bluuebunny/crossref_metadata_2025 huggingface dataset:
Unravelling the Interplay Between Primigravida Pregnant Women Health Profile, Catastrophic Thinking, Tokophobia and Childbirth Preferences in a Rural Area
Authors: Ali Heba Saied Ibrahim , Abdelhafez Amal Ahmed , Hammad Heba Abdel‐Hamid , AbdElmoneam Eman Halim , Othman Ahmed Abdellah , Atta Mohamed Hussein Ramadan
Published: November 2024

Aims

To assess the prevalence of tokophobia (fear of childbirth) and evaluate the relationship between catastrophic thinking, tokophobia, childbirth preferences and the health profile of primigravida (first‐time pregnant women in rural areas).

Design

A descriptive correlational study.

Method

This study, implemented from January 2024 to March 2024, involved 300 primigravidae. Data collection was carried out using the Socio‐Demographic and Clinical Data Sheet, the Pain Catastrophising Scale (PCS) and the Fear of Childbirth Scale, which are specific tools chosen for their relevance to the research objectives.

Results

The mean score for catastrophic thinking is 36.13 (SD = 4.2740), which indicates a clinically significant level of pain catastrophising, and Tokophobia's mean is 42.53, which denotes intense Fear of Childbirth. There are strong positive correlations among catastrophic thinking and its subcomponents, positive correlations between tokophobia and devastating thinking and significant correlations between childbirth preferences and catastrophic thinking.

Conclusion

This study's findings provide compelling insight into the intricate interplay between catastrophic thinking, tokophobia and childbirth preferences. These insights can pave the way for targeted psychological interventions to address catastrophic thinking in pregnant women, potentially alleviating tokophobia and supporting informed, less fear‐driven childbirth decisions. This could lead to a more positive childbirth experience for many birthing people, equipping healthcare professionals with actionable knowledge to improve maternal and child health outcomes.

Reporting Method

The relevant reporting method, that is, STROBE, has been adhered to.

Impact

This study's findings have significant implications for the healthcare of pregnant women, particularly first‐time birthing people deemed high risk. The study suggests that thorough antenatal care can help ease their fear of childbirth, ultimately leading to improved outcomes for both women and babies.

Patient or Public Contribution

Public contribution by females in the community maternal services.
Rationale and Design of a Randomized, Open‐Label, Parallel‐Group Study of Esaxerenone Versus Angiotensin Receptor Blockers in Older Patients With Uncontrolled Hypertension on Calcium Channel Blocker Monotherapy (ESCORT‐HT)
Authors: Kario Kazuomi , Katsuya Tomohiro , Shimosawa Tatsuo , Taguchi Takashi , Tanabe Ayumi , Ohishi Mitsuru ,   the ESCORT‐HT investigators
Published: November 2024

Angiotensin II receptor blockers (ARBs) and calcium channel blockers (CCBs) are commonly prescribed as first‐ and second‐line treatments for older Japanese patients with hypertension. However, due to age‐related decline in renin activity, the effectiveness of ARBs may decrease. This highlights the need for other antihypertensive agents to be used in combination with CCBs to replace ARBs for more effective blood pressure (BP) control. The ESCORT‐HT study is a multicenter, randomized, controlled, open‐label, parallel‐group study with a 4‐week run‐in period and 12‐week treatment period. This study aims to evaluate the efficacy of esaxerenone as a second‐line treatment for hypertension and to determine whether its BP‐lowering effect is noninferior to that of ARBs in older patients with uncontrolled hypertension on CCB monotherapy. The safety profiles of esaxerenone and ARBs will also be evaluated. Patients will be randomly assigned in a 1:1 ratio to receive either esaxerenone or an ARB. The primary efficacy endpoint will be the change from baseline in morning home systolic BP at the end of the treatment period. The BP‐lowering effect of esaxerenone will be considered noninferior to that of ARBs if the upper limit of the two‐sided 95% confidence interval (CI) for the difference in systolic BP change between esaxerenone and ARB is <3.8 mmHg, and will be considered superior if the upper limit of the two‐sided 95% CI is <0. The findings may elucidate the possible benefits of earlier use of mineralocorticoid receptor blockers in combination with CCBs in older patients with essential hypertension.
Study on the mechanism of Shenmai injection in the treatment of sepsis
Authors: Yang Mengxia , Chen Tengfei , Xu Yue , Liu Qingquan , Xu Xiaolong
Published: November 2024

Shenmai injection (SMI) is widely used in the clinical treatment of sepsis, but its mechanism is not yet clear. This study aimed to explore the molecular mechanism through network pharmacology, bioinformatics, and molecular docking technologies. The active ingredients and targets of SMI were screened through traditional Chinese medicine databases and the Swiss Target Prediction database, respectively. The disease genes were searched using GEO and GeneCards databases, and Venn mapping was used to screen potential therapeutic targets. The key targets were selected using Cytoscape 3.9.1 software. The BioGPS database was used to evaluate the expression of these targets in tissues/cells. The DAVID database is used for enrichment analysis. Molecular docking technology was used to evaluate the interaction between these targets and core active ingredients. 122 potential therapeutic targets and 28 key targets were identified. Forty‐six potential therapeutic targets showed highly specific expression in 40 tissues/cells. The PI3K‐AKT, RAP1, and MAPK signalling pathways are highly enriched. The molecular docking results showed good interactions. This study systematically analysed the mechanism of SMI in treating sepsis, involving multiple targets and pathways, possibly related to anti‐inflammatory, anti‐oxidative stress, and immune regulation, providing reference value for future basic research of sepsis.
Flexural strength, surface roughness, and color stability of various CAD‐CAM denture teeth materials
Authors: Orgev Ahmet , Cakmak Gulce , Peng Chin‐chun , Lavrentiadis Grigoris , Li Rui
Published: November 2024

Purpose

To assess the flexural strength (FS), surface roughness, and color stability of additive manufactured (AM) and subtractive manufactured (SM) denture teeth materials, as well as the effect of thermocycling on these properties.

Materials and Methods

Eighty strips (20/material type; 64×10×3.3 mm) and 60 discs (15/material type; 12×4 mm) were fabricated from four different denture teeth materials (Straumann, Flexcera, Ivoclar, and Candulor). The specimens were divided into two subgroups (nonthermal cycled and 5000 thermal cycled,10 per subgroup), and subjected to a 3‐point test for FS using a universal testing machine at a crosshead speed of 5.0 mm/min. Surface roughness (Ra, µm) and color differences (ΔE00) of disc specimens were measured before and after thermocycling using a noncontact optical profilometer and a spectrophotometer, respectively. The CIEDE2000 formula was used to calculate the color differences (ΔE00) before and after thermocycling. Data were analyzed using 2‐way ANOVA followed by post hoc multiple comparison tests (α = 0.05).

Results

There was no significant difference in flexural strength between nonthermal cycled SM materials (p = 0.15), which were significantly higher than AM materials (p < 0.001). The flexural strength values of all tested materials were significantly reduced after thermocycling (p < 0.05). The material type had a significant effect on the Ra values (p < 0.001), whereas thermocycling did not (p = 0.81). After thermocycling, all materials exhibited color changes lower than the clinical perceptible threshold (ΔE00 = 2.7).

Conclusions

Thermocycling decreased the FS of denture teeth materials manufactured with AM and SM, but did not affect the surface roughness. The FS values of SM groups were significantly higher than AM materials, irrespective of thermocycling. No clinically significant color changes of the denture teeth material were noted.
Piecing together oomycete effector processing and host translocation
Authors: Meisrimler Claudia‐Nicole , Eccersall Sophie
Published: November 2024

This article is a Commentary on Xu et al. (2025), 245: 1640–1654.
Beyond the mosaic model of brain evolution: Rearing environment defines local and global plasticity
Authors: Dumitru Magda L. , Frugård Opdal Anders Martin
Published: November 2024

Comparative animal studies have identified a trend toward a more global structural organization as brains become larger, suggesting that brain regions grow in sync as predicted by the concerted model of brain evolution. At the same time, brain plasticity studies have identified a boost in local brain structure triggered by the environment, suggesting that brain regions grow independently, as predicted by the mosaic model. Nevertheless, it is unclear whether the environment can also trigger shifts toward a more global brain structure, that is, whether phenotypic plasticity proceeds in a concerted fashion. Here, we examined the impact of radically different rearing environments on brain organization in a teleost fish, the three‐spined stickleback (Gasterosteus aculeatus). We computed novel indices of local and global brain structure across groups reared in the two environments and entered them as predictors of differences in brain and body sizes. Changes in local brain structure predicted differences in both body and brain sizes, whereas changes in global brain structure only predicted differences in brain size. Our findings highlight the emergence of brain plasticity in a population as local and global changes that are both compatible with the concerted model.
Umbrella review of systematic reviews to inform the development and translation of community‐based childhood obesity prevention interventions
Authors: Jacobs Jane , Wolfenden Luke , Bolton Kristy A. , Brown Vicki , Sultana Marufa , Backholer Kathryn , Allender Steven , Novotny Rachel , Peeters Anna , Nichols Melanie
Published: November 2024

Community‐based interventions (CBIs) can be effective and feasible for the prevention of childhood obesity. The aim of this umbrella review is to determine if systematic reviews report sufficient information to guide replication or adaptation of CBIs to a variety of contexts and aid in further development of childhood obesity prevention CBIs. Six databases were searched for systematic reviews including obesity prevention CBIs involving 0–18 year olds and reporting weight‐related outcomes. Two researchers screened results. Evidence‐to‐decision frameworks guided which details may be required for decision‐makers to design and carry‐out a CBI, including information on intervention characteristics, outcome reporting and translation factors. From 3935 search results, 40 studies were included. The most frequently reported relevant pieces of information were behaviors targeted (100% of systematic reviews), intervention duration (90%) and settings involved (97.5%). Less frequently reported factors included specific actions implemented (48%), intervention intensity (30%) and organizations, or contributors involved (40%). There was a low level of reporting of equity considerations (27.5%), adverse events (20%), and costs/cost‐effectiveness (17.5%). Multilevel interventions for child obesity prevention have demonstrated effectiveness, yet additional documentation of successful intervention processes is needed.
Extracting full information from OCT scans—signs of early age‐related macular degeneration within inner retinal layers by local neighbourhood statistics. Part II: Results
Authors: Wagner Marcus , Sommerer Julia , Rauscher Franziska G.
Published: November 2024

Background and Objectives

Associations between the occurrence of early age related macular degeneration (AMD) and alterations in retinal layer thicknesses have been reported, based on classical processing of optical coherence tomography (OCT) data by noise removal and subsequent image segmentation. However, speckle noise within OCT data itself bears a substantial part of the total information. For this reason, we designed an omics‐type approach for full exploitation of OCT data, which was able to identify signs of early AMD throughout the retina as a whole.

Methods

A nested case‐control study was designed with 200 early AMD cases and 200 healthy controls. For each participant, within a randomly selected OCT scan and a randomly selected column therein, manual grading was performed for 26 retinal feature positions. At every position, a total of 3792 descriptors were computed, based on nonlinear transformations of OCT data, first‐order neighbourhood statistics and Haralick features. Equivalence and differences between cases and controls were tested for each descriptor at every graded position. Results of multiple testing were expressed in terms of false and true discovery rates controlled by the Benjamini–Yekutieli procedure.

Results

In terms of the amount and disparity of true discoveries, overall non‐equivalence was found for early AMD and healthy groups. Strong difference signals were observed at the internal limiting membrane and two central retinal positions, particularly for descriptors emphasising speckle noise.

Conclusions

Between the retinae of healthy controls and early AMD patients, significant differences were observed at the level of local neighbourhood statistics within OCT data. Thus, independent evidence was obtained for AMD affecting not only the outer retinal layers but the retina as a whole, even in the early stages of the disease. Within OCT data, both cartoon and speckle bear essential parts of the total information. We pursued a constructive, completely documented, traceable and repeatable approach without invoking artificial intelligence methods.
Plexiform Schwannoma: An Upper Lip Swelling With an Unexpected Diagnosis
Authors: Deligianni Eleni , Betts Guy , Allan Rigel , Ariyaratnam Senathirajah
Published: November 2024

Aim

Schwannomas are rare benign, usually solitary tumours of the nervous system, with a predilection for adults in their fourth decade of life. Though the head and neck area accounts for about 25% to 45% of all schwannomas, the upper lip is an extremely uncommon location. Here we report a case of a plexiform schwannoma presenting as an upper lip swelling in a 23‐year‐old male.

Materials and Methods

The lesion presented as a longstanding, asymptomatic, firm and mobile submucosal lump on the left‐hand side of the upper lip, seen both intra‐ and extra‐orally. Due to the location and clinical features a provisional diagnosis of a benign minor salivary gland tumour, such as pleomorphic adenoma was considered, and an excisional biopsy arranged.

Results

The microscopic and immunohistochemical examination confirmed the diagnosis of a plexiform cellular schwannoma with no evidence of malignancy.

Conclusion

Less than 20 schwannomas have been reported in the English literature as located on the upper lip. Moreover, plexiform schwannomas are an uncommon variant with a predilection to arise in the skin, thus making the upper lip an extremely rare location. This case illustrates the broad range of pathology that can present as lesions of the upper lip.
Improved Function After Anterior Controllable Antedisplacement and Fusion for Cervical Ossification of Posterior Longitudinal Ligament: A Long‐Term Follow‐Up
Authors: Shi Yangyang , Sun Kaiqiang , Han Linhui , Yan Chen , Wang Jinyu , Yang Jingyun , Wang Yuan , Xu Ximing , Sun Jingchuan , Shi Jiangang
Published: November 2024

Background

Anterior controllable antedisplacement and fusion (ACAF) is an emerging surgical approach for treating cervical ossification of the posterior longitudinal ligament (C‐OPLL), yet there is limited data on its long‐term efficacy and safety. The present study aimed to analyze the short‐ and long‐term postoperative clinical and radiological outcomes and perioperative complications of ACAF for patients with C‐OPLL.

Methods

This was a single‐center, retrospective, cohort study, with the mean duration of follow‐up of at least 24 months. A total of 111 patients with C‐OPLL in our institution from June 2017 to June 2019 were assessed preoperatively and at 3 days, 3, 6, 12, and 24 months postoperatively. The primary outcome was the recovery of neurological function, measured with the Japanese Orthopedic Association (JOA) score. The secondary outcomes included pain, Cobb angle, spinal canal invasion rate, and surgery‐related complications.

Results

The postoperative JOA score at each follow‐up was significantly better than the preoperative JOA score, regardless of preoperative spinal canal invasion rate, K‐line, and segment length. The visual analog scale (VAS) score also decreased dramatically 3 days after surgery and was maintained at a low level throughout the follow‐up period. Improvements in Cobb angle and invasion rate were observed right after the operation and were maintained for 2 years thereafter.

Conclusions

ACAF could achieve satisfactory recovery of neurological function in C‐OPLL patients during a follow‐up of 24 months, regardless of preoperative spinal canal invasion rate, preoperative K‐line, or surgical segment length.
Soybean Oil and Protein: Biosynthesis, Regulation and Strategies for Genetic Improvement
Authors: Li Hui , Sun Jia , Zhang Ying , Wang Ning , Li Tianshu , Dong Huiying , Yang Mingliang , Xu Chang , Hu Limin , Liu Chunyan , Chen Qingshan , Foyer Christine H. , Qi Zhaoming
Published: November 2024

Soybean (Glycine max [L.] Merr.) is one of the world's most important sources of oil and vegetable protein. Much of the energy required for germination and early growth of soybean seeds is stored in fatty acids, mainly as triacylglycerols (TAGs), and the main seed storage proteins are β‐conglycinin (7S) and glycinin (11S). Recent research advances have deepened our understanding of the biosynthetic pathways and transcriptional regulatory networks that control fatty acid and protein synthesis in organelles such as the plastid, ribosome and endoplasmic reticulum. Here, we review the composition and biosynthetic pathways of soybean oils and proteins, summarizing the key enzymes and transcription factors that have recently been shown to regulate oil and protein synthesis/metabolism. We then discuss the newest genomic strategies for manipulating these genes to increase the food value of soybeans, highlighting important priorities for future research and genetic improvement of this staple crop.
A Growing Willow: The Six Rs Indigenous Research Framework—Stories of the Native American Faculty Journey in STEM*
Authors: Tsosie Ranalda L. , Wu Ke , Grant Anne D. , Harrington Jennifer , Chase Stephan T. , Thomas Aaron , Chase‐Begay Damian , Hill Salena Beaumont , Belcourt Annjeanette , Plenty Sweetgrass‐She Kills Ruth
Published: November 2024

Native American faculty in science, technology, engineering, and mathematics (NAF‐STEM) disciplines are historically underrepresented. Creating inclusive academia for Indigenous people that typically live and thrive in rural communities requires insights into their personal, relational, and collective experiences. This study was guided by the Six Rs: relationship, respect, responsibility, relevance, representation, and reciprocity, and was informed by Indigenous Research Methodologies. Twelve NAF‐STEM from tribal colleges and non‐tribal institutions were asked to share their perspectives and experiences in seven Research Circles. NAF‐STEM joined sequential hybrid workshops over seven weeks on how to conduct qualitative data analysis. Authors conducted analysis on the transcripts of Research Circles for themes associated with the professional satisfaction and success of NAF‐STEM. Results of the study identified the importance of holistic support systems that remain mindful of both the opportunities and challenges facing NAF‐STEM and emphasize the significance of balancing the need for respectful relationships, adequate representation, shared responsibility, relevance of diversity, and reciprocity in STEM. Through implementation of the Six Rs throughout the research process, the study identified successes, support systems, and challenges of NAF‐STEM at both tribal and non‐tribal colleges and universities. These outcomes can inform institutions to create an equitable and inclusive environment for NAF‐STEM.
Enhanced salt stress tolerance in plants without growth penalty through increased photosynthesis activity by plastocyanin from Antarctic moss
Authors: Bae NoA , Shim Su‐Hyeon , Alavilli Hemasundar , Do Hackwon , Park Mira , Lee Dong Wook , Lee Jun Hyuck , Lee Hyoungseok , Li Xiaozheng , Lee Choon‐Hwan , Jeon Jong‐Seong , Lee Byeong‐ha
Published: November 2024

Salinity poses a significant challenge to plant growth and crop productivity by adversely affecting crucial processes, including photosynthesis. Efforts to enhance abiotic stress tolerance in crops have been hindered by the trade‐off effect, where increased stress resistance is accompanied by growth reduction. In this study, we identified and characterized a plastocyanin gene (PaPC) from the Antarctic moss Polytrichastrum alpinum, which enhanced photosynthesis and salt stress tolerance in Arabidopsis thaliana without compromising growth. While there were no differences in growth and salt tolerance between the wild type and Arabidopsis plastocyanin genes (AtPC1 and AtPC2)‐overexpressing plants, PaPC‐overexpressing plants demonstrated superior photosynthetic efficiency, increased biomass, and enhanced salt tolerance. Similarly, PaPC‐overexpressing rice plants exhibited improved yield potential and photosynthetic efficiency under both normal and salt stress conditions. Key amino acid residues in PaPC responsible for this enhanced functionality were identified, and their substitution into AtPC2 conferred improved photosynthetic performance and stress tolerance in Arabidopsis, tobacco, and tomato. These findings not only highlight the potential of extremophiles as valuable genetic resources but also suggest a photosynthesis‐based strategy for developing stress‐resilient crops without a growth penalty.
Leadership as a Key Requirement for Being an Effective Public Sector Manager: Evolution of the Concept of “Good Public Sector Leader” Over Time
Authors: Biloa Xaverie Sandrine
Published: November 2024

The concept of leadership has been extensively studied over the last decades and it has taken today a significant importance in our society than ever before. Many different definitions and theories of leadership have been proposed by diverse researchers. According to Stogdill (1950), leadership is a process of influencing the achievement of goals. Leadership can also be described as an art in which people are mobilized for the shared aspirations (Kouzes and Posner, 1995). Leadership is understood to be a key requirement for being an effective public sector manager, and it has shaped what constitutes a “good public sector leader” over time by giving rise to different types of leaders. The present article discusses the evolution of the concept of leadership over time and its impact in public service management.
Asymptotics of parity biases for partitions into distinct parts via Nahm sums
Authors: Bringmann Kathrin , Man Siu Hang , Rolen Larry , Storzer Matthias
Published: November 2024

For a random partition, one of the most basic questions is: what can one expect about the parts that arise? For example, what is the distribution of the parts of random partitions modulo ? As most partitions contain a 1, and indeed many 1s arise as parts of a random partition, it is natural to expect a skew toward . This is indeed the case. For instance, Kim, Kim, and Lovejoy recently established “parity biases” showing how often one expects partitions to have more odd than even parts. Here, we generalize their work to give asymptotics for biases for partitions into distinct parts. The proofs rely on the Circle Method and give independently useful techniques for analyzing the asymptotics of Nahm‐type ‐hypergeometric series.
Comparative Survey-Based Study of Noninvasive Saliva Collection Devices
Authors: Kil Yeokyoung (Anne) , Booeshaghi Ali S. , Pachter Lior S.
Published: November 2024

While saliva is a valuable sample for noninvasive diagnosis, the usability of saliva collection devices can impact its effectiveness in diagnostics. To address this, we evaluated five saliva collection devices: Salivette (swab), SuperSAL (swab), SalivaBio Passive Drool, Medschenker Saliva Collection Kit (funnel), and a cryovial with funnel used in SwabSeq coronavirus disease 19 (COVID-19, SARS-CoV-2) tests. Saliva collection rates and instruction reading rates for each device were measured for 60 healthy adults. Users then reported the difficulties of instructions, assembly, and saliva collection, and whether there was leakage of saliva through a survey. Unstimulated saliva production (=flow) rates and base reading rates for each user were measured for normalization. Device metrics were compared using permutation tests and one-way analysis of variance (ANOVA). Salivette collected saliva easily and most quickly, while SuperSAL's collection was slower and rated difficult by users. Medschenker had high instruction reading rates and the lowest leakage rate. Users found the SwabSeq funnel and Passive drool's instructions easy, but found the devices themselves not easy to collect saliva with. Overall, Medschenker performed well on most metrics, while SuperSAL did not perform as well. Our results show that no single saliva collection device satisfies all requirements of an ideal device: a device that allows for efficient, easy, and safe saliva collection without leakage. With the findings from our study, we aim to guide researchers and clinicians in choosing the appropriate saliva collection device in their practices and to motivate the design of an ideal saliva collection device.
Novel Alloying Strategy to Improve Brazing Properties on Nickel-Based Superalloys for Aircrafts Turbine Application
Authors: Reker Dirk Wilhelm , Sowa Roman , Schwalbe Caspar , Seidel Frank , Moehwald Kai , Nicolaus Martin , Wackenrohr Steffen , Tillmann Wolfgang
Published: November 2024

The continuous improvement of high potential repair technologies is an essential driver for cost-effective and sustainable aviation. To withstand extreme forces and temperatures, the turbine section of aircraft engines is made from Nickel-based superalloys. This class of materials routinely develops cracks and geometrical deviations in service, which require a brazing repair, thus making brazing an indispensable key technology. This study seeks to improve brazing properties on Nickel-based superalloys for aircraft applications. Facilitated by materials simulation, a novel alloying strategy is outlined to design the braze alloy chemistry. The design criteria are established on the optimization of major microstructural properties influencing the mechanical properties known for repair brazed joints. The proposed design criteria were applied to the development of two new braze alloys. The new alloy design approach is validated experimentally by using the developed alloys. Mechanical properties of brazed samples made from Nickel-based superalloys were investigated at a service equivalent temperature of 871 °C. Results indicate that the ultimate tensile strength at 871 °C is 20.5% higher than that published for legacy braze alloys. This study provides a basis for the development of repair technologies applicable to further superalloys.
Short Yardage: A Case Study of College Football, Fiscal Responsibility, and Institutional Brand Implications
Authors: Lee Jason W. , Gregg Elizabeth A. , Cornelius Luke , Miller John J.
Published: November 2024

This case outlines a dilemma that an athletic department stakeholder faces following the challenge of reinstating the football team at his alma mater after it was suddenly eliminated due to financial constraints. The case presents three scenarios with various pros and cons for students, which they then utilize while determining the appropriate course of action moving forward. After receiving guidance from their instructor, students answer questions such as whether the data support the three scenarios for resuming football; whether the student(s) would make the decision to reinstate the program at all, using data to make their determination; facility usage for games if they are resumed; Title IX implications of reinstating football; and a broad question about how the National Collegiate Athletic Association should handle financial support of institutions as well as how institutional support should count. Overall, this case study challenges students to think about the ramifications of decision making, financial aspects of college athletics, and Title IX. Each of these areas is critical in terms of career preparation for those interested in working in intercollegiate athletics and the sport industry broadly.
Risk-adjusted observed minus expected cumulative sum (RA O-E CUSUM) chart for visualisation and monitoring of surgical outcomes
Authors: Cordier Quentin , Prieur Hugo , Duclos Antoine
Published: November 2024

To improve patient safety, surgeons can continually monitor the surgical outcomes of their patients. To this end, they can use statistical process control tools, which primarily originated in the manufacturing industry and are now widely used in healthcare. These tools belong to a broad family, making it challenging to identify the most suitable methodology to monitor surgical outcomes. The selected tools must balance statistical rigour with surgeon usability, enabling both statistical interpretation of trends over time and comprehensibility for the surgeons, their primary users. On one hand, the observed minus expected (O-E) chart is a simple and intuitive tool that allows surgeons without statistical expertise to view and interpret their activity; however, it may not possess the sophisticated algorithms required to accurately identify important changes in surgical performance. On the other hand, a statistically robust tool like the cumulative sum (CUSUM) method can be helpful but may be too complex for surgeons to interpret and apply in practice without proper statistical training. To address this issue, we developed a new risk-adjusted (RA) O-E CUSUM chart that aims to provide a balanced solution, integrating the visualisation strengths of a user-friendly O-E chart with the statistical interpretation capabilities of a CUSUM chart. With the RA O-E CUSUM chart, surgeons can effectively monitor patients’ outcomes and identify sequences of statistically abnormal changes, indicating either deterioration or improvement in surgical outcomes. They can also quantify potentially preventable or avoidable adverse events during these sequences. Subsequently, surgical teams can try implementing changes to potentially improve their performance and enhance patient safety over time. This paper outlines the methodology for building the tool and provides a concrete example using real surgical data to demonstrate its application.
Emerging technology solutions to support national emergency workforce capacity-building initiatives: lessons from Ugandan policy and practice
Authors: McMullen Emily , Kamurari Solomon , Price Richard , Mulimira Moses , James Jonathan , Fryer Andrew , Jjingo Daudi
Published: November 2024

Trauma and emergency care is a national priority in Uganda due to the high burden of injury, impacting a primarily young and rural population. With a significant gap in qualified emergency medicine professionals, a need exists to rapidly upskill the current health workforce and to strengthen access to learning for non-specialist emergency care providers nationally. This review was completed in partnership with the Ugandan Ministry of Health and a consortium of UK partners to support national emergency workforce capacity building in Uganda and East Africa. The review built on policy and practice expertise to explore the feasibility of using emerging digital solutions, such as virtual and augmented reality, to meet the challenges of delivering rapid and equitable access to emergency care training at scale. Data collection included a narrative literature review, key informant interviews, an expert focus group, a technical workshop and field observations. Findings included (1) the identification of local technology expertise and experience, in direct contrast to literature and global perceptions of low-resource environments, (2) high and broad levels of national engagement with digital solutions, (3) existing ambition and infrastructure available to feasibly deliver training at scale and (4) delivery implications for comparable contexts. The review concludes that these emerging technologies should be considered a practical option in the design and delivery of health workforce training at scale. A series of recommendations are proposed for the policy and practice of health professional education and training in Uganda and for comparable contexts.
Gaps in acute upper GI bleed (AUGIB) endoscopy training: a UK trainees and trainers’ survey
Authors: Nigam Gaurav B , Marfin Anna , Ratcliffe Elizabeth , Grant-Casey John , Leithead Joanna A , Oakland Kathryn , Morris Allan John , Travis Simon , Hearnshaw Sarah , Stanley Adrian J , Douds Andrew C
Published: November 2024

Introduction

Trainees report inadequate exposure and training barriers in acute upper gastrointestinal bleed (AUGIB) endoscopic management. This UK-wide survey evaluated the experiences of trainees and trainers in AUGIB endoscopy training.

Methods

A questionnaire was distributed to UK upper GI endoscopy trainees and trainers in 2022–2023.

Results

We received responses from 137 trainees (23%) and 115 trainers (76%). Trainees reported higher exposure to diagnostic oesophagogastroduodenoscopies (OGDs) than AUGIB endoscopy (median 300, IQR 203–441 vs 15, IQR 2.5–35.5 lifetime procedures), with variations among grades and regions. Among trainees, 55% were specialist trainee (ST)3–5 and 28% ST6–7; 73% had Joint Advisory Group (JAG) certification for OGDs, and 32% attended a JAG-approved haemostasis course. For ST6–7 trainees, the highest lifetime procedure counts were for band ligation (median 20, IQR 8.5–39) and injection therapy (median 10, IQR 6.5–29.5); the lowest counts were for glue, over-the-scope clip and Danis stent (median 0). ≤41% of ST6–7 trainees felt confident in independent haemostatic procedures. Most trainees (68%) and trainers (64%) reported difficulties in AUGIB endoscopy training. Key barriers included lack of structured training (94% trainees), not being part of the AUGIB on-call rota (78% trainees and 72% trainers) and intensive acute-take commitments (75% trainees and 85% trainers). Suggested improvements included mandatory AUGIB on-call rota participation (89% trainees and 85% trainers), access to JAG-approved haemostasis courses (85% trainees and 84% trainers), simulation-based training (83% trainees and 72% trainers) and reduced acute-take commitments (80% trainees and trainers).

Conclusion

This survey highlights limited exposure to haemostasis procedures and low perceived competence among UK trainees. Addressing these challenges provides an opportunity for targeted improvements, ensuring a more comprehensive training experience.
Spatial dissection of tumour microenvironments in gastric cancers reveals the immunosuppressive crosstalk betweenCCL2+fibroblasts andSTAT3-activated macrophages
Authors: Lee Sung Hak , Lee Dagyeong , Choi Junyong , Oh Hye Jeong , Ham In-Hye , Ryu Daeun , Lee Seo-Yeong , Han Dong-Jin , Kim Sunmin , Moon Youngbeen , Song In-Hye , Song Kyo Young , Lee Hyeseong , Lee Seungho , Hur Hoon , Kim Tae-Min
Published: November 2024

Background

A spatially resolved, niche-level analysis of tumour microenvironments (TME) can provide insights into cellular interactions and their functional impacts in gastric cancers (GC).

Objective

Our goal was to translate the spatial organisation of GC ecosystems into a functional landscape of cellular interactions involving malignant, stromal and immune cells.

Design

We performed spatial transcriptomics on nine primary GC samples using the Visium platform to delineate the transcriptional landscape and dynamics of malignant, stromal and immune cells within the GC tissue architecture, highlighting cellular crosstalks and their functional consequences in the TME.

Results

GC spatial transcriptomes with substantial cellular heterogeneity were delineated into six regional compartments. Specifically, the fibroblast-enriched TME upregulates epithelial-to-mesenchymal transformation and immunosuppressive response in malignant and TME cells, respectively. Cell type-specific transcriptional dynamics revealed that malignant and endothelial cells promote the cellular proliferations of TME cells, whereas the fibroblasts and immune cells are associated with procancer and anticancer immunity, respectively. Ligand-receptor analysis revealed thatCCL2-expressing fibroblasts promote the tumour progression via JAK-STAT3 signalling and inflammatory response in tumour-infiltrated macrophages.CCL2+fibroblasts andSTAT3-activated macrophages are co-localised and their co-abundance was associated with unfavourable prognosis. We experimentally validated thatCCL2+fibroblasts recruit myeloid cells and stimulateSTAT3activation in recruited macrophages. The development of immunosuppressive TME byCCL2+fibroblasts were also validated in syngeneic mouse models.

Conclusion

GC spatial transcriptomes revealed functional cellular crosstalk involving multiple cell types among which the interaction betweenCCL2+fibroblasts andSTAT3-activated macrophages plays roles in establishing immune-suppressive GC TME with potential clinical relevance.
Beneficial effects of the remifentanil/thiopental combination on cardiac function and redox status in diabetic rats
Authors: Marijanovic Goran V. , Stojanovic Aleksandra Z. , Nikolic Marina R. , Jakovljevic Vladimir L.J. , Vulovic Tatjana V.
Published: November 2024

This study aimed to examine the effect of thiopental monotherapy as well as its combination with different agents used in anesthesia induction, on cardiac function and redox state of rats with type 1 diabetes mellitus (T1DM). A total of 40 Wistar albino male rats were used in this study and randomly divided into five groups: thiopental (TIO), fentanyl + thiopental (FEN + TIO), remifentanil + thiopental (REM + TIO), midazolam + thiopental (MID + TIO), and dexmedetomidine + thiopental (DEX + TIO). Animals were anesthetized by intraperitoneal injection of thiopental 85 mg/kg, fentanyl 0.005 mg/kg, remifentanil 0.04 mg/kg, midazolam 2.5 mg/kg, and dexmedetomidine 0.05 mg/kg of body weight. Four weeks after T1DM induction, all animals were subjected to a short narcosis of tested anesthetic, sacrificed by cervical dislocation and the hearts were retrogradely perfused according to Langendorff technique. Our research demonstrated that most combined anesthetics negatively influenced cardiodynamic parameters and redox state in diabetic rats. However, significantly improved cardiac contractility associated with enhanced antioxidative capacity was achieved in the combination of TIO with REM, which distinguishes this anesthetic combination as the therapy with the most pronounced positive effect on cardiac function in state of T1DM.
QCD topology and axion properties in an isotropic hot and dense medium
Authors: Gong Hong-Fang , Lu Qi , Lu Zhen-Yan , Liu Lu-Meng , Chen Xun , Wang Shu-Peng
Published: November 2024

We study the QCD topology and axion properties at finite temperature and chemical potential in the framework of the two-flavor Nambu–Jona-Lasinio model. We find that the behaviors of the two lowest cumulants of the QCD topological charge distribution and axion properties are highly sensitive to the critical behavior of the chiral phase transition. In particular, the topological susceptibility and the axion mass follow the response of the chiral condensate to temperature and chemical potential, showing that both quantities decrease monotonically with the increment of temperature and/or chemical potential. However, it is important to note that the normalized fourth cumulant behaves differently depending on the temperature. At low temperatures, it is a non-monotonic function of the chemical potential, while at high temperatures, it monotonically decreases. Additionally, its value invariably approaches the asymptotic value of $$b_2^{\text {inst}}=-1/12$$

b
2
inst

=
-
1
/
12

, predicted by the dilute instanton gas model. We also observe that with the increase in chemical potential at relatively low temperatures, the axion self-coupling constant exhibits a sharp peak around the critical point, which can even be more than twice its vacuum value. After that, the self-coupling drops sharply to a much lower value than its vacuum value, eventually approaching zero in the high chemical potential limit. The finding that the axion self-coupling constant is significantly enhanced in high-density environments near the chiral phase transition could lead to the creation or enhancement of an axion Bose–Einstein condensate in compact astrophysical objects.
Latest results and outlook of the KM3NeT neutrino telescope
Authors: Romanov Andrey
Published: November 2024

The KM3NeT research infrastructure includes two underwater Cherenkov telescopes in the Mediterranean Sea, KM3NeT/ARCA and KM3NeT/ORCA. The detectors are under construction but are currently taking data and the first physics results were already obtained. The detection technology is the same for both telescopes but the detector geometries are different as they have been tailored to different scientific goals. The KM3NeT/ARCA telescope, located off-shore the Sicilian coast in Italy, focuses on studying the high-energy cosmic neutrinos in the TeV–PeV energy range. The KM3NeT/ORCA location is off-shore Toulon in France and its main goal is to explore the atmospheric neutrino oscillations in the GeV energy range. An overview of the recent results achieved with the KM3NeT detectors in their partial configurations is given in this work. Also, the sensitivity to the cosmic neutrino measurements and the oscillation studies with the completed KM3NeT/ARCA and KM3NeT/ORCA telescopes are presented.
Analysis of the L3 BEC at Z0-pole: Comparison of the conventional formula against the τ-model
Authors: Mizoguchi Takuya , Matsumoto Seiji , Biyajima Minoru
Published: November 2024

The L3 Collaboration reported data on 2-jet and 3-jet Bose–Einstein correlations (BECs) with the results obtained through the [Formula: see text]-model in 2011. In this study, we analyze these correlations using the conventional formula with the Gaussian long-range correlation ([Formula: see text]). The estimated ranges of interactions for 2-jet and 3-jet, [Formula: see text] and [Formula: see text], are almost the same magnitude as those by [Formula: see text]-model: [Formula: see text] (stat) fm and [Formula: see text] (stat) fm. The anticorrelation in BEC (less than 1.0) observed by the L3 Collaboration is related to the partially negative density profile ([Formula: see text] in [Formula: see text] space) in the [Formula: see text]-model and the [Formula: see text] in [Formula: see text], respectively. Remarkably, the probability [Formula: see text] calculated from the Levy canonical form exhibits partially negative behavior.
Effect of Weibull TEF on SRGM Subject to Field Environment
Authors: Behera Anup Kumar , Agarwal Priyanka
Published: November 2024

The development of dependable software has been a challenging task due to the significant complexity of software that has evolved over the past few decades. Software reliability is crucial because software errors can result in significant societal or financial damages. Many of the software reliability growth models (SRGMs) discussed in the literature make the common assumption that the operating/field environment and the development (testing) environment are the same. The idea that testing and field environments are different emerged in the early 2000s. Expanding upon this premise, our study introduces a novel SRGM that takes the Weibull testing effort function (TEF) into account along with the uncertainty of the field environment. Illustrative examples are shown to highlight the efficiency of the proposed model when compared to several existing SRG models. Our suggested model’s effectiveness and applicability will be evaluated using actual collected software failure data from software applications.
A Novel Goodness-of-Fit Test for Lifetime Models Based on Type II Censored Data
Authors: Alizadeh Noughabi Hadi
Published: November 2024

In this paper, a novel test statistic is introduced to evaluate the goodness of fit of lifetime distributions when dealing with Type II censored data. The test statistic is derived from a local linear regression-based estimator of the Kullback–Leibler information. Extensive analysis is conducted to examine the properties of this test statistic, highlighting its nonnegative nature, as for KL information. The proposed test statistic is applied to various distributions, namely exponential, Weibull, log-normal, and Pareto. Critical values and Type I error rates for the tests are determined, demonstrating their exceptional accuracy and reliability. To further assess their performance, the proposed tests are subjected to Monte Carlo simulations, comparing their power values against alternative tests currently in use. Finally, the proposed method is applied to three real data sets from the engineering reliability aspect to prove their practical versatility.
Special Weingarten surfaces with planar convex boundary
Authors: Nelli B. , Pipoli G. , Tassi M. P.
Published: November 2024

In this paper, we prove a Ros–Rosenberg theorem in the setting of Special Weingarten surfaces. We show that a compact, connected, embedded, Special Weingarten surface in [Formula: see text] with planar convex boundary is a topological disk under mild suitable assumptions.
Path Vertex Cover Number of Some Product Graphs
Authors: Liu Yan , Deng Xingchao
Published: November 2024

A vertex subset [Formula: see text] of a graph [Formula: see text] is a [Formula: see text]-path vertex cover if [Formula: see text] intersects any [Formula: see text]-path in [Formula: see text] for some positive integer [Formula: see text] The minimum magnitude of all [Formula: see text]-path vertex covers is called [Formula: see text]-path vertex cover number of [Formula: see text] (denoted [Formula: see text]). In this contribution, we gave estimations of [Formula: see text] [Formula: see text] and the exact values of [Formula: see text] [Formula: see text] and [Formula: see text]. We also obtain the [Formula: see text] when [Formula: see text] is the Cartesian product of complete and complete bipartite graph.