bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of using birth ball and squatting position during labor on pain, duration, and satisfaction: A randomized controlled trial
Authors: Dunmez Fatma , Yilmaz Tulay
Published: December 2023

Aim

The aim of this study is to assess the effect of using a birth ball and squatting position during labor on labor pain, duration of labor, and satisfaction.

Methods

This study is a randomized controlled experimental trial. It was conducted in the delivery unit of Başakşehir Çam and Sakura City Hospital. The study sample consisted of a total of 159 women, 53 in the birth ball application room, 53 in the squatting position group, and 53 in the control group. The “Information Form,” “Visual Analog Scale,” “Partograph,” and “Maternal Satisfaction Assessment at Delivery Scale‐Normal Birth” were used in the data collection. Data were analyzed using analysis of variance, Pearson's Chi‐square test, Pillai's trace test.

Results

The present study revealed that the pain perception level was lower in the birth ball and squatting position groups compared to the control group, and there was a statistically significant difference between them (p < .05). The duration of the first and second stages of labor and the total duration of labor decreased in the birth ball and squatting position groups (p < .05). The difference was statistically significant in comparing the level of satisfaction (p < .05). It was found that the highest satisfaction was in the birth ball group.

Conclusion

Using a birth ball and squatting position during labor are effective methods of reducing labor pain, shortening the duration of labor, and increasing the level of satisfaction. There is a need for more studies on the effects of the birth ball and squatting position. ClinicalTrials.gov Identifier: NCT05360823.
A P‐type pentatricopeptide repeat protein ZmRF5 promotes 5′ region partial cleavages of atp6c transcripts to restore the fertility of CMS‐C maize by recruiting a splicing factor
Authors: Lin Yanan , Yang Huili , Liu Hongmei , Lu Xiuyuan , Cao Haofei , Li Bing , Chang Yongyuan , Guo Zhanyong , Ding Dong , Hu Yanmin , Xue Yadong , Liu Zonghua , Tang Jihua
Published: December 2023

A fast evolution within mitochondria genome(s) often generates discords between nuclear and mitochondria, which is manifested as cytoplasmic male sterility (CMS) and fertility restoration (Rf) system. The maize CMS‐C trait is regulated by the chimeric mitochondrial gene, atp6c, and can be recovered by the restorer gene ZmRf5. Through positional cloning in this study, we identified the nuclear restorer gene, ZmRf5, which encodes a P‐type pentatricopeptide repeat (PPR) family protein. The over‐expression of ZmRf5 brought back the fertility to CMS‐C plants, whereas its genomic editing by CRISPR/Cas9 induced abortive pollens in the restorer line. ZmRF5 is sorted to mitochondria, and recruited RS31A, a splicing factor, through MORF8 to form a cleaving/restoring complex, which promoted the cleaving of the CMS‐associated transcripts atp6c by shifting the major cleavage site from 480th nt to 344 th nt for fast degradation, and preserved just right amount of atp6c RNA for protein translation, providing adequate ATP6C to assembly complex V, thus restoring male fertility. Interestingly, ATP6C in the sterile line CMo17A, with similar cytology and physiology changes to YU87‐1A, was accumulated much less than it in NMo17B, exhibiting a contrary trend in the YU87‐1 nuclear genome previously reported, and was restored to normal level in the presence of ZmRF5. Collectively these findings unveil a new molecular mechanism underlying fertility restoration by which ZmRF5 cooperates with MORF8 and RS31A to restore CMS‐C fertility in maize, complemented and perfected the sterility mechanism, and enrich the perspectives on communications between nucleus and mitochondria.
Knotted lanugo in a newborn: Cultural practices revealed
Authors: Needle Carli D. , Ramachandran Vignesh , Oza Vikash S.
Published: December 2023

Across the world, there are varied cultural practices applied in the newborn period that pediatric dermatologists need to be familiar with. This report details a 9‐day‐old girl who presented with black, spike‐like hairs across the back after her mother had been rubbing breast milk on her back in a circular motion for the first 7 days of life. On dermatoscopic exam, these lesions were found to be tight bundles of lanugo hairs, consistent with a diagnosis of knotted lanugo. Improved understanding of cultural practices and newborn skin care routines is critical for diagnosis, treatment, and counseling.
Intercropping and appropriate nitrogen application control faba bean Fusarium wilt by improving physiological and biochemical resistance and protein expression of faba bean
Authors: Zheng Yiran , Zhang Jing , Guo Yuting , Lv Jiaxing , Dong Yan
Published: December 2023

This study set up four nitrogen application levels (0, 45, 90 and 135 kg/ha) and two planting systems (faba bean monocropping and faba bean and wheat intercropping) to investigate the incidence of faba bean Fusarium wilt under different treatments and determine the resistance enzyme activities and gene expression, protein expression, and other indexes of faba bean plants. At all N levels, faba bean and wheat intercropping controlled faba bean Fusarium wilt by decreasing the content of hydrogen peroxide and superoxide anion in faba bean roots, increasing the enzyme activity and gene expression of the superoxide dismutase and the gene expression of pathogenesis‐related protein 1 (VfPR1), VfPR2, VfPR5 and VfPR10 disease resistance proteins in the roots, with the most significant effects at the N2 level (90 kg/ha). Further investigation of the impact of intercropping on faba bean roots using the N2 treatment showed that faba bean–wheat intercropping upregulated 288 proteins and downregulated 179 proteins compared with monocropping, and the functions of the upregulated proteins were mainly related to energy metabolism, antioxidant enzymes, stress and DNA repair. GO functional analysis showed that the upregulated proteins were mainly focused on the involvement in amide biological processes. KEGG enrichment analysis revealed that faba bean–wheat intercropping upregulated proteins involved in glutathione metabolism and ascorbic acid metabolism. In summary, at the N2 level, faba bean–wheat intercropping effectively mitigated root oxidative stress by enhancing antioxidant and disease resistance mechanisms in faba bean roots.
Biological biomarkers of oral cancer
Authors: Radaic Allan , Kamarajan Pachiyappan , Cho Alex , Wang Sandy , Hung Guo‐Chin , Najarzadegan Fereshteh , Wong David T. , Ton‐That Hung , Wang Cun‐Yu , Kapila Yvonne L.
Published: December 2023

The oral squamous cell carcinoma (OSCC) 5 year survival rate of 41% has marginally improved in the last few years, with less than a 1% improvement per year from 2005 to 2017, with higher survival rates when detected at early stages. Based on histopathological grading of oral dysplasia, it is estimated that severe dysplasia has a malignant transformation rate of 7%–50%. Despite these numbers, oral dysplasia grading does not reliably predict its clinical behavior. Thus, more accurate markers predicting oral dysplasia progression to cancer would enable better targeting of these lesions for closer follow‐up, especially in the early stages of the disease. In this context, molecular biomarkers derived from genetics, proteins, and metabolites play key roles in clinical oncology. These molecular signatures can help predict the likelihood of OSCC development and/or progression and have the potential to detect the disease at an early stage and, support treatment decision‐making and predict treatment responsiveness. Also, identifying reliable biomarkers for OSCC detection that can be obtained non‐invasively would enhance management of OSCC. This review will discuss biomarkers for OSCC that have emerged from different biological areas, including genomics, transcriptomics, proteomics, metabolomics, immunomics, and microbiomics.
Robust single‐trial event‐related potentials differentiate between distress and fear disorders
Authors: Randau Martin , Reinholt Nina , Pernet Cyril , Oranje Bob , Rasmussen Belinda S. , Arnfred Sidse
Published: December 2023

Recent evidence indicates that measures of brain functioning as indexed by event‐related potentials (ERPs) on the electroencephalogram align more closely to transdiagnostic measures of psychopathology than to categorical taxonomies. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a transdiagnostic, dimensional framework aiming to solve issues of comorbidity, symptom heterogeneity, and arbitrary diagnostic boundaries. Based on shared features, the emotional disorders are allocated into subfactors Distress and Fear. Evidence indicates that disorders that are close in the HiTOP hierarchy share etiology, symptom profiles, and treatment outcomes. However, further studies testing the biological underpinnings of the HiTOP are called for. In this study, we assessed differences between Distress and Fear in a range of well‐studied ERP components. In total, 50 patients with emotional disorders were divided into two groups (Distress, N = 25; Fear, N = 25) according to HiTOP criteria and compared against 37 healthy comparison (HC) subjects. Addressing issues in traditional ERP preprocessing and analysis methods, we applied robust single‐trial analysis as implemented in the EEGLAB toolbox LIMO EEG. Several ERP components were found to differ between the groups. Surprisingly, we found no difference between Fear and HC for any of the ERPs. This suggests that some well‐established results from the literature, e.g., increased error‐related negativity in OCD, are not a shared neurobiological correlate of the Fear subfactor. Conversely, for Distress, we found reductions compared to Fear and HC in several ERP components across paradigms. Future studies could utilize HiTOP‐validated psychopathology measures to more precisely define subfactor groups.
Earnings Losses and the Role of the Welfare State During the COVID‐19 Pandemic: Evidence from Sweden
Authors: Adermon Adrian , Laun Lisa , Lind Patrik , Olsson Martin , Sauermann Jan , Sjögren Anna
Published: December 2023

Many governments introduced temporary adjustments to counter the economic and health consequences of the COVID‐19 pandemic. We study the importance of already‐existing government transfers and new pandemic measures to mitigate individual income losses during the onset of the pandemic in Sweden using a difference‐in‐differences approach and population‐wide data on monthly earnings and government transfer payments. We find that labor earnings dropped by 2.7 percent in 2020. Existing transfers and new pandemic measures reduced earnings losses to 1.5 percent. These average effects mask considerable differences in earnings losses, which were, by and large, evened out by existing transfers and new pandemic measures.
A novel trajectory similarity measurement method based on node‐sequence hierarchical digraph
Authors: Fan Yue , Wang Huiwen , Wang Lihong , Guo Shu , Liu Jing
Published: December 2023

Trajectory similarity measurement is a basic and vital task in trajectory data mining, which has attracted extensive research in the past decades. Recent works focused on the sequence and hierarchy property of trajectories to construct similarity measurements. However, these methods ignore the user information on the visiting locations, such as semantic and time distribution. In light of this, a novel trajectory similarity measurement based on Node‐Sequence Hierarchical Digraph (NSHD) framework is proposed in this article. We first propose a Time‐Weighted Stay Point Detection (TWSPD) method to extract real visiting locations of users more accurately. Then, the nodes of digraph are obtained by clustering users' stay points and the edges of digraph are sequence information that users move between these nodes. An Advanced Earth Mover's Distance (AEMD) is proposed to measure the node similarity between users, considering visiting time distribution and semantic information simultaneously. Both node and sequence similarities are used to calculate the similarity score to obtain the final trajectory similarity measurement. Experiments on Geolife and T‐Drive datasets show that our proposed method offers competitive performance with mean reciprocal rank values reaching 96.01 and 81.26%, which outperforms related trajectory similarity measurements by more than 10 and 15%.
Domestic colonisation: The centrality of the home in experiences of home‐takeovers and hate relationships
Authors: Clayton John , Donovan Catherine , Macdonald Stephen J.
Published: December 2023

In this paper we introduce the concept of ‘domestic colonisation’ as a contribution to the literature on critical geographies of home. This provides a lens to focus on the ways in which domestic spaces might be exploited and/or dominated though familiar relationships. With reference to two research projects in North East England, we explore everyday occupations and sieges of home‐spaces by neighbours as a means of reinforcing positions of relative social advantage. We show how these experiences become overwhelming through the intrusion of home‐spaces and (with it) the life worlds of already structurally vulnerable(ised) communities. Domestic colonisation allows us to think through both the damage done through/to the home and connections beyond those spaces. To do this we focus on ‘home takeovers’ (or ‘cuckooing’) and ‘hate relationships’. Our work on cuckooing shows how the occupation and control of the home by those who re‐produce and seize upon structurally vulnerable(ised) people, is a process which re‐configures the home as an exploitable resource. Understandings of home and intimate social relationships as ‘private’, combined with complexities regarding culpability, conceal the damage done in contexts of diminished social infrastructure. With reference to our work on hate relationships, we outline how homes are a means of identifying and targeting those who become subjected to a range of hateful acts. This produces everyday spaces of siege and entrapment that control, immobilise and are difficult to escape. Formal interventions are unable to adequately support those victimised through lack of recognition, misrecognition as atomised disputes and a tendency to (re)move those victimised. We end by questioning how we might better address the needs of those subjected to such harms, with an emphasis on the relational production of the home.
Process conditions affect microbial diversity and activity in a haloalkaline biodesulfurization system
Authors: Gupta Suyash , de Rink Rieks , Klok Johannes B. M. , Muyzer Gerard , Plugge Caroline M.
Published: December 2023

Biodesulfurization (BD) systems that treat sour gas employ mixtures of haloalkaliphilic sulfur-oxidizing bacteria to convert sulfide to elemental sulfur. In the past years, these systems have seen major technical innovations that have led to changes in microbial community composition. Different studies have identified and discussed the microbial communities in both traditional and improved systems. However, these studies do not identify metabolically active community members and merely focus on members’ presence/absence. Therefore, their results cannot confirm the activity and role of certain bacteria in the BD system. To investigate the active community members, we determined the microbial communities of six different runs of a pilot-scale BD system. 16S rRNA gene-based amplicon sequencing was performed using both DNA and RNA. A comparison of the DNA- and RNA-based sequencing results identified the active microbes in the BD system. Statistical analyses indicated that not all the existing microbes were actively involved in the system and that microbial communities continuously evolved during the operation. At the end of the run, strains affiliated with
Alkalilimnicola ehrlichii
and
Thioalkalivibrio sulfidiphilus
were confirmed as the most active key bacteria in the BD system. This study determined that microbial communities were shaped predominantly by the combination of hydraulic retention time (HRT) and sulfide concentration in the anoxic reactor and, to a lesser extent, by other operational parameters.

IMPORTANCE

Haloalkaliphilic sulfur-oxidizing bacteria are integral to biodesulfurization (BD) systems and are responsible for converting sulfide to sulfur. To understand the cause of conversions occurring in the BD systems, knowing which bacteria are present and active in the systems is essential. So far, only a few studies have investigated the BD system’s microbial composition, but none have identified the active microbial community. Here, we reveal the metabolically active community, their succession, and their influence on product formation.
Confirmation of the New Evolutionary Status of UU Cas
Authors: Gorda S. Yu.
Published: December 2023

A new spectral study of the close binary system (CBS) UU Cas with massive components was carried out, based on spectra obtained on the echelle spectrometer of the 1.2-m telescope of Kourovka Astronomical Observatory of UFU from 2017 to 2022. The results of this study confirm the new evolutionary status of UU Cas, previously determined by the author based on spectrophotometry of this system in 2017 and confirmed in a number of works by other researchers, according to which the system is in the final stage of the mass exchange process, and not at its beginning, as previously thought. Its components are not very massive, and the value of their mass ratio is the opposite of what was previously determined from photometry results. The values of the half-amplitudes of the radial velocities $${{K}_{1}} = 195.6$$ km/s, $${{K}_{2}} = 106.5$$ km/s and the masses of both components $${{M}_{1}} = 9.6\;{{M}_{ \odot }}$$, $${{M}_{2}} = 17.6\;{{M}_{ \odot }}$$ obtained on a much more extensive observational material, for the orbital inclination angle i = 74.5°, given recently in the literature, as well as the orbital radius $$A = 54\;{{R}_{ \odot }}$$ of this close binary system are comparable with the values previously found by the author. The article is based on a talk presented at the astrophysical memorial seminar “Novelties in Understanding the Evolution of Binary Stars,” dedicated to the 90th anniversary of Professor M.A. Svechnikov.
Prediction of ileal digestible phosphorus in broiler chicken diets supplemented with exogenous phytase
Authors: Sung Jung Yeol , Adeola Olayiwola
Published: December 2023

The objectives were to develop equations for predicting ileal digestible phosphorus (P) based on nonphytate P, phytate P, calcium to nonphytate P ratio, and exogenous phytase concentrations in broiler diets and to evaluate the accuracy of the models. The modified Michaelis–Menten model was used to predict apparent ileal digestible (AID) or standardized ileal digestible P in broiler diets. Two different methods were used to analyze 25 published ileal digestible P data to evaluate the accuracy of the equation for predicting AID P. The first method assessed mean and linear biases. While the mean bias was significant ( P < 0.05), the linear bias was not significant. The second method involved regressing the 25 AID P data against those predicted by the current model. The results showed that the intercept and slope of the regression were not statistically different from 0 and 1, respectively. This suggests that the current equation accurately represents the test data. In conclusion, the accuracy of the model depends on validation processes. Considering that the current model was developed using various phytase products, it would be preferable to use an equation that is based on a single phytase product if requisite quantity of data is available.
Lifetimes of fine structure levels of the Li atom for 20 < n < 31 by an extended Ritz formula
Authors: Saeed Muhammad , Uddin Zaheer
Published: December 2023

Lithium and lithium-like elements look like hydrogen atoms if their two electrons and the nucleus are considered as having a core around which a single electron is orbiting. The energy and radii expressions for hydrogen atoms can be used for lithium and lithium-like elements; an important modification is introducing an effective principal quantum number. The effective principal quantum number differs from the principal quantum number of hydrogen by the quantum defect. The quantum defect has respective values for various levels of lithium and lithium-like ions. In this study, we used extended Ritz formulas to calculate quantum defects required to calculate the energies of the ns, np, nd, and nf series up to n < 31. Using these energies, we calculated transition probabilities and then the lifetimes of the lithium levels. The lifetimes were compared with the available published data; an excellent agreement was noticed. The work also extended the available list of lifetimes to higher quantum numbers. Forty lifetimes are newly calculated and presented for the first time. A polynomial formula for each of the ns, np, nd, and nf series lifetimes has been developed that fits well the lifetime values.
Oscillating quintom scenario with time-dependent periodic deceleration parameter
Authors: Ilyas M. , Athar A. R.
Published: December 2023

In this paper, we introduced the deceleration parameter [Formula: see text] in a different manner by proposing a modern law. According to this law, we suggested a time-periodic [Formula: see text]. Furthermore, we used this law to develop a model in which the universe oscillates with quintom matter in a four-dimensional FLRW metric background. Using this model, we obtained the oscillating Hubble parameter [Formula: see text], which remains positive. Consequently, the universe undergoes decelerating expansion and accelerating expansion periodically, avoiding singularities.
Jet grouting to new depths in the Lambeth Group and Thanet Formation beneath London
Authors: Newman T. G. , Skarda A. J.
Published: December 2023

A jet grouting trial was undertaken within the Thames Tideway Tunnel shaft at Kirtling Street in Battersea, SW London, to assess the viability of the technique within the Lambeth Group and Thanet Formation sediments up to 60 m below ground level.

There was no precedent industry experience of jet grouting in the UK at this depth and in these soil types.

Four, separate, upper and lower grout columns were constructed respectively within upper and lower granular zones inside the shaft footprint, and then exhumed for inspection and measurement during ensuing excavation within the diaphragm wall lining. Target diameters for the upper columns were achieved within granular channel sand and Laminated Bed material, with minimal vertical deviation. These were not so successfully achieved, however, within stiff cohesive Laminated Bed and Lower Shelly Clay materials.

Formation of the lower columns was severely restricted in dense gravel belonging to the ‘Pebble Bed’ and stiff gravelly clay, at the top of the Upnor Formation, but target diameters were being achieved in the lower portion of the formation, comprising Upnor sand. At their base, the column diameters were, again, restricted in the very dense sand at the top of the Thanet Formation.
Functional morphology of the stem in the Lower Paleozoic crinoid
Macrostylocrinus
Hall from Scotland
Authors: Donovan Stephen K.
Published: December 2023

Two species of the closely related monobathrid crinoid from the Lower Paleozoic of Scotland, namely
Macrostylocrinus cirrifer
Ramsbottom (Upper Ordovician, Katian) and
Macrostylocrinus silurocirrifer
Brower (Lower Silurian, Telychian), are similar in having elongate, unbranched radices proximally. These were not cirri, as suggested by their names, but were radices that were more or less inflexible, lacking contractile tissues. The function of these radices was uncertain. In the absence of contractile tissues, they could not have been for grasping other upright structures and crinoids do not need help to balance, their posture being maintained by mutable collagenous tissues. It is possible, but unlikely, that they may have acted to direct feeding currents towards the crown. Most probably, in an analogy to the post-Paleozoic isocrinids, the stem acted like a ‘conveyor belt’, the proximal, radicular and upright part being carried away from the cup as further columnals are inserted, eventually forming a distal, recumbent attachment structure. The elongate radices would have stabilized the dististele, but, unlike isocrinids, the arms of
Macrostylocrinus
spp. were not adapted for crawling and thus escaping predators. Both
M. silurocirrifer
(type species) and
M. cirrifer
are included in
Macrostylocrinus
(
Scotimacrostylocrinus
) subgen. nov.
An IoT and Deep Learning-Based Smart Healthcare Framework for Thyroid Cancer Detection
Authors: Sharma Rohit , Mahanti Gautam Kumar , Chakraborty Chinmay , Panda Ganapati , Rath Adyasha
Published: December 2023

A world of healthcare possibilities has been opened with the development of the Internet of Medical Things and related machine learning, deep learning, and artificial intelligence approaches. It has a broad range of uses: when linked to the Internet, common medical equipment and sensors may gather important data; deep learning and artificial intelligence algorithms use this data to understand symptoms and patterns and allow remote healthcare. There are a large number of people affected by thyroid disorders across the world. The ultrasound-based thyroid nodule detection using traditional methods increased the burden on the expertise. Therefore, alternate methods are required to overcome this problem. In order to facilitate early thyroid disorder detection, this research aims to offer an IoT-based ensemble learning framework. In the proposed ensemble model, three pre-trained models DeiT, Mixer-MLP and Swin Transformer, are used for feature extraction. The mRMR technique is used for relevant feature selection. A total of 24 machine learning models have been trained, and weighted average ensemble learning is employed using the Improved Jaya optimization algorithm and Coronavirus Herd Immunity optimization algorithm. The ensemble model with the improved Jaya optimization algorithm achieved excellent results. The best value for accuracy, precision, sensitivity, specificity, F2-score and ROC-AUC score are 92.83%, 87.76%, 97.66%, 88.89%, 0.9551 and 0.9357, respectively. The main focus of this research is to increase the specificity. A poor value of specificity can lead to a high false positive rate. This situation can increase anxiety and emotionally weaken the patient. The proposed ensemble model with the Improved Jaya optimization algorithm outperformed state-of-the-art techniques and can assist medical experts.
Characterization of Cycle-Aged Commercial NMC and NCA Lithium-ion Cells: I. Temperature-Dependent Degradation
Authors: Wittman Reed , Dubarry Matthieu , Ivanov Sergei , Juba Benjamin W. , Romàn-Kustas Jessica , Fresquez Armando , Langendorf Jill , Grant Richard , Taggart Gretchen , Chalamala Babu , Preger Yuliya
Published: December 2023

Lithium-ion batteries are widely used in applications from consumer electronic devices to stationary energy storage. Appropriate management of batteries is challenging due to limited data on their performance and materials degradation. Previous studies have focused on characterization of single cells under specific operating conditions. In the present work, commercial 18650 lithium-ion cells with LiNixMnyCo1-x-yO2 (NMC) and LiNixCoyAl1-x-yO2 (NCA) positive electrodes were characterized by a wide range of electrochemical and materials techniques after cycling at 15, 25, or 35 °C to ∼80% capacity. The NCA cells exhibit weak temperature dependence in their cycle aging and materials degradation. The NMC cells exhibited increased capacity fade and materials degradation as ambient temperature decreased. All cells exhibited loss of lithium inventory as their primary degradation mode. However, the NCA cells only showed evidence of solid electrolyte interphase (SEI) growth whereas the NMC cells showed signs of Li plating at 15 °C, transitioning to SEI growth at 35 °C. The NMC cells displayed signs of loss of active material at the positive electrode at lower temperatures, suggesting that Li plating is correlated to additional processes that increase the rate of degradation. These results highlight the importance of avoiding broad generalizations about Li-ion battery temperature dependence.
Perspectives of Executive Nurse Leaders on Advanced Practice Nursing in Saudi Arabia: Challenges to be Overcome and Opportunities to be Seized
Authors: Alhamed Arwa , Almotairy Monir M. , Nahari Ahmed , Moafa Hamza , Aboshaiqah Ahmad , Alblowi Fahad
Published: December 2023

Aim. To explore the perception of executive nurse leaders regarding the implementation of advanced practice nursing in Saudi Arabia. Design. An exploratory, descriptive, and qualitative design was used. Methods. Purposive sampling was used to recruit chief nurse officers and executive nurse directors from government, private, and military health systems in tertiary, secondary, and primary settings. Data were collected from July to November 2022 using virtual semistructured interviews, which were recorded and transcribed. Thematic analysis was conducted manually. Results. Eleven participants were included in the study. The following themes were identified: unique characteristics of advanced practice nursing, impacts of advanced practice nursing in nursing profession, challenges to utilize the advanced practice nursing roles, opportunities to foster the proper implementation of advanced practice nursing, and recommendations to move forward with fitting advanced practice nursing in Saudi health system. Participants characterized advanced practice nursing as specialized, advanced, and autonomous and reported that it increases access to care, provides efficient and cost-effective care, and expands nursing career pathways. The lack of job description, fragmentation of implementation efforts, lack of training programs, and resistance from physicians, nurses, and patients hinder its implementation. The Saudi Vision 2030, gaps in health care, the growing population, and the familiarity of the healthcare system with advanced practice nursing were viewed as opportunities. The following subthemes emerged under recommendations: establish, train, and implement. Conclusion. Executive nurse leaders perceived advanced practice nursing as a promising initiative to improve healthcare delivery and the nursing profession. Several opportunities make “now” the right time to implement it.
Oral Inflammation and Human Papilloma Virus Association among Hispanics
Authors: Castañeda-Avila Maira A. , Pérez Cynthia M. , Vivaldi José , Díaz-Toro Elba C. , Ramos-Cartagena Jeslie M. , Andriankaja Oelisoa M. , Ortiz Ana P.
Published: December 2023

Background. Identifying factors related to persistent human papillomavirus (HPV) infection is essential to reduce the incidence of HPV-related cancers. Objective. To evaluate whether gingival/periodontal inflammation is associated with oral HPV infection. Methods. This cross-sectional study (n = 740) uses data from the follow-up visit of the San Juan Overweight Adults Longitudinal Study, which recruited overweight/obese adults aged 40–65 from Puerto Rico. Participants completed a dental examination and two interviews (face-to-face/ACASI) and provided oral rinse samples for HPV detection. Oral inflammation was assessed using two definitions: (1) the number of sites with bleeding on probing (BOP), and (2) the number of teeth with probing pocket depths (PPD) ≥ 4 mm and BOP. Multivariate logistic regression was used to assess the association between oral inflammation and oral HPV. Results. Nearly three-quarters (72%) of participants were female, and 68% had 50 years or older. Participants with HPV had a higher mean number of sites with BOP (15.5 vs. 10.1) and teeth with PPD ≥ 4 mm and BOP (8.5 vs. 3.2) than participants without HPV (

p
<
0.05

). After adjusting for sex, age, income, and the number of oral sex partners, the odds of having an oral HPV infection increased by 3% (95% confidence interval (CI): 1.00–1.06) for any additional sites with BOP and 5% (95% CI: 1.02–1.09) for any other teeth with PPD ≥ 4 mm and BOP. Conclusions. We found that oral inflammation was associated with oral HPV infection among adults in Puerto Rico. Future studies need to further investigate the underlying mechanisms.
Development of a Practical Nomogram for Personalized Anemia Management in Patients Treated with Ataxia Telangiectasia and Rad3-related Inhibitor Camonsertib
Authors: Rosen Ezra , Yap Timothy A. , Lee Elizabeth K. , Højgaard Martin , Mettu Niharika B. , Lheureux Stephanie , Carneiro Benedito A. , Plummer Ruth , Fretland Adrian J. , Ulanet Danielle , Xu Yi , McDougall Robin , Koehler Maria , Fontana Elisa
Published: December 2023

Purpose:

Camonsertib is a highly selective and potent inhibitor of ataxia telangiectasia and Rad3-related (ATR) kinase. Dose-dependent anemia is a class-related on-target adverse event often requiring dose modifications. Individual patient risk factors for the development of significant anemia complicate the selection of a “one-size-fits-all” ATR inhibitor (ATRi) dose and schedule, possibly leading to suboptimal therapeutic doses in patients at low risk of anemia. We evaluated whether early predictors of anemia could be identified to ultimately inform a personalized dose-modification approach.

Patients and Methods:

On the basis of preclinical observations and a mechanistic understanding of ATRi-related anemia, we identified several potential factors to explore in a multivariable linear regression modeling tool for predicting hemoglobin level ahead of day 22 (cycle 2) of treatment.

Results:

In patients treated with camonsertib monotherapy (NCT04497116), we observed that hemoglobin decline is consistently preceded by reticulocytopenia, and dose- and exposure-dependent decreases in monocytes. We developed a nomogram incorporating baseline and day 8 hemoglobin and reticulocyte values that predicted the day 22 hemoglobin values of patients with clinically valuable concordance (within 7.5% of observations) 80% of the time in a cross-validation performance test of data from 60 patients.

Conclusions:

The prediction of future hemoglobin decrease, after a week of treatment, may enable a personalized, early dose modification to prevent development of clinically significant anemia and resulting unscheduled dose holds or transfusions.
Comparison of Circulating Tumor DNA Assays for Molecular Residual Disease Detection in Early-Stage Triple-Negative Breast Cancer
Authors: Coakley Maria , Villacampa Guillermo , Sritharan Prithika , Swift Claire , Dunne Kathryn , Kilburn Lucy , Goddard Katie , Pipinikas Christodoulos , Rojas Patricia , Emmett Warren , Hall Peter , Harper-Wynne Catherine , Hickish Tamas , Macpherson Iain , Okines Alicia , Wardley Andrew , Wheatley Duncan , Waters Simon , Palmieri Carlo , Winter Matthew , Cutts Rosalind J. , Garcia-Murillas Isaac , Bliss Judith , Turner Nicholas C.
Published: December 2023

Purpose:

Detection of circulating tumor DNA (ctDNA) in patients who have completed treatment for early-stage breast cancer is associated with a high risk of relapse, yet the optimal assay for ctDNA detection is unknown.

Experimental Design:

The cTRAK-TN clinical trial prospectively used tumor-informed digital PCR (dPCR) assays for ctDNA molecular residual disease (MRD) detection in early-stage triple-negative breast cancer. We compared tumor-informed dPCR assays with tumor-informed personalized multimutation sequencing assays in 141 patients from cTRAK-TN.

Results:

MRD was first detected by personalized sequencing in 47.9% of patients, 0% first detected by dPCR, and 52.1% with both assays simultaneously (P < 0.001; Fisher exact test). The median lead time from ctDNA detection to relapse was 6.1 months with personalized sequencing and 3.9 months with dPCR (P = 0.004, mixed-effects Cox model). Detection of MRD at the first time point was associated with a shorter time to relapse compared with detection at subsequent time points (median lead time 4.2 vs. 7.1 months; P = 0.02).

Conclusions:

Personalized multimutation sequencing assays have potential clinically important improvements in clinical outcome in the early detection of MRD.
Assessing the Clinical Significance of Third-Trimester Post-Coital Bleeding
Authors: Kabiri Doron , Amsalem Hagai , Watad Hadel , Lipschuetz Michal , Haj-Yahya Rani , Alter Roie , Ezra Yossef
Published: December 2023

Introduction: This study aimed to evaluate the impact of third-trimester post-coital bleeding (PCB) on pregnancy outcomes. Methods: A retrospective cohort study was conducted at two tertiary medical centers, including all pregnant women between 24 and 34 weeks of gestation referred due to vaginal bleeding over an 11-year period. The study population includes all singleton deliveries; within this population, women were further classified into three groups: those admitted due to vaginal bleeding related to PCB, those admitted due to vaginal bleeding not related to PCB, and those who did not report vaginal bleeding. The primary outcome measure was delivery prior to 37 weeks of gestation, while secondary outcome measures included maternal and neonatal complications. Baseline characteristics of the two groups were compared. Results: During the study period, there were a total of 51,698 deliveries. Among these, 230 cases involved bleeding between 24 and 34 weeks of gestation, 34 (14.8%) were identified as PCB, and 196 as bleeding unrelated to intercourse. In addition, 51,468 pregnancies without bleeding were analyzed as the general population for comparison. The incidence of preterm labor before 37 weeks of gestation was notably higher in both women with PCB (14.7%) and those with bleeding unrelated to coitus (20.9%) compared to the general population (5.6%); however, there was no statistically significant difference between the two bleeding groups (p = 0.403) while both were significantly different from the general population (p < 0.001). The odds ratio for preterm birth before 37 weeks of gestation after PCB was 3.29 (95% CI: 1.26–8.56, p = 0.0149). There were no significant differences between the PCB and bleeding unrelated to intercourse groups in terms of maternal and neonatal complications. Conclusion: This study found that third-trimester PCB is a risk factor for preterm delivery, with rates similar to other causes of third-trimester bleeding but significantly higher than the general population without bleeding. These findings challenge the assumption that PCB is benign.
A System Thinkingbased Framework for Sustainable Governance in Healthcare
Authors: Mishra Vinaytosh , Quttainah Majdi Anwar
Published: December 2023

This study emphasises the importance of thinking beyond the constrictive perspective of shareholder profit maximisation and putting stakeholder value maximisation front and centre in healthcare. This study uses system thinking approaches to understand the pitfall of the narrow approach of shareholder profit maximisation in healthcare organisations. The study further performs stakeholder analysis to identify each stakeholder’s interests, needs, expectations, and level of influence and power over the health systems and policy. The study used multi-criteria decision analysis approach to identify the priority of the stakeholder organisations. The criteria used for the prioritisation are levels of interest, influence, and impact. Contrary to belief pharmaceutical companies were found to be the most significant player in driving the outcomes of the healthcare system. The study also emphasises the role of government and regulators in the achievement of the same. Stakeholder analysis done in the study also concurs with these findings. Finally, the study uses the grounded theory approach to suggest a framework for the achievement of objectives and providing sustainable governance. This study concludes that by thinking beyond shareholder profit maximisation, healthcare organisations can prioritise patient-centred care, social responsibility, and innovation, ultimately leading to better outcomes for patients and society.
Enhancing Telehealth Competency: Development and Evaluation of Education Modules for Older Adults
Authors: Taylor Steven , Souza Samantha , Little Lauren , Odiaga Jan
Published: December 2023

Despite a rapid increase in telehealth utilization, older adults disproportionately experience disparities to services. To promote telehealth accessibility among this population, there is a need for specific training to increase user perceived competency. For this sequential mixed-methods study, we designed telehealth education modules through consultation with older adults. We then evaluated their impact on older adults’ perceived telehealth competency. To solicit feedback on preliminary modules, we administered a semi-structured interview to a sample ( n = 5) of older adults; then, we assessed the revised modules’ impact on perceived competency among a sample of older adults ( n = 53). Participants critiqued the preliminary training materials as having limited information on telehealth privacy and advised increasing the accessibility of design. Those that completed the revised modules demonstrated significant improvements in perceived telehealth competence. Telehealth training modules may be a promising method to increase perceived telehealth competency among older adults.
Feasibility of a Group-Based Purpose Renewal Intervention for Cancer Survivors Via Zoom
Authors: Radomski Mary Vining , Anheluk Mattie , Carroll Ginger L. , Kath Kristina , Kreiger Rob , Zola Joette
Published: December 2023

The COVID-19 pandemic contributed to both existential distress and the rapid adoption of telehealth-based services. Little is known about the feasibility of delivering group occupational therapy intervention to address purpose-related existential distress via face-to-face synchronous videoconferencing. The objective of the study was to evaluate the feasibility of providing a purpose in life renewal intervention to breast cancer survivors via Zoom. Descriptive data were collected on acceptability and implementability of the intervention. Limited-efficacy testing involved a prospective pretest–posttest study where participants with breast cancer ( n = 15) received an eight-session purpose renewal group intervention plus a Zoom tutorial. Participants completed standardized measures of meaning and purpose at pretest and posttest, and a forced-choice Purpose Status Question. The purpose renewal intervention was acceptable and implementable via Zoom. Pre–post changes in purpose in life were not statistically significant. Group-based purpose in life renewal intervention is acceptable and implementable when delivered via Zoom.
Successful mechanical thrombectomy for terminal ICA bullet embolism: A case report
Authors: Clouse Jared , Thaci Bart , Clark Austin Sy , Baggett Michael , Raslan Osama , Matouk Charles , Waldau Ben , Cord Branden
Published: December 2023

Bullet embolism after high velocity penetrating trauma is a rare event that can have devastating and wide-ranging effects distant from the original site of injury. A 29-year-old presented with multiple gunshot wounds to the chest, back, abdomen, and lower extremities but no penetrating head injury. After proper resuscitation, the patient was noted to have left-sided hemiparesis and computed tomography angiography of the head showed a bullet fragment that had traveled to the right M1 segment of the middle cerebral artery resulting in occlusion of the vessel. Mechanical thrombectomy was performed in an attempt to remove the bullet fragment but this was unsuccessful as the fragment was firmly lodged in the blood vessel. Aspiration of clot distal to the fragment was then performed in hopes of preventing a large volume ischemic event which was angiographically successful resulting in TICI 2c revascularization. This case demonstrates that thrombectomy can be safely and successfully performed distal to a lodged foreign body.
The risks of peace: Exploring the relationship between peaceocracy and journalism in Kenya
Authors: Arregui Olivera Cecilia , Cheruiyot David
Published: December 2023

Scholars have recently suggested that a peaceocracy is emerging in nations experiencing intermittent conflicts. A peaceocracy is an institutionalised political strategy – rather than a political system – that aims to promote stability in states considered fragile. While scholars know how the press functions in a democracy, little is still known about how a peaceocracy shapes journalism. This article explores the Kenyan context to illuminate how the press co-opts a peaceocratic discourse and discusses its implications to the profession. We pose that a political consensus between the state and the press foments a strong peace-building discourse that challenges professional autonomy. Secondly, in a peaceocracy, the state takes the role of the guardian of peace and the press, a promoter of peace, both of which legitimise a degree of restriction on press freedom.
Role of N6-methyladenosine methylation in glioma: recent insights and future directions
Authors: Li Chunlin , Li Bowen , Wang Hui , Qu Linglong , Liu Hui , Weng Chao , Han Jinming , Li Yuan
Published: December 2023

Glioma is the most pervasive intracranial tumor in the central nervous system (CNS), with glioblastoma (GBM) being the most malignant type having a highly heterogeneous cancer cell population. There is a significantly high mortality rate in GBM patients. Molecular biomarkers related to GBM malignancy may have prognostic values in predicting survival outcomes and therapeutic responses, especially in patients with high-grade gliomas. In particular, N6-methyladenine (m6A) mRNA modification is the most abundant form of post-transcriptional RNA modification in mammals and is involved in regulating mRNA translation and degradation. Cumulative findings indicate that m6A methylation plays a crucial part in neurogenesis and glioma pathogenesis. In this review, we summarize recent advances regarding the functional significance of m6A modification and its regulatory factors in glioma occurrence and progression. Significant advancement of m6A methylation-associated regulators as potential therapeutic targets is also discussed.
When chronic obstructive pulmonary disease meets small cell lung cancer: an unusual case report of rapid progression
Authors: Zhang Xu , Zeng Jia , Huang Xiyu , Li Zhishu
Published: December 2023

Background

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease and a risk factor for lung cancer. Small cell lung cancer is a neuroendocrine tumor with a high degree of malignancy and an overall five-year survival rate of less than 7%.

Cases presentation

Herein, we report the case of an 68-year-old male presented to the respiratory department with cough, sputum, and dyspnea.

He was diagnosed as community acquired pneumonia and treated with intravenous anti-infection. Previous pulmonary function was definitively diagnosed as COPD. About 7 months after discharge, the patient returned to the hospital for cough and dyspnea. After diagnosis of the tumor, cisplatin, etoposide and durvalumab were administered. Finally the patient died of respiratory failure approximately 9 months after his diagnosis.

Conclusions

For COPD patients with immunocompromised manifestations, it is necessary to be alert to complications and shorten the follow-up interval of chest CT. COPD may accelerate the formation and progression of SCLC.