bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced material identification via momentum-integrated muon scattering tomography
Authors: Bae JungHyun , Montgomery Rose , Chatzidakis Stylianos
Published: April 2024

Background Cosmic ray muons, originating from interactions in the upper atmosphere, possess high energy and unique penetrative capabilities suitable for non-traditional radiographic inspection. This study explores their application in various fields such as nuclear fuel cask monitoring, nuclear reactor imaging, and archaeology, leveraging the principle of multiple Coulomb scattering for imaging dense materials. While muon scattering tomography has shown promise, accurately measuring muon momentum remains challenging. Methods This research introduces the Momentum Integrated Point-of-Closest Approach (mPoCA) algorithm, integrating muon momentum data into the traditional Point-of-Closest Approach (PoCA) framework. Utilizing the Cherenkov muon spectrometer, renowned for precise muon momentum estimation, the mPoCA algorithm offers a novel imaging approach. Results Simulations conducted with GEANT4 evaluate the mPoCA algorithm’s performance against the standard PoCA method, demonstrating superior image resolution and enhanced material identification capabilities, particularly in distinguishing materials like uranium and lead. Conclusions These findings underscore the potential of the mPoCA algorithm for advancing muon scattering tomography applications.
Regulatory Implications for considering flexible resources in network expansion planning: main lessons from regional cases in the H2020 FlexPlan project
Authors: Morch Andrei , Migliavacca Gianluigi , Egorov Aleksandr , Ergun Hakan , Siface Dario , Lattanzio Giorgia , Sperstad Iver Bakken
Published: April 2024

The FlexPlan Horizon2020 project aimed at establishing a new grid planning methodology which considers the opportunity to introduce new storage and flexibility resources in electricity transmission and distribution grids as an alternative to building new grid elements, in accordance with the intentions of the European Commission regulatory package "Clean Energy for all Europeans". FlexPlan creates a new innovative grid planning tool which is intended to go beyond the state of the art of planning methodologies by including the following innovative features: assessment of best planning strategy by analysing in one shot a high number of candidate expansion options provided by a pre-processor tool, simultaneous mid- and long-term planning assessment over three grid years (2030-2040-2050), incorporation of full range of cost benefit analysis criteria into the target function, integrated transmission distribution planning, embedded environmental analysis (air quality, carbon footprint, landscape constraints), probabilistic contingency methodologies in replacement of the traditional N-1 criterion, application of numerical decomposition techniques to reduce calculation efforts and analysis of variability of yearly RES and load time series through a Monte Carlo process. Six regional cases covering nearly the whole European continent are developed in order to cast a view on grid planning in Europe till 2050. The final step in FlexPlan was formulating guidelines for regulators and planning offices of system operators, by indicating to what extent system flexibility can contribute to reduce overall system costs (operational and investment) yet maintaining current system security levels and which regulatory provisions could foster such process. This paper focuses on the regulatory issues, which were uncovered during the initiation phase and of the project and refined in throughout six regional cases. In order to substantiate this, the paper explains in brief the developed and applied FlexPlan methodology and its testing in six regional cases.
Universal mental health training for frontline professionals (UMHT)’s feasibility analysis
Authors: Gorbunova Viktoriia , Klymchuk Vitalii , Santangelo Philip
Published: April 2024

Background Universal Mental Health Training for Frontline Professionals (UMHT) is an educational programme developed and piloted in Ukraine in 2021-2023 to bridge the mental health treatment gap. The UMHT trains frontline professionals (FLPs) to interact with, support, and refer individuals with mental health conditions for professional help. Methods To assess the UMHT feasibility, we used statistics on the actual use of the programme, as well as data from satisfaction and usability surveying of 144 programme deliverers and 714 trained frontline professionals. A combination of Kruskal-Wallis and Post Hoc Dunn tests was used to identify statistically significant intergroup differences in the UMHT usability. Results All the characteristics defined to assess the UMHT showed its feasibility. Programme’s demand increased through years of implementation (2021, 2022, 2023) in terms of the numbers of training events (27, 35, 90), trained frontline professionals (596, 779, 1548), involved donors and supporters (1, 4, 9) and local and countrywide implementers (2, 10, 18). The UMHT acceptability as satisfaction with the programme content and delivery is 4.81 (0.291) for the UMHT trainers and 4.78 (0.434) for trained FLPs. The UMHT preparedness to use trained skills after participation in the training events is 4.57 (0.438) for the UMHT trainers and 4.46 (0.650) for trained FLPs. The highest rates of usability of all UMHT skills were found for educators (0.68 [0.118]), police officers (0.67 [0.098]), and social workers (0.66 [0.113]). Conclusions The UMHT offers a universal frame of interaction with people with mental health conditions for frontline professionals. Assessment of the UMHT feasibility shows the programme’s potential for further development and implementation. Programme trainers as its deliverers and frontline professionals as its recipients report high satisfaction with training content and delivery as well as preparedness to apply gained knowledge and skills in practice.
Pyrethroid resistance and gene expression profile of a new resistant An. gambiae colony from Uganda reveals multiple resistance mechanisms and overexpression of Glutathione-S-Transferases linked to survival of PBO-pyrethroid combination
Authors: Oruni Ambrose , Lynd Amy , Njoroge Harun , Onyige Ismail , van’t Hof Arjen E. , Matovu Enock , Donnelly Martin J.
Published: April 2024

Background The effectiveness of long-lasting insecticidal nets (LLINs) are being threatened by growing resistance to pyrethroids. To restore their efficacy, a synergist, piperonyl butoxide (PBO) which inhibits cytochrome P450s has been incorporated into pyrethroid treated nets. A trial of PBO-LLINs was conducted in Uganda from 2017 and we attempted to characterize mechanisms of resistance that could impact intervention efficacy. Methods We established an Anopheles gambiae s.s colony in 2018 using female mosquitoes collected from Busia district in eastern Uganda. We first assessed the phenotypic resistance profile of this colony using WHO tube and net assays using a deltamethrin dose-response approach. The Busia colony was screened for known resistance markers and RT-qPCR targeting 15 genes previously associated with insecticide resistance was performed. Results The Busia colony had very high resistance to deltamethrin, permethrin and DDT. In addition, the colony had moderate resistance to alpha-cypermethrin and lambda-cyhalothrin but were fully susceptible to bendiocarb and fenitrothion. Exposure to PBO in combination with permethrin and deltamethrin resulted in higher mortality rates in both net and tube assays, with a higher mortality observed in net assays than tube assays. The kdr marker, Vgsc-995S was at very high frequency (91.7-98.9%) whilst the metabolic markers Coeae1d and Cyp4j5-L43F were at very low (1.3% - 11.5%) and moderate (39.5% - 44.7%) frequencies respectively. Our analysis showed that gene expression pattern in mosquitoes exposed to deltamethrin, permethrin or DDT only were similar in comparison to the susceptible strain and there was significant overexpression of cytochrome P450s, glutathione-s-transferases (GSTs) and carboxyl esterases (COEs). However, mosquitoes exposed to both PBO and pyrethroid strikingly and significantly only overexpressed closely related GSTs compared to unexposed mosquitoes while major cytochrome P450s were underexpressed. Conclusions The high levels of pyrethroid resistance observed in Busia appears associated with a wide range of metabolic gene families.
Family network and household composition: a longitudinal dataset derived from the Karonga Health and Demographic Surveillance System, in rural Malawi
Authors: McLean Estelle , Kalobekamo Fredrick , Mwiba Oddie , Crampin Amelia C , Slaymaker Emma , Sear Rebecca , Dube Albert
Published: April 2024

Proximity to family, household composition, and structure are often studied as outcomes and as explanatory factors in a wide range of scientific disciplines. Here, we describe a large longitudinal dataset (currently including data from over 70,000 individuals from 2004 to 2017), including data on household structure, proximity to kin, population density, and other socio-demographic factors derived from data from the Karonga Health and Demographic Surveillance Site (HDSS) in Northern Malawi. We present how the dataset is generated, list some examples of how it can be used, and provide information on the limitations that affect the types of analyses that can be carried out.
The genome sequences of the marine diatom Epithemia pelagica strain UHM3201 (Schvarcz, Stancheva & Steward, 2022) and its nitrogen-fixing, endosymbiotic cyanobacterium
Authors: Schvarcz Christopher R. , Stancheva Rosalina , Turk-Kubo Kendra A. , Wilson Samuel T. , Zehr Jonathan P. , Edwards Kyle F. , Steward Grieg F. , Archibald John M. , Oatley Graeme , Sinclair Elizabeth , Santos Camilla , Paulini Michael , Aunin Eerik , Gettle Noah , Niu Haoyu , McKenna Victoria , O’Brien Rebecca ,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory Team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics Team,   EBI Aquatic Symbiosis Genomics Data Portal Team,   Aquatic Symbiosis Genomics Project Leadership
Published: April 2024

We present the genome assembly of the pennate diatom Epithemia pelagica strain UHM3201 (Ochrophyta; Bacillariophyceae; Rhopalodiales; Rhopalodiaceae) and that of its cyanobacterial endosymbiont (Chroococcales: Aphanothecaceae). The genome sequence of the diatom is 60.3 megabases in span, and the cyanobacterial genome has a length of 2.48 megabases. Most of the diatom nuclear genome assembly is scaffolded into 15 chromosomal pseudomolecules. The organelle genomes have also been assembled, with the mitochondrial genome 40.08 kilobases and the plastid genome 130.75 kilobases in length. A number of other prokaryote MAGs were also assembled.
Uremic pericarditis: a case report of favorable outcomes with early detection and management
Authors: Davalos Jesus , Sullivan Sierra , McCool Hannah , Fenner Blayne , Islam Ebtesam
Published: April 2024

Uremic pericarditis is a rare, potentially life-threatening complication of end-stage renal disease (ESRD) caused by the accumulation of uremic toxins. This case report describes a 32-year-old man with diabetes and ESRD on hemodialysis who developed uremic pericarditis. The patient presented with fever, chest pain, dyspnea, cough, and foot pain. Diagnostic investigations led to treatment with broad-spectrum antibiotics and surgical debridement of a necrotizing soft tissue infection of the right foot. The lack of clinical improvement in hemodynamic status prompted rapid investigation with electrocardiography and echocardiography, confirming the diagnosis of uremic pericarditis. Prompt initiation of renal replacement therapy with close monitoring led to a successful management outcome. This case report highlights the importance of early recognition, appropriate interventions, and a multidisciplinary approach in treating uremic pericarditis.
 
Keywords: End-stage renal disease, uremic pericarditis, dialysis-associated pericarditis, pericardial friction rub
UMA ANÁLISE DO MONSTRO MORAL NO CONTO “MADRUGADA NEGRA”, DE VIRIATO CORREIA: APRESENTANDO A CATEGORIA ESPACIAL COMO ELEMENTO DE CONSTRUÇÃO DO INSÓLITO FICCIONAL
Authors: Sousa Soraya de Melo Barbosa , Carneiro Gnaína dos Anjos
Published: April 2024

Resumo: Este artigo propõe um olhar sobre a produção literária do autor maranhense Viriato Correia, a partir da leitura do conto “Madrugada negra”, que integra a sua obra Novelas doidas (1921), sob o viés da literatura fantástica e suas mais recentes concepções. Apresentamos um recorte do trabalho de conclusão de curso, produzido, a partir da pesquisa desenvolvida no Projeto de Iniciação Científica – PIBIC/UEMA-22/23 – acerca da manifestação do insólito na produção do referido autor. Tem por objetivo analisar a manifestação do insólito na narrativa do conto “Madrugada negra”, da obra Novelas doidas, de autoria do maranhense Viriato Correia. Investigamos as categorias personagem e espaço como elementos fundamentais para a produção de sentidos por parte do leitor na configuração do monstro moral. O estudo caracteriza-se como bibliográfico, com procedimentos de análise qualitativa à luz da literatura fantástica, com ênfase no insólito ficcional, a partir de teóricos e pesquisadores tais como: Todorov (1981), García (2007), Roas (2014), Gama-Khalil (2012) e França (2012), entre outros. A análise nos fez compreender que o insólito se manifesta na obra, a partir da construção do espaço e das ações narradas pelo protagonista que levam o leitor a uma reflexão sobre as fronteiras entre a realidade e a quebra dos princípios racionais que regem a sociedade e as relações que o homem trava com seu semelhante para não ser desmascarado socialmente.
Palavras-chave: Espaço ficcional. Insólito ficcional. Literatura fantástica. Monstro moral. Viriato Correia
A comparative analysis of the physical fitness profile of Korean women’s national amateur boxers by weight category
Authors: Kim Kwang-Jun , Rhyu Hyun-Seung , Yoon Dong Hyun
Published: April 2024

The purpose of this study was to examine the differences in specific physical fitness of the national amateur women’s boxer. The Korean women’s national amateur boxers were classified into the lightweight category (LWC, n= 21) and middleweight category (MWC, n= 13), and body composition (percentage body fat and body mass index) and specific physical fitness (maximal muscle strength, anaerobic power, isokinetic muscle strength, cardiopulmonary endurance) were measured. The Mann–Whitney U-test was conducted to determine the differences in the body composition and specific physical fitness in women’s boxers. The percentage body fat (P= 0.004) and body mass index (P< 0.001) were significantly higher in the LWC compared to MWC. In addition, LWC showed significantly higher isokinetic muscle strength (P< 0.001), upper anaerobic mean power (P= 0.002), maximal muscle strength (P= 0.003), and maximal heart rate at anaerobic threshold (P= 0.029), maximal oxygen consumption (P< 0.001) and the 20-m shuttle-run exercise (P= 0.004) compared to MWC. In conclusion, the body fat percentage and body mass index levels among body composition were significantly higher in the MWC than in the LWC, and the constant muscle strength, maximum muscle strength, and cardiopulmonary endurance levels were significantly higher in the LWC than in the MWC. The results of this study are expected to provide useful data for planning future strategies for efficient and scientific training programs for each weight category.
Activated carbon cloth versus silver-based dressings in a population with diabetic foot ulcer: a randomised controlled trial
Authors: Bajuri Mohd Yazid , Nordin Abid
Published: April 2024

Objective:

Activated carbon cloth (ACC), known as Zorflex dressing, has emerged as an innovative approach in managing bacterial infection in diabetic foot ulcer (DFU) treatment. This pilot study was undertaken to determine the efficacy of Zorflex ACC dressing (Chemviron Carbon Cloth Division, UK) compared to standard silver-based dressing on DFUs.

Method:

An open label, comparative, randomised controlled trial enrolling patients who attended the diabetic foot clinic was conducted between August 2022 and August 2023. The primary endpoint was a difference of 20% in wound area reduction with the ACC dressing compared to silver-based dressing within eight weeks. The secondary endpoints were proportion of complete healing, time to healing and adverse events.

Results:

The cohort comprised 40 patients. The mean wound reduction percentage at 8 weeks for patients in the ACC arm was 85.40±16.00% compared with 65.08±16.36% in the silver-based dressing arm. Complete healing was observed in six of 20 patients in the ACC arm compared to two of 20 in the silver-based dressing arm.

Conclusion:

These data suggest that the ACC dressing promotes better ulcer healing in DFU patients than the silver-based dressing.
Demonstration of photonics-based D-band integrated localization and communication
Authors: Wang Qigejian , Deng Yirui , Mishra Deepak , Xie Yixuan , Aboutanios Elias , Atakaramians Shaghik
Published: April 2024

The terahertz spectrum has the ability to provide high-speed
communication and millimeter-level resolution. As a result,
terahertz-integrated sensing and communication (ISAC) has been
identified as a key enabler for 6G wireless networks. This work
discusses a photonics-based D-band communication system for integrated
high-resolution localization and high-speed wireless communication.
Our empirical results show that a communication rate of 5 Gbps over a
distance of 1.5 m and location identification of the target with
millimeter-level (<4mm) range resolution can be conducted
simultaneously using the same signal. We also show that the error due
to the thickness of the beam splitter can be eliminated, while the
quantization error and the random drift errors are the limiting
factors of the resolution achieved. This experimental demonstration
using D-band communication indicates that terahertz ISAC can be
realized for 6G networks while considering the underlying system
restrictions (e.g., bandwidth limit and lens diameter).
High-speed eye tracking based on a synchronized imaging mechanism by a dual-ring infrared lighting source
Authors: Zhang Xiao , Wang Lihui , He Yuan , Mou Zhiwei , Cao Yiqi
Published: April 2024

It is a challenge for conventional monocular-camera single-light source eye-tracking methods to achieve high-speed eye tracking. In this work, a dual-ring infrared lighting source was designed to achieve bright and dark pupils in high speed. The eye-tracking method used a dual-ring infrared lighting source and synchronized triggers for the even and odd camera frames to capture bright and dark pupils. A pupillary corneal reflex was calculated by the center coordinates of the Purkinje spot and the pupil. A map function was established to map the relationship between the pupillary corneal reflex and gaze spots. The gaze coordinate was calculated based on the mapping function. The average detection time of each gaze spot was 3.76 ms.
Comprehensive review of the directed design of optomechanical crystal cavities using intelligent algorithms
Authors: Yu Zhe , Bai Jian , Lu Qianbo
Published: April 2024

Optomechanical crystal cavities are devices based on optomechanical
interactions to manipulate photons and phonons on periodic
subwavelength structures, enabling precise measurement of the force
and displacement. The performance of the target structures varies when
applied to different applications. Optomechanical crystal cavities now
rely on an empirical forward design, which is inefficient. Therefore,
a desired shift is toward directed design with a “problem-oriented”
strategy. The directed optimization problem’s nonconvex nature and
extensive parameter space necessitate substantial computational
resources, driving the need for intelligent algorithms in a
sub-wavelength structure design. Intelligent algorithms can surpass
the constraints of traditional methods and discover novel structures
that are effective in different materials, topologies, modes, and
wavelengths. This paper provides an extensive overview of intelligent
algorithms for guiding the directed design of optomechanical crystal
cavities. It presents a systematic classification of 15 algorithmics,
including, but not limited to, topology algorithms, particle swarm
optimization algorithms, convolutional neural networks, and generative
adversarial networks. The article provides a comprehensive review and
thorough analysis of the principle and current application state, as
well as the advantages and disadvantages of each intelligent
algorithm. By using these intelligent algorithms, researchers can
enhance the efficiency and accuracy of optimizing optomechanical
crystal cavities in a broader design space.
Experimental demonstration of scene-based cophasing in optical synthetic aperture imaging using the SPGD algorithm
Authors: Hirose Makoto , Miyamura Norihide
Published: April 2024

Large-aperture telescopes based on optical synthetic aperture imaging are investigated for recent high-resolution spaceborne observations. An enabling technique of aperture synthesis is a cophasing method to suppress a piston-tip-tilt error between sub-apertures. This paper proposes a scene-based cophasing technique using the stochastic parallel gradient descent (SPGD) algorithm, assuming application to high-resolution Earth observation. A significant advantage of the SPGD algorithm is a model-less cophasing capability based on extended scenes, but the simultaneous scene-based piston-tip-tilt correction between multiple apertures has not been demonstrated. In this paper, we developed a tabletop synthetic aperture imaging system with 37 sub-apertures and demonstrated extended-scene-based piston-tip-tilt control by optimizing applied voltages to 111 actuators simultaneously. The demonstration experiments used not only static scenes but also a time-varying dynamic scene for observation targets. In every measurement, the proposed scene-based approach reduced the initially defined piston-tip-tilt errors, and the image sharpness significantly improved, although the correction rate in the dynamic scene observation was slower. Finally, this paper discusses the influence of scene dynamics on image-based cophasing.
Computationally-efficient linear scheme for overlap time-gating spatial frequency domain diffuse optical tomography using an analytical diffusion model
Authors: Dong Yihan , Bai Wenxing , Zhang Yaru , Zhang Limin , Liu Dongyuan , Gao Feng
Published: April 2024

Time-domain (TD) spatial frequency domain (SFD) diffuse optical tomography (DOT) potentially enables laminar tomography of both the absorption and scattering coefficients. Its full time-resolved-data scheme is expected to enhance performances of the image reconstruction but poses heavy computational costs and also susceptible signal-to-noise ratio (SNR) limits, as compared to the featured-data one. We herein propose a computationally-efficient linear scheme of TD-SFD-DOT, where an analytical solution to the TD phasor diffusion equation for semi-infinite geometry is derived and used to formulate the Jacobian matrices with regard to overlap time-gating data of the time-resolved measurement for improved SNR and reduced redundancy. For better contrasting the absorption and scattering and widely adapted to practically-available resources, we develop an algebraic-reconstruction-technique-based two-step linear inversion procedure with support of a balanced memory-speed strategy and multi-core parallel computation. Both simulations and phantom experiments are performed to validate the effectiveness of the proposed TD-SFD-DOT method and show an achieved tomographic reconstruction at a relative depth resolution of ∼4 mm.
Scalable stable comb-to-tone integrated RF photonic drive for superconducting qubits
Authors: Melton T. , DeVore P. T. S. , McMillan J. , Chan J. , Calonico-Soto A. , Beck K. M. , Wong C. W. , Chou J. T. , Gowda A.
Published: April 2024

The recent advent of quantum computing has the potential to overhaul security, communications, and scientific modeling. Superconducting qubits are a leading platform that is advancing noise-tolerant intermediate-scale quantum processors. The implementation requires scaling to large numbers of superconducting qubits, circuit depths, and gate speeds, wherein high-purity RF signal generation and effective cabling transport are desirable. Fiber photonic-enhanced RF signal generation has demonstrated the principle of addressing both signal generation and transport requirements, supporting intermediate qubit numbers and robust packaging efforts; however, fiber-based approaches to RF signal distribution are often bounded by their phase instability. Here, we present a silicon photonic integrated circuit-based version of a photonic-enhanced RF signal generator that demonstrates the requisite stability, as well as a path towards the necessary signal fidelity.
A method to efficiently and rapidly approximate the vectorial fields generated by large area metasurfaces
Authors: Henning A. J. , Martin H. , Jiang X.
Published: April 2024

In order to calculate the electromagnetic fields that are produced after light passes through a metasurface, simulation methods such as the Finite-Difference Time-Domain method are often employed. While these provide a good approximation to the fields, the level of detail at which the volume of space that the light is propagating in needs to be modelled and the time for which simulations need to run, mean that as the area of the metasurface is increased these simulations rapidly become unwieldy. In this paper we show how the result of a FDTD simulation of a unit cell can be used to generate a good approximation of the vectorial field that large area metasurfaces will generate, but using a fraction of the computational resources. This approach can provide an intermediate design step, allowing potentially interesting designs to be rapidly identified or discarded.
Estimation of losses caused by sidewall roughness in thin-film lithium niobate rib and strip waveguides
Authors: Hammer Manfred , Babel Silia , Farheen Henna , Padberg Laura , Scheytt J. Christoph , Silberhorn Christine , Förstner Jens
Published: April 2024

Samples of dielectric optical waveguides of rib or strip type in thin-film lithium niobate (TFLN) technology are characterized with respect to their optical loss using the Fabry-Pérot method. Attributing the losses mainly to sidewall roughness, we employ a simple perturbational procedure, based on rigorously computed mode profiles of idealized channels, to estimate the attenuation for waveguides with different cross sections. A single fit parameter suffices for an adequate modelling of the effect of the waveguide geometry on the loss levels.
Young’s double-slit interference with single hard X-ray photons
Authors: Gureyev Timur E. , Hall Chris J. , Arhatari Benedicta , Pelliccia Daniele , Aminzadeh Alaleh , Pavlov Konstantin M. , Quiney Harry M.
Published: April 2024

Double-slit interference experiments using monochromatic hard X-rays with the energy of 25 keV are presented. The experiments were performed at a synchrotron source with a distance of 110 m between the interferometer and the detector to produce an interference pattern with a sufficiently broad period that could be adequately sampled by a photon-counting detector with 75 micrometre pixels. In the single-particle version of the experiment, over one million image frames with a single registered photon in each one were collected. The sum of these frames showed a clear presence of the interference pattern with the expected period. Subsequent analysis provided an objective estimation of the minimal number of detected photons required to determine, in accordance with the Rose criterion, the presence of the photon interference. Apart from a general theoretical interest, these investigations were aimed at exploring the possibility of medical X-ray phase-contrast imaging in photon-counting regime at minimal radiation doses.
Synergistic epistasis among cancer drivers can rescue early tumors from the accumulation of deleterious passengers
Authors: Alejandre Carla , Calle-Espinosa Jorge , Iranzo Jaime
Published: April 2024

Epistasis among driver mutations is pervasive and explains relevant features of cancer, such as differential therapy response and convergence towards well-characterized molecular subtypes. Furthermore, a growing body of evidence suggests that tumor development could be hampered by the accumulation of slightly deleterious passenger mutations. In this work, we combined empirical epistasis networks, computer simulations, and mathematical models to explore how synergistic interactions among driver mutations affect cancer progression under the burden of slightly deleterious passengers. We found that epistasis plays a crucial role in tumor development by promoting the transformation of precancerous clones into rapidly growing tumors through a process that is analogous to evolutionary rescue. The triggering of epistasis-driven rescue is strongly dependent on the intensity of epistasis and could be a key rate-limiting step in many tumors, contributing to their unpredictability. As a result, central genes in cancer epistasis networks appear as key intervention targets for cancer therapy.
Improving care pathways for children with severe illness through implementation of the ASPIRE mHealth primary ETAT package in Malawi
Authors: Desmond Nicola , Henrion Marc Y. R. , Gondwe Mtisunge , O’Byrne Thomasena , Iroh Tam Pui-Ying , Nyirenda Deborah , Pollock Louisa , Majamanda Maureen Daisy , Makwero Martha , Geldof Marije , Dube Queen , Phiri Chimwemwe , Banda Chimwemwe , Kachala Rabson , Heyderman Prof Robert S. , Masesa Clemens , Lufesi Norman , Lalloo David G.
Published: April 2024

Providing emergency care in low resource settings relies on delivery by lower cadres of health workers (LCHW). We describe the development, implementation and mixed methods evaluation of a mobile health (mHealth) triage algorithm based on the WHO Emergency, Triage, Assessment, and Treatment (ETAT) for primary-level care. We conducted an observational study design of implementation research. Key stakeholders were engaged throughout implementation. Clinicians and LCHW at eight primary health centres in Blantyre district were trained to use an mHealth algorithm for triage. An mHealth patient surveillance system monitored patients from presentation through referral to tertiary and final outcome. A total of 209,174 children were recorded by ETAT between April 2017 and September 2018, and 155,931 had both recorded mHealth and clinician triage outcome data. Concordance between mHealth triage by lower cadres of HCW and clinician assessment was 81·6% (95% CI [81·4, 81·8]) over all outcomes (kappa: 0·535 (95% CI [0·530, 0·539]). Concordance for mHealth emergency triage was 0.31 with kappa 0.42. The most common mHealth recorded emergency sign was breathing difficulty (74·1% 95% CI [70·1, 77·9]) and priority sign was raised temperature (76·2% (95% CI [75·9, 76·6]). A total of 1,644 referrals out of 3,004 (54·7%) successfully reached the tertiary site. Both providers and carers expressed high levels of satisfaction with the mHealth ETAT pathway. An mHealth triage algorithm can be used by LCHWs with moderate concordance with clinician triage. Implementation of ETAT through an mHealth algorithm documented successful referrals from primary to tertiary, but half of referred patients did not reach the tertiary site. Potential harms of such systems, such as cases requiring referral being missed during triage, require further evaluation. The ASPIRE mHealth primary ETAT approach can be used to prioritise acute illness and support future resource planning within both district and national health system.
EMS injury cause codes more accurate than emergency department visit ICD-10-CM codes for firearm injury intent in North Carolina
Authors: Snyder Nicole L. , Ising Amy , Waller Anna E.
Published: April 2024

Background

The timeliness, accuracy, and completeness of data for firearm injury surveillance is crucial for public health surveillance efforts and informing injury prevention measures. While emergency department (ED) visit data can provide near real-time information on firearms injuries, there are concerns surrounding the accuracy of intent coding in these data. We examined whether emergency medical service (EMS) data provide more accurate firearm injury intent coding in comparison to ED data.

Methods

We applied a firearm injury definition to EMS encounter data in NC’s statewide syndromic surveillance system (NC DETECT), from January 1, 2021, through December 31, 2022. We manually reviewed each record to determine intent, and the corresponding manual classifications were compared to the injury cause codes entered in the EMS data and to ED visit records where EMS-ED record linkage was possible. We then calculated the sensitivity, specificity, positive and negative predictive values for each intent classification in SAS 9.4 using the manually reviewed intent classifications as the gold standard.

Results

We identified 9557 EMS encounters from January 1, 2021, through December 31, 2022 meeting our firearm injury definition. After removing false positives and duplicates, 8584 records were available for manual injury classification. Overall, our analysis demonstrated that manual and EMS injury cause code classifications were comparable. However, for the 3401 EMS encounters that could be linked to an ED visit record, sensitivity of the ED ICD-10-CM codes was low for assault and intentional self-harm encounters at 18.2% (CI 16.5–19.9%) and 22.2% (CI 16–28.5%), respectively. This demonstrates a marked difference in the reliability of the intent coding in the two data sources.

Conclusions

This study illustrates both the value of examining EMS encounters for firearm injury intent, and the challenges of accurate intent coding in the ED setting. EMS coding has the potential for more accurate intent coding than ED coding within the context of existing hospital-based coding guidance. This may have implications for future firearm injury research, especially for nonfatal firearm injuries.
Experiences of trauma and psychometric properties of the Life Events Checklist among adults in Uganda
Authors: Morawej Zahra , Misra Supriya , Ametaj Amantia A. , Stevenson Anne , Kyebuzibwa Joseph , Gelaye Bizu , Akena Dickens
Published: April 2024

Exposure to potentially traumatic events (PTE) is common and increases an individual’s risk of developing post-traumatic stress disorder (PTSD) and other psychiatric disorders. PTEs can be screened with the Life Events Checklist for DSM 5 (LEC-5). However, the psychometric properties of the LEC-5 have never been assessed in Uganda. We aimed to estimate the prevalence of PTEs and evaluate the factor structure of the LEC-5 in a sample of N = 4,479 Ugandan adults between February 2018 –March 2020. We used the phenotyping data from a case-control study (NeuroGAP-Psychosis) in Uganda investigating the genetic and environmental risk factors for psychosis spectrum disorders with 4,479 participants (2,375 cases and 2,104 controls). Prevalence for PTEs was determined for all participants and by case-control status. The factor structure of the LEC-5 was assessed using an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). The overall prevalence of exposure to one or more types of PTEs was 60.5%. Cases reported more frequency of exposure to PTEs than controls (64.2% vs 55.4%; p<0.001). The most frequently endorsed traumatic event was physical assault (22.8%), while exposure to toxic substances was the least endorsed (1.7%). There were several differences among the types of events experienced between cases and controls, including cases reporting more experiences of physical (28.6% vs. 16.2%, p<0.001) and sexual assault (11.5% vs. 5.0%, p<0.001) than controls. The EFA yielded a six-factor model that explained 49.8% of the total variance. The CFA showed that a theoretical seven-factor model based on the South African Stress and Health survey was a better fitting model (CFI = 0.935; TLI = 0.908; RMSEA = 0.026) than the EFA. This study revealed a high prevalence of PTEs among cases and controls, and the LEC-5 was found to have good psychometric properties among Ugandan adults.
Sustainability outcomes and policy implications: Evaluating China’s “old urban neighborhood renewal” experiment
Authors: Wang Rui , Wu Hong , Chiles Robert , Yang Yizhao
Published: April 2024

Globally, old urban neighborhood transformation has become a new urban sustainability focus for its significant contribution to the United Nation’s Sustainable Development Goal 11. A regeneration-oriented approach is particularly important for Chinese cities with a dwindling land supply, obsoleting infrastructure, and inadequate standard of living. Using a mixed-methods approach informed by BREEAM Communities, we examined two Chinese initiatives—old urban neighborhood renewal (OUNR) and sponge city development (SCD)—through a comprehensive study of pilot project sustainability, policy emphases and gaps, and broader governance implications. We found that SCD’s top-down technocratic management was highly efficient in enhancing neighborhood hydrological functions and physical environment. However, successes were undermined by the lack of climate considerations and civic participation. Besides actionable recommendations for applied scholarship and policymaking in China, we provide insight into how the OUNR/SCD initiatives may broadly inform worldwide urban regeneration practices through project and policy experimentations that build adaptive capacity.
Field evaluation of a novel semi-quantitative point-of-care diagnostic for G6PD deficiency in Indonesia
Authors: Sadhewa Arkasha , Panggalo Lydia V. , Nanine Illene , Price Ric N. , Thriemer Kamala , Satyagraha Ari W. , Ley Benedikt
Published: April 2024

Background

The WHO recommends routine testing of G6PD activity to guide radical cure in patients with Plasmodium vivax malaria. Females may have intermediate G6PD enzyme activity and to date, only complex diagnostics are able to reliably identify them. The semi-quantitative G6PD diagnostic “One Step G6PD Test” (Humasis, RoK; “RDT”) is a lateral flow assay that can distinguish deficient, intermediate, and normal G6PD status and offers a simpler diagnostic alternative.

Methods

G6PD status of participants enrolled in Malinau and Nunukan Regencies and the capital Jakarta was assessed with the RDT, and G6PD activity was measured in duplicate by reference spectrophotometry. The adjusted male median (AMM) of the spectrophotometry measurements was defined as 100% activity; 70% and 30% of the AMM were defined as thresholds for intermediate and deficient G6PD status, respectively. Results were compared to those derived from spectrophotometry at the clinically relevant G6PD activity thresholds of 30% and 70%.

Results

Of the 161 participants enrolled, 10 (6.2%) were G6PD deficient and 12 (7.5%) had intermediate G6PD activity by spectrophotometry. At the 30% threshold, the sensitivity of the RDT was 10.0% (95%CI: 0.3–44.5%) with a specificity of 99.3% (95%CI: 96.4–100.0%); the positive predictive value was 50.0% (95%CI: 1.3–98.7%) and the negative predictive value 94.3% (95%CI: 89.5–97.4%). The corresponding figures at the 70% threshold were 22.7% (95%CI: 7.8–45.4%), 100.0% (95%CI: 97.4–100.0%), 100.0% (95%CI: 47.8–100.0%) and 89.1% (95%CI: 83.1–93.5%), respectively.

Conclusion

While there is a dire need for an easy-to-use, economical, semi-quantitative diagnostic for the point of care, the observed performance of the “One Step G6PD Test” in its current form was insufficient to guide antimalarial treatment.
Deep multiple instance learning versus conventional deep single instance learning for interpretable oral cancer detection
Authors: Koriakina Nadezhda , Sladoje Nataša , Bašić Vladimir , Lindblad Joakim
Published: April 2024

The current medical standard for setting an oral cancer (OC) diagnosis is histological examination of a tissue sample taken from the oral cavity. This process is time-consuming and more invasive than an alternative approach of acquiring a brush sample followed by cytological analysis. Using a microscope, skilled cytotechnologists are able to detect changes due to malignancy; however, introducing this approach into clinical routine is associated with challenges such as a lack of resources and experts. To design a trustworthy OC detection system that can assist cytotechnologists, we are interested in deep learning based methods that can reliably detect cancer, given only per-patient labels (thereby minimizing annotation bias), and also provide information regarding which cells are most relevant for the diagnosis (thereby enabling supervision and understanding). In this study, we perform a comparison of two approaches suitable for OC detection and interpretation: (i) conventional single instance learning (SIL) approach and (ii) a modern multiple instance learning (MIL) method. To facilitate systematic evaluation of the considered approaches, we, in addition to a real OC dataset with patient-level ground truth annotations, also introduce a synthetic dataset—PAP-QMNIST. This dataset shares several properties of OC data, such as image size and large and varied number of instances per bag, and may therefore act as a proxy model of a real OC dataset, while, in contrast to OC data, it offers reliable per-instance ground truth, as defined by design. PAP-QMNIST has the additional advantage of being visually interpretable for non-experts, which simplifies analysis of the behavior of methods. For both OC and PAP-QMNIST data, we evaluate performance of the methods utilizing three different neural network architectures. Our study indicates, somewhat surprisingly, that on both synthetic and real data, the performance of the SIL approach is better or equal to the performance of the MIL approach. Visual examination by cytotechnologist indicates that the methods manage to identify cells which deviate from normality, including malignant cells as well as those suspicious for dysplasia. We share the code as open source.
From struggle to strength in African and Middle Eastern newcomers’ integration stories to Canada: A participatory health equity research study
Authors: Fong Maggie , Liu Amy , Lung Bryan , Alayche Ibrahim , Sayfi Shahab , Kirenga Ryan Yuhi , Chomienne Marie Hélène , Saad Ammar , Grenier Jean , Kassam Azaad , Ahmed Rukhsana , Pottie Kevin
Published: April 2024

Background and objectives

Newcomers (immigrants, refugees, and international students) face many personal, gender, cultural, environmental and health system barriers when integrating into a new society. These struggles can affect their health and social care, reducing access to mental health care. This study explores the lived experiences of African and Middle Eastern newcomers to Ontario, Canada. An understanding of newcomer integration challenges, successes and social justice issues is needed to improve health equity and social services.

Methods

In this qualitative study, we used a participatory research approach to collect stories reflecting participants’ integration perspectives and experiences. Beginning with our immigrant community network, we used snowball sampling to recruit newcomers, ages 18 to 30, originating from Africa or the Middle East. We used qualitative narrative analysis to interpret stories, identifying context themes, integrating related barriers and facilitators, and resolutions and learnings. We shared our findings and sought final feedback from our participants.

Findings

A total of 18 newcomers, 78% female and approximately half post-secondary students, participated in the study. Participants described an unknown and intimidating migration context, with periods of loneliness and isolation aggravated by cold winter conditions and unfamiliar language and culture. Amidst the struggles, the support of friends and family, along with engaging in schoolwork, exploring new learning opportunities, and participating in community services, all facilitated integration and forged new resilience.

Conclusions

Community building, friendships, and local services emerged as key elements for future immigrant service research. Utilizing a participatory health research approach allowed us to respond to the call for social justice-oriented research that helps to generate scientific knowledge for promoting culturally adaptive health care and access for marginalized populations.
Kooperation in inklusiven Schulen
Authors: Lütje-Klose Birgit , Wild Elke , Grüter Sandra , Gorges Julia , Neumann Phillip , Papenberg Antonia , Goldan Janka
Published: April 2024

Schulische Inklusion kann nur gelingen, wenn tragfähige Kooperationsstrukturen aufgebaut werden. Das Bielefelder Fortbildungskonzept zur Kooperation in inklusiven Schulen (BiFoKi) zeigt, wie die Bereiche teaminterne und multiprofessionelle Zusammenarbeit sowie Kooperation von Schule und Familie optimiert und miteinander in Verbindung gebracht werden können. Das Praxishandbuch bietet die Grundlagen für die eigenständige Durchführung von umfassenden Fortbildungen, die mit Hilfe umfangreicher Online-Materialien auch in einzelne Module geteilt werden können.
The Theological Significance of Non-Chronological Qur'anic Stories
Authors: Varzandeh Mohsen , Dewi Subkhani Kusuma
Published: April 2024

The narration of Qur'anic stories, which are identified as non-chronological, often leads to assertions about their function as advice and moral lessons, raising theological questions about their scientific nature. The way people understand these stories often focuses on their lessons and guidance, missing how they relate to the Prophet's da'wah. This study delves into the relationship between these narratives and their historical context, employing qualitative methods and drawing on the Sapir-Whorf Hypothesis, which suggests that language shapes our understanding of the world. Focusing on the narratives depicting the stories of the Prophets in Surah Hūd [11], the study reveals that the parts of these stories that emphasize the rejection of da'wah resonate with the experiences of Prophet Muhammad. The accounts of the rejected Prophets serve as a catalyst to ignite Prophet Muhammad's fervor for da'wah through the power of language. The portrayal of rejection in every da'wah struggle, accompanied by the narrative of punishment and annihilation, is distinctively crafted in the Qur'an, with a focus on punishment in the afterlife. The Prophet Muhammad's circumstances during the process of proselytizing are the primary factor in arranging the story fragments without chronological order.