bluuebunny/crossref_metadata_2025 huggingface dataset:
Design of Solar Powered Greywater Treatment Unit for Residential Applications
Authors: Waris Abdul , Ghaith Fadi A.
Published: September 2022

Many countries around the world depend primarily on seawater desalination process which is an energy-intensive process and incorporates high electricity consumption. In United Arab Emirates (UAE), desalinated seawater accounts for almost 89.9% of the country’s water needs. The average residential water consumption is 550 liters per capita per day which is almost 82% higher than the world average.

This paper aims to design a greywater treatment plant which is fully powered by solar photovoltaic (PV) panels. The proposed water treatment plant consists of a three-step filtration process to treat greywater. Initially, the collected greywater from households is pumped to a multimedia filter to reduce the level of turbidity followed by pumping the water at high pressure through Reverse Osmosis unit and finally passing the water in the chlorination chamber to remove odor and prevent microbial growth.

The proposed system was implemented to the case study of a villa community located in Dubai which comprises 38 villas and accommodates a total of about 152 residents. The proposed water treatment plant has a capacity of producing about 83 m3 of clean water per day at a high recovery rate of 67%. The solar system proved to be efficient by providing energy of 57397 kWh which was enough to power entirely the greywater treatment plant.

Cost analysis was carried out to assess the economic feasibility of the proposed plant. The system resulted in a tangible reduction in carbon dioxide emissions of 204 ton/year.
Wind Farm Clustering Methods for Power Forecasting
Authors: Goudarzi Navid , Ziaei Dorsa
Published: September 2022

This paper initiates the development of a hybrid model for wind farm output power forecasting based on spatiotemporal parameters of a studied site. The time-dependency of local wind patterns is addressed by developing three wind farm clustering, K-means, Agglomerative, and Density-Based Spatial Clustering of Applications with Noise. Clustered wind turbines obtain a more accurate representation for wind power forecasting. The results for this work will be later used to extract key features based on singular value decomposition (SVD) and build the forecast model. the emphasis in this paper is on the clustering method and not the forecasting algorithms. Hourly-wind data of an onshore wind farm in the US for one year are used for developing this model. The results will be further used in improving wind clustering algorithms, feature identification, and time-dependency analyses of short- to medium wind forecasting.
Meropenem plus Ceftaroline Is Active against Enterococcus faecalis in an
In Vitro
Pharmacodynamic Model Using Humanized Dosing Simulations
Authors: Cusumano Jaclyn A. , Daffinee Kathryn E. , Piehl Emily C. , García-Solache Mónica , Desbonnet Charlene , Rice Louis B. , LaPlante Kerry L.
Published: September 2022

The standard of care for serious
Enterococcus faecalis
infections is ampicillin plus ceftriaxone. Ampicillin’s inconvenient dosing schedule, drug instability, allergy potential, along with ceftriaxone’s high risk for
Clostridioides difficile
infection and its promotion of vancomycin-resistant enterococci (VRE), led our team to explore alternative options.
Model for Evaluating Antimicrobial Therapy To Prevent Life-Threatening Bacterial Infections following Exposure to a Medically Significant Radiation Dose
Authors: Phipps Andrew J. , Bergmann Julie N. , Albrecht Mark T. , Singh Vijay K. , Homer Mary J.
Published: September 2022

More evidence is needed to support recommendations for medical management of acute radiation syndrome (ARS) and associated infections resulting from a radiological/nuclear event. While current guidelines recommend the administration of antibiotics to chemotherapy patients with febrile neutropenia, the clinical benefit is unclear for acute radiation injury patients.
In Vitro
Mechanisms of Resistance Development to Imipenem-Relebactam in KPC-Producing Klebsiella pneumoniae
Authors: Findlay Jacqueline , Rens Céline , Poirel Laurent , Nordmann Patrice
Published: September 2022

Carbapenem-resistant
Enterobacterales
, such as KPC-producing
Klebsiella pneumoniae
, represent a major threat to public health. Novel drug combinations including imipenem-relebactam (IPM-REL) have recently been introduced and have been shown to exhibit excellent activity toward such strains.
RNase HI Depletion Strongly Potentiates Cell Killing by Rifampicin in Mycobacteria
Authors: Al-Zubaidi Abeer , Cheung Chen-Yi , Cook Gregory M. , Taiaroa George , Mizrahi Valerie , Lott J. Shaun , Dawes Stephanie S.
Published: September 2022

Multidrug-resistant (MDR) tuberculosis (TB) is defined by the resistance of
Mycobacterium tuberculosis
, the causative organism, to the first-line antibiotics rifampicin and isoniazid. Mitigating or reversing resistance to these drugs offers a means of preserving and extending their use in TB treatment.
Heterologous Assembly of the Type VI Secretion System Empowers Laboratory Escherichia coli with Antimicrobial and Cell Penetration Capabilities
Authors: Cui Yang , Pei Tong-Tong , Liang Xiaoye , Li Hao , Zheng Hao-Yu , Dong Tao
Published: September 2022

The T6SS is a powerful and versatile protein delivery system. However, the complexity of its macromolecular structure and gene regulation makes it not a trivial task to reconstitute the T6SSs of pathogens in a nonpathogenic host.
Functional
mgrA
Influences Genetic Changes within a Staphylococcus aureus Cell Population over Time
Authors: Lee James , Carda-Diéguez Miguel , Žiemytė Miglė , Vreugde Sarah , Cooksley Clare , Crosby Heidi A. , Horswill Alexander R. , Mira Alex , Zilm Peter S. , Kidd Stephen P.
Published: September 2022

Within a bacterial population, a stochastically generated heterogeneity of phenotypes allows continual survival against current and future stressors. The generation of a sub-population of quasi-dormant Small Colony Variants (SCV) in
Staphylococcus aureus
is such a mechanism, allowing for persistent or relapse of infection despite initial intervention seemingly clearing the infection.
Control of HIV-1 Replication by CD8
+
T Cells Specific for Two Novel Pol Protective Epitopes in HIV-1 Subtype A/E Infection
Authors: Nguyen Hung The , Kuse Nozomi , Zhang Yu , Murakoshi Hayato , Maeda Yosuke , Tamura Yoshiko , Maruyama Rie , Tran Giang Van , Nguyen Trung Vu , Nguyen Kinh Van , Oka Shinichi , Chikata Takayuki , Takiguchi Masafumi
Published: September 2022

It is expected that HIV-1-specific CD8
+
T cells that effectively suppress HIV-1 replication will contribute to HIV-1 vaccine development and therapy to achieve an HIV cure. T cells specific for protective epitopes were identified in HIV-1 subtype B and C infections but not in subtype A/E infection, which is epidemic in Southeast Asia.
Phage-Plasmids Spread Antibiotic Resistance Genes through Infection and Lysogenic Conversion
Authors: Pfeifer Eugen , Bonnin Rémy A. , Rocha Eduardo P. C.
Published: September 2022

The dissemination of antimicrobial resistance is a major threat to global health. Here, we show that a group of temperate bacterial viruses (phages), termed phage-plasmids, commonly encode different and multiple types of resistance genes of high clinical importance, often in integrons.
Interferon-Inducible E3 Ligase RNF213 Facilitates Host-Protective Linear and K63-Linked Ubiquitylation of Toxoplasma gondii Parasitophorous Vacuoles
Authors: Hernandez Dulcemaria , Walsh Stephen , Saavedra Sanchez Luz , Dickinson Mary S. , Coers Jörn
Published: September 2022

Globally, approximately one out of three people become infected with the obligate intracellular parasiteToxoplasma.These infections are typically asymptomatic but can cause severe disease and mortality in immunocompromised individuals. Infections can also be passed on from mother to fetus during pregnancy, potentially causing miscarriage or stillbirth.
Complete Genome Sequence of
Rhizobium
sp. Strain RCAM05350 from Shulgan-Tash Karst Cave
Authors: Sazanova Anna , Safronova Vera , Belimov Andrey , Gogolev Yuri , Chirak Elizaveta , Karlov Denis , Kuznetsova Irina , Kuzmina Lyudmila , Tikhonovich Igor
Published: September 2022

The Shulgan-Tash cave is an extremely interesting object for scientific research, located in the Republic of Bashkortostan (Russia). In this article, we report the complete genome sequence of
Rhizobium
sp. strain RCAM05350 isolated from the “cave silver” biofilms. The sequence was obtained using Oxford Nanopore Technologies MinION.
Truncation of
MAT1-2-7
Deregulates Developmental Pathways Associated with Sexual Reproduction in Huntiella omanensis
Authors: Wilson A. M. , Wingfield M. J. , Wingfield B. D.
Published: September 2022

Secondary mating-type genes are being described almost as quickly as new fungal genomes are being sequenced. Understanding the functions of these genes has lagged behind their description, in part due to limited taxonomic distribution, lack of conserved functional domains, and difficulties with regard to genetic manipulation protocols.
Enterovirus D68 Infection in Human Primary Airway and Brain Organoids: No Additional Role for Heparan Sulfate Binding for Neurotropism
Authors: Sridhar Adithya , Depla Josse A. , Mulder Lance A. , Karelehto Eveliina , Brouwer Lieke , Kruiswijk Leonie , Vieira de Sá Renata , Meijer Adam , Evers Melvin M. , van Kuppeveld Frank J. M. , Pajkrt Dasja , Wolthers Katja C.
Published: September 2022

Recent outbreaks of enterovirus D68, a nonpolio enterovirus, is associated with a serious neurological condition in young children, acute flaccid myelitis (AFM). As there is no antiviral treatment or vaccine available for EV-D68 it is important to better understand how EV-D68 causes AFM and why only recent outbreaks are associated with AFM.
Vitamin D, parathyroid hormone, glucose metabolism and incident diabetes in the multiethnic study of atherosclerosis
Authors: Williams Amaris , Zhao Songzhu , Brock Guy , Kline David , Echouffo-Tcheugui Justin Basile , Effoe Valery S , Bertoni Alain G , Michos Erin D , de Boer Ian H , Kestenbaum Bryan , Golden Sherita H , Joseph Joshua J
Published: September 2022

Introduction

Higher concentrations of serum 25-hydroxyvitamin D (25(OH)D) and lower concentrations of parathyroid hormone (PTH) are associated with lower insulin resistance and incident diabetes in non-Hispanic White and Hispanic Americans. Results are mixed in other populations, with no observational studies in a large multiethnic cohort. The association of serum 25(OH)D with diabetes may vary by adiposity level.

Research design and methods

Among 5611 participants in the Multi-Ethnic Study of Atherosclerosis without diabetes at baseline, cross-sectional associations of serum 25(OH)D with homeostasis model assessment of insulin resistance (HOMA-IR) and HOMA-β were examined using linear regressions. The association of 25(OH)D with incident diabetes over 9 years was examined using Cox proportional hazard regression.

Results

Black Americans had the highest proportion of individuals with 25(OH)D<20 ng/mL (61%) and White Americans had the least (17%). Serum 25(OH)D was inversely associated with HOMA-IR in fully adjusted models (−0.34% difference in HOMA-IR per ng/mL higher 25(OH)D, p<0.0001). Longitudinally, a 1 ng/mL higher serum 25(OH)D was associated with 2% lower risk of incident diabetes (HR 0.982, CI 0.974 to 0.991), and a 1 pg/mL higher serum PTH was associated with 1% higher risk of incident diabetes (HR 1.007, CI 1.004 to 1.010), both prior to adjustment for waist circumference. After adjusting for waist circumference, a 1 ng/mL higher 25(OH)D was associated with 1% lower risk of incident diabetes (HR 0.991, CI 0.983 to 1.000). The magnitude of association of serum 25(OH)D with incident diabetes was largest at lower waist circumference (p for interaction=0.025). There was no heterogeneity by race/ethnicity (p=0.317).

Conclusions

Serum 25(OH)D is inversely associated with insulin resistance and incident diabetes in a diverse cohort, including non-Hispanic White, Black, Hispanic and Chinese Americans. Future research should explore mechanisms for the interaction between serum 25(OH)D and adiposity in this relationship.
Safety of routine childhood vaccine coadministration versus separate vaccination
Authors: Bauwens Jorgen , de Lusignan Simon , Weldesselassie Yonas Ghebremichael , Sherlock Julian , Künzli Nino , Bonhoeffer Jan
Published: September 2022

Introduction

As new vaccines are developed more vaccine coadministrations vaccines are being offered to make delivery more practical for health systems and patients. We compared the safety of coadministered vaccines with separate vaccination for 20 coadministrations by considering nine types of adverse events following immunisation (AEFI).

Methods

Real-life immunisation and adverse event data for this observational cohort study were extracted from the Oxford-Royal College of General Practitioners Research and Surveillance Centre for children registered in the database between 2008 and 2018. We applied the self-controlled case series method to calculate relative incidence ratios (RIR) for AEFI. These RIRs compare the RI of AEFI following coadministration with the RI following separate administration of the same vaccines.

Results

We assessed 3 518 047 adverse events and included 5 993 290 vaccine doses given to 958 591 children. 17% of AEFI occurred less and 11% more frequently following coadministration than would have been expected based on the RIs following separate vaccinations, while there was no significant difference for 72% of AEFI. We found amplifying interaction effects for AEFI after five coadministrations comprising three vaccines: for fever (RIR 1.93 (95% CI 1.63 to 2.29)), rash (RIR 1.49 (95% CI 1.29 to 1.74)), gastrointestinal events (RIR 1.31 (95% CI 1.14 to 1.49)) and respiratory events (RIR 1.27 (1.17–1.38)) following DTaP/IPV/Hib+MenC+ PCV; gastrointestinal events (RIR 1.65 (95% CI 1.35 to 2.02)) following DTaP/IPV/Hib+MenC+ RV; fever (RIR 1.44 (95% CI 1.09 to 1.90)) and respiratory events (RIR 1.40 (95% CI 1.25 to 1.57)) following DTaP/IPV/Hib+PCV+ RV; gastrointestinal (RIR 1.48 (95% CI 1.20 to 1.82)) and respiratory events (RIR 1.43 (95% CI 1.26 to 1.63)) following MMR+Hib/MenC+PCV; gastrointestinal events (RIR 1.68 (95% CI 1.07 to 2.64)) and general symptoms (RIR 11.83 (95% CI 1.28 to 109.01)) following MMR+MenC+PCV. Coadministration of MMR+PCV led to more fever (RIR 1.91 (95% CI 1.83 to 1.99)), neurological events (RIR 2.04 (95% CI 1.67 to 2.49)) and rash (RIR 1.06 (95% CI 1.01 to 1.11)) compared with separate administration, DTaP/IPV/Hib+MMR to more musculoskeletal events (RIR 3.56 (95% CI 1.21 to 10.50)) and MMR+MenC to more fever (RIR 1.58 (95% CI 1.37 to 1.82)). There was no indication that unscheduled coadministrations are less safe than scheduled coadministrations.

Conclusion

Real-life RIRs of AEFI justify coadministering routine childhood vaccines according to the immunisation schedule. Further research into the severity of AEFI following coadministration is required for a complete understanding of the burden of these AEFI.
Operationalising fairness in medical AI adoption: detection of early Alzheimer’s disease with 2D CNN
Authors: Heising Luca , Angelopoulos Spyros
Published: September 2022

Objectives

To operationalise fairness in the adoption of medical artificial intelligence (AI) algorithms in terms of access to computational resources, the proposed approach is based on a two-dimensional (2D) convolutional neural networks (CNN), which provides a faster, cheaper and accurate-enough detection of early Alzheimer’s disease (AD) and mild cognitive impairment (MCI), without the need for use of large training data sets or costly high-performance computing (HPC) infrastructures.

Methods

The standardised Alzheimer’s Disease Neuroimaging Initiative (ADNI) data sets are used for the proposed model, with additional skull stripping, using the Brain Extraction Tool V.2approach. The 2D CNN architecture is based on LeNet-5, the Leaky Rectified Linear Unit activation function and a Sigmoid function were used, and batch normalisation was added after every convolutional layer to stabilise the learning process. The model was optimised by manually tuning all its hyperparameters.

Results

The model was evaluated in terms of accuracy, recall, precision and f1-score. The results demonstrate that the model predicted MCI with an accuracy of 0.735, passing the random guessing baseline of 0.521 and predicted AD with an accuracy of 0.837, passing the random guessing baseline of 0.536.

Discussion

The proposed approach can assist clinicians in the early diagnosis of AD and MCI, with high-enough accuracy, based on relatively smaller data sets, and without the need of HPC infrastructures. Such an approach can alleviate disparities and operationalise fairness in the adoption of medical algorithms.

Conclusion

Medical AI algorithms should not be focused solely on accuracy but should also be evaluated with respect to how they might impact disparities and operationalise fairness in their adoption.
Predicting surgical department occupancy and patient length of stay in a paediatric hospital setting using machine learning: a pilot study
Authors: Barak Corren Yuval , Merrill Joshua , Wilkinson Ronald , Cannon Courtney , Bickel Jonathan , Reis Ben Y
Published: September 2022

Objective

Early and accurate prediction of hospital surgical-unit occupancy is critical for improving scheduling, staffing and resource planning. Previous studies on occupancy prediction have focused primarily on adult healthcare settings, we sought to develop occupancy prediction models specifically tailored to the needs and characteristics of paediatric surgical settings.

Materials and methods

We conducted a single-centre retrospective cohort study at a surgical unit in a tertiary-care paediatric hospital in Boston, Massachusetts, USA. We developed a hierarchical modelling framework for predicting next-day census using multiple types of data—from bottom-up patient-specific orders and procedures to top-down temporal variables and departmental admission statistics.

Results

The model predicted upcoming admissions and discharges with a median error of 17%–21% (2–3 patients per day), and next-day census with a median error of 7% (n=3). The primary factors driving these predictions included day of week and scheduled surgeries, as well as procedure duration, procedure type and days since admission. We found that paediatric surgical procedure duration was highly predictive of postoperative length of stay.

Discussion

Our hierarchical modelling framework provides an overview of the factors driving capacity issues in the paediatric surgical unit, highlighting the importance of both top-down temporal features (eg, day of week) as well as bottom-up electronic health records (EHR)derived features (eg, orders for patient) for predicting next-day census. In the practice, this framework can be implemented stepwise, from top to bottom, making it easier to adopt.

Conclusion

Modelling frameworks combining top-down and bottom-up features can provide accurate predictions of next-day census in a paediatric surgical setting.
Designing an electronic medical record alert to identify hospitalised patients with HIV: successes and challenges
Authors: El-Nahal Walid , Grader-Beck Thomas , Gebo Kelly , Holmes Elizabeth , Herne Kayla , Moore Richard , Thompson David , Berry Stephen
Published: September 2022

Objectives

Electronic medical record (EMR) tools can identify specific populations among hospitalised patients, allowing targeted interventions to improve care quality and safety. We created an EMR alert using readily available data elements to identify hospitalised people with HIV (PWH) to facilitate a quality improvement study intended to address two quality/safety concerns (connecting hospitalised PWH to outpatient HIV care and reducing medication errors). Here, we describe the design and implementation of the alert and analyse its accuracy of identifying PWH.

Methods

The EMR alert was designed to trigger for at least one of four criteria: (1) an HIV ICD-10-CM code in a problem list, (2) HIV antiretroviral medication(s) on medication lists, (3) an HIV-1 RNA assay ordered or (4) a positive HIV-antibody result. We used manual chart reviews and an EMR database search to determine the sensitivity and positive predictive value (PPV) of the overall alert and its individual criteria.

Results

Over a 24-month period, the alert functioned as intended, notifying an intervention team and a data abstraction team about admissions of PWH. Manual review of 1634 hospitalisations identified 18 PWH hospitalisations, all captured by the alert (sensitivity 100%, 95% CI 82.4% to 100.0%). Over the 24 months, the alert triggered for 1191 hospitalisations. Of these, 1004 were PWH hospitalisations, PPV=84.3% (95% CI 82.2% to 86.4%). Using fewer criteria (eg, using only ICD-10-CM codes) identified fewer PWH but increased PPV.

Conclusion

An EMR alert effectively identified hospitalised PWH for a quality improvement intervention. Similar alerts might be adapted as tools to facilitate interventions for other chronic diseases.
Effect of digital-enabled multidisciplinary therapy conferences on efficiency and quality of the decision making in prostate cancer care
Authors: Ronmark Erik , Hoffmann Ralf , Skokic Viktor , de Klerk-Starmans Maud , Jaderling Fredrik , Vos Pieter , Gayet Maudy C W , Hofstraat Hans , Janssen Marco , Akre Olof , Vincent Per Henrik
Published: September 2022

Objectives

To investigate the impact on efficiency and quality of preprostatectomy multidisciplinary therapy conferences (MDT) at Karolinska University Hospital related to the use of a digital solution compared with standard of care. Further, to explore whether gains in MDT efficiency and quality impact oncological or functional patient outcomes.

Methods

We conducted a prospective, observational study of preoperative prostate cancer MDT at Karolinska between February 2017 and March 2021, including 1329 patients. We compared efficiency and quality of the standard MDT and the MDT using the digital solution IntelliSpace Precision Medicine Multidisciplinary Team Orchestrator (ISPM) based on the previously used MDT-MODe approach. Clinical and patient-reported functional outcomes were derived from the medical records and the Swedish National Prostate Cancer Register.

Results

While ISPM was used during the MDT meeting, the time spent per patient was reduced by 24% (p<0.001) and most of the MDT-MODe items were scored significantly higher. There was a reduction in pelvic lymph-node dissection procedures in the ISPM cohort (p=0.001) and an increased proportion of unilateral nerve-sparing procedures (p=0.005), while all other outcome-related measures were not significantly different between the two patient groups.

Discussion and conclusion

To increase the value of the MDT, all data relevant for treatment decision need to be purposefully presented and compiled, which also enables secondary use of the data.

The use of a digital solution during preoperative MDTs for prostate cancer decision making at Karolinska University Hospital improved the efficiency and quality of this multidisciplinary team meeting without impacting patient outcomes.
4 Early identification of high-risk individuals for combination monoclonal antibody therapy is feasible by SARS-CoV-2 anti-spike antibody specific lateral flow assay
Authors: Pallett Scott JC , Rayment Michael , Randell Paul , Davies Gary W , Moore Luke SP
Published: September 2022

Background

Combination monoclonal antibody therapy has recently been approved for prevention and treatment of severe COVID-19 infection in the UK. Available data suggests benefit is limited to those yet to mount an effective immune response from natural infection or vaccination, but concern exists around ability to make timely assessment of immune status of community-based patients.

Methods

Healthcare workers were invited to undergo paired laboratory-based and rapid point-of- care (POC) lateral flow anti-spike antibody testing. Three commercial POC tests were selected to represent currently available testing methods: a split IgM/IgG anti-spike antibody test, an anti-receptor binding domain total antibody test and an anti-spike neutralisation assay. Qualitative POC colourmetric band intensities were independently scored and correlated with quantitative IgG neutralising antibody titres (Abbott Architect SARS-CoV-2 IgG Quant II chemiluminescent microparticle immunoassay [CMIA]). CMIA titres were correlated with the World Health Organisation international reference standard for neutralising antibody. Negative controls were carried out using 2018 pre-pandemic sera and post-pandemic individuals with negative CMIA results (target population).

Results

190 individuals (median 40 years, IQR 29-49; 76.2% female) underwent paired testing, with a further 40 pre-pandemic sera tested. Assays demonstrated high performance characteristics: split IgM/IgG assay sensitivity 96.2% (95%CI 92.4.5–98.5), specificity 100.0% (95%CI 91.8–100.0); anti-receptor binding domain total antibody assay sensitivity 100.0% (95%CI 95.5–100.0), specificity 100.0% (95%CI 69.2–100.0). The neutralising antibody assay had a specificity of 97.0% (95%CI 84.2–99.9%) and strongly correlated with neutralising antibody titre (p<0.001). Probability for matched paired results was significant (McNemar’s p<0.001) while band intensity correlated strongly with neutralising titres (p<0.0001). Positive and negative predictive values for total antibody and neutralising assays were both >99%.

Conclusions

POC assays were found to be reliable predictors of both antibody status and broadly of neutralising antibody titre. Anti-S POC assays have potential to act as suitable alternatives for rapid identification of community patient immune status at presentation.
Ranibizumab port delivery system: a clinical perspective
Authors: Eichenbaum David A , Ahmed Abrahim , Hiya Farhan
Published: September 2022

Age-related macular degeneration (AMD) represents a leading cause of blindness worldwide. Neovascular AMD (nAMD) is a subtype of AMD most frequently treated with intravitreal anti-vascular endothelial growth factor (aVEGF) injections, which has allowed for patients to maintain vision that would have otherwise been lost. However, the need for frequent intravitreal injections for optimal results poses a risk for undertreatment in nAMD patients due to the high treatment burden associated with current aVEGF therapy. Many novel agents and pathways are being explored and targeted for less burdensome treatment options, one of which is the ranibizumab port delivery system (PDS). The PDS is a surgically implanted, refillable device that allows for the sustained release of ranibizumab, a widely used aVEGF agent, into the vitreous cavity. Positive results non-inferior to monthly ranibizumab injections in both phase II and phase III clinical trials allowed for FDA approval of the device with refill intervals of 6 months, which represents the longest approved treatment interval to date for nAMD therapy. This article reviews the need for a durable nAMD treatment option in real-world practice, the clinical trial and extension study data for the PDS, the risk of adverse events and safety profile of the PDS and the potential clinical role of the PDS in answering the real-world needs of nAMD treatment. In addition, other pipeline sustained-treatment modalities are discussed in the context of ongoing clinical trials.
Evaluation of the introduction of QOF quality improvement modules in English general practice: early findings from a rapid, qualitative exploration of implementation
Authors: Bramwell Donna , Hotham Sarah , Peckham Stephen , Checkland Kath , Forbes Lindsay J L
Published: September 2022

Background

A 2018 review of the English primary care pay-for-performance scheme, the Quality and Outcomes Framework, suggested that it should evolve to better support holistic, patient-centred care and leadership for quality improvement (QI). From 2019, as part of the vision of change, financially incentivised QI cycles (initially in prescribing safety and end-of-life care), were introduced into the scheme.

Objectives

To conduct a rapid evaluation of general practice staff attitudes, experiences and plans in relation to the implementation of the first two QI modules. This study was commissioned by NHS England and will inform development of the QI programme.

Methods

Semistructured telephone interviews were conducted with 25 practice managers from a range of practices across England. Interviews were audio recorded with consent and transcribed verbatim. Anonymised data were reflexively thematically analysed using the framework method of analysis to identify common themes across the interviews.

Results

Participants reported broadly favourable views of incentivised QI, suggesting the prescribing safety module was easier to implement than the end-of-life module. Additional staff time needed and challenges of reviewing activities with other practices were reported as concerns. Some highlighted that local flexibility and influence on subject matter may improve the effectiveness of QI. Several questioned the choices of topic, recognising greater need and potential for improving quality of care in other clinical areas.

Conclusion

Practices supported the idea of financial incentivisation of QI, however, it will be important to ensure that focus on QI cycles in specific clinical areas does not have unintended effects. A key issue will be keeping up momentum with the introduction of new modules each year which are time consuming to carry out for time poor General Practitioners (GPs)/practices.
Calibration of resistance factors for design of shallow foundations against sliding
Authors: He Pengpeng , Fenton Gordon A.
Published: September 2022

The design of shallow foundations typically proceeds by using the load and resistance factor design (LRFD) methodology to avoid various limit states with some probability. This paper looks at the sliding limit state of shallow foundations, and the sliding resistance factors required for the LRFD approach are estimated using reliability analyses of surface strip foundations. Cohesive and frictional soils are separately studied under wind loading conditions. Monte Carlo simulations are used to estimate the sliding failure probability of foundation designs on cohesive soils, and an analytical method is developed for frictional soils. The results indicate the existence of a “worst case” correlation length for cohesive soils, and the sliding resistance factor required to achieve target maximum lifetime failure probabilities is around 0.4–0.65 for moderate soil variability. For frictional soils, the required sliding resistance factor is about 0.5–0.85 for ν ϕ′ = 0.15. Overall, the sliding resistance factors recommended here agree well with the resistance factors of ϕ gu = 0.6 for cohesive soils and ϕ gu = 0.8 for frictional soils stipulated by geotechnical LRFD code provisions in Canada. The analyses can be used to estimate the reliability of current designs and can also aid the calibration of geotechnical design codes.
Investigation into the photoluminescence and energy levels in bismuth-doped Sr3MgSi2O8 through first principles calculations
Authors: Song Ting , Zhang Meng , Zhu Hancheng , Zhang Xinyang
Published: September 2022

In this paper, influences of Bi3+ doping on the crystal structure and electronic band structure of Sr3MgSi2O8, and charge transfer process from the valence band to Bi3+ (CT) and from Bi3+ to the conduction band in Sr3MgSi2O8 (MMCT) have been investigated through first principles calculations. The total energy calculations make clear the location of the doped Bi3+ in Sr3MgSi2O8 that the doped Bi3+ preferred to take up the Mg2+ sites and form BiO6. The calculated results of electronic band structure and density of states reveal the constituents that make up the conduction band and valence band of Sr3MgSi2O8 and Sr3Mg0.875Bi0.125Si2O8, respectively. In addition, a defect level appears in the band gap of Sr3Mg0.875Bi0.125Si2O8, which is originated from the p orbit of the doped Bi3+. Also, the calculated absorptions of Sr3MgSi2O8 and Sr3Mg0.875Bi0.125Si2O8 show a gradually shifted absorption band from deep UV region to the blue area with increasing absorption intensity. The above results make clear of the fact that first principles calculations can be useful in investigating the properties of Bi3+ doped luminescent materials and designing new kinds of luminescent host materials.
Evaluation of effect of moisture on fatigue performance of pavement designed with recycled asphalt mixtures
Authors: Bharath G. , Kakade Vijay , Reddy K.S. , Tandon Vivek , Reddy M.A.
Published: September 2022

The moisture resistance of dense- and gap-graded bituminous mixes prepared with the replacement of virgin aggregates and fresh bitumen with reclaimed asphalt pavement (RAP) was evaluated using indirect tensile strength (ITS) and resilient modulus ( Mr). The mechanistic analysis was performed to estimate the effect of moisture resistance on the fatigue performance of thin and thick pavement sections designed with dense- and gap-graded bituminous mixes. The ITS ratio and Mr ratio results indicate that the resilient modulus ratio is more sensitive to moisture damage in bituminous mixes than the ITS ratio. In addition, the results of the fatigue life ratio indicated that the gap-graded mix prepared with different RAP content has better resistance to moisture-related cracking in thick pavement sections than the dense-graded mix. However, the effectiveness of gap-graded and dense-graded mixes prepared with different RAP content on moisture-related cracking depended on the subgrade strength for thin pavement sections.
An extension of binary cyclotomic sequences having order 2lt
Authors: Ghosh Debashis
Published: September 2022

Several reasonably cyclotomic sequences are constructed by cyclotomic classes having good pseudo-randomness property. In this paper, we derive the linear complexity of an extended binary cyclotomic sequences of order [Formula: see text] over finite field having period [Formula: see text]. Our result shows that these sequences have higher linear complexity, which can resist linear attack.
Investigation of Small-Scaled Soil Structure Model under Earthquake Loads via Small Shaking Table Tests
Authors: El Hoseny Mohammed , Ma Jianxun , Luo Dong , Yue Yanchao
Published: September 2022

This paper aims to determine the appropriate scaling coefficient rigorously in the dynamic analysis of structures via small shaking table tests to represent the full real case while considering the soil-structure interaction problem. In addition, we investigate the seismic effects of the superstructure with flexible and fixed bases. To achieve this purpose, seven stories of concrete moment-resisting frames supported on silty clay soil were scaled. According to the shaking table specifications, a small-scaled soil-structure model was executed with a scaled factor of 1 : 50. Consequently, the scale steel skeleton model was built to represent the real superstructure. In addition, the laminar soil container for the soil block was constructed to reduce undesirable boundary effects. Three earthquakes have been applied at the superstructure base as a fixed base and at the bottom of the soil block in the soil structure system as a flexible base. The numerical simulations are implemented for scaled and real models. According to obtained results from experimental and numerical investigations, the numerical model achieved good results with experimental observation. In addition, the small scaling factor of 1 : 50 can represent the seismic response of full construction conditions with acceptable precision. It is observed that the flexible base has overestimated in lateral displacement of the real superstructure compared with a fixed base, in which the maximum amplification percentage at the roof floor level reaches up to 98% under seismic load. Otherwise, the shear force distribution along the height and base shear of the superstructure with a flexible base decreases compared with a fixed base. The maximum reduction percentage is 38% under seismic load. Consequently, the safety and cost of the superstructure are affected.
Clinical Risk Score for Predicting Vascular Dementia after Ischemic Stroke in Thailand
Authors: Dharmasaroja Pornpatr A. , Charernboon Thammanard
Published: September 2022

Background. Poststroke dementia is an important consequence of stroke and warrants early prevention, detection, and management. The objective of the study was to develop a simple clinical risk score for predicting risk of vascular dementia in patients with ischemic stroke. Methods. The design was a prospective cohort study with 177 ischemic stroke survivors. A standard stroke evaluation was performed at admission, and dementia evaluation was conducted at six months after stroke. The significant predictors were used to develop a risk score using a multivariable logistic regression model. Results. Six months after stroke, 27.1% of the patients were diagnosed with vascular dementia. Five predictors were used in the risk score: age, education, history of stroke, white matter hyperintensities, and stroke subtype. The risk score had an area under receiver operating characteristic curve (AuROC) of 0.76, 72.9% sensitivity, and 79.1% specificity in predicting risk of vascular dementia. The predicted probability of vascular dementia for each risk score point was also reported. Conclusion. The clinical risk score had an acceptable accuracy in predicting vascular dementia in ischemic stroke survivors. It can be used for identifying those who are at a high risk of developing vascular dementia.
Experimental Design and Optimization of Decolourization of Reactive Black-5 Dye Using Cloud Point Extraction
Authors: Ramachandran Sathish Kumar , Tolesa Leta Deressa , Abdulkadir Aba Gissa Mohammedsani , Dhanabalan Duraimurugan Alias Saravanan
Published: September 2022

A two-phase separation method called cloud point extraction (CPE) does not use hazardous or flammable organic solvents. The efficient removal of the dye Reactive Black-5 (RB-5) from an aqueous solution using Triton X-114, a nonionic surfactant, is described in this study. Three-level factorial design and response-surface methods were used to quantify the impact of process variables on the CPE process, such as operating temperature and surfactant concentration. Investigations were conducted into how these process variables affected the ratio between the phase volumes, the concentration of dye in the surfactant-rich phase, and the residual amounts of dye in the diluted phase. As a result, ANOVA was used to create and validate mathematical models. The findings demonstrated that the correlation coefficients (R2) exceeded 0.98. The acquired findings showed that the suggested extraction process is efficient, and the proposed CPE approach removes 98% of the RB-5 dye under optimal conditions.
Revealing the Inner-relevance of College Students’ Physical Fitness by Association Analysis and Neural Network
Authors: Pang Yiqun , Pang Yun-Xiang , Wang Qiurui
Published: September 2022

Background: The physical activity and health status of the students in China are not optimistic, there is a general lack of exercise volume and exercise intensity. Normal college students shoulder the future of China’s education. Promoting their physical health is the basic requirement for cultivating teachers in the new era;Methods:Testing and recording 1123 male, 3266 female college students’ physical fitness indicators in a normal college, the relationship between these indicators was mined by correlation analysis and Apriori, and the intelligent prediction models was constructed according to the mined knowledge;Results: There was no correlation between male 1000m running and vital capacity (P > 0.05), but it was correlated with vital capacity weight index (P < 0.05); Most indicators of women showed varying degrees of correlation. There are many association rules between female 50m sprint and standing long jump, sit-ups, and BMI. The introduction of vital capacity weight index slightly improved the accuracy of the 1000m run prediction model; The prediction model of female 50m sprint with standing long jump, sit-ups and BMI as inputs not only keeps the accuracy in a reasonable range, but also reduces the complexity and parameters;ConclusionsFor male students, the ostensibly paradoxical relationships between vital capacity and a 1000 meter run and between vital capacity and pull up were actually due to body shape; Body shape, lower limb explosive power, and core strength play key roles for female college students’ speed quality; BMI, standing long jump and one minute sit-up can be used to predict the 50m sprint performance of general female college students.
Study on Optimization of Pump Shaft Transmission System of Plastic Centrifugal Pump
Authors: Zhang Lili , Tang Lingfeng , Wen Qingzhao , Luo Wenbin
Published: September 2022

At present, the design of the pump shaft transmission system mostly refers to the design method of the metal pump transmission system. The dynamic and static characteristics of the plastic centrifugal pump are not related to the structural parameters of the pump shaft. Aiming at the influence of the structural parameters of the pump shaft transmission system on the dynamic and static performance of the plastic centrifugal pump, the three-dimensional model of the impeller and volute chamber was drawn by Creo5.0. The CFD calculation of the load of the plastic centrifugal pump was carried out. The flow field of the plastic centrifugal pump under ideal working conditions was simulated by ANSYS FLUENT. Combined with the application principle of singular function in mechanics, the mathematical model of a deflection of the pump shaft transmission system was constructed. Considering the minimum deflection and the maximum critical speed of the first order as the objective function, an optimization model of the structural parameters of the pump transmission system was established. The NSGA-II multiobjective optimization method was used to solve the optimal structural parameters of the optimization model, and the optimization design of the pump shaft span, cantilever, front, and rear bearing clearance was completed. The optimal span cantilever ratio of the rotor model of the single span cantilever structure was 1:0.75. Compared with the traditional design model, the optimized pump shaft deflection is reduced by 52.35%, and the first-order critical speed is increased by 42.77%. Simultaneously, using polynomial fitting as a mathematical tool, the experimental data were analyzed, and the mathematical expression of the rotation speed deflection relationship of the pump shaft at the first critical rotation speed and the corresponding function curve was obtained.
Accuracy of Brain Computed Tomography Diagnosis by Emergency Medicine Physicians
Authors: Al Aseri Zohair , Al Aqeel Mohamed , Aldawood Badr , Albadr Fahad , Ghandour Rawan , Al Mulaik Abdulaziz , Malabarey Mohammed A. , Khan Anas
Published: September 2022

Objectives. The objective of this study is to prospectively analyze emergency physicians’ (EP’s) abilities to interpret noncontrast computed tomography (NCCT) brain images in a blinded fashion and assess whether they can make medical decisions solely based on their interpretations. Methods. A cross-sectional study was conducted at the emergency department (ED), King Saud University Medical City (KSU-MC), Saudi Arabia, over a period of one year, from May 2014 to May 2015. Any patient who underwent plain brain NCCT during the study period in our ED was included in this study. An independent attending neuroradiologist compared the EP’s interpretations with the official final reports dictated by an on-call radiologist. Results. A brain NCCT prospective chart audit of 1,524 patients was interpreted by ED physicians (EP) at KSU-MC from 2014–2015. The ages of patients were between 14 and 107 years, and the mean ± SD age was 45.6 ± 22.1 years. Radiological brain lesions were confirmed by EPs and radiology physicians in 230 (15.09) and 239 (15.68) patients, respectively, out of which concordance was observed in 170 (71.13) cases, with a kappa value of r = 0.675. Normal, chronic, and nil acute reports were made by EPs and radiology physicians for 1,295 (84.97) patients and 1,285 (84.32) patients, respectively, out of which concordance was observed in 1,225 (95.33) cases, with a kappa value of r = 0.672. The study results demonstrated that the overall agreement between EPs and radiologist specialists was 91.6, with a kappa value of .675 (p<0.001). Conclusion. Emergency physicians are moderately accurate at interpreting brain NCCT compared to radiologists. More research is needed to discover the most cost-effective technique for reducing the number of significant misinterpretations.
Daily Activity Pattern of Geladas (Theropithecus gelada, Ruppell 1835) in Kotu Forest, Northern Ethiopia
Authors: Abate Degu , Girma Zerihun
Published: September 2022

Gelada (Theropithecus gelada) is one of the endemic primates of Ethiopia. The ecology of meta populations of geladas outside protected areas is less studied, and their population status is uncertain. As a result, we conducted a study to investigate the daily activity pattern of gelada in Kotu forest and associated grasslands in northern Ethiopia from August 2017 to February 2018 covering both wet and dry seasons. The instantaneous scan sampling method was employed to collect behavioral data. The activity pattern of three selected focal groups of geladas was studied, and predominant behavioral activities were scanned in 15 minutes intervals from dawn 7:00 h to dusk at 18:00 h. Feeding comprised 61.65% of the total scan, followed by moving 18.49%. Feeding activity was more frequent during the dry season (about 65%) than in the wet season (58.20%). On the other hand, moving activity was more frequent during the dry season (about 22%) than in the wet season (about 14%). The daily activity pattern of gelada showed a feeding peak early in the morning and in the late afternoon. The time allocated by geladas for feeding and moving in the study area is higher than other activities. Therefore, there is a need for further in-depth research on diet availability and quality to justify why geladas allocate more time for feeding and moving nexus for conservation interventions.
ICU and Sepsis: Role of Myeloid and Lymphocyte Immune Cells
Authors: Wang Anxiu , Zhang Su , Peng Guangming , Tang Yuanxu , Yang Yaopeng
Published: September 2022

Sepsis is a severe immune system reaction to infection and a major cause of ICU-related fatalities. Because of the high mortality, high cost of treatment, and complex aetiology of sepsis, sepsis has a huge impact on healthcare. Some of the health complications in sepsis are abnormal cardiac functions, hypoperfusion, hypotension, tissue damage, multiple organ failure, and ultimately death. Individuals with weak immune systems and chronic medical conditions are highly vulnerable to sepsis. In sepsis, a patient shows the extreme immune response in the initial stage while prolonged immunosuppression in the later stages. Sepsis-driven immunosuppression ushers in death because sepsis cases develop secondary infections postrecovery. The later immunocompromised state in sepsis is attributed myeloid-derived suppressor cell upregulation and reduced immune activity displayed by lymphocytes (lymphocyte anergy). As a result, it is currently suggested that regulating the immune response is a better therapeutic approach than focusing on inflammation to improve the immune system’s capacity to fight infections. Moreover, finding novel and accurate prognostic biomarkers that can help in rapid sepsis diagnoses and deciding better therapeutic strategies will significantly lower clinical case mortality rates.