bluuebunny/crossref_metadata_2025 huggingface dataset:
Feature compensation based on the normalization of vocal tract length for the improvement of emotion-affected speech recognition
Authors: Geravanchizadeh Masoud , Forouhandeh Elnaz , Bashirpour Meysam
Published: August 2021

The performance of speech recognition systems trained with neutral utterances degrades significantly when these systems are tested with emotional speech. Since everybody can speak emotionally in the real-world environment, it is necessary to take account of the emotional states of speech in the performance of the automatic speech recognition system. Limited works have been performed in the field of emotion-affected speech recognition and so far, most of the researches have focused on the classification of speech emotions. In this paper, the vocal tract length normalization method is employed to enhance the robustness of the emotion-affected speech recognition system. For this purpose, two structures of the speech recognition system based on hybrids of hidden Markov model with Gaussian mixture model and deep neural network are used. To achieve this goal, frequency warping is applied to the filterbank and/or discrete-cosine transform domain(s) in the feature extraction process of the automatic speech recognition system. The warping process is conducted in a way to normalize the emotional feature components and make them close to their corresponding neutral feature components. The performance of the proposed system is evaluated in neutrally trained/emotionally tested conditions for different speech features and emotional states (i.e., Anger, Disgust, Fear, Happy, and Sad). In this system, frequency warping is employed for different acoustical features. The constructed emotion-affected speech recognition system is based on the Kaldi automatic speech recognition with the Persian emotional speech database and the crowd-sourced emotional multi-modal actors dataset as the input corpora. The experimental simulations reveal that, in general, the warped emotional features result in better performance of the emotion-affected speech recognition system as compared with their unwarped counterparts. Also, it can be seen that the performance of the speech recognition using the deep neural network-hidden Markov model outperforms the system employing the hybrid with the Gaussian mixture model.
Predicted antiviral drugs Darunavir, Amprenavir, Rimantadine and Saquinavir can potentially bind to neutralize SARS-CoV-2 conserved proteins
Authors: Halder Umesh C.
Published: August 2021

Background

Novel Coronavirus disease 2019 or COVID-19 has become a threat to human society due to fast spreading and increasing mortality. It uses vertebrate hosts and presently deploys humans. Life cycle and pathogenicity of SARS-CoV-2 have already been deciphered and possible drug target trials are on the way.

Results

The present study was aimed to analyze Non-Structural Proteins that include conserved enzymes of SARS-CoV-2 like papain-like protease, main protease, Replicase, RNA-dependent RNA polymerase, methyltransferase, helicase, exoribonuclease and endoribonucleaseas targets to all known drugs. A bioinformatic based web server Drug ReposeER predicted several drug binding motifs in these analyzed proteins. Results revealed that anti-viral drugs Darunavir,Amprenavir, Rimantadine and Saquinavir were the most potent to have 3D-drug binding motifs that were closely associated with the active sites of the SARS-CoV-2 enzymes .

Conclusions

 Repurposing of the antiviral drugs Darunavir, Amprenavir, Rimantadine and Saquinavir to treat COVID-19 patients could be useful that can potentially prevent human mortality.

Graphic abstract
Magnitude of undernutrition and associated factors among children with cardiac disease at University of Gondar hospital, Ethiopia
Authors: Asrade Mulat , Shehibo Abdulkadir , Tigabu Zemene
Published: August 2021

Background

Undernutrition and cardiac disease are interconnected in a vicious cycle. Little is known about the effect of undernutrition on cardiac disease among children in low- and middle-income countries (LMICs). This study aimed to assess magnitude of undernutrition and associated factors among children with cardiac disease at University of Gondar hospital, northwest Ethiopia.

Method

This hospital-based cross-sectional study included children with cardiac disease presenting to the pediatric outpatient clinic at University of Gondar Hospital, Ethiopia. A self-administered questionnaire was administered to participating families, and medical records were reviewed. All participants who fulfill the inclusion criteria were included. Anthropometric measurements were made and the presence of malnutrition was diagnosed according to the WHO criteria. Associated factors of undernutrition analyzed by using binary logistic regression model. Variables with p-value ≤0.2 in bivariate analysis were fitted to the final multivariable analysis and those variables with p-value ≤0.05 were considered as having statistically significant association to the outcome variable. AOR and 95% confidence interval was calculated to assess the strength of association between the variables.

Result

A total of 269 patients participated in the study. 177 (65.7%) were undernourished, of whom 96 (54.5%) were underweight, 70 (39.7%) were stunted, and 95 (53.9%) were wasted. Pulmonary hypertension (adjusted odds ratio [AOR] = 3.82, 95%CI 1.80–8.10), NYHA/modified Ross class III and IV heart failure (AOR = 4.64, 1.69–12.72) and cardiac chamber enlargement (AOR = 2.91, 1.45–5.66) were associated with undernutrition.

Conclusion

Undernutrition is common among children with cardiac disease in northern Ethiopia. Children with pulmonary hypertension, high-grade heart failure, and cardiac chamber enlargement may warrant close follow-up for malnutrition.
Three dimensions of the relationship between gender role attitudes and fertility intentions
Authors: Lappegård Trude , Neyer Gerda , Vignoli Daniele
Published: August 2021

The relationship between gender role attitudes and fertility intentions is highly debated among social scientists. We emphasize the need for a multidimensional theoretical and empirical approach to extend the two-step behavioral gender revolution approach to a three-step attitudinal gender revolution approach distinguishing between gender roles in the public sphere, mothers’ role in the family, and fathers’ role in the family. Using the Generations and Gender Survey of eight European countries, we demonstrate the usefulness of such an approach. Gender equal attitudes related to the public sphere are more widespread than those concerning mothers’ or fathers’ roles in the family. Our results show that the association between gender role attitudes and fertility intentions varies—in terms of significance and magnitude—according to the dimension considered (gender roles in the public sphere, mothers’ and fathers’ role in the family), gender, parity, and country. We conclude that without a clear concept of and empirical distinction between the various elements of the gender role attitudes/fertility nexus, scientific investigations will continue to send conflicting messages.
Reconstruction of irregular missing seismic data using conditional generative adversarial networks
Authors: Wei Qing , Li Xiangyang , Song Mingpeng
Published: August 2021

During acquisition, due to economic and natural reasons, irregular missing seismic data are always observed. To improve accuracy in subsequent processing, the missing data should be interpolated. A conditional generative adversarial network (cGAN) consisting of two networks, a generator and a discriminator, is a deep-learning model that can be used to interpolate the missing data. However, because cGAN is typically data set oriented, the trained network is unable to interpolate a data set from an area different from that of the training data set. We design a cGAN based on Pix2Pix GAN to interpolate irregular missing seismic data. A synthetic data set synthesized from two models is used to train the network. Furthermore, we add a Gaussian-noise layer in the discriminator to fix a vanishing gradient, allowing us to train a more powerful generator. Two synthetic data sets synthesized by two new geologic models and two field data sets are used to test the trained cGAN. The test results and the calculated recovered signal-to-noise ratios indicate that although the cGAN is trained using synthetic data, the network can reconstruct irregular missing field seismic data with high accuracy using the Gaussian-noise layer. We test the performances of cGANs trained with different patch sizes in the discriminator to determine the best structure, and we train the networks using different training data sets for different missing rates, demonstrating the best training data set. Compared with conventional methods, the cGAN-based interpolation method does not need different parameter selections for different data sets to obtain the best interpolation data. Furthermore, it is also an efficient technique as the cost is because of the training, and after training, the processing time is negligible.
PaTH Forward: A Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial of TransCon PTH in Adult Hypoparathyroidism
Authors: Khan Aliya A , Rejnmark Lars , Rubin Mishaela , Schwarz Peter , Vokes Tamara , Clarke Bart , Ahmed Intekhab , Hofbauer Lorenz , Marcocci Claudio , Pagotto Uberto , Palermo Andrea , Eriksen Erik , Brod Meryl , Markova Denka , Smith Alden , Pihl Susanne , Mourya Sanchita , Karpf David B , Shu Aimee D
Published: August 2021

Context

Hypoparathyroidism is characterized by insufficient levels of parathyroid hormone (PTH). TransCon PTH is an investigational long-acting prodrug of PTH(1-34) for the treatment of hypoparathyroidism.

Objective

This work aimed to investigate the safety, tolerability, and efficacy of daily TransCon PTH in adults with hypoparathyroidism.

Methods

This phase 2, randomized, double-blind, placebo-controlled 4-week trial with open-label extension enrolled 59 individuals with hypoparathyroidism. Interventions included TransCon PTH 15, 18, or 21 µg PTH(1-34)/day or placebo for 4 weeks, followed by a 22-week extension during which TransCon PTH dose was titrated (6-60 µg PTH[1-34]/day).

Results

By Week 26, 91% of participants treated with TransCon PTH achieved independence from standard of care (SoC, defined as active vitamin D = 0 μg/day and calcium [Ca] ≤ 500 mg/day). Mean 24-hour urine Ca (uCa) decreased from a baseline mean of 415 mg/24h to 178 mg/24h by Week 26 (n = 44) while normal serum Ca (sCa) was maintained and serum phosphate and serum calcium-phosphate product fell within the normal range. By Week 26, mean scores on the generic 36-Item Short Form Health Survey domains increased from below normal at baseline to within the normal range. The Hypoparathyroidism Patient Experience Scale symptom and impact scores improved through 26 weeks. TransCon PTH was well tolerated with no treatment-related serious or severe adverse events.

Conclusion

TransCon PTH enabled independence from oral active vitamin D and reduced Ca supplements (≤ 500 mg/day) for most participants, achieving normal sCa, serum phosphate, uCa, serum calcium-phosphate product, and demonstrating improved health-related quality of life. These results support TransCon PTH as a potential hormone replacement therapy for adults with hypoparathyroidism.
Low Skeletal Muscle Mass Is Associated With Perioperative Neurocognitive Disorder Due To Decreased Neurogenesis in Rats
Authors: Nemoto Akira , Goyagi Toru , Nemoto Wataru , Nakagawasai Osamu , Tan-No Koichi , Niiyama Yukitoshi
Published: August 2021

BACKGROUND:

Perioperative neurocognitive disorder (PND) is a postsurgical complication associated with neuroinflammation and impaired hippocampal neurogenesis, in which brain-derived neurotrophic factor (BDNF) plays a key role. Sarcopenia refers to age-related muscle loss that causes cognitive decline, muscle atrophy, and postoperative delirium. Rats with tail suspension (TS) were used to represent a low-activity model, which involves decreased hind limb function by TS. This hind limb unloading by TS can induce sarcopenia in 2 weeks. However, the relationship between PND and muscle atrophy is unclear. In this experiment, we investigated whether preoperative muscle atrophy induced by TS would affect neurogenesis and accelerate PND in rats.

METHODS:

Sixty 21-week-old rats were assigned to 4 groups: the TS group, the TS with surgery (TS + S) group, the control group, and the control with surgery (control + S) group. After the abdominal manipulation under 3% sevoflurane anesthesia, cognitive function was assessed using the Morris water maze test and a fear-conditioning test. Neurogenesis was evaluated by checking BDNF secretion and immunohistochemical staining in the hippocampus.

RESULTS:

The TS + S group showed impaired swimming latency (difference of means = 12.4 versus control + S; 95% confidence interval [CI], 2.0–22.7; P = .016) (difference of means = 15.2 versus TS; 95% CI, 0.4–30.1; P = .043) and path length (difference of means = 147.8 versus control + S; 95% CI, 20.7–274.9; P = .020) in the maze test and cued fear memory (difference of means = −26.0 versus TS; 95% CI, −46.4 to −5.6; P = .006) (difference of means = −22.3 versus control + S; 95% CI, −42.7 to −1.9; P = .026) in the fear-conditioning test. The postoperative levels of BDNF in the TS + S and TS groups were reduced compared with the other groups (P = .002). The number of neural precursors in the dentate gyrus was significantly lower in the TS + S group (P < .001).

CONCLUSIONS:

We observed that preoperative hind limb muscle atrophy, indicated by TS, was associated with an increased occurrence of PND through the reduction in BDNF and neurogenesis after abdominal surgery in young adult rats. Therefore, we concluded that preoperative low skeletal muscle mass can induce PND due to impaired postoperative neurogenesis. Our findings might indicate that low-cost perioperative interventions, such as preoperative exercise, is beneficial to preventing PND.
Metabolism navigates neural cell fate in development, aging and neurodegeneration
Authors: Traxler Larissa , Lagerwall Jessica , Eichhorner Sophie , Stefanoni Davide , D'Alessandro Angelo , Mertens Jerome
Published: August 2021

An uninterrupted energy supply is critical for the optimal functioning of all our organs, and in this regard the human brain is particularly energy dependent. The study of energy metabolic pathways is a major focus within neuroscience research, which is supported by genetic defects in the oxidative phosphorylation mechanism often contributing towards neurodevelopmental disorders and changes in glucose metabolism presenting as a hallmark feature in age-dependent neurodegenerative disorders. However, as recent studies have illuminated roles of cellular metabolism that span far beyond mere energetics, it would be valuable to first comprehend the physiological involvement of metabolic pathways in neural cell fate and function, and to subsequently reconstruct their impact on diseases of the brain. In this Review, we first discuss recent evidence that implies metabolism as a master regulator of cell identity during neural development. Additionally, we examine the cell type-dependent metabolic states present in the adult brain. As metabolic states have been studied extensively as crucial regulators of malignant transformation in cancer, we reveal how knowledge gained from the field of cancer has aided our understanding in how metabolism likewise controls neural fate determination and stability by directly wiring into the cellular epigenetic landscape. We further summarize research pertaining to the interplay between metabolic alterations and neurodevelopmental and psychiatric disorders, and expose how an improved understanding of metabolic cell fate control might assist in the development of new concepts to combat age-dependent neurodegenerative diseases, particularly Alzheimer's disease.
Loss of kinesin-8 improves the robustness of the self-assembled spindle in Schizosaccharomyces pombe
Authors: Pineda-Santaella Alberto , Fernández-Castillo Nazaret , Jiménez-Martín Alberto , Macías-Cabeza María del Carmen , Sánchez-Gómez Ángela , Fernández-Álvarez Alfonso
Published: August 2021

Chromosome segregation in female meiosis in many metazoans is mediated by acentrosomal spindles, the existence of which implies that microtubule spindles self-assemble without the participation of the centrosomes. Although it is thought that acentrosomal meiosis is not conserved in fungi, we recently reported the formation of self-assembled microtubule arrays, which were able to segregate chromosomes, in fission yeast mutants, in which the contribution of the spindle pole body (SPB; the centrosome equivalent in yeast) was specifically blocked during meiosis. Here, we demonstrate that this unexpected microtubule formation represents a bona fide type of acentrosomal spindle. Moreover, a comparative analysis of these self-assembled spindles and the canonical SPB-dependent spindle reveals similarities and differences; for example, both spindles have a similar polarity, but the location of the γ-tubulin complex differs. We also show that the robustness of self-assembled spindles can be reinforced by eliminating kinesin-8 family members, whereas kinesin-8 mutants have an adverse impact on SPB-dependent spindles. Hence, we consider that reinforced self-assembled spindles in yeast will help to clarify the molecular mechanisms behind acentrosomal meiosis, a crucial step towards better understanding gametogenesis.
Sleep and conditioning of the siphon withdrawal reflex in Aplysia
Authors: Thiede Kathrin I. , Born Jan , Vorster Albrecht P. A.
Published: August 2021

Sleep is essential for memory consolidation after learning as shown in mammals and invertebrates such as bees and flies. Aplysia californica displays sleep, and sleep in this mollusk was also found to support memory for an operant conditioning task. Here, we investigated whether sleep in Aplysia is also required for memory consolidation in a simpler type of learning, i.e. the conditioning of the siphon withdrawal reflex. Two groups of animals (Wake, Sleep, each n=11) were conditioned on the siphon withdrawal reflex, with the training following a classical conditioning procedure where an electrical tail shock served as the unconditioned stimulus (US) and a tactile stimulus to the siphon as the conditioned stimulus (CS). Responses to the CS were tested before (pre-test), and 24 and 48 h after training. While Wake animals remained awake for 6 h after training, Sleep animals had undisturbed sleep. The 24 h test in both groups was combined with extinction training, i.e. the extended presentation of the CS alone over two blocks. At the 24 h test, siphon withdrawal duration in response to the CS was distinctly enhanced in both Sleep and Wake groups with no significant difference between groups, consistent with the view that consolidation of a simple conditioned reflex response does not require post-training sleep. Surprisingly, extinction training did not reverse the enhancement of responses to the CS. On the contrary, at the 48 h test, withdrawal duration in response to the CS was even further enhanced across both groups. This suggests that processes of sensitization, an even simpler non-associative type of learning, contributed to the withdrawal responses. Our study provides evidence for the hypothesis that sleep preferentially benefits consolidation of more complex learning paradigms than conditioning of simple reflexes.
The Impact of Temporal Variation in Indocyanine Green Administration on Tumor Identification During Fluorescence Guided Breast Surgery
Authors: Kedrzycki Martha S. , Leiloglou Maria , Chalau Vadzim , Chiarini Nicolas , Thiruchelvam Paul T. R. , Hadjiminas Dimitri J. , Hogben Katy R. , Rashid Faiza , Ramakrishnan Rathi , Darzi Ara W. , Elson Daniel S. , Leff Daniel R.
Published: August 2021

Background

On average, 21% of women in the USA treated with Breast Conserving Surgery (BCS) undergo a second operation because of close positive margins. Tumor identification with fluorescence imaging could improve positive margin rates through demarcating location, size, and invasiveness of tumors. We investigated the technique’s diagnostic accuracy in detecting tumors during BCS using intravenous indocyanine green (ICG) and a custom-built fluorescence camera system.

Methods

In this single-center prospective clinical study, 40 recruited BCS patients were sub-categorized into two cohorts. In the first ‘enhanced permeability and retention’ (EPR) cohort, 0.25 mg/kg ICG was injected ~ 25 min prior to tumor excision, and in the second ‘angiography’ cohort, ~ 5 min prior to tumor excision. Subsequently, an in-house imaging system was used to image the tumor in situ prior to resection, ex vivo following resection, the resection bed, and during grossing in the histopathology laboratory to compare the technique’s diagnostic accuracy between the cohorts.

Results

The two cohorts were matched in patient and tumor characteristics. The majority of patients had invasive ductal carcinoma with concomitant ductal carcinoma in situ. Tumor-to-background ratio (TBR) in the angiography cohort was superior to the EPR cohort (TBR = 3.18 ± 1.74 vs 2.10 ± 0.92 respectively, p = 0.023). Tumor detection reached sensitivity and specificity scores of 0.82 and 0.93 for the angiography cohort and 0.66 and 0.90 for the EPR cohort, respectively (p = 0.1051 and p = 0.9099).

Discussion

ICG administration timing during the angiography phase compared with the EPR phase improved TBR and diagnostic accuracy. Future work will focus on image pattern analysis and adaptation of the camera system to targeting fluorophores specific to breast cancer.
Slugging: Casual Carpooling for Urban Transit
Authors: Cui Shiliang , Li Kaili , Yang Luyi , Wang Jinting
Published: August 2021

Problem definition: “Slugging,” or casual carpooling, refers to the commuting practice of drivers picking up passengers at designated locations and offering them a free ride in order to qualify for high-occupancy vehicle (HOV) lanes. Academic/practical relevance: It is estimated that tens of thousands of daily commuters rely on slugging to go to work in major U.S. cities. As drivers save commute time and passengers ride for free, slugging can be a promising Smart Mobility solution. However, little is known about the welfare, policy, and environmental implications of slugging. Methodology: We develop a stylized model that captures the essence of slugging. We characterize commuters’ equilibrium behavior in the model. Results: We find that slugging indeed makes commuters better off. However, the widely observed free-ride tradition is socially suboptimal. As compared with the social optimum, commuters always underslug in the free-slugging equilibrium when highway travel time is insensitive to slugging activities but may overslug otherwise. The socially optimal outcome can be achieved by allowing pecuniary exchanges between drivers and passengers. Interestingly, passengers may be better off if they pay for a ride than if they do not under free slugging. We also find that although policy initiatives to expand highway capacity or improve public transportation always increase social welfare in the absence of slugging, they may reduce social welfare in areas where free slugging is a major commuting choice. Nevertheless, these unintended consequences would be mitigated by the introduction of pecuniary exchanges. Finally, contrary to conventional wisdom, slugging as a form of carpooling can result in more cars on the road and thus, more carbon emissions. Managerial implications: Our results call upon the slugging community to rethink the free-ride practice. We also caution that slugging benefits commuters possibly to the detriment of the environment.
OM Forum—A Vision of Responsible Research in Operations Management
Authors: Netessine Serguei
Published: August 2021

Are we contributing positively to the society at large by research that we conduct in the field of Operations Management? Currently, the answer is probably closer to “no” than to “yes.” We often do not realize it, but there is very real cost of conducting our research nonresponsibly. In this invited OM Forum contribution, which is based on my Manufacturing and Service Operations Management Distinguished Fellow lecture given at the University of Texas at Dallas in 2018, I discuss what I believe it means to conduct research responsibly, I offer some specific steps to improve the relevance of what we do, and I argue that this approach gives our field a new opportunity to make broader impact by expanding the horizon of our work.

History: This paper has been accepted for the Manufacturing & Service Operations Management Special Section on Responsible Research in Operations Management.
The Paradox of Awards: How Status Ripples Affect Who Benefits from CEO Awards
Authors: Jensen Michael , Twardawski Torsten , Younes Nadja
Published: August 2021

Distinguishing between status spillovers and status ripples, we argue that sudden positive status shifts create status ripples when the social actors experiencing the status shifts are more constrained from exploiting their higher status than the social actors to whom they are affiliated. Specifically, we examine the status ripple paradox that the status effects experienced by the affiliated actors sometimes are as strong, or even stronger, as the direct status effects experienced by the ascending actors themselves. Focusing empirically on prestigious CEO awards from U.S. news magazines, we examine the consequences of positive status shifts for the awarded CEOs and the CEOs who are on the boards of directors of the awarded CEOs’ firms. We find evidence of status ripples in CEO compensation by showing that awarded CEOs have relatively greater immediate but smaller subsequent increases in compensation, which results in lower overall compensation effects for the awarded CEOs. Moreover, we provide empirical evidence of the theoretical mechanisms behind the status ripple paradox by showing that external constraints in the form of increased media and analyst attention and increased expectations affect the status ripple effect.
Learning throughout the storm
Authors: Nash Kate , Zanchin Claudia Dalcin , Legge Tara
Published: August 2021

Newly qualified midwives highlight the lessons they learnt during their final year of training during the global pandemic
How do power and hierarchy influence staff safety in maternity services?
Authors: Elliott-Mainwaring Helen
Published: August 2021

Background

There are considerable tensions for healthcare staff between their employee allegiance and contracts, patient safety, and their responsibilities to codes of conduct within professional registration, and the NHS Constitution.

Aims

The research aim was to identify how power and hierarchy influence staff safety in maternity services and this was achieved by reviewing research papers concerned with personal narratives of staff experiences and perspectives of employment in their profession.

Methods

This systematic narrative review was based on the approach of a narrative synthesis, with papers coded using Nvivo software.

Findings

Power and hierarchy influence staff safety in maternity services by creating challenges to staff safety, which appear to essentially derive from poor communication. The workplace adversity described by participants seems to be linked with 1) psychological vulnerability 1.1) anxiety about the job, and 1.2) dysfunctional relationships, alongside 2) working conditions 2.1) poor organisational and structural conditions 2.2) institutional normalisation of dysfunctional relationships and 2.3) interpersonal elements feeding into an obstructive culture.

Conclusion

The negative influences of the cultural concepts of power and hierarchy on staff safety are significant within maternity services. Disconfirmation findings, those which stood out as different from the rest, evidenced the possibilities that healthy, psychologically safe working conditions could offer for healthcare staff in improving their prevailing culture.
Pregnancy in a pandemic: generalised anxiety disorder and health anxiety prevalence
Authors: Rathbone Amy Leigh , Prescott Julie , Cross Duncan
Published: August 2021

Anxieties can be typical to pregnancy. At the beginning of the COVID-19 outbreak, pregnant women were classified as at risk and advised to shield. This may have caused increased generalised anxiety disorder and health anxiety across the demographic. This study aimed to explore current, actual and perceived levels of generalised anxiety disorder and health anxiety in pregnant women during the COVID-19 outbreak. A sample of 674 participants completed an online questionnaire consisting of demographic and pregnancy related questions, the GAD-7 and HAI. The COVID-19 outbreak has increased self-reported levels of general anxiety and health anxiety in pregnant women. Of the sample, 633 (94%) agreed that the outbreak had increased their general anxiety; 607 (90.1%) also reported increased health anxiety. Due to the negative effects that anxieties may cause during pregnancy, it is recommended that reintroducing normality to pre- and postnatal healthcare, where safe to do so, will be beneficial.
Patella dislocation: an overview
Authors: Baryeh Kwaku , Getachew Fanuelle
Published: August 2021

Patella dislocation is one of the most common knee injuries, accounting for 3% of acute knee injuries. Despite its prevalence, patella dislocation is often missed, with a haemarthrosis often the only sign, albeit a non-specific one. A thorough history and examination are necessary to identify patella dislocation and its potential causes. Investigations should include cross-sectional imaging to evaluate both osseous and soft tissue structures in order to guide management. Management in the acute setting is normally non-operative, but damage to structural supports, osteochondral defects or recurrent dislocation should prompt consideration of operative treatment. Operative treatment should address the soft tissue stabilisers and/or osseus deformities that predispose to, or occur secondary to, patella dislocation.
Should positive end-expiratory pressure be used during elective general anaesthesia with supraglottic airway devices?
Authors: Griffiths Megan , Everson James , Mandour Yasser
Published: August 2021

Anaesthetists' use of positive end-expiratory pressure during elective general anaesthesia via supraglottic airway devices varies. Positive end-expiratory pressure may help to maintain oxygenation and prevent atelectasis, but could worsen the risk of air leak, gastric insufflation and catastrophic aspiration.
Day case shoulder arthroplasty: needed now more than ever
Authors: Thangarajah Tanujan
Published: August 2021

The demand for total shoulder arthroplasty has grown over the years and is set to continue in a similar trend because of the ageing population. Following a global reduction in elective orthopaedic treatment and an exponential rise in surgical waiting times, innovative strategies are desperately needed to mitigate against the harmful effects of delaying vital operations on both patients and the wider society. Day case shoulder arthroplasty is a safe alternative to a traditional inpatient approach, with evidence supporting substantial cost savings, improved outcomes and fewer complications. Rigorous patient selection and a multidisciplinary team approach are paramount when adopting a day case service to deliver joint replacement surgery. This review outlines the principles of day case total shoulder arthroplasty and highlights key considerations when transitioning to this approach.
New records and notes on the morphology and biology of Chaetochlorops Malloch (Diptera: Chloropidae)
Authors: RICCARDI PAULA , RODRÍGUEZ-SÁNCHEZ EDNA
Published: August 2021

Chaetochlorops Malloch is a small genus endemic to the New World with a peculiar morphology of the male terminalia. The genus is recorded from Brazil–Amazon and Atlantic forests– and Nicaragua for the first time. Detailed images of the external and internal morphology of all species are provided here. Also, an additional host plant for C. inquilinus is given.
What can we learn from the experiences and expectations of patients on growing waiting lists for planned care in the COVID-19 pandemic?
Authors: Kulkarni Kunal , Shah Rohi , Armaou Maria , Leighton Paul , Mangwani Jitendra , Dias Joseph
Published: August 2021

Aims

COVID-19 has compounded a growing waiting list problem, with over 4.5 million patients now waiting for planned elective care in the UK. Views of patients on waiting lists are rarely considered in prioritization. Our primary aim was to understand how to support patients on waiting lists by hearing their experiences, concerns, and expectations. The secondary aim was to capture objective change in disability and coping mechanisms.

Methods

A minimum representative sample of 824 patients was required for quantitative analysis to provide a 3% margin of error. Sampling was stratified by body region (upper/lower limb, spine) and duration on the waiting list. Questionnaires were sent to a random sample of elective orthopaedic waiting list patients with their planned intervention paused due to COVID-19. Analyzed parameters included baseline health, change in physical/mental health status, challenges and coping strategies, preferences/concerns regarding treatment, and objective quality of life (EuroQol five-dimension questionnaire (EQ-5D), Generalized Anxiety Disorder 2-item scale (GAD-2)). Qualitative analysis was performed via the Normalization Process Theory.

Results

A total of 888 patients responded. Better health, pain, and mood scores were reported by upper limb patients. The longest waiters reported better health but poorer mood and anxiety scores. Overall, 82% had tried self-help measures to ease symptoms; 94% wished to proceed with their intervention; and 21% were prepared to tolerate deferral. Qualitative analysis highlighted the overall patient mood to be represented by the terms ‘understandable’, ‘frustrated’, ‘pain’, ‘disappointed’, and ‘not happy/depressed’. COVID-19-mandated health and safety measures and technology solutions were felt to be implemented well. However, patients struggled with access to doctors and pain management, quality of life (physical and psychosocial) deterioration, and delay updates.

Conclusion

This is the largest study to hear the views of this ‘hidden’ cohort. Our findings are widely relevant to ensure provision of better ongoing support and communication, mostly within the constraints of current resources. In response, we developed a reproducible local action plan to address highlighted issues. Cite this article: Bone Jt Open 2021;2(8):583–593.
208-µs single-shot multi-molecular sensing with spectrum-encoded dual-comb spectroscopy
Authors: Zou Xing , Gu Chenglin , Zhang Menglin , Zuo Zhong , Peng Daowang , Di Yuanfeng , Tang Lulu , Liu Yang , Luo Daping , Zhou Chen , Li Songyang , Xu Xingya , Li Wenxue
Published: August 2021

Dual-comb spectroscopy (DCS) is a powerful spectroscopic technique, which is developing for the detection of transient species in reaction kinetics on a short time scale. Conventionally, the simultaneous determination of multiple species is limited to the requirement of broadband spectral measurement at the cost of the measurement speed and spectral resolution owing to the inherent trade-off among these characteristics in DCS. In this study, a high-speed multi-molecular sensing is demonstrated and achieved through using a programmable spectrum-encoded DCS technique, where multiple narrow encoding spectral bands are reserved selectively and other comb lines are filtered out. As a dual-comb spectrometer with a repetition rate of 108 MHz is encoded spectrally over a spectral coverage range of 1520 to 1580 nm, the measurement speed is increased 6.15 times and single-shot absorption spectra of multiple molecules (C2H2, HCN, CO, CO2) at a time scale of 208 µs are obtained. Compared to conventional single-shot dual-comb spectra, encoded dual-comb spectra have improved short-term signal-to-noise ratios (SNRs) by factors of 3.65 with four encoding bands and 5.68 with two encoding bands. Furthermore, a fiber-Bragg-grating-based encoded DCS is demonstrated, which reaches 17.1 times higher average SNR than that of the unencoded DCS. This spectrum-encoded technique can largely improve the DCS measurement speed, and thus is promising for use in studies on multi-species reaction kinetics.
Study of wavelength-dependent pulse self-compression for high intensity pulse propagation in gas-filled capillaries
Authors: Nagar Garima C. , Shim Bonggu
Published: August 2021

We theoretically investigate the wavelength-dependent pulse self-compression dynamics of intense femtosecond laser pulses in gas-filled capillaries. Simulations with λ = 1, 2, 3 and 4 µm using the multimode carrier-resolved unidirectional pulse propagation equation reveal pulse self-compression or pulse broadening depending on plasma and modal dispersion. Our study shows that the pulse at 1 µm exhibits better pulse self-compression compared with longer wavelengths due to smaller group velocity mismatch between fundamental and higher-order capillary modes.
Characterization and mitigation of electronic crosstalk on InGaAs PIN 3D flash LiDAR imagers
Authors: Reinhardt Andrew D. , Bradley Cullen P. , McManamon Paul F.
Published: August 2021

This research presents methods and results of characterizing and mitigating electronic crosstalk on InGaAs PIN photodiode 3D flash LiDAR imagers, with the goal of significantly simplifying and improving the calibration system design. 3D flash LiDAR detectors use time to digital conversion (TDC) circuits to estimate the time of flight of a pulse when a detection threshold is met. As the underlying TDC circuits require more space and power, these circuits will cause, in high bus loading events, electronic crosstalk. These events are more likely to occur in situations where many detectors simultaneously trigger, something that can occur when viewing a flat object head-on with uniform illumination, thus limiting these sensors to image a full frame due to this simultaneous ranging crosstalk noise (SRCN). Solutions previously devised to mitigate this electronic crosstalk included using a windowed region of interest to mitigate additional noise by preventing triggering on all of the focal plane array (FPA) except the windowed region and using a checkerboard pattern for imaging the full frame. Here the electronic crosstalk is characterized, and mitigated, using a physical checkerboard target, leading to a more compact system design using a spatial light modulator and direct illumination.
2.5D microscopy with polarization independent SLM for enhanced detection efficiency and aberration correction
Authors: Ren Jinhan , Han Kyu Young
Published: August 2021

Fast, volumetric imaging by fluorescence microscopy is essential in studying biological phenomena and cellular functions. Recently, single-shot 2.5D microscopy showed promising results for high-throughput quantitative subcellular analysis via extended depth of field imaging without sequential z-scanning; however, the detection efficiency was limited and it lacked depth-induced aberration correction. Here we report that a spatial light modulator (SLM) in a polarization insensitive configuration can significantly improve the detection efficiency of 2.5D microscopy, while also compensating for aberrations at large imaging depths caused by the refractive index mismatch between the sample and the immersion medium. We highlight the improved efficiency via quantitative single-molecule RNA imaging of mammalian cells with a 2-fold improvement in the fluorescence intensity compared to a conventional SLM-based microscopy. We demonstrate the aberration correction capabilities and extended depth of field by imaging thick specimens with fewer z-scanning steps.
Concatemeric Broccoli reduces mRNA stability and induces aggregates
Authors: Rink Marco R. , Baptista Marisa A. P. , Flomm Felix J. , Hennig Thomas , Whisnant Adam W. , Wolf Natalia , Seibel Jürgen , Dölken Lars , Bosse Jens B.
Published: August 2021

Fluorogenic aptamers are an alternative to established methodology for real-time imaging of RNA transport and dynamics. We developed Broccoli-aptamer concatemers ranging from 4 to 128 substrate-binding site repeats and characterized their behavior fused to an mCherry-coding mRNA in transient transfection, stable expression, and in recombinant cytomegalovirus infection. Concatemerization of substrate-binding sites increased Broccoli fluorescence up to a concatemer length of 16 copies, upon which fluorescence did not increase and mCherry signals declined. This was due to the combined effects of RNA aptamer aggregation and reduced RNA stability. Unfortunately, both cellular and cytomegalovirus genomes were unable to maintain and express high Broccoli concatemer copy numbers, possibly due to recombination events. Interestingly, negative effects of Broccoli concatemers could be partially rescued by introducing linker sequences in between Broccoli repeats warranting further studies. Finally, we show that even though substrate-bound Broccoli is easily photobleached, it can still be utilized in live-cell imaging by adapting a time-lapse imaging protocol.
Statins and the progression of age-related macular degeneration in the United States
Authors: Ludwig Cassie A. , Vail Daniel , Rajeshuni Nitya A. , Al-Moujahed Ahmad , Rosenblatt Tatiana , Callaway Natalia F. , Veerappan Pasricha Malini , Ji Marco H. , Moshfeghi Darius M.
Published: August 2021

Purpose

To study the effect of statin exposure on the progression from non-exudative to exudative age-related macular degeneration (AMD).

Methods

Retrospective cohort study of commercially insured patients diagnosed with non-exudative AMD (n = 231,888) from 2007 to 2015. Time-to-event analysis of the association between exposure to lipid-lowering medications and time from non-exudative AMD to exudative AMD diagnosis was conducted. Outcome measures included progression to exudative AMD, indicated by diagnosis codes for exudative AMD or procedural codes for intravitreal injections.

Results

In the year before and after first AMD diagnosis, 11,330 patients were continuously prescribed lipid-lowering medications and 31,627 patients did not take any lipid-lowering medication. Of those taking statins, 21 (1.6%) patients were on very-high-dose lipophilic statins, 644 (47.6%) on high-dose lipophilic statins, and 689 (50.9%) on low-dose lipophilic statins. We found no statistically significant relationship between exposure to low (HR 0.89, 95% CI 0.83 to 1.38) or high-dose lipophilic statins (HR 1.12, 95% CI 0.86 to 1.45) and progression to exudative AMD. No patients taking very-high-dose lipophilic statins converted from non-exudative to exudative AMD, though this difference was not statistically significant due to the subgroup size (p = .23, log-rank test).

Conclusions

No statistically significant relationship was found between statin exposure and risk of AMD progression. Interestingly, no patients taking very-high-dose lipophilic statins progressed to exudative AMD, a finding that warrants further exploration.
Attempted suicide and suicide of young Turkish women in Europe and Turkey: A systematic literature review of characteristics and precipitating factors
Authors: van Bergen Diana , Eylem-Van Bergeijk Ozlem , Montesinos Amanda Heredia
Published: August 2021

Background

The increased risk of suicidal behaviour among Turkish women living in Europe and Turkey is a serious public health problem. This study compares and synthesises the empirical evidence of demographic, social, psychological and interpersonal characteristics and precipitating factors in the suicides and attempted suicides of Turkish women in Europe and Turkey.

Methods

We systematically searched eight databases (PsycINFO, PubMed, Med Line, Web of Science, Smart Cat, Safety Lit, BASE and Ulakbim), using search terms in English, Turkish, German and Dutch, as well as the reference lists of the retrieved papers. We extracted data on countries/regions, population characteristics, sample characteristics, recruitment, method of data collection, type of suicidal behaviour (suicide or attempted suicide) and precipitating factors and characteristics. The results were qualitatively synthesised.

Results

We retrieved nine studies on attempted suicide in Europe (from Germany, Switzerland and the Netherlands), 17 studies on attempted suicide in Turkey and 10 studies on suicide in Turkey (36 in total). Overall, we found similar precipitating factors and characteristics of attempted suicide and suicide in Turkey and Europe, including socio-demographic factors (young age and not being enrolled in the labour market), poverty and, to some extent, mental illness. Moreover, conflicts with family or spouses and violence against women, including so-called honour violence, were particularly common for women living in or originating from traditional areas in Turkey.

Conclusion

The framework of intersectionality is relevant to understanding our results, because structural inequalities in gender roles, gender role expectations as well as power imbalances among socio-economic classes collectively impact the suicidal behaviour of Turkish women. Moreover, the importance of violence against women points to the cultural continuity of the patriarchal and oppressive structures of Europe and Turkey. Suicide prevention efforts should address cultural attitudes underlying violence against women and girls through community education programmes, cultural and gender-sensitive care provision and jurisdiction.
Developing a Natural Language Processing tool to identify perinatal self-harm in electronic healthcare records
Authors: Ayre Karyn , Bittar André , Kam Joyce , Verma Somain , Howard Louise M. , Dutta Rina
Published: August 2021

Background

Self-harm occurring within pregnancy and the postnatal year (“perinatal self-harm”) is a clinically important yet under-researched topic. Current research likely under-estimates prevalence due to methodological limitations. Electronic healthcare records (EHRs) provide a source of clinically rich data on perinatal self-harm.

Aims

(1) To create a Natural Language Processing (NLP) tool that can, with acceptable precision and recall, identify mentions of acts of perinatal self-harm within EHRs. (2) To use this tool to identify service-users who have self-harmed perinatally, based on their EHRs.

Methods

We used the Clinical Record Interactive Search system to extract de-identified EHRs of secondary mental healthcare service-users at South London and Maudsley NHS Foundation Trust. We developed a tool that applied several layers of linguistic processing based on the spaCy NLP library for Python. We evaluated mention-level performance in the following domains: span, status, temporality and polarity. Evaluation was done against a manually coded reference standard. Mention-level performance was reported as precision, recall, F-score and Cohen’s kappa for each domain. Performance was also assessed at ‘service-user’ level and explored whether a heuristic rule improved this. We report per-class statistics for service-user performance, as well as likelihood ratios and post-test probabilities.

Results

Mention-level performance: micro-averaged F-score, precision and recall for span, polarity and temporality >0.8. Kappa for status 0.68, temporality 0.62, polarity 0.91. Service-user level performance with heuristic: F-score, precision, recall of minority class 0.69, macro-averaged F-score 0.81, positive LR 9.4 (4.8–19), post-test probability 69.0% (53–82%). Considering the task difficulty, the tool performs well, although temporality was the attribute with the lowest level of annotator agreement.

Conclusions

It is feasible to develop an NLP tool that identifies, with acceptable validity, mentions of perinatal self-harm within EHRs, although with limitations regarding temporality. Using a heuristic rule, it can also function at a service-user-level.