bluuebunny/crossref_metadata_2025 huggingface dataset:
Weakly‐supervised structural component segmentation via scribble annotations
Authors: Zhang Chenyu , Li Ke , Yin Zhaozheng , Qin Ruwen
Published: September 2024

Segmentation of structural components in infrastructure inspection images is crucial for automated and accurate condition assessment. While deep neural networks hold great potential for this task, existing methods typically require fully annotated ground truth masks, which are time‐consuming and labor‐intensive to create. This paper introduces Scribble‐supervised Structural Component Segmentation Network (ScribCompNet), the first weakly‐supervised method requiring only scribble annotations for multiclass structural component segmentation. ScribCompNet features a dual‐branch architecture with higher‐resolution refinement to enhance fine detail detection. It extends supervision from labeled to unlabeled pixels through a combined objective function, incorporating scribble annotation, dynamic pseudo label, semantic context enhancement, and scale‐adaptive harmony losses. Experimental results show that ScribCompNet outperforms other scribble‐supervised methods and most fully‐supervised counterparts, achieving 90.19% mean intersection over union (mIoU) with an 80% reduction in labeling time. Further evaluations confirm the effectiveness of the novel designs and robust performance, even with lower‐quality scribble annotations.
Overweight/bowel dysmotility crosslinking and analogous laxative actions of two edible wild fruits in obese/constipated rats
Authors: Wahabi Soumaya , Rtibi Kais , Brinsi Chirine , Jridi Mourad , Sebai Hichem
Published: September 2024

Background

The prompt development of obesity/constipation is the most serious problem for both children and adults. Limited studies suggested an association between them but lacked preclinical studies. This study allows to evaluate their crosslink and to compare the aqueous extracts laxative actions of two edible wild fruits of Arbutus unedo (AUAE) and Crataegus monogyna (CMAE) in constipated high‐fat diet (HFD) rats.

Methods

Wistar rats were divided into experimental groups for 13 weeks: standard (SD) and HFD groups. SD‐rats were randomly redivided into 2 groups: SD and SD + Loperamide (LOP, 3 mg/kg, b.w.). HFD‐rats were randomly reseparated into HFD‐group, (HFD + LOP)‐group, [HFD + Yohimbine (YOH, 2 mg/kg, b.w.)]‐group, [HFD+ LOP]‐groups+ various doses of AUAE or CMAE (75, 150, and 300 mg/kg, b.w.). Diversified indicators were investigated to achieve the expected objectives, including; fecal parameters, gastrointestinal transit (GIT), gastric emptying (GE), oxidative stress‐(OxS), blood biochemical analysis, and accompanied small/large bowel histological modification.

Key Results

The liquid chromatography‐electrospray ionization‐tandem mass spectrometry (LC–ESI–MS) analysis of AUAE and CMAE allowed the identification of 11 and 6 phenolic compounds, respectively. In HFD‐rats, the subsequent dysregulation of GI motility was markedly aggravated. More importantly, with the same way (CMAE and AUAE)‐treated groups showed alleviated outcomes for the following: most stool parameters, GIT, and GE were remarkably recovered; a similar recovery pattern was observed in the histopathological structure, OxS, and blood biochemical indicators.

Conclusions & Inferences

Our results experimentally confirmed the crosslink between overweight and constipation and both fruits have potential as functional foods to reduce metabolic risk of the obesity associated with bowel dysmotility.
An intersectional critique of nursing's efforts at organizing
Authors: Wesp Linda M. , Bowman Mary K. , Adams Bryn
Published: September 2024

Nursing's efforts at organizing in the United States have encompassed various approaches to creating change at a systemic and political level, namely shared governance, professional associations, and nurse unions. The United States is currently experiencing the effects of an authoritarian sociopolitical agenda that has taken aim at our profession's ethic of providing equitable care for all people through legislation that bans gender‐affirming care and abortions. Nursing is simultaneously experiencing a crisis of burnout and moral distress, as we navigate the everyday functions of a for‐profit healthcare system under the Capitalocene. As we situate ourselves within these policies and practices of late‐stage capitalism and an increasingly authoritarian nation‐state, we are compelled to think deeply about how nursing is currently organizing ourselves. Our paper will explore the evolution of various forms of organizing through the lens of intersectionality, which offers a framework for considering the ways that power operates, creating a matrix of sociostructural processes that fuel injustice. Intersectionality also compels us to examine whether our organizing has resisted, or perpetuated, a matrix of oppression. We will conclude by offering examples of radical imagining for a future of nursing resistance, where our collective organizing has a greater impact and responsibility for dismantling the status quo to achieve justice and liberation.
Surgical and Camouflage Orthodontic Treatment of Anterior Open Bite: Comparison of Profile Attractiveness
Authors: Nogueira C. Q. , Cotrin P. , Freitas D. S. , Prado de Souza J. E. , Valarelli F. P. , Freitas K. M. S. , de Freitas M. R.
Published: September 2024

Objective

To evaluate the profile's attractiveness between the different protocols for treating the anterior open bite.

Methods

The sample comprised 39 patients with anterior open bite treated with or without extractions, divided into two groups: The surgical group (G1) comprised 21 subjects (10 males, 11 females) with a mean initial age of 21.86 years (SD = 5.09), treated with fixed orthodontic appliance followed by orthognathic surgery, for a total mean period of 2.53 years (SD = 0.61). The mean overbite was −5.01 mm (SD = 2.50); The camouflaged group (G2) comprised 18 subjects (9 males, 9 females), with a mean initial age of 20.47 years (SD = 4.19), treated only with fixed orthodontic appliance, for a total mean period of 2.56 years (SD = 0.94). The mean overbite was −4.28 mm (SD = 1.15). Lateral photographs from pretreatment and posttreatment were used. These photographs were evaluated by 46 laypeople and 67 dentists, who rated the attractiveness of each profile from 0 (most unattractive profile) to 10 (most attractive profile). Intergroup comparisons were performed with independent t‐tests.

Results

Both groups presented improvement in the profile attractiveness with treatment (p < 0.001). Before treatment, the profile of the surgical group was significantly less attractive than the profile of the camouflaged group (p < 0.001). The surgical presented a more attractive profile at the final stage than the camouflaged group (p < 0.001). The surgical group showed a greater improvement in profile attractiveness with treatment than the camouflaged group (p < 0.001).

Conclusion

In the final stage, the surgical presented a more attractive and greater improvement in profile attractiveness than the camouflaged group. The laypeople and dentists judged similarly the initial profile attractiveness.
Improving Nursing Oral Care Practice for Community‐Dwelling Care‐Dependent Older People
Authors: Oda Keiko , Bakri Nazahiah N. , Majeed Sarah , Bartlett Shennae , Thomson Murray W. , Parsons John , Boyd Michal , Ferguson Anna C. , Smith Moira
Published: September 2024

Aim

Oral care is one of the most neglected nursing practices owing to a lack of training, standard nursing oral care guidelines and low confidence and skills. There is little evidence to inform the development of oral care training and guidelines, which ideally should be done in collaboration with oral health professionals. Further, there is a lack of research, particularly in New Zealand, with nursing staff caring for care‐dependent older people, including those ageing in their own homes. This pilot study aimed to determine the impact of oral care training on nursing staff knowledge, attitudes and confidence in supporting community‐dwelling older peoples' oral care.

Method

Mixed methods design comprising delivery of an oral healthcare and assessment training intervention by a team comprising nursing and oral health professionals, pre‐ and post‐intervention questionnaires (N = 14) and a post‐intervention focus group with community‐based nursing staff (N = 5).

Results

Staff knowledge significantly improved (p = 0.046) following interprofessional collaborative training, but attitude and confidence scores did not (p = 0.127), although focus group responses suggested that participants' confidence was heightened. Participants expressed the need to implement oral care practices to benefit clients' health, clarify roles and identify oral care as a core competency. They sought to make individual‐ and organisational‐level practice changes accordingly.

Conclusion

Oral care training based on interprofessional collaboration and education enhances nursing staff knowledge but not their confidence in oral care provision. Ongoing, hands‐on practical training for nursing staff in collaboration with oral health professionals has the potential to advance nursing oral‐care practice and improve care‐dependent older peoples' oral care.

Implication for Practice

Oral care training and education with oral health professionals is effective to enhance nursing staff knowledge and awareness in oral health care. However, transforming knowledge into nursing oral care practice requires hands on practical training and ongoing collaboration with oral health professionals to improve care‐dependent older people's oral health care.
eHealth Interventions of Health Literacy for Stroke Survivors: Systematic Review and Meta‐Analysis
Authors: Vu Mai Thi Thuy , Ho Hung Quang , Lin Gong‐Hong
Published: September 2024

Background

eHealth literacy interventions have emerged as a new approach in management of stroke survivors. Its effect on knowledge and clinical outcomes presents an inconsistent result in literature.

Objectives

We aim to evaluate the impact of eHealth interventions on health literacy, clinical metrics, adherence to healthy behaviors, stroke recurrence, mortality, and health‐related quality of life in stroke survivors.

Methods

We systematically searched six databases (PubMed, Cochrane Library, CINAHL, EMBASE, Web of Science, ProQuest) up to February 21, 2024, selecting articles that meet these criteria: (i) patients with stroke; (ii) intervention with education content; (iii) eHealth interventions included telehealth, mobile phone, internet or computer; (iv) randomized controlled trials. The mean differences (MD) and standardized mean differences (SMD) between groups were measured. Risk of bias was evaluated using the Cochrane tool.

Results

From 16 studies involving 9646 participants, we observed that eHealth interventions significantly improved systolic blood pressure (MD = −2.78 mmHg, 95% confidence interval (CI) [−4.67 to −0.88], p = 0.004), medication adherence (SMD = 0.28, 95% CI [0.04 to 0.52], p = 0.023), and health‐related quality of life (SMD = 0.21, 95% CI [0.04 to 0.37], p = 0.013). Meta‐regression found that age modified the effect size of systolic blood pressure (p = 0.027). There was insufficient evidence to conclude effects on other outcomes. The quality of evidence was moderate. Outcome variation may be due to the diversity in eHealth intervention approaches. The limited number of studies precluded the subgroup analysis. More interactive interventions with longer follow‐ups were more effective.

Conclusions

eHealth interventions may benefit stroke survivors in terms of blood pressure, medication adherence, and health‐related quality of life.

Implications for Nursing Policy

eHealth literacy interventions could be implemented to improve the management of stroke survivors, especially in the context of resource limitations.

Trial Registration

PROSPERO registration number: CRD42024502470
Autologous platelet concentrates as adjuvant in the surgical management of medication‐related osteonecrosis of the jaw
Authors: Bennardo Francesco , Barone Selene , Antonelli Alessandro , Giudice Amerigo
Published: September 2024

Medication‐related osteonecrosis of the jaw (MRONJ) is an infectious side effect associated with bisphosphonates and monoclonal antibodies (denosumab, immune modulators, and antiangiogenic medications). Adjunctive therapies for the surgical management of MRONJ include autologous platelet concentrates (APCs). These APCs serve as a source of various cells and growth factors that aid tissue healing and regeneration. This review evaluated the use of platelet‐rich plasma (PRP), plasma‐rich in growth factors (PRGF), and leukocyte‐ and platelet‐rich fibrin (L‐PRF) as adjuvant therapies for the surgical management of MRONJ by conducting analyses on the results of 58 articles. Compared to surgical treatment alone, the application of PRP and L‐PRF after surgery appears to increase healing in the management of patients with MRONJ. No studies have reported unhealed lesions as a result of surgical treatment of MRONJ with PRGF application or compared it with surgical treatment alone. The overall results of this review have shown favorable healing rates of MRONJ lesions managed with the application of APCs after surgical treatment; however, significant methodological limitations may limit the scientific evidence supporting their use. Further randomized controlled trials with strict criteria are needed to establish the extent to which APCs can improve wound healing and quality of life in patients with MRONJ requiring surgical treatment.
Autologous platelet concentrates in alveolar ridge preservation: A systematic review with meta‐analyses
Authors: Siawasch Sayed Ahmad Manoetjer , Yu Jize , Castro Ana B. , Dhondt Rutger , Teughels Wim , Temmerman Andy , Quirynen Marc
Published: September 2024

In order to evaluate the therapeutic advantages of various autologous platelet concentrates (APC) as a single biomaterial during alveolar ridge preservation (ARP), a systematic review with meta‐analyses was conducted. PubMed, EMBASE, Web of Science, and Scopus were screened for randomized controlled trials (RCTs) that were released prior to 2024. The selected papers compared an APC with either unassisted healing (blood clot) or another biomaterial during ARP (third molars were not included). The outcome parameters included alveolar bone dimension alterations, soft tissue healing, and post‐op pain intensity. The search yielded 35 papers (33 studies), one applying platelet‐rich plasma (PRP), six using plasma rich in growth factors (PRGF), and 28 using leukocyte‐ and platelet‐rich fibrin (L‐PRF). These studies showed a large heterogeneity (e.g., outcome parameters, timing, surgical approach, and inclusion criteria), which hindered drawing strong conclusions. In most studies, however, ARP with PRP, PRGF, and L‐PRF alone produced faster soft tissue healing, less post‐extraction pain, less alveolar ridge resorption, more socket bone fill, and a higher bone density when compared to unassisted (spontaneous) healing. The ultimate benefit appears to be significantly influenced by the surgical approach. Limited literature exists comparing APC with other biomaterials for ARP, resulting in inconclusive data. APC application for ARP is a promising strategy to improve soft and hard tissue healing and reduce post‐extraction pain.
Inhibitory P300 subprocesses and neural compensation in genetic risk for Alzheimer's disease: The case for temporal–spatial principal component analysis
Authors: Paitel Elizabeth R. , Nielson Kristy A.
Published: September 2024

The P300 event‐related potential (ERP) is widely investigated in cognitive neuroscience, including related to aging, with smaller amplitudes and delayed latency consistently reported in Alzheimer's disease (AD). Given that AD‐related neurological changes begin years before symptom onset, ERPs in asymptomatic elders with AD risk may characterize early changes. ERPs are seldom studied in this population. Yet, healthy carriers of apolipoprotein‐E (APOE) ε4 have evidenced delayed P300 latencies, while P300 amplitude differences are seldom found. However, despite its frequent study, the specific cognitive processes reflected by P300 remain unclear. We propose that these challenges are due to the relatively long P300 window, which likely encompasses multiple underlying subprocesses that overlap in time. Temporal–spatial principal component analysis (tsPCA) maintains the high temporal resolution of EEG and is better suited to isolate processes that overlap in time. Thus, we interrogated APOE ε4 differences in P300 activity during successful stop‐signal inhibitory control in healthy, cognitively intact older adults (25 ε4−, 20 ε4+), using both conventional ERP metrics (i.e., mean and peak amplitude) and P300 tsPCA factors. P300 amplitudes did not differ by ε4 using conventional metrics. tsPCA revealed two P300 factors in each ε4 group: first, a Posterior P300 (attention allocation) factor, and second, a relatively Anterior P300 (performance monitoring, evaluating, and updating) factor. tsPCA uniquely revealed greater activity in ε4+ vs. ε4− in Anterior P300. ε4 groups had comparable task performance, suggesting that greater P300 activity in ε4+ likely reflects neural compensation for ε4‐related deficits, thereby enabling the maintenance of good task performance.
Regulatory offsetting in advanced democracies
Authors: Steinebach Yves , Hinterleitner Markus , Fernández‐i‐Marín Xavier
Published: September 2024

The growth of rules in modern democracies burdens citizens, businesses, and administrative bodies. To address this, many governments have implemented so‐called “regulatory offsetting schemes,” requiring the removal of existing rules and regulations for each new one introduced. However, systematic knowledge on which countries have adopted these schemes and their specific designs remains lacking. Our study maps regulatory offsetting initiatives across OECD states and offers a first theoretical framework for understanding government adoption. While political and ideational factors influence the adoption of offsetting schemes, they do not explain their specific design. Offsetting schemes thus reflect the political tensions between advocates for an activist state and supporters of a more restrained government, with design being of secondary importance. These findings enhance our understanding of how governments and public administrations manage rule growth.
Tightly linked evolution of Franco‐Iberian earthworms (Prosellodrilini, Lumbricidae) and the Pyrenean Mountains supported by molecular phylogenetics
Authors: Jiménez Pinadero Sergio , Martínez Navarro Alejandro , Tilikj Natasha , Novo Marta , Díaz Cosín Darío , Trigo Aza Dolores , Fernández Marchán Daniel
Published: September 2024

The Iberian Peninsula and the South of France are a centre of diversification of the Lumbricidae family, which has many endemisms and basal genera in the phylogeny of lumbricids in that area. Two basal and endemic genera of this area are Cataladrilus and Prosellodrilus. These genera are very poorly studied, and there are very few phylogenetic studies in which representatives of these genera have been included. In the case of Prosellodrilus, the type species has never been included in phylogenetic analyses. Therefore, in this study, after capturing specimens of different species of Cataladrilus and Prosellodrilus in their type localities (including the type species of both genera), a phylogenetic analysis was carried out using the molecular markers COI, 16S (mitochondrial) and 28S (nuclear). Sequences from other lumbricid genera obtained in previous studies were also included, with the purpose of testing the monophyly of Prosellodrilus and Cataladrilus and recovering their phylogenetic relationships with other basal genera. As a result, it was possible to demonstrate that both genera are monophyletic and, therefore, valid. Both genera are evolutionarily very close and are found very close to other basal genera such as Castellodrilus and Zophoscolex. Furthermore, by calculating the ancestral area of Prosellodrilus it was possible to observe that the origin of the genus is located in an area between Sardinia and eastern France and that the genus predates the separation of Sardinia from France and the formation of the Pyrenees, which could explain the presence of P. festae in Sardinia and the presence of this genus on both sides of the Pyrenees. Furthermore, if the geological age of the Pyrenees and its formation process are studied in detail, it can be observed how the different stages of formation of this mountain range largely coincide with the distribution of the different species of Prosellodrilus.
Modulo ℓ distinction problems
Authors: Cui Peiyi , Lanard Thomas , Lu Hengfei
Published: September 2024

Let $F$ be a non-archimedean local field of characteristic different from 2 and residual characteristic $p$. This paper concerns the $\ell$-modular representations of a connected reductive group $G$ distinguished by a Galois involution, with $\ell$ an odd prime different from $p$. We start by proving a general theorem allowing to lift supercuspidal $\overline {\mathbf {F}}_{\ell }$-representations of $\operatorname {GL}_n(F)$ distinguished by an arbitrary closed subgroup $H$ to a distinguished supercuspidal $\overline {\mathbf {Q}}_{\ell }$-representation. Given a quadratic field extension $E/F$ and an irreducible $\overline {\mathbf {F}}_{\ell }$-representation $\pi$ of $\operatorname {GL}_n(E)$, we verify the Jacquet conjecture in the modular setting that if the Langlands parameter $\phi _\pi$ is irreducible and conjugate-selfdual, then $\pi$ is either $\operatorname {GL}_n(F)$-distinguished or $(\operatorname {GL}_{n}(F),\omega _{E/F})$-distinguished (where $\omega _{E/F}$ is the quadratic character of $F^\times$ associated to the quadratic field extension $E/F$ by the local class field theory), but not both, which extends one result of Sécherre to the case $p=2$. We give another application of our lifting theorem for supercuspidal representations distinguished by a unitary involution, extending one result of Zou to $p=2$. After that, we give a complete classification of the $\operatorname {GL}_2(F)$-distinguished representations of $\operatorname {GL}_2(E)$. Using this classification we discuss a modular version of the Prasad conjecture for $\operatorname {PGL}_2$. We show that the ‘classical’ Prasad conjecture fails in the modular setting. We propose a solution using non-nilpotent Weil–Deligne representations. Finally, we apply the restriction method of Anandavardhanan and Prasad to classify the $\operatorname {SL}_2(F)$-distinguished modular representations of $\operatorname {SL}_2(E)$.
Stability Conditions and Stiffness Variability of General Tensegrity Systems With Kinematic Joints
Authors: Luo Jiahui , Ge Longqing , Xu Xiaoming , Liu Xiaodong , Zhuang Ziwei , Han Lulu , Wu Zhigang
Published: September 2024

Tensegrity systems represent promising candidate mechanisms with in situ stiffness variability through changing the cables’ prestress levels. However, prestress-based stiffness behaviors of tensegrity systems with arbitrary kinematic joints have not been analyzed systematically. This paper adopts the natural absolute coordinates for static modeling of tensegrity systems consisting of rigid members and tension elements. Then, a generic stiffness analysis method is developed to formulate the reduced-basis tangent stiffness matrix, which is found to include three parts: positive semi-definite material and geometric stiffness matrices, and an indefinite constraint stiffness matrix. Based on these findings, a systematic stability-checking procedure is derived to determine prestress and super stability, which are qualitative indicators of the softening and stiffening effects in different tensegrity systems. Then, we proceed to quantify the range of prestress-based stiffness variability by formulating semi-definite programming problems that numerically pinpoint the maximum and zero stiffness points. Furthermore, this paper reveals the composable nature of multiple self-stress states, enabling the composability of stiffness properties in mechanism designs. Several numerical examples verify the efficacy and versatility of the proposed method and demonstrate interesting stiffness behaviors of tensegrity systems with kinematic joints.
Three-Dimensional Simulation of Cavitating Flow in Reciprocating Positive Displacement Pumps With Fluid-Actuated Valves
Authors: Munsch Pascal , Kiermeir Joseph , Schilling Rudolf , Schlücker Eberhard , Skoda Romuald
Published: September 2024

An in-house compressible three-dimensional (3D) finite volume computational fluid dynamics (CFD) method, with statistical turbulence model and moving grid capabilities, is presented and applied to the suction stroke of a simplex plunger positive displacement pump. The approach utilizes a pressure-based implicit solution algorithm and a mass transfer cavitation model. Fluid-actuated valve dynamics are approximated using a fluid-structure interaction algorithm. The closed valve and early phase of valve opening are approximated by a permeable wall. A circular segment model is introduced, significantly reducing computing time. Experimental validation is performed by time-resolved pressure and flow rate measurements, as well as high-speed visualizations of the valve dynamics. A speed variation is conducted to investigate harmless advanced and erosive distinctive partial cavitation. The simulation reproduces the delay of cavity collapse, observed with increasing speed, and reveals distinctive void patterns related to the chamber pressure time progression. These void patterns are fundamental for understanding the cavitation dynamics and potential erosion risk in the system. Deviations from data remain in the flow phase subsequent to the collapse due to overestimated wave reflection at the inlet boundary in the suction pipe.
Australian medical regulations and strengthened continuing professional development (CPD): A policy implementation gap analysis with the specialist medical colleges
Authors: Pizzuti Carol , Palmieri Cristiana , Shaw Tim
Published: September 2024

Introduction: Starting from 2023, Australian medical practitioners must meet new mandatory continuing professional development (CPD) requirements for registration renewal. In particular, each year they must complete 12.5 hours of educational activities and 25 hours of CPD activities related to reviewing performance and measuring outcomes, with a minimum of 5 hours each for reviewing performance and measuring outcomes activities, and they are encouraged to use patient health data and large eHealth datasets for better insights. Despite concerns regarding data accessibility and outcome measurement, specialist medical colleges are implementing these requirements. This study aims to explore factors influencing colleges’ efforts and provide recommendations for future research and action to enable data-driven CPD practices.
Methods: A policy implementation gap analysis employing semi-structured interviews as a standalone method was conducted with participating colleges. Four colleges agreed to participate, with a total of 18 participants recruited from either the colleges’ staff who are responsible for interpreting and implementing CPD regulatory policies or the colleges’ CPD committees. Interviews were analysed using inductive and deductive thematic analysis. Data collection, data analysis and final results were reported using the COREQ checklist.
Results: Three themes were identified from the interview analysis: (1) colleges' organisational structure and their roles and responsibilities within the Australasian CPD ecosystem, (2) challenges and enablers for policy implementation and (3) organisational needs and future actions at college level and necessary pre-conditions at ecosystemic level for strengthened CPD.
Conclusions: Internal and external organisational factors are hindering colleges’ efforts to implement policy. More research, a reassessment of colleges’ roles, responsibilities and structure, and collaboration among colleges and data holders are necessary to enable full policy implementation and strengthened CPD practices.
Ethnic bias and the hidden curriculum: The impact of routine inclusion of ethnicity in medical education assessment
Authors: Pitama Suzanne , Manuel Jenni , Wilkinson Tim , Tweed Mike , Cuddy Jessica , Huria Tania , Lacey Cameron
Published: September 2024

Introduction: In 2012, the University of Otago Medical School in New Zealand amended high stakes examination questions to routinely include ethnicity. This policy change was prompted by the assessment committee, including the Māori subcommittee. This study aimed to examine the portrayal of Māori patients and to explore the impact of routine inclusion of ethnicity.
Methods: A quantitative description of demographic variables of examination questions and responses (role-model answers, multiple-response preferred answer, guidelines for markers) from a pre policy (2009–2011), post policy (2012–2013) and follow-up period (2018–2019) was undertaken. A qualitative content analysis of Māori examination questions was conducted with consideration of trends over time.
Results: The majority (98%) of examination questions did not report ethnicity prior to the 2012 policy, whereas around 80% of cases did post policy implementation. Three themes were identified: the non-adherent Māori patient, determinants of health and the patient assigned Māori ethnicity. Examination questions and responses that portrayed Māori as being non-adherent were more common prior to the implementation of the policy. Post policy, many questions did not require students to consider the relevance of ethnicity but presented an increase in social and cultural contextual information of the patient over time.  
Conclusion: Policy implementation by the assessment committee led to less racist stereotyping and “othering” of Māori patients and prompted further refinement of social and cultural determinants of health over time. Future recommendations include increasing representation of Māori as a reflection of the increased burden of disease alongside representing intersectionality using other socio-cultural indicators.
Aperiodic multilayer masks for M3D mitigation in high- and hyper-NA extreme ultraviolet lithography
Authors: Ethan Maguire W. , Smith Bruce W.
Published: September 2024

As extreme ultraviolet lithography tools with higher image numerical apertures (NAi) are introduced, the range of angles at the multilayer mask stack is also increased. Lithography systems are designed to fulfill the “abbe sine rule,” where NAm is related to NAi by the reduction factor. As a result, increases in NAi will increase NAm. High-NA and hyper-NA systems will be implemented with anamorphic optics, 4× in “X,” and 8× in “Y” to reduce the necessary angles. Even so, hyper-NA masks may see illumination angles as high as 13.4°, up from 10.8° for 0.33 NA. This represents a challenge for maintaining through-angle mask reflection using the current periodic mask multilayer structures. In addition to the reflectance amplitude, the phase of reflected light, which plays an important role in imaging, is also strongly influenced by increasing angles. The propagation of light through each bilayer in the stack imparts a phase shift based on the incidence angle. This is then accumulated over many layers, inducing phase effects, which are unique to each illumination point. This will become especially true for high-NA and hyper-NA mask applications. While adjustments to the multilayer period are sufficient to achieve acceptable reflectance, periodic multilayers may suffer in normalized image log slope (NILS) and image placement error (IPE) metrics as a result of strong oblique multilayer M3D phase effects. In this work, we present a first principles methodology for the systematic reduction of oblique multilayer M3D effects through the use of aperiodic multilayer design. We find that when used for low-k1, hyper-NA patterning NILS is improved by 40+%, while IPE through pitch is similarly improved. Under high-NA conditions, a 5%–25% NILS gain is found alongside the enhanced depth of focus.
Genome sequence of multi-drug-resistant
Staphyloccocus aureus
isolated from a clinical sample collected in Maroua, Cameroon
Authors: Mohamadou Mansour , Kagning Tsinda Emmanuel , Hina Qudsia , Javed Kashaf , Dongang Nana Rodrigue Roman , Ngonde Essome Marie Chantal , Essama Sara Riwom , Sattar Sadia , Kamga Hortense Gonsu , Javed Sundus
Published: September 2024

Staphylococcus aureus
is a major pathogen of public health concern due to its implications in pathologies and its increasing antimicrobial resistance. Here, we present the draft genome of a 2.7-Mbp
S. aureus
isolate obtained from a pus swab sampled in Cameroon. The GC content of the draft genome is 32%.
Identification of
Corynebacterium ulcerans
and
Erysipelothrix
sp. in Malayan pangolins—a potential threat to public health?
Authors: Wang Hai , Wang Xiao , Cao Yilin , Chen Yiting , Zou Zanjian , Lu Xingbang , Shan Fen , Tu Jieying , Liu Jianhua , Liu Jiameng , Sa Jiaqi , Zhou Niu , Peng Shi-Ming , Zou Jie-Jian , Shen Xuejuan , Zhai Junqiong , Chen Zujin , Holmes Edward C. , Chen Wu , Shen Yongyi
Published: September 2024

The discovery of severe acute respiratory syndrome-coronavirus-2-like and Middle East respiratory syndrome-coronavirus-like viruses in Malayan pangolins has raised concerns about their potential role in the spread of zoonotic diseases. Herein, we describe the isolation and whole-genome sequencing of potentially zoonotic two bacterial pathogens from diseased Malaysian pangolins (
Manis javanica
)—
Corynebacterium ulcerans
and
Erysipelothrix
sp. The newly identified species were designated as
C. ulcerans
P69 and
Erysipelothrix
sp. P66.
C. ulcerans
P69 exhibited 99.2% whole-genome nucleotide identity to human bacterial isolate 4940, suggesting that it might have zoonotic potential. Notably,
C. ulcerans
P69 lacked the diphtheria toxin (
tox
) gene that is widely used in vaccines to protect humans from corynebacterial infection, which suggests that the current vaccine may be of limited efficacy against this pangolin strain.
C. ulcerans
P69 also contains other known virulence-associated genes such as
pld
and exhibits resistance to several antibiotics (erythromycin, clindamycin, penicillin G, gentamicin, tetracycline), which may affect its effective control.
Erysipelothrix
sp. P66 was closely related to
Erysipelothrix
sp. strain 2-related strains, exhibiting 98.8% whole-genome nucleotide identity. This bacterium is lethal in mice, and two commercial vaccines failed to protect its challenge, such that it could potentially pose a threat to the swine industry. Overall, this study highlights that, in addition to viruses, pangolins harbor bacteria that may pose a potential threat to humans and domestic animals, and which merit attention.

IMPORTANCE

This study firstly reports the presence of two potentially zoonotic bacteria,
Corynebacterium ulcerans
and
Erysipelothrix
sp., in diseased Malaysian pangolins collected in 2019. The pangolin
C. ulcerans
is lethal in mice and resists many antibiotics. It clustered with a lethal human strain but lacked the diphtheria toxin gene. Diphtheria toxin is widely used as a vaccine around the world to protect humans from the infection of corynebacteria. The lack of the
tox
gene suggests that the current vaccine may be of limited efficacy against this pangolin strain. The pangolin
Erysipelothrix
sp. is the sister clade of
Erysipelothrix rhusiopathiae
. It is lethal in mice, and two commercial vaccines failed to protect the mice against challenge with the pangolin
Erysipelothrix
sp., such that this strain could potentially pose a threat to the swine industry. These findings emphasize the potential threat of pangolin bacteria.
Aerobic adaptation and metabolic dynamics of
Propionibacterium freudenreichii
DSM 20271: insights from comparative transcriptomics and surfaceome analysis
Authors: Loivamaa Iida , Sillanpää Annika , Deptula Paulina , Chamlagain Bhawani , Edelmann Minnamari , Auvinen Petri , Nyman Tuula A. , Savijoki Kirsi , Piironen Vieno , Varmanen Pekka
Published: September 2024

Propionibacterium freudenreichii
(
PFR
) DSM 20271
T
is a bacterium known for its ability to thrive in diverse environments and to produce vitamin B12. Despite its anaerobic preference, recent studies have elucidated its ability to prosper in the presence of oxygen, prompting a deeper exploration of its physiology under aerobic conditions. Here, we investigated the response of DSM 20271
T
to aerobic growth by employing comparative transcriptomic and surfaceome analyses alongside metabolite profiling. Cultivation under controlled partial pressure of oxygen (pO
2
) conditions revealed significant increases in biomass formation and altered metabolite production, notably of vitamin B12, pseudovitamin-B12, propionate, and acetate, under aerobic conditions. Transcriptomic analysis identified differential expression of genes involved in lactate metabolism, tricarboxylic acid cycle, and electron transport chain, suggesting metabolic adjustments to aerobic environments. Moreover, surfaceome analysis unveiled growth environment-dependent changes in surface protein abundance, with implications for adaptation to atmospheric conditions. Supplementation experiments with key compounds highlighted the potential for enhancing aerobic growth, emphasizing the importance of iron and α-ketoglutarate availability. Furthermore, in liquid culture, FeSO
4
supplementation led to increased heme production and reduced vitamin B12 production, highlighting the impact of oxygen and iron availability on the metabolic pathways. These findings deepen our understanding of
PFR
’s physiological responses to oxygen availability and offer insights for optimizing its growth in industrial applications.

IMPORTANCE

The study of the response of
Propionibacterium freudenreichii
to aerobic growth is crucial for understanding how this bacterium adapts to different environments and produces essential compounds like vitamin B12. By investigating its physiological changes under aerobic conditions, we can gain insights into its metabolic adjustments and potential for enhanced growth. These findings not only deepen our understanding of
P. freudenreichii'
s responses to oxygen availability but also offer valuable information for optimizing its growth in industrial applications. This research sheds light on the adaptive mechanisms of this bacterium, providing a foundation for further exploration and potential applications in various fields.
Supplemental Material: Rupture direction of paleoearthquakes on the Alpine Fault, New Zealand, as recorded by curved slickenlines
Authors: Barth Nicolas C. , al. et
Published: September 2024

 Four stereonets (one for each main outcrop), Table S1 documenting the structural measurements, and the full-resolution images used in figures are provided.  
Supplemental Material: Timing and geometry of the Chemehuevi Formation reveal a late Pleistocene sediment pulse into the Lower Colorado River
Authors: Gray Harrison J. , al. et
Published: September 2024

U/Th cobble sample photos.
Characterization of Twelve Erwinia amylovora Bacteriophages
Authors: Besarab N. V. , Letarov A. V. , Belalov I. S. , Golomidova A. K. , Kulikov E. E. , Letarova M. A. , Boldyreva D. I. , Lagonenko A. L. , Evtushenkov A. N.
Published: September 2024

Erwinia amylovora bacteriophages are of interest as fire blight control agents. This paper presents data on the biology and molecular genetic properties of 12 E. amylovora tailed bacteriophages. Genome sequences of seven of them were determined and the phages were identified as the representatives of Caudoviricetes; Vequintavirinae, Ounavirinae and Autographiviridae families. The bacteriophages studied were active against E. amylovora, Pantoea agglomerans and Pantoea ananatis strains. The myovirus Hena1 had the narrowest host range lysing 12% of the bacterial cultures tested, the remaining myoviruses—had broader host ranges (56%) for this collection. The phages showed different reactions to the presence of a chelating agent in the cultivation medium. A significant proportion of phage-resistant E. amylovora cells were found both in infected liquid cultures and in the experiments on the plates with the phage agar (more than 20% in case of exposure to podoviruses), which correlates with the data of limited number of previous investigations of the phenomenon for E. amylovora interactions with phages. High prevalence of resistant cells in the host cultures suggest that they are formed not due to spontaneous mutations but result from another phenotypic or genetic dissociation mechanism(s) that remains to be identified.
Baclofen overdose with unique cardiovascular effects
Authors: Dudek Cain M , Yee Christopher H , Greenberg Max , McCarver Stewart C
Published: September 2024

Case presentation

A woman in her 70s was found unresponsive and brought to our hospital with respiratory distress, cardiomyopathy and volatile alternation between hypotension and hypertension. She was intubated and admitted to intensive care for supportive treatment of suspected baclofen overdose. She gradually recovered and was discharged 10 days after presentation. Laboratory testing confirmed baclofen overdose.

Conclusion

This case illustrates the classic features of baclofen toxicity but also includes unusual features including ST elevations on ECG and apical ballooning on echocardiogram. Lack of immediate laboratory testing can be a significant diagnostic challenge, so a high index of suspicion is needed to definitively diagnose baclofen overdose. Furthermore, haemodynamic volatility requires careful and frequent re-evaluation of treatment, so early recognition and anticipation of complications are essential for effective management of this life-threatening condition.
Bortezomib-induced neuropathy in multiple myeloma manifesting as foot drop due to peroneal nerve palsy
Authors: Raveendran Ciniraj , Sunaisha Ashrafudeen Sherin , Yadev IP
Published: September 2024

We present the case of a man in his 50s with multiple myeloma who developed foot drop after receiving bortezomib-dexamethasone combination chemotherapy. Diagnostic evaluations, including haematological parameters, nerve conduction studies and imaging, were performed to confirm the diagnosis and assess the extent of neuropathy. He was managed conservatively with analgesics and vitamin supplements, and bortezomib was temporarily withheld. The neuropathy gradually improved, and bortezomib was successfully reintroduced without recurrence of foot drop. Bortezomib-induced foot drop is a rare complication of bortezomib-based therapy in patients with multiple myeloma. Early recognition and intervention are crucial to minimise impact on quality of life. This case report emphasises the safe reintroduction of bortezomib post-neuropathy resolution, emphasising the importance of early recognition and multidisciplinary management.
Improving role allocation for cardiopulmonary resuscitation (CPR) in the emergency department: a quality improvement project
Authors: Giri Sweta , Gyeltshen Dawa , Wangchuk Neten , Dorji Kinley , Drakpa Loday , Wangdi Sonam , Diyali Kiran Biswa
Published: September 2024

Introduction

In any healthcare setting, cardiopulmonary resuscitations (CPRs) stand out as demanding and chaotic resuscitation endeavours. Emergency departments (EDs) witness a significant volume of CPRs. Given the critical nature of CPR, content knowledge and procedural skills alone fall short in delivering optimal care. Effective teamwork, complemented by a well-coordinated response, is imperative for achieving favourable patient outcomes. A survey conducted in our ED highlighted that while the majority of staff acknowledged the significance of teamwork in CPR and were aware of the whiteboard for assigning team roles, only 19% were familiar with their individual roles during CPR.

Methods

To address this gap, our project aimed to increasing the role delegation for CPR from 19% to 80% within 2 months. We formed an interprofessional team and implemented strategies through four plan–do–study–act cycles. Interventions encompassed increasing sensitisation, creating a simplified format for assigning team roles and entrusting the nursing team leader of each shift with the responsibility of role assignment for accountability. The sharing of progress charts for acknowledgment served as a motivating factor, leading to sustained adherence to the project goals without necessitating reminders in the final two weeks.

Results

This project proved to be highly successful as our process indicator steadily increased and remained above the target for 4 consecutive weeks.

Conclusion

Our results underscore the importance of patience and teamwork in achieving project objectives. It serves as a good example of the efficiency of simple and cost-effective interventions, one that can be replicated and implemented in other EDs.
Prospective cohort study identifying risk factors for sports injuries in adolescent athletes: the Healthy Injury-Free Adolescent Athletes (HIFAA) study
Authors: Lindman Ida , Ryman Augustsson Sofia , Baranto Adad , Sansone Mikael , Abrahamson Josefin
Published: September 2024

A high incidence of injuries has been reported in young athletes. Several factors have been associated with athletes’ sports injuries. However, scientific evidence is lacking, particularly for adolescent athletes. Hence, the Healthy Injury-Free Adolescent Athletes (HIFAA) was designed to evaluate sports injuries and examine associations with risk factors related to physical load and mental health. Secondary aims are to evaluate differences between sex, age, high school year and sports and examine injuries and the athletic situation 5 to 10 years after graduation. Adolescent athletes aged 15–19 years enrolled in high school and competing in sports to reach a national or international level of sports will be included. At inclusion, athletes will sign an informed consent form and fill out a baseline questionnaire addressing potential risk factors (eg, sports, training and competing health and injuries, and psychosocial status). Athletes will then prospectively be monitored weekly regarding injuries, physical (training/match/competing, perceived exertion) and psychological (fatigue, sleep, mental stress, recovery) load until graduation. A shortened version of the baseline questionnaire will be filled out every year, and a follow-up questionnaire regarding injuries, sporting situations and mental health will be filled out 5–10 years after graduation.

Injuries are frequent among adolescent athletes, with consequences ranging from shorter interruptions in sports performance to mental health problems and early termination of sports. A reduction of these injuries is warranted. This study will provide a detailed understanding of risk factors, a prerequisite to introducing appropriate preventive measures.