bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the flow index to detect low inspiratory effort during pressure support ventilation
Authors: Miao Ming-Yue , Chen Wei , Zhou Yi-Min , Gao Ran , Song De-Jing , Wang Shu-Peng , Yang Yan-Lin , Zhang Linlin , Zhou Jian-Xin 
Published: September 2022

AbstractBackgroundBedside assessment of low levels of inspiratory effort, which are probably insufficient to prevent muscle atrophy, is challenging. The flow index, which is derived from the analysis of the inspiratory portion of the flow–time waveform, has been recently introduced as a non-invasive parameter to evaluate the inspiratory effort. The primary objective of the present study was to provide an external validation of the flow index to detect low inspiratory effort.MethodsDatasets containing flow, airway pressure, and esophageal pressure (Pes)–time waveforms were obtained from a previously published study in 100 acute brain-injured patients undergoing pressure support ventilation. Waveforms data were analyzed offline. A low inspiratory effort was defined by one of the following criteria, work of breathing (WOB) less than 0.3 J/L, Pes–time product (PTPes) per minute less than 50 cmH2O•s/min, or inspiratory muscle pressure (Pmus) less than 5 cmH2O, adding “or occurrence of ineffective effort more than 10%” for all criteria. The flow index was calculated according to previously reported method. The association of flow index with Pes-derived parameters of effort was investigated. The diagnostic accuracy of the flow index to detect low effort was analyzed.ResultsModerate correlations were found between flow index and WOB, Pmus, and PTPesper breath and per minute (Pearson’s correlation coefficients ranged from 0.546 to 0.634,P < 0.001). The incidence of low inspiratory effort was 62%, 51%, and 55% using the definition of WOB, PTPesper minute, and Pmus, respectively. The area under the receiver operating characteristic curve for flow index to diagnose low effort was 0.88, 0.81, and 0.88, for the three respective definition. By using the cutoff value of flow index less than 2.1, the diagnostic performance for the three definitions showed sensitivity of 0.95–0.96, specificity of 0.57–0.71, positive predictive value of 0.70–0.84, and negative predictive value of 0.90–0.93.ConclusionsThe flow index is associated with Pes-based inspiratory effort measurements. Flow index can be used as a valid instrument to screen low inspiratory effort with a high probability to exclude cases without the condition.
An architecture and performance evaluation framework for artificial intelligence solutions in beyond 5G radio access networks
Authors: Koudouridis Georgios P. , He Qing , Dán György 
Published: September 2022

AbstractThe evolution of mobile communications towards beyond 5th-generation (B5G) networks is envisaged to incorporate high levels of network automation. Network automation requires the development of a network architecture that accommodates multiple solutions based on artificial intelligence (AI) and machine learning (ML). Consequently, integrating AI into the 5th-generation (5G) systems such that we could leverage the advantages of ML techniques to optimize and improve the networks is one challenging topic for B5G networks. Based on a review of 5G system architecture, the state-of-the-art candidate AI/ML techniques, and the progress of the state of the art, and the on AI/ML for 5G in standards we define an AI architecture and performance evaluation framework for the deployment of the AI/ML solution in B5G networks. The suggested framework proposes three AI architectures alternatives, a centralized, a completely decentralized and an hybrid AI architecture. More specifically, the framework identifies the logical AI functions, determines their mapping to the B5G radio access network architecture and analyses the associated deployment cost factors in terms of compute, communicate and store costs. The framework is evaluated based on a use case scenario for heterogeneous networks where it is shown that the deployment cost profiling is different for the different AI architecture alternatives, and that this cost should be considered for the deployment and selection of the AI/ML solution.
Voice spoofing countermeasure for voice replay attacks using deep learning
Authors: Zhou Jincheng , Hai Tao , Jawawi Dayang N. A. , Wang Dan , Ibeke Ebuka , Biamba Cresantus 
Published: September 2022

AbstractIn our everyday lives, we communicate with each other using several means and channels of communication, as communication is crucial in the lives of humans. Listening and speaking are the primary forms of communication. For listening and speaking, the human voice is indispensable. Voice communication is the simplest type of communication. The Automatic Speaker Verification (ASV) system verifies users with their voices. These systems are susceptible to voice spoofing attacks - logical and physical access attacks. Recently, there has been a notable development in the detection of these attacks. Attackers use enhanced gadgets to record users’ voices, replay them for the ASV system, and be granted access for harmful purposes. In this work, we propose a secure voice spoofing countermeasure to detect voice replay attacks. We enhanced the ASV system security by building a spoofing countermeasure dependent on the decomposed signals that consist of prominent information. We used two main features— the Gammatone Cepstral Coefficients and Mel-Frequency Cepstral Coefficients— for the audio representation. For the classification of the features, we used Bi-directional Long-Short Term Memory Network in the cloud, a deep learning classifier. We investigated numerous audio features and examined each feature’s capability to obtain the most vital details from the audio for it to be labelled genuine or a spoof speech. Furthermore, we use various machine learning algorithms to illustrate the superiority of our system compared to the traditional classifiers. The results of the experiments were classified according to the parameters of accuracy, precision rate, recall, F1-score, and Equal Error Rate (EER). The results were 97%, 100%, 90.19% and 94.84%, and 2.95%, respectively.
Immunotherapy in patients with metastatic castration-resistant prostate cancer: a meta-analysis of data from 7 phase III studies and 3 phase II studies
Authors: Zhang Anqiang , Tong Dali 
Published: September 2022

Abstract
Background
Immunotherapies have emerged as potential treatments for metastatic castration-resistant prostate cancer (mCRPC). However, it is still unclear to identify the efficacy and safety of immunotherapy in large-scale samples. We performed a meta-analysis of 7 phase III randomized trials and 3 phase II trials comparing immunotherapy to placebo in mCRPC.

Methods
Searching the PubMed, ClinicalTrials and Cochrane Library, completed III/IV phase trials were identified. Data extraction was conducted according to the PRISMA statement. The measured outcomes were OS, PFS, ORR and AE. Based on the results of phase III randomized trials, 3 II phase trials with results were identified.

Results
A total of 4185 patients were available for evaluation of OS, and 3320 for PFS. Compared to placebo, immunotherapies were not able to improve OS (HR = 0.90; 95%CI 0.79–1.03; p = 0.13). However, immunotherapies, especially ICBs were able to decrease the risk of progression over placebo by 18% (HR = 0.82; 95%CI 0.68–1.00; p = 0.04). Significant ORR improvement was found in patients treated in ICBs (RR = 1.90; 95%CI 1.30–2.78; p < 0.001). Immunotherapies (OR = 1.01, 95% CI = 0.40–2.56; OR = 1.27, 95% CI = 0.72–2.25) were not associated with significant any grade TRAEs and 3–4 grade TRAEs. However, in subgroup analysis, ICBs (OR = 2.85, 95% CI = 2.27–3.57) and vaccines (OR = 0.78, 95% CI = 0.64–0.53) were associated with significant 3–4 grade TRAEs respectively. Moreover, ICBs alone induced positive PSA response [OR = 2.43(1.09–5.43), P = 0.03(I2 = 0%, P = 0.83)] and was effective in advanced PC even without classical therapies based on three phase II clinical trials about ICBs.

Conclusions
Immunotherapies are not able to improve OS, but significantly improve PFS and ORR especially in ICBs treatment. Immunotherapies were not associated with significant TRAEs. However, in subgroup analysis, ICBs and vaccines were associated with significant 3–4 grade TRAEs.
Sex specificity of dispersal behaviour and flight morphology varies among tree hollow beetle species
Authors: Martínez-Pérez Sandra , Galante Eduardo , Micó Estefanía 
Published: September 2022

Abstract
Background
Flight performance and dispersal behaviour can differ between sexes, resulting in sex-biased dispersal. The primary sex ratio of populations may also explain dispersal bias between sexes, as this bias may evolve with the primary sex ratio to reduce intrasexual competition. Although dispersal bias between sexes is relevant to population dynamics, there are few studies on sex-biased dispersal in insects. We studied the flight performance and dispersal behaviour of seven saproxylic beetle species associated with tree hollows from a sex perspective. We also analysed the possible coevolution of flight performance with the primary sex ratio.

Methods
Wing loading and wing aspect ratio were used as measures of the flight performance of species and sexes. Dispersal behaviour was explored by analysing the frequency of each sex in interception traps versus the primary sex ratio obtained by tree hollow emergence traps using contingency tables and posthoc standardized residuals. A more active flight behaviour was expected for the sex with higher capture frequency in the interception traps. To explore the causes of flight performance bias between sexes, we searched for possible correlations between wing loading or wing aspect ratio and primary sex ratio using Pearson’s correlation coefficient.

Results
Wing loading and wing aspect ratio differed between species and sexes, with flight performance being higher in males than in females for four of the seven species analysed. Dispersal behaviour and flight performance matched in the case of Elater ferrugineus; males showed higher flight performance and were the most collected sex in the interception traps (more active flyers). In contrast, the higher flight activity of Cetonia carthami aurataeformis females was not correlated with a higher flight performance than that of males. Moreover, we found that a bias in the primary sex ratio towards females is often correlated with a decrease in female flight performance.

Conclusions
We stress that flight performance and dispersal behaviour of sexes do not always go hand in hand. Moreover, the relationship between the sex ratio and flight performance bias between sexes is not driven by competition within the most abundant sex. The inclusion of a sex perspective in insect dispersal studies would be useful to detect dispersal bias between sexes and its causes and would allow for further analysis of its effects on population dynamics.
Biotransformation technology and high-value application of rapeseed meal: a review
Authors: Yang Zhengfeng , Huang Zunxi , Cao Lijuan 
Published: September 2022

AbstractRapeseed meal (RSM) is an agro-industrial residue of increased functional biological value that contains high-quality proteins for animal feed. Due to the presence of antinutritional factors and immature development technology, RSM is currently used as a limited feed additive and in other relatively low-value applications. With increasing emphasis on green and sustainable industrial development and the added value of agro-industrial residues, considerable attention has been directed to the removal of antinutritional factors from RSM using high-efficiency, environment-friendly, and cost-effective biotechnology. Similarly, the high-value biotransformations of RSM have been the focus of research programmes to improve utilization rate. In this review, we introduce the sources, the nutrient and antinutrient content of RSM, and emphasize improvements on RSM feed quality using biological methods and its biotransformation applications.
Intravascular papillary endothelial hyperplasia in the cecum: a case report
Authors: Endo Tomoyoshi , Katsuno Hidetoshi , Kikuchi Kenji , Ochi Takayuki , Matsuo Kazuhiro , Suzuki Kazumitsu , Yasuoka Hironobu , Nakano Yuko , Nakagawa Mitsuru , Kuroda Makoto , Morise Zenichi 
Published: September 2022

Abstract
Background
Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson's tumor, is a benign, non-neoplastic vascular lesion that is characterized by reactive proliferation of papillary endothelial cells associated with a thrombus. These lesions typically develop in the vascular regions of the head and neck, oral cavity, or extremities; however, other organ systems have been affected. IPEH in the gastrointestinal tract is rare, with only a few cases reported to date. Thus, the pathogenesis and clinical features of IPEH in the gastrointestinal tract are not entirely understood. Moreover, the local excision of certain subtypes of IPEH can be curative; this makes timely diagnosis essential. We present the case of a patient with IPEH in the cecum that was discovered while investigating the cause of severe anemia.

Case presentation
A 29-year-old woman visited a general practitioner (GP) with the complaint of abdominal pain. She was diagnosed with acute appendicitis and was prescribed antibiotics. After treatment, her abdominal pain disappeared. However, she was found to be severely anemic (hemoglobin level, 6.5 g/dl). To determine the cause of her anemia, the GP referred her to our hospital for further examination and treatment. Computed tomography scan revealed cecal wall thickening. Further, a lower gastrointestinal endoscopy revealed a 2-cm raised mass-like lesion in the cecum. This lesion was pathologically identified as an inflammatory granuloma. The cause of her anemia was determined to be bleeding from the lesion in the cecum. She underwent laparoscopic ileocecal resection.
Histopathological examination of the surgical specimen revealed a spongy structure comprising many small papillary fibrous tissues lined by a typical monolayer endothelium. Further, immunohistochemical analysis showed that the cells of the endothelium monolayer expressed CD31, CD34. The Ki-67 labeling index was < 1%. Based on these findings, the lesion was identified as an IPEH in the cecum. The patient’s postoperative course was uneventful, and there was no evidence of recurrence during the 1.3 years of follow-up.

Conclusions
IPEH rarely arises within the abdominal cavity. Surgery remains the only treatment for IPEH and is associated with an excellent prognosis and a low recurrence rate. More aggressive lesions such as angiosarcoma should be excluded when considering the histologic diagnoses of IPEH, and expert pathologic review is vital. This is the first report of IPEH occurring in the cecum and represents a novel cause of gastrointestinal bleeding which the clinician should consider when evaluating a patient with atypical or difficult gastrointestinal bleeding sources.
“Maybe I’m not that approachable”: using simulation to elicit team leaders’ perceptions of their role in facilitating speaking up behaviors
Authors: Pack Rachael , Columbus Lauren , Duncliffe Trevor Hines , Banner Harrison , Singh Priyanka , Seemann Natashia , Taylor Taryn 
Published: September 2022

Abstract
Background
Simulation research that seeks to solve the problem of silence among interprofessional teams has focused almost exclusively on training subordinate team members to be more courageous and to speak up to team leaders using direct challenge scripts despite the great interpersonal cost. Consequently, the existing literature overemphasizes the responsibility of subordinate team members for speaking up and fails to consider the role and responsibilities of team leaders in sustaining silence. The purpose of this study is to identify and describe the subtle behaviors and actions of team leaders that both promote and discourage speaking up.

Methods
This study used a simulation-primed qualitative inquiry approach. Obstetricians (OB) at one academic center participated in an interprofessional simulation as an embedded participant. Five challenge moments (CM) were scripted for the OB involving deliberate clinical judgment errors or professionalism infractions. Other participants were unaware of the OB embedded participant role. Thirteen iterations were completed with 39 participants. Twelve faculty members completed a subsequent semi-structured interview. Scenarios were videotaped; debriefs and interviews were audio-recorded and transcribed verbatim. Data were analyzed using an inductive thematic approach.

Results
After participating in an interprofessional simulation, faculty participants reflected that being an approachable team leader requires more than simply avoiding disruptive behaviors. We found that approachability necessitates that team leaders actively create the conditions in which team members perceive that speaking up is welcomed, rather than an act of bravery. In practice, this conceptualization of approachability involves the tangible actions of signaling availability through presence, uncertainty through thinking aloud, and vulnerability through debriefing.

Conclusions
By using faculty as embedded participants with scripted errors, our simulation design provided an ideal learning opportunity to prompt discussion of the subtle behaviors and actions of team leaders that both promote and discourage speaking up. Faculty participants gained a new appreciation that their actions create the conditions for speaking up to occur before critical incidents through their verbal and non-verbal communication.
Support for learning under naturalistic conditions
Authors: Cronin-Golomb Lucy M. , Bauer Patricia J. 
Published: September 2022

AbstractEducational opportunities occur through naturalistic everyday life experiences (e.g., reading a newspaper, listening to a podcast, or visiting a museum). Research primarily examines learning under controlled conditions, such as in a classroom or laboratory. There is relatively little known about the extent to which adults extract semantic content, beyond factual recall, from naturalistic educational experiences. In the present work, we focused on virtual museum exhibits. The materials were sourced directly from an art history museum. The naturalistic nature of this work stems from the type of content used though an important component of naturalistic learning—motivational processes—was not measured. In each of three experiments, we assessed adult learners’ performance on tests of factual recall, inferential reasoning, and self-derivation through memory integration from naturalistic virtual museum exhibits. In anticipation of the potential challenge associated with learning outcomes under naturalistic conditions, we administered a yoked protocol under which participants had opportunities to engage in retrieval practice (Experiment 2a) or restudy (Experiment 2b) as explicit mechanisms of support for the three tests of learning. In all experiments, participants performed successfully on all three tests of learning; factual recall was the most accessible of the three learning outcomes. There was no difference in performance at the group level across experiments, but there was at the individual level, such that idea units generated during retrieval practice predicted learning outcomes, whereas restudy of those exact idea units did not. The current work provides novel insight into mechanisms underlying adult learning from naturalistic educational opportunities.
Development of the multidimensional health perceptions questionnaire in English and Spanish
Authors: Juengst Shannon B. , Vega Marlene , Holland Alexandra B. , Herrera Susan , Higashi Robin T. , Boix Braga Maria , Khera Alka , Kew Chung Lin , Silva Valeria 
Published: September 2022

Abstract
Purpose
To develop the novel multidimensional health perceptions questionnaire (MHPQ), a self-reported assessment of health perceptions inclusive of (1) individuals beliefs about the causes and consequences of health conditions, benefits and barriers to maintaining and improving health, ability to accomplish health-related goals and control health circumstances, and the role of God and/or spirituality in health and healthcare, (2) anticipated discrimination in the healthcare systems, and (3) trust in healthcare providers and medicine, illustrated in our newly proposed Multidimensional Health Perceptions Conceptual Model.

Methods
We developed an initial MHPQβ item set, corresponding to domains of our conceptual model, using a patient-centered outcomes development approach. This include literature review, expert and end-user feedback, translation and language validation (specifically to Latin American Spanish), and cognitive interviewing.

Results
The initial 104 items of MHPQβ had excellent content validity, with a Content Validity Index of 98.1%. After expert (n = 13) feedback, translation and language validation, and cognitive interviewing among community-dwelling English-speakers (n = 5) and Spanish-speakers (n = 4), the final MHPQβ comprised 93 items rated on a five-point agreement scale (1 = Strongly disagree to 5 = Strongly agree), with a reading grade level of 6th grade in English and 8th grade in Spanish.

Conclusion
The MHPQβ is a promising tool to assess individuals’ health perceptions. It has excellent content validity and good reading accessibility. Future work will establish the factor structure and final item set of the MHPQ.
Beneficial effects of antitranspirants on water stress tolerance in maize under different plant densities in newly reclaimed land
Authors: Morsy Ahmed Salah Mohamed , Mehanna Hani Mohamed 
Published: September 2022

Abstract
Background
The global freshwater shortage is an important issue threatening the sustainable development of agriculture and food security. A field study was conducted in two seasons, i.e., 2019 and 2020, in the newly reclaimed land at Village 8, El-Minia Governorate, Egypt, to evaluate maize crop response to three irrigation levels (IL1 = 80, IL2 = 70, and IL3 = 60% of the crop evapotranspiration “ETc”), three plant densities (PD1 = 17.500, PD2 = 23.333, and PD3 = 35.000 plants fed−1), and three antitranspirants treatments (An1 = control, An2 = kaolin at 6%, and An3 = chitosan at 150 L fed−1). The experiment was designed as a randomized complete block design (RCBD) using a split plot in strips.

Results
Results revealed that the irrigated maize plants with IL1 (80% of ETc) recorded the maximum values for all traits such as vegetative growth, phenology, and yield and its attributes in both seasons. The heaviest value of grain yield (3.15 and 3.10 tonnes fed−1, where 1 feddan = 0.42 hectare) was realized from IL1 treatment in the 1st and 2nd seasons, respectively. Plant density of 35.000 plants fed−1 (PD3) produced the greatest values of leaf area index (6.70 and 6.85), more days to 50% for each of tasseling (62.16 and 61.99 days), and silking (63.63 and 63.73 days), heaviest grain yield (3.11 and 3.16 ton fed−1) and greater water use efficiency WUE (1.46 and 1.48 kg m−3) in both seasons, respectively.

Conclusions
Foliar spraying with antitranspirants, i.e., kaolin at 6%, led to a tremendous impact on all studied traits by alleviating the water stress and reducing the rate of transpiration. The effect of second-order interaction among IL1 × PD3 × An3 indicated a significant increase in grain yield by 69.91% as compared with the interaction of IL3 × PD1 × An1 in the 2020 season only. CS 10 single-cross maize realized the highest productivity and most efficient use of available resources via using a sowing density of 35.000 plant fed−1, foliar spraying with kaolin at 6%, and irrigation level (80% of ETc) under El-Minia conditions.