bluuebunny/crossref_metadata_2025 huggingface dataset:
Learning environment matters for university EFL learners’ emotions and approaches to online learning technologies: A Chinese perspective
Authors: Han Jiying , Geng Xiaohui , You Yinghui
Published: June 2024

Technology is constantly changing the language learning environment and online language learning (OLL) has attracted increasing attention. In this study, EFL learners’ perceptions of the OLL environments and the relationships between these perceptions and the learners’ emotions and approaches to online learning technologies were investigated. A sample of 567 Chinese university EFL learners from 18 public higher education institutions across 5 provinces responded to an online questionnaire survey. The data analysis based on structural equation modelling revealed that the EFL learners’ perceptions of task orientation, innovation and individualisation were positively related to the deep approach to online learning technologies. However, unlike previous findings, no significant relationship was found between the factors of the relationship dimension and the students' approaches to online learning technologies (SAOLT). Perceived innovation was found to be negatively related to enjoyment, and perceived personalization was found to be positively related to anxiety. Furthermore, the learners’ emotions, especially anxiety, significantly mediated the relationship between perceived task orientation and the surface approach to online learning technologies. Overall, the findings of this study improve the understanding of EFL learners’ online learning experiences and provide practical insights for enhancing the quality of OLL environments and promoting learning outcomes.
Caries status in 12‐year‐old children, geographical location and socioeconomic conditions across European countries: A systematic review and meta‐analysis
Authors: Vukovic Ana , Schmutz Kian Alessandro , Borg‐Bartolo Roberta , Cocco Fabio , Rosianu Ruxandra Sava , Jorda Rainer , Maclennon Anastasia , Cortes‐Martinicorenas Javier F. , Rahiotis Christos , Madléna Melinda , Arghittu Antonella , Dettori Marco , Castiglia Paolo , Esteves‐Oliveira Marcella , Cagetti Maria Grazia , Wolf Thomas G. , Campus Guglielmo
Published: June 2024

Background

Understanding of socioeconomic context might enable more efficient evidence‐based preventive strategies in oral health.

Aim

The study assessed the caries‐related socioeconomic macro‐factors in 12‐year‐olds across European countries.

Design

This systematic review involved epidemiological surveys on the caries status of 12‐year‐olds from 2011 to 2022. DMFT was analyzed in relation to gross national income (GNI), United Nations Statistical Division geographical categorization of European countries (M49), unemployment rate, Human Development Index (HDI), and per capita expenditure on dental health care. A meta‐analysis was performed for countries reporting data on DMFT, stratified by GNI, and geographical location of European countries, using a random‐effects model.

Results

The study involved 493 360 children from 36 countries in the geographic region of Europe. The analysis confirmed a strong negative correlation between income and caries experience (p < .01). Children living in higher‐income countries showed 90% lower odds of poor oral health than in middle‐income countries. Children living in West Europe showed 90% lower odds of poor oral health than children living in East Europe.

Conclusion

The strong effect of macro‐level socioeconomic contexts on children's oral health suggests favoring upstream preventive oral health strategies in countries with economic growth difficulties, Eastern and Southern parts of Europe.
Cancer rehabilitation services for older women with breast cancer: Impact on health‐related quality of life outcomes
Authors: Pergolotti Mackenzi , Wood Kelley C. , Kendig Tiffany , Love Kim , Mayo Stacye
Published: June 2024

Background

Older breast cancer survivors (BCS, age ≥ 65) are vulnerable to experiencing persistent symptoms and associated declines in health‐related quality of life (HRQOL). In research trials, cancer rehabilitation interventions (physical or occupational therapy, PT/OT) have been shown to enhance HRQOL, but the impact of community‐based PT/OT services for older BCS is unknown. We performed a retrospective, observational study to better understand the impact of PT/OT services on the HRQOL of older BCS.

Methods

Outcomes and covariates were extracted from the outpatient rehabilitation medical record. HRQOL outcomes included: PROMIS® global physical health (GPH), global mental health (GMH), physical function (PF), and ability to participate in social roles and activities (SRA). Linear mixed‐effect models were used to examine change in HRQOL outcomes and explore the influence of patient age and service type (PT/OT). ICD‐10 codes were examined and compared between service types to describe the impairments treated.

Results

PT/OT cases (N = 694) were 71.79 ± 5.44 years old and participated in a median of 11 visits (IQR: 7.0–17.25) over 9.71 weeks (IQR: 6.29–15.29). Most (84.4%) attended PT (n = 579; 84%) versus OT (n = 115; 16%). Overall, significant improvement was observed in each HRQOL outcome (GPH: +3.00, p < 0.001; GMH: +1.80, p < 0.001; PF: +1.97, p < 0.001; SRA: +2.34, p < 0.001). Service type influenced only GPH (p = 0.041); mean improvement was +3.24 (SE: 0.290, p < 0.001) for PT cases and + 1.78 for OT cases (SE: 0.651, p = 0.007). PT cases commonly received treatment for weakness/atrophy, pain, walking, and posture; OT cases commonly received treatment for lymphedema and scarring/fibrosis. No age effects were observed.

Conclusions

In this large study of older BCS who participated in community‐based PT/OT services across the United States, we observed significant improvements in HRQOL outcomes that are important to older BCS and their providers. Although more research is needed, these findings suggest that improved access to PT/OT could help address unmet HRQOL needs among this population.
Exploring stakeholders’ opinions on circular economy in the construction sector: A natural language processing analysis of social media discourse
Authors: Tleuken Aidana , Orel Daniil , Iskakova Anel , Varol Huseyin Atakan , Karaca Ferhat
Published: June 2024

The construction industry has been criticized for its negative environmental impacts, leading industry experts to advocate for a shift toward a circular economy (CE) model. However, there is a lack of research on stakeholder opinions regarding that. This research paper examines stakeholders’ perspectives on implementing CE principles in the construction industry by conducting artificial intelligence‐powered natural language processing (NLP) through online sources. It answers three questions: What themes and concepts are associated with the CE in construction? How do opinions on the CE vary across different online platforms? And what factors shape positive attitudes toward the CE? The data obtained from various platforms showed that 57% of sentiments were positive, 28% were neutral, and 15% were negative. This research provides critical knowledge on the analysis of CE representation on social media in construction. Moreover, a webpage tool has been created that can assess any input opinion on the scale (positive, neutral, or negative) for further use (https://ce‐sentiment.streamlit.app/). This NLP‐based research of social media discourse in the construction sector can directly influence policy decisions by offering real‐time insights into public sentiment and preferences, shaping regulations that align with societal needs. It also provides industry professionals with data‐driven guidance, enabling them to identify growth opportunities and innovation pathways within the CE, ultimately fostering a more sustainable and prosperous future.
Circular (de)construction matchmaking: A matter of space and time
Authors: Yu Yifei , van den Berg Marc , Yazan Devrim Murat
Published: June 2024

Industrial symbiosis (IS) facilitates the transition toward a circular built environment. Following IS principles, multiple buildings can be symbiotically linked via closed‐loop material flows beyond the boundaries of individual projects. However, there are few IS matchmaking methods that support the identification of IS opportunities among multiple deconstruction and construction projects. This research develops an agent‐based model to fill this gap. The agent architecture is designed based on the concept of shearing layers. Circularity hubs are proposed to support IS matchmaking by allowing larger transportation ranges and keeping IS requests active for longer periods. The model's applicability is demonstrated through an industrial–urban symbiosis case in Enschede, the Netherlands. The model simulates the spatial–temporal dynamics of IS matchmaking as an emergent phenomenon under future scenarios. The results show operational evidence of IS matchmaking via the strategic implementation of circularity hubs. Overall, this research provides a new methodological perspective to explore the circularity in the built environment at scale.
Delineating the embodied CO2 emissions in Canada's exports: Routes, drivers, and paths
Authors: Li Qiuping , Wu Sanmang , Tu Qingshi
Published: June 2024

This study combined the World Input–Output Database and Asian Development Bank's Multiregional Input–Output database to investigate Canada's embodied CO2 emissions in exports (EEE) for the period of 2000–2018. We examined the key drivers and paths through structural decomposition analysis and structural path analysis. First, the results showed that embodied emissions in the intermediate exports were the major contributor to Canada's EEE, and emission paths involving more than three countries were on the rise, indicating that the expansion of the global industrial supply chains has complicated the paths of Canada's EEE. Second, the factors such as emission intensity of sectors, export structure, and export scale, had varying influences on Canada's EEE over time. For several sectors, the benefit from reduced emission intensity was largely offset by the additional emissions from the increased export scale. Hence, the design of emission regulations should consider the heterogeneity of industrial sectors in order to mitigate emissions for the diverse industries in Canada. Third, energy and resource industries (e.g., electricity, petroleum, wood, metals, and so on) played an essential role in Canada's exports. A significant amount of embodied emissions was transferred from these sectors to the downstream sectors along the supply chain, indicating that abatement measures should be adopted from the whole life cycle perspective of a product/service through an integrated governance of the supply chain. This article met the requirements for a Gold–Silver JIE data openness badge described at http://jie.click/badges.
“I don't think that a medication is going to help someone long‐term stay off opioids”: Treatment and recovery beliefs of rural Vermont family members of people with opioid use disorder
Authors: Peasley‐Miklus Catherine E. , Shaw Julia G. , Rosingana Katie , Smith Mary Lindsey , Sigmon Stacey C. , Heil Sarah H. , Jewiss Jennifer , Villanti Andrea C. , Harder Valerie S.
Published: June 2024

Purpose

Few studies have addressed beliefs about treatment for opioid use disorder (OUD) among family members of people with OUD, particularly in rural communities. This study examined the beliefs of rural family members of people with OUD regarding treatment, including medication for OUD (MOUD), and recovery.

Methods

Semi‐structured qualitative interviews were conducted with rural Vermont family members of people with OUD. Twenty family members completed interviews, and data were analyzed using thematic analysis.

Results

Four primary themes related to beliefs about OUD treatment emerged: (1) MOUD is another form of addiction or dependency and should be used short‐term; (2) essential OUD treatment components include residential and mental health services and a strong support network involving family; (3) readiness as a precursor to OUD treatment initiation; and (4) stigma as an impediment to OUD treatment and other health care services.

Conclusions

Rural family members valued mental health services and residential OUD treatment programs while raising concerns about MOUD and stigma in health care and the community. Several themes (e.g., MOUD as another form of addiction, residential treatment, and treatment readiness) were consistent with prior research. The belief that MOUD use should be short‐term was inconsistent with the belief that OUD is a disease. Findings suggest a need for improved education on the effectiveness of MOUD for family members and on stigma for health care providers and community members.
Power in coordinating supply chain projects in humanitarian settings: A case study of Rohingya refugee camps
Authors: Shaheen Iana , Hossain Muhammad Ismail , Azadegan Arash , Ali Mohammad
Published: June 2024

How and why is power used in humanitarian projects? Coordinating organizations, such as UN agencies, carry power and influence over NGOs to advance the interests of beneficiaries. However, coordination can be managed by a single authority or by multiple authorities that share or delegate responsibilities. Furthermore, coordinators may leverage different types of power, including non‐mediated forms like referent and expert power, or mediated forms such as reward, legitimate, or coercive power. This research draws upon 57 interviews regarding organizational behavior with members of international and local non‐governmental organizations (NGOs), UN agencies, and government officials involved in managing Rohingya refugee camps in Southern Bangladesh. The observations suggest that in single‐authority layered projects, referent and expert powers are commonly employed, leading to improvements in quality and delivery performance. Reward power is typically wielded informally and is linked to cost performance. In dual‐layered projects, legitimate power is used to enhance quality and delivery performance. This article's originality lies in its extension of the use of power to multi‐tiered supply chain settings; its contribution is to organizational theory regarding the resolution of principal‐agent issues; and its insights are into the nuanced effects of different types of power based on project types. It offers valuable guidance to policymakers and practitioners, highlighting effective approaches for coordinating inter‐organizational efforts in challenging and unconventional supply chain settings.
Effects of marine microplastic on marine life and the food webs – A detailed review
Authors: Sethia Prateek , Nandhini Dhuraimurugan , Amutha Sadasivan
Published: June 2024

Microplastics, which are microscopic plastic particles smaller than five millimetres, have become a common global pollution in marine environments. These particles, which come from a variety of sources such as the decomposition of bigger plastic objects and the microfibres that are shed from textiles, are extremely dangerous to ecosystems and marine life. This study provides a detailed analysis of the global issue of microplastic pollution, including its origins, effects on marine ecosystems, current mitigation techniques, and future research prospects. The review divides microplastics into main and secondary categories, detailing their sources ranging from plastic pellets and microbeads to the breakdown of bigger plastic items such as bottles and bags. It emphasises the negative impacts of microplastics on marine species, aquaculture, and human health, such as gastrointestinal obstructions, toxic chemical accumulation, and cancer risk to human health. The review also examines the economic and environmental consequences of marine plastic pollution, highlighting the importance of effective policies and remedies. Furthermore, the article covers several researches on microplastic contamination in coastal sediments, seafood, and aquatic creatures from diverse locales. It addresses methods for collecting, extracting, and analysing microplastics, as well as advances in machine learning and spectroscopic techniques for precise identification and measurement. Furthermore, the study summarises the research on the ecological hazards presented by microplastics, such as their movement patterns, accumulation in marine ecosystems, and possible long‐term effects. The study also examines the problems and limitations in existing research, such as the need for consistent data collection processes, a better knowledge of microplastic behaviour in various settings, and the development of novel mitigating solutions. Overall, this study gives an in‐depth summary of the current state of knowledge on microplastic contamination, emphasising the critical need for more research, legislative interventions, and public awareness campaigns to ameliorate its negative impacts on marine ecosystems and human health.
What is old is new again: The deep roots of ethnic nationalism in the digital age
Authors: Schertzer Robert , Woods Eric Taylor
Published: June 2024

In this article, we elaborate on the central themes of our recent book,The New Nationalism in America and Beyond(OUP, 2022), before responding to the comments and criticisms of several esteemed colleagues (Phil Gorski, Cynthia Miller‐Idriss, and Sophie Duchesne). In sum, our book argues that the relative success of right‐wing populists among the white majorities of the West – including Donald Trump in the US, Marine Le Pen in France, and the Brexit Campaigners in the UK – is partly due to the way in which they draw upon long‐established ethnic nationalist myths and symbols in their political communication. By adapting this cultural content to the contemporary context, these elites are ensuring that their messaging resonates among their target populations. In making this case, our book seeks to demonstrate the value of taking culture seriously in the analysis of the so‐called ‘new nationalism.’
The goals for successful development of treatment in gastroparesis
Authors: Yang David Yi , Camilleri Michael
Published: June 2024

Background

Gastroparesis is a motility disorder of the stomach characterized by cardinal symptoms and delayed gastric emptying of solid food in the absence of mechanical obstruction. There is significant unmet need in its management, and essentially there are no medications approved for its treatment over four decades.

Purpose

The objectives of this review are to develop an understanding of the goals of treatment, the evidence‐based criteria for treatment success based on the current scientific understanding of gastroparesis as well as patient response outcomes, and to propose evidence‐based principles for the successful development of treatments for gastroparesis. Specifically, we discuss the pathophysiologic targets in gastroparesis, eligibility criteria for clinical trial participation based on validated gastric emptying studies, and the patient response outcome measures that have been validated to appraise effects of treatment on clinically relevant outcomes. These considerations lead to recommendations regarding eligibility, design, and duration of proof‐of‐efficacy studies, and to endorsing the American Neurogastroenterology and Motility Society Gastroparesis Cardinal Symptom Index Daily Diary as a validated patient response outcome and to justification of the shortening of proof‐of‐efficacy, placebo‐controlled clinical trials to 4 weeks treatment duration after a baseline period. We believe that such approaches will increase the likelihood of successful assessment of efficacy of novel approaches to treating patients with gastroparesis.
Melatonin activates Nrf2/HO‐1 signalling pathway to antagonizes oxidative stress‐induced injury via melatonin receptor 1 (MT1) in cryopreserved mice ovarian tissue
Authors: Wei Chen Yang , Zhang Xin , Si Li Na , Shu Wei Han , Jiang Sheng Nan , Ding Pei Jian , Cheng Lu Yang , Sun Tie Cheng , Yang Song He
Published: June 2024

Our previous research has shown that melatonin (MLT) can reduce cryopreserved ovarian damage in mice. Yet, the molecular mechanism of MLT protection is still unclear. Some studies have shown that melatonin receptor 1 (MT1) is very important for animal reproductive system. To evaluate whether MLT exerts its protective effect on cryopreserved mice ovarian tissue via MT1, we added antagonist of MT1/MT2 (Luzindor) or antagonist of MT2 (4P‐PDOT) to the freezing solution, followed by cryopreservation and thawing of ovarian tissue. The levels of total superoxide dismutase (T‐SOD), catalase (CAT), nitric oxide (NO) and malondialdehyde (MDA) were detected. Besides, by using RT‐PCR and Western blotting, the expression of Bcl‐2, Bax and Nrf2/HO‐1 signalling pathway‐related proteins was detected. These findings demonstrated that compared with the melatonin group, the addition of Luzindor increased apoptosis, NO and MDA activities, decreased CAT and T‐SOD activities and inhibited Nrf2/HO‐1 signalling pathway. In conclusion, melatonin can play a protective role in cryopreserved ovarian tissue of mice through MT1 receptor.
The ID Digital Institute: Building a digital education toolset and community
Authors: Dong Sara W , Walker Jeremey , Nematollahi Saman , Nolan Nathanial S , Ryder Jonathan H
Published: June 2024

Organic digital education (ODE) includes online medical education content that can take various forms, such as blogs, social media, videos, podcasts, or infographics. Multimedia ODE platforms have unique benefits and have quickly become an essential part of medical education. Modern medical educators with competency in digital teaching modalities can leverage these for teaching as well as career development and dissemination of scientific research. The ID Digital Institute is a digital education program with a curriculum designed to equip infectious diseases (ID) professionals with the skills to appraise, create, curate, and integrate ODE into their teaching and career. We share the structure, content, and lessons learned from the ID Digital Institute program. We also illustrate how digital education skills can present unique opportunities to align with current and future transplant and immunocompromised host infectious diseases education efforts.
Marker-Based Versus IMU-Based Kinematics for Estimates of Lumbar Spine Loads Using a Full-Body Musculoskeletal Model
Authors: Prado Maria , Oyama Sakiko , Giambini Hugo
Published: June 2024

Musculoskeletal modeling, typically implemented using marker-based systems in laboratory environments, is commonly used for noninvasive estimations of loads. Inertial measurement units (IMUs) have become an alternative for the evaluation of kinematics. However, estimates of spine joint contact forces using IMUs have yet to be thoroughly evaluated. Dynamics tasks and static postures from activities of daily living were captured on 11 healthy subjects using both systems simultaneously. Spine kinematics obtained from IMU- and marker-based systems and L4–L5 joint contact forces were compared. Lateral bending resulted in a weak agreement with significant differences between the 2 systems (P = .02, average root mean-squared error = 4.81), whereas flexion–extension and axial rotation exhibited the highest agreement with no significant differences (P < .05, average root mean-squared error = 5.51 and P < .31, average root mean-squared error = 5.08, respectively). All tasks showed excellent correlations (R2 = .76–.99) in estimated loads between systems. Differences in predicted loads at the L4–L5 were only observed during flexion–extension (1041 N vs 947 N, P = .0004) and walking with weights (814 N vs 727 N, P = .004). Different joint reaction force outcomes were obtained in 2 of the 8 tasks between systems, suggesting that IMUs can be robust tools allowing for convenient and less expensive evaluations and for longitudinal assessments inside and outside the laboratory setting.
Supplemental Material: Marine redox and nutrient dynamics linked to the Cambrian radiation of animals
Authors: Liu Yang , al. et
Published: June 2024

Detailed geological setting, methods, supplemental notes, Figures S1–S4, and Tables S1–S2.  
An evaluation of the national testing response during the COVID-19 pandemic in England: a multistage mixed-methods study protocol
Authors: Naidoo Reshania , Lambert Ben , Voysey Merryn , Shretta Rima , Keene Claire Marriott , Wanat Marta , Andersen-Waine Billie , Dahal Prabin , Stepniewska Kasia , Hounsell Rachel , Molyneux Sassy , Pinto-Duschinsky Sarah , Rowe Emily , Yenidogan Gulsen , Fowler Tom , White Lisa , Consortium EY-Oxford Health Analytics
Published: June 2024

Introduction

In 2020, the UK government established a large-scale testing programme to rapidly identify individuals in England who were infected with SARS-CoV-2 and had COVID-19. This comprised part of the UK government’s COVID-19 response strategy, to protect those at risk of severe COVID-19 disease and death and to reduce the burden on the health system. To assess the success of this approach, the UK Health Security Agency (UKHSA) commissioned an independent evaluation of the activities delivered by the National Health System testing programme in England. The primary purpose of this evaluation will be to capture key learnings from the roll-out of testing to different target populations via various testing services between October 2020 and March 2022 and to use these insights to formulate recommendations for future pandemic preparedness strategy. In this protocol, we detail the rationale, approach and study design.

Methods and analysis

The proposed study involves a stepwise mixed-methods approach, aligned with established methods for the evaluation of complex interventions in health, to retrospectively assess the combined impact of key asymptomatic and symptomatic testing services nationally. The research team will first develop a theory of change, formulated in collaboration with testing service stakeholders, to understand the causal pathways and intended and unintended outcomes of each testing service and explore contextual impacts on each testing service’s intended outcomes. Insights gained will help identify indicators to evaluate how the combined aims of the testing programme were achieved, using a mixed-methods approach.

Ethics and dissemination

The study protocol was granted ethics approval by the UKHSA Research Ethics and Governance Group (reference NR0347). All relevant ethics guidelines will be followed throughout. Findings arising from this evaluation will be used to inform lessons learnt and recommendations for UKHSA on appropriate pandemic preparedness testing programme designs; findings will also be disseminated in peer-reviewed journals, a publicly available report to be published online and at academic conferences. The final report of findings from the evaluation will be used as part of a portfolio of evidence produced for the independent COVID-19 government inquiry in the UK.

Transparency declaration

The lead author (the manuscript’s guarantor) affirms that the manuscript is an honest, accurate and transparent account of the study being reported; no important aspects of the study have been omitted, and any discrepancies from the study as planned have been explained.
Assessing the effectiveness of artificial intelligence (AI) in prioritising CT head interpretation: study protocol for a stepped-wedge cluster randomised trial (ACCEPT-AI)
Authors: Vimalesvaran Kavitha , Robert Dennis , Kumar Shamie , Kumar Ayan , Narbone Mariapola , Dharmadhikari Rahul , Harrison Mark , Ather Sarim , Novak Alex , Grzeda Mariusz , Gooch Jane , Woznitza Nicholas , Hall Mark , Shuaib Haris , Lowe David J
Published: June 2024

Introduction

Diagnostic imaging is vital in emergency departments (EDs). Accessibility and reporting impacts ED workflow and patient care. With radiology workforce shortages, reporting capacity is limited, leading to image interpretation delays. Turnaround times for image reporting are an ED bottleneck. Artificial intelligence (AI) algorithms can improve productivity, efficiency and accuracy in diagnostic radiology, contingent on their clinical efficacy. This includes positively impacting patient care and improving clinical workflow. The ACCEPT-AI study will evaluate Qure.ai’s qER software in identifying and prioritising patients with critical findings from AI analysis of non-contrast head CT (NCCT) scans.

Methods and analysis

This is a multicentre trial, spanning four diverse sites, over 13 months. It will include all individuals above the age of 18 years who present to the ED, referred for an NCCT. The project will be divided into three consecutive phases (pre-implementation, implementation and post-implementation of the qER solution) in a stepped-wedge design to control for adoption bias and adjust for time-based changes in the background patient characteristics. Pre-implementation involves baseline data for standard care to support the primary and secondary outcomes. The implementation phase includes staff training and qER solution threshold adjustments in detecting target abnormalities adjusted, if necessary. The post-implementation phase will introduce a notification (prioritised flag) in the radiology information system. The radiologist can choose to agree with the qER findings or ignore it according to their clinical judgement before writing and signing off the report. Non-qER processed scans will be handled as per standard care.

Ethics and dissemination

The study will be conducted in accordance with the principles of Good Clinical Practice. The protocol was approved by the Research Ethics Committee of East Midlands (Leicester Central), in May 2023 (REC (Research Ethics Committee) 23/EM/0108). Results will be published in peer-reviewed journals and disseminated in scientific findings (ClinicalTrials.gov:NCT06027411)

Trial registration number

NCT06027411.
Effectiveness of complex behaviour change interventions tested in randomised controlled trials for people with multiple long-term conditions (M-LTCs): systematic review with meta-analysis
Authors: Rookes Tasmin Alanna , Nimmons Danielle , Frost Rachael , Armstrong Megan , Davies Laura , Ross Jamie , Hopkins Jane , Mistry Manoj , Taylor Stephanie , Walters Kate
Published: June 2024

Introduction

The prevalence of multiple long-term conditions (M-LTCs) increases as adults age and impacts quality of life and health outcomes. To help people manage these conditions, complex behaviour change interventions are used, often based on research conducted in those with single LTCs. However, the needs of those with M-LTCs can differ due to complex health decision-making and engagement with multiple health and care teams.

Objectives

The aim of this review is to identify whether current interventions are effective for people living with M-LTCs, and which outcomes are most appropriate to detect this change.

Methods

Five databases (MEDLINE, Embase, PsycINFO, CINAHL and Web of Science) were systematically searched, between January 1999 and January 2022, to identify randomised controlled trials evaluating effectiveness of behaviour change interventions in people with M-LTCs. Intervention characteristics, intervention effectiveness and outcome measures were meta-analysed and narratively synthesised.

Results

53 eligible articles were included. Emotional well-being and psychological distress (depression and anxiety) outcomes were most amenable to change (emotional well-being: standardised mean difference (SMD) 0.31 (95% CI 0.04 to 0.58); depression psychological distress: SMD −0.45 (95% CI –0.73 to −0.16); anxiety psychological distress: SMD −0.14 (95% CI –0.28 to 0.00)), particularly for interventions with a collaborative care approach. Interventions targeting those with a physical and mental health condition and those with cognitive and/or behavioural activation approach saw larger reductions in psychological distress outcomes. Interventions that lasted for longer than 6 months significantly improved the widest variety of outcomes.

Conclusion

Complex interventions can be successfully delivered to those with M-LTCs. These are most effective at reducing psychological distress in those with physical and mental LTCs. Further research is needed to identify the effective components of interventions for people with two or more physical LTCs and which outcome is most appropriate for detecting this change.
Quantification of breathing irregularity for the diagnosis of dysfunctional breathing using proportional tidal volume variation: a cross-sectional, retrospective real-world study
Authors: Knöpfel Georg , Baty Florent , Uhl Friedrich , Kern Lukas , Brutsche Martin
Published: June 2024

Objectives

To develop a statistical approach that provides a quantitative index measuring the magnitude of the irregularity of the breathing response to exercise for the diagnosis of dysfunctional breathing.

Design

Cross-sectional, retrospective, real-world study.

Setting

Single-centre study.

Participants

A population of 209 patients investigated with cardiopulmonary exercise testing in our institution for unexplained or disproportionate exertional dyspnoea between January and July 2022.

Primary and secondary outcome measures

A novel statistical approach providing a quantitative index—proportional tidal volume variation (PTVV)—was developed to measure the magnitude of the irregularity of the breathing response to exercise.

Results

PTVV provided a reliable statistical readout for the objective assessment of DB with a prediction accuracy of 78% (95% CI: 72 to 83%). The prevalence of DB in the investigated population was high with more than half of the patients affected by moderate-to-severe DB.

Conclusions

PTVV can easily be implemented in the clinical routine. Our study suggests a possible further simplification for the diagnosis of DB with two objective criteria including PTVV and one single criterion for hyperventilation.
Cost-effectiveness of craniotomy versus decompressive craniectomy for UK patients with traumatic acute subdural haematoma
Authors: Pyne Sarah , Barton Garry , Turner David , Mee Harry , Gregson Barbara A , Kolias Angelos G , Turner Carole , Adams Hadie , Mohan Midhun , Uff Christopher , Hasan Shumaila , Wilson Mark , Bulters Diederik Oliver , Zolnourian Ardalan , McMahon Catherine , Stovell Matthew G , Al-Tamimi Yahia , Thomson Simon , Viaroli Edoardo , Belli Antonio , King Andrew , Helmy Adel E , Timofeev Ivan , Menon David , Hutchinson Peter John
Published: June 2024

Objective

To estimate the cost-effectiveness of craniotomy, compared with decompressive craniectomy (DC) in UK patients undergoing evacuation of acute subdural haematoma (ASDH).

Design

Economic evaluation undertaken using health resource use and outcome data from the 12-month multicentre, pragmatic, parallel-group, randomised, Randomised Evaluation of Surgery with Craniectomy for Patients Undergoing Evacuation-ASDH trial.

Setting

UK secondary care.

Participants

248 UK patients undergoing surgery for traumatic ASDH were randomised to craniotomy (N=126) or DC (N=122).

Interventions

Surgical evacuation via craniotomy (bone flap replaced) or DC (bone flap left out with a view to replace later: cranioplasty surgery).

Main outcome measures

In the base-case analysis, costs were estimated from a National Health Service and Personal Social Services perspective. Outcomes were assessed via the quality-adjusted life-years (QALY) derived from the EuroQoL 5-Dimension 5-Level questionnaire (cost-utility analysis) and the Extended Glasgow Outcome Scale (GOSE) (cost-effectiveness analysis). Multiple imputation and regression analyses were conducted to estimate the mean incremental cost and effect of craniotomy compared with DC. The most cost-effective option was selected, irrespective of the level of statistical significance as is argued by economists.

Results

In the cost-utility analysis, the mean incremental cost of craniotomy compared with DC was estimated to be −£5520 (95% CI −£18 060 to £7020) with a mean QALY gain of 0.093 (95% CI 0.029 to 0.156). In the cost-effectiveness analysis, the mean incremental cost was estimated to be −£4536 (95% CI −£17 374 to £8301) with an OR of 1.682 (95% CI 0.995 to 2.842) for a favourable outcome on the GOSE.

Conclusions

In a UK population with traumatic ASDH, craniotomy was estimated to be cost-effective compared with DC: craniotomy was estimated to have a lower mean cost, higher mean QALY gain and higher probability of a more favourable outcome on the GOSE (though not all estimated differences between the two approaches were statistically significant).

Ethics

Ethical approval for the trial was obtained from the North West—Haydock Research Ethics Committee in the UK on 17 July 2014 (14/NW/1076).

Trial registration number

ISRCTN87370545.
Tobacco endgame goals and measures in Europe: current status and future directions
Authors: Ollila Hanna , Ruokolainen Otto , Laatikainen Tiina , Koprivnikar Helena
Published: June 2024

The European Union (EU) aims for a tobacco use prevalence of less than 5% by 2040 with its Tobacco-Free Generation goal, aligning with the tobacco endgame approach. In the Joint Action on Tobacco Control 2 (JATC-2) -project, we examined adopted and planned endgame goals and measures as well as preparedness to counter tobacco industry interference in the process. We surveyed key informants in 24 out of 50 countries in the WHO European Region (19 of the 27 EU Member States, MS). Altogether, eight countries (7 EU MS) had official governmental endgame goals, and an additional six EU MS had similar proposals from government, civil society or research entities. Movement towards tobacco endgame was most evident in retail-oriented and consumer-oriented policies. These include restricting the sales of tobacco and related products and raising the age limit above 18 years. Product standards were used especially to regulate flavours but no measures to substantially reduce addictiveness were reported. Market-oriented measures that tap into industry profits were predominantly missing, and countries often lacked concrete tools to prevent industry interference. Respondents’ concerns around tobacco endgame were related to high smoking prevalence in some population groups, non-combustible and new nicotine products, cross-border marketing, political will, challenges with the existing regulations and industry interference. Results indicate both momentum and challenges in adopting and disseminating measures that facilitate achieving tobacco endgame goals. The EU goal can be used to advocate for national endgame goals and measures, and for the strengthened implementation of the WHO Framework Convention on Tobacco Control.
Joule–Thomson expansion and images of black hole in SU(N)-non-linear sigma model
Authors: Malik Adnan , Chaudhary Shahid , Metwally Ahmed Sayed M.
Published: June 2024

We consider recently constructed black holes in the Einstein SU(N)-non-linear sigma model and study the Joule–Thomson expansion and observable characteristics. We calculate Joule–Thomson coefficient, inversion curves and isenthalpic curves to investigate the heating and cooling phases in $$T-P$$

T
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P

plane of the considered model. Our findings reveal distinct behavior of these black holes different from those reported in existing studies. Notably, inversion curves vanish in the heating regions, resulting in the black holes consistently remaining in the cooling phase. Additionally, we investigate the impact of the flavor number N on the Joule–Thomson expansion of these black holes. We observe that employing higher values of enthalpy and flavor number N extends the ranges of isenthalpic and inversion curves but the black holes remain in cooling phase. We also study the shadow and visual characteristics of the these black hole focusing on its illumination by two theoretical models of static accretion. We analyze that higher flavor numbers have high peaks of observed intensities and it shifts to smaller impact parameter which leads to smaller images.
Constraining photon trajectories in black hole shadows
Authors: Pugliese D. , Stuchlík Z.
Published: June 2024

We examine the shadow cast by a Kerr black hole, focusing on constraints on photons corresponding to different shadow boundaries. The photons are related to different orbital ranges and impact parameter values, creating a map of the shadow boundaries. Our analysis fixes also the conditions under which it is possible to observe an “imprint” of the black hole (outer) ergosurface and (outer) ergoregion on the Kerr black hole shadow boundary. The counter-rotating case resulted strongly constrained with respect to the co-rotating case, constituting a remarkable and significant difference where the counter-rotating component associated with the shadow boundary is strongly distinct from the co-rotating one. However, in this framework, even the co-rotating photons imply restrictions on conditions on the spins and planes, which are bounded by limiting values. We believe the results found here, being a tracer for the central black hole, can constitute new templates for the ongoing observations.
Design and Performance Analysis of Polarity Control Junctionless TFET (PC-JL-TFET)-Based Biosensor
Authors: Bind Mukesh Kumar , Singh Sajai Vir , Nigam Kaushal Kumar
Published: June 2024

This paper proposes a novel polarity-control junctionless tunnel field-effect transistor (PC-JL-TFET)-based biosensor for the label-free detection of biomolecule species in efficient ways. Unlike conventional designs, the polarity-control concept induces the generation of drain (n[Formula: see text]) and source (p[Formula: see text]) regions inside the proposed structure when a bias of [Formula: see text] V is applied at the polarity gates-1/2 (PG-1/2), to form a conventional TFET. To capture the biomolecules, a nano-cavity is created within the source region’s dielectric oxide toward the tunneling interface. The presence of biomolecules is electronically detected based on either solely the dielectric constant (neutral biomolecules) or the combination of charge density and dielectric constant (charged biomolecules). The proposed device can perform label-free recognition of biomolecules such as Uricase, Keratin, Biotin, Streptavidin and so on. To investigate the sensing performance of the proposed biosensor, significant biosensing metrics such as the electric field, energy band diagram, tunneling current, subthreshold slope, [Formula: see text] ratio and threshold voltage have been studied. The proposed PC-JL-TFET biosensor achieves a maximum sensitivity of [Formula: see text] for neutral biomolecules with a dielectric constant of 12 and [Formula: see text] for negatively charged biomolecules [Formula: see text] with a dielectric constant of 8. The proposed biosensor’s selectivity, linearity and temperature-based analysis have also been evaluated for different biomolecules. Additionally, real-time practical scenarios, such as partially filled nano-cavities and the random position of biomolecules in the nano-cavity-based analysis, have also been incorporated.
A Global C-Staggered Composite Model for Shallow Water Equations with Latitude–Longitude Grid and Reductions in the Polar Regions
Authors: Lima Genilson S.
Published: June 2024

To develop a numerical method for global geophysical fluids, we usually need to choose a spherical grid and numerical approximations to represent the partial derivative equations. Some alternatives include the use of finite differences or finite volumes with latitude–longitude or reduced grids. Each of these cases has some advantages and also some limitations. This paper presents a comparison between two methods and describes a composite model using them side by side. The first is a well-known method for latitude–longitude grids and was used from 75[Formula: see text][Formula: see text]S until 75[Formula: see text][Formula: see text]N. The second is a recently developed scheme for reduced grids and was used only in the polar regions. The similarity between the two methods allows the use of small adaptations in their approximations to obtain consistency and mass conservation also in the transition between the two regions. The composite model combines advantages of the other two schemes and has a smaller computational cost. Numerical tests indicated order 2 of convergence, prevention of grid-imprinting errors, and avoidance of nonlinear instability. This model has numerical properties that may lead to efficient implementations with massive parallel computation.
Classification of conformally harmonic Z-recurrent spacetime in F(R)-gravity
Authors: Khatri Mohan , Singh Jay Prakash , Sumlalsanga Robert , Chhakchhuak Zosangzuala
Published: June 2024

In this paper, we give some classification of conformally harmonic [Formula: see text]-recurrent spacetime in the context of [Formula: see text]-gravity theory based on its scalar curvature and obtained the expression for energy density and isotopic pressure. Their behaviors along with EoS parameter are analyzed by considering two [Formula: see text]-gravity models. Moreover, the energy conditions for the considered models are studied and found to support the accelerated expansion of the universe.
Conformal trajectories in three-dimensional space forms
Authors: López Rafael , Munteanu Marian Ioan
Published: June 2024

We introduce the notion of conformal trajectories in three-dimensional Riemannian manifolds [Formula: see text]. Given a conformal vector field [Formula: see text], a conformal trajectory of [Formula: see text] is a regular curve [Formula: see text] in [Formula: see text] satisfying [Formula: see text], for some fixed nonzero constant [Formula: see text]. In this paper, we study the conformal trajectories in the space forms [Formula: see text], [Formula: see text] and [Formula: see text]. For (non-Killing) conformal vector fields in [Formula: see text] (respectively, in [Formula: see text]), we prove that conformal trajectories have constant curvature and its torsion is a linear combination of trigonometric (respectively, hyperbolic) functions on the arc-length parameter. In the case of Euclidean space [Formula: see text], we obtain the same result for the radial vector field and characterizing all conformal trajectories.
Metal reflector-enhanced thermoacoustic imaging as a guidance for puncture biopsy
Authors: Du Shuang , Qiang Tao , Chi Zihui , Jiang Huabei
Published: June 2024

Puncture biopsy is an important clinical technique to obtain diseased tissue for pathological diagnosis, where imaging guidance is critical. In this paper, we describe a metal reflector-enhanced microwave-induced thermoacoustic imaging (TAI) approach capable of guiding puncture biopsy for detection of breast cancer and joint diseases. Numerical experimentations simulating puncture guidance in breast cancer and knee gout models were first conducted using (CST STUDIO SUITE) (CST) software, and then ex-vivo experiments were performed followed by qualitative observations and semi-quantitative analysis. The results of both the simulations and ex-vivo experiments showed that our reflector-enhanced TAI could image the puncture needle in high resolution with a large depth of [Formula: see text][Formula: see text]cm.
On nilpotent ideals of index 2 in finite commutative rings
Authors: Esmkhani Mohammad Ali , Amiri Seyyed Majid Jafarian
Published: June 2024

Let [Formula: see text] be a finite commutative ring with nonzero identity. An ideal [Formula: see text] of [Formula: see text] is called nilpotent of index 2 if [Formula: see text]. [Formula: see text] is called local nilpotent of index 2 if it has a unique maximal nilpotent ideal of index 2. In this paper, we investigate the interplay between cliques in the zero divisor graph and nilpotent ideals of index 2 in [Formula: see text]. In particular, if [Formula: see text] is a maximal clique and [Formula: see text] is an ideal, then [Formula: see text] is a maximal nilpotent ideal of index 2. Also, we study local nilpotent rings of index 2. Finally, we prove that every local ring of order [Formula: see text] with [Formula: see text] is local nilpotent of index 2 and present a counter example for [Formula: see text].