bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving colorectal cancer screening in rural primary care: Preliminary effectiveness and implementation of a collaborative mailed fecal immunochemical test pilot
Authors: Davis Melinda M. , Coury Jen , Larson Jean Hiebert , Gunn Rose , Towey Elke Geiger , Ketelhut Andrea , Patzel Mary , Ramsey Katrina , Coronado Gloria D.
Published: June 2022

Background

Mailed fecal immunochemical test (FIT) outreach can improve colorectal cancer (CRC) screening rates. We piloted a collaborative mailed FIT program with health plans and rural clinics to evaluate preliminary effectiveness and refine implementation strategies.

Methods

We conducted a single‐arm study using a convergent, parallel mixed‐methods design to evaluate the implementation of a collaborative mailed FIT program. Enrollees were identified using health plan claims and confirmed via clinic scrub. The intervention included a vendor‐delivered automated phone call (auto‐call) prompt, FIT mailing, and reminder auto‐call; clinics were encouraged to make live reminder calls. Practice facilitation was the primary implementation strategy. At 12 months post mailing, we assessed the rates of: (1) mailed FIT return and (2) completion of any CRC screening. We took fieldnotes and conducted postintervention key informant interviews to assess implementation outcomes (eg, feasibility, acceptability, and adaptations).

Results

One hundred and sixty‐nine Medicaid or Medicare enrollees were mailed a FIT. Over the 12‐month intervention, 62 participants (37%) completed screening of which 21% completed the mailed FIT (most were returned within 3 months), and 15% screened by other methods (FITs distributed in‐clinic, colonoscopy). Enrollee demographics and the reminder call may encourage mailed FIT completion. Program feasibility and acceptability was high and supported by perceived positive benefit, alignment with existing workflows, adequate staffing, and practice facilitation.

Conclusion

Collaborative health plan‐clinic mailed FIT programs are feasible and acceptable for implementation in rural clinics and support CRC screening completion. Studies that pragmatically test collaborative approaches to mailed FIT and patient navigation follow‐up after abnormal FIT and support broad scale‐up in rural settings are needed.
Recent structural variations in the Medicago chloroplast genomes and their horizontal transfer into nuclear chromosomes
Authors: Jiao Ying‐Xue , He Xiao‐Fan , Song Rui , Wang Xue‐Meng , Zhang Han , Aili Reziya , Chao Yue‐Hui , Shen Yu‐Hua , Yu Long‐Xi , Zhang Tie‐Jun , Jia Shan‐Gang
Published: June 2022

Medicago is a genus of legumes (Fabaceae) that resemble common clovers with pinnately trifoliate leaves and spirally coiled seed pods, and Medicago sativa is a famous forage crop throughout the world. In this study, we systematically assembled the complete plastid genomes of 18 Medicago species, representing 35 Medicago accessions, whose genome size ranged from ~119 to 125 kb, and identified one novel inverted repeat (IR) in two accessions of Medicago soleirolii (PI537242 and PI537243), albeit of no IRs in the most accessions. We built a phylogenetic tree based on common protein‐coding sequences of 55 Medicago accessions in 38 species, which were placed into five clades with a divergence since 9.37 million years ago. Global alignment revealed independent genome evolution events, including eight inversions in nine species and four intron losses (ILs) in 10 species, among which four inversions and two ILs have not been reported previously. Within 109–111 unique genes, ndhA, rpl2, and ycf3 were under positive selection in 54 Medicago accessions. Finally, by aligning chloroplast genes against the nuclear genome assembly of M. sativa cultivar “Zhongmu No.1”, we found that a large number of chloroplast gene fragments were horizontally transferred to nuclear chromosomes in alfalfa, especially on the chr3:47518422–48722257 coordinates of chromosome 3. Our comprehensive exploration of Medicago chloroplast genomes provided insights for the understanding of Medicago diversity and their genomic evolution events.
Comparison of buckwheat genomes reveals the genetic basis of metabolomic divergence and ecotype differentiation
Authors: He Ming , He Yuqi , Zhang Kaixuan , Lu Xiang , Zhang Xuemei , Gao Bin , Fan Yu , Zhao Hui , Jha Rintu , Huda Md. Nurul , Tang Yu , Wang Junzhen , Yang Weifei , Yan Mingli , Cheng Jianping , Ruan Jingjun , Dulloo Ehsan , Zhang Zongwen , Georgiev Milen I , Chapman Mark A. , Zhou Meiliang
Published: June 2022

Golden buckwheat (Fagopyrum dibotrys or Fagopyrum cymosum) and Tartary buckwheat (Fagopyrum tataricum) belong to the Polygonaceae and the Fagopyrum genus is rich in flavonoids. Golden buckwheat is a wild relative of Tartary buckwheat, yet golden buckwheat is a traditional Chinese herbal medicine and Tartary buckwheat is a food crop. The genetic basis of adaptive divergence between these two buckwheats is poorly understood.

Here, we assembled a high‐quality chromosome‐level genome of golden buckwheat and found a one‐to‐one syntenic relationship with the chromosomes of Tartary buckwheat. Two large inversions were identified that differentiate golden buckwheat and Tartary buckwheat.

Metabolomic and genetic comparisons of golden buckwheat and Tartary buckwheat indicate an amplified copy number of FdCHI, FdF3H, FdDFR, and FdLAR gene families in golden buckwheat, and a parallel increase in medicinal flavonoid content. Resequencing of 34 wild golden buckwheat accessions across the two morphologically distinct ecotypes identified candidate genes, including FdMYB44 and FdCRF4, putatively involved in flavonoid accumulation and differentiation of plant architecture, respectively.

Our comparative genomic study provides abundant genomic resources of genomic divergent variation to improve buckwheat with excellent nutritional and medicinal value.
Using Ricoeur's notions on narrative interpretation as a resource in supporting person‐centredness in health and social care
Authors: Josephsson Staffan , Öhlén Joakim , Mondaca Margarita , Guerrero Manuel , Luborsky Mark , Lindström Maria
Published: June 2022

This article suggests a shift in focus from stories as verbal accounts to narrative interpretation of the every day as a resource for achieving person‐centred health and social care. The aim is to explore Ricoeur's notion of narrative and action, as expressed in his arguments on a threefold mimesis process, using this as a grounding for the use of narration to achieve person‐centredness in health and social care practice. This focus emerged from discussions on this matter at the IPONS conference in Gothenburg, 2021. Based on philosophical resources from Ricoeur's notions of narrative and action developed in his arguments on a threefold mimesis process, we propose a wider use of stories in health and social care practices. We suggest expanding from only focusing on verbal accounts to focusing on narrative as a human way to interpret and make sense of everyday life and circumstances and to communicate possible meanings. We discuss how such complementary focus can be a resource in getting patients involved and collaborating in their health and social care and thereby help develop person‐centred practices.
Patients' and health professionals' views on shared decision‐making in age‐related macular degeneration care: A qualitative study
Authors: Scheffer Mariska , Menting Juliane , Roodbeen Ruud , van Dulmen Sandra , van Hecke Manon , Schlingemann Reinier , van Nispen Ruth , Boeije Hennie
Published: June 2022

Background

Age‐related macular degeneration (AMD) is one of the principal causes of irreversible visual impairment in the older adult population. Recent evidence indicates that there are signs of undertreatment and overtreatment, underdiagnosis and insufficient information provision in AMD care. Shared decision‐making (SDM) can aid information sharing between patients and health professionals and enhances high‐quality care. This research aimed to gain insight into patients' and professionals' views on SDM in AMD care.

Methods

Semi‐structured interviews were conducted with 20 patients with AMD and 19 health professionals in June and July 2020. Participants were recruited through hospitals, professional and patient associations and (social) networks. Sample representativeness was ensured in terms of sociodemographic and disease characteristics for patients, and profession‐related characteristics for health professionals. Interviews were analysed according to a predetermined coding framework.

Results

Although SDM is receiving attention in AMD care, health professionals and patients experienced barriers in making shared decisions. The most common barriers reported included limitations in treatment options, time constraints, strict treatment guidelines and patients' comorbidity. Furthermore, most patients indicated that they were not (fully) informed about all aspects of AMD trajectory, such as the possibility to discontinue therapy or the long‐term and invasive character of treatment. Some patients expressed the need for a more empathic and person‐centred communication style from their health professional.

Conclusion

The concerns raised by patients and health professionals suggest that there is room for improvement in delivery of SDM in AMD care. Findings from this study indicate that information provision and communication can be improved.
Support for democracy in ego‐centered social contexts
Authors: Kamiński Paweł , Kołczyńska Marta , Mach Bogdan W.
Published: June 2022

Objective

We investigate the influence of social contexts on democratic attitudes.

Methods

We use a novel survey data set with data from a nationally representative sample of Polish residents (egos) and their friends and acquaintances (alters).

Results

Controlling for several factors defined on the ego‐ and alter‐levels, we find a positive relationship between alters’ and ego's endorsement of democracy over nondemocratic alternatives. This effect is stronger the higher the number of close friends and acquaintances and when all friends know each other.

Conclusion

We find a positive relationship between the average preference of democracy in the social context and an individual endorsement of democracy. Confirmed moderators of this relationship may be cautiously interpreted as measuring the degree to which the context structures political communication between egos and alters.
Formant detail needed for identifying, rating, and discriminating vowels in Wisconsin English
Authors: Jibson Jonathan
Published: June 2022

Neel [(2004). Acoust. Res. Lett. Online 5, 125–131] asked how much time-varying formant detail is needed for vowel identification. In that study, multiple stimuli were synthesized for each vowel: 1-point (monophthongal with midpoint frequencies), 2-point (linear from onset to offset), 3-point, 5-point, and 11-point. Results suggested that a 3-point model was optimal. This conflicted with the dual-target hypothesis of vowel inherent spectral change research, which has found that two targets are sufficient to model vowel identification. The present study replicates and expands upon the work of Neel. Ten English monophthongs were chosen for synthesis. One-, two-, three-, and five-point vowels were created as described above, and another 1-point stimulus was created with onset frequencies rather than midpoint frequencies. Three experiments were administered (n = 18 for each): vowel identification, goodness rating, and discrimination. The results ultimately align with the dual-target hypothesis, consistent with most vowel inherent spectral change studies.
Effect of bat pinna on sensing using acoustic finite difference time domain simulation
Authors: Teshima Yu , Nomura Takumi , Kato Megumi , Tsuchiya Takao , Shimizu Genki , Hiryu Shizuko
Published: June 2022

The practicality of the finite-difference time-domain (FDTD) method was confirmed by comparing head-related transfer functions obtained from a three-dimensional (3D) digital model of a bat (Rhinolophus ferrumequinum nippon) head with acoustic experiments using a 3D printed physical model. Furthermore, we simulated the auditory directionality using a 3D digital model that was modified based on the pinna movement of a bat during echolocation and found that the alternating movements of the left and right pinna result in a binaural sound pressure difference for vertical sources. Using the FDTD method, suitable for simulating acoustics in large spaces, we could analyze in detail the binaural echoes that bats receive and the acoustic cues they use for echolocation.
An algebraic correction for the Westervelt equation to account for the local nonlinear effects in parametric acoustic array
Authors: Červenka Milan , Bednařík Michal
Published: June 2022

This work presents a simple computational approach for the calculation of parametrically generated low-frequency sound fields. The Westervelt wave equation is employed as a model equation that accounts for the wave diffraction, attenuation, and nonlinearity. As it is known that the Westervelt equation captures the cumulative nonlinear effects correctly and not the local ones, an algebraic correction is proposed, which includes the local nonlinear effects in the solution of the Westervelt equation. This way, existing computational approaches for the Westervelt equation can be used even in situations where the generated acoustic field differs significantly from the plane progressive waves, such as in the near-field, and where the local effects manifest themselves strongly. The proposed approach is demonstrated and validated on an example of the parametric radiation from a baffled circular piston.
Understanding the complex rheology of human blood plasma
Authors: Rodrigues T. , Mota R. , Gales L. , Campo-Deaño L.
Published: June 2022

Blood plasma (BP) is a borderline non-Newtonian fluid. Few studies have characterized the rheology of BP and even less focused on understanding its subtle viscoelastic traits, which were only somewhat recently acknowledged. We use passive microrheology to measure the bulk response of human plasma samples under shear at body and ambient temperatures. Evidence of subdiffusive behavior in the mean-squared displacement is observed at the highest frequencies probed, which we attribute to the stress relaxation of protein molecules or chains. Jeffreys-like complex shear moduli were computed thereof. The microenvironments of albumin, fibrinogen, and gamma-globulin solutions (key plasma proteins) were probed as well. Single proteins in an aqueous buffer showed no signs of viscoelasticity within experimental resolution. Conversely, mixed together, they appear to promote the same kind of short-term elastic behavior seen in plasma. All in all, a fresh look at the shear rheology of BP is presented.
Polarization-selective reconfigurability in hybridized-active-dielectric nanowires
Authors: Lee June Sang , Farmakidis Nikolaos , Wright C. David , Bhaskaran Harish
Published: June 2022

Wavelength and polarization are two fundamental properties of light within which information can be encoded and (de)multiplexed. While wavelength-selective systems have widely proliferated, polarization-addressable active photonics has not seen notable progress, primarily because tunable and polarization-selective nanostructures have been elusive. Here, we introduce hybridized-active-dielectric (HAD) nanowires to achieve polarization-selective tunability. We then demonstrate the ability to use polarization as a parameter to selectively modulate the conductance of individual nanowires within a multi-nanowire system. By using polarization as the tunable vector, we show matrix-vector multiplication in a nanowire device configuration. While our HAD nanowires use phase-change materials as the active material, this concept is readily generalized to other active materials hybridized with dielectrics and thus has the potential in a broad range of applications from photonic memories and routing to polarization-multiplexed computing.
Setting of the magnetic structure of chiral kagome antiferromagnets by a seeded spin-orbit torque
Authors: Pal Banabir , Hazra Binoy K. , Göbel Börge , Jeon Jae-Chun , Pandeya Avanindra K. , Chakraborty Anirban , Busch Oliver , Srivastava Abhay K. , Deniz Hakan , Taylor James M. , Meyerheim Holger , Mertig Ingrid , Yang See-Hun , Parkin Stuart S. P.
Published: June 2022

The current-induced spin-orbit torque switching of ferromagnets has had huge impact in spintronics. However, short spin-diffusion lengths limit the thickness of switchable ferromagnetic layers, thereby limiting their thermal stability. Here, we report a previously unobserved seeded spin-orbit torque (SSOT) by which current can set the magnetic states of even thick layers of the chiral kagome antiferromagnet Mn
3
Sn. The mechanism involves setting the orientation of the antiferromagnetic domains in a thin region at the interface with spin currents arising from an adjacent heavy metal while also heating the layer above its magnetic ordering temperature. This interface region seeds the resulting spin texture of the entire layer as it cools down and, thereby, overcomes the thickness limitation of conventional spin-orbit torques. SSOT switching in Mn
3
Sn can be extended beyond chiral antiferromagnets to diverse magnetic systems and provides a path toward the development of highly efficient, high-speed, and thermally stable spintronic devices.
Insect-inspired AI for autonomous robots
Authors: de Croon G. C. H. E. , Dupeyroux J. J. G. , Fuller S. B. , Marshall J. A. R.
Published: June 2022

Autonomous robots are expected to perform a wide range of sophisticated tasks in complex, unknown environments. However, available onboard computing capabilities and algorithms represent a considerable obstacle to reaching higher levels of autonomy, especially as robots get smaller and the end of Moore’s law approaches. Here, we argue that inspiration from insect intelligence is a promising alternative to classic methods in robotics for the artificial intelligence (AI) needed for the autonomy of small, mobile robots. The advantage of insect intelligence stems from its resource efficiency (or parsimony) especially in terms of power and mass. First, we discuss the main aspects of insect intelligence underlying this parsimony: embodiment, sensory-motor coordination, and swarming. Then, we take stock of where insect-inspired AI stands as an alternative to other approaches to important robotic tasks such as navigation and identify open challenges on the road to its more widespread adoption. Last, we reflect on the types of processors that are suitable for implementing insect-inspired AI, from more traditional ones such as microcontrollers and field-programmable gate arrays to unconventional neuromorphic processors. We argue that even for neuromorphic processors, one should not simply apply existing AI algorithms but exploit insights from natural insect intelligence to get maximally efficient AI for robot autonomy.
Calreticulin mutant myeloproliferative neoplasms induce MHC-I skewing, which can be overcome by an optimized peptide cancer vaccine
Authors: Gigoux Mathieu , Holmström Morten O. , Zappasodi Roberta , Park Joseph J. , Pourpe Stephane , Bozkus Cansu Cimen , Mangarin Levi M. B. , Redmond David , Verma Svena , Schad Sara , George Mariam M. , Venkatesh Divya , Ghosh Arnab , Hoyos David , Molvi Zaki , Kamaz Baransel , Marneth Anna E. , Duke William , Leventhal Matthew J. , Jan Max , Ho Vincent T. , Hobbs Gabriela S. , Knudsen Trine Alma , Skov Vibe , Kjær Lasse , Larsen Thomas Stauffer , Hansen Dennis Lund , Lindsley R. Coleman , Hasselbalch Hans , Grauslund Jacob H. , Lisle Thomas L. , Met Özcan , Wilkinson Patrick , Greenbaum Benjamin , Sepulveda Manuel A. , Chan Timothy , Rampal Raajit , Andersen Mads H. , Abdel-Wahab Omar , Bhardwaj Nina , Wolchok Jedd D. , Mullally Ann , Merghoub Taha
Published: June 2022

The majority of JAK2
V617F
-negative myeloproliferative neoplasms (MPNs) have disease-initiating frameshift mutations in calreticulin (
CALR
), resulting in a common carboxyl-terminal mutant fragment (CALR
MUT
), representing an attractive source of neoantigens for cancer vaccines. However, studies have shown that CALR
MUT
-specific T cells are rare in patients with CALR
MUT
MPN for unknown reasons. We examined class I major histocompatibility complex (MHC-I) allele frequencies in patients with CALR
MUT
MPN from two independent cohorts. We observed that MHC-I alleles that present CALR
MUT
neoepitopes with high affinity are underrepresented in patients with CALR
MUT
MPN. We speculated that this was due to an increased chance of immune-mediated tumor rejection by individuals expressing one of these MHC-I alleles such that the disease never clinically manifested. As a consequence of this MHC-I allele restriction, we reasoned that patients with CALR
MUT
MPN would not efficiently respond to a CALR
MUT
fragment cancer vaccine but would when immunized with a modified CALR
MUT
heteroclitic peptide vaccine approach. We found that heteroclitic CALR
MUT
peptides specifically designed for the MHC-I alleles of patients with CALR
MUT
MPN efficiently elicited a CALR
MUT
cross-reactive CD8
+
T cell response in human peripheral blood samples but not to the matched weakly immunogenic CALR
MUT
native peptides. We corroborated this effect in vivo in mice and observed that C57BL/6J mice can mount a CD8
+
T cell response to the CALR
MUT
fragment upon immunization with a CALR
MUT
heteroclitic, but not native, peptide. Together, our data emphasize the therapeutic potential of heteroclitic peptide–based cancer vaccines in patients with CALR
MUT
MPN.
Chronologically modified androgen receptor in recurrent castration-resistant prostate cancer and its therapeutic targeting
Authors: Sawant Mithila , Mahajan Kiran , Renganathan Arun , Weimholt Cody , Luo Jingqin , Kukshal Vandna , Jez Joseph M. , Jeon Myung Sik , Zhang Bo , Li Tiandao , Fang Bin , Luo Yunting , Lawrence Nicholas J. , Lawrence Harshani R. , Feng Felix Y. , Mahajan Nupam P.
Published: June 2022

Resistance to second-generation androgen receptor (AR) antagonists such as enzalutamide is an inevitable consequence in patients with castration-resistant prostate cancer (CRPC). There are no effective therapeutic options for this recurrent disease. The expression of truncated AR variant 7 (AR-V7) has been suggested to be one mechanism of resistance; however, its low frequency in patients with CRPC does not explain the almost universal acquisition of resistance. We noted that the ability of AR to translocate to nucleus in an enzalutamide-rich environment opens up the possibility of a posttranslational modification in AR that is refractory to enzalutamide binding. Chemical proteomics in enzalutamide-resistant CRPC cells revealed acetylation at Lys
609
in the zinc finger DNA binding domain of AR (acK609-AR) that not only allowed AR translocation but also galvanized a distinct global transcription program, conferring enzalutamide insensitivity. Mechanistically, acK609-AR was recruited to the
AR
and
ACK1/TNK2
enhancers, up-regulating their transcription. ACK1 kinase–mediated AR Y267 phosphorylation was a prerequisite for AR K609 acetylation, which spawned positive feedback loops at both the transcriptional and posttranslational level that regenerated and sustained high AR and ACK1 expression. Consistent with these findings, oral and subcutaneous treatment with ACK1 small-molecule inhibitor, (
R
)-9b, not only curbed AR Y267 phosphorylation and subsequent K609 acetylation but also compromised enzalutamide-resistant CRPC xenograft tumor growth in mice. Overall, these data uncover chronological modification events in AR that allows prostate cancer to evolve through progressive stages to reach the resilient recurrent CRPC stage, opening up a therapeutic vulnerability.
Validation of the Colibrí Instrument for Automated Preparation of MALDI-TOF MS Targets for Yeast Identification
Authors: Heestermans Robbe , Herroelen Pauline , Emmerechts Kristof , Vandoorslaer Kristof , De Geyter Deborah , Demuyser Thomas , Wybo Ingrid , Piérard Denis , Muyldermans Astrid
Published: June 2022

Recently, Copan (Italy) introduced the Colibrí instrument for automated colony picking and preparation of matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) target plates. Our study aimed to validate this system for yeasts as such testing has not been performed yet and is a missing link needed to implement the system for routine use.
RG2-VLP: a Vaccine Designed to Broadly Protect against Anogenital and Skin Human Papillomaviruses Causing Human Cancer
Authors: Olczak Pola , Matsui Ken , Wong Margaret , Alvarez Jade , Lambert Paul , Christensen Neil D. , Hu Jiafen , Huber Bettina , Kirnbauer Reinhard , Wang Joshua W. , Roden Richard B. S.
Published: June 2022

Licensed preventive HPV vaccines are composed of VLPs derived by expression of major capsid protein L1. They confer protection generally restricted to infection by the αHPVs targeted by the up-to-9-valent vaccine, and their associated anogenital cancers and genital warts, but do not target βHPV that are associated with CSCC in EV and immunocompromised patients.
Microbiome Restructuring: Dominant Coral Bacterium
Endozoicomonas
Species Respond Differentially to Environmental Changes
Authors: Tandon Kshitij , Chiou Yu-Jing , Yu Sheng-Ping , Hsieh Hernyi Justin , Lu Chih-Ying , Hsu Ming-Tsung , Chiang Pei-Wen , Chen Hsing-Ju , Wada Naohisa , Tang Sen-Lin
Published: June 2022

The coral microbiome has been known to play a crucial role in host health. In recent years, we have known that the coral microbiome changes in response to external stressors and that coral hosts structure their microbiome in a host-specific manner.
Anti-Spike Antibody Response to Natural Infection with SARS-CoV-2 and Its Activity against Emerging Variants
Authors: Chen Cheng-Pin , Huang Kuan-Ying A. , Shih Shin-Ru , Lin Yi-Chun , Cheng Chien-Yu , Huang Yhu-Chering , Lin Tzou-Yien , Cheng Shu-Hsing
Published: June 2022

As spike protein-specific antibody responses play a major role in protection against SARS-CoV-2, we examined spike-binding and ACE2-blocking antibody responses in SARS-CoV-2 infection at different time points. We found robust responses following acute infection, which waned approximately 11 months after infection.
How and why do financial incentives contribute to helping people stop smoking? A realist review protocol
Authors: Siersbaek Rikke , Parker Sarah , Kavanagh Paul , Ford John Alexander , Burke Sara
Published: June 2022

Introduction

Smoking is harmful to human health and programmes to help people stop smoking are key public health efforts that improve individual and population health outcomes. Research shows that financial incentives improve the success of stop smoking programmes. However, a better understanding of how they work is needed to better inform policy and to support building capability for implementation.

The aims of this study: (1) To review the international literature to understand: How, why, in what circumstances and for whom financial incentives improve the success of stop smoking interventions among general population groups and among pregnant women. (2) To provide recommendations for how to best use financial incentives in efforts to promote smoking cessation.

Methods and analysis

A realist review of published international literature will be undertaken to understand how, why, for whom and in which circumstances financial incentives contribute to success in stopping smoking for general population groups and among pregnant women. Systematic searches were undertaken on 16 February 2022 of five academic databases: MEDLINE (ovid), Embase.com, CIHAHL, Scopus and PsycINFO. Iterative searching using citation tracking and of grey literature will be undertaken as needed. Using Pawson and Tilley’s iterative realist review approach, data collected will be screened, selected, coded, analysed and synthesised into a set of explanatory theoretical findings.

Ethics and dissemination

Ethical approval is not required for this review as data sources to be included are previously published. The study will provide important findings for policy-makers and health system leaders to guide the development of stop smoking services which use incentives, for example, as part of the Health Service Executive’s Tobacco Free Programme in Ireland. Understanding how contextual factors impact implementation and programmatic success is key to developing a more effective public health approach to stop smoking. Our dissemination strategy will be developed with our stakeholders.

PROSPERO registration number

CRD42022298941.
Implementing use of sucrose analgesia (non-pharmacological management of neonatal pain) in a standalone private facility level 3 neonatal care unit using point of care quality improvement methodology
Authors: Sawleshwarkar Kedar , Singh Mahtab , Bajaj Ramesh , Loya Sanjog , Chikhlondhe Rakesh , Bhave Sunita
Published: June 2022

Background

Neonatal pain not only has negative impact on the acute physiological parameters of the neonate but also has got the potential to cause long-term neurodevelopmental disabilities. However, neonatal pain especially related to procedures is not well recognised and often poorly managed in neonatal intensive care unit (NICU).

Local problem

Oral sucrose solution became available commercially in late 2017 and this provided us the opportunity to alleviate some of the procedural pain in neonates admitted in our NICU.

Methods

Point of care quality improvement method (POCQI) was leveraged to identify root causes, change ideas and solutions were tested using PDSA cycles. Four procedures were selected by team for sucrose analgesia namely intravenous cannula insertion, tracheal suctioning, removal of tapes and phlebotomy. Change ideas tested included training of staff and doctors, providing dosage chart in NICU, method of administration of sucrose, affixing sucrose vial to baby bed, using prefilled sucrose syringe and bedside availability of sucrose and checklist for documentation. The study was conducted over a period of 8 weeks from 15 June 2017 on all eligible babies getting admitted.

AIM statement

We aim to increase compliance to administration of sucrose analgesia to all eligible newborns (undergoing 4 selected procedures intravenous cannula insertion, tracheal suctioning, removal of tapes and phlebotomy) in NICU prior to painful procedure from current 0% to >80% by 8 weeks.

Results

This quality improvement study implementing the use of evidence-based sucrose analgesia using PDSA cycles found that percentage of babies getting sucrose analgesia has increased from baseline 0% to 96.27% in the study period and is sustained at >80% for 4 years.

Conclusions

POCQI methodology can be used effectively to implement a new simple strategy of administering oral sucrose solution to address procedural pain in care pathway of neonates admitted in NICU. Sustaining the gains achieved by POCQI needs active leadership involvement and addressing adaptive or behavioural challenges with solutions like team huddles.
Role of autoantibodies and blood–brain barrier leakage in cognitive impairment in systemic lupus erythematosus
Authors: Hanly John G , Legge Alexandra , Kamintsky Lyna , Friedman Alon , Hashmi Javeria A , Beyea Steven D , Fisk John , Omisade Antonina , Calkin Cynthia , Bardouille Tim , Bowen Chris , Matheson Kara , Fritzler Marvin J
Published: June 2022

Objective

Cognitive impairment is common in patients with SLE but the cause is unknown. The current cross-sectional study examined the association between select SLE-related autoantibodies, other serological biomarkers and extensive blood–brain barrier (BBB) leakage in patients with SLE with and without cognitive impairment. In addition, we determined whether the relationship between SLE autoantibodies, other biomarkers and cognitive impairment differed depending on the presence or absence of concurrent extensive BBB leakage.

Methods

Consecutive patients with SLE, recruited from a single academic medical centre, underwent formal neuropsychological testing for assessment of cognitive function. On the same day, BBB permeability was determined using dynamic contrast-enhanced MRI scanning. SLE autoantibodies and other serological biomarkers were measured. Regression modelling was used to determine the association between cognitive impairment, extensive BBB leakage and autoantibodies/biomarkers.

Results

There were 102 patients with SLE; 90% were female and 88% were Caucasian, with a mean±SD age of 48.9±13.8 years. The mean±SD SLE disease duration was 14.8±11.0 years. Impairment in one or more cognitive tests was present in 47 of 101 (47%) patients and included deficits in information processing speed (9%), attention span (21%), new learning (8%), delayed recall (15%) and executive abilities (21%). Extensive BBB leakage was present in 20 of 79 (25%) patients and was associated with cognitive impairment (15 of 20 (75%) vs 24 of 59 (41%); p=0.01) and shorter disease duration (median (IQR): 7 (8–24 years) vs 15 (2–16 years); p=0.02). No serological parameters were associated with extensive BBB leakage and there was no statistically significant association between cognitive impairment and circulating autoantibodies even after adjusting for BBB leakage.

Conclusions

Extensive BBB leakage alone was associated with cognitive impairment. These findings suggest that BBB leakage is an important contributor to cognitive impairment, regardless of circulating SLE-related autoantibodies.
Glacial erosion on a snowball Earth: testing for bias in flux balance, geographic setting, and tectonic regime
Authors: Hoffman Paul F.
Published: June 2022

On the southwest cape of the Congo craton, a subtropical carbonate bank the size of Greenland was heavily glaciated during two Cryogenian panglacial episodes spaced 10–20 Myr apart. In NW Namibia, the bank underwent crustal stretching with resultant Aegean Sea-type topography during the older and longer Sturtian glaciation (717–661 Ma). This is indicated by angular discordance between glacial and preglacial strata and diamictites sourced from all older units, including crystalline basement. In contrast, the bank was flat-topped and underwent broad thermal subsidence during Marinoan glaciation (646 ± 5–635 Ma), attested by stratal parallellism and diamictites sourced from ≤100 m stratigraphic depth. However, ≥2.0 km of relief existed on the Marinoan continental slope, where most glacial erosion and accumulation occurred. The average rates of Marinoan erosion (2.55–6.80 m/Myr, n = 190) and accumulation (2.65–7.07 m/Myr, n = 211) are indistinguishable, implying that the location in a continental promontory did not bias erosion over accumulation. The average accumulation rates for the Sturtian and Marinoan, scaled for different averaging times, including Marinoan uncertainty, are 3.95–4.93 m/Myr ( n = 183) and 2.65–7.07 m/Myr ( n = 190), respectively, suggesting that a Marinoan glacioeustatic coastal escarpment substituted for rift-related Sturtian basin-and-range topography. These slow rates, comparable to long-term pre-Quaternary accumulation rates on existing abyssal plains, reconcile glacial sedimentology with the feeble hydrologic cycle of snowball Earth.
Anomalous snow events increase mortality for a winter-adapted species
Authors: Rudolf Michaela F. , Wilson Evan C. , Pauli Jonathan N.
Published: June 2022

Winter is a costly time for animals, requiring individuals to adapt to increased energetic costs and reduced resources. Porcupines ( Erethizon dorsatum (Linnaeus, 1758)) confront winter by storing and catabolizing somatic stores. Increasing temperatures and attenuated snow conditions due to climate change increase porcupine survival, but impacts of greater weather variability have not been explored. In April of 2018, an anomalously heavy and late snowstorm occurred at our long-term study site in central Wisconsin followed by multiple mortalities among adult porcupines. We assessed cause of mortality and determined nutritional condition by extracting bone marrow and quantifying lipid content. Porcupines that died following the snow event had lower fat stores than the fall 2019 group and likely died of starvation. We estimated survival of female porcupines during the winters of 2012 and 2015–2018 to assess the effects of snow conditions and nutritional condition on survival. Survival declined with increased snow depth but increased with improved nutritional condition. The mass starvation event we observed in 2018 appeared to have resulted from deep snow increasing locomotive costs and reducing nutritional condition. As climate change increases the frequency of extreme weather events, including extreme snowfalls, we predict that the frequency of such clustered mortalities will increase.
Rapid detection of defect structures in graphene by the machine learning
Authors: Wu Youtao , Li Lianxin , Wang Bei , Zhu Zhongzhong , Gao Tinghong , Xie Quan , Chen Qian , Xiao Qingquan
Published: June 2022

Graphene has long been considered to have a wide application perspective in many fields, such as electronic information, chemical industry and aerospace. However, the actual graphene materials contain a variety of defects that affect their properties. Accurate and rapid identification of defect structure types is of great significance for the application of graphene. First, the image preprocessing technology is used to improve the classification precision. Next, use the convolutional neural network to classify the type of vacancy defect and perform rapid analytical tasks to accurately identify graphene defect structures. This study aims to contribute to this growing area of research in graphene to classify and count the vacancy defects automatically and quickly in monitoring its surface structures.
The Ecology of Viral Emergence
Authors: Holmes Edward C.
Published: June 2022

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on human health, economic well-being, and societal function. It is essential that we use this generational experience to better understand the processes that underpin the emergence of COVID-19 and other zoonotic diseases. Herein, I review the mechanisms that determine why and how viruses emerge in new hosts, as well as the barriers to this process. I show that traditional studies of virus emergence have an inherent anthropocentric bias, with disease in humans considered the inevitable outcome of virus emergence, when in reality viruses are integral components of a global ecosystem characterized by continual host jumping with humans also transmitting their viruses to other animals. I illustrate these points using coronaviruses, including severe acute respiratory syndrome coronavirus 2, as a case study. I also outline the potential steps that can be followed to help mitigate and prevent future pandemics, with combating climate change a central component.
Experimental Analysis and Modeling of Closed-Loop Redox Flow Desalination
Authors: Mohandass Gowri , Krishnan Sitaraman , Kim Taeyoung
Published: June 2022

Redox flow desalination (RFD) is an emerging electrochemical process utilizing a redox couple for salt separation, which enables continuous and energy-efficient brackish water desalination. Several redox couples have been used to desalinate water along with energy production (from sustainable sources such as sunlight) and storage. However, an in-depth analysis of the redox reactions and ion transport that occur simultaneously in different components of an RFD electrochemical cell is still lacking. We carried out a series of experiments, with different cell configurations, to elucidate the contribution of individual components to the cell voltage. A closed-loop RFD mediated by ferri-/ferrocyanide as a model redox couple was designed for this analysis. The cell voltage gradually increased as the diluate concentration decreased from 3 to 0.5 g l−1, attributed to the solution resistance, membrane resistance, Donnan potential, and overpotential of the redox reaction. We experimentally measured voltage drops due to each component, the sum of which was in good agreement with the time-variant cell voltage. A phenomenological model was used to fit the experimental concentration and voltage data, and a good fit was obtained. The combined experimental and modeling analysis reported herein is expected to guide a rational design and operation of RFD processes.
Underlying Anticancer Mechanisms and Synergistic Combinations of Phytochemicals with Cancer Chemotherapeutics: Potential Benefits and Risks
Authors: Ayaz Muhammad , Nawaz Asif , Ahmad Sajjad , Mosa Osama F. , Eisa Hamdoon Alashary Adam , Khalifa Modawy Alnour , Sadiq Abdul , Ullah Farhat , Wadood Abdul , Kabra Atul , Ananda Murthy H. C.
Published: June 2022

Cancer therapies are associated with various challenges including the emergence of multidrug resistant tumors, toxicological issues, severe side effects, and economic burden. To counteract these effects, natural products as substitutes and adjuvant therapies have received considerable attention owing to their safety, efficacy, and economic aspects. Various preclinical and clinical studies revealed that natural products and their combinations with chemotherapeutics mediate their anticancer effects via modulation of various signaling pathways implicated in promoting apoptosis, inhibiting excessive cellular proliferation, and mobilizing the immune system. Several lead phytochemicals including curcumin, resveratrol, quercetin, and cannabinoids synergistically act with cancer chemotherapeutics reducing cell proliferation and inducing apoptosis and cell cycle arrest. However, clinical studies on the subject matter are limited and need further extensive studies. It has been observed that patients undergoing chemotherapy use alternative therapies to ameliorate the symptoms associated with the use of chemotherapeutic agents. Nevertheless, some of the patients inform their physicians regarding herbal medicine during chemotherapy while others do not, and even most of the patients do not know the composition of herbal medicine they consume during chemotherapy. Herbal interactions with chemotherapeutics are associated with both beneficial and harmful aspects, but the beneficial aspect overweighs the harmful ones in terms of controlling the symptoms associated with the chemotherapy. Nonetheless, a large number of herbal medicines have been demonstrated to have synergistic effect with chemotherapy and alleviate the side effects of chemotherapeutic agents. The concomitant use of the majority of herbal medicines with chemotherapy has been demonstrated to be beneficial in multiple malignant tumors like cancer of blood, lungs, kidneys, liver, skin, and gastrointestinal tract. However, herbal medicines which possess positive interaction and improve the quality of life of patients should be sorted out and integrated with the chemotherapy. There should be a quality control system for the appraisal of herbal medicine, and there should also be an appropriate system of patient-doctor communication to counsel the patients regarding the beneficial and deleterious effects of the herbal medicine in combination with chemotherapy.
Treatment of the Gastroesophageal Reflux Disease with Chinese Herbal Medicine (BanxiaXiexin Decoction): Evidence from Meta-Analysis
Authors: Liu Jiali , Huang Jinke , Zhang Beihua , Yin Xiaolan , Lv Mi , Liu Zhihong , Wang Fengyun , Tang Xudong
Published: June 2022

Objectives. Systematic reviews/meta-analyses (SRs/MAs) are still controversial on the effectiveness of Banxia Xiexin decoction (BXD) to treat gastroesophageal reflux disease (GERD). To assess the evidence reliability and inform the clinical use of BXD, we performed a meta-analysis from previous SRs/MAs to collate, critically appraise, and synthesize the effectiveness of BXD treatment in GERD. Methods. SRs/MAs were collected by searching major medical databases. The included studies were evaluated in terms of methodological quality and quality of evidence using criteria from the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool, and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system, respectively. Results. Six SRs/MAs were included in this study. The methodological quality of SRs/MAs was generally unsatisfactory. Unregistered protocols, failure to provide a list of excluded trials, and lack of a comprehensive search strategy were the main limitations of previous SRs/MAs. No high-quality evidence was found to support the effect of BXD on GERD patients. The qualitative data synthesis relied on low-quality trials with a small sample size, which was the main factor for evidence degradation. Conclusions. BXD seems to have promising efficacy to treat GERD patients. Although the quality of SRs/MAs was generally low and defects were frequent, our study highlights areas where methodologies need to be improved.
Efficacy of Modified Qingre Jiedu Decoction Combined with Three-Dimensional Conformal Radiotherapy in Treating Moderate to Advanced Ovarian Carcinoma and Its Effect on Levels of Serum Carcinoembryonic Antigen and Carbohydrate Antigen 125
Authors: Ai Shufen , Xie Jin
Published: June 2022

Objective. To explore the efficacy of modified Qingre Jiedu decoction combined with three-dimensional conformal radiotherapy (3D-CRT) in treating moderate to advanced ovarian carcinoma (OC) and its effect on patients’ serum carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125). Methods. The clinical data of 84 patients with moderate to advanced OC treated in the gynecology department of Changqing District People’s Hospital of Jinan from February 2017 to February 2018 were selected for retrospective analysis, and the patients were divided into the single chemotherapy group (taxol + carboplatin, n = 42) and the combined group (modified Qingre Jiedu decoction+3D-CRT, n = 42) according to the parity of their admission numbers. By measuring their levels of serum CEA and CA125 after treatment, the cellular immune levels of the two groups were compared. Results. Compared with the single chemotherapy group after treatment, the combined group obtained significantly higher total clinical effective rate and 1-year, 2-year, and 3-year survival rates (P<0.05), significantly higher CD4+/CD8+ and NK cell level values (P<0.001), significantly lower serum CA125 and CEA level values (P<0.001), and significantly lower total incidence rates of toxic and side effects (P<0.05). Conclusion. The abovementioned results show that the combined treatment modality has a significant effect on prolonging the survival of patients with moderate to advanced OC and can effectively reduce the levels of tumor markers and improve the body’s immunity. Further study will be conducive to establishing a better solution for OC patients.