bluuebunny/crossref_metadata_2025 huggingface dataset:
Professional identity formation of medical students in relation to older persons’ healthcare: exploring the views of older persons living in the Netherlands – a qualitative study
Authors: Moll-Jongerius Annemarie , Langeveld Kirsten , Gussekloo Jacobijn , Kramer Anneke , Achterberg Wilco P
Published: September 2024

Objectives

Given the growing population of older persons, medical students need to develop an appropriate professional identity to comply with older persons’ healthcare needs. In this study, we explored the needs and expectations of older persons regarding their doctor to gain more insight into the characteristics of this professional identity.

Design

A qualitative study based on a constructivist research paradigm was conducted, based on individual semistructured, in-depth interviews using a letter as a prompt, and focus groups. Thematic analysis was applied to structure and interpret the data.

Setting and participants

Our study population consisted of older persons, aged 65 years and above, living at home in the South-West of the Netherlands, with no apparent cognitive or hearing problems and sufficient understanding of the Dutch language to participate in writing, talking and reflecting. The in-depth interviews took place at the participant’s home or the Leiden University Medical Center (LUMC), and the focus groups were held at the LUMC.

Results

The older persons shared and reflected on what they need and expect from the doctor who takes care of them. Four major themes were identified: (1) personal attention, (2) equality, (3) clarity and (4) reasons why.

Conclusion

Increasing complexity, dependency and vulnerability that arise at an older age, make it essential that a doctor is familiar with the older person’s social context, interacts respectfully and on the basis of equality, provides continuity of care and gives clarity and perspective. To this end, the doctor has to be caring, involved, patient, honest and self-aware. Participation in a community of practice that provides the context of older persons’ healthcare may help medical students develop a professional identity that is appropriate for this care.
Atrial fibrillation after cardiac surgery: identifying candidate predictors through a Delphi process
Authors: Bedford Jonathan , Fields Kara G , Collins Gary Stephen , Lip Gregory Y H , Clifton David A , O’Brien Benjamin , Muehlschlegel Jochen D , Watkinson Peter J , Redfern Oliver C
Published: September 2024

Objectives

This study was undertaken to identify potential predictors of atrial fibrillation after cardiac surgery (AFACS) through a modified Delphi process and expert consensus. These will supplement predictors identified through a systematic review and cohort study to inform the development of two AFACS prediction models as part of the PARADISE project (NCT05255224). Atrial fibrillation is a common complication after cardiac surgery. It is associated with worse postoperative outcomes. Reliable prediction of AFACS would enable risk stratification and targeted prevention. Systematic identification of candidate predictors is important to improve validity of AFACS prediction tools.

Design

This study is a Delphi consensus exercise.

Setting

This study was undertaken through remote participation.

Participants

The participants are an international multidisciplinary panel of experts selected through national research networks.

Interventions

This is a two-stage consensus exercise consisting of generating a long list of variables, followed by refinement by voting and retaining variables selected by at least 40% of panel members.

Results

The panel comprised 15 experts who participated in both stages, comprising cardiac intensive care physicians (n=3), cardiac anaesthetists (n=2), cardiac surgeons (n=1), cardiologists (n=4), cardiac pharmacists (n=1), critical care nurses (n=1), cardiac nurses (n=1) and patient representatives (n=2). Our Delphi process highlighted candidate AFACS predictors, including both patient factors and those related to the surgical intervention. We generated a final list of 72 candidate predictors. The final list comprised 3 demographic, 29 comorbidity, 4 vital sign, 13 intraoperative, 10 postoperative investigation and 13 postoperative intervention predictors.

Conclusions

A Delphi consensus exercise has the potential to highlight predictors beyond the scope of existing literature. This method proved effective in identifying a range of candidate AFACS predictors. Our findings will inform the development of future AFACS prediction tools as part of the larger PARADISE project.

Trial registration number

NCT05255224.
Communicating COVID-19 vaccine information to Chinese communities in the UK: a qualitative study of their knowledge, information sources and trust
Authors: Gong Qian Sarah , Gao Zhenghan , Somerville Ian , Steele Circle , Wang Dian , Zhou Huiyu
Published: September 2024

Introduction

In late 2020, the COVID-19 vaccine acceptance rates of Chinese people living in the UK were estimated between 52% and 57%, significantly lower than that of the general population (76%). This disparity formed a primary motivation for this study which explored Chinese communities’ overall understanding of and attitude towards the COVID-19 vaccines, the sources of information about the vaccines and levels of (dis)trust in these sources.

Methods

29 focus groups with 154 participants from UK-based Chinese communities of varied sociodemographic backgrounds were conducted between March and November 2021. Focus group data were coded with NVivo and analysed using thematic analysis.

Results

Participants generally had a good understanding of the health benefits of the vaccines, however, many still had concerns about vaccine safety and efficacy. They accessed COVID-19 vaccine information from a multitude of sources and had diverse information needs which to a large extent shaped their knowledge of and attitude towards the vaccines. Participants generally had good digital access and some have developed good digital literacy enabling discernment of mis/disinformation. The ways in which they accessed and engaged with various types of information sources were differentiated by diversities in country/regions of origin, years of residence and main language/dialects spoken. They also demonstrated varying degrees of trust about the communication around vaccines depending on the perceived expertise of the authority, their character and the perceived accuracy and transparency of the information.

Conclusion

The UK government and health authorities need to understand Chinese communities’ diverse information needs and cultural practices to form culturally and linguistically appropriate COVID-19 vaccine communication strategies to develop trust, targeting not the entire community but subgroups within the community via credible media sources and community networks.
Comparing modalities of opioid education in patients undergoing total knee arthroplasty: a randomized pilot trial
Authors: Sheetz Miriam , Puglisi Angela , Trentalange Mark , Reichel Julia , Chalmers Brian , Gonzalez Della Valle Alejandro , Sideris Alexandra , Lee Bradley H
Published: September 2024

Background

Patients undergoing total knee arthroplasty (TKA) experience significant postoperative pain and routinely require opioids, yet they often lack knowledge regarding appropriate use and handling of these medications. Evidence suggests that educational interventions in various formats may help reinforce proper usage and improve postoperative pain control. The aim of this study is to compare the institution standard of care (webinar) with two novel educational interventions—one in-person and the other a video recording—that focus specifically on the use of opioids and pain control.

Methods

This prospective, randomized pilot study included 42 patients undergoing TKA. Patients were randomized into one of three groups: (1) webinar: 50 min virtual session standard of care at Hospital for Special Surgery (HSS), (2) in-person education, or (3) video education. The primary outcomes of this study were the number of opioid refill requests through postoperative day (POD) 30 and POD 60. The secondary outcomes evaluated Numerical Rating Scale (NRS) pain scores, opioid consumption in oral morphine equivalents (OME), surveys on medication usage and opioid knowledge, reported medication storage and disposal. We hypothesize that the novel educational interventions, presented either in-person or by video, will lead to a decrease in opioid refills within 60 days compared with current education delivered through virtual webinar.

Results

No significant differences were found among groups in the number of opioid refill requests, average NRS pain score, or OME consumption at any time point. Opioid refill requests ranged from 0% to 16.7% at POD 30 (Fisher’s exact test, p=0.625) and from 0% to 8.3% at POD 60 (p=1.000). The median opioid refill request was zero requests per group from POD 21 to 60 (webinar 0 (0.0, 0.0), in-person 0 (0.0, 0.0), video 0 (0.0, 0.0), Kruskal-Wallis test, p=0.381). Average NRS pain scores were 5 or below for all groups on POD 1, 7 and 14. By POD 7, all groups had an average daily intake OME of 14 or below.

Conclusions

Overall, patients in each group did well with postoperative pain management after TKA and had minimal opioid refill requests. There were no statistically significant differences in outcomes of NRS pain scores or opioid usage among groups suggesting that educational interventions were similarly effective. As a pilot trial, study demonstrated successful recruitment and retention of participants, and important feedback was elicited from patients regarding education, as well. Of note, this was a pilot study and was likely underpowered to detect a difference.

Trial registration number

NCT05593341.
Controversies in Hirschsprung surgery
Authors: Xu Thomas O , Levitt Marc A , Feng Christina
Published: September 2024

The treatment of Hirschsprung disease (HSCR) is surgical resection of aganglionic bowel and subsequent pull-through of ganglionated bowel. Despite many advances since the initial description of the disease and its surgical management more than half a century ago, there remain considerable controversies regarding the history of the surgical technique, the optimal timing of the primary and multistage pull-through, the best treatment for patients with a delayed diagnosis of HSCR, and the management of post pull-through complications such as soiling due to sphincter incompetence, the presence of a transition zone, and the prevention of enterocolitis. The following review will explore each of these controversies.
Laboratory evaluation of asphalt mixtures reinforced with aramid fibres coated with bituminous oils
Authors: Almutairi Haya , Qabur Ali , Baaj Hassan
Published: September 2024

Adding additives such as fibres to asphalt mixtures is believed to improve the overall performance of hot mix asphalt (HMA). Unlike previous studies, this research investigates the performance of HMA modified with oil-coated aramid fibers, exploring its potential to enhance rutting resistance, fatigue behavior, and low-temperature cracking. The fibers were utilized at various dosages (110, 138, and 164 g/tonne) and lengths (13, 20, and 25 mm). Comprehensive evaluations were conducted using the Hamburg wheel tracking device, four-point bending fatigue test, and thermal stress restrained specimen test to assess the impact of these modifications on HMA properties. The results found that 25 mm long aramid fibres, at all dosages, improved the rutting resistance by up to 65% compared to the control mixture. However, the fatigue behaviour and low-temperature cracking resistance were not as good as the rutting performance. Therefore, and based on this study, it was concluded that the addition of the newly developed bituminous oil-coated aramid fibres has no positive impact as a reinforcement of the asphalt mixture.
Modeling stand fire probabilities with unobserved heterogeneity. Estimating stand age and climate change effects in Chilean radiata pine plantations
Authors: Niklitsckek Mario , Labbé Rodrigo
Published: September 2024

Evenly managed forest plantations are potentially vulnerable to fires because of their high fuel load build-up in each rotation. We use panel data analysis that considers the possible correlation between the observed covariates of interest with spatial unobserved heterogeneity. We compared two alternative approaches to estimate the stand burn probability function of the stand age: the average structural function (ASF) and the local average structural function (LASF). While our results show a significant positive effect of the stand age for the mature stage under both approaches, more differentiation in the stand burn probability for different ages is captured with the LASF. Also, under the LASF, the stand age functions are more sensitive to changes in site productivity. We predicted the burned area under the RCP 4.5 and RCP 8.5 climate scenarios considering adaptation in management regimes to site productivity changes. The largest impact is projected for the coastal areas where site productivity increases are combined with more suitable climate conditions for flammability. For the dryer hinterland, however, stand burn probabilities and the burned area are predicted to decline in the second period and the RCP 8.5 because of the dominant negative effect resulting from the site productivity reduction.
mCaptcha: Replacing Captchas with Rate limiters to Improve Security and Accessibility
Authors: Manivannan Aravinth , Sethuraman Sibi Chakkaravarthy , Vimala Sudhakaran Devi Priya
Published: September 2024

To counter the threat of AI-powered bots, captcha systems are growing increasingly complex, often sacrificing usability and accessibility. Can mCaptcha, a proof-of-work captcha system, effectively address these issues?
Human-Robot Team Performance Compared to Full Robot Autonomy in 16 Real-World Search and Rescue Missions: Adaptation of the DARPA Subterranean Challenge
Authors: Robinson Nicole , Williams Jason , Howard David , Tidd Brendan , Talbot Fletcher , Wood Brett , Pitt Alex , Kottege Navinda , Kulić Dana
Published: September 2024

Human operators in human-robot teams are commonly perceived to be critical for mission success. To explore the direct and perceived impact of operator input on task success and team performance, 16 real-world missions (10 h) were conducted based on the DARPA Subterranean Challenge. Missions involved deploying a heterogeneous team of robots to locate and identify artefacts such as climbing rope, drills and a mannequin representing a human survivor. Two conditions were evaluated: human operators that could control the robot team with state-of-the-art autonomy (Human-Robot Team) compared to autonomous missions without human operator input (Robot-Autonomy). Human interventions included creating waypoints to prioritise high-yield areas, and to navigate through error-prone spaces. Human-Robot Teams were often in directed autonomy mode (70% of mission time), found more items (

\(+\)

10.52%), traversed more distance (

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12.71%), covered more unique ground (

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10.56%), and longer time between safety-related events (34%). In routine conditions, both condition scores were comparable for artefacts, distance and coverage. Human-Robot Teams were faster at finding the first artefact but slower to respond to information from the robot team. Overall, operators contribute to mission-based outcomes, help to overcome environmental situations that can impede progress, and can assist robots to recover faster from difficult events.
Freezing and Capillarity
Authors: Huerre Axel , Josserand Christophe , Séon Thomas
Published: September 2024

Ice structures such as accretion on airplanes, wires, or roadways; ice falls; ice stalactites; frozen rivers; and aufeis are formed by the freezing of capillary flows (drops, rivulets, and films). To understand these phenomena, a detailed exploration of the complex coupling between capillary flow and solidification is necessary. Among the many scientific questions that remain open in order to understand these problems are the confinement of the thermal boundary layer by the free surface, the interaction between a freezing front and a free surface, the effect of freezing on the contact line motion, etc. This review focuses mainly on water and ice, discussing the theoretical framework and recent developments in the main areas of the freezing–capillarity interaction. The text deeply explores the freezing of a moving drop and the fundamental problem of wetting water on ice. Additionally, it highlights some of the main open questions on the subject.
Introduction to the Theme “Novel Therapeutics with the Potential to Advance Health Care”
Authors: Insel Paul A. , Amara Susan G. , Ahluwalia Amrita
Published: September 2024

The reviews in Volume 65 of the Annual Review of Pharmacology and Toxicology cover a wide variety of topics in pharmacology and toxicology focused upon the pathway from preclinical studies to clinical trials. Many of these reviews discuss the identification and validation of new therapeutic targets and/or novel therapeutic approaches. Examples include reviews that focus on the treatment of obesity, neuropsychiatric disorders, Parkinson's disease, substance use disorders, liver fibrosis, cardiac arrythmias, chronic intestinal inflammation, prostate cancer, immuno-oncology, sickle cell disease, and snakebite envenoming. Other topics include drug discovery of biologics, microphysiological systems, and human induced pluripotent stem cell–derived organoids and organ-on-chip technology integrated with artificial intelligence methodologies. Together, these and other reviews give new insights into the assessment of aspects of toxicology and provide readers a glimpse of advances in pharmacology and toxicology that we believe will advance health care and environmental safety.
Reversible Long-Term Operation of a MK35x Electrolyte-Supported Solid Oxide Cell-Based Stack
Authors: Riegraf Matthias , Szabo Patric , Lang Michael , Costa Rémi , Rothe Stefan , Megel Stefan , Kusnezoff Mihails
Published: September 2024

High-temperature reversible solid oxide cells (rSOC) combine electrolyzer and fuel cell in one process unit which promises economic advantages with unrivaled high electrical efficiencies. However, large temperature gradients during dynamic rSOC operation can increase the risk of mechanical failure. Here, the degradation behavior of a 10-cell stack of the type “MK35x” with chromium-iron-yttrium (CFY) interconnects and electrolyte-supported cells (ESC) developed at Fraunhofer IKTS was investigated in rSOC operation at DLR. Its degradation was evaluated during nominal rSOC operation for more than 3400 h with 137 switching cycles between solid oxide fuel cell and solid oxide electrolysis cell operation of 24 h reflecting intermittent availability of solar energy. The voltage degradation rates of +0.58%/kh and −1.23%/kh in electrolysis and fuel cell operation, respectively, are among the lowest reported in literature. Comparison to a previously published long-term test in steam electrolysis did not show any indication for an increased degradation. Electrochemical impedance spectroscopy measurements were performed for all repeat units to evaluate the degradation behavior in detail. An overall polarization resistance decrease due to an improvement of the oxygen electrode was observed during electrolysis operation but was absent during fuel cell operation.
Factors Influencing Induction of Labor Success in Riyadh, Saudi Arabia
Authors: Alshalan Renad A. , Alarfaj Rwan K. , Almojel Yazeed A. , AlHaddad Yara , Alsomali Rahaf , Adham Maysoon Al
Published: September 2024

Introduction. The physiological process by which the fetus and placenta are delivered from the uterus and pass through the vaginal canal for delivery is known as labor. Induction of labor involves deliberately initiating labor before it occurs naturally, using medical interventions or techniques to stimulate contractions and initiate the birthing process. Aim. This study aimed to investigate the factors that influence the success of labor induction procedures in Riyadh, Saudi Arabia, from January to April 2023. Subject and Methods. This retrospective chart review was conducted at the National Guard Hospital in Riyadh, Saudi Arabia. Data were collected from the patient chart of those who underwent labor induction from January to April 2023. The collected data were tabulated and cleaned in MS Excel. Final data were transferred to SPSS for subsequent data analysis. Results. Five hundred and thirty‐one pregnant women were analyzed. 52.7% were aged 30 years or below. The most common indication of IOL was post‐dated pregnancy (26.2%). 62% were normal deliveries, indicative of IOL success, while 31.1% were cesarean deliveries, indicative of IOL failure. In univariate analysis, women with lower gravidity (≤3) and who had received Propess were associated with cesarean delivery. In a multivariate regression analysis, women who received Prostin and increased parity were identified as the significant independent predictors of IOL success. Conclusion. IOL’s success was dependent primarily on increasing parity and Prostin administration. However, lower gravidity (≤3) and Propess medication could lead to operative procedures among pregnant women. Hence, it is necessary to carefully assess the condition of pregnant women before directing them to IOL.
The Journey to Adulthood: A Systematic Review of Interventions in Type 1 Diabetes Paediatric to Adult Transition Care
Authors: Aljohani Nada , Donetto Sara , Due-Christensen Mette , Forbes Angus
Published: September 2024

Young people with type 1 diabetes mellitus (T1DM) transition from paediatric to adult services when they reach late adolescence. This can be a risky period for young people, and it has been associated with a deterioration in glycaemic control and disengagement from diabetes services. This review aimed to identify current interventions addressing the following questions: What adolescents with T1DM healthcare transition interventions have been evaluated? What are the underlying theories and components of these interventions? What outcomes have been considered in these evaluations? Databases, trial registries and other sources were searched using the population and intervention keywords. Studies were included if they explicitly reported a transition intervention targeting young people aged 10–25 years. Studies were critically apprised, and data were extracted. Both tabular and narrative data synthesis were used. The review included 22 studies. Most interventions were service‐oriented, with little use of theory. The interventions included transition planning, service coordination, pre‐transition education, transition clinics, prompting strategies and other less frequent components. Most studies reported metabolic outcomes, with limited data on psychological outcomes such as diabetes adaptation, acceptance and self‐management activation. It is inconsistent how each outcome was defined, measured or reported. Consequently, effective theory‐based interventional transition models are yet to be identified.
Cilostazol Combats Lipopolysaccharide‐Induced Hippocampal Injury in Rats: Role of AKT/GSK3β/CREB Curbing Neuroinflammation
Authors: El-ezz Doaa Abou , Aldahmash Waleed , Esatbeyoglu Tuba , Afifi Sherif M. , Elbaset Marawan Abd
Published: September 2024

Neuroinflammation is important in the pathophysiology of several degenerative brain disorders. This study looked at the potential neuroprotective benefits of cilostazol, a phosphodiesterase inhibitor, against LPS‐induced hippocampus damage in rodents and the principal molecular involvement of AKT/GSK3β/CREB signaling pathways. Behavioral tests revealed that cilostazol successfully corrected LPS‐induced neurobehavioral impairments. Furthermore, cilostazol therapy lowered hippocampal levels of amyloid beta 1–42 (Aβ1‐42) and p‐tau protein, both of which are critical pathological indicators of neurodegenerative disorders. Furthermore, cilostazol administration suppressed LPS‐induced rises in hippocampus caspase‐3 and NF‐κB levels while elevating rat B‐cell/lymphoma 2 (BCL2) and brain‐derived neurotrophic factor (BDNF) levels, which are implicated in neuronal survival and synaptic plasticity. Cilostazol treatment also restored the decreased phosphorylation of protein kinase B (p‐AKT) and reduced the elevated levels of phosphorylated glycogen synthase kinase‐3 beta (p‐GSK3β) and cAMP response element‐binding protein (CREB) in the hippocampus of LPS‐treated rats. Histopathological examination revealed that cilostazol ameliorated LPS‐induced brain damage with reduced neuronal loss and gliosis. Immunohistochemistry analysis showed a decrease in Iba‐1 expression, indicating a reduction in microglial activation in the cilostazol‐treated group compared to the LPS group. The findings advocate that cilostazol exerts neuroprotective effects against LPS‐induced hippocampal injury by modulating the AKT/GSK3β/CREB pathway and curbing neuroinflammation. Cilostazol may hold promise as a therapeutic agent for neuroinflammatory conditions associated with neurodegenerative diseases.
Bilateral Testicular Torsion in Bilateral Polyorchidism—A Case Report
Authors: Cardoso Breno Lanter , da Silva Ferreira Bruno Roberto , Silva Élcio Dias , Mitre Anuar Ibrahim
Published: September 2024

A 17‐year‐old patient with acute testicular pain had no blood flow observed on scrotal ultrasound Doppler on either side, suggestive of bilateral torsion. The patient underwent immediate scrotal surgical exploration, and a numerical anomaly was observed during surgery—there were two testicles on each side, and all four exhibited torsion. After detorsion, circulation was recovered, and three of four testicles were kept. One dystrophic testis was removed.
Advanced Technique of Unilateral Biportal Endoscopy on Revision Surgery for Recurred Herniated Interverbral Disc: A Technical Note
Authors: Kim Hun-Chul , Lee Jin Young , Cho Hyeon Guk , Park Jeong Woo , Han Sang-Ho , Ko Young-Il
Published: September 2024

Introduction: Revision surgery in the spine poses considerable challenges due to the presence of scar tissue and structural differences, necessitating careful surgical planning and precise techniques. In this technical note, we focus on lumbar unilateral biportal endoscopy (UBE) for single‐level reoperations, outlining principles and methods for handling soft tissue in such cases.

Materials and Methods: We reviewed our surgical approach for lumbar reoperations with UBE, emphasizing the importance of meticulous preoperative planning and bone‐centered manipulation. Our technique involves utilizing biportal endoscopy for enhanced visualization and employing specific strategies for managing scar tissue, including the “pull‐and‐cut technique.” We present two illustrative cases to demonstrate the application of our method.

Results: The described approach yielded successful outcomes in both cases presented. Case 1 involved a posterior interlaminar approach for a recurrent disc at the L4–5 level, while Case 2 utilized a far lateral approach for recurrent disc herniation at the L4–5 level. Both surgeries were completed with relatively short operation time, minimal blood loss, and immediate improvement in symptoms postoperatively.

Conclusion: Lumbar UBE offers a promising option for safe and effective reoperation in spinal surgery. Our technique, emphasizing bone‐centered manipulation and specific strategies for scar tissue management, provides excellent visibility and enables precise tissue handling. Overall, UBE facilitates relatively simple and safe reoperations, contributing to improved patient outcomes in the challenging field of spinal surgery.
Phylogenetically Informative Mutations in Drug Resistance Genes of Human‐Infecting Mycobacterium bovis
Authors: Dong Yuhui , Ou Xichao , Zhao Bing , Wang Yuanzhi , Liu Yiduo , Liu Ziyi , Wang Haoran , Ge Xin , Nan Yue , Zhao Yanlin , Zhou Xiangmei
Published: September 2024

The diagnosis of drug‐resistant tuberculosis (TB) by molecular testing of Mycobacterium tuberculosis drug resistance genes is becoming increasingly common clinically. However, M. bovis, as an uncommon pathogen of human TB, may interfere with the test results. A comprehensive understanding of phylogenetically informative mutations in the drug resistance genes of M. bovis is required to distinguish true resistance‐conferring mutations. We analyzed 53 drug resistance genes in 165 M. bovis isolated from humans using whole‐genome sequencing data and found that 98.2% (162/165) of isolates have pyrazinamide intrinsic genotypic resistance, owing to the H57D mutation in the pncA gene. 12.1% (20/165) of M. bovis isolates were resistant to drugs other than pyrazinamide. Furthermore, we discovered 18 phylogenetically informative mutations that differed between M. bovis and the major lineages 1–4 of M. tuberculosis. Additionally, we reported false‐positive ethambutol resistance caused by M. bovis infection due to the phylogenetically informative mutation embB E378A. This study is crucial for gaining insights into the genetic characterization and drug resistance of M. bovis prevalent in humans, as well as contributing to the development of more accurate molecular diagnostic methods and detection tools for drug resistance.
Multiobjective Offloading Optimization in Fog Computing Using Deep Reinforcement Learning
Authors: Mashal Hojjat , Rezvani Mohammad Hossein
Published: September 2024

Edge computing allows IoT tasks to be processed by devices with passive processing capacity at the network’s edge and near IoT devices instead of being sent to cloud servers. However, 5G‐enabled architectures such as Fog Radio Access Network (F‐RAN) use smart devices to bring the delay down to even a few milliseconds. This is important, especially in latency‐sensitive applications such as online digital games. However, a trade‐off must be made between the delay and energy consumption. If too many tasks are processed locally on edge devices or fog servers, energy consumption increases because mobile devices such as smartphones and tablets have limited energy charges. This paper proposes a Deep Reinforcement Learning (DRL) method for offloading optimization. In designing states, we consider all three critical components of memory consumption, the number of CPU cycles, and network mode. This makes the modeling aware of the workload of the tasks. As a result, the model matches the requirements of the real world. For each mobile device that submits a task to the system, we consider a reward. It includes the total delay of tasks and energy consumption. The output of our DRL model specifies to which edge/fog/cloud device each task should be offloaded. The results show that the DRL technique produces less resource waste than RL when the number of tasks is very high. In addition, DRL consumes 30% less network resources than the FIFO method. As a result, DRL provides a better trade‐off between offloading and local execution than other methods.
Morphological Characteristics, Genetic Diversity, and Microsatellite Analysis of the Progenies (F1, F2, and Backcross Descendant) of Siniperca chuatsi and Siniperca scherzeri
Authors: Zhang Zhilun , Sun Jijia , Liu Shuang , Chen Jiahui , Wei Xuchong , Huang Chenlei , Lin Li , Chen Qiuxian , Liu Xuange , Li Haiyang , Yi Huadong , Bi Sheng , Han Linqiang , Liang Jianhui , Zhang Yong , Li Guifeng
Published: September 2024

Hybridization is a common technique in the breeding of new varieties. In this study, we obtained F1 and F2 hybrids through interspecific hybridization between Siniperca chuatsi and Siniperca scherzeri and backcross offspring by backcrossing between F1 and Siniperca chuatsi. We analyzed the morphological traits and genetic diversity of the parents and their progeny. The results showed that although most morphological traits of the progeny were not significantly different from those of their parents, the F1 hybrids exhibited the most pronounced morphological variations. The F2 and backcross hybrids appeared morphological differentiation within their populations. The CPL/CPW ratio emerged as a reliable marker for identifying hybrids morphologically. The expected heterozygosity for F1 (0.6264), F2 (0.6677), and backcross offspring (0.5260) were intermediate between Siniperca chuatsi (0.7388) and Siniperca scherzeri (0.3910), indicating a relatively high level of genetic diversity in the offspring. Additionally, the private allele frequency of F1 and F2 was higher than backcross offspring. One SSR marker (G5220) was identified as a specific molecular marker to distinguish the hybrid F1 population from the parents, hybrid F2, and backcross F1 populations by analyzing specific alleles. The result of Ne, He, I, and PIC confirmed that F2 maintained the genetic diversity of F1. We speculated that both F1 and F2 have higher breeding potential. This study provides essential baseline data for genetic breeding of mandarin fish that will be instrumental in the future.
Assessment of COVID‐19 Vaccine Impact on Women’s Menstrual Health within an 18‐Month Follow‐Up
Authors: Sadat Larijani Mona , Eybpoosh Sana , Doroud Delaram , Bavand Anahita , Moradi Ladan , Ashrafian Fatemeh , Tajmehrabi Namini Parinaz , Zali Mahsan , Ramezani Amitis
Published: September 2024

Considering menstruation as a crucial factor in females’ health and fertility, any factor that could change its cycle is important. This study was conducted from April 2021 to October 2022 on females who got 3 doses of vaccines against SARS‐CoV‐2 through different platforms. The participants were requested to provide the trained experts with any changes regarding menstrual cycles after each dose of the vaccine up to 6 months after the booster shots. The disturbances related to the vaccines were identified by the adverse events committee to find possible associations with the applied vaccines. Of 308 women who participated until the end of the study, 22 (7.1%) complained about at least one abnormality in their menstrual patterns. The most common disturbance was metrorrhagia as 10 (48%) incidences followed by menorrhagia as 6 events (24.2%). Notably, the identified complaints were persistent in 59% of the patients. In addition, 14 studied cases developed COVID‐19 infection after menstrual disorders. In these cases, COVID‐19 could also play a role in the persistence of postvaccine menstrual disturbances. COVID‐19 vaccination could affect menstrual cycle in women with no remarkable previous medical history. More longitudinal studies are required regarding this issue.
Sustainable Soil Stabilization Approach Utilizing Rice Husk Ash and Hydrated Lime for Enhancing Poor Subgrade Soil in Arkansas
Authors: Tarhuni Fares , Uddin Mohammad , Hossain Zahid
Published: September 2024

Soils with a significant proportion of clay or silt tend to have poor geotechnical characteristics (such as volumetric change and low strength) when exposed to varying moisture contents. The chemical stabilizers currently used are costly and have negative effects on the environment. Arkansas, in the United States, is the leading producer of rice in the country. During rice production, ~20% of the harvested grain consists of rice husk (RH). The rice milling process produces ash with a considerable amount of silicate. Research is being conducted to address the environmental concerns associated with its disposal in Arkansas, as there is growing interest in using rice husk ash (RHA) as a stabilizing additive for problematic soils. For RHA to be effective, an activator such as lime may be needed. The present study focuses on investigating the effectiveness of RHA in stabilizing substandard soils, as no prior study has used RHA as a stabilizing agent in the United States. Additionally, the research aims to determine the optimal proportions of RHA, hydrated lime (HL), or a combination of both. The study employs varying percentages of RHA (3%, 6%, and 9%) and HL (1%, 3%, and 5%) in a unary system. In the binary system, 3%, 4%, and 5% of RHA are combined with 1% HL. The study includes a range of routine tests, such as assessments of Atterberg limits, modified proctor compaction, pH levels, California bearing ratio (CBR), unconfined compressive strength (UCS), and free swell (FS). Furthermore, results from scanning electron microscopy (SEM) coupled with X‐ray diffractometer analyses demonstrated significant improvements in UCS and CBR values for the treated soils, indicating enhanced strength and stability. Moreover, the FS test reveals a reduction in swelling characteristics for the stabilized soils. It was found the optimal dosages of RHA and HL were 6% and 3%, respectively. Notably, when RHA and HL were combined, a blend of these two stabilizing agents exhibited the most promising results in terms of improving the swelling. The optimum percentage of the combined stabilizing agents was 4% RHA + 1% HL. The findings of this proof‐of‐concept research hold substantial potential for the construction industry in Arkansas, offering cost‐effective alternatives to conventional soil stabilization methods while promoting the sustainable and environmentally conscious use of RHA.
FLDATN: Black‐Box Attack for Face Liveness Detection Based on Adversarial Transformation Network
Authors: Peng Yali , Liu Jianbo , Long Min , Peng Fei
Published: September 2024

Aiming at the shortcomings of the current face liveness detection attack methods in the low generation speed of adversarial examples and the implementation of white‐box attacks, a novel black‐box attack method for face liveness detection named as FLDATN is proposed based on adversarial transformation network (ATN). In FLDATN, a convolutional block attention module (CBAM) is used to improve the generalization ability of adversarial examples, and the misclassification loss function based on feature similarity is defined. Experiments and analysis on the Oulu‐NPU dataset show that the adversarial examples generated by the FLDATN have a good black‐box attack effect on the task of face liveness detection and can achieve better generalization performance than the traditional methods. In addition, since FLDATN does not need to perform multiple gradient calculations for each image, it can significantly improve the generation speed of the adversarial examples.
Implementation of a Multimode Optical Source in the VPIphotonics Software
Authors: Tshibangu-Mbuebue Blaise , Cuevas-Terrones Rodrigo , Lee Min Won , García-Juárez Alejandro , Zaldívar-Huerta Ignacio Enrique
Published: September 2024

This paper shows the design and implementation of a multimode optical source in the VPIphotonics software. Considering all the powerful features this software provides, the absence of a device such as a multimode source in its library constitutes a limitation for particular simulations. The use of single‐mode optical sources available in the library allows for obtaining a multimode spectrum. The mathematical relationship that describes a multimode optical source is numerically evaluated in MATLAB. Afterward, this graphical result is compared with the obtained in the VPIphotonics software. The importance of using this type of optical source resides in its applications for modern optical communications systems, microwave photonic filters (MPFs), opto‐electronic oscillators (OEOs), and sensors. This implementation aims to drive virtual systems where required, and by setting its parameters similar to the real ones, it allows good studying and understanding of system responses. Even more, it predicts or ensures the results of experimental systems by having the possibility to vary different parameters. A practical application of the obtained multimode optical spectrum is shown with its use in the implementation of an MPF. This last simulation is experimentally corroborated. This work presents a technique for designing a multimode optical source in this particular software and provides also academics and students, with a methodology for the use of this software for this kind of photonic design.
A Group Feature Screening Procedure Based on Pearson Chi‐Square Statistic for Biology Data with Categorical Response
Authors: He Hanji , He Jianfeng , Deng Guangming
Published: September 2024

The analysis of biogenetic data makes an important contribution to the understanding of disease mechanisms and the diagnosis of rare diseases. In this analysis, the selection of significant features affecting the disease provides an effective basis for subsequent disease judgment and treatment direction. However, this is not a simple task as biogenetic data have challenges such as ultra‐high dimensionality of potential features, imbalance of response variables, and genetic associations. This study focuses on the group structure in feature screening with biogenetic data. Specifically, group structure exists for biogenetic data, so we need to analyze the entire genome rather than individual strongly correlated genes. This study proposes a group feature screening method that considers group correlations using adjusted Pearson’s cardinality statistic to address this issue. The method can be applied to both continuous and discrete covariates. The performance of the proposed method is illustrated by simulation studies, where the proposed method performs well with imbalanced data and multicategorical responses. In the application of lung cancer diagnosis, the proposed method for imbalanced data categorization is impressive, and the dimension reduction using linear discriminant is still good.
Effect of MMT‐HNT Hybrid Nanoclay on Properties of UHMWPE Composite
Authors: Hasan Rania , Pande Sarang , Bhalerao Pravin , Salunkhe Sachin , Cep Robert , Nasr Emad Abouel
Published: September 2024

Due to the increasing demand for artificial joint implants, two types of clays, montmorillonite (MMT) and halloysite nanotube (HNT), have been used either in combination as hybrid additives to reinforce the properties of the widely used polymer in the biomedical field (ultra‐high molecular weight polyethylene (UHMWPE)). The 5% nanoclay content was incorporated into all manufactured nanocomposite materials. Several tests were conducted to evaluate the mechanical performance of these nanocomposite materials, including Izod, hardness, abrasion, and compression. Additionally, XRD analysis, scanning electron microscopy, and biocompatibility study were investigated to examine these nanocomposite’s capacity to suit orthopedic applications. Compared to pure UHMWPE, the “hybridization” effect successfully increased the resistance of the nanocomposite. Although 5% HNT‐UHMWPE composites underwent some degradation in impact strength, the excellent ductility preserved the composites to fail without catastrophic fracture. Based on the MTT assay, all nanocomposites exhibited good biocompatibility, evident by favorable cell growth with no signs of cytotoxicity after up to 96 h of incubation in media with different amounts of material in solution.
GALAD Score for the Diagnosis of Hepatocellular Carcinoma in Sub-Saharan Africa: A Validation Study in Ghanaian Patients
Authors: Nartey Yvonne Ayerki , Yang Ju Dong , Zemla Tyler J. , Ayawin Joshua , Asibey Shadrack Osei , El-Kassas Mohamed , Bampoh Sally Afua , Duah Amoako , Agyei-Nkansah Adwoa , Awuku Yaw Asante , Afihene Mary Yeboah , Yamada Hiroyuki , Yin Jun , Plymoth Amelie , Roberts Lewis R.
Published: September 2024

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide including sub-Saharan Africa. The GALAD score, derived from Gender, Age, Lens culinaris agglutinin-reactive fraction of alpha fetoprotein, Alpha fetoprotein, and Des-carboxy-prothrombin, has high accuracy in diagnosing HCC in Asia, Europe, and North America; however, it has not been validated in an African cohort. The aim of this study was to assess the performance of the GALAD score in the diagnosis of HCC in sub-Saharan Africa. Clinical data from patients with cirrhosis (n = 93) or HCC (n = 78) from outpatient hepatology clinics at three teaching hospitals in Ghana were abstracted, and serum samples were analyzed. A logistic regression model predicting HCC status based on the GALAD score was constructed to obtain the ROC curve for GALAD. The AUC with 95% confidence interval (CI) was calculated. The median GALAD score was higher among patients with HCC versus cirrhosis controls (8.0 vs. −4.1, P < 0.01). The AUC of the GALAD score for HCC detection was 0.86 (95% CI, 0.79–0.92). At a cut-off value of −0.37, the GALAD score had a sensitivity of 0.81 and a specificity of 0.86. The AUC (95% CI) was 0.87 (0.80–0.95) and 0.81 (0.67–0.94) in hepatitis B virus–positive and hepatitis B virus–negative patients, respectively. The GALAD score has a high accuracy for HCC detection. It has great potential to improve HCC surveillance in sub-Saharan Africa where imaging resources are limited.

Significance: The GALAD score or its relevant modifications have the potential to aid in improving HCC surveillance efforts in low-resource settings in sub-Saharan Africa. This could enhance early detection rates of HCC and potentially improve survival rates in resource-limited settings.
Novel Method to Monitor Arteriovenous Fistula Maturation: Impact on Catheter Residence Time
Authors: Rosales Merlo Laura , Ye Xiaoling , Zhang Hanjie , Chan Brenda , Mateo Marilou , Johnson Seth , van der Sande Frank M. , Kooman Jeroen P. , Kotanko Peter
Published: September 2024

Introduction: Arteriovenous fistula (AVF) maturation assessment is essential to reduce venous catheter residence. We introduced central venous oxygen saturation (ScvO2) and estimated upper body blood flow (eUBBF) to monitor newly created fistula maturation and recorded catheter time in patients with and without ScvO2-based fistula maturation. Methods: From 2017 to 2019, we conducted a multicenter quality improvement project (QIP) in hemodialysis patients with the explicit goal to shorten catheter residence time post-AVF creation through ScvO2-based maturation monitoring. In patients with a catheter as vascular access, we tracked ScvO2 and eUBBF pre- and post-AVF creation. The primary outcome was catheter residence time post-AVF creation. We compared catheter residence time post-AVF creation between QIP patients and controls. One control group comprised concurrent patients; a second control group comprised historic controls (2014–2016). We conducted Kaplan-Meier analysis and constructed a Cox proportional hazards model with variables adjustment to assess time-to-catheter removal. Results: The QIP group comprised 44 patients (59 ± 17 years), the concurrent control group 48 patients (59 ± 16 years), the historic control group 57 patients (58 ± 15 years). Six-month post-AVF creation, the fraction of non-censored patients with catheter in place was 21% in the QIP cohort, 67% in the concurrent control group, and 68% in the historic control group. In unadjusted and adjusted analysis, catheter residence time post-fistula creation was shorter in QIP patients compared to either control groups (p < 0.001). Conclusion: ScvO2-based assessment of fistula maturation is associated with shorter catheter residence post-AVF creation.