bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Walking‐the‐talk’: How to co‐design an innovative and sustainable integrated care learning programme
Authors: Siddiqui Nazlee
Published: November 2023

Integrated care facilitates better outcomes for patients and their family, health workforce and health and social care systems. Accordingly, integrated care is a global and inherent area of work for health professionals. Despite this, formal learning programmes for workforce development in integrated care are still rare. In this paper, I have shared lessons about developing an innovative and sustainable integrated care learning programme for teachers, practitioners and learners in integrated care discipline. These lessons are drawn from my experience of leading an integrated care specialisation programme (that sits at Australian Qualification Framework Level 9) at a public university in Australia. An integrated care learning programme should be designed with appropriate philosophies (e.g., social constructivism and connected learning) and relevant multidisciplinary content that addresses deficiencies in practices of integrated care. Moreover, the programme should aim for sustainability, through financial feasibility and continuity with offering of creative and effective solutions in integrated care. Similarly, the programme should have a suit of curriculum development and teaching initiatives to promote genuine and collaborative learning. Throughout this learning journey, it would be critical for teachers to engage in ‘walking‐the‐talk’, that is, genuinely collaborate with patients, practitioners and students, for successful delivery of an innovative and sustainable learning programme.
IST1 regulates select recycling pathways
Authors: Clippinger Amy K. , Naismith Teresa V. , Yoo Wonjin , Jansen Silvia , Kast David J. , Hanson Phyllis I.
Published: November 2023

ESCRTs (Endosomal Sorting Complex Required for Transports) are a modular set of protein complexes with membrane remodeling activities that include the formation and release of intraluminal vesicles (ILVs) to generate multivesicular endosomes. While most of the 12 ESCRT‐III proteins are known to play roles in ILV formation, IST1 has been associated with a wider range of endosomal remodeling events. Here, we extend previous studies of IST1 function in endosomal trafficking and confirm that IST1, along with its binding partner CHMP1B, contributes to scission of early endosomal carriers. Functionally, depleting IST1 impaired delivery of transferrin receptor from early/sorting endosomes to the endocytic recycling compartment and instead increased its rapid recycling to the plasma membrane via peripheral endosomes enriched in the clathrin adaptor AP‐1. IST1 is also important for export of mannose 6‐phosphate receptor from early/sorting endosomes. Examination of IST1 binding partners on endosomes revealed that IST1 interacts with the MIT domain‐containing sorting nexin SNX15, a protein previously reported to regulate endosomal recycling. Our kinetic and spatial analyses establish that SNX15 and IST1 occupy a clathrin‐containing subdomain on the endosomal perimeter distinct from those previously implicated in cargo retrieval or degradation. Using live‐cell microscopy, we see that SNX15 and CHMP1B alternately recruit IST1 to this subdomain or the base of endosomal tubules. These findings indicate that IST1 contributes to a subset of recycling pathways from the early/sorting endosome.
Models of care and the advanced practice nurse role in caring for children and adolescents with a cancer predisposition syndrome: a scoping review protocol
Authors: Grant Andrew M. , Signorelli Christina , Taylor Natalie , de Graves Sharon , Tucker Kathrine M. , Cruickshank Marilyn
Published: November 2023

Objective:

This scoping review will examine the literature describing models of care, barriers and facilitators of care, and gaps in care delivery for children and adolescents with a cancer predisposition syndrome (CPS). It will also explore how advanced practice nurses contribute to the delivery of care for children and adolescents with a CPS.

Introduction:

Cancer remains a leading cause of death in children and adolescents. Pediatric CPS clinics proactively aim for early diagnosis or prevention of cancer in children and adolescents with a CPS. Additionally, the holistic well-being of individuals requires a multidisciplinary team, including advanced practice nurses, to manage their complex health care needs.

Inclusion criteria:

This review will consider both published and unpublished literature exploring aspects of models of care and the role of the nurse in pediatric CPS clinics. Literature published in English from 1991 onward will be considered.

Methods:

This scoping review will follow the JBI methodology for scoping reviews. The review will include searches in MEDLINE, Embase, and CINAHL Complete. Gray literature searches will be conducted in OAIster and Social Science Research Network, as well as websites of hospitals in the USA and the UK with large pediatric cancer centers. Two reviewers will screen titles, abstracts, and full-text articles. An extraction table will be used to extract relevant data from all included articles and facilitate data analysis. Results will be presented in narrative and tabular format.

Review registration:

Open Science Framework osf.io/axkp7/
Achievements of the ARIADNE Initiative for Archaeological Data Sharing and Research
Authors:   Salzburg Research Institute, Geser Guntram
Published: November 2023

Following a brief introduction to the ARIADNE initiative, this article presents selected achievements of the initiative with the ARIADNEplus project. It addresses the extension and support of the ARIADNE community, the activities promoting FAIR data in archaeology, and the standardisation of datasets based on the CIDOC CRM and the domain vocabularies Getty AAT and PeriodO. It considers the ARIADNE Portal as an effective data access and research tool, and the development of Virtual Research Environments as a new innovative approach.
Verification and Validation of Rotating Machinery Using Digital Twin
Authors: Yanik Yasar , Ekwaro-Osire Stephen , Dias João Paulo , Porto Edgard Haenisch , Alves Diogo Stuani , Machado Tiago Henrique , Bregion Daniel Gregory , de Castro Helio Fiori , Cavalca Katia Lucchesi
Published: November 2023

Rotating machinery has extensive usage in industrial applications, either as leading equipment (power plants) or as auxiliary equipment (oil and gas exploitation). These highly complex systems demand expensive maintenance programs due to the high costs of eventual shutdown. Consequently, critical fault diagnosis and prognosis are essential during the operation of those systems. Fault identification and classification demand robust verification of codes and calculations and a discerning validation of numerical models used for rotating machinery. Hence, verification and validation (V&V) are an essential initial service for a digital twin (DT), offering some advantages in this application. In this context, the following research question is proposed: Does V&V using DT improve data access and reduce the effort of data exchange? The following objectives are created to address the research question: perform a code verification, conduct the calculation verification, validate the models using two different validation approaches, and demonstrate easy access to asset data. For this study, two identical hydrodynamic bearings and a noncentral disk were considered, representing a laboratory experimental setup. The validation metric requirement is promisingly satisfied for the disk and bearings according to validation Approaches 1 and 2. Furthermore, validation Approach 2 generates even more successful results than approach 1. Accurate estimation and reliable interpretation of the numerical model outcomes encourage the application of DT for future fault diagnosis and prognosis.
Quantitative time intensity curve analysis of contrast-enhanced ultrasound (CEUS) examinations for the assessment of focal liver lesions
Authors: Badiu Simona Maria , Gheorghe Elena Codruța , Nicolau Carmen , Săftoiu Adrian
Published: November 2023

Contrast enhanced ultrasound (CEUS) is well-established for the characterization of focal liver lesions (FLLs). By using intravenous ultrasound contrast agents, followed by specific low mechanical index examinations, CEUS enables a high spatial and temporal resolution as well as a dynamic assessment of macro- and microvascularization down to the capillaries. Nevertheless, CEUS has the disadvantage of being examiner-dependent, so quantitative analysis of time-intensity curves in dynamic CEUS (D-CEUS) could provide further information. The aim of this article is to provide a general review of the current literature regarding the usefulness of D-CEUS in the assessment of FLLs.
Navigating noisy waters: A review of field studies examining anthropogenic noise effects on wild fish
Authors: Pieniazek R. H. , Beach R. K. , Dycha G. M. , Mickle M. F. , Higgs D. M.
Published: November 2023

Anthropogenic noise is globally increasing in aquatic ecosystems, and there is concern that it may have adverse consequences in many fish species, yet the effects of noise in field settings are not well understood. Concern over the applicability of laboratory-conducted bioacoustic experiments has led to a call for, and a recent increase in, field-based studies, but the results have been mixed, perhaps due to the wide variety of techniques used and species studied. Previous reviews have explored the behavioral, physiological, and/or anatomical costs of fish exposed to anthropogenic noise, but few, if any, have focused on the field techniques and sound sources themselves. This review, therefore, aims to summarize, quantify, and interpret field-based literature, highlight novel approaches, and provide recommendations for future research into the effects of noise on fish.
Effect of transducer position on ultrasonic backscatter measurements of cancellous bone
Authors: Hoffmeister Brent K. , Lawler Blake C. , Viano Ann M. , Mobley Joel
Published: November 2023

Ultrasonic backscatter techniques are being developed to detect changes in bone caused by osteoporosis and other diseases. Backscatter measurements performed at peripheral skeletal sites such as the heel may place the interrogated region of bone tissue in the acoustic near field of the transducer. The purpose of this study is to investigate how measurements in the near field affect backscatter parameters used for ultrasonic bone assessment. Ultrasonic measurements were performed in a water tank using a planar 2.25 MHz transducer. Signals were acquired for five transducer-specimen distances: N/4, N/2, 3 N/4, N, and 5 N/4, where N is the near-field distance, a location that represents the transition from the near field to far field. Five backscatter parameters previously identified as potentially useful for ultrasonic bone assessment purposes were measured: apparent integrated backscatter, frequency slope of apparent backscatter (FSAB), frequency intercept of apparent backscatter, normalized mean of the backscatter difference, and backscatter amplitude decay constant. All five parameters depended on transducer-specimen distance to varying degrees with FSAB exhibiting the greatest dependence on distance. These results suggest that laboratory studies of bone should evaluate the performance of backscatter parameters using transducer-specimen distances that may be encountered clinically including distances where the ultrasonically interrogated region is in the near field of the transducer.
Changes in Hip and Knee Strength Are Not Associated With Improved Clinical Outcomes After Rehabilitation in Individuals With Patellofemoral Pain: A Critically Appraised Topic
Authors: Kim Sungwan , Callahan Evyn G. , Malone Zachary C. , Gilgallon Timothy J. , Glaviano Neal R.
Published: November 2023

Clinical Scenario: Patellofemoral pain (PFP) is a widespread knee disorder encountered in clinical practice. Clinicians have often focused on strengthening hip and knee musculature to improve pain and disability, which are the ultimate clinical goals of PFP treatment. However, PFP literature has shown improvement in pain and disability without concurrent changes in lower-extremity strength after rehabilitation. Although some researchers have achieved a significant increase in strength after rehabilitation in PFP cohorts, there was no association with improved pain and disability. The inconsistent improvements in strength and the lack of association with clinical outcomes call for a critical appraisal of the available evidence to better understand the association between changes in hip and knee strength and improved clinical outcomes in individuals with PFP. Clinical Question: Are changes in hip and knee strength associated with improved pain and disability after rehabilitation in individuals with PFP? Summary of Key Findings: Four studies met the inclusion criteria and were included in the appraisal. Following rehabilitation, one study achieved strength improvements in knee extension. One study achieved strength improvements in knee extension, but not in hip external rotation and hip abduction. Two studies did not achieve strength improvements in hip external rotation, hip abduction, hip extension, or knee extension. All included studies achieved improvements in pain or disability after rehabilitation. None of the studies found a significant association between changes in hip and knee strength (either improved or not) and improved pain and disability. Clinical Bottom Line: There is consistent evidence that changes in hip and knee strength are not associated with improved clinical outcomes after rehabilitation in adults with PFP. Strength of Recommendation: Collectively, the body of evidence included is to answer the clinical question aligns with the strength of recommendation of B based on the Strength of Recommendation Taxonomy.
A combination of burn wound injury and
Pseudomonas
infection elicits unique gene expression that enhances bacterial pathogenicity
Authors: Kambouris Adrienne R. , Brammer Jerod A. , Roussey Holly , Chen Chixiang , Cross Alan S.
Published: November 2023

Burns are a leading cause of morbidity and mortality worldwide with the most common cause of death resulting from sepsis, often from
Pseudomonas aeruginosa
. We previously reported that a non-lethal flame burn induced an altered host immune response. Using this model, gene expression in both the murine host and
P. aeruginosa
was measured using a NanoString custom probe panel. We observed differing patterns of gene expression in both host and
P. aeruginosa
in the skin, blood, liver, and spleen of mice that were burned and/or infected, compared to mice that were neither burned nor infected (i.e., Sham). In mice that were both burned and infected (B/I), we observed changes in gene expression in both the host and
P. aeruginosa
that were distinct from all other treatment conditions. These data suggest that the combination of the burned state and superimposed infection affects both host and pathogen gene expression to increase infection propensity. Gene transcription significantly changed from 6 to 24 h post-B/I in each tissue. Finally, inhibiting IL-10 signaling or co-administering arginine at the time of
P. aeruginosa
infection prolonged or restored survival in an otherwise 100% fatal burn and infection model. These findings suggest that disease states such as burns may differentially alter innate immune response gene expression in both a host- and pathogen-specific manner.

IMPORTANCE

The interaction between an underlying disease process and a specific pathogen may lead to the unique expression of genes that affect bacterial pathogenesis. These genes may not be observed during infection in the absence of, or with a different underlying process or infection during the underlying process with a different pathogen. To test this hypothesis, we used Nanostring technology to compare gene transcription in a murine-burned wound infected with
P. aeruginosa
. The Nanostring probeset allowed the simultaneous direct comparison of immune response gene expression in both multiple host tissues and
P. aeruginosa
in conditions of burn alone, infection alone, and burn with infection. While RNA-Seq is used to discover novel transcripts, NanoString could be a technique to monitor specific changes in transcriptomes between samples and bypass the additional adjustments for multispecies sample processing or the need for the additional steps of alignment and assembly required for RNASeq. Using Nanostring, we identified arginine and IL-10 as important contributors to the lethal outcome of burned mice infected with
P. aeruginosa
. While other examples of altered gene transcription are in the literature, our study suggests that a more systematic comparison of gene expression in various underlying diseases during infection with specific bacterial pathogens may lead to the identification of unique host-pathogen interactions and result in more precise therapeutic interventions.
Whole-genome sequence of
Periconia
sp. strain TS-2, an ascomycete fungus isolated from a freshwater outflow and capable of Mn(II) oxidation
Authors: Tsushima Shihori , Kanaly Robert A. , Mori Jiro F.
Published: November 2023

Members of the genus
Periconia
are commonly found as plant-associated filamentous fungi. Here, the first draft genome sequence of a new
Periconia
strain, TS-2, that was isolated from freshwater outflow sediment and possesses the ability to oxidize dissolved Mn(II), was obtained and has an estimated size of 40.7 Mb.
RNA virus diversity in three parasitoid wasps of tephritid flies: insights from novel and known species
Authors: Zhang Wei , Li Rong , Li Shuai , Li Shao-Yang , Niu Jinzhi , Wang Jin-Jun
Published: November 2023

Parasitoid wasps are a diverse group of parasitoid insects that play a crucial role in biological control and integrated pest management programs due to their wide range of host species and complex behaviors. Previous studies have reported that select RNA viruses in parasitoid wasps can affect either the host-parasitoid wasp or the pest host parasitized by the wasps. Therefore, a study of the dynamics of RNA viruses in parasitoid wasps is essential for artificial breeding programs and improving their parasitic capabilities. In this study, we detected the presence of nine novel and three known RNA viruses with complete genomes in three parasitoid wasp species:
Diachasmimorpha longicaudata
,
Fopius arisanus
, and
Spalangia endius
. These wasps are parasitoids that can parasitel tephritid flies, one of the most important pest groups of fruits and vegetables. In
D. longicaudata
, the small RNAs derived from the viruses exhibited distinct peaks at 22 nt and were symmetrically distributed across the viral genome. These findings indicate that these viruses can activate the host’s RNAi immune response. PCR detection further revealed that DlNaLV efficiently infects female individuals of
D. longicaudata
with 100% efficiency, and ZcNLV is capable of infecting both
D. longicaudata
and its host,
Zeugodacus cucurbitae
. Our findings contribute to a better understanding of RNA viruses in parasitoid wasps and lay the foundation for future research on the triple-level trophic relationships between tephritid flies, parasitoid wasps, and RNA viruses.

IMPORTANCE

Parasitoid wasp populations have developed persistent beneficial symbiotic relationships with several viruses through repeated evolution. However, there have been limited reports on RNA viruses in parasitoid wasps of tephritid flies, a significant pest group affecting fruits and vegetables. This study explores the diversity of RNA viruses in three parasitoid wasps of tephritid flies and highlights the potential biological significance of specific viruses in
Diachasmimorpha longicaudata
. These findings have important implications for the development of sustainable pest management strategies and the enhancement of artificial rearing techniques for parasitoid wasps.
Clinical course and treatment interventions for adolescents who vaped during the COVID-19 pandemic
Authors: Su Alex , Albarran Garcia Daisy , Li Mandy , Ogbonna Chinyere , Tsang Thomas , Tsang Alex , Bantug Chynna , Tom Wynnyee , Harris Brooke
Published: November 2023

Vaping nicotine and marijuana have been increasing among adolescents in the past 5 years. Tetrahydrocannabinol is the psychoactive cannabinoid in marijuana. The COVID-19 pandemic created gaps in healthcare access and visits, making it difficult to collect accurate data on adolescent vaping, willingness to quit and methods used to quit. In addition, the literature lacks information regarding effective evidence-based treatment measures for adolescents who vape. In this report, we seek to address this using two patient cases and detailing the interventions a managed care organisation enacted during this timeframe. Our investigation revealed a relationship between social stressors and vaping among teens. Addressing these underlying stressors and eliciting and treating mental health symptoms and polysubstance use appears to be critical to curbing vaping.
Impact of the COVID-19 pandemic on the cost of chronic diseases treatment and care at public hospitals in Wallaga zones, Oromia Regional State, Ethiopia: a hospital-based, cross-sectional study
Authors: Terefa Dufera Rikitu , Tesfaye Edosa , Tolessa Belachew Etana , Desisa Adisu Ewunetu , Olani Wolkite , Fetensa Getahun , Chego Melese , Abdisa Eba , Turi Ebisa , Bekuma Tariku Tesfaye , Getachew Motuma , Tesfaye Lensa , Tilahun Temesgen
Published: November 2023

Objective

Globally, around one-third of the population has at least one long-term health condition that could be affected by the COVID-19 pandemic. Despite the fact that studies have revealed the direct impact of COVID-19 on healthcare provision and utilisation, the impact of the pandemic on the cost of chronic disease treatment and care from a patient perspective was scanty. So, the study aimed to determine the impact of the COVID-19 pandemic on cost of chronic diseases treatment and care at public hospitals in Wallaga zones, Oromia Regional State, Ethiopia, from 1 August to 31 August 2020.

Methods

An institutional-based cross-sectional study design was used, and the sample size for the study (n=642) was determined using a single population mean formula. Data were collected using interviews and analysed using SPSS V.25. Descriptive statistics were performed, and the cost of follow-up care before and after the pandemic was compared using a related-samples Wilcoxon signed-rank test, declaring the level of significance of the median cost difference at p<0.05.

Results

A total of 642 patients were included in the study, of whom 605 (94.2%) responded to the interviews. There was a significant median cost difference (n=593, Z=5.05, p=0.001) between the cost of chronic diseases among follow-up patients during the pandemic and the costs incurred by these patients before the pandemic.

Conclusion

The cost of follow-up care among chronic disease patients during the COVID-19 pandemic was significantly higher compared with before the pandemic era. Therefore, healthcare providers should arrange special fee waiver mechanisms for chronic disease healthcare costs during such types of pandemics and provide the services at proximal health facilities.
Precancerous cervical lesion screening acceptance among women in Eastern Ethiopia
Authors: Wakwoya Elias Bekele , Sadi Chala Gari , Sendo Endalew G
Published: November 2023

Objective

This study assessed perceived barriers, precancerous cervical lesion screening acceptance, and associated factors among women in Eastern Ethiopia.

Setting

This study was conducted in Hiwot Fana Specialized Hospital and Jugal Hospital.

Study design

This study is a facility-based cross-sectional study.

Study participants

This study included 1181 women aged 25–49 years. Bivariate and multivariable logistic regression was used to evaluate the relationship between variables and control confounders.

Results

Nearly half of the participants (587 or 49.7%) agreed to be screened for precancerous cervical lesions. Seventy-six per cent of those checked were negative for visual inspection with acetic acid, 18.5% were positive, and 5.7% had cancer-like lesions. In multivariable analysis, fear of discomfort from the screening procedure, having a male screener, and embarrassment were the perceived barriers that were inversely associated with screening acceptance.

Conclusions

The uptake of the screening service in the study area was not satisfactory, indicating that the programme was underutilised in the area.
Design and evaluation of a digital health intervention with proactive follow-up by nurses to improve healthcare and outcomes for patients with breast cancer in Mexico: protocol for a randomised clinical trial
Authors: Contreras Sánchez Saúl Eduardo , Doubova Svetlana V , Grajales Álvarez Rocío , Dip Borunda Abdel Krim , Martínez Pineda Wendy Jazmín , Nuñez Cerrillo Jose Gustavo , Silva Bravo Fernando , Zalapa Velázquez Rita , Gutiérrez De la Barrera Marcos , Leslie Hannah H
Published: November 2023

Introduction

Nearly 30 000 Mexican women develop breast cancer annually, frequently presenting unmet supportive care needs. In high-income countries, incorporating electronic patient-reported outcomes (ePROs) into cancer care has demonstrated potential for increasing patient-centred care and reducing unmet needs. No such ePRO interventions have been implemented in Mexico. This paper presents the study protocol for designing and evaluating an ePRO digital health application combined with proactive follow-up by nurses.

Methods and analysis

We designed a two-component intervention for women receiving breast cancer treatment: a responsive web application for monitoring ePROs and clinical algorithms guiding proactive follow-up by nurses. We will conduct a pilot test of the intervention with 50 patients with breast cancer for 6 weeks to assess feasibility and adjust the application. We will conduct a parallel arm randomised controlled trial assigning 205 patients each to intervention and control in one of Mexico’s largest public oncology hospitals. The intervention will be provided for 6 months, with additional 3 months of post-intervention observation. The control group will receive usual healthcare and a list of breast cancer information sources. Women diagnosed with stages I, II or III breast cancer who initiate chemotherapy and/or radiotherapy will be invited to participate. The primary study outcome will be supportive care needs; secondary outcomes include global quality of life and breast symptoms. Information on the outcomes will be obtained through web-based self-administered questionnaires collected at baseline, 1, 3, 6 and 9 months.

Ethics and dissemination

The National Research and Ethics Committees of the Mexican Institute of Social Security approved the study (R-2021-785-059). Participants will sign an informed consent form prior to their inclusion. Findings will be disseminated through a policy brief to the local authorities, a webinar for patients, publications in peer-reviewed journals and presentations at national and international conferences.

Trial registration number

NCT05925257.
Identifying and reducing inappropriate aspirin use in primary care
Authors: Brooker Christa , Compton Rebekah , Babineau Terri , Normeshie Cornelius Afetorli , Li Li , Blackstone Sarah Rachel
Published: November 2023

Objective

Recent studies have called into question the safety of aspirin use for the primary prevention of atherosclerotic cardiovascular disease, particularly in older adults. Therefore, the objectives of this study were to (1) develop a systematic approach to identifying patients aged 70 and older taking aspirin for primary prevention, (2) provide patient and provider education about updated literature and recommendations regarding aspirin safety and (3) evaluate the impact of this intervention on aspirin de-prescribing.

Design

This was a quality improvement intervention with prospective, longitudinal follow-up.

Setting

This study was conducted in two family medicine practices within an academic medical centre.

Participants

Patients aged 70 years and older with aspirin listed on the current medication list.

Methods

This is an electronic medical record-based chart review and educational intervention based on shared decision-making to reduce inappropriate aspirin use in primary practice. A chart review process was developed to identify the clinical indication for aspirin use. Patients taking aspirin for primary prevention were flagged for the primary care providers to review. Multilevel logistic regression models assessed factors affecting aspirin de-prescribing and longitudinal trend.

Results

Of 361 patients aged 70 years or older, 145 (40%) were taking aspirin for primary prevention of atherosclerotic cardiovascular disease. After 9 months, aspirin was deprescribed in 42 (29%) of these patients. Patients seen by their providers during the study period had lower odds of having aspirin on their medication list (OR=0.87, 95% CI: 0.81, 0.94) as compared with patients taking aspirin who were not seen by their healthcare provider.

Conclusion

This is the first study to develop and implement a method of identifying potentially inappropriate aspirin use based on recent clinical evidence highlighting the risk of aspirin use for primary prevention in older adults. Future initiatives can leverage existing electronic medical record platforms to efficiently identify patients and expand these efforts to larger patient populations.
Effect of implementing a heart failure admission care bundle on hospital readmission and mortality rates: interrupted time series study
Authors: Woodcock Thomas , Matthew Dionne , Palladino Raffaele , Nakubulwa Mable , Winn Trish , Bethell Hugh , Hiles Stephen , Moggan Susan , Dowell Jackie , Sullivan Paul , Bell Derek , Cowie Martin R
Published: November 2023

This study aimed to evaluate the impact of developing and implementing a care bundle intervention to improve care for patients with acute heart failure admitted to a large London hospital. The intervention comprised three elements, targeted within 24 hours of admission: N-terminal pro-B-type natriuretic peptide (NT-proBNP) test, transthoracic Doppler two-dimensional echocardiography and specialist review by cardiology team. The SHIFT-Evidence approach to quality improvement was used. During implementation, July 2015–July 2017, 1169 patients received the intervention. An interrupted time series design was used to evaluate impact on patient outcomes, including 15 618 admissions for 8951 patients. Mixed-effects multiple Poisson and log-linear regression models were fitted for count and continuous outcomes, respectively. Effect sizes are slope change ratios pre-intervention and post-intervention. The intervention was associated with reductions in emergency readmissions between 7 and 90 days (0.98, 95% CI 0.97 to 1.00), although not readmissions between 0 and 7 days post-discharge. Improvements were seen in in-hospital mortality (0.96, 95% CI 0.95 to 0.98), and there was no change in trend for hospital length of stay. Care process changes were also evaluated. Compliance with NT-proBNP testing was already high in 2014/2015 (162 of 163, 99.4%) and decreased slightly, with increased numbers audited, to 2016/2017 (1082 of 1101, 98.2%). Over this period, rates of echocardiography (84.7–98.9%) and specialist input (51.6–90.4%) improved. Care quality and outcomes can be improved for patients with acute heart failure using a care bundle approach. A systematic approach to quality improvement, and robust evaluation design, can be beneficial in supporting successful improvement and learning.
Erdheim-Chester disease: misdiagnosed as multiple sclerosis
Authors: Yang Jason , Imlay-Gillespie Louise , Dierkes Judith Gerarda , Khoo Tien Kheng
Published: November 2023

Erdheim-Chester disease is a rare histiocytic neoplasm with a wide range of clinical manifestations. Due to its rarity and protean characteristics, this condition often presents a diagnostic challenge. A Caucasian woman in her late 60s presented with unsteadiness, dysphagia and dysarthria. She was initially diagnosed with secondary progressive multiple sclerosis but deteriorated over 2 years with a potential lack of therapeutic response. Subsequent investigations resulted in the diagnosis of Erdheim-Chester disease. She received targeted therapy with BRAF and MAPK-pathway inhibitors. Her initial response to treatment has been positive with functional gains and reduced disease burden on MR brain imaging, and with no significant adverse effects.
Perioperative opioid prescribing and iatrogenic opioid use disorder and overdose: a state-of-the-art narrative review
Authors: Larach Daniel B , Waljee Jennifer F , Bicket Mark C , Brummett Chad M , Bruehl Stephen
Published: November 2023

Background/importance

Considerable attention has been paid to identifying and mitigating perioperative opioid-related harms. However, rates of postsurgical opioid use disorder (OUD) and overdose, along with associated risk factors, have not been clearly defined.

Objective

Evaluate the evidence connecting perioperative opioid prescribing with postoperative OUD and overdose, compare these data with evidence from the addiction literature, discuss the clinical impact of these conditions, and make recommendations for further study.

Evidence review

State-of-the-art narrative review.

Findings

Nearly all evidence is from large retrospective studies of insurance claims and Veterans Health Administration (VHA) data. Incidence rates of new OUD within the first year after surgery ranged from 0.1% to 0.8%, while rates of overdose events ranged from 0.01% to 0.8%. Higher rates were seen among VHA patients, which may reflect differences in data completeness and/or risk factors. Identified risk factors included those related to substance use (preoperative opioid use; non-opioid substance use disorders; preoperative sedative, anxiolytic, antidepressant, and gabapentinoid use; and postoperative new persistent opioid use (NPOU)); demographic attributes (chiefly male sex, younger age, white race, and Medicaid or no insurance coverage); psychiatric comorbidities such as depression, bipolar disorder, and PTSD; and certain medical and surgical factors. Several challenges related to the use of administrative claims data were identified; there is a need for more granular retrospective studies and, ideally, prospective cohorts to assess postoperative OUD and overdose incidence with greater accuracy.

Conclusions

Retrospective data suggest an incidence of new postoperative OUD and overdose of up to 0.8% during the first year after surgery, but prospective studies are lacking.
A Few-Shot Transfer Learning Approach for Motion Intention Decoding from Electroencephalographic Signals
Authors: Mammone Nadia , Ieracitano Cosimo , Spataro Rossella , Guger Christoph , Cho Woosang , Morabito Francesco Carlo
Published: November 2023

In this study, a few-shot transfer learning approach was introduced to decode movement intention from electroencephalographic (EEG) signals, allowing to recognize new tasks with minimal adaptation. To this end, a dataset of EEG signals recorded during the preparation of complex sub-movements was created from a publicly available data collection. The dataset was divided into two parts: the source domain dataset (including 5 classes) and the support (target domain) dataset, (including 2 classes) with no overlap between the two datasets in terms of classes. The proposed methodology consists in projecting EEG signals into the space-frequency-time domain, in processing such projections (rearranged in channels × frequency frames) by means of a custom EEG-based deep neural network (denoted as EEGframeNET5), and then adapting the system to recognize new tasks through a few-shot transfer learning approach. The proposed method achieved an average accuracy of 72.45 ± 4.19% in the 5-way classification of samples from the source domain dataset, outperforming comparable studies in the literature. In the second phase of the study, a few-shot transfer learning approach was proposed to adapt the neural system and make it able to recognize new tasks in the support dataset. The results demonstrated the system’s ability to adapt and recognize new tasks with an average accuracy of 80 ± 0.12% in discriminating hand opening/closing preparation and outperforming reported results in the literature. This study suggests the effectiveness of EEG in capturing information related to the motor preparation of complex movements, potentially paving the way for BCI systems based on motion planning decoding. The proposed methodology could be straightforwardly extended to advanced EEG signal processing in other scenarios, such as motor imagery or neural disorder classification.
Coptis chinensis and Berberine Ameliorate Chronic Ulcerative Colitis: An Integrated Microbiome-Metabolomics Study
Authors: Zhou Rui , Huang Yangyi , Tian Congjian , Yang Yong , Zhang Zaiqi , He Kai
Published: November 2023

Coptis chinensis Franch (RC), has historically been used for the treatment of “Xiao Ke” and “Xia Li” symptoms in China. “Xia Li” is characterized by abdominal pain and diarrhea, which are similar to the clinical symptoms of ulcerative colitis (UC). For the first time, this study aims to compare the anti-colitis effects of berberine (BBR) and total RC alkaloids (TRCA) and investigate the underlying metabolites and gut microbiota biomarkers. Metabolomics results showed that several colitis-related biomarkers, including lysophosphatidyl ethanolamine, lysophosphatidylcholine, scopolamine-methyl-bromide, N1-methyl-2-pyridone-5-carboxamide, 4-hydroxyretinoic acid, and malic acid, were significantly improved in model mice after BBR and TRCA treatments. High-dose BBR and TRCA treatments reversed the mouse colon shortening caused by dextran sodium sulfate (DSS), alleviated bowel wall swelling, and reduced inflammatory cell infiltration. BBR and TRCA restored the damaged mucosa integrity in colitis mice by upregulating claudin 1 and occludin, preventing colon epithelium apoptosis by inhibiting the cleavage of caspase 3. Additionally, BBR and TRCA significantly decreased the richness of the pathogenic bacteria Bacteroides acidifaciens but increased the abundance of the probiotic Lactobacillus spp. Notably, TRCA exhibited superior anti-colitis effects to those of BBR. Thus, this agent warrants further study and application in the treatment of inflammatory bowel disease in the clinic.
The end of the Cretaceous: depositional palaeogeographical reconstruction of the Gulf of Mexico and adjacent areas just prior to the Chicxulub impact
Authors: Snedden John William , Lowery Christopher M. , Lawton Timothy F.
Published: November 2023

Until recently, information about the end of the Cretaceous was based upon investigation of global outcrop sections. New subsurface drilling and characterization from well cores and logs in the Gulf of Mexico Basin have greatly illuminated the end Cretaceous event. However, the palaeogeography of the late Maastrichtian just prior to bolide impact is less well understood and is of great importance in terms of modelling the resulting distribution and composition of the Chicxulub impact material, as well as tsunami and seiche wave height. Here, we examine the Maastrichtian strata in the basin, synthesizing lithostratigraphy and chronostratigraphy, tectonic plate reconstructions, global and local sea level history, palaeoclimate and depositional systems. Our new Maastrichtian palaeogeographical reconstruction shows the basin prior to the Chicxulub impact at a time of globally high sea level, with widespread deposition of deepwater chalks and shallow marine carbonates and local siliciclastic shorelines fed by the nascent Cordilleran belt. Stratigraphic correlations of wells and outcrops illustrate the range of palaeoenvironments from coastal plain to deep marine. As much as 610 m (2000 ft) of Maastrichtian and Campanian section is mapped around the basin, reflecting accommodation provided by basin subsidence, salt deflation and palaeophysiography. A large thickness of carbonates accumulated in the basin centre, with steep shoreline to basin gradients particularly in Mexico. At the end of the Cretaceous, carbonate palaeoenvironments probably covered 96% of the Gulf of Mexico Basin, with less than 4% of the area likely occupied by siliciclastic systems, a distribution that evolved from the Early Cretaceous. Our maps thus explain dominance of carbonate breccia and chalks in K–Pg boundary units deposited over the basin sites proximal or distal to the Chicxulub impact crater. This also elucidates the large impedance contrast and high amplitude seismic response of the K–Pg boundary horizon, mappable over vast portions of the basin.
A Model Personalization-based Federated Learning Approach for Heterogeneous Participants with Variability in the Dataset
Authors: Mishra Rahul , Gupta Hari Prabhat
Published: November 2023

Federated learning is an emerging paradigm that provides privacy-preserving collaboration among multiple participants for model training without sharing private data. The participants with heterogeneous devices and networking resources decelerate the training and aggregation. The dataset of the participant also possesses a high level of variability, which means the characteristics of the dataset change over time. Moreover, it is a prerequisite to preserve the personalized characteristics of the local dataset on each participant device to achieve better performance. This article proposes a model personalization-based federated learning approach in the presence of variability in the local datasets. The approach involves participants with heterogeneous devices and networking resources. The central server initiates the approach and constructs a base model that executes on most participants. The approach simultaneously learns the personalized model and handles the variability in the datasets. We propose a knowledge distillation-based early-halting approach for devices where the base model does not fit directly. The early halting speeds up the training of the model. We also propose an aperiodic global update approach that helps participants to share their updated parameters aperiodically with server. Finally, we perform a real-world study to evaluate the performance of the approach and compare with state-of-the-art techniques.
Critical Data Backup with Hybrid Flash-Based Consumer Devices
Authors: Luo Longfei , Yu Dingcui , Lv Yina , Shi Liang
Published: November 2023

Hybrid flash-based storage constructed with high-density and low-cost flash memory has become increasingly popular in consumer devices in the last decade due to its low cost. However, its poor reliability is one of the major concerns. To protect critical data for guaranteeing user experience, some methods are proposed to improve the reliability of consumer devices with non-hybrid flash storage. However, with the widespread use of hybrid storage, these methods will result in severe problems, including significant performance and endurance degradation. This is caused by the fact that the different characteristics of flash memory in hybrid storage are not considered, e.g., performance, endurance, and access granularity. To address these problems, a critical data backup (CDB) design is proposed to ensure critical data reliability at a low cost. The basic idea is to accumulate two copies of critical data in the fast memory first to make full use of its performance and endurance. Then, one copy will be migrated to the slow memory in the stripe to avoid the write amplification caused by different access granularity between them. By respecting the different characteristics of flash memory in hybrid storage, CDB can achieve encouraging performance and endurance improvement compared with the state-of-the-art. Furthermore, to avoid performance and lifetime degradation caused by the backup data occupying too much space of fast memory, CDB Pro is designed. Two advanced schemes are integrated. One is making use of the pseudo-single-level-cell (pSLC) technique to make a part of slow memory become high-performance. By supplying some high-performance space, data will be fully updated before being evicted to slow memory. More invalid data are generated which reduces eviction costs. Another is to categorize data into three types according to their different life cycles. By putting the same type of data in a block, the eviction efficiency is improved. Therefore, both can improve device performance and lifetime based on CDB. Experiments are conducted to prove the efficiency of CDB and CDB Pro. Experimental results show that compared with the state-of-the-arts, CDB can ensure critical data reliability with lower device performance and lifetime loss whereas CDB Pro can diminish the loss further.
Breeding and Selecting Corals Resilient to Global Warming
Authors: Quigley K.M.
Published: November 2023

Selective breeding of resilient organisms is an emerging topic in marine conservation. It can help us predict how species will adapt in the future and how we can help restore struggling populations effectively in the present. Scleractinian corals represent a potential tractable model system given their widescale phenotypic plasticity across fitness-related traits and a reproductive life history based on mass synchronized spawning. Here, I explore the justification for breeding in corals, identify underutilized pathways of acclimation, and highlight avenues for quantitative targeted breeding from the coral host and symbiont perspective. Specifically, the facilitation of enhanced heat tolerance by targeted breeding of plasticity mechanisms is underutilized. Evidence from theoretical genetics identifies potential pitfalls, including inattention to physical and genetic characteristics of the receiving environment. Three criteria for breeding emerge from this synthesis: selection from warm, variable reefs that have survived disturbance. This information will be essential to protect what we have and restore what we can.
Interjections at the Heart of Language
Authors: Dingemanse Mark
Published: November 2023

Interjections, the words that come between sentences, are easily overlooked and usually treated as peripheral to the language sciences. This review surveys work from disparate disciplines that suggests an inversion of perspective: from interjections as marginal items to interjections at the heart of language. Around one out of every seven turns in conversation is an interjection, and the most common ones are not the involuntary exclamations that typically feature in examples; instead, they form a small set of agile and adaptive interactional tools that streamline everyday language use. Continuers like mmhm help people co-construct complex interactional structures, repair initiators like huh? help people calibrate mutual understanding on the fly, and change-of-state tokens like oh display knowledge as it evolves in interaction. Interjections emerge as words that help us talk and think, scaffolding the complexity of language as we know it. The review critically considers received views of interjections as primitive grunts, affect bursts, or symptoms of strain and provides a number of alternative ways of thinking about interjections.
Structure, Function, and Regulation of the Junctophilin Family
Authors: Hall Duane D. , Takeshima Hiroshi , Song Long-Sheng
Published: November 2023

In both excitable and nonexcitable cells, diverse physiological processes are linked to different calcium microdomains within nanoscale junctions that form between the plasma membrane and endo-sarcoplasmic reticula. It is now appreciated that the junctophilin protein family is responsible for establishing, maintaining, and modulating the structure and function of these junctions. We review foundational findings from more than two decades of research that have uncovered how junctophilin-organized ultrastructural domains regulate evolutionarily conserved biological processes. We discuss what is known about the junctophilin family of proteins. Our goal is to summarize the current knowledge of junctophilin domain structure, function, and regulation and to highlight emerging avenues of research that help our understanding of the transcriptional, translational, and post-translational regulation of this gene family and its roles in health and during disease.