bluuebunny/crossref_metadata_2025 huggingface dataset:
Chimera heuristics: Generative rational heuristics for the unknown from design theory
Authors: Gilain Agathe , Le Masson Pascal , Weil Benoit
Published: November 2023

The learning strategies offered by science for discovering the world by generating and testing hypotheses have been used abundantly to build decision‐making heuristics. In contrast, decision‐making heuristics for (re)designing the world are rarer. This paper develops a heuristic combining the exploratory power of chimeras with a design logic. Chimeras have long been used to foster imagination and build initially unknown futures. And recent advances in design theory show that in decision‐making situations, chimeras can be generated as nonfalsifiable existential statements about desirable alternatives and events. Moreover, design theory offers learning operations that handle nonfalsifiable statements to generate new real objects. This paper uses these operations to build a rational heuristic that may or may not transform initial chimeras into reality. Its main effect is to ensure that stimulated learning leads to decision alternatives (whether pre‐existing or novel) that surpass the initial optimal one. This paves the way for a class of design‐based heuristics extending the main functions of Bayesian learning to a non‐Bayesian world.
Cosine modulated filter bank‐based architecture for extracting and fusing saliency features
Authors: Ali Md. Yousuf , Jiang Bin , Chowdhury Oindrila , Harun‐Ar‐Rashid Md. , Hossain M. Shamim , AlMutib Khalid
Published: November 2023

Many academics are interested in content‐based image retrieval techniques like image segmentation. In computer vision, the most popular method for segmenting a digital image into different parts is known as image segmentation. We assigned the artificially intelligent algorithm to the image's critical areas by modeling human features in specific regions. In order to detect the object and identify the key parts in the ‘RGB’ photographs, we combined scenes based on a colour and depth map, or ‘RGB‐D’, and used cosine modulated filter bank (CMFB), which conducts cross‐scale extraction of joint features from the images during feature extraction. The proposed ‘CMFB’ combines the discovered collaborative elements with the discovered supplementary data. The features in multi‐scale images is combined using fusion blocks with the goal of producing additional features (FB). Then, a saliency mapping calculation is made for the loss linked to two blocks. The suggested ‘CMFB’ is tested with the aid of five data sets, and it is shown that, the proposed ‘CMFB’ outperforms other conventional techniques.
Myrtenal exhibits cardioprotective effects by attenuating the pathological progression associated with myocardial infarction
Authors: Abhirami N , Chandran Mahesh , Ramadasan Athira , Bhasura Dhanalekshmi , Plakkal Ayyappan Janeesh
Published: November 2023

Background

Myocardial infarction poses major risks to human health because of their incredibly high rates of morbidity and mortality. Infarctions are more likely to develop as a result of dysregulation of cell death. Myrtenal can be considered for their bioactive beneficial activity in the context of cardiovascular pathologies and, particularly, in the protection toward oxidative stress followed by ischemic injury.

Objective

This study aimed to put limelight on the antioxidant, anti‐apoptotic, and antibacterial properties of Myrtenal.

Methods

An in vitro model of oxidative stress‐induced injury was entrenched in H9c2 cells using hydrogen peroxide, and the effects of Myrtenal were investigated. The MTT, cellular enzyme level, staining, and flow cytometry analysis were used to examine protective, antioxidant, and anti‐apoptotic effects. The gene expressions were detected by qPCR. Antibacterial effect and biofilm formation were also done.

Result

The findings revealed that Myrtenal alone had negligible cytotoxic effects and that Myrtenal protects H9c2 against H2O2‐induced cell death at micromolar concentrations. Myrtenal pre‐treatment inhibited the generation of reactive oxygen species (ROS) as well as remarkably decreased the fluorescence intensity of ROS. Additionally, Myrtenal considerably increased the synthesis of antioxidant enzymes while dramatically decreasing the production of MDA and LDH. qPCR demonstrated the downregulation of Cas‐9, TNF‐α, NF‐κB, P53, BAX, iNOS, and IL‐6 expression while an upregulation of Bcl‐2 expression in Myrtenal pre‐treated groups. Myrtenal also holds the magnificent property of inhibiting bacterial growth.

Conclusion

Myrtenal ameliorates H2O2‐induced cardiomyocyte injury and protects cardiomyocyte by inhibiting oxidative stress, inflammation, and apoptosis and may be a promise drug for the treatment of heart diseases.
Trait–micro‐environment relationships of forest herb communities across Europe
Authors: Govaert Sanne , Meeussen Camille , Vanneste Thomas , Bollmann Kurt , Brunet Jörg , Calders Kim , Cousins Sara A. O. , De Pauw Karen , Diekmann Martin , Graae Bente J. , Hedwall Per‐Ola , Iacopetti Giovanni , Lenoir Jonathan , Lindmo Sigrid , Orczewska Anna , Ponette Quentin , Plue Jan , Sanczuk Pieter , Selvi Federico , Spicher Fabien , Verheyen Kris , Vangansbeke Pieter , De Frenne Pieter
Published: November 2023

Aim

The microclimate and light conditions on the forest floor are strongly modified by tree canopies. Therefore, we need to better consider the micro‐environment when quantifying trait–environment relationships for forest understorey plants. Here, we quantify relationships between micro‐environmental conditions and plant functional traits at the community level, including intraspecific trait variation, and their relationship with microclimate air temperature, light and soil properties.

Location

Deciduous temperate forests across Europe.

Time period

2018.

Major taxa studied

Herbaceous vegetation.

Methods

We sampled 225 plots across 15 regions along four complementary gradients capturing both macro‐ and microclimatic conditions including latitude, elevation, forest management and distance to forest edges. We related the community‐weighted mean of five plant functional traits (plant height, specific leaf area [SLA], plant carbon [C], plant nitrogen [N] and plant C:N ratio) across 150 vascular plant species to variation in local microclimate air temperature, light and soil properties. We tested the effect of accounting for intraspecific variation in trait–environment relationships and performed variation partitioning to identify major drivers of trait variation.

Results

Microclimate temperature, light availability and soil properties were all important predictors of community‐weighted mean functional traits. When light availability and variation in temperature were higher, the herb community often consisted of taller plants with a higher C:N ratio. In more productive environments (e.g. with high soil nitrogen availability), the community was dominated by individuals with resource‐acquisitive traits: high SLA and N but low C:N. Including intraspecific trait variation increased the strength of the trait–micro‐environment relationship, and increased the importance of light availability.

Main conclusions

The trait–environment relationships were much stronger when the micro‐environment and intraspecific trait variation were considered. By locally steering light availability and temperature, forest managers can potentially impact the functional signature of the forest herb‐layer community.
Predictive value of the Ishii score for sarcopenia and the prognosis of older patients hospitalized with heart failure
Authors: Maeda Daichi , Matsue Yuya , Kagiyama Nobuyuki , Fujimoto Yudai , Sunayama Tsutomu , Dotare Taishi , Nakade Taisuke , Jujo Kentaro , Saito Kazuya , Noda Takumi , Yamashita Masashi , Kamiya Kentaro , Saito Hiroshi , Ogasahara Yuki , Maekawa Emi , Konishi Masaaki , Kitai Takeshi , Iwata Kentaro , Wada Hiroshi , Hiki Masaru , Kasai Takatoshi , Nagamatsu Hirofumi , Ozawa Tetsuya , Izawa Katsuya , Yamamoto Shuhei , Aizawa Naoki , Wakaume Kazuki , Oka Kazuhiro , Momomura Shin‐ichi , Minamino Tohru
Published: November 2023

Aims

Although sarcopenia is common and associated with poor outcomes in patients with heart failure, its simple screening methods remain unclear. We aimed to investigate the predictive value of the Ishii score, which includes age, grip strength, and calf circumference, for sarcopenia and its prognostic predictability in patients with heart failure.

Methods

This was a subanalysis of the FRAGILE‐HF study. Receiver operating characteristic curves were used to evaluate the predictive value for sarcopenia. Patients were stratified into the high and low Ishii score groups based on the cutoff values of the Ishii score determined by the Youden index for sarcopenia, and the 1‐year mortality rates were compared.

Results

Of the 1262 study participants, 936 were evaluated with sarcopenia, and 184 (55 women, 129 men) were diagnosed with sarcopenia. The areas under the receiver operating characteristic curves for sarcopenia were 0.73 and 0.87 for women and men, respectively. The optimal cutoff values for predicting sarcopenia were 165 and 141 for women and men, respectively. Using these cutoff values, the sensitivity and specificity for sarcopenia were 70.9% and 68.5% for women and 88.4% and 69.7% for men, respectively. At 1 year, 151 (low Ishii score group, 98; high Ishii score group, 53) deaths were observed. Adjusted Cox proportional hazards analysis showed that the high Ishii score group was significantly associated with 1‐year mortality.

Conclusion

Among older patients hospitalized for heart failure, the Ishii score is useful for predicting sarcopenia and 1‐year mortality. Geriatr Gerontol Int 2024; 24: 147–153.
Visualization of the landscape of the read alignment shape of ATAC‐seq data using Hellinger distance metric
Authors: Cheng Jian Hao , Zheng Cheng , Yamada Ryo , Okada Daigo
Published: November 2023

Assay for Transposase‐Accessible Chromatin using high‐throughput sequencing (ATAC‐seq) is the popular technique using next‐generation sequencing to measure chromatin accessibility and identify open chromatin regions. While read alignment shape information of next‐generation sequencing data with intensity information has been used in various bioinformatics methods, few studies have focused on pure shape information alone. In this study, we investigated what types of ATAC‐seq read alignment shapes are observed for the promoter region and whether the pure shape information was related or unrelated to other gene features. We introduced a novel concept and pipeline for handling the pure shape information of NGS data as probability distributions and quantifying their dissimilarities by information theory. Based on this concept, we demonstrate that the pure shape information of ATAC‐seq data is correlated with chromatin openness and some gene characteristics. On the other hand, it is suggested that the pure information of ATAC‐seq read alignment shape is unlikely to contain additional information to explain differences in RNA expression. Our study suggests that viewing the read alignment shape of NGS data as probability distributions enables us to capture the characteristics of the genome‐wide landscape of such data in a non‐parametric manner.
Codesigning implementation strategies to improve evidence‐based stroke rehabilitation: A feasibility study
Authors: Lynch Elizabeth A. , Bulto Lemma N. , West Maria , Cadilhac Dominique A. , Cooper Fawn , Harvey Gillian
Published: November 2023

Introduction

People with lived experience are rarely involved in implementation science research. This study was designed to assess the feasibility of codesigning and delivering implementation strategies with people with lived experience of stroke and health professionals to improve evidence‐based stroke rehabilitation.

Methods

We used Experience‐Based CoDesign to design and deliver strategies to implement Stroke Clinical Guideline recommendations at one Australian inpatient stroke rehabilitation unit. Workgroups were formed with health professionals and people with 6–12 months experience of living with stroke (survivors and carers). Feasibility of the codesign approach (focusing on acceptability, implementation fidelity, signal of promise) was evaluated using mixed methods, using data from interviews, observations and inpatient self‐reported outcomes.

Results

Of 18 people with stroke invited, eight (44%) agreed to join the lived experience workgroup. All disciplines with ≥1 full‐time staff members on the stroke unit were represented on the health professional workgroup. Median workgroup attendance over 6 months was n = 8 health professionals, n = 4 survivors of stroke and n = 1 carers. Workgroup members agreed to focus on two Guideline recommendations: information provision and amount of therapy. Workgroup members indicated that the codesign approach was enjoyable and facilitated effective partnerships between health professionals and lived experience workgroup members. Both cohorts reported contributing valuable input to all stages of the project, with responsibility shifting between groups at different project stages. The codesigned strategies signalled promise for improving aspects of information provision and creating additional opportunities for therapy. We could not compare patient‐reported outcomes before and after the implementation period due to high variability between the preimplementation and postimplementation patient cohorts.

Conclusion

It is feasible to codesign implementation strategies in inpatient rehabilitation with people with lived experience of stroke and health professionals. More research is required to determine the effect of the codesigned strategies on patient and service outcomes.

Patient or Public Contribution

People with lived experience of stroke codesigned and evaluated implementation strategies. Author F. C. has lived experience of stroke and being an inpatient at the inpatient rehabilitation service, and has provided input into analysis of the findings and preparation of this manuscript.
Co‐designing a telepractice journey map with disability customers and clinicians: Partnering with users to understand challenges from their perspective
Authors: Benz Cloe , Scott‐Jeffs William , Revitt Jerah , Brabon Chloe , Fermanis Chloe , Hawkes Melanie , Keane Catherine , Dyke Robert , Cooper Samantha , Locantro Matthew , Welsh Mai , Norman Richard , Hendrie Delia , Robinson Suzanne
Published: November 2023

Introduction

Telepractice has the potential to align with the directive to reduce inequalities by United Nations Sustainable Development Goal 10. Telepractice additionally addresses a national digital health strategic plan for accessible digitally enabled models of care. To plan improvements, it is essential to understand the experience of telepractice for people with disability, which may be achieved through an approach such as journey mapping. The current article provides both a disability‐specific case study and a methodological guide for the inclusion of customers and clinicians in the meaningful redevelopment of services. The Perth, Australia‐based case study aimed to gain insights into the experience of telepractice for people with disability. The methodological aim describes using co‐design to produce a journey map in collaboration with customers and clinicians, for potential replication in a wide range of health and social care contexts.

Method

Interview transcripts gathered from a cohort of customer participants (n = 17) were used to inform the journey map. A group of customers (n = 5) and clinicians plus one manager (n = 5) distributed the findings onto a customer experience journey map during a co‐design workshop. The journey map describes the emotional experience and actions taken, along five phases of a timeline through telepractice service interactions: (1) before, (2) selecting telepractice, (3) telepractice preparation, (4) during telepractice sessions and (5) after.

Results

A journey map visualisation of customer experiences was produced that identified strengths of telepractice service delivery (flexibility) while noting challenges (with technology) as opportunities for improvement. The consensus of participants was the desire to have access to telepractice currently and in the future, in addition to in‐person delivery.

Conclusion

These findings are valuable in the context of advocating for the incorporation of customers and clinicians through co‐design workshops in the content analysis and creation of a journey map that is representative of the lived experience of accessing telepractice services.

Patient or Public Contribution

The paper forms part of a larger co‐design process that included customer participants throughout the design and planning of the project, inclusion of a peer researcher and the co‐designers in the workshops, journey map and this article production.
Machine learning‐derived identification of prognostic signature for improving prognosis and drug response in patients with ovarian cancer
Authors: Huan Qing , Cheng Shuchao , Ma Hui‐Fen , Zhao Min , Chen Yu , Yuan Xiaolu
Published: November 2023

Clinical assessments relying on pathology classification demonstrate limited effectiveness in predicting clinical outcomes and providing optimal treatment for patients with ovarian cancer (OV). Consequently, there is an urgent requirement for an ideal biomarker to facilitate precision medicine. To address this issue, we selected 15 multicentre cohorts, comprising 12 OV cohorts and 3 immunotherapy cohorts. Initially, we identified a set of robust prognostic risk genes using data from the 12 OV cohorts. Subsequently, we employed a consensus cluster analysis to identify distinct clusters based on the expression profiles of the risk genes. Finally, a machine learning‐derived prognostic signature (MLDPS) was developed based on differentially expressed genes and univariate Cox regression genes between the clusters by using 10 machine‐learning algorithms (101 combinations). Patients with high MLDPS had unfavourable survival rates and have good prediction performance in all cohorts and in‐house cohorts. The MLDPS exhibited robust and dramatically superior capability than 21 published signatures. Of note, low MLDIS have a positive prognostic impact on patients treated with anti‐PD‐1 immunotherapy by driving changes in the level of infiltration of immune cells. Additionally, patients suffering from OV with low MLDIS were more sensitive to immunotherapy. Meanwhile, patients with low MLDIS might benefit from chemotherapy, and 19 compounds that may be potential agents for patients with low MLDIS were identified. MLDIS presents an appealing instrument for the identification of patients at high/low risk. This could enhance the precision treatment, ultimately guiding the clinical management of OV.
Light activates Ube3a, an Angelman syndrome‐associated gene, by mediating the chromatin structures during postnatal development of mouse retina
Authors: Lin Chao‐Wen , Cheng Yi‐Chun , Yang Chang‐Hao , Huang Hsien‐Sung
Published: November 2023

Angelman syndrome, a severe neurodevelopmental disorder, is primarily caused by mutations or deletions of maternally inherited ubiquitin protein ligase E3A (UBE3A). Activation of the silenced paternal copy of UBE3A can occur with pharmacological perturbation; however, an environmental approach has not been examined. Here, we found Ube3a is highly expressed in embryonic and early neonatal mouse retina and is maternally‐, but not paternally‐, expressed in ganglion cells, amacrine cells, and horizontal cells. Moreover, we analyzed UBE3A expression in the retina and visual cortex of postnatal day 28 mice (P28) following exposure to light emissions from white compact‐fluorescent bulbs or blue light‐emitting diodes from postnatal day 0 (P0) to 28 (P28), encompassing a crucial phase of visual system development. We found higher levels of Ube3a RNA and protein in the retina, but not visual cortex compared with tissues from P28 mice exposure to typical lighting (controls). Levels of both paternal‐ and maternal‐UBE3A protein in mouse retina were higher than controls in P28 mice exposed to white or blue light. Moreover, levels of open and repressive chromatin structures, indicated by histone H3 lysine 4 trimethylation (H3K4me3) and histone H3 lysine 27 trimethylation (H3K27me3), respectively, were increased in the Ube3a promoter from mouse retina exposed to white or blue light. Our findings strongly suggest that extended exposure to white or blue light constitutes a substantial environmental factor that can effectively promote UBE3A expression within the central nervous system.
Evaluation of atherosclerotic risk in rosacea patients through serum fetuin‐A and carotid intima media thickness
Authors: Kulaklı Sevgi , Yıldırmak Sembol , Oğuz Işıl Deniz , Usta Murat , Tosun Alptekin , Akşan Burak
Published: November 2023

Background

The link between rosacea and various systemic conditions has been growing in prominence, even though the relationship between rosacea and cardiovascular disease remains a subject of debate in current research.

Aims

Detecting the connection between rosacea and subclinical atherosclerosis using laboratory and ultrasonographic parameters.

Methods

Fifty rosacea patients and 49 control were included in the study. Demographic, clinical, and laboratory data, including serum high sensitivity C‐reactive protein (hs‐CRP), fetuin‐A (FA), and matrix gla protein levels were assessed. Carotid intima‐media thickness (CIMT) was measured by carotid ultrasonography.

Results

Serum hs‐CRP levels (p = 0.009) and mean CIMT (p = 0.001) were significantly higher, while serum FA levels were significantly lower (p < 0.001) in the rosacea patients compared with control. The number of patients with mean CIMT>75th percentile according to age and sex were significantly higher in the rosacea group (p = 0.001). Rosacea patients with ocular involvement exhibited significantly higher hs‐CRP values in comparison to those without ocular involvement (p = 0.008). No significant correlation was detected between disease duration, severity, subtype and the study parameters.

Conclusions

This study results suggest that rosacea poses an independent risk for subclinical atherosclerosis regardless of its severity, duration, or subtype. Therefore, individuals diagnosed with rosacea should receive careful evaluation and monitoring to detect possible cardiovascular complications promptly. Furthermore, our study hints at a potential elevated risk of subclinical inflammation in rosacea patients with ocular involvement, warranting additional attention and further investigation.
Economies with rights: Efficiency and inequality
Authors: Hervés‐Beloso Carlos , Martínez‐Concha Francisco , Moreno‐García Emma
Published: November 2023

We consider a scenario where inequality levels originate harmful effects on society. To alleviate this negative externality, we introduce tradable consumption licenses within a general equilibrium framework to obtain efficient outcomes, reduce inequality, and improve social welfare. This mechanism would be easily implementable with the necessary support of the law.
Predicting nitrogen excretion of cattle kept under tropical and subtropical conditions using semimechanistic models
Authors: Salazar‐Cubillas Khaterine , Corea Edgardo , Dickhoefer Uta
Published: November 2023

The present study aims at evaluating whether current semimechanistic models developed for temperate cattle systems can be adopted for cattle under (sub‐) tropical husbandry systems to adequately (accurately and precisely) predict total nitrogen (TN), urine nitrogen (UN), faecal nitrogen (FN) excretion and its partition into different FN fractions. Selected models were built based on the feeding recommendations for ruminants of the British (Model A), German (Model G) and French (INRA; Model I) system. Model evaluation was conducted using eight nitrogen balance studies performed in El Salvador, Kenya and Peru (n = 392 individual observations including lactating cows, heifers and steers). Concordance correlation coefficient, root mean square errors (RMSE), and mean biases were estimated to evaluate the models' adequacy in predicting nitrogen excretion. Input variables causing greatest variation in nitrogen excretion prediction were identified by a sensitivity analysis and adjusted. Model G was able to adequately (i.e., RMSE of <25% of observed mean, systematic error of <5% of the mean square error) predict TN excretion through a compensation between overestimation of UN excretion and underestimation of FN excretion. None of the models were able to adequately predict UN, FN, and different FN fractions. Model I adequately predicted FN (RMSE = 18%) when duodenal microbial crude protein flow was increased, and the intercept used to predict FN excretion was reduced from 4.30 to 3.82 g of nitrogen per kilogram of dry matter intake. These adjustments, however, were not sufficient to predict adequately UN excretion (RMSE = 38%), individual FN fractions (RMSE > 56%), and TN (RMSE = 22%) excretion, by Model I.
Assessment of Construct Validity of Recovery Measures through Theoretical Formulations as Applied to Cardiovascular Parameters
Authors: Sawada Yukihiro
Published: November 2023

The recovery period is generally excluded under stress testing, despite its importance, because recovery measures lack information on construct validity. The smaller the carryover effect, the higher the construct validity. Theoretical formulae were derived for three recovery measures (i.e., total carryover [TCO], mean recovery rate [MRR], and area under the curve [AUC]) to assess to what extent this criterion is fulfilled. The cardiovascular parameters (particularly blood pressure [BP] and heart rate [HR]) were targeted. After applying this criterion to theoretical formulae and previous experimental findings, the three recovery measures were ordered as follows: MRR for BP (highly valid) > AUC for both BP and HR (moderately valid) > MRR for HR and TCO for both BP and HR (slightly valid). The unexpected finding of MRR for HR was due to the invisible carryover effect of vagal rebound on HR. The implication of the sharp contrast in MRR for BP versus HR is discussed, indicating their qualitative differences as cardiovascular parameters.
“Valorar el trabajo de farmworkers”: A thematic analysis of input from farmworkers, advocates, and students in a community documentary project about the future of farm work
Authors: Cofie Leslie E. , LePrevost Catherine E. , Harwell Emery L. , Bustos Yessie Y. , Welborn Joanna , Firnhaber Gina C. , Lee Joseph G. L.
Published: November 2023

Farm work is one of the nation's most hazardous occupations, and migrant and seasonal farmworkers face significant health inequities. Awareness and understanding of the needs of this population are crucial in assuring they receive appropriate support. Documentary programs can raise awareness of community member views to better inform services and advocacy efforts. Visions for the future of farm work were collected from farmworkers and persons supporting them through a community‐based, participatory documentary project led by Student Action with Farmworkers (SAF) from 2021 to 2022. Seventy‐nine submissions from participants in North and South Carolina, including text responses and file uploads, were collected and thematically analyzed. Five themes were identified: (1) employment benefits and conditions, (2) living conditions, (3) health access and quality, (4) dignity and visibility of farm work, and (5) policy change for a better future. The visions for the future of farm work expressed by these agricultural workers, advocates, and students raise important implications for agricultural communities, public health practitioners, researchers, funders, and policymakers. Application of these findings in the development and delivery of public health services for farmworkers has the potential to positively impact the morbidity and mortality rates of this at‐risk population.
Uncoupling of Linear Multi-Degree-of-Freedom Damped Gyroscopic Potential Systems
Authors: Udwadia Firdaus E. , Bulatovic Ranislav M.
Published: November 2023

This paper deals with the uncoupling of linear damped multi-degree-of-freedom gyroscopic potential systems in which the damping is taken to have a specifically chosen form. Necessary and sufficient conditions are obtained that guarantee the uncoupling of such damped systems into independent subsystems with at most two degrees-of-freedom. Along with several other results, it is shown that when the potential (stiffness) matrix of the damped system has distinct eigenvalues—a situation commonly found in civil, mechanical, and aerospace engineering, as well as in nature—the damping matrix must have this specifically chosen form for any such multi-degree-of-freedom system to be capable of being uncoupled.
Constant Force Spring System With a Spiral: Accuracy Assessment
Authors: Zampoli Vittorio , Hetnarski Richard B.
Published: November 2023

This paper is an extension of the original research contained in the paper “Constant Force Spring System With a Spiral” by Richard B. Hetnarski, published in J. Mech. Rob., 12, Dec. 2020. The topic of that paper is the introduction and description of a new mechanism which allows to transform the linearly changing force exerted by a helical spring into a constant force. The most important part of the system is a new spiral of which the differential equation was derived and solved, and all this is published in that previous paper. That paper contains the detailed description of the theory of the mechanism and the analysis of its operation. There are also provided examples of a few possible applications. A physical model of the system was built, and its testing showed the system works in agreement with the theory. However, the system is not completely accurate, i.e., the force Fo remains not entirely constant during winding/unwinding of the cord. The present paper deals with this inaccuracy which is discussed and evaluated in depth by analytical and numerical methods, and the way for it to be decreased or eliminated is described. The present paper, together with the previous paper, constitutes the full presentation of the mechanism and should not be separated one from the other. Since the present paper is a continuation of the previous paper, please study the paper (Hetnarski, R. B., 2020, “Constant Force Spring System With a Spiral,” ASME J. Mech. Rob., 12(6), p. 061018. 10.1115/1.4047982), before reading the present paper.
Dissolution enables dolomite crystal growth near ambient conditions
Authors: Kim Joonsoo , Kimura Yuki , Puchala Brian , Yamazaki Tomoya , Becker Udo , Sun Wenhao
Published: November 2023

Crystals grow in supersaturated solutions. A mysterious counterexample is dolomite CaMg(CO
3
)
2
, a geologically abundant sedimentary mineral that does not readily grow at ambient conditions, not even under highly supersaturated solutions. Using atomistic simulations, we show that dolomite initially precipitates a cation-disordered surface, where high surface strains inhibit further crystal growth. However, mild undersaturation will preferentially dissolve these disordered regions, enabling increased order upon reprecipitation. Our simulations predict that frequent cycling of a solution between supersaturation and undersaturation can accelerate dolomite growth by up to seven orders of magnitude. We validated our theory with in situ liquid cell transmission electron microscopy, directly observing bulk dolomite growth after pulses of dissolution. This mechanism explains why modern dolomite is primarily found in natural environments with pH or salinity fluctuations. More generally, it reveals that the growth and ripening of defect-free crystals can be facilitated by deliberate periods of mild dissolution.
Sheehan’s syndrome presenting as massive pericardial effusion, ventricular tachycardia and diabetes insipidus
Authors: Alam Ahmad , Ashraf Hamid , Malik Azharuddin Mohammad , Fatima Razeen
Published: November 2023

Sheehan’s syndrome (SS) is characterised by pituitary necrosis resulting from postpartum haemorrhage. While SS is uncommon in developed nations, it remains a prevalent cause of hypopituitarism in women, particularly in low/middle-income countries. Clinically, SS is characterised by a deficiency in anterior pituitary hormones; involvement of the posterior pituitary is less common. SS presenting as cardiac tamponade is rare, with only a few reported cases in the literature. In this report, we present the case of a patient with SS who arrived at the emergency department with symptoms of light-headedness, palpitations and dyspnoea. Echocardiography revealed a massive pericardial effusion with cardiac tamponade, and during treatment, the patient experienced ventricular tachycardia and circulatory collapse. The collaboration between various medical specialties, including emergency medicine, cardiology, critical care, endocrinology and radiology, played a crucial role in successful patient management. The multidisciplinary approach allowed for comprehensive care addressing acute cardiac complications and underlying hormonal deficiencies.
Covid-19 vaccine effectiveness against post-covid-19 condition among 589 722 individuals in Sweden: population based cohort study
Authors: Lundberg-Morris Lisa , Leach Susannah , Xu Yiyi , Martikainen Jari , Santosa Ailiana , Gisslén Magnus , Li Huiqi , Nyberg Fredrik , Bygdell Maria
Published: November 2023

Objective

To investigate the effectiveness of primary covid-19 vaccination (first two doses and first booster dose within the recommended schedule) against post-covid-19 condition (PCC).

Design

Population based cohort study.

Setting

Swedish Covid-19 Investigation for Future Insights—a Population Epidemiology Approach using Register Linkage (SCIFI-PEARL) project, a register based cohort study in Sweden.

Participants

All adults (≥18 years) with covid-19 first registered between 27 December 2020 and 9 February 2022 (n=589 722) in the two largest regions of Sweden. Individuals were followed from a first infection until death, emigration, vaccination, reinfection, a PCC diagnosis (ICD-10 diagnosis code U09.9), or end of follow-up (30 November 2022), whichever came first. Individuals who had received at least one dose of a covid-19 vaccine before infection were considered vaccinated.

Main outcome measure

The primary outcome was a clinical diagnosis of PCC. Vaccine effectiveness against PCC was estimated using Cox regressions adjusted for age, sex, comorbidities (diabetes and cardiovascular, respiratory, and psychiatric disease), number of healthcare contacts during 2019, socioeconomic factors, and dominant virus variant at time of infection.

Results

Of 299 692 vaccinated individuals with covid-19, 1201 (0.4%) had a diagnosis of PCC during follow-up, compared with 4118 (1.4%) of 290 030 unvaccinated individuals. Covid-19 vaccination with any number of doses before infection was associated with a reduced risk of PCC (adjusted hazard ratio 0.42, 95% confidence interval 0.38 to 0.46), with a vaccine effectiveness of 58%. Of the vaccinated individuals, 21 111 received one dose only, 205 650 received two doses, and 72 931 received three or more doses. Vaccine effectiveness against PCC for one dose, two doses, and three or more doses was 21%, 59%, and 73%, respectively.

Conclusions

The results of this study suggest a strong association between covid-19 vaccination before infection and reduced risk of receiving a diagnosis of PCC. The findings highlight the importance of primary vaccination against covid-19 to reduce the population burden of PCC.
Staff perceptions towards virtual reality-motivated treadmill exercise for care home residents: a qualitative feedback study with key stakeholders and follow-up interview with technology developer
Authors: Bradwell Hannah Louise , Cooper Leonie , Edwards Katie Jane , Baxter Rory , Tomaz Simone A , Ritchie John , Gaudl Swen , Veliz-Reyes Alejandro , Ryde Gemma C , Križaj Tanja , Warren Alison , Chatterjee Arunangsu , Willis Katharine , Haynes Richard , Hennessy Catherine H , Whittaker Anna C , Asthana Sheena , Jones Ray B
Published: November 2023

Objectives

Health and care resources are under increasing pressure, partly due to the ageing population. Physical activity supports healthy ageing, but motivating exercise is challenging. We aimed to explore staff perceptions towards a virtual reality (VR) omnidirectional treadmill (MOTUS), aimed at increasing physical activity for older adult care home residents.

Design

Interactive workshops and qualitative evaluation.

Settings

Eight interactive workshops were held at six care homes and two university sites across Cornwall, England, from September to November 2021.

Participants

Forty-four staff participated, including care home, supported living, clinical care and compliance managers, carers, activity coordinators, occupational therapists and physiotherapists.

Interventions

Participants tried the VR treadmill system, followed by focus groups exploring device design, potential usefulness or barriers for care home residents. Focus groups were audio-recorded, transcribed verbatim and thematically analysed. We subsequently conducted a follow-up interview with the technology developer (September 2022) to explore the feedback impact.

Results

The analysis produced seven key themes: anticipated benefits, acceptability, concerns of use, concerns of negative effects, suitability/unsuitability, improvements and current design. Participants were generally positive towards VR to motivate care home residents’ physical activity and noted several potential benefits (increased exercise, stimulation, social interaction and rehabilitation). Despite the reported potential, staff had safety concerns for frail older residents due to their standing position. Participants suggested design improvements to enhance safety, usability and accessibility. Feedback to the designers resulted in the development of a new seated VR treadmill to address concerns about falls while maintaining motivation to exercise. The follow-up developer interview identified significant value in academia–industry collaboration.

Conclusion

The use of VR-motivated exercise holds the potential to increase exercise, encourage reminiscence and promote meaningful activity for care home residents. Staff concerns resulted in a redesigned seated treadmill for those too frail to use the standing version. This novel study demonstrates the importance of stakeholder feedback in product design.
Prognostic significance of platelet-to-lymphocyte ratio (PLR) in patients with breast cancer treated with neoadjuvant chemotherapy: a meta-analysis
Authors: Qi Xue , Chen Jia , Wei Sheng , Ni Jingyi , Song Li , Jin Conghui , Yang Lei , Zhang Xunlei
Published: November 2023

Objective

Platelet-to-lymphocyte ratio (PLR), known as a key systemic inflammatory parameter, has been proved to be associated with response to neoadjuvant therapy in breast cancer (BC); however, the results remain controversial. This meta-analysis was carried out to evaluate the prognostic values of PLR in patients with BC treated with neoadjuvant chemotherapy (NACT).

Design

Meta-analysis.

Data sources

Relevant literature published on the following databases: PubMed, Embase, Web of Science databases and the Cochrane Library.

Eligibility criteria

All studies involving patients with BC treated with NACT and peripheral blood pretreatment PLR recorded were included.

Data extraction and synthesis

Two researchers independently extracted and evaluated HR/OR and its 95% CI of survival outcomes, pathological complete response (pCR) rate and clinicopathological parameters.

Results

The last search was updated to 31 December 2022. A total of 22 studies with 5533 patients with BC treated with NACT were enrolled in the final meta-analysis. Our results demonstrate that elevated PLR value appears to correlate with low pCR rate (HR 0.77, 95% CI 0.67 to 0.88, p<0.001, I2=75.80%, Ph<0.001) and poor prognosis, including overall survival (OS) (HR 1.90, 95% CI 1.39 to 2.59, p<0.001; I2=7.40%, Ph=0.365) and disease-free survival (HR 1.97, 95% CI 1.56 to 2.50, p<0.001; I2=0.0%, Ph=0.460). Furthermore, PLR level was associated with age (OR 0.86, 95% CI 0.79 to 0.93, p<0.001, I2=40.60%, Ph=0.096), menopausal status (OR 0.83, 95% CI 0.76 to 0.90, p<0.001, I2=50.80%, Ph=0.087) and T stage (OR 1.05, 95% CI 1.00 to 1.11, p=0.035; I2=70.30%, Ph=0.005) of patients with BC.

Conclusions

This meta-analysis demonstrated that high PLR was significantly related to the low pCR rate, poor OS and disease-free survival (DFS) of patients with BC treated with NACT. Therefore, PLR can be used as a potential predictor biomarker for the efficacy of NACT in BC.
Factors associated with continuation of hormonal contraceptives among married women of reproductive age in Gilgit, Pakistan: a community-based case–control study
Authors: Bibi Fazila , Saleem Sarah , Tikmani Shiyam S , Rozi Shafquat
Published: November 2023

Objective

This study aimed to determine the factors associated with continuation of hormonal contraceptive methods among married women of Gilgit, Pakistan at least 6 months after their initiation.

Design

Unmatched case–control study.

Setting

Community settings of Gilgit, Pakistan from 1 April 2021 to 30 July 2021.

Participants

The cases were married women of reproductive age who, at the time of interview, were using a hormonal method of contraception for at least 6 months continuously, and controls were married women of reproductive age who had used a hormonal method in the past and currently were using a non-hormonal method for at least 6 months.

Primary and secondary outcome measures

OR for continuation of hormonal contraceptive.

Results

The factors significantly associated with continuous use of hormonal contraceptive methods for our sample from Gilgit were the family planning centre’s distance from home (adjusted OR (AOR) 6.33, 95% CI 3.74 to 10.71), satisfaction with current method used (AOR 3.64, 95% CI 2.06 to 6.44), visits to the family planning centre to avail services (AOR 1.86, 95% CI 1.07 to 3.45) and relatively older age of women (AOR 1.07, 95% CI 1.02 to 1.12). In addition, women with formal education (AOR 0.27, 95% CI 0.12 to 0.6) were less likely to use a modern contraceptive method.

Conclusion

Continuation of using a hormonal method was associated with easy access to family planning centres, satisfaction with the current method and frequent visits to the family planning centres. Continuation of using a hormonal method was also seen in women with low education status. The importance of the presence of family planning centres near residential areas cannot be emphasised more. This does not only provide easy access to family planning methods, but also reassure women of continuation of modern methods when they face any unpleasant effects while using these.
Do community-based singing interventions have an impact on people living with dementia and their carers? A mixed-methods study protocol
Authors: Polden Megan , Hanna Kerry , Ward Kym , Ahmed Faraz , Brown Heather , Holland Carol , Barrow Hazel , Main Jeanette , Mann Stella , Pendrill Steve , Giebel Clarissa
Published: November 2023

Introduction

Psychosocial interventions have been shown to improve mood, relieve stress and improve quality of life for people living with dementia (PwD). To date, most evaluations of singing interventions have focused on the benefits for PwD and not their carers. This research aims to evaluate the benefits of dementia singing groups for both PwD and their carers.

Methods and analysis

This 2-year project will observe the impact of two different singing intervention services, one combining singing alongside dance and another that includes a sociable lunch. This project will aim to recruit a total of n=150 PwD and n=150 carers across the two singing interventions. Using a mixed-methods approach, the influence of both services will be analysed via the following outcome measures: quality of life, neuropsychiatric symptoms, social isolation, loneliness, cognition, carer burden and depressive symptoms in PwD and their carers using a prestudy/poststudy design. Regression models will be used to analyse the data with time (pre/post) as the exposure variable. Semistructured interviews will be conducted with a subset of people (n=40) to further investigate the impact of singing services with a specific focus on the acceptability of the interventions, barriers to access and prolonged engagement and potential for remote delivery. Interview data will be analysed using Braun and Clarke’s reflexive thematic analysis, and public advisers will assist with coding the transcripts. A social return on investment analysis will be conducted to determine the social impact of the services.

Ethics and dissemination

This project has received ethical approval from the University of Liverpool’s Ethics Committee (App ref: 12374) and Lancaster University’s Ethics Committee (App ref: 3442). All participants will provide informed consent to participate. Results will be presented at national and international conferences, published in scientific journals and publicly disseminated to key stakeholders.
Attitude towards medication deprescribing among older patients attending the geriatric centre: a cross-sectional survey in Southwest Nigeria
Authors: Akande-Sholabi Wuraola , Ajilore Comfort Oluwatobi , Adebusoye Lawrence A , Fakeye Titilayo O
Published: November 2023

Objectives

This study set out to assess older people’s perception of their medications, attitude towards medication use and their willingness to have medications deprescribed in a geriatric centre in Southwestern Nigeria.

Design and setting

A cross-sectional study was conducted at the Chief Tony Anenih Geriatric Centre, University of Ibadan, using an interviewer-administered questionnaire. The questionnaire used was a revised version of the Patient’s Attitude Towards Deprescribing Questionnaire. Descriptive statistics, and multivariate and bivariate analyses were performed using SPSS V.23. Statistical significance was set at p<0.05.

Participants

415 older patients aged ≥60 years who attended the geriatric centre in University College Hospital Ibadan between April and July 2022.

Main outcome measure

The primary outcome was the willingness of the older person to deprescribe if recommended by the physician.

Results

The mean age of the participants was 69.6±6.4 years, and 252 (60.7%) were female. Overall, the willingness and positive attitude to medication deprescribing among respondents were 60.5% and 89.7%, respectively. Factors significantly associated with willingness to deprescribe were financial self-support (p=0.021), having no previous hospital admission (p=0.009), better-perceived quality of health relative to peers (p<0.0001), polypharmacy (p=0.003), and the domains burden of medication (p=0.007), medication appropriateness (p<0.0001), concerns about stopping medications (p<0.0001) and involvement with medications (p<0.0001). The predictive factors for improved willingness to deprescribe were direct involvement with medications (OR=2.463; 95% CI 1.501 to 4.043, p<0.0001), medication appropriateness (OR=0.462; 95% CI 0.254 to 0.838, p=0.011) and concerns about stopping medications (OR=2.031; 95% CI 1.191 to 3.463, p=0.009).

Conclusion

Participants demonstrated greater willingness to deprescribe if the physicians recommended it. Predictive factors that may influence willingness to deprescribe were direct involvement with medications, appropriateness of medication and concerns about stopping medications.