bluuebunny/crossref_metadata_2025 huggingface dataset:
Oncologic Outcomes for Different Axillary Staging Techniques in Patients with Nodal-Positive Breast Cancer Undergoing Neoadjuvant Systematic Treatment: A Cancer Registry Study
Authors: Pfob André , Kokh Daria B. , Surovtsova Irina , Riedel Fabian , Morakis Philipp , Heil Joerg
Published: May 2024

Background

Targeted approaches such as targeted axillary dissection (TAD) or sentinel lymph node biopsy (SLNB) showed false-negative rates of < 10% compared with axillary lymph node dissection (ALND) in patients with nodal-positive breast cancer undergoing neoadjuvant systemic treatment (NAST). We aimed to evaluate real-world oncologic outcomes for different axillary staging techniques.

Methods

We identified nodal-positive breast cancer patients undergoing NAST from 2016 to 2021 from the state cancer registry of Baden-Wuerttemberg, Germany. Invasive disease-free survival (iDFS) was assessed using Kaplan–Meier statistics and multivariate Cox regression models (adjusted for age, ypN stage, ypT stage, and tumor biologic subtype).

Results

A total of 2698 patients with a median follow-up of 24.7 months were identified: 2204 underwent ALND, 460 underwent SLNB (255 with ≥ 3 sentinel lymph nodes [SLNs] removed, 205 with 1–2 SLNs removed), and 34 underwent TAD. iDFS 3 years after surgery was 69.7% (ALND), 76.6% (SLNB with ≥ 3 SLNs removed), 76.7% (SLNB with < 3 SLNs removed), and 78.7% (TAD). Multivariate Cox regression analysis showed no significant influence of different axillary staging techniques on iDFS (hazard ratio [HR] for SLNB with < 3 SLNs removed 0.96, 95% confidence interval [CI] 0.62–1.50; HR for SLNB with ≥ 3 SLNs removed 0.86, 95% CI 0.56–1.3; HR for TAD 0.23, 95% CI 0.03–1.64; ALND reference), and for ypN+ (HR 1.92, 95% CI 1.49–2.49), triple-negative breast cancer (HR 2.35, 95% CI 1.80–3.06), and ypT3-4 (HR 2.93, 95% CI 2.02–4.24).

Conclusion

These real-world data provide evidence that patient selection for de-escalated axillary surgery for patients with nodal-positive breast cancer undergoing NAST was successfully adopted and no early alarm signals of iDFS detriment were detected.
Breath-Hold Diving Injuries — A Primer for Medical Providers
Authors: Yu Elaine , Valdivia-Valdivia Juan M. , Silva Fernando , Lindholm Peter
Published: May 2024

Breath-hold divers, also known as freedivers, are at risk of specific injuries that are unique from those of surface swimmers and compressed air divers. Using peer-reviewed scientific research and expert opinion, we created a guide for medical providers managing breath-hold diving injuries in the field. Hypoxia induced by prolonged apnea and increased oxygen uptake can result in an impaired mental state that can manifest as involuntary movements or full loss of consciousness. Negative pressure barotrauma secondary to airspace collapse can lead to edema and/or hemorrhage. Positive pressure barotrauma secondary to overexpansion of airspaces can result in gas embolism or air entry into tissues and organs. Inert gas loading into tissues from prolonged deep dives or repetitive shallow dives with short surface intervals can lead to decompression sickness. Inert gas narcosis at depth is commonly described as an altered state similar to that experienced by compressed air divers. Asymptomatic cardiac arrhythmias are common during apnea, normally reversing shortly after normal ventilation resumes. The methods of glossopharyngeal breathing (insufflation and exsufflation) can add to the risk of pulmonary overinflation barotrauma or loss of consciousness from decreased cardiac preload. This guide also includes information for medical providers who are tasked with providing medical support at an organized breath-hold diving event with a list of suggested equipment to facilitate diagnosis and treatment outside of the hospital setting.
The Financial Crisis Inquiry Commission and Economic Research
Authors: Edelberg Wendy , Feldberg Greg
Published: May 2024

Researchers and economic research were essential to the success of the Financial Crisis Inquiry Commission. For example, researchers submitted testimony, briefed commissioners, and spoke with our staff in recorded interviews. They also provided access to key data sources and helped us use them. Although we started our investigation barely one year after the height of the crisis, there was already a strong core of early, empirical research grappling with many of our key questions, such as why investors ran certain markets, why incentive problems pervaded securitization markets, and why risk management failed at so many large companies. We also benefited from the wealth of research exploring developments in financial markets leading up to the crisis. The process to build the research staff on a tight deadline was chaotic, and we needed people willing to work long hours, work on a team, and follow the evidence wherever it took us.
Parâmetros farmacocinéticos, farmacodinâmicos e toxicidade da hidroxicloroquina
Authors: De Melo Andrade Júnior Arnon , Machado da Cunha Cavalcanti Ahmad , Inacio Thyago , Lima Caio Laurentino Almeida de , Silva Lins Andrezza Amanda
Published: May 2024

Objetivo: verificar a toxicidade do uso medicamentoso da hidroxicloroquina em pacientes. Metodologia: trata-se de uma revisão integrativa de literatura com uma avaliação documental e abordagem descritiva nas bases de dados eletrônicos LILACS, SCIELO e MEDLINE-PUBMED, usando diferentes combinações de descritores, publicados entre os anos de 2015 a 2023, nos idiomas inglês, espanhol e português. Resultados: este estudo revisou 117 artigos científicos, dos quais 67 foram nos Estados Unidos. Além disso, o ano de 2020 obteve 21,2% a mais de publicações em relação ao ano de 2015. Desse modo, notou-se que a prevalência de 44,07% das lesões pelo uso da hidroxicloroquina foi oftálmica, 35,5% foram cardíacas, 14,4%, dermatológicas e as outras demais porcentagens restantes. Conclusão: portanto, os resultados obtidos confirmam a toxicidade da hidroxicloroquina no uso de tratamentos adjacentes.
Repercussões na saúde mental de profissionais da saúde de um hospital público do Recife durante a pandemia de COVID-19
Authors: Silva do Nascimento Luciana , Aquino Soares Andressa Rállia , José dos Santos Washington , Da Silveira Moreira Rafael , Vieira do Bonfim Cristine , Gomes da Costa de Ceballos Albanita , Maciel Alves de Aguiar Avelino
Published: May 2024

Objetivo: analisar fatores associados à ansiedade e depressão em profissionais de saúde que prestam assistência a pacientes com COVID-19 em um hospital público de Recife. Método: estudo transversal, com aplicação de questionário online contendo variáveis sociodemográficas e relacionadas ao trabalho e instrumento escala de depressão, ansiedade e estresse. Realizadas análises descritivas das variáveis independentes e análise bivariada usando regressão linear da relação entre a variável dependente e das variáveis independentes. Resultados: 77 profissionais responderam ao questionário. A fisioterapia foi a categoria profissional associada à ansiedade, e o setor de atuação no COVID- 19 e o tempo de exercício foram associados à depressão. Conclusão: são imprescindíveis as ações de promoção da saúde mental desses profissionais, considerando, principalmente, os impactos da pandemia de COVID-19.
ATYPICAL EVOLUTION OF COLLAPSING FSGS IN EXTREME ELDERLY: CASE REPORT
Authors: Romão Fonseca Aline , Bezerra de Araújo Flávio , Moura Lima Ricardo Sammuel
Published: May 2024

Segmental and Focal Glomerulosclerosis (FSGS) is an entity characterized by glomerular damage that involves the podocyte as main target. A variant with worse prognosis, poor response to corticosteroid therapy and rapid progression to end-stage renal disease is recognized as collapsing FSGS. A 102-year-old man with nephrotic syndrome and acute kidney injury underwent renal biopsy, revealing collapsing FSGS. He achieved an excellent response to immunosuppressive treatment, presenting renal recovery and being discharged from dialysis treatment. Diagnosis and definition of treatment in elderly are challenging, and each case must be individualized and have functionality and risk assessed in a naturally immunosuppressed population.
Przedmojżeszowy kult Jahwe
Authors: Urbański Piotr
Published: May 2024

Bóg Izraela objawia się Mojżeszowi na górze Synaj pod imieniem Jestem, który jestem oraz Jahwe. Fragmenty biblijne uznawane za najstarsze sugerują, że Jahwe przybywa do Izraelitów z terenów południowej Transjordanii, określanych jako Seir, Teman, Edom, Paran. Pochodzenie kultu Jahwe od Kenitów czy Moabitów zostało wyrażone w teorii kenickiej, która opiera się na roli pochodzącego od Madianitów teścia Mojżesza, Jetro. Wspólne pochodzenie Izraelitów i Edomitów jest kolejną wskazówką za kultem Jahwe na południu poza Izraelem. Spojrzenie mogą pogłębić inskrypcje odkryte w egipskich świątyniach okresu poprzedzającego Wyjście z Egiptu (w Soleb, Amara Zachodnim i Medinet Habu). Zawarta tam forma Yhw utożsamiana z imieniem Boga Izraela pozwala wnioskować, że ludy koczownicze szaszu zamieszkujące pustynię na wshód od Egiptu określały się za pomocą Yhw.
Frazeologia gestyczna – znaczenie gestu a znaczenie idiomu
Authors: Kraśnicka Izabela
Published: May 2024

GESTURAL PHRASEOLOGY – THE RELATIONS BETWEEN THE MEANING OF A GESTURE AND THE MEANING OF AN IDIOM
The aim of the article is to discuss the relationship between the meaning of a gesture and the meaning of an idiom which is a literal description of this gesture, i. e. the so-called gestural phraseme (e. g. machnąć na coś ręką [literally: wave your hand at something; metaphorically: give up something], zacierać ręce [rub your hands], rozkładać ręce [throw up one’s hands]). Selected examples of gestures and their phraseological equivalents were discussed, also taking into account their meanings created in direct dialogue. This is particularly important because the meaning of many gestures, which are part of human communicative activity, depends on the context, which, in this case, is the speaker’s entire utterance. Moreover, analyzing gestures and idioms in the dialogue allows us to trace possible ways of co-occurring of these two semiotic modes, which, in turn, sheds some light on the functions of nonverbal behaviour in creating the meaning of utterances. Thus, the research material will contain recordings of TV programs which show politicians’ speeches and utterances of other famous people, thanks to which it is possible to watch spontaneous gesticulation accompanying speech. Conclusions from qualitative research tend to distinguish three types of relationships between a gesture and its idiomatic description: a gesture with a phraseological description accompanies an utterance which it can complement semantically; the gesture precedes the statement, announcing its content; the gesture occurs simultaneously with the idiom that describes it.
Analiza semantyczna wybranych jednostek języka związanych z wydawaniem pieniędzy
Authors: Kruk Dorota
Published: May 2024

A SEMANTIC ANALYSIS OF SELECTED LANGUAGE UNITS RELATED TO THE CONCEPT OF SPENDING MONEY
The aim of the article is the delimitation and semantic analysis of language units represented in the Polish language by the forms: wykosztować się [spend a lot of money], szarpnąć się [buy something expensive], zrujnować się, spłukać się [spend all one’s money] and szastać [spend money in a reckless manner]. The author distinguishes the relevant language units and carries out their analysis according to the assumptions of reductionist semantics within the structuralist tradition which sets a clear boundary between semantics and pragmatics. The effect of the analysis conducted by the author is the identification of verbal units in the form of [ktośi] [somebody] wykosztował się na [cośj], [ktośi] szarpnął się na [cośj], [ktośi] zrujnował się na [cośj], [ktośi] spłukał się, as well as [ktośi] szasta [czymśj: pieniądze [money]]. The author describes the semantic properties of the distinguished lexemes and formulates explications of the notions assigned to them.
Granice historii języka
Authors: Woźniak Ewa
Published: May 2024

BOUNDARIES OF THE HISTORY OF LANGUAGE
The author of the article presents arguments for the redefinition of the subject of study of the history of the Polish language. Theoretical assumptions of this subdiscipline of diachronic linguistics were formulated more than a century ago by Zenon Klemensiewicz, the author of the, so far, only historical-linguistic synthesis. Since then, along with changing research paradigms, the boundaries of the subdiscipline’s field of study have been expanded to include stylistic, semantic, generic, textual, and discursive issues. The author argues that the growth of knowledge, resulting from the use of diverse methods, tools, and operational terms to describe the language of the past, should lead to the emancipation of such subdisciplines as historical stylistics, historical genre studies, and historical discourse studies. In turn, the history of language, rooted in the idea that it is the community that forms a language, would then focus exclusively on those changes in a language that have been causally related to the history of the community that uses it. Within such narrow boundaries of the research field, a new synthesis of the history of the Polish language could be created.
O wybranych archaizmach w polskiej leksyce ludycznej
Authors: Raszewska-Żurek Beata
Published: May 2024

SELECTED ARCHAISMS IN POLISH LUDIC LEXIS
The article is dedicated to the history of old lexemes from the conceptual field of zabawa [play], which today are already archaisms: krotochwila [joke], krotochwilić [to joke], kłam [a lie], przekwint/ przekwinta [excessive elegance] and wydwarzanie [playing jokes]. The text is a contribution to the analysis of Polish ludic vocabulary in the diachronic aspect. The analysis is based on dictionaries and corpuses of historical Polish. A review of the history of just a few lexemes showed that, within the concept of ZABAWA, changes were taking place which included the withdrawal of lexemes present in this conceptual field from the beginning. These changes concerned both words whose presence in the field was strongly marked (krotochwilić, krotochwila), as well as those that appeared in it only occasionally (przekwinta, wydwarzanie). Regardless of this, all of them eventually left not only the conceptual field of PLAY, but also the Polish language in general.
The link between social care deficiencies and healthcare pressures
Authors: Mechie Sonja , Ujhelyi Gomez Katalin , Harrison Joanna , Hill James Edward
Published: May 2024

In the UK, demand on the social care sector is rising, while a substantial reduction in funding makes meeting those demands a challenge. Exploring potential solutions to address the growing demands on health and social care, this commentary provides a critical evaluation of a systematic review that investigated the association between the availability and supply of social care services and the use of healthcare services among older adults in high-income countries. The commentary used the Rapid Conversion of Evidence Summaries methodology to critically appraise the study. There is some evidence for the benefits of care home support during hospital discharge, although research in the area is scarce. Increasing the supply of social care services may ease the pressures on the healthcare system, but the findings of this systematic review do not provide quantifiable evidence to support this. Nevertheless, it highlights the need for further investigation regarding the association between social care provision and healthcare service use.
Virtual mental health inpatient wards: from inception to implementation
Authors: Kirwan Shane , Creedon John , Donohue Gráinne
Published: May 2024

Shane Kirwan and colleagues describe the virtual mental health inpatient wards implemented in Ireland in response to the COVID-19 pandemic and discuss the continuing development of this model of care delivery.
Some Aspects of Artificial Intelligence Development Strategy for Mobile Technologies
Authors: Slyusar Vadym , Kondratenko Yuriy , Shevchenko Anatolii , Yeroshenko Tetiana
Published: May 2024

The article addresses hardware-software and other key aspects of the artificial intelligence development strategy for mobile technologies. The proposed components of the strategy include a series of approaches to address issues related to the development and deployment of large language models on mobile devices, as well as suggestions for improving connectivity, memory management, and data security.
From Fuzzy to Mobile Fuzzy
Authors: Kosheleva Olga , Kreinovich Vladik , Timchenko Victor L. , Kondratenko Yuriy P.
Published: May 2024

The main limitation of mobile computing in comparison with regular computing is the need to make sure that the battery lasts as long as possible – and thus, the number of computational steps should be as small as possible. In this paper, we analyze how this affects fuzzy computations. We show that the need for the fastest computations leads to triangular membership functions and simplest “and”- and “or”-operations: min and max. It also leads to the need to limit ourselves to a few-bit description of fuzzy degrees – which leads to 3-bit descriptions similar to optical implementation of fuzzy computing.
Introducció
Authors: Comalat Maite , Agustí Lluís
Published: May 2024

Introducció del volum 8 (any 2023) de l'Anuari de Biblioteques, Llibres i Lectura per Maite Comalat i Lluís Agustí.
Diaris i revistes: panoràmica editorial i d’audiències a Catalunya (2018-2022)
Authors: Albet Serrano Meritxell , Gonzàlez Gavara Mònica , Nández Pla Gemma , Perpiñán Arias Marta
Published: May 2024

Es presenta una panoràmica de les publicacions periòdiques publicades o distribuïdes a Catalunya durant el període 2018-2022, en què es mostren les dades d’audiència i de difusió dels principals mitjans d’informació diària i no diària, impresa i digital. S’esmenten els efectes causats per la COVID-19 en el sector, s’enumeren les capçaleres que han nascut i les que han desaparegut durant aquests cinc anys, i es resumeixen les principals subvencions que ha rebut la premsa, així com la presència de publicitat institucional. També es comenten els moviments més destacats dins del sector, com canvis en la direcció dels diaris més rellevants, campanyes de difusió i premis. Finalment, s’expliquen dos factors que intervenen en la crisi de la premsa impresa, com és la davallada de punts de venda, especialment dels quioscos, i l’augment del preu del paper.
Generalized amplitude-phase-shifting interferometry
Authors: Flores-Meneses Carlos Augusto , Meneses-Fabian Cruz
Published: May 2024

Recently, a novel technique was proposed for
recovering the complex amplitude of an optical field from a set of
interferograms modulated in both visibility and phase steps for the
synchronous case, named amplitude-phase-shifting interferometry
(APSI). This requirement leads to errors in the accuracy of phase
recovery due to miscalibration or the nonlinear response of the device
used to generate the phase steps; in the APSI case, these are
polarizers. In this paper, we propose to create a generalized model of
the APSI technique where the phase steps can be different from each
other. APSI has been successfully implemented in a Mach–Zehnder
interferometer, while the present technique has been deployed in a
double-aperture common-path interferometer (DACPI). Additionally, it
is demonstrated that in a DACPI, the use of experimental elements that
may cause aberrations or extra noise in the experimental results is
reduced. The aim is to have an even more robust phase and amplitude
recovery technique, now named generalized amplitude-phase-shifting
interferometry. Experimental results are presented and validated
through a numerical noise study.
Transparent coating on a color surface
Authors: Rogers Geoffrey
Published: May 2024

When a laminate or transparent coating is applied to the surface of a colored slab, there may be a significant change in the color. A reason for the change in color is internal reflection at the slab surface and thus greater selective absorption. The current work develops a random walk model to calculate the reflectance factor of a slab that includes internal reflection at the slab surface to predict the change in color of the bulk reflectance with application of a laminate. The CIELAB colors are calculated from the reflectance, and the model shows that there is not much change in hue but there is significant change in the saturation and lightness: the saturation increases and the lightness decreases. A comparison of the reflectance factor as predicted by the model is compared to a Monte Carlo simulation and shown to have good agreement.
2 × 4 kW near-single-mode laser output assisted by an optimized bidirectional oscillating-amplifying integrated fiber laser configuration
Authors: Liu Jiaqi , Zeng Lingfa , Wang Xiaolin , Ye Yun , Wang Peng , Wu Hanshuo , Shi Chen , Xi Xiaoming , Zhang Hanwei , Ning Yu , Xi Fengjie
Published: May 2024

Bidirectional output oscillating-amplifying integrated fiber laser (B-OAIFL) can achieve the two-ports laser amplification based on a single cavity, showcasing a promising prospect. In order to improve both the laser power and beam quality, we first simulate and optimize the stimulated Raman scattering (SRS) effect in the B-OAIFL. The simulation results show the SRS effect can be suppressed by optimizing the diameter as well as the length of the active fiber at different locations. With the guidance of theoretical and experimental analysis for the combined suppression of SRS and transverse mode instability (TMI), a near-single-mode B-OAIFL with 2 × 4 kW was demonstrated. Based on this foundation, we further devoted ourselves to the pursuit of the optimization of the structure and performance. The necessity of the configuration of side pump, which was initially introduced for its exceptional performance in stabilizing temporal chaos, was reevaluated in detail. With its negative impacts on efficiency improvement and SRS suppression were analyzed and verified, we removed this configuration and finally demonstrated a more simplified design with superior performance. A total bidirectional output of 8105 W was achieved, with an O-O efficiency of 79.6% and a near-single-mode beam quality of M
A
2∼1.36,M
B
2∼1.63. No signs of TMI were observed, and the signal-to-SRS suppression ratio was over 38 dB. The results still demonstrate a promising potential for power scaling based on this configuration and parameters.
Deep ultraviolet laser at 223.8 nm with adjustable repetition rate and narrow pulse width
Authors: Wang Jinyan , Zheng Quan , Wang Xiaohua , Chen Xi , Yao Yi , Li Shijie , Li Qi
Published: May 2024

We presented the first, to our knowledge, demonstration of an ultraviolet (UV) laser at 223.8 nm by six-harmonic generation of an electro-optic Q-switched cavity dumping 1342 nm Nd:YVO4 laser. It offers high power, constant short pulse duration, and adjustable pulse repetition rate. The pulse duration is independent of the pump power and repetition rate compared to classical Q-switched oscillators. The output efficiency of the UV laser is optimized by adjusting the focusing lens. With the incident pump power of 30 W, an maximum average output power of 249 mW was obtained at 13 kHz. The pulse width maintained 3.4–3.5 ns from 5 to 20 kHz. The maximum pulse energy of 28.1 µJ was obtained at 5 kHz, and the corresponding peak power was up to 8.1 kW.
“I’ve accepted it because at the end of the day there is nothing, I can do about it”: A qualitative study exploring the experiences of women living with the HIV, intimate partner violence and mental health syndemic in Mpumalanga, South Africa
Authors: Silima Mpho , Christofides Nicola , Franchino-Olsen Hannabeth , Woollett Nataly , Meinck Franziska
Published: May 2024

In South Africa, Mental Health (MH), HIV, and Intimate Partner Violence (IPV) form a syndemic, that disproportionately affects women. These challenges are often co-occurring and create complex adversities for women. Recognising these intersections and the broader socio-cultural dynamics at play is crucial to understanding the layered experiences of these women and developing effective interventions. This research explores the experiences of the women living with at least two of the epidemics (HIV, IPV and or MH) and how they cope. A qualitative study design was used and 20 women (22–60 years) were recruited from Mpumalanga, South Africa. To be eligible for the study the women had to have experienced at least two of the epidemics. Data were collected through home-based interviews, arts-based activities, and analysed thematically using MAXQDA (2022) software. MH challenges were prevalent among all the participants and were linked to both IPV and HIV, resulting in symptoms such as anxiety, depression, and suicidal thoughts. In relation to the HIV-MH link, MH challenges in this combination included feelings of denial, sadness and anxiety related to participant’s HIV diagnosis. A bidirectional relationship also existed in the IPV-MH group where pre-existing MH challenges among women increased their vulnerability of having violent partners, whilst IPV also increased MH challenges. In the IPV-MH-HIV group early childhood violence exposure was linked with MH challenges and later victimization and vulnerability to HIV. Participants primarily used religion, acceptance, occasional alcohol, and family support as coping strategies. Particularly in IPV situations, alcohol use/misuse was the most prevalent coping strategies. The study highlights the syndemic relationship between HIV, IPV and MH challenges among South African women living in a peri-urban community, with a central emphasis on MH challenges. Interventions should holistically address these challenges, with particular focus on MH challenges, cultural sensitivity, and promotion of healthy coping strategies.
Differences in risky sexual behaviors and HIV prevalence between men who have sex with men and transgender women in the Midwest Brazil
Authors: Cesar Gabriela Alves , do Lago Bárbara Vieira , Ortiz Tanaka Tayana Serpa , Zanini Priscila Brunini , Bandeira Larissa Melo , Puga Marco Antonio Moreira , Pires Fernandes Fernanda Rodas , Pinto Clarice Souza , Castro Lisie Souza , Bertolacci-Rocha Lívia Garcia , dos Santos Fernandes Carlos Eurico , de Rezende Grazielli Rocha , Motta-Castro Ana Rita Coimbra
Published: May 2024

Men who have sex with men (MSM) and transgender women (TW) are disproportionally affected by HIV infection. This cross-sectional study evaluated the HIV-1/2 prevalence, risk factors and HIV molecular features of MSM and TW from Midwest Brazil. Four hundred and thirty participants (278 MSM and 152 TW) from Mato Grosso do Sul, Brazil, were interviewed and tested for HIV-1/2 infection between November 2011 and September 2013. Participants who were assigned male at birth, older than 18 years old and self-declared as MSM or TW were recruited from LGBT+ associations, as well as public (parks, square, streets, etc) and private [nightclubs, saunas, brothels, etc] places. The prevalence of HIV-1 was 14.4% (9.0% among MSM and 24% among TW; p<0.001). The factor independently associated with HIV-1 infection among MSM was being 30 years-old or older. Among TW, having suffered sexual coercion, lifetime syphilis infection and hepatitis C virus exposure were associated with HIV-1 infection. Phylogenetic analyses classified 65% sequences as subtype B and 35% as possible recombinants. All but one recombinant sample were from TW individuals. High HIV-1 prevalences were observed in both groups, highlighting the urgent need to devise specific HIV interventions targeting these key populations. Notably, TWs are more vulnerable to HIV infection, which was associated with sexual violence and co-infection with other STIs. With regard to MSM, being 30 years old or older was significanty associated to HIV, reinforcing the idea that MSM are less exposed [or exposed later] to STIs than TWs, although MSM are clearly more vulnerable than the general population.
Social media trends in obstetrics and gynecology residency programs on Instagram and X (Twitter)
Authors: Gnade Colette M. , Avery Chace C. , Yang Ziyi , Pickett Charlotte M. , Oshinowo Adeoti E.
Published: May 2024

Background

During the COVID pandemic, residency program’s social media presence increased to aid in residency recruitment by attempting to increase engagement and readily available information for applicants across specialties. However, little information exists on what characteristics and content on obstetrics and gynecology (OBGYN) residency program accounts attract more followers or engagement.

Objectives

To identify social media trends in OBGYN residencies and determine which aspects of programs influence the number of followers and interaction with content posted.

Methods

We performed a retrospective review of ACGME accredited OBGYN programs and determined their presence on Instagram and X in the fall of 2021. Content from the thirty programs with the most followers was analyzed independently by two authors. Multivariate analysis and a linear mixed model were used to characterize and evaluate content on Instagram and X.

Results

Most programs utilized Instagram (88.5%, N = 262/296) and were managed solely by residents (84.4%, N = 108/128). Number of followers on Instagram positively correlated with features such as program size, Instagram profile duration, and Doximity rankings (p < 0.0x01). Programs on X had more followers if their profile had a longer duration, followed more individuals, or were ranked higher on Doximity. The most posted Instagram content was biographical and social in nature. Instagram posts with the highest engagement were awards and/or the Match.

Conclusions

Understanding what social media content attracts more followers and increases engagement is crucial as it likely impacts OBGYN resident recruitment. Professional groups should establish guidelines for social media use in recruitment for the protection of both residents and applicants.
Classification of trauma-related preventable death; protocol of a Delphi procedure
Authors: Hakkenbrak Nadia A. G. , Harmsen Annelieke M. K. , Zuidema Wietse P. , Reijnders Udo J. L. , Schober Patrick , Bloemers Frank W.
Published: May 2024

Background

Trauma-related (preventable) death is used to evaluate the management and quality of trauma care worldwide. Therefore, it is necessary to identify fatalities in the trauma care population and assess them on preventability. However, the definition on trauma-related preventable death lacks validity due to differences in terminology and classifications. This study aims to reach consensus on the definition of trauma-related preventable death by performing a Delphi procedure, thereby, improving the assessment of trauma-related preventable death and thereby enhancing the quality of trauma care.

Methods

Based on the results of a recently performed systematic review Hakkenbrak (2021). The definitions used to describe trauma-related preventable death could be divided into four categories: 1) Clinical definition based on panel review or expert opinion, 2) Trauma prediction algorithm, 3) Clinical definition with an additional trauma prediction algorithm and 4) Others (e.g., errors in care or detailed clinical definition). A three round, electronic Delphi study will be performed in the Netherlands to reach consensus. Experts from the department of Trauma surgery, Neurosurgery, Forensic medicine, Anaesthesiology and Emergency medicine, of the designated Level 1 trauma centres in the Netherlands, will be invited to participate. In the first round the panel will comment on the composed categories and trauma prediction algorithms. In the second and third round a feedback report will be presented and the questions with disagreement will be retested.

Discussion

The identification and assessment of trauma-related preventable death is necessary to evaluate and improve trauma care. Therefore, a valid, fair, and applicable definition of trauma-related preventable death is required. The Delphi technique is utilized to reach group consensus to obtain a scientifically valid definition of trauma-related preventable death.
Health-related quality of life in non-alcoholic fatty liver disease: A cross-cultural study between Spain and the United Kingdom
Authors: Funuyet-Salas Jesús , Martín-Rodríguez Agustín , Pérez-San-Gregorio María Ángeles , Vale Luke , Robinson Tomos , Anstee Quentin M. , Romero-Gómez Manuel
Published: May 2024

Background

It is unclear what biopsychosocial factors influence the impact of NAFLD on health-related quality of life (HRQoL), and if these factors are equally important predictors between different nationalities.

Methods

HRQoL (CLDQ) was measured in both Southern European (Spain, n = 513) and Northern European (United Kingdom -UK-, n = 224) cohorts of patients with NAFLD in this cross-sectional study. For each cohort, participant data were recorded on histological grade of steatohepatitis, stage of fibrosis and biopsychosocial variables. Regression analysis was used to explore which of these variables predicted HRQoL. Moderated mediation models were conducted using SPSS PROCESS v3.5 macro.

Results

Participants with severe fibrosis reported more fatigue, systemic symptoms and worry, and lower HRQoL than those with none/mild fibrosis, regardless of place of origin. In addition, body mass index (BMI) and gender were found to be significant predictors of HRQoL in both Spanish and UK participants. Female gender was associated with worse emotional function, higher BMI and more fatigue, which predicted lower participants’ HRQoL. UK participants showed more systemic symptoms and worry than Spanish participants, regardless of liver severity. The negative effects of gender on HRQoL through emotional function, BMI and fatigue were reported to a greater degree in UK than in Spanish participants.

Conclusions

UK participants showed a greater impairment in HRQoL as compared to Spanish participants. Higher fibrosis stage predicted lower HRQoL, mainly in the Spanish cohort. Factors such as female gender or higher BMI contributed to the impact on HRQoL in both cohorts of patients and should be considered in future multinational intervention studies in NAFLD.
Development and validation of the Mentalizing Emotions Questionnaire: A self-report measure for mentalizing emotions of the self and other
Authors: Kasper Lea A. , Hauschild Sophie , Berning Anna , Holl Julia , Taubner Svenja
Published: May 2024

Mentalizing describes the ability to imagine mental states underlying behavior. Furthermore, mentalizing allows one to identify, reflect on, and make sense of one’s emotional state as well as to communicate one’s emotions to oneself and others. In existing self-report measures, the process of mentalizing emotions in oneself and others was not captured. Therefore, the Mentalizing Emotions Questionnaire (MEQ; current version in German) was developed. In Study 1 (N = 510), we explored the factor structure of the MEQ with an Exploratory Factor Analysis. The factor analysis identified one principal (R2 = .65) and three subfactors: the overall factor was mentalizing emotions, the three subdimensions were self, communicating and other. In Study 2 (N = 509), we tested and confirmed the factor structure of the 16-items MEQ in a Confirmatory Factor Analysis (CFI = .959, RMSEA = .078, SRMR = .04) and evaluated its psychometric properties, which showed excellent internal consistency (α = .92 - .95) and good validity. The MEQ is a valid and reliable instrument which assesses the ability to mentalize emotions provides incremental validity to related constructs such as empathy that goes beyond other mentalization questionnaires.
Drug-resistant Mycobacterium tuberculosis among Nepalese patients at a tuberculosis referral center
Authors: Chand Arun Bahadur , Basnet Ajaya , Maharjan Bhagwan , Rai Ganesh , Joshi Yadav Prasad , Bhatt Lok Raj , Sen Bindu , Rai Shiba Kumar
Published: May 2024

Background

Multidrug-resistant tuberculosis (MDR-TB), characterized by isoniazid and rifampicin resistance, is caused by chromosomal mutations that restrict treatment options and complicate tuberculosis management. This study sought to investigate the prevalence of pre-extensively drug-resistant (pre-XDR) and extensively drug-resistant (XDR) tuberculosis, as well as mutation pattern, in Nepalese patients with MDR/rifampicin-resistant (RR)-TB strains.

Methods

A cross-sectional study was conducted on MDR/RR-TB patients at the German Nepal Tuberculosis Project from June 2017 to June 2018. The MTBDRsl line probe assay identified pre-XDR-TB and XDR-TB. Pre-XDR-TB included MDR/RR-TB with resistance to any fluoroquinolone (FLQ), while XDR-TB included MDR/RR-TB with resistance to any FLQ and at least one additional group A drug. Mutation status was determined by comparing bands on reaction zones [gyrA and gyrB for FLQ resistance, rrs for SILD resistance, and eis for low-level kanamycin resistance, according to the GenoType MTBDRsl VER 2.0, Hain Lifescience GmbH, Nehren, Germany definition of pre-XDR and XDR] to the evaluation sheet. SPSS version 17.0 was used for data analysis.

Results

Out of a total of 171 patients with MDR/RR-TB, 160 had (93.57%) had MTBC, of whom 57 (35.63%) had pre-XDR-TB and 10 (6.25%) had XDR-TB. Among the pre-XDR-TB strains, 56 (98.25%) were FLQ resistant, while 1 (1.75%) was SLID resistant. The most frequent mutations were found at codons MUT3C (57.14%, 32/56) and MUT1 (23.21%, 13/56) of the gyrA gene. One patient had SLID resistant genotype at the MUT1 codon of the rrs gene (100%, 1/1). XDR-TB mutation bands were mostly detected on MUT1 (30%, 3/10) of the gyrA and rrs, MUT3C (30%, 3/10) of the gyrA, and MUT1 (30%, 3/10) of the rrs.

Conclusions

Pre-XDR-TB had a significantly higher likelihood than XDR-TB, with different specific mutation bands present in gyrA and rrs genes.
Optimization of ship hull forms by changing CM and CB coefficients to obtain optimal seakeeping performance
Authors: Khosravi Babadi Mohsen , Ghassemi Hassan
Published: May 2024

Ship design involves optimizing the hull in order to enhance safety, economic efficiency, and technical efficiency. Despite the long-term research on this problem and a number of significant conclusions, some of its content still needs to be improved. In this study, block and midship coefficients are incorporated to optimize the ship’s hull. The considered ship was a patrol vessel. The seakeeping analysis was performed employing strip theory. The hull form was generated using a fuzzy model. Though the body lines generated by the midship coefficient (CM) and block coefficient (CB) varied indecently, the other geometric parameters remained the same. Multi-objective optimization was used to optimize CB and CM. According to the results of this study, these coefficients have a significant impact on the pitch motion of the patrol vessel as well as the motion sickness index. Heave and roll motions, as well as the added resistance, were not significantly influenced by the coefficients of CM and CB. However, increasing the hull form parameters increases the maximum Response Amplitude Operator (RAO) of heave and roll motions. The frequency of occurrence of the maximum roll RAO was in direct relation with CB and CM. These coefficients, however, had no meaningful impact on the occurrence frequency of other motion indices. In the end, the CB and CM coefficients were selected based on the vessel’s seakeeping performance. These findings might be used by shipbuilders to construct the vessel with more efficient seakeeping performance.
Comparing two protocols of shock wave therapy for patients with plantar fasciitis: A pilot study
Authors: A. L. Kalbani Fatima , Shalash Reime , Qadah Raneen , Shousha Tamer
Published: May 2024

Objectives

This pilot study primarily aimed to detect the adherence as well as the effect size required to estimate the actual sample size needed for a larger scale study to compare and evaluate the effectiveness of two extracorporeal shock wave therapy (ESWT) protocols along, with a physical therapy program in reducing pain and improving function among patients suffering from plantar fasciitis. The study also aimed to report the effects of the ESWT protocols used on pain and function.

Methods

A total of 26 participants took part in the study, including 17 females and 9 males. The average age of the participants was 34 years with a body mass index (BMI) of 23 kg/m2. Participants were divided into three equal groups; Group A received ESWT at a frequency of 15 Hz and intensity of 3, Group B received ESWT at a frequency of 10 Hz and intensity of 4, while Group C underwent the selected physical therapy program along with sham shock wave therapy as a control. Pain levels were assessed using the Visual Analog Scale (VAS) while functional improvements were evaluated using the Foot Function Index (FFI). Data was collected prior to treatment, after three sessions and at the end of six weeks (after six sessions).

Results

The three groups were well matched, and the results revealed high adherence rates (90%, 90% and 80% respectively). Results also indicated reductions in pain levels and improvements in function for both intervention groups when compared to the control group. Group A demonstrated better outcomes compared to Group B while Group C showed relatively less improvement.

Conclusion

The study concluded a high adherence rate for the three groups as well as a small effect size detected of 0.282 that would suggest a total of 123 participants to be required to replicate the study on a larger scale. With regards to the findings of this pilot, the combination of ESWT and a targeted physical therapy program revealed a possible effective therapeutic approach for plantar fasciitis, with a higher frequency potentially yielding more favourable results.
Advancing responsible genomic analyses of ancient mollusc shells
Authors: Martin-Roy Raphaël , Thyrring Jakob , Mata Xavier , Bangsgaard Pernille , Bennike Ole , Christiansen Gunvor , Funder Svend , Gotfredsen Anne Birgitte , Gregersen Kristian Murphy , Hansen Camilla Haarby , Ilsøe Peter Carsten , Klassen Lutz , Kristensen Inge Kjær , Ravnholt Gerd Bindesbøl , Marin Frédéric , Der Sarkissian Clio
Published: May 2024

The analysis of the DNA entrapped in ancient shells of molluscs has the potential to shed light on the evolution and ecology of this very diverse phylum. Ancient genomics could help reconstruct the responses of molluscs to past climate change, pollution, and human subsistence practices at unprecedented temporal resolutions. Applications are however still in their infancy, partly due to our limited knowledge of DNA preservation in calcium carbonate shells and the need for optimized methods for responsible genomic data generation. To improve ancient shell genomic analyses, we applied high-throughput DNA sequencing to 27 Mytilus mussel shells dated to ~111–6500 years Before Present, and investigated the impact, on DNA recovery, of shell imaging, DNA extraction protocols and shell sub-sampling strategies. First, we detected no quantitative or qualitative deleterious effect of micro-computed tomography for recording shell 3D morphological information prior to sub-sampling. Then, we showed that double-digestion and bleach treatment of shell powder prior to silica-based DNA extraction improves shell DNA recovery, also suggesting that DNA is protected in preservation niches within ancient shells. Finally, all layers that compose Mytilus shells, i.e., the nacreous (aragonite) and prismatic (calcite) carbonate layers, with or without the outer organic layer (periostracum) proved to be valuable DNA reservoirs, with aragonite appearing as the best substrate for genomic analyses. Our work contributes to the understanding of long-term molecular preservation in biominerals and we anticipate that resulting recommendations will be helpful for future efficient and responsible genomic analyses of ancient mollusc shells.
Impact of body mass index at diagnosis on outcomes of pediatric acute leukemia: A systematic review and meta-analysis
Authors: Dong Ling , Dai Guixing , Zhao Jing
Published: May 2024

Background

The incidence of childhood malnutrition i.e., both obesity and undernutrition, is on a rise. While there is extensive evidence of the influence of body mass index (BMI) on the survival and other important outcomes of adult cancers, the impact of childhood BMI on one of the common pediatric cancers i.e., leukemia is not well studied.

Methods

Systematic search of PubMed, Scopus, and Google Scholar databases was done to identify studies that were conducted among pediatric patients with leukemia and had examined outcomes of interest based on BMI at the time of diagnosis.

Results

Effect sizes were reported as pooled hazards ratio (HR) along with 95% confidence intervals (CI). A total of 17 studies were included. Compared to pediatric leukemia patients with normal BMI, underweight (HR 1.07, 95% CI: 1.04, 1.11) and obese (HR 1.42, 95% CI: 1.18, 1.71) children with leukemia had higher risks of overall mortality. Underweight (HR 1.10, 95% CI: 1.02, 1.19) and obese (HR 1.34, 95% CI: 1.15, 1.55) pediatric leukemia patients had a tendency to lower event-free survival compared to children with normal BMI. The risk of relapse was not significant for underweight, overweight, and obese children.

Conclusions

Both underweight and obese status at the time of diagnosis were associated with poor survival outcomes in pediatric patients with leukemia.
Competitive capabilities of higher education institutions from their Employees’ perspectives: A case study of King Khalid University
Authors: Arnout Boshra Ismael Ahmed , AlQahtani Thabet Saeed , A. L. Melweth Hessah
Published: May 2024

This study aimed to uncover the competitive advantages of King Khalid University (KKU) as a higher educational institution and identify the strategies needed to strengthen its competitive stance through a qualitative case study approach. Data were collected via detailed interviews with 30 university staff, comprising 19 faculty members and 11 academic leaders. Following this, the data were qualitatively analyzed using MAXQDA 2022 software. The results showed that KKU has 30 sub-competitive strengths, including work ethics, future vision, academic excellence, creativity, teamwork, respect for intellectual property, continuous customer-focused improvement, a positive workplace environment, organizational trust, and the ability to attract international students. Additionally, the study identified 8 challenges hindering KKU’s advancement in global university rankings, spanning academic, human, and administrative areas. To improve its standing in international rankings, thematic analysis revealed 11 strategies to enhance KKU’s competitiveness. These include aligning academic programs with job market demands, enhancing research facilities, boosting funding for academic and research endeavors, fostering international academic and scientific partnerships, and upgrading the technological infrastructure for academics and administration. The analysis underscores the need for KKU to adopt a comprehensive suite of academic, human, and administrative strategies to bolster its competitive position. This is crucial for KKU’s rise in global university rankings and its alignment with the National Vision 2030, aiming to place over five Saudi universities among the top 100 or 200 globally.