bluuebunny/crossref_metadata_2025 huggingface dataset:
Burnout, collective efficacy and the social network of an intensive care unit
Authors: Kiefer Amy K. , Shoham David A. , Joyce Cara , Burkhart Lisa
Published: February 2025

Background

The prevalence of burnout among critical care nurses is high. Burnout has been explored at the individual and system levels, with little research occurring at the unit level. Increased social support and self‐efficacy are correlated with a decreased risk of burnout at the individual level; however, little is known in how collective efficacy and types of social support are protective against the development of burnout.

Aim

Explore the relationships between burnout, collective efficacy and social supports in an intensive care unit.

Study Design

Using a descriptive design, health care professionals working in an intensive care unit (n = 39) were recruited to complete surveys measuring burnout, collective efficacy and four types of social support (emotional, instrumental, informational and advice‐seeking). Data were analysed using Spearman's rank correlation and sociograms.

Results

The unit displayed burnout with high levels of emotional exhaustion, moderate levels of depersonalization and high levels of personal accomplishment. The unit had high levels of collective efficacy. Collective efficacy demonstrated a significant and strong negative correlation with emotional exhaustion (rs = −0.57, p < .001) and a significant strong positive correlation with personal accomplishment (rs = 0.50, p < .005). The advice‐seeking network was dense (67%) and advice‐seeking social support had a significant negative association with personal accomplishment (rs = −0.35, p < .01).

Conclusions

The results demonstrated that burnout develops sequentially from emotional exhaustion to depersonalization to lack of personal accomplishment. Social network analysis methods displayed a deeper understanding of community on a unit than prior quantitative research exploring burnout.

Relevance to Clinical Practice

To decrease burnout, we recommend assessing burnout as a continuum and as a unit‐level risk factor. Interventions should be identified that strengthen community on the unit as well as supporting unit leaders.
Patients' and family members' dyadic experience of post‐operative delirium in the intensive care unit: A qualitative study
Authors: Jing Dong , Weijing Sui , Yiyu Zhuang
Published: February 2025

Background

Post‐operative delirium is a complication with long‐lasting consequences for both patients and their families. This is particularly true for those transferred to the intensive care unit after surgery, where the incidence of post‐operative delirium is high, and patient outcomes are often poor. Despite the acknowledged role of family engagement in delirium management, previous research has mainly focused on patients, with limited exploration of the shared experiences between patients and family members.

Aim

This study aims to explore the experiences of patients and family members during episodes of post‐operative delirium in the intensive care unit to better understand their unmet needs.

Study Design

A qualitative descriptive study was conducted at a tertiary general hospital. Eighteen pairs of patients, their family members and two other family members were interviewed. Data were collected through face‐to‐face semi‐structured interviews within the first week after patients' discharge from the intensive care unit and analysed using thematic analysis.

Results

Four major themes emerged: (1) the dyadic relationship between patients and family members must be understood in the context of their shared emotional and behavioural experiences; (2) family's history may predispose patients to post‐operative delirium; (3) family engagement may prevent the development of post‐operative delirium; and (4) inadequate communication between health care providers and patients or families may negatively affect post‐operative delirium outcomes.

Conclusions

Post‐operative delirium presents significant emotional and physical challenges for both patients and their families. Addressing these challenges requires improved communication between health care providers and families, as well as strategies that emphasize early family support and collaboration in care.

Relevance to Clinical Practice

Patients and their families should be considered a unit during post‐operative delirium management, and earlier family engagement is essential. Health care systems should adapt intensive care unit practices to meet the dynamic needs of families, promoting more comprehensive support during critical care.
Atrophic Facial Plaque in a 4‐Month‐Old Male: An Unusual Presentation of Hair Follicle Nevus
Authors: Li Christine , Neale Holly , Plumptre Isabella , O'Donnell Patrick , Goldberg Dori , Wiss Karen , Reusch Diana
Published: February 2025

Hair follicle nevus is a rare benign follicular hamartoma that is characterized histologically by the proliferation of vellus hair follicles with peri‐follicular fibrous thickening. Clinically, hair follicle nevus is most commonly reported as an asymptomatic papule or nodule on the head and neck. Here, we describe an unusual presentation of hair follicle nevus presenting as an atrophic plaque on the cheek of a male infant.
NAC transcription factors transcriptionally fine‐tune signal homeostasis in plant systemic acquired resistance
Authors: Wang Hui , Tariq Leeza , Yan Yuqing , Bi Yan , Song Fengming
Published: February 2025

Small signalling molecules, such as salicylic acid (SA) and N‐hydroxypipecolic acid (NHP), act synergistically to activate systemic acquired resistance (SAR), a major form of plant inducible immunity. The transcriptional regulation of SA biosynthesis controlled by different transcription factors (TFs) has been well documented in SAR. Several TFs, e.g., SARD1, CBP60g and WRKY33, positively regulate NHP biosynthesis; however, direct negative modulators have remained elusive. Recently, Cai et al. (2024) identified a NAC triad composed of NAC‐type TFs, NAC90, NAC36, and NAC61, that negatively regulates NHP and SA biosynthesis. NAC90 and NAC36 act as negative regulators of plant immunity by repressing transcription of ALD1, FMO1, and ICS1, the major NHP and SA biosynthetic genes, via direct binding to their promoters. These TFs, along with another NAC TF, NAC61, form heterodimers, further enhancing their repressive effects on NHP and SA biosynthesis. These findings establish the NAC90‐NAC61‐NAC36 triad as a negative regulator of NHP and SA levels. In this viewpoint article, we present our perspectives on further investigations to gain comprehensive insight into transcriptional regulation of SAR signal homeostasis.
Silicon application enhances resistance against sorghum mosaic virus infection in sugarcane
Authors: Chen Jiaoyun , Zeng Zhen , Chen Junyan , Li Yongjia , Zhang Yi , Maqsood Ambreen , Chen Jianwen , Shen Wankuan
Published: February 2025

Mosaic disease is one of the predominant viral diseases affecting sugarcane plants worldwide. In China, it is mainly caused by the sorghum mosaic virus (SrMV). Exogenous silicon (ESi) has emerged as a promising inducer of plant disease resistance. This study aims to elucidate the mechanistic effects of exogenous silicon on enhancing the resistance to SrMV in sugarcane. ESi was applied to the soil at different rates (15 g per barrel−1, 30 g per barrel−1, and 45 g per barrel−1), leading to a significant reduction in disease incidence (26.66–82.22%) compared to non‐silicon‐treated plants. Silicon application (15 g ESi barrel−1, 30 g ESi barrel−1) mitigated SrMV inhibition of sugarcane growth, including plant height, stem diameter, and leaf area, while improving photosynthesis, including stomatal conductance, intercellular CO2 concentration, net photosynthetic rate, and transpiration rate.

Additionally, silicon mitigates SrMV‐induced degradation of chlorophyll a and b and carotenoid content, alongside heightened activities of superoxide dismutase, peroxidase, and catalase, and decreased content of malondialdehyde and hydrogen peroxide in sugarcane leaves. The ultrastructural analysis revealed silicon's capacity to reduce SrMV accumulation within sugarcane mesophyll cells while preserving chloroplast integrity. Additionally, silicon application increases SA content in sugarcane leaves and upregulates the expression of key SA pathway genes (PAL, PR1, NPR1). These findings suggest that silicon may contribute to sugarcane resistance to SrMV by potentially influencing antioxidant enzyme activity, ROS production, and SA pathway genes.
On the nature of signal 1 delivered to lymphocytes: A critical response to some considerations put forward in support of the quantum model of T cell activation
Authors: Bretscher Peter A.
Published: February 2025

The original Two Signal Model of lymphocyte activation stated that antigen‐dependent lymphocyte cooperation is required for lymphocyte activation, whereas a single or a few antigen‐specific lymphocytes can be inactivated by antigen. A virtue of this model is its ability to account for peripheral tolerance. Both the activation and inactivation of lymphocytes were envisaged to require the lymphocytes' antigen‐specific receptors to interact with antigen, leading to signal 1. We consider here the proposition that the sensitivity to antigen concentration for the generation of signal 1, to support both differentiation processes, is the same. This situation optimizes the reliability of peripheral tolerance and minimizes the effects of lymphocyte inactivation in decreasing the diversity of the lymphocytes. We consider the broader implications of this Principle of Parsimonious Sensitivity in regulating the activity of lymphocytes.
A New Allele HLA‐DPA1*02:02:02:19 Identified by HLA‐Targeted Third‐Generation Sequencing
Authors: Zhao Yuanli , Chen Yingjie , Wang Yuqi , Zhu Huachao , Ren Juan
Published: February 2025

HLA‐DPA1*02:02:02:19 differs from HLA‐DPA1*02:02:02:02 by one nucleotide change in intron 1.
A Novel HLA‐DRB1 Allele, HLA‐DRB1*03:72:02, Identified by Sequence‐Based Typing in a Chinese Individual
Authors: Zhang Dan , Li Dongmei , Wang Jie , Lian Xue , Li Wei
Published: February 2025

HLA‐DRB1*03:72:02 differs from HLA‐DRB1*03:01:01:01 by one nucleotide substitution at position 247 (codon 54) in exon 2.
The Novel HLA‐DQA1*05:90 Allele Detected in a Bone Marrow Donor Candidate Using Next‐Generation Sequencing
Authors: Gaballa Ahmed , Söderström Anna , Lundin Nina , Eich Torsten
Published: February 2025

A single nucleotide mismatch within exon 4 of HLA‐DQA1 differentiates the novel DQA1*05:90 allele from DQA1*05:09:01:03.
Characterisation of the Novel HLA‐B*35:628 Allele by Sequencing‐Based Typing
Authors: Pajot Thibault , Elsermans Vincent , Top Isabelle , Labalette Myriam
Published: February 2025

HLA‐B*35:628 differs from HLA‐B*35:01:01:01 by one nucleotide substitution in codon 109 in exon 3.
Identification of Three Novel HLA Alleles: HLA‐DPB1*1619:01, ‐DPB1*1621:01 and ‐DPB1*1737:01
Authors: Fabreti‐Oliveira Raquel Aparecida , de Oliveira Cintia Keilla Fabreti , da Silva Assis Aline , Nascimento Evaldo
Published: February 2025

Identification of three novel HLA alleles HLA‐DPB1*1619:01, ‐DPB1*1621:01, and ‐DPB1*1737:01 in Brazilian individuals.
Discovery of the Novel HLA‐A*02:1196 Allele, First Identified in a Brazilian Individual
Authors: Mendes‐Oliveira Victoria , Pinto Jonathan , Vianna Romulo , Porto Luís Cristóvão , Secco Danielle
Published: February 2025

The novel HLA‐A*02:1196 allele, first described in a potential bone marrow donor from Brazil.
Verb patterning and acculturation in Nigerian English
Authors: Abidoye Mary Ifeoluwa , Wolf Hans‐Georg
Published: February 2025

Speech communities have the tendency to develop habits as to which words tend to co‐occur, in the form of coinages and collocational patterns, thus constituting an aspect conducive to the subtle emergence of language variation. As these co‐occurrence tendencies become lexicalised and confined to specific, rigid word combinations, new phraseological or fixed multi‐word units evolve. Our study aims to investigate the phraseological patterns of verbs in Nigerian English, focusing on the extent to which it has undergone a marked cognitive acculturation process. Utilising lexical keywords as search anchors in the Global Web‐based English corpus, we identified selected verb phraseological patterns indicative of innovations in Nigerian English. The richness of meanings and the unique collocational patterns of these verbs provide evidence of the ongoing acculturation process in Nigerian English.
Religion and Attitudes Toward Xenotransplantation: Results of a Nationwide Survey in the United States
Authors: Hurst Daniel J. , Padilla Luz A. , Zink Amanda , Parent Brendan , Kimberly Laura L.
Published: February 2025

Religious viewpoints have been shown to influence the ways in which many persons approach medical decision‐making and have been noted as a potential barrier to xenotransplantation acceptance. This study sought to explore how attitudes toward xenotransplantation differ among various religious beliefs. A national Likert‐scale survey was conducted in 2023 with a representative sample in the United States. Religious belief was self‐reported. Regression analysis was used to identify associations with religious belief and hesitations about xenotransplantation. Five thousand and eight individuals across the United States responded to the survey. The two biggest concerns about xenotransplantation across religious groups were the current lack of evidence about success and the risk of xenozoonosis. Although they still expressed concerns about certain issues, Catholic and Muslim respondents were most comfortable with xenotransplantation for all. On average, the risk of xenozoonosis was a concern among 25% across all religious beliefs (p <0.0001). Orthodox Christians expressed the highest rate of negative feelings toward the recent xenotransplantation experiments on brain dead and living individuals. Those who reported no religion were most likely to have negative feelings about killing pigs for human organ transplant (OR 1.26; 95% CI: 1.08–1.46). As xenotransplantation progresses from pre‐clinical studies to clinical trials, and potentially to clinical therapy, hesitations among religious groups exist. Specific studies should be designed to investigate how religious viewpoints can affect xenotransplantation acceptance.
An IgM Cleaving Enzyme for Clearance of Anti‐Pig Xenoreactive Antibodies in a Nonhuman Primate Model
Authors: Martinino Alessandro , Smith Timothy J. , Elmore Zachary C. , Yoon Janghoon , Ladowski Joseph , Schiliro Davide , Hull Joshua A. , Schwalb Allie , Hu Meghan , Spangler Ryan , Lee Kyo Won , Kim Min Jung , Williams Kyha , Jackson Annette , Knechtle Stuart J. , Asokan Aravind , Kwun Jean
Published: February 2025

Background

The removal of preformed antibodies with cleaving enzymes like IdeS (imlifidase) has demonstrated therapeutic potential in organ transplantation for sensitized recipients. However, preformed xenoreactive antibodies (XAbs) against porcine glycans are predominantly IgM and considered detrimental in pig‐to‐human xenotransplantation.

Methods

Recombinant IceM, an endopeptidase cleaving IgM, was generated in Escherichia coli (E. coli). Four maximally MHC‐mismatched rhesus macaques underwent two serial skin transplantations to model allosensitized patients awaiting xenotransplantation. IceM was administered IV in allosensitized animals at 28 and 56 days after the first skin transplantation to assess in vivo IgM cleavage. Total IgG and IgM were quantified with western blot, and anti‐pig (xenoreactive) IgG/IgM were evaluated using flow crossmatch. B cells and their subpopulations were assessed using flow cytometry.

Results

IceM selectively cleaved human IgM, while showing no cleavage activity toward other isotypes, including IgG, IgA, IgD, and IgE. Additionally, IceM cleaves only human and nonhuman primate IgM in vitro, but not in sera from other species. At a dose of 0.5 mg/kg, IceM reduced xenoreactive IgM levels to 13.76% ± 4.98% of baseline (B cell flow crossmatch) at 24 h postadministration, with baseline levels restored approximately 2 weeks after treatment. Additionally, animals showed similar kinetics of xenoreactive IgM degradation with the repeated dose of IceM.

Conclusion

In this study, we report a recombinant bacterial enzyme that selectively cleaves IgM in human and nonhuman primate sera. Repeat administration of IceM in macaques enables selective, robust clearance of circulating xenoreactive IgM. This approach will be useful in treating preformed natural and rebound IgM in xenotransplantation.
A procedure to isolate the electrical capacitance of tooth contacts from charging curve measurements of a gear stage
Authors: Werner Michel , Meinel Andreas , Graf Simon , Koch Oliver
Published: February 2025

This paper describes a procedure to partition electrical capacitance measurements of a single-stage gearbox into its individual components: the capacitances of contact zone, inlet/outlet zone of the contact, trailing tooth flank, oil sump and surrounding components, such as the housing. It is shown via a comparison of Bearinx simulations with experimental measurements that the capacitance of a gear stage can be calculated sufficiently accurate by using experimentally determined correction factors. Furthermore, it is shown why both a high temporal resolution and the recording of at least one gear revolution are necessary capture the capacitive behavior of a gearbox in an experimental investigation. It is also shown how speed, load and temperature affect the capacitance and how the capacitance varies along the line of action.
Surgical management of neuromuscular scoliosis in paediatric patients: experiences from a tertiary centre multidisciplinary team
Authors: Khan Faris , Khan Anas , Chinnery Lucy , Loveridge Jake , Zhang James , Polychronakis Theofilos
Published: February 2025

Background

Management of neuromuscular scoliosis (NMS) is challenging, with both surgical and conservative options involving risks. This study aimed to evaluate multimorbidity in patients with NMS and how this influences multidisciplinary team (MDT) decisions as well as postoperative outcomes.

Methods

A retrospective cohort study of patients referred for assessment by the scoliosis MDT in the 8-year period between 2013 and 2021 from a single tertiary centre.

Results

84 patients with NMS were referred for assessment to the MDT. The most common underlying cause of NMS was cerebral palsy (51%). The MDT recommended surgery for 60 patients and 24 were conservatively managed. There were no significant differences in age, sex, body mass index or baseline Cobb angle between the two groups. Patients recommended surgery had fewer comorbidities (2.3 vs 3.5, p<0.05) and greater Cobb angle progression in the 18 months prior to MDT decision (22° vs 8°, p<0.05). No single comorbidity significantly influenced the MDT decision. Of the 48 patients that proceeded with surgery, immediate postoperative complications were documented in 54.1%, with no mortality. The most common complications were postoperative anaemia and respiratory infections. Multivariate logistic regression identified the use of non-invasive ventilation, forced vital capacity <70% of predicted and full-time wheelchair use as significant predictors of immediate postoperative complications. Improved posture was the most common long-term outcome (41.7%) and 81.3% of patients reported no complications at 12 months following their surgery.

Conclusions

Multimorbidity in children with NMS influences scoliosis MDT decisions, alongside factors such as scoliosis curve progression. Immediate postoperative complications were common but longer term outcomes were favourable for most patients. Further research aiming to better inform shared decision-making, improve surgical selection and ultimately enhance the quality of life for patients with NMS is required.
Gut microbiota-related neuroinflammation at the crossroad of food reward alterations: implications for eating disorders
Authors: Huwart Sabrina J P , Morales-Puerto Nuria , Everard Amandine
Published: February 2025

The link between gut microbiome and eating behaviours, especially palatable food intake, is a growing focus of scientific investigation. The complex ecosystem of microorganisms in the gut influences host metabolism, immune function and neurobehavioural signalling. This review explores the role of neuroinflammation in dysregulations of food-induced reward signalling and the potential causal role of the gut microbiota on these proinflammatory processes. Particular attention is given to eating disorders (ED, specifically anorexia nervosa, binge eating disorder and bulimia nervosa) and potential links with the gut microbiota, food reward alterations and neuroinflammation. Finally, we propose gut microbiota modulation as a promising therapeutic strategy in food reward alterations and ED.
Liposomal bupivacaine: examining the factors behind inconsistent analgesic results
Authors: Orebaugh Steven L , Ligocki Mariusz , Guo Henry , Chen Hong
Published: February 2025

Liposomal bupivacaine (LB) has been the subject of a great deal of study, and some degree of controversy, since its development in the late 1990s. While some published studies are supportive of its efficacy, many others are not or demonstrate only marginal improvement in analgesia. This variable efficacy occurs in the face of markedly increased costs when compared with plain local anesthetics. In this education article, we trace the development of LB, summarize the important aspects of its pharmacology, and explore possible causes of its failure to fulfill the promise that the drug held when it was developed and approved. Finally, we discuss some aspects of perineural anatomy that might impact the potential of this drug to provide long-lasting analgesia.
Malaphoric $$Z^\prime $$ models for $$b \rightarrow s \ell ^+ \ell ^-$$ anomalies
Authors: Allanach Ben , Gubernari Nico
Published: February 2025

We study some phenomenological effects of kinetic mixing between the hypercharge field and a new U(1) gauge field in specific

$$Z^\prime $$

Z
′

models that ameliorate the tensions between measurements and Standard Model predictions in

$$b \rightarrow s\ell ^+ \ell ^-$$

b
→
s

ℓ
+

ℓ
-

decays. To this end, we rederive the dimension-6 SMEFT coefficients resulting from integrating out the kinetically-mixed (‘malaphoric’)

$$Z^\prime $$

Z
′

field. The kinetic mixing provides a family-universal component to the couplings of the

$$Z^\prime $$

Z
′

field, which can improve fits to lepton flavour universality observables. We show how kinetic mixing improves the best fit of the

$$B_3-L_2$$

B
3

-

L
2

model to

$$b\rightarrow s$$

b
→
s

data by 7.0 units of

$$\chi ^2$$

χ
2

while remaining compatible with other relevant data sets such as electroweak precision observables and measurements of

$$e^+ e^- \rightarrow \ell ^+ \ell ^-$$

e
+

e
-

→

ℓ
+

ℓ
-

at LEP2.
Phytochemical Composition of Ziziphus lotus (L.) Lam and Its Impact on the Metabolic Syndrome: A Review
Authors: Alla Chaimae , Ali Amanat , Mehiou Afaf , Salhi Youssra , Bouanani Nourelhouda , Legssyer Abdelkhaleq , Ziyyat Abderrahim
Published: February 2025

The long‐term pathological state known as metabolic syndrome is characterized by hypertension, insulin resistance diabetes, abdominal obesity, and hyperlipidemia. Seeking healthcare strategies with fewer side effects, such as herbal remedies, is preferable in terms of mitigating the negative consequences of synthetic medications. Ziziphus lotus (L.) (Rhamnaceae) or wild jujube, commonly known as “Sedra,” is one of the best choices as it contains a variety of phytochemicals and biologically active compounds. Several flavonoids and stilbenes have been recognized as the primary bioactive components in wild jujube, including rutin, hyperin, isoquercitrin, and resveratrol. These polyphenols are pharmacologically active and have broad‐spectrum beneficial effects for reducing the risk factors associated with metabolic syndrome. They exhibit antioxidant and anti‐inflammatory properties, regulate lipid metabolism, and possess antiobesity, antihypertensive, and antidiabetic characteristics. However, there are certain limitations to their therapeutic application, such as low bioavailability. Various strategies have been proposed to enhance their pharmacokinetic profile and therapeutic potential for future use. The main goal of this review is to explore the underlying mechanisms related to the therapeutic effects of wild jujube and its active compounds in the treatment and prevention of metabolic syndrome.
Enhancing Trauma Care in Tertiary Hospitals: Addressing Gaps and Pathways to Improvement
Authors: Yaqoob Eesha , Khan Shahzad Ali , Zaidi Dua Abbas , Chaurasia Bipin , Khan Fazal Ullah , Evangelou Kyriacos , Sahitia Nimirta , Javed Saad
Published: February 2025

Background: Trauma is a major cause of morbidity and mortality globally, with road traffic accidents projected to be the leading cause of death by 2030. In developing countries like Pakistan, trauma patients face significant challenges in receiving timely and effective care. This study aimed to evaluate trauma centers in tertiary care hospitals in the twin cities of Pakistan to highlight gaps and pitfalls in trauma patient management.

Methods: A descriptive cross‐sectional study was conducted using the World Health Organization’s Hospital Emergency Unit Assessment Tool (HEAT) at five major public sector hospitals in Islamabad and Rawalpindi. Data collection involved collaboration between the Violence, Injury Prevention and Disability Unit and key informants, including Emergency Room in‐charges and Heads of Departments. Information on trauma protocols and guidelines was gathered.

Results: All hospitals provided 24/7 emergency services with access to operating rooms and laboratories. However, significant disparities were found in equipment availability, particularly portable X‐rays (40% availability) and RDT/HIV testing (20% availability). Protocol adherence varied, with 80% of hospitals having clinical management protocols but only 20% having specific protocols for conditions like asthma exacerbation and maternal hemorrhage. This study identifies infrastructural deficiencies and highlights systemic barriers that contribute to inadequate trauma care delivery, underscoring the need for targeted reforms.

Conclusion: The study highlights significant gaps in trauma care management in Pakistani tertiary care hospitals, including shortages of personnel, infrastructure deficiencies, and lack of standardized protocols. These findings underscore the urgent need for systemic improvements in trauma care delivery. Recommendations include increased investment in medical infrastructure, addressing staffing and training deficiencies, and standardizing clinical management protocols to enhance trauma care outcomes and reduce morbidity and mortality rates in Pakistan. This research contributes novel insights into the specific barriers faced by trauma care systems in Pakistan, which have not been previously addressed in existing literature.
The Effect of Diabetes Mellitus and Glycemic Parameters on the Prognosis of COVID‐19 Disease
Authors: Kalan Sarı Işılay , Keskin Olgun , Seremet Keskin Ayşegül
Published: February 2025

Studies show that coronavirus disease 2019 (COVID‐19) is more severe in people with diabetes. Although diabetes has been shown to be a risk factor for severe COVID‐19 disease, the relationship between fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) with mortality and prognosis in COVID‐19 is still controversial. We designed this study to investigate the impact of diabetes on the prognosis of COVID‐19 and to show the relationship between FBG and HbA1c and COVID‐19 mortality. In this study, patients with COVID‐19 who were hospitalized in the COVID‐19 Ward of the Department of Chest Diseases and Intensive Care Unit of Antalya Research and Training Hospital between December 2019 and December 2021 were included. The patients’ demographic data, treatment and laboratory results, developing complications, and clinical outcomes were extracted from their electronic medical records. The mortality of patients with diabetes was significantly higher than that of patients without diabetes (p : 0.0001). The duration of hospitalization, the development of complications, and the need for oxygen, antibiotics, and steroids were higher in patients with diabetes than in patients without diabetes (p : 0.0001). C‐reactive protein, erythrocyte sedimentation rate, and fibrinogen, which are associated with poor prognosis in studies, were higher in patients with diabetes (p : 0.0001). When comparing discharged and deceased patients with diabetes, HbA1c was higher in discharged patients and FBG was higher in deceased patients (p : 0.003 and p : 0.030, respectively). Our study confirms the finding that COVID‐19 patients with diabetes have a poor prognosis and mortality. It also shows that FBG level is related to COVID‐19 mortality. Contrary to some studies, the low detection of HbA1c in deceased patients may indicate that initial blood glucose rather than glycemic control prior to infection, is associated with COVID‐19 mortality. The influence of HbA1c and FBG on COVID‐19 prognosis could be investigated in larger studies.
JPEG Image Steganography With Automatic Embedding Cost Learning
Authors: Yang Jianhua , Liao Yi , Shang Fei , Kang Xiangui , Chen Yifang , Shi Yun-Qing
Published: February 2025

A great challenge to steganography has arisen with the wide application of steganalysis methods based on convolutional neural networks (CNNs). To this end, embedding cost learning frameworks based on generative adversarial networks (GANs) has been proposed and achieved success for spatial image steganography. However, the application of GAN to JPEG steganography is still in the prototype stage; its antidetectability and training efficiency should be improved. In conventional steganography, research has shown that the side information calculated from the precover can be used to enhance security. However, it is hard to calculate the side information without the spatial domain image. In this work, an embedding cost learning framework for JPEG image steganography via a GAN (JS–GAN) has been proposed, the learned embedding cost can be further adjusted asymmetrically according to the estimated side information (ESI). Experimental results have demonstrated that the proposed method can automatically learn a content‐adaptive embedding cost function, and using the ESI properly can effectively improve the security performance. For example, under the attack of a classic steganalyzer GFR with a quality factor of 75 and 0.4 bpnzAC, the proposed JS–GAN can increase the detection error by 2.58% over J‐UNIWARD, and the ESI–aided version JS–GAN (ESI) can further increase the security performance by 11.25% over JS–GAN.
Stress in Directed Graphs: A Generalization of Graph Stress
Authors: Madhumitha K. V. , Harshitha A. , Nayak Swati , D’Souza Sabitha
Published: February 2025

In graph theory, centrality measures are used to identify the most important or influential nodes within a network. Stress centrality is one such measure, which helps quantify how “stressed” a node is within the overall graph structure based on the number of shortest paths that pass through it. Stress centrality provides a more thorough assessment of a node’s relevance than other centrality metrics since it considers not only the direct connections of a node but also the indirect effects through its neighboring nodes. Furthermore, stress centrality can be applied to biological, technical, and social networks, among other kinds of networks. The idea of stress has been expanded from undirected graphs to directed graphs in our study. The stress on a vertex v in D is half of the number of geodesics passing through the vertex v, denoted by st(v). This definition reduces to the case of stress of undirected graph whenever the digraph is symmetric. We have some findings on the stress on a digraph as well as the stress on a vertex. A few standard digraphs’ stresses are obtained, including the stress on any vertex in the cartesian product of digraphs, and some characterization on stress regular digraphs is made.
Detection of Virulence Genes and Antimicrobial Susceptibility Profiles of Staphylococcus aureus Isolates From Bovine Mastitis in Chagni, Northwestern Ethiopia
Authors: Wodaje Ahmed , Belete Mequanint Addisu , Menkir Ashenafi Syoum , Zegeye Zemenu Birhan , Yihunie Fanuel Bizuayehu
Published: February 2025

Mastitis is an inflammation of the mammary gland tissue that is generally associated with an infection. Staphylococcus aureus is a primary pathogen responsible for bovine mastitis worldwide. Nonetheless, there is limited information on virulence factors and resistance profile of Staphylococcus aureus associated with bovine mastitis in northwestern Ethiopia. This study aimed to determine the frequency of virulence genes and antibiotic susceptibility profile of Staphylococcus aureus in dairy cows with mastitis. A cross‐sectional study with a simple random sampling method was conducted from October 2022 to June 2023 in Chagni town, Amhara region from a ranch and 20 smallholder farms. Staphylococcus aureus was isolated and identified using standard bacteriological and molecular methods, followed by antibiotic sensitivity testing of the isolates. Descriptive statistics was used to summarize the study results. Of 140 milk samples tested, 64 (45.7%) were positive for Staphylococcus aureus. Enterotoxins (seb = 13 [20.3%], sec = 11 [17.2%], seh = 9 [14.1%], and see = 6 [9.4%]), Panton–Valentine leukocidin (pvl = 11 [17.2%]), toxic shock syndrome toxin (tst = 7 [10.9%]), and alpha‐hemolysin (hlb = 7 [10.9%]) were the prominent virulence genes. The isolates exhibited high antimicrobial sensitivity to sulfamethoxazole (87.5%) and gentamycin (79.7%), followed by tetracycline (75%), erythromycin (72%), and azithromycin (71.8%). However, they were highly resistant to cefoxitin (65.6%), followed by erythromycin, tetracycline, and ciprofloxacin (25%). Multidrug resistance was also observed in 23 isolates, which showed resistance to at least one agent in three or more antimicrobial categories. Our research identified a significant presence of virulent genes and antibiotic‐resistant Staphylococcus aureus responsible for mastitis, underscoring the critical necessity for enhanced specific mastitis control strategies against S. aureus in the study setting.
Table S5 from Human Pancreatic Cancer Single-Cell Atlas Reveals Association of CXCL10+ Fibroblasts and Basal Subtype Tumor Cells
Authors: Loveless Ian M. , Kemp Samantha B. , Hartway Kailee M. , Mitchell Jacob T. , Wu Yuesong , Zwernik Samuel D. , Salas-Escabillas Daniel James , Brender Sydney , George Madison , Makinwa Yetunde , Stockdale Thais , Gartrelle Kendyll , Reddy Rohit G. , Long Daniel W. , Wombwell Allison , Clark Julie M. , Levin Albert M. , Kwon David , Huang Ling , Francescone Ralph , Vendramini-Costa Débora B. , Stanger Ben Z. , Alessio Adam , Waters Andrew M. , Cui Yuehua , Fertig Elana J. , Kagohara Luciane T. , Theisen Brian , Crawford Howard C. , Steele Nina G.
Published: February 2025

Supplemental Table S5
Table S2 from Human Pancreatic Cancer Single-Cell Atlas Reveals Association of CXCL10+ Fibroblasts and Basal Subtype Tumor Cells
Authors: Loveless Ian M. , Kemp Samantha B. , Hartway Kailee M. , Mitchell Jacob T. , Wu Yuesong , Zwernik Samuel D. , Salas-Escabillas Daniel James , Brender Sydney , George Madison , Makinwa Yetunde , Stockdale Thais , Gartrelle Kendyll , Reddy Rohit G. , Long Daniel W. , Wombwell Allison , Clark Julie M. , Levin Albert M. , Kwon David , Huang Ling , Francescone Ralph , Vendramini-Costa Débora B. , Stanger Ben Z. , Alessio Adam , Waters Andrew M. , Cui Yuehua , Fertig Elana J. , Kagohara Luciane T. , Theisen Brian , Crawford Howard C. , Steele Nina G.
Published: February 2025

Supplemental Table S2
Prevalence of Nasal Obstruction in Patients with Primary Muscle Tension Dysphonia: A Pilot Study
Authors: Hamdan Abdul-Latif , Hosri Jad , El Hadi Nadine , Ghzayel Lana , Bou Saab Mounir , Semaan Zeina Maria , Alam Elie , Kasti Maher
Published: February 2025

Introduction: The link between nasal obstruction and muscle tension dysphonia (MTD) has not been previously investigated despite the well-established relationship between respiratory diseases and voice disorders.
Methods: Patients presenting to the Voice and Swallowing Unit at a tertiary referral center between July 2022 and October 2023, and diagnosed with primary MTD were recruited. The prevalence and severity of nasal obstruction was assessed using the Visual Analogue Scale (VAS) and sinonasal symptoms were assessed using the Sinonasal Outcome Test-22 (SNOT-22) questionnaire. A group matched by age and gender, with no history of dysphonia and normal laryngeal examination was recruited as a control group.
Results: A total of 65 patients were enrolled in this study. These were divided into a study group of 31 patients diagnosed with primary MTD and a control group of 34 subjects with no history of dysphonia and normal laryngeal examination. Using the VAS scale for nasal obstruction, 19 patients of the study group (61.3%) had a score above 4 and were found to have moderate to severe nasal obstruction compared to only five in the control group (14.7%) (p<0.001). Using the SNOT-22 questionnaire, 61.3% of patients with MTD had moderate to severe sinonasal symptoms as compared to only 5.9% of the control group (p<0.001).
Conclusion: Patients with primary MTD are more likely to have nasal obstruction and sinonasal symptoms in comparison to patients with no dysphonia and a normal laryngeal examination.
Efficacy and safety of airway stent placement in the treatment of airway esophageal fistula
Authors: Li Xiangnan , Luo Peiyuan , Zhao Mengyu , Wen Feifei , Jiang Guancheng , You Yibei , Liu Yaru , Wu Xuan , Herth Felix J.F. , Zhang Quncheng
Published: February 2025

Introduction: This study aimed to evaluate both the clinical efficacy and safety of airway stent placement in in the treatment of patients with esophageal cancer-associated airway esophageal fistula (AEF). The focus is on evaluating improvements in patient survival and quality of life.
Methods: Overall, this study enrolled 111 patients diagnosed with esophageal cancer-associated AEF. Among them, 50 (45.0%) and 61 (55.0%) patients received airway stent placement and conservative treatment, respectively. Follow-up assessments were conducted to determine the clinical efficacy and safety of the interventions, with survival and quality of life as the primary endpoints.
Results: By the end of the follow-up, 98 of 111 patients (88.3%) had died, leaving 13 survivors (11.7%). Patients with esophageal cancer-associated AEF had an overall mean survival time of 147.4 (95%CI, 123.9–170.9) days. Patients in the stent placement group had a mean survival of 192.5 (95% CI, 151.2–233.7) days, which was significantly longer than the 110.0 (95% CI, 88.1–131.8) days in the conservative treatment group (p < 0.001). Sex (p = 0.017), tumor stage (p = 0.030), surgery (p = 0.005), pulmonary infection (p < 0.001), fistula size (p < 0.001), and pre-Karnofsky Performance Status (KPS) (p < 0.001) were the independent risk factors affecting survival. Furthermore, patients in the stent placement group demonstrated improved KPS scores post-treatment, increasing from 48.2 to 57.9 (p = 0.017).
Conclusion: Airway stent placement is beneficial in alleviating the symptoms, quality of life, and survival of patients with esophageal cancer-associated AEF.
Development and validation of a Japanese outcome tool for perceptual assessment of speech in patients with cleft palate
Authors: Ogata Yuko , Tezuka Masahiro , Fujiwara Yuri , Takei Yoshiko , Sugiyama Chihiro , Hirose Masayuki , Sato Akiko , Imamura Ako , Suzuki Keiko , Imai Satoko , Yamashita Yukari , Hayakawa Toko , Hasegawa Sachiyo , Mizuto Yoko
Published: February 2025

Introduction: The lack of a standardized evaluation method for cleft palate speech makes it difficult to exchange information at the domestic and global levels. We aimed to develop and validate a Japanese outcome tool for the perceptual assessment of speech in patients with cleft palate.
Methods: The tool we developed was based on the Cleft Audit Protocol for Speech-Augmented (CAPS-A) with modifications to some speech parameters. We developed Japanese speech samples and parameters for the Japanese Cleft Speech Outcome Tool (CAPS-A-Japan: CAPS-A-JP). This study was conducted in the Japancleft speech working group at the Japanese Cleft Palate Association. In Phase 1, we constructed and developed the speech sampling protocol. In Phase 2, After the revision of the definitions and criteria for several cleft speech characteristics and the speech sample, a total of 20 audio recordings were tested. In Phase 3, criterion validity was assessed by comparing the CAPS-A-JP resonance outcomes reported for 40 cases with the outcomes of the clinical investigations. In Phase 4, a listening experiment with six Japanese speech-language-hearing therapists was conducted twice to test the intra- and inter-rater reliabilities for 20 cases. Intra-class correlation coefficients (ICCs) were used to analyze reliability.
Results: The mean percentage agreement on criterion validity for resonance was 71% on high-pressure sentences but 54% on low-pressure sentences. The inter-rater reliability was rated moderate/good (ICC: 0.45–0.80), except for developmental immaturities/errors that were rated fair. The ICC was very low or incalculable for hyponasality and syllable error patterns because there were few cases of hyponasality and syllable errors. The intra-rater reliability was rated as good/very good. The ICC was very low or incalculable in hyponasality, nasal emission, and syllable error patterns.
Conclusions: The standardized outcome tool, CAPS-A-JP, was developed for the first time in Japan. Future research is required to optimize this tool based on the inclusion of a training protocol.
How teachers’ AI readiness affects AI integration: insights from modeling analysis
Authors: Chuyen Nguyen Thi Hong , Vinh Nguyen The
Published: February 2025

This study examined the dynamic relationships among professional development and training, resources and accessibility, attitudes and perceptions, pedagogical knowledge and expertise, teachers’ artificial intelligence (AI) readiness, and the integration of AI in teaching practices. The study employed a non-random purposive approach and utilized the structural equation modeling (SEM) method. Five hypotheses were meticulously formulated and subsequently subjected to empirical scrutiny, involving a cohort of 224 participants. Data were collected via Google Form and subjected to analysis to assess the goodness of fit of the proposed conceptual model. The findings revealed a positive relationship between teachers’ AI readiness and the integration of AI in teaching practices. Additionally, attitudes and perceptions, as well as pedagogical knowledge and expertise, exhibited positive effects on teachers’ AI readiness. However, the associations between teachers’ AI readiness and resources and accessibility, as well as pedagogical knowledge and expertise, were found to be relatively weak and statistically insignificant. The proposed conceptual model accounted for 55.3% of the variance, underscoring the significance of these established relationships for instructors, policymakers, and educators in devising practical intervention strategies to effectively harness the potential of AI.
Readiness of Indonesian physics teachers to implement augmented reality-based learning
Authors: Haryanto Zeni , Efwinda Shelly , Sholeh Muhammad , Anggraeni Bening , Pasaribu Dian Rachel
Published: February 2025

In the 21st century, technological development has entered all aspects of life, including education. With its global potential, technology digitizes education, requiring teachers to use technology through media such as augmented reality (AR). This study aims to determine the readiness of physics teachers in Indonesia to implement AR-based learning. More specifically, this research explores the extent to which physics teachers are prepared based on aspects of alignment, capability, and engagement (ACE) in implementing AR-based learning. This exploratory research is conducted by distributing questionnaires with ACE aspects. This study involved several junior and senior high school physics teachers. Data analysis techniques use KH coder and quantitative descriptive. The results show that teachers already know the definition, features, and benefits of AR in learning (alignment aspect). Still, only a minority of teachers have implemented AR-based learning (capability aspect). In the engagement aspect, it is known that teachers want to learn more about how to create AR and implement AR effectively. The implications of this research are recommendations to stakeholders to encourage and facilitate teachers, especially physics teachers.
Understanding the challenges faced by Orang Asli students in solving mathematics problems
Authors: Abd Jalil Abdul Hakim , Abdullah Abdul Halim
Published: February 2025

The educational attainment of Orang Asli students, a minority group in Malaysia, particularly in mathematics, has been a persistent concern. Despite this, research on Orang Asli mathematics education, especially in the southern region of Peninsular Malaysia, remains scarce. This study scrutinized the academic performance of Orang Asli students in whole numbers and operations at level 2 of primary school, focusing on their challenges in solving word problems in mathematics. A total of 22 Orang Asli students from year 4 and 5 in two Orang Asli primary schools participated, undertaking a mathematics test comprising five-word problems. The study identified five prevalent errors among Orang Asli students: i) failure to comprehend the question; ii) misconceptions; iii) inability to grasp specific terms in the question; iv) carelessness; and v) poor reading skills. The findings are thoroughly discussed, and strategies to enhance Orang Asli students’ mathematical problem-solving abilities are proposed.
Adult education in Greek municipalities during COVID-19 pandemic
Authors: Ntafou Athanasia , Jiménez-Fanjul Noelia N. , Gutiérrez-Rubio David
Published: February 2025

State and local governments’ primary purpose is to provide services to their populations by shaping their social and economic life. Adult education is a good example of a public service that extends deeply into people’s everyday lives. It helps adults increase their social roles as employees, parents, and retiree, gain more fulfilment in their personal lives, and solve personal and community problems. The main research purpose of this paper is to investigate and describe adult education in Greek Municipalities during the COVID-19 pandemic, specifically in the Municipality of Piraeus. For this purpose, the research was conducted using the focus group research method. Two groups participated, the first consisting of four employees of the Center for Lifelong Learning of the Municipality of Piraeus and the second group of four adult learners representing the four courses held. The results of the survey show that the unprecedented situation of COVID-19, particularly affected adult education which had stopped for a while and then many courses were discontinued. The imperative to strengthen digital skills, the uncertainty of continuing education and the change of education as a result of the changing world were also identified.