bluuebunny/crossref_metadata_2025 huggingface dataset:
Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance
Authors: Bretherton Christopher Patrick , Hirst Robert , Gacaferi Hamez , Gower Jonathan , Exell Lauren , Johnston Scott , Martin Shan , Leech Caroline , Hilton Catherine , Battle Ceri , Axelrod Daniel , Vallier Heather , Van Embden Daphne , Stockton David J , Cole Elaine , Williams Julia , Johnson Louise , Laubscher Maritz , Webb Melissa , Braude Philip , Norris Sarah , Bell Steve , Maqungo Sithombo , Griffin Xavier Luke
Published: May 2024

Objective

The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals.

Design/setting

An international research priority-setting partnership.

Participants

People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb.

Methods

A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021–October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second international survey asked respondents to prioritise the research questions. A final shortlist of 19 questions was taken to a stakeholder workshop, where consensus was reached on the top 10 priorities.

Results

A total of 1572 uncertainties, submitted by 417 respondents (including 132 patients and carers), were received during the initial survey. These were refined into 53 unique indicative questions, of which all 53 were judged to be true uncertainties after reviewing the existing evidence. 373 people (including 115 patients and carers) responded to the interim prioritisation survey and 19 questions were taken to a final consensus workshop between patients, carers and healthcare professionals. At the final workshop, a consensus was reached for the ranking of the top 10 questions.

Conclusions

The top 10 research priorities for major trauma include patient-centred questions regarding pain relief and prehospital management, multidisciplinary working, novel technologies, rehabilitation and holistic support. These shared priorities will now be used to guide funders and teams wishing to research major trauma around the globe.
Patterns and clinical outcomes of childhood poisoning presenting to a children’s emergency department in Yenagoa, Nigeria: a 10-year retrospective study
Authors: Areprekumor Tare-Ebi , Joboy-Okei Evi , Amadin Nathan Osamwentin , Kalu Shedrach Uka
Published: May 2024

Introduction

Background: Childhood poisoning, characterised by exposure to toxic substances, poses a global health concern with variations across regions. Despite the importance of having current information about childhood acute poisoning in our region, there is a noticeable gap in such research in our local context. Regularly reviewing the agents responsible for poisoning in our locale is essential for devising prevention strategies and treatment approaches. This study aimed to examine the patterns and outcomes of childhood poisoning at the Children’s Emergency Department of the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.

Methods

A retrospective cross-sectional study was conducted, analysing cases of childhood poisoning in the Children’s Emergency Ward, presenting from January 2013 to December 2022. Sociodemographic data, types of poisoning agents, home interventions, clinical features and outcomes were extracted from medical records.

Results

Of 9389 admissions, 81 (0.8%) cases were admitted for childhood poisoning, but only 69 cases were analysed (total n=69). Children aged under 5 years (52.2%) and who were males (59.4%) were mostly involved. Organophosphates (21.7%) and kerosene (20.3%) were common poisoning agents, often accidental (72.5%) and occurring at home (94.2%). Delayed hospital presentation (>2 hours) was common (68.1%). Vomiting (72.5%) and drooling saliva (56.5%) were prevalent symptoms. Hydration (60.9%) was the main hospital intervention, while antidotes were infrequently used (15.9%). Mortality was 8.7%, predominantly due to kerosene ingestion in young children.

Conclusion

Organophosphate and kerosene poisoning are the most common in this facility. Enforcement challenges persist, emphasising the importance of safe storage practices and improved poison control measures. Addressing resource constraints for antidote availability and increasing awareness are vital for effective management and prevention.
When to reinvite initially ineligible populations for targeted lung cancer screening?
Authors: Goodley Patrick , Crosbie Philip A J , Sperrin Matthew , Merchant Zoe , Booton Richard , Balata Haval
Published: May 2024

Introduction

Targeted low-dose CT lung cancer screening reduces lung cancer mortality. England’s Targeted Lung Health Check programme uses risk prediction tools to determine eligibility for biennial screening among people with a smoking history aged 55–74. Some participants initially ineligible for lung cancer screening will later become eligible with increasing age and ongoing tobacco exposure. It is, therefore, important to understand how many people could qualify for reinvitation, and after how long, to inform implementation of services.

Methods

We prospectively predicted future risk (using Prostate, Lung, Colorectal and Ovarian trial’s risk model (PLCOm2012) and Liverpool Lung Project version 2 (LLPv2) risk models) and time-to-eligibility of 5345 participants to estimate how many would become eligible through the course of a Lung Health Check screening programme for 55–74 years.

Results

Approximately a quarter eventually become eligible, with those with the lowest baseline risks unlikely to ever become eligible. Time-to-eligibility is shorter for participants with higher baseline risk, increasing age and ongoing smoking status. At a PLCOm2012threshold ≥1.51%, 68% of those who continue to smoke become eligible compared with 18% of those who have quit.

Discussion

Predicting which participants may become eligible, and when, during a screening programme can help inform reinvitation strategies and service planning. Those with risk scores closer to the eligibility threshold, particularly people who continue to smoke, will reach eligibility in subsequent rounds while those at the lowest risk may be discharged from the programme from the outset.
1 Supporting family carers in best interest decision-making in dementia care at the end of life: findings from a cluster randomised control trial
Authors: Brazil Kevin , Carter Gillian , Cardwell Chris , Clarke Mike , Hudson Peter , Froggatt Katherine , McLaughlin Dorry , Passmore Peter , Kernohan W George
Published: May 2024

Background

Dementia is a leading cause of death worldwide. Often, people with moderate to advanced dementia are admitted to nursing homes for specialist care. When a person with dementia no longer has the capacity to make decisions about their care, nursing home staff, in combination with family members, may have to make decisions based on a person’s best interests. Family carers often report feeling unprepared to participate in these decisions. Advance Care Planning (ACP) can support family carers in best interest decision-making on goals of care at the end of life. However, given its relative importance, the prevalence of ACP in dementia care is poor. This study set out to examine the effectiveness of an intervention designed to facilitate ACP with family carers.

Methods

A paired cluster randomised controlled trial was employed. The intervention comprised: a trained facilitator; family education; family meetings; documentation of ACP decisions; and intervention orientation for GPs and nursing home staff. Twenty-four nursing homes with a dementia nursing category located in Northern Ireland, UK participated. Family carers of nursing home residents classified as having dementia and judged as not having decisional capacity to participate in ACP discussions were invited to take part. Participants completed postal questionnaires prior to receiving the intervention or usual care and again, six weeks later.

Results

12 nursing homes were allocated to each group, 11 from intervention and 12 from usual care were analysed. The primary outcome was family carer uncertainty in decision-making about the care of the resident as measured by the Decisional Conflict Scale (DCS). There was evidence of a reduction in total DCS score in the intervention group compared with the usual care group (−10.5, 95% confidence interval −16.4 to −4.7; p<0.001).

Conclusions

The ACP was effective in reducing family carer uncertainty in decision-making concerning the care of their family member and improving perceptions of quality of care in nursing homes. Implications for clinicians and policy makers include the need to recognise the importance of family carer education and improving communication between family carers and formal care providers.
21 Exploring the effectiveness of a mindfulness-based intervention for staff in a palliative care setting
Authors: Hill Rebecca C , Graham-Wisener Lisa , Finucane Anne , Kavanagh Michele , McCorry Noleen K , Donnelly Michael , Dempster Martin
Published: May 2024

Introduction

Palliative care staff engage in emotional and stressful work; however, research is yet to offer any insights as to what types of psychosocial intervention can effectively improve staff psychological well-being (Hill, Dempster, Donnelly, & McCorry, 2016).

Aims

This research aims to evaluate the effectiveness of a Mindfulness-Based Intervention (MBI), which was condensed to make it more feasible for staff to attend, to improve the psychological well-being of palliative care staff.

Methods

The effectiveness of the intervention was evaluated quantitatively, using four psychological measures taken at baseline, post-intervention, and at follow-up with the intervention group; these measures were also taken at the same three time-points with a comparison group for comparison purposes.

Qualitative data was collected through interviews with intervention participants and then thematic analysis was used to garner information on the feasibility, acceptability, and effectiveness of the intervention.

Results

Participants in the intervention group had significant improvements in resilience (P =<0.001), self-compassion (p=0.003), and mindfulness (p=0.019), whereas the comparison group had no significant improvements on these outcomes.

Initial qualitative findings indicate staff found the mindfulness course a positive experience with some describing a big impact on their personal and/or working life and others describing that they’d taken something away - usually a preferred meditation that they could use a self-care tool but also a more balanced perspective on their thinking.

Conclusion

This research suggests a condensed MBI can effectively improve staff psychological well-being; furthermore, findings can inform future development of MBIs for this setting.

References

. Hill RC, Dempster M, Donnelly M, McCorry NK. Improving the wellbeing of staff who work in palliative care settings: A systematic review of psychosocial interventions. Palliative Medicine2016;30(9):825–833.

. Neff KD, The development and validation of a scale to measure self-compassion. Self and identity2003;2(3):223–250.
22 Barriers and facilitators to implementing the carer support needs assessment toolin a community palliative care setting
Authors: Horseman Zoe , Milton Libby , Finucane Anne
Published: May 2024

Introduction

Family carers play a central role in community-based palliative care. However, caring for a terminally ill person puts the carer at increased risk of physical and mental morbidity, which is detrimental for both carer and patient (Williams & McCorkle, 2011). The validated Carer Support Needs Assessment Tool (CSNAT) provides a comprehensive measure of carer support needs and is intended for use in community palliative care (Ewing & Grande, 2013). The CSNAT creates an opportunity for carers to discuss their needs with healthcare professionals, facilitating the provision of appropriate support. A recent audit demonstrated poor use of the CSNAT in a Scottish community specialist palliative care service despite training and support.

Aim

To identify barriers and facilitators to implementation of the CSNAT in a community specialist palliative care service.

Methods

A qualitative study was undertaken, involving interviews with 12 palliative care nurse specialists from two community nursing teams in Lothian, Scotland. Data was audio-recorded, transcribed and thematically analysed using a framework approach.

Results

Data analysis is in progress. The results will identify factors which enable and prevent the use of the CSNAT in a community palliative care setting. Recommendations for improving the acceptability of the CSNAT will be developed.

Conclusion

Findings from this study have the potential to enhance engagement with the CSNAT, make it more congruent with current nursing practice, and improve the experience of carers of people approaching the end-of-life.

References

. Ewing G, Brundle C, Payne S, Grande G. The carer support needs assessment tool (CSNAT) for use in palliative care and end of life care at home: A validation study. Journal of Pain and Symptom Management 2013;46(2013):395–405.

. Williams A, Mccorkle R. Cancer family caregivers during the palliative, hospice and bereavement phases: a review of the descriptive psychological literature.Palliative and supportive care2011;9:315–325.
27 Palliative care day services operate through therapeutic relationships
Authors: Kernohan George , Brazil Kevin , Coast Jo , Finucane Anne , Graham-Wisener Lisa , Hasson Felicity , Jones Louise , Jordan Joanne , McCorry Noleen , McIlfatrick Sonja
Published: May 2024

Introduction

Marie Curie Palliative Care Day Services have been developed to support people with life-limiting illness who live in their own home. Patients attend on a regular basis, typically receiving a mix of clinical and social care. Despite their popularity and general satisfaction (Kernohan et al, 2006), there is ambiguity concerning the content.

Aim

To provide in-depth knowledge of day services by mapping services at three Marie Curie Hospice sites.

Methods

We: reviewed the records of a 25% random stratified sample of new patients attending in 2015, providing evidence on the content of care; undertook focus groups with staff, focusing on their knowledge and experience of providing Day Services.

Results

The three services are characterised by:

• wide-ranging care that spans physical, psychological, emotional and social domains;

• care for both patients and their informal carers;

• the development of patient-patient and patient-professional therapeutic relationships

• extremely proactive care, based on regular assessment and follow-up;

• being able to respond to a majority of identified needs ‘in-house’;

• where such response in unavailable, ensuring onward referral and follow-up;

• extensive liaison with other health and social care providers.

Conclusion

Findings contribute to the limited evidence base on the organisation and content of day services. They highlight how these services are firmly rooted in, but extend beyond, their immediate context to promote holistic, patient-centred care. This care is premised on meaningful therapeutic relationships, which form between patients themselves and between patients and day services staff.

Reference

. Kernohan WG, Hasson F, Hutchinson P, Cochrane B. Patient satisfaction with hospice day care. Support Care Cancer2006;14(5):462–8.
30 Development of quality indicators for UK palliative day services (QUALPALUK)
Authors: McCorry Noleen K , Dempster Martin , O’Connor Sean , Armour Kathy , Coast Joanna , Donnelly Michael , Finucane Anne , Fyvie Joan , Jones Louise , Kernohan George , Leemans Kathleen , Perkins Paul
Published: May 2024

Introduction

Quality indicators are explicitly defined and measurable items that evaluate and describe healthcare (Campbell, 2002). They can provide care users, staff, providers, and purchasers with feedback in relation to the quality of care, sometimes against benchmarks or previous quality assessments. In addition, by providing a valid and reliable means of measuring quality of care, quality indicators (although not sufficient by themselves) can act as a starting point for quality improvement. There are currently no quality indicators designed to assess the quality of palliative day services (PDS).

Aim

To develop a set of quality indicators to appraise the care provided by PDS in the UK.

Methods

The RAND/UCLA appropriateness method was utilised. This multi-stage method combines best available evidence alongside expert consensus. The resultant draft set of indicators was tested for feasibility in 5 UK hospices. A parallel strategy of stakeholder engagement was implemented throughout the research lifecycle.

Results

The initial list of 185 candidate indicators identified by a systematic review was reduced to a final list of 30 core indicators, which were found to be appropriate and feasible.

Conclusions

This quality indicator set is the first to be produced for PDS, and is available for use by services. It represents a valuable, acceptable and feasible means to assess quality of care in PDS, and a means of identifying goals for quality improvement. Successful implementation of quality indicators in routine practice requires attention to a range of key enablers and barriers.

Reference

. Campbell, S M. (2002) ‘Research Methods Used In Developing And Applying Quality Indicators In Primary Care’.Quality and Safety in Health Care,11(4), pp. 358–364
43 A systematic review and critical discourse analysis (CDA) of the reporting of do not attempt cardiopulmonary resuscitation (DNACPR) decisions in UK national broadsheet and tabloid newspapers
Authors: Gray Alice E , Sleeman Katherine E , Bristowe Katherine
Published: May 2024

Introduction

The Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision is a routine aspect of medical care, but there can be misunderstandings among patients and the public relating to these decisions. The aim of this study was to identify how DNACPR decisions are portrayed in print media, and understand how this contributes to public opinion.

Methods

A systematic review using three databases (Newsbank’s Access World News, ‘Factiva’ database and ‘Daily Mail Historical Archive’) was conducted, for articles published between January 2000 and September 2016. A Critical Discourse Analysis was carried out at three levels: textual (micro); discursive practice (meso); sociocultural practice (macro).

Results

116 articles were identified, comprising a corpus of 68082 words. Textual analysis demonstrated two opposing portrayals: the vulnerable patient requiring life saving through CPR, and the medical body failing in their duty to keep the patient alive. Analysis of discursive practice found the power of truth-telling lay with patients and families who associated DNACPR with poor-quality care and concealment suspicions. Sociocultural analysis found DNACPR decisions were incorporated into wider end of life care criticisms.

Conclusions

This study demonstrates an overwhelmingly negative and inaccurate portrayal of DNACPR within print media, contributing to the public’s mistrust of professionals and their decision-making power. A DNACPR decision awareness campaign to communicate realities about DNACPR decisions more effectively with the public is urgently needed. Access to accurate information will improve understanding between the public and clinicians.
60 Can the ‘surprise question‘ be used to correctly identify people nearing the end of life?: a review
Authors: Vickerstaff Victoria , White Nicola , Kupeli Nuriye , Stone Patrick
Published: May 2024

Introduction

It has been shown that clinicians are inaccurate at prognostication (White et al., 2016) and recognising dying patients (Neuberger et al., 2013). Patients who would benefit from palliative care may be missed because validated prognostic tools (Pirovano et al., 1999; Morita et al., 1999) are not routinely used, either due to the perceived complexity or inconvenience. The surprise question (SQ) (“Would you be surprised if this patient died within the next χ months?”) offers an alternative to standard prognostic estimates.

Aim

To evaluate the performance of the SQ in patients nearing the end of life.

Methods

We searched numerous databases, including: Medline, Embase, CINAHL, AMED. Studies were included if they reported the SQ and were written in English.

Results

Out of the 357 studies identified, 22 were included in the review. In these studies, 25 718 estimates were reported. The results showed a wide variation in the reported accuracy of the SQ, with sensitivity ranging from 11.6% to 96.6% and specificity ranging from 13.9% to 78.6%. The AUROC score across the studies ranged from 0.512 to 0.822. Doctors appeared to be more accurate than nurses at recognising people in the last year of life (c-statistic=0.735 vs. 0.688).

Conclusions

The performance of the SQ varied greatly across the studies. Further work is required to understand the processes by which clinicians arrive at their prognostic estimates, to refine the accuracy of the SQ and to compare its performance against other more sophisticated prognostic tools, particularly in populations where a higher proportions of deaths occur.

References

. Morita, T., Tsunoda, J., Inoue, S. and Chihara, S., 1999. The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients. Supportive Care in Cancer, 7(3), pp.128–133.

. Neuberger, J., Guthrie, C. and Aaronovitch, D., 2013. More care, less pathway: a review of the Liverpool Care Pathway.Department of Health.

. Pirovano, M., Maltoni, M., Nanni, O., Marinari, M., Indelli, M., Zaninetta, G., Petrella, V., Barni, S., Zecca, E., Scarpi, E. and Labianca, R., 1999. A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. Journal of pain and symptom management, 17(4), pp.231–239.

. White, N., Reid, F., Harris, A., Harries, P. and Stone, P., 2016. A systematic review of predictions of survival in palliative care: How accurate are clinicians and who are the experts?. PLoS One, 11(8), p.e0161407.
Modelling the dispersion of infectious salmon anemia virus from Atlantic salmon farms in the Quoddy Region of New Brunswick, Canada and Maine, USA
Authors: Ding Fuhong , Gagné Nellie , Ditlecadet Delphine , Quinn Brady K. , Trudel Marc
Published: May 2024

Pathogen dispersal from infected aquaculture sites into the surrounding ocean poses risks of infection to wild and farmed species, but is difficult to predict. This study aimed to build a framework using an ocean circulation and a particle tracking model in conjunction with a dynamic infection model and a virus inactivation model to simulate the dispersal of the infectious salmon anemia virus (ISAV) from Atlantic salmon farms. Simulated particles were released from hypothetically infected farms and advected by modelled currents. Inactivation of viral cohorts by ambient ultraviolet radiation and natural microbial communities was simulated during advection. Simulations showed that ISAV concentration varied spatiotemporally with the progression of the outbreak, current speed and direction, tidal elevation amplitude, and environmental decay. Connectivity among aquaculture sites varied in relation to seaway distances, though simulations showed that connectivity can also be asymmetrical between farm sites. Sensitivity analyses showed that the dispersal of ISAV was moderately sensitive to uncertainty associated with the viral decay model, highlighting the importance of obtaining accurate estimates of inactivation rates of ISAV. This framework provides an approach to simulate waterborne viral transmission that considers the biology and epidemic features of significance for pathogens and the dynamic conditions of the ocean.
Spherically symmetric anisotropic charged neutron stars in f(Q, T) gravity
Authors: Das Krishna Pada , Debnath Ujjal
Published: May 2024

In this work, we have investigated a new solution for charged anisotropic compact stellar system in the framework of an extended theory of symmetric teleparallel gravity known as f(Q, T) gravity with the non-metricity term Q and the trace T for energy–momentum tensor. We have constructed a complete set of the gravitational field equations for a non-linear function $$f(Q,T)=\alpha Q + \beta (1+Q^{2}) + \lambda T$$

f

(
Q
,
T
)

=
α
Q
+
β

(
1
+

Q
2

)

+
λ
T

with $$\alpha , \beta $$

α
,
β

and $$\lambda $$
λ
are dimensionless constant parameters in case of static spherically symmetric space-time. To evaluate the expression of relevant unknown constants interior space-time has been matched with exterior Reissner–Nordstr$$\ddot{\textrm{o}}$$

o
¨

m metric. We have performed a graphical discussion in detail to test the behavior of physical parameters in the interior region of a stellar system like energy density, radial and tangential pressure, anisotropies of matter portion, electric field intensity etc. Also, to check the physical validity of our solutions, we have performed various tests viz., energy conditions, stability, mass–radius relation, surface redshift etc. The hydrostatic equilibrium position of our stellar system has been analysed through the TOV equation. Finally, we have determined that our stellar structure solutions satisfy all required physical conditions for viability and acceptability in the context of some pulsar like neutron stars. So our model can be used to characterise the neutron stars in f(Q, T) modified gravity.
Higher-order nonlocal approach to classical and quantum mechanics through non-standard Lagrangians: The case of quantum wells and the quantum states of neutron in earth’s gravitational field
Authors: El-Nabulsi Rami Ahmad , Anukool Waranont
Published: May 2024

It is well-known that any dynamical system governed by a differential equation containing time derivatives higher than second order unavoidably holds unbounded energy solutions, dubbed ghosts that appear in the Hamiltonian. They correspond to instabilities displayed at the classical level. In this study, we show first that it is possible to construct in classical mechanics, characterized by non-standard Lagrangians and nonlocal-in-time kinetic energy, higher-order derivative theories that avoid the Ostrogradsky ghost. Second, we show that in the realm of quantum mechanics, higher-order discretized energies emerge in the theory which may lead to extended quantum mechanics formalism. The problem of quantum wells has been treated where we showed that negative energy and negative action, complexified energies and complexified actions may emerge in our formalism. We have also discussed the quantum motion of a neutron in the Earth’s gravitational field. It was observed that within the realm of higher-order non-standard Lagrangians, the quantum energies of the neutrons are higher than the energy levels obtained in the basic formalism.
Controls on the genesis of a giant sand injection complex; insights into the Paleogene evolution of the stress of northern and central California
Authors: Vigorito M. , Grippa A. , Callow R. H. T.
Published: May 2024

Giant sand injection complexes and localized swarms of sandstone intrusions are common in Upper Cretaceous to Miocene sedimentary successions of central and northern California within a distance of less than 100 km from the Pacific margin of the North America plate. One of the best preserved and extensively exposed injection complexes is the late Eocene Tumey Giant Injection Complex. The emplacement of sand injectites was driven by overpressure generated by thermal diagenesis of biosiliceous and smectite-rich mudstone host-rocks. The orientation and size distribution of sandstone intrusions was controlled by stress in which

σ

1
and

σ

3
were horizontal and, respectively, parallel and perpendicular to the present trace of the San Andreas Fault, and

σ

2
was vertical. A strike-slip tectonic regime is inferred. Our analysis documents margin-orthogonal extension and provides support for a late Eocene phase of increase of strain, and possibly active slip, along a syn-subduction strike-slip fault zone. Comparison with other injection complexes in the region indicates that the near-field maximum principal stress rotated through time, from normal to parallel with respect to the plate margin, probably in relation to variations of the relative motion vector of the converging plates.
Coupling bit and modular arithmetic for efficient general-purpose fully homomorphic encryption
Authors: Chielle Eduardo , Mazonka Oleg , Gamil Homer , Maniatakos Michail
Published: May 2024

Fully Homomorphic Encryption (FHE) enables computation directly on encrypted data. This property is desirable for outsourced computation of sensitive data as it relies solely on the underlying security of the cryptosystem and not in access control policies. Even though FHE is still significantly slower than unencrypted computation, practical times are possible for applications easily representable as low-order polynomials, since most FHE schemes support modular addition and multiplication over ciphertexts. If, however, an application cannot be expressed with low-order polynomials, then Boolean logic must be emulated. This bit-level arithmetic enables any computation to be performed homomorphically. Nevertheless, as it runs on top of the natively supported modular arithmetic, it has poor performance, which hinders its use in the majority of scenarios. In this work, we propose Bridging, a technique that allows conversion from bit-level to modular arithmetic and vice-versa. This enables the use of the comprehensive computation provided by bit-level arithmetic and the performance of modular arithmetic within the same application. Experimental results show that Bridging can lead to 1-2 orders of magnitude performance improvement for tested benchmarks and two real-world applications: URL denylisting and genotype imputation. Bridging performance comes from two factors: reduced number of operations and smaller multiplicative depth.
Complexity Column
Authors: Bulatov Andrei
Published: May 2024

Descriptive complexity theory initiated by celebrated Fagin's theorem aims to characterize complexity classes by the kind of logic necessary to express problems in the class. For many complexity classes such a characterization has been found; this includes the class NP that, according to Fagin's theorem, can be characterized by the monadic second order logic. Some classes, however, eludes such a characterization, and this famously includes the class P. Due to the importance of the class P, finding a logic for P is one of the central open problems in descriptive complexity.
Security and Privacy Column
Authors: Kremer Steve
Published: May 2024

Cryptographic protocols are really hard to design: they mix difficulties stemming from distributed systems, rely on cryptographic primitives and need to provide complex guarantees in the presence of an arbitrary attacker running in parallel. Rigorous security proofs are basically the only hope to avoid design flaws as witnessed by numerous examples. This has been recognized since the early 80's and two main approaches have been actively developed since. The
computational model
is rooted in complexity theory and relies on a reduction of the security of the protocol to a security assumption of a cryptographic primitive which itself may rely on the hardness of a computational problem. Attackers are any probabilistic polynomial time Turing Machines (PPTMs). A security proof in this model provides strong guarantees. However, getting proofs in such a detailed model correct is challenging. The
symbolic model
takes a different approach: messages are modeled as first-order logic terms and cryptographic primitives such as encryption schemes are idealized. Typically, only the intended functionality of an encryption is modeled by an equation such as dec(enc(m,k),k) = m to state that decryption and encryption cancel out when the same key k is used. Crucially, only the properties that are explicitly stated hold and the adversary actions are restricted to those. At the cost of being more abstract this approach is amenable to automation and tools nowadays succeed in proving industrial protocols, such as TLS or Signal.
Nuciferine Promotes Longevity and Fitness in Caenorhabditis elegans through the Regulation of the Insulin/IGF-1 Signaling Pathway
Authors: Xu Yan , Miao Yuanxin , Li Rong
Published: May 2024

Nuciferine, as one of the most abundant plant-derived alkaloids, has multiple bioactivities including anti-inflammatory, antitumor, and lipid-lowering effects. Nevertheless, the antiaging effects and related mechanisms of nuciferine are rarely reported. In this study, we found that nuciferine significantly prolonged the mean lifespan of Caenorhabditis elegans (C. elegans) by 14.86% at a dose of 100 μM. Moreover, nuciferine promoted the health of C. elegans by increasing the body bending and pharyngeal pumping rates and reducing the lipofuscin accumulation level. Meanwhile, nuciferine enhanced stress tolerance by inducing the expression of stress-related genes or proteins. The molecular mechanism behind the antiaging effect of nuciferine occurred by downregulating the insulin/IGF-1 signaling (IIS) pathway. Our findings shed new light on the application of nuciferine for longevity promotion and human health.
Fermented Polyherbal Formulation Ameliorates the Severity of Acute Multiple Antibiotics-Resistant Pseudomonas aeruginosa-Infected Burn Wound in a Rat Burn Model
Authors: Chakraborty Subhanil , Sen Subhajit , Das Arghya , Chakraborty Ranadhir
Published: May 2024

Pseudomonas aeruginosa, a Gram-negative opportunistic bacterium, has emerged as a cause of life-threatening infections in burn wounds. Current therapeutic approaches through wound dressings and systemic medicines are far from satisfactory; resistance to more than two antibiotics shown by pathogens contributes to failures of therapy causing mortality. This animal study was conducted to check the efficacy of one Ayurveda-based fermented polyherbal preparation (AP 01) against multiple antibiotics-resistant (MAR) P. aeruginosa HW01-infected rat burn wounds. AP-01 was applied on artificially infected burn wound on a rat model infected with MAR P. aeruginosa to register the healing effects in terms of reduction in residual wound area percentage, the presence of C-reactive protein in blood, and the presence of viable bacteria colony. Topical application with conventional antibiotics served as a positive control. The polyherbal preparation had reduced the infected residual burn wound area at 40.63% ± 0.69 from the initial burn wound area within two weeks after a single intervention, whereas residual burn wound area remained much higher in the case of animals left untreated and in the case of the animals treated with control drug. Restoration to the normalcy of serum C-reactive protein level was also achieved earlier in the case of polyherbal AP-01-treated groups than in other groups. Fermented formulations using components of AP-01 singly or in different combinations had never been tested earlier for topical application in infected burn wound. The formulation of AP-01 was found superior in terms of the rate of healing and control of infection by MAR P. aeruginosa strains in burn wounds in rat models.
Comportamiento Organizacional, Productividad, Cambio y Resistencia: Relación y Causalidades
Authors: Barrientos Oradini Nicolás
Published: May 2024

Aunque los administradores profesionales han comprendido durante mucho tiempo la importancia de las habilidades interpersonales en su desempeño laboral, las escuelas de negocios tardaron en reconocer este hecho. Hasta finales de los años 80, los programas académicos se enfocaban principalmente en aspectos técnicos como economía, contabilidad, finanzas y técnicas cuantitativas, relegando el estudio del comportamiento humano y las habilidades de comunicación a un segundo plano. (seguir leyendo...)
Table S4 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Tumor FKBP51s expression and MRI features.
Supplementary immunophenotyping from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

This supplementary contains row data of immunophenotyping
Supplementary Figure S14 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

Necrosis score and Immunophenotype of TME and peripheral blood. Graphical representation of flow cytometry data of TME (graphs on the left) and peripheral blood (graphs on the right) from primary tumors. Patient were divided into 3 groups, NS=0,1 (black histogram), NS=2 (blue histogram), NS=3 (red histogram). Significant results (one way ANOVA) are underlined in red.
FIGURE 2 from The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona
Published: May 2024

FKBP5 splicing in GBM tumors sustains STAT3 activation and is accompanied by systemic tolerogenic immune condition. A, Left, IB of GB138 cell transfected with Flag-FKBP51, Flag-FKBP51s or correspondent EV as control. The spliced FKBP51s, but not the canonical FKBP51, increased pSTAT3 levels (N = 3). Right, IB of GB138 cell transfected with siFKBP51s or a nonsilencing RNA (NS) as control. Compared with control (NS) cells, siFKBP51s treated cells showed impaired levels of pSTAT3 (N = 3). B, Immunoblot of pSTAT3 expression 4 GBMs, samples 2 and 4 show that pSTAT3 corresponded to FKBP51s expression. Linear regression of tumor-FKBP51s with TME-TAMs (C) and PB-TAMs (D). The Pearson correlation coefficient test calculated a positive correlation with the indicated TAMs (see Supplementary Table S2). E, IFNα levels in clusters 1 and 2. F and G, Linear regression of tumor-FKBP51s and IFNα or IL17A. H, Kaplan–Meier curves for OS rates, compared between FKBP51shigh and FKBP51slow patients. The two groups were divided according to the median value of tumor FKBP51s expression. EV = empty vector; IB = immunoblot.
Examining the Prevalence of Left Atrial Appendage Thrombus in a Cohort of Acute Stroke Patients with an Extended Computed Tomography Angiographic Protocol
Authors: Antal Szabolcs István , Szabó Nikoletta , Klucsai Róbert , Klivényi Péter , Kincses Zsigmond Támas
Published: May 2024

Introduction: Current guidelines recommend transthoracic echocardiography (TTE) for routine screening of cardiac emboli; however, the visualization of the left atrial appendage (LAA) where the thrombi are commonly found is poor. Transesophageal echocardiography (TEE) would provide better detectability of LAA thrombus, but it is a time-consuming and semi-invasive method. Extending non-gated carotid computed tomography angiography (CTA) examination to the LAA could reliably detect thrombi and could also aid treatment and secondary prevention of stroke. Methods: We extended the CTA scan range of acute stroke patients 4 cm below the carina to include the left atrium and appendage. During the review, we evaluated LAA thrombi based on contrast relations. We then used gradient boosting to identify the most important predictors of LAA thrombi from a variety of different clinical parameters. Results: We examined 240 acute stroke patients' extended CTA scans. We detected LAA thrombi in eleven cases (4.58%), eight of them had atrial fibrillation. 23.75% of all patients (57 cases) had recently discovered or previously known atrial fibrillation. Windsack morphology was the most commonly associated morphology with filling defects on CTA. According to the gradient-boosting analysis, LAA morphology showed the most predictive value for thrombi. Conclusion: Our extended CTA scans reliably detected LAA thrombi even in cases where TTE did not and showed that 2 patients’ LAA thrombus would have been untreated based on electrocardiogram monitoring and TTE. We also showed that the benefits of CTA outweigh the disadvantages arising from the slight amount of excess radiation.
Abstract 02: Contributions of Social Determinants of Health to Premature Cardiovascular Mortality in the US General Population
Authors: Kimbrough Alexander , Tian Ling , He Jiang , Mills Katherine T , Bundy Joshua D
Published: May 2024

Introduction:
Quantifying the contributions of 8 social determinants of health (SDOH) to US population-level premature cardiovascular disease (CVD) mortality will aid in developing and implementing strategies to reduce the burden of CVD mortality for diverse populations.

Hypothesis:
Levels of unfavorable SDOH are more common in Black and Hispanic adults in the US and contribute to a higher proportion of US population-level premature CVD mortality compared with White adults.

Methods:
We included 48170 participants aged 20-74 years from the National Health and Nutrition Examination Survey 1999-2018, linked to the National Death Index for cause-specific mortality follow-up through December 31, 2019. Premature CVD mortality was defined as death before age 75 with underlying ICD-10 codes for heart disease or stroke. SDOH included employment, family income-poverty ratio, food security, education, healthcare access, insurance status, home ownership, and marital status. We estimated average population attributable fractions to quantify the contribution of each SDOH to premature CVD mortality by self-reported race/ethnicity. Models controlled for age, sex, and survey year.

Results:
Combined SDOH accounted for >50% of US population-level premature CVD mortality among US adults (Figure). Among Black adults, SDOH accounted for 64.2% of premature CVD mortality, which was larger than that for Hispanic (58.4%) and White (55.0%) adults. Unemployment was generally the SDOH most strongly associated with premature CVD mortality, with PAFs (95% confidence intervals) ranging from 14.7% (7.3-22.0%) among White adults to 20.8% (7.7-33.9%) among Black adults. Low family income-poverty ratio contributed an additional 27.3% of premature CVD mortality in Black adults.

Conclusion:
SDOH account for >50% of premature CVD deaths in US adults but contributions differ by race/ethnicity. Interventions targeting SDOH may simultaneously reduce premature CVD mortality among all adults while addressing associated disparities.
Abstract 10: Trends in Blood Pressure Control With the Covid-19 Pandemic, 2017 to 2022: A Study of 17 US Health Systems in the PCORnet
®
Blood Pressure Control Laboratory
Authors: Chamberlain Alanna M , Cooper-Dehoff Rhonda M , Lin Feng , Fontil Valy , Shaw Kathryn M , Smith Myra , Carton Thomas , O'Brien Emily C , Faulkner Modrow Madelaine , Wozniak Gregory , Rakotz Michael , Smith Steven M , Pletcher Mark J
Published: May 2024

Background:
The COVID-19 pandemic resulted in reduced in-person clinic visits and declines in blood pressure (BP) control among patients with hypertension. The purpose of this study was to report on pre- to post-pandemic trends in BP control and related BP metrics through 2022.

Methods:
We utilized data from 17 US health systems with electronic health record data standardized to the PCORnet
®
Common Data Model. Multiple BP control metrics were calculated as a series of quarterly, 12-month rolling measurement periods from 2017 to 2022 (i.e., 1/1/2017-12/31/2017, 4/1/2017-3/31/2018, …, 1/1/2022-12/31/2022). BP control was defined as the percentage of patients with hypertension whose most recent BP measurement at an ambulatory visit was <140/<90 mmHg. Improvement in BP was defined as the percentage of patients with a reduction of 10 mmHg in systolic BP or achievement of systolic BP <140 mmHg during the last 3 months of the measurement period in patients with previously uncontrolled hypertension.

Results:
In 2022, 1,499,418 persons with hypertension were included (50% 65-85 years old; 47% men; 11% Hispanic, 3% non-Hispanic Asian, 20% non-Hispanic Black, 63% non-Hispanic White). BP control was relatively stable within health systems prior to the COVID-19 pandemic. Worsening of BP control was seen for most health systems in the second quarter of 2020 coinciding with onset of the COVID-19 pandemic (Figure, left panel). The weighted average BP control was 65.3% in 2019, dropped to 61.8% in 2020, and increased to 62.9% in 2021 and 62.6% in 2022. Similar patterns were observed for the improvement in BP metric (Figure, right panel): weighted average 31.4% in 2019, 25.7% in 2020, 29.1% in 2021 and 28.6% in 2022.

Conclusion:
BP control and improvement in BP decreased substantially during the COVID-19 pandemic. While both metrics improved after 2020, they were still below pre-pandemic levels through 2022. These findings underscore the importance of continued surveillance of BP control and other health impacts of the COVID-19 pandemic.