bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and facilitators to learning health systems in primary care: a framework analysis
Authors: Fisher Georgia , Saba Maree , Dammery Genevieve , Ellis Louise A , Churruca Kate , Mahadeva Janani , Foo Darran , Wilcock Simon , Braithwaite Jeffrey
Published: June 2024

Background

The learning health system (LHS) concept is a potential solution to the challenges currently faced by primary care. There are few descriptions of the barriers and facilitators to achieving an LHS in general practice, and even fewer that are underpinned by implementation science. This study aimed to describe the barriers and facilitators to achieving an LHS in primary care and provide practical recommendations for general practices on their journey towards an LHS.

Methods

This study is a secondary data analysis from a qualitative investigation of an LHS in a university-based general practice in Sydney, Australia. A framework analysis was conducted using transcripts from semistructured interviews with clinic staff. Data were coded according to the theoretical domains framework, and then to an LHS framework.

Results

91% (n=32) of practice staff were interviewed, comprising general practitioners (n=15), practice nurses (n=3), administrative staff (n=13) and a psychologist. Participants reported that the practice alignment with LHS principles was influenced by many behavioural determinants, some of which were applicable to healthcare in general, for example, some staff lackedknowledgeabout practice policies andskillsin using software. However, many were specific to the general practice environment, for example, theenvironmental contextof general practice meant that administrative staff were an integral part of the LHS, particularly in facilitating partnerships with patients.

Conclusions

The LHS journey in general practice is influenced by several factors. Mapping the LHS domains in relation to the theoretical domains framework can be used to generate a roadmap to hasten the journey towards LHS in primary care settings.
Defining the Black population in Canadian health research: a scoping review protocol
Authors: Uwamahoro Marie-Claire , Idowu James , Chowdhury Nashit , Bele Sumedh , Popeski Naomi , Boakye Francis , Odame-Ankrah Charles , King Regine , Rabi Doreen , Turin Tanvir C
Published: June 2024

Introduction

In the context of health research in Canada, various terms and labels have been employed to reference the Black population. This practice has had the unintended consequence of diminishing the comparability and efficiency of studies. Furthermore, using a broad term such as ‘Black’ may fail to encompass the diversity and intricacy of the ethnocultural backgrounds of people who are racialised as such. It may also obscure the subtleties of their experiences and health outcomes. This study aims to examine how health researchers have defined Black within the scope of their work and different labels used to identify the Black population in Canada.

Methods and analysis

We have developed and employed a comprehensive and sensitive search strategy to identify articles concerning the health and wellness of the Black population in Canada. Both peer-reviewed and grey literature will be searched. Original articles published in both English and French will be included. The screening process will consist of two stages: the title and abstract screening, followed by a thorough examination of full-text articles. Additionally, single citation tracking and manual search of reference lists will be conducted. Study characteristics and relevant information on the definition of the Black population will be extracted, followed by reflective thematic analysis and presentation of the key findings.

Ethics and dissemination

This review will not require ethical approval. We will disseminate the results through meetings with stakeholders. From the beginning, a knowledge translation approach was decided upon following consultation with citizen researchers and community champions. Our findings will also be disseminated through oral and poster presentations, peer-reviewed publications, and social media.
Knowledge, attitude and practice towards insomnia and sleep hygiene among patients with chronic insomnia in Northwest China in 2023: a cross-sectional survey
Authors: Zhu Jing , Zhang Shiping , Zhu Zhibo , Wang Jinghua , Kang Tao , Li Xin , Zhao Yikang , Zhu Lijuan
Published: June 2024

Objectives

To investigate the knowledge, attitude and practice (KAP) towards insomnia and sleep hygiene among patients with chronic insomnia.

Design

Web-based cross-sectional survey.

Setting

Shaanxi Provincial People’s Hospital (northwest China) between January 2023 and May 2023.

Participants

Patients with chronic insomnia.

Primary and secondary outcome measures

Demographic characteristics and KAP towards insomnia and sleep hygiene were collected by distributing a questionnaire developed by the authors.

Results

A total of 613 people participated in this study, with a Mean Knowledge Score of 7.63±2.56 (total score of 12), a Mean Attitude Score of 48.39±6.643 (total score of 70) and a Mean Practice Score of 42.37±8.592 (total score of 70). Knowledge was significantly correlated with attitude (r=0.447, p<0.001) and practice (r=0.327, p<0.001), and attitude was significantly correlated with practice (r=0.486, p<0.001). Multivariable logistic regression showed that higher knowledge (OR=1.181 (1.062–1.314), p=0.002) and better attitude (OR=1.171 (1.124–1.221), p<0.001) were independently associated with good practice. According to the structural equation modelling analysis, knowledge directly influenced practice (β=0.457, p=<0.001) and attitude (β=1.160, p=<0.001), while attitude influenced practice (β=0.550, p=<0.001).

Conclusion

The KAP towards insomnia and sleep hygiene among patients with chronic insomnia in Northwest China in 2023 was moderate, with better practice showing signs of being influenced by better knowledge and more positive attitudes.
Phase II study in children and adults under 40 years with newly diagnosed Langerhans cell histiocytosis: protocol for an LCH-19-MSMFB clinical trial in Japan
Authors: Ono Rintaro , Sakamoto Kenichi , Kudo Ko , Sato Aki , Kudo Kazuko , Fujino Hisanori , Kawahara Yuta , Hashimoto Hiroya , Doi Takehiko , Yanagisawa Ryu , Kawamata Toyotaka , Miyazaki Osamu , Nakazawa Atsuko , Ota Yasunori , Kanegane Hirokazu , Nakazawa Yozo , Horibe Keizo , Saito Akiko M , Manabe Atsushi , Usuki Kensuke , Kiyoi Hitoshi , Morimoto Akira , Tojo Arinobu , Shioda Yoko
Published: June 2024

Introduction

Although the prognosis of Langerhans cell histiocytosis (LCH) is excellent, the high recurrence rate and permanent consequences, such as central diabetes insipidus and LCH-associated neurodegenerative diseases, remain to be resolved. Based on previous reports that patients with high-risk multisystem LCH show elevated levels of inflammatory molecules, we hypothesised that dexamethasone would more effectively suppress LCH-associated inflammation, especially in the central nervous system (CNS). We further hypothesised that intrathecal chemotherapy would effectively reduce CNS complications. We administer zoledronate to patients with multifocal bone LCH based on an efficacy report from a small case series.

Methods and analysis

This phase II study (labelled the LCH-19-MSMFB study) is designed to evaluate the significance of introducing dexamethasone and intrathecal chemotherapy for multisystem disease and zoledronate for multifocal bone disease in previously untreated, newly diagnosed children, adolescents (under 20 years) and adults under 40 years. The primary endpoint is the 3-year event-free survival rate by risk group of under 20 years and the 3-year event-free survival rate of 20 years and over.

Ethics and dissemination

This study was approved by the Central Review Board of the National Hospital Organisation Nagoya Medical Centre (Nagoya, Japan) on 21 January 2022 and was registered in the Japan Registry of Clinical Trials (https://jrct.niph.go.jp/en-latest-detail/jRCTs041210027). Written informed consent will be obtained from all patients and/or their guardians.

Trial registration number

jRCTs041210027.
Scoping review protocol on the perception and attitude of women on methods for collecting cervicovaginal samples for human papillomavirus testing in sub-Saharan Africa
Authors: Andrew-Bassey Uduak Ima , Oke Deborah Olamiposi , Okunlola Michael A , Morhason-Bello Imran O
Published: June 2024

Introduction

Sub-Saharan Africa (SSA) regions have the highest burden of cervical cancer (CC), accounting for nearly a quarter of global mortality. Many women in SSA are reluctant to access CC screening because they are uncomfortable exposing their private parts to healthcare providers. The perception of women who have experienced self-sampling in SSA is yet to be reviewed. This scoping review will explore the literature on the perception and attitude of women towards methods of collecting cervicovaginal samples for human papillomavirus (HPV) testing in SSA.

Methods and analysis

An extensive search using the Arksey and O’Malley framework will be conducted. The search criteria will be limited to original research conducted in community or clinical settings in SSA within the last 10 years. Four databases, namely, PUBMED, Cochrane, African Journals Online and Google Scholar, will be searched. Two independent persons (UIAB and DOO) will screen the titles and abstracts and later full texts using population, intervention, comparison and outcome criteria. IOMB will serve as a tiebreaker whenever there is no agreement on the choice of eligibility criteria. The screening process will be presented using Preferred Reporting Items for Systematic Reviews and Meta-Analyses for the scoping review flow format. The descriptive analysis of eligible studies for scoping reviews will be summarised. We will describe themes of attitude and perception covering pain, embarrassment, privacy and comfortability, willingness to self-sample, anxiety and confidence.

Ethics and dissemination

This is a scoping review protocol and does not require ethical approval. Findings from this review will be disseminated through peer-reviewed publications, the production of policy briefs, and presentations at local and international conferences.
PRECISE trial (Pain RElief Combination Intervention StratEgies): protocol for the clinical trial of a pregabalin–melatonin combination for fibromyalgia
Authors: Gilron Ian , DeBow Chris , Elkerdawy Hala , Khan James S , Salomons Tim V , Duggan Scott , Tu Dongsheng , Holden Ronald R , Milev Roumen , Buckley D Norman , Moulin Dwight E
Published: June 2024

Introduction

Fibromyalgia is associated with chronic widespread pain and disturbed sleep. Multidisciplinary, multimodal management often includes pharmacotherapy; however, current drugs used to treat fibromyalgia provide meaningful benefit to only 30–60% of treated individuals. Combining two or more different drugs is common in clinical practice with the expectation of better efficacy, tolerability or both; however, further research is needed to identify which combinations actually provide added benefit. Thus, we are planning a clinical trial to evaluate melatonin (MLT)–pregabalin (PGB) combination in participants with fibromyalgia.

Methods and analysis

This will be a single-centre, double-blind, randomised, double-dummy, three-period, crossover trial comparing a MLT–PGB combination to each monotherapy in 54 adult participants satisfying the 2016 American College of Rheumatology criteria for fibromyalgia. Participants will receive maximally tolerated doses of MLT, PGB and MLT–PGB combination for 6 weeks. The primary outcome will be daily pain intensity (0–10); secondary outcomes will include the Fibromyalgia Impact Questionnaire, SF-36 survey, Medical Outcomes Study Sleep Scale, Beck Depression Inventory (BDI-II), adverse events and other measures. Analysis of the primary and secondary outcomes will involve a linear mixed model with sequence, period, treatment, the first-order carryover and baseline pain score as fixed effects and participant as a random effect to test whether there are any treatment differences among three treatments and to estimate the least square mean of the mean daily pain intensity for each treatment, adjusting for carryover as well as period effects (ie, stability of pain levels).

Ethics and dissemination

This trial has been registered with the International Standard Randomised Controlled Trial Number Registry, ISRCTN #18278231, has been granted ethical approval by the Queen’s University Health Sciences Research Ethics Board (Queen’s HSREB Protocol #6040998) and is currently under review for a Clinical Trial Application to Health Canada Natural and Non-prescription Health Products Directorate. All participants will provide written informed consent prior to trial participation. Following trial completion, results will be disseminated in one or more biomedical journal publications and presented at one or more scientific meetings.

Trial registration number

This trial has been registered with the International Standard Randomised Controlled Trial Number Registry,ISRCTN18278231.
Players are positive regarding injury prevention exercise programmes, but coaches need ongoing support: a survey-based evaluation using the Health Action Process Approach model across one season in amateur and youth football
Authors: Lindblom Hanna , Åkerlund Ida , Waldén Markus , Sonesson Sofi , Hägglund Martin
Published: June 2024

Objectives

Implementation of injury prevention exercise programmes (IPEPs) in sports is challenging, and behaviour change among players and coaches is essential for success. The aim was to describe players’ and coaches’ motivation and coaches’ goal pursuit when using IPEPs in amateur and youth football across a season. A secondary aim was to describe players’ motivation to engage in IPEP use in relation to presence or absence of injury.

Methods

The study was based on questionnaires to amateur and youth, male and female football players and coaches at baseline, mid-season and post-season in a three-armed randomised trial in 2020 in Sweden. Questionnaires were based on the Health Action Process Approach (HAPA) model with questions about the motivational phase when intention for change is created (players and coaches) and a goal-pursuit phase when intention is translated into action (coaches).

Results

In total, 455 players (126 male), mean age 20.1 years (SD±5.8, range 14–46) and 59 (52 male) coaches took part. Players generally gave positive answers in the HAPA motivational phase (Likert 6–7 on a 1–7 Likert scale). Differences in ratings between injured and uninjured players were minor. Coaches had positive or neutral ratings (Likert 4–6) in the motivational and goal-pursuit phases. Ratings deteriorated across the season, with less positive responses from 40% of players and 38-46% of coaches post-season.

Conclusion

Positive ratings in the HAPA motivational phase indicated fertile ground for IPEP use. Neutral ratings by coaches and deterioration across the season in players and coaches suggest a need for ongoing support for IPEP use.

Trial registration number

NCT04272047.
Correlation of Ktransderived from dynamic contrast-enhanced MRI with treatment response and survival in locally advanced NSCLC patients undergoing induction immunochemotherapy and concurrent chemoradiotherapy
Authors: Wang DaQuan , Liu SongRan , Fu Jia , Zhang PengXin , Zheng ShiYang , Qiu Bo , Liu Hui , Ye YongQuan , Guo JinYu , Zhou Yin , Jiang HaiHang , Yin ShaoHan , He HaoQiang , Xie ChuanMiao , Liu Hui
Published: June 2024

Purpose

This study aimed to investigate the prognostic significance of pretreatment dynamic contrast-enhanced (DCE)-MRI parameters concerning tumor response following induction immunochemotherapy and survival outcomes in patients with locally advanced non-small cell lung cancer (NSCLC) who underwent immunotherapy-based multimodal treatments.

Material and methods

Unresectable stage III NSCLC patients treated by induction immunochemotherapy, concurrent chemoradiotherapy (CCRT) with or without consolidative immunotherapy from two prospective clinical trials were screened. Using the two-compartment Extend Tofts model, the parameters including Ktrans, Kep, Ve, and Vpwere calculated from DCE-MRI data. The apparent diffusion coefficient was calculated from diffusion-weighted-MRI data. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to assess the predictive performance of MRI parameters. The Cox regression model was used for univariate and multivariate analysis.

Results

111 unresectable stage III NSCLC patients were enrolled. Patients received two cycles of induction immunochemotherapy and CCRT, with or without consolidative immunotherapy. With the median follow-up of 22.3 months, the median progression-free survival (PFS) and overall survival (OS) were 16.3 and 23.8 months. The multivariate analysis suggested that Eastern Cooperative Oncology Group score, TNM stage and the response to induction immunochemotherapy were significantly related to both PFS and OS. After induction immunochemotherapy, 67 patients (59.8%) achieved complete response or partial response and 44 patients (40.2%) had stable disease or progressive disease. The Ktransof primary lung tumor before induction immunochemotherapy yielded the best performance in predicting the treatment response, with an AUC of 0.800. Patients were categorized into two groups: high-Ktransgroup (n=67, Ktrans＞164.3×10−3/min) and low-Ktransgroup (n=44, Ktrans≤164.3×10−3/min) based on the ROC analysis. The high-Ktransgroup had a significantly higher objective response rate than the low-Ktransgroup (85.1% (57/67) vs 22.7% (10/44), p<0.001). The high-Ktransgroup also presented better PFS (median: 21.1 vs 11.3 months, p=0.002) and OS (median: 34.3 vs 15.6 months, p=0.035) than the low-Ktransgroup.

Conclusions

Pretreatment Ktransvalue emerged as a significant predictor of the early response to induction immunochemotherapy and survival outcomes in unresectable stage III NSCLC patients who underwent immunotherapy-based multimodal treatments. Elevated Ktransvalues correlated positively with enhanced treatment response, leading to extended PFS and OS durations.
Evaluation of a portable, lightweight modular system to deliver high inspired oxygen to trauma casualties without the use of pressurised cylinders
Authors: Kirkman Emrys , Pope C , Wilson C , Woolley T , Watts S , Byers M
Published: June 2024

Introduction

Administering supplemental oxygen is a standard of care for trauma casualties to minimise the deleterious effects of hypoxaemia. Forward deployment of oxygen using pressurised cylinders is challenging, for example, logistics (weight and finite resource) and environmental risk (fire and explosion). Oxygen concentrators may overcome these challenges. Although previous studies successfully demonstrated fractional inspired oxygen (FiO2) >0.8 using oxygen concentrators and ventilators, the systems did not fulfil the size, weight and power requirements of agile military medical units. This study evaluated whether a modular system of commercially available clinical devices could supply high FiO2to either ventilated or spontaneously breathing casualties.

Methods

As a proof of principle, we configured an Inogen One G5 oxygen concentrator, Ventway Sparrow ventilator and Wenoll rebreather system to ventilate a simulated lung (tidal volume 500 mL). Casualty oxygen consumption (gas withdrawal inspiratory limb) and carbon dioxide (CO2) production (CO2added expiratory limb) were simulated (respiratory quotient of 0.7–0.8). Three circuit configurations were evaluated: open (supplementary oxygen introduced into air inlet of ventilator); semiclosed (ventilator replaces rebreather bag of Wenoll, oxygen connected to either ventilator or Wenoll); and semiclosed with reservoir tubing (addition of ‘deadspace’ tube between ventilator patient circuit and Wenoll). Data presented as mean and 95% reference range.

Results

There were modest increases in FiO2with increasing Inogen settings in ‘open’ configuration 0.23 (0.23–0.24) and 0.30 (0.28–0.32) (Inogen output 420 and 1260 mL/min, respectively). With the ‘semiclosed’ configuration and oxygen added directly into rebreather circuit, FiO2increased to 0.36 (0.36–0.37). The addition of the ‘reservoir tubing’ elevated FiO2to 0.78 (0.71–0.85). FiO2remained stable over a 4-hour evaluation period. Fractional inspired carbon dioxide CO2increased over time, reaching 0.005 after 170 (157–182) min.

Conclusion

Combining existing lightweight devices can deliver high (>0.8) FiO2and offers a potential solution for the forward deployment of oxygen without needing pressurised cylinders.
Investigating the B-meson production based on the color dipole transverse momentum representation in pp collisions at the LHC
Authors: Sampaio dos Santos G. , Gil da Silveira G. , Machado M. V. T.
Published: June 2024

In this work the B-mesons differential cross sections in pp collisions are evaluated considering the color dipole formalism in transverse momentum representation along with the unintegrated gluon distributions (UGDs). Analytical parametrizations for UGDs including hard scale QCD evolution and those based on parton saturation framework are compared. The theoretical predictions for the B-meson production in terms of the transverse momentum distribution cover the center-of-mass energy of the Large Hadron Collider and the rapidities available at its experiments. The results for different B-mesons are compared to the corresponding measurements reported by the ATLAS, CMS, and LHCb experiments. Predictions are also performed for the nuclear modification factor as a function of the meson transverse momentum.
Neutrino mixing model for best-fit values of θ12 and θ13
Authors: Hyodo Yuta , Kitabayashi Teruyuki
Published: June 2024

Recently, the precise observations have yielded values for the neutrino mixing angles, denoted as [Formula: see text] and [Formula: see text]. Therefore, constructing a neutrino mixing model capable of accurately reflecting these measurements is crucial. In this paper, we propose a novel neutrino mixing model similar to the trimaximal mixing model. Unlike the trimaximal model that falls short of concurrently replicating the best-fit values of [Formula: see text] and [Formula: see text], our proposed mixing model has the ability to simultaneously reproduce the best-fit values for both angles.
Bifurcation Analysis and Spatiotemporal Dynamics in a Diffusive Predator–Prey System Incorporating a Holling Type II Functional Response
Authors: Anshu  , Sajan  , Dubey Balram
Published: June 2024

This study aims to investigate a diffusive predator–prey system incorporating additional food for predators, prey refuge, fear effect, and its carry-over effects. For the temporal model, the well-posedness and persistence of the system have been discussed. We investigated the existence and the stability behavior of the various equilibria. Furthermore, we explored the bifurcations of codimension-1 including transcritical, saddle-node, and Hopf, concerning the crucial parameters. The system also presents codimension-2 bifurcations such as Bogdanov–Takens and cusp bifurcation along with the global homoclinic bifurcation. We observed the bubbling phenomena, which illustrate the fluctuations in the amplitudes of the periodic oscillations. For the spatiotemporal system, we established the non-negativity and boundedness of the solutions. We derived the conditions for the diffusion-driven instabilities in a confined region with Neumann boundary conditions. Extensive numerical simulations have been conducted to depict the various stationary patterns in Turing space. It is observed that incorporating cross-diffusion divides the bi-parametric plane into various sub-regions and dynamic patterns are analyzed in these different regions. The intricate spatiotemporal dynamics exhibited by prey–predator interactions are crucial for unraveling the intricacies within ecological systems.
Beyond Turing: Testing LLMs for Intelligence
Authors: Savage Neil
Published: June 2024

Modern large language models appear to be able to fool the Turing Test. Will we know if they are becoming as intelligent as people?
The Impact of AI on Computer Science Education
Authors: Shein Esther
Published: June 2024

Understanding why “working hard and struggling is … an important way of learning.”
Tailoring the Structure, Optical and Shielding Characteristics of ZnMn2O4 Nanostructures through Sn-Doping
Authors: Heiba Zein K. , Ghannam M. M. , Badawi Ali , Mohamed Mohamed Bakr
Published: June 2024

The current study aims to tailor the structure, optical and shielding characteristics of ZnMn2O4 nanostructures through Sn-doping. ZnMn2−xSnxO4 nanostructures were synthesized by the sol-gel technique. The sample containing 5% Sn exhibits the highest level of absorbance. ZnMn2−xSnxO4 system exhibits a maximum optical energy gap value of 2.55 eV when doped with 10% Sn, and a minimum optical energy gap value of 2.23 eV when doped with 5% Sn. The refractive index values of the samples containing 5 and 10% Sn are the highest in comparison to the other samples. The values of the non-linear optical parameters became maximum as x = 0.05. The radiation shielding constants were computed by Phy-X/PSD software. The half value length and tenth value length values reduced as ZnMn2O4 doped with Sn, implying that doped samples have better shielding capabilities than undoped ZnMn2O4. When compared to doped samples, ZnMn2O4 has the highest fast neutron removal cross-section value. ZnMn2-xSnxO4 samples demonstrate a greater rate of absorption for photons with lower energy as opposed to those with higher energy.
Synthesis and Tuning of Electronic, Optical, and Photoelectrochemical Properties of Copper Metavanadate Alloys via Alkaline Earth Metal Substitution
Authors: Danladi Fahad I. , Rawat Abhishek , Adak Abhishek Kumar , Zhang Chuzhong , Sangwan Vinod K. , Ananth Riddhi , Hersam Mark C. , Meletis Efstathios I. , Rajeshwar Krishnan
Published: June 2024

Unlike the well-studied and technologically advanced Group III-V and Group II-VI compound semiconductor alloys, alloys of ternary metal oxide semiconductors have only recently begun to receive widespread attention. Here, we describe the effect of alkaline earth metal substitution on the optical, electronic, and photoelectrochemical (PEC) properties of copper metavanadate (CuV2O6). As a host, the Cu-V-O compound family presents a versatile framework to develop such composition-property correlations. Alloy compositions of A0.1Cu0.9V2O6 (A = Mg, Ca) photoanodes were synthesized via a time and energy-efficient solution combustion synthesis (SCS) method. The effect of introducing alkaline earth metals (Mg, Ca) on the crystal structure, microstructure, electronic, and optical properties of copper metavanadates was investigated by powder X-ray diffraction (PXRD), scanning electron microscopy (SEM), diffuse reflectance spectroscopy (DRS), transmission electron microscopy (TEM), and Raman spectroscopy. The PXRD, TEM, and Raman spectroscopy data demonstrated the polycrystalline powder samples to be mutually soluble, solid solutions of copper and alkaline earth metal metavanadates and not simple mixtures of these compounds. The DRS data showed a systematic decrease in the optical bandgap with Cu incorporation. These trends were corroborated by electronic band structure calculations. Finally, the PEC properties exhibited a strong dependence on the alloy composition, pointing to possible applicability in solar water splitting, heterogeneous photocatalysis, phosphor lighting/displays, and photovoltaic devices.
Pneumothorax, Pneumomediastinum, and Cervical and Facial Massive Emphysema Secondary to Colonoscopy: A Rare Complication of Colonoscopy
Authors: Perez Lopez Ruben Daniel , Vargas Flores Julian , Orbe Garibay Lenin de Jesus , Narvaez Gonzalez Hugo Fernando
Published: June 2024

Background. Colonoscopy is a resource used for the diagnosis, treatment, and monitoring of benign and malignant colorectal pathologies. The incidence of perforation is 0.03%–0.65% in diagnostic colonoscopy; however, the incidence can be up to 10 times higher in therapeutic interventions, such as polypectomies, increasing the risk of complications up to 0.07–2.1%. Materials and methods. Case report of a 71‐year‐old female who presents a rare complication due to a perforation in the sigmoid which developed pneumoperitoneum, pneumomediastinum, pneumothorax, and massive subcutaneous emphysema as a complication of a diagnostic colonoscopy where a biopsy of a friable lesion was performed. Results. A 71‐year‐old female that went to the emergency room due to acute generalized abdominal colic spasm pain with a duration of 7 hours, associated with significant abdominal distension, malaise, diaphoresis, progressive dyspnea, and massive subcutaneous emphysema that developed after performing panendoscopy and colonoscopy for diverticulosis follow‐up. An abdominal CT scan with double contrast was performed, reporting suggestive data of hollow viscus perforation, pneumoperitoneum, pneumomediastinum, pneumothorax, and massive subcutaneous emphysema in the thorax, neck, and skull base. She underwent an exploratory laparotomy finding a perforation in the sigmoid for which sigmoidectomy was performed, and for the pneumothorax and pneumomediastinum, endopleural tubes were placed in both hemithoraxes. The massive subcutaneous emphysema subsided with observation and oxygen. Conclusion. A rare complication of the use of colonoscopy as a diagnostic and therapeutic method is presented. The purpose of presenting this case is for the doctor who performs these interventions to suspect this complication in a timely manner, not delaying the diagnosis and carrying out an urgent therapeutic approach as in this case with exploratory laparotomy, finding the perforation site and carrying out the corresponding surgical management. We demonstrated that massive subcutaneous emphysema can be managed with observation if there is no other alarm data evident that required another surgical approach.
A Retrospective Review of Neglected Tropical Diseases Diagnosed on Histopathological Specimens in the Free State Province, South Africa, 2015–2020
Authors: le Grange Danita Linda , Pillay She’neze Fatima , Budding Liska , van Rooyen Cornel , Goedhals Jacqueline
Published: June 2024

Background. Neglected tropical diseases (NTDs) are a heterogeneous group of medical conditions that commonly occur in underprivileged populations. NTDs are primarily diagnosed in tropical areas. Although South Africa is not situated in a tropical region, the high poverty rate makes the country susceptible to some NTDs. Limited data are available on the burden of NTDs in the Free State province of South Africa. This study aimed to determine the number of NTDs diagnosed on histopathological specimens in the public sector of the Free State province over a six‐year period and to evaluate the patient demographics. Methods. A retrospective, descriptive study was performed. All NTDs diagnosed in histopathological specimens from public sector hospitals in the province submitted to the Department of Anatomical Pathology, National Health Laboratory Service, and University of the Free State between 1 January 2015 and 31 December 2020 were included in the study. The demographic information, biopsy site, and referring hospital were noted for each case identified. Results. A total of 72 NTDs were diagnosed. The five most common diagnoses were echinococcosis (n = 33; 45.8%), bilharzia (n = 13; 18.1%), leprosy (n = 9; 12.5%), mycetoma (n = 8; 11.1%), and intestinal worms (n = 5; 6.9%). Ten (30.3%) patients diagnosed with echinococcosis came from the Free State’s neighbouring country, Lesotho. Conclusion. Echinococcosis was the most prevalent NTD diagnosed in central South Africa. We recommend that the South African Department of Health add echinococcosis to the principal NTDs of significance in South Africa, alongside soil‐transmitted helminths, schistosomiasis, leprosy, and rabies.
Cardiovascular Diseases Among Indian Older Adults: A Comprehensive Review
Authors: Jan Bisma , Dar Mohammad Imran , Choudhary Bharti , Basist Parakh , Khan Rahmuddin , Alhalmi Abdulsalam
Published: June 2024

Cardiovascular diseases (CVDs) constitute an important cause of morbidity and mortality globally, and India is no exception to this trend. With the ongoing aging of the population in India, there is a notable surge in the prevalence and impact of CVDs among older adults. This review is aimed at providing a comprehensive overview of the current knowledge concerning the prevalence, risk factors, and management of CVDs in the context of Indian older adults. The incidence of CVDs in India is not only alarming but also exhibits an upward trajectory with advancing age. Primary risk factors contributing to the elevated incidence among older adults include hypertension (HT), diabetes, dyslipidemia, obesity, smoking, a sedentary lifestyle, and poor dietary habits. Additionally, stress and genetic predisposition emerge as noteworthy contributors to CVDs in this population. Effectively identifying and managing these risk factors among older adults in India is imperative to alleviate the burden of these diseases and enhance overall quality of life. Strategies aimed at mitigating the impact of CVDs in the country necessitate a comprehensive approach, integrating lifestyle interventions, public health initiatives, and a robust healthcare system. In summary, CVDs represent a significant health concern in both rural and urban areas of India. However, variations exist in the prevalence, risk factors, and accessibility to healthcare between these regions. Therefore, addressing the prevalence of CVDs in India necessitates a complex, multidimensional strategy that takes into account the unique opportunities and challenges that come with living in both rural and urban areas.
The Effect of Supplementation of Fish Protein Hydrolysate to the BSF‐Based Aquafeed on the Growth, Survival, Fatty Acids, and Histopathology of Juvenile Lobster (Panulirus ornatus)
Authors: Saputra Ishaaq , Lee Yih Nin , Fotedar Ravi
Published: June 2024

The present study aims to evaluate the effect of liquid fish protein hydrolysate (FPH) following fishmeal substitution with full‐fat and defatted BSF (black soldier fly, Hermetia illucens) meal in the feeds of juvenile ornate spiny lobster, Panulirus ornatus. The physiological aspects of juvenile lobsters including growth, fatty acids profile, and histopathology were observed. Six isoenergetic experimental feeds having a protein‐to‐energy ratio of 26 CP mg kJ−1 were formulated with the substitution of fishmeal at 25% using liquid FPH, full‐fat BSF (FBSF), defatted BSF (DBSF), and their combination. The specific growth rate, final body weight, final total length, and length increment of juvenile lobsters (initial weight was 0.21 ± 0.01 g and total length was 20.53 ± 0.12 mm) were significantly affected by the fishmeal substitution (P  < 0.05) and improved with the addition of liquid FPH in the feeds containing FBSF and DBSF. The whole body proximate analysis showed that the liquid FPH to the feeds containing DBSF increased the ash and protein content significantly (P  < 0.05). The total monounsaturated fatty acids (∑MUFA), saturated fatty acids (∑SFA), and omega 9 fatty acids (∑n−9 FA) of juvenile lobsters’ whole bodies fed with dietary DBSF and FPH supplementation were significantly higher than those of others (P  < 0.05). The histopathological analysis indicated that the villus size and the muscle thickness in the intestine were not significantly affected by FPH supplementation. However, the hepatopancreas histopathology indicated the presence of B‐cells and R‐cells in the juvenile lobsters fed with FPH‐supplemented feeds. The present results suggested the supplementation of liquid FPH to the formulated feed with FBSF and DBSF for juvenile lobsters can improve the lobsters’ growth and fatty acids availability.
Securing Microservices‐Based IoT Networks: Real‐Time Anomaly Detection Using Machine Learning
Authors: Plazas Olaya Maria Katherine , Vergara Tejada Jaime Alberto , Aedo Cobo Jose Edinson
Published: June 2024

Increased attention is being given to Internet of things (IoT) network security due to attempts to exploit vulnerabilities. Security techniques protecting availability, confidentiality, and information integrity have intensified as IoT devices are viewed as gateways to larger networks by malicious actors. As an additional factor, the microservices‐based platforms have overtaken the deployment of applications that support smart cities; however, the distributed nature of these architectures heightens susceptibility to malicious network infrastructure use. These risks can result in disruptions to system functioning or data compromise. Proposed strategies to mitigate these risks include developing intrusion detection systems and utilizing machine learning to differentiate between normal and anomalous network traffic, indicating potential attacks. This article outlines the development and implementation of an intrusion detection system (IDS) using machine learning to detect online anomalies in network traffic. Comprising a traffic extractor and anomaly detector, the system employs supervised learning with various datasets to train models. The results demonstrate the effectiveness of the decision tree model in detecting traditional denial of service (DoS) attacks, achieving high scores across multiple metrics: an F1‐score of 98.08%, precision of 99.25%, recall of 96.96%, and accuracy of 99.62%. The random forest model excels in identifying slow‐rate DoS attacks, attaining an F1‐score of 99.85%, precision of 99.91%, recall of 99.80%, and accuracy of 99.88%.
Atypical B Cells Promote Cancer Progression and Poor Response to Bacillus Calmette-Guérin in Non–Muscle Invasive Bladder Cancer
Authors: Yolmo Priyanka , Rahimi Sadaf , Chenard Stephen , Conseil Gwenaëlle , Jenkins Danielle , Sachdeva Kartik , Emon Isaac , Hamilton Jake , Xu Minqi , Rangachari Manu , Michaud Eva , Mansure Jose J. , Kassouf Wassim , Berman David M. , Siemens David R. , Koti Madhuri
Published: June 2024

Poor response to Bacillus Calmette-Guérin (BCG) immunotherapy remains a major barrier in the management of patients with non–muscle invasive bladder cancer (NMIBC). Multiple factors are associated with poor outcomes, including biological aging and female sex. More recently, it has emerged that a B-cell–infiltrated pretreatment immune microenvironment of NMIBC tumors can influence the response to intravesically administered BCG. The mechanisms underlying the roles of B cells in NMIBC are poorly understood. Here, we show that B-cell–dominant tertiary lymphoid structures (TLSs), a hallmark feature of the chronic mucosal immune response, are abundant and located close to the epithelial compartment in pretreatment tumors from BCG non-responders. Digital spatial proteomic profiling of whole tumor sections from male and female patients with NMIBC who underwent treatment with intravesical BCG, revealed higher expression of immune exhaustion–associated proteins within the tumor-adjacent TLSs in both responders and non-responders. Chronic local inflammation, induced by the N-butyl-N-(4-hydroxybutyl) nitrosamine carcinogen, led to TLS formation with recruitment and differentiation of the immunosuppressive atypical B-cell (ABC) subset within the bladder microenvironment, predominantly in aging female mice compared to their male counterparts. Depletion of ABCs simultaneous to BCG treatment delayed cancer progression in female mice. Our findings provide evidence indicating a role for ABCs in BCG response and will inform future development of therapies targeting the B-cell–exhaustion axis.
Data from Activation of the Mevalonate Pathway in Response to Anti-cancer Treatments Drives Glioblastoma Recurrences Through Activation of Rac-1
Authors: He Ling , Ioannidis Angeliki , Hoffman Carter J. , Arambula Evelyn , Joshi Purva , Whitelegge Julian , Liau Linda M. , Kornblum Harley I. , Pajonk Frank
Published: June 2024

Abstract
Glioblastoma (GBM) is the deadliest adult brain cancer. Under the current standard of care, almost all patients succumb to the disease and novel treatments are urgently needed. Recognizing that GBMs are addicted to cholesterol, past clinical trials have repurposed statins against GBM but failed. The purpose of this study was to test whether treatments that upregulate the cholesterol biosynthesis pathway in GBM would generate a metabolic vulnerability that can be exploited using statins and to determine the underlying mechanisms.

Effects of radiotherapy and temozolomide or dopamine receptor antagonists on the mevalonate pathway in GBM were assessed in vitro and in vivo. The impact of statins on self-renewal of glioma stem cells and median survival was studied. Branches of the mevalonate pathway were probed to identify relevant effector proteins.

Cells surviving combination treatments that converge in activating the immediate early response, universally upregulated the mevalonate pathway and increased stemness of GBM cells through activation of the Rho-GTPase Rac-1. Activation of the mevalonate pathway and Rac-1 was inhibited by statins, which led to improved survival in mouse models of glioblastoma when combined with radiation and drugs that target the glioma stem cell pool and plasticity of glioma cells.

We conclude that a combination of dopamine receptor antagonists and statins could potentially improve radiotherapy outcome and warrants further investigation.
Significance:
Combination therapies that activate the mevalonate pathway in GBM cells after sublethal treatment enhance self-renewal and migratory capacity through Rac-1 activation, which creates a metabolic vulnerability that can be further potentially exploited using statins.
HUBUNGAN DIABETES MELLITUS DENGAN KATARAK DI POLIKLINIK MATA RSUD MOHAMMAD ANWAR SUMENEP TAHUN 2023
Authors: Nadziroh Ainun , Karnedi
Published: June 2024

Pendahuluan: Katarak merupakan  penyebab kebutaan terbesar kedua di dunia (65,2 juta pasien). Katarak adalah suatu kelainan pada lensa mata yang ditandai timbulnya opasitas pada lensa dan mengakibatkan berkurangnya transparansi dari lensa. Salah satu faktor risiko katarak adalah diabetes mellitus. Penelitian ini bertujuan untuk mengetahui hubungan antara diabetes mellitus dengan katarak. 
Metode: Penelitian ini merupakan suatu penelitian observasional analitik dengan  pendekatan cross sectional. Teknik pengambilan sampel dengan total sampling. Data penelitian adalah data sekunder yang diperoleh dari rekam medik. Analisis data dengan analisis univariat, bivariat menggunakan uji analisis fisher exact dan odds ratio. 
Hasil: Jumlah sampel pada penelitian ini adalah 310 responden. 265 responden mengalami katarak (85,50%), 27 responden mengalami katarak dan diabetes mellitus (8,70%), 18 responden menderita diabetes mellitus (5,80%). Dengan menggunakan analisis fisher exact diperoleh nilai p value = 0.000 (p <0.05) yang bermakna terdapat hubungan antara diabetes mellitus dengan katarak. Nilai odds ratio = 1,667 (OR >1) yang bermakna pasien dengan diabetes mellitus berisiko 1,667 kali lebih besar menderita katarak dibandingkan tidak diabetes mellitus. 
Kesimpulan: Terdapat hubungan antara diabetes mellitus dengan katarak di RSUD Moh. Anwar Sumenep. Pasien yang menderita diabetes berisiko 1,667 kali lebih besar terjadi katarak dibandingkan tidak diabetes mellitus.
Pristification: Defining the convergent evolution of saws in sharks and rays (Chondrichthyes, Neoselachii)
Authors: GREENFIELD TYLER
Published: June 2024

Convergent evolution is the development of analogous structures or bauplans in at least two independent lineages of organisms. Convergence is driven by the occupation of similar ecological niches and by various physical and phylogenetic constraints (McGhee, 2011). Despite the wide recognition of this phenomenon in evolutionary biology, formal terms and definitions for specific examples are rare. The most notable is carcinisation, which refers to the appearances of a crab-like bauplan among crustaceans (Keiler et al., 2017). Here the term ‘pristification’ is proposed for the convergence of saws in sharks and rays. It was coined previously in a preliminary publication (Greenfield, 2021a) but is formally defined for the first time. Not only does it highlight a remarkable convergent structure, but it also serves as a template for future terminology.
Morphological features of the Upper Cretaceous planthopper Mimaeurypterus burmiticus suggest specialization for cryptic camouflage on tree bark
Authors: FABRIKANT DOLEV , HUANG DI-YING , HAUG CAROLIN , HAUG JOACHIM T. , FU YAN-ZHE
Published: June 2024

The extinct planthopper family Mimarachnidae is widely known in the Cretaceous of Eurasia. Two new specimens of the monotypic genus Mimaeurypterus Fu & Huang, 2021, from the early Upper Cretaceous of northern Myanmar are described. The intraspecific variation is assessed, and the description supplemented morphology of the head, pronotum, legs, and abdomen is provided. The flattened pronotum and broad forewings are interpreted as adaptations for the reduction of shadows at body margins, thus blurring the body outline of the insect and facilitating crypsis.
A new species of the family Praeaulacidae (Hymenoptera: Evanioidea) from mid-Cretaceous Kachin amber
Authors: JOUAULT CORENTIN , HUANG DI-YING
Published: June 2024

A new praeaulacid species, Habraulacus splendidus sp. nov., is described and illustrated based on a male specimen from mid-Cretaceous Kachin amber. This newly discovered taxon is, inter alia, characterised by its relatively low number of antennomeres (about 28) and its complex forewing venation (i.e., with both 2rs-m and 3rs-m present). Together with the recent discoveries of praeaulacid wasps from Kachin amber, this new species lets us assume that the family Praeaulacidae was well-diversified in Cretaceous forests. The subsequent decline of this family likely occurred either in the Late Cretaceous or, in a more optimistic scenario, during the Cenozoic era.
A new species of Mesosticta in mid-Cretaceous Kachin amber (Odonata: Platystictidae)
Authors: NEL ANDRÉ , JOUAULT CORENTIN , HUANG DI-YING
Published: June 2024

Mesosticta additicta sp. nov., fourth species of this platystictid genus, is described from the mid-Cretaceous Kachin amber, suggesting its endemic diversification in the West Burma Block (WBB), possibly in relation to the geographic isolation of this area during the formation of mid-Cretaceous Kachin amber.