bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal resource allocation in networked control systems using viterbi algorithm
Authors: Çetin Gökhan , Fadali M. Sami 
Published: May 2021

This paper presents an optimal bandwidth allocation method for a networked control system (NCS) which includes time-driven sensor, event-driven controller and random channels. A hidden markov model (HMM) with a discretized state space is formulated for the random traffic to predict the network states using a suitable data window. Network bandwidth is allocated based on the predicted traffic state subject to bounds on the deterministic traffic that guarantee acceptable NCS performance and do not exceed hardware limitations. Bandwidth allocation uses minimization of unmet bandwidth demand. A stability condition is derived for a variable but bounded sampling period interval. Computer simulation results show the effect of varying the number of discrete states for the HMM and the window width on bandwidth allocation. The results compare favorably with a published approach based on fuzzy logic.
Multi-scale fusion for underwater image enhancement using multi-layer perceptron
Authors: Sudhakara M. , Meena M. Janaki 
Published: May 2021

<span id="docs-internal-guid-54b35aa6-7fff-0992-ed4c-aca4d05cfcfa"><span>Underwater image enhancement (UIE) is an imperative computer vision activity with many applications and different strategies proposed in recent years. Underwater images are firmly low in quality by a mixture of noise, wavelength dependency, and light attenuation. This paper depicts an effective strategy to improve the quality of degraded underwater images. Existing methods for dehazing in the literature considering dark channel prior utilize two separate phases for evaluating the transmission map (i.e., transmission estimation and transmission refinement). Accurate restoration is not possible with these methods and takes more computational time. A proposed three-step method is an imaging approach that does not need particular hardware or underwater conditions. First, we utilize the multi-layer perceptron (MLP) to comprehensively evaluate transmission maps by base channel, followed by contrast enhancement. Furthermore, a gamma-adjusted version of the MLP recovered image is derived. Finally, the multi-scale fusion method was applied to two attained images. The standardized weight is computed for the two images with three different weights in the fusion process. The quantitative results show that significantly our approach gives the better result with the difference of 0.536, 2.185, and 1.272 for PCQI, UCIQE, and UIQM metrics, respectively, on a single underwater image benchmark dataset. The qualitative results also give better results compared with the state-of-the-art techniques.</span></span>
The Mexican social unconscious—part I: The roots of a nation
Authors: Hernández-Tubert Reyna 
Published: May 2021

The social unconscious of a country or people is shaped by their origins and by the major collective traumatic experiences of their past. In the case of Mexico, this has been the trauma of the Spanish Conquest, that aimed to subjugate its originary peoples and obliterate their whole culture, language, and religion, which nonetheless subsisted subterraneously, syncretized with those of their invaders. It was a veritable genocide, both physical and cultural. The Mexican population was born from the mating of a brutal foreign conqueror and a subjected native woman, resulting in mestization, both physical and cultural. The psychic and social aftermath of these origins has been a deep ambivalence of Mexicans towards their identity and the foreign invader. This is similar to the fate of the unwelcome and abused child described by Ferenczi. Such underlying factors, derived from the collective history of peoples should be taken into account in any psychoanalytic or group-analytic enquiry of individual patients and groups.
A case of endophthalmitis following needling procedure after PRESERFLO® Micro Shunt implantation
Authors: Brambati Maria , Bettin Paolo , Ramoni Andrea , Battista Marco , Bandello Francesco 
Published: May 2021

Purpose: To report a case of endophthalmitis following bleb needling in a patient previously implanted with a PRESERFLO® MicroShunt. Methods: Case report. Results: A 40-year-old woman with bilateral malformative glaucoma repeatedly operated on in childhood underwent PRESERFLO® MicroShunt implantation in her right eye and six needling revisions (NRs) and a surgical revision due to unsatisfactory intraocular pressure (IOP) control due to bleb encapsulation. About 3 months after the surgical revision the bleb encapsulation relapsed and she underwent a further NR with betamethasone. About 4 days after the last NR, she experienced visual acuity reduction and was therefore advised to come immediately to the hospital for an unscheduled visit, showing up with hypopyon and diffuse vitreous haze. A clinical diagnosis of endophthalmitis (later confirmed by bacteria culture tests) was made and she was treated with pars-plana vitrectomy with silicone oil and intravitreal antibiotics. Preoperative visual function was luckily completely restored. Conclusions: Endophthalmitis can occur after NR in an eye with PRESERFLO® MicroShunt implant which therefore does not prevent reflux of bacteria from a filtering bleb to the anterior chamber.
Aqueous misdirection after Nd:YAG goniopuncture in deep sclerectomy treated with Nd:YAG irido-zonulo-hyaloidotomy
Authors: Almobarak Faisal A 
Published: May 2021

Background: To report a case of aqueous misdirection after goniopuncture in deep sclerectomy treated with Nd:YAG laser irido-zonulo-hyaloidotomy. Case presentation: About 72 years old patient with pseudoexfoliation glaucoma who underwent deep sclerectomy, developed aqueous misdirection after Nd:YAG laser goniopuncture. Medical management failed and subsequent peripheral Yag laser iridotomy to expose the zonules coupled with laser zonulo-hyaloidotomy was done and an instant gush of aqueous and vitreous substance prolapse through the iridotomy was noticed. Later, the anterior chamber was deep and the pressure was controlled. Conclusions: Aqueous misdirection can occur after Nd:YAG laser goniopuncture. Nd:YAG laser irido-zonulo-hyaloidotomy can be effective in breaking the attack.
Barriers to Human Papillomavirus Vaccine Series Completion among Insured Individuals in an Integrated Healthcare Setting
Authors: Kamineni Aruna , Blasi Paula R , Gundersen Gabrielle D , Oliver Malia , Dunn John B , Galloway Denise A , Madeleine Margaret M 
Published: May 2021

Introduction: Infection with certain types of human papillomavirus (HPV) can lead to cervical cancer as well as other cancers in both men and women. However, the requirement for multiple doses may limit the vaccine’s effectiveness for cancer prevention. We conducted a pilot study to investigate barriers to HPV vaccine series completion among members of an integrated healthcare system with clinical documentation of only 1 dose. Methods: We surveyed parents or legal guardians of 11-17-year-old girls (n = 10) and boys (n = 18), as well as 18-31-year-old women (n = 20) and men (n = 9), about their reasons for not completing the HPV vaccine series. Results: Most participants (70.2%) were non-Hispanic white. Among parents of children, commonly reported barriers to HPV vaccine series completion included not being aware or informed of the need for additional doses (28.6%), as well as the inconvenience of returning for additional doses (17.9%). Concerns about the HPV vaccine or vaccines in general were more common among parents of girls (30.0%) compared with parents of boys (16.7%). Among adults, barriers to HPV vaccine series completion included the inconvenience of returning for additional doses (31.0%), not being aware or informed of the need for additional doses (10.3%), and forgetting (10.3%). Conclusion: Our findings suggest that clinicians and healthcare systems can play a greater role in promoting awareness of the multiple-dose requirement, addressing vaccine concerns, and increasing opportunistic vaccination in a variety of settings. Increasing these efforts may facilitate HPV vaccine completion and increase its effectiveness in cancer prevention.
Blue-Light Therapy Strengthens Resting-State Effective Connectivity within Default-Mode Network after Mild TBI
Authors: Bajaj Sahil , Raikes Adam C , Razi Adeel , Miller Michael A , Killgore William DS 
Published: May 2021

Background: Emerging evidence suggests that post concussive symptoms, including mood changes, may be improved through morning blue-wavelength light therapy (BLT). However, the neurobiological mechanisms underlying these effects remain unknown. We hypothesize that BLT may influence the effective brain connectivity (EC) patterns within the default-mode network (DMN), particularly involving the medial prefrontal cortex (MPFC), which may contribute to improvements in mood. Methods: Resting-state functional MRI data were collected from 41 healthy-controls (HCs) and 28 individuals with mild traumatic brain injury (mTBI). Individuals with mTBI also underwent a diffusion-weighted imaging scan and were randomly assigned to complete either 6 weeks of daily morning BLT (N = 14) or amber light therapy (ALT; N = 14). Advanced spectral dynamic causal modeling (sDCM) and diffusion MRI connectometry were used to estimate EC patterns and structural connectivity strength within the DMN, respectively. Results: The sDCM analysis showed dominant connectivity pattern following mTBI (pre-treatment) within the hemisphere contralateral to the one observed for HCs. BLT, but not ALT, resulted in improved directional information flow (ie, EC) from the left lateral parietal cortex (LLPC) to MPFC within the DMN. The improvement in EC from LLPC to MPFC was accompanied by stronger structural connectivity between the 2 areas. For the BLT group, the observed improvements in function and structure were correlated (at a trend level) with changes in self-reported happiness. Conclusions: The current preliminary findings provide empirical evidence that morning short-wavelength light therapy could be used as a novel alternative rehabilitation technique for mTBI. Trial registry: The research protocols were registered in the ClinicalTrials.gov database (CT Identifiers NCT01747811 and NCT01721356).
Assessing the external validity of the VALIDATE-SWEDEHEART trial
Authors: Rylance Rebecca T , Wagner Philippe , Omerovic Elmir , Held Claes , James Stefan , Koul Sasha , Erlinge David 
Published: May 2021

Aims: The VALIDATE-SWEDEHEART trial was a registry-based randomized trial comparing bivalirudin and heparin in patients with acute myocardial infarction undergoing percutaneous coronary intervention. It showed no differences in mortality at 30 or 180 days. This study examines how well the trial population results may generalize to the population of all screened patients with fulfilled inclusion criteria in regard to mortality at 30 and 180 days. Methods: The standardized difference in the mean propensity score for trial inclusion between trial population and the screened not-enrolled with fulfilled inclusion criteria was calculated as a metric of similarity. Propensity scores were then used in an inverse-probability weighted Cox regression analysis using the trial population only to estimate the difference in mortality as it would have been had the trial included all screened patients with fulfilled inclusion criteria. Patients who were very likely to be included were weighted down and those who had a very low probability of being in the trial were weighted up. Results: The propensity score difference was 0.61. There were no significant differences in mortality between bivalirudin and heparin in the inverse-probability weighted analysis (hazard ratio 1.11, 95% confidence interval (0.73, 1.68)) at 30 days or 180 days (hazard ratio 0.98, 95% confidence interval (0.70, 1.36)). Conclusion: The propensity score difference demonstrated that the screened not-enrolled with fulfilled inclusion criteria and trial population were not similar. The inverse-probability weighted analysis showed no significant differences in mortality. From this, we conclude that the VALIDATE results may be generalized to the screened not-enrolled with fulfilled inclusion criteria.
Third-generation three-dimensional display system for laparoscopic radical nephrectomy reduced surgical complications compared to a two-dimensional display system
Authors: Fujishima Yosuke , Takata Ryo , Tsuyukubo Takashi , Kanzaki Seiko , Isurugi Kazumasa , Kato Yoichiro , Kanehira Mitsugu , Obara Wataru 
Published: May 2021

Objective: Compared with two-dimensional (2D) laparoscope systems, conventional three-dimensional (3D) systems provide a superior understanding of depth. However, they are operator limited due to difficulties with resolution and illumination. A novel third-generation (3G) 3D system may resolve these problems. We prospectively compared the operative performance and perioperative safety results of 2D and 3G 3D systems in laparoscopic radical nephrectomy (LRN). Patients and methods: A single experienced surgeon performed 3G 3D LRN for 19 patients and 2D LRN for 16 patients. After the insertion of the access ports, the execution times of each step in the surgical procedure in the two groups were measured and compared, along with the perioperative complications. Results: Patients in the 3D group were associated with fewer complications than those in the 2D group. In particular, no peritoneal injury was observed in the 3D group (0% vs. 25%, p=0.04). Logistic regression analysis showed no significant differences between the times of each surgical step and the amount of bleeding. Conclusions: The 3G 3D laparoscope system provided a detailed anatomical view for the operator during LRN and may reduce laparoscopic complications. Level of evidence: III.
Incidence, Risk, and Outcome of Pedicle Screw Loosening in Degenerative Lumbar Scoliosis Patients Undergoing Long-Segment Fusion
Authors: Yuan Lei , Zhang Xinling , Zeng Yan , Chen Zhongqiang , Li Weishi 
Published: May 2021

Study Design: Retrospective study. Objective: To investigate the incidence, risk factors, and outcomes of pedicle screw loosening in degenerative lumbar scoliosis (DLS) undergoing long-segment spinal fusion surgery. Methods: One hundred and thirty DLS patients who underwent long-segment fusion surgery with at least a 12-month follow-up were studied. The incidence and risk factors of screw loosening were investigated. VAS, SRS-22, and ODI scores were obtained preoperatively and at follow-up. Results: One hundred and sixty-eight of 1784 (9.4%) screws showed evidence of loosening in 71 (54.6%) patients. Three patients required revision surgery. Screw loosening rates according to vertebral insertion level were lowest instrumented vertebra (LIV): 45.4%; uppermost instrumented vertebra (UIV):17.7%; one vertebra above the LIV: 0.5%; 2 vertebrae above the LIV: 0.4%. Multiple logistic regression analysis of possible risk factors indicated that preoperative lateral subluxation ≥8 mm (odds ratio [OR]: 2.68, 95% confidence interval [CI]: 1.16-6.20), osteopenia (OR: 5.52, 95% CI: 1.64-18.56), osteoporosis (OR: 8.19, 95% CI: 2.40-27.97), fusion to sacrum (OR: 2.55, 95% CI: 1.12-5.83), postoperative TLK greater than 10° (OR: 2.63, 95% CI: 1.14-6.04) and SVA imbalance (OR: 3.44, 95% CI: 1.17-10.14) were statistically significant. No difference was noted in preoperative, follow-up, and change of VAS, ODI, and SRS-22 scores. Conclusions: Screw loosening in DLS underwent long-segment surgery is common and tends to occur in the LIV or UIV. Lateral subluxation ≥8 mm, osteopenia, osteoporosis, fusion to the sacrum, postoperative TLK greater than 10°, and SVA imbalance were the independent influencing factors. Screw loosening can be asymptomatic, while longer-term follow-up is required.
The effectiveness of contact investigation among contacts of tuberculosis patients: a systematic review and meta-analysis
Authors: Velen Kavindhran , Shingde Rashmi Vijay , Ho Jennifer , Fox Greg James 
Published: May 2021

BackgroundWe aimed to evaluate the effectiveness of contact investigation in comparison with passive case detection alone, and estimate the yield of co-prevalent and incident tuberculosis (TB) and latent TB infection (LTBI) among contacts of patients with TB.MethodsA systematic search was undertaken of studies published between 1 January 2011 and 1 October 2019 in the English language. The proportion of contacts diagnosed with co-prevalent TB, incident TB and/or LTBI was estimated. Evaluation of the effectiveness of contact investigation included randomised trials, while the yield of contact investigation (co-prevalent/incident TB and LTBI) was assessed in nonrandomised studies.ResultsData were extracted from 244 studies, of which 187 studies measured the proportion of contacts diagnosed with TB disease and 135 studies measured LTBI prevalence. Individual randomised trials demonstrated that contact investigation increased TB case notification (relative risk 2.5, 95% CI 2.0–3.2) and TB case detection (OR 1.34, 95% CI 0.43–4.24) and decreased mortality (relative risk 0.6, 95% CI 0.4–0.8) and population TB prevalence (risk ratio 0.82, 95% CI 0.64–1.04). The overall pooled prevalence of TB was 3.6% (95% CI 3.3–4.0%; I2=98.9%, 181 studies). The pooled prevalence of microbiologically confirmed TB was 3.2% (95% CI 2.6–3.7%; I2=99.5%, 106 studies). The pooled incidence of TB was highest in the first year after exposure to index patients (2.0%, 95% CI 1.1–3.3%; I2=96.2%, 14 studies) and substantially lower 5 years after exposure to index patients (0.5%, 95% CI 0.3–0.9%; one study). The pooled prevalence of LTBI among contacts was 42.4% (95% CI 38.5–46.4%; I2=99.8%, 135 studies).ConclusionsThis systematic review and meta-analysis found that contact investigation was effective in high-burden settings. The higher pooled prevalence estimates of microbiologically confirmed TB compared with previous reviews suggests newer rapid molecular diagnostics contribute to increased case detection.
Reduced neutrophil elastase inhibitor elafin and elevated transforming growth factor-β1are linked to inflammatory response in sputum of cystic fibrosis patients withPseudomonas aeruginosa
Authors: Thomassen Jan C. , Trojan Tobias , Walz Maxine , Vohlen Christina , Fink Gregor , Rietschel Ernst , Alejandre Alcazar Miguel A. , van Koningsbruggen-Rietschel Silke 
Published: May 2021

Research questionPulmonary disease progression in patients with cystic fibrosis (CF) is characterised by inflammation and fibrosis and aggravated byPseudomonas aeruginosa(Pa). We investigated the impact of Pa specifically on: 1) protease/antiprotease balance; 2) inflammation; and 3) the link of both parameters to clinical parameters of CF patients.MethodsTransforming growth factor-β1(TGF-β1), interleukin (IL)-1β, IL-8, neutrophil elastase (NE) and elastase inhibitor elafin were measured (ELISA assays), and gene expression of the NF-κB pathway was assessed (reverse transcriptase PCR) in the sputum of 60 CF patients with a minimum age of 5 years. Spirometry was assessed according to American Thoracic Society guidelines.ResultsOur results demonstrated the following: 1) NE was markedly increased in Pa-positive sputum, whereas elafin was significantly decreased; 2) increased IL-1β/IL-8 levels were associated with both Pa infection and reduced forced expiratory volume in 1 s, and sputum TGF-β1was elevated in Pa-infected CF patients and linked to an impaired lung function; and 3) gene expression of NF-κB signalling components was increased in sputum of Pa-infected patients, and these findings were positively correlated with IL-8.ConclusionOur study links Pa infection to an imbalance of NE and NE inhibitor elafin and increased inflammatory mediators. Moreover, our data demonstrate an association between high TGF-β1sputum levels and a progress in chronic lung inflammation and pulmonary fibrosis in CF. Controlling the excessive airway inflammation by inhibition of NE and TGF-β1might be promising therapeutic strategies in future CF therapy and a possible complement to cystic fibrosis transmembrane conductance regulator (CFTR) modulators.
The repurposed use of anesthesia machines to ventilate critically ill patients with coronavirus disease 2019 (COVID-19)
Authors: Bottiroli Maurizio , Calini Angelo , Pinciroli Riccardo , Mueller Ariel , Siragusa Antonio , Anelli Carlo , Urman Richard D. , Nozari Ala , Berra Lorenzo , Mondino Michele , Fumagalli Roberto 
Published: May 2021

Abstract
Background
The surge of critically ill patients due to the coronavirus disease-2019 (COVID-19) overwhelmed critical care capacity in areas of northern Italy. Anesthesia machines have been used as alternatives to traditional ICU mechanical ventilators. However, the outcomes for patients with COVID-19 respiratory failure cared for with Anesthesia Machines is currently unknow. We hypothesized that COVID-19 patients receiving care with Anesthesia Machines would have worse outcomes compared to standard practice.

Methods
We designed a retrospective study of patients admitted with a confirmed COVID-19 diagnosis at a large tertiary urban hospital in northern Italy. Two care units were included: a 27-bed standard ICU and a 15-bed temporary unit emergently opened in an operating room setting. Intubated patients assigned to Anesthesia Machines (AM group) were compared to a control cohort treated with standard mechanical ventilators (ICU-VENT group). Outcomes were assessed at 60-day follow-up. A multivariable Cox regression analysis of risk factors between survivors and non-survivors was conducted to determine the adjusted risk of death for patients assigned to AM group.

Results
Complete daily data from 89 mechanically ventilated patients consecutively admitted to the two units were analyzed. Seventeen patients were included in the AM group, whereas 72 were in the ICU-VENT group. Disease severity and intensity of treatment were comparable between the two groups. The 60-day mortality was significantly higher in the AM group compared to the ICU-vent group (12/17 vs. 27/72, 70.6% vs. 37.5%, respectively, p = 0.016). Allocation to AM group was associated with a significantly increased risk of death after adjusting for covariates (HR 4.05, 95% CI: 1.75–9.33, p = 0.001). Several incidents and complications were reported with Anesthesia Machine care, raising safety concerns.

Conclusions
Our results support the hypothesis that care associated with the use of Anesthesia Machines is inadequate to provide long-term critical care to patients with COVID-19. Added safety risks must be considered if no other option is available to treat severely ill patients during the ongoing pandemic.

Clinical trial number
Not applicable.