bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical student motivation in specialised contexts
Authors: Frumm Stacey M. , Brondfield Sam
Published: December 2023

Purpose

During their clinical years, medical students rotate in diverse environments, each with unique factors motivating or demotivating learning. Student motivation to learn in specialised clinical settings has not been robustly described. One framework to understand motivation to learn is self‐determination theory (SDT), which posits that intrinsic motivation requires fulfilment of three innate psychological needs: competence, relatedness and autonomy. Referencing SDT, the authors aimed to understand factors influencing student motivation to learn in the specialised context of internal medicine (IM) subspecialty consult services, with the goal of optimising teaching and learning during these experiences.

Method

Focus groups were conducted with 12 fourth‐year medical students who had completed at least one inpatient IM subspecialty consult elective at the University of California, San Francisco, in 2020–2021. Students discussed factors that promoted and hindered their learning and motivation. The authors performed abductive thematic analysis using SDT as a sensitising framework.

Results

Three themes were identified and provided insight into how student motivation to learn can be supported: teaching at the appropriate level; integration into the team and workflow; and self‐directed learning and career exploration. These themes were overlaid onto the needs of SDT, demonstrating that, in specialised clinical contexts, fulfilment of the needs is interconnected.

Conclusion

This study provided insight into how students' innate needs can be satisfied in the learning environment of IM subspecialty consult electives, thereby promoting students' intrinsic motivation. Based on insights from the study, the authors offer recommendations for how educators can optimise student motivation to learn.
Serotype and anti‐microbial resistance trends among bovine Salmonella isolates from samples submitted to a veterinary diagnostic laboratory in central New York, 2007–2021
Authors: Craig Maya J. , Cummings Kevin J. , Aprea Melissa S. , Franklin‐Guild Rebecca J. , Altier Craig
Published: December 2023

Aims

Salmonella enterica is a leading cause of acute enteritis in people, and dairy cattle are an important reservoir of this pathogen. The objective of this study was to analyse serotype and anti‐microbial resistance trends of Salmonella isolated from dairy cattle in the United States between 2007 and 2021.

Methods and Results

We collected data for bovine Salmonella isolates obtained from samples submitted to Cornell University's Animal Health Diagnostic Center (AHDC). We analysed 5114 isolates for serotype trends, and a subset of 2521 isolates tested for anti‐microbial susceptibility were analysed for resistance trends. The most frequently identified serotypes were Salmonella Cerro, Dublin, Typhimurium, Montevideo, 4,[5],12:i:‐, and Newport. Among these serotypes, a Cochran–Armitage trend test determined there was a significant increase in the proportion of isolates serotyped as Salmonella Dublin (p < 0.0001) and Montevideo (p < 0.0001) over time. There was a significant decrease in the proportion of isolates serotyped as Salmonella Cerro (p < 0.0001), Typhimurium (p < 0.0001), and Newport (p < 0.0001). For the anti‐microbial resistance (AMR) analysis, we found an overall increase in the proportion of multi‐drug‐resistant isolates over time (p = 0.009). There was a significant increase in the proportion of isolates resistant to ampicillin (p = 0.007), florfenicol (p = 0.0002), and ceftiofur (p < 0.0001) and a marginal increase in resistance to enrofloxacin (p = 0.05). There was a significant decrease in the proportion of isolates resistant to spectinomycin (p = 0.0002), trimethoprim/sulphamethoxazole (p = 0.01), sulphadimethoxine (p = 0.003), neomycin (p < 0.0001), and gentamicin (p = 0.0002).

Conclusions

Our results provide evidence of an increase in resistance to key anti‐microbial agents, although the observed trends were driven by the sharp increase in the proportion of Salmonella Dublin isolates over time.
Review of Error Correction in 2D Shingled Magnetic Detection
Authors: M.B Abdulrazaq  , Abdullahi Hassan , B.O Sadiq  , H. Zaharuddeen  , U. Abubakar  , M.D Almustapha
Published: December 2023

This paper presents the review of error correction in 2D shingled magnetic detection. Shingled magnetic recording is one of the techniques proposed in literature for increasing the storage density of magnetic hard disk drive (HDD) due to the number of overwhelming advantages of shingled writing. The success of this technique lies with a proper signal processing and data update approach. In this paper, shingled magnetic recording and two-dimensional magnetic recording has been studied and the current researches done in the two areas has been reviewed with emphasis on elimination of inter-track-interference and inter-symbol-interference. In the reviewed articles studied, a summary was provided on each article depicting the technique adopted and the performance metrics of each of the articles. Summary was provided at the end of the article on the techniques reviewed based on the existing body of knowledge.
Genetic Algorithm for Solving Mobile Robot Scheduling Problem in Flexible Manufacturing Environment
Authors: Samsuria Erlianasha , Mahmud Mohd Saiful Azimi , Abdul Wahab Norhaliza , Mohamad Shukri Zainal Abidin  , Salinda Buyamin
Published: December 2023

The scheduling genuinely a complex process, aimed at optimizing operational activities in pursuit of one or more objectives by leveraging production data which may include previous schedules. The scheduling problem in Flexible Manufacturing System (FMS) is commonly categorized as Nondeterministic Polynomial (NP)-hard combinatorial optimization problems and it remains as an endure problem to industrial practitioners and researchers. As part of real production scheduling, once one task is finished processing on a machine, transportation equipment such as mobile robot transports the completed task to the next machine. The problem of scheduling mobile robot in FMS pertains to the task allocation process for the robots, considering the transportation costs and the time spent to complete all operations. In recent years, Genetic Algorithm (GA) has been a remarkably effective search algorithm for solving a wide range of scheduling problems in a manner that achieves near-optimal solutions. This paper presents the metaheuristic techniques, specifically genetic algorithm, to address the NP-hard scheduling problem of two identical mobile robots in Job-Shop FMS environment. The algorithm is developed with the aim of finding feasible solutions to the integrated problem by minimizing the amount of time it takes to finish all tasks, commonly referred to as makespan. The performance of GA is evaluated with some numerical experiments which is executed via Matlab software. The scheduling results shows that the developed GA able to obtained the near-optimal solution of minimal makespan and converge within a short period of time.
Mosaic trisomy 5 in amniotic fluid in a live fetus with Ebstein anomaly and complete trisomy 5 in chorionic villus sampling
Authors: Andrade Ana , Cunha Ana , Teles Natália , Guedes-Martins Luís
Published: December 2023

Complete trisomy 5 is a rare and lethal abnormality. Mosaic trisomy 5 presents in various phenotypes, ranging from a clinically normal fetus to fetuses presenting uterine growth restriction, congenital heart anomalies, multiple dysmorphic features and psychomotor development abnormalities. Although rare, there are cases of a normal psychomotor development regardless of the associated low fetal growth frequently associated with mosaic trisomy 5. This is the first case report to date of a live fetus with complete trisomy 5 reported in chorionic villus sampling and mosaic trisomy 5 in amniotic fluid with a concomitant Ebstein anomaly. Diagnosis of mosaic trisomy 5 represents a challenge for the clinical team and patients, as the information regarding this syndrome is scarce and based mostly on case reports of liveborns, which may introduce a selection bias when counselling the parents.
Diabetic striatopathy in type 1 diabetes mellitus: a rare conundrum
Authors: Karthik Vijayakumar , Jabbar Puthiyaveetil Khadar , Nair Abilash , Basheer Shameer
Published: December 2023

Diabetic striatopathy is a clinicoradiological syndrome characterised by acute hyperkinetic movement disorder in the form of hemichorea-hemiballism with basal ganglia abnormalities in neuroimaging. The hallmark basal ganglia abnormalities appear as hyperdensities in CT brain and hyperintensities in MRI brain, which could mislead the clinician towards an erroneous diagnosis of cerebral haemorrhage. It is classically described in elderly patients with type 2 diabetes mellitus, and its occurrence in type 1 diabetes is extremely rare. This case report entails the clinical details of a young man in his 20s with type 1 diabetes mellitus who had uncontrolled blood glucose levels and presented with a recent onset of abnormal movements in his left upper and lower limbs. The semiology, biochemistry and radiological investigation findings and treatment are detailed. A clear understanding of the condition could lead to an early diagnosis, spare the patient unnecessary investigations and improve treatment outcomes.
Fetal survival in pregnancy complicated by massive subchorionic thrombohaematoma
Authors: Carlson Karen , Hergenrader Alexandra
Published: December 2023

This case involves a pregnant patient in her late 20s whose pregnancy was complicated by placentamegaly and early-onset, severe fetal growth restriction (FGR). Investigations ruled out genetic and infectious aetiologies. The pregnancy eventually was further complicated by abnormal umbilical artery blood flow. Shared decision-making with the patient and obstetrical team led to delivery by caesarean section at 28 weeks and 4 days. The baby was admitted to the neonatal intensive care unit but, overall, did well. Placental pathology revealed a massive subchorionic thrombohaematoma (MST). This case highlights the importance of early detection, evaluation and management of pregnancies complicated by severe FGR as well as the significance of shared decision-making with patients. We aim to increase the awareness of MST in the differential diagnosis of placentamegaly, as this finding in combination with early and severe FGR has been shown to be a poor prognostic factor for the fetus.
Avoidance of healthcare service use and correlates among HIV-positive patients in Vietnam: a cross-sectional study
Authors: Nguyen Huong Lan Thi , Bui Thu Minh , Dam Vu Anh Trong , Nguyen Tham Thi , Nguyen Hien Thu , Zeng Ga Mei , Bradley Don , Nguyen Quang N , Ngo Toan Van , Latkin Carl A , Ho Roger CM , Ho Cyrus SH
Published: December 2023

Objective

The prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients’ avoidance of healthcare services and its correlates.

Design

A cross-sectional study.

Setting

The secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi.

Methods

Simple random sampling was used to identify 495 eligible patients. Two-tailed χ2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed.

Primary and secondary outcome measures

The main study outcome was the patients’ healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients’ usage of health services was also determined based on the collected data using structured questionnaires.

Results

Nearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61).

Conclusions

Our study’s findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam.

Trial registration number

Thai Clinical Trials Registry TCTR20220928003.
Attitude of cardiac surgery nurses on kinesiophobia management: a qualitative study
Authors: Wang YuChen , Chen YuHong , Zhang XiaoMin , Liu SiYu
Published: December 2023

Objectives

This study aimed to investigate the knowledge, attitudes and practical experiences of cardiac surgery nurses regarding kinesiophobia management during early mobilisation.

Design

Using a descriptive qualitative research method, 21 cardiac surgery nurses participated in this study from October 2022 to January 2023, and the interview data were analysed using the Colaizzi 7-step analysis method.

Setting

Data were collected through in-depth face-to-face or online interviews in a tertiary hospital located in Nanjing, China.

Participants

21 cardiac surgery nurses were interviewed from October 2022 to January 2023.

Results

Two themes were summarised: knowledge, attitude and practice of nurses (high recognition and low participation; low knowledge reserve; low willingness); the promotion and essential elements of kinesiophobia management (efficient health education model; stable medical staff–family caregiver collaboration; simplified clinical protocol; specialist nursing team; clarify the multidisciplinary division of labour).

Conclusion

The management of kinesiophobia in patients undergoing cardiac surgery is currently in the developmental phase. It is advisable to give due consideration to emotional support and cognitive training for medical staff. In addition, a workable management plan, consistent with clinical practice, should be formulated through multidisciplinary and medical staff–family caregiver collaboration to optimise patient outcomes.
Comparative efficacy of acupuncture-related therapy for postmenopausal osteoporosis: protocol for Bayesian network meta-analysis
Authors: Xu Tiantian , Deng Bing , Lin Shen , Wang Hongjin , Xu Yunxiang , Chen Guizhen
Published: December 2023

Introduction

The review aims to conduct the first network meta-analysis to comprehensively evaluate the application of multiple acupuncture techniques in patients with postmenopausal osteoporosis, ranking the best acupuncture treatment and providing a reference for clinical treatment extensively.

Methods and analysis

Randomised controlled trials of different acupuncture-related therapies for postmenopausal osteoporosis will be searched in the following databases from 1 January 2002 to 31 December 2022, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP Database, Wanfang Database and China Biomedical Literature Database. Overall, clinical efficacy rate, bone mineral density and a Visual Analogue Scale score are used as the primary outcome indicators. In addition, the secondary outcome indicator is adverse reactions. The entire screening process will be conducted by two independent investigators; meanwhile, Stata (V.14.0) and RevMan (V.5.4) will be used to conduct the network meta-analysis. If the data are permissible and feasible, we will also perform meta-regression and subgroup analyses to address the underlying causes of data inconsistency and heterogeneity in the statistical analyses. Besides, to improve the credibility of this network meta-analysis, we will evaluate the quality of evidence in this research according to the GRADE assessment.

Ethics and dissemination

Ethics approval is not required for network meta-analyses, which do not involve animals’ or people’s welfare. The results of this network meta-analysis will be submitted to a recognised journal for publication.

PROSPERO registration number

CRD42023401003.
Quality improvement initiative to improve communication domains of patient satisfaction in a regional community hospital with Six Sigma methodology
Authors: Carsten Brittan F , Bhandari Pawan , Fortney Benjamin J , Wilmes Danielle S , Nelson Cassandra M , Brien Amy L , Walth Rachel M , Anil Gokhan
Published: December 2023

Background

Communication gaps, whether incomplete or fragmented communication, have been the cause of many disasters in human civilisation. Coordination of healthcare is directly related to proper communication and handoffs among multidisciplinary teams throughout multiple shifts during a patient’s hospitalisation.

Local problem

Patient surveys and direct patient feedback at Mayo Clinic Health System in Mankato, Minnesota, indicated that patient communication with physicians and nurses had declined in 2017 and 2018. Viewing this as an opportunity for improvement, our leadership initiated several changes to increase physician and nurse communication with patients, which resulted in no notable improvements.

Methods

A systematic quality improvement approach was implemented by using Six Sigma methodology. Stakeholders from multidisciplinary teams were assembled as the project team. The five steps of Six Sigma methodology (Define, Measure, Analyse, Improve and Control) were followed to create a quality improvement intervention.

Intervention

We developed a standardised and easy-to-use bedside team rounding tool to improve patient communication with physicians and nurses.

Results

Postintervention patient satisfaction top-box scores exceeded target improvements for both physician (from 78.5% to 82.0%, p<0.01) and nurse (from 80.5% to 83.1%, p=0.04) communication domains. Physicians had a 33-point increase in percentile rank (from 41st to 74th percentile rank), and nurses had a 25-point increase in percentile rank (from 59th to 84th percentile rank). This increase in communication ranked our institution at the top of national benchmark organisations.

Conclusions

Overwhelmingly positive patient feedback was achieved, and postintervention employee satisfaction was primarily positive when compared with preintervention satisfaction.
Designing a Behaviour Change Wheel guided implementation strategy for a hypoxaemic respiratory failure and ARDS care pathway that targets barriers
Authors: Parhar Ken Kuljit S , Knight Gwen E , Soo Andrea , Bagshaw Sean M , Zuege Danny J , Niven Daniel J , Fiest Kirsten M , Stelfox Henry T
Published: December 2023

Background

A significant gap exists between ideal evidence-based practice and real-world application of evidence-informed therapies for patients with hypoxaemic respiratory failure (HRF) and acute respiratory distress syndrome (ARDS). Pathways can improve the quality of care provided by helping integrate and organise the use of evidence informed practices, but barriers exist that can influence their adoption and successful implementation. We sought to identify barriers to the implementation of a best practice care pathway for HRF and ARDS and design an implementation science-based strategy targeting these barriers that is tailored to the critical care setting.

Methods

The intervention assessed was a previously described multidisciplinary, evidence-based, stakeholder-informed, integrated care pathway for HRF and ARDS. A survey questionnaire (12 open text questions) was administered to intensive care unit (ICU) clinicians (physicians, nurses, respiratory therapists) in 17 adult ICUs across Alberta. The Behaviour Change Wheel, capability, opportunity, motivation - behaviour components, and Theoretical Domains Framework (TDF) were used to perform qualitative analysis on open text responses to identify barriers to the use of the pathway. Behaviour change technique (BCT) taxonomy, and Affordability, Practicality, Effectiveness and cost-effectiveness, Acceptability, Side effects and safety and Equity (APEASE) criteria were used to design an implementation science-based strategy specific to the critical care context.

Results

Survey responses (692) resulted in 16 belief statements and 9 themes with 9 relevant TDF domains. Differences in responses between clinician professional group and hospital setting were common. Based on intervention functions linked to each belief statement and its relevant TDF domain, 26 candidate BCTs were identified and evaluated using APEASE criteria. 23 BCTs were selected and grouped to form 8 key components of a final strategy: Audit and feedback, education, training, clinical decision support, site champions, reminders, implementation support and empowerment. The final strategy was described using the template for intervention description and replication framework.

Conclusions

Barriers to a best practice care pathway were identified and were amenable to the design of an implementation science-based mitigation strategy. Future work will evaluate the ability of this strategy to improve quality of care by assessing clinician behaviour change via better adherence to evidence-based care.
Association between single leg hop tests and patient reported outcome measures and patellar instability in patients with recurrent patellar dislocations
Authors: Nilsgård Tina Løkken , Øiestad Britt Elin , Randsborg Per-Henrik , Årøen Asbjørn , Straume-Næsheim Truls Martin
Published: December 2023

Objectives

To assess the associations between the single leg hop tests at two premises; baseline and the change after 12 months, and change in patient reported outcome measures and persistent instability after 12 months in patients with recurrent lateral patellar dislocation (RLPD).

Methods

61 RLPD patients aged 12–30 with a mean (±SD) of 19.2 (±5.3) were assessed at baseline, and at 12 months after treatment with either active rehabilitation alone, or medial patellofemoral ligament reconstruction and active rehabilitation. Single leg hop for distance, triple hop for distance, crossover hop for distance and 6-metre timed hop were performed for both legs, and the Limb Symmetry Index (LSI) was calculated. Persistent patellar instability was self-reported as ‘Yes’ or ‘No’ at 12-month follow-up. Knee function in sport and recreational activities and knee-related quality of life were assessed at baseline and 12 months follow-up using the Knee injury and Osteoarthritis Outcome Score (KOOS).

Results

LSI for the baseline single leg hop for distance and the triple hop for distance was significantly associated with persistent patellar instability at 12 months follow-up with an OR of 0.94 (95% CI 0.88 to 0.99) and OR of 0.91 (95% CI 0.84 to 0.99), respectively. No other statistically significant associations were detected.

Conclusion

Individuals with higher LSI values for the single leg hop for distance and triple hop for distance conducted at baseline had lower odds for persistent patellar instability at 12 months follow-up. Clinicians can use results from these hop tests to assess the risk of future recurrent patellar instability prior to treatment.

Study design

Retrospective cohort study.

Trial registration number

NCT02263807.
Cognitive trajectory in the first year after first-ever ischaemic stroke in young adults: the ODYSSEY study
Authors: Schellekens Mijntje M I , Springer Ravi C S , Boot Esther M , Verhoeven Jamie I , Ekker Merel S , van Alebeek Mayte E , Brouwers Paul J A M , Arntz Renate M , van Dijk Gert W , Gons Rob A R , van Uden Inge W M , den Heijer Tom , van Tuijl Julia H , de Laat Karlijn F , van Norden Anouk G W , Vermeer Sarah E , van Zagten Marian S G , Van Oostenbrugge Robert J , Wermer Marieke J H , Nederkoorn Paul J , van Rooij Frank G , van den Wijngaard Ido R , de Kort Paul L M , De Leeuw Frank-Erik , Kessels Roy P C , Tuladhar Anil M
Published: December 2023

Background

Limited data exists on cognitive recovery in young stroke patients. We aimed to investigate the longitudinal course of cognitive performance during the first year after stroke at young age and identify predictors for cognitive recovery.

Methods

We conducted a multicentre prospective cohort study between 2013 and 2021, enrolling patients aged 18–49 years with first-ever ischaemic stroke. Cognitive assessments were performed within 6 months and after 1 year following the index event, covering seven cognitive domains. Composite Z-scores using normative data determined cognitive impairment (Z-score<−1.5). A Reliable Change Index (RCI) assessed cognitive recovery (RCI>1.96) or decline (RCI<−1.96).

Results

393 patients (median age 44.3 years, IQR 38.4–47.2) completed cognitive assessments with a median time interval of 403 days (IQR 364–474) between assessments. Based on RCI, a similar proportion of patients showed improvement and decline in each cognitive domain, while the majority exhibited no cognitive change. Among cognitively impaired patients at baseline, improvements were observed in processing speed (23.1%), visuoconstruction (40.1%) and executive functioning (20.0%). Younger age was associated with better cognitive recovery in visuoconstruction, and larger lesion volume was related to cognitive recovery in processing speed. No other predictors for cognitive recovery were identified.

Conclusions

Cognitive impairment remains prevalent in young stroke even 1 year after the event. Most patients showed no cognitive change, however, recovery may have occurred in the early weeks after stroke, which was not assessed in our study. Among initially cognitively impaired patients, cognitive recovery is observed in processing speed, visuoconstruction and executive functioning. It is still not possible to predict cognitive recovery in individual patients.
Association between servant leadership and nurses’ turnover intention: evidence from Jordan
Authors: Alolayyan Main Naser , Nusairat Farid T , Abualhuda Serien A , Azar Suad
Published: December 2023

Background

Nurses’ turnover has remained a concern in the healthcare sector worldwide. Nurse managers should adopt appropriate leadership styles that promote a positive working environment. The literature revealed that effective leadership styles have lower turnover rates and higher job satisfaction among nurses in healthcare settings.

Aim

This research aims to investigate whether a direct association exists between servant leadership and nurse turnover in public and private hospitals. While conventional leadership prioritises organisational success, servant leadership works on employee empowerment, growth and engagement, to secure success and trust among healthcare workers.

Method

A quantitative, cross-sectional study has been performed among 400 nurses from private and public hospitals in the northern parts of Jordan. A self-administered written survey was administered to those nurses in their departments. Structural equation modeling (SEM) using was used to analyse the data.

Results

Findings revealed that servant leadership had a negative direct impact on nurse turnover intention. Servant leadership prioritises employee empowerment of nurses in their workplaces.

Conclusion

Healthcare agencies and healthcare professional organisations could use the study findings to understand better what influences nurses’ decisions and behaviours and what causes them to resign. Further findings of this study may assist nurse managers in developing appropriate retention strategies and reducing the likelihood of nurses resigning.
Ultrasound estimates of the epidural depth in the paramedian sagittal oblique and transverse median planes: the correlation between estimated and actual depth to the epidural space in children with scoliosis
Authors: Choi Yong Seon , Jang Jaewon , Kim Ha Yan , Lee Bora , Kim Eun Jung , Yoon Hei Jin , Lee Jongyun , Kim Hye Jin
Published: December 2023

Introduction

The present study aimed to compare the correlation and agreement of epidural depth estimation using ultrasound in the paramedian sagittal oblique (PSO) versus the transverse median (TM) plane relative to the actual epidural depth observed during midline epidural punctures in children with scoliosis.

Methods

In this prospective observational study, we enrolled 55 children aged 3–14 years with thoracolumbar scoliosis (Cobb angle >10°) requesting postoperative epidural analgesia. Ultrasound imaging was performed to estimate the distance from the skin to the epidural space in the bilateral PSO and TM planes. An anesthesiologist performed midline epidural puncture and measured the actual epidural depth from the skin to the epidural space. The correlation and degree of agreement between the ultrasound-estimated and actual epidural depths were investigated using Pearson’s and concordance correlation coefficients. The image quality of the ligamentum flavum and posterior dura mater was compared.

Results

In the PSO view, where the larger of the two measurements from both sides was used, both Pearson’s and concordance correlation coefficients for comparing the actual epidural and ultrasound-estimated depths were significantly higher than those in the TM view (0.964 vs 0.930, p value=0.002; 0.952 vs 0.892, p value=0.004, respectively). The ligamentum flavum-posterior dura mater unit was more easily distinguished in the PSO view than in the TM view (72.7% vs 38.2%, p value<0.001).

Conclusions

The PSO view can be a reliable guide to facilitate epidural puncture in children with scoliosis with better visualization.

Trial registration number

NCT04877964.
Yoga versus iPad active control for fatigue in paediatric cancer therapy: a randomised controlled trial
Authors: Schechter Tal , Tardif-Theriault Cassandra , Culos-Reed Nicole , Lewis Victor , Orsey Andrea , Diorio Caroline , Tomlinson George A , Sung Lillian
Published: December 2023

Objectives

The primary objective was to determine if individualised yoga for hospitalised children receiving intensive chemotherapy was associated with less fatigue using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS) compared with iPad control.

Methods

This was a multicentre randomised controlled trial of individualised yoga in paediatric patients aged 8–18 years who were inpatients receiving intensive chemotherapy for leukaemia, lymphoma or haematopoietic cell transplantation. Participants were randomised to yoga or iPad groups; allocated programme was delivered individually by trained yoga instructors 5 days/week for 21 days. The primary outcome was day 21 guardian-reported general fatigue using the PedsQL MFS. Secondary outcomes included day 21 PedsQL sleep/rest and cognitive fatigue, Fatigue Scale and PedsQL Acute Cancer Module, and systemic opioid administration.

Results

The study was closed early for poor accrual when 125/210 planned participants had been enrolled and randomised to yoga (n=62) or iPad (n=63). Guardian-reported PedsQL MFS general fatigue scores on day 21 were not significantly different between groups (adjusted difference 7.2, 95% CI −2.6 to 16.9) in favour of yoga. However, day 21 cognitive fatigue (adjusted difference 9.0, 95% CI 0.9 to 17.1), cognitive problems (adjusted difference 11.2, 95% CI 3.5 to 19.0) and communication (adjusted difference 10.6, 95% CI 0.8 to 20.4) were significantly better in the yoga compared with the iPad group. There were no significant differences in the other secondary outcomes including PedsQL sleep/rest fatigue (adjusted difference 4.9, 95% CI −3.5 to 13.3).

Conclusions

The effect of individualised yoga on general fatigue is uncertain in paediatric patients receiving intensive chemotherapy. However, yoga significantly improved cognitive fatigue and cognitive problems.

Trial registration number

NCT02134782.
Commercial tobacco endgame themes in the Australian media from 2000 to 2021
Authors: Perusco Andrew , Holland Alice , Maddox Raglan , Morphett Kylie , Heris Christina , Gartner Coral E
Published: December 2023

Background

Conventional tobacco control is dominated by demand-reduction measures, whereas commercial tobacco endgame (endgame) policies address the key drivers that maintain the tobacco epidemic, such as Tobacco Industry interference in policymaking, the addictiveness of commercial tobacco products and their widespread availability via retail outlets. While Australia has been a pioneer in tobacco control, Australian Governments are yet to commit to endgame policies. The media play an important role reflecting and influencing public opinion and policymaker positions, and can help set the agenda for policy innovation.

Method

Media articles mentioning tobacco endgame goals and policies published between 2000 and 2021 were identified by searchingFactivaandGoogle(News). We used reflexive thematic analysis (RTA) to identify themes in the articles, supported by content analysis, to describe elements of the data and sentiment analysis to categorise the article sentiment. A deductive–inductive approach was applied in the RTA, coding text from the articles against predefined codes, while also generating new codes where novel themes were identified. Codes were then grouped and summarised.

Results

One hundred and ninety-three articles were included for analysis. The media discourse focused on three policies: tobacco-free generation; banning or phasing out retail supply of tobacco; and mandating a very low nicotine content standard for cigarettes. A broad range of themes in the articles supported endgame policies, including the large health toll from tobacco, government responsibility to act and the total social costs far outweighing any economic benefit from the tobacco market. Opposing themes included the purported failures of ‘prohibition’, illicit trade, ‘nanny statism’ and impact on retail trade. Equity themes were scarce. The benefits of a smoke-free society were described at a societal level, rather than the personal benefits for individuals.

Conclusion

Media articles on the tobacco endgame in Australia generally contained positive sentiment about endgame policies. When engaging with the media, endgame advocates should be aware of, and ready to counter, opposing themes such as the purported failures of ‘prohibition’, ‘nanny state’ rhetoric or a growth in illicit tobacco trade.
Impact of Allee Effect on the Spatio-Temporal Behavior of a Diffusive Epidemic Model in Heterogenous Environment
Authors: Acharya Sattwika , Upadhyay Ranjit Kumar , Mondal Bapin
Published: December 2023

In the current study, we have formulated an [Formula: see text] epidemic model incorporating the influence of Allee effect on the dynamics of the model system in space and time. During the spread of the disease, inhibition among the susceptible and infected individuals is seen, which is measured using the Crowley–Martin type incidence function. Extensive analysis explores the system’s stability and different bifurcation scenarios, including Hopf, saddle-node, transcritical, and Bogdanov–Takens. We also examine how these bifurcations react to parameter variations within the proposed model. The temporal model has further been extended to a spatial one to investigate the impact of the Allee effect on the formation of patterns for different values of the cross-diffusion coefficient. The well-posedness of the stationary solution and the global stability of the spatial system are derived. Also, the Turing instability, Hopf, and Turing bifurcation are calculated considering the transmission rate as critical parameter. In a heterogeneous environment, the spatial distribution of the susceptible population shows a complex structure with flat tabular surface and a few almost circular holes in surface plots for both strong and weak Allee effects. To further explore the role of Allee effect on pattern development for various cross-diffusion coefficient values, the temporal model has been spatially extended. Additionally, the transmission rate is taken into account while calculating the Turing instability and Hopf and Turing bifurcations. We ran numerical simulations to validate our analytical results for both spatial and nonspatial models. Our current model system can explain the recent occurrence of respiratory distress syndrome in endangered penguin species.
Impact of Concentration on the Hydrothermally Synthesized NiO Nanosheets’ Photocatalytic Activity
Authors: Jasim Haneen Ali , Fahad Nisreen Khalid , Ali Sahar Mohammed , Ahmed Baida M. , Dakhil Osama Abdul Azeez
Published: December 2023

In this research, nickel oxide (NiO) peculiar nanosheets with a thickness of less than 50 nm were produced via a low-cost, one-step, safe hydrothermal process. The reaction was conducted with two concentrations of Ni (NO[Formula: see text]6H2O (0.01 and 0.03) at 120[Formula: see text]C for 3 h. Methylene Blue (MB) dye was used to examine the photoactivity of NiO nanosheet films under sunlight. The prepared NiO nanosheet films were evaluated using XRD, FE-SEM, EDX and UV-visible techniques. Accordingly, (FE-SEM) images confirm that the films synthesized by a hydrothermal method were flower-like nanosheets with a diameter of 33.4–52.7 nm, and the thickness of the NiO film is about 3.629 [Formula: see text]m. The average particle size and crystalline structures were estimated using XRD Analysis. However, both films were then exposed to direct sunshine for 80 min. The respective photocatalytic efficiencies of films were calculated to be 85% and 88%. The effectiveness of the photocatalytic degradation for eliminating Methylene Blue (MB) depends on the concentration, proving that the efficiency can be improved by increasing the concentration.
Estimation of Damage Levels in Masonry Structures Following Earthquake Impact Using Deep Learning-based Segmentation Method
Authors: Hacıefendioğlu Kemal , Özgan Korhan , Adanur Süleyman , Altunışık Ahmet Can , Demirer Betül , Günaydın Murat
Published: December 2023

This study presents an innovative and automated methodology for assessing damage levels in masonry structures following earthquakes, utilizing a deep learning-based segmentation approach. Central to this research is the use of a U-Net convolutional neural network (CNN) model, which facilitates automated damage detection with a focus on smartphone-enabled, real-time analysis. A key feature of this method is a novel damage index (DI), calculated by normalizing the surface area of detected damages against the total area of the structure, as viewed from the same perspective. The findings indicate a marked improvement in damage detection capabilities, with the U-Net model achieving a precision of approximately 92% and a recall of around 93%. These figures highlight the model’s proficiency in accurately identifying damaged areas and reducing false positives, an essential aspect of post-earthquake evaluations. While this methodology represents a significant step forward in enabling rapid and cost-effective post-earthquake inspections, it is accompanied by certain constraints, particularly in terms of dataset diversity and computational requirements. Despite these challenges, the high accuracy and effectiveness of the damage detection and indexing process demonstrate strong potential for future applications in structural health monitoring, especially in scenarios that demand prompt action and are limited by resources.
Dynamic Bi-layer Graph Learning for Context-aware Sequential Recommendation
Authors: Zhou Xiangmin , Lumbantoruan Rosni , Ren Yongli , Chen Lei , Yang Xiaochun , Shao Jie
Published: December 2023

Sequential recommendations have received great attention in recent years due to their wide application in e-commerce, trip planning, and online education. Contexts reveal the intention of a user in a transaction such as consuming or purchasing an item, and highly affect her behaviour. However, existing techniques cannot fully capture the context-sensitive and dynamic sequential user behaviours for effective and efficient sequential recommendation. To address this limitation, we propose a novel Dynamic Bi-layer Graph learning (DBIG)-based framework for sequential recommendation, which learns the sequence dynamics of user behaviours and contexts. Specifically, we first propose a context graph to identify the relevant contexts to a target user. Then, we propose a transaction context graph that predicts the probability of a transaction happening under certain contexts. In addition, we apply BERT (Bidirectional Encoder Representations from Transformers) to our graph embedding for understanding the user sequential behaviours in bidirectional ways and generating recommendations. Finally, we propose a cluster-structure-based algorithm, which incrementally maintains the DBIG model and BERT over dynamic transaction updates. We evaluate our DBIG-based framework by conducting extensive experiments over five public datasets. The quantitative results demonstrate the superiority of our approach in terms of effectiveness and efficiency.
Towards Mental Health Analysis in Social Media for Low-resourced Languages
Authors: Garg Muskan
Published: December 2023

The surge in internet use for expression of personal thoughts and beliefs has made it increasingly feasible for the social Natural Language Processing (NLP) research community to find and validate associations betweensocial media postsandmental health status. Cross-sectional and longitudinal studies of low-resourced social media data bring to fore the importance of real-time responsible Artificial Intelligence (AI) models for mental health analysis in native languages. Aiming at classifying research for social computing and tracking advances in the development of learning-based models, we propose a comprehensive survey onmental health analysis for social mediaand posit the need of analyzinglow-resourced social media data for mental health. We first classify three components for computing on social media as:SM- data mining/natural language processing onsocial media,IA-integrated applicationswith social media data and user-network modeling, andNM- user andnetwork modelingon social networks. To this end, we posit the need of mental health analysis in different languages of East Asia (e.g., Chinese, Japanese, Korean), South Asia (Hindi, Bengali, Tamil), Southeast Asia (Malay, Thai, Vietnamese), European languages (Spanish, French) and the Middle East (Arabic). Our comprehensive study examines available resources and recent advances in low-resourced languages for different aspects of SM, IA, and NM to discover new frontiers as potential field of research.
Diciclo: Flexible User-level Services for Efficient Multitenant Isolation
Authors: Kappes Giorgos , Anastasiadis Stergios V.
Published: December 2023

Containers are a mainstream virtualization technique for running stateful workloads over persistent storage. In highly utilized multitenant hosts, resource contention at the system kernel leads to inefficient container input/output (I/O) handling. Although there are interesting techniques to address this issue, they incur high implementation complexity and execution overhead. As a cost-effective alternative, we introduce the Diciclo architecture with our assumptions, goals, and principles. For each tenant, Diciclo isolates the control and data I/O path at user level and runs dedicated storage systems. Diciclo includes the libservice unified user-level abstraction of system services and the node structure design pattern for the application and server side. We prototyped a toolkit of user-level components that comprise the library to invoke the standard I/O calls, the I/O communication mechanism, and the I/O services. Based on Diciclo, we built Danaus, a filesystem client that integrates a union filesystem with a Ceph distributed filesystem client and configurable shared cache. Across different host configurations, workloads, and systems, Danaus achieves improved performance stability, because it handles I/O with reserved per-tenant resources and avoids intensive kernel locking. Based on having built and evaluated Danaus, we share valuable lessons about resource contention, file management, service separation, and performance stability in multitenant systems.
Enhancing Robust Liver Cancer Diagnosis: A Contrastive Multi-Modality Learner with Lightweight Fusion and Effective Data Augmentation
Authors: Li Pei-Xuan , Hsieh Hsun-Ping , Fan-Chiang Yang , Wu Ding-You , Ko Ching-Chung
Published: December 2023

This article explores the application of self-supervised contrastive learning in the medical domain, focusing on classification of multi-modality Magnetic Resonance (MR) images. To address the challenges of limited and hard-to-annotate medical data, we introduce multi-modality data augmentation (MDA) and cross-modality group convolution (CGC). In the pre-training phase, we leverage Simple Siamese networks to maximize the similarity between two augmented MR images from a patient, without a handcrafted pretext task. Our approach also combines 3D and 2D group convolution with a channel shuffle operation to efficiently incorporate different modalities of image features. Evaluation on liver MR images from a well-known hospital in Taiwan demonstrates a significant improvement over previous methods. This work contributes to advancing multi-modality contrastive learning, particularly in the context of medical imaging, offering enhanced tools for analyzing complex image data.
Numerical Study of Wax Deposition from Multiphase Flow in Oil Pipelines with Heat and Mass Transfer
Authors: Ochieng Francis Oketch , Kinyanjui Mathew Ngugi , Kiogora Phineas Roy , Abonyo Jeconia Okelo
Published: December 2023

Wax deposition in field‐scale crude oil pipelines poses a significant challenge to the oil and gas industry, leading to reduced flow rates, increased pressure drops, and potential blockages. Understanding the mechanisms governing wax deposition is crucial for developing effective mitigation strategies. This study investigates the impact of multiphase flow conditions, including water‐in‐oil emulsion, wax precipitation kinetics, shear dispersion, and molecular diffusion, on wax deposition in field‐scale crude oil pipelines. A numerical model is developed that employs second‐order semi‐implicit temporal discretization schemes, such as Crank–Nicolson and Adams–Bashforth methods, in conjunction with a bivariate spectral collocation scheme using Chebyshev–Gauss–Lobatto grid points. The impact of various flow parameters, including Reynolds number (Re), mass Grashof number (Gr), Schmidt number (Sc), and Weber number (We), on the flow variables, wall shear stress, and heat and mass fluxes are investigated. The numerical simulations demonstrate that flow parameters significantly influence the flow behavior, wall shear stress, wall heat flux, and wall mass flux in waxy crude oil pipelines. Specifically, the aggregation of wax crystals in the pipeline decreases by at most 2.5% with increasing Reynolds number from 2.2361 to 3.1361. Conversely, it increases by at most 3.4% with increasing mass Grashof number from 5 to 11 and by at most 4.8% with increasing Weber number from 1.0 to 2.5. Furthermore, the Nusselt number increases from 1.9907 to 4.9834 with increasing Reynolds number from 2.2361 to 5.2361 and from 1.9907 to 2.0225 with increasing mass Grashof number from 5 to 20. It also increases from 1.9907 to 2.0434 with increasing Weber number from 1.0 to 2.5. The insights gained from this study can be applied to optimize pipeline design, operational parameters, and wax deposition mitigation strategies, leading to enhanced pipeline performance and reduced operational costs. The numerical model developed in this work serves as a valuable tool for simulating and predicting wax deposition behavior under various operating conditions.