bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomized controlled study to compare oropharyngeal leak pressure between I-gel™ and laryngeal mask airway supreme™ in children in lateral position under general anesthesia
Authors: Kundal Raksha , Puri Kriti , Agrawal Garima , Singh Ranju , Pandey Maitree
Published: March 2023

Background

Supraglottic airway devices (SADs) are the mainstay for airway management in pediatric ambulatory surgeries and may often be a suitable alternative to endotracheal intubation due to their favorable profile. Optimal oropharyngeal leak pressure of SAD is essential for adequate ventilation and prevention of aspiration. Occasionally, lateral position is required for administration of regional block or for the surgery itself.

We aim to compare the oropharyngeal leak pressure of igel™ and LMA Supreme™ in children in lateral position.

A prospective, randomized study was performed on eighty children of either sex, weighing 5–10 kg, belonging to ASA grade I and II undergoing elective surgery requiring lateral position. The primary objective was comparison of Oropharyngeal leak pressure of both devices in lateral position. Secondary objectives included assessment of insertion success rate, number of insertion attempts and manipulations, time and ease of insertion; and comparison of fiberoptic view of the larynx, fractional volume loss, and displacement with respect to both devices in supine and lateral position.

Results

Oropharyngeal leak pressure of i-gel™ was higher than that of LMA Supreme™ in both supine (25.4 ± 1.4 cm H2O Vs 22.9 ± 1.5 cm H2O) and lateral position (23.9 ± 1.6 vs 21.5 ± 1.5 cm H2O) and was statistically significant (p < 0.001). The success rate of insertion of i-gel™ and LMA Supreme™ was similar (95% and 97.5% respectively). The ease of insertion for both devices was statistically similar (p = 0.593). The mean time for insertion was longer for i-gel™ (15.4 ± 1.72 s vs 12.4 ± 1.73 s) as compared to LMA Supreme™ (p < 0.001). Ventilatory parameters for both devices decreased in the lateral position, which was statistically significant. The fractional volume loss after change of position was 0.123 vs 0.478 for i-gel™ and LMA Supreme™ respectively. In both groups, fiberoptic views worsened with a change of position.

Conclusions

Oropharyngeal leak pressure of both devices reduced in lateral position as compared to supine position. I-gel™ yielded higher leak pressures in supine as well as in lateral position as compared to LMA Supreme™.

Implications

The above findings offer valuable insight for decision-making in pediatric daycare surgeries requiring lateral position where GA is warranted.

Trial registration

CTRI NUMBER (CTRI/2021/01/030442)—the trial was registered with the Clinical Trial Registry of India on 13 January 2021.
The expression level of ARF and p53 in AML patients, and their relation to patients' outcome
Authors: Nabil Reem , Elshazly Samar S. , Hassan Naglaa M. , Nooh Hend A.
Published: March 2023

Background

Acute myeloid leukemia (AML) is a cancer of hematopoietic progenitors characterized by gene mutations. The most popular deregulations are mutation and altered expression in the p53 gene, which is considered the guardian of the genome. Its activity is controlled by regulatory genes, e.g., alternate open reading frame (ARF), whose defects could affect p53 activity.

Aim

To study the effect of altered expression of p53 and ARF genes in de novo AML patients and correlate the results to the patients’ characteristics and outcomes.

Methods

Expression levels of p53 and ARF were assessed in 96 AML adult patients compared to 20 healthy controls using quantitative reverse-transcription PCR (RT-qPCR).

Results

There was significant up-regulation of p53 [77.6 (3.8–9528.3)] compared to controls [1.031 (0.210–9.051)], p < 0.001]. The expression level of ARF was significantly upregulated [6.2 (0.5–964.0)] compared to controls [0.854 (0.357–2.519), p < 0.001]. All of the low ARF expressers had low p53 overexpression, 61.1% of patients with high ARF expression had high p53 over-expression, and 38.9% with high ARF expression had low p53 over-expression (p < 0.001). ARF expression shows a trend of association with FLT3 mutation, as 89.3% with FLT3 mutation have high ARF expression (p = 0.080). Low p53 over-expression was seen in 77% of APL patients, while high p53 expression was associated with non-APL (p = 0.040). The median DFS of mutant NPM1 patients was higher than wild NPM1 (46.15 vs. 5.89 days, p = 0.045). Patients aged ≤ 50 years had better OS and DFS than those > 50 (p = 0.05, p = 0.035, respectively).There were no significant statistical associations between DFS and p53, ARF, and FLT3 mutations.

Conclusion

The p53 and ARF genes are overexpressed in de novo AML patients and they are interrelated. low p53 overexpression is associated with APL phenotype and t(15;17) and patients with t(15;17) had slightly better survival than patients with negative t(15;17) (p = 0.061). AML patients with mutated NPM1 had better DFS than wild NPM1 (p = 0.045). p53 pathway regulation can occur by many alternative ways rather than gene mutation.
Post algebras and ternary adders
Authors: Etiemble Daniel
Published: March 2023

Except for qubits for which the different possible values are unordered, the different values of m-valued circuits either with voltage levels, current levels or charge levels are totally ordered. Either at the Math level (Post algebras) or at the circuit level, it means that each multiple valued level must be decomposed into binary levels, processed with binary computation and finally converted into a multiple valued level. Using ternary adders as example, we show that the ternary-to-binary decoding and binary encoding should be applied to the whole adder or to restricted parts of the adder. The second approach using multiplexers leads to the most efficient ternary adders. However, a comparison with binary adders shows that the ternary-to-binary and binary-to-ternary conversions is the reason for which the binary adders are more efficient.
Scour depth downstream sharp-crested weir
Authors: Obaida Arwa A. Mala , Khattab Noor I. , Mohammed Ahmed Y.
Published: March 2023

Weirs are hydraulic obstructions constructed across an open-channel flow causing a rise in water which is useful to convert water to the channels upstream as well as using these structures as a measuring device. There are different types, and a sharp-crested weir is one of them. Local scour downstream hydraulic structures are one of the most critical problems affecting their safety and stability. Many studies conducted to prevent these facilities from collapsing, but the effect of adding a solid apron downstream weir still need deep studies. The current study included a survey of scour reduction downstream sharp-crested weir using a solid apron consisting of three different lengths, four different discharges, and sand bed material to calculate the maximum depth and length of scour hole when using an apron solid. The results proved that the depth and length of the scour hole are reduced to 19.3% and 27.7%, respectively, when an apron solid is used. Two empirical equations were found to determine the maximum depth and length of the hole with a coefficient of determination are 0.892 and 0.804, respectively.
Assessing the priority of human rights and mental health: the PHRAME approach
Authors: Gronholm Petra C. , Gill Neeraj , Carter Grace , Watson Danielle , Helmchen Hanfried , Thornicroft Graham , Sartorius Norman
Published: March 2023

Background

Protecting all human rights of people with mental health conditions is globally important. However, to facilitate practical implementation of rights, it is often necessary to decide which of these rights should be given priority, especially when they conflict with each other.

Aims

The aim of the Priorities of Human Rights and Mental Health (PHRAME) project is to develop a replicable approach to establish a proposed set of high-priority human rights of people with mental health conditions, to facilitate practical decision-making and implementation of such rights.

Method

A two-stage Delphi-style study with stakeholders was conducted to generate a list of key rights of people with mental health conditions, and rank priorities among these rights in terms of feasibility, urgency and overall importance.

Results

The stakeholders in this study consistently ranked three rights as top priorities: (a) the right to freedom from torture, cruel inhuman treatment and punishment; (b) the right to health and access to services/treatment; and (c) the right to protection and safety in emergency situations.

Conclusions

Insights from PHRAME can support decision-making about the priority to be given to human rights, to guide practical action. This approach can also be used to assess how human rights are prioritised in different settings and by different stakeholders. This study identifies the clear need for a central voice for people with lived experience in research and implementation of decisions about the priority of human rights, ensuring that action respects the opinion of people whose rights are directly affected.
Permissive ureter specification by TBX18-mediated repression of metanephric gene expression
Authors: Weiss Anna-Carina , Blank Eva , Bohnenpoll Tobias , Kleppa Marc-Jens , Rivera-Reyes Reginaldo , Taketo Makoto Mark , Trowe Mark-Oliver , Kispert Andreas
Published: March 2023

The murine kidney and ureter develop in a regionalized fashion from the ureteric bud and its surrounding mesenchyme. Whereas the factors that establish the metanephric cell lineages have been well characterized, much less is known about the molecular cues that specify the ureter. Here, we have identified a crucial patterning function in this process for Tbx18, a T-box transcription factor gene specifically expressed in the mesenchymal primordium of the ureter. Using misexpression and loss-of-function mice combined with molecular profiling approaches, we show that Tbx18 is required and sufficient to repress metanephric mesenchymal gene programs. We identify Wt1 as a functional target of TBX18. Our work suggests that TBX18 acts as a permissive factor in ureter specification by generating a mesenchymal domain around the distal ureteric bud where SHH and BMP4 signaling can occur.
The importance of comparative physiology: mechanisms, diversity and adaptation in skeletal muscle physiology and mechanics
Authors: Mendoza E. , Moen D. S. , Holt N. C.
Published: March 2023

Skeletal muscle powers animal movement, making it an important determinant of fitness. The classic excitation–contraction coupling, sliding-filament and crossbridge theories are thought to describe the processes of muscle activation and the generation of force, work and power. Here, we review how the comparative, realistic muscle physiology typified by Journal of Experimental Biology over the last 100 years has supported and refuted these theories. We examine variation in the contraction rates and force–length and force–velocity relationships predicted by these theories across diverse muscles, and explore what has been learnt from the use of workloop and force-controlled techniques that attempt to replicate aspects of in vivo muscle function. We suggest inclusion of features of muscle contraction not explained by classic theories in our routine characterization of muscles, and the use of phylogenetic comparative methods to allow exploration of the effects of factors such as evolutionary history, ecology, behavior and size on muscle physiology and mechanics. We hope that these future directions will improve our understanding of the mechanisms of muscle contraction, allow us to better characterize the variation in muscle performance possible, and enable us to infer adaptation.
O poder de polícia e a liberdade de locomoção: estado de necessidade administrativo em tempos de pandemia ambiental
Authors: Gomes Magno Federici , Alves Amanda Rodrigues
Published: March 2023

O poder de polícia é a capacidade do Estado de intervir na esfera privada, restringindo bens e direitos, em prol do interesse público, sendo tal poder legitimado pelo Estado Democrático de Direito. Ocorre que diante de situações de emergência, o poder de polícia muitas vezes não encontra respaldo legal. Assim, o problema do presente estudo é verificar se a pandemia causada pela COVID-19 pode ser enquadrada como situação de emergência e, assim o sendo, se de fato justifica um estado de necessidade administrativo, capaz de relativizar ou mesmo suspender garantias fundamentais, dentre elas a liberdade de locomoção. Para realizar o estudo foi utilizado raciocínio dedutivo e metodologia teórico-jurídico. Diante do estudo foi possível observar que em conjunturas excepcionais e de anomia, a exemplo de situações de calamidade pública, o Estado pode se valer do estado de necessidade administrativo, desde que o faça de forma racional e técnica.
Association between gestational blood lipids and TSH levels and pregnancy outcome of patients with subclinical hypothyroidism
Authors: Zhang Jiajia , Chen Hao , Dou Xiaobing , Huang Wei , Zeng Haixia
Published: March 2023

Objective: To investigate the association between gestational blood lipids and thyroid stimulating hormone (TSH) levels and pregnancy outcomes of patients with subclinical hypothyroidism (SCH).

Methods: In this retrospective observational study, we analyzed the clinical data of 82 patients (case group) with gestational SCH treated in our hospital from January 2021 to January 2022 at gestational weeks 25-33 and grouped them according to whether SCH was well controlled by treatment (case Group-A: well controlled, n=55; case Group-B: poorly controlled, n=27), and the clinical data of 41 pregnant women (control group) undergoing physical examination during the same period. After comparing the blood lipids and TSH levels of the three groups, we compared their adverse pregnancy outcomes to assess the possible correlations between blood lipids and TSH levels and pregnancy outcomes.

Results: The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and TSH in the case Group-B were significantly higher than those in the case Group-A and the control group (P<0.05). Compared with case Group-B and the control group, the incidence of premature delivery, abortion and neonatal growth restriction was higher in case Group-A (P<0.05). Among 82 patients in the case group 42 presented adverse pregnancy outcomes. The levels of TC, TG, LDL-C and TSH in mothers and infants in the adverse outcome group were significantly higher than those in the favorable outcome group (P<0.05). Our Pearson analysis results showed that the levels of TC, TG and LDL-C were positively correlated with the TSH levels and the pregnancy outcomes, and that TSH was positively correlated with pregnancy outcomes (P<0.05).

Conclusion: The levels of TC, TG, LDL-C and TSH in patients with poorly controlled SCH were increased during pregnancy, and were associated with the pregnancy outcomes and positively correlated with each other.

doi: https://doi.org/10.12669/pjms.39.3.7150

How to cite this: Zhang J, Chen H, Dou X, Huang W, Zeng H. Association between gestational blood lipids and TSH levels and pregnancy outcome of patients with subclinical hypothyroidism. Pak J Med Sci. 2023;39(3):721-725. doi: https://doi.org/10.12669/pjms.39.3.7150

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis
Authors: He Xufeng , Liu Yang
Published: March 2023

Objective: To investigate the effects of arteriovenous fistulas (AVFs) and central venous catheters (CVCs) on the left ventricular function (LVF) and prognosis of maintenance hemodialysis (MHD) patients.

Methods: This retrospective cohort study included 270 patients (139 with AVF and 131 with CVC) undergoing dialysis with newly established vascular access in the blood purification center of Nanhua hospital, University of South China, from January 2019 to April 2021. Dialysis efficiencies, LVF indexes, and one-year prognoses were compared.

Results: At six and twelve months after the establishment of vascular access, the mean urea clearances (Kt/V) and urea reduction ratio (URR) between the AVF- and the CVC-group were similar (P>0.05). The mean LVF values between the two groups were also similar before the establishment of vascular access (P>0.05), but the mean values of left ventricular end diastolic diameter (LVEDd), interventricular septal thickness (IVSTd), and left ventricular posterior wall thickness (LVPWT) in the AVF-group were higher than those in the CVC-group one year later, and mean early (E) and late (A) diastolic mitral velocities, E/A, and ejection fraction (EF) were lower than those in the CVC-group (P<0.05). The incidence of left ventricular hypertrophy and systolic dysfunction in the AVF-group was higher than that in the CVC-group (P<0.05). The hospitalization rate of AVF-group (23.02%) was lower than that of the CVC-group (49.61%) (P<0.05).

Conclusion: Both AVF and CVC can achieve appropriate dialysis effects in MHD patients. AVF has a negative impact on cardiac function while CVC has a high hospitalization rate.

doi: https://doi.org/10.12669/pjms.39.3.7151

How to cite this: He X, Liu Y. Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis. Pak J Med Sci. 2023;39(3):780-784. doi: https://doi.org/10.12669/pjms.39.3.7151

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Η διαλεκτική άστεως και υπαίθρου στην κλασική λατινική ποίηση
Authors: Μαρκούτη Πολυξένη
Published: March 2023

Η διαλεκτική αστικού χώρου και υπαίθρου αποτελεί θεμελιώδες μοτίβο που ενδύεται ποικίλους συμβολισμούς στην ιστορική διαδρομή των ανθρώπινων κοινοτήτων. Τις προϋποθέσεις αυτής της διαλεκτικής στη λατινική γραμματεία ιχνηλατεί η προκείμενη μελέτη, εξετάζοντας εκδοχές της στην ποίηση της αυγούστειας περιόδου και στο έργο του Κάτουλλου. Η πορεία της έρευνας επιχειρεί μία κλιμάκωση, στην οποία προτάσσεται το προφανές (η στατική, δομικού τύπου αντιθετική σχέση μεταξύ αστικού χώρου και υπαίθρου), για να καταλήξει σε λιγότερο προφανείς όψεις της διαλεκτικής (μορφές κινητικότητας που αποδομούν και σχετικοποιούν την αντιπαλότητα ή συνθετικές απόπειρες). Η αξιολόγηση των σχετικών κειμενικών μαρτυριών αποκαλύπτει μία μεταβαλλόμενη αξιακή φόρτιση των όρων urbs και rus στην ποιητική παραγωγή της κλασικής ρωμαϊκής περιόδου και αναδεικνύει τις πολλαπλές τροπές της σχέσης ανάμεσα στο άστυ και τον χώρο της υπαίθρου (από τη στατική αντιπαράθεση μέχρι τη διαφαινόμενη ή πλήρη διαλεκτική κινητικότητα). Αποδεικνύεται έτσι πως το είδος και η ένταση της διαλεκτικής ρυθμίζονται κάθε φορά από τον δημιουργό, τις συμβάσεις των ποιητικών ειδών, καθώς και από τη διάδραση ανάμεσα στη λογοτεχνία και στην εξωλογοτεχνική (ιστορική και πολιτική) πραγματικότητα. Η διακύμανση των αξιολογήσεων που προκύπτουν για τη σχέση άστεως και υπαίθρου (θετική αποτίμηση ή απαξίωση του rus ή της urbs, μεταφορική ή αλληγορική σήμανση) είναι ζήτημα ειδολογικής επιλογής/απόκλισης αλλά είναι και ζήτημα ιδεολογικό-πολιτικό. Η διαλεκτική διελκυστίνδα μεταξύ αστικού χώρου και υπαίθρου επικαθορίζεται όχι μόνο από την αστική διόγκωση της Ρώμης αλλά και από τα «global politics» της ρωμαϊκής υπερδύναμης, για τα οποία δεν υπάρχει προφανές ελληνικό αντίστοιχο.
Digital solutions to the mental healthcare crisis
Authors: Haddad Mark , Gournay Kevin , Clough Isobel
Published: March 2023

With huge demands being placed on mental healthcare services, innovative solutions are required to address this growing need. Digital solutions offer wider accessibility and a patient-focused process for a range of people with mental ill health, freeing healthcare staff to focus on those with the most severe mental health needs and The National Institute for Health and Care Excellence has now issued conditional recommendations on technologies which can be used.
La inclusión digital en la formación inicial del profesorado: una revisión sistemática
Authors: Sanz Benito Iván , Lázaro Cantabrana José Luis , Grimalt Álvaro Carme
Published: March 2023

INTRODUCCIÓN. La inclusión digital es uno de los grandes retos a los que se enfrenta el sistema educativo y, por lo tanto, la formación inicial de docentes. El objetivo del estudio es analizarla producción científica que explica cómo se trata la inclusión digital durante la formación inicial docente. MÉTODO. Se ha realizado una revisión sistemática de la literatura planteada bajo los parámetros que marca la declaración PRISMA. Las bases de datos consultadas durante la estrategia de búsqueda han sido Web of Science, Scopus y ERIC. El periodo de búsqueda se ha situado entre 2017 y 2021. Del proceso de revisión han surgido 20 artículos que han sido el objeto de estudio de la investigación. RESULTADOS. La mayoría de los artículos revisados son investigaciones y tan solo dos se presentan como experiencias formativas. Principalmente, las fuentes consultadas utilizan métodos cuantitativos o cualitativos, muy pocos mixtos. La aproximación conceptual al concepto de inclusión digital, en la mayoría de los casos, hace referencia a aspectos didácticos, al uso de dispositivos y de aplicaciones. La inclusión digital se considera un aspecto fundamental en la formación inicial docente. DISCUSIÓN. A pesar de la relevancia que dan a la inclusión digital un gran número de instituciones educativas, es muy reducida la muestra encontrada en las bases de datos que traten experiencias pedagógicas y/o didácticas relacionadas con el fomento de la inclusión digital durante la formación inicial del profesorado. Tanto los docentes en activo como los futuros maestros que se encuentran cursando estudios universitarios, se muestran partidarios de incorporar las TD a su práctica profesional. En esta línea, una parte de los estudios revisados durante la investigación indican la necesidad de reforzar la enseñanza de la competencia digital docente, ergo de la inclusión digital, en los planes de formación inicial del profesorado.
Localized tenosynovial gigantocellular tumor of the ankle in an adolescent: case report and literature review
Authors: Dimnjaković Damjan , Karakaš Tin , Bojanić Ivan
Published: March 2023

Tenosynovial giant cell tumor (TGCT) is a rare, benign monoarticular disease that affects the synovial lining of joint, tendon or bursa. We distinguish two forms of the disease, localized and diffuse forms, both of which are histologically identical. The incidence rate of the localized form of TGCT (LTGCT) is 10 cases per million people, of which about 5% of all cases occur in the ankle. We present a rare case of LTGCT in the anterior part of the ankle in an adolescent, which was manifested by swelling and occasional pain, especially during sports activities. On the magnetic resonance imaging (MRI) a heterogeneously structured, well encapsulated tumor was visible in the anterior part of the ankle. In addition to the painless swelling in the anterior part of the ankle, the physical examination revealed a deficit of dorsiflexion of the foot. The operation was performed arthroscopically but the tumor could not be removed in a single piece due to its size, so it was removed in multiple pieces. Histopathological analysis confirmed that the tumor was TGCT. During the two-year follow-up period, the patient did not have problems with the operated ankle and no recurrence of the disease was observed on control MRIs. TGCT should be considered as a possible differential diagnosis, especially when pain and swelling of the ankle occur without injury. Arthroscopic surgery is a safe and effective method of treatment if it is performed by an experienced surgeon backed by a welltrained team. The choice of the type of surgical treatment should be determined depending on the anatomical position of the formation in the joint and the surgeon’s assessment and preference.
Subgingival chlorhexidine irrigation for scaling and root planing adjunctive therapy in chronic periodontitis: a systematic review
Authors: Susanto Agus , Nunung Rusminah  , Yohana Putri Pertiwi
Published: March 2023

BACKGROUND Scaling and root planing (SRP) is a conventional treatment for chronic periodontitis; however, it has limitations in treating deep pockets. To enhance its efficacy, chlorhexidine (CHX) is proposed as adjunctive therapy with SRP due to its broad antimicrobial spectrum, low systemic toxic activity in humans, absence of oral microorganism resistance, and lack of teratogenic effects. This study aimed to know the efficacy of the adjunctive therapy of CHX.
METHODS A literature search was conducted using various databases including PubMed, LIVIVO, EBSCOhost, and Google Scholar, following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines within the last 10 years (2011–2021). Clinical parameters such as plaque index (PI), gingival index (GI), bleeding on probing (BOP), pocket depth (PD), and clinical attachment level (CAL) were recorded. The risk of bias in the selected studies was assessed using Cochrane Collaboration’s Handbook version 5.2.0.
RESULTS Of 368 studies, 10 met the inclusion criteria, with 8 of them having a higher quality. Higher reduction of PI, GI, BI, PD, and CAL were observed in SRP with CHX irrigation compared with SRP alone.
CONCLUSIONS Overall, adding CHX to SRP appeared to have additional clinical benefits compared with SRP alone in the treatment of chronic periodontitis.
Simulation of self-modulated laser wakefield acceleration using few TW in downramp injection and ionization injection regimes
Authors: Maldonado Edison Puig , Samad Ricardo Elgul , Zuffi Armando Valter Felicio , Vieira Nilson Dias
Published: March 2023

Simulations of transitional self-modulated laser wakefield acceleration
driven by laser pulses of a few terawatts are discussed, comparing a
downramp-based injection regime with an ionization injection regime.
We demonstrate that a configuration using an N2 gas target and a laser pulse of ∼75mJ with ∼2TW peak power is a good alternative as a
high repetition rate system that produces electrons of many tens of
MeV, pC charge, and emittance of the order of 1 mm mrad.
R-AP’s position-domain model for an RO-receiver and AP placement strategy for an uninterrupted link between the robotic arm and AP in the VLC network
Authors: Gong Guiyu , Gan Chaoqin , Fang Yong , Zhu Yifan , Hu Qiuyue
Published: March 2023

In the visible light communication (VLC) network, the optical link between the robotic arm and the access point (AP) is easily interrupted due to the random orientation of the receiver on the robotic arm. First, based on the VLC channel model, a position-domain model of reliable AP (R-AP) for a random-orientation receiver (RO-receiver) is proposed. The channel gain of the VLC link between the receiver and the R-AP is non-zero. The tilt-angle range of the RO-receiver is [0,π]. Given the field of view (FOV) angle and the orientation of the receiver, the R-AP’s position domain of the receiver can be obtained by this model. Then, based on the R-AP’s position-domain model for the RO-receiver, a novel AP placement strategy is proposed. Under this AP placement strategy, the number of R-APs for the RO-receiver is not less than 1, thereby effectively avoiding link interruption caused by the random orientation of receivers. Finally, it is proved by the Monte Carlo method that, under the AP placement strategy proposed in this paper, the VLC link of the receiver on the robotic arm can remain uninterrupted during the movement of the robotic arm.
Phenotypic plasticity evolves at multiple biological levels in response to environmental predictability in a long-term experiment with a halotolerant microalga
Authors: Leung Christelle , Grulois Daphné , Quadrana Leandro , Chevin Luis-Miguel
Published: March 2023

Phenotypic plasticity, the change in the phenotype of a given genotype in response to its environment of development, is a ubiquitous feature of life, enabling organisms to cope with variation in their environment. Theoretical studies predict that, under stationary environmental variation, the level of plasticity should evolve to match the predictability of selection at the timing of development. However, the extent to which patterns of evolution of plasticity for more integrated traits are mirrored by their underlying molecular mechanisms remains unclear, especially in response to well-characterized selective pressures exerted by environmental predictability. Here, we used experimental evolution with the microalgaeDunaliella salinaunder controlled environmental fluctuations, to test whether the evolution of phenotypic plasticity in responses to environmental predictability (as measured by the squared autocorrelationρ2) occurred across biological levels, going from DNA methylation to gene expression to cell morphology. Transcriptomic analysis indicates clear effects of salinity andρ2× salinity interaction on gene expression, thus identifying sets of genes involved in plasticity and its evolution. These transcriptomic effects were independent of DNA methylation changes incis. However, we did findρ2-specific responses of DNA methylation to salinity change, albeit weaker than for gene expression. Overall, we found consistent evolution of reduced plasticity in less predictable environments for DNA methylation, gene expression, and cell morphology. Our results provide the first clear empirical signature of plasticity evolution at multiple levels in response to environmental predictability, and highlight the importance of experimental evolution to address predictions from evolutionary theory, as well as investigate the molecular basis of plasticity evolution.
Atomistic simulation of protein evolution reveals sequence covariation and time-dependent fluctuations of site-specific substitution rates
Authors: Norn Christoffer , André Ingemar
Published: March 2023

Thermodynamic stability is a crucial fitness constraint in protein evolution and is a central factor in shaping the sequence landscapes of proteins. The correlation between stability and molecular fitness depends on the mechanism that relates the biophysical property with biological function. In the simplest case, stability and fitness are related by the amount of folded protein. However, when proteins are toxic in the unfolded state, the fitness function shifts, resulting in higher stability under mutation-selection balance. Likewise, a higher population size results in a similar change in protein stability, as it magnifies the effect of the selection pressure in evolutionary dynamics. This study investigates how such factors affect the evolution of protein stability, site-specific mutation rates, and residue-residue covariation. To simulate evolutionary trajectories with realistic modeling of protein energetics, we develop an all-atom simulator of protein evolution, RosettaEvolve. By evolving proteins under different fitness functions, we can study how the fitness function affects the distribution of proposed and accepted mutations, site-specific rates, and the prevalence of correlated amino acid substitutions. We demonstrate that fitness pressure affects the proposal distribution of mutational effects, that changes in stability can largely explain variations in site-specific substitution rates in evolutionary trajectories, and that increased fitness pressure results in a stronger covariation signal. Our results give mechanistic insight into the evolutionary consequences of variation in protein stability and provide a basis to rationalize the strong covariation signal observed in natural sequence alignments.
A real-time feedback system stabilises the regulation of worker reproduction under various colony sizes
Authors: Adejumo Simeon , Kikuchi Tomonori , Tsuji Kazuki , Maruyama-Onda Kana , Sugawara Ken , Hayashi Yoshikatsu
Published: March 2023

Social insects demonstrate adaptive behaviour for a given colony size. Remarkably, most species do this even without visual information in a dark environment. However, how they achieve this is yet unknown. Based on individual trait expression, an agent-based simulation was used to identify an explicit mechanism for understanding colony size dependent behaviour. Through repeated physical contact between the queen and individual workers, individual colony members monitor the physiological states of others, reflecting such contact information in their physiology and behaviour. Feedback between the sensing of physiological states and the corresponding behaviour patterns leads to self-organisation with colonies shifting according to their size. We showed (1) the queen can exhibit adaptive behaviour patterns for the increase in colony size while density per space remains unchanged, and (2) such physical constraints can underlie the adaptive switching of colony stages from successful patrol behaviour to unsuccessful patrol behaviour, which leads to constant ovary development (production of reproductive castes). The feedback loops embedded in the queen between the perception of internal states of the workers and behavioural patterns can explain the adaptive behaviour as a function of colony size.
Capturing children food exposure using wearable cameras and deep learning
Authors: Elbassuoni Shady , Ghattas Hala , El Ati Jalila , Zoughby Yorgo , Semaan Aline , Akl Christelle , Trabelsi Tarek , Talhouk Reem , Ben Gharbia Houda , Shmayssani Zoulfikar , Mourad Aya ,   with SCALE Research Group
Published: March 2023

Children’s dietary habits are influenced by complex factors within their home, school and neighborhood environments. Identifying such influencers and assessing their effects is traditionally based on self-reported data which can be prone to recall bias. We developed a culturally acceptable machine-learning-based data-collection system to objectively capture school-children’s exposure to food (including food items, food advertisements, and food outlets) in two urban Arab centers: Greater Beirut, in Lebanon, and Greater Tunis, in Tunisia. Our machine-learning-based system consists of 1) a wearable camera that captures continuous footage of children’s environment during a typical school day, 2) a machine learning model that automatically identifies images related to food from the collected data and discards any other footage, 3) a second machine learning model that classifies food-related images into images that contain actual food items, images that contain food advertisements, and images that contain food outlets, and 4) a third machine learning model that classifies images that contain food items into two classes, corresponding to whether the food items are being consumed by the child wearing the camera or whether they are consumed by others. This manuscript reports on a user-centered design study to assess the acceptability of using wearable cameras to capture food exposure among school children in Greater Beirut and Greater Tunis. We then describe how we trained our first machine learning model to detect food exposure images using data collected from the Web and utilizing the latest trends in deep learning for computer vision. Next, we describe how we trained our other machine learning models to classify food-related images into their respective categories using a combination of public data and data acquired via crowdsourcing. Finally, we describe how the different components of our system were packed together and deployed in a real-world case study and we report on its performance.
It takes more than a machine: A pilot feasibility study of point-of-care HIV-1 viral load testing at a lower-level health center in rural western Uganda
Authors: Boyce Ross M. , Ndizeye Ronnie , Ngelese Herbert , Baguma Emmanuel , Shem Bwambale , Rubinstein Rebecca J. , Rockwell Emmanuel , Lotspeich Sarah C. , Shook-Sa Bonnie E. , Ntaro Moses , Nyehangane Dan , Wohl David A. , Siedner Mark J. , Mulogo Edgar M.
Published: March 2023

Barriers continue to limit access to viral load (VL) monitoring across sub-Saharan Africa adversely impacting control of the HIV epidemic. The objective of this study was to determine whether the systems and processes required to realize the potential of rapid molecular technology are available at a prototypical lower-level (i.e., level III) health center in rural Uganda. In this open-label pilot study, participants underwent parallel VL testing at both the central laboratory (i.e., standard of care) and on-site using the GeneXpert HIV-1 assay. The primary outcome was the number of VL tests completed each clinic day. Secondary outcomes included the number of days from sample collection to receipt of result at clinic and the number of days from sample collection to patient receipt of the result. From August 2020 to July 2021, we enrolled a total of 242 participants. The median number of daily tests performed on the Xpert platform was 4, (IQR = 2–7). Time from sample collection to result was 51 days (IQR = 45–62) for samples sent to the central laboratory and 0 days (IQR = 0–0.25) for the Xpert assay conducted at the health center. However, few participants elected to receive results by one of the expedited options, which contributed to similar time-to-patient between testing approaches (89 versus 84 days, p = 0.07). Implementation of a rapid, near point-of-care VL assay at a lower-level health center in rural Uganda appears feasible, but interventions to promote rapid clinical response and influence patient preferences about result receipt require further study.

Trial registration: ClinicalTrials.gov Identifier: NCT04517825, Registered 18 August 2020. Available at: https://clinicaltrials.gov/ct2/show/NCT04517825.
Impact of COVID-19 on the national development of countries: Implications for the public health
Authors: Kuzmenko Olha , Lyeonov Serhiy , Letunovska Nataliia , Kashcha Mariya , Strielkowski Wadim
Published: March 2023

The article focuses on measuring the fluctuations in countries’ development as a result of the COVID-19 pandemic. The obtained measures make it possible to predict the extent of the impact of risks to public health on the economy, financial-budgetary, political-institutional development of states in the future, as well as the social determinants of public health. This assessment represents a new paradigm that makes it possible to effectively evaluate the manifestations of the consequences of COVID-19 and to identify the relevant determinants of the lack of resilience of the medical and social security systems to the coronavirus pandemic around the world. We picked the determinant of national development indicators of the 59 countries in order to measure the fluctuations in their economic development. In addition, we applied the binary response model for identifying the economic, financial-budgetary, and political-institutional development change with the happiness index of the countries being the dependent variable. The analysis of our empirical model made it possible for us to conclude that economic and financial-budgetary components have significantly increased the influence on well-being during the COVID-19 pandemic. In contrast, we observed the decrease in the impact of political and institutional indicators during the same period.
A complete theoretical framework for inferring horizontal gene transfers using partial order sets
Authors: Belal Nahla A. , Heath Lenwood S.
Published: March 2023

We present a method for detecting horizontal gene transfer (HGT) using partial orders (posets). The method requires a poset for each species/gene pair, where we have a set of species S, and a set of genes G. Given the posets, the method constructs a phylogenetic tree that is compatible with the set of posets; this is done for each gene. Also, the set of posets can be derived from the tree. The trees constructed for each gene are then compared and tested for contradicting information, where a contradiction suggests HGT.
Wayfinding artificial intelligence to detect clinically meaningful spots of retinal diseases: Artificial intelligence to help retina specialists in real world practice
Authors: Shiihara Hideki , Sonoda Shozo , Terasaki Hiroto , Fujiwara Kazuki , Funatsu Ryoh , Shiba Yousuke , Kumagai Yoshiki , Honda Naoto , Sakamoto Taiji
Published: March 2023

Aim/background

To aim of this study is to develop an artificial intelligence (AI) that aids in the thought process by providing retinal clinicians with clinically meaningful or abnormal findings rather than just a final diagnosis, i.e., a “wayfinding AI.”

Methods

Spectral domain optical coherence tomography B-scan images were classified into 189 normal and 111 diseased eyes. These were automatically segmented using a deep-learning based boundary-layer detection model. During segmentation, the AI model calculates the probability of the boundary surface of the layer for each A-scan. If this probability distribution is not biased toward a single point, layer detection is defined as ambiguous. This ambiguity was calculated using entropy, and a value referred to as the ambiguity index was calculated for each OCT image. The ability of the ambiguity index to classify normal and diseased images and the presence or absence of abnormalities in each layer of the retina were evaluated based on the area under the curve (AUC). A heatmap, i.e., an ambiguity-map, of each layer, that changes the color according to the ambiguity index value, was also created.

Results

The ambiguity index of the overall retina of the normal and disease-affected images (mean ± SD) were 1.76 ± 0.10 and 2.06 ± 0.22, respectively, with a significant difference (p < 0.05). The AUC used to distinguish normal and disease-affected images using the ambiguity index was 0.93, and was 0.588 for the internal limiting membrane boundary, 0.902 for the nerve fiber layer/ganglion cell layer boundary, 0.920 for the inner plexiform layer/inner nuclear layer boundary, 0.882 for the outer plexiform layer/outer nuclear layer boundary, 0.926 for the ellipsoid zone line, and 0.866 for the retinal pigment epithelium/Bruch’s membrane boundary. Three representative cases reveal the usefulness of an ambiguity map.

Conclusions

The present AI algorithm can pinpoint abnormal retinal lesions in OCT images, and its localization is known at a glance when using an ambiguity map. This will help diagnose the processes of clinicians as a wayfinding tool.
Mitigation behavior prior to COVID-19 vaccination availability is associated with COVID-19 infection and time to vaccination
Authors: Neighbors Coralei E. , Sloane Richard , Pieper Carl F. , Wixted Douglas , Woods Christopher W. , Newby L. Kristin
Published: March 2023

Background

Mitigation behaviors reduce the incidence of COVID-19 infection. Determining characteristics of groups defined by mitigation behaviors compliance may be useful to inform targeted public health policies and interventions. This study aimed to identify groups of individuals according to self-reported compliance with COVID-19 mitigation behaviors, define compliance class characteristics, and explore associations between compliance classes and important study and public health outcomes.

Methods and findings

We studied 1,410 participants in the Cabarrus County COVID-19 Prevalence and Immunity longitudinal cohort study (June 2020 to December 2021) who were asked 10 questions regarding compliance with recommended COVID-19 mitigation behaviors. By Latent Class Analysis, 1,381 participants were categorized into 3 classes (most [49.4%], moderately [45.0%], and least [5.6%] compliant). Compared with the most compliant class, the least and moderately compliant classes were younger (mean = 61.9 v. 59.0 v. 53.8 years), had fewer medical conditions per individual (1.37 v. 1.08 v. 0.77), and differed in Hispanic ethnicity (6.2% v. 2.8% v. 9.1%) and COVID-19 vaccine intention (65.8% v. 59.8% v. 35.1%). Compared to the most compliant class, the least compliant class had fewer women (54.6% v. 76.3%), fewer insured individuals (92.2% v. 97.4%), and more withdrew from study participation early (28.6% v. 16.0%). Relative to the most compliant class, the least compliant class had a higher likelihood of COVID-19 infection (OR = 2.08 [95% CI 1.13, 3.85]), lower rate of COVID-19 vaccination (72.6% v. 95.1%), and longer time to 50% COVID-19 vaccination following eligibility (8–9 vs 16 days).

Conclusions

Classes defined by mitigation behaviors compliance had distinct characteristics, including age, sex, medical history, and ethnicity, and were associated with important study and public health outcomes. Targeted public health policies and interventions according to the compliance group characteristics may be of value in current and future pandemic responses to increase compliance.
Factors associated with PTSD symptoms and quality of life among nurses during the COVID-19 pandemic: A cross-sectional study
Authors: Lin Cian-Cian , Yeh Chin-Bin
Published: March 2023

Background

Healthcare workers, especially nurses, were one of the most vulnerable groups for developing posttraumatic stress disorder (PTSD) during the coronavirus disease 2019 (COVID-19) pandemic, which also affected their quality of life. However, only limited research has investigated the individual psychological factors as well as the environmental factors responsible for these effects of the pandemic. Demoralization is a state of loss of meaning and anhedonia, which we thought to be an important mediator between fear and PTSD among frontline nurses during the pandemic. This study aimed to explore the role of demoralization in the mechanisms of posttraumatic stress symptoms of nurses facing different infection risks and influencing factors on their well-being.

Method

A cross sectional study was conducted from September 16, 2021 to October 8, 2021 in a medical center in Northern Taiwan. Online questionnaires were used to collect data, including age, sex, vaccination status, working years, previous quarantine experiences, psychiatric history, traumatic events and scales for measuring fear of COVID-19, demoralization, symptoms of posttraumatic stress, depression, anxiety and stress, burnout level, teamwork performance and quality of life. Hierarchical regression analysis and mediation analysis were utilized to identify associated risk factors and mechanisms.

Result

Among 351 included nurses, 148 worked in high-risk areas directly exposed to COVID-19 patients or patients with respiratory symptoms, while 203 nurses worked in low-risk areas. Overall, nurses in the low-risk group had greater fear of COVID-19, and greater demoralization and burnout level, along with poorer teamwork and quality of life. Demoralization was found to have mediating effect in both the high-risk group and low-risk group on the relationships between fear of COVID-19 and posttraumatic stress symptoms. Levels of burnout and teamwork may serve as mediators between depression, anxiety, stress and quality of life.

Conclusion

Hospital-based nurses appear to be at high risk for developing posttraumatic stress disorder during the COVID-19 pandemic. Study findings demonstrated specific associated factors that should be the focus of nursing administration and hospital management while employing preventive measures, psychological resilience of nurses or systematic managements. Future longitudinal research is needed to improve management in pandemic conditions.