bluuebunny/crossref_metadata_2025 huggingface dataset:
CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool—a protocol paper
Authors: Cochran Gerald T. , Brown Jennifer L. , Yu Ziji , Gordon Adam J. , Frede Stacey , Hardy Clinton , Castora-Binkley Melissa , Homsted Felicity , Marsch Lisa A. , Holtyn August F. , Winhusen T. John
Published: November 2024

Background

As the opioid epidemic continues to have a major negative impact across the US, community pharmacies have come under scrutiny from legal systems attempting to hold them accountable for their role in over dispensing and lack of patient intervention. While the most available tool for monitoring patients’ opioid use is Prescription Drug Monitoring Programs (PDMP), these do not provide pharmacists with actionable information and decision support. Our study addresses this gap through three objectives: [1] incorporate validated opioid risk metric thresholds into a PDMP platform to create the Opioid Risk Reduction Clinical Decision Support (ORRCDS) tool; [2] assess ORRCDS’ ability to reduce patient opioid risk; [3] assess ORRCDS’ sustainability and viability for broader dissemination in community pharmacy.

Methods

For objective 1, our team is partnering with leadership from the largest US PDMP organization and a top-five pharmacy chain to implement ORRCDS into the pharmacy chain’s workflow following the Guideline Implementation with Decision Support (GUIDES) framework. For objective 2, our team will conduct a type-1 implementation mixed methods study using a 2-arm parallel group clustered randomized design. We anticipate enrolling ~ 6,600 patients with moderate and high opioid use risk during the 6-month enrollment phase across 80 pharmacies. This sample size will provide 96.3% power to detect a 5% or greater difference in responder rate between the intervention and control arm. Responders are patients with moderate-risk at baseline who reduce to low-risk or those with high-risk at baseline who reduce to moderate or low-risk at 180 days post last intervention. To accomplish objective 3, we will use the Consolidated Framework for Implementation Research (CFIR) to develop and execute cross-sectional qualitative interviews with pharmacists (n = 15), pharmacy leaders (n = 15), and PDMP leaders (n = 15) regarding long term adoption and sustainability of the ORRCDS tool.

Conclusions

A PDMP tool that addresses moderate- and high-risk opioid use is not available in community pharmacy. This study will implement ORRCDS in a large retail pharmacy chain that will include additional screening and guidance to pharmacy staff to address risky opioid medication use. Our results will make critical advancements for protecting patient health and addressing the opioid epidemic.
Roles of posttranslational modifications in lipid metabolism and cancer progression
Authors: Feng Tianyu , Zhang He , Zhou Yanjie , Zhu Yalan , Shi Shiya , Li Kai , Lin Ping , Chen Jie
Published: November 2024

Lipid metabolism reprogramming has emerged as a hallmark of malignant tumors. Lipids represent a complex group of biomolecules that not only compose the essential components of biological membranes and act as an energy source, but also function as messengers to integrate various signaling pathways. In tumor cells, de novo lipogenesis plays a crucial role in acquiring lipids to meet the demands of rapid growth. Increasing evidence has suggested that dysregulated lipid metabolism serves as a driver of cancer progression. Posttranslational modifications (PTMs), which occurs in most eukaryotic proteins throughout their lifetimes, affect the activity, abundance, function, localization, and interactions of target proteins. PTMs of crucial molecules are potential intervention sites and are emerging as promising strategies for the cancer treatment. However, there is limited information available regarding the PTMs that occur in cancer lipid metabolism and the potential treatment strategies associated with these PTMs. Herein, we summarize current knowledge of the roles and regulatory mechanisms of PTMs in lipid metabolism. Understanding the roles of PTMs in lipid metabolism in cancer could provide valuable insights into tumorigenesis and progression. Moreover, targeting PTMs in cancer lipid metabolism might represent a promising novel therapeutic strategy.
Synthesis and characterization of titanium oxynitride catalyst via direct ammonia nitridation of titanium polyacrylate for oxygen reduction reaction
Authors: Tamaki Yushi , Seino Satoshi , Shinyoshi Naoki , Uetake Yuta , Nagai Takaaki , Monden Ryuji , Ishihara Akimitsu , Nakagawa Takashi
Published: November 2024

A titanium oxynitride catalyst for the oxygen reduction reaction (ORR) in polymer electrolyte fuel cells was synthesized through the direct ammonia nitridation of titanium complexes. Titanium polyacrylate was employed as the catalyst precursor, and the effect of the calcination temperature between 600 and 1000 °C on the catalyst structure was studied. The catalysts were characterized via X-ray diffraction, X-ray absorption spectroscopy, transmission electron microscopy, cyclic voltammetry, and powder electrical resistivity measurements. The formation of titanium oxynitride particles and deposited carbon was observed for all the samples; however, significant variations in the catalyst structure and catalytic activity were also observed. With an increase in the calcination temperature, nitridation of titanium oxynitride progressed, and the conductivity of the catalyst powder increased. The highest rest potential and ORR current density were achieved with calcination at 800 °C. Importantly, the results suggest that maintaining an optimal nitrogen doping level within the catalyst particles, along with ensuring the formation of electroconductive deposited carbon, is essential for achieving a high ORR current. This work introduces the direct ammonia nitridation of metal complexes as a promising process for designing metal oxynitride catalysts.
Survey of real-time brainmedia in artistic exploration
Authors: Lin Rem RunGu , Zhang Kang
Published: November 2024

This survey examines the evolution and impact of real-time brainmedia on artistic exploration, contextualizing developments within a historical framework. To enhance knowledge on the entanglement between the brain, mind, and body in an increasingly mediated world, this work defines a clear scope at the intersection of bio art and interactive art, concentrating on real-time brainmedia artworks developed in the 21st century. It proposes a set of criteria and a taxonomy based on historical notions, interaction dynamics, and media art representations. The goal is to provide a comprehensive overview of real-time brainmedia, setting the stage for future explorations of new paradigms in communication between humans, machines, and the environment.
Estimating soil strength using ultra high-resolution seismic data: A case study from a shallow water wind farm
Authors: Zhu Donglin , Jin Ge , Shang Xuefeng , Shen Yi , Chen Jinbo , Goh Vanessa
Published: November 2024

The increasing global reliance on offshore wind farms as a sustainable energy source necessitates precise soil assessment for foundation design due to their high foundation costs and complex integration into marine environments. This study explores the use of ultrahigh-resolution seismic (UHRS) data in conjunction with cone penetration test data for soil strength estimation in offshore wind farm development. We develop a convolutional neural network-based approach that leverages UHRS data for direct soil strength estimation, aiming to address the challenges of limited cone penetration test measurements and potential overfitting in complex geologic settings. Our methodology involves preprocessing UHRS and cone penetration test data, interpreting and integrating geologic unit (GU) information, and applying repeated k-fold cross validation to evaluate model performance. The field data results demonstrate the model’s efficacy in accurately predicting cone penetration test curve trends, albeit with some amplitude discrepancies. We highlight the significance of geologic interpretation in predicting soil strength and identify the dependency on valid data within each GU as a limitation.
Automatic identification of the endangered hawksbill sea turtle behavior using deep learning and cross-species transfer learning
Authors: Jeantet Lorène , Zondo Kukhanya , Delvenne Cyrielle , Martin Jordan , Chevallier Damien , Dufourq Emmanuel
Published: November 2024

The accelerometer, an onboard sensor, enables remote monitoring of animal posture and movement, allowing researchers to deduce behaviors. Despite the automated analysis capabilities provided by deep learning, data scarcity remains a challenge in ecology. We explored transfer learning to classify behaviors from acceleration data of critically endangered hawksbill sea turtles (Eretmochelys imbricata). Transfer learning reuses a model trained on one task from a large dataset to solve a related task. We applied this method using a model trained on green turtles (Chelonia mydas) and adapted it to identify hawksbill behaviors such as swimming, resting and feeding. We also compared this with a model trained on human activity data. The results showed an 8% and 4% F1-score improvement with transfer learning from green turtle and human datasets, respectively. Transfer learning allows researchers to adapt existing models to their study species, leveraging deep learning and expanding the use of accelerometers for wildlife monitoring.
Demographic, Disease, and Treatment Characteristics of Primary Tracheal Cancers
Authors: Armel Kristen , Stamey Taylor , Maitre Joseph , Cunningham Andrew R. , Ju Andrew W. , Burke Aidan , Speicher James E. , Navaid Musharraf , Bhatt Arjun , Larkins Michael C.
Published: November 2024

Background

Primary tracheal cancers (PTCs) are rare neoplasms underreported in the literature. No consensus guidelines exist for the treatment of these cancers and multimodal management of these cancers has not been adequately explored for cases diagnosed over the past 2 decades.

Methods

The Surveillance, Epidemiology, and End Results (SEER) database was queried to identify patients with PTC. Cox proportional hazards and log-rank testing was used to assess the association between demographic and treatment variables and 5-year cause-specific survival (CSS).

Results

Among the 689 identified patients, age < 65 years at diagnosis (hazard ratio [HR] 0.64, p < 0.001), non-squamous cell carcinoma (SCC) histology (HR 0.22, p < 0.001), and treatment with surgery (HR 0.43, p < 0.001) were all associated with increased 5-year CSS. Regarding disease histology, patients with adenoid cystic carcinomas (ACCs) had increased 5-year CSS compared with those with neither SCC nor ACC histology and those with SCC histology (83.4% [76.0%, 90.8%] versus 50.3% [42.5%, 58.1%] and 28.8% [23.2%, 34.4%]; p < 0.001) based on univariate analysis. Despite the improved CSS associated with surgery, 55% of the identified cohort did not undergo surgery, with only 5.5% of these patients having ACC compared with 58% having SCC (p < 0.001).

Conclusions

Age < 65 years, ACC histology, and treatment with surgery were associated with improved 5-year CSS among patients with PTC, although the significant proportion of this group not receiving surgery represents an opportunity for improved outcomes.
Reassessing the Association of Sedentary Behavior and Physical Activity with Ischemic Stroke: A Mendelian Randomization Study
Authors: Lin Yidie , Li Xuechao , Hu Meijing , Zhao Jian , Zhu Cairong
Published: November 2024

Purpose

Findings from previous Mendelian randomization (MR) studies disagreed with the current scientific consensus regarding the role of physical activity (PA) and sedentary behavior in ischemic stroke (IS). We reassessed these associations with a focus on etiological subtypes of IS and the potential mediating roles of cardiometabolic traits and brain imaging-derived phenotypes (IDPs).

Methods

We performed MR analyses using summary statistics from genome-wide association studies of sedentary behavior and PA (n = 88,411~608,595), cardiometabolic traits (n = 393,193~694,649), brain IDPs (n = 33,224) and the latest IS data (62,100 cases and 1,234,808 controls). Inverse-variance weighted regression was used as the primary method, complemented by several sensitivity analyses. A two-step MR approach was employed to assess the mediating effects of cardiometabolic traits and brain IDPs.

Results

Genetic liability to leisure-time moderate-to-vigorous PA (LTMVPA) and higher overall PA (OPA) were associated with reduced risks of IS and small vessel stroke (Benjamini–Hochberg adjusted P < 0.05). Suggestive associations were observed between longer leisure-screen time and higher IS risk and between higher OPA and lower cardioembolic stroke risk (P < 0.05). The isotropic volume fraction in the anterior limb of the left internal capsule (ALIC), as well as some cardiometabolic metrics, partially mediated these associations. There was no evidence for causal effects of overall MVPA, overall light-intensity PA or overall sedentary duration on IS.

Conclusions

Longer LST, less OPA and not engaging in moderate-to-vigorous PA during leisure time were associated with higher risk of ischemic stroke. The associations between PA and ischemic stroke depended on different subtypes and were mediated by changes in ALIC and cardiometabolic biomarkers.
A Single Night in Hypoxia Either with or without Ketone Ester Ingestion Reduces Sleep Quality Without Impacting Next Day Exercise Performance
Authors: Stalmans Myrthe , Tominec Domen , Robberechts Ruben , Lauriks Wout , Ramaekers Monique , Debevec Tadej , Poffé Chiel
Published: November 2024

Background

Sleeping at altitude is highly common in athletes as an integral part of altitude training camps or sport competitions. However, concerns have been raised due to expected negative effects on sleep quality, thereby potentially hampering exercise recovery and next-day exercise performance. We recently showed that ketone ester (KE) ingestion beneficially impacted sleep following strenuous, late evening exercise in normoxia, and alleviated hypoxemia. Therefore, we hypothesized that KE ingestion may be an effective strategy to attenuate hypox(em)ia-induced sleep dysregulations.

Methods

Eleven healthy, male participants completed three experimental sessions including normoxic training and subsequent sleep in normoxia or at a simulated altitude of 3,000 m while receiving either KE or placebo post-exercise and pre-sleep. Sleep was evaluated using polysomnography, while next-day exercise performance was assessed through a 30-min all-out time trial (TT30’). Physiological measurements included oxygen status, heart rate variability, ventilatory parameters, blood acid-base balance and capillary blood gases.

Results

Hypoxia caused a ~3% drop in sleep efficiency, established through a doubled wakefulness after sleep onset and a ~22% reduction in slow wave sleep. KE ingestion alleviated the gradual drop in SpO2 throughout the first part of the night, but did not alter hypoxia-induced sleep dysregulations. Neither KE, nor nocturnal hypoxia affected TT30’ performance, but nocturnal hypoxia hampered heart rate recovery following TT30’.

Conclusions

We observed that sleeping at 3,000 m altitude impairs sleep efficiency. Although this hypoxia-induced sleep disruption was too subtle to limit exercise performance, we for the first time indicate that sleeping at altitude might impair next-day exercise recovery. KE alleviated nocturnal hypoxemia only when SpO2 values dropped below ~85%, but this did not translate into improved sleep or next-day exercise performance.
Limb Underloading in Walking Transmits Less Dynamic Knee Joint Contact Forces after Anterior Cruciate Ligament Reconstruction
Authors: Munsch Amanda E. , Evans-Pickett Alyssa , Davis-Wilson Hope , Pietrosimone Brian , Rauch Carly M. , Roth Joshua D. , Franz Jason R.
Published: November 2024

Introduction

Individuals with anterior cruciate ligament reconstruction (ACLR) often walk with a less dynamic vertical ground reaction force (vGRF), exemplified by a reduced first peak vGRF and elevated midstance vGRF compared to uninjured controls. However, the mechanism by which altered limb loading affects actual tibial plateau contact forces during walking remains unclear.

Methods

Our purpose was to use musculoskeletal simulation to evaluate the effects of first peak vertical ground reaction force (vGRF) biofeedback on bilateral tibiofemoral contact forces relevant to the development of post-traumatic osteoarthritis (OA) in 20 individuals with ACLR. We hypothesized that reduced first peak vGRF would produce less dynamic tibial plateau contact forces during walking in individuals with ACLR.

Results

As the pivotal outcome from this study, and in support of our hypothesis, we found that less dynamic vGRF profiles in individuals with ACLR – observations that have associated in prior studies with more cartilage breakdown serum biomarkers and reduced proteoglycan density – are accompanied by less dynamic tibiofemoral joint contact forces during walking.

Conclusion

We conclude that more sustained limb-level loading, a phenotype that associates with worse knee joint health outcomes following ACLR and was prescribed herein using biofeedback, alters the loading profile and magnitude of force applied to tibiofemoral cartilage.
Hybrid recommender system model for digital library from multiple online publishers
Authors: Jomsri Pijitra , Prangchumpol Dulyawit , Poonsilp Kittiya , Panityakul Thammarat
Published: November 2024

Background The demand for online education promotion platforms has increased. In addition, the digital library system is one of the many systems that support teaching and learning. However, most digital library systems store books in the form of libraries that were developed or purchased exclusively by the library, without connecting data with different agencies in the same system. Methods A hybrid recommender system model for digital libraries, developed from multiple online publishers, has created a prototype digital library system that connects various important knowledge sources from multiple digital libraries and online publishers to create an index and recommend e-books. The developed system utilizes an API-based linking process to connect various important sources of knowledge from multiple data sources such as e-books on education from educational institutions, e-books from government agencies, and e-books from religious organizations are stored separately. Then, a hybrid recommender system suitable for users was developed using Collaborative Filtering (CF) model together with Content-Based Filtering. This research proposed the hybrid recommender system model, which took into account the factors of book category, reading habits of users, and sources of information. The evaluation of the experiments involved soliciting feedback from system users and comparing the results with conventional recommendation methods. Results A comparison of NDCG scores, and Precision scores were conducted for Hybrid Score 50:50, Hybrid Score 20:80, Hybrid Score 80:20, CF-score and CB-score. The experimental result was found that the Hybrid Score 80:20 method had the highest average NDCG score. Conclusions Using a hybrid recommender system model that combines 80% Collaborative Filtering, and 20% Content-Based Filtering can improve the recommender method, leading to better referral efficiency and greater overall efficiency compared to traditional approaches.
Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child.
Authors: Rivero de Rodriguez Zulbey , Ponce Ader , Vera Anthony , Bracho Angela , Murillo Anita
Published: November 2024

Background The cestode Hymenolepis diminuta is a cosmopolitan parasite, which in the adult stage is usually found in the small intestine of rats and accidentally in humans. Case report We describe the finding of eggs of this parasite in an asymptomatic 3-year-old child. The child had extremely high IgE values of 1,376 IU/ml. After receiving treatment with Albendazole suspension 400mg/20mL, on the 10th day post-treatment, he showed no H. diminuta eggs in his fecal matter Conclusions Detailed morphological review of Hymenolepis nana-like eggs is recommended to distinguish them from H. diminuta eggs.
Methodological literature on the reporting of systematic reviews of health economic evaluations: a scoping review protocol
Authors: Tran Phuong Bich , Kwon Joseph , Bastounis Anastasios , Petrou Stavros , Booth Andrew ,   PRISMA-EconEval Management Group
Published: November 2024

Systematic reviews of health economic evaluations play a crucial role in informing evidence-based healthcare decisions, yet they lack standardized reporting guidelines. A project has been initiated that aims to extend the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline for systematic reviews of health economic evaluations (PRISMA-EconEval). This scoping review forms a foundation for the PRISMA-EconEval project, aiming to identify, map, and extract candidate reporting items from the methodological literature. The scoping review will follow the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist and involve comprehensive searches in databases such as PubMed MEDLINE, Embase, and Web of Science, covering the period from 2015 to 2024. Supplementary searching, reference checking and citation searching will target grey literature, overlooked studies and evidence prior to 2015. Inclusion criteria will focus on methodological papers that provide frameworks or recommendations for reporting systematic reviews of health economic evaluations and enhanced case studies that critically discuss methods and reporting structures. The extracted data will be coded and analyzed to produce an initial list of candidate reporting items, structured according to conventional sections of a systematic review (e.g., title, abstract, methods, results). This initial list will be used in the subsequent stages of the project and disseminated through a peer-reviewed publication and presentations at international conferences. The outcome of this scoping review will significantly contribute to the development of a comprehensive PRISMA-EconEval reporting guideline, aimed at enhancing the transparency, consistency, and quality of systematic reviews of health economic evaluations, and provide an essential tool for authors, editors, peer-reviewers, and stakeholders.
Evaluation of Knowledge and Perception of the Third Molar Extraction Procedure Among Patients in the Eastern Province, Saudi Arabia: A Cross-Sectional Study
Authors: Alshehri Sami , Alshehri Turki , AlMutiri Hadeel , Aljami Abdulla , Alsubaie Ahmed , Aljofi Faisal E. , AlSharief Mishali , AlSaadoun Manal , Alali Yasser S. , Al-Dulaijan Yousif A.
Published: November 2024

Background Third molar extraction is one of the most common oral surgical procedures globally. This study assessed patients’ knowledge of third molar extraction procedures. Methods A self-administered questionnaire was administered to patients (N=384) of the dental hospital at Imam Abdulrahman bin Faisal University in the eastern province. The questionnaire covered demographic data, knowledge of third molar extraction, and patients’ perception questions. SPSS Version 24 was used for statistical analysis. Chi-square and Fisher’s Exact test were used. P-values less than or equal to 0.05 were considered statistically significant. Results According to the demographical characteristics of the patient who received 3rd molar removal surgery. As per the history of the extraction, 45% had previous 3rd molar extraction experience, whereas 55% had no previous dental surgical experience. There was no significant difference between the groups with the knowledge about the extraction (p-0.187). Patients with no previous history were more aware of the correct time for 3rd molar extraction at 27% vs 19%, respectively (P=0.046*). Patients with a previous history of third molar extraction showed significant results of knowledge in terms of taking medication prior to 3rd molar surgical procedure. Conclusion The patient with previous experience with third molar extraction showed low misconceptions. However, further studies should consider increasing the knowledge and correcting the patients’ perceptions.
Uniform Cut-Free Bisequent Calculi for Three-Valued Logics
Authors: Indrzejczak Andrzej , Petrukhin Yaroslav
Published: November 2024

We present a uniform characterisation of three-valued logics by means of a bisequent calculus (BSC). It is a generalised form of a sequent calculus (SC) where rules operate on the ordered pairs of ordinary sequents. BSC may be treated as the weakest kind of system in the rich family of generalised SC operating on items being some collections of ordinary sequents, like hypersequent and nested sequent calculi. It seems that for many non-classical logics, including some many-valued, paraconsistent and modal logics, the reasonably modest generalisation of standard SC offered by BSC is sufficient. In this paper, we examine a variety of three-valued logics and show how they can be formalised in the framework of BSC. We present a constructive syntactic proof that these systems are cut-free, satisfy the subformula property, and allow one to prove the interpolation theorem in many cases.
impact of the nocebo effect on discontinuation of statin therapy due to myopathy in patients with cardiovascular disease – a review
Authors: Stanek Jakub , Sornek Patrycja , Izdebska Wiktoria , Borkowska Agata , Ciesielski Radosław , Kaźmierczak Anna , Kiełb Anna , Mich Anna , Perkowska Klaudia , Pawlak Igor
Published: November 2024

Introduction and purpose of review: Statins are widely used drugs in the prevention of cardiovascular diseases, yet many patients experience side effects of statin use, mainly muscle symptoms, such as myopathy, which often lead to discontinuation of treatment. The aim of this literature review is to assess the role of the nocebo effect in reported muscle symptoms and its impact on statin discontinuation in patients with cardiovascular diseases.
Methods: The review analysed the results of several studies, including key publications such as the N-of-1 trial by Wood et al.[1] and the work of Collins et al.[2] on the safety and efficacy of statin therapy. The review covered articles published between 2000 and 2023 that examined the impact of the nocebo effect on statin discontinuation[3-10].
Results: The collected data indicate that the nocebo effect plays a significant role in the reported muscle symptoms during statin use. The study by Wood et al.[1] showed no significant differences in reported symptoms between the groups taking statins, placebo, or receiving no treatment, suggesting that a substantial portion of the symptoms results from the nocebo effect. Similar findings were obtained in the study conducted by the StatinWISE group[4], where patients taking statins and placebo reported a comparable frequency of muscle symptoms. An analysis conducted by Collins et al.[2] indicates that the actual incidence of myopathy associated with statin therapy is much lower than commonly reported.
Conclusions: The nocebo effect significantly influences the perceived adverse effects of statins, which may lead to the unjustified discontinuation of these drugs by patients with cardiovascular diseases. Further research is needed to better understand the psychological mechanisms affecting statin tolerance and to develop educational and clinical strategies aimed at minimizing the nocebo effect and improving long-term adherence to therapy.
Introductory Word by the Scientific Editor of This Issue of the Journal
Authors: Domeracki Piotr
Published: November 2024

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Organic Communities, Atomistic Societies and Loneliness
Authors: Mijuskovic Ben Lazare
Published: November 2024

The article distinguishes two models of human organization: the organic community and the atomistic society. It maintains that the organic paradigm stresses (a) the ideal unity of the whole; (b) internal relations; (c) teleological or dialectical processes; (d) co- or inter-dependent members (e. g. the human body or face); (e) a role-orientation; (f) living functions; (g) freedom defined as doing as you should; and (h) qualitative factors prevail.  By contrast, the atomistic model emphasizes (a) the value of individual freedom; (b) external relations; (c) mechanical or causal explanations; (d) separate “parts”(e.g. a machine); (e) a rule orientation; (f)  formal, legal, or artificial frameworks; (g) freedom defined as doing as you please; and (h) quantitative factors prevail. The article contends that the sense of individual loneliness or alienation experienced is generally much greater in the atomistic society. And since both the American family and its surrounding society are, in the main, atomisticly-structured, it follows that loneliness is more pronounced and prevalent in American society. The article concludes by offering some programmatic ideals and measures to reverse and mitigate the present tendency toward increasing loneliness in the United States.
The Art of Solitude from Modernism to Postmodernism and Beyond
Authors: Stern Julian
Published: November 2024

A philosophical anthropology of solitude is presented through the art, literature and music of and around Modernism, Postmodernism. It is presented as an insight into both Modernism and Postmodernism. These movements portrayed and contributed to the lonely alienated worlds of the early-to-mid twentieth century. Culture and society together developed forms of loneliness that were centred on individualist, alienated, guilt and shame, to which a response may be appropriately silent or humorous, living or dead, and sometimes a lewd masochism. Even those who rejected Modernism and Postmodernism help describe – either positively or apophatically – the distinctive forms of lonely solitude in those movements.
Artificial Intelligence and Strategic Decision-Making: Evidence from Entrepreneurs and Investors
Authors: Csaszar Felipe A. , Ketkar Harsh , Kim Hyunjin
Published: November 2024

This paper explores how artificial intelligence (AI) may impact the strategic decision-making (SDM) process in firms. We illustrate how AI could augment existing SDM tools and provide empirical evidence from a leading accelerator program and a start-up competition that current large language models can generate and evaluate strategies at a level comparable to entrepreneurs and investors. We then examine implications for the key cognitive processes underlying SDM—search, representation, and aggregation. Our analysis suggests that AI has the potential to enhance the speed, quality, and scale of strategic analysis, while also enabling new approaches, like virtual strategy simulations. However, the ultimate impact on firm performance will depend on competitive dynamics as AI capabilities progress. We propose a framework connecting AI use in SDM to firm outcomes and discuss how AI may reshape sources of competitive advantage. We conclude by considering how AI could both support and challenge core tenets of the theory-based view of strategy. Overall, our work maps out an emerging research frontier at the intersection of AI and strategy.

History: This paper has been accepted for the Strategy Science Special Issue on Theory-Based View.

Funding: The authors are grateful to their collaborating organizations and to the University of Michigan, Bocconi University Junior Researchers’ Grant, and the INSEAD eLab Research Fund for financial support.
Going against the grain: a case report of an endometriosis in the canal of Nuck
Authors: Karam Karam , Azizi Lamia , Azizi Mehsen , Dabaj Emile
Published: November 2024

The canal of Nuck is an embryological remnant of the processus vaginalis found in females, and is a potential site for endometriosis seeding. Endometriosis in the canal of Nuck is an exceedingly rare condition. Patients with this condition present with groin swelling or suprapubic pain. We describe a case of a 44-year-old female presenting for left inguinal pain and a lump. Physical examination revealed a 3 cm reducible mass; magnetic resonance imaging (MRI) revealed a 6.2 × 3.0 × 1.7 cm multiloculated cystic structure, extending from the left pelvic region into the left inguinal region near the round ligament. The patient underwent surgical excision of the mass. Pathology revealed a multi-cystic lesion lined with mesothelium cells and a fibrous wall with multiple foci of misplaced endometrial glands and stroma, corroborating a diagnosis of endometriosis in the canal of Nuck.
Medical Diseases in Pregnancy: An Acute on Chronic Focus
Authors: Hill Amanda , Burden Christy , Neuberger Francesca
Published: November 2024

In the last decade or so obstetric care has evolved and become more complex. This can be attributed to a combination of factors including rising obesity rates, maternal age and medical treatment advances. Clinicians are caring for more pregnant women with chronic medical disease in addition to any de novo presentations which may occur, emphasising the need for the general medicine body to feel confident and skilled in the management of medical problems before, during and after pregnancy. One of the difficulties faced by clinicians in the assessment and management of pregnant women is the differentiation between symptoms of a normal pregnancy vs symptoms of clinical significance which warrant further investigation, particularly in mothers with background medical disease. Careful consideration and knowledge of normal pregnancy physiology is required when assessing a pregnant women/birthing person to avoid closed thinking and adverse outcomes. Unfortunately, clinician inertia around the care of pregnant women is a common feature in maternal mortality reviews. The most recent maternal mortality report discusses common themes around cardiovascular disease in pregnancy, alongside management of acute and acute-on-chronic presentations in the context of common endocrine, gastrointestinal and neurological disease in pregnancy. This article discusses some of these themes and the management of common medical problems in pregnancy.
A Survey on Surgical Site Infections Prevention Guidelines Knowledge and Implementation Level of Trauma Centre Healthcare Professionals
Authors: Nepravishta Eris , Topi Skënder , Toçi Ervin , Nepravishta Ervin , Kapaj Armela
Published: November 2024

Aims/Background Surgical site infections (SSIs) significantly influence patient safety and healthcare quality, particularly in low- and middle-income countries where the burden is most evident. This manuscript aims to evaluate the awareness and adherence to SSI prevention guidelines among healthcare providers at a tertiary trauma centre situated in Tirana, Albania.

Methods This cross-sectional survey was conducted among practising surgeons, residents and nurses of Trauma University Hospital, Tirana. The questionnaire explores awareness, attitudes and practices towards SSI prevention in preoperative, perioperative and postoperative phases.

Results The participants demonstrated a high level of patient education about SSI risks (91.9%), but lower adherence to individual prevention practices.

Conclusion Despite adequate knowledge, there remains a significant gap in the implementation of SSI prevention guidelines. Strengthening continuous medical education is crucial to addressing systemic barriers, improving compliance with guidelines, and decreasing SSI rates.
Application of Intelligent Management Model Based on Electronic Patient-Reported Outcome During Immunotherapy in Patients with Gastric Cancer: A Single-Center Retrospective Study
Authors: Li Cuizhen , Wu Danna
Published: November 2024

Aims/Background Gastric cancer is the third leading cause of cancer-related death worldwide, which seriously affects the health of patients. Immunotherapy is a commonly used clinical treatment for gastric cancer, but the adverse events caused by it seriously affect the prognosis of patients. Therefore, it is necessary to control and manage the disease risk of patients during immunotherapy. To explore the effect of applying an intelligent management model based on electronic patient-reported outcome (ePRO) in patients with gastric cancer during immunotherapy.

Methods The clinical data of 184 gastric cancer patients receiving immunotherapy in The Fourth Hospital of Hebei Medical University from September 2021 to September 2023 were retrospectively analyzed. Ninety patients receiving ePRO-based intelligent management were selected, and 85 patients were included in the observation group after excluding 5 patients. For the reference group, 94 patients receiving common case management were selected, with 90 patients being included after excluding 4 patients. After 6 months of follow-up, the nutritional status score, quality of life, treatment compliance and adverse events were compared between the two groups.

Results No significant difference was detected in nutritional status and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores of the patients before discharge (p > 0.05). After 2 months of follow-up, compared with the reference group, the observation group had a higher proportion of patients in grade A and grade B, which was not statistically significant (p > 0.05), and significantly higher physiological and psychological scores (p < 0.001), but showed no meaningful differences in other fields (p > 0.05). After 4 months of follow-up, the nutritional status in the observation group was significantly improved (p < 0.05), and the subjects displayed higher WHOQOL-BREF scores (p < 0.05) than those in the reference group. No significant difference in the incidence of adverse events was detected (p > 0.05). After 6 months of follow-up, the treatment compliance of the observation group was 83.53%, which was significantly higher than that of the reference group (70.00%; p < 0.05).

Conclusion The intelligent management model based on ePRO is conducive to improving the nutritional status of patients with gastric cancer during immunotherapy, as well as enhancing their quality of life and treatment compliance, making it worthy of clinical application.
Impact of Propofol Administered before Extubation on Respiratory Adverse Events in Pediatric Patients Undergoing Tonsillectomy and Adenoidectomy: A Randomized Controlled Trial
Authors: Liao Ruting , Zhou Zhijian , Wang Xuan , Shao Huiying
Published: November 2024

Aims/Background Perioperative respiratory adverse events (PRAEs) are common in pediatric anesthesia, especially in otolaryngology procedures. In this randomized controlled trial, we investigated the impact of administering propofol before extubation on PRAEs in pediatric patients undergoing tonsillectomy and adenoidectomy.

Methods We enrolled children aged 3 to 8 years old, of American Society of Anesthesiologists (ASA) classes I to III, scheduled for tonsillectomy, and randomly divided them into propofol and control groups. The subjects in the propofol group received multiple small doses of propofol (0.5 mg/kg per dose, total 1–2 mg/kg) until the patient resumed regular spontaneous breathing and exhibited no bodily movements. The subjects in the control group received 0.15 mL/kg of saline. The primary outcome was the rate of PRAEs, such as laryngospasm, bronchospasm, breath-holding spell, severe coughing, desaturation, and airway obstruction, post-extubation. The secondary outcomes were the extubation time, pre-extubation Richmond Agitation-Sedation Scale (RASS) score, end-tidal sevoflurane concentration at extubation, incidence of postoperative agitation, time to consciousness, and Face, Legs, Activity, Cry, and Consolability (FLACC) pain score in the recovery room. Results were reported with risk ratios (RR) and their 95% confidence intervals (CI), as well as the p-values indicating statistical significance.

Results A total of 239 patients were included, including 119 in the propofol group and 120 in the control group. Our findings indicated no significant difference in the rate of PRAEs between the two groups (5.9% vs 10.8%, RR: 0.54, 95% CI: 0.23 to 1.31, p = 0.17). However, the propofol group showed a notable decrease in moderate to severe coughs (13.4% vs 60.0%, RR: 0.22, 95% CI: 0.14 to 0.36, p < 0.001) and postoperative agitation (4.2% vs 60.8%, RR: 0.07, 95% CI: 0.03 to 0.17, p < 0.001).

Conclusion This trial demonstrated that while administering repeated small doses of propofol before extubation does not significantly reduce respiratory adverse events in children undergoing tonsillectomy and adenoidectomy, it does significantly reduce the incidence of severe coughing, improving postoperative recovery and clinical outcomes. Moreover, propofol helps reduce postoperative agitation, enhancing the safety and effectiveness of postoperative care, and maintaining its valuable clinical role in postoperative management.

Clinical Trial Registration ClinicalTrials.gov ( NCT05769842 ).
Effect of dietary Extracellular polymeric substances from Lactic acid bacteria on disease resistance and immune response in the whiteleg shrimp (Litopenaeus vannamei)
Authors:   Department of Biotechnology, An Giang University, An Giang 90000, Vietnam. National University Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, Vietnam, Thanh Nguyen Huu , Lan Trinh Thi ,   Department of Aquaculture, An Giang University, An Giang 90000, Vietnam National University Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, Vietnam, Hang Nguyen Thi Thuy ,   Department of Aquaculture, An Giang University, An Giang 90000, Vietnam. National University Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, Vietnam, Nhi Nguyen Huu Yen ,   Department of Aquaculture, An Giang University, An Giang 90000, Vietnam. National University Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, Vietnam, Tho Nguyen Phu ,   Department of Biotechnology, An Giang University, An Giang 90000, Vietnam. National University Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, Vietnam
Published: November 2024

Extracellular polymeric substances (EPSs) are known to have prebiotic properties, promoting the growth of beneficial bacteria in the intestinal tracts of humans and animals. To investigate the prebiotic potential of EPSs isolated from lactic acid bacteria (LAB), specifically Lactiplantibacillus plantarum and Bifidobacterium bifidum, the study examined changes in intestinal LAB and Vibrio parahaemolyticus populations, as well as immune responses in the Pacific white shrimp, Litopenaeus vannamei. The results showed that dietary supplementation with EPSs increased the population of LAB while reducing the level of V. parahaemolyticus in the shrimp gut. Additionally, EPSs were found to enhance the cellular immune responses of the shrimp, including total haemocyte count, respiratory bursts, phenoloxidase activity, and superoxide dismutase activity. Shrimp that were not fed EPSs and later inoculated with V. parahaemolyticus registered a mortality rate of 91%. In contrast, shrimp fed with EPSs showed greater resistance to V. parahaemolyticus, with mortality rates ranging from 27-30% post-infection. These findings suggest that EPSs produced by LAB could be utilized as a potential prebiotic substitute for antibiotics in shrimp feed to inhibit the growth of V. parahaemolyticus, a significant pathogen in aquaculture. The prebiotic and immune-enhancing properties of EPSs demonstrated in this study highlight their potential as a sustainable and eco-friendly approach to disease management in shrimp farming.
Computational multi-epitope based design of a multivalent subunit vaccine against co-infecting African swine fever virus and porcine circovirus type 2
Authors:   Virology and Vaccine Research Program, Department of Science and Technology—Industrial Technology Development Institute, Taguig, Metro Manila 1631, Philippines, Fajardo Lauren Emily , Banico Edward C. ,   Virology and Vaccine Research Program, Department of Science and Technology—Industrial Technology Development Institute, Taguig, Metro Manila 1631, Philippines, Sira Ella Mae Joy S. ,   Virology and Vaccine Research Program, Department of Science and Technology—Industrial Technology Development Institute, Taguig, Metro Manila 1631, Philippines, Odchimar Nyzar Mabeth O. ,   Virology and Vaccine Research Program, Department of Science and Technology—Industrial Technology Development Institute, Taguig, Metro Manila 1631, Philippines, Orosco Fredmoore L. ,   Virology and Vaccine Research Program, Department of Science and Technology—Industrial Technology Development Institute, Taguig, Metro Manila 1631, Philippines,   S&T Fellows Program, Department of Science and Technology, Taguig, Metro Manila 1631, Philippines,   Department of Biology, College of Arts and Sciences, University of the Philippines Manila, Manila, Metro Manila 1000, Philippines
Published: November 2024

African swine fever virus (ASFV) and porcine circovirus type 2 (PCV2) are two prevalent and economically significant viruses causing high rates of pig mortality and large-scale losses to global pork production. Since there is currently no vaccine simultaneously targeting both viruses, this study aimed to computationally design a safe, stable, and effective multi-epitope based multivalent subunit vaccine against co-infecting ASFV and PCV2. Cytotoxic T-lymphocyte (CTL), helper T-lymphocyte (HTL), and linear B-lymphocyte (LBL) epitopes were screened from sequences of the Rep, Cap, and ORF3 PCV2 proteins. PCV2 epitopes predicted to be antigenic, non-allergenic, and non-toxic were linked to previously screened ASFV epitopes and Vibrio vulnificus FlaB flagellin as an adjuvant to create the final vaccine construct, which underwent physicochemical assessment and structure prediction. The vaccine construct was predicted to be stable, soluble, non-cross-reactive, antigenic, and nonallergenic. An immune simulation demonstrated that the vaccine could elicit robust antibody, T-cell, and B-cell responses. The vaccine construct stably docked to TLR5 and formed significant molecular interactions. A 200-ns molecular dynamics simulation showed that the vaccine-TLR5 complex exhibited stability and compactness throughout the run. These results show that the designed vaccine is safe, stable, and effective and warrants experimental validation.