bluuebunny/crossref_metadata_2025 huggingface dataset:
BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study
Authors: Shrestha Rajan , Upadhyay Sanjib Kumar , Khatri Bijay , Bhattarai Janak Raj , Kayastha Manish , Upadhyay Madan Prasad
Published: November 2021

Objective

This non-inferiority study aimed to determine the burden of obesity in a hospital outpatient setting of a developing country, using three commonly employed metrics as predictors of hypertension (HTN).

Design

A cross-sectional study design was adopted.

Setting

This study was conducted in Health Promotion and Risk Factor Screening Services of a tertiary hospital for eye and ear, nose, throat in a semiurban area of Nepal.

Participants

2256 randomly selected outpatients between 40 and 69 years old.

Outcome measures

The three obesity metrics and HTN were analysed for association using correlation, the area under the receiver operating characteristic (ROC) curve and ORs.

Results

The prevalence of obesity or overweight by body mass index (BMI) was 58.29%; by waist-to-height ratio (WHtR) was 85.95%, high waist circumference (WC) was observed among 66.76% of participants. Female participants had a greater prevalence of high WC (77.46%) than males (53.73%) (p<0.001). Prevalence of HTN and pre-HTN were 40.67% and 36.77%, respectively. The areas under the ROC curve were significantly higher than 0.5 for BMI (0.593), WHtR (0.602) and WC (0.610).

Conclusion

This study showed that WHtR and WC measured were not inferior to BMI as a metric for obesity detection and HTN prediction. Because of its low cost, simplicity of measurement and better ability to predict HTN, it may become a more usable metric in health facilities of low-income and middle-income countries.
OPTIMISE: MS study protocol: a pragmatic, prospective observational study to address the need for, and challenges with, real world pharmacovigilance in multiple sclerosis
Authors: Dobson Ruth , Craner Matthew , Waddingham Ed , Miller Aleisha , Cavey Ana , Webb Stewart , Hemingway Cheryl , Hobart Jeremy , Evangelou Nikos , Scolding Neil , Rog David , Nicholas Richard , Marta Monica , Blain Camilla , Young Carolyn Anne , Ford Helen L , Matthews Paul M
Published: November 2021

Introduction

The power of ‘real world’ data to improve our understanding of the clinical aspects of multiple sclerosis (MS) is starting to be realised. Disease modifying therapy (DMT) use across the UK is driven by national prescribing guidelines. As such, the UK provides an ideal country in which to gather MS outcomes data. A rigorously conducted observational study with a focus on pharmacovigilance has the potential to provide important data to inform clinicians and patients while testing the reliability of estimates from pivotal trials when applied to patients in the UK.

Methods and analysis

The primary aim of this study is to characterise the incidence and compare the risk of serious adverse events in people with MS treated with DMTs. The OPTIMISE:MS database enables electronic data capture and secure data transfer. Selected clinical data, clinical histories and patient-reported outcomes are collected in a harmonised fashion across sites at the time of routine clinical visits. The first patient was recruited to the study on 24 May 2019. As of January 2021, 1615 individuals have baseline data recorded; follow-up data are being captured and will be reported in due course.

Ethics and dissemination

This study has ethical permission (London City and East; Ref 19/LO/0064). Potential concerns around data storage and sharing are mitigated by the separation of identifiable data from all other clinical data, and limiting access to any identifiable data. The results of this study will be disseminated via publication. Participants provide consent for anonymised data to be shared for further research use, further enhancing the value of the study.
Acceptability of a mHealth strategy for hypertension management in a low-income and middle-income country setting: a formative qualitative study among patients and healthcare providers
Authors: Bhandari Buna , Schutte Aletta E , Jayasuriya Rohan , Vaidya Abhinav , Subedi Madhusudan , Narasimhan Padmanesan
Published: November 2021

Background

Understanding contextual needs and preferences is important for a successful design and effective outcome of a mHealth strategy.

Objectives

This formative study aimed to explore the perspectives of patients and providers on the acceptability of a mHealth (text message) strategy and elicit preferred features of a mHealth strategy for hypertension management.

Design

A qualitative study was conducted using in-depth interviews and focus group discussions guided by the technology acceptance model.

Setting

The study was conducted at primary healthcare facilities and at a tertiary level referral hospital in Kathmandu, Nepal.

Participants

A total of 61 participants, patients with hypertension (n=41), their family members (n=5), healthcare workers (n=11) and key informants (n=4) were included. We purposively recruited patients with hypertension aged 30–70 who attended the selected healthcare facilities to obtain maximum variation based on their age, sex and literacy.

Results

The respondents perceived the mHealth strategy to be useful as it would reinforce medication compliance and behaviour change. Participants valued the trustworthiness of information from health authorities that could be delivered privately. Some implementation challenges were identified including a lack of technical manpower, resources for software development, gaps in recording a patient’s essential information and digital illiteracy. Solutions proposed were having system-level preparedness for recording the patient’s details, establishing a separate technical department in the hospital and involving a family member to assist illiterate/elderly patients. In addition, participants preferred text messages in the local language, containing comprehensive contextual content (disease, treatment, cultural foods and misconceptions) delivered at regular intervals (2–3 times/week) preferably in the morning or evening.

Conclusions

We found that a simple text messaging strategy was acceptable for hypertension management in this low/middle-income country setting. However, meticulous planning must address the needs of a diverse range of participants to ensure the mHealth strategy is acceptable to wider groups.
Scoping review of food safety at transport stations in Africa
Authors: Ncama Busisiwe Purity , Kuupiel Desmond , Duma Sinegugu E , Mchunu Gugu , Guga Phindile , Slotow Rob
Published: November 2021

Objective

The WHO has declared food safety as a public health concern. Transport hubs such as taxi ranks, bus stations and other transport exchange sites are major food trading/purchasing sites, particularly in Africa. Research evidence is needed to improve food safety policies and ensure consumption of safe food, owing to the increasing burden of foodborne diseases, particularly in the WHO Africa Region. We systematically mapped and described research evidence on food safety at transport stations in Africa.

Design

A scoping review guided by the Arksey and O’Malley framework.

Data sources

We searched for original research articles in PubMed, Web of Science, and EBSCOhost (Academic search complete, CINAHL with Full-text and Health Source), SCOPUS, and Google Scholar from their inception to 25 October 2020.

Eligibility criteria for selecting studies

We included studies that focused on food safety, involved transport stations, involved African countries and were published in English.

Data extraction and synthesis

Data extraction was performed by two reviewers using a piloted-tested form. Thematic analysis was used to organise the data into themes and subthemes, and a narrative summary of the findings is presented.

Results

Of the total 23 852 articles obtained from the database searches, 16 studies published in 6 countries met the inclusion criteria. These 16 studies were published between 1997 and 2019, with the most (5) in 2014. Of the 16 studies, 43.8% (7) were conducted in South Africa, 3 studies in Ghana, 2 in Ethiopia and 1 study each in Nigeria, Kenya, Lesotho and Zambia. Most (44.4%) of the included studies focused on microbial safety of food; few studies (22.2%) focused on hygienic practices, and one study investigated the perspective of consumers or buyers. Microbes detected in the foods samples wereSalmonellaspp,Escherichia coli,Shigellaspp,Bacillussp,Staphylococcus aureus, which resulted mainly from poor hygiene practices.

Conclusions

There is limited research that focused on food safety at transport stations in Africa, especially on aspects such as hygiene practices, food storage and occupational health and food safety. Therefore, we recommend more research in these areas, using various primary study designs, to inform and improve food safety policies and practices for transport stations in African countries alongside improving access to clean water/handwashing facilities, and undertaking structural changes to facilitate behaviours and monitoring for unintended consequences such as livelihoods of vulnerable populations.
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review
Authors: McCleskey Sara G , Shek Lili , Grein Jonathan , Gotanda Hiroshi , Anderson Laura , Shekelle Paul G , Keeler Emmett , Morton Sally , Nuckols Teryl K
Published: November 2021

Background

Hospitals have implemented diverse quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). The economic value of these QI interventions is uncertain.

Objective

To systematically review economic evaluations of QI interventions designed to prevent CAUTI in acute care hospitals.

Methods

A search of Ovid MEDLINE, Econlit, Centre for Reviews & Dissemination, New York Academy of Medicine’s Grey Literature Report, WorldCat, IDWeek conference abstracts and prior systematic reviews was conducted from January 2000 to October 2020.

We included English-language studies of any design that evaluated organisational or structural changes to prevent CAUTI in acute care hospitals, and reported programme and infection-related costs.

Dual reviewers assessed study design, effectiveness, costs and study quality. For each eligible study, we performed a cost-consequences analysis from the hospital perspective, estimating the incidence rate ratio (IRR) and incremental net cost/savings per hospital over 3 years. Unadjusted weighted regression analyses tested predictors of these measures, weighted by catheter days per study.

Results

Fifteen unique economic evaluations were eligible, encompassing 74 hospitals. Across 12 studies amenable to standardisation, QI interventions were associated with a 43% decline in infections (mean IRR 0.57, 95% CI 0.44 to 0.70) and wide ranges of net costs (mean US$52 000, 95% CI −$288 000 to $392 000), relative to usual care.

Conclusions

QI interventions were associated with large declines in infection rates and net costs to hospitals that varied greatly but that, on average, were not significantly different from zero over 3 years. Future research should examine specific practices associated with cost-savings and clinical effectiveness, and examine whether or not more comprehensive interventions offer hospitals and patients the best value.
Socioeconomic deprivation and ethnicity inequalities in disruption to NHS hospital admissions during the COVID-19 pandemic: a national observational study
Authors: Warner Max , Burn Samantha , Stoye George , Aylin Paul P , Bottle Alex , Propper Carol
Published: November 2021

Introduction

Hospital admissions in many countries fell dramatically at the onset of the COVID-19 pandemic. Less is known about how care patterns differed by patient groups. We sought to determine whether areas with higher levels of socioeconomic deprivation or larger ethnic minority populations saw larger falls in emergency and planned admissions in England.

Methods

We conducted a national observational study of hospital care in the English National Health Service (NHS) in 2019–2020. Weekly volumes of elective (planned) and emergency admissions in 2020 compared with 2019 were calculated for each census area. Multiple linear regression analysis was used to estimate the reductions in volumes for areas in different quintiles of socioeconomic deprivation and ethnic minority populations after controlling for national time trends and local area composition.

Results

Between March and December 2020, there were 35.5% (3.0 million) fewer elective admissions and 22.0% (1.2 million) fewer emergency admissions with a non-COVID-19 primary diagnosis than in 2019. Areas with the largest share of ethnic minority populations experienced a 36.7% (95% CI 24.1% to 49.3%) larger reduction in non-primary COVID-19 emergency admissions compared with those with the smallest. The most deprived areas experienced a 10.1% (95% CI 2.6% to 17.7%) smaller reduction in non-COVID-19 emergency admissions compared with the least deprived. These patterns are not explained by differential prevalence of COVID-19 cases by area.

Conclusions

Even in a healthcare system founded on the principle of equal access for equal need, the impact of COVID-19 on NHS hospital care for non-COVID patients has not been spread evenly by ethnicity and deprivation in England. While we cannot conclusively determine the mechanisms behind these differences, they risk exacerbating prepandemic health inequalities.
Developing and testing an automated qualitative assistant (AQUA) to support qualitative analysis
Authors: Lennon Robert P , Fraleigh Robbie , Van Scoy Lauren J , Keshaviah Aparna , Hu Xindi C , Snyder Bethany L , Miller Erin L , Calo William A , Zgierska Aleksandra E , Griffin Christopher
Published: November 2021

Qualitative research remains underused, in part due to the time and cost of annotating qualitative data (coding). Artificial intelligence (AI) has been suggested as a means to reduce those burdens, and has been used in exploratory studies to reduce the burden of coding. However, methods to date use AI analytical techniques that lack transparency, potentially limiting acceptance of results. We developed an automated qualitative assistant (AQUA) using a semiclassical approach, replacing Latent Semantic Indexing/Latent Dirichlet Allocation with a more transparent graph-theoretic topic extraction and clustering method. Applied to a large dataset of free-text survey responses, AQUA generated unsupervised topic categories and circle hierarchical representations of free-text responses, enabling rapid interpretation of data. When tasked with coding a subset of free-text data into user-defined qualitative categories, AQUA demonstrated intercoder reliability in several multicategory combinations with a Cohen’s kappa comparable to human coders (0.62–0.72), enabling researchers to automate coding on those categories for the entire dataset. The aim of this manuscript is to describe pertinent components of best practices of AI/machine learning (ML)-assisted qualitative methods, illustrating how primary care researchers may use AQUA to rapidly and accurately code large text datasets. The contribution of this article is providing guidance that should increase AI/ML transparency and reproducibility.
Influence of cigarette smoking on oral microbiota in patients with recurrent aphthous stomatitis
Authors: Wang Xue , Luo Na , Mi Qili , Kong Weisong , Zhang Wei , Li Xuemei , Gao Qian
Published: November 2021

Recurrent aphthous stomatitis (RAS) is a common recurrent ulcerative disease of the oral mucosa which is closely related to oral microbial composition. However, the specific effect and the mechanism of smoking in RAS are unclear. In this study, 16S rRNA sequencing technology was used to compare the differences in saliva microbial community between 28 non-smoking healthy controls (NSctrl), 31 non-smoking RAS patients (NSras), and 19 smoking RAS patients (Sras). The results showed that the bacterial community diversity in patients with RAS (NSras and Sras) was lower than that of NSctrl. The microbial community in smoking-associated RAS is less diverse and distinct from that of non-smokers. The RAS groups have higher abundance of Veillonella, Rothia, and Sneathia and lower abundance of Bacteroidales, Bacteroides, Wolinella, Moryella, Pyramidobacter, and Christensenellaceae at the genera level. A significantly different abundance of Anaerovorax, Candidatus Endomicrobium, Lactococcus, Sneathia, Veillonella, and Cloacibacterium was observed between the Sras and the NSras group. Notably, there was a significant difference in many species from the genus Prevotella and Treponema between the NSras and the Sras group. Further, the relative abundance of several taxa is correlated with smoking age or frequency, including Megasphaera, Haemophilus, Leptotrichia, and Rothia at the genera level, and Prevotella melaninogenica, Prevotella salivae, Megasphaera micronuciformis, Haemophilus parainfluenzae, Alloprevotella tannerae, Actinomyces naeslundii, Lautropia mirabilis, and Capnocytophaga sputigena at the species level. Among patients with RAS, smoking aggravated the pathways of respiration and human pathogens. Our results suggest that smoking is closely related to changes in the oral microbiota, which may contribute an opposite effect to the pathogenesis of RAS. This study provides new insight and theoretical basis for the cause and pathogenesis of RAS and better prevention and treatment.
Low peripheral blood derived neutrophil-to-lymphocyte ratio (dNLR) is associated with increased tumor T-cell infiltration and favorable outcomes to first-line pembrolizumab in non-small cell lung cancer
Authors: Alessi Joao V , Ricciuti Biagio , Alden Stephanie L , Bertram Arrien A , Lin Jessica J , Sakhi Mustafa , Nishino Mizuki , Vaz Victor R , Lindsay James , Turner Madison M , Pfaff Kathleen , Sharma Bijaya , Felt Kristen D , Rodig Scott J. , Gainor Justin F. , Awad Mark M.
Published: November 2021

Background

An elevated peripheral blood derived neutrophil-to-lymphocyte ratio (dNLR) is a negative prognostic marker for patients with non-small cell lung cancer (NSCLC) receiving chemotherapy and immune checkpoint inhibitors. Whether dNLR is also associated with clinical outcomes to first-line pembrolizumab among patients with NSCLC and a programmed cell death ligand 1 (PD-L1) Tumor Proportion Score (TPS) of ≥50% is uncertain. How dNLR relates to the tumor immune microenvironment is also unclear.

Methods

In two participating academic centers, we retrospectively analyzed the dNLR (defined as the absolute neutrophil count/white cell count – absolute neutrophil count) prior to initiation of first-line pembrolizumab in patients with metastatic NSCLC and a PD-L1 TPS ≥50% and lacking genomic alterations inEGFRandALK. An unbiased recursive partitioning algorithm was used to investigate an optimal dNLR cut-off with respect to objective response rate (ORR). Multiplexed immunofluorescence for CD8+, FOXP3+, PD-1+, and PD-L1 was performed on a separate cohort of NSCLCs to determine the immunophenotype associated with dNLR.

Results

A total of 221 patients treated with first-line pembrolizumab were included in this study. The optimal dNLR cut-off to differentiate treatment responders from non-responders was 2.6. Compared with patients with a dNLR ≥2.6 (n=97), patients with dNLR <2.6 (n=124) had a significantly higher ORR (52.4% vs 24.7%, p<0.001), a significantly longer median progression-free survival (mPFS 10.4 vs 3.4 months, HR 0.48, 95% CI 0.35 to 0.66, p<0.001), and a significantly longer median overall survival (mOS 36.6 vs 9.8 months, HR 0.34, 95% CI 0.23 to 0.49, p<0.001). After adjusting for age, sex, tobacco use, performance status, histology, serum albumin level, oncogenic driver status, and PD-L1 distribution (50%–89% vs ≥90%), a dNLR <2.6 was confirmed to be an independent predictor of longer mPFS (HR 0.47, 95% CI 0.33 to 0.67, p<0.001) and mOS (HR 0.32, 95% CI 0.21 to 0.49, p<0.001). Among advanced NSCLC samples with a PD-L1 TPS of ≥50%, those with a dNLR <2.6 had significantly higher numbers of tumor-associated CD8+, FOXP3+, PD-1 +immune cells, and PD-1 +CD8+T cells than those with a dNLR ≥2.6.

Conclusions

Among patients with NSCLC and a PD-L1 TPS ≥50%, a low dNLR has a distinct immune tumor microenvironment and more favorable outcomes to first-line pembrolizumab.
Perfusion-guided endovascular super-selective intra-arterial infusion for treatment of malignant brain tumors
Authors: Chen Stephen R , Chen Melissa M , Ene Chibawanye , Lang Frederick F , Kan Peter
Published: November 2021

Background

Survival for glioblastoma remains very poor despite decades of research, with a 5-year survival of only 5%. The technological improvements that have revolutionized treatment of ischemic stroke and brain aneurysms have great potential in providing more precise and selective delivery of cancer therapeutic agents to brain tumors.

Methods

We describe for the first time the use of perfusion guidance to enhance the precision of endovascular super-selective intra-arterial (ESIA) infusions of mesenchymal stem cells loaded with Delta-24 (MSC-D24) in the treatment of glioblastoma (NCT 03896568).

Results

MRI imaging, which best defines the location of the tumor, is co-registered and fused with the patient’s position using cone beam CT, resulting in optimal vessel selection and confirmation of targeted delivery through volumetric perfusion imaging.

Conclusions

This technique of perfusion guided-ESIA injections (PG-ESIA) enhances our ability to perform targeted super-selective delivery of therapeutic agents for brain tumors.
Five-year changes in objectively measured cardiorespiratory fitness, physical activity, and sedentary time in mid-to-late adulthood
Authors: Dougherty Ryan J. , Lose Sarah R. , Gaitán Julian M. , Mergen Brandon M. , Chin Nathaniel A. , Okonkwo Ozioma C. , Cook Dane B.
Published: November 2021

This study examined 5-year changes in cardiorespiratory fitness, physical activity, and sedentary time in mid-to-late aged adults. Fifty-seven participants completed baseline and follow-up treadmill exercise tests and physical activity monitoring. We observed a 14% decline in fitness (p < 0.001), 12% decrease in physical activity (p = 0.010), and non-significant increase in sedentary time (p = 0.196). Age was negatively associated with 5-year change in physical activity (r = −0.31; p = 0.02) and this decline was strongest among APOE ε4 carriers (g = −0.75).

Novelty: Cardiorespiratory fitness and physical activity significantly declined from mid-to-late adulthood, these findings were most pronounced among older adults and those with genetic risk for Alzheimer’s disease.
The correlation between the expression of ATF4 and procalcitonin combined with the detection of RET mutation and the pathological stage and clinical prognosis of medullary thyroid carcinoma
Authors: Ma Shihong , Wang Hui , Li Wanling , Yan Zhe , Luo Xuanming , Lu Pinxiang
Published: November 2021

To explore the correlation between the activating transcription factor 4 (ATF4) and procalcitonin (PCT) expressions combined with RET mutation and the pathological staging and clinical prognosis of sporadic medullary thyroid carcinoma (SMTC). Fifty cases (tumor tissue) of SMTC diagnosed by clinicopathology were collected and the patients with nodular goiter were selected as normal control. The RET mutation site was analyzed by detection kit and expressions of PCT and ATF4 in SMTC were analyzed by Western blot and immunohistochemistry. Multiple linear regression was used to analyze the correlation of risk factors (PCT or ATF4 expression, RET mutation, tumor differentiation, SMTC stage, lymphatic metastasis) for 5-year recurrence and survival of SMTC. The ATF4 and PCT expressions were significantly decreased and increased, respectively, with the increase of the SMTC stage. The most frequent mutation of RET gene in cancer tissue was M 22458A in exon 16. The ATF4 and PCT expressions, as well as RET mutation, were significantly associated with a 5-year recurrence, while the ATF4 expression was significantly related to better 5-year survival. ATF4 and PCT expressions combined with RET mutation are related to the clinical prognosis of SMTC and can predict SMTC staging.
The impact of top-quark modelling on the exclusion limits in $$\varvec{t{\bar{t}}}+\text {DM}$$ searches at the LHC
Authors: Hermann J. , Worek M.
Published: November 2021

New Physics searches at the LHC rely very heavily on the precision and accuracy of Standard Model background predictions. Applying the spin-0 s-channel mediator model, we assess the importance of properly modelling such backgrounds in $$t{\bar{t}}$$

t

t

¯

associated Dark Matter production. Specifically, we discuss higher-order corrections and off-shell effects for the two dominant background processes $$t{\bar{t}}$$

t

t

¯

and $$t{\bar{t}}Z$$

t

t

¯

Z

in the presence of extremely exclusive cuts. Exclusion limits are calculated for state-of-the-art NLO full off-shell $$t{\bar{t}}$$

t

t

¯

and $$t{\bar{t}}Z$$

t

t

¯

Z

predictions and compared to those computed with backgrounds in the NWA and / or at LO. We perform the same comparison for several new-physics sensitive observables and evaluate which of them are affected by the top-quark modelling. Additionally, we make suggestions as to which observables should be used to obtain the most stringent limits assuming integrated luminosities of 300 fb$$^{-1}$$

-
1

and 3000 fb$$^{-1}$$

-
1

.
PORTFOLIO INSURANCE UNDER ROUGH VOLATILITY AND VOLTERRA PROCESSES
Authors: DUPRET JEAN-LOUP , HAINAUT DONATIEN
Published: November 2021

Affine Volterra processes have gained more and more interest in recent years. In particular, this class of processes generalizes the classical Heston model and the more recent rough Heston model. The aim of this work is hence to revisit and generalize the constant proportion portfolio insurance (CPPI) under affine Volterra processes. Indeed, existing simulation-based methods for CPPI do not apply easily to this class of processes. We instead propose an approach based on the characteristic function of the log-cushion which appears to be more consistent, stable and particularly efficient in the case of saffine Volterra processes compared with the existing simulation techniques. Using such approach, we describe in this paper several properties of CPPI which naturally result from the form of the log-cushion’s characteristic function under affine Volterra processes. This allows to consider more realistic dynamics for the underlying risky asset in the context of CPPI and hence build portfolio strategies that are more consistent with financial data. In particular, we address the case of the rough Heston model, known to be extremely consistent with past data of volatility. By providing a new estimation procedure for its parameters based on the PMCMC algorithm, we manage to study more accurately the true properties of such CPPI strategy and to better handle the risk associated with it.
Effectual topological complexity
Authors: Cadavid-Aguilar Natalia , González Jesús , Gutiérrez Bárbara , Ipanaque-Zapata Cesar A.
Published: November 2021

We introduce the effectual topological complexity (ETC) of a [Formula: see text]-space [Formula: see text]. This is a [Formula: see text]-equivariant homotopy invariant sitting in between the effective topological complexity of the pair [Formula: see text] and the (regular) topological complexity of the orbit space [Formula: see text]. We study ETC for spheres and surfaces with antipodal involution, obtaining a full computation in the case of the torus. This allows us to prove the vanishing of twice the nontrivial obstruction responsible for the fact that the topological complexity of the Klein bottle is [Formula: see text]. In addition, this gives a counterexample to the possibility — suggested in Pavešić’s work on the topological complexity of a map — that ETC of [Formula: see text] would agree with Farber’s [Formula: see text] whenever the projection map [Formula: see text] is finitely sheeted. We conjecture that ETC of spheres with antipodal action recasts the Hopf invariant one problem, and describe (conjecturally optimal) effectual motion planners.
Optimistic Expectations and Proactivity: Can they be the Key to Successful Strategies in Entrepreneurship?
Authors: Yeşilkaya Mukaddes , Yıldız Tayfun
Published: November 2021

The most valuable thing we learned from expectation theories is that expectations affect behaviors significantly. This study deepens this knowledge, and proposes a model that puts forward the idea that optimistic expectations stimulate proactive personality characteristics and in this way activate strategic vigilance which forms the basis of behavioral decisions. In order to test this model, research was carried out with 280 entrepreneurs participating. Data obtained from the sample were analyzed using statistical programs which examine mediating effect. The research findings have shown that optimistic expectations affect strategic vigilance significantly and positively, and proactive personality traits have a fully mediating role in this effect. This is the first study that examines the relationships among optimistic expectations, personality characteristics, and cognitive abilities. To find out other relations between optimistic expectations and personality characteristics and cognitive abilities, there should be more researches. The findings can help provide a different perspective both in analyzing entrepreneurship success and in developing other management practices that increase positive work outputs.
China–Iran Strategic Partnership: Implications for India
Authors: Rehman Malik Saif ur , Barrech Dost Muhammad
Published: November 2021

China–Iran strategic deal signed on March 27, 2021 has initiated an interesting debate in the regional political discourse. Many area study experts view it as a game changer that has the potential to revamp the complexion of the regional politics. The US sanctions against Iran forced Tehran to move towards a historic deal with China to mitigate the US influence in the region. Ostensibly, global and regional politics are being divided into two blocks underpinned by the US and China. Iran under Chinese influence is jumping at the opportunity, not only capitalizing on the Chinese US$400 billion to reinvigorate its fragile economy but also availing itself of the window of international opening amid isolation. India, on the other hand, notwithstanding its strategic partnership with the US, does not want growing Chinese influence in Iran as well as in the region since it would damage its strategic interests, halting it from Chabahar Port, connectivity with Central Asia and oil import from Iran. China–Iran deal also has a good omen for Pakistan as both Iran and Pakistan clearly incline towards China for explicit reasons. China will leave no stone unturned to make the China–Pakistan Economic Corridor (CPEC) a success story, even connecting with Iran in the foreseeable future. With this backdrop, this paper attempts to assess the implications of the said deal for India and also shed lights on the emerging geopolitical and geoeconomic changes consequent to the deal.
Pregnancy Outcomes Following the First Frozen Blastocyst Transfer Among Women Aged Less Than 35 Years Old: A Retrospective Cohort Study
Authors: Hoang Le , Thang Le Duc , Huong Nguyen Thi Lien , Thuy Nguyen Minh , Anh Vu Thi Mai , Duc Nguyen Thanh , Chi Nguyen Thi Dieu , Dung Tham Chi , Hugues Jean-Noël
Published: November 2021

Background: Many guidelines have been issued regarding the number of embryos to be transferred after in vitro fertilization (IVF), but patients and clinicians may be reluctant to accept or offer a single embryo transfer due to the expected lower chance of pregnancy or live birth. This study was aimed to provide additional information on cycle outcome according to the number and quality of thawed transferred blastocysts.

Methods: A retrospective cohort study was designed to collect the data of 505 patients who performed the first frozen blastocysts transfer at Tam Anh General Hospital from June 2018 to September 2019. One good-quality embryo was transferred for 121 patients (Group 1), two good for 214 patients (Group 2), one good and one poor for 112 patients (Group 3), one good and two poor for 25 patients (Group 4), and one or two poor for 33 patients (Group 5).

Results: The pregnancy rate was 71.9%, 74.8%, 69.4%, 84.0%, and 39.4% in Group 1–5, respectively. The multiple pregnancy rate was 36.9%, 16.9%, and 32.0% in Groups 2–4, respectively, higher than Group 1 (4.9%). The live birth rate was 55.6%, 50.9%, and 60.0% in Group 2–4, respectively, but not significantly different from the Group 1 (47.9%).

Conclusions: Transferring an additional good or poor embryo, along with a good embryo, does not increase the live birth rate while the incidence of multiple pregnancies rises significantly.
A Novel and Robust Approach to Detect Tuberculosis Using Transfer Learning
Authors: Faruk Omar , Ahmed Eshan , Ahmed Sakil , Tabassum Anika , Tazin Tahia , Bourouis Sami , Monirujjaman Khan Mohammad
Published: November 2021

Deep learning has emerged as a promising technique for a variety of elements of infectious disease monitoring and detection, including tuberculosis. We built a deep convolutional neural network (CNN) model to assess the generalizability of the deep learning model using a publicly accessible tuberculosis dataset. This study was able to reliably detect tuberculosis (TB) from chest X-ray images by utilizing image preprocessing, data augmentation, and deep learning classification techniques. Four distinct deep CNNs (Xception, InceptionV3, InceptionResNetV2, and MobileNetV2) were trained, validated, and evaluated for the classification of tuberculosis and nontuberculosis cases using transfer learning from their pretrained starting weights. With an F1-score of 99 percent, InceptionResNetV2 had the highest accuracy. This research is more accurate than earlier published work. Additionally, it outperforms all other models in terms of reliability. The suggested approach, with its state-of-the-art performance, may be helpful for computer-assisted rapid TB detection.
Augmentation of Contextualized Concatenated Word Representation and Dilated Convolution Neural Network for Sentiment Analysis
Authors: Abid Fazeel , Din Ikram Ud , Almogren Ahmad , Khattak Hasan Ali , Baig Mirza Waqar
Published: November 2021

Deep learning‐based methodologies are significant to perform sentiment analysis on social media data. The valuable insights of social media data through sentiment analysis can be employed to develop intelligent applications. Among many networks, convolution neural networks (CNNs) are widely used in many conventional text classification tasks and perform a significant role. However, to capture long‐term contextual information and address the detail loss problem, CNNs require stacking multiple convolutional layers. Also, the stacking of convolutional layers has issues requiring massive computations and the tuning of additional parameters. To solve these problems, in this paper, a contextualized concatenated word representation (CCWRs) is initialized from social media data based on text which is essential to misspelled and out of vocabulary words (OOV). In CCWRs, different word representation models, for example, Word2Vec, its optimized version FastText and Global Vectors, and GloVe, collectively create contextualized representations upon the sequence of input. Second, a three‐layered dilated convolutional neural network (3D‐CNN) is proposed that places dilated convolution kernels instead of conventional CNN kernels. Incorporating the extension in the receptive field’s size successfully solves the detail loss problem and achieves long‐term context information with different dilation rates. Experiments on datasets demonstrate that the proposed framework achieves reliable results with the selection of numerous hyperparameter tuning and configurations for improved optimization leads to reduced computational resources and reliable accuracy.
Applying Sustainable Development to Economic Challenges of Small and Medium Enterprises after Implementation of Targeted Subsidies in Iran
Authors: Sohrabi Rouhollah , Pouri Koorosh , Sabk Ara Majid , Davoodi Sayyed Mohammadreza , Afzoon Esmaeel , Pourghader Chobar Adel
Published: November 2021

Although small and medium enterprises are important in the production and employment, these firms have structural limitation in terms of human and material resources. These limitations are highlighted after implementation of targeted subsidies in Iran, release prices of energy carriers, and simultaneity of political and economic situation. The main challenge in the current path of sustainable development is addressed to all sectors of society such as engineering and production. Manufactured products must consider the impact of three aspects of sustainability over their life cycle. The three aspects of sustainability as an integral part of sustainability issues are economic, environmental, and social factors. Therefore, in this study, for achieve sustainable economic development in Iran, consider only economic aspect. Because, it will greatly benefit from the transfer of advanced production technologies in industry through international agreements such as the clean development mechanism (CDM). However, the highly competitive environment is critical because of more cost-effective projects, which is why Iran needs to strike a balance between sustainable development and profitability for projects. In this study, identifying and ranking of major challenges of leading small and medium industries have been studied. It also uses the failures mode and effect analysis (FMEA) technique and survey experts and managers of small and medium industries in the province recognized and decision model using several branches. VIKOR was ranked as the most important challenge. The results show that exchange rate volatility has been the highest priority, so the first challenge has been identified. Similarly, the political boycott and the rise in the cost of production and cost of product manufacturing enterprises were identified as the next challenges.
Analgesic Effects of Epidural Labor Analgesia at Different Periods and Its Effects on Maternal and Infant Outcomes and MiRNA-146b Level
Authors: Wang Lihong , Liu Hui , Duan Ye , Cheng Qingyu , Feng Suhua
Published: November 2021

This paper aimed to analyze the analgesic effects of continuous epidural labor analgesia (ELA) at different periods and its effects on postpartum depression, maternal and infant outcomes, and maternal blood pressure. Giving birth in our hospital from September 2017 to August 2019, 119 primiparas with spontaneous delivery were enrolled and divided into an observation group (65 cases) and a control group (54 cases). Patients in the observation group received epidural block analgesia in advance, whereas those in the control group received epidural block analgesia routinely. At 25 days after delivery, breast milk samples were collected, in which miRNA-146b level was detected by PCR. The patients were compared between the two groups with respect to progress of labor, analgesic effects during 3 stages of labor, labor outcomes, adverse reactions, and levels of NO, ANP, and ET-1 in the parturients’ umbilical artery blood. Compared with those in the control group, patients in the observation group had a remarkably higher miRNA-146b level in the breast milk (

P
<
0.05

), remarkably lower average Visual Analogue Scale (VAS) scores during the active phase and the second stage of labor (

P
<
0.05

), and remarkably higher levels of NO, ANP, and ET-1 (

P
<
0.05

). There were no statistically significant differences in adverse reactions and modes of delivery between the two groups (

P
<
0.05

). ELA starting from the latent phase can improve the miRNA-146b level in maternal breast milk, alleviate labor pain of parturients, and shorten stages of labor. Therefore, our study is worthy of clinical promotion. We still need to do more experiments and use more data to conclude more scientific results in future research work.
Experimental Investigation on Multiscale Fracturing in Thermally Treated Sandstone under SHPB Impact Loading
Authors: Yang Shang , Wang Jun , Zhang Zhi , Ning Jianguo , Sun Guoqing
Published: November 2021

To study the effect of temperature on the dynamic mechanical behaviors and fracture characteristics of thermally treated sandstone, compressive dynamic loading experiments were performed on a series of samples using a split Hopkinson pressure bar (SHPB). In the tests, the dynamic uniaxial compressive strength of the thermally treated sandstone was inversely proportional to the temperature treatment in the range of 200°C–1000°C, while the dynamic elastic modulus first increased and then gradually decreased after different temperature treatments. The results show that two classical mechanical types (i.e., Class I and Class II) are observed from the dynamic stress‐strain responses of SHPB tests for thermally treated sandstone. By means of scanning electron microscopy (SEM), the microdifference of postloading microfracture characteristics in Class I and Class II behavior was identified. In Class I behavior, intercrystalline cracks (IE) are the chief form of cracks on the fracture surface of a specimen fractured by SHPB loading even though there some intracrystalline cracks may also be present. In contrast, Class II behavior results from the chief cracking type being intracrystalline cracks.
Effect and Mechanism of Lidocaine Pretreatment Combined with Dexmedetomidine on Oxidative Stress in Patients with Intracranial Aneurysm Clipping
Authors: Zhang Junting , Zhang Hongwei , Zhao Liang , Zhao Zhanqi , Liu Ying
Published: November 2021

This study aimed to explore the effect and mechanism of lidocaine pretreatment combined with dexmedetomidine on oxidative stress in patients with intracranial aneurysm clipping. Many studies have used various drugs such as lidocaine to explore the effect and mechanism of lidocaine pretreatment. A total of 80 patients with intracranial aneurysm clipping surgery were randomly divided into 4 groups: the single lidocaine group, single dexmedetomidine group, lidocaine combined with dexmedetomidine group, and control group. The thread embolism method was used to establish a stable intracranial aneurysm model of Hashimoto rats. Fifty adult rats were randomly divided into a sham operation group, ligation of the left common carotid artery and bilateral posterior branch of renal artery, lidocaine group, dexmedetomidine group, and lidocaine combined with dexmedetomidine group. The colorimetric method was used to determine the oxidative stress indicators in brain tissue: MDA content, SOD activity, and T-AOC content. The western blot method characterized the protein levels related to oxidative stress: nNOS, iNOS, and NADPH oxidase subunits p22phox, gp91phox, and p47phox. The differences in each index between the groups were statistically significant (

P
<
0.05

). Animal experiment results revealed that the content of MDA in the brain tissue of rats in the LD group was significantly lower than that in the single-drug group and sham group. The T-AOC and SOD concentrations in the LD group were significantly higher than those in the single-drug group and sham group, and the differences between the groups were statistically significant (

P
<
0.05

). The protein expression of the LD group was significantly lower than that of the drug-alone group and model group, and the difference between groups was statistically significant (

P
<
0.05

). To sum up, lidocaine pretreatment combined with dexmedetomidine can effectively maintain the hemodynamic stability of patients with intracranial aneurysm clipping and reduce postoperative oxidative stress response. Its mechanism of action may be related to the inhibition of oxidative stress damage mediated by nNOS, iNOS, and p22phox, gp91phox, and p47phox in the hippocampus. Our study has significant and applicable medical aspects in lidocaine pretreatment combined with dexmedetomidine on oxidative stress in patients.
Experimental Investigation on the Friction‐Induced Vibration with Periodic Characteristics in a Running‐In Process under Lubrication
Authors: Sun Di , Xing Pengfei , Li Guobin , Gao Hongtao , Yang Sifan , Gao Honglin , Zhang Hongpeng
Published: November 2021

This paper investigated the friction‐induced vibration (FIV) behavior under the running‐in process with oil lubrication. The FIV signal with periodic characteristics under lubrication was identified with the help of the squeal signal induced in an oil‐free wear experiment and then extracted by the harmonic wavelet packet transform (HWPT). The variation of the FIV signal from running‐in wear stage to steady wear stage was studied by its root mean square (RMS) values. The result indicates that the time‐frequency characteristics of the FIV signals evolve with the wear process and can reflect the wear stages of the friction pairs. The RMS evolution of the FIV signal is in the same trend to the composite surface roughness and demonstrates that the friction pair goes through the running‐in wear stage and the steady wear stage. Therefore, the FIV signal with periodic characteristics can describe the evolution of the running‐in process and distinguish the running‐in wear stage and the stable wear stage of the friction pair.
Motion of Charged Spinning Particles in a Unified Field
Authors: Wanas M. I. , Kamal Mona M.
Published: November 2021

Using a geometry wider than Riemannian one, the parameterized absolute parallelism (PAP) geometry, we derived a new curve containing two parameters. In the context of the geometrization philosophy, this new curve can be used as a trajectory of charged spinning test particle in any unified field theory constructed in the PAP space. We show that imposing certain conditions on the two parameters, the new curve can be reduced to a geodesic curve giving the motion of a scalar test particle or/and a modified geodesic giving the motion of neutral spinning test particle in a gravitational field. The new method used for derivation, the Bazanski method, shows a new feature in the new curve equation. This feature is that the equation contains the electromagnetic potential term together with the Lorentz term. We show the importance of this feature in physical applications.
Responses of Xilingol Fractional Vegetation Cover to Climate Change and Human Activities
Authors: Song Xiangyang , Chen Xiang , Wang Xiaodong , Wu Nitu , Liu Aijun , Su Ritu , Yang Yong , Chang Shujuan , Wei Zhijun
Published: November 2021

Based on the MODIS NDVI product data source of Xilingol from 2010 to 2019, we use the pixel dichotomous model to retrieve the vegetation coverage in our study. The spatiotemporal changes of the vegetation cover were analyzed in the model by using the meteorological data from researched sites or the vicinal meteorological stations for evaluating the meteorological influence on the vegetation cover changes. Based on this, an evaluation method was established to estimate the relative influences of the climate changes and anthropogenic activities. The main conclusions are as follows: (1) Fractional vegetation cover in Xilingol was decreased from the northeast to the southwest. (2) The overall trend in Xilingol fractional vegetation cover in the 10-year period shows a fluctuating increasing trend. (3) An opposite distribution pattern was detected between mean precipitation and mean temperature in the study site. (4) Compared with temperature, annual precipitation has a higher correlation with fractional vegetation cover in the study site and is the main climatic factor that affects vegetation growth in the study site. (5) During the 10-year period in the study site, anthropogenic human activities have slightly greater inhibitory effects on vegetation growth than promoting effects. (6) Climate change is a major factor to accelerate grassland degradation from 2010 to 2019 in vegetation degradation regions. The promotion effect of precipitation on vegetation coverage is obviously higher than the limitation of human activities, which leads to the increase of vegetation coverage in 2010–2019.