bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring barriers and enabling factors for surgical task sharing with physician assistants in Liberia: a qualitative pre-implementation study
Authors: Werz Markus Jan , van Duinen Alex J , Hampaye Theophilus C , van den Broek Ankie , Bolkan Håkon A
Published: July 2024

Objectives

This study explores potential barriers and enabling factors that may influence the acceptance of implementation of a surgical task-sharing initiative targeting physician assistants (PAs) in Liberia.

Design

A qualitative, pre-implementation study using semistructured interviews. Data was analysed in NVivo V.12 using deductive coding and the consolidated framework for implementation research as a guide.

Setting

Liberia has few surgical providers and a poor surgical infrastructure resulting in a very low surgical volume. The research was conducted in the context of an already running surgical task-sharing programme for midwives.

Participants

In 2019, a total of 30 key stakeholders in the field of surgery and the PAs training programme were interviewed.

Results

The majority of the stakeholders supported the idea of training PAs in surgery. The high unemployment rate among PAs and the need for career advancement of this cadre were important enabling factors. Resistance against surgical task sharing for mid-level clinicians is multifaceted. The Ministry of Health (MOH) did not share a common vision. Opponents within the MOH believed budgetary constraints within the MOH and the lack of surgical infrastructure is a more pressing problem compared with the surgically trained human resources. Another important group of opponents are medical officers (MOs) and their professional bodies. Many of their negative beliefs around surgical task sharing reflect lessons to be drawn from the current surgical training programme for midwives.

Conclusion

Prior to deciding on implementation of a surgical training programme for PAs, wider support is needed. If surgical task sharing with PAs is to be considered, the intervention should focus on adapting the ‘adaptable’ periphery of the intervention to broaden the support of the MOH, MOs and their professional bodies. Failing to obtain such support should make the implementors consider alternative strategies to strengthen surgical human resources in rural Liberia.
Accuracy of pH strip testing and pH liquid testing versus standard pH meter of gastric contents in critically ill patients: a diagnostic accuracy study
Authors: Phukpattanachai Kanjanaporn , Praditseree Nutcha , Skjolaas Smith , Klaychaiya Sirilux , Trongtrakul Konlawij
Published: July 2024

Objective

The utilisation of pH level measurements from gastric contents may indicate the preferred tip position of a nasogastric tube or monitor the efficacy of stress ulcer prophylaxis in critically ill patients. We aimed to determine the accuracy of pH strip (pHS) tests and pH liquid (pHL) tests compared with the standard pH meter (pHM).

Design

Diagnostic accuracy study.

Setting

Gastric contents from medically critically ill patients.

Participants

In total, 113 gastric samples were collected from 27 critically ill patients.

Outcome measure

The level of pH measured by pHM, pHS and pHL.

Results

The pH values measured by pHM, pHS and pHL were 5.83 (IQR 5.12–6.61), 5.50 (IQR 5.00–6.00) and 5.75 (IQR 5.25–6.25), respectively. The pHS test showed greater accuracy, exhibiting a more positive correlation with the standard pHM measurement than the pHL test, with Y=0.95*X+0.56; rho=0.91, p<0.001, and Y=1.09*X - 0.72; rho=0.75, p<0.001, respectively. However, the pHS test demonstrated less agreement with the pHM than the pHL test, with biases of –0.27 versus 0.18, respectively. Noticeably, a slight variation in pHL from the standard pH values was found when we measured gastric contents with a pH lower than 5.

Conclusion

Both the pHS and pHL methods were good options for measuring gastric pH in critically ill patients. However, it was advisable to find alternative approaches to the pHL testing method when anticipated gastric acidity levels fall below 5.

Trial registration number

TCTR20220530004.
Gothenburg Breast reconstruction (GoBreast) II protocol: a Swedish partially randomised patient preference, superiority trial comparing autologous and implant-based breast reconstruction
Authors: Hansson Emma , Löfstrand Jonas , Larsson Camilla , Uusimaki Alexandra , Svensson Karolina , Ekman Anna , Svensson Mikael , Paganini Anna
Published: July 2024

Introduction

Although breast reconstruction is an integral part of breast cancer treatment, there is little high-quality evidence to indicate which method is the most effective. Randomised controlled trials (RCTs) are generally thought to provide the most solid scientific evidence, but there are significant barriers to conducting RCTs in breast reconstruction, making both recruitment and achieving unbiased and generalisable results a challenge. The objective of this study is to compare implant-based and autologous breast reconstruction in non-irradiated patients. Moreover, the study aims to improve the evidence for trial decision-making in breast reconstruction.

Methods and analysis

The study design partially randomised patient preference trial might be a way to overcome the aforementioned challenges. In the present study, patients who consent to randomisation will be randomised to implant-based and autologous breast reconstruction, whereas patients with strong preferences will be able to choose the method. The study is designed as a superiority trial based on the patient-reported questionnaire BREAST-Q and 124 participants will be randomised. In the preference cohort, patients will be included until 62 participants have selected the least popular alternative. Follow-up will be 60 months. Embedded qualitative studies and within-trial economic evaluation will be performed. The primary outcome is patient-reported breast-specific quality of life/satisfaction, and the secondary outcomes are complications, factors affecting satisfaction and cost-effectiveness.

Ethics and dissemination

The study has been approved by the Swedish Ethical Review Authority (2023-04754-01). Results will be published in peer-reviewed scientific journals and presented at peer-reviewed scientific meetings.

Trial registration number

NCT06195865.
Effectiveness of Rapid Response Team implementation in a tertiary hospital in Egypt: an interventional study
Authors: Hosny Rania , Hussein Rasha Saad , Hussein Wafaa Mohamed , Hakim Sally Adel , Habil Ihab Shehad
Published: July 2024

Background

Rapid response teams (RRTs) help in the early recognition of deteriorating patients in hospital wards and provide the needed management at the bedside by a qualified team. RRT implementation is still questionable because there is insufficient evidence regarding its effects. To date, according to our knowledge, no published studies have addressed the effectiveness of RRT implementation on inpatient care outcomes in Egypt.

Objective

We aimed to assess the impact of an RRT on the rates of inpatient mortality, cardiopulmonary arrest calls and unplanned intensive care unit (ICU) admission in an Egyptian tertiary hospital.

Methods

An interventional study was conducted at a university hospital. Data was evaluated for 24 months before the intervention (January 2018 till December 2019, which included 4242 admissions). The intervention was implemented for 12 months (January 2021 till December 2021), ending with postintervention evaluation of 2338 admissions.

Results

RRT implementation was associated with a significant reduction in inpatient mortality rate from 88.93 to 46.44 deaths per 1000 discharges (relative risk reduction (RRR)=0.48; 95% CI, 0.36 to 0.58). Inpatient cardiopulmonary arrest rate decreased from 7.41 to 1.77 calls per 1000 discharges (RRR, 0.76; 95% CI, 0.32 to 0.92), while unplanned ICU admissions decreased from 5.98 to 4.87 per 1000 discharges (RRR, 0.19; 95% CI, −0.65 to 0.60).

Conclusions

RRT implementation was associated with a significantly reduced hospital inpatient mortality rate, cardiopulmonary arrest call rate as well as reduced unplanned ICU admission rate. Our results reveal that RRT can contribute to improving the quality of care in similar settings in developing countries.
Health benefits of pedestrian and cyclist commuting: evidence from the Scottish Longitudinal Study
Authors: Friel Catherine , Walsh David , Whyte Bruce , Dibben Chris , Feng Zhiqiang , Baker Graham , Kelly Paul , Demou Evangelia , Dundas Ruth
Published: July 2024

Background

Despite active travel investment increasing, evidence of benefit is often limited to selected health outcomes and a short follow-up period, and cyclists and pedestrians are often analysed together. We aimed to examine prospective associations with multiple health outcomes over 18 years for pedestrians and cyclists separately.

Methods

The Scottish Longitudinal Study is based on census data, from which we selected 82 297 individuals aged 16–74 years. Individuals were followed-up between 2001 and 2018 through linkage to hospitalisation, death and prescription records. Cox proportional hazard models were used to compare cyclist and pedestrian commuters with non-active commuters for a range of health outcomes, controlling for pre-existing health conditions, and demographic and socioeconomic characteristics.

Results

Compared with non-active commuting, cyclist commuting was associated with lower all-cause mortality risk (HR 0.53, 95% CI 0.38 to 0.73), lower risk of any hospitalisation (HR 0.90, 95% CI 0.84 to 0.97), lower risk of cardiovascular disease (CVD) hospitalisation (HR 0.76, 95% CI 0.64 to 0.91) and of having a CVD prescription (HR 0.70, 95% CI 0.63 to 0.78), lower risk of cancer mortality (HR 0.49, 95% CI 0.30 to 0.82) and cancer hospitalisation (HR 0.76, 95% CI 0.59 to 0.98), and lower risk of having a prescription for mental health problems (HR 0.80, 95% CI 0.73 to 0.89). Pedestrian commuting was associated with lower risk of any hospitalisation (HR 0.91, 95% CI 0.88 to 0.93), lower risk of CVD hospitalisation (HR 0.90, 95% CI 0.84 to 0.96) and of having a CVD prescription (HR 0.90, 95% CI 0.87 to 0.93), and lower risk of a mental health prescription (HR 0.93, 95% CI 0.90 to 0.97).

Conclusion

Active commuters were less likely to suffer from a range of negative physical and mental health outcomes than non-active commuters. These findings strengthen the evidence for the health benefits of active commuting.
Performance and safety of the PRICO closed-loop oxygen saturation targeting system in neonates: pragmatic multicentre cross-over study (TarOx Study)
Authors: Wilinska Maria , Bachman Thomas , Szczapa Tomasz , Wroblewska-Seniuk Katarzyna , Chojnacka Karolina , Loniewska Beata , Olszanska Karolina , Rzepecka Weglarz Beata , Janusz Katarzyna , Piwowarczyk Pawel , Onland Wes , Hutten G Jeroen , van Leuteren Ruud W , van Kaam Anton H
Published: July 2024

Objective

This study aims to evaluate the performance of the fabian-Predictive-Intelligent-Control-of-Oxygenation (PRICO) system for automated control of the fraction of inspired oxygen (FiO2).

Design

Multicentre randomised cross-over study.

Setting

Five neonatal intensive care units experienced with automated control of FiO2and the fabian ventilator.

Patients

39 infants: median gestational age of 27 weeks (IQR: 26–30), postnatal age 7 days (IQR: 2–17), weight 1120 g (IQR: 915–1588), FiO20.32 (IQR: 0.22–0.43) receiving both non-invasive (27) and invasive (12) respiratory support.

Intervention

Randomised sequential 24-hour periods of automated and manual FiO2control.

Main outcome measures

Proportion (%) of time in normoxaemia (90%–95% with FiO2>0.21 and 90%–100% when FiO2=0.21) was the primary endpoint. Secondary endpoints were severe hypoxaemia (<80%) and severe hyperoxaemia (>98% with FiO2>0.21) and prevalence of episodes ≥60 s at these two SpO2extremes.

Results

During automated control, subjects spent more time in normoxaemia (74%±22% vs 51%±22%, p<0.001) with less time above and below (<90% (9%±8% vs 12%±11%, p<0.001) and >95% with FiO2>0.21 (16%±19% vs 35%±24%) p<0.001). They spent less time in severe hyperoxaemia (1% (0%–3.5%) vs 5% (1%–10%), p<0.001) but exposure to severe hypoxaemia was low in both arms and not different. The differences in prolonged episodes of SpO2were consistent with the times at extremes.

Conclusions

This study demonstrates the ability of the PRICO automated oxygen control algorithm to improve the maintenance of SpO2in normoxaemia and to avoid hyperoxaemia without increasing hypoxaemia.
Risk factors of acute exacerbation and disease progression in young patients with COPD
Authors: Bae Juye , Lee Hyo Jin , Choi Kwang Yong , Lee Jung-Kyu , Park Tae Yun , Heo Eun Young , Lee Chang Hoon , Kim Deog Kyeom , Lee Hyun Woo
Published: July 2024

Objective

We aimed to elucidate the clinical factors associated with acute exacerbation and disease progression in young patients with chronic obstructive pulmonary disease (COPD).

Methods

This retrospective longitudinal observational study included patients with COPD aged between 20 and 50 years with post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC)<0.7. Eligible patients were followed up with ≥2 spirometry examinations at 1 year interval after COPD diagnosis. The primary outcome was moderate-to-severe acute exacerbation in young patients with COPD. Secondary outcomes were early initiation of regular inhalation therapy and accelerated annual post-bronchodilator FEV1decline.

Results

A total of 342 patients were followed up during a median of 64 months. In multivariable analyses, risk factors for moderate-to-severe exacerbation were history of asthma (adjusted HR (aHR)=2.999, 95% CI=[2.074–4.335]), emphysema (aHR=1.951, 95% CI=[1.331–2.960]), blood eosinophil count >300/µL (aHR=1.469, 95% CI=[1.038–2.081]) and low FEV1(%) (aHR=0.979, 95% CI=[0.970–0.987]). A history of asthma, sputum, blood eosinophil count >300/µL, low FEV1(%) and low diffusing capacity of the lung for carbon monoxide (DLCO) (%) were identified as clinical factors associated with the early initiation of regular inhalation therapy. The risk factors associated with worsened FEV1decline were increasing age, female sex, history of pulmonary tuberculosis, sputum, low FEV1(%) and low DLCO(%).

Conclusions

In young COPD patients, specific high-risk features of acute exacerbation and disease progression need to be identified, including a history of previous respiratory diseases, current respiratory symptoms, blood eosinophil counts, and structural or functional pulmonary impairment.
Prevalence of irritable bowel syndrome and functional dyspepsia after acute gastroenteritis: systematic review and meta-analysis
Authors: Porcari Serena , Ingrosso Maria Rosa , Maida Marcello , Eusebi Leonardo Henry , Black Christopher , Gasbarrini Antonio , Cammarota Giovanni , Ford Alexander Charles , Ianiro Gianluca
Published: July 2024

Objective

Disorders of gut-brain interaction may arise after acute gastroenteritis. Data on the influence of pathogen type on the risk of postinfection IBS (PI-IBS), as on postinfection functional dyspepsia (PI-FD), are limited. We conducted a systematic review and meta-analysis to determine prevalence of PI-IBS or PI-FD after acute gastroenteritis.

Design

We included observational studies recruiting ≥50 adults and reporting prevalence of IBS or FD after acute gastroenteritis with ≥3-month follow-up. A random effects model was used to estimate prevalence and ORs with 95% CIs.

Results

In total, 47 studies (28 170 subjects) were eligible. Overall prevalence of PI-IBS and PI-FD were 14.5% and 12.7%, respectively. IBS persisted in 39.8% of subjects in the long-term (>5 years follow-up) after diagnosis. Individuals experiencing acute gastroenteritis had a significantly higher odds of IBS (OR 4.3) and FD (OR 3.0) than non-exposed controls. PI-IBS was most associated with parasites (prevalence 30.1%), but in only two studies, followed by bacteria (18.3%) and viruses (10.7%). In available studies,
Campylobacter
was associated with the highest PI-IBS prevalence (20.7%) whereas Proteobacteria and SARS-CoV-2 yielded the highest odds for PI-IBS (both OR 5.4). Prevalence of PI-FD was 10.0% for SARS-CoV-2 and 13.6% for bacteria (Enterobacteriaceae 19.4%).

Conclusion

In a large systematic review and meta-analysis, 14.5% of individuals experiencing acute gastroenteritis developed PI-IBS and 12.7% PI-FD, with greater than fourfold increased odds for IBS and threefold for FD. Proinflammatory microbes, including Proteobacteria and subcategories, and SARS-CoV-2, may be associated with the development of PI-IBS and PI-FD.
Evaluation of the World Health Organization-HEARTS hypertension control package in Bangladesh: a quasi-experimental trial
Authors: Abrar Ahmad , Hu Xiao , Akhtar Jubaida , Jubayer Shamim , Noor Nabi Sayem Mohammad , Sultana Sarmin , Al Mamun Mohammad Abdullah , Bhuiyan Mahfuzur Rahman , Malik Fazila , Amin Mohammad Robed , Alim Abdul , Gupta Reena , Zhao Di , Farrell Margaret , Banigbe Bolanle , Matsushita Kunihiro , Burka Daniel , Appel Lawrence , Moran Andrew E , Choudhury Sohel Reza
Published: July 2024

Background

The World Health Organization (WHO) promotes the HEARTS technical package for improving hypertension control worldwide, but its effectiveness has not been rigorously evaluated.

Objective

To compare hypertension outcomes in clinics implementing HEARTS versus clinics continuing usual hypertension care in rural Bangladesh.

Methods

A matched-pair cluster quasi-experimental trial in Upazila Health Complexes (UHCs; primary healthcare facilities) was conducted in rural Bangladesh. A total of 3935 patients (mean age 52.3 years, 70.5% female) with uncontrolled hypertension (blood pressure (BP) ≥140/90 mm Hg regardless of treatment history) were enrolled: 1950 patients from 7 HEARTS UHCs and 1985 patients from 7 matched usual care UHCs. The primary outcome was systolic BP at 6 months measured at the patient’s home; secondary outcomes were diastolic BP, hypertension control rate (<140/90 mm Hg) and loss to follow-up. Multivariable mixed-effects linear and Poisson models were conducted.

Results

Baseline mean systolic BP was 158.4 mm Hg in the intervention group and 158.8 mm Hg in the usual care group. At 6 months, 95.5% of participants completed follow-up. Compared with usual care, the intervention significantly lowered systolic BP (−23.7 mm Hg vs −20.0 mm Hg; net difference −3.7 mm Hg (95% CI −5.1 to –2.2)) and diastolic BP (−10.2 mm Hg vs −8.3 mm Hg; net difference −1.9 mm Hg (95% CI −2.7 to –1.1)) and improved hypertension control (62.0% vs 49.7%, net difference 12.3% (95% CI 9.0 to 16.8)). Rate of missed clinic visits was lower in the intervention group (8.8% vs 39.3%, p<0.001).

Conclusions

After WHO-HEARTS package implementation in rural Bangladesh, BP was lowered and hypertension control improved significantly compared with usual care.

Trial registration number

NCT04992039
.
Additional outlet occlusion as an important factor in avoiding retreatment after transvenous embolization for cavernous sinus dural arteriovenous fistulas
Authors: Miyamoto Satoshi , Tsuruta Wataro , Isozaki Jun , Ishigami Daiichiro , Hosoo Hisayuki , Ito Yoshiro , Marushima Aiki , Hayakawa Mikito , Matsumaru Yuji
Published: July 2024

Background

Transvenous embolization (TVE), such as selective shunt occlusion, is the first line treatment for cavernous sinus dural arteriovenous fistula (CSDAVF). Despite the favorable outcomes of TVE, some cases necessitating retreatment due to recurrence or incomplete occlusion persist. Given the physical, psychological, and financial burden of multiple treatments, understanding the predictive factors for recurrence, spontaneous occlusion, or retreatment is important. However, few reports have addressed these factors, complicating decision making regarding the need for retreatment. This study analyzed predictive factors for retreatment and spontaneous occlusion to offer new insights into CSDAVF management.

Methods

This retrospective, observational study was conducted in two acute care hospitals. Patients aged 18–100 years undergoing endovascular treatment for CSDAVF from January 2011 to December 2022 were included.

Results

Of 65 patients treated with TVE, 29 experienced immediate complete occlusion. Meanwhile, 22 of 36 patients with incomplete occlusion had spontaneous occlusion, and retreatment was performed in 20% of patients. Additional outlet occlusion was negatively associated with retreatment (P=0.046), and it tended to promote spontaneous occlusion (P=0.056). Favorable functional outcomes were observed in all patients, and approximately 94% of patients showed complete occlusion at the latest follow-up.

Conclusion

TVE is an effective treatment for CSDAVF. Outlet occlusion, when immediate complete occlusion is unattainable, is important to reduce retreatment and promote spontaneous occlusion. Substantially reducing shunt flow, carefully assessing dangerous drainage routes, and closely monitoring the residual shunt are crucial for preventing intracranial hemorrhage when outlet occlusion is performed.
Carotid web catheter angiography hemodynamic parameters
Authors: Damiani Monteiro Mateus , Tarek Mohamed A , Martins Pedro N , Allen Jason W , Nogueira Raul G , Landzberg David , Dolia Jaydevsinh , Park Charlie Chulhyun , Liberato Bernardo , Frankel Michael R , Haussen Diogo C
Published: July 2024

Background

Carotid web (CaW)-related contrast stagnation on digital subtraction angiography (DSA) may be a marker supporting the pathophysiological theory of stasis and thrombosis/embolization. We aim to assess the correlation between DSA hemodynamic parameters with CT angiography (CTA) structural measurements and clinical characteristics.

Methods

Cross-sectional analysis of consecutive patients with CaW who underwent CTA+DSA. DSA-derived hemodynamic parameters were calculated based on a region of interest at the carotid bulb (time–density curves; TDC). The correlation between duration of contrast stagnation with CaW structural features and with clinical characteristics was evaluated with a mixed effects model.

Results

Sixty patients of mean±SD age 52.2±10.3 years were included, of whom 38 (63.3%) were women, 51 (85%) were black, and 59 (98.3%) had symptomatic lesions. The median CaW base was 2.46 mm (range 1.95–3.76), length 2.7 mm (range 2.15–3.96), thickness (length/base) 1.05 (IQR 0.81–1.36), caudal angle 31.93° (IQR 22.35–43.58), mean±SD distal angle 66.91±15.84°, pocket area 1.62 mm² (0.96–1.62), and pocket perimeter 6.03±2.6 mm. The TDC consistently showed an initial fast decay from the peak concentration followed by a plateau with a negative exponential pattern. The median stagnation time from peak density to 80% contrast clearance was 2.91 s (range 1.81–4.94). No significant associations were observed between the stagnation time and CaW CTA structural measurements (length/base/thickness, caudal and cranial angles web surface angles, web pocket area/perimeter) or clinical characteristics.

Conclusions

A negative exponential pattern in the DSA contrast clearance of the CaW pocket was observed. There were no morphological or clinical features clearly associated with the duration of contrast stagnation on DSA. The hemodynamic disruption caused by CaW and its thrombotic risk may not be appropriately measured by contrast stagnation time.
Sex-specific comparative outcomes between oral anticoagulants in patients with atrial fibrillation: a systematic review and meta-analysis
Authors: Chobanov Jan D , Wang Zixuan , Man Kenneth K C , Dayib Edil , Lip Gregory Y H , Hingorani Aroon D , Leung Wai K , Wong Ian C K , Mongkhon Pajaree , Lau Wallis C Y
Published: July 2024

Aims

Women with atrial fibrillation (AF) are under-represented in randomised controlled trials (RCTs) of direct oral anticoagulants (DOACs). This systematic review and meta-analysis of RCTs and observational studies examined sex-specific outcomes of DOACs in AF.

Methods

PubMed, Embase, Web of Science and Cochrane Library were searched from January 2008 to November 2022. Sex-specific comparative outcomes of stroke/systemic embolism (SE), major bleeding, intracranial haemorrhage (ICH) and gastrointestinal bleeding (GIB) between oral anticoagulants were pooled using random effects models. P values for interaction were calculated to examine differences in results between sexes. RCTs and observational studies were meta-analysed separately.

Results

5 RCTs and 33 observational studies were included, totalling 1 085 931 women and 1 387 123 men. Meta-analyses showed that for both sexes, DOAC versus warfarin was generally associated with lower risk of stroke/SE, major bleeding and ICH; in DOAC–DOAC comparisons, rivaroxaban versus dabigatran had higher GIB risk. The only sex-specific difference observed was that when compared with warfarin, women had higher GIB risk with rivaroxaban (women: pooled risk ratio (pRR)=1.34, 95% CI=1.18 to 1.51; men: pRR=0.97, 95% CI=0.85 to 1.10; p value for interaction (p for interaction)<0.001) and possibly dabigatran (women: pRR=1.25, 95% CI=0.92 to 1.70; men: pRR=0.83, 95% CI=0.72 to 0.97; p-for-interaction=0.02). The sex difference in GIB remained for rivaroxaban when a Bonferroni-corrected significance level was used (α=0.003). No sex-specific GIB data for apixaban and edoxaban was available for the meta-analysis.

Conclusions

For both sexes, DOACs generally demonstrated favourable effectiveness and safety over warfarin. However, observational data suggested that women may have higher GIB risk with rivaroxaban and possibly dabigatran than warfarin. Further studies are warranted to verify our findings and elucidate sex-specific GIB risk with apixaban and edoxaban, of which the data is currently lacking.

PROSPERO registration number

CRD42022325027.
Individual fertilization response with social status and crown characteristics for western hemlock (Tsuga heterophylla)
Authors: Jang Woongsoon , Eskelson Bianca N.I. , Littke Kim M. , Turnblom Eric
Published: July 2024

Due to their high variability, the growth responses of western hemlock ( Tsuga heterophylla (Raf.) Sarg.) stands to fertilization have been regarded as unresponsive or inconsistent. Tree-level fertilization response models for western hemlock were constructed to clarify the inconsistent stand-level responses, using extensive datasets from the United States and Canada. Tree growth in diameter and height, mortality, were assessed by fertilization, stand- and tree-level variables using generalized linear and nonlinear mixed-effects models. Western hemlock fertilization response was influenced not only by stand-level variables and application rates but also by tree social status and crown characteristics. Greater dominance and crown ratio in trees increased height growth responses but decreased diameter growth. The peak of fertilization effect on diameter growth was observed 3 years after application, while effect on height growth peaked at 6 years. Fertilization increased the overall mortality rate, but also ameliorated it for suppressed and steady-growing trees. These complicated fertilization responses of western hemlock may imply its tolerance and allocation strategy of resources at a given size and social status. The results highlight the importance of adopting a tree-level modeling approach to better understanding how western hemlock trees respond to fertilization, improving the accuracy of growth and yield prediction after fertilization.
Matrix decompositions in quantum optics: Takagi/Autonne, Bloch–Messiah/Euler, Iwasawa, and Williamson
Authors: Houde Martin , McCutcheon Will , Quesada Nicolás
Published: July 2024

In this tutorial, we summarize four important matrix decompositions commonly used in quantum optics, namely the Takagi/Autonne, Bloch–Messiah/Euler, Iwasawa, and Williamson decompositions. The first two of these decompositions are specialized versions of the singular-value decomposition when applied to symmetric or symplectic matrices. The third factors any symplectic matrix in a unique way in terms of matrices that belong to different subgroups of the symplectic group. The last one instead gives the symplectic diagonalization of real, positive definite matrices of even size. While proofs of the existence of these decompositions exist in the literature, we review explicit constructions to implement these decompositions using standard linear algebra packages and functionalities such as singular-value, polar, Schur, and QR decompositions, and matrix square roots and inverses.
Dietary flexibility of insectivorous bats, Eptesicus fuscus and Myotis lucifugus, during Magicicada spp. Brood X emergence
Authors: Isenhour Zackary W. , Harris Garrett L. , Stewart Richard L. , Hampton Ekaterina D. , Scafini Michael R. , Turner Gregory G. , Bergsten Sherri E.
Published: July 2024

Emergence of periodical cicadas, Magicicada spp. Davis, 1925, presents an ideal opportunity to study dietary flexibility and selective feeding behavior of bats. It is known that a wide array of taxa prey upon Magicicada spp., but few bat species have been documented to consume them. When larger than typical prey items, such as periodical cicadas, become abundant for a short time frame, insectivorous bats may exhibit alteration in dietary selection that provides insight into capacity and conditions for feeding. Evidence of Magicicada spp. consumption was detected in guano via polymerase chain reaction (PCR) and physical detection in both Eptesicus fuscus (Palisot de Beauvois, 1796) and Myotis lucifugus (Le Conte, 1831), two bat species of different sizes and with different dietary profiles. The consumption of these larger prey items, when they are locally abundant, supports a display of opportunistic behavior and diet flexibility in these two bat species.
Determinants of multiple brooding in Barn Swallows (Hirundo rustica) in Atlantic Canada
Authors: Mann Hilary A.R. , Imlay Tara L. , Leonard Marty L.
Published: July 2024

Multiple brooding is an important component of reproductive success in many birds and the frequency of this behaviour has been linked to intrinsic (e.g., age, experience) and extrinsic factors (e.g., weather and food availability). When extrinsic factors drive multiple brooding, it may be possible to identify conservation actions to support multiple-brooded species at risk. The Barn Swallow ( Hirundo rustica Linnaeus, 1758), is a multiple-brooded aerial insectivore, currently listed as Threatened on Canada’s Species at Risk Act. We examined how weather, landcover, the presence of livestock and metal roofs (with associated heat) above nests affected the likelihood of multiple brooding in Barn Swallows nesting in Nova Scotia and New Brunswick, Canada. We found that sites with a lower proportion of open habitats, including pastures, hayfields, and lawns, within the typical foraging range (i.e., 400 m) of nests, were associated with a higher probability of multiple brooding. Also, multiple brooding may be less likely in windy conditions. We found no effect of proportion of other landcover types, weather conditions, livestock or metal roofs above nests. When possible, decreasing the proportion of open habitats around breeding sites could result in higher rates of multiple brooding, and in turn, help slow population declines.
Smart data harvesting in cache-enabled MANETs: UAVs, future position prediction, and autonomous path planning
Authors: Chaudhry Umair B. , Phillips Chris Ian
Published: July 2024

The task of gathering data from nodes within mobile ad hoc wireless sensor networks presents an enduring challenge. Conventional strategies employ customized routing protocols tailored to these environments, with research focused on refining them for improved efficiency in terms of throughput and energy utilization. However, these elements are interconnected, and enhancements in one often come at the expense of the other. An alternative data collection approach involves the use of unmanned aerial vehicles (UAVs). In contrast to traditional methods, UAVs directly collect data from mobile nodes, bypassing the need for routing. While existing research predominantly addresses static nodes, this paper proposes an evolutionary based, innovative path selection approach based on future position prediction of caching enabled mobile ad hoc wireless sensor network nodes for UAV data collection, aimed at maximizing node encounters and gathering the most valuable information in a single trip. The proposed technique is evaluated for different movement models and parameter configurations.
On the radiation quality characterization in radiation therapy: from linear energy transfer to experimental microdosimetry
Authors: Missiaggia Marta
Published: July 2024

Radiation-induced biological damage is primarily characterized by the average dose absorbed by the tissue. Nevertheless, it is acknowledged that other parameters, collectively constituting ”radiation quality,” play a crucial role in this context. However, defining and characterizing the radiation quality in radiotherapy to assess the radiobiological damage remains an open challenge. The most commonly used approach to quantify the radiation quality, the Linear Energy Transfer (LET), reveals many flaws in its applications. Microdosimetry represents an alternative approach that has been developed in the last decades and is considered a more accurate description of the radiation quality. Both approaches are explored, each with its inherent limitations and promising potential.
On the entanglement of co-ordinate and momentum degrees of freedom in noncommutative space
Authors: Nandi Shilpa , Rahaman Muklesur , Patra Pinaki
Published: July 2024

In this paper, we investigate the quantum entanglement induced by phase-space noncommutativity. Both the position–position and momentum–momentum noncommutativity are incorporated to study the entanglement properties of coordinate and momentum degrees of freedom under the shade of oscillators in noncommutative space. Exact solutions for the systems are obtained after the model is re-expressed in terms of canonical variables, by performing a particular Bopp’s shift to the noncommuting degrees of freedom. It is shown that the bipartite Gaussian state for an isotropic oscillator is always separable. To extend our study for the time-dependent system, we allow arbitrary time dependency on parameters. The time-dependent isotropic oscillator is solved with the Lewis–Riesenfeld invariant method. It turns out that even for arbitrary time-dependent scenarios, the separability property does not alter.

We extend our study to the anisotropic oscillator, which provides an entangled state even for time-independent parameters. The Wigner quasi-probability distribution is constructed for a bipartite Gaussian state. The noise matrix (covariance matrix) is explicitly studied with the help of Wigner distribution. Simon’s separability criterion (generalized Peres–Horodecki criterion) has been employed to find the unique function of the (mass and frequency) parameters, for which the bipartite states are separable. In particular, we show that the mere inclusion of non-commutativity of phase-space is not sufficient to generate the entanglement, rather anisotropy is important at the same footing.

We explore the experimental viability of our result through the computation of extractable work for the current situation.
Background gravitational waves as signature of the accelerated cosmic expansion
Authors: Cruz Cláudio Nassif , de Faria A. C. Amaro
Published: July 2024

We propose a toy model of a spherical universe made up of an exotic dark gas with temperature T in thermal equilibrium with a black-body in adiabatic expansion. Each particle of this exotic gas mimics a kind of particle of dark energy. So, each dark particle occupies a very small area of space so-called Planck area [Formula: see text], which represents the minimum area of the whole space-time given by the spherical surface with area [Formula: see text], where [Formula: see text] is the Hubble radius. We realize that such spherical surface is the surface of the black-body for representing the dark universe as if it were the surface of an expanding balloon. Thus, we are able to derive the law of universal gravitation, thus leading us to understand the cosmological anti-gravity. We estimate the tiny order of magnitude of the cosmological constant and the acceleration of expansion of the dark sphere. In this toy model, as the dark universe can be thought of as a large black body, when we obtain its power and frequency of emission of radiation, we find very low values. We conclude that such radiation and frequency of the black body made up of dark energy is a background gravitational wave with very low frequency in the order of [Formula: see text] due to the slight stretching of the fabric of space-time.
NEXT-GENERATION EDGE CLOUD-TO-THING CONTINUUM MODEL FOR EVALUATING CHILDREN’S MOTOR SKILLS USING DEEP LEARNING ALGORITHM
Authors: ALJEBREEN MOHAMMED , ALSHARDAN AMAL , HASSINE SIWAR BEN HAJ , MILED ACHRAF BEN , AL-KHAWAJA HANEEN A. , YAFOZ AYMAN , ALSINI RAED
Published: July 2024

Young children can enhance their movements and develop motor abilities through play and education with guidance and practice. Understanding young children’s physical development and identifying potential growth areas require an analysis of their motor skills. In this study, we assess young children’s motor skills using a unique deep residual technique on the cloud-to-thing continuum. Seven kids were used to identify autistic movements. The dataset was gathered from the Tamimi Centre for Autism in Saudi Arabia. The data preprocessing to standardize the data’s scale using min–max normalization and removing noise-relevant features is extracted using principal component analysis (PCA). This step is crucial for ensuring the quality and reliability of the data used for subsequent analysis. The bumble bees mating optimization with deep residual algorithm (BBMO-DRN) is designed to handle the complexities of motor skill assessment. Finally, we explore the potential of cloud–fog–edge computing in data storing and processing young children’s motor skill development. The results showed that the proposed method performs better compared to the existing methods. This will make it possible to evaluate how well the suggested solution works in terms of accuracy, precision, recall, [Formula: see text]1-score, and scalability. As a result, this proposed approach in evaluating young children’s motor skills is to improve data storage in the cloud to the thing continuum.
An approach to generalized (η1,η2)-convex functions via local fractional calculus and some applications
Authors: Sanabria José E. , Ramos-Fernández Julio C. , Sánchez C. Rainier V.
Published: July 2024

The purpose of this paper is to study a generalization of [Formula: see text]-convex functions using the local fractional calculus developed by Yang [Advanced Local Fractional Calculus and its Applications (World Science Publisher, New York, 2012)], namely generalized [Formula: see text]-convex functions. Among other results, we obtain some Fejér-type inequalities for this class of functions. As applications, we present some inequalities with generalized probability density functions and generalized special means.
On constraint manifolds of spatial closed chains in Lorentzian space
Authors: Aktaş Buşra , Durmaz Olgun , Aydin Öznur
Published: July 2024

The objective of this paper is to explore the unexplored algebraic representations of the constraint manifolds associated with [Formula: see text] and [Formula: see text] spatial closed chains in Lorentzian space. Initially, we establish the structure equations of spatial closed chains by utilizing the structure equations for spatial open chains in Lorentzian space. Subsequently, we employ these structure equations to derive the algebraic expressions defining the constraint manifolds of [Formula: see text] and [Formula: see text] spatial closed chains in Lorentzian space, considering factors such as the causal character of the first link and the rotational axis of the cylindrical joint. This study will finalize all algebraic representations of constraint manifolds for spacelike and timelike mechanisms in Lorentzian space.
Warped product manifolds: Characterizations through the symmetry of the semiconformal curvature tensor and applications
Authors: Chen Bang-Yen , De Uday Chand , Turki Nasser Bin , Syied Abdallah Abdelhameed
Published: July 2024

This paper investigates the impact of the semiconformal curvature tensor’s symmetry on the base and fiber manifolds of a warped product manifold. It establishes that the fiber manifold of a warped product manifold has a constant sectional curvature, whereas the base manifold is semiconformally symmetric. Furthermore, the paper derives the specific forms of the semiconformal curvature tensor for both the base and fiber manifolds. Also, it is demonstrated that a semiconformally symmetric (flat) GRW space-time is a perfect fluid space-time and exhibits an irrotational velocity vector field.
Constraining hybrid potential scalar field cosmological model in Lyra’s geometry with recent observational data
Authors: Bhardwaj Vinod Kumar , Yadav Anil Kumar , Gupta Lalit Kumar , Prasad Rajendra , Srivastava Sudhir Kumar
Published: July 2024

In this study, we investigate a scalar field cosmological model with Lyra’s geometry to explain the present cosmic expansion in a homogeneous and isotropic flat FRW universe. In Einstein’s field equations, we presupposed a variable displacement vector as an element of Lyra’s geometry. In the context of the conventional theory of gravity, we suggest a suitable parametrization of the scalar field’s dark energy density in the hybrid function of redshift [Formula: see text], confirming the essential transition behavior of the universe from a decelerating era to the present accelerated scenario. We present constraints on model parameters using the most recent observational datasets from OHD, BAO/CMB and Pantheon, taking Markov Chain Monte Carlo (MCMC) analysis into account. For the proposed model, the best estimated values of parameters for the combined dataset (OHD, BAO/CMB and Pantheon) are [Formula: see text][Formula: see text]km/s/Mpc, [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text]. The model exhibits a flipping nature, and the redshift transition occurs at [Formula: see text]. The current value of the decelerated parameter for the proposed model is calculated as [Formula: see text] for the combined dataset. Some dynamical properties of the model like energy density ([Formula: see text]), scalar field pressure ([Formula: see text]), EoS parameter of scalar field ([Formula: see text]), and effective EoS parameter ([Formula: see text]) are analyzed and presented. Further, we have also examined the statefinder diagnosis and jerk parameters of the derived model. The total density parameter for the derived model is found to be unity which is in nice agreement with recent standard findings.
EVALUATION OF THE POSTOPERATIVE ANALGESIC EFFECTS OF TUNING ELEMENT RELIEF PATCHES IN DOGS UNDERGOING OVARIOHYSTERECTOMY
Authors: Chang Chun , Lu Chia-Yun , Chen I-Ying , Wang Hsien-Chi
Published: July 2024

Ovariohysterectomy (OHE) is a common surgical procedure in small animals that causes significant postoperative pain. Tuning Element Relief Patches (TERPs) are silicone patches containing titanium salts, believed to relieve pain by resonating pain-related ion channels. In this experiment, 12 dogs undergoing OHE surgery received subcutaneous robenacoxib (group R, [Formula: see text]) injection or two sheets of TERPs (group T, [Formula: see text]) as postoperative analgesia to assess the analgesic effect of TERPs. The results demonstrated no significant differences in physiological parameters, pain scores and mechanical nociceptive thresholds (MNTs) between groups postoperatively, indicating that the TERPs provide comparable results to robenacoxib in managing postoperative pain in dogs undergoing OHE. While this study provides evidence of the pain-relieving effects of TERPs, further studies are required to evaluate their long-term safety and efficacy in various clinical conditions.
Travel-Tourism-Related Advanced TOPSIS MCGDM Model in Spherical Linguistic Environment
Authors: Chakraborty Avishek , Haque Tipu Sultan , Alam Shariful
Published: July 2024

The main objective of this paper is to introduce the novel concept of spherical linguistic fuzzy number. The spherical linguistic fuzzy number contains linguistic term, positive, neutral and negative membership degrees with the conditions that the square sum of its membership degrees is less than or equal to [Formula: see text]. Then, we discuss some basic operational rules of SLFNs and define a generalized distance measure between two SLFNs. Here, we define two newly aggregation operators, namely, SLFNWA operator and SLFNWG operator. Furthermore, we demonstrate an MCGDM technique using the defined aggregation operator, which has been applied to solve a real-life numerical problem. Finally, rigorous sensitivity analysis and comparative study are given to check the effectiveness, utility and rationality of the proposed operational law and multi-criteria group decision-making technique.
An effective IoT and deep learning-based patient healthcare monitoring system for chronic diseases prediction and classification
Authors: Anil Kumar B. , Kumar Lella Kranthi
Published: July 2024

The state of the environment and human behavior today contributes to a wide range of diseases that affect people. Medical professionals often find it challenging to detect disorders by themselves appropriately; it is crucial to recognize and anticipate them early on. This paper aims to detect and predict people with more widespread chronic illnesses. To prevent such diseases from worsening, this research proposes a new deep learning-based technique to predict chronic diseases. Initially, patient data will be collected using Internet of Things (IoT) devices. Then, the missing values from input data are eliminated, and categorical data encoding, outlier detection, and data transformation are performed in the pre-processing stage. After that, the necessary attributes are selected to optimize the performance by eliminating unnecessary features using Binary Grasshopper Whale Optimization Algorithm (BGWOA), which combines the benefits of the Binary Grasshopper Optimization Algorithm (BGOA) and Binary Whale Optimization Algorithm (BWOA) algorithms. Then, the disease can be classified as chronic or not, utilizing a three-layer stacked bidirectional long short-term memory (TLSBLSTM) technique. The performance is evaluated on two chronic disease datasets that are publicly available. It successfully obtained good results by preparing the dataset on heart disease and comparing the findings using the most recent state-of-the-art approaches. According to the experimental findings, the proposed approach performs better in evaluating performance measures than the existing approaches. The observed accuracy of the proposed method is 99.87% and 99.84% for chronic kidney disease dataset and cardiovascular disease dataset, respectively.
Reconstruction-Free Image Compression for Machine Vision via Knowledge Transfer
Authors: Tu Hanyue , Li Li , Zhou Wengang , Li Houqiang
Published: July 2024

Reconstruction-free image compression for machine vision aims to perform machine vision tasks directly on compressed-domain representations instead of reconstructed images. Existing reports have validated the feasibility of compressed-domain machine vision. However, we observe that when using recently learned compression models, the performance gap between compressed-domain and pixel-domain vision tasks is still large due to the lack of some natural inductive biases in pixel-domain convolutional neural networks. In this article, we attempt to address this problem by transferring knowledge from the pixel domain to the compressed domain. A knowledge transfer loss defined at both output level and feature level is proposed to narrow the gap between the compressed domain and the pixel domain. In addition, we modify neural networks for pixel-domain vision tasks to better suit compressed-domain inputs. Experimental results on several machine vision tasks show that the proposed method improves the accuracy of compressed-domain vision tasks significantly, which even outperforms learning on reconstructed images while avoiding the computational cost of image reconstruction.