bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep learning-based lung sound analysis for intelligent stethoscope
Authors: Huang Dong-Min , Huang Jia , Qiao Kun , Zhong Nan-Shan , Lu Hong-Zhou , Wang Wen-Jin
Published: September 2023

Auscultation is crucial for the diagnosis of respiratory system diseases. However, traditional stethoscopes have inherent limitations, such as inter-listener variability and subjectivity, and they cannot record respiratory sounds for offline/retrospective diagnosis or remote prescriptions in telemedicine. The emergence of digital stethoscopes has overcome these limitations by allowing physicians to store and share respiratory sounds for consultation and education. On this basis, machine learning, particularly deep learning, enables the fully-automatic analysis of lung sounds that may pave the way for intelligent stethoscopes. This review thus aims to provide a comprehensive overview of deep learning algorithms used for lung sound analysis to emphasize the significance of artificial intelligence (AI) in this field. We focus on each component of deep learning-based lung sound analysis systems, including the task categories, public datasets, denoising methods, and, most importantly, existing deep learning methods, i.e., the state-of-the-art approaches to convert lung sounds into two-dimensional (2D) spectrograms and use convolutional neural networks for the end-to-end recognition of respiratory diseases or abnormal lung sounds. Additionally, this review highlights current challenges in this field, including the variety of devices, noise sensitivity, and poor interpretability of deep models. To address the poor reproducibility and variety of deep learning in this field, this review also provides a scalable and flexible open-source framework that aims to standardize the algorithmic workflow and provide a solid basis for replication and future extension:https://github.com/contactless-healthcare/Deep-Learning-for-Lung-Sound-Analysis.
Bacterial endophthalmitis following anti-VEGF intravitreal injections: a retrospective case series
Authors: Bergamo Vinicius Campos , Nakayama Luis Filipe , Moraes Nilva Simeren Bueno De , Yu Maria Cecília Zorat , Höfling-Lima Ana Luiza , Maia Maurício
Published: September 2023

Background

To describe the incidence of endophthalmitis and the treatment outcomes of acute bacterial endophthalmitis following intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections in a Brazilian hospital. The analysis was based on the timing of infection after intravitreal injection, culture results, visual acuity, and the presence of epiretinal membrane after a 1-year follow-up period, spanning nine years.

Methods

This retrospective case series, conducted over a 9-year period, aimed to evaluate the treatment outcomes of acute endophthalmitis following intravitreal Bevacizumab injections. The inclusion criteria involved a chart review of 25 patients who presented clinical signs of acute endophthalmitis out of a total of 12,441 injections administered between January 2011 and December 2019. Negative culture results of vitreous samples or incomplete data were excluded. Ultimately, 23 patients were enrolled in the study. Eight patients were treated with intravitreal antibiotic injections (IVAI) using vancomycin 1.0 mg/0.05mL and ceftazidime 2.25 mg/0.05mL, while 15 patients underwent pars plana vitrectomy (PPV) followed by intravitreal antibiotic injections at the end of surgery (IVAIES). The main outcome measures were the efficacy of controlling the infection with IVAI as a standalone therapy compared to early PPV followed by IVAIES. Data collected included pre-infection and one-year post-treatment best corrected visual acuity (BCVA), optical coherence tomography (OCT) abnormalities, and enucleation/evisceration rates. To compare groups, Mann-Whitney and ANOVA tests were employed for statistical analysis.

Results

The incidence rate of bacterial endophthalmitis was 0.185% (1/541 anti-VEGF injections), with the highest infection rates observed in 2014 and 2017. Patients presented clinical symptoms between 2 and 7 days after injection. The most common isolated organisms were coagulase-negative Staphylococci and Streptococci spp. Treatment outcomes showed that both IVAI and PPV + IVAIES effectively controlled the infection and prevented globe atrophy. After one year, the PPV group with BCVA better than Light Perception had a significantly better BCVA compared to the IVAI group (p 0.003). However, PPV group had higher incidence of epiretinal membranes formation compared to the IVAI group. (P 0.035)

Conclusion

Anti-VEGF injections carry a risk of developing acute bacterial endophthalmitis. Isolated antibiotic therapy could be an effective treatment to control the infection, but performing PPV + IVAIES as a primary treatment showed promising results in terms of improving BCVA after one year, despite a higher rate of epiretinal membrane formation. Further studies are needed to confirm these findings.
The subjective and objective outcomes of endoscopic sinus surgery for nasal polyposis using microdebrider versus conventional instruments: a randomized controlled trial
Authors: Abdoul Jaleel Ahmad Aboul Wafa , Abo El Magd Esam Ali , El Tahan Abd El Rahman Ahmed , Henry Engy Nagy
Published: September 2023

Background

Since the evolution of the microdebrider technology and its modulations to be suitable for rhinology, many attempts were carried out to replace the conventional instruments with microdebrider especially in cases of nasal polyposis. Also, many studies were conducted to compare the efficacy of both tools in functional endoscopic sinus surgery. Those studies focused on objective outcomes as the duration of surgery and the amount of blood loss.

Aim of the study

Comparing the efficacy of microdebrider in cases of resistant chronic rhinosinusitis with nasal polyposis to conventional instruments. Analysis of subjective outcomes is mainly the quality of life of our patients, and not neglecting the objective outcomes but analyzing them thoroughly.

Method

This is a randomized controlled clinical trial, conducted on 100 patients which were diagnosed to have resistant chronic rhinosinusitis with polyposis. We used the microdebrider in functional endoscopic sinus surgery for 50 patients and conventional instruments for the other 50 cases. We compared the operative time, amount of blood loss, and postoperative improvement of quality of life, the presence of adhesions, crustations, and complications, or recurrence of nasal polyposis in both groups.

Results

We found significant differences in favor of microdebrider mainly in the duration of surgery and the amount of blood loss. Patient satisfaction was better in the microdebrider group, especially in the short-term follow-up, while the postoperative clinical scores were better in the long run.

Conclusion

Using the microdebrider in dealing with nasal polyposis is much preferable to conventional instruments. For patients, they feel much better in a shorter duration postoperatively. For surgeons, the manipulations are easier, and the operative field is bloodless and clear.
A Comparison of Study Behaviors and Metacognitive Evaluation Used by Biology Students
Authors: Ewell Sharday N. , Driessen Emily P. , Grogan William , Johnston Quinn , Ferdous Shobnom , Mehari Yohannes , Peart Ashley , Seibenhener Michael , Ballen Cissy J.
Published: September 2023

Study behaviors and metacognitive-evaluation skills can promote positive-academic outcomes. This study investigates the contextual and metacognitive influences that drive the selection and use of specific-study behaviors.
Measuring response to treatment in axial spondyloarthritis using quantitative imaging biomarkers: a prospective observational cohort study
Authors: Jones Alexis , Bray Timothy JP , Sakai Naomi S , Bainbridge Alan JP , Ciurtin Coziana , Hall-Craggs Margaret A
Published: September 2023

Objective

Objective assessments of disease activity and response to treatment in axial spondyloarthritis (axSpA) remain a challenge; quantitative imaging biomarkers (QIBs) of inflammation could enhance assessments of disease activity and therapeutic response. We aimed to determine the responsiveness of QIBs obtained from diffusion-weighted imaging (DW-MRI) and chemical shift-encoded MRI (CSE-MRI) using the partially automated Bone Edema and Adiposity Characterisation with Histograms (BEACH) software tool in axSpA patients undergoing biologic therapy.

Methods

We conducted a prospective longitudinal cohort study, including 30 patients with axSpA undergoing biologic therapy. Patients were scanned before and after biologic therapy using conventional MRI, DWI and CSE-MRI at 3T. Apparent diffusion coefficient (ADC) and proton density fat fraction (PDFF) were assessed using the BEACH tool (https://github.com/TJPBray/BEACH), and conventional MR images were assessed using established visual scoring methods by expert radiologists. Responsiveness – the ability of the MRI measurements to capture changes in disease occurring as a result of biologic therapy – was assessed using the standardized response mean (SRM). Inter-reader reliability of the ADC and PDFF maps was assessed using Bland-Altman limits of agreement analysis and the intraclass correlation coefficient.

Results

Responsiveness to therapy was moderate for ADC-based parameters (SRM 0.50) and comparable to established visual scoring methods for bone marrow oedema (SRM 0.53). Interobserver variability was lower for QIBs compared with conventional visual scores methods.

Conclusions

QIBs measured using the BEACH tool are sensitive to changes in inflammation in axSpA following biologic therapy, with similar responsiveness and lower interobserver variability to visual scoring by expert radiologists.

Advances in knowledge

QIBs measured using the partially automated BEACH tool offer an objective measure of response to biologic therapy in axSpA.
Automated classification of fat-infiltrated axillary lymph nodes on screening mammograms
Authors: Song Qingyuan , diFlorio-Alexander Roberta M. , Sieberg Ryan T. , Dwan Dennis , Boyce William , Stumetz Kyle , Patel Sohum D. , Karagas Margaret R. , MacKenzie Todd A. , Hassanpour Saeed
Published: September 2023

Objective:

Fat-infiltrated axillary lymph nodes (LNs) are unique sites for ectopic fat deposition. Early studies showed a strong correlation between fatty LNs and obesity-related diseases. Confirming this correlation requires large-scale studies, hindered by scarce labeled data. With the long-term goal of developing a rapid and generalizable tool to aid data labeling, we developed an automated deep learning (DL)-based pipeline to classify the status of fatty LNs on screening mammograms.

Methods:

Our internal data set included 886 mammograms from a tertiary academic medical institution, with a binary status of the fat-infiltrated LNs based on the size and morphology of the largest visible axillary LN. A two-stage DL model training and fine-tuning pipeline was developed to classify the fat-infiltrated LN status using the internal training and development data set. The model was evaluated on a held-out internal test set and a subset of the Digital Database for Screening Mammography.

Results:

Our model achieved 0.97 (95% CI: 0.94–0.99) accuracy and 1.00 (95% CI: 1.00–1.00) area under the receiver operator characteristic curve on 264 internal testing mammograms, and 0.82 (95% CI: 0.77–0.86) accuracy and 0.87 (95% CI: 0.82–0.91) area under the receiver operator characteristic curve on 70 external testing mammograms.

Conclusion:

This study confirmed the feasibility of using a DL model for fat-infiltrated LN classification. The model provides a practical tool to identify fatty LNs on mammograms and to allow for future large-scale studies to evaluate the role of fatty LNs as an imaging biomarker of obesity-associated pathologies.

Advances in knowledge:

Our study is the first to classify fatty LNs using an automated DL approach.
Prospective inter- and intra-tracer repeatability analysis of radiomics features in [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 PET scans in metastatic prostate cancer
Authors: Kendrick Jake , Francis Roslyn J , Hassan Ghulam Mubashar , Rowshanfarzad Pejman , Ong Jeremy SL , Jeraj Robert , Barry Nathaniel , Hagan Tammy , Ebert Martin A
Published: September 2023

Objective:

This study aimed to quantify both the intra- and intertracer repeatability of lesion-level radiomics features in [68Ga]Ga-prostate-specific membrane antigen (PSMA)-11 and [18F]F-PSMA-1007 positron emission tomography (PET) scans.

Methods:

Eighteen patients with metastatic prostate cancer (mPCa) were prospectively recruited for the study and randomised to one of three test–retest groups: (i) intratracer [68Ga]Ga-PSMA-11 PET, (ii) intratracer [18F]F-PSMA-1007 PET or (iii) intertracer between [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 PET. Four conventional PET metrics (standardised uptake value (SUV)max, SUVmean, SUVtotal and volume) and 107 radiomics features were extracted from 75 lesions and assessed using the repeatability coefficient (RC) and the ICC. Radiomic feature repeatability was also quantified after the application of 16 filters to the PET image.

Results:

Test–retest scans were taken a median of 5 days apart (range: 2–7 days). SUVmean demonstrated the lowest RC limits of the conventional features, with RCs of 7.9%, 14.2% and 24.7% for the [68Ga]Ga-PSMA-11 PET, [18F]F-PSMA-1007 PET, and intertracer groups, respectively. 69%, 66% and 9% of all radiomics features had good or excellent ICC values (ICC ≥ 0.75) for the same groups. Feature repeatability therefore diminished considerably for the intertracer group relative to intratracer groups.

Conclusion

In this study, robust biomarkers for each tracer group that can be used in subsequent clinical studies were identified. Overall, the repeatability of conventional and radiomic features were found to be substantially lower for the intertracer group relative to both intratracer groups, suggesting that assessing patient response quantitatively should be done using the same radiotracer where possible.

Advances in knowledge:

Intertracer biomarker repeatability limits are significantly larger than intratracer limits.
Relative fat fraction of malignant bone lesions from breast cancer, prostate cancer and myeloma are significantly lower than normal bone marrow and shows excellent interobserver agreement
Authors: Castagnoli Francesca , Donners Ricardo , Tunariu Nina , Messiou Christina , Koh Dow-Mu
Published: September 2023

Objectives

To compare relative fat fraction (rFF) of active bone lesions from breast, prostate and myeloma malignancies and normal bone marrow; to assess its inter-reader agreement.

Methods

Patients with breast (n = 26), myeloma (n = 32) and prostate cancer (n = 52) were retrospectively evaluated. 110 baseline rFF maps from whole-body MRI were reviewed by two radiologists. Regions of interest for up to four focal active lesions in each patient were drawn on rFF maps, one each at the cervicothoracic spine, lumbosacral spine, pelvis and extremity. The mean and standard deviation of rFF were recorded. The rFF of normal marrow was measured in the pelvis for patients without diffuse bone disease (n = 88). We compared the rFF of malignant bone lesions and normal marrow using Mann–Whitney test. Interobserver agreement was assessed by interclass correlation coefficient.

Results

Malignant bone lesions showed significantly lower median rFF (13.87%) compared with normal marrow (89.76%) with little overlap (p < 0.0001). There was no significant difference in the median rFF of malignant lesions from breast (14.46%), myeloma (13.12%) and prostate cancer (13.67%) (p > 0.017, Bonferroni correction) and in the median rFF of bone disease according to their anatomical locations (p > 0.008, Bonferroni correction). There was excellent interobserver agreement (0.95).

Conclusion

The low rFF of active bone lesions in breast, prostate and myeloma malignancies provides high image contrast relative to normal marrow that may be used to detect bone metastases.

Advances in knowledge

This study shows the importance of rFF towards detecting bone metastases.
Real-time MRI of the moving wrist at 0.55 tesla
Authors: Chaudhari Abhijit J , Lim Yongwan , Cui Sophia X. , Bayne Christopher O. , Szabo Robert M. , Boutin Robert D. , Nayak Krishna S
Published: September 2023

Objectives:

Magnetic resonance imaging (MRI) using 1.5T or 3.0T systems is routinely employed for assessing wrist pathology; however, due to off-resonance artifacts and high power deposition, these high-field systems have drawbacks for real-time (RT) imaging of the moving wrist. Recently, high-performance 0.55T MRI systems have become available. In this proof-of-concept study, we tested the hypothesis that RT-MRI during continuous, active, and uninterrupted wrist motion is feasible with a high-performance 0.55T system at temporal resolutions below 100 ms and that the resulting images provide visualization of tissues commonly interrogated for assessing dynamic wrist instability.

Methods:

Participants were scanned during uninterrupted wrist radial-ulnar deviation and clenched fist maneuvers. Resulting images (nominal temporal resolution of 12.7–164.6 ms per image) were assessed for image quality. Feasibility of static MRI to supplement RT-MRI acquisition was also tested.

Results:

The RT images with temporal resolutions < 100 ms demonstrated low distortion and image artifacts, and higher reader assessment scores. Static MRI scans showed the ability to assess anatomical structures of interest in the wrist.

Conclusion:

RT-MRI of the wrist at a high temporal resolution, coupled with static MRI, is feasible with a high-performance 0.55T system, and may enable improved assessment of wrist dynamic dysfunction and instability.

Advances in knowledge:

Real-time MRI of the moving wrist is feasible with high-performance 0.55T and may improve the evaluation of dynamic dysfunction of the wrist.
Towards AI-augmented radiology education: a web-based application for perception training in chest X-ray nodule detection
Authors: Borgbjerg Jens , Thompson John D , Salte Ivar Mjøland , Frøkjær Jens Brøndum
Published: September 2023

Objectives:

Artificial intelligence (AI)-based applications for augmenting radiological education are underexplored. Prior studies have demonstrated the effectiveness of simulation in radiological perception training. This study aimed to develop and make available a pure web-based application called Perception Trainer for perception training in lung nodule detection in chest X-rays.

Methods:

Based on open-access data, we trained a deep-learning model for lung segmentation in chest X-rays. Subsequently, an algorithm for artificial lung nodule generation was implemented and combined with the segmentation model to allow on-the-fly procedural insertion of lung nodules in chest X-rays. This functionality was integrated into an existing zero-footprint web-based DICOM viewer, and a dynamic HTML page was created to specify case generation parameters.

Results:

The result is an easily accessible platform-agnostic web application available at: https://castlemountain.dk/mulrecon/perceptionTrainer.html.

The application allows the user to specify the characteristics of lung nodules to be inserted into chest X-rays, and it produces automated feedback regarding nodule detection performance. Generated cases can be shared through a uniform resource locator.

Conclusion:

We anticipate that the description and availability of our developed solution with open-sourced codes may help facilitate radiological education and stimulate the development of similar AI-augmented educational tools.

Advances in knowledge:

A web-based application applying AI-based techniques for radiological perception training was developed. The application demonstrates a novel approach for on-the-fly generation of cases in chest X-ray lung nodule detection employing deep-learning-based segmentation and lung nodule simulation.
Aberrant functional and causal connectivity of the amygdala in herpes zoster and post-herpetic neuralgia patients
Authors: Jiang Xiaofeng , Kuang Hongmei , Lv Huiting , Xiong Jiaxin , Li Jiahao , Hong Shunda , Yan YI , Gu Lili , Jiang Jian
Published: September 2023

Objective

Resting-state functional magnetic resonance imaging (rs-fMRI) and Granger causality analysis (GCA) were used to observe the characteristics of amygdala and whole-brain effect connections in patients with herpes zoster (HZ) and post-herpetic neuralgia (PHN) and to determine their relationship with clinical features.

Methods

Rs-fMRI scans were performed on 50 HZ; 50 PHN; and 50 age-, sex- and education-year-matched healthy controls (HCs). Bilateral amygdala subregions were used as seeds for functional connectivity (FC). GCA was used to analyze the effective connection of brain regions that were significantly different among groups. Then, the correlation between FC, and GCA values and clinical indices was investigated.

Results:

PHN had impaired FC between the amygdala subregion with the putamen, cortex, anterior cingulate cortex (ACC) to HCs and reduced FC of medial amygdala (MeA) with the parieto-occipital lobe and motor cortex to HZ; HZ had reduced FC of the lateral amygdala (LA) with the insula to HCs. GCA values from the bilateral LA to the bilateral ACC, left MeA to the bilateral ACC and left putamen, and right ACC to the bilateral MeA were reduced in PHN patients compared to HCs. Compared with HCs, the GCA values from the left MeA to the left ACC and right putamen were reduced in HZ. The GCA values from the amygdala subregion to the ACC were positively correlated with HAMA or HAMD scores in PHN.

Conclusion:

PHN showed reduced FC between the amygdala subregions and cortico-putamen and decreased effective connectivity from the amygdala subregion to the ACC and putamen.

Advances in knowledge:

HZ and PHN patients had significant changes in effective connectivity in brain regions, including diverse functional areas emanating from and projecting to the amygdala. The current findings will provide a new perspective for understanding the neuropathophysiological mechanism HZ and PHN.
Developing a CT-based radiomics nomogram for predicting post-acute pancreatitis diabetes mellitus incidence
Authors: Zhong Shuting , Du Qinglin , Liu Nian , Chen Yuwei , Yang Tianyue , Qin Shize , Jiang Yu , Huang Xiaohua
Published: September 2023

Objective

The present study aimed to develop the utility of a nomogram based on clinical and radiomics as a tool for predicting post-acute pancreatitis diabetes mellitus (PPDM-A).

Methods

This retrospective investigation evaluated 244 patients with acute pancreatitis. Patients were randomized in a 7:3 ratio into training and validation cohorts. Radiomics feature selection was then achieved using the variance threshold, select best K, and least absolute shrinkage and selection operator methods. The area under the curve values, decision, and calibration curves have been used to determine the models' predictive value.

Results

The developed nomogram performed superior to the clinical model in the validation (0.815 vs 0.677, p = 0.016) and training cohorts (0.803 vs 0.683, p = 0.002). The calibration curves demonstrated that the expected and actual values were satisfactory. In contrast, decision curve analysis revealed a stronger relationship between the nomogram and net clinical value than with the distinct radiomics or clinical signature effects.

Conclusion

In summary, the findings of this study demonstrated that establishing a predictive nomogram as a non-invasive technique may be useful in predicting the risk of PPDM-A.

Advances in knowledge

This is the first time to use a CT radiomics nomogram to predict PPDM-A. The nomogram is conducive to the personalized prediction of patients. It only needs to input the patient’s information, and a simple addition operation can quantitatively obtain its risk. The resultant tool has the potential to provide new opportunities to treat or prevent PPDM-A more effectively.
The level of school anxiety and the specificity of its manifestations in children with down syndrome
Authors: Sukhonos O.
Published: September 2023

Children with Down syndrome studying in general schools together with children without this pathology often face an increased risk of maladjustment in the school environment. Due to the inadequacy of general education programs for children with developmental disabilities and the low level of awareness of school teachers and, especially, neurotypical school-age children about effective strategies for interacting with children with Down syndrome, the latter have an increased risk of developing school anxiety.

The aim of the study was to determine the level of school anxiety depending on the ability to verbal communication in children with Down syndrome.

Materials and methods: The research was carried out on the basis of the National Medical Center of ZOR, 97 children with Down's syndrome were thoroughly examined. The patients were divided into two groups according to the criterion of the ability to verbal communication: group 1 (G1) included 77 children capable of verbal communication, group 2 (G2) - 20 children who do not speak.

Results of the study. As a result of the research, the level of school anxiety in its various aspects was established, depending on the ability to verbal communication in children with Down syndrome. Children with Down syndrome who are able to communicate were found to have significantly higher anxiety scores on almost all subscales than children with Down syndrome who are not able to communicate verbally.

In children with Down syndrome who are incapable of verbal communication, a pathological decrease in anxiety in its various aspects is much more often noted, which may indicate a lack of understanding of social situations as a result of the lack of sufficient experience of being in a team (due to the inability to verbally produce the quality and quantity of communicative practices in such children suffer significantly). Children with Down syndrome who are able to talk have shown pathological reductions in school anxiety only in rare cases.
The Effect of Dual Sensory Impairment on Cognitive Function Decline in the Elderly: The Moderating Effect of Social Support
Authors: Yang Soo Jee , Yoon Ju Young
Published: September 2023

Purpose: This study verified that the dual sensory impairment (DSI) in the elderly is associated with cognitive impairment (CI) and confirmed how change in cognitive function varies depending on the social support (SS). Methods: For a study sample of Korean older people, data from the Korean Longitudinal Study of Ageing (KLoSA) from the 7th (2018) to the 8th (2020), were included in this cross-sectional descriptive study. Among people who responded in both 2018 and 2020, a total of 2,069 people of those who are 65 years of age or older, and have living children and normal cognitive function, were analyzed. X2 -test, t-test and logistic regression analyses were utilized. Results: First, the number of elderly with visual impairment (VI), hearing impairment, and DSI increased on 8th data compared with 7th data. In addition, 22.9% of the 2,069 people showed a decrease in cognitive function. Second, compared to the elderly with normal sensory function, the cognitive function of the elderly with only VI was found to be more degraded, and the cognitive function of the elderly with DSI was found to be much more degraded. In addition, among SS, only participation in social gatherings was found to show significant change in cognitive function of the elderly with DSI. Third, the interaction effect of participating in social gatherings was not significant in the CI of the elderly with DSI. Conclusion: VI and DSI effected cognitive function, but participation in social gatherings such as SS has not significant interaction effect on CI of the elderly with DSI.
Applying Analytics to Design Lung Transplant Allocation Policy
Authors: Papalexopoulos Theodore , Alcorn James , Bertsimas Dimitris , Goff Rebecca , Stewart Darren , Trichakis Nikolaos
Published: September 2023

In 2019, the United Network for Sharing (UNOS), which has been operating the Organ Procurement and Transplantation Network (OPTN) in the United States since 1984, was seeking to design a new national lung transplant allocation policy. The goal was to develop a point system that would prioritize candidates on the waiting list in a way that would yield more efficient and equitable outcomes. Our joint Massachusetts Institute of Technology (MIT)/UNOS team joined forces with the OPTN Lung Transplantation Committee in these policy design efforts. We discuss how our team applied a novel analytical framework, which was developed at MIT and utilizes optimization, regression, and simulation techniques, to illuminate salient trade-offs among outcomes and guide the choice of how to weigh different point attributes in the allocation formula. The committee selected for the allocation formula weights that were highlighted in the team’s analysis. The team’s proposal was implemented as the national lung allocation policy on March 9, 2023 across the United States.

History: This paper has been accepted for the INFORMS Journal on Applied Analytics Special Issue—2022 Daniel H. Wagner Prize for Excellence in the Practice of Advanced Analytics and Operations Research.
Networking Behind the Scenes: Institutional Cross-Industry Holdings and Corporate Loan Markets
Authors: He Jie (Jack) , Liang Lantian , Wang Hui (Grace) , Xia Han
Published: September 2023

Institutional investors increasingly hold firms in both the industrial and financial sectors. These cross-industry holdings link firms to “outside” banks that they have not borrowed from, creating a network between the two sectors. We show that such networks reduce firms’ loan spreads. This effect is more prominent when cross-holders are actively involved in borrowers’ routine operations and when they have stronger incentives to advocate for borrowers in the loan process. Furthermore, outside banks begin to lend more to firms once the two parties become linked. This network is “behind-the-scenes” because it does not arise from prior interactions between firms and banks, but is instead built through institutions’ cross-holdings.

This paper was accepted by Victoria Ivashina, finance.

Supplemental Material: The data files and online appendices are available at https://doi.org/10.1287/mnsc.2023.4911 .
The Booms and Busts of Beta Arbitrage
Authors: Huang Shiyang , Liu Xin , Lou Dong , Polk Christopher
Published: September 2023

Low-beta stocks deliver high average returns and low risk relative to high-beta stocks, an opportunity for professional investors to “arbitrage” away. We argue that beta-arbitrage activity generates booms and busts in the strategy’s abnormal trading profits. In times of low arbitrage activity, the beta-arbitrage strategy exhibits delayed correction, taking up to three years for abnormal returns to be realized. In contrast, when arbitrage activity is high, prices overshoot and then revert in the long run. We document a novel positive-feedback channel operating through firm leverage that facilitates these boom-and-bust cycles.

This paper was accepted by Lukas Schmid, finance.

Funding: This work is financially supported by National Natural Science Foundation of China [NSFC Grant Number 72303226] and the Key Program of National Natural Science Foundation of China [NSFC Grant Number 72233003].

Supplemental Material: The internet appendix and data are available at https://doi.org/10.1287/mnsc.2023.4929 .
Aerospace Test and Development Show 2023
Authors: Sampson Ben
Published: September 2023

Join us for the launch of Aerospace Testing International's premier live event in Toulouse
Tribological Behavior of Powder Metallurgy Processed Carbon Nanotube Reinforced Alsi Functionally Graded Materials
Authors: Pasha Azeem , Rajaprakash B.M.
Published: September 2023

Tribological behavior of powder metallurgically processes AlSi-MWCNT functionally graded materials was apparatus with pins on discs was examined. Using a Taguchi design of experiments, the signal-to-noise ratio, the analysis of variance, and an orthogonal array were all used to determine the best testing parameters. Analysis revealed wear loss occurs due to increase in load and sliding distance and reduced with MWCNT increased content in
FGM. The composites with 1wt% of FGM exhibited both excellent wear resistance and friction coefficients. Wear mechanisms help in understanding the morphology of worn surfaces. The wear mechanism is dictated by delamination layer and other oxide layers. Overall, the findings showed that AlSi-MWCNT functionally graded materials are regarded as remarkable materials in industries where wear-resistant components are crucial, such
as aerospace and automotive engineering
New Analyses on US Immigrant Health Care Access Underscore the Need to Eliminate Discriminatory Policies
Authors:   Guttmacher Institute, Fuentes Liza , Desai Sheila , Dawson Ruth
Published: September 2023

Introduction Previous Guttmacher Institute research has described sexual and reproductive health disparities between immigrant women and their US-born counterparts. We present new analyses, based on two nationally representative surveys, that show inequities in health insurance coverage by citizenship status and race or ethnicity, and health care service use by citizenship status. These new findings are consistent with existing evidence indicating a need for policies to eliminate sexual and reproductive health inequities that have long persisted along lines of race and ethnicity, immigration status and income in the United States. These analyses make it clear that policymakers need to address these inequities. Two bills, the Health Equity and Access Under the Law (HEAL) for Immigrant Families Act and the Lifting Immigrant Families Through Benefits Access Restoration (LIFT the BAR) Act, represent opportunities to do just that.
1.36  J nanosecond laser at 1  kHz repetition based on a slab amplifier chain
Authors: Yu Yi , Tong Lixin , Wu Yingchen , Xu Liu , Gao Qingsong , Zhang Wei , Tang Chun , Chen Lei
Published: September 2023

A high beam quality diode-pumped Nd:YAG master oscillator power-amplifier (MOPA) laser with three end-pumped slab amplifiers is developed. The Q-swtiched side-pumped rod oscillator presented a pulse energy 3.1 mJ with beam quality factors of Mx2=1.17 and My2=1.15 at a repetition of 1 kHz. The MOPA system delivered a pulse energy of 1.36 J with a pulse width of 48.2 ns and an extraction efficiency of 44.8%. The beam quality factors of Mx2=1.72 and My2=3.85 are measured without any phase-conjugators or adaptive optics.
Fast focusing method in ghost imaging with a tracking trajectory
Authors: Huang Xianwei , Xu Yangting , Bai Yanfeng , Fu Xiquan
Published: September 2023

The imaging environment is unstable for trembling disturbance, which is detrimental to object reconstruction. In this Letter, we experimentally investigated ghost imaging (GI) under a temporal trembling disturbance. The fast-focusing method based on imaging with small sampling measurements is proposed, and the theoretical model and algorithm are validated. It is demonstrated that the proposed method is effective to obtain a better-resolution image of the object under the strong trembling disturbance including a laboratory and a real trembling environment. The results provide a promising approach to deal with image degradation caused by an unstable environment and can find potential applications for ghost imaging in remote sensing.
Monolithic integrated MQW-based optoelectronic glucose sensor
Authors: Gao Xumin , Li Tai , Wu Dongmei , Zhu Fujun , Xie Mingyuan , Wang Yongjin , Shi Zheng
Published: September 2023

This study presents the development process of a multi-quantum well (MQW)-based optoelectronic integrated device designed for precise glucose concentration measurements. The proposed monolithic device consists of two identical diodes containing InGaN/GaN MQWs, serving as a light emitter (LED) and a photodetector (PD), respectively. The chip is meticulously packaged with polydimethylsiloxane (PDMS) to facilitate exposure to the glucose solution. By monitoring changes in the photocurrent of the PD that detects scattered light of the LED propagating through the sapphire substrate, the chip can accurately reflect alterations in the glucose solution’s concentration. The device’s uniqueness lies in its ability to achieve this precision without the need for external optical components. The device exhibits a fast response, operating at a sub-second level, and can gauge glucose solutions with concentrations ranging from 5% to 40%. The fabricated optical sensing device showcases appealing characteristics, including compactness, stability, repeatability, and rapid response, making it highly suitable for glucose concentration measurement applications.
Simulation on the dynamic process of dissipative solitons in fiber lasers under multiparameter combinations
Authors: Yongli Liu , Liu Pingan , Zhang Zhaohui
Published: September 2023

Positive dispersion ring cavity ultrafast lasers can obtain dissipative soliton output with higher power density. The process of establishing a stable soliton is affected by complex factors such as dispersion, nonlinearity, loss, gain, and key component parameters. Due to the complexity of the parameters involved, the experimental system cannot guarantee the reproduction of the input elements. This means that the experimental research cannot implement strict variable control. Therefore, establishing a laser simulation model and studying the dynamics of soliton development under complex parameter combinations can help us to conveniently understand the feasibility of the scheme. Through the simulation of complex parameter combinations, it is found that there is a clear optimal working range for obtaining stable mode-locked soliton output, which can be used to guide the design and optimization of laser experiment schemes.
Evaluation of the Emergency Obstetric and Newborn Care training in Gondar, Ethiopia; a mixed methods study
Authors: Hulsbergen Myrrith , Abera Birhanu , Adefris Mulat , Kassahun Dawit , Meulenbeld Marieke , van Nievelt Sabine , Ameh Charles , Bruinooge Mimosa , Rijken Marcus J. , Stekelenburg Jelle
Published: September 2023

In Ethiopia maternal and perinatal morbidity and mortality remains high. Timely access to quality emergency obstetric and neonatal care is essential for the prevention of adverse outcomes. Training healthcare providers can play an important role in improving quality of care, thereby reducing maternal and perinatal mortality and morbidity. The aim of this study was to evaluate change of knowledge, skills and behaviour in health workers who attended a postgraduate Emergency Obstetric and Newborn Care training in Gondar, Ethiopia. A descriptive study with before-after approach, using a mix of quantitative and qualitative data, based on Kirkpatrick’s model for training evaluation was conducted. The evaluation focussed on reaction, knowledge, skills, and change in behaviour in clinical practice of health care providers and facilitator’s perspectives on performance. A ‘lessons learned approach’ was included to summarize facilitators’ perspectives. Health care providers reacted positively to the Emergency Obstetric and Newborn Care training with significant improvement in knowledge and skills. Of the 56 participants who attended the training, 44 (79%) were midwives. The main evaluation score for lectures was 4,51 (SD 0,19) and for breakout sessions was 4,52 (SD 0.18) on scale of 1–5. There was a statistically significant difference in the pre and post knowledge (n = 28, mean difference 13.8%, SD 13.5, t = 6.216, p<0.001) and skills assessments (n = 23, mean difference 27.4%, SD 22.1%, t = 5.941, p<0.001). The results were the same for every component of the skills and knowledge assessment. Overall, they felt more confident in performing skills after being trained. Local sustainability, participant commitment and local context were identified as challenging factors after introducing a new training program. In Gondar Ethiopia, the Emergency Obstetric and Newborn Care training has the potential to increase skilled attendance at birth and improve quality of care, both vital to the reduction of maternal and perinatal mortality and morbidity.
Effects of a clinical decision support system and patient portal for preventing medication-related falls in older fallers: Protocol of a cluster randomized controlled trial with embedded process and economic evaluations (ADFICE_IT)
Authors: de Wildt Kelly K. , van de Loo Bob , Linn Annemiek J. , Medlock Stephanie K. , Groos Sara S. , Ploegmakers Kim J. , Seppala Lotta J. , Bosmans Judith E. , Abu-Hanna Ameen , van Weert Julia C. M. , van Schoor Natasja M. , van der Velde Nathalie ,   on behalf of the ADFICE_IT study team
Published: September 2023

Background

Falls are the leading cause of injury-related mortality and hospitalization among adults aged ≥ 65 years. An important modifiable fall-risk factor is use of fall-risk increasing drugs (FRIDs). However, deprescribing is not always attempted or performed successfully. The ADFICE_IT trial evaluates the combined use of a clinical decision support system (CDSS) and a patient portal for optimizing the deprescribing of FRIDs in older fallers. The intervention aims to optimize and enhance shared decision making (SDM) and consequently prevent injurious falls and reduce healthcare-related costs.

Methods

A multicenter, cluster-randomized controlled trial with process evaluation will be conducted among hospitals in the Netherlands. We aim to include 856 individuals aged ≥ 65 years that visit the falls clinic due to a fall. The intervention comprises the combined use of a CDSS and a patient portal. The CDSS provides guideline-based advice with regard to deprescribing and an individual fall-risk estimation, as calculated by an embedded prediction model. The patient portal provides educational information and a summary of the patient’s consultation. Hospitals in the control arm will provide care-as-usual. Fall-calendars will be used for measuring the time to first injurious fall (primary outcome) and secondary fall outcomes during one year. Other measurements will be conducted at baseline, 3, 6, and 12 months and include quality of life, cost-effectiveness, feasibility, and shared decision-making measures. Data will be analyzed according to the intention-to-treat principle. Difference in time to injurious fall between the intervention and control group will be analyzed using multilevel Cox regression.

Discussion

The findings of this study will add valuable insights about how digital health informatics tools that target physicians and older adults can optimize deprescribing and support SDM. We expect the CDSS and patient portal to aid in deprescribing of FRIDs, resulting in a reduction in falls and related injuries.

Trial registration

ClinicalTrials.gov NCT05449470 (7-7-2022).
The impacts of social restrictions during the COVID-19 pandemic on the physical activity levels of over 50-year olds: The CHARIOT COVID-19 Rapid Response (CCRR) cohort study
Authors: Green Conall , Beaney Thomas , Salman David , Robb Catherine , de Jager Loots Celeste A. , Giannakopoulou Parthenia , Udeh-Momoh Chi , Ahmadi-Abhari Sara , Majeed Azeem , Middleton Lefkos T. , McGregor Alison H.
Published: September 2023

Objectives

To quantify the associations between shielding status and loneliness at the start of the COVID-19 pandemic, and physical activity (PA) levels throughout the pandemic.

Methods

Demographic, health and lifestyle characteristics of 7748 cognitively healthy adults aged >50, and living in London, were surveyed from April 2020 to March 2021. The International Physical Activity Questionnaire (IPAQ) short-form assessed PA before COVID-19 restrictions, and up to 6 times over 11 months. Linear mixed models investigated associations between shielding status and loneliness at the onset of the pandemic, with PA over time.

Results

Participants who felt ‘often lonely’ at the outset of the pandemic completed an average of 522 and 547 fewer Metabolic Equivalent of Task (MET) minutes/week during the pandemic (95% CI: -809, -236, p<0.001) (95% CI: -818, -275, p<0.001) than those who felt ‘never lonely’ in univariable and multivariable models adjusted for demographic factors respectively. Those who felt ‘sometimes lonely’ completed 112 fewer MET minutes/week (95% CI: -219, -5, p = 0.041) than those who felt ‘never lonely’ following adjustment for demographic factors.

Participants who were shielding at the outset of the pandemic completed an average of 352 fewer MET minutes/week during the pandemic than those who were not (95% CI: -432, -273; p<0.001) in univariable models and 228 fewer MET minutes/week (95% CI: -307, -150, p<0.001) following adjustment for demographic factors. No significant associations were found after further adjustment for health and lifestyle factors.

Conclusions

Those shielding or lonely at pandemic onset were likely to have completed low levels of PA during the pandemic. These associations are influenced by co-morbidities and health status.
Prevalence and clinical impacts of obstructive sleep apnea in patients with idiopathic pulmonary fibrosis: A single-center, retrospective study
Authors: Lee Jae Ha , Jang Ji Hoon , Park Jin Han , Lee Sunggun , Kim Ji Yeon , Ko Junghae , Jung So Young , Kim Dae-Wook , Hong SungMin , Jang Hang-Jea
Published: September 2023

Background

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with chronic, progressive lung fibrosis with a poor prognosis. Recent studies have reported a high prevalence of obstructive sleep apnea (OSA) in IPF patients and an association with poor prognosis. This study aimed to evaluate the prevalence, risk factors, and clinical effects on mortality of OSA in patients with IPF.

Methods

Clinical data were retrospectively analyzed in 167 patients with IPF at Haeundae-Paik Hospital, Republic of Korea. A type 4 portable device was used to monitor OSA, and an apnea-hypopnea index of 5 events per sleep hour and above was diagnosed as OSA.

Results

The mean follow-up period and age were 26.9 months and 71.4 years, respectively, with male predominance. OSA was confirmed in 108 patients (64.7%). Mild OSA was the most common (62.1%). Independent risk factors for OSA in the multivariate logistic regression analysis were age (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.02–1.13, p = 0.007), body weight (OR 1.05, 95% CI 1.02–1.09, p = 0.002), and risk based on the Berlin questionnaire (OR 2.76, 95% CI 1.12–6.80, p = 0.028). Shorter six-minute walk distance (6MWD) (hazard ratio [HR] 1.00, 95% CI: 1.00–1.00, p < 0.001), acute exacerbation (AE) (HR 13.83, 95% CI: 5.71–33.47, p < 0.001), and higher percentage of cumulative time with oxygen saturation below 90% in total sleep time (HR 1.08, 95% CI: 1.02–1.14, p = 0.007) were risk factors for mortality in IPF patients in the Cox regression analysis.

Conclusion

Approximately two-thirds of the IPF patients had OSA. Older age, higher body weight, and high risk based on the Berlin questionnaire were independent risk factors for OSA in IPF patients. Shorter 6MWD, experience of AE, and night hypoxemia during sleep were associated with a higher risk of mortality in patients with IPF.