bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular Drug Delivery into the Eyes Using Drug-Releasing Soft Contact Lens
Authors: Tashima Toshihiko
Published: May 2024

The impact of visual impairment, such as blindness, on quality of life is immeasurable. However, effective ocular drug delivery into the eyes has not yet been established, primarily due to the impermeability imposed by the blood–retinal barrier (BRB) based on the tight junctions and efflux transporters at the endothelium or the epithelium in oral or intravenous administration, as well as the dilution with tear fluid and excretion through the nasolacrimal duct in eye drop administration. Furthermore, intravitreous injections induce pain and fear in patients. Unmet medical needs persist in ocular diseases such as age-related macular degeneration and diabetic retinopathy. Therefore, innovative non-invasive administration methods should be developed. Drug-releasing soft contact lenses (DR-SCLs) affixed to the eye’s surface can continuously and locally deliver their loaded drugs to the eyes. The use of DR-SCLs is expected to greatly enhance the bioavailability and patient adherence to the drug regimen. It is known that several solute carrier (SLC) transporters are expressed in various parts of the eyes, including the cornea, the ciliary body, and the bulbar conjunctiva. Carrier-mediated transport through SLC transporters may occur in addition to passive diffusion. Moreover, nanoparticles can be loaded into DR-SCLs, offering various intelligent approaches based on modifications to induce receptor-mediated endocytosis/transcytosis or to control the loaded drug release within this delivery system. In this perspective review, I discuss the implementation and potential of DR-SCL-mediated ocular drug delivery, particularly focusing on low-molecular-weight compounds because of their fine distribution in living body, ease of handling, and ease of manufacturing.
Survey on the Knowledge and the Management of Helicobacter pylori Infection by Italian General Practitioners and Doctors in General Practice Training
Authors: Tosetti Cesare , Ubaldi Enzo , Benedetto Edoardo , Bertolusso Luciano , Napoli Luigi , Cottone Carmelo , Scoglio Riccardo , Belvedere Alessandra , Casella Giovanni , Mancuso Maurizio , Abagnale Gennaro , Sanna Guido , De Bastiani Rudi
Published: May 2024

The management of gastric Helicobacter pylori (H. pylori) infection represents a significant concern in primary healthcare. This survey evaluates the approaches, attitudes, and knowledge regarding gastric H. pylori infection among Italian general practitioners (GPs) and young doctors undergoing general practice training (ITGPs). The survey enrolled 466 GPs and 70 ITGPs. Among GPs, specialist recommendations and the Maastricht–Florence guidelines were frequently referenced sources, while ITGPs relied more on the Maastricht–Florence guidelines and internet resources. ITGPs demonstrated more proactive approaches than GPs in investigating and treating conditions such as gastric ulcers, atrophic gastritis, and iron-deficiency anemia. However, there was limited attention given to the role of H. pylori treatment in first-degree relatives of gastric cancer patients. The most used diagnostic methods were the urea breath test and fecal test. Triple therapy was the most frequently chosen initial treatment regimen, with quadruple bismuth therapy becoming the primary option after initial treatment failure, followed by quinolone therapy and concomitant therapy. This survey underscores a disparity between real-world practices and the recommendations outlined in current guidelines, indicating a need for improved understanding of H. pylori guidelines among both GPs and ITGPs.
Disentangling Eben-Ezer: William Okeley and His Barbary Captivity Narrative
Authors: Capp Bernard
Published: May 2024

Eben-ezer (1675) was the most successful Barbary captivity narrative and remains the most challenging. This article engages with debates over its authorship, publication history, purpose, and significance, and offers new information and interpretations on each aspect.
Benefit or Problem: Exploration of How Response Options Affect Self-Reported Behaviors and Interests in Autistic Adults
Authors: Lee Hyein , Jadav Nikita , Wilkinson Ellen , Bal Vanessa H.
Published: May 2024

Assessment of restricted, repetitive behaviors (RRB) in autism evaluations often assumes that these behaviors negatively impact the individual. Qualitative studies of first-person accounts indicate the negative impact of the stigma associated with RRBs but also provide insights into the positive aspects. The current study explores how framing response options as negative (i.e., level of problem associated with occurrence) or positive (i.e., level of benefit associated with occurrence) affects RRB self-reports in autistic adults. Sixty-six autistic adults aged 18–59 filled out the Repetitive Behavior Scale-Revised (RBS-R) and a modified RBS-R+, assessing problems and benefits of reported behaviors, respectively. There was a moderate to strong correlation between the forms, each assessing problems and benefits in terms of the number of behaviors endorsed (r = 0.746) and the levels of benefits and problems (r = 0.637). Autistic adults reported a higher number of RRBs in the form that assessed problems, but the number of behaviors was comparable between the forms when counting in the response option of the occurrence of behavior without having a benefit. Despite some variability in the level of problems and the benefits across the subdomains of RRB, autistic adults largely rated comparable levels of associated benefits and problems, highlighting the complexity of RRBs as having both positive and negative impacts. Future screening and diagnostic tools for adults should aim to assess both positive and negative aspects of autistic features to afford a more nuanced understanding of individual experiences while still yielding diagnostically relevant information. Qualitative studies are needed to better understand the complex experiences associated with these behaviors; however, it may be important to ensure that options for endorsement of behaviors without a specific benefit are also needed to ensure some behaviors (e.g., self-injurious behaviors) are not missed.
Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators
Authors: Vera-Salmerón Eugenio , Domínguez-Nogueira Carmen , Sáez José A. , Romero-Béjar José L. , Mota-Romero Emilio
Published: May 2024

Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient’s requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level.
How Professional and Market Logics and the Conflict between Institutional Demands Affect Hospital Accreditation Compliance: A Multiple-Case Study in Brazil
Authors: Silva Tiago Martins Ramos da , Rossoni Luciano
Published: May 2024

Hospital accreditation has become ubiquitous in developing countries. While research acknowledges that accreditation can enhance healthcare quality, efficiency, and safety, concerns persist regarding hospitals’ management of conflicts stemming from the diverse institutional logic inherent in this process. Therefore, this study aimed to investigate how professional and market logic, alongside conflicts arising from institutional demands, affect compliance with hospital accreditation. To this end, we conducted a multiple-case study in four Brazilian hospitals employing in-depth interviews and on-site observations. The triangulation of narrative analysis and the outcomes of multiple correspondence analysis revealed that when professional logic predominates, there is a greater propensity to tailor accredited activities by segmenting the tasks between physicians and nurses with the intention of mitigating existing conflicts. Conversely, when conflicts occur over established goals between professionals and orientated marked logic executives, the accreditation process is impeded, resulting in non-compliance. Ultimately, the findings underscore the alignment between the pursuit of legitimacy and efficiency within the accreditation process. We conclude by delineating the theoretical and practical implications of scrutinizing the internal dynamics of institutional logic.
The Role of Tele-Exercise for People with Type 2 Diabetes: A Scoping Review
Authors: Albalawi Hani Fahad A.
Published: May 2024

Background: Supervised exercise interventions tend to be more effective than unsupervised exercises or physical activity advice alone. However, people with type 2 diabetes may find it difficult to attend supervised exercise interventions due to several obstacles. Tele-exercise, or utilizing technology to deliver home-based exercise, might be a solution. Objective: This scoping review aimed to explore clinical trials investigating the impact of tele-exercise interventions in individuals with type 2 diabetes Methods: Four electronic databases were searched for the period up to January 2024 for clinical trials investigating the impact of tele-exercise on health-related outcomes in adults with type 2 diabetes. Results: Seven trials involving 460 individuals with type 2 diabetes met the inclusion criteria. In these trials, combined aerobic and resistance exercise programs were the main types delivered remotely. To deliver such programs, both synchronous (n = 4) and asynchronous (n = 3) delivery modes were adopted. Regardless of the delivery mode, all tele-exercise interventions led to improvements in various factors related to type 2 diabetes and its complications, including glycemic control, blood lipids, body composition, functional capacity, muscle strength, and quality of life. The improvements were also found to be as effective as those of supervised exercise. Conclusions: Tele-exercise interventions seem to be feasible and as effective as supervised exercise interventions in terms of improving glycemic control, blood lipids, functional capacity, muscle strength, body composition, and quality of life for people with type 2 diabetes.
Establishment of a Dataset for the Traditional Korean Medicine Examination in Healthy Adults
Authors: Kim Soyoung , Lim Ancho , Kim Young-Eun , Lee Youngseop , Jun Hyeong Joon , Yim Mi Hong , Kim Daehyeok , Jun Purumea , Park Jeong Hwan , Lee Sanghun
Published: May 2024

We established a protocol for the traditional Korean medicine examination (KME) and methodically gathered data following this protocol. Potential indicators for KME were extracted through a literature review; the first KME protocol was developed based on three rounds of expert opinions. The first KME protocol’s feasibility was confirmed, and data were collected over four years from traditional Korean medicine (KM) hospitals, focusing on healthy adults, using the final KME protocol. A literature review identified 175 potential core indicators, condensed into 73 indicators after three rounds of expert consultation. The first KME protocol, which was categorized under questionnaires and medical examinations, was developed after the third round of expert opinions. A pilot study using the first KME protocol was conducted to ensure its validity, leading to modifications resulting in the development of the final KME protocol. Over four years, data were collected from six KM hospitals, focusing on healthy adults; we obtained a dataset comprising 11,036 healthy adults. This is the first protocol incorporating core indicators of KME in a quantitative form and systematically collecting data. Our protocol holds potential merit in evaluating predisposition to diseases or predicting diseases.
One World, One Health: Zoonotic Diseases, Parasitic Diseases, and Infectious Diseases
Authors: Deiana Giovanna , Arghittu Antonella , Dettori Marco , Castiglia Paolo
Published: May 2024

When we take into account how the boundaries between human, animal, and environmental health are inextricably linked and increasingly intertwined, it comes as no surprise that the One Health approach has assumed an unprecedented level of importance over the past decade [...]
Exploring the Experiences and Perspectives of Division III Athletes Regarding Personalized Nutrition Plans for Improved Performance—A Qualitative Investigation
Authors: Stavitz James , Koc Thomas
Published: May 2024

(1) Background: This qualitative study explores Division III college student-athletes’ experiences and perceptions of personalized nutrition plans in collegiate sports settings. (2) Methods: Semi-structured interviews were conducted using a general qualitative research design. Using a grounded theory approach, a thematic analysis was utilized to analyze the interview transcripts, allowing for the identification of recurring themes and patterns. (3) Results: A total of 30 Division III college student-athletes, 16 males (53.3%) and 14 females (46.7%), representing a diverse range of sports disciplines, engaged in discussions about personalized nutrition plans. Analysis of the data revealed five main themes: (1) Nutritional Knowledge and Awareness, (2) Perceived Benefits of Personalized Nutrition Plans, (3) Challenges and Barriers to Implementation, (4) Influence of Team Culture and Environment, and (5) Suggestions for Improvement. (4) Conclusion: This study sheds light on the complexities of implementing personalized nutrition plans in collegiate sports settings and emphasizes the need for comprehensive, athlete-centered approaches to optimize performance and well-being.
Age Unplugged: A Brief Narrative Review on the Intersection of Digital Tools, Sedentary and Physical Activity Behaviors in Community-Dwelling Older Adults
Authors: Ramalho André , Paulo Rui , Duarte-Mendes Pedro , Serrano João , Petrica João
Published: May 2024

This brief narrative review assesses how digital technologies—such as wearables, mobile health apps, and various digital tools such as computers, game consoles, tablets, smartphones, and extended reality systems—can influence sedentary and physical activity behaviors among community-dwelling older adults. Each section highlights the central role of these technologies in promoting active aging through increased motivation, engagement and customized experiences. It underlines the critical importance of functionality, usability and adaptability of devices and confirms the effectiveness of digital interventions in increasing physical activity and reducing sedentary behavior. The sustainable impact of these technologies needs to be further investigated, with a focus on adapting digital health strategies to the specific needs of older people. The research advocates an interdisciplinary approach and points out that such collaborations are essential for the development of accessible, effective and ethical solutions. This perspective emphasizes the potential of digital tools to improve the health and well-being of the aging population and recommends their strategic integration into health promotion and policy making.
Appraising the Physical Activity Levels of Saudis with Physical Disabilities: Effects of Disability Type, Mobility Assistive Devices, and Demographic Factors
Authors: Said Mohamed A. , Alhumaid Majed M.
Published: May 2024

Physical activity (PA) has numerous health benefits for individuals with physical disabilities (IWPD). However, it is common for activity levels to fall below the suggested limits. This study aimed to evaluate the prevalence, pattern, and levels of PA among IWPD in Saudi Arabia. It also investigated the effects of individuals’ type of disability, mobility assistive devices, and demographic features on PA levels. Data were collected from 238 participants, mostly male (62.2%), aged 39.76 ± 12.19 years. Among them, 19.3% had spinal conditions, 14.7% had progressive muscular dystrophy, 15.1% had multiple sclerosis, 17.6% had cerebral palsy, 16.4% had poliomyelitis, and 16.8% had limb or foot amputations. The participants were assessed using the Arabic version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD-AR). The results showed that 62.6% (64.9% of males and 58.9% of females) met the minimum PA guidelines specified by the WHO. The average PASIPD-AR score was 10.33 ± 10.67 MET-hours/day, indicating lower PA levels, and 8.4% of individuals did not participate in any form of PA. Significant discrepancies were detected in disability type and mobility assistive device use after age adjustment. Marital status, education, and occupation greatly affected PA components. Greater attention should be paid to promoting an active lifestyle among IWPD in Saudi Arabia.
Impact of Incorporating Future Mandatory Price Reductions with Generic Drug Entry on the Cost-Effectiveness of New Drugs: A Policy Simulation Study of Dupilumab in Atopic Dermatitis Treatment
Authors: Kim Maryanne , Quan Guiguan , Noh Youran , Hong Song Hee
Published: May 2024

The introduction of high-cost medications often poses challenges in achieving cost-effectiveness for drug insurance coverage. Incorporating future price reductions for these medications may enhance their cost-effectiveness. We examined the influence of future cost reductions mandated by the national insurer’s equal pricing for equivalent drugs (EPED) policy on the cost-effectiveness of dupilumab, a biologic drug for moderate to severe atopic dermatitis in the Korean healthcare system. We conducted a policy simulation study using semi-Markovian cost utility analysis of dupilumab in combination with supportive care (SC) versus SC alone, with and without the EPED policy adjustment. The EPED would lower dupilumab’s price to 70% following the entry of a biosimilar drug in 10.3 years. Scenario analyses quantified the impact of changing time to the EPED, chemical versus biological designation, response criteria, discount rates, and time horizons on the Incremental Cost-Effectiveness Ratio (ICER) and acceptability with and without EPED adjustment. The EPED adjustment of dupilumab’s future price significantly improved its cost-effectiveness, with a 9.7% decrease in ICER and a substantial 14.6% increase in acceptability. Assuming EPED in 5 years, the ICER fell below the predefined willingness-to-pay threshold. If dupilumab were a chemical drug, EPED adjustment demonstrated a 19.1% increase in acceptability. Incorporating future cost reductions via the EPED system in economic evaluations is crucial, especially for drugs facing imminent generic entry. This study underscores the importance of EPED adjustment in the cost-effectiveness analysis of innovative medications, especially for those nearing willingness-to-pay thresholds.
Current Therapeutic Sequencing in Chronic Lymphocytic Leukemia
Authors: Mouhssine Samir , Maher Nawar , Kogila Sreekar , Cerchione Claudio , Martinelli Giovanni , Gaidano Gianluca
Published: May 2024

The treatment landscape of chronic lymphocytic leukemia (CLL), the most frequent leukemia in adults, is constantly changing. CLL patients can be divided into three risk categories, based on their IGHV mutational status and the occurrence of TP53 disruption and/or complex karyotype. For the first-line treatment of low- and intermediate-risk CLL, both the BCL2 inhibitor venetoclax plus obinutuzumab and the second generation BTK inhibitors (BTKi), namely acalabrutinib and zanubrutinib, are valuable and effective options. Conversely, venetoclax-based fixed duration therapies have not shown remarkable results in high-risk CLL patients, while continuous treatment with acalabrutinib and zanubrutinib displayed favorable outcomes, similar to those obtained in TP53 wild-type patients. The development of acquired resistance to pathway inhibitors is still a clinical challenge, and the optimal treatment sequencing of relapsed/refractory CLL is not completely established. Covalent BTKi-refractory patients should be treated with venetoclax plus rituximab, whereas venetoclax-refractory CLL may be treated with second generation BTKi in the case of early relapse, while venetoclax plus rituximab might be used if late relapse has occurred. On these grounds, here we provide an overview of the current state-of-the-art therapeutic algorithms for treatment-naïve patients, as well as for relapsed/refractory disease.
Unraveling a Historical Mystery: Identification of a Lichen Dye Source in a Fifteenth Century Medieval Tapestry
Authors: Lackner Rachel M. , Ferron Solenn , Boustie Joël , Le Devehat Françoise , Lumbsch H. Thorsten , Shibayama Nobuko
Published: May 2024

As part of a long-term campaign to document, study, and conserve the Heroes tapestries from The Cloisters collection at The Metropolitan Museum of Art, organic colorant analysis of Julius Caesar (accession number 47.101.3) was performed. Analysis with liquid chromatography–quadrupole time-of-flight mass spectrometry (LC-qToF-MS) revealed the presence of several multiply chlorinated xanthones produced only by certain species of lichen. Various lichen dye sources have been documented in the literature for centuries and are classified as either ammonia fermentation method (AFM) or boiling water method (BWM) dyes based on their method of production. However, none of these known sources produce the distinctive metabolites present in the tapestry. LC-qToF-MS was also used to compare the chemical composition of the dyes in the tapestry with that of several species of crustose lichen. Lichen metabolites, including thiophanic acid and arthothelin, were definitively identified in the tapestry based on comparison with lichen xanthone standards and a reference of Lecanora sulphurata, confirming the presence of a lichen source. This finding marks the first time that lichen xanthones have been identified in a historic object and the first evidence that BWM lichen dyes may have been used prior to the eighteenth century.
An Innovative Layer-by-Layer Edible Coating to Regulate Oxidative Stress and Ascorbate–Glutathione Cycle in Fresh-Cut Melon
Authors: Cice Danilo , Ferrara Elvira , Pecoraro Maria Tommasina , Capriolo Giuseppe , Petriccione Milena
Published: May 2024

Fresh-cut fruits, renowned for their convenience and nutritional value, are susceptible to rapid deterioration, compromising their quality and shelf life. In this study, a sustainable and environmentally friendly edible coating was developed based on sodium alginate (SA; 1% w/v), cedar mucilage (CM; 4% w/v), and calcium chloride (2% w/v), applied using a layer-by-layer technique to preserve the quality and prolong the shelf life of fresh-cut melon. Fruits were cut into cubes coated or uncoated by dipping and subsequently packaged in a polyethylene terephthalate container and stored for 15 days at 4 °C. Physicochemical traits and qualitative features such as polyphenol, flavonoid, carotenoid, ascorbic acid content, as well as antioxidant activity, were assessed. Furthermore, the enzymatic antioxidant system and the ascorbate–glutathione cycle were investigated. The coating reduced weight loss and enhanced polyphenol, flavonoid, and ascorbic acid content and antioxidant activity during cold storage. Edible coating (SA + CM) represents a valid tool to extend the postharvest life, improve the storability, and enhance the physicochemical and qualitative traits of fresh-cut melon. Further research is required to optimize coating formulations and application techniques to maximize their effectiveness and commercial viability in the food industry.
Intermediate Care for Patient-Centered Care, Shared Decision Making, and Hospital Discharge Support in a Japanese Acute Care Hospital: A Cross-Sectional Study
Authors: Goto Yuko , Miura Hisayuki
Published: May 2024

[Background] Intermediate care is a limited-time service founded on patient-centered care (PCC) that ensures continuity and quality of care during the transition between home and acute care services, promotes recovery, and restores independence and confidence. In Japan, systematic education on intermediate care for care providers is lacking. [Method] The present study explored the relationship between a Japanese scale used to evaluate individualized discharge support skills, a Japanese version of a tool for evaluating intermediate care based on PCC, and a tool that measures the shared decision making of care providers, which is the pinnacle of PCC. [Results] Clear correlations were found between the concepts evaluated using these three tools. Some concepts were not correlated between the Japanese scale that evaluated individualized discharge support skills and intermediate care based on PCC. [Conclusions] Elucidating the perspectives that help expand discharge care to intermediate care based on PCC will contribute to future education on intermediate care for Japanese care providers and to enriching patient-centered intermediate care.
A Comparative Analysis of Sediment Concentration Using Artificial Intelligence and Empirical Equations
Authors: Khalid Muhammad Ashraf , Ghumman Abdul Razzaq , Pasha Ghufran Ahmed
Published: May 2024

Morphological changes in canals are greatly influenced by sediment load dynamics, whose estimation is a challenging task because of the non-linear behavior of the sediment concentration variables. This study aims to compare different techniques including Artificial Intelligence Models (AIM) and empirical equations for estimating sediment load in Upper Chenab Canal based on 10 years of sediment data from 2012 to 2022. The methodology involves utilization of a newly developed empirical equation, the Ackers and White formula and AIM including 20 neural networks with 10 training functions for both Double and Triple Layers, two Artificial Neuro-Fuzzy Inference System (ANFIS), Particle Swarm Optimization, and Ensemble Learning Random Forest models. Sensitivity analysis of sediment concentration variables has also been performed using various scenarios of input combinations in AIM. A state-of-the-art optimization technique has been used to identify the parameters of the empirical equation, and its performance is tested against AIM and the Ackers and White equation. To compare the performance of various models, four types of errors—correlation coefficient (R), T-Test, Analysis of Variance (ANOVA), and Taylor’s Diagram—have been used. The results of the study show successful application of Artificial Intelligence (AI) and empirical equations to capture the non-linear behavior of sediment concentration variables and indicate that, among all models, the ANFIS outperformed in simulating the total sediment load with a high R-value of 0.958. The performance of various models in simulating sediment concentration was assessed, with notable accuracy achieved by models AIM11 and AIM21. Moreover, the newly developed equation performed better (R = 0.92) compared to the Ackers and White formula (R = 0.88). In conclusion, the study provides valuable insights into sediment concentration dynamics in canals, highlighting the effectiveness of AI models and optimization techniques. It is suggested to incorporate other AI techniques and use multiple canals data in modeling for the future.
Hydrologic Sensitivity of a Critical Turkish Watershed to Inform Water Resource Management in an Altered Climate
Authors: Cevahir Furkan Yunus Emre , Adam Jennifer C. , Liu Mingliang , Sheffield Justin
Published: May 2024

This study introduces a novel sensitivity analysis approach to assess the resilience and susceptibility of hydrologic systems to the stresses of climate change, moving away from conventional top-down methodologies. By exploring the hydrological sensitivity of the upper Kızılırmak River basin using the Variable Infiltration Capacity (VIC) hydrologic model, we employed a sensitivity-based approach as an alternative to the traditional Global Climate Model (GCM)-based methods, providing more insightful information for water managers. Considering the consistent projections of increasing temperature over this region in GCMs, the hydrologic system was perturbed to examine gradients of a more challenging climate characterized by warming and drying conditions. The sensitivity of streamflow, snow water equivalent, and evapotranspiration to temperature (T) and precipitation (P) variations under each perturbation or “reference” climate was quantified. Results indicate that streamflow responds to T negatively under all warming scenarios. As the reference climates become drier, streamflow sensitivity to P increases, indicating that meteorological drought impacts on water availability could be exacerbated. These results suggest that there will be heightened difficulty in managing water resources in the region if it undergoes both warming and drying due to the following setbacks: (1) water availability will shift away from the summer season of peak water demand due to the warming effects on the snowpack, (2) annual water availability will likely decrease due to a combination of warming and lower precipitation, and (3) streamflow sensitivity to hydroclimatic variability will increase, meaning that there will be more extreme impacts to water availability. Water managers will need to plan for a larger set of extreme conditions.
Enhancing Monthly Streamflow Prediction Using Meteorological Factors and Machine Learning Models in the Upper Colorado River Basin
Authors: Thota Saichand , Nassar Ayman , Filali Boubrahimi Soukaina , Hamdi Shah Muhammad , Hosseinzadeh Pouya
Published: May 2024

Streamflow prediction is crucial for planning future developments and safety measures along river basins, especially in the face of changing climate patterns. In this study, we utilized monthly streamflow data from the United States Bureau of Reclamation and meteorological data (snow water equivalent, temperature, and precipitation) from the various weather monitoring stations of the Snow Telemetry Network within the Upper Colorado River Basin to forecast monthly streamflow at Lees Ferry, a specific location along the Colorado River in the basin. Four machine learning models—Random Forest Regression, Long short-term memory, Gated Recurrent Unit, and Seasonal AutoRegresive Integrated Moving Average—were trained using 30 years of monthly data (1991–2020), split into 80% for training (1991–2014) and 20% for testing (2015–2020). Initially, only historical streamflow data were used for predictions, followed by including meteorological factors to assess their impact on streamflow. Subsequently, sequence analysis was conducted to explore various input-output sequence window combinations. We then evaluated the influence of each factor on streamflow by testing all possible combinations to identify the optimal feature combination for prediction. Our results indicate that the Random Forest Regression model consistently outperformed others, especially after integrating all meteorological factors with historical streamflow data. The best performance was achieved with a 24-month look-back period to predict 12 months of streamflow, yielding a Root Mean Square Error of 2.25 and R-squared (R2) of 0.80. Finally, to assess model generalizability, we tested the best model at other locations—Greenwood Springs (Colorado River), Maybell (Yampa River), and Archuleta (San Juan) in the basin.
Feasibility and Acceptability of a Meditation Mobile App Intervention for Adolescent and Young Adult Survivors of Childhood Cancer
Authors: Kwok Gary , Sharma Archana , Mandato Ivelisse , Devine Katie A.
Published: May 2024

Background: Adolescent and young adult (AYA) survivors of childhood cancer are increasingly recognized as a vulnerable group with unique emotional, social, and practical needs due to the intersection of cancer survivorship and normal developmental processes. Mindfulness meditation has shown early efficacy in improving psychological distress among cancer patients. However, the overall scientific study of app-based mindfulness-based interventions is still in its early stages. The goal of this study was to evaluate the feasibility and acceptability of a commercially available mindfulness mobile app intervention “Ten Percent Happier” among AYA survivors of childhood cancer. Methods: We conducted a single-arm pilot intervention with 25 AYA survivors of childhood cancer ages 18–29 years. Results: A total of 108 potentially eligible individuals were initially identified for screening. Of the 45 individuals reached (contact rate = 41.67%), 20 declined to participate; 25 were enrolled in the study and completed the baseline survey (enrollment rate = 55.56%). Twenty-one participants completed the study (retention rate = 84%). Changes in several outcomes were promising, with medium to large effect sizes: Mindfulness (d = 0.74), Negative Emotion (d = 0.48), Perceived Stress (d = 0.52), and Mental Health (d = 0.45). Furthermore, results suggested that participants with consistent app usage showed greater improvement in reported outcomes than those who stopped their usage (e.g., Mindfulness: d = 0.74, Perceived Stress: d = 0.83, Mental Health: d = 0.51; Meaning and Purpose: d = 0.84; and Sleep Disturbance: d = 0.81). Qualitative feedback indicated high satisfaction, but participants suggested adding group or individual peer support to improve their experience with the app. Conclusions: AYA survivors can be difficult to reach, but a mindfulness app was feasible and acceptable to this group. In particular, the robust retention rate and high satisfaction ratings indicate that the meditation mobile app was well received. Preliminary results suggest positive changes in health-related quality of life outcomes, warranting a larger efficacy trial.
Association between Current Substance Use, Healthy Behaviors, and Depression among Ukrainian College Students
Authors: Burlaka Julia , Johnson Renee M. , Marsack-Topolewski Christina N. , Hughesdon Kathryn , Owczarzak Jill , Serdiuk Oleksii , Bogdanov Roman , Burlaka Viktor
Published: May 2024

Depression is a pervasive issue among college students worldwide, yet there is a significant gap in the literature regarding its prevalence and coping strategies in the Ukrainian context. The present study aims to fill this gap by investigating how substance use and health-promoting behaviors relate to depressive symptoms among Ukrainian college students. Health-promoting behaviors are an important strategy to prevent depression, whereas substance use can contribute to depression or make it harder to manage. Given the substantial psychosocial problems and stressors related to the ongoing war in Ukraine and the limited availability of mental health services for college students, it is important to understand how we can encourage college students to keep themselves mentally healthy. A cross-sectional study was conducted among college students on 10 campuses in 2018. Almost 16% of participants met a cut-off for depression. Female students and those who were older reported significantly higher depressive symptoms. Participants were more likely to report depressive symptoms if they were more often involved with alcohol and cannabis use, were older, and engaged in fewer health-promoting behaviors. Tobacco use was not significantly associated with depressive symptoms. Our findings suggest a moderate prevalence of depressive symptoms in our study population. We recommend implementing balanced public health interventions that address risk factors (such as substance use) while also promoting protective behaviors and can be tailored to the specific cultural and environmental context of the region.
Evaluation of the First Three Years of Treatment of Children with Congenital Hypothyroidism Identified through the Alberta Newborn Screening Program
Authors: Sosova Iveta , Archibald Alyssa , Rosolowsky Erik W. , Rathwell Sarah , Christian Susan , Rosolowsky Elizabeth T.
Published: May 2024

The effectiveness of newborn screening (NBS) for congenital hypothyroidism (CH) relies on timely screening, confirmation of diagnosis, and initiation and ongoing monitoring of treatment. The objective of this study was to ascertain the extent to which infants with CH have received timely and appropriate management within the first 3 years of life, following diagnosis through NBS in Alberta, Canada. Deidentified laboratory data were extracted between 1 April 2014 and 31 March 2019 from Alberta Health administrative databases for infants born in this time frame. Time to lab collection was anchored from date of birth. Timeliness was assessed as the frequency of monitoring of Thyroid Stimulating Hormone (TSH) and appropriateness as the frequency of children maintaining biochemical euthyroidism. Among 160 term infants, 95% had confirmation of diagnosis by 16 days of age. The cohort had a median of 2 (range 0–5) TSH measurements performed in the time interval from 0 to 1 month, 4 (0–12) from 1 to 6 months, 2 (0–10) from 6 to 12 months, and 7 (0–21) from 12 to 36 months. Approximately half were still biochemically hypothyroid (TSH > 7 mU/L) at 1 month of age. After becoming euthyroid, at least some period of hypo- (60%) or hyperthyroidism (TSH < 0.2 mU/L) (39%) was experienced. More work needs to be performed to discern factors contributing to prolonged periods of hypothyroidism or infrequent lab monitoring.
Physiological Response and Comprehensive Resistance Evaluation of East African Endemic Aeollanthus repens under Water and Heat Stress
Authors: Tu Yingying , Li Jitao , Liao Yiying , Mbuni Yuvenalis Morara , Li Xiaoning , Khong Qiyan
Published: May 2024

Aeollanthus repens, native to East Africa, thrives in seasonally dry tropical biomes and boasts qualities ideal for both ornamental and ground cover purposes. However, despite its potential, its current resistance levels remain uncertain. Assessing its adaptability could offer valuable insights for its wider adoption and utilization. In this study, researchers employed 3-month-old cuttings of A. repens, subjecting them to six distinct environments by manipulating the temperature (25/20 °C and 35/30 °C) and soil moisture levels (100%, 20%, and 40%). Their leaf physiological and photosynthetic indices were assessed at intervals of 5, 10, and 15 days following exposure to stress. The findings unveiled that exposure to prolonged moisture, elevated temperatures, or a combination of both led to an increase in osmoregulatory substances in the leaves. This increase was accompanied by heightened enzyme activity and an increased intercellular carbon dioxide concentration, followed by a subsequent decline. Additionally, chlorophyll content, net photosynthetic rate, stomatal conductance, and transpiration rate exhibited a decreasing trend over time. Through a comprehensive assessment of stress tolerance utilizing a composite affiliation function value index, the study concluded that A. repens exhibits optimal growth in a certain high-temperature environments and demonstrates substantial resistance to waterlogging, drought, and simultaneous high-temperature stress. However, the resilience of A. repens appears to diminish under the compounded stresses of high temperature and drought.
Proactive Agent Behaviour in Dynamic Distributed Constraint Optimisation Problems
Authors: Agyemang Brighter , Ren Fenghui , Yan Jun
Published: May 2024

In multi-agent systems, the Dynamic Distributed Constraint Optimisation Problem (D-DCOP) framework is pivotal, allowing for the decomposition of global objectives into agent constraints. Proactive agent behaviour is crucial in such systems, enabling agents to anticipate future changes and adapt accordingly. Existing approaches, like Proactive Dynamic DCOP (PD-DCOP) algorithms, often necessitate a predefined environment model. We address the problem of enabling proactive agent behaviour in D-DCOPs where the dynamics model of the environment is unknown. Specifically, we propose an approach where agents learn local autoregressive models from observations, predicting future states to inform decision-making. To achieve this, we present a temporal experience-sharing message-passing algorithm that leverages dynamic agent connections and a distance metric to collate training data. Our approach outperformed baseline methods in a search-and-extinguish task using the RoboCup Rescue Simulator, achieving better total building damage. The experimental results align with prior work on the significance of decision-switching costs and demonstrate improved performance when the switching cost is combined with a learned model.
FIWARE-Compatible Smart Data Models for Satellite Imagery and Flood Risk Assessment to Enhance Data Management
Authors: Kouloglou Ioannis-Omiros , Antzoulatos Gerasimos , Vosinakis Georgios , Lombardo Francesca , Abella Alberto , Bakratsas Marios , Moumtzidou Anastasia , Maltezos Evangelos , Gialampoukidis Ilias , Ouzounoglou Eleftherios , Vrochidis Stefanos , Amditis Angelos , Kompatsiaris Ioannis , Ferri Michele
Published: May 2024

The increasing rate of adoption of innovative technological achievements along with the penetration of the Next Generation Internet (NGI) technologies and Artificial Intelligence (AI) in the water sector are leading to a shift to a Water-Smart Society. New challenges have emerged in terms of data interoperability, sharing, and trustworthiness due to the rapidly increasing volume of heterogeneous data generated by multiple technologies. Hence, there is a need for efficient harmonization and smart modeling of the data to foster advanced AI analytical processes, which will lead to efficient water data management. The main objective of this work is to propose two Smart Data Models focusing on the modeling of the satellite imagery data and the flood risk assessment processes. The utilization of those models reinforces the fusion and homogenization of diverse information and data, facilitating the adoption of AI technologies for flood mapping and monitoring. Furthermore, a holistic framework is developed and evaluated via qualitative and quantitative performance indicators revealing the efficacy of the proposed models concerning the usage of the models in real cases. The framework is based on the well-known and compatible technologies on NGSI-LD standards which are customized and applicable easily to support the water data management processes effectively.
Keap1 Negatively Regulates Transcription of Three Counter-Defense Genes and Susceptibility to Plant Toxin Gossypol in Helicoverpa armigera
Authors: Xie Xingcheng , Wang Qian , Deng Zhongyuan , Gu Shaohua , Liang Gemei , Li Xianchun
Published: May 2024

Expressions of a wide range of cytoprotective counter-defense genes are mainly regulated by the Keap1-Nrf2-ARE signaling pathway in response to oxidative stress from xenobiotics. Gossypol is the major antiherbivore secondary metabolite of cotton, but how the polyphagous pest Helicoverpa armigera copes with this phytochemical to utilize its favorite host plant cotton remains largely elusive. In this study, we first suppressed the Keap1 gene in newly hatched larvae of cotton bollworm by feeding them the siRNA diet for 4 days. All of the larvae were subsequently fed the artificial diet supplied with gossypol or the control diet for 5 days. We identified that the knockdown of the Keap1 gene significantly decreased larval mortality and significantly increased the percentages of larval survival, reaching the fourth instar, compared with ncsiRNA when exposed to a diet containing gossypol. Three counter-defense genes CYP9A17, CYP4L11 and UGT41B3, which were related to the induction or metabolism of gossypol according to the report before, were all significantly up-regulated after the knockdown of the Keap1 gene. The Antioxidant Response Elements (AREs) were also detected in the promoter regions of the three counter-defense genes above. These data indicate that the suppression of the Keap1 gene activates the Keap1-Nrf2-ARE signaling pathway, up-regulates the expressions of counter-defense genes involved in the resistance of oxidative stress and finally contributes to reducing the susceptibility of gossypol. Our results provide more knowledge about the transcriptional regulation mechanisms of counter-defense genes that enable the cotton bollworm to adapt to the diversity of host plants including cotton.
Is Conduction System Pacing a Valuable Alternative to Biventricular Pacing for Cardiac Resynchronization Therapy?
Authors: Castagno Davide , Zanon Francesco , Pastore Gianni , De Ferrari Gaetano Maria , Marcantoni Lina
Published: May 2024

Cardiac resynchronization therapy (CRT) significantly improves clinical outcomes in patients with ventricular systolic dysfunction and dyssynchrony. Biventricular pacing (BVP) has a class IA recommendation for patients with symptomatic heart failure with reduced ejection fraction (HFrEF) and left bundle branch block (LBBB). However, approximately 30% of patients have a poor therapeutic response and do not achieve real clinical benefit. Pre-implant imaging, together with tailored programming and dedicated device algorithms, have been proposed as possible tools to improve success rate but have shown inconsistent results. Over the last few years, conduction system pacing (CSP) is becoming a real and attractive alternative to standard BVP as it can restore narrow QRS in patients with bundle branch block (BBB) by stimulating and recruiting the cardiac conduction system, thus ensuring true resynchronization. It includes His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). Preliminary data coming from small single-center experiences are very promising and have laid the basis for currently ongoing randomized controlled trials comparing CSP with BVP. The purpose of this review is to delve into the emerging role of CSP as an alternative method of achieving CRT. After framing CSP in a historical perspective, the pathophysiological rationale and available clinical evidence will be examined, and crucial technical aspects will be discussed. Finally, evidence gaps and future perspectives on CSP as a technique of choice to deliver CRT will be summarized.