bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial
Authors: Machado Pedro , Pimenta Sara , Garcia Ana Luís , Nogueira Tiago , Silva Sónia , dos Santos Claúdia Lares , Martins Maria Vitória , Canha André , Oliveiros Bárbara , Martins Raul A. , Cruz Joana
Published: November 2023

Background

Preoperative exercise training is recommended for improvement of clinical outcomes after lung cancer (LC) surgery. However, its effectiveness in preventing postoperative decline in quality of life (QoL) remains unknown. This study investigated the effect of preoperative home-based exercise training (PHET) on QoL after LC surgery.

Methods

Patients awaiting LC resection were randomized to PHET or a control group (CG). The PHET program combined aerobic and resistance exercise, with weekly telephone supervision. Primary outcome was QoL-assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) at baseline, before surgery, and 1 month after surgery. The secondary outcomes were hospital length of stay and physical performance. The main analysis included a factorial repeated-measures analysis of variance. Additionally, the proportion of patients experiencing clinical deterioration from baseline to post-surgery was assessed.

Results

The study included 41 patients (68.1 ± 9.3 years; 68.3% male) in the intention-to-treat analysis (20 PHET patients, 21 CG patients). A significant group × time interaction was observed for global QoL (p = 0.004). Between-group differences in global QoL were statistically and clinically significant before surgery (mean difference [MD], 13.5 points; 95% confidence interval [CI], 2.4–24.6; p = 0.019) and after surgery (MD, 12.4 points; 95% CI, 1.3–23.4; p = 0.029), favoring PHET. Clinical deterioration of global QoL was reported by 71.4% of the CG patients compared with 30 % of the PHET patients (p = 0.003). Between-group differences in favor of PHET were found in pain and appetite loss as well as in physical, emotional and role functions after surgery (p < 0.05). Compared with CG, PHET was superior in improving preoperative five-times sit-to-stand and postoperative exercise capacity (p < 0.05). No between-group differences in other secondary outcomes were observed.

Conclusion

The study showed that PHET can effectively prevent the decline in QoL after LC surgery.
Perceptions of Readiness for Practice After Complex General Surgical Oncology Fellowship: A Survey Study
Authors: Behrens Shay , Lillemoe Heather A. , Dineen Sean P. , Russell Maria C. , Visser Brendan , Berman Russell S. , Farma Jeffrey M. , Grubbs Elizabeth , Davis Jeremy L.
Published: November 2023

Background

Surgical subspecialty training aims to meet the needs of practicing surgeons and their communities. This study investigates career preparedness of Complex General Surgical Oncology (CGSO) fellowship graduates, identifies factors associated with practice readiness, and explores potential opportunities to improve the current training model.

Methods

The Society of Surgical Oncology partnered with the National Cancer Institute to conduct a 36-question survey of CGSO fellowship graduates from 2012 to 2022.

Results

The overall survey response rate was 38% (221/582) with a slight male predominance (63%). Forty-six percent of respondents completed their fellowship after 2019. Factors influencing fellowship program selection include breadth of cancer case exposure (82%), mentor influence (66%), and research opportunities (38%). Overall, graduates reported preparedness for practice; however, some reported unpreparedness in research (18%) and in specific clinical areas: thoracic (43%), hyperthermic intraperitoneal chemotherapy (HIPEC) (15%), and hepato-pancreato-biliary (15%) surgery. Regarding technical preparedness, 70% reported being “very prepared”. Respondents indicated lack of preparedness in robotic (63%) and laparoscopic (33%) surgery approaches. Suggestions for training improvement included increased autonomy and case volumes, program development, and research infrastructure. Current practice patterns by graduates demonstrated discrepancies between ideal contracts and actual practice breakdowns, particularly related to the practice of general surgery.

Conclusions

This study of CGSO fellowship graduates demonstrates potential gaps between trainee expectations and the realities of surgical oncology practice. Although CGSO fellowship appears to prepare surgeons for careers in surgical oncology, there may be opportunities to refine the training model to better align with the needs of practicing surgical oncologists.
Performance of Malnutrition Universal Screening Tool and Patient-Generated Subjective Global Assessment in screening for cancer-related malnutrition in Nairobi, Kenya
Authors: Auma Caroline M.N. , Mweu Marshal M. , Opiyo Rose O.
Published: November 2023

Background Malnutrition is a common feature among oncology patients. It is responsible for poor response and tolerance to anticancer therapy, increased morbidity, and mortality. More than half of malnourished cancer patients remain undetected owing to lack of effective screening. Body mass index is the main indicator for assessing malnutrition in Kenyan public hospitals. However, it underestimates weight loss in patients with chronic illnesses. The Malnutrition Universal Screening Tool and Patient-Generated Subjective Global Assessment have been widely used in research and clinical practice and have both reported good validity and reliability. However, their diagnostic evaluation has not been performed in Kenya. Methods A cross-sectional study was conducted among 138 and 76 cancer outpatients from Kenyatta National Hospital and Texas cancer treatment centres, respectively. Participants had a confirmed disease, stage 1-4 cancer, and aged 18 years and above. They were screened for malnutrition using both Malnutrition Universal Screening Tool and Patient Generated-Subjective Global Assessment. A separate study questionnaire was utilized to gather participant’s socio-demographic and clinical characteristics. A Bayesian latent class modelling framework was employed to infer the tests’ estimates based on participants ‘cumulative scores from the two tests. Results The cut-off value of ≥ 1 and ≥ 4 gave the best combination of sensitivity and specificity of Malnutrition Universal Screening Tool and Patient Generated-Subjective Global Assessment. Both tests yielded statistically similar sensitivities and specificities. Predictive values were comparable between the tests and across the two populations. The posterior median true prevalences of malnutrition were high (˃ 54%) and numerically similar between the studied populations. Conclusions The performance of both tests among patients with cancer is similar. Healthcare workers are therefore at liberty to use either of them to inform treatment. Given the high true prevalence of cancer-related malnutrition, routine screening is critical and should be included as part of cancer care.
Recreational handball-based training for people with type 2 diabetes: a feasibility trial
Authors: Andersen Martin Færch , Riis Allan , Borup Henrik Foged , Dall Astrid , Torp Mie , Elversøe Rikke Hareskov , Thomsen Janus Laust , Vestergaard Peter , Dissing Anne-Mette Lücke
Published: November 2023

Introduction Type 2 diabetes mellitus (T2DM) is recognized as a serious public health concern with a considerable impact on people suffering from the disease and the society. The benefit of physical activity in the prevention and treatment of T2DM are well documented, however, a considerable proportion of individuals with T2DM have an inactive and sedentary lifestyle. Although most people with T2DM are aware of the importance of exercise, many are not interested in joining traditional exercise options, and long-term adherence is poor for those who do. Thus, we aim to investigate the feasibility of recreational handball-based training (HBT) for people diagnosed with T2DM. Methods This single-arm feasibility trial included adults (over 30 years) with a clinical diagnosis of T2DM. They were invited to participate in a 12-week HBT consisting of two weekly 60-minute exercise sessions. The outcome was feasibility, determined by adherence, exercise intensity, adverse events, dropout rate, and metabolic parameters. Results From September to December 2021, 10 people were included in the study. One participant dropped out because of illness and one participant dropped out due to suspected atrial fibrillation. Eight participants concluded the intervention and participated on average 86% (range 14–23) of the HBT sessions exercising with a mean heart rate of 73.4% (standard deviation (SD) 10.2) of individual maximum heart rate. Conclusions HBT for people diagnosed with T2DM was found feasible with a high attendance rate and clinically relevant exercise intensities. However, future randomized controlled trials about the effects of the handball intervention are needed. Trial registration This trial was registered in ClinicalTrials.gov (NCT05015946) on 23/08/2021.
Clinical performance of light-cured orthodontic adhesives for bonding brackets – an in-vitro study.
Authors: Tallani Sachin , Singla Ritesh , Singla Nishu , Natarajan Madhumitha , Kukkila Jayaprakash
Published: November 2023

Background The dental profession is seeing a constant influx of new adhesive systems from manufacturers, each claiming to be more dependable than the last. This study assessed the bond strength and adhesive remnants of different light-cured adhesives used for bonding metal brackets to teeth. Methods 80 extracted maxillary premolars with the sound crown structure were acid etched and bonded with brackets on their buccal surfaces utilizing primer and light-cured adhesives into four equal groups, which are Transbond XT, Heliosit, Enlight, and Bracepaste. Shear bond strength (SBS) for de-bonding the brackets were evaluated with Instron- testing machine after 48 hours. The de-bonded samples’ adhesive remnant index (ARI) scores were also measured. Results The maximum mean SBS was found for Transbond XT (12.91 ± 2.0 MPa), followed by Bracepaste (12.87 ± 1.59 MPa), Enlight (11.77 ± 1.87 MPa), and lowest for Heliosit (10.93 ± 1.71 MPa). According to the four point scale, adhesive remnant index (ARI), Transbond XT has the least adhesive residue left on the tooth, followed by Heliosit. Enlight and Bracepaste have a similar distribution of adhesive, with both having a maximum amount left. Conclusion It can be inferred that all groups involved demonstrated a satisfactory level of bond strength from a clinical perspective. Transbond XT is the preferred orthodontic adhesive over the other three adhesives due to its superior SBS and ARI properties.
A comparative study to monitor drug adherence to antihypertensive drugs among preeclamptic women and to determine factors contributing to drug compliance restrictions.
Authors: Agrawal Harshita , Quazi Syed Zahiruddin
Published: November 2023

Background Preeclampsia, a perilous pregnancy complication, affects 4–5% of pregnancies worldwide, contributing to a significant proportion of maternal deaths, particularly due to pregnancy-related hypertension diseases. Adherence to antihypertensive medication is crucial for improving maternal and fetal health outcomes. However, evidence suggests that pregnant women often fail to comply with prescribed regimens, with reasons ranging from ignorance to amnesia. Methods This study proposes a cross-sectional, questionnaire-based approach to assess drug adherence among pregnant patients with preeclampsia in rural areas. The study aims to evaluate awareness levels and barriers to adherence. The study will be conducted in a tertiary care teaching hospital and will involve 114 eligible patients. Sociodemographic data, diagnosis, medication details, awareness about antihypertensive use, and medication adherence will be collected through semi-structured interviews and questionnaires. The 8-Item Morisky’s Medication Adherence Scale (MMAS-8) will be employed to assess adherence levels. Data analysis will involve descriptive statistics, Chi-square tests, and logistic regression. Expected results The study anticipates revealing insights into the level of drug adherence and awareness among pregnant women with preeclampsia. By identifying barriers to adherence, the study aims to tailor interventions to enhance compliance, reduce costs, and optimize drug therapy. The dissemination of results through publication in indexed journals and presentation at scientific conferences will contribute to the understanding of medication adherence in pregnancy-related disorders.
Epidemiological profiles and causes of sudden deaths of various ages in Ethiopia: an autopsy-based study
Authors: Lema Alemayehu Shiferaw , Tekle Sesen Tsegaye
Published: November 2023

Background Sudden death is an important global public health issue. An autopsy is an important source of epidemiological data, as the considerable causes of sudden death remain hermetic until postmortem examination. This study is devoted to evaluating the sociodemographic, behavioral, clinical and pathological characteristics of sudden deaths of various ages in Ethiopia. Methods This is an observational, prospective, descriptive study that included all sudden deaths observed over 1 year at St. Paul’s Hospital and Millennium Medical College, Addis Ababa, Ethiopia. Results Sudden death (n = 568) accounted for 11.5% of all autopsied cases. There were 482 males and 86 females (M:F ratio of 5.6:1) and a mean age of 44.81±17.349. The peak age group was the fourth and fifth decades, accounting for 43.9% of the cases. Chronic substance abuse and a history of prior illness were declared in 40.1% and 38% of victims of sudden death, respectively. Cardiovascular (36.1%), respiratory (32.6%), and gastrointestinal system (19.5%) pathologies were the most common causes. The leading underlying causes of sudden death were ischemic heart disease and pneumonia. Most (86.6%) sudden deaths occurred outside of a hospital setting. Conclusions Most of the causes of sudden death in Ethiopia can be prevented and treated. The majority of sudden deaths are silent without preexisting symptoms. Therefore, it is vital to develop public health measures that will help educate the community about the importance of recognizing the manifestation of various clinical conditions and the need to seek immediate clinical help. Furthermore, efforts should be made to make healthcare facilities accessible and affordable with adequate diagnostic and management capacity. Documentation of autopsy-based data could provide important epidemiological information to guide medical services, prevention efforts, and control measures.
Twelve Tips for using Learning Curves in Health Professions Education Research
Authors: Howard Neva , Edwards Roger , Boutis Kathy , Alexander Seth , Pusic Martin
Published: November 2023

Learning curves can be used to design, implement, and evaluate educational interventions. Attention to key aspects of the method can improve the fidelity of this representation of learning as well as its suitability for education and research purposes. This paper addresses when to use a learning curve, which graphical properties to consider, how to use learning curves quantitatively, and how to use observed thresholds to communicate meaning. We also address the associated ethics and policy considerations. We conclude with a best practices checklist for both educators and researchers seeking to use learning curves in their work.
Adult height in girls with central precocious puberty without gonadotropin-releasing hormone agonist treatment: a retrospective case-control study
Authors: Jang Hyun Ji , Kwak Min Jung , Kim Young Mi , Choi Soo-Han , Park Kyung Hee , Yoo Hye Won , Park Su Jeong , Jo Yoon Hee , Jo Ha Young
Published: November 2023

Background: The primary aim of this study was to investigate the final adult height (FAH) of girls diagnosed with central precocious puberty (CPP) who were untreated.Methods: We retrospectively analyzed the medical records of 36 girls diagnosed with CPP between 8 and 9 years of age who did not receive treatment, and 206 girls diagnosed with CPP within the same age range who received gonadotropin-releasing hormone (GnRH) agonist treatment. Midparental height (MPH), predicted adult height (PAH) obtained using height and bone age (BA) at the time of diagnosis (PAH for BA), and PAH obtained using the Bayley-Pinneau method (PAH by BP) were calculated. Additionally, height at the time of growth completion was compared with the predicted height.Results: The FAHs were 160.71±4.56 cm in the untreated group and 159.31±4.26 cm in the treated group. In the untreated group, the FAH was 0.99±4.50 cm shorter than the MPH but 4.29±3.33 cm and 3.46±3.93 cm greater than the PAH for BA and PAH by BP, respectively.Conclusion: In children diagnosed with CPP between 8 and 9 years of age who were untreated, FAH was greater than PAH for BA and PAH by BP at the time of diagnosis, indicating that the prognosis of FAH was not poor. Therefore, for girls diagnosed with CPP, it is recommended to consider various conditions, such as pubertal onset, height at diagnosis, BA, peak luteinizing hormone level, predicted height, and speed of puberty, when deciding whether to administer GnRH agonists.
Methodological support of the pedagogical content of the managerial activity of the head of the internal Affairs body of the Russian Federation
Authors: Blagoveshchenskaya Maria
Published: November 2023

The article defines the importance of the pedagogical aspect of the managerial activity of the head of the internal affairs body of the Russian Federation. The author focuses on the fact that for the effective implementation by the head of the internal affairs bodies of pedagogical functions that implement the pedagogical content of management activities, he should form pedagogical competence. The pedagogical competence of the head presupposes mastering the methodology of managerial activity, for which it is necessary to provide methodological support for the pedagogical content of the managerial activity of the head of the internal affairs body of the Russian Federation. Special attention is paid to pedagogical stimulation, presented as the process of applying external stimuli that interact with the motives and internal attitudes of the individual. The author presents the results of an empirical study of the motivation of official and professional activities, types of incentives and incentive measures, which substantiates the need to create a methodology for the application of pedagogical functions in the management activities of the head of the internal affairs body at any level. 350 employees of the internal affairs bodies took part in the study: 170 people – managers of various levels, 180 people - subordinates. The normalized sample from among the heads of the Department of Internal Affairs was distributed as follows: male managers – 54%, female – 46%. Age from 28 years to 51 years. The category of subordinate employees is represented by: male employees – 44% and female employees – 56%. The age of the interviewed employees ranges from 23 to 54 years. In conclusion, a reasoned conclusion is made about the importance and necessity of mastering the methodology of providing the pedagogical content of managerial activities by the heads of internal affairs bodies.
Cięcie ciała w real time’ie
Authors: Sieciechowicz Ida
Published: November 2023

Ida Sieciechowicz poszerza pole widzenia. Dorysowuje dalsze piętra. Ponad rytuałami zakleszczonej codzienności wznosi się coś jeszcze. Gmach języka okazuje się labiryntem. Pytania zaplątane w mechanizmy ekspresji rozpoczynają ten seans – bezradna tożsamość staje naprzeciw mamiącego, mieniącego się języka, a właściwie języków. Już nie widać bohaterki (samotnej istotności) – wszystko ma się rozpływać, rozpadać i na nowo powstać w akcie wypowiedzenia. Karol Maliszewski Ta poezja drażni. Stawia język i postawy czytelnicze w stan nieufności wobec tego, co wydawałoby się stałe i oczywiste. Cięcia są ostre, wykonywane w krótkich zdaniach. Czasem niedokończonych, jakby zahaczały, prowokowały do bólu. Czytelnicy pozostają w stanie ciągłego niepokoju i stałej gotowości odbiorczej. Krzysztof Biedrzycki Wiersze Idy Sieciechowicz są pełne ruchu, dynamicznych pytań. Czy? Rozognione miejsca toczą się w nas. Tak! Rozgrywają się w nas między wersami. Rwana składnia wraz ze starannie wypracowanym brzmieniem pracują na rzecz poruszającej się ludzkiej machiny, która nieustannie jako zbiór jednostek – „ja”, „ktoś”, „oni” – coś przerabia, tworzy, niszczy, a nawet zabija. Carlos Delgado Jimeno, tłumacz
Field Experimental Evidence on the Effect of Pricing on Residential Electricity Conservation
Authors: Burkhardt Jesse , Gillingham Kenneth T. , Kopalle Praveen K.
Published: November 2023

This study examines how electric utilities and regulators can encourage residential consumers to conserve electricity during the hottest summer days and shift electricity load from the day to off-peak, nighttime hours. We analyze a two-year field experiment involving 280 Texas households that explores approaches to conservation and load-shifting to enable emission reductions and reduce generation costs. Our critical peak pricing intervention reduces electricity consumption by 14% on the peak hours of the hottest days, leading to greenhouse gas emission reductions of about 16%. A key contribution of this study is the use of high-frequency appliance-level data. We show that 74% of the critical peak response is from reducing air conditioning. In a complementary nighttime pilot program, consumers respond strongly to lower prices by programming the timing of electric vehicle charging. Our work highlights how automation can influence the consumer tradeoffs relating to effort costs, discomfort, monetary incentives, and warm glow.

This paper was accepted by Rajesh Chandy, Special Section of Management Science on Business and Climate Change.

Supplemental Material: The data and online appendices are available at https://doi.org/10.1287/mnsc.2020.02074 .
The Challenge of Understanding What Users Want: Inconsistent Preferences and Engagement Optimization
Authors: Kleinberg Jon , Mullainathan Sendhil , Raghavan Manish
Published: November 2023

Online platforms have a wealth of data, run countless experiments, and use industrial-scale algorithms to optimize user experience. Despite this, many users seem to regret the time they spend on these platforms. One possible explanation is that incentives are misaligned: platforms are not optimizing for user happiness. We suggest the problem runs deeper, transcending the specific incentives of any particular platform, and instead stems from a mistaken foundational assumption. To understand what users want, platforms look at what users do. This is a kind of revealed-preference assumption that is ubiquitous in the way user models are built. Yet research has demonstrated, and personal experience affirms, that we often make choices in the moment that are inconsistent with what we actually want. The behavioral economics and psychology literatures suggest, for example, that we can choose mindlessly or that we can be too myopic in our choices, behaviors that feel entirely familiar on online platforms. In this work, we develop a model of media consumption where users have inconsistent preferences. We consider a platform which wants to maximize user utility, but only observes behavioral data in the form of the user’s engagement. We show how our model of users’ preference inconsistencies produces phenomena that are familiar from everyday experience but difficult to capture in traditional user interaction models. These phenomena include users who have long sessions on a platform but derive very little utility from it, and platform changes that steadily raise user engagement before abruptly causing users to go “cold turkey” and quit. A key ingredient in our model is a formulation for how platforms determine what to show users: they optimize over a large set of potential content (the content manifold) parametrized by underlying features of the content. Whether improving engagement improves user welfare depends on the direction of movement in the content manifold: For certain directions of change, increasing engagement makes users less happy, whereas in other directions on the same manifold, increasing engagement makes users happier. We provide a characterization of the structure of content manifolds for which increasing engagement fails to increase user utility. By linking these effects to abstractions of platform design choices, our model thus creates a theoretical framework and vocabulary in which to explore interactions between design, behavioral science, and social media.

This paper was accepted by Yan Chen, behavioral economics and decision analysis.

Funding: This work was supported by the Vannevar Bush Faculty Fellowship and Multidisciplinary University Research Initiative [Grant W911NF-19-0217].

Supplemental Material: The online appendices are available at https://doi.org/10.1287/mnsc.2022.03683 .
Post-Zionism, Post-Modernism, and Globalization: A Zionist Critique of Israel as "Start-Up Nation" in the Writings of Eliezer Schweid
Authors: Magid Shaul
Published: November 2023

Abstract: This article explores the later work of Eliezer Schweid on the questions of Zionism, post-Zionism, globalization, and postmodernity. It argues that Schweid viewed postmodernity as emerging in the post-World War II era where communism and socialism largely collapsed, leaving free-market capitalism as the dominant force in world economies and, by extension, as the template for moral living. This produced, among other things, neoliberalism and globalization that threatened the very core of Zionism as an ideology of collective Jewish self-determination built on a democratic socialist ethos. On Schweid's reading, the neoliberal and globalist (postmodern) developments produce a serious challenge to Zionism. This includes, I argue, the idea of Israel as "Start-Up Nation," which is often championed as the success of contemporary Zionism.
Design of an optimized Alvarez lens based on the fifth-order polynomial combination
Authors: Ye Zhichao , Yan Jiapu , Jiang Tingting , Chen Shiqi , Xu Zhihai , Feng Huajun , Li Qi , Chen Yueting
Published: November 2023

This paper proposes an optimized design of the Alvarez lens by utilizing a combination of three fifth-order X-Y polynomials. It can effectively minimize the curvature of the lens surface to meet the manufacturing requirements. The phase modulation function and aberration of the proposed lens are evaluated by using first-order optical analysis. Simulations compare the proposed lens with the traditional Alvarez lens in terms of surface curvature, zoom capability, and imaging quality. The results demonstrate the exceptional performance of the proposed lens, achieving a remarkable 26.36% reduction in the maximum curvature of the Alvarez lens (with a coefficient A value of 4×10−4 and a diameter of 26 mm) while preserving its original zoom capability and imaging quality.
Performance prediction of a circularly polarized graphene-dielectric resonator-based antenna for THz frequency application using machine learning algorithms
Authors: Kumar Kundan , Sadhu Pradip Kumar
Published: November 2023

In this article, a graphene-dielectric resonator-based antenna is designed in the THz frequency regime. Circular polarization is achieved by feeding the cylindrical-shaped ceramic using a perturbed square-shaped aperture. Graphene loading over the alumina ceramic provides the frequency reconfigurable feature. In order to overcome the difficulty of simulating the THz antenna (i.e., very large simulation time), machine learning algorithms such as the artificial neural network (ANN) and random forest are used to effectively predict the performance of the designed antenna. The proposed antenna works effectively in between 5.0 and 5.5 THz with a 3 dB axial ratio frequency range from 5.1 to 5.35 THz. There is good correlation found between the predicted, measured, and simulated reflection coefficient and axial ratio. Due to stable radiation properties and good diversity performance within the operating frequency band, the proposed antenna can be employable for different wireless applications in the THz frequency regime.
Parameters of 391  nm lasing from molecular nitrogen ions pumped by a 950  nm femtosecond laser pulse
Authors: Zyatikov Ilya A. , Losev Valery F.
Published: November 2023

The results of experimental studies of spectral, temporal, and spatial self-seed lasing characteristics at the wavelength of 391 nm in pure nitrogen at different values of specific pump power are presented. Pumping was carried out by a femtosecond radiation pulse at the wavelength of 950 nm. The possibility of obtaining lasing pulse duration close to transform-limited (1.83 ps) is presented. It is shown that far-field radiation divergence decreases with increasing lens focal length, and it correlates well with the geometric dimensions of laser plasma.
Broadband mirrors for thermophotovoltaics
Authors: Omair Zunaid , Hooten Sean , Menon Varun , Oduor Patrick , Choi Kwong-Kit , Dutta Achyut K.
Published: November 2023

We present an innovative solution to improve the efficiency of thermophotovoltaic (TPV) devices by tackling the problem of sub-bandgap photon losses. We propose an optimized design for thin-film mirrors using inverse electromagnetic design principles, thereby enhancing the average reflectivity and photon re-use. Our method surpasses the traditional Bragg mirror by employing a gradient-descent based optimization over Bragg mirror geometrical parameters, leveraging the transfer matrix method for derivative calculations. The optimized structure, based on continuously chirped distributed Bragg reflectors proposed herein demonstrates a remarkable increase in reflectivity beyond 98%, over an almost three-octaves bandwidth (0.1eV-0.74eV). We show that the incident power loss in InGaAs TPV cells at an emitter temperature of 1200°C is significantly reduced. While our work shows considerable promise, further exploration is needed to ascertain the practicability and robustness of these designs under various operational conditions. This study thus provides a major step forward in TPV technology, highlighting a new route towards more effective energy conversion systems.
Diet-induced glial insulin resistance impairs the clearance of neuronal debris in Drosophila brain
Authors: Alassaf Mroj , Rajan Akhila
Published: November 2023

Obesity significantly increases the risk of developing neurodegenerative disorders, yet the precise mechanisms underlying this connection remain unclear. Defects in glial phagocytic function are a key feature of neurodegenerative disorders, as delayed clearance of neuronal debris can result in inflammation, neuronal death, and poor nervous system recovery. Mounting evidence indicates that glial function can affect feeding behavior, weight, and systemic metabolism, suggesting that diet may play a role in regulating glial function. While it is appreciated that glial cells are insulin sensitive, whether obesogenic diets can induce glial insulin resistance and thereby impair glial phagocytic function remains unknown. Here, using a Drosophila model, we show that a chronic obesogenic diet induces glial insulin resistance and impairs the clearance of neuronal debris. Specifically, obesogenic diet exposure down-regulates the basal and injury-induced expression of the glia-associated phagocytic receptor, Draper. Constitutive activation of systemic insulin release from Drosophila insulin-producing cells (IPCs) mimics the effect of diet-induced obesity on glial Draper expression. In contrast, genetically attenuating systemic insulin release from the IPCs rescues diet-induced glial insulin resistance and Draper expression. Significantly, we show that genetically stimulating phosphoinositide 3-kinase (Pi3k), a downstream effector of insulin receptor (IR) signaling, rescues high-sugar diet (HSD)-induced glial defects. Hence, we establish that obesogenic diets impair glial phagocytic function and delays the clearance of neuronal debris.
Exploring factors affecting the adoption and continuance usage of drone in healthcare: The role of the environment
Authors: Marfo John Serbe , Kyeremeh Kwadwo , Asamoah Pasty , Owusu-Bio Matilda Kokui , Marfo Afia Frimpomaa Asare
Published: November 2023

Drone technologies and healthcare delivery have attracted scholarly attention over the years. Studies have acknowledged the positive impact of the adoption and usage of drone technologies for healthcare delivery. We argue however that, knowledge is lacking on the role of the environment in drone technologies adoption, usage and continuance usage. An examination of 330 health facilities that engage in the use of drone services from Zipline Ghana showed that the environment inversely moderates the relationship between actual usage and intention to continue usage, suggesting that reducing the influence of environmental factors will increase the impact actual usage has on the continuance usage of drone technology in healthcare delivery.
Determinants of differences in RT-PCR testing rates among Southeast Asian countries during the first six months of the COVID-19 pandemic
Authors: Van Haute Michael , Agagon Alexandra , Gumapac Franz Froilan , Anticuando Marie Abigail , Coronel Dianne Nicole , David Mary Coleen , Davocol Dan Ardie , Din Eunice Jairah , Grey Carlos Alfonso , Lee Young Hee , Muyot Marvin Bryan , Ragasa Charissma Leiah , Shao Genesis , Tamaña Cailin Adrienne , Uy Trixia Scholastica , De Silos Jeriel
Published: November 2023

A positive correlation has been demonstrated between gross domestic product (GDP) per capita and COVID-19 tests per 1000 people. Although frequently used as an indicator of economic performance, GDP per capita does not directly reflect income distribution inequalities and imposed health costs. In this longitudinal ecological study, we aimed to determine if, besides GDP per capita, indicators relating to governance, public health measures enforcement, and health and research investment explain differences in RT-PCR testing rates among countries in Southeast Asia (SEA) during the first six months of the COVID-19 pandemic. Using open-access COVID-19 panel data, we estimated the effect of various indicators (GDP per capita, health expenditure per capita, number of researchers per one million population, corruption perceptions index, stringency index, regional authority index) on daily COVID-19 testing by performing fixed-effects negative binomial regression. After accounting for all indicators, the number of daily confirmed COVID-19 cases, and population density, the model provided a 2019 GDP per capita coefficient of 0.0046330 (95% CI: 0.0040171, 0.0052488;p<0.001), indicating that a rise in 2019 GDP per capita by 100 international dollars is associated with a 46.33% increase in the number of daily tests performed. Additionally, all indicators were significantly associated with the daily number of RT-PCR testing on multivariable analysis. In conclusion, we identified different country-level indicators significantly associated with differences in COVID-19 testing rates among SEA countries. Due to the study’s ecological design, we caution on applying our results to the individual level given potential for systematic differences between the included countries. Additional investigation is likewise needed to understand how government expenditure on healthcare may have impacted COVID-19 testing capacity during the initial stages of the pandemic.
Classification and distribution of functional groups of birds and mammals in Mexico
Authors: Mayani-Parás Fernando , Moreno Claudia E. , Escalona-Segura Griselda , Botello Francisco , Munguía-Carrara Mariana , Sánchez-Cordero Víctor
Published: November 2023

There has been a recent exponential growth in the study of functional trait ecology. Nonetheless, the study of functional traits and functional groups has been limited for terrestrial vertebrates. We conducted a classification update of functional groups (FG) of birds and mammals in Mexico, and determined the distribution patterns of FG species richness in different ecosystems nationwide. We selected six functional traits (feeding habit, locomotion, feeding substrate and technique, activity period, seasonality, and body size) obtained for 987 and 496 species of birds and mammals, respectively. A cophenetic correlation analyses resulted in values of 0.82 for the bird species dendrogram, and 0.79 for the mammal species dendrogram showing that the structures adequately reflected the similarity between observations. We obtained 52 FG for birds, assembled into 9 broader groups based on their feeding habits (16 invertivores, 6 carnivores: 5 herbivores, 9 aquatic vertivore/invertivore, 5 granivores, 1 scavenger, 3 nectarivores, 4 frugivores, and 3 omnivores). We obtained 35 FG for mammals, assembled into 9 broader groups based on their feeding habits (4 granivores, 10 herbivores, 1 nectarivore, 4 frugivores, 8 invertivores, 3 omnivores, 2 aquatic vertivore/invertivore, 1 hematophagous, and 2 carnivores). Overall, the distribution of FG species richness for birds and mammals gradually increased from the Nearctic to the Neotropical region, following a typical latitudinal species richness pattern. Few FG of migratory birds, and FG of granivore and herbivore mammals showed more species in the Nearctic and in the transitional regions. Our study provides a baseline for identifying ecological functions of species of birds and mammals in different ecosystems in Mexico, and contributes to understand the relationship between species diversity, community structure and ecosystem functioning. Identifying spatial patterns of functional trait diversity is important as biodiversity loss has a negative impact on ecosystem functioning and provision of environmental services.
How effective is extracorporeal life support for patients with out-of-hospital cardiac arrest initiated at the emergency department? A systematic review and meta-analysis
Authors: Wongtanasarasin Wachira , Krintratun Sarunsorn , Techasatian Witina , Nishijima Daniel K.
Published: November 2023

Background

Extracorporeal cardiopulmonary resuscitation (ECPR) is commonly initiated for adults experiencing cardiac arrest within the cardiac catheterization lab or the intensive care unit. However, the potential benefit of ECPR for these patients in the emergency department (ED) remains undocumented. This study aims to assess the benefit of ECPR initiated in the ED for patients with out-of-hospital cardiac arrest (OHCA).

Methods

We conducted a systematic review and meta-analysis of studies comparing ECPR initiated in the ED versus conventional CPR. Relevant articles were identified by searching several databases including PubMed, EMBASE, Web of Science, and Cochrane collaborations up to July 31, 2022. Pooled estimates were calculated using the inverse variance heterogeneity method, while heterogeneity was evaluated using Q and I2 statistics. The risk of bias in included studies was evaluated using validated bias assessment tools. The primary outcome was a favorable neurological outcome at hospital discharge, and the secondary outcome was survival to hospital discharge or 30-day survival. Sensitivity analyses were performed to explore the benefits of ED-initiated ECPR in studies utilizing propensity score (PPS) analysis. Publication bias was assessed using Doi plots and the Luis Furuya-Kanamori (LFK) index.

Results

The meta-analysis included a total of eight studies comprising 51,173 patients. ED-initiated ECPR may not be associated with a significant increase in favorable neurological outcomes (odds ratio [OR] 1.43, 95% confidence interval [CI] 0.30–6.70, I2 = 96%). However, this intervention may be linked to improved survival to hospital discharge (OR 3.34, 95% CI 2.23–5.01, I2 = 17%). Notably, when analyzing only PPS data, ED-initiated ECPR demonstrated efficacy for both favorable neurological outcomes (OR 1.89, 95% CI 1.26–2.83, I2 = 21%) and survival to hospital discharge (OR 3.37, 95% CI 1.52–7.49, I2 = 57%). Publication bias was detected for primary (LFK index 2.50) and secondary (LFK index 2.14) outcomes.

Conclusion

The results of this study indicate that ED-initiated ECPR may not offer significant benefits in terms of favorable neurological outcomes for OHCA patients. However, it may be associated with increased survival to hospital discharge. Future studies should prioritize randomized trials with larger sample sizes and strive for homogeneity in patient populations to obtain more robust evidence in this area.
“With group antenatal care, pregnant women know they are not alone”: The process evaluation of a group antenatal care intervention in Ghana
Authors: Zielinski Ruth , Kukula Vida , Apetorgbor Veronica , Awini Elizabeth , Moyer Cheryl , Badu-Gyan Georgina , Williams John , Lockhart Nancy , Lori Jody
Published: November 2023

Background

An essential component to improving maternal and newborn outcomes is antenatal care. A trial of group antenatal care was implemented in Ghana where 7 health care facilities were randomized to be intervention sites and 7 control sites continued traditional antenatal care. Group antenatal care, where 10–14 women with similar due dates meet together for visits, includes traditional components such as risk assessment with increased opportunity for education and peer support. The study aim was to assess and report the process evaluation of the implementation of a group antenatal care intervention.

Methods

Process evaluation data were collected alongside intervention data and included both quantitative and qualitative data sources. Midwives at the health facilities which were randomized as intervention sites completed tracking logs to measure feasibility of the intervention. Research team members traveled to intervention sites where they conducted structured observations and completed fidelity and learning methods checklists to determine adherence to the model of group antenatal care delivery. In addition, midwives facilitating group antenatal care meetings were interviewed and focus groups were conducted with women participating in group antenatal care.

Results

In the majority of cases, midwives facilitating group antenatal care completed all components of the meetings with fidelity, following best practices such as sitting with the group rather than standing. Across 7 intervention sites, 7 groups (622 pregnant women) were documented in the tracking logs and of these participants, the majority (74%) attended more than half of the meetings, with 32% attending all 8 group meetings. Three themes were identified in both the midwife interviews and focus groups with pregnant women: 1) information sharing, 2) sense of community, and 3) time management challenges. An additional theme emerged from the focus groups with the women: women who had already given birth noticed a disconnect between what they learned and treatment received during labor and birth.

Conclusion

This process evaluation determined that group antenatal care can be implemented with fidelity in low and middle-income countries. Time management was the biggest challenge, however both midwives and pregnant women found the model of care not only acceptable, but preferable to traditional care. The knowledge shared and sense of community built during the meetings was a valuable addition to the individual model of antenatal care.
Predictors of COVID-19 vaccine uptake among persons aged 18 years and above in Ga North Municipality, Ghana using the Health Belief Model: A community-based cross-sectional study
Authors: Nasiratu Imoro , Pencille Lilian Belole , Khuzwayo Nelisiwe , Aboagye Richard Gyan , Tarkang Elvis Enowbeyang
Published: November 2023

Background

Although the coronavirus disease 2019 (COVID-19) vaccination rollout has been accepted by the population of the Ga North Municipality, a substantial proportion has developed hesitancy to COVID-19 vaccination uptake. This study determined the predictors of COVID-19 vaccine uptake among persons aged 18 years and above in the Ga North Municipality using the Health Belief Model.

Methods

The study used a cross-sectional study design. Structured questionnaires were used to collect data from a multistage sample of 388 respondents. Multivariable binary logistic regression was used to determine the predictors of COVID-19 vaccination uptake at the level of 0.05 and 95% confidence interval.

Results

Vaccination uptake was 72.2%. The odds of COVID-19 vaccination uptake were higher among men than women [AOR = 2.02, 95% Cl: 1.13–3.20] and among singles than the married [AOR = 1.90, 95% Cl: 1.07–3.36], but lower among Muslims than Christians [AOR = 0.33, 95%Cl: 0.18–0.60]. Perceived susceptibility [AOR = 2.43, 95% Cl: 1.36–4.35], perceived barriers [AOR = 0.54, 95%Cl: 0.31–0.95], cues to action [AOR = 2.23, 95% Cl: 1.19–4.21] and self-efficacy [AOR = 3.23 95% Cl: 1.82–5.71] were the significant predictors of COVID-19 vaccination uptake.

Conclusion

The uptake of the COVID-19 vaccine in GA North Municipality is high. Health promotion interventions should focus on increasing perceived susceptibility to COVID-19, minimising barriers to COVID-19 vaccine uptake, and promoting cues and self-confidence for COVID-19 vaccine uptake. It should also target women, the married, and Muslims.
The experience of bereaved cancer carers in rural and regional areas: The impact of the COVID-19 pandemic and the potential of peer support
Authors: Winter Natalie , McKenzie Kerry , Spence Danielle , Lane Katherine , Ugalde Anna
Published: November 2023

Background

Caring for someone with cancer during end of life care can be a challenging and complex experience. Those living in rural and regional areas are less likely to have local healthcare services and may be physically isolated. Even where support services such as respite do exist, they may be less likely to be accessed due to the time burden in travelling to services. This was compounded by the COVID-19 pandemic.

Aim

To understand the potential benefits of peer support for bereaved carers of people with cancer from rural and regional locations during the COVID-19 period.

Methods

Phone interviews were conducted with bereaved cancer carers living in rural and regional areas in Victoria. Semi-structured interviews were used, and participants were asked about their experience as a carer, bereavement and the potential for peer support. Interviews were audio recorded and transcribed verbatim; transcripts were coded and a thematic analysis was conducted.

Findings

12 interviews were conducted. Carers were mostly female (85%) and were on average 58 years of age (range 42–71). Interviews lasted an average of 58 minutes (range 53–91 minutes). Three themes were derived from the data; 1) Supportive care needs while caring and the impact of COVID-19; 2) Isolation during bereavement compounded by the COVID-19 pandemic; and 3) Peer support requires flexibility to meet diverse needs.

Conclusion

Peer support has potential to assist bereaved carers of people with cancer. A co-design approach may be beneficial for developing a flexible model for supporting and linking carers together.