bluuebunny/crossref_metadata_2025 huggingface dataset:
Guenevere's Raptus-Sanctus Triumphs in Sir Thomas Malory's Morte Darthur
Authors: Hanks D. Thomas
Published: December 2023

Abstract: Generally speaking, scholars of Malory's Morte Darthur have given Guenevere bad press. Terms like 'shrew' and 'virago' have been often applied, while her agency has been largely ignored or minimized. Recently, however, scholars have begun to reconsider her characterization and even her agency. Analysis of her response to Meleagant's attempted raptus , however, has been minimal; likewise minimal has been discussion of her response to Lancelot both with respect to Meleagant and to Lancelot's late and apparently marital desire. Both men become wholly subject to Guenevere's subtle but masterful agency.
On the New Stars in Ulysses
Authors: Usher Peter D.
Published: December 2023

Abstract: The Ghost in William Shakespeare’s Hamlet appears from the direction of a bright new star, which James Joyce in Ulysses identifies as the New Star of 1572, a supernova in the constellation Cassiopeia. In the book, Stephen Dedalus asserts that this celestial outburst occurs about the time of Shakespeare’s birth, but Shakespeare was born eight years earlier. This essay studies this New Star and the three other stellar outbursts for which Ulysses supplies information. It posits that Joyce creates the eight-year discrepancy intentionally and that, suitably parsed, the discrepancy does not exist. Also, it suggests that the assumed coincidence of the apparition of T Coronae Borealis nova on the birthdate of Leopold Bloom matches the seemingly erroneous coincidence of dates of the New Star of 1572 and the birth of Shakespeare, and that the text suggests that Joyce proclaims Shakespeare more intelligent than Bloom. The conclusions reached in this essay are in agreement with Bloom’s relationship to Shakespeare. We suggest that Joyce deliberately picks the star named delta of Cassiopeia over two more suitable choices for locating the direction of the New Star.
Reintroducing the Sirens’ Fugue
Authors: Meng Elvin
Published: December 2023

Abstract: This essay revisits the difficulty around “musical” interpretations of the “Sirens” episode of Ulysses . It argues that reading the episode through a looser notion of the fugue than previously suggested can contribute significantly to the understanding of the episode’s texture, narrative mediation, and renderings of affect, without committing to the establishment of formal correspondences between literary and fugal structures that more literal “fugal” readings of the episode tend to require. Furthermore, the essay suggests that the “fugal” quality of the episode is best understood as an extra-diegetic semiosis-through-composition that draws upon, interacts with, and at times perverts the language of diegetic characters, and that Bloom’s journey to the musical world of the Sirens is best understood as modulations in modes of meaning-making throughout the episode that lean into or move away from this second-level, musical semiosis.
Induction, Deduction, and Visual-Spatial Perception: The Finnegans Wake Intelligence Test
Authors: Violaris Elena
Published: December 2023

Abstract: Finnegans Wake makes intense demands on its readers’ intellectual energies, and I propose that the text brings our cognitive reasoning capacities to the foreground by putting them to work. In this, the Wake resembles an intelligence test, calling upon abilities of deduction, induction, and visual-spatial perception. Using deduction, readers draw upon existing linguistic paradigms in order to make sense of Joyce’s neologisms, while induction involves identifying patterns created by the text itself. Moreover, “characters” such as HCE are often denoted only by the appearance of these letters, activating pattern-recognition skills. Nevertheless, identifying these references is not the end-point of studying the Wake , since dissecting Joyce’s text into an inventory of allusions would dissolve its artistry. Instead, discerning familiar elements in Joycean innovations is a fluid and ongoing process, where the manifestation of one’s own cognitive processes constitutes an aesthetic effect.
Gulf States and Sharp Power: Allies to Adversaries
Authors: Davidson Christopher
Published: December 2023

Abstract: The UAE, Saudi Arabia, and Qatar have recently been linked to a range of contentious exploits in the West. These include covert influence operations, espionage, and (in Saudi Arabia's case) even acts of political violence. At first glance, such adversarial activity makes little sense, given longstanding economic, security, and 'soft power' ties. As this essay demonstrates, however, a potent mix of shared and state-specific motives has been steering these increasingly assertive monarchies—themselves experiencing intensive autocratization—into uncharted waters. Amidst serious divergences with the US, the European Union and other such partners, this has pitched Gulf-Western relations into a complex and unpredictable new era, with clear diplomatic and national-security ramifications as well as a pressing need for strengthened democratic defenses.
How Latin America's Judges are Defending Democracy
Authors: Zambrano Diego A. , da Silva Ludmilla Martins , Miron Rolando Garcia , Rodríguez Santiago P.
Published: December 2023

Abstract: Ten years of debates over democratic backsliding have failed to produce many examples of independent institutions thwarting authoritarian attempts on democracy. Yet Latin American courts seem to be countering this larger trend. The three largest countries in the region—Brazil, Mexico, and Colombia—have produced robust institutions able to check leaders with authoritarian tendencies, with high courts playing a fundamental role. In a dramatic succession of recent cases, courts in these three countries have been innovative, acted with a high degree of independence, and appear legitimately interested in defending democratic norms. All of this is profoundly surprising. There is little to no track record of independent Latin American judiciaries that stand in the way of authoritarian governments. Closer study of these three countries is therefore critical for scholars and practitioners, who are otherwise locked in debates over the importance of judicial review in preserving democracy. After dozens of judicial reform failures since the 1990s, we may be observing some overdue success. It appears that 1990s judicial reforms are making a comeback in Latin America.
Do dielectric bilayer metasurfaces behave as a stack of decoupled single-layer metasurfaces?
Authors: Palmieri Alfonso , Dorrah Ahmed H. , Yang Jun , Oh Jaewon , Dainese Paulo , Capasso Federico
Published: December 2023

Flat optics or metasurfaces have opened new frontiers in wavefront shaping and its applications. Polarization optics is one prominent area which has greatly benefited from the shape-birefringence of metasurfaces. However, flat optics comprising a single layer of meta-atoms can only perform a subset of polarization transformations, constrained by a symmetric Jones matrix. This limitation can be tackled using metasurfaces composed of bilayer meta-atoms but exhausting all possible combinations of geometries to build a bilayer metasurface library is a very daunting task. Consequently, bilayer metasurfaces have been widely treated as a cascade (product) of two decoupled single-layer metasurfaces. Here, we test the validity of this assumption for dielectric metasurfaces by considering a metasurface made of titanium dioxide on fused silica substrate at a design wavelength of 532 nm. We explore regions in the design space where the coupling between the top and bottom layers can be neglected, i.e., producing a far-field response which approximates that of two decoupled single-layer metasurfaces. We complement this picture with the near-field analysis to explore the underlying physics in regions where both layers are strongly coupled. We also show the generality of our analysis by applying it to silicon metasurfaces at telecom wavelengths. Our unified approach allows the designer to efficiently build a multi-layer dielectric metasurface, either in transmission or reflection, by only running one full-wave simulation for a single-layer metasurface.
Applications of natural language processing at emergency department triage: A narrative review
Authors: Stewart Jonathon , Lu Juan , Goudie Adrian , Arendts Glenn , Meka Shiv Akarsh , Freeman Sam , Walker Katie , Sprivulis Peter , Sanfilippo Frank , Bennamoun Mohammed , Dwivedi Girish
Published: December 2023

Introduction

Natural language processing (NLP) uses various computational methods to analyse and understand human language, and has been applied to data acquired at Emergency Department (ED) triage to predict various outcomes. The objective of this scoping review is to evaluate how NLP has been applied to data acquired at ED triage, assess if NLP based models outperform humans or current risk stratification techniques when predicting outcomes, and assess if incorporating free-text improve predictive performance of models when compared to predictive models that use only structured data.

Methods

All English language peer-reviewed research that applied an NLP technique to free-text obtained at ED triage was eligible for inclusion. We excluded studies focusing solely on disease surveillance, and studies that used information obtained after triage. We searched the electronic databases MEDLINE, Embase, Cochrane Database of Systematic Reviews, Web of Science, and Scopus for medical subject headings and text keywords related to NLP and triage. Databases were last searched on 01/01/2022. Risk of bias in studies was assessed using the Prediction model Risk of Bias Assessment Tool (PROBAST). Due to the high level of heterogeneity between studies and high risk of bias, a metanalysis was not conducted. Instead, a narrative synthesis is provided.

Results

In total, 3730 studies were screened, and 20 studies were included. The population size varied greatly between studies ranging from 1.8 million patients to 598 triage notes. The most common outcomes assessed were prediction of triage score, prediction of admission, and prediction of critical illness. NLP models achieved high accuracy in predicting need for admission, triage score, critical illness, and mapping free-text chief complaints to structured fields. Incorporating both structured data and free-text data improved results when compared to models that used only structured data. However, the majority of studies (80%) were assessed to have a high risk of bias, and only one study reported the deployment of an NLP model into clinical practice.

Conclusion

Unstructured free-text triage notes have been used by NLP models to predict clinically relevant outcomes. However, the majority of studies have a high risk of bias, most research is retrospective, and there are few examples of implementation into clinical practice. Future work is needed to prospectively assess if applying NLP to data acquired at ED triage improves ED outcomes when compared to usual clinical practice.
Do participants in a physical activity program from a Care Sport Connector become healthier? An explorative study from the Netherlands
Authors: Smit E. , Leenaars K. E. F. , Wagemakers M. A. E. , Bakker E. J. , Velden J. van der , Molleman G. R. M.
Published: December 2023

Introduction

Care Sport Connectors (CSCs) have been appointed to create a connection between the primary care and physical activity (PA) sectors to stimulate residents who are inactive to become more physically active to gain health benefits. The objective of this explorative study was to find out whether CSCs achieve these goals by testing the hypothesis that more residents become physically active, and score higher for health-related fitness and health-related quality of life.

Method

We conducted a longitudinal study design whereby participants (n = 402) were measured at three time points: at the start of their PA program (T0); after 6 months (T1); and after 1 year (T2). Participants conducted a fitness test to measure their health-related physical fitness and filled in questionnaires to assess PA level (PA-, Fit-, Combi-, and sport norm), health-related quality of life, motivation for PA, and personal information. We used a multi-level analysis to test whether outcomes of participants differ over time. Participants who dropped out and maintainers were compared with a chi-square test and a one-way ANOVA.

Results

This study showed that one-third of the participants dropped out (n = 139). Participants who dropped out were, compared with maintainers, less physically active (P = 0.004) and were more often reached in bigger municipalities, by an integral approach. More participants meet the PA norm (P = 0.007) and sport norm (P<0.001) at T2 then at T0. Scores in health-related physical fitness and quality of life were significant but not a meaningful gain in health-related fitness.

Conclusion

More residents become physically active and participate in sport because they took part in a PA programs or activity organized by a CSC. Lifestyle interventions should be offered with a higher frequency, intensity, and focus on behavior change. It is necessary to invest in combined lifestyle interventions offered by a collaboration of primary care, welfare, and PA professionals.
LimoRhyde2: Genomic analysis of biological rhythms based on effect sizes
Authors: Obodo Dora , Outland Elliot H. , Hughey Jacob J.
Published: December 2023

Genome-scale data have revealed daily rhythms in various species and tissues. However, current methods to assess rhythmicity largely restrict their focus to quantifying statistical significance, which may not reflect biological relevance. To address this limitation, we developed a method called LimoRhyde2 (the successor to our method LimoRhyde), which focuses instead on rhythm-related effect sizes and their uncertainty. For each genomic feature, LimoRhyde2 fits a curve using a series of linear models based on periodic splines, moderates the fits using an Empirical Bayes approach called multivariate adaptive shrinkage (Mash), then uses the moderated fits to calculate rhythm statistics such as peak-to-trough amplitude. The periodic splines capture non-sinusoidal rhythmicity, while Mash uses patterns in the data to account for different fits having different levels of noise. To demonstrate LimoRhyde2’s utility, we applied it to multiple circadian transcriptome datasets. Overall, LimoRhyde2 prioritized genes having high-amplitude rhythms in expression, whereas a prior method (BooteJTK) prioritized “statistically significant” genes whose amplitudes could be relatively small. Thus, quantifying effect sizes using approaches such as LimoRhyde2 has the potential to transform interpretation of genomic data related to biological rhythms.
Research on the synergetic development of producer services and manufacturing in northwest China’s inland central cities—A case study of Lanzhou
Authors: Gong Weimin , Zhang Zhibin , Zhang Ming , Wang Jian , Men Dan
Published: December 2023

Under the post Ford flexible production organization system, the existence of specialized division of labor has made the forward and backward connections between the producer services as an intermediate input and the manufacturing increasingly close. With the proposal of the "Belt and Road" and the deepening of “The development of the western region in China”, the northwest region plays an increasingly important role in China’s regional development strategy, and the economic transformation, especially the transformation and upgrading of the manufacturing, and it is crucial to its completion of the strategic mission entrusted by the state. Taking Lanzhou City as a case area, based on the measurement of the cooperative development level of producer services and manufacturing, this paper explores the internal law of the synergetic development of producer services and manufacturing in the northwest inland central city. The study found: The overall synergy development level of producer services and manufacturing in Lanzhou has been significantly improved in the dynamic evolution process, and two industries are in the transition stage from the primary coordinated development to the intermediate coordinated development at present. The spatial layout of producer services and manufacturing in Lanzhou City has certain spatial proximity, and the overall presents a "center-periphery" spatial pattern with the main urban area as the main component. From the perspective of the synergistic development of producer services and manufacturing in Lanzhou, the two industries have initially formed an interactive relationship of two-way promotion at present, but there is a significant asymmetry in the two-way promoting effect of the two industries.
Effects of biofertilizers on the growth, leaf physiological indices and chlorophyll fluorescence response of spinach seedlings
Authors: Zhang Beibei , Zhang Hui , Lu Di , Cheng Liping , Li Jiajia
Published: December 2023

Chemcial fertilizer as the main strategy for improving the vegetable yields was excessively applied in recent years which led to progressively serious soil problems such as the soil acidification. According the situation, five different biofertilizer treatments [no fertilizer (CK), inoculations of Bacillus subtilis (Bs, T1), combination of Bs and Bacillus mucilaginosus (Bs+Bm, T2), Bs and Bacillus amyloliquefaciens (Bs+Ba, T3), and Bm+Ba (T4)] were conducted to investigate the effect of the growth, leaf physiological indices, and chlorophyll fluorescence of spinach seedlings in the growth chamber. The growth and physiological indices of the spinach seedlings attained a maximum under the T2 treatments. Under the T2 treatment, the ABS/RC (Absorption flux per RC), TR0/RC (Trapping flux per RC), and ET0/RC (Electron transport flux per RC) was significantly increased, while the DI0/RC [Dissipated energy flux per RC (at t = 0)] was decreased. The OJIP curve was improved under of the inoculations of fertilizers, and the increasing range was the largest under the T2 treatment. The leaf light response curve (LC) was also significantly increased under the T2 treatment. The plant growth characteristics [leaf length (LL), leaf weight (LW), plant height (PH)] were positively correlated with the J-I-P test chlorophyll fluorescence parameters [PIABS (Performance index for energy conservation from exciton to the reduction of intersystem electron acceptors), φP0 (Maximum quantum yield of primary photochemistry), φE0 (Quantum yield of electron transport), ψ0 (The probability that a trapped exciton moved an electron in electron transport chain further than QA-), TR0/RC, and ET0/RC] while negatively correlated with φD0 (Quantum yield of energy dissipation) and DI0/RC. The leaf physiological characteristics [SP (soluble protein concentrations), SC (soluble carbohydrate concentrations), Chl a (chlorophyll a), Chl b (chlorophyll b), Chl a+b, Chl a/b, and WP (water potential)] were positively correlated with the J-I-P test chlorophyll fluorescence parameters (PIABS, φP0, φE0, ψ0, ABS/RC, TR0/RC, and ET0/RC) while negatively correlated with φD0 and DI0/RC. These results indicated that the combination of Bs+Bm inoculations promoted the growth of the spinach and improved the adaptability of the vegetable to acid soil while Ba inoculation didn’t have any effects to plants.
In silico identification and functional prediction of differentially expressed genes in South Asian populations associated with type 2 diabetes
Authors: Rabby Md. Golam , Rahman Md. Hafizur , Islam Md. Numan , Kamal Md. Mostafa , Biswas Mrityunjoy , Bonny Mantasa , Hasan Md. Mahmudul
Published: December 2023

Type 2 diabetes (T2D) is one of the major metabolic disorders in humans caused by hyperglycemia and insulin resistance syndrome. Although significant genetic effects on T2D pathogenesis are experimentally proved, the molecular mechanism of T2D in South Asian Populations (SAPs) is still limited. Hence, the current research analyzed two Gene Expression Omnibus (GEO) and 17 Genome-Wide Association Studies (GWAS) datasets associated with T2D in SAP to identify DEGs (differentially expressed genes). The identified DEGs were further analyzed to explore the molecular mechanism of T2D pathogenesis following a series of bioinformatics approaches. Following PPI (Protein-Protein Interaction), 867 potential DEGs and nine hub genes were identified that might play significant roles in T2D pathogenesis. Interestingly, CTNNB1 and RUNX2 hub genes were found to be unique for T2D pathogenesis in SAPs. Then, the GO (Gene Ontology) showed the potential biological, molecular, and cellular functions of the DEGs. The target genes also interacted with different pathways of T2D pathogenesis. In fact, 118 genes (including HNF1A and TCF7L2 hub genes) were directly associated with T2D pathogenesis. Indeed, eight key miRNAs among 2582 significantly interacted with the target genes. Even 64 genes were downregulated by 367 FDA-approved drugs. Interestingly, 11 genes showed a wide range (9–43) of drug specificity. Hence, the identified DEGs may guide to elucidate the molecular mechanism of T2D pathogenesis in SAPs. Therefore, integrating the research findings of the potential roles of DEGs and candidate drug-mediated downregulation of marker genes, future drugs or treatments could be developed to treat T2D in SAPs.
Estimating the number of required nurses in different types of hospitals: An application of the workload indicators of staffing needs (WISNS) method
Authors: Najafpour Zhila , Zare Nasiri Mohsen , Nozarian Mohammad-Hussein , Keliddar Iman , Shayanfard Kamran
Published: December 2023

Background

Health system performance depends on the availability, accessibility, acceptability, and quality of health workforces. Policymakers seek whether the number of nurses is optimally matched based on patients’ needs. This study aimed to assess the workforce stock, workload activities, activity standards, and workload pressure to determine the number of required nurses in different types of hospitals in Iran.

Methods

This study applied the workload indicators of staffing needs (WISNs) method and was conducted in 22 surgical and internal medicine wards at five hospitals in the southwest of Iran during six months. A time-motion study, and several group discussions, interviews were used to extract the required data. Descriptive statistics were used for data analysis.

Results

All selected hospitals faced nursing shortages. The highest shortage (-47) and workload pressure (WISN ratio 0.45) were observed in the general-educational hospitals. In the specialized hospitals, the workload pressure was high (WISN ratio 0.49). The lowest shortage belonged to the private hospital. Based on our assessment, in all of the hospitals, nurses typically worked overtime due to high workload. The studied hospitals covered an average of 25% of their shortage with nursing overtime working. We noted that nurses were predominantly occupied with health service and supportive activities (≈90% of their time).

Conclusions

Based on the WISN method, all of the hospitals faced nursing shortages from moderate to high. However, it would be essential to consider current labor market analysis based on accurate data to adopt appropriate policies in HRH planning.
The role of social capital in shaping livelihood for rural Vietnamese households
Authors: Chuong Huynh Ngoc
Published: December 2023

This study explores the role of social capital in the livelihoods of rural households in Vietnam, examining both direct and indirect impacts. The author uses a revised sustainable livelihood framework to analyze social capital, focusing on bonding-bridging and linking forms. The study applies quantitative methods to a secondary dataset from a rural household survey, including entropy-weighted indicators, cluster analysis, and SEM models. The findings suggest that social capital has complex and significant impacts on household livelihood strategies. Bridging and linking social capital promotes non-agricultural and wage-based strategies, while bonding social capital drives transfer-based strategies. The study highlights the importance of social capital as a complementary resource to other livelihood capitals, such as financial, human, and physical capital. These results have important implications for policy implementation aimed at supporting rural households and their livelihoods, especially regarding social capital’s interaction with other livelihood capitals. By understanding the complex relationship between social capital, other livelihood capitals and livelihood strategies, policymakers can design more effective policies that harness the potential of social connections to support rural households.
Investigating the interconnectedness of carbon, fossil energy, and financial markets: A dynamic spillover index approach
Authors: Li Tianyou , Ju Yanbing , Dong Peiwu
Published: December 2023

Against the background of the global active pursuit of carbon neutrality, this paper uses the DY spillover index method to analyze the spillover network effects between carbon, fossil energy and financial markets. The research results show that the spillover effects between these three markets change over time, with an average spillover index of 25.30%, showing a significant mutual influence. Further analysis found that the EU carbon market plays an important role in spillover effects. Especially under the influence of extreme events, the spillover effects reach their peak. At this time, the degree of mutual influence between markets is as high as 60.01%. In addition, during the COVID-19 epidemic, the spillover effect of the EU carbon market on other markets also reached its maximum, indicating that the epidemic increased the contagion of cross-market risks and caused the carbon market to bear greater risks. The research results of this article have important guiding significance for environmental protection investment and emphasize the importance of formulating differentiated environmental protection policies in different time frames. Facing the dual challenges of global climate change and promoting the goal of carbon neutrality, governments and relevant institutions should pay close attention to changes in spillover effects between markets and timely adjust environmental protection policies to achieve maximum results.
Research on distribution network fault processing technology based on knowledge of graph
Authors: Li Qiang , Zhao Feng , Zhuang Li , Su Jiangwen , Zhang Xiaodong
Published: December 2023

Safety and reliability are the basis of the development of a distribution network. To analyze the risk transmission process in the distribution network and ensure the safe and reliable operation of the power system, this paper intends to use the knowledge graph method to realize the risk analysis of the distribution network information system. Firstly, the knowledge graph method is used to extract and integrate the risk knowledge of the multi-dimensional information collected by the distribution network. Secondly, the knowledge graph model of distribution network risk analysis is constructed, and the multi-dimensional distribution network fault handling and knowledge graph construction oriented to the feeder and platform area are designed. The distribution line parameters of the low-voltage distribution network model, neutral point grounding mode, and different fault types are analyzed, and the non-planned island is searched based on the knowledge graph adjacency matrix. Finally, combined with the simulation experiment, it is verified that the proposed method can effectively depict the information risk process of the distribution network. The structure of this paper starts from the multi-node complex distribution network, combined with a knowledge graph and deep learning method, which can solve the distribution network fault more quickly.
Importance of mega-environments in evaluation and identification of climate resilient maize hybrids (Zea mays L.)
Authors: Kachapur Rajashekhar M. , Patil Nandan L. , Talekar Sidramappa C. , Wali Mrutyunjaya C. , Naidu Gopalakrishna , Salakinakop Shiddappa R. , Harlapur Sharanappa I. , Bhat Jayant S. , Kuchanur Prakash H.
Published: December 2023

Multi-location experiments on maize were conducted from 2016 to 2019 at ten locations distributed across two agro-climatic zones (ACZ) i.e., ACZ-3 and ACZ-8 of Karnataka, India. Individual analysis of variance for each location-year combination showed significant differences among the hybrids; similarly, combined analysis showed a higher proportion of GE interaction variance than due to genotype. Mega-environments were identified using biplot approaches such as AMMI, GGE, and WAASB methodologies for the years 2016 to 2019. The BLUP method revealed a high correlation between grain yield and stability indices ranging from 0.67 to 1.0. Considering all three methods together, the three location pairs Arabhavi-Belavatagi, Bailhongal-Belavatagi, and Hagari-Sirguppa had three occurrences in the same mega-environment with a value of 0.67, and these location combinations consistently produced winning genotypes. Among the common winning genotypes identified, it was G7 during 2016 and 2017 and G10 during 2018 and 2019, based on WAASBY. The likelihood of Arabhavi-Nippani, Hagari-Mudhol, and Dharwad-Hagari occurring in the same mega-environment is minimal because they did not share the same winning genotype, with the exception of a small number of events. Despite being in the same agro-climatic zone, Arabhavi, Hagari, and Mudhol rarely had a winning genotype in common. An agro-climatic zone is grouped based on climatic and soil conditions which doesn’t consider GE interaction of cultivars thus, releasing the cultivars for commercial cultivation considering mega environments pattern would enhance the yield for the given target region.
Understanding challenges to medical and dental student research practices. An insight from a cross-sectional study of the public sector in Pakistan
Authors: Qamar Wajiha
Published: December 2023

Objective

The objective of the study is to identify and comprehend the challenges experienced by the undergraduate medical and dental students in enrolled in public sector in Pakistan while conducting research.

Methodology

A cross-sectional study was carried out from April to June of 2023 among undergraduate students at public sector medical and dental schools in Khyber Pakhtunkhwa, Pakistan. A customized questionnaire was developed to gather information on the challenges faced by students when undertaking research. The survey was circulated online using Google Forms, and participation was entirely optional. Descriptive statistics were used to analyse the responses.

Results

Participants in the study were 58 male and 139 female students who were enrolled in the Bachelor of Medicine & Bachelor of Surgery (MBBS) and Bachelor of Dental Surgery (BDS) programs. The analysis found that 47% of students cited a lack of knowledge and research skills as a major barrier, while 40% cited time restrictions as a major issue. Mentorship and training issues were cited as major barriers by 51% of students, while a lack of institutional support was cited as a significant issue by 53% of students. Language issues made it difficult to produce research papers for 14% of students, while finding research opportunities was challenging for 38% of students.

Conclusion

According to the research, undergraduate medical and dentistry students in the public sector encountered a number of challenges when conducting research. It was suggested that these issues be resolved by include research projects in the curriculum, providing specific interventions for enhancing research skills, establishing mentorship programs, and allocating funds for research activities.
Efficient Nyström-type method for the solution of highly oscillatory Volterra integral equations of the second kind
Authors: Wu Qinghua , Sun Mengjun
Published: December 2023

Highly oscillatory Volterra integral equations are frequently encountered in engineering applications. The Nyström-type method is an important numerical approach for solving such problems. However, there remains scope to further optimize and accelerate the Nyström method. This paper presents a novel Nyström-type method to efficiently approximate solutions to second-kind Volterra integral equations with highly oscillatory kernels. First, the unknown function is interpolated at Chebyshev points. Then the integral equation is solved using the Nyström-type method, which leads to a problem of solving a system of linear equations. A key contribution is the technique to express the fundamental Lagrange polynomial in matrix form. The elements of the matrix, which involves highly oscillatory integrals, are calculated by using the classical Fejér quadrature formula with a dilation technique. The proposed method is more efficient than the one proposed in the recent literature. Numerical examples verify the efficiency and accuracy of the proposed method.
Advancing minimally invasive surgery: A cutting-edge cable-actuated conveying mechanism for reliable tissue transportation
Authors: Kortman Vera Gesina , Verberne Yinte , Jovanova Jovana , Sakes Aimée
Published: December 2023

Introduction

Tissue extraction plays a crucial role in various medical disciplines, with aspiration catheters serving as the prevailing method. Unfortunately, these catheters face limitations such as clogging and dependence on tissue properties and device dimensions. Therefore, there is a pressing need for an improved tissue extraction device that enables efficient and reliable tissue removal during Minimally Invasive Surgery (MIS).

Methods

In this study, we present a novel tissue transport system that utilizes a cylindrical conveyor belt mechanism for reliable tissue transportation. We conducted experiments using a proof-of-principle prototype to explore the influence of tissue elasticity, rotational velocity, instrument orientation, and tissue shape on the transportation rate, efficiency, and reliability. Tissue phantoms with gelatine concentrations of 3, 9, and 12 wt% were employed to simulate a range of Young’s moduli from 1 to 110 kPa.

Results

The mean transportation rates for these phantoms were 7.75±0.48, 8.43±1.50, and 8.90±0.56 g/min, respectively. Notably, all phantoms were transported successfully. The perfect reliability exhibited underscores the potential of our instrument as an alternative to aspiration catheters. CONCLUSION: This research presents a significant step forward in the field of tissue extraction, offering a promising approach for MIS with enhanced efficiency and reliability.
Patient-provider experiences with chronic non-communicable disease care during COVID-19 lockdowns in rural Uganda: A qualitative analysis
Authors: Olds Peter K. , Nuwagaba Gabriel , Obwoya Paul S. , Nuwagira Edwin , Haberer Jessica E. , Okello Samson
Published: December 2023

Non-communicable diseases (NCDs) are a growing health burden in Sub-Saharan Africa and especially Uganda, where they account for over one third of all deaths. During the COVID-19 pandemic, public health control measures such as societal “lockdowns” had a significant impact on longitudinal NCD care though no studies have looked at the lived experience around NCD care during the pandemic. Our objective was to understand the experience of NCD care for both patients and providers in southwestern Uganda during the COVID-19 pandemic. We conducted in-depth, in-person qualitative interviews with 20 patients living with hypertension, diabetes, and/or cardiac disease purposefully selected from the outpatient clinics at Mbarara Regional Referral Hospital and 11 healthcare providers from public health facilities in Mbarara, southwestern Uganda. We analyzed transcripts according to conventional content analysis. We identified four major themes that emerged from the interviews; (1) difficulty accessing medication; (2) food insecurity; (3) barriers to the delivery of NCD clinical care and (4) alternative forms of care. Pre-existing challenges with NCD care were exacerbated during COVID-19 lockdown periods and care was severely disrupted, leading to worsened patient health and even death. The barriers to care were exacerbations of underlying systemic problems with NCD care delivery that require targeted interventions. Future work should leverage digital health interventions, de-centralizing NCD care, improving follow-up, providing social supports to NCD patients, and rectifying supply chain issues.
Physiological and clinical effects of low-intensity blood-flow restricted resistance exercise compared to standard rehabilitation in adults with knee osteoarthritis–Protocol for a randomized controlled trial
Authors: Sørensen Brian , Aagaard Per , Hjortshøj Mikkel H. , Hansen Sofie K. , Suetta Charlotte , Couppé Christian , Magnusson S. Peter , Johannsen Finn E.
Published: December 2023

Introduction

Osteoarthritis (OA) is a common disease with high socioeconomical costs. In Denmark, standard rehabilitation (SR) consists of a combination of patient education and supervised physical exercise involving a standardized neuromuscular training program. As an evidence-based alternative, high–load (>70% 1RM) resistance training (HIRT) has shown positive rehabilitation effects in knee-OA but may not be tolerated in all patients (~25%) due to knee joint pain. However, low-load resistance training (20–40% 1RM) with concurrent partial blood-flow restriction (BFR) appears to produce effects similar to HIRT yet involving reduced joint pain during and after exercise.

The aim is to examine the effect of low-load BFR training compared to SR on pain, thigh muscle mass and muscle function in adults with knee-OA. We hypothesize that 12 weeks of BFR will lead to superior improvements in pain, muscle mass and mechanical muscle function compared to SR.

Methods and analysis

90 participants diagnosed with radiographic knee-OA will be randomized to either BFR or SR twice a week for 12 weeks. BFR will consist of two selected lower limb strength exercises performed with an inflated pneumatic occlusion cuff. Intervention procedures in SR consist of a full 8 weeks GLA:D course followed by 4 weeks of team group training.

Primary outcome variable is the change in KOOS-Pain subscale from baseline to 12 weeks. Secondary outcome variables are changes in pain sensitivity, functional performance, muscle mass and mechanical muscle function.

Intention-to-treat and per-protocol analyses will be conducted. One-way analysis of variance will be performed to evaluate between-group changes. Pre-to-post intervention comparisons will be analyzed using a mixed linear model. Regression analysis will be performed to evaluate potential associations between selected outcome variables.
Business forecasting methods: Impressive advances, lagging implementation
Authors: Goodwin Paul , Hoover Jim , Makridakis Spyros , Petropoulos Fotios , Tashman Len
Published: December 2023

Reliable forecasts are key to decisions in areas ranging from supply chain management to capacity planning in service industries. It is encouraging then that recent decades have seen dramatic advances in forecasting methods which have the potential to significantly increase forecast accuracy and improve operational and financial performance. However, despite their benefits, we have evidence that many organizations have failed to take up systematic forecasting methods. In this paper, we provide an overview of recent advances in forecasting and then use a combination of survey data and in-depth semi-structured interviews with forecasters to investigate reasons for the low rate of adoption. Finally, we identify pathways that could lead to the greater and more widespread use of systematic forecasting methods.
Contraceptive use by number of living children in Ghana: Evidence from the 2017 maternal health survey
Authors: Compton Sarah , Nakua Emmanuel , Moyer Cheryl , Dzomeku Veronica , Treleaven Emily , Otupiri Easmon , Lori Jody
Published: December 2023

Background

There is a significant literature describing the link between parity and contraceptive use. However, there is limited knowledge about the disaggregation by parity of the type of contraceptives. In this study, we describe the use of contraceptives by parity among women of reproductive age in Ghana, focusing on use of highly effective methods (injection, pill, intrauterine device, implant, and sterilization).

Methods

Using the 2017 Ghana Maternal Health Survey, a nationally-representative cross-sectional household survey, we describe contraceptive method use by number of living children among sexually active women of reproductive age. We then estimated predictors of use of highly effective contraception in a multilevel logistic regression model.

Results

Most women in this survey are not using any method of contraception, although this varies by whether or not they have begun childbearing. Contraceptive method use varies by number of living children. Before having children, natural (periodic abstinence and withdrawal) and episodic (condoms) methods dominate. Once a woman has one living child, method preference changes to injectables and implants. Factors associated with using a highly effective method of contraception are: having >3 children, being in a relationship, having had an abortion, being younger than age 30, and having had sexual intercourse within days of answering the survey (p < .001 for all).

Conclusion

In this analysis, the number of living children a woman has, her age, and timing of last intercourse are the most significant predictors of using a highly effective method of contraception. However, the majority of participants in this study report not using any method of contraception to avoid unwanted pregnancies. Future research that attempts to unpack the disconnect between not wanting to become pregnant and not using contraception is warranted.
Evaluation of PPP-ABS investment environment based on combined weighting of level difference maximization and TOPSIS method
Authors: Zhang Lijun , Feng Junwen , Feng Bo
Published: December 2023

Asset-backed securitization (ABS) is currently used to refinance public-private partnership (PPP) projects in the infrastructure field. To stimulate the investors’ enthusiasm, this study evaluated the investment environment of PPP projects asset-backed securitization (PPP-ABS). Firstly, we established a PPP-ABS investment environment evaluation indicator system based on the literature review and the practice of PPP-ABS. Then, the optimal weights of each indicator were determined by the combined weighting of level difference maximization method, where the subjective weights were determined by the AHP method, and the objective weights were determined by the entropy method. Finally, we evaluated the PPP-ABS investment environment from 2015 to 2022 with the technique for order preference by similarity to ideal solution (TOPSIS) method. The final valuation results are consistent with the actual situation. The results showed that the PPP-ABS investment environment exhibits a stable and upward trend. Under the overall guidance of the government, the approval process, information disclosure and supervisory systems have continued to improve, the number of ABS products issued has continued to grow, and the overall market risk is controllable. However, some problems still need to be solved and improved, including inadequate accounting and tax systems, insufficient liquidity in the secondary market, and the recovery of economic development in the post-COVID-19 era. This study fills the research gap in PPP-ABS. It proves the rationality and feasibility of PPP-ABS and is expected to provide a reference for investors’ decision-making and promote the sustainable and healthy development of PPP-ABS.
Deciphering the immune landscape of head and neck squamous cell carcinoma: A single-cell transcriptomic analysis of regulatory T cell responses to PD-1 blockade therapy
Authors: Miraki Feriz Adib , Bahraini Fatemeh , Khosrojerdi Arezou , Azarkar Setareh , Sajjadi Seyed Mehdi , HosseiniGol Edris , Honardoost Mohammad Amin , Saghafi Samira , Silvestris Nicola , Leone Patrizia , Safarpour Hossein , Racanelli Vito
Published: December 2023

Immunotherapy is changing the Head and Neck Squamous Cell Carcinoma (HNSCC) landscape and improving outcomes for patients with recurrent or metastatic HNSCC. A deeper understanding of the tumor microenvironment (TME) is required in light of the limitations of patients’ responses to immunotherapy. Here, we aimed to examine how Nivolumab affects infiltrating Tregs in the HNSCC TME. We used single-cell RNA sequencing data from eight tissues isolated from four HNSCC donors before and after Nivolumab treatment. Interestingly, the study found that Treg counts and suppressive activity increased following Nivolumab therapy. We also discovered that changes in the CD44-SSP1 axis, NKG2C/D-HLA-E axis, and KRAS signaling may have contributed to the increase in Treg numbers. Furthermore, our study suggests that decreasing the activity of the KRAS and Notch signaling pathways, and increasing FOXP3, CTLA-4, LAG-3, and GZMA expression, may be mechanisms that enhance the killing and suppressive capacity of Tregs. Additionally, the result of pseudo-temporal analysis of the HNSCC TME indicated that after Nivolumab therapy, the expression of certain inhibitory immune checkpoints including TIGIT, ENTPD1, and CD276 and LY9, were decreased in Tregs, while LAG-3 showed an increased expression level. The study also found that Tregs had a dense communication network with cluster two, and that certain ligand-receptor pairs, including SPP1/CD44, HLA-E/KLRC2, HLA-E/KLRK1, ANXA1/FPR3, and CXCL9/FCGR2A, had notable changes after the therapy. These changes in gene expression and cell interactions may have implications for the role of Tregs in the TME and in response to Nivolumab therapy.
Espektro zabaleko antigorputzen rola GIBaren aurkako terapian eta prebentzioan
Authors: Apellániz Beatriz , Insausti Sara
Published: December 2023

Terapia antirretrobiral konbinatuaren erabilera iraultza bat izan zen GIBaren infekzioaren tratamenduan eta prebentzioan. Hala ere, terapia hau ez da gai birusa organismotik erabat ezabatzeko, eta GIB infekzio kasu berrien munduko tasak mantso jaisten jarraitu du. Beraz, GIBaren prebentzio eta tratamendurako ikuspegi berriak aztertzeko beharra dago. Antigorputzak GIBaren aurkako aukera terapeutiko gisa proposatuak izan dira, epitopo biralak blokeatzeaz gain ostalariaren immunitate sistemarekin elkar ekiteko gaitasuna dutelako. Azken urteotan, GIBaren fusio proteinaren eskualde desberdinak ezagutzen dituzten espektro zabaleko zenbait antigorputz neutralizatzaile (bnAb) saio klinikoetan ebaluatuak izan dira. Lan honetan, GIBaren testuinguruan bnAb-ek eskaintzen dituzten aukerak eta beren garapen klinikoan ager daitezkeen oztopoak aztertuko dira.
The landscape of integrative pluralism
Authors: Mitchell Sandra D.
Published: December 2023

In this essay, I revisit and extend my arguments for a view of science that is pluralistic, perspectival and pragmatist. I attempt to resolve mismatches between metaphysical assumptions, epistemological desiderata, and scientific practice. I consider long-held views about unity of science and reductionism, emergent properties and physicalism, exceptionless necessity in explanatory laws, and in the justification for realism. My solutions appeal to the partiality of representation, the perspectivism of theories and data, and the interactive co-construction of warranted claims for realism.