bluuebunny/crossref_metadata_2025 huggingface dataset:
Can video communication in the emergency medical communication centre improve dispatch precision? A before–after study in Norwegian helicopter emergency medical services
Authors: Ulvin Ole Erik , Skjærseth Eivinn Årdal , Krüger Andreas J , Thorsen Kjetil , Nordseth Trond , Haugland Helge
Published: October 2023

Objectives

Dispatching helicopter emergency medical services (HEMS) to the patients with the greatest medical or logistical benefit remains challenging. The introduction of video calls (VC) in the emergency medical communication centres (EMCC) could provide additional information for EMCC operators and HEMS physicians when assessing the need for HEMS dispatch. The aim of this study was to evaluate the impact from VC in the EMCC on HEMS dispatch precision.

Design

An observational before–after study.

Setting

The regional EMCC and one HEMS base in Mid-Norway.

Participants

EMCC operators and HEMS physicians at the EMCC and HEMS base in Trondheim, Norway.

Intervention

In January 2022, VC became available in emergency calls in Trondheim EMCC. Data were collected from 2020 2021 (pre-intervention) and 2022 (post-intervention).

Primary and secondary outcome measures

The primary outcome was the proportion of seriously ill or injured HEMS patients, defined as a National Advisory Committee for Aeronautics (NACA) score between 4 and 7. The secondary outcome was the proportion of inappropriate dispatches, defined as missions with neither provision of additional competence nor any logistical contribution based on quality indicators for physician-staffed emergency medical services.

Results

811 and 402 HEMS missions with patient contact were included in the pre- and post-intervention group, respectively. The proportion of missions with NACA 4–7 was not significantly changed after the intervention (OR 1.21, 95% CI 0.92 to 1.61, p=0.17). There was no significant change in HEMS alarm times between the pre- and post-intervention groups (7.6 min vs 6.4 min, p=0.15). The proportion of missions with neither medical nor logistical benefit was significantly lower in the post-intervention group (28.4% vs 40.3%, p=0.007).

Conclusion

The results from this study indicate that VC is a promising, feasible and safe tool for EMCC operators in the complex HEMS dispatch process.
Long-term impact of the COVID-19 pandemic on self-management of chronic conditions among high-risk adults in the USA: protocol for the C3 observational cohort study
Authors: Lovett Rebecca , Filec Sarah , Bonham Morgan , Yoshino Benavente Julia , O'Conor Rachel , Russell Andrea , Zheng Pauline , Wismer Guisselle , Yoon Esther , Weiner-Light Sophia , Vogeley Abigail , Morrissey Kwasny Mary , Lowe Sarah , Curtis Laura M , Federman Alex , Bailey Stacy C , Wolf Michael
Published: October 2023

Introduction

COVID-19 is an unprecedented public health threat in modern times, especially for older adults or those with chronic illness. Beyond the threat of infection, the pandemic may also have longer-term impacts on mental and physical health. The COVID-19 & Chronic Conditions (‘C3’) study offers a unique opportunity to assess psychosocial and health/healthcare trajectories over 5 years among a diverse cohort of adults with comorbidities well-characterised from before the pandemic, at its onset, through multiple surges, vaccine rollouts and through the gradual easing of restrictions as society slowly returns to ‘normal’.

Methods and analysis

The C3 study is an extension of an ongoing longitudinal cohort study of ‘high-risk’ adults (aged 23–88 at baseline) with one or more chronic medical conditions during the COVID-19 pandemic. Five active studies with uniform data collection prior to COVID-19 were leveraged to establish the C3 cohort; 673 adults in Chicago were interviewed during the first week of the outbreak. The C3 cohort has since expanded to include 1044 participants across eight survey waves (T1–T8). Four additional survey waves (T9–T12) will be conducted via telephone interviews spaced 1 year apart and supplemented by electronic health record and pharmacy fill data, for a total of 5 years of data post pandemic onset. Measurement will include COVID-19-related attitudes/behaviours, mental health, social behaviour, lifestyle/health behaviours, healthcare use, chronic disease self-management and health outcomes. Mental health trajectories and associations with health behaviours/outcomes will be examined in a series of latent group and mixed effects modelling, while also examining mediating and moderating factors.

Ethics and dissemination

This study was approved by Northwestern University’s Feinberg School of Medicine Institutional Review Board (STU00215360). Results will be published in international peer-reviewed journals and summaries will be provided to the funders of the study.
Triple vasodilator therapy in pulmonary arterial hypertension associated with congenital heart disease
Authors: Luna-Lopez Raquel , Segura de la Cal Teresa , Sarnago Cebada Fernando , Martin de Miguel Irene , Hinojosa Williams , Cruz-Utrilla Alejandro , Velazquez Maria Teresa , Delgado Juan F , Mendoza Alberto , Arribas Ynsaurriaga Fernando , Escribano-Subías Pilar
Published: October 2023

Objective

This study assessed the long-term effects of triple therapy with prostanoids on patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD), as there is limited information on the safety and efficacy of this treatment approach.

Methods

A retrospective cohort study was conducted on patients with PAH-CHD who were actively followed up at our centre. All patients were already receiving dual combination therapy at maximum doses. Clinical characteristics, including functional class (FC), 6-minute walking test distance (6MWTD) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, were documented before initiating triple therapy and annually for a 2-year follow-up period.

Results

A total of 60 patients were included in the study, with a median age of 41 years and 68% being women. Of these, 32 had Eisenmenger syndrome, 9 had coincidental shunts, 18 had postoperative PAH and 1 had a significant left-to-right shunt. After 1 year of triple combination initiation, a significant improvement in 6MWTD was observed (406 vs 450; p=0.0027), which was maintained at the 2-year follow-up. FC improved in 79% of patients at 1 year and remained stable in 76% at 2 years. NT-proBNP levels decreased significantly by 2 years, with an average reduction of 199 ng/L. Side effects were experienced by 33.3% of patients but were mostly mild and manageable. Subgroup analysis showed greater benefits in patients without Eisenmenger syndrome and those with pre-tricuspid defects.

Conclusions

Triple therapy with prostanoids is safe and effective for patients with PAH-CHD, improving FC, 6MWTD and NT-proBNP levels over 2 years. The treatment is particularly beneficial for patients with pre-tricuspid defects and non-Eisenmenger PAH-CHD.
Computed tomography calcium scoring in aortic stenosis: bicuspid versus tricuspid morphology
Authors: Ye Zi , Clavel Marie-Annick , Foley Thomas A , Pibarot Philippe , Enriquez-Sarano Maurice , Michelena Hector I
Published: October 2023

Objective

CT aortic valve calcium score (AVCscore) and density (AVCdensity) thresholds have been recommended for aortic stenosis (AS) severity assessment in tricuspid aortic valve (TAV). We aimed to compare AVCscoreand AVCdensityin bicuspid aortic valve (BAV) versus TAV.

Methods

Retrospective single-centre study of patients with echocardiographic AS-severity and CT-AVC assessments within 6 months, and left ventricular ejection fraction ≥50%, all referred for clinical AS evaluation.

Severe AS was defined as aortic valve area (AVA) ≤1 cm2or indexed AVA ≤0.6cm2/m2plus mean gradient ≥40 mm Hg or peak velocity ≥4 m/s. AVC was assessed by Agatston method.

Results

Of the 1957 patients, 328 had BAV and 1629 had TAV, age 65±11 vs 80±9 years (p<0.001), men 65% vs 56% (p=0.006), respectively. BAV morphology was associated with higher AVCscoreand AVCdensityindependent of age, comorbidities and AS severity (p<0.001) in men only (sex and BAV interaction p<0.001). In patients with severe AS, mean AVCscoreand AVCdensitywere higher in BAV-men than that in TAV-men (both p<0.001), but similar in BAV-women and TAV-women (both p≥0.4). Such patterns remained the same after adjustment for clinical covariates and AS severity. Best thresholds for severe AS diagnosis in BAV-men were 2916 AU by AVCscoreand 600 AU/cm2by AVCdensitywhich were higher than the guideline-recommended thresholds, while thresholds in BAV-women (1036 AU and 282 AU/cm2) were similar to guideline-recommended ones.

Conclusion

Valve calcification in AS differs according to valve morphology and sex. BAV-men with severe AS exhibit greater AVCscoreand AVCdensitythan TAV-men. This presents a diagnostic challenge to the current guidelines, which needs confirmation in larger studies.
Effects of exercise during chemotherapy for breast cancer on long-term cardiovascular toxicity
Authors: Naaktgeboren Willeke R , Stuiver Martijn M , van Harten Wim H , Aaronson Neil K , Scott Jessica M , Sonke Gabe , van der Wall Elsken , Velthuis Miranda , Leiner Tim , Teske Arco J , May Anne M , Groen Wim G
Published: October 2023

Objective

Animal data suggest that exercise during chemotherapy is cardioprotective, but clinical evidence to support this is limited. This study evaluated the effect of exercise during chemotherapy for breast cancer on long-term cardiovascular toxicity.

Methods

This is a follow-up study of two previously performed randomised trials in patients with breast cancer allocated to exercise during chemotherapy or non-exercise controls. Cardiac imaging parameters, including T1 mapping (native T1, extracellular volume fraction (ECV)), left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), cardiorespiratory fitness, and physical activity levels, were acquired 8.5 years post-treatment.

Results

In total, 185 breast cancer survivors were included (mean age 58.9±7.8 years), of whom 99% and 18% were treated with anthracyclines and trastuzumab, respectively. ECV and Native T1 were 25.3%±2.5% and 1026±51 ms in the control group, and 24.6%±2.8% and 1007±44 ms in the exercise group, respectively. LVEF was borderline normal in both groups, with an LVEF<50% prevalence of 22.5% (n=40/178) in all participants. Compared with control, native T1 was statistically significantly lower in the exercise group (β=−20.16, 95% CI −35.35 to −4.97). We found no effect of exercise on ECV (β=−0.69, 95% CI −1.62 to 0.25), LVEF (β=−1.36, 95% CI −3.45 to 0.73) or GLS (β=0.31, 95% CI −0.76 to 1.37). Higher self-reported physical activity levels during chemotherapy were significantly associated with better native T1 and ECV.

Conclusions

In long-term breast cancer survivors, exercise and being more physically active during chemotherapy were associated with better structural but not functional cardiac parameters. The high prevalence of cardiac dysfunction calls for additional research on cardioprotective measures, including alternative exercise regimens.

Trial registration number

NTR7247.
Collisional Penrose process of extended test particles near an extremal Kerr black hole
Authors: Sang Aofei , Jiang Jie , Zhang Ming
Published: October 2023

We investigate the collisional Penrose process of extended test particles near an extremal Kerr black hole using the pole-dipole-quadrupole approximation. We analyze the motion of the test particles and examine the dynamics and maximal efficiency of energy extraction in this process. Our results demonstrate that the maximal extracted energy in the collisional Penrose process is influenced by the spin s and quadrupolar parameter C of the test particles. Specifically, we observe that, at a fixed collisional position, the energy extraction efficiency decreases as the spin increases for either the pole-dipole or the pole-dipole-quadrupole approximation case. Furthermore, for a fixed spin, the energy extraction efficiency is higher in the pole-dipole-quadrupole approximation compared to the pole-dipole approximation. These findings provide insight into the role of the internal structures of the test particles in the collisional Penrose process.
Study on chemical forms of aluminum in tea leaves using micro-PIXE method
Authors: Yasuda K. , Yamada N. , Yamagata R. , Ishii Y. , Suzui N. , Satoh T. , Kawachi N.
Published: October 2023

Elemental analysis of the epidermis of tea leaves was performed using the micro-beam particle-induced X-ray emission (micro-PIXE) method. The ratios of the X-ray yields of silicon (Si), potassium (K), calcium (Ca), and manganese (Mn) to that of aluminum (Al) in the cell wall of epidermal cells of tea leaves were determined. The ratio of Si to Al X-ray yields agreed within a range of 11% in the four samples measured in this study. On the other hand, the ratio of the X-ray yields of K, Ca, and Mn to Al varied from 41% to 87%. This result suggests that Al forms compounds with Si in tea leaves.
Luminescent Probe Based on Terbium-Carbon Quantum Dots for the Quantification of Imidacloprid in Caneberries
Authors: Llorent-Martínez Eulogio J. , Jiménez-López Julia , Ruiz-Medina Antonio
Published: October 2023

We propose a modification of terbium-sensitized luminescence (TSL) by means of the introduction of nanoparticles to improve the sensitivity and selectivity of the analytical methods. TSL detection is usually based on the complexation between fluorescent organic compounds (the analytes) and terbium. The organic compound is then excited, and, after an energy transfer towards terbium, the latter emits the luminescence signal. Here, the modification consists of the introduction of nanoparticles (carbon quantum dots, CQDs) into the system. The carboxylic groups of CQDs react with terbium, providing an interesting time-resolved luminescence probe. We applied this system for the determination of the neonicotinoid imidacloprid (IMID). When IMID was introduced in the terbium-CQDs system, the luminescent signal (λexc/λem of 256/545 nm) was quenched, proportionally to IMID concentration in the range of 100–2500 ng·mL−1, obtaining a limit of detection of 30 ng·mL−1. A method detection limit of 0.9 mg·kg−1 was reached in caneberries, thus complying with the maximum residue level of 5 mg·kg−1 established by Codex Alimentarius. We performed recovery experiments in caneberries (blackberries, blueberries, raspberries, and mulberries), obtaining recovery yields close to 100% in all cases. These results show that the use of terbium ions-nanoparticles luminescence probes can be useful for screening purposes in quality control laboratories.
The Geographical Coexist of the Migratory Birds, Ticks, and Nairobi Sheep Disease Virus May Potentially Contribute to the Passive Spreading of Nairobi Sheep Disease
Authors: Kim KwangHyok , Wang HaoNing , Cha JinMyong , Wang XiaoLong
Published: October 2023

Nairobi sheep disease (NSD) is a hemorrhagic vector-borne disease of small ruminants caused by the Nairobi sheep disease virus (NSDV), also known as Ganjam virus (GV). NSDV and GV refer to the same virus. The NSDV has been identified in East Africa, India, Sri Lanka, and China, and NSDV vector ticks can be carried by birds. There is few research on the mechanism of the global cycle and spillover of NSDV. Based on the prediction of the high probability distribution areas of NSD by the maximum entropy model (MaxEnt), the possible passive transport routes of NSDV vector ticks by migratory birds were simulated for further evaluation. The transmission probability of NSDV vector ticks by migrating birds was calculated using evaluations of the parasitism intensity of ticks on migratory birds at start points, the flying burden of parasitized birds, and the attachment coefficient of ticks on birds during migration. A total of 31 potential transport routes were predicted, which, through interaction with each other, constitute a spreading network for NSDV. Seven species of migratory birds were predicted as intra or interregional carriers. Our study first provides measurable support for estimating the possibility of passive migration of NSDV vector ticks by migratory birds that may be potential carriers of ticks and proposes a transmission mechanism between all known natural foci and potential natural foci. These findings highlight the necessity of cooperation in the management of the NSDV in all known and potential natural foci located in different countries, with the aim of blocking global circulation in a cost-effective way. Furthermore, these findings may also contribute to the prevention of other similar diseases.
Mid-Perineal Scrotal Flap for the Repair of Urorectal Fistulas: A New Technique
Authors: Martinez-Piñeiro Luis
Published: October 2023

Rectourethral fistula (RUF) is an infrequent but severe complication of the treatment of prostate cancer. Herein, we describe a new surgical approach used successfully in 3 patients that incorporates a partially de-epithelialized mid-perineal scrotal flap (MPSF), used as interposition flap, that can be used in almost every patient with RUF after radiotherapy, regardless of having or not a concomitant posterior urethra or bladder neck stricture or contracture that might require a simultaneous urethroplasty. The interposition flap includes well vascularized subcutaneous fat tissue by distal vascular branches of the internal pudendal vessels that reaches without tension the deep perineum up to the posterior bladder neck. The MPSF is a time efficient procedure that allows excellent access to the bulbar urethra and to the surgical plane between rectum and prostate and it does not require a separate incision for the flap harvesting procedure when required.
Smile Incision-Modified Technique for Better Scrotal Outcome in Surgical Management of Penile Paraffinoma
Authors: Daniswara Nanda , Pandoyo Pramatama Andhika Sunarso , Nugroho Eriawan Agung , Santosa Ardy , Soedarso Mohamad Adi , Addin Sofyan Rais , Wibisono Dimas Sindhu , Wicaksono Fandy
Published: October 2023

Introduction: Penile augmentation with foreign material injection is used to increase penile length, girth, or both. Most of these individuals develop complications due to an abnormal mass formation known as penile paraffinoma. Multiple surgical techniques for restoring penile function and correcting near-normal penile shape have been developed, but prior techniques have some post-operative complications. Methods: We explained the smile incision-modified technique for penile paraffinoma reconstruction using illustrations to describe step-by-step procedures. This study aimed to describe our modified surgical technique for reconstruction to correct complications due to disastrous consequences of failed penile augmentation. Results: A total of 16 patients aged 28–66 years (mean: 44.25 ± 2.63) were operated with a smile incision-modified technique from January 2017 until December 2020 in Semarang Dr. Kariadi tertiary hospital. There were no intraoperative complications observed. We found hematoma in 3 patients in a 1-week follow-up. After 2 weeks of post-operative surgery, all patients had no skin dehiscence or necrosis. Cosmetic appearance and functional improvement after reconstruction were acceptable by all patients. Conclusion: Penile paraffinoma reconstruction using the smile incision-modified technique was a feasible and effective technique to manage penile paraffinoma patients with good esthetic results and minor complications.
Frequency and Characteristics of Spinal Bleeding Sources in Nontraumatic Angiogram-Negative Subarachnoid Hemorrhage
Authors: Lampmann Tim , Brandecker Simon , Weller Johannes , Schmeel Frederic Carsten , Asoglu Harun , Hamed Motaz , Radbruch Alexander , Güresir Erdem , Vatter Hartmut , Banat Mohammed
Published: October 2023

Introduction: Angiogram-negative subarachnoid hemorrhage (AN-SAH) accounts for 5–15% of spontaneous SAH. This study aims to analyze the frequency and characteristics of spinal bleeding sources in patients with AN-SAH. Methods: 140 patients suffering from AN-SAH treated at our institution from 2012 to 2022 were included in this retrospective cohort study. Results: 52.1% were diagnosed with perimesencephalic SAH, 35.0% with non-perimesencephalic, SAH and 12.9% with CT-negative SAH (diagnosed by lumbar puncture). Additional magnetic resonance imaging (MRI) identified a spinal bleeding source in 4 patients (2.86%). These patients presented with local spine pain or neurological deficits (relative risk: 3.9706 [95% confidence interval [CI]: 0.7272–21.6792]; p < 0.001) and were younger (mean difference 14.85 years [95% CI: 0.85–28.85; p = 0.038]) compared to patients without a spinal bleeding source. Conclusions: AN-SAH caused by spinal pathology is rare. This study indicates that craniocervical and holospinal MRI should be considered in AN-SAH, especially for young patients with AN-SAH who present with back pain or neurological deficits.
Importance of Minimal Residual Disease in the Era of Targeted Therapies in Chronic Lymphocytic Leukemia
Authors: Al-Sawaf Othman
Published: October 2023

Background: The level of minimal residual disease (MRD), often binarized into detectable or undetectable MRD according to certain thresholds, is strongly associated with long-term outcomes after chemo- and chemoimmunotherapy. Summary: Driven by our improved understanding of the biology of chronic lymphocytic leukemia (CLL), the recent decade has shown a shift from chemotherapy-based regimens to regimens based on targeted agents that exploit distinct biological vulnerabilities of CLL. These targeted agents can be broadly classified into inhibitors of Bruton tyrosine kinase (BTK) and BCL2 as well as CD20-directed antibodies. Depending on which agent and which combination of agents is used, the levels or status of MRD can have varying clinical relevance. This has implications on the prognosis after therapy as well as on possible strategies to guide treatment duration and intensity. Key Messages: This review summarizes the main discoveries related to MRD in the context of targeted therapies. Furthermore, it provides an overview on current hurdles and caveats related to the implementation of MRD in regular clinical care and summarize open research questions that need to be addressed with future clinical studies.
Contribution of critical thinking, science process skills towards learning outcomes based on gender
Authors: Supratman Supratman , Zubaidah Siti , Tarigan Muhammad Rafi’i Ma’arif , Azis Suhartini
Published: October 2023

The purpose of this study is to ascertain importance of scientific reasoning and process abilities to students’ learning outcomes based on gender differences. This type of research uses the kind of correlation research. This research was carried out for one semester a sample of 104 students studying biology in senior high schools in Sumbawa, Indonesia, with a total of 55 female and 49 male students. In this study, multiple-choice examinations were used to assess the students’ science process skills as well as their critical thinking abilities and learning outcomes. The findings the results of the multiple regression analysis demonstrate that the scientific method and critical thinking abilities are strongly correlated effectively children learn, depending on the gender difference. The importance of critical thinking abilities’ positive effects on learning outcomes of the female students was 81.60% and towards the learning results of the male students was 59.1. The usefulness of the science process skill in terms of practical contribution variable towards the learning results of the female students was 4.5%, and the male students were 20.6%. This means that the average simultaneous is classified as high. However, science process skills’ contribution to learning results is relatively low. The research finding shows that the science process skills have a low effective contribution towards students’ learning results based on gender differences, needs to be a serious concern. That is, implementing the appropriate learning models to enhance the development of science process abilities.
Teachers’ experiences of developing the teacher-student relationships during COVID-19 in China
Authors: Li Wenling , Muhamad Mohd Mokhtar , Fakhruddin Fathiyah Mohd , Zhou Weili , Zuo Ruijia
Published: October 2023

The purpose of this study was to express middle school teachers’ experiences of developing teacher-student relationships (TSRs) in online teaching during COVID-19 in China. The study used a qualitative phenomenological design to offer an in-depth description of the experience’s teachers perceive as strategies to develop TSRs. Participants (N=6) were from several middle schools in Nanning, GuangXi, China. Information was collected with semi-structured interviews and analyzed using a five-step phenomenological method in mental research. Data analysis revealed five general themes about teachers’ experiences. The study found that teachers’ proactively initiating dialogues, responding to student needs, emotion-based information exchange, treating students with respect, and expressing motivation and expectations for students were the strategies to develop TSRs. The results of this study can be used in middle school to create positive interventions to enhance educators’ understanding of strategies associated with TSRs.
Video with multiple representations approach to promote students’ conceptual understanding of intermolecular forces
Authors: Erlina Erlina , Enawaty Eny , Melati Husna Amalya , Lestari Ira
Published: October 2023

A number of studies have reported that the main cause of misconceptions are the abstract concepts and students’ low ability to integrate multiple representations (macroscopic, sub-microscopic and symbolic) in chemistry is also a cause of misconceptions. The aim of this study is to develop the video using multiple representations approach to improve students’ conceptual understanding. The method used is the analyze, design, development, implementation, and evaluation or ADDIE development model. Tests (pre and post) and questionnaire were used to collect the data. A video of intermolecular forces has been developed and tested to 82 first-year cohort students of the Chemistry Education Study Program who had taken basic chemistry courses. The average scores were increased from 57.31 (pre-test) to 78.19 (post-test) with the average gain is 20.88. The statistically significant increase in scores (p=0.000) was found, which signifies that the video could support students’ conceptual understanding. In addition to that, majority of students showed a positive response to the video as 99% (N=82) of them either agree or strongly agree with the statements of the questionnaire. This result verified that the video was successfully maintain students’ attention.
Alignment of English as a foreign language teachers’ understanding of classroom assessment practices
Authors: Widiastuti Ida Ayu Made Sri , Weir Katie , Sukoco Heru , Sulistyo Gunadi Harry
Published: October 2023

A comprehensive understanding of classroom assessment is essential for improving students’ learning and teachers’ professionalism. This study was conducted to gain better information about teachers’ understanding of classroom assessment compared to their classroom practices. Semi-structured interviews and classroom observations were employed to collect the data. The collected data were then analyzed comprehensively using comparative and argumentative methods. The results were then presented descriptively to establish the findings. The findings showed that some teachers’ classroom assessment practices were consistent with their assessment understanding, while others were inconsistent. The findings suggest that different contextual factors may influence teachers’ classroom practices. Furthermore, English as a foreign language (EFL) teachers need to be re-trained on comprehending the influencing contextual factors to utilize their understanding of assessment in the classroom effectively.
Vocational education’s growing focus on employability skills: A bibliometrics evaluation of current research
Authors: Triyono Mochamad Bruri , Rafiq Arif Ainur , Djatmiko Istanto Wahyu , Kulanthaivel Govindarajan
Published: October 2023

The study aimed to investigate one of the search’s core issues, ‘employability skills’, and their relationship. It also attempted to recognize the valuable contributions of writers, journals, governments, and institutions worldwide in pursuing employability skills. The quantitative study of bibliographic content is known as bibliometric analysis. Furthermore, it provides a broad view of a study subject that may be subdivided into publications, authors, and journals. This study offers a bibliometric summary of recent research on employability skills. Data was taken from the Scopus database between 2003 and 2022 and examined using VOSviewer software, open refine, tableau public, and Microsoft Excel. The data from the Scopus database are 1,070 documents. Researchers observed that researchers mainly focus on employability skills, higher education, engineering education, curricula, employment, and vocational education. Education and Training journal is the most appropriate journal for contributions, followed by Higher Education, Skills, and Work-based Learning journal, and then the Higher Education Research and Development journal. This study informs researchers by providing insights into basic background knowledge about employability skills for visual and quantitative research. Therefore, this method can observe the research gap in employability skills and more in-depth academic discussions. The study demonstrates how employability skills research has arisen and progressed, as well as prospective future research agendas.
Validation of Pomacentrus novaeguineae, P. umbratilus and P. xanthocercus Allen, Erdmann & Pertiwi (Perciformes: Pomacentridae) from Melanesia and the eastern and central Indian Ocean
Authors: ALLEN GERALD R. , ERDMANN MARK V. , PERTIWI NI PUTU DIAN
Published: October 2023

N/A
Addressing multiple perspectives in studying environmental changes in forest landscapes during the modernization period (18th–19th centuries)
Authors: Związek Tomasz , Łuców Dominika , Popek Joachim , Klisz Marcin , Obremska Milena , Sobechowicz Łukasz , Solon Jerzy , Słowiński Michał , Przybylski Paweł , Tyburski Łukasz , Zin Ewa , Jastrzębowski Szymon , Płaczkowska Eliza , Pilch Kamil , Szewczyk Krzysztof , Konczal Agata A , Rutkowski Paweł , Główka Dariusz , Swoboda Paweł
Published: October 2023

Combining different diverse data on human and environmental history during the Anthropocene is an extremely challenging task, particularly, if one wants to compare written or cartographic data with a whole range of environmental data recorded for more than the past 200–300 years. In this article, our objective was to demonstrate that one of the keys to facilitating syntheses for the study of forest landscape dynamics was to conduct a thorough investigation into the historical phenomena of modernization. We believe that a comprehensive understanding of the advancements in post-enlightenment thought and contextualizing them within the evolution of the state apparatus during the 18th and 19th centuries will empower us to formulate new research questions and broaden our understanding of the mutual relations between nature and humans in the past.
A Qualitative Study of VA Entrants’ Experiences Discussing Community Care With Veterans
Authors: Golden Sara E. , Lafferty Megan , Tyzik Anna , Govier Diana , Barton Jennifer , Teo Alan R. , Edwards Samuel T. , Ono Sarah S. , Hynes Denise M. , Slatore Christopher G.
Published: October 2023

We conducted interviews with clinicians and staff involved in Veterans’ decisions about where to receive their health care to assess experiences with community care coordination and identify areas for improvement. Insufficient time and knowledge were cited as barriers to assisting Veterans in making decisions about whether to use community care resources. Concerns regarding quality of community care and lack of patient understanding on the implications of accessing community care also arose. Clinicians need to be able to help Veterans make informed choices about where to receive their health care and may require decision support that integrates their informational needs with their values and preferences, clarity on the referral process, and improved ways to measure and describe quality of care to Veterans. VA has recognized issues with community care and established new initiatives but the rollout is complex and ongoing.
Timing of anti–PD-L1 antibody initiation affects efficacy/toxicity of CD19 CAR T-cell therapy for large B-cell lymphoma
Authors: Hirayama Alexandre V. , Kimble Erik L. , Wright Jocelyn H. , Fiorenza Salvatore , Gauthier Jordan , Voutsinas Jenna M. , Wu Qian , Yeung Cecilia C. S. , Gazeau Nicolas , Pender Barbara S. , Kirchmeier Delaney R. , Torkelson Aiko , Chutnik Abigail N. , Cassaday Ryan D. , Chapuis Aude G. , Green Damian J. , Kiem Hans-Peter , Milano Filippo , Shadman Mazyar , Till Brian G. , Riddell Stanley R. , Maloney David G. , Turtle Cameron J.
Published: October 2023

More than half of the patients treated with CD19-targeted chimeric antigen receptor (CAR) T-cell immunotherapy for large B-cell lymphoma (LBCL) do not achieve durable remission, which may be partly due to PD-1/PD-L1–associated CAR T-cell dysfunction. We report data from a phase 1 clinical trial (NCT02706405), in which adults with LBCL were treated with autologous CD19 CAR T cells (JCAR014) combined with escalating doses of the anti–PD-L1 monoclonal antibody, durvalumab, starting either before or after CAR T-cell infusion. The addition of durvalumab to JCAR014 was safe and not associated with increased autoimmune or immune effector cell–associated toxicities. Patients who started durvalumab before JCAR014 infusion had later onset and shorter duration of cytokine release syndrome and inferior efficacy, which was associated with slower accumulation of CAR T cells and lower concentrations of inflammatory cytokines in the blood. Initiation of durvalumab before JCAR014 infusion resulted in an early increase in soluble PD-L1 (sPD-L1) levels that coincided with the timing of maximal CAR T-cell accumulation in the blood. In vitro, sPD-L1 induced dose-dependent suppression of CAR T-cell effector function, which could contribute to inferior efficacy observed in patients who received durvalumab before JCAR014. Despite the lack of efficacy improvement and similar CAR T-cell kinetics early after infusion, ongoing durvalumab therapy after JCAR014 was associated with re-expansion of CAR T cells in the blood, late regression of CD19+ and CD19– tumors, and enhanced duration of response. Our results indicate that the timing of initiation of PD-L1 blockade is a key variable that affects outcomes after CD19 CAR T-cell immunotherapy for adults with LBCL.
Prevalence and factors associated with immunization coverage among children under five years in Mohamed Mooge health center, Hargeisa, Somaliland: a cross-sectional study
Authors: Abdilahi Mohamed Mussa , Mohamed Ahmed Ismail , Jonah Kiruja M. , Ismail Abdisamad Shukri
Published: October 2023

Background

Routine immunization contributes greatly to reduction in mortality from vaccine preventable diseases among children. The Somaliland Demographic and Health survey, 2020 revealed that only 13.7% of children in Marodijeh (Hargeisa) region had received all recommended vaccines, which is far below the World Health Organization (WHO) target of 80%. We therefore, assessed factors associated with immunization coverage among children under five years at Mohamed Mooge Health Center in Hargeisa, Somaliland.

Methods

Institutional based cross-sectional study was conducted on 174 systematically sampled, consented mothers that visited Mohamed Mooge Health Center for antenatal care during December 2022 to May 2023. Data was collected using a structured questionnaire. Data was analysed using SPSS and the relationship between dependent and independent variables was checked chi-square test at p ≤ 0.05. Finally, candidate variables were tested by using multivariate logistic regression in order to control potential confounders and the result was presented using AOR and 95% confidence interval. Model fitness was checked using Hosmer-Lemeshaw goodness of fit test with P > 0.05 for fitness. Multicollinearity between variables was checked using correlation coefficients at 0.80 or higher. 

Result

Among 174 study participants, the prevalence of overall vaccine completion in this study was 55.3%. Women who had being aware about childhood immunization on BCG vaccination (AOR = 3.887; 95% CI: 1.275, 6.844), pentavalent (AOR = 11.385; 95% CI: 5.424–14.464), and measles (AOR = 3.074; 95% CI: 1.822–6.130) had higher odds of having immunized their children. Mothers who had employment had higher odds of having their children immunized against measles (AOR = 4.069; 95% CI: 1.822–6.130) compared to those who had not.

Conclusions

Full immunization coverage was lower than the target set by the World Health Organization in this study area. The current study revealed that, the mother’s awareness of childhood vaccinations on BCG, pentavalent, measles and employment status of mothers were positively associated with immunization coverage. To promote vaccination coverage, the government should implement a national awareness campaign on childhood immunization and increase the number of outreach services.
Neurobiological mechanisms of ECT and TMS treatment in depression: study protocol of a multimodal magnetic resonance investigation
Authors: Frid Leila Marie , Kessler Ute , Ousdal Olga Therese , Hammar Åsa , Haavik Jan , Riemer Frank , Hirnstein Marco , Ersland Lars , Erchinger Vera Jane , Ronold Eivind Haga , Nygaard Gyrid , Jakobsen Petter , Craven Alexander R. , Osnes Berge , Alisauskiene Renata , Bartsch Hauke , Le Hellard Stephanie , Stavrum Anne-Kristin , Oedegaard Ketil J. , Oltedal Leif
Published: October 2023

Background

Noninvasive neurostimulation treatments are increasingly being used to treat major depression, which is a common cause of disability worldwide. While electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are both effective in treating depressive episodes, their mechanisms of action are, however, not completely understood. ECT is given under general anesthesia, where an electrical pulse is administered through electrodes placed on the patient’s head to trigger a seizure. ECT is used for the most severe cases of depression and is usually not prescribed before other options have failed. With TMS, brain stimulation is achieved through rapidly changing magnetic fields that induce electric currents underneath a ferromagnetic coil. Its efficacy in depressive episodes has been well documented. This project aims to identify the neurobiological underpinnings of both the effects and side effects of the neurostimulation techniques ECT and TMS.

Methods

The study will utilize a pre-post case control longitudinal design. The sample will consist of 150 subjects: 100 patients (bipolar and major depressive disorder) who are treated with either ECT (N = 50) or TMS (N = 50) and matched healthy controls (N = 50) not receiving any treatment. All participants will undergo multimodal magnetic resonance imaging (MRI) as well as neuropsychological and clinical assessments at multiple time points before, during and after treatment. Arterial spin labeling MRI at baseline will be used to test whether brain perfusion can predict outcomes. Signs of brain disruption, potentiation and rewiring will be explored with resting-state functional MRI, magnetic resonance spectroscopy and multishell diffusion weighted imaging (DWI). Clinical outcome will be measured by clinician assessed and patient reported outcome measures. Memory-related side effects will be investigated, and specific tests of spatial navigation to test hippocampal function will be administered both before and after treatment. Blood samples will be stored in a biobank for future analyses. The observation time is 6 months. Data will be explored in light of the recently proposed disrupt, potentiate and rewire (DPR) hypothesis.

Discussion

The study will contribute data and novel analyses important for our understanding of neurostimulation as well as for the development of enhanced and more personalized treatment.

Trial registration

ClinicalTrials.gov Identifier: NCT05135897.
Prevalence and significance of clonal hematopoiesis of indeterminate potential in lung transplant recipients
Authors: Swaminathan Aparna C. , Barfield Richard , Zhang Mengqi , Povysil Gundula , Chen Cliburn , Frankel Courtney , Kelly Francine , McKinney Matthew , Todd Jamie L. , Allen Andrew , Palmer Scott M.
Published: October 2023

Background

Clonal hematopoiesis of indeterminate potential (CHIP), the age-related acquisition of somatic mutations that leads to an expanded blood cell clone, has been associated with development of a pro-inflammatory state. An enhanced or dysregulated inflammatory response may contribute to rejection after lung transplantation, however the prevalence of CHIP in lung recipients and influence of CHIP on allograft outcomes is unknown.

Methods

We analyzed whole-exome sequencing data in 279 lung recipients to detect CHIP, defined by pre-specified somatic mutations in 74 genes known to promote clonal expansion of hematopoietic stem cells. We compared the burden of acute rejection (AR) over the first post-transplant year in lung recipients with vs. without CHIP using multivariable ordinal regression. Multivariate Cox proportional hazards models were used to assess the association between CHIP and CLAD-free survival. An exploratory analysis evaluated the association between the number of CHIP-associated variants and chronic lung allograft dysfunction (CLAD)-free survival.

Results

We detected 64 CHIP-associated mutations in 45 individuals (15.7%), most commonly in TET2 (10.8%), DNMT3A (9.2%), and U2AF1 (9.2%). Patients with CHIP tended to be older but did not significantly differ from patients without CHIP in terms of race or native lung disease. Patients with CHIP did not have a higher incidence of AR over the first post-transplant year (p = 0.45) or a significantly increased risk of death or CLAD (adjusted HR 1.25, 95% CI 0.88–1.78). We did observe a significant association between the number of CHIP variants and CLAD-free survival, specifically patients with 2 or more CHIP-associated variants had an increased risk for death or CLAD (adjusted HR 3.79, 95% CI 1.98–7.27).

Conclusions

Lung recipients have a higher prevalence of CHIP and a larger variety of genes with CHIP-associated mutations compared with previous reports for the general population. CHIP did not increase the risk of AR, CLAD, or death in lung recipients.
Pharmacokinetics and metabolism of lidocaine HCl 2% with epinephrine in horses following a palmar digital nerve block
Authors: Knych Heather K. , Katzman Scott , McKemie Daniel S. , Arthur Rick M. , Blea Jeff
Published: October 2023

Background

Lidocaine is a local anesthetic that is sometimes administered in combination with epinephrine. The addition of epinephrine increases the time lidocaine remains at the site of administration, thus prolonging the duration of effect. Due to their potential to prevent the visual detection of lameness, the administration of local anesthetics is strictly regulated in performance and racehorses. Recent reports of positive regulatory findings for lidocaine in racehorses suggests a better understanding of the behavior of this drug is warranted. The objective of the current study was to describe serum and urine concentrations and the pharmacokinetics of lidocaine and its primary metabolites following administration in combination with epinephrine, as a palmar digital nerve block in horses. Twelve horses received a single administration of 1 mL of 2% lidocaine HCl (20 mg/horse) with epinephrine 1:100,000, over the palmar digital nerve. Blood samples were collected up to 30 h and urine samples up to 48 h post administration. Lidocaine and metabolite concentrations were determined by liquid chromatography- mass spectrometry and pharmacokinetic (non-compartmental and compartmental) analysis was performed.

Results

Serum concentrations of lidocaine and 3-hydroxylidocaine were above the LOQ of the assay at 30 h post administration and monoethylglycinexylidide (MEGX) and glycinexylidide (GX) were below detectable levels by 24 and 48 h, respectively. In urine, lidocaine, MEGX and GX were all non-detectable by 48 h post administration while 3-hydroxylidocaine was above LOQ at 48 h post administration. The time of maximal concentration for lidocaine was 0.26 h (median) and the terminal half-life was 3.78 h (mean). The rate of absorption (Ka) was 1.92 1/h and the rate of elimination (Kel) was 2.21 1/h.

Conclusions

Compared to previous reports, the terminal half-life and subsequent detection time observed following administration of lidocaine in combination with epinephrine is prolonged. This is likely due to a decrease in systemic uptake of lidocaine because of epinephrine induced vasoconstriction. Results of the current study suggest it is prudent to use an extended withdrawal time when administering local anesthetics in combination with epinephrine to performance horses.
Association between high sensitivity cardiac troponin and mortality risk in the non-diabetic population: findings from the National Health and Nutrition Examination Survey
Authors: Liu Lin , Cheng Yuen Ting , Xu Aimin , Cheung Bernard M. Y.
Published: October 2023

Objective

We investigated the association of high-sensitivity cardiac troponin (Hs-cTn) with all-cause and cardiovascular mortality in non-diabetic individuals.

Methods

This study included 10,393 participants without known diabetes and cardiovascular disease from the US National Health and Nutrition Examination Survey (NHANES). Serum Hs-cTnI and Hs-cTnT concentrations were measured. Prediabetes was defined as fasting blood glucose between 100 and 125 mg/dL or HbA1c between 5.7 and 6.4%. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality risk. Time-dependent receiver operating characteristics (tROC) curves were utilized to measure the predictive performance of the biomarkers. Net Reclassification Improvement (NRI) were calculated to estimate the improvement in risk classification for adding Hs-cTnT or Hs-cTnI to the standard models based on Framingham risk factors.

Results

The mean age of the participants was 48.1 ± 19.1 years, with 53.3% being female and 25.8% being prediabetic. After multivariable adjustment, compared to those with Hs-cTnI concentration less than the limit of detection, the HRs (95% CIs) of the participants with Hs-cTnI concentration higher than the 99th upper reference limit were 1.74 (1.35, 2.24) for all-cause mortality and 2.10 (1.36, 3.24) for cardiovascular mortality. The corresponding HRs (95% CIs) for Hs-cTnT were 2.07 (1.53, 2.81) and 2.92 (1.47, 5.80) for all-cause and cardiovascular mortality. There was a significant interaction between prediabetes and Hs-cTnI on the mortality risk; a positive relationship was only observed in prediabetic individuals. No interaction was observed between prediabetes and Hs-cTnT on mortality risk. The Areas Under tROC indicated both Hs-cTnT and Hs-cTnI show better predictive performance in cardiovascular mortality than in all-cause mortality. NRI (95% CI) for adding Hs-cTnT to the standard model were 0.25 (0.21, 0.27) and 0.33 (0.26, 0.39) for all-cause and cardiovascular mortality. The corresponding NRI (95% CI) for Hs-cTnI were 0.04 (0, 0.06) and 0.07 (0.01, 0.13).

Conclusions

Elevated blood levels of Hs-cTnI and Hs-cTnT are associated with increased mortality. Measurement of Hs-cTnT in non-diabetic subjects, particularly those with prediabetes, may help identify individuals at an increased risk of cardiovascular disease and provide early and more intensive risk factor modification.