bluuebunny/crossref_metadata_2025 huggingface dataset:
A moral economy of care: How clinical discourses perpetuate Indigenous‐specific discrimination and racism in western Canadian emergency departments
Authors: Muller da Silva Megan
Published: May 2024

Recent research has unveiled the pervasiveness with which Indigenous patients are subjected to racialized stereotypes within the Canadian health system. Because discrimination in health care is associated with poor health outcomes and undertreated illness, there is a need to better understand how racism is perpetuated systemically in order to rectify the policies, practices, and attitudes that enable it. This article outlines a moral economy of care in emergency departments in western Canada by exploring the discourses that medical professionals employ when discussing cases of medical racism. While these discourses respond to the everyday realities of working in hospitals, they are also rooted in the colonial genealogy of health care in Canada and perpetuated by neoliberal shifts in health care services. By exploring the moral economy of care, this article sheds light on the way pervasive discourses contribute to reproducing and circulating Indigenous‐specific racism and its role in decision‐making.
Transforming medical education: Implementing ‘disruptors’ to break the cycle of ableism
Authors: Meeks Lisa M. , Bullock Justin L.
Published: May 2024

@meekslisa and @jbullockruns in @MedEd_Journal highlight the struggles of disabled students and call for strategic disruptions to dismantle ableism and foster inclusion in #HPE. #DocsWithDisabilities #MedTwitter #MedEd
Clarity without simplicity: researching lived experience in health professions education
Authors: Kelly Martina , Brown Megan E. L.
Published: May 2024

Kelly and Brown outline how research into lived experience is different, shining value on subjectivity by being evocative while promoting visceral, felt responses, and enabling surprise.
Preventing too much of a good thing: epigenetic regulation limits sucrose‐induced anthocyanin production in Arabidopsis
Authors: LaFountain Amy M.
Published: May 2024

This article is a Commentary on Zhang et al. (2024), 243: 1374–1386.
Does photobiomodulation alter mitochondrial dynamics?
Authors: Trajano Larissa Alexsandra da Silva Neto , Siqueira Priscyanne Barreto , Rodrigues Mariana Moreno de Sousa , Pires Bruno Ricardo Barreto , da Fonseca Adenilson de Souza , Mencalha Andre Luiz
Published: May 2024

Mitochondrial dysfunction is one of the leading causes of disease development. Dysfunctional mitochondria limit energy production, increase reactive oxygen species generation, and trigger apoptotic signals. Photobiomodulation is a noninvasive, nonthermal technique involving the application of monochromatic light with low energy density, inducing non‐thermal photochemical effects at the cellular level, and it has been used due to its therapeutic potential. This review focuses on the mitochondrial dynamic's role in various diseases, evaluating the possible therapeutic role of low‐power lasers (LPL) and light‐emitting diodes (LED). Studies increasingly support that mitochondrial dysfunction is correlated with severe neurodegenerative diseases such as Parkinson's, Huntington's, Alzheimer's, and Charcot–Marie‐Tooth diseases. Furthermore, a disturbance in mitofusin activity is also associated with metabolic disorders, including obesity and type 2 diabetes. The effects of PBM on mitochondrial dynamics have been observed in cells using a human fibroblast cell line and in vivo models of brain injury, diabetes, spinal cord injury, Alzheimer's disease, and skin injury. Thus, new therapies aiming to improve mitochondrial dynamics are clinically relevant. Several studies have demonstrated that LPL and LED can be important therapies to improve health conditions when there is dysfunction in mitochondrial dynamics.
The exposure of nonhuman living organisms to mobile communication emissions: A survey to establish European stakeholders’ policy option preferences
Authors: Recuero Virto Laura , Thielens Arno , Czerwiński Marek , Froidevaux Jérémy
Published: May 2024

There is an unprecedented exposure of living organisms to mobile communications radiofrequency electromagnetic field (RF‐EMF) emissions. Guidelines on exposure thresholds to limit thermal effects from these emissions are restricted to humans. However, tissue heating can occur in all living organisms that are exposed. In addition, exposure at millimetric frequencies used by 5G may impact surface tissues and organs of plants and small‐size species. It is also expected that the addition of 5G to existing networks will intensify radiofrequency absorption by living organisms.

A European Parliament report proposed policy options on the effects of RF‐EMF exposure of plants, animals, and other living organisms in the context of 5G: funding more research, implementing monitoring networks, accessing more information from operators on antennas and EMF emissions, and developing compliance studies when antennas are installed. However, there is no evidence on the preferences of relevant stakeholders regarding these policy options. This paper reports the findings of a survey of key European stakeholders’ policy option preferences based on the European Parliament's report. It reveals a broad consensus on funding more research on the effects of exposure of plants, animals, and other living organisms to EMFs. It also highlights the need for deliberation concerning the other policy options that could provide solutions for regulatory authorities, central administrations, the private sector, nongovernmental associations and advocates, and academics. Such deliberation would pave the way for effective solutions, focusing on long‐term output from funding research, and enabling short‐term socially and economically acceptable actions for all parties concerned.
First report of target‐site resistance to glyphosate in Amaranthus hybridus L. in the Republic of South Africa
Authors: Shabangu Nhlanhla M. , Simelane Nonduduzo A. , Reinhardt Carl F. , Marais Diana , Vorster Barend J.
Published: May 2024

Amaranthus hybridus L. is a major weed for summer crops. Although A. hybridus has been a known crop weed in the Republic of South Africa (RSA) for a long time, herbicide resistance has not been a problem. Nevertheless, A. hybridus populations from KwaZulu Natal (KZN) Province have caught the attention of farmers since glyphosate has been progressively becoming less effective in controlling the species. This study aimed to evaluate herbicide resistance in A. hybridus and the underlying mechanisms of resistance. Seeds from 50 glyphosate‐resistant plants were collected from fields at Bergville and Winterton in KZN and compared with a susceptible population from Hendrina (Mpumalanga Province). Glasshouse screening was conducted where glyphosate (Roundup® PowerMax) was applied at 6‐leaf stage, at doses 0, 540, 1080 (recommended dose), 2160 and 4320 g ae ha−1. Surviving plants were sampled for molecular analysis to establish any target site mutations in the EPSPS gene that confer glyphosate resistance. Dose–response assay indicated 100% control in the Hendrina population, variation in the control of the Winterton population and 100% survival in the Bergville population. Molecular analysis indicated a rare triple mutation (TAP‐IVS) in the KZN populations. This kind of mutation endows a high level of glyphosate resistance, which explains why these populations survived even the 4× dose. These findings confirmed the first cases of glyphosate‐resistant A. hybridus and established the mechanism of resistance as target site mutations in the EPSPS gene reported in the RSA. These findings will serve as a base for other herbicide resistance cases and the development of initiatives to control and minimize the spread of this weed in the RSA.
Hypoxia‐inducible factor‐1α attenuates renal podocyte injury in male rats in a simulated high‐altitude environment by upregulating Krüppel‐like factor 4 expression
Authors: Xiaoshan Zeng , Huan Cheng , Zhilin Gan , Liwen Mo , Yan Zeng , Yue Cheng
Published: May 2024

Previous studies have shown that podocyte injury is involved in the development of proteinuria in rats under hypobaric hypoxia conditions. Prolyl hydroxylase inhibitors (PHIs) may reduce proteinuria. This study aimed to further investigate whether the protective effects of hypoxia‐inducible factor 1α (HIF1α) on podocyte injury induced by hypobaric hypoxia are related to Krüppel‐like factor 4 (KLF4). Rats were housed in a low‐pressure oxygen chamber to simulate a high‐altitude environment (5000 m), and a PHI was intraperitoneally injected. Urinary protein electrophoresis was performed and the morphology of the podocytes was observed by electron microscopy. Rat podocytes were cultured under 1% O2, and siRNA was used to interfere with KLF4 expression. The protein expression levels of HIF1α, KLF4, CD2‐associated protein (CD2AP) and nephrin were determined by western blotting. Compared with those in the experimental group, the rats in the intervention group on day 14 had lower urinary protein levels, increased protein expression levels of CD2AP and nephrin, and reduced podocyte injury. The results of in vitro experiments showed that the protein expression levels of KLF4, CD2AP and nephrin were greater in the PHI intervention group and lower in the HIF1α inhibitors group than in the low‐oxygen group. The protein expression of CD2AP and nephrin in the siKLF4‐transfected podocytes treated with PHI and HIF1α inhibitors did not differ significantly from that in the low‐oxygen group. HIF1α may be involved in reducing progressive high‐altitude proteinuria by regulating KLF4 expression and contributing to the repair of podocyte injury induced by hypobaric hypoxia.
The RhoA guanine exchange factor ABR: a glucose‐sensitive mediator of actin reorganization in feto‐placental arterial endothelial cells altered by gestational diabetes mellitus
Authors: Tokic Silvija , Novakovic Boris , Leopold‐Posch Barbara , Mühlberger Magdalena , Hoch Denise , Lögl Jelena , Bernhart Eva M. , Saffery Richard , Desoye Gernot , Hiden Ursula
Published: May 2024

In utero exposure to gestational diabetes mellitus (GDM) programs the fetus, increasing offspring risk for endothelial dysfunction and cardiovascular disease later in life. Hyperglycaemia is widely recognized as the driving force of diabetes‐induced programming. We have previously shown that GDM exposure alters DNA methylation and gene expression associated with actin remodelling in primary feto‐placental arterial endothelial cells (fpEC). Thus, we hypothesized that hyperglycaemic insults underlie programmed changes in fpEC morphology and actin organization by GDM. Therefore, arterial fpECs isolated after normal and GDM pregnancy, as well as normal fpECs that were exposed to hyperglycaemia in vitro, were analysed for the effect of GDM and hyperglycaemia on actin organization and network formation. Integration of gene expression and DNA methylation data identified the RhoA activator active BCR‐related (ABR) as programmed by GDM and altered by in vitro hyperglycaemia. ABR silencing in GDM‐exposed cells reduced RhoA activity by 34 ± 26% (P = 0.033) and restored normal fpEC phenotype. In fact, in vitro hyperglycaemia induced a similar fpEC phenotype as intrauterine exposure to GDM, i.e. round morphology and increased network formation on Matrigel by 34 ± 33% (P = 0.022) vs. 22 ± 20% for GDM (P = 0.004). Thus, we identified ABR as a novel glucose sensitive regulator of actin organization and cell shape, programmed by GDM and upregulated by hyperglycaemia. Identification of mechanisms induced by hyperglycaemia and affecting endothelial function in the long term will contribute to understanding GDM‐induced programming of offspring endothelial dysfunction and cardiovascular disease. Future studies could focus on investigating the prevention or reversal of such malprogramming.

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Key points

In utero exposure to gestational diabetes mellitus (GDM) affects future health of the offspring, with an increased risk for endothelial dysfunction and cardiovascular disease in later life.

GDM alters DNA methylation and expression of ABR in feto‐placental arterial endothelial cells (fpEC), a model for endothelial cells exposed to the intrauterine environment of the fetus.

GDM phenotype of fpECs is also induced by hyperglycaemia in vitro, and is characterized by altered actin organization and cell shape, which can be restored by ABR silencing.

Revealing the cellular mechanisms induced by GDM and hyperglycaemia is important for understanding the mechanisms of how these conditions disturb endothelial function in the offspring.
An Experimental Investigation of Sweeping Air/Mist Jet Film Cooling Through a Row of Passive Fluidic Oscillators
Authors: Abdelmaksoud Ramy , Wang Ting
Published: May 2024

Sweeping jet fluidic oscillators can be a promising candidate in film cooling applications since they have a large lateral jet spreading with more uniform cooling, which can be considered an advantage when compared to the regular steady jet film cooling. Sweeping jet fluidic oscillators are passive and can generate a sweeping movement without the need for any moving parts. In addition, they can be more conveniently manufactured by additive manufacturing techniques. This paper presents an experimental study of employing two-phase (air/mist) flow through a row of passive fluidic oscillators in film cooling applications for gas turbine airfoil cooling. The objective of this study is to investigate the potential enhancement of film cooling by using sweeping jets injected with water mist. Three blowing ratios (BR = 0.85, 1.66, 2.40) and two mist ratios (MR = 2.75% and 6.92%) are used (i.e., a total of nine cases including the air-only cases). Infrared thermography and E-type thermocouples were used to measure the wall temperature, while a phase Doppler particle analyzer (PDPA) was used to measure the droplets' size distributions. The initial mean droplet size is 11.6 μm. An interesting observation was found where thin water liquid streaks were formed at the exit of the fluidic oscillators and traveled for very long distances (about 140D) providing excellent local film cooling under the laboratory low heating condition. The forming of liquid streaks is due to the significant droplets' coalescence phenomenon caused by large oscillating vortical flows inside the fluidic oscillator. Adding small mist ratios provided better cooling effectiveness with an overall time-averaged cooling enhancement of 15–90% and a maximum local cooling enhancement of 300–350% in all the cases studied. The sweeping mist jet provided better film cooling effectiveness at the centerline and spanwise direction (87% and 76%, respectively) when compared to steady jets under the laboratory conditions with low temperatures and low pressure.
Lightweight Reseach of Tube Sheet for Spiral Wound Heat Exchanger Based on ANSYS
Authors: Wu Jinxing , Li Jiawen , Chen Yabo
Published: May 2024

Tube sheet is the key pressure-bearing part in the spiral wound heat exchanger, and the high-strength and light-weight tube sheet structure is of great engineering significance for the development of a large-scale heat exchanger. In order to further realize the lightweight of the spiral-wound heat exchanger, this paper analyzes the influence of the thickness of the heat exchanger tube sheet on its strength based on the Ansys software and proposes the optimization design method of the tube sheet based on the strength safety factor F, which solves the problem that the software cannot take the stress linearization result as the state variable in the optimization calculation. The optimization results show that the thickness of the tube sheet is reduced by 40%. At this time, the stress strength at the connection between the tube sheet and the head and the center of the tube sheet first exceeds the design bearing capacity, indicating that the strength conditions of the two places are the controlling factors of the thickness. The results are important for the lightweight design of heat exchanger tube plate and material saving.
Reliability Analysis of Steam Generator Level Control Valves
Authors: Pandey Mahesh , Goodchild Mark , Sherzad Ahmad , Wang Rui
Published: May 2024

The feedwater level in steam generators of a nuclear reactor is controlled by air-operated level control valves (LCVs). In the air operated valves, aging related degradation of diaphragm causing the air leak is a dominant mode of malfunction of the valve actuator. The paper summarizes the operating experience of a group of 32 large LCVs (10” size), which includes occurrences of various types of malfunctions, repair actions, and valve overhauls over a period of 20 years. The operating history of each valve is translated into complete and right-censored lifetime data. This paper presents the statistical analysis of the valve lifetime data and estimates the Weibull reliability curve for various failure modes of the valve. The three major groups of components, actuator, control, and packing have an adequate reliability. The mean lifetime of the actuator, control, and packing system are estimated as 21, 15, and 37 years, respectively. Further, these components do not exhibit any statistical aging effect, i.e., increase in failure rate with valve age. A simulation analysis was performed to confirm that the absence of aging effect is not an artefact of data. In other words, there is a high probability (over 0.8) of detecting the aging effect from the current dataset, if the aging were indeed present in the valve components.
Integrated Asset Management for Extreme Disasters: Assessing the 2023 Flood Events and Resilience of Critical Infrastructures
Authors: Nkwazema Oscar Chijioke , Dokuchits Emilia Yu. , Ejairu Emuesiri D.
Published: May 2024

The global community is currently witnessing many casualties and economic losses resulting from extreme weather and climate-related disasters, particularly floods. These occurrences have become more pronounced in terms of their intensity and frequency due to climate change. In 2023, many countries experienced devastating floods and heavy rainfall, and the problem is further exacerbated by humanity’s increasing reliance on critical infrastructure and essential assets, which will lead to increased susceptibility to situations classified as 'extreme occurrences'. Therefore, it is imperative to prioritize the development of climate-resilient non-structural and structural means to enhance the effectiveness of water governance.

This study assesses the extreme flood disasters in 2023 and investigated a more integrated flood management approach using risk-informed based method. Additionally, the study aims to enhance the resilience of critical infrastructure to mitigate the impact of future disruptive flood disasters. Technical development that echoes the principle of adopting new information is incorporated into the methodology to improve the resilience. To effectively implement a flood management strategy based on risk assessment, it is essential to have a comprehensive understanding of the risk patterns in a floodplain and to determine the key factor that requires prioritization to mitigate the risk.

The findings indicated a need to explore strategies that is necessary for adapting to evolving environmental, hydrological, and social conditions, which builds sustainable resilience. To facilitate socioeconomic growth, water resource infrastructure needs to be proliferated to meet increasing current realities.

In a climate-change-affected world with massive floods, preparation is crucial. We need resilience and green infrastructure that can be adapted to various disasters. This vital research develops sophisticated decision-support tools and builds resilience to help managers and decision-makers. Thus, identifying, assessing, and implementing appropriate structural and nonstructural interventions would reduce damages and enhance future flood planning, resulting in significant economic, social, and environmental benefits.
Remaining Technical Gaps for Electric Power Utilities
Authors: Komljenovic Dragan
Published: May 2024

This section outlines the primary challenges that have been identified, along with their corresponding gaps. The first part provides a summary of the challenges and gaps related to electric utilities, as provided by experts from Hydro-Quebec (Quebec, Canada), in alphabetic order: Stéphane Alarie, Vito Deluca, Rémi Dumoulin, Anne-Marie Giroux, Dragan Komljenovic, Simon Lebeau, Laurent Lenoir, Nickie Menemenlis, Darragi Messaoudi, Marc Morissette, Luc Perreault, Patrick Picher, Jacques Prévost, Jean Raymond, Denis Thibault, Pierre Van Dyke, Mohamed Ryad Zemouri, and Rawad Zgheib.
Barriers and Facilitators to Including Students With Down Syndrome in Integrated Physical Education: Chilean Physical Educators’ Perspectives
Authors: Gustavo Teixeira Fabricio dos Santo Luiz , Arroyo-Rojas Fabián , Martinez Rivera Sheyla , Felipe Castelli Correia de Campos Luis , Nowland Lindsey A. , Wilson Wesley J. , Haegele Justin A.
Published: May 2024

The purpose of this study was to explore Chilean physical educators’ perspectives on barriers and facilitators to students with Down syndrome experiencing inclusion in integrated physical education. Data were collected from a cohort of 91 physical educators, comprising 50 males and 41 females from various regions in Chile, who responded to an online survey between March 2023 to June 2023. A two-step coding protocol was used to analyze responses. Cumulatively, the respondents identified 350 barriers (3.84 per participant) and 393 facilitators (4.32 per participant), which they perceived to influence feelings of inclusion among students with Down syndrome. Predominantly, factors that centered around teachers themselves were emphasized as both facilitators and barriers, as well as the role of a welcoming environment and supportive peers. This study, the first within the Chilean context, demonstrates that teachers believe that inclusiveness predominantly stems from educators’ initiatives, complemented by the surrounding environment and peer interactions.
Supplemental Material: Deformation of the Gruithuisen region lava tube under compressional stress on the Moon
Authors: Kimi K.B. , al. et
Published: May 2024

 Additional descriptions of the procedure followed in the study, supporting figures, tables, and links to model GIFs of lunar lava tube deformation.  
ST-segment elevation myocardial infarction (STEMI) caused by spontaneous coronary artery dissection (SCAD) in a patient with von Willebrand disease
Authors: Padam Jaspreet , Cenkowski Michael , Nosib Shravankumar
Published: May 2024

A postpartum woman in her early 40s, with a history of pre-eclampsia and von Willebrand disease (VWD), presented to the emergency room with chest pain suggestive of an acute coronary syndrome. Initial workup revealed an evolving anterior wall ST-segment elevation myocardial infarction on ECG and elevated cardiac biomarkers, confirming myocardial damage. Point-of-care ultrasound showed apical hypokinesis and coronary angiography revealed a distal dissection of the left anterior descending coronary artery. There was TIMI 3 flow and no evidence of plaque rupture. No percutaneous coronary intervention was performed and the patient was managed conservatively.

Fibromuscular dysplasia was ruled out on screening CT angiography. Dual antiplatelet therapy was initiated for an amended course of 3 months given the history of VWD. Our patient had an uncomplicated course in the hospital with a downward trend in their cardiac biomarkers, resolving anterior ST elevation on serial ECGs, and no bleeding complications.
Development and validation of a reliable method for automated measurements of psoas muscle volume in CT scans using deep learning-based segmentation: a cross-sectional study
Authors: Choi Woorim , Kim Chul-Ho , Yoo Hyein , Yun Hee Rim , Kim Da-Wit , Kim Ji Wan
Published: May 2024

Objectives

We aimed to develop an automated method for measuring the volume of the psoas muscle using CT to aid sarcopenia research efficiently.

Methods

We used a data set comprising the CT scans of 520 participants who underwent health check-ups at a health promotion centre. We developed a psoas muscle segmentation model using deep learning in a three-step process based on the nnU-Net method. The automated segmentation method was evaluated for accuracy, reliability, and time required for the measurement.

Results

The Dice similarity coefficient was used to compare the manual segmentation with automated segmentation; an average Dice score of 0.927 ± 0.019 was obtained, with no critical outliers. Our automated segmentation system had an average measurement time of 2 min 20 s ± 20 s, which was 48 times shorter than that of the manual measurement method (111 min 6 s ± 25 min 25 s).

Conclusion

We have successfully developed an automated segmentation method to measure the psoas muscle volume that ensures consistent and unbiased estimates across a wide range of CT images.
Effectiveness of educational and psychological survivorship interventions to improve health-related quality of life outcomes for men with prostate cancer on androgen deprivation therapy: a systematic review
Authors: Sara Sally AM , Heneka Nicole , Green Anna , Chambers Suzanne K , Dunn Jeff , Terry Victoria R
Published: May 2024

Objectives

Androgen deprivation therapy (ADT), a common treatment for prostate cancer, has debilitating impacts on physical and psychological quality of life. While some interventions focus on managing the physical side effects of ADT, there is a paucity of interventions that also address psychosocial and educational needs. The objective of this systematic review was to identify psychological and educational survivorship interventions targeting health-related quality of life (HRQoL) outcomes in men on ADT.

Design

A systematic review of randomised controlled trials.

Data sources

Web of Science, Cochrane, EBSCO Host, PubMed, SCOPUS from inception (1984) to 28 January 2023.

Eligibility criteria for selecting studies

Psychological and/or educational survivorship interventions targeting HRQoL outcomes for men on ADT; minimum 80% of participants on ADT; used a validated HRQoL outcome measure; published in English in a peer-reviewed journal.

Data extraction and synthesis

Data extraction using pre-specified study criteria was conducted. Heterogeneity of eligible studies precluded a meta-analysis.

Results

A total of 3381 publications were identified with eight meeting the criteria. Interventions were either psychological with a cognitive behavioural approach (n=4), or educational with (n=2) or without (n=2) psychoeducational components.

Two studies reported a statistically significant improvement using a specific HRQoL measure. Most studies were not adequately powered and/or included small sample sizes limiting the conclusions that can be drawn on effectiveness. The most effective interventions were (i) individually based, (ii) educational with a psychoeducational component, (iii) supplemented with information packages and/or homework and (iv) included personalised needs assessments.

Conclusion

There is a paucity of literature reporting psychological and educational survivorship interventions targeting HRQoL outcomes for men on ADT. What is urgently needed are person-centred survivorship interventions that are flexible enough to identify and address individual needs, taking into account the impact ADT has on both physical and psychological quality of life.

PROSPERO registration number

CRD4202230809.
Intersectoral health interventions to improve the well-being of people living with type 2 diabetes: a scoping review protocol
Authors: Yapi Sopie Marielle , Boudrias Marguerite , Tremblay Alexandre , Belanger Gabrielle , Sourial Nadia , Boivin Antoine , Sasseville Maxime , Côté André , Gartner Jean-Baptiste , Taleb Nadine , Lavoie Marie-Eve , Trépanier Emmanuelle , Vachon Brigitte , Labelle Marcel , Layani Géraldine
Published: May 2024

Introduction

Intersectoral collaboration is a collaborative approach between the health sectors and other sectors to address the interdependent nature of the social determinants of health associated with chronic diseases such as diabetes. This scoping review aims to identify intersectoral health interventions implemented in primary care and community settings to improve the well-being and health of people living with type 2 diabetes.

Methods and analysis

This protocol is developed by the Arksey and O’Malley (2005) framework for scoping reviews and the Levacet almethodological enhancement. MEDLINE, Embase, CINAHL, grey literature and the reference list of key studies will be searched to identify any study, published between 2000 and 2023, related to the concepts of intersectorality, diabetes and primary/community care. Two reviewers will independently screen all titles/abstracts, full-text studies and grey literature for inclusion and extract data. Eligible interventions will be classified by sector of action proposed by the Social Determinants of Health Map and the conceptual framework for people-centred and integrated health services and further sorted according to the actors involved. This work started in September 2023 and will take approximately 10 months to be completed.

Ethics and dissemination

This review does not require ethical approval. The results will be disseminated through a peer-reviewed publication and presentations to stakeholders.
Protocol for the development of the Chatbot Assessment Reporting Tool (CHART) for clinical advice
Authors:   The CHART Collaborative
Published: May 2024

Introduction

Large language model (LLM)-linked chatbots are being increasingly applied in healthcare due to their impressive functionality and public availability. Studies have assessed the ability of LLM-linked chatbots to provide accurate clinical advice. However, the methods applied in these Chatbot Assessment Studies are inconsistent due to the lack of reporting standards available, which obscures the interpretation of their study findings. This protocol outlines the development of the Chatbot Assessment Reporting Tool (CHART) reporting guideline.

Methods and analysis

The development of the CHART reporting guideline will consist of three phases, led by the Steering Committee. During phase one, the team will identify relevant reporting guidelines with artificial intelligence extensions that are published or in development by searching preprint servers, protocol databases, and the Enhancing the Quality and Transparency of health research Network. During phase two, we will conduct a scoping review to identify studies that have addressed the performance of LLM-linked chatbots in summarising evidence and providing clinical advice. The Steering Committee will identify methodology used in previous Chatbot Assessment Studies. Finally, the study team will use checklist items from prior reporting guidelines and findings from the scoping review to develop a draft reporting checklist. We will then perform a Delphi consensus and host two synchronous consensus meetings with an international, multidisciplinary group of stakeholders to refine reporting checklist items and develop a flow diagram.

Ethics and dissemination

We will publish the final CHART reporting guideline in peer-reviewed journals and will present findings at peer-reviewed meetings. Ethical approval was submitted to the Hamilton Integrated Research Ethics Board and deemed “not required” in accordance with the Tri-Council Policy Statement (TCPS2) for the development of the CHART reporting guideline (#17025).

Registration

This study protocol is preregistered with Open Science Framework:https://doi.org/10.17605/OSF.IO/59E2Q.
Pharmacist-led medication management services: a qualitative exploration of transition-of-care cardiovascular disease patient experiences
Authors: Bennetts Joshua , White Jennifer , Croft Hayley , Cooper Joyce , McIvor Dawn , Eadie Nicholas , Appay Marcelle , Sverdlov Aaron L , Ngo Doan
Published: May 2024

Objective

Hospitalisation due to medication-related problems is a major health concern, particularly for those with pre-existing, or those at high risk of developing cardiovascular disease (CVD). Postdischarge medication reviews (PDMRs) may form a core component of reducing hospital readmissions due to medication-related problems. This study aimed to explore postdischarge CVD patients’ perspectives of, and experiences with, pharmacist-led medication management services. A secondary aim explored attitudes towards the availability of PDMRs.

Design

An interpretative qualitative study involving 16 semistructured interviews. Data were analysed using an inductive thematic approach.

Setting

Patients with CVD discharged to a community setting from the John Hunter Hospital, an 820-bed tertiary referral hospital based in New South Wales, Australia.

Participants

Patients with pre-existing or newly diagnosed CVD who were recently discharged from the hospital.

Results

A total of 16 interviews were conducted to reach thematic saturation. Nine participants (56%) were male. The mean age of participants was 57.5 (±13.2) years. Three emergent themes were identified: (1) poor medication understanding impacts transition from the hospital to home; (2) factors influencing medication concordance following discharge and (3) perceived benefits of routine PDMRs.

Conclusions

There is a clear need to further improve the quality use of medicines and health literacy of transition-of-care patients with CVD. Our findings indicate that the engagement of transition-of-care patients with CVD with pharmacist-led medication management services is minimal. Pharmacists are suitable to provide essential and tailored medication review services to patients with CVD as part of a multidisciplinary healthcare team. The implementation of routine, pharmacist-led PDMRs may be a feasible means of providing patients with access to health education following their transition from hospital back to community, improving their health literacy and reducing rehospitalisations due to medication-related issues.
Efficacy and safety of transcutaneous auricular vagus nerve stimulation (ta-VNS) in the treatment of tinnitus: protocol for an updated systematic review and meta-analysis
Authors: Lin Xiaoqi , Fang Yiyan , Hu Hantong , Ye Ziyu
Published: May 2024

Introduction

With an increasing incidence and significant effects on patients, tinnitus has become a major disease burden. There is a dearth of therapies with established efficacy for tinnitus. Transcutaneous auricular vagus nerve stimulation (ta-VNS) is being investigated as a potential therapy for tinnitus, but the current body of evidence remains inconclusive due to conflicting results across different studies. As a result, this protocol aims to synthesise and update the evidence to clarify whether ta-VNS is effective and safe for alleviating tinnitus.

Methods and analysis

To identify relevant randomised controlled trials (RCTs), seven representative bibliographical databases will be searched from their inception to December 2023: PubMed, Embase (via OVID), Cochrane Library, Chinese National Knowledge Infrastructure, Wangfang Database, Chinese BioMedical Literature Database, and Chongqing VIP Chinese Science and Technology Periodical Database. Publications in English or Chinese will be considered for inclusion. RCTs comparing ta-VNS with active treatments, no intervention, waitlist control or sham ta-VNS in adult patients with subjective tinnitus will be included. Studies on objective tinnitus will be excluded. Primary outcome is tinnitus symptom severity measured by validated scales. With all eligible trials included, when applicable, quantitative analysis via meta-analyses will be performed using RevMan V.5.4.1 software. Otherwise, a qualitative analysis will be conducted. The methodological quality of the included RCTs will be assessed using the Risk of Bias 2.0 tool. Sensitivity analyses, subgroup analysis and publication bias evaluation will also be performed. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to grade the certainty of the evidence.

Ethics and dissemination

Ethical approval is not required for this systematic review, as no primary data will be collected. The results will be reported and disseminated through publication in a peer-reviewed journal.

PROSPERO registration number

CRD42022351917.
Outcomes of patients with COPD switching from multiple-inhaler to once-daily single-inhaler triple therapy in a real-world primary care setting in England: a retrospective pre-post cohort study
Authors: Rothnie Kieran J , Wood Robert P , Czira Alexandrosz , Banks Victoria L , Camidge Lucinda J , Massey Olivia K I , Seif Monica , Compton Chris , Sharma Raj , Halpin David M G , Ismaila Afisi S , Vogelmeier Claus F
Published: May 2024

Background

Compared with multiple-inhaler triple therapy (MITT), single-inhaler triple therapy (SITT) with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) demonstrated improved lung function and meaningful improvements in chronic obstructive pulmonary disease (COPD) Assessment Test score. This real-world study compared the effectiveness of switching patients with COPD in England from MITT to once-daily SITT with FF/UMEC/VI by evaluating rates of COPD exacerbation, healthcare resource use (HCRU) and associated direct medical costs.

Methods

Retrospective cohort pre-post study using linked primary care electronic health record and secondary care administrative datasets. Patients diagnosed with COPD at age ≥35 years, with smoking history, linkage to secondary care data and continuous GP registration for 12 months pre-switch and 6 months post-switch to FF/UMEC/VI were included. Index date was the first initiation of an FF/UMEC/VI prescription immediately following MITT use from 15 November 2017 to 30 September 2019. Baseline was 12 months prior to index, with outcomes assessed 6/12 months pre-switch and post-switch, and stratified by prior COPD exacerbation status.

Results

We included 2533 patients (mean [SD] age: 71.1 [9.9] years; 52.1% male). In the 6 months post-switch, there were significant decreases in the proportion of patients experiencing ≥1 moderate-to-severe (36.2%–28.9%), moderate only (24.4%–19.8%) and severe only (15.4%–11.8%) COPD exacerbation (each, p<0.0001) compared with the 6 months pre-switch. As demonstrated by rate ratios, there were significant reductions in exacerbation rates of each severity overall (p<0.01) and among patients with prior exacerbations (p<0.0001). In the same period, there were significant decreases in the rate of each COPD-related HCRU and total COPD-related costs (−24.9%; p<0.0001).

Conclusion

Patients with COPD switching from MITT to once-daily SITT with FF/UMEC/VI in a primary care setting had significantly fewer moderate and severe exacerbations, and lower COPD-related HCRU and costs, in the 6 months post-switch compared with the 6 months pre-switch.
Can climate variability and landscape position predict white pine blister rust incidence, mortality due to the disease, and regeneration in whitebark pine?
Authors: Kovalenko Vladimir , Bate Lisa , Six Diana L.
Published: May 2024

Invasive forest pathogens, like Cronartium ribicola (Fisch), the fungus that causes white pine blister rust, threaten native tree species. Federally listed whitebark pine ( Pinus albicaulis Engelmann) is highly susceptible and faces extensive mortality due to this disease. Understanding infection conditions and disease incidence variability is crucial for management and restoration efforts. We surveyed whitebark pine stands in Glacier National Park, Montana, USA from 2020 to 2022, examining the impact of landform and climate on tree mortality, rust incidence, cone production, and regeneration. Our analysis revealed that tree diameter, elevation, and aspect significantly influenced mortality, rust incidence, and cone production, while climatic factors such as spring solar radiation, humidity, and late summer snowpack also played key roles. Regeneration was primarily affected by elevation, geographic location, and humidity. Although landform variables similarly predicted disease incidence in this and other studies, climatic drivers varied by region, emphasizing the need to consider region-specific landform and climate for effective management. Our study highlights the importance of protecting large trees, which harbor genetic diversity crucial for recovery and adaptation to disturbance and climate change.
Digitising the Deep Past: Machine Learning for Rock Art Motif Classification in an Educational Citizen Science Application
Authors: Turner-Jones Richard N. , Tuxworth Gervase , Haubt Robert A. , Wallis Lynley
Published: May 2024

Digitising the Deep Past (DDP) is an interdisciplinary project based at Griffith University, Australia, that innovates in three areas: Indigenous cultural heritage, Indigenous education, and Machine Learning (ML) and Artificial Intelligence (AI). The project investigates the use of a purpose-built citizen science application that engages Indigenous youth in educational exercises grounded in local cultural heritage, specifically rock art, making learning more engaging and exposing them to digital technologies. Furthermore, ML models trained with the data gathered through these educational activities can then assist with classifying new rock art images and assisting rangers and archaeologists with site archiving and conservation efforts. This article discusses the project’s significance in enhancing Indigenous science and technology education and outlines its results in using ML for rock art classification. Adopting deep learning in rock art classification offers a compelling avenue for the automated analysis and interpretation of heritage objects and places. However, training deep neural networks from scratch often requires enormous datasets and computational resources, posing challenges for domain-specific applications with smaller datasets. With a dataset comprising approximately 3,100 labeled rock art images, we evaluated various tools within the transfer learning toolbox using three prominent pre-trained architectures: VGG19, ResNet50 and EfficientNet V2 S. Through the collaborative efforts of Indigenous students and ML, we demonstrate that even with limited training resources, using transfer learning to re-purpose an existing model can achieve motif classification Top 1 accuracy of 79.76% and Top 5 of 94.56%. The project ran from 2021 to 2023, including 3 week-long sessions with students of Laura State School to trial the citizen science app and the evaluation, development and refinement of the ML models.

The DDP project not only serves as a beacon for community-centric research but also forges a new frontier in integrating Indigenous cultural heritage with modern technology. The impact reaches beyond academia, directly enriching the educational experience for Indigenous students in Laura and equipping local rangers and archaeologists with advanced tools for rock art conservation.
Transplantation of alveolar macrophages improves the efficacy of endothelial progenitor cell therapy in mouse model of bronchopulmonary dysplasia
Authors: Mohammed Afzaal Nadeem , Kohram Fatemeh , Lan Ying-Wei , Li Enhong , Kolesnichenko Olena A. , Kalin Tanya V. , Kalinichenko Vladimir V.
Published: May 2024

Recent studies demonstrated that transplantation of lung-resident endothelial progenitor cells (EPC) is an effective therapy in mouse model of bronchopulmonary dysplasia (BPD). However, key factors regulating the efficacy of EPC are unknown. Herein, we demonstrate that transplantation of tissue-resident alveolar macrophages (rAM) increases CXCL12 expression in neonatal mouse lungs. rAM are required for retention of donor EPC in hyperoxia-injured lungs. Co-transplantation of rAM and EPC improves the efficacy of EPC therapy in mouse BPD model.
Stability Evaluation of Slope Based on Global Sensitivity Analysis
Authors: Xu Zhaoxia , Wang Xiuzhen , Guo Lu , Yu Teng
Published: May 2024

The uncertainty of parameters will have a significant impact on slope stability, where sensitivity analysis is a commonly used method in uncertainty research. However, traditional sensitivity analysis method costs much computation time. When calculating the sensitivity index of one parameter, all other parameters are taken as fixed values, and the uncertainty of all parameters cannot be considered simultaneously. Therefore, the variance-based and the moment-independent global sensitivity analysis (GSA) methods are both introduced to determine the influence of geotechnical parameters on slope stability in this study. To solve the importance index of GSA, the least angle regression algorithm, the kernel density estimation, and orthogonal polynomial estimation methods are developed to obtain variance-based importance index and the moment-independent importance index, respectively. The proposed methods allow all variables to change simultaneously within their variation range and have high computational efficiency. The results are in good at with those obtained by the variance-based Monte Carlo simulation method, which is considered as the exact solution forobtaining the importance index. The influence of the correlation between the shear strength parameters (c and φ) on the importance index is also studied, which indicates that the negative correlation will have a great impact on the importance index, which in turn affects the safety assessment of slope. Three engineering cases have been studied for engineering application, and the compared results indicate that the impact of the geotechnical parameters uncertainty on the safety factor (Fs) and failure probability (pf) are different. Therefore, the approaches based on GSA which can integrate the Fs with pf will be a promising approach for slope stability evaluation.
Effects of Loom Speed, Insertion Air Pressure, and Yarn Type on Fabric Air Permeability: Case Study on Air Jet Loom
Authors: Admas Anmen , Assefa Alemayehu
Published: May 2024

The air permeability of the fabric is affected by the type of yarn used, the loom speed, and the amount of air pressure delivered by the relay nozzles. In this study, 21 Ne of ring and rotor spun yarns were used as a weft in an air jet loom. Loom speed and left‐ and right‐side relay nozzles pressure in a range of 400–600 RPM, 2–4 bar, and 3–6.5 bar, respectively, were taken as additional factors. To develop and analyze the experiment, a full factorial design was used. It was observed that the air permeability of rotor spun weft yarn fabric’s is greater than ring spun weft yarn fabrics. Furthermore, when the speed of the loom increased and the left‐ and right‐side relay nozzles air pressure decreased, the fabric’s air permeability increased and vice versa.
The Sequential Conformable Langevin‐Type Differential Equations and Their Applications to the RLC Electric Circuit Problems
Authors: Aydin M. , Mahmudov N. I.
Published: May 2024

In this paper, the sequential conformable Langevin‐type differential equation is studied. A representation of a solution consisting of the newly defined conformable bivariate Mittag‐Leffler function to its nonhomogeneous and linear version is obtained via the conformable Laplace transforms’ technique. Also, existence and uniqueness of a global solution to its nonlinear version are obtained. The existence and uniqueness of solutions are shown with respect to the weighted norm defined in compliance with (conformable) exponential function. The concept of the Ulam–Hyers stability of solutions is debated based on the fixed‐point approach. The LRC electrical circuits are presented as an application to the described system. Simulated and numerical instances are offered to instantiate our abstract findings.