bluuebunny/crossref_metadata_2025 huggingface dataset:
Retrospective evaluation of the predictive value of tumour burden at baseline [68 Ga]Ga-DOTA-TOC or -TATE PET/CT and tumour dosimetry in GEP-NET patients treated with PRRT
Authors: Gålne Anni , Sundlöv Anna , Enqvist Olof , Sjögreen Gleisner Katarina , Larsson Erik , Trägårdh Elin
Published: August 2024

Purpose

There is a lack of validated imaging biomarkers for prediction of response to peptide receptor radionuclide therapy (PRRT). The primary objective was to evaluate if tumour burden at baseline PET/CT could predict treatment outcomes to PRRT with [177Lu]Lu-DOTA-TATE. Secondary objectives were to evaluate if there was a correlation between tumour burden and mean tumour absorbed dose (AD) during first cycle, and if mean tumour AD or the relative change of tumour burden at first follow-up PET/CT could predict progression free survival (PFS) or overall survival (OS).

Methods

Patients with gastroenteropancreatic neuroendocrine tumour (GEP-NET) treated with [177Lu]Lu-DOTA-TATE PRRT were retrospectively included. Tumour burden was quantified from [68 Ga]Ga-DOTA-TOC/TATE PET/CT-images at baseline and first follow-up and expressed as; whole-body somatostatin receptor expressing tumour volume (SRETVwb), total lesion somatostatin receptor expression (TLSREwb), largest tumour lesion diameter and highest SUVmax. The relative change of tumour burden was evaluated in three categories. Mean tumour AD was estimated from the first cycle of PRRT. PFS was defined as time from start of PRRT to radiological or clinical progression. OS was evaluated as time to death. Kaplan Meier survival curves and log-rank test were used to compare PFS and OS between different groups.

Results

Thirty-one patients had a baseline PET/CT < 6 months before treatment and 25 had a follow-up examination. Median tumour burden was 132 ml (IQR 61–302) at baseline and 71 ml (IQR 36–278) at follow-up. Twenty-two patients had disease progression (median time to progression 17.2 months) and 9 patients had no disease progression (median follow-up 28.7 months). SRETVwb dichotomized by the median at baseline was not associated with longer PFS (p = 0.861) or OS (p = 0.937). Neither TLSREwb, largest tumour lesion or SUVmax showed significant predictive value. There was a moderately strong correlation, however, between SUVmax and mean tumour AD r = 0.705, p < 0.001, but no significant correlation between SRETVwb nor TLSREwb and mean tumour AD. An increase of SRETVwb, TLSREwb or largest tumour lesion at first follow-up PET/CT was significantly correlated with shorter PFS/OS.

Conclusion

Tumour burden at baseline showed no predictive value of PFS/OS after PRRT in this small retrospective study. An increase of tumour burden was predictive of worse outcome.
Assessment and analysis of polydimethylsiloxane-coated solar photovoltaic panels for cost-efficient solutions
Authors: Ali Mohd Syukri , Awalin Lilik Jamilatul , Abdul Jaafar Amirul Syafiq , Omar Azimah , Abu Bakar Ab Halim , Abd Rahim Nasrudin , Abd Halim Syahirah
Published: August 2024

Solar photovoltaic (PV) is a crucial renewable energy source in the fight against carbon dioxide emissions, aligning well with growing energy demands. However, solar PV efficiency naturally degrades over time, primarily due to uncontrollable outdoor factors such as irradiance, humidity, shading, soiling, aging, and temperature. These collectively lead to decreased efficiency in PV systems. Soiling on PV glass surfaces significantly impacts light penetration and subsequently reduces power generation. To combat this, a self-cleaning nano-calcium carbonate coating has been proposed. The effectiveness of this method is compared with a developed solar PV thermal (PV/T) system, evaluating both performance and cost-effectiveness. After six months of outdoor exposure, the coated glass solar PV achieved an efficiency of 7.6%, surpassing bare glass solar PV at 6.0%. Moreover, the coated glass solution boasts exceptional cost-effectiveness, incurring only an annual expense of 17.6 USD per panel compared to the PV/T system of 59.8 USD per panel. These findings highlight the potential of coatings to enhance solar PV performance and economics, particularly in addressing challenging uncontrollable factors like soiling.
Mathematical modeling of the effects of thickness and temperature on thin-layer drying kinetics of oven-dried cooking bananas (Musa spp., sub. grp. ABB) slices
Authors: Chigbo Kenechukwu Sixtus , Linus-Chibuezeh Adindu , Moufunanya Umunna Francis , Adindu-Linus Chidiamara Onyinyechi , Adepoju Feyisayo O. , Eke Akachukwu Ben , Okechukwu Queency N.
Published: August 2024

Cooking bananas is a major beneficial food in developing countries that is involved in improving human well-being and health. However, owing to its high moisture content, it quickly deteriorates. Understanding the dehydration mechanism of raw banana slices is important for subsequent processing, preservation, transportation, and product quality. Thus, this study investigates the influence of slice thickness (5, 10, and 15 mm) at varying temperatures (45, 55, and 65 °C) in a convective oven dryer on thin-layer drying kinetics and extrapolates their effect on the drying kinetics of cooking banana slices. As the temperature and slice thickness increased, the drying time also increased. Midilli’s model was found to be the best for explaining the experimental data. The effective moisture diffusivity ranged from 1.393 × 10 −8 to 8.889 10 −8 m2/s. The dependence of moisture diffusivity on temperature was described by an Arrhenius-type equation, and the activation energies were found to be 23.599, 24.804, and 24.223 kJ/mol for thicknesses of 5, 10, and 15 mm, respectively.
Engagement and retention in digital mental health interventions: a narrative review
Authors: Boucher Eliane M. , Raiker Joseph S.
Published: August 2024

Background

While many digital mental health interventions (DMHIs) have been shown to be effective, such interventions also have been criticized for poor engagement and retention rates. However, several questions remain about how users engage with DMHIs, how to define engagement, and what factors might help improve DMHI engagement.

Main abstract

In this narrative review, we show that although DMHIs are criticized for poor engagement, research suggests engagement rates are quite variable across studies and DMHIs. In some instances, engagement rates are high, even in real-world settings where there is evidence of a subset of users who could be considered ‘superusers’. We then review research on the barriers and facilitators to DMHI engagement, highlighting that qualitative research of users’ perceptions does not always align with quantitative research assessing relationships between these barriers/facilitators and actual engagement with DMHIs. We also introduce several potential issues in conceptualizations of DMHI engagement that may explain the mixed findings, including inconsistent definitions of engagement and assumptions about linear relationships between engagement and outcomes. Finally, we outline evidence suggesting that engagement with DMHIs is comparable to mobile application use broadly as well as engagement with more traditional forms of mental health care (i.e., pharmacological, psychotherapy).

Conclusions

In order to increase the number of people who can benefit from DMHIs, additional research on engagement and retention is necessary. Importantly, we believe it is critical that this research move away from several existing misconceptions about DMHI engagement. We make three recommendations for research on DMHI engagement that we believe, if addressed, are likely to substantially improve the impact of DMHIs: (1) the need to adopt a clearly defined, common definition of engagement, (2) the importance of exploring patterns of optimal engagement rather than taking a ‘one size fits all’ approach, and (3) the importance of defining success within DMHIs based on outcomes rather than the frequency or duration of a user’s engagement with that DMHI.
Association Between Antidepressants and Antianxiety Medications and Weight Gain in Korean Adults Aged 19 to 39 Years
Authors: Huh Youn , Kim Hae-Rim , Park Hye Soon
Published: August 2024

Context

The number of young Koreans using antidepressants and antianxiety medications is increasing.

Objective

Studies evaluating the association between these medications and weight gain are limited. We investigated this association among Korean young adults.

Methods

We included 792 022 participants aged 19 to 39 years who underwent Korean National Health Insurance Service health examinations more than twice between 2009 and 2019. Multivariable logistic regression analysis was performed to evaluate the association between antidepressants and antianxiety medications and weight gain.

Results

The participants’ average age and body mass index were 29.4 ± 4.7 years and 23.0 ± 3.6, respectively. The proportions of weight gain of 10 kg/year or more were 1.7%; 2.4%; 2.9%; and 4.1% in individuals using neither antidepressants nor antianxiety medications; only antianxiety medications; only antidepressants; and both antidepressants and antianxiety medications, respectively. Compared with individuals using neither antidepressants nor antianxiety medications, the rate ratios (95% CI) for weight gain of 10 kg/year or more were higher in those using only antianxiety medications; only antidepressants; and both antidepressants and antianxiety medications; at 1.77 (1.69-1.85); 2.15 (2.05-2.0); and 3.04 (2.91-3.18), respectively.

Conclusion

Using antidepressants and antianxiety medications may contribute to an increased risk of weight gain among Korean young adults. The potential risk for weight gain should be considered when those medications are used and the prevention of weight gain is needed.
Adiponectin and Adiponectin Receptors in Atherosclerosis
Authors: Gianopoulos Ioanna , Mantzoros Christos S , Daskalopoulou Stella S
Published: August 2024

Adiponectin is an abundantly secreted hormone that communicates information between the adipose tissue, and the immune and cardiovascular systems. In metabolically healthy individuals, adiponectin is usually found at high levels and helps improve insulin responsiveness of peripheral tissues, glucose tolerance, and fatty acid oxidation. Beyond its metabolic functions in insulin-sensitive tissues, adiponectin plays a prominent role in attenuating the development of atherosclerotic plaques, partially through regulating macrophage-mediated responses. In this context, adiponectin binds to its receptors, adiponectin receptor 1 (AdipoR1) and AdipoR2 on the cell surface of macrophages to activate a downstream signaling cascade and induce specific atheroprotective functions. Notably, macrophages modulate the stability of the plaque through their ability to switch between proinflammatory responders, and anti-inflammatory proresolving mediators. Traditionally, the extremes of the macrophage polarization spectrum span from M1 proinflammatory and M2 anti-inflammatory phenotypes. Previous evidence has demonstrated that the adiponectin-AdipoR pathway influences M1-M2 macrophage polarization; adiponectin promotes a shift toward an M2-like state, whereas AdipoR1- and AdipoR2-specific contributions are more nuanced. To explore these concepts in depth, we discuss in this review the effect of adiponectin and AdipoR1/R2 on 1) metabolic and immune responses, and 2) M1-M2 macrophage polarization, including their ability to attenuate atherosclerotic plaque inflammation, and their potential as therapeutic targets for clinical applications.
Incidence of High Risk and Malignant Pathological Findings in Transgender and Gender Diverse Individuals Undergoing Gender-Affirming Mastectomy
Authors: McCaffrey Rachel L. , James Andrew J. , Torres-Guzman Ricardo A. , Addae Jamin K. , Sullivan Lauren E. , Dash Elianna , Slutsky Hanna , Finer Zoe R. , Assi Patrick E. , Al-Kassis Salam
Published: August 2024

Background

Concrete, data-driven guidelines for breast cancer screening among the transgender and gender diverse (TGD) population is lacking. The present study evaluates possible associations of gender-affirming hormone therapy (GAHT) on incidental breast pathology findings in trans-masculine patients to inform decision making about breast cancer screening.

Patients and Methods

This was a retrospective cohort study of patients who had gender-affirming mastectomy or breast reduction at a single center from July 2019 to February 2024. A total of 865 patients met the inclusion criteria. Gender-affirming testosterone therapy and length of exposure were evaluated to seek differences in post-operative pathology findings.

Results

The median age at the time of surgery was 27 years [interquartile range (IQR) 21–30]. Most participants identified as female to male (658, 75.6%). A significant portion of the participants (688, 79.2%) were undergoing testosterone therapy at the time of surgery, with the median duration of testosterone use prior to surgery being 14 months (IQR 4–29). High risk or malignant findings were noted in pathology results for 12 of 1730 breasts (0.7%). Ordered logistic regression found that duration of testosterone therapy was not associated with increasing severity of incidental breast pathology. Additionally, patients under 25 years of age were 70% less likely to have any incidental finding on pathological evaluation than older patients [odds ratio (OR) 0.3, p < 0.01, confidence interval (CI) 0.18–0.50].

Conclusions

The present study found that patients undergoing GAHT should not be screened for breast cancer with increased frequency compared with cis-gender women. Additionally, it may be appropriate for trans women under the age of 25 with normal breast cancer risk to forego pathological breast tissue examination.
Understanding the metabolic signatures of haematological cancers through an integrative multi-Omics approach
Authors: Παπατζήκας Γρηγόριος
Published: August 2024

Οι αιματολογικοί καρκίνοι είναι ετερογενείς ασθένειες που προκαλούνται από μια σειρά γεγονότων, οδηγώντας τα κύτταρα σε ανεξέλεγκτο πολλαπλασιασμό. Σήμερα, κατανοούμε ότι ένα από τα χαρακτηριστικά των καρκινικών κυττάρων είναι ο επανα-προγραμματισμός του φυσιολογικού κυτταρικού μεταβολισμού τους, ώστε να διατηρήσουν τις αναβολικές ανάγκες για συνεχή ανάπτυξη και πολλαπλασιασμό. Ωστόσο, παρά την αξιοσημείωτη πρόοδο στην κατανόηση του μεταβολισμού των καρκινικών κυττάρων, οι ακριβείς μηχανισμοί πίσω από τον μεταβολικό επανα-προγραμματισμό τους δεν είναι ακόμη πλήρως κατανοητοί. Η εργασία που παρουσιάζεται σε αυτή τη διατριβή στοχεύει να παράσχει νέες βιολογικές γνώσεις σχετικά με τον μεταβολικό επανα-προγραμματισμό των αιματολογικών καρκίνων και να αναδείξει πιθανούς μεταβολικούς στόχους για μελλοντικές θεραπευτικές παρεμβάσεις. Για το σκοπό αυτό επιλέχθηκε μια προσέγγιση ενοποίησης δεδομένων πολλαπλών Ομικών τεχνολογιών. Εφαρμόστηκαν πρόσφατες υπολογιστικές μεθοδολογίες για την ενοποίηση και ανάλυση μεταγραφικών και μεταβολικών δεδομένων που προέρχονται από δείγματα ασθενών με αιματολογικούς καρκίνους, καθώς και αυτά κυτταρικών σειρών.
Therapeutics Dataset from COVID-19 Medicine Delivery Units in England: an OpenSAFELY Data Report
Authors: Nab Linda , Green Amelia , Higgins Rose , Zheng Bang , Schultze Anna , Tazare John , Mahalingasivam Viyaasan , Inglesby Peter , Davy Simon , Smith Rebecca , Mehrkar Amir , Bates Christopher , Cockburn Jonathan , Marks Michael , Brown Michael , Wiedemann Milan , Walker Alex , Douglas Ian , Goldacre Ben , MacKenna Brian , Tomlinson Laurie , Curtis Helen
Published: August 2024

Background Between December 2021 and June 2023, COVID-19 medicine delivery units (CMDUs) in England offered antiviral medicines and neutralising monoclonal antibodies to non-hospitalised individuals with COVID-19, identified at high risk of developing severe outcomes. In order to prescribe and supply medicines CMDUs were required to notify NHS England of every prescription via an electronic form. This data was supplied to OpenSAFELY, a secure analytics platform for electronic patient records, as the COVID-19 “Therapeutics” dataset. We aimed to explore the analytic potential of the dataset for research into the use and effectiveness of these therapeutics offered by CMDUs. Methods Working on behalf of NHS England, we assessed the content and data quality of the COVID-19 Therapeutics dataset within OpenSAFELY. We focused on therapeutics provided in outpatient settings by CMDUs. We described for each field the: data format, completeness and summarised its content. Results The COVID-19 Therapeutics dataset contained 18 columns and 58,590 rows of data, for 54,435 distinct patient IDs (92.9%) treated in outpatient settings. The dataset was well-structured, with completeness of almost all fields of 100%. The dataset included details on the specific treatment received, date administered, high-risk group(s) to which the patient belonged and the region in which they were assessed. The values were largely plausible. Conclusion The COVID-19 Therapeutics dataset is well-structured, complete, and is suitable for research. The dataset is made available for all researchers in OpenSAFELY where it is linked to other data sources (e.g., primary care), enabling important research.
The genome sequence of a segmented worm, Terebella lapidaria Linnaeus, 1767
Authors: Darbyshire Teresa , Adkins Patrick , Holmes Anna , Bishop John , Mieszkowska Nova ,   Marine Biological Association Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: August 2024

We present a genome assembly from an individual Terebella lapidaria (segmented worm; Annelida; Polychaeta; Terebellida; Terebellidae). The genome sequence spans 765.20 megabases. Most of the assembly is scaffolded into 16 chromosomal pseudomolecules. The mitochondrial genome has also been assembled and is 15.97 kilobases in length.
The genome sequence of a leaf beetle, Chrysolina haemoptera (Linnaeus, 1758)
Authors: Levey Brian ,   Natural History Museum Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: August 2024

We present a genome assembly from a female leaf beetle, Chrysolina haemoptera (Arthropoda; Insecta; Coleoptera; Chrysomelidae). The total length of the genome sequence is 718.30 megabases. Most of the assembly is scaffolded into 20 chromosomal pseudomolecules, including the X sex chromosome. The mitochondrial genome has also been assembled and is 17.87 kilobases long. Gene annotation of this assembly on Ensembl identified 12,298 protein-coding genes.
“with my love”: the colonial legacy of racialized pedophilic pornography in the atlantic world
Authors: Patton Stacey
Published: August 2024

This essay provides a critical analysis of early-20th-century American postcards, focusing on the portrayal of black and white children as an aesthetic tool of white supremacy and pedophilic racist pleasures. These representations not only reflected but also perpetuated colonial ideologies and racial stereotypes, directly influencing educational practices and policies, and contributing to a social environment where discrimination and sexualization of children was normalized. The article begins with the contrast in the depiction of white and black children, revealing a pattern in which white children were often fetishized as embodiments of innocence and purity, while black children were subjected to pornified portrayals that reinforced negative stereotypes and sought to ensure the continued intergenerational subjugation of African Americans in the afterlife of slavery. A significant aspect of this analysis delves into the role of the zealous purity crusader Anthony Comstock in shaping societal views on childhood innocence and obscenity during the Progressive Era. As a U.S. postal inspector, Comstock wielded influence over public discourse and policy, particularly through his campaigns against the distribution of what he considered morally objectionable representations. This examination extends to the racial implications of Comstock’s adult-centric actions, exploring how they contributed to the differential treatment of black and white children in both media representations and broader societal contexts. The article argues that these images were not merely passive reflections of societal beliefs; rather, they were active tools used to shape and influence the educational and socialization processes of children, and they contributed to the perpetuation of Jim Crow violence, which was manifested through the sexual assault, castration, and lynching of black youth. Furthermore, this essay examines the broader socio-historical context in which racist and pedophilic images were produced and circulated. These postcards are still trafficked today under the false designation of ‘Black Memorabilia,’ reaching significant prices as vintage collector’s items, but the article reframes them as a genre of child pornography. This perspective critically challenges prevailing narratives that may sanitize or downplay the exploitative and violent nature of these images. This essay urges a reconsideration of these consumer items’ historical significance as instruments intricately complicit in sustaining colonial structures and ideologies surrounding childhood innocence in North America. Within this analytical framework, the dehumanization of black children through pedophilic pornography reflects a long heritage of anti-child violence in Western traditions and the colonial strategy of exploiting children of color as a lucrative mechanism for profit and libidinal pleasure.
Prevalence, contributing factors and consequences of workplace bullying against nurse managers
Authors: Aly Nagah Abd El-Fattah Mohamed , El-Shanawany Safaa M , Ghanem Maha , Fayad Elham Abd El Kader , Lotfy Wael M
Published: August 2024

Background/Aims

Research has indicated a high prevalence of bullying among nurses, but there has been limited research into bullying among nurse managers. This study aimed to identify prevalence and consequences of workplace bullying, as well as the environmental factors that can contribute to this behaviour, towards nurse managers.

Methods

A descriptive correlational study was conducted with 135 nurse managers. Data were collected using a self-reported questionnaire, including a workplace bullying scale, authentic leadership scale, workplace culture scale, workplace justice scale, workplace trust scale, job demand and control scales, job satisfaction scale and stress scale. Items were scored using 5-point Likert scales. Data were analysed using the SPSS version 15, with Spearman's rho correlation and logistic regression analyses performed to identify relationships between variables.

Results

Participants reported a high prevalence of workplace bullying from staff nurses, leaders and other colleagues (64.7%). Factors that contributed to this behaviour included ineffective leadership, high workload, low job control, injustice, distrust in the organisation and weak organisational culture. Stress and dissatisfaction were identified as consequences of bullying.

Conclusions

High rates of bullying against nurse managers may lead to adverse consequences, including stress and job dissatisfaction. Healthcare managers and leaders need to target environmental factors that could reduce the incidence of workplace bullying, such as strong authentic leadership, organizational culture and job demand.
Increasing the number of adults on a palliative care end‑of‑life register: a quality improvement project
Authors: Lawrence Emma , Massey Alison , Whatley Vanessa , Nicholls Lynn , Hay Fiona , Willis Derek
Published: August 2024

Background/Aims

Identifying patients at the end of life can facilitate easier access to support and reduce unnecessary emergency care admissions. This study aimed to increase the number of adults on the palliative and end-of-life care register by at least 10% in 20% of primary care practices in an English integrated care system.

Methods

A quality improvement project was carried out, using the Model for Improvement, with plan-do-study-act cycles. A hospice within a UK integrated care system added standard wording and system codes to letters sent to patients’ primary care provider. The number of patients on the palliative and end-of-life care register was monitored monthly between September 2022 and April 2023.

Results

By the end of the study period, the number of patients on the palliative and end-of-life care register had increased by >10% in 20% of practices.

Conclusions

Adding a recommendation to add a patient to palliative and end-of-life care registers on letters sent to primary care providers can lead to an increase in the number of patients being identified to be in the last year of their life.
Gestational diabetes: addressing health inequalities and barriers to identification
Authors: Jones Julie Dawn
Published: August 2024

Dr Julie Dawn Jones discusses barriers to the identification of gestational diabetes and how these relate to health inequalities, suggesting that a compassionate, inclusive approach using quality improvement methodologies could help to address these issues.
What can healthcare organisations learn from the global IT outage?
Authors: Clough Isobel
Published: August 2024

Writing in the wake of the 19 July global IT outage, which affected healthcare organisations around the world, the editor considers the multifaceted role of digital systems in modern care services and the importance of protecting them from external risks.
Implications of ratios change
Authors: Hayes Derren
Published: August 2024

The government has announced plans to relax rules on how many children childcare staff can look after
A–Z of prescribing for children
Authors: Davies Kate
Published: August 2024

This series focuses on aspects of prescribing for neonates, children and young people, from A–Z. Aspects of pharmacokinetics will be considered, alongside legal considerations, consent and medications in schools
“I CAN'T TAKE IT ANYMORE”: THE EXPERIENCE OF BEING MANAGED FOR SUSPECTED CAUDA EQUINA SYNDROME IN THE EMERGENCY DEPARTMENT
Authors: Karia R. , Roberts L.C. , Ryan C.
Published: August 2024

Purpose and background

Cauda equina syndrome (CES) leads to nerve compression in the lumbar spine, and requires immediate treatment to prevent permanent neurological dysfunction, including urinary/anorectal incontinence. The consequences for the patient are significant as, in the decade to 2018, CES has cost the NHS £186,134,049. No study has reported patients’ experiences of being managed with suspected CES in an emergency department (ED), and this study explores patients’ experiences and how the NHS can optimise care for patients experiencing this condition.

Methods and Results

In this qualitative secondary analysis, 14 participants (aged 23–63 years) with suspected CES were purposively sampled from 4 EDs in England. Online, semi-structed interviews were undertaken (in 2021, during the pandemic), and were audio-recorded and transcribed verbatim. Data were managed using a Framework approach and analysed thematically.

Three themes were identified: quality of care; environmental factors; and expectations. The quality of care included managing uncertainty, the importance of communication, appropriate assessment and follow-up care. Environmental factors, including the chairs, waiting times and the busy nature of the ED, negatively impacted patients’ experiences. Furthermore, an expectation gap was identified, as most individuals came to the ED expecting to receive a scan, an accurate diagnosis and a cure. Despite frustrations, patients expressed gratitude towards the ED staff.

Conclusion

This study highlights the importance of empathically acknowledging the patient's pain and providing comprehensive assessments and management plans for people attending ED with suspected CES. Optimising the ED environment to minimise patients’ pain and distress while waiting to access care is paramount and overdue.

No conflicts of interest

 

Sources of funding

Funding for primary data: Health Education England & National Institute of Health and Care Research (ICA-CDRF-2018-04-ST2-040)
“YOU THINK YOU'VE GOT THEM ON BOARD AND THEN THEY'RE BACK”: PRIMARY CARE CLINICIANS’ EXPERIENCES OF OFFERING SELF-MANAGEMENT ADVICE TO PEOPLE WITH BACK PAIN
Authors: Osborn-Jenkins L. , Turnbull J. , Geraghty A.W.A. , Roberts L.C.
Published: August 2024

Purpose and background of the study

Self-management and behaviour change is at the core of back pain management. Despite the high-rate of recurrence and healthcare utilisation, clinical guidelines do not include guidance for clinicians on return consultations. This project aimed to identify primary care clinicians’ reported practices and experiences of delivering self-management advice for people returning with persistent low back pain (LBP), to inform future delivery of self-management care.

Methods and Results

In this qualitative study involving 27 primary care clinicians, four focus groups and two semi-structure interviews were conducted online. GPs (n=5) and physiotherapists working in primary care roles (First contact practitioners n=7, community and interface roles n=7, and mixed roles n=8) in England and Scotland shared their experience of delivering self-management advice to people returning with persistent LBP. Video recordings were transcribed verbatim and analysed with reflexive thematic analysis.

Clinicians unanimously shared their frustrations identifying the challenges involved in supporting people who return with LBP. Helpful strategies to support self-management in return consultations were identified by clinicians in addition to service and system-level changes vital to optimise care. Patient-factors affecting delivery of care, lack of defined responsibility and challenges in meeting patients’ expectations illustrated the tensions that exist in return consultations.

Conclusion

This novel study provides insight into the experiences and practices of the frontline primary care workforce seeing patients return with persistent or recurrent LBP. It identifies the tensions that exist between services, professional roles and between clinicians and patients regarding self-management. Important practice implications have been identified to improve information-sharing, agenda-setting, and exploring expectations.

No conflicts of interest

 

Source of funding

Lisa Osborn-Jenkins is funded by University Hospital Southampton NHS Foundation Trust (UHS) Research & Development PhD Fellowship [GRT0723]
“I JUST WANTED TO GET THE PAIN OUT OF THE WAY”: WHY PEOPLE WITH SIGNS AND SYMPTOMS OF SUSPECTED CAUDA EQUINA SYNDROME ATTEND THE EMERGENCY DEPARTMENT
Authors: Wakefield B. , Roberts L.C. , Ryan C.
Published: August 2024

Purpose and background

Cauda Equina Syndrome (CES), a rare (<1 per 100,000) and potentially devasting condition, involves compression of the lumbosacral nerve roots. If not quickly identified and treated, it can lead to lasting disability, and high medicolegal costs (>£186 million in the decade to 2018). This study identified why people with suspected CES attend the emergency department (ED) and explored any delays in attending.

Methods and Results

The design was a secondary analysis of a qualitative dataset comprising patients with back pain who attended the ED, undertaken using an interpretivist approach. Fourteen patients (8M:6F, aged 23–63 years) with suspected CES were purposively sampled from 4 EDs (2 Northern and 2 Southern) in England between August and December 2021. Semi-structured interviews were conducted online, audio-recorded, transcribed verbatim and analysed thematically.

Acopia with pain was the biggest factor in a participant's decision to attend the ED, along with the need for a diagnosis. This pain was the worst ever experienced and debilitating, leaving people unable to cope and desperate for relief. 12/14 were advised to attend the ED following identification of red flags by: GPs (n=9); physiotherapists (n=2); surgical colleague (n=1); and 111 (n=1). Factors such as guilt, previous experience of being disregarded, and symptom misattribution were seen to cause delays in seeking care.

Conclusion

This paper revealed a disconnect between the priorities of patients and clinicians prior to attending the ED. Clinicians need to validate the pain experience, communicate clearly why signs and symptoms are concerning, and convey the urgency and potential impact of CES.

Conflicts of interest

None

Sources of funding

Funding for primary data: Health Education England & National

Institute of Health and Care Research (ICA-CDRF-2018-04-ST2-040)
Nepal and the Middle East: Nonalignment and Economic Interests
Authors: Bishku Michael B.
Published: August 2024

Abstract: Nepal is a poor, nonaligned, landlocked country surrounded by India and China that has had good relations with both Israel and the Arab states due in large part to a foreign policy conducted on the basis of Panchasheel , composed of five principles: (1) mutual respect for each other’s territorial integrity and sovereignty, (2) noninterference in each other’s internal affairs, (3) respect for mutual equality, (4) nonaggression and peaceful settlements of disputes, and (5) cooperation for mutual benefit. This outlook has also motivated Nepal’s participation in many United Nations peacekeeping operations. Originally the object of a rivalry between Egypt and Israel, Nepal has attracted the attention of a number of other Middle Eastern states, particularly those in the Arab Gulf region, as witnessed by increasing diplomatic interactions and transportation connections with Nepal and/or its officials especially in recent years, while Nepalis provide much-needed labor for many of those same countries. Despite numbers of cases of worker abuse in the Middle East, Nepali laborers there provide remittances essential for families dealing with difficult living conditions in Nepal as well as a source of foreign revenue for that country.
A Quest for the Presence of Financialization in the Global South The Case of India
Authors: Sarkar Kaustav K.
Published: August 2024

Abstract: The globalized world is witnessing increasing dominance of the financialization of the economy and society. A rapidly changing association among finance capitalists, individuals, the economy, geography, and society, with financialization at the center of these relationships, has been observed recently. However, existing research on this subject is primarily concentrated on advanced capitalist economies of the Global North. As global finance is penetrating the Global South as well, there is a necessity to understand the features, nuances, and theoretical debates surrounding financialization in the context of countries from the Global South. A comprehensive review of the literature reveals that studies on financialization exhibit unsettled and inconclusive debates in relation to the genesis, characteristics, causes, and consequences of the phenomenon. In the case of India, it is particularly difficult to establish strong evidence on the financialization of the Indian economy since the macro-evidence of financialization is not robust in comparison to evidence from the developed capitalist economies in the Global North. However, some recent microstudies have cited traces of financialization in microfinance, manufacturing firms, and digital banking in India. This micro-evidence, despite being a sector-specific phenomenon, is crucial to the larger debate on financialization. This article argues that in cases of blurred features of financialization, macro-findings may not be completely reliable or even relevant. A better approach is to collate both macroand micro-data and contextualize the findings in specific contemporary socioeconomic structures.
Staff Perspectives and Organizational Climate Factors Related to Implementation of Food is Medicine Programming in a Federally Qualified Health Center
Authors: Raber Margaret , Brozovich Joseph , Le Thuan , Brown Asyjia , Saenz Tabbie , Caracostis Andrea , Basen-Engquist Karen
Published: August 2024

Abstract: The Food is Medicine (FIM) movement posits that food access and knowledge are key parts of disease prevention and treatment, but little research has explored how FIM programs fit into the organizational context of federally qualified health centers (FQHC). The purpose of this study was to explore the organizational climate and clinic staff perspectives on a FIM program being implemented in an FQHC. We conducted a cross-sectional survey study with clinic staff during the early implementation of a clinicbased FIM program. Clinic staff (n=40) perceived that patient nutrition was a high priority for the clinic, but that support for providing nutrition resources was more limited. We found high willingness and likelihood of using the FIM program services among staff, but some expressed concern regarding staffing and cultural appropriateness of programming. Optimal adoption and use of FIM investments in FQHCs may be supported by integration with existing clinical workflows.
Ethnoracial Differences in Social Determinants of Health and Acute Mental Health Symptoms Among Adults Hospitalized After Emergency Care
Authors: Wright Blanche , Carlson Eve , Barlow M. Rose , Flores Michael W. , Spain David A. , Cook Benjamin Lê
Published: August 2024

Abstract: Research has established relationships between social determinants of health (SDOH) and mental health, with mixed findings on which ethnoracial groups are most vulnerable to deleterious outcomes. The current study examines ethnoracial differences in SDOH and their associations with acute mental health symptoms among patients hospitalized after emergency care. Using data collected in a multi-site study of 1,318 diverse adults admitted to inpatient units, we performed analyses using linear regression models. Findings show that Multiracial/Indigenous and Black adults had significantly higher discrimination and financial stress scores. However, compared with White adults, the positive association between extreme discrimination and acute mental health symptoms was diminished among Latinx (B=–2.3; p=.02) and Black individuals (B=–1.6; p=.05) as was the positive association between financial insecurity and acute mental health symptoms for Black adults (B=–2.3; p=.04). This study provides evidence of differential experiences of SDOH and mental health challenges that may warrant tailored interventions.
Outsourcing Supply Logistics for Health Commodities in Africa
Authors: Tetteh Ebenezer Kwabena
Published: August 2024

Abstract: Outsourcing of health-commodity supplies to third-party logistics providers is one of the ways of reducing costs and/or improving service levels in the public sector. This paper evaluates three forms of outsourcing: full outsourcing of inventory management, partial outsourcing of specific activities, and contingent partial outsourcing of specific logistics activities. It notes that, in Africa, contracting-out supply logistics has mostly taken the form of partial outsourcing of transportation only or storage and transportation of specific health commodities to all or selected geographical regions. Partial outsourcing offers limited benefits since it cannot provide adequate pressures on public-sector logistics to be efficient or maintain uninterrupted supplies in times of catastrophes. Improvements in logistics performance achieved through partial outsourcing should not mask the need for more expansive arrangements that support not only partial outsourcing but also full outsourcing in situations of inefficiency and in times of supply-disruption catastrophe.
Coarticulation: Mutual Transformation in Human and Nonhuman Relations
Authors: Janicka Iwona
Published: August 2024

Abstract: “Representation” and “articulation” are important terms in discussions of multispecies relations. In this article, I propose the term “coarticulation” that describes a process of mutual intelligibility between a human and a nonhuman and of rendering each other capable in new ways. This article argues that the concept of “coarticulation” offers a way to enrich our understanding of our human-nonhuman relations and give ontological consistency to various types of nonhumans that matter to us. It traces the reciprocal imprints that nonhumans and humans make on each other. Not least, it provides an alternative way to think about politics with nonhumans: a politics of cohabitation.
Parallel RSA encryption algorithm based on a ternary optical computer
Authors: Song Kai , Hu Huanyu , Yan Liping , Hou Xinjun , Wei Jingyang
Published: August 2024

The RSA algorithm remains one of the most influential and extensively used public-key encryption algorithms in today’s cryptographic domain. However, the traditional RSA encryption algorithm has several drawbacks, including slow computational speed, high computational cost, and substantial space requirements in practical applications. Consequently, this study amalgamates the characteristics of a ternary optical computer (TOC), including high parallelism, multi-digit precision, and low energy consumption, to research and propose a dual-channel transmission encryption strategy and a parallel rapid RSA encryption algorithm. Leveraging the dual-rotary optical structure of TOC and the simplest most significant digit (MSD) encoding, we implement a fundamental encryption strategy based on TOC. Concurrently, we harness the high-parallelism attributes of TOC to design large-number parallel modular exponentiation modules, enabling the generation of large prime numbers and efficient computation of large integer modular exponentiation operations. This innovation surmounts the drawbacks of traditional RSA algorithms and further enhances the efficiency of the encryption algorithm. Through resource and time analysis of the algorithm, as well as validation through experimental cases, it is evident that the TOC-based parallel rapid RSA encryption algorithm exhibits excellent computational efficiency and time performance. This research optimally exploits TOC’s advantages in handling high parallelism and extensive computational tasks.
Towards improved 3D reconstruction of cystoscopies through real-time feedback for frame reacquisition: erratum
Authors: Eimen Rachel , Pillai Mayaank , Scarpato Kristen R. , Bowden Audrey K.
Published: August 2024

In this erratum, we correct a small error in Fig. 5 of in Biomed. Opt. Express 15, 3394 (2024)10.1364/BOE.523361.
Missing Cone Problem Correction with Deep Learning Based Segmentation
Authors: Gontarz Michał , Krauze Wojciech , Dutta Vibekananda , Kujawińska Małgorzata
Published: August 2024

The missing cone problem comes from limited angle scanning in Holographic Tomography. It causes an object elongation along the optical axis. This paper proposes creating a mask of the object via segmentation of reconstruction.
Raman imaging through a multimode fiber with principal component analysis
Authors: Collard Liam , Kazemzadeh Mohammadrahim , Piscopo Linda , Pisano Filippo , De Vittorio Massimo , Pisanello Ferruccio
Published: August 2024

We evaluate the use of principal component analysis to analyze Raman images made through a multimode fiber using holographic wavefront shaping.
Lensless on-chip super-resolution microscopy based on array illumination and phase recovery algorithm
Authors: Li Yulong , Su Ping
Published: August 2024

We present a lensless on chip microscopy system based on array illumination and a super-resolution reconstruction algorithm based on sub-pixel displacement, the resolution of which breaks through the limitation of pixel size.
Label-free Cell Imaging and Biochemical Analysis Using Multimodal Holographic Tomography
Authors: Huang Chung-Hsuan , Tu Han-Yen , Cheng Chau-Jern
Published: August 2024

We present a label-free multimodal holographic tomography combining three-dimensional refractive index imaging with Raman spectroscopy. Experimental results show cellular tomograms and specific Raman signals of human retinal cells are detected for cellular analysis and diagnosis.
Advances in Computational Label-Free Three-Dimensional Quantitative Phase Imaging Extend Microscopy Beyond Fluorescence
Authors: Pirone Daniele , Bianco Vittorio , Miccio Lisa , Memmolo Pasquale , Psaltis Demetri , Ferraro Pietro
Published: August 2024

Despite advances in QPI-microscopes, their acceptance is hindered by limited specificity compared to fluorescence-microscopy. Efforts worldwide aim to overcome this by developing computational methods for label-free single-cell imaging, bridging QPI and FM for practical use.
Experimental Method to Remove Occlusions in Digital Lensless Holographic Microscopy
Authors: Buitrago-Duque C. , Zapata-Valencia S. , Garcia-Sucerquia J.
Published: August 2024

An experimental method to remove occlusions in digital lensless holographic microscopy is presented. The coordinated addition of a set of in-line holograms produces a composite hologram, whose reconstruction retrieves the sample information without any occlusions.
Optimizing label free circulating tumor cell detection for liquid biopsy in ovarian cancer
Authors: Cavina Beatrice , Giugliano Giusy , Schiavo Michela , Pirone Daniele , Miccio Lisa , Memmolo Pasquale , Porcelli Anna Maria , Perrone Anna Myriam , Gasparre Giuseppe , Ferraro Pietro , Kurelac Ivana
Published: August 2024

Liquid biopsy could be groundbreaking in ovarian cancer (OC), where most patients are still diagnosed at advanced stages. We demonstrate a proof of concept for holographic label free distinction of OC cells from monocytes.
Phase Stabilized Digital Holographic Imaging of Vibrating Objects
Authors: Goodman Matthew A. , Mohan R. Krishna , Babbitt Wm. Randall
Published: August 2024

Range selective Digital Holographic imaging is performed on a vibrating object, where feedback from a lidar subassemply provides real-time phase compensation, which stabilizes the holographic recording of an object moving many wavelengths during sensor integration.
Holography-based Full-field Characterization for Solid Polymer Membranes and Films
Authors: Wang Zhe , Palma Anna , Ferraro Vincenzo , Di Natale Concetta , Vespini Veronica , Graziano Fabiana , Ferranti Francesca , Mari Silvia , Grilli Simonetta , Maffettone Pier Luca , Coppola Sara
Published: August 2024

Space-time digital holography allows expanded fields of view, enhanced contrast, and improved resolution during phase imaging. Here we propose a specialized strategy for achieving characterization and analysis of solid functionalized membrane under spatiotemporal modulation.
Integrating Digital Holographic Microscopy with Data Analysis for Monitoring Lymphocyte Activation in Cellular Immunotherapy
Authors: Mazur Martyna , Baczewska Maria , Laskowska Paulina , Gontarz Michał , Ziemczonok Michał
Published: August 2024

The approach utilizing digital holographic microscopy (DHM) for analysing the status of T cells activation, the important part of CAR T cells immunotherapy, is presented. The preliminary research reveals usability of DHM in this field.
Phase Imaging from X-ray Intensity Images using Transport of Intensity Equation
Authors: Kumar Ram , Nishchal Naveen K.
Published: August 2024

X-ray imaging lacks phase information necessary for better medical diagnosis. We bridge the gap between X-ray imaging and comprehensive 3D visualization by using transport of intensity equation to recover the phase information.
A strategy for hereditary anemia taxonomy through hierarchical intelligent classification scheme in digital holography
Authors: Valentino Marika , Pirone Daniele , Schiavo Michela , Wang Zhe , Memmolo Pasquale , Bianco Vittorio , Miccio Lisa , Ferraro Pietro
Published: August 2024

The phenotyping of hereditary anemias remains a challenge in clinical diagnostics. Digital Holography allows exploiting a bunch of descriptive information of red blood cells that, in tandem with Machine Learning, accurately classify anemia’s type.