bluuebunny/crossref_metadata_2025 huggingface dataset:
Mathematical Modeling of the Growth Suppression of HER2+ Breast Cancer Colonies Under the Effect of Trastuzumab and PD-1/PD-L1 Inhibitor
Authors: Padmanabhan Regina , Kheraldine Hadeel , Gupta Ishita , Meskin Nader , Hamad Anas , Vranic Semir , Al Moustafa Ala-Eddin
Published: May 2022

Immune checkpoint blockade (ICB)-based therapy is revolutionizing cancer treatment by fostering successful immune surveillance and effector cell responses against various types of cancers. However, patients with HER2+ cancers are yet to benefit from this therapeutic strategy. Precisely, several questions regarding the right combination of drugs, drug modality, and effective dose recommendations pertaining to the use of ICB-based therapy for HER2+ patients remain unanswered. In this study, we use a mathematical modeling-based approach to quantify the growth inhibition of HER2+ breast cancer (BC) cell colonies (ZR75) when treated with anti-HER2; trastuzumab (TZ) and anti-PD-1/PD-L1 (BMS-202) agents. Our data show that a combination therapy of TZ and BMS-202 can significantly reduce the viability of ZR75 cells and trigger several morphological changes. The combination decreased the cell’s invasiveness along with altering several key pathways, such as Akt/mTor and ErbB2 compared to monotherapy. In addition, BMS-202 causes dose-dependent growth inhibition of HER2+ BC cell colonies alone, while this effect is significantly improved when used in combination with TZ. Based on the in-vitro monoculture experiments conducted, we argue that BMS-202 can cause tumor growth suppression not only by mediating immune response but also by interfering with the growth signaling pathways of HER2+ BC. Nevertheless, further studies are imperative to substantiate this argument and to uncover the potential crosstalk between PD-1/PD-L1 inhibitors and HER2 growth signaling pathways in breast cancer.
Series with Binomial-Like Coefficients for the Investigation of Fractal Structures Associated with the Riemann Zeta Function
Authors: Belovas Igoris , Sabaliauskas Martynas , Kuzma Lukas
Published: May 2022

The paper continues the study of efficient algorithms for the computation of zeta functions over the complex plane. We aim to apply the modifications of algorithms to the investigation of underlying fractal structures associated with the Riemann zeta function. We discuss the computational complexity and numerical aspects of the implemented algorithms based on series with binomial-like coefficients.
Enabling Co-Innovation for A Successful Digital Transformation in Wind Energy Using the WeDoWind Ecosystem and A Fault Detection Case Study
Authors: Barber Sarah , Lima Luiz , Sakagami Yoshiaki , Quick Julian , Latiffianti Effi , Liu Yichao , Ferrari Riccardo , Letzgus Simon , Zhang Xujie , Hammer Florian
Published: May 2022

In the next decade, further digitalisation of the entire wind energy project lifecycle is expected to be a major driver for reducing project costs and risks. In this paper, a literature review on the challenges related to implementation of digitalisation in the wind energy industry is first carried out, showing that there is a strong need for new solutions that enable co-innovation within and between organisations. Therefore, a new collaboration method called the WeDoWind Ecosystem is developed and demonstrated. The method is centred around specific "challenges", which are defined by "challenge providers" within a topical "space" and made available to participants via a digital platform. The data required in order to solve a particular "challenge" is provided by the "challenge providers" under the confidentiality conditions they specify. The method is demonstrated via a case study, the EDP Wind Turbine Fault Detection Challenge. Six submitted solutions using diverse approaches are evaluated. Two of the methods perform significantly better than EDP’s existing method in terms of Total Prediction Costs (saving up to €120,000). The WeDoWind Ecosystem is found to be a promising solution for enabling co-innovation in wind energy, providing a number of tangible benefits for both challenge and solution providers.
Comparison of Magnesium Sulfat Gargle and Ketamine Gargle on The Incidence of Sore Throat and Cough After Extubation
Authors: Arianto Ardana Tri , Santosa Sugeng Budi , Anindita Anindita
Published: May 2022

Background : Postoperative sore throat (POST) or postoperative sore throat is one of the most common complications in patients receiving endotracheal intubation. The incidence of sore throat is reduced by administering mouthwash analgesics. The purpose of this study was to determine the difference in the effectiveness of magnesium sulfate gargle and ketamine gargle on the incidence of sore throat and cough after endotracheal extubation.

Methods : The research was conducted at the Central Surgical Installation of RSUD Dr. Moewardi Surakarta, started in August 2020. This study is an experimental double-blind randomized control trial in patients undergoing general anesthesia after endotracheal extubation. Mann Whitney U test was used to process the data. The research group was divided into two groups, namely magnesium sulfate gargle (M) and ketamine gargle (K).

Results : This study found a significant difference in sore throat when using magnesium sulfat gargle and ketamine gargle on the NRS scale. From the results of the study, there was a significant difference between magnesium sulfate and ketamine gargle at NRS 1 (p = 0.01) and NRS 6 (p = 0.022). In the incidence of cough, there were 7 patients in the magnesium sulfat group who had cough (30.4%) and 7 patients in the ketamine group who had cough (30.4%), the statistical test got p = 1,000 (p> 0.050).

Conclusion : There is a significant difference in the incidence of sore throat which is lower in the administration of magnesium sulfate gargle compared to ketamine gargle and there is no significant difference between the administration of magnesium sulfate gargle and ketamine gargle on the incidence of cough after endotracheal extubation.
Operative Treatment of Proximal Humeral Fractures with Reverse Total Shoulder Arthroplasty in Patients ≥65 Years Old
Authors: Lin Charles C. , Karlin Elan , Boin Michael A. , Dankert John F. , Larose Gabriel , Zuckerman Joseph D. , Virk Mandeep S.
Published: May 2022

» The majority of proximal humeral fractures (PHFs) in patients who are ≥65 years of age are treated nonoperatively, but certain complex fracture patterns benefit from surgical intervention. However, there continues to be debate regarding the indications for surgery and the optimal surgical treatment (repair versus replacement) in this population.

» Reverse total shoulder arthroplasty (RTSA) has grown in popularity for surgical treatment of fracture-dislocations and displaced complex PHFs in patients who are ≥65 years of age; it has definite advantages over surgical repair and hemiarthroplasty, but this finding requires additional higher-quality evidence.

» RTSA provides early pain relief and return of shoulder function as well as predictable elevation above shoulder level in the forward plane, but the indications for and understanding of the effect of timing on RTSA after a PHF continue to evolve.

» RTSA for an acute PHF is indicated in patients who are ≥65 years of age with 3- and 4-part fracture-dislocations, head-split fractures, and severely displaced fractures, and is an option in patients who are not able to tolerate nonoperative treatment of severely displaced 3- and 4-part fractures.

» RTSA is also indicated as a salvage operation for PHFs that have failed initial surgical repair (i.e., fixation failure, implant failure, rotator cuff failure, or osteonecrosis) and is an option for symptomatic nonunion or malunion after nonoperative treatment.
Optimizing acquisition times for total-body positron-emission tomography/computed tomography with half-dose 18F-fluorodeoxyglucose in oncology patients
Authors: He Yibo , Gu Yushen , Yu Haojun , Wu Bing , Wang Siyang , Tan Hui , Cao Yanyan , Chen Shuguang , Sui Xiuli , Zhang Yiqiu , Shi Hongcheng
Published: May 2022

Background
The present study aimed to explore the boundary of acquisition time and propose an optimized acquisition time range for total-body positron emission tomography (PET)/computed tomography (CT) oncological imaging using half-dose 18F-fluorodeoxyglucose (FDG) activity based on diagnostic needs.
Methods
In this retrospective study, an exploration cohort (October 2019 to December 2019) of 46 oncology patients was first studied. The acquisition time for all patients was 15 min and the acquired images were reconstructed and further split into 15-, 8-, 5-, 3-, 2, 1-min duration groups (abbreviated as G15, G8, G5, G3, G2, and G1). The image quality and lesion detectability of reconstructed PET images with different acquisition times were evaluated subjectively (5-point scale, lesion-detection rate) and objectively (standardized uptake values, target-to-background ratio). In the same way, the filtered acquisition times were further validated in a cohort of 147 oncology patients (December 2019 to June 2021).
Results
In the exploration cohort, the subjective scores for G1, G2, G3, G5, and G8 images were 2.0 ± 0.2, 2.9 ± 0.3, 3.0 ± 0.0, 3.9 ± 0.2, and 4.2 ± 0.4, respectively. Two cases in G1 were rated as 1 point. No significant difference in scores was observed between G5 and G8 (p > 0.99). In general, groups with a longer acquisition time showed lower background uptake and lesion conspicuity. Compared with G15, lesion-detection rate significantly reduced to 85.3% in G1 (p < 0.05). In the validation cohort, the subjective score was 3.0 ± 0.2 for G2, 3.0 ± 0.1 for G3, 3.6 ± 0.5 for G5, 4.0 ± 0.3 for G8, and 4.4 ± 0.5 for Gs. Only the scores between G2 and G3 were not significantly different (p > 0.99). The detection rates (204 lesions) significantly reduced to 94.1–90.2% in G3 and G2 (all p < 0.05).
Conclusion
A 2-min acquisition time provided acceptable performance in certain groups and specific medical situations. And protocols with acquisition times ≥ 5 min could provide comparable lesion detectability as regular protocols, showing better compatibility and feasibility with clinical practice.
Almost-quasifibrations and Fundamental Groups of Orbit Configuration Spaces
Authors: Sayed Roushon
Published: May 2022

We introduce the notion of an almost-quasifibration and give many examples. As a consequence, supporting the Asphericity conjecture of [11], we deduce that the fundamental group of the orbit configuration space of an effective and properly discontinuous action of a discrete group, on an aspherical 2-manifold with isolated fixed points is torsion free. Furthermore, if the 2-manifold has at least one puncture then it is poly-free, and hence has an iterated semi-direct product of free groups structure, which generalizes a result of Xicot´encatl ([[16], Theorem 6.3]).
Improved low crosstalk, high transmission and quality factor eight channel demultiplexer based on photonic crystal
Authors: Azadi Mohammad , Mohammadi Masoud , Olyaee Saeed , seifouri mahmood
Published: May 2022

Due to the importance of all-optical demultiplexers (DEMUXs) in optical communication networks, this study aims to design and simulate a novel type of DEMUX using 2D photonic crystals (2D-PhCs). The proposed structure consists of one input waveguide and eight output channels considering linear and point defects. To design this DEMUX, silicon dielectric rods with the refractive index of 3.45 are employed in the air background, the radius of which is equal to R = 0.21Ʌ (Ʌ = 0.522µm) where Ʌ is the lattice constant. The photonic band gap (PBG) and output spectrum of the structure are analyzed by the plane wave expansion (PWE) and finite-difference time-domain (FDTD) methods, respectively. The simulation results indicate the average quality factor and transmission efficiency are 3,602 and 98%, respectively, and inter-channel crosstalk ranges from − 60.5 to -25.5 dB.
Multi-granularity Feature Utilization Network for Cross-modality Visible-Infrared Person Re-identification
Authors: Zhang Guoqing , Zhang Yinyin , Chen Yuhao , Zhang Hongwei , Zheng Yuhui
Published: May 2022

Cross-modality Visible-Infrared Person Re-identification (VI-ReID) aims to recognize images with the same identity between visible modality and infrared modality, which is a very challenging task. Because it not only includes the trouble of variations between cross-cameras in traditional person re-identification, but also suffers from the huge differences between two modalities. Some existing VI-ReID methods are often limited to single learning of global features or local features, while ignoring the complementarity between fine-grained and coarse-grained information. To solve this problem, our paper designs a multi-granularity feature utilization network (MFUN), which makes up for the lack of modality-shared information by learning fine-grained and coarse-grained features. Firstly, for the sake of learning fine-grained information, a local feature constraint module is introduced, in this module we use hard-mining triplet loss and heterogeneous center loss to constrain local features simultaneously to better promote intra-class closeness and inter-class differences at the coarse and fine granularity levels. Then, our method uses a multi-modality feature aggregation module for global features to fuse the information of two modalities to narrow the modality gap. Through the combination of these two modules, visible and infrared image features can be better fused, thus alleviating the problem of modality discrepancy and supplementing the lack of modality-shared information. Extensive experimental results on RegDB and SYSU-MM01 datasets fully prove that our proposed MFUN has superiority over the state-of-the-art solutions.
Knowledge Mapping of Planetary Boundaries based on Bibliometrics Analysis
Authors: CHEN Siying , Chen Demin , Tan Zhixiong , Chen Maozhi , Han Jingwei
Published: May 2022

There are an increasing number of academic researches and sustainable development policies focusing on planetary boundaries. However, no research has been conducted to far on drawing scientific investigation map of planetary boundaries. Therefore, this paper conducted a scientometric analysis of 530 academic publications and their 1784 references on planetary boundaries from 2009 to 2021 by visualizing the social network, dual-map overlay, co-cited references, structure variation article, and co-occurrence keywords with Citespace. The results show that as a new achievement and paradigm in the field of sustainable development research, the planetary boundaries framework is gradually getting global attention and promotion, which increasingly becomes an interdisciplinary hot research topic. The most productive authors and institutions are concentrated in England, the United States, Germany, and Sweden. Relevant articles were mainly published in journals focusing on ecology, earth, marine, veterinary, animal, economics and politics, as represented by the dual-map overlay. In addition, we summarized three predominant research themes by clustering keywords: the calculation of single boundary threshold and present value, the integration with assessment methods such as life cycle assessment and footprint families, the downscaling of planetary boundaries, and the expansion to economic and social domains. For scholars interested in this topic, this paper would be a useful reference and guideline.
MicroRNAs 181a and 125a are highly expressed in early diagnosed RRMS: a pilot case-control study
Authors: D'AMICO EMANUELE , allegretta caterina , Zanghì Aurora , manuti virginia , amoruso antonella , avolio carlo
Published: May 2022

Background: Recently microRNAs (miRs) have been proposed as possible disease biomarkers in Multiple Sclerosis (MS) field. Among miRs, those secreted through microvesicles (MVs) may contribute to different disease phases. Methods: This is a case-control study performed at the Department of Medical and Surgical Sciences, University of Foggia, Italy. Patients have not been yet exposed to disease modifying therapies (DMTs) and had received a confirmed diagnosis of relapsing remitting MS (RRMS). We analyzed the serum level of 6 MVs miRs by using Quantitative Real-Time PCR, comparing RRMS to HCs, with a 2:1 ratio. Subsequently, the differentially expressed miRNAs, were further tested with receiving operator curves (ROC). We aimed to explore possible role of MVs miRs as disease biomarker at the time of diagnosis.Results: A total of 12 patients were enroled. MiR-181a and miR-125a had higher levels in RRMS patients when compared to HCs (p<.01 and p<.05 respectively). The ROC curve indicated that both miR-181a and 125a could be considered as biomarkers with an area under the curve of 0.896 (p=.014; 95% CI: 0.72–1.00) and 0.785 (p=.046; 95% CI:0.59–1.00) respectively.Conclusions: Our study suggested MVs miR-181a and 125a as possible disease biomarkers in early diagnosed RRMS patients, not yet exposed to DMTs.
Gut microbiome contributes to cold-climate adaptation in lizards
Authors: Chen Jun-Qiong , Zhang Lu-Wen , Zhao Ru-Meng , Wu Hai-Xia , Lin Long-Hui , Li Peng , Li Hong , Qu Yan-Fu , Ji Xiang
Published: May 2022

Background: The metabolic cold-climate adaption hypothesis predicts that animals from cold environments have relatively high metabolic rates compared with their warm-climate counterparts. However, studies testing this hypothesis are sparse. Here, we compared gut microbes between two cold-climate lizard species of the genus Phrynocephalus to test the hypothesis that gut microbiota can help lizards adapt to cold environments by promoting metabolism and absorption efficiency. We kept lizards at 24°C and 30°C for 25 d, and then collected their fecal samples to analyze and compare the microbiota based on 16S rRNA gene sequencing technology.Results: The gut microbiota was mainly composed of Proteobacteria, Firmicutes, Bacteroidetes, and Verrucomicrobia at the phylum level in both species (Proteobacteria > Firmicutes > Verrucomicrobiota in P. erythrurus, and Bacteroidota > Proteobacteria > Firmicutes in P. przewalskii). Further analysis revealed that the gut microbiota contributed to the host’s cold adaptation, but with differences in the relative abundance of these contributory bacteria between the two species. KEGG analysis revealed that the gut microbiota primarily played roles in metabolism, genetic information processing, cellular processes, and environmental information processing in both species. Furthermore, genes related to metabolism were more abundant in P. erythrurus at 24 °C than in other species ´ temperature combinations, indicating the role of gut microbiota in long-term cold-climate adaptation.Conclusion: Our study provides evidence that gut microbiome contributes to cold-climate adaptation in both species but more evidently in P. erythrurus using colder habitats than P. przewalskii throughout a year, thus confirming the gut microbiota’s role in the cold-climate adaptation in lizards.
The starting mechanism study on rainfall-induced sloop loose source in strong earthquake area
Authors: Li Mingli , Cheng Jianlong
Published: May 2022

Regarding risks from debris flows, previously unrecognized low-frequency loose slope source materials starting in formation areas constitute an especially significant threat. The 5.12 Wenchuan earthquake in 2008 led to a large number of loose deposits on the slope on both sides of the gully in the formation area. Under the triggering action of heavy rainfall, the gully easily failed and started earlier than the overall start of the gully debris flow, which has practical significance for realizing the early warning of the gully debris flow starting. The special loose source conditions and postearthquake geological environment change the hydraulic mechanism of traditional debris flow start-up, which brings great difficulties to the monitoring and early warning of postearthquake debris flows. Therefore, based on hydraulics, on the premise of building a hydraulic model of groundwater level change of loose slope accumulation body, the characteristics and rules of groundwater level change are analyzed with the aid of hydraulic seepage theories, and the action characteristics of hydrodynamic pressure and hydrostatic pressure on the accumulation body are quantitatively studied. Based on field exploration data and average slope gradient, we divided the accumulation body in a reasonable manner; completed the sliding force, anti-sliding force and residual-sliding force mechanical expression and establishment; and performed a slope stability analysis. The research results show that the slope-starting mode is divided into the thrust-type landslide and the retrogressive landslide mode of the subsection disintegration. The hydraulic deposit mechanism analytical results can also reverse the critical rainfall condition of slope failure. Finally, taking the Yindongzi gully in Dujiangyan as an example, the hydraulic mechanism of typical slope deposits in the formation area was analyzed and combined with the historical debris flow events in the study area to verify the physical simulation test, which was consistent with the field investigation results after the disaster.
Clinical decision-making and adaptive expertise in residency: A think-aloud study
Authors: Gamborg Maria Louise , Mehlsen Mimi , Paltved Charlotte , Vetter Sigrid Strunge , Musaeus Peter
Published: May 2022

Background: Clinical decision-making (CDM) depends on residents’ learning, experience and knowledge. Previous research has used dual-process theory to explain the cognitive processes involved in how physicians acquire experiences that help them develop CDM. However, research is lacking about how CDM is shaped by the physicians’ situated cognition in the clinical environment. The challenge is that novice physicians need to train their cognitive competencies as adaptable processes. The adaptive expert framework is meant to explain how novice physicians learn to make clinical decisions in demanding clinical situations.Purpose: The aim of this study was to analyse how residents utilize and develop adaptive expert cognition in a natural setting. By describing cognitive processes through verbalization of thought processes, we sought to explore their CDM strategies in light of the adaptive expert framework.Methods: We used concurrent and retrospective think-aloud interviews in a natural setting of an emergency department at a university hospital to query residents about their reasoning during a patient encounter. We analyzed data using protocol analysis to infer cognitive strategies from these verbalizations and compared these to the framework of adaptive expertise.Results: 14 interviews were audio recorded over the course of 17 hours of observation. We coded 78 informational concepts and 46 cognitive processes. Residents who were quick to move on to hypothesis testing, tended to be more laborious in their CDM. Here a qualitative analysis demonstrated that uncertainty and differences in how informants assumed their role as a physician affected their hypothesis generation and information gathering. Discussion and conclusion: In order for a resident to learn to act as an adaptive decision-maker, they relied on contextual support. The professional role was crucial in decisional competency. This supports current literature, which argue that role clarification helps decisional competency. This study adds that promoting professional development by tolerating uncertainty may improve adaptive decisional competency.
Nutrient scoring for the DEGS1-FFQ – from food intake to nutrient intake
Authors: Thieleking Ronja , Schneidewind Lennard , Kanyamibwa Arsene , Hartmann Hendrik , Horstmann Annette , Witte A. Veronica , Medawar Evelyn
Published: May 2022

Background: While necessary for studying dietary decision-making or public health, estimates of nutrient supply based on self-reported food intake are barely accessible or fully lacking and remain a challenge in human research. In particular, detailed information on dietary fiber is limited. In this study we introduce an automated openly available approach to assess self-reported nutrient intake for research purposes for a popular, validated German food frequency questionnaire (FFQ).Methods: To this end, we i) developed and shared a code for assessing nutrients (carbohydrates, fat, protein, sugar, fiber...) for 53 items of the quantitative, validated German DEGS1-FFQ questionnaire implementing expert-guided nutritional values of diverse sources with several raters. In a sample of individuals (nGUT-BRAIN = 61 (21 female) overweight, omnivorous), we ii) cross-validated nutrient intake of the last 7 days and the last 24 hours and iii) computed test-retest reliability across two timepoints. Further, iv) we report newly computed nutrient intake for two independent cross-sectional cohorts with continuous weight status and different dietary habits (nMensa= 134 (79 female, 1 diverse), nGREADT = 76 male). Exploratively, we correlated computed nutrient intake with v) anthropometric and vi) blood-based biomarkers.Results: In overweight adults (n= 61 (21 female), mean age 28.2±6.5 years, BMI 27.4±1.6 kg/m2) nutrient intakes were mostly normally distributed and within or surpassing recommended reference nutrient ranges for both last 7 days and last 24 hours. Reliability between last 7 days and 24 hours per visit was moderate (Pearson’s rall≥ 0.34, pall < 0.001, rmax = 0.54) and absolute agreement across two timepoints was moderate for 7 days (kappaall > 0.40, pall < 0.001) and poor for 24 hours (kappaall> 0.08, pall < 0.001). Associations of dietary components to anthropometric markers showed distinct sex differences, with overall higher intake by males compared to females and opposite associations of fiber intake and BMI in males compared to females. Links between nutrient intake relative to calorie intake and anthropometrics as well as serum markers remain inconclusive.Conclusion: We provide an openly available tool to systematically assess nutrient intake, including fiber, based on self-report by a common German FFQ. The computed nutrient scores resembled overall plausible and reliable measures of nutrient intake given the known limitations of FFQs regarding over- or underreporting. Our open code nutrient scoring can help to examine dietary intake in experimental studies, including dietary fiber and its subclasses, and can be readily adapted to other FFQs. Further validation of computed nutrients with biomarkers and nutrient-specific metabolites in serum, urine or feces will help to interpret self-reported dietary intake.
Adsorption Coupling Photocatalytic Removal of Gaseous n-Hexane by Phosphorus Doped g-C3N4/TiO2/Zn(OAc)2-ACF Composites
Authors: Sun EnCheng , Wei Haidi , Zhang Shuai , Bi Yuxi , Huang Ziyan , Ji Guoyang , Liu Fang , Zhao Chaocheng
Published: May 2022

VOCs emission reduction in the petroleum and petrochemical industry is a hot and difficult topic at present. The single method may not be able to meet the actual treatment status. Therefore, the adsorption coupled photocatalytic degradation technology was used to remove VOCs. Phosphorus doped carbon nitride (PCN) and PCN/TiO2 were prepared by hydrothermal synthesis and sol-gel method, and then PCN/TiO2/Zn(OAc)2-ACF composites were prepared by ultrasonic impregnation on zinc acetate modified activated carbon fibers (Zn(OAc)2-ACF). The removal efficiency of n-Hexane by composite materials was explored in a self-made reactor, and the factors affecting, removal efficiency, removal mechanism and possible ways of degradation were investigated. The results showed that under the optimum reaction conditions (initial concentration of n-hexane 200 mg/m3, space velocity 1000 h-1, light intensity 24 W, mass fraction of doped PCN 6%, loading twice, calcination temperature 450 ℃), PCN/TiO2/Zn(OAc)2-ACF composite has the highest removal efficiency of n-hexane (90.2%). The adsorption capacity of the composites after doping the P element was 215.3 mg/g, which didn’t enhance the adsorption performance compared with that before doping, but the removal rate of n-hexane was higher. This showed that doping P element was helpful to enhance the photocatalytic activity of the composites.
Comparative effect of cooling on the physico-chemical-sensory properties of ghee from cow and buffalo milk, and evaluation of the low-fat spread prepared from cow and buffalo milk ghee
Authors: Deverao Patange Dnyaneshwar , Vinayak Dhanake Virshasen , Chandran Deepak , Radha Radha , Kumar Manoj , Lorenzo Jose Manuel
Published: May 2022

Low-fat spread (LFS) is the product harmonizing with the idea of healthy nutrition. At the same time, it has a good taste and flavour, as well as very good spreadability at refrigerator temperature. The present investigation studied the effect of method of cooling on the properties of cow and buffalo milk ghee, and comparative evaluation of LFS prepared from them. Slowly pre-cooled cow ghee had intense yellow colour than rapidly pre-cooled cow ghee, whereas slowly pre-cooled buffalo ghee has creamish white colour and rapidly pre-cooled buffalo ghee had white colour. Rapidly pre-cooled cow ghee had a very smooth and pasty texture than rapidly pre-cooled buffalo ghee. The LFS of cow ghee had shown maximum sensory scores for colour and appearance, body and texture, spreadability, and overall acceptability, as compared to buffalo ghee LFS. Chemically it was observed that both the LFS differs in FFA content, while they had similar fat, protein, carbohydrate, ash and total solids content, as well as pH. Oiling off and wheying off was found higher in cow ghee LFS over buffalo ghee LFS. Colour, appearance and flavour score were found improved by the addition of butter annatto colour and diacetyl flavour respectively. Color and appearance, body and texture, spreadability, as well as overall acceptability scores were higher for cow ghee LFS when subjected to 35°C for 10, 20, and 30 minutes. It was found that after 10 minutes of exposure to 35°C, the physical qualities of both LFS were unchanged, but the sensory properties diminished as time passed.
Total intravenous anesthesia in combination with remimazolam and remifentanil without a neuromuscular blocking agent: a prospective observational study
Authors: Na Hyo-Seok , Park InSun , Cho Mincheul , Nam Sun Woo , Hwang Jung-Won , Do Sang-Hwan
Published: May 2022

Background: A novel short-acting benzodiazepine, Remimazolam, has recently been approved for general anesthesia and sedation. Hence, we investigated the feasibility and safety of remimazolam during the induction and maintenance of general anesthesia without using a neuromuscular blocking agent (NMBA) in patients undergoing hysteroscopic surgery.Methods: This prospective observational study included 38 patients undergoing hysteroscopic surgery. Remimazolam and remifentanil were the main anesthetic agents without an NMBA, and a supraglottic airway was inserted to protect the airway. The induction time, amount of each anesthetic agent used during anesthesia, intraoperative bispectral index (BIS) hemodynamic parameters, and recovery profiles were measured. Results: General anesthesia was successfully administered to 37 patients using remimazolam and remifentanil without NMBA. The induction doses of remimazolam and remifentanil were 0.4 mg/kg (interquartile range [IQR] 0.34–0.47 mg/kg) and 1.07 μg/kg (IQR, 0.90–1.29 μg/kg), respectively. Additionally, the maintenance doses of remimazolam and remifentanil were 1.14 mg/kg/h (IQR, 0.88–1.55 mg/kg/h) and 0.06 μg/kg/min (IQR, 0.04–0.08 μg/kg/min), respectively. Intraoperative BIS values had risen temporarily >60 in eight patients (21.6%) despite administration of 2 mg/kg/h of remimazolam; thus, they were treated with supplementary midazolam. The median recovery time was 7 min (IQR, 5–8 min) after approximately 40 min (IQR, 40.0–57.5 min). There was no correlation between the infusion dose of remimazolam and recovery profiles, such as recovery time, recovery BIS, modified observer assessment of alertness/sedation (OAA/S) scale in the post-anesthesia care unit (PACU), post-anesthesia recovery (PAR) score in the PACU, and length of stay in the PACU (all P>0.05).Conclusion: Remimazolam can be combined with remifentanil without an NMBA in female patients who undergo hysteroscopic surgery, during which a supraglottic airway is a feasible method to protect the airway.Trial registration: The study protocol was registered at ClinicalTrials.gov (NCT05025410) on 27/08/2021.
Development and internal validation of an improved prognostic model with limited resources (Broaln-MEWS) for predicting 28-day mortality of critical illness: a retrospective cohort study
Authors: Zhang Xianming , yang Rui , Tan Yuanfei , Zhou Yaoliang , Lu Biyun , Ji Xiaoying , chen Hongda , Cai Jinwen
Published: May 2022

Background
Prognostic models in intensive care unit (ICU) were extensively applied in high-income countries, but were limited in lower income countries for lack of resource. A simple prognostic model for easy use in ICU was more attractive. The modified early warning score (MEWS), age, body mass index (BMI), red cell distribution width(RDW), neutrophil to lymphocyte ratio (NLR), lactate (lac) and osmolarity were easily accessible and objective indexes in resource limited settings to predict mortality of patients in ICU. However, using these indexes alone to predict mortality has the disadvantage of insufficient diagnostic efficiency. The usefulness of a combination of these indexes to predict 28-day mortality of critical illness was unclear.
Methods
This was a retrospective cohort study of patients admitted to ICU in MIMIC-III database. A total of 44103 patients older than 14 years were randomly assigned to a development (29402 patients) or validation cohort (14701 patients). Captured variables included demographic characteristics, clinical assessments, laboratory data, acute physiology and Chronic Health Evaluation (APACHE)-II, and MEWS. After identifying independent risk factors of 28-day mortality, we developed a 28-day mortality prediction model with multivariate logistic regression in development cohort. We compared the difference among Broaln-MEWS, APACHE-II, MEWS, RDW, NLR, lac and osmolarity by using area under the receiver operating characteristic curve (AUROC) to calculate discriminative ability, Hosmer-Lemeshow C-Statistic (H/L C-statistic) to assess calibration and Brier score to evaluate accuracy. Finally, the model was validated in the validation cohort and nomogram graph was offered to fast calculate predicted mortality risk.
Results
The 28-day mortality of critical illness was 22.85% in the development cohort. Patients with increased age, MEWS, NLR, RDW, lac, osmolarity and decreased BMI at baseline exhibited higher risks of 28-day mortality. The mortality prediction model (Broaln-MEWS) that incorporated age, BMI, MEWS, RDW, NLR, lac and osmolarity had an AUROC of 0.741 for the developing data, which was higher than that of MEWS (0.669), NLR (0.634), RDW (0.591), lac (0.580), or osmolarity (0.592) alone(p < 0.000) and slightly lower than APACHE-II (0.747) (p = 0.060). The H/L C-statistic of Broaln-MEWS were equal to 9.641(p = 0.291) and Brier score was 0.103, respectively. Additionally, Broaln-MEWS model demonstrated good discriminative power in the validation group by AUROC that was 0.744 (p < 0.000)
Conclusion
The Broaln-MEWS model had higher predictive value for 28-day prognosis in critically illness, which was used easily in resource limited settings.
Women empowerment and Health insurance utilisation in Rwanda: a nationwide cross-sectional survey
Authors: Kawuki Joseph , Gatasi Ghislaine , Sserwanja Quraish
Published: May 2022

Background: Health insurance coverage is one of the several measures being implemented to reduce the inequity in access to quality health services among the vulnerable groups. Moreover, women empowerment has been viewed as a cost-effective strategy for the reduction of maternal and child morbidity and mortality, as it enables women tackle the barriers to accessing healthcare. Our study aims at examining the prevalence of health insurance utilisation and its association with women empowerment among Rwandan women. Methods: We used Rwanda Demographic and Health Survey (RDHS) 2020 data of 14,634 women aged 15 to 49 years. Multistage stratified sampling was used to select study participants and we conducted multivariable logistic regression to establish the association between women empowerment and health insurance utilisation using SPSS version 25. Results: Out of the 14,634 women, 12095 (82.6%) (95% CI: 82.0-83.2) were using or had subscribed to health insurance, and the majority (77.2%) were covered by mutual/community organization insurance. Women empowerment indicators significantly associated with health insurance utilisation were; exposure to mass media, decision making and economic empowerment. Low decision making (AOR=1.195, 95% CI: 0.897-1.592), and low economic empowerment (AOR=1.128, 95% CI: 0.986-1.290) had a positive association with health insurance coverage, while high exposure to media had a negative association (AOR=0.664, 95% CI: 0.522-0.845). Other factors that were significant include; educational level, wealth index, residence, region, household size, and household head.Conclusions: Improving women's access to health facilities as well as media material tailored to the specific knowledge gaps could significantly increase enrolment rates of Rwandan women to health insurance.
Restriction policies and effects of COVID-19 pandemic in environment: analysis and role of sustainable technology to cope with future pandemics
Authors: Coccia Mario
Published: May 2022

Restriction or containment policies (e.g., business and workplace closures, travel bans and restrictions, compulsory facemask coverings, mandatory vaccinations, etc.) can prevent high numbers of Coronavirus Disease 2019 (COVID-19) related infected individuals and deaths. However, one of the critical questions is varying degrees of strictness in containment policies to cope with negative effects of COVID-19 pandemic crisis in environment and society. This study confronts the question here by developing a comparative analysis between countries with high and low levels of strictness in containment measures to assess the effectiveness of their policy responses to cope with high numbers of infections and deaths of COVID-19 in society. A homogenous sample of 31 countries having a level of Gross Domestic Product (GDP) per capita higher than U$16,000 are categorized in two sets: countries with high or low containment index (100 = highest restrictions and strictness). The findings here seem to be that countries with a containment index lower than 50 (i.e., lower degree of strictness) have average COVID-19 confirmed cases on population (24.69% vs. 26.06%) and fatality rates (74.33% vs = 76.38%) lower than countries with high level of containment index (about 60). This empirical evidence reveals that government responses based on high degrees of strictness seem to be ineffective to cope with COVID-19 pandemic crisis because can create socioeconomic issues. This study suggests that one of the best strategy of prevention of high numbers of deaths of new airborne diseases generating respiratory disorders is based on high levels of investment in health sector and in particular, high investments in new sustainable technology of medical ventilators that can reduce negative effects of emerging infectious diseases similar to COVID-19, when specific drugs lack and/or need months or years for process of drug discovery.
Biomedical Named Entity Recognition with the Combined Feature Attention and Fully-Shared Multi-Task Learning
Authors: Zhang Zhiyu , Chen Arbee L.P.
Published: May 2022

Background: Biomedical named entity recognition (BioNER) is a basic and important task for biomedical text mining with the purpose of automatically recognizing and classifying biomedical entities. The performance of BioNER systems directly impact on downstream applications. Recently, deep neural networks, especially pre-trained language models, have made great progress for BioNER. However, because of the lack of high-quality and large-scale annotated data and relevant external knowledge, the capability of the BioNER system remains limited.Results: In this paper, we propose a novel fully-shared multi-task learning model based on the pre-trained language model in biomedical domain, namely BioBERT, with a new attention module to integrate the auto-processed syntactic information for the BioNER task. We have conducted numerous experiments on seven benchmark BioNER datasets. The proposed best multi-task model obtains F1 score improvements of 1.03% on BC2GM, 0.91% on NCBI-disease, 0.81% on Linnaeus, 1.26% on JNLPBA, 0.82% on BC5CDR-Chemical, 0.87% on BC5CDR-Disease, and 1.10% on Species-800 compared to the single-task BioBERT model. Conclusion: The results demonstrate our model outperforms previous studies on all datasets. Further analysis and case studies are also provided to prove the importance of the proposed attention module and fully-shared multi-task learning method used in our model.
Risk factors of postoperative hypoxemia after shoulder arthroscopic surgery: a single-center retrospective study
Authors: Chen Wenchao , Yu Guojun , Ning Fanyou , Yuan Zhe
Published: May 2022

Background
Shoulder arthroscopic surgery has become the first choice for the surgical treatment of a variety of shoulder diseases. In previous studies, the incidence of hypoxemia after shoulder arthroscopic surgery was 12.6% and 16%, which is usually accompanied by several unfavourable consequences, including prolonged ventilator support, increased hospital length of stay, increased intensive care unit length of stay, and higher perioperative mortality. The Purpose of this study is to identify independent risk factors of postoperative hypoxemia in the post anesthesia care unit(PACU)after shoulder arthroscopic surgery.
Methods
This was a single-center retrospective study including 358 patients undergoing shoulder arthroscopic surgery between January 2020 and January 2021 at LuoYang Orthopedic Hospital of Henan Province Orthopedic Hospital of Henan Province. The relative factors of postoperative hypoxemia were tested through descriptive analysis and logistic regression, and the independent risk factors were obtained.
Results
The incidence of postoperative hypoxemia was 14.0% in our study. Through descriptive analysis and logistic regression, the independent risk factors of postoperative hypoxemia were as follows: age[odd ratio(OR)=1.069, 95% confidence interval (CI) = 1.012–1.129,P = 0.018]、body mass index (BMI) (OR = 1.425,95% CI = 1.250–1.626,P = 0.000、operating time (OR = 1.011,95%CI = 1.000-1.021,P = 0.041) irrigation fluid volume (OR = 1.093,95%CI 1.033–1.156,P = 0.002) .
Conclusion
Age, BMI, operating time, irrigation fluid volume were 4 independent risk factors for postoperative hypoxemia in the PACU after shoulder arthroscopic surgery.
Evaluation and countermeasures of the contracted services of Chinese family doctors from the perspective of demanders -- a case study of a city
Authors: Liu Songyi , Meng Wenqi , Yu Qianqian , Peng Haibo , Jiang Xiaoli , Li Zixin , Yin Wenqiang , Chen Zhongming , Ma Dongping , Sun Kui
Published: May 2022

Background: From the perspective of the demander, the purpose of the study is to find out the weak link of the family doctor contracted service in a city, that is, to optimize the effect of the family doctor contracted service in China.Methods: In this study, a city in Shandong Province, China was selected as the sample city. In January 2020, 1098 contracted residents (including 40.5% men and 59.5% women) from 18 primary medical institutions (including township health centers and community health centers) were selected for on-site investigation. The PCAT-AS scale revised in Chinese was used as the research tool to understand the treatment experience of contracted residents in primary medical institutions.Results: Among the four core dimensions of PCAT-AS, the score of Continuous was the highest (3.44 ± 0.58); The score of Coordinated was the lowest (3.08 ± 0.66); Among the three derived dimensions, the score of Family-centeredness was the highest (3.33 ± 0.65); The score of Culturally-competent was the lowest (2.93 ± 0.77). The PCAT scores of contracted residents with different demographic characteristics such as contracted institution, age, education level, marital status and occupation were statistically significant (P < 0.05).Conclusions: The family doctor contracted service in the city has achieved certain results. At the same time, there are still some problems, such as difficult access to outpatient services during nonworking hours and incomplete service items. It is suggested that primary medical institutions further improve their service capacity in the dimensions of Coordinated and Comprehensiveness, in order to provide better services for contracted residents.
Prevalence and management of dysphagia in Nursing Home Residents in Europe and Israel: the SHELTER Project
Authors: Dell’Aquila Giuseppina , Peladic Nikolina Jukic , Nunziata Vanessa , Fedecostante Massimiliano , Salvi Fabio , Carrieri Barbara , Liperoti Rosa , Carfì Angelo , Eusebi Paolo , Onder Graziano , Orlandoni Paolo , Cherubini Antonio
Published: May 2022

Background
Dysphagia is a frequent condition in older nursing home residents (NHRs) which may cause malnutrition and death. Nevertheless, its prevalence is still underestimated and there is still debate about the appropriateness and efficacy of artificial nutrition in subjects with severe dysphagia. The objective assesses the prevalence of dysphagia in European and Israeli NHRs, its association with mortality, and the relationship of different nutritional interventions, i.e. texture modified diets and artificial nutrition (AN) - with weight loss and mortality.
Methods
A prospective observational study three thousand fifty one European and Israeli NHRs older than 65 years, participating in the SHELTER study from 2009 to 2011, at baseline and after 12 months. All residents underwent a standardized comprehensive evaluation using the interRAI Long Term Care Facility (LTCF). Cognitive status was assessed using the Cognitive Performance Scale (CPS), functional status using Activities of Daily Living (ADL) Hierarchy scale. Trained staff assessed dysphagia at baseline by clinical observation. Data on weight loss were collected for all participants at baseline and after 12 months. Deaths were registered by nursing home staff.
Results
The prevalence of dysphagia was 30,3%. During the one-year follow-up, the mortality rate in subjects with dysphagia was significantly higher compared with that of non-dysphagic subjects (31.3% vs 17.0% (p = 0,001). The multivariate analysis showed that NHRs with dysphagia had 58% higher risk of death within 1 year compared with non-dysphagic subjects (OR 1.58, 95% CI, 1.31–1.91). The majority of NHRs with dysphagia were prescribed texture modified diets (90,6%), while AN was used in less than 10% of subjects. No statistically significant difference was found concerning weight loss and mortality after 12 months following the two different nutritional treatments.
Conclusions
Dysphagia is prevalent among NHRs and it is associated with increased mortality, independent of the nutritional intervention used. Noticeably, after 12 months of nutritional intervention, NHRs treated with artificial nutrition had similar mortality and weight loss compared to those who were treated with texture modified diets, despite the clinical conditions of patients on artificial nutrition were more compromised.