bluuebunny/crossref_metadata_2025 huggingface dataset:
Specific microRNAs in stallion spermatozoa are potential biomarkers of high functionality
Authors: Ing Nancy H. , Konganti Kranti , Ghaffari Noushin , Johnson Charles D. , Forrest David W. , Love Charles C. , Varner Dickson D.
Published: July 2024

Males of some species, from horses to humans, require medical help for subfertility problems. There is an urgent need for novel molecular assays that reflect spermatozoal function. In the last 25 years, studies examined RNAs in spermatozoa as a window into gene expression during their development and, more recently, for their functions in early embryo development. In clinics, more dense spermatozoa are isolated by density gradient centrifugation before use in artificial insemination to increase pregnancy rates. The objectives of the current study were to discover and quantify the microRNAs in stallion spermatozoa and identify those with differential expression levels in more dense versus less dense spermatozoa. First, spermatozoa from seven stallions were separated into more dense and less dense populations by density gradient centrifugation. Next, small RNAs were sequenced from each of the 14 RNA samples. We identified 287 different mature microRNAs within the 11,824,720 total mature miRNA reads from stallion spermatozoa. The most prevalent was miR‐10a/b‐5p. The less dense spermatozoa had fewer mature microRNAs and more microRNA precursor sequences than more dense spermatozoa, perhaps indicating that less dense spermatozoa are less mature. Two of the most prevalent microRNAs in more dense stallion spermatozoa were predicted to target mRNAs that encode proteins that accelerate mRNA decay. Nine microRNAs were more highly expressed in more dense spermatozoa. Three of those microRNAs were predicted to target mRNAs that encode proteins involved in protein decay. Both mRNA and protein decay are very active in late spermiogenesis but not in mature spermatozoa. The identified microRNAs may be part of the mechanism to shut down those processes. The microRNAs with greater expression in more dense spermatozoa may be useful biomarkers for spermatozoa with greater functional capabilities.
Optimal management of international reserves
Authors: Keungne Kouotang Léo‐Spencer , Ngoupeyou Armand Brice , Nji Fifen Ngangue Hussein
Published: July 2024

This article develops a continuous time stochastic model for determining the optimal international reserves management policy when the data generating process of international reserves is a geometric Brownian motion. The policy is a two‐parameter control‐limit that consists of an appropriate and a ceiling level on reserves holdings, given an exogenous floor on international reserves. The optimal solution is determined so as to minimize the total costs of international reserves holdings. It is proved that our results extend the framework of Frenkel and Jovanovic when the logarithm of international reserves is an arithmetic Brownian motion. We also explain that Jung paper does not extend Frenkel and Jovanovic model as claimed by the former. The model is calibrated to derive the optimal level and liquidity tranche size upper bound of international reserves of the CEMAC monetary union.
Strong heterologous electron sink outcompetes alternative electron transport pathways in photosynthesis
Authors: Hubáček Michal , Wey Laura T. , Kourist Robert , Malihan‐Yap Lenny , Nikkanen Lauri , Allahverdiyeva Yagut
Published: July 2024

Improvement of photosynthesis requires a thorough understanding of electron partitioning under both natural and strong electron sink conditions. We applied a wide array of state‐of‐the‐art biophysical and biochemical techniques to thoroughly investigate the fate of photosynthetic electrons in the engineered cyanobacterium Synechocystis sp. PCC 6803, a blueprint for photosynthetic biotechnology, expressing the heterologous gene for ene‐reductase, YqjM. This recombinant enzyme catalyses the reduction of an exogenously added substrate into the desired product by utilising photosynthetically produced NAD(P)H, enabling whole‐cell biotransformation. Through coupling the biotransformation reaction with biophysical measurements, we demonstrated that the strong artificial electron sink, outcompetes the natural electron valves, the flavodiiron protein‐driven Mehler‐like reaction and cyclic electron transport. These results show that ferredoxin‐NAD(P)H‐oxidoreductase is the preferred route for delivering photosynthetic electrons from reduced ferredoxin and the cellular NADPH/NADP+ ratio as a key factor in orchestrating photosynthetic electron flux. These insights are crucial for understanding molecular mechanisms of photosynthetic electron transport and harnessing photosynthesis for sustainable bioproduction by engineering the cellular source/sink balance. Furthermore, we conclude that identifying the bioenergetic bottleneck of a heterologous electron sink is a crucial prerequisite for targeted engineering of photosynthetic biotransformation platforms.
Plotinus on Individuation
Authors: Schall Ina
Published: July 2024

No other Neoplatonic treatise has sparked as much debate as Ennead V. 7 [18] of Plotinus, ‘On the question of whether there are also Forms of individuals’. In this treatise, Plotinus is believed to postulate the existence of Forms of individuals alongside the traditional Platonic Forms of genera and species. If so, Plotinus stands as the sole figure in Platonism to advocate this problematic theory. Regrettably, most research on V. 7 [18] has focused solely on the Forms of individuals, overlooking other interesting aspects. This book demonstrates how Plotinus reconciles transmigration and biological heredity within his metaphysics of individuality, addressing a longstanding challenge for ancient philosophers from Pythagoras on. Plotinus’s theory of individuation represents a significant innovation in ancient thought. Plotinus On Individuation offers a comprehensive assessment of V. 7 [18], providing a new translation and the first running commentary in English. Filling an important void, this book enriches the scholarship on Plotinus and contributes considerably to the growing interest in Plotinus’s natural philosophy and the natural philosophies of the Neoplatonists in general.
Random Dynamic Responses of Two Parallel Interfacial Cracks Between a Functionally Graded Material Strip and Two Dissimilar Elastic Strips
Authors: Singh Ritika
Published: July 2024

An analytical approach is presented in this article for the random dynamic study of two parallel interfacial cracks in a functionally graded material (FGM) strip that is bonded between two distinct elastic strips. One of the parallel cracks is placed at the interface of the elastic strip I and the FGM strip, and another is at the interface of the FGM strip and elastic strip II. A stationary stochastic process of time is used to model the dynamic loadings that are applied to the crack faces. To find the solution, the FGM strip is split into a number of substrips, and using an average method, the material properties of each substrip are reduced to random variables. A fundamental problem is formulated to find the solution. The boundary conditions are reduced to a set of singular integral equations employing the Fourier sine, Fourier cosine, and Laplace transforms, which are solved by using the collocation method. Further, the analytical expressions of dynamic stress intensity factors (DSIFs) about the crack tips in the time domain are obtained with the help of the improved Dubner and Abate's method. Finally, the Monte Carlo method is used to obtain the mathematical expectation and standard deviation of DSIFs. The outcomes of this study are also verified. The unique aspect of this study is the pictorial illustration of mathematical expectation and standard deviation as functions of the number of substrips, functionally graded parameter, thickness of the strips, and length of parallel interfacial cracks.
Prediction of Oil Pipeline Process Operating Parameters Based on Mechanism and Data Mining
Authors: Wei Lixin , Wang Lan , Zhou Qiang , Gao Yuhang
Published: July 2024

Precisely forecasting the operational characteristics of oil pipelines is essential for developing rational design, production, and operation strategies, as well as reducing energy consumption and saving energy. Due to significant disparities in the computation outcomes of conventional mechanism models and the inadequate performance of machine learning models when handling limited sample data, their conclusions likewise lack tangible significance. In this study, a novel physics-guided neural network (PGNN) model, which integrates mechanisms with machine learning models, is introduced. The proposed model incorporates essential physical intermediate factors that impact the temperature and pressure of oil pipelines as artificial neurons within the loss function. Additionally, an adaptive moment estimate approach is employed to optimize the parameters of the model. Through a comparative analysis of various models' predictive capabilities on an oil pipeline, it was shown that PGNN has the highest level of accuracy in forecasting pipeline temperature and pressure. Furthermore, PGNN demonstrates the ability to generate satisfactory prediction outcomes even with a limited sample size. Simultaneously, the predictive outcomes of PGNN exhibit a stronger correlation with variables that have a direct impact on temperature and pressure.
Experimental and Mathematical Investigation of Thermochemical Conversion for Horse Manure
Authors: Maache Mohamed , Kada Cheikh , Amano Ryoichi S. , Kumano Hiroyuki , Selim Osama M. , Kada Kada
Published: July 2024

Horse manure is one of the highest potential biowastes for heat and power generation. This article investigates the experimental and mathematical modeling of thermochemical conversion for horse manure. As one type of thermochemical conversions, the pyrolysis process was carried out at eight different heating rates on horse manure using three parameters: the extent of reaction, the rate change of the extent of reaction, and differential thermal analysis (DTA), all used to determine kinetic data that will be validated with a mathematical model. Slow pyrolysis: below 15 °C/min showed optimistic results of obtaining exothermic reaction over a wide range of temperature which makes it self-sustainable with steady heat generation. Also, low heating rates allowed a quasi-equilibrium state through slow heating with a minimum delay in response for any transient error that could be generated from differential thermal gravimetry (DTG) device.
Active Constrained Layer Damping of Beams With Natural Fiber Reinforced Viscoelastic Composites
Authors: Mishra Vibhooti N. , Sarangi Saroj Kumar
Published: July 2024

Viscoelastic composite reinforced with natural fibers is proposed here for the damping treatment of structures for vibration attenuation. The constrained layer damping (CLD) method is found a prominent structural vibration damping method and as a result of the inclusion of natural fiber, substantial damping could be achieved due to the development of shear as well as extensional strains in the viscoelastic material. Finite element analysis of a substrate beam combined with CLD treatment is used to investigate the corresponding improvement in damping. The influence of various geometry of presently considered natural viscoelastic composite layers on the CLD treatment's damping performance has been evaluated and discussed. Damping performances of natural as well as synthetic fibers have been assessed and compared for using natural fibers in viscoelastic composite for various structural applications. The addition of natural fiber has resulted from enhanced damping capacity due to substantial friction at the natural fiber–matrix interface compared to the case of interface with synthetic fiber. Natural fiber attributes less stiffness and a higher loss factor as compared to synthetic fiber and the insertion of stiff fibers affects the polymer chain's movements, decreasing the matrix phase's damping behavior. The dynamic mechanical analysis test is performed to evaluate the damping characteristics in the form of loss factor, storage, and loss modulus over the temperature range from frozen state to melting state.
An Investigation of Tensile, Fatigue, and Fracture Behavior of 3D-Printed Polymers
Authors: Rahman M. Shafiqur , Alam Chowdhury Sadid , Pulok Mohammad Khairul Habib , Zeng Congyuan , Chakravarty Uttam K.
Published: July 2024

The progression of manufacturing technology has significantly benefited from the adoption of 3D printing techniques, which enable the production of parts with intricate geometries. However, it is important to acknowledge that components fabricated through this additive manufacturing method frequently manifest defects and are prone to failure under severe conditions. Therefore, a thorough examination of the mechanical properties of these parts is essential to effectively reduce the failure. This study aimed to explore the mechanical properties of two prevalently used 3D-printed polymers, specifically Onyx and acrylonitrile butadiene styrene (ABS), by integrating computational and experimental analyses. The experimental study utilized a material testing system and digital image correlation (DIC) technology, while the computational analysis covered the finite element (FE) modeling of the 3D-printed samples. The research focused on evaluating the tensile strength and fatigue resistance of the specimens printed in various orientations, alongside a detailed investigation of their fracture behavior. The crack propagation analysis was carried out using the DIC system and the separating morphing and adaptive re-meshing technology (SMART) scheme in ansys. It was observed that upright build orientation produced the weakest samples for axial loading and specimens with notches failed earlier than those without. Moreover, Onyx was found to have a higher resistance to fracture or failure compared to ABS. The FE modeling results demonstrated strong agreement with the experimental results, validating their accuracy and reliability in characterizing the critical mechanical response of 3D-printed parts rapidly and cost effectively.
A new species of Antennoseius- from the Caspian region and the species composition of the oudemansi--group (Acari, Mesostigmata, Ascidae)
Authors: Makarova Olga , Kazemi Shahrooz
Published: July 2024

A new mesostigmatic mite species, Antennseius (Vitzthumia) circumcaspius sp. nov., is described from Russia and Iran on the adult specimens. This soil-dwelling species populates different habitats (including coastal maritime and inner salty grasslands, forest and orchard soil-litter, and moss) in Kalmykia, Dagestan, Kazakhstan, and Iran. The new species is very close to Antennoseius oudemansi (Thor, 1930); A. janus Lindquist & Walter, 1989 (granulate form); and A. koroljevae Chelebiev, 1984. All these species compose together a natural group as designated by Chelebiev (1984). Idiosomal integument of most shields and soft cuticle of their adult is tuberculate-granulate. Females of these species are possessed the inversely trapezoidal opisthonotal shield with posterolateral margins usually emarginated; anal shield bearing only three circumanal setae. Map of records of oudemansi-group members in the Palaearctic and key for their female identification are given.
Revealing the controlling mechanisms of atomic layer etching for high-k dielectrics in conventional inductively coupled plasma etching tool
Authors: Kuzmenko Vitaly , Melnikov Alexander , Isaev Alexandr , Miakonkikh Andrey
Published: July 2024

The possibilities of optimization of the two-step atomic layer etching process for HfO2 in conventional plasma etching tools were studied. The surface modification step was realized in Ar/CF4/H2 plasma, and the reaction between the modified layer and the surface was activated by Ar ion bombardment from the plasma in the second step. Investigation of the effects of activation step duration, DC bias during activation, and Ar plasma density was carried out. The mechanism of the etching process has been shown to involve fluorination of oxide during the modification step and subsequent removal of fluorine-containing particles at the activation step. An increase in parasitic sputtering rate and lower process saturation with the growth of DC bias during activation was demonstrated. The advantage of the ALE process in lower surface roughness over the conventional etching process was shown. Similar etching characteristics of HfO2 and ZrO2 suggest a similarity in the etching process for the mixed hafnium-zirconium oxide material.
Dietary fiber monosaccharide content alters gut microbiome composition and fermentation
Authors: Jensen Nick , Maldonado-Gomez Maria , Krishnakumar Nithya , Weng Cheng-Yu , Castillo Juan , Razi Dale , Kalanetra Karen , German J. Bruce , Lebrilla Carlito B. , Mills David A. , Taft Diana H.
Published: July 2024

Members of the mammalian gut microbiota metabolize diverse complex carbohydrates that are not digested by the host, which are collectively labeled “dietary fiber.” While the enzymes and transporters that each strain uses to establish a nutrient niche in the gut are often exquisitely specific, the relationship between carbohydrate structure and microbial ecology is imperfectly understood. The present study takes advantage of recent advances in complex carbohydrate structure determination to test the effects of fiber monosaccharide composition on microbial fermentation. Fifty-five fibers with varied monosaccharide composition were fermented by a pooled feline fecal inoculum in a modified MiniBioReactor array system over a period of 72 hours. The content of the monosaccharides glucose and xylose was significantly associated with the reduction of pH during fermentation, which was also predictable from the concentrations of the short-chain fatty acids lactic acid, propionic acid, and the signaling molecule indole-3-acetic acid. Microbiome diversity and composition were also predictable from monosaccharide content and SCFA concentration. In particular, the concentrations of lactic acid and propionic acid correlated with final alpha diversity and were significantly associated with the relative abundance of several of the genera, including
Lactobacillus
and
Dubosiella
. Our results suggest that monosaccharide composition offers a generalizable method to compare any dietary fiber of interest and uncover links between diet, gut microbiota, and metabolite production.

IMPORTANCE

The survival of a microbial species in the gut depends on the availability of the nutrients necessary for that species to survive. Carbohydrates in the form of non-host digestible fiber are of particular importance, and the set of genes possessed by each species for carbohydrate consumption can vary considerably. Here, differences in the monosaccharides that are the building blocks of fiber are considered for their impact on both the survival of different species of microbes and on the levels of microbial fermentation products produced. This work demonstrates that foods with similar monosaccharide content will have consistent effects on the survival of microbial species and on the production of microbial fermentation products.
Genetic diversity accelerates canine distemper virus adaptation to ferrets
Authors: Siering Oliver , Langbein Mareike , Herrmann Maike , Wittwer Kevin , von Messling Veronika , Sawatsky Bevan , Pfaller Christian K.
Published: July 2024

RNA viruses adapt rapidly to new host environments by generating highly diverse genome sets, so-called “quasispecies.” Minor genetic variants promote their rapid adaptation, allowing for the emergence of drug-resistance or immune-escape mutants. Understanding these adaptation processes is highly relevant to assessing the risk of cross-species transmission and the safety and efficacy of vaccines and antivirals. We hypothesized that genetic memory within a viral genome population facilitates rapid adaptation. To test this, we investigated the adaptation of the Morbillivirus canine distemper virus to ferrets and compared an attenuated, Vero cell-adapted virus isolate with its recombinant derivative over consecutive ferret passages. Although both viruses adapted to the new host, the reduced initial genetic diversity of the recombinant virus resulted in delayed disease onset. The non-recombinant virus gradually increased the frequencies of beneficial mutations already present at very low frequencies in the input virus. In contrast, the recombinant virus first evolved
de novo
mutations to compensate for the initial fitness impairments. Importantly, while both viruses evolved different sets of mutations, most mutations found in the adapted non-recombinant virus were identical to those found in a previous ferret adaptation experiment with the same isolate, indicating that mutations present at low frequency in the original virus stock serve as genetic memory. An arginine residue at position 519 in the carboxy terminus of the nucleoprotein shared by all adapted viruses was found to contribute to pathogenesis in ferrets. Our work illustrates the importance of genetic diversity for adaptation to new environments and identifies regions with functional relevance.

IMPORTANCE

When viruses encounter a new host, they can rapidly adapt to this host and cause disease. How these adaptation processes occur remains understudied. Morbilliviruses have high clinical and veterinary relevance and are attractive model systems to study these adaptation processes. The canine distemper virus is of particular interest, as it exhibits a broader host range than other morbilliviruses and frequently crosses species barriers. Here, we compared the adaptation of an attenuated virus and its recombinant derivative to that of ferrets. Pre-existing mutations present at low frequency allowed faster adaptation of the non-recombinant virus compared to the recombinant virus. We identified a common point mutation in the nucleoprotein that affected the pathogenesis of both viruses. Our study shows that genetic memory facilitates environmental adaptation and that erasing this genetic memory by genetic engineering results in delayed and different adaptation to new environments, providing an important safety aspect for the generation of live-attenuated vaccines.
Supplemental Material: Mineral, bulk rock, and isotope geochemistry of the Late Cretaceous Sabzevar ophiolite in NE Iran and the magmatic and tectonic evolution of a continental back-arc basin oceanic crust in the Mesozoic Tethyan orogenic belt
Authors: Moghadam H.S. , al. et
Published: July 2024

Supplemental materials include field photos, back-scattered images from representative rocks, mineral classification diagrams, Harker plots and zircon U-Pb plots as well as geochemical tables.
Doping Evolution of the Superconducting Order Parameter of Na(Fe, Co)As Alkali-Metal Pnictides
Authors: Kuzmichev S. A. , Morozov I. V. , Shilov A. I. , Rakhmanov Ye. O. , Kuzmicheva T. E.
Published: July 2024

Using incoherent multiple Andreev reflection effect spectroscopy, we have studied the multiple-gap superconducting state of underdoped and overdoped Na(Fe, Co)As single crystals. We directly determined the magnitudes of the microscopic superconducting order parameters, their temperature dependences, and characteristic ratios $$2\Delta (0){\text{/}}{{k}_{B}}{{T}_{c}}$$. The obtained large data statistics unambiguously proves a significant decrease in the degree of the large superconducting gap possible anisotropy in the overdoped compositions away from the antiferromagnetic and nematic regions of the doping phase diagram.
Service development project to pilot a digital technology innovation for video direct observation of therapy in adult patients with asthma
Authors: O’Neill Katherine , Gormley Cairine , Kelly Martin G , Huey Rachel , Fleming Glenda , Scott Michael , Shields Michael , McElnay James C
Published: July 2024

Background

Adherence to pharmacotherapy and use of the correct inhaler technique are important basic principles of asthma management. Video- or remote-direct observation of therapy (v-DOT) could be a feasible approach to facilitate monitoring and supervising therapy, supporting the delivery of standard care.

Objective

To explore the utility and the feasibility of v-DOT to monitor inhaler technique and adherence to treatment in adults attending the asthma outpatient service in a tertiary hospital in Northern Ireland.

Method

The project evaluated use of the technology with 10 asthma patients. Patient and clinician feedback was obtained, in addition to measures of patient engagement and disease-specific clinical markers to assess the feasibility and utility of v-DOT technology in this group of patients.

Results

The engagement rate with v-DOT for participating patients averaged 78% (actual video uploads vs expected video uploads) over a median 7 week usage period. Although 50% of patients reported a technical issue at some stage during the usage period, all patients and clinicians reported that the technology was easy to use and that they were satisfied with the outcomes. A range of positive impacts were observed, including optimised inhaler technique and an observed improvement in lung function. An increase in asthma control test scores aligned with clinical aims to promote adherence and alleviate symptoms.

Conclusion

The v-DOT technology was shown to be a feasible method of assessing inhaler technique and monitoring adherence in this small group of adult asthma patients. A range of positive impacts for participating patients and clinicians were observed. Not all patients invited to join the project agreed to participate or engage with using the technology, highlighting that in this setting, digital modes of delivering care provide only one of the approaches in the necessary “tool kit” for clinicians and patients.
Fulfilling last wishes: improving the compassionate discharge process
Authors: Alias Rasidah , Neo Yi Ling , Wang Liyun , Sie Long Zhen , Goh Hwee Jin , Mohamed Hussein Mohamed Yazid , Abdullah Hasnah , Wong Yoke Ping
Published: July 2024

Background

Compassionate discharges (ComD), commonly known as rapid discharges, are urgent one-way discharges for critically ill hospitalised patients with death expected within hours or less than 7 days, to die at their place of choice—usually in their own home. Challenges abound in this time-sensitive setting when multiple parties must work together to prepare medically unstable patients for discharge, yet healthcare staff are largely unaware of the process, resulting in delays.

Methods

Process mapping, an Ishikawa diagram and a Pareto chart were used to identify barriers, which included timely acquisition of home equipment and medication and poor communication among stakeholders. In May 2020, the Quality Improvement (QI) team embarked on a pilot project to reduce family caregiver anxiety and delays in the ComD process while maintaining a success rate above 90% over a 12-month period.

Interventions

Three Plan-Do-Study-Act (PDSA) cycles were used to refine a ComD resource package that was developed; this consisted of a checklist, a kit and caregiver resources. This was to support nurses, doctors and families during this difficult and emotional transition. Items in the ComD resource package were revised iteratively based on user feedback, with further data collected to measure its usefulness.

Results

The 12-month ComD success rate over 3 PDSA cycles were 88.9%, 94.2% and 96.7%, respectively, after each cycle. There was a consistent reduction in the level of family anxiety before and after caregiver training and resources. Reasons for failed ComD included acute clinical deterioration or delays in obtaining home oxygen support.

Conclusion

The ComD resource package allowed collaborative work across different disciplines, strengthening the safety and utility of ComD and allowing patients to die in their place of choice. These are ubiquitous across settings; this QI problem is thus relevant beyond our local institution.
Factors associated with decreased anal sphincter tone and the accuracy of forced anal examinations to detect individuals having receptive anal intercourse: an observational study
Authors: Nyitray Alan G , Rosser B R Simon , Hazra Aniruddha , Nitkowski Jenna , Smith Derek , Brzezinski Bridgett , Ridolfi Timothy J , Schneider John A , Chiao Elizabeth Y , Sanos Sandrine , Mkonyi Ever , Mgopa Lucy , Ross Michael W
Published: July 2024

Introduction

Forced anal examinations are used to prosecute sexual and gender minorities (SGM) in multiple countries under the presumption that decreased sphincter tone, assessed by a finger inserted into the anal canal, can detect persons practising receptive anal intercourse. Using baseline data from a longitudinal study, we aimed to determine factors associated with sphincter tone and the accuracy of sphincter tonality to detect persons engaging in receptive anal intercourse.

Methods

Clinicians in Chicago, Houston and Milwaukee, USA conducted digital anal rectal examinations (DARE) to score sphincter resting tone (RT) and squeeze tone (ST). On a separate survey, individuals reported their preferred position for anal intercourse, that is, either always/mostly insertive anal intercourse, always/mostly receptive anal intercourse or both receptive and insertive anal intercourse. Multivariable regression assessed factors associated with decreased sphincter tone while the area under the receiver operating characteristic curves (AUC) estimated the accuracy of sphincter tonality to detect receptive anal intercourse.

Results

Of 838 participants, 94.0% of whom were cisgendered males, 11.3% had decreased RT (95/838) and 6.3% had decreased ST (53/838). The accuracy of DARE to detect any receptive anal intercourse was little better than random guessing (AUC 0.53, 95% CI 0.51 to 0.55 and AUC 0.51, 95% CI 0.49 to 0.53, respectively). RT and ST decreased with age regardless of sexual behaviour (p
trend
<0.01 for both). Compared with individuals having always/mostly insertive anal intercourse, individuals having always/mostly receptive anal intercourse were associated with decreased RT, but not ST, while those equally preferring both insertive and receptive anal intercourse were not associated with decreased RT or ST.

Conclusion

Decreased sphincter tone is uncommon among SGM who prefer receptive anal intercourse. Given virtually no accuracy, a finger inserted into the anus has no utility to detect individuals practising receptive anal intercourse and thus should not be used as such.

Trial registration number

NCT04090060
.
High-flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis
Authors: Seow Daniel , Khor Yet H , Khung Su-Wei , Smallwood David M , Ng Yvonne , Pascoe Amy , Smallwood Natasha
Published: July 2024

Background

High-flow nasal oxygen therapy (HFNO) is used in diverse hospital settings to treat patients with acute respiratory failure (ARF). This systematic review aims to summarise the evidence regarding any benefits HFNO therapy has compared with conventional oxygen therapy (COT) for patients with ARF.

Methods

Three databases (Embase, Medline and CENTRAL) were searched on 22 March 2023 for studies evaluating HFNO compared with COT for the treatment of ARF, with the primary outcome being hospital mortality and secondary outcomes including (but not limited to) escalation to invasive mechanical ventilation (IMV) or non-invasive ventilation (NIV). Risk of bias was assessed using the Cochrane risk-of-bias tool (randomised controlled trials (RCTs)), ROBINS-I (non-randomised trials) or Newcastle-Ottawa Scale (observational studies). RCTs and observational studies were pooled together for primary analyses, and secondary analyses used RCT data only. Treatment effects were pooled using the random effects model.

Results

63 studies (26 RCTs, 13 cross-over and 24 observational studies) were included, with 10 230 participants. There was no significant difference in the primary outcome of hospital mortality (risk ratio, RR 1.08, 95% CI 0.93 to 1.26; p=0.29; 17 studies, n=5887) between HFNO and COT for all causes ARF. However, compared with COT, HFNO significantly reduced the overall need for escalation to IMV (RR 0.85, 95% CI 0.76 to 0.95 p=0.003; 39 studies, n=8932); and overall need for escalation to NIV (RR 0.70, 95% CI 0.50 to 0.98; p=0.04; 16 studies, n=3076). In subgroup analyses, when considering patients by illness types, those with acute-on-chronic respiratory failure who received HFNO compared with COT had a significant reduction in-hospital mortality (RR 0.58, 95% CI 0.37 to 0.91; p=0.02).

Discussion

HFNO was superior to COT in reducing the need for escalation to both IMV and NIV but had no impact on the primary outcome of hospital mortality. These findings support recommendations that HFNO may be considered as first-line therapy for ARF.

PROSPERO registration number

CRD42021264837.
Evaluation of the impact of artificial intelligence-assisted image interpretation on the diagnostic performance of clinicians in identifying pneumothoraces on plain chest X-ray: a multi-case multi-reader study
Authors: Novak Alex , Ather Sarim , Gill Avneet , Aylward Peter , Maskell Giles , Cowell Gordon W , Espinosa Morgado Abdala Trinidad , Duggan Tom , Keevill Melissa , Gamble Olivia , Akrama Osama , Belcher Elizabeth , Taberham Rhona , Hallifax Rob , Bahra Jasdeep , Banerji Abhishek , Bailey Jon , James Antonia , Ansaripour Ali , Spence Nathan , Wrightson John , Jarral Waqas , Barry Steven , Bhatti Saher , Astley Kerry , Shadmaan Amied , Ghelman Sharon , Baenen Alec , Oke Jason , Bloomfield Claire , Johnson Hilal , Beggs Mark , Gleeson Fergus
Published: July 2024

Background

Artificial intelligence (AI)-assisted image interpretation is a fast-developing area of clinical innovation. Most research to date has focused on the performance of AI-assisted algorithms in comparison with that of radiologists rather than evaluating the algorithms’ impact on the clinicians who often undertake initial image interpretation in routine clinical practice. This study assessed the impact of AI-assisted image interpretation on the diagnostic performance of frontline acute care clinicians for the detection of pneumothoraces (PTX).

Methods

A multicentre blinded multi-case multi-reader study was conducted between October 2021 and January 2022. The online study recruited 18 clinician readers from six different clinical specialties, with differing levels of seniority, across four English hospitals. The study included 395 plain CXR images, 189 positive for PTX and 206 negative. The reference standard was the consensus opinion of two thoracic radiologists with a third acting as arbitrator. General Electric Healthcare Critical Care Suite (GEHC CCS) PTX algorithm was applied to the final dataset. Readers individually interpreted the dataset without AI assistance, recording the presence or absence of a PTX and a confidence rating. Following a ‘washout’ period, this process was repeated including the AI output.

Results

Analysis of the performance of the algorithm for detecting or ruling out a PTX revealed an overall AUROC of 0.939. Overall reader sensitivity increased by 11.4% (95% CI 4.8, 18.0, p=0.002) from 66.8% (95% CI 57.3, 76.2) unaided to 78.1% aided (95% CI 72.2, 84.0, p=0.002), specificity 93.9% (95% CI 90.9, 97.0) without AI to 95.8% (95% CI 93.7, 97.9, p=0.247). The junior reader subgroup showed the largest improvement at 21.7% (95% CI 10.9, 32.6), increasing from 56.0% (95% CI 37.7, 74.3) to 77.7% (95% CI 65.8, 89.7, p<0.01).

Conclusion

The study indicates that AI-assisted image interpretation significantly enhances the diagnostic accuracy of clinicians in detecting PTX, particularly benefiting less experienced practitioners. While overall interpretation time remained unchanged, the use of AI improved diagnostic confidence and sensitivity, especially among junior clinicians. These findings underscore the potential of AI to support less skilled clinicians in acute care settings.
Relationship between family history of mandatory boarding school experiences and suicide risk in US reservation-based Native American youth: a cross-sectional analysis
Authors: Brockie Teresa , Wissow Lawrence , Campbell Jacquelyn C , Ivanich Jerreed , Nelson Katie , Wallen Gwenyth , Wetsit Lawrence , Wilcox Holly
Published: July 2024

Introduction

Suicide is a leading cause of death among Native American youth and adolescents in the USA. A myriad of factors have been correlated with risk for suicide ideation (SI)/suicide attempt (SA), including historical trauma; however, accurate measurement of historical trauma has been inconsistent.

Objective

To examine the association of family history of a negative mandatory boarding school experience with SI and SAs.

Methods

An anonymous online survey was conducted with 288 Native youth aged 15–24 years from the Fort Peck Reservation in Montana. Multinomial regression was applied adjusting for other known risk and protective factors of SI and SAs.

Results

Thirty-five percent reported past SAs and 15% reported ideation without prior attempt. Of the 129 (45%) reporting a family history of mandatory boarding school experiences, 28% perceived the experience as positive while 22% as negative. After adjusting for risk and protective factors, both SI and SAs were associated with a family history of negative mandatory boarding school experiences (adjusted OR (AOR)=4.8 and 4.3, respectively) and polydrug use (AOR=3.6 and 2.3). SAs were also associated with post-traumatic stress disorder (AOR=2.6) and depressive symptoms (AOR=3.6).

Conclusion

The association between family history of negative mandatory boarding school experiences and SI and SAs implies that culturally responsive interventions are needed to reduce the intergenerational impacts of historical trauma.
Firearm businesses as partners in suicide prevention: a cross-sectional study of the Gun Shop Project in Colorado, USA
Authors: Wright-Kelly Erin , Buck-Atkinson Jessica Theresa , Betz Marian E , Little Kate , Little Jani S , Kingston Beverly E , Sigel Eric , Arredondo-Mattson Sabrina
Published: July 2024

Background

The Gun Shop Project aims to reduce firearm suicide and is widely implemented in the USA, yet little is known about the core firearm business practices and behaviours that might contribute to preventing firearm suicide.

Methods

Owners or managers of all firearm businesses identified as participants in Colorado’s Gun Shop Project were invited to respond to a questionnaire. Data collection occurred from March to May 2021. Analyses included unweighted descriptive statistics with CIs and Pearson χ2tests for categorical associations.

Results

54 firearm businesses participated (response rate: 28%). Under half reported practices that are Gun Shop Project core aspects (range: 14%–45%). 22% of businesses frequently engaged customers on the importance of safe firearm storage in suicide prevention while 26% had denied a firearm sale and 14% had assisted with temporary secure storage in the past year with customers perceived to be in suicidal crisis. However, high proportions reported willingness to engage in these behaviours if a customer was in crisis: 74% were willing to refuse a sale of a firearm or ammunition, 70% were willing to discuss temporary secure storage options and 70% were willing to direct customers to mental health services.

Conclusions

This study suggests that efforts to continue educating and involving firearm businesses may have an impact on the adoption of organisational suicide prevention practices and behaviours. Ongoing efforts are needed to understand core components of Gun Shop Project to inform standardised recommendations for effective firearm business practices that prevent firearm suicide.
Nasal epithelial gene expression identifies relevant asthma endotypes in the ATLANTIS study
Authors: Karp Tatiana , Faiz Alen , van Nijnatten Jos , Kerstjens Huib A M , Boudewijn Ilse , Kraft Monica , Vonk Judith M , Nawijn Martijn C , Heijink Irene H , Beghé Bianca , Rabe Klaus F , Papi Alberto , Brightling Chris , Singh Dave , van der Molen Thys , Siddiqui Salman , Christenson Stephanie , Guryev Victor , van den Berge Maarten
Published: July 2024

Introduction

Asthma is an inflammatory airways disease encompassing multiple phenotypes and endotypes. Several studies suggested gene expression in nasal epithelium to serve as a proxy for bronchial epithelium, being a non-invasive approach to investigate lung diseases. We hypothesised that molecular differences in upper airway epithelium reflect asthma-associated differences in the lower airways and are associated with clinical expression of asthma.

Methods

We analysed nasal epithelial gene expression data from 369 patients with asthma and 58 non-asthmatic controls from the Assessment of Small Airways Involvement in Asthma study. Unsupervised hierarchical clustering was performed on asthma-associated genes. Asthma-associated gene signatures were replicated in independent cohorts with nasal and bronchial brushes data by comparing Gene Set Variation Analysis scores between asthma patients and non-asthmatic controls.

Results

We identified 67 higher expressed and 59 lower expressed genes in nasal epithelium from asthma patients compared with controls (false discovery rate<0.05), includingCLCA1, CST1andPOSTN, genes well known to reflect asthma in bronchial airway epithelium. Hierarchical clustering revealed several molecular asthma endotypes with distinct clinical characteristics, including an endotype with higher blood and sputum eosinophils, high fractional exhaled nitric oxide, and more severe small airway dysfunction, as reflected by lower forced expiratory flow at 50%. In an independent cohort, we demonstrated that genes higher expressed in the nasal epithelium reflect asthma-associated changes in the lower airways.

Conclusion

Our results show that the nasal epithelial gene expression profile reflects asthma-related processes in the lower airways. We suggest that nasal epithelium may be a useful non-invasive tool to identify asthma endotypes and may advance personalised management of the disease.
Changes in payer mix of new and established trauma centers: the new trauma center money grab?
Authors: Haddad Diane N , Hatchimonji Justin , Kumar Satvika , Cannon Jeremy W , Reilly Patrick M , Kim Patrick , Kaufman Elinore
Published: July 2024

Background

Although timely access to trauma center (TC) care for injured patients is essential, the proliferation of new TCs does not always improve outcomes. Hospitals may seek TC accreditation for financial reasons, rather than to address community or geographic need. Introducing new TCs risks degrading case and payer mix at established TCs. We hypothesized that newly accredited TCs would see a disproportionate share of commercially insured patients.

Study design

We collected data from all accredited adult TCs in Pennsylvania using the state trauma registry from 1999 to 2018. As state policy regarding supplemental reimbursement for underinsured patients changed in 2004, we compared patient characteristics and payer mix between TCs established before and after 2004. We used multivariable logistic regression to assess the relationship between payer and presentation to a new versus established TC in recent years.

Results

Over time, there was a 40% increase in the number of TCs from 23 to 38. Of 326 204 patients from 2010 to 2018, a total of 43 621 (13.4%) were treated at 15 new TCs. New TCs treated more blunt trauma and less severely injured patients (p<0.001). In multivariable analysis, patients presenting to new TCs were more likely to have Medicare (OR 2.0, 95% CI 1.9 to 2.1) and commercial insurance (OR 1.6, 95% CI 1.5 to 1.6) compared with Medicaid. Over time, fewer patients at established TCs and more patients at new TCs had private insurance.

Conclusions

With the opening of new centers, payer mix changed unfavorably at established TCs. Trauma system development should consider community and regional needs, as well as impact on existing centers to ensure financial sustainability of TCs caring for vulnerable patients.

Level of evidence

Level III, prognostic/epidemiological.
Differences in the intensity of past forest fire events inferred from stable oxygen isotope analysis of charred bark
Authors: McWhirter Tegan , Webb Elizabeth A. , Dech Jeffery P.
Published: July 2024

Understanding past fire regimes requires reliable proxy data that record fire conditions and preserve them over time. The objective of this study was to determine if the oxygen isotope composition of charred bark samples (pyrogenic organic matter) could be used as proxy data to differentiate wildfires based on burn intensity. We collected charred and uncharred bark samples from three fire sites in northern Ontario, Canada that represented a gradient of fire intensity as depicted by Fire Weather Index (FWI) data. We hypothesized that the mean Δ18Obark-char (the difference between δ18O of uncharred bark and a charred sample) would be greater for fires with higher intensities. Analysis of variance of Δ18Obark-char indicated a significant effect of fire event ( F = 73.6, p < 0.001), which explained 57.0% of the variance. A prescribed surface fire treatment (mean FWI = 9.5) had significantly lower Δ18Obark-char than two natural crown fires (FWI = 21 and 27). These results demonstrate that Δ18Obark-char differentiated moderate from high intensity fires in a similar manner to the FWI data.
Quantum nature of spacetime near the black hole singularity
Authors: Singh Harpreet , Nandy Malay K.
Published: July 2024

The concept of spacetime loses its usual interpretation at the essential singularity of a black hole. In consequence, all laws of physics must fail at this classical singularity. This unphysical behavior of spacetime at the singularity originates from general relativity. In order to have a consistent description of spacetime, this singularity must disappear in a quantum mechanical description of spacetime which is expected to be given by a quantum theory of gravity. In this paper, we therefore attempt to describe the quantum nature of spacetime in the vicinity of the (classical) singularity of a black hole. We take the Kantowsi–Sachs representation for the interior spacetime of a black hole and include inevitable vacuum fluctuations of matter field in the Klein–Gordon representation. Hence we obtain the Wheeler–DeWitt equation for the black hole interior and solve this equation exactly yielding a general expression for the interior wave function of the black hole. Admissible wave functions consistent with the DeWitt boundary condition implies that the Hilbert space has three nonoverlapping sectors distinguished by the relative character of the eigenvalues. Regular quantum black holes with admissible and well-behaved wave function having no singularity can exist only in two of those sectors. However, the remaining sector does not contain any regular quantum black hole.