bluuebunny/crossref_metadata_2025 huggingface dataset:
Usability and user expectations of a HoloLens-based augmented reality application for learning clinical technical skills
Authors: Escalada-Hernández Paula , Soto-Ruiz Nelia , Ballesteros-Egüés Tomás , Larrayoz-Jiménez Ana , Martín-Rodríguez Leticia San
Published: November 2023

The application of augmented reality in training health science students is increasingly widespread. The aim of this work was to assess the usability and user expectations of an augmented reality application for smart glasses (Microsoft HoloLens) that can be used to train on four invasive procedures (i.e. intramuscular injection, nasogastric tube insertion, endotracheal intubation and suctioning via tracheostomy tube). A descriptive study was conducted with nursing students from three Spanish universities. Participants answered a questionnaire to assess the use of the ARSim2care application. This application offers the possibility of visualizing the internal anatomical structures during the training of the clinical technical skills for the performance of the mentioned invasive techniques. The questionnaire included demographic data, the System Usability Scale and questions about the user expectations in relation to learning with the use of augmented reality. In total, 61 participants responded to the questionnaire after using the ARSim2care application. The mean score of the System Usability Scale was 73.15 (standard deviation: 15.04) and 62.4% (n = 38) of the participants considered their experience with the application as excellent or good. In relation to user expectations, more than 90% of students indicated that the use of the application could improve their motivation and stimulation in learning, their content retention and their anatomical understanding. The developed ARSim2care application for Microsoft HoloLens showed a high level of usability and acceptance as a learning tool for training certain clinical procedures by visualizing the internal structures of the body.
Association between Lifelines Diet Score (LLDS) and some novel anthropometric indices, including BRI, ABSI, VAI, and BAI, in Iranian women: A cross-sectional study
Authors: Nazari Matin , Mirzaei Khadijeh , Keshavarz Seyedali
Published: November 2023

Background
Anthropometry is a reliable method to assess obesity status, and previous studies have shown the association of several dietary quality scores with obesity using anthropometric indices. This study aimed to evaluate the association between LLDS and anthropometric measurements.
Methods
A total of 217 women between the ages of 18 and 48 participated in the study. Anthropometric values, biochemical tests, and body composition were assessed for each participant using standard protocols and methods. The LLDS was determined based on 12 components using a reliable and valid food frequency questionnaire (FFQ) that contained 147 items.
Results
We detected a marginally significant inverse association between the LLDS and VAI scores in the second tertile. Study participants in the second tertile of LLDS had lower odds of having high VAI than those in the reference tertile after adjusting for age, energy intake, physical activity, education, and economic status (OR: -0.16; 95% CI: -0.8, 0.06; P = 0.06). There was no statistically significant trend for the association between LLDS and all assessed anthropometric indices, including BRI, ABSI, VAI, and BAI, across tertiles of LLDS in the crude and all adjusted models (P-trend > 0.05).
Conclusions
There was no significant association between LLDS and some novel anthropometric indices, including BRI, ABSI, VAI, and BAI. However, after adjusting for probable confounders, a marginally significant inverse association between LLDS and VAI was detected.
The role of women’s autonomy and empowerment in maternal health decision making: Implications on the implementation process of a service delivery reform in Kenya. A qualitative exploratory study
Authors: Olwanda Easter , Opondo Kennedy , Oluoch Dorothy , Croke Kevin , Maluni Justinah , Jepkosgei Joyline , Nzinga Jacinta
Published: November 2023

Background
A maternal and child health service delivery redesign (SDR) that aims to reorganize maternal and newborn health services is being implemented in Kakamega County in Kenya. Women's voice, agency, and autonomy are critical aspects of gender equality and women's empowerment since women’s ability to make decisions alone or in consultation with others in the household is an important determinant of access and utilization. As part of the process evaluation, this study sought to understand women’s process of decision-making in seeking maternal health care and how these affect women’s ability to access and use these services.
Methods
We adapted the International Centre for Research on Women (ICRW) conceptual framework for reproductive empowerment that combines the interrelated concepts of “female autonomy”, and “women’s agency” with the latter incorporating ‘voice’, ‘choice’ and ‘power’. We conducted key informant interviews, in-depth interviews, and focus group discussions with pregnant women attending Antenatal clinics, women who had delivered, and women attending post-natal clinics. A thematic analysis approach was used to analyze the data in NVivo 12.
Results
The results revealed significant findings across three dimensions of agency. Women with previous birthing experiences, high self-esteem, and support from their social networks exhibited greater agency. Additionally, positive previous birthing experiences were associated with increased confidence in making reproductive health choices. Women who had control over financial resources and experienced respectful communication with their partners exhibited higher levels of agency within their households. Distance relational agency demonstrated the impact of health system factors and socio-cultural norms on women's agency and autonomy. Finally, women who faced barriers such as long waiting times or limited staff availability experienced reduced agency in seeking healthcare.
Conclusions
Individual agency, immediate relational agency, and distance relational agency all play crucial roles in shaping women's decision-making power and control over their utilization of maternal health services. By identifying specific determinants within each dimension, this study provides valuable insights that can provide guidance for the ongoing implementation of an innovative service delivery redesign model by emphasizing the critical need for developing holistic and context-specific strategies to promote women's voices to ensure acceptability and sustained use.
Risk Model of Climate Change and Water Scarcity for Energy Resources of Iraq
Authors: Marcellin Megan C. , Pavur Gigi , Loose Davis C. , Cardenas John J. , Denehy David , Almashhadani Mustafa , Waheed Saddam Q. , Trump Benjamin D. , Polmateer Thomas L. , Linkov Igor , Lakshmi Venkataraman , Lambert James H.
Published: November 2023

Water security in arid and semi-arid Middle Eastern climates has been severely impacted by effects of climate change such as reduced precipitation, diminished storage, increased evapotranspiration, and prolonged heat waves. These climate effects are compounded in Iraq, where populations, agriculture, industry, and energy rely heavily on varying transboundary water flows to meet water demands. Iraq’s most profitable sector, energy, is especially threatened by insufficient water supply, which complicates government decision making in energy infrastructure development. The goal of this paper is to develop a scenario-based multi-criteria analysis framework to prioritize infrastructure investments in the context of climate change and scarcity of natural resources. Infrastructure facilities are evaluated against social, economic, climate, and hydrologic criteria across a set of disruptive climatological, economic, and social scenarios to identify robust initiatives and the most and least disruptive scenarios to the system. A particular innovation of this paper is the use of hydrology data derived from satellites in determining water scarcity impact on individual energy facilities. The methods are demonstrated for a critical sector of Iraq’s economy: oil and natural gas. The demonstration includes 13 system order criteria, 44 oil and gas initiatives within Iraq, and seven risk scenarios. The results include an accounting of the most and least disruptive scenarios to energy sector priorities and scenario-based system orderings to guide stakeholders in investment prioritization.
Opioid Use Following Cardio-thoracic Intensive Care – Risk Factors and Outcomes: a Cohort Study
Authors: von Oelreich Erik , Jalde Francesca , Rysz Susanne , Eriksson Jesper
Published: November 2023

Opioid misuse has become a serious public health problem. Patients admitted to cardio-thoracic critical care are usually exposed to opioids, but the incidence and effects of chronic opioid use are not known. The primary objective was to describe opioid use after admission to a cardio-thoracic intensive care unit. Secondary objectives were to identify factors associated with chronic opioid usage and analyze risk of death. This cohort study included all cardio-thoracic ICU care episodes in Sweden between 2010 and 2018. Among the 34,200 patients included in the final study cohort, 4,050 developed persistent opioid use after ICU care. Younger age, preadmission opioid use, female sex, presence of comorbidities and earlier year of ICU admission were all found to be associated with persistent opioid use. The adjusted hazard ratio for mortality between 6 to 18 months after admission among individuals with persistent opioid use was 2.2 (95% CI: 1.8–2.6; P < 0.001). For opioid-naïve patients before ICU admission, new onset of chronic opioid usage was significant during the follow-up period of 24 months. Despite the absence of conclusive evidence supporting extended opioid treatment, the average opioid consumption remains notably elevated twelve months subsequent to cardio-thoracic ICU care.
Longitudinal associations of depression, mild cognitive impairment, and quality of life with handgrip strength
Authors: Palazuelos-González Rosa , Salinas-Rodríguez Aarón , Manrique-Espinoza Betty
Published: November 2023

Background. Mental health and quality of life (QoL) are key components of healthy aging, and their deterioration may lead to a loss of health, dependence, and mortality among older adults. Handgrip strength (HGS) has been widely used given its practicality and reliability as an indicator of general health status and physical functioning and even as a biomarker of aging. This study aimed to estimate the longitudinal associations of handgrip strength (HGS) with depression, mild cognitive impairment (MCI), and quality of life (QoL).
Methods. Data come from the first three wave of the Study on Global Aging and Adult Health in Mexico (2009, 2014, 2017). 2,943 older adults aged 50 years or older were included. HGS was measured using a handheld dynamometer. We used the Composite International Diagnostic Interview for the diagnosis of depression based on DSM‐IV criteria. MCI was determined according to the recommendations of the National Institute on Aging and the Alzheimer's Association of the United States. Quality of life was assessed using the WHOQOL (WHO Quality of Life) instrument. HGS was considered as a time-varying exposure and the between- and within-person effects were disaggregated using the hybrid models with random intercept.
Results. Higher HGS values were significantly associated with the three outcomes, decreasing the probability of depression (OR=0.98, p=0.02) and MCI (OR=0.97, p<0.01), and increasing quality of life levels (β=0.10, p<0.01). Likewise, those with weak grip strength had a higher probability of depression (OR=1.36, 95% CI 1.01;1.82), MCI (OR=1.32, 95% CI 1.03;1.68) and lower quality of life (β= -1.21 95% CI -1.95;-0.47). a higher proportion of this association will be better explained by between-person differences than within-person differences. A predominance of between-person effects over within-person effects was observed.
Conclusion. Given the explanatory power of HGS, routine use of its measurement should be implemented, both in the community and in clinical settings, to identify older adults at risk for adverse health outcomes.
IFN-β plasmatic levels are best predictors of muscle disease activity than IFN-α in a longitudinal cohort of patients with juvenile dermatomyositis
Authors: Moreau Thomas RJ , Bondet Vincent , Ramos Juliette , Ouldali Naïm , Alyanakian Marie-Alexandra , Bodemer Christine , Dingulu Glory , Dumaine Cécile , Duong Ngoc-Bao , Charuel Jean-Luc , Eveillard Laurye-Anne , Fournier Benjamin , Frémond Marie-Louise , Herbeuval Jean-Philippe , Isapof Arnaud , Quartier Pierre , Vinit Caroline , Welfringer-Morin Anne , Gitiaux Cyril , Melki Isabelle , Duffy Darragh , Bader-Meunier Brigitte , Rodero Mathieu P
Published: November 2023

This study was conducted to identify the contribution of myositis-specific antibodies (MSAs) on the correlation between type I interferon (IFN-I) plasma levels and disease activity in juvenile dermatomyositis (JDM) patients. We prospectively obtained 198 samples from 49 JDM patients. Autoantibody levels were determined for all patients. Muscle activity was scored using Childhood Myositis Assessment Scale (CMAS) and Manual Muscle Testing in 8 muscles (MMT-8) and skin involvement with a Disease Activity Score (DAS). Three homebrew digital ELISA measuring respectively the IFN-α2 subtype, all 12 interferon alpha (IFN-α) subtype proteins (Pan-α), and interferon beta (IFN-β) were used to quantify IFN-I in patient’s plasma. Correlations between IFN-I titers and clinical scores were evaluated using linear mixed-effect models. In our entire cohort, Pan-α and IFN-β were associated with all three clinical scores. Correlations between IFN-β plasma levels and muscle disease activity were stronger than those with IFN-α levels. After stratification on MSAs expression, we found a relatively equal distribution for the most frequent MSAs phenotypes (MDA5+:n=13, NXP2+:n=12, TIF1g+:n=11, No MSAs:n=13). We observed an association between CMAS and IFN-β in all 4 subgroups. In contrast, Pan-α levels were associated with clinical scores only in MDA5+ patients. In this subgroup, IFN-α2 was also strongly associated with muscle scores. These findings underscore the potential role of IFN-β in blood as a reliable biomarker of muscle disease activity in JDM, irrespectively of MSAs positivity. The association of IFN-α subtypes plasma levels with clinical scores only in MDA5+ patients suggests a distinct pathophysiological mechanism in this subgroup.
Psychometric evaluation of the translated Chinese version of the Toxic Leadership Behaviors of Nurse Managers Scale (ToxBH-NM)
Authors: Wang Yuhan , Guo Xueqin , Li Xin , Xiong Lijuan , Wang Yumei , Wang Yangjing , He Jia , Jin Huan
Published: November 2023

Aim
To translate and psychometrically validate the Toxic Leadership Behaviors of Nurse Managers Scale in China.
Background
Toxic leadership is a negative or ineffective leadership style, the prevalence of which is rising in the field of nursing. Toxic leadership can manifest itself in different ways in different cultural contexts and we currently lack a specific and standard instrument to evaluate nurse managers' toxic leadership behaviors in China.
Methods
The Toxic Leadership Behaviors of Nurse Managers Scale was translated into Chinese based on Brislin's classical back translation model. Item analysis, content validity, exploratory and confirmatory factor analysis (EFA and CFA), internal consistency reliability, test-retest reliability were used to test the psychometric attributes of the scale.
Results
EFA yielded a four-factor scale structure with a cumulative variance contribution of 72.020%. CFA suggested acceptable indices which were consistent with the four-factor model of the original scale. Cronbach's α was 0.967 for the whole scale.
Conclusions
The Chinese version of ToxBH-NM (C-ToxBH-NM) was reliable and valid, and the scale was a potentially useful instrument to assess and present nurse managers' toxic leadership behaviors in China.
Wall shear stress measurement using a zero-displacement floating-element balance
Authors: Ferreira M. Aguiar , Ganapathisubramani B.
Published: November 2023

The floating element (FE) balance, introduced nearly a century ago, remains one of the most versatile direct wall shear stress measurement methods. Yet, its intrinsic sources of systematic error, associated with the flow-exposed gap, off-axis load sensitivity, signal-to-noise ratio, and calibration, have thus far limited its widespread application. In combination with the lack of standard designs and testing procedures, measurement reliability still hinges heavily on individual judgement and expertise. This paper presents a framework to curb these limitations, whereby the design and operation of a FE balance are leveraged by an analytical model that attempts to capture the behaviour and predict the relative contribution of the systematic error sources. The design is based on a parallel-shift linkage and a zero-displacement force-feedback system. The FE balance has a surface area of 200×200mm, and measurement sensitivity is adjustable depending on the surface condition and the Reynolds number. It is thus suitable for application in a wide range of low-speed, boundary-layer wind tunnels, from small to large scale. Measurements of the smooth-wall skin friction coefficient show a remarkable agreement with oil-film interferometry, especially for Reθ > 1.3 × 104. The discrepancy relative to the empirical Coles-Fernoholz relation (κ = 0.39 and C = 4.352) is within 0.5 %, and the level of uncertainty is below 1% for a confidence interval of 95 %.
Leveraging 3D Convolutional Neural Networks for Accurate Recognition and Localization of Ankle Fractures
Authors: Ying Jichong , Huang Dichao , Liu Jianlei , Yu Tianming , Wang Hua
Published: November 2023

Background
Ankle fractures are common injuries with substantial implications for patient mobility and quality of life. Traditional imaging methods, while standard, have limitations in detecting subtle fractures and distinguishing them from complex bone structures. The advent of 3D Convolutional Neural Networks (3D-CNNs) offers a promising avenue for enhancing the accuracy and reliability of ankle fracture diagnoses.
Methods
In this study, we acquired 1,453 high-resolution CT scans and processed them through three distinct 3D-CNN models: 3D-Mobilenet, 3D-Resnet101, and 3D-EfficientNetB7. Our approach involved rigorous preprocessing of images, including normalization and resampling, followed by a comparative evaluation of the models using accuracy, Area Under the Curve (AUC), and recall metrics. Additionally, the integration of Gradient-weighted Class Activation Mapping (Grad-CAM) provided visual interpretability of the models' predictive focus points.
Results
The 3D-EfficientNetB7 model demonstrated superior performance, achieving an accuracy of 0.91 and an AUC of 0.94 after 20 training epochs. Furthermore, Grad-CAM visualizations aligned closely with expert radiologists' assessments, validating the model's diagnostic precision. Spatial localization techniques further enhanced the interpretability of fracture detection, providing clear visual cues for medical professionals.
Conclusions
The implementation of 3D-CNNs, particularly the 3D-EfficientNetB7 model, significantly improved the detection and localization of ankle fractures. The use of Grad-CAM has also proved essential in providing transparency to AI-driven diagnostics. Our research supports the integration of 3D-CNNs in clinical settings, potentially revolutionizing the standard of care in fracture diagnosis and paving the way for their application in broader medical imaging tasks.
Intelligent Traffic Light Switch Based on Deep Reinforcement Learning with Attention Mechanism
Authors: Wang Min , Cui Jianqun , Chang Yanan , Wu Libing
Published: November 2023

How to design a good traffic signal switch scheme is crucial to alleviate transportation pressure. However, some existing traffic signal control methods based on reinforcement learning apply a convolutional neural network (CNN) to extract features from the state matrix, which is too coarse because state matrices sometimes are sparse. These methods use the discrete traffic state encoding (DTSE) approach to build the position and speed matrices. We overcome this problem in two ways: by reducing the number of zero value in the state matrix and using a spatial attention mechanism in convolution operations. This paper redefines the state at the intersection by dividing each entering road with an unequal length and then concatenating them. Our division method can reduce the state matrix’s sparsity by reducing the size of the input matrix and the number of zero value. We then propose a deep Q-learning network (DQN) with spatial attention in CNN to control the traffic light. The spatial attention mechanism can focus on the specific element in the con-volutional feature vectors and overcome the sparse matrix’s difficult problem to extract features. Besides, we set a discount factor β on the reward definition, which can diminish the received reward and alleviate the overestimation caused by DQN. We conduct experiments on the Simulation of Urban MObility (SUMO) with two datasets, a synthetic intersection and Cologne’s traffic intersection in Germany. Experimental results on synthetic intersection demonstrate that our method can reduce delay, travel time, and queue length than three other methods. Results on Cologne confirm that the proposed method can save 23.7%, 9.1%, 4.5% travel time compared with the fixed-time traffic light control, self-organizing traffic light control, and DQN method, respectively.
Biological and physico-chemical properties of the soil in an acidified environment influenced by previous mining activities at the Šobov locality (Slovakia)
Authors: Nosalj Sanja , Hrabovský Andrej , Labuda Roman , Kollár Jozef , Šimonovičová Alexandra
Published: November 2023

More than 20 years after remedial measures were carried out, six plots (Š1 – Š6) at the Šobov locality were examined in more detail. From a pedological viewpoint, the physico-chemical differences of the soils in these areas are not the result of pedogenesis. This is the effect of extremely acidic mineralised solutions that have leaked from or are still leaking from the heap at the site. The plant community here is most often poor to weakly developed with acidophilic vegetation (Š1, Š2, Š5), without vegetation (Š4) or with dense species-rich vegetation (Š3, Š6). Saprotrophic microscopic fungi of the phylum Zygomycota are notably suppressed and their biodiversity is low. Species of the genera Absidia and Zygorhynchus were found most often. In contrast, the biodiversity of the phylum Ascomycota is notably high. The genera Penicillium (35 species), Aspergillus (7 species) and Trichoderma (5 species) are dominantly represented. Species of microscopic filamentous fungi in every soil sample that did not occur in the other samples were also recorded; i.e. they form the specific soil mycobiome of the given location. From the 15 types of keratinophilic fungi, the most commonly occurring were Purpureocillium lilacinum and Keithomyces carneus. Keratinolytic properties were recorded only in the species Trichophyton ajelloi. Soil reaction is the most important ecological factor that influences the biological properties of soils.
Tribological properties of PTFE/PI-PAI composite coatings filled by GO/ ZrO2 on the surfaces of different micro-textures
Authors: Xiang Peng , Cao Jun , Long Qihua , Wang Shiming , Wu Jinxing , Abbas Zeshan
Published: November 2023

Three different PTFE/PI-PAI composite coatings filled by GO/ZrO2 were designed to improve the tribological properties of engine bearing. The pentagonal and triangular textures were prepared on the surface of copper alloy by laser processing. The designed coatings were prepared on the surfaces of textures and smooth substrates by liquid spraying. The results indicated that the coating with 0.25 wt.% of GO and 4.75 wt.% of ZrO2 has the best tribological properties at room temperature and 75°C. The coating has the better mechanical and tribological performances on the surface of the pentagonal textures. The mechanical simulation showed that the contact stress and deformation of the coating on the pentagonal texture is less than that of the triangular texture.
Extent and early impacts of France’s first established population of the little fire ant, Wasmannia auropunctata
Authors: Blight Olivier , Thomas Theophile , Jourdan Hervé , Bichaton Jean-Yves , Colindre Laurent , GALKOWSKI Christophe
Published: November 2023

The little fire ant, Wasmannia auropunctata, is one of the most widely distributed invasive alien ant species on earth, with major environmental, economic and sanitary impacts. Here we report the first established outdoor population of W. auropunctata in South East of France. We describe its detection, its extent and its early ecological impacts. Currently, the invaded area extends over around 1ha. Given the area invaded and the first reports of stings in 2019, it is likely that W. auropunctata was introduced at least five years ago. Although the introduction is probably recent, negative impacts on the abundance and richness of native ants can already be observed. We have not yet recorded any impact on other arthropods. In parallel with identifying the pathway of introduction, an eradication plan is being prepared to tackle this major environmental and economic problem. Widespread species such as the little fire ant represent a new challenge for biosecurity monitoring for Europe.
Seafood independence is within reach: multi-scale assessment of seafood self-reliance in the United States
Authors: Oyikeke Tolulope Samuel , Advani Sahir , Stoll Joshua
Published: November 2023

As a vital source of nutrition, cultural identity, and economic activity, seafood has become one of the most globally traded commodities worldwide. However, increased concerns about food security, coupled with the disruptive effects of climate change, contagious diseases, and geopolitical conflict are bringing acute attention to the need for food transformation at multiple scales. Here, we investigate the United States’ potential to achieve seafood “independence” and maximize health benefits to the nation by integrating production, utilization, yield, and consumption data across six regions of the United States and nationally over 50 years (1970-2021). Although the United States is the second largest importer of seafood worldwide, findings from this study show that self-reliance at the national-level is achievable, though the ability for different subregions to meet demand is variable. Achieving greater seafood independence will require shifts in consumer behavior, investments in infrastructure, and continual adaptation in the face of climate change.
Exploring MGMT Methylation-Driven Structural Connectivity Changes in Insular Gliomas: A Tractography and Graph Theoretical Analysis
Authors: Yang Zuo-cheng , Yin Chuan-dong , Yeh Fang-cheng , Xue Bo-wen , Song Xin-yu , Li Gen , Sun Sheng-jun , Deng Zheng-hai , Hou Zong-gang , Xie Jian
Published: November 2023

Objectives
To investigate the correlation between methylation of the O-6-methylguanine-DNA methyltransferase (MGMT) promoter levels and structural connectivity in insular gliomas across hemispheres.
Methods
We analyzed 61 left insular glioma cases and 50 healthy controls, using differential tractography, correlational tractography, and graph theoretical analysis to investigate the correlation between structural connectivity and the methylation level.
Results
The differential tractography results revealed that in left insular glioma, the volume of affected inferior fronto-occipital fasciculus (IFOF, p = 0.012) and uncinate fascicle (UF, p = 0.030) significantly correlated with methylation levels. Correlational tractography results showed that the quantitative anisotropy (QA) value of peritumoral fiber tracts also exhibited a significant correlation with methylation levels (FDR < 0.05). On the other hand, in right insular glioma, anterior internal part of the reticular tract, IFOF, and thalamic radiation showed a significant correlation with methylation levels but at a different correlation direction from the left side (FDR < 0.05). The graph theoretical analysis showed that in the left insular gliomas, only the radius of graph was significantly lower in methylated MGMT group than unmethylated group (p = 0.047). No significant correlations between global properties and methylation levels were observed in insular gliomas on both sides.
Conclusion
MGMT methylation levels are significantly associated with structural connectivity changes in insular gliomas, displaying hemisphere-dependent differences.
Effect of Stress Urinary Incontinence on Vaginal Microbiota Stability
Authors: Zhang Man , Zhou Yanhua , Yao Siqi , Zhao Yiming , Batool Syeda , Huang Jing , Jiang Li , Yan Dayu , Yan Wenguang , Yu Zheng
Published: November 2023

Background Stress urinary incontinence and vaginal microbial dysbiosis frequently occur in postpartum women. A better understanding of the relationship between SUI and the composition of vaginal microbiota may help to prevent the emergence of vaginal diseases. However, limited research has been conducted to investigate the potential association between vaginal microbial dysbiosis and stress urinary incontinence. Results The present study revealed a strong correlation between changes in the composition of vaginal microbiota and stress urinary incontinence, with stress urinary incontinence being more likely to lead to dysbiosis of vaginal microbiota. In terms of the vaginal microbiota, both alpha diversity and evenness were significantly higher in the stress urinary incontinence group compared to the group without stress urinary incontinence. Additionally, there were notable differences in the composition of the vaginal microbiota between two groups. Specifically, among stress urinary incontinence patients, the abundance of bacteria associated with bacterial vaginosis, such as Streptococcus, Prevotella, Dialister, and Veillonella, showed an increase, while the abundance of Lactobacillus decreased. Furthermore, the vaginal microbial co-occurrence network of stress urinary incontinence patients displayed higher connectivity, complexity, and clustering. Conclusions As a result, our study emphasizes the significant role of Lactobacillus in maintaining homeostasis within the vaginal microbial community. A correlation between stress urinary incontinence and the vaginal microbiota was observed, indicating an increased risk of vaginal microbial disorders and bacterial vaginosis for individuals with stress urinary incontinence. Consequently, we anticipate that our findings will contribute novel insights into the prevention of bacterial vaginal diseases associated with stress urinary incontinence.
Multifaceted ORganizational InterventiONs (M-ORION) project for prevention of depression and anxiety among workers: A five-arm cluster randomized controlled trial
Authors: Watanabe Kazuhiro , Hikich Hiroyuki , Imamura Kotaro , Sakuraya Asuka , Yoshikawa Toru , Izawa Shuhei , Eguchi Hisashi , Inoue Akiomi , Yoshida Kengo , Orihashi Yasushi , Tsutsumi Akizumi
Published: November 2023

Background
Depression and anxiety are the most common mental health issues experienced by workers. Although organizational intervention has been extensively evaluated as a primary prevention of depression and anxiety, the corresponding scientific evidence remains limited because of the lack of cluster randomized controlled trials (cRCT) and failure to detect organizational-level effects. Therefore, the present study aims to assess the preventive effects of four types of interventions on depression and anxiety among workers in an open, five-arm, parallel-group cRCT.
Methods
Overall, 140 worksites and 18,200 nested employees will be recruited from September 2023. The eligible worksites will be randomly assigned to each of the five arms, and programs will be offered for 6–12 months. The five arms are 1) psychoeducation for workers, 2) psychoeducation for supervisors, 3) work environment improvement, 4) physical activity promotion, and 5) active control. The primary outcomes of interest are depression and anxiety. We will also assess psychosocial factors at work, work engagement, health-related quality of life, well-being, economic outcomes, physiological outcomes of health checkups, cortisol levels extracted from fingernails, and indices representing the process and implementation outcomes, including program completion rates. Follow-up surveys will be conducted at 6, 12, and 18 months from baseline, and the primary endpoint is set at the 6-month follow-up. Repeated-measures multi-level mixed modeling will be used to evaluate the effect of each intervention compared with the control.
Ethics and dissemination:
The study protocol was approved by the Research Ethics Committee of the Kitasato University Medical Ethics Organization (C22-082). The results and findings of this study will be published in a scientific journal and disseminated to companies that participate in the study.
Trial registration number:
UMIN000050949
Age at first sexual intercourse and pan- cancers: Mendelian Randomization Study
Authors: Wu Xinhua , Feng Xu , Qi Shiguai , Yang Xiuwen , Shi Zheng-rong
Published: November 2023

Background
Whether the age of first sexual intercourse increases the risk of cancer has attracted widespread attention, but the conclusion is still controversial. It is unclear whether the age of first sexual intercourse has a definite causal effect on pan- cancers.
Methods
Based on the Genome-Wide Association Study (GWAS) dataset from the large prospective UK Biobank and other alliance databases, two sample mendelian randomization (MR) analysis was used to explore the causal impact of age at first sexual intercourse on cancer risk in different regions. Five MR methods were applied to to investigate the causality. The stability, heterogeneity, and pleiotropy of MR results were also evaluated.
Results
196 SNPs were selected as instrumental variables in the population of the age of first sexual intercourse, which satisfies the local wide significance level (p < 5*10 − 8). the age of first sexual intercourse has a significant causal effect on the risk of head and neck cancer(OR = 0.997, 95%CI:0.9955–0.9984, p < 0.0001) and lung cancer(OR = 0.9928, 95%CI:0.9903–0.9954, p < 0.0001). And there is a slight causal relationship between the age of first sexual intercourse and the liver cell cancer(OR = 0.9993, 95%CI:0.9988–0.9999, p = 0.0260) and cervical cancer(OR = 0.9979, 95%CI:0.9960–0.9998, p = 0.0366). At the same time, the age of first sexual intercourse has a slight causal effect on breast cancer(OR = 1.005, 95%CI:1.0009–1.0092,p = 0.0175) and prostate cancer(OR = 1.1732, 95%CI:1.0118–1.3604, p = 0.0344).
Conclusion
This study explored the causal relationship between the age of first sexual intercourse and pan-cancer, and found that the age of first sexual intercourse has a significant protective effect on head and neck cancer and lung cancer, a slight protective effect on liver cell cancer and cervical cancer, and a slight promoting effect on breast cancer cancer and prostate cancer. However, more rigorous research is still needed to explore the relationship between first sexual intercourse and pan-cancer.
Diversity in Lacrimal Pathway Morphology Among Japanese Patients with Congenital Nasolacrimal Duct Obstruction
Authors: Nakamura Jutaro , Ohno Tomoko , Asano Mizuki , Takeuchi Masaki , Mizuki Nobuhisa , Matsumura Nozomi
Published: November 2023

Objective:
This study aimed to explore the diversity in lacrimal pathway morphology among Japanese patients with congenital nasolacrimal duct obstruction (CNLDO) by examining dacryocystography (DCG) images.
Study Design:
Prospective observational study
Methods:
The study involved 64 patients who underwent DCG prior to undergoing general anesthesia surgery for unilateral CNLDO at our institution between July 2012 and February 2023. Several parameters were measured from the sagittal section DCG images: (1) The angle between the lacrimal sac and the nasolacrimal duct, (2) The angle between the superior orbital rim, the center of the lacrimal sac, and the nasolacrimal duct, (3) The length of the bony nasolacrimal duct, (4) The length of the lacrimal sac. Additionally, following parameters were measured from coronal section images: (5) The angle formed by the lacrimal sac and the nasolacrimal duct, (6) The angle formed by the lacrimal sac concerning the midline.
Results:
The average age of the patients was 34.3 months, ranging from 14 to 84 months. The mean ± standard deviation of the measurements of the above parameters were (1) –1.2 ± 16.5° (range, –44.6° to +46.6°), (2) –5.0 ± 10.3° (range, –24.0° to +19.0°), (3) 8.0 ± 2.5 mm (range, 3.1 mm to 14.8 mm), (4) 10.2 ± 2.4 mm (range, 6.5 mm to 16.0 mm), (5) 15.6 ± 11.2° (range, –16.8° to +41.0°), (5) 15.1 ± 5.2° (range, +3.3° to +29.8°). Our study revealed that all parameters, except for parameter (4) (length of the lacrimal sac), conformed to a normal distribution, as determined by the Shapiro-Wilk test.
Conclusions:
This study offers valuable anthropometric data derived from DCG images, and the results emphasize the substantial variability in lacrimal pathway morphology among individuals. Moreover, probing with straight probes was considered anatomically infeasible in 25.0% of cases in the patients included in this study.
These findings have the potential to impact the diagnosis and treatment planning for CNLDO.
CSF interferon-β: A key player in Alzheimer’s disease pathogenesis and cognitive impairment
Authors: Shen Yong , Wang Qiong , Yuan Shufen , Wang Chenxi , Huang Duntao , Zhang Mengguo , Zhan Yaxi , Gao Feng , Shi Jiong , Levey Allan
Published: November 2023

Recent research has postulated that the activation of interferon signaling pathways could be implicated in the pathogenesis of Alzheimer's disease (AD). However, the precise types of interferons and related cytokines, both from the brain and periphery, responsible for cognitive impairment in patients with AD remain unclear. A total of 131 participants (78 [59.5%] female and 53 [40.5%] male; mean [SD] age, 61.5 [7.6] years) with normal cognition and cognitive impairment from the China Aging and Neurodegenerative Initiative cohort were included. CSF and serum IFNα-2a, IFN-β, IFN-γ, TNF-α, IL-6, IL-10, MCP-1and CXCL-10 were tested. The correlation between these interferons and related cytokines with AD core biomarkers in the CSF and plasma, cognition performance, and brain MRI measures were analyzed. We found that only CSF IFN-β levels were significantly elevated in Alzheimer’s disease compared to normal cognition. Furthermore, CSF IFN-β levels were significantly associated with AD core biomarkers (CSF P-tau and Aβ42/Aβ40 ratio) and cognitive performance (MMSE and CDR score). Additionally, the CSF IFN-β levels were significantly correlated with the typical pattern of brain atrophy in AD (such as hippocampus, amygdala, and precuneus). In contrast, CSF IL-6 levels were significantly elevated in non-AD cognitively impaired patients compared to other groups. Moreover, CSF IL-6 levels were significantly associated with cognitive performance in non-AD individuals and correlated with the vascular cognitive impairment-related MRI markers (such as white matter hyperintensity). Our findings demonstrate that distinct inflammatory molecules are associated with different cognitive disorders. Most notably, CSF IFN-β levels are significantly linked to the pathology and cognitive performance of AD, identifying this interferon as a potential target for AD therapy.
Effectiveness of Water, Sanitation, Hygiene, and Nutritional Interventions to Reduce Pathogenic Infections and Improve Nutritional Status in Children: Systematic Review and Meta-Analysis of Randomized Controlled Trial
Authors: Pradana F. Josse Pasca , Kaizar Hafidz Ardan , Tuba Syahrul
Published: November 2023

Objective
This systematic review and meta-analysis aimed to assess the effectiveness of water, sanitation, hygiene (WASH), and nutritional interventions in reducing pathogenic infections and improving nutritional status in children.
Method
Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Cochrane, Scopus, and Epistemonikos. Only randomized controlled trials (RCTs) were included, comparing interventions related to WASH and nutritional enhancements against control groups. Meta-analysis techniques were applied to analyze the impact on weight, height, and pathogenic infections.
Result
WASH interventions exhibited significant reductions in weight-related outcomes (OR: 0.58) and pathogenic infections (OR: 0.40). Height outcomes showed a positive effect (OR: 0.66). Nutritional interventions indicated significant reductions in weight-related outcomes (OR: 0.33) and positive effects on height (OR: 0.27). Although a trend towards reduced pathogenic infections was observed (OR: 0.78), statistical significance was not reached.
Conclusion
WASH and nutritional interventions demonstrated meaningful impacts on weight, height, and pathogenic infections in children. These findings emphasize the importance of prioritizing such interventions for enhancing child health and well-being.
Comparative analysis of the mitochondrial and chloroplast genomes of Purple nutsedge (Cyperus rotundus), a noxious weed
Authors: Yu Shixian , Miao Xiaorong , Li Donghai , Niu Junqi , Tang Wenwei
Published: November 2023

Background Cyperus rotundus L. is a notorious weed that harms agricultural ecosystems worldwide. Although the chloroplast genome (cpgenome) of C. rotundus has been studied, there have been no reports on the mitochondrial genome (mitogenome) of C. rotundus.
Results The mitogenome and the cpgenome of C. rotundus XFZ01 have four circular DNA moleculesand one circular DNA molecule, respectively. Their total lengths were 1,491,358 bp and 186,119 bp, respectively. The mitogenome contained 75 genes, including 40 protein-coding genes (PCGs), 9 rRNA genes, and 26 tRNA genes. The cpgenome contained 121 genes, including 69 PCGs, 8 rRNA genes, and 44 tRNA genes. Analysis of repetitive sequences identified 350 and 88 SSRs, 144 and 123 tandem repeats, 686 and 1,210 interspersed repeats in the mitogenome and cpgenome, respectively. Homologous fragment analysisindicated that 11 homologous fragments migrated from the cpgenome to the mitogenome. Codon preference analysis showed that both the mitogenome and cpgenome had weak codon preferences. Furthermore, cpgenome PCGs had 23 RNA editing sites compared to 13 in mitogenome PCGs. Phylogenetic analysis verified that C. rotundus had the closest genetic relationship with C. esculentus. Finally, Ka/Ks research showed that most mitogenomic PCGs, except for the nad6 gene, undergo negative selection.
Conclusions In this study, we assembled and annotated the mitogenome of the noxious weed C. rotundus and conducted a differential analysis using its cpgenome. These results lay a theoretical foundation for understanding the genetic variation, phylogeny, and population control of C. rotundus.
Effects of Implementing a Standardized Surveillance Program on Cardiac Neurodevelopmental Program Referral Outcomes
Authors: Hennrick Heather , Miller Elizabeth , Lai Wyman , Carmona Viannae , Flores Ana-Mercedes , Olson Marissa , Kong Dianne , Tan Alexander
Published: November 2023

Background:Differences in surveillance methods have resulted in significant variability in referral outcomes across cardiac neurodevelopmental programs, with frequent barriers to referral completion including high no-show rates, lack of education, and inaccessibility for underrepresented populations. The purpose of this study was to describe implementation of a standardized surveillance program and investigate impact on referral outcomes over a two-year period.
Methods:Between fiscal years 2021 and 2022, a surveillance program was implemented which standardized assessment of neurodevelopmental risk via a checklist as well as family education and referral procedures. All patients referred to the cardiac neurodevelopmental program during these two fiscal years were included in the analysis, representing one cohort before implementation and one cohort after implementation.
Results:Implementation of the formal surveillance program resulted in a 66.7% increase in referral volume. Proportions of both incomplete referrals (z = 2.00, p < 0.05) and incomplete referrals due to physician-related factors (z = 4.34, p < 0.01) were significantly higher after implementation. A significant association was found after implementation between referral completion and race/ethnicity (x2 = 14.08, p < 0.01) due to a significantly higher number of completed referrals compared to expected values for patients identifying as Hispanic/Latino.
Conclusions:This study describes the successful implementation of a standardized surveillance program, including improvements to referral volume and outcomes, and benefits to patients/families, clinicians, and systems. Findings also support implementation of methods that improve accessibility for historically marginalized groups at greatest risk for disparities in access and quality of care.
Application research on durability and low carbonation of concrete modified with limestone powder and silica ash
Authors: Ma Chao , Yao Zhaolong , Yang Zhao , Liu Pengfei , Liu Jie , Chen Fuxiang
Published: November 2023

In order to reduce the carbon emissions caused by the use of a large amount of concrete during tunnel construction and achieve the goal of green and low-carbon construction. This paper develops a low- carbon modified concrete by adding limestone powder (LP) and silica fume (SF) on the basis of ordinary concrete mixture. This paper analyzes the effects of different LP and SF dosages as well as the water-to-cement (w/c) ratios on rheological properties, early-age heat release and compressive strength of the material. The workability of the cementitious material was further comprehensively evaluated by introducing the expansion and water absorption indicators. The results confirmed that the incorporation of more than 15% LP led to a slight decrease in the strength of the cementitious material; however, it improved the pumpability and significantly reduced early-age heat release of the cementitious material, which contributed to the control of temperature-induced cracking in cementitious material. Also, the addition of SF with a content of more than 5% could further optimize the pumpability, which was beneficial for long-distance pumping of high-performance cementitious materials. Modified concrete has good mechanical properties, good pumpability, and low hydration heat. This study developed a low-carbon concrete material for green construction of tunnel construction, further promoting the efficient and clean utilization of LP and SF.
Probing fractional statistics in quantum simulators of spin liquid Hamiltonians
Authors: Zhou Shiyu , Zelenayova Maria , Hart Oliver , Chamon Claudio , Castelnovo Claudio
Published: November 2023

Recent advances in programmable quantum devices brought to the fore the intriguing possibility of using them to realise and investigate topological quantum spin liquid phases. This new and exciting direction brings about important research questions on how to probe and determine the presence of such exotic, highly entangled phases in a noisy quantum environment. One of the most promising tools is investigating the behaviour of the topological excitations, and in particular their fractional statistics. In this work we put forward a generic route to achieve this, and we illustrate it in the specific case of \mathbb{Z}_2ℤ2 topological spin liquids implemented with the aid of combinatorial gauge symmetry. We design a convenient architecture to study signatures of fractional statistics via quasiparticle interferometry, and we assess its robustness to diagonal and off-diagonal disorder, as well as to dephasing - effects that are generally pervasive in current quantum programmable devices. Interestingly, when turned on its head, our scheme provides a remarkably clear test of the “quantumness” of these devices, with robust signatures that crucially hinge on quantum coherence and quantum interference effects, and cannot be mimicked by classical stochastic processes.