuous progression of EOC. Survival curves illustrated that patients with a lower level of CDCA5 and ESPL1 had better overall survival and progression-free survival statistically.

Conclusion

Two hub genes, CDCA5 and ESPL1, identified as probably playing tumor-promotive roles, have great potential to be utilized as novel therapeutic targets for EOC treatment.
Association of the past epidemic of Mycobacterium tuberculosis with mortality and incidence of COVID-19
Authors: Inoue Kazuo , Kashima Saori
Published: June 2021

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created a remarkable and varying impact in every country, inciting calls for broad attention. Recently, the Bacillus Calmette-Guérin (BCG) vaccination has been regarded as a potential candidate to explain this difference. Herein, we hypothesised that the past epidemic ofMycobacterium tuberculosis(M.tuberculosis) may act as a latent explanatory factor for the worldwide differences seen in COVID-19 impact on mortality and incidence. We compared two indicators of past epidemic ofM.tuberculosis, specifically, incidence (90 countries in 1990) and mortality (28 countries in 1950), with the mortality and incidence of COVID-19. We determined that an inverse relationship existed between the past epidemic indicators ofM.tuberculosisand current COVID-19 impact. The rate ratio of the cumulative COVID-19 mortality per 1 million was 2.70 (95% confidence interval [CI]: 1.09–6.68) per 1 unit decrease in the incidence rate of tuberculosis (per 100,000 people). The rate ratio of the cumulative COVID-19 incidence per 1 million was 2.07 (95% CI: 1.30–3.30). This association existed even after adjusting for potential confounders (rate of people aged 65 over, diabetes prevalence, the mortality rate from cardiovascular disease, and gross domestic product per capita), leading to an adjusted rate ratio of COVID-19 mortality of 2.44, (95% CI: 1.32–4.52) and a COVID-19 incidence of 1.31 (95% CI: 0.97–1.78). After latent infection,Mycobacteriumsurvives in the human body and may continue to stimulate trained immunity. This study suggests a possible mechanism underlying the region-based variation in the COVID-19 impact.
Evidence-based practice by physiotherapists in UAE: Investigating behavior, attitudes, awareness, knowledge and barriers
Authors: AlKetbi Hamda , Hegazy Fatma , Alnaqbi Arwa , Shousha Tamer
Published: June 2021

Evidence-based practice (EBP) is an important factor determining the quality of healthcare. The field of physiotherapy is still limited by indirect access in several countries including the United Arab Emirates (UAE) which creates added pressure to justify the merit in its practitioner’s capabilities. This study explores the behavior, attitudes, awareness and knowledge towards EBP among practicing physiotherapists in the UAE. It also enquires about their perception of the barriers in the implementation of EBP. Using a questionnaire survey of 258 physiotherapists, results show that the awareness of EBP is limited to a few terms including EBP, systematic literature review, and random trials while other terms associated with scientific studies are not known well. The attitude towards EBP was found to be significantly related to the knowledge of EBP (r = 0.208) and the perception of barriers to it (r = 0.156). The EBP behavior was found positively related to its knowledge (r = 0.134) and the perception of barriers (r = 0.216). The physiotherapists prefer to use their own experience and books and research articles to apply EBP but do not consider their peers to be as worthy sources as the others. However, their attitudes towards EBP are largely positive though their perception of barriers grows with better knowledge and understanding of EBP. The barriers in the implementation of EBP are a lack of research knowledge and skills, time, support, and resources which indicate opportunities for the decision-makers to improve the adoption of EBP among these professionals. This study concluded that although physiotherapists in the UAE claim awareness about EBP, their knowledge is limited to a few key terms whereas, attention is needed to improve EBP knowledge and practice.
Respiratory virus surveillance in Canada during the COVID-19 pandemic: An epidemiological analysis of the effectiveness of pandemic-related public health measures in reducing seasonal respiratory viruses test positivity
Authors: Park Kyu Young , Seo Sumin , Han Junhee , Park Ji Young
Published: June 2021

Background

Various public health measures have been implemented globally to counter the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this study was to evaluate respiratory virus surveillance data to determine the effectiveness of such interventions in reducing transmission of seasonal respiratory viruses.

Method

We retrospectively analysed data from the Respiratory Virus Detection Surveillance System in Canada, before and during the COVID-19 pandemic, by interrupted time series regression.

Results

The national level of infection with seasonal respiratory viruses, which generally does not necessitate quarantine or contact screening, was greatly reduced after Canada imposed physical distancing and other quarantine measures. The 2019–2020 influenza season ended earlier than it did in the previous year. The influenza virus was replaced by rhinovirus/enterovirus or parainfluenza virus in the previous year, with the overall test positivity remaining at approximately 35%. However, during the 2019–2020 post-influenza period, the overall test positivity of respiratory viruses during the COVID-19 was still low (7.2%). Moreover, the 2020–2021 influenza season had not occurred by the end of February 2021.

Conclusion

Respiratory virus surveillance data may provide real-world evidence of the effectiveness of implemented public health interventions during the current and future pandemics.