bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey Study among Dentist in Bulgaria to Develop a Model for Risk Management in Dental Practice
Authors: Schiller Tihomira , Musurlieva Nina , Bozhkova Tanya , Kondeva Veselina , Dimitrova Mariana , Rimalovska Sevda
Published: June 2022

Background. Quality control and risk management in the field of dental services is an important part of improving patient safety as well as that of the dentists. The introduction of a risk management model would simplify and facilitate this process. Aim. The aim of the study is to gather information about the structurе and organization of work processes in Bulgarian dental practices, which will serve as a basis for building a risk management model. Material and Methods. A survey was conducted among randomly selected dental associations in Bulgaria‐Plovdiv, Sofia, Varna, and Burgas through an anonymized questionnaire, containing 30 questions. The respondents meet the main criteria, namely, to be dentists and to practice in Bulgaria. The study includes demographic data, information on the attitude of Bulgarian dentists towards issues related to quality management, and safety and risk in respect to dental practice. The results have been processed and analyzed through descriptive and graphical analysis using the statistical program SPSS 20.0. Results. A total of 103 Bulgarian dentists took part in the study, out of which 25.24% ± 4.28% have acquired a specialty. Women are 52.43% ± 4.92%, and men −47.57% ± 4.92%. The largest is the relative share of the respondents in the age range of 25‐35 years −63.10% ± 4.75% and with work experience of 6‐15 years −52.43% ± 4.92%. Most of the respondents do not define in writing the main tasks and activities −52.43% ± 4.92%, and do not use checklists in their practice ‐54.73%. The majority of the respondents do not hold regular meetings with their teams −50.49% ± 4.93%, as well as they do not conduct surveys among their patients −68.93% ± 4.56%. The majority of the respondents −41.75% ± 4.86% are guided by their personal judgment in respect to whether the written information provided to patients is comprehensible and accessible. The majority of dentists −45.63% ± 4.91% take informed consent only for expensive procedures in written and oral form −53.40% ± 4.92%. Out of all the respondents, 75.73% ± 4.22% have not analyzed the risk of slipping in their practices for the last two years. Conclusion. There is a lack of written definition of the main tasks and processes, as well as no use of checklists in the practices of most of the interviewed dentists. Meetings with teams are held irregularly. There is a lack of surveys among patients, as well as no objective feedback from patients regarding the comprehensibility of the information materials provided. Informed consent is obtained from patients mainly in written and oral form and only for costly manipulations. In the practices of most of the interviewed dentists, there has been no assessment of the risk of slipping and falling for the last 2 years.
Numerical Study on the Thermal Enhancement of Phase Change Material with the Addition of Nanoparticles and Changing the Orientation of the Enclosure
Authors: Teja P. Narasimha Siva , Gugulothu S. K. , Reddy P. Dinesh Sankar , Ashraf Abdul , Deepanraj B. , Arasu P. Thillai
Published: June 2022

The global demand of the heating and cooling applications gives a larger potential to study the thermal energy storage system. Phase change materials (PCM) that are used to charge, store, and discharge the heat energy are inferior in heat transfer characteristics. The properties of PCM can be improved by adding nanoparticles, changing the orientation of the enclosure or both. Two‐dimensional transient numerical analysis on the effect of Grashoff number (5000, 13000, and 20000), nanoparticle type (Al2O3, CuO, and MWCNT), and volume concentration (0%, 1%, 3%, and 5%) added in RT 42 PCM and orientation of square enclosure (30, 45, and 60°) to enhance the heat transfer rate is carried out. The thermophysical properties of the nano‐PCM are evaluated and presented. From the results, it is affirmed that the melt fraction of the PCM rises with the increase in Gr and volume concentration of the nanoparticles up to an optimum level. The MWCNT‐based nano‐PCM attained a larger portion of melt fraction followed by Al2O3, CuO, and pure PCM. It is noted that an orientation of 60° and 45° will convert more quantities of pure PCM and nano‐PCM into liquid fraction, respectively. The (3% MWCNT/RT‐42 PCM) filled in 45° oriented container attained the highest melt fraction by 3.4%, 2.04%, and 2.94% than (3% Al2O3/RT‐42 PCM), (1%CuO/RT‐42 PCM), and pure PCM. The variation in the maximum melt fraction of the nanomaterial is because of the change in thermophysical characteristics of the nano‐PCM.
Prognostic Nutritional Index Predicts Outcome of PD‐L1 Negative and MSS Advanced Cancer Treated with PD‐1 Inhibitors
Authors: Zhang Yan , Jin Jun , Tang Min , Li Ping , Zhou Li-Na , Du Yi-Ping , Chen Min-Bin
Published: June 2022

Purpose. Tumor mutational burden (TMB), microsatellite instability‐high (MSI‐H), and expression of programmed death ligand‐1 (PD‐L1) have emerged as predictive biomarkers for responsiveness to immune checkpoint inhibitors (ICIs) in several cancer types. However, for patients with negative PD‐L1 expression, or microsatellite stability (MSS), some cases may experience favorable response to immunotherapy, and there is currently a lack of good relevant predictors. We tried to introduce several peripheral blood markers for predicting treatment outcome and immune‐related adverse events (irAEs) in PD‐L1 negative and MSS patients. Methods. A retrospective study of 142 PD‐L1 negative and MSS patients was carried out. The association of peripheral blood markers including lactate dehydrogenase (LDH), neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), albumin‐to‐globulin ratio (AGR), prognostic nutrition index (PNI), and other factors with clinicopathological characters and prognosis were assessed by Cox regression and Kaplan‐Meier methods. Results. Lower level of PNI and poor performance status (ECOG score of 2) was correlated with significantly shorter overall survival (OS) and worse outcome of ICIs. The multivariate analysis revealed that PNI (for OS HR = 0.465, 95% CI: 0.236–0.916, p = 0.027; for PFS HR = 0.493, 95% CI: 0.251–0.936, p = 0.031) and ECOG score (for OS HR = 4.601, 95% CI: 2.676–7.910, p < 0.001; for PFS HR = 2.830, 95% CI: 1.707–4.691, p < 0.001) were independent prognostic factors for OS and PFS. NLR was related to the onset of irAEs. Conclusions. Pretreatment level of PNI and NLR, beyond PD‐L1 expression and MSS, can improve the predictive accuracy for immunotherapy outcomes and has the potential to expand the candidate pool of patients for treatment with ICIs.
Industrial Internet of Things Anti-Intrusion Detection System by Neural Network in the Context of Internet of Things for Privacy Law Security Protection
Authors: Teng Di
Published: June 2022

Today, the Industrial Internet of Things (IIoT) and network technology are highly developed, and network data breaches occur every year. Therefore, an anti-intrusion detection system has been established to improve the privacy law security protection of IIoT. In the adversarial network, the security performance requirements and structural system of the Internet of Things have high-strength requirements. The network system must adopt a system with strong stability and a low data loss rate. After comparing a large number of network structures, the initial network technology in deep learning is adopted. The Convolutional Neural Network (CNN) technology for handwritten character recognition optimizes and upgrades the LeNet-5 network, and the new LeNet-7 is built. Additionally, three network technologies are combined, and an IIoT anti-intrusion detection system is constructed. The performance of the system is tested and verified. The model has high data accuracy, detection rate, and low false-positive rate. The model’s generality on high-performance data is validated and compared with privacy-aware task offloading methods, achieving the best performance. Therefore, the system can be applied to the data privacy law security protection of IIoT.
The Effect of Distance between Sheet Pile and Foundation on Bearing Capacity of Foundation
Authors: Ozpolat Aykut , Aksoy Huseyin Suha
Published: June 2022

In this study, the presence of a foundation near the sheet pile wall built on sand soil was simulated in the laboratory, similar to the field conditions. For this purpose, laboratory tests of sheet pile wall (SPW) (defo) and bearing capacity (qult) of the foundation were carried out by applying vertical loads to the steel model foundation. Besides, laboratory tests were represented by the Mohr‐Coulomb material model under 3D plane deformation conditions, and numerical analyses were performed. These studies were performed by varying the distance among the SPW, the foundation (L), and the penetration depth of SPW (Hp). The results demonstrated that L had a greater effect on qult and δmax than the Hp. When L was kept constant and Hp was increased, it was seen that qult increased and δmax decreased. Moreover, the raise in L has resulted in an increment in the qult and δmax decreased. In addition, a good agreement between numerical analysis and experimental test was observed.
Fuzzy Decision-Making Analysis of Quantitative Stock Selection in VR Industry Based on Random Forest Model
Authors: Zhu Jia-Ming , Geng Yu-Gan , Li Wen-Bo , Li Xia , He Qi-Zhi
Published: June 2022

Since Professor L.A. Zadeh published “Fuzzy Set Theory” in the 1960s, the theory of fuzzy mathematics has been formally established and developed and has been gradually introduced into work in all walks of life. At the same time, fuzzy mathematics theory has also been widely used in VR industry selection. In the stock strategy, the advantages of improving unit classification accuracy, screening high-quality stocks, and constructing near-perfect investment portfolios continue to emerge. On the other hand, with the increasing maturity and continuous development of China’s computer and Internet technologies, the VR industry has gained a new round of development space, and its own investment value and the investable space between related industries have been gradually tapped. Different from the analysis of quantitative stock selection by constructing a logistics multifactor stock selection model in the existing research, the research mainly adopts the random forest algorithm based on fuzzy mathematics to construct the initial investment strategy portfolio. Secondly, different from the single effective frontier algorithm, the research is based on the random forest algorithm, calculates the average AUC of the index, and continuously checks and tests the results to obtain the optimal investment portfolio. Finally, select appropriate risk indicators and performance indicators to evaluate the performance of the strategy portfolio. The study concludes that the portfolios selected by the random forest model are highly investable and have good stability.
The Measurement Method of the Impact Force of Shoulder Tackle and the Influence of the Lower-Extremity Strength on the Impact Force of Shoulder Tackle in Rugby Players
Authors: Song Xiaoneng , Wang Lei , Xu Hui
Published: June 2022

With the rapid development of Internet of things engineering, intelligent sports products are gradually understood by people, providing help for the health and performance of athletes. In rugby training, coaches record and observe the force of data only based on their own experience; the impact force (IF) of shoulder tackle (ST) is a key defensive ability evaluation component for rugby players. However, the information related to female rugby players is limited. Purpose. To understand the strength characteristics of the lower-extremity of rugby players and to develop theoretical references for ST training. Methods. The force sensing device is made with FLexiForceTMA502 pressure sensor, its data acquisition adopts LabVIEW and USB. The strength of the lower extremity was tested by IsoMed 2000, and the IF of ST was measured by a testing system among eighteen Chinese female rugby players, respectively. Results. (1) The reliability and validity of the impact force tester are tested by comparing the actual load with the calibration value and the difference and correlation between the actual load value of different loads and the calibration value of it. (2) At 60°/s and 180°/s, the PT (PT) and relative PT (PT/BW) of bilateral lower-extremity extensors were greater than the flexors. (3) The flexor/extensor PT ratio of the left knee at 60°/s was higher than the right knee. (4) The linear regression equation was established between PT of dominant-side knee extensors and IF of ST. The coefficient β of the linear regression equation was 0.866, 0.862, 0.892, 0.722, 0.788, and 0.737, respectively. Conclusions. (1) The design uses LabVIEW, USB, and FLexiForceTM A502 pressure sensor to complete the overall construction of the data acquisition system and impact force sensing device. (2) It is feasible to use the extensor strength of the dominant-side knee joint as a reference index to evaluate the IF of ST. (3) The balanced development of the front/reverse ST techniques can enhance its defensive capacity of it.
A Loss Function Base on Softmax for Expression Recognition
Authors: Lu Jin , Wu Bo
Published: June 2022

Benefiting from deep learning, the accuracy of face expression recognition tasks based on convolutional neural networks has been greatly improved. However, the traditional SoftMax activation function lacks the ability to discriminate between classes. To solve this problem, the industry has proposed several activation functions based on softmax, such as A-softmax, LMCL, etc. We investigate the geometric significance of the weights from a fully connected layer and consider the weights as the class centers. By extracting the feature vector of several samples and extending the corresponding means to the weights, the model can develop the ability to recognize custom classes without training, while maintaining the accuracy of the original classification. On the expression task, the original seven-category classification is validated to obtain 97.10% accuracy on the CK+ dataset and 88% accuracy on the custom dataset.
MAPK/ERK-CBP-RFPL-3 Mediates Adipose-Derived Stem Cell-Induced Tumor Growth in Breast Cancer Cells by Activating Telomerase Reverse Transcriptase Expression
Authors: Li Wenjie , Qian Cheng , Ma Fei , Liu Meng , Sun Xiaojun , Liu Xu , Liu Chunxiao , Chen Zhenghua , Ma Weichang , Liu Jian , Xu Haiqian , Yang Zhenlin
Published: June 2022

Adipose-derived stem cells (ASCs) improve the self-renewal and survival of fat grafts in breast reconstruction after oncology surgery. However, ASCs have also been found to enhance breast cancer growth, and its role in tumor proliferation remains largely elusive. Here, we explored a novel mechanism that mediates hTERT reactivation during ASC-induced tumor growth in breast cancer cells. In this study, we found the proliferative ability of breast cancer cells markedly increased with ASC coculture. To explore the molecular mechanism, we treated cells with anibody/inhibitor and found that the activation of MEK-ERK pathway was triggered in breast cancer cells by SCF secreted from ASCs, leading to the nuclear recruitment of CBP. As a coactivator of hTERT, CBP subsequently coordinated with RFPL-3 upregulated hTERT transcription and telomerase activity. The inhibition of CBP and RFPL-3 abrogated the activation of hTERT transcription and the promotion of proliferation in breast cancer cells with cocultured ASCs in vitro and in vivo. Collectively, our study findings indicated that CBP coordination with RFPL-3 promotes ASC-induced breast cancer cell proliferation by anchoring to the hTERT promoter and upregulating telomerase activity, which is activated by the MAPK/ERK pathway.
Generative Adversarial Network for Musical Notation Recognition during Music Teaching
Authors: Li Na
Published: June 2022

In order to improve the quality and efficiency of music teaching, we try to automate the teaching of music notation. With the addition of computer vision technology and note recognition algorithms, we improve the generative adversarial network to enhance the recognition accuracy and efficiency of music short scores. We adopt an embedded matching structure based on adversarial neural networks, starting from generators and discriminators, respectively, to unify generators and discriminators from the note input side. Each network layer is then laid out according to a cascade structure to preserve the different layers of note features in each convolutional layer. Residual blocks are then inserted in some network layers to break the symmetry of the network structure and enhance the ability of the adversarial network to acquire note features. To verify the efficiency of our method, we select monophonic spectrum, polyphonic spectrum, and miscellaneous spectrum datasets for validation. The experimental results demonstrate that our method has the best recognition accuracy in the monophonic spectrum and the miscellaneous spectrum, which is better than the machine learning method. In the recognition efficiency of note detail information, our method is more efficient in recognition and outperforms other deep learning methods.
Artificial Intelligence Algorithm in Classification and Recognition of Primary Hepatic Carcinoma Images under Magnetic Resonance Imaging
Authors: He Zehua , Huang Qingqiang , Liao Yingyang , Xu Xiaojie , Wu Qiulin , Nong Yuanle , Peng Ningfu , He Wanrong
Published: June 2022

This study aimed to discuss the application value of the bias field correction algorithm in magnetic resonance imaging (MRI) images of patients with primary hepatic carcinoma (PHC). In total, 52 patients with PHC were selected as the experimental group and divided into three subgroups: mild (15 cases), moderate (19 cases), and severe (18 cases) according to pathological grading. Another 52 patients with hepatic nodules in the same period were included in the control group. All the patients underwent dynamic contrast‐enhanced (DCE) MRI examination, and the image qualities of MRI before and after bias field correction were compared. The DCE‐MRI perfusion parameters were measured, including the transport constant Ktrans, reverse rate constant Kep, extravascular extracellular volume fraction (Ve), plasma volume (Vp), microvascular density (MVD), hepatic artery perfusion index (HPI), mean transit time of contrast agent (MTT), time to peak (TTP), blood volume (BV), hepatic arterial perfusion (HAP), full perfusion (FP), and portal venous perfusion (PVP). It was found that the sensitivity (93.63%), specificity (71.62%), positive predictive value (95.63%), negative predictive value (71.62%), and accuracy (90.01%) of MRI examination processed by the bias field correction algorithm were all significantly greater than those before processing (P < 0.05). The Ktrans, Kep, Ve, Vp, and MVD of patients in the experimental group were significantly larger than those of the control group, and severe group> moderate group> mild group (P < 0.05). HPI, MTT, TTP, BV, and HAP of patients in the experimental group were also significantly greater than those of the control group, which was shown as severe group > moderate group > mild group (P < 0.05). FP and PVP of the experimental group were significantly lower than those of the control group, and severe group < moderate group < mild group (P < 0.05). It was suggested that in MRI images of patients with PHC, the bias field correction algorithm could significantly improve the diagnosis rate. Each perfusion parameter was related to the pathological grading, which could be used to evaluate the prognosis of patients.
Effect and Mechanism of lncRNA CERS6-AS1 on the Biological Behavior of Prostate Cancer Cell
Authors: Huang Fu , Zhou Li Quan
Published: June 2022

Objective. To investigate the effect of long noncoding RNA (lncRNA) CERS6 antisense RNA1 (CERS6-AS1) on the biological behavior of prostate cancer cells DU145 and its mechanism. Methods. RT-PCR was used to detect the relative level of CERS6-AS1 and miR-16-5p in prostate cancer tissues, adjacent tissues, prostate cancer cells DU145, and human normal prostate epithelial cells RWPE-1. DU145 cells were divided into control group, si-CERS6-AS1 group, si-NC group, miR-16-5p mimic group, miR-NC group, and si-CERS6-AS1+miR-16-5p inhibitor group. And CCK-8 method and colony formation test was applied to detect cell proliferation ability, flow cytometry was selected to calculate cell apoptosis, and scratch healing test was employed to assess cell migration ability. Western blot was determined to detect high mobility protein A2 (HMGA2) expression. RT-PCR and dual-luciferase reporter experiments were used to analyze the targeting relationship among CERS6-AS1, miR-16-5p, and HMGA2. Results. Compared with the adjacent tissues, the relative level of CERS6-AS1 in prostate cancer tissue was increased (

P
<
0.05

), and the relative level of miR-16-5p was decreased (

P
<
0.05

). Compared with RWPE-1 cells, the relative level of CERS6-AS1 in DU145 cells was increased (

P
<
0.05

), and the relative level of miR-16-5p was decreased (

P
<
0.05

). Compared with the control group and the si-NC group, the HMGA2 protein expression, the colony formation number, and the scratch healing rate of DU145 cells in the si-CERS6-AS1 group and the miR-16-5p mimic group were reduced (

P
<
0.05

), and the relative level of miR-16-5p and the proliferation inhibition rate and apoptosis were increased (

P
<
0.05

). miR-16-5p is specifically bound to CERS6-AS1 and HMGA2, respectively. Compared with the si-CERS6-AS1 group, the HMGA2 protein expression, the colony formation number, and the scratch healing rate of DU145 cells in the si-CERS6-AS1+miR-16-5p inhibitor group were increased (

P
<
0.05

), and the cell proliferation inhibition rate and apoptosis rate were reduced (

P
<
0.05

). Conclusion. Silencing CERS6-AS1 can inhibit the proliferation and migration of prostate cancer cell DU145 and induce cell apoptosis, the mechanism is related to the regulation of the miR-16-5p/HMGA2 axis.
Analysis of Fuzzy Kuramoto-Sivashinsky Equations under a Generalized Fuzzy Fractional Derivative Operator
Authors: Aljahdaly Noufe H. , Naeem Muhammad , Wyal Noorolhuda
Published: June 2022

This paper evaluates a semianalytical strategy combined with a novel fuzzy integral transformation and an iterative method inside the fuzziness concept known as the new iterative transform method. Additionally, we apply the abovementioned technique to the fractional fuzzy Kuramoto-Sivashinsky equations with

g
H

-differentiability by employing various initial conditions. Numerous algebraic properties of the fuzzy fractional derivative Atangana-Baleanu operator are illustrated concerning the Shehu transformation to demonstrate their utility. Additionally, a general technique for Atangana-Baleanu fuzzy fractional derivatives is proposed in the sense of Caputo. It is important to note that the purpose of the suggested fuzziness technique is to establish the efficiency and accuracy of analytical solution to nonlinear fuzzy fractional partial differential equations that emerge in complex and physical structures.
[Retracted] Empirical Method for Thyroid Disease Classification Using a Machine Learning Approach
Authors: Alyas Tahir , Hamid Muhammad , Alissa Khalid , Faiz Tauqeer , Tabassum Nadia , Ahmad Aqeel
Published: June 2022

There are many thyroid diseases affecting people all over the world. Many diseases affect the thyroid gland, like hypothyroidism, hyperthyroidism, and thyroid cancer. Thyroid inefficiency can cause severe symptoms in patients. Effective classification and machine learning play a significant role in the timely detection of thyroid diseases. This timely classification will indeed affect the timely treatment of the patients. Automatic and precise thyroid nodule detection in ultrasound pictures is critical for reducing effort and radiologists’ mistake rate. Medical images have evolved into one of the most valuable and consistent data sources for machine learning generation. In this paper, various machine learning algorithms like decision tree, random forest algorithm, KNN, and artificial neural networks on the dataset create a comparative analysis to better predict the disease based on parameters established from the dataset. Also, the dataset has been manipulated for accurate prediction for the classification. The classification was performed on both the sampled and unsampled datasets for better comparison of the dataset. After dataset manipulation, we obtained the highest accuracy for the random forest algorithm, equal to 94.8% accuracy and 91% specificity.
Hypertension Resolution after Laparoscopic Adrenal Tumor Resection in Patients of Adrenal Incidentaloma with Normal Hormone Levels
Authors: Wang Jing , Zhu Yunpeng , Wang Zhixian , Liu Chang , Liu Shiliang , Li Xing , Chen Ruibao , Zhan Ying , Wang Shaogang , Zeng Xiaoyong
Published: June 2022

Introduction: Postoperative hypertension resolution among patients with adrenal incidentalomas and normal hormone levels was unknown. Identifying the predictive factors was beneficial to the management of adrenal incidentalomas. Methods: We conducted a retrospective cohort study, recruiting patients undergoing laparoscopic adrenal tumor resection for adrenal incidentaloma with hypertension and normal hormone levels. Demographic, clinical, treatment, and laboratory data were collected and compared. We used univariable and multivariable logistic regression methods to identify the predictive factors of postoperative hypertension resolution. Results: Of the 171 patients in our study, 130 (76.0%) patients performed a resolution of hypertension, and 57 (33.3%) patients had a significant reduction. Multivariate logistic regression analysis showed that the male sex (odds ratio (OR) 0.305, 95% confidence interval (CI): 0.098–0.948, p = 0.040), body mass index (BMI) (OR 0.973, 95% CI: 0.670–0.938, p = 0.007), aldosterone and plasma renin activity ratio (APR) in erect position (OR 1.206, 95% CI: 1.042–1.397, p = 0.012), and preoperative systolic pressure (OR 1.044, 95% CI: 1.009–1.080, p = 0.014), were significantly associated with the outcomes of hypertension resolution. Discussion/Conclusion: Adrenal incidentalomas patients with hypertension and normal hormone levels would perform hypertension resolution after laparoscopic adrenal tumor resection, especially for females with low BMI, high preoperative systolic blood pressure, and high APR (erect position).
Spontaneous Twin Pregnancy: A Challenging and Exceptional Scenario in a Patient on Maintenance Hemodialysis in Sub-Saharan Africa
Authors: Maimouna Mahamat , Fouda Hermine Menye Ebana , Nzana F. Victorine , Nono Aristide Eric Tomta , Mekone Isabelle Nkwelle , Mbala Peter , Kaze François Folefack , Ashuntantang Gloria
Published: June 2022

Chronic hemodialysis is associated with reduced fertility. Hence, pregnancy remains rare, challenging, and deleterious when unplanned, especially in low-resource countries. Contraception and births are very important in these settings. Though the main modes of contraception have been proposed in the chronic kidney disease (CKD) population, contraception still remains challenging in patients on maintenance hemodialysis. Most doctors, however, overlook contraception because of the low fertility, high rate of amenorrhea, and low libido. Furthermore, patients are less receptive to contraceptive counseling either because of a high desire to give birth or due to amenorrhea and low libido. Management of unplanned pregnancies is therefore very challenging and a multidisciplinary approach is the rule; however, it does not guarantee a good prognosis for both the mother and child. Very few cases of multiple pregnancies without induction of ovulation have been reported in patients with severe renal failure, especially those on maintenance dialysis. A 32-year-old multiparous woman with end-stage kidney failure (ESKF) and a residual diuresis of 700 mL per day who had been on inadequate maintenance hemodialysis for 36 months, presented with abdominal distension, which was confirmed on abdominal ultrasound to be a twin pregnancy at 22 weeks of gestation. Thereafter, we intensified hemodialysis (3 sessions/week), managed hypertension and anemia. The obstetrical course was uneventful until the 25th week of gestation when she developed grade 3 (WHO) hypertension and peripheral fluid overload. At the 29th week, she had a spontaneous vaginal preterm delivery of 2 babies weighing 1,350 g and 1,000 g, with an Apgar score of 8 and 7, respectively. Babies, however, died on day 1 and day 5 postpartum, respectively, from respiratory distress and early neonatal infection. The evolution of the mother was uneventful as she continued with her hemodialysis sessions. Twin pregnancies are a rare and very high-risk condition in end-stage renal disease and require multidisciplinary management.
Estudo ergométrico evolutivo de portadoras de fibromialgia primária em programa de treinamento cardiovascular supervisionado
Authors: Sabbag Lívia Maria dos Santos , Dourado Maristela Palácios , Yasbek Júnior Paulo , Novo Neil Ferreira , Kaziyama Helena Hideko Seguchi , Miyazaki Margarida Harumi , Battistella Linamara Rizzo
Published: June 2022

Fibromialgia é uma síndrome dolorosa crônica caracterizada por dor musculoesquelética generalizada1,2,3,4,5. Na última década, o exercício físico tornou-se promissor como opção terapêutica da síndrome6,7,8,9,10,11,12,13,14. Objetivo: avaliação ergométrica prospectiva de portadoras de fibromialgia primária (FP) em programa de treinamento cardiovascular supervisionado (TCS). Treze mulheres, média de idade de 48,9 anos, portadoras de FP, submeteram-se a teste ergométrico (TE) em esteira rolante, protocolo de Ellestad, no tempo zero, 3o e 6o meses de TCS. Os critérios de interrupção do TE foram cansaço e dor. Para o TCS, foi estabelecida uma faixa de 60% a 70% da freqüência cardíaca (FC) máxima, calculada pelo método de Karvonen. A assiduidade foi superior a 80% de 72 sessões, 3 vezes por semana, com duração de 60 minutos. Realizada a avaliação subjetiva da dor muscular e analisadas as variáveis do TE. Análise estatística: variância dos postos de Friedman e teste de comparações múltiplas15. Resultados: no 3o mês, houve aumento significativo da resposta cronotrópica. No 3o e 6o meses, foram significativos: aumento do tempo de exercício, capacidade funcional, trabalho total e diminuição da FC carga máxima comum. Não houve diferença significante da DPAS, duplo produto (DP), DP carga máxima comum e %FC máxima. Comparadas com o final do TE do tempo zero, a maior porcentagem de pacientes atingiu cargas mais elevadas e a mesma intensidade de dor no 3o e 6o meses de TCS. Conclusão: a partir do 3o mês de TCS, as portadoras de FP apresentaram maior tolerância à dor muscular e ao esforço, melhora da capacidade funcional cardiovascular e muscular periférica.
Densidade mineral óssea após lesão medular
Authors: Brito Christina May Moran de , Battistella Linamara Rizzo , Sakamoto Hatsue , Saito Elizabete Tsubomi
Published: June 2022

A osteoporose é uma das reconhecidas complicações da lesão medular, mas na prática clínica muitas vezes tem sido deixada para segundo plano quando comparada às outras complicações decorrentes da lesão. Grande parte da perda óssea ocorre nos primeiros quatro a seis meses após a lesão e se estabiliza doze a dezesseis meses após. Ocorre em todos os segmentos, mas é mais acentuada nos segmentos paralisados, situando-se em torno de 4% ao mês em áreas ricas em osso trabecular e 2% ao mês em áreas com predomínio de osso cortical no primeiro ano após a lesão. A incidência de fraturas se situa entre 1% a 7% e estas são muitas vezes decorrentes de traumas mínimos. Os mecanismos envolvidos na perda óssea não estão totalmente esclarecidos. Trabalhos com ortostatismo e cinesioterapia não demonstraram benefício significativo no que diz respeito à redução da perda de massa óssea e trabalhos com estimulação elétrica funcional apresentam resultados divergentes, parecendo resultar em algum benefício local. O uso de medicação anti-reabsortiva parece constituir opção promissora, juntamente com a ingesta diária adequada de cálcio, mas estudos são ainda necessários para este fim. Este estudo teve como objetivo avaliar o impacto da lesão medular na densidade mineral óssea de 20 pacientes lesados medulares crônicos em acompanhamento ambulatorial na Divisão de Medicina de Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo e possíveis fatores de influência sobre o padrão de perda óssea. Os métodos utilizados incluíram exames clínico e laboratorial e densitometria óssea de corpo inteiro. Foram incluídos nesse estudo 15 homens e 5 mulheres, entre 17 e 50 anos (mulheres até 35 anos), sendo 8 com tetraplegia e 12 com paraplegia, e o tempo de lesão variou de 10 meses a 10 anos. A avaliação densitométrica não evidenciou diferença significativa entre pacientes com e sem espasticidade. Também não houve correlação entre a porcentagem de massa magra e a densidade mineral óssea. A dissociação da densidade mineral óssea entre a coluna lombar e a pelve, com maior perda óssea em nível da pelve, foi um achado comum. A maior perda foi evidenciada em membros inferiores com média de -3,3 desvios-padrão em comparação ao pico de massa óssea do adulto jovem. Conclui-se então que tanto pacientes tetraplégicos quanto paraplégicos apresentam perda óssea significativa, particularmente em pelve e membros inferiores, sem influência do grau de espasticidade.
A Predictive Processing Model of Episodic Memory and Time Perception
Authors: Fountas Zafeirios , Sylaidi Anastasia , Nikiforou Kyriacos , Seth Anil K. , Shanahan Murray , Roseboom Warrick
Published: June 2022

Human perception and experience of time are strongly influenced by ongoing stimulation, memory of past experiences, and required task context. When paying attention to time, time experience seems to expand; when distracted, it seems to contract. When considering time based on memory, the experience may be different than what is in the moment, exemplified by sayings like “time flies when you're having fun.” Experience of time also depends on the content of perceptual experience—rapidly changing or complex perceptual scenes seem longer in duration than less dynamic ones. The complexity of interactions among attention, memory, and perceptual stimulation is a likely reason that an overarching theory of time perception has been difficult to achieve. Here, we introduce a model of perceptual processing and episodic memory that makes use of hierarchical predictive coding, short-term plasticity, spatiotemporal attention, and episodic memory formation and recall, and apply this model to the problem of human time perception. In an experiment with approximately 13,000 human participants, we investigated the effects of memory, cognitive load, and stimulus content on duration reports of dynamic natural scenes up to about 1 minute long. Using our model to generate duration estimates, we compared human and model performance. Model-based estimates replicated key qualitative biases, including differences by cognitive load (attention), scene type (stimulation), and whether the judgment was made based on current or remembered experience (memory). Our work provides a comprehensive model of human time perception and a foundation for exploring the computational basis of episodic memory within a hierarchical predictive coding framework.
Reading between the lines:
Authors: Dann Beverly , Drabble Anne , Martin Janet
Published: June 2022

The aim of this paper is to explore how first-year university students at a regional university in Australia perceive and use Information Literacy (IL) as they transition from school to university. A survey method was used to gather data through pre- and post-intervention surveys with 1,333 first-year students enrolled in their first semester of study across all disciplines at the university. The study identified that between 25–35% of students did not enjoy reading, with many students preferring not to read. Students arrived at university with largely misguided confidence in their personal IL skills, especially the skills needed to meet the demands of university level coursework, with up to 47% of students unlikely to have experienced well-resourced libraries at school. The study concludes that implications for university teaching include gaining an early understanding of the IL skills students have when they arrive at university, and the explicit teaching of IL skills, given the identified impact of IL skills on student success and retention rates.
Latent Heat Nudging in the Canadian High-Resolution (2.5 km) Regional Deterministic Prediction System
Authors: Jacques Dominik , Michelson Daniel
Published: June 2022

This study examines the application of latent heat nudging (LHN) for the assimilation of radar-derived precipitation rates in the 2.5-km High-Resolution Deterministic Prediction System (HRDPS) operated by Environment and Climate Change Canada. One goal of this study is to document the overall impact of applying LHN in the most recent operational implementation of the HRDPS. On average, for 110 forecasts conducted over a 2-month period in 2016, LHN is shown to improve a composite NWP index (measuring the average change in RMSE over many variables and observation types) by ∼1.5% compared to a control experiment with no LHN. For winds between 400 and 100 hPa, reductions in RMSE between 1% and 4% are found for lead times up to 48 h. For precipitation, improvements for lead times up to 6 h are shown. Another goal of this study is to quantify the relative contributions for certain components of the LHN implementation. The features being investigated are the inclusion of LHN within the assimilation cycle, the use of idealized heating profiles and the conservation of relative humidity. The 2-month forecasting experiments are conducted with these components deactivated in turn. By comparing these experiments, it is found that the inclusion of LHN in the assimilation cycle has the largest impact. It is also found that the use of idealized profiles in locations where precipitation is observed but not simulated is a critical aspect of this implementation of LHN. A case study is also provided to illustrate the impact of LHN on altitude winds.
A Blameworthy Burial: A Methodology for Inner-Biblical Allusion with a Case Study from Chronicles
Authors: Hutchison D. Allen
Published: June 2022

King Asa’s funeral description is the longest in the book of Chronicles and unique in the number of specific details it includes. Scholars generally see Asa’s funeral in 2 Chron. 16.14 in a positive light despite the negative tone of the preceding verses. Certainly, Chronicles is not afraid to portray a Judean king in both positive and negative terms (e.g., Manasseh). However, using an adapted synchronic and diachronic methodology for assessing inner-biblical connections, this study identifies and evaluates the shared language found in Exod. 30.25, 1 Chron. 9.30, and 2 Chron. 16.14. The study reveals a recurrent allusion that is both 1) an indication that post-exilic temple workers followed the Torah and 2) an indictment against using a special anointing oil for honoring the dead instead of honoring God.
Endangered or Dangerous? YHWH’s Presence and Impurity in Levitical Perspective
Authors: Harper G. Geoffrey
Published: June 2022

The working assumption in much secondary literature on Leviticus is that unchecked sin and impurity threaten, even endanger, YHWH’s earthly presence. Accordingly, purgation within the Israelite cult is primarily viewed as a means of securing and safeguarding divine immanence. Support is drawn from ANE concepts of sanctuary desecration, the exit of YHWH’s כבוד from the temple in Ezekiel 8–11 and tannaitic formulations. Nevertheless, this article contends that Leviticus nowhere indicates or assumes the departure of YHWH’s presence from the sanctuary. On the contrary, Leviticus asserts the permanence of divine presence and the resulting danger posed to impurity and its sources. This dynamic better coheres with the wider texture of the Pentateuch. In fact, importing motifs from ANE, Ezekielian and rabbinic sources arguably distorts the rhetorical force of Leviticus in its literary setting.
Eglon’s Fat and Ehud’s Oracle: A Reconsideration of Humour in Judges 3.12–30
Authors: Schroeder Ryan D.
Published: June 2022

Judg. 3.12–30 details the assassination of King Eglon of Moab by the Benjaminite Ehud ben Gera. Many scholars insist that the story was originally meant to be funny, contending that the text casts Eglon (i.e. ‘Little Calf’) humorously as a slaughtered bovine. Indeed, some regard the text as ‘satire’, though there remains no consensus as to what, exactly, constitutes the butt of the joke. In this article, I argue that Eglon’s fat and Ehud’s feigned oracle work together to form a comical critique of foreign rulers and their reliance on divination. The argument draws on Victor Raskin’s semantic theory of verbal humour along with a re-examination of fat on elite male bodies in the Hebrew Bible and the practice of ancient oracle giving, as reflected in cuneiform sources. I thus aim to elucidate ways the text would have registered as humorous and meaningful for an ancient West Asian audience.
Long-term outcome and predictors of long-term outcome in patients with lupus nephritis managed at a tertiary hospital in Mumbai
Authors: Yadav Sandeep , Balakrishnan C , Kothari Jatin
Published: June 2022

Aim

Study the long-term outcome of the patients with LN and identify the baseline factors that can predict the long-term outcome of these patients

Methods

All biopsy-proven LN patients who attended our regular ‘lupus nephritis’ clinic from 2013 to 2021 were studied. Data of these patients were collected from the hospital patient records. Standard therapy was given as per the KDIGO guidelines, and the renal response was evaluated according to KDIGO outcome criteria. Cox’ regression analysis was used to determine predictors of chronic kidney disease (persistent doubling of serum creatinine with creatinine ≥1.5 mg%). Kaplan–Meier analysis was used for renal survival.

Results

Eighty patients with at least 1 year of follow-up were included. Median age of onset was 24 years (IQR18-35). Median follow up was 6.5 years (IQR 3–10). World Health Organisation renal biopsy profile was Class I 1(1.2 %), Class II 6(7.5 %), Class III 9(11.2 %), Class IV 36(45 %), Class V 18(22.5 %) and Mixed Class IV + V 10 (12%). Complete remission was achieved in 63.75%, 70 % and 66.6% patients at 1, 2 and 5 years, respectively. Survival with normal renal function was 88.5 %, 85.8% and 60 % at 5, 10 and 15 years, respectively. Risk factors for poor outcome on univariate analysis were presence of Raynaud’s phenomena-hazard ratio(HR) 7.78 (CI 1.944–31.207; p < .004), baseline hypertension-HR 5.356 (CI 1.479–19.403; p < .011), tubulointerstitial involvement-HR 1.076 (CI 1.032–1.222; p < .001), time to complete response-HR 1.036 (CI 1.036–1.067; p < .02 ), serum creatinine at 6 months HR 10.51 (CI 2.19–50.39; p < .003), failure to achieve complete response at 2 years HR 6.271 (CI 1.567–25.092; p < .009) and the number of nephritic flares HR 1.868(CI 1.103–3.164 ; p < .02). Renal relapses were quite common, with 1.8 flares per 10 patient-years of follow up. Infection was the most common cause of death, with bacterial lower respiratory infections and pulmonary tuberculosis being the most common.

Conclusions

Apart from conventional risk factors, other predictive factors like the presence of Raynaud’s phenomenon, tubulointerstitial fibrosis and tubular atrophy on kidney biopsy, and initial response to induction therapy by 6 months have a significant impact on the long-term outcome in patients with LN.
Benjamin W. Betts and his computable approach towards morphogenesis
Authors: Soltan Rahmati Hossein , Ayatollahi Mohammad Hossein
Published: June 2022

Morphological theories in architecture are more popular than ever partly due to the rapid developments in computational techniques. This rapid development, however, is more fruitful when it is informed of the philosophical and ethical bases of such techniques. The neglected historical case of Benjamin W. Betts, an architect of the late Victorian Britain, is an early example of the effects of philosophical presuppositions on computable theories of morphogenesis in arts and architecture. The aims of this study are to shed light on his motivations and sources of inspiration, and also to present an algorithm for his procedure. We used the only book available on the Betts' works in addition to archival materials to conduct the research. Betts was under heavy influence of Idealism and Oriental thought in his symbology and the morphogenetic procedure he designed. The Python/Grasshopper algorithm for Rhino presented in this paper produces two dimensional Betts' diagrams that can be used as an educational tool or an opportunity of enjoying the beauty of mathematical forms, and the immense variety they offer thanks to parameterization.
Health Disparities Likely Emerge Early in the Course of Type-1 Diabetes in Youth
Authors: Tremblay Elise Schlissel , Liu Enju , Laffel Lori M.
Published: June 2022

Background:

Type-1 diabetes (T1D) management and glycemic control the year after diagnosis affects the long-term trajectory of T1D. Disparities in hemoglobin A1c (HbA1c) based on race, ethnicity, and socioeconomic status (SES) have been well-documented; however, there has been limited investigation into the timeline with which these disparities develop. This study aims to assess differences in HbA1c by race/ethnicity and SES among youth with T1D over 1 year post diagnosis.

Methods:

HbA1c at onset, and 3, 6, 9, and 12 months following diagnosis was collected from youth with T1D between 2016 and 2020. Mixed-effect models examined associations of HbA1c over time with race/ethnicity and SES.

Results:

Of 758 patients, 71% identified as white. Mean (± SD) HbA1c was 11.4% ± 2.2% at diagnosis and 7.3% ± 1.2%, 7.3% ± 1.3%, 7.7% ± 1.4%, and 7.9% ± 1.4% at 3, 6, 9, and 12 months, respectively. HbA1c trajectories over time differed significantly by race (adjusting for sex and zip-code education and poverty levels) with Hispanic and black youth demonstrating higher HbA1c 1 year after diagnosis (8.7% vs 7.7%, p < .001) than white youth.

Conclusions:

These data revealed that youth did not meet glycemic targets at 1 year post diagnosis and that racial/ethnic minority youth had higher HbA1c 1 year post diagnosis, highlighting the need to optimize glycemic control and mitigate disparities early. Understanding the time course of these outcomes helps to inform the need for early interventions, particularly in disadvantaged patient populations, to lay the groundwork for improved control. Further research must also be done to better understand overlapping axes of disparities including race, ethnicity, and SES.