bluuebunny/crossref_metadata_2025 huggingface dataset:
Де стародавнє дно океану?
Authors: Maric Filip , Poto Margherita Paola , Panieri Giuliana , Peftieva Olena
Published: November 2023

Фокусуємося на:

тому, щоб зрозуміти, що дно океану динамічне і змінюється з часом. Іноді воно далеко, а іноді набагато ближче, ніж ми думаємо. Але де знаходиться дно океану?

Мета навчання:

У цьому занятті учні зрозуміють, що ми можемо знайти дно стародавнього океану на суші завдяки тектонічній активності.NB: Це потребує попереднього планування та може бути неможливим, якщо ваша школа знаходиться надто далеко від таких тектонічних утворень.

Ключові слова:

Осадонакопичення, осадові породи, тектоніка, історія Землі
Наскільки глибокий океан?
Authors: Maric Filip , Poto Margherita Paola , Panieri Giuliana , Peftieva Olena
Published: November 2023

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визначенні глибини океану за допомогою масштабу та фізичної культури.

Цілі навчання:З цими ДВОМА діяльностями учні почнуть розуміти (і відчувати), наскільки глибоким може бути океан порівняно з їхньою власною висотою та зростом. Вони отримають відчуття різниці між висотою (над землею) та глибиною (відносно води).

Ключові слова:

Висота, (океанічна) глибина
Під тиском
Authors: Maric Filip , Poto Margherita Paola , Panieri Giuliana , Peftieva Olena
Published: November 2023

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відчутті, як змінюється тиск води з глибиною.

Мета навчання:

У цій вправі учні відчують залежність між глибиною води та тиском. Учні зможуть поміркувати про те, як на форми життя в морських глибинах може вплинути високий тиск води в їхніх екосистемах.

Ключові слова:

Глибина, вага, тиск
Седиментація
Authors: Maric Filip , Poto Margherita Paola , Panieri Giuliana , Peftieva Olena
Published: November 2023

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розумінні ролі седиментації у створенні унікальних умов екосистем океанічного дна.

Мета навчання:

Завдяки цій вправі учні отримають базове розуміння того, як осади в океані опускаються на дно (седиментація) і як це виглядає.

Ключові слова:

Осади, осадові породи, теригенні, пелагічні
Factors influencing burnout among Korean nurses caring for patients with COVID-19: a cross-sectional study
Authors: Lee Seon Yeong , You Mi-Ae , Ahn Jeong Ah , Seo Eun Ji
Published: November 2023

Purpose: The purpose of this study was to investigate the levels of fatigue, social support, and burnout among nurses caring for coronavirus disease 2019 (COVID-19) patients, and to identify factors that affect burnout. Methods: Data were collected from 115 nurses who were caring for COVID-19 patients in Gyeonggi Province and Seoul from December 2021 to February 2022. Results: The mean scores for fatigue, social support, and burnout were 63.31 ± 11.48 (of 95), 48.34 ± 6.97 (of 60), and 81.90 ± 15.50 (of 132) points, respectively. The level of burnout of nurses caring for patients with COVID-19 was high. Fatigue (β = .49, p < .001) and social support (β = -.21, p = .012) were significantly associated with burnout. Conclusion: Higher levels of fatigue and lower levels of social support were associated with higher levels of burnout. Reducing fatigue among nurses and strengthening their social support can be a strategy to reduce nurse burnout.
An intelligent zero trust secure framework for software defined networking
Authors: Guo Xian , Xian Hongbo , Feng Tao , Jiang Yongbo , Zhang Di , Fang Junli
Published: November 2023

Software-defined networking (SDN) faces many of the same security threats as traditional networks. The separation of the SDN control plane and data plane makes the controller more vulnerable to cyber attacks. The conventional “perimeter defense” network security model cannot prevent lateral movement attacks caused by malicious insider users or hardware and software vulnerabilities. The “zero trust architecture” has become a new security network model to protect enterprise network security. In this article, we propose an intelligent zero-trust security framework IZTSDN for the software-defined networking by integrating deep learning and zero-trust architecture, which adopts zero-trust architecture to protect every resource and network connection in the network. IZTSDN uses a traffic anomaly detection mode CALSeq2Seql based on a deep learning algorithm to analyze users’ network behavior in real-time and achieve continuous tracking and analysis of users, restrict malicious users from accessing network resources, and realize the dynamic authorization process. Finally, the Mininet simulation platform is extended to build the simulation platform MiniIZTA supporting zero-trust architecture and the proposed security framework IZTSDN is experimentally analyzed. The experimental results show that the IZTSDN security framework can provide about 80.5% of throughput when the network is attacked. The accuracy of abnormal traffic detection reaches 99.56% on the SDN dataset, which verifies that the reliability and availability of the IZTSDN security framework are verified.
Analysis of Glycaemic Changes and their Outcome in Critically Ill Non-diabetic Patients Admitted to the ICU: A Cohort Study
Authors: Yadav Bharat , Kumar Vinod , Nachankar Amit
Published: November 2023

Introduction: Critical illness results in physiological and metabolic changes that lead to dysglycaemia, which is associated with morbidity and mortality. There exists a J- or U-shaped relationship between average glucose levels and mortality, emphasising the importance of evaluating glycaemic variability in critical illness. Aim: To assess glycaemic changes in critically ill patients and their association with Intensive Care Unit (ICU) outcomes. Materials and Methods: The prospective cohort study was conducted from August 2018 to August 2019. A total of 100 non-diabetic critically ill patients admitted to the ICU were observed for seven days. The severity of illness was evaluated using the Glasgow Coma Score (GCS) and Sequential Organ Failure Assessment (SOFA) scores. Plasma glucose levels were recorded every four hours in the ICU. Patients were followed for a maximum of seven days or until discharge or death. They were categorised into hypoglycaemia, normoglycaemia, or stress hyperglycaemia groups for analysis. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 24.0. Results: The study included 64 male and 36 female patients, with an average mean age of 55.90±16.51 years (range: 18- 86 years). Among the 100 patients, 21 died within the sevenday hospitalisation period. Among these, two were in the hypoglycaemic group, 13 were in the normoglycaemic group, and six were in the stress hyperglycaemic group. The patients had a mean SOFA score of 11.55±2.20, which was significantly higher compared to patients without organ failure (mean score: 2.54±2.55), with a statistically significant association (p<0.01). Similarly, patients who died during hospitalisation had a very high SOFA score (mean score: 9.76±3.36), also statistically significant (p<0.01). Conclusion: Critically ill patients in the stress hyperglycaemia and hypoglycaemia groups during their ICU stay had a worse prognosis compared to patients with normoglycaemia. Hypoglycaemia during the ICU stay was associated with the poorest outcome. Maintaining normoglycaemia can significantly reduce morbidity and mortality in critically ill non-diabetic patients; therefore, considering Continuous Glucose Monitoring Systems (CGMS) for more frequent glycaemic monitoring and reducing glycaemic variability may lead to better outcomes in the ICU.
Streamlining Thyroidectomy Treatment with a Multidisciplinary Approach: A Case Report
Authors: Mohapatra Avilash , Vashishtha Deepanshi , Padhan Srikanta
Published: November 2023

Multiple Endocrine Neoplasia 2 (MEN2) is a rare genetic disorder that affects the endocrine glands and can lead to the development of tumours in the thyroid gland, parathyroid gland, and adrenal glands. Individuals with all subtypes of MEN2 syndrome {MEN2A, MEN2B, and familial Medullary Thyroid Cancer (MTC)} are at an increased risk of developing MTC. In the present case report, authors present the case of a 26-year-old female who presented to the Department of Surgery for family screening due to her mother’s diagnosis of MEN 2A syndrome. During the screening, a swelling was identified in the anterior neck region. The swelling was firm, non tender, and not fixed to the skin. Additionally, the patient had an elevated calcitonin level. Although the patient had no history of voice abnormalities, she occasionally experienced dysphagia. A Contrast-enhanced Computed Tomography (CECT) scan of the neck revealed involvement of both lobes of the thyroid gland. To confirm the diagnosis, a DOTA NOC scan (an imaging procedure involving the injection of a radiotracer dye known as DOTA and NOC, followed by Positron Emission Tomography (PET) or Computed Tomography (CT) scan and ultrasound-guided Fine Needle Aspiration Cytology (FNAC) of the thyroid were conducted. Based on the confirmed diagnosis, the patient underwent surgical management in the form of total thyroidectomy and central compartmental lymph node dissection. However, postoperatively, the patient experienced difficulty in speech and swallowing due to involvement of the Recurrent Laryngeal Nerve (RLN). These issues were managed through physiotherapy and speech therapy as part of a holistic approach, which proved to be crucial in improving the patient’s condition and preventing complications. Therefore, the management of thyroidectomy should adopt a patient-centric and multidisciplinary approach to enhance patient outcomes and minimise complications.
Significance of Neutrophil-lymphocyte Ratio, Neutrophil-platelet Ratio, and Neutrophil-tolymphocyte and Platelet Ratio in Predicting Outcomes in Dengue Patients on Admission in Wardha, Maharashtra, India: A Retrospective Cohort Study
Authors: Agrawal Sachin , Kumar Sunil , Talwar Dhruv , Patel Mansi , Reddy Harshitha
Published: November 2023

Introduction: Dengue is an important viral infectious disease, mostly seen in tropical countries during the rainy season, and is emerging as a public health hazard for healthcare facilities. The most common parameters used to assess the severity of dengue are platelet count and haematocrit. However, new haematological parameters have emerged to predict the severity of dengue fever and assist clinicians, especially in resource-limited settings. Aim: To highlight the significance of Neutrophil-Lymphocyte Ratio (NLR), Neutrophil-Platelet Ratio (NPR), and Neutrophil-toLymphocyte and Platelet Ratio (NLPR) in predicting outcomes in patients with dengue infection. Materials and Methods: A retrospective observational study was conducted in rural central India in the Department of Medicine at Jawaharlal Nehru Medical College, Wardha, Maharashtra, India. A total of 540 patients infected with the dengue virus between June 2021 and December 2021. Data analysis was conducted from January to April 2022. Neutrophil, platelet, and lymphocyte counts were used to calculate NLR, NPR, and NLPR, and their roles in predicting the final outcome were studied. The final analysis was performed using the Statistical Package for Social Sciences (SPSS) software, version 21.0. The p-value<0.05 than 0.05 was considered statistically significant. Results: The mean age of the patients was 29.85±13.40 years, ranging from 18 to 85 years, with a median age of 25 years. A total of 331 (61.7%) patients below 30 years of age were significantly higher than patients aged 30 years or older (38.3%) (Z=3.39; p=0.0007). The Area Under Curve (AUC) for NLR (0.852) was higher than that for NLPR (0.828) and NPR (0.708). Therefore, NLR was more effective in predicting adverse outcomes compared to NLPR and NPR. However, the efficacies of NLR and NLPR seemed to be more or less equal. Conclusion: The NLR was a better predictor of outcome or severity in dengue fever when compared to NPR and NLPR. Hence, it can be a cost-effective tool used by physicians working in rural hospitals with limited resources.
Burden of Anaemia and its Impact on Lymphoma Patients in Southern Rajasthan, India: A Cross-sectional Study
Authors: Mukhiya Gulshan Kumar , Mukhiya Geeta W , Patel Pruthvi , Pokar Reeti , Patel Arpan , Thaiyam Dilshano , Mukhiya Khushi
Published: November 2023

Introduction: The frequency of lymphoma is progressively rising. A key clinical feature of lymphoid malignancies is anaemia. The impact of anaemia goes beyond physical symptoms and can negatively affect functional capacity and Quality of Life (QoL). The presence of anaemia has been identified as a predictive factor for event-free and disease-free survival in patients diagnosed with lymphoma and is regarded as a significant unfavourable predictor for treatment results. Aim: To investigate the prevalence and impact of anaemia in naive lymphoma patients. Materials and Methods: This hospital-based, cross-sectional study was conducted in the Department of Pathology at Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India, from January 2019 to December 2022. A total of 66 patients diagnosed with lymphoid malignancies were included in the study. Various parameters of lymphoma cases were assessed to determine the presence of anaemia and its association with demographic features, disease stage, and haematological indices. Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) version 20.0 The Pearson's Chi-square test was used to analyse the difference in the prevalence of anaemia in different groups. Results: The mean age of the study patients was 47.35±20.60 years .The present study included 66 patients with lymphoid malignancies and revealed a high incidence of anaemia among them, with 38 (57.58%) cases presenting with anaemia. There was a male predominance, with 52 (78.79%) out of 66 patients male. Out of the total number of patients, 36 (54.55%) were classified as having stage I and stage II disease, while 30 (45.45%) had stage III and stage IV based on age, Ann Arbor staging, extranodal involvement, Lactate Dehydrogenase (LDH) level, and lymphoma prognostic score. Differentiation between anaemic and non anaemic patients was made by statistical analysis. Based on the findings from the complete blood count, the patients were categorised according to the severity and type of anaemia. It was determined that 38 out of 66 patients, accounting for 57.58%, had anaemia. Conclusion: Anaemia was more prevalent in younger patients and females. Microcytic hypochromic anaemia and Anaemia of Chronic Disease (ACD) were the most common types observed. Anaemia was associated with bone marrow infiltration and advanced disease stages. The present study emphasised the importance of early diagnosis and appropriate management of anaemia in lymphoma patients, as it can negatively impact treatment outcomes and reduce QoL.
Correlation of HbA1c and Insulin Resistance with Urine Albumin Excretion in Non Diabetic Obese Population: A Cross-sectional Study
Authors: Pooyath Sujaya , Chandran Sajeevan Kundila , Nair Shajee Sivasankaran
Published: November 2023

Introduction: A number of metabolic disorders are linked to obesity, which is a global health concern. Although renal impairment is a serious side-effect of obesity, its connection to insulin resistance is still a subject of discussion. Aim: To assess the correlation between microalbuminuria and HbA1c levels, as well as the association between Insulin Resistance (IR) and renal function in obese individuals. Materials and Methods: The present study was a crosssectional study conducted in patients attending the obesity clinic, in Endocrinology department, of a tertiary hospital in Kerala, India. A total of 144 obese individuals participated, meeting age, Body Mass Index (BMI), and health-related. Insulin resistance was measured using Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), while renal function was measured using the Urine Albumin Creatinine Ratio (UACR). Correlation analysis was conducted to investigate relationships between variables. Results: The study found a weak association between UACR and HbA1c levels and insulin resistance (r-value=0.159, p-value=0.056). Subjects with insulin resistance had significantly higher levels of microalbuminuria. Despite these connections, the mean UACR levels remained within the typical reference range. Conclusion: This study emphasises the importance of early renal health screening in obese individuals, with HbA1c and microalbuminuria measurements as promising methods for preventing kidney impairment. To establish causation in the complex interplay between metabolic variables and renal function in obesity and insulin resistance, future research should focus on understanding the underlying mechanisms and conducting longitudinal examinations.
Influence of Leadership Style, Financial Compensation, Workload, and Work Stress on Performance with Job Motivation as an Intervening Variable
Authors: Rahmawati Linda Ade , Purwidianti Wida , Wahyuni Sri , Astuti Herni Justiana
Published: November 2023

Aims: The low employee performance in this increasingly competitive era remains a significant issue in Human Resource Management (HRM). The purpose of this research is to analyze the influence of leadership style on employee performance with motivation as an intervening variable.
Study Design: This study falls under the category of quantitative research with a population of all marketing staff working at PT BRI Banjarnegara Branch, totaling 150 individuals. The sample for this study was determined using the Slovin formula and resulted in 109 participants.
Methodology: The hypothesis testing is conducted using the Partial Least Square (PLS) based Structural Equation Model (SEM) approach. By employing the PLS-based SEM approach, researchers can analyze the relationships among the variables in the study and test the proposed hypotheses.
Results: The results of the study show that leadership style, workload, work stress have a positive effect on employee motivation, and financial compensation has a negative effect on employee motivation. However, leadership style and workload do not have a significant effect on employee performance. Meanwhile, financial compensation and work stress have a positive influence on employee performance. In addition, work motivation has a positive influence on employee performance, leadership style has a positive influence on employee performance with motivation as an intervening variable, financial compensation has a negative influence on employee performance with motivation as an intervening variable.
Infection Prevention Knowledge, Practice, and Its Associated Factors among Healthcare Providers in Eradah and Mental Health Complex Jeddah, Saudi Arabia
Authors: Almehmadi Saud Jabr , Alhazme Meshal Ghaze , Dajani Muneef Homoud Al , Qattan Reem Mohammed , Al-Harbi Manal Fahd
Published: November 2023

Aim: This review aims to provide a clear understanding of the current state of infection prevention measures in this particular healthcare setting by synthesizing the available evidence. 

Study Design: It is a systematic review that includes some previous studies and literature that are discussing with an emphasis on the Eradah Mental Health Complex in Jeddah, this systematic review employs a rigorous research design to investigate healthcare personnel’ knowledge and practices related to infection prevention in mental health settings. A thorough examination of the topic is provided by the methodical synthesis of the body of available literature.

Results: The most important discoveries on the knowledge and practices of healthcare professionals in infection prevention in mental health settings are highlighted in this summary of the findings from the included research. The data are synthesized, combined and identifying patterns from several investigations. This summary not only identifies barriers to sustaining high compliance rates but also highlights elements that have a beneficial impact on infection prevention.

Discussion: The discussion also includes any gaps in the literature that were found throughout the process of the systematic review. A thorough summary of the state of infection prevention techniques in mental health settings is given by synthesizing the findings. The field’s recommendations for upcoming studies and interventions are influenced by this insightful information. The research enhances patient safety and the standard of care in mental health facilities, particularly the Eradah Mental Health Complex in Jeddah, by addressing these important components of infection prevention.
The Relationship between Nursing Burnout and Job Performance in Eradah Complex: A Cross-Sectional Study
Authors: Ghubari Mahdi Hussain Al , Faqeeh Mazen Ali Al , Alsulami Khalf Falah , Alsulami Fahad Falah , Alsulami Awad Falah , Alzahrani Rashed Shakeer , Alawi Ali Thabet
Published: November 2023

Aims: This study aims to examine the relationship between job burnout and practical performance among nursing staff in the Eradah Complex in Jeddah Region.

Study Design:  A cross-sectional study design.

Place and Duration of Study: Registered nurses for this research were randomly selected, and the data were collected for one year, starting from August 2022 till July 2023.

Methodology: Data in this study were collected through the administration of the Maslach Burnout Inventory (MBI) as a standard inventory tool which was used to measure job burnout. as well as self-report questionnaire was used to measure practical performance. Questionnaires developed through MBI scale and self report survey forms were distributed among the participants to collect the data. Data reliability and statistical analyses using appropriate tests were done using the SPSS version 25.0 program.

Results: This study involved 219 registered nurses as participants from different age groups with a mean age of 37.23±11.23 years old and a predominantly male gender (72%); in this study,  these study results showed that there was a significant difference between factors affecting nurses' job performance and feeling stressed and their monthly income (P-value 0.027), while there was no significant difference between age, gender, marital status, education level, job title, and experience years and actors affecting nurses' job performance and feeling stressed.

Conclusion: The existing evidence indicates that occupational fatigue might detrimentally affect practical performance. Job burnout can have a detrimental effect on practical performance as it can result in a decline in motivation and focus. A further manner in which job burnout can influence practical performance is through the manifestation of emotional tiredness. Nurses who are encountering job burnout may experience emotional exhaustion and a sense of being overwhelmed. This phenomenon has the potential to result in insufficiencies in personnel, hence exacerbating job burnout and diminishing practical performance.
Quality Assessment of Portable Water Sourced from Various Locations within Yenagoa Metropolis of Bayelsa State, Nigeria
Authors: Osaribie N. A. , Ewa O. , Aisha M. , Ekata E. , O. Oda  , Wassagwa J.
Published: November 2023

The indispensability of water cannot be over emphasized being an essential resource upon which life thrives. Good quality water is critical to a healthy living. Thus, the aim of this study was to evaluate the quality of portable water obtained from different locations within the City of Yenagoa, Bayelsa State. Two categories of borehole water; Treated Borehole Water Sample (TS) and the Untreated Borehole Water Sample (US) were randomly sourced from eight locations within Yenagoa. Analysis was performed on the samples to determine their physicochemical, chemical and microbiological qualities using standard procedures. While the pH values reported for the TS and US sourced from Opolo and Swali were within the WHO acceptable limit, the value recorded on the turbidity of US fetched from Onopa, Opolo, Okaka and Amarata were in tandem with the stipulated WHO value for turbidity of drinking water. The temperature reported for all samples was deviant to the stipulated WHO standard for water meant for drinking. On the Total Solid reported for the samples, only the values reported for TS sourced from Onopa, Opolo, and Etegwe were in line with the WHO standard for TS in drinking water. The concentration of Ca, K, and Na reported for US sample sourced from Okaka were higher than those reported for water samples fetched from other sources studied. However, the concentration of Mg in the US sourced from Kpansia was higher than that reported for other samples, while the presence of E. coli and coliform was scanty. In conclusion, it can be deduced from these findings, which qualities of the US were in line with the WHO stipulation even though more samples from TS and US were either below or above the recommended values.
1D/2D Rod-sheet Shape Bi2S3 Photocatalyst for Photocatalytic Reduction Cr(VI) under Visible Light
Authors: Wu Xinzhuo , Chen Shaojie , Jiang Yinxing , Zhao Xinshan , Li Zhao , Zhou Yingmei , Li Jing
Published: November 2023

The crystal structure and morphology of photocatalysts play a crucial role in determining their photocatalytic performance. In this study, we synthesized and investigated 1D/2D Bi2S3 as a potential visible-light-activated photocatalyst for the reduction of aqueous Cr(VI). The 1D/2D Bi2S3 was synthesized using hydrothermal synthesis technique by heating Bi2(H2O)2(SO4)2(OH)2 precursor and sodium sulfide at 190 ℃ for 24 h, where the molar ratio of Bi to S elements in the reaction reagents was changed from 1:6 to 2:3. The structure, composition, and optoelectronic properties of the prepared Bi2S3 were characterized using X-ray diffraction, UV-vis diffuse reflectance spectra, field emission scanning electron microscopy, electrochemical impedance spectra, and transient photocurrent. It is shown that the prepared orthorhombic Bi2S3 has full-spectrum photoresponsivity. Bi2S3-B with 1D/2D heterogeneous structure exhibits the lowest charge carrier transport resistance, and its photocurrent intensity is nearly twice that of Bi2S3-C. It demonstrates the highest photocatalytic activity in visible-light photocatalytic reduction of aqueous Cr(VI), with a reduction rate of 54.5% after 140 minutes of light exposure. According to the bandgap of Bi2S3 and radical scavenger experiments, a reaction mechanism for the photocatalytic reduction of Cr(VI) by Bi2S3 was proposed. Furthermore, the results highlight the economic and environmentally friendly nature of the hydrothermal synthesis method using homemade precursors, which allows for the regulation of Bi2S3 morphology and the enhancement of its visible photocatalytic activity. Copyright © 2023 by Authors, Published by BCREC Group. This is an open access article under the CC BY-SA License (https://creativecommons.org/licenses/by-sa/4.0).
Physicians’ Refusal to Wear Masks to Protect Vulnerable Patients—An Ethical Dilemma for the Medical Profession
Authors: Dorfman Doron , Raz Mical , Berger Zackary
Published: November 2023

This Viewpoint discusses why clinician masking is still important for patients who are immunocompromised or disabled.
Trends in Proportion of Medicare Part D Claims Subject to 340B Discounts, 2013-2020
Authors: Dickson Sean , Gabriel Nico , Hernandez Inmaculada
Published: November 2023

Importance

Despite controversy surrounding the 340B program, no study has analyzed trends in the proportion of Medicare Part D pharmacy claims eligible for 340B discounts.

Objective

To describe trends in the proportion of Medicare Part D claims that are prescribed by 340B-affiliated clinicians and filled in 340B pharmacies.

Design and Setting

This longitudinal, retrospective cohort study included 2013 to 2020 claims data from a 5% random sample of Medicare Part D beneficiaries from the Centers for Medicare & Medicaid Services and 6292 nine-digit national drug codes that were used by at least 1000 Part D beneficiaries in a given year. Data analysis was completed from November 2022 to April 2023.

Main Outcomes and Measures

For each drug and year, there were 3 outcomes: (1) proportion of total Part D claims that were prescribed by a 340B-affiliated clinician; (2) proportion of claims prescribed by a 340B-affiliated clinician that were filled in a 340B pharmacy; and (3) proportion of total Part D claims under the 340B program (ie, prescribed by a 340B-affiliated clinician and filled in a 340B pharmacy).

Results

The proportion of prescriptions written by a 340B-affiliated clinician doubled from 9.4% in 2013 to 19.3% in 2020. The capture of 340B prescriptions by 340B pharmacies, defined as the proportion of claims prescribed by 340B-affiliated clinicians that were filled by 340B pharmacies, increased from 18.4% in 2013 to 49.9% in 2020. As a result, the total proportion of 340B claims in Part D increased from 1.7% in 2013 to 9.6% in 2020. Rates of 340B prescribing and capture increased consistently across therapeutic classes. In 2020, the antiviral therapeutic class was the class with the largest proportion of 340B claims (16.1%), followed by targeted antineoplastics (15.7%).

Conclusions and Relevance

This cohort study demonstrated that from 2013 to 2020, the share of Medicare Part D claims prescribed by a 340B-affiliated clinician increased; however, the rate at which 340B-eligible prescriptions were filled at 340B pharmacies increased at a faster rate, driving the overall increase in 340B claims. Despite these trends, only half of 340B-eligible prescriptions were subject to the 340B discount in 2020.
Educational Outcomes for Children at 7 to 9 Years of Age After Birth at 39 vs 40 to 42 Weeks’ Gestation
Authors: Hiscock Richard J. , Atkinson Jessica A. , Tong Stephen , Walker Susan P. , Kennedy Amber , Cheong Jeanie Y. L. , Quach Jon L. , Gurrin Lyle C. , Hastie Roxanne , Lindquist Anthea
Published: November 2023

Importance

Birth at 39 weeks’ gestation is common and thought to be safe for mother and neonate. However, findings of long-term outcomes for children born at this gestational age have been conflicting.

Objective

To evaluate the association of birth at 39 weeks’ gestation with childhood numeracy and literacy scores at ages 7 to 9 years compared with birth at 40 to 42 weeks’ gestation.

Design, Setting, and Participants

In this Australian statewide, population-based cohort study using a causal inference framework based on target trial emulation, perinatal data on births between January 1, 2005, and December 31, 2011, were linked to educational outcomes at 7 to 9 years of age. Statistical analyses were performed from December 2022 to June 2023.

Exposure

Birth at 39 weeks’ gestation compared with birth at 40 to 42 weeks’ gestation.

Main Outcomes and Measures

Numeracy and literacy outcomes were assessed at 7 to 9 years of age using Australian National Assessment Program–Literacy and Numeracy data and defined by overall z score across 5 domains (grammar and punctuation, reading, writing, spelling, and numeracy). Multiple imputation and doubly robust inverse probability weighted regression adjustment were used to estimate population average causal effects.

Results

The study population included 155 575 children. Of these children, 49 456 (31.8%; 24 952 boys [50.5%]) were born at 39 weeks’ gestation and were compared with 106 119 (68.2%; 52 083 boys [49.1%]) born at 40 to 42 weeks’ gestation. Birth at 39 weeks’ gestation was not associated with altered educational outcomes for children aged 7 to 9 years compared with their peers born at 40 to 42 weeks’ gestation (mean [SE] z score, 0.0008 [0.0019] vs –0.0031 [0.0038]; adjusted risk difference, −0.004 [95% CI, −0.015 to 0.007]). Each educational domain was investigated, and no significant difference was found in grammar and punctuation (risk difference [RD], −0.006 [95% CI, −0.016 to 0.005]), numeracy (RD, −0.009 [95% CI, −0.020 to 0.001]), spelling (RD, 0.001 [95% CI, −0.011 to 0.0013]), reading (RD, −0.008 [95% CI, −0.019 to 0.003]), or writing (RD, 0.006 [95% CI, −0.005 to 0.016]) scores for children born at 39 weeks’ gestation compared with those born at 40 to 42 weeks’ gestation. Birth at 39 weeks’ gestation also did not increase the risk of scoring below national minimum standards in any of the 5 tested domains.

Conclusions and Relevance

Using data from a statewide linkage study to emulate the results of a target randomized clinical trial, this study suggests that there is no evidence of an association of birth at 39 weeks’ gestation with numeracy and literacy outcomes for children aged 7 to 9 years.
Mutant p53 and ELK1 co‐drive FRA‐1 expression to induce metastasis in breast cancer
Authors: Hu Sike , Wang Manxue , Ji Ailing , Yang Jie , Gao Ruifang , Li Xia , Sun Lili , Wang Jing , Zhang Ying , Liu Hongbin
Published: November 2023

Tumor‐associated p53 mutations induce activities different from wild‐type p53, thus causing loss of the protein's tumor inhibition function. The cells carrying p53 mutations have more aggressive characteristics related to invasion, metastasis, proliferation, and cell survival. By comparing the gene expression profiles of mutant p53 (mutp53) and mutp53 silenced cohorts, we found that FOS‐related antigen‐1 (FRA‐1), which is encoded by FOSL1, is a potential effector of mutp53‐mediated metastasis. We demonstrate that the expression of FRA‐1, a gatekeeper of mesenchymal–epithelial transition, is elevated in the presence of p53 mutations. Mechanistically, mutant p53 cooperates with the transcription factor ELK1 in binding and activating the promoter of FOSL1, thus fostering lung metastasis. This study reveals new insights into how mutant p53 contributes to metastasis in breast cancer.
Ceftriaxone exerts antitumor effects in MYCN‐driven retinoblastoma and neuroblastoma by targeting DDX3X for translation repression
Authors: Chittavanich Pamorn , Saengwimol Duangporn , Roytrakul Sittiruk , Rojanaporn Duangnate , Chaitankar Vijender , Srimongkol Atthapol , Anurathapan Usanarat , Hongeng Suradej , Kaewkhaw Rossukon
Published: November 2023

MYCN proto‐oncogene, bHLH transcription factor (MYCN) amplification is associated with aggressive retinoblastoma (RB) and neuroblastoma (NB) cancer recurrence that is resistant to chemotherapies. Therefore, there is an urgent need to identify new therapeutic tools. This study aimed to evaluate the potential repurposing of ceftriaxone for the treatment of MYCN‐amplified RB and NB, based on the clinical observations that the drug was serendipitously found to decrease the volume of the MYCN‐driven RB subtype. Using patient‐derived tumor organoids and tumor cell lines, we demonstrated that ceftriaxone is a potent and selective growth inhibitor targeting MYCN‐driven RB and NB cells. Profiling of drug‐induced transcriptomic changes, cell‐cycle progression, and apoptotic death indicated cell‐cycle arrest and death of drug‐treated MYCN‐amplified tumor cells. Drug target identification, using an affinity‐based proteomic and molecular docking approach, and functional studies of the target proteins revealed that ceftriaxone targeted DEAD‐box helicase 3 X‐linked (DDX3X), thereby inhibiting translation in MYCN‐amplified tumors but not in MYCN‐nonamplified cells. The data suggest the feasibility of repurposing ceftriaxone as an anticancer drug and provide insights into the mechanism of drug action, highlighting DDX3X as a potential target for treating MYCN‐driven tumors.
Nuclear‐Targeted Nanostrategy Regulates Spatiotemporal Communication for Dual Antitumor Immunity
Authors: Wang Ben , Hu Zhi‐Chao , Chen Li‐Jie , Liang Hai‐Feng , Lu Hong‐Wei , Chen Qing , Liang Bing , Aji Abudula , Dong Jian , Tian Qi‐Wei , Jiang Li‐Bo , Xue Feng‐Feng
Published: November 2023

Intercellular communication between tumor cells and immune cells regulates tumor progression including positive communication with immune activation and negative communication with immune escape. An increasing number of methods are employed to suppress the dominant negative communication in tumors such as PD‐L1/PD‐1. However, how to effectively improve positive communication is still a challenge. In this study, a nuclear‐targeted photodynamic nanostrategy is developed to establish positive spatiotemporal communication, further activating dual antitumor immunity, namely innate and adaptative immunity. The mSiO2‐Ion@Ce6‐NLS nanoparticles (NPs) are designed, whose surface is modified by ionic liquid silicon (Ion) and nuclear localization signal peptide (NLS: PKKKRKV), and their pores are loaded with the photosensitizer hydrogen chloride e6 (Ce6). Ion‐modified NPs enhance intratumoral enrichment, and NLS‐modified NPs exhibit nuclear‐targeted characteristics to achieve nuclear‐targeted photodynamic therapy (nPDT). mSiO2‐Ion@Ce6‐NLS with nPDT facilitate the release of damaged double‐stranded DNA from tumor cells to activate macrophages via stimulator of interferon gene signaling and induce the immunogenic cell death of tumor cells to activate dendritic cells via “eat me” signals, ultimately leading to the recruitment of CD8+ T‐cells. This therapy effectively strengthens positive communication to reshape the dual antitumor immune microenvironment, further inducing long‐term immune memory, and eventually inhibiting tumor growth and recurrence.
NOX2 Enzyme Mimicking Nano‐Networks Regulate Tumor‐Associated Macrophages to Initiate Both Innate and Adaptive Immune Effects
Authors: Zhang Tingting , Yin Weimin , Zhao Yuge , Huang Li , Gu Jingjing , Zang Jie , Zheng Xiao , Chang Jiao , Sun Jiuyuan , Dong Haiqing , Li Yongyong , Li Yan
Published: November 2023

Macrophages, capable of both direct killing and antigen presentation, are crucial for the interplay between innate and adaptive immunity. However, strategies mainly focus on polarizing tumor‐associated macrophages (TAMs) to M1 phenotype, while overlooking the inefficient antigen cross‐presentation due to hyperactive hydrolytic protease within lysosomes which leads to antigen degradation. In light of the significant influence of reactive oxygen species (ROS) on TAMs' polarization and the inhibition of phagosomal proteolysis, a novel nanosystem termed OVA‐Fe‐GA (OFG) is engineered, drawing inspiration from the NOX2 enzyme's role. OFG integrates ovalbumin (OVA) and a network composed of Fe‐gallic acid (GA), emulating the NOX2 enzyme's sequential ROS generation process (“O2 to O2•− to H2O2/•OH”). Furthermore, it elucidates a biological mechanism that augments antigen cross‐presentation by suppressing the expression of cysteine proteases. OFG restores the innate anti‐tumor functionality of TAMs and significantly amplifies their antigen cross‐presentation (4.5‐fold compared to the PBS control group) in B16‐OVA tumor‐bearing mice. Notably, the infiltration and activity of intratumoral CD8+ T cells are enhanced, indicating an adaptive immune response. Moreover, OFG exhibits excellent photothermal properties, thereby fostering a system antitumor immune response. This study provides a promising strategy for initiating both innate and adaptive immunity via TAMs activation.
Biomimetic Nanoarchitectonics with Chitosan Nanogels for Collaborative Induction of Ferroptosis and Anticancer Immunity for Cancer Therapy
Authors: Yang Ning , Pan Xiuhua , Zhou Xiawei , Liu Zengyi , Yang Jie , Zhang Jun , Jia Zengguang , Shen Qi
Published: November 2023

Immunogenic cell death (ICD) shows promising therapeutic potential for tumor regression. However, the low sensitivity and immunosuppressive state of current cell death manners seriously impede tumor immunogenicity. Ferroptosis characterized by excessive lipid peroxidation, has emerged as a potential strategy to induce ICD and activate antitumor immune responses. However, the effectiveness of ferroptosis is limited by antioxidant regulatory networks, including the glutathione peroxidase 4 (GPX4) and ferroptosis suppressor protein 1 (FSP1) pathways, presenting challenges for its induction. Herein, they propose a novel approach that involves utilizing functionalized chitosan‐ferrocene‐sodium alginate (CFA) crosslinked nanogels, which are modified to pravastatin (PRV) and M1 macrophage membrane (MM) (designing as CFA/PRV@MM). Specifically, ferrocene boots intracellular reactive oxygen species levels for efficient glutathione (GSH) depletion through Fenton reaction, thus disrupting the GPX4/GSH axis, while PRV intervenes in the mevalonate pathway to inhibit the FSP1/CoQ10 antioxidant axis, thereby synergistically causing pronounced ferroptotic damage and promoting ICD. The CFA/PRV@MM nanogels demonstrate superior therapeutic efficacy in a mouse breast model, resulting in effective tumor ablation and immune response with minimal side effects. RNA transcription analysis reveals that nanogels can significantly affect metabolic progress, as well as immune activation. This research provides valuable insights into the design of ferroptosis induction for cancer immunotherapy.
Tandem Catalysis inside Double‐Shelled Nanocages with Separated and Tunable Atomic Catalyst Sites for High Performance Lithium‐Sulfur Batteries
Authors: Ren Longtao , Sun Kai , Wang Yan , Kumar Anuj , Liu Jun , Lu Xiwen , Zhao Yajun , Zhu Qingyi , Liu Wen , Xu Haijun , Sun Xiaoming
Published: November 2023

Single‐atomic catalysts are effective in mitigating the shuttling effect and slow redox kinetics of lithium polysulfides (LiPSs) in lithium‐sulfur (Li‐S) batteries, but their ideal performance has yet to be achieved due to the multi‐step conversion of LiPSs requiring multifunctional active sites for tandem catalysis. Here double‐shelled nano‐cages (DSNCs) have been developed to address this challenge, featuring separated and tunable single‐atom sites as nano reactors that trigger tandem catalysis and promote the efficient electrochemical conversion of LiPSs. This enables high capacity and durable Li‐S batteries. The DSNCs, with inner Co‐N4 and outer Zn‐N4 sites (S/CoNC@ZnNC DSNCs), exhibit a high specific capacity of 1186 mAh g−1 at 1 C, along with a low capacity fading rate of 0.063% per cycle over 500 cycles. Even with a high sulfur loading (4.2 mg cm−2) and a low E/S ratio (6 µL mg−1), the cell displays excellent cycling stability. Moreover, the Li‐S pouch cells are capable of stable cycling for more than 160 cycles. These results demonstrate the feasibility of driving successive sulfur conversion reactions with separated active sites, and are expected to inspire further catalyst design for high performance Li−S batteries.
Decoupling the Trade‐Off Between the Photosignal and Photonoise in Upconversion Devices Through a Solution‐Processed Nickel Oxide Interconnecting Layer
Authors: Hu Yuanhong , Chen Lixiang , Li Hao , Jiang Haohong , Wang Ke , Li Ning , Zhang Qiaoming , Lei Yanlian
Published: November 2023

Near‐infrared (NIR) to visible upconversion devices (UCDs) provide a viable and cost‐effective way for NIR visualization and pixel‐less imaging techniques. An excellent electrical connection between the NIR detection unit and the visible emission unit in the UCD is one of the prerequisites for achieving efficient upconversion performance. In this study, a low temperature‐ and solution‐processed nickel oxide (NiOx) interconnecting layer (ICL) with high hole mobility and favorable energy levels is demonstrated to decouple the trade‐off between photosignal and photonoise in the UCDs. The use of such a NiOx ICL suppresses intrinsic visible emission in the dark (photonoise) but enhances visible light output under NIR illumination (photosignal) by triggering an efficient charge injection in the UCDs. As a result, a hybrid UCD monolithically integrating an organic NIR photodetector and a visible quantum dot light‐emitting diode via the NiOx ICL achieves excellent performance, exhibiting an ultralow turn‐on voltage as low as 1.6 V, a high luminance close to 6.3 × 103 cd m−2, a wide operation voltage window up to 7.4 V, and a high contrast ratio reaching 5 × 104. The resulting UCD is also used for imaging demonstrations showing clear visible images of the NIR targets, which paves the way for practical applications.
Near‐Infrared Emission of Sm2+ in Oxynitrides
Authors: Lv Ying , Li Yunkai , Li Zhongyuan , Xie Rong‐Jun
Published: November 2023

Near‐infrared (NIR) luminescent materials hold promising applications in NIR spectroscopy technologies, but the NIR emitters are largely limited to some transition metals with spin‐forbidden transitions that lead to low absorption efficiency of the pumping light. Exploring novel efficient NIR emitters is thus an urgent and challenging task for developing high‐efficiency NIR luminescent materials. Here, an interesting NIR emission of Sm2+ is reported in BaAlSi5O2N7, which exhibits both a line spectrum at 682 nm and a broadband centered at 778 nm with a full‐width at half maximum (FWHM) of 141 nm. Temperature‐dependent photoluminescence spectra and decay curves evidence that the thermally assisted electrons crossover (TAEC) process contributes to the enhancement of the broadband NIR emission. The fabricated NIR phosphor‐converted light‐emitting diode (pc‐LED) shows promising potential as a NIR lighting source and proves robust thermal stability under high‐temperature aging test. The present surprising NIR emission from Sm2+ in highly stable oxynitrides opens a way to explore efficient and reliable NIR phosphors that are suitable for commercial LED chips.
Urethral Microenvironment Adapted Sodium Alginate/Gelatin/Reduced Graphene Oxide Biomimetic Patch Improves Scarless Urethral Regeneration
Authors: Wang Liyang , Wang Kai , Yang Ming , Yang Xi , Li Danyang , Liu Meng , Niu Changmei , Zhao Weixin , Li Wenyao , Fu Qiang , Zhang Kaile
Published: November 2023

The nasty urine microenvironment (UME) is an inherent obstacle that hinders urethral repair due to fibrosis and swelling of the oftentimes adopted hydrogel‐based biomaterials. Here, using reduced graphene oxide (rGO) along with double‐freeze‐drying to strengthen a 3D‐printed patch is reported to realize scarless urethral repair. The sodium alginate/gelatin/reduced graphene oxide (SA/Gel/rGO) biomaterial features tunable stiffness, degradation profile, and anti‐fibrosis performance. Interestingly, the 3D‐printed alginate‐containing composite scaffold is able to respond to Ca2+ present in the urine, leading to enhanced structural stability and strength as well as inhibiting swelling. The investigations present that the swelling behaviors, mechanical properties, and anti‐fibrosis efficacy of the SA/Gel/rGO patch can be modulated by varying the concentration of rGO. In particular, rGO in optimal concentration shows excellent cell viability, migration, and proliferation. In‐depth mechanistic studies reveal that the activation of cell proliferation and angiogenesis‐related proteins, along with inhibition of fibrosis‐related gene expressions, play an important role in scarless repair by the 3D‐printed SA/Gel/rGO patch via promoting urothelium growth, accelerating angiogenesis, and minimizing fibrosis in vivo. The proposed strategy has the potential of resolving the dilemma of necessary biomaterial stiffness and unwanted fibrosis in urethral repair.
Robotic Vectorial Field Alignment for Spin‐Based Quantum Sensors
Authors: Smith Joe A. , Zhang Dandan , Balram Krishna C.
Published: November 2023

Developing practical quantum technologies will require the exquisite manipulation of fragile systems in a robust and repeatable way. As quantum technologies move toward real world applications, from biological sensing to communication in space, increasing experimental complexity introduces constraints that can be alleviated by the introduction of new technologies. Robotics has shown tremendous progress in realizing increasingly smart, autonomous, and highly dexterous machines. Here, a robotic arm equipped with a magnet is demonstrated to sensitize an NV center quantum magnetometer in challenging conditions unachievable with standard techniques. Vector magnetic fields are generated with 1° angular and 0.1 mT amplitude accuracy and determine the orientation of a single stochastically‐aligned spin‐based sensor in a constrained physical environment. This work opens up the prospect of integrating robotics across many quantum degrees of freedom in constrained settings, allowing for increased prototyping speed, control, and robustness in quantum technology applications.