bluuebunny/crossref_metadata_2025 huggingface dataset:
Extensive systemic thrombo-embolism including intra-cardiac thrombosis mimicking an atrial myxoma in a patient with beta thalassaemia major – a case report
Authors: Welhenge Chiranthi , Ranasinghe Rumesh , Rajapakse Sanjeewa , Premawardhena Anuja
Published: October 2023

Background

Sepsis and thrombo-embolic disease are well known complications of thalassemia major. Intracardiac thrombi are however rare and can lead to diagnostic dilemmas.

Case presentation

We report the case of a 20-year-old female splenectomised thalassaemia major patient with severe iron overload, who presented with life threatening sepsis associated with a liver abscess. Discovery of a large oscillating intra cardiac lesion on 2D echocardiogram confirmed by Contrast Enhanced Computed Tomography (CECT) chest in the right atrium extending from the left hepatic vein through the inferior vena cava complicated the clinical course. After a prolonged Intensive Care Unit (ICU) stay supported with antibiotics and anticoagulation, she recovered with evidence of resolution of the intra cardiac thrombus.

Conclusions

Early recognition and prompt aggressive treatment of sepsis in patients with thalassemia is essential to prevent complications. Intracardiac thrombosis is a potentially treatable cause for an intra cardiac mass in patients with thalassemia major, which should not be missed.
A magnetic resonance imaging-based decision-making tool for predicting complex anal fistulas healing in the early postoperative period
Authors: Xu Hao , Xiao Guo-Zhong , Zheng Yi-Hui , Fu Yuan-Ji , Zhong Sheng-Lan , Ren Dong-Lin , Li Wen-Ru , Lin Hong-Cheng
Published: October 2023

Background

Magnetic resonance imaging (MRI) has excellent accuracy in diagnosing preoperative lesions before anal fistula surgery. However, MRI is not good in identifying early recurrent lesions and effective methods for quantitative assessment of fistula healing are still warranted. This retrospective study aimed to develop and validate a specific MRI-based nomogram model to predict fistula healing during the early postoperative period.

Methods

Patients with complex cryptoglandular anal fistulas who underwent surgery between January 2017 and October 2020 were included in this study. MRI features and clinical parameters were analyzed using univariate and multivariate logistic regression analysis. A nomogram for predicting fistula healing was constructed and validated.

Results

In total, 200 patients were included, of whom 186 (93%) were male, with a median age of 36 (18–65) years. Of the fistulas, 58.5% were classified as transsphincteric and 19.5% as suprasphincteric. The data were randomly divided into the training cohort and testing cohort at a ratio of 7:3. Logistic analysis revealed that CNR, ADC, alcohol intake history, and suprasphincteric fistula were significantly correlated with fistula healing. These four predictors were used to construct a predictive nomogram model in the training cohort. AUC was 0.880 and 0.847 for the training and testing cohorts, respectively. Moreover, the decision and calibration curves showed high coherence between the predicted and actual probabilities of fistula healing.

Conclusions

We developed a predictive model and constructed a nomogram to predict fistula healing during the early postoperative period. This model showed good performance and may be clinically utilized for the management of anal fistulas.
Comparison of the clinical characteristics of SARS-CoV-2 Delta (B.1.617.2) and Omicron (B.1.1.529) infected patients from a single hospitalist service
Authors: Radhakrishnan N. , Liu M. , Idowu B. , Bansari A. , Rathi K. , Magar S. , Mundhra L. , Sarmiento J. , Ghaffar U. , Kattan J. , Jones R. , George J. , Yang Y. , Southwick F.
Published: October 2023

Background

While existing evidence suggests less severe clinical manifestations and lower mortality are associated with the Omicron variant as compared to the Delta variant. However, these studies fail to control for differences in health systems facilities and providers. By comparing patients hospitalized on a single medical service during the Delta and Omicron surges we were able to conduct a more accurate comparison of the two varaints’ clinical manifestations and outcomes.

Methods

We conducted a prospective study of 364 Omicron (BA.1) infected patients on a single hospitalist service and compared these findings to a retrospective analysis of 241 Delta variant infected patients managed on the same service. We examined differences in symptoms, laboratory measures, and clinical severity between the two variants and assessed potential risk drivers for case mortality.

Findings

Patients infected with Omicron were older and had more underlying medical conditions increasing their risk of death. Although they were less severely ill and required less supplemental oxygen and dexamethasone, in-hospital mortality was similar to Delta cases, 7.14% vs. 4.98% for Delta (q-value = 0.38). Patients older than 60 years or with immunocompromised conditions had much higher risk of death during hospitalization, with estimated odds ratios of 17.46 (95% CI: 5.05, 110.51) and 2.80 (1.03, 7.08) respectively. Neither vaccine history nor variant type played a significant role in case fatality. The Rothman score, NEWS-2 score, level of neutrophils, level of care, age, and creatinine level at admission were highly predictive of in-hospital death.

Interpretation

In hospitalized patients, the Omicron variant is less virulent than the Delta variant but is associated with a comparable mortality. Clinical and laboratory features at admission are informative about the risk of death.
“A net for everyone”: fully personalized and unsupervised neural networks trained with longitudinal data from a single patient
Authors: Strack Christian , Pomykala Kelsey L. , Schlemmer Heinz-Peter , Egger Jan , Kleesiek Jens
Published: October 2023

Background

With the rise in importance of personalized medicine and deep learning, we combine the two to create personalized neural networks. The aim of the study is to show a proof of concept that data from just one patient can be used to train deep neural networks to detect tumor progression in longitudinal datasets.

Methods

Two datasets with 64 scans from 32 patients with glioblastoma multiforme (GBM) were evaluated in this study. The contrast-enhanced T1w sequences of brain magnetic resonance imaging (MRI) images were used. We trained a neural network for each patient using just two scans from different timepoints to map the difference between the images. The change in tumor volume can be calculated with this map. The neural networks were a form of a Wasserstein-GAN (generative adversarial network), an unsupervised learning architecture. The combination of data augmentation and the network architecture allowed us to skip the co-registration of the images. Furthermore, no additional training data, pre-training of the networks or any (manual) annotations are necessary.

Results

The model achieved an AUC-score of 0.87 for tumor change. We also introduced a modified RANO criteria, for which an accuracy of 66% can be achieved.

Conclusions

We show a novel approach to deep learning in using data from just one patient to train deep neural networks to monitor tumor change. Using two different datasets to evaluate the results shows the potential to generalize the method.
Estrogen-related genes for thyroid cancer prognosis, immune infiltration, staging, and drug sensitivity
Authors: Zhang Leiying , Zhou Man , Gao Xiaoni , Xie Yang , Xiao Junqi , Liu Tao , Zeng Xiangtai
Published: October 2023

Background

Thyroid cancer (THCA) has become increasingly common in recent decades, and women are three to four times more likely to develop it than men. Evidence shows that estrogen has a significant impact on THCA proliferation and growth. Nevertheless, the effects of estrogen-related genes (ERGs) on THCA stages, immunological infiltration, and treatment susceptibility have not been well explored.

Methods

Clinicopathological and transcriptome data of patients with THCA from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) were cleaned before consensus clustering. Differential expression analysis was performed on the genes expressed between THCA and paraneoplastic tissues in TCGA, and Wayne analysis was performed on the ERGs obtained from the Gene Set Enrichment Analysis MsigDB and differentially expressed genes (DEGs). Univariate Cox and least absolute shrinkage and selection operator (LASSO) analyses were used to identify the set of estrogen-related differentially expressed genes (ERDEGs) associated with progression-free intervals (PFI) and to establish a prediction model. Receiver operating characteristic curves were plotted to calculate the risk scores and PFI status to validate the predictive effect of the model. Enrichment analyses and immune infiltration analyses were performed to analyze DEGs between the high- and low-risk groups, and a nomogram plot was used in the risk model to predict the PFI of THCA.

Results

The expression of 120 ERDEGs differed significantly between the two groups (P < 0.05). Five (CD24, CAV1, TACC1, TIPARP, and HSD17B10) of the eight ERDEGs identified using univariate Cox and LASSO regression were validated via RT-qPCR and immunohistochemistry analysis of clinical tissue samples and were used for clinical staging and drug sensitivity analysis. Risk-DEGs were shown to be associated with immune modulation and tumor immune evasion, as well as defense systems, signal transduction, the tumor microenvironment, and immunoregulation. In 19 of the 28 immune cells, infiltration levels differed between the high- and low-risk groups. High-risk patients in the immunotherapy dataset had considerably shorter survival times than low-risk patients.

Conclusion

We identified and confirmed eight ERDEGs using a systematic analysis and screened sensitive drugs for ERDEGs. These results provide molecular evidence for the involvement of ERGs in controlling the immunological microenvironment and treatment response in THCA.
Validation of a short version of the Lee fatigue scale in adults living in Norway: a cross-sectional population survey
Authors: Lerdal Anners , Gay Caryl , Bonsaksen Tore , Ekeberg Øivind , Grimholt Trine , Heir Trond , Kottorp Anders , Lee Kathryn A. , Skogstad Laila , Schou-Bredal Inger
Published: October 2023

Background

Due to the nature of fatigue, a brief reliable measure of fatigue severity is needed. Thus, the aim of our study was to evaluate a short version of the Lee Fatigue Scale (LFS) in the Norwegian general population.

Methods

This cross-sectional survey consists of a representative sample from the Norwegian population drawn by The National Population Register in Norway. The study is part of a larger study (NORPOP) aimed at collecting normative data from several questionnaires focused on health in adults living in Norway. Registered citizens between 18 and 94 years of age were randomly selected stratified by age, sex and geographic region. Of the 4971 respondents eligible for the study, 1792 (36%) responded to the survey. In addition to age and sex, we collected responses on a 5-item version of the LFS measuring current fatige severity. The psychometric properties focusing on internal structure and precision of the LFS items were analyzed by a Rasch rating scale model.

Results

Complete LFS scores for analyses were available for 1767 adults. Women had higher LFS-scores than men, and adults < 55 years old had higher scores than older respondents. Our analysis of the LFS showed that the average category on each item advanced monotonically. Two of the five items demonstrated misfit, while the three other items demonstrated goodness-of-fit to the model and uni-dimensionality. Items #1 and #4 (tired and fatigue respectively) showed differential item functioning (DIF) by sex, but no items showed DIFs in relation to age. The separation index of the LFS 3-item scale showed that the sample could be separated into three different groups according to the respondents’ fatigue levels. The LFS-3 raw scores correlated strongly with the Rasch measure from the three items. The core dimensions in these individual items were very similarly expressed in the Norwegian language version and this may be a threat to the cultural-related or language validity of a short version of the LFS using these particular items.

Conclusions

The study provides validation of a short LFS 3-item version for estimating fatigue in the general population.
Understanding social risk factors of county-level disparities in COVID-19 tests per confirmed case in South Carolina using statewide electronic health records data
Authors: Shi Fanghui , Zhang Jiajia , Yang Xueying , Sun Xiaowen , Li Zhenlong , Weissman Sharon , Olatosi Bankole , Li Xiaoming
Published: October 2023

Background

COVID-19 testing is essential for pandemic control, and insufficient testing in areas with high disease burdens could magnify the risk of poor health outcomes. However, few area-based studies on COVID-19 testing disparities have considered the disease burden (e.g., confirmed cases). The current study aims to investigate socioeconomic drivers of geospatial disparities in COVID-19 testing relative to disease burden across 46 counties in South Carolina (SC) in the early (from April 1, 2020, to June 30, 2020) and later (from July 1, 2020, to September 30, 2021) phases of the pandemic.

Methods

Using SC statewide COVID-19 testing data, the COVID-19 testing coverage was measured by monthly COVID-19 tests per confirmed case (hereafter CTPC) in each county. We used modified Lorenz curves to describe the unequal geographic distribution of CTPC and generalized linear mixed-effects regression models to assess the association of county-level social risk factors with CTPC in two phases of the pandemic in SC.

Results

As of September 30, 2021, a total of 641,201 out of 2,941,227 tests were positive in SC. The Lorenz curve showed that county-level disparities in CTPC were less apparent in the later phase of the pandemic. Counties with a larger percentage of Black had lower CTPC during the early phase (β = -0.94, 95%CI: -1.80, -0.08), while such associations reversed in the later phase (β = 0.28, 95%CI: 0.01, 0.55). The association of some other social risk factors diminished as the pandemic evolved, such as food insecurity (β: -1.19 and -0.42; p-value is < 0.05 for both).

Conclusions

County-level disparities in CTPC and their predictors are dynamic across the pandemic. These results highlight the systematic inequalities in COVID-19 testing resources and accessibility, especially in the early stage of the pandemic. Counties with greater social vulnerability and those with fewer health care resources should be paid extra attention in the early and later phases, respectively. The current study provided empirical evidence for public health agencies to conduct more targeted community-based testing campaigns to enhance access to testing in future public health crises.
Sexual assault and vulnerability to sexually transmitted infections among homeless Brazilian women: a cross sectional qualitative study
Authors: Gonçalves Barbosa Nayara , Carvalho Mendes Lise Maria , da Costa Carbogim Fábio , Maria e Silva Angela , de Oliveira Gozzo Thaís , Gomes-Sponholz Flávia Azevedo
Published: October 2023

Background

Homeless women have complex life conditions and are often exposed to violence, sexual exploitation, rape, prostitution, reproductive disorders, survival sex trading, unintended pregnancies and sexually transmitted infections (STIs). The aim was to explore the existence of sexual aggression and vulnerability to STIs among homeless Brazilian women.

Methods

Fifteen interviews were conducted with homeless women who were admitted to a women’s shelter in a large city in Brazil. Data were collected through semi-structured interviews, audiorecorded and complemented with notes of the researcher in field diary, subjected to inductive thematic analysis and analyzed in light of the social relations of gender.

Results

Two themes were constructed: “Being a woman on the streets: a look at gender inequalities” and “Pain and the raped body: the scars of homeless women”. The transgression of women’s rights was observed with reports of sexual abuse interspersed with physical violence. Unprotected sexual practices were part of the daily lives of these women, with repercussions for their exposure to sexually transmitted infections. Dependence on psychoactive substances was mentioned, and transactional sex was used as a source of income to maintain such dependence, as well as to promote the women’s livelihood.

Conclusion

Homeless women experience complex situations on the streets involving exposure to different types of violence, the use of transactional sex as a survival strategy and unprotected sexual practices. Furthermore, the way in which women have been exposed to sexual assault and their coping mechanisms to those require attention. Interventions are need to improve the healthcare assistance of homeless women victims of sexual assault, considering the vulnerability of this population.
Self-care strategies for medical students: an uncontrolled mixed-methods evaluation of a mind-body-medicine group course
Authors: Scullion Raphael , Icke Katja , Tissen-Diabaté Tatjana , Adam Daniela , Ortiz Miriam , Witt Claudia M. , Brinkhaus Benno , Stöckigt Barbara
Published: October 2023

Background

High stress during medical education and its detrimental effects on student health is well documented. This exploratory evaluation study assesses a 10-week Mind-Body-Medicine student course, created to promote student self-care at Charité Universitätsmedizin Berlin, Germany.

Methods

During 2012–2019, uncontrolled quantitative and qualitative data were gathered from 112 student participants. Outcomes including changes in perceived stress (PSS), mindfulness (FMI/MAAS), self-reflection (GRAS), self-efficacy (GSE), empathy (SPF), and health-related quality of life (SF-12) were measured between the first (T0) and last sessions (T1). Qualitative data were obtained in focus groups at course completion and triangulated with quantitative data.

Results

Quantitative outcomes showed decreases in perceived stress and increased self-efficacy, mindfulness, self-reflection, and empathy. In focus groups, students reported greater abilities to self-regulate stressful experiences, personal growth and new insights into integrative medicine. Triangulation grounded these effects of MBM practice in its social context, creating an interdependent dynamic between experiences of self and others.

Conclusion

After completing an MBM course, students reported reduced perceived stress, increased self-efficacy, mindfulness, empathy and positive engagement with integrative concepts of doctor–patient relationships. Further research with larger randomized confirmatory studies is needed to validate these benefits.
Clinical effectiveness of supraspinatus tendon reconstruction using autogenous fascia latas for irreparable posterosuperior massive rotator cuff tears: study protocol for a randomized, controlled clinical trial
Authors: Ma Lin , Gou Xiaoli , Zhou Binghua
Published: October 2023

Background

Supraspinatus tendon reconstruction (STR) was recently introduced as a new treatment option for irreparable posterosuperior massive rotator cuff tears (IPMRCT). STR was thought to be more advantageous than superior capsule reconstruction (SCR) for restoring supraspinatus (SSP) dynamics. However, there has been no prospective randomized controlled study on the early clinical efficacy of STR.

Methods

A single-site, prospective, observers and patients double-blinding randomized controlled trial was designed. Fifty-eight patients aged 50–85 years with IPMRCT will be randomized 1:1 to receive either STR or SCR. The clinical outcomes were evaluated using the American Society for Shoulder and Elbow Surgery (ASES) score, range of motion (ROM), visual analogue scale (VAS) for pain, acromiohumeral distance (AHD), Goutlliar grade for fatty infiltration in the SSP, Sugaya grade for the autogenous fascia latas, isokinetic muscle strength testing and surface electromyography (EMG) testing for shoulder abduction muscle strength and complications.

Discussion

The results of this study will contribute to the treatment algorithm of IPMRCT and assist surgeons in making treatment decisions. This is the first randomized controlled trial to compare the effects of STR and SCR for the treatment of IPMRCT.

Trial registration

We registered the trial in chictr.org.cn on July 17, 2023 (register number: ChiCTR2300073716). Items from the WHO trial registry were found within the protocol.
The influence of dapagliflozin on cardiac remodeling, myocardial function and metabolomics in type 1 diabetes mellitus rats
Authors: Rodrigues Eder Anderson , Rosa Camila Moreno , Campos Dijon Henrique Salome , Damatto Felipe Cesar , Murata Gilson Masahiro , Souza Lidiane Moreira , Pagan Luana Urbano , Gatto Mariana , Brosler Jessica Yumi , Souza Hebreia Oliveira Almeida , Martins Mario Machado , Bastos Luciana Machado , Tanni Suzana Erico , Okoshi Katashi , Okoshi Marina Politi
Published: October 2023

Background

Sodium-glucose cotransporter (SGLT)2 inhibitors have displayed beneficial effects on the cardiovascular system in diabetes mellitus (DM) patients. As most clinical trials were performed in Type 2 DM, their effects in Type 1 DM have not been established.

Objective

To evaluate the influence of long-term treatment with SGLT2 inhibitor dapagliflozin on cardiac remodeling, myocardial function, energy metabolism, and metabolomics in rats with Type 1 DM.

Methods

Male Wistar rats were divided into groups: Control (C, n = 15); DM (n = 15); and DM treated with dapagliflozin (DM + DAPA, n = 15) for 30 weeks. DM was induced by streptozotocin. Dapagliflozin 5 mg/kg/day was added to chow. Statistical analysis: ANOVA and Tukey or Kruskal-Wallis and Dunn.

Results

DM + DAPA presented lower glycemia and higher body weight than DM. Echocardiogram showed DM with left atrium dilation and left ventricular (LV) hypertrophy, dilation, and systolic and diastolic dysfunction. In LV isolated papillary muscles, DM had reduced developed tension, +dT/dt and -dT/dt in basal condition and after inotropic stimulation. All functional changes were attenuated by dapagliflozin. Hexokinase (HK), phosphofructokinase (PFK) and pyruvate kinase (PK) activity was lower in DM than C, and PFK and PK activity higher in DM + DAPA than DM. Metabolomics revealed 21 and 5 metabolites positively regulated in DM vs. C and DM + DAPA vs. DM, respectively; 6 and 3 metabolites were negatively regulated in DM vs. C and DM + DAPA vs. DM, respectively. Five metabolites that participate in cell membrane ultrastructure were higher in DM than C. Metabolites levels of N-oleoyl glutamic acid, chlorocresol and N-oleoyl-L-serine were lower and phosphatidylethanolamine and ceramide higher in DM + DAPA than DM.

Conclusion

Long-term treatment with dapagliflozin attenuates cardiac remodeling, myocardial dysfunction, and contractile reserve impairment in Type 1 diabetic rats. The functional improvement is combined with restored pyruvate kinase and phosphofructokinase activity and attenuated metabolomics changes.
Metabolic regulation of microglial phagocytosis: Implications for Alzheimer's disease therapeutics
Authors: Lepiarz-Raba Izabela , Gbadamosi Ismail , Florea Roberta , Paolicelli Rosa Chiara , Jawaid Ali
Published: October 2023

Microglia, the resident immune cells of the brain, are increasingly implicated in the regulation of brain health and disease. Microglia perform multiple functions in the central nervous system, including surveillance, phagocytosis and release of a variety of soluble factors. Importantly, a majority of their functions are closely related to changes in their metabolism. This natural inter-dependency between core microglial properties and metabolism offers a unique opportunity to modulate microglial activities via nutritional or metabolic interventions. In this review, we examine the existing scientific literature to synthesize the hypothesis that microglial phagocytosis of amyloid beta (Aβ) aggregates in Alzheimer’s disease (AD) can be selectively enhanced via metabolic interventions. We first review the basics of microglial metabolism and the effects of common metabolites, such as glucose, lipids, ketone bodies, glutamine, pyruvate and lactate, on microglial inflammatory and phagocytic properties. Next, we examine the evidence for dysregulation of microglial metabolism in AD. This is followed by a review of in vivo studies on metabolic manipulation of microglial functions to ascertain their therapeutic potential in AD. Finally, we discuss the effects of metabolic factors on microglial phagocytosis of healthy synapses, a pathological process that also contributes to the progression of AD. We conclude by enlisting the current challenges that need to be addressed before strategies to harness microglial phagocytosis to clear pathological protein deposits in AD and other neurodegenerative disorders can be widely adopted.
Social media usage and students’ social anxiety, loneliness and well-being: does digital mindfulness-based intervention effectively work?
Authors: Sun Li
Published: October 2023

Background

The increasing integration of digital technologies into daily life has spurred a growing body of research in the field of digital psychology. This research has shed light on the potential benefits and drawbacks of digital technologies for mental health and well-being. However, the intricate relationship between technology and psychology remains largely unexplored.

Purpose

This study aimed to investigate the impact of mindfulness-based mobile apps on university students' anxiety, loneliness, and well-being. Additionally, it sought to explore participants' perceptions of the addictiveness of these apps.

Method

The research utilized a multi-phase approach, encompassing a correlational research method, a pretest–posttest randomized controlled trial, and a qualitative case study. Participants were segmented into three subsets: correlations (n = 300), treatment (n = 60), and qualitative (n = 20). Data were gathered from various sources, including the social anxiety scale, well-being scale, social media use integration scale, and an interview checklist. Quantitative data was analyzed using Pearson correlation, multiple regression, and t-tests, while qualitative data underwent thematic analysis.

Results

The study uncovered a significant correlation between social media use and the variables under investigation. Moreover, the treatment involving mindfulness-based mobile apps led to a reduction in students' anxiety and an enhancement of their well-being. Notably, participants held various positive perceptions regarding the use of these apps.

Implications

The findings of this research hold both theoretical and practical significance for the field of digital psychology. They provide insight into the potential of mindfulness-based mobile apps to positively impact university students' mental health and well-being. Additionally, the study underscores the need for further exploration of the intricate dynamics between technology and psychology in an increasingly digital world.
Social anxiety and celebrity worship: the mediating effects of mobile phone dependence and moderating effects of family socioeconomic status
Authors: Jia Rong , Yang Qing , Liu Bo , Song Han , Wang Zhengjun
Published: October 2023

The Absorption-addiction model suggests that people worship celebrities to compensate for some personal or social defects, so poor mental state is related to celebrity worship. The current study aimed to explore the underlying mechanisms influencing celebrity worship. A total of 1,147 participants (aged 19–26 years) completed online questionnaires to assess social anxiety, mobile phone dependence, parental income and celebrity worship. Results showed that: (1) social anxiety, socioeconomic status (SES) and celebrity worship were positively correlated; (2) Social anxiety affected celebrity worship through mobile phone dependence; (3) SES played a moderating role in the mediation model. At higher levels of SES, individuals with high social anxiety showed reduced dependence on mobile phones. These findings highlight the importance of mobile phone dependence and family SES in celebrity worship. Additionally, the findings demonstrated that females are more likely to pay attention to celebrities, but the greater SES and reduced mobile phone dependence can mitigate their celebrity addiction.
Integration of distributed acoustic sensing for real-time seismic monitoring of a geothermal field
Authors: Azzola Jérôme , Thiemann Katja , Gaucher Emmanuel
Published: October 2023

To accelerate the energy transition, the exploitation of deep geothermal reservoirs is becoming a priority to supply district heating networks in areas with high potential for geothermal applications. However, the sustainable development of the resource exploitation implies minimizing the associated risks, in particular related to induced seismicity, while optimizing operational processes. Besides, the growth of this energy sector, often supported by financial aid programs, provides resources to the industry that were not available in the past to implement advanced monitoring strategies. In this context, we present a monitoring system establishing Distributed Acoustic Sensing (DAS) as an effective component of the seismic network used for the monitoring of the geothermal field of Schäftlarnstraße (Munich, Germany). We also investigate its potential for real-time seismic monitoring in an urban environment and for risk mitigation. The monitoring system is based on a data management system linking the on-site acquisition infrastructure, including the fiber optic cable deployed in an injection well and the associated DAS interrogator, to a cloud Internet-of-Things (IoT) platform. The latter is designed to deliver both a secure storage environment for the DAS recordings and optimized computing resources for their processing. The proposed solution has been tested over a six-month period under operating conditions of the geothermal field. The survey proves the feasibility of efficiently acquiring and processing the large flow of continuous DAS data. The processing outcomes, emphasized by two detected local seismic events, demonstrate the suitability of DAS, cemented behind the casing of a flowing well, for (micro-) seismic monitoring of the geothermal site. The processing applied to the data takes advantage of the high spatial density of the acquisitions for their de-noising and for the detection of events. We find that the DAS monitoring system is capable of successfully detecting an event that could not be detected by the standard surface or shallow-borehole 3C-seismometers, despite noisy conditions associated with the urban environment and the field operation. The six-month test period demonstrates the potential of DAS to be integrated as a routine seismic monitoring component of an operating geothermal field. In addition, it highlights its advantageous role as a complement to surface seismometer-based networks, particularly in urban environments.
Challenges in reaching patients with severe mental illness for trials in general practice—a convergent mixed methods study based on the SOFIA pilot trial
Authors: Tranberg Katrine , Due Tina Drud , Rozing Maarten , Jønsson Alexandra Brandt Ryborg , Kousgaard Marius Brostrøm , Møller Anne
Published: October 2023

Background

Patients with severe mental illness (SMI) die prematurely due to undetected and inadequate treatment of somatic illnesses. The SOFIA pilot study was initiated to mend this gap in health inequity. However, reaching patients with SMI for intervention research has previously proven difficult. This study aimed to investigate the recruitment of patients with SMI for the SOFIA pilot study in 2021.

Methods

We used a mixed-method convergent design. The qualitative material comprised 20 interviews with general practitioners (GPs) and staff, during patient recruitment. The quantitative data consisted of process data on baseline characteristics, GPs reported reasons for excluding a patient, reported reasons for patients declining participation, and registered data from a Danish population of patients with SMI. We used thematic analysis in the qualitative analysis and descriptive statistics for the quantitative analysis. Pillar integration was used for integrating the material.

Results

Our findings show that selection bias occurred in the pilot study. We describe four main themes based on the integrated analysis that highlights selection issues: (1) poor data quality and inconsistency in defining severity definitions troubled identification and verification, (2) protecting the patient and maintaining practice efficiency, (3) being familiar with the patient was important for a successful recruitment, and (4) in hindsight, the GPs questioned whether the target population was reached.

Conclusions

In the light of theories of professions and street-level bureaucracy, we find that the main drivers of the patient selection bias occurring in the SOFIA pilot study were that 1) GPs and staff mended eligibility criteria to protect certain patients and/or to minimize workload and maintain efficiency in the practice 2) the data from the GP record systems and the digital assessment tool to assist recruitment was not optimal. Interventions targeting this patient group should carefully consider the recruitment strategy with a particular focus on professionals’ discretionary practices and information technology pitfalls.

Trial registration

The pilot trial protocol was registered on the 5th of November 2020. The registration number is NCT04618250.
Group-based PFMT programme for preventing and/or treating UI in pregnant women: protocol of a randomized controlled feasibility study
Authors: Yang Xiaowei , Zhang Aixia , Zhu Rong , Sayer Lynn , Bassett Sam , Woodward Sue
Published: October 2023

Background

Urinary incontinence (UI) is a prevalent health problem in women worldwide. Many women experience UI during pregnancy. The National Institute for Health and Care Excellence (NICE) recommended pelvic floor muscle training (PFMT) as the first-line conservative treatment for UI. However, it is not widely implemented due to the limited number of healthcare trainers. Group-based PFMT has been used with older women and a limited number of maternity studies. But the effectiveness of the group-based PFMT needs to be investigated because the overall quality of the studies is low. Therefore, this study aims to assess the feasibility of delivering a group-based PFMT programme for pregnant women in Nanjing city.

Methods

This feasibility study will be conducted in Nanjing Maternity and Child Health Care Hospital in China, using a mixed methods design to investigate the feasibility and acceptability of delivering group-based PFMT to pregnant women. Pregnant women with or without the symptoms of UI will be included. This study aims to recruit 48 pregnant women with 24 in each arm. Participants will receive either the group-based PFMT delivered by a midwife or usual antenatal care which includes only verbal instruction on PFMT. The study will assess the completion rates, acceptability of outcome measures, recruitment and retention rate and calculate an appropriate sample size for a future study.

Discussion

The results of this study will inform the design and implementation of a definitive randomized clinical trial to explore the effectiveness of the intervention.

Trial registration

ClinicalTrials.gov, NCT05242809.
Some properties for meromorphic functions associated with integral operators
Authors: Kota W. Y. , El-Ashwah R. M.
Published: October 2023

In the present paper we aim at proving some subordinations properties for meromorphic functions analytic in the punctured unit disc $$\Delta ^*=\{z:0<|z|<1\}$$

Δ
∗

=

{
z
:
0
<
|
z
|
<
1
}

with a simple pole at the origin. The functions under investigation are associated with two integral operators $$\mathcal {P}_\sigma ^\gamma$$

P
σ
γ

and $$\mathcal {Q}_\sigma ^\gamma$$

Q
σ
γ

(see Lashin in Comput Math Appl 59:524–531, 2010, https://doi.org/10.1016/j.camwa.2009.06.015). Several other results and numerical examples are also obtained.
Do Credit Supply Shocks Affect Employment in Middle-Income Countries?
Authors: Gutierrez Emilio , Jaume David , Tobal Martín
Published: October 2023

This paper studies the effect of bank credit supply shocks on formal employment in Mexico using a proprietary dataset containing information on all loans extended to firms by commercial banks during 2010–2015. We find large impacts on the formal employment of small and medium firms: a positive credit shock of 1 standard deviation increases yearly employment by 1.4 percentage points. The shares of uncollateralized credit and credit received by family firms, younger firms, and firms with no previous bank relationships also increase, suggesting that credit shocks may play a more prominent role for employment creation in credit-constrained settings. (JEL D22, G21, G32, J23, L25, M51, O16)
Juvenile Crime and Anticipated Punishment
Authors: Arora Ashna
Published: October 2023

Can sanctions deter juvenile crime? Research indicates that they may not, as offending barely decreases when individuals cross the age of criminal majority and begin to face harsher sanctions. Several models of criminal behavior predict, however, that these small reactions close to the threshold may mask larger behavioral responses among individuals below the age threshold. Policy variation between 2007–2015 in the United States is used to show evidence consistent with these predictions—juvenile crime increases when the age of majority is increased. This increase is driven by younger age groups and is considerably larger than discontinuity estimates at the threshold. (JEL D91, J13, K42)
Public and Private Options in Practice: The Military Health System
Authors: Frakes Michael D. , Gruber Jonathan , Justicz Timothy
Published: October 2023

Recent debates over health care reform, including in the context of the Military Health System (MHS) and Veterans Administration, highlight the dispute between public and private provision of health care services. Using novel data on childbirth claims from the MHS and drawing on the combination of plausibly exogenous patient moves and heterogeneity across bases in the availability of base hospitals, we identify the impact of receiving obstetrical care on versus off military bases. We find evidence that off-base care is associated with slightly greater resource intensity, but also notably better outcomes, suggesting marginal efficiency gains from care privatization. (JEL H51, H56, I11, I18, J13, L33)
Μελέτη της ριφαξιμίνης ως πρόληψη των λοιμώξεων από κλεμπσιέλα της πνευμονίας που παράγει καρβαπενεμάση
Authors: Ξενοφώντος Ελένη
Published: October 2023

Εισαγωγή: Πρόσφατα δεδομένα δείχνουν ότι ο αποικισμός του εντερικού αυλού προηγείται της λοίμωξης από εντεροβακτήρια ανθεκτικά στις καρβαπενέμες. Υπάρχει η υπόθεση ότι ο αποικισμός είναι δυνατό να εκριζωθεί από μη απορροφούμενα αντιμικροβιακά όπως η ριφαξιμίνη. Σκοπός της παρούσας μελέτης είναι να διερευνηθεί η δράση της ριφαξιμίνης έναντι της ανθεκτικής στις καρβαπενέμες K.pneumoniae (CRKP) τόσο in vitro, όσο και σε ένα πειραματικό μοντέλο. Μέθοδος: Μελετήθηκε η in vitro αποτελεσματικότητα της ριφαξιμίνης έναντι 257 CRKP απομονωμένων από κλινικά δείγματα, 188 στελεχών που παράγουν KPC και 69 στελεχών που παράγουν OXA-48-like, μέσω της ελάχιστης ανασταλτικής συγκέντρωσης και καμπυλών βακτηριακής ανάπτυξης στο χρόνο. Στη συνέχεια, δημιουργήθηκε μοντέλο εντερικού αποικισμού, εκτρέφοντας 30 μύες C57BI6 με 10 8 αποικίες από μία KPC-KP η οποία είχε απομονωθεί από 7ημέρου. Οι μύες είχαν ήδη λάβει φυσιολογικό ορό ή ομεπραζόλη ή αμπικιλλίνη. Επιπλέον 60 μύες με ήδη εγκατεστημένο εντερικό αποικισμό από KPC-2 έλαβαν από του στόματος ριφαξιμίνη για 7 συνεχόμενες ημέρες, σε δοσολογία 180mg/kg διαλυμένη σε αιθανόλη και 4%χολικών αλάτων ή διαλύτη. Τις ημέρες 0, 3, 7 συλλέχθηκαν δείγματα κοπράνων. Οι μύες θυσιάστηκαν με σκοπό τον καθορισμό της υπερανάπτυξης του ιστού. Αποτελέσματα: Συγκέντρωση 1000 μg/ml ριφαξιμίνης ανέστειλε το 84.8% των απομονωμένων στελεχών CRKP. Μείωση κατά 3 x log10 του αρχικού εμβολισμού, επετεύχθη με 100, 250 και 500 μg/ml ριφαξιμίνης μετά από 24 ώρες έναντι του 25, 55 και 55% των απομονωμένων στελεχών αντίστοιχα. Η προετοιμασία με αμπικιλλίνη ήταν απαραίτητη για τον εντερικό αποικισμό από KPC-KP. Η θεραπεία με ριφαξιμίνη μείωσε το φορτίο της KPC-KP τόσο στα κόπρανα, όσο και στον εντερικό αυλό. Συμπέρασματα: Η ριφαξιμίνη αναστέλλει κλινικά σημαντικά την εντερική συγκέντρωση της πλειονότητας των CRKP απομονωμένων στελεχών και είναι αποτελεσματική έναντι του αποικισμού του εντερικού αυλού από KPC-KP.
Implementation of the Country Study Approach When Teaching the General Features of the Earth’s Nature in the 7th Grade Geography Course (on the Example of the Topic «Lithosphere and Terrain of the Earth»)
Authors: Zotov Dmitrii
Published: October 2023

The article aims to investigate the role of the country study approach in the 7th grade geography course «Continents, oceans, peoples and countries». The relevance of this study is due to the fact that the country study approach is widely used when teaching school geography, its role in teaching is constantly increasing as it provides a comprehensive study of the territories and water areas of the Earth, large regions and countries of the world. The purpose of this article is to identify the possible ways to implement the country-study approach while studying the general features of the nature of the Earth during the 7th grade geography course. The article analyzes the main goals and structure of the course «Continents, oceans, peoples and countries». The author describes the possibilities of implementing the country study approach when studying the general features of the nature of our planet using the topic «Lithosphere and terrain of the Earth» as an example. The most successful methodological methods for its implementation are mentioning regions, countries and cities of the world, their geographical location and other information, as well as their distinctive features related to the topic of the lesson. Accordingly, the application of the country study approach when teaching the general features of the Earth’s nature in the course «Continents, oceans, peoples and countries» helps students to explore the main features of the Earth’s geospheres on the example of various territories of the world. The materials presented in the article confirm the importance of applying the regional approach in studying the general features of the nature of the Earth in the 7th grade geography course and illustrate the possibilities of its implementation. The material of this article can be used by geography teachers when lesson planning on the topic of the lithosphere and the terrain of the Earth.
The Study of Social Engineering and Organizational and Legal Aspects of Information Security in the Section “Digital Literacy” of the Course of Computer Science of Secondary General Education with the Use of Cases
Authors: Samylkina N. , Dorohova A.
Published: October 2023

The article is devoted to the preparation and use of cases on social engineering to consider organizational and legal aspects of information security. With the increasing availability of digital tools, the topic of personal information security remains relevant, as the proportion of people who are deceived by fraudsters is only increasing. Sophisticated phishing scenarios and attacks on social networks and messengers have become especially popular. The formation of a holistic view in the field of information security with an emphasis on the formation of digital competencies in the field of information ethics and law is becoming increasingly demanded in general education. To achieve subject outcomes on the topic, computer science teachers are encouraged to use interactive social engineering cases in a computer science course at the secondary general education level.
Embracing an outcome-based approach to cyber security
Authors: Brucciani Paul
Published: October 2023

Cyber security is often seen as an activity separate from an organisation's main business processes. It is something that only comes to the fore when an incident occurs – which may be too late. And this can create a gap between the true security needs of the organisation and its security posture. In contrast, outcome-based security creates direct links between business goals and security requirements.
Improving national security through accountability
Authors: Danhieux Pieter
Published: October 2023

The cyber security of an organisation starts with the software it uses. And that places a responsibility on software vendors to ensure that the code they ship is intrinsically secure. And that security can't be added as an afterthought – it needs to be integrated deep into the development process.
Synthesis and Cyclooxygenase-2 Inhibitory Activity Evaluation of Some Pyridazine Derivatives
Authors: Imran Mohd , Mohd Abida Ash , Nayeem Naira , Al-Otaibi Nawaf M. , Homoud Malik , Alshammari Muhannad Thafi
Published: October 2023

This work aimed to discover safe and effective pyridazine-based cyclooxygenase-2 (COX-2) inhibitors. Thirty-three pyridazine-based compounds (compounds 1 to 33) were designed. The in silico studies were conducted to predict their toxicity, docking scores (DS), pharmacokinetic parameters, and drug-likeliness properties compared to celecoxib. Based on the safety and efficacy data obtained by in silico studies, four compounds (7, 12, 16, and 24) were synthesized, and the spectral analysis confirmed their chemical structures. Additionally, the in vitro COX-2 inhibitory activity of these four compounds was evaluated. Eleven compounds were predicted as non-toxic compounds. The DS of four compounds, 7 (DS = -9.72 kcal/mol), 12 (DS = -10.48 kcal/mol), 16 (DS = -9.71 kcal/mol), and 24 (DS = -9.46 kcal/mol), was better than celecoxib (DS = -9.15). These compounds (7, 12, 16, and 24) also demonstrated better oral absorption (83.53% each) than celecoxib (79.20%) in addition to their promising drug-likeliness properties. The compounds 7 (101.23%; p < 0.05), 12 (109.56%; p < 0.05), 16 (108.25%; p < 0.05), and 24 (103.90%; p < 0.05) also exhibited superior COX-2 inhibition to celecoxib (100%; p < 0.05). Compounds 7, 12, 16, and 24 are useful lead compounds in developing drugs for various diseases in which high levels of COX-2 are implicated.
Cissus Quadrangularis is a Potential Anticancer Herb: A-Review
Authors: D Arthi Rashmi , Yadav Sangilimuthu Alagar , A Harishchander , M Karpagavalli , D Ranjithkumar
Published: October 2023

Cancer is uncontrolled growth of abnormal cells due to heredity, mutation, genetic factors, environment factors, chain smoking, alcoholic addiction and exposure of chemical carcinogen. Treating modern medicine for cancer are producing numerous adverse effects. Hence natural remedy is essential to combat disease with less side effects. Eighty percentage of the peoples are used the medicinal plants for various illness in developing countries asper the WHO survey. The present review was written extensively with past scientific reports on Cissus quadrangularis (CQ) and its anticancer properties. From the ancient times the various parts of CQ have used for various diseases and disorders as folk medicine by traditional healer and practice. Traditionally CQ has vital role in various disease management. Its active extracts and ingredients reported against various diseases such as inflammation, cancer, ulcer, bone fracture and epilepsy. Still its therapeutic potentials not yet fully explored to use common people after clinical trial. Mainly CQ and its active phytoconstituents contains potential action for the treatment of various types of cancer which is scientifically proven upto the lab scale that needs to be evolved as medicine for world threatened disease cancer.