bluuebunny/crossref_metadata_2025 huggingface dataset:
Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study
Authors: Sinha Abhinav , Puri Parul , Pati Sanghamitra
Published: November 2022

Objectives

India, a major contributor to the global diabetes burden, is witnessing a simultaneous epidemic of obesity leading to rise in diabesity. Diabesity, the coexistence of diabetes and obesity in an individual, has emerged as a risk factor for other morbidities and hence, multimorbidity. Although diabesity has long been recognised, still, there is a poor understanding of its social determinants in India, necessary for its control. We aimed to estimate and compare the prevalence and identify social determinants of obesity, diabetes and diabesity; explore their association with other selected non-communicable diseases (NCDs) multimorbidity; and assess its outcomes among adults aged ≥45 years.

Design and setting

We undertook an observational analyses employing nationally representative data from Longitudinal Ageing Study in India, 2017–2018.

Participants

This study was conducted among n=59 073 respondents.

Outcome measures

Descriptive analysis was conducted among n=59 073 respondents to determine prevalence of diabetes, obesity and diabesity. The social determinants were assessed using multinomial regression, reported as adjusted relative risk ratio (RRR). A multiple correspondence analysis generated life satisfaction.

Results

The prevalence of obesity, diabetes, and diabesity was 21.2%, 6%, and 5.8%, respectively. We identified women (RRR: 2.16 (1.72 to 2.71)), urban residents (RRR: 3.73 (3.07 to 4.54)) and affluent groups (RRR: 3.60 (2.46 to 4.58)) had a higher likelihood of having diabesity. The association with various NCDs showed multimorbidity to be akin to the diabesity group. We observed inferior life satisfaction and significantly higher healthcare utilisation among participants with diabesity as compared with other two groups.

Conclusion

Increased obesity prevalence has led to the rise in diabesity in India. Additionally, the level of multimorbidity in this group cannot be overlooked. Rather than focusing on individual conditions, an in toto approach to multimorbidity is warranted.
Conceptualising difference: a qualitative study of physicians’ views on healthcare encounters with asylum seekers
Authors: Jahn Rosa , Biddle Louise , Ziegler Sandra , Nöst Stefan , Bozorgmehr Kayvan
Published: November 2022

Objectives

In many high-income countries, structural, legal, social and political barriers to adequate healthcare interfere with the ability of health professionals to respond to the healthcare needs of a fluctuating and superdiverse population of asylum seekers. However, the relationship between individual, interpersonal and structural factors is not well understood. We explore the views and experiences of physicians working with asylum seekers in Germany and aim to identify how these may impact the provision of medical care.

Methods

A secondary analysis of 16 semistructured interviews conducted in two qualitative studies was performed. These explored the delivery of medical care to asylum seekers in Germany. In order to examine physicians’ views towards their work with asylum seekers, we analysed evaluative judgements on interpersonal relationships, workplace factors, the external environment, the physician’s own self and individual medical conduct. Analysis was conducted by identifying cross-cutting themes through thematic analysis and mapping these onto a framework matrix.

Results

Physicians perceive the provision of medical care to asylum seekers as ‘different’. This ‘difference’ is conceptualised at three levels: patients’ perceived cultural attributes, the workplace or contextual level. Evaluative judgements on patients perceived as ‘other’ and the difference of the space of care provision were found to impede appropriate care, while physicians emphasising contextual factors reported more responsive medical practices.

Conclusions

Concepts of difference at patient level resemble processes of ‘othering’ asylum seekers as a ‘different patient group’, while differences in rules, norms and practices in settings of medical care to asylum seekers create heterotopic spaces. Both appear to endanger the doctor–patient relationship and responsiveness of care, while an understanding of differences attributed to context seemed to foster a more caring approach. Training in contextual competence, sufficient physical and human resources and encouraging support between physicians working with asylum-seeking patients could counteract these processes.
Effects of postharvest deficit irrigation on sweet cherry (Prunus avium) in five Okanagan Valley, Canada, orchards: I. Tree water status, photosynthesis, and growth
Authors: Houghton E. , Bevandick K. , Neilsen D. , Hannam K. , Nelson L.M.
Published: November 2022

The timing and availability of water supply are changing in the Okanagan Valley, and the availability of irrigation water in the late summers is a growing concern. Postharvest deficit irrigation (PDI) is a strategy that can be used to reduce water demands in sweet cherry orchards; previous studies in this region have reported no change in plant physiology or tree growth with irrigation volume reductions of up to 25%, postharvest. However, the effects of more severe postharvest reductions in irrigation volume remain unknown. We compared the effects of full irrigation (100% of conventional grower practice through the growing season) with 27%–33% reductions in irrigation postharvest (∼70% of conventional grower practice) and 47%–52% reductions in irrigation postharvest (∼50% of conventional grower practice) over a 3-year period (2019–2021) in five commercial sweet cherry orchards that ranged in elevation and latitude across the Okanagan Valley, BC, Canada. In the growing season following treatment application, PDI had no effect on stem water potential or photosynthesis in any year and at any site; there were also no effects of PDI treatment on tree growth. Findings from this study suggest that postharvest stem water potentials from −0.5 to −1.3 MPa, and one-time stem water potentials as low as −2.0 MPa, have no lasting effects on future plant water status, rates of photosynthesis, or plant growth. PDI shows potential as an effective water-saving measure in sweet cherry orchards in the Okanagan Valley.
Effect of fluctuations on the geodesic rule for topological defect formation
Authors: Digal Sanatan , Mamale Vinod
Published: November 2022

At finite temperatures, the field along a linear stretch of correlation length size is supposed to trace the shortest path in the field space given the two end point values, known as the geodesic rule. In this study, we compute the probability that, the field variations over distances of correlation length follow this rule in theories with [Formula: see text] global symmetry. We consider a simple ferromagnetic [Formula: see text]-spin model and a complex [Formula: see text] theory. The computations are carried out on an ensemble of equilibrium configurations, generated using Monte Carlo simulations. The numerical results suggest a significant deviation to the geodesic rule, relevant for the formation of topological defects during quench in second-order phase transition. Also for the case of [Formula: see text]-spins in two dimensions, the distribution and density of vortices, have been studied. It is found that, for quench temperatures close to the transition point, the Kibble–Zurek mechanism underestimates the equilibrium density of defects. The exponents corresponding to the width of the distributions are found to be smaller than Kibble mechanism estimates and match only when there is no deviation from the geodesic rule.
Comparison of Convolutional Neural Network for Classifying Lung Diseases from Chest CT Images
Authors: Mohan Ramya , Rama A. , Ganapathy Kirupa
Published: November 2022

This paper proposes a convolutional neural network for diagnosing various lung illnesses from chest CT images based on a customized Medical Image Analysis and Detection network (MIDNet18). With simplified model building, minimal complexity, easy technique, and high-performance accuracy, the MIDNet-18 CNN architecture classifies binary and multiclass medical images. Fourteen convolutional layers, 7 pooling layers, 4 dense layers, and 1 classification layer comprise the MIDNet-18 architecture. The medical image classification process involves training, validating, and testing the MIDNet-18 model. In the Lung CT image binary class dataset, 2214 images as training set, 1800 images as validation set, and 831 as test set are considered for classifying COVID images and normal lung images. In the multiclass dataset, 6720 images as training sets belonging to 3 classes, 3360 images as validation sets and 601 images as test sets are considered for classifying COVID, cancer images and normal images. Independent sample size calculated for binary classification is 26 samples for each group. Similarly, 10 sample sizes are calculated for multiclass dataset classification keeping GPower at 80%. To validate the performance of the MIDNet18 CNN architecture, the medical images of two different datasets are compared with existing models like LeNet-5, VGG-16, VGG-19, ResNet-50. In multiclass classification, the MIDNet-18 architecture gives better training accuracy and test accuracy, while the LeNet5 model obtained 92.6% and 95.9%, respectively. Similarly, VGG-16 is 89.3% and 77.2% respectively; VGG-19 is 85.8% and 85.4%, respectively; ResNet50 is 90.6% and 99%, respectively. For binary classification, the MIDNet18 architecture gives better training accuracy and test accuracy, while the LeNet-5 model has obtained 52.3% and 54.3%, respectively. Similarly, VGG 16 is 50.5% and 45.6%, respectively; VGG-19 is 50.6% and 45.6%, respectively; ResNet-50 is 96.1% and 98.4%, respectively. The classified images are further predicted using detectron-2 model and the results identify abnormalities (cancer, COVID-19) with 99% accuracy. The MIDNET18 is significantly more accurate than LeNet5, VGG19, VGG16 algorithms and is marginally better than the RESNET50 algorithm for the given lung binary dataset (Bonferroni — one-way Anova and pairwise comparison of MIDNET, LeNet5, VGG19, VGG16, and RESNET 50 ([Formula: see text])). The proposed MIDNet18 model is significantly more accurate than LeNet5, VGG19, VGG16, ResNet50 algorithms in classifying the diseases for the given multiclass lung dataset (Bonferroni — one-way Anova and pairwise comparison of MIDNET18, LeNet5, VGG19, VGG16, ResNet50 ([Formula: see text])).
DYNAMICS OF A FISHERY MODEL WITH CONTINUOUS THRESHOLD HARVESTING POLICY AND ITS LEVERAGE FOR CONSERVATION AND MANAGEMENT
Authors: BHATTACHARYYA JOYDEB , CHATTERJEE ANAL
Published: November 2022

There is a global decline in marine fish abundance due to unsustainable harvesting. An effective harvesting policy can protect the overfished population from possible extinction. In this study, we used a mathematical model characterized by density-dependent refuge protection for herbivorous fish, exhibiting an anti-predator response in presence of a generalist invasive fish. The anti-predator behavior entails predator density-dependent reduced fecundity of the herbivorous fish. The model assumes a continuous threshold harvesting policy (CTHP) for the herbivorous fish and uses the catch-per-unit-effort (CPUE) hypothesis for harvesting the invasive fish. The CTHP allows harvesting of the herbivorous fish only when the density of the herbivorous fish exceeds a specified threshold value, thus ensuring the long-term sustainability of the herbivorous fish stock. The existence and stability of steady-state solutions and the bifurcations of the model are investigated. Our study reveals that the level of apprehension of the herbivorous fish and fishing efforts will play a significant role in the stability of the system. We examine the existence of the bionomic equilibrium and then study the dynamic optimization of the harvesting policy by employing Pontryagin’s maximum principle. We discuss different subsidies and tax policies for the effective management of a sustainable fishery. We use numerical simulations to compare the revenues corresponding to the harvest policies based on maximum sustainable yield (MSY), maximum economic yield (MEY), and optimal sustainable yield (OSY) for inferring an ecologically sustainable and economically viable harvesting policy.
Catalytic production of hydrogen peroxide and its fuel cells with metalloporphyrins, metallophthalocyanines, and analogs
Authors: Hong Young Hyun , Lee Yong-Min , Nam Wonwoo , Fukuzumi Shunichi
Published: November 2022

Metalloporphyrins, metallophthalocyanines, and analogs are known to act as efficient catalysts for the reduction of dioxygen in the presence of an acid in solution. Whether dioxygen is reduced to hydrogen peroxide (H2O2: two-electron reduced species of O2) or water (H2O: four-electron reduced species of O2) is changed depending on metals and ligands. This mini-review focuses on the catalytic production of hydrogen peroxide by a combination of 2e−O2reduction and 2e−or 4e−H2O oxidation with the use of metalloporphyrins and metallophthalocyanines as photocatalysts. H2O2generated by the photocatalytic H2O oxidation with O2can be used as a fuel in hydrogen peroxide fuel cells in which metalloporphyrins, metallophthalocyanines, and analogs are employed as the cathode catalysts. Metalloporphyrins are also employed as efficient electrocatalysts to exhibit significantly improved performance in a Zn-air battery that has a much higher energy density than that of lithium-ion batteries.
Identification of Potential Molecular Targets and Active Ingredients of Mingmu Dihuang Pill for the Treatment of Diabetic Retinopathy Based on Network Pharmacology
Authors: Zhou Yini , Fan Gujing , Zhang Yadong , Xu Luning
Published: November 2022

Objective. Mingmu Dihuang Pill (MMDHP) is a traditional Chinese formula that has shown remarkable improvements of dry eyes, tearing, and blurry vision; however, the mechanisms underlying MMDHP treatment for diabetic retinopathy have not been fully understood. This study is aimed at identifying the molecular targets and active ingredients of MMDHP for the treatment of diabetic retinopathy based on network pharmacology. Methods. All active ingredients of MMDHP were retrieved from TCMSP and BATMAN‐TCM databases, and the targets of active ingredients of MMDHP were predicted on the SwissTargetPrediction website. Diabetic retinopathy‐related target sets were retrieved from GeneCards and OMIM databases, and the intersecting targets between targets of active ingredients of MMDHP and potential therapeutic targets of diabetic retinopathy were collected to generate the traditional Chinese medicine‐ingredient‐target‐diabetic retinopathy network and to create the protein‐protein interaction network. In addition, GO terms and KEGG pathway enrichment analyses were performed to identify the potential pathways, and molecular docking was employed to verify the binding of active ingredients of MMDHP to key targets of diabetic retinopathy. Results. Network pharmacology predicted 183 active ingredients and 904 targets from MMDHP, and 203 targets were intersected with the therapeutic targets of diabetic retinopathy. The top 10 hub targets included PIK3RA, TP53, SRC, JUN, HRAS, AKT1, VEGFA, EGFR, ESR1, and PI3KCA. GO terms and KEGG pathway enrichment analyses identified AGE‐RAGE, PI3K‐AKT, and Rap1 signaling pathways as major pathways involved in MMDHP treatment for diabetic retinopathy. Molecular docking confirmed a good binding affinity of active ingredients of MMDHP, including luteolin, acacetin, naringenin, and alisol B, with AKT1, SRC, and VEGFA as the three key targets of diabetic retinopathy. Conclusion. MMDHP may be effective for the treatment of diabetic retinopathy through active ingredients luteolin, acacetin, naringenin, and alisol B via AKT1, SRC, and VEGFA in AGE‐RAGE, PI3K‐AKT, and Rap1 signaling pathways.
Changes in Bone Turnover Markers after Osteoporotic Vertebral Compression Fractures in Males and Females
Authors: Jia Zhongxiong , Tang Min , Zhang Xiaojun , Jiang Wei , Shen Jieliang , Zhou Nian , Hao Jie
Published: November 2022

Background. To explore the normal changes in bone turnover markers (BTMs) and the correlations between the different BTMs after osteoporotic vertebral compression fracture (OVCF). Meanwhile, we explored the related differences that exist between sexes. Methods. A total of 130 OVCF patients were retrospectively reviewed. Using IBM SPSS 19.0 statistical software, the differences in the levels of BTMs and clinical parameters between sexes were assessed using Student’s unpaired t test, and one‐way ANOVA was used for the comparison of the three groups of samples. The correlations between P1NP, CTX, and clinical factors were assessed using Pearson’s correlation coefficient. Results. P1NP was 52.15 ng/ml within two weeks in male patients, and the level increased to 96.33 ng/ml after 12 weeks; in female patients, the increase was not as obvious as in male patients. CTX in male patients reached as much as approximately twice the initial value after 12 weeks. However, the situation in female patients was diverse. CTX was 0.58 ng/ml within two weeks and increased to 0.61 ng/ml within 2‐12 weeks after the onset of OVCF. Subsequently, CTX decreased suddenly after 12 weeks. The increase in P1NP levels within 2 weeks after OVCF was significantly correlated with the levels of osteocalcin (OC) and bone‐specific alkaline phosphatase (BAP). Changes in CTX within 2 weeks after OVCF were considerably related to phosphorus, 25 hydroxyvitamin D (25‐OHD), OC, and BAP. Conclusion. The levels of P1NP and CTX increased differently in males and females after OVCF. The levels of OC and BAP were correlated with the levels of P1NP and CTX within 2 weeks of OVCF.
Leukemia can be Effectively Early Predicted in Routine Physical Examination with the Assistance of Machine Learning Models
Authors: Yu Cheng , Peng Yin-yin , Liu Lin , Wang Xin , Xiao Qing
Published: November 2022

Objectives. The diagnosis of leukemia relies very much on the results of bone marrow examinations, which is never generally performed in routine physical examination. In many rural areas even community hospitals and primary care clinics, the lack of hematological specialist and facility does not allow a definite diagnosis of leukemia. Thus, there will be a significant benefit if machine learning (ML) models could help early predict leukemia using preliminary blood test data in a routine physical examination in community hospitals to save time before a definite diagnosis. Methods. We collected the routine physical examination data of 1230 newly diagnosed leukemia patients and 1300 healthy people. We trained and tested 3 machine learning (ML) models including linear support vector machine (LSVM), random forest (RF), and XGboost models. We not only examined the accordance between model results and statistical analysis of the input data but also examined the consistency of model accuracy scores and relative importance order of model factors with regard to different input data sets and different model arguments to check the applicability of both the models and the input data. Results. Generally, the RF and XGboost models give more identical, consistent, and robust relative importance order of factors that is also accordant with the statistical analysis, while the LSVM gives much different and nonsense orders for different inputs. Results of the RF and XGboost models show that (1) generally, the models achieve accuracy scores above 0.9, indicating effective identification of leukemia, and (2) the top three factors that contribute most to the identification of leukemia include red blood cell (RBC), hematocrit (HCT), and white blood cell (WBC), while the other factors contribute relatively less. Conclusions. This study shows a feasible case example for early identification of leukemia using routine physical examination data with the assistance of ML models, which can be conveniently, cheaply, and widely applied in community hospitals or primary care clinics to save time before definite diagnosis; however, more studies are still needed to validate the applicability of more ML models to a larger variety of input data sets.
Identification of Markers for Diagnosis and Treatment of Diabetic Kidney Disease Based on the Ferroptosis and Immune
Authors: Ma JingYuan , Li ChangYan , Liu Tao , Zhang Le , Wen XiaoLing , Liu XiaoLing , Fan WenXing
Published: November 2022

Background. In advanced diabetic kidney disease (DKD), iron metabolism and immune dysregulation are abnormal, but the correlation is not clear. Therefore, we aim to explore the potential mechanism of ferroptosis-related genes in DKD and their relationship with immune inflammatory response and to identify new diagnostic biomarkers to help treat and diagnose DKD. Methods. Download data from gene expression omnibus (GEO) database and FerrDb database, and construct random forest tree (RF) and support vector machine (SVM) model to screen hub ferroptosis genes (DE-FRGs). We used consistent unsupervised consensus clustering to cluster DKD samples, and enrichment analysis was performed by Gene Set Variation Analysis (GSVA), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) and then assessed immune cell infiltration abundance using the single-sample gene set enrichment analysis (ssGSEA) and CIBERSORT algorithms. Ferroptosis scoring system was established based on the Boruta algorithm, and then, core compounds were screened, and binding sites were predicted by Coremine Medical database. Results. We finally established a 7-gene signature (DUSP1, PRDX6, PEBP1, ZFP36, GABARAPL1, TSC22D3, and RGS4) that exhibited good stability across different datasets. Consistent clustering analysis divided the DKD samples into two ferroptosis modification patterns. Meanwhile, autophagy and peroxisome pathways and immune-related pathways can participate in the regulation of ferroptosis modification patterns. The abundance of immune cell infiltration differs significantly across patterns. Further, molecular docking results showed that the core compound could bind to the protein encoded by the core gene. Conclusions. Our findings suggest that ferroptosis modification plays a crucial role in the diversity and complexity of the DKD immune microenvironment, and the ferroptosis score system can be used to effectively verify the relationship between ferroptosis and immune cell infiltration in DKD patients. Kaempferol and quercetin may be potential drugs to improve the immune and inflammatory mechanisms of DKD by affecting ferroptosis.
Factor XIII in the Acute Care Setting and Its Relevance in Obstetric Bleeding
Authors: Duque Patricia , Korte Wolfgang
Published: November 2022

Background: Major hemorrhage is one of the main causes of preventable mortality in either severe trauma, high-risk surgical patient, or the obstetric population. As underlined by the cell-based coagulation model, a resistant and stable clot is essential to prevent or to stop an ongoing bleeding. Coagulation factor XIII (FXIII) stabilizes the newly formed clot by cross-linking the fibrin monomers into a three-dimensional network and by impeding fibrinolysis. Thus, FXIII is an essential coagulation factor in the acutely bleeding patient. Summary: Acquired FXIII deficiency is much more common than the inherited form. On the basis of acute tissue injury which leads to major bleeding, acquired FXIII deficiency is traditionally considered to be secondary to consumption. However, recent evidence in the field of obstetrics and high-risk surgery suggests that it might be an associated factor rather than a consequence of the bleeding, which would mean that early replacement of FXIII could potentially improve outcomes. However, FXIII measurement is not universally available. Assessing FXIII through viscoelastic assays seems feasible, though likely it is not yet accurate. Moreover, the target population at risk and the aimed FXIIIlevel required to achieve hemostasis in each condition are yet to be defined. Key Messages: FXIII should be assessed and replaced if necessary in the acutely bleeding patient. We recommend FXIII to be included in an escalating scheme of hemostatic therapies in the acute care setting.
Angiographic Systems for Classifying Distal Arterial Occlusions
Authors: Pillai Presaad , Mitchell Peter J. , Phan Thanh G. , Ma Henry , Yan Bernard
Published: November 2022

Background: Extensive randomized controlled clinical trials for endovascular thrombectomy in anterior circulation large vessel occlusions (internal carotid arteries and M1 segment of middle cerebral arteries) have been published over the past decade, but there have not been randomized controlled trials for distal arterial occlusions to date. Distal arterial occlusion randomized controlled trials are essential to decide on patient selection, imaging criteria, and endovascular approach to improve the outcome and reduce complications. Summary: The definition of distal arterial occlusion is however unclear, and we believe that a uniform nomenclature of distal arterial occlusions is essential for the design of robust randomized controlled studies. We undertook a systematic literature review and comprehensive analysis of 70 articles looking at distal arterial occlusions and previous attempts at classifying them as well as comparing their similarities and differences with a more selective look at the middle cerebral artery. Thirty-two articles were finally deemed suitable and included for this review. In this review article, we present 3 disparate classifications of distal arterial occlusions, namely, classical/anatomical, functional/imaging, and structural/calibre, and compare the similarities and differences between them. Key Messages: We propose the adoption of functional/imaging classification to guide the identification of distal arterial occlusions with the M2 segment starting at the point of bifurcation of the middle cerebral artery trunk/M1 segment. With regards to the anterior temporal artery, we propose that it will be considered a branch of the M1 and only be considered as the M2 segment if it is a holo-temporal artery. We believe that this is a practical method of classification in the time-critical decision-making period.
Perinephric Toxic Fat: Impact on Surgical Complexity, Perioperative Outcome, and Surgical Approach in Partial Nephrectomy
Authors: Walach Margarete Teresa , Schiefelbein Frank , Schneller Andreas , Schoen Georg , von Klot Christoph A.J. , Katzendorn Olga , Mühlbauer Julia , Nuhn Philipp , Kriegmair Maximilian Christian , Harke Nina Natascha
Published: November 2022

Introduction: To assess influencing factors on perinephric toxic fat (high Mayo Adhesive Probability [MAP] score) and the impact of high MAP scores on surgical complexity, perioperative outcome, and surgical approach in patients with localized renal tumors undergoing open (OPN) and robot-assisted partial nephrectomy (RAPN). Methods: 698 patients were included in this study. Based on preoperative imaging, adherent perinephric fat (APF) was assessed to define MAP scores. Regression analyses assessed influencing parameters for high MAP scores (≥3), predictors of surgical outcome, and influencing factors on surgical approach. Results: OPN was performed in 331 (47%) patients, and 367 (53%) patients underwent RAPN. Male gender (p < 0.001), age ≥65 (p < 0.001), and BMI ≥27.4 kg/m2 (p < 0.001) showed to be significantly influencing factors for the presence of APF. High MAP scores showed to be an influencing factor for a prolonged surgery duration (OR = 1.68, 95% CI 1.22–2.31, p = 0.002) and a significant predictor to rather undergo OPN than RAPN (OR = 1.5, 95% CI 1.05–2.15, p = 0.027). Conclusion: Older, male patients with high BMI scores have a higher risk for APF. The presence of APF increases surgery time and may have an impact on decision making regarding the preferred surgical approach.
La literatura peruana en el pensamiento crítico de Sebastián Salazar Bondy
Authors: Salazar Mejía Nécker
Published: November 2022

Sebastián Salazar Bondy (1924-1965) es uno de los principales escritores de la Generación del 50 y su producción literaria está conformada por diferentes géneros literarios, entre los cuales se halla el periodismo. El trabajo estudia sus artículos periodísticos con el fin de conocer su pensamiento crítico sobre la literatura peruana. El artículo pone de relieve la función del crítico de arte y literatura según Salazar Bondy, así como sus juicios sobre la obra de los principales escritores de nuestra literatura. El trabajo se centra, en particular, en sus estudios sobre el curso de la poesía y la narrativa en el contexto de la primera mitad del siglo XX. Se concluye que las reflexiones de Salazar Bondy constituyen un balance del estado de la literatura peruana y de sus principales tendencias en dicho periodo.
Trends in Veno‐Arterial Extracorporeal Life Support With and Without an Impella or Intra‐Aortic Balloon Pump for Cardiogenic Shock
Authors: Hendrickson Michael J. , Jain Vardhmaan , Bhatia Kirtipal , Chew Christopher , Arora Sameer , Rossi Joseph S. , Villablanca Pedro , Kapur Navin K. , Joshi Aditya A. , Fox Arieh , Mahmood Kiran , Birati Edo Y. , Ricciardi Mark J. , Qamar Arman
Published: November 2022

Background

Mechanical circulatory support devices, such as the intra‐aortic balloon pump (IABP) and Impella, are often used in patients on veno‐arterial extracorporeal life support (VA‐ECLS) with cardiogenic shock despite limited supporting clinical trial data.

Methods and Results

Hospitalizations for cardiogenic shock from 2016 to 2018 were identified from the National Inpatient Sample. Trends in the use of VA‐ECLS with and without an IABP or Impella were assessed semiannually. Multivariable logistic regression and general linear regression evaluated the association of Impella and IABP use with in‐hospital outcomes. Overall, 12 035 hospitalizations with cardiogenic shock and VA‐ECLS were identified, of which 3115 (26%) also received an IABP and 1880 (16%) an Impella. Use of an Impella with VA‐ECLS substantially increased from 10% to 18% over this period (
P
<0.001), whereas an IABP modestly increased from 25% to 26% (
P
<0.001). In‐hospital mortality decreased 54% to 48% for VA‐ECLS only, 61% to 58% for VA‐ECLS with an Impella, and 54% to 49% for VA‐ECLS with an IABP (
P
<0.001 each). Most (57%) IABPs or Impellas were placed on the same day as VA‐ECLS. After adjustment, there were no differences in in‐hospital mortality or length of stay with the addition of an IABP or Impella compared with VA‐ECLS alone.

Conclusions

From 2016 to 2018 in the United States, use of an Impella and IABP with VA‐ECLS significantly increased. More than half of Impellas and IABPs were placed on the same day as VA‐ECLS, and the use of a second mechanical circulatory support device did not impact in‐hospital mortality. Further studies are needed to decipher the optimal timing and patient selection for this growing practice.
Self-Cleaning Characteristics of Mesoporous Nano-Crystalline TiO2–SiO2 Thin Films
Authors: Pei Rui , Ma Xinguo , Xie Qihai , Chen Chen , Wang Mei , Deng Shuiquan , Bo Huating , Dong Xiaoru
Published: November 2022

Mesoporous TiO2–SiO2 films with remarkable self-cleaning capability were prepared by Sol–Gel methods and pressureless sintering. Here, the results show that the incorporation of 20 V% SiO2 onto the TiO2 films enhances the performance
of anti-fog and self-cleaning. According to the SEM image, it is found that the TiO2 particles are dispersed by the SiO2, thus enlarging the specific surface area of the TiO2 particles. Therefore, super hydrophilicity and self-cleaning performance are promoted.
Besides, the mesoporous structure is formed on the surface of the TiO2–SiO2 films after calcination. The mesoporous structure can improve the light utilization efficiency and the surface roughness of the films, thus promoting the performance of super hydrophilicity.
Consequently, the mesoporous TiO2–SiO2 composite films as environmentally friendly coatings presented great potential in environmental governance.
An Objective Weather Regime Classification for Aotearoa New Zealand Using a Two-Tiered K-Means Clustering Approach
Authors: Rampal Neelesh , Lorrey Andrew , Fauchereau Nicolas
Published: November 2022

Weather regimes (WRs), also known as synoptic types, are defined as recurrent patterns that have been used to categorize variability in atmospheric circulation. However, defining the optimal number of patterns can often be arbitrary, and there are common shortcomings when oversimplifying a wide range of synoptic conditions and weather outcomes. We build on previous work that has defined regional WRs and objectively ascribe an optimal number of once-daily weather patterns for Aotearoa New Zealand (ANZ) using affinity propagation combined with K-means clustering. Nine primary WRs for ANZ were classified based on once-daily geopotential height spatial patterns, but these patterns still retained a wide degree of spatial variability. Subsidiary clusters were subsequently defined within each primary WR by applying affinity propagation and K-means clustering to reveal the largest within-cluster differences based on joint daily temperature and precipitation anomalies. Up to three subsidiary patterns in each of the primary regimes were revealed, with a total of 21 unique daily patterns emerging from the two-tier classification. Subsidiary WRs reveal subtle differences in the location and intensity of regional-scale pressure anomalies, pressure gradients, and wind flow over both main islands that lead to large differences in surface weather anomalies. Impacts of atmospheric variability related to each subsidiary WR are exemplified by different spatial outcomes for rainfall and temperature (including intensity of anomalies) at regional and subregional levels. The approach presented in this study has utility for enhancing prediction of weather outcomes, including extreme weather, and can also be applied more widely over a range of time scales to improve understanding of weather and climate linkages.
Development and validation of a predictive model combining patient-reported outcome measures, spirometry and exhaled nitric oxide fraction for asthma diagnosis
Authors: Louis Gilles , Schleich Florence , Guillaume Michèle , Kirkove Delphine , Nekoee Zahrei Halehsadat , Donneau Anne-Françoise , Henket Monique , Paulus Virginie , Guissard Françoise , Louis Renaud , Pétré Benoit
Published: November 2022

Introduction

Although asthma is a common disease, its diagnosis remains a challenge in clinical practice with both over- and underdiagnosis. Here, we performed a prospective observational study investigating the value of symptom intensity scales alone or combined with spirometry and exhaled nitric oxide fraction (FENO) to aid in asthma diagnosis.

Methods

Over a 38-month period we recruited 303 untreated patients complaining of symptoms suggestive of asthma (wheezing, dyspnoea, cough, sputum production and chest tightness). The whole cohort was split into a training cohort (n=166) for patients recruited during odd months and a validation cohort (n=137) for patients recruited during even months. Asthma was diagnosed either by a positive reversibility test (≥12% and ≥200 mL in forced expiratory volume in 1 s (FEV1)) and/or a positive bronchial challenge test (provocative concentration of methacholine causing a 20% fall in FEV1≤8 mg·mL−1). In order to assess the diagnostic performance of symptoms, spirometric indices andFENO, we performed receiver operating characteristic curve analysis and multivariable logistic regression to identify the independent factors associated with asthma in the training cohort. Then, the derived predictive models were applied to the validation cohort.

Results

63% of patients in the derivation cohort and 58% of patients in the validation cohort were diagnosed as being asthmatic. After logistic regression, wheezing was the only symptom to be significantly associated with asthma. Similarly, FEV1(% pred), FEV1/forced vital capacity (%) andFENOwere significantly associated with asthma. A predictive model combining these four parameters yielded an area under the curve of 0.76 (95% CI 0.66–0.84) in the training cohort and 0.73 (95% CI 0.65–0.82) when applied to the validation cohort.

Conclusion

Combining a wheezing intensity scale with spirometry andFENOmay help in improving asthma diagnosis accuracy in clinical practice.
Impact of socioeconomic factors and health determinants on preterm birth in Brazil: a register-based study
Authors: de Andrade Luciano , Kozhumam Arthi S. , Rocha Thiago Augusto Hernandes , de Almeida Dante Grapiuna , da Silva Núbia Cristina , de Souza Queiroz Rejane Christine , Massago Miyoko , Rent Sharla , Facchini Luiz Augusto , da Silva Antônio Augusto Moura , Staton Catherine Ann , Vissoci João Ricardo Nickenig , Thomaz Erika Barbara Abreu Fonseca
Published: November 2022

Background

More than 15 million children are born preterm annually. While preterm survival rates have increased in high-income countries. Low- and middle-income countries, like Brazil, continue to battle high neonatal mortality rates due to a lack of adequate postnatal care. Globally, neonatal mortality is higher for preterm infants compared to those born at term. Our study aims to map and analyze the spatial, socioeconomic, and health coverage determinants related to preterm birth in Brazil in order to understand how spatial variations in demographics and access to primary care may affect preterm birth occurrences. 

Methods

Using publicly available national-level data from the Brazilian health system for 2008–2017, we conducted an ecological study to visualize the spatial distributions of preterm birth along with socioeconomic status, the structure of health services, and primary care work process, each consisting of multiple variables reduced via principal component analysis. Regression models were created to determine predictive effects of numeric and spatial variation of these scores on preterm birth rates.

Results

In Brazil, preterm birth rates increased from 2008–2017, with small and rural municipalities frequently exhibiting higher rates than urban areas. Scores in socioeconomic status and work process were significant predictors of preterm birth rates, without taking into account spatial adjustment, with more positive scores in socioeconomic status predicting higher preterm birth rates (coefficient 0.001145) and higher scores in work process predicting lower preterm birth rates (coefficient -0.002416). Geographically weighted regression showed socioeconomic status to be a more significant predictor in the North, with the work process indicators being most significant in the Northeast.

Conclusions

Results support that primary care work process indicators are more significant in estimating preterm birth rates than physical structures available for care. These results emphasize the importance of ensuring the presence of the minimum human resources needed, especially in the most deprived areas of Brazil. The association between social determinants of health and preterm birth rates raises questions regarding the importance of policies dedicated to foster equity in the accessibility of healthcare services, and improve income as protective proxies for preterm birth.
STEAP3 can predict the prognosis and shape the tumor microenvironment of clear cell renal cell carcinoma
Authors: Wu Jiyue , Bi Qing , Zheng Xiang , Cao Huawei , Hao Changzhen , Sun Zejia , Wang Wei
Published: November 2022

Clear cell renal cell carcinoma (ccRCC) is a common malignant tumor of the urinary system characterized by poor prognosis and difficult treatment. It has been reported that iron metabolism dysregulation is a common phenomenon in ccRCC and is closely related to the process of ccRCC. But still now, the exact function and underlying mechanisms of iron metabolism dysregulation in ccRCC have not been fully elucidated. In this study, we comprehensively investigated the prognostic value and potential role of STEAP3 (an iron metabolism-related gene) in ccRCC. STEAP3 is significantly up-regulated in ccRCC. High STEAP3 expression is associated with gender, hemoglobin level, pathological grade, tumor stage and significantly predicts an unfavorable prognosis of ccRCC patients. Functional enrichment analysis and evaluation of the tumor microenvironment indicated that STEAP3 was involved in the remodeling of tumor extracellular matrix and the shaping of an immune-suppressive tumor microenvironment to promote tumor metastasis and evade immune killing. Besides, the expression of STEAP3 is also associated with the expression of various immune checkpoint molecules and the IC50 of targeted drugs. Finally, we verified STEAP3 by RT-qPCR and IHC staining. In conclusion, we found that STEAP3 can serve as a candidate prognostic biomarker for ccRCC, and targeting STEAP3 and its biological processes may provide new references for the individualized treatment of ccRCC.
A comparative study to determine the association of gut microbiome with schizophrenia in Zhejiang, China
Authors: Yan Fuyang , Xia Lehong , Xu Li , Deng Liyun , Jin Guolin
Published: November 2022

Background

With the rapid progress of high-throughput sequencing technology, characterization of schizophrenia (SZ) with underlying probing of the gut microbiome can explore pathogenic mechanisms, estimate disease risk, and allow customization of therapeutic and prophylactic modalities. In this study, we compared the differences in gut microbial diversity and composition between 50 SZ subjects and 50 healthy matched subjects in Zhejiang, China via targeted next-generation sequencing (16S rRNA amplicon).

Results

Accordingly, the alpha diversity indices (observed species index, Shannon index, and Simpson index) of the gut microbiome in the healthy control group were higher than those in the SZ group. Additionally, principal coordinate analysis and non-metric multidimensional scaling of beta diversity revealed that patients with SZ clustered more tightly than healthy controls. At the phylum level, we found that the abundance ofBacteroidetesandProteobacteriain the SZ group was significantly increased. At the genus level, the relative abundances ofPrevotella,Parabacteroides, andSutterellawere significantly higher, whereas the abundances ofFaecalibacterium,Blautia,Lachnospira,Clostridium,Ruminococcus, andCoprococcuswere lower than those in the healthy control group. Further analyses revealed thatSuccinivibrio,Megasphaera, andNesterenkoniamay serve as potential biomarkers for distinguishing patients with SZ from those in the control cohort.

Conclusions

This study profiled differences in gut microbiome diversity, taxonomic composition, and function between SZ and healthy cohorts, and the insights from this research could be used to develop targeted next-generation sequencing-based diagnoses for SZ.
Mental health challenges and perceived risks among female sex workers in Nairobi, Kenya
Authors: Panneh Mamtuti , Gafos Mitzy , Nyariki Emily , Liku Jennifer , Shah Pooja , Wanjiru Rhoda , Wanjiru Mary , Beksinska Alicja , Pollock James ,   The Maisha Fiti Study Champions, Gwala Demtilla , Oside Daisy , Kamene Ruth , Watata Agnes , Atieno Agnes , Njau Faith , Njeri Elizabeth , Orobi Evelyn , Lwingi Ibrahim , Jama Zaina , Babu Hellen , Kaul Rupert , Seeley Janet , Bradley John , Kimani Joshua , Beattie Tara
Published: November 2022

Background

Female sex workers (FSWs) in Kenya are at an increased risk of violence, poverty, police arrest, and problematic alcohol and other substance use, all of which are linked to poor mental health and suicidal ideation. Despite the psychological stressors experienced by FSWs, there is no published qualitative methods research investigating their mental health experiences in Kenya. In this paper, we draw on data from in-depth interviews to examine FSWs’ lifetime mental health experiences and perceived risk factors.

Methods

We used baseline in-depth interviews of the Maisha Fiti longitudinal study of FSWs in Nairobi. We randomly selected 40 FSWs from 1003 FSWs who attended a baseline behavioural-biological interview as part of the Maisha Fiti study. The interview guide was semi-structured, and participants were asked to detail their life stories, including narrating specific events such as entry into sex work, experiences of violence, mental health experiences, and use of alcohol and other substances. Interviews were recorded in Kiswahili/ English and transcribed in English. Data were coded and thematically analysed in Nvivo (v.12).

Results

Results indicated that the majority of participants understood ‘mental health’ as ‘insanity’, ‘stress’, ‘depression’, and ‘suicide’; nevertheless, a number described mental health symptomatically, while a few believed that mental health problems were caused by witchcraft. Interestingly, poverty, low levels of education, poor job opportunities, a lack of family support, harmful gender norms, intimate partner violence and subsequent relationship breakdowns, and family bereavement all contributed to poor mental health and subsequent entry into sex work. In addition, the consequences of sex work such as sexual risks, and ongoing violence from police and clients, further exacerbated poor mental health.

Conclusions

There is a need for both micro- and macro interventions to address poverty and violence against FSWs in Kenya, thereby reducing mental health problems. Addressing violence against women and girls may also reduce entry into sex work. Improving mental health literacy and providing mental health intervention services for ‘at-risk’ populations such as FSWs should enhance coping strategies and help-seeking efficacy.
Multilevel correlates of domain-specific physical activity among rural adults – a cross-sectional study
Authors: Beck Alan M. , Serrano Natalicio H. , Toler Audrey , Brownson Ross C.
Published: November 2022

Background

Increasing physical activity (PA) in rural communities is a vital prevention tactic in multiple chronic diseases; however, little is known on the multilevel correlates of PA rural areas. A better understanding of domain-specific PA adds context for promoting PA in rural communities. The current study sought to determine factors associated with domain-specific and overall moderate-vigorous physical activity (MVPA) in rural communities.

Methods

Surveys were conducted across 14 rural mid-Western communities, with the final analytical sample including 1241 adults (ages 19–96, M = 57.0 [SD = 16.7], 67.8% female, 83.8% white). Generalized linear models with negative binomial distributions examined the relation between demographics, trail use, and perceptions of the neighborhood environment, with domain-specific and overall MVPA, measured via the Global Physical Activity Questionnaire.

Results

Rural residents reported an average of 617 total minutes of weekly MVPA (SD = 1141), with 58.5% meeting MVPA guidelines. Higher age, female gender, and higher educated individuals had lower levels of overall and occupational MVPA. Females, higher education, and perceived indoor recreational access were associated with lower levels of transportation-related MVPA, while trail use was associated with increased transportation MVPA. Higher age and female gender respondents had lower levels of recreational MVPA, while trail users and those who perceived favorable indoor recreational access had higher levels of recreational MVPA.

Conclusions

PA primarily occurred in the occupational domain among this sample of rural mid-Western adults. Findings highlight the need for multilevel interventions to address PA across multiple domains in rural communities, especially among females and older adults.