bluuebunny/crossref_metadata_2025 huggingface dataset:
A expansão dos condomínios fechados: o caso de Campos dos Goytacazes, RJ
Authors: Manhães Viviane Rangel Ribeiro , Arruda Ana Paula Serpa Nogueira de
Published: July 2021

O presente artigo analisa a expansão dos condomínios residenciais de alto padrão na cidade de Campos dos Goytacazes, o seu impacto sobre a produção do espaço urbano, a ampliação e ressignificação das áreas periféricas e principalmente as motivações para a moradia nestes espaços. Especialmente no caso dos condomínios horizontais fechados de médio e alto padrão temos a conformação de um processo de “autossegregação”, na qual a qualidade de vida e o exclusivismo de classe parecem ser fatores determinantes no momento da escolha de se morar em um condomínio horizontal fechado, aliados ainda à presença de áreas verdes, de lazer e o status social. Cercados por muros, modernos dispositivos de segurança e de distinção de classes, vetores esses utilizados como estratégias de propaganda e venda por grandes e influentes incorporadoras, estes condomínios determinam um novo estilo de vida e normas de convívio entre os iguais, no espaço privado.
Inovação e Desenvolvimento Regional: uma análise sobre a produção científica da Universidade Estadual do Norte Fluminense e sua potencial contribuição para a sociedade
Authors: Chaffin Cezario Raquel , Terra Azevedo Filho Edson , Rego Monteiro da Hora Henrique
Published: July 2021

O presente trabalho apresenta um estudo sobre a Universidade Estadual do Norte Fluminense Darcy Ribeiro – UENF, para averiguar qual é o papel da universidade na sociedade e, mais especificamente, analisar como esta instituição pode contribuir, por meio da produção de conhecimento, com o desenvolvimento regional via inovação. O objetivo é verificar se a produção de conhecimento e inovação contribui em alguma medida para o desenvolvimento regional, utilizando uma metodologia com abordagem quali-quantitativa mediante pesquisa bibliométrica no Banco de Dados Scopus. Constatou-se que a UENF tem gerado conhecimento por meio de publicações de documentos, principalmente na área das Ciências Agrárias e Biológicas. Conclui-se, portanto, que esta instituição tem potencial inovador e pode sim contribuir com o desenvolvimento da Região desde que haja engajamento entre ela, governoe empresa, numa Hélice Tríplice.
Capilaridade territorial na provisão de medicamentos básicos no estado do Rio de Janeiro
Authors: Manhaes Eduardo , Hasenclever Lia
Published: July 2021

Esse artigo analisa a Política Pública de Assistência Farmacêutica (AF) nas mesorregiões do estado do Rio de Janeiro por meio da distribuição terraitorial das Unidades Básicas de Saúde (UBS) e dos estabelecimentos do Programa Farmácia Popular do Brasil rede credenciada bem como a relação existente entre a instalação de unidades de AF com o volume populacional e a renda média per capita no ano de 2018. A metodologia emprega indicadores para mensurar a correlação linear entre as variáveis e constrói mapas contendo a localização das unidades de provisionamento de medicamentos básicos. Os resultados mostram que apesar de ter havido uma expansão da provisão de medicamentos, os estabelecimentos da rede credenciada são mais concentrados e os das UBS são mais dispersos no território, o que indica um melhordesempenho destas últimas em termos de distribuição territorial.
Produção científica, capital social e o desenvolvimento regional: um estudo sobre o Norte Fluminense
Authors: Matta Ludmila Gonçalves da , Fonseca Sebastião De Melo
Published: July 2021

O Norte Fluminense possui o segundo maior PIB entre as regiões do estado do Rio de Janeiro. Esse feito se deve, primordialmente, à presença de um conjunto de atividades produtivas de alto valor agregado e especializado alavancado pela indústria de Exploração e Produção de Petróleo e Gás. Na esteira dessa atividade, o setor de serviço tem se desenvolvido na região com uma ampla rede de saúde, de comércio e educação, entre outras. O polo  educacional que se formou na região possui reconhecimento nacional e é responsável por uma expressiva produção científica. Todavia, o que chama atenção na região é o fato de, apesar da presença de atividades econômicas e produtivas de alto valor agregado, de um conjunto evidente de atividades de serviço, de um polo educacional reconhecido, os indicadores sociais ficarem  na esteira do estado e do País. Tendo como baliza essa constatação, levantamos o seguinte questionamento: a produção científica  (capital científico) construída nas instituições de ensino tem sido convertida em capital social e contribuído para o desenvolvimento da Região Norte Fluminense? A partir desse questionamento, tivemos como objetivos mapear as instituições de ensino e pesquisa instaladas no Norte Fluminense; levantar  a produção  científica por meio de teses e dissertações com  o “Norte Fluminense” no título; e analisar o potencial dessa produção em se converter em capital social com capacidade de gerar desenvolvimento regional. A pesquisa tem caráter exploratório e utiliza o método qualitativo, fazendo uso de dados socioeconômicos e do levantamento das dissertações e teses. Como resultado, encontramos uma vasta produção científica com capacidade de contribuir para o desenvolvimento regional, contudo, essa conversão depende da relação entre os demais atores da sociedade, da cooperação mútua, da apropriação do conhecimento gerado pelas instituições de ensino pela sociedade, o que não tem se mostrado efetivo.
O Desenvolvimento Rural sob o olhar de um Novo Paradigma: o caso do estado do Rio de Janeiro
Authors: Ribeiro Alcimar Chagas
Published: July 2021

A crise econômica no estado do Rio de Janeiro gera reflexões sobre possíveis alternativas à atividade petrolífera. As expectativas do setor, sem estratégias efetivas para absorção das externalidades positivas, viraram frustação com o encolhimento produtivo da Bacia de Campos na última década. O investimento no setor agropecuário é indicado pelas lideranças sem um diagnóstico mais abrangente. É nesse sentido a contribuição do presente trabalho, cujo objetivo é desenvolver um diagnostico sistematizado da economia rural fluminense a luz dos fundamentos característicos da economia de baixa densidade conceituada pela OECD. Complementarmente, o trabalho busca ainda enquadrar a economia rural fluminense nos parâmetros do Novo Paradigma Rural da OECD, encontrando resultados desalentadores.
Editorial
Authors: Oliveira Floriano José Godinho de
Published: July 2021

Editorial
Patient-centred prescribing, autonomy and concordance
Authors: Nordoff Joe
Published: July 2021

This article in the JPP Prescribing Paramedic series will focus on patient-centred prescribing, autonomy and concordance. Patient-centred prescribing means putting the patient at the centre of everything we do as clinicians. Autonomy means a patient has an inherent right to make decisions about their care. Concordance means the patient takes medication as prescribed, for the correct length of time. This article details how these three aspects of prescribing can be achieved by the paramedic prescriber, detailing strategies to ensure a consultation and prescribing decision is patient-centred while respecting autonomy, and how concordance can be improved. The article uses a patient consultation as a framing device to detail how these essential aspects of prescribing can be achieved.
Ciprofloxacin
Authors: Rees Sharon
Published: July 2021

In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #ciprofloxacin
Time-domain uplink synchronization method for a spectral efficient OFDMA-based PON
Authors: Nunes Reginaldo B. , Coelho Diogo V. N. , Oliveira Gianni L. S. , Rocha Helder R. O. , Silva Jair A. L. , Segatto Marcelo E. V.
Published: July 2021

The feasibility of a time-domain technique, proposed for uplink synchronization of the bandwidth scalable orthogonal frequency division multiple access passive optical network (BS-OFDMA PON), is experimentally demonstrated. The results show that a delay variation of less than 50% of the cyclic prefix is tolerable, relaxing the thin time synchronization required in the uplink of the evaluated architecture. Moreover, we enhance the spectral efficiency of the BS-OFDMA PON by reducing the guard band (

B
g

) between the optical carrier and the signal bandwidth, as well as by eliminating the frequency gap (

Δ

f
G

) between the optical network units. The downlink results demonstrate that

Δ

f
G

can be eliminated with negligible performance penalties, and

B
g

can be reduced to almost half the signal bandwidth. Error-free transmissions were achieved after uplink propagation over 45 km of single-mode fibers with received power of

≈

−

16.8

d
B
m

and

B
g

=
450

M
H
z

, with a signal bandwidth of 1 GHz.
Tunable dual-comb spectrometer for mid-infrared trace gas analysis from 3 to 4.7 µm
Authors: Nitzsche Leonard , Goldschmidt Jens , Kiessling Jens , Wolf Sebastian , Kühnemann Frank , Wöllenstein Jürgen
Published: July 2021

Dual-frequency comb spectroscopy has emerged as a disruptive technique for measuring wide-spanning spectra with high resolution, yielding a particularly powerful technique for sensitive multi-component gas analysis. We present a spectrometer based on two electro-optical combs with subsequent conversion to the mid-infrared via tunable difference frequency generation, operating in the range from 3 to 4.7 µm. The repetition rate of the combs can be tuned from 250 to 500 MHz. For 500 MHz, the number of detected comb modes is 440 with a signal-to-noise ratio exceeding 105 in 1 s. The conversion preserves the coherence of the combs within 3 s measurement time. Concentration measurements of 5 ppm methane at 3.3 µm, 100 ppm nitrous oxide at 3.9 µm and a mixture of 15 ppm carbon monoxide and 5% carbon dioxide at 4.5 µm are demonstrated with a noise-equivalent absorption coefficient of 6.4(3) x 10−6 cm−1 Hz−1/2.
Frequency-comb-calibrated swept-wavelength interferometry
Authors: Twayana Krishna , Ye Zhichao , Helgason Óskar B. , Vijayan Kovendhan , Karlsson Magnus , Torres-Company Victor
Published: July 2021

Lasers are often used to characterize samples in a non-destructive manner and retrieve sensing information transduced in changes in amplitude and phase. In swept wavelength interferometry, a wavelength-tunable laser is used to measure the complex response (i.e. in amplitude and phase) of an optical sample. This technique leverages continuous advances in rapidly tunable lasers and is widely used for sensing, bioimaging and testing of photonic integrated components. However, the tunable laser requires an additional calibration step because, in practice, it does not tune at a constant rate. In this work, we use a self-referenced frequency comb as an optical ruler to calibrate the laser used in swept-wavelength interferometry and optical frequency domain reflectometry. This allows for realizing high-resolution complex spectroscopy over a bandwidth exceeding 10 THz. We apply the technique to the characterization of low-loss integrated photonic devices and demonstrate that the phase information can disentangle intrinsic from coupling losses in the characterization of high-Q microresonators. We also demonstrate the technique in reflection mode, where it can resolve attenuation and dispersion characteristics in integrated long spiral waveguides.
Color-difference evaluation for 3D objects
Authors: Jiang Lan , Cui Guihua , Melgosa Manuel , Xiao Kaida , Sueeprasan Suchitra
Published: July 2021

A psychophysical experiment using 3D printed samples was conducted to investigate the change of perceived color differences caused by two different illuminations and two 3D sample shapes. 150 pairs of 3D printed samples around five CIE color centers [Color Res. Appl. 20, 399–403, 1995], consisting of 75 pairs of spherical samples and 75 pairs of flat samples, with a wide range of color differences covering from small to large magnitude, were printed by an Mcor Iris paper-based 3D color printer. Each pair was assessed twice by a panel of 10 observers using a gray-scale psychophysical method in a spectral tunable LED viewing cabinet with two types of light sources: diffuse lighting with and without an additional overhead spotlight. The experimental results confirmed that the lighting conditions had more effect on the perceived color difference between complex 3D shapes than between 2D objects. The results for 3D and 2D objects were more similar under only diffuse lighting. Current 3D results had good correlations with previous ones [Color Res. Appl. 24, 356-368, 1999; J. Opt. Soc. Am. A 36, 789-799, 2019] using 2D samples with large color differences, meaning that color-difference magnitude had more effect on perceived color differences than sample shape and lighting. Considering ten modern color-difference formulas, the best predictions of the current experimental data were found for CAM02-LCD formula [Color Res. Appl. 31, 320-330, 2006]. For current results, it was also found that predictions of current color-difference formulas were below average inter-observer variability, and remarkable improvements were found by adding power corrections [Opt. Express 23, 597-610, 2015].
Optical feedback interferometry with 40  km transmission distance based on a distributed feedback fiber laser
Authors: Tu Yourui , Zhao Yuanyang , Zhu Desheng , Li Ruifeng , Liu Keyan , Xu Lin , Zhang Lei , Cao Zhigang , Yu Benli , Lu Liang
Published: July 2021

This Letter proposes an all-fiber self-mixing interferometric method based on laser feedback technology with long transmission distance, which has advantages of high sensitivity and compact structure. We theoretically and experimentally verify that the measurement distance of the self-mixing sensor is not limited to the coherence length of the solitary laser used. In the experiment, the velocity of a non-cooperative target was successfully measured with 40 km transmission distance. Therefore, the all-fiber self-mixing Doppler velocimeter has a great application prospect in the field of remote sensing measurement. Its unique flexibility can be applied to a variety of complex environments of non-cooperative target measurement.
Airy beams on incoherent background
Authors: Hajati Morteza , Sieben Vincent , Ponomarenko Sergey A.
Published: July 2021

We present a class of diffraction-free partially coherent beams, each member of which comprises a finite-power, non-accelerating Airy bump residing on a statistically homogeneous, Gaussian-correlated background. We examine free-space propagation of soft apertured realizations of the proposed beams and show that their evolution is governed by two spatial scales: the coherence width of the background and the aperture size. A relative magnitude of these factors determines the practical range of propagation distances over which the novel beams can withstand diffraction. The proposed beams can find applications to imaging and optical communications through random media.
Space-division multiplexing for optical fiber communications
Authors: Puttnam Benjamin J. , Rademacher Georg , Luís Ruben S.
Published: July 2021

Research on space-division multiplexing (SDM) came to prominence in
early 2010 being primarily proposed as a means of multiplying the
information-carrying capacity of optical fibers at the same time as
increasing efficiency through resource sharing. Proposed SDM
transmission systems range from parallel single-mode fibers with
shared amplifier pump lasers to the full spatial integration of
transceiver hardware, signal processing, and amplification around a
fiber with over 100 spatial channels comprising multiple cores each
carrying multiple modes. In this paper, we review progress in SDM
research. We first outline the main classifications and features of
novel SDM fibers such as multicore fibers (MCFs), multimode fibers,
few-mode MCFs, and coupled-core MCFs. We review research achievements
of each fiber type before discussing digital-signal processing,
amplifier technology, and milestones of transmission and networking
demonstrations. Finally, we draw comparisons between fiber types
before discussing the current trends and speculate on future
developments and applications beyond optical data transmission.
Robustness of neuronal tuning to binaural sound localization cues against age-related loss of inhibitory synaptic inputs
Authors: Ashida Go , Tollin Daniel J. , Kretzberg Jutta
Published: July 2021

Sound localization relies on minute differences in the timing and intensity of sound arriving at both ears. Neurons of the lateral superior olive (LSO) in the brainstem process these interaural disparities by precisely detecting excitatory and inhibitory synaptic inputs. Aging generally induces selective loss of inhibitory synaptic transmission along the entire auditory pathways, including the reduction of inhibitory afferents to LSO. Electrophysiological recordings in animals, however, reported only minor functional changes in aged LSO. The perplexing discrepancy between anatomical and physiological observations suggests a role for activity-dependent plasticity that would help neurons retain their binaural tuning function despite loss of inhibitory inputs. To explore this hypothesis, we use a computational model of LSO to investigate mechanisms underlying the observed functional robustness against age-related loss of inhibitory inputs. The LSO model is an integrate-and-fire type enhanced with a small amount of low-voltage activated potassium conductance and driven with (in)homogeneous Poissonian inputs. Without synaptic input loss, model spike rates varied smoothly with interaural time and level differences, replicating empirical tuning properties of LSO. By reducing the number of inhibitory afferents to mimic age-related loss of inhibition, overall spike rates increased, which negatively impacted binaural tuning performance, measured as modulation depth and neuronal discriminability. To simulate a recovery process compensating for the loss of inhibitory fibers, the strength of remaining inhibitory inputs was increased. By this modification, effects of inhibition loss on binaural tuning were considerably weakened, leading to an improvement of functional performance. These neuron-level observations were further confirmed by population modeling, in which binaural tuning properties of multiple LSO neurons were varied according to empirical measurements. These results demonstrate the plausibility that homeostatic plasticity could effectively counteract known age-dependent loss of inhibitory fibers in LSO and suggest that behavioral degradation of sound localization might originate from changes occurring more centrally.
Intraperitoneal injection of PDTC on the NF-kB signaling pathway and osteogenesis indexes of young adult rats with anterior palatal suture expansion model
Authors: Li Yafang , Qiao Yiqiang , Wang Huanhuan , Wang Zao
Published: July 2021

In recent years, many studies have found that mechanical tension can activiate NF-kB signal pathway and NF-kB plays an important role in the process of osteogenesis. However, it is still unclear whether this process exists in the anterior palatal suture expansion. In this paper, we mainly studied the effect of intraperitoneal injection of PDTC on the NF-kB signaling pathway and osteogenesis index of the anterior palatal suture expansion model in young adult rats. The expansion model is grouped and established: 45 male 8-week-old Sprague-Dawley rats were randomly divided into three groups, an expansion only (EO) group, an expansion plus PDTC (PE) group, and a control group. The results revealed that PDTC inhibited the activity of NF-kB signaling pathway and promote one morphogenetic protein 2 (BMP-2), steocalatin (OCN) expression. Compared with the control group, the optical density (OD) value of BMP in the EO group and PE group rats increased significantly from the first day to the seventh day, and the difference was statistically significant (P<0.05). After 6.0Gy irradiation, PDTC administration group could slightly increase the total SOD level in the liver and serum of rats, and reduce the MDA level in the liver and serum, especially the effect of 60mg/kg and 90mg/kg was the most obvious.
Domestic laundry and microfiber pollution: Exploring fiber shedding from consumer apparel textiles
Authors: Vassilenko Ekaterina , Watkins Mathew , Chastain Stephen , Mertens Joel , Posacka Anna M. , Patankar Shreyas , Ross Peter S.
Published: July 2021

Synthetic fibers are increasingly seen to dominate microplastic pollution profiles in aquatic environments, with evidence pointing to textiles as a potentially important source. However, the loss of microfibers from textiles during laundry is poorly understood. We evaluated microfiber release from a variety of synthetic and natural consumer apparel textile samples (n = 37), with different material types, constructions, and treatments during five consecutive domestic laundry cycles. Microfiber loss ranged from 9.6 mg to 1,240 mg kg-1 of textile per wash, or an estimated 8,809 to > 6,877,000 microfibers. Mechanically-treated polyester samples, dominated by fleeces and jerseys, released six times more microfibers (161 ± 173 mg kg-1 per wash) than did nylon samples with woven construction and filamentous yarns (27 ± 14 mg kg-1 per wash). Fiber shedding was positively correlated with fabric thickness for nylon and polyester. Interestingly, cotton and wool textiles also shed large amounts of microfibers (165 ± 44 mg kg-1 per wash). The similarity between the average width of textile fibers here (12.4 ± 4.5 μm) and those found in ocean samples provides support for the notion that home laundry is an important source of microfiber pollution. Evaluation of two marketed laundry lint traps provided insight into intervention options for the home, with retention of up to 90% for polyester fibers and 46% for nylon fibers. Our observation of a > 850-fold difference in the number of microfibers lost between low and high shedding textiles illustrates the strong potential for intervention, including more sustainable clothing design.
Relevance of diffusion-weighted imaging with background body signal suppression for staging, prognosis, morphology, treatment response, and apparent diffusion coefficient in plasma-cell neoplasms: A single-center, retrospective study
Authors: Yamada Akiko , Araki Yoichi , Tanaka Yuko , Otsuki Shunsuke , Yamada Arisa , Moriyama Mitsuru , Katagiri Seiichiro , Suguro Tamiko , Asano Michiyo , Yoshizawa Seiichiro , Akahane Daigo , Furuya Nahoko , Fujimoto Hiroaki , Okabe Seiichi , Gotoh Moritaka , Suzuki Kunihito , Saito Kazuhiro , Gotoh Akihiko
Published: July 2021

Accurate staging and evaluation of therapeutic effects are important in managing plasma-cell neoplasms. Diffusion-weighted imaging with body signal suppression magnetic resonance imaging (DWIBS-MRI) allows for acquisition of whole-body volumetric data without radiation exposure. This study aimed to investigate the usefulness of DWIBS-MRI in plasma-cell neoplasms. We retrospectively analyzed 29 and 8 Japanese patients with multiple myeloma and monoclonal gammopathy of undetermined significance, respectively, who underwent DWIBS-MRI. We conducted a histogram analysis of apparent diffusion coefficient values. The correlations between each histogram parameter and staging, cell maturation, prognosis, and treatment response were evaluated. We found that the apparent diffusion coefficient values in patients with monoclonal gammopathy of undetermined significance were lower than those in patients with multiple myeloma. Pretreatment apparent diffusion coefficient values of immature myeloma were lower than those of mature myeloma. Moreover, these values decreased in proportion to stage progression in Durie-Salmon classification system but showed no significant correlation with other staging systems or prognosis. Patients were stratified as responder, stable, and non-responder based on the International Myeloma Working Group criteria. The magnitude of changes in apparent diffusion coefficients differed significantly between responders and non-responders (0.154 ± 0.386 ×10–3 mm2/s vs. -0.307 ± 0.424 ×10–3 mm2/s, p = 0.003). Although its usefulness has yet to be established, DWIBS-MRI combined with apparent diffusion coefficient measurement allowed for excellent response evaluation in patients with multiple myeloma. Furthermore, apparent diffusion coefficient analysis using DWIBS-MRI may be useful in predicting cell maturation and total tumor volume.
Operative treatment of fragility fractures of the pelvis is connected with lower mortality. A single institution experience
Authors: Rommens Pol Maria , Boudissa Mehdi , Krämer Sven , Kisilak Miha , Hofmann Alexander , Wagner Daniel
Published: July 2021

Background

Fragility fractures of the pelvis (FFP) represent an increasing clinical entity. Until today, there are no guidelines for treatment of FFP. In our center, recommendation for operative treatment was given to all patients, who suffered an FFP type III and IV and to patients with an FFP type IIwith unsuccessful non-operative treatment. We performed a retrospective observational study and investigated differences between fracture classes and management alternatives. We hypothetized that operative treatment may reduce mortality.

Materials and methods

The medical charts and radiographs of 362 patients were analysed. Patient demographics, FFP-classification, length of hospital stay (LoS), type of treatment, general and surgery-related complications, mortality, Short Form-8 physical component score (SF-8 PCS) and mental component score (SF-8 MCS), Parker Mobility Score (PMS) and Numeric Rating Scale (NRS) were documented.

Results

238 patients had FFP type II and 124 FFP type III and IV. 52 patients with FFP type II (21.8%) and 86 patients with FFP type III and IV (69.4%) were treated operatively (p<0.001). Overall mortality did not differ between the fracture classes (p = 0.127) but was significantly lower in the operative group (p<0.001). Median LoS was significantly higher in FFP type III and IV (p<0.001) and in operated patients (p<0.001). There were more in-hospital complications in patients with FFP type III and IV (p = 0.001) and in the operative group (p = 0.006). More patients of the non-operative group were mobile (p<0.001) and independent (p<0.001) at discharge. Half of the patients could not return in their living environment.203 of the 235 surviving patients (86%) answered the questionnaires after a mean follow-up time of 38 months. SF-8 PCS, SF-8 MCS and PMS did not differ between the fracture classes and treatment groups. Pain perception was higher in the operated group (p = 0.013).

Conclusion

In our study, we observed that operative treatment of FFP provides low mortality rates, although LoS and in-hospital complications were higher in the operative group. At discharge, the non-operative group was more mobile and independent. At follow up, quality of life and mobility were comparable between the groups. Further prospective studies are needed to clarify the impact of operative treatment of FFP on mortality and functional outcome.
Unsupervised multi-source domain adaptation with no observable source data
Authors: Jeon Hyunsik , Lee Seongmin , Kang U
Published: July 2021

Given trained models from multiple source domains, how can we predict the labels of unlabeled data in a target domain? Unsupervised multi-source domain adaptation (UMDA) aims for predicting the labels of unlabeled target data by transferring the knowledge of multiple source domains. UMDA is a crucial problem in many real-world scenarios where no labeled target data are available. Previous approaches in UMDA assume that data are observable over all domains. However, source data are not easily accessible due to privacy or confidentiality issues in a lot of practical scenarios, although classifiers learned in source domains are readily available. In this work, we target data-free UMDA where source data are not observable at all, a novel problem that has not been studied before despite being very realistic and crucial. To solve data-free UMDA, we propose DEMS (Data-free Exploitation of Multiple Sources), a novel architecture that adapts target data to source domains without exploiting any source data, and estimates the target labels by exploiting pre-trained source classifiers. Extensive experiments for data-free UMDA on real-world datasets show that DEMS provides the state-of-the-art accuracy which is up to 27.5% point higher than that of the best baseline.
Health care system efficiency and life expectancy: A 140-country study
Authors: Zarulli Virginia , Sopina Elizaveta , Toffolutti Veronica , Lenart Adam
Published: July 2021

Despite the evidence of links between health expenditure and health care efficiency, it is still unclear why countries with similar levels of health expenditures experience different outputs in terms of life expectancy at birth. Health care system efficiency might shed some light on the question. Using output-oriented data envelopment analysis, we compared the health systems of 140 countries in terms of attained life expectancy. Efficiency is determined by the distance from the closest country on the best practice frontier, which identifies the highest attainable life expectancy observed for any given level of health care spending. By using national data form the Human Development Data, we built the efficiency frontier and computed the potential life expectancy increase for each country. The potential improvement was, on average, 5.47 years [95%CI: 4.71–6.27 years]. The least efficient countries (10th percentile of the efficiency score) could improve by 11.78 years, while the most efficient countries (90th percentile of the efficiency score) could only improve by 0.83 years. We then analyzed, with regression analysis stratified by average education level, and by the role of health-related variables in differentiating efficient and inefficient countries from each other. The results suggest that, among countries with lower levels of education, decreasing unemployment and income inequality increases average life expectancy, without increasing health expenditure levels.
Age-dependent shifts and spatial variation in the diet of endangered Black-faced Spoonbill (Platalea minor) chicks
Authors: Jeong Min-Su , Choi Chang-Young , Lee Woo-Shin , Lee Ki-Sup
Published: July 2021

The endangered Black-faced Spoonbill (Platalea minor) strictly breeds in marine environments and is threatened by the rapid loss of coastal wetlands within its breeding range. Adults with chicks are thought to gradually switch feeding sites from freshwater wetlands to coastal mudflats as the chicks’ osmoregulatory system develops. We investigated age-dependent shifts in the diet of Black-faced Spoonbill chicks at four breeding colonies with varying freshwater habitat availability by examining stable isotopes (δ13C, δ15N) between the tip (grown at the age of 10 days) and middle (grown at the age of 22 days) portions of their primary feathers. The δ13C value of the middle portions was significantly higher than that of the tips, which suggested that the ratio of marine resources increased with the growth and development of chicks. A Bayesian isotope mixing model revealed that the diet proportion of marine prey in the early-chick rearing season was slightly higher than in the late-chick rearing season at three colonies in inshore areas, although this proportion was approximately 60% even in the early chick-rearing period. In contrast, isotopic values and reconstructed diet composition suggested that chicks in an offshore colony with limited freshwater wetlands relied more heavily on freshwater diets for both chick-rearing periods (>80%). Our results suggest that the shifts in feeding sites seen in previous studies might be related to the age-dependent dietary shift of chicks, highlighting the importance of freshwater wetlands for spoonbills on offshore islands without an inflow of freshwater in nearby intertidal mudflats. These findings emphasize the importance of freshwater prey and wetlands even for the endangered marine-breeding spoonbills, even though the negative impact of salt stress remains inconclusive.
Association between smoking history and optical coherence tomography angiography findings in diabetic patients without diabetic retinopathy
Authors: Liu Dong-Wei , Haq Zeeshan , Yang Daphne , Stewart Jay M.
Published: July 2021

Purpose

To investigate any associations between cigarette smoking and retinal microvascular changes in diabetic patients without visible retinopathy.

Design

Retrospective, cross-sectional study.

Participants

1099 eyes from 1099 diabetic patients with no clinical evidence of diabetic retinopathy (DR) were included in this study.

Methods

Diabetic patients underwent optical coherence tomography angiography (OCTA) scanning at Zuckerberg San Francisco General Hospital and Trauma Center between April 2018 and September 2019. Patient demographic and clinical information was collected. Standard bivariate statistics and multivariate linear regression were performed.

Main outcome measures

OCTA parameters included metrics related to the foveal avascular zone (FAZ; area, perimeter, circularity), perfusion density (PD; full, center, inner), and vessel length density (VLD; full, center, inner).

Results

The study population included 750 non-smokers and 349 smokers. FAZ perimeter was the only OCTA parameter that was significantly different between the two groups on uncontrolled analysis (P = 0.033). Multivariate regression analyses revealed significant associations between lower VLD full (β = -0.31, P = 0.048), lower VLD inner (β = -0.35, P = 0.046) and a history of smoking. No significant associations between cigarette smoking and either FAZ or PD were detected.

Conclusions

Our results suggest that smoking is likely associated with deleterious changes in the retinal microvasculature of patients with a history of diabetes and no visible DR. Based on these findings, diabetic patients with a history of smoking may benefit from higher prioritization in terms of ophthalmic screening.
Exploration of physiological sensors, features, and machine learning models for pain intensity estimation
Authors: Pouromran Fatemeh , Radhakrishnan Srinivasan , Kamarthi Sagar
Published: July 2021

In current clinical settings, typically pain is measured by a patient’s self-reported information. This subjective pain assessment results in suboptimal treatment plans, over-prescription of opioids, and drug-seeking behavior among patients. In the present study, we explored automatic objective pain intensity estimation machine learning models using inputs from physiological sensors. This study uses BioVid Heat Pain Dataset. We extracted features from Electrodermal Activity (EDA), Electrocardiogram (ECG), Electromyogram (EMG) signals collected from study participants subjected to heat pain. We built different machine learning models, including Linear Regression, Support Vector Regression (SVR), Neural Networks and Extreme Gradient Boosting for continuous value pain intensity estimation. Then we identified the physiological sensor, feature set and machine learning model that give the best predictive performance. We found that EDA is the most information-rich sensor for continuous pain intensity prediction. A set of only 3 features from EDA signals using SVR model gave an average performance of 0.93 mean absolute error (MAE) and 1.16 root means square error (RMSE) for the subject-independent model and of 0.92 MAE and 1.13 RMSE for subject-dependent. The MAE achieved with signal-feature-model combination is less than 1 unit on 0 to 4 continues pain scale, which is smaller than the MAE achieved by the methods reported in the literature. These results demonstrate that it is possible to estimate pain intensity of a patient using a computationally inexpensive machine learning model with 3 statistical features from EDA signal which can be collected from a wrist biosensor. This method paves a way to developing a wearable pain measurement device.
Addressing cluster-constant covariates in mixed effects models via likelihood-based boosting techniques
Authors: Griesbach Colin , Groll Andreas , Bergherr Elisabeth
Published: July 2021

Boosting techniques from the field of statistical learning have grown to be a popular tool for estimating and selecting predictor effects in various regression models and can roughly be separated in two general approaches, namely gradient boosting and likelihood-based boosting. An extensive framework has been proposed in order to fit generalized mixed models based on boosting, however for the case of cluster-constant covariates likelihood-based boosting approaches tend to mischoose variables in the selection step leading to wrong estimates. We propose an improved boosting algorithm for linear mixed models, where the random effects are properly weighted, disentangled from the fixed effects updating scheme and corrected for correlations with cluster-constant covariates in order to improve quality of estimates and in addition reduce the computational effort. The method outperforms current state-of-the-art approaches from boosting and maximum likelihood inference which is shown via simulations and various data examples.
Gender-affirming care, mental health, and economic stability in the time of COVID-19: A multi-national, cross-sectional study of transgender and nonbinary people
Authors: Jarrett Brooke A. , Peitzmeier Sarah M. , Restar Arjee , Adamson Tyler , Howell Sean , Baral Stefan , Beckham S. Wilson
Published: July 2021

Background

Transgender and nonbinary people are disproportionately affected by structural barriers to quality healthcare, mental health challenges, and economic hardship. This study examined the impact of the novel coronavirus disease (COVID-19) crisis and subsequent control measures on gender-affirming care, mental health, and economic stability among transgender and nonbinary people in multiple countries.

Methods

We collected multi-national, cross-sectional data from 964 transgender and nonbinary adult users of the Hornet and Her apps from April to August 2020 to characterize changes in gender-affirming care, mental health, and economic stability as a result of COVID-19. We conducted Poisson regression models to assess if access to gender-affirming care and ability to live according to one’s gender were related to depressive symptoms, anxiety, and changes in suicidal ideation.

Results

Individuals resided in 76 countries, including Turkey (27.4%, n = 264) and Thailand (20.6%, n = 205). A majority were nonbinary (66.8%, n = 644) or transfeminine (29.4%, n = 283). Due to COVID-19, 55.0% (n = 320/582) reported reduced access to gender-affirming resources, and 38.0% (n = 327/860) reported reduced time lived according to their gender. About half screened positive for depression (50.4%,442/877) and anxiety (45.8%, n = 392/856). One in six (17.0%, n = 112/659) expected losses of health insurance, and 77.0% (n = 724/940) expected income reductions. The prevalence of depressive symptoms, anxiety, and increased suicidal ideation were 1.63 (95% CI: 1.36–1.97), 1.61 (95% CI: 1.31–1.97), and 1.74 (95% CI: 1.07–2.82) times higher for individuals whose access to gender-affirming resources was reduced versus not.

Discussion

The COVID-19 crisis is associated with reduced access to gender-affirming resources and the ability of transgender and nonbinary people to live according to their gender worldwide. These reductions may drive the increased depressive symptoms, anxiety, and suicidal ideation reported in this sample. To improve health of transgender and nonbinary communities, increased access to gender-affirming resources should be prioritized through policies (e.g., digital prescriptions), flexible interventions (e.g., telehealth), and support for existing transgender health initiatives.
Serum adipokine profiles in patients with microscopic polyangiitis and granulomatosis with polyangiitis: An exploratory analysis
Authors: Ahn Sung Soo , Yoon Taejun , Song Jason Jungsik , Park Yong-Beom , Lee Sang-Won
Published: July 2021

Objectives

Previous studies have shown that adipokines may serve as potential biomarkers reflecting disease activity in various autoimmune diseases. Here, we investigated the relationship between four adipokines and clinical/laboratory findings in patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA).

Methods

Sera from 63 patients with MPA and GPA who were registered in a prospective cohort were used to detect serum levels of adiponectin, chemerin, resistin, and vaspin using commercial enzyme-linked immunosorbent assay kits. Associations between adipokines and clinical and laboratory data was assessed using Pearson’s correlation analysis.

Results

The median age was 65.0 years, 24 patients were male, and 42 patients were diagnosed with MPA. The median levels of adiponectin, chemerin, resistin, and vaspin in patient sera were 13.9 ng/mL, 9.2 ng/mL, 23.7 ng/mL, and 0.1 ng/mL, respectively. A significant correlation between chemerin level and five-factor score (FFS) was found (r = 0.320, p = 0.011), and resistin was correlated with both Birmingham vasculitis activity score and FFS (r = 0.256, p = 0.043 and r = 0.320, p = 0.011). Regarding laboratory data, adiponectin level was associated with creatinine, and chemerin level was associated with creatinine, albumin, and erythrocyte sedimentation rate (ESR). On the other hand, resistin was found to be associated with white blood cell count, creatinine, ESR, and C-reactive protein. Age did not have a significant impact on the levels of adipokines.

Conclusions

The expression of adipokines in the sera of patients with MPA and GPA differs depending on clinical and laboratory features, and serum resistin may be suggested as a potential biomarker reflecting disease activity.
Nitrogen and phosphorus losses by surface runoff and soil microbial communities in a paddy field with different irrigation and fertilization managements
Authors: Wang Limin , Huang Dongfeng
Published: July 2021

Rice cultivation usually involves high water and fertilizer application rates leading to the nonpoint pollution of surface waters with phosphorus (P) and nitrogen (N). Here, a 10-year field experiment was conducted to investigate N and P losses and their impact factors under different irrigation and fertilization regimes. Results indicated that T2 (Chemical fertilizer of 240 kg N ha−1, 52 kg P ha−1, and 198 kg K ha−1 combined with shallow intermittent irrigation) decreased N loss by 48.9% compared with T1 (Chemical fertilizer of 273 kg N ha−1, 59 kg P ha−1, and 112 kg K ha−1 combined with traditional flooding irrigation). The loss ratio (total N loss loading/amount of applied N) of N was 9.24–15.90%, whereas that of P was 1.13–1.31% in all treatments. Nitrate N (NO3-−N) loss was the major proportion accounting for 88.30–90.65% of dissolved inorganic N loss through surface runoff. Moreover, the N runoff loss was mainly due to high fertilizer input, soil NO3-−N, and ammonium N (NH4+−N) contents. In addition, the N loss was accelerated by Bacteroidetes, Proteobacteria, Planotomycetes, Nitrospirae, Firmicutes bacteria and Ascomycota fungi, but decreased by Chytridiomycota fungi whose contribution to the N transformation process. Furthermore, T2 increased agronomic N use efficiency (AEN) and rice yield by 32.81% and 7.36%, respectively, in comparison with T1. These findings demonstrated that T2 might be an effective approach to ameliorate soil chemical properties, regulate microbial community structure, increase AEN and consequently reduce N losses as well as maintaining rice yields in the present study.
A modified fluorescent sensor for reporting glucose concentration in the airway lumen
Authors: Bearham Jade , Krutrök Nina , Lindberg Botilda , Woodall Maximillian , Astrand Annika , Taylor John D. , Biggart Matthew , Vasiljevs Stanislavs , Tarran Robert , Baines Deborah L.
Published: July 2021

We have modified the periplasmic Escherichia coli glucose/galactose binding protein (GBP) and labelled with environmentally sensitive fluorophores to further explore its potential as a sensor for the evaluation of glucose concentration in airway surface liquid (ASL). We identified E149C/A213R GBP labelled with N,N’-Dimethyl-N-(iodoacetyl)-N’-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)ethylenediamine (IANBD, emission wavelength maximum 536nm) with a Kd for D-glucose of 1.02mM and a fluorescence dynamic range of 5.8. This sensor was specific for D-glucose and exhibited fluorescence stability in experiments for several hours. The use of E149C/A213R GBP-IANBD in the ASL of airway cells grown at air-liquid-interface (ALI) detected an increase in glucose concentration 10 minutes after raising basolateral glucose from 5 to 15mM. This sensor also reported a greater change in ASL glucose concentration in response to increased basolateral glucose in H441 airway cells compared to human bronchial epithelial cells (HBEC) and there was less variability with HBEC data than that of H441 indicating that HBEC more effectively regulate glucose movement into the ASL. The sensor detected glucose in bronchoalveolar lavage fluid (BALf) from diabetic db/db mice but not normoglycaemic wildtype mice, indicating limited sensitivity of the sensor at glucose concentrations <50μM. Using nasal inhalation of the sensor and spectral unmixing to generate images, E149C/A213R GBP-IANBD fluorescence was detected in luminal regions of cryosections of the murine distal lung that was greater in db/db than wildtype mice. In conclusion, this sensor provides a useful tool for further development to measure luminal glucose concentration in models of lung/airway to explore how this may change in disease.
A patient-oriented research approach to assessing patients’ and primary care physicians’ opinions on trauma-informed care
Authors: Kokokyi Seint , Klest Bridget , Anstey Hannah
Published: July 2021

Objective

To gather patients’ and primary care physicians’ (PCP) opinions on trauma-informed Care (TIC) and to investigate the acceptability of recommendations developed by patient, family, and physician advisors.

Design

Cross-sectional research survey design and patient engagement.

Setting

Canada, 2017 to 2019.

Participants

English-speaking adults and licensed PCPs residing in Canada.

Main outcome measures

Participants were given a series of questionnaires including a list of physician actions and a list of recommendations consistent with TIC.

Results

Patients and PCPs viewed TIC as important. Both patients and PCPs rated the following recommendations as helpful and likely to positively impact patient care: physician training, online trauma resource centres, information pamphlets, the ability to extend appointment times, and clinical pathways for responding to trauma. PCPs’ responses were significantly more positive than patients’ responses.

Conclusion

TIC is important to patients and PCPs. Patients and PCPs believe changes to physician training, patient engagement, and systemic factors would be helpful and likely to positively impact patient care. Future research needs to be conducted to investigate whether these recommendations improve patient care.