bluuebunny/crossref_metadata_2025 huggingface dataset:
Myxotrichum persicum sp. nov., and two new combinations in the genus Myxotrichum
Authors: MEHRABI MEHDI , ASGARI BITA , ZARE RASOUL
Published: May 2024

We describe Myxotrichum persicum sp. nov. as a seed endophyte of Aegilops triuncialis in Lorestan province of Iran, using morphological traits and sequences of the internal transcribed spacer regions 1 and 2 including the intervening 5.8S nuclear ribosomal DNA (ITS) and partial nuclear 28S ribosomal DNA (LSU) regions. Myxotrichum persicum is differentiated from its closest relative, M. deflexum, by possessing smaller ascomata bearing much shorter, usually unbranched appendages, and smaller, ellipsoidal to fusiform, smooth-walled ascospores. Based on morphology and the multilocus phylogeny of ITS, LSU, MCM7 and RPB1, we herein propose to combine two species of Malbranchea, namely M. circinata and M. flavorosea, into the genus Myxotrichum as Myxotrichum circinatum and M. flavoroseum, respectively.
Enhanced Mid-to-Late Summer Precipitation over Midlatitude East Asia under Global Warming
Authors: Wang Chuan-Yang , Zheng Xiao-Tong , Song Fengfei
Published: May 2024

East Asian summer monsoon precipitation is projected to increase under greenhouse warming with strong intraseasonal variation. Using a 35-member CESM Large Ensemble and 30 CMIP6 models, this study reveals that in July and August, maximum rainfall changes in East Asia take place in the midlatitudes, influencing regions encompassing North and Northeast China, the Korean Peninsula, and Japan. The intensified precipitation is attributed to the combined effect of the thermodynamic and dynamic components. The former stems from the enriched low-level moisture, which peaks in continental East Asia in July and August, under global warming. The dynamic effect is due to the enhanced upward motion, associated with the enhanced southerlies throughout the troposphere over midlatitude East Asia. The southerlies also act to intensify the low-level monsoonal circulation, strengthening moisture transport from the tropical ocean to the midlatitudes. In addition to the mean-state changes, the precipitation interannual variability in this region also intensifies, partly due to the enhanced low-level moisture and partly associated with enhanced large-scale circulation anomalies, such as the northwestern Pacific anticyclone. The enhanced background precipitation, along with the intensified interannual variability, may lead to more rainy summers in a warmer climate, with instances where historically extreme precipitation events become more frequent, posing challenges for water resource management and agriculture in the region.
Compound Flooding Potential from the Joint Occurrence of Precipitation and Storm Surge in the Qiantang Estuary, China
Authors: Wu Yanjuan , Haigh Ivan D. , Gao Chao , Jenkins Luke J. , Green Joshua , Jane Robert , Xu Yu , Hu Hengzhi , Wu Naicheng
Published: May 2024

In coastal regions, compound flooding, driven by multiple flood hazard sources, can cause greater damage than when the flood drivers occur in isolation. This study focuses on compound flooding from extreme precipitation and storm surge in China’s Qiantang Estuary. We quantify the potential of compound flooding by measuring bivariate joint statistical dependence and joint return period (JRP). We find a significant positive dependence between the two flood drivers considered, as indicated by Kendall’s rank correlation coefficients. Compound events occur frequently, with an average of 2.65 events per year from 1979 to 2018, highlighting the significant concern of compound flooding for this estuary. Using a copula model, we demonstrate that considering the dependence between the two flood drivers shortens the JRP of compound flooding compared to the JRP assuming total independence. For a 1-in-10-yr precipitation event and 1-in-10-yr storm surge event, the JRP is 1 in 100 years when assuming total independence. However, it decreases to 1 in 32.44 years when considering their dependence. Ignoring the dependence between flood drivers can lead to an increase in the JRP of compound events, resulting in an underestimation of the overall flood risk. Our analysis reveals a strong link between the weather patterns creating compound events and extreme storm surge only events with tropical cyclone activity. Additionally, the extreme precipitation only events were found to be connected with the frontal system of the East Asian summer monsoon. This study highlights the importance of considering the dependence between multiple flood drivers associated with certain types of the same weather systems when assessing the flood risk in coastal regions.
Structure and Maintenance of a Quasi-Linear Mesoscale Convective System That Caused Torrential Rain in Southern Kyushu, Japan, on 11 July 2021
Authors: Mashiko Wataru
Published: May 2024

A quasi-linear mesoscale convective system that remained nearly stationary (hereafter referred to as a stationary QLCS) for almost 8 h in southern Kyushu, Japan, caused torrential rainfall exceeding 350 mm on 11 July 2021. The stationary QLCS consisted of several rainbands organized by back-building convection. As the cold pool intensified, the system attained a more widespread structure, leaning on the upshear side. To elucidate the mechanism responsible for the upshear tilt, numerical simulations with 250-m horizontal grid spacing were conducted, including sensitivity experiments in which the evaporative cooling rates from rain were reduced to modify the cold pool intensity. Results show that the cold pool is critical to the organization of the QLCS, and the structure normal to it is mainly governed by the balance between the low-level shear magnitude and cold pool intensity, supporting the application of so-called Rotunno–Klemp–Weisman (RKW) theory to this event. The cause of the weak updraft that accompanies the leaning system over the strong cold pool was also investigated, analyzing the trajectories, vertical momentum equation, and pressure perturbation field using the anelastic equation. It is revealed that the updraft travels a longer distance through the tilted system experiencing more mixing with the ambient air, which results in less thermal buoyancy. In addition, the updraft is decelerated by the downward perturbation gradient force owing to the vertical buoyancy gradient around the sloping surface of the cold pool and the dynamical effect caused by the baroclinicity-associated strong horizontal vorticity around the cold pool leading edge.
Influential and Worthy: A Video-centric Exploration of Travel Influencers’ Value Chain Logic
Authors: Guo Siqi , Deng Ning , He Zeya
Published: May 2024

Influencer marketing has ushered in a new mode of electronic commerce, necessitating research to explore this emerging business logic. This study, grounded in communication and persuasion theory, develops a theoretical framework of travel influencers’ value chain logic. It elucidates how these influencers’ communication strategies drive their audience members’ online engagement and influencers’ business value on short video platforms. A multi-method design and video-centric approach revealed three dimensions of influencers’ communication strategies—physical attractiveness, content richness, and social activity—that significantly shaped audience members’ online engagement with the content. Such engagement in turn had a positive impact on influencers’ business value. These findings help to clarify value chain logic in influencer marketing and carry managerial implications for influencers and travel brands.
Data-based modeling of cerebral hemodynamics quantifies impairment of cerebral blood flow regulation in type-2 diabetes
Authors: Marmarelis Vasilis Z , Shin Dae C , Kang Yue , Novak Vera
Published: May 2024

We studied the regulation dynamics of cerebral blood velocity (CBv) at middle cerebral arteries (MCA) in response to spontaneous changes of arterial blood pressure (ABP), termed dynamic cerebral autoregulation (dCA), and end-tidal CO2 as proxy for blood CO2 tension, termed dynamic vasomotor reactivity (DVR), by analyzing time-series data collected at supine rest from 36 patients with Type-2 Diabetes Mellitus (T2DM) and 22 age/sex-matched non-diabetic controls without arterial hypertension. Our analysis employed a robust dynamic modeling methodology that utilizes Principal Dynamic Modes (PDM) to estimate subject-specific dynamic transformations of spontaneous changes in ABP and end-tidal CO2 (viewed as two “inputs”) into changes of CBv at MCA measured via Transcranial Doppler ultrasound (viewed as the “output”). The quantitative results of PDM analysis indicate significant alterations in T2DM of both DVR and dCA in terms of two specific PDM contributions that rise to significance (p < 0.05). Our results further suggest that the observed DVR and dCA alterations may be due to reduction of cholinergic activity (based on previously published results from cholinergic blockade data) that may disturb the sympatho-vagal balance in T2DM. Combination of these two model-based “physio-markers” differentiated T2DM patients from controls (p = 0.0007), indicating diabetes-related alteration of cerebrovascular regulation, with possible diagnostic implications.
Opening up openings: Zooming in on improvisation in the Theater of Home
Authors: Burke Robert L , Sappho Maria , Birrell Ross , MacDonald Raymond , DeNora Tia
Published: May 2024

This article presents a qualitative analysis of the opening section of an online improvisation session. The session, which was organized by the Glasgow Improvisers Orchestra, included an international group of musicians. It took place during the global COVID-19 pandemic where the participants were experiencing lockdown conditions. Phenomenological reflexive analysis and video elicitation techniques were utilized to develop a number of key themes related to the multimodal improvisation strategies identified as emergent in the session. The results highlight how technical, physical, and psychological constraints of online practice can facilitate new creative insights and approaches to improvisation. Particular emphasis is placed upon how an improvisation begins and the role of distributed and collaborative creativity within the overall process. The importance of the domestic environment, what we term The Theater of Home, is central to these new ideas, as is how particular scenarios/items function as psychological and creative boundary objects. The spontaneous multimodal integration of text, visual, and audio material within the domestic and virtual environment can be seen to support a new type of creative collaboration and one that draws out features of social improvisation.
Value of the HOTAIR expression assay in predicting therapy target in hepatocellular carcinoma: A meta-analysis and bioinformatics analysis
Authors: Wen Ping , Qi Xiyu , Zheng Ruzhen
Published: May 2024

Background

Several studies show that the long non-coding RNA HOX transcript antisense RNA (HOTAIR) was upregulated in human cancer, which was associated with several clinical features and may have the potential to be prognostic markers. However, the significance of HOTAIR in hepatocellular carcinoma remains unclear. We performed a meta-analysis and bioanalysis to further investigate the association between HOTAIR and hepatocellular carcinoma.

Methods

Eligible literature was systematically retrieved from PubMed, Embase, and Web of Science databases. The pooled hazard ratios with 95% confidence intervals were used to evaluate to the effect. Raw data on HOTAIR expression were obtained from The Cancer Genome Atlas data portals. All bioinformatics analyses were performed using R software (version 4.3.1).

Results

We identified eight studies in this meta-analysis with a total of 399 patients. High-level HOTAIR expression was found to be significantly related to advanced tumor node metastasis stage, distant metastasis, poor tumor differentiation, and patients with hepatitis. Correspondingly, HOTAIR was also associated with poor overall survival and relapse-free survival. Subsequently, in bioanalysis, HOTAIR expression was higher in hepatocellular carcinoma as well as poor overall survival. High HOTAIR expression was strongly correlated with tumor node metastasis stage. Kyoto Encyclopedia of Genes and Genomes analysis revealed that the differentially expressed genes related to HOTAIR may be involved in the cancer-associated signaling pathway.

Conclusion

HOTAIR may be a potential biomarker for HCC prediction and is expected to become a new choice for clinical HCC prediction..
The Role of the Tissue Perfusion Index in Predicting Disease Severity and Prognosis in Patients with Severe and Critical COVID-19
Authors: Lin Wan-Ting , Zhang Yan-Jie , Yan Ming-Kun , Cai Xiao-Tian , Cai Xin-Er , Xu Jingyuan
Published: May 2024

Objectives

The study investigated whether percutaneous partial pressure of oxygen (PtcO2), percutaneous partial pressure of carbon dioxide (PtcCO2), and the derived tissue perfusion index (TPI) can predict the severity and short-term outcomes of severe and critical COVID-19.

Design

Prospective observational study conducted from January 1, 2023 to February 10, 2023.

Setting

A teaching hospital specializing in tertiary care in Nanjing City, Jiangsu Province, China.

Participants

Adults (≥18 years) with severe and critical COVID-19.

Interventions

Not applicable.

Main outcome measures

The general information and vital signs of the patients were collected. The PtcO2 and PtcCO2 were monitored in the left dorsal volar. The ratio of TPI was defined as the ratio of PtcO2/fraction of inspired oxygen (FiO2) to PtcCO2. Mortality at 28 was recorded. The ability of the TPI to assess disease severity and predict prognosis was determined.

Endpoint

Severity of the disease on the enrollment and mortality at 28.

Results

A total of 71 patients with severe and critical COVID-19, including 40 severe and 31 critical cases, according to the COVID-19 treatment guidelines published by WHO, were recruited. Their median age was 70 years, with 56 (79%) males. The median SpO2/FiO2, PtcO2, PtcCO2, PtcO2/ FiO2, and TPI values were 237, 61, 42, 143, and 3.6 mm Hg, respectively. Compared with those for severe COVID-19, the TPI, PtcO2/ FiO2, SpO2/FiO2, and PtcO2 were significantly lower in critical COVID-19, while the PtcCO2 was significantly higher. After 28 days, 26 (37%) patients had died. TPI values < 3.5 were correlated with more severe disease status (AUC 0.914; 95% CI: 0.847-0.981, P < 0.001), and TPI < 3.3 was associated with poor outcomes (AUC 0.937; 95% CI 0.880-0.994, P < 0.001).

Conclusions

The tissue perfusion index (TPI), PtcCO2, and PtcO2/ FiO2 can predict the severity and outcome of severe and critical COVID-19.
Troops are Business Schools: Military Service and Entrepreneurial Behaviors in China
Authors: Zhao Chunkai , Xu Guangyi , Cai Wenjun
Published: May 2024

Although research has examined the benefits of military service and the impact of military executives on business operations, the relationship between military service and entrepreneurial behavior remains poorly understood. Using the instrumental variable approach and a nationally representative male sample from the China Labor-forces Dynamic Survey, we discovered that military service significantly increased the probability of entrepreneurship in China, even after a series of robustness checks. Mechanism tests indicated that this positive effect could be explained by human and political capital accumulation, military-related social capital formation, and risk appetite traits. Our supplemental analyses demonstrated that exogenous shocks from the special military-in-business policy strengthened the positive entrepreneurial effect, whereas the higher education expansion policy and China’s accession to the World Trade Organization weakened this effect. Additionally, military entrepreneurs had better business performance and more resilient, persistent, and confident traits. We found no evidence that Chinese veterans were forced to become entrepreneurs. This study enriches research on the styles and traits of military entrepreneurs and managers and provides important insights for assessing and improving veteran welfare policies in China and other developing countries.
Psychiatric Mental Health Nurses’ Perceptions and Experiences of Inpatient Mental Health Care Safety Culture in Saudi Arabia
Authors: Alyousef Seham Mansour , Alhamidi Sami Abdulrahman
Published: May 2024

Background:

Although patient safety culture is gaining attention globally, more studies are needed to investigate its relevance to the nursing care of mental health (MH) patients.

Aims:

This study aimed to illustrate the perceptions and experiences of nurses who work in inpatient mental health care (IMHC) concerning the patient safety practices that are employed to avert safety hazards encountered during the provision of care in IMHC settings.

Methods:

Eighteen postgraduate students working as MH nurses in nonprofit hospitals comprised the study sample. The participants had a minimum of 2 years’ nursing experience in IMHC settings. Each participant was interviewed individually using a guided interview technique. The inductive data underwent thematic analysis.

Results:

Patient protection and a safety perspective were the overarching themes that emerged from the data. Three principal themes and 9 subthemes were illuminated: (a) patient care safety knowledge and background, (b) improving MH care, and (c) development of MH nursing care.

Conclusions:

The findings of this investigation may assist in providing guidance for the further research into and development of a patient safety culture appropriate for IMHC nursing practice, including increased structured educational experiences, judicious risk assessment, assignment of staff to include a mixture of skills and experience levels during assignments, use of standardized handoff procedures, engagement with multidisciplinary care providers, blame-free reflective information sharing and mentoring, and attention to the built environment with consideration of patient and staff safety needs.
Human Pose Estimation for Clinical Analysis of Gait Pathologies
Authors: Ali Manal Mostafa , Medhat Hassan Maha , Zaki M
Published: May 2024

Gait analysis serves as a critical diagnostic tool for identifying neurologic and musculoskeletal damage. Traditional manual analysis of motion data, however, is labor-intensive and heavily reliant on the expertise and judgment of the therapist. This study introduces a binary classification method for the quantitative assessment of gait impairments, specifically focusing on Duchenne muscular dystrophy (DMD), a prevalent and fatal neuromuscular genetic disorder. The research compares spatiotemporal and sagittal kinematic gait features derived from 2D and 3D human pose estimation trajectories against concurrently recorded 3D motion capture (MoCap) data from healthy children. The proposed model leverages a novel benchmark dataset, collected from YouTube and publicly available datasets of their typically developed peers, to extract time-distance variables (e.g. speed, step length, stride time, and cadence) and sagittal joint angles of the lower extremity (e.g. hip, knee, and knee flexion angles). Machine learning and deep learning techniques are employed to discern patterns that can identify children exhibiting DMD gait disturbances. While the current model is capable of distinguishing between healthy subjects and those with DMD, it does not specifically differentiate between DMD patients and patients with other gait impairments. Experimental results validate the efficacy of our cost-effective method, which relies on recorded RGB video, in detecting gait abnormalities, achieving a prediction accuracy of 96.2% for Support Vector Machine (SVM) and 97% for the deep network.
Environmental Predictors of Undernutrition Among Under-5 Children at Dabat District Health Facilities, Northwest Ethiopia, 2023
Authors: Melese Mihret , Esubalew Dereje , Malede Asmamaw , Birhan Tsegaye Adane , Azanaw Jember
Published: May 2024

Background:

In Ethiopia, undernutrition remains a significant public health concern throughout the year due to persistent household food insecurit. The intensifying conflict in the Dabat district, involving the Ethiopian government and the Tigray Liberation Front, has increased the threat of undernutrition among under-5 children. The cessation of humanitarian aid has worsened food insecurity, increasing the vulnerability of the children in the region. However,there was no data showing the prevalence and environmental pridictors of undernutrition in the Dabat district, northwestern Ethiopia. Therefore, the objective of this study was to determine the prevalence of undernutrition and identify environmental pridictors in this study setting.

Methods:

This institutional-based cross-sectional study was conducted from January to March 2023. A total of 400 under-5 children were included in this study using systematic random sampling techniques with a 100% response rate. The study included all under-5 children who visited healthcare facilities during the data collection period. However, it excluded children under-5 who had physical deformities, were critically ill, or had congenital abnormalities or known chronic diseases such as HIV/AIDS, tuberculosis, or chronic heart diseases. Binary logistic regression was used to determine environmental predictors of undernutrition, with statistical significance at a P-value of ⩽.05.

Results:

The overall prevalence of undernutrition was found to be 12% (95% CI: 8.72-21.5). Among those affected, 32.8% (95% CI: 21.5-39.8) were stunted, 37.9% (95% CI: 28.8-47.50) were underweight, and 29.3% (95% CI: 21.3-29.7) were wasted. The environmental predictors of undernutrition were latrine use, recent diarrhea episodes, mothers’ occupation and place of residence, water treatment before consumption, water sources and storage, water extraction methods, and mothers’ handwashing habits.

Conclusions and recommendations:

The study found a higher prevalence of undernutrition among under-5 children compared to the 2019 Ethiopia Mini Demographic and Health Survey. This study recommended raising awareness about establishing private toilets, promoting water treatment, proper latrine use, and handwashing practices. Training on personal hygiene and economic support for households should also be provided. Healthcare providers should offer quality health services for under-5 children. Further research is needed to explore specific nutrient deficiencies using laboratory methods.
Student Persistence Through a Different Lens
Authors: Tinto Vincent
Published: May 2024

Unlike many earlier models of student persistence that viewed the process of student persistence through the lens of the institution, the model proposed here looks at persistence through the eyes of students. It draws on the research on student motivation, student perceptions, and the impact of student networks on student engagement to propose a model of student persistence that stresses the importance of student perceptions of their engagement with others on campus and the meanings their draw from their engagements to their decisions to stay or leave. In doing so, it argues that to further promote student persistence, institutions should ask how their actions can influence student perceptions and in turn their motivation to learn and persist.
Rapid Access From Primary Care to a Multidisciplinary Clinic at Tertiary Care Improves Clinical Outcomes for Patients With Diabetic Foot Ulcers: Results From Diabetic Foot in Primary and Tertiary (DEFINITE) Care's Lower Extremity Amputation Prevention Program (LEAPP) Clinic
Authors: Lin Jaime H X , Ge Lixia , Liew Huiling , Tan Elaine , Hoe Jeremy , Yong Enming , Loh Zhiwen , Chew Tiffany , Farhan Mohd F M , Li Zhang , Tan Donna , Loh Yi Bing , Zhu Julia , Ang Pauline , Shi Claris , Seng Chan Dexter Yak , Law Chelsea , Raman Nadiah , Molina Joseph , Ang Gary , Koo Hui Yan , Low Kai Qiang , Choo Julia , Tan Cin Yee , Lim Jo Ann , Siow James , Chan Shaun WY , Chandraskear Sadhana , Chew Daniel , Lo Zhiwen Joseph
Published: May 2024

Diabetic Foot in Primary and Tertiary (DEFINITE) Care is an inter-institutional, multidisciplinary team (MDT) program for patients with diabetic foot ulcers (DFU) within a healthcare cluster in Singapore. This is one of our subgroup analyses within DEFINITE Care, assessing clinical outcomes of lower extremity amputation prevention program (LEAPP), a multidisciplinary diabetic foot clinic, and non-LEAPP patients within the program. From June 2020 to June 2022, 2798 patients within the DEFINITE cohort completed a minimum of 12-month follow up. Of these patients, 20.6% were managed by LEAPP, whereas 79.4% were non-LEAPP patients. Patients in the LEAPP cohort were older with co-existing metabolic conditions and complications of diabetes. Using non-LEAPP cohort as the reference group and after adjusting for age, gender, ethnicity, comorbidities, and medications, there was a significantly lower risk of death (odds ratio [OR] 0.60, P = .001) and composite major lower extremity amputation (LEA) or death (OR 0.66, P = .002) among LEAPP patients at 1 year with longer mean days from enrollment to minor LEA, major LEA, and death. The adjusted 1-year healthcare utilization outcomes for LEAPP patients demonstrated an increase in inpatient admissions, primary care polyclinic visits, hospital specialist outpatient clinic (SOC) visits and elective day surgery procedures. Despite the increased in inpatients admissions, cumulative hospital length of stay in LEAPP patients were lower. This subgroup analysis has demonstrated that the MDT approach to caring for patients with DFU in tertiary centers not only improves mortality by 40%, but also delayed the incidence of minor LEA, major LEA, and death.
A Drop of Epistemic Humility
Authors: Ghaziani Amin
Published: May 2024

Amin Ghaziani interviews Charles Fain Lehman, a fellow at the Manhattan Institute and contributing editor of City Journal, about the value-add of conservative viewpoints in public debate.
The New Final Girl Shares Her Trauma
Authors: green kyle , berry kelsey
Published: May 2024

Kyle Green and Kelsey Berry on the real fears behind scary movies.
Information needs of caregivers of adults with intellectual and/or developmental disabilities in India
Authors: Murthy Sumithra , Parker Harris Sarah , Hsieh Kelly
Published: May 2024

Many families of adults with intellectual and/or developmental disabilities in India experience difficulty in accessing services/supports, due to lack of awareness/knowledge of disability rights/laws and available services, and in accessing the services. There remains insufficient research on the information needs of these caregivers and on designing interventions that aim to increase their awareness/knowledge about human rights and supports/services. A strengths-based mixed methods needs assessment was conducted to understand the information needs of these family caregivers. Results showed that caregivers ≥50 years had significantly higher information needs than younger caregivers. Specifically, caregivers with no proficiency in English needed more information on the available services for the care recipients (n = 100). Qualitative results showed that very few caregivers had any awareness or access to information on human rights, disability-related laws/policies or available supports/services (n = 15). Study findings underscore the government’s role in improving awareness-raising initiatives and imparting the information in multiple Indian languages.
Malignancy pattern analysis of breast ultrasound images using clinical features and a graph convolutional network
Authors: Montaha Sidratul , Azam Sami , Bhuiyan Md. Rahad Islam , Chowa Sadia Sultana , Mukta Md. Saddam Hossain , Jonkman Mirjam
Published: May 2024

Objective

Early diagnosis of breast cancer can lead to effective treatment, possibly increase long-term survival rates, and improve quality of life. The objective of this study is to present an automated analysis and classification system for breast cancer using clinical markers such as tumor shape, orientation, margin, and surrounding tissue. The novelty and uniqueness of the study lie in the approach of considering medical features based on the diagnosis of radiologists.

Methods

Using clinical markers, a graph is generated where each feature is represented by a node, and the connection between them is represented by an edge which is derived through Pearson's correlation method. A graph convolutional network (GCN) model is proposed to classify breast tumors into benign and malignant, using the graph data. Several statistical tests are performed to assess the importance of the proposed features. The performance of the proposed GCN model is improved by experimenting with different layer configurations and hyper-parameter settings.

Results

Results show that the proposed model has a 98.73% test accuracy. The performance of the model is compared with a graph attention network, a one-dimensional convolutional neural network, and five transfer learning models, ten machine learning models, and three ensemble learning models. The performance of the model was further assessed with three supplementary breast cancer ultrasound image datasets, where the accuracies are 91.03%, 94.37%, and 89.62% for Dataset A, Dataset B, and Dataset C (combining Dataset A and Dataset B) respectively. Overfitting issues are assessed through k-fold cross-validation.

Conclusion

Several variants are utilized to present a more rigorous and fair evaluation of our work, especially the importance of extracting clinically relevant features. Moreover, a GCN model using graph data can be a promising solution for an automated feature-based breast image classification system.
Low-intensity repetitive transcranial magnetic stimulation is safe and well tolerated by people living with MS – outcomes of the phase I randomised controlled trial (TAURUS)
Authors: Nguyen Phuong Tram , Zarghami Amin , Makowiecki Kalina , Stevens Natasha , Ezegbe Chigozie , Kyle Kain , Wang Chenyu , Ly Linda , De La Rue Katie , Hinder Mark R , Johnson Lewis , Rodger Jennifer , Cooper Samantha , Cullen Carlie L , Barnett Michael , Young Kaylene M , Taylor Bruce V
Published: May 2024

Background

Low-intensity repetitive transcranial magnetic stimulation (rTMS), delivered as a daily intermittent theta burst stimulation (iTBS) for four consecutive weeks, increased the number of new oligodendrocytes in the adult mouse brain. Therefore, rTMS holds potential as a remyelinating intervention for people with multiple sclerosis (MS).

Objective

Primarily to determine the safety and tolerability of our rTMS protocol in people with MS. Secondary objectives include feasibility, blinding and an exploration of changes in magnetic resonance imaging (MRI) metrics, patient-reported outcome measures (PROMs) and cognitive or motor performance.

Methods

A randomised (2:1), placebo controlled, single blind, parallel group, phase 1 trial of 20 rTMS sessions (600 iTBS pulses per hemisphere; 25% maximum stimulator output), delivered over 4–5 weeks. Twenty participants were randomly assigned to ‘sham’ ( n = 7) or active rTMS ( n = 13), with the coil positioned at 90° or 0°, respectively.

Results

Five adverse events (AEs) including one serious AE reported. None were related to treatment. Protocol compliance was high (85%) and blinding successful. Within participant MRI metrics, PROMs and cognitive or motor performance were unchanged over time.

Conclusion

Twenty sessions of rTMS is safe and well tolerated in a small group of people with MS. The study protocol and procedures are feasible. Improvement of sham is warranted before further investigating safety and efficacy.
A Systematic Review of Humor Employed in Teaching English as a Second Language in Asia
Authors: Tianli Zhou , Mansor Nor Shahila , Liu Guoqiang , Junhua Peng
Published: May 2024

In recent times, the number of studies examining the use of humor in teaching English as a second language (ESL) in Asian countries has increased as researchers have acknowledged the positive effects that humor has on language teaching. This study presents a systematic review focused on the use of humor in ESL teaching within Asian countries. Its objectives are to acquire comprehensive knowledge of the current research status, research participants and methods, and research perspectives, and to examine the outcomes of incorporating humor into ESL instruction in Asian contexts in order to pinpoint research gaps for future studies. This study included the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2020). Moreover, 35 articles relevant to the use of humor in Asian ESL teaching were identified as of the date when this study was conducted. After performing content analysis, the findings revealed that the first related articles in Asia were published in 2009, after which more and more articles emerged. These studies took place in 14 Asian countries, with most of them focusing on Turkey, Iran, and Indonesia. In addition, they involve diverse research methods and perspectives, whilst most of the participants are university students. This suggests that humor is more suitable for use when teaching high-proficiency English learners. Moreover, humor is a double-edged sword that has positive and negative impacts on ESL teaching in Asian countries. Finally, a number of recommendations for future studies have been proposed in this study.
Socioeconomic status, cosmopolitanism, and educational aspirations: A study of China’s middle-class students pursuing higher education in the U.S. amidst geopolitical tensions
Authors: Wang Xin
Published: May 2024

As the demand for American education has been growing in China in the last two decades, it is important to understand the desire of Chinese students for pursuing their higher education in the U.S. Based on a recent survey of Chinese students in the U.S., this study intersects the desire for education abroad with social class theories, particularly on how China’s middle class view studying in the U.S. as a way of pursuing their global mobility as well as social mobility, and how their desires intersect with the interests of state, market, society as well as interests of family and self. The study employs both qualitative and quantitative research design in order to understand how Chinese middle-class students see studying in the U.S. as a means to seek cosmopolitan capital and self-development. It examines which socio-economic factors have significant impacts on the motivations of China’s middle-class students pursuing their higher education in the U.S. The findings reveal that middle-class families view studying abroad in the U.S. as a way of pursuing their global mobility, social mobility as well as cosmopolitan capital.
“Troubled” Meanings: An Affect Control Theory Exploration of the Conflict in Northern Ireland
Authors: Fields Benjamin C. , Huft Justin
Published: May 2024

The Troubles in Northern Ireland ranks among the most violent periods in recent history. While social movements scholars have long sought to understand the conflict, often they do not include micro-level approaches. We use affect control theory and cultural meanings among Catholics gathered at the height of The Troubles to create prototypical group members and then simulate interactions across and between groups. Using cultural meanings gathered at a Catholic high school in Belfast in 1977, we find that Catholic (in-group) identities hold more positive meanings than Protestant identities. This remains true for identities within the paramilitary organizations and non-combatant identities. However, we find that the meanings of combatant identities are much lower in evaluation—a measure of goodness—than non-combatant identities. Our simulations suggest that interactions between groups are expected to be relatively innocuous. However, we do find that, in simulations, combatants—on both sides of the conflict—are expected to interact negatively with others. These findings and the methods we use suggest future avenues for both researchers and policymakers to better understand conflict and peacemaking.
Assessment of Heart Failure Post-discharge Management Strategies, Needs and Acceptance of Mobile Application-based Remote Patient Management in South India
Authors: Lalthanthuami H.T. , Ramamoorthy Lakshmi , Satheesh Santhosh , Subrahmanyam D.K.S. , Zayaraz G.
Published: May 2024

The demand for digital platforms in managing heart failure (HF) is expected to increase with promising effects on readmission and health expenditure. The study aims to explore current post-discharge management strategies and identify the need and acceptance of digital platforms, to ensure the development of a user-friendly mobile application for HF patients. Using a cross-sectional analytical research design, 90 consecutive patients diagnosed with HF who were discharged from a Tertiary Care Center were enrolled. Tele-interview was conducted using a self-developed and validated tool. The mean age of participants was 55.54 ± 10.33 years. The participants’ adherence to HF management strategies was low in terms of physical exercise and weight monitoring. More than one-third were willing to self-record their measurements and use a mobile application. The common mobile application features requested were medication information/reminder (88.6%), health education (84.3%), chat with nurses (84.3%), physical activity (81.4%), symptoms (78.6%), diet (78.6%) and weight management (72.9%). The findings from this initial phase of mobile development are expected to help leverage better development of digital interventions for HF patients.
Biological and clinical determinants shaping heterogeneity in mantle cell lymphoma
Authors: López Cristina , Silkenstedt Elisabeth , Dreyling Martin , Beà Sílvia
Published: May 2024

Mantle cell lymphoma (MCL) is an uncommon mature B-cell lymphoma that presents a clinical spectrum ranging from indolent to aggressive disease, with challenges in disease management and prognostication. MCL is characterized by significant genomic instability, affecting various cellular processes, including cell cycle regulation, cell survival, DNA damage response and telomere maintenance, NOTCH and NF-κB/ B-cell receptor pathways, and chromatin modification. Recent molecular and next-generation sequencing studies unveiled a broad genetic diversity among the 2 molecular subsets, conventional MCL (cMCL) and leukemic nonnodal MCL (nnMCL), which may partially explain their clinical heterogeneity. Some asymptomatic and genetically stable nnMCL not requiring treatment at diagnosis may eventually progress clinically. Overall, the high proliferation of tumor cells, blastoid morphology, TP53 and/or CDKN2A/B inactivation, and high genetic complexity influence treatment outcome in cases treated with standard regimens. Emerging targeted and immunotherapeutic strategies are promising for refractory or relapsed cases and a few genetic and nongenetic determinants of refractoriness have been reported. This review summarizes the recent advances in MCL biology, focusing on molecular insights, prognostic markers, and novel therapeutic approaches.
Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio
Authors: Zhou Xiaofan , Wong Hung
Published: May 2024

Background

Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations.

Methods

Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis.

Results

Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life.

Conclusions

Increase elderly’s meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly’s meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.
An online survey of women’s views of respectful and disrespectful pregnancy and early labour care in the Czech Republic
Authors: Daly Deirdre , Sedlicka Natalie , Švanderlíková Kateřina , Kovařčíková PetraAnn Ann , Wilhelmová Radka , Begley Cecily
Published: May 2024

Objective

To ascertain and explore the views of women and their partners, giving birth in the Czech Republic, of the level of respectful or disrespectful care provided during pregnancy and early labour.

Design

Ethical approval was granted for a descriptive, online anonymous survey of 65 questions, with quantitative and qualitative responses.

Setting

The Czech Republic.The survey was completed by 8,767 women and 69 partners in 2018.

Measurements and findings

Descriptive statistics and thematic analysis were used to present results. The majority of women were aged 26-35 years. Most had birthed in one of 93 hospitals, with 1.5% home births. Almost 40% never had an abdominal examination.in pregnancy. Quantitative data analysis revealed that less than half were given information on place of birth, or how to keep labour normal or non-interventionist. Almost 60% did not get information on positions for birth. Most (68%) commenced labour naturally, 25% had labour induced, 40% of them before term, and 7% had an elective caesarean section; 55% stated they had not been given any choice in the decision. Over half of those who had a membrane sweep said permission had not been sought. Half (54%) only had ‘checking’ visits from the midwife in labour.

Key conclusions

Findings reveal a lack of information-giving, discussion and shared decision-making from healthcare professionals during pregnancy and early labour. Some practices were non-evidenced-based, and interventions were sometimes made without consent.

Implications for practice

The examples of disrespectful care described in this study caused women distress during childbirth, which may result in an increased fear of childbirth or an increase in free-birthing.
Sacred space: a qualitative interpretive meta-synthesis of women’s experiences of supportive birthing environments
Authors: Maxwell December , Leat Sarah R. , Gallegos Toni , Praetorius Regina T.
Published: May 2024

Background

In the United States there are roughly three million births a year, ranging from cesarean to natural births. A major aspect of the birthing process is related to the healing environment, and how that helps or harms healing for the mother and child. Using the theoretical framework, Theory of Supportive Care Settings (TSCS), this study aimed to explore what is necessary to have a safe and sacred healing environment for mothers.

Method

This study utilized an updated Qualitative Interpretive Meta-synthesis (QIMS) design called QIMS-DTT [deductive theory testing] to answer the research question, What are mother’s experiences of environmental factors contributing to a supportive birthing environment within healthcare settings?

Results

Key terms were run through multiple databases, which resulted in 5,688 articles. After title and abstract screening, 43 were left for full-text, 12 were excluded, leaving 31 to be included in the final QIMS. Five main themes emerged from analysis: 1) Service in the environment, 2) Recognizing oneself within the birthing space, 3) Creating connections with support systems, 4) Being welcomed into the birthing space, and 5) Feeling safe within the birthing environment.

Conclusions

Providing a warm and welcoming birth space is crucial for people who give birth to have positive experiences. Providing spaces where the person can feel safe and supported allows them to find empowerment in the situation where they have limited control.
Neonatal healthcare professionals’ experiences of intact cord resuscitation in the mother´s bed- an interview study
Authors: Patriksson Katarina , Andersson Ola , Thies-Lagergren Li , Rönnerhag Maria
Published: May 2024

Background

Intact cord resuscitation in the first three minutes of life improves oxygenation and Apgar scores. The practise of intact cord resuscitation implies the umbilical cord still being connected to the placenta for at least one minute while providing temperature control and equipment for resuscitation. Healthcare professionals described practical challenges in providing intact cord resuscitation. This study aimed to explore neonatal healthcare professionals’ experiences of providing intact cord resuscitation in the mother’s bed.

Method

An interview study with an inductive, interpretative approach was chosen and analysed according to reflexive thematic analysis by Braun & Clarke. An open interview guide was used and 20 individual interviews with neonatal healthcare professionals were performed. The study was conducted at five level I-III neonatal care units. In Sweden, resuscitation is performed either in or outside the labour room.

Results

The results contributed insight into the participants’ experiences of prerequisites for providing neonatal care in intact cord resuscitation. The sense of the mother’s vulnerability was noticeable, as the participants reported reducing the risk of exposure to protect and preserve the mother’s integrity. The practical challenges in the environment involved working in a limited space. The desire for multi-professional team training comprised education and training as well as debriefing to manage intact cord resuscitation.

Conclusion

The result of the present study highlights the fact that neonatal healthcare professionals’ experiences of providing ICR in the mother’s bed were positive and had significant benefits for the neonate, namely zero separation between the neonate and parents and better physical recovery for the neonate. However, the fact that ICR in the mother’s bed can be challenging in several ways, such as emotionally, managing environmental circumstances and ensuring effective team collaboration. Therefore, it is of the utmost importance that healthcare professionals are given the opportunity to reflect and train together as a team. Future recommendations are to summarize evidence-based knowledge to design guidelines for ICR situation.