bluuebunny/crossref_metadata_2025 huggingface dataset:
Chest compressions superimposed with sustained inflation during neonatal cardiopulmonary resuscitation: are we ready for a clinical trial?
Authors: Koo Jenny , Cheung Po-Yin , Pichler Gerhard , Solevåg Anne Lee , Law Brenda Hiu Yan , Katheria Anup C , Schmölzer Georg M
Published: March 2024

Neonates requiring cardiopulmonary resuscitation (CPR) are at risk of mortality and neurodevelopmental injury. Poor outcomes following the need for chest compressions (CCs) in the delivery room prompt the critical need for improvements in resuscitation strategies. This article explores a technique of CPR which involves CCs with sustained inflation (CC+SI). Unique features of CC+SI include (1) improved tidal volume delivery, (2) passive ventilation during compressions, (3) uninterrupted compressions and (4) improved stability of cerebral blood flow during resuscitation. CC+SI has been shown in animal studies to have improved time to return of spontaneous circulation and reduced mortality without significant increase in markers of inflammation and injury in the lung and brain, compared with standard CPR. The mechanics of CCs, rate of compressions, ventilation strategies and compression-to-ventilation ratios are detailed here. A large randomised controlled trial comparing CC+SI versus the current 3:1 compression-to-ventilation ratio is needed, given the growing evidence of its potential benefits.
The uncommon preoperative diagnosis of a De Garengeot hernia and its more novel laparoscopic treatment
Authors: Sylvester Rochelle , Singh Gautam , Haque Ali
Published: March 2024

This case report involves an elderly woman who presented with a 3-day history of a tender groin swelling on her right side. Her admission bloods were fairly unremarkable, but a preoperative ultrasound impressively confirmed a femoral hernia containing the appendix (De Garengeot hernia) and she underwent emergency laparoscopic hernioplasty with a prosthetic mesh and appendicectomy. The procedure found an incarcerated hernia with a strangulated tip of the appendix that unexpectedly separated upon gentle manipulation and histopathology revealed appendiceal inflammation. There were no complications with the patient’s recovery and she was discharged 2 days after surgery.
Descending necrotising mediastinitis: a rare entity in children
Authors: Marques Davide Lourenço , Rato Catarina , Miguéis António , Miguéis Jorge
Published: March 2024

We present a case of descending necrotising mediastinitis (DNM) originating from a retropharyngeal abscess in a healthy early childhood patient. The patient had a history of fever, odynophagia and refusal to eat, followed by rapid deterioration of the clinical state. Cervicothoracic CT was performed, which revealed a right parapharyngeal abscess, extending to the mediastinum and occupying the retropharyngeal/visceral space, with gaseous content throughout this collection, associated with bilateral pleural effusion, aspects compatible with DNM. She started broad-spectrum antibiotic therapy and transoral drainage of the parapharyngeal and retropharyngeal collections was performed under general anaesthesia. She was admitted to the intensive care unit. The patient showed clinical, analytical and imaging improvement, having been transferred to the ear, nose and throat department, with favourable evolution. Early diagnosis of DNM by cervicothoracic CT and multidisciplinary approaches, including intensive care, broad-spectrum antibiotics and surgical intervention, are crucial to minimise the morbidity and mortality.
Osteoid osteoma presenting with scoliosis: successful resection with endoscopic excision
Authors: Pannu Chaitanya Dev , Hess Michael , Baxter David
Published: March 2024

A young male in his mid-teen years presented with severe back pain for 3 months and was subsequently diagnosed with osteoid osteoma in the left superior articular process of the L4 vertebra. Initial treatment with non-steroidal anti-inflammatory drugs provided temporary relief. Due to concerns about scoliosis progression along with unrelieved pain, a multidisciplinary team recommended endoscopic excision of the osteoid osteoma. The procedure resulted in complete pain relief and an improvement in the scoliosis curve from 22° of Cobb’s angle to 12 degrees at the 8-month follow-up.
Chronic high-dose dimenhydrinate use contributing to early multifactorial cognitive impairment
Authors: Fabiano Nicholas , Dholakia Saumil , Walker Lisa A S , Smith Andrew L
Published: March 2024

Dimenhydrinate is an over-the-counter antihistaminergic medication with anticholinergic properties used to treat nausea or motion sickness worldwide. There is a well-established correlation between the use of anticholinergic medications and dementia, however, it is unclear if a causal role exists. We report a case of minor neurocognitive disorder in a woman in her 40s with several years of high-dose daily dimenhydrinate abuse who subsequently developed significant delusional beliefs. Her clinical presentation was confounded by numerous other factors that could have impacted her cognition, such as a longstanding presumed learning disability, ankylosing spondylitis with adalimumab treatment, extensive cannabis use or potential development of a primary psychotic disorder. Her workup was within normal limits, and she has not responded to first-line antipsychotic medications to date. This case report adds to the growing evidence supporting concerns about potentially irreversible cognitive deficits in chronic misuse of anticholinergic agents, an association previously observed only in the elderly population.
Dizzy spells in pregnancy: successful antenatal removal of a huge left atrial myxoma with mitral valve obstruction
Authors: Shahbuddin Hafridz Murshid Al-wafi , Hussin Siti Aisyah , W Isa W Yus Haniff , Mamat Ahmad Zuhdi , Marzuki Ariffin , Yusof Zurkurnai
Published: March 2024

Diagnosing atrial myxoma in pregnancy is challenging because patients may present with non-specific symptoms that might be overlooked. The timing of non-obstetric operation usually depends on the nature of the disease, after careful consideration of feto-maternal safety, including the use of cardiopulmonary bypass and placental transfer of anaesthetic drug. A woman in her 30s at 18 weeks of pregnancy presented with recurring dizziness. She underwent successful myxoma excision at 20 weeks under general anaesthesia and cardiopulmonary bypass. The 6×5 cm myxoma was histologically confirmed as myxoma. Early detection of atrial myxoma in pregnancy is crucial, and a clinician has to consider the diagnosis of left atrial myxoma with mitral valve obstruction as a cause of severe dizziness. Optimal outcomes require multidisciplinary management. In this case, surgery during the second trimester of pregnancy enabled a full-term pregnancy with the patient’s and foetal well-being and normal postprocedural echocardiography.
Comparison of prior authorization across insurers: cross sectional evidence from Medicare Advantage
Authors: Gupta Ravi , Fein Jay , Newhouse Joseph P , Schwartz Aaron L
Published: March 2024

Objective

To measure and compare the scope of US insurers’ policies for prior authorization (PA), a process by which insurers assess the necessity of planned medical care, and to quantify differences in PA across insurers, physician specialties, and clinical service categories.

Design

Cross sectional analysis.

Setting

PA policies for five insurers serving most of the beneficiaries covered by privately administered Medicare Advantage in the US, 2021, as applied to utilization patterns observed in Medicare Part B.

Participants

30 540 086 beneficiaries in traditional Medicare Part B.

Main outcome measures

Proportions of government administered traditional Medicare Part B spending and utilization that would have required PA according to Medicare Advantage insurer rules.

Results

The insurers required PA for 944 to 2971 of the 14 130 clinical services (median 1899; weighted mean 1429) constituting 17% to 33% of Part B spending (median 28%; weighted mean 23%) and 9% to 41% of Part B utilization (median 22%; weighted mean 18%). 40% of spending ($57bn; £45bn; €53bn) and 48% of service utilization would have required PA by at least one insurer; 12% of spending and 6% of utilization would have required PA by all insurers. 93% of Part B medication spending, or 74% of medication use, would have required PA by at least one Medicare Advantage insurer. For all Medicare Advantage insurers, hematology and oncology drugs represented the largest proportion of PA spending (range 27-34%; median 33%; weighted mean 30%). PA rates varied widely across specialties.

Conclusion

PA policies varied substantially across private insurers in the US. Despite limited consensus, all insurers required PA extensively, particularly for physician administered medications. These findings indicate substantial differences in coverage policies between government administered and privately administered Medicare. The results may inform ongoing efforts to focus PA more effectively on low value services and reduce administrative burdens for clinicians and patients.
Designathons in health research: a global systematic review
Authors: Tieosapjaroen Warittha , Chen Elizabeth , Ritchwood Tiarney , Li Chunyan , Conklin Jamie L , Babatunde Abdulhammed Opeyemi , Ongkeko Arturo M , Nwaozuru Ucheoma , Tucker Joseph D , Castillo Carandang Nina T , Ong Jason J
Published: March 2024

Introduction

A designathon is a three-stage participatory activity informed by design thinking. There is a growing literature on designathons in health. This study synthesised designathons’ effectiveness and implementation-related factors to address health challenges.

Methods

We searched Cochrane Library, Embase, PubMed, Scopus and the ClinicalTrials.gov registry for articles containing primary data on designathons for health from their dates of inception to 29 November 2022. We retrieved additional studies from citation searching and a complementary open call. We synthesised data on designathons’ effectiveness (ie, engagement, outputs and implementation), required resources and implementation-related factors (ie, resources, facilitators, barriers, strengths and limitations). We assessed the risk of bias using a checklist adapted from Joanna Briggs Institute Critical Appraisal tools.

Results

In total, 4973 citations were identified, and 42 studies were included. In total, 26 studies (62%) were from high-income countries. The median number of total participants was 49, divided into a median of 8 teams. The duration of the intensive collaboration phase ranged from 3 hours to 7 days. Common evaluation criteria were feasibility, innovation and impact. Idea and prototype outputs included mobile phone applications, educational programmes and medical devices. Interventions developed from a designathon was estimated to be highly cost-effective. The most common facilitators were interdisciplinary participants and high-quality mentorship. The most common barriers were suboptimal execution of the events, difficulties in balancing interdisciplinary participants across teams and limited support for participants along the process. There were limited data on required resources and further implementation of solutions after designathons.

Conclusion

Given designathons’ adaptability in terms of budget, mode of delivery, type of output and involvement of diverse participants, including end users, designathons can be implemented in a wide range of contexts to address various health issues.

PROSPERO registration number

CRD42023389685.
Effectiveness of Yijinjing exercise in the treatment of early-stage knee osteoarthritis: a randomized controlled trial protocol
Authors: Guo Guangxin , Wang Yihang , Xu Xiruo , Lu Kaiqiu , Zhu Xuanying , Gu Yijia , Yang Guangpu , Yao Fei , Fang Min
Published: March 2024

Introduction

Knee osteoarthritis (KOA) is still a challenging degenerative joint disease with high morbidity and disease burden. Early-stage KOA, the focus of this study, could present a Window of Opportunity to arrest the disease process and reduce the disease burden. Yijinjing exercise is an important part of physical and psychological therapies in Traditional Chinese Exercise and may be an effective treatment. However, there is no clinical efficacy assessment of Yijinjing exercise for patients with early-stage KOA. Therefore, we designed a randomised controlled trial to evaluate the effectiveness of Yijinjing exercise on patients with early-stage KOA.

Methods and analysis

This is a parallel-design, two-arm, analyst assessor-blinded, randomised controlled trial. In total, 60 patients with early-stage KOA will be recruited and randomly assigned to the Yijinjing exercise group (n=30) and health education group (n=30) at a ratio of 1:1, receiving 12 weeks of Yijinjing exercise or health education accordingly. The primary outcome will be measured with the Western Ontario and McMaster Universities Osteoarthritis Index, and the secondary outcomes will include the Visual Analogue Scale, Short-Form 36 Item Health Survey Questionnaire, Beck Depression Inventory, Perceived Stress Scale, Berg Balance Scale, and Gait Analysis for a comprehensive assessment. Outcome measures are collected at baseline, at 12 week ending intervention and at the 12 week, 24 week and 48 week ending follow-up. The primay time point will be 12 weeks postintervention. Adverse events will be recorded for safety assessment.

Ethics and dissemination

This study has been approved by the ethical application of the Shanghai Municipal Hospital of Traditional Chinese Medicine Ethics Committee (2021SHL-KY-78).

Trial registration number

ChiCTR2200065178
Prevalence of metabolic syndrome in patients with inflammatory bowel disease: a systematic review and meta-analysis
Authors: Shen Zhaofeng , Zhang Mengyuan , Liu Yijing , Ge Changchang , Lu Yi , Shen Hong , Zhu Lei
Published: March 2024

Objectives

Patients with inflammatory bowel disease (IBD) may experience comorbidities involving metabolic syndrome (MetS). However, this association remains controversial. Our objective was to estimate the prevalence of MetS in patients with IBD and assess whether MetS is more strongly associated with ulcerative colitis (UC) or Crohn’s disease (CD).

Design

Systematic review and meta-analysis.

Data sources

PubMed, Cochrane Library, Web of Science, EMBASE and MEDLINE were searched from their inception to July 2022.

Eligibility criteria

Observational studies reporting data regarding the rate of comorbid MetS among patients with IBD and published in English.

Data extraction and synthesis

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology reporting guidelines were followed. Pooled prevalence, ORs and 95% CIs were calculated using random-effects models. The Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality checklist were used. Heterogeneity, sensitivity and stratified analyses were performed using R (V.4.2.1).

Results

11 eligible studies involving 2501 patients were included. Of these studies, four reported MetS prevalence separately by IBD phenotype, and only one contained a non-IBD comparison group. Overall, the methodological quality of the included studies was moderate. The pooled prevalence of MetS in IBD was 19.4% (95% CI 15.1% to 23.8%), with a moderate heterogeneity (I2=51.8%, Cochrane Q statistic=12.4, p=0.053). Stratified analyses demonstrated that the aggregate estimate of comorbid MetS was significantly higher in UC than in CD (38.2% vs 13.6%, χ2=4.88, p=0.03). We found a positive association between MetS and UC compared with CD (OR=2.11, 95% CI 1.19 to 3.74, p=0.01). Additionally, four studies identified that higher age was a risk factor associated with the development of MetS.

Conclusions

MetS is not rare in IBD, especially in UC. However, longitudinal studies are needed to further clarify the relationship between IBD and MetS.

PROSPERO registration number

CRD42022346340.
Modifying effect of urban parks on socioeconomic inequalities in diabetes prevalence: a cross-sectional population study of Madrid City, Spain
Authors: Plans-Beriso Elena , Gullon Pedro , Fontan-Vela Mario , Franco Manuel , Perez-Gomez Beatriz , Pollan Marina , Cura-Gonzalez Isabel , Bilal Usama
Published: March 2024

Background

Evidence has shown contradicting results on how the density of urban green spaces may reduce socioeconomic inequalities in type 2 diabetes (equigenic hypothesis). The aim of this study is to test whether socioeconomic inequalities in diabetes prevalence are modified by park density.

Methods

We designed a population-wide cross-sectional study of all adults registered in the primary healthcare centres in the city of Madrid, Spain (n=1 305 050). We obtained georeferenced individual-level data from the Primary Care Electronic Health Records, and census-tract level data on socioeconomic status (SES) and park density. We modelled diabetes prevalence using robust Poisson regression models adjusted by age, country of origin, population density and including an interaction term with park density, stratified by gender. We used this model to estimate the Relative Index of Inequality (RII) at different park density levels.

Findings

We found an overall RII of 2.90 (95% CI 2.78 to 3.02) and 4.50 (95% CI 4.28 to 4.74) in men and women, respectively, meaning that the prevalence of diabetes was three to four and a half times higher in low SES compared with high SES areas. These inequalities were wider in areas with higher park density for both men and women, with a significant interaction only for women (p=0.008).

Interpretation

We found an inverse association between SES and diabetes prevalence in both men and women, with wider inequalities in areas with more parks. Future works should study the mechanisms of these findings, to facilitate the understanding of contextual factors that may mitigate diabetes inequalities.
Redefining treatment expectations: exploring mid- and long-term outcomes of venous sinus stenting in idiopathic intracranial hypertension
Authors: Midtlien Jackson P , Kittel Carol , Klever Lucas A , Kiritsis Nicholas R , Aldridge Jennifer Bernhardt , Fargen Kyle M
Published: March 2024

Background

Venous sinus stenting (VSS) is recognized as a safe and effective intervention for medically-refractory idiopathic intracranial hypertension (IIH). However, its long-term efficacy remains uncertain.

Methods

This retrospective review analyzed a single-center database of adult patients with severe, medically-refractory IIH, who underwent VSS and had minimum 3-month follow-up (FU). Patients were divided into three groups based on post-stenting symptom trajectories: group 1 (sustained improvement without relapse), group 2 (temporary improvement with relapse), and group 3 (no improvement).

Results

Of 178 patients undergoing VSS, the majority were female (94%), with a median opening pressure (OP) of 31 cm H2O and trans-stenosis gradient of 14 mm Hg. Of these, 153 (86%) received transverse sinus (TS) stenting, and 19 (11%) underwent concurrent TS and superior sagittal sinus stenting. At a mean FU of 166 days, 53 patients (30%) showed long-term improvement without relapse (group 1). Symptomatic recurrence was noted in 101 patients (57%; group 2) within a mean FU of 390 days. Despite recurrent headache and tinnitus, the average OP reduction was 9.6 cm H2O on repeat lumbar puncture, with 75% showing papilledema improvement or resolution post-VSS. Only 17% required further surgical intervention.

Conclusions

The most common clinical outcome post-VSS in IIH patients is initial symptomatic improvement followed by symptom recurrence in about 60% at a mean of 274 days, despite a consistent intracranial pressure reduction. These findings can guide physicians in setting realistic expectations with patients regarding VSS outcomes.
Infantile dural arteriovenous fistula: a reconsideration
Authors: Oushy Soliman , Orbach Darren B
Published: March 2024

Background

Infantile-type dural arteriovenous shunts (IDAVS) are rare and heterogeneous vascular lesions, complicating their classification and management. The current tripartite classification of pediatric dural arteriovenous shunts (DAVS) into dural sinus malformation, infantile-type, and adult-type, does not stand up to scrutiny, given the variable presentations of the latter two types in children. We estimate the prevalence of IDAVS and evaluate the long term outcomes after endovascular treatment (EVT).

Methods

A retrospective review of a pediatric cerebrovascular database between 2006 and 2023 was conducted. Clinical and radiographic data were analyzed to evaluate the presentation and long term outcomes of IDAVS.

Results

IDAVS were identified in 8 (0.5%) of 1463 patients, with mean age at diagnosis of 34.7 months; male infants comprised 62.5%. The most common clinical presentations included macrocephaly (37.5%), seizures (25%), and dilated scalp veins (25%). EVT was performed in 87.5% of cases, averaging 5.8 procedures per patient. Radiographic obliteration was observed in 28.6%. Good clinical outcomes (modified Rankin Scale score of ≤2) were achieved in 85.7%. Our findings showcased discrepancies and limitations in the current classification of pediatric DAVS, prompting a re-evaluation.

Conclusion

IDAVS accounted for a small proportion of pediatric cerebrovascular pathologies, with markedly heterogeneous presentations. Stepwise selective embolization was associated with favorable outcomes, and is recommended over an aggressive approach with the goal of complete angiographic obliteration. Our proposed revised classification system bifurcates pediatric DAVS into dural sinus malformations and all other DAVS that are manifest in children, thereby enhancing diagnostic clarity and therapeutic approaches.
Central vein sign and trigeminal lesions of multiple sclerosis visualised by 7T MRI
Authors: Jing Jing , Zhang Zhe , Su Lei , Gao Chenyang , Guo Ai , Liu Xinyao , Wang Huabing , Zhang Xinghu , Liu Yaou , Comi Giancarlo , Waubant Emmanuelle , Shi Fu-Dong , Tian De-Cai
Published: March 2024

Background

Although trigeminal nerve involvement is a characteristic of multiple sclerosis (MS), its prevalence across studies varies greatly due to MRI resolution and cohort selection bias. The mechanism behind the site specificity of trigeminal nerve injury is still unclear. We aim to determine the prevalence of trigeminal nerve involvement in patients with MS in a consecutive 7T brain MRI cohort.

Methods

This observational cohort originates from an ongoing China National Registry of Neuro-Inflammatory Diseases. Inclusion criteria were the following: age 18 years or older, diagnosis of MS according to the 2017 McDonald criteria and no clinical relapse within the preceding 3 months. Each participant underwent 7T MAGNETOM Terra scanner (Siemens, Erlangen, Germany), using a 32-channel phased array coil at Beijing Tiantan Hospital. T1-weighted magnetisation-prepared rapid acquisition gradient echoes, fluid-attenuated inversion recovery (FLAIR) and fluid and white matter suppression images were used to identify lesions. FLAIR* and T2* weighted images were used to identify central vein sign (CVS) within the trigeminal lesions.

Results

120 patients underwent 7T MRI scans between December 2021 and May 2023. 19/120 (15.8%) patients had a total of 45 trigeminal lesions, of which 11/19 (57.9%) were bilateral. The linear lesions extended along the trigeminal nerve, from the root entry zone (REZ) (57.8%, 26/45) to the pontine-medullary nucleus (42.2%, 19/45). 26.9% (7/26) of the lesions in REZ showed a typical central venous sign.

Conclusion

In this 7T MRI cohort, the prevalence of trigeminal nerve involvement was 15.8%. Characteristic CVS was detected in 26.9% of lesions in REZ. This suggests an inflammatory demyelination mechanism of trigeminal nerve involvement in MS.
Comparing ocrelizumab to interferon/glatiramer acetate in people with multiple sclerosis over age 60
Authors: Foong Yi Chao , Merlo Daniel , Gresle Melissa , Buzzard Katherine , Zhong Michael , Yeh Wei Zhen , Jokubaitis Vilija , Monif Mastura , Skibina Olga , Ozakbas, Serkan , Patti Francesco , Grammond Pierre , Amato Maria Pia , Kalincik Tomas , Horakova Dana , Kubala Havrdova Eva , Weinstock-Guttman Bianca , Lechner Scott Jeanette , Boz Cavit , Sa Maria Jose , Butzkueven Helmut , van der Walt Anneke , Zhu Chao
Published: March 2024

Background

Ongoing controversy exists regarding optimal management of disease modifying therapy (DMT) in older people with multiple sclerosis (pwMS). There is concern that the lower relapse rate, combined with a higher risk of DMT-related infections and side effects, may alter the risk-benefit balance in older pwMS. Given the lack of pwMS above age 60 in randomised controlled trials, the comparative efficacy of high-efficacy DMTs such as ocrelizumab has not been shown in older pwMS. We aimed to evaluate the comparative effectiveness of ocrelizumab, a high-efficacy DMT, versus interferon/glatiramer acetate (IFN/GA) in pwMS over the age of 60.

Methods

Using data from MSBase registry, this multicentre cohort study included pwMS above 60 who switched to or started on ocrelizumab or IFN/GA. We analysed relapse and disability outcomes after balancing covariates using an inverse probability treatment weighting (IPTW) method. Propensity scores were obtained based on age, country, disease duration, sex, baseline Expanded Disability Status Scale, prior relapses (all-time, 12 months and 24 months) and prior DMT exposure (overall number and high-efficacy DMTs). After weighting, all covariates were balanced. Primary outcomes were time to first relapse and annualised relapse rate (ARR). Secondary outcomes were 6-month confirmed disability progression (CDP) and confirmed disability improvement (CDI).

Results

A total of 248 participants received ocrelizumab, while 427 received IFN/GA. The IPTW-weighted ARR for ocrelizumab was 0.01 and 0.08 for IFN/GA. The IPTW-weighted ARR ratio was 0.15 (95% CI 0.06 to 0.33, p<0.001) for ocrelizumab compared with IFN/GA. On IPTW-weighted Cox regression models, HR for time to first relapse was 0.13 (95% CI 0.05 to 0.26, p<0.001). The hazard of first relapse was significantly reduced in ocrelizumab users after 5 months compared with IFN/GA users. However, the two groups did not differ in CDP or CDI over 3.57 years.

Conclusion

In older pwMS, ocrelizumab effectively reduced relapses compared with IFN/GA. Overall relapse activity was low. This study adds valuable real-world data for informed DMT decision making with older pwMS. Our study also confirms that there is a treatment benefit in older people with MS, given the existence of a clear differential treatment effect between ocrelizumab and IFN/GA in the over 60 age group.
Video training of nursing home healthcare workers in palliative care
Authors: Lim Yujun , Toh Ezekiel , Tan Laurence , Lee Perry , Low James Alvin Yiew Hock
Published: March 2024

Objectives

The provision of palliative care in nursing homes (NHs) is of paramount importance, a realism underscored by the frailty and medical complexity of the residents. However, palliative care (PC) education tends to be resource-intensive both for educators and healthcare workers (HCWs). The aim of this study was to investigate how PowerFacts, a video animation series that taught basic PC to NH HCWs in Singapore impacted their knowledge, attitudes and confidence.

Methods

A cohort study design was adopted for the study. A total of 264 NH HCWs across 12 NHs in Singapore participated in the study from January 2021 to October 2022. Participants were assessed using a 20-summative multiple-choice question assessment, a 30-item Frommelt Attitude Toward Care of the Dying Scale (FATCOD) and four questions on their confidence level before and after the PowerFacts course.

Results

Paired t-test was performed. Significant changes were noted in the knowledge and confidence score post-intervention. The knowledge score improved significantly from preintervention (12.2±3.5) to post-intervention (15.8±3.4; p<0.01). The confidence score increased significantly from 14.7±2.7 to 16.7±2.2 (p<0.01). However, the FATCOD score did not reveal any significant changes between preintervention and post-intervention results (p>0.05).

Conclusions

PowerFacts has demonstrated its potential as a valuable addition to the array of teaching methods available to NH HCWs. Future studies are required to evaluate the impact of animation on patient care and clinical practice.
Investigating the spatiotemporal dynamics of apple tree phyllosphere bacterial and fungal communities across cultivars in orchards
Authors: Boutin Sophie , Lussier Ema , Laforest-Lapointe Isabelle
Published: March 2024

The phyllosphere, a reservoir of diverse microbial life associated with plant health, harbors microbial communities that are subject to various complex ecological processes acting at multiple scales. In this study, we investigated the determinants of the spatiotemporal variation in bacterial and fungal communities within the apple tree phyllosphere, employing 16S and ITS amplicon sequencing. Our research assessed the impact of key factors—plant compartment, site, time, and cultivar—on the composition and diversity of leaf and flower microbial communities. Our analyses, based on samples collected from three cultivars in three orchards in 2022, revealed that site and time are the strongest drivers of apple tree phyllosphere microbial communities. Conversely, plant compartment and cultivar exhibited minor roles in explaining community composition and diversity. Predominantly, bacterial communities comprised Hymenobacter (25%) and Sphingomonas (10%), while the most relatively abundant fungal genera included Aureobasidium (27%) and Sporobolomyces (10%). Additionally, our results show a gradual decrease in alpha-diversity throughout the growth season. These findings emphasize the necessity to consider local microbial ecology dynamics in orchards, especially as many groups worldwide aim for the development of biocontrol strategies (e.g., by manipulating plant–microbe interactions). More research is needed to improve our understanding of the determinants of time and site-specific disparities within apple tree phyllosphere microbial communities across multiple years, locations, and cultivars.
Wigner time delay and Hartman effect in quantum motion along deformed Riemannian manifolds
Authors: Schwager Benjamin , Meschede Lars , Berakdar Jamal
Published: March 2024

Elastic scattering of a wave can be quantified by a shift in the phase with respect to the phase of the incoming wave. A qualitative measure of the time during which the effect occurs is given by the Wigner time delay. The tunneling time is known to saturate with increasing tunneling barrier width (Hartman effect). Here, we analyze the elastic quantum mechanical scattering in a deformed one-dimensional Riemannian manifold, particularly with respect to the Wigner time delay and conclude on the Hartman effect. It is shown that scattering due to local curvature variations results in imperfect conduction and leads to a Wigner time delay that at low energies, is in variance with the classical time delay that is inferred from the arc length. At moderate and high energies, however, classical and quantum time delays coincide.
The right to audit and power asymmetries in algorithm auditing
Authors: Urman Aleksandra , Smirnov Ivan , Lasser Jana
Published: March 2024

In this paper, we engage with and expand on the keynote talk about the “Right to Audit” given by Prof. Christian Sandvig at the International Conference on Computational Social Science 2021 through a critical reflection on power asymmetries in the algorithm auditing field. We elaborate on the challenges and asymmetries mentioned by Sandvig — such as those related to legal issues and the disparity between early-career and senior researchers. We also contribute a discussion of the asymmetries that were not covered by Sandvig but that we find critically important: those related to other disparities between researchers, incentive structures related to the access to data from companies, targets of auditing and users and their rights. We also discuss the implications these asymmetries have for algorithm auditing research such as the Western-centrism and the lack of the diversity of perspectives. While we focus on the field of algorithm auditing specifically, we suggest some of the discussed asymmetries affect Computational Social Science more generally and need to be reflected on and addressed.
Evaluating Twitter’s algorithmic amplification of low-credibility content: an observational study
Authors: Corsi Giulio
Published: March 2024

Artificial intelligence (AI)-powered recommender systems play a crucial role in determining the content that users are exposed to on social media platforms. However, the behavioural patterns of these systems are often opaque, complicating the evaluation of their impact on the dissemination and consumption of disinformation and misinformation. To begin addressing this evidence gap, this study presents a measurement approach that uses observed digital traces to infer the status of algorithmic amplification of low-credibility content on Twitter over a 14-day period in January 2023. Using an original dataset of ≈ 2.7 million posts on COVID-19 and climate change published on the platform, this study identifies tweets sharing information from low-credibility domains, and uses a bootstrapping model with two stratifications, a tweet’s engagement level and a user’s followers level, to compare any differences in impressions generated between low-credibility and high-credibility samples. Additional stratification variables of toxicity, political bias, and verified status are also examined. This analysis provides valuable observational evidence on whether the Twitter algorithm favours the visibility of low-credibility content, with results indicating that, on aggregate, tweets containing low-credibility URL domains perform better than tweets that do not across both datasets. However, this effect is largely attributable to a difference in high-engagement, high-followers tweets, which are very impactful in terms of impressions generation, and are more likely receive amplified visibility when containing low-credibility content. Furthermore, high toxicity tweets and those with right-leaning bias see heightened amplification, as do low-credibility tweets from verified accounts. Ultimately, this suggests that Twitter’s recommender system may have facilitated the diffusion of false content by amplifying the visibility of low-credibility content with high-engagement generated by very influential users.
Numerical simulation for radiative hybrid nanofluid (TiO2+Fe3O4∕H2O) flow due to a non-uniform stretching sheet with variable permeability
Authors: Thamizhselvi V. , Satya Narayana P. V.
Published: March 2024

Variable permeability plays a crucial role in various manufacturing and technical applications such as fixed-bed catalytic reactors, heat exchangers, and dying, among others. The primary focus of this paper is to investigate the impacts of variable permeability on hybrid nanofluid (HNF) flow due to nonlinear sheet stretching with thermal heat flux. The HNF is made up of a mixer of [Formula: see text] and [Formula: see text] nanoparticles and water serving as the base fluid. Using efficient similarity transformations, the flow-governing equations are converted into a set of ordinary differential equations, and the resulting system is computationally solved by using the MATLAB program (bvp4c). The impact of various physical variables on the fluid velocity and heat transfer characteristics is analyzed via graphs. It is found that as the permeability parameter rises, the velocity of the HNF diminishes while the temperature amplifies. The drag force coefficient declines with an intensification of the volume fraction of the [Formula: see text] nanoparticles. The HNF [Formula: see text] exhibits 0.45–0.75% increase in heat transfer rate when compared to a nanofluid [Formula: see text] for different values of heat source parameter. The current investigation is compared to the existing literature, revealing a good level of agreement.
Monte Carlo study exploring interplays intricate parameter in dielectric behavior of nano-Borophene lattice
Authors: Fadil Z. , Kabouchi D. , Sabbah Hussein , El Fdil R. , Mhirech A. , Salmani E. , Jayprakash Raorane Chaitany
Published: March 2024

This study focuses on the dielectric responses of the [Formula: see text] nano-Borophene lattice, using Monte Carlo simulations. It explores the impact of various parameters, including temperature, the [Formula: see text] coupling interaction, the crystal field D, and the impact of the longitudinal electric field [Formula: see text], on the dielectric characteristics of nano-Borophene. Simulation study results show that these parameters significantly influence the blocking temperature [Formula: see text] and modify the shape and area of the electrical hysteresis cycle. This research can make an important contribution to the understanding of dielectric phenomena, which is essential in fields such as high-temperature dielectric devices and other advanced technological applications.
Application of Generative Adversarial Network in Image Color Correction
Authors: Chen Meiling , Shi Yao , Zhu Lvfen
Published: March 2024

The popularity of electronic products has increased with the development of technology. Electronic devices allow people to obtain information through the transmission of images. However, color distortion can occur during the transmission process, which may hinder the usefulness of the images. To this end, a deep residual network and a deep convolutional network were used to define the generator and discriminator. Then, self-attention-enhanced convolution was applied to the generator network to construct an image resolution correction model based on coupled generative adversarial networks. On this basis, a generative network model integrating multi-scale features and contextual attention mechanism was constructed to achieve image restoration. Finally, performance and image restoration application tests were conducted on the constructed model. The test showed that when the coupled generative adversarial network was tested on the Set5 dataset, the image peak signal-to-noise ratio and image structure similarity values were 31.2575 and 0.8173. On the Set14 dataset, they were 30.8521 and 0.8079, respectively. The multi-scale feature-fusion algorithm was tested on the BSDS100 dataset with an image peak signal-to-noise ratio of 30.2541 and an image structure similarity value of 0.8352. Based on the data presented, it can be concluded that the image correction model constructed in this study has a strong image restoration ability. The reconstructed image has the highest similarity with the real high-resolution image and a low distortion rate. It can achieve the task of repairing problems such as color distortion during image transmission. In addition, this study can provide technical support for similar information correction and restoration work.
Non-Cognitive Skills at the Time of COVID-19: An Experiment with Professional Traders and Students
Authors: Angrisani Marco , Cipriani Marco , Guarino Antonio , Kendall Ryan , Zarate-Pina Julen
Published: March 2024

We study the stability of non-cognitive skills by comparing experimental data gathered before and during the COVID-19 pandemic. Using a sample of professional traders, we find a significant decrease in Agreeableness and Locus of Control and a moderate decrease in Grit. These patterns are primarily driven by those with more negative experiences of the pandemic. Other skills, such as Trust, Conscientiousness, and Self-Monitoring, are unchanged. We contrast these results with those from a sample of undergraduate students whose non-cognitive skills remain constant (except Conscientiousness). Our findings provide evidence against the stability of some non-cognitive skills, particularly among professional traders.
Unravelling the influencing hydrogeological factors contributing to land subsidence in the Tianjin Plain of China using a multi-scale geographically weighted regression model and monitoring data
Authors: Long Zhao , Yumei Li , Yong Luo
Published: March 2024

The establishment of a quantitative relationship between land subsidence and its influencing factors is a crucial task in developing prevention strategies of land subsidence in specific areas. In this study we examined the dynamic patterns of land subsidence before and after establishing the South-to-North Water Division Project (SNWDP) in the Tianjin Plain (TJP) that aims to reduce groundwater extractions in certain areas. Statistical analyses were used to determine the key attributing factors contributing to land subsidence that were subsequently used to derive the so-called ‘critical water level of land subsidence’(CWLS), which were used to manage groundwater extractions with the objective of minimizing further land subsidence. The main results obtained were as follows: under the influence of the SNWDP, the groundwater level in the TJP stopped declining and the water level rose in most areas. The area of ‘strong’ subsidence, defined as the area with a subsidence rate greater than 50 mm a
−1
, decreased from 16.0% before the SNWDP to 2.5% after. The results of the multi-scale geographically weighted regression (MGWR) model revealed that groundwater drawdown in the second and third confined aquifer was the main contributor to the areas classified as ‘strong’ and ‘medium’ land subsidence areas. Following the reduction in groundwater extractions, the behaviour of surface deformation can be grouped into two categories: first, a rebound in surface elevation; and, second, continuous compression with a lower subsidence rate. The first mode occurs mainly in the area of ‘medium’ and ‘weak’ subsidence, and the second mode occurs mainly in the ‘strong’ subsidence area.

Supplementary material
:
The result of the MGWR model is available at
https://doi.org/10.6084/m9.figshare.c.7103611
Backdoor Two-Stream Video Models on Federated Learning
Authors: Zhao Jing , Yang Hongwei , He Hui , Peng Jie , Zhang Weizhe , Ni Jiangqun , Sangaiah Arun Kumar , Castiglione Aniello
Published: March 2024

Video models on federated learning (FL) enable continual learning of the involved models for video tasks on end-user devices while protecting the privacy of end-user data. As a result, the security issues on FL, e.g., the backdoor attacks on FL and their defense have increasingly become the domains of extensive research in recent years. The backdoor attacks on FL are a class of poisoning attacks, in which an attacker, as one of the training participants, submits poisoned parameters and thus injects the backdoor into the global model after aggregation. Existing backdoor attacks against videos based on FL only poison RGB frames, which makes it that the attack could be easily mitigated by two-stream model neutralization. Therefore, it is a big challenge to manipulate the most advanced two-stream video model with a high success rate by poisoning only a small proportion of training data in the framework of FL. In this paper, a new backdoor attack scheme incorporating the rich spatial and temporal structures of video data is proposed, which injects the backdoor triggers into both the optical flow and RGB frames of video data through multiple rounds of model aggregations. In addition, the adversarial attack is utilized on the RGB frames to further boost the robustness of the attacks. Extensive experiments on real-world datasets verify that our methods outperform the state-of-the-art backdoor attacks and show better performance in terms of stealthiness and persistence.
ADAPT: Adaptive Camouflage Based Deception Orchestration For Trapping Advanced Persistent Threats
Authors: Putrevu Venkata Sai Charan , Mukhopadhyay Subhasis , Manna Subhajit , Rani Nanda , Vaid Ansh , Chunduri Hrushikesh , Putrevu Mohan Anand , Shukla Sandeep
Published: March 2024

Honeypots serve as a valuable deception technology, enabling security teams to gain insights into the behaviour patterns of attackers and investigate cyber security breaches. However, traditional honeypots prove ineffective against advanced adversaries like Advanced Persistent Threats (APT) groups due to their evasion tactics and awareness of typical honeypot solutions. This article emphasises the need to capture these attackers for enhanced threat intelligence, detection, and protection. To address this, we propose the design and deployment of a customized honeypot network based on adaptive camouflaging techniques. Our work focuses on orchestrating a behavioral honeypot network tailored for three APT groups, with strategically positioned attack paths aligning with their tactics, techniques, and procedures, covering all cyber kill chain phases. We introduce a novel approach, deploying a camouflaged chatterbox application within the honeypot network. This application offers a regular chat interface while periodically tracking attacker activity by enabling periodic log transfers. Deployed for 100 days, our orchestrated honeypot recorded 13,906,945 hits from 4,238 unique IP addresses. Our approach categorizes attackers, discerning varying levels of sophistication, and identifies attacks from Hong Kong with similarities to known Chinese threat groups. This research significantly advances honeypot technology and enhances the understanding of sophisticated threat actors’ strategies in real operating networks.
Experimental Design of High-Performing Open-Cathode Polymer Electrolyte Membrane Fuel Cells
Authors: Sagar Anand , Chugh Sachin , Kjeang Erik
Published: March 2024

Open-cathode polymer electrolyte membrane fuel cells (PEMFCs) utilize a unique air-cooled system design to eliminate the humidifiers, air compressor, and liquid cooling loop of conventional, liquid-cooled PEMFC systems, thereby greatly reducing system cost. However, the open-cathode PEMFC performance is restricted by poor humidification, high membrane and charge transfer resistances, and overheating due to inefficient thermal and water management. This work aims to strategically modify the membrane electrode assembly (MEA) design to overcome these issues and achieve high open-cathode PEMFC performance that approaches that of liquid-cooled systems. The use of thinner membrane along with short side chain ionomer is found to elevate the cell performance due to increased water retention at the cathode catalyst layer (CCL) and decreased ohmic losses. Thinner gas diffusion layers with high porosity enable additional cell performance increment by improving oxygen availability at the CCL. An overall current density rise of 88% at 0.6 V and 53% at 0.4 V is achieved by the strategically designed MEA for open-cathode cells. The enhanced power density enabled by the custom MEA can both reduce the stack cost and expand the power range of open-cathode PEMFCs, thus expanding their potential use for low-cost fuel cell system applications.
Cognate antigen-independent differentiation of resident memory T cells in chronic kidney disease
Authors: Moore Kyle H. , Erman Elise N. , Traylor Amie M. , Esman Stephanie K. , Jiang Yanlin , LaFontaine Jennifer R. , Zmijewska Anna , Lu Yan , Soliman Reham H. , Agarwal Anupam , George James F.
Published: March 2024

Resident memory T cells (TRMs) differentiate and are retained within the kidneys of mice with aristolochic acid (AA)-induced chronic kidney disease (CKD). Here, we characterized this kidney TRM population and demonstrated TRM derivation in the kidneys of OT-1 transgenic mice with AA-induced CKD. A better understanding of TRMs and the processes by which they can differentiate independent of antigen may help our understanding of the interactions between the immune system and kidneys.