bluuebunny/crossref_metadata_2025 huggingface dataset:
Design thinking to improve rational use of oral rehydration salts: lessons from an innovative co-packaged diarrhoea treatment kit
Authors: Ramchandani Rohit , Berry Simon , Berry Jane , Pratt Beth Anne , Saka Albert , Black Robert E
Published: May 2023

Introduction

We explored whether greater consideration of product design, informed by end users’ opinions, led to improved utilisation (ie, rational use) of oral rehydration salts (ORS) in home settings. We tested whether a ‘design thinking’ approach, focusing on product acceptability, functionality and ease of use, contributed to an increased likelihood of appropriate ORS use, specifically dosing and preparation of ORS in the correct concentration.

Methods

Intervention design decisions were used to develop a co-packaged diarrhoea treatment kit containing ORS and zinc, branded as ‘Kit Yamoyo’. In addition to co-packaging, key product design features were the inclusion of 200 mL ORS sachets and a water measurement function incorporated in the packaging design. Cross-sectional data from household surveys of caregivers in rural Zambia were then used to compare ORS preparation and use for diarrhoea patients aged <5 years, who used either the novel co-pack or standard 1 L sachets of ORS. Design benefits were demonstrated to caregivers from two rural areas by trained community health workers (CHWs).

Results

Odds of correct ORS preparation were 10.93 times greater (p<0.001; 95% CI 5.74 to 20.78) among Kit Yamoyo users versus individuals who used 1 L sachets. Co-pack users prepared ORS to the correct concentration 93% (95% CI 0.89% to 0.96%) of the time, while non-users prepared it in the correct concentration just 60% (95% CI 0.54% to 0.66%) of the time.

Conclusion

Application of design thinking to the development of a co-packaged ORS and zinc diarrhoea treatment kit, coupled with demonstrations by CHWs, can improve rational use of ORS.
National initiative to promote public involvement in medicine safety: the use of a cross-sectional population survey to identify candidate behaviours for intervention development in Scotland
Authors: Gangannagaripalli Jaheeda , McIver Laura , Abutheraa Nouf , Brewster Richard , Dixon Diane , Watson Margaret C
Published: May 2023

Objectives

The aim of this study was to explore the public’s current awareness of the safe use of medicines in general, and over-the-counter (OTC) analgesics (painkillers) in particular, as well as their information-seeking and advice-seeking, medicine use and disposal.

Setting

General population, Scotland.

Participants

Adults (aged >16 years) living in Scotland.

Interventions

A cross-sectional survey was undertaken in collaboration with Ipsos MORI (a market research company). The content was informed by a multi-stakeholder prioritisation event and supplemented with information from earlier studies.

Results

The survey was completed in March 2020 by 1000 respondents, most of whom had used a pharmacy in the previous 12 months to obtain a medicine. Of the 1000 respondents, 39% (n=389) were 55 years and over; 52% (n=517) were women; and 58% were degree-educated.

On receipt of a new prescription, up to 29.8% (95% CI 27.0% to 32.7%) of respondents proactively sought specific information or advice from the pharmacist. Few (5.2% (95% CI 4.0% to 6.8%) respondents ‘always’ discussed their new prescription medicine with pharmacy staff and 28.9% (95% CI 26.2% to 31.8%) reported ‘never’ engaging in this behaviour. Respondents aged >35 years were less likely to engage in this behaviour.

Just over half (53% (95% CI 50.5% to 56.7%)) the respondents reported oral OTC analgesic use at least once in the previous month.

In terms of medicine disposal, 29.3% (95% CI 26.6% to 32.2%) of respondents considered waste bin disposal to be of low or no harm.

Conclusions

This study identified low levels of information-seeking and advice-seeking from pharmacy personnel especially on receipt of new prescription medicines. Potentially unsafe behaviours were identified in the use and disposal of medicines. These results will inform the development of interventions to promote advice-seeking and increase awareness regarding safe medicine use.
Family stress during the COVID-19 pandemic: a qualitative analysis
Authors: Mathur Mala , Robiolio Hannah , Ebert Lucas , Kerr Bradley
Published: May 2023

Objective

This study aimed to understand experiences with stress and coping strategies used among families in the COVID-19 pandemic.

Design/Setting

This qualitative study took place in the paediatric outpatient clinics of a large academic medical centre in the USA between March and July of 2021.

Participants

Parents (over the age of 18 years) of children under the age of 18 years were invited to complete a 30-minute semistructured interview.

Primary and secondary outcome measures

Participants were asked about types of stressors experienced during the COVID-19 pandemic and coping strategies used. All interviews were audio recorded and transcribed. In the grounded theory tradition, transcripts underwent thematic analysis.

Results

A total of 26 participants completed interviews, including 88% (n=23) women, 85% (n=22) reported having children under the age of 10 years and 65% (n=17) were 30–50 years of age. Themes that emerged included the compounding effect of COVID-19 stressors, in which participants described multiple, intersecting sources of stress. One parent noted, “I worked two different jobs, since the other job I had counted on working, I lost because of COVID. And so, working from home, also with the kids, was stressful.” The second theme reflected the challenges for children with virtual schooling due to decreased educational support. The third theme was the need for parental self-care. The fourth theme was finding the silver lining in which parents noted unforeseen opportunities for resilience by spending time in nature and activities promoting family bonding.

Conclusions

Parents indicated need for self-care, connecting with their child(ren) and spending time in nature. Future work should develop approaches to support families in these areas when facing complex stressors, especially during a pandemic or other times of crisis.
Exploration of the Acceptance of the Use of Procalcitonin Point-of-Care Testing and Lung Ultrasonography by General Practitioners to Decide on Antibiotic Prescriptions for Lower Respiratory Infections: A Qualitative Study
Authors: Geis Daniel , Canova Nina , Lhopitallier Loïc , Kronenberg Andreas , Meuwly Jean-Yves , Senn Nicolas , Mueller Yolanda , Fasseur Fabienne , Boillat-Blanco Noémie
Published: May 2023

Objectives

We aimed to explore the acceptance and opinions of general practitioners (GPs) on the use of procalcitonin point-of-care and lung ultrasonography for managing patients with lower respiratory tract infections in primary care. We suppose that there are several factors that can influence the physician’s antibiotic prescribing decision, and the implementation of a new tool will only be possible when it can be inserted into the physician’s daily practice, helping him/her in the decision-making process.

Design

Semistructured interviews; data analysis using the grounded theory method.

Setting

Lausanne, Switzerland.

Participants

12 GPs who participated in the randomised clinical trial UltraPro, which evaluated the impact of the use of procalcitonin only or an algorithm combining procalcitonin and lung ultrasonography on antibiotic prescription.

Results

GPs had mostly positive attitudes towards the use of point-of-care procalcitonin in lower respiratory tract infections and uncertainties regarding the usefulness of ultrasonography. Physicians’ prescribing decisions result from interactions between three kinds of TrustS (core category): ‘self-confidence’, ‘trust in the results’ and ‘trust in the doctor–patient relationship’. Procalcitonin reinforced the three levels of trust, while ultrasonography only strengthened the physician–patient relationship. To facilitate implementation of procalcitonin, physicians pointed out the need of coverage by insurance and of clear guidelines describing the targeted patient population.

Conclusions

Our data show that there is a preference for the implementation of procalcitonin rather than lung ultrasonography for the management of patients with lower respiratory tract infections in primary care. Coverage by insurance plans and updated guidelines are prerequisite to the successful implementation of procalcitonin testing in primary care.

Trial Registration number

NCT03191071
Calcium supplementation to prevent pre-eclampsia: protocol for an individual participant data meta-analysis, network meta-analysis and health economic evaluation
Authors: Rocha Thaís , Allotey John , Palacios Alfredo , Vogel Joshua Peter , Smits Luc , Carroli Guillermo , Mistry Hema , Young Taryn , Qureshi Zahida P , Cormick Gabriela , Snell Kym I E , Abalos Edgardo , Pena-Rosas Juan-Pablo , Khan Khalid Saeed , Larbi Koiwah Koi , Thorson Anna , Singata-Madliki Mandisa , Hofmeyr George Justus , Bohren Meghan , Riley Richard , Betran Ana Pilar , Thangaratinam Shakila
Published: May 2023

Introduction

Low dietary calcium intake is a risk factor for pre-eclampsia, a major contributor to maternal and perinatal mortality and morbidity worldwide. Calcium supplementation can prevent pre-eclampsia in women with low dietary calcium. However, the optimal dose and timing of calcium supplementation are not known. We plan to undertake an individual participant data (IPD) meta-analysis of randomised trials to determine the effects of various calcium supplementation regimens in preventing pre-eclampsia and its complications and rank these by effectiveness. We also aim to evaluate the cost-effectiveness of calcium supplementation to prevent pre-eclampsia.

Methods and analysis

We will identify randomised trials on calcium supplementation before and during pregnancy by searching major electronic databases including Embase, CINAHL, MEDLINE, CENTRAL, PubMed, Scopus, AMED, LILACS, POPLINE, AIM, IMSEAR, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform, without language restrictions, from inception to February 2022. Primary researchers of the identified trials will be invited to join the International Calcium in Pregnancy Collaborative Network and share their IPD. We will check each study’s IPD for consistency with the original authors before standardising and harmonising the data. We will perform a series of one-stage and two-stage IPD random-effect meta-analyses to obtain the summary intervention effects on pre-eclampsia with 95% CIs and summary treatment–covariate interactions (maternal risk status, dietary intake, timing of intervention, daily dose of calcium prescribed and total intake of calcium). Heterogeneity will be summarised using tau2, I2and 95% prediction intervals for effect in a new study. Sensitivity analysis to explore robustness of statistical and clinical assumptions will be carried out. Minor study effects (potential publication bias) will be investigated using funnel plots. A decision analytical model for use in low-income and middle-income countries will assess the cost-effectiveness of calcium supplementation to prevent pre-eclampsia.

Ethics and dissemination

No ethical approvals are required. We will store the data in a secure repository in an anonymised format. The results will be published in peer-reviewed journals.

PROSPERO registration number

CRD42021231276.
Explaining racial disparities in surgical survival: a tapered match analysis of patient and hospital factors
Authors: Lasater Karen B , Rosenbaum Paul R , Aiken Linda H , Brooks-Carthon J Margo , Kelz Rachel R , Reiter Joseph G , Silber Jeffrey H , McHugh Matthew D
Published: May 2023

Objectives

Evaluate whether hospital factors, including nurse resources, explain racial differences in Medicare black and white patient surgical outcomes and whether disparities changed over time.

Design

Retrospective tapered-match.

Setting

571 hospitals at two time points (Early Era 2003–2005; Recent Era 2013–2015).

Participants

6752 black patients and three sets of 6752 white controls selected from 107 001 potential controls (Early Era). 4964 black patients and three sets of 4964 white controls selected from 74 108 potential controls (Recent Era).

Interventions

Black patients were matched to white controls on demographics (age, sex, state and year of procedure), procedure (demographics variables plus 136 International Classification of Diseases (ICD)-9 principal procedure codes) and presentation (demographics and procedure variables plus 34 comorbidities, a mortality risk score, a propensity score for being black, emergency admission, transfer status, predicted procedure time).

Outcomes

30-day and 1-year mortality.

Results

Before matching, black patients had more comorbidities, higher risk of mortality despite being younger and underwent procedures at different percentages than white patients. Whites in the demographics match had lower mortality at 30 days (5.6% vs 6.7% Early Era; 5.4% vs 5.7% Recent Era) and 1-year (15.5% vs 21.5% Early Era; 12.3% vs 15.9% Recent Era). Black–white 1-year mortality differences were equivalent after matching patients with respect to presentation, procedure and demographic factors. Black–white 30-day mortality differences were equivalent after matching on procedure and demographic factors. Racial disparities in outcomes remained unchanged between the two time periods spanning 10 years. All patients in hospitals with better nurse resources had lower odds of 30-day (OR 0.60, 95% CI 0.46 to 0.78, p<0.010) and 1-year mortality (OR 0.77, 95% CI 0.65 to 0.92, p<0.010) even after accounting for other hospital factors.

Conclusions

Survival disparities among black and white patients are largely explained by differences in demographic, procedure and presentation factors. Better nurse resources (eg, staffing, work environment) were associated with lower mortality for all patients.
Which clinical features best predict occult scaphoid fractures? A systematic review of diagnostic test accuracy studies
Authors: Coventry Laura , Oldrini Ilaria , Dean Ben , Novak Alex , Duckworth Andrew , Metcalfe David
Published: May 2023

Background

Plain radiographs cannot identify all scaphoid fractures; thus ED patients with a clinical suspicion of scaphoid injury often undergo immobilisation despite normal imaging. This study determined (1) the prevalence of scaphoid fracture among patients with a clinical suspicion of scaphoid injury with normal radiographs and (2) whether clinical features can identify patients that do not require immobilisation and further imaging.

Methods

This systematic review of diagnostic test accuracy studies included all study designs that evaluated predictors of scaphoid fracture among patients with normal initial radiographs. Quality assessment was undertaken using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Meta-analyses included all studies.

Results

Eight studies reported data on 1685 wrist injuries. The prevalence of scaphoid fracture despite normal radiographs was 9.0%. Most studies were at overall low risk of bias but two were at unclear risk; all eight were at low risk for applicability concerns. The most accurate clinical predictors of occult scaphoid fracture were pain when the examiner moved the wrist from a pronated to a supinated position against resistance (sensitivity 100%, specificity 97.9%, LR+ 45.0, 95% CI 6.5 to 312.5), supination strength <10% of contralateral side (sensitivity 84.6%, specificity 76.9%, LR+ 3.7, 95% CI 2.2 to 6.1), pain on ulnar deviation (sensitivity 55.2%, specificity 76.4%, LR+ 2.3, 95% CI 1.8 to 3.0) and pronation strength <10% of contralateral side (sensitivity 69.2%, specificity 64.6%, LR+ 2.0, 95% CI 1.2 to 3.2). Absence of anatomical snuffbox tenderness significantly reduced the likelihood of an occult scaphoid fracture (sensitivity 92.1%, specificity 48.4%, LR- 0.2, 95% CI 0.0 to 0.7).

Conclusion

No single feature satisfactorily excludes an occult scaphoid fracture. Further work should explore whether a combination of clinical features, possibly in conjunction with injury characteristics (such as mechanism) and a normal initial radiograph might exclude fracture. Pain on supination against resistance would benefit from external validation.

Trial registration number

CRD42021290224.
In critique of moral resilience: UK healthcare professionals’ experiences working with asylum applicants housed in contingency accommodation during the COVID-19 pandemic
Authors: Tomkow Louise , Prager Gabrielle , Worthing Kitty , Farrington Rebecca
Published: May 2023

This research explores the experiences of UK NHS healthcare professionals working with asylum applicants housed in contingency accommodation during the COVID-19 pandemic. Using a critical understanding of the concept of moral resilience as a theoretical framework, we explore how the difficult circumstances in which they worked were navigated, and the extent to which moral suffering led to moral transformation. Ten staff from a general practice participated in semistructured interviews. Encountering the harms endured by people seeking asylum prior to arrival in the UK and through the UK’s ‘Hostile Environment’ caused healthcare staff moral suffering. They responded to this in several ways, including: (1) feeling grateful for their own fortunes; (2) defining the limitations of their professional obligations; (3) focusing on the rewards of work and (4) going above and beyond usual care. Although moral resilience is reflected in much of the data, some participants described how the work caused ideological transformations and motivated challenges to systems of oppression. We show how current moral resilience theory fails to capture these transformative political and social responses, warning of how, instead, it might encourage healthcare staff to maintain the status quo. We caution against the widespread endorsement of current formulations of moral resilience in contemporary social and political climates, where the hostile and austere systems causing suffering are the result of ideological political decisions. Future work should instead focus on enabling working conditions to support, and developing theory to capture, collective resistance.
Multiparametric quantitative MRI reveals progressive cortical damage over time in clinically stable relapsing-remitting MS
Authors: Maiworm Michelle , Hamid Celona , Wagner Marlies , Nöth Ulrike , Deichmann Ralf , Seiler Alexander , Gracien René-Maxime
Published: May 2023

Background

In relapsing-remitting multiple sclerosis (RRMS), cortical grey matter pathology relevantly contributes to long-term disability. Still, diffuse cortical inflammation cannot be detected with conventional MRI.

Objective

We aimed to assess microstructural damage of cortical grey matter over time and the relation to clinical disability as well as relapse activity in patients with RRMS using multiparametric quantitative (q)MRI techniques.

Methods

On 40 patients with RRMS and 33 age-matched and sex-matched healthy controls, quantitative T1, T2, T2* and proton density (PD) mapping was performed at baseline and follow-up after 2 years. Cortical qMRI parameter values were extracted with the FreeSurfer software using a surface-based approach. QMRI parameters, cortical thickness and white matter lesion (WML) load, as well as Expanded Disability Status Scale (EDSS) and relapse rate, were compared between time points.

Results

Over 2 years, significant increases of T1 (p≤0.001), PD (p≤0.001) and T2 (p=0.005) values were found in the patient, but not in the control group. At decreased relapse rate over time (p=0.001), cortical thickness, WML volume and EDSS remained unchanged.

Conclusion

Despite clinical stability, cortical T1, T2 and PD values increased over time, indicating progressive demyelination and increasing water content. These parameters represent promising surrogate parameters of diffuse cortical inflammation in RRMS.
Effectiveness and safety of morphine administration for refractory dyspnoea among hospitalised patients with advanced heart failure: the Morphine-HF study
Authors: Hamatani Yasuhiro , Iguchi Moritake , Moriuchi Kenji , Anchi Yuta , Inuzuka Yasutaka , Nishikawa Ryusuke , Shimamura Kiyotaka , Kondo Hirokazu , Mima Hibiki , Yamashita Yugo , Takabayashi Kensuke , Takenaka Kotoe , Korai Kengo , Kawase Yuichi , Murai Ryosuke , Yaku Hidenori , Nagao Kazuya , Kitano Mariko , Aono Yuya , Kitai Takeshi , Sato Yukihito , Kimura Takeshi , Akao Masaharu
Published: May 2023

Objectives

Morphine is effective in alleviating dyspnoea in patients with cancer. We aimed to investigate the effectiveness and safety of morphine administration for refractory dyspnoea in patients with advanced heart failure (HF).

Methods

We conducted a multicentre, prospective, observational study of hospitalised patients with advanced HF in whom morphine was administered for refractory dyspnoea. Morphine effectiveness was evaluated by dyspnoea intensity changes, assessed regularly by both a quantitative subjective scale (Visual Analogue Scale (VAS; graded from 0 to 100 mm)) and an objective scale (Support Team Assessment Schedule—Japanese (STAS-J; graded from 0 to 4 points)). Safety was assessed by vital sign changes and new-onset severe adverse events, including nausea, vomiting, constipation and delirium based on the Common Terminology Criteria for Adverse Events.

Results

From 15 Japanese institutions between September 2020 and August 2022, we included 28 hospitalised patients with advanced HF in whom morphine was administered (mean age: 83.8±8.7 years, male: 15 (54%), New York Heart Association class IV: 26 (93%) and mean left ventricular ejection fraction: 38%±19%). Both VAS and STAS-J significantly improved from baseline to day 1 (VAS: 67±26 to 50±31 mm; p=0.02 and STAS-J: 3.3±0.8 to 2.6±1.1 points; p=0.006, respectively), and thereafter the improvements sustained through to day 7. After morphine administration, vital signs including blood pressure, pulse rate and oxygen saturation did not change, and no new-onset severe adverse events occurred through to day 7.

Conclusions

This study suggested acceptable effectiveness and safety for morphine administration in treating refractory dyspnoea in hospitalised patients with advanced HF.
Ten-year follow-up investigation of stroke risk in systemic lupus erythematosus
Authors: Huang Jin-An , Lin Ching-Heng , Wu Ming-Ju , Chen Yi-Hsing , Chang Kuo-Cheng , Hou Chung-Wei
Published: May 2023

Background and purpose

To analyse the long-term risk of ischaemic stroke and the clinical effects of antithrombotics on the risk of haemorrhagic stroke in patients with systemic lupus erythematosus (SLE).

Methods

A retrospective cohort study was conducted using a population-based database taken from Taiwan National Health Insurance Research Database. Patients with SLE between 2000 and 2008 were registered and matched with two controls by the index date, age, gender and Charlson Comorbidity Index (CCI). These subjects were followed until either stroke event or 31 December 2013. Adjusted HRs (aHRs) for strokes were estimated with Cox regression models, and the cumulative incidence of ischaemic stroke was analysed by log-rank test and Kaplan-Meier survival analysis.

Results

In total, 8310 patients with SLE and 16 620 patients without SLE were included. In general, patients with SLE had higher rates of ischaemic stroke (5.4% vs 3.3%) and haemorrhagic stroke (1.5% vs 0.6%) than in controls. In multivariate analysis adjusted to age, gender, CCI, urbanisation level and antithrombotics uses, aHRs of all strokes, ischaemic stroke and haemorrhagic stroke were 1.73 (95% CI: 1.54 to 1.94), 1.65 (95% CI: 1.45 to 1.87) and 2.24 (95% CI: 1.71 to 2.95), respectively, in patients with SLE. Patients with SLE were significantly more likely to suffer ischaemic stroke than patients without SLE, even 10 years after SLE diagnosis (6.12% vs 3.50%, p<0.001). Antiplatelet use increased the risk of haemorrhagic stroke in SLE group (aHR=1.74, 95% CI: 1.18 to 2.57).

Conclusions

Patients with SLE are at greater risk of developing ischaemic stroke that lasts for 10 years. Antiplatelets should be carefully administered to prevent cardiovascular events in patients with SLE due to the risk of haemorrhagic stroke.
Intra-arterial tenecteplase during thrombectomy for acute stroke (BRETIS-TNK II): rationale and design
Authors: Zhao Zi-Ai , Qiu Jing , Li Wei , Nguyen Thanh , Wang Shouchun , Shi Huaizhang , Wei Ming , Wang Feng , Li Di , Chen Hui-Sheng
Published: May 2023

Background

Our recent pilot study suggests intra-arterial tenecteplase (TNK) during the first pass of endovascular treatment (EVT) seems safe, may increase first-pass reperfusion and good outcome in acute ischaemic stroke (AIS) patients with large-vessel occlusion (LVO).

Aims

To determine the efficacy and safety of intra-arterial TNK administration during EVT in AIS-LVO patients presenting up to 24 hours from symptom onset.

Sample size estimates

A maximum of 380 patients are required to test the superiority hypothesis with 80% power according to a two-side 0.05 level of significance, stratified by age, gender, baseline systolic blood pressure, prestroke modified Rankin Scale (mRS), baseline National Institute of Health stroke scale, baseline ASPECTS, time from onset to groin puncture, intravenous thrombolysis before EVT, stroke territory and stroke aetiology.

Design

Intra-arterial TNK during thrombectomy for acute stroke (BRETIS-TNK II) study is a prospective, randomised, adaptive enrichment, open-label, blinded end point, multicentre study. Eligible AIS-LVO patients are randomly assigned into the experimental group and control group with a ratio of 1:1. The experimental group will be treated with intra-arterial infusion of TNK during EVT. The control group will be treated with standard EVT.

Outcome

The primary end point is a favourable outcome, defined as an mRS score of 0–2 at 90 days. The primary safety end point is symptomatic intracranial haemorrhage within 48 hours, which is defined as an increase in the National Institutes of Health Stroke Scale score of ≥4 points as a result of the intracranial haemorrhage.

Conclusions

The results of BRETIS-TNK II will provide evidence for the efficacy and safety of intra-arterial TNK administration during EVT in AIS patients with LVO.
Quality care is equitable care: a call to action to link quality to achieving health equity within acute care surgery
Authors: Knowlton Lisa M , Zakrison Tanya , Kao Lillian S , McCrum Marta L , Agarwal, Suresh , Bruns Brandon , Joseph Kathie-Ann , Berry Cherisse
Published: May 2023

Health equity is defined as the sixth domain of healthcare quality. Understanding health disparities in acute care surgery (defined as trauma surgery, emergency general surgery and surgical critical care) is key to identifying targets that will improve outcomes and ensure delivery of high-quality care within healthcare organizations. Implementing a health equity framework within institutions such that local acute care surgeons can ensure equity is a component of quality is imperative. Recognizing this need, the AAST (American Association for the Surgery of Trauma) Diversity, Equity and Inclusion Committee convened an expert panel entitled ‘Quality Care is Equitable Care’ at the 81st annual meeting in September 2022 (Chicago, Illinois). Recommendations for introducing health equity metrics within health systems include: (1) capturing patient outcome data including patient experience data by race, ethnicity, language, sexual orientation, and gender identity; (2) ensuring cultural competency (eg, availability of language services; identifying sources of bias or inequities); (3) prioritizing health literacy; and (4) measuring disease-specific disparities such that targeted interventions are developed and implemented. A stepwise approach is outlined to include health equity as an organizational quality indicator.
New design equations for corrugated steel culverts responding to live loads
Authors: Liu Yuchen , Moore Ian D. , Hoult Neil A.
Published: May 2023

The current design provisions for corrugated steel culverts in North America consider thrust at the springline to be the critical mechanism and location, respectively, when checking capacity. However, experiments have shown that, at shallow cover depths under vehicle loading, the response of these culverts involves both bending moments and thrust forces, and the critical location in terms of capacity is not at the springline. To address this, 3D finite element modeling of the culvert was undertaken using orthotropic shell elements for the corrugated steel structure and continuum elements for a discrete volume of the surrounding soil. The results of an extensive parametric study are used to develop equations for the critical thrust and bending moment under three different vehicle loading configurations. The proposed equations are then compared to the current design code equations in terms of how well they capture the behavior of the finite element model results. The proposed equations are then used to estimate the response of physical experiments conducted in the laboratory and the field and compared to the responses from distributed strain measurements. The equations were found to provide better estimates of thrust and allow the bending moments, which are currently not considered in North American design codes, to be estimated accurately. Limitations of the proposed equations are also discussed.
Pore network modeling of capillary barrier effects: impact of pore sizes
Authors: Li Guangyao , Zhan Liangtong , Zhang Zhihong , Zhang Shuai , Feng Song
Published: May 2023

Although the working principles of capillary barrier effects (CBEs) have been well explained based on unsaturated soil mechanics, the selection of materials for engineering structures with CBEs mostly relies on designers’ experience or previously reported data, largely due to the lack of understanding of the microscale behavior of CBEs. This study explores the impact of pore sizes on CBEs based on pore network modeling. The results indicate that the pore size variability in either the fine or coarse layer has a remarkable influence on CBEs, with the latter having a dominating influence. A larger coarse-to-fine mean pore size ratio results in more effective CBEs. In addition to selecting materials with more uniform pore sizes, the coarse-to-fine mean pore size ratio is recommended to be >6 (median particle size ratio of 30) to ensure the performance of CBEs.
Density functional theory study on direct dehydrogenation of propane catalyzed by N-, O-, and P-doped graphene catalysts
Authors: Liu Dexin , Zhang Xunchao , Kang Lihua , Zhu Mingyuan
Published: May 2023

The density functional theory was used to calculate the reaction mechanism and selectivity of nonmetallic single-atom catalysts, such as N, O, and P, doped on graphene in the direct dehydrogenation of propane (PDH) . Our results show that the rate-controlling step in PDH varies with the doping atom. We also found that N, O, and P nonmetallic single-atom-doped graphene catalysts showed relatively low adsorption performance for propane and the active site was the C atom adjacent to N, O, and P, rather than the doped atom itself. Interestingly, for the O-doped graphene catalysts, which can reduce the reaction energy barrier by searching for multiple transition states, and the more transition states in the reaction path, the lower the energy barrier for the reaction rate-controlling step. Finally, the results show that the energy barrier of P-doped propane direct dehydrogenation reflecting the speed control step is the lowest, which is 44.32 kcal·mol−1, and the energy barrier of deep dehydrogenation is 53.08 kcal·mol−1; so it has good selectivity. Therefore, the P-doped graphene catalyst has a promising application as a nonmetallic catalyst for the direct PDH, which provides the possibility for the design of cheap and environmentally friendly catalysts.
Constraining the Lorentz-violating bumblebee vector field with big bang nucleosynthesis and gravitational baryogenesis
Authors: Khodadi Mohsen , Lambiase Gaetano , Sheykhi Ahmad
Published: May 2023

By assuming the cosmological principle i.e., an isotropic and homogeneous universe, we consider the cosmology of a vector-tensor theory of gravitation known as the bumblebee model. In this model a single Lorentz-violating timelike vector field with a nonzero vacuum expectation value (VEV) couples to the Ricci tensor and scalar, as well. Taking the ansatz $$B(t)\sim t^\beta $$

B

(
t
)

∼

t
β

for the time evolution of the vector field, where $$\beta $$
β
is a free parameter, we derive the relevant dynamic equations of the Universe. In particular, by employing observational data coming from the Big Bang Nucleosynthesis (BBN) and the matter–antimatter asymmetry in the baryogenesis era, we impose some constraints on the VEV of the bumblebee timelike vector field i.e., $$\xi b^2$$

ξ

b
2

, and the exponent parameter $$\beta $$
β
. The former and the latter limit the size of Lorentz violation, and the rate of the time evolution of the background Lorentz-violating bumblebee field, respectively.
Non-ambiguous and simplified quantum teleportation protocol
Authors: Mastriani Mario
Published: May 2023

In this study, a new version of the quantum teleportation protocol is presented, which does not require a Bell state measurement (BSM) module on the sender side (Alice), a unitary transform to reconstruct the teleported state on the receiver side (Bob), neither a disambiguation process through two classic bits that travel through a classic disambiguation channel located between sender and receiver. The corresponding theoretical deduction of the protocol, as well as the experimental verification of its operation for several examples of qubits through implementation on an optical table, complete the present study. Both the theoretical and experimental outcomes show a marked superiority in the performance of the new protocol over the original version, with more simplicity and lower implementation costs, and identical fidelity in its most complete version.
Noncommutative instantons in diverse dimensions
Authors: Szabo Richard J. , Tirelli Michelangelo
Published: May 2023

This is a mini-review about generalized instantons of noncommutative gauge theories in dimensions 4, 6 and 8, with emphasis on their realizations in type II string theory, their geometric interpretations, and their applications to the enumerative geometry of non-compact toric varieties.
Emergence of the Gambier equation in cosmology
Authors: Batic D. , Guha P. , Choudhury A. Ghose
Published: May 2023

In this paper, we show how the Gambier equation arises in connection to Friedmann–Lemaître–Robertson–Walker (FLRW) cosmology and a Dark Matter equation of state. Moreover, we provide a correspondence between the Friedmann equations and the Gambier equations that possess the Painlevé property in (2 + 1) dimensions. We also consider special cases of the Gambier G27 equation such as the generalized Pinney equation. For an extended FLRW model with dynamic scalar field as matter model, the Einstein equations correspond to the Milne–Pinney equation which in turn can be mapped to the parametric Gambier equation of second order.
Federated Learning for Computationally Constrained Heterogeneous Devices: A Survey
Authors: Pfeiffer Kilian , Rapp Martin , Khalili Ramin , Henkel Jörg
Published: May 2023

With an increasing number of smart devices like internet of things devices deployed in the field, offloading training of neural networks (NNs) to a central server becomes more and more infeasible. Recent efforts to improve users’ privacy have led to on-device learning emerging as an alternative. However, a model trained only on a single device, using only local data, is unlikely to reach a high accuracy. Federated learning (FL) has been introduced as a solution, offering a privacy-preserving tradeoff between communication overhead and model accuracy by sharing knowledge between devices but disclosing the devices’ private data. The applicability and the benefit of applying baseline FL are, however, limited in many relevant use cases due to the heterogeneity present in such environments. In this survey, we outline the heterogeneity challenges FL has to overcome to be widely applicable in real-world applications. We especially focus on the aspect of computation heterogeneity among the participating devices and provide a comprehensive overview of recent works on heterogeneity-aware FL. We discuss two groups: works that adapt the NN architecture and works that approach heterogeneity on a system level, covering Federated Averaging, distillation, and split learning–based approaches, as well as synchronous and asynchronous aggregation schemes.
Efficient Bi-objective SQL Optimization for Enclaved Cloud Databases with Differentially Private Padding
Authors: Chen Yaxing , Zheng Qinghua , Yan Zheng
Published: May 2023

Hardware-enabled enclaves have been applied to efficiently enforce data security and privacy protection in cloud database services. Such enclaved systems, however, are reported to suffer from I/O-size (also referred to as communication-volume)-based side-channel attacks. Albeit differentially private padding has been exploited to defend against these attacks as a principle method, it introduces a challenging bi-objective parametric query optimization (BPQO) problem and current solutions are still not satisfactory. Concretely, the goal in BPQO is to find a Pareto-optimal plan that makes a tradeoff between query performance and privacy loss; existing solutions are subjected to poor computational efficiency and high cloud resource waste. In this article, we propose a two-phase optimization algorithm called TPOA to solve the BPQO problem. TPOA incorporates two novel ideas:divide-and-conquerto separately handle parameters according to their types in optimization for dimensionality reduction;on-demand-optimizationto progressively build a set of necessary Pareto-optimal plans instead of seeking a complete set for saving resources. Besides, we introduce an acceleration mechanism in TPOA to improve its efficiency, which prunes the non-optimal candidate plans in advance. We theoretically prove the correctness of TPOA, numerically analyze its complexity, and formally give an end-to-end privacy analysis. Through a comprehensive evaluation on its efficiency by running baseline algorithms over synthetic and test-bed benchmarks, we can conclude that TPOA outperforms all benchmarked methods with an overall efficiency improvement of roughly two orders of magnitude; moreover, the acceleration mechanism speeds up TPOA by 10-200×.
Context-Aware 3D Points of Interest Detection via Spatial Attention Mechanism
Authors: Shu Zhenyu , Gao Ling , Yi Shun , Wu Fangyu , Ding Xin , Wan Ting , Xin Shiqing
Published: May 2023

Detecting points of interest is a fundamental problem in 3D shape analysis and can be beneficial to various tasks in multimedia processing. Traditional learning-based detection methods usually rely on each vertex’s geometric features to discriminate points of interest from other vertices. Observing that points of interest are related to not only geometric features on themselves but also the geometric features of surrounding vertices, we propose a novel context-aware 3D points of interest detection algorithm by adopting the spatial attention mechanism in this article. By designing a context attention module, our approach presents a novel deep neural network to simultaneously pay attention to the geometric features of vertices and their local contexts during extracting points of interest. To obtain satisfactory extraction results, our method adaptively assigns different weights to those features in a data-driven way. Extensive experimental results on SHREC 2007, SHREC 2011, and SHREC 2014 datasets show that our algorithm achieves superior performance over existing methods.
Waste-to-Wealth: Wheat-Based Porous Electrodes for Electrochemical Energy Storage Devices
Authors: Parsimehr Hamidreza , Kazemzadeh Parya , Ehsani Ali
Published: May 2023

Energy production/storage as one of the world’s leading issues has been widely studied. This significant problem can be solved by using disposable/low-cost biomass materials. Electrochemical energy storage (EES) devices including supercapacitors, rechargeable batteries, and hybrid EES devices have been extensively developed in recent years. The EES devices have been recognized as a proper answer to the energy storage problem in the world. Numerous studies have been accomplished to develop biomass-based and biochar-based EES devices to decrease environmental pollution and production costs. The most important part of the EES devices are electrodes including the cathode and anode. According to recent studies, biochar-based electrodes have considerable electrochemical properties. Wheat is one of the most important parts of the human diet. The wheat wastes have amazing electrochemical properties to be used as a precursor of electrochemical energy storage (EES) electrodes including supercapacitors, batteries, and hybrid EES devices. The benign/low-cost wheat wastes especially wheat straw and wheat husk have been used to fabricate wheat-based biochar materials. The electrochemical properties of the wheat-based biochar electrodes (cathode and anode) in the EES devices have determined that these benign/low-cost EES electrodes reduce production costs and obtain acceptable electrochemical performance and environmentally friendly procedures.
Obesity wars: may the smell be with you
Authors: López Miguel , Fernández-Real José Manuel , Tomarev Stanislav I.
Published: May 2023

Classically, the regulation of energy balance has been based on central and peripheral mechanisms sensing energy, nutrients, metabolites, and hormonal cues. Several cellular mechanisms at central level, such as hypothalamic AMP-activated protein kinase (AMPK), integrate this information to elicit counterregulatory responses that control feeding, energy expenditure, and glucose homeostasis, among other processes. Recent data have added more complexity to the homeostatic regulation of metabolism by introducing, for example, the key role of “traditional” senses and sensorial information in this complicated network. In this regard, current evidence is showing that olfaction plays a key and bidirectional role in energy homeostasis. Although nutritional status dynamically and profoundly impacts olfactory sensitivity, the sense of smell is involved in food appreciation and selection, as well as in brown adipose tissue (BAT) thermogenesis and substrate utilization, with some newly described actors, such as olfactomedin 2 (OLFM2), likely playing a major role. Thus, olfactory inputs are contributing to the regulation of both sides of the energy balance equation, namely, feeding and energy expenditure (EE), as well as whole body metabolism. Here, we will review the current knowledge and advances about the role of olfaction in the regulation of energy homeostasis.
Autophagy and mitophagy: physiological implications in kidney inflammation and diseases
Authors: Bhatia Divya , Choi Mary E.
Published: May 2023

Autophagy is a ubiquitous intracellular cytoprotective quality control program that maintains cellular homeostasis by recycling superfluous cytoplasmic components (lipid droplets, protein, or glycogen aggregates) and invading pathogens. Mitophagy is a selective form of autophagy that by recycling damaged mitochondrial material, which can extracellularly act as damage-associated molecular patterns, prevents their release. Autophagy and mitophagy are indispensable for the maintenance of kidney homeostasis and exert crucial functions during both physiological and disease conditions. Impaired autophagy and mitophagy can negatively impact the pathophysiological state and promote its progression. Autophagy helps in maintaining structural integrity of the kidney. Mitophagy-mediated mitochondrial quality control is explicitly critical for regulating cellular homeostasis in the kidney. Both autophagy and mitophagy attenuate inflammatory responses in the kidney. An accumulating body of evidence highlights that persistent kidney injury-induced oxidative stress can contribute to dysregulated autophagic and mitophagic responses and cell death. Autophagy and mitophagy also communicate with programmed cell death pathways (apoptosis and necroptosis) and play important roles in cell survival by preventing nutrient deprivation and regulating oxidative stress. Autophagy and mitophagy are activated in the kidney after acute injury. However, their aberrant hyperactivation can be deleterious and cause tissue damage. The findings on the functions of autophagy and mitophagy in various models of chronic kidney disease are heterogeneous and cell type- and context-specific dependent. In this review, we discuss the roles of autophagy and mitophagy in the kidney in regulating inflammatory responses and during various pathological manifestations.
Chronic treatment with IL-25 increases renal M2 macrophages and reduces renal injury in obese Dahl salt-sensitive rats during the prepubescent stage
Authors: Poudel Bibek , Ekperikpe Ubong S. , Mandal Sautan , Wilson Gregory E. , Shields Corbin A. , Cornelius Denise C. , Williams Jan M.
Published: May 2023

For the past few decades, immune cells and inflammatory cytokines have been demonstrated to play an important role in the development of renal disease. The present study provides strong evidence that interleukin-25 slows the early progression of renal injury in obese Dahl salt-sensitive rats before puberty by increasing systemic anti-inflammatory cytokines and renal M2a macrophages.
Endothelial mechanical stretch regulates the immunological synapse interface of renal endothelial cells in a sex-dependent manner
Authors: Colvert C. Alex , Hawkins Kennedy P. , Semenikhina Marharyta , Stefanenko Mariia , Pavlykivska Olesia , Oates Jim C. , DeLeon-Pennell Kristine Y. , Palygin Oleg , Van Beusecum Justin P.
Published: May 2023

Endothelial cells contribute to the development of renal inflammation and have the unique ability to express antigen presentation proteins. Whether increased endothelial mechanical stretch regulates immunological synapse interface proteins remains unknown. We found that antigen presentation proteins and costimulatory proteins on renal endothelial cells are modulated by mechanical stretch in a sex-dependent manner. Our data provide novel insights into the sex-dependent ability of renal endothelial cells to present antigens in response to endothelial mechanical stimuli.
Male Akita mice develop signs of bladder underactivity independent of NLRP3 as a result of a decrease in neurotransmitter release from efferent neurons
Authors: Hughes Francis M. , Allkanjari Armand , Odom Michael R. , Mulcrone Jack E. , Jin Huixia , Purves J. Todd
Published: May 2023

In this study, we show that diabetic bladder dysfunction (the most common diabetic complication) manifests through different mechanisms that may be related to severity of hyperglycemia and/or sex. Male Akita mice, which have severe hyperglycemia, develop bladder underactivity as a result of a decrease in efferent neurotransmitter release that is independent of inflammation. This contrasts with females, who have milder hyperglycemia, where diabetic bladder dysfunction progresses from overactivity to underactivity in an inflammation-dependent manner.
Influence of internal muscle properties on muscle shape change and gearing in the human gastrocnemii
Authors: Kelp Nicole Y. , Clemente Christofer J. , Tucker Kylie , Hug François , Pinel Sabrina , Dick Taylor J. M.
Published: May 2023

Here, we measured internal muscle properties in vivo to determine their influence on the varying shape change and gearing behaviors in the synergistic gastrocnemii muscles. These relationships have previously only been hypothesized or examined within isolated muscles during supramaximal contractions. Our results contribute to a more comprehensive understanding of the factors that influence a muscle’s mechanical response to force with implications for preventing or treating muscle deficits associated with aging, disease, and disuse.