bluuebunny/crossref_metadata_2025 huggingface dataset:
Pyrexia of unknown origin (PUO) and the cost of care in a tertiary care institute in Sri Lanka
Authors: Premathilaka Rusiru , Darshana Thamal , Ekanayake Chanil , Chathurangani Kossinnage Chethana , Mendis Iroshan , Perinparajah Sajeethan , Shashiprabha Madhushini , Nishshanka Sachith , Tilakaratna Yasoma , Premawardhena Anuja
Published: February 2023

Background

Despite advancements in diagnostic technology, pyrexia of unknown origin (PUO) remains a clinical concern. Insufficient information is available regarding the cost of care for the management of PUO in the South Asian Region.

Methods

We retrospectively analyzed data of patients with PUO from a tertiary care hospital in Sri Lanka to determine the clinical course of PUO and the burden of the cost incurred in the treatment of PUO patients. Non-parametric tests were used for statistical calculations.

Results

A total of 100 patients with PUO were selected for the present study. The majority were males (n = 55; 55.0%). The mean ages of male and female patients were 49.65 (SD: 15.55) and 46.87 (SD: 16.19) years, respectively. In the majority, a final diagnosis had been made (n = 65; 65%). The mean number of days of hospital stay was 15.16 (SD; 7.81). The mean of the total number of fever days among PUO patients was 44.47 (SD: 37.66). Out of 65 patients whose aetiology was determined, the majority were diagnosed with an infection (n = 47; 72.31%) followed by non-infectious inflammatory disease (n = 13; 20.0%) and malignancies (n = 5; 7.7%). Extrapulmonary tuberculosis was the most common infection detected (n = 15; 31.9%). Antibiotics had been prescribed for the majority of the PUO patients (n = 90; 90%). The mean direct cost of care per PUO patient was USD 467.79 (SD: 202.81). The mean costs of medications & equipment and, investigations per PUO patient were USD 45.33 (SD: 40.13) and USD 230.26 (SD: 114.68) respectively. The cost of investigations made up 49.31% of the direct cost of care per patient.

Conclusion

Infections, mainly extrapulmonary tuberculosis was the most common cause of PUO while a third of patients remained undiagnosed despite a lengthy hospital stay. PUO leads to high antibiotic usage, indicating the need for proper guidelines for the management of PUO patients in Sri Lanka. The mean direct cost of care per PUO patient was USD 467.79. The cost of investigations contributed mostly to the direct cost of care for the management of PUO patients.
Causal relationship between gut microbiota and cancers: a two-sample Mendelian randomisation study
Authors: Long Yiwen , Tang Lanhua , Zhou Yangying , Zhao Shushan , Zhu Hong
Published: February 2023

Background

Evidence from observational studies and clinical trials suggests that the gut microbiota is associated with cancer. However, the causal association between gut microbiota and cancer remains to be determined.

Methods

We first identified two sets of gut microbiota based on phylum, class, order, family, and genus level information, and cancer data were obtained from the IEU Open GWAS project. We then performed two-sample Mendelian randomisation (MR) to determine whether the gut microbiota is causally associated with eight cancer types. Furthermore, we performed a bi-directional MR analysis to examine the direction of the causal relations.

Results

We identified 11 causal relationships between genetic liability in the gut microbiome and cancer, including those involving the genus Bifidobacterium. We found 17 strong associations between genetic liability in the gut microbiome and cancer. Moreover, we found 24 associations between genetic liability in the gut microbiome and cancer using multiple datasets.

Conclusions

Our MR analysis revealed that the gut microbiota was causally associated with cancers and may be useful in providing new insights for further mechanistic and clinical studies of microbiota-mediated cancer.
Identification of RimR2 as a positive pathway-specific regulator of rimocidin biosynthesis in Streptomyces rimosus M527
Authors: Li Huijie , Hu Yefeng , Zhang Yongyong , Ma Zheng , Bechthold Andreas , Yu Xiaoping
Published: February 2023

Background

Streoptomyces rimosus M527 is a producer of the polyene macrolide rimocidin which shows activity against various plant pathogenic fungi. Notably, the regulatory mechanisms underlying rimocidin biosynthesis are yet to be elucidated.

Results

In this study, using domain structure and amino acid alignment and phylogenetic tree construction, rimR2, which located in the rimocidin biosynthetic gene cluster, was first found and identified as a larger ATP-binding regulators of the LuxR family (LAL) subfamily regulator. The rimR2 deletion and complementation assays were conducted to explore its role. Mutant M527-ΔrimR2 lost its ability to produce rimocidin. Complementation of M527-ΔrimR2 restored rimocidin production. The five recombinant strains, M527-ER, M527-KR, M527-21R, M527-57R, and M527-NR, were constructed by overexpressing rimR2 gene using the promoters permE*, kasOp*, SPL21, SPL57, and its native promoter, respectively, to improve rimocidin production. M527-KR, M527-NR, and M527-ER exhibited 81.8%, 68.1%, and 54.5% more rimocidin production, respectively, than the wild-type (WT) strain, while recombinant strains M527-21R and M527-57R exhibited no obvious differences in rimocidin production compared with the WT strain. RT-PCR assays revealed that the transcriptional levels of the rim genes were consistent with the changes in rimocidin production in the recombinant strains. Using electrophoretic mobility shift assays, we confirmed that RimR2 can bind to the promoter regions of rimA and rimC.

Conclusion

A LAL regulator RimR2 was identified as a positive specific-pathway regulator of rimocidin biosynthesis in M527. RimR2 regulates the rimocidin biosynthesis by influencing the transcriptional levels of rim genes and binding to the promoter regions of rimA and rimC.
Assessing contraceptive use as a continuum: outcomes of a qualitative assessment of the contraceptive journey
Authors: Simmons Rebecca G. , Baayd Jami , Waters Megan , Diener Zoë , Turok David K. , Sanders Jessica N.
Published: February 2023

Background

Contraceptive use is often a multi-decade experience for people who can become pregnant, yet few studies have assessed how this ongoing process impacts contraceptive decision-making in the context of the reproductive life course.

Methods

We conducted in-depth interviews assessing the contraceptive journeys of 33 reproductive-aged people who had previously received no-cost contraception through a contraceptive initiative in Utah. We coded these interviews using modified grounded theory.

Results

A person’s contraceptive journey occurred in four phases: identification of need, method initiation, method use, and method discontinuation. Within these phases, there were five main areas of decisional influence: physiological factors, values, experiences, circumstances, and relationships. Participant stories demonstrated the ongoing and complex process of navigating contraception across these ever-changing aspects. Individuals stressed the lack of any “right” method of contraception in decision-making and advised healthcare providers to approach contraceptive conversations and provision from positions of method neutrality and whole-person perspectives.

Conclusions

Contraception is a unique health intervention that requires ongoing decision-making without a particular “right” answer. As such, change over time is normal, more method options are needed, and contraceptive counseling should account for a person’s contraceptive journey.
Clear cell renal cell carcinoma with cystic component similar to multilocular cystic renal neoplasm of low malignant potential: a rare pattern of cyst-dependent progression from multilocular cystic renal neoplasm of low malignant potential
Authors: Yang Bo , Sun Lin , Cao Wen-feng , Qi Li-sha , Guo Yu-hong , Sun Yan
Published: February 2023

Background

For clear cell renal cell carcinoma (ccRCC) with cystic component similar to multilocular cystic renal neoplasm of low malignant potential (MCRN-LMP) and solid low-grade component simultaneously, we propose the designation “ccRCC with cystic component similar to MCRN-LMP” and to study the relationship between MCRN-LMP and it.

Methods

Twelve cases of MCRN-LMP and 33 cases of ccRCC with cystic component similar to MCRN-LMP were collected from 3,265 consecutive RCCs to compare them in clinicopathological features, immunohistochemical findings (PAX8, CA-IX, CK7, Vimentin, CD10, P504s, TFE3, 34βE12) and prognosis.

Results

There was no significant difference in age, sex ratio, tumor size, treatment, grade and stage between them (P > 0.05). All ccRCCs with cystic component similar to MCRN-LMP coexisted with MCRN-LMP and solid low-grade ccRCCs, and MCRN-LMP component ranged from 20 to 90% (median, 59%). The positive ratio of CK7 and 34βE12 in MCRN-LMPs and ccRCCs’ cystic parts was significantly higher than that in ccRCCs’ solid parts, but the positive ratio of CD10 in MCRN-LMPs and ccRCCs’ cystic parts was significantly lower than that in ccRCCs’ solid parts (P < 0.05). There was no significant difference of all immunohistochemistry profiles between MCRN-LMPs and ccRCCs’ cystic parts (P > 0.05). No patient developed recurrence or metastasis.

Conclusions

MCRN-LMP and ccRCC with cystic component similar to MCRN-LMP have similarity and homology in clinicopathological features, immunohistochemical findings and prognosis, and form a low-grade spectrum with indolent or low malignant potential behavior. The ccRCC with cystic component similar to MCRN-LMP may be a rare pattern of cyst-dependent progression from MCRN-LMP.
Development of a nomogram to predict surgical site infection after open reduction and internal fixation for closed pilon fracture: a prospective single-center study
Authors: Xie Lei , Liu Guofeng , Wang Xin , Luo Zixuan , Li Yansen , Wang Xiaomeng , Zhang Fengqi
Published: February 2023

Background

To explore the risk factors and develop a nomogram in order to predict surgical site infection (SSI) after open reduction and internal fixation (ORIF) for closed pilon fractures (CPF).

Methods

A prospective cohort study with one-year follow-up was carried out in a provincial trauma center. From January 2019 to January 2021, 417 adult patients with CPFs receiving ORIF were enrolled. A Whitney U test or t test, Pearson chi-square test, and multiple logistic regression analyses were gradually used for screening the adjusted factors of SSI. A nomogram model was built to predict the risk of SSI, and the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used for evaluating the prediction performance and consistency of the nomogram model. The bootstrap method was employed to test the validity of the nomogram.

Results

The incidence of SSI after ORIF for CPFs was 7.2% (30/417): 4.1% (17/417) of superficial SSIs and 3.1% (13/417) of deep SSIs. The most common pathogenic bacteria were Staphylococcus aureus (36.6%, 11/30). The multivariate analysis showed tourniquet use, longer preoperative stay, lower preoperative albumin (ALB), higher preoperative body mass index (BMI) and hypersensitive C-reactive protein (Hs-CRP) were independent risk factors of SSI. Additionally, the C-index and bootstrap value of the nomogram model were 0.838 and 0.820, respectively. Finally, the calibration curve indicated that the actual diagnosed SSI had good consistency with the predicted probability, and the DCA showed that the nomogram had clinical value.

Conclusions

Tourniquet use, longer preoperative stay, lower preoperative ALB, higher preoperative BMI and Hs-CRP were five independent risk factors of SSI after closed pilon fractures treated by ORIF. These five predictors are shown on the nomogram, with which we may be able to further prevent the CPS patients from SSI.

Trial registration NO 2018-026-1, October /24/2018, prospectively registered. The study was registered in October 24, 2018. The study protocol was designed based on the Declaration of Helsinki and admitted by the Institutional Review Board. The ethics committee approved the study on factors related to fracture healing in orthopedic surgery. Data analyzed in the present study were acquired from the patients who underwent open reduction and internal fixation from January 2019 to January 2021.
Treatment of rigid post-traumatic thoracolumbar kyphosis by a novel technique of spinal joints release
Authors: Wang Qing , Tang Chao , Wang GaoJu , Li GuangZhou , Zhong DeJun , Wang Song , Ma Fei
Published: February 2023

Objective

The purpose of this study was to evaluate the feasibility of a novel technique named spinal joints release (SJR) and observe its efficacy in treating rigid post-traumatic thoracolumbar kyphosis (RPTK).

Methods

RPTK patients who were treated by SJR with facet resection, limited laminotomy, clearance of the intervertebral space, and release of the anterior longitudinal ligament through the intervertebral foramen and disc of injury segment from August 2015 to August 2021 were reviewed. Intervertebral space release, internal fixation segment, operation time, and intraoperative blood loss were recorded. The intraoperative, postoperative, and final follow-up complications were observed. An improvement in the VAS score and ODI index was observed. Spinal cord functional recovery was evaluated by American Spinal Injury Association Impairment Scale (AIS). Improvement of local kyphosis (Cobb angle) was evaluated by radiography.

Results

Forty-three patients were successfully treated by the SJR surgical technique. Open-wedge anterior intervertebral disc space was performed in 31 cases, and repeated release and dissection of the anterior longitudinal ligament and callus were performed in 12 cases. There was no lateral annulus fibrosis release in 11 cases, the anterior half release of lateral annulus fibrosis in 27 cases, and complete release in five cases. There were five cases of screw placement failure in one or two side pedicles of the injured vertebrae due to excessive resection of the facets and improper pre-bending of the rod. Sagittal displacement occurred in four cases at the released segment due to the complete release of bilateral lateral annulus fibrosus. Autologous granular bone + Cage was implanted in 32 cases, and autologous granular bone was implanted in 11 cases. There were no serious complications. The average operation time was 224 ± 31 min, and intraoperative blood loss was 450 ± 225 mL. All the patients were followed up with an average of 26 ± 8.5 months. The VAS scores and ODI index improved significantly at the final follow-up. All of the 17 patients with incomplete spinal cord injury achieved more than one grade of neurological recovery at the final follow-up. An 87% correction rate of kyphosis was achieved and maintained, with the Cobb angle decreasing from 27.7° preoperatively to 5.4° at the final follow-up.

Conclusion

Posterior SJR surgery for patients with RPTK has the advantages of less trauma and less blood loss, and kyphosis correction is satisfactory.
The bronchiolitis epidemic in 2021–2022 during the SARS-CoV-2 pandemic: experience of a third level centre in Northern Italy
Authors: Faraguna Martha Caterina , Lepri Irene , Clavenna Antonio , Bonati Maurizio , Vimercati Chiara , Sala Debora , Cattoni Alessandro , Melzi Maria Luisa , Biondi Andrea
Published: February 2023

Background

The aim of this study is to compare the 2021–2022 bronchiolitis season to the four previous years (2017–2018, 2018–2019, 2019–2020, 2020–2021) to see if there was an anticipation of the peak, an overall increase of cases, and an increased need of intensive care.

Methods

A retrospective single-centre study in the San Gerardo Hospital Fondazione MBBM, Monza, Italy was performed. Emergency Departments (ED) visits of patients aged < 18 years and ≤ 12 months were analyzed: the incidence of bronchiolitis on total assessments, the urgency level at triage and the hospitalization rate were compared. Data of children admitted to the Pediatric Department due to bronchiolitis were analyzed in terms of need of intensive care, respiratory support (type and duration), length of hospital stay, main etiological agent, patient characteristics.

Results

During 2020–2021 (first pandemic period) an important reduction in the ED attendance for bronchiolitis was observed, while in 2021–2022 there was an increase in incidence of bronchiolitis (13% of visits in infants < 1 year) and in the rate of urgent accesses (p = 0.0002), but hospitalization rates did not differ compared to previous years. Furthermore, an anticipated peak in November 2021 was observed. In the 2021–2022 cohort of admitted children to the Pediatric Department, a statistically significative increased need of intensive care unit was detected (Odds Ratio 3.1, 95% CI 1.4–6.8 after adjustment for severity and clinical characteristics). Instead, respiratory support (type and duration) and length of hospital stay did not differ. RSV was the main etiological agent and RSV-bronchiolitis determined a more severe infection (type and duration of breathing support, intensive care need and length of hospital stay).

Conclusions

During Sars-CoV-2 lockdowns (2020–2021), there was a dramatic decrease of bronchiolitis and others respiratory infections. In the following season, 2021–2022, an overall increase of cases with an anticipated peak was observed and data analysis confirmed that patients in 2021–2022 required more intensive care than children in the four previous seasons.
Improved wild horse optimization with levy flight algorithm for effective task scheduling in cloud computing
Authors: Saravanan G. , Neelakandan S. , Ezhumalai P. , Maurya Sudhanshu
Published: February 2023

Cloud Computing, the efficiency of task scheduling is proportional to the effectiveness of users. The improved scheduling efficiency algorithm (also known as the improved Wild Horse Optimization, or IWHO) is proposed to address the problems of lengthy scheduling time, high-cost consumption, and high virtual machine load in cloud computing task scheduling. First, a cloud computing task scheduling and distribution model is built, with time, cost, and virtual machines as the primary factors. Second, a feasible plan for each whale individual corresponding to cloud computing task scheduling is to find the best whale individual, which is the best feasible plan; to better find the optimal individual, we use the inertial weight strategy for the Improved whale optimization algorithm to improve the local search ability and effectively prevent the algorithm from reaching premature convergence. To deliver services and access to shared resources, Cloud Computing (CC) employs a cloud service provider (CSP). In a CC context, task scheduling has a significant impact on resource utilization and overall system performance. It is a Nondeterministic Polynomial (NP)-hard problem that is solved using metaheuristic optimization techniques to improve the effectiveness of job scheduling in a CC environment. This incentive is used in this study to provide the Improved Wild Horse Optimization with Levy Flight Algorithm for Task Scheduling in cloud computing (IWHOLF-TSC) approach, which is an improved wild horse optimization with levy flight algorithm for cloud task scheduling. Task scheduling can be addressed in the cloud computing environment by utilizing some form of symmetry, which can achieve better resource optimization, such as load balancing and energy efficiency. The proposed IWHOLF-TSC technique constructs a multi-objective fitness function by reducing Makespan and maximizing resource utilization in the CC platform. The IWHOLF-TSC technique proposed combines the wild horse optimization (WHO) algorithm and the Levy flight theory (LF). The WHO algorithm is inspired by the social behaviours of wild horses. The IWHOLF-TSC approach's performance can be validated, and the results evaluated using a variety of methods. The simulation results revealed that the IWHOLF-TSC technique outperformed others in a variety of situations.
A shift in focus: Mothers’ descriptions of sharing a child with a co-parent with unhealthy alcohol use after participating in a support program
Authors: Siljeholm Ola , Ekström Veronica
Published: February 2023

Background

Unhealthy alcohol use (UAU) affects not only the drinking individual, but also significant others (SOs), such as partners and children. Most of the harm to others caused by alcohol can be attributed to common, moderate drinking patterns, but existing studies have mainly included SOs of individuals with severe UAU. There is a need for increased knowledge regarding SOs of individuals in an earlier stage of UAU and efficacious support programs for this group. The aims of this study were to investigate reasons for seeking support as described by SOs sharing a child with a co-parent with UAU and to investigate how SOs perceived effects of a web-based self-delivered support program.

Methods

A qualitative design conducting semi-structured interviews with 13 female SOs sharing a child with a co-parent with UAU. The SOs were recruited from a randomized controlled trial of the web-based program and had completed at least two of four modules in the program. Transcribed interviews were analyzed using conventional qualitative content analysis.

Results

Regarding reasons for seeking support, we created four categories and two subcategories. Main reasons were wanting validation/emotional support and coping strategies for handling the co-parent, and negative perceptions of available support options for SOs. Regarding perceived effects of the program, we created three categories and three subcategories. Main effects were an improved relationship to their children, increased own positive activities, and less adaptation to the co-parent, though SOs also mentioned what was perceived as missing in the program. We argue that the interviewees represent a population of SOs living with co-parents with slightly less severe UAU than previous studies and therefore provide new insights for future interventions.

Conclusions

The web-based approach with potential anonymity was important for facilitating support-seeking. Support for the SOs themselves and coping strategies for co-parent alcohol consumption were more common reasons for seeking help than worry about the children. For many SOs, the program was a first step in seeking further support. Spending more dedicated time with their children and being validated as living under stressful conditions were described by the SOs as particularly helpful.

Trial registration The trial was pre-registered at isrctn.com, reference number ISRCTN38702517, November 28, 2017
Experiment to distinguish two fumaroles consistently emanating infrasound at Kirishima Iwo-Yama
Authors: Yamakawa Kazuya , Ichihara Mie , Muramatsu Dan , Matsushima Takeshi , Takahashi Hidetoshi , Wada Ruka , Shimoyama Isao
Published: February 2023

In the infrasonic observation of a fumarolic field, distinguishing multiple fumarolic sources is challenging. The array technique effectively estimates the source locations and identifies the target signal from other signals and noise. We conducted an experiment at Kirishima Iwo-Yama, Japan, where two active fumarolic areas were separated by ~ 450 m. A three-element array with an aperture of ~ 20 m was installed between the two fumarolic areas. In addition, a single microphone was installed near one of the fumaroles. The array combined with the waveform correlation analysis estimated the most prominent source but failed to estimate the other weak source. A joint analysis of the array and the single microphone effectively resolved the two sources. It was also confirmed that newly developed power-saving MEMS microphones were useful for observing the fumaroles. This paper presents the instrumentation and analytical method that would be beneficial for monitoring volcanoes that have multiple hydrothermally active vents.

Graphical Abstract
Performance characteristic of a PV module as influenced by dust accumulation: theory versus experiment
Authors: Kamal Reham , Abdel-Salam Mazen , Nayel Mohamed
Published: February 2023

This paper is aimed at assessing by theory and experiment the current–voltage and power-voltage characteristics of a PV module as influenced by dust accumulation. A method is proposed in a computer code to follow-up an incident solar radiation through the module layers considering the reflection and transmission of radiation at the interfaces between the layers to evaluate how the incident radiation is attenuated before reaching the module. Also, absorption of radiation in the dust layer and the glass cover is considered. The evaluation of the reflectance and transmittance calls for analysis of the accumulated dust to identify its constituents using X-ray fluorescence apparatus. The refractive and absorption indices are assessed for dust constituents as well as the corresponding effective values for the sample as a whole. The current–voltage characteristic of the dusty module is calculated using Simulink with consideration of module parameters after being corrected according to the incident radiation received by the solar cell and the ambient temperature where the module is installed. The calculated current–voltage and power-voltage characteristics of the dusty module agreed reasonably with the measured ones for a 175-W module as the incident radiation decreased to 68% due to dust accumulation with a subsequent decrease of the maximum output power of dusty module by 31% when compared with the clean one. The percentage decrease of short-circuit current recorded 31% due to dust deposition against 2% for the increase of open-circuit voltage at ambient temperature of 44 °C and incident solar radiation of 1027 W/m2. This conforms to previous findings in the literature.
Two-dimensional echocardiographic and strain values of the proximal thoracic aorta in a normal sub-Saharan African population
Authors: Meel Ruchika , Blair Kelly
Published: February 2023

Background

There is limited data regarding reference ranges for aortic dimensions in African populations. This study aims to establish normal reference ranges for echocardiographic dimensions and circumferential strain (CS) of the proximal thoracic aorta in a healthy sub-Saharan African population.

Methods

This was a secondary analysis of data from a prospective cross-sectional study of 88 participants conducted at Chris Hani Baragwanath Hospital (2017–2019). Aortic measurements were obtained as per the 2015 American Society of Echocardiography guidelines using a Philips iE33 system. Circumferential Strain was measured using Philips QLAB version 11.0 software offline semi-automated analysis of speckle-based strain 2-D speckle-tracking software (Amsterdam, The Netherlands).

Results

Mean age was 37.22 ± 10.79 years (41% male). The mean diameter at the aortic annulus, sinuses, sino-tubular junction (STJ) and ascending aorta (AAO) were 19.11 ± 2.38 mm, 27.40 ± 6.11 mm, 25.32 ± 3.52 mm and 25.36 ± 3.38 mm, respectively. Males had larger absolute and indexed aortic diameters at all levels when compared to females. The mean aorta CS was 11.97 ± 5.05%. There was no significant difference in CS based on gender (12.19 ± 5.04% vs 11.51 ± 5.02%, P = 0.267). On multivariate linear regression analysis, male sex was the most significant predictor of increased diameter at the level of the aortic annulus (r = 0.17, P = 0.014), body surface area was the most significant predictor at the sinuses (r = 0.17, P = 0.014) and AAO (r = 0.30, P < 0.001), while age was the most significant predictor at the STJ (r = 0.27, P = 0.004). There was a negative correlation between age and aortic CS (r = − 0.12, P < 0.001). The most important predictor of aorta CS was age, on multivariate analysis (r = − 0.19, P = 0.024).

Conclusions

This study provides normal reference ranges for dimensions of the proximal aorta and circumferential strain (CS) in a sub-Saharan African population according to age, sex, and body habitus. It serves as a platform for future larger studies and allows for risk stratification of cardiovascular disease in an African population.
Integration of a Cross-Ancestry Polygenic Model With Clinical Risk Factors Improves Breast Cancer Risk Stratification
Authors: Tshiaba Placede T. , Ratman Dariusz K. , Sun Jiayi M. , Tunstall Tate S. , Levy Brynn , Shah Premal S. , Weitzel Jeffrey N. , Rabinowitz Matthew , Kumar Akash , Im Kate M.
Published: February 2023

PURPOSE

To develop and validate a cross-ancestry integrated risk score (caIRS) that combines a cross-ancestry polygenic risk score (caPRS) with a clinical estimator for breast cancer (BC) risk. We hypothesized that the caIRS is a better predictor of BC risk than clinical risk factors across diverse ancestry groups.

METHODS

We used diverse retrospective cohort data with longitudinal follow-up to develop a caPRS and integrate it with the Tyrer-Cuzick (T-C) clinical model. We tested the association between the caIRS and BC risk in two validation cohorts including > 130,000 women. We compared model discrimination for 5-year and remaining lifetime BC risk between the caIRS and T-C and assessed how the caIRS would affect screening in the clinic.

RESULTS

The caIRS outperformed T-C alone for all populations tested in both validation cohorts and contributed significantly to risk prediction beyond T-C. The area under the receiver operating characteristic curve improved from 0.57 to 0.65, and the odds ratio per standard deviation increased from 1.35 (95% CI, 1.27 to 1.43) to 1.79 (95% CI, 1.70 to 1.88) in validation cohort 1 with similar improvements observed in validation cohort 2. We observed the largest gain in positive predictive value using the caIRS in Black/African American women across both validation cohorts, with an approximately two-fold increase and an equivalent negative predictive value as the T-C. In a multivariate, age-adjusted logistic regression model including both caIRS and T-C, caIRS remained significant, indicating that caIRS provides information over T-C alone.

CONCLUSION

Adding a caPRS to the T-C model improves BC risk stratification for women of multiple ancestries, which could have implications for screening recommendations and prevention.
Monitoring cone-beam CT radiation dose levels in a University Hospital
Authors: Brasil Danieli Moura , Merken Karen , Binst Joke , Bosmans Hilde , Haiter-Neto Francisco , Jacobs Reinhilde
Published: February 2023

Objective:

To present patient dose levels for different CBCT scanners, acquired by a dose monitoring tool in a University Hospital, as a function of field of view (FOV), operation mode, and patient age.

Methods:

An integrated dose monitoring tool was used to collect radiation exposure data [type of CBCT unit, dose-area product (DAP), FOV size, and operation mode] and patient demographic information (age, referral department) performed on a 3D Accuitomo 170 and a Newtom VGI EVO unit. Effective dose conversion factors were calculated and implemented into the dose monitoring system. For each CBCT unit, the frequency of examinations, clinical indications, and effective dose levels were obtained for different age and FOV groups, and operation modes.

Results:

A total of 5163 CBCT examinations were analyzed. Surgical planning and follow-up were the most frequent clinical indications. For the standard operation mode, effective doses ranged from 35.1 to 300 µSv and 9.26-117 µSv using 3D Accuitomo 170 and Newtom VGI EVO, respectively. In general, effective doses decreased with increasing age and FOV size reduction.

Conclusions:

Effective dose levels varied notably between systems and operation modes.Operation mode selection and FOV size were indication-oriented, with larger FOV sizes election serving surgical planning and follow-up. Seeing the influence of FOV size on effective dose levels, manufacturers could be advised to move toward patient-specific collimation and dynamic FOV selection. Systematically monitoring patient doses could be recommended for steering future CBCT optimization.
Analysis and detection of deviant and malicious behaviors in social media and beyond
Authors: Λυκουσάς Νικόλαος
Published: February 2023

Σκοπός αυτής της διατριβής είναι να αναδείξει και να κατανοήσει διάφορες πτυχές κακόβουλων συμπεριφορών τόσο στον κόσμο των μέσων κοινωνικής δικτύωσης όσο και στον κόσμο του κυβερνοεγκλήματος. Συγκεκριμένα, η παρούσα μελέτη απαρτίζεται από δύο μέρη. Το πρώτο μέρος εστιάζεται στην μελέτη αποκλινουσών συμπεριφορών συνυφασμένων με την παραγωγή και κατανάλωση πορνογραφικού υλικού σε κοινωνικά δίκτυα ζωντανής µετάδοσης εικονοροών (Social Live Streaming Services - SLSS). Τα εν λόγω δίκτυα επιτρέπουν στους χρήστες να μοιράζονται την καθημερινότητά τους μέσω της κάμερας των κινητών συσκευών τους. Το επίπεδο διεπαφής που προσφέρουν τέτοιες πλατφόρμες, σε συνδυασμό με την αδυναμία επαλήθευσης της ηλικίας των χρηστών τους καθώς και την έλλειψη αποτελεσματικών μέσων επιβολής των κανόνων ασφαλούς χρήσης τους, δίνει σε κακόβουλους χρήστες τη δυνατότητα να προσεγγίζουν ευάλωτα άτομα (π.χ. ανηλίκους) με απώτερο σκοπό την αποπλάνηση και τη σεξουαλική εκμετάλλευσή τους. Στα πλαίσια αυτής της διατριβής έγινε εκτενής μελέτη συναφών συμπεριφορών σε δύο κοινωνικά δίκτυα αυτής της κατηγορίας, από τα οποία συλλέχθηκε μεγάλος όγκος από αλληλεπιδράσεις μεταξύ χρηστών. Τα δεδομένα που προέκυψαν, κατόπιν αναλύθηκαν ώστε να μοντελοποιηθούν τέτοιας φύσης παραβατικές συμπεριφορές και να “αποκρυπτογραφηθούν” τα μοτίβα επικοινωνίας κακόβουλων χρηστών που έχουν διαμορφωθεί με τρόπο τέτοιο ώστε να παρακάμπτουν τις δικλείδες ασφαλείας που εφαρμόζονται από αυτές τις πλατφόρμες. Επίσης, η μελέτη επεκτείνεται και στην ανάλυση της παράνομης εμπορευματοποίησης και διάχυσης πορνογραφικού υλικού σε δημοφιλή μέσα κοινωνικής δικτύωσης. Το δεύτερο σκέλος της διατριβής επικεντρώνεται στον κόσμο της σύγχρονης ηλεκτρονικής εγκληματικότητας. Συγκεκριμένα, τα προϊόντα και οι επί πληρωμή υπηρεσίες που προσφέρουν κυβερνοεγκληματίες στον ιστό επιφανείας (Surface Web), εκμεταλλευόμενοι την αποκεντροποιημένη και ανώνυμη φύση που χαρακτηρίζει εμπορικές πλατφόρμες όπως το Shoppy. Τέτοια παράνομα “προϊόντα” περιλαμβάνουν κλεμμένα διαπιστευτήρια για ψηφιακές υπηρεσίες, κακόβουλο λογισμικό κ.α. Εστιάζοντας στο κακόβουλο λογισμικό, η παρούσα διατριβή επιχειρεί να συμβάλλει στην αντιμετώπιση της εξάπλωσής του, μέσω της συλλογής και ανάλυσης ενός εκτενους συνόλου διευθυνσεων που έχουν δημιουργηθεί από αλγορίθμους δημιουργίας διευθύνσεων (Domain Generation Algorithms) και χρησιμοποιούνται για την ενορχήστρωση επιθέσεων και τον απομακρυσμένο έλεγχο προσβεβλημένων συστημάτων. Επίσης, παρουσιάζει και αξιολογεί ένα νέο σύνολο χαρακτηριστικών για την αποτελεσματική ανίχνευση τους με μεθόδους μηχανικής μάθησης. Τέλος, η διατριβή σκιαγραφεί τους κινδύνους που ελλοχεύουν στον αναδυόμενο κόσμο των συστημάτων διευθυνσιοδότησης που στηρίζονται στην τεχνολογία blockchain (Blockchain DNS), αναλύοντας τα οικοσυστήματα Namecoin και Emercoin που ως επί το πλείστον γίνονται αντικείμενο κατάχρησης από κυβερνοεγκληματίες για κακόβουλους σκοπούς.
Συντομογραφίες και σύμβολα στους αρχαίους ελληνικούς παπύρους
Authors: Σούρλας Ηλίας
Published: February 2023

Η παρούσα διδακτορική διατριβή εξετάζει τα σύμβολα και τις συντομογραφίες στους αρχαίους ελληνικούς παπύρους. Η εξοικονόμηση χρόνου, χώρου ακόμα και ενέργειας αποτέλεσε το βασικότερο κίνητρο στον αρχαίο κόσμο για την εκτεταμένη χρήση συντομογραφιών και συμβόλων στους παπύρους – και όχι μόνο – κατά την παραγωγή γραπτών κειμένων μιας περιόδου, στην οποία όλα τα κείμενα ήταν χειρόγραφα. Χρησιμοποιούνταν δε τόσο από άτομα που ήταν επιφορτισμένα με την αντιγραφή φιλολογικών παπύρων όσο και από εκείνους τα κείμενα των οποίων εξυπηρετούσαν πρακτικές ανάγκες καθημερινής επικοινωνίας, διοίκησης και λογιστικής μέριμνας (π.χ. γραφείς, φοροεισπράκτορες κτλ.). Οι βραχυγραφίες και τα σύμβολα απαντούν, συνεπώς, τόσο σε λογοτεχνικούς όσο και σε μη λογοτεχνικούς παπύρους, καθώς επίσης και σε όλους τους γνωστούς φορείς γραφής της αρχαιότητας: σε πάπυρο, όστρακα, ξύλο, περγαμηνή, επιγραφές κτλ. Εκ πρώτης όψεως δε φαίνεται να υπάρχουν κανόνες κατά την παραγωγή συντομογραφιών και η συντομογράφηση των λέξεων μοιάζει να είναι λίγο έως πολύ αυθαίρετη. Ωστόσο, με μια προσεκτικότερη ματιά και καθώς η βραχυγραφία ή το σύμβολο προορίζεται να διαβαστεί από έναν διαφορετικό άνθρωπο, θεωρείται απολύτως κατανοητό ότι οτιδήποτε συντομογραφείται από τον πομπό, πρέπει επίσης να γίνεται και εύκολα κατανοητό από τον δέκτη. Εξετάζοντας κανείς παπύρους σε βάθος διαπιστώνει ότι τα συστήματα συντομογραφιών και συμβόλων που δημιουργήθηκαν προκειμένου να ικανοποιήσουν βασικές πρακτικές ανάγκες – παρά τη σποραδική εμφάνιση τυχαίων επιλογών κατά τη συντομογράφηση των λέξεων – παρουσιάζουν κατά κανόνα μεγάλες ομοιότητες μεταξύ τους, που δεν θα ήταν υπερβολή αν τις χαρακτηρίζαμε ακόμα και «συντομογραφικές συμβάσεις». Όπως η μορφή και το σχήμα των γραμμάτων αλλάζει ανά τους αιώνες, έτσι και η μορφή καθώς και οι τεχνικές και οι μέθοδοι συντομογράφησης των λέξεων μεταμορφώνονται με το πέρας του χρόνου. Η παρούσα διατριβή ασχολείται τόσο με την κατασκευή ενός εκτενούς ευρετηρίου συμβόλων και συντομογραφιών των μη λογοτεχνικών παπύρων όσο και με την κριτική εξέταση και ερμηνεία του φαινομένου, τις τεχνικές, μεθόδους και βασικές αρχές που διέπουν τη συντομογράφηση των λέξεων και τις μεταβολές αυτών κατά την πτολεμαϊκή (332 π.Χ.–31 π.Χ.) και ρωμαϊκή εποχή της Αιγύπτου (31 π.Χ.–330 μ.Χ.).
Identification d'une langue à partir des indices suprasegmentaux
Authors: Δήμου Αθανασία-Λήδα
Published: February 2023

Φωνητική μελέτη και σύγκριση δυο ιδιωμάτων της Ελληνικής (Ιδίωμα Αγιάσου Λέσβου και ιδίωμα Αθηνών). Από την συλλογή των έξι ωρών ηχογραφημένου υλικού καθενός από τα δύο ιδιώματα επιλέχθηκαν προτάσεις οι οποίες αποτέλεσαν το υλικό για την πειραματική μελέτη αυτής της έρευνας. Κάνοντας χρήση συνθετικών ήχων που προέκυψαν από την ψηφιακή επεξεργασία των αυθεντικών ηχογραφήσεων, δημιουργήθηκαν τριών ειδών «μάσκες» οι οποίες επικάλυψαν την χροιά και τα λόγια των αυθεντικών ηχογραφήσεων των ομιλητών των δύο διαλέκτων αφήνοντας μόνα διακριτά υπερτεμαχιακά στοιχεία, τον ρυθμό και την μελωδία κάθε πρότασης. Οι προτάσεις από τις δύο διαλέκτους περιλήφθηκαν σε ένα ακουστικό πείραμα, οι συμμετέχοντες του οποίου καλούνταν να αναγνωρίσουν κατά πόσο οι προτάσεις που άκουγαν προέρχονταν ή όχι από την ίδια διάλεκτο. Το πείραμα στέφθηκε με επιτυχία και η βασική υπόθεση εργασίας της έρευνας, ότι δηλαδή ο ρυθμός και η μελωδία είναι στοιχεία αναγνωρίσιμα και ικανά να δηλώσουν την ταυτότητα των συγκεκριμένων δύο διαλέκτων, αποδείχθηκε.
Effects of creatine supplementation on brain in the healthy population
Authors: Swatko Tomasz , Blicharz Monika , Czubala Marta , Bartosik-Zielińska Diana , Blicharz Agnieszka , Bartosik Magdalena
Published: February 2023

Introduction and purpose:  Creatine supplementation is playing an increasingly important role not only in sports, but is beneficial in the context of brain health (e.g., cognitive processing, brain function and recovery from injury). This is a growing field of research, and the purpose of this brief review is to provide an update on the effects of creatine supplementation on brain health in healthy people.

Description of the state of knowledge: Creatine, is an organic compound produced mainly by the liver and kidneys. From the liver, kidneys and gastrointestinal tract, creatine enters through the bloodstream into skeletal muscle, where a total of about 95% of the body's total creatine is stored. It is stored in the muscles, heart and brain.

Summary: There is potential for creatine supplementation to improve cognitive processing, especially in conditions characterized by creatine deficits in the brain, which can be triggered by acute stress factors (e.g., exercise, lack of sleep) or chronic, pathological conditions (e.g., creatine synthesis enzyme deficiencies, mild traumatic brain injury, aging, Alzheimer's disease). People with depression, the elderly, people with diseases associated with certain genetic defects (where creatine production and storage in the brain is impaired) are just some of the groups of people in whom creatine supplementation may be helpful. More research is needed to determine the clinical impact of long-term creatine supplementation dosing strategies on brain function and health.
Local Optimality Conditions for a Family of Hidden Convex Optimization
Authors: Song Mengmeng , Xia Yong , Liu Hongying
Published: February 2023

Hidden convex optimization is a class of nonconvex optimization problems that can be globally solved in polynomial time via equivalent convex programming reformulations. In this paper, we study a family of hidden convex optimization that joints the classical trust region subproblem (TRS) with convex optimization (CO). It also includes p-regularized subproblem (p > 2) as a special case. We present a comprehensive study on local optimality conditions. In particular, a sufficient condition is given to ensure that there is at most one local nonglobal minimizer, and at this point, the standard second-order sufficient optimality condition is necessary. To our surprise, although (TRS) has at most one local nonglobal minimizer and (CO) has no local nonglobal minimizer, their joint problem could have any finite number of local nonglobal minimizers.

Funding: This work was supported by the National Natural Science Foundation of China [Grants 12171021, 12131004, and 11822103], the Beijing Natural Science Foundation [Grant Z180005], and the Fundamental Research Funds for the Central Universities.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/ijoo.2023.0089 .
Charitable Giving by the Poor: A Field Experiment in Kyrgyzstan
Authors: Adena Maja , Hakimov Rustamdjan , Huck Steffen
Published: February 2023

In a large-scale natural field experiment, we partnered with a microlending company in Kyrgyzstan that asked over 180,000 of its clients for donations to social projects as a form of corporate philanthropy. In a 2 × 2 design, we explored two main (preregistered) hypotheses about giving by the poor. First, based on a conjecture that the poor are more price sensitive than the rich and in contrast to previous studies, we hypothesize that matching incentives induce crowding in of out-of-pocket donations. Second, we hypothesize that our population cares about their proximity to the charitable project. We find evidence in favor of the former hypothesis but not the latter. Previous studies of charitable giving focus on middle- or high-income earners in Western countries, neglecting the poor, although the lowest-income groups are often shown to contribute substantial shares of their income to charitable causes. Our results challenge the evidence in the extant literature but are in line with our theoretical model. The implications for fundraising managers are that the optimal design of fundraising campaigns crucially depends on the targeted groups and that donation matching is successful in stimulating participation in poorer populations.

This paper was accepted by Yan Chen, behavioral economics and decision analysis.

Funding: Financial support was from the Deutsche Forschungsgemeinschaft [Grant 280092119] and the Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung [Grant 100018_189152].

Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4702 .
Cadence Academic Network Celebrates 10th Anniversary
Authors: Tyler Neil
Published: February 2023

THE CADENCE ACADEMIC NETWORK IS 10 YEARS OLD. PATRICK HASPEL, WHO SET UP AND RUNS THE PROGRAMME, TALKS TO NEIL TYLER ABOUT FUTURE PLANS.
A Tipping Point?
Authors: Walko John
Published: February 2023

The Telecommunications Infrastructure Project is looking to apply open source technologies to next generation fixed and mobile networks.
Driving Innovation
Authors: Tyler Neil
Published: February 2023

Oxford University Innovation continues to impress with a growing list of spin out formations. Why is Oxford so successful?
Small, But Mighty
Authors: Grylls Bethan
Published: February 2023

VISION PROCESSING CHIP COULD USE 20 TIMES LESS POWER THAN CURRENT DEVICES, SAYS TEAM.
Test Complexity Grows
Authors: Babbé Erik
Published: February 2023

Considering Type-C validation simply as an ‘incremental’ change to your testing environment is wrong and dangerous.
Under New Ownership
Authors: Pitcher Graham
Published: February 2023

AWS takes ‘stewardship’ of FreeRTOS as its continues to build its embedded IoT presence from edge to cloud.
Ensuring Reliability
Authors: Tyler Neil
Published: February 2023

When it comes to supplying innovative connectors to motor sports, the key challenge is ensuring reliability.
Employment Law SOS
Authors: Chander Tina
Published: February 2023

This month, our employment law expert looks at time off during a major sporting occasion and how to appropriately deal with sexist remarks made by a company’s CEO
Pollution Matters
Authors: Offord Adam
Published: February 2023

Waste and air pollution is still dominating headlines. What are companies across the globe doing to stem the problem that could inspire UK manufacturers?
The Robotic Warehouse
Authors: Beck Chris
Published: February 2023

With an army of robots autonomously picking over 1.5 million items per day from a building the size of six football pitches, Ocado’s Andover CFC is a glimpse into the future of warehousing - and something manufacturers can learn from
Back to the Future
Authors: Beck Chris
Published: February 2023

With manufacturing facing a critical skills shortage, employers are beginning to look at new ways of plugging the gap, inclduing re-hiring those who have left the industry
Brexit Shutdowns: Do They Work?
Authors: Gane Richard
Published: February 2023

The news that JLR has shut its Solihull plant made for dramatic headlines, but there may be a more pragmatic reason behind it
Back from the Brink
Authors: Beck Chris
Published: February 2023

When Tata Chemicals Europe’s soda ash operation faced potentially business-threatening energy price hikes, it required a Herculean effort from the team to drag it out of the mire
Back to the Future
Authors: Barrett Martin
Published: February 2023

Lean manufacturing principles have long been the backbone of successful factories, and this will remain the case especially as the industry enters the Fourth Industrial Revolution
Protect and Survive
Authors: Bernstein Adam
Published: February 2023

With Brexit looming large on the horizon, there has never been a better, or more urgent, time to give your business a financial health check
Measuring Up
Authors: Stansfield Neil
Published: February 2023

Aerospace engineering company, Currock Engineering, engaged its workforce to ensure its products were made right first time, every time
Lengua hablada y análisis de la conversación en griego antiguo: estudio de εἶἑν en los diálogos de Platón
Authors: Verano Liaño Rodrigo
Published: February 2023

Este trabajo estudia los usos de la interjección εἶἑν en el corpus platonicum con auxilio de la metodología del Análisis de la Conversación. El examen de la posición en la organización secuencial de la interacción hablada que ocupan los turnos que contienen la interjección determina que el uso prototípico de la expresión se dé en contextos de cierre secuencial, en posición de inicio de turnos que forman parte de posexpansiones. La alta frecuencia de este uso puede explicar la especialización y convencionalización de la interjección como fórmula de cierre y apertura de nueva secuencia en su uso interactivo y, de manera menos frecuente, también en contextos polifónicos en el seno del discurso monológico.
Spanish Lexical Accessibility and Vocabulary Acquisition: Catalan Dominant Bilinguals and Spanish Monolinguals Compared
Authors: Ruiz Moreno Mario
Published: February 2023

In this study it was investigated whether Catalan dominant bilinguals from Girona performed differently on a Spanish vocabulary test in comparison to Spanish monolinguals from Toledo. The test measured both lexical knowledge and lexical accessibility. The test was administered to two groups of bilinguals and monolinguals: one aged 5-6 and another aged 8-9. The monolinguals outperformed the bilinguals at both ages, but most of the Catalan dominant bilinguals fell within monolingual norm at age 8-9, despite the fact that at group level the differences were still observable.