bluuebunny/crossref_metadata_2025 huggingface dataset:
Crimean‐Congo haemorrhagic fever outbreak in Northern Senegal in 2022: Prevalence of the virus in livestock and ticks, associated risk factors and epidemiological implications
Authors: Ngom Déthié , Khoulé Aliou , Faye Elisabeth Thérèse , Sène Ousseynou , Diop Sokhna Maymouna , Sagne Samba Niang , Diallo Mamadou Korka , Dia Moussa , Barry Mamadou Aliou , Diaw Yoro , Bocoum Mamoudou , Ndiaye El Hadji Mamadou , Sall Yoro , Diop Boly , Faye Oumar , Faye Ousmane , Diallo Mawlouth , Simon‐Lorière Etienne , Sakuntabhai Anavaj , Fall Gamou , Diallo Diawo
Published: April 2024

Objective

Crimean‐Congo haemorrhagic fever (CCHF) is a severe zoonotic arboviral disease that occurs widely in Eastern and Western Europe, Asia and Africa. The disease is becoming of growing public health importance in Senegal. However, analysis of tick infestation, CCHF virus (CCHFV) circulation extent and risk factors during ongoing outbreak are scarce. A thorough outbreak investigation was carried out during a CCHF outbreak in Podor (Northern Senegal) in August 2022.

Methods

Ticks and blood samples were collected from animals (cattle, goats and sheep) randomly selected from confirmed CCHF human cases houses, neighbourhoods and surrounding villages. Blood samples were tested for CCHFV antibodies using a commercial enzyme‐linked immunosorbent assay (ELISA) test. Tick samples were screened for CCHFV RNA by RT‐PCR.

Results

Overall, tick infestation rate (TIR) and CCHFV seroprevalence of livestock were 52.12% (95% confidence interval (CI): 45.54%–58.64%) and 43.28% (95% CI: 36.33%–50.44%), respectively. The TIRs were 87.7% in cattle, 57.6% in sheep and 20.0% in goats. These rates were significantly associated with location, host species and tick control (p < 0.001) but not with animal age and sex (p > 0.7). CCHFV seroprevalence was 80.4% (95% CI: 67.57%–89.77%) in cattle, 35.4% (95% CI: 25.00%–47.01%) in sheep and 21.2% (95% CI: 12.11%–33.02%) in goats. Age, sex, location, animal host and presence of ticks were significantly associated to the presence of antibodies. The 950 ticks collected included among other species, Hyalomma impeltatum (48.84%) and H. rufipes (10.21%). Five pools of Hyalomma ssp. were found CCHFV RT‐PCR positive. These infected ticks included 0.86% (4/464) of H. impeltatum collected on cattle and sheep and 1.03% (1/97) of H. rufipes collected on a sheep.

Conclusions

To our knowledge, this is the first report on the extend of tick infestation and CCHFV infection in livestock during an outbreak in Senegal. The results highlight the risk of human infections and the importance of strengthening vector, animal and human surveillance as well as tick control measures in this area to prevent CCHF infections in humans.
Micro-Channel Cutting on Glass in Electrochemical Discharge Machining Process Using Different Electrolytes and Tool Polarity
Authors: Ali M. N. , Sarkar B. R. , Doloi B. , Bhattacharyya B.
Published: April 2024

Microchannel cutting on electrically nonconducting materials with electrochemical discharge machining (ECDM) process has drawn a momentous attention in manufacturing field as compared to other existing nontraditional machining processes. In the present research work, an effort has been accomplished to investigate the effects of process parameters, namely, applied voltage (V), electrolyte concentrations(wt%), pulse frequency, and duty ratio on different performance characteristics of ECDM viz., material removal rate (MRR), overcut (OC) and heat-affected zone (HAZ) area during microchannel cutting on glass. Also, the comparative performance studies during microchannel cutting have been done by using mixed electrolyte of NaOH and KOH and different tool polarities. Overcut is measured as lower (42.26 μm) when aqueous KOH electrolyte is used and as higher (133.44 μm) for aqueous NaOH electrolyte. HAZ enlarges with enrichment in concentration for both types of electrolyte. It is observed that polarity has a vital role on various machining characteristics. As compared to direct polarity, MRR is found very low (3.2 mg/h) in reverse polarity of tool. Overcut is found low in KOH electrolyte for both types of tool polarity (i.e., 64.68 μm for direct polarity and 42.27 μm for reverse polarity). The process parameters influence on the surface texture of microchannels. Microcrack is noticed for direct polarity of tool.
Numerical Modeling, Experimental Investigation, and Optimization of a Micro Hot Embossing Process
Authors: Mondal Partha Protim , Ferreira Placid Matthew , Kapoor Shiv Gopal , Bless Patrick
Published: April 2024

This paper describes the development of a finite element simulation model and a self-made low-cost experimental setup for the micro hot embossing process. The simulation model incorporates stress relaxation behavior through the utilization of the generalized Maxwell model. It also considers thermal expansion and contact friction effects, enabling accurate prediction of the deformed pattern of polymethyl methacrylate (PMMA). Simulations and experiments were performed for various pressure and temperature combinations, and the resulting pattern profile depths were found to be in good agreement, between the simulation and experimental results. In addition, the simulation model was used to generate response surfaces through face-centered central composite design (CCD) to identify the ideal combination of process parameters of the micro hot embossing process for creating a patterned SMD (surface mount device) LED chip panel.
Eulerian–Lagrangian Investigation of Erosion Wear Within a Water-Submerged Jet: Two-Way Coupling
Authors: Turki Zied , Selmi Naceur , Hamdi Fathi , Chrigui Mouldi
Published: April 2024

The present study focuses on the erosion phenomenon caused by particle transport during fluid flow, specifically in complex geometries. A cylindrical geometry is used in conjunction with a conical bore known as “throat.” In-situ focus is performed to target the effects of surface roughness and the rotation of transported particles. The two-phase flow is modeled using the Euler-Lagrange approach. The near-wall turbulence model, K-ω, governs the stochastic flow. The number of particles injected in terms of “number of tries” plays a significant impact not just on the erosion rate, but also on the quality of the numerical resolution. To predict the erosion rate, a user-defined function (UDF) is used to model erosion based on the equations proposed by Mansouri, Zhang, and DNV. Several empirical parameters have been implemented. The obtained results are validated based on Mansouri's experimental work. The findings reveal severe degradation in the drilled conical shape due to the sudden increase in velocity at the inlet of the throat. The erosion rate in the throat geometry increases by 46% compared to the flat plate. The particle rotation is mainly generated by the Magnus-lift force which is caused by the shear flow and velocity gradients. The latter are predominant phenomena close to the wall, where the erosion takes place. Surface erosion decreases proportionally to surface roughness. The rotation of the particles increases the erosion rate by 12%. Combined with surface roughness, particle rotation dominates material removal.
Performance Analysis of a Compact Offset Strip Fin Heat Exchanger for Lubrication System in Aero Engine
Authors: Lang Lei , Liu Zhijie , Liu Yishu , Qin Jiang , Zhang Xiaobin , Huang Hongyan
Published: April 2024

As a typical fuel-oil heat exchanger, an offset strip fin heat exchanger (OSFHX) can ensure the efficient and stable operation of the aero engine lubrication system. The paper establishes 20 kinds of numerical models of OSFHX that are verified by experiments. The effects of different structural parameters on the performance of lubricating oil in OSFHX were systematically studied. Based on dimensional analysis, the prediction model which can describe the overall performance of the OSFHX is obtained. The results show that with the decrease of fin distance (s), fin length (l), fin height (h), fin thickness (t), and fin shape angle (α), the heat transfer performance of the OSFHX is enhanced and the resistance is increased. With the decrease of s and h, and the increase of t and α, the comprehensive performance of the OSFHX is enhanced. The OSFHX exhibits the optimal performance when l = 4 mm. α has the most significant effect on the comprehensive performance of the OSFHX, successively followed by h, s, t, and l. The average error of Colburn factor (j) and friction factor (f) prediction models is 4.09% and 5.31%, respectively, which can realize the theoretical calculation of the performance of the OSFHX for aviation.
Achieving room temperature plasticity in brittle ceramics through elevated temperature preloading
Authors: Shen Chao , Li Jin , Niu Tongjun , Cho Jaehun , Shang Zhongxia , Zhang Yifan , Shang Anyu , Yang Bo , Xu Ke , García R. Edwin , Wang Haiyan , Zhang Xinghang
Published: April 2024

Ceramic materials with high strength and chemical inertness are widely used as engineering materials. However, the brittle nature limits their applications as fracture occurs before the onset of plastic yielding. There has been limited success despite extensive efforts to enhance the deformability of ceramics. Here we report a method for enhancing the room temperature plastic deformability of ceramics by artificially introducing abundant defects into the materials via preloading at elevated temperatures. After the preloading treatment, single crystal (SC) TiO
2
exhibited a substantial increase in deformability, achieving 10% strain at room temperature. SC α-Al
2
O
3
also showed plastic deformability, 6 to 7.5% strain, by using the preloading strategy. These preinjected defects enabled the plastic deformation process of the ceramics at room temperature. These findings suggest a great potential for defect engineering in achieving plasticity in ceramics at room temperature.
Acoustothermal transfection for cell therapy
Authors: Liu Xiufang , Rong Ning , Tian Zhenhua , Rich Joseph , Niu Lili , Li Pengqi , Huang Laixin , Dong Yankai , Zhou Wei , Zhang Pengfei , Chen Yizhao , Wang Congzhi , Meng Long , Huang Tony Jun , Zheng Hairong
Published: April 2024

Transfected stem cells and T cells are promising in personalized cell therapy and immunotherapy against various diseases. However, existing transfection techniques face a fundamental trade-off between transfection efficiency and cell viability; achieving both simultaneously remains a substantial challenge. This study presents an acoustothermal transfection method that leverages acoustic and thermal effects on cells to enhance the permeability of both the cell membrane and nuclear envelope to achieve safe, efficient, and high-throughput transfection of primary T cells and stem cells. With this method, two types of plasmids were simultaneously delivered into the nuclei of mesenchymal stem cells (MSCs) with efficiencies of 89.6 ± 1.2%. CXCR4-transfected MSCs could efficiently target cerebral ischemia sites in vivo and reduce the infarct volume in mice. Our acoustothermal transfection method addresses a key bottleneck in balancing the transfection efficiency and cell viability, which can become a powerful tool in the future for cellular and gene therapies.
Nonlocal metasurface for dark-field edge emission
Authors: Yao Jin , Hsu Wei-Lun , Liang Yao , Lin Rong , Chen Mu Ku , Tsai Din Ping
Published: April 2024

Nonlocal effects originating from interactions between neighboring meta-atoms introduce additional degrees of freedom for peculiar characteristics of metadevices, such as enhancement, selectivity, and spatial modulation. However, they are generally difficult to manipulate because of the collective responses of multiple meta-atoms. Here, we experimentally demonstrate the nonlocal metasurface to realize the spatial modulation of dark-field emission. Plasmonic asymmetric split rings (ASRs) are designed to simultaneously excite local dipole resonance and nonlocal quasi-bound states in the continuum and spatially extended modes. With one type of unit, nonlocal effects are tailored by varying array periods. ASRs at the metasurface’s edge lack sufficient interactions, resulting in stronger dark-field scattering and thus edge emission properties of the metasurface. Pixel-level spatial control is demonstrated by simply erasing some units, providing more flexibility than conventional local metasurfaces. This work paves the way for manipulating nonlocal effects and facilitates applications in optical trapping and sorting at the nanoscale.
Generation of entanglement using a short-wavelength seeded free-electron laser
Authors: Nandi Saikat , Stenquist Axel , Papoulia Asimina , Olofsson Edvin , Badano Laura , Bertolino Mattias , Busto David , Callegari Carlo , Carlström Stefanos , Danailov Miltcho B. , Demekhin Philipp V. , Di Fraia Michele , Eng-Johnsson Per , Feifel Raimund , Gallician Guillaume , Giannessi Luca , Gisselbrecht Mathieu , Manfredda Michele , Meyer Michael , Miron Catalin , Peschel Jasper , Plekan Oksana , Prince Kevin C. , Squibb Richard J. , Zangrando Marco , Zapata Felipe , Zhong Shiyang , Dahlström Jan Marcus
Published: April 2024

Quantum entanglement between the degrees of freedom encountered in the classical world is challenging to observe due to the surrounding environment. To elucidate this issue, we investigate the entanglement generated over ultrafast timescales in a bipartite quantum system comprising two massive particles: a free-moving photoelectron, which expands to a mesoscopic length scale, and a light-dressed atomic ion, which represents a hybrid state of light and matter. Although the photoelectron spectra are measured classically, the entanglement allows us to reveal information about the dressed-state dynamics of the ion and the femtosecond extreme ultraviolet pulses delivered by a seeded free-electron laser. The observed generation of entanglement is interpreted using the time-dependent von Neumann entropy. Our results unveil the potential for using short-wavelength coherent light pulses from free-electron lasers to generate entangled photoelectron and ion systems for studying spooky action at a distance.
Real-world humanoid locomotion with reinforcement learning
Authors: Radosavovic Ilija , Xiao Tete , Zhang Bike , Darrell Trevor , Malik Jitendra , Sreenath Koushil
Published: April 2024

Humanoid robots that can autonomously operate in diverse environments have the potential to help address labor shortages in factories, assist elderly at home, and colonize new planets. Although classical controllers for humanoid robots have shown impressive results in a number of settings, they are challenging to generalize and adapt to new environments. Here, we present a fully learning-based approach for real-world humanoid locomotion. Our controller is a causal transformer that takes the history of proprioceptive observations and actions as input and predicts the next action. We hypothesized that the observation-action history contains useful information about the world that a powerful transformer model can use to adapt its behavior in context, without updating its weights. We trained our model with large-scale model-free reinforcement learning on an ensemble of randomized environments in simulation and deployed it to the real-world zero-shot. Our controller could walk over various outdoor terrains, was robust to external disturbances, and could adapt in context.
Deep learning assists detection of esophageal cancer and precursor lesions in a prospective, randomized controlled study
Authors: Li Shao-wei , Zhang Li-hui , Cai Yue , Zhou Xian-bin , Fu Xin-yu , Song Ya-qi , Xu Shi-wen , Tang Shen-ping , Luo Ren-quan , Huang Qin , Yan Ling-ling , He Sai-qin , Zhang Yu , Wang Jun , Ge Shu-qiong , Gu Bin-bin , Peng Jin-bang , Wang Yi , Fang Li-na , Wu Wei-dan , Ye Wen-guang , Zhu Min , Luo Ding-hai , Jin Xiu-xiu , Yang Hai-deng , Zhou Jing-jing , Wang Zhen-zhen , Wu Jian-fen , Qin Qiao-qiao , Lu Yan-di , Wang Fei , Chen Ya-hong , Chen Xia , Xu Shan-jing , Tung Tao-Hsin , Luo Chen-wen , Ye Li-ping , Yu Hong-gang , Mao Xin-li
Published: April 2024

Endoscopy is the primary modality for detecting asymptomatic esophageal squamous cell carcinoma (ESCC) and precancerous lesions. Improving detection rate remains challenging. We developed a system based on deep convolutional neural networks (CNNs) for detecting esophageal cancer and precancerous lesions [high-risk esophageal lesions (HrELs)] and validated its efficacy in improving HrEL detection rate in clinical practice (trial registration ChiCTR2100044126 at
www.chictr.org.cn
). Between April 2021 and March 2022, 3117 patients ≥50 years old were consecutively recruited from Taizhou Hospital, Zhejiang Province, and randomly assigned 1:1 to an experimental group (CNN-assisted endoscopy) or a control group (unassisted endoscopy) based on block randomization. The primary endpoint was the HrEL detection rate. In the intention-to-treat population, the HrEL detection rate [28 of 1556 (1.8%)] was significantly higher in the experimental group than in the control group [14 of 1561 (0.9%),
P
= 0.029], and the experimental group detection rate was twice that of the control group. Similar findings were observed between the experimental and control groups [28 of 1524 (1.9%) versus 13 of 1534 (0.9%), respectively;
P
= 0.021]. The system’s sensitivity, specificity, and accuracy for detecting HrELs were 89.7, 98.5, and 98.2%, respectively. No adverse events occurred. The proposed system thus improved HrEL detection rate during endoscopy and was safe. Deep learning assistance may enhance early diagnosis and treatment of esophageal cancer and may become a useful tool for esophageal cancer screening.
Inactivation of the ribosome assembly factor RimP causes streptomycin resistance and impairs motility in
Salmonella
Authors: Lyu Zhihui , Ling Yunyi , van Hoof Ambro , Ling Jiqiang
Published: April 2024

The ribosome is the central hub for protein synthesis and the target of many antibiotics. Although the majority of ribosome-targeting antibiotics inhibit protein synthesis and are bacteriostatic, aminoglycosides promote protein mistranslation and are bactericidal. Understanding the resistance mechanisms of bacteria against aminoglycosides is not only vital for improving the efficacy of this critically important group of antibiotics but also crucial for studying the molecular basis of translational fidelity. In this work, we analyzed
Salmonella
mutants evolved in the presence of the aminoglycoside streptomycin (Str) and identified a novel gene
rimP
to be involved in Str resistance. RimP is a ribosome assembly factor critical for the maturation of the 30S small subunit that binds Str. Deficiency in RimP increases resistance against Str and facilitates the development of even higher resistance. Deleting
rimP
decreases mistranslation and cellular uptake of Str and further impairs flagellar motility. Our work thus highlights a previously unknown mechanism of aminoglycoside resistance via defective ribosome assembly.
Employment of mastoparan-like peptides to prevent
Staphylococcus aureus
associated with bovine mastitis
Authors: Orozco Raquel M. Q. , Oshiro Karen G. N. , Pinto Ingrid B. , Buccini Danieli F. , Almeida Claudiane V. , Marin Valentina Nieto , de Souza Camila Maurmann , Macedo Maria L. R. , Cardoso Marlon H. , Franco Octávio L.
Published: April 2024

Bovine mastitis is a frequent infection in lactating cattle, causing great economic losses.
Staphylococcus aureus
represents the main etiological agent, which causes recurrent and persistent intramammary infections because conventional antibiotics are ineffective against it. Mastoparan-like peptides are multifunctional molecules with broad antimicrobial potential, constituting an attractive alternative. Nevertheless, their toxicity to host cells has hindered their therapeutic application. Previously, our group engineered three mastoparan-L analogs, namely mastoparan-MO, mastoparan-R1, and [I
5
, R
8
] MP, to improve cell selectivity and potential. Here, we were interested in comparing the antibacterial efficacy of mastoparan-L and its analogs against bovine mastitis isolates of
S. aureus
strains, making a correlation with the physicochemical properties and structural arrangement changes promoted by the sequence modifications. As a result, the analog’s hemolytic and/or antimicrobial activity was balanced. All the peptides displayed α-helical folding in hydrophobic and membrane-mimetic environments, as determined by circular dichroism. The peptide [I
5
, R
8
] MP stood out for its enhanced selectivity and antibacterial features related to mastoparan-L and the other derivatives. Biophysical approaches revealed that [I
5
, R
8
] MP rapidly depolarizes the bacterial membrane of
S. aureus
, causing cell death by subsequent membrane disruption. Our results demonstrated that the [I
5
, R
8
] MP peptide could be a starting point for the development of peptide-based drugs for the treatment of bovine mastitis, with the advantage of no residue in milk, which would help reduce the use of classical antibiotics.

IMPORTANCE

Staphylococcus aureus
is a leading cause of mastitis, the world’s most important dairy cattle disease. The multidrug resistance and zoonotic potential of
S. aureus
, besides the likelihood of antibiotic residues in milk, are of critical concern to public and animal health. Antimicrobial peptides offer a novel antimicrobial strategy. Here, we demonstrate that [I
5
, R
8
] MP is a potent and selective peptide, which acts on
S. aureus
by targeting the bacterial membrane. Therefore, understanding the physicochemical determinants and the modes of action of this class of antimicrobials opens novel prospects for peptide development with enhanced activities in the bovine mastitis context.
Novel genetic variant in hereditary spastic paraparesis
Authors: Knight Kathryn A W , Barbour-Hastie Catriona , Gane Angus , O'Riordan Jonathan
Published: April 2024

A man in his 30s was referred to neurology with right-sided paraesthesia, tremors, chest pain and lower urinary tract and erectile dysfunction. He had a medical history of left acetabular dysplasia, and subjective memory impairment, the latter being in the context of depression and chronic pain with opioid use. There was no notable family history. On examination, he had a spastic paraparesis. Imaging revealed atrophy of the thoracic spine. Lumbar puncture demonstrated a raised protein but other constituents were normal, including no presence of oligoclonal bands. Genetic testing revealed a novel heterozygous likely pathogenic SPAST variant c. 1643A>T p.(Asp548Val), confirming the diagnosis of hereditary spastic paraparesis. Symptomatic treatment with physiotherapy and antispasmodic therapy was initiated. This is the first study reporting a patient with this SPAST variant. Ensembl variant effect predictor was used, with the application of computational variant prediction tools providing support that the variant we have identified is likely deleterious and damaging. Our variant CADD score was high, indicating that our identified variant was a highly deleterious substitution.
Aplasia cutis congenita type VII of the lower extremity: a favourable disease course with minimal conservative treatment
Authors: Quach Kwong Tack , Wind Carolien , van Mierlo Kim , Vos Lydia E
Published: April 2024

Aplasia cutis congenita (ACC) is a group of rare heterogeneous disorders characterised by absent areas of skin at birth. The majority of cases involve the scalp region. ACC limited to one lower limb is extremely rare. We report an usual case of ACC limited to the left thigh of which healing occurred in utero. The case was managed conservatively and the disease course has been favourable with no limitations in limb function and an entirely normal development. Most cases of ACC are self-healing, justifying a conservative approach. This holds further true for ACC limited to one lower limb where the majority of cases reported to date show a favourable disease course with minimal conservative treatment.
Management of hepatorenal syndrome and associated outcomes: a systematic review
Authors: Roozbeh Jamshid , Ezzatzadegan Jahromi Shahrokh , Rezazadeh Mohamad Hossein , Hamidianjahromi Anahid , Malekmakan Leila
Published: April 2024

Background

Hepatorenal syndrome (HRS), a multiorgan condition of acute kidney injury, is seen in advanced liver disease. This study aims to evaluate the current treatment for HRS.

Methods

The authors searched PubMed, Scopus and Google Scholar literature. After quality assessment, 31 studies were included in this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology and the population, intervention, comparison and outcome scheme were used. We included human-controlled trials that evaluate the current treatment for HRS. Two authors independently screened articles for inclusion, extracted data and assessed the quality of included studies.

Results

This study investigated the studies conducted on the effects of different treatments on follow-up of HRS patients. We gathered 440 articles, so 31 articles remained in our study. Of which 24 articles were conducted on terlipressin versus placebo or other treatments (midodrine/octreotide, norepinephrine, etc) that showed the higher rate of HRS reversal was detected for terlipressin in 17 studies (10 of them were significant), 2 studies achieved an insignificant lower rate of the model for end-stage liver disease score for terlipressin, 15 studies showed a decreased mortality rate in the terlipressin group (4 of them were significant).

Conclusion

This review showed that terlipressin has a significantly higher reversal rate of HRS than the other treatments. Even the results showed that terlipressin is more efficient than midodrine/octreotide and norepinephrine as a previous medication, in reverse HRS, increasing patient survival.
Trends and determinants of clinical staff retention in the English NHS: a double retrospective cohort study
Authors: Moscelli Giuseppe , Nicodemo Catia , Sayli Melisa , Mello Marco
Published: April 2024

Objectives

To investigate how demographic, contractual and organisational factors are related to the retention of hospital workers in the English NHS. The study will specifically examine the trends in age-retention profiles.

Design

A double retrospective cross-cohort study using administrative data on senior and specialty doctors, nurses and midwives who were included in the 2009 and 2014 payrolls of all English NHS hospital Trusts. These individuals were tracked over time until 2019 to examine the associations between sociodemographic characteristics and the retention of hospital workers in each cohort. Logistic regressions were estimated at the individual worker level to analyse the data. Additionally, a multilevel panel regression was performed using linked payroll-survey data to investigate the association between hospital organisation characteristics and the retention of clinical staff.

Setting

Secondary acute and mental healthcare NHS hospital Trusts in England.

Participants

70 777 senior doctors (specialty and specialist doctors and hospital consultants) aged 30–70, and a total of 448 568 between nurses and midwives of any grade aged 20–70, employed by English NHS Trusts.

Primary outcome measures

Employee retention, measured through binary indicators for stayers and NHS leavers, at 1-year and 5-year horizons.

Results

Minority doctors had lower 1-year retention rates in acute care than white doctors, while minority nurses and midwives saw higher retention. Part-time roles decreased retention for doctors but improved it for nurses. Fixed-term contracts negatively impacted both groups’ retention. Trends diverged for nurses and doctors from 2009 to 2014—nurses’ retention declined while doctors’ 5-year retention slightly rose. Engagement boosted retention among clinical staff under 51 years of age in acute care. For nurses over 50, addressing their feedback was positively associated with retention.

Conclusions

Demographic and contractual factors appear to be stronger predictors of hospital staff retention than organisational characteristics.
De-imFAR phase II project: a study protocol for a cluster randomised implementation trial to evaluate the effectiveness of de-implementation strategies to reduce low-value statin prescribing in the primary prevention of cardiovascular disease
Authors: Sanchez Alvaro , Pijoan Jose Ignacio , Sainz de Rozas Rita , Lekue Itxasne , San Vicente Ricardo , Quindimil Jose Antonio , Rotaeche Rafael , Etxeberria Arritxu , Mozo Carmela , Martinez-Cengotitabengoa Monica , Monge Monica , Gómez-Ramírez Cristina , Samper Ricardo , Ogueta Lana Mikel , Celorrio Sara , Merino-Inda Nerea , Llarena Marta , Gonzalez Saenz de Tejada Marta , García-Alvarez Arturo , Grandes Gonzalo
Published: April 2024

Introduction

This study aims to reduce potentially inappropriate prescribing (PIP) of statins and foster healthy lifestyle promotion in cardiovascular disease (CVD) primary prevention in low-risk patients. To this end, we will compare the effectiveness and feasibility of several de-implementation strategies developed following the structured design process of the Behaviour Change Wheel targeting key determinants of the clinical decision-making process in CVD prevention.

Methods and analysis

A cluster randomised implementation trial, with an additional control group, will be launched, involving family physicians (FPs) from 13 Integrated Healthcare Organisations (IHOs) of Osakidetza-Basque Health Service with non-zero incidence rates of PIP of statins in 2021. All FPs will be exposed to a non-reflective decision assistance strategy based on reminders and decision support tools. Additionally, FPs from two of the IHOs will be randomly assigned to one of two increasingly intensive de-implementation strategies: adding a decision information strategy based on knowledge dissemination and a reflective decision structure strategy through audit/feedback. The target population comprises women aged 45–74 years and men aged 40–74 years with moderately elevated cholesterol levels but no diagnosed CVD and low cardiovascular risk (REGICOR<7.5%), who attend at least one appointment with any of the participating FPs (May 2022–May 2023), and will be followed until May 2024. We use the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate outcomes. The main outcome will be the change in the incidence rate of PIP of statins and healthy lifestyle counselling in the study population 12 and 24 months after FPs’ exposure to the strategies. Moreover, FPs’ perception of their feasibility and acceptability, and patient experience regarding the quality of care received will be evaluated.

Ethics and dissemination

The study was approved by the Basque Country Clinical Research Ethics Committee and was registered in ClinicalTrials.gov (NCT04022850). Results will be disseminated in scientific peer-reviewed journals.

Trial registration number

NCT04022850.
Outcomes after cancer diagnosis in children and adult patients with congenital heart disease in Sweden: a registry-based cohort study
Authors: Karazisi Christina , Dellborg Mikael , Mellgren Karin , Giang Kok Wai , Skoglund Kristofer , Eriksson Peter , Mandalenakis Zacharias
Published: April 2024

Objective

Patients with congenital heart disease (CHD) have an increased cancer risk. The aim of this study was to determine cancer-related mortality in CHD patients compared with non-CHD controls, compare ages at cancer diagnosis and death, and explore the most fatal cancer diagnoses.

Design

Registry-based cohort study.

Setting and participants

CHD patients born between 1970 and 2017 were identified using Swedish Health Registers. Each was matched by birth year and sex with 10 non-CHD controls. Included were those born in Sweden with a cancer diagnosis.

Results

Cancer developed in 758 out of 67814 CHD patients (1.1%), with 139 deaths (18.3%)—of which 41 deaths occurred in patients with genetic syndromes. Cancer was the cause of death in 71.9% of cases. Across all CHD patients, cancer accounted for 1.8% of deaths. Excluding patients with genetic syndromes and transplant recipients, mortality risk between CHD patients with cancer and controls showed no significant difference (adjusted HR 1.17; 95% CI 0.93 to 1.49). CHD patients had a lower median age at cancer diagnosis—13.0 years (IQR 2.9–30.0) in CHD versus 24.6 years (IQR 8.6–35.1) in controls. Median age at death was 15.1 years (IQR 3.6–30.7) in CHD patients versus 18.5 years (IQR 6.1–32.7) in controls. The top three fatal cancer diagnoses were ill-defined, secondary and unspecified, eye and central nervous system tumours and haematological malignancies.

Conclusions

Cancer-related deaths constituted 1.8% of all mortalities across all CHD patients. Among CHD patients with cancer, 18.3% died, with cancer being the cause in 71.9% of cases. Although CHD patients have an increased cancer risk, their mortality risk post-diagnosis does not significantly differ from non-CHD patients after adjustements and exclusion of patients with genetic syndromes and transplant recipients. However, CHD patients with genetic syndromes and concurrent cancer appear to be a vulnerable group.
Building CapaCITY/É for sustainable transportation: protocol for an implementation science research program in healthy cities
Authors: Winters Meghan , Fuller Daniel , Cloutier Marie-Soleil , Harris M Anne , Howard Andrew , Kestens Yan , Kirk Sara , Macpherson Alison , Moore Sarah , Rothman Linda , Shareck Martine , Tomasone Jennifer R , Laberee Karen , Stephens Zoé Poirier , Sones Meridith , Ayton Darshini , Batomen Brice , Bell Scott , Collins Patricia , Diab Ehab , Giles Audrey R , Hagel Brent E , Harris Mike S , Harris Patrick , Lachapelle Ugo , Manaugh Kevin , Mitra Raktim , Muhajarine Nazeem , Myrdahl Tiffany Muller , Pettit Christopher J , Pike Ian , Skouteris Helen , Wachsmuth David , Whitehurst David , Beck Ben
Published: April 2024

Introduction

Improving sustainable transportation options will help cities tackle growing challenges related to population health, congestion, climate change and inequity. Interventions supporting active transportation face many practical and political hurdles. Implementation science aims to understand how interventions or policies arise, how they can be translated to new contexts or scales and who benefits. Sustainable transportation interventions are complex, and existing implementation science frameworks may not be suitable. To apply and adapt implementation science for healthy cities, we have launched our mixed-methods research programme, CapaCITY/É. We aim to understand how, why and for whom sustainable transportation interventions are successful and when they are not.

Methods and analysis

Across nine Canadian municipalities and the State of Victoria (Australia), our research will focus on two types of sustainable transportation interventions: all ages and abilities bicycle networks and motor vehicle speed management interventions. We will (1)documentthe implementation process and outcomes of both types of sustainable transportation interventions; (2)examineequity, health and mobility impacts of these interventions; (3)advanceimplementation science by developing a novel sustainable transportation implementation science framework and (4)developtools for scaling up and scaling out sustainable transportation interventions. Training activities will develop interdisciplinary scholars and practitioners able to work at the nexus of academia and sustainable cities.

Ethics and dissemination

This study received approval from the Simon Fraser University Office of Ethics Research (H22-03469). A Knowledge Mobilization Hub will coordinate dissemination of findings via a website; presentations to academic, community organisations and practitioner audiences; and through peer-reviewed articles.
Achieving high inter-rater reliability in establishing data labels: a retrospective chart review study
Authors: Wu Guosong , Eastwood Cathy , Sapiro Natalie , Cheligeer Cheligeer , Southern Danielle A , Quan Hude , Xu Yuan
Published: April 2024

Background

In medical research, the effectiveness of machine learning algorithms depends heavily on the accuracy of labeled data. This study aimed to assess inter-rater reliability (IRR) in a retrospective electronic medical chart review to create high quality labeled data on comorbidities and adverse events (AEs).

Methods

Six registered nurses with diverse clinical backgrounds reviewed patient charts, extracted data on 20 predefined comorbidities and 18 AEs. All reviewers underwent four iterative rounds of training aimed to enhance accuracy and foster consensus. Periodic monitoring was conducted at the beginning, middle, and end of the testing phase to ensure data quality. Weighted Kappa coefficients were calculated with their associated 95% confidence intervals (CIs).

Results

Seventy patient charts were reviewed. The overall agreement, measured by Conger's Kappa, was 0.80 (95% CI: 0.78-0.82). IRR scores remained consistently high (ranging from 0.70 to 0.87) throughout each phase.

Conclusion

Our study suggests the detailed manual for chart review and structured training regimen resulted in a consistently high level of agreement among our reviewers during the chart review process. This establishes a robust foundation for generating high-quality labeled data, thereby enhancing the potential for developing accurate machine learning algorithms.
Immunotherapy-based regimens for patients with EGFR-mutated non-small cell lung cancer who progressed on EGFR-TKI therapy
Authors: Qin Bao-Dong , Jiao Xiao-Dong , Yuan Ling-Yan , Wu Ying , Ling Yan , Zang Yuan-Sheng
Published: April 2024

The sustained benefit of immunotherapy-based regimens in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) after EGFR-tyrosine kinase inhibitor (TKI) failure is debatable. Neither Checkmate-722 nor Keynote-789 reached the prespecified statistical level of clinical benefit, but the ORIENT-31 and ATTLAS trials showed that the addition of a VEGF inhibitor to immunotherapy plus chemotherapy could significantly prolong survival. However, head-to-head comparisons of the efficacy of immunotherapy plus bevacizumab with chemotherapy versus that of immunotherapy with chemotherapy in this patient population are lacking. In addition, the critical question of who would benefit from an immunotherapy-based regimen remains unclear. We conducted an indirect comparative meta-analysis using chemotherapy as a common comparator to classify the relative efficacy of the two immunotherapy-based regimens. The indirect comparison showed that immunotherapy and bevacizumab plus chemotherapy had a significantly better progression-free survival (PFS) (HRIO+Bev+Chemo/IO+Chemo=0.71, 95% CI 0.55 to 0.91) than immunotherapy plus chemotherapy. The EGFR mutation type and T790M mutation were found to be significantly associated with PFS of immunotherapy-based regimens. Compared with their counterparts, patients with L858R (HR 0.52, 95%CI 0.37 to 0.72), without T790M mutation (HR 0.50, 95% CI 0.35 to 0.71) tended to benefit significantly more from immunotherapy-based regimens. In conclusion, our findings support that the addition of VEGF inhibitor to immunotherapy and chemotherapy could be the preferred option for TKI-resistant, EGFR-mutated NSCLC, and that L858R mutation and T790M negativity could be identified as efficacy-associated factors for immunotherapy-based regimens.
Combinational therapy of CAR T-cell and HDT/ASCT demonstrates impressive clinical efficacy and improved CAR T-cell behavior in relapsed/refractory large B-cell lymphoma
Authors: Liu Wei , Liu Wei , Zou Hesong , Chen Lianting , Huang Wenyang , Lv Rui , Xu Yan , Liu Huimin , Shi Yin , Wang Kefei , Wang Yi , Xiong Wenjie , Deng Shuhui , Yi Shuhua , Sui Weiwei , Peng Guangxin , Ma Yueshen , Wang Huijun , Lv Lulu , Wang Jianxiang , Wei Jun , Qiu Lugui , Zheng Wenting , Zou Dehui
Published: April 2024

Background

Approximately two-thirds of patients with relapsed or refractory large B-cell lymphoma (R/R LBCL) do not respond to or relapse after anti-CD19 chimeric antigen receptor T (CAR T)-cell therapy, leading to poor outcomes. Previous studies have suggested that intensified lymphodepletion and hematological stem cell infusion can promote adoptively transferred T-cell expansion, enhancing antitumor effects. Therefore, we conducted a phase I/II clinical trial in which CNCT19 (an anti-CD19 CAR T-cell) was administered after myeloablative high-dose chemotherapy and autologous stem cell transplantation (HDT/ASCT) in patients with R/R LBCL.

Methods

Transplant-eligible patients with LBCL who were refractory to first-line immunochemotherapy or experiencing R/R status after salvage chemotherapy were enrolled. The study aimed to evaluate the safety and efficacy of this combinational therapy. Additionally, frozen peripheral blood mononuclear cell samples from this trial and CNCT19 monotherapy studies for R/R LBCL were used to evaluate the impact of the combination therapy on the in vivo behavior of CNCT19 cells.

Results

A total of 25 patients with R/R LBCL were enrolled in this study. The overall response and complete response rates were 92.0% and 72.0%, respectively. The 2-year progression-free survival rate was 62.3%, and the overall survival was 68.5% after a median follow-up of 27.0 months. No unexpected toxicities were observed. All cases of cytokine release syndrome were of low grade. Two cases (8%) experienced grade 3 or higher CAR T-cell-related encephalopathy syndrome. The comparison of CNCT19 in vivo behavior showed that patients in the combinational therapy group exhibited enhanced in vivo expansion of CNCT19 cells and reduced long-term exhaustion formation, as opposed to those receiving CNCT19 monotherapy.

Conclusions

The combinational therapy of HDT/ASCT and CNCT19 demonstrates impressive efficacy, improved CNCT19 behavior, and a favorable safety profile.

Trial registration numbers

ChiCTR1900025419 andNCT04690192.
Acute performance fatigability following continuous versus intermittent cycling protocols is not proportional to total work done
Authors: MacDougall Keenan B. , Zhang Jenny , Grunau Micah , Anklovitch Eric , MacIntosh Brian R. , MacInnis Martin J. , Aboodarda Saied Jalal
Published: April 2024

Classical training theory postulates that performance fatigability following a training session should be proportional to the total work done (TWD); however, this notion has been questioned. This study investigated indices of performance and perceived fatigability after primary sessions of high-intensity interval training (HIIT) and constant work rate (CWR) cycling, each followed by a cycling time-to-task failure (TTF) bout. On separate days, 16 participants completed an incremental cycling test, and, in a randomized order, (i) a TTF trial at 80% of peak power output (PPO), (ii) an HIIT session, and (iii) a CWR session, both of which were immediately followed by a TTF trial at 80% PPO. Central and peripheral aspects of performance fatigability were measured using interpolated twitch technique, and perceptual measures were assessed prior to and following the HIIT and CWR trials, and again following the TTF trial. Despite TWD being less following HIIT ( P = 0.029), subsequent TTF trial was an average of 125 s shorter following HIIT versus CWR ( P < 0.001), and this was accompanied by greater impairments in voluntary and electrically evoked forces ( P < 0.001), as well as exacerbated perceptual measures ( P < 0.001); however, there were no differences in any fatigue measure following the TTF trial ( P ≥ 0.149). There were strong correlations between the decline in TTF and indices of peripheral ( r = 0.70) and perceived fatigability ( r ≥ 0.80) measured at the end of HIIT and CWR. These results underscore the dissociation between TWD and performance fatigability and highlight the importance of peripheral components of fatigability in limiting endurance performance during high-intensity cycling exercise.
RECENT PROGRESS IN THE SYNTHESIS AND PHOTOCATALYTIC DEGRADATION OF ORGANIC POLLUTANTS BY GRAPHENE-BASED TiO2 NANOCOMPOSITE: A REVIEW
Authors: KOM LEIVON CHUNGKHOLEN , SINGH HENAM PREMANANDA , NAGARAJAN SANKARANARAYANAN
Published: April 2024

Numerous sustainable water processing techniques have been widely investigated and are capable of boosting the quality of water. Among these techniques, photonanocatalysis has stood tall with great promises in the last few decades. Nonetheless, a major challenge in the environmental remediation of photocatalyst technology is to develop an ideal photocatalyst that must have excellent photocatalytic efficiency, large specific surface area, maximum harvesting of solar energy, high durability and recyclability. Due to their stability, low toxicity, low cost and superhydrophilicity TiO2 has been used by researchers as an efficient photocatalyst for the degradation of organic pollutants. Unfortunately, it suffers greatly due to its high band gap with 3.2[Formula: see text]eV, insufficient visible light response, fast photogenerated electrons and holes recombination rate and serious agglomeration. Keeping these views, the present review highlights the principal results of studies on current practical synthesis and photocatalytic activity of graphene-based TiO2 nanocomposite materials for the treatment of water. The amalgamation of graphene oxide (GO) and reduced graphene oxide (rGO) with nanoscale TiO2 particles results in synergistic properties thereby tuning and increasing the functionality of the composite. In this regard, the review also addressed the progress and insight into graphene-based TiO2 nanocomposite in photocatalytic removal of organic pollutants including basis mechanism, possible key strategies of the composite, and an overview of how to elevate efficacy. Finally, brief challenges and future perspectives in this field are also presented. Indeed, this work illustrated that graphene-based TiO2 composite nanomaterials can be a green signal in the future of photocatalysis targeting water pollution remediation.
ENHANCING AA5083/MgAZ31B PROPERTIES VIA FRICTION STIR WELDING
Authors: VIGNESH N. J. , SHENBAGA VELU P. , RAJESH JESUDOSS HYNES N. , SUBRAMANIAN S. K. , SREEDHARAN M. , TAMILZHARASAN C. , VENKATACHALAM G.
Published: April 2024

Friction stir welding (FSW) is a solid-state joining technology that is recognized for its potential to form high-strength welds between different materials. The purpose of this study is to investigate the enhancement of mechanical properties in AA5083/MgAZ31B joints through the use of FSW. The microstructure, mechanical properties, and appearance of Al–Mg joints are the primary areas of focus of the inquiry about the effects of various feed rates and rotational speeds. In particular, the macrostructure, impact strength, tensile strength, and microhardness of the welds were all thoroughly analyzed to determine the welding conditions that affected the quality of the joints. The findings show that the welding parameters, especially the rotating speed, have a substantial impact on the mechanical properties of the joints. A rotational speed of 700[Formula: see text]rpm and a feed rate of 10[Formula: see text]mm/min were found to be the ideal parameters, resulting in an impact energy of 7.6[Formula: see text]J and a tensile strength of 138.33[Formula: see text]MPa at the interface. Additionally, the production of an intermetallic compound in the heat-affected zone was seen to increase microhardness. A ductile failure mechanism typified by dimple rupture was identified by the microstructural study. This is a sign of well-made welds that enable appropriate heat input and suitable mixing of the different materials. The results of this study demonstrate FSW may improve the performance and structural integrity of AA5083/MgAZ31B joints. Future research will further refine the welding parameters and investigate the effects of post-weld heat treatments on the joints’ mechanical properties and corrosion resistance. This will pave the way for more widespread applications in industries that require lightweight and high-strength material combinations.