bluuebunny/crossref_metadata_2025 huggingface dataset:
Process evaluation of the implementation of the ABC method, an intervention for nurses dealing with challenging behaviour of patients with brain injury
Authors: Pouwels Climmy , Spauwen Peggy , Verbeek Hilde , Winkens Ieke , Ponds Rudolf
Published: May 2024

Background

Introducing new working methods is common in healthcare organisations. However, implementation of a new method is often suboptimal. This reduces the effectiveness of the innovation and has several other negative effects, for example on staff turnover. The aim of the current study was to implement the ABC method in residential departments for brain injured patients and to assess the quality of the implementation process. The ABC method is a simplified form of behavioural modification based on the concept that behaviour operates on the environment and is maintained by its consequences.

Methods

Four residential departments for brain injured patients introduced the ABC method sequentially as healthcare innovation using a stepped-wedge design. A systematic process evaluation of the implementation was carried out using the framework of Saunders et al. Descriptive statistics were used to analyse the quantitative data; open questions were clustered.

Results

The training of the ABC method was well executed and the nursing staff was enthusiastic and sufficiently involved. Important aspects for successful implementation had been addressed (like a detailed implementation plan and implementation meetings). However, facilitators and barriers that were noted were not addressed in a timely manner. This negatively influenced the extent to which the ABC method could be properly learned, implemented, and applied in the short and long term.

Conclusions

The most challenging part of the introduction of this new trained and introduced method in health care was clearly the implementation. To have a successful implementation serious attention is needed to tailor-made evidence-based implementation strategies based on facilitators and barriers that are identified during the implementation process. Bottlenecks in working with the ABC method have to be addressed as soon as possible. This likely requires ‘champions’ who are trained for the job, next to an organisation’s management that facilitates the multidisciplinary teams and provides clarity about policy and agreements regarding the training and implementation of the new method. The current process evaluation and the recommendations may serve as an example for the implementation of new methods in other healthcare organisations.
Epidemic preparedness and innovations in digital healthcare: enhancing post-pandemic speech-language pathology services for child and adolescent mental health in Qatar
Authors: Amro Abdullah , Kotkot Hanan Abdallah , Albobali Yahia , Chandra Prem , Khan Yasser Saeed
Published: May 2024

Background

This paper discusses the critical importance of epidemic preparedness and innovations in digital health care by examining the transformative impact on speech-language pathology (SLP) services in a specialist outpatient child and adolescent service (CAMHS).

Method

This retrospective review analyzes referral data from three periods: pre-pandemic (15 March 2019–14 March 2020), pandemic (15 March 2020–14 March 2021), and post-pandemic (15 March 2021–14 March 2022). Statistical analyses assess trends in referrals and diagnoses during these periods. Feedback was also obtained from Parents of children who received virtual consultations during the pandemic.

Results

The results reveal an increase in the demand for SLP services during and after the pandemic, with a surge in referrals (increased from 9.7 to 12.9% when compared pre-pandemic to post-pandemic periods; Chi-Square value 3.33, P = 0.068) for children with social communication challenges and autism spectrum disorder. Phone and video consultations were effectively adopted. Feedback from families shows a positive response (69%–98% of participants responded as strongly agreed and agreed on various items listed in feedback form specifically designed in line with the service objectives) to telehealth interventions, with many parents finding virtual consultations effective and helpful.

Conclusions

The study emphasizes the importance of telehealth SLP services in meeting the increasing demand for mental health interventions among children and adolescents. It suggests integrating telehealth into clinical practice beyond the pandemic and highlights the need for long-term evaluation and addressing potential barriers to access.
Universal health coverage and equal access in Sweden: a century-long perspective on macro-level policy
Authors: Fredriksson Mio
Published: May 2024

Background

When today’s efforts to achieve universal health coverage are mainly directed towards low-income settings, it is perhaps easy to forget that countries considered to have universal, comprehensive and high-performing health systems have also undergone this journey. In this article, the aim is to provide a century-long perspective to illustrate Sweden’s long and ongoing journey towards universal health coverage and equal access to healthcare.

Methods

The focus is on macro-level policy. A document analysis is divided into three broad eras (1919–1955; 1955–1989; 1989–) and synthesises seven points in time when policies relevant to overarching goals and regulation of universal health coverage and equal access were proposed and/or implemented. The development is analysed and concluded in relation to two egalitarian goals in the context of health: equality of access and equal treatment for equal need.

Results

Over the past century, macro-level policy evolved from the concept of creating access for the neediest and those reliant on wages for their survival to a mandatory insurance with equal right to healthcare for all. However, universal health coverage was not achieved until 1955, and individuals had to rely on their personal financial resources to cover the cost at the time of care utilization until the 1970s. It was not until 1983 that legislation explicitly stated that access to healthcare should be equal for the entire population (horizontal equity), while a vertical equity-principle was not added until 1997. Subsequently, ideas of free choice and privatization have gained significance. For instance, they aim to increase service access, addressing the Swedish health system’s Achilles’ heel in this regard. However, the principle of equal access for all is now being challenged by the emergence of private health insurance, which offers quicker access to services.

Conclusions: brief summary and potential implications

It can be concluded that there is no perpetual Swedish healthcare model and various dimensions of access have been the focus of policy discussion. The discussion on access barriers has shifted from financial to personal and organizational ones. Today, Sweden still ranks high in terms of affordability and equity in international comparisons: although not as well as a decade ago. Whether this marks the beginning of a new trend intertwined with a decline in Sweden’s welfare ‘exceptionalism’, or is a temporary decline remains to be assessed in the future.
Clinical decision support systems to optimize adherence to anticoagulant guidelines in patients with atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials
Authors: Amin Ahmed Mazen , Ghaly Ramy , Abuelazm Mohamed T. , Ibrahim Ahmed A. , Tanashat Mohammad , Arnaout Moumen , Altobaishat Obieda , Elshahat Ahmed , Abdelazeem Basel , Balla Sudarshan
Published: May 2024

Background

Clinical decision support systems (CDSS) have been utilized as a low-cost intervention to improve healthcare process measures. Thus, we aim to estimate CDSS efficacy to optimize adherence to oral anticoagulant guidelines in eligible patients with atrial fibrillation (AF).

Methods

A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) with a 95% confidence interval (CI). PROSPERO ID: CRD42023471806.

Results

We included nine RCTs with a total of 25,573 patients. There was no significant difference, with the use of CDSS compared to routine care, in the number of patients prescribed anticoagulants (RR: 1.06, 95% CI [0.98, 1.14], P = 0.16), the number of patients prescribed antiplatelets (RR: 1.01 with 95% CI [0.97, 1.06], P = 0.59), all-cause mortality (RR: 1.19, 95% CI [0.31, 4.50], P = 0.80), major bleeding (RR: 0.84, 95% CI [0.21, 3.45], P = 0.81), and clinically relevant non-major bleeding (RR: 1.05, 95% CI [0.52, 2.16], P = 0.88). However, CDSS was significantly associated with reduced incidence of myocardial infarction (RR: 0.18, 95% CI [0.06, 0.54], P = 0.002) and cerebral or systemic embolic event (RR: 0.11, 95% CI [0.01, 0.83], P = 0.03).

Conclusion

We report no significant difference with the use of CDSS compared to routine care in anticoagulant or antiplatelet prescription in eligible patients with AF. CDSS was associated with a reduced incidence of myocardial infarction and cerebral or systemic embolic events.
The impact of bolus on clinical outcomes for post-mastectomy breast cancer patients treated with IMRT: data from China
Authors: Jiang Tao , Tian Jiao , Lei Peijie , Meng Chunliu , Fu Jialei , Cao Lianjing , Cheng Jingjing , Zhou Fei , Zhang Hongjun , Song Hao , Lu Haijun , Wei Xiaojuan
Published: May 2024

Purpose

This study aims to investigate the effects of chest wall bolus in intensity-modulated radiotherapy (IMRT) technology on clinical outcomes for post-mastectomy breast cancer patients.

Materials and methods

This retrospective study included patients with invasive carcinoma ((y)pT0-4, (y)pN0-3) who received photon IMRT after mastectomy at the Affiliated Hospital of Qingdao University from 2014 to 2019. The patients were divided into two groups based on whether they received daily bolus application or not, and the baseline characteristics were matched using propensity score matching (PSM). Cumulative incidence (CI) of local recurrence (LR), locoregional recurrence (LRR), overall survival (OS) and disease-free survival (DFS) were evaluated with a log-rank test. Acute skin toxicity and late radiation pneumonia was analyzed using chi-square test.

Results

A total of 529 patients were included in this study, among whom 254 (48%) patients received bolus application. The median follow-up time was 60 months. After matching, 175 well-paired patients were selected. The adjusted 5-year outcomes (95% confidence interval) in patients treated with and without bolus were, respectively: CI of LR 2.42% (0.04–4.74) versus 2.38% (0.05–4.65), CI of LRR 2.42% (0.04–4.74) versus 3.59% (0.73–6.37), DFS 88.12% (83.35–93.18) versus 84.69% (79.42–90.30), OS 94.21% (90.79–97.76) versus 95.86% (92.91–98.91). No correlation between bolus application and skin toxicity (P = 0.555) and late pneumonia (P = 0.333) was observed.

Conclusions

The study revealed a low recurrence rate using IMRT technology. The daily used 5 mm chest wall bolus was not associated with improved clinical outcomes.
The effectiveness of relugolix compared with leuprorelin for preoperative therapy before laparoscopic myomectomy in premenopausal women, diagnosed with uterine fibroids: protocol for a randomized controlled study (MyLacR study)
Authors: Kitade Mari , Kumakiri Jun , Kobori Hiroyuki , Murakami Keisuke
Published: May 2024

Background

The oral gonadotropin-releasing hormone antagonist relugolix, which temporarily stops menstruation, is used to treat heavy menstrual bleeding, pelvic pressure, and low back pain in women with uterine fibroids. Treatment can also help women recover from low hemoglobin levels and possibly shrink the fibroids. However, evidence of preoperative use of relugolix before laparoscopic myomectomy is limited. Nevertheless, the treatment could reduce interoperative blood loss, decrease the risk of developing postoperative anemia, and shorten the operative time. Thus, we aim to test whether 12-week preoperative treatment with relugolix (40 mg orally, once daily) is similar to or not worse than leuprorelin (one injection every 4 weeks) to reduce intraoperative blood loss.

Methods

Efficacy and safety of preoperative administration of drugs will be studied in a multi-center, randomized, open-label, parallel-group, noninferiority trial enrolling premenopausal women ≥ 20 years of age, diagnosed with uterine fibroids and scheduled for laparoscopic myomectomy. Participants (n = 80) will be recruited in the clinical setting of participating institutions. The minimization method (predefined factors: presence or absence of fibroids ≥ 9 cm and the International Federation of Gynecology and Obstetrics [FIGO] type 1–5 fibroids) with randomization is used in a 1:1 allocation. Relugolix is a 40-mg oral tablet taken once a day before a meal, for 12 weeks, up to the day before surgery. Leuprorelin is a 1.88 mg, or 3.75 mg subcutaneous injection, given in three 4-week intervals during patient visits before the surgery. For the primary outcome measure of intraoperative bleeding, the blood flow is collected from the body cavity, surgical sponges, and collection bag and measured in milliliters. Secondary outcome measures are hemoglobin levels, myoma size, other surgical outcomes, and quality-of-life questionnaire responses (Kupperman Konenki Shogai Index and Uterine Fibroid Symptoms—Quality of Life).

Discussion

Real-world evidence will be collected in a clinical setting to use pre-treatment with an oral gonadotropin-releasing hormone antagonist to reduce intraoperative bleeding in women who undergo laparoscopic myomectomy.

Trial registration

jRCTs031210564 was registered on 19 January 2022 in the Japan Registry of Clinical Trials (https://jrct.niph.go.jp).
A three-term conjugate gradient descent method with some applications
Authors: Alhawarat Ahmad , Salleh Zabidin , Alolaiyan Hanan , El Hor Hamid , Ismail Shahrina
Published: May 2024

The stationary point of optimization problems can be obtained via conjugate gradient (CG) methods without the second derivative. Many researchers have used this method to solve applications in various fields, such as neural networks and image restoration. In this study, we construct a three-term CG method that fulfills convergence analysis and a descent property. Next, in the second term, we employ a Hestenses-Stiefel CG formula with some restrictions to be positive. The third term includes a negative gradient used as a search direction multiplied by an accelerating expression. We also provide some numerical results collected using a strong Wolfe line search with different sigma values over 166 optimization functions from the CUTEr library. The result shows the proposed approach is far more efficient than alternative prevalent CG methods regarding central processing unit (CPU) time, number of iterations, number of function evaluations, and gradient evaluations. Moreover, we present some applications for the proposed three-term search direction in image restoration, and we compare the results with well-known CG methods with respect to the number of iterations, CPU time, as well as root-mean-square error (RMSE). Finally, we present three applications in regression analysis, image restoration, and electrical engineering.
The interrelation between microbial immunoglobulin coating, vaginal microbiota, ethnicity, and preterm birth
Authors: Schuster H. J. , Breedveld A. C. , Matamoros S. P. F. , van Eekelen R. , Painter R. C. , Kok M. , Hajenius P. J. , Savelkoul P. H. M. , van Egmond M. , van Houdt R.
Published: May 2024

Background

Vaginal microbiota composition is associated with spontaneous preterm birth (sPTB), depending on ethnicity. Host-microbiota interactions are thought to play an important underlying role in this association between ethnicity, vaginal microbiota and sPTB.

Methods

In a prospective cohort of nulliparous pregnant women, we assessed vaginal microbiota composition, vaginal immunoglobulins (Igs), and local inflammatory markers. We performed a nested case–control study with 19 sPTB cases, matched based on ethnicity and midwifery practice to 19 term controls.

Results

Of the 294 included participants, 23 pregnancies ended in sPTB. We demonstrated that Lactobacillus iners-dominated microbiota, diverse microbiota, and ethnicity were all independently associated with sPTB. Microbial Ig coating was associated with both microbiota composition and ethnicity, but a direct association with sPTB was lacking. Microbial IgA and IgG coating were lowest in diverse microbiota, especially in women of any ethnic minority. When correcting for microbiota composition, increased microbial Ig coating correlated with increased inflammation.

Conclusion

In these nulliparous pregnant women, vaginal microbiota composition is strongly associated with sPTB. Our results support that vaginal mucosal Igs might play a pivotal role in microbiota composition, microbiota-related inflammation, and vaginal community disparity within and between ethnicities. This study provides insight in host-microbe interaction, suggesting that vaginal mucosal Igs play an immunomodulatory role similar to that in the intestinal tract.
Global soil metagenomics reveals distribution and predominance of Deltaproteobacteria in nitrogen-fixing microbiome
Authors: Masuda Yoko , Mise Kazumori , Xu Zhenxing , Zhang Zhengcheng , Shiratori Yutaka , Senoo Keishi , Itoh Hideomi
Published: May 2024

Background

Biological nitrogen fixation is a fundamental process sustaining all life on earth. While distribution and diversity of N2-fixing soil microbes have been investigated by numerous PCR amplicon sequencing of nitrogenase genes, their comprehensive understanding has been hindered by lack of de facto standard protocols for amplicon surveys and possible PCR biases. Here, by fully leveraging the planetary collections of soil shotgun metagenomes along with recently expanded culture collections, we evaluated the global distribution and diversity of terrestrial diazotrophic microbiome.

Results

After the extensive analysis of 1,451 soil metagenomic samples, we revealed that the Anaeromyxobacteraceae and Geobacteraceae within Deltaproteobacteria are ubiquitous groups of diazotrophic microbiome in the soils with different geographic origins and land usage types, with particular predominance in anaerobic soils (paddy soils and sediments).

Conclusion

Our results indicate that Deltaproteobacteria is a core bacterial taxon in the potential soil nitrogen fixation population, especially in anaerobic environments, which encourages a careful consideration on deltaproteobacterial diazotrophs in understanding terrestrial nitrogen cycling.
Psychometric properties of the chinese version of multidimensional experiential avoidance questionnaire-30
Authors: Xue Dongdong , Meng Hongxing , Liu Hongpei , Wang Nana , He Jin , Feng Lina , Su Juan , Wang Xiaozhuang
Published: May 2024

Background

Experiential avoidance represents the tendency to avoid negative internal experiences, which is a key concept in Acceptance and Commitment Therapy. However, existing measures of experiential avoidance (i.e., Acceptance and Action Questionnaire–II, AAQ-II) have some limitations. This study aims to assess the psychometric properties of the Chinese version of Multidimensional Experiential Avoidance Questionnaire-30 (MEAQ-30) and provide evidence for the reliability and validity of this new instrument.

Methods

Two questionnaire surveys were conducted. The first sample (N = 546) was analyzed using classical test theory (CTT), and the second sample (N = 511) was analyzed using multidimensional item response theory (MIRT).

Results

CTT supported the six-factor structure of MEAQ-30, indicating good internal consistency and measurement invariance across genders. Furthermore, the Chinese version of MEAQ-30 showed satisfactory convergent and discriminant validity. The incremental validity test showed that after controlling for the effects of neuroticism and AAQ-II, the Chinese version of MEAQ-30 could still significantly predict depression, anxiety, and stress. MIRT indicated that 30 items had good discrimination and difficulty, and the six subscales were sufficiently reliable across the continuum of experiential avoidance.

Conclusion

The Chinese version of MEAQ-30 has good reliability and validity and is suitable for assessing experiential avoidance among Chinese populations.
Working through multiple crises: the experience of psychotherapists and psychoanalysts in Lebanon
Authors: Nassif Rose Marie , Husseini Mayssa’ El , Beaini Nour , Choueiri Tonnie , Tarazi-Sahab Layla , Moro Marie-Rose
Published: May 2024

Introduction

This research explores the impact of the COVID-19 pandemic on psychotherapists' practices and their ability to maintain a framework despite a shared reality with their patients. The specific focus in this article is on the Lebanese context, which is characterized by a series of crises including economic collapse, the COVID-19 pandemic, and the Beirut blast. The objective of this study was to examine how the destabilization of the meta-frame due to crises necessitates adaptations in theoretical knowledge, practice, and setting.

Methods

We conducted a qualitative study among a population consisting of mental health professionals, which were recruited in Lebanon through associations and societies of psychologists, psychotherapists, and psychoanalysts. Data was collected using semi-structured individual interviews. The interviews were analyzed using interpretative phenomenological analysis (IPA), which allowed for a dynamic exploration of the participants' experiences.

Results

Our study revealed four superordinate themes: (1) The strained frontiers; (2) The cumulative traumatic reality and its impact; (3) A challenged professional identity; (4) The creativity stemming from collective trauma.

Conclusions

Our results highlight the insecurity caused by external reality infiltrating the therapeutic setting. Online therapy allowed for continued work, but uncertainty about the online environment's impact on therapeutic relationships was observed. The study underscores the importance of adaptability, containment, and support for therapists navigating crises, particularly in the online setting.
Efficiently approaching vertical federated learning by combining data reduction and conditional computation techniques
Authors: Folino Francesco , Folino Gianluigi , Pisani Francesco Sergio , Pontieri Luigi , Sabatino Pietro
Published: May 2024

In this paper, a framework based on a sparse Mixture of Experts (MoE) architecture is proposed for the federated learning and application of a distributed classification model in domains (like cybersecurity and healthcare) where different parties of the federation store different subsets of features for a number of data instances. The framework is designed to limit the risk of information leakage and computation/communication costs in both model training (through data sampling) and application (leveraging the conditional-computation abilities of sparse MoEs). Experiments on real data have shown the proposed approach to ensure a better balance between efficiency and model accuracy, compared to other VFL-based solutions. Notably, in a real-life cybersecurity case study focused on malware classification (the KronoDroid dataset), the proposed method surpasses competitors even though it utilizes only 50% and 75% of the training set, which is fully utilized by the other approaches in the competition. This method achieves reductions in the rate of false positives by 16.9% and 18.2%, respectively, and also delivers satisfactory results on the other evaluation metrics. These results showcase our framework’s potential to significantly enhance cybersecurity threat detection and prevention in a collaborative yet secure manner.
Dynamics of acyl carrier protein in de novo fatty acid synthesis by Enterococcus faecalis based on NMR spectroscopy and molecular dynamics simulation
Authors: Oh Sujung , Lee Chaeyoung , Son Minwon , Yeon Jiwon , Kim Yangmee
Published: May 2024

Fatty acid synthesis (FAS) is essential for the production of biological components such as cell membrane building blocks and metabolism-related compounds. There are two types of bacterial FAS: de novo FAS and FAS through the incorporation of external fatty acids. Enterococcus faecalis possesses two distinct acyl carrier proteins (ACPs), AcpA (EfAcpA) and AcpB (EfAcpB), which serve as cofactors in the two types of FAS. We previously showed through NMR spectroscopy that EfAcpA comprises only three long helices, while EfAcpB consists of four helices, including a short α3 helix, similar to other bacterial ACPs. An increase in melting temperature (Tm) from 64.0 to 76.1 °C confirmed that protein structural stability increased in the presence of calcium ions. Using NMR spectroscopy, two metal binding sites were identified in EfAcpA: site A was located at the start of the α2 helix while site B was situated near the α2 helix and α2α3 loop. To understand the importance of structural flexibility of EfAcpA in de novo FAS, we investigated its motional properties using backbone spin relaxation and molecular dynamics simulations. The α2α3 loop in EfAcpA displayed high flexibility, as indicated by low heteronuclear NOE values. The residues Val51, Glu54, and Gly58 exhibited significant R2 values, likely due to the movement of this loop. EfAcpA created a novel cavity towards the α1α2 loop, in contrast to conventional cavity formation in most bacterial ACPs. This unique behavior was attributed to the flexibility exhibited by the α2α3 loop. The structural and motional characteristics of EfAcpA confirmed that its conformational plasticity is a crucial factor influencing acyl chain transfers in de novo FAS. Given the increasing antibiotic resistance observed for E. faecalis in clinical settings, the findings of this study may contribute to the development of more effective pathogen management strategies targeting FAS.
Characteristics and reasons for delayed presentation in acute ischemic stroke: single-centered study in Indonesia
Authors: Yang Natasha , Hartanto Yohan Budi
Published: May 2024

Background

Effective therapy for acute ischemic stroke relies on timely intervention. We aimed to evaluate the factors associated with the onset-to-arrival time and delayed hospital presentation in acute ischemic stroke patients. Subjects with acute ischemic stroke in Bethesda Hospital Yogyakarta, Indonesia from March to June, 2023 were prospectively recruited. A questionnaire was used to collect the information by direct interviews. Prespecified variables were included in univariate and multivariable analyses to identify the predictors of delayed hospital presentation of more than 4.5 h.

Results

Among a total of 175 patients, 64.6% of the patients arrived at the hospital more than 4.5 h after the stroke onset. Only 3 (1.7%) patients were eligible and received intravenous thrombolysis. In multivariable analysis, monthly income of more than IDR 550,000 (OR, 4.22; 95% CI 1.47–12.17; p = 0.007), wake-up stroke or unknown stroke onset (OR vs. known onset, 0.17; 95% CI 0.05–0.56; p = 0.004), distance from location of stroke onset more than 9.45 km (OR, 3.13; 95% CI 1.41–6.92; p = 0.005) and no history of coronary artery disease or heart failure (OR vs. present history, 0.12; 95% CI 0.04–0.37; p = 0.000) were related to delayed hospital presentation. The most frequently mentioned reasons for the delay were waiting for spontaneous improvement at home and unawareness of the stroke symptoms.

Conclusions

There is an enormous disparity in stroke services between developed and developing countries. This study highlighted the need to increase public stroke symptoms awareness.
Comparative analysis of energy efficiency for three heating and cooling supply schemes in a region with hot summers and cold winters in a chemical industrial park
Authors: Jiang Kewen , Zhang Wei
Published: May 2024

Building energy consumption in China accounts for 45% of the total national energy consumption, with air conditioning energy consumption representing approximately two-thirds of that. Therefore, energy efficiency in buildings is of utmost importance. This study focuses on a chemical industrial park located along the Fujiang River and compares three heating and cooling supply schemes: the river water source heat pump system, which utilizes river water as the heat source and heat sink; the water cooling unit and boiler system, which uses water-cooled electric compression chillers for cooling and an oil-fired boiler system for heating; and the split air conditioning and gas water heater scheme, which relies on refrigerants such as fluorine-containing compounds for cooling and a gas water heater for heating. By calculating the energy consumption of the above three schemes and conducting a comparative analysis, it is found that the river water source heat pump system exhibits significantly higher energy efficiency throughout the year compared to the water cooling unit and boiler system and the split air conditioning and gas water heater scheme. This highlights the notable energy efficiency advantage of the river water source heat pump system.
Measuring flow rate and purity in portable oxygen concentrators
Authors: Sivalingam Vijai , Jayaraj Jayakumar , Paul Subha Hency Jose
Published: May 2024

For people with respiratory disorders who need additional oxygen therapy, oxygen concentrators are vital medical equipment. By concentrating oxygen from the ambient air, they function to give the user a greater flow of oxygen-enriched air. The application of lithium zeolite for oxygen concentration in POCs is the most intense part of this work. One kind of zeolite material that may selectively absorb nitrogen from the air to increase oxygen concentration is lithium zeolite. The capacity, effectiveness, and dependability of a POC fitted with lithium zeolite are all examined in this study, along with its overall performance. The findings show that lithium zeolite, which has benefits including high oxygen purity and low energy consumption, is a potential material for use in POCs. The results of this study aid in the creation of POCs for oxygen therapy that are more effective and efficient. This study suggests utilizing an Arduino microcontroller and an HX710B air pressure sensor to measure the oxygen flow rate in a POC. The POC’s oxygen flow channel incorporates the HX710B sensor to monitor pressure variations, which the Arduino uses to translate into flow rate readings. To verify the accuracy and dependability of the system, its performance is assessed under different flow rate scenarios. Lithium zeolites are well-known for having a high selectivity for nitrogen adsorption, which can enhance the concentrator’s oxygen separation process’s effectiveness. Lithium-zeolite-based oxygen concentrators may have a lower environmental effect than standard concentrators.
Providing a hybrid approach to increase the accuracy of intrusion detection systems in computer networks
Authors: Zhao Wei , Zhao Zhitong
Published: May 2024

Intrusion detection is a critical obstacle in the realm of security and data mining methodologies. Consequently, researchers have extensively investigated the quest for the swiftest and most precise means of identifying intrusions. Essentially, intrusion detection systems are tasked with recognizing any unauthorized activities, misuse, or harm inflicted upon a system, be it by internal or external users. Recently, in order to design intrusion detection systems, artificial intelligence and machine learning methods have been used, each of which has its own characteristics and advantages. Accordingly, this article focuses on using machine learning to improve the accuracy of the intrusion detection process. In fact, by using machine learning, trends, and patterns can be easily identified and thus used in a network environment to detect intrusion. It can be very useful. For this purpose, we utilize Radial Basis Function (RBF) neural networks and support vector machine (SVM) algorithm to improve decision-making and intrusion detection. By employing RBF neural networks, important features of the data are extracted, which in turnPlease check if the author details and affiliations are presented correctly. Kindly amend if necessary. enhance the overall performance of the solution and the efficiency of the SVM algorithm. This is because feature reduction ultimately leads to improved effectiveness of the SVM algorithm. In methods lacking this capability, the learning algorithm is compelled to utilize features that have no specific correlation with intrusion and essentially do not contribute to identifying attacks. Such learning approaches essentially learn from noisy data, which negatively impacts the intrusion detection solution. Finally, the proposed solution was evaluated using Python programming language and KDD99 data set. The results of the evaluation indicate that the proposed solution has a higher accuracy and precision than other evaluated solutions. So, the accuracy is 97, and the precision is over 99%.
Who is Represented in the Research on Undergraduate Research Experiences in the Natural Sciences? A Review of Literature
Authors: Goodwin Emma C. , Gin Logan E. , Aeschliman Allyson , Afoakwa Adwoa Kumi , Allred Bryttani A. , Avalle Sarah T. , Bell Amanda , Berkheimer Jessica , Brzezinski Hannah , Campos Rachel , Emerson Hozhoo , Hess Savage Cree , Montelongo Arron M. , Noshirwani Nereus , Shelton W. Levi , Valdez Emma M. , White Jennifer , White Quinn , Wittekind Ehren , Cooper Katelyn M. , Brownell Sara E.
Published: May 2024

We conducted a review of the education research literature on student outcomes from participation in undergraduate research experiences to document how demographic variables are reported and considered in analyses. This information is critical to assess whether goals to diversify research undergraduate research experiences are being met.
The Effect of Apalutamide on Thyroid Function in Prostate Cancer Patients
Authors: Moffatt Clare , Lechner Melissa G , Angell Trevor E , Shen John , Drakaki Alexandra , Acosta Gonzalo J , Liang Tom Z , Tsai Karen
Published: May 2024

Context

Apalutamide (APT) is a nonsteroidal antiandrogen medication used to treat metastatic castrate-sensitive and nonmetastatic castrate-resistant prostate cancer. Early clinical trials of APT identified thyroid dysfunction as a common adverse effect of therapy, but the clinical presentation and management of APT-induced hypothyroidism has not been studied.

Objective

The objective of our study is to elucidate the clinical presentation and treatment approach of APT-associated thyroid dysfunction in prostate cancer patients.

Methods

We report a case series of 16 patients with APT-associated thyroid dysfunction during prostate cancer treatment at 2 academic medical centers. Patient clinical parameters, thyroid function laboratory data, and thyroid hormone requirements over the course of APT treatment were analyzed.

Results

Among the 16 patients in our case series with APT-associated hypothyroidism, 3 had no prior thyroid disease and 13 had preexisting hypothyroidism. The patterns of thyroid dysfunction included overt and subclinical hypothyroidism. The median time from APT initiation to thyroid function test abnormality was 19 weeks, but occurred in some cases as early as 2 to 4 weeks. Hypothyroidism was effectively managed with thyroid hormone replacement using levothyroxine (LT4), though some patients with preexisting hypothyroidism required a 2- to 3-fold dose increase while on APT to achieve a euthyroid state. In the subset of patients who completed or stopped APT therapy, thyrotropin levels fell at a median of 11 weeks post APT therapy and thyroid hormone requirements decreased to near pre-APT levels.

Conclusion

APT-associated thyroid dysfunction presents as new or worsening hypothyroidism and should prompt initiation or increase in thyroid hormone replacement. Monitoring of thyroid function tests is recommended every 1 to 2 months for all patients on APT and 2 to 3 months after completion of APT.
Assessing the Features of Diabetic Foot Ulcers among Individuals with Type 2 Diabetes Mellitus in Thi Qar, Iraq
Authors: Mohammed Adel Gassab , Kadhim Al-Waeli Dheyaa , Abed Odhaib Samih , Altemimi Mahmood Thamer
Published: May 2024

Background This study aimed to evaluate the characteristics of diabetic foot ulcers in individuals with type 2 diabetes mellitus (T2DM) in Iraq. Methods The study included 881 participants with T2DM and different types of foot ulcers, who attended a specialized diabetes center. Data on demographics, clinical characteristics, biochemical investigations, comorbidities, and treatment regimens were collected and analyzed. Results The majority of the cases (96.8%) were due to T2DM, with an average age of 58 years and a mean BMI of 30 kg/m2. Participants had elevated serum creatinine, blood urea, and glucose levels, with uncontrolled HbA1c levels. Comorbidities included hypertension, ischemic heart disease, diabetic neuropathy, and retinopathy. Most participants were on insulin and statins. Diabetic foot ulcers were mainly on the right foot (48%) and classified as Grade 2 in Wagner's system. Some participants had Charcot deformity or stages of amputation. Conclusions Random plasma glucose levels and diabetic retinopathy were significantly associated with the classification of foot ulcers. Further research is needed to explore additional variables related to T2DM and foot ulcers, emphasizing the importance of glucose control and retinopathy in ulcer classification.
When I say inclusion
Authors: Kusurkar Rashmi
Published: May 2024

There is no unified understanding of the concept of inclusion in the literature. Since inclusion is a hot topic in the current debates on equity diversity and inclusion, it is important to move towards creating a common understanding of this term. In this article I explore the concept of inclusion based on the current literature. When I say inclusion, it is not just a sense of belonging, but also the opportunity to participate and contribute meaningfully.
The experts of the GARANT legal consulting service are responsible
Authors: Davydova Ol'ga , Corieva Zara , Ignatov Dmitriy , Chashina Tat'yana
Published: May 2024

The experts of the Legal Consulting GARANT answer questions concerning tax accounting, accrual of penalties, VAT.
Sztuczna inteligencja w pracy bibliotekarza – szanse, możliwości, obawy
Authors: Baranowski Karol
Published: May 2024

The article discusses the role of pedagogical libraries in the era of digital transformation, focusing on challenges and possibilities connected with the development of new technologies. The author has emphasised the evolution of the role of librarians which become not only protectors of traditional collections, but also guides in a digital world, offering support within the scope of digital education and data management. The article analyses the influence of the Artificial Intelligence on education, with particular emphasis on concerns of teachers and perception of AI by students. Furthermore, trends in digital libraries are discussed, such as personalisation of services, development of hybrid education and adaptation of the library space to social needs.
Żywa Biblioteka jako niekonwencjonalny zasób wiedzy o tolerancji i prawach człowieka
Authors: Kawoń-Noga Dagmara
Published: May 2024

The goal of this article is to present the project of the Living Library as a method of education about tolerance and human rights. It consists of three essential parts. The first part includes theoretical considerations about stereotypes, their essence and mechanisms of creation. The second part (the shortest) indicates research in the field of social psychology concerning the reducing of stereotype strength. The third section discusses the genesis of the Living Library project, the accepted standards of activities, the dictionary of terms and the guidelines for organisers. The author analyses a library „metaphor” through isolation the similarities and differences of the „living” and „traditional” library. She presents examples of practical use of the discussed idea including Polish experiences.
Kolekcja ze Zbiorów Jana Feusette’a (ze szczególnym uwzględnieniem książek z dedykacjami) w Pedagogicznej Bibliotece Wojewódzkiej w Opolu
Authors: Zacłona Anna
Published: May 2024

The article discusses a set of books from the Collections of Jan Feusette, which was given in the years 2022-2023 to the Pedagogical Voivodship Library in Opole by its multiannual director. This book collection includes circa 3000 volumes. The text pays special attention to books with proprietary marks: bookplates and seals. Moreover, selected manuscript dedications have been discussed, which constitute a valuable component of the collections given by the donor. Authors of the dedications written in books from the presented set comprise outstanding Polish writers, critics and literary historians from the 20th and 21st centuries. Dedicatory entries shown in the article constitute unique supplement of Jan Feusette’s biographical note – they are meaningful evidence of his achievements within the literary and editorial fields.
Quality Improvement of Health Plaster Products With Six Sigma Method and QCDSME Analysis
Authors: Nur Janah Ragillia Fitri , Wahyuni Hana Catur , Marodiyah Inggit
Published: May 2024

Health plasters are one of a pharmaceutical company's excellent items. There are still defective products in the manufacturing process, including torn paper, joint 1, not cut, perforated edges, joint 2, tucked, long-short, and asymmetrical. Research conducted between June and December 2021 reveals that 192.960 Kg of substandard items were discovered. The contribution of this research is to identify the underlying reasons of the problem and decrease the number of product faults. By using the QCDSME (Quality-Cost-Delivery-Safety-Morale) method analysis in the cost stage, this company is known to experience losses due to defective products of IDR 18,047,232 / year. The results of the analysis using the six sigma method at the analyze stage using the fishbone diagram tool are known that defective products are caused by the absence of size standards in the repair of plate and pressure roll positions, differences in operator responses, the absence of written procedures for handling product defects, and the existence of product roll rolls that are too loose or tight. The improvement proposal made next is to make a size standard for the plate position with a value of 12.5 ± 1 cm and a pressure roll with a value of 22 ± 1 mm with additional tools in the form of a ruler. After taking corrective steps and quality control on product defects, the results showed that the value of product defects decreased from the previous average of 1,119 pcs/day to 205 pcs/day, so that the company's loss value was reduced to IDR 3,306,240/year.
UK practitioners' motivations and experiences of farm animal internship programmes
Authors: Prior Stephanie , Mahendran Sophie A
Published: May 2024

Background:

Recruitment and retention of practicing farm animal veterinary surgeons is of growing importance in the UK. Farm animal internships are one route for early career veterinarians to pursue, and can be offered by both universities and corporate practices.

Aims:

This survey established the motivations, experiences and drivers for farm animal veterinary surgeons undertaking internships.

Methods:

An online questionnaire consisting of 14 questions of both free text and multiple-choice questions was used to evaluate the opinions of veterinarians who have undertaken farm animal internships in the UK.

Findings:

The main motivation for carrying out an internship was the desire for support, which was stated by 63.3% of participants. Interns who received weekly or fortnightly contact with a mentor were significantly more likely to regard this as sufficient (P<0.05) compared to interns whose support was less frequent.

Conclusions:

The results of this questionnaire suggest that internship programmes are well received by those undertaking them.
Looking into lungworm
Authors: Carty Helen
Published: May 2024

The Control of Worms Sustainably (COWS) group has launched a survey to find out more about lungworm and its treatment across the UK.
The role of the Animal Sentience Committee
Authors: Seals Michael
Published: May 2024

The Animal Sentience Committee has a remit to look at policies which may impact the welfare needs of sentient animals.
Cracking the silent gallstone code: Wait or operate?
Authors: Goswami Aakansha Giri , Basu Somprakas
Published: May 2024

The widespread availability of abdominal ultrasound has revealed the common occurrence of asymptomatic gallstones. While the treatment for symptomatic gallstones is clear, the benefits of minimally invasive laparoscopic cholecystectomy have sparked debate about the best approach to managing silent gallstones. The potential for asymptomatic gallstones to become symptomatic or lead to complications complicates the decision-making process regarding surgical intervention, as it's uncertain when or which patients might develop complications. Consequently, risk stratification appears to play a critical role in guiding decisions about silent gallstones. However, there is no definitive evidence to direct management, and a consensus-based on high-quality evidence is yet to be established.
Relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine fetal distress
Authors: Chen Ji , Liu Fei-Xue , Tao Rui-Xue
Published: May 2024

BACKGROUND

By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries, doctors can more accurately identify fetal intrauterine distress, as well as assess its severity, so that timely interventions can be implemented to safeguard the health and safety of the fetus.

AIM

To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.

METHODS

Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups (n = 50 each), according to the presence or absence of intrauterine distress. The ultrasound hemodynamic parameters of the uterine artery (UtA), fetal middle cerebral artery (MCA), and umbilical artery (UmA) were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.

RESULTS

Comparison of ultrasonic hemodynamic parameters, resistance index (RI), pulsatility index (PI), and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity (S/D), revealed higher values of fetal MCA, PI, and S/D of UmA in pregnant women with UtA compared to controls (P < 0.05), while there was no difference between the two groups in terms of RI (P < 0.05) The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group (66.7%) than in the control group (90.0%), and neonatal weight (2675.5 ± 27.6 g) was lower than in the control group (3117.5 ± 31.2 g). Further, cesarean section rate was higher in the observation group (70.0%) than in the control group (11.7%), and preterm labor rate was higher in the observation group (40.0%) than in the control group (10.0%). The incidence of fetal distress, neonatal growth restriction and neonatal asphyxia were also higher in the observation group (all P < 0.05).

CONCLUSION

Fetal MCA, UmA, and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy, which suggests that clinical attention should be paid to them, and monitoring should be strengthened to provide guidance for clinical intervention.