bluuebunny/crossref_metadata_2025 huggingface dataset:
One degree of freedom resonance wave energy convertor
Authors: Milkov V , Dimitrov D M , Iliyaz Sh
Published: September 2023

In this work, a single degree of freedom resonant converter model is proposed and theoretical studies of the converter are carried out. The converter is suitable for waves with height of up to 2 m and period of up to 5 seconds, such as the waves on the western coast of the Black Sea. It is shown that at resonance its power increases significantly and approaches the theoretical values of the power of the swell. In high waves (up to 5 m) its efficiency decreases, but its power remains relatively constant and equal to about half of its power at resonance.
Grounding Political Obligation
Authors: Valentini Laura
Published: September 2023

This chapter brings the agency-respect framework to bear on the question of political obligation, that is, whether we have a “content-independent obligation” to obey the law because it is the law. It first critically reviews familiar affirmative answers and finds some difficulties with all of them. In particular, while several succeed in showing that we often have content-dependent obligations to act in conformity with the law, they fail to establish a content-independent obligation to obey the law because it is the law. The chapter then argues that such a content-independent obligation can be successfully grounded in agency respect for people’s commitment to the rule of law. In doing so, the agency-respect view offers a defence of political obligation which, surprisingly, should appeal to anarchists too. On this view, obligations to obey the law are “pro tanto” and highly qualified. Moreover, what explains the bindingness of legal norms also explains the bindingness of informal social norms. From an agency-respect perspective, the law is therefore not morally special.
Combining Inserts With Warning Labels on Cigarette Packs to Promote Smoking Cessation: A 2-Week Randomized Trial
Authors: Thrasher James F , Ferguson Stuart G , Hackworth Emily E , Wu Chung-Li , Lambert Victoria C , Porticella Norman , Kim Minji , Hardin James W , Niederdeppe Jeff
Published: September 2023

Background

Cigarette pack inserts with messages on cessation benefits and advice are a promising labeling policy that may help promote smoking cessation.

Purpose

To assess insert effects, with and without accompanying pictorial health warning labels(HWLs), on hypothesized psychosocial and behavioral outcomes.

Methods

We conducted a 2 × 2 between-subject randomized trial (inserts with efficacy messages vs. no inserts; large pictorial HWLs vs. small text HWLs), with 367 adults who smoked at least 10 cigarettes a day. Participants received a 14-day supply of their preferred cigarettes with packs modified to reflect their experimental condition. Over 2 weeks, we surveyed participants approximately 4–5 times a day during their smoking sessions, querying feelings about smoking, level of worry about harms from smoking, self-efficacy to cut down on cigarettes, self-efficacy to quit, hopefulness about quitting, and motivation to quit. Each evening, participants reported their perceived susceptibility to smoking harms and, for the last 24 hr, their frequency of thinking about smoking harms and cessation benefits, conversations about smoking cessation or harms, and foregoing or stubbing out cigarettes before they finished smoking. Mixed-effects ordinal and logistic models were estimated to evaluate differences between groups.

Results

Participants whose packs included inserts were more likely than those whose packs did not include inserts to report foregoing or stubbing out of cigarettes (OR = 2.39, 95% CI = 1.36, 4.20). Otherwise, no statistically significant associations were found between labeling conditions and outcomes.

Conclusions

This study provides some evidence, albeit limited, that pack inserts with efficacy messages can promote behaviors that predict smoking cessation attempts.
The Relationship Between L2 Interactional Competence and Proficiency
Authors: Roever Carsten , Ikeda Naoki
Published: September 2023

The relationship between L2 linguistic skills and the ability to use language for social purposes is still under-explored. While previous research suggests that higher proficiency coincides with better pragmatic and interactional performance, incongruities are also apparent with some low-proficiency learners being able to communicate effectively, and some high-proficiency learners showing pronounced weaknesses in interactional performance. In this study, 150 ESL learners completed a standardized speaking proficiency test, the TOEFL iBT Speaking section, followed by a test of interactional competence consisting of role plays and monologues. Quantitatively, we found a fairly strong correlation between measures of speaking proficiency and interactional ability, but our qualitative analysis showed a more nuanced picture with some interactionally relevant features apparently impacted by speaking proficiency, whereas others were largely independent of it. We discuss implications for the conceptualization of second language ability, language teaching, and language testing.
Linguistic Features Distinguishing Students’ Writing Ability Aligned with CEFR Levels
Authors: Ma Hong , Wang Jinglei , He Lianzhen
Published: September 2023

A substantive body of research has been revolving around the linguistic features that distinguish different levels of students’ writing samples (e.g. Crossley and McNamara 2012; McNamara et al. 2015; Lu 2017). Nevertheless, it is somewhat difficult to generalize the findings across various empirical studies, given that different criteria were adopted to measure language learners’ proficiency levels (Chen and Baker 2016). Some researchers suggested using the Common European Framework of Reference for Languages (CEFR) (Council of Europe 2001) as the common standard of evaluating and describing students’ proficiency levels. Therefore, the current research intends to identify the linguistic features that distinguish students’ writing samples across CEFR levels by adopting a machine-learning method, decision tree, which provides the direct visualization of decisions made in each step of the classification procedure. The linguistic features that emerged as predicative of CEFR levels could be employed to (i) inform L2 writing instruction, (ii) track long-term development of writing ability, and (iii) facilitate experts’ judgment in the practice of aligning writing tests/samples with CEFR.
XII—Knowing and Acknowledging Others
Authors: Avramides Anita
Published: September 2023

It is possible to tease out two questions in connection with the epistemological problem of other minds: (i) How do I know what others think and feel? and (ii) How do I know that others think and feel? Fred Dretske offers a perceptual account of our knowledge of other minds that yields an answer to (i) but not (ii). Quassim Cassam uses Dretske’s perceptual account to show how we can answer both (i) and (ii). In this paper I show how we can use Dretske’s work to understand some work by Stanley Cavell. I suggest that, where Dretske claims that we cannot answer (ii), Cavell holds that (ii) is a question that reflects a misunderstanding of our relations to others. In the place of asking how I can know that others think and feel, Cavell holds that I must acknowledge the other. And at the heart of this acknowledgment is an acceptance of others as separate from me. I must acknowledge the other as an other to me.
Preparation and processing of dried blood spots for microRNA sequencing
Authors: Morgunova Alice , Ibrahim Pascal , Chen Gary Gang , Coury Saché M , Turecki Gustavo , Meaney Michael J , Gifuni Anthony , Gotlib Ian H , Nagy Corina , Ho Tiffany C , Flores Cecilia
Published: September 2023

Dried blood spots (DBS) are biological samples commonly collected from newborns and in geographic areas distanced from laboratory settings for the purposes of disease testing and identification. MicroRNAs (miRNAs)—small non-coding RNAs that regulate gene activity at the post-transcriptional level—are emerging as critical markers and mediators of disease, including cancer, infectious diseases, and mental disorders. This protocol describes optimized procedural steps for utilizing DBS as a reliable source of biological material for obtaining peripheral miRNA expression profiles. We outline key practices, such as the method of DBS rehydration that maximizes RNA extraction yield, and the use of degenerate oligonucleotide adapters to mitigate ligase-dependent biases that are associated with small RNA sequencing. The standardization of miRNA readout from DBS offers numerous benefits: cost-effectiveness in sample collection and processing, enhanced reliability and consistency of miRNA profiling, and minimal invasiveness that facilitates repeated testing and retention of participants. The use of DBS-based miRNA sequencing is a promising method to investigate disease mechanisms and to advance personalized medicine.
A Pilot Randomised Controlled Trial to Improve Social Problem-Solving Skills of Kunjing Children without Sufficient Parental Care
Authors: Wang Miao , Zhou Yue
Published: September 2023

Social problem-solving skills (SPS) are essential to child development, especially for kunjing children without sufficient parental care (KCw/oSPC). This study aimed to design and implement a group-based pilot intervention programme to improve KCw/oSPC’s SPS and assessed its effectiveness. This pilot intervention was a randomised controlled trial, fifty-seven KCw/oSPC at seventh grade (aged twelve to thirteen years) were recruited and randomly assigned into experimental (n = 24) and waiting (n = 33) groups. All participants in the experimental group received SPS training, whilst the waiting group did not receive any services at the research stage. Both pre- and post-test data about participants’ SPS from both groups were analysed with Mann–Whitney–Wilcoxon and Wilcoxon signed-rank tests, respectively. Results indicated that KCw/oSPC’s SPS in the experimental group improved significantly, with large effect size (Cohen’s d = 1.15). This pilot study, although with limitations, contributed to informing future social work intervention studies and practice to promote KCw/oSPC’s SPS in Mainland China and worldwide.
Generalizability of a Machine Learning Model for Improving Utilization of Parathyroid Hormone-Related Peptide Testing across Multiple Clinical Centers
Authors: Yang He S , Pan Weishen , Wang Yingheng , Zaydman Mark A , Spies Nicholas C , Zhao Zhen , Guise Theresa A , Meng Qing H , Wang Fei
Published: September 2023

Background

Measuring parathyroid hormone-related peptide (PTHrP) helps diagnose the humoral hypercalcemia of malignancy, but is often ordered for patients with low pretest probability, resulting in poor test utilization. Manual review of results to identify inappropriate PTHrP orders is a cumbersome process.

Methods

Using a dataset of 1330 patients from a single institute, we developed a machine learning (ML) model to predict abnormal PTHrP results. We then evaluated the performance of the model on two external datasets. Different strategies (model transporting, retraining, rebuilding, and fine-tuning) were investigated to improve model generalizability. Maximum mean discrepancy (MMD) was adopted to quantify the shift of data distributions across different datasets.

Results

The model achieved an area under the receiver operating characteristic curve (AUROC) of 0.936, and a specificity of 0.842 at 0.900 sensitivity in the development cohort. Directly transporting this model to two external datasets resulted in a deterioration of AUROC to 0.838 and 0.737, with the latter having a larger MMD corresponding to a greater data shift compared to the original dataset. Model rebuilding using site-specific data improved AUROC to 0.891 and 0.837 on the two sites, respectively. When external data is insufficient for retraining, a fine-tuning strategy also improved model utility.

Conclusions

ML offers promise to improve PTHrP test utilization while relieving the burden of manual review. Transporting a ready-made model to external datasets may lead to performance deterioration due to data distribution shift. Model retraining or rebuilding could improve generalizability when there are enough data, and model fine-tuning may be favorable when site-specific data is limited.
Circulating GDF11 exacerbates myocardial injury in mice and associates with increased infarct size in humans
Authors: Kraler Simon , Balbi Carolina , Vdovenko Daria , Lapikova-Bryhinska Tetiana , Camici Giovanni G , Liberale Luca , Bonetti Nicole , Canestro Candela Diaz , Burger Fabienne , Roth Aline , Carbone Federico , Vassalli Giuseppe , Mach François , Bhasin Shalender , Wenzl Florian A , Muller Olivier , Räber Lorenz , Matter Christian M , Montecucco Fabrizio , Lüscher Thomas F , Akhmedov Alexander
Published: September 2023

Aims

The heart rejuvenating effects of circulating growth differentiation factor 11 (GDF11), a transforming growth factor-β superfamily member that shares 90% homology with myostatin (MSTN), remains controversial. Here, we aimed to probe the role of GDF11 in acute myocardial infarction (MI), a frequent cause of heart failure and premature death during ageing.

Methods and results

In contrast to endogenous Mstn, myocardial Gdf11 declined during the course of ageing and was particularly reduced following ischaemia/reperfusion (I/R) injury, suggesting a therapeutic potential of GDF11 signalling in MI. Unexpectedly, boosting systemic Gdf11 by recombinant GDF11 delivery (0.1 mg/kg body weight over 30 days) prior to myocardial I/R augmented myocardial infarct size in C57BL/6 mice irrespective of their age, predominantly by accelerating pro-apoptotic signalling. While intrinsic cardioprotective signalling pathways remained unaffected by high circulating GDF11, targeted transcriptomics and immunomapping studies focusing on GDF11-associated downstream targets revealed attenuated Nkx2-5 expression confined to CD105-expressing cells, with pro-apoptotic activity, as assessed by caspase-3 levels, being particularly pronounced in adjacent cells, suggesting an indirect effect. By harnessing a highly specific and validated liquid chromatography-tandem mass spectrometry–based assay, we show that in prospectively recruited patients with MI circulating GDF11 but not MSTN levels incline with age. Moreover, GDF11 levels were particularly elevated in those at high risk for adverse outcomes following the acute event, with circulating GDF11 emerging as an independent predictor of myocardial infarct size, as estimated by standardized peak creatine kinase-MB levels.

Conclusion

Our data challenge the initially reported heart rejuvenating effects of circulating GDF11 and suggest that high levels of systemic GDF11 exacerbate myocardial injury in mice and humans alike. Persistently high GDF11 levels during ageing may contribute to the age-dependent loss of cardioprotective mechanisms and thus poor outcomes of elderly patients following acute MI.
Seasonal activity of spotted lanternfly (Hemiptera: Fulgoridae), in Southeast Pennsylvania
Authors: Calvin Dennis D , Rost John , Keller Joseph , Crawford Stephen , Walsh Brian , Bosold Michael , Urban Julie
Published: September 2023

The spotted lanternfly, Lycorma delicatula (White, 1845), is an invasive species in the United States. This pest causes damage to vineyards and has the potential to negatively affect other crops and industries. Information describing the seasonal timing of life stages can improve its management. In 2019 and 2020, spotted lanternfly seasonal activity was followed weekly from spring egg hatch to the first hard freeze. Weighted mean timing of activity for each nymphal instar, early adults, late adults, total adults, and egg mass deposition are presented for 2019 and 2020 on Acer rubrum and 2020 on Ailanthus altissima. Logistic equations describing the percentage completion of each activity period on these hosts were fitted using a start date of 1 January to calculate accumulated degree days (ADD). For the adult and egg mass deposition periods, we additionally used a biofix of the date adults were first observed to calculate ADD. ADD from 1 January adequately estimated the timing of nymphal instars but ADD from observation of the first adult better estimated the timing of adult activity and egg mass deposition. Late adult activity and egg mass deposition periods appeared to be influenced by another environmental cue, such as day length. Maps of season-long ADD show that spotted lanternflies are unlikely to reach adulthood in colder regions of the northeast United States, and therefore may not establish there. We also report a strong seasonal trend in sex ratio on A. rubrum, where the population shifted from over 80% male to over 80% female in October.
Pleiotropic fitness effects across sexes and ages in the Drosophila genome and transcriptome
Authors: Wong Heidi W S , Holman Luke
Published: September 2023

Selection varies between categories of individuals, with far-reaching ramifications: Sex-specific selection can impede or accelerate adaptation, and differences in selection between young and old individuals are ultimately responsible for senescence. Here, we measure early- and late-life fitness in adults of both sexes from the Drosophila genetic reference panel and perform quantitative genetic and transcriptomic analyses. Fitness was heritable, showed positive pleiotropy across sexes and age classes, and appeared to be influenced by very large numbers of loci with small effects plus a smaller number with moderate effects. Most loci affected male and female fitness in the same direction; relatively few candidate sexually antagonistic loci were found, though these were enriched on the X chromosome as predicted by theory. The expression level of many genes showed an opposite correlation with fitness in males and females, consistent with unresolved sexual conflict over transcription. The load of deleterious mutations correlated negatively with fitness across genotypes, and we found some evidence for the mutation accumulation (but not the antagonistic pleiotropy) theory of aging.
Rensch’s rule: linking intraspecific to evolutionary allometry
Authors: Reyes-Puig Carolina , Adams Dean C , Enriquez-Urzelai Urtzi , Kaliontzopoulou Antigoni
Published: September 2023

Sexual dimorphism describes phenotypic differences between the sexes; the most prominent of which is sexual size dimorphism (SSD). Rensch’s rule (RR) is an allometric trend in which SSD increases in male-larger taxa and decreases in female-larger ones. Covariation between a trait and overall size within and across species can both be affected by sexual and natural selection. Thus, intraspecific allometric variation could influence the expression of RR. Here we used computer simulations to dissect how RR emerges under specific allometric patterns of intraspecific sexual differentiation in a trait. We found that sexual differentiation in static allometric slopes is the main determinant of RR. Based on our findings, RR and its converse can manifest in both body size and other traits. As a realistic showcase, we also examined RR and static allometry of different body parts in Mediterranean green lizards to establish whether intraspecific and evolutionary allometry are linked. Here, we identified RR and its converse for different traits, where the amount of sexual differentiation in static allometric slopes within species had a significant contribution to RR. Integrating the simulations and the empirical case we corroborate that sexual differentiation in static allometric slopes is a major parameter affecting evolutionary allometry.
Production of Lactobacillus plantarum ghosts by conditional expression of a prophage-encoded holin
Authors: Riangrungroj Pinpunya , Visessanguan Wonnop , Leartsakulpanich Ubolsree
Published: September 2023

Bacterial ghosts (BGs) are nonviable empty bacterial cell envelopes with intact cellular morphology and native surface structure. BGs made from pathogenic bacteria are used for biomedical and pharmaceutical applications. However, incomplete pathogenic cell inactivation during BG preparation raises safety concerns that could limit the intended use. Therefore, safer bacterial cell types are needed for BG production. Here, we produced BGs from the food-grade Gram-positive bacterium Lactobacillus plantarum TBRC 2–4 by conditional expression of a prophage-encoded holin (LpHo). LpHo expression was regulated using the pheromone-inducible pSIP system and LpHo was localized to the cell membrane. Upon LpHo induction, a significant growth retardation and a drastic decrease in cell viability were observed. LpHo-induced cells also showed membrane pores by scanning electron microscopy, membrane depolarization by flow cytometry, and release of nucleic acid contents in the cell culture supernatant, consistent with the role of LpHo as a pore-forming protein and L. plantarum ghost formation. The holin-induced L. plantarum BG platform could be developed as a safer alternative vehicle for the delivery of biomolecules.
Effects of Caregiver Sleep Disturbances on Relationship Quality With Their Care Recipient
Authors: Perepezko Kate , Shaffer Kelly , Beach Scott , Rolle Natalie , Fields Beth
Published: September 2023

Objectives

Sleep problems are highly prevalent and disruptive for caregivers. Although the connection between caregivers’ sleep and outcomes like caregiver burden and quality of life is well established, the potential influence of caregivers’ sleep on their reported relationship quality with the care recipient is not known. The current study sought to address this gap.

Methods

We analyzed data from the 2017 National Health and Aging Trends Study and linked it with data from the 2017 National Study of Caregiving. Our dependent variable was caregiver-reported relationship quality, and our predictor variable of interest was caregiver sleep problems. We also included several covariates related to the caregiver and care recipient. We used a generalized linear model to examine the relationship between caregiver sleep problems and relationship quality, controlling for other potentially influential factors.

Results

Sleep problems were significantly related to relationship quality. Compared to caregivers who reported no sleep problems, those who reported at least one sleep problem (β: −0.23, 95% CI: −0.46 to −0.01) had lower relationship quality with the care recipient. Other factors that remained related to relationship quality in the generalized linear model were negative aspects of caregiving, emotional difficulties, caregiver race, relationship type, care recipient depressive symptoms, and care recipient sex.

Discussion

Sleep problems are influential health behaviors that are related to relationship quality for caregivers. Therefore, it is critical that sleep is more systematically assessed and addressed in caregiving populations.
Nitric oxide is required for lung alveolarization revealed by deficiency of argininosuccinate lyase
Authors: Jin Zixue , Jiang Ming-Ming , Lee Brendan
Published: September 2023

Inhaled nitric oxide (NO) therapy has been reported to improve lung growth in premature newborns. However, the underlying mechanisms by which NO regulates lung development remain largely unclear. NO is enzymatically produced by three isoforms of nitric oxide synthase (NOS) enzymes. NOS knockout mice are useful tools to investigate NO function in the lung. Each single NOS knockout mouse does not show obvious lung alveolar phenotype, likely due to compensatory mechanisms. While mice lacking all three NOS isoforms display impaired lung alveolarization, implicating NO plays a pivotal role in lung alveolarization. Argininosuccinate lyase (ASL) is the only mammalian enzyme capable of synthesizing L-arginine, the sole precursor for NOS-dependent NO synthesis. ASL is also required for channeling extracellular L-arginine into a NO-synthetic complex. Thus, ASL deficiency (ASLD) is a non-redundant model for cell-autonomous, NOS-dependent NO deficiency. Here, we assessed lung alveolarization in ASL-deficient mice. Hypomorphic deletion of Asl (AslNeo/Neo) results in decreased lung alveolarization, accompanied with reduced level of S-nitrosylation in the lung. Genetic ablation of one copy of Caveolin-1, which is a negative regulator of NO production, restores total S-nitrosylation as well as lung alveolarization in AslNeo/Neo mice. Importantly, NO supplementation could partially rescue lung alveolarization in AslNeo/Neo mice. Furthermore, endothelial-specific knockout mice (VE-Cadherin Cre; Aslflox/flox) exhibit impaired lung alveolarization at 12 weeks old, supporting an essential role of endothelial-derived NO in the enhancement of lung alveolarization. Thus, we propose that ASLD is a model to study NO-mediated lung alveolarization.
Gastroenterology Clinic Follow-Up Reduces Gastroenterology-Specific Readmissions Among Patients With Severe Ulcerative Colitis
Authors: Barber Grant E , Zhuo Justin , Okafor Philip N , Streett Sarah
Published: September 2023

Background and aims

Readmission within 30 days occurs in up to 18% of admitted patients with ulcerative colitis (UC). The importance of postdischarge follow-up with a gastroenterologist as well as the optimal follow-up interval is unknown.

Methods

We conducted a retrospective cohort study of patients with UC who were admitted to Stanford University Hospital between 2010 and 2020. We included adult patients with UC who were admitted for a UC flare. Patients with a colectomy during hospitalization or with Clostridium difficile infection at the index hospitalization were excluded. The primary outcome was time to readmission for a gastroenterology (GI) indication, and the primary predictor (time dependent) was follow-up with a GI provider. Patients were followed for 180 days after discharge. Data were analyzed using a Cox proportional hazards model.

Results

Of the 223 patients hospitalized with UC during the study period, 25% (n = 57) were readmitted within 180 days, with 13.9% occurring within 30 days. Early follow-up (within 7 days) was observed in 29% (n = 65) of patients, while 30-day follow-up was seen in 68.7% (n = 153), and follow-up within 180 days was seen in 198 (89%) patients. In the adjusted Cox proportional hazards model, GI follow-up was associated with fewer readmissions (hazard ratio, 0.42; 95% confidence interval, 0.22-0.81; P = .009). Early follow-up was strongly associated with a reduced risk of readmission (hazard ratio, 0.24; 95% 95% confidence interval, 0.09-0.69; P = .008). Follow-up in 7 days was associated with fewer readmissions (P < .0001).

Conclusions

Outpatient GI follow-up after UC hospitalization reduces readmissions, with the greatest reduction occurring among patients followed up within 1 week of discharge.
Brain-Gut Axis: Invasive and Noninvasive Vagus Nerve Stimulation, Limitations, and Potential Therapeutic Approaches
Authors: Hesampour Fatemeh , Bernstein Charles N , Ghia Jean-Eric
Published: September 2023

Inflammatory bowel disease (IBD) is a chronic relapsing condition with no known etiology and is characterized by disrupted gut homeostasis, chronic inflammation, and ulcerative lesions. Although current treatments can reduce disease activity, IBD frequently recurs once treatments are discontinued, indicating that treatments are ineffective in providing long-term remission. The lack of responsiveness and reluctance of some affected persons to take medications because of potential adverse effects has enhanced the need for novel therapeutic approaches. The vagus nerve (VN) is likely important in the pathogenesis of IBD, considering the decreased activity of the parasympathetic nervous system, especially the VN, and the impaired interaction between the enteric nervous system and central nervous system in patients with IBD. Vagus nerve stimulation (VNS) has demonstrated anti-inflammatory effects in various inflammatory disorders, including IBD, by inhibiting the production of inflammatory cytokines by immune cells. It has been suggested that stimulating the vagus nerve to induce its anti-inflammatory effects may be a potential therapeutic approach for IBD. Noninvasive techniques for VNS have been developed. Considering the importance of VN function in the brain-gut axis, VNS is a promising treatment option for IBD. This review discusses the potential therapeutic advantages and drawbacks of VNS, particularly the use of noninvasive transcutaneous auricular vagus nerve stimulation.
In Acute Severe Ulcerative Colitis Patients Who Receive Rescue Therapy, Prior Maintenance Therapy and Day 3 C-Reactive Protein After Rescue Therapy Are Associated With 12-Month Colectomy Risk
Authors: Sninsky Jared A , Staicu Ana-Maria , Barnes Edward L
Published: September 2023

Lay Summary

In steroid-refractory patients with acute severe ulcerative colitis, the number of advanced therapies prior to admission and day 3 C-reactive protein post–rescue therapy is associated with a higher risk of colectomy within 12 months.
Outcomes of completed quality activities in an Australian tertiary hospital, 2015–2019
Authors: Li Qun Catherine , Karnon Jonathan , Codde Jim
Published: September 2023

Quality activities including quality assurance and quality improvement are an integral part of safety and quality governance for hospitals. Previous studies identified that (i) majority are for quality assurance and knowledge-acquiring purposes and (ii) adherence to the quality cycle as well as impact on patient-related outcomes at the hospital level are unclear, neither associated with costs. This study aims to (i) assess adherence to the quality cycle for quality activities in a large Australian tertiary hospital; (ii) report outcomes of quality activities at the hospital level, including impact on patient-related outcomes measured by the occurrence of hospital-acquired complications; and (iii) estimate time and costs for data collection.

This quantitative study utilized three data sources. First is the hospital’s electronic quality management system, Governance, Evidence, Knowledge and Outcome that identifies completed quality activities over a 5-year period; second is Tableau dashboards for hospital-acquired complication performance; third is Microsoft Teams Forms used to capture time of data collection for bedside observations and retrospective notes reviews. Median sample size and median hourly rates in 2018 were used for calculations.

A total of 1768 quality activities were completed over a 5-year period representing an average of 353 quality activities per year, of which 87.8% were initiated by clinicians and 12.2% planned and coordinated by safety and quality or equivalent. The activity reports indicated that less than a fifth (17.1%) brought about improvement in process measures and only 7.1% improved outcome measures. Two-thirds of the quality activities (66.3%) provided recommendations based on their findings, but evidence of action plan was available in 14.1% of the reports only. No association was found between the number of activities completed and overall hospital-acquired complication performance. Retrospective data collection (64.7%) was common. The estimated time and cost for data collection averaged at 3490 h/year, equivalent to 1.8 full-time employees, for a cost of $171 000 at the nursing rate (A$49.0), $280 000 at the medical rate (A$79.5), and $200 000 at the Health Service Union rate (A$58.9). Most quality activities were clinician-initiated. Implementing change and achieving and sustaining improvement were the two challenging stages in the quality cycle. No clear association was observed between activities completed and improvement in patient-related outcomes although some improvement in processes. A paradigm shift may be needed to engineer quality activities in hospitals to be more outcome-oriented. Opportunities exist for hospitals to consider how quality activities can be organized to maximize returns from investment.
Physics-statistics-based hybrid simulation scheme of coupled nonstationary hurricane wind and wave fields for long-span floating bridges
Authors: Li Shaopeng , Wu Teng
Published: September 2023

Long-span bridges with floating towers have recently drawn great attention from the engineering community. Due to their sensitivity to the aerodynamic and hydrodynamic loads during extreme storms, accurate and efficient simulation tools for hurricane winds and waves are needed for improved understanding of the complex dynamics of the fully coupled wind–wave–structure interaction system. Conventional simulation schemes usually generate winds and waves separately, and hence cannot capture the intense wind–wave interactions under hurricanes. In this study, a physics-statistics-based hybrid simulation scheme of nonstationary hurricane wind and wave fields is presented, where the winds and waves are coupled in both large and small scales. To simulate the large-scale winds and waves, a height-resolving hurricane wind model is coupled with a parametric hurricane wave model through a dependence between sea surface roughness and surface wind speed. In the small-scale simulations, the nonstationary wind fluctuations are statistically obtained by a Hilbert-wavelet-based scheme in which the target parameters (e.g. fluctuation intensity) are estimated based on the local sea state, while the nonstationary sea surface elevations are physically acquired by solving the governing equation of the nonlinear wave evolution under the action of winds. The simulation fidelity of the proposed physics-statistics-based hybrid scheme is demonstrated by generating the coupled nonstationary wind and wave fields approaching to a hypothetical long-span bridge with floating towers under a hurricane event.
Relationship between hindgut microbes and feed conversion ratio in Hu sheep and microbial longitudinal development
Authors: Xu Dan , Cheng Jiangbo , Zhang Deyin , Huang Kai , Zhang Yukun , Li Xiaolong , Zhao Yuan , Zhao Liming , Wang Jianghui , Lin Changchun , Yang Xiaobin , Zhai Rui , Cui Panpan , Zeng Xiwen , Huang Yongliang , Ma Zongwu , Liu Jia , Han Kunchao , Liu Xiaoqiang , Yang Fan , Tian Huibin , Weng Xiuxiu , Zhang Xiaoxue , Wang Weimin
Published: September 2023

Feed efficiency is an important indicator in the sheep production process, which plays an important role in improving economic benefits and strengthening energy conservation and emission reduction. Compared with the rumen, the fermentation of the hindgut microorganisms can also provide part of the energy for the host, and the composition of the hindgut microorganisms will affect the feed efficiency. Therefore, we hope to find new ways to regulate sheep feed efficiency by studying the sheep gut microbes. In this study, male Hu sheep with the same birth date were raised under the same conditions until 180 d old. The sheep were divided into high and low groups according to the feed conversion ratio (FCR) at 80 to 180 d old, and the differences in rectal microorganisms between the two groups were compared. The permutational multivariate analysis (PERMANOVA) test showed that there were differences in microorganisms between the two groups (P < 0.05). Combined with linear fitting analysis, a total of six biomarkers were identified, including Ruminobacter, Eubacterium_xylanophilum_group, Romboutsia, etc. Functional enrichment analysis showed that microorganisms may affect FCR through volatile fatty acids synthesis and inflammatory response. At the same time, we conducted a longitudinal analysis of the hindgut microbes, sampling nine-time points throughout the sheep birth to market stages. The microbiota is clearly divided into two parts: before weaning and after weaning, and after weaning microbes are less affected by before weaning microbial composition.
Acquisition, duplicates and exchange
Authors: Dowler Amelia
Published: September 2023

Charles Philippe de Bosset (1773–1845) was a Swiss soldier and British imperial official who established an extensive archaeological and numismatic collection from the Mediterranean region, particularly the Ionian Islands. His collections are now in the British Museum, the Laténium in Neuchâtel and the Musée d’Art et d’Histoire de Neuchâtel. This article establishes the circumstances of the British Museum’s acquisition in the early nineteenth century of its part of the de Bosset collection of coins, two bas-reliefs and a bronze. It then considers the process of removing duplicate coins from the British Museum collection through sales and exchanges by an examination of the de Bosset acquisition. Finally, it uses de Bosset’s own publication in 1815 of the coins of Cephalonia, Ithaca and Delphi as a case-study to restore archaeological provenance and a catalogue of that part of de Bosset’s collection.
Metabolic engineering and optimization of Escherichia coli co-culture for the de novo synthesis of genkwanin
Authors: Thuan Nguyen Huy , Tatipamula Vinay Bharadwaj , Trung Nguyen Thanh , Van Giang Nguyen
Published: September 2023

Genkwanin has various significant roles in nutrition, biomedicine, and pharmaceutical biology. Previously, this compound was chiefly produced by plant-originated extraction or chemical synthesis. However, due to increasing concern and demand for safe food and environmental issues, the biotechnological production of genkwanin and other bioactive compounds based on safe, cheap, and renewable substrates has gained much interest. This paper described recombinant Escherichia coli-based co-culture engineering that was reconstructed for the de novo production of genkwanin from d-glucose. The artificial genkwanin biosynthetic chain was divided into 2 modules in which the upstream strain contained the genes for synthesizing p-coumaric acid from d-glucose, and the downstream module contained a gene cluster that produced the precursor apigenin and the final product, genkwanin. The Box–Behnken design, a response surface methodology, was used to empirically model the production of genkwanin and optimize its productivity. As a result, the application of the designed co-culture improved the genkwanin production by 48.8 ± 1.3 mg/L or 1.7-fold compared to the monoculture. In addition, the scale-up of genkwanin bioproduction by a bioreactor resulted in 68.5 ± 1.9 mg/L at a 48 hr time point. The combination of metabolic engineering and fermentation technology was therefore a very efficient and applicable approach to enhance the production of other bioactive compounds.
Management of Haemaphysalis longicornis (Acari: Ixodidae) on a cow–calf farm in East Tennessee, USA
Authors: Butler R A , Trout Fryxell R T
Published: September 2023

Haemaphysalis longicornis Neumann is an exotic and invasive tick species rapidly expanding across the United States. Large infestations of these ticks on cattle can cause anemia, and in eastern regions of the country, they are transmitting Theileria orientalis Ikeda within herds. Methods for managing H. longicornis in the environment are rarely successful and rely on chemicals. To document population effects from producer management decisions, we investigated the change in H. longicornis populations to different tick management practices chosen by producers at 3 different H. longicornis-infested farms. Farm 1 kept a closed herd, chose to cut brush monthly, used on-animal acaricides, and allowed us to drag weekly. Farm 2 kept an open herd, chose to cut brush yearly, did not use on-animal acaricides, and allowed us to drag for ticks weekly/monthly. Farm 3 kept an open herd, chose to cut brush yearly, used on-animal acaracides, and allowed us to drag for ticks monthly. We assessed H. longicornis populations responding to those methods over time using active surveillance methods at each farm. Management decisions on Farms 1 and 3 significantly reduced H. longicornis on farms. Importantly, Farm 1 management decisions reduced the chance of a tick being present by 90%; the number of questing ticks collected fell from 5,000 to 12 H. longicornis in 2 years. Therefore, combined management strategies such as keeping a closed herd, use of on-animal chemical control, mechanical control, and reducing the amount of vegetation on farms were effective ways for producers to manage Haemaphysalis longicornis Neuman (Ixodidae).
Mitochondrial DNA variation in Aedes aegypti (Diptera: Culicidae) mosquitoes from Jeddah, Saudi Arabia
Authors: Thia Joshua A , Endersby-Harshman Nancy , Collier Sophie , Nassar Majed S , Tawfik Essam A , Alfageeh Mohamed B , Elfekih Samia , Hoffmann Ary A
Published: September 2023

Wolbachia (Hertig 1936) (Rickettsiales: Ehrlichiaceae) has emerged as a valuable biocontrol tool in the fight against dengue by suppressing the transmission of the virus through mosquitoes. Monitoring the dynamics of Wolbachia is crucial for evaluating the effectiveness of release programs. Mitochondrial (mtDNA) markers serve as important tools for molecular tracking of infected mitochondrial backgrounds over time but require an understanding of the variation in release sites. In this study, we investigated the mitochondrial lineages of Aedes aegypti (Linnaeus 1762) in Jeddah, Saudi Arabia, which is a prospective release site for the “wAlbBQ” Wolbachia-infected strain of this mosquito species. We employed a combination of comprehensive mitogenomic analysis (including all protein-coding genes) and mtDNA marker analysis (cox1 and nad5) using data collected from Jeddah. We combined our mitogenome and mtDNA marker data with those from previous studies to place mitochondrial variation in Saudi Arabia into a broader global context. Our findings revealed the presence of 4 subclades that can be broadly categorized into 2 major mitochondrial lineages. Ae. aegypti mosquitoes from Jeddah belonged to both major lineages. Whilst mitogenomic data offered a higher resolution for distinguishing Jeddah mosquitoes from the wAlbBQ strain, the combination of cox1 and nad5 mtDNA markers alone proved to be sufficient. This study provides the first important characterization of Ae. aegypti mitochondrial lineages in Saudi Arabia and offers essential baseline information for planning future molecular monitoring efforts during the release of Wolbachia-infected mosquitoes.
Rickettsia tillamookensis (Rickettsiales: Rickettsiaceae) in Ixodes scapularis (Acari: Ixodidae) in Oklahoma
Authors: Noden Bruce H , Gilliland Meghan , Propst Jozlyn , Slater Kimetha , Karpathy Sandor E , Paddock Christopher D
Published: September 2023

Some of the most prevalent arthropod-borne pathogens impacting humans in the United States are transmitted by Ixodes ticks. However, little is known regarding the Rickettsia species that inhabit Ixodes scapularis in the United States. The aim of this study was to screen adult I. scapularis collected in central Oklahoma over an 8-yr period for the presence of tick-borne rickettsial pathogens or potential pathogens. During 2014–2021, 112 adult specimens of I. scapularis were collected from central Oklahoma. Amplicons for Rickettsia spp. were amplified from 53 (47.3%) of the samples. Of the positive ticks, 42 (79.2%) amplicon-positive Rickettsia samples were 100% identical to Rickettsia buchneri, 10 (18.9%) were 100% identical to R. tillamookensis strain Tillamook 23, and 1 (1.9%) specimen showed high identity for Rickettsia amblyommatis. This study highlights the importance of considering Rickettsia-specific assays when assessing Ixodes species ticks for potential pathogens.
Assessing the Effects of User Accountability in Contracting Out
Authors: Esteve Marc , Garrido-Rodríguez Juan Carlos , Moore Alice , Schuster Christian , Zafra Gómez José Luis
Published: September 2023

How does contracting out affect service performance? Evidence to date is mixed. We argue that this is partially due to prior studies focusing often on whether—not how—services are contracted. Yet, how services are contracted matters. In particular, we argue that whether users pay user fees for services to contractors affects efficiency. Where they do, contractor revenue depends on user satisfaction and contractors face incentives to provide quality services to users to retain revenue. Where, by contrast, governments fund services, information asymmetry about the quality of services users receive allows contractors to shirk quality. The assertion is substantiated by empirical evidence derived from a comprehensive analysis of conditional efficiency within the water supply services across 2,111 municipalities in Spain, employing a two-stage conditional order-m data panel estimation. Our results show that contracting out where users pay service fees and thus have incentives to hold contractors accountable outperforms contracting out without user fees in quality-adjusted service provision.
A JROD survey: nationwide overview of radiotherapy data from 2015 to 2021
Authors: Ohba Hisateru , Nakada Yoshihiro , Numasaki Hodaka , Umehara Kensuke , Ota Junko , Okuda Yasuo , Teshima Teruki , Ogawa Kazuhiko , Nakamura Katsumasa , Japanese Society for Radiation Oncology Database Committee
Published: September 2023

The purpose of this survey was to examine the status of radiotherapy in Japan based on the cases registered in the Japanese Radiation Oncology Database (JROD), from 2015 to 2021, and to provide basic data to help improve the usefulness of the JROD in the future. The study population consisted of patients who underwent radiotherapy between 2014 and 2020 and did not opt out of the study. The survey item data analyzed in this study were entered into the database at each radiotherapy institution by referring to medical records from the preceding year. Our results show that the number of registered radiotherapy institutions and cases increased by ~50% in 2019 compared to those in 2015 (to 113 institutions and 60 575 cases, respectively). Among the survey item categories, the registration rate was lowest for prognostic information (13.9% on average over the 7-year period). In terms of the Japanese Society for Radiation Oncology disease site, the breast; lung, trachea and mediastinum and urogenital sites accounted for >50% of the total cases. The average survival and mortality rates over the 7-year study period were 67.4 and 17.4%, respectively. The X-ray radiotherapy completion rate exceeded 90% for all years and across all disease categories. 192Ir-based brachytherapy and 223Ra-based radionuclide therapy accounted for an average of 61.9 and 44.6%, respectively, of all corresponding cases over the 7-year period. In conclusion, this survey enables us to infer the actual status of radiotherapy in Japan based on the analysis of relevant nationwide data.
Definitive carbon ion re-irradiation with pencil beam scanning in the treatment of unresectable locally recurrent rectal cancer
Authors: Cai Xin , Li Ping , Zhao Jingfang , Wang Weiwei , Cheng Jingyi , Zhang Guangyuan , Cai Sanjun , Zhang Zhen , Jiang Guoliang , Zhang Qing , Wang Zheng
Published: September 2023

This study aimed to evaluate the oncological outcomes and safety of carbon ion re-irradiation with pencil beam scanning (PBS) delivery technique for previously irradiated and unresectable locally recurrent rectal cancer (LRRC). Between June 2017 and September 2021, 24 patients of unresectable LRRC with prior pelvic photon radiotherapy who underwent carbon ion re-irradiation at our institute were retrospectively analyzed. Carbon ion radiotherapy was delivered by raster scanning with a median relative biological effectiveness-weighted dose of 72 Gy in 20 fractions. Weekly CT reviews were carried out, and offline adaptive replanning was performed whenever required. The median follow-up duration was 23.8 months (range, 6.2–47.1 months). At the last follow-up, two patients had a local disease progression, and 11 patients developed distant metastases. The 1- and 2-year local control, progression-free survival and overall survival rates were 100 and 93.3%, 70.8 and 45.0% and 86.7 and 81.3%, respectively. There were no Grade 3 or higher acute toxicities observed. Three patients developed Grade 3 late toxicities, one each with gastrointestinal toxicity, skin reaction and pelvic infection. In conclusion, definitive carbon ion re-irradiation with PBS provided superior oncologic results with tolerable toxicities and may be served as a curative treatment strategy in unresectable LRRC.