bluuebunny/crossref_metadata_2025 huggingface dataset:
Promoting and Protecting the Developing Self-identity of the Young, Transracially Adopted Child in South Africa
Authors: Heyns Maynette , Moen Melanie , Finestone Michelle , Shabangu Sifiso
Published: July 2024

Purpose

Transracial adoption (TRA), where parents from one race adopt a child from another race, usually occurs with Black children being adopted by White parents in South Africa.

Method

Using multiple case studies (seven children) and a qualitative research design, the self-identity (personal and social) of six- to ten-year-old TRA children was explored. Data were collected from the adoptive parents and teachers by means of semi-structured interviews and the Child Behaviour Checklist. Additionally, parents completed a questionnaire and a Likert-style response scale. Participating children were assessed by an independent psychologist using three projective techniques. The data generated were thematically analysed.

Results

There were six emergent themes, all conducive to healthy self-identity development by securing primary identity motivators of belonging and acceptance. The children exhibited advanced communicative skills and a novel approach to group membership, increasing their social accessibility and inclusion. A distinctive theme was a desire for a dedicated personal space and possessions symbolizing permanence in the family. The universal adoptive elements of loss and rejection was confirmed, possibly more prevalent due to an observable adoptive status and physical dissimilarity from the adoptive family. Intentional parenting promoting healthy self-identity was apparent. Lastly, the importance of placing the children in an accommodating and sensitive school environment was noted.

Discussion

While not a comparative study, and with only seven children, it appears that these TRA children, with the acquisition of positive social skills and a sensitive and purposeful home and school environment, possessed the building blocks necessary to nurture a healthy self-identity.
Flow birefringence of cellulose nanocrystal suspensions in three-dimensional flow fields: revisiting the stress-optic law
Authors: Nakamine Kento , Yokoyama Yuto , Worby William Kai Alexander , Muto Masakazu , Tagawa Yoshiyuki
Published: July 2024

This study systematically investigates the flow birefringence of cellulose nanocrystal (CNC) suspensions. The aim is to clarify the importance of the stress component along the camera’s optical axis in the stress-optic law (SOL), which describes the relationship between birefringence, the retardation of transmitted polarized light, and the stress field. More than 100 datasets pertaining to the retardation of CNC suspensions (concentrations of 0.1, 0.3, 0.5, and 1.0 wt%) in a laminar flow field within a rectangular channel (aspect ratios of 0.1, 1, and 3) are systematically obtained. The measured retardation data are compared with the predictions given by the conventional SOL excluding the stress component along the camera’s optical axis and by the SOL including these components as second-order terms (2nd-order SOL). The results show that the 2nd-order SOL gives a significantly better agreement with the measurements. Based on the 2nd-order SOL, the retardation at the center of the channel, where the effect of the stress component along the camera’s optical axis is most pronounced, is predicted to be proportional to the square of the flow rate, which agrees with the experimental data. The results confirm the importance of considering the stress component along the camera’s optical axis in the flow birefringence of CNC suspensions at high flow rates, even for quasi-two-dimensional channel flow.
$$\textsf {TOPAS}$$2-pass key exchange with full perfect forward secrecy and optimal communication complexity
Authors: Schäge Sven
Published: July 2024

We present Transmission optimal protocol with active security ($$\textsf {TOPAS}$$
TOPAS
), the first key agreement protocol with optimal communication complexity (message size and number of rounds) that provides security against fully active adversaries. The size of the protocol messages and the computational costs to generate them are comparable to the basic Diffie-Hellman protocol over elliptic curves (which is well-known to only provide security against passive adversaries). Session keys are indistinguishable from random keys—even under reflection and key compromise impersonation attacks. What makes $$\textsf {TOPAS}$$
TOPAS
stand out is that it also features a security proof of full perfect forward secrecy (PFS), where the attacker can actively modify messages sent to or from the test-session. The proof of full PFS relies on two new extraction-based security assumptions. It is well-known that existing implicitly-authenticated 2-message protocols like $$\textsf {HMQV}$$
HMQV
cannot achieve this strong form of (full) security against active attackers (Krawczyk, Crypto’05). This makes $$\textsf {TOPAS}$$
TOPAS
the first key agreement protocol with full security against active attackers that works in prime-order groups while having optimal message size. We also present a variant of our protocol, $$\textsf {TOPAS+}$$

TOPAS
+

, which, under the Strong Diffie-Hellman assumption, provides better computational efficiency in the key derivation phase. Finally, we present a third protocol termed $$\textsf {FACTAS}$$
FACTAS
(for factoring-based protocol with active security) which has the same strong security properties as $$\textsf {TOPAS}$$
TOPAS
and $$\textsf {TOPAS+}$$

TOPAS
+

but whose security is solely based on the factoring assumption in groups of composite order (except for the proof of full PFS).
Conditionals: Inferentialism Explicated
Authors: Crupi Vincenzo , Iacona Andrea
Published: July 2024

According to the view of conditionals named inferentialism, a conditional holds when its consequent can be inferred from its antecedent. This paper identifies some major challenges that inferentialism has to face, and uses them to assess three accounts of conditionals: one is the classical strict account, the other two have recently been proposed by Douven and Rott. As will be shown, none of the three proposals meets all challenges in a fully satisfactory way. We argue through novel formal results that a variation of the evidential account of conditionals suggested by Crupi and Iacona is the most promising candidate to develop inferentialism in a coherent formal framework.
An Edge-Preserving Regularization Model for the Demosaicing of Noisy Color Images
Authors: Boccuto Antonio , Gerace Ivan , Giorgetti Valentina , Martinelli Francesca , Tonazzini Anna
Published: July 2024

This paper proposes an edge-preserving regularization technique to solve the color image demosaicing problem in the realistic case of noisy data. We enforce intra-channel local smoothness of the intensity (low-frequency components) and inter-channel local similarity of the depth of object borders and textures (high-frequency components). Discontinuities of both the low-frequency and high-frequency components are accounted for implicitly, i.e., through suitable functions of the proper derivatives. For the treatment of even the finest image details, derivatives of first, second, and third orders are considered. The solution to the demosaicing problem is defined as the minimizer of an energy function, accounting for all these constraints plus a data fidelity term. This non-convex energy is minimized via an iterative deterministic algorithm, applied to a family of approximating functions, each implicitly referring to geometrically consistent image edges. Our method is general because it does not refer to any specific color filter array. However, to allow quantitative comparisons with other published results, we tested it in the case of the Bayer CFA and on the Kodak 24-image dataset, the McMaster (IMAX) 18-image dataset, the Microsoft Demosaicing Canon 57-image dataset, and the Microsoft Demosaicing Panasonic 500-image dataset. The comparisons with some of the most recent demosaicing algorithms show the good performance of our method in both the noiseless and noisy cases.
Green Fabrication of Nanomaterials Using Microorganisms as Nano-Factories
Authors: Eweis Abdullah A. , El-Raheem Hany Abd , Ahmad Maged S. , Hozzein Wael N. , Mahmoud Rehab
Published: July 2024

Nanoparticle synthesis under environmentally friendly conditions has been conducted utilizing natural resources in order to reduce the reliance on hazardous chemicals. For example, the utilization of microbial synthesis has enabled the production of nanoparticles that exhibit biocompatibility, stability, and safety. Microorganisms facilitate the growth of crystals while preventing aggregation. They serve as both reducing agents and capping agents by offering enzymes, peptides, poly(amino acids), polyhydroxyalkanoate, and polysaccharides. In this review, we present an overview of nanoparticle synthesis based on microorganisms including bacteria, fungi, algae, and actinobacteria, encompassing metals such as gold (Au), silver (Ag), platinum (Pt), palladium (Pd), copper (Cu), titanium dioxide ((TiO2), zinc oxide (ZnO), iron oxide (Fe2O3), and selenium (Se). The nanoparticles typically vary in size from 1 to 100 nm and exhibit various shapes including spherical, rod-shaped, triangular, cubic, and hexagonal shapes. Additionally, this review discusses the mechanisms behind the synthesis of metal nanoparticles by microorganisms, whether they occur intracellularly or extracellularly.
Comparison of continuous temperature measurement methods in the intensive care unit: standard bladder catheter measurements versus non-invasive transcutaneous sensors
Authors: Ehlers Ulrike Elisabeth , Ulmer Jens , Keller Mirja , Klein Carsten , Pietsch Urs
Published: July 2024

The purpose of this study was to compare a wearable system for body core temperature measurement versus bladder and tympanic thermometers in an intensive care setting. The question was, if continuous non-invasive sensors in the intensive care unit represent an alternative to current standard methods of invasive continuous bladder temperature measurement methods?

Between May and September 2023, a comparative investigation involving 112 patients was conducted in a 20-bed surgical intensive care unit to assess various temperature probes, including those placed in the tympanic tube, bladder, and skin. To achieve this, a wireless non-invasive sensor system provided by greenTEG AG, Switzerland, was affixed to different body locations (clavicular and lateral chest) of each catheterized patient (equipped with a temperature probe) admitted to the intensive care unit. Furthermore, tympanic temperatures were recorded at specified intervals. The measurement duration ranged from a minimum of six hours to a maximum of six days, resulting in the analysis of a total of 355 simultaneous temperature measurements.

In this study, a wearable temperature measurement system attached to two different body sites revealed a consistent negative bias compared to bladder temperature. In addition, the measurements were particularly influenced by body constitution. The tested system in all patients showed a mean absolute error (MAE) of 0.45 °C for the lateral chest and 0.50 °C for the clavicular position. Tympanic measurements had a mean absolute error of 0.35 °C. In patients with body mass index (BMI) ≥ 25 the MAE increased to 0.5 °C for the lateral chest and 0.56 °C for the clavicular position. In contrast, the tympanic measurement had a reduced MAE of 0.32 °C, which is well below this threshold when compared to bladder measurements.

In conclusion the investigated system did not meet the clinically relevant acceptance criteria and showed low precision in correctly identifying fever episodes compared to invasive temperature probes, however its main advantage lies in its continuity and non-invasiveness. This makes it a potential alternative to intermittent tympanic measurement devices. In this study we were able to show, that in at least one subset of patients, the non-invasive and continuous device demonstrated a precision comparable to tympanic measurements.

The accuracy of all non-invasive methods was lower than in previous studies, suggesting that the use of bladder temperature as reference and user related variations may have introduced additional errors.
A new combined fabrication process to shape small flexure hinges
Authors: Fava Marco , Parenti-Castelli Vincenzo , Conconi Michele , Sancisi Nicola
Published: July 2024

This paper presents a new combined fabrication method, named 3D-PLAST, aimed at overcoming inherent limitations of conventional additive manufacturing techniques when producing small flexure hinges in compliant mechanisms. Flexure hinges play a crucial role in various applications, offering advantages such as cost reduction, increased precision, and weight reduction. However, traditional additive manufacturing proves challenging in achieving satisfactory mechanical properties when manufacturing small-size hinges. To overcome these limitations, the 3D-PLAST process combines fused filament fabrication with compressive plastic deformation. This hybrid process exploits the advantages of both techniques, i.e., flexibility, low cost, and ease of use. This process enables the fabrication of small-size mechanisms with good dimensional accuracy. Finally, the paper reports experimental tests on two materials comparing flexure hinges manufactured by 3D-PLAST versus 3D printing methods to demonstrate the effectiveness of the proposed process.
Inhibition of cytochrome P450 epoxygenase promotes endothelium-to-mesenchymal transition and exacerbates doxorubicin-induced cardiovascular toxicity
Authors: Dhulkifle Hevna , Therachiyil Lubna , Hasan Maram H. , Sayed Tahseen S. , Younis Shahd M. , Korashy Hesham M. , Yalcin Huseyin C. , Maayah Zaid H.
Published: July 2024

Background

Doxorubicin (DOX) is a potent chemotherapy widely used in treating various neoplastic diseases. However, the clinical use of DOX is limited due to its potential toxic effect on the cardiovascular system. Thus, identifying the pathway involved in this toxicity may help minimize chemotherapy risk and improve cancer patients’ quality of life. Recent studies suggest that Endothelial-to-Mesenchymal transition (EndMT) and endothelial toxicity contribute to the pathogenesis of DOX-induced cardiovascular toxicity. However, the molecular mechanism is yet unknown. Given that arachidonic acid and associated cytochrome P450 (CYP) epoxygenase have been involved in endothelial and cardiovascular function, we aimed to examine the effect of suppressing CYP epoxygenases on DOX-induced EndMT and cardiovascular toxicity in vitro and in vivo.

Methods and Results

To test this, human endothelial cells were treated with DOX, with or without CYP epoxygenase inhibitor, MSPPOH. We also investigated the effect of MSPPOH on the cardiovascular system in our zebrafish model of DOX-induced cardiotoxicity. Our results showed that MSPPOH exacerbated DOX-induced EndMT, inflammation, oxidative stress, and apoptosis in our endothelial cells. Furthermore, we also show that MSPPOH increased cardiac edema, lowered vascular blood flow velocity, and worsened the expression of EndMT and cardiac injury markers in our zebrafish model of DOX-induced cardiotoxicity.

Conclusion

Our data indicate that a selective CYP epoxygenase inhibitor, MSPPOH, induces EndMT and endothelial toxicity to contribute to DOX-induced cardiovascular toxicity.
Optimizing Antifungal Treatment Strategies to Prevent Invasive Pulmonary Aspergillosis Infection-Related Deaths in Intensive Care Unit Patients: The Need for Standardization of Research Definitions
Authors: Bassetti Matteo , Vena Antonio , Bavastro Martina , Giacobbe Daniele Roberto
Published: July 2024

The clinical spectrum of invasive pulmonary aspergillosis (IPA) has expanded in recent decades. A large group of patients admitted to intensive care units (ICU) is indeed susceptible to the development of IPA. Although timely diagnosis and antifungal therapy of IPA in this expanding population is crucial to prevent IPA-related deaths, the magnitude of the favorable prognostic impact of antifungal therapy is difficult to measure precisely. In our opinion, the development of standardized research definitions could have favorable implications for further improving our ability both to measure the favorable effect of antifungal treatment and to prevent IPA-related death in ICU patients.
Rocking block simulation based on numerical dissipation
Authors: D’Altri A. M. , Vlachakis G. , de Miranda S. , Lourenço P. B.
Published: July 2024

In this paper, a computational approach based on numerical dissipation is proposed to simulate rocking blocks. A rocking block is idealized as a solid body interacting with its foundation through a contact-based formulation. An implicit time integration scheme with numerical dissipation, set to optimally treat dissipation in contact problems, is employed. The numerical dissipation is ruled by the time step and the rocking dissipative phenomenon at impacts is accurately predicted without any damping model. A broad numerical campaign is conducted to define a regression law in analytic form for the setting of the time step, depending on the block size and aspect ratio, the contact stiffness, as well as the coefficient of restitution selected. The so-obtained regression law appears accurate and an a posteriori validation with cases not in the training dataset confirms the effectiveness of the approach. Finally, the comparison with available experimental tests highlights the approach efficacy for free rocking and harmonic loading cases (in a deterministic sense), and for earthquake-like loading cases (in a statistical sense). It is found that rocking blocks with sizes of interest for structural engineering (e.g., cultural heritage structures) can be simulated with time steps within 10–3 ÷ 10–1 s, so allowing very fast computations.
Nonlinear dynamics analysis of hydraulic turbochargers in reverse osmosis desalination plants
Authors: Sayed Hussein , El-Sayed Tamer A. , Friswell Michael I. , El-Mongy Heba H.
Published: July 2024

The hydraulic turbocharger plays a vital role in harnessing the energy stored in brine within reverse osmosis desalination plants. To optimize the efficiency and durability of this equipment, it is crucial to develop accurate dynamic models of the turbocharger rotor. An improved understanding of rotor dynamics enables the integration of innovative technologies such as Hydraulic Energy Management Integration, effectively enhancing efficiencies in systems characterized by small capacities and high rotational speeds. This study presents a dynamic modeling methodology for the hydraulic turbocharger. The analysis involves approximating the turbocharger rotor with an equivalent finite element shaft line model. Verification of the model’s natural frequency is conducted using three-dimensional finite element analysis, employing the ANSYS modal analysis module. Computational fluid dynamics is employed to evaluate the fluid forces, while the Reynolds equation is utilized to assess the journal bearing forces. The resulting model is employed to investigate the nonlinear dynamics of the rotor, examining the impact of various system parameters, including rotational speed, unbalance forces, and shaft geometrical parameters. The results highlight the significance of balancing the turbine and pump disks for optimal performance. Furthermore, the research demonstrates that increasing the shaft length reduces the rotor’s threshold speed, while increasing the shaft diameter initially raises the threshold speed until it reaches a critical value. Beyond this critical value, further increases in shaft diameter lead to a decrease in the threshold speed.
Very Long Transient Oxidation of a Nickel-based Single-Crystal Superalloy at 900 °C and 850 °C
Authors: Batiste Martin , Perez Thomas , Sanviemvongsak Tom , Desgranges Clara , Monceau Daniel
Published: July 2024

The isothermal oxidation of Ni-base single-crystal superalloy AM1 was investigated for up to 3600 h at 850 °C and 900 °C. The aim of the study was to test an existing model of oxidation kinetics that considers transitory oxide growth. The samples were characterized at various intervals to correlate the microstructure of the oxide scale with the oxidation kinetics. Transition alumina (θ) was observed among other transition oxides such as spinel, rutile, and chromia, which helped in understanding the nature and kinetics of the transitory stage. After a sufficiently long duration, all samples formed a continuous α-alumina layer at the metal/oxide interface. The previously published model, based on three kinetic parameters, was validated in the temperature range of 800–1200 °C. The duration of the transient regime characterized in this study at 850 °C and 900 °C was consistent with the kinetics model, with a slight increase in the value of the model parameter describing the lateral growth kinetics of α-alumina. This modification resulted in a slight reduction in the duration of the transient regime at low temperatures.
Modification of crystalline graphitic carbon nitride for improve efficiency in photocatalytic destruction of volatile organic compounds (VOCs) under visible light irradiation
Authors: Shvalagin Vitaliy , Kutsenko Aleksandr , Stara Tetyana , Hlukhova Polina , Skoryk Mykola , Kuchmiy Stepan
Published: July 2024

In this study, we show that the use of a mixture of melamine and oxalic acid during the synthesis of acid-treated crystalline graphitic carbon nitride samples significantly enhances its photocatalytic activity in VOCs destruction processes. The rate of photocatalytic ethanol destruction with the participation of modified crystalline graphitic carbon nitride obtained under optimal conditions is 67.1 μmol h−1, which is almost twice higher than sample synthesized in the absence of oxalic acid, and is two orders of magnitude higher than the activity of bulk g–C3N4. The synthesized materials were characterized using XRD, FT-IR, UV–Vis, PL, SEM, and EDXA methods. The high activity of the modified carbon nitride samples is attributed to increased light absorption in the visible region of the spectrum and better crystallinity, which can lead to more efficient separation and transport of photogenerated charges. To our knowledge, the effect of the simultaneous use of melamine and oxalic acid for obtaining acid-treated crystalline graphitic carbon nitride is, shown for the first time.
Through the secret gate: a study of member-contributed submissions in PNAS
Authors: Andersen Jens Peter , Horbach Serge P. J. M. , Ross-Hellauer Tony
Published: July 2024

This work studies “Contributed” articles in the Proceedings of the National Academy of Sciences of the United States of America (PNAS), a streamlined submission track for members of the US National Academy of Sciences (NAS). We assess the characteristics and impact of those articles and the background and status of their authors, by comparing these articles to PNAS articles following the traditional editorial process. Analyzing over 46,000 articles published between 2007 and 2020, we find: Firstly, and perhaps most centrally, (1) Contributed articles generally appear in lower per-author citation deciles than Direct submissions, but are more likely to appear in the overall top citation deciles of authors; (2) PNAS-Contributed articles tend to spend less time in the review process than Direct submissions; (3) Direct submissions tend to be slightly higher cited than Contributed articles, which are particularly overrepresented amongst least-cited PNAS papers. Disciplinary differences were negligible; (4) authors with lower mean normalized citation scores are profiting most from articles published as Contributed papers, in terms of citation impact; (5) NAS members tend to publish most Contributed articles in the first years after becoming an NAS member, with men publishing more of these articles than women; (6) Contributing authors take up a unique niche in terms of authorship roles, mainly performing supervisory and conceptualisation tasks, without the administration and funding acquisition tasks usually associated with last authors.
Private security for curbing unwanted sexual behaviours in train stations: a place-based randomised controlled trial
Authors: Ariel Barak , Langton John , Peters Kerry , Webster Kim , Assaraf Noy
Published: July 2024

Background

Unwanted sexual behaviours (USB) are widespread within mass transit networks worldwide. The present study examines the effectiveness of a place-based approach to tackle USB: repeated visits by capable guardians to prevent victimisation in train stations with a greater propensity for incidence of USB.

Methods

Pretest-posttest between groups randomised controlled trial on the effect of an intervention administered by a non-police security team at a prominent train operating company in England and Wales. Eligible hotspot stations (n = 51) were randomly assigned to two conditions: enhanced security measures, encompassing heightened presence of security staff, proactive interaction with possible victims, and pre-emptive efforts to prevent USB, and business-as-usual conditions. Negative binomial regression models estimate the treatment effect in terms of USB, violence, and all other incidents in the treatment compared to the control arms.

Findings

The implementation of heightened security measures led to significant reductions in reported incidents of USB at treatment stations compared to control stations. The intervention has also led to significant decreases in reported violent incidents but has had no significant effect on other reported incidents.

Conclusions

Security personnel have the potential to serve as efficient guardians in train stations, effectively reducing the risk of USB and violence. The findings highlight the efficacy of place-based interventions as measures against USB. However, the intervention comes with a significant opportunity cost as the security teams had limited capacity to deal with other crime types. Implications for future research and practice are discussed.
Changes in the urinary metabolome accompanied alterations in body mass and composition in women with overweight – impact of high versus low protein breakfast
Authors: Correia Banny Silva Barbosa , Dalgaard Line Barner , Thams Line , Hansen Mette , Bertram Hanne Christine
Published: July 2024

Introduction

Understanding why subjects with overweight and with obesity vary in their response to dietary interventions is of major interest for developing personalized strategies for body mass regulation.

Objectives

The aim of this study was to investigate the relationship between changes in the urine metabolome and body mass during a breakfast meal intervention. Furthermore, we aimed to elucidate if the baseline urine metabolome could predict the response to the two types of breakfast meals (high versus low protein) during the intervention.

Methods

A total of 75 young, women with overweight were randomly allocated to one of two intervention groups: (1) High-protein (HP) or (2) low-protein (LP) breakfast as part of their habitual diet during a 12-week intervention. Beside the breakfast meal, participants were instructed to eat their habitual diet and maintain their habitual physical activity level. Nuclear magnetic resonance-based metabolomics was conducted on urine samples collected at baseline (wk 0), mid-intervention (wk 6), and at endpoint (wk 12). At baseline and endpoint, body mass was measured and DXA was used to measure lean body mass and fat mass.

Results

The baseline urine metabolite profile showed a slightly higher correlation (R2 = 0.56) to body mass in comparison with lean body mass (R2 = 0.51) and fat mass (R2 = 0.53). Baseline 24-h urinary excretion of trigonelline (p = 0.04), N, N-dimethylglycine (p = 0.02), and trimethylamine (p = 0.03) were significantly higher in individuals who responded with a reduction in body mass to the HP breakfast.

Conclusions

Differences in the urine metabolome were seen for women that obtained a body weight loss in the response to the HP breakfast intervention and women who did not obtain a body weight loss, indicating that the urine metabolome contains information about the metabolic phenotype that influences the responsiveness to dietary interventions.
Radiomics as a tool for prognostic prediction in transarterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis
Authors: Deng Kaige , Chen Tong , Leng Zijian , Yang Fan , Lu Tao , Cao Jingying , Pan Weixuan , Zheng Yongchang
Published: July 2024

Introduction

Transarterial chemoembolization (TACE) is one of the predominant locoregional therapeutic modalities for addressing hepatocellular carcinoma (HCC). However, achieving precise prognostic predictions and effective patient selection remains a challenging pursuit. The primary objective of this systematic review and meta-analysis is to evaluate the efficacy of radiomics in forecasting the prognosis associated with TACE treatment.

Methods

A comprehensive exploration of pertinent original studies was undertaken, encompassing databases of PubMed, Web of Science and Embase. The studies' quality was meticulously evaluated employing the quality assessment of diagnostic accuracy studies 2 (QUADAS-2), the radiomics quality score (RQS) and the METhodological RadiomICs Score (METRICS). Pooled statistics, along with 95% confidence intervals (95% CI), were computed for sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Additionally, a summary receiver operating characteristic curve (sROC) was generated. To discern potential sources of heterogeneity, meta-regression and subgroup analyses were performed.

Results

The systematic review incorporated 29 studies, comprising a total of 5483 patients, with 14 studies involving 2691 patients qualifying for inclusion in the meta-analysis. The assessed studies exhibited commendable quality with regard to bias risk, with mean RQS of 12.90 ± 5.13 (35.82% ± 14.25%) and mean METRICS of 62.98% ± 14.58%. The pooled sensitivity was 0.83 (95% CI: 0.78–0.87), specificity was 0.86 (95% CI: 0.79–0.92), PLR was 6.13 (95% CI: 3.79–9.90), and NLR was 0.20 (95% CI: 0.15–0.27). The area under the sROC was 0.90 (95% CI: 0.87–0.93). Significant heterogeneity within all the included studies was observed, while meta-regression and subgroup analyses revealed homogeneous and promising findings in subgroups where principal methodological variables such as modeling algorithms, imaging modalities, and imaging phases were specified.

Conclusion

Radiomics models have exhibited robust predictive capabilities concerning prognosis subsequent to TACE, thereby presenting promising prospects for clinical translation.
Comparing shear wave elastography of breast tumors and axillary nodes in the axillary assessment after neoadjuvant chemotherapy in patients with node-positive breast cancer
Authors: Huang Jia-Xin , Liu Feng-Tao , Sun Lu , Ma Chao , Fu Jia , Wang Xue-Yan , Huang Gui-Ling , Zhang Yu-Ting , Pei Xiao-Qing
Published: July 2024

Background

Accurately identifying patients with axillary pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer patients remains challenging.

Purpose

To compare the feasibility of shear wave elastography (SWE) performed on breast tumors and axillary lymph nodes (LNs) in predicting the axillary status after NAC.

Materials and Methods

This prospective study included a total of 319 breast cancer patients with biopsy-proven positive node who received NAC followed by axillary lymph node dissection from 2019 to 2022. The correlations between shear wave velocity (SWV) and pathologic characteristics were analyzed separately for both breast tumors and LNs after NAC. We compared the performance of SWV between breast tumors and LNs in predicting the axillary status after NAC. Additionally, we evaluated the performance of the most significantly correlated pathologic characteristic in breast tumors and LNs to investigate the pathologic evidence supporting the use of breast or axilla SWE.

Results

Axillary pCR was achieved in 51.41% of patients with node-positive breast cancer. In breast tumors, there is a stronger correlation between SWV and collagen volume fraction (CVF) (r = 0.52, p < 0.001) compared to tumor cell density (TCD) (r = 0.37, p < 0.001). In axillary LNs, SWV was weakly correlated with CVF (r = 0.31, p = 0.177) and TCD (r = 0.29, p = 0.213). No significant correlation was found between SWV and necrosis proportion in breast tumors or axillary LNs. The predictive performances of both SWV and CVF for axillary pCR were found to be superior in breast tumors (AUC = 0.87 and 0.85, respectively) compared to axillary LNs (AUC = 0.70 and 0.74, respectively).

Conclusion

SWE has the ability to characterize the extracellular matrix, and serves as a promising modality for evaluating axillary LNs after NAC. Notably, breast SWE outperform axilla SWE in determining the axillary status in breast cancer patients after NAC.
COVID-19 Disruptions to Social Care Delivery: A Qualitative Study in Two Large, Safety-Net Primary Care Clinics
Authors: Brown Christopher O. , Perez Yesenia , Campa Manuel , Sorto Gerson , Sonik Rajan , Taira Breena R.
Published: July 2024

Background

Social care integration refers to the incorporation of activities into health systems that assist patients with health-related social needs (HRSNs) that negatively impact the health outcomes of their patients, such as food insecurity or homelessness. Social care integration initiatives are becoming more common. The COVID-19 pandemic strained health systems while simultaneously increasing levels of unmet social needs.

Objective

To describe the effects of the COVID-19 pandemic on established social care delivery in a primary care setting.

Design

We used qualitative semi-structured interviews of stakeholders to assess barriers and facilitators to social care delivery in the primary care setting during the COVID-19 health emergency. Data was analyzed using a hybrid inductive/deductive thematic analysis approach with both the Consolidated Framework for Implementation Research (CFIR) and the Screen-Navigate-Connect-Address-Evaluate model of social care integration.

Setting

Two safety-net, hospital-based primary care clinics with established screening for food insecurity, homelessness, and legal needs.

Participants

Six physicians, six nurses, six members of the social work team (clinical social workers and medical case workers), six community health workers, and six patients (total N = 30) completed interviews.

Results

Four major themes were identified. (1) A strained workforce experienced challenges confronting increased levels of HRSNs. (2) Vulnerable populations experienced a disproportionate negative impact in coping with effects of the COVID-19 pandemic on HRSNs. (3) COVID-19 protections compounded social isolation but did not extinguish the sense of community. (4) Fluctuations in the social service landscape led to variable experiences.

Conclusions

The COVID-19 pandemic disrupted established social care delivery in a primary care setting. Many of the lessons learned about challenges to social care delivery when health systems are strained are important considerations that can inform efforts to expand social care delivery.
Identifying and Linking Patients At Risk for MASLD with Advanced Fibrosis to Care in Primary Care
Authors: Xiao Ted G. , Witek Lauren , Bundy Richa A. , Moses Adam , Obermiller Corey S. , Schreiner Andrew D. , Dharod Ajay , Russo Mark W. , Rudnick Sean R.
Published: July 2024

Background and Aims

Severity of fibrosis is the driver of liver-related outcomes in metabolic dysfunction-associated steatotic liver disease (MASLD), and non-invasive testing such as fibrosis-4 (FIB-4) score is utilized for risk stratification. We aimed to determine if primary care patients at risk for MASLD and advanced fibrosis were evaluated with subsequent testing. A secondary aim was to determine if at-risk patients with normal aminotransferases had advanced fibrosis.

Methods

Primary care patients at increased risk for MASLD with advanced fibrosis (n = 91,914) were identified using previously established criteria. Patients with known alternative/concomitant etiology of liver disease or cirrhosis were excluded. The study cohort included patients with calculated FIB-4 score in 2020 (n = 52,006), and stratified into low, indeterminate, and high likelihood of advanced fibrosis. Among those at indeterminate/high risk, rates of subsequent testing were measured.

Results

Risk stratification with FIB-4 characterized 77% (n = 40,026) as low risk, 17% (n = 8847) as indeterminate, and 6% (n = 3133) as high risk. Among indeterminate/high-risk patients (n = 11,980), 78.7% (n = 9433) had aminotransferases within normal limits, 0.95% (n = 114) had elastography, and 8.2% (n = 984) were referred for subspecialty evaluation.

Conclusion

In this cohort of primary care patients at risk for MASLD with fibrosis, the FIB-4 score identified a substantial proportion of indeterminate/high-risk patients, the majority of which had normal aminotransferase levels. Low rates of subsequent testing were observed. These data suggest that a majority of patients at increased risk for liver-related outcomes remain unrecognized and highlight opportunities to facilitate their identification.
Disparities in Use of Novel Diabetes Medications by Insurance: A Nationally Representative Cohort Study
Authors: Bepo Lurit , Nguyen Oanh K. , Makam Anil N.
Published: July 2024

Background

Minority racial and ethnic populations have the highest prevalence of type 2 diabetes mellitus but lower use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1ra), novel medications that reduce morbidity and mortality. Observed disparities may be due to differences in insurance coverage, which have variable cost-sharing, prior authorization, and formulary restrictions that influence medication access.

Objective

To assess whether racial/ethnic differences in SGLT2i and GLP1ra use differ by payer.

Design

Cross-sectional analysis of 2018 and 2019 Medical Expenditure Panel Survey data.

Participants

Adults ≥ 18 years old with diabetes.

Main Measures

We defined insurance as private, Medicare, or Medicaid using ≥ 7 months of coverage in the calendar year. We defined race/ethnicity as White (non-Hispanic) vs non-White (including Hispanic). The primary outcome was use of ≥ 1 SGLT2i or GLP1ra medication. We used multivariable logistic regression to assess the interaction between payer and race/ethnicity adjusted for cardiovascular, socioeconomic, and healthcare access factors.

Key Results

We included 4997 adults, representing 24.8 million US adults annually with diabetes (mean age 63.6 years, 48.8% female, 38.8% non-White; 33.5% private insurance, 56.8% Medicare, 9.8% Medicaid). In our fully adjusted model, White individuals with private insurance had significantly more medication use versus non-White individuals (16.1% vs 8.3%, p < 0.001), which was similar for Medicare beneficiaries but more attenuated (14.7% vs 11.0%, p = 0.04). Medication rates were similar among Medicaid beneficiaries (10.0% vs 9.0%, p = 0.74).

Conclusions

Racial/ethnic disparities in novel diabetes medications were the largest among those with private insurance. There was no disparity among Medicaid enrollees, but overall prescription rates were the lowest. Given that disparities vary considerably by payer, differences in insurance coverage may account for the observed disparities in SGLT2i and GLP1ra use. Future studies are needed to assess racial/ethnic differences in novel diabetes use by insurance formulary restrictions and out-of-pocket cost-sharing.
Mountain research for sustainability: where are we and where to go?
Authors: Palau Anna Zango , Claramunt-López Bernat
Published: July 2024

Mountains have socio-economic and environmental importance for the entire world, and they are also one of the regions most threatened by global change. As mountains are systems in which the human and nature dimensions are tightly interconnected, studying them as social–ecological systems (SES) is increasingly common. To date, a variety of approaches and frameworks have been used to study mountain SES, making comparisons across mountain areas challenging. In this paper, we use Ostrom’s SES framework to review the mountain SES peer-reviewed literature under a common scope, aiming at unraveling which frameworks, approaches, domains, sectors, and elements are studied by researchers. Among the 169 reviewed manuscripts, only 28% of them employed a framework to study their system, and custom-made frameworks were preferred over existing ones. Although most research articles were in the domain of environmental sciences, socio-economic attributes were included more often than ecological ones, and more than 30% did not combine social and ecological information. Moreover, albeit most manuscripts had an empirical approach, field data were seldomly used. Future works should focus on collecting social and ecological data at comparable scales, as well as on developing tools to effectively integrate both dimensions in mountain SES studies. Finally, we examine components of mountain socio-ecological systems commonly addressed in literature, highlighting important elements for overall and sector-specific sustainability. Regarding social aspects, understanding local inhabitants’ diverse perspectives and socioeconomic context is crucial. In terms of ecological elements, describing climatic patterns and ecosystem history is key.
Regional agroecological stewardship: a framework to analyze the (re)territorialization of sustainable food systems
Authors: Ying William , Egermann Markus
Published: July 2024

The negative effects of climate change as well as the COVID-19 pandemic have underscored the fragility of the current global food system. To respond to such crises, the European Union’s (EU) “Farm to Fork” strategy strives to reshape the region’s food system to be more resilient and calls for new approaches to do so. The practices connected to the concepts of both agroecology and environmental stewardship are referenced for their potential to foster a transformation toward a more sustainable food system. However, these practices have been conducted on a small scale and independent from each other. A combined and holistic view of food systems based on the practices of both concepts remains missing. To close this gap, we developed a regional agroecological stewardship framework using the current literature to explore how these concepts can be combined to generate new insights for (re)territorialization by expanding agroecological practices beyond individual initiatives. To validate and refine the key components of the framework, we used an illustrative case study (Free State of Saxony, Germany) and interviewed relevant stakeholders including an agroecology expert, farm workers, network actors, and public officials from different governance levels. We identified actors and their motivations and capacity, a stewardship network, the outcomes of agroecological activities and the amplification of (re)territorialization as key components for regional agroecological stewardship. The framework can be used as an evaluation tool to assess the status of agroecological stewardship in a region and to determine regional challenges that need to be addressed.
On some properties of Cronbach’s α coefficient for interval-valued data in questionnaires
Authors: García-García José , Gil María Ángeles , Lubiano María Asunción
Published: July 2024

Along recent years, interval-valued rating scales have been considered as an alternative to traditional single-point psychometric tools for human evaluations, such as Likert-type or visual analogue scales. More concretely, in answering to intrinsically imprecise items in a questionnaire, interval-valued scales seem to allow capturing a richer information than conventional ones. When analyzing data from given performances of questionnaires, one of the main targets is that of ensuring the internal consistency of the items in a construct or latent variable. The most popular indicator of internal consistency, whenever answers to items are given in accordance with a numerically based/encoded scale, is the well-known Cronbach α coefficient. This paper aims to extend such a coefficient to the case of interval-valued answers and to analyze some of its main statistical properties. For this purpose, after presenting some formal preliminaries for interval-valued data, firstly Cronbach’s α coefficient is extended to the case in which the constructs of a questionnaire allow interval-valued answers to their items. The range of the potential values of the extended coefficient is then discussed. Furthermore, the asymptotic distribution of the sample Cronbach α coefficient along with its bias and consistency properties, are examined from a theoretical perspective. Finally, the preceding asymptotic distribution of the sample coefficient as well as the influence of the number of respondents to the questionnaire and the number of items in the constructs are empirically illustrated through simulation-based studies.
Quantitative evaluation of nicotine and particulate matter exposure for passive- and non-smokers via a nicotine passive sampler and a particulate matter sensor
Authors: Hoshino Saria , Noro Kazushi , Moriya Miyu , Komatsu Ayana , Wang Qi , Miyake Yuichi , Amagai Takashi
Published: July 2024

Passive smoking poses a major hazard to the health of non-smokers. Cigarette combustion emits environmental tobacco smoke (ETS) that contains various pollutants, including volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons, and particulate matter with particles < 2.5 μm in aerodynamic diameter (PM2.5). Therefore, to assess the risk of passive smoking, it is necessary to determine the exposure levels to ETS compounds caused by passive smoking. However, it is difficult to assess exposure to ETS compounds by excluding the effects of other sources of pollution. In this study, we assessed the individual exposure levels to ETS compounds using a nicotine passive sampler and PM2.5 sensor in 258 non-smokers. Median nicotine and PM2.5 concentrations were 0.065 and 7.5 µg m− 3, respectively. The median nicotine concentration was nearly identical to that found in non-smoking areas (0.05 µg m− 3). The median PM2.5 concentrations were below the standard value for indoor PM2.5 concentrations (12 µg m− 3). These results indicated that the effect of passive smoking was rather modest. Nicotine concentrations in individuals exposed to passive smoking indoors were significantly higher than in those not exposed to passive smoking. Nicotine exposure from domestic passive smoking was twice that from non-domestic passive smoking. There was no significant difference in PM2.5 exposure between passive smoking in domestic and non-domestic settings. Moreover, it was suggested that passive smoking was equivalent to the act of smoking 2.4 × 10− 3 cigarettes per day.