bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction of immune cells with renal cancer development: Mendelian randomization (MR) study
Authors: Lu Zhongwen , Yin Yu , Rao Tian , Xu Xinchi , Zhao Kai , Liu Zhanpeng , Qin Chao , Tang Min
Published: April 2024

Background

Renal cell carcinoma (RCC) is a prevalent and extensively immune-infiltrated malignancy of the urinary system. Immune cells play a crucial role in both the progression and therapeutic interventions targeting RCC. Nevertheless, the interplay between RCC and immune cells remains understudied, lacking substantial evidence supporting their causal relationship.

Methods

For the purpose of investigating the causal connection between RCC and immune cell characteristics, a two-way two-sample Mendelian randomization (MR) analysis was carried out in this study. The aim was to determine whether specific immune cell traits have a causal impact on the risk of RCC. In order to achieve this, publicly accessible genetic data was utilized to examine and establish the potential relationship between 731 immune cell characteristics and the likelihood of developing RCC. Additionally, various techniques were applied to verify the reliability, variability, and presence of horizontal pleiotropy in the outcomes.

Results

We found a bidirectional causal relationship between RCC and immune cells according to the MR analysis results. It should be noted that CD4-CD8-T cells (OR = 1.61, 95%CI = 1.02–2.55, P = 4.07 × 10–2) pose a risk for RCC, whereas BAFF-R (OR = 0.69, 95%CI = 0.53–0.89, P = 5.74 × 10–3) and CD19 (OR = 0.59, 95%CI = 1.02–2.55, P = 4.07 × 10–2) on B cells act as protective factors. Furthermore, the presence of RCC reduces the levels of B cells (OR = 1.05, 95%CI = 1.01–1.09, P = 1.19 × 10–2) and CD8 + T cells (OR = 1.04, 95%CI = 1.00–1.08, P = 2.83 × 10–2).

Conclusions

Our research illustrates the intricate correlation between immune cells and RCC, presenting novel insights for the prospective safeguarding against RCC risk and the exploration of fresh therapeutic targets.
A preliminary metabolomics study of the database for biological samples of schizophrenia among Chinese ethnic minorities
Authors: Ye Jun , Chen Haixia , Wang Yang , Chen Haini , Huang Jiang , Yang Yixia , Feng Zhen , Li Wenfeng
Published: April 2024

Background

Schizophrenia (SCZ) is a profound mental disorder with a multifactorial etiology, including genetics, environmental factors, and demographic influences such as ethnicity and geography. Among these, the studies of SCZ also shows racial and regional differences.

Methods

We first established a database of biological samples for SCZ in China’s ethnic minorities, followed by a serum metabolomic analysis of SCZ patients from various ethnic groups within the same region using the LC-HRMS platform.

Results

Analysis identified 47 metabolites associated with SCZ, with 46 showing significant differences between Miao and Han SCZ patients. These metabolites, primarily fatty acids, amino acids, benzene, and derivatives, are involved in fatty acid metabolism pathways. Notably, L-Carnitine, L-Cystine, Aspartylphenylalanine, and Methionine sulfoxide demonstrated greater diagnostic efficacy in Miao SCZ patients compared to Han SCZ patients.

Conclusion

Preliminary findings suggest that there are differences in metabolic levels among SCZ patients of different ethnicities in the same region, offering insights for developing objective diagnostic or therapeutic monitoring strategies that incorporate ethnic considerations of SCZ.
Perception of pregnant individuals, health providers and decision makers on interventions to cease substance consumption during pregnancy: a qualitative study
Authors: Vila-Farinas Andrea , Pérez-Ríos Mónica , Montes-Martínez Agustín , Ahluwalia Jasjit S- , Mourino Nerea , Rey-Brandariz Julia , Triñanes-Pego Yolanda , Candal-Pedreira Cristina , Ruano-Ravina Alberto , Gómez-Salgado Patricia , Miguez-Varela Carmen , Tajes-Alonso María , Loureiro-Fuentes Isabel , Riesgo-Martín Juan , Valverde-Trillo Araceli , Fernández-Lema Isabel , Rey-Arijón Mercedes , Freiría-Somoza Isabel , Rodríguez-Pampín María , Varela-Lema Leonor
Published: April 2024

Background

Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders’ perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement.

Methods

A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified.

Results

The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals.

Conclusions

Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.
Physical therapy interventions for people experiencing homelessness to improve pain and self-perceived health status
Authors: Jiménez-Sánchez Carolina , la Cruz Natalia Brandín-de , Lafuente-Ureta Raquel , Francín-Gallego Marina , Calvo Sandra , Fortún-Rabadán Rocío , Pérez-Palomares Sara
Published: April 2024

Background

Homeless shelters have emerged as components of the social services network, playing an important role in providing health care to the homeless population. The aim of this study was to evaluate an individualized physical therapy intervention for people experiencing homelessness and to determine the relationship between self-perceived variables.

Methods

Pre and post study, setting at the “Santa y Real Hermandad de Nuestra Señora del Refugio y Piedad” homeless shelter in Zaragoza, Spain. Participants were people experiencing homelessness with musculoskeletal disorders who attended a physical therapy service at shelter facilities. A physical therapy program was implemented including health education, exercise and manual therapy, electrotherapy, thermotherapy and bandaging. Demographic variables (age and gender), nationality, employment situation, educational level, pain location, number of painful areas, feeling of loneliness (3-Item Loneliness Scale; values from 3 to 9), pain intensity (Numerical Pain Rating Scale [NPRS]; from 0 to 10) and self-perceived health (Clinical Global Impression [CGI]; from 1 to 7).

Results

Sixty-four homeless people (age of 46.4 ± 10.9 years) participated in the study. Musculoskeletal pain was reported by 98.4% of subjects, with moderate pain intensities (6.1), and 48.4% presenting with pain at multiple sites. Perceptions of loneliness were low (3.7 ± 2.5) and self-perceived health status was moderately ill (3.5 ± 1.7). Positive significant correlations were identified between pain intensity and self-perceived health. The average number of sessions was 1.5 (± 0.8), with manual therapy (35.6%) followed by health education (23.5%) being the most frequently used techniques. Both pain and self-perceived health improved after treatment, even following a brief intervention.

Conclusions

This study demonstrates the potentially negative impact of untreated pain on the self-perceived health of homeless individuals with musculoskeletal disorders that should be targeted for consideration. The findings suggest that a paradigm shift in pain management, including a physical therapy service in shelters, is needed to address the rehabilitation demands of these individuals in a real-life context. This study was approved by the Aragon Ethics Committee (PI19/438) and performed according to the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement.
National norms for the obstetric nurses’ and midwives’ health education competence, and its influencing factors: a nationwide cross-sectional study
Authors: Zou Jingjing , Wu Jingling , Jiang Xiumin
Published: April 2024

Background

Strengthening obstetric nurses’ and midwives’ health education competence is the investment and guarantee for the population’s future health. The purpose of study is to establish national norms for their health education competence, and explore possible influencing factors for providing an uniform criterion identifying levels and weaknesses.

Methods

An online questionnaire with a standard process was used to collect data. Three normative models were constructed, and multiple linear regression analysis analyzed possible influencing factors.

Results

The sample respondents (n = 3027) represented obstetric nurses and midwives nationally. Three health education competency normative norms (mean, percentile and demarcation norm) were constructed separately. Locations, hospital grade, department, marital status, training times and satisfaction with health education training influenced obstetrical nurses’ and midwives’ health education competence (P<0.05).

Conclusion

This study constructed the first national standard for assessing obstetric nurses’ and midwives’ health education competence, providing a scientific reference to evaluate the degree of health education competence directly. These known factors could help clinical and policy managers designate practice improvement measures. In future research, Grade I hospitals should be studied with larger sample sizes, and indicators need to improve to reflect health education’s effect better.
Preparing medical students for their educational task as physicians: important, desirable and unexplored territory
Authors: ter Brugge Bas PH , Fegg Lena Sophia , Wijnen-Meijer Marjo
Published: April 2024

Background

Physicians engage in educational activities in daily practice and take over an important role in providing information and transferring knowledge to patients and medical students. Therefore, it is important to focus on methods to develop teaching skills during medical school. Peer-teaching is a teaching method that is connected to different positive learning outcomes. This study aims to investigate the perspective of medical students regarding teaching as a core competency of physicians and peer-teaching as an opportunity to acquire educational skills. The study also aims to examine to what extent medical students are prepared for their teaching role at medical schools.

Methods

This cross-sectional study was performed by an online survey amongst Dutch medical students from all medical schools across all years of study. In total, 2666 medical students filled out the survey. The survey was part of the annual online survey of the Dutch medical advocacy group (DeGeneeskundestudent) amongst all medical students in the fall of 2017. The data were analysed with descriptive statistics and statistical tests (chi-squared-test and binomial test).

Results

The results show that 49% of medical students see teaching as one of the core tasks of a physician. However, only 25% feel well prepared by their medical school for this teaching role. Instead, there are many students who gain experiences and teaching skills on their own outside medical schools. 64% of the respondents agrees that senior medical students can educate junior medical students well.

Conclusions

Implementing peer-teaching in the curricular of medical schools could be an effective teaching method to prepare medical students for their future teaching role. It is important that medical schools focus on enhancing educational quality and designing learning environments for best learning outcomes to better prepare medical students for professional life.
Barriers to increasing paid parental leave in U.S. neurology residencies: a survey of program directors
Authors: Conway Sarah E. , Wang Wei , Prasad Sashank
Published: April 2024

Background

The American Board of Psychiatry and Neurology (ABPN) and the Accreditation Council for Graduate Medical Education (ACGME) require that residency programs allow at least 6 weeks of parental leave. The American Medical Association (AMA) recommends 12 weeks of paid parental leave. Despite these recommendations, there is little information about parental leave policies across U.S. neurology residencies. The objective of our study was to assess parental leave policies in U.S. adult neurology residencies and barriers to increasing the duration of leave.

Methods

We distributed an anonymous online survey to U.S. adult neurology program directors (PDs) to assess demographics, components and length of parental leave, perceived impact on residents’ clinical training and academic development, and barriers to increasing the length of leave.

Results

We contacted 163 PDs and received 54 responses (response rate of 33%). 87% reported policies for both childbearing and non-childbearing residents. The average maximal length of leave allowed without extension of training was 8.5 weeks (range 0–13) for childbearing and 6.2 weeks (range 0–13) for non-childbearing residents. Most PDs felt that parental leave had a positive impact on resident wellness and neutral impact on clinical competency, academic opportunities, and career development. The most common barriers to providing a 12-week paid policy were concerns about equity in the program (82%), staffing of clinical services (80%), and impact on clinical training (78%).

Conclusions

Although most programs in our study have parental leave policies, there is significant variability. Policies to improve parental leave should focus on addressing common barriers, such as additional solutions to staffing clinical services.
Final-year nursing students’ perceptions of humanistic education in nursing: a cross-sectional descriptive study
Authors: Zhang Jun , Tian Yangyang
Published: April 2024

Background

Humanistic education is an important part of nursing education. Final-year nursing students’ perceptions of nursing humanistic education are under-investigated. This study aimed to examined final-year nursing students’ perceptions of nursing humanistic education in both school and hospital.

Methods

This was a cross-sectional descriptive study conducted from May to June 2022 among 107 final-year nursing students with a self-designed questionnaire.

Results

Final-year nursing students recognized the importance of humanistic education, scoring above 4.0 on a 1–5 scale, while their initiative to enhance humanistic qualities was relatively low. Students’ satisfaction with the number of humanities courses offered was only 3.7 ± 0.862. Moreover, 62.6% of students believed there was a need to enhance humanistic environmental development including corridor culture. The “monotonous teaching format” (63.6%) and “teaching methods” (64.5%) have emerged as focal points that students identified as needing attention and improvement.

Conclusions

In the future, nursing humanistic education can be enhanced by increasing the proportion of humanities, improving teaching methods, stimulating students’ learning motivation, and strengthening the construction of humanistic environment.
Nurses’ perspectives on professional self-concept and its influencing factors: A qualitative study
Authors: Miao Chuyuan , Liu Chunqin , Zhou Ying , Zou Xiaofang , Song Liqin , Chung Joanne W.Y. , Tan Wenying , Li Xiaohua , Li Dong
Published: April 2024

Background

Nurses with a strong professional self-concept tend to exhibit a positive mindset and strong work engagement, delivering high-quality patient care. Although numerous quantitative studies have examined the factors impacting professional self-concept, there remains a limited exploration of these factors from the perspective of nurses themselves.

Methods

This qualitative descriptive study uses the PERMA theory and Social Cognitive Theory as the theoretical framework. Semi-structured interviews were conducted with 15 nurses from six public hospitals in China. The data were analyzed thematically using a combination of inductive and deductive approaches.

Results

Nurses’ understanding of professional self-concept could be divided into four categories: professional identity, competence, care, and knowledge. Factors influencing nurses’ professional self-concept were categorized into eight subthemes in three domains: (1) personal factors, including psychological qualities and attitude towards the nursing profession; (2) occupational-related behavioral factors, including role-oriented behavior and knowledge-oriented behavior; and (3) work environment and external factors, including external evaluation and perceptions of nurses, time allocation, nursing work tasks, work atmosphere, school education, and perceived supports.

Conclusions

This study found that, although nurses had different personal experiences, their perceptions of professional self-concept were similar. Nurses’ professional self-concept is a multidimensional concept and involves various factors, such as personality, work-related characteristics, environment, and family. To thrive in a nursing career, nurses must discern the factors that can enhance or hinder their professional self-concept. By identifying and adjusting these factors, personalized support and positive interventions can be tailored to meet nurses’ specific needs, which ultimately nurtures their professional development.

Trial registration

This study was registered on December 14, 2022, in the Chinese Clinical Trial Registry (ChiCTR2200066699) as part of our ongoing study.
Equine-assisted services for people living with dementia: a systematic review
Authors: Sebalj Menka , Lakhani Ali , Grindrod Andrea , Stuckey Rwth
Published: April 2024

Background

Dementia has a significant impact on the social, physical, and psychological wellbeing of people living with dementia, their families and society. Animal-assisted interventions can have positive effects on the health and wellbeing of people living with dementia. Equine-assisted services are animal-assisted non-pharmacological interventions which have improved the health and wellbeing of diverse populations. The impact of participating in equine-assisted services on the health and wellbeing of people with dementia is unclear. A systematic review was conducted to synthesise evidence investigating the effects of participating in equine-assisted services on the health and wellbeing of people living with dementia.

Design

Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Methods

The databases CINAHL, EMBASE, MEDLINE, and Web of Science were searched for any research published prior to 14 June 2023. Peer-reviewed publications in the English language utilizing methods deriving quantitative and/or qualitative data were eligible. Methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Findings from studies were synthesised using a deductive approach.

Results

Of the 223 articles screened, six met the inclusion criteria: four quantitative and two qualitative studies. The six studies represent four separate equine interventions. Studies were of moderate to strong quality. Participants were people living with dementia (n = 44, mean age range 70–83 years), dementia care partners (n = 5, mean age 58), and equine-assisted services providers (n = 5). Interventions varied in duration, activities conducted, outcomes measured, and measurement tools used. Studies found a favourable impact of participating in equine-assisted services on the neuropsychiatric symptoms and quality of life of people living with dementia. Participating in equine-assisted services improved well-being, functional abilities, social participation, and communication, while also having a positive effect on social, emotional, and behavioural outcomes, and physical health.

Conclusions

The limited but high-quality literature investigating the impact of equine-assisted services among people living with dementia suggests that equine-assisted services can have a positive impact on the health and wellbeing of people living with dementia. Additional robust studies contributing to the evidence base are warranted; such studies can support the development of programs and further elucidate the impact of participation.
Stacked-CNN-BiLSTM-COVID: an effective stacked ensemble deep learning framework for sentiment analysis of Arabic COVID-19 tweets
Authors: Abdelhady Naglaa , Hassan A. Soliman Taysir , F. Farghally Mohammed
Published: April 2024

Social networks are popular for advertising, idea sharing, and opinion formation. Due to COVID-19, coronavirus information disseminated on social media affects people’s lives directly. Individuals sometimes managed it well, but it often hampered daily activities. As a result, analyzing people’s feelings is important. Sentiment analysis identifies opinions or sentiments from text. In this paper, we present an effective model that leverages the benefits of Convolutional Neural Network (CNN) and Bidirectional Long Short-Term Memory (BiLSTM) to categorize Arabic tweets using a stacked ensemble learning model. First, the tweets are represented as vectors using a word embedding model, then the text feature is extracted by CNN, and finally the context information of the text is acquired by BiLSTM. Aravec, FastText, and ArWordVec are employed separately to assess the impact of the word embedding on the our model. We also compare the proposed method to various deep learning models: CNN, LSTM, and BiLSTM. Experiments are performed on three different Arabic datasets related to COVID-19 and vaccines. Empirical findings show that the proposed model outperformed the other models’ results by achieving F-measures of 76.76%, 87.%, and 80.5% on the SenWave, AraCOVID19-SSD, and ArCovidVac datasets, respectively.
Comparative analysis of metabolites and in vitro hypoglycemic activity of Taiwanofungus camphoratus cultured using various methods
Authors: Ming YongFei , Li Yin , Chu JianZhi , Zhou XiaoShuang , Huang YuXuan , Yang ShuDe , Mu YueJun , Wang Lin , Zhang Rui , Cheng XianHao
Published: April 2024

Taiwanofungus camphoratus has attracted much attention because it can abundantly produce various active substances that exhibit blood-sugar lowering, immunity improving, and antioxidant properties. Currently, T. camphoratus is cultured using four main methods: cutting wood culture, solid-state fermentation, submerged fermentation, and dish culture. T. camphoratus produces different metabolites under different culture methods. In this study, nontargeted metabolomics was used to compare the metabolites of T. camphoratus produced under these four culture methods. Principal component analysis and supervised partial least squares-discriminant analysis were used to analyze the differences in the metabolites. Moreover, in vitro hypoglycemic activity of T. camphoratus extracts produced under four culture methods was compared by assessing their ability to inhibit the activity of α-glucosidase, α-amylase, and sucrase. A total of 186 metabolites were identified. In total, 127 metabolites were common under the four culture methods. Under solid-state fermentation, submerged fermentation, and cutting wood culture, 12, 1, and 4 metabolites were unique, respectively. The differential metabolites produced by T. camphoratus under four culture methods were mainly triterpenoids, phenolic compounds, and fatty acid compounds. α-glucosidase, α-amylase, and sucrase activity inhibition was the best using T. camphoratus extract obtained under cutting wood culture; the inhibition rates were 55.97%, 51.96%, and 78.02%, respectively, which were comparable to those exhibited by 0.001, 3, and 12 mg/mL acarbose (positive control). The metabolites produced by T. camphoratus and α-glucosidase, α-amylase, and sucrase inhibitory activities were different under the four culture methods. Cutting wood culture exhibited the best enzyme inhibitory activity. This study provided a theoretical basis for further use and development of various culture methods for the rational production of active metabolites of T. camphoratus.
Primary intracranial malignant melanoma in an adolescent female: a case report
Authors: Vishwajeet Vikarn , Saraf Pallavi , Elhence Poonam Abhay , Tiwari Sarbesh , Gosal Jaskaran Singh , Jha Deepak Kumar
Published: April 2024

Background

Primary central nervous system melanoma is an extremely rare entity and even rarer in children and adolescents as compared to adults. It is often difficult to consider a diagnosis of intracranial melanoma pre-operatively without any clinical evidence of neurocutaneous melanosis.

Case presentation

Herein, a case of primary melanoma of the brain is reported in a 17-year-old female who presented with headache, vomiting, and focal neurological deficit in the form of left-sided facial palsy and limb weakness. A contrast-enhanced computed tomography of head was performed which revealed a heterogeneously hyperattenuating mass lesion at left gangliocapsular region showing peripheral enhancement with internal non-enhancing cystic component. The patient underwent left frontotemporal craniotomy. The diagnosis was made on histopathological examination, which showed an invasive tumor comprising of epithelioid to spindled cells arranged in sheets, nests, and singly scattered. The special stains and immunohistochemical markers proved very helpful in establishing the diagnosis.

Conclusions

The case highlights the uncommon occurrence of primary intracranial melanoma in the pediatric age group, the perplexing histological features, and the rapid and fatal course.
Artificial intelligence-driven enhanced skin cancer diagnosis: leveraging convolutional neural networks with discrete wavelet transformation
Authors: Claret S. P. Angelin , Dharmian Jose Prakash , Manokar A. Muthu
Published: April 2024

Background

Artificial intelligence (AI) has shown great promise in the field of healthcare as a means of improving the diagnosis of skin cancer. The objective of this research is to enhance the precision and effectiveness of skin cancer identification by the incorporation of convolutional neural networks (CNNs) and discrete wavelet transformation (DWT). Making use of AI-driven techniques has the potential to completely transform the diagnosis process by providing quicker and more accurate evaluations of skin lesions. In an effort to improve dermatology and give physicians reliable resources for early and precise skin cancer diagnosis, this work explores the combination of CNNs with DWT.

Methods

The accurate and timely classification of skin cancer lesions plays a crucial role in early diagnosis and effective treatment. In this, we propose a novel approach for skin cancer classification using discrete wavelet transformation (DWT). The DWT is employed to extract relevant features from skin lesion images, which are then used to train a classification model. The effectiveness of the suggested approach is assessed through the examination of a dataset of skin lesion images with known classes (malignant or benign).

Results

The outcomes of the experiment demonstrate that the suggested model successfully attained a classification result of sensitivity as 94% and specificity as 91% when compared with artificial neural network (ANN) and multilayer perceptron methods.

Conclusions

The HAM 10000 dataset is employed to explore and evaluate the effectiveness of the proposed model, leading to improved accuracy compared to the existing machine learning algorithms in utilization. The results demonstrate the effectiveness of the DWT-based approach in accurately classifying skin cancer lesions, thus aiding in early detection and diagnosis.
Unpacking overuse of androgen deprivation therapy for prostate cancer to inform de-implementation strategies
Authors: Skolarus Ted A. , Hawley Sarah T. , Forman Jane , Sales Anne E. , Sparks Jordan B. , Metreger Tabitha , Burns Jennifer , Caram Megan V. , Radhakrishnan Archana , Dossett Lesly A. , Makarov Danil V. , Leppert John T. , Shelton Jeremy B. , Stensland Kristian D. , Dunsmore Jennifer , Maclennan Steven , Saini Sameer , Hollenbeck Brent K. , Shahinian Vahakn , Wittmann Daniela A. , Deolankar Varad , Sriram S.
Published: April 2024

Background

Many men with prostate cancer will be exposed to androgen deprivation therapy (ADT). While evidence-based ADT use is common, ADT is also used in cases with no or limited evidence resulting in more harm than benefit, i.e., overuse. Since there are risks of ADT (e.g., diabetes, osteoporosis), it is important to understand the behaviors facilitating overuse to inform de-implementation strategies. For these reasons, we conducted a theory-informed survey study, including a discrete choice experiment (DCE), to better understand ADT overuse and provider preferences for mitigating overuse.

Methods

Our survey used the Action, Actor, Context, Target, Time (AACTT) framework, the Theoretical Domains Framework (TDF), the Capability, Opportunity, Motivation–Behavior (COM-B) Model, and a DCE to elicit provider de-implementation strategy preferences. We surveyed the Society of Government Service Urologists listserv in December 2020. We stratified respondents based on the likelihood of stopping overuse as ADT monotherapy for localized prostate cancer (“yes”/“probably yes,” “probably no”/“no”), and characterized corresponding Likert scale responses to seven COM-B statements. We used multivariable regression to identify associations between stopping ADT overuse and COM-B responses.

Results

Our survey was completed by 84 respondents (13% response rate), with 27% indicating “probably no”/“no” to stopping ADT overuse. We found differences across respondents who said they would and would not stop ADT overuse in demographics and COM-B statements. Our model identified 2 COM-B domains (Opportunity–Social, Motivation–Reflective) significantly associated with a lower likelihood of stopping ADT overuse. Our DCE demonstrated in-person communication, multidisciplinary review, and medical record documentation may be effective in reducing ADT overuse.

Conclusions

Our study used a behavioral theory-informed survey, including a DCE, to identify behaviors and context underpinning ADT overuse. Specifying behaviors supporting and gathering provider preferences in addressing ADT overuse requires a stepwise, stakeholder-engaged approach to support evidence-based cancer care. From this work, we are pursuing targeted improvement strategies.

Trial registration

ClinicalTrials.gov, NCT03579680
Stereo-Electroencephalography–Guided Network Neuromodulation for Psychiatric Disorders: The Neurophysiology Monitoring Unit
Authors: Allawala Anusha B. , Bijanki Kelly R. , Adkinson Joshua , Oswalt Denise , Tsolaki Evangelia , Mathew Sanjay , Mathura Raissa K. , Bartoli Eleonora , Provenza Nicole , Watrous Andrew J. , Xiao Jiayang , Pirtle Victoria , Mocchi Madaline M. , Rajesh Sameer , Diab Nabeel , Cohn Jeffrey F. , Borton David A. , Goodman Wayne K. , Pouratian Nader , Sheth Sameer A.
Published: April 2024

BACKGROUND AND OBJECTIVES:

Recent advances in stereotactic and functional neurosurgery have brought forth the stereo-electroencephalography approach which allows deeper interrogation and characterization of the contributions of deep structures to neural and affective functioning. We argue that this approach can and should be brought to bear on the notoriously intractable issue of defining the pathophysiology of refractory psychiatric disorders and developing patient-specific optimized stimulation therapies.

METHODS:

We have developed a suite of methods for maximally leveraging the stereo-electroencephalography approach for an innovative application to understand affective disorders, with high translatability across the broader range of refractory neuropsychiatric conditions.

RESULTS:

This article provides a roadmap for determining desired electrode coverage, tracking high-resolution research recordings across a large number of electrodes, synchronizing intracranial signals with ongoing research tasks and other data streams, applying intracranial stimulation during recording, and design choices for patient comfort and safety.

CONCLUSION:

These methods can be implemented across other neuropsychiatric conditions needing intensive electrophysiological characterization to define biomarkers and more effectively guide therapeutic decision-making in cases of severe and treatment-refractory disease.
Behavior of steel building structures subjected to strong and benchmark seismic actions: An overview of damage from the observations of the last 40 years
Authors: ANASTASIADIS ANTHIMOS
Published: April 2024

It is well known that steel structures have high ductility capacity and high strength to weight ratio, which, theoretically, by nature makes them, the most efficient seismic structural system against strong earthquakes. However, the recorded experience of failures which have befallen over the last 40 years, as a result of strong seismic actions, suggests that this by itself isn't always sufficient. Generally, it is essential that an appropriate and preferred conformation and configuration of the structural system and in particular of its joints should be adopted. In any case, the steel building structures showed local failures without general and complete collapses. The work in this paper presents the seismic performance focused on steel building structures, as revealed by strong earthquakes, such as those of Mexico (1985), Northridge (1994), USA, Kobe (1995), Japan, Christchurch (2010-2011), N. Zealand, which affected and changed the design of metal structures, as well as other earthquakes like Maule (2010), Chile, Emilia (2012), Amatrice (2016), Italy, which completed the picture in the better understanding of failures and their reasons. On the basis of the lessons learnt from, a discussion for avoiding such situations are commented on and provided in this work.
Normative Method of the Account of the Expenses on Production: Theoretical Aspect
Authors: Polenova S.
Published: April 2024

In article is executed attempt to consider essence such component normative method of the account of the production expenses, as formation normative calculation and account of the change the rates of the spending resource and their practical application
The Recovery of the Natural Desire for Salvation:
Authors: Montoya Camacho Jorge Martín , Giménez Amaya José Manuel
Published: April 2024

Dynamic Theodicy (DT) is a broad concept we bring up to designate some modern Philosophical Theology attempts to reconcile the necessary and perfect existence of God with the contingent characteristics of human life. In this paper we analyze such approaches and discuss how they have become incomprehensible because the metaphysical assumptions implicit in these explanations have lost their intrinsic relation to the natural human desire for salvation. In the first part we show Charles Hartshorne's DT-model, arising from the modal logic of perfection, and the modern rational problems of this position in making infinite-necessary Being (God) and finite-contingent being (human) compatible. We note that at the heart of the contradictions in this DT account is a dialectical mode of thinking that makes it difficult to find a correct solution to this dichotomy, and to assume a human desire that could be considered related to lifelong goals. In the second part, supported by the proposal of Hans Urs von Balthasar's DT, we develop the concepts of bodily vulnerability, corporeal intentionality, and natural desire for salvation, which come from an Aristotelian-Thomistic thought. This theory is established in order to build an argument, following Alasdair MacIntyre’s ethical framework, on how to make possible the recovery of a metaphysical and anthropological desire that transcends natural aging and goes beyond death. We conclude that both human dependence and the virtues that arise naturally when human beings decide to seek the good of their transcendent condition, make it possible to recover the natural desire for salvation through divine and human love.
Influenza, vaccines and new developments
Authors: Duncan Debbie Louise
Published: April 2024

This article was sponsored by CSL Seqirus. CSL Seqirus had no involvement in the writing or editorial process of this article.

Vaccines are the first step in prevention of many infectious disease such as influenzae and have has dramatically reduced the burden of infectious disease ( van Panhuis et al, 2013 ). Their aim is to induce an immune response to the targeted pathogen without developing the disease. Vaccines work by initiating an innate immune response which is the body's first line of defence against invading pathogens. The Influenza virus is a challenge for global immunisation programmes as the virus can change and adapt creating a need for an annual vaccine and continuous monitoring of the effectiveness of these interventions
Organ-Level Instance Segmentation of Oilseed Rape at Seedling Stage Based on 3D Point Cloud
Authors: Li Jie , Qingqing Li , Qiao Jiangwei , Li Li , Yao Jian , Tu Jingmin
Published: April 2024

Highlights

Provides a low-cost, fast, accurate, and non-destructive method for segmenting stems and leaves of oilseed rape at the seedling stage.

Different varieties and leaf shapes of oilseed rape can all be accurately and efficiently segmented at organ level.

The results of accurate organ instance segmentation are used for further organ morphological structure analysis and organ-level phenotype extraction. The calculated phenotypic data is highly correlated with the true phenotypic data.

Abstract. Organ-level plant point cloud instance segmentation is crucial for three-dimensional (3D) plant structure investigations and plant phenotypic formations. Due to the complexity of 3D plant structures, accurate plant organ segmentation methods remain a bottleneck in current development of plant organ phenotypes. In this work, we present a fast, accurate, low-cost, and non-destructive method of stem and leaf instance segmentation at the organ level for oilseed rape point cloud. Firstly, we use a 3D scanner to obtain the point cloud of oilseed rape plants. Then, principal component analysis (PCA) is used to perform surface feature extraction on the point cloud after preprocessing. Subsequently, the stems and leaves in different features are segmented by region growing. The irrational segmentation results are finally optimized. Segmentation results of stems and leaves of oilseed rape of different sizes and leaf shapes are evaluated using manually segmented oilseed rape point clouds as a benchmark. The precision, recall, F-score, and average accuracy of the proposed stem and leave segmentation method are 0.983, 0.897, 0.937, and 0.883, respectively. The experimental results suggest that the proposed method can accurately segment an oilseed rape 3D point cloud into instances corresponding to the organs of the plant. Additionally, the separated leaf and stem organs of oilseed rape can be further used for plant structure studies and organ phenotype extraction. The organ phenotypic parameters of oilseed rape are calculated based on the results of stem and leaf instances segmentation. The leaf area, stem length and stem angle of oilseed rape calculated from the point cloud are also compared with the corresponding manual measurements, which are highly correlated with coefficients of determination R2 (0.82-0.97). In conclusion, the proposed segmentation method can be applied as a fundamental segmentation step to extract organ phenotype data from oilseed rape plants. Namely, our research is valuable for precision breeding and basic plant research. Keywords: 3D point cloud, Oilseed rape plant, Phenotypic traits, Stem-leaf segmentation.
Environmental Realism in the Arthurian Forest of Adventure
Authors: Twomey Michael W.
Published: April 2024

Abstract: Considering the trees and marginal areas of forests known ecologically as ecotones enables an appreciation of environmental realism as a purposeful literary strategy in the Forest of Adventure of Arthurian romances.
Baptism, Social Ethics, and Sanctification According to Maximus the Confessor's Commentary On The Lord's Prayer
Authors: Summerson Andrew J.
Published: April 2024

ABSTRACT: The Byzantine celebration of Christ's baptism dramatizes the interpersonal and interior dynamics of conversion and salvation. Unlike the transformation of the cosmos underscored by liturgical texts, human transformation in baptism is hardly a fait accompli, due to interpersonal injury, a necessary consequence when one is entangled in the web of fallen human relationships. Maximus the Confessor offers an exploration of the dynamics between the grace of baptism and ongoing sanctification in his Exposition on the Lord's Prayer . In his Exposition , Maximus focuses his meditation on relationship: with the addressee, with God, and with each other. For Maximus, divinization entails asceticism on earth, which is perfected in eternity. The Christian must "suffer" forgiveness below to experience it above.
The Short Forms of Readings in the Ordo Lectionum Missae (1969/1981): Origins, Analysis, and Proposals (Part I)
Authors: Hazell Matthew P.
Published: April 2024

ABSTRACT: The lectionary of the post-Vatican II Roman Rite provides optional short forms for a number of readings. However, no specific guidelines for their use are given, there is no real attempt to explain why they are provided, and the extent of their use seems to go beyond "certain rather long texts" ( Praenotanda , no. 80). Furthermore, these short forms and what is omitted in them have received very little scholarly attention. This article attempts to remedy this by examining the process of the lectionary reform as detailed in the documentation of the Consilium ad exsequendam , as well as analysing each of the Sunday Gospel readings in Tempus per annum that have been assigned optional short forms. To conclude, some recommendations for a future editio typica of the lectionary are given.
Sex Ratio, Health, and Social Status: A Biographical Description of Middle- and Late-Period Bay Area Children
Authors: Fournier Nichole A. , Eerkens Jelmer W. , Buonasera Tammy , Parker Glendon J. , Arellano Monica , Leventhal Alan
Published: April 2024

ABSTRACT: This article presents new information pertaining to the demographic profile of the juvenile burial assemblage ( n = 39) from a Late Holocene site located on the eastern shore of the San Francisco Bay. CA-ALA-329 is commonly referred to as Ryan Mound and now bears the Muwekma Ohlone name Mánni Muwékma Kúksú Hóowok Yatiš Túnnešte-tka , which means “place where the people of the kúksú (bighead) pendants are buried.” This site has been extensively studied and has contributed significantly to our understanding of life on the bay during the Middle and Late Periods. However, most of the previous studies have focused on adults. The goal of the present study was to identify patterns in the profiles of those who died prematurely: their sex, the degree of stress they experienced based on skeletal indicators of disease/malnutrition, and their social status based on associated grave goods. Results show high incidence of skeletal indicators in the sample consistent with nutritional deficiency, disease/infection, and/or metabolic disorders. This suggests that this population was experiencing stress. Individual circumstances, such as age and sex, may also have contributed to poor health because infants have the highest prevalence of cribra orbitalia and periostitis. The distribution of wealth, as evidenced by burial goods associated with the sample, shows some correlation with age at death and types of artifacts. Distribution of wealth also differs temporally. Inequality seems to have been highest in the Middle Period, whereas inequality decreased but overall wealth increased into the Late Period.
Effects of Economic Uncertainty on the Asset Quality of Banking Sector: Evidence from a Developing Country
Authors: Bin Kamal Javed , Hassan M. Kabir , Bin Kamal Khaled
Published: April 2024

ABSTRACT: Extant literature investigates on the determinants of NPL (non-performing loan) many a time, however, little is known on the relationship between economic uncertainty and NPL for any developing country. Historically, Bangladesh is suffering from high level of NPL in the banking sector. In addition to that, Bangladesh observes high level of macroeconomic uncertainty as characterized by high and volatile Gross Domestic Products and inflation, continuous exchange rate devaluations, and shallow financial markets. Motivated by this, we investigate the nexus between economic uncertainty and NPL for Bangladesh. Based on the data availability, we use the annual dataset covering 1990–2018. Furthermore, we use autoregressive distributed lag (ARDL) model considering its benefit accommodating both I(0) and I(1) variables. The empirical results show that there is positive relationship between economic uncertainty and NPL in the long run. The results are robust to the alternative measures of economic uncertainty and specifications. Consistent with the expectation, financial development carries a negative sign on the asset quality albeit the effect of economic uncertainty is actually pronounced (both the size and significance changes) in the augmented models. Key policy implication of this study is that government should formulate well anchored, rule-based policies to reduce inflation and interest related uncertainties. With a rule-based policy (for example, inflation targeting), people believe that central bank can achieve its targets. Government should adopt floating exchange rate regime that will adjust the external shocks well via exchange rates. In addition to this, government can monitor, and regulate stock market so that uncertainty in stock market is reduced. Finally, monetary and fiscal policies should be communicated well to the people. Thus, it is possible to reduce asymmetric information among the people, which may reduce economic uncertainty, and thus reduce NPL.