bluuebunny/crossref_metadata_2025 huggingface dataset:
Water ingress detection in an aluminum honeycomb sandwich structure using laser ultrasonics based on mode conversion behaviors
Authors: Dong Zeyu , Chen Weikun , Saito Osamu , Yu Fengming , Okabe Yoji
Published: November 2023

This paper investigates the method for water ingress detection in an aluminum honeycomb sandwich structure by laser ultrasonics. To clarify the propagation of Scholte waves generated at the solid-liquid interface, the theoretical dispersion curves in the water-aluminum layered structure are calculated by the global matrix method. Using a laser ultrasonic visualizing inspector, the guided wave propagation in the wavefields has been visualized, which shows the mode conversion behaviors occurring in the water ingress area. The clarification of mode conversion is then investigated by the finite element method. The Scholte modes at the solid-fluid interface and the Lamb modes in the face sheet are interconverted because of the change in the waveguide structure. Wavenumber filter reconstruction and the resulting energy maps are applied to illustrate the mode conversion in the wavefields and to detect the water ingress area. Results show that the appearance of the water layer contributes to the mode conversion behaviors during the guided wave propagation in the honeycomb sandwich structure, which offers the potential for water ingress detection based on the mode conversion behaviors.
Hysterically y-ours: Reclaiming academic writing as a hysterical practice
Authors: Kaasila-Pakanen Anna-Liisa , Mandalaki Emmanouela
Published: November 2023

Yet another hysteric! Can’t bear it anymore? Neither can we! In this text, we reclaim this highly derogatory term, “hysteric,” so often used against us, as women academic writers, to rewrite the gendered architecture of academic membership in organization studies. Performing hysterical writing interweaves affects, poems and reflections with feminist theoretical and methodological inspirations to challenge the masculine norms that marginalize affective, sentient, feminine and/or other, nonconforming, different bodies from academic texts. Specifically, drawing on Irigarayan mimesis as an activist feminist practice, we develop hysteria’s transformative, response-able potentials for writing, researching, relating and eventually knowing differently in organization studies. Our account contributes to burgeoning debates on writing differently particularly by situating the ethico-political potentials of écriture feminine for knowledge creation and resistance against epistemic oppression and violence.
Clarifying an approach to consultation: The impact of a systemic consultation training for schools-based child and adolescent mental health services clinicians
Authors: Van Roosmalen Marc , Daniels Michelle , Lawrence Helena
Published: November 2023

Despite the importance of consultation in early intervention of mental health difficulties, there has been little consideration of the specific competencies needed nor a model underpinning this intervention. Eleven schools- and children’s centre-based child and adolescent mental health services clinicians were interviewed with semi-structured interviews before and after a systemic consultation training. Four main themes emerged; participants gained: (1) a better understanding of organisational and multi-agency contexts, (2) a clear theoretical basis for practice, consistent with a destigmatising understanding of mental wellbeing, (3) clarity on the role, remit, and process of consultation, and (4) confidence and skills to carry out the role. The skills gained were in line with systems-level competencies. These findings suggest that the systemic consultation training increased the confidence of clinicians to work with complex networked systems in schools and communities. Future research can further understand the impact of this approach on other stakeholders, such as schools and families.
Characterization and Evaluation of the In Vitro Antioxidant, α-Glucosidase Inhibitory Activities of Camellia longii Orel and Luu. (Theaceae) Flower Essential Oil and Extracts From Vietnam
Authors: Tran-Trung Hieu , Nguyen Thi Chung , Dung Vo Cong , Ngoc Hieu Nguyen , Nguyen Dang Khoa , Vu Danh Cong , Van Son Dang , Nguyen Quynh Anh Thai , Nguyen Trang Ha Dieu , Tham Vo Mong , Dau Xuan Duc
Published: November 2023

Objective/Background: Camellia longii Orel and Luu was discovered for the first time in Cat Tien National Park of Lam Dong Province, Southern Vietnam, was determined as a new species. To the best of our knowledge, this is the first report on the phytochemical and bioactivity of this species. Methods: The chemical profile of essential oil (EO) prepared from C. longii flowers was determined by GC/MS analysis and comparison of the recorded retention indices and the corresponding literature values. The total phenolic and flavonoid contents in different flower extracts were estimated by Folin-Ciocalteu and aluminum chloride methods with a spectrophotometer, respectively. The antioxidant activities of the extracts were determined by various bioassays, including DPPH free radical scavenging, ferric reducing power, and cupric reducing antioxidant capacity. The α-glucosidase inhibitory activity of the extracts was evaluated using p-nitrophenyl α-D-glucopyranoside solution as a substrate and acarbose as the positive control. Results: Fifty-seven compounds were identified from the EO of C. longii flowers. Among these, the main components were α-eudesmol (16.1%), followed by ( E)-nerolidol (13.0%), β-eudesmol (8.9%), τ-cadinol (6.5%), and γ-eudesmol (5.8%). The total phenolic and flavonoid contents were found high in ethyl acetate, n-butanol, and ethanol extracts (206.8-378.6 mg gallic acid equivalents/g crude extract and 298.5-390.3 mg rutin equivalents/g crude extract, respectively). These extracts were shown to possess potent antioxidant activities in the examined bioassays. As for the α-glucosidase inhibitory assay, the ethyl acetate, butanol, and ethanol extracts were shown to be more potent than acarbose with IC50 values of 2.16 ± 0.04, 1.95 ± 0.05, and 1.53 ± 0.04 μg/mL, respectively. Conclusion: The findings first provide the phytochemical profiles of Camellia longii Orel and Luu and its bioactivities, indicating moderate potentials in antioxidant activity and strong α-glucosidase inhibition.
Decentralizing Platform Power: A Design Space of Multi-Level Governance in Online Social Platforms
Authors: Jhaver Shagun , Frey Seth , Zhang Amy X.
Published: November 2023

Many have criticized the centralized and unaccountable governance of prominent online social platforms, leading to renewed interest in platform governance that incorporates multiple centers of power. Decentralization of power can arise horizontally, through parallel communities, each with local administration, and vertically, through multiple hierarchies of overlapping jurisdiction. Drawing from literature on federalism and polycentricity in analogous offline institutions, we scrutinize the landscape of existing platforms through the lens of multi-level governance. Our analysis describes how online platforms incorporate varying forms and degrees of decentralized governance. In particular, we propose a framework that characterizes the general design space and the various ways that middle levels of governance vary in how they can interact with a centralized governance system above and end users below. This focus provides a starting point for new lines of inquiry between platform- and community-governance scholarship. By engaging themes of decentralization, hierarchy, power, and responsibility, while discussing concrete examples, we connect designers and theorists of online spaces.
Assessing Differences in Social Determinants of Health Screening Rates in a Large, Urban Safety-Net Health System
Authors: Lindenfeld Zoe , Chen Kevin , Kapur Supriya , Chang Ji Eun
Published: November 2023

Introduction/Objective:

Previous studies have evaluated the implementation of standardized social determinants of health (SDOH) screening within healthcare settings, however, less is known about where screening gaps may exist following initial implementation based on facility characteristics. The objective of this study is to assess differences in screening rates for SDOH at a large, urban healthcare system.

Methods:

We used electronic health record data obtained from NYC Health + Hospitals primary care sites from 2019 to 2022. We calculated the mean number of visits that were SDOH screened by visit type, facility size, and the percentages of community characteristics. We conducted 4 logistic regression models predicting the odds of screening for any SDOH and for specific SDOH needs (housing, food, and medical cost assistance) based on facility type, facility size, and the socioeconomic characteristics of the surrounding community.

Results:

Among the 3 212 650 visits included, 16.90% were SDOH screened. Across all 4 multivariate logistic regression models predicting SDOH screening, a visit had significantly lower odds of being screened if based at a midsize or small facility, if it was a telemedicine visit, or based at a facility located in a zip-code with a higher percentage of SDOH needs.

Conclusions:

Our study found important differences in SDOH screening rates at a large, NYC-based health system based on size, visit type, and community level characteristics. In particular, our findings point to barriers related to facility size and telemedicine workflow that should be addressed to increase uptake of SDOH screening within different visits and facility types.
The Duration of Symptoms Influences Outcomes After Lumbar Microdiscectomies: A Michigan Spine Surgery Improvement Collaborative
Authors: Kasir Rafid , Zakko Philip , Hasan Sazid , Aleem Ilyas , Park Daniel , Nerenz David , Abdulhak Muwaffak , Perez-Cruz Mick , Schwalb Jason , Saleh Ehab S. , Easton Richard , Khalil Jad G.
Published: November 2023

Study Design

Retrospective Cohort.

Objective

We investigate whether duration of symptoms a patient experiences prior to lumbar microdiscectomy affects pain, lifestyle, and return to work metrics after surgery.

Methods

A retrospective review of patients with a diagnosis of lumbar radiculopathy undergoing microdiscectomy was conducted using a statewide registry. Patients were grouped based on self-reported duration of symptoms prior to surgical intervention (Group 1: symptoms less than 3 months; Group 2: symptoms between 3 months and 1 year; and Group 3: symptoms greater than 1 year). Radicular pain scores, PROMIS PF Physical Function measure (PROMIS PF), EQ-5D scores, and return to work rates at 90 days, 1 year, and 2 years after surgery were compared using univariate and multivariate analysis.

Results

There were 2408 patients who underwent microdiscectomy for lumbar disc herniation for radiculopathy with 532, 910, and 955 in Groups 1, 2, and 3, respectively. Postoperative leg pain was lower for Group 1 at 90 days, 1 year, and 2 years compared to Groups 2 and 3 ( P < .05). Postoperative PROMIS PF and EQ-5D scores were higher for Group 1 at 90 days, 1 year, and 2 years compared to Groups 2 and 3 ( P < .05).

Conclusion

Patients with prolonged symptoms prior to surgical intervention experience smaller improvements in postoperative leg pain, PROMIS PF, and EQ-5D than those who undergo surgery earlier. Patients undergoing surgery within 3 months of symptom onset have the highest rates of return to work at 1 year after surgery.
Causal associations between female reproductive behaviors and psychiatric disorders: a lifecourse Mendelian randomization study
Authors: Yu Yifan , Hou Lei , Wu Yutong , Yu Yuanyuan , Liu Xinhui , Wu Sijia , He Yina , Ge Yilei , Wei Yun , Qian Fengtong , Luo Qingxin , Feng Yue , Cheng Xiaojing , Yu Tiangui , Li Hongkai , Xue Fuzhong
Published: November 2023

Background

The timings of reproductive life events have been examined to be associated with various psychiatric disorders. However, studies have not considered the causal pathways from reproductive behaviors to different psychiatric disorders. This study aimed to investigate the nature of the relationships between five reproductive behaviors and twelve psychiatric disorders.

Methods

Firstly, we calculated genetic correlations between reproductive factors and psychiatric disorders. Then two-sample Mendelian randomization (MR) was conducted to estimate the causal associations among five reproductive behaviors, and these reproductive behaviors on twelve psychiatric disorders, using genome-wide association study (GWAS) summary data from genetic consortia. Multivariable MR was then applied to evaluate the direct effect of reproductive behaviors on these psychiatric disorders whilst accounting for other reproductive factors at different life periods.

Results

Univariable MR analyses provide evidence that age at menarche, age at first sexual intercourse and age at first birth have effects on one (depression), seven (anxiety disorder, ADHD, bipolar disorder, bipolar disorder II, depression, PTSD and schizophrenia) and three psychiatric disorders (ADHD, depression and PTSD) (based on p<7.14×10-4), respectively. However, after performing multivariable MR, only age at first sexual intercourse has direct effects on five psychiatric disorders (Depression, Attention deficit or hyperactivity disorder, Bipolar disorder, Posttraumatic stress disorder and schizophrenia) when accounting for other reproductive behaviors with significant effects in univariable analyses.

Conclusion

Our findings suggest that reproductive behaviors predominantly exert their detrimental effects on psychiatric disorders and age at first sexual intercourse has direct effects on psychiatric disorders.
Immersive virtual reality for shoulder rehabilitation: evaluation of a physical therapy program executed with oculus quest 2
Authors: Longo Umile Giuseppe , Carnevale Arianna , Andreoli Flavia , Mannocchi Ilaria , Bravi Marco , Sassi Mohamed Saifeddine Hadj , Santacaterina Fabio , Carli Marco , Schena Emiliano , Papalia Rocco
Published: November 2023

Background

Virtual Reality (VR) systems have been increasingly used across several medical fields. A crucial preliminary step for developing optimized VR-based applications for rehabilitation purposes is identifying potential interventions to meet the requirements necessary to satisfy end-users’ needs. This study aims to assess the acceptability, usability, and appropriateness of a VR physical therapy program executed with Oculus Quest 2 by expert physiotherapists of shoulder musculoskeletal rehabilitation.

Methods

Eleven physiotherapists were enrolled to test a VR program for shoulder musculoskeletal rehabilitation. At the end of each session, physiotherapists completed three questionnaires about the acceptability, usability, and appropriateness of the VR system and application, investigating aspects such as wearability, safety, stability, ease of control, comfort, size, utility, playability, and use mode.

Results

The acceptability questionnaire revealed that all the physiotherapists found the VR system easy to wear and control, very confident, and safe. The usability questionnaire showed that most physiotherapists (73%) found the VR application entertaining, although only 45% said the system could be used independently by patients without the support of a therapist. Many physiotherapists found the use of the VR application appropriate for patients with rotator cuff tears treated conservatively (63.6%) or surgically (54.5%), for patients with shoulder osteoarthritis treated conservatively (72.7%), for patients with shoulder osteoarthritis after surgical treatment (63.6%). 91% of physiotherapists think it would be best for patients to use the VR system under the supervision of a therapist and not independently in a home setting.

Conclusions

The use of VR in orthopaedic rehabilitation is encouraging, although further efforts are needed to increase the independent use of patients without the supervision of a physiotherapist. Moreover, future studies should strive to ensure the clinical effectiveness of VR rehabilitation in reaching therapeutic goal settings.
Stratified support pattern-based internet-assisted self-management therapy for diabetes mellitus -mild cognitive impairment: a randomized controlled trial protocol
Authors: Wang Yun-xian , Liang Ji-xing , Lin Rong , Yan Yuan-jiao , Li Hong , Chen Ming-feng
Published: November 2023

Background

Mild cognitive impairment (MCI) associated with diabetes mellitus (DM) is common among older adults, and self-management is critical to controlling disease progression. However, both MCI and DM are heterogeneous diseases, and existing integrated self-management interventions do not consider patient differences. Grouping patients by disease characteristics could help to individualize disease management and improve the use of available resources. The current study sought to explore the feasibility and effectiveness of a stratified support model for DM-MCI patients.

Methods

Eighty-four DM-MCI patients will be randomly divided into an intervention group and a control group in a 1:1 ratio. The intervention group will receive a self-management intervention using the stratified support pattern-based internet-assisted therapy (SISMT), while the control group will receive the health manual intervention (HMI). The study recruiter will be blinded to the group allocation and unable to foresee which group the next participant will be assigned to. At the same time, the allocation will be also hidden from the research evaluators and participants. After 12 weeks and 24 weeks, cognitive function, blood glucose, self-management ability, psychological status, health literacy, and self-management behavior of patients in both groups will be measured and compared.

Discussion

This study developed a stratified support pattern-based internet-assisted to provide self-management intervention for patients with DM-MCI. The impact of different models and forms of self-management intervention on cognitive function, blood glucose management, and psychological status health literacy and self-management behavior of patients will be assessed. The results of this study will inform related intervention research on the stratified support pattern-based internet-assisted self-management therapy, and help to slow the decline of cognitive function in patients with DM-MCI.

Trial registration

ChiCTR2200061991. Registered 16 July 2022.
The causal effect of educational attainment on stress urinary incontinence: a two-sample mendelian randomization study
Authors: Zhang Shufei , Chen Mao , Liu Jianfeng , Yang Lian , Li Hanyue , Hong Li
Published: November 2023

Background

Stress urinary incontinence (SUI) is characterized by involuntary urine leakage in response to increased abdominal pressure, such as coughing, laughing, or sneezing. It significantly affects women’s quality of life and imposes a substantial disease burden. While pregnancy and childbirth have been previously identified as risk factors for SUI, educational attainment may also play a role. Therefore, this paper investigates the causal relationship between educational attainment and SUI using two-sample Mendelian randomization (TSMR) analysis, years of schooling (YOS), and college or university degree (CUD) as proxies.

Methods

Summary statistics of YOS, CUD, and SUI were obtained from genome-wide association studies (GWAS), and TSMR analysis was applied to explore potential causal relationships between them. Causal effects were mainly estimated using the standard inverse variance weighting (IVW) method, and complementary and sensitivity analyses were also performed using multiple methods.

Results

The results indicate that both YOS (OR = 0.994, 95% CI: 0.992–0.996; P = 7.764E-10) and CUD (OR = 0.987, 95% CI: 0.983–0.991; P = 1.217E-09) may have a negative causal effect on SUI.

Conclusions

Improving educational attainment may go some way towards reducing the risk of SUI. Therefore, it is important to increase efforts to improve the imbalance in educational development and safeguard women’s health.
Cornual invasive hydatidiform mole: a rare case report and literature review
Authors: Qian Jing , Xu Song , Chen Li
Published: November 2023

Background

The cornual pregnancy is a rare condition of ectopic pregnancies. Invasive hydatidiform mole is a rare form of gestational trophoblastic diseases. Cornual invasive hydatidiform mole is extremely rare.

Case presentation

A 17-year-old girl presented to the gynecology department with irregular vaginal bleeding. This patient was diagnosed with cornual invasive hydatidiform mole. Mono-chemotherapy was admitted firstly and with poor efficacy. The patient was cured by a combination of chemotherapy and resection of the uterine mass.

Conclusion

Cases with cornual invasive hydatidiform mole are extremely rare conditions. Unlike common site of invasive hydatidiform mole, mono-chemotherapy may be insufficient for cornual invasive hydatidiform mole. Chemotherapy in combination with other treatments may be needed in this rare condition.
Effect of using a mobile drug management application on medication adherence and hospital readmission among elderly patients with polypharmacy: a randomized controlled trial
Authors: Poorcheraghi Hossein , Negarandeh Reza , Pashaeypoor Shahzad , Jorian Javad
Published: November 2023

Background

Adherence to complex drug regimens and polypharmacy are among the challenges of old age, which may negatively affect their motivation to continue drug therapy or lead to incorrect drug consumption. The present study was conducted to evaluate the effect of using a mobile drug management application on medication adherence and hospital readmission among polypharmacy older adults.

Methods

In this randomized controlled trial study conducted in 2022, with Trial Registration Number (IRCT20191231045966N1) (18/07/2021), 192 Iranian older adults with polypharmacy were selected according to the inclusion criteria and allocated to case and control groups using the block randomization method. The data collection tools included a demographic questionnaire, case report form, and Morisky Medication Adherence Scale. The intervention was done using a mobile drug management application. Drug adherence was measured at baseline and both with hospital readmission were measured after 8 weeks. The collected data were entered into the SPSS software version 22 and analyzed using descriptive (frequency, percentage, mean, standard deviation) and inferential (Chi-square, Fisher’s exact test, independent t-test) statistics.

Results

The case and control groups were homogeneous in terms of demographic variables and drug adherence level before the intervention. A significant difference was found in the drug adherence level after using the app (p < 0.001). Moreover, a significant difference was found in adverse events, including re-hospitalization due to disease aggravation, re-hospitalization due to error in medication consumption, falling, hypo or hypertension, and hypo or hyperglycemia, and medication use accuracy between the groups after the intervention (p < 0.05).

Conclusion

The results showed that using a mobile drug management application that meets the specifications of older adults can improve drug adherence, reduce the adverse events and pave the way for a better disease period management.
Clinical service delivery implications of the COVID-19 pandemic on people with Inflammatory bowel disease: a qualitative study
Authors: Kemp Karen , Avery Pearl , Bryant Ruby , Cross Amanda , Danter Kayleigh , Kneebone Andrew , Morris Deborah , Walker Amy , Whitley Lisa , Dibley Lesley
Published: November 2023

Background

During the COVID-19 pandemic, clinical services were severely disrupted, restricted, or withdrawn across the country. People living with Inflammatory Bowel Disease (IBD) – an auto-immune disorder for which medical treatment often results in immunosuppression, thus requiring regular monitoring—may have struggled to access clinical support. As part of a larger qualitative study, we investigated experiences of access to clinical services during the pandemic, and patient concerns about and preferences for services in the future.

Methods

This exploratory qualitative study used semi-structured interviews to explore participants’ experiences of clinical services across the UK during the pandemic. All data were collected remotely (March – May 2021) using online video-calling platforms or by telephone. Audio files were transcribed professionally and anonymised for analysis. Data were analysed using thematic analysis.

Results

Of the eight themes found across all data, four related specifically to accessing GP, local (district) hospital, and specialist (tertiary) referral services for IBD: 1) The Risk of Attending Hospital; 2) Missing Routine Monitoring or Treatment; 3) Accessing Care as Needed, and 4) Remote Access and The Future.

Conclusions

Our findings support other studies reporting changes in use of health services, and concerns about future remote access methods. Maintenance of IBD services in some form is essential throughout crisis periods; newly diagnosed patients need additional support; future dependence on IBD services could be reduced through use of treatment / self-management plans. As the NHS digitalises it’s future services, the mode of appointment—remote (telephone, video call), or in-person – needs to be flexible and suit the patient.
Control of pathogenic bacteria using marine actinobacterial extract with antiquorum sensing and antibiofilm activity
Authors: Wijaya Marco , Delicia Dea , Waturangi Diana Elizabeth
Published: November 2023

Objective

The objectives of this research were to screen the anti-quorum sensing and antibiofilm activity of marine actinobacteria, isolated from several aquatic environments in Indonesia against several pathogenic bacteria, such as Staphylococcus aureus, Bacillus cereus, Enterococcus faecalis, Vibrio cholerae, Salmonella Typhimurium, and Pseudomonas aeruginosa.

Results

Ten out of 40 actinobacteria were found to have anti-quorum sensing activity against wild-type Chromobacterium violaceum (ATCC 12472); however, the validation assay showed that only eight of 10 significantly inhibited the quorum sensing system of Chromobacterium violaceum CV026. The crude actinobacteria extracts inhibited and disrupted biofilm formation produced by pathogens. The highest antibiofilm inhibition was discovered in isolates 11AC (90%), 1AC (90%), CW17 (84%), TB12 (94%), 20PM (85%), CW01 (93%) against Staphylococcus aureus, Bacillus cereus, Enterococcus faecalis, Vibrio cholerae, Salmonella Typhimurium, and Pseudomonas aeruginosa, respectively. The highest biofilm destruction activity was observed for isolate 1AC (77%), 20PM (85%), 16PM (72%), CW01 (73%), 18PM (82%), 16PM (63%) against Staphylococcus aureus, Bacillus cereus, Enterococcus faecalis, Vibrio cholerae, Salmonella Typhimurium, and Pseudomonas aeruginosa, respectively. Actinobacteria isolates demonstrated promising anti-quorum and/or antibiofilm activity, interfering with the biofilm formation of tested pathogens. Appropriate formulations of these extracts could be developed as effective disinfectants, eradicating biofilms in many industries.
Simeprevir restores the anti-Staphylococcus activity of polymyxins
Authors: Wu Yuan , Wu Pingyun , Wu Ruolan , Li Huilong , Duan Yao , Cai Chaoni , Liu Zixin , She Pengfei , Zhang Di
Published: November 2023

Methicillin-resistant Staphylococcus aureus (MRSA) infection poses a severe threat to global public health due to its high mortality. Currently, polymyxins are mainly used for the treatment of Gram-negative bacterial-related infection, while exhibiting limited antibacterial activities against Staphylococcus aureus (S. aureus). However, the combination of antibiotics with antibiotic adjuvants is a feasible strategy for the hard-treated infection and toxicity reducing. We will investigate the antibacterial activity of simeprevir (SIM), which treated for genotype 1 and 4 chronic hepatitis C, combined with polymyxins against MRSA through high-throughput screening technology. In our study, the synergistic antibacterial effect of SIM and polymyxins against S. aureus in vitro was found by checkerboard assay and time-growth curve. The cytotoxicity of SIM combined with polymyxin B sulfate [PB(S)] or polymyxin E (PE) in vitro was evaluated using CCK-8, human RBC hemolysis and scratch assays. In addition, we investigated the eradication of biofilm formation of S. aureus by biofilm inhibition assay and the killing of persister cells. Moreover, we evaluated the therapeutic effect and in vivo toxicity of the combination against MRSA in murine subcutaneous abscess model. Furthermore, it was preliminarily found that SIM significantly enhanced the destruction of MRSA membrane by SYTOX Green and DISC3(5) probes. In summary, these results reveal that the therapy of SIM combined with polymyxins (especially PE) is promising for the treatment of MRSA infection.
CT-based nomogram for early identification of T790M resistance in metastatic non-small cell lung cancer before first-line epidermal growth factor receptor-tyrosine kinase inhibitors therapy
Authors: Li Ye , Lv Xinna , Wang Yichuan , Xu Zexuan , Lv Yan , Hou Dailun
Published: November 2023

Background

To evaluate the value of computed tomography (CT) radiomics in predicting the risk of developing epidermal growth factor receptor (EGFR) T790M resistance mutation for metastatic non-small lung cancer (NSCLC) patients before first-line EGFR-tyrosine kinase inhibitors (EGFR-TKIs) therapy.

Methods

A total of 162 metastatic NSCLC patients were recruited and split into training and testing cohort. Radiomics features were extracted from tumor lesions on nonenhanced CT (NECT) and contrast-enhanced CT (CECT). Radiomics score (rad-score) of two CT scans was calculated respectively. A nomogram combining two CT scans was developed to evaluate T790M resistance within up to 14 months. Patients were followed up to calculate the time of T790M occurrence. Models were evaluated by area under the curve at receiver operating characteristic analysis (ROC-AUC), calibration curve, and decision curve analysis (DCA). The association of the nomogram with the time of T790M occurrence was evaluated by Kaplan–Meier survival analysis.

Results

The nomogram constructed with the rad-score of NECT and CECT for predicting T790M resistance within 14 months achieved the highest ROC-AUCs of 0.828 and 0.853 in training and testing cohorts, respectively. The DCA showed that the nomogram was clinically useful. The Kaplan–Meier analysis showed that the occurrence time of T790M difference between the high- and low-risk groups distinguished by the rad-score was significant (p < 0.001).

Conclusions

The CT-based radiomics signature may provide prognostic information and improve pretreatment risk stratification in EGFR NSCLC patients before EGFR-TKIs therapy. The multimodal radiomics nomogram further improved the capability.

Relevance statement

Radiomics based on NECT and CECT images can effectively identify and stratify the risk of T790M resistance before the first-line TKIs treatment in metastatic non-small cell lung cancer patients.

Key points

• Early identification of the risk of T790M resistance before TKIs treatment is clinically relevant.

• Multimodel radiomics nomogram holds potential to be a diagnostic tool.

• It provided an imaging surrogate for identifying the pretreatment risk of T790M.

Graphical Abstract
The effect of letrozole as an adjunct in GnRH-antagonist protocol on IVF/ICSI outcome in women with endometriosis: a randomized clinical trial
Authors: Mojtahedi Maryam Farid , Moini Ashraf , Kashani Ladan , Mirzarahimi Tiba
Published: November 2023

Background

To evaluate the effect of adding letrozole to the antagonist ovarian stimulation protocol (COS) on in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcome in endometriosis patients.

Methods

This randomized clinical trial was carried out in the department of infertility treatment at Arash Women’s Hospital from May 2019 to May 2021. The eligible women with normal ovarian reserve tests who had endometriosis diagnosis and underwent IVF/ICSI cycles were evaluated. A flexible regimen of GnRH-antagonist protocol was used for COS. In the experimental (n = 34), the patients received 5 mg letrozole daily for the first 5 days in combination with 150 IU of recombinant follicle-stimulating hormone (rFSH). In the control group (n = 30), the patients received only the same dose of rFSH. The treatment cycle was compared between groups.

Results

Analysis of demographic characteristics, severity of endometriosis, and baseline hormonal tests of patients showed that the two groups were similar and comparable. The means of total used gonadotropins ampoules and serum E2 level on oocyte trigger day in the letrozole group were significantly lower than those of in the control group (P = 0.03 and P = 0.004, respectively). No statistically significant difference in terms of the total number of retrieved and MII oocytes as well as the total numbers of obtained and top-quality embryos, and cryopreserved embryos was found.

Conclusion

The co-treatment of letrozole with gonadotropins during the antagonist protocol was associated with a reduction in the total dose of gonadotropins, although it had no effect on the oocyte or embryo yield in patients with endometriosis.

Trial registration

The study was registered in the Iranian Registry of Clinical Trials on 2018 -07-13 (IRCT20150310021420N4 at www.irct.ir, registered while recruiting).
Understanding the Impact of Population and Cancer Type on Tumor Mutation Burden Scores: A Comprehensive Whole-Exome Study in Cancer Patients From India
Authors: Tanwar Nishtha AjitSingh , Malhotra Richa , Satheesh Aiswarya Padmaja , Khuntia Satya Prakash , Sreekanthreddy Peddagangannagari , Varghese Linu , Kolla Srivalli , Chandrani Pratik , Choughule Anuradha , Pange Priyanka , Gupta Vinod , Noronha Vanita , Patil Vijay Maruti , Pramanik Raja , Kumar Sunila , Nayak Sandeep Peraje , Babu Suresh , Shetty Rohan , Kantharaju Madan , Chinder Pramod Shekarappa , Korlimarla Aruna , Srinath BS , Prabhash Kumar , Rishi Kshitij Datta , Goswami Hitesh Madan , Veldore Vidya Harini
Published: November 2023

The study depicts significance of TMB as a biomarker, variable across cancers and populations/ethnicities.
Fully autonomous weapon systems
Authors: Εμιρλή Άρτεμις
Published: November 2023

Η αυτόνομη τεχνολογία εξελίσσεται ραγδαία σε σημαντική μαχητική δύναμη των στρατών παγκοσμίως. Ταυτόχρονα, επιστήμονες και ένοπλες δυνάμεις σε όλο τον κόσμο έχουν βάλει στόχο την κατασκευή νέων τύπων ρομπότ - πλήρως αυτόνομων - που προορίζονται να καταταχθούν ως εντελώς νέο είδος στρατιώτη. Η ανάπτυξη και η χρήση μιας τέτοιας τεχνολογίας φαίνεται αναπόφευκτη. Αυτή η προοπτική, ωστόσο, κάνει νομοθέτες και ακαδημαϊκούς να φοβούνται ότι η πραγματικότητα μπορεί να υπερκεράσει τους υπάρχοντες νόμους και τις τρέχουσες νομοθετικές διαδικασίες, εκθέτοντας έτσι την ανθρωπότητα σε μεγάλους κινδύνους και απειλές. Θέματα συμμόρφωσης με τη νομοθεσία, λογοδοσίας και χρήσης θανατηφόρου βίας σε ανθρώπους από μηχανές γίνονται το επίκεντρο του παγκόσμιου ενδιαφέροντος με αφορμή την ανάπτυξη πλήρως αυτόνομων οπλικών συστημάτων στα πεδία των μαχών. Η παρούσα διατριβή αναγνωρίζει ότι η εποχή της τεχνητής νοημοσύνης στον πόλεμο έχει έρθει και αναζητά το νομικό πλαίσιο που θα μπορούσε ενδεχομένως να ρυθμίσει τα πλήρως αυτόνομα οπλικά συστήματα, ώστε να μπορούν να ενσωματωθούν με ασφάλεια στις κοινωνίες και τους στρατούς μας, χωρίς η ύπαρξη και οι ενέργειές τους να δημιουργούν νομικά κενά. Σε αυτό το πλαίσιο, διερευνάται η δυνατότητα απονομής του νομικού καθεστώτος του τεχνητού στρατιώτη στα πλήρως αυτόνομα οπλικά συστήματα, καθώς και η δυνατότητα ρύθμισής τους με βάση τους νόμους για τα στρατιωτικά όπλα. Τα ευρήματα της έρευνας δείχνουν ότι είναι πολύ νωρίς για τη διεθνή κοινότητα να εξετάσει το ενδεχόμενο αναγνώρισης του καθεστώτος του τεχνητού στρατιώτη σε πλήρως αυτόνομα οπλικά συστήματα. Φαίνεται όμως ότι υπάρχει περιθώριο για διαφορετική εξέλιξη στο μέλλον. Ταυτόχρονα, η προσπάθεια ενσωμάτωσης των πλήρως αυτόνομων οπλικών συστημάτων στο νομικό πλαίσιο που ρυθμίζει τα στρατιωτικά όπλα καταλήγει επίσης άκαρπη. Τα τεχνικά χαρακτηριστικά των πλήρως αυτόνομων οπλικών συστημάτων μαζί με το ιδιαίτερο χαρακτηριστικό της αυτονομίας τους εμποδίζουν αυτή τη προοπτική. Η διατριβή αυτή προτείνει ως λύση στο αδιεξοδο τα πλήρως αυτόνομα οπλικά συστήματα να υπηρετούν την ανθρωπότητα ως «στρατιωτικοί υπηρέτες». Επί του παρόντος, είναι ασφαλές να υποστηριχθεί ότι τα εξαιρετικά εξελιγμένα στρατιωτικά ρομπότ μπορούν να υπηρετούν τους στρατούς ως αμυντικοί μηχανισμοί ή να συμβάλλουν σε στρατιωτικές επιχειρήσεις υπό την ιδιότητα στρατηγικών συμβούλων, χειριστών, γιατρών κ.λπ. Θεωρείται αυτή τη στιγμή απαγορευτικό το να χρησιμοποιούνται αυτά τα συστήματα για εμπροσθοφυλακή.
Causal relationship model of marketing innovation and competitiveness of small and medium enterprises (SMEs) with digital technologies in Thailand
Authors: Vuttichat Soonthonsmai , Patchara Piluk
Published: November 2023

Background: This study investigates the causal model of marketing innovation and competitiveness of small and medium enterprises (SMEs) with digital technologies in Thailand. This study aimed to investigate market orientation, digital marketing strategies, competitiveness, innovative marketing behavior, and digital marketing efficiency of SMEs. Methods: We validated the causal model of digital marketing efficiency using empirical evidence to investigate the direct and indirect effects of market orientation, digital marketing strategies, and innovative marketing behavior on digital marketing efficiency. The study was conducted using a questionnaire. Results: A total of 361 samples were collected using purposive sampling. A Structural Equation Model was developed and tested using LISREL software. The study found that the causal relationship model was consistent with the empirical evidence. Conclusions: Digital marketing strategy and competitiveness directly positively affected innovative marketing behavior and explained 89% of the variance in innovative marketing behavior. Innovative marketing behavior directly positively affects digital marketing efficiency, and competitiveness indirectly positively affects digital marketing efficiency through innovative marketing behavior and explains the variance in digital marketing efficiency by 18%.
Two new species of Leptogium (Collemataceae) with transversely septate ascospores from East Africa
Authors: Kaasalainen Ulla , Kirika Paul M. , Mollel Neduvoto P. , Hemp Andreas , Rikkinen Jouko
Published: November 2023

Two epiphytic Leptogium species from East Africa, both with transversely septate ascospores, are here described as new. They produce plicate thalli and have a paraplectenchymatous proper exciple and a one cell layer thick cortex on the thalline exciple. Leptogium bellum has so far only been collected from Mt. Kilimanjaro, Tanzania, where it occurs from mid- montane forests up to the subalpine zone. Leptogium tiinae occurs in relatively open habitats at lower elevations, with the type specimen collected from the Taita Hills, Kenya. Additionally, details from a Leptogium chloromeloides isotype and a key for Leptogium species with transversely septate ascospores are provided.
Four new Pyrenula species from primary forests in the Guianas, South America, and their ascospore development
Authors: Sipman Harrie J. M.
Published: November 2023

Four new species of the genus Pyrenula (Pyrenulaceae, Pyrenulales, lichenized Ascomycetes) are presented. They originate from primary forests in the Guianas: Pyrenula cubica Sipman, with cubical central lumina in the ascospores; Pyr­enula flavida Sipman, with a yellow-pigmented thallus; P. rubromarginata Sipman, with red pigment on the excipulum and not on the thallus; and P. submicromma Sipman, like P. micromma but with submuriform instead of bacillar ascospores. In addition, a description for P. atropurpurea is provided, and P. subvariabilis is reduced to synonymy of P. infrastroidea. Special attention was paid to the development of the ascospores. Two different development types are recognized. The phylogenetic significance of these types is unclear.
Leprarioid lichens and associated lichenicolous fungi from the Commander Islands (Kamchatka Territory, Russia) including a new species Lepraria tiinae
Authors: Stepanchikova Irina S. , Himelbrant Dmitry E. , Prokopiev Ilya A. , Pankova Viktoria V. , Zhukova Anastasiya A. , Gainetdinova Irina I. , Zueva Anna S.
Published: November 2023

Here, we present new records of leprarioid lichens from the Commander Islands, including one species of Lithocalla and six species of Lepraria. Notably, we describe as new to science Lepraria tiinae, which is quite common in coastal biotopes of the archipelago. The main distinguishing phenotypic features of this new species include large granules of the thallus, a well-developed hypothallus, dark rhizohyphae, and the production of thiophanic acid, arthothelin, and dichlorolichexanthone. Additionally, three species of lichenicolous fungi or fungi associated with leprarioid lichens were found in the studied specimens, all of which are new to the Kamchatka Territory.
Characterizing Rational Transplant Program Response to Outcome-Based Regulation
Authors: Mildebrath David , Lee Taewoo , Sinha Saumya , Schaefer Andrew J. , Gaber A. Osama
Published: November 2023

U.S. health agencies periodically evaluate transplant programs based on their patients’ posttransplant survival outcomes, and a program is flagged for review if the number of unsuccessful transplants far exceeds what would be expected based on national averages. Some researchers have expressed concerns that these regulations might cause programs to reject high-risk patients, whereas others have questioned if such a response would be rational. In “Characterizing Rational Transplant Program Response to Outcome-Based Regulation,” Mildebrath et al. use chance-constrained optimization to demonstrate that it may, in fact, be rational for a transplant program to become more selective when evaluating transplant candidates for admittance to the waitlist. They also demonstrate that the regulations may unfairly penalize medium-sized programs. Moreover, their model quantifies which patients may be most at risk for adverse selection by programs. Their results provide insights to policymakers by quantitatively characterizing the response of rational programs to outcome-based regulations.
Pengaruh pemberian media poster kesehatan terhadap minat remaja mengikuti posbindu PTM
Authors: Wijayanti Anisa Catur , Edita Enggin Putri
Published: November 2023

Non-communicable diseases (NCD) are still a health problem in Indonesia in recent years. Non-communicable diseases often go undetected because no symptoms are found, so they are difficult to cure or will end in disability or death.  There has been an epidemiological transition by shifting morbidity and mortality rates from infectious diseases to non-communicable diseases at a young age. The Indonesian government has created a program to overcome the problem of NCDs with the existence of NCDs Posbindu aimed at people over 15 years old who are still healthy and people with NCDs. There is a need to provide information using poster media regarding NCDs and NCDs Posbindu problems in adolescent understanding to prevent and control NCDs now and in the future. This study aims to determine the effect of giving poster media on teenagers' interest in participating in Posbindu at Ambarawa 1 High School. The results of the analysis showed that there was an influence of poster media on teenagers' involve in participating in NCDs Posbindu (p:0,001). The results showed a decrease in the average interest of adolescents in participating in the NCDs Posbindu by 3.15. This happened because adolescents objected to the implementation of the NCDs Posbindu, which was held one a month. Adolescents need to know that participating in Posbindu is an effort to prevent and control NCDs in the future. The data can be provided through cooperation between schools and community health centers that can involve existing extracurriculars and provide a better understanding of the importance of NCDs prevention and control efforts to adolescents, teachers and parents.
A Nurse Prepared for the World
Authors: Boreham Renata
Published: November 2023

Renata Boreham was approached by an institute of medical sciences in Colombo to design a module and facilitate teaching sessions with an emphasis on compassion and soft skills
Maternal mortality and morbidity in Pakistan: a situational analysis
Authors: Asif Nimira , Adnan Farzana , Ali Shahnaz Shahid , Memon Zahid , Ali Tazeen Saeed
Published: November 2023

Background

The maternal mortality rate in Pakistan is high, which has been attributed partly to delays in accessing healthcare for women who are pregnant and in labour. This study aimed to explore the community's perspectives of delays to use of health services in pregnancy and labour, using the ‘three delays’ model and the framework for determinants of maternal mortality.

Methods

An explorative-descriptive approach was used, with purposeful sampling of 382 participants selected from across Pakistan. Four groups of participants were selected: married women, married men, adolescent girls and adolescent boys.

Results

Several factors led to delays seeking healthcare. Women were unable to decide for themselves whether to attend a healthcare facility, there were issues reaching a facility in time and at the facility, either the resources or healthcare workers were lacking.

Conclusions

Women must be given education and access to healthcare in order to reduce maternal mortality and morbidity.
Carbetocin vs oxytocin in third stage labour: a quantitative review of low- and middle-income countries
Authors: Jacob Danielle
Published: November 2023

Background/Aims

Postpartum haemorrhage is a global concern and is a leading cause of maternal mortality in low- and middle-income countries. Oxytocin is the preferred prophylactic uterotonic; however, it is heat sensitive and therefore may not be suitable in low- and middle-income countries, which are often warm climates. An alternative is carbetocin, which is heat stable and longer acting.

Methods

Literature was sourced from the EBSCO, CINAHL, Medline and Global Health databases. Studies written in English in the last 10 years, that compared carbetocin to oxytocin in management of postpartum haemorrhage were selected. An ABCDFIX mnemonic tool was used to individually critique each study.

Results

The key themes were postpartum haemorrhage over 500ml, postpartum haemorrhage over 1000ml, need for blood transfusion, retained placenta, haemoglobin levels and need for additional uterotonics. The use of carbetocin may reduce the risk of postpartum haemorrhage and the need for additional uterotonics in low- and middle-income countries.

Conclusions

The use of carbetocin, instead of oxytocin, in low- and middle-income countries may reduce the risk of postpartum haemorrhage after vaginal birth and the need for more uterotonics. However, more research is needed in these settings.
Human Donor Milk in Maternity
Authors: Salmoral Ines , McGuinness Denise
Published: November 2023

Ines Salmoral and Denise McGuinness reflect on whether human donor milk should be made available for healthy term infants in the maternity setting
The Ockenden café initiative
Authors: Kubba Tamara , Pizer-Mason Ilana , Cornet Isabelle , Wilson Meg
Published: November 2023

In the wake of the Ockenden report, a new initiative has been established at the Whittington Health NHS Trust, to discuss and reflect on patient safety