bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the “Action Leadership for Adolescents Approach” in Traditional Classroom Settings
Authors: Hamdorf Leslie
Published: July 2023

Action Leadership for Adolescents (ALA) is a cutting-edge inclusive approach to adolescent leadership development. The Self-Reflection Evaluation Inventory evaluated the growth of 21st-century skills taught through the five principles of ALA. The five principles: Brain Balance, Skill Development, Interdisciplinary Collaboration, Innate Wisdom, and Cultural Responsibility; guided the curriculum of a course for seniors in a traditional high school and validated the hypothesis that the curriculum rooted in these principles ensured growth and empowerment for adolescents. ALA was born from a combination of Positive Youth Development and Transformational Leadership models and the efficacy of the approach was confirmed through the mixed-methods action research study presented in this article. Overall, the participants of the study demonstrated significant growth in the maturation of their 21st-century skills. The next steps for ALA include partnering with social researchers to continue analyzing the efficacy of ALA in all activities for adolescents.
Effect of gastric mucosal status on the invasion of undifferentiated early gastric cancer and the role of the glucocholesterol glycoside-a multicenter study
Authors: Jiang Zhang-Xiu , Deng wei , Ning Jia-Juan , Qin yue-qiu , Qi Jing-Jing , Yan yu-dong , Li hong , Liang Yun-Xiao
Published: July 2023

Background
Undifferentiated early gastric cancer in different patients can show a completely different type of biological behavior. The purpose of this study was to clarify the effect of Helicobacter pylori infection in the gastric mucosa on the biological behavior of undifferentiated early gastric cancer and to provide ideas for the selection of treatment and the control of its occurrence and development.
Methods
According to the inclusion and exclusion criteria, patients suspected of undifferentiated early gastric cancer who underwent gastroscopy in several hospitals in Guangxi from 2018 to 2020 were included in succession.
Results
A total of 61 cases of undifferentiated early gastric cancer, 41 cases from the H. pylori related gastric cancer group (including 16 cases of H. pylori infection and 25 cases of previous infection), 20 cases from the H. pylori negative group (control group). The neutrophil lymphocyte ratio, lymph node metastasis rate, and the glucocholesterol glycoside from the H. pylori related gastric cancer group were higher than those from the control group.
Conclusion
H. pylori can inhibit T cell immunity through the glucocholesterol glycoside and promote the development and metastasis of undifferentiated early gastric cancer.
Neuropsychological stimulation for children living in low socioeconomic level suburbs from Guatemala City: A study protocol.
Authors: Rodríguez-Prieto Pablo , Simpson Ian Craig , Gómez-Baya Diego , Cadena Claudia García de la , Ruiz-Aranda Desirée , Ibáñez-Alfonso Joaquín A.
Published: July 2023

Background: Guatemala remains one of the poorest countries in central America and suffers from high rates of social inequality and violence. Among other disadvantages, this unfavourable socioeconomic context poses a risk to children’s emotional and cognitive development. In addition to the negative impact that two years without attending school has had on Guatemalan children, the impact of the COVID-19 pandemic on the country’s economic stability has worsened the socioeconomic divide that these children face. This work presents a protocol for implementing a cognitive and emotional stimulation program with the goal of increasing the academic performance of these children and consequently improve their quality of life.
Methods: The protocol proposes the implementation of a randomized controlled trial to assess the efficacy of a 24-session-long stimulation program. It contains activities targeting the cognitive functions of attention, language, executive functions, and social cognition, using the digital neurorehabilitation platform NeuronUP. The participants (n = 480) will be randomly assigned to either the Experimental or Control group. Pre- and post-intervention assessments will be carried out, together with a follow-up in the next academic year, in which both groups will change roles.
Discussion: Mid- and long-term outcomes are still unknown, but effective interventions based on this protocol are expected to facilitate the following benefits for participants: (1) improved cognitive and emotional development; (2) improved academic performance; (3) improved well-being. We expect to create a validated neuropsychological stimulation program that could be applied in similar socioeconomically disadvantaged contexts around the world to help these children improve their life chances.
Trial registration: This project has been registered in the Open Science Foundation data base on the 10th of February 2022 (https://doi.org/10.17605/OSF.IO/JVZ6W).
How reliability and carbon prices impact pathways to universal electricity access in Africa
Authors: Beath Hamish , Mittal shivika , Few Sheridan , Winchester Benedict , Sandwell Philip , Markides Christos N. , Nelson Jenny , Gambhir Ajay
Published: July 2023

Off-grid PV systems have been proposed as a panacea for economies with poor electricity access, offering a lower-cost “leapfrog” over grid infrastructure used in higher-income economies. Previous research examining pathways to electricity access may understate the role of off-grid PV as it has not considered reliability and carbon pricing impacts. We perform high-resolution geospatial analysis on universal household electricity access in Sub-Saharan Africa that includes these aspects via least-cost pathways at different electricity demand levels. Under our "Tier 3" demand reference scenario, 24% of our study’s 470 million people obtaining electricity access by 2030 do so via off-grid PV. A penalty for unmet demand (0.50 $/kWh) increases this share to 41% and applying a carbon price (around $80/tonne CO2-eq) increases it to 38%. We identify thresholds for policy effectiveness in different regions and highlight the high degree of spatial heterogeneity and the areas where policy intervention may be most effective.
Introducing a triage and Nurse on Call model in primary health care – a focus group study of health care staff’s experiences
Authors: Gelin Maria , Gesar Berit , Källberg Ann-Sofie , Ehrenberg Anna , Gustavsson Catharina
Published: July 2023

Background
With the increased demand for health care services and with simultaneous staff shortages, new work models are needed in primary health care. In November 2015, a Swedish primary health care centre introduced a work model consisting of a structured patient sorting system with triage and Nurse on Call. The aim of this study was to describe the staff’s experiences of introducing the triage and Nurse on Call model at the primary health care centre.
Methods
Five focus group discussions with staff (n = 39) were conducted 4 years after the introduction of the work model. Groups were divided by profession: medical secretaries, nursing assistants, physicians, primary health care nurses, and registered nurses. The transcribed text from the discussions was analysed using qualitative inductive content analysis.
Results
The analysis resulted in the main category: The introduction of triage and Nurse on Call addresses changed preconditions in primary health care, but the organization, work culture and acquisition of new knowledge are lagging behind. The main category had five generic categories: (1) Changed preconditions in primary health care motivate new work models; (2) The triage and Nurse on Call model increases the quality of care; (3) Unclarity of purpose and vague leadership make introducing the work model difficult; (4) Difficulties to adopt the work model are due to a strong work tradition; and (5) The triage and Nurse on Call model requires more knowledge and competence from nurses in primary health care.
Conclusions
This study contributes with knowledge about implementation of a new work model in primary health care from the perspective of health care staff. The work model using triage and Nurse on Call in primary health care was perceived by participants to increase the quality of health care and optimize the use of resources. However, before implementation, it is important to identify barriers to and facilitators for successful improvements in the local health care context. Additional education for the health care staff is important if the transition is to be successful. Complementary skills, especially for registered nurses and primary health care nurses, are important to ensure a well-prepared workforce.
Role of interfaces on the mechanical response of accumulative roll bondednanometallic laminates investigated via dislocation dynamics simulations
Authors: Chakraborty Aritra , Kohnert Aaron , Hunter Abigail , capolungo Laurent
Published: July 2023

Unraveling the effects of continuous dislocation interactions with interfaces, particularly at the nanometer length scales, is key to a broader understanding of plasticity, to material design and to material certification. To this end, this work proposes a novel discrete dislocation dynamics-based model for dislocation interface interactions tracking the fate of residual dislocation on interfaces. This new approach is used to predict the impact of dislocation/interface reactions on the overall mechanical behavior of accumulative roll bonded nanometallic laminates. The framework considers the dynamic evolution of the interface concurrent with a large network of dislocations, thus, accounting for the local short and long range effects of the dislocations under the external boundary conditions.Specifically, this study focuses on two-phase Fe/Cu nanometallic laminates, and investigates the role of the underlying elastic and plastic contrast of the Fe and the Cu layers on the composite response of the material. Moreover, the role of initial microstructures, resulting from processing is also investigated. Subsequently, the model is used to examine the effect of layer thickness and interface orientation relationship on the residual stresses of the relaxed microstructure. The associated mechanical response of these laminates are compared when loaded under normal direction compression, as well as shear compression.Finally, this work predicts a dominant effect of the layer thickness, as compared to the interface orientation relationship, on the macroscopic response and on the residual stresses of these nanolaminates, while the local dislocation transmission propensity through the interface is significantly influenced by the corresponding orientation relationship.
Resistance of central European oat cultivars (A.sativa L.) to powdery mildew (Blumeria graminis f. sp. aveane)
Authors: Cieplak Magdalena , Okoń Sylwia
Published: July 2023

An important aspect of breeding work aimed at increasing resistance to fungal diseases is the constant monitoring of the level of resistance of cultivars and identifying the group of genes used in the fight against diseases. This allows estimating the pressure of pathogens to break down the main resistance genes. The aim of the presented work was to determine the level of resistance and to postulate the presence of resistance genes to powdery mildew in oat cultivars currently growing in central Europe. Studies have shown that these cultivars are characterized by a low level of resistance. We identified only 5 characterized by the above resistance to the B. graminis f.sp. avenae isolates used in the test, in 4 we postulated the presence of the Pm7 gene. In order to protect oat crops more effectively against powdery mildew, it is necessary to introduce cultivars with a wider range of resistance genes or to build gene pyramids.
Dynamic Response and Liquefaction Potential of Porous Seabed Induced by Partial Standing Ocean Waves
Authors: Wang Guocai , Liu Yiyang , Liu Kai , Xu Chate
Published: July 2023

The analysis of ocean wave-induced dynamic response of a porous seabed is particularly important for coastal and geotechnical engineers when designing and constructing maritime structures. In this study, an analytical solution is presented to analyze the dynamic response and liquefaction potential of a poro-elastic seabed induced by partial standing waves with arbitrary reflectivity. The porous seabed is modeled using Biot’s theory describing the propagation of elastic waves, and coupled deformation and water flow of porous media, whereas the ocean waves are described using linear ocean wave theory. Based on the mixed boundary-value conditions, explicit expressions of displacements, effective stresses and excess pore water pressure of seabed are derived with consideration of the effects of inertial forces, compressibility of solid and fluid, and arbitrary reflectivity of standing waves. The results of degenerated analytical solutions are compared with the existing ones to verify the correctness of the proposed method. The effects of several pertinent parameters of ocean wave-seabed system, including reflection coefficient, phase lag and period of standing waves, depth of water, permeability, degree of saturation, and shear modulus of seabed deposits, etc., on the dynamic response of seabed and liquefaction potential, are examined and discussed.
Activation procedure to unleash the power of N2-selective ETS-4 membranes for CH4 upgrading
Authors: Zakeri Fatemeh , Vosoughi Mahsa , Maghsoudi Hafez , Denayer Joeri F.M.
Published: July 2023

Microporous ETS-4 zeotype, with its 4Å pore openings, is an adequate material for the kinetic separation of nitrogen from methane. Small-sized ETS-4 was synthesized by a novel method and then utilized as membrane seeding powder. High-quality and uniform ETS-4 membranes were fabrucated utilizing a new recipe and the secondary growth approach on α-alumina supports. XRD, FESEM, and EDX studies were used to analyse the synthesized ETS-4 powder and membranes. The effect of membrane activation temperature (80–140 ºC) on permeance was evaluated. In addition to N2 and CH4, the membrane permeance was also evaluated for O2 and Ar gases. N2 permeance increased gradually as the activation temperature was raised in the 80–120 ºC range, reaching its highest value (i.e., 2.6×10− 8 mol m− 2 s− 1 Pa− 1) after activation at 140 ºC. The permeances of pure N2 and CH4 gases were quantified through the ETS-4 membrane at 30, 50, and 70 ºC, and a pressure difference up to 600 kPa. N2/CH4 permselectivity of 75.19 ( N2 permeance of 1.94 × 10− 8 mol m-2 s− 1 Pa− 1 ) were measured at 30°C and 200 kPa of feed pressure, respectively, which is the highest N2/CH4 permselectivity among all membranes reported in the literature.
Effect of three pro-nuclei (3PN) on the outcomes of PGT
Authors: WU XIAO-HUA , jiang yan , YUAN JING-CHUAN , SONG GE , GENG CAI-PING , ZHANG XU-HUI
Published: July 2023

Aims
To explore the influence of 3PN on outcomes in preimplantation genetic testing (PGT) cycles.
Methods
This was a retrospective study of patients undergoing PGT treatment included 139 PGT for aneuploidy (PGT-A) cycles and 285 cycles PGT for monogenic/single gene defects and/or chromosomal structural rearrangements (PGT-M/SR). The 424 PGT cycles were divided into two groups as follows: group 1 included 343 cycles with no 3PN zygotes and group 2 included 81 cycles with 3PN zygotes. 3PN cycle rate was compared between PGT-A and PGT-M/SR cycles. The outcomes of PGT were analyzed between the two groups.
Results
The female and male's age were significantly higher in PGT-A than PGT-M/SR cycles. Whereas 3PN rate was not significantly different between the two groups. The number of retrieved oocytes was significantly higher in 3PN group than Non 3PN group (13.98 ± 7.10 vs. 10.89 ± 6.65; P < 0.05). The MII oocyte rate, 2PN fertilizaion rate, D3 high embryo rate, biopsy blastocyst rate, per oocyte utilization and D5 blastocyst rate were significantly lower in 3PN group than Non 3PN group (P < 0.05). The results of chromosomal mosaic rate was significantly higher in 3PN group than Non 3PN group (16.3 vs. 11.9; P < 0.05).
Conclusions
No correlation was observed between 3PN formation rate and PGT-A or PGT-M/SR cycles. The occurrence of 3PN seems to impair the developing blastocyst and interfere with good embryo formation rate and mosaic rate in PGT. But the occurrence of 3PN does not seem to impair the euploid rate and aneuploid rate.
Screening of drought tolerant tomato genotypes based on biochemical attributes
Authors: Khan Rizwan Taj , Gerdezi Ahmed , Rizwan Syed , Hafeez Muhammad , Abbas Kamran , Mehmood Ansar
Published: July 2023

This research was conducted with the aim to distinguish the selected tomato genotypes based on drought tolerance level under Poly ethylene glycol (PEG 6000) simulated drought stress by the biochemical markers like proline, phenolics, flavonoids, reducing and non- reducing sugars. The experiment was performed in controlled conditions using complete randomized block design with three replications. The tomato genotypes investigated showed varying response for different biochemical attributes. Control (0%), 5%, 7.5%, 10% and 12.5% Poly ethylene glycol (PEG) treatments were used in experiment. Leaf extract was used to quantify these biochemical traits. It was observed that successive increase in PEG concentration increases the proline. The highest 54.5 mg/g proline contents was recorded in G-45-19212. The maximum 20.7 mg/g proline contents were recorded for G- 31–00623 and the lowest was 16. 5 mg/g for G-8-19219. G-38-19896 produced the maximum 60 µg / g phenolic contents and 5 µg / g the minimum was produced by the G 8-19219 at control (without PEG). 12µg /g maximum flavonoid contents were observed in the genotype G 31-19896 and minimum 4 µg /g by G 7- 10593. Reducing and non- reducing sugars showed similar behavior for the selected genotypes. G-7-88527 showed the higher amount of sugars. Based on the performance of tomato genotypes on selected stress tolerance indices, these genotypes may be used in breeding programs.
Color visual field measurements for detecting glaucoma
Authors: Sato Hiroyuki , Kunikata Hiroshi , Tanaka Yoshiki , Omodaka Kazuko , Himori Noriko , Ichikawa Kazuo , Nakazawa Toru
Published: July 2023

This study evaluated the difference between glaucoma and normal eyes using a color visual field (CVF) test.
Thirty-seven eyes of 37 normal subjects (mean age 56.6±12.0 years) and 39 eyes of 39 patients with glaucoma (mean age 57.1±11.3 years) underwent a CVF test by presenting red and blue-purple visual targets with the same brightness as the background. Measurements were made at 16 points within the central 5 degrees and at 6 points peripheral to that area in the papillary macular bundle (PMB). Thresholds were detected for each measurement point, and the total values for each central, upper, lower, and PMB region were compared between normal and glaucomatous eyes.
The sum of thresholds obtained by the red target was significantly higher in the central, upper, lower, and PMB regions (P=0.008, P<0.001, P=0.02, and P=0.02, respectively) in glaucomatous eyes. The sum of thresholds obtained by the blue-purple target was higher in all regions except the PMB (P<0.01, P<0.01, P=0.04, and P=0.08, respectively). Of 8 patients under 50 years old who had no abnormalities in the 4 central points by standard automated perimetry (SAP), 4 showed a significant increase (more than 2 standard deviations) in at least one CVF threshold value of the 4 central points.
CVF with both the red and blue-purple targets was detectably worse in eyes with glaucoma, and abnormalities were observed where SAP was determined to be within normal limits. This suggests that CVF testing may be an efficient tool for detecting glaucoma.
18F-AlF-FAPI nanotracer visualized the quick response of sarcoma to radiotherapy by PET/CT
Authors: Li Zili , Ren Caiyue , Liu Mingyu , Zhang Jiangang , Zhang Jianping , Qi Ming , Xue Yangbo , Xu Xiaoping , Yao An , Song Shaoli , Cheng Jingyi , SUN YUN
Published: July 2023

Background
MRI or CT-based RECIST is the current clinical standard for evaluating the efficacy of radiation therapy. Typically, several months are required after treatment to determine the extent of tumor control, with the possibility of malignant progression. In this study, we synthesize a novel nanoscale 18F-AlF-labeled FAPI radiotracer and assess its capacity to monitor instant radiotherapy response by PET/CT in tumor xenografted mouse models and a patient with sarcoma, utilizing 18F-FDG, 68Ga-FAPI PET/CT imaging, and MRI imaging as controls.
Results
Current research has generated an 18F-AlF-FAPI radiotracer with an unique pharmacological architecture. The radiotracer 18F-AlF-FAPI was a colloid with a diameter of 100–200 nm. The diameter of AlF clusters ranges between 10 and 80 nm, and the majority of 18F-AlF-FAPI molecules comprise between 2 and 5 AlF clusters. In comparison to 68Ga-FAPI, 18F-AlF-FAPI has a distinct excretion mechanism and a significantly smaller background signal, resulting in a higher tumor-to-background ratio (TBR). After a single dose of 10 Gy of non-lethal X-ray therapy, the xenografted tumor in the mouse exhibited a high uptake of 18F-AlF-FAPI, followed by tumor progression. In a patient with sarcoma who underwent complete carbon ion radiotherapy (CIRT) treatment and tumor regression, tumor uptake of 18F-AlF-FAPI was barely detectable, highlighting the potential of 18F-AlF-FAPI probe-based PET/CT for visualization of quick response to CIRT radiotherapy within one month. Additionally, the tumor site in this case was around 1,4 times larger in 18F-AlF-FAPI PET imaging than in MRI and 18F-FDG PET/CT imaging. The physician finally expanded the target volume delineation for CIRT treatment based on the positive region and heterogeneity, indicating the potential of 18F-AlF-FAPI nanotracer in target volume delineation.
Conclusions
In PET/CT imaging, the novel 18F-AlF-FAPI nanotracer had a higher TBR and a lower background than 68Ga-FAPI due to its distinct formation. 18F-AlF-FAPI uptake was found to be favorably linked with tumor progression in tumor-xenografted mice and sarcoma patients. Compared to 18F-FDG, 68Ga-FAPI PET/CT imaging, and MRI imaging, 18F-AlF-FAPI PET/CT imaging revealed greater potential for identifying the rapid response of sarcoma to radiotherapy within one month. 18F-AlF-FAPI PET/CT imaging has also shown potential in radiotherapy target volume delineation.
Malat1 regulates PMN-MDSC expansion and immunosuppression through p-STAT3 ubiquitination in sepsis
Authors: Lu Guoping , Wang Yaodong , Zhang Caiyan , Liu Tingyan , Yu Zhenhao , Wang Kexin , Ying Jiayun , Wang Yao , Zhu Ting , Li Jingjing , Zhou Yufeng
Published: July 2023

Myeloid-derived suppressor cells (MDSCs) expand during sepsis and contribute to the development of persistent inflammation-immunosuppression-catabolism syndrome. However, the underlying mechanism remains unclear. Exploring the mechanisms of MDSCs generation may provide therapeutic targets for improving immune status in sepsis. Here, a sepsis mouse model is established by cecal ligation and perforation. Bone marrow cells at different sepsis time points are harvested to detect the proportion of MDSCs and search for differentially expressed genes by RNA-sequence. In lethal models of sepsis, polymorphonuclear-MDSCs (PMN-MDSCs) decrease in early but increase and become activated in late sepsis, which is contrary to the expression of metastasis-associated lung adenocarcinoma transcript 1 （Malat1）. In vivo, Malat1 inhibitor significantly increases the mortality in mice with late sepsis. And in vitro, Malat1 down-regulation increases the proportion of PMN-MDSCs and enhanced its immunosuppressive ability. Mechanistically, Malat1 limits the differentiation of PMN-MDSCs by accelerating the degradation of phosphorylated STAT3. Furthermore, Stattic, an inhibitor of STAT3 phosphorylation, improves the survival of septic mice by inhibiting PMN-MDSCs. Overall, the study identifies a novel insight into the mechanism of sepsis-induced MDSCs and provides more evidence for targeting MDSCs in the treatment of sepsis.
The association between blood pressure control and long-term cardiovascular outcomes in hypertension coexists with obstructive sleep apnea
Authors: Yao Xiaoguang , Li Nanfang , Heizhati Mulalibieke , Wang Yingchun , Ma Yue , Wang Run , Zhang Delian , Luo Qin , Hu Junli , Wang Menghui , Zhu Qing
Published: July 2023

Purpose: The goal of blood pressure (BP) control will be lower when hypertensive patients have comorbidities that can affect the risk of cardiovascular diseases. But, the goal of BP control for hypertensive patients who coexists with obstructive sleep apnea (OSA) is not discussed, which is a special population at high risk of cardiovascular diseases.
Patients and methods: Using data from the UROSAH Study, we enrolled 3267 participants who were diagnosed with hypertension and performed polysomnography during 2011-2013 to explore the association between BP control and long-term major adverse cardiovascular and cerebrovascular events (MACCEs). Outcomes of interest were the levels of BP control, MACCEs, cardiac events and cerebrovascular events. Then we calculated the cumulative incidence of MACCEs and performed Cox proportional hazards with stepwise models.
Results: 379 of 3267 patients experienced MACCEs during a median follow-up of 7.0 years. After full risk adjustment, BP control of 120-140/80-90mmHg was associated with the lowest risk of cerebrovascular events (HR: 0.53, 95%CI:0.35-0.82) rather than MACCEs and cardiac events in the total cohort. The association did not changed much in patients with OSA. When the SBP and DBP were discussed separately, the SBP control of 120-140mmHg or <120 mmHg was associated with the decreased incidence of MACCEs and cerebrovascular events. When DBP control<80 mmHg, the risk of cerebrovascular events showed 54% decrease[(HR:0.46, 95%CI: 0.25-0.88)] in patients with hypertension and OSA.
Conclusion: In this retrospective study, antihypertensive-drug-induced BP control at 120-140/80-90mmHg showed possible beneficial effect on incident MACCEs. However, SBP≤120mmHg or DBP<80mmHg respectively showed the significant benefit to reduce incident cerebrovascular events in hypertensives with OSA.
“The Great Escape”: How an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage.
Authors: Quinn Sam , Ferguson Libby , Read Derek , Richards Naomi
Published: July 2023

Background:
This case report from [LOCATION] illustrates how unresolved traumatic experiences across the life course can affect a patient's engagement with palliative care and offers insights into the flexibility and adaptations necessary for taking a trauma informed approach to care for an individual experiencing multiple disadvantage. Trauma informed care is a cornerstone in the pursuit of equitable palliative care, particularly for those facing multiple disadvantage, as it acknowledges the impact of past traumas on current healthcare experiences, and fosters an environment of understanding, acceptance, and tailored support to alleviate suffering in the final stages of life.
Case Presentation:
"M" was a veteran with a history of homelessness, living with end stage anal cancer and symptoms consistent with post-traumatic stress disorder (PTSD), although he never received a formal diagnosis. M exhibited complex behaviours perceived to be related to his history of trauma, including his decision to elope from the hospice, reluctance to accept personal care from nurses, and unpredictability. These behaviours posed a significant challenge to his palliative care team, both in the hospice and at home. An individualised and flexible approach to care delivery was eventually adopted, which included a 'safety-netting' approach and care delivery outside of the hospice. M was ultimately supported to remain at home until a week before he died.
Conclusion:
M's case underscores the necessity of adopting a trauma informed approach to palliative care, particularly for patients with a history of trauma and multiple disadvantage. The case highlights the importance of understanding and respecting a patient's past traumas, promoting safety and autonomy, and ensuring flexibility in care delivery.
Dialister pneumosintes and aortic graft infection – a case report
Authors: Patel Rachel , Chong Debra S T , Guy Alison J , Kennedy Matthew
Published: July 2023

Background:
Dialister pneumosintes is an anaerobic, gram negative bacillus, found in the human oral cavity and associated with periodontitis. Recent case reports implicate D. pneumosintes in local infection such as dental root canals, sinusitis, Lemierres syndrome and brain abscesses, as well as distal infections of the liver and lung through haematogenous spread.
Case presentation:
We present a novel case of an aortic graft infection in a 75 year old Caucasian male, associated with D. pneumonintes bacteraemia. Microbiological evaluation of septic emboli in the lower limbs revealed other oral flora, supporting a dental origin of graft infection. To our knowledge this is the first report of D. pneumonintes associated aortic graft infection. The patient underwent surgical explantation, oversew of the aorta and placement of extra-anatomical bypass graft in conjunction with antimicrobial therapy, making a good recovery with discharge home after 35 day hospital admission.
Conclusion:
We report a case of Dialister pneumosintes bacteraemia secondary to aortic graft infection. To our knowledge, vascular graft-associated infection with D. pneumosintes has not been reported before.
Qualitative study: Perceptions of surgical competence among Chinese professional surgical postgraduate students in clinical medicine
Authors: Zhao Feiyu , Yan Yuanyuan , Li Zhihui , Tan Shuo , Ou Jingxin , Zhao Lei
Published: July 2023

Purpose
The purpose of this study is to explore the perceptions of surgical competence among Chinese professional surgical postgraduate students in clinical medicine with the aim of improving the surgical competence of postgraduate students and exploring the recommendations of postgraduate students regarding the current program for the development of surgical competence.
Background
China has officially mandated the integration of master's degree education into clinical medicine and standardized residency training since 2015. Since that time, the training of Chinese postgraduate students in clinical medicine has improved significantly, and the number of postgraduate students in clinical medicine in China has been increasing in recent years. Due to the use of various new technologies in the field of surgery, the perceptions of some surgeons regarding surgical competence have changed.
Methodology:
This study was conducted using qualitative methods. Data were collected from voice recordings of one-on-one, in-depth interviews, which were conducted using semistructured questions. Qualitative content analysis was used to evaluate the audio recordings.
Results
The major themes and subthemes of the study were as follows: (1)surgical competence is considered to be very important by clinical medicine professional surgical postgraduate students (surgical ability is considered to be useful for improving clinical operation by clinical medicine professional surgical postgraduate students and that surgical ability is considered to be useful for developing the clinical thinking of clinical medicine professional surgical postgraduate students) and (2) the ways in which surgical ability can be improved according to clinical medicine professional surgical postgraduate students (clinical medicine professional surgical postgraduate students believe that more effort is needed to develop surgical skills and that clinical medicine professional surgical postgraduate students believe that they need more help from the hospital/department in terms of improving their surgical skills).
Conclusions
Chinese professional surgical postgraduate students in clinical medicine consider surgical competence to be very important because they believe that it enhances clinical operations and clinical thinking, which are necessary for them to become great surgeons. They are interested in ways of improving their surgical competence, and this study found that they believe that investing more time and effort in the development of their surgical competence is likely to lead to improved surgical competence and that the help provided by the department/hospital could also lead to improvements in their surgical competence.
Impact of Charge Extraction on Current-Voltage Characteristics of Perovskite Solar Cells
Authors: Li Deli , Zhang Xiao , Liang Qianqian , Sun Jian , Chen Ximan , Liu Yang , Song Qing , Wang Yue , Chen Yonghua , Huang Wei
Published: July 2023

This work presents an extended Shockley equation (ESE) to elucidate the impact of charge extraction on the current density voltage (J–V) characteristics of perovskite solar cells (PSCs). In the ESE, the driving forces of charge extraction are described by explicit voltage drops across the transport layer and at the contacts, which consume the electromotive force established by the maximum quasi-Fermi level splitting. As a result, the ESE can efficiently produce the J–V curves showing excellent agreement with the exact results by the drift-diffusion simulations. Based on the ESE, we studied the impact of charge extraction on the shape of the J–V curves and identified three types of J–V curves. We also revealed the complicated relationship between the realistic material parameters and the performance of the PSCs. The results show that the ESE accurately relates the material and contact properties to the power conversion efficiency of the PSCs. Then, we used the ESE inversely to quantitatively determine the efficiency losses due to the impact of charge extraction from the measured J–V curves of the PSCs with spiro-OMeTAD or NiOx as the hole transport layers. Our results suggest that the ESE provides a simple alternative way to model the PSCs precisely. This work could contribute to the understanding of the PSCs and the processing of new efficient transport layers.
Digital Transformation in Higher Education Institutions: Bibliometric Analysis
Authors: Acuña Javier Muñoz , Hernández-Perlines Felipe , Vega-Muñoz Alejandro , Salazar-Sepulveda Guido , Contreras-Barraza Nicolas , Vinueza-Martinez Jorge , Torres-Alcayaga Mario
Published: July 2023

The purpose of this article is to carry out a bibliometric analysis of the advances in digital transformation in higher education institutions worldwide. This was done using a search vector on Digital Transformation in Higher Education TS= ((Digital NEAR/0 transform) AND (Higher NEAR/0 education)), without restricted time parameters, performing the extraction on October 15, 2022, of the Web of Science (WoS) database, obtaining a total of 384 records, between the years 2014 and October 2022. Within this universe, most of the documents extracted were articles (206, 59.2%), followed by records (132, 37, 9%) and reviews (10, 2.9%). These publications were analyzed per year (Price's Law); concentration by journals (Bradford Law); concentration by authors (Lotka's Law); concentration of citations per article (Hirsch Index); and concentration of keywords (Zipf's Law). Regarding the results, we observed an exponential increase in the scientific production on DT2HE in the last 9 years, with a concentration of the scientific discussion on DT2HE, in 14 journals that published more than 2 articles each, on DT2HE in the period studied; a production distributed in 50 closely related countries, forming a global community of knowledge about DT2HE, concentrated in Russia, Spain, Germany and Portugal. Regarding citations, there are two prolific authors: both with 115 citations each. Finally, three groups of keywords were identified: the first group is related to the goals of modernization in higher education, the second, with the effects on students produced by DT2HE, and a third group, which emphasizes the DT2HE process itself.
Hypertension knowledge, attitudes and perceptions among adults in the Navrongo Health and Demographic Surveillance Site: A mixed methods analysis
Authors: Singh Ahaana , Agongo Godfred , Chatio Samuel T. , Logonia Bernard , Debpuur Cornelius Y. , Ansah Patrick O , Oduro Abraham R. , Klipstein-Grobusch Kerstin , Nonterah Engelbert A
Published: July 2023

Background
This study assessed knowledge, behaviors, and perceptions towards hypertension following community dissemination on cardiovascular disease (CVD) risk within the Navrongo Health and Demographic Surveillance Site in Northern Ghana.
Methods
A cross-sectional mixed methods study was conducted among middle aged men and women following education on CVD and their risk factors. Knowledge and attitudes of participants regarding hypertension were measured using a survey tool and the resultant data was analyzed with descriptive statistics. Focus group discussions (FDG) were used to assess perceptions of study participants. Recorded interviews were transcribed verbatim and coded into themes using Nvivo 12 software before thematic analysis.
Results
A total of 350 participants (54% women) with a mean age of 50 ± 6 years took part in the survey while 40 took part in FGDs. The results showed that84% of participants had heard about hypertension, 70% attributed hypertension to an increase in blood pressure and could be caused by excess salt intake. Majority of the participants were aware that hypertension could be treated with hypertensive medication and that untreated or uncontrolled hypertension could result in adverse health consequences. Few participants had ever had their blood pressure measured and did not access screening or care services. Participants perceived the health system was inadequate to screen, treat and control hypertension.
Conclusion
Though, knowledge on hypertension was high, there was low access to screening and healthcare services. Community beliefs and perceptions strongly influence treatment, and control of hypertension. Effective community dissemination efforts addressing misperceptions could improve hypertension treatment and control.
What factors affect job embeddedness among clinical nurses? A structural model design
Authors: Yun Mi-Soon , Lee Miyoung , Choi Eun-Hi
Published: July 2023

Background
This study adopted a model-building research approach to analyze the factors affecting clinical nurses’ job embeddedness and explore the pathways to increase their embeddedness. The results are expected to provide a basis for efficient human resource management in hospitals.
Methods
Participants were 260 clinical nurses with less than one year of experience in general and tertiary general hospitals in G province and D metropolitan city in South Korea. A structured questionnaire was administered from January 10 to February 28, 2022. The variables analyzed included role conflict, positive psychological capital, social support, job crafting, and job embeddedness.
Results
The direct and total effects (both β = .806, p = .007) of positive psychological capital on job crafting were significant. The direct and total effects (both β = .451, p = .004) of social support on job crafting were significant. The direct (γ = .292, p = .055), indirect (γ = -. 671, p = .003), and total (γ = − .379, p = .008) effects of role conflict on job crafting were significant. The direct (γ = − .382, p = .007), indirect (γ = − .208 p = .003), and total (γ = − .589, p = .006) effects of role conflict on job embeddedness were significant. The direct and total (both β = .548, p = .005) effects of job crafting on job embeddedness were significant.
Conclusions
Nurses’ job embeddedness is directly influenced by their job crafting, which is shaped by high levels of positive psychological capital and social support. When job crafting takes place, role conflict increases, and if job crafting becomes difficult because of severe role conflict, job embeddedness decreases. Therefore, to increase job embeddedness among clinical nurses, hospitals must implement support systems and programs to increase job autonomy, positive psychological capital, and social support to promote job crafting.
Image-based crop disease detection with federated learning
Authors: KABALA Denis MAMBA , HAFIANE Adel , BOBELIN Laurent , CANALS Raphael
Published: July 2023

Crop disease detection and management is critical to improving productivity, reducing costs, and promoting environmentally friendly crop treatment methods. Modern technologies, such as data mining and machine learning algorithms, have been used to develop automated crop disease detection systems. However, centralized approach to data collection and model training induces challenges in terms of data privacy, availability, and transfer costs. To address these challenges, federated learning appears to be a promising solution. In this paper, we explored the application of federated learning for crop disease classification using image analysis. We developed and studied convolutional neural network (CNN) models and those based on attention mechanisms, in this case vision transformers (ViT), using federated learning, leveraging an open access image dataset from the "PlantVillage" platform. Experiments conducted concluded that the performance of models trained by federated learning is influenced by the number of learners involved, the number of communication rounds, the number of local iterations and the quality of the data. With the objective of highlighting the potential of federated learning in crop disease classification, among the CNN models tested, ResNet50 performed better in several experiments than the other models, and proved to be an optimal choice, but also the most suitable for a federated learning scenario. The ViT_B16 and ViT_B32 Vision Transformers require more computational time, making them less suitable in a federated learning scenario, where computational time and communication costs are key parameters. The paper provides a state-of-the-art analysis, presents our methodology and experimental results, and concludes with ideas and future directions for our research on using federated learning in the context of crop disease classification.
Safety and efficacy of endovascular interventions on transplant renal vessels within the 30-day perioperative period
Authors: Tan Weiken , Frood Russell , Masood Omar , Baker Richard , Patel Jai , Puppala Sapna
Published: July 2023

Background:
Vascular complications following recent renal transplantation causes a significant incidence of sub-optimal graft outcomes. These range from delayed graft function and resistant hypertension to early graft loss. Early endovascular intervention is largely avoided as it is perceived as high risk to the new vascular anastomosis. However, surgical intervention in this setting is technically challenging and associated with poor outcomes. The aim of this study is to evaluate technical and clinical outcomes after endovascular intervention within the first 30 days.
Materials and Methods:
All radiological interventions performed on transplant renal vessels within the 30-day perioperative period from April 2007 to December 2022 were assessed. The patient’s electronic notes, radiological reports and blood results were reviewed retrospectively. Parameters such as angiographic diagnosis, complications, procedure outcomes and serum creatinine levels before and after intervention were analysed.
Results:
39 early transplant renal endovascular procedures were performed in our institution. The mean endovascular intervention time after transplantation was 12 days (range 1-30 days).
Vascular pathology included transplant renal artery stenosis (n=21), renal venous stenosis (n=5), pseudoaneurysm (n=2), thrombosed renal artery (n=1), occluded renal vein with subcapsular haematoma (n=1), segmental arterial bleeding (n=1), common iliac artery stenosis (n=1) and subcortical arteriovenous fistula (n=1). Six cases did not demonstrate any significant vascular pathology.
Endovascular stenting (n=14), percutaneous transluminal angioplasty only (n=10), angiography only (n=11) and embolisation (n=4) were performed with a technical success rate of 90%. Complications occurred in six cases (arterial dissection, thromboembolism and arterial spasm). However, they were either not significant or they were successfully treated and did not lead to graft functional decline. Only two cases proceeded to surgical exploration for anastomotic reconstruction and haematoma evacuation. Seven transplants failed within a year from the endovascular intervention.
For those that had endovascular treatment, there was a significant decrease in serum creatinine levels post-procedure with a mean difference of 96.5 ± 26.8 µmol/L (p=0.002; n=22) at 1 week and 235.2 ± 42.3 µmol/L (p=0.0001; n=22) at 1 month.
Conclusion:
Endovascular intervention in newly transplanted kidneys is a safe and less invasive option which avoids the morbidity of open surgery. When used selectively, it has good therapeutic outcomes and can significantly improve graft function.
Deep Learning Framework for Automated Goblet Cell Density Analysis in In-Vivo Rabbit Conjunctiva
Authors: Jang Seunghyun , Kim Seonghan , Lee Jungbin , Choi Wan Jae , Yoon Chang Ho , Yang Sejung , Kim Ki Hean
Published: July 2023

Goblet cells (GCs) in the conjunctiva are specialized epithelial cells secreting mucins on the ocular surface and play important roles for ocular surface health. Because GC loss is observed in various ocular surface diseases, GC examination is important. A non-invasive GC imaging method was recently developed, and a robust analysis is needed to make GC information available. In this study, we developed a deep learning framework for GC image analysis. Dual-channel convolution was used to extract the overall texture of image and to acquire the morphological characteristics of GCs. A global channel attention module was adopted by combining attention algorithms and channel-wise pooling. The module generated an adaptive attention map through matrix multiplication with channel-wise weights and propagated information to strengthen low-level features. DCAU-Net showed 93.1% GC segmentation accuracy and 94.3% GC density estimation accuracy. Further application, both normal and ocular surface damage rabbit models revealed the spatial variations of both GC density and size and the decreases of both GC density and size in damage rabbit models during recovery after acute damage. GC image analysis results were consistent with histology. Together with the non-invasive imaging method, DCAU-Net would provide GC information for the diagnosis of ocular surface diseases.
A bi-objective optimization model for the UAV caching at amusement parks in fog computing
Authors: Darbanian Elham , Nickray Mohsen
Published: July 2023

Unmanned Aerial Vehicle (UAV) is designed to provide low-latency and high-quality transmission with a UAV deployed nearby to serve ground users. UAVs can be used as effective flying base stations for a dynamic cache of popular content, tracking user mobility patterns to provide effective services to users. In this paper, we investigate a network consisting of a UAV as a fog node at amusement parks. We calculate the best location of UAV that is entitled geometric median, which is calculated using a Weiszfeld-type algorithm. We define a bi-objective function problem that simultaneously minimizes the caching energy consumption and maximizes the average service success. Then we use the Goal Programming method to solve it because our problem is non-convex. Finally, we found the best number of cache contents in UAV among Pareto front points with the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method.