bluuebunny/crossref_metadata_2025 huggingface dataset:
Pacing Strategies in Elite Individual-Medley Swimmers: A Decision-Tree Approach
Authors: Yang Chin-Kuei , Hsu Yu-Chia , Chang Chen-Kang
Published: May 2024

Purpose: This study aimed to examine pacing strategies and identify the stroke that has the most significant impact on overall performance in men’s and women’s 200-m and 400-m individual-medley events from 2000 to 2021. Methods: The time in each lap and overall race was retrieved from the World Aquatics website. The standardized time for each stroke in individual medley was calculated by dividing the actual time by a reference time specific to each stroke. The reference time was derived from the respective laps in single-stroke finals in the 2017 World Swimming Championships. The decision-tree method was used for analysis. The dependent variables were qualified or nonqualified in heats and semifinals, and winning medals in finals. The independent variables were the ratio of standardized time in each stroke to the sum of standardized time in all 4 strokes. Results: Swimmers who spent a higher ratio of standardized time in the butterfly stroke (>0.236–0.245) are associated with a higher likelihood of winning medals or qualifying for the next stage in most men’s and women’s 200-m and 400-m individual medley. Butterfly exhibited the highest normalized importance that distinguished medalists from nonmedalists in the finals. The front-crawl stroke is the second most important determinant in medalists in men’s and women’s 200-m individual medley, whereas backstroke and breaststroke were the second most important in men’s and women’s 400-m individual medley, respectively. Conclusion: Individual-medley swimmers who were excellent in butterfly and conserved energy in butterfly had a higher likelihood of success.
Visual Performance and Sports: A Scoping Review
Authors: Lochhead Liam , Feng Jiren , Laby Daniel M. , Appelbaum Lawrence G.
Published: May 2024

Vision is central to success in nearly all sports, and there is an emerging body of research investigating the links between visual abilities and athletic performance. This preregistered scoping review seeks to clarify the topics of study, methodologies used, populations under investigation, researchers, and disciplines driving this field. Systematic searches of English-language articles were conducted in PubMed and Web of Science, with additional literature identified through bibliographic searches. Six hundred sixty-seven articles published between 1976 and 2023 were identified with 547 empirical studies, 58 review articles, 20 commentaries, and 4 meta-analyses, among others. Among the empirical papers, 411 reported on visual assessments and 98 on vision training interventions. The most represented sports included baseball, soccer, basketball, and cricket, with over 150 articles reporting on professional, elite, or Olympic athletes. This scoping review describes the breadth of this emerging field, identifies its strengths and weaknesses, and provides recommendations for future improvement.
Quantifying the impact of misinformation and vaccine-skeptical content on Facebook
Authors: Allen Jennifer , Watts Duncan J. , Rand David G.
Published: May 2024

Low uptake of the COVID-19 vaccine in the US has been widely attributed to social media misinformation. To evaluate this claim, we introduce a framework combining lab experiments (totalN= 18,725), crowdsourcing, and machine learning to estimate the causal effect of 13,206 vaccine-related URLs on the vaccination intentions of US Facebook users (N≈ 233 million). We estimate that the impact of unflagged content that nonetheless encouraged vaccine skepticism was 46-fold greater than that of misinformation flagged by fact-checkers. Although misinformation reduced predicted vaccination intentions significantly more than unflagged vaccine content when viewed, Facebook users’ exposure to flagged content was limited. In contrast, unflagged stories highlighting rare deaths after vaccination were among Facebook’s most-viewed stories. Our work emphasizes the need to scrutinize factually accurate but potentially misleading content in addition to outright falsehoods.
Winning researchers unlocked GLP-1 drugs for obesity
Authors: Phelan Meagan
Published: May 2024

Award recognizes individuals whose work best underpins the
Science
Breakthrough of the Year
Voyager 1 science resumes after interstellar crisis
Authors: Blinder Collin
Published: May 2024

Before a computer crash, venerable NASA probe entered mysterious new region of space
New insights into understanding obesity: from measures to mechanisms
Authors: Timpson Nicholas J , Wade Kaitlin H , Smith Madeleine L , Goudswaard Lucy J , Sattar Naveed , Pournaras Dimitri J , Corbin Laura J
Published: May 2024

Associations between obesity and health are unequivocal and coupled with a substantial body of evidence suggesting that associations are likely causal. These associations and the supporting causal evidence are useful, but hide both the inadequacies of the measures used to qualify obesity and the mechanisms that are responsible for the observable relationships. A challenge therefore remains to determine both the intermediate factors associated with obesity and the mechanisms responsible for connecting excess adiposity (the defining feature of obesity) and health. A growing collection of detailed measures including examples in genomics, proteomics, metabolomics, and the microbiome are now available, allowing a broad approach to characterising obesity and analysing the associations between excess adiposity and health—but to what extent do these associations also provide insight into mechanism? In this specialist review, the problems facing the analysis of obesity (and related measures) both as a disease and as a risk factor for many downstream health outcomes are explored. This review looks to shift focus away from mechanisms of obesity and towards a useful interpretation of mechanisms associated with obesity in the context of promising developments in causal epidemiology.
Disease burden and risk factors of children aged 0–14 years in China: a retrospective study on data from the Global Burden of Disease Study 2019
Authors: Chen Jingjing , Liu Dan , Zeng Linan , Jia Zhi-Jun , Cheng Guo , Xiao Xue , Zhang Lingli
Published: May 2024

Objectives

This study aimed to analyse the current status, trends and risk factors of disease burden from 1990 to 2019 among Chinese children.

Design and participants

It was a retrospective study on data from the Global Burden of Disease Study 2019 (GBD 2019). Data of disease burden and risk factors were extracted from the GBD 2019. Children were divided into two groups of <5 and 5–14 years. Data were analysed using GBD results query tool, Excel and Pareto analysis.

Primary outcome measures

Disability-Adjusted Life Years (DALYs) and deaths.

Results

The overall disease burden for both children <5 years and those aged 5–14 years significantly decreased from 1990 to 2019. For children aged <5 years, in 2019, the leading cause of deaths and DALYs were ‘neonatal disorders’, and the top risk factor was ‘low birth weight’. Compared with data of 1990, the ranking of causes of deaths and DALYs in 2019 saw the most significant increase for ‘HIV/AIDS and sexually transmitted infections’ and ‘skin and subcutaneous diseases’ respectively. Conversely, the ranking of deaths/DALYs causes that dropped most significantly was ‘nutritional deficiencies’. For children aged 5–14, in 2019, the leading deaths and DALYs causes were ‘unintentional injuries’ and ‘mental disorders’ respectively. The top risk factors were ‘alcohol use’ and ‘short gestation’, respectively. The ranking of deaths and DALYs causes rose most significantly were ‘HIV/AIDS and sexually transmitted infections’ and ‘neonatal disorders’, respectively. Conversely, the ranking of deaths causes that dropped most significantly were ‘other infectious diseases’, ‘enteric infections’ and ‘nutritional deficiencies’. For DALYs, the causes that dropped most significantly in ranking were ‘other infectious diseases’.

Conclusions

The disease burden of children has significantly changed from 1990 to 2019, with notable differences between children aged <5 and 5–14 years. To optimise the allocation of health resources, it is necessary to adjust management strategies based on the latest disease burden.
Effects of implementation of a care bundle on rates of necrotising enterocolitis and own mother’s milk feeding in the East Midlands: protocol for a mixed methods impact and process evaluation study
Authors: Abramson Janine , Szatkowski Lisa , Bains Manpreet , Orton Elizabeth , Budge Helen , Spruce Marie , Ojha Shalini
Published: May 2024

Introduction

Prevention of necrotising enterocolitis (NEC) is vital for improving neonatal outcomes. Feeding own mother’s milk helps prevent NEC. Rates of own mother’s milk feeding in the East Midlands are lower than the national average and the incidence of NEC is higher. The East Midlands Neonatal Operational Delivery Network (EMNODN) has created a care bundle to improve these in babies born at <32 weeks’ gestation, the group at the highest risk of NEC. The bundle was introduced in September 2022 and embedded by December 2022. We will evaluate its effectiveness and conduct a process evaluation to understand barriers and facilitators to implementation.

Methods and analysis

We will conduct a retrospective cohort study (workstream 1) using data from the National Neonatal Research Database (NNRD). We will identify infants receiving any own mother’s milk on day 14 and at discharge, and cases of severe NEC. We will aggregate outcomes by birth month and use interrupted time series analysis to estimate an incidence rate ratio for changes after the care bundle was embedded, relative to pre-implementation. We will model data from all other NNRD units and assess whether there are any concurrent changes to exclude confounding due to other events.

We will apply the RE-AIM framework (workstream 2), supplemented by the Consolidated Framework for Implementation Research and Framework for Implementation Fidelity, to conduct a mixed methods evaluation in EMNODN units. We will triangulate data from several sources, including questionnaires and semistructured interviews with parents and healthcare professionals, and data from patient records.

Ethics and dissemination

The study has approval from the South East Scotland Research Ethics Committee 01 and the Health Research Authority and Health and Care Research Wales (IRAS 323099). Results will be disseminated via scientific journals and conferences, to neonatal service commissioners and through public-facing infographics.

Trial registration number

NCT05934123.
Community-acquired pneumonia: use of clinical characteristics of acutely admitted patients for the development of a diagnostic model – a cross-sectional multicentre study
Authors: Cartuliares Mariana B , Mogensen Christian Backer , Rosenvinge Flemming S , Skovsted Thor Aage , Lorentzen Morten Hjarnø , Heltborg Anne , Hertz Mathias Amdi , Kaldan Frida , Specht Jens Juel , Skjøt-Arkil Helene
Published: May 2024

Objectives

This study aimed to describe the clinical characteristics of adults with suspected acute community-acquired pneumonia (CAP) on hospitalisation, evaluate their prediction performance for CAP and compare the performance of the model to the initial assessment of the physician.

Design

Cross-sectional, multicentre study.

Setting

The data originated from the INfectious DisEases in Emergency Departments study and were collected prospectively from patient interviews and medical records. The study included four Danish medical emergency departments (EDs) and was conducted between 1 March 2021 and 28 February 2022.

Participants

A total of 954 patients admitted with suspected infection were included in the study.

Primary and secondary outcome

The primary outcome was CAP diagnosis assessed by an expert panel.

Results

According to expert evaluation, CAP had a 28% prevalence. 13 diagnostic predictors were identified using least absolute shrinkage and selection operator regression to build the prediction model: dyspnoea, expectoration, cough, common cold, malaise, chest pain, respiratory rate (>20 breaths/min), oxygen saturation (<96%), abnormal chest auscultation, leucocytes (<3.5×109/L or >8.8×109/L) and neutrophils (>7.5×109/L). C reactive protein (<20 mg/L) and having no previous event of CAP contributed negatively to the final model. The predictors yielded good prediction performance for CAP with an area under the receiver-operator characteristic curve (AUC) of 0.85 (CI 0.77 to 0.92). However, the initial diagnosis made by the ED physician performed better, with an AUC of 0.86 (CI 84% to 89%).

Conclusion

Typical respiratory symptoms combined with abnormal vital signs and elevated infection biomarkers were predictors for CAP on admission to an ED. The clinical value of the prediction model is questionable in our setting as it does not outperform the clinician’s assessment. Further studies that add novel diagnostic tools and use imaging or serological markers are needed to improve a model that would help diagnose CAP in an ED setting more accurately.

Trial registration number

NCT04681963.
Evidence of community health workers’ delivery of physical rehabilitation services in sub-Saharan Africa: a scoping review
Authors: Mapulanga Miriam , Kgarosi Kabelo , Maluleke Kuhlula , Hlongwa Mbuzeleni , Dlungwane Thembelihle
Published: May 2024

Objectives

To map the evidence and scope of physical rehabilitation services delivered by community health workers (CHWs) in sub-Saharan Africa (SSA).

Design

Scoping review

Data sources

PubMed, Scopus, Cochrane Central and databases within the EBSCOhost platform. We also searched other literature sources including reference lists, conference presentations and organisational websites such as WHO, Ministries of Health and non-governmental organisations in SSA.

Eligibility criteria for selection of studies

Articles presenting evidence on CHWs’ delivery of physical rehabilitation services in SSA from September 1978 to June 2023.

Data extraction and synthesis

Screening was conducted by two reviewers and was guided by the inclusion criteria. Thematic content analysis of data was employed. The results are presented according to the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews.

Results

A total of 6996 articles were identified through various databases, with only 20 studies qualifying for data extraction. Evidence was presented by Eritrea, Ethiopia, Malawi, Mauritius, Namibia, South Africa and Uganda. Assessments, case management, health education, community liaison with support, health systems linkage and administration were the CHWs’ scope of practice identified. The review identified home-based, community-based, community and facility-based, home and community-based and facility-based as modes of delivery. The barriers experienced are resources, societal and community attitudes, governance, geographical barriers and delivery capacity, while proximity to the community, positive job attitude and support with collaboration facilitated service delivery.

Conclusion

Training and integrating CHWs in national health care systems, with careful selection of existing CHWs, would minimise the barriers faced.
Families in transition (FIT) study protocol: feasibility, acceptability and preliminary effects of a group-based parent training in parents of youth in psychiatric residential treatment
Authors: Herbell Kayla , Breitenstein Susan M , Tan Alai , Melnyk Bernadette Mazurek , Thai Anh Thu , Berger Sophie
Published: May 2024

Introduction

Although adolescents make treatment gains in psychiatric residential treatment (RT), they experience significant difficulty adapting to the community and often do not sustain treatment gains long term. Their parents are often not provided with the necessary support or behaviour management skillset to bridge the gap between RT and home. Parent training, a gold standard behaviour management strategy, may be beneficial for parents of these youth and web-based parent training programmes may engage this difficult-to-reach population. This study focuses on a hybrid parent training programme that combines Parenting Wisely (PW), a web-based parent training with facilitated discussion groups (Parenting Wisely for Residential Treatment (PWRT)). This study aims to: (1) establish the feasibility and acceptability of PWRT, (2) evaluate whether PWRTengages target mechanisms (parental self-efficacy, parenting behaviours, social support, family function) and (3) determine the effects of PWRTon adolescent outcomes (internalising and externalising behaviours, placement restrictiveness).

Methods and analysis

In this randomised control trial, parents (n=60) will be randomly assigned to PWRTor treatment as usual. Each week for 6 weeks, parents in the PWRTcondition will complete two PW modules (20 min each) and attend one discussion group via Zoom (90 min). Adolescents (n=60) will not receive intervention; however, we will evaluate the feasibility of adolescent data collection for future studies. Data from parents and adolescents will be collected at baseline, post intervention (6 weeks post baseline) and 6 months post baseline to allow for a robust understanding of the longer-term effects of PWRTon treatment gain maintenance.

Ethics and dissemination

The study has been approved by The Ohio State University Institutional Review Board (protocol number 2022B0315). The outcomes of the study will be shared through presentations at both local and national conferences, publications in peer-reviewed journals and disseminated to the families and organisations that helped to facilitate the project.

Trial registration number

NCT05764369(V.1, December 2022).
Can FDG-PET/CT imaging be used to predict decline in quality of life in interstitial lung disease? A prospective study of the relationship between FDG uptake and quality of life in a UK outpatient setting
Authors: Jordon Louise Helen , Ganeshan Balaji , Nadeem Iftikhar , Hoy Luke , Mahdi Noor , Porter Joanna C , Groves Ashley , Win Thida
Published: May 2024

Background

18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) CT imaging has been used in many inflammatory and infectious conditions to differentiate areas of increased metabolic activity. FDG uptake differs between areas of normal lung parenchyma and interstitial lung disease (ILD).

Objectives

In this study, we investigated whether FDG-PET/CT parameters were associated with a change in the quality of life (QoL) in patients with ILD over 4 years of follow-up.

Methods

Patients underwent PET-CT imaging at diagnosis and were followed up with annual QoL assessment using the St George’s Respiratory Questionnaire (SGRQ) until death or 4 years of follow-up. Maximum standard uptake value (SUVmax) and Tissue-to-Background Ratio (TBR) were assessed against SGRQ overall and subscale scores.

Results

193 patients (94 patients in the idiopathic pulmonary fibrosis (IPF) subgroup and 99 patients in the non-IPF subgroup) underwent baseline FDG-PET/CT imaging and QoL assessment. Weak-to-moderate correlation was observed between baseline SUVmax and SGRQ scores in both ILD subgroups. No relationship was observed between baseline SUVmax or TBR and change in SGRQ scores over 4 years of follow-up. In the IPF subgroup, surviving patients reported a decline in QoL at 4 years post diagnosis whereas an improvement in QoL was seen in surviving patients with non-IPF ILD.

Conclusions

Weak-to-moderate positive correlation between baseline SUVmax and SGRQ scores was observed in both ILD subgroups (IPF:rs=0.187, p=0.047, non-IPF: rs=0.320, p=0.001). However, baseline SUVmax and TBR were not associated with change in QoL in patients with IPF and non-IPF ILD over 4 years of follow-up. At 4 years post diagnosis, surviving patients with IPF reported declining QoL whereas improvement was seen in patients with ILD who did not have IPF.
Cross-sectional study of prevalence, causes and trends in visual impairment in Nirmal District, Telangana, India: Nirmal Eye Evaluation for Trends study
Authors: Marmamula Srinivas , Chinya Aritra , Yelagondula Vijay Kumar , Varada Rajashekar , Khanna Rohit C , Narayanan Raja
Published: May 2024

Objective

To determine the prevalence, causes and risk factors associated with visual impairment (VI) in the Nirmal district of Telangana, India, using extended Rapid Assessment of Visual Impairment (RAVI) methodology.

Design

Cross-sectional study.

Setting

Community setting.

Participants

Participants aged ≥16 years were enumerated from 90 randomly selected clusters and 4629/5400 (85.7%) participants were examined. Presenting visual acuity (VA) was assessed using a Snellen chart with E optotypes at a 6 m distance. Near vision was assessed binocularly using an N notation chart with tumbling E optotypes at a 40 cm distance. An anterior segment examination done followed by distance direct ophthalmoscopy at 50 cm. Non-mydriatic fundus images were obtained. VI was defined as presenting VA worse than 6/12 in the better eye. The prevalence of VI in the current study was compared with a RAVI study conducted in 2014 to assess the trends in VI among those aged ≥40 years.

Primary outcome

Prevalence, causes and risk factors for VI.

Results

Among those examined, 55% were women, 53% had at least school-level education, 2.3% self-reported diabetes and 8.7% self-reported hypertension. The prevalence of VI was 8.81% (95% CI 8.01% to 9.67%). Overall, uncorrected refractive errors (49.5%) were the leading cause of VI, followed by cataracts (40.2%) and posterior segment diseases (4.9%). Among those aged ≥40 years, the prevalence of VI declined by 19.3% compared with the 2014 baseline study (from 20.2% to 16.3%; p<0.01).

Conclusion

The extended RAVI study conducted in the Nirmal district showed a considerable decline in the prevalence of VI. Targeted interventions are needed to provide adequate eye care for the high-risk groups in this district.
Effectiveness of a peer-supported crisis intervention to reduce the proportion of compulsory admissions in acute psychiatric crisis interventions in an outreach and outpatient setting: study protocol for an exploratory cluster randomised trial combined with qualitative methods
Authors: Oeltjen Lena Katharina , Schulz Maike , Heuer Imke , Knigge Georg , Nixdorf Rebecca , Briel Denis , Hamer Patricia , Brannath Werner , Utschakowski Jörg , Mahlke Candelaria , Gerhardus Ansgar
Published: May 2024

Introduction

Compulsory admissions are associated with feelings of fear, humiliation and powerlessness. The number of compulsory admissions in Germany and other high-income countries has increased in recent years. Peer support has been shown to increase the self-efficacy of individuals with mental health conditions in acute crises and to reduce the use of coercive measures in clinical settings. The objective of this study is to reduce the number of compulsory admissions by involving peer support workers (PSWs) in acute mental health crises in outreach and outpatient settings.

Methods and analysis

This one-year intervention is an exploratory, cluster randomised study. Trained PSWs will join the public crisis intervention services (CIS) in two of five regions (the intervention regions) in the city of Bremen (Germany). PSWs will participate in crisis interventions and aspects of the mental health services. They will be involved in developing and conducting an antistigma training for police officers. The remaining three regions will serve as control regions. All individuals aged 18 and older who experience an acute mental health crisis during the operating hours of the regional CIS in the city of Bremen (around 2000 in previous years) will be included in the study. Semistructured interviews will be conducted with PSWs, 30 patients from control and intervention regions, as well as two focus group discussions with CIS staff. A descriptive comparison between all participants in the intervention and control regions will assess the proportion of compulsory admissions in crisis interventions during the baseline and intervention years, including an analysis of temporal changes.

Ethics and dissemination

This study was approved by the Ethics Committee of the University of Bremen (file 2022-09) on 20 June 2022. The results will be presented via scientific conferences, scientific journals and communicated to policy-makers and practitioners.

Trial registration number

DRKS00029377.
The 6I model: an expanded 4I framework to conceptualise interorganisational learning in the global health sector
Authors: Wodnik Breanna K , Andiappan Meena , Di Ruggiero Erica , Lavery James V
Published: May 2024

Introduction

An organisation’s ability to learn and adapt is key to its long-term performance and success. Although calls to improve learning within and across health organisations and systems have increased in recent years, global health is lagging behind other sectors in attention to learning, and applications of conceptual models for organisational learning to this field are needed.

Leveraging the 4I Framework

This article proposes modifications to the 4I framework for organisational learning (which outlines the processes of intuition, interpretation, integration and institutionalisation) to guide the creation, retention and exchange of knowledge within and across global health organisations.

Proposed Expansions

Two expansions are added to the framework to account for interorganisational learning in the highly interconnected field: (1) learning pathways across organisations via formal or informal partnerships and communities of practice and (2) learning pathways to and from macro-level ‘coordinating bodies’ (eg, WHO). Two additional processes are proposed by which interorganisational learning occurs:interactionacross partnerships and communities of practice, andincorporationlinking global health organisations to coordinating bodies. Organisational politics across partnerships, communities of practice and coordinating bodies play an important role in determining why some insights are institutionalised while others are not; as such, the roles of the episodic influence and systemic domination forms of power are considered in the proposed additional organisational learning processes.

Discussion

When lessons are not shared across partnerships, communities of practice or the research community more broadly, funding may continue to support global health studies and programmes that have already been proven ineffective, squandering research and healthcare resources that could have been invested elsewhere. The ‘6I’ framework provides a basis for assessing and implementing organisational learning approaches in global health programming, and in health systems more broadly.
Impact of no publicly accessible prenatal education programming on patients and their care providers: a descriptive qualitative study in Nova Scotia, Canada
Authors: Strachan-Whaley Megan Rae , Scruton Sarah , Blennerhassett C J , Urquhart Robin
Published: May 2024

Objective

Patients in Nova Scotia do not have access to public prenatal education programming. This study aimed to explore whether care providers find patients are uninformed or misinformed, and the impact of that on patients and their care providers with a focus on clinical outcomes, time, resources and informed decision-making.

Methods

Semistructured interviews were conducted with 13 care providers around Halifax and Cape Breton. An interview guide (supplemental) of open-ended questions was used for consistency. A descriptive qualitative approach was employed to describe the contents of the interviews. Each interview was audio-taped and transcribed verbatim by an interdependent transcriber. Transcripts were analysed using established techniques in qualitative descriptive research including coding, grouping, detailing and comparing the data using NVivo V.12 software. A co-coder (SS) independently coded two interviews for inter-rater reliability.

Results

The study revealed six themes: (1) concern for a significant population of Nova Scotians experiencing pregnancy, birth and postpartum uninformed and misinformed, (2) consequences for patients who are uninformed and misinformed, (3) more time and resources spent on care for patients who are uninformed or misinformed, (4) patients and their care providers need a publicly available education programme, particularly vulnerable populations, (5) emphasis on programme quality and disappointment with the programme previously been in place and (6) recommendations for an effective prenatal education programme for Nova Scotians.

Conclusions

This study shows care providers believe a public prenatal education programme could improve health literacy in Nova Scotia. Patients are seeking health education, but it is not accessible to all and being uninformed or misinformed negatively impacts patients’ experiences and outcomes. This study revealed excess time and resources are being spent on individualised prenatal education by care providers with high individual and system-wide cost and explored the complicated process of providing patient-centred care for people who are uninformed or misinformed.
Hearing, sharing and applying: a qualitative study of the experiences of family caregivers’ end-of-life decision-making in Singapore
Authors: Ong Min Li , Foong Pin Sym , Tan See Mieng , Xia Xingyu , Koh Gerald Choon Huat
Published: May 2024

Objectives

This study aims to describe the caregivers’ end-of-life (EOL) decision-making experience, what made family caregivers feel assured when they were making the right call, and when they felt uncertain or regretful about decisions made. The objective is to describe the decision-making journey and identify how interventions can be developed for these caregivers.

Methods

Semi-structured interviews with 14 adult and spousal caregivers were conducted using an interview guide and transcripts were coded inductively via reflexive thematic analysis.

Results

First, clarity in communication enhances satisfaction with their decisions. This involves transparency of communication channels within the family unit which is in charge of helping their patient make EOL decisions, and with the healthcare professional. Second, satisfaction was enhanced with clear prognostication of the patient’s condition to the family who then used it to discuss their options. Finally, families often elect a lead facilitator within the family unit who manages the decision-making process, and collates multiple perspectives from all the stakeholders.

Conclusions

Based on these findings, we recommend that interventions to support family-based decision-making in Singapore should be based on the three principles of hearing patient values, sharing these values with other loved ones and providers and applying these values in collaboration with the providers and family members.
Number of passes and outcome of endovascular treatment of anterior circulation large core ischemic stroke: insights from the Endovascular Treatment in Ischemic Stroke (ETIS) registry
Authors: Lambrou Victoria , Gory Benjamin , Lapergue Bertrand , Marnat Gaultier , Pop Raoul , Calviere Lionel , Anadani Mohammad , Blanc Raphael , Finitsis Stephanos Nikolaos
Published: May 2024

Background

The effect of multiple attempts on the outcome of endovascular treatment (EVT) of anterior circulation large ischemic core (LIC) stroke has not been fully explored.

Methods

We analyzed data from the Endovascular Treatment in Ischemic Stroke (ETIS) registry, a prospective, observational, multicenter study of acute ischemic stroke patients treated with EVT at 21 centers in France between January 1, 2015 and June 31, 2023. We included patients with proximal intracranial occlusion and LIC defined as Alberta Stroke Program Early CT Score (ASPECTS) of 0–5 up to 24 hours after last being seen well. We divided patients according to the number of passes with successful reperfusion (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2b) into seven groups, according to the corresponding number of passes. We compared them to the group of patients with unsuccessful reperfusion.

Results

A total of 1235 patients with LIC constituted the study cohort. The rate of a modified Rankin Scale (mRS) score of 0 to 3 at 90 days was significantly higher for the one-pass successful recanalization category compared to no recanalization (48.1% vs 17.2%; adjusted OR (aOR) 7.99, 95% CI 4.30 to 14.8, P<0.001) and remained so even after six or more attempts (27.7% vs 17.2%; aOR 3.59, 95% CI 1.37 to 9.39, P=0.009). The rate of symptomatic intracranial hemorrhage was lower for successful recanalization up to two passes (11.1% vs 18.8%; aOR 0.36, 95% CI 0.18 to 0.69, P=0.002) without any significant differences for a higher number of passes.

Conclusion

In anterior circulation LIC patients, successful reperfusion, even after six passes, is associated with favorable clinical outcomes with no increased hemorrhagic risk when compared to unsuccessful reperfusion.
Synthesis of robust memory modes for linear quantum systems with unknown inputs
Authors: Miao Zibo , Chen Xinpeng , Pan Yu , Gao Qing
Published: May 2024

In this paper, the synthesis of robust memory modes for linear quantum passive systems in the presence of unknown inputs has been studied, aimed at facilitating secure storage and communication of quantum information. In particular, we can switch on decoherence-free (DF) modes in the storage stage by placing the poles on the imaginary axis via a coherent feedback control scheme, and these memory modes can further be simultaneously made robust against perturbations to the system parameters by minimizing the condition number associated with imaginary poles. The DF modes can also be switched off by tuning the controller parameters to place the poles in the left half of the complex plane in the writing/reading stage. We develop explicit algebraic conditions guiding the design of such a coherent quantum controller, which involves employing an augmented system model to counter the influence of unknown inputs. Examples are provided to illustrate the procedure of synthesizing robust memory modes for linear optical quantum systems.
Robust 3D Point Cloud Recognition: Enhancing Robustness with GPT-4 and CLIP Integration
Authors: Pan Lei , Li Junhui , Luan Wuyang , Zhen Yuan , Xu Chang
Published: May 2024

In recent years, deep neural networks have achieved significant success in 3D point cloud recognition tasks. However, these models still demonstrate substantial performance challenges in the presence of data corruption. It is crucial to improve the robustness and generalization ability of the model. In this work, we propose a novel framework that combines GPT and CLIP models to enhance the robustness of existing point cloud classification models, which has two main modules: the Text-Image Fusion Module, which includes a GPT-Driven TextGen Processor and FocalView Projection, and the Dual-Path Intelligent Adapter Module. First, the GPT-Driven TextGen Processor leverages GPT-4’s capabilities to generate detailed textual descriptions tailored to point cloud intricacies. FocalView Projection dynamically selects viewpoints based on attention maps, enhancing two-dimensional representations of three-dimensional point clouds. Secondly, the Dual-Path Intelligent Adapter Module achieves fine-tuning and feature adaptation by combining internal and external adapters. Additionally, during the fine-tuning process, we employ a variant of Projected Gradient Descent (PGD) adversarial training, named VPGD, to increase the model’s resilience to adversarial perturbations. Our approach has achieved state-of-the-art results on robust 3D points cloud recognition datasets such as ModelNet40-C and ScanObjectNN-C.
Self-Voltage Balanced Switched-Capacitor Seven-Level Inverter for Asymmetrical Solar PV Source Applications
Authors: Krishna Bekkam , Reddy Reddy Srinivasa , Karthikeyan V.
Published: May 2024

In this paper, a novel structure of self-voltage balanced switched-capacitor-based seven-level inverter (SVB-SCSLI) is proposed for asymmetrical input energy source applications. SVB-SCSLI develops a seven-level staircase waveform with a minimum number of semiconductor devices compared to existing multilevel inverters (MLIs). The proposed converter is more suitable for the solar PV system where unequal DC voltage sources are available. The SVB-SCSLI also resolves the main difficulty of connecting many inverters in parallel to achieve staircase voltage. Besides, it attains voltage balancing capability at DC-link by holding constant capacitor voltage at every cycle. The detailed loss and steady-state analysis of the SVB-SCSLI are examined. Furthermore, the proposed converter’s efficiency improves with better power quality than other topologies reported in the literature. Finally, a prototype is fabricated, and experimental results are presented to validate the feasibility of SVB-SCSLI.
A Genetic Algorithm and Fuzzy Neural Network-Based Intelligent Temperature Control Decision Model for Coagulation Cooling Systems
Authors: Luo Chunyan , Zhao Jiawei , Sun Hui
Published: May 2024

The coagulation cooling system is a common key component in many industrial processes, and reasonable temperature control is crucial. However, due to the complexity of the coagulation cooling system, traditional temperature control methods often cannot achieve optimal performance. To solve this problem, we design an intelligent temperature control decision model by a combination of genetic algorithm and fuzzy neural network. The study firstly utilizes genetic algorithm to optimize the objective function and constraint conditions of the coagulation cooling PID system. At the same time, fuzzy neural network is fused with genetic algorithm to establish a dedicated T-S/2 neural network structure, completing the complete model design of this study. Finally, cooling efficiency, task completion rate and model stability analysis are evaluated on real-world datasets. To validate the proposed model, an example of a coagulation cooling system was constructed in the laboratory and compared with traditional temperature control methods. The experimental results show that the proposal can significantly improve the performance of temperature control and reduce energy consumption under different conditions. In addition, the proposal has the characteristics of adaptability and optimization performance, and can effectively achieve optimal temperature control in uncertain and complex environments.
Green Synthesis of Silver Nanoparticles Using Plant Extract Blends and Its Impact on Antibacterial and Biological Activity
Authors: Ozturk Selin Naz , Tomak Aysel , Karakus Ceyda Oksel
Published: May 2024

There is a strong interest in using green resources for synthesizing nanoparticles (NPs) of industrial and biomedical utility in a way to maintain desired material properties throughout use while not inducing any harmful effects. The use of various plant extracts as reducing, capping, or stabilizing agents is widely attempted in green nanotechnology. However, very little has been explored about incorporating plant extract blends into green NP synthesis routes. Here, we used the combination of tea and olive leaf extracts for the synthesis of silver NPs and evaluated the advantages it provided over both chemical and single-plant-mediated synthesis routes. Four different reducing agents (tannic acid, black tea leaves extract, olive leaves extract and their blend) were used to synthesize silver NPs (Ag NP) from silver nitrate (AgNO[Formula: see text]. The synthesized Ag NP was characterized by scanning electron microscopy (SEM), dynamic light scattering (DLS), and ultraviolet-visible (US-Vis) spectroscopy. The antimicrobial properties of Ag NP were assessed against Escherichia coli (E. Coli) and Staphylococcus aureus (S. Aureus) using the colony-forming unit (CFU) assay and the minimum inhibitory concentration (MIC) assay. The cytotoxic potential of Ag NP on human colorectal adenocarcinoma (Caco-2) cells was assessed by the WST-1 assay. Results showed that Ag NP synthesized using plant extract mixtures had a primary particle size of 40[Formula: see text]nm and were very effective antibacterial agents, with the MIC values ranging from [Formula: see text]g/mL to 10[Formula: see text][Formula: see text]g/mL. While the particle size obtained in chemical synthesis was slightly lower, the resultant Ag NP did not serve as an effective antibacterial agents at low doses. Further understanding of how best to integrate extracts of different plants into green NP synthesis routes will enable wider and safer biomedical applications.
Circle-valued angle structures and obstruction theory
Authors: Hodgson Craig D. , Kricker Andrew J. , Siejakowski Rafał M.
Published: May 2024

We study spaces of circle-valued angle structures, introduced by Feng Luo, on ideal triangulations of 3-manifolds. We prove that the connected components of these spaces are enumerated by certain cohomology groups of the 3-manifold with [Formula: see text]-coefficients. Our main theorem shows that this establishes a geometrically natural bijection between the connected components of the spaces of circle-valued angle structures and the obstruction classes to lifting boundary-parabolic PSL[Formula: see text]-representations of the fundamental group of the 3-manifold to boundary-unipotent representations into SL[Formula: see text]. In particular, these connected components have topological and algebraic significance independent of the ideal triangulations chosen to construct them. The motivation and main application of this study is to understand the domain of the state-integral defining the meromorphic 3D-index of Garoufalidis and Kashaev, necessary in order to classify the boundary-parabolic representations contributing to its asymptotics.
Large piezoelectric property of Bi(Fe0.93Mn0.05Ti0.02)O3 film by constructing internal bias electric field
Authors: Yuan Xiufang , Fan Mengjia , Wang Wenxuan , Wang Guoguo , Lin Xiujuan , Huang Shifeng , Yang Changhong
Published: May 2024

BiFeO3 (BFO), Mn-doped-BFO (BFMO), Ti-doped-BFO (BFTO), and (Mn,Ti)-codoped-BFO (BFMTO) thin films are fabricated on the Pt/TiO2/SiO2/Si substrates via a sol–gel method combined with spin-coating and the subsequent layer-by-layer annealing technique. Compared with BFO film, the BFMTO film exhibits the lowest leakage current density ([Formula: see text][Formula: see text]A/cm2@290[Formula: see text]kV/cm). Notably, the polarization–electric field (P–E) loop of BFMTO film exhibits a positive displacement along the x-axis due to the existence of internal bias electric field, which is in agreement with the results of the PFM phase and amplitude curves. Especially, a very prominent inverse piezoelectric constant of [Formula: see text][Formula: see text]pm/V was obtained, which overcomes other related thin films. The internal bias electric field of BFMTO film can be caused by the different work functions of the thin film and the bottom electrode, accumulation of oxygen vacancies and the formation of defect dipoles. Besides, the internal bias electric field of BFMTO film has a good stability at the same electric field after experiencing the test cycle from low electric field to high electric field (400–1900[Formula: see text]kV/cm). These results indicate that self-polarized BFMTO film can be integrated to devices without additional polarization process, and have a wide range of application in microelectromechanical systems.
Impedance spectroscopy and electrical conductivity of 0.7Bi(1−x)NdxFeO3–0.3BaTiO3 ferroelectric ceramics
Authors: Tang Hui , Peng Xiao-Cao , Ma Jiu-Ming , Yang Zhi-Peng , Niu Xiang , Wen Jun-Xia , Tang Xin-Gui , Lu Sheng-Guo
Published: May 2024

0.7Bi[Formula: see text]NdxFeO3–0.3BaTiO3 (BNFO–BTO, [Formula: see text], 0.010, 0.020 and 0.050) ceramics were fabricated using the high-temperature solid-state reaction method. The X-ray diffraction (XRD) patterns revealed that the primary phase in these ceramics was pseudocubic. The Scanning Electron Microscopy (SEM) micrographs exhibited dense microstructures throughout all BNFO–BTO ceramics. Furthermore, the temperature dependence of dielectric behaviors and ferroelectric hysteresis loop shapes suggested the occurrence of a relaxor ferroelectric-type phase transition in BNFO–BTO ceramics. Additionally, the frequency dispersion characteristics and remnant polarization were enhanced with increasing substitution of Bi[Formula: see text] by Nd[Formula: see text]. Conducted impedance analysis on 0.7Bi[Formula: see text]NdxFeO3–0.3BaTiO3 ceramics and two dielectric responses of the grain at high frequency and grain boundary at low frequency were illustrated, respectively. The combination of imaginary impedance ([Formula: see text] and imaginary modulus ([Formula: see text] versus log[Formula: see text]f plots revealed that the charge carriers’ motion was not entirely long-range, short-range migration also exists. Through calculations based on Curie–Weiss Law, the relaxation activation energy ([Formula: see text] and conductance activation energy ([Formula: see text] were investigated, confirming that doping Nd[Formula: see text] effectively mitigates the concentration of oxygen vacancies (OVs) and prevents the formation of oxygen vacancies clusters, ultimately suppressing conductivity in BNFO–BTO ceramics.
Can Learned Indexes be Built Efficiently? A Deep Dive into Sampling Trade-offs
Authors: Choi Minguk , Yoo Seehwan , Choi Jongmoo
Published: May 2024

By embedding the distribution of keys in indexing structure, learned indexes can minimize the index size and maximize the lookup performance. Yet, one of the problems in the present learned index is the long index-building time. The conventional learned index requires a complete traversal of the entire dataset, which makes it less practical than traditional index. This paper challenges the efficiency of build time to make the learned index practical.

Our approach for a build time-efficient learned index is to employ sampled learning. In this paper, we present two error-bounded sampling schemes: Sample EB-PLA, and Sample EB-Histogram. Although sampling is a simple idea, there are several considerations to make it practical. For example, sampling interval, error-boundness, and index hyper-parameters are inter-related each other, presenting complicated trade-offs between build-time, index size, accuracy and lookup latency.

Throughout the extensive experiments over six real-world datasets, we show that the index-building time can be efficiently reduced over an order of magnitude by our sampling schemes. The results reveal that the sampling expands the design space of learned indexes, including the build-time as well as lookup performance and index size. Our Pareto analysis shows that a learned index can be built more efficiently than a traditional index through sampling.
Auto-Formula: Recommend Formulas in Spreadsheets using Contrastive Learning for Table Representations
Authors: Chen Sibei , He Yeye , Cui Weiwei , Fan Ju , Ge Song , Zhang Haidong , Zhang Dongmei , Chaudhuri Surajit
Published: May 2024

Spreadsheets are widely recognized as the most popular end-user programming tools, which blend the power of formula-based computation, with an intuitive table-based interface. Today, spreadsheets are used by billions of users to manipulate tables, most of whom are neither database experts nor professional programmers.

Despite the success of spreadsheets, authoring complex formulas remains challenging, as non-technical users need to look up and understand non-trivial formula syntax. To address this pain point, we leverage the observation that there is often an abundance of similar-looking spreadsheets in the same organization, which not only have similar data, but also share similar computation logic encoded as formulas. We develop an Auto-Formula system that can accurately predict formulas that users want to author in a target spreadsheet cell, by learning and adapting formulas that already exist in similar spreadsheets, using contrastive-learning techniques inspired by "similar-face recognition" from compute vision. Extensive evaluations on over 2K test formulas extracted from real enterprise spreadsheets show the effectiveness of Auto-Formula over alternatives. Our benchmark data is available at https://github.com/microsoft/Auto-Formula to facilitate future research.