bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the landscape of Canadian midwifery research: strengths, gaps and priorities – results of a scoping review
Authors: Ruby Emma , Brunton Ginny , Rack Joanne , Al Balkhi Sofia , Banfield Laura , Grenier Lindsay N , Ghandi Shikha , Ahmed Maisha , Hutton Eileen Katherine , Darling Elizabeth Kathleen , Mattison Christina , Kaufman Karyn , Murray-Davis Beth
Published: December 2024

Objectives

The 2014 Lancet Series on Midwifery developed the Quality of Maternal and Newborn Care (QMNC) framework outlining care needed for all childbearing people and newborns. Furthermore, this was a global call to action to invest in research capacity building. While evidence-informed care is a cornerstone of midwifery practice, there has been limited exploration of how Canadian midwifery research priorities within the Canadian context align with the global framework. In response to the call from the Lancet series, this scoping review aimed to investigate the current strengths and gaps of midwifery research in Canada. Secondarily, our goal was to map existing Canadian evidence to the QMNC framework to guide future priority setting and build research capacity.

Design

A scoping review.

Data sources

We searched nine electronic databases for articles up to 2022, inclusive: AMED (Allied and Complementary Medicine), CINAHL, EconLit, EMBASE, HealthSTAR, MEDLINE, PsycINFO, EmCare and Web of Science.

Eligibility criteria for selecting studies

We included research conducted by (a) Canadian midwives on Canadian and non-Canadian populations, (b) international midwives on Canadian midwifery populations or (c) non-midwife researchers on Canadian midwifery populations.

Data extraction and synthesis

We analysed data using categories from the Lancet Series’ QMNC framework. At least two independent reviewers conducted screening and data extraction.

Results

We identified 590 articles for inclusion. Most Canadian midwifery research is related to organisation of care and care providers, clinical practice categories including promoting normal physiological processes during pregnancy, research pertaining to prenatal and intrapartum periods, and policy. Research gaps included neonatal and postpartum outcomes, midwifery education, and midwifery values and philosophy. Lastly, there were gaps in the number of randomised trials and systematic reviews, which may impact guidance of clinical decision-making.

Conclusions

There has been an exponential increase in midwifery-led research in Canada. Assessment against the QMNC framework has highlighted gaps related to research conduct, clinical and non-clinical research focuses. Identifying midwifery research priorities is an important next step of consolidating Canadian research evidence. Future directions may include collaboration with midwifery stakeholders to prioritise research topics related to improving care for clients, strengthening the profession and building research capacity.
Alienation and/or anomie in pharmacists: a protocol for a narrative systematic review
Authors: Forsyth Paul , Maguire Barry , O'Brien Robert , Carey James , Rushworth Gordon F , Cunningham Scott , Radley Andrew
Published: December 2024

Introduction

Episodes of alienation and/or anomie in pharmacists have been reported in historical accounts since the 19th century. Alienation and anomie are distinct types of psychological or social ills where people are problematically separated from, or their skills and values are misaligned with, others and their environment. Alienation and/or anomie can be important precursors of many negative work experiences, including job dissatisfaction, burnout and/or intention to leave.

Methods and analysis

We aim to study alienation and/or anomie in pharmacists from across the globe, reviewing all types of methodological designs, published in peer-reviewed journals, including all primary qualitative, quantitative and/or mixed-method research studies. We will narratively describe any focuses, causes, associated factors and/or consequences of alienation and/or anomie. We will identify all published peer-reviewed research by searching seven electronic databases (MEDLINE, Embase, APA PsychINFO, CINAHL Plus, Cochrane Library, Web of Science Core Collection and Scopus) and Google Scholar in May 2024. Extensive hand and citation-searching will also take place. Two independent reviewers will identify eligible studies, conduct a critical appraisal of the study conduct, extract data and synthesise reported findings by narratively exploring relationships within and between studies. The synthesis will follow a hybrid thematic analysis. Initially, we will deductively structure the findings according to six themes from underpinning alienation and anomie theory: Care, Values, Meaning, Recognition, Autonomy and Shared Responsibility. This structure may thereafter be inductively adapted, by creating new additional themes, if required from the data. A GRADE Confidence in the Evidence from Reviews of the Qualitative research approach will be used to determine a confidence profile of each theme. A thematic map showing the links between themes will also be produced.

Ethics and dissemination

Ethical permission is not required, as this study uses data from published research. Dissemination will be through publication in peer-reviewed journals and conference presentations.

PROSPERO registration number

CRD42024536336.
Multimodal prehabilitation combined with perioperative enhanced recovery after surgery care for older patients undergoing spinal fusion surgery in China: protocol for a multicentre randomised controlled trial (PRACTICE trial)
Authors: Wang Shuai-Kang , Wang Peng , Wang Wei , Lu Shibao
Published: December 2024

Introduction

Besides the comorbid risk factors shared by older and younger patients, older individuals may also experience malnutrition, as well as cognitive or functional impairments. The accumulation of frailty and various geriatric syndromes in older individuals results in decreased physiological reserves, which makes the recovery process after spine surgery particularly challenging. Theoretically, combining the presurgery optimisation provided by a multimodal prehabilitation programme with the reduction of surgical stress provided by an enhanced recovery after surgery (ERAS) programme could improve postoperative recovery of older patients.

Methods and analysis

This is a prospective, multicentre, assessor-blinded, randomised controlled study. Patients who are 75 years of age or older and are scheduled for spinal fusion surgery will be enrolled on three academic medical centres. Regular preadmission education and perioperative ERAS care will be given to participants who were randomised to the control group. Participants randomised to the intervention group will receive multimodal prehabilitation combined with ERAS (PREERAS) management. We will include 164 patients with spinal fusion in three hospitals in China. All included patients will be followed for 90 days after surgery or until death. The primary outcome is the Comprehensive Complication Index (CCI), which ranges from 0 to 100, where a score of 100 indicates death due to complications. Secondary outcomes include length of stay and non-home discharge, rates of postoperative complications and unplanned readmission, North American Spine Society satisfaction, and Oswestry Disability Index/Neck disability index. Ninety-day CCI will be compared between groups using linear regression. Other continuous or categorical outcomes will be compared using linear or logistic regression.

Ethics and dissemination

This study has received ethical approval from the Xuanwu Hospital of Capital Medical University Ethics Committees (2024-088-001). The findings will be submitted to a peer-reviewed journal for publication.

Trial registration number

NCT06140797.
Effectiveness and cost-effectiveness of a structured integrated post-pulmonary embolism follow-up care model (Attend-PE): a rationale and protocol for a multicentre clinical pre-post study
Authors: Rolving Nanna , Lindegaard Stine Foged , Johnsen Søren Paaske , Grove Erik Lerkevang , Kümler Thomas , Valentin Jan Brink , Risør Bettina Wulff , Klok Frederikus A , Konstantinides Stavros , Højen Anette Arbjerg
Published: December 2024

Introduction

Patients with pulmonary embolism (PE) experience impaired functional ability and reduced quality of life long after discharge from the hospital. However, there are no structured follow-up programmes in Denmark for these patients, and there is considerable variation in practice patterns of post-PE management. No studies have investigated the effectiveness of structured follow-up care models in patients with PE. This study aims to investigate the effect and cost-effectiveness of a structured integrated post-pulmonary embolism follow-up care model (Attend-PE) compared with usual care. The Attend-PE model outlines a structured approach for in-hospital follow-up, involving group-based patient education, individual consultations and systematic use of patient-reported outcome measures to assess the patient’s physical and psychological well-being.

Methods and analysis

The study is conducted in Denmark, where the healthcare system is tax-funded and services are freely available for all citizens, with an expected inclusion of 2000 patients in total. A pre-post-intervention study design is used to compare outcomes in the post-implementation cohort with the pre-implementation cohort. The co-primary outcomes are (1) health-related quality of life (patient-reported outcome, PRO) and (2) adherence to medical treatment (register-based data). Secondary outcomes include PROs on disability, treatment satisfaction, self-management, anxiety, depression and work productivity, and register-based outcomes, including recurrent PE, bleeding, mortality and healthcare use. Register-based data will be assessed at baseline (date of PE event), 6 and 12 months, while PRO-data will be assessed at 6 and 12 months after the PE event. The health economic evaluation of the Attend-PE model will include a cost-effectiveness analysis and a cost-utility analysis.

Ethics and dissemination

The project will be conducted by the Declaration of Helsinki. In accordance with the Danish Act on Health Research Ethics §14, the study is exempt from approval. The use of survey responses in research (in anonymous form) is, however, contingent on participants’ consent, and the invitation letter therefore included information about the purpose of the study and participants’ rights to withdraw consent at any time, and that completion of the questionnaire is considered as consent to their survey data to be included in research.

Study findings will be disseminated in scientific peer-reviewed journals, at national and international conferences, and for staff and decision-makers at participating hospitals and patients and relatives via the Danish Heart Association.

Trial registration number

Clinicaltrials.govNCT06037096.
Typologies of activity-related behaviours during adolescence and their transitions: a longitudinal analysis of the ELSPAC cohort
Authors: Janda David , Gába Aleš , Contardo Ayala Ana María , Timperio Anna , Andrýsková Lenka , Piler Pavel , Arundell Lauren
Published: December 2024

Objectives

The objective of this study was to identify typologies of activity-related behaviours during adolescence and to explore transitions between the identified typologies. Additionally, we aimed to identify demographic indicators associated with the transitions and typology membership.

Design

Prospective cohort study.

Setting

Czech Republic.

Participants

Individuals involved in the Czech part of the European Longitudinal Study of Pregnancy and Childhood study, aged 11 to 18 years. The study involved over 563 individuals, of whom 380 provided complete data for the analysis.

Primary outcome measures

Time spent outdoors, participation in organised physical activity (PA) and sport activities, time spent watching television and using a personal computer, and total sleep duration at ages 11, 15 and 18 years. Typologies were identified using Latent Transition Analysis.

Results

Four typologies of activity-related behaviours were identified and labelled to reflect their behavioural profiles: (1)Actives(high outdoor time and organised PA and sport participation, low screen time and optimal sleep duration); (2)Active screeners(median outdoor time, high organised PA and sport participation, high screen time, and optimal sleep duration); (3)Poor sleepers(average outdoor time and organised PA and sport participation, low screen time and not meeting sleep guidelines) and (4)Averages(average duration of all behaviours and optimal sleep duration). A major shift in typology membership from 11 to 18 years was observed, with a decreasing proportion of individuals in typologies characterised by a high proportion of outdoor time and participation in organised PA and sport activities (ie,Actives;Active screeners). A high proportion of individuals also transitioned to the typology with poor sleeping habits (ie,Poor sleepers). Sex and maternal education were associated with the typology membership and transition probabilities (p<0.05).

Conclusions

Targeting lifestyle interventions to those with specific lifestyle patterns in early adolescence may be beneficial for reducing the risk of poor sleep and promoting healthy lifestyle patterns later in life.
Customised 96-ocular TaqMan (iCAM) microarray PCR card for rapid diagnosis of microbial keratitis
Authors: Yang Yunfei , Roble Ahmed , Deshmukh Rashmi , Myerscough James , Curran Martin D , Rajan Madhavan S
Published: December 2024

Aim

To validate the diagnostic performance of a custom 96-micro-organism TaqMan PCR card (iCAM) for microbial keratitis (MK) from a single corneal epithelial sample.

Methods

Patients over the age of 18 referred to Cambridge University Hospital with MK were recruited in this single-site prospective cohort study between September 2021 and January 2023. An ocular-specific, customised microarray card (iCAM) was constructed according to primer and probe nucleotide sequences developed in our department to detect bacteria, viruses,Acanthamoebaand fungi commonly implicated in MK using a single corneal epithelial sample. Part of the corneal epithelial sample was taken for conventional cultures per local protocol, followed by iCAM array. Microbial detection rate and positive predictive value (PPV) were evaluated.

Results

38 corneal epithelial samples from 32 patients with MK and 4 control samples from healthy participants were obtained from 36 consecutive patients. A causative microbe was isolated in 15/34 samples (44%) using the iCAM test, compared with 15 by conventional methods (44%). iCAM test processing time varied between 6 and 24 hours compared with up to 7 days for conventional tests. Combined, the microbial detection rate was 65%, with the correlation between methods at 62%. The iCAM test could detect all major micro-organism groups with 56% sensitivity and 60% PPV.

Conclusions

The iCAM test can detect bacterial, fungal, viral and protozoan organisms using one corneal epithelial sample. The limitations include small patient cohort size and reduced volume of available corneal epithelial sample when shared between the iCAM PCR test and conventional culture methods utilised in the study. A multicentre trial is being planned to validate the clinical impact of using iCAM test on accuracy of diagnosis, early institution of appropriate antimicrobials and clinical outcomes.

Trial registration number

ISRCTN17422545.
Acceptability of artificial intelligence in breast screening: focus groups with the screening-eligible population in England
Authors: Gatting Lauren , Ahmed Syeda , Meccheri Priscilla , Newlands Rumana , Kehagia Angie A , Waller Jo
Published: December 2024

Introduction

Preliminary studies of artificial intelligence (AI) tools developed to support breast screening demonstrate the potential to reduce radiologist burden and improve cancer detection which could lead to improved breast cancer outcomes. This study explores the public acceptability of the use of AI in breast screening from the perspective of screening-eligible women in England.

Methods

64 women in England, aged 50–70 years (eligible for breast screening) and 45–49 years (approaching eligibility), participated in 12 focus groups—8 online and 4 in person. Specific scenarios in which AI may be used in the mammogram reading process were presented. Data were analysed using a reflexive thematic analysis.

Results

Four themes described public perceptions of AI in breast screening found in this study: (1)Things going wrong and being missedsummarises a predominant and pervasive concern about an AI tool being used in breast screening; (2)Speed of change and loss of controlcaptures a positive association of AI with technological advances held by the women but also feelings of things being out of their control, and that they were being left behind and in the dark; (3)The importance of humansreports concern around the possibility that AI excludes humans and renders them redundant and (4)Desire for thorough research, staggered implementation and double-checkingof scans included insistence that any AI be thoroughly trialled, tested and not solely relied on when initially implemented.

Conclusions

It will be essential that future decision-making and communication about AI implementation in breast screening (and, likely, in healthcare more widely) address concerns surrounding (1) the fallibility of AI, (2) lack of inclusion, control and transparency in relation to healthcare and technology decisions and (3) humans being left redundant and unneeded, while building on women’s hopes for the technology.
Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study
Authors: Gleason Jessica L , Lambert Calvin , Chen Zhen , Wagner Kathryn A , Mendola Pauline , Ouidir Marion , Grobman William A , Newman Roger , Tekola-Ayele Fasil , Grantz Katherine L
Published: December 2024

Introduction

Racial and ethnic differences in fetal growth and birth size in the USA have not been adequately explained by individual-level socioeconomic status (SES) factors. We explored whether differences may be partially explained by county-level indicators of SES.

Methods

We linked participant zip codes from the National Institute of Child Health and Human Development Fetal Growth Studies (2009–2013; n=1614) to county-level US census data to calculate a neighbourhood deprivation index, education isolation index and two indices of segregation: racial isolation and evenness. Using causal mediation methods, we evaluated the extent to which racial/ethnic differences in neonatal anthropometrics could be eliminated in a hypothetical setting where everyone lived in counties with high resource availability and racial/ethnic integration.

Results

Setting racial evenness to levels consistent with the highest diversity eliminated 79.9% of the difference in birth weight between non-Hispanic White and non-Hispanic Black and all the difference (106.3%) in birth weight between Hispanic and non-Hispanic White individuals. Setting racial evenness, racial isolation and education isolation to levels consistent with higher diversity and education was also associated with similar reductions in differences for other anthropometric measures.

Conclusions

Our findings suggest that, in a hypothetical scenario where everyone lived in counties with low deprivation or segregation, race/ethnic differences in neonatal anthropometry may substantially decrease or be eliminated. Our results also highlight the importance of considering community-level and structural factors in analyses of race/ethnic health disparities.
E-learning module on tobacco counselling for students of medicine and dentistry in India: a needs analysis using mixed-methods research
Authors: B R Chandrashekar , Khanum Nishath , Kulkarni Praveen , Basavegowda Madhu , M Kishor , S Suma
Published: December 2024

Introduction

In the background of lack of integrated tobacco counselling training (TCT) in the existing medical and dental curriculum, the present study was undertaken to determine the need for developing an e-learning module on tobacco counselling for students of medicine and dentistry in India.

Methods

A mixed-method research with a modified exploratory sequential design was undertaken between January and August 2022 in a private medical and a dental college in Southern India, where the qualitative research was done by conducting in-depth interviews with six subject experts and two focus group discussions (FGDs) separately among six medical and six dental interns to identify the gaps in current TCT. Based on the themes from qualitative research, a questionnaire was developed and validated to elicit the knowledge and competence in tobacco counselling. This questionnaire was subsequently used to explore quantitatively the current knowledge and competence in tobacco counselling among the final-year MBBS (bachelor of medicine and bachelor of surgery) and BDS (bachelor of dental surgery) students. The results of the questionnaire study were triangulated with the themes of the qualitative research.

Results

The qualitative research proffered the lack of structured TCT in the present curriculum and emphasised the need for an integrated, self-paced e-learning tobacco counselling training module (TCTM) in the background of curricular time constraints to accommodate a conventional classroom-based TCTM. During the in-depth interviews and FGDs, the participants suggested including the global burden and pattern of tobacco consumption, tobacco control laws and tobacco counselling methods, as some of the key contents of the module. The quantitative data analysis revealed the lack of knowledge and competence of students in tobacco counselling. The results of the quantitative phase substantiated the themes that emerged from the qualitative phase.

Conclusion

There is a need for introducing a customised, self-paced, integrated e-learning module on tobacco counselling for the students of medicine and dentistry in India. The e-learning module can be included as a choice-based value addition to the regular curriculum.
Future time perspectives and concerns among adolescents in 2022
Authors: Dumont Roxane , Lorthe Elsa , Richard Viviane , Loizeau Andrea , Posfay-Barbe Klara M , Barbe Rémy P , Stringhini Silvia , Guessous Idris
Published: December 2024

Future time perspectives (FTP) and future-related concerns in adolescence remain underexplored. We aimed to identify factors associated with limited FTP and describe future-related concerns. Data were drawn from a population-based sample of adolescents aged 14–17 participating in the SEROCoV-KIDS cohort study, in Geneva, Switzerland (October 2022). Of 329 adolescents, 56/329 (17%) reported limited FTP; determinants included prior low mental well-being, limited social support, sexual minority identity, academic difficulties and excessive screen time. Adolescents’ main future-oriented concerns encompassed failure, education and climate change. These results underscore the need to address future perspectives/concerns among young people and implement interventions that strengthen adolescent resilience.
Associations between adolescent psychiatric disorders and adulthood payment problems: a Norwegian register study of complete birth cohorts of 1995–1997
Authors: Hiilamo Aapo , Jensen Maria Reinholdt , Hermansen Åsmund
Published: December 2024

Background

Psychiatric disorder diagnoses are linked to long-term socioeconomic ‘shadows’ into adulthood, but little is known about how these diagnoses are associated with adulthood payment problems in Norway and whether these associations are moderated by parental and area characteristics.

Methods

We combine Norwegian registry data with payment problem records from the public debt enforcement agency for the 1995–1997 birth cohorts (n=173 750). We ascertain behavioural, neurotic, mood and substance use disorder diagnoses from specialised care at ages 13–17. Payment problems are defined as any records of mandatory deductions in wages or benefits up to age 23. Causal forests are used to explore the potential moderating role of sociodemographic variables.

Results

Some 6% of the sample have payment problems, but the share is higher among men and among people with low childhood socioeconomic status. After adjusting for background characteristics, behavioural problem diagnoses are linked to a 4.6 percentage point higher risk of payment problems (95% CI 4.1 to 5), mood disorder diagnoses to a 2.2 percentage point higher risk (95% CI 1.5 to 2.9), neurotic disorder diagnoses to a 2.5 percentage point higher risk (95% CI 2 to 3.1) and substance use disorder diagnoses to a 9.3 percentage point higher risk (95% CI 7.6 to 10.9). The associations between substance use and behavioural diagnoses and payment problems are stronger for people with low childhood socioeconomic status.

Conclusion

The associations between adolescent substance and behavioural diagnoses and adulthood payment problems are particularly strong among people with low childhood socioeconomic status. Reducing these associations is critical for preventing the accumulation of disadvantages.
Quiet effect of lacking leadership in healthcare education
Authors: Arigapudi Nithya
Published: December 2024

Background

In the landscape of Indian healthcare, the role of leadership in addressing disparities and driving change is often overlooked, particularly within medical education. Through the lens of the author journeying from a volunteer to ultimately a leader of a student-led non-profit organisation, this article explores the reason, rhyme and possible resolutions to the quiet effect of lacking leadership in healthcare education.

Methods

Drawing from personal experience and reflections, the article highlights the profound impact of grassroots initiatives in reaching underserved populations and how inadequate leadership hindered their ability to scale effectively. Insights into the challenges encountered and the barriers that needed to be overcome have been elaborated to unravel the possible origins of this problem and address potential solutions throughout various levels of health education.

Results

Although there is rarely a simple solution to a complex challenge, building adequate mentorship and support can help sustain leadership efforts in leadership by providing a pillar to lean on without diminishing individualised effort for growth. Cultivating collaborative networks can further provide opportunities to kindle the flame of leadership among young doctors.

Conclusions

By fostering a culture of leadership, medical education can produce professionals who are skilled clinicians and innovative leaders capable of driving change in the community.
Impact of competency training on medical administrators: an evaluation of medical management and leadership development programme
Authors: Cheng Shuyuan , He Fengying , Su Xiaoxin , Liu Yanxin , Cheung Mingyen , Mah Alastair P
Published: December 2024

Background

China’s healthcare sector is facing unprecedented challenges, placing substantial requirements on the competencies of medical administrators. Training programmes play a crucial role in enhancing the competencies of medical administrators to deliver high-quality healthcare services. This study aims to investigate the outcome of training on the competency of medical administrators and to use the findings to guide the development of future training content.

Methods

The Medical Management and Leadership Development Programme, grounded in the Royal Australasian College of Medical Administrators competency model, was implemented as a three-phase training programme for medical administrators at United Family Healthcare to assess the impact of training on their competency.

Results

The study’s results revealed significant differences in participants’ competencies across various domains between the pretest and post-test phases of the training programmes. These findings highlight parts where the training was effective and areas that may require further development to enhance overall competency.

Conclusions

The results indicate a positive impact of competency training on enhancing the skills of medical administrators. Additionally, the study offers valuable insights for optimising future training content.
Patients achieving low lupus disease activity state, systemic lupus erythematosus disease control or remission showed lower rates of organ damage during longitudinal follow-up: analysis of the Hopkins Lupus Cohort
Authors: Hunnicutt Jacob , Georgiou Mary Elizabeth , Richards Anna , Quasny Holly , Magder Laurence , Goldman Daniel , Petri Michelle A
Published: December 2024

Objective

One key target of treating patients with systemic lupus erythematosus (SLE) is to prevent organ damage. This analysis quantified the association between time spent in four specific SLE low disease activity (LDA) states and organ damage rate.

Methods

This retrospective real-world data analysis (GSK Study 207168), undertaken to help contextualise the BLISS-BELIEVE clinical trial, included adults with SLE enrolled for≥1 year in the Hopkins Lupus Cohort and treated with standard therapy in a specialist care centre between 1987 and 2019. LDA states (Lupus Low Disease Activity State (LLDAS), disease control, clinical and complete remissions) were defined using SLE Disease Activity Index (SLEDAI)/Physician Global Assessment scores, prednisone-equivalent dose and medication use criteria combinations. Time spent in each LDA state was expressed as a percentage of total follow-up (0%; >0–<25%; 25–49%; 50–74%; ≥75%). Pooled logistic models were used to estimate adjusted rate ratios (aRR) between time spent in LDA states and organ damage rate (assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)).

Results

Overall, 1632 patients experienced 1246 organ damage events. Follow-up time (calculated from days of follow-up) totalled 9841.1 person-years. At baseline, the mean (SD) SLEDAI score was 2.8 (3.3) and the mean (SD) SDI score was 1.7 (1.9). Organ damage rates were lower in patients who achieved an LDA state versus those who did not. Rates decreased with increasing time spent in each LDA state. Even a small percentage of time (>0–<25% vs 0%) spent in an LDA state was associated with reduced damage (aRR (95% CI): LLDAS, 0.75 (0.61, 0.91); disease control, 0.80 (0.68, 0.93); clinical remission, 0.73 (0.60, 0.88); complete remission, 0.80 (0.68, 0.93)).

Conclusions

Regardless of definition, achieving and maintaining a low disease activity state was associated with reduced organ damage in patients with SLE.
What do medical students, residents and graduated physicians think about occupational physicians? A cross-national survey on stereotypes
Authors: Lamouroux Céline , Julien Cédric , Rolland Franck , Gouy Evan , Truong Linh-Nam , Frajerman Ariel , Vinchon Florent , Hadouiri Nawale
Published: December 2024

Introduction

French medical students can access occupational medicine after passing the residency examination. Few studies have looked at the lack of attractiveness of occupational medicine, contributing to the demographic decline of occupational physicians (OPs). The purpose of this study was to explore the stereotypes of OPs by their colleagues at different levels of formation to understand the determinants of the current lack of attractiveness.

Methods

An anonymous survey was sent to medical students, residents and graduated physicians in March and April 2021. After filling a part about socio-demographic data, participants were asked to give four words about OP, based on the hierarchical evocation method. A descending hierarchical classification method was used to classify words according to their lexical proximity. Then, the corpus’ central core was defined by prototypical analysis.

Results

268 students (107 medical students and 161 residents) and 136 graduated physicians completed the questionnaire. The most important class was about ‘negative stereotypes of OP’. In the prototypical analysis, the central core was composed of both words relative to the « OP’s skills » and a majority of words concerning ‘OP’s negative stereotypes’.

Conclusion

This study confirmed that OPs suffer from negative stereotyping by their colleagues. Better communication of their functions throughout medical school would improve their image in the medical community.
Petrography and geochemical characterization of lithium-bearing pegmatites at Sambaru, Ikungi District, Central Tanzania
Authors: Mwambeje Solomon Agrey , Sankaranna Gaduputi , Msabi Michael , Godfray Godson , Mahwa Joshua
Published: December 2024

This study aimed to analyse the mineralogical and elemental composition of pegmatites, classify the pegmatites and assess the potential for lithium exploration in the Sambaru area. Various analytical techniques were employed, including petrography, X-ray fluorescence for major elements, laser ablation–inductively coupled plasma–mass spectrometry for trace and rare earth elements, microwave extraction for lithium concentration, electron probe micro-analysis for individual minerals and scanning electron microscopy with energy dispersive X-ray spectroscopy for mineral composition and morphology analysis. The results indicated that Sambaru pegmatites showed imperfections in internal evolution, characterized by mineral assemblages such as quartz–K-feldspar–apatite, quartz–K-feldspar–plagioclase–lepidolite–muscovite, with accessory minerals such as apatite, monazite and garnet. The presence of trace elements (Sc, V, Co, Zn, Rb, Sr, Nb, Sn, Cs, Ta, Th, U) and minerals such as Fe, Li and Mn-rich muscovite, monazite and columbite suggests that these pegmatites belong to the lithium–cesium–tantalum family of pegmatites, originating from a peraluminous silica melt. The positive correlation between Fe and F contents and the presence of albite-rich feldspars indicates evolution from a highly differentiated melt. A chondrite-normalized diagram revealed a negative Eu anomaly and enrichment of medium rare earth elements (Sm, Gd, Tb), suggesting that the pegmatites evolved from a fractionated plagioclase-rich melt, with lepidolite identified as the main lithium ore mineral. The evolution of the pegmatite occurred in two stages: the primary stage involved the crystallization of key minerals such as plagioclase (mainly albite), muscovite and K-feldspar, while the secondary stage saw the formation of Li-rich muscovite. The transition between these stages was marked by the presence of accessory minerals such as monazite and zircon. Most samples contained lithium concentrations above 0.016 g t
−1
, with three samples showing significant concentrations of 2.6, 3.3 and 3.8 g t
−1
, highlighting the potential for further lithium exploration and small-scale mining.
Diagenetic evolution of the Bunter Sandstone Formation and its controls on reservoir quality: implications for CO
2
injectivity and storage
Authors: Rushton Jeremy C. , Hannis Sarah , Pearce Jonathan , Williams John , Milodowski Antoni E.
Published: December 2024

The Bunter Sandstone Formation (BSF) is a target reservoir for the storage of CO
2
in the UK Southern North Sea (UKSNS). Previous industry studies highlighted diagenetic features that influence fluid flow in the BSF but failed to identify the controls and patterns of regional diagenesis that are now needed to inform more accurate prediction of porosity distribution and connectivity for CO
2
storage. This study presents a regional diagenetic model from the petrographical analysis of 78 samples from 12 wells in the northern UKSNS. Diagenetic cements (carbonates, sulfates and halite) are common. Most are early and episodic, patchy at local and regional scales, with periods of replacement and dissolution. Consequential fine-scale heterogeneous compaction textures are unrelated to current or maximum burial depths. Calcrete and dolocrete layers, associated with the formation of displacive eodiagenetic carbonate nodules, form discontinuous millimetre- to metre-thick vertical flow barriers. Halite and anhydrite are developed preferentially in coarser-grained sandstones, resulting in the ‘reservoir quality inversion’ noted in previous studies. There is abundant evidence for local, late mobilization and dissolution of halite and anhydrite, observed to preferentially affect samples from depths above
c
.1400 m, restoring some zones to good porosity. Additional high-density sampling and petrography is recommended, however, to provide the predictability required for CO
2
storage.
Piecing Together the Jigsaw Puzzle of Transactions on Heterogeneous Blockchain Networks
Authors: Hu Xiaohui , Feng Hang , Xia Pengcheng , Tyson Gareth , Wu Lei , Zhou Yajin , Wang Haoyu
Published: December 2024

The Web3 ecosystem is increasingly evolving to multi-chain, with decentralized applications (dApps) distributing across different blockchains, which drives the need for cross-chain bridges for blockchain interoperability. However, it further opens new attack surfaces, and media outlets have reported serious attacks related to cross-chain bridges. Nevertheless, few prior research studies have studied cross-chain bridges and their related transactions, especially from a security perspective. To fill the void, this paper presents the first comprehensive analysis of cross-chain transactions. We first make efforts to create by far the largest cross-chain transaction dataset based on semantic analysis of popular cross-chain bridges, covering 13 decentralized bridges and 7 representative blockchains, with over 80 million transactions in total. Based on this comprehensive dataset, we present the landscape of cross-chain transactions from angles including token usage, user profile and the purposes of transactions, etc. We further observe that cross-chain bridges can be abused for malicious/aggressive purposes, thus we design an automated detector and deploy it in the wild to flag misbehaviors from millions of cross-chain transactions. We have identified hundreds of abnormal transactions related to exploits and arbitrages, etc. Our research underscores the prevalence of cross-chain ecosystems, unveils their characteristics, and proposes an effective detector for pinpointing security threats.
ScaleOPT: A Scalable Optimal Page Replacement Policy Simulator
Authors: Han Hyungseok , Lee Sangjin , Son Yongseok
Published: December 2024

This paper proposes a scalable optimal page replacement policy (OPT) simulator called ScaleOPT to scale the OPT simulation by leveraging multi-core parallelism. Specifically, we first propose AccessMap which collects the future references of pages in parallel before the OPT simulation. It enables calculating the next reference time of the accessed page in a constant time. Second, we introduce Pipelined-Tree consisting of multiple trees which organize caches based on min-max reference times. It enables traverse and update operations of each cache to be performed in a partially parallel manner (i.e., pipelined), thereby scaling out the OPT simulation on multi-cores. Finally, we implement ScaleOPT with two techniques and evaluate it on a 72-core machine. The experimental results demonstrate that ScaleOPT improves the simulation time by up to 6.3×, 7.7×, 20.5×, and 13.9× compared with the long-established standard algorithm-based simulator along with our AccessMap, a variable-size cache scheme, and two widely-used cache simulators (webcachesim and libCacheSim), respectively.
INT-MC: Low-Overhead In-Band Network-Wide Telemetry Based on Matrix Completion
Authors: Zeng Xin , Xie Kun , Li Yanbiao , Xu Ke , Xie Gaogang , Wen Jigang , Cong Yinchuan , Liang Wei
Published: December 2024

In-band Network Telemetry (INT) enhances real-time, high-resolution network monitoring capabilities by incorporating fine-grained internal state information into packets. Utilizing INT for network-wide visualization can significantly bolster network management and operation. Although existing studies have made significant contributions, they have not been able to simultaneously meet the following two objectives: 1)
Comprehensive visibility of the network's internal state,
which refers to obtaining information on all switch ports and their corresponding link states; 2)
Low measurement overhead,
which involves reducing measurement bandwidth overhead and minimizing the impact of the measurement process on the network. We designed INT-MC to meet both of these objectives. INT-MC is an efficient and cost-effective network-wide telemetry solution based on matrix completion. By modeling link metadata as a matrix and leveraging its low-rank property, INT-MC selectively measures certain links. It then employs matrix completion algorithms to infer information about unmeasured links, thereby achieving low-overhead network-wide telemetry. Designing paths to cover the target links involves an NP-complete problem, and the high computational complexity may delay the measurement tasks. To circumvent this, we propose an improved scheme based on Eulerian digraph decomposition, transforming the path calculation problem into a high-information path selection problem, significantly reducing computational costs.

We have implemented an INT-MC prototype within the NSFNet topology, consisting of 14 Tofino switches and 10 end-hosts, and conducted extensive experiments and evaluations. The results indicate that INT-MC incurs only 16% of the measurement overhead compared to existing network-wide telemetry solutions, while achieving nearly identical accuracy. Even under high-frequency measurements of 20 times per second, the bandwidth overhead of INT-MC is approximately 0.075% of the total bandwidth, exerting minimal impact on the network.
The Power of Migrations in Dynamic Bin Packing
Authors: Mellou Konstantina , Molinaro Marco , Zhou Rudy
Published: December 2024

In the
Dynamic Bin Packing
problem,
n
items arrive and depart the system in an online manner, and the goal is to maintain a good packing throughout. We consider the objective of minimizing the total active time, i.e., the sum of the number of open bins over all times. An important tool for maintaining an efficient packing in many applications is the use of
migrations
; e.g., transferring computing jobs across different machines. However, there are large gaps in our understanding of the approximability of dynamic bin packing with migrations. Prior work has covered the power of no migrations and > n migrations, but we ask the question: What is the power of limited (≤ n) migrations?

Our first result is a dichotomy between no migrations and linear migrations: Using a sublinear number of migrations is asymptotically equivalent to doing
zero
migrations, where the competitive ratio grows with μ, the ratio of the largest to smallest item duration. On the other hand, we prove that for every α ∈ (0,1], there is an algorithm that does ≈ α n migrations and achieves competitive ratio ≈ 1/α (in particular, independent of μ); we also show that this tradeoff is essentially best possible. This fills in the gap between zero migrations and > n migrations in Dynamic Bin Packing.

Finally, in light of the above impossibility results, we introduce a new model that more directly captures the impact of migrations. Instead of limiting the number of migrations, each migration adds a delay of
C
time units to the item's duration; this commonly appears in settings where a blackout or set-up time is required before the item can restart its execution in the new bin. In this new model, we prove a O(min(√C, μ))-approximation, and an almost matching lower bound. We also present preliminary experiments that indicate that our theoretical results are predictive of the practical performance of our algorithms.
DistMeasure
: A Framework for Runtime Characterization and Quality Assessment of Distributed Software via Interprocess Communications
Authors: Fu Xiaoqin , Zaman Asif , Cai Haipeng
Published: December 2024

A defining, unique aspect of distributed systems lies in interprocess communication (IPC) through which distributed components interact and collaborate toward the holistic system behaviors. This highly decoupled construction intuitively contributes to the scalability, performance, and resiliency advantages of distributed software, but also adds largely to their greater complexity, compared to centralized software. Yet despite the importance of IPC in distributed systems, little is known about
how to quantify IPC-induced behaviors in these systems through IPC measurement and how such behaviors may be related to the quality of distributed software
. To answer these questions, in this article, we present
DistMeasure
, a framework for measuring distributed software systems via the lens of IPC hence enabling the study of its correlation with distributed system quality. Underlying
DistMeasure
is a novel set of IPC metrics that focus on gauging the coupling and cohesion of distributed processes. Through these metrics,
DistMeasure
quantifies relevant runtime characteristics of distributed systems and their quality relevance, covering a range of quality aspects each via respective direct quality metrics. Further,
DistMeasure
enables predictive assessment of distributed system quality in those aspects via learning-based anomaly detection with respect to the corresponding quality metrics based on their significant correlations with related IPC metrics. Using
DistMeasure
, we demonstrated the practicality and usefulness of IPC measurement against 11 real-world distributed systems and their diverse execution scenarios. Among other findings, our results revealed that IPC has a strong correlation with distributed system complexity, performance efficiency, and security. Higher IPC coupling between distributed processes tended to be negatively indicative of distributed software quality, while more cohesive processes have positive quality implications. Yet overall IPC-induced behaviors are largely independent of the system scale, and higher (lower) process coupling does not necessarily come with lower (higher) process cohesion. We also show promising merits (with 98% precision/recall/F1) of IPC measurement (e.g., class-level coupling and process-level cohesion) for predictive anomaly assessment of various aspects (e.g., attack surface and performance efficiency) of distributed system quality.
Disease Outbreak Detection and Forecasting: A Review of Methods and Data Sources
Authors: Babanejaddehaki Ghazaleh , An Aijun , Papagelis Manos
Published: December 2024

Infectious diseases occur when pathogens from other individuals or animals infect a person, causing harm to both individuals and society. Outbreaks of such diseases can pose a significant threat to human health. However, early detection and tracking of these outbreaks have the potential to reduce mortality rates. To address these threats, public health authorities have endeavored to establish comprehensive mechanisms for collecting disease data. Many countries have implemented infectious disease surveillance systems, with epidemic detection as a primary objective. The clinical healthcare system, local/state health agencies, federal agencies, academic/professional groups, and collaborating governmental entities all play pivotal roles within this system. Moreover, search engines and social media platforms can serve as valuable tools for monitoring disease trends. The Internet and social media have become significant platforms where users share information about their preferences and relationships. This real-time information can be harnessed to gauge the influence of ideas and societal opinions, proving highly useful across various domains and research areas, such as marketing campaigns, financial predictions, and public health. This article provides a review of the existing standard methods developed by researchers for detecting outbreaks using time series data. These methods leverage various data sources, including conventional data sources and social media data or Internet data sources. The review particularly concentrates on works published within the timeframe of 2015 to 2022.