bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic burden of musculoskeletal disorders in Tanzania: results from a community-based survey
Authors: Deidda Manuela , Grieve Eleanor , Krauth Stefanie , Hsieh Ping-Hsuan , Yongolo Nateiya , Siebert Stefan , Halliday Jo , Biswaro Sanjura Mandela , Kilonzo Kajiru , Walker Richard , Kelly Clive , Msoka Elizabeth F , Kiula Kiula , Mmbaga Blandina , McIntosh Emma
Published: January 2025

Objectives

To identify, measure and value the economic burden of musculoskeletal (MSK) disorders in the Kilimanjaro region, Tanzania.

Design

Community-based cross-sectional survey (undertaken between January and September 2021).

Setting

Hai district, Kilimanjaro, Tanzania.

Participants

Households resident in the Hai district.

Methods

A two-stage cluster sampling was used to select a representative sample of all Hai district residents. Clinical screening tools were used to identify and measure MSK disorders through a tiered approach. An economic questionnaire measuring healthcare costs, out-of-pocket costs, absenteeism, presenteeism and work productivity loss was administered to those with likely MSK disorders and selected controls (individuals without MSK disorders, matched by age and gender). Resource use was valued using country-specific costs. Two-part model regressions were fitted. A descriptive analysis of catastrophic expenditure was also conducted.

Main outcome measure

Healthcare costs, productivity costs and total costs.

Results

Annual average productivity and healthcare costs were, respectively, 3.5 and 3 times higher for those with likely MSK disorders than controls. Productivity costs of individuals with MSK disorders were Int$487 vs Int$132 in the control group (difference: Int$355, 95% CI Int$222 to Int$488). Healthcare costs in those with MSK were Int$269 vs Int$88 in the control group (difference: Int$181, 95% CI Int$34 to Int$327). The difference in terms of out-of-pocket expenses was economically substantial in magnitude, although not statistically significant.

Conclusion

The evidence will be used to inform policies addressing MSK disorders, by promoting the design of interventions, service provision, health promotion and awareness activities at local, regional and national level.
Prevalence of delirium in German nursing homes: protocol for a cross-sectional study
Authors: Dörner Jonas , Houdelet-Oertel Alexandre , Arslan Zafer , Lauer Romy , Otte Ina , Vollmar Horst Christian , Thürmann Petra , Palm Rebecca , Holle Bernhard
Published: January 2025

Introduction

Delirium is a neuropathological syndrome that is associated with several negative outcomes. Nursing home residents are vulnerable to developing delirium. Valid prevalence data and associated factors are not yet available for Germany. Therefore, the aim of the prevalence study of the DeliA project (Delirium in Nursing Homes) is to assess the prevalence of delirium and its associated factors in 750 nursing home residents.

Methods and analysis

Trained registered nurses from each participating nursing home will collect the data in a multicentre cross-sectional study. The inclusion criteria for residents are valid informed consent, age ≥65 years and sufficient language skills. The exclusion criteria are aphasia, coma, deafness or end-of-life status. The 4 ‘A’s Test will be used as the primary measurement. Delirium motor subtypes will be determined using the Delirium Motor Subtype Scale. Covariables for associated factors, including functional impairments, pain, cognitive status and nutritional status, are assessed through standardised measurements. Moreover, data such as prescribed drugs or medical diagnosis, hearing impairment or falls will be assessed from the nursing records. Furthermore, the Drug Burden Index will be calculated, and associated factors will be determined using a logistic regression model. The period for data collection in participating nursing homes is planned for 2 consecutive weeks in April 2024.

Ethics and dissemination

This study was approved by the Ethics Committee of Witten/Herdecke University (no. 82/2023). Findings will be published in peer-reviewed journals and presented at conferences.

Registration

https://osf.io/xkfvh/(DOI 10.17605/OSF.IO/XKFVH).
Prevalence, determinants and impact of urinary incontinence on quality of life among Palestinian postpartum women: a cross-sectional study
Authors: Hersh Bayan , Shaban Rawan , Nazzal Zaher
Published: January 2025

Objectives

Urinary incontinence (UI) is prevalent among women, particularly during the postpartum period, impacting various aspects of quality of life (QoL). The objectives of this study are to determine the prevalence of postpartum UI among Palestinian women, explore its relationship with delivery mode, identify associated risk factors and assess its impact on QoL.

Design

A cross-sectional study.

Setting and participants

The study targeted postpartum women attending primary healthcare centres in the North West Bank of Palestine. Data were collected using interviewer-administered questionnaires. The primary outcome was the prevalence of postpartum UI, and the secondary outcomes included risk factors associated with UI and its impact on QoL. We used multivariate logistic regression analysis to identify factors associated with UI while adjusting for confounding variables. The Institutional Review Board of An-Najah National University approved the study.

Results

Out of 507 participants, 13.6% (95% CI 10.8% to 16.9%) experienced postpartum UI, with 78.3% reporting moderate-to-severe symptoms. Maternal body mass index (BMI) (adjusted OR (aOR) 1.98; 95% CI 1.1 to 3.7; adjusted p=0.033) and experiencing UI during the last pregnancy (aOR 2.25; 95% CI 1.3 to 3.8; adjusted p=0.003) were significant risk factors for postpartum UI. No significant association was found between the normal vaginal delivery and postpartum UI compared with caesarean section (aOR 1.5; 95% CI 0.90 to 1.5; adjusted p=0.284). Postpartum UI severity significantly correlated with QoL, particularly in social embarrassment (p=0.005), psychosocial impact (p≤0.001) and avoidance and limiting behaviours (p≤0.001).

Conclusion

The prevalence of postpartum UI in Palestinian women is consistent with global findings. Experiencing UI during the last pregnancy and higher maternal BMI were identified as key risk factors for postpartum UI. These results highlight the need for early detection, intervention and preventive strategies to mitigate the impact of postpartum UI on QoL.
Barriers to early diagnosis and treatment of cervical cancer in Addis Ababa, Ethiopia: qualitative study
Authors: Dereje Nebiyu , Addissie Adamu , Worku Alemayehu , Assefa Mathewos , Gebremariam Alem , Kantelhardt Eva Johanna , Jemal Ahmedin
Published: January 2025

Objective

Cervical cancer remains the most diagnosed and deadly cancer among women in low and middle income countries, including Ethiopia, although it can be controlled if detected and treated early. However, research on contextual barriers to early diagnosis and treatment of cervical cancer is limited in Ethiopia. This study aimed to describe the lived experience of the patients and to explore the barriers to early diagnosis and treatment of cervical cancer.

Design

We conducted a phenomenological qualitative study, which was part of a larger mixed-methods study.

Setting

Tikur Anbesa Specialised Comprehensive Hospital, Addis Ababa, Ethiopia.

Participants

24 purposively selected patients with diagnostic delay and 16 patients with treatment delay were interviewed using an in-depth interview guide (IDI).

Results

Two broad themes and seven sub-themes to explain the barriers to early diagnosis and treatment of cervical cancer emerged. These themes and sub-themes include patient related barriers (inadequate knowledge, visits to traditional healers and practice of religious rituals as a solution for illness, poor adherence to the treatments and fear of side effects, and financial hardships) and provider related barriers (limited access to diagnostic and treatment infrastructure, inadequate training of healthcare providers and poor quality of care).

Conclusions

The findings of the study underscore the need to reinforce awareness among patients and the community, scale up the screening, diagnostic and treatment infrastructure, and advocate for quality of care in the healthcare facilities in Ethiopia to promote early diagnosis and treatment of cervical cancer.
Mapping the landscape and evidence of cross-sectoral collaboration models targeting individuals referred for assessment of attention-deficit hyperactivity disorder or autism spectrum disorder: protocol for a scoping review
Authors: Kristensen Rikke Kirstine , Andersen Pernille Tanggaard , Bilenberg Niels , Milling Emilie Dalsgaard , Dalgaard Guldager Julie
Published: January 2025

Introduction

Neurodevelopmental disorders, notably attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), present substantial challenges in mental health. Individuals referred for assessment in a psychiatric unit experience complex needs. This implies that their needs necessitate coordination across multiple sectors. Cross-sectoral collaboration models have emerged as essential strategies for addressing the complexities of these disorders. However, evidence of their existence, implementation and success remains limited. This protocol aims to outline a scoping review where we will explore existing collaboration models, evaluate their implementation and gain an understanding of how cross-sectoral collaboration models can be developed to ultimately benefit individuals referred for assessment of ADHD or ASD.

Methods and analysis

This proposed scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search will be conducted across PubMed, CINAHL, Embase, PsycINFO and Google Scholar, as well as grey literature sources, between 1 December 2024 and 1 January 2025. Inclusion criteria will encompass studies focusing on cross-sectoral collaboration for individuals referred for assessment of ADHD or ASD, published in English, Danish, Norwegian or Swedish. The search will use a three-block search string, with iterative refinement guided by familiarity with the evidence base. Data extraction will involve study characteristics and implementation details, using the Consolidated Framework for Implementation Research in combination with Proctoret al’s implementation outcomes framework. Results will be synthesised into descriptive tables, providing a comprehensive mapping of existing models and emphasising implementation feasibility.

Ethics and dissemination

Ethical approval is not required for this protocol since it involves the review of existing literature without the involvement of human participants or personal data. Findings will be disseminated at national and international conferences and will be integrated into future efforts to develop cross-sectoral collaboration models in Denmark.
Detection of Elder Abuse Through Emergency Care Technicians Screening Tool Revision for Home-Based Primary Care (DETECT-RPC): a cluster randomised controlled trial study protocol
Authors: Cannell Brad , Sevey Nicholas , Livingston Melvin D , Burnett Jason , Lees Haggerty Kristin , Pickering Carolyn
Published: January 2025

Introduction

The annual prevalence of elder mistreatment (EM) in cognitively intact older adults is estimated to be 11%, yet the annual prevalence in older adults with Alzheimer’s disease and related dementias (AD/ADRD) is estimated to be as high as 75%. Associated with a decrease in quality of life and increase in risk of mortality, EM represents a significant public health burden. Home-based primary care (HBPC) providers are uniquely positioned to address the critical need for robust EM screening and reporting, especially among individuals with AD/ADRD. This protocol seeks to adapt the Detection of Elder mistreatment Through Emergency Care Technicians (DETECT) screening tool, previously used by emergency medical technicians, for use by HBPC providers.

Methods and analysis

The protocol consists of two main phases which include four substudies. Substudy 1 uses a qualitative approach to understand the current barriers to clinician identification and reporting of EM in HBPC, including what adaptations need to be made to DETECT for use in HBPC. Substudy 2 is a cluster randomised controlled trial evaluating the impact of Detection of Elder Abuse Through Emergency Care Technicians Screening Tool Revision for Home-Based Primary Care (DETECT-RPC) on clinician identification of older adult patients with increased risk of EM and referring their concerns to the appropriate authorities and service providers. Substudies 3 and 4 apply a mixed-methods approach to postscreening interviews with clinicians and caregiver/care recipient dyads, respectively. These substudies aim to evaluate DETECT-RPC’s impact on barriers to EM identification and reporting as well as the harms and benefits of using the screening tool from the perspective of patients and their caregivers.

Ethics and dissemination

All components of this study are conducted with the approval of the Institutional Review Board of the University of Texas Health Science Center at Houston (HSC-SPH-22-0732, HSC-SPH-23-0105, HSC-SPH-23-0965, HSC-SPH-24-0123). The results of this study will be disseminated through a peer-reviewed journal as well as through presentations at professional conferences, invited talks and other standard channels.

Trial registration number

NCT05958654(ClinicalTrials.gov).
Burnout in New Zealand resident doctors: a cross-sectional study of prevalence and risk factors
Authors: Boyle Alex B , Shay Denys , Martyn Tanushk , Savage Earle , MacLean Simon B M , Every-Palmer Susanna
Published: January 2025

Objective

Burnout syndrome, characterised by emotional exhaustion, depersonalisation and decreased personal accomplishment, is well documented in the medical workforce. This study aimed to investigate the prevalence of burnout in New Zealand resident doctors (doctors who have yet to complete their specialty training).

Design

Cross-sectional survey study of resident doctors in New Zealand.

Setting

Distributed by email.

Participants

509 resident doctors currently working in New Zealand. Doctors not currently working or those who have completed their specialty training (consultants) were excluded.

Primary and secondary outcome measures

Participants were asked about a number of demographic and work-related factors and to complete the Maslach Burnout Inventory, which measures the three dimensions of burnout: ‘Emotional Exhaustion’, ‘Depersonalisation’ and low ‘Personal Accomplishment’.

Results

409/509 (80%) of respondents had scores indicating high burnout on at least one dimension. 163 (32%) had high burnout on one dimension, 111 (22%) on two dimensions and 135 (26%) on all three dimensions. Feeling well supported protected against burnout in all three dimensions: emotional exhaustion (OR 0.34, CI 0.19 to 0.60), depersonalisation (OR 0.52, CI 0.31 to 0.86) and decreased personal accomplishment (OR 0.51, CI 0.29 to 0.78). Having a manageable workload protected against emotional exhaustion (OR 0.23, CI 0.13 to 0.37) and depersonalisation (OR 0.39, CI 0.24 to 0.61). Increasing weekly exercise was protective for personal accomplishment (OR 0.846, CI 0.73 to 0.98). Having children was protective for depersonalisation (OR 0.7, CI 0.53 to 0.90). A personal history of depression or anxiety was associated with burnout on all three dimensions: emotional exhaustion (OR 2.86, CI 1.67 to 5.00), depersonalisation (OR 1.66, CI 1.01 to 2.73) and decreased personal accomplishment (OR 1.71, CI 1.05 to 2.80). Alcohol misuse was associated with an increased risk of depersonalisation (OR 1.68, CI 1.08 to 2.62), and feeling inadequately remunerated was associated with emotional exhaustion (OR 2.27, CI 1.28 to 4.17). Qualitative data revealed concerns about poor staffing, inadequate remuneration, a focus on service provision over education, slow career progression and difficulty balancing work and specialty examinations.

Conclusions

Burnout has a high prevalence in New Zealand’s resident doctor workforce. Several associations and qualitative themes were identified. These findings may aid in the development of interventions to mitigate burnout in the medical workforce.
Impact of the COVID-19 pandemic on epidemiological and clinical characteristics of inpatients with burns in a Northwest China burn centre: a retrospective study
Authors: Cui Yiwei , Feng Jian , Xiao Shuao , Liu Jiaqi , Han Yige , Zhang Yuheng , Bian Yongqian , Li Xueyong
Published: January 2025

Objective

This study aimed to assess the impact of the COVID-19 pandemic on the characteristics and outcomes of patients with burns in a burn centre situated in Northwest China.

Design

A retrospective descriptive study.

Setting

This study was conducted in Tangdu Hospital, a major regional burn centre in Xi'an, Shaanxi Province of China.

Participants

A total of 1413 patients with burns were included in the study, with the admission period spanning from 2017 to 2019 (before the pandemic) and 2020 to 2022 (during the pandemic).

Results

Burn hospitalisations decreased during the pandemic for both children (9.80%) and adults (24.68%). The pandemic was associated with a decrease in work-related burns and a corresponding increase in the risk of domestic burns (both p<0.001). The proportions of burns due to scald and flame increased, while electrical injury cases and proportions decreased significantly (both p=0.001). The estimated range of % total body surface area (TBSA) for children increased from 8% (IQR: 5–12%) to 10% (IQR: 8–15%) in children (p<0.001) and from 8% (IQR: 4–18%) to 11% (IQR: 6–25%) in adults (p<0.001). In children, the number of burn cases transferred from other hospitals decreased (p=0.011). Among adults, the number of female patients with burns rose (p=0.013), and the number of patients with inhalation injury also rose (p=0.009).

Conclusion

During the COVID-19 pandemic, the number of inpatients with burns declined. Domestic burns became more common, and scald and flame burns as well as the average burn area (% TBSA) increased. These findings might highlight the significance of implementing specific public health strategies and safety measures to improve family safety both during and after the pandemic.
‘It is an emotional rollercoaster!!!’ Experiences of mothers of preterm newborns seeking care at a tertiary hospital in Ghana: a qualitative phenomenological study
Authors: Nukpezah Ruth Nimota , Atanuriba Gideon Awenabisa
Published: January 2025

Objective

To describe, through the phenomenological lens, the experiences of mothers following preterm birth and admitted at a tertiary hospital.

Methods

Design

Descriptive phenomenological study.

Setting

Neonatal intensive care unit (NICU) of a tertiary hospital in Ghana.

Population

Mothers who delivered prematurely and were admitted.

Main outcome measures

Experiences of mothers who delivered prematurely and had their neonates admitted to the NICU.

Results

Four themes and three subthemes were realised: (1) maternal anxiety about unknown outcomes of the newborn condition, (2) the positive impact of family-centred care, (3) maternal roles for preterm care and (4) poor support for maternal involvement in care.

Conclusions

Mothers of preterm newborns sustained varying degrees of emotional trauma and faced challenges that deprived them of active involvement in their newborn care. Despite these, family-centred care was impactful and gave a window of opportunity for mothers to provide maternal roles. We highly recommend tailored emotional and psychological supports for mothers who have delivered prematurely, as it is crucial to ensuring both maternal and neonatal survival.
Cardiometabolic risk factors in the Swedish Werlabs cohort based on self-initiated health screening: cohort profile
Authors: Coudé Adam Hannah , Hajimirsadeghi Omid , Krantz Lovisa , Brismar Kerstin , Norhammar Anna , Ueda Peter , Andersson Daniel Peter , Bandstein Forsberg Nadia
Published: January 2025

Purpose

There is limited research on individuals undergoing self-initiated health examinations, and the Werlabs cohort will be a base for such research.

Participants

All individuals aged 18 or older who had undertaken a self-initiated health examination at Werlabs AB with at least one recorded value of creatinine or cholesterol in Sweden (from 1 January 2015 through 31 December 2023) was included. Medical history and anthropometric measurements were self-reported through an online questionnaire. We describe cohort baseline characteristics, demographic variables and cardiometabolic risk factors.

Findings to date

The study population includes 149 556 individuals who provided at least one health screening. The median (IQR) age was 43 (33–54) years and 54% were women. The most common self-reported chronic disease was hypertension (4.5%), followed by cardiovascular disease (0.9%) and 12.6% reported values of obesity. The prevalence was 2.1% for diabetes, 1.2% for kidney disease (including an estimated glomerular filtration rate of <60 mL/min/1.73 m2), 57.8% for a low-density lipoprotein cholesterol level of >3.0 mmol/L and 4.1% for anaemia (haemoglobin <120 g/L and <130 g/L for women and men, respectively). Interestingly, 1.5% of the individuals had a glucose measurement of >7.0 mmol/L, without reporting a previous diagnosis of diabetes. In an analysis restricted to 621 individuals with recorded blood pressure data between the age of 40 and 70 years and without existing cardiovascular disease, diabetes or kidney disease, 35,4% were classified as high or very high cardiovascular risk according to the 2021 ESC guidelines on cardiovascular disease prevention and with lipid levels that made them eligible for lipid-lowering therapy.

Future plans

The Werlabs cohort comprises a rather healthy and young population that can provide opportunities for future studies on individuals undergoing self-initiated health examinations and has the potential to impact treatment of cardiometabolic risk factors.
Head and neck injuries from personal motorised vehicles in the United States
Authors: Edalati Shaun , Ratna Sujay , Slobin Jacqueline , Wallace Nathan J , Govindaraj Satish , Iloreta Alfred Marc
Published: January 2025

Background

The use of personal electric vehicles in the United States has increased head and neck injuries. This study analyses the types, frequencies, demographics and management of these injuries across motorised vehicles.

Methods

This study uses 2020–2023 data from the National Electronic Injury Surveillance System to analyse injuries from various powered vehicles, incorporating diagnostic, event-related and demographic factors. In addition, the study evaluates non-powered skateboard-related injuries, which provided a comparable baseline for motorised vehicle injuries.

Results

Our analysis included 3721 head and neck injuries: 1359 from scooters, 1743 from skateboards and 619 from hoverboards. Males sustained most injuries, accounting for 64% of scooter accidents, 74% of skateboard accidents and 58% of hoverboard accidents. Hospitalisation was required in 10% of scooter accidents, 9.2% of skateboard accidents and 6.9% of hoverboard accidents. Males, alcohol use and drug use were associated with increased risk of hospitalisation (p=0.00002, p=0.00004 and p<0.00001, respectively). Internal injury (37%) and lacerations (24%) were the most common types of injury. In cases, wear helmets were worn involving helmets, there were no significant differences in hospitalisation rates.

Discussion

These findings underscore the need for improved injury prevention strategies, including more effective helmet designs and infrastructure enhancements, to reduce the growing burden of micromobility vehicle-related head and neck injuries.

Conclusion

The rising incidence of head and neck injuries associated with personal mobility vehicles highlights the need for injury management and prevention strategies. Helmets may mitigate head and neck injuries associated with motorised scooters, skateboards and hoverboards.
Mass and angular momentum for the Kerr black hole in TEGR and STEGR
Authors: Emtsova E. D. , Petrov A. N. , Toporensky A. V.
Published: January 2025

We study the energy–momentum characteristics of the rotating black hole–Kerr solution of general relativity in the teleparallel equivalent of general relativity (TEGR) and the symmetric teleparallel equivalent of general relativity (STEGR). The previously constructed spacetime-covariant and Lorentz-invariant expressions for conserved Noether currents, superpotentials, and charges are used. The Noether charges describe the total energy, momentum, or angular momentum of a gravitational system depending on the choice of displacement vector

$$\xi $$

ξ

. To define the covariant and invariant conserved quantities in both TEGR and STEGR, one needs to use external fields which are flat teleparallel connections. To determine the non-dynamical connections in TEGR and STEGR, we use the unified “turning-off” gravity principle. In addition, to analyze the Noether conserved quantities in these theories, we use the concept of “gauges.” Changes in the gauge can affect the Noether conserved quantities. We highlight two ways to turn off gravity—by

$$M \rightarrow 0$$

M
→
0

and by

$$M \rightarrow 0, ~ a \rightarrow 0$$

M
→
0
,

a
→
0

—which give us different gauges in TEGR and STEGR. In both kinds of gauges, we obtain the expected values of black hole mass and angular momentum. Our attempts to find gauges which could lead to a correspondence to Einstein’s equivalence principle for the Kerr solution were unsuccessful in both TEGR and STEGR. However, these exercises helped us to find a related gauge for the Schwarzschild solution in STEGR that is a novel finding.
The Effect of Voice and Repair Strategy on Trust Formation and Repair in Human-Robot Interaction
Authors: Romeo Marta , Torre Ilaria , Le Maguer Sébastien , Sleat Alexander , Cangelosi Angelo , Leite Iolanda
Published: January 2025

Trust is essential for social interactions, including those between humans and social artificial agents, such as robots. Several factors and combinations thereof can contribute to the formation of trust and, importantly in the case of machines that work with a certain margin of error, to its maintenance and repair after it has been breached. In this article, we present the results of a study aimed at investigating the role of robot voice and chosen repair strategy on trust formation and repair in a collaborative task. People helped a robot navigate through a maze, and the robot made mistakes at pre-defined points during the navigation. Via in-game behaviour and follow-up questionnaires, we could measure people’s trust towards the robot. We found that people trusted the robot speaking with a state-of-the-art synthetic voice more than with the default robot voice in the game, even though they indicated the opposite in the questionnaires. Additionally, we found that three repair strategies that people use in human-human interaction (justification of the mistake, promise to be better and denial of the mistake) work also in human-robot interaction.
Short-Time Peeling of Large Anodic Porous Alumina Membranes from Al Substrates by Two-Layer Anodization Using Concentrated Sulfuric Acid
Authors: Kuroiwa Mayuno , Yanagishita Takashi
Published: January 2025

Ordered anodic porous alumina membranes, which have a uniform cylindrical pore array with a high density, are promising materials for the precise filtration of target substances. We previously reported that when a sample that has undergone anodizing is re-anodized in concentrated sulfuric acid, a highly soluble alumina layer is formed at the bottom of the anodized oxide film. When the re-anodized sample was etched, the highly soluble alumina layer was selectively dissolved; thus, it was possible to obtain a large ordered anodic porous alumina membrane without cracks. In this study, we succeeded in reducing the time required for anodization and etching to obtain an alumina membrane by optimizing the anodization conditions using concentrated sulfuric acid. According to this method, after the alumina membrane was peeled off, it was possible to retain a regular pattern of depressions on the surface of the residual Al substrate, which acted as the starting points for the generation of pores during subsequent anodization. By repeating this process on a single Al substrate, we can repeatedly form an ordered anodic porous alumina membrane. The obtained ordered anodic porous alumina membranes can be used as filtration membranes, catalyst supports, and templates for preparing one-dimensional nanostructures.
Carbohydrate supplementation maintains physical performance during short-term energy deficit despite reductions in exogenous glucose oxidation
Authors: Margolis Lee M. , Allen Jillian T. , Murphy Nancy E. , Carrigan Christopher T. , Howard Emily E. , Barney David E. , Drummer Devin J. , Michalak Julia , Ferrando Arny A. , Pasiakos Stefan M. , Gwin Jess A.
Published: January 2025

Short-term (6-day) energy deficit reduced exogenous glucose oxidation during exercise. Though less exogenous glucose was used for fuel, young healthy individuals appear to have a metabolic resilience to short-term periods of low energy availability, with no observed differences in the ability to take up and oxidize exogenous glucose between minimal (20%), moderate (40%), and severe (60%) energy deficits. Similar metabolic responses to carbohydrate supplementation independent of deficit severity likely contributed to sustainment of physical performance.
Effects of leg immobilization and recovery resistance training on skeletal muscle-molecular markers in previously resistance-trained versus untrained adults
Authors: Michel J. Max , Godwin Joshua S. , Plotkin Daniel L. , McIntosh Mason C. , Mattingly Madison L. , Agostinelli Philip J. , Mueller Breanna J. , Anglin Derick A. , Kontos Nicholas J. , Berry Alexander C. , Vega Marina Meyer , Pipkin Autumn A. , Stock Matt S. , Graham Zachary A. , Baweja Harsimran S. , Mobley C. Brooks , Bamman Marcas M. , Roberts Michael D.
Published: January 2025

Formerly trained and untrained individuals demonstrate similar atrophic responses to disuse while untrained individuals exhibited a greater hypertrophic response to subsequent resistance training. The molecular responses accompanying these changes were largely similar between groups and included increases in satellite cell content with resistance training and increases in ribosome biogenesis, which was largely driven by the formerly trained group.
Machine Learning Meets Encrypted Search: The Impact and Efficiency of OMKSA in Data Security
Authors: Wei Zhongkai , Su Ye , Zhang Xi , Yang Haining , Qin Jing , Ma Jixin
Published: January 2025

The convergence of machine learning and searchable encryption enhances the ability to protect the privacy and security of data and enhances the processing power of confidential data. To enable users to efficiently perform machine learning tasks on encrypted data domains, we delve into oblivious keyword search with authorization (OKSA). The OKSA scheme effectively maintains the privacy of the user’s query keywords and prevents the cloud server from inferring ciphertext information through the searching process. However, limitations arise because the traditional OKSA approach does not support multi‐keyword searches. If a data file is associated with multiple keywords, each keyword and corresponding data must be encrypted one by one, resulting in inefficiency. We introduce an innovative approach aimed at enhancing the efficiency of search processes while addressing the limitation of current encryption and search systems that handle only a single keyword. This method, known as the oblivious multiple keyword search with authorization (OMKSA), is designed for more effective keyword retrieval. One of our important innovations is that it uses the arithmetic techniques of bilinear pairs to generate new tokens and new search methods to optimize communication efficiency. Moreover, we present a detailed and rigorous demonstration of the security for our proposed protocol, aligned with the predefined security model. We conducted a comparative experiment to determine which of the two schemes, OKSA and OMKSA, is more efficient when querying multiple keywords. Based on our experimental results, our OMKSA is very efficient for data searchers. As the number of query keywords increases, the computational overhead of connected keyword searches remains stable. Finally, as we move into the 5G era, the potential applications of OMKSA are huge, with clear implications for areas such as machine learning and artificial intelligence. Our findings pave the way for further exploration and deployment of these frontier areas.
Numerical Optimization of the Hydraulic and Hemolytic Performance of a Centrifugal Ventricular Assist Device Based on Impeller Flow Passage and Outlet Geometry
Authors: Sahebi-Kuzeh Kanan Reza , Niroomand-Oscuii Hanieh , Badri Ghavifekr Habib , Ghalichi Farzan , Yazdanpanah-Ardakani Kohyar
Published: January 2025

As technology continues to advance and modern lifestyles become increasingly mechanized, the prevalence of heart disease is steadily growing. On the other hand, donor hearts ready for transplantation are limited worldwide. Therefore, blood pumps are a suitable alternative to help the patient during the waiting period and even until the end of life. Blood pumps must meet biological requirements, including adequate output pressure and flow rate, within an acceptable margin of safety in the event of blood damage. Reduction of pump size, blood exposure time, and blood damage such as hemolysis have been mentioned as important challenges in the design of blood pumps. Statistics show that 30% of the patients who use a left ventricular blood pump need a right ventricular blood pump due to right ventricular failure. The purpose of this research is to determine the effect of the geometrical shape of the impellers (flow passage) and the thrust tube geometry of the volute chamber on the pump’s hydraulic performance, the amount of axial and radial forces, and the amount of blood damage. So, for this study, six blades and two types of geometry for the volute chamber thrust tube were designed. This pump has been simulated using computational fluid dynamics used the Ansys CFX 17. Finally, the appropriate pump has been selected for low hemolysis index (HI). The HI calculated using the Lagrangian method is 0.00279 in the pump with a flow rate of 5 L per minute and 1100 rpm.
Inpatient Mortality and Safety Culture: The Critical Role of Nurses and Nurse Staffing
Authors: Alanazi Faisal Khalaf , Molloy Luke , Lapkin Samuel , Sim Jenny
Published: January 2025

Background: Inpatient mortality is a critical outcome measure for healthcare services. Improving patient outcomes and ensuring high‐quality healthcare outcomes requires an understanding of the factors that contribute to inpatient mortality.

Aim: This study aimed to investigate the impact of safety culture, quality of care, missed care, and nurse staffing on inpatient mortality rates and nurse‐reported inpatient death frequency.

Methods: A cross‐sectional survey and an administrative dataset on inpatient mortality were used in this study. A web‐based survey was conducted among nurses from 34 units in five acute public hospitals. Inpatient mortality data between 2018 and 2021 were collected from participating units. The study variables were analyzed using generalized linear models.

Results: Safety culture scores were less than positive in all hospitals, and most nurses reported missed care during their last shift. However, nursing units that had strong subscale scores for teamwork climate, safety climate, and safety behavior had lower incidence rates of inpatient mortality and fewer nurse‐reported inpatient deaths in their units.

Conclusion: The study’s findings highlight the importance of teamwork climate, safety climate, and safety behaviors on safety culture and the role nurses play in reducing inpatient mortality rates and lowering nurse‐reported inpatient death frequency.
Lifitegrast in Treatment of Dry Eye Disease—A Practical, Narrative Expert Review
Authors: Landsend Erlend C. S. , Istre Mads , Utheim Tor P.
Published: January 2025

Purpose: Dry eye disease (DED) is a multifactorial disorder affecting millions worldwide. Inflammation plays a central role in DED. The aim of this review is to critically evaluate the literature concerning the efficacy and safety of lifitegrast, a small molecule immunomodulator that blocks the action of lymphocyte function‐associated antigen‐1.

Methods: Studies were identified using PubMed and ClinicalTrials.gov. Fourteen studies met the inclusion criteria, six of which were randomized controlled trials. The articles were assessed regarding the effect of lifitegrast on symptoms and signs of DED, its usefulness compared to other treatments, and potential adverse events.

Results: The analysis demonstrated positive effects of lifitegrast on subjective and objective parameters of DED in the selected studies. However, despite promising results, the included studies did not provide enough evidence to conclude that lifitegrast could outperform other treatments of DED. No major side effects were reported.

Conclusions: Based on the current literature, we conclude that lifitegrast could improve various parameters of DED. Still, larger controlled trials are required to establish additional benefits of this medication beyond those of other DED treatments.
Modified Gegen Qinlian Decoction Ameliorates DSS‐Induced Colitis in Mice via the Modulation of NF‐κB and Nrf2/HO‐1 Pathways
Authors: Huang Jinke , Zhang Jiaqi , Liu Zhihong , Ma Jing , Wang Yifan , Wang Fengyun , Tang Xudong
Published: January 2025

Background: This study aims to reveal the potential molecular mechanisms of modified Gegen Qinlian decoction (MGQD) in relieving ulcerative colitis (UC).

Methods: C57BL/6J mice were used to establish experimental colitis via dextran sodium sulfate (DSS). Body weight, disease activity index (DAI), spleen weight, colon length, and histopathologic features were measured to evaluate the therapeutic effects of MGQD on mice with UC. The ELISA kits were employed to assess the concentrations of interleukin (IL)‐6, IL‐1β, tumor necrosis factor‐α (TNF‐α), glutathione (GSH), reactive oxygen species (ROS), and malondialdehyde (MDA). Western blot analyses were used to assess the levels of IκBα, p65, p‐IκBα, p‐p65, HO‐1, and Nrf2. Moreover, the protein levels of Nrf2 and p‐p65 were assessed by immunofluorescence.

Results: Colitis‐related symptoms in mice were significantly alleviated by MGQD. Moreover, MGQD inhibited the levels of TNF‐α, IL‐1β, IL‐6, MDA, and ROS and increased the level of GSH in mice with UC. Mechanistically, MGQD prevented the activation of the NF‐κB pathway and concomitantly promoted the activation of the Nrf2/HO‐1 pathway.

Conclusion: MGQD alleviated UC by suppressing inflammation and oxidative stress via the modulation of NF‐κB and Nrf2/HO‐1 pathways, suggesting that MGQD may be a candidate therapy for UC.
Supplemental Table 3 from Single-Cell RNA Sequencing before and after Light Chain Escape Reveals Intrapatient Multiple Myeloma Subpopulations with Divergent Osteolytic Gene Expression
Authors: Ohlstrom Denis , Walker Zachary J. , Pandey Abhishek , Davis Lorraine N. , Engel Krysta L. , Pan Zenggang , Forsberg Peter A. , Mark Tomer M. , Gillen Austin E. , Sherbenou Daniel W.
Published: January 2025

Top 15 genes higher in IGH-MM vs LCE-MM at diagnosis.
Supplemental Figure 5 from Single-Cell RNA Sequencing before and after Light Chain Escape Reveals Intrapatient Multiple Myeloma Subpopulations with Divergent Osteolytic Gene Expression
Authors: Ohlstrom Denis , Walker Zachary J. , Pandey Abhishek , Davis Lorraine N. , Engel Krysta L. , Pan Zenggang , Forsberg Peter A. , Mark Tomer M. , Gillen Austin E. , Sherbenou Daniel W.
Published: January 2025

HIF1 Signaling Pathway Genes Overexpressed in IGH-MM.
Supplemental Figure 10 from Single-Cell RNA Sequencing before and after Light Chain Escape Reveals Intrapatient Multiple Myeloma Subpopulations with Divergent Osteolytic Gene Expression
Authors: Ohlstrom Denis , Walker Zachary J. , Pandey Abhishek , Davis Lorraine N. , Engel Krysta L. , Pan Zenggang , Forsberg Peter A. , Mark Tomer M. , Gillen Austin E. , Sherbenou Daniel W.
Published: January 2025

Gene Expression at First Relapse Exhibiting a Dysregulation of Apoptosis.
Figure 3 from Single-Cell RNA Sequencing before and after Light Chain Escape Reveals Intrapatient Multiple Myeloma Subpopulations with Divergent Osteolytic Gene Expression
Authors: Ohlstrom Denis , Walker Zachary J. , Pandey Abhishek , Davis Lorraine N. , Engel Krysta L. , Pan Zenggang , Forsberg Peter A. , Mark Tomer M. , Gillen Austin E. , Sherbenou Daniel W.
Published: January 2025

Differential myeloma drug sensitivity profiles of malignant subpopulations at diagnosis. A, Flow cytometry showed a monotypic population by typical markers CD138 and CD38 (left), but showed rarer subpopulations with CD45 expression, with or without CD19 (right) that were not detected by scRNA-seq. B, Of the cell surface proteins measured by flow cytometry, the mRNA for CD46 showed the most differential expression (l2FC = 0.44, P = 5.76 × 10−7) between the LCE-multiple myeloma (MM) and IGH-MM subpopulations. C, Relatively CD46-high and CD46-low populations were divided to approximate subpopulation drug sensitivity of IGH-MM and LCE-MM, respectively. D, The drug sensitivity profiles implied that the CD46-high/IGH-MM subpopulation had a primary IMiD refractory phenotype and was relatively less bortezomib sensitive compared with LCE-MM (n = 3, tested by t test, bars depict standard deviation. *, P < 0.05; ***, P < 0.001). Bor, bortezomib; Car, carfilzomib; Dara, daratumumab; Len, lenalidomide; norm %, percent viability normalized to untreated controls; Pom, pomalidomide.
Pigmented Superficial Basal Cell Carcinoma of the Nipple-Areola Complex: A Case Report
Authors: Chen Xinru , Zhang Na , Ge Hongping , Zhai Xiaoli , Wang Meiyan , Zhang Min
Published: January 2025

Introduction: Basal cell carcinoma (BCC) is the most common type of skin malignancy, accounting for approximately 80% of all non-melanoma skin cancers (NMSCs). Ultraviolet (UV) exposure is a significant risk factor for BCC development, which typically occurs in sun-exposed areas. BCC arising in non-sun-exposed regions, such as the nipple-areola complex (NAC), is exceedingly rare, with fewer than 100 cases reported globally. This report describes a case of pigmented superficial BCC in the NAC of a 76-year-old Asian woman. Case Presentation: A 76-year-old Asian female presented with a 5-year history of a slowly enlarging lesion on her left breast, with recent rapid growth. Physical examination revealed a 10 mm × 8 mm blue-gray, pearl-like plaque on the NAC. Histopathology confirmed pigmented superficial BCC. Preoperative imaging, including breast ultrasound, chest computed tomography (CT), SPECT-CT, and axillary lymph node ultrasound, showed no evidence of metastasis. The patient underwent standard surgical excision with a 10 mm margin, followed by pathologic evaluation, confirming clear margins. The patient was discharged on the second postoperative day and remained asymptomatic at a 3-month follow-up. Conclusion: Pigmented superficial BCC of the NAC is an uncommon presentation due to the area’s minimal sun exposure and lack of pilosebaceous units. This case underscores the importance of considering BCC in non-sun-exposed areas, particularly in elderly patients. While nonsurgical options such as photodynamic therapy may offer superior esthetic outcomes, the patient’s financial constraints led to the selection of a cost-effective surgical excision, which successfully eliminated the tumor.
A Case of Concomitant Acute Zonal Occult Outer Retinopathy and Secondary Nonparaneoplastic Autoimmune Retinopathy
Authors: Khan Shawn , Saigal Khushi , Moxam Jillene , Maleki Arash
Published: January 2025

Introduction: Acute zonal occult outer retinopathy (AZOOR) is a rare inflammatory retinal disease with rapid outer retinal function loss, photopsias, unremarkable fundus findings, and electroretinography abnormalities. AZOOR diagnosis can be challenging due to its overlap with other retinal conditions, such as acute idiopathic blind spot enlargement syndrome and autoimmune retinopathies (AIRs). Multimodal imaging, including fundus autofluorescence and optical coherence tomography, has improved detection, revealing progressive outer retinal damage. Although the etiology of AZOOR remains uncertain, autoimmune mechanisms and viral associations have been proposed. Recent studies have identified anti-retinal antibodies, complicating differentiation from other AIRs. Case Presentation: A 63-year-old male presented with photopsias, floaters, and worsening vision in his left eye. He had a prior diagnosis of AIR with serum antibodies against enolase, arrestin, and heat shock protein 27 (HSP27). Despite corticosteroid therapy, his visual acuity worsened from 20/20 to 20/60. Fundus examination showed subtle changes, and multimodal imaging revealed outer retinal damage consistent with AZOOR. He was started on mycophenolate mofetil, cyclosporine, and intravenous immunoglobulin. Over a year of follow-up, his vision improved to 20/25, and imaging showed stabilization of retinal damage. Conclusion: This case report highlights AZOOR can be associated with secondary np-AIR. Multimodal imaging, electrophysiologic testing of retina and retinal pigment epithelial, and anti-retinal antibody may be helpful for diagnosis of these patients. A combination of conventional immunomodulatory therapy and IVIg can help with controlling AZOOR and secondary np-AIR.
Associations of Social, Behavioral, and Clinical Factors With Sex Differences in Stroke Recurrence and Poststroke Mortality
Authors: Chen Chen , Reeves Mathew J. , He Kevin , Morgenstern Lewis B. , Lisabeth Lynda D.
Published: January 2025

BACKGROUND:

Few population-based studies have assessed sex differences in stroke recurrence. In addition, contributors to sex differences in recurrence and poststroke mortality, including social factors, are unclear. We investigated sex differences in these outcomes and the contribution of social, clinical, and behavioral factors to the sex differences.

METHODS:

First-ever ischemic stroke cases identified from 2008 to 2019 from the population-based Brain Attack Surveillance in Corpus Christi Project in Texas were included and followed for recurrence and all-cause mortality through 2020. Sex differences in outcomes with and without adjustment for potential confounding factors, including social, behavioral, and clinical factors, were examined using Cox proportional hazard models. Factors that changed the log hazard ratio (HR) for sex by at least 10% after adjustment were identified as confounders/contributors. Final models were adjusted for all identified confounders.

RESULTS:

Of 2326 participants (mean age, 68 years; 48% women; 57% Mexican American), over median follow-ups of 5.4 years for recurrence and 3.7 years for mortality, 274 recurrences and 965 deaths occurred. No significant sex differences in recurrence were noted in unadjusted (HR, 0.89 [95% CI, 0.70–1.13]), age-adjusted (HR, 0.92 [95% CI, 0.72–1.18]), or fully adjusted models (HR, 0.88 [95% CI, 0.67–1.16]). Although women had a higher crude mortality rate than men (HR, 1.22 [95% CI, 1.08–1.38]), this sex difference disappeared after age adjustment (HR, 0.91 [95% CI, 0.80–1.03]). Other factors contributing to the sex difference included education, marital status, prestroke depression, health behaviors, initial stroke severity, prestroke disability, comorbidities, atrial fibrillation, and coronary artery disease. After simultaneously adjusting for all identified confounders, women had lower poststroke mortality (HR, 0.79 [95% CI, 0.68–0.91]).

CONCLUSIONs:

Sex differences in stroke recurrence were not apparent. Women had a higher unadjusted poststroke mortality rate but lower adjusted mortality than men. Social and psychosocial factors, alongside clinical factors, primarily explained the sex disparity in poststroke mortality.