bluuebunny/crossref_metadata_2025 huggingface dataset:
Acoustical methods for remote sensing in seagrass meadows
Authors: Ballard Megan , Lee Kevin M. , Capistrant-Fossa Kyle , McNeese Andrew R. , Cushing Colby W. , Jerome Thomas S. , Wilson Preston S. , Dunton Kenneth H.
Published: April 2023

Seagrasses provide a multitude of ecosystem services and act as important carbon sinks. However, seagrass habitats are declining globally, and they are among the most threatened ecosystems on earth. For these reasons, long-term and continuous measurements of seagrass parameters are of primary importance for ecosystem health assessment and sustainable management. After a brief historical overview, this talk will present results from both active and passive acoustical methods for ecosystem monitoring in seagrass meadows. From a propagation perspective, gas bodies contained within the seagrass tissue as well as photosynthetic-driven bubble production results in attenuation and scattering of sound that produces increased transmission loss. For the passive approach, the detachment of gas bubbles from the plants is an important component of the ambient soundscape. Examples of both techniques will be presented based on data collected as part of an 18-month continuous deployment of an acoustical measurement system operating in a moderately dense seagrass bed dominated by Thalassia testudinum (turtle grass) in Corpus Christi Bay, Texas. The data show annual trends related to the seasonal growth pattern of Thalassia as well as diurnal trends correlated with photosynthetically active radiation. [Work supported by NSF.]
A fully physiologically-informed time- and rate-dependent hemorheological constitutive model
Authors: Javadi Elahe , Armstrong Matthew J. , Jamali Safa
Published: April 2023

From a mechanical perspective, blood is a complex fluid with a rate- and time-dependent response to an applied deformation. At small deformation rates, cell aggregations owing to the bridging of fibrinogen proteins result in the formation of rouleaux structures manifesting in a large increase in the overall viscosity of the blood viscosity and the emergence of measurable yield stress. At elevated deformation rates, these internal aggregated mesostructures are broken down in a dynamical fashion, giving rise to a thermokinematic memory and thixotropic behavior of the blood. These rich and complex rheological features of blood are primarily governed by the interactions between different cells as well as the fraction of red blood cells (RBCs). Here, using a series of detailed computational tools and benchmarking experimental measurements, we present a constitutive model that accurately describes the rate- and time-dependent rheology of blood based on two physiological metrics of the blood: the hematocrit and fibrinogen concentration. We show that the model is capable of accurately predicting blood flow, not only under simple steady flows but also under different flow protocols relevant to a real circulatory system.
Policies, Procedures, and Confidence in Managing Pregnancy Among Secondary School Athletic Trainers
Authors: Simpson Kaylie , Goetschius John , Liberi Victor
Published: April 2023

Adolescent pregnancy rates are higher in the United States than in other developed countries. Clear policies and procedures are necessary for managing pregnancy in the secondary school setting. This study aimed to determine if athletic trainers had a policy for, and their confidence in, managing pregnant athletes in the secondary school setting. Sixteen percent of the participants have previously managed adolescent pregnancy, yet only 4% had a policy. Athletic trainers with pregnancy policies and procedures or previous experience managing pregnancy reported greater confidence in managing pregnancy in adolescent athletes. Participants were only “slightly confident” in managing pregnant adolescent athletes.
What Are the Load and Wellness of Young Second-Team Football Players When Transitioning to the First Team? A Comparison of 2 Consecutive Preseasons
Authors: Martin-Garetxana Imanol , Ciaurri Jon , Gil Susana M. , Monasterio Xabier , Ugarte Aitor , Lekue Jose A. , Larruskain Jon
Published: April 2023

Purpose: To compare the load and wellness of second-team academy football players during a first-team preseason with those of first-team players and those of their previous second-team preseason. Methods: Athletic Club’s first- (n = 10) and second-team (n = 9) players were prospectively followed during the 2019–20 first- and second-team and 2020–21 first-team preseasons. Weekly external and internal loads and average wellness z-scores (fatigue, sleep quality, muscle soreness, stress, and mood) were compared between preseasons and teams. Results: While training together during the 2020–21 preseason, second-team players performed more decelerations <−3 m/s2 per week than first-team players (moderate effect size). For first-team players, there were only small differences between preseasons in external load, but session rating of perceived exertion was higher (moderate) and stress (moderate) and mood (large) z-scores were worse in 2020–21. For second-team players, more total distance (large), accelerations >3 m/s2 (large), and decelerations <−3 m/s2 (very large) were performed; total loading (moderate) and session rating of perceived exertion (moderate) were higher; and fatigue (very large) and stress (moderate) z-scores were worse during the 2020–21 first-team preseason compared to their previous second-team preseason. Conclusions: Players transitioning from the second team faced higher external and internal loads, fatigue, and stress during the first-team preseason compared to the previous second-team preseason. Player development and monitoring plans appear necessary to manage the transition from the academy to the first team.
Exercise and Protein Supplementation Recommendations for Older Adults With Sarcopenic Obesity: A Meta-Review
Authors: Contillo Allison T. , Rodriguez Nancy R. , Pescatello Linda S.
Published: April 2023

This systematic meta-review evaluated the effects of exercise with and without protein interventions on muscle strength and function in older adults with sarcopenic obesity. PubMed, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Scopus, and SPORTDiscus databases were searched through February 2021 for relevant systematic reviews and meta-analyses with aerobic, resistance, and/or combined training interventions with and without protein supplementation in older adults ≥ 65 years with sarcopenic obesity. This meta-review showed that exercise with and without protein supplementation improved body composition (i.e., decreased percentage body fat) and functional outcomes (i.e., gait speed and grip strength). Because the current literature is limited, determining the effects of exercise and combined protein supplementation in this population requires further investigation. In the meantime, protein recommendations should align with general sarcopenia recommendations. Based upon available findings, tentative exercise recommendations to optimize health outcomes in this population are proposed.
Protein Supplementation in Addition to Strength Training Programs for Improving Body Composition in Older Adults: What Else Is Left to Know? A Brief Update Review of the Current Evidence
Authors: de Camargo Júlio Benvenutti Bueno
Published: April 2023

Resistance training alongside proper protein intake is an important tool to mitigate the deleterious effects of the aging process on skeletal muscle tissue. However, it is not completely elucidated whether adding protein supplementation provides further improvements on body composition outcomes of older adults during resistance training programs. The present narrative review aimed to describe the most recent evidence regarding the effects of protein supplementation on both lean body mass and fat mass of older adults and to provide insight into how health professionals may use this information to properly design nutritional programs for this population. While individuals with previous training experience, not meeting daily protein requirement, or displaying frailty symptoms may experience some benefits, protein supplementation does not seem to provide further improvements in untrained and healthy subjects. Aspects such as the age of the individuals and the different characteristics of the supplementation protocols must be considered when making evidence-based decisions regarding this topic.
Overcoming the “Ostrich Effect”: A Narrative Review on the Incentives and Consequences of Questionable Research Practices in Kinesiology
Authors: Tiller Nicholas B. , Ekkekakis Panteleimon
Published: April 2023

Increasing transparency and openness in science is an ongoing endeavor, one that has stimulated self-reflection and reform in many fields. However, kinesiology and its related disciplines are among those exhibiting an “ostrich effect” and a reluctance to acknowledge their methodological shortcomings. Notwithstanding several high-profile cases of scientific misconduct, scholars in the field are frequently engaged in questionable research practices (QRPs) such as biased experimental designs, inappropriate statistics, and dishonest/inexplicit reporting. To advance their careers, researchers are also “gaming the system” by manipulating citation metrics and publishing in predatory and/or pay-to-publish journals that lack robust peer review. The consequences of QRPs in the discipline may be profound: from increasing the false positivity rate to eroding public trust in the very institutions tasked with informing public health policy. But what are the incentives underpinning misconduct and QRPs? And what are the solutions? This narrative review is a consciousness raiser that explores (a) the manifestations of QRPs in kinesiology; (b) the excessive publication pressures, funding pressures, and performance incentives that are likely responsible; and (c) possible solutions for reform.
Genomics expands the mammalverse
Authors: Upham Nathan S. , Landis Michael J.
Published: April 2023

Diverse mammal genomes open a new portal to hidden aspects of evolutionary history
RAD51 bypasses the CMG helicase to promote replication fork reversal
Authors: Liu Wenpeng , Saito Yuichiro , Jackson Jessica , Bhowmick Rahul , Kanemaki Masato T. , Vindigni Alessandro , Cortez David
Published: April 2023

Replication fork reversal safeguards genome integrity as a replication stress response. DNA translocases and the RAD51 recombinase catalyze reversal. However, it remains unknown why RAD51 is required and what happens to the replication machinery during reversal. We find that RAD51 uses its strand exchange activity to circumvent the replicative helicase, which remains bound to the stalled fork. RAD51 is not required for fork reversal if the helicase is unloaded. Thus, we propose that RAD51 creates a parental DNA duplex behind the helicase that is used as a substrate by the DNA translocases for branch migration to create a reversed fork structure. Our data explain how fork reversal happens while maintaining the helicase in a position poised to restart DNA synthesis and complete genome duplication.
Engineering longevity—design of a synthetic gene oscillator to slow cellular aging
Authors: Zhou Zhen , Liu Yuting , Feng Yushen , Klepin Stephen , Tsimring Lev S. , Pillus Lorraine , Hasty Jeff , Hao Nan
Published: April 2023

Synthetic biology enables the design of gene networks to confer specific biological functions, yet it remains a challenge to rationally engineer a biological trait as complex as longevity. A naturally occurring toggle switch underlies fate decisions toward either nucleolar or mitochondrial decline during the aging of yeast cells. We rewired this endogenous toggle to engineer an autonomous genetic clock that generates sustained oscillations between the nucleolar and mitochondrial aging processes in individual cells. These oscillations increased cellular life span through the delay of the commitment to aging that resulted from either the loss of chromatin silencing or the depletion of heme. Our results establish a connection between gene network architecture and cellular longevity that could lead to rationally designed gene circuits that slow aging.
Ultrafast reversible self-assembly of living tangled matter
Authors: Patil Vishal P. , Tuazon Harry , Kaufman Emily , Chakrabortty Tuhin , Qin David , Dunkel Jörn , Bhamla M. Saad
Published: April 2023

Tangled active filaments are ubiquitous in nature, from chromosomal DNA and cilia carpets to root networks and worm collectives. How activity and elasticity facilitate collective topological transformations in living tangled matter is not well understood. We studied California blackworms (
Lumbriculus variegatus
), which slowly form tangles in minutes but can untangle in milliseconds. Combining ultrasound imaging, theoretical analysis, and simulations, we developed and validated a mechanistic model that explains how the kinematics of individual active filaments determines their emergent collective topological dynamics. The model reveals that resonantly alternating helical waves enable both tangle formation and ultrafast untangling. By identifying generic dynamical principles of topological self-transformations, our results can provide guidance for designing classes of topologically tunable active materials.
Pressing regulatory challenges for psychedelic medicine
Authors: McGuire Amy L. , Lynch Holly Fernandez , Grossman Lewis A. , Cohen I. Glenn
Published: April 2023

Policy must support generation of evidence on safety and effectiveness
From pipelines to pathways in the study of academic progress
Authors: Kizilcec René F. , Baker Rachel B. , Bruch Elizabeth , Cortes Kalena E. , Hamilton Laura T. , Lang David Nathan , Pardos Zachary A. , Thompson Marissa E. , Stevens Mitchell L.
Published: April 2023

Students and administrators can benefit from new analytics
Rethinking science education
Why We Teach Science (and Why We Should)
John L. Rudolph
Oxford University Press, 2023. 224 pp.
Authors: Wai Jonathan
Published: April 2023

If our goal is to increase science literacy and trust in science, we may need to reimagine science curriculum
Panel urges caution in tying social, behavioral traits to genes
Authors: Kaiser Jocelyn
Published: April 2023

Experts split on whether risks of perpetuating racism mean group comparisons should not be done
The Brucella abortus Type IV Effector BspA Inhibits MARCH6-Dependent ERAD To Promote Intracellular Growth
Authors: Kambarev Stanimir , Borghesan Elizabeth , Miller Cheryl N. , Myeni Sebenzile , Celli Jean
Published: April 2023

Brucella abortus
, the intracellular causative agent of brucellosis, relies on type IV secretion system (T4SS) effector-mediated modulation of host cell functions to establish a replicative niche, the
Brucella
-containing vacuole (BCV).
Brucella
exploits the host’s endocytic, secretory, and autophagic pathways to modulate the nature and function of its vacuole from an endocytic BCV (eBCV) to an endoplasmic reticulum (ER)-derived replicative BCV (rBCV) to an autophagic egress BCV (aBCV). A role for the host ER-associated degradation pathway (ERAD) in the
B. abortus
intracellular cycle was recently uncovered, as it is enhanced by the T4SS effector BspL to control the timing of aBCV-mediated egress.
Aging-Associated Augmentation of Gut Microbiome Virulence Capability Drives Sepsis Severity
Authors: Colbert James F. , Kirsch Joshua M. , Erzen Christopher L. , Langouët-Astrié Christophe J. , Thompson Grace E. , McMurtry Sarah A. , Kofonow Jennifer M. , Robertson Charles E. , Kovacs Elizabeth J. , Sullivan Ryan C. , Hippensteel Joseph A. , Sawant Namrata V. , De Nisco Nicole J. , McCollister Bruce D. , Schwartz Robert S. , Horswill Alexander R. , Frank Daniel N. , Duerkop Breck A. , Schmidt Eric P.
Published: April 2023

Older adults suffer more frequent and worse outcomes from sepsis, a critical illness secondary to infection. The reasons underlying this unique susceptibility are incompletely understood.
The Fitness of Beta-Lactamase Mutants Depends Nonlinearly on Resistance Level at Sublethal Antibiotic Concentrations
Authors: Farr Andrew D. , Pesce Diego , Das Suman G. , Zwart Mark P. , de Visser J. Arjan G. M.
Published: April 2023

The evolution of antibiotic-resistant bacterial populations underpins the ongoing antibiotic resistance crisis. We aim to understand how antibiotic-degrading enzymes can evolve to cause increased resistance, how this process is constrained, and whether it can be predictable.
Calculating Vertical Ionization Energies of Hydrated Biological Chromophores Based on Multiconfigurational Perturbation Theory
Authors: Boichenko A. N. , Bochenkova A. V.
Published: April 2023

Here we introduce a methodology for calculating vertical detachment energies (VDE) and vertical ionization energies (VIE) of anionic and neutral chromophores in aqueous environment. The proposed method is based on the extended multiconfigurational quasidegenerate perturbation theory coupled to the explicit treatment of solvent effects in the frame of the effective fragment potential method. We show that the solvent polarization contribution must be considered for getting accurate quantitative estimations of VDEs and VIEs. The calculated values of VDE for phenolate (7.3 eV) and VIE for phenol (7.9 eV) in aqueous environment are in good agreement with the experimental results obtained using X-ray and multiphoton UV photoelectron spectroscopy. Our approach will be useful for studying processes of photoinduced electron transfer from anionic as well as neutral biological chromophores in aqueous solution.
Modelling accessibility of adult neurology care in Australia, 2020–2034
Authors: Simpson-Yap Steve , Frascoli Federico , Harrison Lucinda , Malpas Charles , Burrell James , Child Nicholas , Giles Lauren P , Lueck Christian , Needham Merrilee , Tsang Benjamin , Kalincik Tomas
Published: April 2023

Introduction

In 2015/2016, annual national expenditure on neurological conditions exceeded $A3 billion. However, a comprehensive study of the Australian neurological workforce and supply/demand dynamics has not previously been undertaken.

Methods

Current neurological workforce was defined using neurologist survey and other sources. Workforce supply modelling used ordinary differential equations to simulate neurologist influx and attrition. Demand for neurology care was estimated by reference to literature regarding incidence and prevalence of selected conditions. Differences in supply versus demand for neurological workforce were calculated. Potential interventions to increase workforce were simulated and effects on supply versus demand estimated.

Results

Modelling of the workforce from 2020 to 2034 predicted an increase in neurologist number from 620 to 896. We estimated a 2034 capacity of 638 024 Initial and 1 269 112 Review encounters annually, and deficits against demand estimated as 197 137 and 881 755, respectively. These deficits were proportionately greater in regional Australia, which has 31% of Australia’s population (Australian Bureau of Statistics) but is served by only 4.1% of its neurologists as determined by our 2020 survey of Australia and New Zealand Association of Neurologists members. Nationally, simulated additions to the neurology workforce had some effect on the review encounter supply deficit (37.4%), but in Regional Australia, this impact was only 17.2%.

Interpretation

Modelling of the neurologist workforce in Australia for 2020–2034 demonstrates a significant shortfall of supply relative to current and projected demand. Interventions to increase neurologist workforce may attenuate this shortfall but will not eliminate it. Thus, additional interventions are needed, including improved efficiency and additional use of support staff.
Association between gender social norms and cardiovascular disease mortality and life expectancy: an ecological study
Authors: Lyell Iona , Khan Sadiya S , Limmer Mark , O’Flaherty Martin , Head Anna
Published: April 2023

Objective

Examine the association between country-level gender social norms and (1) cardiovascular disease mortality rates; (2) female to male cardiovascular disease mortality ratios; and (3) life expectancy.

Design

Ecological study with the country as the unit of analysis.

Setting

Global, country-level data.

Participants

Global population of countries with data available on gender social norms as measured by the Gender Social Norms Index (developed by the United Nations Development Programme).

Main outcome measures

Country-level female and male age-standardised cardiovascular disease mortality rates, population age-standardised cardiovascular disease mortality rates, female to male cardiovascular disease mortality ratios, female and male life expectancy at birth. Outcome measure data were retrieved from the WHO and the Institute for Health Metrics and Evaluation. Multivariable linear regression models were fitted to explore the relationship between gender social norms and the outcome variables.

Results

Higher levels of biased gender social norms, as measured by the Gender Social Norms Index, were associated with higher female, male and population cardiovascular disease mortality rates in the multivariable models (β 4.86, 95% CIs 3.18 to 6.54; β 5.28, 95% CIs 3.42 to 7.15; β 4.89, 95% CIs 3.18 to 6.60), and lower female and male life expectancy (β −0.07, 95% CIs −0.11 to −0.03; β −0.05, 95% CIs −0.10 to −0.01). These results included adjustment within the models for potentially confounding country-level factors including gross domestic product per capita, population mean years of schooling, physicians per 1000 population, year of Gender Social Norms Index data collection and maternal mortality ratio.

Conclusions

Our analysis suggests that higher levels of biased gender social norms are associated with higher rates of population cardiovascular disease mortality and lower life expectancy for both sexes. Future research should explore this relationship further, to define its causal role and promote public health action.
Effect of Fu’s subcutaneous needling for cancer pain management: protocol for a pragmatic randomised controlled trial
Authors: Xu Danghan , Yu Zhanbo , Cai Ximin , Lin Jietao , Lin Tengjiao , Sun Jian , Liu Zhaoxi , Cao Yang , He Yihan
Published: April 2023

Introduction

Pain is a common symptom in patients with cancer, and pain management is crucial for these patients. Fu’s subcutaneous needling (FSN) is a modern acupuncture therapy based on basic medicine commonly used in patients with pain. However, evidence of its effectiveness in treating cancer pain has not been systematically proven. Therefore, this pragmatic randomised controlled trial aims to evaluate the effectiveness and safety of FSN for cancer pain management.

Methods and analysis

Overall, 120 eligible patients will be recruited and randomly assigned into two groups using block randomisation. Both groups will be administered analgesic drugs according to the National Comprehensive Cancer Network guidelines. The treatment group will receive FSN therapy one time a day for 6 days. Additionally, we will assess analgesic consumption as the primary outcome and the Numerical Rating Scale, outbreak pain, symptom assessment and adverse events as secondary outcomes to evaluate the effect and safety of FSN in treating cancer pain. The incidence of adverse events will be monitored to assess the safety of FSN.

Ethics and dissemination

Ethics approval was obtained from the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine (approval No: K(2021)096). The results will be published in a peer-reviewed journal, and trial participants will be informed via email and/or phone calls.

Trial registration number

ChiCTR2200056348.
Exposure of medical students to sexism and sexual harassment and their association with mental health: a cross-sectional study at a Swiss medical school
Authors: Barbier Jeanne Marie , Carrard Valerie , Schwarz Joelle , Berney Sylvie , Clair Carole , Berney Alexandre
Published: April 2023

Objectives

To assess the self-reported prevalence of sexism and sexual harassment at a Swiss medical school, and to investigate their association with mental health. Research hypotheses were an association between sexism/sexual harassment and poor mental health and a higher prevalence of sexism/sexual harassment in clinical rotations.

Design

Cross-sectional study as a part of ETMED-L project, an ongoing cohort study of interpersonal competences and mental health of medical students.

Setting

Single-centre Swiss study using an online survey submitted to medical students.

Participants

From 2096 registered students, 1059 were respondents (50.52%). We excluded 26 participants (25 due to wrong answers to attention questions, and 1 who did not answer the sexism exposure question). The final sample (N=1033) included 720 women, 300 men and 13 non-binary people.

Measures

Prevalence of self-reported exposure to sexism/sexual harassment. Multivariate regression analyses of association between being targeted by sexism or sexual harassment and mental health (depression, suicidal ideation, anxiety, stress, burnout, substance use and recent mental health consultation). Regression models adjusted for gender, academic year, native language, parental education level, partnership and an extracurricular paid job.

Results

Being targeted by sexism or sexual harassment was reported by 16% of participants with a majority of women (96%). The prevalence increased with clinical work. After adjusting for covariates, we found association between being targeted by sexism/harassment and risk of depression (OR 2.29, 95% CI 1.54 to 3.41, p<0.001), suicidal ideation (B coefficient (B) 0.37, p<0.001) and anxiety (B 3.69, p<0.001), as well as cynicism (B 1.46, p=0.001) and emotional exhaustion (B 0.94, p=0.044) components of burnout, substance use (B 6.51, p<0.001) and a recent mental health consultation (OR 1.78, 95% CI 1.10 to 2.66, p=0.005).

Conclusions

Sexism and sexual harassment, although less common than usually reported, are behaviours of concern in this medical school and are significantly associated with mental health.
How do hospitals address health inequalities experienced by children and young people: a grey literature scoping review protocol
Authors: Brennan Louise , Brewster Liz , Lunn Judith , Egboko Fiona , Pestotnik Stres Dora , Patel Pallavi , Isba Rachel
Published: April 2023

Introduction

Health inequalities are unfair, systematic differences in health between people. In the UK, the Health and Social Care Act 2012 recognised health inequalities as a responsibility of the National Health Service (NHS). Health inequalities were foregrounded in the publication of 2019 NHS Long Term Plan and during the SARS-CoV-2/COVID-19 pandemic. Hospitals are well placed to address health inequalities through their role as anchor institutions. While many hospitals have begun to address inequalities, children are often overlooked or assumed to have the same needs as adult populations. This grey literature scoping review aims to identify, collate and present approaches taken by hospitals to address health inequalities in children and young people.

Methods and analysis

This scoping review will follow Joanna Briggs Institute guidance. A four-step approach to identifying grey literature will be used. Literature will be examined to identify approaches that aim to address health inequalities. Literature must describe the health inequality they aim to address and be initiated by the hospital. It will exclude literature not available in English and published before 2010. Two reviewers will independently review the results of the searches using the inclusion and exclusion criteria. Data will be extracted using a data extraction tool. Study findings will be presented in tabular form detailing the interventions identified.

Dissemination

The review will synthesise information on worldwide hospital approaches to addressing child health inequalities. The findings will be used to inform guidelines for children’s hospitals in the UK and will be disseminated through national and international professional bodies, conferences and research papers.
Development and validation of the paediatric elbow trauma (PET) rules as a decision rule for radiography in traumatic elbow injuries: a study protocol
Authors: Saris Tim Frans Frederik , van Bergen Christiaan J A , The Bertram , Boele van Hensbroek Pieter , Schep Niels W L , van Boekel Leonieke C , Eygendaal Denise
Published: April 2023

Background

Traumatic elbow injuries in children occur frequently and are among the most common traumatic injuries seen in the emergency department (ED) and in general practice. The use of a validated decision rule to enhance selective radiography in paediatric patients with possible elbow fractures may reduce unnecessary exposure to radiation in children.

Method and analysis

This study is designed as a multicentre prospective cohort study. An expert panel of orthopaedic elbow surgeons, paediatric orthopaedic surgeons and trauma surgeons will initially determine clinical parameters that provide a possible predictive value for elbow fractures. Four hundred children between the ages of 2 and 17 years visiting the ED with pain following elbow trauma will then be included. The clinical parameters will be collected via patient history and physical examination. Elbow radiographs will be obtained in all patients to identify fractures. The data will be processed in a multivariable logistic regression analysis to determine which clinical parameters predict the presence of an elbow fracture. Only the clinical parameters that predict a fracture will be used to formulate the new decision rule: the paediatric elbow trauma (PET) rules. Internal validation of the prediction model will take place after inclusion is complete and by means of a bootstrap analysis on the acquired data. A calculation will be made to determine how many radiographs can potentially be reduced by applying the PET rules and a cost analysis will be performed.

Ethics and dissemination

The study will be conducted according to the principles of the Declaration of Helsinki and in accordance with the Medical Research Involving Human Subjects Act. The Medical Research Ethics Committees United stated on 16 May 2022 that The Medical Research Involving Human Act (WMO) does not apply to this study and an official approval by the committee is not required, reference number; project W22.086.
Reducing opioid use for chronic non-cancer pain in primary care using an evidence-based, theory-informed, multistrategic, multistakeholder approach: a single-arm time series with segmented regression
Authors: Moffat Anna K , Apajee Jemisha , Le Blanc Vanessa T , Westaway Kerrie , Andrade Andre Q , Ramsay Emmae N , Blacker Natalie , Pratt Nicole L , Roughead Elizabeth Ellen
Published: April 2023

Background

Many countries have high opioid use among people with chronic non-cancer pain. Knowledge about effective interventions that could be implemented at scale is limited. We designed a national intervention that included audit and feedback, deprescribing guidance, information on catastrophising assessment, pain neuroscience education and a cognitive tool for use by patients with their healthcare providers.

Method

We used a single-arm time series with segmented regression to assess rates of people using opioids before (January 2015 to September 2017), at the time of (October 2017) and after the intervention (November 2017 to August 2019). We used a cohort with historical comparison group and log binomial regression to examine the rate of psychologist claims in opioid users not using psychologist services prior to the intervention.

Results

13 968 patients using opioids, 8568 general practitioners, 8370 pharmacies and accredited pharmacists and 689 psychologists were targeted. The estimated difference in opioid use was −0.51 persons per 1000 persons per month (95% CI −0.69, –0.34; p<0.001) as a result of the intervention, equating to 25 387 (95% CI 24 676, 26 131) patient-months of opioid use avoided during the 22-month follow-up. The targeted group had a significantly higher rate of incident patient psychologist claims compared with the historical comparison group (rate ratio: 1.37, 95% CI 1.16, 1.63; p<0.001), equating to an additional 690 (95% CI 289, 1167) patient-months of psychologist treatment during the 22-month follow-up.

Conclusions

Our intervention addressed the cognitive, affective and sensory factors that contribute to pain and consequent opioid use, demonstrating it could be implemented at scale and was associated with a reduction in opioid use and increasing utilisation of psychologist services.
Cost-utility of direct transfer to angiography suite (DTAS) bypassing conventional imaging for patients with acute ischemic stroke in Spain: results from the ANGIOCAT trial
Authors: Requena Manuel , Vanden Bavière Henri , Verma Sanjay , Gerrits Carin , Kokhuis Tom , Tomasello Alejandro , Molina Carlos A , Ribo Marc
Published: April 2023

Background

The ANGIOCAT trial showed a clinical benefit of direct to angiography suite (DTAS) for patients with large vessel occlusion (LVO) stroke admitted within 6 hours after symptom onset in decreased hospital workflow time and improved clinical outcome. However, the impact of DTAS implementation on hospital costs is unknown. This economic evaluation aims to assess the cost-utility of DTAS from the provider (hospital) perspective.

Methods

A cost-utility analysis was applied to compare DTAS with the standard direct to CT (DTCT) suite approach using direct cost and health outcomes data. The time horizon was 90 days. One-way sensitivity analysis as well as probabilistic sensitivity analysis was performed, varying the model parameters by ±25%. Measures included costs, quality-adjusted life years, and incremental cost-effectiveness ratios. Health outcomes, classified according to the modified Rankin Scale, were obtained from the ANGIOCAT trial. Respective utilities were obtained from the literature.

Results

DTAS is the dominant strategy. The incremental cost-effectiveness ratio is −€89 110 (−$97 600) with cost saving per patient of –€2848 (–$3120). The improved clinical outcome is directly related with a decrease in costs for the hospital, mainly due to the decrease in costs of hospital stay, improved clinical outcome and fewer complications.

Conclusions

For patients with LVO admitted within 6 hours after symptom onset, the DTAS not only improves clinical outcome but also decreases the costs (dominant option) compared with the standard DTCT. Multicentric international randomized clinical trials are ongoing to determine the replicability of our findings.
Deep machine learning for the PANDA software trigger
Authors: Jiang Peiyong , Götzen Klaus , Kliemt Ralf , Nerling Frank , Peters Klaus ,   the P.A.N.D.A. Collaboration
Published: April 2023

Deep machine learning methods have been studied for the software trigger of the future PANDA experiment at FAIR, using Monte Carlo simulated data from the GEANT-based detector simulation framework PandaRoot. Ten physics channels that cover the main physics topics, including electromagnetic, exotic, charmonium, open charm, and baryonic reaction channels, have been investigated at four different anti-proton beam momenta. Different classification concepts and network architectures have been studied. Finally a residual convolutional neural network with four residual blocks in a binary classification scheme has been chosen due to its extendability, performance and stability. The presented study represents a feasibility study of a completely software-based trigger system. Compared to a conventional selection method, the deep machine learning approach achieved a significant efficiency gain of up to 200%, while keeping the background reduction factor at the required level of 1/1000. Furthermore, it is shown that the use of additional input variables can improve the data quality for subsequent analysis. This study shows that the PANDA software trigger can benefit greatly from the deep machine learning methods.
Evidence of a lepto-hadronic two-zone emission in flare states
Authors: Aguilar-Ruiz E. , Fraija N. , Galván-Gámez A.
Published: April 2023

The BL Lac Markarian 501 exhibited two flaring activities in the very-high-energy (VHE) band in May 2009. The lack of correlation between X-rays and TeV gamma-rays without increasing in other bands suggested that more than one emission zone could be involved. Moreover, fast variability in the flaring state was observed, indicating that the emission zones responsible must have small sizes. We use a lepto-hadronic model with two-zone emission to explain the spectral energy distribution during quiescent and these flaring states. In the proposed scenario, the photopion processes explain the VHE flaring activities successfully, and variability constraints place the activity in a zone located near the jet’s base or named inner blob, while synchrotron self-Compton emission describing the X-ray signature during that flaring state occurs in the zone situated far the central engine or named outer blob.
The Role ofGynostemma pentaphyllumin Regulating Hyperlipidemia
Authors: Li Ying , Ouyang Qiong , Li Xu , Alolgal Raphael N. , Fan Yuanming , Sun Yangyang , Gong Hang , Xiao Pingxi , Ma Gaoxiang
Published: April 2023

Developing effective and safe lipid-lowering drugs is highly urgent. This study aims to investigate the effectiveness and underlying mechanisms of Gynostemma pentaphyllum (GP) in the treatment of hyperlipidemia. First, a meta-analysis was performed to determine the lipid-lowering effects of GP. Thereafter, hyperlipidemia was induced in mice using a high-fat diet (HFD) and was subsequently treated with Gynostemma pentaphyllum extract (GPE) by daily gavage for 12 weeks. The body weight, tissue weight, blood lipid level, and liver lipid level were determined. Additionally, mouse serum samples were subjected to metabolomic profiling and feces were collected at different time points for metagenomic analysis via 16S rDNA sequencing. A total of 15 out of 1520 studies were retrieved from six databases. The pooled results of the meta-analysis showed that GP effectively reduced triglyceride levels and increased high-density lipoprotein cholesterol (both [Formula: see text]). Animal experiments revealed that GPE administration significantly reduced body weight, ameliorated high blood lipid levels, limited lipid deposition, and improved insulin resistance. Furthermore, GPE treatment markedly changed the intestinal microbiota structure and constitution of tryptophan metabolites. In conclusion, our results confirm the lipid-lowering effect of GP, which may be partly attributable to regulation of the intestinal microbiota and tryptophan metabolism.
An analysis of composites with two-dimensional decagonal quasicrystal matrix and spheroidal inclusions
Authors: Li Guangfang , Li Shuang , Li Lianhe
Published: April 2023

Eshelby tensors in elasticity are obtained for two-dimensional (2D) decagonal quasicrystal containing an ellipsoidal inclusion. Based on the intrinsic strain formula and Mori–Tanaka theory, the effective elastic properties of 2D decagonal composites are obtained. The effects of inclusion volume fraction and inclusion aspect ratio on elastic properties of composites with 2D decagonal quasicrystal are discussed.
Convective micropolar fluid over inclined surface with thermal radiation and velocity slip condition effects: Duality and stability
Authors: Deebani Wejdan , Lund Liaquat Ali , Chandio Abdul Fattah , Yashkun Ubaidullah , Shah Zahir , Alshehri Ahmed
Published: April 2023

This research examines the flow of 2D micropolar fluid across an inclined linear shrinking/stretching surface with suction, convective, slip and thermal radiation impact. The governing partial differential equations (PDEs) are transformed into an ordinary differential equations (ODEs) system using a linear similarity transformation, and the bvp4c technique is then used to solve the ODEs system in MATLAB. Comparisons of both solutions are presented. The effects of regulating flow parameters on dimensionless temperature profiles, angular velocity, velocity, skin friction, wall couple stress and heat transfer are shown graphically. Stable velocity profiles are inversely related to velocity slip and material parameter. For a given suction and stretching/shrinking parameter value, graphs show double solutions. The couple stress and skin friction in the first solution, drop then increase as the material parameter K increases. Critical points of the stretching/shrinking parameter, [Formula: see text] where both solutions occur, are indicated by the symbols [Formula: see text] (i.e., [Formula: see text], and that there is no solution when [Formula: see text]. A table summarizes the stability study’s results and highlights.
Numerical simulation of bioconvective Casson nanofluid through an exponentially permeable stretching surface
Authors: Basit M. A. , Tahir Madeeha , Riasat Ayesha , Khan S. A. , Imran Muhammad , Akgül Ali
Published: April 2023

Nanofluids are a very productive etymology of intensifying the process of heat and mass transport systems linked with the industrial and thermal engineering systems. Nanomaterials have effective thermal properties and various applications in our daily life like in heat transfer, electronic cooling systems, energy production and biomedicine and also in the food industry. Keeping the entire motivating potential ramifications of nanoparticles in mind, this work is visualized in the mathematical model developed to show the heat and mass transport behavior of swimming motile organisms in the existence of the magnetic field, heat conduction source, thermal radiation, chemical processes and viscous dissipation. The flow of mass and heat transport under consideration is governed by nonlinear partial differential equations (PDEs) transformed into ordinary differential equations (ODEs) by implementing an eminent method called similarity transform and then numerical results obtained through MATLAB inbuilt package ‘bvp4c’. Numerical solution is visualized through the comparison of Casson fluid results with Newtonian fluid. The impact of numerous nondimensional parameters of temperature, heat transfer, velocity and concentration profiles involved in governing equations is debated and visualized graphically. Furthermore, the effects of parameters and local Nusselt number, motile organism’s number, Biot number, Sherwood number, thermal radiation and microorganism concentration are elaborated through graphical representation. From these results, we clearly see that the velocity profile shows a decrement by raising the values of Buoyancy ratio Nr and Bioconvection Rayleigh number Nc, thermal profile depicted propagation by incrementing the values of Biot and radiation variables, concentration profile decreases by incrementing Lewis parameter Le and microorganisms profile revealed an increase and decrease by the presence of magnetic M and bioconvection Lewis variable Lb, respectively.
Study on effective electroelastic properties of one-dimensional hexagonal piezoelectric quasicrystal containing randomly oriented inclusions
Authors: Li Lu , Li Xinpei , Li Lianhe
Published: April 2023

In this paper, the effective electroelastic properties of one-dimensional (1D) hexagonal piezoelectric quasicrystal containing randomly oriented inclusions are considered. The explicit expressions are obtained for the Eshelby tensors for 1D hexagonal piezoelectric quasicrystals containing rod-shaped and penny-shaped inclusions. The closed forms of the electroelastic constants are acquired for four special cases of random orientations of inclusions. Numerical results are given for the 1D hexagonal piezoelectric quasicrystal containing randomly oriented ellipsoidal inclusions. The results indicate that the effective electroelastic properties of 1D hexagonal piezoelectric quasicrystal composites are strongly affected by both the aspect ratio and the orientation of inclusions.
China–US Strategic Competition and Indonesia’s Status Anxiety
Authors: Bao Guangjiang
Published: April 2023

Indonesia has been actively seeking to improve its status and has gradually developed a trinity of national–regional–world status, consisting of independent status, regional leadership status and middle power status. In the context of China–US strategic competition, Indonesia is more sensitive to the consolidation and pursuit of its status. In response, Indonesia not only inherits the traditional diplomatic policy of “rowing between two rocks” and refuses to take sides between China and the US, but also tries to lead the ASEAN countries to develop a “third way” in the Indo-Pacific region. This paper analyzes Indonesia’s perception of and response to China–US strategic competition from the perspective of status politics, arguing that status politics plays a key role as the underlying logic of Indonesia’s “free and active” diplomacy — maintaining close relations with both China and the United States at the material level can enhance Indonesia’s economic and military status, and maintaining autonomy at the social level can gain international recognition of its status.
Islamic Finance’s Search for Meaning
Authors: Azmat Saad , Shah Mohamed Eskandar
Published: April 2023

Islamic finance industry since its inception has faced a dilemma that has persisted in spite of its significant increase in market share and tremendous growth. The similarity that it has with the conventional finance industry makes many of the participants very unconformable. Behind this criticism are many embedded assumptions. One of it is that Islamic finance in its current form may not be ‘Islamic’: As if this line of the thinking opens the door for an existential crisis. In this paper we discuss the existential crisis of Islamic finance and explain the different ways it continues to deal with it and provide meaning to the industry and academia. Firstly, we offer a historical perspective on Islamic finance and how the first generation of Islamic finance scholars conceived the problem. Then we discuss the different ways the Islamic finance scholars continue to explain the meaning that Islamic finance contains. Here the focus particularly would be on the deontological nature of Islamic ethics and the importance of risk sharing instruments. The success of the Islamic finance industry in terms of its profitability and the opportunity it holds as a possible provider of meaning are presented. Finally, we focus on the role of the actor as not simply a receiver of meaning but as the creator of meaning.
Application of Data Collected by Endpoint Detection and Response Systems for Implementation of a Network Security System based on Zero Trust Principles and the EigenTrust Algorithm
Authors: Kumar Nitesh , Kasbekar Gaurav S. , Manjunath D.
Published: April 2023

Traditionally, security systems for enterprises have implicit access based on strong cryptography, authentication and key sharing, wherein access control is based on Role Based Access Control (RBAC), in which roles such as manager, accountant and so on provide a way of deciding a subject's authority. However, years of post-attack analysis on enterprise networks has shown that a majority of times, security breaches occur intentionally or accidently due to implicitly trusted people of an enterprise itself. Zero Trust Architecture works on the principle of never granting trust implicitly, but rather continuously evaluating the trust parameters for each resource access request and has a strict, but not rigid, set of protocols for access control of a subject to resources. Endpoint Detection and Response (EDR) systems are tools that collect a large number of attributes in and around machines within an enterprise network to have close visibility into sophisticated intrusion. In our work, we seek to deploy EDR systems and build trust algorithms using tactical provenance analysis, threshold cryptography and reputation management to continuously record data, evaluate trust of a subject, and simultaneously analyze them against a database of known threat vectors to provide conditional access control. However, EDR tools generate a high volume of data that leads to false alarms, misdetections and correspondingly a high backlog of tasks that makes it infeasible, which is addressed using tactical provenance analysis and information theory.