bluuebunny/crossref_metadata_2025 huggingface dataset:
The efficacy and safety of the innovative cold atmospheric‐pressure plasma technology in the treatment of striae distensae: A randomized controlled trial
Authors: Suwanchinda Atchima , Nararatwanchai Thamthiwat
Published: October 2022

Background

Available current therapeutics modalities for striae distensae (SD) provide inconsistently effective outcomes. There is ongoing research on innovative treatment modalities to find better treatment solutions.

Objectives

To evaluate the efficacy and safety of innovative cold atmospheric plasma (CAP) technology in the treatment of striae distensae.

Methods

This study includes twenty‐three patients with striae distensae. The body was divided into two halves. One side was randomly treated with CAP biweekly on the same treated side for five sessions with 30 days follow‐up after the last session. Another half was left untreated. Efficacy assessment was done using patient and observer scar assessment scale (POSAS), patient satisfaction scales, and Antera 3D® skin imaging system. Safety assessment was evaluated using the visual analog scale (VAS) and adverse effects monitoring.

Results

Patient and observer scar assessment scale, patient and observer overall opinion score, and patient and observer total score in a summary of all rated characteristics, comparing treated and untreated areas, showed a statistically significant reduction in all parameters after one treatment (*p‐value <0.05). Patients rated satisfaction as a great improvement in 52.3%, moderate improvement in 39.1%, extreme improvement in 4.3%, and slight improvement in 4.3%. Adverse effects included small scabs, shallow wounds, and rash.

Conclusion

Cold atmospheric plasma is a safe and effective, innovative treatment modality for striae distensae with minimal side effects.
Clinical application of brain perfusion imaging in detecting stroke mimics: A review
Authors: Khalili Neda , Wang Richard , Garg Tushar , Ahmed Amara , Hoseinyazdi Meisam , Sair Haris I. , Luna Licia P. , Intrapiromkul Jarunee , Deng Francis , Yedavalli Vivek
Published: October 2022

Stroke mimics constitute a significant proportion of patients with suspected acute ischemic stroke. These conditions may resemble acute ischemic stroke and demonstrate abnormalities on perfusion imaging sequences. The most common stroke mimics include seizure/epilepsy, migraine with aura, brain tumors, functional disorders, infectious encephalopathies, Wernicke's encephalopathy, and metabolic abnormalities. Brain perfusion imaging techniques, particularly computed tomography perfusion and magnetic resonance perfusion, are being widely used in routine clinical practice for treatment selection in patients presenting with large vessel occlusion. At the same time, the utilization of these imaging modalities enables the opportunity to better diagnose patients with stroke mimics in a time‐sensitive setting, leading to appropriate management, decision‐making, and resource allocation. In this review, we describe patterns of perfusion abnormalities that could discriminate patients with stroke mimics from those with acute ischemic stroke and provide specific case examples to illustrate these perfusion abnormalities. In addition, we discuss the challenges associated with interpretation of perfusion images in stroke‐related pathologies. In general, perfusion imaging can provide additional information in some cases—when used in combination with conventional magnetic resonance imaging and computed tomography—and might help in detecting stroke mimics among patients who present with acute onset focal neurological symptoms.
Magnifying inequality: How Black women found safety in the midst of dual pandemics
Authors: Geyton Taylor A. , Town Matthew , Hunte Roberta , Johnson Nia
Published: October 2022

In 2020, COVID‐19 in tandem with racial tensions spurred by various occurrences throughout the nation proved detrimental to minoritized persons. Black women, who are often the heads of households, familial and communal caregivers, and organizers, were tasked with protecting themselves, their families, and their communities from racialized violence and infection. This article explores the idea of safety and the responsibilities of Black women to ensure, secure, and maintain safety. The intersection of these two forces creates dual inequities. Whether sacrificing safety for the sake of racial equality or experiencing medical racism while seeking treatment for COVID‐19, the duality of Being black and a woman during two prevalent threats exacerbate existing inequities. Using symbolic interactionism to illustrate the function of structures and roles in defining Black women's positionality and intersectionality to examine the policies and systems that act on the lives of these women, we discuss the ways in which Black women created safety for themselves and their families at the intersection of both threats emphasizing the inequity in home, health, and financial outcomes among Black women.
Disability inclusion in Medical Education: Towards a quality improvement approach
Authors: Fitzpatrick Siobhan , Barrett Darryl
Published: October 2022

The authors highlight how improving the participation of people with disability will strengthen the health workforce if collaboration across learners, institutions, regulatory bodies, health workers and employers can be achieved.
Histoplasma capsulatum modulates the immune response, affects proliferation and differentiation, and induces apoptosis of mesenchymal stromal cells
Authors: Rodríguez‐Echeverri Carolina , Gómez Beatriz L. , González Ángel
Published: October 2022

Mesenchymal stromal cells (MSC) have been widely used not only for tissue regeneration but also for the treatment of various diseases; however, it has been shown that infection of MSCs by different pathogens can attenuate their intrinsic immunomodulatory properties, affecting the proliferation and differentiation of these cells. Currently, the mechanisms by which MSCs respond to pathogen invasion are poorly understood. Therefore, the objective of the present study was to determine if the infection of bone marrow‐derived MSCs, with yeasts of the pathogenic fungus Histoplasma capsulatum affects the activation, differentiation and/or proliferation of the MSCs. The results indicate that MSCs have the ability to phagocytose H. capsulatum yeasts but do not exert a notable antifungal effect. On the contrary, the infection of the MSCs with this fungal pathogen not only modulates the expression of inflammatory mediators by a mechanism dependent on TLR2, TLR4 and Dectin‐1 but also affects the viability and differentiation capacity of the MSCs. These findings suggest that infection of MSCs by H. capsulatum could not only affect haematopoiesis but also modulate the immune response in the infected host and, furthermore, these MSCs could provide a niche for the fungus, allowing it to persist and evade the immune response of the host.
Synchronous odontogenic tumors: A systematic review
Authors: Neumann Bruna Luísa , Só Bruna Barcelos , Santos Lucas Gonçalves , Silveira Felipe Martins , Wagner Vivian Petersen , Vargas Pablo Agustin , dos Santos Jean Nunes , Mosqueda‐Taylor Adalberto , Fonseca Felipe Paiva , Schuch Lauren Frenzel , Martins Manoela Domingues
Published: October 2022

This systematic review aimed to incorporate published information about synchronous odontogenic tumors (SOTs) with an analysis of the demographic and clinical characteristics from the cases published in the literature. Case reports and case series of SOT were searched in PubMed, Web of Science, Scopus, and EMBASE. A descriptive statistical analysis was performed. Twenty‐eight studies comprising 30 cases of SOTs were included. Considering all cases published, SOTs mostly occurred simultaneously in the maxilla and mandible (n = 19/63.3%). Lesions were bifocal in 13 (43.3% of all the 30 cases) and multifocal in 17 cases (56.7% of all the 30 cases). All SOTs available in the literature presented the same type of lesion, and two of them also involved another different SOT (n = 2/6.7% of all the 30 cases). Out of all published cases, the most frequent SOTs in the literature were odontomas (n = 10/33.3% of all the 30 cases), squamous odontogenic tumors (OTs) (n = 8/26.7% of all the 30 cases), calcifying epithelial OTs (n = 8/26.7% of all the 30 cases), and adenomatoid OTs (n = 2/6.7% of all the 30 cases). Considering all SOTs cases included, the overall recurrence was 13.3%. Inside a subgroup of the lesion, synchronous calcifying epithelial OT presented the highest (25%). Five cases (16.7% of all the 30 cases) had a previously associated syndrome, with two cases of Schimmelpenning syndrome being reported. Among published SOTs, odontomas were the most common. All SOTs available in the scientific literature showed the same type of OT and mainly affected both jaws simultaneously. Only a few of these cases were associated with a syndrome.
Abatement of microfibre pollution and detoxification of textile dye – Indigo by engineered plant enzymes
Authors: Wakade Geetanjali , Lin Shina , Saha Prasenjit , Kumari Uma , Daniell Henry
Published: October 2022

Microfibres (diameter <5 mm) and textile dyes released from textile industries are ubiquitous, cause environmental pollution, and harm aquatic flora, fauna, animals and human life. Therefore, enzymatic abatement of microfibre pollution and textile dye detoxification is essential. Microbial enzymes for such application present major challenges of scale and affordability to clean up large scale pollution. Therefore, enzymes required for the biodegradation of microfibres and indigo dye were expressed in transplastomic tobacco plants through chloroplast genetic engineering. Integration of laccase and lignin peroxidase genes into the tobacco chloroplast genomes and homoplasmy was confirmed by Southern blots. Decolorization (up to 86%) of samples containing indigo dye (100 mg/L) was obtained using cp‐laccase (0.5% plant enzyme powder). Significant (8‐fold) reduction in commercial microbial cellulase cocktail was achieved in pretreated cotton fibre hydrolysis by supplementing cost effective cellulases (endoglucanases, ß‐glucosidases) and accessory enzymes (swollenin, xylanase, lipase) and ligninases (laccase lignin peroxidase) expressed in chloroplasts. Microfibre hydrolysis using cocktail of Cp‐cellulases and Cp‐accessory enzymes along with minimal dose (0.25% and 0.5%) of commercial cellulase blend (Ctec2) showed 88%–89% of sugar release from pretreated cotton and microfibres. Cp‐ligninases, Cp‐cellulases and Cp‐accessory enzymes were stable in freeze dried leaves up to 15 and 36 months respectively at room temperature, when protected from light. Use of plant powder for decolorization or hydrolysis eliminated the need for preservatives, purification or concentration or cold chain. Evidently, abatement of microfibre pollution and textile dye detoxification using Cp‐enzymes is a novel and cost‐effective approach to prevent their environmental pollution.
Vascular epiphyte populations with higher leaf nutrient concentrations showed weaker resilience to an extreme drought in a montane cloud forest
Authors: Hu T. , Liu W. Y. , Wen H. D. , Song L. , Zhang T. T. , Chen Q. , Liu S.
Published: October 2022

Leaf stoichiometry can characterize plant ecological strategies and correlate with plant responses to climate change. The role of vascular epiphytes in the ecosystem processes of tropical and subtropical forest ecosystems cannot be ignored. Vascular epiphytes are very vulnerable to climate change, however, the relationship between the response of epiphytes to climate change and leaf stoichiometry is not well understood.

We present data for 19 vascular epiphyte species that were collected during four consecutive censuses (in 2005, 2010, 2015, and 2020) over 15 years in a subtropical montane cloud forest. We assessed the relationships between the population dynamics and leaf stoichiometry of these vascular epiphytes.

Experiencing an extreme drought, 14 of the 19 epiphyte species showed an obvious decrease in the number of individuals, and all species showed negative growth in the number of populations. Subsequently, the total number of individuals gradually recovered, increasing from 7,195 in 2010 to 10,121 in 2015, then to 13,667 in 2020. The increase in the number of vascular epiphyte individuals from 2010 to 2015 was significantly negatively correlated with leaf nitrogen and phosphorus concentration, and was significantly positively correlated with the leaf carbon‐nitrogen ratio.

Vascular epiphyte populations with higher leaf nutrient concentrations exhibited weaker resilience to the extreme drought, which demonstrated that a resource‐conservative strategy was advantageous for the recovery of epiphyte populations. Our findings suggest that ecological stoichiometry can be a useful framework for forecasting the dynamics of vascular epiphyte populations in response to climate change.
How police agency diversity, policies, and outcomes shape citizen trust and willingness to engage
Authors: Stauffer Katelyn E. , Song Miyeon , Shoub Kelsey
Published: October 2022

While widespread agreement that policing in the United States needs to be reformed arose in the summer of 2020, little consensus about specific reforms was reached. A common theme that arose, however, is a general lack of trust in the police. One response has been to increase agency diversity in terms of both officer race and officer gender. However, important questions exist about when – and what type(s) of – diversity shape citizen trust in and willingness to cooperate with the police – especially when considered in conjunction with agency performance and policies. To answer these questions, we use two conjoint experiments to evaluate whether citizens consider diversity when evaluating police agencies. We find that while both racial and gender diversity can influence public evaluations sometimes, these effects tend to emerge in the context of only the most (least) diverse institutions and are muted compared to the effects of agency policies and performance.
Underreporting of Top Incomes and Inequality: A Comparison of Correction Methods using Simulations and Linked Survey and Tax Data
Authors: Flachaire Emmanuel , Lustig Nora , Vigorito Andrea
Published: October 2022

Household surveys do not capture incomes at the top of the distribution well. This yields biased inequality measures. We compare the performance of the reweighting and replacing methods to address top incomes underreporting in surveys using information from tax records. The biggest challenge is that the true threshold above which underreporting occurs is unknown. Relying on simulation, we construct a hypothetical true distribution and a “distorted” distribution that mimics an underreporting pattern found in a novel linked data for Uruguay. Our simulations show that if one chooses a threshold that is not close to the true one, corrected inequality measures may be significantly biased. Interestingly, the bias using the replacing method is less sensitive to the choice of threshold. We approach the threshold selection challenge in practice using the Uruguayan linked data. Our findings are analogous to the simulation exercise. These results, however, should not be considered a general assessment of the two methods.
RHD genotyping to resolve weak and discrepant RhD patient phenotypes
Authors: Barriteau Christina M. , Lindholm Paul F. , Hartman Karyn , Sumugod Ricardo D. , Ramsey Glenn
Published: October 2022

Background

We instituted RHD genotyping in our transfusion service for obstetrical patients and transfusion candidates. We sought to examine how RHD genotyping resolved weak or discrepant automated microplate direct agglutination (MDA) RhD phenotypings and impacted needs for Rh Immune Globulin (RhIG) and D‐negative RBCs.

Study Design and Methods

We investigated RhD phenotypes with equivocal or reagent‐discrepant automated MDA (Immucor, Norcross, GA), weak‐2+ immediate‐spin tube typings, historically discrepant RhD typings, or D+ typings with anti‐D. We performed microarray RHD genotyping (RHD BeadChip, Immucor BioArray Solutions, Warren, NJ). Patients were managed as D+ with weak‐D types 1, 2, and 3, and as D‐negative with all other results.

Results

Our weak‐D prevalence was 0.14%. Among 138 patients (73 obstetrics, 65 transfusion candidates), 38% had weak‐D types 1, 2 or 3, 25% weak partial type 4.0, 21% other partial‐D variant alleles, and 15% no variant detected. One novel allele with weak partial type 4.0 variants plus c.150T>C (Val50Val) was discovered. Weak D types 1, 2 or 3 were identified in 66% (48/73) of Whites versus 3% (2/62) of diverse ethnic patients (p < .0001). RHD genotyping changed RhD management in 60 patients (43%) (49 to D+, 11 to D‐negative), resulting in net conservation of D‐negative RBCs (98 avoided, 14 given) and RhIG (8 avoided, 3 given).

Conclusion

In our patient population, equivocal or reagent‐discrepant MDA RhD phenotypes were highly specific for weak‐D or partial‐D RHD genotypes. Resolution of RHD genotype status reduced our use of D‐negative RBCs and RhIG.
A Physics-Guided Neural Operator Learning Approach to Model Biological Tissues From Digital Image Correlation Measurements
Authors: You Huaiqian , Zhang Quinn , Ross Colton J. , Lee Chung-Hao , Hsu Ming-Chen , Yu Yue
Published: October 2022

We present a data-driven workflow to biological tissue modeling, which aims to predict the displacement field based on digital image correlation (DIC) measurements under unseen loading scenarios, without postulating a specific constitutive model form nor possessing knowledge of the material microstructure. To this end, a material database is constructed from the DIC displacement tracking measurements of multiple biaxial stretching protocols on a porcine tricuspid valve anterior leaflet, with which we build a neural operator learning model. The material response is modeled as a solution operator from the loading to the resultant displacement field, with the material microstructure properties learned implicitly from the data and naturally embedded in the network parameters. Using various combinations of loading protocols, we compare the predictivity of this framework with finite element analysis based on three conventional constitutive models. From in-distribution tests, the predictivity of our approach presents good generalizability to different loading conditions and outperforms the conventional constitutive modeling at approximately one order of magnitude. When tested on out-of-distribution loading ratios, the neural operator learning approach becomes less effective. To improve the generalizability of our framework, we propose a physics-guided neural operator learning model via imposing partial physics knowledge. This method is shown to improve the model's extrapolative performance in the small-deformation regime. Our results demonstrate that with sufficient data coverage and/or guidance from partial physics constraints, the data-driven approach can be a more effective method for modeling biological materials than the traditional constitutive modeling.
Next Generation Air Plasma Spray Porous Thermal Barrier Coatings for Gas Turbine Combustors
Authors: Rudrapatna Nagaraja , Lutz Bradley , Kington Harry
Published: October 2022

Modern gas turbine combustors rely on thermal barrier coatings (TBC) in addition to sophisticated cooling strategies to survive high temperature environments. The need for lower emissions either driven by International Civil Aviation Organization (ICAO) regulations or by customer's desire for green engines often necessitates an increased air budget for improved mixing, thus resulting in less available cooling flow. Even with state-of-the-art cooling schemes to offset reduced cooling air allocation, combustors can benefit from better TBC performance to mitigate durability challenges. This paper showcases the next generation air plasma spray (APS) porous TBC developed by Honeywell as well as discusses tests performed and results gathered to assess its suitability for combustor application. A configured test specimen was utilized to evaluate suitability of a new coating system for combustor application. The configured specimen captures the material system, geometric features, manufacturing, and assembly process associated with combustor fabrication and thus provides a realistic environment for performance assessment. The configured specimen test results indicate the new APS porous TBC showed better performance than the standard 6–8% Yttria stabilized zirconia (YSZ) porous TBC. The new TBC with its lower conductivity at higher temperature increased thickness capability, and superior stability at substantially higher temperature than 6–8% YSZ TBC enables hot section components to survive hotter engine cycles.
Temperature Dependent Property Considerations for Biot Number Matching With Composite Materials
Authors: Bryant Carol E. , Rutledge James L.
Published: October 2022

High-temperature materials such as ceramic matrix composites (CMCs) are promising for advancements in gas turbine engines; however, experimental techniques are necessary to characterize the thermal behavior of high-temperature materials in scaled representative environments. In turbine cooling applications, the results of low-temperature experiments in laboratories must be scaled to the intended operating conditions to predict the thermal state at high-temperature engine conditions where such measurements are generally not feasible. Scaling of turbine cooling experiments with metallic components has been aided by the fortuitous fact that the thermal conductivity of turbine-relevant metal alloys varies with temperature in such a way that the Biot number is relatively insensitive to temperature, at least to the extent that Biot number affects the overall effectiveness. However, unlike traditional metallic alloys, materials such as CMCs have unique anisotropic thermal conductivities which vary with temperature in quite different ways than traditional metals. The through-thickness and in-plane thermal conductivities of CMCs may vary with temperature in different ways, thereby adding further complexity. Since most existing low-temperature experimental methods were developed with isotropic metallic alloys in mind, it is necessary to consider the potential for errors due to the unique characteristics of composite materials. Analyses to determine the expected Biot number errors for various composite materials were conducted at a range of experimental conditions. These are compared to a traditional metallic alloy for context and computational simulations were performed on the various materials at engine and laboratory conditions. Additionally, a novel technique was implemented to isolate and quantify the effects of both Biot number and fluid property mismatches at low temperatures. The results show overall effectiveness experiments conducted at low temperatures using composite materials will likely have a large error and could significantly skew the expected thermal characteristics of a turbine component. Careful experimental design should be practiced to mitigate the effect that a mismatched Biot number can have on experimental results.
A Switched Dynamical System Approach to the Flow and Heat Transfer of Immiscible Fluids
Authors: Hosham Hany A.
Published: October 2022

This paper provides important insights into immiscible fluids models, which can exhibit complex nonlinear behavior due to variations in thickness, viscosity, thermal conductivity, and jump velocity fields across the interface surface. These characteristics will be used to model our problem as a switching dynamical system. The bifurcation tools for switching systems will be used to create a systematic computational analysis of the rise dynamics of the behavior of solutions influenced by the interface surface. This technique is applied to investigate the flow and heat transfer behavior of two immiscible fluids for a recently proposed model. The explicit formula for tracking the accurate behavior of the interface surface, which is used as a critical part of the bifurcation analysis, is provided. The results show that the existence of heteroclinic connections and switching stability of multiple equilibria are the primary causes of the formation of a novel class of trapping phenomena. The biological significance of our results on flow and heat transfer characteristics is discussed.
Reconsidering lateral vocalisation: Evidence from perception and production of Australian English /l/
Authors: Szalay Tünde , Benders Titia , Cox Felicity , Proctor Michael
Published: October 2022

Lateral vocalisation is assumed to arise from changes in coronal articulation but is typically characterised perceptually without linking the vocalised percept to a coronal articulation. Therefore, we examined how listeners' perception of coda /l/ as vocalised relates to coronal closure. Perceptual stimuli were acquired by recording laterals produced by six speakers of Australian English using electromagnetic articulography (EMA). Tongue tip closure was monitored for each lateral in the EMA data. Increased incidence of incomplete coronal closure was found in coda /l/ relative to onset /l/. Having verified that the dataset included /l/ tokens produced with incomplete coronal closure—a primary articulatory cue of vocalised /l/—we conducted a perception study in which four highly experienced auditors rated each coda /l/ token from vocalised (3) to non-vocalised (0). An ordinal mixed model showed that increased tongue tip (TT) aperture and delay correlated with vocalised percept, but auditors ratings were characterised by a lack of inter-rater reliability. While the correlation between increased TT aperture, delay, and vocalised percept shows that there is some reliability in auditory classification, variation between auditors suggests that listeners may be sensitive to different sets of cues associated with lateral vocalisation that are not yet entirely understood.
A simplified model for the gas-vapor bubble dynamics
Authors: Tian Lei , Zhang Yongxue , Yin Jianyong , Lv Liang , Zhu Jianjun
Published: October 2022

This paper presents a full numerical model accounting for the heat transfer and phase-change by combining the modified Keller–Miksis equation with the second order term of compressibility of liquid, partial differential equations (PDEs), and Hertz–Knudsen–Langmuir equation. Then, a simplified model for studying the dynamics of the cavitation bubble or bubble excited by the acoustic waves is proposed. The major contribution is to simplify the full model with PDEs to a set of coupled ordinary differential equations (ODEs). Specifically, two energy PDEs are converted to three ODEs by coupling the boundary conditions. The comparison among the full model and other simplified models is used to validate the accuracy and superiority of the simplified model, from which the application range of the proposed simplified model can be determined.
SARS-CoV-2 RNA Is Readily Detectable at Least 8 Months after Shedding in an Isolation Facility
Authors: Coil David A. , Pechacek Randi , Kaze Mo , Zuniga-Montanez Rogelio , Guerrero Roque G. , Eisen Jonathan A. , Shapiro Karen , Bischel Heather N.
Published: October 2022

Environmental monitoring of SARS-CoV-2 is rapidly becoming a key tool in infectious disease research and public health surveillance. Such monitoring offers a complementary and sometimes novel perspective on population-level incidence dynamics relative to that of clinical studies by potentially allowing earlier, broader, more affordable, less biased, and less invasive identification.
A Unit of Shock-Ionized Dynistors with a High-Voltage Pulse Sharpener in the Control Circuit
Authors: Korotkov S. V. , Aristov Yu. V.
Published: October 2022

The results from studies of a high-voltage unit of shock-ionized dynistors in the switching mode of current pulses with an amplitude of several kiloamperes and a rise rate of up to 100 kA/μs are presented. The control circuit of this unit with a front sharpener of the trigger voltage pulses is described, which provides a significant reduction in energy losses in dynistors.
Cost optimisation analysis of the expanded programme for immunisation: balancing equity and coverage in Pakistan
Authors: Houdroge Farah , Yunus Hammad , Delport Dominic , Stearns Erin , Palmer Anna , Naim Amber , Kashif Aliya , Pyne Hnin Hnin , Scott Nick , Oelrichs Robert , Wilson David
Published: October 2022

Introduction

With limited resources, attaining maximal average health service coverage can be at odds with maximising equity which attempts to promote greater reach among underserved populations. In this study, we examined the trade-offs in immunisation coverage levels and equity for children under 5 years of age in Pakistan across various subpopulations who can be targeted with different combinations of immunisation service modalities.

Methods

We conducted a detailed costing exercise across 16 geographically and demographically diverse districts in Pakistan. These data were the basis for (a) technical efficiency benchmarking via Data Envelopment Analysis to identify potential efficiency gains by location, delivery model and cost ingredient; (b) allocative efficiency optimisation modelling to understand how resource allocations could be optimised and to devise recommended budget allocations and operational metrics. Finally, the hypothetical overall efficiency gains attainable were estimated if available resources were allocated with the optimal emphases, and if service delivery models operated at productivity levels at the benchmarked frontier of efficiency.

Results

Benchmarking suggests that ~44% of delivery models are running efficiently and 37% are highly inefficient. While coverage and equity are usually at odds, surprisingly, the optimisation modelling revealed that substantial improvements in equity between subpopulations does not necessarily cost very much in overall immunisation coverage: theoretically, equity can be achieved while still attaining close to maximal immunisation coverage. Overall, analyses suggest greater emphases should be placed on outreach delivery models which particularly target rural areas and slum populations.

Conclusion

The unit cost differentials within districts are not sufficiently large for there to be a large reduction in potential Fully Immunised Children coverage if one focuses on maximising equity. However, reallocations of programme budgets can have a significant impact on equity outcomes, particularly at current low spending amounts. Therefore, it is recommended to address equity as the key objective in national immunisation programming.
Adults with spinal muscular atrophy: a large-scale natural history study shows gender effect on disease
Authors: Maggi Lorenzo , Bello Luca , Bonanno Silvia , Govoni Alessandra , Caponnetto Claudia , Passamano Luigia , Grandis Marina , Trojsi Francesca , Cerri Federica , Gardani Alice , Ferraro Manfredi , Gadaleta Giulio , Zangaro Vittoria , Caumo Luca , Maioli Mariantonietta , Tanel Raffaella , Saccani Elena , Meneri Megi , Vacchiano Veria , Ricci Giulia , Sorarù Gianni , D'Errico Eustachio , Bortolani Sara , Pavesi Giovanni , Gellera Cinzia , Zanin Riccardo , Corti Stefania , Silvestrini Mauro , Politano Luisa , Schenone Angelo , Previtali Stefano Carlo , Berardinelli Angela , Turri Mara , Verriello Lorenzo , Coccia Michela , Mantegazza Renato , Liguori Rocco , Filosto Massimiliano , Marrosu Gianni , Tiziano Francesco Danilo , Siciliano Gabriele , Simone Isabella Laura , Mongini Tiziana , Comi Giacomo , Pegoraro Elena
Published: October 2022

Background

Natural history of spinal muscular atrophy (SMA) in adult age has not been fully elucidated yet, including factors predicting disease progression and response to treatments. Aim of this retrospective, cross-sectional study, is to investigate motor function across different ages, disease patterns and gender in adult SMA untreated patients.

Methods

Inclusion criteria were as follows: (1) clinical and molecular diagnosis of SMA2, SMA3 or SMA4 and (2) clinical assessments performed in adult age (>18 years).

Results

We included 64 (38.8%) females and 101 (61.2%) males (p=0.0025), among which 21 (12.7%) SMA2, 141 (85.5%) SMA3 and 3 (1.8%) SMA4. Ratio of sitters/walkers within the SMA3 subgroup was significantly (p=0.016) higher in males (46/38) than in females (19/38). Median age at onset was significantly (p=0.0071) earlier in females (3 years; range 0–16) than in males (4 years; range 0.3–28), especially in patients carrying 4SMN2copies. Median Hammersmith Functional Rating Scale Expanded scores were significantly (p=0.0040) lower in males (16, range 0–64) than in females (40, range 0–62); median revised upper limb module scores were not significantly (p=0.059) different between males (24, 0-38) and females (33, range 0–38), although a trend towards worse performance in males was observed. In SMA3 patients carrying three or four SMN2 copies, an effect of female sex in prolonging ambulation was statistically significant (p=0.034).

Conclusions

Our data showed a relevant gender effect on SMA motor function with higher disease severity in males especially in the young adult age and in SMA3 patients.
Generic 3-point statistics with tensor modes in light of Swampland and Trans-Planckian Censorship Conjecture
Authors: Naskar Abhishek , Pal Supratik
Published: October 2022

Recently proposed Swampland Criteria (SC) and Trans-Planckian Censorship Conjecture (TCC) question the theoretical consistency of inflationary cosmology. While SC can be in tension with the recent observational bound on tensor-to-scalar ratio which is a consequence of single field consistency relation, the requirement of TCC translates to the fact that inflation can not produce a detectable signal for stochastic gravitational wave, raising a question on future prospects of detection of Primordial Gravitational Waves (PGW). But the constraint can be relaxed significantly by considering Non Bunch Davies (NBD) initial states, that in turn brings back the observational relevance of PGW via its 2-point function. Also with NBD states the tension between SC and observational bound on tensor-to-scalar ratio vanishes. Focusing on these theoretical importance of NBD states, in this article we develop consistent 3-point statistics with tensor modes for all possible correlators (auto and mixed) for NBD initial states in a generic, model independent framework of Effective Field Theory of inflation and analyze the properties of the correlators in the light of TCC. We also construct the templates of the corresponding nonlinearity parameters $$f_{NL}$$

f

NL

for different shapes of relevance and investigate if any of the 3-point correlators could be of interest for future CMB missions. Our analysis reveals that the prospects of detecting the tensor auto correlator are almost nil whereas the mixed correlators might be relevant for future CMB missions.
A theoretical study on partial slip impact in radiative-hydromagnetic liquid configured by extending surface
Authors: Zubair M. , Waqas M. , Nasir M. , Bafakeeh Omar T. , Ameen Hawzhen Fateh M. , Galal Ahmed M.
Published: October 2022

This research elaborates Darcy–Forchheimer magnetized flow based on non-Newtonian liquid induced by elongating surface. Rheological expressions of Casson liquid are utilized for mathematical analysis. Thermal stratification along with velocity and thermal slip aspects is considered. Heat transfer describes radiation and heat source/sink. The complex mathematical expressions featuring partial differential systems are rendered to ordinary differential systems by implementing boundary-layer approach. Numerical results are achieved through bvp4c scheme. Description of nondimensional factors is exhibited via pictorial and tabular depictions. The velocity and thermal field diminish when subjected to larger velocity and thermal slip factors.
Disentangling Decentralized Finance (DeFi) Compositions
Authors: Kitzler Stefan , Victor Friedhelm , Saggese Pietro , Haslhofer Bernhard
Published: October 2022

We present a measurement study on compositions of Decentralized Finance (DeFi) protocols, which aim to disrupt traditional finance and offer services on top of distributed ledgers, such as Ethereum. Understanding DeFi compositions is of great importance, as they may impact the development of ecosystem interoperability, are increasingly integrated with web technologies, and may introduce risks through complexity. Starting from a dataset of 23 labeled DeFi protocols and 10,663,881 associated Ethereum accounts, we study the interactions of protocols and associated smart contracts. From a network perspective, we find that decentralized exchange (DEX) and lending protocol account nodes have high degree and centrality values, that interactions among protocol nodes primarily occur in a strongly connected component, and that known community detection methods cannot disentangle DeFi protocols. Therefore, we propose an algorithm to decompose a protocol call into a nested set of building blocks that may be part of other DeFi protocols. This allows us to untangle and study protocol compositions. With a ground truth dataset that we have collected, we can demonstrate the algorithm’s capability by finding that swaps are the most frequently used building blocks. As building blocks can be nested, that is, contained in each other, we provide visualizations of composition trees for deeper inspections. We also present a broad picture of DeFi compositions by extracting and flattening the entire nested building block structure across multiple DeFi protocols. Finally, to demonstrate the practicality of our approach, we present a case study that is inspired by the recent collapse of the UST stablecoin in the Terra ecosystem. Under the hypothetical assumption that the stablecoin USD Tether would experience a similar fate, we study which building blocks — and, thereby, DeFi protocols — would be affected. Overall, our results and methods contribute to a better understanding of a new family of financial products.
Analysis of the Effect of the Communication Ability of Nurses in Outpatient Infusion Room on the Treatment Experience of Patients and Their Families
Authors: Shen Xiuqin , Zhang Ying , Wei Jiao
Published: October 2022

Objective. To observe the effect of nursing communication ability in outpatient infusion room on the treatment experience of outpatients and their families and analyze whether improving nurses’ communication skills can reduce the incidence of doctor-patient disputes. Methods. According to the results of the communication ability survey, the outpatient nurses in our hospital are divided into groups A (

score
<
65

), B (

65
≤
score
<
80

), C (

80
≤
score
<
95

), and D (

score
≥
95

). Taking outpatients and their families in our hospital from September 2019 to December 2020 as the research objects, they were divided into corresponding groups according to the nurses who served them. Finally, there were 73 cases in group A, 85 in group B, 92 in group C, and 65 in group D. The mental toughness scale (Connor-Davidson Resilience Scale Chinese (CD-RISC)) scores and Herth Hope Index (HHI) scores of the four groups of patients were compared, and the correlation between nurse communication scores and CD-RISC scores and HHI scores was analyzed. The incidence of negative events (patient-nurse disputes, complaints, etc.) and the results of nursing satisfaction surveys during the visits of the four study groups were also counted. Results. The four groups of CD-RISC and HHI total scores were ranked from highest to lowest as groups D, C, B, and A, respectively (

P
<
0.05

). There was a positive correlation between the resilience dimension scores of the family members’ CD-RISC and the toughness, strength, optimism dimension scores of the HHI and the nurses’ communication dimension scores (

r
=
0.191

-0.472,

P
<
0.05

). Besides, the incidence of negative events was higher in group A than in the other three groups, while the satisfaction with care was lower than in the other three groups (

P
<
0.05

). Conclusion. Improving nurses’ communication skills in infusion room nursing quality management can improve the mental toughness and hope level of patients’ accompanying family members, which is conducive to controlling their emotions and avoiding the occurrence of dispute incidents.
Low Prognostic Nutritional Index Contributes to High Adverse Events in Preeclampsia
Authors: Wei Songquan , Lian Liyou , Li Guimin , Wang Jiawei , Chen Guixian , Yu Lin
Published: October 2022

Background. Preeclampsia (PE) is a common obstetric complication that has caused significant harm to pregnant mothers. The clinical significance of poor nutritional status in PE patients is unclear. The aim of our study was to evaluate the nutritional status as measured by the prognostic nutritional index (PNI) score at admission, and its ability to predict in-hospitalization adverse events in patients with PE. Methods. We enrolled patients diagnosed with PE in the Third Affiliated Hospital of Guangzhou Medical University from January 2019 to December 2021. Patients were divided into low and high nutritional status group according to the cut-off value of PNI score at admission using the receiver operating characteristic (ROC) curve. PNI score were used to explore the relationship between PNI score and in-hospitalization adverse events presented with hazard ratio (HR) and 95% confidence intervals (CI). Results. A total of 733 patients were included in the study. The proportion of adverse events and admission to intensive care unit (ICU) was higher in the low nutritional status group than in the high nutritional status group (

P
<
0.05

). ROC curve analysis revealed an area under curve (AUC) of 0.628 for PNI score and the cut-off value of PNI was 37. The free-event rates determined by KM analysis were significantly lower in the low nutritional status compared to the high nutritional status (

P
<
0.05

). Adjusted multivariate analysis showed that PNI score was independently associated with favorable outcomes (HR: 2.66; 95% CI: 1.724-4.050,

P
<
0.001

). Conclusion. High PNI score at admission was associated with reduced in-hospitalization risk of adverse events in patients with PE. Additional enhancing nutritional status during hospitalization may help to prevent unfavorable prognosis in clinical practices.
EDTA Combined with C-Pilot Files and Microultrasound for Root Canal Calcification: Dredging Effect and Safety Analysis
Authors: Chu Ting , Ni Xiufeng , Zhu Yanhua
Published: October 2022

Objective. This paper discussed the dredging effect and safety of ethylenediaminetetraacetic acid (EDTA) combined with C-pilot files and microultrasound (mUS) on root canal calcification. Methods. From October 2021 to January 2022, 132 patients with calcified root canals treated in our hospital were selected as the research subjects. Among them, 64 cases who received EDTA combined with C-pilot Files and mUS plus ultrasonic instruments to dredge calcified root canals were regarded as the research group (RG), and another 68 cases given ultrasonic instruments plus C-pilot files were regarded as the control group (CG). The root canal dredging time was recorded, and the dredging success rate and total success rate of different tooth positions and calcification sites were compared between groups. The clinical efficacy was assessed 6 months after treatment. Pain severity was evaluated by the Pain Intensity Numerical Rating Scale (PI-NRS) before (

T
0

), during (

T
1

), and after treatment (

T
2

). Finally, the incidence of adverse reactions within one week after treatment was counted. Results. RG was observed with statistically higher success rates of root canal dredging in different tooth positions and calcified sites than CG (

P
<
0.05

). Besides, the total effective rate of treatment was 92.19% in RG, which was also higher compared with CG, while the root canal dredging time in RG was shorter than that in CG (

P
<
0.05

). Increased NRS scores were found in both groups at

T
1

, and the score in RG was significantly lower compared with that in CG. At

T
2

, both groups showed a lower PI-NRS score than

T
1

but higher than

T
0

, and the score at

T
2

was also lower in RG as compared to CG (

P
<
0.05

). Moreover, the reduced incidence of adverse reactions were observed in RG compared with CG (

P
<
0.05

). Conclusions. EDTA combined with C-pilot files and mUS can effectively improve the dredging success rate of root canals obstructed by calcification, shorten the dredging time, and improve patient comfort, which is an effective method for clinical dredging of calcification obstructed root canals.
An Efficient Multispectral Image Classification and Optimization Using Remote Sensing Data
Authors: Janarthanan S. , Ganesh Kumar T. , Janakiraman S. , Dhanaraj Rajesh Kumar , Shah Mohd Asif
Published: October 2022

A significant amount of effort and cost is required to collect training samples for remote sensing image classifications. The study of remote sensing and how to read multispectral images is becoming more important. High-dimensional multispectral images are created by the various bands that show how materials behave. The need for more information about things and the improvement of sensor resolutions have led to the creation of multispectral data with a higher size. In recent years, it has been shown that the high dimensionality of these data makes it hard to preprocess them in multiple ways. Recent research has demonstrated that one of the most crucial methods to address this issue is by adopting a variety of learning strategies. But as the data gets more complicated, these methodologies are not adequate to support. The proposed methodology shows that the classification experiment using remote sensing images indicates the maximum likelihood classifier with different deep learning models; weight vector (WV) AdaBoost and ADAM can greatly limit overfitting, and it obtains high classification accuracy. Proposed VGG16 and Inception v3 increase classification accuracy along with optimization process produce 96.08%.
Parenting Style and Suicidal Behavior: A Focused Review
Authors: Arafat S. M. Yasir , Menon Vikas , Dinesh M. , Kabir Russell
Published: October 2022

Objectives. Parenting is the general child-rearing practice that has both long- and short-term impacts on the physical, emotional, mental, and social development of the children. We aims at seeing the relationship between parenting style and suicidal behaviors. Methods. A search was conducted in Medline, Embase, and PsychINFO to identify the articles assessing the relationship between different types of parenting styles and suicidal behavior. We included 32 articles in the review published from inception to search date. Results. Among the 32 studies, 27 studies used a cross-sectional study design, 17 were published between 2011 and 2020, and most of the studies included respondents with ages between 9 and 21 years. A wide variety of the used instruments to assess suicidal behavior, and parenting style was noted. Eight studies revealed that authoritarian parenting style is one of the predictors of suicidal behavior, while one study reported the authoritarian parenting style as a resilient factor. Both dominating and flexible parenting styles were associated with higher suicidal behavior, and two studies reported that the permissive style is a contributing factor to suicidal ideation among participants. Conclusion. This review identified the supportive notion that authoritarian parenting style has an association with suicidal behavior in adolescence, and later life. However, a prudential judgment is warranted due to the heterogeneity of study methods, population, contexts, and measurement tools.