bluuebunny/crossref_metadata_2025 huggingface dataset:
Progression from healthy periodontium to gingivitis and periodontitis: Insights from bioinformatics‐driven proteomics – A systematic review with meta‐analysis
Authors: Ahmad Paras , Escalante‐Herrera Andrea , Marin Lina M. , Siqueira Walter L.
Published: June 2024

Aim

The current study aimed to: (1) systematically review the published literature regarding the proteomics analyses of saliva and gingival crevicular fluid (GCF) in healthy humans and gingivitis and/or periodontitis patients; and (2) to identify the differentially expressed proteins (DEPs) based on the systematic review, and comprehensively conduct meta‐analyses and bioinformatics analyses.

Methods

An online search of Web of Science, Scopus, and PubMed was performed without any restriction on the year and language of publication. After the identification of the DEPs reported by the included human primary studies, gene ontology (GO), the Kyoto encyclopedia of genes and genomes pathway (KEGG), protein–protein interaction (PPI), and meta‐analyses were conducted. The risk of bias among the included studies was evaluated using the modified Newcastle–Ottawa quality assessment scale.

Results

The review identified significant differences in protein expression between healthy individuals and those with gingivitis and periodontitis. In GCF, 247 proteins were upregulated and 128 downregulated in periodontal diseases. Saliva analysis revealed 79 upregulated and 70 downregulated proteins. There were distinct protein profiles between gingivitis and periodontitis, with 159 and 31 unique upregulated proteins in GCF, respectively. Meta‐analyses confirmed significant upregulation of various proteins in periodontitis, including ALB and MMP9, while CSTB and GSTP1 were downregulated. AMY1A and SERPINA1 were upregulated in periodontitis saliva. HBD was upregulated in gingivitis GCF, while DEFA3 was downregulated. PPI analysis revealed complex networks of interactions among DEPs. GO and KEGG pathway analyses provided insights into biological processes and pathways associated with periodontal diseases.

Conclusion

The ongoing MS‐based proteomics studies emphasize the need for a highly sensitive and specific diagnostic tool for periodontal diseases. Clinician acceptance of the eventual diagnostic method relies on its ability to provide superior or complementary information to current clinical assessment procedures. Future research should prioritize the multiplex measurement of multiple biomarkers simultaneously to enhance diagnostic accuracy and large study cohorts are necessary to ensure the validity and reliability of research findings.
Household food and water insecurity and its association with diarrhoea, respiratory illness, and stunting in Ecuadorian children under 5 years
Authors: Chakraborty Rishika , Armijos Rodrigo X. , Beidelman Erika T. , Rosenberg Molly , Margaret Weigel M.
Published: June 2024

Household food and water insecurity has been previously associated with adverse health consequences in children. However, these relationships are understudied in middle‐income Latin American populations such as in Ecuador, where a high prevalence of food and water insecurity has been reported. Using cross‐sectional data from 2018 Ecuadorian National Health and Nutrition Survey, we examined the association of household food insecurity (HFI), household water insecurity (HWI), and concurrent HFI‐HWI with diarrhoea, respiratory illness (RI), and stunting in 20,510 children aged ≤59 months. HFI was measured using the Food Insecurity Experience Scale. HWI was defined when households responded negatively to one or more of four drinking water indicators. Maternal caregivers reported on child diarrhoea and RI episodes during the previous 2 weeks. Measured length or height was used to assess stunting. We constructed log‐binomial regression models to estimate the associations of HFI, HWI, and concurrent HFI‐HWI with child outcomes. Moderate‐severe HFI was associated with a higher prevalence of diarrhoea (PR = 1.39; 95% CI: 1.18, 1.63) and RI (PR = 1.34; 95% CI: 1.22, 1.47), HWI with a higher prevalence of RI (PR = 1.13; 95% CI: 1.04, 1.22), and concurrent HFI‐HWI with a higher prevalence of diarrhoea (PR = 1.30; 95% CI: 1.05, 1.62) and RI (PR = 1.45; 95% CI: 1.29, 1.62). Stunting was not associated with HFI, HWI nor concurrent HFI‐HWI. These findings suggest that HFI and HWI can independently and jointly act to negatively affect children's health. Policies and interventions aimed at alleviating both food and water insecurity are needed to bring sustained health improvements in Ecuadorian children.
Urinary eosinophil‐derived neurotoxin is associated with reduced lung function in pediatric asthma
Authors: Omony Jimmy , Thölken Clemens , Salimi Azam , Laubhahn Kristina , Illi Sabina , Weckmann Markus , Grychtol Ruth , Rabe Klaus Friedrich , Thiele Dominik , Foth Svenja , Weber Stefanie , Brinkmann Folke , Kopp Matthias Volkmar , Hansen Gesine , Renz Harald , von Mutius Erika , Schaub Bianca , Skevaki Chrysanthi ,   the ALLIANCE Study Group
Published: June 2024

Introduction

Eosinophil‐derived neurotoxin (EDN) is a biomarker for eosinophilic activation. Urinary (u) EDN may allow non‐invasive monitoring of asthma, but clinical recommendations are lacking. We assessed the potential of uEDN as a marker of disease activity in pediatric asthma.

Methods

We assessed urine samples of 371 children from the German ALLIANCE study cohort, from which we had: 169 preschool wheezers (<6 years), 80 asthmatics (≥6 years), and 122 healthy controls using the ImmunoCAP™ EDN Assay. Creatinine (Cr)‐adjusted uEDN values were analyzed using correlations, association tests, (non) parametric statistics, multiple linear, and multivariable regression.

Results

uEDN/uCr values were higher in atopic versus non‐atopic preschool‐aged subjects (p = .035) and associated with the sum of allergen‐specific IgE in younger (r = 0.24, p = .003), and older subjects (r = 0.23, p = .043). uEDN/uCr was marginally a good determinant for atopy (p = .078, for subjects aged <6 years, and p = .058 for subjects ≥6 years). Children with the T2‐high phenotype had higher uEDN/uCr (p < .001) versus T2‐low—irrespective of using uEDN/uCr or blood eosinophils in combination to allergen sIgE for disease phenotyping. uEDN/uCr significantly correlated with reduced lung function among asthmatics (FEV1 z‐scores: r = −0.30, p = .007, and FEV1/FVC z‐scores: r = −0.24, p = .038). Using multivariable modeling, uEDN/uCr was an independent determinant of FEV1 (p = .038), and to a lesser extent, FEV1/FVC (p = .080).

Conclusions

uEDN/uCr may serve as a non‐invasive biomarker for clinical features such as lung function in pediatric asthma. We highlight the utility of uEDN/uCr as a biomarker that can be easily assessed using widely available robust diagnostic immunoassays.
Leveraging successional facilitation to improve restoration of foundational dune grasses along a frequently disturbed coastline
Authors: Fischman Hallie S. , Cromwell Copeland W. , Morton Joseph P. , Temmink Ralph J. M. , van der Heide Tjisse , Adams Peter N. , Angelini Christine
Published: June 2024

Coastal ecosystems provide critical storm and flood protection but are rapidly degrading worldwide, making their restoration urgent. We evaluated whether successional facilitation, where pioneers facilitate climax species, could be leveraged to accelerate coastal dune revegetation. A survey spanning 270 km of Southeast U.S. coastline revealed that Panicum amarum (bitter panicum) supported higher plant richness than Uniola paniculata (sea oats) and that sea oat cover was 230% greater on mature dunes than disturbed dunes, suggesting bitter panicum functions as a pioneer and sea oats as a climax species. A reciprocal transplant experiment confirmed this interpretation: bitter panicum stem production and height fell by 37% and >20 cm, respectively, when planted proximate to sea oats versus in isolation, whereas sea oats produced 38% more and >12 cm taller stems when planted proximate to bitter panicum versus in isolation. A second experiment evaluating the density‐dependence of this facilitative interaction revealed that sea oats transplanted into low densities of bitter panicum grew >15% taller than isolated and high‐density treatments. However, within 7 months, wave inundation eliminated over 60% of propagules in both experiments. To explore foredune inundation frequency and its implications for dune revegetation, we applied empirical wave runup models at 101 locations throughout Volusia County, Florida. While disturbance frequency varied seasonally and annually, sites with low dune crests and steep beach slopes experienced frequent inundation (>50 events/year). Given the interactions between geomorphology and vegetation success, we present a decision matrix to guide managers in determining optimal revegetation methods tailored to project goals and site conditions.
Mortality‐associated risk factors for transfusion‐associated circulatory overload
Authors: Soni Lipika , Saeed Samia , Cserti‐Gazdewich Christine , McVey Mark J.
Published: June 2024

Background and Objectives

Respiratory transfusion reactions associate strongly with morbidity and mortality, and transfusion‐associated circulatory overload (TACO) is the leading cause of reaction‐related deaths. Risk factors for TACO include transfusion speed and volume and cardiorenal comorbidities.

Materials and Methods

An academic health network haemovigilance database was interrogated to assess variables associating with 371 cases of TACO and involved‐visit outcomes, using univariate and multivariate regression analysis.

Results

TACO reactions over 11 years were reported in 179 males and 192 females, median age (interquartile range) 65 (53–75) years. In‐hospital and 28‐day mortality were 17.5% and 12.9%, respectively. In univariate regression modelling, male sex, injury severity grade, product volume administered, the use of platelets and intensive care admissions were each associated with in‐hospital and 28‐day mortality (p < 0.05). However, after multivariate regression analysis, only male sex in transfusion recipients independently associated with mortality (p < 0.05).

Conclusion

In this cohort, male recipient sex and platelet administration were associated with TACO‐involving admissions not ending in survival.
A comparison of machine learning methods for estimation of snow density using satellite images
Authors: Goodarzi Mohammad Reza , Sabaghzadeh Maryam , Barzkar Ali , Niazkar Majid , Saghafi Mostafa
Published: June 2024

Low snow density causes snow to melt quickly, so there is no runoff during the warmer months of the year. Therefore, knowing the snow density can be useful in determining the amount of water. To predict snow density, this study used seven machine learning methods, including adaptive neural‐fuzzy inference system (ANFIS), M5P, multivariate adaptive regression spline (MARS), random forest (RF), support vector regression (SVR), gene expression programming (GEP) and eXtreme gradient boosting (XGBoost). Nine factors expected to affect snow density were considered. These factors were extracted using Google Earth Engine (GEE) from 1983 to 2022. The results showed that the surface temperature had the highest correlation (coefficient = −0.7), and the wind speed had the lowest correlation (coefficient = 0.3) among the considered factors on the snow density. Also, the best method was XGBoost (Nash–Sutcliffe efficiency [NSE] = 0.978, R = 0.957), and the worst method is SVR (NSE = 0.7, R = 0.9). Therefore, snow density can be estimated with good accuracy using a combination of machine learning methods and remote sensing.
Coalescence and total‐variation distance of semi‐infinite inverse‐gamma polymers
Authors: Rassoul‐Agha Firas , Seppäläinen Timo , Shen Xiao
Published: June 2024

We show that two semi‐infinite positive temperature polymers coalesce on the scale predicted by KPZ (Kardar–Parisi–Zhang) universality. The two polymer paths have the same asymptotic direction and evolve in the same environment, independently until coalescence. If they start at distance apart, their coalescence occurs on the scale . It follows that the total variation distance of two semi‐infinite polymer measures decays on this same scale. Our results are upper and lower bounds on probabilities and expectations that match, up to constant factors and occasional logarithmic corrections. Our proofs are done in the context of the solvable inverse‐gamma polymer model, but without appeal to integrable probability. With minor modifications, our proofs give also bounds on transversal fluctuations of the polymer path. As the free energy of a directed polymer is a discretization of a stochastically forced viscous Hamilton–Jacobi equation, our results suggest that the hyperbolicity phenomenon of such equations obeys the KPZ exponent.
Investigating the Use of B-Spline Signature Responses to Detect Internal Rail Defects
Authors: Gedney Brennan L. , Naseri Reza , Rizos Dimitris C.
Published: June 2024

The aim of this work is to explore the implementation of a structural change detection method proposed by the authors to detect internal rail defects. The B-Spline Signature Response (BSR) is a signature time history response of a dynamic system which is independent of loading, is a characteristic of the system, and captures the condition of the system at the time of acquisition without the need for identifying structural properties. The BSR changes only when the system changes. This is the basis of a non-parametric data-driven change detection method, which utilizes cross-correlation to distinguish variance in two BSRs of the same system extracted at different points in time. System change is determined when the correlation of two BSRs drops below a threshold value that is dependent on the type and level of change being monitored. The methodology is first demonstrated in a deterministic manner through computer simulations with a numerical sensitivity study on an idealized dynamic system and through an experimental study on a steel plate supported by a braced frame. Next, the method is implemented in a numerical computer simulation to detect a transverse cut in the rail head of a 2-meter-long segment of rail. A parametric study determined the optimal excitation and response types and locations, and the method was conducted successfully with both high and low frequency sampling rates, demonstrating flexibility that will facilitate laboratory and field implementation.
Passenger Railcar Production in North America: Rationalization and Standardization
Authors: Trout Stuart F.
Published: June 2024

Standardization of rail passenger vehicles provides for substantially increased procurement efficiency for agencies and manufacturers. Within broad categories of rail passenger vehicle types, there is substantial commonality between structures, power, traction, suspensions, and passenger amenities. The commonality can exceed 95% on procurements for agencies across North America. If agencies adopt a continuous replacement and growth strategy for rolling stock procurements, manufacturers can optimize production at fewer locations with much higher productivity and quality. There are five basic types of rail passenger vehicles that include trollies at one end of the spectrum up to and including multi-level high speed train sets. Within each of the types, designs and production systems can be optimized. If the passenger rail sector can migrate to the continuous replacement theory and accept standardization, agencies and passengers can enjoy the benefits of more equipment for service at a lower capital and operational cost.
Experimental Investigation of Lateral Load Effects on Railway Tapered Roller Bearing Performance
Authors: Sanchez Trinidad Abel David , Tarawneh Constantine , Aguila Diego , Fuentes Arturo , Guiterrez Santanna , Pena Curtis , Reyna Daniel
Published: June 2024

In the quest to maintain the reliability and safety of railway systems, vibration signatures emerge as a crucial diagnostic tool for identifying and tracking the progression of railway bearing health. It is important to note that, in the case of spall deterioration, temperature variations may only become noticeable once spalling has spread extensively across the raceway. Hence, a comprehensive understanding of the effects of lateral loading under various train speeds at empty and full railcar loads is important. Surprisingly, limited research has been carried out or made publicly available on the effects of lateral loading on the performance of railroad tapered-roller bearings. Motivated by this, researchers at the University Transportation Center for Railway Safety (UTCRS) are conducting laboratory testing utilizing the available dynamic bearing test rig to explore the effects of lateral loading on bearing performance. The laboratory testing is performed on Association of American Railroads (AAR) class F and K bearings, which represent about 85% of the railroad bearings utilized in freight rail revenue service. Lateral loads are applied by a specially designed hydraulic cylinder setup that can deliver up to 44.5 kN (10 kips) of lateral force on the bearing while in operation. The laboratory testing is designed to mimic lateral forces that bearings will experience during events like hunting, buckled track, uneven track, and instances where trains are navigating curved sections of track. This study sheds light on critical factors influencing bearing performance in the rail industry, particularly the impact of lateral loading on bearing performance and operating temperature fluctuations. Its unique contribution lies in exploring the previously uninvestigated effects of lateral loads on bearing vibration (in addition to temperature). Ultimately, the aim is to enhance the long-term reliability and safety of rail systems by identifying and mitigating factors that compromise bearing performance. Based on the insights gained from this study, the team is refining vibration and load measurement sensors to gather even more precise data on lateral load effects in future experiments.
Ultrasensitive and multiplexed tracking of single cells using whole-body PET/CT
Authors: Nguyen Hieu T. M. , Das Neeladrisingha , Ricks Matthew , Zhong Xiaoxu , Takematsu Eri , Wang Yuting , Ruvalcaba Carlos , Mehadji Brahim , Roncali Emilie , Chan Charles K. F. , Pratx Guillem
Published: June 2024

In vivo molecular imaging tools are crucially important for elucidating how cells move through complex biological systems; however, achieving single-cell sensitivity over the entire body remains challenging. Here, we report a highly sensitive and multiplexed approach for tracking upward of 20 single cells simultaneously in the same subject using positron emission tomography (PET). The method relies on a statistical tracking algorithm (PEPT-EM) to achieve a sensitivity of 4 becquerel per cell and a streamlined workflow to reliably label single cells with over 50 becquerel per cell of
18
F-fluorodeoxyglucose (FDG). To demonstrate the potential of the method, we tracked the fate of more than 70 melanoma cells after intracardiac injection and found they primarily arrested in the small capillaries of the pulmonary, musculoskeletal, and digestive organ systems. This study bolsters the evolving potential of PET in offering unmatched insights into the earliest phases of cell trafficking in physiological and pathological processes and in cell-based therapies.
Experimental observation of Earth’s rotation with quantum entanglement
Authors: Silvestri Raffaele , Yu Haocun , Strömberg Teodor , Hilweg Christopher , Peterson Robert W. , Walther Philip
Published: June 2024

Precision interferometry with quantum states has emerged as an essential tool for experimentally answering fundamental questions in physics. Optical quantum interferometers are of particular interest because of mature methods for generating and manipulating quantum states of light. Their increased sensitivity promises to enable tests of quantum phenomena, such as entanglement, in regimes where tiny gravitational effects come into play. However, this requires long and decoherence-free processing of quantum entanglement, which, for large interferometric areas, remains unexplored territory. Here, we present a table-top experiment using maximally path-entangled quantum states of light in a large-scale interferometer sensitive enough to measure the rotation rate of Earth. The achieved sensitivity of 5 μrad s
−1
constitutes the highest rotation resolution ever reached with optical quantum interferometers. Further improvements to our methodology will enable measurements of general-relativistic effects on entangled photons, allowing the exploration of the interplay between quantum mechanics and general relativity, along with tests for fundamental physics.
The physical basis for solvent flow in organic solvent nanofiltration
Authors: Fan Hanqing , He Jinlong , Heiranian Mohammad , Pan Weiyi , Li Ying , Elimelech Menachem
Published: June 2024

Organic solvent nanofiltration (OSN) is an emerging membrane technology that could revolutionize chemical separations in numerous vital industries. Despite its significance, there remains a lack of fundamental understanding of solvent transport mechanisms in OSN membranes. Here, we use an extended Flory-Rehner theory, nonequilibrium molecular dynamic simulations, and organic solvent transport experiments to demonstrate that solvent flow in OSN membranes is driven by a pressure gradient. We show that solvent molecules migrate as clusters through interconnected pathways within the membrane pore structure, challenging the widely accepted diffusion-based view of solvent transport in OSN. We further reveal that solvent permeance is dependent on solvent affinity to the OSN membrane, which, in turn, controls the membrane pore structure. Our fundamental insights lay the scientific groundwork for the development of next-generation OSN membranes.
Supplemental Material: P–T evolution of metapelitic and metamafic rocks from the Northern Liaoning: Implications on the Neoarchean tectonic regime of the North China Craton
Authors: Guo Minjie , Zhang Jian , al. et
Published: June 2024

This section includes additional data figures and tables that support the findings presented in the main manuscript.
Chylomicron retention disease: a rare aetiology of failure to thrive
Authors: Sunkoj Yojana , Yu Zhongxin , Altaf Adnan , Talathi Saurabh
Published: June 2024

The aetiology of failure to thrive (FTT) in children is broad, of which some conditions are extremely rare. It is important to consider these rarer conditions, especially in the setting of other concerning signs/symptoms or when there is no improvement with conventional treatment. In this case report we highlight such a rare condition—chylomicron retention disease (CRD) as an aetiology of FTT. CRD often presents with non-specific symptoms, resulting in delayed diagnosis which is established by genetic workup and histology from small intestinal biopsies. Despite being rare, CRD needs to be considered as one of the differential diagnoses after ruling out the more common causes of FTT.
Spontaneous bilateral pampiniform plexus thrombosis in a teenager
Authors: Chan Esther Ern Hwei , Li Fay Xiangzhen , Goh Matthew Chien Ern , Sim Siam Wee
Published: June 2024

Spontaneous pampiniform plexus thrombosis is an extremely rare condition. Its aetiology and pathophysiology are unknown, and its diagnosis remains challenging. We present the first case of an adolescent patient with bilateral spontaneous pampiniform plexus thrombosis. He presented with a 2-day history of bilateral testicular pain. Biochemical investigations were unremarkable, and the patient did not have any risk factors. Ultrasound of the scrotum demonstrated bilateral pampiniform plexus thrombosis. He was managed conservatively and repeat scrotal ultrasound 3 months later revealed complete resolution. This case adds to the minimal literature on spontaneous pampiniform plexus thrombosis, supporting diagnosis via scrotal ultrasound while recommending conservative management without the use of anticoagulation for patients with no pre-existing coagulopathy.
Lymphomatoid granulomatosis mimicking PJP infection
Authors: Azam Hamza , Chandran Durga , Shetty Anita C , Patel Girish
Published: June 2024

A male patient in his 40s who had been unwell for months with fever of unknown origin and clinicopathological features suspicious for haemophagocytic lymphohistiocytosis presented to hospital with worsening subacute shortness of breath. CT pulmonary angiogram demonstrated ground glass changes involving all lung lobes with an apicobasal gradient. These changes, combined with long-term steroid exposure for granulomatous hepatitis without pneumocystis prophylaxis, raised concern for pneumocystis jirovecii pneumonia (PJP). A subsequent bronchoscopic lavage specimen was positive on PCR for PJP and the patient was started on appropriate therapy. Clinical and radiological changes initially improved but after completion of therapy, symptoms and radiological abnormalities returned. Retreatment with second-line treatment resulted again in initial improvement followed by relapse with acute deterioration. Further investigations for an alternate diagnosis were made, with a surgical lung biopsy performed finally revealing immunosuppression-related Epstein-Barr virus positive large B cell lymphoma with lymphomatoid granulomatosis of grade 3 pattern.
Developing prediction algorithms for late-life depression using wearable devices: a cohort study protocol
Authors: Lee Jin-kyung , Kim Min-Hyuk , Hwang Sangwon , Lee Kyoung-Joung , Park Ji Young , Shin Taeksoo , Lim Hyo-Sang , Urtnasan Erdenebayar , Chung Moo-Kwon , Lee Jinhee
Published: June 2024

Introduction

Despite the high prevalence of major depressive disorder (MDD) among the elderly population, the rate of treatment is low due to stigmas and barriers to medical access. Wearable devices such as smartphones and smartwatches can help to screen MDD symptoms earlier in a natural setting while forgoing these concerns. However, previous research using wearable devices has mostly targeted the younger population. By collecting longitudinal data using wearable devices from the elderly population, this research aims to produce prediction algorithms for late-life depression and to develop strategies that strengthen medical access in community care systems.

Methods and analysis

The current cohort study recruited a subsample of 685 elderly people from the Korean Genome and Epidemiology Study—Cardiovascular Disease Association Study, a national large cohort established in 2004. The current study has been conducted over a 3-year period to explore the development patterns of late-life depression. Participants have completed three annual face-to-face interviews (baseline, the first follow-up and the second follow-up) and 2 years of app-based surveys and passive sensing data collection. All the data collection will end at the second follow-up interview. The collected self-report, observational and passive sensing data will be primarily analysed by machine learning.

Ethics and dissemination

This study protocol has been reviewed and approved by the Yonsei University Mirae Campus Institutional Review Board (1041849–2 02 111 SB-180-06) in South Korea. All participants provided written informed consent. The findings of this research will be disseminated by academic publications and conference presentations.
Prevalence of headaches in healthcare workers while using personal protective equipment during the COVID-19 pandemic: a systematic review and meta-analysis
Authors: Zarei Nafiseh , Negarandeh Reza , Eghbali Mohammad
Published: June 2024

Objectives

During the COVID-19 pandemic, healthcare workers (HCWs) are at a serious risk of contracting this virus. Therefore, they should use personal protective equipment (PPE) to protect themselves. Long-term use of these devices has led to many side effects, including headaches. This study investigated the prevalence of headaches related to using PPE in HCWs during the COVID-19 pandemic.

Design

Systematic review and meta-analysis.

Data sources

Embase, PubMed, Scopus and Web of Science databases were searched from December 2019 to February 2023.

Eligibility criteria for selecting studies

All cross-sectional studies that investigated the prevalence of headache complications caused by PPE were included.

Data extraction and synthesis

Two researchers reviewed the articles separately and independently. The Appraisal Tool for Cross-Sectional Studies was used to address study design quality and the risk of bias in cross-sectional studies. The heterogeneity of the studies was checked with the I2statistic, and due to the high heterogeneity, the random effects model was used for synthesis. Data were analysed using Comprehensive Meta-Analysis software V.3.3.70.

Results

Out of 3218 articles retrieved for all side effects, 40 were eligible for this meta-analysis. The prevalence of headaches related to the use of PPE in these 40 studies, with a sample size of 19 229 people, was 43.8% (95% CI 43.1% to 44.6%, I2=98.6%, p<0.001). Based on the meta-regression results, no significant relationship was observed between the prevalence of headaches and variables such as year of publication, study location, sample size and quality of studies.

Conclusion

Headache is one of the common side effects of PPE, which can interfere with HCWs’ performance. It is suggested that manufacturers improve the quality of their equipment while healthcare managers should equip and train staff adequately to minimise side effects, ensuring health and enhanced service delivery.

PROSPERO registration number

CRD42021264874.
Implications of interhospital patient transfers for emergency medical services transportation systems in the Netherlands: a retrospective study
Authors: van der Zee Durk-Jouke , Maruster Laura , Buijs Paul , Aerts-Veenstra Marjolein , Hatenboer Jaap , Buskens Erik
Published: June 2024

Objectives

Interhospital patient transfers have become routine. Known drivers are access to specialty care and non-clinical reasons, such as limited capacity. While emergency medical services (EMS) providers act as main patient transfer operators, the impact of interhospital transfers on EMS service demand and fleet management remains understudied. This study aims to identify patterns in regional interhospital patient transfer volumes and their spatial distribution, and to discuss their potential implications for EMS service demand and fleet management.

Design

A retrospective study was performed analysing EMS transport data from the province of Drenthe in the Netherlands between 2013 and 2019 and public hospital listings. Yearly volume changes in urgent and planned interhospital transfers were quantified. Further network analysis, including geomapping, was used to study how transfer volumes and their spatial distribution relate to hospital specialisation, and servicing multihospital systems. Organisational data were considered for relating transfer patterns to fleet changes.

Setting

EMS in the province of Drenthe, the Netherlands, 492 167 inhabitants.

Participants

Analyses are based on routinely collected patient data from EMS records, entailing all 248 114 transports (137 168 patients) of the Drenthe EMS provider (2013–2019). From these interhospital transports were selected (24 311 transports).

Results

Interhospital transfers represented a considerable (9.8%) and increasing share of transports (from 8.6% in 2013 to 11.3% in 2019). Most transfers were related to multihospital systems (47.3%, 11 509 transports), resulting in a considerable growth of planned EMS transports (from 2093 in 2013 to 3511 in 2019). Geomapping suggests increasing transfer distances and diminishing resource efficiencies due to lacking follow-up rides. Organisational data clarify how EMS fleets were adjusted by expanding resources and reorganising fleet operation.

Conclusions

Emerging interhospital network transfers play an important role in EMS service demand. Increased interhospital transport volumes and geographical spread require a redesign of current EMS fleets and management along regional lines.
Strategies to address recruitment to a randomised trial of surgical and non-surgical treatment for cancer: results from a complex recruitment intervention within the Mesothelioma and Radical Surgery 2 (MARS 2) study
Authors: Mills Nicola , Farrar Nicola , Warnes Barbara , Ashton Kate E , Harris Rosie , Rogers Chris A , Lim Eric , Elliott Daisy
Published: June 2024

Objectives

Recruiting to randomised trials is often challenging particularly when the intervention arms are markedly different. The Mesothelioma and Radical Surgery 2 randomised controlled trial (RCT) compared standard chemotherapy with or without (extended) pleurectomy decortication surgery for malignant pleural mesothelioma. Anticipating recruitment difficulties, a QuinteT Recruitment Intervention was embedded in the main trial phase to unearth and address barriers. The trial achieved recruitment to target with a 4-month COVID-19 pandemic-related extension. This paper presents the key recruitment challenges, and the strategies delivered to optimise recruitment and informed consent.

Design

A multifaceted, flexible, mixed-method approach to investigate recruitment obstacles drawing on data from staff/patient interviews, audio recorded study recruitment consultations and screening logs. Key findings were translated into strategies targeting identified issues. Data collection, analysis, feedback and strategy implementation continued cyclically throughout the recruitment period.

Setting

Secondary thoracic cancer care.

Results

Respiratory physicians, oncologists, surgeons and nursing specialists supported the trial, but recruitment challenges were evident. The study had to fit within a framework of a thoracic cancer service considered overstretched where patients encountered multiple healthcare professionals and treatment views, all of which challenged recruitment. Clinician treatment biases, shaped in part by the wider clinical and research context alongside experience, adversely impacted several aspects of the recruitment process by restricting referrals for study consideration, impacting eligibility decisions, affecting the neutrality in which the study and treatment was presented and shaping patient treatment expectations and preferences. Individual and group recruiter feedback and training raised awareness of key equipoise issues, offered support and shared good practice to safeguard informed consent and optimise recruitment.

Conclusions

With bespoke support to overcome identified issues, recruitment to a challenging RCT of surgery versus no surgery in a thoracic cancer setting with a complex recruitment pathway and multiple health professional involvement is possible.

Trial registration number

ISRCTNISRCTN44351742, Clinical Trials.govNCT02040272.
Preoperative walking exercise to improve prognosis in patients with supratentorial brain tumours after craniotomy: protocol for a randomised controlled trial
Authors: Qu Chunrun , Cao Zeng , Zhou Jun , He Shihan , Liu Fangkun , Liu Zhixiong
Published: June 2024

Introduction

Cardiopulmonary complications and cognitive impairment following craniotomy have a significantly impact on the general health of individuals with brain tumours. Observational research indicates that engaging in walking is linked to better prognosis in patient after surgery. This trial aims to explore whether walking exercise prior to craniotomy in brain tumour patients can reduce the incidence of cardiopulmonary complications and preserve patients’ cognitive function.

Methods and analysis

In this randomised controlled trial, 160 participants with supratentorial brain tumours aged 18–65 years, with a preoperative waiting time of more than 3–4 weeks and without conditions that would interfere with the trial such as cognitive impairment, will be randomly assigned in a ratio of 1:1 to either receive traditional treatment or additional combined with a period of 3–4 weeks of walking exercise of 10 000–15 000 steps per day. Wearable pedometer devices will be used to record step counts. The researchers will evaluate participants at enrolment, baseline, 14 days preoperatively, 3 days prior to surgery and 1 week after surgery or discharge (select which occurs first). The primary outcomes include the incidence of postoperative cardiopulmonary complications and changes in cognitive function (gauged by the Montreal Cognitive Assessment test). Secondary outcomes include the average length of hospital stay, postoperative pain, participant contentment, healthcare-associated costs and incidence of other postoperative surgery-related complications. We anticipate that short-term preoperative walking exercises will reduce the incidence of surgery-related complications in the short term after craniotomy, protect patients’ cognitive function, aid patients’ postoperative recovery and reduce the financial cost of treatment.

Ethics and dissemination

The study protocol has been approved by Ethics Committee of Xiangya Hospital of Central South University (approval number: 202305117). The findings of the research will be shared via publications that have been reviewed by experts in the field and through presentations at conferences.

Trial registration number

NCT05930288.
Protocol for Improving Care by FAster risk-STratification through use of high sensitivity point-of-care troponin in patients presenting with possible acute coronary syndrome in the EmeRgency department (ICare-FASTER): a stepped-wedge cluster randomised quality improvement initiative
Authors: Pickering John W , Devlin Gerard , Body Richard , Aldous Sally , Jaffe Allan S , Apple Fred S , Mills Nicholas , Troughton Richard W , Kavsak Peter , Peacock W Frank , Cullen Louise , Lord Sarah J , Müller Christian , Joyce Laura , Frampton Chris , Lacey Cameron James , Richards Arthur M , Pitama Suzanne , Than Martin
Published: June 2024

Introduction

Clinical assessment in emergency departments (EDs) for possible acute myocardial infarction (AMI) requires at least one cardiac troponin (cTn) blood test. The turn-around time from blood draw to posting results in the clinical portal for central laboratory analysers is ~1–2 hours. New generation, high-sensitivity, point-of-care cardiac troponin I (POC-cTnI) assays use whole blood on a bedside (or near bedside) analyser that provides a rapid (8 min) result. This may expedite clinical decision-making and reduce length of stay. Our purpose is to determine if utilisation of a POC-cTnI testing reduces ED length of stay. We also aim to establish an optimised implementation process for the amended clinical pathway.

Methods and analysis

This quality improvement initiative has a pragmatic multihospital stepped-wedge cross-sectional cluster randomised design. Consecutive patients presenting to the ED with symptoms suggestive of possible AMI and having a cTn test will be included. Clusters (comprising one or two hospitals each) will change from their usual-care pathway to an amended pathway using POC-cTnI—the ‘intervention’. The dates of change will be randomised. Changes occur at 1 month intervals, with a minimum 2 month ‘run-in’ period. The intervention pathway will use a POC-cTnI measurement as an alternate to the laboratory-based cTn measurement. Clinical decision-making steps and logic will otherwise remain unchanged. The POC-cTnI is the Siemens (Erlangen Germany) Atellica VTLi high-sensitivity cTnI assay. The primary outcome is ED length of stay. The safety outcome is cardiac death or AMI within 30 days for patients discharged directly from the ED.

Ethics and dissemination

Ethics approval has been granted by the New Zealand Southern Health and Disability Ethics Committee, reference 21/STH/9. Results will be published in a peer-reviewed journal. Lay and academic presentations will be made. Māori-specific results will be disseminated to Māori stakeholders.

Trial registration number

ACTRN12619001189112.
Appropriate use of blood cultures in the emergency department through machine learning (ABC): study protocol for a randomised controlled non-inferiority trial
Authors: van der Zaag Anuschka Y , Bhagirath Sheena C , Boerman Anneroos W , Schinkel Michiel , Paranjape Ketan , Azijli Kaoutar , Ridderikhof Milan L , Lie Mei , Lissenberg-Witte Birgit , Schade Rogier , Wiersinga Joost , de Jonge Robert , Nanayakkara Prabath W B
Published: June 2024

Introduction

The liberal use of blood cultures in emergency departments (EDs) leads to low yields and high numbers of false-positive results. False-positive, contaminated cultures are associated with prolonged hospital stays, increased antibiotic usage and even higher hospital mortality rates. This trial aims to investigate whether a recently developed and validated machine learning model for predicting blood culture outcomes can safely and effectively guide clinicians in withholding unnecessary blood culture analysis.

Methods and analysis

A randomised controlled, non-inferiority trial comparing current practice with a machine learning-guided approach. The primary objective is to determine whether the machine learning based approach is non-inferior to standard practice based on 30-day mortality. Secondary outcomes include hospital length-of stay and hospital admission rates. Other outcomes include model performance and antibiotic usage. Participants will be recruited in the EDs of multiple hospitals in the Netherlands. A total of 7584 participants will be included.

Ethics and dissemination

Possible participants will receive verbal information and a paper information brochure regarding the trial. They will be given at least 1 hour consideration time before providing informed consent. Research results will be published in peer-reviewed journals. This study has been approved by the Amsterdam University Medical Centers’ local medical ethics review committee (No 22.0567). The study will be conducted in concordance with the principles of the Declaration of Helsinki and in accordance with the Medical Research Involving Human Subjects Act, General Data Privacy Regulation and Medical Device Regulation.

Trial registration number

NCT06163781.
Mass and width of an unstable particle
Authors: Willenbrock Scott
Published: June 2024

We show that the mass and width of an unstable particle are precisely defined by the pole in the complex energy plane, $$\mu = m - (i/2)\Gamma$$

μ
=
m
-
(
i
/
2
)
Γ

, by identifying the width, $$\Gamma$$
Γ
, with the particle’s decay rate and the mass, m, with the oscillatory frequency. We find that the physical Z boson mass lies 26 MeV below its quoted value, while the physical W boson mass lies 20 MeV below. We also clarify the various Breit–Wigner formulae that are used to describe a resonance.
A note on the dynamics of a COVID-19 epidemic model with saturated incidence rate
Authors: Gümüş Mehmet , Türk Kemal
Published: June 2024

This paper aims to study a discrete-time COVID-19 epidemic model with a saturated incidence rate. The basic reproductive number is calculated and the endemic steady state is obtained for the model. The stability of the COVID-19-free steady state (CFSS) of the model is investigated when the basic reproduction number is less than one and the step size h satisfies the exact condition. The theoretical result is also supported with numerical simulations.
Synthesis Techniques for Fault-tolerant Quantum Circuit Implementation using Clifford+

Z
N

-group
Authors: Biswal Laxmidhar , Bhattacharjee Debjyoti , Chakrabarti Amlan , Chattopadhyay Anupam
Published: June 2024

Decoherence jeopardizes the entanglement of fragile quantum states, and is among the foremost challenges towards engineering scalable quantum computers. Realizing quantum circuit implementation with small qubit count and shallow circuit depth is necessary due to the linear scaling of decoherence rate with qubit count and circuit depth. Conversely, reasonable correction of small unitary errors can be achieved by using surface codes along with a transversal gate set to protect quantum information from decoherence. In this paper, we analyze and report the upper bound of non-Clifford phase-depth for different mapping schemes and synthesis approaches. We introduce a synthesis methodology based on lookup-table (LUT) networks, wherein the Boolean logic translates into fault-tolerant quantum logic using Clifford+

Z
N

group with zero ancillary cost. We also present fault-tolerant synthesis techniques for
k
-LUT network using additional ancillary lines with exponential phase-count and unit phase-depth.
Analysis of False Negative Rates for Recycling Bloom Filters (Yes, They Happen!)
Authors: Dozier Kahlil , Salamatian Loqman , Rubenstein Dan
Published: June 2024

Bloom Filters are a desirable data structure for distinguishing new values in sequences of data (i.e., messages), due to their space efficiency, their low false positive rates (incorrectly classifying a new value as a repeat), and never producing false negatives (classifying a repeat value as new). However, as the Bloom Filter's bits are filled, false positive rates creep upward. To keep false positive rates below a reasonable threshold, applications periodically "recycle" the Bloom Filter, clearing the memory and then resuming the tracking of data. After a recycle point, subsequent arrivals of recycled messages are likely to be misclassified as new; recycling induces false negatives. Despite numerous applications of recycling, the corresponding false negative rates have never been analyzed. In this paper, we derive approximations, upper bounds, and lower bounds of false negative rates for several variants of recycling Bloom Filters. These approximations and bounds are functions of the size of memory used to store the Bloom Filter and the distributions on new arrivals and repeat messages, and can be efficiently computed on conventional hardware. We show, via comparison to simulation, that our upper bounds and approximations are extremely tight, and can be efficiently computed for megabyte-sized Bloom Filters on conventional hardware.
Deep Dive into NTP Pool's Popularity and Mapping
Authors: Moura Giovane C. M. , Davids Marco , Schutijser Caspar , Hesselman Cristian , Heidemann John , Smaragdakis Georgios
Published: June 2024

Time synchronization is of paramount importance on the Internet, with the Network Time Protocol (NTP) serving as the primary synchronization protocol. The NTP Pool, a volunteer-driven initiative launched two decades ago, facilitates connections between clients and NTP servers. Our analysis of root DNS queries reveals that the NTP Pool has consistently been the most popular time service. We further investigate the DNS component (GeoDNS) of the NTP Pool, which is responsible for mapping clients to servers. Our findings indicate that the current algorithm is heavily skewed, leading to the emergence of time monopolies for entire countries. For instance, clients in the US are served by 551 NTP servers, while clients in Cameroon and Nigeria are served by only one and two servers, respectively, out of the 4k+ servers available in the NTP Pool. We examine the underlying assumption behind GeoDNS for these mappings and discover that time servers located far away can still provide accurate clock time information to clients. We have shared our findings with the NTP Pool operators, who acknowledge them and plan to revise their algorithm to enhance security.