bluuebunny/crossref_metadata_2025 huggingface dataset:
The Trumpization of the Grand Old Party
Authors: Harmel Robert , Mjelde Hilmar , Svåsand Lars
Published: February 2024

Background

The purposes of this article are to (1) detail the extent to which the Republican Party personalized in the period from Donald Trump's first becoming a presidential candidate through 2022 and the process by which it occurred, (2) suggest plausible explanatory factors, and (3) speculate as to possible consequences.

Methods

The authors employ this special issue's common conceptual framework and glean evidence from a broad accumulation of reportage and expert impressions from professional journalists.

Results and conclusion

It is found that “Trumpization” invaded all aspects of the Grand Old Party, with de‐institutionalization encompassing both de‐routinization and value‐displacement affecting all faces of the party: as organization, in elective office, and in the electorate.
Friendship and the grades of doxastic partiality
Authors: Vahid Hamid
Published: February 2024

It has been claimed that friendship not only involves partial treatment of one's friends but that it also involves some degree of doxastic partiality towards them. Taking these claims as their starting points, some philosophers have argued that friendship not only involves such partiality but that this is also what is normatively required. This gives rise to the possibility of conflict between the demands of friendship on the one hand and the demands of epistemic norms on the other. In this paper, I consider some of the responses to this claim and show why they fail. I distinguish between different grades of doxastic partiality and explain why, although low grades of doxastic partiality fall within the bounds of the standard epistemic norm, the higher grades might infringe such norms. I conclude with an explanation of a fundamental intuition that seems to lie at the heart of the thesis of epistemic partiality.
Racism and the uneven geography of welfare sanctioning in England
Authors: Williams Andrew , Webb Brian , Gale Richard
Published: February 2024

This paper presents the first spatial analysis of racial disparities in the UK welfare sanction regime. As part of their austerity programme, the UK government tightened the conditionality of welfare programmes and intensified the use of financial penalties against welfare claimants who failed to demonstrate compliance with these conditions. Analysing Jobseeker's Allowance (JSA) data from the Department of Work and Pensions (DWP) and the Office for National Statistics between 2012 and 2019 we draw attention to the spatially uneven and highly racialised geography of welfare sanctions in England. Claimants from racially minoritised backgrounds are consistently more likely to be referred for a sanction by Jobcentre caseworkers and receive an adverse decision at the hands of institutional decision‐makers. Within this, however, there are important scalar and spatial differences that warrant critical attention. In rural England, the risk of being sanctioned is substantially higher for all groups, but especially for Mixed heritage and Black/Black British claimants who in some areas are over twice as likely to be sanctioned as their White counterparts. Since ethnicity data have not been published for Universal Credit sanction decisions, the presented evidence offers critical insight into the potential persistence of racial injustice in applying welfare sanctions. We identify ‘hotspots’ of racism in the sanction regime, most of which are in rural areas, before offering three interpretative frameworks through which spatial and racial disparities might be explained. Any suggestion that such disparities simply derive from the behaviour of DWP staff fails to adequately account for deeply entrenched histories of welfare racism, rural racism and the role of welfare sanctioning in dynamics of racial capitalism: that is, disciplining and impoverishing racialised populations in ways that generate conditions for capital accumulation. By contributing new empirical and theoretical insights to the often neglected study of rural austerity and welfare, the paper calls for scholarship to investigate the variegations of welfare, austerity and racial capitalism in diverse rural contexts.
Volume of Seifert representations for graph manifolds and their finite covers
Authors: Derbez Pierre , Liu Yi , Wang Shicheng
Published: February 2024

For any closed orientable 3‐manifold, there is a volume function defined on the space of all Seifert representations of the fundamental group. The maximum absolute value of this function agrees with the Seifert volume of the manifold due to Brooks and Goldman. For any Seifert representation of a graph manifold, the authors establish an effective formula for computing its volume, and obtain restrictions to the representation as analogous to the Milnor–Wood inequality (about transversely projective foliations on Seifert fiber spaces). It is shown that the Seifert volume of any graph manifold is a rational multiple of . Among all finite covers of a given nongeometric graph manifold, the supremum ratio of the Seifert volume over the covering degree can be a positive number, and can be infinite. Examples of both possibilities are discovered, and confirmed with the explicit values determined for the finite ones.
Plasma electron characterization in electron chemical vapor deposition
Authors: Niiranen Pentti , Kapran Anna , Nadhom Hama , Čada Martin , Hubička Zdeněk , Pedersen Henrik , Lundin Daniel
Published: February 2024

Recently, a novel approach of depositing metallic films with chemical vapor deposition (CVD), using plasma electrons as reducing agents, has been presented and is herein referred to as e-CVD. By applying a positive substrate bias to the substrate holder, plasma electrons are drawn to the surface of the substrate, where the film growth occurs. In this work, we have characterized the electron flux at the substrate position in terms of energy and number density as well as the plasma potential and floating potential when maintaining an unbiased and a positively biased substrate. The measurements were performed using a modified radio frequency Sobolewski probe to overcome issues due to the coating of conventional electrostatic probes. The plasma was generated using a DC hollow cathode plasma discharge at various discharge powers and operated with and without precursor gas. The results show that the electron density is typically around 1016 m−3 and increases with plasma power. With a precursor, an increase in the substrate bias shows a trend of increasing electron density. The electron temperature does not change much without precursor gas and is found in the range of 0.3–1.1 eV. Introducing a precursor gas to the vacuum chamber shows an increase in the electron temperature to a range of 1–5 eV and with a trend of decreasing electron temperature as a function of discharge power. From the values of the plasma potential and the substrate bias potential, we were able to calculate the potential difference between the plasma and the substrate, giving us insight into what charge carriers are expected at the substrate under different process conditions.
Wigner versus Stark: Connecting quantum to classical in a tunnel ionization process
Authors: Yusofsani Seyedmohammad , Kolesik Miroslav
Published: February 2024

We present a framework designed to illustrate the dynamics of a quantum particle tunneling from a bound state into a continuum of states under the influence of an external field. We concentrate on the question of what is the best classical-level description of the escaping particle. A toy model is constructed and investigated through complementary numerical, analytical, and approximate solutions. Issues related to the location of the apparent exit from the “quantum tunnel” are addressed in the language of Wigner trajectories and discussed in relation to the other types of solutions.
Predicting the axial deformation of an extensible garden hose when pressurized
Authors: Renart Jordi , Roura-Grabulosa Pere
Published: February 2024

Extensible or expandable garden hoses have become popular. However, their behavior may be surprising to physicists. In this paper, the stress–strain equations that explain this behavior are derived and compared with experiments. The results clearly demonstrate that, since deformation is very large, conventional definitions of strain and stress are not useful and so-called real definitions are needed instead.
Downward migrating microplastics in lake sediments are a tricky indicator for the onset of the Anthropocene
Authors: Dimante-Deimantovica Inta , Saarni Saija , Barone Marta , Buhhalko Natalja , Stivrins Normunds , Suhareva Natalija , Tylmann Wojciech , Vianello Alvise , Vollertsen Jes
Published: February 2024

Plastics are a recent particulate material in Earth’s history. Because of plastics persistence and wide-range presence, it has a great potential of being a global age marker and correlation tool between sedimentary profiles. In this research, we query whether microplastics can be considered among the array of proxies to delimit the Anthropocene Epoch (starting from the year 1950 and above). We present a study of microplastics deposition history inferred from sediment profiles of lakes in northeastern Europe. The sediments were dated with independent proxies from the present back to the first half of the 18th century. Regardless of the sediment layer age, microplastic particles were found throughout the cores in all sites. Depending on particles’ aspect ratio, less elongated particles were found deeper, while more elongated particles and fibers have reduced mobility. We conclude that interpretation of microplastics distribution in the studied sediment profiles is ambiguous and does not strictly indicate the beginning of the Anthropocene Epoch.
Robust land surface temperature record for north China over the past 21,000 years
Authors: Guo Jingjing , Ziegler Martin , Wanders Niko , Vreeken Mike , Yin Qiuzhen , Lu Hao , Fuchs Louise , Dong Jibao , Sun Youbin , Peterse Francien
Published: February 2024

Numerous proxy reconstructions have provided general insight into late Quaternary East Asian Monsoon variability. However, challenges persist in precisely assessing absolute temperature impacts on proxy variations. Here, we use two independent paleothermometers, based on bacterial membrane lipids and clumped isotopes of snail shells, in the same section of the western Chinese Loess Plateau to establish a robust land surface temperature record spanning the past approximately 21,000 years. Our independent temperature records consistently reveal (i) similar land surface temperatures between the Last Glacial Maximum and late Holocene and (ii) a gradual cooling Holocene, which contrasts with the climate model predictions. We propose that changes in soil moisture availability over the deglaciation modulates the land surface temperature recorded by the proxies. A land surface energy partitioning model confirms this mechanism, suggesting that effects of soil moisture availability should be properly considered when comparing proxy records with climate model outputs.
Phase-shifting optothermal microscopy enables live-cell mid-infrared hyperspectral imaging of large cell populations at high confluency
Authors: Yuan Tao , Riobo Lucas , Gasparin Francesca , Ntziachristos Vasilis , Pleitez Miguel A.
Published: February 2024

Rapid live-cell hyperspectral imaging at large fields of view (FOVs) and high cell confluency remains challenging for conventional vibrational spectroscopy–based microscopy technologies. At the same time, imaging at high cell confluency and large FOVs is important for proper cell function and statistical significance of measurements, respectively. Here, we introduce phase-shifting mid-infrared optothermal microscopy (PSOM), which interprets molecular-vibrational information as the optical path difference induced by mid-infrared absorption and can take snapshot vibrational images over broad excitation areas at high live-cell confluency. By means of phase-shifting, PSOM suppresses noise to a quarter of current optothermal microscopy modalities to allow capturing live-cell vibrational images at FOVs up to 50 times larger than state of the art. PSOM also reduces illumination power flux density (PFD) down to four orders of magnitude lower than other conventional vibrational microscopy methods, such as coherent anti-Stokes Raman scattering (CARS), thus considerably decreasing the risk of cell photodamage.
Dietary
14
C reservoir effects and the chronology of prehistoric burials at Sakhtysh, central European Russia
Authors: Meadows John , Khramtsova Anastasia , Piezonka Henny , Krause-Kyora Ben , da Silva Nicolas , Kostyleva Elena , Dobrovolskaya Maria , Veselovskaya Elizaveta , Vasilyev Sergey
Published: February 2024

We present a robust radiocarbon (
14
C) chronology for burials at Sakhtysh, in European Russia, where nearly 180 inhumations of Lyalovo and Volosovo pottery-using hunter-gatherer-fishers represent the largest known populations of both groups. Past dating attempts were restricted by poor understanding of dietary
14
C reservoir effects (DREs). We developed a DRE correction approach that uses multiple linear regression of differences in
14
C, δ
13
C, and δ
15
N between bones and teeth of the same individuals to predict DREs of up to approximately 900 years. Our chronological model dates Lyalovo burials to the early fifth millennium BCE, and Volosovo burials to the mid-fourth to early third millennium. It reveals a change in the subsistence economy at approximately 3300 BCE, coinciding with a reorientation of trade networks, and dates the final burial to the early Fatyanovo period, the regional expression of the Yamnaya/Corded Ware expansion. Our approach is applicable when freshwater
14
C reservoir effects are poorly constrained and grave goods cannot be dated directly.
All-optical ultrafast polarization switching with nonlinear plasmonic metasurfaces
Authors: Wang Heng , Hu Zixian , Deng Junhong , Zhang Xuecai , Chen Jiafei , Li Kingfai , Li Guixin
Published: February 2024

Optical switching has important applications in optical information processing, optical computing, and optical communications. The long-term pursuit of optical switch is to achieve short switching time and large modulation depth. Among various mechanisms, all-optical switching based on Kerr effect represents a promising solution. However, it is usually difficult to compromise both switching time and modulation depth of a Kerr-type optical switch. To circumvent this constraint, symmetry selective polarization switching via second-harmonic generation (SHG) in nonlinear crystals has been attracting scientists’ attention. Here, we demonstrate SHG-based all-optical ultrafast polarization switching by using geometric phase controlled nonlinear plasmonic metasurfaces. A switching time of hundreds of femtoseconds and a modulation depth of 97% were experimentally demonstrated. The function of dual-channel all-optical switching was also demonstrated on a metasurface, which consists of spatially variant meta-atoms. The nonlinear metasurface proposed here represents an important platform for developing all-optical ultrafast switches and would benefit the area of optical information processing.
Upper limits for post-wildfire floods and distinction from debris flows
Authors: Ebel Brian A.
Published: February 2024

Upper magnitude limits and scaling with basin size for post-wildfire floods are unknown. An envelope curve was estimated defining post-wildfire flood upper limits as a function of basin area. We show the importance of separating peak flows by floods versus debris flows. Post-wildfire flood maxima are a constant 43 m3s−1km−2for basins from 0.01 to 23 to 34 km2and then declining with added basin area according to a power law relation. Intense rainfall spatial scaling may cause the envelope curve threshold at 23 to 34 km2. Post-wildfire flood maxima are smaller than unburned flood maxima for similar basin area. Rainstorm comparisons indicate that post-wildfire floods are triggered by smaller precipitation depths than unburned floods. Post-wildfire exceptional floods are driven by extreme rainfall rates, in contrast to post-wildfire debris flows. Runoff rates for post-wildfire envelope floods are consistent with infiltration-excess runoff. Future increases in precipitation intensity or wildfire frequency and extent could increase post-wildfire flood upper limits.
No evidence for a direct extracellular interaction between human Fc receptor–like 3 (MAIA) and the sperm ligand IZUMO1
Authors: Bianchi Enrica , Jiménez-Movilla Maria , Cots-Rodríguez Paula , Viola Cristina , Wright Gavin J.
Published: February 2024

Fertilization involves the recognition and fusion of sperm and egg to form a previously unidentified organism. In mammals, surface molecules on the sperm and egg have central roles, and while adhesion is mediated by the IZUMO1-JUNO sperm-egg ligand-receptor pair, the molecule/s responsible for membrane fusion remain mysterious. Recently, MAIA/FCRL3 was identified as a mammalian egg receptor, which bound IZUMO1 and JUNO and might therefore have a bridging role in gamete recognition and fusion. Here, we use sensitive assays designed to detect extracellular protein binding to investigate the interactions between MAIA and both IZUMO1 and JUNO. Despite using reagents with demonstrable biochemical activity, we did not identify any direct binding between MAIA/FCRL3 and either IZUMO1 or JUNO. We also observed no fusogenic activity of MAIA/FCRL3 in a cell-based membrane fusion assay. Our findings encourage caution in further investigations on the role played by MAIA/FCRL3 in fertilization.
An anti-mycobacterial conjugated oligoelectrolyte effective against
Mycobacterium abscessus
Authors: Zhang Kaixi , Limwongyut Jakkarin , Moreland Alex S. , Wei Samuel Chan Jun , Jim Jia Min Tania , Sun Yan , Shin Sung Jae , Kim Su-Young , Jhun Byung Woo , Pethe Kevin , Bazan Guillermo C.
Published: February 2024

Infections caused by nontuberculous mycobacteria have increased more than 50% in the past two decades and more than doubled in the elderly population.
Mycobacterium abscessus
(Mab), one of the most prevalent of these rapidly growing species, is intrinsically resistant to numerous antibiotics. Current standard-of-care treatments are not satisfactory, with high failure rate and notable adverse effects. We report here a potent anti-Mab compound from the flexible molecular framework afforded by conjugated oligoelectrolytes (COEs). A screen of structurally diverse, noncytotoxic COEs identified a lead compound, COE-PNH
2
, which was bactericidal against replicating, nonreplicating persisters and intracellular Mab.COE-PNH
2
had low propensity for resistance development, with a frequency of resistance below 1.25 × 10
−9
and showed no detectable resistance upon serial passaging. Mechanism of action studies were in line with COE-PNH
2
affecting the physical and functional integrity of the bacterial envelope and disrupting the mycomembrane and associated essential bioenergetic pathways. Moreover, COE-PNH
2
was well-tolerated and efficacious in a mouse model of Mab lung infection. This study highlights desirable in vitro and in vivo potency and safety index of this COE structure, which represents a promising anti-mycobacterial to tackle an unmet medical need.
Preclinical characterization of a non-peptidomimetic HIV protease inhibitor with improved metabolic stability
Authors: Mulato Andrew , Lansdon Eric , Aoyama Ron , Voigt Johannes , Lee Michael , Liclican Albert , Lee Gary , Singer Eric , Stafford Brian , Gong Ruoyu , Murray Bernard , Chan Julie , Lee Johnny , Xu Yili , Ahmadyar Shekeba , Gonzalez Ana , Cho Aesop , Stepan George J. , Schmitz Uli , Schultz Brian , Marchand Bruno , Brumshtein Boris , Wang Ruth , Yu Helen , Cihlar Tomas , Xu Lianhong , Yant Stephen R.
Published: February 2024

Protease inhibitors (PIs) remain an important component of antiretroviral therapy for the treatment of HIV-1 infection due to their high genetic barrier to resistance development. Nevertheless, the two most commonly prescribed HIV PIs, atazanavir and darunavir, still require co-administration with a pharmacokinetic boosting agent to maintain sufficient drug plasma levels which can lead to undesirable drug-drug interactions. Herein, we describe GS-9770, a novel investigational non-peptidomimetic HIV PI with unboosted once-daily oral dosing potential due to improvements in its metabolic stability and its pharmacokinetic properties in preclinical animal species. This compound demonstrates potent inhibitory activity and high on-target selectivity for recombinant HIV-1 protease versus other aspartic proteases tested. In cell culture, GS-9770 inhibits Gag polyprotein cleavage and shows nanomolar anti-HIV-1 potency in primary human cells permissive to HIV-1 infection and against a broad range of HIV subtypes. GS-9770 demonstrates an improved resistance profile against a panel of patient-derived HIV-1 isolates with resistance to atazanavir and darunavir. In resistance selection experiments, GS-9770 prevented the emergence of breakthrough HIV-1 variants at all fixed drug concentrations tested and required multiple protease substitutions to enable outgrowth of virus exposed to escalating concentrations of GS-9770. This compound also remained fully active against viruses resistant to drugs from other antiviral classes and showed no
in vitro
antagonism when combined pairwise with drugs from other antiretroviral classes. Collectively, these preclinical data identify GS-9770 as a potent, non-peptidomimetic once-daily oral HIV PI with potential to overcome the persistent requirement for pharmacological boosting with this class of antiretroviral agents.
Regional centromere configuration in the fungal pathogens of the
Pneumocystis
genus
Authors: Cissé Ousmane H. , Curran Shelly J. , Folco H. Diego , Liu Yueqin , Bishop Lisa , Wang Honghui , Fischer Elizabeth R. , Davis A. Sally , Combs Christian , Thapar Sabrina , Dekker John P. , Grewal Shiv , Cushion Melanie , Ma Liang , Kovacs Joseph A.
Published: February 2024

Centromeres are constricted chromosomal regions that are essential for cell division. In eukaryotes, centromeres display a remarkable architectural and genetic diversity. The basis of centromere-accelerated evolution remains elusive. Here, we focused on
Pneumocystis
species, a group of mammalian-specific fungal pathogens that form a sister taxon with that of the
Schizosaccharomyces pombe
, an important genetic model for centromere biology research. Methods allowing reliable continuous culture of
Pneumocystis
species do not currently exist, precluding genetic manipulation. CENP-A, a variant of histone H3, is the epigenetic marker that defines centromeres in most eukaryotes. Using heterologous complementation, we show that the
Pneumocystis
CENP-A ortholog is functionally equivalent to CENP-A
Cnp1
of
S. pombe
. Using organisms from a short-term
in vitro
culture or infected animal models and chromatin immunoprecipitation (ChIP)-Seq, we identified CENP-A bound regions in two
Pneumocystis
species that diverged ~35 million years ago. Each species has a unique short regional centromere (<10 kb) flanked by heterochromatin in 16–17 monocentric chromosomes. They span active genes and lack conserved DNA sequence motifs and repeats. These features suggest an epigenetic specification of centromere function. Analysis of centromeric DNA across multiple
Pneumocystis
species suggests a vertical transmission at least 100 million years ago. The common ancestry of
Pneumocystis
and
S. pombe
centromeres is untraceable at the DNA level, but the overall architectural similarity could be the result of functional constraint for successful chromosomal segregation.

IMPORTANCE

Pneumocystis
species offer a suitable genetic system to study centromere evolution in pathogens because of their phylogenetic proximity with the non-pathogenic yeast
S. pombe
, a popular model for cell biology. We used this system to explore how centromeres have evolved after the divergence of the two clades ~ 460 million years ago. To address this question, we established a protocol combining short-term culture and ChIP-Seq to characterize centromeres in multiple
Pneumocystis
species. We show that
Pneumocystis
have short epigenetic centromeres that function differently from those in
S. pombe
.
Heme sequestration by hemophilin from
Haemophilus haemolyticus
reduces respiratory tract colonization and infection with non-typeable
Haemophilus influenzae
Authors: Fulte Sam , Atto Brianna , McCarty Arianna , Horn Kadi J. , Redzic Jasmina S. , Eisenmesser Elan , Yang Michael , Marsh Robyn L. , Tristram Stephen , Clark Sarah E.
Published: February 2024

Iron acquisition is a key feature dictating the success of pathogen colonization and infection. Pathogens scavenging iron from the host must contend with other members of the microbiome similarly competing for the limited pool of bioavailable iron, often in the form of heme. In this study, we identify a beneficial role for the heme-binding protein hemophilin (Hpl) produced by the non-pathogenic bacterium
Haemophilus haemolyticus
against its close relative, the opportunistic respiratory tract pathogen non-typeable
Haemophilus influenzae
(NTHi). Using a mouse model, we found that pre-exposure to
H. haemolyticus
significantly reduced NTHi colonization of the upper airway and impaired NTHi infection of the lungs in an Hpl-dependent manner. Further, treatment with recombinant Hpl was sufficient to decrease airway burdens of NTHi without exacerbating lung immunopathology or systemic inflammation. Instead, mucosal production of the neutrophil chemokine CXCL2, lung myeloperoxidase, and serum pro-inflammatory cytokines IL-6 and TNFα were lower in Hpl-treated mice. Mechanistically,
H. haemolyticus
suppressed NTHi growth and adherence to human respiratory tract epithelial cells through the expression of Hpl, and recombinant Hpl could recapitulate these effects. Together, these findings indicate that heme sequestration by non-pathogenic, Hpl-producing
H. haemolyticus
is protective against NTHi colonization and infection.

IMPORTANCE

The microbiome provides a critical layer of protection against infection with bacterial pathogens. This protection is accomplished through a variety of mechanisms, including interference with pathogen growth and adherence to host cells. In terms of immune defense, another way to prevent pathogens from establishing infections is by limiting the availability of nutrients, referred to as nutritional immunity. Restricting pathogen access to iron is a central component of this approach. Here, we uncovered an example where these two strategies intersect to impede infection with the respiratory tract bacterial pathogen
Haemophilus influenzae
. Specifically, we find that a non-pathogenic (commensal) bacterium closely related to
H. influenzae
called
Haemophilus haemolyticus
improves protection against
H. influenzae
by limiting the ability of this pathogen to access iron. These findings suggest that beneficial members of the microbiome improve protection against pathogen infection by effectively contributing to host nutritional immunity.
Supplemental Material: Lithospheric mantle as a metal storage reservoir for orogenic gold deposits in active continental margins: Evidence from Hg isotopes
Authors: Zhang Jing-Yuan , Qiu Kun-Feng , Deng Jun , al. et
Published: February 2024

Geology of the Jiaodong gold province, analytical methods, supplementary notes, Figure S1, and Tables S1–S2.  
Supplemental Material: Ice? Salt? Pressure? Sediment deformation structures as evidence of late-stage shallow groundwater in Gale crater, Mars
Authors: Banham Steven , al. et
Published: February 2024

Slide pack of high-quality images used as part of this study and additional data. 
Supplemental Material: Impact of rift history on the structural style of intracontinental rift-inversion orogens
Authors: Vasey Dylan A. , al. et
Published: February 2024

Methods, additional tables and figures, and videos of model runs. 
Management of a rapidly enlarging supraclavicular mass of unknown aetiology
Authors: Cukman Mateo , Luzaic Karla , Krstanovic Kristina , Stevanovic Sinisa
Published: February 2024

Intramuscular haemangiomas are benign tumours showing an extremely rare occurrence and making up less than 1% of all haemangiomas. The goal of this case report is to share our experience in treating a patient with an extremely rare intramuscular haemangioma, which occurred in the supraclavicular region VB level of the neck and extended towards the infraclavicular space, localised within and inferior to the trapezius muscle. The lesion was diagnosed by using multimodal imaging and a wide excision was performed with intraoperative feeding vessel ligation and a good postoperative result. The main difficulties regarding diagnosis and treatment include a lack of evidence-based guidelines, due to limited publications on this topic, the nature of the lesion frequently showing obscure anatomic localisation deep within muscles and unclear delineation, various anatomic origin requiring an individual treatment approach, inconclusive radiologic signs as well as non-specific symptoms.
Haemosuccus pancreaticus and seven episodes of recurrent unlocalised upper gastrointestinal bleeding
Authors: Abdalla Moustafa , Abdalla Salwa , Panda Nikhil , Castillo Carlos Fernández-del
Published: February 2024

Upper gastrointestinal (GI) bleeding is a common medical condition that results in extensive morbidity and mortality, as well as substantial healthcare costs. While there is variation among society and consensus guidelines, the approaches to assessment and evaluation are generally consistent. Our case describes a man in his 40s who presented with seven episodes of recurrent upper GI bleeding over 2 years secondary to haemosuccus pancreaticus. While rare, this case study highlights key principles to the initial diagnostic approach that, in appropriate clinical contexts, should be applied to patients with unlocalised upper GI bleeding. We further perform a complete systematic review of similar cases available in PubMed (36 patients in 24 case reports) to further refine these diagnostic principles.
Comparison of supramalleolar and inframalleolar correction for Takakura stage IIIB ankle arthritis in a single patient
Authors: Choi Jun Young , Suh Jin Soo
Published: February 2024

A man in his early 60s with bilateral Takakura stage IIIB varus ankle arthritis underwent calcaneal osteotomy on the right side and supramalleolar osteotomy (SMO) with fibular osteotomy on the left side. Both sides underwent identical procedures, including multiple drilling of the denuded talar dome and gutter, deltoid ligament release, anterior talofibular ligament (ATFL) reconstruction and posterior tibial tendon (PTT) lengthening. This aimed to minimise patient-related factors when assessing correction efficacy. Both procedures demonstrated a similar degree of improvement in talar tilt. Supramalleolar correction contributed more significantly to lateralising the talar centre, while greater improvement in preoperative hindfoot varus was achieved through inframalleolar correction.
Acute superior mesenteric artery syndrome complicated by severe gastric, pancreatic and renal ischaemia
Authors: Moore Zachary James , Eldredge Richard Scott , Russell Katie W
Published: February 2024

Superior mesenteric artery syndrome (SMAS) is a rare and potentially life-threatening cause of small bowel obstruction in which the superior mesenteric artery impinges on the third portion of the duodenum. SMAS is typically encountered in patients with low body fat and a history of rapid weight loss and is often diagnosed as a chronic or subacute condition. Here, we describe a case of a healthy adolescent boy without typical SMAS prodromal symptoms presenting with a severe, hyperacute proximal small bowel obstruction due to SMAS. Complications arising from massive gastric and duodenal distension, including gastric, pancreatic and renal ischaemia, necessitated emergent surgical intervention consisting of the duodenojejunostomy bypass with partial gastric resection. The patient recovered without significant lasting consequences.
Integrating large language models in systematic reviews: a framework and case study using ROBINS-I for risk of bias assessment
Authors: Hasan Bashar , Saadi Samer , Rajjoub Noora S , Hegazi Moustafa , Al-Kordi Mohammad , Fleti Farah , Farah Magdoleen , Riaz Irbaz B , Banerjee Imon , Wang Zhen , Murad Mohammad Hassan
Published: February 2024

Large language models (LLMs) may facilitate and expedite systematic reviews, although the approach to integrate LLMs in the review process is unclear. This study evaluates GPT-4 agreement with human reviewers in assessing the risk of bias using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool and proposes a framework for integrating LLMs into systematic reviews. The case study demonstrated that raw per cent agreement was the highest for the ROBINS-I domain of ‘Classification of Intervention’. Kendall agreement coefficient was highest for the domains of ‘Participant Selection’, ‘Missing Data’ and ‘Measurement of Outcomes’, suggesting moderate agreement in these domains. Raw agreement about the overall risk of bias across domains was 61% (Kendall coefficient=0.35). The proposed framework for integrating LLMs into systematic reviews consists of four domains: rationale for LLM use, protocol (task definition, model selection, prompt engineering, data entry methods, human role and success metrics), execution (iterative revisions to the protocol) and reporting. We identify five basic task types relevant to systematic reviews: selection, extraction, judgement, analysis and narration. Considering the agreement level with a human reviewer in the case study, pairing artificial intelligence with an independent human reviewer remains required.
German primary care data collection projects: a scoping review
Authors: Moser Konstantin , Massag Janka , Frese Thomas , Mikolajczyk Rafael , Christoph Jan , Pushpa Joshi , Straube Johanna , Unverzagt Susanne
Published: February 2024

Background

The widespread use of electronic health records (EHRs) has led to a growing number of large routine primary care data collection projects globally, making these records a valuable resource for health services and epidemiological and clinical research. This scoping review aims to comprehensively assess and compare strengths and limitations of all German primary care data collection projects and relevant research publications that extract data directly from practice management systems (PMS).

Methods

A literature search was conducted in the electronic databases in May 2021 and in June 2022. The search string included terms related to general practice, routine data, and Germany. The retrieved studies were classified as applied studies and methodological studies, and categorised by type of research, subject area, sample of publications, disease category, or main medication analysed.

Results

A total of 962 references were identified, with 241 studies included from six German projects in which databases are populated by EHRs from PMS. The projects exhibited significant heterogeneity in terms of size, data collection methods, and variables collected. The majority of the applied studies (n = 205, 85%) originated from one database with a primary focus on pharmacoepidemiological topics (n = 127, 52%) including prescription patterns (n = 68, 28%) and studies about treatment outcomes, compliance, and treatment effectiveness (n = 34, 14%). Epidemiological studies (n = 77, 32%) mainly focused on incidence and prevalence studies (n = 41, 17%) and risk and comorbidity analysis studies (n = 31, 12%). Only 10% (n = 23) of studies were in the field of health services research, such as hospitalisation.

Conclusion

The development and durability of primary care data collection projects in Germany is hindered by insufficient public funding, technical issues of data extraction, and strict data protection regulations. There is a need for further research and collaboration to improve the usability of EHRs for health services and research.
Nursing students’ Health Literacy skills: a scoping review protocol for driving research
Authors: Bulfone Giampiera , Bressan Valentina , Zerilli Irene , Mazzotta Rocco , Favara Giuliana , Magnano San Lio Roberta , Barchitta Martina , Agodi Antonella
Published: February 2024

Introduction

The healthcare systems in Europe are changing rapidly due to the increased complexity of healthcare needs, specifically for the ageing population with chronic diseases. Nurses play a key role in providing care for patients with chronic diseases, encouraging patients to take care of their own health improving their Health Literacy (HL) too. Previous works have highlighted the paucity of HL content in nursing curricula, and the need to prioritise the development of HL skills in academic teaching and assessment methods. The aim of this study is to analyse HL skills nursing literature to further develop scientific knowledge in this area of research.

Methods and analysis

This scoping review will be conducted following Arksey and O’Malley’s framework. This study is based on the Joanna Briggs Institute manual. A systematic search will be performed by four researchers using the electronic databases of MEDLINE (via PubMed), the Education Resources Information Centre, the Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and Google Scholar. We will include any paper that focuses on HL skills and undergraduate nursing students. We will select every primary study (quantitative, qualitative and mixed method design) published in peer-reviewed journals up until February 2023, in both Italian and English language, without any time limit.

Ethics and dissemination

This scoping review is part of a large project of the University of Catania which aims at developing higher educational standards for nursing student. This project will not involve patients/public and does not require ethical committee approval. This scoping review will be submitted to international peer-reviewed journals.

Registration details

The protocol was registered with the Open Science Framework on 20 April 2023 (https://osf.io/cn8d7).
Predictors at diagnosis for start of biologic disease-modifying antirheumatic drugs in patients with early rheumatoid arthritis: a cohort study
Authors: Hameed Mohaned , Exarchou Sofia , Eberhard Anna , Sharma Ankita , Bergström Ulf , Cagnotto Giovanni , Einarsson Jon Thorkell , Turesson Carl
Published: February 2024

Objectives

To investigate the relation between patient characteristics at rheumatoid arthritis (RA) diagnosis and subsequent initiation of treatment with biologic disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic DMARDs (tsDMARDs).

Design

A retrospective cohort study.

Setting and participants

Consecutive patients (N=330) with early RA (symptom duration <12 months) diagnosed at Skåne University Hospital, Malmö/Lund, Sweden, from 2012 to 2016, were included. Data on demographics, education, comorbidities and treatment were obtained from national registers.

Outcome

The relation between patient characteristics at diagnosis and time to first bDMARD/tsDMARD initiation was analysed using Cox regression models. As a secondary outcome, the relation between characteristics at diagnosis and b/tsDMARD initiation within 3 years was analysed using logistic regression.

Results

A total of 330 patients (mean age 59.2 years; SD 16.4) were included. During follow-up, 41% received a bDMARD (never preceded by a tsDMARD). Higher age at diagnosis was associated with a lower probability of starting bDMARD treatment (multivariable-adjusted HR 0.66 per SD; 95% CI 0.56 to 0.78). Anticitrullinated protein antibody (ACPA) positivity and higher tender joint count at diagnosis were also associated with subsequent bDMARD treatment initiation in multivariable analysis. A higher level of formal education and absence of comorbidities predicted start of a bDMARD in crude, but not in age-adjusted, analyses.

Conclusions

Older patients with RA were less likely to start bDMARDs, whereas ACPA-positive patients, and those with extensive joint involvement at diagnosis, were more likely to receive early bDMARD treatment. The impact of age on the subsequent start of bDMARD therapy was not explained by level of education or comorbidities, suggesting that other aspects of age influence treatment decisions in early RA.
Computerised modified paramedian approach technique versus conventional midline approach technique of lumbar puncture: a randomised control trial protocol
Authors: Zhuang Yuan-Dong , Chen Yi-Ze , Lin Qi-Ying , Chen Yi-Xin , Zhong Si-Qi , Lei Ding , Chen Chun-Mei
Published: February 2024

Introduction

The lumbar puncture (LP) technique is widely used for diagnostic and therapeutic purposes. In recent years, the paramedian approach technique (PAT) has gained increasing interest due to its advantages over the conventional midline approach technique (MAT) that has been traditionally employed in clinical practice for LP. However, there have been inconsistent discussions regarding the efficacy of different LP techniques. Based on digital virtual human and computer simulation techniques, a new approach called computerised modified PAT (CMPAT) was proposed. Therefore, the aim of this study is to discuss a randomised controlled trial (RCT) protocol to investigate and compare the effects of CMPAT and MAT in patients undergoing LP.

Methods and analysis

We will conduct a prospective, multicentre RCT. The study will recruit 84 patients aged 18–99 years who require LP. Participants will be randomly assigned to either the CMPAT treatment group (group A) or the MAT treatment group (group B). The primary outcome measure will be the number of needle insertion attempts required for a successful LP. Secondary outcomes will include the puncture success rate, pain assessment in the back, head, and legs, and the occurrence of complications. The measurement of these secondary outcomes will be taken during the procedure, as well as at specific time points: 30 min, 6 hours, 1 day, 3 days, 7 days, 2 weeks and 4 weeks after the procedure. Pain levels will be assessed using a Numerical Rating Scale.

Ethics and dissemination

Ethical approval (2022YF052-01) has been obtained from the Ethics Committee of Fujian Medical University Union Hospital, Fuzhou, China. The research findings will be published in an international peer-reviewed scientific journal and presented at scientific conferences.

Trial registration number

ChiCTR2300067937.
Study protocol for a randomised open-label clinical trial examining the safety and efficacy of the Android Artificial Pancreas System (AAPS) with advanced bolus-free features in adults with type 1 diabetes: the ‘CLOSE IT’ (Closed Loop Open SourcE In Type 1 diabetes) trial
Authors: Wilkinson Tom , Tomic Dunya , Boyle Erin , Burren David , Elghattis Yasser , Jenkins Alicia , Keesing Celeste , Middleton Sonia , Nanayakkara Natalie , Williman Jonathan , de Bock Martin , Cohen Neale D
Published: February 2024

Introduction

Multiple automated insulin delivery (AID) systems have become commercially available following randomised controlled trials demonstrating benefits in people with type 1 diabetes (T1D). However, their real-world utility may be undermined by user-associated burdens, including the need to carbohydrate count and deliver manual insulin boluses. There is an important need for a ‘fully automated closed loop’ (FCL) AID system, without manual mealtime boluses. The (Closed Loop Open SourcE In Type 1 diabetes) trial is a randomised trial comparing an FCL AID system to the same system used as a hybrid closed loop (HCL) in people with T1D, in an outpatient setting over an extended time frame.

Methods and analysis

Randomised, open-label, parallel, non-inferiority trial comparing the Android Artificial Pancreas System (AAPS) AID algorithm used as FCL to the same algorithm used as HCL. Seventy-five participants aged 18–70 will be randomised (1:1) to one of two treatment arms for 12 weeks: (a) FCL—participants will be advised not to bolus for meals and (b) HCL—participants will use the AAPS AID algorithm as HCL with announced meals. The primary outcome is the percentage of time in target sensor glucose range (3.9–10.0 mmol/L). Secondary outcomes include other glycaemic metrics, safety, psychosocial factors, platform performance and user dietary factors. Twenty FCL arm participants will participate in a 4-week extension phase comparing glycaemic and dietary outcomes using NovoRapid (insulin aspart) to Fiasp (insulin aspart and niacinamide).

Ethics and dissemination

Approvals are by the Alfred Health Ethics Committee (615/22) (Australia) and Health and Disability Ethics Committees (2022 FULL 13832) (New Zealand). Each participant will provide written informed consent. Data protection and confidentiality will be ensured. Study results will be disseminated by publications, conferences and patient advocacy groups.

Trial registration numbers

ACTRN12622001400752 and ACTRN12622001401741.
Exploring the safety and quality of mobile X-ray imaging in a new infectious disease biocontainment unit: an in situ simulation and video-reflexive study
Authors: Wyer Mary , Hor Su-yin , Barratt Ruth , Garrahy Phillip , Moore Cameron , Williams Veazey Leah , Degeling Chris , Gilbert G L
Published: February 2024

Objectives

During a precommissioning inspection of a new biocontainment centre, radiographers noted structural features of quarantine rooms that could compromise staff and patient safety and the X-ray image quality, even after significant modifications had been made to an earlier radiography protocol. The aim of this study was to explore the safety and effectiveness of the modified protocol, in the new space, and identify improvements, if required.

Design

A qualitative study using in situ simulation and video-reflexive methods.

Setting

A newly built biocontainment centre, prior to its commissioning in 2021, in a large, tertiary hospital in Sydney, Australia.

Participants

Five radiographers, and a nurse and a physician from the biocontainment centre, consented to participate. All completed the study.

Interventions

Two simulated mobile X-ray examinations were conducted in the unit prior to its commissioning; simulations were videoed. Participants and other stakeholders analysed video footage, collaboratively, and sessions were audio recorded, transcribed and analysed thematically. Problems and potential solutions identified were collated and communicated to the hospital executive, for endorsement and actioning, if possible.

Results

Four themes were identified from the data: infection exposure risks, occupational health and exposure risks, communication and X-ray image quality. Facilitated group reviews of video footage identified several important issues, across these four areas of risk, which had not been identified previously.

Conclusions

In situ simulation is used, increasingly, to evaluate and improve healthcare practices. This study confirmed the added value of video-reflexive methods, which provided experienced participants with a richer view of a familiar protocol, in a new setting. Video footage can be examined immediately, or later if required, by a broader group of stakeholders, with diverse experience or expertise. Using video reflexivity, clinicians identified potential safety risks, which were collated and reported to the hospital executive, who agreed to implement modifications.