bluuebunny/crossref_metadata_2025 huggingface dataset:
Global-local attention for emotion recognition
Authors: Le Nhat , Nguyen Khanh , Nguyen Anh , Le Bac
Published: December 2021

Human emotion recognition is an active research area in artificial intelligence and has made substantial progress over the past few years. Many recent works mainly focus on facial regions to infer human affection, while the surrounding context information is not effectively utilized. In this paper, we proposed a new deep network to effectively recognize human emotions using a novel global-local attention mechanism. Our network is designed to extract features from both facial and context regions independently, then learn them together using the attention module. In this way, both the facial and contextual information is used to infer human emotions, therefore enhancing the discrimination of the classifier. The intensive experiments show that our method surpasses the current state-of-the-art methods on recent emotion datasets by a fair margin. Qualitatively, our global-local attention module can extract more meaningful attention maps than previous methods. The source code and trained model of our network are available at https://github.com/minhnhatvt/glamor-net.
Alternative management of proximal aortic dissection: concept and application
Authors: Yuan Xun , Mitsis Andreas , Mozalbat David , Nienaber Christoph A.
Published: December 2021

Open surgery remains the mainstay of treatment for acute type A aortic dissection and should be offered to most patients. However, there are elderly patients in which surgical treatment may be deemed extremely high risk or futile. Endovascular treatment approaches have been applied to a small number of these patients and data are limited to case reports and small series. The application of endovascular therapies to ascending aorta is currently limited by anatomical and technical challenges posed by the dynamic motion of the ascending aorta and the proximity of vital structures to intended landing zones (aortic valve, coronary arteries, and supra-aortic branches) and lack of specially designed endografts to address these issues. While thoracic endovascular aortic repair (TEVAR) has replaced open aortic repair for a suitable lesion in distal aortic dissection, some selected patients with type A aortic dissection at high surgical may be candidates. Hence, there is potential because, in proximal (Stanford type A) dissections, 10–30% of patients are not accepted for surgery, and 30–50% are technically amenable for TEVAR. Recent experience has shown that carefully selected patients with favorable anatomical characteristics may be subject to endovascular stent-graft treatment as a last resort with mixed results. Technical improvement is necessary to offer. satisfactory endovascular options in non-surgical candidates.
AI audits for assessing design logics and building ethical systems: the case of predictive policing algorithms
Authors: Ugwudike Pamela
Published: December 2021

Organisations, governments, institutions and others across several jurisdictions are using AI systems for a constellation of high-stakes decisions that pose implications for human rights and civil liberties. But a fast-growing multidisciplinary scholarship on AI bias is currently documenting problems such as the discriminatory labelling and surveillance of historically marginalised subgroups. One of the ways in which AI systems generate such downstream outcomes is through their inputs. This paper focuses on a specific input dynamic which is the theoretical foundation that informs the design, operation, and outputs of such systems. The paper uses the set of technologies known as predictive policing algorithms as a case example to illustrate how theoretical assumptions can pose adverse social consequences and should therefore be systematically evaluated during audits if the objective is to detect unknown risks, avoid AI harms, and build ethical systems. In its analysis of these issues, the paper adds a new dimension to the literature on AI ethics and audits by investigating algorithmic impact in the context of underpinning theory. In doing so, the paper provides insights that can usefully inform auditing policy and practice instituted by relevant stakeholders including the developers, vendors, and procurers of AI systems as well as independent auditors.
New Hermite–Hadamard and Jensen Inequalities for Log-h-Convex Fuzzy-Interval-Valued Functions
Authors: Khan Muhammad Bilal , Abdullah Lazim , Noor Muhammad Aslam , Noor Khalida Inayat
Published: December 2021

In the preset study, we introduce the new class of convex fuzzy-interval-valued functions which is called log-h-convex fuzzy-interval-valued functions (log-h-convex FIVFs) by means of fuzzy order relation. We have also investigated some properties of log-h-convex FIVFs. Using this class, we present Jensen and Hermite–Hadamard inequalities (HH-inequalities). Moreover, some useful examples are presented to verify HH-inequalities for log-h-convex FIVFs. Several new and known special results are also discussed which can be viewed as an application of this concept.
Multi-criteria Optimization Technique with Complex Pythagorean Fuzzy N-soft Information
Authors: Akram Muhammad , Wasim Faiza , Alcantud José Carlos R. , Al-Kenani Ahmad N.
Published: December 2021

The main objective of this article is to lay the foundations of a novel multi-criteria optimization technique, namely, the complex Pythagorean fuzzy N-soft VIKOR (CPFNS-VIKOR) method that is highly proficient to express a great deal of linguistic imprecision and vagueness inherent in human assessments. This strategy provides a versatile decision-making tool for the ranking-based fuzzy modeling of two-dimensional parameterized data. The CPFNS-VIKOR method integrates the ground-breaking specialities of the VIKOR method with the outstanding parametric structure of the complex Pythagorean fuzzy N-soft model. It is exclusively designed for the specification of a compromise optimal solution having maximum group utility and minimum individual regret of the opponent by analyzing their weighted proximity from ideal solutions. The developed strategy factually permits specific linguistic terms to demystify the individual perspectives of the decision-making experts regarding the efficacy of the alternatives and the priorities of the applicable criteria. We comprehensively assemble these independent appraisals of all the experts using the complex Pythagorean fuzzy N-soft weighted averaging operator. Moreover, we calibrate the ranking measure by utilizing group utility measure and regret measure in order to specify the hierarchical outranking of the feasible alternatives. We demonstrate the systematic methodology and framework of the proposed method with the assistance of an explicative flow chart. We skilfully investigate an empirical analysis related to selection of constructive industrial robots for the modernization of a manufacturing industry which really justifies the remarkable accountability of the proposed strategy. Furthermore, we validate this technique by a comparative study with the existing complex Pythagorean fuzzy TOPSIS (CPF-TOPSIS) method, complex Pythagorean fuzzy VIKOR (CPF-VIKOR) method and Pythagorean fuzzy TOPSIS (PF-TOPSIS) method. The comparative study is exemplified with an illustrative bar chart that visually endorses the rationality of the proposed methodology by interpreting highly compatible and accurate final outcomes. Finally, we holistically analyze the functionality of the developed strategy to enlighten its merits and prominence over other available competent approaches.
Some Integral Inequalities for Generalized Convex Fuzzy-Interval-Valued Functions via Fuzzy Riemann Integrals
Authors: Khan Muhammad Bilal , Noor Muhammad Aslam , Mohammed Pshtiwan Othman , Guirao Juan L. G. , Noor Khalida Inayat
Published: December 2021

In this study, we introduce the new concept of $$h$$
h
-convex fuzzy-interval-valued functions. Under the new concept, we present new versions of Hermite–Hadamard inequalities (H–H inequalities) are called fuzzy-interval Hermite–Hadamard type inequalities for $$h$$
h
-convex fuzzy-interval-valued functions ($$h$$
h
-convex FIVF) by means of fuzzy order relation. This fuzzy order relation is defined level wise through Kulisch–Miranker order relation defined on fuzzy-interval space. Fuzzy order relation and inclusion relation are two different concepts. With the help of fuzzy order relation, we also present some H–H type inequalities for the product of $$h$$
h
-convex FIVFs. Moreover, we have also established strong relationship between Hermite–Hadamard–Fej´er (H–H–Fej´er) type inequality and $$h$$
h
-convex FIVF. There are also some special cases presented that can be considered applications. There are useful examples provided to demonstrate the applicability of the concepts proposed in this study. This paper's thoughts and methodologies could serve as a springboard for more research in this field.
Interactive Artistic Multi-style Transfer
Authors: Wang Xiaohui , Lyu Yiran , Huang Junfeng , Wang Ziying , Qin Jingyan
Published: December 2021

Artistic style transfer is to render an image in the style of another image, which is a challenge problem in both image processing and arts. Deep neural networks are adopted to artistic style transfer and achieve remarkable success, such as AdaIN (adaptive instance normalization), WCT (whitening and coloring transforms), MST (multimodal style transfer), and SEMST (structure-emphasized multimodal style transfer). These algorithms modify the content image as a whole using only one style and one algorithm, which is easy to cause the foreground and background to be blurred together. In this paper, an iterative artistic multi-style transfer system is built to edit the image with multiple styles by flexible user interaction. First, a subjective evaluation experiment with art professionals is conducted to build an open evaluation framework for style transfer, including the universal evaluation questions and personalized answers for ten typical artistic styles. Then, we propose the interactive artistic multi-style transfer system, in which an interactive image crop tool is designed to cut a content image into several parts. For each part, users select a style image and an algorithm from AdaIN, WCT, MST, and SEMST by referring to the characteristics of styles and algorithms summarized by the evaluation experiments. To obtain richer results, the system provides a semantic-based parameter adjustment mode and the function of preserving colors of content image. Finally, case studies show the effectiveness and flexibility of the system.
Multi-experts Joint Decision with Adaptive Model Updater for Robust Visual Tracking
Authors: Li Da , Zou Qixiang , Zhang Ke
Published: December 2021

Over these years, correlation filters based trackers have shown edges both in accuracy and speed. However, variations of target appearance caused by heavy occlusion, rotation, background clutters and target deformations are the major challenges for tracking. To solve these problems, many works put on exploiting the power of target representation, such as high-level convolutional features. Nonetheless, these methods make a great compromise between the speed and performance. At the same time, there are few researches on improving the performance of model updater and the ensemble methods. In this paper, a multi-experts joint decision strategy base on kernelized correlation filters is proposed to obtain robust and accurate visual tracking, two trackers with handcrafted features and deep convolutional neural network features are integrated in this framework. We also investigate the mechanism of tracking failure caused by occlusion and background clutters, and propose a novel criterion to evaluate the reliability of samples. Our work includes extending the kernelized correlation filter-based tracker with the capability of handling scale changes as well. The proposed tracker is extensively evaluated on the OTB-2013, OTB-2015 and VOT2015 benchmark datasets. Compared with the state-of-the-art trackers, the distinguished experimental results demonstrate the effectiveness of the proposed framework.
New Concepts of Intuitionistic Fuzzy Trees with Applications
Authors: Rao Yongsheng , Kosari Saeed , Shao Zehui , Talebi A. A. , Mahdavi A. , Rashmanlou Hossein
Published: December 2021

It is known that Intuitionistic fuzzy models give more precision, flexibility and compatibility to the system as compared to the classic and fuzzy models. Intuitionistic fuzzy tree has an important role in neural networks, computer networks, and clustering. In the design of a network, it is important to analyze connections between the levels. In addition, the intuitionistic fuzzy tree is becoming increasingly significant as it is applied to different areas in real life. The study proposes the novel concepts of intuitionistic fuzzy graph (IFG) and some basic definitions. We investigate the types of arcs, for example,$$\alpha _{\mu }$$αμ-strong,$$\beta _{\mu }$$βμ-strong, and$$\delta _{\mu }$$δμ-arc in an intuitionistic fuzzy graph, and introduce some of their properties. In particular, the present work develops the concepts of intuitionistic fuzzy bridge (IFB), intuitionistic fuzzy cut nodes (IFCN) and some important properties of an intuitionistic fuzzy bridge. Next, we define an intuitionistic fuzzy cycle (IFC) and an intuitionistic fuzzy tree (IFT). Likewise, we discuss some properties of the IFT and the relationship between an intuitionistic fuzzy tree and an intuitionistic fuzzy cycle. Finally, an application of intuitionistic fuzzy tree is illustrated in other sciences.
On Neutrosophic Quadruple Groups
Authors: Smarandache F. , Rezaei A. , Agboola A. A. A. , Jun Y. B. , Borzooei R. A. , Davvaz B. , Borumand Saeid Arsham , Akram M. , Hamidi M. , Mirvakili S.
Published: December 2021

As generalizations and alternatives of classical algebraic structures there have been introduced in 2019 the NeutroAlgebraic structures (or NeutroAlgebras) and AntiAlgebraic structures (or AntiAlgebras). Unlike the classical algebraic structures, where all operations are well defined and all axioms are totally true, in NeutroAlgebras and AntiAlgebras, the operations may be partially well defined and the axioms partially true or, respectively, totally outer-defined and the axioms totally false. These NeutroAlgebras and AntiAlgebras form a new field of research, which is inspired from our real world. In this paper, we study neutrosophic quadruple algebraic structures and NeutroQuadrupleAlgebraicStructures. NeutroQuadrupleGroup is studied in particular and several examples are provided. It is shown that $$(NQ({\mathbb {Z}}),\div )$$

(
N
Q
(
Z
)
,
÷
)

is a NeutroQuadrupleGroup. Substructures of NeutroQuadrupleGroups are also presented with examples.
An Improved Lightning Search Algorithm Employed Performance Enhancement in Distribution System
Authors: Isha G. , Jagatheeswari P.
Published: December 2021

The proposed research work minimizes the power loss in distribution system under load conditions which is the major issue nowadays that has been reduced to reach the maximum possible power for satisfying the customer needs. Optimal siting of Distribution Static Compensator (DSTATCOM) and Photo-Voltaic (PV) array in distribution system is used to attain voltage profile improvement, reduced voltage instability and less power loss. For this, Improved Lightning Search Algorithm (ILSA) has been proposed to accomplish the objectives. The proposed ILSA has reached the Voltage Stability Index (VSI) value as 0.9877 and it outstandingly decreased the power loss to 55.92 kW which are validated with IEEE 30-bus system using MATLAB toolbox. The obtained results are compared with the existing optimization algorithms and it depicts that the proposed ILSA is more advantageous than other optimization algorithms.
Epidemiological Characteristics of 69,382 COVID-19 Patients in Oman
Authors: Al Awaidy Salah T. , Khamis Faryal , Al Rashidi Badria , Al Wahaibi Ahmed H. , Albahri Abdulrahim , Mahomed Ozayr
Published: December 2021

Objectives

To describe the epidemiological characteristics of the first 69,382 patients with COVID-19 infection in Oman.

Methods

A retrospective case series study of patients diagnosed with SARS-CoV-2 infection in Oman from 24 February to 23 July 2020. The data were obtained from the National surveillance COVID-19 network.

Results

The overall mean age of patients was 34 (± 14) years, 74% (n = 51,391) were males, 40,859 (59%) were Omani citizens, and 28,523 (41%) were foreign-born individuals. The most common symptoms at presentation were fever 50% (n = 34,600), cough 46% (n = 32,062), sore throat 46% (n = 31,953) and shortness of breath (SOB) 35% (n = 24,567). Overall, 8,960 (12.9%) patients required hospitalization with 1189 (13.3%) individuals requiring admission to the intensive care unit (ICU) and mechanical ventilation (MV). Patients hospitalized with COVID-19 infection were mostly Omani nationals and males between 30 and 39 years old (p < 0.001). The mortality rate was 7.7 per 100,000 population (n = 359) with rates of 9.4 (n = 278) and 4.8 (n = 81) deaths per 100,000 population in Omani nationals and foreign-born individuals, respectively. Females hospitalized with COVID-19 had a mean age of 64 (± 18) years versus a mean age of 55 (± 17) years in males. Mean age of patients with COVID-19-related mortality was 58 (± 18) years with significant differences in mean age between females and males 64 (± 18) versus 55 (± 17) years, respectively.

Conclusions

Young Omani males accounted for the highest incidence of COVID-19 infection and hospitalization, while mortality rates were higher among males and the older age (> 50 years). Identifying the epidemiological characteristics and outcomes of COVID-19-infected patients is essential for developing targeted intervention strategies and preparing for the resurgence of anticipated second and third waves of this pandemic.
Prevalence and Socioeconomic Factors of Diabetes and High Blood Pressure Among Women in Kenya: A Cross-Sectional Study
Authors: Yaya Sanni , El-Khatib Ziad , Ahinkorah Bright Opoku , Budu Eugene , Bishwajit Ghose
Published: December 2021

Background

The emerging burden of high blood pressure (HBP) and diabetes in sub-Saharan Africa will create new challenges to health systems in African countries. There is a scarcity of studies that have reported associations of diabetes and HBP with socioeconomic factors on women within the population. We assessed the prevalence and socioeconomic factors of diabetes and high blood pressure among women in Kenya.

Methods

We analysed cross-sectional data from the 2014 Kenya Demographic and Health Survey. Subjects were women aged 15–49 years. Self-reported status of HBP and diabetes was used to measure the prevalences. The association between educational and wealth index with HBP and diabetes was assessed by multivariable binary logistic regression.

Results

The prevalences of self-reported HBP and diabetes were 9.4% and 1.3%, respectively. Women with secondary [aOR = 1.53; 95% CI = 1.15–2.02] and primary [aOR = 1.48; 95% CI = 1.15–1.92] levels of education were more likely to report having HBP, compared to those with no formal education. However, there was no significant association between educational level and self-reported diabetes. In terms of wealth quintile, we found that women with higher wealth quintile were more likely to report having HBP and diabetes compared to those with poorest wealth quintile. Specifically, the highest odds of self-reported HBP was found among women with richest wealth quintile compared to those with poorest wealth quintile [aOR = 2.22; 95% CI = 1.71–2.88]. Also, women with poorer wealth quintile were more likely to have self-reported diabetes compared to those with poorest wealth quintile [aOR = 1.89; 95% CI = 1.08–2.38].

Conclusion

The prevalence of HBP and diabetes was low among women in Kenya. Household wealth status was associated with HBP and diabetes. No causation can be inferred from the data; hence, longitudinal studies focusing on health-related behaviour associated with NCDs are recommended. Proper dissemination of health information regarding the risk factors for HBP and diabetes may prove to be beneficial for NCD prevention programmes.
Risk Factors for SARS-CoV-2 Infection Severity in Abu Dhabi
Authors: Baynouna AlKetbi Latifa Mohammad , Nagelkerke Nico , Abdelbaqi Hanan , ALBlooshi Fatima , AlSaedi Mariam , Almansoori Shamsa , AlNuaimi Ruqaya , AlKhoori Amal , AlAryani Aysha , AlShamsi Mariam , Kayani Fatima , Alblooshi Noura , AlKhajeh Shamma , AlFalahi Jehan , AlAmeri Sumaya , AlDhahei Saeed
Published: December 2021

Background

Prediction models are essential for informing screening, assessing prognosis, and examining options for treatment. This study aimed to assess the risk of SARS-CoV-2 infection severity in the Abu Dhabi population.

Methods

This is a mixed retrospective cohort study and case–control study to explore the associated factors of receiving treatment in the community, being hospitalized, or requiring complex hospital care among patients with a diagnosis of SARS-CoV-2. Of 641 patients included, 266 were hospitalized; 135 were hospitalized and either died or required complex care, i.e., required ICU admission, intubation, or oxygen and 131 did not develop severe disease requiring complex care. The third group (“controls”) were 375 patients who were not hospitalized. Logistic regression analyses were used to study predictors of disease severity.

Results

Among hospitalized patients older age and low oxygen saturation at admission were the consistent and strongest predictors of an adverse outcome. Risk factors for the death in addition to age and low oxygen saturation were elevated white blood count and low reported physical activity. Chronic kidney disease and diabetes were also associated with more severe disease in logistic regression. The mortality rate among those with less than 30 min per week of physical activity was 4.9%, while the mortality rate was 0.35% for those with physical activity > 30 min at least once a week. The interval from the onset of symptoms to admission and mortality was found to have a significant inverse relationship, with worse survival for shorter intervals.

Conclusion

Oxygen saturation is an important measure that should be introduced at screening sites and used in the risk assessment of patients with SARS-CoV-2. In addition, an older age was a consistent factor in all adverse outcomes, and other factors, such as low physical activity, elevated WBC, CKD, and DM, were also identified as risk factors.
Epidemiokinetic Tools to Monitor Lockdown Efficacy and Estimate the Duration Adequate to Control SARS-CoV-2 Spread
Authors: Mégarbane Bruno , Bourasset Fanchon , Scherrmann Jean-Michel
Published: December 2021

Various key performance indicators (KPIs) are communicated daily to the public by health authorities since the COVID-19 pandemic has started. “Upstream” KPIs mainly include the incidence of detected Sars-CoV-2-positive cases in the population, and “downstream” KPIs include daily hospitalizations, intensive care unit admissions and fatalities. Whereas “downstream” KPIs are essential to evaluate and adapt hospital organization, “upstream” KPIs are the most appropriate to decide on the strength of restrictions such as lockdown set up and evaluate their effectiveness. Here, we suggested tools derived from pharmacokinetic calculations to improve understanding the epidemic progression. From the time course of the number of new cases of SARS-coV-2 infection in the population, it is possible to calculate the infection rate constant using a simple linear regression and determine its corresponding half-life. This epidemic regression half-life is helpful to measure the potential benefits of restriction measures and to estimate the adequate duration of lockdown if implemented by policymakers in relation to the decided public health objectives. In France, during the first lockdown, we reported an epidemic half-life of 10 days. Our tools allow clearly acknowledging that the zero-COVID target is difficult to reach after a period of lockdown as seven half-lives are required to clear 99.2% of the epidemic and more than 10 half-lives to almost reach the objective of eliminating 100% of the contaminations.
Age-Specific Etiology of Severe Acute Respiratory Infections and Influenza Vaccine Effectivity in Prevention of Hospitalization in Russia, 2018–2019 Season
Authors: Sominina Anna , Danilenko Daria , Komissarov Andrey , Pisareva Maria , Musaeva Tamila , Bakaev Mikhail , Afanasieva Olga , Stolyarov Kirill , Smorodintseva Elizaveta , Rozhkova Elena , Obraztsova Elena , Dondurey Elena , Guzhov Dmitry , Timonina Veronica , Golovacheva Ekaterina , Kurskaya Olga , Shestopalov Alexander , Smirnova Svetlana , Alimov Alexander , Lioznov Dmitry
Published: December 2021

The expansion and standardization of clinical trials, as well as the use of sensitive and specific molecular diagnostics methods, provide new information on the age-specific roles of influenza and other respiratory viruses in development of severe acute respiratory infections (SARI). Here, we present the results of the multicenter hospital-based study aimed to detect age-specific impact of influenza and other respiratory viruses (ORV). The 2018–2019 influenza season in Russia was characterized by co-circulation of influenza A(H1N1)pdm09 and A(H3N2) virus subtypes which were detected among hospitalized patients with SARI in 19.3% and 16.4%, respectively. RSV dominated among ORV (15.1% of total cases and 26.8% in infants aged ≤ 2 years). The most significant SARI agents in intensive care units were RSV and influenza A(H1N1)pdm09 virus, (37.3% and 25.4%, respectively, of PCR-positive cases). Hyperthermia was the most frequently registered symptom for influenza cases. In contrast, hypoxia, decreased blood O2 concentration, and dyspnea were registered more often in RSV, rhinovirus, and metapneumovirus infection in young children. Influenza vaccine effectiveness (IVE) against hospitalization of patients with PCR-confirmed influenza was evaluated using test-negative case–control design. IVE for children and adults was estimated to be 57.0% and 62.0%, respectively. Subtype specific IVE was higher against influenza A(H1N1)pdm09, compared to influenza A(H3N2) (60.3% and 45.8%, respectively). This correlates with delayed antigenic drift of the influenza A(H1N1)pdm09 virus and genetic heterogeneity of the influenza A(H3N2) population. These studies demonstrate the need to improve seasonal influenza prevention and control in all countries as states by the WHO Global Influenza Strategy for 2019–2030 initiative.
Understanding the Prevalence and Geographic Heterogeneity of SARS-CoV-2 Infection: Findings of the First Serosurvey in Uttar Pradesh, India
Authors: Namasivayam Vasanthakumar , Jain Amita , Agrawal Vikasendu , Prakash Ravi , Dehury Bidyadhar , Becker Marissa , Blanchard James , Isac Shajy , Prasad Amit Mohan
Published: December 2021

Population-based serological antibody test for SARS-CoV-2 infection helps in estimating the exposure in the community. We present the findings of the first district representative seroepidemiological survey conducted between 4 and 10 September 2020 among the population aged 5 years and above in the state of Uttar Pradesh, India. Multi-stage cluster sampling was used to select participants from 495 primary sampling units (villages in rural areas and wards in urban areas) across 11 selected districts to provide district-level seroprevalence disaggregated by place of residence (rural/urban), age (5–17 years/aged 18 +) and gender. A venous blood sample was collected to determine seroprevalence. Of 16,012 individuals enrolled in the study, 22.2% [95% CI 21.5–22.9] equating to about 10.4 million population in 11 districts were already exposed to SARS-CoV-2 infection by mid-September 2020. The overall seroprevalence was significantly higher in urban areas (30.6%, 95% CI 29.4–31.7) compared to rural areas (14.7%, 95% CI 13.9–15.6), and among aged 18 + years (23.2%, 95% CI 22.4–24.0) compared to aged 5–17 years (18.4%, 95% CI 17.0–19.9). No differences were observed by gender. Individuals exposed to a COVID confirmed case or residing in a COVID containment zone had higher seroprevalence (34.5% and 26.0%, respectively). There was also a wide variation (10.7–33.0%) in seropositivity across 11 districts indicating that population exposed to COVID was not uniform at the time of the study. Since about 78% of the population (36.5 million) in these districts were still susceptible to infection, public health measures remain essential to reduce further spread.
Psychological Impact of COVID-19 Pandemic on Healthcare Workers in Riyadh, Saudi Arabia: Perceived Stress Scale Measures
Authors: Alwaqdani Nuha , Amer Hala A. , Alwaqdani Reem , AlMansour Fahad , Alzoman Hind A. , Saadallah Amal , Alsuwaidan Salem , Soule Barbra M. , Memish Ziad A.
Published: December 2021

Background

The COVID-19 pandemic has been stressful and of considerable concern among health care workers (HCWs). Being particularly at increased risk for exposure, HCWs worry about becoming infected as well as infecting co-workers, patients and family members. Such distress and panic may have destructive effects on individuals and may last long after the pandemic situation leading to depression or post-traumatic stress disorder. Therefore, the aim of the current study is to measure and investigate the prevalence of the factors affecting psychological stress during the COVID-19 pandemic among HCWs.

Methods

A self-administered online survey—including perceived stress scale (PSS) questions—was disseminated among HCWs in Riyadh, Saudi Arabia (SA) between1st June and 30th July 2020.

Results

A total of 469 HCWs responded to the survey for a high response rate (93.8%). The PSS revealed that 15.8% of the respondents were suffering from high stress levels, 77.2% were suffering from moderate stress levels and 7% with low stress levels. Females and junior frontline staff reported more severe stress levels. Participation on the pandemic team shows significant impact on stress levels.

Conclusion

COVID-19 pandemic has increased stress levels among HCWs and affects their psychological wellbeing. Designing programs promoting HCWs mental health are crucial and emotional and psychological support strategies should be part of every public health crisis management plan.
Conjunctival Lesions: A 5-Year Basic Demographic Data and Clinicopathological Review in a Tertiary Eye Care Hospital
Authors: Alkatan Hind M. , Alshomar Khalid M. , Helmi Hala A. , Alhothali Wajda M. , Alshalan Abdulaziz M.
Published: December 2021

Background

Conjunctival lesions are common with a wide spectrum of benign, premalignant, and malignant lesions. Few histopathological studies have been conducted on conjunctival lesions with variable designs and results. Our aim in this study is to provide information on common conjunctival lesions seen in an ophthalmology tertiary care center in Saudi Arabia.

Methods

A retrospective, observational study of all consecutive conjunctival tissue specimens sent for histopathological assessment to the pathology department from 2015 to 2019 were analyzed. Clinical data were collected from medical records, and the histopathological slides were reviewed by a single pathologist.

Results

A total of 110 conjunctival specimens from 108 patients were included (mean age: 53 years, 67 males and 43 females). Bilateral involvement was mostly found in inflammatory lesions (40%). Most lesions were benign (91%), with a significantly longer duration of symptoms in malignant lesions (p = 0.036*). The clinical diagnosis matched the final histopathological diagnosis in 75.5% of the total specimens. The most frequent category of benign lesions was fibrodegenerative and proliferative lesions (53.6%), with a significantly higher prevalence among adult males (p < 0.001). Melanocytic lesions were more common in children (33.3%) than adults (9.8%), and the mean age of children was significantly lower (p = 0.013). The most frequent malignant lesion was ocular surface squamous neoplasia (50%), with equal prevalence among males and females. The overall outcome was favorable in 89.4% and unfavorable in 10.6%, mostly due to surgical complications, further progression of the lesion, or recurrence.

Conclusion

This study shows variability in the frequency of conjunctival lesions based on gender, age, geographical, racial, and environmental factors. There has been a shift in the gender-based prevalence of ocular squamous neoplasia over the last three decades, probably due to a change in lifestyle.
Senile Cataract in Patients with Diabetes with and Without Diabetic Retinopathy: A Community-Based Comparative Study
Authors: Alabdulwahhab Khalid Mohammad
Published: December 2021

Aim

We compare the incidence rates of cataract in persons with diabetes with and without diabetic retinopathy in Saudi Arabia, for the first time. In addition, we explored the role of new factor, diabetes age of onset and several other known factors.

Methods

In a community-based cross-sectional study, 334 persons with diabetes type 2 were randomly selected from a diabetic register. Detailed history and comprehensive ophthalmic examination was done at an eye clinic. Body Mass Index, blood pressure and glycosylated hemoglobin were also recorded.

Results

In 668 eyes, cataract and diabetic retinopathy were present in 35.5% and 32.2%, respectively. Diabetic retinopathy, age, duration of diabetes and systolic BP were found to be independent risk factors for cataract. Whereas, gender, BMI, HbA1c use of insulin and diastolic BP have no significant association with cataract. Persons with cataract had significantly higher age of onset of diabetes. Most of the cataracts were cortical followed by PSC, while minority were nuclear.

Conclusion

DR is an independent risk factor of developing cataract in persons with diabetes. Others are age, duration of DM and hypertension. Age-of-onset of DM is a new factor we report it to be significantly associated with cataract.
Systematic Analysis of the Global, Regional and National Burden of Cardiovascular Diseases from 1990 to 2017
Authors: Wang Zhenkun , Du Aihua , Liu Hong , Wang Ziwei , Hu Jifa
Published: December 2021

Background

Previous studies on the burden of cardiovascular diseases (CVDs) were mainly based on limited data of the study period or area, or did not include detailed risk factor analysis.

Objective

To investigate up-to-date temporal and regional trends and risk factors of mortality and disability-adjusted life years (DALYs) attributed to CVDs by age, sex, and disease throughout the world.

Methods

Data for the disease burden of CVDs in 195 countries and territories from 1990 to 2017, including mortality, DALYs, age-standardized mortality rates, and age-standardized DALY rates, were estimated from the Global Burden of Disease Study 2017. Risk factors attributable to deaths and DALYs for CVDs were also estimated using the comparative risk assessment framework.

Results

The number of deaths from CVDs increased by 48.62%, from 11.94 (95% UI 11.78–12.18) million in 1990 to 17.79 (17.53–18.04) million in 2017. However, the age-standardized mortality rate decreased by an average of − 1.45% (− 1.72% to − 1.18%) annually. After fluctuation in the expected age-standardized mortality rate of CVDs in most of the socio-demographic index (SDI) scale, these rates decrease rapidly for SDI values of 0.7 and higher. In 2017, metabolic risks accounted for 73.48% of deaths and 73.25% of DALYs due to CVDs, behavioral factors accounted for 63.23% of deaths and 66.71% of attributable DALYs.

Conclusion

CVDs remain a major global health burden due to the increment in death numbers and DALYs. Aging and the main risk factors are the main drivers of mortality and health loss. More attention to main risk factors should be paid with supportive health policies.
Global Existence and Blow-Up for the Pseudo-parabolic p(x)-Laplacian Equation with Logarithmic Nonlinearity
Authors: Zeng Fugeng , Deng Qigang , Wang Dongxiu
Published: December 2021

In this paper, we study the initial boundary value problem of the pseudo-parabolic p(x)-Laplacian equation with logarithmic nonlinearity. The existence of the global solution is obtained by using the potential well method and the logarithmic inequality. In addition, the sufficient conditions of the blow-up are obtained by concavity method.
The Extended Birnbaum–Saunders Distribution Based on the Scale Shape Mixture of Skew Normal Distributions
Authors: Poursadeghfard Tahereh , Nematollahi Alireza , Jamalizadeh Ahad
Published: December 2021

In this article, a large class of univriate Birnbaum–Saunders distributions based on the scale shape mixture of skew normal distributions is introduced which generates suitable subclasses for modeling asymmetric data in a variety of settings. The moments and maximum likelihood estimation procedures are disscused via an ECM-algorithm. The observed information matrix to approximate the asymptotic covariance matrix of the parameter estimates is then derived in some subclasses. A simulation study is also performed to evaluate the finite sample properties of ML estimators and finally, a real data set is analyzed for illustrative purposes.
Publication and the Papacy in Late Antiquity and the Middle Ages
Authors: Niskanen Samu
Published: December 2021

This Element explores the papacy's engagement in authorial publishing in late antiquity and the Middle Ages. The opening discussion demonstrates that throughout the medieval period, papal involvement in the publication of new works was a phenomenon, which surged in the eleventh century. The efforts by four authors to use their papal connexions in the interests of publicity are examined as case studies. The first two are St Jerome and Arator, late antique writers who became highly influential partly due to their declaration that their literary projects enjoyed papal sanction. Appreciation of their publication strategies sets the scene for a comparison with two eleventh-century authors, Fulcoius of Beauvais and St Anselm. This Element argues that papal involvement in publication constituted a powerful promotional technique. It is a hermeneutic that brings insights into both the aspirations and concerns of medieval authors. This title is also available as Open Access on Cambridge Core.
Complement Inhibition in Myasthenia Gravis and Neuromyelitis Optica Spectrum Disorder
Authors: Dodig Dubravka , Genge Angela , Selchen Daniel , Freedman Mark S.
Published: December 2021

The complement system is a tightly controlled signaling network that plays a role in innate immune surveillance. However, abnormal signaling through this pathway contributes to tissue damage in several inflammatory, autoimmune, and degenerative diseases. Myasthenia gravis (MG) and neuromyelitis optica spectrum disorders (NMOSD) have complement dysfunction at the core of pathogenesis, providing a strong rationale for therapeutic targeting of complement components. The purpose of this paper is to briefly review the role of complement activation in the pathogenesis of MG and NMOSD, to discuss the rationale and evidence for complement inhibition as a method to manage these diseases, and to provide a Canadian perspective on the use of complement inhibition therapy through real-world cases of MG and NMOSD.
Clinical Features of Patients With Heart Failure After the 2016 Kumamoto Earthquakes
Authors: Nagayoshi Yasuhiro , Yufu Tetsuo , Miyamoto Shinzo , Yumoto Shinya , Hashiyama Motohiro , Kai Yutaka , Kawano Hiroaki , Tsujita Kenichi
Published: December 2021

Objective:

Acute and chronic stress after severe earthquakes can contribute to cardiovascular events, including heart failure (HF). On April 14, 2016, magnitude 7 earthquakes occurred in the Aso region in the western part of Japan. This study aimed to investigate the clinical characteristics of HF in this area after these earthquakes.

Methods:

We investigated the clinical characteristics and 1-y mortality rate of patients with HF. Nutritional status was evaluated with the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI).

Results:

Among a total of 58 cardiovascular events, HF was the most frequently observed (n = 28). The mean age of individuals with HF was 85.5 y. The total incidence of HF was significantly higher compared with the average of the prior 2 y. Disaster influence on mental health was suggested by patient history in 20 patients (71%). The 1-y mortality rate among patients with HF was 50%. Among those who died, 93% had malnutrition status (GNRI <92 and /or PNI ≤38).

Conclusions:

Our results demonstrated the poor prognosis of patients with HF following the disaster. The prevalence of malnutrition was high in those patients. Careful follow-up is necessary, especially for older people with frailty.
Validation of the Communication Profile-Adapted in Ethiopian children with neurodevelopmental disorders
Authors: Ceccarelli Caterina , Bakolis Ioannis , Tekola Bethlehem , Kinfe Mersha , Borissov Anton , Girma Fikirte , Abdurahman Rehana , Zerihun Tigist , Hanlon Charlotte , Hoekstra Rosa A.
Published: December 2021

Background

Neurodevelopmental disorders (NDDs) are conditions affecting a child's cognitive, behavioural, and emotional development. Appropriate and validated outcome measures for use in children with NDDs in sub-Saharan Africa are scarce. The aim of this study was to validate the Communication Profile Adapted (CP-A), a measure developed in East Africa to assess caregivers' perception of communication among children with NDDs.

Methods

We adapted the CP-A for use in Ethiopia, focusing on the communicative mode (CP-A-mode) and function (CP-A-function) scales. The CP-A was administered to a representative sample of caregivers of children with NDDs and clinical controls. We performed an exploratory factor analysis and determined the internal consistency, test-retest reliability, within-scale, known-group, and convergent validity of the identified factors.

Results

Our analysis included N = 300 participants (N = 139 cases, N = 139 clinical controls, N = 22 who did not meet criteria for either cases or controls). Within the CP-A-mode, we identified two factors (i.e. verbal and physical communication); the CP-A-function scale was unidimensional. Combining both scales into one summary variable (the CP-A-total) resulted in a scale with excellent internal consistency and test-retest reliability (Cronbach's alpha = 0.97; Kappa = 0.60–0.95, p < 0.001; ICC = 0.97, p < 0.001). Testing known-group validity, the CP-A-total scores were significantly higher for controls than cases (Δ mean = 33.93, p < 0.001). Convergent validity assessment indicated that scores were negatively and moderately correlated with clinical severity (ρ = −0.25, p = 0.04).

Conclusion

The CP-A is a valid tool for the assessment of communication among children with NDDs in Ethiopia. It holds promise as a brief, quantitative, and culturally appropriate outcome measure for use in sub-Saharan Africa.
Low vitamin B12 but not folate is associated with incident depressive symptoms in community-dwelling older adults: a 4-year longitudinal study
Authors: Laird Eamon J. , O’Halloran Aisling M. , Molloy Anne M. , Healy Martin , Hernandez Belinda , O’Connor Deirdre M. A. , Kenny Rose A. , Briggs Robert
Published: December 2021

This was a longitudinal study utilising the Irish Longitudinal Study on Ageing (n 3849 aged ≥ 50 years) and investigated the relationship between blood plasma folate and B12 levels at baseline (wave 1) and incident depressive symptoms at 2 and 4 years (waves 2 and 3). A score ≥ 9 on the Center for Epidemiological Studies Depression Scale-8 at wave 2 or 3 was indicative of incident depressive symptoms. B12 status profiles (pmol/l) were defined as < 185, deficient low; 185 to < 258, low normal; > 258–601, normal and > 601 high. Folate status profiles (nmol/l) were defined as ≤ 10·0, deficient low; > 10–23·0, low normal; > 23·0–45·0, normal; >45·0, high. Logistic regression models were used to analyse the longitudinal associations. Both B12 and folate plasma concentrations were lower in the group with incident depressive symptoms v. non-depressed (folate: 21·4 v. 25·1 nmol/l; P = 0·0003; B12:315·7 v. 335·9 pmol/l; P = 0·0148). Regression models demonstrated that participants with deficient-low B12 status at baseline had a significantly higher likelihood of incident depression 4 years later (OR 1·51, 95 % CI 1·01, 2·27, P = 0·043). This finding remained robust after controlling for relevant covariates. No associations of folate status with incident depression were observed. Older adults with deficient-low B12 status had a 51 % increased likelihood of developing depressive symptoms over 4 years. The findings highlight the need to further explore the low-cost benefits of optimising vitamin B12 status for depression in older adults.
Academic Absences, Disciplinary Siloes and Methodological Prejudices within the Political Science Discipline in Canada
Authors: Everitt Joanna
Published: December 2021

Canadian political science has changed over the past 50 years; however, these changes have come slowly and lag behind larger societal demographic transformations. While early attention to diversity concentrated on the place of women within the discipline, more recent attention focuses on the presence of Black, Indigenous and other political scientists of colour. Accompanying a diversification of personnel has been a broadening of the substantive focus of our research, as well as an expansion in the epistemological and methodological approaches applied to the study of politics. Yet despite these adaptations, the study of political science in Canada remains siloed and often exclusionary, challenging our ability to train the next generation of scholars to be capable of addressing the issues facing a world that is increasingly complex and diverse.
Mucosal healing with lacrimal and double mucosal flaps endoscopic dacryocystorhinostomy – comparison with flap sacrificed technique: randomised, controlled study
Authors: Ciğer E , İşlek A
Published: December 2021

Objective

This study aimed to compare two endoscopic dacryocystorhinostomy techniques: lacrimal and double nasal mucosal flaps, and endoscopic dacryocystorhinostomy without flap preservation.

Method

This study was designed as a prospective randomised, controlled trial. Mucosal healing, granulation tissue formation and mucosal scar contracture were investigated after the surgery.

Results

Ninety patients were included in the study (lacrimal and double nasal mucosal flaps, 46; endoscopic dacryocystorhinostomy without flap preservation, 44). Nine (18.8 per cent) patients in the endoscopic dacryocystorhinostomy without flap preservation group and two patients (4.2 per cent) in the lacrimal and double nasal mucosal flaps group had inadequate wound healing (p = 0.025). Granulation tissue formation was detected in nine patients (18.8 per cent) in the endoscopic dacryocystorhinostomy without flap preservation group and in 1 patient (2.1 per cent) in the lacrimal and double nasal mucosal flaps group (p = 0.008). Functional success rates in the endoscopic dacryocystorhinostomy without flap preservation and lacrimal and double nasal mucosal flaps groups were 89.6 per cent and 97.9 per cent, respectively (p = 0.092). The operation time was similar in both groups (p = 0.122).

Conclusion

The double mucosal flaps technique is a surgical procedure with satisfactory outcomes for the repair of mucosal defects and related issues.