bluuebunny/crossref_metadata_2025 huggingface dataset:
Proton Stereotactic Body Radiotherapy for Liver Metastases From Malignant Pancreatic Insulinoma
Authors: Kloeber Jake A , Ebner Daniel K , Jethwa Krishan R , Merrell Kenneth W , Halfdanarson Thorvardur R , Callaghan Cameron M
Published: September 2024

Insulin-producing pancreatic tumors are a common subtype of neuroendocrine tumor. Standard of care includes surgical resection of the pancreatic tumor and medical management with somatostatin analogs. For patients with metastatic disease, tumor control and hypoglycemic symptom relief can be achieved through surgical resection of the tumor, hepatic artery embolization, radiofrequency ablation, or radioembolization using radioactive isotopes as well as with systemic therapy such as somatostatin analogs and everolimus. We present the case of a 74-year-old male with metastatic insulin-producing pancreatic carcinoma. After a long history of successfully controlling his hypoglycemic episodes post-liver wedge resection, bland embolizations subsequently failed to maintain control of the frequency and severity of his hypoglycemic symptoms. Stereotactic body radiotherapy (SBRT) with protons was used to achieve symptomatic control and led to partial radiographic response with complete resolution of his hypoglycemic episodes. This case demonstrates the potential utility of proton SBRT in metastatic insulinomas.
Creating “Iron Triangles”
Authors: Effland Anne
Published: September 2024

This essay suggests the “iron triangle” concept may have possibilities as a foundation for reorienting the farm bill. The essay incorporates the broader concept of “power clusters” to more accurately reflect the shaping of farm policy and to better illustrate the premise that these influence structures might offer a viable pathway forward for a reorientation of farm policy. Focusing on congressional committee jurisdiction and executive branch implementation of policies, the essay provides examples of how power cluster interests groups have used both pathways to expand the range of debate and program coverage associated with agricultural policy, both within and outside the farm bill. Changes to tobacco policy, farm labor assistance, conservation on agricultural lands, and rural development have all been achieved through those pathways, suggesting that creative exploitation of the iron triangle or power clusters approach can offer a strategy for achieving farm bill reorientation goals.
Assessing Electronic Health Records for Describing Racial and Ethnic Health Disparities: A Research Note
Authors: Limburg Aubrey , Young Jordan , Carey Timothy S. , Chelminski Paul Roman , Udalova Victoria M. , Entwisle Barbara
Published: September 2024

The use of data derived from electronic health records (EHRs) to describe racial and ethnic health disparities is increasingly common, but there are challenges. While the number of patients covered by EHRs can be quite large, such patients may not be representative of a source population. One way to evaluate the extent of this limitation is by linking EHRs to an external source, in this case with the American Community Survey (ACS). Relying on a stratified random sample of about 200,000 patient records from a large, public, integrated health delivery system in North Carolina (2016–2019), we assess linkages to restricted ACS microdata (2001–2017) by race and ethnicity to understand the strengths and weaknesses of EHR-derived data for describing disparities. The results in this research note suggest that Black–White comparisons will benefit from standard adjustments (e.g., weighting procedures) but that misestimation of health disparities may arise for Hispanic patients because of differential coverage rates for this group.
Closing Gaps or Holding Steady? The Affordable Care Act, Medicaid Expansion, and Racial Disparities in Coverage, 2010–2021
Authors: Sommers Benjamin D. , Smith Rebecca Brooks , Figueroa Jose F.
Published: September 2024

Context: Medicaid expansion under the Affordable Care Act (ACA) produced major gains in coverage. However, findings on racial and ethnic disparities are mixed and may depend on how disparities are measured. This study examines absolute and relative changes in uninsurance from 2010 to 2021 by race and ethnicity, stratified by Medicaid expansion status.

Methods: The sample included all respondents younger than age 65 (N = 30,339,104) from the American Community Survey, 2010–21. Absolute and relative differences in uninsurance, compared to white Non-Hispanic individuals, were calculated for individuals who were Hispanic; Black; Asian American, Pacific Islander, and Native Hawaiian (AANHPI); American Indian and Alaska Native (AIAN); and multiracial. States were stratified into ever-expanded versus nonexpansion status.

Findings: After the ACA, three patterns of coverage disparities emerge. For Hispanic and Black individuals, relative to white individuals, absolute disparities in uninsurance declined, but relative disparities were largely unchanged in both expansion and nonexpansion states. For AANHPI individuals, disparities were eliminated entirely in both expansion and nonexpansion states. For AIAN individuals, disparities declined in absolute terms but grew in relative terms, particularly in expansion states.

Conclusions: All groups experienced coverage gains after the ACA, but changes in disparities were heterogeneous. Focused interventions are needed to improve coverage rates for Black, Hispanic, and AIAN individuals.
Public Health Insurance Coverage for Immigrants during Pregnancy, Childhood, and Adulthood: A Discussion of Relevant Policies and Evidence
Authors: Wherry Laura R. , Fabi Rachel E. , Steenland Maria W.
Published: September 2024

Context: Despite major expansions in public health insurance under Medicaid and the Children's Health Insurance Program over the last 60 years, many immigrants remain ineligible for coverage.

Methods: The authors discuss the existing federal and state policies that extend public health eligibility to low-income pregnant immigrants, children, and nonelderly adults. They also conduct a literature review and summarize quasi-experimental evidence examining the impact of public health insurance eligibility expansions on insurance coverage, health care use, and health outcomes among immigrants.

Findings: Public health insurance eligibility for immigrants varies widely across states because of the implementation of different federal and state policy options. Previous studies on expanded eligibility identified positive effects on insurance coverage and health care utilization among pregnant and child immigrants as well as some evidence indicating improved health outcomes. Additional research is required to understand the longer-term impacts of expanded coverage and to examine impacts of recent state expansions for adults.

Conclusions: A complicated patchwork of federal and state policies leads to major differences in immigrant access to publicly funded insurance coverage across states and population groups. These policies likely have important implications for immigrant access to health care and health.
Plunge-diving into dynamic body acceleration and energy expenditure in the Peruvian booby
Authors: van Oordt Francis , Silva Jaime , Patterson Allison , Elliott Kyle H.
Published: September 2024

Daily energy expenditure (DEE) is the result of decisions on how to allocate time among activities (resting, commuting and foraging) and the energy costs of those activities. Dynamic body acceleration (DBA), which measures acceleration associated with movement, can be used to estimate DEE. Previous studies of DBA–DEE correlations in birds were carried out on species foraging below their thermoneutral zone, potentially decoupling the DBA–DEE relationship. We used doubly labelled water (DLW) to validate the use of DBA on plunge-diving seabirds, Peruvian boobies (Sula variegata), foraging in waters above their thermoneutral zone (>19°C). Mass-specific DEEDLW in boobies was 1.12 kJ day−1 g−1, and higher in males than in females. DBA alone provided the best fitting model to estimate mass-specific DEEDLW compared with models partitioned per activity and time budget models. Nonetheless, the model parametrizing activity at and away from their onshore breeding colony was the most parsimonious (r=0.6). This r value, although high, is lower than that of all other avian studies, implying that temperature is not the main cause of DBA–DEE decoupling in birds. Time at the colony (∼80% of the day) was the largest contributor to DEE as it was the most time-consuming activity and involved nest defence. However, foraging was the most power-consuming activity (4.6 times higher activity-specific metabolic rate than resting at the colony), and commuting flight was higher than in other gliding seabirds. In short, DBA alone can act as a proxy for DEE, opening avenues to measure the conservation energetics of this seabird in the rapidly changing Peruvian Humboldt Current system.
Dynamic Outside Options and Optimal Negotiation Strategies
Authors: McClellan Andrew
Published: September 2024

We study the design of negotiation strategies when a principal and agent must decide how to split a pie while the agent's outside option changes over time. The principal's optimal strategy under commitment demonstrates a new, but intuitive, set of negotiation dynamics. When the agent is tempted to leave, the principal gradually promises a larger share (decreasing demands) and more time to explore the outside option (decreasing pressure), illustrating a complementarity between these two tools. Although the principal's expected utility is decreasing in the outside option, his expected utility and demands are increasing in the outside option's drift and volatility. (JEL D63, D82, D86)
A Study of Housewives , Self-esteem and Depression in Korean Urban
Authors: Lee Suk
Published: September 2024

In Korea society, speadly economic growth, urbanization and industrialization were changed from traditional large family that was rooted in agricultural society to nuclear family. This change of family type was diminished women’s role in family with industrialization, and women especially the rate of married women’s participation in economic activities has increased year by year. These social changes brought on conflict to wives be remained in home. Especially these conflict revealed in clinic.Wives client have increased at Neuropsychiatric clinic.And this study forcused on self-esteem and depression of housewives and identified the relation ship of self-esteem and depression of housewives by state of working /non—working.The method used in thes study are questionaire method and the wubject of investigation were 143married women living in Seoul. The instrument for thes study were Rosenberg’s Self-esteem Scale, Zung’s Self—Rating Depression Scale. Analysis of data was done by use of frequency, Mean, standard deviation, ANOVA, Pearson correlation coefficient by SPSS /pct Findings are as follows : -1. House wives* self-esteem was degreeof middling (mean 29.10). Aspect dignity, respect of self is lower especially. Working married women was higher level of value(p=.003), ability(p=.000), positive attitude (p=.027) than non-working married women.2. The factor which effect the degree of housewive*s Self-esteem were Age(p=.025), personality(p= .000)，significant person (p=.001), Number of brother and sister (p=.003), nurturing attitude of parent (p=.001), relationship of marriage(p= .000).3. Housewives’s depression was degree of normal (mena 44.65). But, depression was influenced by state of working /non-working. Non-working married women was higher level of crying spells (p=.018), indeciveness(p=.008), personal devaluation (p=. 000), suicidal rumination(p=.014) than working married women. Working married women was higher level of confusion than non-working marreid women.4. The factor which effect the degree of housewives depression were age (p=. 028), personality (p=.024), nurturing attitude of parent(p=.034), relationship of mother-in-law(p=. 001), conflict of husband’s personality (p=. 000), satisfaction of marriage(p=.000).5. The relationship between self-esteem and depression was negativs. The lower level of self-esteem, the higher level of depression(r = .570, p=.000).In this study had not clarified the problem of wives in urban low-income class because of the subject of inbestigation was over middle class wives.But this study shall have evaluated that clarifying the content of housewives* self-esteem and depression through community mental health nursing.
A Survey of Clinical Nurse’s Opinion on Nursing Specialization
Authors: Kim Susie
Published: September 2024

Rapid changes in technology, globalization, and consumerism call for a major transformation not only in economies and businesses to be competitive in the international market but also health delivery systems within a society and related professions. Nursing profession should also train competent nurse - practitioney who can deliver high quality care to meet the needs of health consumers. As a step toward this goal, I condcted a opinion survey of 1,600 clinical nurses (herein after nurses), who attended national and regional conferences between March and November 1995 on nursing specialization. These nurses represent opinion leaders in nursing profession in Korea.Major findgs include: (1) A majority of nurses believe that nursing specialization should be established at the level of that in medical profession. (2)Nrrsing specialization should in principle adopt ICN’s framework, which includes medical-surgical nursing, Maternal-child nursing, pediatric nursing, psychiatric and mental health nursing, geriatric nursing, and community nursing. Detailed description of specializations should be prepared in a flexible term, so that nursing specialization may be able to meet the changing needs of health consumers. (3) Current RN(Registered Nurse) should be called “general nurse(GN)” while those GNs who complete specific special programs stipulated in Article 56 of the Health Practice Law and Article 54 of its Implementing Decree should be called “certified nurse(CN) W and those certified nurses who complete the specialized Master of Nursing Science program, which includes advanced nursing theory courses, clinical experiences, and a research methodology course, should be called “advanced practice nurse(APN) W . (4) The criteria and standards of training programs for CN and APN should be establixhed not by a single organization but in joint efforts among Korean Academy of Nursing, Certified nurses* society, and other related organizations. (5) The current one-year training program for CN is adequate. (6) APN should be required to pass licensing examinations to be administered jointly by various nursing organizations. License should, however, be issued by the government. (7) 52.3% of surveyed nurses aspire to become an APN within four years. Preferred specialization are in the order of medical - surgical nursing, community nursing, psychiatric and mental health nursing, maternal-child nursing, pediatric nursing, and geriatric nursing.
Prothrombotic state and thrombotic events in COVID-19 pandemic period, including portal vein and splenic artery thromboses
Authors: Karcioglu Ozgur , Akman Canan , Ozturk Göksu Afacan
Published: September 2024

This editorial article is intended to perform a discussion on the manuscript entitled “Simultaneous portal vein thrombosis and splenic vein thrombosis in a COVID-19 patient: A case report and review of literature” written by Abramowitz et al . The article focuses on the diagnostic processes in a 77-year-old-male patient with a simultaneous portal vein and splenic artery thrombosis accompanying coronavirus disease 2019 (COVID-19). The authors postulated that splanchnic thrombosis should be on the list of differential diagnoses in a patient presenting with abdominal pain in presence of a COVID-19 infection. The tendency for venous and arterial thrombosis in COVID-19 patients is encountered, largely attributed to hypercoagulopathy. In general, venous thromboembolism mostly manifest as deep vein thrombosis (DVT), pulmonary embolism (PE) or catheter-related thromboembolic events. Acute PE, DVT, cerebrovascular events and myocardial infarction are seen as the most common thromboembolic complications in COVID-19 patients. COVID-19-associated hemostatic abnormalities include mild thrombocytopenia and increased D-dimer level. Similar to other coagulopathies, the treatment of the underlying condition is the mainstay. Addition of antiplatelet agents can be considered in critically ill patients at low bleeding risk, not on therapeutic anticoagulation, and receiving gastric acid suppression Early administration of antithrombotic drugs will have a beneficial effect in both the prevention and treatment of thrombotic events, especially in non-ambulatory patients. Low molecular weight heparin (LMWH) should be started if there is no contraindication, including in non-critical patients who are at risk of hospitalization LMWH (enoxaparin) is preferred to standard heparin.
Risk factors and risk prediction model for mucocutaneous separation in enterostomy patients: A single center experience
Authors: Liu Yun , Li Hong , Wu Jin-Jing , Ye Jian-Hong
Published: September 2024

BACKGROUND

Mucocutaneous separation (MCS) is a common postoperative complication in enterostomy patients, potentially leading to significant morbidity. Early identification of risk factors is crucial for preventing this condition. However, predictive models for MCS remain underdeveloped.

AIM

To construct a risk prediction model for MCS in enterostomy patients and assess its clinical predictive accuracy.

METHODS

A total of 492 patients who underwent enterostomy from January 2019 to March 2023 were included in the study. Patients were divided into two groups, the MCS group (n = 110), and the non-MCS (n = 382) based on the occurrence of MCS within the first 3 weeks after surgery. Univariate and multivariate analyses were used to identify the independent predictive factors of MCS and the model constructed. Receiver operating characteristic curve analysis was used to assess the model’s performance.

RESULTS

The postoperative MCS incidence rate was 22.4%. Suture dislodgement (P < 0.0001), serum albumin level (P < 0.0001), body mass index (BMI) (P = 0.0006), hemoglobin level (P = 0.0409), intestinal rapture (P = 0.0043), incision infection (P < 0.0001), neoadjuvant therapy (P = 0.0432), stoma site (P = 0.0028) and elevated intra-abdominal pressure (P = 0.0395) were potential predictive factors of MCS. Suture dislodgement [P < 0.0001, OR: 28.0075 95%CI: (11.0901-82.1751)], serum albumin level (P = 0.0008, OR: 0.3504, 95%CI: [0.1902-0.6485]), BMI [P = 0.0045, OR: 2.1361, 95%CI: (1.2660-3.6235)], hemoglobin level [P = 0.0269, OR: 0.5164, 95%CI: (0.2881-0.9324)], intestinal rapture [P = 0.0351, OR: 3.0694, 95%CI: (1.0482-8.5558)], incision infection [P = 0.0179, OR: 0.2885, 95%CI: (0.0950-0.7624)] and neoadjuvant therapy [P = 0.0112, OR: 1.9769, 95%CI: (1.1718-3.3690)] were independent predictive factors and included in the model. The model had an area under the curve of 0.827 and good clinical utility on decision curve analysis.

CONCLUSION

The mucocutaneous separation prediction model constructed in this study has good predictive performance and can provide a reference for early warning of mucocutaneous separation in enterostomy patients.
Tricuspid mass-curious case of Li-Fraumeni syndrome: A letter to the editor
Authors: Al-Haggar Mohammad S , Abdelmoneim Zahraa A
Published: September 2024

We focus specifically on the rare occurrence of cardiac thrombi in Li-Fraumeni syndrome (LFS). LFS is a hereditary risk to a diverse range of specific, uncommon, malignancies. Children and young adults have a heightened susceptibility to many malignancies, particularly soft-tissue and bone tumors, breast malignancies, central nervous system malignancies, adrenocortical carcinoma, and blood cancers. Additionally, LFS patients may experience other cancer types such as gastrointestinal, lung, kidney, thyroid, and skin cancers, along with those affecting gonadal organs (ovaries, testicles, and prostate). An accurate diagnosis of LFS is crucial to enable affected families to access appropriate genetic counseling and undergo surveillance for early cancer detection.
Secondary diabetes due to different etiologies: A problem worthy of attention
Authors: Wei Zhao , Wang Xue-Jian
Published: September 2024

There are many factors in the occurrence of diabetes, which can result in insufficient insulin secretion and insulin receptor resistance. Including pituitary tumors, can also lead to the occurrence of diabetes, if the primary disease can not be well controlled in time, such secondary diabetes control is more difficult. In the process of clinical diagnosis and treatment, these factors need to be taken into account, timely detection and treatment of primary diseases, so as to reduce the possibility of clinical missed diagnosis.
Flexner's legacy and the future of medical education: Embracing challenge and opportunity
Authors: Zeren Quzhen , Zeng Yan , Zhang Jun-Wen , Yang Jian
Published: September 2024

This editorial comments on the article by Alzerwi. We focus on the development course, present challenges, and future perspectives of medical education. Modern medical education is gradually undergoing significant and profound changes worldwide. The emergence of new ideas, methodologies, and techniques has created opportunities for medical education developments and brought new concerns and challenges, ultimately promoting virtuous progress in medical education reform. The sustainable development of medical education needs joint efforts and support from governments, medical colleges, hospitals, researchers, administrators, and educators.
Reflections on the Early Works of Ghassan Kanafani
1
Authors: Brehony Louis , Silmi Amira , Baroud Ramzy , Rubeo Romana , Abisaab Malek
Published: September 2024

Emerging from the confluent processes of translation, research, and discussion that shaped Ghassan Kanafani: Selected Political Writings (2024), this article consists of a set of reflections on the notebooks composed by Kanafani during an earlier, formative period of his political thought. The analyses that follow are based on three unpublished translations of texts from the mid to late 1950s: “A Methodology for Implementing Arab Socialism,” “The Arab cause during the era of the United Arab Republic,” and “Marxism in Theory and Practice: A Discussion.” Setting the context for the distinct themes that occupied Kanafani as a young Arabist, contributors to this study trace the engagement of the writer with socialism, as a dynamic process with the most oppressed sections of humanity as its basis. Read together, the reflections offer new grounding to understandings of political development, and the role played by Marxism in the transformation of the Arab Nationalist Movement and its adherents.
Numerical simulation and experimental study on guidance performance of hypersonic seeker under aerodynamic optical transmission effects
Authors: Zhang Wenzhi , Ju Lin , Fan Wenwen , Zhang Yichao , Ning Yangang , Guo Huigai , Chen Shouqian , Fan Zhigang
Published: September 2024

When a hypersonic seeker flies at high speed within the atmosphere, intense interaction with the incoming flow gradually develops into a complex turbulent flow field. This interaction results in complex thermal responses at the seeker window, causing aerodynamic optical effects such as image shift, jitter, and blur of the target image, thereby restricting the seeker's detection capability and accuracy. This paper uses a numerical simulation model for the guidance performance of a hypersonic seeker under aerodynamic optical transmission effects. The study focuses on an ellipsoidal seeker, with its supersonic flight simulation on the basis of the Reynolds-Averaged Navier-Stokes (RANS) equations to get a non-uniform gradient flow field. The correctness of the flow filed results can be verified by wind tunnel experiments. The transient temperature field of the seeker is solved using an unsteady thermal conduction-radiation coupled fluid-solid heat transfer method. Finally, the guidance performance of the hypersonic seeker under aerodynamic optical effects is predicted using the ray tracing method, which employs wavefront aberration, point spread function, degraded images, and image shift.
Optical absorption spectrum reveals gaseous chlorine in anti-resonant hollow core fibers
Authors: Harrington K. , Mears R. , Stone J. M. , Wadsworth W. J. , Knight J. C. , Birks T. A.
Published: September 2024

We have observed unexpected spectral attenuation of ultraviolet light in freshly drawn hollow core optical fibers. When the fiber ends are left open to atmosphere, this loss feature dissipates over time. The loss matches the absorption spectrum of gaseous (molecular) chlorine and, given enough time, the transmission spectrum of the fiber recovers to that expected from the morphological structure of the fiber. Our measurements indicate an initial chlorine concentration of 0.45 µmol/cm3 in the hollow core, equivalent to 1.1 mol% Cl2 at atmospheric pressure.
Coupling of two helical circular waveguides
Authors: Cui Mingjie , Wang Zhuo , Yu Changyuan
Published: September 2024

Coupling between optical waveguides has always been an important topic. By using the finite element method (FEM) based on a helicoidal coordinate system, we present a detailed study of the couplings between two helical coupled circular waveguides, showing several important aspects that were not found in previous studies. Our numerical results show that for the two-fold rotationally symmetric cases, intersections will appear in the effective index curves of the two composite modes with increasing twist rate, and we have found that this is related to the different increases of the composite modes in the helical path and the emergence of high-order harmonics. Further, for the one-fold rotationally symmetric structures formed by the two waveguides with the same radical but different azimuthal positions, as the twist rate increases, we observe the emerging asymmetric modal distributions of the composite modes, indicating that couplings between the two waveguides are no longer equivalent.
Kilowatt-level supercontinuum generation employing a homemade taper-shaped ytterbium-doped fiber amplifier
Authors: Dai Jianan , Hong Zhifeng , Pan Zhiyong , Zhu Xiran , Zhang Bin , Hou Jing
Published: September 2024

A simple generation method of high-power supercontinuum (SC) based on a homemade long ytterbium-doped taper fiber (T-YDF) amplifier has been demonstrated experimentally and analyzed in this work. The power and spectra of the obtained SC are made adjustable by changing the seed pulse repetition rates. Under a 7.5 MHz seed pulse repetition rate, a SC output is obtained with a spectral range of 1000 nm–1650 nm, maximum output power of 1066 W, and conversion efficiency of 75.7%. The core/clad diameters of the homemade T-YDF are ∼20/400 µm and ∼30/600 µm at the input and output ends, respectively, and the total length is 25 m. Such a long taper fiber can further enhance the properties of the SC while ensuring high power and good beam quality. To the best of the authors’ knowledge, this is the first report of directly generating a high average power SC based on the T-YDF amplifier, which provides a proof-of-concept experiment to achieve a high average power SC source and greatly improves the potential application value of the SC source.
Wideband FMCW radar for long-distance target detection based on photonic chirp pulse stitching
Authors: Zhu Zhengyuan , Li Shangyuan , Xue Xiaoxiao , Zheng Xiaoping
Published: September 2024

Current wideband frequency-modulated continuous-wave (FMCW) radar fails
in detecting long-distance target, since only the target whose echo is
temporally close to the reference linear frequency modulation (LFM)
chirp can be detected. We propose a long-distance target detection
method for the wideband FMCW radar based on photonic chirp pulse
stitching. The stitching photonic chirp pulse that is generated
through optical up- and downconversion of the LFM is employed as local
signal for the de-chirping process instead of the LFM itself, as
currently used. By adjusting the transmitting signal period, a
theoretically arbitrarily large detection distance can be obtained
with the proposed method. Experiments obtain high-resolution range
profiles for two targets located at 1.44 km and 14.5 km,
respectively, proving the feasibility of the proposed scheme.
Metro-scale QKD using multimode fiber
Authors: Brzosko A. , Woodward R. I. , Lo Y. S. , Pittaluga M. , Smith P. R. , Dynes J. F. , Shields A. J.
Published: September 2024

We report a proof-of-principle realization of a decoy-state BB84 quantum key distribution (QKD) protocol with phase encoding over a record-breaking 17 km of multimode fiber (MMF) at a rate of 193 kbits/s, as well as over 1 Mbit/s at a distance of 1 km. These results suggest that QKD can be deployed over MMF in metropolitan-scale telecommunication connections. Such MMF metropolitan networks are ubiquitous—thus, this advance could pave the way to wide scale metropolitan deployment. We also assess the advantages of adapting the OM3 channel using mode-matching photonic lanterns on the quantum bit error rate, signal gain, and key rate and compare different encoding techniques in light of MMF propagation effects. This work confirms the suitability of current QKD technology for use in existing MMF links, unlocking new opportunities for quantum applications using legacy fiber.
HELP: A computational framework for labelling and predicting human common and context-specific essential genes
Authors: Granata Ilaria , Maddalena Lucia , Manzo Mario , Guarracino Mario Rosario , Giordano Maurizio
Published: September 2024

Machine learning-based approaches are particularly suitable for identifying essential genes as they allow the generation of predictive models trained on features from multi-source data. Gene essentiality is neither binary nor static but determined by the context. The databases for essential gene annotation do not permit the personalisation of the context, and their update can be slower than the publication of new experimental data. We propose HELP (Human Gene Essentiality Labelling & Prediction), a computational framework for labelling and predicting essential genes. Its double scope allows for identifying genes based on dependency or not on experimental data. The effectiveness of the labelling method was demonstrated by comparing it with other approaches in overlapping the reference sets of essential gene annotations, where HELP demonstrated the best compromise between false and true positive rates. The gene attributes, including multi-omics and network embedding features, lead to high-performance prediction of essential genes while confirming the existence of essentiality nuances.
Algebraic method for multisensor data fusion
Authors: Chen Xiangbing , Chen Chen , Lu Xiaowen
Published: September 2024

In this contribution, we use Gaussian posterior probability densities to characterize local estimates from distributed sensors, and assume that they all belong to the Riemannian manifold of Gaussian distributions. Our starting point is to introduce a proper Lie algebraic structure for the Gaussian submanifold with a fixed mean vector, and then the average dissimilarity between the fused density and local posterior densities can be measured by the norm of a Lie algebraic vector. Under Gaussian assumptions, a geodesic projection based algebraic fusion method is proposed to achieve the fused density by taking the norm as the loss. It provides a robust fixed point iterative algorithm for the mean fusion with theoretical convergence, and gives an analytical form for the fused covariance matrix. The effectiveness of the proposed fusion method is illustrated by numerical examples.
Protocol for exploring pathways to equitable outcomes in post-stroke aphasia and dysphagia
Authors: Ellis Charles , Perraillon Marcello , Lindrooth Richard , Jacobs Molly , Hegland Karen , Grubaugh Anouk , Adams-Mitchell Candice
Published: September 2024

Introduction

Longstanding racial disparities in stroke-related outcomes have been well documented. However, the underlying causes of observed disparities have neither been clearly determined nor have strategies to mitigate disparities been developed. Evidence suggests that racial disparities may be partially explained by structural barriers that can arise from implicit and explicit provider biases, institutional practices, public policies, or characteristics of the community where patients reside and recover from their conditions. The objective of this study is to move beyond traditional measures of disparities by identifying the mechanisms that drive these observed disparities in aphasia and dysphagia across the continuum of care. In this study we will follow stroke survivors for 12 months post-discharge, which will allow us to examine the patient, provider, health system, and administrative factors that impact their aphasia and dysphagia recovery.

Methods

This study will utilize a 100% sample of Medicare fee-for-service claims data for persons hospitalized for stroke. Patients discharged from acute stroke care will be followed for at least 12 months to measure the timing of post-acute care transition(s) and post-acute care speech-language pathology (SLP) utilization. Functional communication and swallowing outcomes will be measured at initiation, conclusion of post-acute care treatment, and points in-between allowing us to link improvement of functional communication (i.e., aphasia) and swallowing ability (i.e., dysphagia) to aphasia/dysphagia treatments as patients transition through post-acute settings. Then, using regression decomposition methods, we will examine the relationships between race and: (a) where patients receive treatment, (b) the timing of transition between sites of care, and (c) the quality of care received. Decomposition methods will allow us to elucidate the multiple factors that contribute to underlying observed health disparities by quantifying the extent to which differences between the outcomes of two groups are explained by 1) differential endowments or characteristics, such as geographic access, education, risk factors, or insurance coverage; or 2) differences in decision-making, defined as between group differences in outcomes despite equal endowments or unmeasured differences.

Discussion

We hypothesize that racial disparities in aphasia and dysphagia outcomes will not only result from differences in the quantity and timing of services provided in the post-acute and community settings, but also structural differences at the community level. These findings will provide a more comprehensive understanding of healthcare use and outcomes.
Initial experimentation with tobacco is associated with subsequent tobacco use patterns among youth in the United States
Authors: El-Shahawy Omar , Walker Kandi L. , Groom Allison M. , Payne Thomas J. , Tompkins Lindsay K. , Kesh Anshula , Landry Robyn , Pfeiffer Jack , Giachello Aida L. , Vu Thanh-Huyen T. , Ma Jennie Z. , Robertson Rose Marie , Gunturu Sasidhar , Blaha Michael J. , Hart Joy L.
Published: September 2024

Understanding the association between initial experimentation with a tobacco product and subsequent patterns of tobacco use among youth is important to informing prevention activities for youth in the US. We conducted an online survey from August to October 2017 among youth aged 13–18 years. The current analysis focused on respondents reporting initial experimentation with any tobacco product (n = 2,022). Using multinomial logistic regression, we examined the association between first tobacco product tried (cigarettes; cigars including cigarillos, little cigars, and bidis; electronic nicotine delivery systems (ENDS); smokeless and chewing tobacco; or hookah) with subsequent patterns of tobacco use while adjusting for covariates. Of the youth who experimented, 56.8% were non-current tobacco users. Of current tobacco users (n = 934), 13% were exclusive ENDS users, 5.3% exclusive combustible mono-users, 13.4% ENDS plus combustible poly-users, 3.3% combustible product only poly-users, and 8.2% other tobacco poly-users. The most common type of first tobacco product tried was ENDS (44.7%), followed by cigarettes (35.0%) and cigars (8.6%). Those who experimented with combustible tobacco products were less likely to be exclusive ENDS users [Relative Risk Ratio (RRR) = 0.46; 95% CI = 0.28, 0.73 for cigarettes; RRR = 0.32; 95% CI = 0.13, 0.81 for cigars; and RRR = 0.33; 95% CI = 0.14, 0.79 for hookah] when compared to non-current tobacco users (reference group). Tobacco product choices for initial experimentation appear to play a role in subsequent tobacco use patterns among youth. Understanding the reasons behind initial product choice may inform our understanding regarding the reasons for subsequent current tobacco product use, thus informing youth prevention efforts.
Type 2 diabetes severity in the workforce: An occupational sector analysis using German claims data
Authors: Safieddine Batoul , Grasshoff Julia , Sperlich Stefanie , Epping Jelena , Geyer Siegfried , Beller Johannes
Published: September 2024

Background

Individuals of working age spend a significant amount of time at the workplace making it an important context for disease prevention and management. The temporal development and prevalence of T2D have been shown to differ in the working population based on gender, age group and occupational sector regardless of socioeconomic status. Given potential differences in risk factors associated with different work environments, this study aims to define vulnerable occupational groups by examining T2D severity and its trends in working men and women with T2D of two age groups and among nine occupational sectors.

Methods

The study is based on claims data of the statutory health insurance provider AOKN. The study population consisted of all insured working individuals with T2D. T2D severity was measured using the adapted diabetes complications severity index—complication count (DCSI-CC). Mean DCSI-CC scores were calculated over four time periods between 2012 and 2019 for men and women of the age groups 18–45 and 46+ years and among nine occupational sectors. Trends of DCSI-CC were investigated using ordinal logistic regression analyses to examine the effect of time-period on the odds of having higher DCSI scores.

Results

Overall, there was a significant rise in T2D severity over time in working men and women of the older age group. Moreover, the study displayed occupational sector differences in T2D severity and its trends. Over all, working men of all sectors had higher DCSI-CC scores compared to working women. Individuals working in the sector “Transport, logistics, protection and security” and “Construction, architecture, measuring and building technology” had higher T2D severity, while those working in the “Health sector, social work, teaching & education” had relatively lower T2D severity. There was a gender-specific significant increase over time in T2D severity in the above-mentioned occupational sectors.

Conclusion

The study displayed gender, age group and occupational sector differences in T2D severity and its trends. Working individuals could thus benefit from personalized prevention interventions that consider occupational contexts. As a next step, examining T2D trends and severity in specific occupations within the vulnerable occupational sectors is needed.
Simulation of cardiac arrhythmias in human induced pluripotent stem cell-derived cardiomyocytes
Authors: Bommer Thea , Knierim Maria , Unsöld Julia , Riedl Dominic , Stengel Laura , Paulus Michael , Körtl Thomas , Liaw Norman , Maier Lars S. , Streckfuss-Bömeke Katrin , Sossalla Samuel , Pabel Steffen
Published: September 2024

The effects and mechanisms of cardiac arrhythmias are still incompletely understood and an important subject of cardiovascular research. A major difficulty for investigating arrhythmias is the lack of appropriate human models. Here, we present a protocol for a translational simulation of different types of arrhythmias using human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) and electric cell culture pacing. The protocol comprises the handling of ventricular and atrial hiPSC-CM before and during in vitro arrhythmia simulation and possible arrhythmia simulation protocols mimicking clinical arrhythmias like atrial fibrillation. Isolated or confluent hiPSC-CM can be used for the simulation. In vitro arrhythmia simulation did not impair cell viability of hiPSC-CM and could reproduce arrhythmia associated phenotypes of patients. The use of hiPSC-CM enables patient-specific studies of arrhythmias, genetic interventions, or drug-screening. Thus, the in vitro arrhythmia simulation protocol may offer a versatile tool for translational studies on the mechanisms and treatment options of cardiac arrhythmias.
Contrast enhanced longitudinal changes observed in an experimental bleomycin-induced lung fibrosis rat model by radial DCE-MRI at 9.4T
Authors: in ‘t Zandt René , Mahmutovic Persson Irma , Tibiletti Marta , von Wachenfeldt Karin , Parker Geoff J. M. , Olsson Lars E. ,   on behalf of the TRISTAN Consortium
Published: September 2024

Identifying biomarkers in fibrotic lung disease is key for early anti-fibrotic intervention. Dynamic contrast-enhanced (DCE) MRI offers valuable perfusion-related insights in fibrosis but adapting human MRI methods to rodents poses challenges. Here, we explored these translational challenges for the inflammatory and fibrotic phase of a bleomycin lung injury model in rats. Eleven male Sprague-Dawley rats received a single intratracheal dose of bleomycin (1000iU), four control rats received saline. Imaging was performed on days 7 and 28 post-induction. Ultra-short echo time imaging was used to image the lung for 7 minutes after which Clariscan was injected intravenously. Lung signal changes were measured for an additional 21 minutes. Images were reconstructed with a sliding-window approach, providing a temporal resolution of 10 seconds per image. After imaging on day 28, animals were euthanized, and lungs were collected for histology. Bleomycin-exposed rats initially exhibited reduced body weight, recovering to control levels after 20 days. Lung volume increased in bleomycin animals from 4.4±0.9 ml in controls to 5.5±0.5 ml and 6.5±1.2 ml on day 7 and 28. DCE-MRI showed no change of initial gradient of relative enhancement in the curves between controls and bleomycin animals on day 7 and 28 post-induction. On day 7, the DCE-MRI washout phase in bleomycin animals had higher signals than the saline group and than observed at a later time point. Lung pixels were binned in 7 enhancement classes. On day 28, the size of low relative enhancement bins almost doubled in volume compared to controls and animals on day 7 post-induction. Histology on day 28 suggests that findings could be explained by changes in lung tissue density due to lung volume increase. Adapting this clinical MRI method to rodents at 9.4T remains a challenge. Future studies may benefit from lower field strength MRI combined with higher temporal resolution DCE-MRI.
Influence of peer discussions on trust in recommendations for prevention of mother-to-child transmission (PMTCT) of HIV
Authors: Philemon Rune Nathaniel , Mboya Innocent B. , Mmbaga Blandina T. , Bartlett John , Msuya Sia E.
Published: September 2024

Background

Mothers attending prevention of mother-to-child transmission (PMTCT) of HIV clinics seem to lack knowledge on many aspects of PMTCT, among which is breastfeeding. Breastfeeding recommendations in PMTCT have changed several times over the years leaving some confused and doubtful of what is currently recommended. One method shown to help improve their knowledge and acceptance of PMTCT recommendations is the use of peer educators. We sought to determine if mothers engage in discussions with other mothers during clinics and how these engagements influence trust in PMTCT recommendations.

Methods

We interviewed 524 mothers with children under two years enrolled in PMTCT clinics in Kilimanjaro, Tanzania. We selected 5 clinics with the highest numbers of PMTCT enrolment from each district in the region. In each clinic, over a one-month period, we recruited all mothers attending the PMTCT clinic. We collected information on their engagement in discussions regarding PMTCT during clinics and how they perceived the information from their peers in relation to that from healthcare providers.

Results

Fifty-five percent of the mothers reported engaging in peer discussions. Of the 90 (17%) mothers who reported noticing a change in PMTCT recommendations, 33 (36.7%) reported trusting previous recommendations more. A greater proportion (52.9%) of mothers who engaged in peer discussions reported trusting the information from peers more than that from healthcare workers.

Conclusions

Peers have a great influence on mothers, which is concerning when their knowledge shared is outdated. Harnessing their influence and training them on current recommendations might be key to improving adherence to PMTCT recommendations.
Creating a diagnostic assessment model for autism spectrum disorder by differentiating lexicogrammatical choices through machine learning
Authors: Kato Sumi , Hanawa Kazuaki , Saito Manabu , Nakamura Kazuhiko
Published: September 2024

This study explores the challenge of differentiating autism spectrum (AS) from non-AS conditions in adolescents and adults, particularly considering the heterogeneity of AS and the limitations of diagnostic tools like the ADOS-2. In response, we advocate a multidimensional approach and highlight lexicogrammatical analysis as a key component to improve diagnostic accuracy. From a corpus of spoken language we developed, interviews and story-recounting texts were extracted for 64 individuals diagnosed with AS and 71 non-AS individuals, all aged 14 and above. Utilizing machine learning techniques, we analyzed the lexicogrammatical choices in both interviews and story-recounting tasks. Our approach led to the formulation of two diagnostic models: the first based on annotated linguistic tags, and the second combining these tags with textual analysis. The combined model demonstrated high diagnostic effectiveness, achieving an accuracy of 80%, precision of 82%, sensitivity of 73%, and specificity of 87%. Notably, our analysis revealed that interview-based texts were more diagnostically effective than story-recounting texts. This underscores the altered social language use in individuals with AS, a crucial aspect in distinguishing AS from non-AS conditions. Our findings demonstrate that lexicogrammatical analysis is a promising addition to traditional AS diagnostic methods. This approach suggests the possibility of using natural language processing to detect distinctive linguistic patterns in AS, aiming to enhance diagnostic accuracy for differentiating AS from non-AS in adolescents and adults.
Compreensão do crowdfunding como redes colaborativas para startups: Uma agenda de pesquisa
Authors: Telles Renato , Goes Weslei , Ferreira Gabriel , Zenke Adriane , Ferraro Rosangela
Published: September 2024

Objetivo: Contribuir para a expansão da eficiência de estratégias de crowdfunding, a partir da incorporação da perspectiva de uma rede colaborativa, no financiamento da operação de partida de startups. Nesse sentido, o foco do estudo residiu na investigação da propriedade da compreensão do processo de crowdfunding como uma rede com gestão e cultura colaborativa. Metodologia: inventário da literatura orientado para a identificação de convergências conceituais entre crowdfunding e redes colaborativas, avaliando-se a viabilidade de aperfeiçoamento potencial de estratégias de crowdfunding por meio da compreensão desse processo como uma rede colaborativa. Relevância/originalidade: o artigo oferece uma abordagem inovadora e adicional para a estratégia de crowdfunding, colaborando conceitual e operacionalmente no seu design e gestão, quando considerada como uma rede de colaboração. Resultados: o estudo oferece um cotejamento conceitual consistente entre dimensões associadas a crowdfunding e redes colaborativas, iden