bluuebunny/crossref_metadata_2025 huggingface dataset:
A block-based numerical strategy for modeling the dynamic out-of-plane behavior of unreinforced brick masonry walls
Authors: Ghezelbash Amirhossein , D’Altri Antonio Maria , Sharma Satyadhrik , Lourenço Paulo B. , Rots Jan G. , Messali Francesco
Published: October 2024

In this paper, a numerical procedure is proposed to simulate the dynamic out-of-plane response of unreinforced masonry (URM) walls. A state-of-the-art damaging block-based model, originally developed for quasi-static simulations, is extended for the first time in a dynamic regime. The blocks are represented using solid 3D finite elements governed by a plastic-damage constitutive law for both tension and compression. A cohesive-frictional contact-based formulation is used to account for interactions between the blocks. A simplified mechanical characterization is formulated to improve efficiency in wall-level analyses. Dynamic simulation is performed using a generalized HHT-$$\alpha$$
α
direct integration implicit solver and by implementing Rayleigh damping in the bulk. Such consideration allows the use of both mass and stiffness proportional terms of the Rayleigh damping without compromising efficiency. The strategy is applied to simulate incremental dynamic experiments performed on full-scale walls, showing good agreement between numerical and experimental results. The calibrated numerical model is then optimized to reduce computational effort while maintaining accuracy. The optimized model is used to investigate the effect of relative support motion on the one-way bending out-of-plane seismic response of URM walls, demonstrating the potential of the modeling strategy to explore the effect of boundary conditions that occur in real buildings but are often overlooked in laboratory experiments. This investigation also explores the adequacy of simplifications in capturing the effect of relative support motion, which can be adopted for simple modeling strategies commonly used in standard engineering practice.
Open-loop swept frequency response of nonlinear structures subjected to weak coupling
Authors: Gabos Zoltan , Dombovari Zoltan
Published: October 2024

The present study demonstrates a common behaviour of a forced nonlinear structure with smooth nonlinearity, while coupled dynamics are apparent, originating from the attached electrodynamic shaker. This appears as a variation in the transmitted forcing amplitude and is often subjected to a hysteretic (multi-state) behaviour for up and down open-loop sweeping. This situation differs from the ideal constant amplitude harmonic excitation, on which parameter extraction and engineering comprehension are based on. Untreated or ignored, this can lead to the misinterpretation of the underlying dynamics through the measured nonlinear frequency response curves and their force-normalised version, often called quasi-frequency response function. In this paper, a post-processing solution is introduced for the correct interpretation of frequency response curves at constant forcing amplitudes through the open-loop construction and resectioning of the so-called frequency response surface. The phenomenon and the proposed methodology are demonstrated using a two-degrees-of-freedom model on a shaker-nonlinear beam structure. First, open-loop frequency sweeps are executed on the mechanical system to create the nonlinear frequency response surface, where their actual amplitudes and hysteresis widths are significantly different from the ideal constant forcing amplitude case. The response surface is then sectioned at the assumed constant forcing values by using an appropriate interpolation law. These resectioned curves represent the forced nonlinear standalone structure under ideal constant harmonic excitation. The frequency response surfaces are characterised and resectioned on a nonlinear structure with stiffening and softening cases. Furthermore, an improvement in the operational resonance decay (ORD) method in its filtering and automation is shown to extract the backbone curves (BBCs). The BBC and the resectioned surface provide a complete picture and cross-validation of the underlying dynamics. Finally, the BBC and its distortion are also shown in the response surfaces in relation with the excitation normalization.
Trajectory of health-related quality of life during and after hospitalisation due to worsening of heart failure
Authors: Kuan Wai Chee , Lim Ka Keat , Chee Kok Han , Kasim Sazzli , Dujaili Juman Abdulelah , Lee Kenneth Kwing-Chin , Teoh Siew Li
Published: October 2024

Purpose

This study aimed to examine the trajectory in health-related quality of life (HRQoL) during and after hospitalisation for worsening of heart failure (HF) in Malaysia.

Methods

200 patients with heart failure and reduced ejection fraction (HFrEF) admitted into two hospitals in Malaysia due to worsening of HF were surveyed using the EQ-5D-5 L questionnaire. The primary outcomes were utility values at admission, discharge and 1-month post-discharge (1MPD). Secondary outcomes included the visual analogue scores (VAS) and the proportion of patients reporting each EQ-5D-5 L dimension levels. Missing data were imputed using multiple imputation, and generalised linear mixed models were fitted.

Results

At admission, the unadjusted mean utility values and VAS scores for HFrEF patients in Malaysia were as low as 0.150 ± 0.393 and 38.2 ± 20.8, respectively. After a median hospital stay of 4 days, there was a significant improvement in utility values and VAS scores by 0.510 (95% CI: 0.455–0.564) and 28.8 (95% CI: 25.5–32.1), respectively. The utility value and VAS score at 1-month post-discharge were not significantly different from discharge. The proportion of HFrEF patients reporting problems and severe problems in mobility, self-care, usual activities, and anxiety/depression, pain/discomfort reduced at varying degree from admission to discharge and 1MPD.

Conclusion

HF is a progressive condition with substantial variation in HRQoL during the disease trajectory. During hospitalisation due to worsening of HF, HFrEF population has unfavourable HRQoL. Rapid and significant HRQoL improvement was observed at discharge, which sustained over one month. The study findings can inform future cost-effectiveness analyses and policies.
Multi-modal scene graph inspired policy for visual navigation
Authors: He Yu , Zhou Kang , Tian T. Lifang
Published: October 2024

Visual navigation needs the agent locate the given target with visual perception. To enable robots to effectively execute tasks, combining large language models (LLMs) with multi-modal inputs in navigation is necessary. While LLMs offer rich semantic knowledge, they lack specific real-world information and real-time interaction capabilities. This paper introduces a Multi-modal Scene Graph (MMSG) navigation framework that aligns LLMs with visual perception models to predict next steps. Firstly, a multi-modal scene dataset is constructed, containing triplets of object-relations-target words. We provide target words and lists of existing objects in the scene to generate a large number of instructions and corresponding action plans for GPT$$-$$
-
3.5. The generated data is then utilized for pre-train LLM for path planning. During inference, we discover objects in the scene by extending the DETR visual object detector to multi-view RGB image collected from different reachable positions. Experimental results show that path planning generated from MMSG outperforms state-of-the-art methods, indicating its feasibility in complex environments. We evaluate our methods on the ProTHOR dataset and show superior navigation performance.
Aging disrupts blood–brain and blood-spinal cord barrier homeostasis, but does not increase paracellular permeability
Authors: Cummins Mitchell J. , Cresswell Ethan T. , Bevege Renee J. , Smith Doug W.
Published: October 2024

Blood-CNS barriers protect the CNS from circulating immune cells and damaging molecules. It is thought barrier integrity becomes disrupted with aging, contributing to impaired CNS function. Using genome-wide and targeted molecular approaches, we found aging affected expression of predominantly immune invasion and pericyte-related genes in CNS regions investigated, especially after middle age, with spinal cord being most impacted. We did not find significant perturbation of endothelial cell junction genes or proteins, nor were vascular density or pericyte coverage affected by aging. We evaluated barrier paracellular permeability using small molecular weight tracers, serum protein extravasation, CNS water content, and iron labelling measures. We found no evidence for age-related increased barrier permeability in any of these tests. We conclude that blood–brain (BBB) and blood-spinal cord barrier (BSCB) paracellular permeability does not increase with normal aging in mouse. Whilst expression changes were not associated with increased permeability, they may represent an age-related primed state whereby additional insults cause increased leakiness.
Sex-related differences in vitamin D testing in the Veneto Region, Italy: a retrospective analysis from 2005 to 2016
Authors: Giannini Sandro , Pitino Annalisa , Sella Stefania , Fusaro Maria , Arcidiacono Gaetano Paride , Torres Marco Onofrio , Zaninotto Martina , Gori Mercedes , Aghi Andrea , Egan Colin Gerard , Simioni Paolo , Tripepi Giovanni , Plebani Mario
Published: October 2024

Summary

A retrospective analysis was performed to evaluate the frequency of vitamin D blood testing in individuals from the Padua province, Veneto, Italy from 2005 to 2016. A significant increase in the frequency of vitamin D blood tests, particularly in females was observed and in individuals with severe vitamin D deficiency (Class I).

Purpose

Vitamin D deficiency has been linked to negative health outcomes that extend beyond bone-related conditions. The frequency of vitamin D blood testing in residents from the Padua province, (Veneto, Italy) from 2005 to 2016 was evaluated.

Methods

Data were retrospectively retrieved from blood test databases (Laboratory Medicine Unit, Padua University Hospital) and information on number of vitamin D blood tests performed on residents from 2005 to 2016 was collected. Data were stratified by sex and ten birth cohorts from 1901 to 2016. Blood tests were classified into five vitamin D classes: I < 50 nmol/L, II 50–74.9 nmol/L, III 75–149 nmol/L, IV 150–250 nmol/L, and V > 250–1000 nmol/L. Blood test trends were analyzed as blood test rate and vitamin D class rate/resident population. Population analysis was analyzed by incidence rates and stratified by vitamin D class.

Results

293,013 vitamin D blood tests were conducted between 2005 and 2016 across 10 birth cohorts. Females accounted for 75% of tests and fewer were conducted in the youngest and oldest birth cohorts. Sex differences in vitamin D blood test frequency were observed; adjusted rates ranging from 1.7 to 35.6% for males and 8 to 81% for females from 2005 to 2016. Crude incidence rates (per 1000 from 2005 to 2016) varied from 1.5 to 10.8‰ for males and 7 to 19.4‰ for females. Crude blood test rates for vitamin D deficiency (Class I) increased from 1.1 to 9.9‰ in 2016 for males and 5 to 17.3‰ for females. Crude incidence rates (from 2005 to 2016) for Class I were 9.7–57.1‰ in males and 43.6–92.4‰ in females.

Conclusions

These findings highlight sex-related differences in vitamin D testing, providing valuable insight for healthcare planning.
The Electrical Conductivity Mechanisms and Dielectric Properties of Multiphase Co-synthesized CuV2O6–MnV2O6
Authors: El-Naggar Mohamad Awad , Mousa Mahmoud Ahmed , Reda S. M. , Emara Mahmoud Mohamed
Published: October 2024

Many research studies on photodegradation, energy storage applications, and biosensing have focused on single and mixed Cu and Mn divanadates (MV2O6, M2+ = Cu2+ and/or Mn2+). In this work, MV2O6 was synthesized, and its electrical conductivity and dielectric properties were studied. The electrical and dielectric properties were investigated in a frequency range of 0.1-300 kHz and a temperature range of 298 K to 573 K. The results indicate that the DC conductivity, AC conductivity, dielectric constant, dielectric loss factor, and loss tangent of the investigated materials increase with temperature, which support the contribution of grains and grain boundaries to the electrical properties. The materials exhibit non-Debye type relaxation, as indicated by the progression of the relaxation frequency. As frequency increases, the activation energy of AC conduction decreases, indicating that hopping conduction is the dominant mechanism. In all samples, the DC conduction activation energy is higher than the AC conduction activation energy. The circuit model was used to estimate the relaxation times. The results revealed remarkable dielectric characteristics, notably higher dielectric loss tangent values at frequencies below 1 kHz. Consequently, these materials can be used as electromagnetic attenuation absorbers.

Graphical Abstract
Practical computational fluid dynamic predictions of a cyclist in a time trial position
Authors: Taylor Morgan , Butcher Daniel , Crickmore Conor , Walker A. Duncan
Published: October 2024

On a flat road, at race speeds, aerodynamic drag is the main resistive force a cyclist must overcome. Computational fluid dynamics (CFD) can be a useful tool to predict and understand the complex flow and, therefore, drive developments to reduce drag. However, cycling aerodynamics is complex. The effects of Reynolds number, surface roughness, boundary layer transition, flow separation, and turbulent wakes are challenging to accurately predict. High fidelity time-resolved computations, such as Large eddy simulations (LES), require high-performance computing and lengthy simulation times. This paper examines whether lower fidelity CFD, such as Reynolds averaged approaches, can predict the drag of a cyclist with sufficient accuracy and within practical timescales on a desktop PC. Wind tunnel tests of a rider model (without bicycle) were conducted at Reynolds numbers equivalent to speeds of ~ 20–70 km/h. Measured drag showed a notable Reynolds number dependency with the drag coefficient reducing almost linearly by ~ 20% from 0.88 to 0.71. The computational accurately replicated this relationship but only when employing a boundary layer transition model. The steady computations underpredicted the magnitude of the measured drag coefficient by ~ 3% but the unsteady computations were within ~ 2%. Examination of the predicted flow field revealed variations in boundary layer transition, separation, and wake formation from each body part which combine in a complex wake system. Overall, the data confirm validity and suitable accuracy of the CFD, and therefore this provides a practical time and cost-effective tool for further examination of drag reduction within cycling.
The Current Status of Global Digital Mental Health Implementation: Results and Implications of a Web-Based Survey from All WPA Regions
Authors: Volpe Umberto , Orsolini Laura , Ramalho Rodrigo , Ransing Ramdas , Samal Shreyasta , Gaebel Wolfgang
Published: October 2024

The aim of this study was to compare the availability and use of digital mental health (DMH) across all World Psychiatric Association (WPA) regions (WR) and to guide future regional-tailored initiatives to upscale DMH contingent on introducing international policies, regulations, guidelines, education, and training, the WPA Working Group on Digital Psychiatry developed and disseminated a web-based survey among all 145 WPA National Psychiatric Association (NPA) members, according to official WR including (1) The Americas (WR1), (2) Europe (WR2), (3) Africa, Middle East, Central/Western Asia (WR3), and (4) Asia/Australasia (WR4). Collected data were analyzed using the Qualtrics analytic dashboard. The availability of digital tools/programs in DMH largely varies among WPA regions. In Europe and Asia/Australasia, mobile apps were the most available digital tools (respectively, 76.9% and 90.9%), followed by telemental health (respectively, 65.4% and 81.8%). Wearables, serious games, virtual/augmented reality, and chatbots represented the least commonly used tools/programs across all WR. National policies were mainly reported by Asia/Australasia (81.8%), followed by Europe (38.5%) and the Americas (27.3%). In all WR, less than 40% of NPAs reported the provision of education and training in the use of digital tools and programs in their countries. WPA regional analysis of digital needs promotes designing a roadmap to develop targeted actions to implement DMH and guide global digital upscaling of psychiatric services. Improving digital literacy and digital capacity building of the psychiatric workforce are key priorities for future digital initiatives led by the WPA across all WR.
Frontiers in metal–organic frameworks: innovative nanomaterials for next-generation supercapacitors
Authors: Ansari Mohd Zahid , Habib Faiza , Gupta Jhalak , Alsubaie Abdullah Saad , Barsoum Imad , Alfantazi Akram , Yatoo Mudasir A. , Ahmad Zubair , Hussain Iftikhar
Published: October 2024

Metal–organic frameworks (MOFs) have emerged as a versatile class of porous materials with tremendous potential for various applications, including energy storage devices. This review provides a comprehensive analysis of recent advancements and applications of MOFs in the field of energy storage including a brief overview of the fundamental aspects of MOFs, including their synthesis, structural diversity, and tuneable properties. MOFs have been extensively investigated for applications in advanced energy storage systems including supercapacitors. MOFs can be employed as electrode materials, separators, and catalysts, offering enhanced electrochemical performance, improved charge/discharge rates, and prolonged cycling stability. The unique tunability of MOFs allows for the rational design of tailored materials with desired properties, such as high specific capacity, excellent conductivity, and superior cycling stability. The recent developments in MOF-based electrochemical capacitors, particularly the significant progress reported in achieving high energy and power densities, are noteworthy. The exceptional charge storage capacity of MOFs, combined with their facile synthesis and scalability, makes them promising candidates for next-generation energy storage technologies. This review sheds light on the challenges and opportunities in the practical implementation of MOFs in energy storage devices and discusses strategies for enhancing the stability of MOFs in different environments, improving their electrical conductivity, and developing scalable synthesis methods. We briefly discuss perspectives and future directions, with particular focus on their research and development in the use of MOFs for energy storage applications.
Precision drip Irrigation System and Foliar Application of Biostimulant and Fertilizers Containing Micronutrients Optimize Photochemical Efficiency and Grain Yield of Maize (Zea mays L)
Authors: Ocwa Akasairi , Bojtor Csaba , Illés Árpád , Ssemugenze Brian , Balaout Ibtissem , Rátonyi Tamás , Széles Adrienn , Harsányi Endre
Published: October 2024

Asymmetric drought propagation and depletion of soil nutrients threaten cereal crop productivity worldwide, calling for the application of validated agronomic practices to curtail their effect on crop production. This study evaluated the effect of precision drip irrigation, biostimulant, and micronutrients application on photochemical efficiency and yield of maize.An experiment laid in a randomized complete block design with irrigation and water stress was established in 2022 and 2023 growing seasons at the experimental area of the University of Debrecen. Other treatments included T1 (non-microbial biostimulant from plant origin), T2 (zinc based chemical fertilizer), T3 (boron and molybdenum based chemical fertilizer), and T4 (control). Data was collected on steady-state fluorescence (F’), maximal fluorescence (Fm’), quantum photosynthetic yield or efficiency of photosystem II (ΦPSII or Y(II)), electron transport rate (ETR), and grain yield and yield components. Precision drip irrigation significantly optimized ΦPSII, ETR, cob weight, number of seeds per cob, weight of 1000 seeds and grain yield. The biostimulant and micronutrients optimized Fm’, ΦPSII, and ETR at VT and R2 growth stages. Regardless of the water management regime, T1, T2 and T3 seasonally optimized grain yield. Between water management regimes, biostimulant had the highest yield optimization effect under precision drip irrigation in the season with elevated water stress.Optimum photochemical efficiency and grain yield is achievable through precision drip irrigation, biostimulant, and micronutrient application. However, further research involving 2–3 application times at critical stages of maize under precision drip irrigation and/or combined application of these treatments at season specific precision drip irrigation is required.
Empowering health: exploring the vital role of facilitator organisations in supporting chronic disease patients in Assam, India
Authors: Bhuyan Hiranmoyee , Singha Seema S.
Published: October 2024

Background

The research centers on an underrated type of mediator organization namely facilitator organizations (FO) that work in the health care setting. These organizations are mediators that bridge the gap between patients (healthcare customers) and medical services. The facilitator organizations considered for the study are non-governmental organizations situated in Assam that works in align to chronic diseases, particularly cancer.

Methods

The data collection was done through organizational referrals for the study making it a snowball sampling, progressively incorporating additional contemporary entities. The study's respondents were facilitator organizations (i.e.Non-Government Organizations) actively involved in addressing chronic disease. Data were gathered from these facilitator organizations situated in Assam, India, supporting healthcare customers specifically those with cancer. Key informant interviews and semi-structured questionnaires were used for data collection, the responses were documented using a field diary and the Lovelock service model was used as a reference for the construction of the questionnaire and developing the research framework.

Results

The analysis of data shows that facilitator organisations maintain continuity in relationships, which enhances health management and outcomes for customers. The shift in cancer care towards a patient-centred approach and the crucial role of FOs in providing comprehensive and individualized care, addressing diverse patient needs thereby addressing the holistic development of the health care customer is vital. In addition, effective patient-centred communication, incorporating trust, compassion, respect and comprehensive support including mental health therapy, occupational therapy, and rehabilitation plays a crucial role in leading a normal life. `

Conclusion

The facilitator organizations dealing with Cancer have to meet a broad range of services outside the core medical service providers for their healthcare customers. These efforts contribute to the overall recovery of both the healthcare customer with cancer and their family.
Optimizing cervical cancer classification using transfer learning with deep gaussian processes and support vector machines
Authors: Ahishakiye Emmanuel , Kanobe Fredrick
Published: October 2024

Background

Cervical cancer is the fourth most frequent cancer in women worldwide. Even though cervical cancer deaths have decreased significantly in Western countries, low and middle-income countries account for nearly 90% of cervical cancer deaths. While Western countries are leveraging the powers of artificial intelligence (AI) in the health sector, most countries in sub-Saharan Africa are still lagging. In Uganda, cytologists manually analyze Pap smear images for the detection of cervical cancer, a process that is highly subjective, slow, and tedious. Machine learning (ML) algorithms have been used in the automated classification of cervical cancer. However, most of the MLs have overfitting limitations which limits their deployment, especially in the health sector where accurate predictions are needed.

Methods

In this study, we propose two kernel-based algorithms for automated detection of cervical cancer. These algorithms are (1) an optimized support vector machine (SVM), and (2) a deep Gaussian Process (DGP) model. The SVM model proposed uses an optimized radial basis kernel while the DGP model uses a hybrid kernel of periodic and local periodic kernel.

Results

Experimental results revealed accuracy of 100% and 99.48% for an optimized SVM model and DGP model respectively. Results on precision, recall, and F1 score were also reported.

Conclusions

The proposed models performed well on cervical cancer detection and classification, and therefore suitable for deployment. We plan to deploy our proposed models in a mobile application-based tool. The limitation of the study was the lack of access to high-performance computational resources.
Perspective: Floquet engineering topological states from effective models towards realistic materials
Authors: Zhan Fangyang , Chen Rui , Ning Zhen , Ma Da-Shuai , Wang Ziming , Xu Dong-Hui , Wang Rui
Published: October 2024

With significant advances in classifying and cataloguing topological matter, the focus of topological physics has shifted towards quantum control, particularly the creation and manipulation of topological phases of matter. Floquet engineering, the concept of tailoring a system by periodic fields, offers a powerful tool to manipulate electronic properties of condensed systems, and even to create exotic non-equilibrium topological states that are impossibly present in equilibrium scenarios. In this perspective, we give a brief review of recent progress in theoretical investigations of Floquet engineering topological states from effective models towards realistic materials. We show that light irradiation can realize various desired topological states through the introduction of symmetry breaking, such as first- and higher-order Weyl fermions, quadrupole topological insulator with periodic driving and disorder, quantum anomalous Hall effects with a tunable Chern number, as well as beyond. Moreover, based on first-principles calculations and Floquet theorem, we show several realistic material candidates proposed as potential hosts for promising Floquet topological states, facilitating their verification in experiments. We believe that our perspective on Floquet engineering of topological states will advance further studies of rich exotic light-induced phenomena in condensed matter physics.
Impacts of a growing population on the coastal environment of the Bay of Bengal
Authors: Saengsupavanich Cherdvong , Agarwala Nitin , Magdalena Ikha , Ratnayake Amila Sandaruwan , Ferren Vinsensia
Published: October 2024

The Bay of Bengal has been at the heart of human civilisation and trade for many centuries. Accordingly, this oceanic space has seen influx of people from around the world including European traders who plundered natural wealth of this region for many years. Unabated exploitation of natural resources has been the primary reason for deterioration of environment of this part of the world. To add to this, supporting a growing population through unsustainable anthropogenic activities for decades is considered a primary cause for deterioration of marine life, habitats, coastal and marine ecosystems and numerous ocean ecosystem services of this oceanic space. Since the health of the oceanic space is critical for survival of life of Earth, a detailed study of the impacts of a growing population on the coastal environment of the Bay is considered important. Unfortunately, since the anthropogenic activities causing this deterioration are numerous, they cannot be covered in one paper. Hence, only a select few critical anthropogenic activities causing coastal erosion, resource degradation, and marine pollution are being analysed here. The study shows that as a result of increasing population, terrestrial activities such as increasing built up area, industries, land use activities, fisheries and aquaculture, and construction of shore protection structures have resulted in reduced coastal vegetation and increased pollution of the ocean. As a result the coastal landscape is witnessing increased coastal erosion, coastal flooding and inundation, loss of vegetation and faunal communities especially fishes. While local initiatives and projects reflect a positive commitment to address resource degradation and to create resilient coastal ecosystems, these efforts need to be transformed into achievements by dedicated and nuanced involvement of all stakeholders, especially the public, for the desired results.
PD-1 inhibitors plus chemotherapy for refractory EBV-positive DLBCL: a retrospective analysis
Authors: Li Youli , Wu Yonghe , Cao Sufen , Yu Baohua , Zhang Qunling , Xia Zuguang , Cao Junning , Lv Fangfang , Chen Guang-Liang
Published: October 2024

Background

Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expression in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL.

Methods

This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment.

Results

The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy.

Conclusion

The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treatment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.
Orthorexia Nervosa
Authors: Brytek-Matera Anna
Published: October 2024

Whilst many people try to make healthy food choices to improve their health, for others the focus on healthy eating can become obsessive and lead to maladaptive eating behaviours and poorer health. Orthorexia nervosa is a preoccupation with the quality of healthy food, where a refusal of certain foods is driven by the desire to be healthy. Orthorexia Nervosa: Current Understanding and Perspectives is the first clinical book that systematically explores this condition. The book contains in-depth information, with chapters highlighting diagnostic criteria, assessment, prevalence, multidimensional characteristics, future directions and treatment. Additional expert commentary delivers valuable insights to further provide readers with a better understanding of this condition. This informative and engaging book is a valuable resource for academics, researchers, health professionals and students interested in eating behaviour. It is an essential read for anyone wanting a better understanding of orthorexia nervosa and its impact on individuals' health.
Randomized Trial of Self-Guided, Internet-Based, Cognitive Behavior Therapies for Migraine
Authors: Huguet Anna , Rozario Sharlene , Chaplin William , McDonald Margaret , Wozney Lori M. , Lagman Bartolome Ana Marissa , Kronish Ian M. , Purdy Allan , Stinson Jennifer N. , McGrath Patrick J.
Published: October 2024

Background:

Self-guided Internet-based cognitive behavior therapy (iCBT) for migraine interventions could improve access to care, but there is poor evidence of their efficacy.

Methods:

A three-arm randomized controlled trial compared: iCBT focused on psychoeducation, self-monitoring and skills training (SPHERE), iCBT focused on identifying and managing personal headache triggers (PRISM) and a waitlist control. The primary treatment outcome was a ≥ 50% reduction in monthly headache days at 4 months post-randomization.

Results:

428 participants were randomized (mean age = 30.1). 240 participants (56.2%) provided outcome data at 4 months. Intention-to-treat (ITT) analysis with missing data imputed demonstrated that the proportion of responders with a ≥ 50% reduction was similar between combined iCBTs and waitlist (48.5/285, 17% vs. 16.6/143, 11.6%, p = 0.20), but analysis of completers showed both iCBT programs to be superior to the waitlist (24/108, 22.2% vs. 13/113, 11.5%, p = 0.047). ITT analysis with missing data imputed showed no difference between the two iCBTs (SPHERE: 24.8/143, 17.3% vs. PRISM: 23.7/142, 16.7%, p = 0.99). Uptake rates of the iCBTs were high (76.9% and 81.69% logged in at least once into SPHERE and PRISM, respectively), but adherence was low (out of those who logged in at least once, 19.01% [21/110] completed at least 50% modules in SPHERE and 7.76% [9/116] set a goal for trying out a given trigger-specific recommendation in PRISM). Acceptability ratings were intermediate.

Conclusions:

Self-guided iCBTs were not found to be superior in our primary ITT analysis. Low adherence could explain the lack of effects as completer analysis showed effects for both interventions. Enhancement of adherence should be a focus of future research.
Global Health Impacts of Wildfire Disasters From 2000 to 2023: A Comprehensive Analysis of Mortality and Injuries
Authors: Mani Zakaria A. , Khorram-Manesh Amir , Goniewicz Krzysztof
Published: October 2024

Background

Wildfires have escalated into a global threat with profound impacts on health, society, and the environment. The increasing frequency and intensity of these disasters, influenced by climate change and urban expansion, necessitate a comprehensive understanding of their direct health consequences.

Methods

This study conducted a retrospective analysis of global wildfire disasters from January 2000 to December 2023, utilizing data from the Emergency Events Database (EM-DAT). The analysis focused on the direct health outcomes—mortalities and injuries—excluding indirect effects such as smoke inhalation. Data were meticulously cleaned, categorized, and analyzed using quantitative methods, with statistical tests employed to validate the findings.

Results

The study identified 309 significant wildfire disasters, with forest fires accounting for 80% of these events. These incidents resulted in 1890 fatalities and 14 360 injuries, with the highest tolls observed in Southern Europe, Northern America, and the Australia-New Zealand region. A notable rise in wildfire incidents was observed over the study period, underscoring the critical intersections between climate change, urban expansion, and wildfire risks. The analysis highlighted significant geographical and temporal patterns, emphasizing the regions and factors contributing to heightened wildfire vulnerability.

Conclusions

The findings underscore the urgent need for robust disaster preparedness and effective mitigation strategies. Integrating advanced early warning systems and Traditional Ecological Knowledge into wildfire management practices is essential. The study calls for proactive public health measures and interdisciplinary approaches to address the multifaceted challenges posed by wildfires. Continuous research and policy formulation are crucial to protect vulnerable communities and mitigate the increasing threat of wildfires globally.
Emergency Nurses Knowledge, Attitude and Practices Regarding Disaster Preparedness and Management in Emergency Departments in the Northern Division, The Republic of Fiji
Authors: Prasad Ajnesh Avinit , Brown Diane , Singh Keshni
Published: October 2024

Introduction

Since the adoption of the Hyogo Framework, much work has been done to mitigate the effects of disasters as adequate preparation will enable Registered emergency nurses (ENs) to mitigate the negative consequences of disasters.

Objective

To assess the knowledge, attitude, and practices of ENs in the northern division of Fiji (ND) toward disaster preparedness and management.

Method

A quantitative, cross-sectional study design using a self-administered questionnaire queried 61 ENs working in Emergency Departments (ED) in divisional, sub-divisional hospitals and health centers in the ND.

Results

A low proportion (23%) of these ENs have attended disaster preparedness training from the time they started working with the employer demonstrating they are not prepared to mitigate the effects of disaster on the affected population in the ND. Though they have adequate knowledge and a positive attitude in engaging themselves towards disaster management, only 43% of these ENs were knowledgeable about appropriate policies and procedures. This study found that 72.1% have never read or seen their health disaster management policy.

Conclusion

Given the number of disasters experienced in Fiji every year, there is an urgent need for a comprehensive disaster management policy and training for ENs across the ND.
An Exploratory Evaluation of Implementing a Rapid-response Online Mental Health Service During the COVID-19 Pandemic: A Mixed Methods Study from India
Authors: Agrawal Ravindra , Monteiro Kimberley , Biswal Bijayalaxmi , Raikwar Brinda Singh , Gupta Devika , Amonkar Akshada , Amonkar Nishadh , Fernandes Wenona , Dhume Rajesh , Srivastava Ashish , Rane Anil , Nadkarni Abhijit
Published: October 2024

Objectives

Strict social distancing and lockdown measures imposed to curb transmission during the early phase of the outbreak of the COVID-19 pandemic posed challenges to people’s psychological wellbeing, limited access to social support, and disrupted routine mental health service delivery. In response, a consortium of mental health stakeholders from Goa, India launched the COVIDAV program, which provided pro-bono virtual psychiatric and counselling consultations across India through an online platform. This study describes the acceptability and feasibility of the program from the perspective of various stakeholders.

Methods

Data were collected via a survey with clinicians who had volunteered on COVIDAV (n = 40), in depth interviews of the clinicians (n = 14), and focus group discussion with key collaborators (n = 1). Process data were mapped at various stages during the online platform’s development and use. The qualitative and quantitative data was analysed using thematic analysis and a descriptive analysis respectively.

Results

Over 17 months, 63 clinicians conducted 2245 online sessions through the COVID platform, primarily accessed by youth across the country. The clinicians acknowledged the online platform’s ability to enhance access and reduce stigma. Challenges included session time constraints, connectivity issues, and user interface inconsistencies that interfered with clients’ accessibility to the services. High satisfaction rates amongst the service providers were reported, with 79.3% content with the service provision and 82.8% with pro bono contributions through the platform.

Conclusions

This study illustrates the feasibility, flexibility, and applicability of a rapidly designed pro-bono online platform for delivering mental health care services through the collaboration of stakeholder groups in the mental health care, private, social, and governmental sector. Our findings highlight the potential of rapidly deployed digital platforms, developed via cross-sector partnerships, to meet mental health care needs during unprecedented global emergencies such as the COVID-19 pandemic.
Disaster Knowledge, Skills, and Preparedness among Emergency Medical Services in Saudi Arabia
Authors: Almukhlifi Yasir , Crowfoot Gary , Wilson Amanda , Hutton Alison
Published: October 2024

Objectives

Emergency Medical Services (EMS) workers are critical to effective disaster response. Therefore, it is important to understand their knowledge, skills, and preparedness for disasters. This study investigated factors influencing EMS workers’ disaster knowledge, skills, and preparedness in the Saudi Arabian context. The study also sought to identify challenges to disaster preparedness among Saudi Arabian EMS workers.

Methods

A descriptive cross-sectional survey using The Disaster Preparedness Evaluation Tool was distributed to EMS workers in military and government hospitals across 3 Saudi Arabian cities. Responses were recorded on a 6-point Likert scale where higher scores indicated higher knowledge, skills, or preparedness. The results were analysed using descriptive and inferential statistical analysis.

Results

272EMS workers participated in this study. EMS workers reported a moderate level of knowledge (3.56), skills (3.44), and preparedness (3.73) for disasters. Despite this, EMS workers reported a high level of involvement in regular disaster drills (M = 4.24, SD = 1.274) and a strong interest in further disaster education opportunities (M = 5.43, SD = 1.121). Participants also reported a high skill level with the triage principles used in their workplace during a disaster (M = 4.06, SD = 1.218). The study findings revealed a significant positive correlation between disaster preparedness levels and age, years of experience, education level, and the facility worked in.

Conclusions

EMS workers have moderate disaster knowledge, skills, and preparedness levels. Knowledge, skill, and preparedness have a significant relationship on the EMS workers’ demographics. These findings demonstrate the need to invest in preparing Saudi Arabian EMS workers to effectively respond to bioterrorism disasters.
Air-jet impact craters on granular surfaces: a universal scaling
Authors: Sonar Prasad , Katsuragi Hiroaki
Published: October 2024

Craters form as the lander's exhaust interacts with the planetary surfaces. Understanding this phenomenon is imperative to ensuring safe landings. We investigate the crater morphology, where a turbulent air jet impinges on granular surfaces. To reveal the fundamental aspect of this phenomenon, systematic experiments are performed with various air-jet velocities, nozzle positions and grain properties. The resultant crater morphology is characterized by an aspect ratio. We find a universal scaling law in which the aspect ratio is scaled by a dimensionless variable consisting of the air velocity at the nozzle, the speed of sound in air, the nozzle diameter, the nozzle-tip distance from the surface, the grain diameter, the density of the grains and the density of air. The obtained scaling reveals the cross-over of the length scales governing the crater aspect ratio, providing a useful guideline for ensuring safe landings. Moreover, we report a novel drop-shaped sub-surface cratering phenomenon.
Reliable uncertainty estimation in emotion recognition in conversation using conformal prediction framework
Authors: Roohi Samad , Skarbez Richard , Nguyen Hien Duy
Published: October 2024

Emotion recognition in conversation (ERC) faces two major challenges: biased predictions and poor calibration. Classifiers often disproportionately favor certain emotion categories, such as neutral, due to the structural complexity of classifiers, the subjective nature of emotions, and imbalances in training datasets. This bias results in poorly calibrated predictions where the model’s predicted probabilities do not align with the true likelihood of outcomes. To tackle these problems, we introduce the application of conformal prediction (CP) into ERC tasks. CP is a distribution-free method that generates set-valued predictions to ensure marginal coverage in classification, thus improving the calibration of models. However, inherent biases in emotion recognition models prevent baseline CP from achieving a uniform conditional coverage across all classes. We propose a novel CP variant, class spectrum conformation, which significantly reduces coverage bias in CP methods. The methodologies introduced in this study enhance the reliability of prediction calibration and mitigate bias in complex natural language processing tasks.
A sub-functor for Ext and Cohen–Macaulay associated graded modules with bounded multiplicity-II
Authors: Mishra Ankit , Puthenpurakal Tony J.
Published: October 2024

Let
$(A,\mathfrak{m})$
be a Cohen–Macaulay local ring, and then the notion of a
$T$
-split sequence was introduced in the part-1 of this paper for the
$\mathfrak{m}$
-adic filtration with the help of the numerical function
$e^T_A$
. In this article, we explore the relation between Auslander–Reiten (AR)-sequences and
$T$
-split sequences. For a Gorenstein ring
$(A,\mathfrak{m})$
, we define a Hom-finite Krull–Remak–Schmidt category
$\mathcal{D}_A$
as a quotient of the stable category
$\underline{\mathrm{CM}}(A)$
. This category preserves isomorphism, that is,
$M\cong N$
in
$\mathcal{D}_A$
if and only if
$M\cong N$
in
$\underline{\mathrm{CM}}(A)$
.This article has two objectives: first objective is to extend the notion of
$T$
-split sequences, and second objective is to explore the function
$e^T_A$
and
$T$
-split sequences. When
$(A,\mathfrak{m})$
is an analytically unramified Cohen–Macaulay local ring and
$I$
is an
$\mathfrak{m}$
-primary ideal, then we extend the techniques in part-1 of this paper to the integral closure filtration with respect to
$I$
and prove a version of Brauer–Thrall-II for a class of such rings.
The impact of dominant ventricle morphology and additional ventricular chamber size on clinical outcomes in patients with Fontan circulation
Authors: Padalino Massimo A. , Ponzoni Matteo , Reffo Elena , Azzolina Danila , Cavaliere Annachiara , Puricelli Filippo , Cabrelle Giulio , Bergonzoni Emma , Cao Irene , Gozzi Anna , Castaldi Biagio , Vida Vladimiro , Di Salvo Giovanni
Published: October 2024

Objectives:

The functional roles of ventricular dominance and additional ventricular chamber after Fontan operation are still uncertain. We aim to assess and correlate such anatomical features to late clinical outcomes.

Methods:

Fontan patients undergoing cardiac MRI and cardiopulmonary exercise test between January 2020 and December 2022 were retrospectively reviewed. Clinical, cardiac MRI, and cardiopulmonary exercise test data from the last follow-up were analysed.

Results:

Fifty patients were analysed: left dominance was present in 29 patients (58%, median age 20 years, interquartile range:16–26). At a median follow-up after the Fontan operation was 16 years (interquartile range: 4–42), NYHA classes III and IV was present in 3 patients (6%), 4 (8%) underwent Fontan conversion, 2 (4%) were listed for heart transplantation, and 2 (4%) died. Statistical analysis showed that the additional ventricular chamber was larger (>20 mL/m2) in patients with a right dominant ventricle (p = 0.01), and right dominance was associated with a higher incidence of post-operative low-cardiac output syndrome (p = 0.043). Left ventricular dominance was associated with a better ejection fraction (p = 0.04), less extent of late gadolinium enhancement (p = 0.022), higher metabolic equivalents (p = 0.01), and higher peak oxygen consumption (p = 0.033). A larger additional ventricular chamber was associated with a higher need for post-operative extracorporeal membrane oxygenation support (p = 0.007), but it did not influence functional parameters on cardiac MRI or cardiopulmonary exercise test.

Conclusions:

In Fontan patients, left ventricular dominance correlated to better functional outcomes. Conversely, a larger additional ventricular chamber is more frequent in right ventricular dominance and can negatively affect the early post-Fontan course.