bluuebunny/crossref_metadata_2025 huggingface dataset:
Mediastinal lymph node removal ameliorates cytotoxic T-lymphocyte functions in patients with non-small cell lung cancer
Authors: Engin Ayse , Turna Akif , Esen Fehim , Agkoc Melek , Cikman Duygu Ilke , Saglam Omer Faruk , Deniz Gunnur , Aktas Esin Cetin
Published: December 2021

Introduction:

Mediastinal lymph node (MLN) removal by video-assisted mediastinoscopic lymphadenectomy (VAMLA) for preoperative cancer staging was reported to be associated with increased survival. The aim of this study was to evaluate the immunologic effects of complete MLN removal by VAMLA on cytotoxic T lymphocyte (CTL) phenotype and function.

Methods:

Seventeen patients with non-small cell lung cancer (NSCLC) (stage cT1-4N0-3M0-1A) and 20 healthy participants were included in this study. Blood samples were collected before and 4 weeks after the procedure. Lymphocytes were isolated from the removed MLNs. CTL phenotypes and functions were evaluated by flow cytometry. Plasma levels of soluble programmed cell death protein 1 (sPD-1), soluble programmed cell death protein 1 ligand, and soluble CTL antigen 4 (sCTLA-4) were measured with enzyme-linked immunosorbent assay.

Results:

The ratio of the immunosenescent CTLs (CD3+CD8+CD28−) was increased in peripheral blood and MLNs of the patients with NSCLC compared to controls ( p = 0.037), and MLN removal did not change this ratio. PD-1 and CTL antigen 4 expressions were significantly reduced in peripheral blood CTLs after MLN removal by VAMLA ( p = 0.01 and p = 0.01, respectively). Granzyme A expression was significantly reduced in the peripheral blood CTLs of the patients compared to controls ( p = 0.006) and MLN removal by VAMLA significantly improved Granzyme A expression in CTLs ( p = 0.003). Plasma concentrations of sPD-1 and sCTLA-4 remained unchanged after VAMLA.

Conclusion:

CTLs in the MLNs and peripheral blood of the patients with NSCLC had an immunosenescent phenotype, increased immune checkpoint receptor expression, and impaired cytotoxicity. MLN removal by VAMLA improved these phenotypic and functional characteristics of CTLs. These changes may explain the potential contribution of VAMLA to improved survival.
Trained Clinician's Documentation of Serious Illness Conversations and Use of Billing CPT 99497
Authors: Daly Jeanette M. , Schmidt Megan E. , Thoma Kate DuChene , Levy Barcey T.
Published: December 2021

Background: Advance care planning (ACP) involves patients and family members in discussions with clinicians about their values, goals, and preferences regarding future medical care. Objectives: To (1) assess whether an ACP conversation using the Serious Illness Conversation (SIC) was initiated and documented; (2) assess which components of SIC were documented; (3) determine how frequently clinicians trained to use the SIC guide used ACP billing codes during the study time period, (4) determine whether there was a significant difference in mortality risk score according to documentation of each component of the SIC. Methods; Thirteen clinicians at three family medicine offices were trained in the Serious Illness Care Program and asked to document SICs in the electronic medical record (EMR). A retrospective chart review of SIC components was conducted in the EMRs of patients who presumably had ACP conversations initiated by the trained clinicians. Patients were identified using the billing codes for ACP conversations and through referrals from another study that requires clinicians to have ACP conversations with their patients. Pearson chi-square test for categorical variables and t-tests for continuous variables were conducted. Results: A total of 157 patients were included in this study; 131 patients referred from another ACP study and an additional 26 patients using the billing codes of ACP conversations. Through retrospective chart review, the mean age of patients was 72 years and 54 were male. Sixty-two (40%) charts had one or more SIC components documented. “Explore key topics” was documented most frequently for 58 (38%) patients by the 13 participating clinicians. Mean mortality risk score was 10.7 and higher scores were significantly correlated with more SIC components documented ( rp = 0.217, P = 0.007). Conclusion: Little use of the SIC guide among trained physicians was found in the EMR. It was expected that provision of an EMR template for documenting the SIC would have facilitated documentation of SICs.
Revision and Validation of the Chinese Version of the McGill Quality of Life Questionnaire for ICU End-of-Life Patients
Authors: Zhang Ting-ting , Mao Shi-fang , Zeng Yi , Mei Xu , Qiu Fang , Yin Ai-ni , Liu Meng-jie
Published: December 2021

Background

Hospice care for end-of-life patients in the ICU should focus on quality of life. Currently, there are no specific quality-of-life measures for ICU end-of-life patients in China.

Objective

The aim of this study was to revise and culturally adapt the Taiwanese version of the McGill Quality of Life Questionnaire (MQOL-Taiwan) and to test its reliability and validity to provide an effective instrument for assessing the quality of life of ICU patients at the end of life.

Methods

The revision and cultural adaptation of the MQOL-Taiwan were performed to develop a Chinese version of the McGill Quality of Life Questionnaire for ICU end-of-life patients (MQOL-ICU). A total of 156 ICU doctors, 286 ICU nurses and 120 ICU family members of end-of-life patients were surveyed with the revised scale to evaluate the quality of life of ICU patients at the end of life. The content validity, construct validity, and internal consistency of the scale were measured after the revision.

Results

The Chinese version of the MQOL-ICU scale was formed based on the MQOL-Taiwan scale, which includes 8 items. For the Chinese version of the MQOL-ICU, the item-content validity index (I-CVI) ranged from 0.789 to 0.905, and the average scale-level content validity index (S-CVI/Ave) was 0.845. After exploratory factor analysis, the Kaiser-Meyer-Olkin (KMO) value was 0.700, and 3 dominant factors were extracted: physical and psychological symptoms, existential well-being, and support. In addition, 70.385% of the total variance was explained. The internal consistency (Cronbach's α) coefficient of the whole MQOL-ICU was 0.804, and the coefficients for the 3 domains ranged from 0.779 to 0.833.

Conclusion

The Chinese version of the MQOL-ICU showed good reliability and validity, and it can be used to assess the quality of life of ICU patients at the end of life.
A novel electro-hydraulic servo steering system for Ackermann steering of heavy multi-axle vehicle
Authors: Zhang Zhizhong , Du Heng , Chen Shumei , Li Yuzheng , Wang Han
Published: December 2021

Ackermann steering is important for the steering performance of heavy multi-axle vehicle. When Ackermann steering condition is not satisfied, it will lead to abnormal tire wear. Traditional trapezoidal mechanism of heavy multi-axle vehicle is a single degree of freedom (DOF) mechanism, which is difficult to completely realize Ackermann steering. In this paper, a new two DOF electro-hydraulic servo steering system (TDEHSSS) by using a variable length tie rod is proposed for solving the issue. First, a complex nonlinear dynamic model of TDEHSSS is established. This model includes the two DOF mechanical model based on a Lagrange equation, the valve-controlled double steering power cylinders model and the valve-controlled tie rod cylinder model. Then, a simulation model is built through MATLAB/Simulink and the simulation results show that TDEHSSS can realize the proposed requirement. At last, a test bench is founded to verify model. It is indicated that the simulation and experimental curves are consistent, showing that mathematical model is in accordance with the experimental system. This research is valuable for analyzing TDEHSSS, designing advanced controllers, and finally realizing Ackermann steering for heavy multi-axle vehicles.
Naturalistic Face Learning in Infants and Adults
Authors: Zhou Xiaomei , Vyas Shruti , Ning Jinbiao , Moulson Margaret C.
Published: December 2021

Everyday face recognition presents a difficult challenge because faces vary naturally in appearance as a result of changes in lighting, expression, viewing angle, and hairstyle. We know little about how humans develop the ability to learn faces despite natural facial variability. In the current study, we provide the first examination of attentional mechanisms underlying adults’ and infants’ learning of naturally varying faces. Adults ( n = 48) and 6- to 12-month-old infants ( n = 48) viewed videos of models reading a storybook; the facial appearance of these models was either high or low in variability. Participants then viewed the learned face paired with a novel face. Infants showed adultlike prioritization of face over nonface regions; both age groups fixated the face region more in the high- than low-variability condition. Overall, however, infants showed less ability to resist contextual distractions during learning, which potentially contributed to their lack of discrimination between the learned and novel faces. Mechanisms underlying face learning across natural variability are discussed.
Exergy, Exergoeconomic, Exergoenvironmental, Emergy-based Assessment and Advanced Exergy-based Analysis of an Integrated Solar Combined Cycle Power Plant
Authors: Nourpour M. , Khoshgoftar Manesh M. H. , Pirozfar A. , Delpisheh M.
Published: December 2021

The high amount of solar energy as clean and sustainable energy has increased awareness in solar energy concentration, especially in integrated concepts. One of the best and promising hybrid configurations for converting solar energy into power is an integrated solar combined cycle system (ISCCS). In this study, conventional and advanced analysis tools for the ISCCS located in Yazd (Iran) have been investigated. In this paper, thermodynamic simulation, exergy, exergoeconomic, and exergoenvironmental analysis based on Life Cycle Assessment (LCA) have been performed. In addition, an emergy-based concept, including emergoeconomic and emergoenvironmental assessment, has been performed. In-depth analysis of exergy, exergoeconomic, and exergoenvironmental modelling, advanced exergy analysis based on endogenous/exogenous and avoidable/unavoidable parts have been done. In this regard, MATLAB code has been developed for thermodynamic simulation, exergy, exergoeconomic, exergoenvironment, emergoeconomic and emergoenvironment analysis. Furthermore, THERMOFLEX (commercial software) applied for thermodynamic simulation and verification. The Sankey diagram based on each analysis tool has been constructed. Furthermore, the priority of improvement based on each analysis has been identified. The thermal efficiency and net power generation of ISCCS are 48.25% and 419600 kW, respectively. It was obsereved that in most equipment, less than 10% of exergy destruction and cost and environmental impact rates were avoidable/endogenous.
Book Review: Bajpai, Kanti, India Versus China: Why They Are Not Friends
Authors: Kaushik Prashant
Published: December 2021

Bajpai, Kanti, India Versus China: Why They Are Not Friends (Juggernaut, 2021), Pp. 284, ₹ 599. ISBN: 9789391165086.
Shape memory polyimide composites with high storage modulus and high glass transition temperature
Authors: Li Yuejia , Pan Wei , Zhang Fenghua , Leng Jinsong
Published: December 2021

Shape memory polymers (SMPs) are smart materials that can be programmed to change shape under external stimuli, whereas the low storage modulus limit the application of them. Herein, carbon fabric (CF) reinforced shape memory polyimide composites (SMPICs) with high storage modulus were manufactured via hot pressing molding process. Firstly, we synthesized one kind of thermoplastic shape memory polyimide (SMPI) with glass transition temperature of 205°C by the two-step high-temperature solution polycondensation. In addition, the triamine was added in the SMPI system as a crosslinking agent to form the thermosetting SMPI with different crosslinking degree. In order to improve the storage modulus of SMPI, the CFs with three layers were embedded in thermosetting SMPI matrix. The storage modulus of the obtained SMPICs was as high as 26 GPa. The glass transition temperature and thermal decomposition temperature of SMPICs were up to 213°C and 505°C, respectively. Moreover, the shape fixation rate and recovery rate of SMPICs were both more than 94%. These SMPICs with high storage modulus is of great significance, proving more application potential in many fields such as aerospace.
Quality of Life After Orthognathic Surgery in Patients with Cleft: An Overview of Available Patient-Reported Outcome Measures
Authors: Ploumen Roan L. M. , Willemse Samuel H. , Jonkman Ronald E. G. , Nolte Jitske W. , Becking Alfred G.
Published: December 2021

Measuring the impact of orthognathic surgery on quality of life is of significant importance in patients with cleft deformities. Standardized tools such as patient-reported outcome measures (PROMs) are needed to fully comprehend patients’ needs and perceptions. Therefore, the availability of reliable, valid, and comprehensive questionnaires for patients is essential. The aim of this study is to identify PROMs measuring the impact of orthognathic surgery on quality of life in patients with cleft deformities and to evaluate the identified PROMs.

A systematic search of the literature was performed according to the preferred reporting items for systematic reviews and meta-analysis guidelines. All validated PROMs, regarding the impact of orthognathic surgery on quality of life in patients with cleft deformities, were identified and assessed according to the quality criteria proposed for measurement properties of health status questionnaires.

An electronic search yielded 577 articles. After a full-text review of 87 articles, 4 articles met the inclusion criteria, comprising 58 PROMs. Of these 58 PROMs, 1 PROM (the CLEFT-Q) has been validated to measure the impact of orthognathic surgery on patients with a facial cleft. Evaluation of methodological quality of the included articles and assessment of the measurement properties of the CLEFT-Q show that the CLEFT-Q scores relatively good for all available measurement properties, making it suitable for immediate use.

The CLEFT-Q was found to be the only valid instrument so far to measure the impact of orthognathic surgery on the quality of life in patients with cleft deformities.
A Discourse Analysis of Accounting Syllabuses to Assess the Extent of Curriculum Change: The Case of Lesotho General Certificate of Secondary Education
Authors: Nketekete Malefetsane E.
Published: December 2021

This study was undertaken to assess the extent of changes brought by the Lesotho General Certificate of Secondary Education (LGCSE). The LGCSE replaced the British General Certificate of Secondary Education (GCE O level). The new system was hailed as modern and progressive, recognizing wider ability performance. The study employed a comparative research methodology within qualitative research paradigm, comparing two Accounting syllabuses from GCE O level and LGCSE. Document and discourse analysis was used to obtain data. The study found that despite the educational rhetoric accompanying the introduction of the LGCSE, the syllabuses did not reflect any substantial changes or shifts.
Women’s Representation and Implications for Fairness, Trust, and Performance in Local Government: A Survey Experiment in Sri Lanka
Authors: Baniamin Hasan Muhammad , Jamil Ishtiaq
Published: December 2021

How do quotas for women in Sri Lanka’s local government institutions affect key governance indicators such as perceived fairness, institutional trust, and perceived performance? These dimensions of governance are underexplored in the context of gender quota policies in patriarchal societies like that of Sri Lanka. The study hypothetically varied the quota provision for women (decrease to 10%, increase to 45%, or keep at the current 25%) in local government, and then tried to understand people’s opinions about the three governance indicators. When examining the results of the experiment (around 1,200 samples), it was found that perceived fairness, institutional trust, and perceived performance increased along with the greater quota provision. Possible mechanisms for the increases in institutional trust and perceived performance may be associated with the signal of fairness generated by the increase of quota provision for women.
Efficacy and safety of plasma exchange or immunoadsorption for the treatment of option neuritis in demyelinating diseases: A systematic review and meta-analysis
Authors: Zhang Jianping , Fan Aifang , Wei Lili , Wei Shihui , Xie Lindan , Li Meixuan , Zhang Wenfang , Liu Qin , Yang Kehu
Published: December 2021

Background

There are no systematic reviews yet that evaluated the effects of PE/IA in patients with optic neuritis (ON) in demyelinating diseases. A meta-analysis of available study is needed to further explore the value of plasma exchange (PE) or immunoadsorption (IA) in treating ON in demyelinating diseases.

Methods

All relevant articles published on PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang, Sinomed and ophthalmology professional websites were searched. Study characteristics, demographic characteristics, clinical features and outcome measures were extracted. Response rate, adverse events (AE) rate, serious adverse event (SAE) rate, the log of the minimum angle of resolution (logMAR), visual outcome scale (VOS) and expanded disability status scales (EDSS) were evaluated using a random-effects model.

Results

35 studies were included between 1985 and 2020, containing 1191 patients. The response rates of PE and IA in acute attack of ON were 68% and 82% respectively. LogMAR (−0.60 to − 1.42) and VOS (−1.10 to −1.82) had been significantly improved from within 1 month to more than 1 month after PE treatment. Besides, we found that logMAR improved 1.78, 0.95 and 0.38, respectively ,when the time from symptom onset to the first PE/IA was less than 21 days, 21–28 days, and more than 28 days. The pooled mean difference of EDSS was −1.14.Adverse effects rate in patients with PE or IA were 0.20 and 0.06, respectively.

Conclusion

The meta-analysis provided evidence that PE/IA treatment was an effective and safe intervention, and it is recommended that early initiation of PE/IA treatment is critical.
Theorizing the globally engaged city in world politics
Authors: Gordon David J. , Ljungkvist Kristin
Published: December 2021

Cities both large and small, more and less economically advanced, are deeply involved in efforts to address the most challenging and complex issues of contemporary global governance, ranging from climate change and conditions of insecurity to human migration and public health. Yet this puzzling phenomenon is largely ignored within International Relations (IR) scholarship, and only partially theorized by scholars working in other fields of inquiry. Our premise in this article is that attempts to understand and assess city participation in world politics are augmented by focusing on the global identity of the city, since understanding what cities do in world politics is shaped by who cities (think they) are on the global stage. In proposing a subtle shift, from the passively labeled global city to what we call the globally engaged city, we direct analysis to the political and discursive forces shaping, delimiting, and informing this novel role for the city as a world-political actor. We propose that city identity is now fractured into local and global dimensions and set out two analytically distinct contexts in which the global identity of the city is forged through a process of differentiation from the nation-state. Our framework highlights in particular the politics of recognition shaping how the globally engaged city is defined and diffused. Through two empirical vignettes we illustrate the value of our framework as a means for IR scholarship to bring cities in from the analytic hinterlands and better understand their (potential) impact on the world stage.
Toward an anthropology of plastics
Authors: Abrahms-Kavunenko Saskia
Published: December 2021

Materially plastics are ambivalent. In spite of their often lauded quality of creating seemingly untethered imitations, representations and replacements, they have a materiality that leaks, off-gasses and disintegrates. They are accomplished at mimicry yet frequently unable to be remoulded. They are ostensibly resistant to microbial contamination yet absorb environmental pollutants and leach endocrine disrupting plasticisers. This article argues that, due to the material influence of plastics, their ubiquity, and the societal transformations that they have enabled, that anthropologists need to pay sustained attention to this material. Moreover, it argues that anthropological methods and theories are crucial to understanding plastics at a vital moment in their (and our) history. It articulates three ways in which anthropology can engage plastics at all stages in their lifecycles. Firstly, to study plastics challenges what it means to exist: whether or not human beings are bounded or permeable entities, experienced as individuated, collective or somewhere in between. Secondly, plastics disrupt what people know, are willing to know, or are persuaded is worth knowing about the production and disposal of the products that they consume. Thirdly, the materiality of plastics expose contemporary inequalities. Plastics can create unseen violence, both in their geographically unequal toxic distributions and in the vastness of their temporal effects.
Metaphor, magic, and mental disorder: Poetics and ontology in Mexican (Purépecha) curanderismo
Authors: Sass Louis , Alvarez Edgar
Published: December 2021

This article offers an epistemological, poetic, and ontological reading of the ways of knowing regarding mental disorders that are characteristic of the traditional healers ( curanderas and curanderos) of an Indigenous group in Mexico. The study is based on ethnographic interviews with traditional Purépecha (Tarascan) healers in rural Michoacan. Interviews focused on local conceptions of emotional and mental illness, especially Nervios, Susto, and Locura (nerves, fright, and madness). We discuss the conceptual structure of these Indigenous illness notions, the nature of the associated imagery and notions of the soul, as well as the general sense of meaningfulness and reality implicit in Purépecha curanderismo. The highly metaphorical modes of understanding characteristic of these healers defy analysis in purely structuralist terms. They do, however, have strong affinities with the Renaissance “episteme” or implicit framework of understanding described in The Order of Things, Michel Foucault's classic study of modes of knowing and experiences of reality in Western thought—a work profoundly influenced by Heidegger's interest in the historical and cultural constitution of what Heidegger termed “Being.” After examining the individual illness concepts, we explore both the poetic and the ontological dimension (the foundational sense of reality or of Being) that they involve, with special emphasis on supernatural concerns.
They would have transitioned me: third conditional TERF grammar of trans childhood
Authors: Breslow Jacob
Published: December 2021

Some of the most virulent public trans-exclusionary radical feminist (TERF) discourse in the UK follows the grammatical form of the third conditional: if I had grown up now, I would have been persuaded to transition. This articulation of the hypothetical threat of a transition that did not happen but is imagined, in retrospect, to be not just possible but forcibly enacted plays an important role, both politically and psychically, in a contemporary political landscape that is threatening the livelihoods of trans children. Interrogating this discourse via an analysis of an open letter by J.K. Rowling, and a documentary by Stella O’Malley, this article asks: what might we learn about contemporary transphobia in the UK if we took seriously the grammar of TERF discourse animated by trans childhood? It argues that while the third conditional grammar of TERF discourse could articulate a politics of solidarity between cis and trans positionalities and politics, its potential for a shared political standpoint is routinely interrupted by the defence mechanisms that are oriented by the psychic life of the child. Interrogating these defence mechanisms at the level of the cultural, the article traces out paranoia (as reading practice and psychic state) as well as projection, as two main modes of TERF engagement with trans childhood. The article thus engages with the range of real and fantasmatic impossibilities that haunt the trans child both in the present and the past, and it contributes to the growing body of scholarship on trans childhoods. In doing so, it makes the case that public discourse on trans children should desist from hypothetical third conditional claims, and instead find ways of embracing trans childhoods unconditionally.
The analyses of frictional losses and thermal stresses in a diesel engine piston coated with different thicknesses of thermal barrier films using co-simulation method
Authors: Bayata Fatma , Yildiz Cengiz
Published: December 2021

This study comparatively presents the thermal and mechanical effects of different Thermal Barrier Coatings (TBCs) and their thicknesses on the performance of aluminum diesel engine piston by combining Finite Element Analyses (FEA) and Artificial Neural Network (ANN) methods. The piston structure of MWM TbRHS 518S indirect injection six-cylinder diesel engine was modeled. The clustered TBCs (NiCrAlY–Gd2Zr2O7, NiCrAlY–MgO-ZrO2, NiCrAl–Yttria Partially Stabilized Zirconia (YPSZ), and NiCrAlY–La2Zr2O7) were implemented to the related surface of aluminum alloy piston and then static, thermal, and transient structural FEA were conducted for each model. Based on both of the temperature and equivalent stress distributions, NiCrAlY–Gd2Zr2O7 coated model displayed the best performance. Additionally, the effects of top coating thicknesses of TBCs were investigated in the range of 0.1–1.0 mm with 0.1 mm increments in FEAs. The thermally effective top coating thickness was predicted as 0.95 mm for the selected TBC using ANN method. Then the effects of coating thickness on frictional performance were revealed by generating transient structural FE models and utilizing stribeck diagram. The uncoated and 0.95 mm NiCrAlY–Gd2Zr2O7 coated models were adjusted as transient and the related crank angle – dependent in-cylinder combustion pressure data was implemented. The friction force was reduced by at least 15% in NiCrAlY–Gd2Zr2O7 coated model.
Integrated Care Pathways for Black Persons With Traumatic Brain Injury: A Critical Transdisciplinary Scoping Review of the Clinical Care Journey
Authors: Omar Samira , Nixon Stephanie , Colantonio Angela
Published: December 2021

Objectives: This novel critical transdisciplinary scoping review examined the literature on integrated care pathways that consider Black people living with traumatic brain injury (TBI). The objectives were to (a) summarize the extent, nature, and range of literature on care pathways that consider Black populations, (b) summarize how Blackness, race, and racism are conceptualized in the literature, (c) determine how Black people come to access care pathways, and (d) identify how care pathways in research consider the mechanism of injury and implications for human occupation. Methods: Six databases were searched systematically identifying 178 articles after removing duplicates. In total, 43 articles on integrated care within the context of Black persons with TBI were included. Narrative synthesis was conducted to analyze the data and was presented as descriptive statistics and as a narrative to tell a story. Findings: All studies were based in the United States where 81% reported racial and ethnic disparities across the care continuum primarily using race as a biological construct. Sex, gender, and race are used as demographic variables where statistical data were stratified in only 9% of studies. Black patients are primarily denied access to care, experience lower rates of protocol treatments, poor quality of care, and lack access to rehabilitation. Racial health disparities are disconnected from racism and are displayed as symptoms of a problem that remains unnamed. Conclusion: The findings illustrate how racism becomes institutionalized in research on TBI care pathways, demonstrating the need to incorporate the voices of Black people, transcend disciplinary boundaries, and adopt an anti-racist lens to research.
Fault detection of contactor using acoustic monitoring
Authors: Inoue Katsuhito , Stewart Edward , Entezami Mani
Published: December 2021

Recently, condition monitoring methods using the sound of the machine have attracted attention. Since approaching high voltage equipment increases the risk of electrocuting, non-contact data acquisition is desirable. Most of the research targets of acoustic monitoring are rotating machines and it is not clear whether it is effective for machines that switch between two states, such as contactors and circuit breakers. In this work, several investigations have been carried out on the acoustic condition monitoring of contactor. The Mel-frequency cepstrum coefficients (MFCCs) were obtained from the sound data of the contactors under normal and simulated fault conditions. Support Vector Machine (SVM) was trained with MFCCs and found that it could detect and diagnose contactor faults with high accuracy.
Adverse events of rituximab in neuromyelitis optica spectrum disorder: a systematic review and meta-analysis
Authors: Wang Hao , Zhou Juanping , Li Yi , Wei Lili , Xu Xintong , Zhang Jianping , Yang Kehu , Wei Shihui , Zhang Wenfang
Published: December 2021

Background:

The adverse events (AEs) of rituximab (RTX) for neuromyelitis optica spectrum disorder (NMOSD) are incompletely understood.

Aim:

To collate information on the reported the AEs of RTX in NMOSD and assess the quality of evidence.

Methods:

PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang Data, CBM, CNKI, VIP, clinicaltrials.gov, and so on were searched for studies with control groups as well as for case series that had assessed the RTX-associated AEs. The incidence of AEs and the comparison of AE risks among different therapies were pooled. The GRADE was developed for evidence quality.

Results:

A total of 3566 records were identified. Finally, 36 studies (4 RCTs, 6 crochet studies, 2 NRCTs, and 24 case series), including 1542 patients (1299 females and 139 males), were included for final analyses. Rates of patients with any AEs, any serious AEs (SAEs), infusion-related AEs, any infection, respiratory infection, urinary infection, and death were 28.57%, 5.66%, 27.01%, 17.36%, 4.76%, 4.76%, and 0.17%, respectively. The results from subgroup analysis showed that AE rates were most likely not associated with covariates such as duration of illness and study designs. Very low-quality evidence suggested that the risk ratios (RR) of any AEs (0.84, 95% CI = 00.42–1.69, p = 0.62) and any infections (1.24 95% CI = 0.18–8.61) of RTX were similar to that of azathioprine, and the RR of any AEs of RXT was akin to that of mycophenolate mofetil (0.66, 95% CI = 0.32–1.35 p = 0.26). Evidence of low to high quality showed the lower RR of RTX in other AEs, but not in infusion-related AEs. Strategies to handle AEs focused on symptomatic treatments.

Conclusions:

RTX is mostly safer than other immunosuppressants in NMOSD: the incidence of RTX-associated AEs was not high, and when present, the AEs were usually mild or moderate and could be well controlled. Given its efficacy and safety, RTX could be recommended as a first-line treatment for NMOSD.
Erythema in local and trunk skin caused by intramuscular injection of vitamin K1: A case report and literature review
Authors: Hu Cai-Xia , Cui Yu , Liu Hui , Han Xiao-Mei , Jiang Shao-Qian , Zhao Lu , Wang Wen-Qing
Published: December 2021

A 52-year-old woman presented with erythema, papules, pain, and itching on the buttocks and trunk that had persisted for 1 week. Twenty-two days before admission, the patient received three intramuscular injections of vitamin K1 in the gluteal muscles. Two weeks after the last intramuscular injection edematous hard erythema developed bilaterally on the gluteal muscles, accompanied by itching, pain, and a burning sensation. Afterward, the erythema and papules gradually spread to the trunk, with notable itching. Dermatological examination revealed a large area of well-defined edematous hard erythema, and blisters around the injection sites on both hips. The skin temperature was high, with mild tenderness. Dense distributions of edematous erythema and papules were observed on the trunk, some of which were fused into pieces. The patient received a diagnosis of a skin reaction induced by intramuscular injections of vitamin K1. Therefore, she was administered glycyrrhizin, calcium, vitamin C, antihistamines, topical polysulfonic mucopolysaccharide cream, and glucocorticoid cream, and the lesions subsided after 2 weeks.
Outcomes in Pediatric Post-Cardiotomy ECMO Support With Modification of Systematic Support Strategy
Authors: Sorabella Robert A. , Padilla Luz , Byrnes Jonathan W. , Timpa Joseph , O’Meara Carlisle , Buckman Joseph R. , Maxwell Kathryn , Borasino Santiago , Zaccagni Hayden , Asfari Ahmed , Law Mark A. , Cleveland David C. , Dabal Robert J.
Published: December 2021

Background

Utilization of extracorporeal membrane oxygenation (ECMO) support in the post-cardiotomy setting is vital to successful perioperative outcomes following pediatric cardiac surgery. Specific analysis of protocolized management strategies and staff preparedness is imperative to optimizing institutional ECMO outcomes.

Methods

All patients requiring post-cardiotomy ECMO support at a single institution from 2013 to 2019 were retrospectively reviewed. In 2015, several modifications were made to the ECMO support paradigm that addressed deficiencies in equipment, critical care protocols, and staff preparedness. Cases were stratified according to era of ECMO support; patients supported prior to paradigm change from 2013 to 2015 (Group EARLY, n = 20), and patients supported following the implementation of systematic modifications from 2016 to 2019 (Group LATE, n = 26). The primary outcomes of interest were survival to decannulation and hospital discharge.

Results

Median age at cannulation was 24.5 days (IQR 7-96) and median duration of support was 4 days (IQR 2-8). Overall survival to decannulation was 78.3% (65% EARLY vs. 88.5% LATE, P = .08) and overall survival to hospital discharge was 58.7% (35% EARLY vs. 76.9% LATE, P = .004).

Conclusion

Systematic modifications to ECMO support strategy and staff preparation are associated with a significant increase in perioperative survival for pediatric patients requiring post-cardiotomy ECMO support.
A Technique for Safe Redo Sternotomy in Patients with Aortic Proximity to the Sternum
Authors: Mavroudis Constantine D. , Smood Benjamin , Grasty Madison A. , Fuller Stephanie , Desai Nimesh D.
Published: December 2021

The risk of redo sternotomy is greatly elevated in the setting of aortic proximity to the sternum. Current strategies to avoid catastrophic neurologic injury upon sternal reentry include establishment of peripheral bypass with the use of deep hypothermia and low-flow bypass, both of which may increase risk of neurologic complications. Here, we describe a technique for safe sternal reentry and illustrate its successful use in a patient with close proximity of the aorta to the sternum. With this technique, peripheral cardiopulmonary bypass is established prior to sternal reentry via cannulation of the right axillary artery and femoral vein, and the patient is cooled as the innominate artery is dissected, mobilized, and controlled. This permits the rapid institution of selective antegrade cerebral perfusion (SACP) in the event of aortic injury during sternal reentry. Once the innominate artery is isolated and SACP is initiated, one can safely complete the redo sternotomy, dissection, and distal ascending aortic cross-clamping to continue the operation without interruption in cerebral blood flow. This technique offers a safe approach in select patients and should be utilized in similar high-risk cases.
A Scoping Review of the Empirical Literature on Peer Support for People Living with HIV
Authors: Øgård-Repål Anita , Berg Rigmor C. , Fossum Mariann
Published: December 2021

People living with HIV receiving antiretroviral therapy need support related to linkage to care and self-management in everyday life. Peer support has been found to provide varied support according to the unique needs of the group. This scoping review aims to provide an overview of research on peer support provided to people living with HIV. A search was conducted in eight databases until May 2021, and two reviewers independently screened all identified studies. We sorted the included studies into categories and conducted descriptive analyses. For this communication, we included 34 studies representing three study categories: the experiences of peer support (n = 23), program descriptions (n = 6), and training of peer supporters (n = 5). The studies were published between 2000 and 2021 and included 4275 participants from 10 countries. The flexibility of peer support complements healthcare services, but there is a need to clarify and adjust the ongoing support when living with HIV.
Risk Factors of Shoulder and Elbow Injuries in Baseball: A Scoping Review of 3 Types of Evidence
Authors: Mine Koya , Milanese Steve , Jones Mark A. , Saunders Steve , Onofrio Ben
Published: December 2021

Background:

Shoulder and elbow overuse injuries are the most common problems in baseball players. No scoping review has compared the findings from different types of evidence.

Purpose:

To map the broad evidence from 3 types of evidence (epidemiological, biomechanical, and narrative) on potential risk factors for shoulder and elbow injuries in baseball and identify gaps in the existing literature to guide future research.

Study Design:

Scoping review.

Methods:

Eight electronic databases were searched from inception to May 14, 2020. Any peer-reviewed papers that investigated or discussed potential risk factors for shoulder and elbow injuries in baseball were included.

Results:

A total of 302 studies (107 epidemiological studies, 85 biomechanical studies, and 110 narrative reviews) were included. Risk factors were categorized into 9 domains: sports profiles, physical characteristics/functions, pitching mechanics, performance, behavioral, psychosocial, biological and developmental, injury/sports profiles, and environmental factors. Studies were consistent in supporting limited shoulder range of motion (ROM) and player positions (pitchers or catchers) as risk factors for shoulder injuries. For elbow injuries, the majority of the included studies suggested that being pitchers or catchers and working with higher ball velocity can be risk factors.

Conclusion:

Findings were consistent in some risk factors, such as limited shoulder ROM and positions. However, findings were inconsistent or limited for most factors, and substantial research gaps were identified. Research assessing those factors with inconsistent or limited evidence in the current literature were recognized to be priorities for future studies.
DEEP Study: Modeling Outcomes and Costs of Persistent Orofacial Pain
Authors: Durham J. , Breckons M. , Vale L. , Shen J.
Published: December 2021

Persistent orofacial pain (POFP) affects patients’ daily lives and can lead to significant costs for them and/or the health service provider. This partial economic evaluation examined costs and utilities experienced by individuals with POFP over a 24-mo period and used these data to populate the life course Markov model used to estimate costs and quality-adjusted life years (QALYs) from pain onset over an individual’s life course while receiving usual health care. A total of 202 people receiving care for POFP were followed for 24 mo. Data were collected every 6 mo on pain-related disability (Graded Chronic Pain Scale dichotomized to low [0–IIa] or high [IIb–IV] pain-related disability states), health service utilization, and health-related quality of life measured by QALYs derived from the EQ-5D-5L. Unbalanced regressions were used to demonstrate how costs and QALYs varied according to participant characteristics with the results used to parameterize a Markov model. This probabilistic Markov model was used to estimate the outcomes for a cohort of POFP patients from age 25 y until death as determined by age- and sex-specific mortality rates. Across all time points, complete data were available from 129 participants. A high pain-related disability state led to significantly increased health care cost (£221; 95% confidence interval [CI], 87–355; P < 0.01) and a significant decrease in quality of life (mean difference, –0.08; 95% CI, –0.11 to −0.05; P < 0.0001) over a 24-mo period. The Markov model estimated that the average cost was £27,317 (95% CI, 26,558–28,046) and the average lifetime QALYs were 17.54 (95% CI, 17.38–17.71). The modeling suggests that a cohort of POFP patients from age 25 y would only accrue 18 QALYs per person before death. POFP therefore exerts a considerable impact on health, and it is likely more effective care (pathways) could realize substantial gains in terms of both treatment outcomes and health care utilization.

Knowledge of Transfer Statement:

Despite a substantial number of consultations, individuals experiencing the care pathways in this study continued to have far from perfect health over their life course. The modeling suggests they would only experience 18 y in “perfect health.” There is considerable scope to improve current care/outcomes and patient experience.
Evolution of Non-communicable Disease Programs in Kerala: Lessons Learnt and the Way Forward
Authors: Ramesh Jeena , Gaitonde Rakhal
Published: December 2021

Addressing the double burden of disease in a country like India is a massive challenge, especially when the system is tuned to do monitoring and surveillance of mainly communicable diseases. Achieving the sustainable development goal target 3.4 to bring down the premature mortality from non-communicable diseases (NCDs) to one-third will need to consider the requirement of robust indicators at the national level to keep track of the prevalence of NCD and its risk factors among its population. The state of Kerala in contrast has a strong primary health care system that it can build on to address the rising NCD burden.
Combining word embeddings to extract chemical and drug entities in biomedical literature
Authors: López-Úbeda Pilar , Díaz-Galiano Manuel Carlos , Ureña-López L. Alfonso , Martín-Valdivia M. Teresa
Published: December 2021

Background

Natural language processing (NLP) and text mining technologies for the extraction and indexing of chemical and drug entities are key to improving the access and integration of information from unstructured data such as biomedical literature.

Methods

In this paper we evaluate two important tasks in NLP: the named entity recognition (NER) and Entity indexing using the SNOMED-CT terminology. For this purpose, we propose a combination of word embeddings in order to improve the results obtained in the PharmaCoNER challenge.

Results

For the NER task we present a neural network composed of BiLSTM with a CRF sequential layer where different word embeddings are combined as an input to the architecture. A hybrid method combining supervised and unsupervised models is used for the concept indexing task. In the supervised model, we use the training set to find previously trained concepts, and the unsupervised model is based on a 6-step architecture. This architecture uses a dictionary of synonyms and the Levenshtein distance to assign the correct SNOMED-CT code.

Conclusion

On the one hand, the combination of word embeddings helps to improve the recognition of chemicals and drugs in the biomedical literature. We achieved results of 91.41% for precision, 90.14% for recall, and 90.77% for F1-score using micro-averaging. On the other hand, our indexing system achieves a 92.67% F1-score, 92.44% for recall, and 92.91% for precision. With these results in a final ranking, we would be in the first position.
PI3Kδ inhibition prevents IL33, ILC2s and inflammatory eosinophils in persistent airway inflammation
Authors: Uddin Sorif , Amour Augustin , Lewis David J. , Edwards Chris D. , Williamson Matthew G. , Hall Simon , Lione Lisa A. , Hessel Edith M.
Published: December 2021

Background

Phosphoinositide-3-kinase-delta (PI3Kδ) inhibition is a promising therapeutic approach for inflammatory conditions due to its role in leucocyte proliferation, migration and activation. However, the effect of PI3Kδ inhibition on group 2 innate lymphoid cells (ILC2s) and inflammatory eosinophils remains unknown. Using a murine model exhibiting persistent airway inflammation we sought to understand the effect of PI3Kδ inhibition, montelukast and anti-IL5 antibody treatment on IL33 expression, group-2-innate lymphoid cells, inflammatory eosinophils, and goblet cell metaplasia.

Results

Mice were sensitised to house dust mite and after allowing inflammation to resolve, were re-challenged with house dust mite to re-initiate airway inflammation. ILC2s were found to persist in the airways following house dust mite sensitisation and after re-challenge their numbers increased further along with accumulation of inflammatory eosinophils. In contrast to montelukast or anti-IL5 antibody treatment, PI3Kδ inhibition ablated IL33 expression and prevented group-2-innate lymphoid cell accumulation. Only PI3Kδ inhibition and IL5 neutralization reduced the infiltration of inflammatory eosinophils. Moreover, PI3Kδ inhibition reduced goblet cell metaplasia.

Conclusions

Hence, we show that PI3Kδ inhibition dampens allergic inflammatory responses by ablating key cell types and cytokines involved in T-helper-2-driven inflammatory responses.
Identification of Barrett's esophagus in endoscopic images using deep learning
Authors: Pan Wen , Li Xujia , Wang Weijia , Zhou Linjing , Wu Jiali , Ren Tao , Liu Chao , Lv Muhan , Su Song , Tang Yong
Published: December 2021

Background

Development of a deep learning method to identify Barrett's esophagus (BE) scopes in endoscopic images.

Methods

443 endoscopic images from 187 patients of BE were included in this study. The gastroesophageal junction (GEJ) and squamous-columnar junction (SCJ) of BE were manually annotated in endoscopic images by experts. Fully convolutional neural networks (FCN) were developed to automatically identify the BE scopes in endoscopic images. The networks were trained and evaluated in two separate image sets. The performance of segmentation was evaluated by intersection over union (IOU).

Results

The deep learning method was proved to be satisfying in the automated identification of BE in endoscopic images. The values of the IOU were 0.56 (GEJ) and 0.82 (SCJ), respectively.

Conclusions

Deep learning algorithm is promising with accuracies of concordance with manual human assessment in segmentation of the BE scope in endoscopic images. This automated recognition method helps clinicians to locate and recognize the scopes of BE in endoscopic examinations.