bluuebunny/crossref_metadata_2025 huggingface dataset:
Digital Defiance’s Affecting Use of Information Communication Technology Deployed for Prevention and Detection of Crime in Community Policing in Malawi
Authors: Kumwenda David , Tembo Mavuto , Mphande Chrispin , Nundwe Vincent , Chazema Thokozani
Published: July 2024

ICTs digital space has modernized citizen socialization amongst citizens to enhance security and is augmenting for lack of resource constraints as well as promoting less agents on ground thereby strengthening internal security through community policing. Availability of ICT gadgets, applications, and initiatives make simple and influential crime reporting and crime control. This study examines factors that affect the use of information communication technology deployed for crime prevention and detection in community policing. Mixed methods exploratory sequential design was used to collect data. Qualitative purposive sampling targeted four focus group discussions of 10 participants each and one key informant interview of 10 participants, interview guide instrument was utilized. Quantitative household survey used Yamene (1969) formular to identify 432 respondents who were randomly distributed into 10 locations of Muloza and used structured questionnaire. Qualitative data analysis follows transcribing, coding, and grouping into sub-themes, themes that answer research objectives aided by NVivo application. Quantitative analysis used descriptive statistics in SPSS version 20. Under pragmatics paradigm guided by democratic participation, social-disorganization and broken window theories, results show that the majority of ICTs are mobile telephones, which play an important role in the storage, dissemination, and replication of security information in community policing. Dominated by married persons at 56.5% in the youth category of 57.2% respondents. The police are faced with the technical challenge of installing and maintaining ICTs. The police have no ICT resources deployed for the prevention, detection, and investigation of crime in Muloza. Hence, the police rely on personal mobile phones, which are operated on do it yourself as convenience by victim or law enforcement agent to follow an issue. Regression when tested at confidence interval 95.0% showed that some factors have significance value on use of ICTs deployed for prevention and detection of crime in community policing (i) Age at p=.001 (ii) Education at p=.000 (iii) Income at p=.000 (iv) Knowledge expertise at p=.000 (v) Cost of accessing technologies at p=.009 and (vi) Trust issues between police and people at p=.009. The importance of ICTs is that they have revolutionized monitoring and surveillance that may improve prevention, detection, and investigation of crime in community policing, and allow for storage, dissemination, and replication of security information. Proper use of ICTs for prevention and detection of crime may improve police investigations. Citizens’ wide use of ICTs in formal and non-formal ways may help reduce corruption through wide information storage replication and dissemination.
Phenotypic Analysis of Native Goats Suitable for Export at the Organic and Akseker Slaughter Houses for the Purpose of Meat Consumption in Modjo Town, Ethiopia
Authors: Alkadir Gebeyehu , Assefa Dejen
Published: July 2024

This study was conducted in Organic and Akseker Export abattoirs of Modjo district of Eastern Shoa zone of central Ethiopia with the aim of phenotypic evaluations of indigenous goats exportable to Akseker and Organic Export abattoirs of Modjo modern export abattoirs aimed at improving the community-based breeding strategies of indigenous goats and their phenotypic traits exported to export abattoirs for meat consumption. A total of 200 goats from both export abattoirs were sampled randomly for phenotypic evaluations. Length, weight, height, and heart girth of the animal were measured for each goat exported to both abattoirs. The results show that significantly (P<0.05) presence of clear phenotypic variations between and within these indigenous goats exportable to Akseker export abattoirs whereas heart girth significantly (P<0.05) increased by 20.271 (CM) the length, weight (KG) and height increases by (0.163 CM), (0.256 KG) and (0.479 CM) respectively. However, there is no evidence showing any association with sex, age, body condition, and age of animals. The examined phenotypic parameters of goats exported to organic export abattoirs were measured but there is no-showed significant (P-value >0.05) association between and within heart girth, height, and body length of the goats except for the high level of significant variations (P<0.05) between hearth girth on body weights which says when heart girth increases by 7.26 (CM) centimeters, the body weight significantly with P value (0.001) increases by 1.92 (Kg) kilograms. In conclusion, to sustainably utilize these goat populations the production constraints should be solved and selective community-based breeding strategies should be designed and well implemented.
Neurobehavioral Changes Resulting from Recurrent Head Injuries
Authors: Mogallapu Raja , Chudasama Ravirajsinh , King Madelynne , Bosley Julie , Ang-Rabanes Michael , Toolan Carla
Published: July 2024

In recent years, there has been a significant focus on the potential link between traumatic brain injury (TBI) due to recurrent head injuries (RHI) and the development of Traumatic Encephalopathy Syndrome (TES), whichcould lead to chronic traumatic encephalopathy (CTE). Recurrent head injuries may cause neurobehavioral changes, significantly impacting an individual's cognitive and behavioral functioning. These changes can lead to various challenges, including difficulties in social interactions, work performance, and overall quality of life. CTE is a progressive disease characterized by Axonal injury tau neurofibrillary tangles (NFTs) and, in some cases, transactive response DNA binding protein 43 (TDP43). This case report discusses a patient who experienced auditory verbal hallucinations (AVH) and cognitive symptoms with behavioral issues due to recurrent RHI. The aim is to investigate this presentation further to examine the relationship between recurrent head injury (RHI) and chronic traumatic encephalopathy (CTE) and to understand the psychological impact of physical brain trauma. A 43-year-old white male with a history of RHI from multiple sports-related concussions was admitted to the psychiatric unit for cognitive difficulties with auditory verbal hallucinations and associated mood symptoms for the past four years, impacting both his sleep and productivity at work. This article will discuss the different types of auditory hallucinations seen in patients with RHI and CTE, along with exploring the evidence to support our determination due to repeated RHI, which led to symptomatology suggestive of CTE. Differential diagnoses will be considered, and evidence is provided to rule them out based on the patient's history. This case report underscores the diagnostic challenges associated with CTE, which can manifest with a spectrum of psychiatric symptoms encompassing mood, cognition, and behavior. The medical diagnosis of Chronic Traumatic Encephalopathy (CTE) in living patients is still a challenge, as effective biomarkers for this condition have yet to be discovered. Although research diagnostic criteria have been proposed, there is no definitive way to diagnose CTE in living patients. Therefore, further investigation is necessary to develop accurate diagnostic tools and effective treatments for CTE.
Husbandry Practices of Indigenous Goats Types in South West Shewa Zone, Oromia, Ethiopia
Authors: Elala Murtessa , Getachew Tesfaye , Woyamo Wondimu
Published: July 2024

This study was conducted in South west Shewa zone, to identify Husbandry practices in Tole and Becho districts. Data were collected through questionnaire and, focal group discussion. A total of 180 households were selected for interview. Data collected via questionnaire were summarized with descriptive statistics and analyzed using SPSS, V.21. Chi–square test was employed for categorical data. Indices were calculated to provide ranking. Castration was primarily practiced to improve the fattening potential and acquire better price by selling fattened goats. Most of castration carried out at the age of >6months. Majority of respondents use shelter constructed in the main house and the remaining respondents use separate house. The primary feed resource during dry season was natural pasture followed by Shrubs and during wet season the primary feed resource was Shrubs and bushes followed by natural pasture. Majority of the respondents herd their goats separated from kids adult mainly to protect kids from attack by predators and to protect the does from losing their weight. The primary source of water during dry season River followed by spring and the primary source of water during wet season was Rain water followed by river. The primary disease affects goats were Orf followed by Foot root. The primary cause of death for goats was disease followed by accident. Generally, goats play a significant role for farmers as source of income generation and home consumption throughout the year. The primary feed resource during dry season was natural pasture followed by Shrubs, to increase production productive the goats in the study its better if focused on improving feed source and concentrated feed.
Cancer Mortality Surges Post COVID ModRNA Vaccination Ronald Palacios Castrillo
Authors: Castrillo Ronald
Published: July 2024

Recent investigations have revealed a concerning association between the administration of the third dose of the ModRNA COVID-19 vaccine and statistically significant increases in cancer mortality rates. A study conducted in Japan highlighted this correlation, noting a marked rise in cancer-related deaths post-vaccination. This phenomenon is not isolated to Japan; similar trends have been observed in Europe, Australia, and the USA, with an excess of deaths reported from 2020 to 2023 compared to 2019. In this review, we explore seven potential mechanisms through which ModRNA COVID-19 vaccines may contribute to the initiation and progression of cancer. Each mechanism is discussed in detail, with a focus on the underlying molecular and cellular pathways. The potential for varied combinations of these mechanisms to influence different cancer types is also considered, providing a comprehensive overview of how ModRNA vaccines might impact cancer biology. Our analysis underscores the necessity for further research to elucidate the precise relationship between ModRNA COVID-19 vaccination and cancer progression. Understanding these mechanisms is critical for developing strategies to mitigate potential adverse effects while harnessing the benefits of vaccination.
Modulation of Wide Voltage Range Interface DC-DC Converter in DC Distribution System
Authors: Zhang Dezhen , Ouyang Zhen , Ma Wei , Shen Xiang , Lv Jinwei , Zou Yangxin
Published: July 2024

Bipolar DC distribution systems rely on various power sources like photovoltaics and distributed energy storage, each with its unique voltage characteristics. To accommodate these fluctuations, interface converters must adjust over a wide voltage range. The bipolar non-isolated DC-DC converter emerges as a promising solution due to its versatile modulation capabilities, reduced switch voltage stress, and cost-effectiveness. This article explores how wide voltage range regulation is achieved in bipolar DC-DC converters interfacing with bipolar DC power grids. It delves into the operational strategies and modulation techniques employed, ensuring stable output despite varying input voltages. Design considerations and challenges associated with implementing such converters are also discussed. An experimental platform was constructed to validate the proposed methodology. Through rigorous testing and analysis, the effectiveness of the topology's operation mode was confirmed. Real-world data from the experimental setup provided insights into the converter's performance under different operating conditions, supporting its applicability for bipolar DC distribution systems. In summary, this article provides a comprehensive examination of wide voltage range regulation in bipolar DC-DC converters, highlighting their potential to enhance efficiency and reliability in bipolar DC power grids. Through theoretical discussions and practical validation, it contributes to the advancement and adoption of these converters in modern energy systems.
Research on the Impact of gGreen Human Hesource Management on Employees' Organizational Citizenship Behavior of Internet Enterprises
Authors: Liu Yonghan , Zhang Yufeng , Cui Zichen , Zhang Jiahui , Yang Zihan , Li Zhihong
Published: July 2024

In the context of the current era of sustainable development, green human resource management has become a hot topic of concern among enterprises. Green human resources are the driving force for the development of enterprises, and the strong initiative and creativity of employees can better serve the enterprise, promote the efficient, sustainable and healthy development of the enterprise, and promote the common progress of employees and the enterprise. In order to effectively promote the sustainable development of green human resources and expand the influence and effectiveness of green human resources, this project collects the working environment, training programs, performance appraisal programs and incentive policies under green human resource management through online questionnaires, field visits and face-to-face interviews, and studies green human resource management and employees' spontaneous changes within the organization, such as the improvement of employees' loyalty to the enterprise, The relationship between organizational citizenship behaviors such as performance level growth will further explore the impact of green human resource management on the organizational citizenship behaviors of employees in Internet enterprises.
Evaluation of the Pilot Test Effect of Steam Stimulation in Horizontal Wells of Sand Bodies 1-1308 in Bohai L Oilfield
Authors: Chai Shichao , Lian Zhengxin , Zheng Jianjun , Li Enlin
Published: July 2024

In order to reduce the risk of large-scale thermal recovery of heavy oil in Bohai Oilfield, L Oilfield is selected to carry out horizontal well steam stimulation pilot tests. Previous studies have summarized the rationality of the injection parameters and initial production characteristics of this experiment, but the evaluation of its development effectiveness is still blank. Based on the study of the decline law of A23H well cold recovery using reservoir engineering methods, this article evaluates the initial production capacity, production increase effect, technical recoverable reserves, and throughput cycles of steam stimulation. The results show that the thermal recovery production of steam stimulation is three times that of cold recovery, which can significantly improve the production capacity of a single well. The initial daily oil production of two wells is 74m3/d and 90m3/d, respectively, which is 3.0 times and 3.6 times that of the initial production of cold recovery, exceeding the design level of the reservoir; The first round has the best yield increase effect, with an average daily oil increase of 31m3/d, and gradually decreasing thereafter. By the fifth round, it was only 13m3/d. In terms of yield increase multiples, each round can reach about 2 times; The technically recoverable reserves are 19.03 × 104m3, requiring 8-9 rounds. Through this performance evaluation, we have strengthened our confidence in promoting the application of steam injection technology in Bohai Oilfield to achieve large-scale thermal recovery.
Research Progress of Immune Checkpoint Inhibitors in Small Cell Lung Cancer
Authors: Han Han , Chen Yuchen , Wang Xiyong
Published: July 2024

Small cell lung cancer has high malignant degree, rapid progression and poor prognosis, and has lacked effective treatment strategies for a long time. In the past, the treatment strategy for small cell lung cancer has been dominated by chemotherapy and radiotherapy, and although first-line treatment is highly effective, the vast majority of patients will relapse and become resistant within a year.In recent years, the application and research of immune checkpoint inhibitors in small cell lung cancer have been increasing, bringing new hope for survival of small cell lung cancer patients, multiple clinical trials have demonstrated long-lasting efficacy and clinical activity of programmed death receptor/ligand-1 and cytotoxic T lymphocyte antigen-4 in small cell lung cancer. The main immune checkpoint inhibitors that have been well studied in small cell lung cancer are Nivolumab, Pembrolizumab, Serplulimab, Tislelizumab, Atezolizumab, Durvalumab, Adebrelimab and Ipilimumab. In this paper, the research progress of these drugs is reviewed, and the research progress of the combined application of immune checkpoint inhibitors with chemotherapy, radiotherapy, PARP inhibitors, WEE1 inhibitors, etc. The final results showed that immune checkpoint inhibitors brought survival benefits to patients with small cell lung cancer. However, due to the particularity of this disease, the survival time is still shorter than that of non-small cell lung cancer. It is expected that follow-up studies can further extend the survival time of patients.
Probabilistic Neural Networks for Ensemble Postprocessing
Authors: Liu Pu , Dabernig Markus , Atencia Aitor , Wang Yong , Zhao Yuchu
Published: July 2024

Accurate temperature forecasts are critical for various industries and sectors. We propose a probabilistic neural network (PNN), an extension of the distributional regression network (DRN), for 2-m temperature forecasts, consisting of three variants with different inputs and target variables. The first variant, standardized anomaly probabilistic neural network (SAPNN), employs a two-step approach involving standardized anomalies and global PNN modeling to effectively capture underlying features and anomalies. The second variant, PNN with geographical predictors (PNNGE), incorporates raw and static geographical predictors to enhance predictive performance. The third variant, PNN with station one-hot encoding (PNNEN), utilizes raw with station one-hot encoding predictors to represent geographical information effectively. We compare three PNN variants with two benchmarks: 1) standardized anomaly model output statistics (SAMOS) and 2) three DRN variants identical to those applied to PNN. These evaluations utilize ECMWF data from 2019 to 2020 at 6-h intervals up to 72 h over Hebei, China. Results show that SAPNN and PNNGE are better than SAMOS, while PNNEN notably exhibits a significant 14% improvement in the continuous ranked probability skill score (CRPSS). Moreover, the PNN variants exhibit comparable or superior performance to DRN regarding forecast accuracy, CRPSS, and reliability, showcasing a better-calibrated spread–error relationship. This study highlights the value of the proposed PNN variants with a distribution output in capturing nonlinear relationships within different sources of predictors and improving temperature forecast skills.

Significance Statement

This study aims to improve the accuracy, skills, and reliability of 2-m temperature forecasts, which are crucial in agriculture and energy management. To achieve this, we extend a popular artificial intelligence framework and explore four data sources with two schemes to systematically compare the predictive performances in making temperature forecasts. The findings of this research are vital as they offer novel ways to improve forecast skills. Imagine having a weather app that is significantly more accurate, enabling you to plan your day better. This study is about discovering innovative approaches to enhance forecast skills and reliability, which could benefit various aspects of our daily lives. One of the new methods even exhibits a 14% improvement in forecast skills.
Exploring NWS Forecasters’ Assessment of AI Guidance Trustworthiness
Authors: Cains Mariana G. , Wirz Christopher D. , Demuth Julie L. , Bostrom Ann , Gagne David John , McGovern Amy , Sobash Ryan A. , Madlambayan Deianna
Published: July 2024

As artificial intelligence (AI) methods are increasingly used to develop new guidance intended for operational use by forecasters, it is critical to evaluate whether forecasters deem the guidance trustworthy. Past trust-related AI research suggests that certain attributes (e.g., understanding how the AI was trained, interactivity, and performance) contribute to users perceiving the AI as trustworthy. However, little research has been done to examine the role of these and other attributes for weather forecasters. In this study, we conducted 16 online interviews with National Weather Service (NWS) forecasters to examine (i) how they make guidance use decisions and (ii) how the AI model technique used, training, input variables, performance, and developers as well as interacting with the model output influenced their assessments of trustworthiness of new guidance. The interviews pertained to either a random forest model predicting the probability of severe hail or a 2D convolutional neural network model predicting the probability of storm mode. When taken as a whole, our findings illustrate how forecasters’ assessment of AI guidance trustworthiness is a process that occurs over time rather than automatically or at first introduction. We recommend developers center end users when creating new AI guidance tools, making end users integral to their thinking and efforts. This approach is essential for the development of useful and used tools. The details of these findings can help AI developers understand how forecasters perceive AI guidance and inform AI development and refinement efforts.

Significance Statement

We used a mixed-methods quantitative and qualitative approach to understand how National Weather Service (NWS) forecasters 1) make guidance use decisions within their operational forecasting process and 2) assess the trustworthiness of prototype guidance developed using artificial intelligence (AI). When taken as a whole, our findings illustrate that forecasters’ assessment of AI guidance trustworthiness is a process that occurs over time rather than automatically and suggest that developers must center the end user when creating new AI guidance tools to ensure that the developed tools are useful and used.
Deletion of GPR81 activates CREB/Smad7 pathway and alleviates liver fibrosis in mice
Authors: Zhi Ying , Fan Kerui , Liu Shuang , Hu Kai , Zan Xinyan , Lin Ling , Yang Yongqiang , Gong Xianqiong , Chen Kun , Tang Li , Li Longjiang , Huang Jiayi , Zhang Shujun , Zhang Li
Published: July 2024

Background

Enhanced glycolysis is a crucial metabolic event that drives the development of liver fibrosis, but the molecular mechanisms have not been fully understood. Lactate is the endproduct of glycolysis, which has recently been identified as a bioactive metabolite binding to G-protein-coupled receptor 81 (GPR81). We then questioned whether GPR81 is implicated in the development of liver fibrosis.

Methods

The level of GPR81 was determined in mice with carbon tetrachloride (CCl4)-induced liver fibrosis and in transforming growth factor beta 1 (TGF-β1)-activated hepatic stellate cells (HSCs) LX-2. To investigate the significance of GPR81 in liver fibrosis, wild-type (WT) and GPR81 knockout (KO) mice were exposed to CCl4, and then the degree of liver fibrosis was determined. In addition, the GPR81 agonist 3,5-dihydroxybenzoic acid (DHBA) was supplemented in CCl4-challenged mice and TGF-β1-activated LX-2 cells to further investigate the pathological roles of GPR81 on HSCs activation.

Results

CCl4 exposure or TGF-β1 stimulation significantly upregulated the expression of GPR81, while deletion of GPR81 alleviated CCl4-induced elevation of aminotransferase, production of pro-inflammatory cytokines, and deposition of collagen. Consistently, the production of TGF-β1, the expression of alpha-smooth muscle actin (α-SMA) and collagen I (COL1A1), as well as the elevation of hydroxyproline were suppressed in GPR81 deficient mice. Supplementation with DHBA enhanced CCl4-induced liver fibrogenesis in WT mice but not in GPR81 KO mice. DHBA also promoted TGF-β1-induced LX-2 activation. Mechanistically, GPR81 suppressed cAMP/CREB and then inhibited the expression of Smad7, a negative regulator of Smad3, which resulted in increased phosphorylation of Smad3 and enhanced activation of HSCs.

Conclusion

GPR81 might be a detrimental factor that promotes the development of liver fibrosis by regulating CREB/Smad7 pathway.
gcplyr: an R package for microbial growth curve data analysis
Authors: Blazanin Michael
Published: July 2024

Background

Characterization of microbial growth is of both fundamental and applied interest. Modern platforms can automate collection of high-throughput microbial growth curves, necessitating the development of computational tools to handle and analyze these data to produce insights.

Results

To address this need, here I present a newly-developed R package: gcplyr. gcplyr can flexibly import growth curve data in common tabular formats, and reshapes it under a tidy framework that is flexible and extendable, enabling users to design custom analyses or plot data with popular visualization packages. gcplyr can also incorporate metadata and generate or import experimental designs to merge with data. Finally, gcplyr carries out model-free (non-parametric) analyses. These analyses do not require mathematical assumptions about microbial growth dynamics, and gcplyr is able to extract a broad range of important traits, including growth rate, doubling time, lag time, maximum density and carrying capacity, diauxie, area under the curve, extinction time, and more.

Conclusions

gcplyr makes scripted analyses of growth curve data in R straightforward, streamlines common data wrangling and analysis steps, and easily integrates with common visualization and statistical analyses.
Comparative proteomics in tall fescue to reveal underlying mechanisms for improving Photosystem II thermotolerance during heat stress memory
Authors: Wang Guangyang , Wang Xiulei , Li Dongli , Yang Xuehe , Hu Tao , Fu Jinmin
Published: July 2024

Background

The escalating impacts of global warming intensify the detrimental effects of heat stress on crop growth and yield. Among the earliest and most vulnerable sites of damage is Photosystem II (PSII). Plants exposed to recurring high temperatures develop heat stress memory, a phenomenon that enables them to retain information from previous stress events to better cope with subsequent one. Understanding the components and regulatory networks associated with heat stress memory is crucial for the development of heat-resistant crops.

Results

Physiological assays revealed that heat priming (HP) enabled tall fescue to possess higher Photosystem II photochemical activity when subjected to trigger stress. To investigate the underlying mechanisms of heat stress memory, we performed comparative proteomic analyses on tall fescue leaves at S0 (control), R4 (primed), and S5 (triggering), using an integrated approach of Tandem Mass Tag (TMT) labeling and Liquid Chromatography-Mass Spectrometry. A total of 3,851 proteins were detected, with quantitative information available for 3,835 proteins. Among these, we identified 1,423 differentially abundant proteins (DAPs), including 526 proteins that were classified as Heat Stress Memory Proteins (HSMPs). GO and KEGG enrichment analyses revealed that the HSMPs were primarily associated with the “autophagy” in R4 and with “PSII repair”, “HSP binding”, and “peptidase activity” in S5. Notably, we identified 7 chloroplast-localized HSMPs (HSP21, DJC77, EGY3, LHCA4, LQY1, PSBR and DEGP8, R4/S0 > 1.2, S5/S0 > 1.2), which were considered to be effectors linked to PSII heat stress memory, predominantly in cluster 4. Protein-protein interaction (PPI) analysis indicated that the ubiquitin-proteasome system, with key nodes at UPL3, RAD23b, and UCH3, might play a role in the selective retention of memory effectors in the R4 stage. Furthermore, we conducted RT-qPCR validation on 12 genes, and the results showed that in comparison to the S5 stage, the R4 stage exhibited reduced consistency between transcript and protein levels, providing additional evidence for post-transcriptional regulation in R4.

Conclusions

These findings provide valuable insights into the establishment of heat stress memory under recurring high-temperature episodes and offer a conceptual framework for breeding thermotolerant crops with improved PSII functionality.
Prior emergency medical services utilization is a risk factor for in-hospital death among patients with substance misuse: a retrospective cohort study
Authors: Gupta Preeti , Mayampurath Anoop , Gruenloh Tim , Oguss Madeline , Afshar Askar Safipour , Spigner Michael , Gussick Megan , Churpek Matthew , Lee Todd , Afshar Majid
Published: July 2024

Background

Substance misuse poses a significant public health challenge, characterized by premature morbidity and mortality, and heightened healthcare utilization. While studies have demonstrated that previous hospitalizations and emergency department visits are associated with increased mortality in patients with substance misuse, it is unknown whether prior utilization of emergency medical service (EMS) is similarly associated with poor outcomes among this population. The objective of this study is to determine the association between EMS utilization in the 30 days before a hospitalization or emergency department visit and in-hospital outcomes among patients with substance misuse.

Methods

We conducted a retrospective analysis of adult emergency department visits and hospitalizations (referred to as a hospital encounter) between 2017 and 2021 within the Substance Misuse Data Commons, which maintains electronic health records from substance misuse patients seen at two University of Wisconsin hospitals, linked with state agency, claims, and socioeconomic datasets. Using regression models, we examined the association between EMS use and the outcomes of in-hospital death, hospital length of stay, intensive care unit (ICU) admission, and critical illness events, defined by invasive mechanical ventilation or vasoactive drug administration. Models were adjusted for age, comorbidities, initial severity of illness, substance misuse type, and socioeconomic status.

Results

Among 19,402 encounters, individuals with substance misuse who had at least one EMS incident within 30 days of a hospital encounter experienced a higher likelihood of in-hospital mortality (OR 1.52, 95% CI [1.05 – 2.14]) compared to those without prior EMS use, after adjusting for confounders. Using EMS in the 30 days prior to an encounter was associated with a small increase in hospital length of stay but was not associated with ICU admission or critical illness events.

Conclusions

Individuals with substance misuse who have used EMS in the month preceding a hospital encounter are at an increased risk of in-hospital mortality. Enhanced monitoring of EMS users in this population could improve overall patient outcomes.
Development of training program for the Eye, Ear, Nose, and Throat emergency nurses in China based on core competency: a Delphi study
Authors: Hu Yanqiu , Wang Fang , Cao Wenzhu , Gui Chunyi
Published: July 2024

Background

Nursing work in the Eye, Ear, Nose, and Throat (EENT) emergency department is highly specialised and faces significant challenges. Therefore, a high level of nursing competence is necessary for nurses. To develop core competencies, a systematic and standardised training program is required. This study aims to construct a standardised, systematic, and professional training program for nurses working in the EENT emergency department in China.

Methods

Based on a literature review and semi-structured interviews, the training scheme draft was developed according to the theoretical framework of core competency for emergency nurses. From July 2023 to October 2023, a total of 21 experts including clinical experts, and nursing experts were selected to conduct 2 rounds of Delphi consultation to construct the training program for EENT emergency nurses.

Results

The effective response rate for 2 rounds of expert consultation was 100%. The expert authority coefficient was 0.905, and Kendall’s W coefficients were found to be 0.359 and 0.340, respectively. The coefficients of variation for each item of the second round of expert consultation ranged from 0 to 0.19. The finalised training program for EENT emergency nurses consisted of 4 first-level indexes (training objectives, training management, training contents, and training assessment). The training objectives included 3 secondary indicators and 16 tertiary indicators. Training management included 5 secondary indicators and 8 tertiary indicators. Training contents included 4 secondary indicators and 16 tertiary indicators. Training assessment included 3 secondary indicators and 6 tertiary indicators.

Conclusion

This study systematically and comprehensively explores the cultivation of nurses working in the EENT emergency department from the aspects of training objectives, training management, training contents, and training assessment. This training program is based on the theoretical framework of core competency standards for emergency nurses. It is in line with the actual needs of the clinic, and the training program is scientific and reliable, which can be promoted nationwide to provide a reference basis for the improvement of the training of emergency specialist nurses.

Trial registration

Not applicable.
Evaluation of the sentinel yellow fever surveillance system in Uganda, 2017–2022: strengths and weaknesses
Authors: Wanyana Mercy Wendy , King Patrick , Migisha Richard , Kwesiga Benon , Okello Paul Edward , Kadobera Daniel , Bulage Lilian , Kayiwa Joshua , Nankya Annet Martha , Ario Alex Riolexus , Harris Julie R.
Published: July 2024

Background

Uganda has a sentinel surveillance system in seven high-risk sites to monitor yellow fever (YF) patterns and detect outbreaks. We evaluated the performance of this system from 2017 to 2022.

Methods

We evaluated selected attributes, including timeliness (lags between different critical time points), external completeness (proportion of expected sentinel sites reporting ≥ 1 suspect case in the system annually), and internal completeness (proportion of reports with the minimum required data elements filled), using secondary data in the YF surveillance database from January 2017–July 2022. We conducted key informant interviews with stakeholders at health facility and national level to assess usefulness, flexibility, simplicity, and acceptability of the surveillance system.

Results

In total, 3,073 suspected and 15 confirmed YF cases were reported. The median time lag from sample collection to laboratory shipment was 37 days (IQR:21–54). External completeness was 76%; internal completeness was 65%. Stakeholders felt that the surveillance system was simple and acceptable, but were uncertain about flexibility. Most (71%) YF cases in previous outbreaks were detected through the sentinel surveillance system; data were used to inform interventions such as intensified YF vaccination.

Conclusion

The YF sentinel surveillance system was useful in detecting outbreaks and informing public health action. Delays in case confirmation and incomplete data compromised its overall effectiveness and efficiency.
Prevalence and mechanisms of aminoglycoside resistance among drug-resistant Pseudomonas aeruginosa clinical isolates in Iran
Authors: Saeli Nilofar , Jafari-Ramedani Saghar , Ramazanzadeh Rashid , Nazari Maryam , Sahebkar Amirhossein , Khademi Farzad
Published: July 2024

Background

Aminoglycosides have been a cornerstone of the treatment of nosocomial infections caused by Pseudomonas aeruginosa for over 80 years. However, escalating emergence of resistance poses a significant challenge. Therefore, this study aimed to investigate the prevailing patterns of aminoglycoside resistance among clinical isolates of P. aeruginosa in Iran; as well as the underlying resistance mechanisms observed in patients referred to Ardabil hospitals.

Methods

A total of 200 isolates from five hospitals were evaluated. The resistance profiles of P. aeruginosa isolates to tobramycin, amikacin, and netilmicin were determined using the disk diffusion method. The capacity of aminoglycoside-resistant isolates to form biofilms was assessed through a phenotypic assay, and the results were confirmed using the gene amplification technique. The presence of genes associated with aminoglycoside resistance was detected using polymerase chain reaction (PCR). Quantitative reverse transcription PCR (qRT-PCR) was performed to measure the expression levels of genes encoding the MexXY-OprM efflux pump and PhoPQ two-component system (TCS).

Results

The prevalence of aminoglycoside-resistant P. aeruginosa isolates was 48%, with 94.7% demonstrating multidrug resistance (MDR). All aminoglycoside-resistant P. aeruginosa strains exhibited biofilm-forming capabilities and harbored all the genes associated with biofilm production. Among the nine genes encoding 16S rRNA methylase and aminoglycoside-modifying enzymes, three genes were detected in these isolates: aac(6’)-Ib (85.4%), ant(2’’)-Ia (18.7%), and aph(3’)-VI (3.1%). Additionally, all aminoglycoside-resistant P. aeruginosa isolates carried mexY and phoP genes, although the expression levels of mexY and phoP were 75% and 87.5%, respectively.

Conclusion

Given the considerably high prevalence of aminoglycoside-resistant P. aeruginosa strains, urgent measures are warranted to transition towards the use of novel aminoglycosides and to uphold vigilant surveillance of resistance patterns.
‘A lightbulb moment’: carers’ experiences of behavioural symptoms in motor neurone disease before and after MiNDToolkit
Authors: Mioshi Eneida , Heal Sue , Katangwe-Chigamba Thando
Published: July 2024

Background

To explore carers’ experiences of behavioural symptoms in Motor Neurone Disease (MND), before and after using the MiNDToolkit, a novel internet-based psychoeducational intervention to support management of behavioural symptoms (BehSymp) in MND. The study also investigated carers’ views and acceptability of MiNDToolkit.

Methods

A qualitative process evaluation of carers engagement with, and acceptability of, the MiNDToolkit conducted using semi-structured interviews with carers (n = 11). All interviews were audio-recorded, professionally transcribed verbatim and analysed thematically.

Results

Five themes were identified: (1) In the dark: carers’ experiences and reactions to BehSymp; (2) Others can see: the role of HCPs in identifying symptoms – and perceived opportunities for carers to receive support; (3) Shedding light: carers implementation and perceived impact of the MiNDToolkit content; (4) Acceptability and carers’ engagement with MiNDToolkit; (5) Future implementation. Carers’ experience of BehSymp was particularly distressing when symptoms were apparently out of context. MiNDToolkit appeared to support learning that BehSymp were part of MND. Content resonated with carers, who reported learning about the full picture of MND, which led to acceptance and use of newly learned strategies. Engagement with the platform was good, with varied input from HCPs. Greater and nuanced involvement from HCPs seem important to support management of BehSymp. Recommendations for a full-scale trial emerged, including adding a paper booklet to accompany the intervention and creation of new modules on emotional lability, changes in relationships, and transitioning to a care home.

Conclusions

MiNDToolkit was acceptable to carers overall. Recommended improvements should be actioned in a full-scale trial.
Meta-analysis of intrauterine hCG perfusion efficacy in recurrent implantation failure as defined by ESHRE guidelines
Authors: Luo Xi , Wu Yuerong , Xu Yongfang , Rong Lujuan , Liu Xiaoping , Zhou Xiaoting , Bai Yun , Wu Ze
Published: July 2024

Purpose

This study evaluates the efficacy of intrauterine hCG perfusion for RIF, as defined by ESHRE 2023 guidelines, highlighting hCG as a cost-effective alternative to other immunotherapies, especially suitable for less developed regions. It aims to clarify treatment guidance amidst previous inconsistencies.

Methods

This meta-analysis, registered with PROSPERO (CRD42024443241) and adhering to PRISMA guidelines, assessed the efficacy and safety of intrauterine hCG perfusion in enhancing implantation and pregnancy outcomes in RIF. Comprehensive literature searches were conducted through December 2023 in major databases including PubMed, Web of Science, Embase, the Cochrane Library, and key Chinese databases, without language restrictions. Inclusion and exclusion criteria were strictly aligned with the 2023 ESHRE recommendations, with exclusions for studies lacking robust control, clear outcomes, or adequate data integrity. The risk of bias was evaluated using the Newcastle-Ottawa Scale, ROBINS-I, and RoB2 tools. Data analysis was performed in R using the ‘meta’ package, employing both fixed and random effect models to account for study variability. Subgroup analyses by dosage, volume, hCG concentration, timing of administration, and type of embryo transfer were conducted to deepen insights, enhancing the reliability and depth of the meta-analysis in elucidating the role of hCG perfusion in RIF treatments.

Results

Data from 13 studies, comprising six retrospective and six prospective studies from single centers, along with one multi-center RCT, totaling 2,157 participants, were synthesized to evaluate the effectiveness of intrauterine hCG perfusion in enhancing implantation and pregnancy outcomes in patients with RIF. Significant improvements were observed in clinical pregnancy and embryo implantation rates across various dosages, timing of administration, and embryo developmental stages, without impacting miscarriage rates. Notably, the most significant efficacy within subgroups occurred with a 500 IU dosage and perfusion parameters of ≤ 500µL volume and ≥ 2 IU/µL concentration. Additionally, a limited number of studies showed no significant increases in ectopic pregnancy or multiple pregnancy rates, and a modest improvement in live birth rates, although the small number of these studies precludes definitive conclusions.

Conclusions

The analysis suggests that intrauterine hCG perfusion probably enhances embryo implantation, clinical pregnancy, and live birth rates slightly in RIF patients. Benefits are indicated with a dosage of 500 IU and a maximum volume of 500µL at concentrations of at least 2 IU/µL. However, substantial heterogeneity from varying study types and the limited number of studies necessitate cautious interpretation. These findings underscore the need for more rigorously designed RCTs to definitively assess the efficacy and safety.
Comparative analysis of changes in retinal layer thickness following femtosecond laser-assisted cataract surgery and conventional cataract surgery
Authors: Surl Dongheon , Kim Seungmin , Kim Sangyeop , Kim Tae-Im , Seo Kyoung Yul , Jun Ikhyun
Published: July 2024

Background

To investigate the influence of femtosecond laser-assisted cataract surgery (FLACS) on macula by examining changes in retinal layers after FLACS and to compare these changes with those after conventional cataract surgery (CCS).

Methods

This study included 113 unrelated Korean patients with age-related cataract who underwent CCS or FLACS in Severance Hospital between September 2019 and July 2021. Optical coherence tomography was performed before and 1 month after surgery. The total retinal layer (TRL) was separated into the inner retinal layer (IRL) and outer retinal layer (ORL); moreover, the IRL was subdivided into the retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer (INL), outer plexiform layer, and outer nuclear layer. We performed between-group comparisons of the postoperative thickness in each retinal layer and the postoperative differences in retinal thickness. The average retinal thickness of the four inner macular ring quadrants was used for comparative analysis.

Results

Compared with the CCS group, the FLACS group exhibited a thicker ORL (P = 0.004) and a thinner INL (P = 0.007) after surgery. All retinal layer thickness values showed significant postoperative changes regardless of the type of surgery (P < 0.05). The postoperative increase in TRL and IRL thickness was significantly smaller in the FLACS group than in the CCS group (P = 0.027, P = 0.012).

Conclusions

The 1-month postoperative retinal changes were less pronounced in the FLACS group than in the CCS group.
Autism spectrum: parents’ perspectives reflecting the different needs of different families
Authors: Battanta Nadja K. , Jenni Oskar G. , Schaefer Christina , von Rhein Michael
Published: July 2024

Background

Parents of children on the autism spectrum often face great challenges in the care of their child. Early support tailored to families’ individual needs is therefore crucial for the development and quality of life of both children on the autism spectrum and their families. However, to date it is unclear whether the support available meets the parents’ needs.

Study Aim

To investigate how the system of care, support, and therapies for children on the autism spectrum is perceived by their parents.

Method

A total of 57 parents of Swiss children on the autism spectrum participated in an online survey, and 20 of them participated in additional semi-structured interviews.

Results

We found that parents of children on the autism spectrum may face substantial challenges and that social support is essential. Two thirds of the participating parents reported a long and difficult diagnostic process as challenging, and 60% expressed their need for closer follow-up after diagnosis and more support. Only one third of the parents stated that they manage their everyday lives well, whereas 17.5% felt exhausted, and more than half of the parents responded that they felt challenged. One fifth indicated that they had poor family support, and half reported substantial financial challenges. At the same time, most families also emphasize how important their neurodivergent children are to the family`s life together.

Conclusion

It is important that primary pediatricians not only initiate the diagnostic process, but also assess the different needs of the different family independent of the diagnosis and, if necessary, initiate adequate measures or guide parents to institutions in charge. Parents who do not actively express their individual needs should nevertheless be advised about support services, including financial counseling. The positive aspects mentioned by families can be emphasized and used as resources to improve their quality of life.