bluuebunny/crossref_metadata_2025 huggingface dataset:
Valoración de experiencias y necesidades en la implementación de la prueba piloto de despliegue de los equipos territoriales: modelo de salud basado en atención primaria en Bogotá (Colombia), 2021
Authors: Callejas De Luca Estefanía , Albornoz Sánchez Mateo , Gómez Ayala María Camila , Rodríguez Viviana , Matiz María Paula , Pulido Edwin , Peña Torres Esperanza , Cepeda-Gil Magda Cristina , Botero Rodríguez Felipe , Cadena-Camargo Yazmín , Hernández González Camila
Published: August 2023

La actual administración distrital de Bogotá (Colombia) busca ajustar el modelo de salud de la ciudad, para basarlo en la atención primaria y ofrecer calidad de cuidado en salud. De ahí que la Secretaría Distrital de Salud haya realizado, durante tres meses, una prueba piloto de equipos territoriales interdisciplinarios que brindan atención resolutiva domiciliaria en las zonas más vulnerables de la ciudad, para hacerle ajustes antes de su despliegue en toda la ciudad. El objetivo del acompañamiento fue, entre otros, indagar las experiencias y perspectivas de los actores involucrados en la planeación y ejecución de esta, con el fin de reconocer aprendizajes y generar recomendaciones para el ajuste de la operación de los equipos. Mediante un análisis mixto, se analizó la información recolectada por medio de grupos focales y entrevistas a profundidad a los participantes del ejercicio, quienes resaltaron la importancia de las fases previas a la implementación, abarcando una adecuada inducción y capacitación de los profesionales en campo; la difusión previa de la intervención; la vinculación de la comunidad durante el proceso de planeación, implementación y monitorización; el aseguramiento previo de los insumos y conocimientos requeridos para la atención, y la adaptación de las estrategias propuestas al contexto territorial. Es importante señalar que este tipo de programas en salud deben tener un proceso de desarrollo iterativo, lo que requiere una constante evaluación en las diferentes etapas de planeación e implementación que lleven a mejoras en los procesos.
Improved Ballistic Impact Resistance of Nanofibrillar Cellulose Films With Discontinuous Fibrous Bouligand Architecture
Authors: Caviness Colby , Chen Yitong , Yang Zhangke , Wang Haoyu , Wu Yongren , Meng Zhaoxu
Published: August 2023

Natural protective materials offer unparalleled solutions for impact-resistant material designs that are simultaneously lightweight, strong, and tough. Particularly, the Bouligand structure found in the dactyl club of mantis shrimp and the staggered structure in nacre achieve excellent mechanical strength, toughness, and impact resistance. Previous studies have shown that hybrid designs by combining different bioinspired microstructures can lead to enhanced mechanical strength and energy dissipation. Nevertheless, it remains unknown whether combining Bouligand and staggered structures in nanofibrillar cellulose (NFC) films, forming a discontinuous fibrous Bouligand (DFB) architecture, can achieve enhanced impact resistance against projectile penetration. Additionally, the failure mechanisms under such dynamic loading conditions have been minimally understood. In our study, we systematically investigate the dynamic failure mechanisms and quantify the impact resistance of NFC thin films with DFB architecture by leveraging previously developed coarse-grained models and ballistic impact molecular dynamics simulations. We find that when nanofibrils achieve a critical length and form DFB architecture, the impact resistance of NFC films outperforms the counterpart films with continuous fibrils by comparing their specific ballistic limit velocities and penetration energies. We also find that the underlying mechanisms contributing to this improvement include enhanced fibril sliding, intralayer and interlayer crack bridging, and crack twisting in the thickness direction enabled by the DFB architecture. Our results show that by combining Bouligand and staggered structures in NFC films, their potential for protective applications can be further improved. Our findings can provide practical guidelines for the design of protective films made of nanofibrils.
Three-Dimensional-Slice-Super-Resolution-Net: A Fast Few Shooting Learning Model for 3D Super-Resolution Using Slice-Up and Slice-Reconstruction
Authors: Lin Hongbin , Xu Qingfeng , Xu Handing , Xu Yanjie , Zheng Yiming , Zhong Yubin , Nie Zhenguo
Published: August 2023

3D modeling accurately depicts the physical world but typically requires substantial data acquisition resources and significant storage space. We introduce a novel three-dimensional slice-reconstruction model (3DSR) to address these challenges. This 3D data super-resolution model leverages low-resolution 3D data as input to generate high-resolution results promptly and accurately, reducing the time and storage required to create detailed 3D models. To enhance the computational efficiency and accuracy of deep learning models, the 3D data are partitioned into multiple slices. The 3DSR processes each slice into a high-resolution 2D image, which is then reassembled into high-resolution 3D data. Our slice-up method and slice-reconstruction technique are specifically designed to preserve the primary characteristics of the 3D data. We employ a pre-trained deep 2D convolutional neural network to expand the resolution of the 2D image, resulting in excellent performance. This approach reduces the time required for training deep learning models and enhances computational efficiency during the resolution improvement process. Importantly, our model can deliver superior performance even when trained on fewer data.
Experimental Study on the Simulated Defects Detection in Submerged Transmission Pipeline
Authors: Durai Mathivanan , Huang Chun-Wei , Chi-Chuan Peng , Lan Chou-Wei , Son Kwon Joong , Chang Ho
Published: August 2023

The transport of oil, natural gas, water, and other petrochemical substances is extensively supported by pipelines over long distances. However, long-term use without maintenance causes the residue in the pipeline to gradually settle in the pipeline due to physical or chemical action, and the pipeline becomes an accident. This leads to overpressure and leakages in the pipeline, which in turn affects the safety of the industry and people's lives. This study aims to develop a nondestructive inspection to measure defects in a water pipeline using an ultrasonic technique. An SCH80 carbon steel pipe with a standard thickness of about 11 mm was used for the experiments, and various sets of defects inside and outside of the pipe were simulated, such as holes and grooves. A submerged ultrasonic transducer was used to evaluate the simulated pipeline defects and then acquire the defect data in an imaging system using LabVIEW and origin software. In this way, the thickness and location of the defects were clearly located. In addition, the ultrasonic detection error was calculated to be less than 6.5%. It helps to use this technique and equipment for the inspection of underground fluid pipelines.
Orientation-dependent etching of silicon by fluorine molecules: A quantum chemistry computational study
Authors: Dwivedi Omesh Dhar , Barsukov Yuri , Jubin Sierra , Vella Joseph R. , Kaganovich Igor
Published: August 2023

Anisotropic etching is a widely used process in semiconductor manufacturing, in particular, for micro- and nanoscale texturing of silicon surfaces for black silicon production. The typical process of plasma-assisted etching uses energetic ions to remove materials in the vertical direction, creating anisotropic etch profiles. Plasmaless anisotropic etching, considered here, is a less common process that does not use ions and plasma. The anisotropy is caused by the unequal etching rates of different crystal planes; the etching process, thus, proceeds in a preferred direction. In this paper, we have performed quantum chemistry modeling of gas-surface reactions involved in the etching of silicon surfaces by molecular fluorine. The results confirm that orientation-dependent etch rates are the reason for anisotropy. The modeling of F2 dissociative chemisorption on F-terminated silicon surfaces shows that Si–Si bond breaking is slow for the Si(111) surface, while it is fast for Si(100) and Si(110) surfaces. Both Si(100) and Si(110) surfaces incorporate a larger number of fluorine atoms resulting in Si–Si bonds having a larger amount of positive charge, which lowers the reaction barrier of F2 dissociative chemisorption, yielding a higher etch rate for Si(100) and Si(110) surfaces compared to Si(111) surfaces. Molecular dynamics modeling of the same reactions has shown that the chosen reactive bond order potential does not accurately reproduce the lower reaction barriers for F2 dissociative chemisorption on Si(100) and Si(100) surfaces. Thus, reparameterization is necessary to model the anisotropic etching process that occurs at lower temperatures.
Physical Education Teachers’ Perceptions of a Motor Competence Assessment Digital App
Authors: Sousa-Sá Eduarda , Lander Natalie , Alqumsan Ahmad Abu , Alsanwy Shehab , Nahavandi Darius , Toomey Nicole , Mohamed Shady , Lewis Steven , Barnett Lisa M.
Published: August 2023

Purpose: To refine a motor competence assessment app prototype, enabling its redesign. Method: Workshops were conducted to inform the prototype development. App’s usability was evaluated on its ability to communicate relevant information to the teachers (n = 9). A “think out loud” protocol was applied by the users. Results: Both workshops refined the app, namely: interface, background, acceptability/feasibility, results, teachers themselves, and effectiveness. Competitor analysis revealed recommendations for the wireframe, visuals, and proposed skills to be assessed. The need to include a demonstration for first-time users, video guidance, and links to more information for each skill was also raised. There was a recommendation on the design brief features and experiences. Conclusions: This study will provide guidance in discovering how digital solutions may shape motor competence assessment. The usability testing process with the teachers provides insight on the essential/desirable features required on these apps, enabling the prototype’s redesign to meet the users’ needs.
Why the Early Paleozoic was intrinsically prone to marine extinction
Authors: Pohl Alexandre , Stockey Richard G. , Dai Xu , Yohler Ryan , Le Hir Guillaume , Hülse Dominik , Brayard Arnaud , Finnegan Seth , Ridgwell Andy
Published: August 2023

The geological record of marine animal biodiversity reflects the interplay between changing rates of speciation versus extinction. Compared to mass extinctions, background extinctions have received little attention. To disentangle the different contributions of global climate state, continental configuration, and atmospheric oxygen concentration (
p
O
2
) to variations in background extinction rates, we drive an animal physiological model with the environmental outputs from an Earth system model across intervals spanning the past 541 million years. We find that climate and continental configuration combined to make extinction susceptibility an order of magnitude higher during the Early Paleozoic than during the rest of the Phanerozoic, consistent with extinction rates derived from paleontological databases. The high extinction susceptibility arises in the model from the limited geographical range of marine organisms. It stands even when assuming present-day
p
O
2
, suggesting that increasing oxygenation through the Paleozoic is not necessary to explain why extinction rates apparently declined with time.
An inhaled ACE2 decoy confers protection against SARS-CoV-2 infection in preclinical models
Authors: Urano Emiko , Itoh Yumi , Suzuki Tatsuya , Sasaki Takanori , Kishikawa Jun-ichi , Akamatsu Kanako , Higuchi Yusuke , Sakai Yusuke , Okamura Tomotaka , Mitoma Shuya , Sugihara Fuminori , Takada Akira , Kimura Mari , Nakao Shuto , Hirose Mika , Sasaki Tadahiro , Koketsu Ritsuko , Tsuji Shunya , Yanagida Shota , Shioda Tatsuo , Hara Eiji , Matoba Satoaki , Matsuura Yoshiharu , Kanda Yasunari , Arase Hisashi , Okada Masato , Takagi Junichi , Kato Takayuki , Hoshino Atsushi , Yasutomi Yasuhiro , Saito Akatsuki , Okamoto Toru
Published: August 2023

The Omicron variant continuously evolves under the humoral immune pressure exerted by vaccination and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and the resulting Omicron subvariants display further immune evasion and antibody escape. An engineered angiotensin-converting enzyme 2 (ACE2) decoy composed of high-affinity ACE2 and an IgG1 Fc domain could offer an alternative modality to neutralize SARS-CoV-2. We previously reported its broad spectrum and therapeutic potential in rodent models. Here, we demonstrate that the engineered ACE2 decoy retains neutralization activity against Omicron subvariants, including the currently emerging XBB and BQ.1 strains, which completely evade antibodies currently in clinical use. SARS-CoV-2, under the suboptimal concentration of neutralizing drugs, generated SARS-CoV-2 mutants escaping wild-type ACE2 decoy and monoclonal antibodies, whereas no escape mutant emerged against the engineered ACE2 decoy. Furthermore, inhalation of aerosolized decoys improved the outcomes of rodents infected with SARS-CoV-2 at a 20-fold lower dose than that of intravenous administration. Last, the engineered ACE2 decoy exhibited therapeutic efficacy for cynomolgus macaques infected with SARS-CoV-2. These results indicate that this engineered ACE2 decoy represents a promising therapeutic strategy to overcome immune-evading SARS-CoV-2 variants and that liquid aerosol inhalation could be considered as a noninvasive approach to enhance the efficacy of COVID-19 treatments.
A novel ruthenium-silver based antimicrobial potentiates aminoglycoside activity against
Pseudomonas aeruginosa
Authors: Donkor Gracious Yoofi , Anderson Greg M. , Stadler Michael , Tawiah Patrick Ofori , Orellano Carl D. , Edwards Kevin A. , Dahl Jan-Ulrik
Published: August 2023

The rapid dissemination of antibiotic resistance combined with the decline in the discovery of novel antibiotics represents a major challenge for infectious disease control that can only be mitigated by investments in novel treatment strategies. Alternative antimicrobials, including silver, have regained interest due to their diverse mechanisms of inhibiting microbial growth. One such example is AGXX, a broad-spectrum antimicrobial that produces highly cytotoxic reactive oxygen species (ROS) to inflict extensive macromolecular damage. Due to the connections identified between ROS production and antibiotic lethality, we hypothesized that AGXX could potentially increase the activity of conventional antibiotics. Using the gram-negative pathogen
Pseudomonas aeruginosa
, we screened possible synergistic effects of AGXX on several antibiotic classes. We found that the combination of AGXX and aminoglycosides tested at sublethal concentrations led to a rapid exponential decrease in bacterial survival and restored the sensitivity of a kanamycin-resistant strain. ROS production contributes significantly to the bactericidal effects of AGXX/aminoglycoside treatments, which is dependent on oxygen availability and can be reduced by the addition of ROS scavengers. Additionally,
P. aeruginosa
strains deficient in ROS detoxifying/repair genes were more susceptible to AGXX/aminoglycoside treatment. We further demonstrate that this synergistic interaction was associated with a significant increase in outer and inner membrane permeability, resulting in increased antibiotic influx. Our study also revealed that AGXX/aminoglycoside-mediated killing requires an active proton motive force across the bacterial membrane. Overall, our findings provide an understanding of cellular targets that could be inhibited to increase the activity of conventional antimicrobials.

IMPORTANCE

The emergence of drug-resistant bacteria coupled with the decline in antibiotic development highlights the need for novel alternatives. Thus, new strategies aimed at repurposing conventional antibiotics have gained significant interest. The necessity of these interventions is evident especially in gram-negative pathogens as they are particularly difficult to treat due to their outer membrane. This study highlights the effectiveness of the antimicrobial AGXX in potentiating aminoglycoside activities against
P. aeruginosa
. The combination of AGXX and aminoglycosides not only reduces bacterial survival rapidly but also significantly re-sensitizes aminoglycoside-resistant
P. aeruginosa
strains. In combination with gentamicin, AGXX induces increased endogenous oxidative stress, membrane damage, and iron-sulfur cluster disruption. These findings emphasize AGXX’s potential as a route of antibiotic adjuvant development and shed light on potential targets to enhance aminoglycoside activity.
Emergence of the
Dickeya
genus involved duplication of the OmpF porin and the adaptation of the EnvZ-OmpR signaling network
Authors: Cochard Clémence , Caby Marine , Gruau Peggy , Madec Edwige , Marceau Michael , Macavei Iulia , Lemoine Jérôme , Le Danvic Chrystelle , Bouchart Franck , Delrue Brigitte , Bontemps-Gallo Sébastien , Lacroix Jean-Marie
Published: August 2023

Genome evolution, and more specifically gene duplication, is a key process shaping host–microorganism interaction. The conserved paralogs usually provide an advantage to the bacterium to thrive. If not, these genes become pseudogenes and disappear. Here, we show that during the emergence of the genus
Dickeya
, the gene encoding the porin OmpF was duplicated. Our results show that the
ompF2
expression is deleterious to the virulence of
Dickeya dadantii
, the agent causing soft rot disease. Interestingly,
ompF
2 is regulated while
ompF
is constitutive but activated by the EnvZ-OmpR two-component system.
In vitro
, acidic pH triggers the system. The pH measured in four eudicotyledons increased from an initial pH of 5.5 to 7 within 8 h post-infection. Then, the pH decreased to 5.5 at 10 h post-infection and until full maceration of the plant tissue. Yet, the production of phenolic acids by the plant’s defenses prevents the activation of the EnvZ-OmpR system to avoid the
ompF2
expression even though environmental conditions should trigger this system. We highlight that gene duplication in a pathogen is not automatically an advantage for the infectious process and that, there was a need for our model organism to adapt its genetic regulatory networks to conserve these duplicated genes.

IMPORTANCE

Dickeya
species cause various diseases in a wide range of crops and ornamental plants. Understanding the molecular program that allows the bacterium to colonize the plant is key to developing new pest control methods. Unlike other enterobacterial pathogens,
Dickeya dadantii
, the causal agent of soft rot disease, does not require the EnvZ-OmpR system for virulence. Here, we showed that during the emergence of the genus
Dickeya
, the gene encoding the porin OmpF was duplicated and that the expression of
ompF2
was deleterious for virulence. We revealed that while the EnvZ-OmpR system was activated
in vitro
by acidic pH and even though the pH was acidic when the plant is colonized, this system was repressed by phenolic acid (generated by the plant’s defenses). These results provide a unique— biologically relevant—perspective on the consequence of gene duplication and the adaptive nature of regulatory networks to retain the duplicated gene.
Hypertriglyceridaemic waist phenotype and waist circumference triglyceride index are associated with higher incidence of acute pancreatitis: a nationwide population-based retrospective cohort study
Authors: Chung Kwang Hyun , Choi Young Hoon , Cho In Rae , Son Byoung Kwan , Ryu Ji Kon , Kim Yong-Tae , Lee Sang Hyub , Han Kyungdo
Published: August 2023

Objectives

The hypertriglyceridaemic waist (HTGW) phenotype, an indicator to assess metabolic syndrome, could be a useful predictive marker for the risk of acute pancreatitis. This study aimed to evaluate the association between the HTGW phenotype and the risk of acute pancreatitis with a nationwide population-based cohort.

Design

A retrospective, nationwide cohort study.

Setting

Registry of health check-up result from Korean National Health Insurance Service.

Participants

A total of 3 912 551 adults who underwent health checkups under the National Health Insurance Service in 2009 were enrolled in this study.

Interventions

Subjects with both increased waist circumference (WC) and elevated blood triglyceride concentrations were defined as the HTGW phenotype. The participants were divided into four groups, classified as NWNT (normal WC-normal triglycerides), EWNT (elevated WC-normal triglycerides), NWET (normal WC-elevated triglycerides) and HTGW. The WC triglyceride index (WTI) is a quantitative indicator of the HTGW phenotype which is calculated by multiplying WC (cm) by triglyceride levels (mmol/L).

Primary outcome measure

The subjects were followed until 31 December 2018. The adjusted HRs of acute pancreatitis in each group were estimated.

Results

During the follow-up, there were a total of 8933 of acute pancreatitis occurrences. The incidence of acute pancreatitis in all subjects was 0.278 per 1000 person-year. The HTGW group had the highest incidence (0.444), followed by the NWET (0.381), and EWNT (0.316) groups. The HTGW group had a significant higher incidence of acute pancreatitis than the NWNT groups (HR 1.364 (95% CI 1.279 to 1.454)). The risk of acute pancreatitis steadily increased as the WTI increased (HR 1.847 (95% CI 1.657 to 2.058) in 10th decile).

Conclusions

The HTGW phenotype is confirmed to be an independent risk factor that increases the risk of acute pancreatitis.
Delay in health-seeking behaviour and associated factors among adult patients with cancer in Ethiopia: a multicentre cross-sectional study
Authors: Bayable Alem , Tegenaw Abebu , Tesfaye Zerihun , Lidetu Tadios , Assefa Amare , Dessie Getenet
Published: August 2023

Objectives

Delays in obtaining proper cancer treatment can lead to advanced stages at diagnosis. Despite the problems, there is not enough evidence regarding delay in presentation. This study aims to assess delay in health-seeking behaviour and associated factors among adult patients with cancer in Ethiopia.

Design

Multicentre cross-sectional study design.

Setting

Data were collected from selected oncology centres in Ethiopia.

Participants

A multistage sampling technique was used to select 635 study participants from May 9 to June 9 2022.

Outcome measures

Patients who have a duration of ≥3 months from symptom recognition to the first healthcare visit were considered as delay in health-seeking behaviour. Data were entered using Epi data and exported to SPSS for further analysis. Before analysis, model fitness was carried out using Hosmer and Lemeshow test. Variables with a p value<0.25 in the bivariable analysis were included in multivariable logistic regression. In multivariable logistic regression, a p value<0.05 significant level was considered as the factor for delay in health-seeking behaviour.

Results

In this study, a total of 628 adult patients with cancer participated. A total of 72.6% of patients had a delay in health-seeking behaviour. Variables such as being female (AOR=2.81; 95% CI=1.29 to 6.14), rural residence (AOR=2.82; 95% CI=1.43 to 5.58), low social support (AOR=4.16; 95% CI=2.04 to 8.49), not having comorbidity (AOR=4.44; 95% CI=2.28 to 8.66), stage III cancer (AOR=3.73; 95% CI=1.37 to 9.98), stage IV cancer (AOR=3.07; 95% CI=1.28 to 6.41), additional symptoms (AOR=3.03; 95% CI=1.55 to 5.94), never heard about cancers (AOR=4.09; 95% CI=2.06 to 8.11) and never heard about cancer screening (AOR=2.16; 95% CI=1.06 to 4.40) were identified as factors for delay in health-seeking behaviour.

Conclusion

This study showed that relatively higher magnitude in which approximately three-fourth of adult patients with cancer were delayed in seeking medical attention. As a result, more effort must be made to tackle delay in health-seeking behaviour and associated factors.
Lived experience of people with lateral elbow tendinopathy: a qualitative study from the OPTimisE pilot and feasibility trial
Authors: Bateman Marcus , Hill Jonathan C , Cooper Karin , Littlewood Chris , Saunders Benjamin
Published: August 2023

Objectives

To explore the lived experience of people with lateral elbow tendinopathy (LET) and its impact on everyday life.

Design

Qualitative semi-structured interviews, analysed using thematic analysis.

Setting

Conducted as part of the mixed-methods OPTimisE pilot and feasibility randomised controlled trial of outpatient physiotherapy patients in the UK.

Participants

17 participants with LET, purposively sampled from the trial to provide representativeness based on age, sex, ethnicity, deprivation index and treatment allocation.

Results

Four themes were identified from the participants’ responses: (1) cause of onset—typically symptoms were attributed to: sudden changes in activity, repetitive work or compensating for other musculoskeletal conditions; (2) impact on everyday life—which included substantial impacts on quality-of-life, particularly due to pain disturbing sleep and difficulties performing daily tasks (related to work and hobbies) due to pain, although most reported being able to persevere with work; (3) self-help and understanding of the condition—with uncertainty about the appropriateness and potential harm of online advice and confusion from the diagnostic term ‘Tennis Elbow’ that non-sporting individuals struggled to relate to; (4) healthcare experiences—the treatments received were highly variable and often perceived as ineffectual.

Conclusions

For the first time, the lived experience of people from a range of backgrounds suffering from LET has been explored. Findings suggest that people frequently related the cause to a specific activity. They reported substantial impacts on daily tasks, sleep, work and hobbies. People also reported hesitancy to trust online information without formal healthcare advice, were confused by the common label of ‘Tennis Elbow’, and perceived the wide array of healthcare treatment options they had received to offer false hope and be largely ineffective. This study provides stimulus for clinicians to consider the advice and treatment provided, and whether the messages conveyed reflect the favourable natural history of the condition.

Trial registration number

ISRCTN64444585
TripleAiM1: a nationwide registry of de novo metastatic hormone-sensitive prostate cancer with prospective quality-of-life assessment
Authors: van Elst Tessa , van Basten Jean-Paul A , van den Berg Pieter L , van den Bergh Roderick CN , Bloem Sjaak , van Dodewaard-de Jong Joyce M , Hendriks Mathijs P , Klaver Sjoerd O , Lalmahomed Zarina , Luijendijk Daphne , van de Luijtgaarden Addy CM , Roelofs Luc AJ , Vis André N , Vreugdenhil Gerard , Vrijhof Eric HJEJ , Wijsman Bart P , Bloemendal Haiko J , Mulders Peter FA , Mehra Niven
Published: August 2023

Introduction

The treatment landscape forde novometastatic hormone sensitive prostate cancer (mHSPC) is rapidly evolving. With an abundance of available treatment strategies, selecting the optimal strategy for an individual patient is becoming increasingly challenging. TripleAiM1 aims to evaluate the impact of mHSPC treatments on health-related quality of life (HRQoL) and to provide real-world data insights on diagnostics, treatment strategies, patient subgroups and related healthcare expenditure for mHSPC. The aspirational target of TripleAiM1 is that in the near future, a more tailored therapy can be offered based on the individual patient’s wishes and needs in accordance with the overarching principle of value-based healthcare.

Methods and analysis

We describe the TripleAiM1 study design; a nationwide registry comprising a retrospective and prospective cohort of patients withde novomHSPC. Starting in May 2020, eligible patients are identified, selected and recruited in 14 participating hospitals in the Netherlands. Our hypothesis is that, in a real-world setting, differences in clinically meaningful HRQoL deterioration will be observed for treatment strategies over time. HRQoL data, assessed with patient-reported outcome measures, costs and clinical data will be collected for 24 months.

For the retrospective cohort, all patients diagnosed withde novomHSPC from January 2017 onwards are eligible for inclusion. Patient and tumour characteristics, imaging modalities and treatment patterns will be analysed descriptively to provide a real-world overview.

Time-to-event endpoints will be assessed using the Kaplan-Meier method and regression models will be employed to analyse baseline characteristics associated with an increased likelihood of death, progression and HRQoL deterioration. Longitudinal mixed-effects models will be employed to assess change of patient-reported outcome scores from baseline until the end of follow-up.

Ethics and dissemination

Ethical approval was obtained from the Medical Research Ethics Committee, Twente. Study results will be published in peer-reviewed journals.

Trial registration number

NL9719.
Diagnostic potential of plasma biomarkers and exhaled volatile organic compounds in predicting the different stages of acute mesenteric ischaemia: protocol for a multicentre prospective observational study (TACTIC study)
Authors: Duivenvoorden Annet A M , Clarysse Mathias , Ceulemans Laurens J , Geelkerken Robert H , Derikx Joep P M , de Vries Jean-Paul P M , Buscher Hessel C J L , Olde Damink Steven W M , van Schooten Frederik Jan , Lubbers Tim , Lenaerts Kaatje
Published: August 2023

Introduction

Acute mesenteric ischaemia (AMI) is a life-threatening condition with short-term mortality of up to 80%. The diagnosis of AMI has remained troublesome due to the non-specific clinical presentation, symptoms and laboratory findings. Early unambiguous diagnosis of AMI is critical to prevent progression from reversible to irreversible transmural intestinal damage, thereby decreasing morbidity and improving survival. The present study aims to validate a panel of plasma biomarkers and investigate volatile organic compound (VOC) profiles in exhaled air as a tool to timely and accurately diagnose AMI.

Methods and analysis

In this international multicentre prospective observational study, 120 patients (>18 years of age) will be recruited with clinical suspicion of AMI. Clinical suspicion is based on: (1) clinical manifestation, (2) physical examination, (3) laboratory measurements and (4) the physician’s consideration to perform a CT scan. The patient’s characteristics, repetitive blood samples and exhaled air will be prospectively collected. Plasma levels of mucosal damage markers intestinal fatty acid-binding protein and villin-1, as well as transmural damage marker smooth muscle protein 22-alpha, will be assessed by ELISA. Analysis of VOCs in exhaled air will be performed by gas chromatography time-of-flight mass spectrometry. Diagnosis of AMI will be based on CT, endovascular and surgical reports, clinical findings, and (if applicable) verified by histopathological examination.

Ethics and dissemination

The study protocol was approved by the Medical Research Ethics Committee (METC) of Maastricht University Medical Centre+ and Maastricht University (METC azM/UM), the Netherlands (METC19-010) and the Ethics Committee Research UZ/KU Leuven, Belgium (S63500). Executive boards and local METCs of other Dutch participating centres Gelre Ziekenhuizen (Apeldoorn), Medisch Spectrum Twente (Enschede), and University Medical Centre Groningen have granted permission to carry out this study. Study results will be disseminated via open-access peer-reviewed scientific journals and national/international conferences.

Trial registration number

NCT05194527.
Protocol for a parallel assignment prospective, randomised, comparative trial to evaluate the safety and efficacy of intense pulsed light (IPL) combined with 3% diquafosol (DQS) ophthalmic solution in dry eye syndrome
Authors: Chen Jiayan , Qin Guanghao , Li Liangzhe , Qi Yifan , Che Huixin , Huang He , Xia Yang , Zhang Qing , Wu Yi , Yang Lanting , Moutari Salissou , Moore Jonathan E , Xu Ling , He Wei , Yu Sile , Pazo Emmanuel Eric , He Xingru
Published: August 2023

Introduction

Evaporative dry eye (EDE) is common and can lead to ocular pain, decreased visual quality and reduced quality of life. Intense pulsed light (IPL) and 3% diquafosol ophthalmic solution have been found to be beneficial in reducing signs and symptoms of dry eye.

Methods and analysis

A randomised clinical trial will be performed at He Eye Specialist Hospital in Shenyang. 360 dry eye disease patients will be equally divided randomly into the IPL group, DQS group (3% diquafosol ophthalmic solution eye-drops) and IPL+group (IPL combined with 3% diquafosol eye-drops). All groups will be followed up for 4 weeks. The primary outcome measures will be the non-invasive tear break-up time and the Ocular Surface Disease Index change from the baseline. The secondary outcome measures willincludeconjunctival and cornea staining with fluorescein and lissamine, meibomian gland function and secretion quality, tear film lipid layer score, tear meniscus height, conjunctival hyperemia (redness score) changes . Adverse events also will be monitored and documented.

Discussion

This study aimed to assess whether the combination of IPL with 3% diquafosol ophthalmic solution (study group), IPL+ (study group), is more effective than IPL (active control group) or DQS (active control group) in participants with EDE.

Ethics and dissemination

Management of dry eye with IPL combined with 3% diquafosol ophthalmic solution, registered on 23 January 2023. Ethics approval number: IRB (2022) K029.01. The study’s findings will be shared regardless of the effect’s direction.

Trial registration number

NCT05694026.
Prediction of violence or threat of violence among employees in social work, healthcare and education: the Finnish Public Sector cohort study
Authors: Airaksinen Jaakko , Pentti Jaana , Seppälä Piia , Virtanen Marianna , Ropponen Annina , Elovainio Marko , Kivimäki Mika , Ervasti Jenni
Published: August 2023

Objectives

To develop a risk prediction algorithm for identifying work units with increased risk of violence in the workplace.

Design

Prospective cohort study.

Setting

Public sector employees in Finland.

Participants

18 540 nurses, social and youth workers, and teachers from 4276 work units who completed a survey on work characteristics, including prevalence and frequency of workplace violence/threat of violence at baseline in 2018–2019 and at follow-up in 2020–2021. Those who reported daily or weekly exposure to violence or threat of violence daily at baseline were excluded.

Exposures

Mean scores of responses to 87 survey items at baseline were calculated for each work unit, and those scores were then assigned to each employee within that work unit. The scores measured sociodemographic characteristics and work characteristics of the work unit.

Primary outcome measure

Increase in workplace violence between baseline and follow-up (0=no increase, 1=increase).

Results

A total of 7% (323/4487) of the registered nurses, 15% (457/3109) of the practical nurses, 5% of the social and youth workers (162/3442) and 5% of the teachers (360/7502) reported more frequent violence/threat of violence at follow-up than at baseline. The area under the curve values estimating the prediction accuracy of the prediction models were 0.72 for social and youth workers, 0.67 for nurses, and 0.63 for teachers. The risk prediction model for registered nurses included five work unit characteristics associated with more frequent violence at follow-up. The model for practical nurses included six characteristics, the model for social and youth workers seven characteristics and the model for teachers included four characteristics statistically significantly associated with higher likelihood of increased violence.

Conclusions

The generated risk prediction models identified employees working in work units with high likelihood of future workplace violence with reasonable accuracy. These survey-based algorithms can be used to target interventions to prevent workplace violence.
Impact of prior therapies and subsequent transplantation on outcomes in adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia treated with brexucabtagene autoleucel in ZUMA-3
Authors: Shah Bijal D , Cassaday Ryan D , Park Jae H , Houot Roch , Oluwole Olalekan O , Logan Aaron C , Boissel Nicolas , Leguay Thibaut , Bishop Michael R , Topp Max S , Tzachanis Dimitrios , O'Dwyer Kristen M , Arellano Martha L , Lin Yi , Baer Maria R , Schiller Gary J , Subklewe Marion , Abedi Mehrdad , Minnema Monique C , Wierda William G , DeAngelo Daniel J , Stiff Patrick J , Jeyakumar Deepa , Mao Daqin , Adhikary Sabina , Zhou Lang , Schuberth Petra C , Damico Khalid Rita , Ghobadia Armin
Published: August 2023

Background

Brexucabtagene autoleucel (brexu-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved in the USA for adults with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL) and in the European Union for patients ≥26 years with R/R B-ALL. After 2 years of follow-up in ZUMA-3, the overall complete remission (CR) rate (CR+CR with incomplete hematological recovery (CRi)) was 73%, and the median overall survival (OS) was 25.4 months in 78 Phase 1 and 2 patients with R/R B-ALL who received the pivotal dose of brexu-cel. Outcomes by prior therapies and subsequent allogeneic stem cell transplantation (alloSCT) are reported.

Methods

Eligible adults had R/R B-ALL and received one infusion of brexu-cel (1×10⁶ CAR T cells/kg) following conditioning chemotherapy. The primary endpoint was the CR/CRi rate per central review. Post hoc subgroup analyses were exploratory with descriptive statistics provided.

Results

Phase 1 and 2 patients (N=78) were included with median follow-up of 29.7 months (range, 20.7–58.3). High CR/CRi rates were observed across all prior therapy subgroups examined: 1 prior line of therapy (87%, n=15) and ≥2 prior lines (70%, n=63); prior blinatumomab (63%, n=38) and no prior blinatumomab (83%, n=40); prior inotuzumab (59%, n=17) and no prior inotuzumab (77%, n=61); and prior alloSCT (76%, n=29) and no prior alloSCT (71%, n=49). The frequency of Grade ≥3 cytokine release syndrome, neurological events, and treatment-related Grade 5 adverse events were largely similar among prior therapy subgroups.

Median duration of remission (DOR) in responders with (n=14) and without (n=43) subsequent alloSCT was 44.2 (95% CI, 8.1 to not estimable (NE)) and 18.6 months (95% CI, 9.4 to NE); median OS was 47.0 months (95% CI, 10.2 to NE) and not reached (95% CI, 23.2 to NE), respectively. Median DOR and OS were not reached in responders without prior or subsequent alloSCT (n=22).

Conclusions

In ZUMA-3, adults with R/R B-ALL benefited from brexu-cel, regardless of prior therapies and subsequent alloSCT status, though survival appeared better in patients without certain prior therapies and in earlier lines of therapy. Additional studies are needed to determine the impact prior therapies and subsequent alloSCT have on outcomes of patients who receive brexu-cel.
Persistent high prevalence of modifiable cardiovascular risk factors among patients with osteoarthritis in the UK in 1992–2017
Authors: Yu Dahai , Huang Xiaoyang , Mamas Mamas A , Wilkie Ross
Published: August 2023

Objectives

To compare the annual and period prevalence of modifiable cardiovascular risk factors (MCVRFs) between populations with and without osteoarthritis (OA) in the UK over 25 years.

Methods

215 190 patients aged 35 years and over from the UK Clinical Practice Research Datalink GOLD database who were newly diagnosed OA between 1992 and 2017, as well as 1:1 age-matched, sex-matched, practice-matched and index year-matched non-OA individuals, were incorporated. MCVRFs including smoking, hypertension, type 2 diabetes, obesity and dyslipidaemia were defined by Read codes and clinical measurements. The annual and period prevalence and prevalence rate ratios (PRRs) of individual and clustering (≥1, ≥2 and ≥3) MCVRFs were estimated by Poisson regression with multiple imputations for missing values.

Results

The annual prevalence of MCVRFs increased in the population with OA between 1992 and 2017 and was consistently higher in the population with OA compared with the population without OA between 2004 and 2017. Trends towards increased or stable annual PRRs for individuals and clustering of MCVRFs were observed. A 26-year period prevalence of single and clustering MCVRFs was significantly higher in individuals with OA compared with non-OA individuals. Period PRRs were higher in Southern England, women and increased with age for most MCVRFs except for obesity, which has the higher PRR in the youngest age group.

Conclusions

A consistently higher long-term prevalence of MCVRFs was observed in individuals with OA compared to those without OA. The higher prevalence of obesity in the youngest age group with OA highlights the need for public health strategies. Further research to understand MCVRF management in OA populations is necessary.
Staff well-being in UK children’s hospices: a national survey
Authors: Bedendo Andre , Papworth Andrew , Taylor Johanna , Beresford Bryony , Mukherjee Suzanne , Fraser Lorna , Ziegler Lucy
Published: August 2023

Objectives

Poor psychological well-being among healthcare workers can have numerous negative impacts, but evidence about levels of burnout in children’s hospice care staff is limited. This study aimed to determine the prevalence of burnout and to explore the association between staff characteristics and support mechanisms with burnout among children’s hospice care staff in the UK.

Methods

Two national online surveys collecting data on hospice care staff psychological well-being and hospice organisational characteristics. All children’s hospices in the UK were invited.

Thirty-one hospices (out of 52) responded to the hospice survey and 583 staff responded to the staff survey. Data collection took place between May and December 2020 and measures included the Copenhagen Burnout Inventory, Work Engagement and the Health and Safety Executive Management Standards Indicator Tool.

Results

Burnout prevalence was 11% and mean burnout score was 32.5 (SD: 13.1). Burnout levels were independent of working arrangements (eg, working from home or at the hospice) during the COVID-19 pandemic. Hospices performed well in most management standards, but poorly on the ‘Control’ domain. The average Work Engagement score for staff was 7.5 (SD: 1.5).

Conclusions

Burnout levels for staff in children’s hospices in the UK were lower than in other healthcare settings, with this comparing to 17.3% among palliative care staff generally. Overall, hospices performed well in management standards and there was no indication of urgent action needed. Work Engagement in our sample was higher compared with other National Health Service workers during the COVID-19 pandemic.
Chiral perturbation theory of the hyperfine splitting in (muonic) hydrogen
Authors: Hagelstein Franziska , Lensky Vadim , Pascalutsa Vladimir
Published: August 2023

The ongoing experimental efforts to measure the hyperfine transition in muonic hydrogen prompt an accurate evaluation of the proton-structure effects. At the leading order in$$\alpha $$α, which is$$O(\alpha ^5)$$O(α5)in the hyperfine splitting (hfs), these effects are usually evaluated in a data-driven fashion, using the empirical information on the proton electromagnetic form factors and spin structure functions. Here we perform a first calculation based on the baryon chiral perturbation theory (B$$\chi $$χPT). At leading orders it provides a prediction for the proton polarizability effects in hydrogen (H) and muonic hydrogen ($$\mu $$μH). We find large cancellations among the various contributions leading to, within the uncertainties, a zero polarizability effect at leading order in the B$$\chi $$χPT expansion. This result is in significant disagreement with the current data-driven evaluations. The small polarizability effect implies a smaller Zemach radius$$R_\textrm{Z}$$RZ, if one uses the well-known experimental 1Shfs in H or the 2Shfs in$$\mu $$μH. We, respectively, obtain$$R_\textrm{Z}(\textrm{H}) = 1.010(9)$$RZ(H)=1.010(9)fm,$$R_\textrm{Z}(\mu \textrm{H}) = 1.040(33)$$RZ(μH)=1.040(33)fm. The total proton-structure effect to the hfs at$$O(\alpha ^5)$$O(α5)is then consistent with previous evaluations; the discrepancy in the polarizability is compensated by the smaller Zemach radius. Our recommended value for the 1Shfs in$$\mu \text {H}$$μHis$$182.640(18)\,\textrm{meV}.$$182.640(18)meV.
$$B\pi $$ excited-state contamination in lattice calculations of B-meson correlation functions
Authors: Bär Oliver , Broll Alexander , Sommer Rainer
Published: August 2023

Multi-particle states with additional pions are expected to result in a difficult-to-control excited-state contamination in lattice simulations. We show that heavy meson chiral perturbation theory can be employed to estimate the contamination due to two-particle$$B\pi $$Bπstates in variousB-meson observables, like theB-meson decay constant and the$$B^*B\pi $$B∗Bπcoupling. We work in the static limit and to next-to-leading order in the chiral expansion, i.e. including$$\textrm{O}(p).$$O(p).The$$B\pi $$Bπstates are found to typically lead to an overestimation of the observables at the few percent level. We determine two of the LECs from$$B\rightarrow \pi $$B→πform factor computations of the KEK group (Colquhoun et al. in Phys. Rev. D 106:054502, 2022) and discuss ways to determine the others. In particular, one LEC which is associated with smeared interpolating fields seems to be easily accessible and thus opens up a way to systematically study the effect of smearing on excited-state effects.
Balanced Pairs on Triangulated Categories
Authors: Fu Xianhui , Hu Jiangsheng , Zhang Dongdong , Zhu Haiyan
Published: August 2023

Let [Formula: see text] be a triangulated category. We first introduce the notion of balanced pairs in [Formula: see text], and then establish the bijective correspondence between balanced pairs and proper classes [Formula: see text] with enough [Formula: see text]-projectives and [Formula: see text]-injectives. Assume that [Formula: see text] is the proper class induced by a balanced pair [Formula: see text]. We prove that [Formula: see text] is an extriangulated category. Moreover, it is proved that [Formula: see text] is a triangulated category if and only if [Formula: see text], and that [Formula: see text] is an exact category if and only if [Formula: see text]. As an application, we produce a large variety of examples of extriangulated categories which are neither exact nor triangulated.
On ϕ - ( n,N ) -ideals of Commutative Rings
Authors: Anebri Adam , Mahdou Najib , Tekir Ünsal , Yıldız Eda
Published: August 2023

Let [Formula: see text] be a commutative ring with nonzero identity and [Formula: see text] be a positive integer. In this paper, we introduce and investigate a new subclass of [Formula: see text]-[Formula: see text]-absorbing primary ideals, which are called [Formula: see text]-[Formula: see text]-ideals. Let [Formula: see text] be a function, where [Formula: see text] denotes the set of all ideals of [Formula: see text]. A proper ideal [Formula: see text] of [Formula: see text] is called a [Formula: see text]-[Formula: see text]-ideal if [Formula: see text] and [Formula: see text] imply that the product of [Formula: see text] with [Formula: see text] of [Formula: see text] is in [Formula: see text] for all [Formula: see text]. In addition to giving many properties of [Formula: see text]-[Formula: see text]-ideals, we also use the concept of [Formula: see text]-[Formula: see text]-ideals to characterize rings that have only finitely many minimal prime ideals.