bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the causes of variability in quality of oropharyngeal swab sampling for SARS-CoV-2 nucleic acid testing and proposed improvement measures: a multicenter, double-blind study
Authors: Zhu Jie , Xing Fanfan , Li Yunzhu , Wu Chunchen , Li Shasha , Wang Qin , Huang Jinyue , Zhang Yafei , Zheng Xiaowei , Liu Zhenjun , Rao Jianguo , Hong Rui , Tian Shuilin , Xiong Shuangyun , Tan Lin , Chen Xinlei , Li Yanwu , He Wei , Hong Xiaodan , Xia Jianbo , Zhou Qiang , Zhang Zhenhua
Published: October 2024

Although coronavirus disease 2019 (COVID-19) has not been considered a public health emergency of international concern since last year, intermittent regional impacts still persist, and accurate testing remains crucial. Ribonuclease
P
protein subunit P30 (
RPP30
) RNA, known for its broad and stable expression in tissue cells, was used to evaluate samples from 10 hospitals with over 3,000 negative nucleic acid tests. The results revealed that the overall pass rate for the collected samples was consistently low and exhibited significant heterogeneity. After reassessing the evaluative effectiveness of
RPP30
RNA Ct values from the samples of 132 positive individuals under quarantine observation, it was used to identify factors affecting sampling quality. These factors included different stages ranging from sample collection to PCR processing, various characteristics of both samplers and individuals being sampled, as well as sampling season and location. The results indicated that post-sampling handling had minimal impact, winter and fever clinic samples showed higher quality, whereas children’s samples had lower quality. The key finding was that the characteristics of samplers were closely related to sampling quality, emphasizing the role of subjectivity. Quality control warnings led to substantial improvements, confirming this finding. Consequently, although there are various factors during the testing process, the most critical aspect is to improve, supervise, and maintain standardized practices among sampling staff.

IMPORTANCE

This study further confirmed the reliability of internal references (IRs) in assessing sample quality, and utilized a large sample IR data to comprehensively and multidimensionally identify significant interference factors in nucleic acid test results. By further reminding and intervening in the subjective practices of specimen collectors, good results could be achieved.
Does surgery to preserve fertility in Sertoli-Leydig cell tumours increase the likelihood of spontaneous conception?
Authors: Suchismita Amitkumar D E , Vembu Radha , Pandurangi Monna , Reddy N Sanjeeva
Published: October 2024

A nulligravida in her 30s presented with primary infertility and secondary amenorrhoea. General examination revealed virilisation; sonological examination detected a right ovarian solid mass. International Ovarian Tumour Analysis (IOTA) was suggestive of malignancy and serum testosterone was raised. A strong clinical suspicion and negative tumour markers pointed towards androgen producing sex cord stromal ovarian neoplasm. MRI excluded pelvic lymphadenopathy. Given the patient’s desire for conception, fertility sparing staging laparotomy was done. Histopathology confirmed Sertoli-Leydig cell tumour (SLCT) International Federation of Gynaecology and Obstetrics stage IA. Serum testosterone fell drastically by day 10. Spontaneous menstruation resumed within 30 days. The significance of SLCTs as a differential diagnosis in young women with secondary amenorrhoea and virilising features underscores the role of fertility-preserving surgery in certain circumstances. Here we discuss the clinical features, diagnostic challenges and management strategies for SLCTs, emphasising the need for multidisciplinary collaboration and option of fertility preservation in early stages.
Costs and resource distribution of direct services for HIV in Uganda
Authors: Ekirapa Elizabeth , Jordan Monica , Nong Thuong , Marton Tozoe Elaine , Balidawa Hudson , Ssempala Richard , Ssebagereka Anthony , Kagaayi Joseph , Nandakumar Allyala , McBain Ryan K
Published: October 2024

Objective

In high HIV-burden countries like Uganda, financing and resource allocation for HIV services have rapidly evolved. This study aimed to employ time-driven activity-based costing (TDABC) to examine the allocation of resources and associated costs for HIV care throughout the country.

Design

A cross-sectional study.

Setting

This study was conducted at 31 health facilities throughout Uganda: 16 level III health centres, 10 level IV health centres and 5 district hospitals.

Participants

1119 persons receiving HIV services in 2020.

Methods

We conducted TDABC to quantify costs, resource consumption and duration of service provision associated with antiretroviral therapy, prevention of mother-to-child transmission, HIV counselling and testing (HCT), voluntary medical male circumcision (VMMC) and pre-exposure prophylaxis. We also quantified disparities in resource consumption according to client-level and facility-level characteristics to examine equity. Fixed-effects multivariable regression analyses were employed to inspect factors associated with service costs and provider-client interaction time.

Results

The mean cost of services ranged from US$8.18 per visit for HCT to US$32.28 for VMMC. In terms of disparities, those in the Western region received more provider time during visits compared with other regions (35 more minutes, p<0.001); and those receiving care at private facilities received more provider time compared with public facilities (13 more minutes, p=0.02); and those at level IV health centres received more time compared with those at level III (12 more minutes, p=0.01). Absent consumables, services for older adults (US$2.28 higher, p=0.02), those with comorbidities (US$1.44 higher, p<0.001) and those living in the Western region (US$2.88 higher, p<0.001) were more expensive compared with younger adults, those without comorbidities and those in other regions, respectively. Inclusive of consumables, services were higher-cost for individuals in wealthier households (US$0.83 higher, p=0.03) and those visiting level IV health centres (US$3.41 higher, p=0.006) compared with level III.

Conclusions

Costs and resources for HIV care vary widely throughout Uganda. This variation requires careful consideration: some sources of variation may be indicative of vertical and horizontal equity within the health system, while others may be suggestive of inequities.
ECO-MIND: enhancing pro-environmental behaviours and mental health through nature contact for urban youth – a research protocol for a multi-country study using geographic ecological momentary assessment and mental models
Authors: Bubalo Martina , van den Broek Karlijn , Helbich Marco , Labib S M
Published: October 2024

Introduction

Urban youth are experiencing increasing mental health problems due to diverse personal, social and environmental concerns. Youths’ detachment from natural environments, including green and blue spaces, may intensify such issues further. Contact with nature can benefit mental health and promote pro-environmental behaviour (PEB). Yet, only a few studies assess these relationships among the youth usually ignoring effects of living in diverse urban contexts, and everyday nature experiences. ECO-MIND will investigate whether urban youth’s dynamic greenspace exposure and their mental models about nature connectedness explain the associations between greenspace exposure, mental health and PEB in multiple urban contexts.

Methods and analysis

We will collect data from university students from the Global South (ie, Dhaka, Kampala) and Global North cities (ie, Utrecht). Participants aged 18–24 will be recruited through stratified random sampling. We will use geographic ecological momentary assessment to assess respondents’ everyday experiences and exposure to greenspaces. Our definition of greenspace exposure will be based on the availability, accessibility and visibility of greenspaces extracted from satellite and street view images. We will administer a baseline questionnaire to participants about mental health, nature connectedness and PEB characteristics. Further, we will ask participants to build mental models to show their perception of nature connectedness. Finally, we will fit partial least square structural equation models and multi-level models to our longitudinal geographic momentary assessment data.

Ethics and dissemination

The study was approved by the Ethical Review Board of the Utrecht University (Geo S-23221). Informed consent must be given freely, without coercion and based on a clear understanding of the participation in the study. Findings will be disseminated in peer-reviewed journals and at conferences. Furthermore, we will implement public engagement activities (eg, panel discussion) to share results among local stakeholders and policymakers and cocreate policy briefs.
Deep brain stimulation versus vagus nerve stimulation for the motor function of poststroke hemiplegia: study protocol for a multicentre randomised controlled trial
Authors: Xu Junpeng , Liu Bin , Shang Guosong , Liu Shuzhen , Feng Zhebin , Zhang Yanyang , Yang Haonan , Liu Di , Chang Qing , Yuhan Chen , Yu Xinguang , Mao Zhiqi
Published: October 2024

Introduction

Deep brain stimulation (DBS) and vagus nerve stimulation (VNS) can improve motor function in patients with poststroke hemiplegia. No comparison study exists.

Methods and analysis

This is a randomised, double-blind, controlled clinical trial involving 64 patients who had their first stroke at least 6 months ago and are experiencing poststroke limb dysfunction. These patients must receive necessary support at home and consent to participate. The aim is to evaluate the effectiveness and safety of DBS and VNS therapies. Patients are excluded if they have implantable devices that are sensitive to electrical currents, severe abnormalities in their lower limbs or are unable to comply with the trial procedures. The study has two parallel, distinct treatment arms: the Stimulation Group and the Sham Group. Initially, the Stimulation Group will undergo immediate electrical stimulation postsurgery, while the Sham Group will receive non-stimulation 1 month later. After 3 months, these groups will swap treatments, with the Stimulation Group discontinuing stimulation and the Sham Group initiating stimulation. Six months later, both groups will resume active stimulation. Our primary outcomes will meticulously assess motor function improvements, using the Fugl-Meyer Assessment, and safety, monitored by tracking adverse reaction rates. Furthermore, we will gain a comprehensive view of patient outcomes by evaluating secondary measures, including clinical improvement (National Institutes of Health Stroke Scale), surgical complications/side effects, quality of life (36-item Short Form Questionnaire) and mental health status (Hamilton Anxiety Rating Scale/Hamilton Depression Rating Scale). To ensure a thorough understanding of the long-term effects, we will conduct follow-ups at 9 and 12 months postsurgery, with additional long-term assessments at 15 and 18 months. These follow-ups will assess the sustained performance and durability of the treatment effects. The statistical analysis will uncover the optimal treatment strategy for poststroke hemiplegia, providing valuable insights for clinicians and patients alike.

Ethics and dissemination

This study was reviewed and approved by the Ethical Committee of Chinese PLA General Hospital (S2022-789-01). The findings will be submitted for publication in peer-reviewed journals with online accessibility, ensuring adherence to the conventional scientific publishing process while clarifying how the research outcomes will be disseminated and accessed.

Trial registration number

NCT06121947.
Diagnostic value of impulse oscillometry in chronic obstructive pulmonary disease: a multicentre, retrospective, observational study
Authors: Gao Lijuan , Wang Hao , Wu Yanqiu , Wang Tao , Xiong Shuguang , Qiu Rong , Zhou Hui , Liu Lin , Jia Huizhuo , Qin Jiangyue , Xu Dan , Shen Yongchun , Chen Lei , Wen Fu-Qiang
Published: October 2024

Objectives

Diagnosis and assessment of chronic obstructive pulmonary disease (COPD) rely extensively on spirometry, which necessitates patient cooperation. The clinical value of impulse oscillometry (IOS) as a non-volitional method in patients with COPD remains uncertain.

Design

This retrospective observational study was conducted using patient data from between January 2014 and December 2015.

Setting

Five public hospitals in China: West China Hospital, Nuclear Industry 416 Hospital, Suining Central Hospital, Affiliated Hospital, Medical College of Chengdu University and 363 Hospital.

Participants

The study included 6307 participants aged>40 years, comprising 2109 COPD patients and 4198 general non-COPD individuals, according to the Global Initiative for Obstructive Lung Disease (GOLD) spirometry standard. Participants with lung cancer, pulmonary tuberculosis, pneumonia or those who underwent lung resection were excluded from the study.

Outcome measures and analysis

Demographic data, spirometry results and IOS results were collected. Spearman’s correlation analysis was used to examine the correlation between the IOS and spirometry parameters. Receiver operating characteristic curve analysis was used to evaluate the IOS performance in COPD diagnosis and severity staging.

Results

Patients with COPD exhibited significant increases in Z5, R5, R20, R5−R20, Fres and Rp, but a decrease in X5 compared with non-COPD subjects (p<0.0001). IOS parameters, including Z5, R5−R20, Fres, Rp and X5, varied with the GOLD stages, with mild-to-moderate correlations with MMEF25%–75%, forced expiratory volume in one second (FEV1)/forced vital capacity and FEV1%, respectively. However, the combination of these five IOS parameters did not exhibit ideal performance in diagnosing COPD (area under the curve (AUC) 0.78; sensitivity 63.68%; specificity 80.09%), differentiating GOLD stage 1 patients from the general non-COPD population (AUC 0.71; sensitivity 54.71%; specificity 77.49%) or identifying GOLD stages 3 and 4 patients among those with COPD (AUC 0.75; sensitivity 69.51%; specificity 70.32%).

Conclusion

IOS parameters, while showing good correlation with spirometry in patients with COPD, did not perfectly substitute for spirometry in diagnosing COPD, especially in the early and advanced stages of the disease.
Modifications to the National Early Warning Score: a scoping review protocol
Authors: Milne-Ives Madison , Riccalton Victoria , Plummer Chris , Threlfall Lynsey , Cong Cen , Ananthakrishnan Ananya , Meinert Edward
Published: October 2024

Introduction

The National Early Warning Score (NEWS/2) system was developed to enable the detection and early intervention of patients at risk of clinical deterioration. It has demonstrated good accuracy in identifying imminent critical outcomes but has limitations in its applicability to various patient types and its ability to predict upcoming deterioration beyond 24 hours. Various studies have attempted to improve its predictive accuracy and clinical utility by modifying or adding variables to the standard NEWS/2 system. The purpose of this scoping review is to identify modifications to the NEWS and NEWS2 systems (eg, the inclusion of additional patient demographic, physiological or other characteristics) and how those modifications influence predictive accuracy to provide an evidence base for subsequent improvement of the system.

Methods and analysis

The review will be structured using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and the Population, Intervention, Comparator, Outcome, and Study frameworks. Six databases (PubMed, ScienceDirect, Embase, CINAHL, Web of Science and Cochrane Library) will be searched in April 2024 for articles published in English. Article screening and data extraction will be conducted by two independent reviewers, with any conflicts resolved by discussion. The analysis will be descriptive to provide a summary of modifications identified and their influence on the predictive accuracy of NEWS/NEWS 2.

Ethics and dissemination

Ethical approval is not required as data will be obtained from already published sources. Findings from this study will be disseminated via publication in a peer-reviewed journal.
Periodic health evaluation in Para athletes: a position statement based on expert consensus
Authors: Pinheiro Larissa , Verhagen Evert , Ocarino Juliana , Fagher Kristina , Ahmed Osman Hassan , Dalton Kristine , Mann David L , Weiler Richard , Akinyi Okoth Carole , Blauwet Cheri A , Lexell Jan , Derman Wayne , Webborn Nick , Silva Andressa , Resende Renan
Published: October 2024

Para athletes present a broad range of sports-related injuries and illnesses, frequently encountering barriers when accessing healthcare services. The periodic health evaluation (PHE) is a valuable tool for continuously monitoring athletes’ health, screening for health conditions, assisting in the surveillance of health problems by establishing baseline information and identifying barriers to athlete’s performance. This position statement aims to guide sports healthcare providers in the PHE for Para athletes across key impairment categories: intellectual, musculoskeletal, neurological and vision. A panel of 15 international experts, including epidemiologists, physiotherapists, optometrists and physicians with expertise in Para athlete health, convened via videoconferences to discuss the position statement’s purpose, methods and themes. They formed working groups to address clinical, cardiorespiratory, neuromusculoskeletal, nutritional status, mental and sleep health, concussion and female Para athlete health assessment considerations. The PHE’s effectiveness lies in its comprehensive approach. Health history review can provide insights into factors impacting Para athlete health, inform physical assessments and help healthcare providers understand each athlete’s needs. During the PHE, considerations should encompass the specific requirements of the sport modality and the impairment itself. These evaluations can help mitigate the common tendency of Para athletes to under-report health issues. They also enable early interventions tailored to the athlete’s health history. Moreover, the PHE serves as an opportunity to educate Para athletes on preventive strategies that can be integrated into their training routines, enhancing their performance and overall health. This position statement can potentially enhance clinical translation into practice and improve the healthcare quality for Para athletes.
Effects of tenofovir disoproxil fumarate on intrahepatic viral burden and liver immune microenvironment in patients with chronic hepatitis B
Authors: Pan David Z , Soulette Cameron M , Aggarwal Abhishek , Han Dong , van Buuren Nicholas , Wu Peiwen , Feierbach Becket , Lin Jaw-Town , Tseng Cheng-Hao , Chen Chi-Yi , Downie Bryan , Mo Hongmei , Diehl Lauri , Li Li , Fletcher Simon P , Balsitis Scott , Ramirez Ricardo , Suri Vithika , Hsu Yao-Chun
Published: October 2024

Background

The impact of nucleos(t)ide analogues on intrahepatic viral burden and immune microenvironment in patients with chronic hepatitis B (CHB) is not clear.

Objective

We aimed to characterise the effects of tenofovir disoproxil fumarate (TDF) on intrahepatic viral burden and the liver immune microenvironment in patients with CHB.

Design

Core liver biopsies were collected at baseline and year 3 from patients with CHB with minimally raised serum alanine aminotransferase in a double-blind placebo-controlled trial (NCT01522625). Paired biopsies were analysed by RNA-sequencing (n=119 pairs), a custom multiplex immunofluorescence assay (n=30 pairs), and HBV-targeted long-read DNA sequencing (n=49 pairs).

Results

Both non-integrated and integrated HBV DNA were present in all patients at baseline, with >65% having interchromosomal translocations. Treatment significantly reduced the frequency of HBV core+ hepatocytes and intrahepatic (integrated and non-integrated) HBV DNA, but had no effect on HBsAg+ hepatocytes. Clonally expanded integrations were enriched for HBsAg coding regions and showed dysregulation of nearby genes. At baseline, there was significant enrichment of intrahepatic CD8+ T cell proximity to HBV core+ hepatocytes, but not to HBsAg+ cells. The densities of T cells and B cells were significantly reduced by TDF. Transcriptomic analyses found TDF induced widespread downregulation of immune-related genes including inhibitory and regulatory genes.

Conclusion

TDF significantly reduced intrahepatic integrated and non-integrated HBV DNA, exerting disparate effects on HBV core+ and HBsAg+ cells and on different immune cell subsets. Our data suggest there may be differential cytotoxic T cell-mediated killing of HBV core+ versus HBsAg+ hepatocytes, providing insights for HBV cure strategies.
Inequalities in adolescent mental health and allocation of students to selective classes in comprehensive schools in Finland: a longitudinal study
Authors: Kesanto-Jokipolvi Heidi , Siipola Mari , Koivuhovi Satu , Pasu Terhi , Seppänen Piia , Rimpelä Arja
Published: October 2024

Background

Lower socioeconomic positions (SEP) and poor academic achievement increase children’s risk for mental health problems. The Finnish education system is officially non-selective and unified, but a part of children can be selected into emphasised teaching classes by aptitude tests, which are known to segregate students by SEP and academic achievement. We study here if allocation of students to mainstream and selective classes segregates students by mental health, too.

Methods

Students from primary school (6th grade) were followed to lower secondary school (7th grade). The number in selective classes was n=209 and in mainstream classes n=551. Outcomes were depressed mood, anxiety and daily health complaints. Association between class type and the outcomes was analysed by cross-tabulation and logistic regression models. Gender, academic achievement, SEP and previous mental health were independent and confounding/moderating variables.

Results

Students in selective classes had better academic achievement and higher SEP compared with students in mainstream classes. Girls reported poorer mental health than boys. Depressive mood did not vary by class type, but anxiety and daily health complaints were more common among girls in mainstream classes. When academic achievement and background factors were considered, among girls only anxiety was more common in mainstream classes, but among boys, anxiety appeared to be statistically significantly more common in selective classes.

Conclusion

Grouping students by aptitude tests to different classes may select them by mental health, too. Longer follow-up and gender-specific studies would give more reliable answers for education policy makers about student grouping by aptitude test and its effects on segregation.
HDAC inhibitor SAHA enhances antitumor immunity via the HDAC1/JAK1/FGL1 axis in lung adenocarcinoma
Authors: Xu Tingting , Fang Yuan , Gu Yunru , Xu Duo , Hu Tong , Yu Tao , Xu Yang-Yue , Shen Hao-Yang , Ma Pei , Shu Yongqian
Published: October 2024

Background

Histone deacetylase (HDAC), a kind of protease that regulates gene expression by modifying protein acetylation levels, is usually aberrantly activated in tumors. The approved pan-HDAC inhibitors (HDACi) have exhibited clinical benefits for hematopoietic malignancies. Recently, HDACis have emerged as enhancers of antitumor immunity. However, the effect of HDACs on the tumor immune microenvironment of lung adenocarcinoma (LUAD) and the underlying mechanism is largely unknown.

Methods

C57BL/6J and BALB/c nude mice with subcutaneous tumors were used for in vivo therapeutic effects and mechanistic investigations. Flow cytometry was used to measure the toxicity and exhaustion of human CD8+T cells after co-culturing with tumor cells and to determine the immunophenotype of tumor-infiltrating CD8+T cells. A series of experimental techniques, including RNA sequencing, quantitative PCR, western blot, ELISA, mass spectrometry, co-immunoprecipitation, chromatin immunoprecipitation and immunohistochemistry, were used to explore the underlying molecular mechanism.

Results

The pan-HDACi vorinostat (SAHA) promoted CD8+T cell infiltration and effector function in LUAD through suppressing FGL1, a newly identified major ligand of LAG-3. Mechanistically, SAHA inhibited the activity of HDAC1, an essential deacetylase of JAK1. This increased the acetylation level of JAK1 at lysine 1109, thus promoting its proteasomal degradation and subsequently reducing STAT3-driven FGL1 transcription. The combination regimen of SAHA and anti-LAG-3 therapy was further explored in an immunocompetent LUAD mouse model. Compared with those receiving control or single agent treatments, mice receiving combination therapy exhibited a lower tumor burden and superior CD8+T-cell-killing activity.

Conclusions

Our results revealed a novel mechanism by which the HDACi SAHA potentiates CD8+T-cell-mediated antitumor activity through the HDAC1/JAK1/FGL1 axis, providing a rationale for the combined use of HDACis and immunotherapy.
Algorithms advise, humans decide: the evidential role of the patient preference predictor
Authors: Makins Nicholas
Published: October 2024

An AI-based ‘patient preference predictor’ (PPP) is a proposed method for guiding healthcare decisions for patients who lack decision-making capacity. The proposal is to use correlations between sociodemographic data and known healthcare preferences to construct a model that predicts the unknown preferences of a particular patient. In this paper, I highlight a distinction that has been largely overlooked so far in debates about the PPP—that between algorithmic prediction and decision-making—and argue that much of the recent philosophical disagreement stems from this oversight. I show how three prominent objections to the PPP only challenge its use as the sole determinant of a choice, and actually support its use as a source of evidence about patient preferences to inform human decision-making. The upshot is that we should adopt the evidential conception of the PPP and shift our evaluation of this technology towards the ethics of algorithmic prediction, rather than decision-making.
Defending the disease view of pregnancy: a reply to our critics
Authors: Räsänen Joona , Smajdor Anna
Published: October 2024

We recently suggested that there are both pragmatic and normative reasons to classify pregnancy as a disease. Several scholars argued against our claims. In this response, we defend the disease view of pregnancy against their criticism. We claim that the dysfunctional account of disease that some of our critics rely on has some counterintuitive results. Furthermore, we claim that our critics assume what needs to be argued that the primary function of our sexual organs is to reproduce. Since only a small percentage of sexual intercourse leads to pregnancy, it is far from obvious that reproduction is the primary biological function of our sexual organs. We also claim that while taking pregnancy itself as a reference class could avoid the conclusion that pregnancy is a disease, the strategy is problematic since it renders the Boorsean approach to disease and health circular and effectively deprives it of any utility in determining whether a particular phenomenon is a disease or not.
Nomogram for predicting early neurological deterioration in patients with mild large and medium vessel occlusion stroke intended for medical management: a multicenter retrospective study
Authors: Qiu Kai , Hang Yu , LYV Penghua , Liu Ying , Li Mingchao , Zhao Liandong , Zhai Qijin , Chen Jinan , Jia Zhenyu , Cao Yuezhou , Zhao Lin-Bo , Shi Hai-Bin , Liu Sheng
Published: October 2024

Background

Accurately forecasting early neurological deterioration of ischemic origin (ENDi) following medical management may aid in identifying candidates for thrombectomy. We aimed to develop and validate a nomogram to predict ENDiin patients with mild large and medium vessel occlusion stroke intended for medical management.

Methods

Two hundred and forty-eight patients were enrolled (173 and 75 randomised into training and validation cohorts). The risk factors were identified using logistic regression analyses. A nomogram was constructed based on the risk factors identified. The discrimination, calibration, and clinical practicability of the nomogram were assessed using receiver operating characteristic curve (ROC) analysis, the Hosmer–Lemeshow test, and decision curve analysis (DCA), respectively.

Results

ENDiwas detected in 44 (17.7%) patients. Four predictors were identified in the training cohort and entered into the nomogram including age, symptom fluctuation characteristics, presence of core infarct, and occlusion site. ROC analysis showed that the area under the curve was 0.930 (95% CI 0.884 to 0.976) and 0.889 (95% CI 0.808 to 0.970) in the training and validation cohorts, respectively. The Hosmer–Lemeshow test yielded a mean absolute error of 0.025 and 0.038, respectively, for the two cohorts. The DCA showed that the nomogram model had superior practicality and accuracy across the majority of the threshold probabilities.

Conclusion

The proposed nomogram showed a favourable predictive performance for ENDiin patients with mild large and medium vessel occlusion stroke intended for medical management. For such patients, immediate thrombectomy or at least intensive medical monitoring may be reasonable to avoid delays in rescue thrombectomy.
Effect of thrombolysis type on the efficacy of aspiration versus stent retriever first line thrombectomy: results from the AcT trial
Authors: Bala Fouzi , Diprose William , Menon Bijoy K , Singh Nishita , Khosravani Houman , Tkach Aleksander , Catanese Luciana , Dowlatshahi Dariush , Field Thalia S , Hunter Gary , Sajobi Tolulope , Hill Michael D , Buck Brian H , Swartz Richard H , Almekhlafi Mohammed A
Published: October 2024

Background

Intravenous (IV) tenecteplase is increasingly being used in lieu of alteplase for acute ischemic stroke. We sought to study the influence of IV tenecteplase versus IV alteplase on the efficacy of first line thrombectomy strategy.

Methods

This was a secondary analysis of the Alteplase versus Tenecteplase (AcT) trial. We included anterior and posterior circulation stroke patients in whom a thrombectomy was attempted. We compared outcomes for stent retriever as first line strategy versus contact aspiration alone, and interactions with thrombolysis type. We examined angiographic outcomes (extended final thrombolysis in cerebral infarction (eTICI) 2c–3 after first-pass, eTICI 2b–3 and eTICI 2 c–3 on final angiography), and clinical and safety outcomes. Mixed effect regression analyses with interaction terms were performed. All outcomes were assessed and analyzed by blinded adjudicators.

Results

Among 506 patients who received thrombectomy, 435 were included (222 (51.0%) IV tenecteplase, 213 (49.0%) IV alteplase). A stent retriever was used as the first line endovascular thrombectomy (EVT) approach in 288 (66.2%), and aspiration in 147 (33.8%) patients. There was no difference in rates of final eTICI 2c–3 between groups (57.0% with stent retriever vs 61.9% with aspiration; P=0.35). There was, however, a significant interaction (P=0.02) between thrombolysis type and first line EVT strategy for final eTICI 2c–3, where tenecteplase was associated with higher odds of final eTICI 2c–3 with aspiration (adjusted OR (aOR) 2.29, 95% CI 1.10 to 4.75), but not with stent retriever (aOR 0.63, 95% CI 0.38 to 1.04). No significant interaction between thrombolysis and first line strategy was found for the other angiographic, clinical or safety outcomes.

Conclusion

IV tenecteplase before EVT may enhance reperfusion with first line aspiration.

Trial registration number

NCT03889249.
Endovascular treatment in pediatric stroke: an individual patient pooled analysis on presentation, management and outcomes
Authors: Zhang Wanqiu , Duan Cuirong , Niu Mingyang , Zhu Bin , Zhong Jinghui , Xu Yingjie , Xiao Lulu , Li Qiankun , Liu Xinfeng , Sun Wen
Published: October 2024

Background

This study aimed to perform a comprehensive pooled analysis of all published series involving pediatric patients with large vessel occlusion (LVO) undergoing endovascular treatment (EVT) to study the disease landscape including presentation, management, and outcomes.

Methods

The data used in this study were pooled from published literature on EVT for pediatric stroke spanning from 1980 to 2023. The relevant articles were carefully reviewed, and only those reporting at least one case of pediatric LVO undergoing EVT were included. Furthermore, pediatric patients with LVO who received EVT from the Chinese Pediatric Ischemic Stroke Registry database were also included. The primary outcome for this study was the unfavorable outcome after stroke. The risk factors influencing the outcomes of patients with pediatric stroke treated with EVT were analyzed using Cox proportional hazards models.

Results

A total of 221 pediatric patients who underwent EVT were included. During an average follow-up period of 6 months, 20.8% of patients had an unfavorable outcome. Multivariate Cox regression showed that patients with a higher Pediatric National Institutes of Health Stroke Scale (pedNIHSS) score (aHR=7.54, 95% CI 2.38 to 23.58) and unsuccessful reperfusion (aHR=5.84, 95% CI 2.86 to 11.93) were associated with an increased risk of unfavorable outcomes, while older age (aHR=0.27, 95% CI 0.09 to 0.82) was associated with a lower risk of unfavorable outcomes.

Conclusion

Following EVT treatment, a significant proportion of pediatric patients with LVO achieved favorable outcomes. However, factors such as the severity of the pedNIHSS score and unsuccessful reperfusion were found to be associated with a poorer prognosis.
Evaluating the effects of cement asphalt emulsion paste as a grouting material on the fatigue and thermal contraction properties of semi-flexible asphalt composite pavement
Authors: Zarei Sohrab , Ouyang Jian , Alae Mohsen , Liu Wanqiu
Published: October 2024

Semi-flexible asphalt (SFA) composite pavement is widely used in pavement engineering for its high load-bearing capacity, enhanced durability, impermeability, and resistance to fuel and oil spillage. However, its cracking resistance remains a concern, influenced by repeated vehicle loads and thermal contraction stresses. This study investigates the impact of cement asphalt emulsion paste as a grouting material on SFA’s fatigue and thermal contraction. SFA specimens were grouted with cement paste (CP) containing 20%, 40%, and 60% asphalt emulsion. These specimens were subjected to indirect tensile strength, resilient modulus, and fatigue tests, along with evaluation of thermal contraction behavior using coefficient of thermal contraction. Results indicated that adding asphalt emulsion to CP enhances the flexibility and ductility of SFA but reduces its indirect tensile strength and stiffness modulus. A mathematical model was introduced to predict the resilient modulus based on indirect tensile strength tests. The fatigue analysis demonstrated significant difference in fatigue resistance between SFA and AC16 materials. Incorporating asphalt emulsion also improved SFA’s thermal contraction behavior.
Nonminimal coupling holographic superconductors
Authors: Mohammadi Mahya , Sheykhi Ahmad
Published: October 2024

We explore a holographic superconductor model in which a real scalar field is nonminimally coupled to a gauge field. We consider several types of the nonminimal coupling function h(ψ) including exponential, hyperbolic (cosh), power-law, and fractional forms. We investigate the influences of the nonminimal coupling parameter α on condensation, critical temperature, and conductivity. We can categorize our results in two groups. In the first group, conductor/superconductor phase transition is easier to occur for larger values of α, while in the second group stronger effects of the nonminimal coupling makes the formation of scalar hair harder. Although the real and imaginary parts of conductivity are impressed by different forms of h(ψ), they follow some universal behaviors such as connecting with each other through Kramers–Kronig relation in ω → 0 limit or the appearance of gap frequency at low temperatures around ωg ∼ 8 Tc, which shifts to larger values by increasing the strength of α. Among all forms of h(ψ) we observe that h(ψ) = 1 + αψ2 gives us better information in wide range of nonminimal coupling constant and temperature. Choosing the best form of h(ψ), we construct a family of solutions for holographic conductor/superconductor phase transitions to discover the effect of the hyperscaling violation when the gauge and scalar fields are nonminimally coupled. we find that the critical temperature increases for higher effects of hyperscaling violation θ and nonminimal coupling constant α. By increasing these two parameters, we obtain lower values of condensation which means that conductor/superconductor phase transition will acquire easier. Furthermore, we understand that the hyperscaling violation affects the conductivity σ of the holographic superconductors and changes the expected relation in the gap frequency. Some universal behaviors like infinite DC conductivity are observed. In addition, we consider a five-dimensional Gauss–Bonnet (GB) black hole with a flat horizon. We find out that the critical temperature decreases for larger values of GB coupling constant, λ, or smaller values of nonminimal coupling constant, α, which means that the condensation is harder to form. Moreover, we study the electrical conductivity in the holographic setup. We observe that the gap frequency shifts to larger values for stronger λ, and becomes flat by increasing α.
Effects of urbanization on diet in eastern chipmunks (Tamias striatus) as determined by stable isotopes
Authors: Ouellette Raven , Schulte-Hostedde Albrecht I
Published: October 2024

Urban environments offer wildlife a consistent supply of anthropogenic food waste, divergent from natural food sources in nutrient composition. This study investigates the dietary impact of urbanization on eastern chipmunks ( Tamias striatus (Linnaeus, 1758)) by analyzing stable isotope signatures (∂13C and ∂15N) in their hair. The hypothesis posits that chipmunks in urban locales consume more corn-based and high-protein foods, reflected in elevated isotopic signatures compared to their rural counterparts. Sampling encompassed 20 sites across Sudbury, Ontario, varying in urbanization levels. Urbanization was gauged via surveys capturing human activity and sources of anthropogenic food waste. Contrary to expectations, chipmunks did not exhibit δ13C signatures indicative of substantial corn consumption from human food waste. However, δ15N signatures positively correlated with urbanization, suggesting heightened animal protein intake in urban habitats. Elevated δ15N signatures may also result from the use of fertilizers in urban areas. Future avenues involve using stable isotope mixing models to pinpoint dietary sources and exploring the health and reproductive ramifications of urban diets, including effects on gut microbiome composition.
Measurement of cross section of proton-induced reactions on oxygen with silicon dioxide target
Authors: Matulewicz Joanna , Skwira-Chalot Izabela , Kusyk Sebastian , Matulewicz Tomasz , Sȩkowski Przemyslaw , Spyra Adam , Swakoń Jan , Szcześniak Wiktoria , Taranienko Agata , Wróbel Damian
Published: October 2024

Oxygen is one of the most common elements in the human body. Proton beams used in therapy induce nuclear reactions that cause a loss of fluence along the beam path. These reactions often lead to production of $$\beta ^+$$

β
+

emitters with relatively short half-lives (less than 20 min). Cross sections for reactions on oxygen are not sufficiently known, particularly at proton energies above few tens of MeV. This contribution presents the results of an experiment, where silicon dioxide targets were used to study nuclear reactions induced by protons with energy below 60 MeV on oxygen. The proton beam was delivered by the AIC-144 cyclotron of the Institute of Nuclear Physics in Kraków. Cross sections of reactions leading to production of $$ ^{11}$$

11

C, $$ ^{13}$$

13

N and $$ ^{15}$$

15

O were obtained. They agree well with the measurements using Cherenkov radiation in bulk SiO$$_2$$

2

. The recent measurements performed with a PET scanner provided similar results, except in the case of $$ ^{16}$$

16

O(p,x)$$ ^{11}$$

11

C reaction studied in the energy of up to 200 MeV, where our results are 30% lower.
Semi-transparent boundary in Lee–Wick electrodynamics
Authors: Rodrigues E. H. , Barone F. A. , Barone F. E. , Borges L. H. C. , Nogueira A. A.
Published: October 2024

In this paper, we investigate certain aspects of Lee–Wick electrodynamics near a semitransparent planar mirror. Specifically, we derive the modified propagator for the Lee–Wick gauge field in the presence of the mirror and conduct a detailed analysis of the interaction energy and the interaction force that arise between the mirror and a stationary point-like charge. We demonstrate that there are several peculiarities in this interaction compared to the results obtained for Maxwell electrodynamics. Our focus is on the divergences mitigated by the Podolsky mass term.
Fermion bound states from Yukawa coupling with periodic bosonic background
Authors: Bazeia Dionisio , Simas Fabiano C.
Published: October 2024

The Yukawa coupling of fermions with a periodic bosonic background is shown to give rise to several bound states to the fermionic spectrum, with some bound states gluing together around specific energy eingenvalues as the Yukawa coupling increases. This effect induces the presence of degenerate energy states inside the fermionic gap and may be of current interest.
Hardware Design Strategies Oriented to Edge Computing and AgriFood Electronics for Image Processing using Cellular Automata
Authors: Vourkas Ioannis
Published: October 2024

There has been a growing interest from academia and industry in developing circuits and systems for edge computing and quality control tasks in food production lines, where image-processing is frequently required. This paper outlines the required considerations for designing a fruit classification system based on image-processing using Cellular Automata (CA) models and integrating it into reconfigurable hardware (HW) such as Field Programmable Gate Arrays (FPGAs). Parallel processing in CA requires numerous processing elements to be implemented and mapping CA models to HW generally comes with limitations. Homogeneous CA arrays are easier to design and implement in HW but can be resource-demanding. To fill this gap, this study explores different alternatives for the HW implementation of CA models, particularly trading computational-parallelism for a more optimized use of the available HW resources. We conducted experimental tests of the designed HW system using the Digilent Nexys development board, and the operation was validated against software-based benchmarks for image-processing, particularly concerning edge-detection. The presented study provides a broader range of design solutions for the HW implementation of two-dimensional CA models and a better understanding of their advantages and disadvantages. The results show that solutions focusing on instruction-parallelism add some complexity to the conception and require more design effort, compared to homogeneous CA models composed of identical cells. However, the instruction-parallel design solutions can significantly improve the HW resource utilization, especially when implementing computationally intensive CA rules in FPGAs.
Wilson-Fisher fixed points in the presence of Dirac fermions
Authors: Herbut I. F.
Published: October 2024

Wilson–Fisher expansion near upper critical dimension has proven to be an invaluable conceptual and computational tool in our understanding of the universal critical behavior in the [Formula: see text] field theories that describe low-energy physics of the canonical models, such as Ising, XY, and Heisenberg. Here, I review its application to a class of the Gross–Neveu–Yukawa (GNY) field theories, which emerge as possible universal description of a number of quantum phase transitions in electronic two-dimensional systems such as graphene and d-wave superconductors. GNY field theories may be viewed as minimal modifications of the [Formula: see text] field theories in which the order parameter is coupled to relativistic Dirac fermions through Yukawa term and which still exhibit critical fixed points in the suitably formulated Wilson–Fisher [Formula: see text]-expansion. I discuss the unified GNY field theory for a set of different symmetry-breaking patterns, with focus on the semimetal-Néel-ordered-Mott insulator quantum phase transition in the half-filled Hubbard model on the honeycomb lattice, for which a comparison between the state-of-the-art [Formula: see text]-expansion, quantum Monte Carlo, large N, and functional renormalization-group calculations can be made.
On the minimum number of generators for the module of derivations of the ring of invariants for some dihedral groups
Authors: Patra Amit
Published: October 2024

In this paper, we study the generators of the module of derivations of the ring of invariants for some dihedral groups. Let [Formula: see text] be an algebraically closed field of characteristic [Formula: see text] and [Formula: see text] be a finite dihedral group. Let [Formula: see text] be the ring of invariants obtained by the linear action of [Formula: see text] on [Formula: see text]. In [ R. V. Gurjar and A. Patra, On minimum number of generators for some derivation modules, J. Pure Appl. Algebra [Formula: see text](11) (2022) 107105], Gurjar–Patra proved that [Formula: see text]. We will give a better bound on [Formula: see text] in this paper.
On C4-Modules
Authors: Ibrahim Yasser , Eid Hussein , El-Guindy Ahmad
Published: October 2024

An [Formula: see text]-module [Formula: see text] is called a [Formula: see text]-module if, whenever [Formula: see text] and [Formula: see text] are submodules of [Formula: see text] with [Formula: see text] and [Formula: see text] is an [Formula: see text]-homomorphism with [Formula: see text], then [Formula: see text]. The class of [Formula: see text]-modules was introduced and thoroughly investigated as a strict generalization of the well-known classes of [Formula: see text]-modules and square-free modules. In this paper, we study the modules all of whose submodules are [Formula: see text]-modules, extending many of the known results on the subject and obtaining new ones. Also, we study when a module has a [Formula: see text]-hull and a pseudo-continuous hull.
THE RELATIONSHIP BETWEEN EMOTIONAL COMPETENCE, SOCIAL ENTREPRENEURIAL OUTCOME EXPECTATIONS AND SOCIAL ENTREPRENEURIAL INTENTION
Authors: LUC PHAN TAN
Published: October 2024

This study investigates the influence of four dimensions of emotional competence, including self-awareness, empathy, motivation, self-regulation and social skills on the social entrepreneurial intention of students through social entrepreneurial outcome expectations. Based on a data set of 482 final year students, the results of the study show that self-awareness, self-regulation and self-motivation affect social entrepreneurial intention and outcome expectations. In contrast, empathy and social skills only directly affect social entrepreneurial intention. This study suggests that higher educators and policymakers incorporate emotional competency development into the higher education process. Higher education should be the place to nurture a generation of emotionally competent and socially conscious entrepreneurs by establishing an educational environment that values and develops emotional intelligence and by providing practical, encouraging experiences that align with the tenets of social enterprise.