bluuebunny/crossref_metadata_2025 huggingface dataset:
HealthCare Access Barrier (HCAB) framework for the barriers to cancer care during conflicts: perspective from Iraq
Authors: Mohsin Kouther , Mula-Hussain Layth , Gilson Richard
Published: March 2024

The Iraqi population has lived under four decades of conflicts, warfare and political instability. The health consequences of the protracted conflict continue to persist. This work critically analyses Iraq’s barriers to delivering and accessing cancer care during the conflicts that Iraq passed through from 1980 to 2017. To identify the barriers to accessing and delivering cancer care services, we used the HealthCare Access Barriers framework, which categorises the barriers into three groups: financial, structural and cognitive. Moreover, a structured search was performed in multidisciplinary databases. To produce a comprehensive body of literature, further materials were retrieved using alternative methods, such as hand-searching and snowballing. The key findings and themes identified in the literature were issues related to funding and affordability (within the financial), destruction and inaccessibility of facilities, therapeutic and diagnostic shortages, workforce and human resources and lack of national guidelines and awareness programmes (within the structural), awareness and knowledge and finally attitudes and beliefs (within the cognitive). These results demonstrated that the barriers to cancer care delivery are complex and inter-related. The financial and structural barriers were particularly intertwined with the protracted conflict, but this relationship was not demonstrable within the findings of the cognitive barriers. We concluded that the barriers facing the delivery and access to cancer care in Iraq are intertwined mainly with its protracted conflict. To ensure that future generations do not continue to pay the price of war, improved reconstructive efforts and further research are necessary.
Trends of hospitalisation among new admission inpatients with oesophagogastric variceal bleeding in cirrhosis from 2014 to 2019 in the Affiliated Hospital of Southwest Medical University: a single-centre time-series analysis
Authors: Peng Jieyu , Zeng Xinyi , Huang Shu , Zhang Han , Xia Huifang , Zou Kang , Zhang Wei , Shi Xiaomin , Shi Lei , Zhong Xiaolin , Lü Muhan , Peng Yan , Tang Xiaowei
Published: March 2024

Objectives

This study aimed to assess the internal law and time trend of hospitalisation for oesophagogastric variceal bleeding (EGVB) in cirrhosis and develop an effective model to predict the trend of hospitalisation time.

Design

We used a time series covering 72 months to analyse the hospitalisation for EGVB in cirrhosis. The number of inpatients in the first 60 months was used as the training set to establish the autoregressive integrated moving average (ARIMA) model, and the number over the next 12 months was used as the test set to predict and observe their fitting effect.

Setting and data

Case data of patients with EGVB between January 2014 and December 2019 were collected from the Affiliated Hospital of Southwest Medical University.

Outcome measures

The number of monthly hospitalised patients with EGVB in our hospital.

Results

A total of 877 patients were included in the analysis. The proportion of EGVB in patients with cirrhosis was 73% among men and 27% among women. The peak age at hospitalisation was 40–60 years. The incidence of EGVB varied seasonally with two peaks from January to February and October to November, while the lowest number was observed between April and August. Time-series analysis showed that the number of inpatients with EGVB in our hospital increased annually. The sequence after the first-order difference was a stationary series (augmented Dickey-Fuller test p=0.02). ARIMA (0,1,0) (0,1,1)12with a minimum Akaike Information Criterion value of 260.18 could fit the time trend of EGVB inpatients and had a good short-term prediction effect. The root mean square error and mean absolute error were 2.4347 and 1.9017, respectively.

Conclusions

The number of hospitalised patients with EGVB at our hospital is increasing annually, with seasonal changes. The ARIMA model has a good prediction effect on the number of hospitalised patients with EGVB in cirrhosis.
Preparing occupational therapy students for practice in rural areas: a scoping review protocol
Authors: Hayes Karen , Dos Santos Vagner , Boyd Nerida , Connelly Bronwyn , Lustig Kim
Published: March 2024

Introduction

Despite greater needs in rural areas, occupational therapists are maldistributed to urban spaces which limits service access and health outcomes for rural people and communities. Preparation of students for rural practice may improve rural workforce recruitment and retention; however, the range and scope of preparation strategies employed by education providers are unclear. This scoping review aims to understand and describe the range of strategies education services use to prepare occupational therapy students for rural practice across the globe.

Methods and analysis

The study will include all publications about strategies used to prepare occupational therapy students for future rural practice, prior to enrolment, during the programme or on graduation.MEDLINE (Ovid),Emcare (Ovid),APA PsychInfo (Ovid),CINAHL (EBSCOhost),Health Source: Nursing/Academic(EBSCOHost),Educational Resources Information Centre (ERIC),Open Access Theses and Dissertations (OATD), andScientific Electronic Library Online (SciELO)databases will be systematically searched in English, Spanish, French and Portuguese languages. Citations will be screened by two or more independent researchers against inclusion criteria and data extracted from included publications using a customised extraction tool. Frequency counts will be provided for study type, student location and sociodemographics, and the timing/educational strategy. The extracted data will be analysed using a matrix framework and presented in diagrammatic/tabular form and accompanied by a narrative summary which will describe how the results relate to the reviews’ questions.

Ethics and dissemination

This study will not involve human/animal subjects and does not require ethics approval. Results will be disseminated to relevant groups in peer-reviewed journal(s) and at relevant occupational therapy, higher education and/or rural health conferences. Results will also be translated and shared in blogs/social media to support access for non-research audiences and shared with other regional universities to influence curriculum design.
Thiamine as adjunctive therapy for diabetic ketoacidosis (DKAT) trial protocol and statistical analysis plan: a prospective, single-centre, double-blind, randomised, placebo-controlled clinical trial in the USA
Authors: Vine Jacob , Mehta Shivani , Balaji Lakshman , Berg Katherine M , Berlin Noa , Liu Xiaowen , Ngo Long , Shea Meredith , Moskowitz Ari , Donnino Michael W , Grossestreuer Anne V
Published: March 2024

Introduction

Diabetic ketoacidosis (DKA) is a potentially life-threatening diabetic complication. Despite the high prevalence of DKA and the substantial associated healthcare burden, limited research on strategies to improve outcomes currently exists.

Thiamine (vitamin B1) is a cofactor of pyruvate dehydrogenase, which plays a key role in aerobic glucose metabolism. Thiamine deficiency is common in patients with DKA, resulting in a shift to anaerobic metabolism and hyperlactatemia, which can prolong and complicate recovery. Therefore, we hypothesise that thiamine administration will improve aerobic metabolism and lead to faster resolution of acidemia in patients with DKA.

Methods and analysis

In this single centre, double-blind, randomised, placebo-controlled, parallel group interventional trial, 100 patients admitted to the hospital with DKA will be randomised to receive either intravenous thiamine (200 mg in 50 mL 0.9% saline) or placebo (0.9% saline identical in appearance and volume) two times per day for 2 days. The primary outcome will be the change in bicarbonate level over 24 hours as compared between the two treatment groups. Additional secondary outcomes include the change over time in anion gap, lactate levels, oxygen consumption by circulating mononuclear cells, intensive care unit and hospital length-of-stay and hospital resource usage when comparing the two study arms.

Ethics and dissemination

This trial was approved by the Committee on Clinical Investigations, the institutional review board of Beth Israel Deaconess Medical Center (protocol number 2018P000475). Findings will be disseminated through peer-reviewed publications and professional conference presentations.

Trial registration number

NCT03717896; clinicaltrials.gov.
What role does community-based health insurance play in the utilisation of health services among households in Ethiopia? A community-based comparative cross-sectional study
Authors: Terefa Dufera Rikitu , Geta Edosa Tesfaye , Shama Adisu Tafari , Desisa Adisu Ewunetu
Published: March 2024

Objective

In Ethiopia, despite increased health service coverage, health service utilisation remains very low. However, evidence on the level of health service utilisation between insured and non-insured households in the study area was scanty. Therefore, this study aimed to assess health service utilisation and its predictors among insured and non-insured households of community-based health insurance in the East Wallaga Zone, Oromia region, Ethiopia, in 2022.

Methods

A community-based comparative cross-sectional study was employed. Data were collected using semi-structured interviewer-administered pretested questionnaire by face-to-face interviewing of heads of the households or spouse from 1 January 2022 to 30 January 2022, on 900 (450 insured and 450 non-insured). Epi-Data V.3.1 and Statistical Package for Social Science V.26 were used for data entry and analysis, respectively. The association between dependent (health service utilisation) and independent variables was analysed first using binary logistic regression. Multivariable logistic regression was used to identify potential predictor variables at a p<0.05.

Results

About 60.5% (95% CI 55.7% to 64.8%) of insured households had used health services compared with 45.9% (95% CI 41.4% to 50.9%) of non-insured households in the last 6 months. Family health status (Adjusted Odd Ratio (AOR) and 95% CI=2.74 (1.37 to 5.45), AOR and 95% CI=1.62 (1.01 to 3.14)); family with chronic disease (AOR and 95% CI=8.33 (5.11 to 13.57), AOR and 95% CI=4.90 (2.48 to 9.67)); perceived availability of drugs (AOR and 95% CI=0.34 (0.15 to 0.79), AOR and 95% CI=3.97 (1.69 to 9.34)); perceived transportation cost (AOR and 95% CI=0.44 (0.21 to 0.90), AOR and 95% CI=1.71 (1.00 to 2.93)); participated in indigenous community insurance (AOR and 95% CI=3.82 (1.96 to 7.45), AOR and 95% CI=0.13 (0.06 to 0.29)) and >10 km travel distance from nearby health facilities (AOR and 95% CI=1.52 (1.02 to 2.60), AOR and 95% CI=8.37 (4.54 to 15.45)) among insured and non-insured households, respectively, were predictors of health service utilisation.

Conclusion

Insured households were more likely to utilise health services compared with non-insured households. Family health status, family with chronic disease, perceived availability of drugs, perceived transportation cost, participation in indigenous community insurance and >10 km travel were predictors of health service utilisation among insured and non-insured households. Hence, the greatest emphasis should be given to enhancing enrolment in the community-based health insurance scheme to achieve universal health coverage.
Should intermittent pneumatic compression devices be standard therapy for the prevention of venous thromboembolic events in major surgery? Protocol for a randomised clinical trial (IMPOSTERS)
Authors: Lott Natalie , Douglas Jeanene Lizbeth , Magnusson Monique , Gani Jonathan , Reeves Penny , Connah David , Organ Nicole , Oldmeadow Chris , Attia John , Smith Stephen Ridley
Published: March 2024

Introduction

Venous thromboembolism (VTE) is a recognised postsurgical risk. Current prevention methods involve low molecular weight heparin (LMWH), graduated compression stockings (GCS), and intermittent pneumatic compression devices (IPCDs). Australian guidelines, commonly adopted by surgeons, recommend LMWH with GCS and/or IPCDs. IPCDs pose clinical risks, increase care burden, are poorly tolerated, and are costly single-use plastic items. Utilising only LMWH and GCS, without IPCDs, could be more practical, patient-friendly, and cost-effective, with added environmental benefits.

Methods

This is a multicentre, prospective, two-arm randomised controlled non-inferiority trial at five New South Wales (NSW) hospitals, in Australia. We propose to randomise 4130 participants in a 1:1 ratio between arm A: LMWH+GCS+IPCDs (n=2065) or arm B: LMWH+GCS (n=2065). The primary outcome of interest is symptomatic VTE (deep vein thrombosis/pulmonary embolism) identified at the day 30 phone follow-up (FU), confirmed by ultrasound or imaging. Radiologists interpreting the lower-extremity ultrasonography will be blinded to intervention allocation. Secondary outcomes are quality of life at baseline, days 30 and 90 FU using the 5-level European Quality of Life Score, compliance and adverse events with IPCDs, GCS, and LMWH, as well as healthcare costs (from the perspective of the patient and the hospital), and all-cause mortality. The trial has 90% power to detect a 2% non-inferiority margin to detect a reduction rate of VTE from 4% to 2%.

Ethics and dissemination

This study has been approved by the Hunter New England Human Research Ethics Committee (2022/ETH02276) protocol V.10, 13 July 2023. Study findings will be presented at local and national conferences and in scientific research journals.

Trial registration number

ANZCTR12622001527752
Breastfeeding assessment and management instruments: a scoping review protocol
Authors: Souza Joyce Wadna Rodrigues , Silva Janiny Lima , Câmara Saionara Maria Aires
Published: March 2024

Introduction

Different aspects are involved in the breastfeeding process that may vary according to the target population, postpartum phase and evaluation scenario. The identification of such instruments, their constructs and applicability in health services will contribute to the understanding of the most relevant aspects and dissemination of tools that can be implemented in the necessary spaces to promote breast feeding. This article describes a review protocol to map the assessment and management instruments applied to breast feeding in the puerperal period existing in the literature.

Methods and analysis

This is a protocol of a scoping review that follows the methodological recommendations of the Joanna Briggs Institute (JBI). In March 2024, a search will be carried out in the databases Medical Literature Analysis and Retrieval System Online—Medline (PubMed), Latin American and Caribbean Health Science Literature—Lilacs (BVS), Cochrane Library and Embase (CAPES). Peer-reviewed studies that address instruments for evaluating the breastfeeding process during the puerperium will be included, regardless of year of publication or language. The selection of studies and data extraction will be done by peers and disagreements will be resolved by a third researcher. The selection will be made through the Rayann platform (https://www.rayyan.ai/). Data extraction and synthesis will be performed by pairs, using a semistructured instrument, based on the model available in the JBI manual. The studies will be summarised according to the postpartum period in which the instrument was used (immediate, remote or late postpartum) and their constructs, domains and contexts of utilisation will be identified.

Ethics and dissemination

Ethical approval is not necessary for this scoping review. The results of the review will be shared through publications in peer-reviewed journals, at relevant scientific conferences and seminars and meetings with maternal and child healthcare providers.

Study registration

This study was registered with Open Science Framework registry (osf.io/f4hz8) on 27 April 2023.
Effects of cardiopulmonary resuscitation training on mortality rates after out-of-hospital cardiac arrest: protocol for a systematic review and meta-analysis
Authors: Alcázar Artero Petronila Mireia , Teixeira dos Santos Thais , Guillen Martinez Daniel , Ferrandini Price Mariana , Pardo Ríos Manuel , Piuvezam Grasiela
Published: March 2024

Introduction

An out-of-hospital cardiac arrest occurs at a rate of 67–170 cases per 100 000 inhabitants per year in Europe. The early recognition of the occurrence of a cardiac arrest, placing an emergency call, performing cardiopulmonary resuscitation (CPR) and performing defibrillation are the most important response measures. The objective of this systematic review and meta-analysis is to assess the effects of laypersons’ CPR training with respect to CPR initiation rates, cardiovascular mortality rates, survival rate and the use of an automated external defibrillator.

Methods and analysis

The literature search will be performed in the following databases: MEDLINE, Web of Science, the Cochrane Central Register of Controlled Studies, CINAHL, HBI, TESEO and NTX. Intervention studies and quasi-experimental studies in which CPR training interventions were performed will be included. We will exclude studies in which the participants do not meet the inclusion criteria, without a control group and in which the methodology of the intervention applied is unclear. There will be no restrictions on publication date or language of publication. The risk of bias will be assessed using the Risk of Bias in Non-randomized Studies of Interventions tool for randomised controlled trials (RCT), non-RCT and quasi-experimental trials. Data analysis and synthesis will be performed using RevMan V.5.4.1 software. The findings will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance.

Ethics and dissemination

Ethical approval is not required, as only secondary data will be used. The findings will be published in a journal and presented at conferences.

PROSPERO registration number

CRD42022365288.
Protective role of the HSP90 inhibitor, STA-9090, in lungs of SARS-CoV-2-infected Syrian golden hamsters
Authors: Teixeira Alves Luiz Gustavo , Baumgardt Morris , Langner Christine , Fischer Mara , Maria Adler Julia , Bushe Judith , Firsching Theresa Catharina , Mastrobuoni Guido , Grobe Jenny , Hoenzke Katja , Kempa Stefan , Gruber Achim Dieter , Hocke Andreas Christian , Trimpert Jakob , Wyler Emanuel , Landthaler Markus
Published: March 2024

Introduction

The emergence of new SARS-CoV-2 variants, capable of escaping the humoral immunity acquired by the available vaccines, together with waning immunity and vaccine hesitancy, challenges the efficacy of the vaccination strategy in fighting COVID-19. Improved therapeutic strategies are urgently needed to better intervene particularly in severe cases of the disease. They should aim at controlling the hyperinflammatory state generated on infection, reducing lung tissue pathology and inhibiting viral replication. Previous research has pointed to a possible role for the chaperone HSP90 in SARS-CoV-2 replication and COVID-19 pathogenesis. Pharmacological intervention through HSP90 inhibitors was shown to be beneficial in the treatment of inflammatory diseases, infections and reducing replication of diverse viruses.

Methods

In this study, we investigated the effects of the potent HSP90 inhibitor Ganetespib (STA-9090) in vitro on alveolar epithelial cells and alveolar macrophages to characterise its effects on cell activation and viral replication. Additionally, the Syrian hamster animal model was used to evaluate its efficacy in controlling systemic inflammation and viral burden after infection.

Results

In vitro, STA-9090 reduced viral replication on alveolar epithelial cells in a dose-dependent manner and lowered significantly the expression of proinflammatory genes, in both alveolar epithelial cells and alveolar macrophages. In vivo, although no reduction in viral load was observed, administration of STA-9090 led to an overall improvement of the clinical condition of infected animals, with reduced oedema formation and lung tissue pathology.

Conclusion

Altogether, we show that HSP90 inhibition could serve as a potential treatment option for moderate and severe cases of COVID-19.
Effect of a lower target oxygen saturation range on the risk of hypoxaemia and elevated NEWS2 scores at a university hospital: a retrospective study
Authors: O'Driscoll B Ronan , Kirton Louis , Weatherall Mark , Bakerly Nawar Diar , Turkington Peter , Cook Julie , Beasley Richard
Published: March 2024

Background

The optimal target oxygen saturation (SpO2) range for hospital inpatients not at risk of hypercapnia is unknown. The objective of this study was to assess the impact on oxygen usage and National Early Warning Score 2 (NEWS2) of changing the standard SpO2target range from 94–98% to 92–96%.

Methods

In a metropolitan UK hospital, a database of electronic bedside SpO2measurements, oxygen prescriptions and NEWS2 records was reviewed. Logistic regression was used to compare the proportion of hypoxaemic SpO2values (<90%) and NEWS2 records ≥5 in 2019, when the target SpO2range was 94–98%; with 2022, when the target range was 92–96%.

Results

In 2019, 218 of 224 936 (0.10%) observations on room air and 162 of 11 328 (1.43%) on oxygen recorded an SpO2<90%, and in 2022, 251 of 225 970 (0.11%) and 233 of 12 845 (1.81%), respectively (risk difference 0.04%, 95% CI 0.02% to 0.07%). NEWS2 ≥5 was observed in 3009 of 236 264 (1.27%) observations in 2019 and 4061 of 238 815 (1.70%) in 2022 (risk difference 0.43%, 0.36% to 0.50%; p<0.001). The proportion of patients using supplemental oxygen with hyperoxaemia (SpO2100%) was 5.4% in 2019 and 3.9% in 2022 (OR 0.71, 0.63 to 0.81; p<0.001).

Discussion

The proportion of observations with SpO2<90% or NEWS2 ≥5 was greater with the 92–96% range; however, absolute differences were very small and of doubtful clinical relevance, in contrast to hyperoxaemia for which the proportion was markedly less in 2022. These findings support proposals that the British Thoracic Society oxygen guidelines could recommend a lower target SpO2range.
Prospective study of complications and sequelae of glucocorticoid therapy in ANCA-associated vasculitis
Authors: Scherbacher Paul J , Hellmich Bernhard , Feng You-Shan , Löffler Christian
Published: March 2024

Objective

Glucocorticoids (GC) are a cornerstone in treating antineutrophil cytoplasmic antibodies-associated vasculitides (AAV), however, they add to morbidity and mortality. To date, GC toxicity in AAV has rarely been systematically investigated.

Methods

Patients with a confirmed AAV were included in this monocentric prospective study. GC toxicity was assessed by structured interviews, clinical examination and electronic medical record analysis. The Glucocorticoid Toxicity Index (GTI) consisting of the Aggregate Improvement Score (GTI-AIS) and the Cumulative Worsening Score (GTI-CWS) was assessed at two time points (t1 baseline, t2 6 months later). We used regression analyses to assess the relationship between GTI and GC exposure, toxicity, and disease activity, and a receiver operating characteristic analysis to calculate a GC threshold dose beyond which toxicity is expected to occur.

Results

We included 138 patients with AAV. The median cumulative GC dose was 9014.0 mg. The most frequent adverse events were skin atrophy, osteoporosis and myopathy. GC exposure and toxicity were significantly correlated (p<0.001). GTI-AIS was significantly higher in active disease compared with patients in remission (p<0.001). GTI-CWS scored significantly higher in long-standing diseases (p=0.013) with high cumulative GC doses (p=0.003). Patients with a cumulative GC dose of 935 mg or more showed an 80% likelihood for a clinically meaningful change in GTI scoring.

Conclusion

The GTI is capable of capturing GC toxicity in AAV and identifies patients at increased risk for GC side effects. Our data support efforts to limit GC exposure in patients with AAV.
Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative
Authors: McLauchlan Nathaniel , Ali Ali , Beyer Carl A , Brinson Martha M , Joergensen Sarah M , Yelon Jay , Dumas Ryan Peter , Vella Michael A , Cannon Jeremy W
Published: March 2024

Objectives

Percutaneously placed small-bore (14 Fr) catheters and pleural lavage have emerged independently as innovative approaches to hemothorax management. This report describes techniques for combining percutaneous thoracostomy with pleural lavage and presents results from a performance improvement series of patients managed with percutaneous thoracostomy with immediate lavage.

Methods

This was a prospective performance improvement series of patients treated at a level 1 trauma center with percutaneous thoracostomy and immediate lavage between April 2021 and May 2023.

Results

Percutaneous thoracostomy with immediate lavage was used to treat nine hemodynamically normal patients with acute hemothorax. Injuries included both blunt and penetrating mechanisms. 56% of patients presented immediately after injury, and 44% presented in a delayed fashion ranging from 2 to 26 days after injury. Median length of stay was 6 days (IQR 6, 9). Seven patients were discharged home in stable condition, one was discharged to an acute rehabilitation facility, and one was discharged to a skilled nursing facility.

Conclusions

Percutaneous thoracostomy with pleural lavage is clinically feasible and effective and warrants further evaluation with a multicenter clinical trial.

Level of evidence

Therapeutic/care management, level V.
Comparison of military and civilian surgeon outcomes with emergent trauma laparotomy in a mature military-civilian partnership
Authors: Lammers Daniel , Uhlich Rindi , Rokayak Omar , Manley Nathan , Betzold Richard D , Hu Parker
Published: March 2024

Introduction

Medical readiness is of paramount concern for active-duty military providers. Low volumes of complex trauma in military treatment facilities has driven the armed forces to embed surgeons in high-volume civilian centers to maintain clinical readiness. It is unclear what impact this strategy may have on patient outcomes in these centers. We sought to compare emergent trauma laparotomy (ETL) outcomes between active-duty Air Force Special Operations Surgical Team (SOST) general surgeons and civilian faculty at an American College of Surgeons verified level 1 trauma center with a well-established military-civilian partnership.

Methods

Retrospective review of a prospectively maintained, single-center database of ETL from 2019 to 2022 was performed. ETL was defined as laparotomy from trauma bay within 90 min of patient arrival. The primary outcome was to assess for all-cause mortality differences at multiple time points.

Results

514 ETL were performed during the study period. 22% (113 of 514) of patients were hypotensive (systolic blood pressure ≤90 mm Hg) on arrival. Six SOST surgeons performed 43 ETL compared with 471 ETL by civilian faculty. There were no differences in median ED length of stay (27 min vs 22 min; p=0.21), but operative duration was significantly longer for SOST surgeons (129 min vs 110 min; p=0.01). There were no differences in intraoperative (5% vs 2%; p=0.30), 6-hour (3% vs 5%; p=0.64), 24-hour (5% vs 5%; p=1.0), or in-hospital mortality rates (5% vs 8%; p=0.56) between SOST and civilian surgeons. SOST surgeons did not significantly impact the odds of 24-hour mortality on multivariable analysis (OR 0.78; 95% CI 0.10, 6.09).

Conclusion

Trauma-related mortality for patients undergoing ETL was not impacted by SOST surgeons when compared with their civilian counterparts. Military surgeons may benefit from the valuable clinical experience and mentorship of experienced civilian trauma surgeons at high volume trauma centers without creating a deficit in the quality of care provided.

Level of evidence

Level IV, therapeutic/care management.
Safety and efficacy of a probiotic cocktail containing P. acidilactici and L. plantarum for gastrointestinal discomfort in endurance runners: randomized double-blinded crossover clinical trial
Authors: Lennon Sarah , Lackie Thomas , Miltko Adriana , Kearns Zoey C. , Paquette Maxime R. , Bloomer Richard J. , Wang Anyou , van der Merwe Marie
Published: March 2024

Probiotics are increasingly used to treat conditions associated with gastrointestinal injury and permeability, including exercise-induced gastrointestinal discomfort. This study assessed safety and efficacy of a probiotic in altering the intestinal milieu and mitigating gastrointestinal symptoms (GIS) in endurance runners. In a double blind, crossover study, 16 runners were randomized to 4 weeks of daily supplementation with a probiotic cocktail containing Pediococcus acidilactici bacteria and Lactobacillus plantarum or placebo. Fasting blood and stool samples were collected for measurement of gut permeability markers, immune parameters, and microbiome analyses. Treadmill run tests were performed before and after treatment; participants ran at 65%–70% of VO2max at 27 °C for a maximum of 90 min or until fatigue/GIS developed. A blood sample was collected after the treadmill run test. In healthy individuals, 4 weeks of probiotic supplementation did not alter health parameters, although a marginal reduction in aspartate aminotransferase levels was observed with probiotic treatment only ( p = 0.05). GIS, gut permeability-associated parameters (intestinal fatty acid binding protein, lipopolysaccharide binding protein, zonulin, and cytokines), and intestinal microbial content were not altered by the probiotic supplementation. Post-run measurements of GIS and gut-associated parameters did not differ between groups; however, the observed lack of differences is confounded by an absence of measurable functional outcome as GIS was not sufficiently induced during the run. Under the current study conditions, the probiotic was safe to use, and did not affect gut- or immune-associated parameters, or intestinal symptoms in a healthy population. The probiotic might reduce tissue damage, but more studies are warranted.
“We call it soul food”: Inuit women and the role of country food in health and well-being in Nunavut
Authors: Caughey Amy , Kilabuk Pitsiula , Koonoo Theresa , Sanguya Igah , Jaw Martha , Allen Jean , Doucette Michelle , Sargeant Jan , Moeller Helle , Harper Sherilee L.
Published: March 2024

Indigenous knowledge is central to understanding environment and health sciences in the Arctic, yet limited research in these fields has explored the human–animal–environment interface from the unique perspectives of Inuit women. Using a community-led, Inuit-centred research approach, we characterized the use and meaning of country food in the context of community well-being for Inuit women in Nunavut, Canada. In-depth conversational interviews and focus groups ( n = 16) were held with Inuit women ( n = 10) who are knowledge holders in the Qikiqtani region that hold decades of country food knowledge. Data were analyzed using thematic analysis and constant comparative methods. Inuit women described country food in the context of (1) well-being, connection, and identity, (2) hunger, craving, and healing, (3) food security and nourishment, and (4) change and adaptation. Inuit women described a wide range of country food as central to physical and mental health, food security, identity, culture, healing and medicine. Adaptive strategies were discussed, such as eating more fish when caribou were scarce. This research highlights the critical role of country food for health and well-being for Inuit women and shares knowledge and perspective that is relevant to wildlife and environment researchers, public health practitioners, policy makers, and others interested in advancing health, well-being, and food sovereignty in Inuit communities.
Role of substrate roughness in soil desiccation cracking
Authors: Yang Yuhan , Zhang Chao , Gou Lingyun , Chen Renpeng , Dong Yi
Published: March 2024

Soil desiccation crack is ubiquitous in nature, yet the physics of its initiation and propagation remain under debate, as it involves complex interactions across multiple fields of mechanics, hydraulics, and thermals. Here, an experimental attempt is made to uncover the role of substrate roughness on the soil desiccation process. The substrate roughness is deliberately fabricated by 3D printing, whereas the thickness of sample and environmental humidity are controlled to eliminate the effect of large hydraulic gradient. Four types of soils with varying expansibilities were desiccated on substrates with varying roughness. It reveals that (1) soil desiccation crack evolution can be conceived as a competing process between the shear failure of soil–substrate interface, i.e., slippage of interface, and the tensile failure of soil, i.e., crack initiation, in minimizing the total energy of drying soil; (2) substrate roughness alters the failure mode and shear strength of soil–substrate interface and its sensitivity to moisture, thereby it regulates the pattern of how soil crack propagates upon drying; and (3) soil expansibility is recognized as a key factor governing the crack initiation in addition to the widely recognized air entry, and flaws in soil are the sources for the 120° crack angle and bimodal crack angle distribution.
Suitability of DIC in capturing flexural behaviour of as-built and CFRP-strengthened RC beams
Authors: Kadhom Bessam , Simova Eli , Zhang Jieying , Krys Dennis
Published: March 2024

In this paper, the suitability of digital image correlation (DIC) technology in evaluating the flexural behaviour of as-built and carbon-fiber-reinforced polymer (CFRP) strengthened reinforced concrete beams was verified by conducting a four-point bending test on four large-size beams. The DIC data obtained during the tests were compared to the results measured using traditional techniques such as displacement sensors and electrical strain gauges, as well as the findings derived from finite element (FE) numerical simulations. A good agreement was achieved between the local displacement and strain measurements and the data from DIC as a function of the applied load. Moreover, the crack patterns generated by the FE modelling were validated by the corresponding patterns derived from DIC. This suitability study is expected to contribute to the future field implementation of DIC technology to monitor the CFRP-strengthened members of critical structures such as bridges.
Impact of biological sex on valvular heart disease, interventions, and outcomes
Authors: Wiens Evan J. , Kawa Kristal , Kass Malek , Shah Ashish H.
Published: March 2024

Valvular heart disease (VHD) is common, affecting >14% of individuals aged >75, and is associated with morbidity, including heart failure and arrhythmia, and risk of early mortality. Increasingly, important sex differences are being found between males and females with VHD. These sex differences can involve the epidemiology, pathophysiology, presentation, diagnosis, and outcomes of the disease. Females are often disadvantaged, and female sex has been shown to be associated with delayed diagnosis and inferior outcomes in various forms of VHD. In addition, the unique pathophysiologic state of pregnancy is associated with increased risk for maternal and fetal morbidity and mortality in many forms of VHD. Therefore, understanding and recognizing these sex differences, and familiarity with the attendant risks of pregnancy and management of pregnant females with VHD, is of great importance for any primary care or cardiovascular medicine practitioner caring for the female patient. This review will outline sex differences in aortic, mitral, pulmonic, and tricuspid VHD, with particular focus on differences in pathophysiology, clinical presentation, and outcomes. In addition, the pathophysiology and management implications of pregnancy will be discussed.
A search for $$\upmu ^+ \rightarrow \textrm{e}^+ \upgamma $$ with the first dataset of the MEG II experiment
Authors: Afanaciev K. , Baldini A. M. , Ban S. , Baranov V. , Benmansour H. , Biasotti M. , Boca G. , Cattaneo P. W. , Cavoto G. , Cei F. , Chiappini M. , Chiarello G. , Corvaglia A. , Cuna F. , Maso G. Dal , De Bari A. , De Gerone M. , Barusso L. Ferrari , Francesconi M. , Galli L. , Gallucci G. , Gatti F. , Gerritzen L. , Grancagnolo F. , Grandoni E. G. , Grassi M. , Grigoriev D. N. , Hildebrandt M. , Ieki K. , Ignatov F. , Ikeda F. , Iwamoto T. , Karpov S. , Kettle P.-R. , Khomutov N. , Kobayashi S. , Kolesnikov A. , Kravchuk N. , Krylov V. , Kuchinskiy N. , Kyle W. , Libeiro T. , Malyshev V. , Matsushita A. , Meucci M. , Mihara S. , Molzon W. , Mori Toshinori , Nakao M. , Nicolò D. , Nishiguchi H. , Ochi A. , Ogawa S. , Onda R. , Ootani W. , Oya A. , Palo D. , Panareo M. , Papa A. , Pettinacci V. , Popov A. , Renga F. , Ritt S. , Rossella M. , Rozhdestvensky A. , Schwendimann P. , Shimada K. , Signorelli G. , Takahashi M. , Tassielli G. F. , Toyoda K. , Uchiyama Y. , Usami M. , Venturini A. , Vitali B. , Voena C. , Yamamoto K. , Yanai K. , Yonemoto T. , Yoshida K. , Yudin Yu. V. ,   MEG II Collaboration
Published: March 2024

The MEG II experiment, based at the Paul Scherrer Institut in Switzerland, reports the result of a search for the decay $$\upmu ^+ \rightarrow {\textrm{e}}^+ \upgamma $$

μ
+

→

e

+

γ

from data taken in the first physics run in 2021. No excess of events over the expected background is observed, yielding an upper limit on the branching ratio of $${\mathcal {B}} (\upmu ^+ \rightarrow {\textrm{e}}^+ \upgamma ) < 7.5 \times 10^{-13}$$

B

(

μ
+

→

e

+

γ
)

<
7.5
×

10

-
13

(90% CL). The combination of this result and the limit obtained by MEG gives $${\mathcal {B}} (\upmu ^+ \rightarrow {\textrm{e}}^+ \upgamma ) < 3.1 \times 10^{-13}$$

B

(

μ
+

→

e

+

γ
)

<
3.1
×

10

-
13

(90% CL), which is the most stringent limit to date. A ten-fold larger sample of data is being collected during the years 2022–2023, and data-taking will continue in the coming years.
A Complexity Dichotomy in Spatial Reasoning via Ramsey Theory
Authors: Bodirsky Manuel , Bodor Bertalan
Published: March 2024

Constraint satisfaction problems (CSPs) for first-order reducts of finitely bounded homogeneous structures form a large class of computational problems that might exhibit a complexity dichotomy, P versus NP-complete. A powerful method to obtain polynomial-time tractability results for such CSPs is a certain reduction to polynomial-time tractable finite-domain CSPs defined over
k
-types, for a sufficiently large
k
. We give sufficient conditions when this method can be applied and apply these conditions to obtain a new complexity dichotomy for CSPs of first-order expansions of the basic relations of the well-studied spatial reasoning formalism RCC5. We also classify which of these CSPs can be expressed in Datalog. Our method relies on Ramsey theory; we prove that RCC5 has a Ramsey order expansion.
Learning Cross-modality Interaction for Robust Depth Perception of Autonomous Driving
Authors: Liang Yunji , Chen Nengzhen , Yu Zhiwen , Tang Lei , Yu Hongkai , Guo Bin , Zeng Daniel Dajun
Published: March 2024

As one of the fundamental tasks of autonomous driving, depth perception aims to perceive physical objects in three dimensions and to judge their distances away from the ego vehicle. Although great efforts have been made for depth perception, LiDAR-based and camera-based solutions have limitations with low accuracy and poor robustness for noise input. With the integration of monocular cameras and LiDAR sensors in autonomous vehicles, in this article, we introduce a two-stream architecture to learn the modality interaction representation under the guidance of an image reconstruction task to compensate for the deficiencies of each modality in a parallel manner. Specifically, in the two-stream architecture, the multi-scale cross-modality interactions are preserved via a cascading interaction network under the guidance of the reconstruction task. Next, the shared representation of modality interaction is integrated to infer the dense depth map due to the complementarity and heterogeneity of the two modalities. We evaluated the proposed solution on the KITTI dataset and CALAR synthetic dataset. Our experimental results show that learning the coupled interaction of modalities under the guidance of an auxiliary task can lead to significant performance improvements. Furthermore, our approach is competitive against the state-of-the-art models and robust against the noisy input. The source code is available at
https://github.com/tonyFengye/Code/tree/master
.
Robust Image Hashing via CP Decomposition and DCT for Copy Detection
Authors: Liang Xiaoping , Liu Wanting , Zhang Xianquan , Tang Zhenjun
Published: March 2024

Copy detection is a key task of image copyright protection. This article proposes a robust image hashing algorithm by CP decomposition and discrete cosine transform (DCT) for copy detection. The first contribution is the third-order tensor construction with low-frequency coefficients in the DCT domain. Since the low-frequency DCT coefficients contain most of the image energy, they can reflect the basic visual content of the image and are less disturbed by noise. Hence, the third-order tensor construction with the low-frequency DCT coefficients can ensure robustness of our algorithm. Another contribution is the application of the CP decomposition to the third-order tensor for learning a short binary hash. As the factor matrices learned from the CP decomposition can preserve the topology of the original tensor, the binary hash derived from the factor matrices can reach good discrimination. Lots of experiments and comparisons are done to validate effectiveness and advantage of our algorithm. The results demonstrate that our algorithm has superior classification and copy detection performances than several baseline algorithms. In addition, our algorithm is also better than some baseline algorithms with regard to hash length and computational time.
Building Shortcuts between Distant Nodes with Biaffine Mapping for Graph Convolutional Networks
Authors: Zhang Acong , Huang Jincheng , Li Ping , Zhang Kai
Published: March 2024

Multiple recent studies show a paradox in graph convolutional networks (GCNs)—that is, shallow architectures limit the capability of learning information from high-order neighbors, whereas deep architectures suffer from over-smoothing or over-squashing. To enjoy the simplicity of shallow architectures and overcome their limits of neighborhood extension, in this work we introduce a
biaffine
technique to improve the expressiveness of GCNs with a shallow architecture. The core design of our method is to learn direct dependency on long-distance neighbors for nodes, with which only 1-hop message passing is capable of capturing rich information for node representation. Besides, we propose a multi-view contrastive learning method to exploit the representations learned from long-distance dependencies. Extensive experiments on nine graph benchmark datasets suggest that the shallow biaffine graph convolutional networks (BAGCN) significantly outperform state-of-the-art GCNs (with deep or shallow architectures) on semi-supervised node classification. We further verify the effectiveness of biaffine design in node representation learning and the performance consistency on different sizes of training data.
Toward Unrivaled Chromatographic Resolving Power in Proteomics: Design and Development of Comprehensive Spatial Three-Dimensional Liquid-Phase Separation Technology
Authors: Eeltink Sebastiaan , De Vos Jelle , Desmet Gert
Published: March 2024

Spatial comprehensive three-dimensional chromatography (3D-LC) offers an innovative approach to achieve unprecedented resolving power in terms of peak capacity and sample throughput. This advanced technique separates components within a 3D separation space, where orthogonal retention mechanisms are incorporated. The parallel development of the second- and third-dimension stages effectively overcomes the inherent limitation of conventional multidimensional approaches, where sampled fractions are analyzed sequentially. This review focuses on the design aspects of the microchip for spatial 3D-LC and the selection of orthogonal separation modes to enable the analysis of intact proteins. The design considerations for the flow distributor and channel layout are discussed, along with various approaches to confine the flow during the subsequent development stages. Additionally, the integration of stationary phases into the microchip is addressed, and interfacing to mass spectrometry detection is discussed. According to Pareto optimality, the integration of isoelectric focusing, size-exclusion chromatography, and reversed-phase chromatography in a spatial 3D-LC approach is predicted to achieve an exceptional peak capacity of over 30,000 within a 1-h analysis, setting a new benchmark in chromatographic performance.
Emerging Areas in Undergraduate Analytical Chemistry Education: Microfluidics, Microcontrollers, and Chemometrics
Authors: Hupp Amber M. , Kovarik Michelle L. , McCurry Daniel A.
Published: March 2024

Analytical chemistry is a fast-paced field with frequent introduction of new techniques via research labs; however, incorporation of new techniques into academic curricula lags their adoption in research and industry. This review describes the recent educational literature on microfluidics, microcontrollers, and chemometrics in the undergraduate analytical chemistry curriculum. Each section highlights opportunities for nonexpert faculty to get started with these techniques and more advanced implementations suitable for experienced practitioners. While the addition of new topics to any curriculum brings some opportunity costs, student engagement with cutting edge techniques brings many benefits, including enhanced preparation for graduate school and professional careers and development of transferable skills, such as coding. Formal assessment of student outcomes is encouraged to promote broader adoption of these techniques.
Using Synthetic Biology to Understand the Function of Plant Specialized Metabolites
Authors: Bai Yuechen , Liu Xinyu , Baldwin Ian T.
Published: March 2024

Plant specialized metabolites (PSMs) are variably distributed across taxa, tissues, and ecological contexts; this variability has inspired many theories about PSM function, which, to date, remain poorly tested because predictions have outpaced the available data. Advances in mass spectrometry–based metabolomics have enabled unbiased PSM profiling, and molecular biology techniques have produced PSM-free plants; the combination of these methods has accelerated our understanding of the complex ecological roles that PSMs play in plants. Synthetic biology techniques and workflows are producing high-value, structurally complex PSMs in quantities and purities sufficient for both medicinal and functional studies. These workflows enable the reengineering of PSM transport, externalization, structural diversity, and production in novel taxa, facilitating rigorous tests of long-standing theoretical predictions about why plants produce so many different PSMs in particular tissues and ecological contexts. Plants use their chemical prowess to solve ecological challenges, and synthetic biology workflows are accelerating our understanding of these evolved functions.