bluuebunny/crossref_metadata_2025 huggingface dataset:
Mesothelioma among seamen: a systematic review and meta-analysis
Authors: Rota Matteo , Viscardi Angelo , Maghin Francesca , Placidi Donatella , Conti Adelaide
Published: March 2024

Objectives

Navy personnel and seafarers live and work 24 h per day in the shipboard environment and they are exposed to asbestos fibers released into the confined spaces aboard ships. We conducted a systematic review and meta-analysis to quantify the mesothelioma risk of seamen working aboard ships, either commercial or naval vessels, as compared to that of the general population.

Methods

We carried out a literature search in MEDLINE through PubMed and EMBASE, from inception to 31 December 2021, of all studies on seamen working aboard ships, either commercial or naval vessels, characterized by exposure to asbestos and providing mesothelioma risk estimates. The Newcastle-Ottawa Scale was used to assess the quality of the studies included. The pooled standardized mortality ratio (SMR) was computed across eligible studies. The study protocol was registered on PROSPERO and reporting followed the preferred reporting items for systematic reviews and meta-analyses guidelines.

Results

A total of 10 studies published from 1990 to 2020 were considered eligible and included in the systematic review and meta-analysis. All the included studies were of good quality, with a median score of seven out of nine. Overall, there were 235 mesothelioma cases/deaths in the included studies versus 115.6 expected, with a pooled SMR of 2.11 (95% confidence intervals, 1.70–2.62), in the absence of a significant between-study heterogeneity (I
2 = 39%, P = 0.11).

Conclusion

A more than double excess risk for mesothelioma among seamen working aboard ships emerged from our meta-analysis.
Occupational exposure to diesel exhaust and head and neck cancer: a systematic review and meta-analysis of cohort studies
Authors: Seyyedsalehi Monireh Sadat , Collatuzzo Giulia , Teglia Federica , Boffetta Paolo
Published: March 2024

Exposure to diesel exhaust (DE) and other fossil fuels in the workplace can cause several health effects including cancer. We conducted a systematic review and meta-analysis of cohort studies examining the association between occupational DE exposure and the risk of head and neck cancer (HNC), including cancer of the oral cavity, pharynx and larynx. We included cohort studies mentioned in the Monograph of the International Agency for Research on Cancer, 2014, on DE. Forest plots of relative risk (RR) were constructed for HNC overall and its anatomical subtypes. A random-effects model was used to address heterogeneity between studies. Fifteen articles were included after removing duplicates and irrelevant reports. The summary RR for DE exposure was 1.08 [95% confidence interval (CI) = 1.01–1.17, P heterogeneity = <0.001] for HNC overall, 0.98 (95% CI = 0.87–1.11) for oral cavity, 1.05 (95% CI = 0.77–1.43) for pharyngeal, 1.15 (95% CI = 0.96–1.38) for oral cavity and pharyngeal combined, and 1.13 (95% CI = 1.03–1.24) for laryngeal cancer. There were elevated RRs for incidence studies of HNC (RR = 1.13; 95% CI = 1.05–1.22, P = 0.001), European studies (RR = 1.13; 95% CI = 1.05–1.23, P = 0.001), and female studies (RR = 1.77; 95% CI = 1.31–2.39, P = 0.003). Our study suggested an association between occupational DE exposure and the risk of HNC, particularly laryngeal cancer. Although residual confounding cannot be ruled out, our results support the importance of controlling occupational DE exposure.
Use of Flow-through Free Flaps in Head and Neck Reconstruction
Authors: Maier Mark A. , Palines Patrick A. , Guidry Richard F. , Stalder Mark W.
Published: March 2024

Background:

Reconstructive obstacles in composite head and neck defects are compounded in reoperated, traumatized, irradiated, and vessel-depleted surgical fields. In cases that require multiple free flaps, recipient vessel accessibility and inset logistics become challenging. Strategic flow-through flap configurations mitigate these issues by supplying arterial inflow and venous outflow to a second flap in a contiguous fashion. This approach (1) permits the use of a singular native recipient vessel, (2) increases the reach of the vascular pedicle, avoiding the need for arteriovenous grafting, and (3) allows for a greater three-dimensional flexibility in configuring soft tissue and bony flap inset.

Methods:

To demonstrate this technique, we conducted a retrospective review of all head and neck reconstruction patients presenting to us from March 2019 to April 2021.

Results:

We present seven oncological and two traumatic patients (N = 9) who received flow-through free flaps for head and neck reconstruction. The most common flap used as the flow-through flap was the anterolateral thigh flap (N = 7), followed by the fibula flap (N = 2). Mean follow-up time was 507 days. No flap failures occurred.

Conclusion:

In head and neck reconstruction, the use of the flow-through principle enables uninterrupted vascular flow for two distinct free flaps in single-stage reconstruction for patients with vessel-depleted, irradiated, and/or reoperated fields. We demonstrate that flow-through flaps in the head and neck may be used successfully for a variety of cases and flaps.
Amplitude and Frequency Modulation of EEG Predicts Intraventricular Haemorrhage in Preterm Infants
Authors: Arasteh Emad , Tataranno Maria Luisa , Vos Maarten De , Wang Xiaowan , Benders Manon J.N.L. , Dudink Jeroen , Alderliesten Thomas
Published: March 2024

Background

Intraventricular hemorrhage (IVH) is a common and significant complication in premature infants. While cranial ultrasound is the golden standard for IVH detection, it may not identify lesions until hours or days after occurring, which limits early intervention. Predicting IVH in premature infants would be highly advantageous. Recent studies have shown that EEG data’s amplitude and frequency modulation features could offer predictive insights for neurological diseases in adults.

Methods

To investigate the association between IVH and EEG monitoring, a retrospective case-control study was conducted in preterm infants. All infants underwent amplitude integrated EEG monitoring for at least 3 days after birth. The study included 20 cases who had an IVH diagnosed on cranial ultrasound and had a negative ultrasound 24h earlier, and 20 matched controls without IVH. Amplitude and frequency modulation features were extracted from single-channel EEG data, and various machine learning algorithms were evaluated to create a predictive model.

Results

Cases had an average gestational age and birth weight of 26.4 weeks and 965 grams, respectively. The best-performing algorithm was adaptive boosting. EEG data from 24 hours before IVH detection proved predictive with an area under the receiver operating characteristic curve of 93%, an accuracy of 91%, and a Kappa value of 0.85. The most informative features were the slow varying instantaneous frequency and amplitude in the Delta frequency band.

Conclusion

Amplitude and frequency modulation features obtained from single-channel EEG signals in extremely preterm infants show promise for predicting IVH occurrence within 24 hours before detection on cranial ultrasound.
Three-Month Interim Analyses of Repeated Low-Level Red-Light Therapy in Myopia Control in Schoolchildren: A Multi-Ethnic Randomized Controlled Trial
Authors: Deen Nellie , Zhu Zhuoting , Qi Ziyi , Aung Yuri Yin-Moe , Bulloch Gabriella , Miao Di , He Mingguang
Published: March 2024

Purpose

To assess the efficacy and safety of repeated low-level red-light (RLRL) therapy in controlling myopia progression among multi-ethnic school-aged children. This report focuses on 3-month interim analysis.

Design

Multi-ethnic, parallel controlled randomized trial

Participants

A total of 34 children aged 8-13 years with myopia of cycloplegic spherical equivalent (SE) of −0.50 to – 5.00 (inclusive) diopters (D), astigmatism of 2.50 D or less, anisometropia of 1.50 D or less, and monocular best-corrected visual acuity (BCVA) of 20/20 or better were enrolled.

Methods

Participants were randomly assigned to the RLRL group (n = 16) or the single-vision spectacles (SVS) group (n = 18). RLRL therapy was administered twice daily on weekdays for 3-minute sessions, while the SVS group continued routine activities. Assessments were scheduled at baseline and follow-up visits at 1, 3, 6, and 12 months, with compliance monitoring and safety assessments throughout.

Main Outcome Measures

The primary outcome and a key secondary outcome included axial length (AL) change and cycloplegic spherical equivalent (SE) change.

Results

A total of 31 (91.2%) participated in the 3-month follow-up visit. The RLRL group demonstrated a significant shortening in AL (−0.07 ± 0.07 mm) compared to the SVS group (0.03 ± 0.05 mm, P<0.001). Similarly, SE progression was hyperopic shift in the RLRL group (0.26 ± 0.14 D) while the SVS group exhibited a myopic shift (−0.03 ± 0.38 D, P=0.009). No severe adverse events were reported.

Conclusions

The 3-month interim analysis shows that the efficacy of RLRL therapy in controlling myopia progression among multi-ethnic children is comparable to, or even better than, that idenfied in Chinese patients in previous trials.
Nine high-quality Anas genomes provide new insights into Anas evolution and domestication
Authors: Zhang Zhou , Ni Zijia , Li Te , Ning Mengfei , Gao Chuze , Hu Jiaxiang , Han Mengying , Yang Jiawen , Wu Fusheng , Chen Li , Lu Lizhi , Wu Zhongzi , Ai Huashui , Huang Yinhua
Published: March 2024

The evolutionary origin and genetic architecture of domestic animals are becoming more tractable as the availability of more domestic species genomes. Evolutionary studies of wild and domestic organisms have yielded many fascinating discoveries, while the stories behind the species diversity of Anas or the domestication of duck were largely unknown. Here, we assembled eight chromosome-level Anas genomes. Together with our recently available Pekin duck genome, we investigated Anas phylogeny, genetic differentiation, and gene flow. Extensive phylogenetic inconsistencies were observed in Anas genomes, particularly two phylogeny conflicts between autosome and Z-chromosome. However, the Z chromosome was less impacted by introgression and more suitable to elucidate phylogenetic relationships than autosomes. From the Z-chromosome perspective, we found that the speciation of Anas platyrhynchos and Anas zonorhyncha accompanied with female-biased gene flow, and remodeled duck domestication history. Moreover, we constructed an Anas pan-genome and identified several differentiated SVs between domestic and wild ducks. These SVs might act as repressors/enhancers to regulate their neighboring genes (i.e., GHR and FER), which represented the promising "domestication genes". Additionally, Anas genomes were found being presented LTR retrotransposon bursts, which might largely contribute to functional shifts of genes involved in duck domestication (i.e., MITF and IGF2BP1). This study opens a new window to unravel avian speciation and domestication from Z chromosome.
Electrical Impedance Spectroscopy Quantifies Skin Barrier Function in Organotypic In Vitro Epidermis Models
Authors: van den Brink N.J.M , Pardow F. , Meesters L.D. , van Vlijmen-Willems I. , Rodijk-Olthuis D. , Niehues H. , Jansen P.A.M. , Roelofs S. H. , Brewer M.G. , van den Bogaard E.H. , Smits J.P.H.
Published: March 2024

3 D human epidermal equivalents (HEEs) are a state-of-the-art organotypic culture model in pre– clinical investigative dermatology and regulatory toxicology. Here, we investigated the utility of electrical impedance spectroscopy (EIS) for non–invasive measurement of HEE epidermal barrier function. Our setup comprised a custom–made lid fit with 12 electrode pairs aligned on the standard 24–transwell cell culture system. Serial EIS measurements for seven consecutive days did not impact epidermal morphology and readouts showed comparable trends to HEEs measured only once. We determined two frequency ranges in the resulting impedance spectra: a lower frequency range termed EISdiffcorrelated with keratinocyte terminal differentiation independent of epidermal thickness and a higher frequency range termed EISSCcorrelated withstratum corneumthickness. HEEs generated from CRISPR/Cas9 engineered keratinocytes that lack key differentiation genesFLG,TFAP2A, AHRorCLDN1confirmed that keratinocyte terminal differentiation is the major parameter defining EISdiff. Exposure to pro–inflammatory psoriasis– or atopic dermatitis–associated cytokine cocktails lowered the expression of keratinocyte differentiation markers and reduced EISdiff. This cytokine–associated decrease in EISdiffwas normalized after stimulation with therapeutic molecules. In conclusion, EIS provides a non– invasive system to consecutively and quantitatively assess HEE barrier function and to sensitively and objectively measure barrier development, defects and repair.
Crystal structure of (S)-5-(3-acetyl-5-chloro-2-ethoxy-6-fluorophenyl)-2-oxazolidinone
Authors: Li Victor , Yap Glenn P. A. , Ni Chaoying
Published: March 2024

The structure of (S)-5-(3-acetyl-5-chloro-2-ethoxy-6-fluorophenyl)-2-oxazolidinone, C13H13ClFNO4, at 100 K has monoclinic (P21) symmetry. The compound has a polymeric structure propagated by a screw axis parallel to the b axis with N—H...O hydrogen bonding. It is of interest with respect to efforts in the synthesis of a candidate anticancer drug, parsaclisib.
A meta-analytic integration of the theory of planned behavior and the value-belief-norm model to predict green consumption
Authors: Jebarajakirthy Charles , Sivapalan Achchuthan , Das Manish , Maseeh Haroon Iqbal , Ashaduzzaman Md , Strong Carolyn , Sangroya Deepak
Published: March 2024

Purpose

This study aims to integrate the theory of planned behavior (TPB) and the value-belief-norm (VBN) theory into a meta-analytic framework to synthesize green consumption literature.

Design/methodology/approach

By integrating the findings from 173 studies, a meta-analysis was performed adopting several analytical methods: bivariate analysis, moderation analysis and path analysis.

Findings

VBN- and TPB-based psychological factors (adverse consequences, ascribed responsibility, personal norms, subjective norms, attitude and perceived behavioral control) mediate the effects of altruistic, biospheric and egoistic values on green purchase intention. Further, inconsistencies in the proposed relationships are due to cultural factors (i.e. individualism-collectivism, power distance, uncertainty avoidance, masculinity–femininity, short- vs long-term orientation and indulgence-restraint) and countries’ human development status.

Research limitations/implications

The authors selected papers published in English; hence, other relevant papers in this domain published in other languages might have been missed.

Practical implications

The findings are useful to marketers of green offerings in designing strategies, i.e. specific messages, targeting different customers based on countries’ cultural score and human development index, to harvest positive customer responses.

Originality/value

This study is the pioneering attempt to synthesize the TPB- and VBN-based quantitative literature on green consumer behavior to resolve the reported inconsistent findings.
Health care use experiences of ethnoculturally diverse immigrant older adults: a meta-ethnography
Authors: de Witt Lorna , Pfaff Kathryn A. , Reka Roger , Mirza Noeman Ahmad
Published: March 2024

Purpose

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?

Design/methodology/approach

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.

Findings

“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.

Originality/value

The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.
Impacts of land use changes on discharge and water quality in rivers and streams: Case study of the continental United States
Authors: Gunawardana Charitha , McDonald Walter
Published: March 2024

Water quality trends in streams and rivers are impacted by several factors including land use of the watershed; however, it is unclear what influence changes in the land use of a watershed subsequently have on changes in discharge and water quality in streams and rivers. This study seeks to fill this gap by evaluating the relationship between changes in land use and changes in discharge and water quality at United States Geological Survey (USGS) stream gages over the period of 2008–2016. Using land cover data and discharge and water quality data from 60 USGS gages, regression methods were applied to determine the strength of relationship between land use changes and changes in water quality and quantity. Trends in discharge and water quality were mixed, with a majority of watersheds demonstrating a decrease in dissolved oxygen and turbidity, no overall trend for discharge, and increases in specific conductance. A regression analysis revealed that discharge, turbidity, and specific conductance were correlated with changes in individual land use types with an R2 between 0.12 and 0.25. Combining the influences of multiple land uses in multivariate regression improved the predictions for discharge (R2 0.58) and specific conductance (R2 0.47), highlighting the magnitude for which land cover changes influence trends in water quality. Overall, this study demonstrates the impact that large‐scale land use changes have on surface water quality.
Utility of 30‐day mortality as a quality metric for palliative radiation treatment: A population‐based analysis from Queensland, Australia
Authors: Guan Tracey L , Kutzko Justin H , Lunn Dominic P , Dunn Nathan AM , Burmeister Bryan H , Dadwal Parvati , Tran Nancy , Holt Tanya R
Published: March 2024

Introduction

Palliative radiotherapy (PRT) is frequently used to treat symptoms of advanced cancer, however benefits are questionable when life expectancy is limited. The 30‐day mortality rate after PRT is a potential quality indicator, and results from a recent meta‐analysis suggest a benchmark of 16% as an upper limit. In this population‐based study from Queensland, Australia, we examined 30‐day mortality rates following PRT and factors associated with decreased life expectancy.

Methods

Retrospective population data from Queensland Oncology Repository was used. Study population data included 22,501 patients diagnosed with an invasive cancer who died from any cause between 2008 and 2017 and had received PRT. Thirty‐day mortality rates were determined from the date of last PRT fraction to date of death. Cox proportional hazards models were used to identify factors independently associated with risk of death within 30 days of PRT.

Results

Overall 30‐day mortality after PRT was 22.2% with decreasing trend in more recent years (P = 0.001). Male (HR = 1.20, 95% CI = 1.13–1.27); receiving 5 or less radiotherapy fractions (HR = 2.97, 95% CI = 2.74–3.22 and HR = 2.17, 95% CI = 2.03–2.32, respectively) and receiving PRT in a private compared to public facility (HR = 1.61, 95% CI = 1.51–1.71) was associated with decreased survival.

Conclusion

The 30‐day mortality rate in Queensland following PRT is higher than expected and there is scope to reduce unnecessarily protracted treatment schedules. We encourage other Australian and New Zealand centres to examine and report their own 30‐day mortality rate following PRT and would support collaboration for 30‐day mortality to become a national and international quality metric for radiation oncology centres.
Waxy papules, infiltrated alopecic plaques, and shin ichthyosis
Authors: Bhat Kriti , Madhudiya Rinkal , Elhence Poonam A. , Singh Saurabh
Published: March 2024

A 38‐year‐old male presented with waxy papules, plaques over the neck and extremities, and ichthyotic scales over the lower limbs. Skin biopsy revealed a dense medium‐sized lymphocytic infiltrate in the dermis, with perifollicular accentuation and focal exocytosis into the follicular epithelium with strong positivity for CD 3, 4, and 5. Considering the clinicopathological correlation, a diagnosis of follicular mycosis fungoides (FMF) was made. It is a variant of classic mycosis fungoides (MF) where atypical cells invade the follicular epithelium.
The γδ T Cell Club: bringing a global scientific community together in the age of Zoom
Authors: Damani‐Yokota Payal , Eberl Matthias
Published: March 2024

Immunologists are very social people—they love to meet other immunologists and talk about immunology (and immunologists). Constantly! γδ T‐cell researchers are no exception. On the contrary, as there are not so many of them compared to, say, researchers working on dendritic cells, they especially crave frequent interactions with like‐minded scientists. This is where the technological solutions being developed during the coronavirus disease 2019 (COVID‐19) pandemic come into play that have, almost overnight, allowed researchers to hold meetings and lectures online. We here describe how we set up the virtual ‘γδ T Cell Club’, a monthly webinar series that aims to bring the field closer together, and present our musings about what we have learned from this experience, which we hope is useful for other researchers interested in connecting online.
Determinants of left atrial local impedance: Relationships with contact force, atrial fibrosis, and rhythm
Authors: Bates Alexander P. , Paisey John , Yue Arthur , Banks Phil , Roberts Paul R. , Ullah Waqas
Published: March 2024

Introduction

The relationships between baseline tissue local impedance (LI), contact force (CF), atrial fibrosis, and atrial rhythm are uninvestigated in a clinical setting. We compared the relationship of LI and CF between atrial fibrillation (AF) and sinus rhythm (SR) accounting for the effects of atrial fibrosis as assessed by bipolar voltage and LI.

Methods

Patients undergoing persistent AF ablation were recruited. LI was recorded referenced to patient blood pool (LIr) and concurrent to changes in CF, with data collected at the same locations in AF and SR.

Results

Twenty patients were recruited. 109 locations were sampled obtaining 1903 data points (SR: 966, AF: 937). CF correlated strongly with LI (repeated measures correlation = 0.64). The relationship between CF and LIr was logarithmic. Rhythm and CF had a significant main (both p < .0005) and interaction effect (p = .022) on tissue LI: AF demonstrated higher LIr values than SR for similar CF. Bipolar voltage had no effect on the relationship of CF to LIr in either rhythm. Assessing fibrosis using LIr showed an interaction effect with CF for LIr in SR and AF, (SR: p < .0005, AF: p = .01), with increased fibrosis showing lesser change in LIr per gram of CF.

Conclusions

CF and rhythm significantly affect the measured LIr of LA myocardium. Optimal catheter‐tissue coupling may be better achieved with higher levels of CF and in AF rather than SR. Atrial fibrosis, as assessed by LIr but not bipolar voltage, affected the CF–LI relationship.
Nurse and midwife involvement in task‐sharing and telehealth service delivery models in primary care: A scoping review
Authors: Moulton Jessica E. , Botfield Jessica R. , Subasinghe Asvini K. , Withanage Nishadi Nethmini , Mazza Danielle
Published: March 2024

Aim

To synthesise and map current evidence on nurse and midwife involvement in task‐sharing service delivery, including both face‐to‐face and telehealth models, in primary care.

Design

This scoping review was informed by the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews.

Data Source/Review Methods

Five databases (Ovid MEDLINE, Embase, PubMed, CINAHL and Cochrane Library) were searched from inception to 16 January 2024, and articles were screened for inclusion in Covidence by three authors. Findings were mapped according to the research questions and review outcomes such as characteristics of models, health and economic outcomes, and the feasibility and acceptability of nurse‐led models.

Results

One hundred peer‐reviewed articles (as 99 studies) were deemed eligible for inclusion. Task‐sharing models existed for a range of conditions, particularly diabetes and hypertension. Nurse‐led models allowed nurses to work to the extent of their practice scope, were acceptable to patients and providers, and improved health outcomes. Models can be cost‐effective, and increase system efficiencies with supportive training, clinical set‐up and regulatory systems. Some limitations to telehealth models are described, including technological issues, time burden and concerns around accessibility for patients with lower technological literacy.

Conclusion

Nurse‐led models can improve health, economic and service delivery outcomes in primary care and are acceptable to patients and providers. Appropriate training, funding and regulatory systems are essential for task‐sharing models with nurses to be feasible and effective.

Impact

Nurse‐led models are one strategy to improve health equity and access; however, there is a scarcity of literature on what these models look like and how they work in the primary care setting. Evidence suggests these models can also improve health outcomes, are perceived to be feasible and acceptable, and can be cost‐effective. Increased utilisation of nurse‐led models should be considered to address health system challenges and improve access to essential primary healthcare services globally.

Reporting Method

This review is reported against the PRISMA‐ScR criteria.

Patient or Public Contribution

No patient or public contribution.

Protocol registration

The study protocol is published in BJGP Open (Moulton et al., 2022).
Impact of COPD stage on self management with COPD patients: The mediating role of symptoms management
Authors: Ceyhan Yasemin , Aydin Cihan
Published: March 2024

Aims

It is extremely important to determine the relationship between COPD and self‐management (SM) in the disease process. However, the impact of symptom management (SpM) on this relationship is still unclear. The study aimed to examine the mediating role of SpM in the effect of the COPD stage on SM.

Design

A predictive correlational study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Methods

This study was conducted between 15 February 2023 and 15 June 15 2023, with 306 patients. Data were collected using the Symptom Management Scale for Self‐Efficacy and the Chronic Disease Self‐Management Scale. Descriptive statistics and Process Macro Model 4 in the SPSS program were used for data analysis.

Results

Most of the patients were in the moderate stage of COPD; their SM scores were at low levels; SpM scores were at moderate levels. The model was significant, and the variables explained 65% of the model. The COPD stage was significantly positively correlated with SpM and negatively correlated with SM. There was a significant positive impact between SpM and SM. The positive and significant standardised indirect effect of SpM on SM evidenced a full mediating effect.

Conclusions

Symptom management has a full mediating role in the effect of the COPD stage on SM. It was revealed that the level of SM can be increased by achieving SpM.

Implications for the Profession and/or Patient Care

Symptoms are vital in COPD. Progression of COPD increases symptom severity. Being successful in SpM greatly contributes to the achievement of self‐management. Therefore, nurses should definitely consider symptom control in strengthening self‐management in the care of patients with COPD.

Patient or Public Contribution

Patients' COPD stage was determined by a pulmonologist involved in the study. Voluntary patients with COPD hospitalised in the pulmonology clinic were included in the study.
Spillover effects of government subsidies on outward foreign direct investment: Evidence from China
Authors: Li Siqi , Sun Mengdi
Published: March 2024

We examine the effect of government subsidies on outward foreign direct investment (OFDI) by Chinese listed firms. Based on a panel dataset covering Chinese listed firms from 2009 to 2021, our findings indicate that government subsidies can promote OFDI by enhancing the production efficiency, innovation capability, and social performance of Chinese listed firms. Furthermore, the heterogeneous analyses show that non‐tax‐based subsidies significantly promote OFDI by Chinese listed firms, and government subsidies do not result in a discernible preference for greenfield investments or mergers and acquisitions. In addition, government subsidies can significantly contribute to promoting OFDI for non‐SOEs, older firms, firms in globally emerging sectors and domestically catching‐up sectors, as well as firms located in eastern China.
“Okay, I respect this publicity stunt.” A snapshot of public perceptions of an online game‐based blood donation campaign
Authors: Edwards Abigail , Masser Barbara
Published: March 2024

Background

With a decrease in young and first‐time donors, applying gaming elements to blood donation may provide a novel means of encouraging young donors. In August 2023, the online game DiabloIV launched the Blood Harvest in which players were encouraged to donate blood products in the United States to receive virtual in‐game rewards. Given the novelty of this independent initiative, our aim was to capture Diablov IV players opinions of the Blood Harvest through thematically analyzing their online discourse related to this blood donation campaign.

Study Design and Methods

We captured publicly available Twitter/X posts (n = 78) and engagement (n = 390) relevant to the Blood Harvest posted during and immediately after the campaign (October 13, 2023–November 27, 2023).

Results

Using thematic analysis, we identified 5 themes relating to the Blood Harvest campaign: (1) Positive perceptions and community motivations to donate, (2) Negative perceptions of the initiative and online game, (3) Players' inability to donate and participate in the initiative, (4) Incentives and incentive comparisons, and (5) Benefiting from positive associations focusing on the reputational gain that may be accessed through promoting blood donation.

Discussion

Situating a donation campaign in an established video game provides a novel opportunity to engage young donors. Through capturing public data, we provide a unique snapshot of how an online gaming community perceives and reacts to an independently initiated game‐integrated blood donation campaign. This highlights key strengths of the approach as well as identifying potential risks for blood collection agencies.
Breathing patterns and associated cardiovascular changes in intermittently breathing animals: (Partially) correcting a semantic quagmire
Authors: Burggren Warren , Fahlman Andreas , Milsom William
Published: March 2024

Many animal species do not breathe in a continuous, rhythmic fashion, but rather display a variety of breathing patterns characterized by prolonged periods between breaths (inter‐breath intervals), during which the heart continues to beat. Examples of intermittent breathing abound across the animal kingdom, from crustaceans to cetaceans. With respect to human physiology, intermittent breathing—also termed ‘periodic’ or ‘episodic’ breathing—is associated with a variety of pathologies. Cardiovascular phenomena associated with intermittent breathing in diving species have been termed ‘diving bradycardia’, ‘submersion bradycardia’, ‘immersion bradycardia’, ‘ventilation tachycardia’, ‘respiratory sinus arrhythmia’ and so forth. An examination across the literature of terminology applied to these physiological phenomena indicates, unfortunately, no attempt at standardization. This might be viewed as an esoteric semantic problem except for the fact that many of the terms variously used by different authors carry with them implicit or explicit suggestions of underlying physiological mechanisms and even human‐associated pathologies. In this article, we review several phenomena associated with diving and intermittent breathing, indicate the semantic issues arising from the use of each term, and make recommendations for best practice when applying specific terms to particular cardiorespiratory patterns. Ultimately, we emphasize that the biology—not the semantics—is what is important, but also stress that confusion surrounding underlying mechanisms can be avoided by more careful attention to terms describing physiological changes during intermittent breathing and diving.
The perception of code-switched speech in noise
Authors: Gavino Maria Fernanda , Goldrick Matthew
Published: March 2024

This study investigates heritage bilingual speakers' perception of naturalistic code-switched sentences (i.e., use of both languages in one sentence). Studies of single word perception suggest that code-switching is more difficult to perceive than single language speech. However, such difficulties may not extend to more naturalistic sentences, where predictability and other cues may serve to ameliorate such difficulties. Fifty-four Mexican-American Spanish heritage bilinguals transcribed sentences in noise in English, Spanish, and code-switched blocks. Participants were better at perceiving speech in single language blocks than code-switched blocks. The results indicate that increased language co-activation when perceiving code-switching results in significant processing costs.
Choline degradation in
Paracoccus denitrificans
: identification of sources of formaldehyde
Authors: Parekh Trusha , Tsai Marcus , Spiro Stephen
Published: March 2024

Paracoccus denitrificans
is a facultative methylotroph that can grow on methanol and methylamine as sole sources of carbon and energy. Both are oxidized to formaldehyde and then to formate, so growth on C1 substrates induces the expression of genes encoding enzymes required for the oxidation of formaldehyde and formate. This induction involves a histidine kinase response regulator pair (FlhSR) that is likely triggered by formaldehyde. Catabolism of some complex organic substrates (e.g., choline and L-proline betaine) also generates formaldehyde. Thus,
flhS
and
flhR
mutants that fail to induce expression of the formaldehyde catabolic enzymes cannot grow on methanol, methylamine, and choline. Choline is oxidized to glycine via glycine betaine, dimethylglycine, and sarcosine. By exploring
flhSR
growth phenotypes and the activities of a promoter and enzyme known to be upregulated by formaldehyde, we identify the oxidative demethylations of glycine betaine, dimethylglycine, and sarcosine as sources of formaldehyde. Growth on glycine betaine, dimethylglycine, and sarcosine is accompanied by the production of up to three, two, and one equivalents of formaldehyde, respectively. Genetic evidence implicates two orthologous monooxygenases in the oxidation of glycine betaine. Interestingly, one of these appears to be a bifunctional enzyme that also oxidizes L-proline betaine (stachydrine). We present preliminary evidence to suggest that growth on L-proline betaine induces expression of a formaldehyde dehydrogenase distinct from the enzyme induced during growth on other formaldehyde-generating substrates.

IMPORTANCE

The bacterial degradation of one-carbon compounds (methanol and methylamine) and some complex multi-carbon compounds (e.g., choline) generates formaldehyde. Formaldehyde is toxic and must be removed, which can be done by oxidation to formate and then to carbon dioxide. These oxidations provide a source of energy; in some species, the CO
2
thus generated can be assimilated into biomass. Using the Gram-negative bacterium
Paracoccus denitrificans
as the experimental model, we infer that oxidation of choline to glycine generates up to three equivalents of formaldehyde, and we identify the three steps in the catabolic pathway that are responsible. Our work sheds further light on metabolic pathways that are likely important in a variety of environmental contexts.
Cell envelope structural and functional contributions to antibiotic resistance in
Burkholderia cenocepacia
Authors: Hogan Andrew M. , Motnenko Anna , Rahman A. S. M. Zisanur , Cardona Silvia T.
Published: March 2024

Antibiotic activity is limited by the physical construction of the Gram-negative cell envelope. Species of the
Burkholderia cepacia
complex (Bcc) are known as intrinsically multidrug-resistant opportunistic pathogens with low permeability cell envelopes. Here, we re-examined a previously performed chemical-genetic screen of barcoded transposon mutants in
B. cenocepacia
K56-2, focusing on cell envelope structural and functional processes. We identified structures mechanistically important for resistance to singular and multiple antibiotic classes. For example, susceptibility to novobiocin, avibactam, and the LpxC inhibitor, PF-04753299, was linked to the BpeAB-OprB efflux pump, suggesting these drugs are substrates for this pump in
B. cenocepacia
. Defects in peptidoglycan precursor synthesis specifically increased susceptibility to cycloserine and revealed a new putative amino acid racemase, while defects in divisome accessory proteins increased susceptibility to multiple β-lactams. Additionally, disruption of the periplasmic disulfide bond formation system caused pleiotropic defects on outer membrane integrity and β-lactamase activity. Our findings highlight the layering of resistance mechanisms in the structure and function of the cell envelope. Consequently, we point out processes that can be targeted for developing antibiotic potentiators.

IMPORTANCE

The Gram-negative cell envelope is a double-layered physical barrier that protects cells from extracellular stressors, such as antibiotics. The
Burkholderia
cell envelope is known to contain additional modifications that reduce permeability. We investigated
Burkholderia
cell envelope factors contributing to antibiotic resistance from a genome-wide view by re-examining data from a transposon mutant library exposed to an antibiotic panel. We identified susceptible phenotypes for defects in structures and functions in the outer membrane, periplasm, and cytoplasm. Overall, we show that resistance linked to the cell envelope is multifaceted and provides new targets for the development of antibiotic potentiators.
Supplemental Material: Neoarchean and Paleoproterozoic magmatism in the Longjiang area, NE China: Implications for the recycling history of supracrustal components in the eastern Central Asian Orogenic Belt
Authors: Sun Chenyang , Xu Wenliang , et al.
Published: March 2024

Supplemental Text S1, Figures S1–S4, and Tables S1 and S2.
Supplemental Material: Revisiting the stratigraphic development of the postglacial, transgressive paleo-Changjiang (Yangtze River) mouth: A journey from tide-dominated estuary to delta
Authors: Liu  , et al.
Published: March 2024

Figure S1: Paleogeography of the Changjiang delta plain, detailing the evolution of the historical shoreline and the en echelon pattern of elongated paleo-islands (river mouth bars and mid-channel bars) of the delta (modified after Fan et al., 2017). Figure S2: Lithological profiles of core YD0902 (modified after Su et al., 2020); enlarged from Figure 10A. Figure S3: Lithological profiles of core CJK08 (modified after Wang, 2011); enlarged from Figure 10A. Figure S4: Lithological profiles of core CJK10 (modified after Wang, 2011); enlarged from Figure 10A.
How to Design an ISA
Authors: Chisnall David
Published: March 2024

The popularity of RISC-V has led many to try designing instruction sets.
A3C: An Image-Association-Based Computing Device Authentication Framework for People with Upper Extremity Impairments
Authors: Lewis Brittany , Kirupaharan Priyankan , Ranalli Tina-Marie , Venkatasubramanian Krishna
Published: March 2024

Current computing device authentication often presents accessibility barriers for people with
upper extremity impairments (UEI)
. In this article, we present a framework called
Accessible image-Association-based Authentication for Computing devices (A3C)
, a novel recognition-based graphical authentication framework specifically designed for people with UEI to authenticate to their computing devices. A3C requires users to provide a set of primary images the user knows that are recognizable to them and subsequently associate each primary image with a secondary image. To evaluate the efficacy of the A3C framework, we instantiated the framework by implementing a version of A3C called
A3C-FA
, which uses images of faces of people the user knows as the primary image and animal images as the secondary image. We then performed three studies to evaluate A3C-FA: a shoulder-surfing attack study (

N

\(=\)

319

), a close-adversary attack study (

N

\(=\)

268

), and a usability study with people with UEI (

N

\(=\)

14

). We found that A3C was robust against both shoulder-surfing and close-adversary attacks. We also performed a detailed study to evaluate the accessibility of A3C-FA. Our participants reported that A3C-FA was more usable and more secure than the authentication approaches with which they were familiar. Based on these findings, we suggest four areas of future research to further improve the design of the A3C framework.
Representative and Back-In-Time Sampling from Real-world Hypergraphs
Authors: Choe Minyoung , Yoo Jaemin , Lee Geon , Baek Woonsung , Kang U , Shin Kijung
Published: March 2024

Graphs are widely used for representing pairwise interactions in complex systems. Since such real-world graphs are large and often evergrowing, sampling subgraphs is useful for various purposes, including simulation, visualization, stream processing, representation learning, and crawling. However, many complex systems consist of group interactions (e.g., collaborations of researchers and discussions on online Q&A platforms) and thus are represented more naturally and accurately by hypergraphs than by ordinary graphs. Motivated by the prevalence of large-scale hypergraphs, we study the problem of sampling from real-world hypergraphs, aiming at answering (Q1) how can we measure the goodness of sub-hypergraphs, and (Q2) how can we efficiently find a “good” sub-hypergraph. Regarding Q1, we distinguish between two goals: (a)
representative sampling
, which aims at capturing the characteristics of the input hypergraph, and (b)
back-in-time sampling
, which aims at closely approximating a past snapshot of the input time-evolving hypergraph. To evaluate the similarity of the sampled sub-hypergraph to the target (i.e., the input hypergraph or its past snapshot), we consider 10 graph-level, hyperedge-level, and node-level statistics. Regarding Q2, we first conduct a thorough analysis of various intuitive approaches using 11 real-world hypergraphs. Then, based on this analysis, we propose
MiDaS
and
MiDaS-B
, designed for representative sampling and back-in-time sampling, respectively. Regarding representative sampling, we demonstrate through extensive experiments that
MiDaS
, which employs a sampling bias toward high-degree nodes in hyperedge selection, is (a)
Representative
: finding overall the most representative samples among 15 considered approaches, (b)
Fast
: several orders of magnitude faster than the strongest competitors, and (c)
Automatic
: automatically tuning the degree of sampling bias. Regarding back-in-time sampling, we demonstrate that
MiDaS-B
inherits the strengths of
MiDaS
despite an additional challenge—the unavailability of the target (i.e., past snapshot). It effectively handles this challenge by focusing on replicating universal evolutionary patterns, rather than directly replicating the target.
Forecasting Ionospheric TEC Changes Associated with the December 2019 and June 2020 Solar Eclipses: A Comparative Analysis of OKSM, FFNN, and DeepAR Models
Authors: Mukesh R. , Dass Sarat C. , Gurmu Negash Lemma , Vijay M. , Kiruthiga S. , Mythili S. , Ratnam D. Venkata , Indira Dutt V. B. S. Srilatha
Published: March 2024

This paper presents forecast and investigation of the variation in ionospheric Total Electron Content (TEC) during the solar eclipses (SEs) of December 2019 and June 2020 using three different methods: Deep Autoregressive model (DeepAR), Feed-Forward Neural Network (FFNN), and Ordinary Kriging-based Surrogate Model (OKSM), and the TEC data predicted by DeepAR, FFNN, and OKSM were compared with the actual TEC during the observation days. The study was conducted based on GPS data taken from the IISC receiver located in Bangalore, India, during the SEs which happened on 26.12.2019 and 21.06.2020. The TEC data were examined to assess the effect of solar eclipses on TEC values. Eighty-day prior TEC data for the IISC station are gathered from IONOLAB servers along with the other parameter data like Dst, Ap, F10.7, and Kp taken from OMNIWEB servers which were used to predict TEC. The reliability of the forecasted results is evaluated using numerical factors like Normalized Root Mean Square Error (NRMSE), Correlation Coefficient (CC), Root Mean Square Error (RMSE), Mean Absolute Error (MAE), and R-squared. The study demonstrates the usefulness of combining multiple methods for analyzing TEC variations during SEs and highlights the potential of OKSM, FFNN, and DeepAR models for studying TEC variation in the same context. The findings may be useful for satellite broadcasting and navigational services and for further research into the influence of solar eclipses on the TEC changes.