bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the effectiveness of using flipped classroom in puncture skills teaching
Authors: Zhang Weihao , Jiang Miao , Zhao Wei , Li Shuai , Li Fan , Feng Feifei , Wang Yongjing , Li Yan , Liu Lan
Published: February 2024

Background

The effectiveness of flipped classroom (FC) on puncture skills in medical education is still uncertain. This study aimed to assess the role of the FC model in puncture skills and investigate the acceptance and approval of FC among medical students and instructors.

Methods

A mixed research approach of quasi-experimental research design and descriptive qualitative research was conducted in September 2022 for one month, using an FC teaching method that combined instructional videos and group learning. The study participants were 71 fifth-year medical students from two classes at a Chinese medical school and four instructors. The medical students were randomly divided into two groups: the traditional classroom (TC) group (Group A) and the FC group (Group B). For teaching, Group B used FC, and Group A used PowerPoint-based TC. The effectiveness of the two teaching models was assessed with Objective Structured Clinical Examination (OSCE), and questionnaires were distributed to the medical students and instructors after the assessment. Two independent sample t-tests were used to analyse the differences in demographic data and the OSCE scores of the two groups of medical students.

Results

Group B scored higher in puncture skills than Group A, especially regarding abdominal puncture (p = 0.03), thoracentesis (p < 0.001), bone marrow puncture (p < 0.001) and average performance of puncture skills (p < 0.001). For lumbar puncture, no difference in skill scores was observed between groups A and B (p > 0.409). The medical students thought that the FC improved their self-learning ability and helped them acquire knowledge. Regarding the OSCE of their skills, most medical students thought that it was more innovative and objective than traditional examinations and that it was better for assessing their overall abilities. Both the FC and OSCE were supported by the medical students. The instructors were also satisfied with the students’ performance in the FC and supported the teaching model, agreeing to continue using it.

Conclusions

This study shows that FC teaching that combines instructional videos and group learning is a reliable and well-received teaching method for puncture skills, which supplements and expands existing teaching methods in the medical field.
Developing a competency framework for training with simulations in healthcare: a qualitative study
Authors: Zafošnik Uroš , Cerovečki Venija , Stojnić Nataša , Belec Anja Poženel , Klemenc-Ketiš Zalika
Published: February 2024

Background

Simulation is a technique used to create an experience without going through the real event. Competency-based medical education focuses on outcomes and ensures professionals have the necessary knowledge, skills, and attitudes. The purpose of this study was to develop a set of competencies for the instructors providing basic and advanced levels of simulation-based training in healthcare.

Methods

We conducted a qualitative study in three steps, with each next step building on and influenced by the previous one. First, we conducted a literature review, then a consensus development panel, and finally a three-step Delphi process. The participants were experts in the fields of healthcare, education, and simulations.

Results

The six main competencies identified for the instructor providing simulation-based training at the basic level in healthcare include knowledge of simulation training, education/training development, education/training performance, human factors, ethics in simulation, and assessment. An instructor providing simulation-based training at an advanced level in healthcare should also possess the following five competencies: policies and procedures, organisation and coordination, research, quality improvement, and crisis management.

Conclusion

The identified competencies can serve as a valuable resource for simulation educators and organisations involved in simulation education, to plan curriculum and implement a continuous train-the-trainers programme.
Improving care for veterans’ environmental exposure concerns: applications of the consolidated framework for implementation research in program evaluation
Authors: Bloeser Katharine , Kimber Justin M. , Santos Susan L. , Krupka Chana B. , McAndrew Lisa M.
Published: February 2024

Background

Healthcare systems, like the US Department of Veterans Affairs (VA), need policies and procedures for delivering care to special populations including those with environmental exposure concerns. Despite being common and pervasive, especially among Veterans, environmental exposures are largely overlooked by healthcare providers. To successfully implement care for Veterans with military environmental exposure concerns, an understanding of contextual factors impeding care on the provider (e.g., knowledge and beliefs) and organizational (e.g., leadership’s priorities) level is needed. Our goal was to conduct an operational needs assessment of providers to examine provider educational needs regarding Veterans’ military environmental exposure concerns.

Methods

In 2020, we surveyed 2,775 VA medical and behavioral health providers. Our cross-sectional assessment was informed by the Consolidated Framework for Implementation Research (CFIR) and assessed barriers and facilitators to the uptake and application of knowledge regarding interdisciplinary care for environmental exposure concerns. The web-based survey was emailed to providers across the United States representing a variety of disciplines and practice settings to reflect the interdisciplinary approach to care for environmental exposures. We used bivariate statistics to investigate the intervention setting, inner setting, and individual characteristics of providers regarding care for environmental exposure concerns.

Results

Approximately one-third of VA medical and behavioral health clinicians report low to no knowledge of environmental exposure concerns. We find 88% of medical and 91% of behavioral health providers report they are ready to learn more about environmental exposures. Half of medical and behavioral health providers report they have access to information on environmental exposures and less than half report care for environmental exposures is a priority where they practice.

Conclusions

Our findings suggest interdisciplinary providers’ knowledge of and discussion with Veterans about environmental exposures may be influenced by contextual factors at the organizational level. Considering individual-level factors and organizational culture is important to consider when supporting care for environmental exposures. Since this needs assessment, VA established targeted programs to improve care related to military environmental exposures in response to legislation; future exploration of these same variables or contextual factors is warranted.
First insights on the susceptibility of native coccidicidal fungi Mucor circinelloides and Mucor lusitanicus to different avian antiparasitic drugs
Authors: Lozano João , Cunha Eva , de Carvalho Luís Madeira , Paz-Silva Adolfo , Oliveira Manuela
Published: February 2024

Background

The combined application of predatory fungi and antiparasitic drugs is a sustainable approach for the integrated control of animal gastrointestinal (GI) parasites. However, literature addressing the possible interference of antiparasitic drugs on the performance of these fungi is still scarce. This research aimed to assess the in vitro susceptibility of six native coccidicidal fungi isolates of the species Mucor circinelloides and one Mucor lusitanicus isolate to several antiparasitic drugs commonly used to treat GI parasites’ infections in birds, namely anthelminthics such as Albendazole, Fenbendazole, Levamisole and Ivermectin, and anticoccidials such as Lasalocid, Amprolium and Toltrazuril (drug concentrations of 0.0078–4 µg/mL), using 96-well microplates filled with RPMI 1640 medium, and also on Sabouraud Agar (SA).

Results

This research revealed that the exposition of all Mucor isolates to the tested anthelminthic and anticoccidial drug concentrations did not inhibit their growth. Fungal growth was recorded in RPMI medium, after 48 h of drug exposure, as well as on SA medium after exposure to the maximum drug concentration.

Conclusions

Preliminary findings from this research suggest the potential compatibility of these Mucor isolates with antiparasitic drugs for the integrated control of avian intestinal parasites. However, further in vitro and in vivo studies are needed to confirm this hypothesis.
Identifying functional subtypes of IgA nephropathy based on three machine learning algorithms and WGCNA
Authors: Ren Hongbiao , Lv Wenhua , Shang Zhenwei , Li Liangshuang , Shen Qi , Li Shuai , Song Zerun , Cheng Xiangshu , Meng Xin , Chen Rui , Zhang Ruijie
Published: February 2024

Background

IgA nephropathy (IgAN) is one of the most common primary glomerulonephritis, which is a significant cause of renal failure. At present, the classification of IgAN is often limited to pathology, and its molecular mechanism has not been established. Therefore we aim to identify subtypes of IgAN at the molecular level and explore the heterogeneity of subtypes in terms of immune cell infiltration, functional level.

Methods

Two microarray datasets (GSE116626 and GSE115857) were downloaded from GEO. Differential expression genes (DEGs) for IgAN were screened with limma. Three unsupervised clustering algorithms (hclust, PAM, and ConsensusClusterPlus) were combined to develop a single-sample subtype random forest classifier (SSRC). Functional subtypes of IgAN were defined based on functional analysis and current IgAN findings. Then the correlation between IgAN subtypes and clinical features such as eGFR and proteinuria was evaluated by using Pearson method. Subsequently, subtype heterogeneity was verified by subtype-specific modules identification based on weighted gene co-expression network analysis(WGCNA) and immune cell infiltration analysis based on CIBERSORT algorithm.

Results

We identified 102 DEGs as marker genes for IgAN and three functional subtypes namely: viral-hormonal, bacterial-immune and mixed type. We screened seventeen genes specific to viral hormonal type (ATF3, JUN and FOS etc.), and seven genes specific to bacterial immune type (LIF, C19orf51 and SLPI etc.). The subtype-specific genes showed significantly high correlation with proteinuria and eGFR. The WGCNA modules were in keeping with functions of the IgAN subtypes where the MEcyan module was specific to the viral-hormonal type and the MElightgreen module was specific to the bacterial-immune type. The results of immune cell infiltration revealed subtype-specific cell heterogeneity which included significant differences in T follicular helper cells, resting NK cells between viral-hormone type and control group; significant differences in eosinophils, monocytes, macrophages, mast cells and other cells between bacterial-immune type and control.

Conclusion

In this study, we identified three functional subtypes of IgAN for the first time and specific expressed genes for each subtype. Then we constructed a subtype classifier and classify IgAN patients into specific subtypes, which may be benefit for the precise treatment of IgAN patients in future.
The preventive effects of Lactobacillus casei 03 on Escherichia coli-induced mastitis in vitro and in vivo
Authors: Li Ke , Yang Ming , Tian Mengyue , Jia Li , Wu Yinghao , Du Jinliang , Yuan Lining , Li Lianmin , Ma Yuzhong
Published: February 2024

Background

Lactobacillus casei possesses many kinds of bioactivities, such as anti-inflammation and anti-oxidant, and has been applied to treating multiple inflammatory diseases. However, its role in mastitis prevention has remained ambiguous.

Methods

This study aimed to examine the mechanisms underlying the preventive effects of L. casei 03 against E. coli- mastitis utilizing bovine mammary epithelial cells (BMECs) and a mouse model.

Results

In vitro assays revealed pretreatment with L. casei 03 reduced the apoptotic ratio and the mRNA expression levels of IL1β, IL6 and TNFα and suppressed phosphorylation of p65, IκBα, p38, JNK and ERK in the NF-κB signaling pathway and MAPK signaling pathway. Furthermore, in vivo tests indicated that intramammary infusion of L. casei 03 relieved pathological changes, reduced the secretion of IL1β, IL6 and TNFα and MPO activity in the mouse mastitis model.

Conclusions

These data suggest that L. casei 03 exerts protective effects against E. coli-induced mastitis in vitro and in vivo and may hold promise as a novel agent for the prevention and treatment of mastitis.
Predictive accuracy of boosted regression model in estimating risk of venous thromboembolism following minimally invasive radical surgery in pharmacological prophylaxis-naïve men with prostate cancer
Authors: Leong Chie Hui , Ranjan Sushil Rodrigues , Javed Anna , Alsaedi Basim S.O. , Nabi Ghulam
Published: February 2024

Background

Venous thromboembolism (VTE) is a potentially life-threatening but preventable complication after urological surgery. Physicians are faced with the challenges of weighing the risks and benefits of thromboprophylaxis given scanty evidence for or against and practice variation worldwide.

Objective

The primary objective of the study was to explore the possibility of a risk-stratified approach for thromboembolism prophylaxis following radical prostatectomy.

Design, setting, and participants

A prospective database was accessed to cross-link venous thromboembolism events in 522 men who underwent minimally invasive prostatectomy between February 2010 and October 2021. A deterministic data linkage method was used to record events through electronic systems. Community Health Index (CHI) numbers were used to identify patients via electronic health records. Patient demographics and clinical characteristics such as age, comorbidities, Gleason staging, and readmission details accrued.

Outcomes

VTE within 90 days and development of a risk-stratified scoring system. All statistical analysis was performed using R-Statistical Software and the risk of VTE within 90 days of surgery was estimated via gradient-boosting decision trees (BRT) model.

Results and limitations

1.1% (6/522) of patients developed deep vein thrombosis or pulmonary embolism within 3 months post-minimally invasive prostatectomy. Statistical analysis demonstrated a significant difference in the body mass index (p = 0.016), duration of hospital stay (p < 0.001), and number of readmissions (p = 0.036) between patients who developed VTE versus patients who did not develop VTE. BRT analysis found 8 variables that demonstrated relative importance in predicting VTE. The receiver operating curves (ROC) were constructed to assess the discrimination power of a new model. The model showed an AUC of 0.97 (95% confidence intervals [CI]: 0.945,0.999). For predicting VTE, a single-center study is a limitation.

Conclusions

The incidence of VTE post-minimally invasive prostatectomy in men who did not receive prophylaxis with low molecular weight heparin is low (1.1%). The proposed risk-scoring system may aid in the identification of higher-risk patients for thromboprophylaxis.

Patient summary

In this report, we looked at the outcomes of venous thromboembolism following minimally invasive radical prostatectomy for prostate cancer in consecutive men. We developed a new scoring system using advanced statistical analysis. We conclude that the VTE risk is very low and our model, if applied, can risk stratify men for the development of VTE following radical surgery for prostate cancer.
Psychometric validation of four-item exercise identity and healthy-eater identity scales and applications in weight loss maintenance
Authors: Caldwell Ann E. , More Kimberly R. , Chui Tsz Kiu , Sayer R. Drew
Published: February 2024

Background

Identifying as someone who engages in health promoting behaviors like healthy eating and exercising may be associated with sustained engagement in those behaviors, but reliable and valid instruments are needed to improve the rigor of this research. Two studies were conducted to (1) examine the psychometric properties of a four-item exerciser identity measure (4-EI) and an adapted healthy-eater identity measure (4-HEI) and (2) examine differences in identity strengths across categories of weight loss success.

Methods

Data from 1,709 community dwelling adults in the International Weight Control Registry (IWCR) were used. A random half of the sample was used to assess the proposed unidimensional factor structure of the 4-EI and 4-HEI and examine convergent and discriminant validity using Spearman rank-order correlations. One-way ANOVA was used in the other random half of the sample to compare 4-EI and 4-HEI scores (-3 to + 3) across three self-defined weight loss categories (‘Successful’, ‘Regain’, and ‘Unsuccessful’) and those maintaining ≥ 5% weight loss for > 1 year vs. not.

Results

Results support the unidimensional factor structure with all four items (eigenvalue scores > 2.89) as well as convergent and discriminant validity for both measures. Exercise identity was strongly correlated with self-reported physical activity (r (735) = 0.52, p <.001) and measures of autonomous motivation. Healthy eating identity was moderately correlated with cognitive restraint in eating (r (744) = 0.42, p <.001) and other measures predictive of eating behavior. 4-EI and 4-HEI are stronger in Successful (4-EI: M = 0.90, SD = 1.77; 4-HEI: M = 1.56 SD = 1.37) vs. Regain (4-EI: M=-0.18, SD = 1.68; 4-HEI: M =.57, SD = 1.48) and Unsuccessful (4-EI:M=-0.28, SD = 1.62; 4-HEI: M = 0.51, SD = 1.33) and those maintaining ≥ 5% weight loss (4-EI:M = 0.47, SD = 1.78; 4-HEI: M = 1.13, SD = 1.49) vs. not (4-EI:M=-0.27, SD = 1.66; 4-HEI: M = 0.53, SD = 1.47), p’s < 0.001.

Conclusions

The 4-EI and 4-HEI have acceptable psychometric properties and can advance understanding of the role of identity in exercise and dietary behaviors and weight loss maintenance.

Trial registration

The parent observational study, International Weight Control Registry (IWCR), for these sub-studies is registered in ClinicalTrials.gov (NCT04907396).
Identification and characterisation of Gamma-herpesviruses in zoo artiodactyla
Authors: Bianchessi Laura , Flach Edmund , Monacchia Giulia , Dagleish Mark , Maley Madeleine , Turin Lauretta , Rocchi Mara Silvia
Published: February 2024

Background

Viruses within the γ-herpesviruses subfamily include the causative agents of Malignant Catarrhal Fever (MCF) in several species of the order Artiodactyla. MCF is a usually fatal lymphoproliferative disease affecting non-adapted host species. In adapted host species these viruses become latent and recrudesce and transmit during times of stress or immunosuppression. The undetected presence of MCF-causing viruses (MCFVs) is a risk to non-adapted hosts, especially within non-sympatric zoological collections. This study investigated the presence of MCFVs in six different zoological collections in the UK, to evaluate the presence of subclinical/latent MCFVs in carrier animals.

Methods

One-hundred and thirty eight samples belonging to 54 different species of Artiodactyla were tested by Consensus Pan-herpes PCR. The positive samples were sequenced and subjected to phylogenetic analyses to understand their own evolutionary relationships and those with their hosts.

Results

Twenty-five samples from 18 different species tested positive. All viruses but one clustered in the γ-herpesvirus family and within the Macavirus as well as the non-Macavirus groups (caprinae and alcelaphinae/hippotraginae clusters, respectively). A strong association between virus and host species was evident in the Macavirus group and clustering within the caprinae group indicated potential pathogenicity.

Conclusion

This study shows the presence of pathogenic and non-pathogenic MCFVs, as well as other γ-herpesviruses, in Artiodactyla species of conservation importance and allowed the identification of new herpesviruses in some non-adapted species.
Vancomycin and nisin-modified magnetic Fe3O4@SiO2 nanostructures coated with chitosan to enhance antibacterial efficiency against methicillin resistant Staphylococcus aureus (MRSA) infection in a murine superficial wound model
Authors: Nasaj Mona , Farmany Abbas , Shokoohizadeh Leili , Jalilian Farid Aziz , Mahjoub Reza , Roshanaei Ghodratollah , Nourian Alireza , Shayesteh Omid Heydari , Arabestani Mohammadreza
Published: February 2024

Background

The objective of this research was to prepare some Fe3O4@SiO2@Chitosan (CS) magnetic nanocomposites coupled with nisin, and vancomycin to evaluate their antibacterial efficacy under both in vitro and in vivo against the methicillin-resistant Staphylococcus. aureus (MRSA).

Methods

In this survey, the Fe3O4@SiO2 magnetic nanoparticles (MNPs) were constructed as a core and covered the surface of MNPs via crosslinking CS by glutaraldehyde as a shell, then functionalized with vancomycin and nisin to enhance the inhibitory effects of nanoparticles (NPs). X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FT-IR), field emission scanning electron microscope (FE-SEM), vibrating sample magnetometer (VSM), and dynamic light scattering (DLS) techniques were then used to describe the nanostructures.

Results

Based on the XRD, and FE-SEM findings, the average size of the modified magnetic nanomaterials were estimated to be around 22–35 nm, and 34–47 nm, respectively. The vancomycin was conjugated in three polymer-drug ratios; 1:1, 2:1 and 3:1, with the percentages of 45.52%, 35.68%, and 24.4%, respectively. The polymer/drug ratio of 1:1 exhibited the slowest release rate of vancomycin from the Fe3O4@SiO2@CS-VANCO nanocomposites during 24 h, which was selected to examine their antimicrobial effects under in vivo conditions. The nisin was grafted onto the nanocomposites at around 73.2–87.2%. All the compounds resulted in a marked reduction in the bacterial burden (P-value < 0.05).

Conclusion

The vancomycin-functionalized nanocomposites exhibited to be more efficient in eradicating the bacterial cells both in vitro and in vivo. These findings introduce a novel bacteriocin–metallic nanocomposite that can suppress the normal bacterial function on demand for the treatment of MRSA skin infections.
Frequency of Anaplasma phagocytophilum, Borrelia spp., and coinfections in Ixodes ricinus ticks collected from dogs and cats in Germany
Authors: Probst Julia , Springer Andrea , Fingerle Volker , Strube Christina
Published: February 2024

Background

Changing geographical and seasonal activity patterns of ticks may increase the risk of tick infestation and tick-borne pathogen (TBP) transmission for both humans and animals.

Methods

To estimate TBP exposure of dogs and cats, 3000 female I. ricinus from these hosts were investigated for Anaplasma phagocytophilum and Borrelia species.

Results

qPCR inhibition, which was observed for ticks of all engorgement stages but not questing ticks, was eliminated at a template volume of 2 µl. In ticks from dogs, A. phagocytophilum and Borrelia spp. prevalence amounted to 19.0% (285/1500) and 28.5% (427/1500), respectively, while ticks from cats showed significantly higher values of 30.9% (464/1500) and 55.1% (827/1500). Accordingly, the coinfection rate with both A. phagocytophilum and Borrelia spp. was significantly higher in ticks from cats (17.5%, 262/1500) than dogs (6.9%, 104/1500). Borrelia prevalence significantly decreased with increasing engorgement duration in ticks from both host species, whereas A. phagocytophilum prevalence decreased only in ticks from dogs. While A. phagocytophilum copy numbers in positive ticks did not change significantly over the time of engorgement, those of Borrelia decreased initially in dog ticks. In ticks from cats, copy numbers of neither A. phagocytophilum nor Borrelia spp. were affected by engorgement. Borrelia species differentiation was successful in 29.1% (365/1254) of qPCR-positive ticks. The most frequently detected species in ticks from dogs were B. afzelii (39.3% of successfully differentiated infections; 70/178), B. miyamotoi (16.3%; 29/178), and B. valaisiana (15.7%; 28/178), while B. afzelii (40.1%; 91/227), B. spielmanii (21.6%; 49/227), and B. miyamotoi (14.1%; 32/227) occurred most frequently in ticks from cats.

Conclusions

The differences in pathogen prevalence and Borrelia species distribution between ticks collected from dogs and cats may result from differences in habitat overlap with TBP reservoir hosts. The declining prevalence of A. phagocytophilum with increasing engorgement duration, without a decrease in copy numbers, could indicate transmission to dogs over the time of attachment. The fact that this was not observed in ticks from cats may indicate less efficient transmission. In conclusion, the high prevalence of A. phagocytophilum and Borrelia spp. in ticks collected from dogs and cats underlines the need for effective acaricide tick control to protect both animals and humans from associated health risks.

Graphical Abstract
The efficacy and safety of exercise regimens to mitigate chemotherapy cardiotoxicity: a systematic review and meta-analysis of randomized controlled trials
Authors: Amin Ahmed Mazen , Khlidj Yehya , Abuelazm Mohamed , Ibrahim Ahmed A. , Tanashat Mohammad , Imran Muhammad , Nazir Abubakar , Shaikhkhalil Hosam , Abdelazeem Basel
Published: February 2024

Background

Cardiotoxicity is one of the most common adverse events of the chemotherapy. Physical exercise was shown to be cardioprotective. We aim to estimate the efficacy and safety of exercise in cancer patients receiving cardiotoxic chemotherapy.

Methods

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, Web of Science, SCOPUS, Cochrane, Clinical Trials.gov, and MedRxiv through July 17th, 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI). PROSPERO ID: CRD42023460902.

Results

We included thirteen RCTs with a total of 952 patients. Exercise significantly increased VO2 peak (MD: 1.95 with 95% CI [0.59, 3.32], P = 0.005). However, there was no significant effect regarding left ventricular ejection fraction, global longitudinal strain, cardiac output, stroke volume, left ventricular end-diastolic volume, left ventricular end-systolic volume, E/A ratio, resting heart rate, peak heart rate, resting systolic blood pressure, and resting diastolic blood pressure. Also, there was no significant difference regarding any adverse events (AEs) (RR: 4.44 with 95% CI [0.47, 41.56], P = 0.19), AEs leading to withdrawal (RR: 2.87 with 95% CI [0.79, 10.43], P = 0.11), serious AEs (RR: 3.00 with 95% CI [0.14, 65.90], P = 0.49), or all-cause mortality (RR: 0.25 with 95% CI [0.03, 2.22], P = 0.21).

Conclusion

Exercise is associated with increased VO2 peak in cancer patients receiving cardiotoxic chemotherapy. However, there was no significant difference between exercise and usual care regarding the echocardiographic and safety outcomes.
Improved electrical coupling integrated energy system based on particle swarm optimization
Authors: Wang Lei
Published: February 2024

The rational utilization of energy is an important issue for sustainable development. Electrically coupled integrated energy systems can enhance energy utilization efficiency and reduce energy costs. However, traditional integrated energy system optimization has problems with local optima and slow convergence speed, which cannot fully utilize energy resources. Therefore, this study proposes an improved electrical coupling integrated energy system on the ground of particle swarm optimization algorithm. In response to the problems of local optima and slow convergence speed in traditional optimization algorithms, particle swarm optimization algorithm is introduced for system optimization. By combining PSO with simulated annealing algorithm, the possibility of PSO in global optimization is reduced. The local search ability of PSO and the global search ability of simulated annealing algorithm are used to find the optimal solution. The particle swarm optimization algorithm is used for preliminary search. When the particle falls into the local optimal, the simulated annealing algorithm is introduced for global search, and the particle is guided to jump out of the local optimal and continue searching. The experiment demonstrates that the improved algorithm has certain advantages in solving test functions. The variance, mean, and optimal values are 0.00125, 0.13874, and 0.105531, respectively, which are all better than the particle swarm optimization algorithm. The simulated annealing algorithm improved the particle swarm optimization algorithm with a high accuracy index, which eventually stabilized above 0.9, and the recall index also remained above 0.8. After 100 iterations, it had already fallen into a local optimal solution. By applying the improved hybrid optimization algorithm to the electrically-coupled integrated energy system, the distribution of various energy sources can be managed and optimized more effectively, and the overall performance of the system can be improved. Especially when dealing with complex energy scheduling and distribution problems, the algorithm can provide more stable, efficient and reliable solutions. This study can achieve efficient operation and optimized scheduling of integrated energy systems, reduce energy consumption and environmental pollution, and reduce energy costs. And it can improve the reliability and stability of energy supply, which has important application value and research significance.
Can ultrasound shear wave elastography differentiate between malignant and benign pleural effusions?
Authors: Taymour Takeya Ahmed , Mohamed Libya Saleh Wasel , El Hinnawy Yasmine Hamdy , El-Mageed Mohammed Raafat Abd
Published: February 2024

Background

Malignant pleural effusion is a common and unfortunately serious condition that is related to life poor quality and mortality. The majority of malignant pleural effusion is metastatic in nature, with the most encountered primary neoplasm in men is the lung cancer while in women is the breast cancer. Ultrasound elastography, with its ability of evaluating tissue stiffness, has been used to differentiate malignant from benign diseases. Shear wave elastography (SWE) has been explored in several organs, like the liver, breast, thyroid, lymph nodes and prostate, with the pleura can now be included among the growing list of SWE applications. Shear wave elastography may help in the differentiation of transudative and exudative types of pleural effusions.

Results

In this study, a total of 36 patients were included, 50% revealed malignant pleural effusions (10/18 mesothelioma) and (8/18 metastatic), while the 50% revealed benign pleural effusions (9/18 transudates) and (9/18 exudates). By using sensitivity analysis test of the SWE values with V1 represents the minimum value, V2 the maximum value to calculate the cutoff values that will be used in our final diagnosis in order to differentiate benign and malignant cases. V1 shear wave elastography can significantly predict the malignant pleural effusion with p value 0.001 using a cutoff 48 kPa with calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were as follows 94.4%, 88.9%, 89.5% & 94.4% respectively with diagnostic accuracy of 92%. SWE maximum value (V2) can significantly predict the malignant pleural effusion with p value 0.001 using a cutoff 54.2 kPa, with calculated sensitivity, specificity, PPV and NPV were as follows 94.4%, 94.4%, 94.4% and 94.4% respectively with diagnostic accuracy 94.4%. So, through comparing both cutoff values, we concluded that the cutoff value 2 is better with greater specificity, PPV and NPV in relation to the final diagnosis.

Conclusions

Combination of both conventional transthoracic ultrasound and SWE quantitative and qualitative abilities in assessment of both pleural and parenchymal lesions can result in high diagnostic accuracy. Shear wave elastography alone is a sensitive, specific, useful, cost-effective, widely available and noninvasive tool for assessment of tissue stiffness and in matters of high sensitivity. 54.2 kPa can be used as the cutoff value to distinguish MPE from benign pleural disease.
Sensor placement algorithm for faults detection in electrical secondary distribution network using dynamic programming method: focusing on dynamic change and expansion of the network configurations
Authors: Mnyanghwalo Daudi Charles , Kawambwa Shamte Juma
Published: February 2024

Modern power grids are developing toward smartness through the use of sensors in gathering data for situation awareness, visibility, and fault detection. In most developing countries, fault detection in the electrical secondary distribution network (SDN) is very challenging due to the lack of automated systems for network monitoring. Systems for monitoring faults require sensor placement on each node, which is not economically feasible. Hence, optimal placement algorithms are required to ensure that the network is observable with few sensors possible. The existing sensor placement methods based on mathematical and heuristic approaches are efficient for transmission and primary distribution networks which are mostly static in size and layout. Such methods may not be efficient in SDN which is dynamic in size and have a relatively large number of nodes. This study proposes an enhanced dynamic programming method for sensor placement to enhance fault detection in SDN. The proposed algorithm employs the depth search concepts and the parent–children relationship between nodes to determine sensor types and locations considering the optimal cost. The proposed algorithm was compared with other methods including particle swarm optimization, genetic algorithm, and chaotic crow search algorithm using different network configurations. The results revealed that the proposed algorithm suggested the minimum number of sensors and shortest convergence time of 1.27 min. The results also revealed that, on network expansion, maintaining the location of the existing sensors is more cost-effective by 20% than reallocating the existing sensors. Furthermore, the results revealed that an average of 30% of nodes, need sensors to observe the entire network, hence cost optimization.
Revealing complexity: segmentation of hippocampal subfields in adolescents with major depressive disorder reveals specific links to cognitive dysfunctions
Authors: Zhang Yixin , Liu Xuan , Yang Ying , Zhang Yihao , He Qiang , Xu Feiyu , Jin Xinjuan , Gao Junqi , Yao Yuan , Yu Dexin , Hommel Bernhard , Zhu Xingxing , Wang Kangcheng , Zhang Wenxin
Published: February 2024

Background

Hippocampal disruptions represent potential neuropathological biomarkers in depressed adolescents with cognitive dysfunctions. Given heterogeneous outcomes of whole-hippocampus analyses, we investigated subregional abnormalities in depressed adolescents and their associations with symptom severity and cognitive dysfunctions.

Methods

MethodsSeventy-nine first-episode depressive patients (ag = 15.54 ± 1.83) and 71 healthy controls (age = 16.18 ± 2.85) were included. All participants underwent T1 and T2 imaging, completed depressive severity assessments, and performed cognitive assessments on memory, emotional recognition, cognitive control, and attention. Freesurfer was used to segment each hippocampus into 12 subfields. Multivariable analyses of variance were performed to identify overall and disease severity-related abnormalities in patients. LASSO regression was also conducted to explore the associations between hippocampal subfields and patients’ cognitive abilities.

Results

Depressed adolescents showed decreases in dentate gyrus, CA1, CA2/3, CA4, fimbria, tail, and molecular layer. Analyses of overall symptom severity, duration, self-harm behavior, and suicidality suggested that severity-related decreases mainly manifested in CA regions and involved surrounding subfields with disease severity increases. LASSO regression indicated that hippocampal subfield abnormalities had the strongest associations with memory impairments, with CA regions and dentate gyrus showing the highest weights.

Conclusions

Hippocampal abnormalities are widespread in depressed adolescents and such abnormalities may spread from CA regions to surrounding areas as the disease progresses. Abnormalities in CA regions and dentate gyrus among these subfields primarily link with memory impairments in patients. These results demonstrate that hippocampal subsections may serve as useful biomarkers of depression progression in adolescents, offering new directions for early clinical intervention.
Exploring Demographic Differences and Outcomes in Early-Onset Colorectal Cancer
Authors: Siromoni Beas , Groman Adrienne , Parmar Kanak , Mukherjee Sarbajit , Vadehra Deepak
Published: February 2024

PURPOSE

Early-onset colorectal cancer (EOCRC), defined as CRC diagnosed before age 50 years, has increased significantly worldwide. The majority of EOCRCs do not appear to be driven by genetic factors and may be influenced by environmental factors. We hypothesized that sociodemographic disparities exist in EOCRC. The purpose was of the study was to examine the geographic disparities in patients with EOCRC.

METHODS

We retrospectively examined the SEER database from 1976 to 2016 to examine the geographic disparities in EOCRC. A total of 73,378 patients with EOCRC were included in the analysis. We performed univariate and multivariable analyses to evaluate overall survival (OS) and disease-specific survival (DSS). Sociodemographic factors, including the location of residence (metropolitan areas [MA] or rural areas [RA]), sex, race, insurance status, and marital status, were included in the statistical analysis.

RESULTS

The incidence and mortality rates were consistently higher in RA versus MA during the study period. Multivariable analysis showed that patients living in RA had worse OS (hazard ratio [HR], 1.14; P < .01) and DSS (HR, 1.15; P < .001) compared with those living in MA. Similarly, non-Hispanic Black ethnicity and uninsured patients had significantly worse survival when compared with non-Hispanic White and insured patients, respectively. Married status showed better survival outcomes.

CONCLUSION

Patients with EOCRC living in RA have worse outcomes. Understanding the mechanisms behind such socioeconomic disparities is important so that future studies can reduce these disparities.
Concordance in Oncogenic Alterations Between the Primary Tumor and Advanced Disease: Insights Into the Heterogeneity of Intrahepatic Cholangiocarcinoma
Authors: McIntyre Sarah M. , Preston William A. , Walch Henry , Sharib Jeremy , Kundra Ritika , Sigel Carlie , Lidsky Michael E. , Allen Peter J. , Morse Michael A. , Chen Wei , Cercek Andrea , Harding James J. , Abou-Alfa Ghassan K. , O'Reilly Eileen M. , Park Wungki , Balachandran Vinod P. , Drebin Jeffrey , Soares Kevin C. , Wei Alice , Kingham T. Peter , D'Angelica Michael I. , Iacobuzio-Donahue Christine , Jarnagin William R.
Published: February 2024

PURPOSE

Intrahepatic cholangiocarcinoma (ICCA) is characterized by significant phenotypic and clinical heterogeneities and poor response to systemic therapy, potentially related to underlying heterogeneity in oncogenic alterations. We aimed to characterize the genomic heterogeneity between primary tumors and advanced disease in patients with ICCA.

METHODS

Biopsy-proven CCA specimens (primary tumor and paired advanced disease [metastatic disease, progressive disease on systemic therapy, or postoperative recurrence]) from two institutions were subjected to targeted next-generation sequencing. Overall concordance (oncogenic driver mutations, copy number alterations, and fusion events) and mutational concordance (only oncogenic mutations) were compared across paired samples. A subgroup analysis was performed on the basis of exposure to systemic therapy. Patients with extrahepatic CCA (ECCA) were included as a comparison group.

RESULTS

Sample pairs from 65 patients with ICCA (n = 54) and ECCA (n = 11) were analyzed. The median time between sample collection was 19.6 months (range, 2.7-122.9). For the entire cohort, the overall oncogenic concordance was 49% and the mutational concordance was 62% between primary and advanced disease samples. Subgroup analyses of ICCA and ECCA revealed overall/mutational concordance rates of 47%/58% and 60%/84%, respectively. Oncogenic concordance was similarly low for pairs exposed to systemic therapy between sample collections (n = 50, 53% overall, 68% mutational). In patients treated with targeted therapy for IDH1/2 alterations (n = 6) or FGFR2 fusions (n = 3), there was 100% concordance between the primary and advanced disease specimens. In two patients, FGFR2 (n = 1) and IDH1 (n = 1) alterations were detected de novo in the advanced disease specimens.

CONCLUSION

The results reflect a high degree of heterogeneity in ICCA and argue for reassessment of the dominant driver mutations with change in disease status.
Association of COVID-19 symptoms and functional status of the COVID-19 survivors in a tertiary health care center in a developing country
Authors: Islam Mohammad Tariqul , Mahjabin Afsana , Islam Md Mahbubul , Tasnim Anika , Khan Fahmida Afroz , Khan Iffat Islam , Alim Abdul , Khasru Moshiur Rahman , Uddin Taslim
Published: February 2024

Background The COVID-19 pandemic has affected people globally, causing widespread illness and functional limitations. Methods This cross-sectional study aimed to investigate the association between COVID-19 symptoms and the functional status of COVID-19 survivors at Bangabandhu Sheikh Mujib Medical University (BSMMU) in Bangladesh. A total of 244 COVID-19 survivors were enrolled in the study, and their symptoms and functional status were assessed using standardized questionnaires. The post-COVID-19 functional status scale (PCFS) was used to assess the entire range of functional outcomes. Results Among the participants 57.4% were male and 42.6% were female. The mean (SD) age of the patients was 44.6 ±14.7 years where 37.7% were from the 20-35 years age group. The mean duration of suffering from COVID-19 was 15.9 ±6.1 days where 61.5 % of the patients had a duration of suffering of 11-20 days. Out of the 244 patients, 40 patients had no functional limitation (grade 0 functional status in the PCFS scale) while 100 had negligible functional limitation and 14 had severe functional limitation. We found patients who were suffering from multi-symptoms were statistically significant with PCFS scale grade 4, whereas grade 1 was found to be statistically significant with only respiratory distress. There was a significant association between the duration of COVID-19 symptoms and post-COVID-19 functional status for patients who experienced symptoms for 14 days or more (p<0.05). Conclusions Considering the negative impact of COVID-19 symptoms on functional status, comprehensive care and support are required for COVID-19 survivors.
Navigating Sample Size Determination in Educational Research: A Rapid Review Unveiling Strategies, Challenges, and Recommendations.
Authors: Besekar Smruti , Jogdand Sangita , Naqvi Waqar
Published: February 2024

Background By conducting an in-depth study of the publications, a review was conducted with the goal of evaluating the sample size in educational research. The sample size, represented by the letter “n,” is a key factor in this research because it specifies the number of participants who represent the target population. Although various studies have been published in the literature defining the processes for calculating sample sizes, there is still much uncertainty. It is vital to understand that there is no single all-encompassing method for determining sample sizes for different study designs. Instead, different study designs call for different approaches to determine sample numbers. Methods Information was retrieved from the databases in accordance with updated PRISMA recommendations. The keywords used for the retrieval of the relevant articles from two databases (Google Scholar and PubMed). The articles were selected by thorough scrutiny and application of inclusion and exclusion criteria. Results Seven articles were selected from the 9282 articles. The comparison was made among the studies in the relation to methods, objective, and outcome from the enrolled studies. Conclusions The evaluation of the seven studies as a whole concluded that the sample size for testing any novel approach essentially required 24.24 participants in each group. The median sample size for the simulation-based educational research was 30. Further research is required to determine the proper sample size based on a single universal formula for all types of designs.
Erratum to “Consumer Choice Under Limited Attention When Alternatives Have Different Information Costs”
Authors: Huettner Frank , Boyacı Tamer , Akçay Yalçın
Published: February 2024

There is an error in one of the results of our paper [Huettner F, Boyacı T, Akçay Y (2019) Consumer choice under limited attention when alternatives have different information costs. Oper. Res. 67(3):671–699]. In this erratum, we point out the error and provide a correction based on Walker-Jones [(2023) Rational inattention with multiple attributes. J. Econom. Theory 212:105688]. Our key characterizations, insights, and numerical examples do not depend on this error and, hence, remain valid. The main implication is on the stopping condition used in the algorithm. We propose a fix based on the new sufficient condition and, if needed, standard convex optimization techniques.
Managing Web-based Information Resources Under Uncertainty: A Probabilistic Approach
Authors: Omri Asma , Omri Mohamed-Nazih
Published: February 2024

“Uncertainty” is related to working with inaccurate data, imprecise and incomplete information, and unreliable results that can lead to irrational decisions. Several approaches to managing uncertain data on the Web have been proposed in the literature to resolve this problem. These approaches have failed to find the solution to this problem with accuracy and performance. Our study aims to propose a new probabilistic approach to manage Web information resources in an uncertain large-scale cloud environment. Our approach is based on three main steps: (1) modelling uncertain Web resources, (2) computing HTTP request model, and (3) interpretation and evaluation of uncertain Web resources in a context of classic hypertext navigation. The experimental study shows that the analysis of the execution time necessary for the composition of the services, by our approach, is negligible, compared to that of the other studied approaches. The algorithm that deals with the impact of the variation in the number of nodes, which we have proposed, has also been evaluated and checks all the possibilities in polynomial time and can adapt to many possibilities of multiplexing of values.