bluuebunny/crossref_metadata_2025 huggingface dataset:
Defining conditions for effective interdisciplinary care team communication in an open surgical intensive care unit: a qualitative study
Authors: Diaz Carmen M , Egide Abahuje , Berry Andrew , Rafferty Miriam , Amro Ali , Tesorero Kaithlyn , Shapiro Michael , Ko Bona , Jones Whitney , Slocum John D , Johnson Julie , Stey Anne Madeleine
Published: December 2023

Objective

Poor interdisciplinary care team communication has been associated with increased mortality. The study aimed to define conditions for effective interdisciplinary care team communication.

Design

An observational cross-sectional qualitative study.

Setting

A surgical intensive care unit in a large, urban, academic referral medical centre.

Participants

A total 6 interviews and 10 focus groups from February to June 2021 (N=33) were performed. Interdisciplinary clinicians who cared for critically ill patients were interviewed. Participants included intensivist, transplant, colorectal, vascular, surgical oncology, trauma faculty surgeons (n=10); emergency medicine, surgery, gynaecology, radiology physicians-in-training (n=6), advanced practice providers (n=5), nurses (n=7), fellows (n=1) and subspecialist clinicians such as respiratory therapists, pharmacists and dieticians (n=4). Audiorecorded content of interviews and focus groups were deidentified and transcribed verbatim. The study team iteratively generated the codebook. All transcripts were independently coded by two team members.

Primary outcome

Conditions for effective interdisciplinary care team communication.

Results

We identified five themes relating to conditions for effective interdisciplinary care team communication in our surgical intensive care unit setting: role definition, formal processes, informal communication pathways, hierarchical influences and psychological safety. Participants reported that clear role definition and standardised formal communication processes empowered clinicians to engage in discussions that mitigated hierarchy and facilitated psychological safety.

Conclusions

Standardising communication and creating defined roles in formal processes can promote effective interdisciplinary care team communication by fostering psychological safety.
What are the features of high-performing quality improvement collaboratives? A qualitative case study of a state-wide collaboratives programme
Authors: McGowan James G , Martin Graham P , Krapohl Greta L , Campbell Darrell A , Englesbe Michael J , Dimick Justin B , Dixon-Woods Mary
Published: December 2023

Objectives

Despite their widespread use, the evidence base for the effectiveness of quality improvement collaboratives remains mixed. Lack of clarity about ‘what good looks like’ in collaboratives remains a persistent problem. We aimed to identify the distinctive features of a state-wide collaboratives programme that has demonstrated sustained improvements in quality of care in a range of clinical specialties over a long period.

Design

Qualitative case study involving interviews with purposively sampled participants, observations and analysis of documents.

Setting

The Michigan Collaborative Quality Initiatives programme.

Participants

38 participants, including clinicians and managers from 10 collaboratives, and staff from the University of Michigan and Blue Cross Blue Shield of Michigan.

Results

We identified five features that characterised success in the collaboratives programme: learning from positive deviance; high-quality coordination; high-quality measurement and comparative performance feedback; careful use of motivational levers; and mobilising professional leadership and building community. Rigorous measurement, securing professional leadership and engagement, cultivating a collaborative culture, creating accountability for quality, and relieving participating sites of unnecessary burdens associated with programme participation were all important to high performance.

Conclusions

Our findings offer valuable learning for optimising collaboration-based approaches to improvement in healthcare, with implications for the design, structure and resourcing of quality improvement collaboratives. These findings are likely to be useful to clinicians, managers, policy-makers and health system leaders engaged in multiorganisational approaches to improving quality and safety.
Impact of digital assistive technologies on the quality of life for people with dementia: protocol for a scoping review
Authors: Schneider Charlotte , Kowatsch Tobias , Vinay Rasita
Published: December 2023

Introduction

Digital assistive technologies (eg, applications, wearables and robots) have emerged as promising tools for managing various aspects of daily life, such as basic assistance, encompassing social interaction, memory support, leisure activities, location tracking and health monitoring. In order to understand how these technologies can be utilised for people living with dementia, their impacts must first be reviewed. Currently, there is limited literature available on the topic, usually only focusing on a particular kind of digital assistive technology. Therefore, this paper presents a protocol for a scoping review that aims to provide a general overview of the impact digital assistive technologies can have on the quality of life for people living with dementia.

Methods and analysis

We will follow the scoping review framework proposed by Arksey and O'Malley. A comprehensive search will be performed to identify original research articles or clinical trials published between 2013 and 2023 across five online databases (Cochrane, Embase, PubMed, Scopus and Web of Science). The review will encompass both qualitative and quantitative themes derived from the literature. Relevant studies will be identified through a comprehensive search using specific search terms related to the population (people with dementia), intervention (digital assistive technologies) and outcome (quality of life). The screening of titles, abstracts and full texts will be performed to select eligible studies based on predetermined inclusion and exclusion criteria. Data will be extracted using a standardised form, and the findings will be synthesised and reported qualitatively and quantitatively.

Ethics and dissemination

Ethical approval is not required because this study is a scoping review based on published data. We intend to publish our findings in a peer-reviewed journal.
Development of an international core outcome set for treatment trials in paediatric inguinal hernia: protocol for a three-phase study including a systematic review and Delphi survey
Authors: Maat Sanne C , Gorter Ramon R , van Heurn Ernest L W , Rippen Hester , Butcher Nancy J , Offringa Martin , Derikx Joep P M
Published: December 2023

Introduction

In children, open inguinal hernia repair has been the gold standard for treatment, but with recent technical advancements in laparoscopy, laparoscopic hernia repair is gaining popularity. Despite available results from comparative studies, there is still no consensus regarding the superiority of open versus laparoscopic treatment strategy. An important reason for lack of consensus is the large heterogeneity in the trials’ reported outcomes and outcome definitions, which limits comparisons between studies and precludes conclusions regarding the superiority of treatment strategies. The development and implementation of a core outcome set (COS) is a solution for this heterogeneity in the selection, measurement and reporting of trial outcome measures across studies. Currently, there is no COS for the treatment of paediatric inguinal hernia.

Methods and analysis

The aim of this project is to reach international consensus on a minimal set of outcomes that should be measured and reported in all future clinical trials investigating inguinal hernia repair in children. The development process comprises three phases. First, we identify outcome domains associated with paediatric inguinal hernia repair from a patient perspective and through a systematic review of the literature using EMBASE, MEDLINE and the Cochrane Library databases. Second, we conduct a three-step Delphi study to identify and prioritise ‘core’ outcomes for the eventual minimal set. In the third phase, an expert meeting is held to establish the final COS and develop implementation strategies with participants from all stakeholder groups: healthcare professionals, parents and patients’ representatives. The final COS will be reported in accordance with the COS-Standards for Reporting statement.

Ethics and dissemination

The medical research ethics committee of the Amsterdam UMC confirmed that the Dutch Medical Research Involving Human Subjects Act (WMO) does not apply to this study and that full approval by the committee is not required. Electronic informed consent will be obtained from all participants. Results will be presented in peer-reviewed academic journals and at relevant conferences.

PROSPERO registration number

CRD42021281422.
Sequence analysis of sickness absence and disability pension days in 2012–2018 among privately employed white-collar workers in Sweden: a prospective cohort study
Authors: Salonen Laura , Alexanderson Kristina , Farrants Kristin
Published: December 2023

Objective

The aim of the study is to explore sequences of sickness absence (SA) and disability pension (DP) days from 2012 to 2018 among privately employed white-collar workers.

Design

A 7-year prospective cohort study using microdata from nationwide registers.

Setting

Sweden.

Participants

All 1 283 516 privately employed white-collar workers in Sweden in 2012 aged 18–67.

Methods

Sequence analysis was used to describe clusters of individuals who followed similar development of SA and DP net days/year, and multinomial logistic regression to analyse associations between sociodemographic variables and belonging to each observed cluster of sequences. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for baseline sociodemographics.

Results

We identified five clusters of SA and DP sequences: (1) ‘low or no SA or DP’ (88.7% of the population), (2) ‘SA due to other than mental diagnosis’ (5.2%), (3) ‘SA due to mental diagnosis’ (3.4%), (4) ‘not eligible for SA or DP’ (1.4%) and (5) ‘DP’ (1.2%). Men, highly educated, born outside Sweden and high-income earners were more likely to belong to the first and the fourth cluster (ORs 1.13–4.49). The second, third and fifth clusters consisted mainly of women, low educated and low-income (ORs 1.22–8.90). There were only small differences between branches of industry in adjusted analyses, and many were not significant.

Conclusion

In general, only a few privately employed white-collar workers had SA and even fewer had DP during the 7-year follow-up. The risk of belonging to a cluster characterised by SA or DP varied by sex, levels of education and income, and other sociodemographic factors.
Non-high-density lipoprotein cholesterol levels as a risk factor for short-term mortality in elderly Chinese: a large-scale, population-based cohort study
Authors: Xiao Weiwei , Liu Shiqi , Huang Zheng , Jin Donghui , Yang Yiping , Li Fei , Duan Jingwen , Wang Jie , Li Yalan , Deng Peizhi , Wang Wei , Meng Changjiang , Wu Jingjing , Cai Jingjing , Li Yan , Hong Yuan
Published: December 2023

Objectives

To explore the association between non-high-density lipoprotein (non-HDL) and mortality risk, both short-term and long-term, in Chinese people.

Design

A prospective cohort study.

Setting

The National Basic Public Health Service (BPHS) in China.

Participants

Including 621 164 elderly individuals around Hunan Province who underwent healthcare management receiving check-ups in China BPHS from 2010 to 2020. Exclusion criteria: (1) missing information on gender; (2) missing records of lipid screening; (3) missing information on key covariates; and (4) missing records of comorbidities (cardiovascular disease, hypertension, diabetes, cancer.)

Primary and secondary outcome measures

The study’s primary endpoint was all-cause and cause-specific mortality, sourced from Hunan’s CDC(Center for Disease Control and Prevention)-operated National Mortality Surveillance System, tracking participants until 24 February 2021.

Results

26 758 (4.3%) deaths were recorded, with a median follow-up of 0.83 years. Association between non-HDL and mortality was non-linear after multivariable adjustment, with the optimum concentration (OC) being 3.29 and 4.85 mmol/L. Compared with OC, the risk increased by 1.12-fold for non-HDL <3.29 mmol/L (HR: 1.12 (1.09 to 1.15)) and 1.08-fold for non-HDL ≥4.85 mmol/L (HR: 1.08 (1.02 to 1.13)) for all-cause mortality. Furthermore, there is also an increased risk of cardiovascular mortality (HRfor non-HDL <3.29: 1.10 (1.06 to 1.32) and HRfor non-HDL ≥4.85: 1.07 (1.01 to 1.14)). However, cancer mortality risk was significantly increased only for non-HDL <3.29 mmol/L (HR: 1.11 (1.04 to 1.18)). Non-optimum concentration of non-HDL had significant effects on both the long-term and the short-term risk of mortality, especially for risks of mortality for all-cause (log HR:0 .086 (0.038 to 0.134)), cardiovascular (log HR:0 .082 (0.021 to 0.144)), and cancer (log HR:0 .187 (0.058 to 0.315)) within 3 months. A two-sided value of p <0.05 was considered to be statistically significant.

Conclusions

Non-HDL was non-linearly associated with the risk of mortality, and non-optimal concentrations of non-HDL significantly increased short-term mortality in elderly Chinese, which needs more attention for cardiovascular disease prevention.
Improving the standardisation, timeliness and efficiency of the occupational therapy admission process in an older adult inpatient service
Authors: Ige Joshua Jesudunsin , Hunt David Fancis , Mitchell Amanda , Eaton Emma , Walker Anne , Fearn Rachael , Kirkham Lizzie , Staples Abigail , Giles Adam , Wilson Bethany
Published: December 2023

Occupational therapists (OTs) are at the forefront of providing recovery-oriented care for older people through timely assessments of patient’s engagement in daily living activities among many other interventions. This aids a timely, safe and successful discharge from hospital.

This project built on the foundations of previous work while considering the context and requirements of two older adult wards, the rates of admission and staff retention. The specific aim agreed was for 90% of patients admitted to the older adults’ inpatient units to be assessed by the occupational therapy (OTY) team within days of admission by December 2022.

The OTs worked in collaboration to initiate two tests of change with a total of five PDSA cycles.

Our tests of change resulted in an increase of patients engaging in OTY initial assessments within seven days of admission from 47.65% (May to November 2021) to 78% (December 2021 to December 2022).

Our team embarked on a quality improvement project to improve standardisation, efficiency and timeliness of the OTY process in an older adult inpatient service by using a pragmatic measure and tests of change evidenced in a previous study. This evidenced the generalisability of the findings of this study. While we were able to improve the timeliness of OTY initial assessments, we concluded that the overall impact on outcomes such as timely discharge was also dependent on other clinical and social factors.
Early kinetics of C reactive protein for cancer-agnostic prediction of therapy response and mortality in patients treated with immune checkpoint inhibitors: a multicenter cohort study
Authors: Barth Dominik A , Moik Florian , Steinlechner Sarah , Posch Florian , Mayer Marie-Christina , Sandner Amelie M , Berton Franziska , Schlintl Verena , Koch Lukas , John Nikolaus , Wurm Robert , Pichler Martin , Bauernhofer Thomas , Reimann Patrick , Wohlkönig Christoph , Richtig Erika , Winder Thomas , Preusser Matthias , Jost Philipp J , Ay Cihan , Gerger Armin , Terbuch Angelika , Riedl Jakob Michael
Published: December 2023

Background

C reactive protein (CRP) kinetics have recently been suggested as predictive biomarkers for the efficacy of immune checkpoint inhibitor (ICI) therapy in selected cancer types. The aim of this study was to characterize early CRP kinetics as a tumor-agnostic biomarker for ICI treatment outcomes.

Methods

In this multicenter retrospective cohort study, two independent cohorts of patients with various cancer types undergoing palliative ICI treatment at Austrian academic centers served as the discovery (n=562) and validation cohort (n=474). Four different patterns of CRP kinetics in the first 3 months of ICI therapy were defined (CRP-flare responders, CRP-responders, CRP non-responders, patients with all-normal CRP). Objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) were defined as coprimary endpoints. Univariable and multivariable logistic regression, landmark analysis and Cox regression including CRP kinetics as time-dependent variable were performed.

Results

The ORR in patients with all-normal CRP, CRP responders, CRP flare-responders and CRP non-responders was 41%, 38%, 31% and 12%, respectively. The median OS and PFS estimates were 24.5 months (95% CI 18.5 to not reached) and 8.2 months (95% CI 5.9 to 12.0) in patients with all-normal CRP, 16.1 months (95% CI 12.6 to 19-8) and 6.1 months (95% CI 4.9 to 7.2) in CRP-responders, 14.0 months (95% CI 8.5 to 19.4) and 5.7 months (95% CI 4.1 to 8.5) in CRP flare-responders and 8.1 months (95% CI 5.8 to 9.9) and 2.3 months (95% CI 2.2 to 2.8) in CRP non-responders (log-rank p for PFS and OS<0.001). These findings prevailed in multivariable analysis and could be fully confirmed in our validation cohort. Pooled subgroup analysis suggested a consistent predictive significance of early CRP kinetics for treatment efficacy and outcome independent of cancer type.

Conclusion

Early CRP kinetics represent a tumor-agnostic predictor for treatment response, progression risk and mortality in patients with cancer undergoing ICI therapy.
Braid stability after flow diverter treatment of intracranial aneurysms: a systematic review and meta-analysis
Authors: Ortega-Gutierrez Santiago , Rodriguez-Calienes Aaron , Vivanco-Suarez Juan , Cekirge H Saruhan , Hanel Ricardo A , Dibas Mahmoud , Lamin Saleh , Rice Hal , Saatci Isil , Fiorella David , Lylyk Pedro , Baltacioglu Feyyaz , Lylyk Ivan , Mendes Pereira Vitor , Gounis Matthew J , Fiehler Jens
Published: December 2023

Background

The aim of this study was to evaluate the overall rates of braid changes associated with flow diverter (FD) treatment for intracranial aneurysms (IAs). Additionally, we sought to provide an overview of the currently reported definitions related to these complications.

Methods

A systematic search was conducted from the inception of relevant literature up to April 2023, encompassing six databases. The included studies focused on patients with IAs treated with FDs. We considered four main outcome measures as FD braid changes: (1) fish-mouthing, (2) device braid narrowing, (3) device braid collapsing, and (4) device braid deformation. The data from these studies were pooled using a random-effects model.

Results

A total of 48 studies involving 3572 patients were included in the analysis. Among them, 14 studies (39%) provided definitions for fish-mouthing. However, none of the included studies offered specific definitions for device braid narrowing, collapsing, or deformation, despite reporting rates for these complications in six, five, and three studies, respectively. The pooled rates for braid changes were as follows: 3% (95% CI 2% to 4%, I2=27%) for fish-mouthing, 7% (95% CI 2% to 20%, I2=85%) for narrowing, 1% (95% CI 0% to 3%, I2=0%) for collapsing, and 1% (95% CI 1% to 4%, I2=0%) for deformation.

Conclusion

The findings of this study suggest that FD treatment for IAs generally exhibits low rates of fish-mouthing, device braid narrowing, collapsing, and deformation. However, the lack of standardized definitions hinders the ability to compare device outcomes objectively, emphasizing the need for uniform definitions for FD braid changes in future prospective studies on FD.
Increased cardiovascular mortality in patients with mechanically expandable transcatheter aortic valve and without permanent pacemaker
Authors: Hájek Petr , Horvath Martin , Hansvenclova Eva , Pecková Monika , Adlova Radka
Published: December 2023

Introduction

Use of the mechanically expandable transcatheter aortic valve (MEV) has been recently linked to increased risks of valve dysfunction and cardiovascular mortality. The risk of developing conduction disturbance with the MEV valve is well known, and the negative prognostic impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation is another consideration.

Aim

This study aimed to compare the mid-term survival of patients with MEV and self-expandable valves (SEV), and to examine survival of both groups according to the presence or absence of PPI.

Methods

This single-centre, retrospective, observational study examined data from MEV and SEV groups comprising 92 and 373 patients, respectively. The mean clinical follow-up was 2.5±1.7 years. Mortality information was obtained from the National Institutes of Health Information and Statistics.

Results

Baseline characteristics were comparable between the groups. The log-rank test showed higher cardiovascular mortality in the MEV group (p=0.042; the relative risk (RR) 1.594 (95% CI 1.013 to 2.508)). The Cox proportional hazards model identified MEV implantation as an independent predictor of cardiovascular mortality. The rate of PPI was twice as high in the MEV vs SEV group (33.7% vs 16.1%; p<0.001). We compared the survival of both groups according to the presence or absence of PPI and found higher mortality in the MEV group without PPI versus the SEV group without PPI (p=0.007; RR 2.156 (95% CI 1.213 to 3.831)). Survival did not differ in the groups with PPI.

Conclusions

A higher mid-term cardiovascular mortality rate was observed with MEV versus SEV implants. Comparing both groups according to the presence or absence of PPI, we observed a higher mortality risk in patients with MEV without PPI than in SEV without PPI. In contrast, mortality did not differ between the groups when PPI was implanted.
Clinical risk associated with COVID-19 among 86000 patients with congenital heart disease
Authors: Williams Simon G. , Frain Simon , Guo Hui , Carr Matthew J , Ashcroft Darren M , Keavney Bernard D
Published: December 2023

Objective

To determine the magnitude of any excess risk of mortality and hospitalisation due to COVID-19 infection in patients with congenital heart disease (CHD) in the UK healthcare system.

Methods

Matched case–control study within the Clinical Practice Research Datalink study of anonymised general practice records in the National Health Service in England. Patients with CHD were stratified for disease severity according to the European Society of Cardiology guidelines. Presence of a positive COVID-19 test, hospitalisation with a diagnosis of COVID-19 and COVID-19-related mortality were compared in case and control groups.

Results

86 441 patients with CHD and 335 839 controls were studied. Of patients with a positive COVID-19 test, patients with CHD were more likely than controls to be hospitalised (22.4% vs 14.5%; OR=1.77 (95% CI 1.60 to 1.96); p=2.11e−28) and suffer COVID-19-related death (6.1% vs 3.8%; OR=1.60 (95% CI 1.35 to 1.89); p=7.00e−08). The excess risk of COVID-19 hospitalisation and death rose with increasing physiological severity of CHD (presence of pulmonary vascular disease and/or cyanosis), rather than anatomical complexity.

Conclusions

In this study of the COVID-19 pandemic experience, using population health records in over 86000 patients with CHD in England, patients with CHD with COVID-19 were at around 50–75% higher risk of hospitalisation and mortality compared with matched controls with COVID-19. We provide the first primary care-derived estimates for COVID-19 hospitalisation and case-fatality rates in patients with CHD. Some factors predictive of worse COVID-19 outcome in general populations (such as non-white ethnic group), and other CHD-specific comorbidities (such as pulmonary hypertension), influenced outcomes among patients with CHD.
Country and health expenditure are major predictors of withholding anticoagulation in atrial fibrillation patients at high risk of stroke
Authors: Siegal Deborah M , Verbrugge Frederik H , Martin Anne-Celine , Virdone Saverio , Camm John , Pieper Karen , Gersh Bernard J , Goto Shinya , Turpie Alexander G G , Angchaisuksiri Pantep , Fox Keith A A
Published: December 2023

Background

Guidelines for patients with atrial fibrillation (AF) at high thromboembolic risk recommend oral anticoagulants (OACs) for preventing stroke and systemic embolism (SE). The reasons for guideline non-adherence are still unclear.

Aim

The aim is to identify clinical, demographic and non-patient characteristics associated with withholding OAC in patients with AF at high stroke risk.

Methods

Patients in the Global Anticoagulant Registry in the FIELD-AF, newly diagnosed with AF between March 2010 and August 2016, and with CHA2DS2-VASc Score≥2 (excluding sex), were grouped by OAC treatment at enrolment. Factors associated with OAC non-use were analysed by multivariable logistic regression.

Results

Of 40 416 eligible patients, 12 126 (30.0%) did not receive OACs at baseline. Globally, OAC prescription increased over time, from 60.4% in 2010–2011 to 74.7% in 2015–2016. Country of enrolment was the major predictor for OAC withholding (χ2−df=2576). Clinical predictors of OAC non-use included type of AF (χ2−df=404), history of bleeding (χ2−df=263) and vascular disease (χ2−df=99). OACs were used most frequently around the age of 75 years and decreasingly with younger as well as older age beyond 75 years (χ2−df=148). Non-cardiologists (χ2−df=201) and emergency room physicians (χ2−df=14) were less likely to prescribe OACs. OAC prescription correlated positively with country health expenditure.

Conclusions

Approximately one out of three AF patients did not receive OAC, while eligible according to the guidelines. Country of enrolment was the major determinant of anticoagulation strategy, while higher country health expenditure was associated with lower likelihood of withholding anticoagulation.
Medical oncologist stereotypes among medical students, residents and physicians: a national cross-sectional study
Authors: Piffoux Max , Delaye Matthieu , Gouy Evan , Rolland Franck , Truong Linh-Nam , Frajerman Ariel , Vinchon Florent , Hadouiri Nawale
Published: December 2023

Objectives

The perception of oncologists could impact the attractiveness of the specialty and dialogue between oncologists and other physicians. The aim of the study was to describe and understand the stereotypes and social representation (SR) associated with oncologists among medical students, residents and physicians in France.

Methods

This nationwide web-based survey conducted in 2021 was based on hierarchical evocation methods. Qualitative analyses were based on the Reinert method with factorial analyses. Each respondent’s SR was graded from 1 to 5 (from 1: very positive SR to 5: very negative SR).

Results

Oncologists suffer from a rather negative SR. The negative representation was mostly related to difficulties in practising and the proximity with death and end of life. Oncologists were also associated with more positive notions like interdisciplinarity or intellectual complexity. Attendance to an oncology course was associated with a better SR of oncology (p=0.036), whereas having someone in the family practising oncology had a negative impact (p=0.028).

Conclusions

SR of oncologists is rather contrasted. It was positively influenced by attendance to an oncology course, which could be an option to correct stereotypes and update on this rapidly evolving specialty.
Fracture morphology of desiccation cracks in clayey soil
Authors: Cai Zhao-Lin , Tang Chao-Sheng , Cheng Qing , Shi Bin
Published: December 2023

Desiccation cracks compromise soil integrity and weaken its strength, causing a range of detrimental consequences across various domains. Elucidating the cracking mechanism can aid in managing crack propagation and mitigating the associated risks. This study monitored and compared the evolution of crack patterns on the soil surface and fracture morphologies on the soil cross-section during the drying process using a tested soil sample. Multiple fracture morphological features are discerned on the soil cross-section, encompassing initiation points and plumose structures. Soil fracture morphologies are categorized into three cases based on the initiation point's location, referred to as “Top-initiated structure”, “Bottom-initiated structure”, and “Truncated structure”. Experimental results demonstrate that plumose structures result from the division of the crack front under mixed-mode loading. Cracking under mixed-mode I + II loading leads to cross-section tilting, resulting in curved surface cracks. Conversely, cracking under mixed-mode I + III loading causes cross-section twisting, generating hackle lines and step structures. Furthermore, the crack front radiates from the initiation point, creating orthogonal hackle lines. The geometric relationship confirms that the soil fracture morphology is a good indicator of the cracking process, both in laboratory tests and field observations.
Regge trajectories for the light diquarks
Authors: Chen Jiao-Kai , Xie Jia-Qi , Feng Xia , Song He
Published: December 2023

We attempt to present an unified description of the light meson spectra and the light diquark spectra by applying the Regge trajectory approach. However, we find that the direct application of the linear Regge trajectory formula for the light mesons and baryons fails. To address this issue, we fit the experimental data of light meson spectra and the light diquark spectra obtained by other theoretical approaches. By considering the light quark mass and the parameter C in the Cornell potential, we provide a provisional Regge trajectory formula. We also crudely estimate the masses of the light diquarks (ud), (us), and (ss), and find that they agree with other theoretical results. The diquark Regge trajectory not only becomes a new and very simple approach for estimating the spectra of the light diquarks, but also can explicitly show the behavior of the masses with respect to l or $$n_r$$

n
r

. Moreover, it is expected that the diquark Regge trajectory can provide a simple method for investigating the $$\rho $$
ρ
-mode excitations of baryons, tetraquarks and pentaquarks containing diquarks.
Restoring strong cosmic censorship in Reissner–Nordström–de Sitter black holes via non-minimal electromagnetic-scalar couplings
Authors: Jiang Jie , Tan Jia
Published: December 2023

We investigate whether the Strong Cosmic Censorship (SCC) Conjecture can be reinstated at the classical level in Reissner–Nordström–de Sitter (RNdS) black holes by introducing non-minimal couplings between the electromagnetic and scalar fields in Einstein–Maxwell-scalar (EMS) theory. By conducting numerical calculations, we find that the SCC can be restored within a specific range of the coupling constant. Notably, for a given value of the cosmological constant, there exists a critical coupling constant above which the EMS theory satisfies the SCC. These findings suggest that the non-minimal couplings between the electromagnetic and scalar fields may play a crucial role in the restoration of the SCC in RNdS spacetime. Additionally, under negative coupling constants, the low-lying modes of nearly extremal black holes exhibit $$\beta > 1,$$

β
>
1
,

enabling $$C^2$$

C
2

extensions beyond the Cauchy horizon and intensifying the violation of the SCC.
FLOW IN A CATHETERIZED EXPONENTIALLY DIVERGING TUBE WITH A PERIPHERAL LAYER OF DIFFERENT VISCOSITY BY MEANS OF PERISTALTIC WAVES OF DILATING AMPLITUDE
Authors: PANDEY SANJAY KUMAR , PANDEY ANUPAM KUMAR
Published: December 2023

In this paper, we investigate the impact of catheterization on swallowing if esophagus suffers from a hiatus hernia. It is modeled as a partially diverging tube having a peripheral layer of different viscosity besides the core layer. The model duly considers mass conservation in the two layers separately. It is inferred that even in the presence of a catheter inside esophagus, any sliding herniation requires less pressure for flow, i.e., swallowing will be easier if the esophagus diverges more near the cardiac sphincter. However, the presence of a catheter requires esophagus to work more in order to swallow the same quantity. Pressure enhances by many folds, but its distribution remains similar. The time-averaged flow rate and the maximum pressure, restraining fluid from swallowing, give some clues about a catheterized herniated esophagus. The flow enhances for a thinner peripheral layer. A more viscous peripheral layer as well favors flow. However, the thickness of the catheter hinders swallowing. This is to be taken care of while a patient undergoes any catheterized treatment. Increasing wave amplitude and dilating parameters can enhance flow in the presence of a catheter. It is also concluded that the frictional forces exerted by the tube wall on the peripheral layer increase in the catheter’s presence.
The Hidden Labor of Sustaining Community Partnerships
Authors: Hartline Megan Faver
Published: December 2023

In this experience report, I discuss the difficult, often hidden, labor of setting up, developing, and maintaining the relationships that are foundational to community-engaged research. Drawing on my own partnership building experiences as a graduate student, a Director of Community Learning, and an Assistant Professor of English, I illuminate the complexities of relationship building while detailing practical examples of how to build and sustain strong community partnerships through three core processes: establishing connections, following through, and growing trust.
Community-Engaged User Experience Pedagogy: Stories, Emergent Strategy, and Possibilities
Authors: Lee Soyeon , Turner Heather Noel , Rose Emma J.
Published: December 2023

In this article, we discuss the unique challenges of Community-Engaged User Experience (CEUX) by using storytelling and present a framework of emergent patterns (brown, 2017) to make visible labor, practice, and messiness of the process of building, maintaining, and renewing partnerships with community members and partners. We share three models for CEUX engagements: one-to-many, many-to-many, and one-to-plural. Within the models, we detail the structure of each CEUX engagement, what students did, and the affordances and constraints of each model. In addition, we share thoughts or voices from the community partners or collaborators or students engaged in the projects. We conclude by connecting the models to the elements of Emergent Strategy in the section From Patterns to Possibilities where we call on fellow instructors and community partners to embrace abundance-oriented questions.
Nationwide Air Pollution Forecasting with Heterogeneous Graph Neural Networks
Authors: Terroso-Saenz Fernando , Morales-García Juan , Muñoz Andres
Published: December 2023

Nowadays, air pollution is one of the most relevant environmental problems in most urban settings. Due to the utility in operational terms of anticipating certain pollution levels, several predictors based on Graph Neural Networks (GNN) have been proposed for the last years. Most of these solutions usually encode the relationships among stations in terms of their spatial distance, but they fail when it comes to capturing other spatial and feature-based contextual factors. Besides, they assume a
homogeneous
setting where all the stations are able to capture the same pollutants. However, large-scale settings frequently comprise different types of stations, each one with different measurement capabilities. For that reason, the present article introduces a novel GNN framework able to capture the similarities among stations related to the land use of their locations and their primary source of pollution. Furthermore, we define a methodology to deal with heterogeneous settings on the top of the GNN architecture. Finally, the proposal has been tested with a nation-wide Spanish air-pollution dataset with very promising results.
Preparation and Performance Testing of Green Non-toxic Polishing Solution for Medical Titanium Alloy
Authors: Zhang Peiyan , Zou Zhe , Pang Minghua , Wang Zhankui
Published: December 2023

To obtain the lower toxic residue on the medical titanium alloy surface in chemical mechanical polishing process, a new green polishing solution was proposed and evaluated in this study. The humoral fluid was selected as the basic solution in which the silica abrasive particles were used for the grinding particles, and the H2O2 was added as the oxidant. A chemical mechanical polishing test was carried out for its performance investigation with titanium alloy material. Then the surface roughness and material remove ratio of test samples were analyzed and compared with that of existed polishing solution condition. At last, the toxic residue of the titanium alloy samples was obtained by scanning electron microscopy technology. The experimental results indicated that the better material removal rate and surface roughness of medical titanium alloy with humoral polishing solution are obtained comparing with existed polishing solution condition. More importantly, the content of toxic elements on the sample surface was significantly reduced due to the more aluminum and vanadium ions dissolved in polishing solution, which is more beneficial for its application in the medical prosthetics field. This study provides a new reference for the toxic residue reduction on the material surface of medical titanium alloy in chemical mechanical polishing process.
Operando Color-Coding of Reversible Lithiation and Cycle Life in Batteries Using Photonic Crystal Materials
Authors: Lonergan Alex , Gulzar Umair , Zhang Yan , O’Dwyer Colm
Published: December 2023

Innovative new materials are consistently emerging as electrode candidates from lithium-ion and emerging alternative battery research, promising high energy densities and high-rate capabilities. Understanding potential structural changes, morphology evolution, degradation mechanisms and side reactions during lithiation is important for designing, optimizing and assessing aspiring electrode materials. In-situ and operando analysis techniques provide a means to investigate these material properties under realistic operating conditions. Here, we demonstrate operando spectroscopic sensing using photonic crystal-structured electrodes that uses the optical transmission spectrum to monitor changes to the state of charge or discharge during lithiation, and the change to electrode structure, in real-time. Photonic crystals possess a signature optical response, with a photonic bandgap (or stopband) presenting as a structural color reflection from the material. We leverage the presence of this photonic stopband, alongside its intricate relationship to the electrode structure and material phase, to correlate electrode lithiation with changes to the optical spectrum during operation. We explore the optical and electrochemical behavior of a TiO2 anode in a lithium-ion battery, structured as a photonic crystal. The operando optical sensing demonstrated here is versatile and applicable to a wide range of electrochemical electrode material candidates when structured with ordered porosity akin to a photonic crystal structure.
Joint User Detection and Channel Estimation in Grant-Free Random Access for Massive MIMO Systems
Authors: Yang Yang , Song Guanghua , Liu Hui
Published: December 2023

Grant-free random access (RA) utilizing massive multiple-input multiple-output (MIMO) technology has attracted considerable attention in recent years due to its potential to enhance spectral efficiency. This paper introduces an innovative and advanced approach for the joint detection of users and estimation of channels in grant-free RA. The approach incorporates two distinct preamble structures: the single orthogonal preamble (SOP) and the concatenated orthogonal preamble (COP). The proposed algorithms make full use of the inherent quasiorthogonal characteristic of massive MIMO, thereby enabling the accurate estimation of user channels while effectively avoiding collisions in the preambles. As a result, these algorithms generate highly precise estimations of user channels. To substantiate the effectiveness of the proposed algorithms, this paper provides an extensive theoretical analysis and presents a comprehensive set of experimental results. These findings offer robust evidence for the efficacy of the algorithms in substantially bolstering the performance of grant-free RA. Additionally, we have conducted further research and analysis, which has led to additional insights and refinements in our proposed approach. Moreover, the experimental results validate the statistical significance and reliability of the performance enhancements achieved by these algorithms. Moreover, the proposed approach exhibits robustness in scenarios with different levels of user density and varying channel conditions. Through a thorough analysis of these scenarios, we showcase the versatility and applicability of our algorithms in real-world environments.
Multicriteria Methodology for the Efficient Programming of Agricultural Cultivation Activities in a Colombian Region
Authors: Vargas Dayhanna S. , Vélez Andrés C. , Yépez Christian J. , Bravo Juan J. , Osorio Juan C.
Published: December 2023

The potato is one of the main agricultural products in Colombia and is the second most important crop in the country. The production of this tuber represents 3.3% of the country’s agricultural gross domestic product (GDP). More than 100,000 producer families subsist on cultivation at the national level, the vast majority of which are smallholdings. However, smallholders are not able to exploit the full potential of this activity, and one of the main factors that does not allow for improving productivity is the inefficient use of land in agricultural activities. This leads to issues such as erosion, overexploitation of soil resources, reduced productivity, and, depending on the time of year, even an excess of potato supply. Therefore, a multicriteria methodology is proposed based on the key elements of the potato crop production cycle and its environment, made up of farmers from the municipality of Ventaquemada, located in Boyacá, where potato cultivation is a traditional practice. This department is the second-largest potato-producing department in the country. A review of the literature was carried out to determine and characterise the area of the selected department, and based on the above, the relevant criteria were defined and the alternatives to be evaluated were identified. Second, the proposed model is evaluated with its respective prioritisation process of both the criteria and the alternatives according to the analytic hierarchy process (AHP) methodology. Finally, the results of the model are presented, prioritizing the type of tillage, irrigation method, seed type, and its disinfection process for potato cultivation. This takes into account topographic and climatic conditions, the ecosystem, soil type, implementation costs, among other factors specific to the case study.
Action Mechanisms of Metformin Combined with Exenatide and Metformin Only in the Treatment of PCOS in Obese Patients
Authors: Gan Jingwen , Chen Jie , Ma Rui-lin , Deng Yan , Ding Xue-song , Zhu Shi-yang , Sun Ai-jun
Published: December 2023

Background. Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of reproductive age, whose clinical characteristics are hyperandrogenism (HA), ovulatory dysfunction, and polycystic ovary, often accompanied by insulin resistance (IR) and metabolic abnormalities. Glucagon-like peptide (GLP)-1 receptor agonists (GLP-1Ra), such as exenatide, can bind to specific receptors on tissues such as the ovaries to improve the clinical phenotype of PCOS, while insulin-sensitizing agents, such as metformin, can also benefit to metabolic abnormalities in PCOS. Liquid chromatography-mass spectrometry (LC/MS) metabolomics revealed differences between the mechanisms of exenatide and metformin treatment of PCOS to some extent. Methods. In this study, 50 obese subjects with PCOS were randomly divided into the exenatide combined with metformin group (COM group, n = 28) and the metformin group (MF group, n = 22) for 12-week treatment. Before and after, serum samples were subjected to LC/MS analysis. Results. After treatment, there were 153 named differential metabolites in the COM group and 99 in the MF group. Most phosphatidylcholines (PC) and deoxycholic acid 3-glucuronide (DA3G) were significantly upregulated, while most glycerophosphoethanolamine (PE-NMe2), glycerophosphocholine (GPC), and threonine were downregulated in both groups. Only the decrease of neuromedin B, glutamate, and glutamyl groups and the increase of chenodeoxycholic acid sulfate docosadienoate (22: 2n6), and prostaglandin E2 have been observed in the COM group. In addition, salicylic acid and spisulosine increased and decanoylcarnitine decreased in the MF group. Both groups were enriched in glycerophospholipid, choline, and sphingolipid metabolism, while the COM group was especially superior in the glutamine and glutamate, bile secretion, and amino acid metabolism. Conclusion. Compared with metformin alone in the treatment of PCOS, the differential metabolites of the exenatide combined with metformin group are more extensive. The COM group may act on the hypothalamic-pituitary-gonadal axis (HPO) and its bypass, regulate multiple metabolism pathways such as phospholipids, amino acids, fatty acids, carnitine, bile acids, and glucose directly or indirectly in obese PCOS patients.
A Natural Organic Compound “Decursin” Has Both Antitumor and Renal Protective Effects: Treatment for Osteosarcoma
Authors: Hayashi Daichi , Shirai Toshiharu , Terauchi Ryu , Tsuchida Shinji , Mizoshiri Naoki , Mori Yuki , Shimomura Seiji , Mazda Osam , Takahashi Kenji
Published: December 2023

Osteosarcoma is a rare malignant tumor that commonly occurs in children. Anticancer drugs, for example, cisplatin, aid in postsurgery recovery but induce side effects such as renal damage, affecting the life prognosis of patients. Decursin which is one of the bioactive components has been reported for its anti-inflammatory, antioxidant, and antitumor effects, but the effect on osteosarcoma is unexplained. In this study, the research theme was to examine the sensitizing effect of decursin and its influence on cisplatin-induced nephrotoxicity. The cell viability and half maximal inhibitory concentration (IC50), apoptosis induction, and effect on cell cycle and Akt pathways were examined. In vivo, we examine the effects of decursin on tumors and mice bodies. Additionally, the effects of the cisplatin-decursin combination were evaluated in vitro and in vivo. Decursin suppressed cell viability and induced apoptosis via the cell cycle. Decursin also inhibited the Akt pathway by suppressing the phosphorylation of Akt. It enhanced apoptosis induction and lowered cell viability in combination with cisplatin. The increasing tumor volume was suppressed in the decursin-administrated group with further suppression in combination with cisplatin compared to sole cisplatin administration. The decrease in renal function and renal epithelial cell damage caused by cisplatin was improved by the combinatorial treatment with decursin. Therefore, decursin demonstrated an antitumor effect on the osteosarcoma cells and a renal protective effect in combination with cisplatin. Therefore, decursin is a prospective therapeutic agent against osteosarcoma.