bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract Su803: Sudden Cardiac Arrest Prediction via Deep Learning Electrocardiogram Analysis
Authors: Neri Luca , Oberdier Matt , Orro Alessandro , Carrick Richard , Nobile Marco S. , Jaipalli Sujai , Khan Mariam , Diciotti Stefano , Borghi Claudio , Halperin Henry
Published: November 2024

Background:
Sudden cardiac arrest (SCA) is a potentially fatal event that often occurs without prior indications.

Hypothesis:
It was hypothesized that electrocardiogram (ECG) data could be used in conjunction with Deep Learning (DL) algorithms to predict the occurrence of SCA’s.

Aims:
To improve SCA outcomes and enable preventative strategies, the ECG data from the Nightingale Open Science - Subtyping Cardiac Arrest dataset were utilized to create a DL model to serve as a screening tool for sudden cardiac arrest.

Methods:
A publicly-available dataset containing ten seconds of 12-lead ECGs from individuals who had a SCA and persons who did not have a SCA, and information about time from ECG to arrest, and age and sex were utilized for individualized prediction of SCA. Subsets of the initial data were used to train, validate, and test deep convolution neural network models that processed cardiac cycles from single-lead ECG voltage waveforms.

Results:
The cohort comprised 221 (mean age: 68.5 and #females: 75) patients who experienced SCA and 1046 controls (mean age: 69.7 and #females: 497) who did not have a cardiac arrest. The SCA ECG-DL base model, with ECGs within one day and with age and sex data, had an area under the receiver operating curve (AUROC) of 0.774 during hold-out testing for discrimination of subsequent SCA. With sensitivity set at 95%, the base model specificity of the SCA ECG-DL model was 31%. Gradient-weighted class activation mapping showed that the SCA ECG-DL model relied most heavily on the QRS complex to make predictions. The performance of the SCA ECG-DL model was similar removing age and sex data (AUROC 0.775) and less reliable when predicting SCA within one month (AUROC 0.734) or between one month and one year (AUROC 0.574).

Conclusion:
DL interpretation of ECG data is a promising means of screening for SCA, and this method explains differences in SCA’s due to age and sex. Model performance improved when ECGs were obtained at shorter intervals to the incident SCA event, and SCA prediction was more dependent upon QRS complex data than other temporal segments of the ECG.
Abstract Su805: Early-Latency Evoked Brain Response Revealed using Novel Filtering Technique
Authors: Arginteanu Toren , Cao Mingfeng , Kang Fausto , Thakor Nitish , Geocadin Romergryko
Published: November 2024

Background:
Cardiac arrest (CA) can cause coma in resuscitated patients. Accuracy of prognosis is limited. Presence of brain signals such as somatosensory evoked potential (SSEP) reveals integrity of the thalamocortical pathway, which is necessary for arousal but insufficient to predict positive outcome.

The N10 is a SSEP component that diminishes in CA. The N7, which can be obscured by stimulus artifact or other components, is associated with subcortical structures. Phase space area (PSA) quantifies SSEP morphology and is associated with CA recovery. It has been measured at least 5ms after stimulus.

Hypothesis:
Early SSEP and PSA diminish under anesthesia and during CA but may recover afterwards.

Aims:
By removing stimulus artifact, we capture early SSEP (N7 and early PSA) to enable improved prognostication.

Methods:
Six rats received 1.2, 1.8, and 2.5% isoflurane anesthesia for 30min. Two underwent 5 or 7min CA and were observed over 2hr. SSEP was recorded every 2s.

An adaptive filter removed the artifact. Peaks were measured near 7 (N7) and 15 (N10) ms post-stimulus. PSA, the area occupied by the phase space curve, was recorded over 0-9ms (“early”) and 0-30ms (“total”). Signal-to-noise ratio (SNR) is the ratio of N10 amplitude to standard deviation of the signal. T tests were used for comparisons between SNR values and between experimental conditions.

Results:
We identified 4153 N7 peaks with latency (mean±95% C.I.) 8.6±1.3ms in the filtered data, compared to 2464 with latency 8.5±1.4ms in the unfiltered data. SNR was greater in the filtered signal (2.3±1.5) than unfiltered (0.3±0.4).

N7 amplitude decreased at the highest anesthesia level; N10 decreased for each level. N7 and N10 decreased during CA and recovered after, although N10 remained below baseline during 2hr recovery. Early PSA was lower under the higher anesthesia levels, while total PSA decreased for each level. PSA decreased during CA and recovered after 5min CA; total PSA recovered to baseline and early PSA exceeded it after 2hr.Early PSA did not recover from 7min CA, while total PSA recovered but remained below baseline.

Conclusion:
We demonstrate a novel technique to discover an elusive early-latency response, adding detail to a neural pathway involved in arousal. We reduce noise, capture N7 consistently, and measure PSA beginning at 0ms, providing additional diagnostic dimensions responsive to anesthesia and CA. Future study will investigate outcomes in resuscitated patients.
‘Obligatory Relegation’, ‘Willing Translation’, or ‘Unreserved Declaration’? The Place of Religious Ideas in Public Square Deliberation
Authors: Fong Edmung
Published: November 2024

This paper describes three basic positions that have been held in relation to the place of religious ideas and reasons in public square deliberation by outlining the arguments of major representatives of each position. The three positions are: ‘obligatory relegation’ (Robert Audi); ‘willing translation’ (John Rawls and Jürgen Habermas), and ‘unreserved declaration’ (Nicholas Wolterstorff and Charles Taylor). I conclude by offering an observation from the survey. Even as the question of the place of religious ideas in public square deliberation can be approached from either broader domains of the secularisation/post-secularisation of societies or the essence of liberal democracy, it is not the domain itself but rather specific conceptions of key ideas or notions within each domain that push the representatives to take the position that they do.
Planting Seeds in a New Land
Authors: Greene Alexander M.
Published: November 2024

Around 1,000 Hmong refugees arrived in French Guiana in the late 1970s to found two agricultural communities. They were members of an emerging global diaspora of survivors fleeing the violence of the Laotian Civil War. From the perspective of the French government, the relocation became linked with the contemporaneous “Plan Vert” to develop the agricultural potential of the overseas territories. At that time, a significant percentage of the produce consumed in French Guiana was imported from Suriname. Within a few decades, government support helped the Hmong communities of Cacao and Javouhey to develop into critically important agricultural producers. Today they supply more than half of French Guiana’s produce, which has helped to eliminate dependence on imports from Suriname. In the early 2010s, the Surinamese government collaborated with Hmong leaders from French Guiana to bring a new wave of Hmong immigrants from Laos to Suriname. Their project, mirroring that of the French government nearly 40 years before, was to reinvigorate the agricultural sector by reclaiming land abandoned during the Surinamese Interior War of 1986–92. These waves of Hmong agricultural immigration are part of a long and ongoing history of displacements and mobilizations of groups of people by colonial and postcolonial governments in the Guianas. At the same time, the ongoing success of Hmong communities in the Guianas cannot be wholly attributed to government support: it is as much due to the dynamism and initiative of the Hmong themselves.
1. The Onomasticon with and without yahu Names
Authors: Hornkohl Aaron D.
Published: November 2024

The chapter examines the evolution of Hebrew onomastics, with special focus on the use of Yahwistic names (names containing the divine element Yhwh) in the Bible. Apparently early biblical texts, like the books of the Torah, Joshua, Judges, and Samuel, contain very few Yahwistic names, in contrast to monarchic and post-exilic periods, where such names are prominent. Th absence of Yahwistic names in Genesis–Samuel suggests that they reliably reflect pre-monarchic naming traditions in which yahu names had yet to become common. One may thus hypothesise three stages in yahu naming practices: pre-monarchic rarity; widespread use of names ending in the long form -yahu during the Divided Monarchy; and ascendancy of names ending in the short form -yah in post-exilic times.

Scholars debate the significance of these patterns, with some suggesting that the Torah and other pre-monarchic texts preserve naming conventions from before 900 BCE. This challenges certain versions of the dating of Pentateuchal sources in the framework of the Documentary Hypothesis, which propose later dating for certain sources, and, to a lesser extent, the dominant dichotomous theory concerning BH linguistic periodisation. Despite the lack of direct extrabiblical Hebrew evidence from the pre-monarchic period, the absence of Yahwistic names in biblical texts depicting pre-monarchic times finds indirect confirmation in contemporary Mesopotamian and other ancient Near Eastern writings, supporting the idea that the Hebrew naming traditions found in Genesis–Samuel, which differ from those of the later monarchic and post-exilic periods, are authentically representative of pre-monarchic times.
4. Construct מְאַת versus Absolute מֵאָה
Authors: Hornkohl Aaron D.
Published: November 2024

The cardinal numeral ‘hundred’ in ancient Hebrew presents two distinct forms: construct מְאַת and absolute מֵאָה. Their usage is not random, as evidenced by the distribution in biblical and extrabiblical texts. In Iron Age II epigraphic Hebrew, the construct form appears in a single instance, whereas the Masoretic Text (MT) shows a notable difference in the ratio of construct to absolute forms, with the construct outnumbering the absolute in the Pentateuch (27:5), but being less common in other parts of the MT (3:48). The analysis reveals that certain nouns only co-occur with one of the forms, and among the nouns that appear with both, the overall ratio is relatively balanced at 26:21, although the Torah significantly favours the construct.

The examination of various sources, including the Dead Sea Scrolls (DSS), Samaritan Pentateuch (SP), and Rabbinic Hebrew (RH), further elucidates the evolution of these forms. Due to harmonistic tendencies, the SP shows a higher occurrence of the construct form than the MT, while RH exhibits a strong preference for the absolute form. Notably, RH seldom uses the construct outside of direct allusion to Biblical Hebrew. The diachronic data indicates that while both forms were used in Classical Biblical Hebrew, the construct form fell out of favour in later sources. The linguistic distinction between the Torah and the rest of the Hebrew Bible also emerges as a significant observation, revealing a preference for the construct in the Torah that is not mirrored in other texts, highlighting the unique characteristics of the linguistic context in which the Torah was composed or, at the very least, the conservatism of its linguistic tradition.
7. 1CPL ונ ְ חַנ versus ונ ְ חַנ ֲ א
Authors: Hornkohl Aaron D.
Published: November 2024

In Biblical Hebrew (BH), there are three notable forms of the first-person plural independent subject pronoun: standard אֲנַחְנוּ and non-standard נַחְנוּ and אנו. Each of the forms finds support beyond BH, whether in other forms of ancient Hebrew or cognate languages. Additionally, the development of two of these forms is the subject of an interesting linguistic debate, with differing opinions on whether אֲנַחְנוּ or נַחְנוּ is the more archaic form, reflecting varying theories on their historical usage and evolution.

The evidence suggests that while נַחְנוּ may be older, אֲנַחְנוּ became established as the standard form in Classical Biblical Hebrew (CBH). The fact that the Tiberian Pentateuch preserves minority cases of נַחְנוּ (in quoted speech), matching the only form found in Iron Age II Hebrew epigraphy, whereas the rest of CBH, along with the Samaritan Pentateuch, consistently resorts to אֲנַחְנוּ is taken here as evidence of sub-chronolects. Analysis of the purported sources of the Pentateuch indicates that all sources primarily employ the standard form, with instances of נַחְנוּ appearing mostly in the J and P sources.
9. FPL -ן versus - הָנ
Authors: Hornkohl Aaron D.
Published: November 2024

The text discusses the prevalence and characteristics of the feminine plural (FPL) verbal suffix forms in ancient Hebrew. The dominant form across various ancient Hebrew sources, including the Tiberian biblical tradition and the Mishna, is vowel-final -נה. However, there exists a minority alternative, consonant-final -ן, whose presence and distribution within the biblical text, especially in the Masoretic tradition, is explored.

The analysis also presents statistical data illustrating the distribution of these forms in the Tiberian biblical tradition. It shows that vowel-final spellings dominate overall, while consonant-final forms are particularly concentrated in the Pentateuch. The text posits that these forms may reflect historical linguistic diversity in Hebrew that later evolved into a standardisation favouring vowel-final morphology. It suggests that the differing frequencies of consonant-final forms in the Torah compared to other biblical texts could indicate a preservation of older linguistic characteristics. The chapter concludes by raising questions about the implications of such morphological variation for theories of literary formation and textual transmission.
12. Orthography
Authors: Hornkohl Aaron D.
Published: November 2024

The chapter explores the orthography of the Tiberian Torah in relation to other biblical texts, emphasising the linguistic and diachronic distinctiveness of the written component within the Masoretic tradition. It argues that while features discussed in chapters 8–11 might be viewed as purely orthographic peculiarities, they are better understood as linguistic differences. But even so, the distinctive defective orthography of the Torah, especially when compared to the more plene orthography in the rest of the Masoretic Bible, suggests that the spelling conventions of the Torah are conservative and may reflect an earlier stage of the Hebrew language. The presence of secondary developments in orthography raises questions about the authenticity and reliability of these conventions, but there remains a possibility of discerning meaningful early data amidst these changes.

The text further delves into various examples of pre-Tiberian and proto-Tiberian orthography, drawing evidence from biblical manuscripts, including the Dead Sea Scrolls, which illustrate more defective spellings than the Masoretic Text. Studies on the orthographic distinctiveness of the Tiberian Torah reveal that its conservative defectiveness correlates with early spelling conventions, particularly in Priestly material. While some scholars argue that orthographic variations can be attributed to secondary processes, the overall findings suggest that the orthographic conservatism of the Torah may be indicative of its antiquity. The distinction between the orthography of the Torah and the Former Prophets suggests a nuanced interplay of diachronic developments within the Hebrew Bible, highlighting the complex relationship between language, orthography, and textual transmission.
Carl Sagan and libraries: An original thinker remembered
Authors: Garrett Jeffrey
Published: November 2024

This article considers the legacy of astronomer Carl Sagan (1934–1996), whose book The Dragons of Eden presents a complete etiology of the library in the context of human evolution. Essential to Sagan's theory of the origins of the library is the concept of extrasomatic information, or knowledge stored outside the body. Surprising evidence on behalf of Sagan's theory has been presented in recent years by Nobel-Prize-winning neuroscientist Eric Kandel and others: that the human brain has not significantly grown for 50,000 years, presumably not due to evolutionary stagnation, but because cultural evolution has superseded biological evolution in Homo sapiens, an advance which has led to us becoming the dominant species on Earth.
Fibromyalgia, mood disorders and chronic damage are the main determinants of worse quality of life in systemic lupus erythematosus patients: Results from a cross-sectional analysis
Authors: Ceccarelli Fulvia , Ciancarella Claudia , Pirone Carmelo , Natalucci Francesco , Picciariello Licia , Garufi Cristina , Mancuso Silvia , Truglia Simona , Spinelli Francesca Romana , Alessandri Cristiano , Cont Fabrizio
Published: November 2024

Objective

As suggested by the EULAR recommendations, a comprehensive management of Systemic Lupus Erythematosus (SLE) should include the evaluation of disease activity, chronic damage, and quality of life (QoL). QoL is significantly impaired in SLE patients, even in those achieving a state of remission, suggesting the possible contribution of other factors. Thus, in the present study we aimed at analyzing QoL in a large SLE cohort by using LupusQoL, and at identifying the main determinant of poorer QoL.

Methods

We conducted a cross-sectional study by including consecutive SLE patients diagnosed according to the 2019 ACR/EULAR criteria. Clinical, laboratory and therapeutical data were collected. Disease activity was assessed by SLEDAI-2k, while chronic damage by the SLICC Damage Index (SDI). The diagnosis of fibromyalgia was made in accordance with the ACR criteria (2016). At the time of the enrollment, all patients completed the following questionnaires: LupusQoL to assess quality of life and hospital anxiety and depression scale (HADS) for anxiety and depression.

Results

Our analysis included 237 SLE patients [92.4% female, median age 46 years (IQR 19.5), median disease duration 156.8 months (IQR 180.6)]. At the time of enrollment, we found a mean SLEDAI-2k of 1.7 (DS 2.4); 104 patients (43.9%) had chronic damage, with a mean SDI value of 0.8 (DS 1.3). Patients diagnosed with fibromyalgia were 69 (29.1%); moreover, HADS questionnaire identified a condition of anxiety and depression in 112 (47.3%) and 94 (39.7%) patients, respectively. The most compromised domain in the LupusQoL resulted “fatigue”, followed by “burden to others”. Patients with SDI ≥ 1 showed lower quality of life than patients without chronic damage, as demonstrated by significantly lower values in all items of the LupusQoL ( p < .01). Furthermore, significantly lower values in all the LupusQoL domains were observed in patients with fibromyalgia, anxiety and depression, in comparison to those patients without these manifestations ( p < .0001). No association was demonstrated between QoL and disease activity. Finally, the linear regression analysis confirmed mood disorders, in particular depression, and fibromyalgia as the main determinants of worse quality of life in our cohort.

Conclusions

The present study demonstrated the influence of different factors in the quality of life of SLE patients. In particular, the presence of mood disorders, fibromyalgia and chronic damage resulted the main determinants of poorer QoL. This evidence reinforces the need for a comprehensive patient care.
Interdisciplinary Rheumatoid Arthritis Research and Patient Care: An Introduction and Critique of the Biopsychosocial Model of Disease Experience in Rheumatoid Arthritis
Authors: McGarrity-Yoder Maureen , Insel Kathleen , Crane Tracy , Pace Thaddeus
Published: November 2024

Introduction: Rheumatoid arthritis (RA), a debilitating autoimmune disease, affects approximately 78 million people globally. RA is often managed solely by rheumatology providers, but an interdisciplinary approach to RA may be the key to improving health equity and outcomes. An interdisciplinary model is an important step towards this goal. The Biopsychosocial Model of Disease Experience in RA (BDRA) is a conceptual approach that considers individual disease determinants in interdisciplinary research and care. Objective: To introduce and critique the evidence-based, interdisciplinary BDRA. Methods: Engel’s Biopsychosocial Model of Health (BMH) and the Revised Symptom Management Conceptual Model (RSMCM) were blended in the BDRA. A literature search of articles published prior to December 2021 was completed using “disease exacerbation,” “disease improvement,” and “disease activity” in RA. Results were categorized as biological, psychological, and social determinants of disease activity in RA. These biopsychosocial factors alter biological function and result in the individual RA experience. Model development and critique were completed using guidelines established by Walker and Avant. Conclusion: The BDRA is a visual depiction of RA biopsychosocial factors, disease activity, and individual experience. This model can guide interdisciplinary research and patient care, in efforts to improve RA health equity and rates of sustained remission.
The Cross-sectional Relationship Between Use of Automatic Insulin Delivery Systems and Eating Styles Among Older Adults With Type 1 Diabetes: An Exploratory Analysis
Authors: Kahkoska Anna R. , Sprinkles Jessica , Gopisetty Nikhita , Ercolino Gabriella , Fruik Angela , Muthukkumar Rashmi , Qu Xiaorui , Mayer-Davis Elizabeth J. , Cristello Sarteau Angelica
Published: November 2024

Background:

The number of older adults with type 1 diabetes (T1D) is increasing. Use of automated insulin delivery (AID) may influence nutrition and eating behaviors. We explored how three eating styles (restrained, external, emotional) differ between older adults with T1D who use and do not use AID.

Methods:

We administered a one-time electronic survey from September to November 2023 to adults ≥65 years with T1D receiving care through a university-affiliated hospital system. Clinical and demographic information was collected from medical records. Eating styles were characterized with the Dutch Eating Behavior Questionnaire.

Results:

Our sample ( n = 77, 95% non-Hispanic white) had mean (SD) age: 71.8 (4.1) years, diabetes duration: 33 (18) years, hemoglobin A1c (HbA1c): 6.83 (1.12%), and body mass index (BMI): 27.3 (4.7) kg/m2. Respondents reported variable eating styles, with the highest median scores for external and restrained eating and lower scores for emotional eating. Older adults using AID systems had higher median scores for emotional and external eating, and more varied restrained eating scores compared to those not using AID systems. Weak correlations were found between eating styles and HbA1c (restrained: r = −0.14; external: r = 0.08; emotional: r = 0.15), as well as between restrained ( r = 0.09) and external ( r = 0.04) eating with BMI, with a small correlation between emotional eating and BMI ( r = 0.27).

Conclusions:

Eating styles may vary between older adult AID users and non-users. To our knowledge, this is the first study to characterize eating styles in this population, though generalizability is limited by a non-diverse and small sample with high technology use overall (eg, continuous glucose monitoring, insulin pumps).
The Minimotor Ltd: Pioneering digital transformation in production and operations
Authors: Wörner Dominik
Published: November 2024

This teaching case examines the complexities encountered by a global industrial company undergoing digital transformation, particularly due to its heterogeneous production landscape. It highlights the critical factors for effectively orchestrating digital transformation initiatives and utilizing the scalability of technological applications. This industry example is relevant for delegates, students and practitioners aiming to implement maturity models and to realize the digital transformation within the context of Industry 4.0.
The Great Transition Towards Populism in Indian Politics: Populist Attitudes and Populist Radical Right (PRR) Voting in the 2019 Indian General Election
Authors: Han Jinwon
Published: November 2024

While extant research has identified several determinants of the Bharatiya Janata Party (BJP)’s unprecedented victory in the 2019 general election, they have overlooked the party’s populist radical right (PRR) nature, particularly under the leadership of Narendra Modi. Based on the demand side of PRR voting, this article examines the effect of Indian voters’ populist attitudes on their voting choices for the BJP during the 2019 election. Using binary logistic regression (BLR) and conducting a robustness check, this article identifies that the variable of individuals’ populist attitudes does indeed exert a significant effect on their vote choices for the BJP during the 2019 election. In addition to this main variable, a number of controls that were included in the analysis were also found to be significantly correlated with the dependent variable. In light of the findings, the article proposes some theoretical implications.
Multinational Democratic Federations: Comparing India with Multi-level Systems from the Global North
Authors: Adeney Katharine , Swenden Wilfried
Published: November 2024

In this article, we compare the Indian experience with that of some of the multinational and multi-level polities from the Global North, namely Belgium, Canada, Spain and the United Kingdom. We first summarize the essence of multinationalism. Drawing from our comparative examples of the Global North we then show how dominant narratives of state nationalism condition the extent to which the state can accommodate plurinational difference through self-rule, shared rule and ethno-symbolic recognition within these states, and then compare and contrast this with the Indian experience. Despite the stickiness of elite narratives on the meaning of the state during state formation and democratization, we highlight the ability of electoral competition to push multi-level politics into a more accommodative or majoritarian direction. We illustrate this with reference to India including the 2024 General Election Outcome.
Impact of TiO2, ZnO, and Ag nanoparticles on anammox activity in enriched river Nile sediment cultures: unveiling differential effects and environmental implications
Authors: Abd EL-Aziz Mohamed A. , Saeed Ali M. , Ibrahim Mohamed K. , El-Sayed Wael S.
Published: November 2024

Background

The increasing use of nanoparticles (NPs) necessitates investigation of their impact on wastewater treatment processes, particularly anammox, a critical biological nitrogen removal pathway. This study explored the effects of short-term exposure to TiO2, ZnO, and Ag-NPs on anammox activity in enriched cultures derived from River Nile sediments.

Materials and methods

Anammox bacteria were identified and enriched, with activity confirmed through 16S rRNA and hydrazine oxidoreductase (hzo) gene amplification and sequencing. Activity assays demonstrated efficient ammonium removal by the enriched culture. Subsequently, the impact of different sized and concentrated NPs on anammox activity was assessed.

Results

XRD analysis confirmed NP behavior within the microcosms: TiO2 transformed, ZnO partially dissolved, and Ag remained ionic. hzo gene expression served as a biomarker for anammox bacterial activity. Interestingly, 100 nm TiO2-NPs up-regulated hzo expression, potentially indicating a non-inhibitory transformed phase. Conversely, ZnO and Ag-NPs across all sizes and concentrations significantly down-regulated hzo expression, suggesting detrimental effects. Ag-NPs amended microcosms showed a significant reduction (79%) in hzo gene expression and a detrimental effect on bacterial populations. Overall, anammox activity mirrored hzo expression patterns, with TiO2 (21 and 25 nm, respectively) exhibiting the least inhibition, followed by ZnO and Ag-NPs.

Conclusion

This study highlights the differential effects of NPs on anammox, with the order of impact being Ag > ZnO > TiO2. These findings provide valuable insights into the potential environmental risks of NPs on anammox-mediated nitrogen cycling in freshwater ecosystems.
Evidence pointing toward invalidity of the SF-8 physical and mental scales: a fusion validity assessment
Authors: Hayduk Leslie A. , Hoben Matthias , Estabrooks Carole
Published: November 2024

Background

The SF-8™ Short Form Health Survey creates physical and mental health scale scores from responses to eight survey questions. These widely used scales demonstrate reasonable reliablity, and some forms of validity but have not been assessed for fusion validity. We assess the fusion validity of the SF-8 physical and mental health scales, and provide comments assisting fusion validity assessment of other scales.

Methods

Checking the fusion validity of a scale requires including the scale and its constituent indicators in a structural equation model that has at least one variable causally downstream from the scale. We assessed fusion validity of the SF-8 physical and mental health scales in the context of work-related variables for care aides working in Canadian long-term care homes. Variables causally downstream from physical and mental health, such as work burnout, permit checking whether the SF-8 indicator items fuse to form cogent physical and mental scales, irrespective of whether those indicators share common-factor foundations.

Results

We found that the SF-8 physical and mental health scales did not function appropriately. The scales inappropriately claimed effects for several items that had no effects and provided biased estimates of other effects. These deficiencies seem grounded in the scales’ developmental history, which implicitly bolstered selection of some causally ambiguous items and paid insufficient attention to component factor model testing.

Conclusion

Our observations of causal incongruities question whether the SF-8 can provide valid assessments of physical and mental health. However, it would be imprudent to discontinue SF-8 use on the basis of a single study suggesting invalidity. This uncomfortable conclusion can be rechecked by re-analyzing data from any project that employed the SF-8 and recorded even one causal consequence of physical or mental health. The power of fusion validity assessment comes from connecting the recorded consequences simultaneously to both the scale and the items from which that scale is calculated.
Depression in geriatrics: a systematic review and meta-analysis of prevalence and risk factors in Egypt
Authors: Ahmed Hebatalla , Khaled Heba , Allam Ahmed A. , Alodini Bassima , Azzam Ahmed , Hjazeen Anees Adel , Hassan Hassan Samy , Hussein Sarah Mohamed , Hassan Fatma E.
Published: November 2024

Background

Depression is the most common psychiatric disorder in older adults, even though it is commonly misdiagnosed and undertreated, leading to exacerbations of preexisting medical conditions and even a higher mortality rate. In the present systematic review with meta-analysis, we quantify the magnitude of depression and its associated risk factors among the older adult population in Egypt.

Methods

A thorough literature search was performed from 2010 up to October 2023. The results were presented as proportions or risk difference with a 95% confidence interval (CI) calculated using the random effects model. A sensitivity analysis was performed to examine the robustness of the results.

Results

Our study included 14 articles with 5857 older adults published between 2011 and 2023. All the included studies assessed depression in geriatrics using the Geriatric Depression Scale. Of the 14 studies, 5 were for community-dwelling older adults, 3 were for older adults attending primary health care (PHC) centers, 2 were for hospitalized older adults, 3 were for residing in geriatric homes, and one for residing in geriatric homes, hospitalized older adults, and community-dwelling older adults. The overall prevalence of depression among Egyptian geriatrics was 64.6%. The pooled prevalence of depression was 59.6%, 67.0%, 67.0%, and 62.0% for community-dwelling older adults, older adults people attending PHC, hospitalized older adults, and older adults residing in geriatric homes, respectively. Older adults with chronic illness, female sex, and low-income elders and elders who were not employed had a higher risk for depression with pooled risk differences of 34.9%, 17.8%, 23.8%, and 15.1% (P < 0.05), respectively. In contrast, there was no significant difference in risk for depression in the older adults residing in urban areas compared to rural areas, the older adults aged + 70 compared to those less than 70, individuals with low levels of education or who are illiterate compared with those with higher levels of education and the older adults who live alone compared with those living with family.

Conclusion

More than half of the older adults in Egypt suffer from depressive symptoms. Chronic diseases, female sex, unemployment, and low-income inequality are the most significant factors contributing to depression among Egypt’s older adults.
Multicriteria optimization achieves superior normal tissue sparing in volumetric modulated arc therapy for gastric cancer
Authors: He Ling , Gao Xinrui , Li Tao , Li Xia , Sun Xiaowen , Wei Zhigong , Peng Xingchen , Xiao Jianghong
Published: November 2024

Objective

To evaluate the benefits of volumetric modulated arc therapy (VMAT) based on multicriteria optimization (MCO) for gastric cancer patients, particularly the protection of serial organs at risk (OARs) that overlap with the target volume.

Methods

MCO and single-criterion optimization (SCO) VMAT plans were conducted among 30 gastric cancer patients, with a prescription dose of 50.4 Gy delivered in 28 fractions. All treatment plans underwent review, and a comparison was made between the active planning time and different dose-volume parameters.

Results

Both the MCO and SCO VMAT plans achieved the target dose coverage, with no significant difference in the conformity index (CI) for the planning target volume (PTV), at median CI values of 0.887 and 0.891, respectively (P = 0.417). The MCO plans showed a slight but significant increase in the homogeneity index of the PTV, with a median increase of 0.029 (P < 0.001). Additionally, the MCO plans resulted in a lower D2% to the small intestine and duodenum, with reductions of 3.43 Gy and 0.3 Gy, respectively (P < 0.05). Furthermore, the Dmax to the small intestine correlated moderately with the overlapping volume between the small intestine and the target volume (ρ = 0.42, P = 0.023). Except for the mean dose to the liver, the MCO plans performed better in terms of dose indicators for other OARs. Moreover, compared to the SCO plans, the median active planning time in the MCO plans was significantly reduced by 53.2 min (P < 0.0001).

Conclusions

MCO can effectively help the physicians to quickly select an optimal treatment plan for patients with gastric cancer. It has been shown that MCO VMAT plans can significantly reduce the dose to OARs and shorten the active planning time, with acceptable target coverage. In addition, these plans take less dosimetric time, thereby streamlining the treatment planning process.
Participant and group facilitator perspectives on a novel culturally tailored diabetes self-management program for African Americans
Authors: Tarfa Adati , Salihu Ejura Yetunde , Xiong Phanary , Brewer Cierra , Maurer Martha , Liu Yao , Shiyanbola Olayinka
Published: November 2024

Background

African Americans with type 2 diabetes experience disparities in their care and diabetes health-related outcomes. Diabetes self-management programs such as Healthy Living with Diabetes (HLWD) are important but do not account for the unique cultural experiences of African Americans. Also, a culturally tailored program focused on addressing sociocultural beliefs and providing race-congruent peer support, Peers LEAD (Peers Supporting Health Literacy, Self-Efficacy, Self-Advocacy, and Adherence) was implemented in two midwestern cities to improve medication adherence but does not include diabetes self-management topics included in HLWD. In an attempt to fill the gaps from both HLWD and Peers LEAD, Peers EXCEL (Peers’ Experience in Communicating and Engaging in Healthy Living) was designed to integrate both programs.

Methods

Our study explored the perceptions of African American participants and facilitators of the separate HLWD and Peers LEAD programs, on the proposed new Peers EXCEL program using focus groups and interviews. Findings were analyzed by research assistants trained in qualitative research using deductive and inductive open coding approaches.

Results

Participants appreciated the cultural fit of Peers EXCEL for African American communities which is a feature that was lacking in HLWD. They shared the need to include topics such as the relationships between systemic racism and diabetes.

Conclusion

Participants’ feedback of Peers EXCEL reveals the importance of including various community members’ perspectives in the design of new diabetes self-management programs tailored for African Americans.
Mixed-methods to explore barriers to the use of food security initiatives in a historically black college and university (HBCU)
Authors: Antwi Janet , Olawuyi Yetunde , Ifafore Modupe , Opara Innocent
Published: November 2024

Background

To assess students’ use and perception of the initiatives to tackle food insecurity (FI) in a Texas historically black college and university (HBCU).

Methods

HBCU students > 18 years (288 students). A mixed-methods approach involving an online survey, focus group discussions and key informant interviews were conducted among the students and major stakeholders to evaluate the prevalence of FI, and gain insights into the challenges to accessing, utilizing and effectively implementing food security (FS) initiatives.

Results

FI affected 63.5% of the participants. The awareness and utilization of the food pantry were 27.9% and 8.1% respectively while for the meal share programs, awareness and utilization were 30.1% and 15.0%, respectively. A significant association was found between FI and the place of residence (p = 0.027). Binary logistic regression model showed that students’ school year was a predictor of food pantry awareness (p < 0.05), residence and FI status were predictors of the meal share program utilization (p < 0.05). Five themes, including poor awareness and visibility of campus resources, bureaucratic process and logistics, insufficient funds, personnel and other resources to run the initiatives, ineffective communication, and stigma due to location emerged as the main barriers to the use of the resources.

Conclusions

This study emphasizes the necessity for HBCUs to address these hurdles in order to successfully help students in need with FI resources.
Psychometric properties of a COVID-19 health literacy scale in a sample of German school principals applying Rasch analysis
Authors: Meyer Marlene , Dadaczynski Kevin , Messer Melanie , Okan Orkan
Published: November 2024

Background

During the COVID-19 pandemic, health literacy was found to be an asset to manage health-related information. The HLS-COVID-Q22 has been developed to measure COVID-19 health literacy. External validation needs to be assessed in different populations to verify the questionnaire’s functioning. The present study aimed to evaluate the psychometric properties of the HLS-COVID-Q22 in a sample of German school principals.

Methods

The sample consisted of 2187 German school principals who completed the HLS-COVID-Q22 online from April to March 2021. The data was analyzed using Rasch analysis, applying the Partial Credit Model for polytomous data. Dimensionality, item fit statistics and rating scale functioning was tested. Values for item difficulty and person ability as well as reliability indices were computed.

Results

Unidimensionality could be confirmed. The rating scale categories worked as intended, participants used every rating step category. Generally, item fit was verified. One item showed potential misfit but could remain in the questionnaire as excluding the item did not reduce reliability. A person separation index of 3.41 and person reliability of 0.92 showed excellent differentiation between COVID-19 health literacy levels. Furthermore, the values for item separation of 20.08 and item reliability of 1.0 indicate good construct validity.

Conclusions

The German version of the HLS-COVID-Q22 appears to be a reliable measurement tool for the target population. Evidence for construct, statistical and fit validity was collected. Future studies need to test additional types of validity like convergent and divergent validity to further evaluate the questionnaire. Moreover, the psychometric properties of the translated versions of the HLS-COVID-Q22 should be compared using Rasch analysis.
An interactive dashboard for analyzing user interaction patterns in the i2b2 clinical data warehouse
Authors: Baum Lena , Müller Armin , Johns Marco , Abu Attieh Hammam , Halilovic Mehmed , Milicevic Vladimir , Neves Diogo Telmo , Otte Karen , Pasquier Anna , Wirth Felix Nikolaus , Segelitz Patrick , Schönrath Katharina , Weber Joachim E. , Prasser Fabian
Published: November 2024

Background

Clinical data warehouses provide harmonized access to healthcare data for medical researchers. Informatics for Integrating Biology and the Bedside (i2b2) is a well-established open-source solution with the major benefit that data representations can be tailored to support specific use cases. These data representations can be defined and improved via an iterative approach together with domain experts and the medical researchers using the platform. To facilitate these discussions, it is important to understand how users interact with the system.

Objective

The objective of this work was to develop metrics for describing user interactions with clinical data warehouses in general and i2b2 in particular. Moreover, we aimed to develop a dashboard featuring interactive visualizations that inform data engineers and data stewards about potential improvements.

Methods

We first identified metrics for different data usage dimensions and extracted the relevant metadata about previous user queries from the i2b2 database schema for further analysis. We then implemented associated visualizations in Python and integrated the results into an interactive dashboard using Dash.

Results

The identified categories of metrics include frequency of use, session duration, and use of functionality and features. We created a dashboard that extends our local i2b2 data warehouse platform, focusing on the latter category, further broken down into the number of queries, frequently queried concepts, and query complexity. The implementation is available as open-source software.

Conclusion

A range of metrics can be derived from metadata logged in the i2b2 database schema to provide data engineers and data stewards with a comprehensive understanding of how users interact with the platform. This can help to identify the strengths and limitations of specific instances of the platform for specific use cases and aid their iterative improvement.
Clinical values of nuclear morphometric analysis in fibroepithelial lesions
Authors: Lee Conrad , Yip Heilum , Li Joshua J.X. , Ng Joanna , Tsang Julia Y. , Loong Thomson , Tse Gary M.
Published: November 2024

Background

Fibroepithelial lesions (FELs) of the breast encompass a broad spectrum of lesions, ranging from commonly encountered fibroadenomas (FAs) to rare phyllodes tumors (PTs). Accurately diagnosing and grading these lesions is crucial for making management decisions, but it can be challenging due to their overlapping features and the subjective nature of histological assessment. Here, we evaluated the role of digital nuclear morphometric analysis in FEL diagnosis and prognosis.

Methods

A digital nuclear morphometric analysis was conducted on 241 PTs and 59 FAs. Immunohistochemical staining for cytokeratin and Leukocyte common antigen (LCA) was used to exclude non-stromal components, and nuclear area, perimeters, calipers, circularity, and eccentricity in the stromal cells were quantified with QuPath software. The correlations of these features with FEL diagnosis and prognosis was assessed.

Results

All nuclear features, including area, perimeter, circularity, maximum caliper, minimum caliper and eccentricity, showed significant differences between FAs and benign PTs (p ≤ 0.002). Only nuclear area, perimeter, minimum caliper and eccentricity correlated significantly with PT grading (p ≤ 0.022). For differentiation of FAs from benign PTs, the model integrating all differential nuclear features demonstrated a specificity of 90% and sensitivity of 70%. For PT grading, the nuclear morphometric score showed a specificity of 78% and sensitivity of 96% for distinguishing benign/borderline from malignant PTs. In addition, a relationship of nuclear circularity was found with PT recurrence. The Kaplan-meier analysis, using the best cutoff determined by ROC curve, showed shorter event free survival in benign PTs with high circularity (chi-square = 4.650, p = 0.031).

Conclusions

Our data suggested the digital nuclear morphometric analysis could have potentials to objectively differentiate different FELs and predict PT outcome. These findings could provide the evidence-based data to support the development of deep-learning based algorithm on nuclear morphometrics in FEL diagnosis.
SpottedPy quantifies relationships between spatial transcriptomic hotspots and uncovers environmental cues of epithelial-mesenchymal plasticity in breast cancer
Authors: Withnell Eloise , Secrier Maria
Published: November 2024

Spatial transcriptomics is revolutionizing the exploration of intratissue heterogeneity in cancer, yet capturing cellular niches and their spatial relationships remains challenging. We introduce SpottedPy, a Python package designed to identify tumor hotspots and map spatial interactions within the cancer ecosystem. Using SpottedPy, we examine epithelial-mesenchymal plasticity in breast cancer and highlight stable niches associated with angiogenic and hypoxic regions, shielded by CAFs and macrophages. Hybrid and mesenchymal hotspot distribution follows transformation gradients reflecting progressive immunosuppression. Our method offers flexibility to explore spatial relationships at different scales, from immediate neighbors to broader tissue modules, providing new insights into tumor microenvironment dynamics.
Multilayer textile-based concept for non-invasive biosensor platform
Authors: Soekoco Asril Senoaji , Septiani Ni Luh Wulan , Iqbal Muhammad , Irzaman  , Nugroho Widagdo Sri , Rusydi Febdian , Nugraha  , Yuliarto Brian
Published: November 2024

The surface area of the working electrode plays a crucial role in determining the sensor’s performance, especially in enzymatic sensors. Increasing the surface area of the working electrode has a significant impact on the sensor’s functionality. This research focused on developing textile-based sensors using a multi-layer concept, employing the direct coating method. Two different sensors which are multilayer textile-based sensor (MTBS) and single-layer textile-based sensor (STBS) were prepared, while commercial screen-printed carbon electrode (SPCE) was also used as a comparison. The measurements were carried out using potassium ferricyanide solutions with concentrations of 0.01 M, 0.02 M, 0.03 M, 0.04 M, and 0.05 M at a voltage of 1 V, with a maximum duration up to the end of the measurement and a time interval of 0.5 s. According to the research findings, the fluid spreading speed of the SPCE is the lowest when compared to the spreading speeds of the MTBS and STBS. Specifically, the fluid spreading speed of the SPCE is 4.3 times slower than that of the STBS and 51 times slower than that of the MTBS. Utilizing a multi-layer concept with specific coatings can lead to better-performing sensors in terms of stability and sensitivity. The MTBS exhibits the greatest sensitivity, as indicated by its linear equation slope of 717.230 µA µM−1 cm−2.