bluuebunny/crossref_metadata_2025 huggingface dataset:
A knowledge-embedded close-looped deep-learning framework for intelligent inversion of multisolution problems
Authors: Zhang Fanchang , Zhu Lei , Xu Xunyong
Published: December 2023

Deep learning is prevalent in many fields and attempts have been made to use it in nonbidirectional mapping problems, such as seismic inversion. These nonbidirectional mapping problems have two special issues, that is, insufficient labels and uncertainty of solution. Therefore, current deep-learning structures are not suitable for handling this kind of problem. A distinctive knowledge-embedded close-looped (KECL) deep-learning framework is developed, tuned to the characteristics of the seismic inverse problem. The KECL deep-learning framework is composed of a reservoir parameter generator (RPG) and a reservoir parameter updater (RPU). The former half-loop is RPG, which takes the seismic data as input to generate the initial reservoir parameters. The latter loop is RPU, which takes the initial parameters as input to output synthetic seismic data. Through the training by well data, the difference between field seismic data and synthetic seismic data modeled by the RPU is used to optimize the RPG and RPU. In this deep-learning framework, knowledge of the Robinson convolutional model is embedded to address the problem of insufficient labels. Furthermore, semisupervised learning is used as prior information to reduce the uncertainty of solution. After the training, with the help of prior geologic information data, the RPU is used to update the initial reservoir parameters generated by RPG for final reservoir parameter inversion. Numerical models and field data are used to test the feasibility of our deep-learning framework. We find that intelligent inversion results using data from one well to train the KECL network are consistent with results using multiple well data. Experiments demonstrate that it is adaptable to situations in which insufficient well data are available and is able to achieve reliable intelligent inversion.
Changes in Collagen Type I C-Telopeptide and Procollagen Type I N-Terminal Propeptide During the Menopause Transition
Authors: Shieh Albert , Karlamangla Arun S , Gossiel Fatma , Eastell Richard , Greendale Gail A
Published: December 2023

Context

Collagen type I C-telopeptide (CTX) and procollagen type I N-terminal propeptide (PINP) are reference bone resorption and formation markers, respectively.

Objective

To characterize CTX and PINP trajectories across the menopause transition (MT).

Methods

This 18-year longitudinal analysis of a community-based cohort from the Study of Women’s Health Across the Nation included 541 women (126 Black, 90 Chinese, 87 Japanese, 238 White) who transitioned from pre- to postmenopause. Multivariable mixed effects regression fit piecewise linear models of CTX or PINP relative to years from final menstrual period (FMP); covariates were race/ethnicity, body mass index (BMI), and age at FMP. In the referent participant (White, 52.46 years at FMP, BMI 27.12 kg/m2), CTX and PINP were stable until 3 years pre-FMP (premenopause). During the MT (3 years before to 3 years after the FMP), CTX and PINP increased 10.3% (P < .0001) and 7.5% (P < .0001) per year, respectively; MT-related gains totaled 61.9% for CTX and 45.2% for PINP. Starting 3 years post-FMP (postmenopause), CTX and PINP decreased 3.1% (P < .0001) and 2.9% (P < .0001) per year, respectively. Compared with the White participants, during the MT, Chinese participants had larger gains in CTX (P = .01), and Japanese women experienced greater increases in CTX (P < .0001) and PINP (P = .02). In postmenopause, CTX (P = .01) and PINP (P = .01) rose more in Japanese relative to White women.

Conclusion

CTX and PINP are stable in premenopause, increase during the MT, and decrease in postmenopause. During the MT and postmenopause, bone turnover change rates vary by race/ethnicity.
Physician Unionization: Opportunities and Challenges for Anesthesiologists in the United States
Authors: Hendrix Joseph Maxwell , Burgart Alyssa M. , Baker E. Brooke , Wolman Richard L. , Kras Joseph F.
Published: December 2023

Physician unionization is gaining traction in the United States, with <10% of practicing physicians now members, up from historically weak support. Factors that drive interest in unions include a decreased number of independent practitioners, an increase in workloads, and the erosion of autonomy. Approximately 56% of anesthesiologists are considered employees and may be eligible for union membership. Physician unions may provide higher wages, better working conditions, and legal protection. However, they also raise concerns about patient care and professionalism. This article discusses the legal and regulatory framework governing the unionization of physicians, benefits, challenges, and potential future developments. Continued analysis and debate are necessary to determine the optimal role of physician unions in the health care industry.
Intracranial Pressure, Autoregulation, and Cerebral Perfusion in Infants With Nonsyndromic Craniosynostosis at the Time of Surgical Correction
Authors: Hurth Helene , Zipfel Julian , Kerscher Susanne Regina , Decker Karlheinz , Haas-Lude Karin , Krimmel Michael , Neunhoeffer Felix , Schuhmann Martin Ulrich
Published: December 2023

BACKGROUND AND OBJECTIVE:

Although an increased intracranial pressure (ICP) is a known problem in children with syndromic craniosynostosis, it remains unclear whether elevated ICP and impaired cerebral perfusion exist in nonsyndromic synostosis and should be defined as targets of primary treatment. This study aimed to investigate ICP, cerebral autoregulation (CAR), and brain perfusion in infants with nonsyndromic craniosynostosis at first surgical intervention.

METHODS:

Forty-three infants were prospectively included. The patients underwent perioperative measurement of mean arterial blood pressure, ICP, and brain perfusion before and after cranial vault decompression. Physiological parameters with possible influences on ICP and autoregulation/brain perfusion were standardized for age. CAR was assessed by the pressure reactivity index (PRx), calculated using the mean arterial blood pressure and ICP.

RESULTS:

Biparietal decompression was performed in 29 infants with sagittal synostosis (mean age, 6.1 ± 1.3 months). Fronto-orbital advancement was performed in 10 and 4 infants with metopic and unilateral coronal synostosis, respectively (mean age, 11.6 ± 2.1 months). An elevated ICP (>15 mm Hg) was found in 20 of 26 sagittal (mean, 21.7 ± 4.4 mm Hg), 2 of 8 metopic (mean, 17.1 ± 0.4 mm Hg), and 2 of 4 unilateral coronal synostosis cases (mean, 18.9 ± 2.5 mm Hg). Initial ICP was higher in sagittal synostosis than in metopic/coronal synostosis (P = .002). The postdecompression ICP was significantly reduced in sagittal synostosis cases (P < .001). The relative cerebral blood flow and blood flow velocity significantly increased after decompression. Impaired CAR was found in infants with a mean ICP >12 mm Hg (PRx, 0.26 ± 0.32), as compared with those with a mean ICP ≤ 12 mm Hg (PRx, −0.37 ± 0.07, P = .001).

CONCLUSION:

Contrary to common belief, an elevated ICP and significantly impaired CAR can exist early in single suture synostosis, particularly sagittal synostosis. Because an influence of raised ICP on long-term cognitive development is known in other diseases, we suggest that preventing increased ICP during the phase of maximal brain development may be a goal for decompressive surgery, at least for sagittal synostosis cases.
Understanding evidence ecosystems: What influences the production, translation, and use of modeled evidence in Burkina Faso, Nigeria, India, and Kenya?
Authors: Sié Ali , Fofana Habibou , Kagoné Moubassira , Ouédraogo Moussa , Onwujekwe Obinna E. , Mbachu Chinyere O. , Chokshi Maulik , Chilgod Latha , Mokashi Tushar , Nair Arun B. , Muriuki Peter , Taddese Abeba , Ewald Leah , Handigol Apoorva
Published: December 2023

Background This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations. Methods The study used mixed methods drawing on analysis from key informant interviews and surveys, complemented by a rapid desk review to map modeling activities and actors. The survey was conducted online while the qualitative research entailed in-depth interviews with modelers, knowledge brokers, and decision-makers working in a representative variety of health fields, organizations, and levels of government. This study was approved by Health Media Lab IRB (Institutional Review Board) in the United States and a local IRB in each study country and conducted between September 2021 and June 2022. Results Informants interviewed for this study described a range of factors that facilitate and inhibit the use of modeled evidence in public health decision-making at the individual, organizational, and environmental levels. Key themes included the capacity to produce, translate, and use modeled evidence; the timing and relevance of modeling outputs; the existence of communications channels between modelers and decision-makers; the strength of underlying data systems; the role of sustained funding; and the impact of global crises. Conclusion This study highlights the importance of taking an ecosystem approach to supporting modeling activities, considering individual, organizational, and environmental factors and how different actors and interact to inform the production, translation, and use of modeled evidence. Structured interaction that promotes dialogue, debate, and joint sense making between the producers and users of evidence is critical to informing and influencing the use of evidence in decision-making.
Investigating syntactic priming cumulative effects in MT-human interaction
Authors: Resende Natália
Published: December 2023

Background A question that deserves to be explored is whether the interaction between English language learners and the popular Google neural machine translation (GNMT) system could result in learning and increased production of a challenging syntactic structure in English that differs in word order between speakers first language and second language. Methods In this paper, we shed light on this issue by testing 30 Brazilian Portuguese L2 English speakers in order to investigate whether they tend to describe an image in English with a relation of possession between nouns using a prepositional noun phrase (e.g. the cover of the book is red) or re-use the alternative syntactic structure seen in the output of the GNMT (e.g. the book cover is red), thus manifesting syntactic priming effects. In addition, we tested whether, after continuous exposure to the challenging L2 structure through Google Translate output, speakers would adapt to that structure in the course of the experiment, thus manifesting syntactic priming cumulative effects. Results Our results show a robust syntactic priming effect as well as a robust cumulative effect. Conclusions These results suggest that GNMT can influence L2 English learners linguistic behaviour and that L2 English learners unconsciously learn from the GNMT with continuous exposure to its output.
Protection of the Right to Privacy in States’ Unilateral Access to Extraterritorially Located Data in Criminal Investigations
Authors: Laurits Eneli
Published: December 2023

The process of striving to enhance law enforcement's access to digital data held extraterritorially while finding the right balance in fundamental-rights protection began with establishing the Convention on Cybercrime. Evolving risks of evidence being lost, intimately connected with the urgency of collecting digital data, impose a constant need for new, more efficient models for data acquisition and access. The article examines the set of mechanisms connected with states gaining access unilaterally (without needing foreign states’ assistance) to extraterritorially located data from the perspective of protecting suspects' privacy and family-life rights. In light of the fact that one virtually steps onto foreign ground to gain such access, most states have refrained from regulating it domestically and have officially addressed the issue by means of international co-operation instruments created for situations significantly different from this, yet investigators in circumstances such as a domestic criminal investigation wherein the only connection to the other state lies in an e-mail message sent via a foreign service provider ought to avoid resorting to extremely burdensome mutual legal-assistance instruments. At the same time, sufficient domestic guarantees of fundamental-rights protection should be in place.
The author proposes a model for unilaterally accessing extraterritorial data that considers the rights of individuals involved in criminal procedure and, alongside these, state interests in unilaterally accessing and receiving extraterritorially held data.
Effects of feeding different densities of Artemia nauplii on the growth and survival of larvae of the hairy river prawn, Macrobrachium rude (Heller, 1862)
Authors: Hinzano Sheban Mdzomba , Ngarari Morine Mukami , Opiyo Mary , Okalo Francis , Nyonje Betty Mindraa , Midumbi David , Gitari Derrick
Published: December 2023

The effects of feeding at different densities of Artemia nauplii on the growth and survival of Macrobrachium rude larvae were explored in this study. Two experiments were carried out. In the first trial, larvae were fed three different feeding densities: 1, 3, and 5 nauplii/mL. In the second experiment, feeding densities of 5, 10, and 15 nauplii/mL were used to determine the maximal feeding density of Artemia nauplii for M. rude larvae. There were no significant differences statistically in growth rate or survival between larvae fed 1, 3, or 5 nauplii/mL (P>0.05). Increased feeding density from 5 to 10 nauplii/mL resulted in growth but drastically decreased survival. Feeding above 10 nauplii/mL decreased both growth rate and survival. According to the results of the study, the optimal feeding density of M. rude with Artemia nauplii should be between 5 and 10 nauplii/mL. The study suggests further research into determining ideal feeding density at various phases of larval development in order to better understand the individual feeding requirements at each stage.
Escherichia coli endocarditis and cardiac abscess: a rare presentation in a patient with a prosthetic aortic valve
Authors: Chavada Ishan , Anwar Ramsha , Dumont Michael W. , Khutubuddin Mohammed
Published: December 2023

Introduction: There are very few documented cases of Escherichia coli endocarditis with cardiac abscesses in the literature. Here we describe a case presentation with diagnostic challenges and a multidisciplinary approach to management. Case description: This is a rare presentation of E. coli endocarditis in a patient with a prosthetic aortic valve. Initial tests were inconclusive and further investigation with transoesophageal echocardiography was required to make the diagnosis. Despite initial improvement, the patient deteriorated and ultimately died of complications related to the presentation. Discussion/conclusion: E. coli is a rare causative organism for endocarditis, which can itself be difficult to diagnose. A multidisciplinary approach to investigation and treatment is required when infective endocarditis is suspected. Transoesophageal echocardiography may be required to diagnose endocarditis when there is a strong clinical suspicion and risk factors present.
A Case Study of Four Pre-service Science Teachers: What Do Teacher Reflections Tell Us?
Authors: Sengul Ozden
Published: December 2023

Reflection requires someone to think in deep and express the impression of a phenomenon or an event. Reflection can be defined as a mirror to look at and see the personal insights, feelings, motivation, or purposes of individuals within a particular context and practice in a realistic way. This study examined the nature of pre-service science teachers’ reflections during the last semester of the teacher education program. There were four cases as student-teachers attending science teacher education program in northwest region of Turkey. The qualitative data, written reflections and researcher field notes were utilized and analyzed through inductive methods. The results indicated that even though pre-service science teachers learned scientific practices and inquiry, they were not able to implement due to some constraints: mentor teachers forced them to teach on a traditional basis. They could only complete the required four-hour teaching practice. Student teachers reflected on their learning as becoming a science teacher, but their actions were restricted, and they could not find supportive community in school and classroom context.
Resource allocation performance analysis and idle resource reallocation for FOV-limited indoor VLC networks
Authors: Zhou Yiming , Huang Nuo , Xu Zhengyuan
Published: December 2023

Visible light communication (VLC) networks based on multiple access points (APs) have gained significant attention in enhancing indoor communication coverage and transmission capacity. Since interference can significantly impact the quality of VLC links, this paper investigates and compares the performance of three resource allocation (RA) schemes based on the user equipment (UE) location to avoid interference under specific VLC deployments. Towards this end, we first derive statistical channel gain models in different overlap settings of coverage areas of optical APs according to the structural information, assuming that the UE distribution follows the Poisson point process (PPP) model. Then we derive the expressions for the performance metrics of the three RA schemes. Meanwhile, we construct a conflict graph to reveal potential interference relations and propose an idle resource reallocation policy (IRRP) in the case of low UE density. Finally, simulation results are provided to verify the correctness of derived expressions. It is shown that the performance of field-of-view (FOV)-limited VLC networks depends heavily on the RA schemes free of intercell interference (ICI). Without resource reallocation, more detailed resource division leads to worse system performance. With a user density of only 0.1UE/m2, the IRRP can even enhance the area spectral efficiency (ASE) of the proposed joint transmission (JT) scheme by 330% under linear deployment and 780% under hexagonal deployment, making the JT scheme the best among all relevant schemes in most situations.
Efficient and high-spatiotemporal-quality terawatt-class mid-infrared optical parametric amplifiers by spatially shaped pumping
Authors: Liu Xin , Li Jinhui , Zhen Qiwen , Liu Keyang , Wang Yishan , Zhao Wei , Cao Huabao , Fu Yuxi
Published: December 2023

We propose a method to efficiently generate terawatt (TW)-class mid-infrared (MIR) femtosecond laser pulses with high spatiotemporal quality through optical parametric chirped-pulse amplification (OPCPA). By transforming the pump-beam profile for the OPCPA from Gaussian to flat-top using a designed field mapping optics consisting of two aspherical lenses, we obtain a TW-class femtosecond laser pulse at 2 µm with a conversion efficiency of over 36% according to our simulations. Furthermore, the spatiotemporal coupling effects are greatly suppressed in our method compared to an OPCPA system that is pumped by a widely employed Gaussian profile beam. Our work provides a simple and robust method for developing OPCPA systems with high efficiency and high pulse quality.
Investigation of unidirectional coupling of dipole emitters in valley photonic heterostructure waveguides
Authors: Zhang Qiankun , Xing Xiaohua , Zou Die , Liu Yin , Mao Bingxuan , Zhang Guizhong , Ding Xin , Yao Jianquan , Wu Liang
Published: December 2023

Photonic heterostructure has recently become a promising platform to study topological photonics with the introduction of mode width degree of freedom (DOF). However, there is still a lack of comprehensive analysis on the coupling of dipole emitters in photonic heterostructures, which constrains the development of on-chip quantum optics based on chiral dipole sources. We systematically analyze the unidirectional coupling mechanism between dipole emitters and valley photonic heterostructure waveguides (VPHWs). With the eigenmode calculations and full-wave simulations, the Stokes parameters are obtained to compare the coupling performance of two types of valley-interface VPHWs. Simulation results show that compared to the zigzag interface with inversion symmetry, the strategy of bearded interface with glide symmetry is easier to realize high-efficiency coupling. By adjusting the position and chirality of dipole emitters in VPHWs, the transmission of light reverses with guided modes coupled to different directions. Furthermore, a topological beam modulator is realized based on VPHWs, which maintains the robustness to large-area potential barriers and sharp corners. Our work supplies a powerful guide for chiral light-matter interaction, which is expected to be applied to increasingly compact and efficient on-chip optical platforms in the future.
Frequency-stabilized improvement of saturated absorption spectroscopy based on laser linewidth-control strategy
Authors: Zeng Chun , Zhao Qilai , Yang Changsheng , Sun Yuxin , Li Jialong , Wang Changhe , Zheng Junjie , Yang Zhongmin , Xu Shanhui
Published: December 2023

Single-frequency fiber lasers (SFFLs), 1083 nm, have been extensively applied in 4He optical pumping magnetometers (OPMs) for magnetic field detection. However, the sensitivity and accuracy of OPMs are constrained by the frequency stability of SFFLs. Focusing on this concern, the frequency-stabilized performance of the 1083 nm SFFLs is successfully improved by externally tailoring the laser linewidth to match the spectral width of the error signal in saturated absorption spectroscopy. Thereinto, a high-intensity error signal of saturated absorption is generated as a large number of 4He atoms with a wide range of velocities interacting with the 1083 nm laser. Consequently, the root mean square value of the fluctuating frequency after locking is effectively decreased from 24.6 to 13.6 kHz, which achieves a performance improvement of 44.7%. Such a strategy can provide a technical underpinning for effectuating an absolute frequency stabilization with higher precision based on atomic and molecular absorption spectroscopy techniques.
Polarization-separated feedback spectral beam combining source
Authors: Zhang Jun , Peng Hangyu , Zhang Jiye , Wang Jingbo , Han Jinliang , Fu Xinpeng , Lei Yuxin , Qin Li , Ning Yongqiang , Wang Lijun
Published: December 2023

A novel, to the best of our knowledge, structure for spectral beam combining (SBC) is proposed, utilizing a polarization-separated feedback (PSF). A polarization separation element is introduced to separate the laser beam into a TE-polarized light and a TM-polarized light. The lower-power light is selected as the external feedback to adjust the resonant wavelength, while the other light is combined spectrally. Compared to the conventional SBC source with a similar feedback, the power and efficiency of the PSFSBC are improved by approximately 20%. Additionally, the beam quality in the non-SBC direction is optimized by 10%, and the power on the output coupler is reduced to nearly one-third. This provides an effective method for achieving an optimized SBC performance.
The Frank-Wolfe Algorithm: A Short Introduction
Authors: Pokutta Sebastian
Published: December 2023

In this paper we provide an introduction to the Frank-Wolfe algorithm, a method for smooth convex optimization in the presence of (relatively) complicated constraints. We will present the algorithm, introduce key concepts, and establish important baseline results, such as e.g., primal and dual convergence. We will also discuss some of its properties, present a new adaptive step-size strategy as well as applications.
Machine learning identification of Pseudomonas aeruginosa strains from colony image data
Authors: Rattray Jennifer B. , Lowhorn Ryan J. , Walden Ryan , Márquez-Zacarías Pedro , Molotkova Evgeniya , Perron Gabriel , Solis-Lemus Claudia , Pimentel Alarcon Daniel , Brown Sam P.
Published: December 2023

When grown on agar surfaces, microbes can produce distinct multicellular spatial structures called colonies, which contain characteristic sizes, shapes, edges, textures, and degrees of opacity and color. For over one hundred years, researchers have used these morphology cues to classify bacteria and guide more targeted treatment of pathogens. Advances in genome sequencing technology have revolutionized our ability to classify bacterial isolates and while genomic methods are in the ascendancy, morphological characterization of bacterial species has made a resurgence due to increased computing capacities and widespread application of machine learning tools. In this paper, we revisit the topic of colony morphotype on the within-species scale and apply concepts from image processing, computer vision, and deep learning to a dataset of 69 environmental and clinical Pseudomonas aeruginosa strains. We find that colony morphology and complexity under common laboratory conditions is a robust, repeatable phenotype on the level of individual strains, and therefore forms a potential basis for strain classification. We then use a deep convolutional neural network approach with a combination of data augmentation and transfer learning to overcome the typical data starvation problem in biological applications of deep learning. Using a train/validation/test split, our results achieve an average validation accuracy of 92.9% and an average test accuracy of 90.7% for the classification of individual strains. These results indicate that bacterial strains have characteristic visual ‘fingerprints’ that can serve as the basis of classification on a sub-species level. Our work illustrates the potential of image-based classification of bacterial pathogens and highlights the potential to use similar approaches to predict medically relevant strain characteristics like antibiotic resistance and virulence from colony data.
The economic burden of households affected by tuberculosis in Brazil: First national survey results, 2019-2021
Authors: Noia Maciel Ethel Leonor , Negri Letícya dos Santos Almeida , Guidoni Leticia Molino , Fregona Geisa Carlesso , Johansen Fernanda Dockhorn Costa , Sanchez Mauro Niskier , Moreira Adriana da Silva Rezende , Diaz-Quijano Fredi Alexander , Tonini Maiko , Zandonade Eliana , Ershova Julia , Nguhiu Peter , Baena Inés Garcia
Published: December 2023

Background

One of the three main targets of the World Health Organization (WHO) End TB Strategy (2015-2035) is that no tuberculosis (TB) patients or their households face catastrophic costs (defined as exceeding 20% of the annual household income) because of the disease. Our study seeks to determine, as a baseline, the magnitude and main drivers of the costs associated with TB disease for patients and their households and to monitor the proportion of households experiencing catastrophic costs in Brazil.

Methods

A national cross-sectional cluster-based survey was conducted in Brazil in 2019-2021 following WHO methodology. TB patients of all ages and types of TB were eligible for the survey. Adult TB patients and guardians of minors (<18 years old) were interviewed once about costs, time loss, coping measures, income, household expenses, and asset ownership. Total costs, including indirect costs measured as reported household income change, were expressed as a percentage of annual household income. We used descriptive statistics to analyze the cost drivers and multivariate logistic regression to determine factors associated with catastrophic costs.

Results

We interviewed 603 patients, including 538 (89%) with drug-sensitive (DS) and 65 (11%) with drug-resistant (DR) TB. Of 603 affected households, 48.1% (95%CI: 43–53.2) experienced costs above 20% of their annual household income during their TB episode. The proportion was 44.4% and 78.5% among patients with DS- and DR-TB, respectively. On average, patients incurred costs of US$1573 (95%CI: 1361.8–1785.0) per TB episode, including pre-diagnosis and post-diagnosis expenses. Key cost drivers were post-diagnosis nutritional supplements (US$317.6, 95%CI: 232.7–402.6) followed by medical costs (US$85.5, 95%CI: 54.3–116.5) and costs of travel for clinic visits during treatment (US$79.2, 95%CI: 61.9–96.5). In multivariate analysis, predictors of catastrophic costs included positive HIV status (aOR = 3.0, 95%CI:1.1–8.6) and self-employment (aOR = 2.7, 95%CI:1.1–6.5); high education was a protective factor (aOR = 0.1, 95%CI:0.0–0.9).

Conclusions

Although the services offered to patients with TB are free of charge in the Brazilian public health sector, the availability of free diagnosis and treatment services does not alleviate patients’ financial burden related to accessing TB care. The study allowed us to identify the costs incurred by patients and suggest actions to mitigate their suffering. In addition, this study established a baseline for monitoring catastrophic costs and fostering a national policy to reduce the costs to patients for TB care in Brazil.
Enhancing breast ultrasound segmentation through fine-tuning and optimization techniques: Sharp attention UNet
Authors: Khaledyan Donya , Marini Thomas J. , M. Baran Timothy , O’Connell Avice , Parker Kevin
Published: December 2023

Segmentation of breast ultrasound images is a crucial and challenging task in computer-aided diagnosis systems. Accurately segmenting masses in benign and malignant cases and identifying regions with no mass is a primary objective in breast ultrasound image segmentation. Deep learning (DL) has emerged as a powerful tool in medical image segmentation, revolutionizing how medical professionals analyze and interpret complex imaging data. The UNet architecture is a highly regarded and widely used DL model in medical image segmentation. Its distinctive architectural design and exceptional performance have made it popular among researchers. With the increase in data and model complexity, optimization and fine-tuning models play a vital and more challenging role than before. This paper presents a comparative study evaluating the effect of image preprocessing and different optimization techniques and the importance of fine-tuning different UNet segmentation models for breast ultrasound images. Optimization and fine-tuning techniques have been applied to enhance the performance of UNet, Sharp UNet, and Attention UNet. Building upon this progress, we designed a novel approach by combining Sharp UNet and Attention UNet, known as Sharp Attention UNet. Our analysis yielded the following quantitative evaluation metrics for the Sharp Attention UNet: the Dice coefficient, specificity, sensitivity, and F1 score values obtained were 0.93, 0.99, 0.94, and 0.94, respectively. In addition, McNemar’s statistical test was applied to assess significant differences between the approaches. Across a number of measures, our proposed model outperformed all other models, resulting in improved breast lesion segmentation.
Supported: Supporting, enabling, and sustaining homecare workers to deliver end-of-life care: A qualitative study protocol
Authors: Bayley Zana , Bothma Joan , Bravington Alison , Forward Cat , Hussain Jamilla , Manthorpe Jill , Pearson Mark , Roberts Helen , Taylor Paul , Walker Liz , White Caroline , Wray Jane , Johnson Miriam J.
Published: December 2023

Background

Homecare workers provide essential care at home for people at end-of-life but are often poorly trained and supported.

Aim

To explore the experiences and needs of homecare workers and the views of homecare clients and carers, and other community-based health and social care staff about the homecare worker role, including identification of good practice.

Methods

In this qualitative exploratory study, we will conduct 150 semi-structured interviews with homecare workers within three geographic English localities chosen for maximum socio-demographic variation. Eligible participants will be consenting adults providing care services (workers [n = 45], managers [n = 15] community practitioners [n = 30]), receiving care (clients thought to be in the last 6 months of life [n = 30], family carers [n = 15], or commissioners of homecare services supporting end-of-life care [n = 15]. Interviews may adopt a Pictor-guided or standard semi-structured approach according to their preference. Managers and commissioners can contribute to an online focus group if preferred. A range of recruitment strategies will be used, including through homecare agencies, local authorities, local NHS services, charities, voluntary sector groups and social media. Interviews and focus groups will be recorded, transcribed, anonymised, and analysed adopting a case-based approach for each geographic area within-case and then comparison across cases using reflexive thematic analysis. The design and analysis will be informed by Bronfenbrenner’s Adapted Ecological Systems theory. This study is registered on the Research Registry (No.8613).

Contribution

We will provide evidence on ways to improve the experiences and address the needs of homecare workers in relation to caring for people nearing end-of-life. It will offer insight into good practice around supporting homecare workers including responding to their training and development needs. Findings will inform subsequent stages of an evaluation-phase study of a training resource for homecare workers.
Bioactivity and efficacy of a hyperimmune bovine colostrum product- Travelan, against shigellosis in a non-Human primate model (Macaca mulatta)
Authors: Islam Dilara , Ruamsap Nattaya , Imerbsin Rawiwan , Khanijou Patchariya , Gonwong Siriphan , Wegner Matthew D. , McVeigh Annette , Poly Frédéric M. , Crawford John M. , Swierczewski Brett E. , Kaminski Robert W. , Laird Renee M.
Published: December 2023

Infectious diarrhea is a World Health Organization public health priority area due to the lack of effective vaccines and an accelerating global antimicrobial resistance crisis. New strategies are urgently needed such as immunoprophylactic for prevention of diarrheal diseases. Hyperimmune bovine colostrum (HBC) is an established and effective prophylactic for infectious diarrhea. The commercial HBC product, Travelan® (Immuron Ltd, Australia) targets multiple strains of enterotoxigenic Escherichia coli (ETEC) is highly effective in preventing diarrhea in human clinical studies. Although Travelan® targets ETEC, preliminary studies suggested cross-reactivity with other Gram-negative enteric pathogens including Shigella and Salmonella species. For this study we selected an invasive diarrheal/dysentery-causing enteric pathogen, Shigella, to evaluate the effectiveness of Travelan®, both in vitro and in vivo. Here we demonstrate broad cross-reactivity of Travelan® with all four Shigella spp. (S. flexneri, S. sonnei, S. dysenteriae and S. boydii) and important virulence factor Shigella antigens. Naïve juvenile rhesus macaques (NJRM) were randomized, 8 dosed with Travelan® and 4 with a placebo intragastrically twice daily over 6 days. All NJRM were challenged with S. flexneri 2a strain 2457T on the 4th day of treatment and monitored for diarrheal symptoms. All placebo-treated NJRM displayed acute dysentery symptoms within 24–36 hours of challenge. Two Travelan®-treated NJRM displayed dysentery symptoms and six animals remained healthy and symptom-free post challenge; resulting in 75% efficacy of prevention of shigellosis (p = 0.014). These results strongly indicate that Travelan® is functionally cross-reactive and an effective prophylactic for shigellosis. This has positive implications for the prophylactic use of Travelan® for protection against both ETEC and Shigella spp. diarrheal infections. Future refinement and expansion of pathogens recognized by HBC including Travelan® could revolutionize current management of gastrointestinal infections and outbreaks in travelers’ including military, peacekeepers, humanitarian workers and in populations living in endemic regions of the world.
Human and animal skin identified by palaeoproteomics in Scythian leather objects from Ukraine
Authors: Brandt Luise Ørsted , Mackie Meaghan , Daragan Marina , Collins Matthew J. , Gleba Margarita
Published: December 2023

Leather was one of the most important materials of nomadic Scythians, used for clothing, shoes, and quivers, amongst other objects. However, our knowledge regarding the specific animal species used in Scythian leather production remains limited. In this first systematic study, we used palaeoproteomics methods to analyse the species in 45 samples of leather and two fur objects recovered from 18 burials excavated at 14 different Scythian sites in southern Ukraine. Our results demonstrate that Scythians primarily used domesticated species such as sheep, goat, cattle, and horse for the production of leather, while the furs were made of wild animals such as fox, squirrel and feline species. The surprise discovery is the presence of two human skin samples, which for the first time provide direct evidence of the ancient Greek historian Herodotus’ claim that Scythians used the skin of their dead enemies to manufacture leather trophy items, such as quiver covers. We argue that leather manufacture is not incompatible with a nomadic lifestyle and that Scythians possessed sophisticated leather production technologies that ensured stable supply of this essential material.
Socioeconomic inequalities in vaccine uptake: A global umbrella review
Authors: Sacre Amber , Bambra Clare , Wildman Josephine M. , Thomson Katie , Bennett Natalie , Sowden Sarah , Todd Adam
Published: December 2023

This global umbrella review aimed to synthesise evidence of socioeconomic inequalities in the uptake of routine vaccinations and identify the mechanisms that may contribute to the association. To our knowledge, no attempt has been made to synthesise the global body of systematic reviews across a variety of vaccines, geographical locations, and measures of SES. The inclusion criteria were as follows: studies assessing vaccination uptake according to education, income, occupation/employment, and/or area-level deprivation; any country or universally recommended routine vaccination (according to the WHO); qualitative or quantitative reviews, published 2011-present. The searches were performed in eight databases. The screening process followed PRISMA-E guidelines, each stage was performed by one reviewer, and a 10% sample checked by a second for consistency. Included reviews underwent data extraction, quality appraisal (AMSTAR-2), and narrative synthesis according to country-context. After deduplication, 9,163 reports underwent title and abstract screening, leaving 119 full texts to be assessed for eligibility. Overall, 26 studies were included in the umbrella review. Evidence for lower uptake amongst disadvantaged SES individuals was found in all 26 reviews. However, 17 reviews showed mixed results, as inverse associations were also identified (lower uptake for advantaged SES, and/or higher uptake for disadvantaged SES). Those that explored high-income countries had a greater prevalence of mixed findings than those focusing on low/middle-income countries. The two most frequently cited mechanisms were vaccination knowledge, and confidence in vaccination or vaccination providers. These mechanisms were often understood by review authors as varying by level of education. We find socioeconomic differences in routine vaccination uptake, but the association did not always follow a gradient. Whilst education may be associated with uptake globally, our study indicates that its role varies by country-context. A limitation is the overlap of some primary studies across the included systematic reviews.
Does the 11-year solar cycle affect lake and river ice phenology?
Authors: Schmidt Daniel F. , Grise Kevin M. , Pace Michael L.
Published: December 2023

Records of ice-on and ice-off dates are available for lakes and rivers across the Northern Hemisphere spanning decades and in some cases centuries. This data provides an opportunity to investigate the climatic processes that may control ice phenology. Previous studies have reported a trend toward shorter ice-covered seasons with global warming, as well as links between ice phenology and several modes of natural climate variability such as the North Atlantic Oscillation, the Pacific-North American Pattern, the El Niño-Southern Oscillation, the Pacific Decadal Oscillation, and the Atlantic Multidecadal Oscillation. The 11-year sunspot cycle has also been proposed as a driver of ice phenology, which is somewhat surprising given that this cycle’s strongest impacts are in the stratosphere. In this study, we use a large data set of lakes and rivers across the Northern Hemisphere to test this potential link. We find little or no connection between the sunspot cycle and either ice-on or ice-off dates. We conclude that while many well-known climate cycles do impact ice phenology, we are able to rule out any strong impact of the solar cycle.
The Jena Eyewitness Research Stimuli (JERS): A database of mock theft videos involving two perpetrators, presented in 2D and VR formats with corresponding 2D and 3D lineup images
Authors: Kruse Ulrike , Schweinberger Stefan R.
Published: December 2023

Empirical investigations into eyewitness identification accuracy typically necessitate the creation of novel stimulus materials, which can be a challenging and time-consuming task. To facilitate this process and promote further research in this domain, we introduce the new Jena Eyewitness Research Stimuli (JERS). They comprise six video sequences depicting a mock theft committed by two different perpetrators, available in both two-dimensional (2D) and 360° format, combined with the corresponding lineup images presented in 2D or three-dimensional (3D) format. Images of one suspect and eight fillers are available for each lineup. We evaluated lineup fairness by using mock eyewitness paradigm and noted a Tredoux’s E of 4.687 for Perpetrator 1 and 5.406 for Perpetrator 2. Moreover, no bias towards the perpetrators was observed in the lineups. We incorporated 360° videos and 3D lineup images to encourage the adoption of innovative data formats in experimental investigations of eyewitness accuracy. In particular, compatibility with Virtual Reality (VR) makes JERS a promising tool for advancing eyewitness research by enabling researchers to construct controlled environments that offer observers an immersive experience. JERS is freely accessible for the use of academic purposes via the Open Science Framework (OSF).
Don’t worry, be happy: Habitat selection of Blanding’s Turtles (Emydoidea blandingii) living in a reference condition in Georgian Bay
Authors: Meng Reta Lingrui , Chow-Fraser Patricia
Published: December 2023

Few areas within the Great Lakes basin are currently free from impact of human activities, and it is important to study these reference conditions for comparison with degraded sites in those regions. Here, we use radio telemetry to investigate habitat use, movement, and habitat selection of a population of the endangered (Federally in Canada) Blanding’s turtle (Emydoidea blandingii, BLTU) inhabiting a mostly undisturbed archipelago located at the northern shore of Mnidoo gamii (Georgian Bay), Ontario over two active seasons (May to September 2021 and 2022). We found a mean home range of 16.21 ha for females (n = 7) and 15.10 ha for males (n = 7). Of the five habitat classes (Marsh, Open Water, Rock, Peatland, and Forest), females used all except Peatland during the nesting season, and both sexes used all five habitat classes throughout both active seasons in 2021 and 2022. Disproportionate habitat use was detected at the landscape scale but not at the home range scale which was consistent with the hypothesis that adult Blanding’s turtles residing in relatively undisturbed sites with abundant habitat types use all habitat types according to their availability. We also observed the use of open, deep water by Blanding’s Turtles as travel corridors for nesting and mating. Effective future conservation strategies should prioritize the protection and connectivity of relatively undisturbed wetlands, forests, and rock barrens in this region and use this study as a reference condition to compare BLTU habitat use and movement across disturbance gradients within Georgian Bay.
Lifestyle factors associated with a rapid decline in the estimated glomerular filtration rate over two years in older adults with type 2 diabetes–Evidence from a large national database in Japan
Authors: Li Yaya , Fujii Makoto , Ohno Yuko , Ikeda Asuka , Godai Kayo , Nakamura Yuko , Akagi Yuya , Yabe Daisuke , Tsushita Kazuyo , Kashihara Naoki , Kamide Kei , Kabayama Mai
Published: December 2023

Background

The present study investigated lifestyle risk factors from metabolic syndrome-related lifestyles for a rapid decline in the estimated glomerular filtration rate (eGFR) among adults aged 40–74 years with treated and untreated type 2 diabetes.

Methods and results

This study analyzed data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan, encompassing the period from fiscal year (FY) 2017 to FY2020. We established FY2018 as our baseline year. The subjects of this study were adults aged 40–74 in FY2018(baseline) who had type 2 diabetes and underwent specific health checkups in FY2020. We excluded adults with a medical record of kidney dialysis between FY2017 and FY2018, records of suspected type 1 diabetes between FY2017 and FY2020, or a baseline eGFR >85 mL/min/1.73 m2 or missing eGFR data as of FY2020. Eventually we analyzed 573,860 individuals. The outcome variable was a rapid decline in eGFR (≥30%) during the follow-up. Exposure lifestyle factors included skipping breakfast, late-night dinners, regular smoking, a high alcohol intake, non-refreshing sleep, and a lack of habitual exercise. Logistic regression models were stratified by age (40–59 and 60–74 years) and baseline eGFR levels (60–85, 30–59, and <30 mL/min/1.73 m2). Covariates included sex, a history of heart disease, a history of stroke, a history of renal failure, anemia, low-density lipoprotein, systolic blood pressure, hemoglobin A1C, body mass index, antidiabetic medications, antihypertension drugs, lipid-lowering drugs, the oral adsorbent Kremezin, non-steroidal anti-inflammatory drugs, and drugs for the treatment of renal anemia. A rapid decline in eGFR was detected in approximately 1.3% of participants (7,683 cases). In the baseline eGFR >30 subgroups (60–85 or 30–59 mL/min/1.73 m2), skipping breakfast and regular smoking were associated with a rapid decline in eGFR in both age groups, while a lack of habitual exercise and late-night dinners in the 60–74 age group and non-refreshing sleep in the 40–59 age group were identified as risk factors. Additionally, skipping breakfast was a risk factor for a rapid decline in eGFR in the 60–74 age group regardless of baseline eGFR levels. In the baseline eGFR <30 mL/min/1.73 m2 subgroup, skipping breakfast and non-refreshed sleep were risk factors for a rapid decline in eGFR.

Conclusions

We found specific lifestyle risk factors were associated with a rapid eGFR decline among people with type 2 diabetes from a nationwide database in Japan. The associations varied by baseline eGFR level, age, and sex. Lifestyle modifications may effectively prevent the aggravation of diabetic kidney disease.