bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond access to sanitary pads: a comprehensive analysis of menstrual health scheme impact among rural girls in Northeast India
Authors: Achuthan Krishnashree , Khobragade Sugandh , Kolil Vysakh Kani
Published: December 2024

Menstrual hygiene management (MHM) among girls in rural India poses a substantial challenge for public health, education, and quality of life, exacerbated by limited access to and affordability of menstrual products. In response to these issues, the Government of India initiated the Menstrual Hygiene Scheme (MHS) to enhance access and awareness. This study evaluates the impact of the MHS in Assam and Tripura, designated as “treatment states” with consistent pad supply from 2017 to 2021 compared to neighboring “control states” with negligible pad distribution. Utilizing data from two National Family Health Surveys, NFHS-4 and NFHS-5, and employing the propensity score matching difference-in-differences approach, we isolated the causal effect of the MHS distribution program. The key findings reveal a significant rise in sanitary pad and hygienic method usage in the treatment states, particularly among girls aged 15–19 years who received pads during the survey period. Their sanitary pad usage increased by 10.6 percentage points [95% confidence interval (CI) (0.046, 0.167)], and adoption of hygienic methods overall saw a 13.8 percentage point [95% CI (0.087, 0.188)] jump. Notably, younger girls aged 15–19 years also experienced a 6.1-percentage point [95% CI (0.004, 0.118)] increase in their understanding of ovulation, showcasing the MHS’s potential to go beyond providing products and promoting menstrual health awareness. A rise in reported sexually transmitted infections in both age groups, with a statistically significant 1.8-percentage point [95% CI (0.004, 0.032)] increase for younger girls, warrants further exploration. Disparities in impact were observed, with girls with high media exposure and greater autonomy demonstrating greater improvements in hygienic practices, highlighting the importance of information dissemination and empowering girls. Most socioeconomic groups, except the highest wealth and education levels, witnessed rises in hygienic method usage, indicating the scheme’s potential to reduce inequalities while hinting at the need for tailored interventions for marginalized communities.
Application research of artificial intelligence algorithms in energy-efficient design for low-carbon building landscapes
Authors: Zhang Jianhua , Zhan Qinchuan , Liang Haipeng
Published: December 2024

The study focuses on a resort hotel, exploring from multiple facets how energy-saving concepts can be integrated into landscape design to enhance customer satisfaction. By employing the analytic hierarchy process and the fuzzy comprehensive evaluation model, and optimizing the placement of architectural landscape facilities based on the Adaptive Niche Genetic Algorithm, the study strives to enhance resource efficiency while ensuring the aesthetic quality of the landscape. The research findings indicate that the hotel’s landscape design performs well overall and offers targeted optimization suggestions, thereby promoting the practical application of energy-saving landscape design principles.
Evaluation and improvement of personalized recommendation system in low-carbon network marketing
Authors: Li Dan , Yang Xin
Published: December 2024

As an advanced online marketing tool, the personalized recommendation system achieves precise recommendations by analyzing product and user-behavior data, thereby enhancing user experience and satisfaction. This paper proposes a recommendation algorithm based on product attributes and contexts, specifically for low-carbon online marketing. The incorporation of context weights aids the algorithm in more effectively comprehending user needs within specific contexts. Comparative experiments with collaborative filtering and content-based recommendation methods reveal that the hybrid recommendation system proposed in this paper outperforms in terms of recommendation accuracy and user satisfaction, providing theoretical support for low-carbon online marketing.
Strain phylogroup and environmental constraints shape Escherichia coli dynamics and diversity over a 20-year human gut time series
Authors: Condamine Bénédicte , Morel-Journel Thibaut , Tesson Florian , Royer Guilhem , Magnan Mélanie , Bernheim Aude , Denamur Erick , Blanquart François , Clermont Olivier
Published: December 2024

Escherichia coli is an increasingly antibiotic-resistant opportunistic pathogen. Few data are available on its ecological and evolutionary dynamics in its primary commensal niche, the vertebrate gut. Using Illumina and/or Nanopore technologies, we sequenced whole genomes of 210 E. coli isolates from 22 stools sampled during a 20-year period from a healthy man (ED) living in Paris, France. All phylogroups, except C, were represented, with a predominance of B2 (34.3%), followed by A and F (19% each) phylogroups. Thirty-five clones were identified based on their haplogroup and pairwise genomic single nucleotide polymorphism distance and classified in three phenotypes according to their abundance and residence time: 25 sub-dominant/transient (52 isolates), five dominant/transient (48 isolates) and five dominant/resident (110 isolates). Four over five dominant/resident clones belonged to B2 and closely related F phylogroups, whereas sub-dominant/transient clones belonged mainly to B1, A and D phylogroups. The long residence times of B2 clones seemed to be counterbalanced by lower colonization abilities. Clones with larger within-host frequency persisted for longer. By comparing ED strain genomes to a collection of commensal E. coli genomes from 359 French individuals, we identified ED-specific genomic properties including an enrichment in genes involved in a metabolic pathway (mhp cluster) and the presence of a very rare antiviral defense island. The E. coli colonization within the gut microbiota was shaped by both the intrinsic properties of the strain lineages, in particular longer residence of phylogroup B2, and the environmental constraints such as diet or phages.
Insuring the Weak: The Institutional Power Equilibrium in International Organizations
Authors: Daßler Benjamin , Heinkelmann-Wild Tim , Huysmans Martijn
Published: December 2024

Materially powerful states tend to dominate both the creation of international organizations (IOs) as well as subsequent IO policymaking. Materially weak states are nevertheless expected to participate in IOs since it is generally assumed that they will still profit from cooperation and prefer power to be exercised through institutions. Yet, we know surprisingly little about how exactly institutional rules protect weak states from the powerful in IOs. This paper develops a theory of institutional design that specifies the institutional power equilibrium at the heart of IOs’ constitutional treaties. Through the inclusion of veto or exit rights, weak states obtain formal safeguards against exploitation by the powerful during an IO’s operation. This expectation of a power equilibrium in IOs’ design is borne out in design patterns within the constitutional treaties of IOs created between 1945 and 2005. Our results indicate that the distribution of power among an IO’s founding members indeed affects the inclusion of institutional safeguards in their constitutional treaties and that veto and exit rights are functional substitutes in this regard. Our findings matter since the institutional power equilibrium at IO creation has important implications for relations between the materially powerful and the weak during IO operations.
Frequencies and mechanisms of mutational resistance to ceftibuten/avibactam in Enterobacterales
Authors: Mushtaq Shazad , Vickers Anna , Doumith Michel , Garello Paolo , Woodford Neil , Livermore David M
Published: December 2024

Background

Antibiotic resistance complicates treatment of urinary infections, particularly when these ascend above the bladder, with few oral options remaining. New oral β-lactamase inhibitor combinations present a potential answer, with ceftibuten/avibactam—now undergoing clinical trials—widely active against strains with ESBLs and serine carbapenemases. To inform its development we undertook mutant selection studies.

Methods

Single-step mutants were sought from Enterobacterales (n = 24) with AmpC, ESBL, OXA-48 and KPC β-lactamases. MICs were determined by CLSI agar dilution. Illumina WGS of selected mutants (n = 50) was performed.

Results

Even at low MIC multiples, mutant frequencies were mostly only c. 10−8. β-Lactamase structural mutants were obtained only from KPC and AmpC enzymes. The KPC mutants had Trp105Arg or Ser130Thr substitutions, causing only small MIC shifts; the AmpC mutant had an Asn346Trp replacement, as previously selected with other avibactam combinations. No ESBL mutants were obtained. Rather, from Escherichia coli, we predominantly selected mutants with modifications to ftsI, encoding penicillin-binding protein (PBP) 3. From Klebsiella pneumoniae and Enterobacter cloacae we predominantly obtained variants with modification of uptake and efflux components or their regulators. ftsI mutants lacked cross-resistance to other avibactam combinations; uptake mutants had broader MIC rises. A few putative mutants had other lesion(s) of uncertain significance, or grew as small, stressed colonies lacking detectable lesions.

Conclusions

There seems little risk of ESBLs mutating to confer ceftibuten/avibactam resistance, though some risk may apply for KPC and AmpC enzymes. The propensity to select E. coli ftsI/PBP3 mutants is notable and was not seen with other avibactam combinations.
The impact of the COVID-19 pandemic on the antimicrobial stewardship workforce in Scottish acute care hospitals—a qualitative study
Authors: Matuluko Ayodeji , Ness Valerie , Macdonald Jennifer , Sneddon Jacqueline , Seaton Ronald Andrew , Currie Kay
Published: December 2024

Background

Antimicrobial stewardship (AMS) programmes seek to reduce the risk of antimicrobial resistance by minimizing inappropriate antimicrobial use. The SARS-CoV-2 coronavirus (COVID-19) pandemic was characterized by initial widespread use of antimicrobials in patients with COVID-19, with potential negative effects on AMS efforts.

Objective

To explore the impact of the pandemic on the AMS workforce in Scottish acute care hospitals.

Method

Individual, semi-structured online interviews were conducted with a purposive sample of clinical staff who had an AMS focused role in Scottish Health Boards. Interviews explored staff experiences of facilitating AMS during the pandemic. Data were analysed using inductive content analysis.

Results

Thirteen staff from seven of 15 Scotland Health Boards participated. The data revealed negative (including staff redeployment and shortages) and positive effects (including improved working relationships and use of technology) on the AMS workforce. Notably, greater appreciation of the work of the AMS team was a positive outcome.

Conclusions

The robust qualitative methods applied in this original study have generated greater understanding of factors that impeded AMS services in Scotland during the pandemic. These findings may resonate internationally. Adaptation to technology and investment in the workforce are recommended to improve the resilience of AMS services in future crises.
Antler size decreases with increasing age: evidence of reproductive senescence in male Fallow Deer (Dama dama)
Authors: Cambreling Solène , Gaillard Jean-Michel , Lemaître Jean-François , Smith Adam F , David Anna , Ciuti Simone
Published: December 2024

Reproductive senescence, the decline in reproductive performance with increasing age, is extensively documented in females but much less investigated in males. However, senescence of secondary sexual traits in males, such as horns or antlers, has been reported across various vertebrate species. Our study investigates reproductive senescence in antler size, a conspicuous precopulatory trait in male deer, by taking advantage of detailed monitoring of a free-ranging population of Fallow Deer (Dama dama) living in a peri-urban area. We focused on 2 metrics utilizing noninvasive photogrammetry to measure antler length and palm width in 127 free-living males. Our results demonstrate clear evidence of reproductive senescence, with both antler length and palm width declining synchronously from approximately 7 years of age onwards. This decline matches previously reported decreases in male mating success from ages 6 to 7, suggesting that antler size may impact sexual competition and mating success. Males older than 7 years of age may experience reduced competitive abilities and diminished attractiveness to females. This study provides new evidence of senescence of antler size in cervids, enhancing our understanding of the eco-evolutionary factors driving male senescence and emphasizing the importance that antler size may have in the reproductive success of Fallow Deer.
The method of gain parameterizing measurement data and parameter estimation for a proton exchange membrane fuel cell model
Authors: Fitriani Raydha Z , Kuan Yean-Der
Published: December 2024

Proton exchange membrane fuel cells (PEMFCs) are a technology that produces clean energy, with promising prospects in wide applications because of their high power density and low operating temperature. Experiments conducted to develop the PEMFC are both time-consuming and costly. Through modeling and simulation, performance development and analysis can be done more efficiently. This paper presents a simulation model for PEMFC based on mathematical equations developed using MATLAB/Simulink. To fully grasp and reproduce PEMFC characteristics, empirical parameter estimation using the genetic algorithm (GA) is implemented. The parameters estimated from the loss equations have not been previously utilized. A script connecting Simulink and the GA was developed to estimate these parameters. Validation is conducted by comparing the polarization curve simulation results with experimental data for both single-cell and stack-type PEMFCs. Comparisons with various other estimation methods were conducted to assess the reliability of the employed method. The model that utilizes estimated parameters exhibits agreement with experimental data showcasing an error value <3%. Furthermore, the method's superiority is evident from the polarization curve as well as the objective value. Observing the reaction conditions in each PEMFC loss region with the obtained parameter values becomes easier and more accessible.
Default Antibiotic Order Durations for Skin and Soft Tissue Infections in Outpatient Pediatrics: A Cluster Randomized Trial
Authors: Broussard Kali A , Chaparro Juan D , Erdem Guliz , Abdel-Rasoul Mahmoud , Stevens Jack , Watson Joshua R
Published: December 2024

Background

Antibiotic durations for uncomplicated skin/soft tissue infections (SSTI) often exceed the guideline-recommended 5–7 days. We assessed the effectiveness of a default duration order panel in the Electronic Health Record to reduce long prescriptions.

Methods

Cluster randomized trial of an SSTI order panel with default antibiotic durations (implemented 12/2021), compared to a control panel (no decision support) in 14 pediatric primary care clinics. We assessed long prescription rates from 23 months before to 12 months after order panel implementation (1/2020–12/2022). Antibiotic duration was considered long if >5 days for cellulitis or drained abscess, or >7 days for undrained abscess, impetigo, or other SSTI.

Results

We included 1123 and 511 encounters in intervention and control clinics, respectively. In a piecewise generalized linear model, the long prescription rate decreased from 63.8% to 54.6% (absolute difference, −9.2%) in the intervention group and from 70.0% to 54.9% (absolute difference, −15.1%) in the control group. The relative change in trajectories from pre-panel to post-panel periods did not differ significantly between intervention and control groups (P = .488). Although used in only 29.4% of eligible encounters, intervention panel use had lower odds of long prescription compared to all other prescriptions (odds ratio 0.18).

Conclusions

We did not detect an overall impact of an order panel with default durations in reducing long antibiotic prescriptions for SSTIs. When ordered from the intervention panel, prescriptions were usually guideline-concordant. Effective strategies to make choosing a default duration more automatic are necessary to further reduce long prescriptions.
Computing most general unifiers in Euclidean modal logics
Authors: Gougeon Quentin
Published: December 2024

We prove that all extensions of $\textbf{K5}$ have unitary unification, even with parameters. Our proof is constructive in the sense that we can effectively compute, in 4-exponential space, a most general unifier for any unifiable formula. In particular, this proves that unification and admissibility are decidable. We also investigate special unification types: we show that $\textbf{K5}$ and $\textbf{KD5}$ are transparent, and we characterize the projective extensions of $\textbf{K5}$.
Refractory skin ulcers and afebrile bacteraemia with Staphylococcus aureus in antimelanoma differentiation-associated gene 5 antibody-positive dermatomyositis: A case report
Authors: Katakura Tokio , Shirai Tsuyoshi , Ishii Yusho , Sato Hiroko , Fujii Hiroshi
Published: December 2024

Skin ulcers sometimes appear in patients with antimelanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM) and are usually associated with disease activity. Here, we report a case of a 41-year-old woman with anti-MDA5 antibody-positive DM, who developed refractory skin ulcers during the remission induction therapy, which were proven to be associated with clinically silent Staphylococcus aureus bacteraemia with septic thrombi in her lung. The patient was referred to our hospital for the treatment of amyopathic DM with interstitial lung disease. Anti-MDA5-positive DM was diagnosed, and she was treated with triple therapy combined with tofacitinib because poor prognostic factors existed. Although the remission induction therapy improved most of the symptoms, she developed erythematous rashes with ulcers on her left auricle and forearm, which were refractory to topical immunosuppressive medications. Despite the absence of systemic symptoms or elevated inflammatory markers, blood and wound cultures revealed S. aureus, and a new cavitary lesion was detected in her left lung. Subsequent antibiotic therapy resolved both the cutaneous and pulmonary lesions. This case highlights the importance of considering bacteraemia and performing blood cultures when DM-related skin ulcers resist conventional treatments, even without fever during immunosuppressive therapy.
Pervasive RNA-binding protein enrichment on TAD boundaries regulates TAD organization
Authors: Sun Qiang , Zhou Qin , Qiao Yulong , Chen Xiaona , Sun Hao , Wang Huating
Published: December 2024

Mammalian genome is hierarchically organized by CTCF and cohesin through loop extrusion mechanism to facilitate the organization of topologically associating domains (TADs). Mounting evidence suggests additional factors/mechanisms exist to orchestrate TAD formation and maintenance. In this study, we investigate the potential role of RNA-binding proteins (RBPs) in TAD organization. By integrated analyses of global RBP binding and 3D genome mapping profiles from both K562 and HepG2 cells, our study unveils the prevalent enrichment of RBPs on TAD boundaries and define boundary-associated RBPs (baRBPs). We found that baRBP binding is correlated with enhanced TAD insulation strength and in a CTCF-independent manner. Moreover, baRBP binding is associated with nascent promoter transcription. Additional experimental testing was performed using RBFox2 as a paradigm. Knockdown of RBFox2 in K562 cells causes mild TAD reorganization. Moreover, RBFox2 enrichment on TAD boundaries is a conserved phenomenon in C2C12 myoblast (MB) cells. RBFox2 is downregulated and its bound boundaries are remodeled during MB differentiation into myotubes. Finally, transcriptional inhibition indeed decreases RBFox2 binding and disrupts TAD boundary insulation. Altogether, our findings demonstrate that RBPs can play an active role in modulating TAD organization through co-transcriptional association and synergistic actions with nascent promoter transcripts.
Exploring adult glioma through MRI: A review of publicly available datasets to guide efficient image analysis
Authors: Abbad Andaloussi Meryem , Maser Raphael , Hertel Frank , Lamoline François , Husch Andreas Dominik
Published: December 2024

Background

Publicly available data are essential for the progress of medical image analysis, in particular for crafting machine learning models. Glioma is the most common group of primary brain tumors, and magnetic resonance imaging (MRI) is a widely used modality in their diagnosis and treatment. However, the availability and quality of public datasets for glioma MRI are not well known.

Methods

In this review, we searched for public datasets of glioma MRI using Google Dataset Search, The Cancer Imaging Archive, and Synapse.

Results

A total of 28 datasets published between 2005 and May 2024 were found, containing 62 019 images from 5515 patients. We analyzed the characteristics of these datasets, such as the origin, size, format, annotation, and accessibility. Additionally, we examined the distribution of tumor types, grades, and stages among the datasets. The implications of the evolution of the World Health Organization (WHO) classification on tumors of the brain are discussed, in particular the 2021 update that significantly changed the definition of glioblastoma.

Conclusions

Potential research questions that could be explored using these datasets were highlighted, such as tumor evolution through malignant transformation, MRI normalization, and tumor segmentation. Interestingly, only 2 datasets among the 28 studied reﬂect the current WHO classification. This review provides a comprehensive overview of the publicly available datasets for glioma MRI currently at our disposal, providing aid to medical image analysis researchers in their decision-making on eﬃcient dataset choice.
The rice microRNA159–SPOROCYTELESS EAR2 module regulates starch biosynthesis during pollen development and maintains male fertility
Authors: Tao Jinyuan , Kong Wenwen , Luo Weigui , Wang Li , Dai Xing , Lin Xiaojing , Dong Haijiao , Yang Xiaoyu , Mo Beixin , Chen Xuemei , Yu Yu
Published: December 2024

Starch is an indispensable energy reserve for pollen and failure of starch biosynthesis in pollen leads to male sterility in flowering crops. Nonetheless, the regulatory mechanisms underlying starch biosynthesis in rice (Oryza sativa) pollen remain unclear. Here, we identified a target of the microRNA OsmiR159, SPOROCYTELESS ETHYLENE-RESPONSIVE ELEMENT BINDING FACTOR-ASSOCIATED AMPHIPHILIC-REPRESSION 2 (OsSPEAR2). OsSPEAR2 is predominantly expressed in mature pollen and OsSPEAR2 possesses transcriptional repressor activity and localizes in the nucleus. Disruption of OsSPEAR2 results in severely shrunken pollen grains and male sterility. OsSPEAR2 interacts with multiple OsTCPs, including OsTCP14. OsTCP14 is a target of OsmiR319 and a knockout mutation in OsTCP14 partially rescues the defective pollen phenotype of Osspear2. In addition, transcriptome analyses revealed significant downregulation of numerous genes associated with carbohydrate metabolism, specifically in Osspear2 anthers, including several genes critical for starch biosynthesis. Moreover, OsTCP14 directly represses the expression of the essential starch biosynthesis gene OsUGP2; however, this repression could be alleviated by OsSPEAR2. Noteworthily, embryophyte-specific SPEAR2 and SPOROCYTELESS were also identified as miR159 targets involved in regulating plant growth and development in Arabidopsis (Arabidopsis thaliana), indicating that the miR159-SPEAR regulatory module may be conserved among embryophytes. Collectively, our findings reveal OsmiR159-OsSPEAR2-OsTCP14-OsUGP2 as a regulatory cascade that modulates starch biosynthesis during pollen development in rice.
The efficacy of an interdisciplinary pain management program for complex regional pain syndrome compared to low back pain and chronic widespread pain: an observational study
Authors: Bean Debbie J , Tuck Natalie L , Magni Nico , Aamir Tipu , Pollard Catherine , Lewis Gwyn N
Published: December 2024

Background

Little research has assessed the efficacy of interdisciplinary pain management programs (IPMPs) for complex regional pain syndrome (CRPS), whereas evidence shows that IPMPs are effective for low back pain (LBP) and chronic widespread pain (CWP). This study aimed to determine whether outcomes following an IPMP differ for people with CRPS compared to LBP and CWP. In addition, we determined whether it is possible to predict IPMP outcomes using baseline characteristics.

Methods

People with CRPS (N = 66) who had completed a 3-week IPMP were compared with age- and gender- matched controls with LBP (N = 66) and CWP (N = 66). Measures of pain intensity, pain interference and psychological factors were extracted for pre- and post-program, and at 1, 6, and 12 months. Latent class analysis identified recovery trajectories for pain intensity and pain interference, and χ2 analyses assessed differences between diagnostic groups in recovery trajectories. Machine learning models were implemented to predict recovery trajectories from baseline scores.

Results

Two recovery trajectories for each dependent variable (pain interference and for pain intensity) were identified: Good responders and poorer responders. Following IPMPs, 37% of people belonged to a good responder recovery trajectory for pain interference, and 11% belonged to a good responder recovery trajectory for pain intensity. Recovery trajectories were similar across the three diagnostic groups (CRPS, LBP, CWP) for pain interference (χ2 = 1.8, P = .4) and intensity (χ = 0.2, P = .9). Modeling to predict outcomes correctly classified 69% of cases for pain interference and 88% of cases for pain intensity recovery trajectories using baseline scores.

Conclusion

People with CRPS, LBP, and CWP experience similar benefits following an IPMP. This supports the use of IPMPs for people with CRPS.
Measurement Properties of the BESTest Scale in People With Neurological Conditions: A Systematic Review With Meta-Analysis
Authors: Arcolin Ilaria , Giardini Marica , Tagliabue Federica , Belluscio Valeria , Horak Fay , Godi Marco
Published: December 2024

Objective

People with neurological conditions (PwNC) frequently fall, mainly due to balance impairments. Among the scales assessing balance, the Balance Evaluation System Test (BESTest) is one of the most comprehensive in evaluating all components of postural control. This study aimed to systematically review and summarize the measurement properties of the BESTest in PwNC.

Methods

Embase, MEDLINE, ScienceDirect, Scopus, and PEDro were searched up to December 2023. Studies assessing at least 1 BESTest measurement property in PwNC were included. Methodological quality of studies was assessed with the COSMIN Risk of Bias checklist. Overall rating and level of evidence for each property were given according to COSMIN criteria. Where possible, meta-analysis was performed.

Results

Thirty-six studies (1749 PwNC) were included. The BESTest demonstrated a high quality of evidence supporting good reliability (intraclass correlation coefficients = 0.96–0.98 for total score, and 0.70–0.98 for subsections), internal consistency, and measurement error. High quality levels of responsiveness, and content and construct validity were also found. However, evidence for structural validity was insufficient to be sure the BESTest actually tests several, or 1, balance constructs. Criterion validity cannot be evaluated. While translated into different languages, cross-cultural validity has never been assessed in PwNC. Evidence to support use of the BESTest for specific neurological conditions is limited to Parkinson disease and stroke, due to the small sample sizes and number of studies in other populations.

Conclusion

This systematic review provided high quality evidence supporting the reliability, content and construct validity, and responsiveness of the BESTest to intervention, being able to detect balance changes and to differentiate heterogeneous PwNC based on fall history, falling risk, and physical performance. However, low-quality evidence was found when considering each neurological condition alone. To comprehensively understand the BESTest measurement properties, future studies are needed with larger samples for each neurological condition, especially assessing cross-cultural and structural validity.

Impact

Assessing balance is crucial for fall risk prevention. The BESTest has been demonstrated to be a reliable, responsive, and valid scale usable in clinical setting for assessing balance in PwNC.
Stationary neutron star envelopes at high accretion rates
Authors: Nava-Callejas Martín , Cavecchi Yuri , Page Dany
Published: December 2024

In this work we model stationary neutron star envelopes accreting under various conditions and describe our new code for such studies, which we plan to couple to a full thermal evolution code. We put special emphasis on the rp-process, resulting in the synthesis of heavy elements, and study its dependence on the mass accretion rate and the chemical composition of the accreted matter. We show that at $\dot{M} \sim 0.01 \dot{M}_{\text{Edd}}$, mostly low mass ($A\le$ 24) elements are synthesized with a few heavier ones below the $^{40}$Ca bottleneck. Once $\dot{M}$ is above ${\buildrel\sim \over \gt } 0.1 \dot{M}_{\text{Edd}}$ this bottleneck is surpassed and nuclei in the iron peak region ($A\sim$ 56) are abundantly produced. This synthesis of heavy elements reaches $A \sim 70$ at $\dot{M}_{\text{Edd}}$ and $A \sim 90$ at $5 \dot{M}_{\text{Edd}}$. Their density profiles of the energy generation rate are discussed, particularly at high density beyond the hydrogen exhaustion point. We explored the efficiency of the rp-process under variations of the relative abundances of H and He. We find that when the rp-process is efficient, the nucleosynthesis it generates is independent of the accreted abundance of CNO elements as these are directly and copiously generated once the $3\alpha$-reaction is operating. Our results are of importance for the study of neutron stars mostly in systems in which X-ray bursts are absent, but they are also relevant for describing the low density region of other systems, mostly below $10^6$ g cm$^{-3}$, in-between bursts.
Major change in swine influenza virus diversity in France owing to emergence and widespread dissemination of a newly introduced H1N2 1C genotype in 2020
Authors: Richard Gautier , Hervé Séverine , Chastagner Amélie , Quéguiner Stéphane , Beven Véronique , Hirchaud Edouard , Barbier Nicolas , Gorin Stéphane , Blanchard Yannick , Simon Gaëlle
Published: December 2024

Swine influenza A viruses (swIAVs) are a major cause of respiratory disease in pigs worldwide, presenting significant economic and health risks. These viruses can reassort, creating new strains with varying pathogenicity and cross-species transmissibility. This study aimed to monitor the genetic and antigenic evolution of swIAV in France from 2019 to 2022. Molecular subtyping revealed a marked increase in H1avN2 cases from 2020 onwards, altering the previously stable subtypes’ distribution. Whole-genome sequencing and phylogenetic analyses of H1av (1C) strains identified 10 circulating genotypes, including 5 new genotypes. The most predominant genotype from 2020 onwards, denominated H1avN2#E, was characterized by an HA-1C.2.4, an N2-Gent/84, and internal protein-encoding genes belonging to a newly defined subclade within the Eurasian avian–like (EA) lineage termed EA-DK. H1avN2#E emerged in Brittany, the country’s most pig-dense region, and rapidly became the most frequently detected swIAV genotype across France. This drastic change in the swIAV lineage proportions at a national scale was unprecedented, making H1avN2#E a unique case for understanding swIAV evolution and spreading patterns. Phylogenetic analyses suggested an introduction of the H1avN2#E genotype from a restricted source, likely originating from Denmark. It spread rapidly with low genetic diversity at the start of the epizootic in 2020, showing increasing diversification in 2021 and 2022 as the inferred population size grew and stabilized, and exhibited reassortments with other enzootic genotypes. Amino acid sequence alignments of H1avN2#E antigenic sites revealed major mutations and deletions compared to commercial vaccine 1C strain (HA-1C.2.2) and previously predominant H1avN1 strains (HA-1C.2.1). Antigenic cartography confirmed significant antigenic distances between H1avN2#E and other 1C strains, suggesting that the new genotype has escaped the pre-existing immunity of the swine population. Epidemiologically, the H1avN2#E virus exhibited epizootic hallmarks with more severe clinical outcomes compared to H1avN1 viruses. These factors likely contributed to the spread of H1avN2#E within the pig population. The rapid rise of H1avN2#E highlighted the dynamic nature of swIAV genetic and antigenic diversity, underscoring the importance of tailored surveillance programs to support risk assessment during potential new outbreaks. It also demonstrates the need to strengthen biosecurity measures when introducing pigs into a herd, including swIAV positivity assessment followed by quarantine, and restrict the trade of swIAV-excreting live swine between European countries.
Trade Networks in Latin America: Spatial Inefficiencies and Optimal Expansions
Authors: Gorton Nicole , Ianchovichina Elena
Published: December 2024

Using a spatial general equilibrium framework and a new discretization procedure to address the large spatial scale of countries such as Brazil, this study identifies optimal domestic and transnational transport networks and expansions to existing ones in Latin America. Most countries have underinvested in domestic road networks connecting their more populous and productive urban areas. The average annual welfare losses due to such inefficiencies are largest in Argentina and Brazil, averaging respectively 2.4 percent and 2.1 percent of consumption. The estimated welfare losses due to spatial misallocation of transnational transport networks are 1.8 percent in MERCOSUR and 1.5 percent in the Andean Community, but the losses of landlocked members of the bloc are more than double these averages. Optimal expansions of existing networks can correct existing inefficiencies and reduce spatial inequality within and across countries. World Bank transportation infrastructure projects correlate relatively well with the optimal investments in most countries.
How Did We End Up in an Overdose Crisis?
Authors: Glasner Suzette
Published: December 2024

This chapter provides an overview of the
overdose crisis which resulted in over 500,000lives being lost due to opioid overdose
deaths over the last 15 years. It elaborates on the history of the opioid crisis and its
three major sources that fueled the surge in prescription. Moreover, one of the most
alarming trends to emerge yet is the rise in overdose deaths among American teens for
the first time in a decade. While medication is available to reverse the toxic and
lethal effects of overdosing on opioids, there are no medicines to save a life when
someone is experiencing a stimulant overdose. Thus, helping people with opioid addiction
access highly effective treatments is the best opportunity to reverse the opioid
overdose death crisis.
Developing CLOUT: A Longitudinal, Cross-Program Chief Resident Curriculum to Increase Psychological Safety in the Clinical Learning Environment
Authors: Dunne Dana , Asnes Andrea , Berg David , Chen Alissa , Dewey Jeff , Gupta Shaili , Fernandes Claudia-Santi , Huot Stephen J.
Published: December 2024

Psychological safety in the clinical learning environment is essential for learning and thriving. The authors aimed to leverage the leadership position and influence that chief residents hold and invited them to participate in a longitudinal professional development curriculum designed to provide them with the tools to promote psychological safety. A total of 66 chief residents from 25 residency programs, along with 18 faculty allies, participated in 5 workshops, which were designed to increase their understanding of and effective responses to workplace mistreatment or bias directed toward trainees. These skills-based workshops focused on effective coaching, conflict management, and self-regulation of emotions for themselves and their trainees. There was a significant improvement in self-reported efficacy in these domains at the completion of the curriculum and evidence of behavior change as assessed by baseline and final case scenario responses. Additionally, the relationship building that resulted by bringing all chief residents together further enhanced the curriculum’s impact as assessed qualitatively. Providing chief residents with skills and resources to become change agents through a longitudinal curriculum in a cohort model improves individual self-efficacy and responses to exemplar cases. Assessment of the overall impact on individual programs and institutional climate is planned.
Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect
Authors: Zhou Zhegang , Qin Haotian , Marei Abdelhakim Ezzat , Wen Jingjing , Yu Longbiao , Meng Fanbin , Zhou Tao , Xiao Yingfeng , Zeng Hui , Yu Fei
Published: December 2024

A 57-year-old man presented with a tibial shaft fracture treated with tibial intramedullary nail fixation and plate and screw fixation for fibular fracture. Two weeks postoperatively, the patient developed skin sloughing with exposed bone and metal at the fracture site. Three weeks postoperatively, a physical examination revealed swelling of the left lateral malleolus and lower leg, a skin defect of approximately 3 × 5 cm2 at the lower third of the left tibia with an exposed fracture site and hardware in between the fracture fragments. The patient underwent debridement, removal of the intramedullary nail, vacuum sealing drainage, removal of the fibular plate, repositioning, and application of an external fixator. Antibiotic-impregnated bone cement was applied at the fracture site. One week postoperatively, the medullary canal was debrided, and a free anterolateral thigh flap was designed to repair the skin defect. Approximately 5 cm of the opposed fracture fragments was removed from the tibia, and antibiotic-calcium sulfate bone substitutes were applied to the fracture site. Definitive fixation was obtained by a circular external fixation and a minimally invasive osteotomy of the proximal tibia was performed. The patient had no recurrence of infection, and his limb function has recovered well.
INTRAVITREAL BEVACIZUMAB FOR THE TREATMENT OF CHOROIDAL HEMANGIOMAS
Authors: Elkayal Hassan E. , Sagoo Mandeep S. , Negretti Guy S.
Published: December 2024

Purpose:

To investigate the use of intravitreal bevacizumab for the treatment of subretinal fluid (SRF) and intraretinal fluid associated with circumscribed choroidal hemangiomas.

Methods:

This was a retrospective review of all patients treated with at least three bevacizumab injections for circumscribed choroidal hemangiomas–associated SRF between May 2020 and August 2023 in Moorfields eye hospital. Outcome measures included change in best-corrected visual acuity, change in patient-reported symptoms, change in SRF, and change in central subfield thickness. Data on further management after cessation of injections were analyzed.

Results:

The study included nine patients. Median best-corrected visual acuity was 6/19 before and 6/24 after injections (P = 0.41). Central subfield thickness decreased from a median of 466 to 447 µm (P = 0.11). Two thirds of (n = 6) patients did not show any reduction in foveal SRF, one third (n = 3) showed a partial reduction, and no patients had a complete resolution of SRF. Eight patients received rescue-photodynamic therapy, and one received external beam radiotherapy. Best-corrected visual acuity changed from a median of 6/60 to a median of 6/12 after rescue treatment (P = 0.63). The median central subfield thickness decreased significantly from 470 µm to 249 µm (P = 0.01).

Conclusion:

Intravitreal bevacizumab is unlikely to be an effective treatment for exudative circumscribed choroidal hemangiomas.
Anterior segment pharmacological accommodative changes and its impact on the circumferential anterior chamber angle after ICL V4c implantation
Authors: Liu Shengtao , Cheng Mingrui , Liu Fang , Lin Feng , Xiao Yichen , Wang Xiaoying , Zhou Xingtao
Published: December 2024

Purpose:

To investigate the pharmacological accommodative changes of the anterior segment and its impact on the circumferential anterior chamber angle (ACA) after implantable collamer lens (ICL) implantation using swept-source optical coherence tomography (SS-OCT).

Setting:

Eye and ENT Hospital, Fudan University, Shanghai, China.

Design:

Prospective randomized contralateral eye study.

Methods:

8 men and 24 women (mean age, 28.2 ± 5.8 years; range, 19 to 42 years); 64 eyes were included at 3 months after ICL implantation. One eye per patient was randomly assigned to undergo tropicamide instillation (mydriasis group), and the contralateral eye underwent pilocarpine instillation (miosis group). SS-OCT examinations were performed before and after instillation to measure angle parameters. Trabecular–iris angle 500 (TIA500), angle opening distance 500 (AOD500), trabecular–iris space area (TISA500), angle opening distance circumference area 500 (AODA500), trabecular–iris circumference volume 500 (TICV500), and central vault (ICL to crystalline lens [ICL-L]) were evaluated.

Results:

Relative to baseline levels, TIA500, AOD500, and TISA500 values all increased significantly in both groups (all P < .01). AODA500 and TICV500 values increased by 19.7% and 12.1%, respectively, in the mydriasis group (all P < .001), and these values similarly increased by 23.4% and 27.7%, respectively, in the miosis group (all P < .001). After instillation, the ICL-L decrease in the miosis group was significantly larger than that in the mydriasis group (P = .004). Mean AOD500, TISA500, and TICV500 in the miosis group were significantly larger than those in the mydriasis group (all P ≤ .036), especially at 8 and 10 o'clock (all P ≤ .014). Correlation analyses indicated that the increase in ACA parameters was positively correlated with the change in ICL-L for both groups.

Conclusions:

Pilocarpine induced a more significant increase in ACA than tropicamide, because of a different mechanism of anterior segment changes. A circumferential meridian scan to assess angle status is recommended.
Acute Care Physical Therapy Literature
Authors: Toonstra Amy , Kumble Sowmya , Steinhorn Gabrielle , Skrzat Julie
Published: December 2024

Purpose:

Acute care physical therapy (PT) is a rapidly evolving area of practice. To ensure continuity and consistency of care and advance the science effectively, communication between clinicians, researchers, and academicians is essential. This can occur in the form of literature. Unfortunately, barriers limit dissemination, integration, and progression of literature to all interested parties. The purpose of this article is to highlight selected acute care PT literature published in 2023 to share current knowledge amongst all members of the acute care PT community.

Methods:

Acute care PT literature from the year 2023 was searched for and reviewed. Articles for presentation were selected based on relevance to today’s health care environment, hot topics, and the anticipated future of acute care PT.

Results:

Articles were stratified into value-based care, clinical practice including differential diagnoses and treatment dosage, and entry level Doctor of PT didactic and clinical education. Following the summary of each topic’s articles, clinical relevance and future directions are discussed.

Conclusions:

Evidence supports the importance of intra-professional collaboration. The acute care PT community must work together to further demonstrate our value in a rapidly changing health care environment, optimize patient outcomes through progressive interventions and rigorous outcome measures, and implement novel techniques to educate the next generation of physical therapists.
Nutritional therapy for gastroparesis
Authors: Wang Zhen , Song Qin-Zhou , Jiang Jin-Xun , Wu Xiang-Hua , Chen Jun-Qiang
Published: December 2024

Gastroparesis is a common postoperative complication of abdominal surgery, mainly manifested by postprandial fullness, early satiety, nausea, vomiting, and bloating. Gastroparesis should be addressed with a comprehensive treatment plan that includes nutritional therapy and medications such as metoclopramide, domperidone, cisapride, and antiemetic drugs. Surgical treatment, such as pyloroplasty or partial gastrectomy, should be considered if the conservative therapy is ineffective. Enteral and parenteral nutrition therapy can promote the recovery of gastrointestinal function, maintain the mucosal integrity and immunity, and reduce complications. Thus, nutrition can play an important role in the treatment of gastroparesis.
Using the EPIS Framework to Implement a Physical Activity Promotion Intervention at a Large Academic Healthcare System
Authors: McCarthy Margaret M. , O'Neill Krista , Zhong Judy , Xia Yuhe , Heffron Sean P.
Published: December 2024

Objectives

This study aimed to describe the implementation of a workplace health promotion to address low levels of physical activity (PA).

Methods

Using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, we implemented and evaluated a 10-week workplace step-count challenge to promote PA. All health system employees invited to participate. Data were collected on the exploration, preparation, and implementation phases.

Results

During exploration, we recognized inadequate PA among employees. Meetings with key personnel were held to determine details of the health promotion and obtain support. We pursued a step-count PA intervention, capitalizing on employee ownership of smartphones with accelerometers. Vendors to host the intervention were evaluated. All employees were invited to participate. Participants received weekly messages about improving PA and notifications of weekly challenges. Exit interviews provided feedback and suggestions.

Conclusions

A workplace health promotion focused on employee PA is feasible using EPIS.