bluuebunny/crossref_metadata_2025 huggingface dataset:
KLPPS: A k-Anonymous Location Privacy Protection Scheme via Dummies and Stackelberg Game
Authors: Yang Dongdong , Ye Baopeng , Zhang Wenyin , Zhou Huiyu , Qian Xiaobin
Published: December 2021

Protecting location privacy has become an irreversible trend; some problems also come such as system structures adopted by location privacy protection schemes suffer from single point of failure or the mobile device performance bottlenecks, and these schemes cannot resist single-point attacks and inference attacks and achieve a tradeoff between privacy level and service quality. To solve these problems, we propose a k-anonymous location privacy protection scheme via dummies and Stackelberg game. First, we analyze the merits and drawbacks of the existing location privacy preservation system architecture and propose a semitrusted third party-based location privacy preservation architecture. Next, taking into account both location semantic diversity, physical dispersion, and query probability, etc., we design a dummy location selection algorithm based on location semantics and physical distance, which can protect users’ privacy against single-point attack. And then, we propose a location anonymous optimization method based on Stackelberg game to improve the algorithm. Specifically, we formalize the mutual optimization of user-adversary objectives by using the framework of Stackelberg game to find an optimal dummy location set. The optimal dummy location set can resist single-point attacks and inference attacks while effectively balancing service quality and location privacy. Finally, we provide exhaustive simulation evaluation for the proposed scheme compared with existing schemes in multiple aspects, and the results show that the proposed scheme can effectively resist the single-point attack and inference attack while balancing the service quality and location privacy.
Study on the Universal Tapered Segmental Ring Assembly Simulation Algorithm and Deviation Assessment: A Case Study on Metro Line Tunnel
Authors: Zheng Guoping , Karlovsek Jurij
Published: December 2021

Universal tapered segmental ring system has been adopted to assemble tangent and curve line elements into the shield tunnels through the relative rotation of the adjacent front and rear rings, which simplifies the formwork design, demonstrates strong universality, and is easy for quality assurance. To evaluate the position deviation caused by the taper value and propose the assembly scheme for the contractor, this article developed the universal tapered segmental ring assembly simulation technology. Firstly, the assembly procedure of the universal tapered segmental ring system both in normal case and in special case is introduced, including the interval tunnel of special rings and actual engineering that needs deviation correction. Secondly, relevant core algorithms are introduced in detail, including the coordinate position algorithm of horizontal and vertical curves and computer graphic algorithm of spatial point rotating around any axis. Finally, this article takes a background metro line tunnel as a case to validate the algorithm and illustrate the assessment methodology of universal tapered segmental ring assembly accuracy. The sections with maximum deviation are found as an alert ahead of the shield advancing. In conclusion, the algorithms and methodology proposed in this article illustrate the excellent suitability and robustness in shield tunnels adopting a universal tapered segmental ring system in the stage of both design and construction.
Disparities in Secondary Prevention between Stroke and Coronary Heart Disease in China: Cross-Sectional Community-Based Study, 2014–2016
Authors: Xia Shijun , Wang Chi , Du Xin , Guo Lizhu , Du Jing , Zheng Yang , Wu Shulin , Guang Xuefeng , Zhou Xianhui , Lin Hongbo , Cheng Xiaoshu , Anderson Craig S. , Huffman Mark D. , Dong Jianzeng , Yuan Yiqiang , Ma Changsheng
Published: December 2021

Background: Health care quality and insurance coverage have improved with economic development in China, but the burden of cardiovascular diseases (CVDs) continues to increase with ongoing gaps in prevention. We aimed to compare the uptake of secondary CVD prevention between stroke and coronary heart disease (CHD) patients in China. Methods: In a cross-sectional community-based survey of 47,841 adults (age ≥45 years) in 7 regions of China between 2014 and 2016, we identified those with a history of stroke or CHD to quantify disparities in conventional secondary CVD prevention strategies in multivariable logistic regression models. Results: There were 4,105 and 1,022 participants with a history of stroke and CHD, respectively. Compared to participants with CHD, those with a history of stroke were significantly less likely to be taking blood-pressure-lowering (39.7% vs. 53%), lipid-lowering (13.7% vs. 36.8%), and antiplatelet (20.8% vs. 50.6%) agents, at least one (48.9% vs. 70.8%) or all 3 recommended medicines (6.1% vs. 24.0%), and were less likely to achieve a lipid-cholesterol target (30.3% vs. 44.0%). Participants with a history of stroke achieved less optimal secondary prevention goals for medication use, either from any (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.44–0.66) or all 3 medications (aOR 0.27, 95% CI 0.20–0.36), as well as better blood pressure (aOR 0.81, 95% CI 0.66–0.98) and low-density lipoprotein cholesterol (aOR 0.34, 95% CI 0.27–0.43) levels of control. There were no significant differences in weight, smoking, or physical activity between the groups. Conclusion: Stroke patients had lower use of secondary CVD-preventive medication and achieved lower levels of risk factor control than those of CHD patients in China. Nationwide disease-specific strategies, and better education of participants and health care providers, may narrow these gaps.
Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients
Authors: Chanprapaph Kumutnart , Limtong Preeyachat , Ngamjanyaporn Pintip , Suchonwanit Poonkiat
Published: December 2021

Background: Hair and scalp involvement is prevalent in connective tissue diseases (CTDs). Trichoscopic features may provide a diagnostic implementation and enable differentiation among CTDs; however, a direct comparison of these signs among CTD patients is lacking. Objectives: To compare trichoscopic findings in dermatomyositis (DM), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc) as well as determine their distinctive features and associations with disease activity. Methods: Trichoscopic photographs were taken from DM, SLE, and SSc patients and further evaluated for hair shaft and scalp surface abnormalities. Data regarding patients’ clinical manifestations, laboratory results, and disease activity were analyzed. Results: One hundred fifty participants, consisting of 30 DM, 60 SLE, and 60 SSc patients, were included. Perifollicular red-brown pigmentation, brown scattered pigmentation, and white patches were exclusive findings in DM, SLE, and SSc, respectively (p < 0.001). A multinomial logistic regression analysis revealed that DM demonstrated higher odds for having microaneurysmal blood vessels than SLE and SSc (odds ratio [OR] = 22.22, 95% confidence interval [CI] = 1.73–285.13, p = 0.017, and OR = 15.34, 95% CI = 1.36–177.59, p = 0.029, respectively). Polymorphic vessels forming a telangiectatic network suggested SSc over SLE (OR = 12.83, 95% CI = 1.35–121.98, p = 0.026), while avascular areas were more pronounced in SSc than DM and SLE (OR = 43.24, 95% CI = 5.17–361.67, p = 0.001, and OR = 0.03, 95% CI = 0.01–0.24, p = 0.001, respectively). In a quantile regression analysis, perifollicular red-brown pigmentation, reduction in hair diameter, and the absence of thin arborizing vessels were linked to higher disease activity in DM, SLE, and SSc, respectively (all p < 0.05). Conclusions: Trichoscopy is a valuable tool possessing diagnostic and prognostic values for CTDs. Specific trichoscopic features allow adequate distinction between DM, SLE, and SSc and may help identify active disease.
Radiofrequency Thermoablation and Hypofractionated Radiotherapy Combined Treatment for Bone Metastases: A Retrospective Study
Authors: Piras Antonio , Boldrini Luca , Menna Sebastiano , Sanfratello Antonella , D’Aviero Andrea , Guarini Aurelia , Toscano Angelo , Gebbia Vittorio , Angileri Tommaso , Daidone Antonino
Published: December 2021

Introduction: Bone metastases (BMs) are the common cause of cancer-related pain, as approximately 45% of cancer patients suffer from bone pain (BP). Radiotherapy (RT) is well established as BP treatment strategy; also, other approaches have been shown to be effective in this setting. Radiofrequency thermoablation (RFA) in a combined strategy with RT appears to be feasible and effective in the treatment of metastatic BP ensuring a better quality of life. Aim of this retrospective study was to describe a case series of patients with painful osteolytic lesions at risk of fracture treated with the RFA-RT combined approach, analyzing local control and pain control as outcomes. Methods: Data of all patients with BM treated with combined approach in our center from April 2016 to June 2020 were retrospectively analyzed. Patients underwent RFA followed by cementoplasty on the same day and RT in a second phase. RT dose ranged between 30 and 37.5 Gy in 5/10 fractions. BP was evaluated according to the numeric rating scale (NRS), at the beginning of treatment and at 1, 2, 3, 6, 9, and 12 months from the end of combined treatment. Results: A total of 27 patients were treated from April 2016 to June 2020 with RFA-RT combined approach. The large majority of patients underwent stereotactic body radiotherapy (SBRT) (23/27). All patients experienced an NRS value decrease >2 at 1 month and between the first and second months. NRS mean value reached 0 at 3, 6, 9, and 12 months’ evaluations. Discussion/Conclusion: The results of this retrospective analysis of patients treated with RFA-RT combined approach for BP support its safety and efficacy in terms of pain reduction. SBRT role in this combined approach has to be investigated in randomized trials.
Abstract 114: Common Diagnostic Tests Do Not Guide Treatment for Acute Respiratory Conditions in Patients Hospitalized with Heart Failure
Authors: Dharmarajan Kumar , Strait Kelly M , Lagu Tara , Li Shu-Xia , Krumholz Harlan M
Published: December 2021

Background:
Patients hospitalized with heart failure (HF) are often treated for concomitant respiratory disease due to diagnostic uncertainty or coexisting conditions. Testing with natriuretic peptides, chest radiograph (CXR), and transthoracic echocardiogram (TTE) is common and may influence these treatment decisions. We examined hospital variation in diagnostic testing among inpatients with HF and how testing relates to additional treatment for coexisting respiratory conditions.

Methods:
We identified hospitalizations with a principal discharge diagnosis of HF from 2009-2010 Premier, Inc. hospitals and age>18y, known admission source, non-pediatric attending physician, receipt of HF treatment (loop diuretics, inotropes, or IV vasodilators), and >2 day hospital stay. We excluded hospitalizations with present-on-admission codes for infections besides pneumonia or inflammatory, allergic, or autoimmune conditions besides COPD. For hospital days 1-2, we calculated each hospital’s proportion of admissions receiving selected diagnostic tests (natriuretic peptides, CXR, TTE) and respiratory treatments (short-acting inhaled bronchodilators, antibiotics, high-dose steroids). Treatment categories were mutually exclusive. The proportion of admissions receiving diagnostic testing and respiratory treatments was calculated for each hospital, and summary statistics were reported across hospitals.

Results:
We identified 164,494 HF hospitalizations among 368 hospitals. Natriuretic peptide testing across hospitals was done in 81% to 92% (IQR; median 87%) of HF admissions, CXR testing was done in 87% to 94% (IQR; median 91%), and TTE testing was done in 39% to 56% (IQR; median 48%). The median proportion of hospitalizations receiving diagnostic testing at the hospital level was similar among patients treated only for HF and those also treated with at least one respiratory therapy (respectively, 88% vs. 90% for natriuretic peptides, 90% vs. 93% for CXR, and 51% vs. 49% for TTE). Detailed description of diagnostic testing among each treatment group at the hospital level is provided in the accompanying table.

Conclusion:
Hospital use of relatively inexpensive diagnostic tests among HF inpatients including natriuretic peptides and CXR is frequent with little inter-hospital variation. In contrast, more expensive testing with TTE is less common though more variable across hospitals. Although often ordered, natriuretic peptides, CXR, and TTE do not appear to influence physicians’ decisions to treat only for heart failure or also for potential coexisting respiratory conditions.
Introduction
Authors: Ditchfield Simon
Published: December 2021

After a discussion of the twentieth anniversary issue, the author of the book which is the subject of our “round table” review of this twenty-fifth anniversary issue: Merry Wiesner Hanks’ What is Early Modern History (2021) is introduced. This is followed by a brief account of the rationale behind the foundation of the JEMH in the 1990s and how, from the very first issue, the journal has tried to decolonize our understanding of the period 1300–1800, as exemplified by Antony Black’s warning that: “we should stop selling off second-hand concepts to unsuspecting non-European cultures.” Passing comment is made on the chronological (as well as geographical) breadth of the coverage of the JEMH which accords well with the recent merger of the Centers for Medieval and Early Modern History at the University of Minnesota (to form the Center for Premodern Studies). At a time when the advocacy of the study of pre-modern history is vital as never before, this situates the JEMH very well. The introduction closes with a series of acknowledgements and thanks not only directed to the editorial team both in Minnesota and Leiden for the support they have given me, as editor-in-chief, since July 2010, but also to the numerous authors and readers of manuscripts who have made the journal what it is today.
Economic and Social History
Authors: Riello Giorgio
Published: December 2021

The last quarter of a century has been one of great changes for the field of early modern economic history. My argument is that, in this period, early modern economic history has shown a remarkably innovative spirit. However, this is most apparent not at the core of the discipline, but in how economic history has interacted with other branches of early modern history, be they social, cultural, environmental, or material. This argument is supported by the analysis of quantitative evidence. I then move on to consider two important developments in early modern economic history since the late 1990s: global economic history and the history of consumption and trade. This article concludes with a reflection on recent developments in the so-called New History of Capitalism (NHC) and on studies of pre-modern inequality, sustainability, and the environment.
Religious, Intellectual, and Cultural History
Authors: Vélez Karin
Published: December 2021

Inspired by Merry Wiesner-Hanks’ What is Early Modern History? chapter on religious, intellectual, and cultural history, this reflection considers the current state of these three subfields. It advocates for early modern historians to expand their bounding of religion beyond Christianity and Europe. It is also a call to extend the list of agents credited with the production of science, Enlightenment, and “culture.”
Medieval juristic regulae: unity or disunity?
Authors: Kotlyar Ilya A.
Published: December 2021

This article is dedicated to the regulae iuris in general, and their role in medieval jurisprudence in particular. After providing a survey of the state-of-the-art literature on regulae and discussions surrounding them, the article provides arguments in support of the thesis that the use of existing regulae and the creation of new ones were an integral part of the method of medieval jurisprudence, itself part of the general medieval dialectical method of reasoning. The article also discloses the parameters and interesting preliminary results of an ongoing research project on regulae iuris in the University of Ghent.
“Where to Publish?” Avoiding Mediocrity for Academic Staff Promotion at the University of Dar es Salaam
Authors: Makulilo Alexander
Published: December 2021

Does “where to publish” affect academic staff promotion outcome? Using rational choice theory and the University of Dar es Salaam as case study, this article analyses the law and practice associated with academic staff promotion regarding “where to publish”. The article finds that the University has relatively well elaborate and adequate promotion guidelines and institutional frameworks to guide on “where to publish” in line with its vision of becoming a world-class university. Nonetheless, through series of workshops with staff and heads of department as well as interviews with the University management, it was observed that there is still little understanding of “where to publish” among staff although the situation is progressively changing. Some staff prefer predatory journals due to ignorance, frequent failures and lack of confidence to publish in credible journals. Consequently, the annual promotion rate remains low suggesting high rejection of publications by the University due to predatory nature of media of publication and failure by majority staff to publish.
Pleioblastus triangulata (Poaceae: Bambusoideae), a new combination for Indosasa triangulata based on morphological and molecular evidence
Authors: NIU ZHENG-YANG , TONG YI-HUA , XIA NIAN-HE
Published: December 2021

This study aims to end the debate whether Indosasa triangulata belongs to Indosasa or Pleioblastus. The evidence from our morphological study and molecular phylogenetic analyses clearly indicate that Indosasa triangulata should be a member of Pleioblastus, rather than Indosasa, and is a distinct species close to Pleioblastus maculatus and P. oleosus. Thus, it is transferred from Indosasa to Pleioblastus in this study. A detailed description as well as two color plates of this species is also provided.
A new saprotrophic species of Amanita (Amanitaceae, Agaricales) from Inner Mongolia, China
Authors: LIU XIAOLIANG , BAU TOLGOR , YANG ZHU L.
Published: December 2021

A new saprotrophic species in Amanita sect. Lepidella, A. orientisororia, was discovered on lawn and sand dunes in Northeast China. This species was macroscopically characterized by a small white pileus, conical to subconical to pyramidal volval remnants on pileal surface, large broadly ellipsoid to ellipsoid basidiospores measuring 9–13×7–9.5 μm, and the common presence of clamps in all parts of basidiomata. It was described and compared with related species in the genus, based on morphological characteristics and phylogenetic evidence inferred from sequences of the nuclear ribosomal internal transcribed spacer (ITS) and the large subunit of the nuclear ribosomal region (nrLSU).
Attitudes Towards Assisted Dying in Dementia: A Focus Group Study with Younger and Older Adults
Authors: Thompson Freya , Nelson Alexandra R. , Coats Rachel O. , Johnson Judith
Published: December 2021

Objectives: To explore attitudes towards assisted dying in dementia (ADID) and the rationales underlying these attitudes, among younger and older adults.

Method: We conducted separate focus groups with younger ( n = 11) and older adults ( n = 14) in the United Kingdom with personal or professional experience of dementia. Discussions were prompted by two vignettes depicting scenarios of ADID. The data were transcribed and analysed using thematic analysis.

Results: Though sometimes stronger in the older adults, many of the attitudes and underlying rationales were common across the age groups. Analysis generated four themes: ‘Perceptions of the disease’, ‘A case for empowerment’, ‘The morality of killing’ and ‘Logistical complexities’.

Conclusions: For some, ADID was a hopeful alternative to the challenges they had witnessed in dementia. For others, the logistical problems surrounding ADID were insurmountable. Discussions were informed and insightful, highlighting the importance of including the general public in this ongoing debate.
HARMONIC: A multimodal dataset of assistive human–robot collaboration
Authors: Newman Benjamin A. , Aronson Reuben M. , Srinivasa Siddhartha S. , Kitani Kris , Admoni Henny
Published: December 2021

We present the Human And Robot Multimodal Observations of Natural Interactive Collaboration (HARMONIC) dataset. This is a large multimodal dataset of human interactions with a robotic arm in a shared autonomy setting designed to imitate assistive eating. The dataset provides human, robot, and environmental data views of 24 different people engaged in an assistive eating task with a 6-degree-of-freedom (6-DOF) robot arm. From each participant, we recorded video of both eyes, egocentric video from a head-mounted camera, joystick commands, electromyography from the forearm used to operate the joystick, third-person stereo video, and the joint positions of the 6-DOF robot arm. Also included are several features that come as a direct result of these recordings, such as eye gaze projected onto the egocentric video, body pose, hand pose, and facial keypoints. These data streams were collected specifically because they have been shown to be closely related to human mental states and intention. This dataset could be of interest to researchers studying intention prediction, human mental state modeling, and shared autonomy. Data streams are provided in a variety of formats such as video and human-readable CSV and YAML files.
Optimal allocation of product reliability using novel multi-population particle swarm optimization algorithm
Authors: Zhang Wei , Ran Yan , Zhang Genbao , Shao Yimin
Published: December 2021

Reliability optimal allocation is a critical method in engineering and operation fields to improve and ensure product quality. However, conventional model generally uses the single objective with research and development (R & D) cost or product reliability. Moreover, the popular particle swarm optimization (PSO) algorithm solving the model has insufficient global search ability. In this paper, a novel reliability optimal allocation method is developed based on double-objective model and multi-population PSO (MPPSO) algorithm. The cost function is established considering all the cost related to reliability using analytical hierarchical process (AHP) and ordered weighted averaging (OWA) operator. Multi-population particle swarm optimization algorithm is developed based on information exchange mechanism among subpopulations. In the algorithm, the inertia weight is optimized by chaotic map, and different mutation operations are carried out on the subpopulations. An illustrative example, which implements to computer numerical control (CNC) grinding machine, is presented to illustrate the practicality and application of the proposed method. Finally, the comparison and analysis are implemented to show the advantage of proposed model and MPPSO algorithm.
Refractory cytokine release reaction to Nivolumab: Following desensitization algorithms to optimize the management of drug hypersensitivity
Authors: Sánchez Togneri Laura , Duran Ignacio , Rodríguez Fernández Fernando , de las Vecillas Leticia
Published: December 2021

Introduction

Nivolumab is a fully human IgG4 monoclonal antibody (moAb) against programmed cell death protein 1, approved for the treatment of over ten types of cancer. The use of this and other moAbs has augmented considerably in recent years and this in turn has caused an increase of hypersensitivity reactions (HSR).

Case report

We present the case of a patient with metastatic renal cell cancer (RCC) who developed a grade 3 cytokine release reaction (CRR) to nivolumab. The maintenance of the symptoms despite of the administration of symptomatic treatment and slowing down the infusion rate of nivolumab during the 1st and 2nd reaction required an allergy evaluation of our patient.

Management and outcome

Skin testing to Nivolumab with negative results and baseline tryptase within the normal range were observed during the allergy workout. A desensitization protocol with specific premedication was applied to reintroduce the moAb, with no further issues. Moreover, a follow up of the patient in the oncology setting was done showing disease stabilization.

Discussion

The CRR should be treated by desensitization, in contrast to infusion reactions. The diagnosis of CRR phenotype is based on the clinical presentation and recently, and elevation of IL-6 levels has been shown to be a useful biomarker along with negative skin testing. We can conclude that after a HSR and an appropriate allergy diagnosis of CRR, nivolumab can be safely reintroduced by desensitization without reducing the target dose or the appropriate dilution concentration.
COVID-19–Related Stigma and Mental Health of Children and Adolescents During Pandemic
Authors: Ozbaran Burcu , Turer Furkan , Yilancioglu Hazal Y. , Kose Sezen , Senturk Pilan Birsen , Guzel Ozge , Baskol Dilsah , Polat Furkan , Bildik Tezan , Sertoz Saziye R. , Arda Bilgin , Ozhan Mustafa H.
Published: December 2021

This cross-sectional study aimed to evaluate depression and anxiety symptoms of the children/grandchildren of COVID-19 patients, children/grandchildren of healthcare workers who have not infected COVID-19, and children/grandchildren of the control group. Parent and children’s perception about COVID-19–related stigma is also investigated and compared between groups. The perception about COVID-19–related stigma between different age and gender groups among children also investigated and compared. The mental health of the 71 participants aged 6–18 years was evaluated via a telemedicine-based semi-structured interview between March and April 2020. Children’s Depression Inventory (CDI), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), and COVID-19–Related Stigma Form were administered to the participants. A significant negative correlation was found between age and separation anxiety disorder ( p = .005) and a significant positive correlation was found between age and generalized anxiety disorder ( p = .035) in the SCARED-Child report. Generalized anxiety disorder was found to be higher in females compared to males. A significant difference was found between the groups of parents in the COVID-19–Related Stigma Form. Patients infected with COVID-19, healthcare workers, and the control group have different perceptions about COVID-19–related stigma. The age of the children have an impact on stigma perceptions. Anxiety symptoms of children affected by age and gender. Future studies are recommended to determine the other factors associated with perceptions about COVID-19–related stigma among children and parents.
Bilingual speech in Jaru–Kriol conversations: Codeswitching, codemixing, and grammatical fusion
Authors: Dahmen Josua
Published: December 2021

Aims and objectives:

Language contact in the Yaruman community of Western Australia has led to prevalent bilingual practices between the endangered language Jaru and the creole language Kriol. This study examines ordinary conversations in the community and investigates whether the observable bilingual practices are interactionally relevant, and whether codemixing has led to the emergence of a conventionalised mixed language.

Approach:

The research is based on a qualitative analysis of bilingual speech in natural conversation. The approach combines the methodological framework of interactional linguistics with an analysis of the grammatical structures of conversational data.

Data and analysis:

The analysed data consist of two hours and thirty minutes of transcribed video recordings, comprising 13 casual multi-party conversations involving all generations in the Yaruman community. The recordings were made using lapel microphones and two high-definition cameras.

Findings:

Bilingual Jaru–Kriol speakers use codeswitching as an interactional resource for a range of conversational activities. In many cases, however, speakers’ code choices are not interactionally relevant. Instead, codemixing is often oriented to as a normative way of speaking and participants exploit their full linguistic repertoire by relatively freely combining elements from both languages. There are also signs of morphological fusion in the mixed speech of younger Jaru speakers, who more frequently combine Kriol verb structure and Jaru nominal morphology. However, this morphological split is not fully conventionalised and variation is still substantial.

Originality:

The bilingual speech continuum is supported by the analysis of conversational data in a situation of language shift. This article shows that fusion involving core grammatical categories can occur among a subgroup of speakers without developing into a community-wide mixed language.

Significance:

The study contributes to a better understanding of community bilingualism and bilingual practices in a situation of language shift. It demonstrates how codeswitching, codemixing, and grammatical fusion can co-exist in a bilingual community.
Reliability aspects in a dynamic time-to-failure degradation-based model
Authors: Kayid Mohamed , Alshagrawi Lolwa
Published: December 2021

Although the ordinary time-to-failure degradation-based model has been extensively used in practice, it also has its limitations. In this paper, we consider a time-to-failure degradation-based model recently proposed by Albabtain et al., where a limiting conditional survival probability entertains further stochastic relationships between the failure time and the degree of degradation. In the particular case where the limited survival probability is available for the proportional failure rate model, the model is developed using two well-known degradation paths, namely the additive degradation path and the multiplicative degradation path, each of which has a component of random variation. Preservation of various stochastic orders and aging properties of the random variation component in the model in the described setting is developed. To illustrate the model in the modified design, some examples of interest in reliability are presented.
Use of high-flow nasal cannula and intravenous propofol sedation while performing flexible video bronchoscopy in the intensive care unit: Case reports
Authors: Briones-Claudett Killen H , Briones-Claudett Mónica H , López Briones Bertha , Briones Zamora Killen H , Briones Marquez Diana C , Orozco Holguin Lourdes A , Villavicencio Maria Fernanda , Grunauer Andrade Michelle
Published: December 2021

Flexible video bronchoscopy is a procedure that plays an important role in diagnosing various types of pulmonary lesions and abnormalities. Case 1 is a 68-year-old male patient with a lesion in the right lung apex of approximately 4 mm × 28 mm with atelectasis bands due to a crash injury. High-flow system with 35 L/min and fraction of inspired oxygen (FiO2) 0.45 and temperature of 34 °C was installed prior to the video bronchoscopy. SpO2 was maintained at 98%–100%. The total dose of sedative was 50 mg of propofol. In Case 2, a 64-year-old male patient with bronchiectasis, cystic lesions and pulmonary fibrosis of the left lung field was placed on a high-flow system with 45 L/min and 0.35 FiO2 at a temperature of 34 °C. SpO2 was maintained at 100%. The total duration of the procedure was 25 min; SpO2 of 100% was sustained with oxygenation during maintenance time with the flexible bronchoscope within the airway. The total dose of propofol to reach the degree of desired sedation was 0.5–1 mg/kg. Both patients presented hypotension. For the patient of case 1, a vasopressor (norepinephrine at doses of 0.04 µg/kg/min) was given, and for the patient of case 2, only saline volume expansion was used. The video bronchoscopy with propofol sedation and high-flow nasal cannula allows adequate oxygenation during procedure in the intensive care unit.
Patient Perceived Involvement in Their Treatment is Influenced by Factors Other Than Independently Rated Clinician Communication Effectiveness
Authors: van Rossenberg Luke X. , Ring David , Jacobs Xander , Sulkers George , van Heijl Mark , van Hoorn Bastiaan T.
Published: December 2021

We analyzed (1) the correspondence of patient and clinician perceived patient involvement in decision making and ratings made by independent observer's independent ratings, as well as (2), factors associated with patient-perceived involvement, among patients seeking hand specialty care. During 63 visits, the patient, their hand specialist, and 2 independent observers each rated patient involvement in decision making using the 9-item shared decision-making questionnaire for patients and clinicians, and the 5-item observing patient involvement scale (OPTION-5). We also measured health literacy (Newest Vital Sign), patient and visit characteristics (gender, age, race, years of education, occupation, marital status, and family present). There was no correlation ( ρ = 0.17; P = .17) between patient (median 42, IQR 36-44.5) and clinician (38, IQR 35-43) ratings of patient involvement in decision making. Independently rated patient involvement correlated moderately with specialist ( ρ = 0.35, P <.01), but not patient ( ρ = 0.22, P = .08) ratings. The finding that patient perception of their involvement in decision making has little or no relationship to independently rated clinician communication effectiveness and effort, suggests that other aspects of the encounter—such as empathy and trust—may merit investigation as mediators of the patient agency.
The association between Fc gamma RIIb expression levels and chronic hepatitis B virus infection progression
Authors: Jin Jinglan , Liu Yuwei , Xu Xiaotong , Wang Zhongfeng , Niu Junqi
Published: December 2021

Background

Fc gamma receptor IIb (FcγRIIb) is an important inhibitory receptor that plays vital roles in regulating various immune response processes and the pathogenesis of many infectious diseases. The purpose of our research was to evaluate FcγRIIb expression in serum and liver biopsy specimens from hepatitis B virus (HBV)-infected patients and to explore the association of FcγRIIb with chronic HBV infection.

Methods

Enzyme-linked immunosorbent assay (ELISA) was adopted to measure the serum FcγRIIb levels in 119 HBV-infected patients and 24 healthy controls. An immunohistochemical method was then employed to identify FcγRIIb expression in biopsy specimens from patients with chronic hepatitis B (CHB). The integrated optical density (IOD) value was measured to represent FcγRIIb expression levels.

Results

Serum FcγRIIb levels were decreased in CHB patients compared to controls (P < 0.001). The FcγRIIb levels in the CHB patient group were remarkably lower than those in the HBV carrier group (P < 0.001). In addition, FcγRIIb levels were negatively associated with AST and ALT (r = −0.3936, P = 0.0063; r = −0.3459, P = 0.0097, respectively). The IOD values of FcγRIIb expression in the moderate and severe CHB groups were significantly lower than those in the control group (P = 0.006 and P < 0.001, respectively). The FcγRIIb level tended to be lower with pathological changes related to hepatitis. Furthermore, correlation analysis revealed that FcγRIIb had negative correlations with AST and ALT (r = −0.688, P = 0.0016; r = −0.686, P = 0.0017, respectively) but a positive association with the platelet count (r = 0.6464, P = 0.0038).

Conclusions

FcγRIIb levels are significantly related to chronic HBV infection and the progression of CHB. Changes in FcγRIIb may affect the progression of liver inflammation and fibrosis in CHB patients.
Identifying youth at high risk for sexually transmitted infections in community-based settings using a risk prediction tool: a validation study
Authors: Kranzer Katharina , Simms Victoria , Dauya Ethel , Olaru Ioana D. , Dziva Chikwari Chido , Martin Kevin , Redzo Nicol , Bandason Tsitsi , Tembo Mandikudza , Francis Suzanna C. , Weiss Helen A. , Hayes Richard J. , Mavodza Constancia , Apollo Tsitsi , Ncube Gertrude , Machiha Anna , Ferrand Rashida Abbas
Published: December 2021

Background 

Chlamydia trachomatis(CT) andNeisseria gonorrhoeae(NG) are the most common bacterial sexually transmitted infections (STIs) worldwide. In the absence of affordable point-of-care STI tests, WHO recommends STI testing based on risk factors. This study aimed to develop a prediction tool with a sensitivity of > 90% and efficiency (defined as the percentage of individuals that are eligible for diagnostic testing) of < 60%.

Methods

This study offered CT/NG testing as part of a cluster-randomised trial of community-based delivery of sexual and reproductive health services to youth aged 16–24 years in Zimbabwe. All individuals accepting STI testing completed an STI risk factor questionnaire. The outcome was positivity for either CT or NG. Backwards-stepwise logistic regression was performed with p ≥ 0.05 as criteria for exclusion. Coefficients of variables included in the final multivariable model were multiplied by 10 to generate weights for a STI risk prediction tool. A maximum likelihood Receiver Operating Characteristics (ROC) model was fitted, with the continuous variable score divided into 15 categories of equal size. Sensitivity, efficiency and number needed to screen were calculated for different cut-points.

Results

From 3 December 2019 to 5 February 2020, 1007 individuals opted for STI testing, of whom 1003 (99.6%) completed the questionnaire. CT/NG prevalence was 17.5% (95% CI 15.1, 19.8) (n = 175). CT/NG positivity was independently associated with being female, number of lifetime sexual partners, relationship status, HIV status, self-assessed STI risk and past or current pregnancy. The STI risk prediction score including those variables ranged from 2 to 46 with an area under the ROC curve of 0.72 (95% CI 0.68, 0.76). Two cut-points were chosen: (i) 23 for optimised sensitivity (75.9%) and specificity (59.3%) and (ii) 19 to maximise sensitivity (82.4%) while keeping efficiency at < 60% (59.4%).

Conclusions

The high prevalence of STIs among youth, even in those with no or one reported risk factor, may preclude the use of risk prediction tools for selective STI testing. At a cut-point of 19 one in six young people with STIs would be missed.
Predictive role of lymphoscintigraphy undergoing lymphovenous anastomosis in patients with lower extremity lymphedema: a preliminary study
Authors: Kwon Hye Ryeong , Hwang Ji Hye , Mun Goo-Hyun , Hyun Seung Hyup , Moon Seung Hwan , Lee Kyung-Han , Choi Joon Young
Published: December 2021

Background

We investigated whether preoperative lymphoscintigraphy could predict the treatment response of unilateral lymphovenous anastomosis (LVA) in patients with lower extremity lymphedema.

Materials and methods

A total of 17 patients undergoing lymphoscintigraphy subsequent to LVA was included. As qualitative lymphoscintigraphic indicators, ilioinguinal lymph node uptake, main lymphatic vessel, collateral vessel, and four types of dermal backflow patterns (absent; distal only; proximal only; whole lower limb) were evaluated. Lymph node uptake ratio, extremity uptake ratio, and injection site clearance ratio were obtained as quantitative lymphoscintigraphic indicators at 1 and 2-h after injection. To evaluate therapy response, the volume difference ratio of the whole lower limb at 3 months (early response) and 1 year (late response) was measured. Volume difference ratios (continuous variable and binary variable with a cut-off value of zero) were compared according to the lymphoscintigraphic variables.

Results

The group with whole lower limb dermal backflow had a greater volume change than the other groups (p = 0.047). The group with dermal backflow in the whole lower limb OR only in the distal part had a higher rate of volume reduction than the group with dermal backflow only in the proximal part OR absent (p = 0.050). The 2-h extremity uptake ratio was the only indicator that positively correlated with early and late volume difference ratio (p = 0.016, p = 0.001). The rate of volume decrease at 1 year was high in patients with high 2-h extremity uptake ratio (p = 0.027). As the amount of dermal backflow increases, the postoperative therapeutic effect increases (p = 0.040).

Conclusions

Preoperative lymphoscintigraphy is useful to predict both early and late therapy response in patients with lower extremity lymphedema undergoing LVA. Both dermal backflow pattern and extremity uptake ratio may be predictive lymphoscintigraphic indicators.
Pneumoconiosis computer aided diagnosis system based on X-rays and deep learning
Authors: Yang Fan , Tang Zhi-Ri , Chen Jing , Tang Min , Wang Shengchun , Qi Wanyin , Yao Chong , Yu Yuanyuan , Guo Yinan , Yu Zekuan
Published: December 2021

Purpose

The objective of this study is to construct a computer aided diagnosis system for normal people and pneumoconiosis using X-raysand deep learning algorithms.

Materials and methods

1760 anonymous digital X-ray images of real patients between January 2017 and June 2020 were collected for this experiment. In order to concentrate the feature extraction ability of the model more on the lung region and restrain the influence of external background factors, a two-stage pipeline from coarse to fine was established. First, the U-Net model was used to extract the lung regions on each sides of the collection images. Second, the ResNet-34 model with transfer learning strategy was implemented to learn the image features extracted in the lung region to achieve accurate classification of pneumoconiosis patients and normal people.

Results

Among the 1760 cases collected, the accuracy and the area under curve of the classification model were 92.46% and 89% respectively.

Conclusion

The successful application of deep learning in the diagnosis of pneumoconiosis further demonstrates the potential of medical artificial intelligence and proves the effectiveness of our proposed algorithm. However, when we further classified pneumoconiosis patients and normal subjects into four categories, we found that the overall accuracy decreased to 70.1%. We will use the CT modality in future studies to provide more details of lung regions.
Neopterin and kynurenic acid as predictors of stroke recurrence and mortality: a multicentre prospective cohort study on biomarkers of inflammation measured three months after ischemic stroke
Authors: Alme Katinka Nordheim , Ulvik Arve , Askim Torunn , Assmus Jörg , Mollnes Tom Eirik , Naik Mala , Næss Halvor , Saltvedt Ingvild , Ueland Per-Magne , Knapskog Anne-Brita
Published: December 2021

Background

Chronic low-grade inflammation is associated with both ischemic stroke and sedentary behaviour. The aim of this study was to investigate the predictive abilities of biomarkers of inflammation and immune modulation associated with sedentary behaviour for ischemic stroke recurrence and mortality in a stroke population.

Methods

Patients admitted to hospital for acute stroke were recruited to the prospective multicentre cohort study, the Norwegian Cognitive Impairment After Stroke (Nor-COAST) study, from May 2015 until March 2017. Patients with ischemic stroke, blood samples available from the three-month follow-up, and no stroke recurrence before the three-month follow-up were included. Serum was analysed for C-reactive protein (CRP) with high-sensitive technique, and plasma for interleukin-6 (IL-6), neopterin, pyridoxic acid ratio index (PAr-index: 4-pyridoxic acid: [pyrioxal+pyridoxal-5′-phosphate]) and kynurenic acid (KA). Ischemic stroke recurrence and death were identified by the Norwegian Stroke Registry and the Cause of Death Registry until 31 December 2018.

Results

The study included 354 patients, 57% male, mean age 73 (SD 11) years, mean observation time 2.5 (SD 0.6) years, and median National Institute of Health Stroke Scale of 0 (IQR 1) at three months. CRP was associated with mortality (HR 1.40, CI 1.01, 1.96, p = 0.046), and neopterin was associated with the combined endpoint (recurrent ischemic stroke or death) (HR 1.52, CI 1.06, 2.20, p = 0.023), adjusted for age, sex, prior cerebrovascular disease, modified Rankin Scale, and creatinine. When adding neopterin and KA to the same model, KA was negatively associated (HR 0.57, CI 0.33, 0.97, p = 0.038), and neopterin was positively associated (HR 1.61, CI 1.02, 2.54, p = 0.040) with mortality. Patients with cardioembolic stroke at baseline had higher levels of inflammation at three months.

Conclusion

Neopterin might be a valuable prognostic biomarker in stroke patients. The use of KA as a measure of anti-inflammatory capacity should be investigated further.

Trial registration

The study was registered at Clinicaltrials.gov (NCT02650531). First posted on 08/01/2016.
Predictors of maternal and neonatal complications in women with severe valvular heart disease during pregnancy in Tunisia: a retrospective cohort study
Authors: Hammami Rania , Ibn Hadj Mohamed Ali , Mejdoub Yosra , Bahloul Amine , Charfeddine Selma , Abid Leila , Kammoun Samir , Dammak Abdallah , Chaabene Kais
Published: December 2021

Background

Severe valvular heart disease, especially stenosis, is a contraindication for conception according to the World Health Organization. This is still encountered in countries with a high rheumatic fever prevalence. The objective of this study was to determine predictors of maternal cardiac, obstetric and neonatal complications in pregnant women with severe valve disease.

Methods

This is an observational retrospective cohort study of all pregnant women with severe heart valvulopathy who gave birth between 2010 and 2017.

Results

We included 60 pregnancies in 54 women. Cardiac complications occurred during 37 pregnancies (61%). In multivariate analysis, parity (aOR =2.41, 95% CI[1.12–5.16]), revelation of valvulopathy during pregnancy (aOR = 6.34; 95% CI[1.26–31.77]), severe mitral stenosis (aOR = 6.98, 95% CI[1.14–41.05],) and systolic pulmonary arterial pressure (aOR =1.08, 95% CI[1.01–1.14]) were associated with cardiac complications. Obstetrical complications were noted during 19 pregnancies (31.8%). These complications were associated with nulliparity (aOR = 5.22; 95% CI[1.15–23.6]), multiple valve disease (aOR = 5.26, 95% CI[1.19–23.2]), systolic pulmonary arterial pressure (aOR =1.04, 95% CI[1.002–1.09]), and treatment with vitamin K antagonists (aOR = 8.71, 95% CI[1.98–38.2]). Neonatal complications were noted in 39.3% of newborns (n = 61) and these were associated with occurrence of obstetric complications (aOR = 16.47, 95% CI[3.2–84.3]) and revelation of valvulopathy during pregnancy (aOR = 7.33, 95% CI[1.4–36.1]).

Conclusions

Revelation of valvular heart disease during pregnancy is a predictor of not only cardiac but also neonatal complications. Valvular heart disease screening during pre-conceptional counseling is thus crucial.