bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility study of a multimodal prehabilitation programme in women receiving neoadjuvant therapy for breast cancer in a major cancer hospital: a protocol
Authors: Grant Suzanne J , Kay Shelley , Lacey Judith , Kumar Sanjeev , Kerin-Ayres Kim , Stehn Justine , Gonzalez Maria , Templeton Sandra , Heller Gillian , Cockburn Jane , Wahlroos Sara , Malalasekera Ashanya , Mak Cindy , Graham Susannah
Published: March 2024

Introduction

Neoadjuvant therapy has become a standard treatment for patients with stage II/III HER2 positive and triple negative breast cancer, and in well-selected patients with locally advanced and borderline resectable high risk, luminal B breast cancer. Side effects of neoadjuvant therapy, such as fatigue, cardiotoxicity, neurotoxicity, anxiety, insomnia, vasomotor symptoms, gastrointestinal disturbance as well as a raft of immune-related adverse events, may impact treatment tolerance, long-term outcomes, and quality of life. Providing early supportive care prior to surgery (typically termed ‘prehabilitation’) may mitigate these side effects and improve quality of life.

During our codesign of the intervention, consumers and healthcare professionals expressed desire for a programme that ‘packaged’ care, was easy to access, and was embedded in their care pathway. We hypothesise that a multimodal supportive care programme including exercise and complementary therapies, underpinned by behavioural change theory will improve self-efficacy, quality of life, readiness for surgery and any additional treatment for women with breast cancer. We seek to explore cardiometabolic, residual cancer burden and surgical outcomes, along with chemotherapy completion (relative dose intensity). This article describes the protocol for a feasibility study of a multimodal prehabilitation programme.

Methods and analysis

This is a prospective, mixed-method, feasibility study of a multi-modal programme in a hospital setting for 20–30 women with breast cancer receiving neoadjuvant therapy. Primary outcomes are recruitment rate, retention rate, adherence and acceptability. Secondary outcomes include patient reported outcome measures (PROMs), surgical outcomes, length of stay, satisfaction with surgery, chemotherapy completion rates, changes in metabolic markers and adverse events. Interviews and focus groups to understand the experience with prehabilitation and different factors that may affect feasibility of the intervention . The output of this study will be a codesigned, evidence-informed intervention assessed for feasibility and acceptability by women with breast cancer and the healthcare professionals that care for them.

Ethics and dissemination

The study received ethics approval from the St Vincents Hospital HREC (HREC/2021/ETH12198). Trial results will be communicated to participants, healthcare professionals, and the public via publication and conferences.

Trial registration number

ACTRN12622000584730.
Barriers and enablers of quality high-acuity neonatal care in sub-Saharan Africa: protocol for a synthesis of qualitative evidence
Authors: Mersha Abera , Demissie Asresash , Nemera Gugsa
Published: March 2024

Introduction

Neonatal intensive care unit (NICU) in sub-Saharan Africa face limited resources and systemic challenges, resulting in poorer quality care, higher infant mortality, and dissatisfaction among both patients and healthcare workers. This review aims to bridge the knowledge gap by identifying and analysing the key barriers and enablers affecting quality care, informing interventions to improve patient outcomes and overall NICU effectiveness in this critical region.

Methods and analysis

This systematic review will search and gather data from a variety of databases, including JBI Database, Cochrane Database, MEDLINE/PubMed, CINAHL/EBSCO, EMBASE, PEDro, POPLINE, Proquest, OpenGrey (SIGLE), Google Scholar, Google, APA PsycINFO, Web of Science, Scopus and HINARI. The review will also include unpublished studies and grey literature from a variety of sources. This review will only include qualitative and mixed-methods studies that explore the barriers and enablers of quality care for high-acuity neonates using qualitative data collection and analysis methods. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research will be used by two independent reviewers to critically appraise the eligible studies. Any disagreements that arise will be resolved through discussion. Qualitative research findings will be pooled using the meta-aggregation approach in QARI software, where possible. Only unequivocal and credible findings will be included in the synthesis. If textual pooling is not possible, the findings will be presented in narrative form.

Ethics and dissemination

This systematic review does not require ethical clearance, and the findings will be disseminated to relevant stakeholders to ensure the widest possible outreach and impact.

PROSPERO registration number

CRD42023473134.
Talking in primary care (TIP): protocol for a cluster-randomised controlled trial in UK primary care to assess clinical and cost-effectiveness of communication skills e-learning for practitioners on patients’ musculoskeletal pain and enablement
Authors: Bishop Felicity L , Cross Nadia , Dewar-Haggart Rachel , Teasdale Emma , Herbert Amy , Robinson Michelle E , Ridd Matthew J , Mallen Christian , Clarson Lorna , Bostock Jennifer , Becque Taeko , Stuart Beth , Garfield Kirsty , Morrison Leanne , Pollet Sebastien , Vennik Jane , Atherton Helen , Howick Jeremy , Leydon Geraldine M , Nuttall Jacqui , Islam Nazrul , Lee Paul H , Little Paul , Everitt Hazel A
Published: March 2024

Introduction

Effective communication can help optimise healthcare interactions and patient outcomes. However, few interventions have been tested clinically, subjected to cost-effectiveness analysis or are sufficiently brief and well-described for implementation in primary care. This paper presents the protocol for determining the effectiveness and cost-effectiveness of a rigorously developed brief eLearning tool, EMPathicO, among patients with and without musculoskeletal pain.

Methods and analysis

A cluster randomised controlled trial in general practitioner (GP) surgeries in England and Wales serving patients from diverse geographic, socioeconomic and ethnic backgrounds. GP surgeries are randomised (1:1) to receive EMPathicO e-learning immediately, or at trial end. Eligible practitioners (eg, GPs, physiotherapists and nurse practitioners) are involved in managing primary care patients with musculoskeletal pain. Patient recruitment is managed by practice staff and researchers. Target recruitment is 840 adults with and 840 without musculoskeletal pain consulting face-to-face, by telephone or video. Patients complete web-based questionnaires at preconsultation baseline, 1 week and 1, 3 and 6 months later. There are two patient-reported primary outcomes: pain intensity and patient enablement. Cost-effectiveness is considered from the National Health Service and societal perspectives. Secondary and process measures include practitioner patterns of use of EMPathicO, practitioner-reported self-efficacy and intentions, patient-reported symptom severity, quality of life, satisfaction, perceptions of practitioner empathy and optimism, treatment expectancies, anxiety, depression and continuity of care. Purposive subsamples of patients, practitioners and practice staff take part in up to two qualitative, semistructured interviews.

Ethics approval and dissemination

Approved by the South Central Hampshire B Research Ethics Committee on 1 July 2022 and the Health Research Authority and Health and Care Research Wales on 6 July 2022 (REC reference 22/SC/0145; IRAS project ID 312208). Results will be disseminated via peer-reviewed academic publications, conference presentations and patient and practitioner outlets. If successful, EMPathicO could quickly be made available at a low cost to primary care practices across the country.

Trial registration number

ISRCTN18010240.
End-of-life health literacy, knowledge and behaviours towards advance care planning among older adults: cross-sectional evidence from Switzerland
Authors: Meier Clément , Vilpert Sarah , Wieczorek Maud , Borrat-Besson Carmen , Jox Ralf J , Maurer Jürgen
Published: March 2024

Introduction

Population ageing, technological advancements and an increasing emphasis on patient empowerment imply that individuals are increasingly confronted with intricate end-of-life decisions. Personal end-of-life health literacy skills may help empower individuals to participate more actively in their own end-of-life decisions, including engagement in advance care planning (ACP). This study thus investigates the associations between individuals’ end-of-life health literacy and their knowledge and behaviours toward ACP among a population-based sample of adults aged 58+ years in Switzerland.

Methods

We used data from 1319 respondents from Wave 8 (2019/2020) of the Survey on Health, Ageing, and Retirement in Europe. The Subjective End-of-life Health Literacy Scale (S-EOL-HLS) served as the measurement tool. Respondents’ end-of-life knowledge was assessed using test-based questions about 11 end-of-life medical situations. Behaviours toward ACP were measured by whether respondents have discussed their end-of-life wishes, completed advance directives (AD) and appointed a potential surrogate for medical decisions in case of incapacity. Associations were estimated using separate ordinary least square and probit regressions, controlling for social, health and regional characteristics.

Results

Respondents with higher end-of-life health literacy tended to have better end-of-life knowledge and were more likely to have discussed their end-of-life wishes, to have completed AD and to have appointed a surrogate for medical decisions in case of incapacity. On regressing the outcomes on the three end-of-life health literacy dimensions, interactive health literacy positively correlated with end-of-life knowledge and the three behaviours toward ACP, while critical health literacy was only associated with having an AD and appointing a surrogate for medical decisions.

Conclusions

Our findings suggest that end-of-life health literacy may play a significant role in individuals' level of end-of-life knowledge and their behaviour toward ACP. Thus, developing public health policies that aim at strengthening their end-of-life health literacy skills may increase individuals’ engagement in the ACP process and make ACP more effective.
Extracellular vesicles targeting non-parenchymal cells: the therapeutical effect on liver fibrosis
Authors: Liu Yingying , Wang Lin
Published: March 2024

Liver fibrosis is the formation of a fibrous scar due to chronic liver disease including viral hepatitis, alcohol and non-alcoholic fatty liver disease. Without treatment, it will develop into cirrhosis and hepatocellular carcinoma. Up to now, there is no effective way to cure liver fibrosis. Extracellular vesicles (EVs) are biological nanoparticles with potential to be therapeutical agents or delivery tools. A lot of studies have demonstrated the therapeutical effect of EVs on liver fibrosis. In this review, we mainly pay attention to roles of liver non-parenchymal cells in pathology of fibrosis, the basic information about EVs and therapeutical effect on liver fibrosis of EVs when they act on non-parenchymal cells.
Long COVID and financial outcomes: evidence from four longitudinal population surveys
Authors: Rhead Rebecca , Wels Jacques , Moltrecht Bettina , Shaw Richard John , Silverwood Richard , Zhu Jingmin , Hughes Alun , Chaturvedi Nishi , Demou Evangelia , Katikireddi Srinivasa Vittal , Ploubidis George
Published: March 2024

Background

Long-term sequelae of COVID-19 (long COVID) include muscle weakness, fatigue, breathing difficulties and sleep disturbance over weeks or months. Using UK longitudinal data, we assessed the relationship between long COVID and financial disruption.

Methods

We estimated associations between long COVID (derived using self-reported length of COVID-19 symptoms) and measures of financial disruption (subjective financial well-being, new benefit claims, changes in household income) by analysing data from four longitudinal population studies, gathered during the first year of the pandemic. We employed modified Poisson regression in a pooled analysis of the four cohorts adjusting for a range of potential confounders, including pre-pandemic (pre-long COVID) factors.

Results

Among the 20 112 observations across four population surveys, 13% reported having COVID-19 with symptoms that impeded their ability to function normally—10.7% had such symptoms for <4 weeks (acute COVID-19), 1.2% had such symptoms for 4–12 weeks (ongoing symptomatic COVID-19) and 0.6% had such symptoms for >12 weeks (post-COVID-19 syndrome). We found that post-COVID-19 syndrome was associated with worse subjective financial well-being (adjusted relative risk ratios (aRRRs)=1.57, 95% CI=1.25, 1.96) and new benefit claims (aRRR=1.79, CI=1.27, 2.53). Associations were broadly similar across sexes and education levels. These results were not meaningfully altered when scaled to represent the population by age.

Conclusions

Long COVID was associated with financial disruption in the UK. If our findings reflect causal effects, extending employment protection and financial support to people with long COVID may be warranted.
Prospective evaluation of the safety of ultrasound-guided cervical medial branch blocks using the in-plane technique
Authors: Etheridge John-Paul B , Finlayson Roderick J , Venter Jan , De Villiers Frederik , Etheridge Jonathan P , Wakefield Reece , Watanitanon Arraya
Published: March 2024

Background

While fluoroscopic guidance is currently the imaging standard for cervical medial branch blocks (CMBBs), ultrasound guidance (USG) offers several potential safety advantages such as real-time needle visualization and the ability to detect and avoid critical soft tissue vascular or neural structures. However, no large-scale trials have examined the safety of USG for CMBB.

Methods

Five hundred patients undergoing 2308 individual block levels were recruited using a prospective cohort design, and blocks were performed in an outpatient office setting using an in-plane USG technique. Primary outcomes included immediate block-related complication, as well as delayed occurrences, in the following 2 weeks. Vascular structures adjacent to the target area, as well as the occurrence of vascular breach, were recorded.

Results

Three minor immediate complications were noted (two subcutaneous hematomas, one vasovagal reaction) comprising 0.13% of blocks (0.03% to 0.38%; 95% two-sided CI), and no delayed events were recorded (0% to 0.16%; 97.5% one-sided CI). Blood vessels were detected and avoided in 8.2% of blocks, and vascular breach was noted in 0.52% of blocks (0.27% to 0.91%; 95% two-sided CI).

Conclusion

When performed using an in-plane technique by experienced operators, USG CMBB was found to be safe, with rare minor immediate complications and no further adverse event reported in the following 2 weeks.

Trial registration number

NCT04852393.
Human mesenchymal stromal cells inhibitMycobacterium aviumreplication in clinically relevant models of lung infection
Authors: Shaw Timothy D , Krasnodembskaya Anna D , Schroeder Gunnar N , Doherty Declan F , Silva Johnatas Dutra , Tandel Shikha M , Su Yue , Butler David , Ingram Rebecca J , O'Kane Cecilia M
Published: March 2024

Introduction

Novel therapeutic strategies are urgently needed forMycobacterium aviumcomplex pulmonary disease (MAC-PD). Human mesenchymal stromal cells (MSCs) can directly inhibit MAC growth, but their effect on intracellular bacilli is unknown. We investigated the ability of human MSCs to reduce bacterial replication and inflammation in MAC-infected macrophages and in a murine model of MAC-PD.

Methods

Human monocyte-derived macrophages (MDMs) were infected withM. aviumChester strain and treated with human bone marrow-derived MSCs. Intracellular and extracellular colony-forming units (CFUs) were counted at 72 hours. Six-week-old female balb/c mice were infected by nebulisation ofM. aviumChester. Mice were treated with 1×106intravenous human MSCs or saline control at 21 and 28 days post-infection. Lungs, liver and spleen were harvested 42 days post-infection for bacterial counts. Cytokines were quantified by ELISA.

Results

MSCs reduced intracellular bacteria in MDMs over 72 hours (median 35% reduction, p=0.027). MSC treatment increased extracellular concentrations of prostaglandin E2 (PGE2) (median 10.1-fold rise, p=0.002) and reduced tumour necrosis factor-α (median 28% reduction, p=0.025). Blocking MSC PGE2 production by cyclo-oxygenase-2 (COX-2) inhibition with celecoxib abrogated the antimicrobial effect, while this was restored by adding exogenous PGE2. MSC-treated mice had lower pulmonary CFUs (median 18% reduction, p=0.012), but no significant change in spleen or liver CFUs compared with controls.

Conclusion

MSCs can modulate inflammation and reduce intracellularM. aviumgrowth in human macrophages via COX-2/PGE2 signalling and inhibit pulmonary bacterial replication in a murine model of chronic MAC-PD.
Co-inoculation with novel nodule-inhabiting bacteria reduces the benefits of legume–rhizobium symbiosis
Authors: Kosmopoulos James C. , Batstone-Doyle Rebecca T. , Heath Katy D.
Published: March 2024

The ecologically and economically vital symbiosis between nitrogen-fixing rhizobia and leguminous plants is often thought of as a bi-partite interaction, yet studies increasingly show the prevalence of non-rhizobial endophytes (NREs) that occupy nodules alongside rhizobia. Yet, what impact these NREs have on plant or rhizobium fitness remains unclear. Here, we investigated four NRE strains found to naturally co-occupy nodules of the legume Medicago truncatula alongside Sinorhizobium meliloti in native soils. Our objectives were to (1) examine the direct and indirect effects of NREs on M. truncatula and S. meliloti fitness, and (2) determine whether NREs can re-colonize root and nodule tissues upon reinoculation. We identified one NRE strain (522) as a novel Paenibacillus species, another strain (717A) as a novel Bacillus species, and the other two (702A and 733B) as novel Pseudomonas species. Additionally, we found that two NREs (Bacillus 717A and Pseudomonas 733B) reduced the fitness benefits obtained from symbiosis for both partners, while the other two (522, 702A) had little effect. Lastly, we found that NREs were able to co-infect host tissues alongside S. meliloti. This study demonstrates that variation of NREs present in natural populations must be considered to better understand legume–rhizobium dynamics in soil communities.
Observational redshift from general spherically symmetric black holes
Authors: Martínez-Valera Diego A. , Momennia Mehrab , Herrera-Aguilar Alfredo
Published: March 2024

In this work, we obtain an expression for the total observational frequency shift of photons emitted by massive geodesic particles circularly orbiting a black hole in a general spherically symmetric background. Our general relations are presented in terms of the metric components and their derivatives that characterize the black hole parameters. As a concrete example of this general relativistic approach, a special case is studied by applying the formalism to a nonsingular black hole conformally related to the Schwarzchild solution that possesses a length scale parameter l and an integer parameter N in addition to the black hole mass. Besides, we express the nonsingular black hole mass in terms of the observational redshift/blueshift. Finally, we investigate the effects of the free parameters of the conformal gravity theory on the observational frequency shift and compare results with those of the standard Schwarzschild black hole.
A Note of Reliability Analysis of SM-λ in Folded-Crossed Hypercube with Conditional Faults
Authors: Ma Jinjie , Zhang Mingzu , Li Chenxi , Qiao Hengji , Fan Yang
Published: March 2024

The fault tolerance of an interconnection network of parallel and distributed systems can be evaluated by various topological parameters of its underlying graph [Formula: see text], with strong Menger edge connectivity being a vital parameter in this regard. A connected graph [Formula: see text] is called strongly Menger edge connected (SM-[Formula: see text]) if it connects any pair of vertices [Formula: see text] and [Formula: see text] with [Formula: see text] number of edge-disjoint paths. Under the uniform distribution of faults in a large interconnection network, it is improbable that each faulty edge incident to a vertex will occur simultaneously. Thus, [Formula: see text]-strongly Menger edge connected of order [Formula: see text] was introduced in 2018 by He et al. Here, [Formula: see text] is called as [Formula: see text]-strongly Menger edge connected of order [Formula: see text], if [Formula: see text] remains SM-[Formula: see text], where [Formula: see text] is an arbitrary edge set in a graph [Formula: see text] with [Formula: see text] and the minimum degree of the remaining graph [Formula: see text]. The largest [Formula: see text] keeping the property of [Formula: see text] being SM-[Formula: see text] is denoted as [Formula: see text]. Among variants of hypercube, the [Formula: see text]-dimensional folded-crossed hypercube [Formula: see text] attracts attention in recent years. In this paper, we focus on calculating the exact value of the maximum conditional edge-fault-tolerant number of order [Formula: see text] of [Formula: see text], [Formula: see text] for two integers [Formula: see text] and [Formula: see text].
Transient magnetohydrodynamic heat and mass transfer analysis of chemically reacting fluid flow over oscillatory permeable media
Authors: Rath Ashirbad Kumar , Nayak Itishree , Padhi Sukanya
Published: March 2024

This study focuses on the numerical observation of the convective motion of chemically active magnetohydrodynamic (MHD) fluid through a vertically oriented permeable medium, incorporating variations in mass and heat transfer. The fluid type is assumed to be incompressible, chemically strongly ionized and viscous with some mass infusibility. The model associated with this problem is solved by a highly stable Implicit Finite Difference Method (IFDM). The method is used for small and large deflection of the physical parameters, which results in a noticeable fluid flow behavior. Numerical configuration is graphically depicted to scrutinize the fluid behavior. The momentum, energy, concentration diffusion, skin friction, Nusselt number and Sherwood number are investigated for numerous factors such as magnetic field, permeability and chemical reaction rate. The current study unveils significant findings, demonstrating that a heightened rate of chemical reaction in the presence of magnetic effects, coupled with specific porosity, diminishes ionization energy, resulting in a concurrent decrease in the concentration and momentum profiles of the fluid flow. The rise in the viscous diffusion rate is attributed to escalating values of the Schmidt number, causing an augmentation in dynamic viscosity and consequently resulting in an overall reduction in the momentum of the fluid flow.
Bifurcation Regulations Induced by Joint Noise in a Tri-Rhythmic Van Der Pol System
Authors: Yuan Jing , Ning Lijuan , Li Ze
Published: March 2024

Tri-rhythmical nature has attracted extensive attention from scholars in describing the dynamical behaviors of self-sustained systems. In this paper, we consider a tri-rhythmic van der Pol system and give a bifurcation analysis of a stochastic tri-rhythmic self-sustained system under joint noise perturbation. Based on an approximate approach, we give the stationary probability density function of amplitudes, and we find that the noise and time-delay feedback, regulating the velocity time-delay feedback strength parameter, may not cause transitions among unimodal, bimodal and trimodal in the tri-rhythmic system. More stochastic bifurcations appear by regulating the time delay in this system. The system, surprisingly, undergoes five times of stochastic bifurcations when the time delay is monotonically increased. It is shown that the time delay is more sensitive to the tri-rhythmic system and a much stronger dependence on the system. From a biological point of view, the reaction rate of biological molecules can be enhanced or diminished by the change of the noise intensity or correlation time of Gaussian colored noise. More surprisingly, an increase in displacement feedback will delay the reaction rate; however, the effect of an increase in velocity feedback on the reaction rate depends on the time delay. A detailed research on the parameter space indicates that time delay and colored noise parameters can effectively control the multirhythmicity of the system. Finally, this paper verifies the effectiveness of the theoretical solution through the numerical results of Monte Carlo simulation of the original system. These results may help to further explore forking bifurcations in real-world applications. This research provides new insight into the understanding of nontrivial effects of joint noise on the tri-rhythmic system.
Generalized Early Stopping in Evolutionary Direct Policy Search
Authors: Arza Etor , Le Goff Léni K. , Hart Emma
Published: March 2024

Lengthy evaluation times are common in many optimization problems such as direct policy search tasks, especially when they involve conducting evaluations in the physical world, for example, in robotics applications. Often when evaluating solution over a fixed time period, it becomes clear that the objective value will not increase with additional computation time (e.g., when a two-wheeled robot continuously spins on the spot). In such cases, it makes sense to stop the evaluation early to save computation time. However, most approaches to stop the evaluation are problem specific and need to be specifically designed for the task at hand. Therefore, we propose an early stopping method for direct policy search. The proposed method only looks at the objective value at each timestep and requires no problem-specific knowledge. We test the introduced stopping criterion in five direct policy search environments drawn from games, robotics, and classic control domains and show that it can save up to

\(75\%\)

of the computation time. We also compare it with problem-specific stopping criteria and show that it performs comparably, while being more generally applicable.
Path Planning for UAVs under GPS Permanent Faults
Authors: Sulieman M. Hani , Liu Mengyu , Gursoy M. Cenk , Kong Fanxin
Published: March 2024

Unmanned aerial vehicles (UAVs) have various applications in different settings, including for example, surveillance, packet delivery, emergency response, data collection in the Internet of Things (IoT), and connectivity in cellular networks. However, this technology comes with many risks and challenges such as vulnerabilities to malicious cyber-physical attacks. This article studies the problem of path planning for UAVs under GPS sensor permanent faults in a cyber-physical system (CPS) perspective. Based on studying and analyzing the CPS architecture of the UAV, the cyber “attacks and threats” are differentiated from attacks on sensors and communication components. An efficient way to address this problem is to introduce a novel approach for UAV’s path planning resilience to cyber-attack artificial potential field (RCA-APF) algorithm. The proposed algorithm completes the three stages in a coordinated manner. In the first stage, the permanent faults on the GPS sensor of the UAV are detected, and the UAV starts to divert from its initial path planning. In the second stage, we estimated the location of the UAV under GPS permanent fault using received signal strength (RSS) trilateration localization approach. In the final stage of the algorithm, we implemented the path planning of the UAV using an open source UAV simulator. Experimental and simulation results demonstrate the performance of the algorithm and its effectiveness, resulting in efficient path planning for the UAV.
Faster High-accuracy Log-concave Sampling via Algorithmic Warm Starts
Authors: Altschuler Jason M. , Chewi Sinho
Published: March 2024

It is a fundamental problem to understand the complexity of high-accuracy sampling from a strongly log-concave density π on ℝ

d

. Indeed, in practice, high-accuracy samplers such as the Metropolis-adjusted Langevin algorithm (MALA) remain the de facto gold standard; and in theory, via the proximal sampler reduction, it is understood that such samplers are key for sampling even beyond log-concavity (in particular, for sampling under isoperimetric assumptions).

This article improves the dimension dependence of this sampling problem to

\(\widetilde{O}(d^{1/2})\)

. The previous best result for MALA was

\(\widetilde{O}(d)\)

. This closes the long line of work on the complexity of MALA and, moreover, leads to state-of-the-art guarantees for high-accuracy sampling under strong log-concavity and beyond (thanks to the aforementioned reduction).

Our starting point is that the complexity of MALA improves to

\(\widetilde{O}(d^{1/2})\)

, but only under a
warm start
(an initialization with constant Rényi divergence w.r.t. π). Previous algorithms for finding a warm start took
O(d)
time and thus dominated the computational effort of sampling. Our main technical contribution resolves this gap by establishing the first

\(\widetilde{O}(d^{1/2})\)

Rényi mixing rates for the discretized underdamped Langevin diffusion. For this, we develop new differential-privacy-inspired techniques based on Rényi divergences with Orlicz–Wasserstein shifts, which allow us to sidestep longstanding challenges for proving fast convergence of hypocoercive differential equations.
Feature Extraction Matters More: An Effective and Efficient Universal Deepfake Disruptor
Authors: Tang Long , Ye Dengpan , Lu Zhenhao , Zhang Yunming , Chen Chuanxi
Published: March 2024

Face manipulation can modify a victim’s facial attributes (e.g., age or hair color) in an image, which is an important component of deepfakes. Adversarial examples are an emerging approach to combat the threat of visual misinformation to society. To efficiently protect facial images from being forged, designing a universal face anti-manipulation disruptor is essential. However, existing works treat deepfake disruption as an end-to-end process, ignoring the functional difference between feature extraction and image reconstruction. In this work, we propose
FOUND
, a novel
F
eature-
O
utput ensemble
UN
iversal
D
isruptor against face manipulation networks, which explores a new opinion considering attacking feature-extraction (encoding) modules as the critical task in deepfake disruption. We conduct an effective two-stage disruption process. We first perform ensemble disruption on multi-model encoders, maximizing the Wasserstein distance between features before and after the adversarial attack. Then we develop a Gradient-Ensemble strategy to enhance the disruption effect by simplifying the complex optimization problem of disrupting ensemble end-to-end models. Extensive experiments indicate that one FOUND generated with a few facial images can successfully disrupt multiple face manipulation models on cross-attribute and cross-face images, surpassing state-of-the-art universal disruptors in both success rate and efficiency.
The control of the arm’s equilibrium position
Authors: Takagi Atsushi , Burdet Etienne , Koike Yasuharu
Published: March 2024

According to numerous theories, the brain controls posture and movement by activating muscles that attract the limb toward a so-called equilibrium position, but the universality of this mechanism has not been shown for different motor behaviors. Here, we show that even when pushing or pulling against the environment, the brain achieves the desired force through an equilibrium position that lies beyond the physical constraint.
Decision Support System for Single‐Valued Neutrosophic Aczel–Alsina Aggregation Operators Based on Known Weights
Authors: Latif Sajid , Ullah Kifayat , Hussain Abrar , Awsar Amrullah
Published: March 2024

Multiattribute decision making (MADM) approach is a well‐known decision‐making process utilized in a variety of fields such as solid waste management, renewable energy resources, air quality assurance, hotel location decision, sustainable supplier selection, partner recognition, green supplier enterprises, game theory, construction development authority, and weapon group target estimation. The aggregation operators (AOs) are essential components of the decision‐making process and have a great capability to deal with ambiguous and unpredictable information in the different fields of fuzzy environments. In this article, we expressed the theory concepts of single‐valued neutrosophic (SVN) sets (SVNS) and also characterized their basic operations. The power aggregation tools are allowed to input arguments to support each other among different arguments. Recently, Aczel–Alisna aggregation tools conquered great attention from several research scholars. We also exposed some reliable operations of Aczel–Alsina aggregation models under the consideration of SVN information. We established a series of new approaches, including the “single‐valued neutrosophic Aczel–Alsina power weighted average” (SVNAAPWA) operator and “single‐valued neutrosophic Aczel–Alsina power weighted geometric” (SVNAAPWG) operators. To show the effectiveness and compatibility of derived approaches, some prominent characteristics are also established. We constructed a MADM technique to solve an application of engineering and construction materials under consideration of our derived methodologies. An experimental case study is also presented to determine a suitable optimal option from a group of options. To find the flexibility of our proposed work, we provided a comparative study that compares the results of existing AOs with our proposed work. A comprehensive overview is also presented here.
Innovative Virtual Reality (VR) Application for Preventing of Falls among Chinese Older Adults: A Usability and Acceptance Exploratory Study
Authors: Ip Wing Keung , Soar Jeffrey , James Christina , Wang Zoe , Fong Kenneth N. K.
Published: March 2024

Objective. Full immersive virtual reality (VR) technology shows potential for reducing the risks of falls in older adults. There is yet little evidence to support the usability and acceptance on using VR technology application in community aged care service. The study reports on research that aims to address that gap by evaluating the usefulness and acceptance of using an innovative VR application among Chinese older adults from Hong Kong. Methods. A single-arm exploratory study was conducted to evaluate how the participants experienced the use of a fully immersive cave automatic virtual environment (CAVE) VR program on fall prevention. Thirty-one participants were recruited by convenience sampling based on their fall concerns and potential risk of falls. The participants completed 16 training sessions over eight weeks using the VR CAVE application. They were asked to complete a VR usability questionnaire (HK-version) based on the Technology Acceptance Model and previous research, and they took fall risk assessments at the pretest, posttest, and follow-up. Results. The participants’ group significantly showed improvements in reducing the risk factors of falls including balance, functional mobility, walking speed, and fear of falling after VR intervention. Perceived usefulness (PU), perceived enjoyment (PE), user experience (UE), and intention to use (IU) had an overall significant change at different time points. These are important factors to influence the participants’ acceptance of the use of VR technology applications. Perceived ease of use (PEOU) and social norms (SNs) had an inconsistent result, and some items had low validity. The findings indicated a positive training effect on fall prevention and high acceptance of the adoption of the VR technology application. Conclusion. This study supports the growing evidence on the usefulness and acceptance of using full immersive VR training on fall prevention among Chinese older adults. They perceived that the VR CAVE application was useful and innovative as an effective fall prevention training. Technically, the application of VR CAVE technology faces many challenges and is not easily manageable under COVID-19 restrictions and the limitation on technological adaptation for older adults. However, investment in full immersive VR technology application is supported for future adoption in aged care and rehabilitation services.
Insulin Secretion Defect in Children and Adolescents with Obesity: Clinical and Molecular Genetic Characterization
Authors: Enders-Seidlitz Helena , Raile Klemens , Gong Maolian , Galler Angela , Kuehnen Peter , Wiegand Susanna
Published: March 2024

Introduction. Childhood obesity is increasing worldwide and presents as a global health issue due to multiple metabolic comorbidities. About 1% of adolescents with obesity develop type 2 diabetes (T2D); however, little is known about the genetic and pathophysiological background at young age. The objective of this study was to assess the prevalence of impaired glucose regulation (IGR) in a large cohort of children and adolescents with obesity and to characterize insulin sensitivity and insulin secretion. We also wanted to investigate adolescents with insulin secretion disorder more closely and analyze possible candidate genes of diabetes in a subcohort. Methods. We included children and adolescents with obesity who completed an oral glucose tolerance test (OGTT, glucose + insulin) in the outpatient clinic. We calculated Matsuda index, the area under the curve (AUC (Ins/Glu)), and an oral disposition index (ISSI‐2) to estimate insulin resistance and beta‐cell function. We identified patients with IGR and low insulin secretion (maximum insulin during OGTT < 200 mU/l) and tested a subgroup using next generation sequencing to identify possible mutations in 103 candidate genes. Results. The total group consisted of 903 children and adolescents with obesity. 4.5% showed impaired fasting glucose, 9.4% impaired glucose tolerance, and 1.2% T2D. Matsuda index and Total AUC (Ins/Glu) showed a hyperbolic relationship. Out of 39 patients with low insulin secretion, we performed genetic testing on 12 patients. We found five monogenetic defects (ABCC8 (n = 3), GCK (n = 1), and GLI2/PTF1A (n = 1)). Conclusion. Using surrogate parameters of beta‐cell function and insulin resistance can help identify patients with insulin secretion disorder. A prevalence of 40% mutations of known diabetes genes in the subgroup with low insulin secretion suggests that at least 1.7% of patients with adolescent obesity have monogenic diabetes. A successful molecular genetic diagnosis can help to improve individual therapy.
Knowledge, Attitude, and Prevention Practices towards Common Zoonotic Diseases in and around Bahir Dar City, North Western Ethiopia
Authors: Alemayehu Kassa Demelash , Mitiku Birhan Agmas , Alemu Yeshwas Ferede , Nibret Tsegaye Birtualem
Published: March 2024

The problem of zoonoses diseases is a global public and veterinary health concern. Globally coordinated and well‐established research efforts are essential to successfully fighting and reducing the health burden of zoonoses. In our study area, the interplay of intense livestock animals, agricultural activities, and poor health services characterized the high risks of zoonotic diseases. Thus, people suffer from easily preventable diseases with hygiene and good‐quality food. The main objectives of this study were to: (i) evaluate the knowledge, attitude, and prevention practices of people handling farm animals and their products toward common zoonotic diseases; and (ii) estimate the associated risk factors influencing their knowledge, attitude, and prevention practices. A questionnaire‐based cross‐sectional study was conducted from December 2021 to August 2022. A simple random sampling technique was followed to select respondents. Multivariable logistic regression model analysis was conducted using STATA version 14. The overall level of knowledge, attitude, and prevention practice for the major zoonotic disease was 52.5%, 68.6%, and 39.4%, respectively. Rabies, tuberculosis, taeniasis, anthrax, and brucellosis were the major zoonotic diseases selected by respondents in the study areas. The age of respondents, training status, educational status, and farm location were significantly (P  < 0.05) associated with the level of knowledge and prevention practice against zoonotic diseases. This study revealed that the level of knowledge, attitude, and prevention practices for major zoonotic diseases in Bahir Dar City were relatively poor. Therefore, a concerted effort among various government and nongovernment stakeholders, including veterinarians, public health officials, and environmental experts, is needed to create and raise awareness among livestock producers about the transmission and control methods and the economic and public health importance of zoonotic diseases.
Investigation of the Combined Effects of Ultrasonic Vibration‐Assisted Machining and Minimum Quantity Lubrication on Al7075‐T6
Authors: Namlu Ramazan Hakkı , Çetin Barış , Lotfi Bahram , Kılıç S. Engin
Published: March 2024

The aluminum alloy Al7075‐T6 finds extensive application in the aviation and automotive industries, where machining plays a pivotal role. Emerging techniques such as Ultrasonic Vibration‐Assisted Machining (UVAM) and Minimum Quantity Lubrication (MQL) hold promise for enhancing machining efficiency. In this study, the combined use of UVAM and MQL for slot milling of Al7075‐T6 was investigated. The results demonstrate that UVAM reduced cutting forces by an average of 10.87% in MQL and 8.31% in Conventional Cutting Fluid (CCF) conditions when compared to Conventional Machining (CM). In addition, UVAM yielded significantly improved surface finishes, characterized by an average reduction in surface roughness of 41.86% in MQL and 32.11% in CCF conditions relative to CM. Furthermore, surfaces subjected to UVAM exhibited fewer instances of burn marks and tool‐induced markings, reduced chip splashing, and more uniform surface integrity compared to those manufactured with CM. Lastly, chips generated through UVAM exhibited distinct characteristics, notably shorter length, curvier shape, and a distinctive half‐turn morphology when compared with the irregular chips produced through CM. In conclusion, our findings underscore the potential of UVAM in synergy with MQL to augment the machining of Al7075‐T6 alloy, thereby yielding superior‐quality machined components with enhanced operational efficiency.
Trends in Gastric Cancer Mortality in Montenegro, 1990–2018: Joinpoint Regression
Authors: Nedović Vuković Mirjana , Jakšić Marina , Smolović Brigita , Lukić Miloš , Bukumirić Zoran
Published: March 2024

Introduction: Gastric cancer (GC) remains a significant global public health problem, despite the decreasing trends in GC mortality rates in the last 5 decades. Our study aimed to examine the pattern of GC mortality in Montenegro between 1990 and 2018 and to contribute to the future by designing a national long-term strategy for the control and prevention of GC. Methods: Gastric cancer mortality data in Montenegro from 1990 to 2018 were collected. Mortality rates were age-standardized to the World Standard Population for estimating both the overall and gender-specific trends. The joinpoint regression model was used to assess GC mortality and identified significant changes in the linear time trend. Linear and Poisson regressions were also applied for additional trend analyses. Results: Joinpoint regression reveals a statistically significant decrease in the age-standardized rate for the overall level, on average by 1.4% per year (AAPC [95% IP] = −1.4 [−2.4 to −0.4]; p = 0.007), which was due to a decrease in the age-standardized rate in men with an average annual change of −1.8% (AAPC [95% IP] = −1.8 [−2.9 to −0.6]; p = 0.003), while in women the rates were stable (p = 0.565). The results for age groups indicate that a decline was registered at the overall level, and among men, as a consequence of the trend of decreasing age-specific rates for the age group 55–64 on average annually by 2% among men (AAPC [95% IP] = −2 [−3.8 to −0.1]; p = 0.035), and for the overall level (AAPC [95% IP] = −2 [−3.7 to −0.3]; p = 0.026). Conclusion: Our findings indicate a noteworthy decline in age-standardized overall GC mortality rates among men in Montenegro, while rates for women have remained constant. National strategies to further reduce mortality rates for GC are necessary.
Clinical Presentation and Outcome of Critically Ill Patients with Inflammatory Bowel Disease
Authors: Böttcher Marius , Bertram Franziska , Sabihi Morsal , Lücke Jöran , Ahmadi Payman , Kluge Stefan , Roedl Kevin , Huber Samuel , Wichmann Dominic , Manthey Carolin F.
Published: March 2024

Introduction: Admission to the intensive care unit severely affects inflammatory bowel disease (IBD) patients. This study aimed to determine factors associated with mortality in IBD patients admitted to the intensive care unit. Methods: A retrospective cohort study was performed, analyzing data of all IBD patients admitted to the Department of Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf between 2013 and 2022. Bivariate comparisons and multivariate regression analyses were performed to identify factors associated with mortality. Results: Overall, 439 IBD patients were admitted to the intensive care unit, representing 0.56% of total admissions. In 98 of these patients, IBD-associated complications were accountable for admission (22.3%). In detail, 39 (40.8%) patients were admitted after IBD-related surgery, 36 (35.7%) due to infections, and 23 (23.5%) due to medical conditions such as bleeding or electrolyte derangement. A total of 16 (16.3%) of these patients died within 90 days after admission. Parameters associated with increased mortality were age (p < 0.001), later age at diagnosis (p 0.026), catecholamine therapy (p 0.003), mechanical ventilation (p < 0.001), renal replacement therapy (p < 0.001), and parenteral nutrition (p 0.002). Prior treatment with anti-TNF therapy was associated with a higher chance of survival (p 0.018). There was no association between prior immunosuppressant therapy and admission because of infections (p 0.294). Conclusions: 16.3% of IBD patients admitted to the intensive care unit died within 90 days after admission. Prior treatment with anti-TNF therapy was associated with a higher chance of survival.