bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual collaborative spaces: a case study on the antecedents of collaboration in an open‐source software community
Authors: Conaldi Guido , De Vita Riccardo , Ghinoi Stefano , Foster Dawn Marie
Published: April 2023

Collaboration enables the sharing amongst individuals of resources and knowledge required to innovate. In recent years, this phenomenon has increasingly manifested in virtual collaborative spaces such as open‐source software communities because of the advancement in the use of online technologies and the heightened need for distance work. However, it is still unclear which underlying mechanisms foster collaboration in these spaces. By using the Linux kernel open‐source software community as a case study, we analyze data from the linux‐pci@vger.kernel.org mailing list to model the influence of proximity on the likelihood of collaboration between individuals. Our dataset is composed of 10,513 message replies to the PCI mailing list posted by its 654 active members in the years 2013 to 2015. Our results show that geographical proximity does not have a direct impact on collaboration, while organizational features defined by institutional and organizational proximity do significantly affect collaboration. Cognitive and social proximity also significantly, and positively, affects collaboration, but these relationships show an inverted u‐shaped form. Our results confirm the need to develop specific theorizing about virtual spaces, as they present unique features when compared to traditional physical environments.
Risk assessment of airborne virus transmission in an intensive care unit due to single and sequential coughing
Authors: Kusuluri Rajendra , Mirikar Dnyanesh , Palanivel Silambarasan , Arumuru Venugopal
Published: April 2023

The virus causing COVID‐19 has constantly been mutating into new variants. Some of them are more transmissive and resistant to antibiotics. The current research article aims to examine the airborne transmission of the virus expelled by coughing action in a typical intensive care unit. Both single and sequential coughing actions have been considered to get closer to practical scenarios. The objective is to assess the effectiveness of air change per hour (ACH) on the risk of infection to a healthcare person and how the air change rate influences the dispersion of droplets. Such a study is seldom reported and has significant relevance. A total of four cases were analyzed, of which two were of sequential cough. When the ACH is changed from 6 to 12, the average particle residence time is reduced by ∼7 s. It is found that the risk of infection in the case of sequential cough will be relatively low compared to a single cough if the outlet of the indoor environment is placed above the patient's head. This arrangement also eliminates the requirement of higher ACH, which has significance from an energy conservation perspective.
Debt and real interest rates: Evidence from G20 countries
Authors: Sun Lixin
Published: April 2023

In this article, we examine the relationship between the debt and the ex‐post real interest rate on the basis of a sample from the G20 with the panel analysis, the panel threshold model, and a panel VAR model, particularly during times of high debt levels. In contrast to the results from the previous literature, our estimates suggest the negative connections between debt levels and real rates of interest: high debt levels reduce the current and expected real rate of interest, and the low real interest rate would raise the current and forward‐looking debt levels. Further investigations using the panel threshold model identify and quantify threshold values of debt on the forward real interest rate. In addition, we find that the threshold values of debt levels for advanced countries are far higher than the relevant values for emerging countries, which confirms the theory of “debt intolerance.” Third, the estimated impulse response functions from the panel VAR simulation support the significantly negative associations between debt levels and real interest rates. Fourth, the system GMM regressions and dynamic panel threshold tests show that our above conclusions are robust.
Influence of the grain shape and packing texture on the primary porosity of sandstone: Insights from a numerical simulation
Authors: Yan Yiming , Zhang Liqiang , Luo Xiaorong , Liu Keyu , Jia Tong , Lu Yanjun
Published: April 2023

Sandstone is an important carrier of underground hydrocarbon and the geological sequestration of carbon dioxide. Primary porosity is an important parameter used to predict reservoir quality, and it is influenced by the grain shape, grain‐size distribution and grain packing texture. However, few studies have focused on deriving multivariate equations of the grain size, grain‐size distribution and grain packing texture to predict the primary porosity of sandstone. The natural sedimentary process of sandstones was designed and simulated using a discrete element method. The results confirmed that the primary porosity is influenced by roundness, flatness, elongation, grain‐size distribution and grain packing texture; of the attributes, the mean grain size contributes less to the primary porosity of sandstone. Based on 193 simulated sandstone samples with a one‐component grain packing texture, a mathematical model considering roundness, flatness, elongation, grain packing texture and grain‐size distribution was proposed. The maximum, mean absolute and root mean square errors were 0.71, 0.26 and 0.32, respectively. The correlation coefficient between the simulated results and mathematical predicted results was 0.94. Furthermore, the primary porosity was positively correlated with the kurtosis of the grain‐size distribution in sandstone with the same grain shape but different kurtosis. The primary porosity was found to be independent of the mean grain size and mainly affected by the grain packing texture. Moreover, the primary porosity prediction model for sandstones with different grain‐size distribution curves based on the grain packing texture, which was proposed by the author in a previous study, was verified, and the correlation coefficient between the simulated results and predicted results was >0.92. The new mathematical model proposed in this study is a useful supplement for key parameter acquisition in the previous primary porosity prediction model of sandstone with different grain‐size distribution curves and grain packing texture. A mathematical model considering roundness, flatness, elongation, grain packing texture and grain‐size distribution is of great significance for reservoir quality prediction and conducting a quantitative evaluation of the diagenesis.
World Marrow Donor Association guidelines for the reporting of novel HLA alleles
Authors: Hofmann Jan A. , Bochtler Werner , Robinson James , Sauter Jürgen , Askar Medhat , Houdova Lucie , Melchers Mark , Schmidt Alexander H. , Spierings Eric , Urban Christine , Venter Alicia , Maiers Martin , Marsh Steven G. E. , Eberhard Hans‐Peter
Published: April 2023

The guidelines for the implementation and reporting of HLA nomenclature for the World Marrow Donor Association have served as a reliable standard for communication of HLA data in the hematopoietic cell transplantation process. Wider use of next‐generation sequencing made a special provision of the guidelines increasingly pertinent: how to communicate novel HLA alleles. Novel alleles need to be recognized by the WHO Nomenclature Committee for Factors of the HLA system to obtain official allele designations. Until then they have to be handled according to the specific rules. Leaving the actual rules basically unchanged we give some advice on how to communicate novel alleles to best facilitate the search process for cases where novel alleles are identified on donor or patient side.
The Segal conjecture for smash powers
Authors: Bergsaker Håkon Schad , Rognes John
Published: April 2023

We prove that the comparison map from ‐fixed points to ‐homotopy fixed points, for the ‐fold smash power of a bounded below spectrum , becomes an equivalence after ‐completion if is a finite ‐group and is of finite type. We also prove that the map becomes an equivalence after ‐completion if is any finite group and is of finite type, where is the augmentation ideal in the Burnside ring.
Can muscle typology explain the inter‐individual variability in resistance training adaptations?
Authors: Van Vossel Kim , Hardeel Julie , Van de Casteele Freek , Van der Stede Thibaux , Weyns Anneleen , Boone Jan , Blemker Silvia Salinas , Lievens Eline , Derave Wim
Published: April 2023

Considerable inter‐individual heterogeneity exists in the muscular adaptations to resistance training. It has been proposed that fast‐twitch fibres are more sensitive to hypertrophic stimuli and thus that variation in muscle fibre type composition is a contributing factor to the magnitude of training response. This study investigated if the inter‐individual variability in resistance training adaptations is determined by muscle typology and if the most appropriate weekly training frequency depends on muscle typology. In strength‐training novices, 11 slow (ST) and 10 fast typology (FT) individuals were selected by measuring muscle carnosine with proton magnetic resonance spectroscopy. Participants trained both upper arm and leg muscles to failure at 60% of one‐repetition maximum (1RM) for 10 weeks, whereby one arm and leg trained 3×/week and the contralateral arm and leg 2×/week. Muscle volume (MRI‐based 3D segmentation), maximal dynamic strength (1RM) and fibre type‐specific cross‐sectional area (vastus lateralis biopsies) were evaluated. The training response for total muscle volume (+3 to +14%), fibre size (−19 to +22%) and strength (+17 to +47%) showed considerable inter‐individual variability, but these could not be attributed to differences in muscle typology. However, ST individuals performed a significantly higher training volume to gain these similar adaptations than FT individuals. The limb that trained 3×/week had generally more pronounced hypertrophy than the limb that trained 2×/week, and there was no interaction with muscle typology. In conclusion, muscle typology cannot explain the high variability in resistance training adaptations when training is performed to failure at 60% of 1RM.

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Key points

This study investigated the influence of muscle typology (muscle fibre type composition) on the variability in resistance training adaptations and on its role in the individualization of resistance training frequency.

We demonstrate that an individual's muscle typology cannot explain the inter‐individual variability in resistance training‐induced increases in muscle volume, maximal dynamic strength and fibre cross‐sectional area when repetitions are performed to failure.

Importantly, slow typology individuals performed a significantly higher training volume to obtain similar adaptations compared to fast typology individuals.

Muscle typology does not determine the most appropriate resistance training frequency. However, regardless of muscle typology, an additional weekly training (3×/week vs. 2×/week) increases muscle hypertrophy but not maximal dynamic strength.

These findings expand on our understanding of the underlying mechanisms for the large inter‐individual variability in resistance training adaptations.
Response Mitigation of Floating Platform by Porous-Media-Tuned Liquid Dampers
Authors: Tsao Wen-Huai , Chen Ying-Chuan , Kees Christopher E. , Manuel Lance
Published: April 2023

A porous-media-tuned liquid damper (PMTLD) can serve as an effective and economical dynamic vibration absorber. Placing porous media within a water tank can improve the capacity for energy dissipation and optimize the performance by varying its material properties. Two numerical models are adopted to simulate the sloshing problem in PMTLD and the dynamics of a floating platform in waves. Besides, the effectiveness of response mitigation can be verified numerically. The first potential-based approach employs a mixed-type boundary value problem (BVP) solver and a free-surface particle tracker. This approach not only simulates the inviscid water wave but also includes the nonlinear damping of the PMTLD via a quadratic Forchheimer term. Another equivalent mechanical model is used to reduce the degree-of-freedom of the PMTLD system. The Newmark method is incorporated to solve the rigid-body dynamics. The second viscous approach uses the finite element method (FEM) to spatially discretize the Navier–Stokes (NS) equations and handles the free surface via the volume of fluid (VOF) and the level set (LS) equations. The multiphase simulation is implemented by computational modeling toolkits, Proteus and Chrono, for the fluid and solid phases, respectively. The correlations between potential flow and two-phase NS models are presented. The PMTLD is designed by analogy with the tuned mass damper (TMD). Numerical results show that the PMTLD can effectively reduce the structure's dynamic response in terms of vibration amplitude around resonance. Such damping devices have great potential for offshore platforms and wind turbine design.
Variable Stiffness and Antagonist Actuation for Cable-Driven Manipulators Inspired by the Bird Neck
Authors: Muralidharan Vimalesh , Testard Nicolas , Chevallereau Christine , Abourachid Anick , Wenger Philippe
Published: April 2023

This paper discusses stiffness and antagonistic actuation in light-weight cable-driven bio-inspired manipulators suitable for safe interactions. Manipulators under study are built upon arranging in series several tensegrity joints, called “modules.” A comparative study of several modules revealed that the X module, in contrast to modules based on pivots, allows one to increase joint stiffness by increasing antagonistic input forces like during muscle coactivation. For a planar manipulator with N modules, antagonistic actuation schemes with 2N and N + 1 cables are proposed and compared. It is shown that the N + 1 cable actuation scheme allows controlling both the manipulator configuration and joint stiffness satisfactorily. As compared with a manipulator with 2N active cables, one on each side of each module, higher forces are required to achieve the manipulator configuration. However, the N + 1 cable actuation scheme is a reasonable solution that allows reducing the moving masses and cost.
Computation of ultrasound propagation in a population of nonlinearly oscillating microbubbles including multiple scattering
Authors: Matalliotakis A. , Verweij M. D.
Published: April 2023

In contrast-enhanced echography, the simulation of nonlinear propagation of ultrasound through a population of oscillating microbubbles imposes a computational challenge. Also, the numerical complexity increases because each scatterer has individual properties. To address these problems, the Iterative Nonlinear Contrast Source (INCS) method has been extended to include a large population of nonlinearly responding microbubbles. The original INCS method solves the Westervelt equation in a four-dimensional spatiotemporal domain by generating increasingly accurate field corrections to iteratively update the acoustic pressure. The field corrections are computed by the convolution of a nonlinear contrast source with the Green's function of the linear background medium. Because the convolution integral allows a coarse discretization, INCS can efficiently deal with large-scale problems. To include a population of microbubbles, these are considered as individual contrast point sources with their own nonlinear response. The field corrections are computed as before, but now, in each iteration, the temporal signature of each contrast point source is computed by solving the bubble's Marmottant equation. Physically, each iteration adds an order of multiple scattering. Here, the performance of the extended INCS method and the significance of multiple scattering is demonstrated through various results from different configurations.
Impact of Minor Carbapenemases on Susceptibility to Novel β-Lactam/β-Lactamase Inhibitor Combinations and Cefiderocol in
Enterobacterales
Authors: Sadek Mustafa , Bosch Duran Juan , Poirel Laurent , Nordmann Patrice
Published: April 2023

The
in vitro
activity of imipenem-relebactam, meropenem-vaborbactam, ceftazidime-avibactam, and cefiderocol was evaluated against both clinical and isogenic enterobacterial isolates producing carbapenemases of the SME, NmcA, FRI, and IMI types. Ceftazidime-avibactam and meropenem-vaborbactam showed the highest activity against all tested isolates; imipenem-relebactam showed only moderate activity.
The SFTSV Nonstructural Proteins Induce Autophagy to Promote Viral Replication via Interaction with Vimentin
Authors: Liu Sihua , Su Yazhi , Lu Zhuozhuang , Zou Xiaohui , Xu Leling , Teng Yue , Wang Zhiyun , Wang Tao
Published: April 2023

Severe fever with thrombocytopenia syndrome virus (SFTSV) is a newly emerging tick-borne pathogen that causes multifunctional organ failure and even death in humans. As a housekeeping mechanism for cells to maintain steady state, autophagy plays a dual role in viral infection and the host’s immune response.
Human Sapovirus Replication in Human Intestinal Enteroids
Authors: Euller-Nicolas Gabriel , Le Mennec Cécile , Schaeffer Julien , Zeng Xi-Lei , Ettayebi Khalil , Atmar Robert L. , Le Guyader Françoise S. , Estes Mary K. , Desdouits Marion
Published: April 2023

Human sapoviruses (HuSaVs) are a frequent but overlooked cause of acute gastroenteritis, especially in children. Little is known about this pathogen, whose successful
in vitro
cultivation was reported only recently, in a cancer cell-derived line.
Cell Wall Carbohydrate Dynamics during the Differentiation of Infection Structures by the Apple Scab Fungus, Venturia inaequalis
Authors: Rocafort Mercedes , Srivastava Vaibhav , Bowen Joanna K. , Díaz-Moreno Sara M. , Guo Yanan , Bulone Vincent , Plummer Kim M. , Sutherland Paul W. , Anderson Marilyn A. , Bradshaw Rosie E. , Mesarich Carl H.
Published: April 2023

Plant-pathogenic fungi are a major threat to food security. Among these are subcuticular pathogens, which often cause latent asymptomatic infections, making them difficult to control.
A Compatible System of Equations Related to the Lie Superalgebra gl(n|m) and Integrable Calogero–Moser Model
Authors: Dotsenko E.
Published: April 2023

A joint system of equations based on the $$\mathfrak{g}\mathfrak{l}(n{\text{|}}m)$$ superalgebra has been determined and its relation to the integrable Calodgero–Moser system of particles has been established.
Zonisamide-induced distal renal tubular acidosis and critical hypokalaemia
Authors: MacMahon Thomas , Kelly Yvelynne P
Published: April 2023

A woman in her 20s presented with rapidly progressive muscle weakness and a 1-month preceding history of fatigability, nausea and vomiting. She was found to have critical hypokalaemia (K+1.8 mmol/L), a prolonged corrected QT interval (581 ms) and a normal anion gap metabolic acidosis (pH 7.15) due to zonisamide-induced distal (type 1) renal tubular acidosis. She was admitted to the intensive care unit for potassium replacement and alkali therapy. Clinical and biochemical improvement ensued, and she was discharged after a 27-day inpatient stay.
Laryngeal tuberculosis in patients treated with adalimumab: a casual or causal connection?
Authors: Molinari Giulia , Rosti Alessandro , Presutti Livio , Marzocchi Guido
Published: April 2023

This article presents two consecutive cases of laryngeal tuberculosis in patients treated with a specific anti-tumour necrosis factor-alpha (adalimumab), with a focus on their diagnostic process and therapeutic management. Both patients presented with aspecific chronic laryngeal symptoms that had been worsening for a few months in one case and for almost 1 year in the other one. They were both studied with fibreoptic laryngoscopy and contrast-enhanced CT and MRI scans. In both cases, the laryngeal biopsy proved negative to Ziehl-Neelsen test, while positive to Koch’s bacillus sensitive to rifampicin at PCR test. Both patients completely responded to standard antitubercular antibiotic therapy with rifampicin, isoniazid, pyrazinamide and etambutol protocol.

In the differential diagnosis of such patients, laryngeal tuberculosis should be considered due to the reasonable linkage between the immunosuppressant therapy with adalimumab and the tuberculosis infection/reactivation.
Efficacy of ketamine mouthwash in the management of oral and pharyngeal toxicity associated with head and neck chemoradiotherapy: protocol for a phase II, Simon’s two-stage trial
Authors: Koffler Daniel , Eckstein Jacob , Herman Joseph , Martins-Welch Diana , Seetharamu Nagashree , Ghaly Maged , Kohn Nina , Potters Louis , Frank Douglas , Sullivan Kevin , Parashar Bhupesh
Published: April 2023

Introduction

Curative intent treatment of head and neck cancer (HNC) is frequently radiation therapy over 7 weeks with concurrent chemotherapy. This regimen is effective but carries a burden of toxicity leading to severe pain and treatment breaks portending inferior outcomes. Conventional palliation methods include opioids, anticonvulsants and local anaesthetics. Breakthrough toxicities are nevertheless ubiquitous and present an urgent unmet need. Ketamine is an inexpensive drug with mechanisms of analgesia outside the opioid pathway including N-methyl-D-aspartate (NMDA) receptor antagonism and a pharmacologically unique property of opioid desensitisation. Systemic ketamine is validated in randomised controlled trials for efficacy in reducing pain and/or opioid burden in the oncologic setting. Literature supports peripherally administered ketamine for pain control without systemic toxicity. These data support our rationale of using ketamine mouthwash to decrease acute toxicity of curative treatment of HNC, the efficacy of which is our aim to elucidate.

Methods and analysis

This is a phase II, Simon’s two-stage trial. Patients have pathologically confirmed HNC and an intended regimen of 70 Gy of radiation with concurrent cisplatin. The protocol is initiated on diagnosis of grade 3 mucositis and consists of 2 weeks of 4 times daily (QID) ketamine mouthwash use. The primary endpoint is pain response defined as a combination of pain score and opioid use. 23 subjects will be enrolled in stage 1. If statistical criteria are met, 33 subjects will be enrolled in stage 2. Secondary endpoints include daily pain, daily opioid use, dysphagia at baseline and completion, nightly sleep quality, feeding tube placement and any unscheduled treatment breaks.

Ethics and dissemination

All trial data will be stored in an Institutional Review Board (IRB) approved database. The protocol is registered under Northwell IRB registration number #22-0292 and U.S. Food and Drug Administration (FDA) Investigational New Drug (IND) approval has been granted under IND number 161609. Results are intended to be published in an open-source journal and further data, statistics and source documents are available on request.

Trial registration number

NCT05331131.
C reactive protein-guided prescription of antibiotics for children under 12 years with respiratory symptoms in Kyrgyzstan: protocol for a randomised controlled clinical trial with 14 days follow-up
Authors: Isaeva Elvira , Bloch Joakim , Poulsen Anja , Kurtzhals Jørgen , Reventlow Susanne , Siersma Volkert , Akylbekov Azamat , Sooronbaev Talant , Munck Aabenhus Rune , Kjærgaard Jesper
Published: April 2023

Introduction

While lower respiratory tract infections are the main cause of death for children under 5 globally, only a small proportion of children with respiratory tract infections need antibiotics. Overuse of antibiotics globally is leading to increasing rates of antibiotic resistance. In Kyrgyzstan, healthcare workers regularly prescribe antibiotics when clinical uncertainty is present to err on the side of caution. Targeting antibiotic use with biomarkers of inflammation such as C reactive protein (CRP) testing at the point-of-care test (POCT) has been shown to reduce antibiotic use in general, but only few studies have been done in children and no studies exist from Central Asia. This study aims to assess whether the use of a CRP POCT can safely decrease prescription of antibiotics for children with acute respiratory symptoms in primary level healthcare centres in Kyrgyzstan.

Methods and analysis

Multicentre, open-label, individually randomised, controlled clinical trial with 14 days follow-up (follow-up by phone on days 3, 7 and 14) in rural lowland Chui and highland Naryn regions of Kyrgyzstan. The population are children aged 6 months to 12 years attending the primary level healthcare centres during normal business hours with acute respiratory symptoms. CRP POCT equipment will be supplied to healthcare centres, along with a short training session in CRP use, including the interpretation of results to support the clinical evaluation of the child with acute respiratory infection. The primary outcomes are the proportion of patients prescribed an antibiotic within 14 days of index consultation (superiority analysis) and days to recovery (non-inferiority analysis). Secondary outcomes are antibiotics prescribed at index consultation, reconsultations, hospital admission and vital status within 14 days. Analysis of the first primary outcome, antibiotic use, will be intention to treat using a logistic regression model. Analysis of the second primary outcome, days to recovery, will be per protocol using a linear regression model and a non-inferiority margin of 1 day.

Ethics and dissemination

The study was approved on 18 June 2021 by the Ethics Committee (ref: no. 1) of the National Centre of Maternity and Childhood Care, Bishkek, Kyrgyzstan. The results of the study regardless of the conclusion will be presented at international conferences and published in peer-reviewed scientific medical journals along with policy briefs and technical reports.

Trial registration number

NCT05195866.
Effects of oral immunonutritional supplement on 3-year disease-free survival in gastric cancer patients with pathological stage III after total gastrectomy (CRUCIAL): study protocol of a multicentre, randomised clinical trial
Authors: Zhou Da , Liu Yuxiu , Zhang Li , Lu Mengjie , Gao Xuejin , Li Guoli , Xiang Xiaosong , Xu Hao , Li Gang , Sun Zhiping , Wei Wei , Yi Kui , Zuo Junbo , Wu Yugang , Qian Jun , Zhou Jian , Duan Kaipeng , Wu Yong , Tian Zhiqiang , Jiang Chao , Wang Xinying
Published: April 2023

Introduction

The nutritional status of patients with gastric cancer (GC) after total gastrectomy continues to deteriorate and lasts a long time after discharge, which is an independent risk factor for mortality. Recent guidelines have recommended appropriate nutritional support after discharge for cancer surgery patients with malnutrition or nutritional risk. The evidence on the efficacy of oral immunonutritional supplement (INS) and its effect on long-term disease-free survival (DFS) in patients with GC is limited. This study was designed to test the hypothesis that oral INS compared to diet alone may improve 3-year DFS of GC patients with pathological stage III after total gastrectomy (Nutrition Risk Screening 2002 score ≥3 at discharge).

Methods and analysis

This is a pragmatic, open-label, multicentre, randomised controlled study. 696 eligible GC patients with pathological stage III after total gastrectomy will be randomised in a 1:1 ratio to oral INS group or normal diet group for 6 months. The primary endpoint is 3-year DFS after discharge. The following secondary endpoints will be evaluated: 3-year overall survival; unplanned readmission rate at 3 and 6 months after discharge; quality of life, body mass index and haematological index at 3, 6 and 12 months after discharge; incidence of sarcopenia at 6 and 12 months after discharge; and the tolerance to chemotherapy. The adverse events of oral INS will also be evaluated during the intervention.

Ethics and dissemination

This study was approved by the ethics committee of Jinling Hospital, Nanjing University (number 2021NZKY-069-01). The present study may validate the effectiveness of oral immunonutritional therapy in improving 3-year DFS for GC patients with pathological stage III after total gastrectomy for the first time. The results of this trial will be disseminated in peer-reviewed journals and at scientific conferences.

Trial registration number

NCT05253716.
GRACE-trial: a randomised active-controlled trial for vulvovaginal atrophy in patients with breast cancer on endocrine therapy – study protocol
Authors: Vergauwen Glenn , Cools Piet , Denys Hannelore , Fiers Tom , Van de Vijver Koen , Veldeman Liv , Verstraelen Hans
Published: April 2023

Introduction

Breast cancer is the most common cancer type in women worldwide. Due to hormone receptor positivity in the majority of the breast cancer tumours is endocrine therapy a crucial part in the treatment landscape of breast cancer. Endocrine therapy consists of the use of selective oestrogen-receptor modulators or aromatase inhibitors. These medicines generate a hypoestrogenic environment by reducing circulating oestrogen or by altering the effect of oestrogen on tissue cells by receptor blockade. As a common side effect, vulvovaginal atrophy occurs in the majority of patients with breast cancer using endocrine therapy. Vulvovaginal atrophy has a significant impact on physical and psychological well-being due to negative influence on quality-of-life, self-esteem and sexuality. As a consequence, adherence to endocrine therapy for the standard duration of 5–10 years is challenging, resulting in higher rates of therapy interruption, leading to poorer prognosis with shorter distant disease-free survival. The standard treatment for vulvovaginal atrophy in postmenopausal women is based on the use of local hormonal treatment. However, when a patient has a history of breast cancer, delay of treatment and undertreatment are ubiquitous.

Methods and analysis

In this first ever prospective randomised trial patients with breast cancer on endocrine therapy with vulvovaginal atrophy will be treated with the available local treatment modalities with a 1:1:1:1 randomisation: oestrogen, dehydroepiandrosterone, moisturisers and a co-treatment of oestrogen and probiotics. Patient-reported outcomes measurements will be implemented to investigate the efficacy of the implemented treatments. Safety of the treatments will be evaluated by assessing systemic sex hormones concentrations.

Ethics and dissemination

This study was approved by the Ethical Committee of Ghent University Hospital and by the Federal Agency for Medicines and Health Products. Results will be published in peer-reviewed journals and released in international conferences.

Trial registration number

2021-001921-31.
What learning strategies are commonly used by hospital pharmacists in the process of self-directed learning? A multicentre qualitative study
Authors: Yao Xiali , Li Hongye , Wen Linlin , Tian Yutong , Zhang Yan , Zhang Xiaojian , Du Shuzhang , Li Jun , Fu Hang , Yin Zhao
Published: April 2023

Objective

As lifelong learners, hospital pharmacists must continually improve their self-directed learning skills. Reasonable learning strategies have been proven to enhance self-directed learning (SDL) significantly. Therefore, this study aims to investigate the SDL strategies used by hospital pharmacists in depth to provide them with a reference for the development of their SDL skills.

Setting

The study was conducted in three tertiary hospitals in Henan, China.

Design and participants

This study employed a multicentre qualitative design and lasted 12 months. One-on-one interviews and focus group discussions were used to collect data. All interviews were transcribed verbatim, and the interview data were analysed using the thematic analysis method. Purposive sampling was used to select interviewees (n=17) from three tertiary hospitals in Henan province in central China.

Results

After conducting data analysis, we summarised 12 learning strategies related to SDL, which were grouped into four themes: use of information resources, application of cognitive strategies, development of learning plans and use of learning platforms.

Conclusion

The findings suggest that classic learning strategies, such as cognitive strategies and the development of learning plans, remain the cornerstones of hospital pharmacists’ SDL abilities, while contemporary advances in information technology and changes in learning concepts have enriched the learning resources and learning platforms that are available to hospital pharmacists and have confronted contemporary hospital pharmacists with certain challenges.
Clinical evidence for high-risk medical devices used to manage diabetes: protocol for a systematic review and meta-analysis
Authors: Bano Arjola , Laimer Markus , Wehrli Faina , Kunzler Juri , Rivero Tania , Fraser Alan G , Stettler Christoph , Hovorka Roman , Bally Lia
Published: April 2023

Introduction

Medical devices, including high-risk medical devices, have greatly contributed to recent improvements in the management of diabetes. However, the clinical evidence that is submitted for regulatory approval is not transparent, and thus a comprehensive summary of the evidence for high-risk devices approved for managing diabetes in Europe is lacking. In the framework of the Coordinating Research and Evidence for Medical Devices group, we will, therefore, perform a systematic review and meta-analysis, which will evaluate the efficacy, safety and usability of high-risk medical devices for the management of diabetes.

Method and analysis

This study has been reported according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will search Embase (Elsevier), Medline All (Ovid), Cochrane Library (Wiley), Science Citation Index Expanded and Emerging Sources Citation Index (Web of Science) to identify interventional and observational studies that evaluate the efficacy and/or safety and/or usability of high-risk medical devices for the management of diabetes. No language or publication dates’ limits will be applied. Animal studies will be excluded. In accordance with the Medical Device Regulation in European Union, high-risk medical devices are those in classes IIb and III. The following medical devices for diabetes management are considered as having a high risk: implantable continuous glucose monitoring systems, implantable pumps and automated insulin delivery devices. Selection of studies, data extraction and quality of evidence assessment will be performed independently by two researchers. Sensitivity analysis will be performed to identify and explain potential heterogeneity.

Ethics and dissemination

No ethical approval is needed for this systematic review, as it is based in already published data. Our findings will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42022366871.
Oncology mortality: weekend and summer vacation effect
Authors: Rakici Sema Yilmaz , Terzi Ozlem
Published: April 2023

Objectives

In this study, we investigated the effect of the weekend and summer vacation on mortality in patients with cancer.

Methods

All patient data were obtained from their hospital registry records and the Death Notification System of the Ministry of Health.

Results

The majority of patients died in the hospital compared at home, 80.8% versus 19.2%, respectively. Patients aged <65 died mostly in hospital, which was the opposite of those aged ≥65, who died at home. While tumour location and histopathological type had no effect on the place of death, patients with metastasis (including single organ metastasis), diffuse metastases (diffuse metastases: multiple organ metastases) and patients with locally advanced stage disease were found to die more frequently in the hospital. Deaths in the hospital occurred most frequently in August, while deaths at home occurred most frequently in April and October. Deaths in the hospital occurred most frequently on Friday, Saturday and Sunday, while deaths at home occurred more frequently on Monday. It was determined that the deaths in the hospital were significantly higher at the weekend.

Conclusion

This study contains data supporting the weekend effect in oncology patients. Moreover, it provides new data on the increased death rates in August, which coincides with the summer vacation leave month.
Transforming the management of colon injury: Dr Timothy C Fabian – scholar, scientist, leader, and teacher
Authors: Stewart Ronald M
Published: April 2023

Dr Fabian and his colleagues have transformed the management of colon injury during a span of more than four decades. They have done so by following a patient-centered, rigorous, and dogged approach to improving patient care and standardizing care with a simplified and widely applicable algorithm. All non-destructive colon injuries are primarily repaired. Healthy patients without massive blood loss who have sustained destructive wounds are treated with resection and anastomosis without fecal diversion. Patients with coexisting significant medical conditions or those requiring greater than 6 units of packed red blood cell(PRBC) transfusions are treated with resection and fecal diversion. Following this simple algorithm has led to a low rate of anastomotic leak with minimal colon-related morbidity in penetrating and blunt colon trauma and in those patients requiring abbreviated laparotomy/damage control procedures.

During his four decades in Memphis, Dr Fabian established, led, and developed a regional trauma system which transformed trauma care, significantly improving survival and minimizing disability of patients in the Memphis community and across the entire mid-South region.

I was fortunate to be a trauma and surgical critical care fellow 30 years ago in Memphis. As a leader, Dr Fabian gave us the freedom to pursue our own interests and explore ideas with full academic freedom with only one caveat—always do the right thing for our patient. A general principle championed by Dr Fabian is that patient care is not a means to some other goal (academic, reputational, or financial); no, serving the patient’s interests first is the reason we exist as surgeons and the reason why the trauma system exists. This human-centered approach was central to the Memphis approach to trauma care led by Timothy C Fabian and will live on in the work of those who are following his leadership.
Torsional dark energy in quadratic gauge gravity
Authors: van de Venn Armin , Vasak David , Kirsch Johannes , Struckmeier Jürgen
Published: April 2023

The covariant canonical gauge theory of gravity (CCGG) is a gauge field formulation of gravity which a priori includes non-metricity and torsion. It extends the Lagrangian of Einstein’s theory of general relativity by terms at least quadratic in the Riemann–Cartan tensor. This paper investigates the implications of metric compatible CCGG on cosmological scales. For a totally anti-symmetric torsion tensor we derive the resulting equations of motion in a Friedmann–Lemaître–Robertson–Walker (FLRW) Universe. In the limit of a vanishing quadratic Riemann–Cartan term, the arising modifications of the Friedmann equations are shown to be equivalent to spatial curvature. Furthermore, the modified Friedmann equations are investigated in detail in the early and late times of the Universe’s history. It is demonstrated that in addition to the standard $$\Lambda $$
Λ
CDM behaviour of the scale factor, there exist novel time dependencies, emerging due to the presence of torsion and the quadratic Riemann–Cartan term. Finally, at late times, we present how the accelerated expansion of the Universe can be understood as a geometric effect of spacetime through torsion, rendering the introduction of a cosmological constant redundant. In such a scenario it is possible to compute an expected value for the parameters of the postulated gravitational Hamiltonian/Lagrangian and to provide a lower bound on the vacuum energy of matter.
On the emergence of a classical isotropic universe from a quantum f(R) Bianchi cosmology in the Jordan frame
Authors: De Angelis Mariaveronica , Montani Giovanni
Published: April 2023

We demonstrate a spontaneous tendency of quantum wave packets to become quasi-classical, providing a classical limit for the Universe dynamics. However, this limit is not maintained in the future (after a critical value of the relational time) and a spreading process is turned on. We show that the onset of an inflationary scenario is not able to make this localization stable of the wave packets for the Bianchi I model. Instead, when we implement a perturbative inflationary scenario for the isotropic Universe a mechanism of stable classicalization of the Universe emerges. This result outlines a sharp difference between the standard relativistic cosmology and a modifiedf(R) paradigm.
INTERGENERATIONAL INCOME MOBILITY ACROSS THREE GENERATIONS: THE CASE OF TAIWAN
Authors: JIA ZHI-XIAO
Published: April 2023

This research analyzes intergenerational income mobility over three generations in Taiwan by estimating intergenerational income elasticity (IGE). Results indicate that IGE between fathers and sons is 0.349, and IGE between fathers and grandsons is 0.139. Fathers’ death during grandsons’ early ages does not affect IGE between them, and the independent effect of fathers’ income on grandsons’ income is weak. Roughly, 65% of IGE between fathers and grandsons is explained by sons’ couples’ income. Quantile results show that IGE between fathers and grandsons is stronger at upper tail of fathers’ income distribution, and it is especially strong for extremely rich grandsons.
Resource Allocation for 5G Network Considering Privacy Protection in Edge Computing Environment
Authors: Wang Li , Wang Xiaokai
Published: April 2023

In the field of Internet of Things, mobile communication will be deeply integrated with industrial construction, biomedicine, agricultural production, transportation and other industries to fully realize the “Internet of Everything” and realize smart city and sustainable development. This paper intends to solve problems in increasing latency and consumption of energy and security after deploying Mobile Edge Computing (MEC) servers in single cell multi-user network model, and has advocated a strategy of allocating the resources of 5G communication in regards to the protection mechanism for privacy in the environment of edge computing. First of all, solution model for the problem is characterized as a model with time delay and energy consumption. Second, privacy is used to measure the uncertainty of data in order to quantify privacy data while computing the allocation of tasks and facilitate the design of objective function. Finally, the task migration problem of minimizing energy consumption under the limitation of completion time is constructed as a nonlinear 0–1 programming problem. Besides, we design the optimal resource allocation strategy of discrete algorithm of binary particle swarm optimization (BPSO) for problem solution. Results indicate that while the quantity of users is 100, the total user expenditure of proposed method is 18.3J, which is lower than 20.0J and 30.7J of the compared methods. Moreover, the proposed method has lower latency and energy consumption, which can well balance the load of MEC servers.
FRACTAL DIMENSION VARIATION OF CONTINUOUS FUNCTIONS UNDER CERTAIN OPERATIONS
Authors: YU BINYAN , LIANG YONGSHUN
Published: April 2023

In this paper, we make research on the fractal structure of the space of continuous functions and explore how the fractal dimension of continuous functions under certain operations changes. We prove that any nonzero real power and the logarithm of a positive continuous function can keep the fractal dimensions of bi-Lipschitz invariance closed. For continuous functions having finite zero points, the relationship between its global behavior and the local behavior of its square on zero points has been given. Further, we discuss the fractal dimension of the product of continuous functions and provide the product decomposition of a continuous function in terms of the lower and upper box dimensions. Some special properties of the space of one-dimensional continuous functions have also been shown.
IN THE EYE OF THE STORM: UNCOVERING FRACTALITY IN GREEK BANK DEPOSITS DURING CRISIS
Authors: DAGLIS THEODOROS , CONSTANTOUDIS VASSILIOS , MICHAELIDES PANAYOTIS G.
Published: April 2023

In this work, we analyze the high-frequency time series of the deposits collected from the systemic biggest Greek banks during the recent economic crisis in Greece. Our focus has been to reveal hidden fractal and periodic patterns using a hybrid approach, which combines correlation and frequency analysis of the original and difference series in a synergistic manner. We find that during the first period of the recorded series featured by the dramatic decrease of deposits, the short time behavior exhibits Brownian motion characteristics with fractal dimension close to 1.5, while a cyclical pattern of monthly repetition (21 days) is detected in the difference series to bound fractal behavior. The Brownian property is also observed in the second uprising segment of deposit series, but it lasts more (50 days) and no well-defined cyclical pattern is detected. Our work reveals that the economic crisis in Greece has gradually eroded the cyclical behavior of daily differences in bank deposits, while maintaining a short-term Brownian motion pattern, albeit with an increased duration.
MATHEMATICAL MODELING OF STEM CELL THERAPY FOR LEFT VENTRICULAR REMODELING AFTER MYOCARDIAL INFARCTION
Authors: BÜYÜKKAHRAMAN MEHTAP LAFCI , CHEN-CHARPENTIER BENITO M. , LIAO JUN , KOJOUHAROV HRISTO V.
Published: April 2023

The heart is an organ with a limited capacity for regeneration and repair. In this paper, a new mathematical model is presented to study the left ventricular remodeling after myocardial infarction (MI) and followed stem cell therapeutic effort. The model represents the post-MI regeneration process of cardiomyocytes under stem cell therapy with oxygen restoration. The resulting system of nonlinear ordinary differential equations (ODE) is studied numerically in order to demonstrate the functionality and performance of the new model. The optimal time of stem cell injection for various oxygen restorations is determined. Moreover, the regeneration of cardiomyocytes is successfully correlated with improved left ventricle function observed in experiments. The proposed nonlinear ODE model is able to capture the complicated biological interactions in post-MI remodeling and can serve as a platform for in silico simulation and perturbation to optimize MI stem cell therapy.
CONTRAST-ENHANCED MICROTOMOGRAPHY FOR VOLUMETRIC ANALYSIS OF MICROSTRUCTURE IN LIGAMENTS AND TENDONS
Authors: BUSHARA FATEHIA , MAGLIO MELANIA , MARCHIORI GREGORIO , GIAVARESI GIANLUCA , SIGNORONI ALBERTO , GUERRINI FABRIZIO , LOPOMO NICOLA FRANCESCO
Published: April 2023

Tendons and ligaments play an important role to ensure mobility and stability. To correctly understand the characteristics of these fibrous collagenous connective tissues, it is fundamental to highlight their 3D microstructure. In this study a microtomography (microCT) system was used to acquire human hamstring tendons after performing specific preparations to enhance image contrast. Specifically, samples were treated either through chemical dehydration or by 2% of phosphotungstic acid ([Formula: see text]) in water ([Formula: see text]) or in 70% ethanol ([Formula: see text]) solution. Acquired images were elaborated using dedicated techniques based on 3D Hessian multiscale filter so as to highlight the fibrous structure and identify specific geometric features. For any strategy of sample preparation, the proposed approach resulted to be adequate for identifying fascicle features, thus obtaining structures with diameter in the range of 100–600 [Formula: see text] and proper longitudinal alignment. In conclusion, a novel contrast enhancement microCT protocol was designed and preliminarily validated for the microstructural analysis of fibrous tissues.