bluuebunny/crossref_metadata_2025 huggingface dataset:
Fractional exhaled nitric oxide in the assessment of exercise‐induced bronchoconstriction: A multicenter retrospective analysis of UK‐based athletes
Authors: Dickinson John , Gowers William , Sturridge Savannah , Williams Neil , Kippelen Pascale , Simpson Andrew , Jackson Anna , Hull James H. , Price Oliver J.
Published: April 2023

Introduction

Exercise‐induced bronchoconstriction (EIB) is not only highly prevalent in people with asthma, but can also occur independently, particularly in athletes. Fractional exhaled nitric oxide (FeNO) is an indirect biomarker of type 2 airway inflammation that has an established role in the assessment and management of asthma. The aim was to evaluate the value of FeNO in the assessment of EIB in athletes.

Method

Multicenter retrospective analysis. In total, 488 athletes (male: 76%) performed baseline FeNO, and spirometry pre‐ and post‐indirect bronchial provocation via eucapnic voluntary hyperpnea (EVH). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for established FeNO thresholds—that is, intermediate (≥25 ppb) and high FeNO (≥40 ppb and ≥ 50 ppb)—and were evaluated against objective evidence of EIB (≥10% fall in FEV1). The diagnostic accuracy of FeNO was calculated using receiver operating characteristics area under the curve (ROC‐AUC).

Results

Thirty‐nine percent of the athletes had a post‐EVH fall in FEV1 consistent with EIB. FeNO values ≥25 ppb, ≥40 ppb, and ≥ 50 ppb were observed in 42%, 23%, and 17% of the cohort, respectively. The sensitivity of FeNO ≥25 ppb was 55%, which decreased to 37% and 27% at ≥40 ppb and ≥ 50 ppb, respectively. The specificity of FeNO ≥25 ppb, ≥40 ppb, and ≥ 50 ppb was 66%, 86%, and 89%, respectively. The ROC‐AUC for FeNO was 0.656.

Conclusions

FeNO ≥40 ppb provides good specificity, that is, the ability to rule‐in a diagnosis of EIB. However, due to the poor sensitivity and predictive values, FeNO should not be employed as a replacement for indirect bronchial provocation in athletes.
An ecological pedagogy of embeddedness: Theological education for human flourishing
Authors: Tollison Wm. Taylor
Published: April 2023

This paper sets forth a proposal for an ecological pedagogy of embeddedness informed by place‐based, challenge‐based, and competency‐based methodologies. While some theological institutions have begun implementing principles from competency‐based models, theological educators have not adequately explored the resources within place‐based and challenge‐based systems. This paper will contribute to the literature on theological education in three distinct ways: first, this proposal will perform the oft‐overlooked task of bringing these three pedagogical models into conversation with one another; second, this proposal will aim the outcomes and effects of the three pedagogical models toward the flourishing of the communities in which institutions are embedded; and third, this proposal will break new ground in its application of these three pedagogical systems to the context of a theological seminary.
Establishing Human Observer Criterion in Evaluating Artificial Social Intelligence Agents in a Search and Rescue Task
Authors: Huang Lixiao , Freeman Jared , Cooke Nancy J. , Cohen Myke C. , Yin Xiaoyun , Clark Jeska , Wood Matt , Buchanan Verica , Corral Christopher , Scholcover Federico , Mudigonda Anagha , Thomas Lovein , Teo Aaron , Colonna‐Romano John
Published: April 2023

Artificial social intelligence (ASI) agents have great potential to aid the success of individuals, human–human teams, and human–artificial intelligence teams. To develop helpful ASI agents, we created an urban search and rescue task environment in Minecraft to evaluate ASI agents’ ability to infer participants’ knowledge training conditions and predict participants’ next victim type to be rescued. We evaluated ASI agents’ capabilities in three ways: (a) comparison to ground truth—the actual knowledge training condition and participant actions; (b) comparison among different ASI agents; and (c) comparison to a human observer criterion, whose accuracy served as a reference point. The human observers and the ASI agents used video data and timestamped event messages from the testbed, respectively, to make inferences about the same participants and topic (knowledge training condition) and the same instances of participant actions (rescue of victims). Overall, ASI agents performed better than human observers in inferring knowledge training conditions and predicting actions. Refining the human criterion can guide the design and evaluation of ASI agents for complex task environments and team composition.
Impact of the COVID‐19 pandemic on blood donation and transfusions in the United States in 2020
Authors: Basavaraju Sridhar V. , Free Rebecca J. , Chavez Ortiz Joel L. , Stewart Phylicia , Berger James , Sapiano Mathew R. P.
Published: April 2023

Introduction

Reports have suggested the COVID‐19 pandemic resulted in blood donation shortages and adverse impacts on the blood supply. Using data from the National Blood Collection and Utilization Survey (NBCUS), we quantified the pandemic's impact on red blood cell (RBC) and apheresis platelet collections and transfusions in the United States during year 2020.

Methods

The 2021 NBCUS survey instrument was modified to include certain blood collection and utilization variables for 2020. The survey was distributed to all US blood collection centers, all US hospitals performing ≥1000 surgeries annually, and a 40% random sample of hospitals performing 100–999 surgeries annually. Weighting and imputation were used to generate national estimates for whole blood and apheresis platelet donation; RBC and platelet transfusion; and convalescent plasma distribution.

Results

Whole blood collections were stable from 2019 (9,790,000 units; 95% CI: 9,320,000–10,261,000) to 2020 (9,738,000 units; 95% CI: 9,365,000–10,110,000). RBC transfusions decreased by 6.0%, from 10,852,000 units (95% CI: 10,444,000–11,259,000) in 2019 to 10,202,000 units (95% CI: 9,811,000–10,593,000) in 2020. Declines were steepest during March–April 2020, with transfusions subsequently rebounding. Apheresis platelet collections increased from 2,359,000 units (95% CI: 2,240,000–2,477,000) in 2019 to 2,408,000 units (95% CI: 2,288,000–2,528,000) in 2020. Apheresis platelet transfusions increased from 1,996,000 units (95% CI: 1,846,000–2,147,000) in 2019 to 2,057,000 units (95% CI: 1,902,000–2,211,000) in 2020.

Conclusion

The COVID‐19 pandemic resulted in reduced blood donations and transfusions in some months during 2020 but only a minimal annualized decline compared with 2019.
Mortality and outcomes by blood group in trauma patients: A systematic review and meta‐analysis
Authors: Lubkin David T. , Van Gent Jan‐Michael , Cotton Bryan A. , Brill Jason B.
Published: April 2023

Background and Objectives

Blood group O contains lower levels of factor VIII and von Willebrand factor. Higher incidence of bleeding among group O is reported in multiple contexts. Results of studies vary regarding outcomes stratified by blood group in trauma. We systematically reviewed the literature for outcomes related to blood group in trauma patients. Meta‐analysis of studies evaluating mortality related to blood group was performed.

Materials and Methods

The PubMed and Embase databases were searched for studies analysing relationships between blood group and outcomes in trauma patients. Preferred Reporting Items in Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. We synthesized outcomes data related to blood group. Meta‐analysis compared mortality rates between group O and non‐O patients.

Results

Inclusion criteria were met by 13 studies. Statistically significant differences by blood group were reported in 3 of 10 (30%) studies evaluating mortality, 2 of 3 (66.7%) evaluating mortality from haemorrhage and 2 of 9 (22.2%) evaluating transfusion requirement. Meta‐analysis was performed on seven studies evaluating mortality (total n = 11,835). There was significant heterogeneity among studies (I2 = 86%, p < 0.00001). No difference was found in mortality between group O and non‐O patients (relative risk = 1.21, 95% confidence interval = 0.89–1.64, p = 0.23).

Conclusion

Existing literature does not consistently demonstrate a mortality difference between trauma patients with O and non‐O blood groups. High variability in the methods and results among studies limits this conclusion, and further research is needed to delineate under what circumstances blood group may influence outcomes.
A characteristic nonlinear distortion length for broadband Gaussian noise
Authors: Muhlestein Michael B. , Gee Kent L.
Published: April 2023

The nonlinear evolution of high-amplitude broadband noise is important to the psychoacoustic perception, usually annoyance, of high-speed jet noise. One method to characterize the nonlinear evolution of such noise is to consider a characteristic nonlinear waveform distortion length for the signal. A common length scale for this analysis is the shock formation distance of an initially sinusoidal signal. However, application of this length scale to broadband noise, even with the amplitude and source frequency replaced with characteristic values, may lead to underestimates of the overall nonlinear waveform distortion of the noise as indicated by the skewness of the time derivative of the acoustic pressure (or derivative skewness). This paper provides an alternative length scale derived directly from the evolution of the derivative skewness of Gaussian noise that may be more appropriate when analyzing the nonlinear evolution of broadband noise signals. This Gaussian-based length scale is shown to be a useful metric for its relative consistency and its physical interpretation. Various analytical predictions of the evolution of the derivative skewness for an ensemble of numerical simulations of noise propagation are used to highlight various aspects of this new length scale definition.
The Road to Becoming a World Champion in Futsal
Authors: Travassos Bruno , Braz Jorge , Mendes José L. , Palas Pedro , Rodrigues Manuel , Silvério Jorge , Brito João
Published: April 2023

Purpose: The aim of the current study was to report the training program and monitoring outcomes of the Portuguese national futsal team during the preparation and competition phases of the FIFA Futsal World Cup Lithuania 2021™. For that, the variations in training load and wellness were measured, as well as their relationship. Methods: The study followed a retrospective cohort design. For all field training sessions, the volume, exercise structure, and area of play were identified. Player load, session rating of perceived exertion (sRPE), and wellness were collected. Descriptive statistics and Kruskal–Wallis tests were used for comparison purposes. A visualization method was used for load and well-being. Results: No significant differences were observed in the number of training sessions, session duration, and player load between preparation and competitive periods. sRPE showed significantly higher values in preparation than in competition periods (P < .05, d = 0.86) and significant differences between weeks (P < .05, d = 1.08). Wellness showed a general statistical difference between periods (P < .001, d = 1.28) and weeks (P < .05, d = 1.17). The correlation analysis for the overall period revealed a general linear relationship within variables of training load and wellness (P < .001). Variations occurred for preparation and competition periods. The visualization method through quadrant plots allowed us to understand the adaptation of the team and the players over the specific period under analysis. Conclusions: Through this study, it was possible to better understand the training program and monitoring strategies of a high-performance futsal team over a high-level tournament.
Assisted reproductive technologies at the nexus of fertility treatment and disease prevention
Authors: Herbert Mary , Choudhary Meenakshi , Zander-Fox Deidre
Published: April 2023

Assisted reproductive technology (ART) refers to processing gametes in vitro and usually involves in vitro fertilization. Originally developed for the treatment of infertility, culture of human embryos in vitro also provides an opportunity to screen embryos for inherited genetic disorders of the nuclear and mitochondrial genomes. Progress in identifying causative genetic variants has massively increased the scope of preimplantation genetic testing in preventing genetic disorders. However, because ART procedures are not without risk of adverse maternal and child outcomes, careful consideration of the balance of risks and benefits is warranted. Further research on early human development will help to minimize risks while maximizing the benefits of ART.
Sleep like a bear
Authors: Schattner Mirta
Published: April 2023

Reduced expression of a platelet protein protects against thrombosis during chronic immobilization
Reproductive medicine
Authors: Nusinovich Yevgeniya
Published: April 2023

The quest for safer and better planned reproduction
In Other Journals
Authors: Nusinovich Yevgeniya , Hurtley Stella M. , Maroso Mattia , Lopez Bianca , Stajic Jelena , Smith Keith T. , Funk Michael A.
Published: April 2023

Editors’ selections from the current scientific literature
The dCache Domain of the Chemoreceptor Tlp1 in Campylobacter jejuni Binds and Triggers Chemotaxis toward Formate
Authors: Duan Jingjing , Zhao Qi , Wang Yuxin , Chi Zhe , Li Wei , Wang Xue , Liu Shuangjiang , Bi Shuangyu
Published: April 2023

Chemotaxis is important for
Campylobacter jejuni
to colonize favorable niches in the gastrointestinal tract of its host. However, there is still a lack of knowledge about the ligand molecules for
C. jejuni
chemoreceptors.
Ambulatory antenatal fetal electrocardiography in high-risk pregnancies (AMBER): protocol for a pilot prospective cohort study
Authors: Liu Becky , Marler Emily , Thilaganathan Basky , Bhide Amarnath
Published: April 2023

Introduction

Fetal heart rate (FHR) monitoring is a vital aspect of fetal well-being assessment, and the current method of computerised cardiotocography (cCTG) is limited to the hospital setting. Non-invasive fetal ECG (NIFECG) has the ability to produce FHR patterns through R wave detection while eliminating confusion with maternal heart rate, but is presently limited to research use. Femom is a novel wireless NIFECG device that is designed to be placed without professional assistance, while connecting to mobile applications. It has the ability to achieve home FHR monitoring thereby allowing more frequent monitoring, earlier detection of deterioration, while reducing hospital attendances. This study aims to assess the feasibility, reliability, and accuracy of femom (NIFECG) by comparing its outputs to cCTG monitoring.

Methods and analysis

This is a single-centred, prospective pilot study, taking place in a tertiary maternity unit. Women with a singleton pregnancy over 28+0weeks’ gestation who require antenatal cCTG monitoring for any clinical indication are eligible for recruitment. Concurrent NIFECG and cCTG monitoring will take place for up to 60 min. NIFECG signals will be postprocessed to produce FHR outputs such as baseline FHR and short-term variation (STV). Signal acceptance criteria is set as <50% of signal loss for the trace duration. Correlation, precision and accuracy studies will be performed to compare the STV and baseline FHR values produced by both devices. The impact of maternal and fetal characteristics on the effectiveness of both devices will be investigated. Other non-invasive electrophysiological assessment parameters will be assessed for its correlation with the STV, ultrasound assessments and maternal and fetal risk factors.

Ethics and dissemination

Approval has been obtained from South-East Scotland Research Ethics Committee 02 and MHRA. The results of this study will be published in peer-reviewed journals, and presented at international conferences.

Trial registration number

NCT04941534.
Sleep IntervEntion as Symptom Treatment for ADHD (SIESTA)-Blended CBT sleep intervention to improve sleep, ADHD symptoms and related problems in adolescents with ADHD: Protocol for a randomised controlled trial
Authors: Keuppens Lena , Marten Finja , Baeyens Dieter , Boyer Bianca , Danckaerts Marina , van der Oord Saskia
Published: April 2023

Introduction

Adolescents with attention deficit hyperactivity disorder (ADHD) experience a more disrupted sleep and more sleep problems compared with typically developing adolescents. This is particularly concerning, because disrupted sleep is related to worsened clinical, neurocognitive and functional outcomes and leads to increased ADHD symptom impairment. Due to the specific difficulties adolescents with ADHD experience, a tailored sleep treatment is needed. Therefore, our lab developed a cognitive behavioural treatment—Sleep IntervEntion as Sympom Treatment for ADHD (SIESTA)—that integrates sleep training with motivational interviewing, and planning/organisational skills training with the aim of improving sleep problems in adolescents with ADHD.

Methods and analysis

A randomised, controlled, investigator-blinded monocentre trial is used to test whether SIESTA in combination with treatment as usual (TAU) for ADHD results in greater improvement in sleep problems than TAU only. Adolescents (aged 13–17 years) with ADHD and sleep problems are included. They complete measurements before treatment (pre-test), approximately 7 weeks after the pre-test (post-test), and approximately 3 months after the post-test (follow-up). The assessment includes questionnaires filled out by adolescents, parents and teachers. Additionally, sleep is assessed by actigraphy and sleep diaries at all time-points. Primary outcomes include objectively and subjectively measured sleep architecture (specified as total sleep time, sleep onset latency, sleep efficiency and number of awakenings), subjectively measured sleep problems and sleep hygiene. Secondary outcomes include ADHD symptoms, comorbidities and functional outcomes. To analyse the data, a linear mixed effects model will be used with an intent-to-treat approach.

Ethics and dissemination

The study activities, informed consent and assent forms have been approved by the Ethical Committee Research UZ/KU Leuven (study ID S64197). If proven effective, the intervention will be implemented throughout Flanders. Therefore, an advisory board consisting of societal partners in healthcare is appointed at the start of the project, giving advice throughout the project and assistance with implementation afterwards.

Trial registration number

NCT04723719.
Consultation skills development in general practice: findings from a qualitative study of newly recruited and more experienced clinical pharmacists during the COVID-19 pandemic
Authors: Madden Mary , Stewart Duncan , Mills Thomas , McCambridge Jim
Published: April 2023

Objective

The new structured medication review (SMR) service was introduced into the National Health Service in England during the COVID-19 pandemic, following a major expansion of clinical pharmacists within new formations known as primary care networks (PCNs). The aim of the SMR is to tackle problematic polypharmacy through comprehensive, personalised medication reviews involving shared decision-making. Investigation of clinical pharmacists’ perceptions of training needs and skills acquisition issues for person-centred consultation practice will help better understand their readiness for these new roles.

Design

A longitudinal interview and observational study in general practice.

Setting and participants

A longitudinal study of 10 newly recruited clinical pharmacists interviewed three times, plus a single interview with 10 pharmacists recruited earlier and already established in general practice, across 20 newly forming PCNs in England. Observation of a compulsory 2-day history taking and consultation skills workshop.

Analysis

A modified framework method supported a constructionist thematic analysis.

Results

Remote working during the pandemic limited opportunities for patient-facing contact. Pharmacists new to their role in general practice were predominantly concerned with improving clinical knowledge and competence. Most said they already practiced person-centred care, using this terminology to describe transactional medicines-focused practice. Pharmacists rarely received direct feedback on consultation practice to calibrate perceptions of their own competence in person-centred communication, including shared decision-making skills. Training thus provided knowledge delivery with limited opportunities for actual skills acquisition. Pharmacists had difficulty translating abstract consultation principles into specific consultation practices.

Conclusion

SMRs were introduced when the dedicated workforce was largely new and being trained. Addressing problematic polypharmacy requires structural and organisational interventions to enhance the communication skills of clinical pharmacists (and other health professionals), and their use in practice. The development of person-centred consultation skills requires much more substantial support than has so far been provided for clinical pharmacists.
Factors that influence compliance for referral from primary care to hospital for maternal and neonatal complications in Bosaso, Somalia: a qualitative study
Authors: Morris Catherine N , Meehan Kate , Had Hussein , Barasa Sammy O , Zainul Hasna , Hynes Michelle , Amsalu Ribka
Published: April 2023

Objectives

To estimate referral compliance and examine factors that influence decisions to comply with referral for newborn and maternal complications in Bosaso, Somalia.

Setting

Bosaso, Somalia, is a large port city that hosts a large proportion of internally displaced persons. The study was conducted at the only four primary health centres offering 24/7 delivery services and the only public referral hospital in Bosaso.

Participants

All pregnant women who sought care at four primary centres and were referred to the hospital for maternal complications or mothers whose newborns were referred for neonatal complications were approached for enrolment from September to December 2019. In-depth interviews (IDIs) of 54 women and 14 healthcare workers (HCWs) were conducted.

Outcome measures

This study examined timely referral compliance from the primary centre to the hospital. IDIs were analysed for a priori themes investigating the decision-making process and experience of care for maternal and newborn referrals.

Results

Overall, 94% (n=51/54) of those who were referred, 39 maternal and 12 newborns, complied with the referral and arrived at the hospital within 24 hours. Of the three that did not comply, two delivered on the way, and one cited lack of money as the reason for noncompliance. Four themes emerged: trust in medical authority, cost of transportation and care, quality of care, and communications. The factors that facilitated compliance were the availability of transportation, family support, concern for health, and trust in medical authority. HCWs raised the importance of considering the maternal-newborn dyad throughout the referral process, and the need for official standard operating procedures for referrals including communications between the primary care and the hospital.

Conclusions

High compliance for referral from primary to hospital care for maternal and newborn complications was observed in Bosaso, Somalia. Costs associated with transportation and care at the hospital need attention to motivate compliance.
Effects of infant feeding with goat milk formula or cow milk formula on atopic dermatitis: protocol of the randomised controlled Goat Infant Formula Feeding and Eczema (GIraFFE) trial
Authors: Ferry Jill Marie , Galera-Martínez Rafael , Campoy Cristina , Sáenz de Pipaón Miguel , Jarocka-Cyrta Elzbieta , Walkowiak Jarosław , Romańczuk Bartosz , Escribano Joaquin , Gispert Mariona , Grattarola Paula , Gruszfeld Dariusz , Iglesia Iris , Grote Veit , Demmelmair Hans , Handel Uschi , Gallier Sophie , Koletzko Berthold
Published: April 2023

Introduction

Atopic dermatitis (AD) is a chronic, inflammatory skin condition significantly affecting quality of life. A small randomised trial showed an approximately one-third lower incidence of AD in goat milk formula-fed compared with cow milk formula-fed infants. However, due to limited statistical power, AD incidence difference was not found to be significant. This study aims to explore a potential risk reduction of AD by feeding a formula based on whole goat milk (as a source of protein and fat) compared with a formula based on cow milk proteins and vegetable oils.

Methods and analysis

This two-arm (1:1 allocation), parallel, randomised, double-blind, controlled nutritional trial shall enrol up to 2296 healthy term-born infants until 3 months of age, if parents choose to start formula feeding. Ten study centres in Spain and Poland are participating. Randomised infants receive investigational infant and follow-on formulas either based on whole goat milk or on cow milk until the age of 12 months. The goat milk formula has a whey:casein ratio of 20:80 and about 50% of the lipids are milk fat from whole goat milk, whereas the cow milk formula, used as control, has a whey:casein ratio of 60:40 and 100% of the lipids are from vegetable oils. The energy and nutrient levels in both goat and cow milk formulas are the same. The primary endpoint is the cumulative incidence of AD until the age of 12 months diagnosed by study personnel based on the UK Working Party Diagnostic Criteria. The secondary endpoints include reported AD diagnosis, measures of AD, blood and stool markers, child growth, sleep, nutrition and quality of life. Participating children are followed until the age of 5 years.

Ethics and dissemination

Ethical approval was obtained from the ethical committees of all participating institutions.

Trial registration number

NCT04599946.
Early breast cancer risk detection: a novel framework leveraging polygenic risk scores and machine learning
Authors: Tao Lynn Rose , Ye Yixuan , Zhao Hongyu
Published: April 2023

Background

Breast cancer (BC) is the most common cancer and the second leading cause of cancer death in women; an estimated one in eight women in the USA will develop BC during her lifetime. However, current methods of BC screening, including clinical breast exams, mammograms, biopsies and others, are often underused due to limited access, expense and a lack of risk awareness, causing 30% (up to 80% in low-income and middle-income countries) of patients with BC to miss the precious early detection phase.

Methods

This study creates a key step to supplement the current BC diagnostic pipeline: a prescreening platform, prior to traditional detection and diagnostic steps. We have developed BREast CAncer Risk Detection Application (BRECARDA), a novel framework that personalises BC risk assessment using artificial intelligence neural networks to incorporate relevant genetic and non-genetic risk factors. A polygenic risk score (PRS) was enhanced by employing AnnoPred and validated by fivefolds cross-validation, outperforming three existing state-of-the-art PRS methods.

Results

We used data from 97 597 female participants of the UK BioBank to train our algorithm. Using the enhanced PRS thus trained together with non-genetic information, BRECARDA was evaluated in a testing dataset with 48 074 UK Biobank female participants and achieved a high accuracy of 94.28% and area under the curve of 0.7861. Our optimised AnnoPred outperformed other state-of-the-art methods on quantifying genetic risk, indicating its potential for supplementing the current BC detection tests, population screening and risk evaluation.

Conclusion

BRECARDA can enhance disease risk prediction, identify high-risk individuals for BC screening, facilitate disease diagnosis and improve population-level screening efficiency. It can serve as a valuable and supplemental platform to assist doctors in BC diagnosis and evaluation.
Downhill progressive landslide hazard assessment: a simple framework for prediction of triggering thresholds and failure modes
Authors: Zhang Longfei , Gui Lei , Wang Yang , Liu Jizhixian , Cao Ying
Published: April 2023

The pronounced discrepancies in triggering intensities and failure modes observed in downhill progressive landslides pose significant challenges to their risk prediction and mitigation. Instead of focusing on an individual triggering event and/or failure mode as done in previous studies, this study systematically explores the instability issues of downhill progressive failure in long slopes. A unified analytical model is proposed to understand these observed discrepancies, in which criteria for the initiation of slope failure corresponding to all possible failure modes are formulated. Accordingly, a simple framework is established that is capable of predicting possible triggering thresholds and failure modes in advance. This would improve the accuracy of landslide hazard assessment, which is often reduced by the unknowns of the failure mechanisms and inaccurate assumptions of stress distribution along the failure surface. Furthermore, three practical cases are analyzed based on the established framework, and the findings are compared with field observations and existing studies, showing good consistency. This work gives an insight into a systematic understanding of the various failure phenomena in downhill progressive landslides and provides a reference for their risk assessment and subsequent decision-making.
Extrusion effects on the starch and fibre composition of Canadian pulses
Authors: Babatunde Olufemi O. , Cargo-Froom Cara L. , Ai Yongfeng , Newkirk Rex W. , Marinangeli Christopher P.F. , Shoveller Anna K. , Columbus Daniel A.
Published: April 2023

Pulses are important as alternative sources of protein and carbohydrates for the animal industry and, thus, require accurate evaluation of their nutrient profile during processing. Extrusion is a thermal processing of ingredients to induce physiochemical changes that convert them into more valuable products. The current study evaluated the effects of extrusion on the starch and fibre components of Amarillo peas, Dun peas, chickpeas, faba beans, lentils, and soybean meal (SBM). Pulses were extruded at 18% or 22% moisture and 110, 130, or 150 °C. Extrusion decreased ( P < 0.05) the starch content in Amarillo and Dun peas but increased ( P < 0.05) the same in faba beans, lentils, and SBM when compared with their whole counterparts. There was no difference in the total dietary fibre content of whole and extruded Amarillo peas, Dun peas, chickpeas, and SBM. Extrusion increased ( P < 0.05) the soluble dietary fibre (SDF) content of all pulses and SBM except chickpeas. Extrusion increased ( P < 0.05) for all fibre types in faba beans. Results indicate that extrusion increased the starch and SDF content of most pulses but had negative or no effects on other fibre components in all pulses except faba beans.
Integration of Deep Direction Distribution Feature Extraction and Optimized Attention Based Double Hidden Layer GRNN Models for Robust Cursive Handwriting Recognition
Authors: Manibharathi D. , Vasanthanayaki C.
Published: April 2023

Cursive handwriting recognition (CHWR) is an interesting area of research as it has a wide range of applications but lacks an accurate approach to provide better results due to its character shapes, the non-uniform spacing between words and within a word, diverse placements of dots, and diacritics, and very low inter-class variation among individual classes. A novel CHWR model is proposed to enhance the recognition accuracy with high global stability. The proposed model introduces three major phases: pre-processing, feature extraction and classification. In the pre-processing stage, the noise removal and binarization are adapted with the intrusion of improved adaptive wiener filtering (IAWF) and structural symmetric pixels. A hybrid deep direction distribution feature extraction (HDDDFE) approach is proposed to extract directional Local gradient histogram (LGH), column gradient histogram (CGH) features and a wavelet convolutional neural network with Block Attention Module (WCNN-BAM) is proposed to extract deep global features (GF), profile features (PF) and dynamic features (DF). A novel double hidden layer gated recurrent neural network with a feature attention mechanism (ODHL-GRNN-FAM) is proposed to offer handwritten classification results. The developed model is evaluated with the IAM database and attains an overall recognition accuracy of 98%, precision of 97%, f-measure of 97.99%, character error rate (CER) of 1.23%, word error rate (WER) of 4.8%, respectively.
High Performance FPGA Implementation of Single MAC Adaptive Filter for Independent Component Analysis
Authors: Ezilarasan M. R. , Britto Pari J. , Leung Man-Fai
Published: April 2023

Blind source separation (BSS) is the process of extracting sources from mixed data without or with limited awareness of the sources. This paper uses field programmable gate array (FPGA) to create an effective version of the Blind source separation algorithm (ICA) with a single Multiply Accumulate (MAC) adaptive filter and to optimize it. Recently, space research has paid a lot of attention to this technique. We address this problem in two sections. The first approach is ICA, which seeks a linear revolution that can enhance the mutual independence of the mixture to distinguish the source signals from mixed signals. The second is a powerful flexible finite impulse response (FIR) filter construction that makes use of a MAC core and is adaptable. The adjustable coefficient filters have been used in the proposed study to determine the undiscovered system utilizing an optimal least mean square (LMS) technique. The filter tap under consideration in this paper includes 32 taps, and hardware description language (HDL) and FPGA devices were used to carry out the analysis and synthesis of it. When compared to the described architecture, the executed filter architecture uses 80% fewer resources and increases clock frequency by nearly five times, and speed is increased up to 32%.
Thermodynamical character and the radiation process of the thin accretion disk of minimum measurable length-inspired regular black hole
Authors: Barman Himangshu , Shababi Homa , Moussa Mohamed , Rahaman Anisur
Published: April 2023

We investigate the impact of quantum gravity on the thermodynamic characteristics and radiation processes of thin accretion disks surrounding Schwarzschild-like black holes. To incorporate quantum gravity into our study, we apply the framework of generalization of uncertainty, which is equivalent to the renormalization group improved quantum gravity and maintains the limit of asymptotically safe preposition of gravity. A free parameter, reflecting the quantum effects on spacetime geometry, is introduced to enable the study of the thermal properties of the black hole itself and the accretion disk surrounding it at the quantum level. We explicitly calculate the entropy, temperature, free energy, and enthalpy of the modified black hole and show how they vary with the free parameter encoding the quantum effects. Moreover, we provide estimations of the quantum correction to the time-averaged energy flux, temperature of the disk, differential luminosity, and the conversion efficiency of accretion mass into radiation. We observe a conspicuous shifting of the radius of the innermost stable circular orbit (ISCO) toward small values together with an enhancement of the maximum values of the average thermal radiation and greater conversion efficiency of accreting mass into radiation compared to the classical gravity scenario.
A Highly Stable Fusion Positioning System of Smartphone under NLoS Acoustic Indoor Environment
Authors: Wang Hucheng , Wang Zhi , Zhang Lei , Luo Xiaonan , Wang Xinheng
Published: April 2023

Fusion positioning technology requires stable and effective positioning data, but this is often challenging to achieve in complex
Non-Line-of-Sight (NLoS)
environments. This paper proposes a fusion positioning method that can achieve stable and no hop points by adjusting parameters and predicting trends, even with a one-sided lack of fusion data. The method combines acoustic signal and
Inertial Measurement Unit (IMU)
data, exploiting their respective advantages. The fusion is achieved using the Kalman filter and Bayesian parameter estimation is performed for tuning IMU parameters and predicting motion trends. The proposed method overcomes the problem of fusion failure caused by long-term unilateral data loss in traditional fusion positioning. The positioning trajectory and error distribution analysis show that the proposed method performs optimally in severe NLoS experiments.
A Survey of Threats to Research Literature-dependent Medical AI Solutions
Authors: Saini Shalini , Saxena Nitesh
Published: April 2023

Medical Artificial Intelligence (MedAI) harnesses the power of medical research through AI algorithms and vast data to address healthcare challenges. The security, integrity, and credibility of MedAI tools are paramount, because human lives are at stake. Predatory research, in a culture of “publish or perish,” is exploiting the “pay for publish” model to infiltrate he research literature repositories. Although, it is challenging to measure the actual predatory research induced data pollution and patient harm, our work shows that the breached integrity of MedAI inputs is a serious threat to trust the MedAI output. We review a wide range of research literature discussing the threats of data pollution in the research literature, feasible attacks impacting MedAI solutions, research literature-based tools, and influence on healthcare. Our contribution lies in presenting a comprehensive literature review, addressing the gap of predatory research vulnerabilities affecting MedAI solutions, and helping to develop robust MedAI solutions in the future.
Performance Modeling and Analysis of BASUR-CARQ Protocol Based on Interrelay Interference Cancellation
Authors: Zhou Yongqiang , Qian Huan , Song Zhenggang
Published: April 2023

To recover the performance loss of nodes in half-duplex mode, this paper proposes a buffer-aided successive relay protocol based on cooperative automatic repeat request mechanism (BASUR-CARQ). Based on the fact that interrelay interference (IRI) will occur when relay nodes transmit or receive simultaneously, an interference cancellation operator is proposed to determine whether the interference is eliminated to reduce the outage probability. Moreover, a delay model for data frame transmission is proposed based on CARQ mechanism, and a closed-form expression for the average delay is derived. A 6-state discrete-time Markov chain (DTMC) model is developed to obtain the system throughput, and a closed-form expression for the system energy efficiency under M-ary modulation is derived. Finally, the simulation results show that with the setting of parameters that can balance the main performance, the delay performance of BASUR-CARQ protocol is significantly enhanced compared to the traditional protocols, and the throughput of BASUR-CARQ protocol is also optimized at high signal-to-noise ratio (SNR). Meanwhile, the energy efficiency of BASUR-CARQ protocol is significantly improved for the successive relay communication system without interference cancellation technique.
Identifying and Addressing Bias in Nursing Teaching: A Creative Controversy Essay
Authors: Gleasman-DeSimone Sara L.
Published: April 2023

Nursing faculty all have some form of unconscious or implicit bias. This type of bias is not intentional, but negative enough that it can influence students and ultimately help to create healthcare disparities for students’ future patients. These disparities are likely evident, for instance, in the anomalously high death rate of Black women with breast cancer, and in the hesitancy that transgender, lesbian, gay, and bisexual individuals often have to obtain medical help at crucial times. To help address a paradigm shift, is therefore, required in how faculty educate future nursing providers. This review paper has been written to encourage reflection about implicit bias and bias in teaching nursing students required to engender such a change. It also describes tools such as a bias checklist that can be used by faculty to help reflect on ways to minimize implicit bias in teaching materials.
Improving the Corrosion Resistance of NiNb-Based Bulk Metallic Glass through the Hot Compression
Authors: Al Anazi Abeer Abdullah , Ramírez-Coronel Andrés Alexis , Obaid Rasha Fadhel , Albaker Abdullah , Gatea M. Abdulfadhil , Mostafavi Seyed Mojtaba
Published: April 2023

This paper aims to study and evaluate the corrosion resistance of Ni55Nb45 and Ni55Nb35Co5Zr5 bulk metallic glasses (BMGs) in an environment similar to proton exchange membrane fuel cells. Moreover, the hot compression process was carried out to find the effects of a thermomechanical treatment on the corrosion resistance. The X-ray diffraction (XRD) test indicated that the hot compression process led to formation of crystalline species in both samples; however, it was more pronounced in the Ni55Nb35Co5Zr5 alloy. It is suggested that the minor addition of Zr and Co facilitated the crystallization in the material. The polarization test unveiled that the hot compression deteriorated the corrosion resistance of the Ni55Nb45 alloy through the introduction of anomalous chemical interfaces. On the other hand, the hot deformation affected the Ni55Nb35Co5Zr5 alloy in a positive way, so that the corrosion behavior improved compared with its fully glassy state. It is suggested that the hot deformation induces some NiNb crystalline constituencies in the microstructure of Ni55Nb35Co5Zr5 BMG, leading to the enrichment of glassy matrix from Zr/Co constituencies and the enhancement of corrosion resistance.
[Retracted] Apatinib plus Radiotherapy on the Expression of CEA and VEGF in Advanced Oligometastatic Non‐Small‐Cell Lung Cancer
Authors: Zhu Yanxing , Lin Zhiren , Wu Chengde
Published: April 2023

Objective. The purpose of this study was to evaluate the clinical efficacy of apatinib plus concurrent radiotherapy on carcinoma embryonic antigen (CEA) and vascular endothelial growth factor (VEGF) expression in patients with non‐small‐cell lung cancer (NSCLC) with oligometastases. Methods. This is a prospective randomized controlled trial. Sixty‐four patients with oligometastatic NSCLC who were treated in the Central South University Xiangya School of Medicine Affiliated Haikou Hospital from January 2017 to January 2019 were randomly assigned into the control group and the study group, with 32 cases in each group. The control group was treated with stereotactic body radiotherapy (SBRT), and the study group was treated with apatinib. Results. The overall response rate (ORR) of the study group was significantly higher than that of the control group. The carcinoma embryonic antigen (CEA) and the vascular endothelial growth factor (VEGF) in the two groups were significantly decreased, with lower results in the study group compared to the control group. The 12‐month and 24‐month overall survival (OS) of the study group were significantly higher than those of the control group. There was no significant difference in progression‐free survival (PFS) between the two groups. The median OS in the control group was 20.0 months, and the study group had not yet reached the median OS; the OS in the study group was significantly higher than that in the control group. There was no significant difference in adverse reactions between the two groups. Conclusion. For patients with oligometastatic lung cancer, apatinib combined with chemotherapy can significantly improve clinical efficacy, reduce tumor marker expression, and extend overall survival with good safety profiles.
Effect of COVID-19 Pandemic-Related Delays in Chemoembolization on the Survival of Patients with Hepatocellular Carcinoma
Authors: Bannangkoon Kittipitch , Hongsakul Keerati , Tubtawee Teeravut , Janjindamai Phurich
Published: April 2023

Background and Aims. COVID-19 has led to potential delays in liver cancer treatment, which may have undesirable effects on the prognosis of patients. We aimed to quantify the COVID-19 pandemic impact on the survival of patients with hepatocellular carcinoma (HCC) who underwent transarterial chemoembolization (TACE). Methods. A retrospective study was conducted in patients with HCC who underwent TACE at a tertiary care center during the prelockdown (March to July 2019) and lockdown (March to July 2020) periods. Demographic data, tumor characteristics, functional status, and vital status were collected from the hospital medical records. The endpoints were TACE interval, treatment response, and survival after TACE. Cox proportional hazards regression determined the significant preoperative factors influencing survival. Results. Compared to prelockdown, a significant delay occurred during the lockdown in repeated TACE treatments (76.7 vs. 63.5 days,

P
=
0.007

). The trend suggested a significant decrease in patients with HCC in the repeated TACE group (−33.3%). After screening, 145 patients were included (prelockdown (n = 87), lockdown (n = 58)). There was no significant difference in the 1-month objective response rate between the prelockdown and lockdown groups (65.5% vs. 64.4%,

P
=
1.00

). During follow-up, 56 (64.4%) and 34 (58.6%) deaths occurred in the prelockdown and lockdown groups, respectively (

P
=
0.600

). Multivariate analysis revealed no association between the lockdown group and decreased survival (HR 0.88, 95% CI 0.57–1.35,

P
=
0.555

). Conclusions. The impact of the COVID-19 pandemic on liver cancer care resulted in significant decreases and delays in repeated TACE treatments in 2020 compared to 2019. However, treatment delays did not seem to significantly impact survival.