bluuebunny/crossref_metadata_2025 huggingface dataset:
A preliminary investigation of precise visualization, localization, and resection of pelvic lymph nodes in bladder cancer by using indocyanine green fluorescence-guided approach through intracutaneous dye injection into the lower limbs and perineum
Authors: Zhang Yunmeng , Guo Xinyu , Zhang Yueying , Wei Jinzheng , Yan Pengyu , Kang Haiming , Shu Yang , Liu Chao , Yang Xiaofeng
Published: May 2024

Objective

This study aimed to investigate the feasibility and effectiveness of using indocyanine green (ICG) injected intracutaneously through the lower limbs and perineum for visualized tracking, localization, and qualitative assessment of pelvic lymph nodes (LNs) in bladder cancer to achieve their accurate resection.

Methods

First, ICG was injected into the LN metastasis model mice lower limbs, and real-time and dynamic in vivo and ex vivo imaging was conducted by using a near-infrared fluorescence imaging system. Additionally, 26 patients with bladder cancer were enrolled and divided into intracutaneous group and transurethral group. A near-infrared fluorescence imaging device with internal and external imaging probes was used to perform real-time tracking, localization, and resection of the pelvic LNs.

Results

The mice normal LNs and the metastatic LNs exhibited fluorescence. The metastatic LNs showed a significantly higher signal-to-background ratio than the normal LNs (3.9 ± 0.2 vs. 2.0 ± 0.1, p < 0.05). In the intracutaneous group, the accuracy rate of fluorescent-labeled LNs was 97.6%, with an average of 11.3 ± 2.4 LNs resected per patient. Six positive LNs were detected in three patients (18.8%). In the transurethral group, the accuracy rate of fluorescent-labeled LNs was 84.4%, with an average of 8.6 ± 2.3 LNs resected per patient. Two positive LNs were detected in one patient (12.5%).

Conclusion

Following the intracutaneous injection of ICG into the lower limbs and perineum, the dye accumulates in pelvic LNs through lymphatic reflux. By using near-infrared fluorescence laparoscopic fusion imaging, physicians can perform real-time tracking, localization, and precise resection of pelvic LNs.
Structural perspectives on recent breakthrough efforts toward direct drugging of RAS and acquired resistance
Authors: Lokhandwala Jameela , Smalley Tracess B. , Tran Timothy H.
Published: May 2024

The Kirsten rat sarcoma viral oncoprotein homolog (KRAS) is currently a primary focus of oncologists and translational scientists, driven by exciting results with KRAS-targeted therapies for non-small cell lung cancer (NSCLC) patients. While KRAS mutations continue to drive high cancer diagnosis and death, researchers have developed unique strategies to target KRAS variations. Having been investigated over the past 40 years and considered “undruggable” due to the lack of pharmacological binding pockets, recent breakthroughs and accelerated FDA approval of the first covalent inhibitors targeting KRASG12C, have largely sparked further drug development. Small molecule development has targeted the previously identified primary location alterations such as G12, G13, Q61, and expanded to address the emerging secondary mutations and acquired resistance. Of interest, the non-covalent KRASG12D targeting inhibitor MRTX-1133 has shown promising results in humanized pancreatic cancer mouse models and is seemingly making its way from bench to bedside. While this manuscript was under review a novel class of first covalent inhibitors specific for G12D was published, These so-called malolactones can crosslink both GDP and GTP bound forms of G12D. Inhibition of the latter state suppressed downstream signaling and cancer cell proliferation in vitro and in mouse xenografts. Moreover, a non-covalent pan-KRAS inhibitor, BI-2865, reduced tumor proliferation in cell lines and mouse models. Finally, the next generation of KRAS mutant-specific and pan-RAS tri-complex inhibitors have revolutionized RAS drug discovery. This review will give a structural biology perspective on the current generation of KRAS inhibitors through the lens of emerging secondary mutations and acquired resistance.
Comparing time to recovery in wasting treatment: simplified approach vs. standard protocol among children aged 6–59 months in Ethiopia—a cluster-randomized, controlled, non-inferiority trial
Authors: Maru Yetayesh , Tamiru Dessalegn , Baye Kaleab , Chitekwe Stanley , Kifle Yehenew G. , Lailou Arnaud , Belachew Tefera
Published: May 2024

Introduction

Wasting occurs when the body's nutritional needs are unmet due to insufficient intake or illness. It represents a significant global challenge, with approximately 45 million infants and children under 5 years of age suffering from wasting in 2022.

Methods

A cluster-randomized, controlled, non-inferiority trial was conducted in three regions of Ethiopia. A non-inferiority margin of 15%, along with a recovery rate of 90% and a minimum acceptable recovery rate of 75%, were considered alongside an intra-cluster correlation coefficient of 0.05 and an anticipated loss to follow-up of 10% in determining the total sample size of 1,052 children. Children with severe acute malnutrition (SAM) in the simplified group received two sachets of ready-to-use therapeutic food (RUTF) daily, while the standard group received RUTF based on their body weight. For moderate acute malnutrition (MAM) cases, the simplified group received one sachet of RUTF, whereas the standard group received one sachet of ready-to-use supplementary food daily. A non-parametric Kaplan–Meir curve was utilized to compare the survival time to recovery.

Results

A total of 1,032 data points were gathered. For SAM cases, the average length of stay was 8.86 (±3.91) weeks for the simplified protocol and 8.26 (±4.18) weeks for the standard protocol (P = 0.13). For MAM cases, the average length of stay was 8.18 (±2.96) weeks for the simplified approach and 8.32 (±3.55) weeks for the standard protocol (P = 0.61). There was no significant difference (P = 0.502) observed between the simplified protocol [8 weeks, interquartile range (IQR): 7.06–8.94] and the standard protocol [9 weeks (IQR: 8.17–9.83)] among children with SAM on the median time to cure. There was no significant difference (P = 0.502) in the time to cure between the simplified approach [8 weeks (IQR: 7.53–8.47)] and the standard protocol [8 weeks (IQR: 7.66–8.34)] among children with MAM. The survival curves displayed similarity, with the log-rank test not showing significance (P > 0.5), indicating the non-inferiority of the simplified approach for cure time.

Conclusion

The findings showed that the simplified and standard protocols demonstrated no significant differences in terms of the average duration of stay and time required for recovery.

Clinical Trial Registration

https://pactr.samrc.ac.za/, Identifier (PACTR202202496481398).
COVID-19 vaccination-related tinnitus is associated with pre-vaccination metabolic disorders
Authors: Wang Weihua , Yellamsetty Anusha , Edmonds Robert M. , Barcavage Shaun R. , Bao Shaowen
Published: May 2024

Cases of tinnitus have been reported following administration of COVID-19 vaccines. The aim of this study was to characterize COVID-19 vaccination-related tinnitus to assess whether there is a causal relationship, and to examine potential risk factors for COVID-19 vaccination-related tinnitus. We analyzed a survey on 398 cases of COVID-19 vaccination-related tinnitus, and 699,839 COVID-19 vaccine-related reports in the Vaccine Adverse Effect Reporting System (VAERS) database that was retrieved on 4 December 2021. We found that following COVID-19 vaccination, 1) tinnitus report frequencies for Pfizer, Moderna and Janssen vaccines in VAERS are 47, 51 and 70 cases per million full vaccination; 2) the symptom onset was often rapid; 3) more women than men reported tinnitus and the sex difference increased with age; 4) for 2-dose vaccines, the frequency of tinnitus was higher following the first dose than the second dose; 5) for 2-dose vaccines, the chance of worsening tinnitus symptoms after second dose was approximately 50%; 6) tinnitus was correlated with other neurological and psychiatric symptoms; 7) pre-existing metabolic syndromes were correlated with the severity of the reported tinnitus. These findings suggest that COVID-19 vaccination increases the risk of tinnitus, and metabolic disorders is a risk factor for COVID-19 vaccination-related tinnitus.
Natural near field coupled leaky-mode resonant anti-reflection structures: the setae of Cataglyphis bombycina
Authors: Schwind Bertram , Wu Xia , Tiemann Michael , Fabritius Helge-Otto
Published: May 2024

Leaky mode resonances of the setae of Cataglyphis bombycina are found to enhance the thermal emission of the animals by near field coupling to the chitinous exoskeleton. This is remarkable, as the setae are also an adaption to enhance the reflectivity in the visible wavelength range. Both effects are dependent on morphology, dimensions and spatial arrangement. These parameters were experimentally characterized and simulated by finite difference time domain simulations to elucidate the optical impact of the setae in the mid infrared range and the contribution of leaky mode resonances. This mode of action and the setae’s optical properties in the visible range explain evolutionary strains that led to the actual morphology and size of the setae.
Deleterious effects of polypropylene released from paper cups on blood profile and liver tissue of Clarias gariepinus: bioremediation using Spirulina
Authors: Eid Zainab , Mahmoud Usama M. , Sayed Alaa El-Din H.
Published: May 2024

Despite numerous studies on microplastics, the biological impacts of polypropylene microplastics (PP-MPs) and its toxicity on freshwater fish have yet to be fully revealed. The purpose of this research was to look at the potentially harmful effects of PP-MPs in freshwater African catfish Clarias gariepinus and bioremediation using Spirulina. After acclimatization to laboratory conditions, 108 fish (125 ± 3 gm and 27 ± 2 cm) were assigned into triplicate six experimental groups (12 fish/group), a control group, Spirulina group (SP), PP-MP-treated groups (0.14 and 0.28 mg/l PP-MPs), and PP-MP + Spirulina-treated groups (0.14 mg/l PP-MPs + 200 mg/L SP and 0.28 mg/l PP-MPs +200 mg/L SP) for 15-day exposure and 45-day recovery after that. The hematological parameters exhibiting significance (RBCs, Hct, Hb, and MCV) or non-significance (MCH and MCHC) either decreased with the increase in PP-MP doses from 0.0 in the control to 0.28 mg/L red blood cells (RBCs), hematocrit (Hct), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), hemoglobin (Hb) and platelets or increased with such an increase in doses (mean corpuscular volume (MCV)). The liver enzyme activity, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) exhibited non-significant (p ≥ 0.05) or significant (p < 0.05) increases in (0.14 and 0.28 mg/L) PP-MP-exposed groups, respectively, except ALP. Furthermore, there was a significant (p < 0.05) or non-significant (p ≥ 0.05) increase in 0.14 and 0.28 mg/l PP-MP +200 mg/L-exposure groups, respectively, compared to the control group and the same exposure group without Spirulina. In comparison to the control group, PP-MPs (0.14 and 0.28 mg/L) induced a significant (p < 0.05) increase in the percentage of poikilocytosis and nuclear abnormalities of RBCs. The liver tissue from fish exposed to PP-MPs exhibited varying degrees of pathological changes. These results indicated that these pathological changes increased with PP-MP concentration, suggesting that the effect of PP-MPs was dose-dependent. After 45 days of recovery under normal conditions, it was obvious that there was a significant improvement in the percentage of poikilocytosis and nuclear abnormalities of RBCs, as well as a non-significant improvement in hemato-biochemical parameters and liver tissue.
Dormant carbohydrate reserves enhance pecan tree spring freeze tolerance: controlled environment observations
Authors: Kaur Amandeep , Zhang Lu , Maness Niels O. , Ferguson Louise , Graham Charles J. , Sun Yanwei , Panta Srijana , Pokhrel Niranjan , Yang Ming , Moss Justin Q.
Published: May 2024

Pecan (Carya illinoensis), an economically important deciduous tree, bears commercially valuable nutritional nuts. Spring freezes in April can severely injure pecan buds, decreasing bloom, and fruit set. This study determined how low temperatures affect pecan buds/flowers at different growth stages in several pecan scion/rootstock combinations. This study focused on three pecan scion/rootstock combinations: Pawnee/Peruque (PP), Kanza/Giles (KG), and Maramec/Colby (MC), grown at the Cimarron Valley Research Station, Perkins, Oklahoma. Branches at three different growth stages, i.e., outer bud scale shed, one week after bud break, and early bloom stages were collected from PP, MC, and KG. Branches were held in a Conviron E8 freezing unit at 4 temperatures (-2, 0, 2, and 4°C) for 4 and 8 hours; A total of 8 treatments. One sample set was kept as an untreated control. After 2–3 weeks, branch samples from all the temperature treatments were observed and categorized into two groups. Group one with number of branches had healthy buds/formation of healthy leaves/flowers and group two with number of dead branches. The carbohydrate content reserved from dormant was analyzed using an Anthrone reagent. Visual observations and carbohydrate analyses revealed differences in damage and carbohydrate content among the scion/rootstock combinations, low-temperature treatments, and growth stages. The MC combination had minimum visual damage to leaves, buds, and flowers and significantly lower soluble sugars and starch in bark phloem as well as significantly lower soluble sugars in woody tissue xylem. The KG combination had maximum visual damage and significantly higher soluble sugars and starches in the bark, and soluble sugars in the woody tissues. These results indicate the MC combination is more tolerant to spring freeze damage at all three growth stages compared to the other two pecan scion/rootstock combinations. The results also demonstrate the MC combination is using more non-structural carbohydrates, soluble sugars and starches, suggesting this is a possible mechanism in its freeze tolerance.
Redundancy can hinder adult L2 grammar learning: evidence from case markers of varying salience levels
Authors: Kenanidis Panagiotis , Llompart Miquel , Santos Sara Fernández , Dąbrowska Ewa
Published: May 2024

Grammatical redundancy is a widespread feature across languages. Although redundant cues can be seen to increase the complexity and processing burden of structures, it has been suggested that they can assist language acquisition. Here, we explored if this learning benefit can be observed from the very initial stages of second language (L2) acquisition and whether the effect of redundancy is modulated by the perceptual salience of the redundant linguistic cues. Across two experiments, three groups of adult native speakers of English were incidentally exposed to three different artificial languages; one that had a fixed word order, Verb-Object-Subject, and two in which thematic role assignment was additionally determined by a low-salient (Experiment 1) or a high-salient (Experiment 2) redundant case marker. While all groups managed to learn the novel language, our results pointed towards a hindering role of redundancy, with participants in the non-redundant condition achieving greater learning outcomes compared to those in both redundant conditions. Results also revealed that this impeding effect of redundancy on L2 learners can be attenuated by the salience of the redundant cue (Experiment 2). In conjunction with earlier findings, the present results suggest that the effect of redundancy on L2 acquisition can be differentially manifested depending on the stage of L2 development, learners’ first language biases and age.
Testing influences of openness, conscientiousness, nationalism, media diversity, social class, and informational echo chambers on support for official responses to COVID-19 in Wuhan in November, 2020
Authors: Miao Bo , Ding Hanqing
Published: May 2024

Introduction

As the COVID-19 pandemic raged, controversies about governmental responses to the epidemic also emerged in China. Previous studies mainly described the phenomenon of individual differences on support for governmental responses to COVID-19 with less attention to the underlying causal mechanisms. Thus, this study tries to verify the factors influencing public support for official behaviors in COVID-19.

Method

A questionnaire survey was drew on in Wuhan city during the COVID-19 outbreak. The quota sampling method was adopted according to the gender and age structure of the population in Wuhan as well as the educational structure of the urban population in China.

Results

Through structural equation analysis, this study confirms that personal factors (namely conscientiousness and nationalistic ideology), behavioral factors (namely media diversity and echo chamber acts) exert significantly positive impacts on support for governmental responses. The echo chamber acts play important mediating roles in the relationship between each independent variable and support for governmental responses.

Discussion

The originality of this study is that it constructs a comprehensive model of influencing factors of support for governmental responses with the personal, behavioral, and environmental factors. While contributing insight to political attitude in China, the research results also have significance for promoting public trust and constructing healthy public opinion in China.
The High Five Model as a predictor of academic performance over conventional psychological predictors in university students
Authors: Quito-Calle Jessica V. , Cosentino Alejandro César
Published: May 2024

Introduction

The High Five Model (HFM) categorizes five positive human characteristics-erudition, peace, joviality, honesty, and tenacity-utilizing an inductive psycholexic approach. This study examines the predictive power of HFM on academic performance among university students, hypothesizing that it surpasses conventional predictors such as academic motivation, exam anxiety, and academic procrastination.

Methods

A non-experimental cross-sectional correlational design was implemented using a non-probabilistic convenience sample of 1,007 Ecuadorian university students (403 females). Self-reported measures of the “high factors,” academic motivation, exam anxiety, and academic procrastination were collected. Linear regression analysis was utilized to evaluate the predictive capacity of the HFM on academic performance.

Results

The analysis revealed that the high factors of the HFM significantly predict academic performance, demonstrating a stronger predictive ability than traditional psychological predictors.

Discussion

The findings suggest that incorporating the HFM into academic settings could enhance understanding and prediction of student performance. This could potentially inform targeted interventions that leverage these high factors, thereby fostering better academic outcomes. Further research could explore the integration of the HFM with other educational strategies and its applicability across diverse educational contexts.
Mental health and frailty in people with multiple sclerosis: unraveling a complex relationship
Authors: Al Worikat Nida’ , Zanotto Anna , Sosnoff Jacob J. , Zanotto Tobia
Published: May 2024

People with multiple sclerosis (MS) have up to a 15 times higher risk of being frail compared to age-matched individuals without MS. Frailty is a biological syndrome of decreased physiological reserve and resilience that increases the vulnerability to adverse clinical outcomes and leads to a lower quality of life. Recent studies have begun investigating frailty in the context of MS, highlighting several associations between frailty and adverse events, such as falls, and common MS-related symptoms involving the physical health domain, such as walking and sleeping problems. However, there is a critical knowledge gap regarding the relationship between mental health and frailty in people with MS. This mini-review article aimed to shed light on the potential relationships between MS, frailty, and mental health. Despite the dearth of studies on this topic, indirect evidence strongly suggests that the association between frailty and mental health in people with MS is likely bidirectional in nature. Specifically, mental health disorders such as depression and anxiety may be involved in the etiology of frailty in people with MS. However, they could also be exacerbated by the detrimental effects of frailty on overall health. The complex relationship between frailty and mental health in MS underscores the multifaceted challenges people with MS face. Conducting further research to untangle such a relationship is critical to developing early detection and intervention strategies for improving well-being and medical outcomes in people with MS.
Ancillary and instrumental body movements during inhalation in clarinetists
Authors: Nusseck Manfred , Immerz Anna , Hohagen Jesper , Spahn Claudia
Published: May 2024

Background

Playing a musical instrument requires physical movements that are involved in sound production and movements with more expressive and communicative characteristics. Both movements co-occur during a performance; however, the interaction between the movements is still unclear.

Methods

Using motion capture technology, the movement patterns of clarinetists were analyzed at certain points in a performance to investigate how instrumental and ancillary movements interplay. Movements in the arms and knees of clarinetists during a performance were recorded using this technology. The mean angular movements at specific points in the piece, where some players inhaled and others did not, were compared.

Results

While the players who inhaled adopted significantly more upright body and neutral arm positions, the players who did not inhale seemed less interrupted in their performance. The results showed that the players performed rather individual ancillary movements, but at specific points, such as during melodic transitions, they performed similarly. At certain points in the melody, while some players needed to inhale, others adjusted their playing according to the inhalation moment to adopt a suitable body position.

Discussion

The ancillary movement was consequently interrupted by the physiological necessity to inhale. The findings provide more insights into the interplay of instrumental and ancillary movements during a performance.
Fostering emotional well-being in adolescents: the role of physical activity, emotional intelligence, and interpersonal forgiveness
Authors: Yang Shicheng , Jing Longjun , He Qianqian , Wang Huilin
Published: May 2024

Introduction

Adolescence is considered a stress-sensitive developmental period, and the escalating and sustained pressure during this phase poses a significant threat to the mental and physical well-being of adolescents. Therefore, enhancing positive emotions in adolescents is crucial. This study aims to investigate the impact of physical activity on the emotional intelligence, interpersonal forgiveness, and positive emotions of adolescents.

Methods

Using a cluster sampling method, data were collected from 500 adolescents in four schools across the Xiangxi Tujia and Miao Autonomous Prefecture of Hunan Province, China. A total of 428 valid questionnaires were collected and analyzed. The study employed AMOS v.23 to construct a structural equation model to validate the hypotheses.

Results

The results indicate that physical activity significantly influences the emotional intelligence, interpersonal forgiveness, and positive emotions of adolescents. Furthermore, emotional intelligence and interpersonal forgiveness mediate the relationship between physical activity and positive emotions.

Discussion

Based on these findings, collaborative efforts from government agencies, schools, and families are essential to provide robust support for adolescents’ participation in physical activity, encouraging more adolescents to actively engage in sports.
A roadmap to understanding interoceptive awareness and post-traumatic stress disorder: a scoping review
Authors: Leech Kelly , Stapleton Peta , Patching Alan
Published: May 2024

The concept of interoception has existed since the beginning of the 1900s. It is suggested that humans can observe feelings arising from the body that allows them to develop a sense of their emotional status and physical condition. The term interoceptive awareness appears to originate with clinicians working with individuals who had experienced trauma, in particular Post Traumatic Stress Disorder (PTSD). The purpose of this scoping review was to provide an overview of the existing literature surrounding the combination of these two themes: interoceptive awareness and PTSD. A total of 226 articles were initially screened and 52 articles were retained for comprehensive review. Nine articles were excluded, resulting in 43 studies included in the review. The review aimed to answer: (a) how is interoceptive awareness defined? (b) how is interoceptive awareness measured? (c) what is the function of interoceptive awareness? (d) is there/what is the relationship between interoceptive awareness and PTSD? The scoping review identified nine terms that are used synonymously throughout the literature surrounding interoceptive awareness and PTSD, and three primary ways in which interoceptive awareness is measured in relation to PTSD. The primary function documented was the role interoceptive awareness played in an individual’s ability to regulate their emotions, and the most common and compelling function emerging was the association with emotion regulation. The evidence supports the utilisation of a definition of interoceptive awareness to include one that includes the quality of cognitive appraisal and focuses on the adaptive mindful approach to internal physical sensations as opposed to the heightened ruminative self-focus. Limitations and future research are suggested.
Why am I grinding and clenching? Exploration of personality traits, coping strategies, oral parafunctional behaviors, and severe sleep bruxism in a polysomnographic study
Authors: Wieczorek Tomasz , Jodkowska Anna , Orzeszek Sylwia , Wieckiewicz Mieszko , Michalek-Zrabkowska Monika , Mazur Grzegorz , Rymaszewska Joanna , Smardz Joanna , Wojakowska Anna , Martynowicz Helena
Published: May 2024

Introduction

Causal relationships between psychopathological symptoms, personality traits, coping mechanisms, and sleep bruxism (SB) were studied in the past, giving inconsistent results mostly based on self-assessment evaluations. This polysomnography-based cross-sectional study aimed to explore the relationships between severe SB, personality traits (according to the Big Five model), and coping strategies with objective polysomnographic verification.

Methodology

The study included 66 participants divided into severe SB (SSB) (n=32) and no or mild SB (n=34) groups based on video-polysomnography performed in the sleep laboratory. Questionnaire assessment included the use of the Beck Depression Inventory, Beck Anxiety Inventory, Mini-COPE, International Personality Item Pool Big Five Markers 20-Item version, and Oral Behavior Checklist.

Results

Participants with SSB presented with fewer self-reported anxiety (p=0.008) and depressive (p=0.01) symptoms than the non- or mild-SB groups. The SSB group scored significantly higher in Big Five personal traits such as extraversion (p=0.007), emotional stability (p=0.013), and intellect (p=0.004), while regarding coping strategies, the SSB group was less likely to use negative strategies: self-distraction (p=0.036), denial (p=0.006), venting (p=0.03), behavioral disengagement (p=0.046), and self-blame (p=0.003), and turning to religion (p=0.041). The intensity of oral parafunctional behaviors was comparable in both groups (p=0.054). Emotional stability was a moderate protective factor (p=0.004), and the self-blame strategy was a strong risk factor (p<0.001) for increased oral parafunctional behavior intensity. Phasic activity negatively correlated with anxiety symptom severity (p=0.005), whereas tonic (p=0.122) and mixed (p=0.053) phenotypes did not. SB intensity was a protective factor against anxiety symptoms (p=0.016).

Conclusion

In terms of psychopathology, severe sleep bruxers tend to present less severe anxiety and depressive symptoms, while some of their personality traits (extraversion, emotional stability, and intellect) were more strongly pronounced. SSB is possibly related to the lesser use of the “maladaptive” coping strategies and there were no specific coping strategies preferred by SSB participants, compared to the other group. These observations require further studies, as it should be determined whether SB (especially phasic activity) might be a form of a somatization/functional disorder. Further research should focus on the psychogenic background of oral parafunctional behaviors, which occur more often in less emotionally stable personalities and in people using self-blame coping strategies.
Confirmation of a measurement model for hospital supply chain resilience
Authors: Ding Baoyang , Yang Xiaohan , Gao Tiantian , Liu Zheng , Sun Qiang
Published: May 2024

Background

The hospital supply chain has revealed increasing vulnerabilities and disruptions in the wake of the COVID-19 pandemic, threatening the healthcare services and patient safety. The resilience of hospital supply chains has emerged as a paramount concern within the healthcare system. However, there is a lack of systematic research to develop an instrument tailored to the healthcare industry that is both valid and reliable for measuring hospital supply chain resilience. Therefore, this study aims to construct and validate a comprehensive scale for assessing hospital supply chain resilience, based on dynamic capability theory.

Methods

This study followed rigorous scale development steps, starting with a literature review and 15 semi-structured interviews to generate initial items. These items were then refined through expert panel feedback and three rounds of Delphi studies. Using data from 387 hospitals in Province S, mainland China, the scale underwent rigorous testing and validation using structural equation modeling. To ensure the most effective model, five alternative models were examined to determine the most suitable parsimonious model.

Results

The study produced a 26-item scale that captures five dimensions of resilience in line with dynamic capability theory: anticipation, adaptation, response, recovery, and learning, all showing satisfactory consistency, reliability and validity.

Conclusion

The multi-dimensional scale offers hospital managers a valuable tool to identify areas needing attention and improvement, benchmark resilience against their counterparts, and ultimately strengthen their supply chains against unexpected risks.
Life satisfaction among Spanish children and adolescents participating in Physical Education
Authors: Gómez-Paniagua Santiago , Castillo-Paredes Antonio , Galán-Arroyo Carmen , Rojo-Ramos Jorge
Published: May 2024

Life satisfaction has been determined as a cognitive indicator of subjective wellbeing, a term that acquires vital relevance during adolescence as a protective factor against numerous psychological, mental and social disorders. Therefore, the objectives of this study are: (1) to evaluate differences in life satisfaction as a function of gender and school environment in Spanish children and adolescents; and (2) examine the possible associations between life satisfaction and age and/or body mass index (BMI) of the student body. For this purpose, a cross-sectional study was carried out with 723 students (aged 6 to 18 years) in which the “Satisfaction with life Scale” was applied, consisting of 5 items that measure self-perception of life satisfaction. Nonparametric statistics (Mann–Whitney U test) were used to explore differences in scores according to sex and school environment, in addition to Spearman’s Rho test to identify associations between scale scores and students’ age and BMI. Significant differences were obtained in terms of sex in favor of the male gender, and between the two environments of the centers in favor of the rural ones. In addition, the two variables explored (age and BMI) showed significant inverse associations with life satisfaction levels. Therefore, educational interventions and policies must take this information into account to design and develop actions aimed at improving this cognitive factor.
Voices of care: unveiling patient journeys in primary care for hypertension and diabetes management in Kerala, India
Authors: Ravindranath Ranjana , Sarma P. Sankara , Sivasankaran Sivasubramonian , Thankappan Kavumpurathu Raman , Jeemon Panniyammakal
Published: May 2024

Background

Diabetes and hypertension are leading public health problems, particularly affecting low- and middle-income countries, with considerable variations in the care continuum between different age, socio-economic, and rural and urban groups. In this qualitative study, examining the factors affecting access to healthcare in Kerala, we aim to explore the healthcare-seeking pathways of people living with diabetes and hypertension.

Methods

We conducted 20 semi-structured interviews and one focus group discussion (FGD) on a purposive sample of people living with diabetes and hypertension. Participants were recruited at four primary care facilities in Malappuram district of Kerala. Interviews were transcribed and analyzed deductively and inductively using thematic analysis underpinned by Levesque et al.’s framework.

Results

The patient journey in managing diabetes and hypertension is complex, involving multiple entry and exit points within the healthcare system. Patients did not perceive Primary Health Centres (PHCs) as their initial points of access to healthcare, despite recognizing their value for specific services. Numerous social, cultural, economic, and health system determinants underpinned access to healthcare. These included limited patient knowledge of their condition, self-medication practices, lack of trust/support, high out-of-pocket expenditure, unavailability of medicines, physical distance to health facilities, and attitude of healthcare providers.

Conclusion

The study underscores the need to improve access to timely diagnosis, treatment, and ongoing care for diabetes and hypertension at the lower level of the healthcare system. Currently, primary healthcare services do not align with the “felt needs” of the community. Practical recommendations to address the social, cultural, economic, and health system determinants include enabling and empowering people with diabetes and hypertension and their families to engage in self-management, improving existing health information systems, ensuring the availability of diagnostics and first-line drug therapy for diabetes and hypertension, and encouraging the use of single-pill combination (SPC) medications to reduce pill burden. Ensuring equitable access to drugs may improve hypertension and diabetes control in most disadvantaged groups. Furthermore, a more comprehensive approach to healthcare policy that recognizes the interconnectedness of non-communicable diseases (NCDs) and their social determinants is essential.
The carbon footprint of a Dutch academic hospital—using a hybrid assessment method to identify driving activities and departments
Authors: Lau Ise , Burdorf A. , Hesseling Simone , Wijk Louise , Tauber Martin , Hunfeld Nicole
Published: May 2024

Background

The healthcare sector is responsible for 7% of greenhouse gas (GHG) emissions in the Netherlands. However, this is not well understood on an organizational level. This research aimed to assess the carbon footprint of the Erasmus University Medical Center to identify the driving activities and sources.

Methods

A hybrid approach was used, combining a life cycle impact assessment and expenditure-based method, to quantify the hospital’s carbon footprint for 2021, according to scope 1 (direct emissions), 2 (indirect emissions from purchased energy), and 3 (rest of indirect emissions) of the GHG Protocol. Results were disaggregated by categories of purchased goods and services, medicines, specific product groups, and hospital departments.

Results

The hospital emitted 209.5 kilotons of CO2-equivalent, with scope 3 (72.1%) as largest contributor, followed by scope 2 (23.1%) and scope 1 (4.8%). Scope 1 was primarily determined by stationary combustion and scope 2 by purchased electricity. Scope 3 was driven by purchased goods and services, of which medicines accounted for 41.6%. Other important categories were medical products, lab materials, prostheses and implants, and construction investment. Primary contributing departments were Pediatrics, Real Estate, Neurology, Hematology, and Information & Technology.

Conclusion

This is the first hybrid analysis of the environmental impact of an academic hospital across all its activities and departments. It became evident that the footprint is mainly determined by the upstream effects in external supply chains. This research underlines the importance of carbon footprinting on an organizational level, to guide future sustainability strategies.
Standardized evaluation of the extent of resection in glioblastoma with automated early post-operative segmentation
Authors: Luque Lidia , Skogen Karoline , MacIntosh Bradley J. , Emblem Kyrre E. , Larsson Christopher , Bouget David , Helland Ragnhild Holden , Reinertsen Ingerid , Solheim Ole , Schellhorn Till , Vardal Jonas , Mireles Eduardo E. M. , Vik-Mo Einar O. , Bjørnerud Atle
Published: May 2024

Standard treatment of patients with glioblastoma includes surgical resection of the tumor. The extent of resection (EOR) achieved during surgery significantly impacts prognosis and is used to stratify patients in clinical trials. In this study, we developed a U-Net-based deep-learning model to segment contrast-enhancing tumor on post-operative MRI exams taken within 72 h of resection surgery and used these segmentations to classify the EOR as either maximal or submaximal. The model was trained on 122 multiparametric MRI scans from our institution and achieved a mean Dice score of 0.52 ± 0.03 on an external dataset (n = 248), a performance ­on par with the interrater agreement between expert annotators as reported in literature. We obtained an EOR classification precision/recall of 0.72/0.78 on the internal test dataset (n = 462) and 0.90/0.87 on the external dataset. Furthermore, Kaplan-Meier curves were used to compare the overall survival between patients with maximal and submaximal resection in the internal test dataset, as determined by either clinicians or the model. There was no significant difference between the survival predictions using the model's and clinical EOR classification. We find that the proposed segmentation model is capable of reliably classifying the EOR of glioblastoma tumors on early post-operative MRI scans. Moreover, we show that stratification of patients based on the model's predictions offers at least the same prognostic value as when done by clinicians.
Bayesian learning of nonlinear gene regulatory networks with switching architectures
Authors: Vélez-Cruz Nayely , Papandreou-Suppappola Antonia
Published: May 2024

Introduction: Gene regulatory networks (GRNs) are characterized by their dynamism, meaning that the regulatory interactions which constitute these networks evolve with time. Identifying when changes in the GRN architecture occur can inform our understanding of fundamental biological processes, such as disease manifestation, development, and evolution. However, it is usually not possible to know a priori when a change in the network architecture will occur. Furthermore, an architectural shift may alter the underlying noise characteristics, such as the process noise covariance.

Methods: We develop a fully Bayesian hierarchical model to address the following: a) sudden changes in the network architecture; b) unknown process noise covariance which may change along with the network structure; and c) unknown measurement noise covariance. We exploit the use of conjugate priors to develop an analytically tractable inference scheme using Bayesian sequential Monte Carlo (SMC) with a local Gibbs sampler.

Results: Our Bayesian learning algorithm effectively estimates time-varying gene expression levels and architectural model indicators under varying noise conditions. It accurately captures sudden changes in network architecture and accounts for time-evolving process and measurement noise characteristics. Our algorithm performs well even under high noise conditions. By incorporating conjugate priors, we achieve analytical tractability, enabling robust inference despite the inherent complexities of the system. Furthermore, our method outperforms the standard particle filter in all test scenarios.

Discussion: The results underscore our method’s efficacy in capturing architectural changes in GRNs. Its ability to adapt to a range of time-evolving noise conditions emphasizes its practical relevance for real-world biological data, where noise presents a significant challenge. Overall, our method provides a powerful tool for studying the dynamics of GRNs and has the potential to advance our understanding of fundamental biological processes.
A gender-responsive breeding approach to the intensification of sesame (Sesamum indicum L.) production in the Maradi region of Niger
Authors: Lawali Sitou , Boureima Seyni , Idi Salissou
Published: May 2024

Climatic variability and a decrease in soil fertility have had a detrimental effect on the productivity of the main rainfed crops in Niger (millet, sorghum, and cowpea) and led to a deterioration of the nutritional status and income of the country's farmers. The spatio-temporal variability in rainfall has led rural populations to diversify their farms by integrating sesame (Sesamum indicum L.) into their cropping systems because of its low water and fertilizer requirements. Sesame is increasingly becoming a significant source of income for farmers, and it contributes to their food and nutritional security. To boost the production of sesame and facilitate its rapid adoption, our breeding program focused on participatory breeding and varietal selection with the inclusion of gender-specific preferences, from the variety design to the evaluation of new lines on farms. This case study shows that, although women have more experience in sesame cultivation than men, they have less access to production factors such as land. This limited access is especially problematic, as recent trends in land tenure mean that the poorest are no longer able to exploit large areas of cultivable land. It also evidenced that the varietal preferences of sesame growers as well as the mastery of production techniques are a function of the livelihoods and the investment capacity of actors in the value chain. Our study found that men mainly prefer production traits, whereas women have fewer trait preferences, and their preferences tend to be related to marketing and processing. This finding highlights the contrasting roles and responsibilities between men and women in the sesame value chain. Therefore, the inclusion of complementary traits preferred by women and men, provided that they are not negatively correlated with a variety profile, will help meet the full range of needs across the value chain. We recommend the inclusion of gender research in setting breeding goals prior to variety design.
Maternal and Child Health Services Utilization During COVID-19 in Eastern Ethiopia
Authors: Tilahun Bereket Tefera , Tariku Zerihun , Alemu Mesfin Kebede , Dejene Tafese , Natae Legesse Abera , Mohammed Hussen , Assegid Daniel Tadesse , Tekle Mickiale Hailu
Published: May 2024

Objectives: This study aimed to describe the impact of COVID-19 on maternal and child health service utilization in the Eastern part of Ethiopia.

Methods: Comparative analysis was used to examine 2 years of maternal and child health service utilization. Data were extracted from client registers. A traditional Expert Modeler and one-way Analysis of Variance were used to compare service utilization before and during the COVID-19 pandemic.

Results: A total of 34,576 client records were reviewed, of which 17,100 (49.5%) and 17,476 (50.5%) had visited the MCH service before and during the COVID-19 pandemic, respectively. The total client visit has shown a 2% percentage point increase. However, postnatal care and child immunization services showed a decrease. Moreover, there was a significant difference between service visits before and during COVID-19 (f = 4.6, p < 0.04).

Conclusion: Mothers and children have missed or unattended facility appointments due to protective impositions or fear of getting infected with COVID-19, which might suggest a higher proportion of MCH issues were not addressed during the pandemic. The health system should therefore improve its resilience and strengthen its access at the lowest health care inlets.
Research on Delamination Damage Localization of Carbon Fiber-Reinforced Polymer Curved Plate Using Lamb Wave
Authors: Yu Quanpeng , Zhou Shiyuan , Cheng Yuhan , Deng Yao
Published: May 2024

Carbon fiber-reinforced polymers (CFRPs) are extensively employed in the aerospace industry due to their excellent properties. Delamination damage occurring at critical locations in CFRPs can seriously reduce the safety of in-service components. The detection and localization of delamination damage using Lamb waves hold significant potential for widespread application in non-destructive testing. However, the choice of damage localization algorithm may produce different delamination damage localization results. This research presented an IRAPID (improved reconstruction algorithm for probabilistic inspection of defects) method derived from the RAPID (reconstruction algorithm for probabilistic inspection of defects) method, aiming to improve the accuracy and reliability of delamination damage localization. Three CFRP curved plates, including a healthy curved plate and two curved plates with delamination damage sizes of Φ20 mm and Φ40 mm, were prepared in the experiment. The detection experiment of the CFRP curved plate using lead zirconate titanate (PZT) as a transducer to excite and receive Lamb waves was conducted, and the influence of excitation signal frequency on the performance of the proposed method was discussed. Under the condition of an excitation signal frequency of 220~320 kHz and a step size of 10 kHz, the accuracy of the delamination damage localization method proposed in this paper was compared with that of existing methods. The experimental results indicate that the IRAPID algorithm exhibits good stability in the localization of delamination damage across the range of frequency variations considered. The localization error of the IRAPID algorithm for delamination damage is significantly lower than that of the DaS (delay-and-sum) algorithm and the RAPID algorithm. As the size of the delamination damage increases, so does the localization error. The accuracy of delamination damage localization is lower in the X-axis direction than in the Y-axis direction. By averaging the localization results across various frequencies, we can mitigate the potential localization errors associated with single-frequency detection to a certain extent. For the localization of delamination damage, Lamb waves at multiple frequencies can be employed for detection, and the detection results at each frequency are averaged to enhance the reliability of localization.