bluuebunny/crossref_metadata_2025 huggingface dataset:
Population pharmacokinetic rationale for intravenous contezolid acefosamil followed by oral contezolid dosage regimens
Authors: Bulitta Jürgen B. , Fang Edward , Stryjewski Martin E. , Wang Wen , Atiee George J. , Stark Jeffrey G. , Hafkin Barry
Published: February 2024

Contezolid is a novel oxazolidinone antibiotic with a promising safety profile. Oral contezolid and its intravenous (IV) prodrug contezolid acefosamil (CZA) are in development for treatment of diabetic foot and acute bacterial skin and skin structure infections (ABSSSI). The prodrug CZA is converted to active contezolid via intermediate MRX-1352. This study aimed to provide the pharmacokinetic rationale for safe, effective, and flexible dosage regimens with initial IV CZA followed by oral contezolid. We simultaneously modeled plasma concentrations from 110 healthy volunteers and 74 phase 2 patients with ABSSSI via population pharmacokinetics (using the importance sampling estimation algorithm), and optimized dosage regimens by Monte Carlo simulations. This included data on MRX-1352, contezolid, and its metabolite MRX-1320 from 66 healthy volunteers receiving intravenous CZA (150–2400 mg) for up to 28 days, and 74 patients receiving oral contezolid [800 mg every 12 h (q12h)] for 10 days. The apparent total clearance for 800 mg oral contezolid with food was 16.0 L/h (23.4% coefficient of variation) in healthy volunteers and 17.7 L/h (53.8%) in patients. CZA was rapidly converted to MRX-1352, which subsequently transformed to contezolid. The proposed dosage regimen used an IV CZA 2000 mg loading dose with 1000 mg IV CZA q12h as maintenance dose(s), followed by 800 mg oral contezolid q12h (with food). During each 24-h period, Monte Carlo simulations predicted this regimen to achieve consistent areas under the curve of 91.9 mg·h/L (range: 76.3–106 mg·h/L) under all scenarios. Thus, this regimen was predicted to reliably achieve efficacious contezolid exposures independent of timing of switch from IV CZA to oral contezolid.

IMPORTANCE

This study provides the population pharmacokinetic rationale for the dosage regimen of the intravenous (IV) prodrug contezolid acefosamil (CZA) followed by oral contezolid. We developed the first integrated population model for the pharmacokinetics of the MRX-1352 intermediate prodrug, active contezolid, and its main metabolite MRX-1320 based on data from three clinical studies in healthy volunteers and phase 2 patients. The proposed regimen was predicted to reliably achieve efficacious contezolid exposures independent of timing of switch from IV CZA to oral contezolid.
Progress on network modeling and analysis of gut microecology: a review
Authors: Luo Meng , Zhu Jinlin , Jia Jiajia , Zhang Hao , Zhao Jianxin
Published: February 2024

The gut microecological network is a complex microbial community within the human body that plays a key role in linking dietary nutrition and host physiology. To understand the complex relationships among microbes and their functions within this community, network analysis has emerged as a powerful tool. By representing the interactions between microbes and their associated omics data as a network, we can gain a comprehensive understanding of the ecological mechanisms that drive the human gut microbiota. In addition, the network-based approach provides a more intuitive analysis of the gut microbiota, simplifying the study of its complex dynamics and interdependencies. This review provides a comprehensive overview of the methods used to construct and analyze networks in the context of gut microecological background. We discuss various types of network modeling approaches, including co-occurrence networks, causal networks, dynamic networks, and multi-omics networks, and describe the analytical techniques used to identify important network properties. We also highlight the challenges and limitations of network modeling in this area, such as data scarcity and heterogeneity, and provide future research directions to overcome these limitations. By exploring these network-based methods, researchers can gain valuable insights into the intricate relationships and functional roles of microbial communities within the gut, ultimately advancing our understanding of the gut microbiota’s impact on human health.
Supplemental Material: Comprehensive seismic evidence for the inducing mechanism of extremely shallow 2019 Changning Ms 6.0 earthquake by solution salt mining, Sichuan Basin, China
Authors: Anyiam Uzonna Okenna , Qian Jiawei , Tan Yuyang , Zhang Haijiang
Published: February 2024

Details on seismic tomography, model resolution tests, in-situ Vp/Vs ratio estimation, focal mechanism determination, stress parameters inversion, excess pore fluid pressures estimation, and Coulomb failure stress analysis, as well as additional figures and tables supporting main text and supplementary material.  
Supplemental Material: Spatiotemporal dynamics of dissolved organic matter in subtropical karst cave waters identified by optical properties
Authors: Dong Hui , Zhou Zhongfa , al. et
Published: February 2024

Contains the dataset of physicochemical parameters of the cave system.
Development and evaluation of a manualised mental health awareness and stigma reduction intervention for Black faith communities: study protocol for the ON TRAC feasibility study
Authors: Codjoe Louisa Natalie , Henderson Claire , N'Danga-Koroma Joelyn , Lempp Heidi , Romeo Renee , Bakolis Ioannis , Thornicroft Graham
Published: February 2024

Introduction

This paper presents the study protocol for a feasibility study of a manualised mental health awareness and stigma reduction intervention for Black faith communities, as part of the Outcomes and Needs of Traditional Religious And Complementary practitioners (ON TRAC) project. The primary objective is to assess the feasibility and acceptability of the intervention and the secondary objectives include assessment of the feasibility of: recruiting participants to take part in the intervention, delivering the intervention, and conducting qualitative assessments, and use of the selected scales. The findings from this study will be used to inform the development of a subsequent trial which will focus on exploring the potential impact of the intervention on stigma-related knowledge, attitudes, and behaviour.

Methods and analysis

The study uses a mixed-methods approach. A total of 80 participants from four Black Majority Churches in South London will be recruited. Randomisation of the participants will be at an individual level to either the intervention group (who will participate in the 10 week Mental Health Awareness Course intervention) or to the waiting list control group (who will receive the same intervention, 8 weeks after the intervention group). Outcomes for both arms will be collected at baseline, postintervention, and at 4 week follow-up. In addition, focus group discussions will be conducted with participants in the intervention group, a week following the end of the 10 week session course, to investigate the feasibility and acceptability of the mental health awareness course.

Ethics and dissemination

The results of this research will be disseminated at local, national, and international levels.

Trial registration number

ISRCTN12253092.
Health economic evaluations of preventative care for perinatal anxiety and associated disorders: a rapid review
Authors: Pisavadia Kalpa , Spencer Llinos Haf , Tuersley Lorna , Coates Rose , Ayers Susan , Edwards Rhiannon Tudor
Published: February 2024

Objectives

Perinatal mental health problems affect one in five women and cost the UK £8.1 billion for every year of births, with 72% of this cost due to the long-term impact on the child. We conducted a rapid review of health economic evaluations of preventative care for perinatal anxiety and associated disorders.

Design

This study adopted a rapid review approach, using principles of the standard systematic review process to generate quality evidence. This methodology features a systematic database search, Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram, screening of evidence, data extraction, critical appraisal and narrative synthesis.

Data sources

PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Applied Social Sciences Index and Abstracts, PsycINFO and MEDLINE.

Eligibility criteria for selecting studies

Studies that evaluated the costs and cost-effectiveness of preventative care for perinatal anxiety and associated disorders carried out within the National Health Service and similar healthcare systems.

Data extraction and synthesis

A minimum of two independent reviewers used standardised methods to search, screen, critically appraise and synthesise included studies.

Results

The results indicate a lack of economic evaluation specifically for perinatal anxiety, with most studies focusing on postnatal depression (PND). Interventions to prevent postnatal mental health problems are cost-effective. Modelling studies have also been conducted, which suggest that treating PND with counselling would be cost-effective.

Conclusion

The costs of not intervening in maternal mental health outweigh the costs of preventative interventions. Preventative measures such as screening and counselling for maternal mental health are shown to be cost-effective interventions to improve outcomes for women and children.

PROSPERO registration number

CRD42022347859.
Uncertainty associated with parents of preterm infants hospitalised in neonatal intensive care unit among selected governmental hospitals in Addis Ababa, Ethiopia, 2022: an institution-based cross-sectional study
Authors: Tilahun Befkad Derese , Yilak Gizachew , Amena Nimona , Abate Biruk Beletew , Fantahun Addishiwet , Deribe Leul
Published: February 2024

Objective

To assess the uncertainty associated with parents of preterm infants hospitalised in neonatal intensive care units of selected governmental hospitals in Addis Ababa, Ethiopia, 2022.

Design

A cross-sectional study conducted from 3 March 2022 to 30 March 2022.

Setting

The research was conducted at a government hospital in Addis Ababa, Ethiopia.

Participants

Out of 305 eligible participants, 303 were parents of preterm infants’ participants with complete data.

Primary outcome measure

Levels of parental uncertainty, assessed by using the Mishel scale of uncertainty. Simple and multivariable linear regression analyses were conducted to assess associations between variables.

Results

The mean uncertainty expressed by parents was 101.3 (SD=21.12). There were significant associations found with various factors. The sex of the respondent fathers (β=−4.65, 95% CI −9.32 to –0.025), length of neonatal intensive care unit (NICU) stay >10 days (β=14.64, 95% CI 8.71 to 20.56), gestational week between 34 and 37 weeks (β=−7.47, 95% CI −11.42 to –3.52), parents with college degrees and above (β=−14.15, 95% CI −22.94 to –5.34), parents with neonates who were preterm and had neonatal sepsis (β=10.42, 95% CI −17.57 to –3.27), parents without a history of neonatal NICU admission (β=−6.16, 95% CI −11.69 to –0.63) and parents who were housewives (β=6.51, 95% CI 1.83 to 12.19) all showed significant associations.

Conclusion

Factors like educational status, gestational week, neonatal admission history and NICU stay length contribute to parental uncertainty. Promoting empathy and clear communication is crucial. Hospitals should develop compassionate protocols for information delivery, including regular updates and effective addressing of concerns. Fostering a supportive environment helps parents express emotions and seek support.
Evaluation of the effectiveness and safety of a novel substrate-based radiofrequency ablation for persistent atrial fibrillation: a prospective, randomised, parallel-controlled, single-blinded study protocol
Authors: Yang Jie , Song Yuanbin , Bian Shizhu , Zhang Bo , Zhang Yi , Wang Xia , Cheng Li , Fan Yu , Liu Changsong , Tan Hu
Published: February 2024

Introduction

Pulmonary vein isolation (PVI) is the cornerstone of radiofrequency (RF) ablation for atrial fibrillation (AF). However, a single ablation strategy does not always achieve the desired therapeutic effect in all patients with persistent AF, and individualised strategies are required for different clinical characteristics.

Methods and analysis

This study aimed to determine the optimal catheter ablation strategy for persistent AF by comparing the efficacy of PVI and BCXL (BC: big circles encircling pulmonary vein isolation; XL: unfixed number of lines based on the left atrial substrate). The BCXL-AF study (clinical trial no. ChiCTR2200067081) was designed as a prospective, randomised, parallel-controlled, single-blinded clinical trial. Overall, 400 patients with persistent AF were randomised in a 1:1 ratio into PVI-only and BCXL-individualised ablation groups. Patients randomised to the individualised ablation group will be further categorised into risk strata according to their clinical condition using the actual ablation method determined by the strata. Seven postoperative visits were conducted from discharge to 24 months of age. The primary observation endpoint will be the incidence of atrial tachyarrhythmia (including AF, atrial flutter and atrial tachycardia with a duration of ≥30 s) without using antiarrhythmic drugs after a blank period of 3 months following a single ablation procedure. The BCXL-AF study will assess an optimal approach for persistent AF RF ablation and evaluate the effectiveness of individualised RF ablation strategies in reducing the recurrence rate of AF.

Ethics and dissemination

The study protocol was reviewed, and ethical approval was obtained from the Army Medical University Human Ethics Committee (approval number: 2022-484-01). All the participants provided written informed consent. This study was conducted according to the principles of the Declaration of Helsinki and its amendments. The results of this study will be disseminated through manuscript publication and conference presentations.

Trial registration number

ChiCTR2200067081.
Predictors of perinatal mortality in Liberia’s post-civil unrest: A comparative analysis of the 2013 and 2019–2020 Liberia Demographic and Health Surveys
Authors: Koray Munawar Harun , Curry Tanya
Published: February 2024

Introduction

Perinatal mortality remains a pressing concern, especially in lower and middle-income nations. Globally, 1 in 72 babies are stillborn. Despite advancements, the 2030 targets are challenging, notably in sub-Saharan Africa. Post-war Liberia saw a 14% spike in perinatal mortality between 2013 and 2020, indicating the urgency for in-depth study.

Objective

The study aims to investigate the predictors of perinatal mortality in Liberia using 2013 and 2019–2020 Liberia Demographic and Health Survey datasets.

Methods

In a two-stage cluster design from the Liberia Demographic and Health Survey, 6572 and 5285 respondents were analysed for 2013 and 2019–2020, respectively. Data included women aged 15–49 with pregnancy histories. Descriptive statistics was used to analyse the sociodemographic characteristics, the exposure to media and the maternal health services. Bivariate and multivariate logistic regressions were used to examine the predictors of perinatal mortality at a significance level of p value ≤0.05 and 95% CI. The data analysis was conducted in STATA V.14.

Results

Perinatal mortality rates increased from 30.23 per 1000 births in 2013 to 42.05 in 2019–2020. In 2013, increasing age of respondents showed a reduced risk of perinatal mortality rate. In both years, having one to three children significantly reduced mortality risk (2013: adjusted OR (aOR) 0.30, 95% CI 0.14 to 0.64; 2019: aOR 0.24, 95% CI 0.11 to 0.54), compared with not having a child. Weekly radio listenership increased mortality risk (2013: aOR 1.36, 95% CI 0.99 to 1.89; 2019: aOR 1.86, 95% CI 1.35 to 2.57) compared with not listening at all. Longer pregnancy intervals (p<0.0001) and receiving 2+ tetanus injections (p=0.019) were protective across both periods. However, iron supplementation showed varied effects, reducing risk in 2013 (aOR 0.90, 95% CI 0.48 to 1.68) but increasing it in 2019 (aOR 2.10, 95% CI 0.90 to 4.92).

Conclusion

The study reports an alarming increase in Liberia’s perinatal mortality from 2013 to 2019–2020. The findings show dynamic risk factors necessitating adaptable healthcare approaches, particularly during antenatal care. These adaptable approaches are crucial for refining health strategies in line with the Sustainable Development Goals, with emphasis on the integration of health, education, gender equality, sustainable livelihoods and global partnerships for effective health outcomes.
Impact of the pandemic and concomitant COVID-19 on the management and outcomes of middle cerebral artery strokes: a nationwide registry-based study
Authors: Ghaith Abdul Karim , El-Hajj Victor Gabriel , Atallah Elias , Rios Zermeno Jorge , Ravindran Krishnan , Gharios Maria , Hoang Harry , Bydon Mohamad , Ohlsson Marcus , Elmi-Terander Adrian , Tawk Rabih G , Jabbour Pascal
Published: February 2024

Objectives

To investigate the impact of the COVID-19 pandemic as well as concomitant COVID-19 itself on stroke care, focusing on middle cerebral artery (MCA) territory infarctions.

Design

Registry-based study.

Setting

We used the National Inpatient Sample (NIS) database, which covers a wide range of hospitals within the USA.

Participants

The NIS was queried for patients with MCA strokes between 2016 and 2020. In total, 35 231 patients were included.

Outcome measures

Outcome measures were postprocedural complications, length of stays (LOSs), in-hospital mortality and non-routine discharge. Propensity score matching using all available baseline variables was performed to reduce confounders when comparing patients with and without concomitant COVID-19.

Results

Mechanical thrombectomy (MT) was performed in 48.4%, intravenous thrombolysis (IVT) in 38.2%, and both MT and IVT (MT+IVT) in 13.4% of patients. A gradual increase in the use of MT and an opposite decrease in the use of IVT (p<0.001) was detected during the study period. Overall, 25.0% of all patients were admitted for MCA strokes during the pandemic period (2020), of these 209 (2.4%) were concomitantly diagnosed with COVID-19. Patients with MCA strokes and concomitant COVID-19 were significantly younger (64.9 vs 70.0; p<0.001), had significantly worse NIH Stroke Severity scores, and worse outcomes in terms of LOS (12.3 vs 8.2; p<0.001), in-hospital mortality (26.3% vs 9.8%; p<0.001) and non-routine discharge (84.2% vs 76.9%; p=0.013), as compared with those without COVID-19. After matching, only in-hospital mortality rates remained significantly higher in patients with COVID-19 (26.7% vs 8.5%; p<0.001). Additionally, patients with COVID-19 had higher rates of thromboembolic (12.3% vs 7.6%; p=0.035) and respiratory (11.3% vs 6.6%; p=0.029) complications.

Conclusions

Among patients with MCA stroke, those with concomitant COVID-19 were significantly younger and had higher stroke severity scores. They were more likely to experience thromboembolic and respiratory complications and in-hospital mortality compared with matched controls.
Fathers’ mental health and coping strategies: a qualitative study in Mwanza, Tanzania
Authors: Jeong Joshua , McCann Juliet K , Joachim Damas , Ahun Marilyn N , Kabati Mary , Kaaya Sylvia
Published: February 2024

Objectives

To investigate the nature of paternal mental health problems, their causes and the coping strategies used by fathers of young children under the age of 2 years.

Design and setting

We conducted in-depth interviews with fathers, mothers, community leaders and community health workers as well as focus group discussions with fathers-only, mothers-only and mixed groups of fathers and mothers. Respondents provided their perspectives on the psychosocial challenges affecting fathers and how fathers responded to their mental health problems. Data were triangulated across stakeholders and analysed using thematic content analysis.

Setting

The study was conducted in four communities in Mwanza, Tanzania.

Participants

The total sample included 56 fathers, 56 mothers and 8 community stakeholders that were equally distributed across the four communities.

Results

Respondents highlighted a spectrum of mental health concerns affecting fathers, including elevated parenting stress, depressive symptoms, and anxiety. Causes of paternal mental health problems included poverty, child-related concerns, marital problems and family illness. When asked about paternal coping strategies, both fathers and mothers shared that fathers mostly turned to negative coping strategies to manage their distress, such as paternal alcohol use and poor conflict resolution strategies. However, respondents also shared how some fathers used positive coping strategies, such as seeking out social support from their family and friends, engaging in exercise and leisure activities and relying on their faith.

Conclusions

Overall, this study highlights the importance of supporting positive mental health among fathers. Our findings can inform the design of psychosocial programme components that can be integrated within parenting interventions to promote the well-being of specifically fathers and ultimately improve the family caregiving environment.
Assessment of the role of gut health in childhood stunting in a multisite, longitudinal study in India, Indonesia and Senegal: a UKRI GCRF Action Against Stunting Hub protocol
Authors: Momo Kadia Benjamin , Ramsteijn Anouschka S , Dasi Teena , Fahmida Umi , Kulkarni Bharati , Faye Babacar , Htet Min Kyaw , Sow Doudou , Kalashikam Rajender Rao , Sharma Ritu , Sudibya Arienta R P , Kusuma Sari , Angelin Tiffany C , Nurfadilah Mifa , Jobarteh Modou Lamin , Diop Ndeye Sokhna , Gabain Isobel , Calvo-Urbano Beatriz , Ferguson Elaine , Haggarty Paul , Heffernan Claire , Webster Joanne P , Walker Alan W , Allen Stephen
Published: February 2024

Introduction

Childhood stunting has a complex aetiology, with poor gut health being an important contributor. This study will assess inter-relationships between maternal and infant gut health indices and infant linear growth. Inter-relationships between gut health indices, systemic inflammation and growth hormones in early childhood will also be assessed.

Methods and analysis

A longitudinal observational study of cohorts of 600 newborns and their mothers in India, Indonesia and Senegal will be conducted. Women will be recruited during pregnancy and their children followed up to age 24 months. Stool, urine and blood samples will be collected from the women and children for assessments of helminthic and protozoal parasites, bacterial pathogens, faecal microbiota taxa, biomarkers of environmental enteric dysfunction, systemic inflammation and growth hormones. Child anthropometric measurements will be collected at birth and at ages 3, 6, 9, 12, 18 and 24 months. The gut health indices will be integrated with cohort data from other Action Against Stunting Hub (AASH) workstreams for interdisciplinary analyses of childhood stunting and the development of a new typology of stunting.

Discussion

This study will advance scientific understanding of the role of gut health in childhood stunting and will contribute to a broader knowledge of the complex aetiology of this condition as part of the interdisciplinary AASH research to reduce the global burden of childhood stunting.

Ethics and dissemination

This study has been approved by the relevant Ethics Committees in Senegal, India, and Indonesia and LSHTM. The results will be submitted for publication in peer-reviewed journals.
Measurement of cognition and profiling early learning environments in India, Indonesia and Senegal: a UKRI GCRF Action Against Stunting Hub protocol paper
Authors: Dockrell Julie , Massonnié Jessica , Ang Lynn , Munoz-Chereau Bernardita , Fernandez Rao Sylvia , Kolopaking Risatianti , Ndiaye Moustapha , Heffernan Claire
Published: February 2024

Introduction

Childhood stunting is associated with poorer child health, growth and development including diminished cognitive abilities. Mapping out the links between child stunting and Early Childhood Education and Development is critical to increasing understanding of the causes and effects of childhood stunting, and for programme and policy development. The aim of this study is to investigate and compare the development and educational environments across India, Indonesia and Senegal, and to identify the multifactorial drivers and impacts of childhood stunting to inform a new typology.

Methods and analysis

This current study is part of an interdisciplinary observational research study, where women are recruited during pregnancy and mother–infant pairs followed prospectively, up to 24 months after birth. Eight measures will be used to profile children’s early development and learning environments in two sample cohorts: (A) children aged 12 and 24 months born to the women recruited during pregnancy (ie, 500 pregnant mothers per country) and (B) a preschool case–control cohort of siblings from the main cohort aged between 3:6 and 5:6 years of age where anthropomorphic measures will be collected to assess degrees of stunting. Profiling of the development and learning environments in the countries will include both parent/caregiver self-reported and local staff (enumerators) direct assessments of children and settings.

Ethics and dissemination

This study was approved by the institutional ethics committees of all partner institutions. In India, Indian Council of Medical Research-National Institute of Nutrition, Hyderabad; In Indonesia, Ethics Committee of the Faculty of Medicine, University of Indonesia; and in Senegal, National Ethics Committee for Scientific Research in Senegal.The findings of the study will be disseminated in national and international meetings, seminars, conferences and peer-reviewed journals.
Impact of SARS-CoV-2 infection and mitigation strategy during pregnancy on prenatal outcome, growth and development in early childhood in India: a UKRI GCRF Action Against Stunting Hub protocol paper
Authors: Jobarteh Modou Lamin , Saxena Deepak B , Kulkarni Bharati , Shah Komal , Banjara Santosh Kumar , Shah Priyanka Akshay , Memon Farjana , Chilumula Monica , Palepu Dharani Pratyusha , Selvaraj Kiruthika , Dasi Teena , Madhari Radhika , Calvo-Urbano Beatriz , Dockrell Julie , Antalek Catherine , Davies-Kershaw Hilary , Ferguson Elaine , Heffernan Claire
Published: February 2024

Introduction

The COVID-19 pandemic has offset some of the gains achieved in global health, particularly in relation to maternal, child health and nutrition. As pregnancy is a period of plasticity where insults acting on maternal environment have far-reaching consequences, the pandemic has had a significant impact on prenatal outcomes, intrauterine and postnatal development of infants. This research will investigate both the direct and indirect impacts of the COVID-19 pandemic during pregnancy on prenatal outcomes, growth and development in early childhood.

Methods and analysis

Community and hospital data in Hyderabad and Gujarat, India will be used to recruit women who were pregnant during the COVID-19 pandemic and contracted SARS-CoV-2 infection. In comparison with women who were pregnant around the same time and did not contract the virus, the study will investigate the impact of the pandemic on access to healthcare, diet, nutrition, mental health and prenatal outcomes in 712 women (356 per study arm). Children born to the women will be followed prospectively for an 18-month period to investigate the impact of the pandemic on nutrition, health, growth and neurocognition in early childhood.

Ethics and dissemination

Ethics approval was granted from the institutional ethics committees of the Indian Institute of Public Health Gandhinagar (SHSRC/2021/2185), Indian Council of Medical Research-National Institute of Nutrition (EC/NEW/INST/2021/1206), and London School of Hygiene and Tropical Medicine (72848). The findings of the study will be disseminated to policy and research communities through engagements, scientific conferences, seminars, and open-access, peer-reviewed publication.
Advancement, barriers and collaboration: the ABC’s of addressing challenges and designing solutions between front-line physicians and business-oriented leaders
Authors: Ramedani Shayann , Miller Jeffery , Gonzalo Jed D
Published: February 2024

Background

The complexity of US healthcare has been increasing for many years, requiring clinicians and learners to understand care delivery systems in addition to clinical sciences. Thus, there has been a major push to educate faculty and trainees on healthcare functionality. This comes as hospitals expand into health systems requiring the help of more sophisticated expertise of departments such as operations excellence when problem-solving. As a medical student with a background in operations excellence, medical education leader and clinical administration leader all currently facilitating this transition, we wanted to reflect on the barriers we have experienced in clinical implementation of quality improvement projects and educating learners on the impact of operations excellence principles in their clinical education.

Methods

The ideas presented in this article were the result of a several collaborative discussion between the authors, on the key challenges to adopting operations excellence principles into health system science education. In an effort to add context to this reflection through the current body of research present, they supplemented a literature review on the topic which included 86 studies published between 2013 and 2021 regarding health systems science and healthcare leadership engagement in the USA. The themes that intersected between the literature review and the discussions were then expanded on in this paper.

Results

Through this process, we identified four challenges: (1) the difference in thinking styles, which we term, ‘mental model differences’; (2) the strategic nature of process improvement projects and how that collides with physician priorities, or ‘the chess game of stakeholder engagement’; (3) the language and precise methodology, or ‘consistency of language and need for administrative resilience’ and (4) the issue of teaching these concepts or bridging the learning gap.’

Conclusion

In an increasingly complex healthcare landscape, physicians and trainee’s need to bridge gaps between the mental models of administrative and clinical workflow.
Faculty retention at a young medical school in crisis times and beyond: prospects, challenges and propositions from a mixed-methods study
Authors: Yazbeck Karam Vanda G , Bahous Sola , Awada Ghada M , Youssef Nazih
Published: February 2024

Background

Retention of faculty constitutes a significant challenge for higher education institutions, especially in times of crisis. Lebanon has been experiencing economic recession since the end of its civil war in 1990 until its complete collapse in 2019. This resulted in a massive faculty exodus, escaping the daily struggle with the sinking economy.

Purpose

The purpose of this study was to empirically investigate the factors that precipitate faculty attrition and the measures that foster long-term commitment to the institution in a time of unprecedented crisis.

Methods

An online anonymous survey, using a Likert scale, gathered responses from 92 faculty members. Quantitative findings were complemented by a qualitative exploration of emergent themes in comments. A team of three certified researchers conducted the analysis. Inductive analysis identified recurring themes, with steps like intercoder reliability checks and member-checking enhancing data validity. The researchers ensured methodological rigour, subject expertise, and overall reliability and validity of the thematic analysis.

Results

A total of 78 faculty participated in the survey (84.8%), with 79.5% reporting overall satisfaction, but a varying degree of satisfaction was noted across items. Faculty satisfaction was highest in areas such as respectful interactions (91.0%), belonging to the workplace (85.9%), communication from the Dean’s office (85.9%), supportive environment and medical school leadership’s commitment to retaining faculty (82.1%). Financial assistance, support for research and professional assistance were identified as important retention measures. Effective, transparent communication from leadership was highlighted as a critical factor during times of crisis.

Conclusion

This study provides strategies for faculty retention in times of crisis that include ensuring timely salary payments, supporting research and professional development, fostering a positive work environment and implementing bonding programmes. Transparent communication from leadership is vital for faculty satisfaction and retention. These findings can aid medical schools and other institutions facing faculty attrition during crises.
On codimension one holomorphic distributions on compact toric orbifolds
Authors: Rodríguez Peña Arnulfo Miguel
Published: February 2024

The number of singularities, counted with multiplicity, of a generic codimension one holomorphic distribution on a compact toric orbifold is determined. As a consequence, we provide a classification for regular distributions on rational normal scrolls and weighted projective spaces. Additionally, under specific conditions, we prove that the singular set of a codimension one holomorphic foliation on a compact toric orbifold admits at least one irreducible component of codimension two, and we also present a Darboux–Jouanolou type integrability theorem for codimension one holomorphic foliations. Our results are exemplified through various illustrative examples.
Stagnant points and uniform film analysis of Eyring fluid film flow on a vertically upward moving slippery flat plate
Authors: Walait A. , Siddiqui A. M. , Ashraf H. , Siddique I. , Ghazwani Hassan Ali , Jabeen S.
Published: February 2024

In this paper, we analyze how Eyring fluid film behavior on a vertically upward moving slippery flat plate can help predictive models in engineering, notably in coating and lubrication operations. This paper deals with the stagnant points and uniform film analysis of Eyring fluid film flow on a vertically upward moving slippery flat plate. The formulated ordinary differential equation is solved for exact analytic solution. Exact analytic expressions for velocity, flow rate, average velocity, shear stress components, and stagnant points are derived. A highly nonlinear algebraic equation is derived for film thickness. Equation is solved by Newton’s method using Maple code. The thickness of film widens with increasing relaxation time, constant plate velocity, and fluid density, while it decreases with increasing fluid viscosity and constant slip parameter. The analysis delineates that the positions of stagnant points tend to relocate closer the slippery plate as the Stokes number, Deborah number, and constant slip parameter increase. A high Deborah number enhances drainage, causing stagnant points to relocate closer to the slippery plate and the development of a stable elastic layer adjacent to the plate. For stagnant points and fluid film thickness, a comparison between the Eyring fluid and existing studies (EPTT, LPTT, UCM, and Newtonian fluid) is also provided. The validity of this paper with the existing studies is also presented by reducing Eyring fluid model to Newtonian model. The results of this research are significant for a wide range of biofluid applications, including agrochemical uses, paint and surface coating flow behavior, thin films on the cornea and lungs, and chemical and nuclear reactor design.
A FRACTAL-FRACTIONAL TSUNAMI MODEL CONSIDERING NEAR-SHORE FRACTAL BOUNDARY
Authors: WANG YAN , HOU WEIFAN , GEPREEL KHALED , LI HONGJU
Published: February 2024

Every fluid problem is greatly affected by its boundary conditions, especially the near-shore seabed could produce an irrevocable harm when a tsunami wave is approaching, and a real-life mathematical model could stave off the worst effect. This paper assumes that the unsmooth seabed is a fractal surface, and fractal-fractional governing equations are established according to physical laws in the fractal space. The geometrical potential theory is used to explain the force produced by the wave surface, and Kong-He friction law is applied to further figuring out the local and memory properties of the friction along the fractal boundary. This paper aims at studying tsunami waves in a fractal space, rendering a reliable mathematical model for both prediction of the tsunami motion and the coastal protection.
Time-Variant Reliability for Systems with Non-monotonic Limit-State Functions
Authors: Savage Gordon J. , Son Young Kap
Published: February 2024

Most engineering time-variant reliability problems are the result of component degradation and stochastic loading. The resultant failure modes, and their resultant limit-state functions, produce limit-state surfaces with unpredictable temporal trajectories that may exhibit a combination of increasing and decreasing failure probabilities. In many cases the trajectories are monotonic so that failure increases predictably: in other cases, this is not so. In this paper we present the discrete-time set theory derivation for non-monotonic situations wherein the limit-state surface may recede to provide, what only appears to be, ever decreasing failure probability. The presence of both monotonic and non-monotonic limit-state functions can be easily detected by a parametric polar plot of the most-likely failure points in standard normal space. The polar plot reveals the temporal limit-state surfaces that need to be retained to represent the system limit-state surfaces at any time instant. The minimum set herein is called the extreme limit-state surface. The impact of the work is that the cumulative distribution function (cdf) can be provided with a minimum of failure and safe events. This in turn gives rise to several solution options such as the multi-normal integral method or a special Monte Carlo simulation that obviates the tedious marching-out routine. A series system and a parallel system show the efficacy of the theory.
Enhanced Photocatalytic Degradation of Organic Matter In Nuclear Waste Liquid Under Visible Light by a Ternary Thin Layer System Based on g-C3N4
Authors: Shi Xiaozhong , Zhao Bin , Sun Siqin , Wu Linzhen , Zhang Ling , Zhang Youkui , Duan Tao
Published: February 2024

Graphitic carbon nitride (g-C3N4)-based materials are considered promising catalysts for organic waste photodegradation due to their excellent photocatalytic activity and stability. Herein, a ternary thin layer system based on g-C3N4 was prepared by hexagonal boron nitride (h-BN) deposition followed by liquid phase ultrasonic stripping and Ag deposition (marked as Ag-BCN), which increased the specific surface area of g-C3N4, expanded the corresponding range of the visible-near-infrared spectrum of g-C3N4 and promoted the photo-generated electron–hole pair separation in g-C3N4 to improve the photocatalytic efficiency of pure g-C3N4. The results showed that after deposition of h-BN and Ag into bulk g-C3N4 and liquid phase ultrasonic stripping, the efficiency of photocatalytic degradation of tannic acid (TA) was enhanced. The efficiency of photocatalytic degradation of TA by Ag-BCN-2 was 84.3% at 90 min, which was 1.6 times the efficiency of bulk g-C3N4.
Harnessing the Power of LLMs in Practice: A Survey on ChatGPT and Beyond
Authors: Yang Jingfeng , Jin Hongye , Tang Ruixiang , Han Xiaotian , Feng Qizhang , Jiang Haoming , Zhong Shaochen , Yin Bing , Hu Xia
Published: February 2024

This article presents a comprehensive and practical guide for practitioners and end-users working with Large Language Models (LLMs) in their downstream Natural Language Processing (NLP) tasks. We provide discussions and insights into the usage of LLMs from the perspectives of models, data, and downstream tasks. First, we offer an introduction and brief summary of current language models. Then, we discuss the influence of pre-training data, training data, and test data. Most importantly, we provide a detailed discussion about the use and non-use cases of large language models for various natural language processing tasks, such as knowledge-intensive tasks, traditional natural language understanding tasks, generation tasks, emergent abilities, and considerations for specific tasks. We present various use cases and non-use cases to illustrate the practical applications and limitations of LLMs in real-world scenarios. We also try to understand the importance of data and the specific challenges associated with each NLP task. Furthermore, we explore the impact of spurious biases on LLMs and delve into other essential considerations, such as efficiency, cost, and latency, to ensure a comprehensive understanding of deploying LLMs in practice. This comprehensive guide aims to provide researchers and practitioners with valuable insights and best practices for working with LLMs, thereby enabling the successful implementation of these models in a wide range of NLP tasks. A curated list of practical guide resources of LLMs, regularly updated, can be found at
https://github.com/Mooler0410/LLMsPracticalGuide
. An LLMs evolutionary tree, editable yet regularly updated, can be found at
llmtree.ai
.
Exploration on Advanced Intelligent Algorithms of Artificial Intelligence for Verb Recognition in Machine Translation
Authors: Ai Qinghua , Ai Qingyan , Wang Jun
Published: February 2024

This article aimed to address the problems of word order confusion, context dependency, and ambiguity in traditional machine translation (MT) methods for verb recognition. By applying advanced intelligent algorithms of artificial intelligence, verb recognition can be better processed and the quality and accuracy of MT can be improved. Based on Neural machine translation (NMT), basic attention mechanisms, historical attention information, dynamically obtain information related to the generated words, and constraint mechanisms were introduced to embed semantic information, represent polysemy, and annotate semantic roles of verbs. This article used the Workshop on MT (WMT), British National Corpus (BNC), Gutenberg, Reuters Corpus, and OpenSubtitles corpus, and enhanced the data in the corpora. The improved NMT model was compared with traditional NMT models, Rule-Based MT (RBMT), and Statistical MT (SMT). The experimental results showed that the average verb semantic matching degree of the improved NMT model in five corpora was 0.85, and the average Bilingual Evaluation Understudy (BLEU) score in five corpora was 0.90. The improved NMT model in this article can effectively improve the accuracy of verb recognition in MT, providing new methods for verb recognition in MT.
Layer-Type AxRhO2 (A = Li, Na, K, Rb, Cs) and KxMO2 (M = Co, Rh, Ir) Electrodes: Structure and Electrochemistry
Authors: Kim Eun Jeong , Hirayama Takumi , Moriya Kodai , Hosaka Tomooki , Kubota Kei , Tatara Ryoichi , Komaba Shinichi
Published: February 2024

Layered lithium transition-metal oxides have remained at the forefront since the first commercialization of layered LiCoO2 in lithium-ion batteries in 1991. The scientific interest in layered sodium transition-metal oxides as well as potassium transition-metal oxides has been considerably growing for application to sodium- and potassium-ion batteries. We extend our systematic studies on the series of layered oxides to AxRhO2 (A = Li, Na, K, Rb, Cs) and KxMO2 (M = Co, Rh, Ir) electrode system focusing on their crystal structure and electrochemical behaviors in non-aqueous cells as a function of A+ ion. Further studies on P2-type KxRhO2 in comparison to P2-type KxCoO2 show that larger Rh(III/IV) ion than Co(III/IV) is believed to be beneficial for reversibility and kinetic of redox process, accompanied with reversible structural evolution upon oxidation/reduction maintaining the P2 framework.
Modulation of adipose tissue metabolism by exosomes in obesity
Authors: Xu Yajing , Huang Linghong , Zhuang Yong , Huang Huibin
Published: February 2024

Obesity and its related metabolic complications represent a significant global health challenge. Central to this is the dysregulation of glucolipid metabolism, with a predominant focus on glucose metabolic dysfunction in the current research, whereas adipose metabolism impairment garners less attention. Exosomes (EXs), small extracellular vesicles (EVs) secreted by various cells, have emerged as important mediators of intercellular communication and have the potential to be biomarkers, targets, and therapeutic tools for diverse diseases. In particular, EXs have been found to play a role in adipose metabolism by transporting cargoes such as noncoding RNAs (ncRNA), proteins, and other factors. This review article summarizes the current understanding of the role of EXs in mediating adipose metabolism disorders in obesity. It highlights their roles in adipogenesis (encompassing adipogenic differentiation and lipid synthesis), lipid catabolism, lipid transport, and white adipose browning. The insights provided by this review offer new avenues for developing exosome-based therapies to treat obesity and its associated comorbidities.
Temporal and region-specific tau hyperphosphorylation in the medulla and forebrain coincides with development of functional changes in male obese Zucker rats
Authors: Das-Earl Paromita , Schreihofer Derek A. , Sumien Nathalie , Schreihofer Ann M.
Published: February 2024

Male obese Zucker rats (OZRs) lack functional leptin receptors and develop metabolic syndrome (MetS). At 16–19 wk, OZRs are insulin resistant, with increased ptau in dorsal medulla and impaired autonomic regulation of AP. At 28–29 wk OZRs develop increased ptau in hippocampus with deficits in spatial learning and memory. Juvenile OZRs lack elevated ptau and these deficits, demonstrating that leptin is not essential for normal function. Elevated ptau and deficits emerge before the onset of diabetes in insulin-resistant OZRs.
Coherent categorical information triggers integration-related alpha dynamics
Authors: Chen Lixiang , Cichy Radoslaw Martin , Kaiser Daniel
Published: February 2024

Our brain integrates dynamic inputs across the visual field to create coherent visual experiences. Such integration processes have previously been linked to cortical alpha dynamics. In this study, the integration-related alpha activity was observed not only when snippets from the same video were presented, but also when different video snippets from the same basic-level category were presented, highlighting the flexibility of neural integration processes.