bluuebunny/crossref_metadata_2025 huggingface dataset:
Optoelectronic metadevices
Authors: Ha Son Tung , Li Qitong , Yang Joel K. W. , Demir Hilmi Volkan , Brongersma Mark L. , Kuznetsov Arseniy I.
Published: November 2024

Metasurfaces have introduced new opportunities in photonic design by offering unprecedented, nanoscale control over optical wavefronts. These artificially structured layers have largely been used to passively manipulate the flow of light by controlling its phase, amplitude, and polarization. However, they can also dynamically modulate these quantities and manipulate fundamental light absorption and emission processes. These valuable traits can extend their application domain to chipscale optoelectronics and conceptually new optical sources, displays, spatial light modulators, photodetectors, solar cells, and imaging systems. New opportunities and challenges have also emerged in the materials and device integration with existing technologies. This Review aims to consolidate the current research landscape and provide perspectives on metasurface capabilities specific to optoelectronic devices, giving new direction to future research and development efforts in academia and industry.
Microscale droplet assembly enables biocompatible multifunctional modular iontronics
Authors: Zhang Yujia , Tan Cheryl M. J. , Toepfer Christopher N. , Lu Xin , Bayley Hagan
Published: November 2024

Hydrogel iontronic devices can emulate biological functions and communicate with living matter. But the fabrication of miniature, soft iontronic devices according to modular designs has not been achieved. In this work, we report the use of surfactant-supported assembly of freestanding microscale hydrogel droplets to construct various iontronic modules, circuits, and biointerfaces. Chemical modifications of silk fibroin produced a pair of oppositely charged hydrogels. Microscale assembly of various combinations of hydrogel droplets produced iontronic diodes, npn- and pnp-type transistors, and diverse reconfigurable logic gates. Through the incorporation of poly(amino acid)s, we have demonstrated a droplet-based synthetic synapse with ionic polymer–mediated long-term plasticity. Further, our iontronic transistor can serve as a biocompatible sensor to record electrophysiological signals from sheets of human cardiomyocytes, paving a way to the building of miniature bioiontronic systems.
Magnetically programmed diffractive robotics
Authors: Smart Conrad L. , Pearson Tanner G. , Liang Zexi , Lim Melody X. , Abdelrahman Mohamed I. , Monticone Francesco , Cohen Itai , McEuen Paul L.
Published: November 2024

Microscopic robots with features comparable with the wavelength of light offer new ways of probing the microscopic world and controlling light at the microscale. We introduce a new class of magnetically controlled microscopic robots (microbots) that operate at the visible-light diffraction limit, which we term diffractive robots. We combined nanometer-thick mechanical membranes, programmable nanomagnets, and diffractive optical elements to create untethered microbots small enough to diffract visible light and flexible enough to undergo complex reconfigurations in millitesla-scale magnetic fields. We demonstrated their applications, including subdiffractive imaging by using a variant of structured illumination microscopy, tunable diffractive optical elements for beam steering and focusing, and force sensing with piconewton sensitivity.
The philosopher’s intuition
Herald of a Restless World: How Henri Bergson Brought Philosophy to the People
Emily Herring
Basic Books, 2024. 320 pp.
Authors: Hannibal Mary Ellen
Published: November 2024

A forgotten scholar sought to reconcile subjective experience with the laws of nature
Contemporary hominin locomotor diversity
Authors: Harcourt-Smith William E. H.
Published: November 2024

Footprints in Kenya show that hominin bipedalism had a complex evolutionary history
Eating the Earth
Authors: Bourne Joel K.
Published: November 2024

The burgeoning global food trade is a lifeline for billions, but it is fragile and hard on the planet
Knowledge, attitude and practices of ayurvedic medicine practitioners in Kerala towards millets and millet-based diet: a prospective cross-sectional online survey study
Authors: Chettiyam Kandy Saniya , Singhal Richa , V Krishna Kumar , Yadav Babita , Jameela Sophia , Deverakonda Sudhakar , Rao Bhogavalli Chandra Sekhar , Rana Rakesh Kumar , Sreekanth Narayanam , Acharya Rabinarayan
Published: November 2024

Introduction

Diet and lifestyle play pivotal roles in Ayurveda’s preventive and therapeutic principles. The rich culinary heritage of Kerala harmoniously aligns with Ayurvedic dietetic principles. With the recent designation of 2023 as the International Year of Millets, there has been a surge of interest in integrating millets into dietary practices worldwide. Ayurveda physicians are poised to offer nutritional guidance to endorse health.

Methods

A cross-sectional online survey was conducted from 26 July to 9 August 2023 among Ayurveda practitioners in Kerala. The survey used a semi-structured questionnaire finalised through the face and content validity, comprising eight items each for knowledge, attitudes and practices (KAP) domains. A target sample size of 422 participants was determined through convenience sampling methodology. Spearman’s rank correlation test was used to examine the correlations between KAP while binary logistic regression analyses were employed to identify determinants associated with favourable levels of KAP among participants.

Results

A total of 386 complete responses were used for analysis. The average scores for KAP items were 5.21, 6.36 and 5.34, respectively, (range 0–8). It was found that better Knowledge scores were associated with more favourable Attitudes towards the prescription of millet-based diet (MBD) (adjusted Odd’s Ratio (AOR): 3.04) and even more positive responses towards Practice (AOR: 8.59).

Conclusion

The knowledge of Ayurveda practitioners in Kerala regarding the use of MBD is satisfactory. There is a significant relationship between Knowledge and Attitude as well as Practice. This study has underscored the importance of education and awareness in shaping favourable attitudes and practices related to MBD, aligning with Ayurvedic principles. Despite practitioners demonstrating good KAP behaviour towards MBD, gaps persist in certain aspects of contemporary knowledge and limitations in translating knowledge into practice. Addressing these gaps and barriers is essential to promote the widespread adoption and prescription of MBD.
Priorities and expectations of researchers, funders, patients and the public regarding the funding of medical research: results from the PERSPECT qualitative study
Authors: Cristall Nora , Drozdowska Bogna A , Fladt Joachim , Jaroenngarmsamer Tanaporn , Sehgal Arshia , Victoria McDonough Rosalie , Goyal Mayank , Ganesh Aravind
Published: November 2024

Background

Ideally, medical research provides crucial data about disease processes, diagnoses, prognoses, treatment targets and outcomes, and systems of care. However, medical research is costly, and funding is difficult to receive because the processes are highly competitive. There is a paucity of data on the perspectives of researchers, funders, patients and the public about current funding paradigms. This study sought to understand the priorities and opinions of each group to better guide meaningful innovation in research funding processes.

Method

In this Priorities & Expectations of Researchers, Funders, Patients and the Public Regarding the Funding & Conduct of Stroke Research study, we conducted in-depth interviews with medical researchers, funders, patients and members of the general public to learn their opinions of the current funding process and thoughts about alternative approaches. We used both purposive and snowball sampling to recruit participants and conducted semistructured interviews. The study ended when thematic saturation was attained. Qualitative analysis followed inductive grounded theory methodology.

Results

41 interviews were completed (11 researchers, 10 funders, 10 patients, 10 members of the general public; 61% female). Interviewees expressed a high interest in supporting a comprehensive evaluation of the research grant funding process while integrating funding mechanisms that are more inclusive and reduce bias in topic selection and researchers who receive funds. Participants acknowledged a gap in patient and public involvement in setting a research agenda, choosing topics to be studied and focusing on specific outcomes. Crowdfunding was identified as an alternative strategy that could facilitate research democratisation; however, participants emphasised the importance of expert review of research proposals, as in current processes to continue to support rigour and trust in research proposal quality.

Conclusion

Our research revealed stakeholder concerns about the transparency and equity of current research funding paradigms. Suggestions to democratize research and explore alternative fundraising platforms necessitate a fundamental shift in traditional research funding processes.
Mediating role of inflammatory biomarkers on the association of physical activity, sedentary behaviour with chronic kidney disease: a cross-sectional study in NHANES 2007–2018
Authors: Peng Pan , Liu Zhisheng
Published: November 2024

Objectives

This study aims to investigate the association of physical activity (PA) and sedentary behaviour (SB) with chronic kidney disease (CKD), and to illustrate whether inflammatory biomarkers play a mediating role.

Design

A cross-sectional study.

Setting

This study analysed cross-sectional data from the National Health and Nutrition Examination Survey 2007–2018.

Participants

A total of 27 808 participants aged 20–80 years old were enrolled in the final analysis.

Outcome measures

PA and SB were self-reported by participants using the Global Physical Activity Questionnaire. Inflammatory biomarkers including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic immune inflammation index (SII) were examined in subjects’ peripheral blood samples. Estimated glomerular filtration rate <60 mL/min/1.73 m2was defined as CKD. Multivariable logistic regression and medication model were performed to examine the associations of PA, SB and inflammatory biomarkers with CKD.

Results

PA was associated with CKD, with a 20% lower OR of CKD compared with inactive (p=0.002) and a 2% lower OR per 30 min moderate-to-vigorous PA increase (p=0.027). SB was also associated with CKD, with a significant 39% higher OR for high SB (p<0.001), and a 3% higher OR per 30 min SB increase (p<0.001). NLR and SII both significantly mediated the association of PA and SB with CKD. NLR explained 1.87% (medication effect: −0.0003, direct effect: −0.0162) and 2.73% (medication effect: 0.0005, direct effect: 0.0192) association of PA and SB with CKD (p<0.001), respectively. While SII explained 1.77% (medication effect: −0.0003, direct effect: −0.0162) and 1.22% (medication effect: 0.0002, direct effect: 0.0199) association of PA and SB with CKD (p<0.001), respectively. The results did not show any statistical association between PLR and CKD in this sample.

Conclusion

This finding revealed increasing PA and shortening SB may be effective strategies in CKD prevention and early management through the regulation of systemic inflammation. NLR and SII may not only be prognostic indicators of CKD, but also novel potential markers in predicting CKD occurrence.
Temporal changes in the burden of leukaemia and lymphoma in the Australasia and Oceania regions, 2010–2019: an analysis of the Global Burden of Disease Study 2019
Authors: Ho Thi Quynh Anh , Lee Peter , Gao Lan
Published: November 2024

Objectives

Leukaemias and lymphomas are among the most prevalent and significant cancers in Australasia and Oceania. This study aims to examine the burden of leukaemias/lymphomas and its temporal trend in Australasia and Oceania from 2010 to 2019.

Design

Epidemiological study

Methods

Data from the Global Burden of Disease (GBD) 2019 were used to examine the burden of leukaemia/lymphoma key subtypes (acute lymphocytic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL), chronic myeloid leukaemia (CML), Hodgkin-lymphoma (HL) and non-Hodgkin’s lymphoma (NHL)) by sex and 5 year age groups (from <5 years to 85 years+), in terms of incidence, prevalence, disability-adjusted life years (DALYs) and deaths. Estimated average percentage changes were calculated to assess the temporal trends of leukaemia/lymphoma burden (incidence/prevalence/DALYs/deaths) from 2010 to 2019 in Australasia and Oceania.

Results

AML and NHL were the leading causes of leukaemia/lymphoma burden in both regions. Age-standardised rates (ASRs) for AML versus NHL in Australasia were: incidence 4.72 versus 19.06, DALYs 89.01 versus 161.68 and deaths 4.15 versus 8.02 per 100 000 population. ASRs for AML versus NHL in Oceania were: incidence 1.36 versus 1.08, DALYs 49.16 versus 38.30 and deaths 0.91 versus 0.98 per 100 000 population. From 2010 to 2019, Australasia observed an increasing trend in incidence/prevalence/deaths across most leukaemias/lymphomas and increasing/stable trend in DALYs for AML/CLL/NHL, while Oceania observed increasing trends in incidence/prevalence/DALYs for CLL/NHL and stable trends in all outcomes (except for prevalence (stable)) for AML. Contrasting mortality trends for ALL/CML/HL were observed between the two regions (increasing/stable in Australasia and decreasing in Oceania). Statistically significant differences were observed in disease burden trends between sexes, with males experiencing a greater increase (or smaller decrease) in the burden for AML in both regions.

Conclusions

Different temporal trends in leukaemia/lymphoma burden observed in two closely situated geographic regions with different sociodemographic indices highlight the necessity for region-specific intervention strategies to enhance the access to innovative disease treatments, reducing leukaemia/lymphoma burden.
A mindfulness-based, cognitive, social, digital relapse-prevention intervention for youth with depression in Australia: study protocol for a randomised controlled trial of Rebound
Authors: Mangelsdorf Shaminka N , Cagliarini Daniela , Lee Yong Yi , Mihalopoulos Cathrine , Liu Virginia , Valentine Lee , Bendall Sarah , Koval Peter , D'Alfonso Simon , Davey Christopher , Russon Penni , Phillips Jess , Gonzalez-Blanch Cesar , Pawsey Brendan , Ryan Richard M , Parker Alexandra , Hetrick Sarah , Rice Simon , Lederman Reeva , Herrman Helen , Murray Greg , Gleeson John , Alvarez-Jimenez Mario
Published: November 2024

Introduction

Major depressive disorder (MDD) causes significant disease burden and functional impairment during adolescence and young adulthood. While most young people recover from their first episode, around two-thirds will experience one or more relapses, which can become more severe and treatment-resistant with each episode. To address relapse in MDD, we developed a moderated online social therapy platform (titledRebound) that integrates: (i) peer-to-peer social networking; (ii) tailored third-wave therapeutic content targeting mindfulness, self-compassion and rumination; and (iii) three types of human support (clinicians, peer workers, career consultants), informed by self-determination theory. The aim of this trial is to determine whether, in addition to treatment as usual (TAU),Rebound, an 18-month complex digital intervention, is superior to 18 months of enhanced TAU in preventing relapse and managing depressive symptoms.

Methods and analysis

This study is a rater-masked randomised controlled trial. The treatment conditions includeReboundplus TAU or enhanced TAU alone. We aim to recruit 255 young people with at least one episode of MDD, aged 14–27 years. The study includes monthly assessment points over 18 months. The study includes a 48-month recruitment period and an 18-month treatment phase. The primary outcome is depressive relapse at 18 months, as measured by the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Research Version (SCID-5-RV). Secondary outcomes include the severity of depressive symptoms, time to relapse, time to remission, remission status, severity of anxiety symptoms, study and employment outcomes and cost-effectiveness. We will also examine four therapeutic mechanisms (mindfulness, self-compassion skills, social support and reduced rumination) to understand the ‘how and why’ of the intervention effects.

Ethics and dissemination

Melbourne Health Human Research Ethics Committee (HREC/42967/MH-2018) provided ethics approval for this study. Findings will be made available through scientific journals and forums and to the public via social media and the Orygen website.

Trial registration number

ANZCTR, ACTRN12619001412123.
What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providers
Authors: Abdelaziz Shahd , Garfield Sara , Neves Ana Luisa , Lloyd Jill , Norton John , van Dael Jackie , Wheeler Carly , McLeod Monsey , Franklin Bryony Dean
Published: November 2024

Objective

To identify patient-safety-related unintended consequences of healthcare technologies experienced by their primary users: patients, carers and healthcare providers (HCPs).

Design

Qualitative study based on data collected in online focus groups. Transcripts were analysed inductively after each focus group using reflexive thematic analysis, focusing on identifying unintended consequences of healthcare technologies with implications for patient safety. Patient safety was broadly conceptualised to include a more subjective concept of ‘feeling safe’ as well as risks of actual harm.

Setting

Patient/public and HCP participants from the UK with experience in healthcare technologies were recruited using a mixture of purposive, convenience and snowball sampling.

Participants

40 participants (29 patients/public, 11 HCPs) took part in 5 focus groups between November 2021 and February 2022.

Results

We identified five main themes of unintended consequences with implications for patient safety: inequity of access, increased end-user burden, loss of the human element of healthcare, over-reliance on technology and unclear responsibilities. Both groups of participants identified unintended consequences directly affecting patients; HCPs also described those affecting themselves. Some unintended consequences are described in previous literature, including alert fatigue, the ‘illusion of communication’, reduced opportunities for face-to-face interactions and increased end-user burden. Others are potentially novel, including patients’ psychological dependence on technologies, ‘gaming’ of data entry and incorrect interpretation of health data.

Conclusions

Drawing on the perspectives of patients/public as well as HCPs, we identified five areas of patient-safety-related unintended consequences associated with healthcare technologies. These should be considered when developing tools to identify and mitigate the patient-safety-related unintended consequences of healthcare technologies.
Who has the responsibility to inform relatives at risk of hereditary cancer? A population-based survey in Sweden
Authors: Grill Kalle , Phillips Amicia , Numan Hellquist Barbro , Rosén Anna
Published: November 2024

Objectives

Hereditary cancer has implications not only for patients but also for their at-risk relatives (ARRs). In current clinical practice, risk disclosure to ARRs involves collaboration between patients and healthcare providers (HCPs). However, the specific responsibilities of each party are intertwined and at times unclear. In this study, we explored public attitudes regarding moral and legal responsibilities to disclose familial risk information to uninformed ARRs.

Design

In an online cross-sectional survey, participants were prompted with a hypothetical scenario where a gender-neutral patient learnt about their familial risk of colorectal cancer. The patient was advised to regularly undergo colonoscopy screening, and this recommendation was extended to both their siblings and cousins. While the patient informed their siblings, they had not spoken to their cousins in 20 years and did not want to contact them. The survey assessed respondents’ views on the patient’s and HCPs’ ethical responsibility and legal obligation to inform the cousins (ARRs).

Participants

A random selection of 1800 Swedish citizens 18–74 years of age were invited. Out of those, 914 (51%) completed the questionnaire.

Results

In total, 75% believed that HCPs had a moral responsibility to inform ARRs, while 59% ascribed this moral responsibility to the patient. When asked about the ultimate responsibility for risk disclosure to ARRs, 71% placed this responsibility with HCPs. Additionally, 66% believed that HCPs should have a legal obligation to inform ARRs, while only 21% thought the patient should have such an obligation. When prompted about a scenario in which the patient actively opposed risk disclosure, a majority believed that HCPs should still inform the ARRs.

Conclusion

Our study indicates that the Swedish public ascribes moral responsibility for informing ARRs to both the patient and HCPs. However, contrary to current practice, they believe HCPs hold the ultimate responsibility. The majority of respondents support disclosure even without patient consent.
Using normalisation process theory to evaluate the implementation of a digital health intervention in community and secondary care long COVID clinics
Authors: Stevenson Fiona A , Pfeffer Paul , Walker Sarah , Ismaila Hadiza , Jegatheesan Vinosh , Mohammad Ibrahim , Blandford Ann , Linke Stuart , Hurst John R , Ricketts William , Hamilton Fiona L , Sunkersing David , Bradbury Katherine , Goodfellow Henry
Published: November 2024

Objectives

The potential and expected benefits of digital health interventions (DHI) have long been discussed, yet substantial challenges are associated with deploying DHI at scale. Insights are presented concerning the implementation of a DHI consisting of a patient-facing app and a digital dashboard for clinicians providing supported self-management for long COVID to support both clinicians and patients.

Design

Qualitative reflexive thematic analysis, mapped against Normalisation Process Theory.

Setting

Fifty-five and a half hours of zoom recordings of meetings between clinicians in community and secondary care long COVID clinics and members of the research team.

Participants

Allied health professionals, service delivery managers and members of the core team, including representatives from industry partners.

Results

The DHI fitted with contextual circumstances and the design supported flexibility to suit circumstances in different trusts. The DHI also aligned with existing ways of working.

Healthcare professionals worked together to support the implementation of the DHI, requiring flexibility to take account of local circumstances. The DHI was appraised in both positive and negative terms by healthcare professionals. Using DHIs was said to have the potential to complement care but not be a replacement for face-to-face clinical input. The DHI was judged to have demonstrated the potential to affect long-established patterns and organisational structures of engagement between healthcare professionals and patients in terms of access to care.

Conclusions

NPT provided a framework for considering both individual agency and the organisation context, enabling reflections to be made at the level of the structure of services as well as people’s experiences. The discipline of considering first the context, then the work and finally the practical effects helped place order on the ‘mess’ involved in the rapid cycle of developing, refining and implementing a DHI in an atypical environment (a pandemic).
Review on obesity management: bariatric surgery
Authors: Peri Katya , Eisenberg Mark
Published: November 2024

Obesity is a chronic disease whose prevalence has increased to epidemic proportions in North America and across the world. Leading organisations in healthcare have compiled guidelines to help primary care practitioners screen, manage and treat patients with overweight and obesity. This review is the final part of our three-part series conducting an overview of the current clinical guidelines for obesity management. In this review, we provide an overview of the types of bariatric surgery, eligible populations, weight loss outcomes and future directions of surgical intervention for weight loss. Obesity is an important health issue that can lead to significant impacts on the heath. In severe cases, bariatric surgery is an appropriate intervention to help patients lose weight. This weight loss is associated with improved quality of life and comorbidity remission.
Determinants of treatment-seeking behaviour and healthcare provider choice in Afghanistan in 2018: a cross-sectional study
Authors: van Gurp Margo , Abdianwall Mohammad Haris , Safi Sohrab , Saeedzai Sayed Ataullah , Juszkiewicz Konrad T , Arab Sayed Rahim , Sondorp Egbert , Alba Sandra
Published: November 2024

Introduction

In Afghanistan, remarkable achievements have been made in improving access to healthcare and health outcomes since the introduction of essential healthcare packages. Nonetheless, sociodemographic and geographical inequities persist, and out-of-pocket expenditures are high. This study investigates the client and provider determinants of access to care that affect treatment-seeking behaviour in 2018.

Methods

Secondary data analysis using data on treatment-seeking behaviour in public and private healthcare from the Afghanistan Health Survey 2018 was combined with data on the quality of public healthcare facilities from a national healthcare facility assessment of the same year. Logistic regression analyses were performed to explore associations between client characteristics and accessibility of public healthcare facilities, and treatment-seeking behaviour and choice of public versus private healthcare provider.

Results

The results suggest that the odds of seeking treatment are lowest among the rural poor. The odds of treatment-seeking and choosing a public healthcare provider are higher for pregnancy-related health needs but lower for chronic conditions. Affordability of healthcare was associated with lower odds of treatment-seeking (OR 0.96, 95% CI 0.95 to 0.98) and using private healthcare providers (OR 0.97, 95% CI 0.96 to 0.99). Increased satisfaction with opening hours (OR 1.04, 95% CI 1.02 to 1.05) and availability of a female nurse or doctor (OR 1.03, 95% CI 1.01 to 1.04) in public health facilities, and a higher level of trust in healthcare provider (OR 1.04, 95% CI 1.03 to 1.06) were associated with higher odds of using public healthcare.

Conclusion

Afghanistan’s public healthcare system is vital in providing care to the economically disadvantaged and managing infectious diseases and maternal health problems. The private sector plays a dominant role, particularly for those illnesses not covered under the essential healthcare packages. The study suggests opportunities for the public healthcare system to alleviate financial barriers to healthcare access and broaden its service offerings to encompass the management of chronic illnesses.
Is emergency doctors’ tolerance of clinical uncertainty on a novel measure associated with doctor well-being, healthcare resource use and patient outcomes?
Authors: Budworth Luke , Wilson Brad , Sutton-Klein Joanna , Basu Subhashis , O'Keeffe Colin , Mason Suzanne M , Ang Andrew , Anne-Wilson Sally , Reynard Kevin , Croft Susan , Shah Anoop D , Bank Sakarias , Conner Mark , Lawton Rebecca
Published: November 2024

Introduction

Emergency doctors routinely face uncertainty—they work with limited patient information, under tight time constraints and receive minimal post-discharge feedback. While higher uncertainty tolerance (UT) among staff is linked with reduced resource use and improved well-being in various specialties, its impact in emergency settings is underexplored. We aimed to develop a UT measure and assess associations with doctor-related factors (eg, experience), patient outcomes (eg, reattendance) and resource use (eg, episode costs).

Methods

From May 2021 to February 2022, emergency doctors (specialty trainee 3 and above) from five Yorkshire (UK) departments completed an online questionnaire. This included a novel UT measure—an adapted Physicians’ Reaction to Uncertainty scale collaboratively modified within our team according to Hillenet al’s (2017) UT model. The questionnaire also included well-being-related measures (eg, Brief Resilience Scale) and assessed factors like doctors’ seniority. Patient encounters involving prespecified ‘uncertainty-inducing’ problems (eg, headache) were analysed. Multilevel regression explored associations between doctor-level factors, resource use and patient outcomes.

Results

39 doctors were matched with 384 patients. The UT measure demonstrated high reliability (Cronbach’sα=0.92) and higher UT was significantly associated with better psychological well-being including greater resilience (Pearson’s r=0.56; 95% CI=0.30 to 0.74) and lower burnout (eg, Cohen’s d=−2.98; −4.62 to −1.33; mean UT difference for ‘no’ vs ‘moderate/high’ burnout). UT was not significantly associated with resource use (eg, episode costs: β=−0.07; −0.32 to 0.18) or patient outcomes including 30-day readmission (eg, OR=0.82; 0.28 to 2.35).

Conclusions

We developed a reliable UT measure for emergency medicine. While higher UT was linked to doctor well-being, its impact on resource use and patient outcomes remains unclear. Further measure validation and additional research including intervention trials are necessary to confirm these findings and explore the implications of UT in emergency practice.
Diversity, community engagement and co-design in research: a rapid review
Authors: Khan Nagina , Keck Lily , Sykes Claudia , Rowden Cassidy , Simister Julia , Fenlon Stephen , Mccallum Edyta , Bell Madeline , Whiting David , Shelton Claire , Wells Gary , Giles Richard , Howard Jane , Peckham Stephen
Published: November 2024

There is increasing recognition in the field of health and social care research that community-engaged methods should include patients and the public throughout the research process. Therefore, individuals from all backgrounds should be involved in the research. We explored the public and patient engagement experience in research and how researchers and community groups can work together to make the research process more inclusive and sustainable. We carried out a rapid review and we present three themes from our results as a narrative summary. We found that partnerships and peer support was important for individuals, and it helped them to understand their role and the expectations of stakeholders. Also, using inclusive environments for diverse communities to participate helped individuals to access research training in their communities enabling them to co-create and co-design with facilitators and their community together. Trust was an important factor for diverse community participation in research and was linked to past experiences of taking part in research. We also found that partnerships, innovative methods of information sharing and context of the individual were important facilitators of inclusion. Analysis also indicated that the design of the studies and recruitment approaches such as using flyers, word of mouth, attending health fairs and partnering with nonprofit community, led to an increase in diverse population partcipation in research.
Relationship between high-resolution computed tomography quantitative imaging analysis and physiological and clinical features in antisynthetase syndrome-related interstitial lung disease
Authors: Bae Sangmee Sharon , Abtin Fereidoun , Kim Grace , Markovic Daniela , Chan Cato , Moghadam-Kia Siamak , Oddis Chester V , Sullivan Daniel , Marder Galina , Venuturupalli Swamy , Dellaripa Paul F , Doyle Tracy J , Hunninghake Gary Matt , Falk Jeremy , Charles-Schoeman Christina , Tashkin Donald P , Goldin Jonathan , Aggarwal Rohit
Published: November 2024

Objectives

To explore the association between the extent of CT abnormalities by quantitative imaging analysis (QIA) and clinical/physiological disease parameters in patients with antisynthetase syndrome associated interstitial lung disease (ARS-ILD).

Methods

We analysed 20 patients with antisynthetase antibodies and active ILD enrolled in the Abatacept in Myositis-Associated Interstitial Lung Disease study. High-resolution chest CT was obtained at weeks 0, 24 and 48 and QIA scored the extent of ground glass (quantitative score for ground glass), fibrosis (quantitative score for lung fibrosis, QLF) and total ILD (quantitative ILD, QILD). Mixed-effects models estimated longitudinal QIA scores over time. Associations between QIA scores with clinical/physiological parameters were analysed longitudinally using repeated-measures mixed-effects models.

Results

Patients were median age 57 years, 55% males and 85% white. Higher (worse) baseline QIA scores correlated with lower baseline forced vital capacity (FVC) and diffusing capacity adjusted for haemoglobin (DLCO). Longitudinal QIA trajectories trended towards improving scores during the trial, and patients on O2at baseline had worsening QIA trajectories which were different from patients who were not on O2. Longitudinal QIA scores demonstrated strong associations with both FVC and DLCO over time. Higher QILD scores over time were also associated with worse dyspnoea scores, pulmonary visual analogue scale, physician and patient global disease activity, health status in 6/8 domains of the Short Form-36 and higher oxygen requirements. Patients with significant radiographic improvement at 48 weeks had higher baseline QLF, QILD and worse DLCO.

Conclusions

Longitudinal QIA scores associate with lung physiology, patient perception of respiratory status, overall disease activity and quality of life over time in ARS-ILD. QIA may allow reproducible monitoring of disease progression and response to therapy over time.

Trial registration number

NCT03215927.
Identification of a machine learning-based diagnostic model for axial spondyloarthritis in rheumatological routine care using a random forest approach
Authors: Redeker Imke , Tsiami Styliani , Eicker Jan , Kiltz Uta , Kiefer David , Andreica Ioana , Sewerin Philipp , Baraliakos Xenofon
Published: November 2024

Objectives

In axial spondyloarthritis (axSpA), early diagnosis is crucial, but diagnostic delay remains long and diagnostic criteria do not exist. We aimed to identify a diagnostic model that distinguishes patients with axSpA from patients without axSpA with chronic back pain based on clinical data in routine care.

Methods

Clinical data from patients with chronic back pain were used, with information on rheumatological examinations based on clinical indications. The total dataset was randomly divided into training and test datasets at a 7:3 ratio. A machine learning-based model was built to distinguish axSpA from non-axSpA using the random forest algorithm. Overall accuracy, sensitivity, specificity and the area under the receiver operating characteristic curve-area under the curve (ROC-AUC) in the test dataset were calculated. The contribution of each variable to the accuracy of the model was assessed.

Results

Data from 939 randomly selected patients were available: 659 diagnosed with axSpA and 280 with non-axSpA. In the test dataset, the model reached an accuracy of 0.9234, a sensitivity of 0.9586, a specificity of 0.8438 and a ROC-AUC of 0.9717. Human leucocyte antigen B27 (HLA-B27) contributed most to the accuracy of the model; that is, the accuracy would suffer most from not using HLA-B27, followed by insidious onset of back pain and erosions in the sacroiliac joint.

Conclusions

We provide a machine learning-based model that reveals high performance in diagnosing patients with chronic back pain with axSpA versus without axSpA based on information from a tertiary rheumatology practice. This model has the potential to improve diagnostic delay in patients with axSpA in daily routine settings.
IRIS, a randomised, double-blind, placebo-controlled trial of interleukin-6 receptor inhibition undergoing endovascular treatment in acute anterior circulation ischaemic stroke: study rationale and design
Authors: Chu Xuehong , Ma Zhengfei , Liu Yifeng , Sun Jun , Wang Ning , Li Chaoqun , Feng Xiangyang , Li Jianqiao , Wang Benxiao , Zhou Chen , Li Chuanhui , Zhao Wenbo , Ji Xunming , Wu Chuanjie
Published: November 2024

Rationale

Neuroprotective strategies based on reperfusion therapy hold substantial promise for acute ischaemic stroke (AIS). Preclinical research indicates that tocilizumab, an interleukin-6 receptor antagonist, can attenuate ischaemia-reperfusion damage by exerting anti-inflammatory and neuroprotective effects.

Aim

To determine tocilizumab’s efficacy and safety when combined with endovascular thrombectomy (EVT) in patients with acute anterior circulation large vessel occlusion (LVO).

Sample size estimates

To determine a 30% decrease in average infarct core volume comparing the intervention and historical control groups (mean increase of 18.7 mL (SD=9.7 mL) post-thrombectomy) via a two-sided test (alpha=0.05, power=80%), accounting for a 10% drop-out rate, we plan to recruit 108 participants.

Methods and design

This trial is designed as a randomised, multicentre, double-blind, placebo-controlled trial. Patients will be randomly and evenly allocated to the tocilizumab or placebo groups.

Study outcomes

The primary endpoint is the change in infarct core volume between baseline and 72 hours post-treatment. Secondary outcomes include the 90-day modified Rankin scale score (0–2, indicating functional independence). The key safety endpoints include 90-day mortality and symptomatic intracerebral haemorrhage within 72 hours after EVT.

Discussion

Administering tocilizumab within 24 hours of stroke as an adjunct to EVT may effectively reduce the infarct core volume for patients experiencing AIS with anterior circulation LVO, potentially improving functional outcomes in these patients.
Peak V̇O2 during handcycling in spinal cord injured athletes: incremental versus verification testing
Authors: Rosa Caio de Araújo , Antunes Diego , Ventura Thiago Pereira , Fischer Gabriela , Brickley Gary , de Lucas Ricardo Dantas , Turnes Tiago
Published: November 2024

The present study aimed to compare peak oxygen uptake (V̇O2peak), peak heart rate (HRpeak), and peak O2pulse during an incremental and a verification test performed on the same day in hand-cyclists with spinal cord injury (SCI). Eight competitive SCI hand-cyclists (age: 23 ± 2.7 years; V̇O2peak: 36.3 ± 14.0 mL.kg−1.min−1) performed a maximal incremental handcycling test and a verification test to exhaustion at 100% of the peak speed on an oversized treadmill. The V̇O2peak, HRpeak, and peak O2pulse (i.e., VO2/HR) were compared between incremental and verification tests. Absolute and relative V̇O2peak obtained in the verification test (2.51 ± 0.96 L.min−1; 36.3 ± 14.0 mL.kg.min−1) were significantly higher than values obtained in the incremental test (2.24 ± 0.79 L.min−1; 33.5 ± 12.9 mL.kg.min−1; P < 0.05). The mean differences (95% CL) of absolute and relative V̇O2peak between tests were 8.2% (3.3%–13.2%) and 10.9% (4.3%–18.1%), respectively. There was no difference in HR peak (incremental: 169 ± 24 bpm; verification 167 ± 25 bpm; P = 0.130). Peak O2pulse from the verification test (14.6 ± 4.7 mL.beat−1) was higher than incremental test (13.0 ± 3.8 mL.beat−1; P = 0.007). In conclusion, the verification test elicited greater V̇O2peak and O2pulse than a two-phase incremental test despite the similar HRpeak. This indicates that for this progressive protocol lasting ≥25 min, the verification phase adds value to determining V̇O2peak in SCI athletes.
Phonon dispersion of nanoscale honeycomb phononic crystal: gigahertz and terahertz spectroscopy comparison
Authors: Diego Michele , Anufriev Roman , Yanagisawa Ryoto , Nomura Masahiro
Published: November 2024

Phonons—quantized vibrational modes in crystalline structures—govern phenomena ranging from thermal and mechanical transport to quantum mechanics. In recent years, a new class of artificial materials called phononic crystals has emerged, aiming to control phononic properties. These materials are created by introducing a superlattice structure on top of an already-existing atomic lattice. Typically, phononic crystals are described using a continuous model, in which effective elastic constants approximate potentials between atoms. This approximation, however, assumes the wavelengths of vibrations to be significantly greater than the interatomic distance. In this work, we experimentally investigate the behavior of a honeycomb silicon phononic crystal in the gigahertz range, where the continuum approximation holds, and in the terahertz range, where the phonon wavelengths are comparable to interatomic distances. Using Brillouin light scattering, we investigate the phonon dispersion of the phononic crystal in the gigahertz range, finding a close match with simulations based on the continuous model. Conversely, Raman spectroscopy reveals no difference between the phononic crystal, an unpatterned membrane, and a bulk silicon structure in the terahertz range, showing that the continuous model no longer holds at these higher frequencies.
Mathematical modeling and analysis of leptospirosis–COVID-19 co-infection with real data
Authors: Said Muhammad , Roh Yunil , Jung Il Hyo
Published: November 2024

In this paper, we present a mathematical model to analyze the dynamics of leptospirosis and COVID-19 co-infection. The model used actual data, and estimation of the parameters via the MLE method is performed, which includes the rates of disease transmission, progression of the disease, disease-related death, and recovery rates for each disease and their co-infection. Key parameters: $$\beta _1$$

β
1

, $$\beta _2$$

β
2

, $$\phi _1$$

ϕ
1

, $$\phi _2$$

ϕ
2

, and $$\mu _c$$

μ
c

are used to characterize the dynamics of the co-infection burden of leptospirosis and COVID-19. The results reveal a notable contrast in transmission dynamics and clinical outcomes between the two diseases, with leptospirosis demonstrating a higher transmission rate and increased morbidity. Co-infections showed more severe clinical outcomes, with higher mortality and delayed recovery than single infections. These findings highlight the importance of targeted public health strategies for managing co-infected populations.
Implications of Privacy Regulations on Video Surveillance Systems
Authors: Kansal Kajal , Wong Yongkang , Kankanhalli Mohan S.
Published: November 2024

Advanced video surveillance systems (VSS), which collect information of every individual who passes through a surveilled area, have become ubiquitous due to its utility for security. However, such proactive monitoring threatens the individual's privacy due to the public's lack of control over personal data. Additionally, individuals or organizations may unethically misuse VSS for other purposes (e.g. individual profiling and unwarranted monitoring). To safeguard individual privacy, various governments have introduced mandatory information privacy regulations (e.g. GDPR, PDPA, and CCPA) to provide extensive guidelines for the purpose of achieving identity confidentiality. Currently, there is a gap between the information privacy regulations and VSS. This paper aims to bridge this gap through four contributions. First, this paper conceptualizes VSS as comprising various data stages based on the idea of data life cycle and studies the implications of existing regulations on VSS. Second, we conducted a survey in ASEAN and European regions to understand the public perception of data risks at each data stage. Third, we review existing privacy-enhancing technologies and its relation to each data stage. Finally, we discuss open research problems in order to realize privacy-aware VSS.
Teaching the Bubble Sort Algorithm Using CS Unplugged Activities at the K-12 Level
Authors: Mladenović Monika , Medak Lucija , Krpan Divna
Published: November 2024

Computer Science (CS) Unplugged activities are designed to engage students with CS concepts. It is an active learning approach combining physical interaction with visual representation. This research article investigates the impact of CS Unplugged on students’ understanding of the bubble sort algorithm. Algorithm visualization, traditionally employed for active knowledge construction, serves as the foundation for this approach. The research was conducted as a quasi-experiment in middle and high schools in Split, Croatia, among 204 students. We divided the participants into two groups: experimental (CS Unplugged) and control (traditional teaching). The study included pre-test, mid-test, and post-test assessments. While CS Unplugged did not significantly affect students’ understanding of bubble sort, it positively influenced long-term retention of the algorithm. These results highlight the potential of CS Unplugged activities as an effective teaching approach for CS concepts, specifically in promoting long-term retention of the bubble sort algorithm. The study also revealed misconceptions that included restarting comparisons after each swap, assuming the largest element reaches the end after one swap, and repeatedly swapping the largest element with its neighbor. Addressing these misconceptions through active learning activities like CS Unplugged can contribute to deeper understanding beyond memorization.
Structural and Optical Characteristic of Fe10+ Ion Implanted Nanostructured WO3 Film for Gas Sensing Application
Authors: Kumar Ashutosh , Rajput Shailendra , Parida Sabyasachi
Published: November 2024

300 keV Fe10+ ions with fluences of 1×1015, 3 × 1016, and 1 × 1017 ions cm−2 were used to implant

W

O

3

films, developed by thermal evaporation method. After implantation, all samples were characterized for structural, morphological and optical study for gas sensing application. Furthermore, a thorough investigation and discussion of the gas sensing characteristics of pristine and Fe ion implanted

W

O

3

gas sensors was conducted. Dynamic gas-sensing performance were tested at room temperature for

C

H

4

gas at various concentrations of 50 ml min−1, 100 ml min−1, and 150 ml min−1. Sensitivity of all gas sensors to

C

H

4

gas was calculated by the static gas response curve within and without methane environment. The obtained results indicate the Fe-ion implanted

W

O

3

gas sensor (1 × 1017 ion/cm2) possess better sensing properties than that of pure

W

O

3

films. This outcome might be related to the development of active sites and structural defects created by Fe ion implantation. These findings suggested that metal oxide sensitivity could be enhanced by ion implantation.
A control policy can be adapted to task demands during both motor execution and motor planning
Authors: Orban de Xivry Jean-Jacques , Hardwick Robert M.
Published: November 2024

Movement preparation consists of different processes such as target selection and movement parameters selection. We investigate the time that it takes to tune movement parameters to task demands. We found that the brain does this instantaneously and that this can even happen during movement. Therefore, this suggests that there exists an overlap during movement planning and execution.