bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymph-targeted high-density lipoprotein-mimetic nanovaccine for multi-antigenic personalized cancer immunotherapy
Authors: Liu Mingqi , Feng Yang , Lu Yougong , Huang Renqi , Zhang Ying , Zhao Yanan , Mo Ran
Published: March 2024

Cancer vaccines show huge potential for cancer prevention and treatment. However, their efficacy remains limited due to weak immunogenicity regarding inefficient stimulation of cytotoxic T lymphocyte (CTL) responses. Inspired by the unique characteristic and biological function of high-density lipoprotein (HDL), we here develop an HDL-mimicking nanovaccine with the commendable lymph-targeted capacity to potently elicit antitumor immunity using lipid nanoparticle that is co-loaded with specific cancer cytomembrane harboring a collection of tumor-associated antigens and an immune adjuvant. The nanoparticulate impact is explored on the efficiency of lymphatic targeting and dendritic cell uptake. The optimized nanovaccine promotes the co-delivery of antigens and adjuvants to lymph nodes and maintains antigen presentation of dendritic cells, resulting in long-term immune surveillance as the elevated frequency of CTLs within lymphoid organs and tumor tissue. Immunization of nanovaccine suppresses tumor formation and growth and augments the therapeutic efficacy of checkpoint inhibitors notably on the high-stemness melanoma in the mouse models.
Majorana-fermion origin of the planar thermal Hall effect in the Kitaev magnet α-RuCl
3
Authors: Imamura Kumpei , Suetsugu Shota , Mizukami Yuta , Yoshida Yusei , Hashimoto Kenichiro , Ohtsuka Kenichi , Kasahara Yuichi , Kurita Nobuyuki , Tanaka Hidekazu , Noh Pureum , Nasu Joji , Moon Eun-Gook , Matsuda Yuji , Shibauchi Takasada
Published: March 2024

The field-induced quantum-disordered state of layered honeycomb magnet α-RuCl
3
is a prime candidate for Kitaev spin liquids hosting Majorana fermions and non-Abelian anyons. Recent observations of anomalous planar thermal Hall effect demonstrate a topological edge mode, but whether it originates from Majorana fermions or bosonic magnons remains controversial. Here, we distinguish these origins from combined low-temperature measurements of high-resolution specific heat and thermal Hall conductivity with rotating magnetic fields within the honeycomb plane. A distinct closure of the low-energy bulk gap is observed for the fields in the Ru-Ru bond direction, and the gap opens rapidly when the field is tilted. Notably, this change occurs concomitantly with the sign reversal of the Hall effect. General discussions of topological bands show that this is the hallmark of an angle rotation–induced topological transition of fermions, providing conclusive evidence for the Majorana-fermion origin of the thermal Hall effect in α-RuCl
3
.
Direct observation of strong momentum-dependent electron-phonon coupling in a metal
Authors: Mo Mianzhen , Tamm Artur , Metsanurk Erki , Chen Zhijiang , Wang Ling , Frost Mungo , Hartley Nicholas J. , Ji Fuhao , Pandolfi Silvia , Reid Alexander H. , Sun Peihao , Shen Xiaozhe , Wang Yongqiang , Wang Xijie , Glenzer Siegfried , Correa Alfredo A.
Published: March 2024

Phonon scattering in metals is one of the most fundamental processes in materials science. However, understanding such processes has remained challenging and requires detailed information on interactions between phonons and electrons. We use an ultrafast electron diffuse scattering technique to resolve the nonequilibrium phonon dynamics in femtosecond–laser-excited tungsten in both time and momentum. We determine transient populations of phonon modes which show strong momentum dependence initiated by electron-phonon coupling. For phonons near Brillouin zone border, we observe a transient rise in their population on a timescale of approximately 1 picosecond driven by the strong electron-phonon coupling, followed by a slow decay on a timescale of approximately 8 picosecond governed by the weaker phonon-phonon relaxation process. We find that the exceptional harmonicity of tungsten is needed for isolating the two processes, resulting in long-lived nonequilibrium phonons in a pure metal. Our finding highlights that electron-phonon scattering can be the determinant factor in the phonon thermal transport of metals.
Ag-doped non–imperfection-enabled uniform memristive neuromorphic device based on van der Waals indium phosphorus sulfide
Authors: Li Yesheng , Xiong Yao , Zhai Baoxing , Yin Lei , Yu Yiling , Wang Hao , He Jun
Published: March 2024

Memristors are considered promising energy-efficient artificial intelligence hardware, which can eliminate the von Neumann bottleneck by parallel in-memory computing. The common imperfection-enabled memristors are plagued with critical variability issues impeding their commercialization. Reported approaches to reduce the variability usually sacrifice other performances, e.g., small on/off ratios and high operation currents. Here, we demonstrate an unconventional Ag-doped nonimperfection diffusion channel–enabled memristor in van der Waals indium phosphorus sulfide, which can combine ultralow variabilities with desirable metrics. We achieve operation voltage, resistance, and on/off ratio variations down to 3.8, 2.3, and 6.9% at their extreme values of 0.2 V, 10
11
ohms, and 10
8
, respectively. Meanwhile, the operation current can be pushed from 1 nA to 1 pA at the scalability limit of 6 nm after Ag doping. Fourteen Boolean logic functions and convolutional image processing are successfully implemented by the memristors, manifesting the potential for logic-in-memory devices and efficient non–von Neumann accelerators.
Molecular imaging of tumor metabolism: Insight from pyruvate- and glucose-based deuterium MRI studies
Authors: Montrazi Elton T. , Sasson Keren , Agemy Lilach , Scherz Avigdor , Frydman Lucio
Published: March 2024

Cancer diagnosis by metabolic MRI proposes to follow the fate of glycolytic precursors such as pyruvate or glucose, and their in vivo conversion into lactate. This study compares the
2
H MRI outlooks afforded by these metabolites when targeting a pancreatic cancer model. Exogenously injected [3,3′,3″-
2
H
3
]-pyruvate was visible only briefly; it generated a deuterated lactate signal throughout the body that faded after ~5 min, showing a minor concentration bias at the rims of the tumors. [6,6′-
2
H
2
]-glucose by contrast originated a lactate signal that localized clearly within the tumors, persisting for over an hour. Investigations alternating deuterated and nondeuterated glucose injections revealed correlations between the lactate generation and the glucose available at the tumor, evidencing a continuous and avid glucose consumption generating well-localized lactate signatures as driven by the Warburg effect. This is by contrast to the transient and more promiscuous pyruvate-to-lactate transformation, which seemed subject to transporter and kinetics effects. The consequences of these observations within metabolic MRI are briefly discussed.
ANYmal parkour: Learning agile navigation for quadrupedal robots
Authors: Hoeller David , Rudin Nikita , Sako Dhionis , Hutter Marco
Published: March 2024

Performing agile navigation with four-legged robots is a challenging task because of the highly dynamic motions, contacts with various parts of the robot, and the limited field of view of the perception sensors. Here, we propose a fully learned approach to training such robots and conquer scenarios that are reminiscent of parkour challenges. The method involves training advanced locomotion skills for several types of obstacles, such as walking, jumping, climbing, and crouching, and then using a high-level policy to select and control those skills across the terrain. Thanks to our hierarchical formulation, the navigation policy is aware of the capabilities of each skill, and it will adapt its behavior depending on the scenario at hand. In addition, a perception module was trained to reconstruct obstacles from highly occluded and noisy sensory data and endows the pipeline with scene understanding. Compared with previous attempts, our method can plan a path for challenging scenarios without expert demonstration, offline computation, a priori knowledge of the environment, or taking contacts explicitly into account. Although these modules were trained from simulated data only, our real-world experiments demonstrate successful transfer on hardware, where the robot navigated and crossed consecutive challenging obstacles with speeds of up to 2 meters per second.
Complete genome sequences of
Blautia hydrogenotrophica
DSM 10507
T
isolated from human feces and
Blautia coccoides
DSM 935
T
isolated from mouse feces
Authors: Böer Tim , Bengelsdorf Frank R. , Daniel Rolf , Poehlein Anja
Published: March 2024

We report on the closed genome sequences of the acetogen
Blautia hydrogenotrophica
S5a33
T
(DSM 10507
T
) and of
Blautia coccoides
CLC-1
T
(DSM 935
T
). The
B. hydrogenotrophica
S5a33
T
genome harbors a chromosome (3,590,609 bp) and a plasmid (7,176 bp). The
B. coccoides
CLC-1
T
genome consists of a single chromosome (6,097,890 bp).
Corneal epithelial and fibrovascular downgrowth postcataract surgery with intrastromal bleed: a rare case study with multimodal imaging
Authors: Uday Shylaja , Modak Durgalaxmi , Sanjay Srinivasan
Published: March 2024

A woman in her 60s presented with diminution of vision and redness in her right eye (OD) 1.5 months duration, 10 months post cataract surgery. The best-corrected visual acuity (BCVA) on the OD was fingers counting at 0.5 m. The anterior section of the OD demonstrated superior pre-Descemet’s intrastromal bleeding, superior dense fibrovascular growth in the corneal mid-stroma and superior fibrovascular downgrowth measuring 5×5 mm in the anterior chamber. Along with topical prednisolone acetate (1%) suspension 4 times per day on a tapering dose, antivascular endothelial growth factor therapy was administered intrastromally and subconjunctivally in the superior bulbar conjunctiva near limbus (0.05 mL of 2.5 mg/0.1 mL at each site). Over the course of a week, the intrastromal bleed had completely stopped. Three months later, at the final follow-up, the BCVA had marginally improved to fingers counting 2 m, with a lingering 4×4 mm nebulomacular scar.
Recurrent leishmaniasis infection isolated in the pleural fluid
Authors: Qiam Hina , Lowe Emily , Fung Adriel Heilong , Sankaran Prasanna
Published: March 2024

We present a rare case of recurrent leishmaniasis infection in a female in her 80s who re-presented with a pleural effusion. The patient was initially investigated as an outpatient for cytopenia and underwent a bone marrow biopsy which subsequently diagnosed visceral leishmaniasis. Following full treatment, and apparent recovery, she re-presented with pleural effusion, hypoalbuminaemia and cytopenia. Leishmania was eventually isolated in a pleural fluid sample obtained on therapeutic drainage, and she was treated for a recurrence at a tertiary infectious disease unit. This interesting and challenging case demonstrates the importance of suspecting leishmaniasis recurrence in previously treated cases and the diagnostic benefit of pleural fluid analysis in the context of suspected leishmaniasis.
Giant coronary sinus aneurysm: an incidental discovery in a case of acute coronary syndrome
Authors: Nagpal Raghav , Lalani Kanhai , Ramachandran Padmakumar
Published: March 2024

Coronary sinus (CS) anomalies, although infrequent, are increasingly diagnosed with advances in interventional procedures and imaging techniques. Most cases are asymptomatic and incidentally diagnosed. We present a case of an elderly male without comorbidities who presented with acute angina. Coronary catheterisation revealed a double-vessel disease, but incidentally, sequential angiograms captured contrast filling in the levophase of CS, revealing a giant CS. Primary percutaneous angioplasty of the right coronary artery was performed successfully. Echocardiography confirmed the aneurysm, and a CT scan showed an aneurysmally dilated CS and other coronary veins alongside a normal-sized persistent left superior vena cava draining to the right atrium through CS. CS aneurysms may lead to complications such as thrombosis, embolic events, arrhythmias and heart failure, stressing the importance of vigilant monitoring and timely intervention. This case underscores the significance of recognising CS anomalies in cardiac procedures, even when asymptomatic, for proper management.
Comparative effectiveness of baricitinib and alternative biological DMARDs in a Swiss cohort study of patients with RA
Authors: Gilbert Benoit Thomas P , Mongin Denis , Aymon Romain , Lauper Kim , Laedermann Cédric , Perrier Clémentine , Mueller Ruediger , Courvoisier Delphine S , Finckh Axel
Published: March 2024

Objectives

This observational study compares the effectiveness of baricitinib (BARI), a targeted synthetic disease-modifying antirheumatic drug (tsDMARD), with alternative biological DMARDs (bDMARDs) in patients with rheumatoid arthritis (RA), from a prospective, longitudinal cohort.

Methods

We compared patients initiating a treatment course (TC) of BARI, tumour necrosis factor inhibitors (TNFi) or bDMARDs with other modes of action (OMA), during a period when all these DMARDs were available in Switzerland. The primary outcome was drug maintenance; secondary outcomes included discontinuation rates related specifically to ineffectiveness and adverse events. We further analysed rates of low disease activity (LDA) and remission (REM) at 12 months and drug maintenance in bDMARD-naïve and tsDMARD-naïve population.

Results

A total of 1053 TCs were included: 273 on BARI, 473 on TNFi and 307 on OMA. BARI was prescribed to older patients with longer disease duration and more previous treatment failures than TNFi. Compared with BARI, the adjusted drug maintenance was significantly shorter for TNFi (HR for discontinuation: 1.76; 95% CI, 1.32 to 2.35) but not compared with OMA (HR 1.27; 95% CI, 0.93 to 1.72). These results were similar in the b/tsDMARD-naïve population. The higher discontinuation of TNFi was mostly due to increased discontinuation for ineffectiveness (HR 1.49; 95% CI, 1.03 to 2.15), with no significant differences in drug discontinuation for adverse events (HR 1.46; 95% CI, 0.83 to 2.57). The LDA and REM rates at 12 months did not differ significantly between the three groups.

Conclusions

BARI demonstrated a significantly higher drug maintenance compared with TNFi, mainly due to lower drug discontinuations for ineffectiveness. We found no difference in drug maintenance between BARI and OMA. Clinical outcomes did not differ between the three groups. Our results suggest that BARI is an appropriate therapeutic alternative to bDMARDs in the management of RA.
Differences in inpatient performance of public general hospitals following implementation of a points-counting payment based on diagnosis-related group: a robust multiple interrupted time series study in Wenzhou, China
Authors: Zhu Tingting , Chen Chun , Zhang Xinxin , Yang Qingren , Hu Yipao , Liu Ruoyun , Zhang Xiangyang , Dong Yin
Published: March 2024

Objectives

This study measures the differences in inpatient performance after a points-counting payment policy based on diagnosis-related group (DRG) was implemented. The point value is dynamic; its change depends on the annual DRGs’ cost settlements and points of the current year, which are calculated at the beginning of the following year.

Design

A longitudinal study using a robust multiple interrupted time series model to evaluate service performance following policy implementation.

Setting

Twenty-two public general hospitals (8 tertiary institutions and 14 secondary institutions) in Wenzhou, China.

Intervention

The intervention was implemented in January 2020.

Outcome measures

The indicators were case mix index (CMI), cost per hospitalisation (CPH), average length of stay (ALOS), cost efficiency index (CEI) and time efficiency index (TEI). The study employed the means of these indicators.

Results

The impact of COVID-19, which reached Zhejiang Province at the end of January 2020, was temporary given rapid containment following strict control measures. After the intervention, except for the ALOS mean, the change-points for the other outcomes (p<0.05) in tertiary and secondary institutions were inconsistent. The CMI mean turned to uptrend in tertiary (p<0.01) and secondary (p<0.0001) institutions compared with before. Although the slope of the CPH mean did not change (p>0.05), the uptrend of the CEI mean in tertiary institutions alleviated (p<0.05) and further increased (p<0.05) in secondary institutions. The slopes of the ALOS and TEI mean in secondary institutions changed (p<0.05), but not in tertiary institutions (p>0.05).

Conclusions

This study showed a positive effect of the DRG policy in Wenzhou, even during COVID-19. The policy can motivate public general hospitals to improve their comprehensive capacity and mitigate discrepancies in treatment expenses efficiency for similar diseases. Policymakers are interested in whether the reform successfully motivates hospitals to strengthen their internal impetus and improve their performance, and this is supported by this study.
Exploring community behaviours and stakeholder challenges in engaging communities with dengue prevention behaviour in Malaysia: implementation research for a qualitative study with a community-based participatory research design
Authors: Samsudin Nurul Adilah , Karim Norhafizah , Othman Hidayatulfathi , Naserrudin Nurul Athirah , Sahani Mazrura , Hod Rozita , Siau Ching Sin , Harif Muhammad Norhanizam , Abd. Samad Badrul Hisham , Zaini Zul-Izzat Ikhwan
Published: March 2024

Objectives

To use a community-based participatory research (CBPR) design to explore local community behaviours and stakeholders’ challenges in engaging communities in dengue prevention behaviours in Hulu Langat, Selangor, Malaysia.

Design

This CBPR design in implementation comprised in-depth interviews (IDIs) and focus group discussions (FGDs). Themes were identified from the data with inductive and deductive thematic analysis.

Setting

FGDs were conducted in local community areas and IDIs were conducted in the local authority (LA) office and the Hulu Langat district health office.

Participants

All FGD and IDI participants consented to the study, and included health authorities (n=4), LAs (n=7), community leader (n=1), faith leader (n=1), patients diagnosed with dengue (IDIs, n=2) and permanent residents of Hulu Langat who had been exposed to dengue infectious disease (FGDs, n=27).

Results

The main themes were categorised into community behaviour and stakeholder challenges. The community behaviour-related themes were awareness of dengue disease andAedesmosquitoes, perception of risk and severity, and involvement of authorities. The themes related to stakeholder challenges were resource constraints and capacity issues, jurisdictional constraints and coordination, and educational dissemination and vandalism.

Conclusions

The actions of the authorities shape community and stakeholder behaviours. Effective communication, including clear and aesthetically pleasing messages, motivates individuals to take appropriate actions. It is crucial for the authorities to engage in inclusive communication and consider diverse perspectives, such as those of residents and individuals exposed to dengue infection. Authorities that provide accurate and unbiased information foster transparency and enable informed decision-making by all stakeholders.
Tuberculosis infection and hypertension: prevalence estimates from the US National Health and Nutrition Examination Survey
Authors: Salindri Argita D , Auld Sara C , Gujral Unjali P , Urbina Elaine M , Andrews Jason R , Huaman Moises A , Magee Matthew J
Published: March 2024

Objectives

Tuberculosis infection (TBI) is marked by dynamic host–pathogen interactions with persistent low-grade inflammation and is associated with increased risk of cardiovascular diseases (CVD) including acute coronary syndrome, myocardial infarction and stroke. However, few studies assess the relationship between TBI and hypertension, an intermediate of CVD. We sought to determine the association between TBI and hypertension using data representative of the adult US population.

Methods

We performed cross-sectional analyses using data from the 2011–2012 US National Health and Nutrition Examination Survey (NHANES). Eligible participants included adults with valid QuantiFERON-TB Gold In-Tube (QFT-GIT) test results who also had blood pressure measures and no history of TB disease. TBI was defined by a positive QFT-GIT. We defined hypertension by either elevated measured blood pressure levels (ie, systolic ≥130 mm Hg or diastolic ≥80 mm Hg) or known hypertension indications (ie, self-reported previous diagnosis or use of antihypertensive medications). Analyses were performed using robust quasi-Poisson regressions and accounted for the stratified probability sampling design of NHANES.

Results

The overall prevalence of TBI was 5.7% (95% CI 4.7% to 6.7%) and hypertension was present among 48.9% (95% CI 45.2% to 52.7%) of participants. The prevalence of hypertension was higher among those with TBI (58.5%, 95% CI 52.4% to 64.5%) than those without TBI (48.3%, 95% CI 44.5% to 52.1%) (prevalence ratio (PR) 1.2, 95% CI 1.1 to 1.3). However, after adjusting for confounders, the prevalence of hypertension was similar for those with and without TBI (adjusted PR 1.0, 95% CI 1.0 to 1.1). The unadjusted prevalence of hypertension was higher among those with TBI versus no TBI, especially among individuals without CVD risk factors including those with normal body mass index (PR 1.6, 95% CI 1.2 to 2.0), euglycaemia (PR 1.3, 95% CI 1.1 to 1.5) or non-smokers (PR 1.2, 95% CI 1.1 to 1.4).

Conclusions

More than half of adults with TBI in the USA had hypertension. Importantly, we observed a relationship between TBI and hypertension among those without established CVD risk factors.

The prevalence of hypertension was high (59%) among adults with TBI in the USA. In addition, we found that the prevalence of hypertension was significantly higher among adults with positive QFT without established hypertension risk factors.
Evaluating the decentralisation of the Spanish healthcare system: a data envelopment analysis approach
Authors: Armenteros-Ruiz Tamara , Ballesteros-Ron Alejandro , Rodriguez-Mañero Moisés , Reyes-Santías Francisco
Published: March 2024

Objectives

The aim of the study was to answer whether the central government has been more efficient than the regional governments or vice versa. Likewise, through the analysis of the data, the aim was to shed light on whether decentralisation has had a positive impact on the efficiency of the hospital sector or not.

Design

In this paper, we have used data envelopment analysis to analyse the evolution of efficiency in the last 10 Autonomous Regions to receive healthcare competences at the end of 2001.

Participants

For this study, we have taken into account the number of beds and full-time workers as inputs and the calculation of basic care units as outputs to measure the efficiency of the Spanish public sector, private sector and jointly in the years 2002, 2007, 2012 and 2017 for the last Autonomous Regions receiving healthcare competences.

Results

Of the Autonomous Regions that received the transfers at the end of 2001, the following stand out for their higher efficiency growth: the Balearic Islands (81.44% improvement), the Madrid Autonomous Region, which practically reached absolute efficiency levels (having increased by 63.77%), and La Rioja which, together with the Balearic Islands which started from very low values, improved notably (46.13%).

Conclusion

In general, it can be observed that the transfer of responsibilities in the health sector has improved efficiency in the National Health Service.

JEL classification

C14; I18; H21.
Co-design and evaluation of a youth-informed organisational tool to enhance trauma-informed practices in the UK public sector: a study protocol
Authors: Hugh-Jones Siobhan , Butcher Isabelle , Bhui Kamaldeep
Published: March 2024

Introduction

A trauma-informed approach (TIA) means working with awareness that people’s histories of trauma may shape the way they engage with services, organisations or institutions. Young people with adverse childhood experiences may be at risk of retraumatisation by organisational practices in schools and universities and by employers and health agencies when they seek support. There are limited evidence-based resources to help people working in the public sector to work with adolescents in trauma-informed ways and the needs of adolescents have not been central in resource development. This study contributes to public sector capacity to work in trauma-informed ways with adolescents by codesigning and evaluating the implementation of a youth-informed organisational resource.

Methods and analysis

This is an Accelerated Experience-based Co-design (AEBCD) Study followed by pre–post evaluation. Public sector organisations or services, and adolescents connected with them, will collaboratively reflect on lived experience data assembled through creative arts practice, alongside data from epidemiological national data sets. These will present knowledge about the impact of adverse childhood experiences on adolescents’ mental health (stage 1). Collaboratively, priorities (touch points) for organisational responses will be identified (stage 2), and a low-burden resource will be codesigned (stage 3) and offered for implementation (stage 4) and evaluation (stage 5) in diverse settings. The study will provide insights into what adolescents and public sector organisations in the UK want from a TIA resource, the experience of services/organisations in implementing this and recommendations for resource development and implementation.

Ethics and dissemination

The UK National Health Service Health Research Authority approved this study (23/WM/0105). Learning will be shared across study participants in a workshop at the end of the study. Knowledge products will include a website detailing the created resource and a youth-created film documenting the study process, the elements of the codesigned resource and experiences of implementation. Dissemination will target academic, healthcare, education, social care, third sector and local government settings via knowledge exchange events, social media, accessible briefings, conference presentations and publications.
What do spouse primary caregivers of patients with glioblastoma want medical providers to know? A qualitative thematic reflexive analysis of letters written by primary caregivers from a secret Facebook support group
Authors: Coman Diana L , Chard Megan P , Desautels Lisa , Lutz Barbara J. , Minns Laurie A
Published: March 2024

Objectives

To analyse the content of letters written by female spouse primary caregivers of patients with glioblastoma multiforme (GBM), a devastating and terminal primary brain cancer, and give voice to their experiences for medical providers of patients with GBM.

Design

A qualitative study using reflexive thematic analysis of letters written by female spouses/life partners and primary caregivers of patients with GBM.

Participants

101 current or former female spouse primary caregivers of patients with GBM wrote letters to share with the medical community between July 2019 and August 2019. Inclusion criteria: (1) the primary caregiver who is a spouse of a patient with glioblastoma, (2) be a member of the secret Facebook group, ‘We are the wives of GBM and this is our story’, and (3) completed informed consent for the contents of their letter to be included for primary and secondary data analysis. Participants who wrote letters but did not complete the informed consent were excluded from the study.

Results

Themes from the letters included the patient experiences: (1) medical details of the disease trajectory, (2) interactions of the patient/caregiver dyads with healthcare and (3) the changing patient condition over time. Themes focused on the caregiver experiences: (1) caregiver challenges, (2) caregiver responses and (3) caregiver coping strategies, and description of tangible needs that would help other caregivers in the future. Caregiver needs were highest during the living with disease progression phase. Caregivers wanted more education and to be valued as members of the care team.

Conclusion

Shared decision-making through family-centred care would be beneficial for primary caregivers of patients with GBM. These findings provide opportunities to guide more timely and tailored interventions to provide support and improve care for patient/caregiver dyads to help mitigate the burden of this progressive disease and improve quality of life for caregivers.
Exploring promotion factors of resilience among emergency nurses: a qualitative study in Shanghai, China
Authors: Jiang Jinxia , Liu Shuyang , Chi Chunwei , Liu Yi , Han Peng , Sun Li , Zhuang Yugang
Published: March 2024

Objective

To qualitatively explore the factors that enhance resilience among emergency nurses (ENs).

Design

This study is an exploratory qualitative investigation. Semistructured in-depth interviews were used for data collection, while qualitative content analysis was applied for data analysis.

Setting

A grade A tertiary hospital in Shanghai, China.

Participants

The study subjects comprised 17 ENs, who were selected using a purposive sampling method.

Results

Three main themes and the nine subthemes emerged from the study, that is, individual resources, including competency, personality traits and occupational benefits; family resources, including close parent–child attachment and supportive family dynamics; social resources, including peer support, organisational support, resilient leadership and popular support.

Conclusion

This qualitative study explored the factors promoting resilience among ENs and provided a reference for managers to formulate future management strategies. From the perspective of positive psychology, nurses should receive comprehensive support, focusing on improving their professional accomplishment and role ability while prioritising the development of resilient leadership. These efforts are expected to drive progress and growth across the emergency care team.
Reinforcing informed medication prescription for low back pain in the emergency department (RIME): a controlled interrupted time series implementation study protocol
Authors: O'Leary Shaun , Heine Janelle , Warren Jacelle , Smyth Tanya , Ballard Emma , Mitchell Gary , See William , Barlas Panos , Machado Gustavo C , Cottrell Michelle , Comans Tracy , Foster Nadine E
Published: March 2024

Introduction

Management guidelines for low back pain (LBP) recommend exclusion of serious pathology, followed by simple analgesics, superficial heat therapy, early mobilisation and patient education. An audit in a large metropolitan hospital emergency department (ED) revealed high rates of non-recommended medication prescription for LBP (65% of patients prescribed opioids, 17% prescribed benzodiazepines), high inpatient admission rates (20% of ED LBP patients), delayed patient mobilisation (on average 6 hours) and inadequate patient education (48% of patients). This study aims to improve medication prescription for LBP in this ED by implementing an intervention shown previously to improve guideline-based management of LBP in other Australian EDs.

Methods and analysis

A controlled interrupted time series study will evaluate the intervention in the ED before (24 weeks; 20 March 2023–3 September 2023) and after (24 weeks; 27 November 2024–12 May 2024) implementation (12 weeks; 4 September 2023–26 November 2023), additionally comparing findings with another ED in the same health service. The multicomponent implementation strategy uses a formalised clinical flow chart to support clinical decision-making and aims to change clinician behaviour, through clinician education, provision of alternative treatments, educational resources, audit and feedback, supported by implementation champions. The primary outcome is the percentage of LBP patients prescribed non-recommended medications (opioids, benzodiazepines and/or gabapentinoids), assessed via routinely collected ED data. Anticipated sample size is 2000 patients (n=1000 intervention, n=1000 control) based on average monthly admissions of LBP presentations in the EDs. Secondary outcomes include inpatient admission rate, time to mobilisation, provision of patient education, imaging requests, representation to the ED within 6 months and healthcare costs. In nested qualitative research, we will study ED clinicians’ perceptions of the implementation and identify how benefits can be sustained over time.

Ethics and dissemination

This study received ethical approval from the Metro North Human Research Ethics Committee (HREC/2022/MNHA/87995). Study findings will be published in peer-reviewed journals and presented at international conferences and educational workshops.

Trial registration number

ACTRN12622001536752.
Predictive value of the Trauma Rating Index in Age, Glasgow Coma Scale, Respiratory rate and Systolic blood pressure score (TRIAGES) for the short-term mortality of older patients with isolated traumatic brain injury: a retrospective cohort study
Authors: Jiang Daishan , Chen Tianxi , Yuan Xiaoyu , Yang Yang , Shen Yanbo , Huang Zhongwei
Published: March 2024

Objectives

This study aimed to evaluate the effectiveness of the Trauma Rating Index in Age, Glasgow Coma Scale, Respiratory rate and Systolic blood pressure score (TRIAGES) in predicting 24-hour in-hospital mortality among patients aged 65 years and older with isolated traumatic brain injury (TBI).

Design

A retrospective, single-centre cohort study.

Setting

This study was conducted at a government-run tertiary comprehensive hospital.

Participants

This study included 982 patients aged 65 years or older with isolated TBI, who were admitted to the emergency department between 1 January 2020 and 31 December 2021.

Interventions

None.

Primary outcome

24-hour in-hospital mortality was the primary outcome.

Results

Among the 982 patients, 8.75% died within 24 hours of admission. The non-survivors typically had higher TRIAGES and lower GCS scores. Logistic regression showed significant associations of both TRIAGES and GCS with mortality; the adjusted ORs were 1.98 (95% CI 1.74 to 2.25) for TRIAGES and 0.72 (95% CI 0.68 to 0.77) for GCS. Receiver operating characteristic (ROC) analysis indicated an area under the ROC curve of 0.86 for GCS and 0.88 for TRIAGES, with a significant difference (p=0.012). However, precision–recall curve (PRC) analysis revealed an area under the PRC of 0.38 for GCS and 0.47 for TRIAGES, without a significant difference (p=0.107).

Conclusions

The TRIAGES system is a promising tool for predicting 24-hour in-hospital mortality in older patients with TBI, demonstrating comparable or slightly superior efficacy to the GCS. Further multicentre studies are recommended for validation.
Association of high-sensitivity CRP and FEV1%pred: a study on non-pulmonary disease in a population in Beijing, China
Authors: Yang Xiaoyu , Liao Jiping , Zhu Sainan , Zhang Cheng , Ma Xiaoyu , Zhang Chunbo , Wang Yunxia , Sun Kunyan , Wang Guangfa
Published: March 2024

Background

No studies have investigated whether high-sensitivity C reactive protein (hsCRP) can be used to predict the forced expiratory volume in 1 s (FEV1)/estimated value of FEV1 (FEV1%pred). This study aimed to assess the association between hsCRP and FEV1%pred in middle-aged and elderly individuals without underlying lung disease.

Methods

The data for this study were obtained from a prospective cohort study that included 1047 middle-aged and elderly citizens from Beijing aged 40–75 years without any evidence of underlying lung diseases with FEV1 >70% after receiving inhalational bronchodilators. The baseline analysis of the participants was performed from 30 May 2018 to 31 October 2018. Restricted cubic spline regression and multivariate linear regression models were used to assess the non-linear association and linear association between hsCRP and FEV1/FEV in 6 s (FEV6) and FEV1%pred, respectively.

Results

The hsCRP values of 851 participants were recorded; the values were normal in 713 (83.8%) participants. The remaining 196 participants (18.7%) had missing data. A non-linear association was observed between normal hsCRP values and FEV1/FEV6. hsCRP was linearly and negatively correlated with FEV1%pred, and each 1 SD increase in hsCRP was significantly associated with a 2.4% lower in FEV1%pred. Significantly higher FEV1/FEV6 differences were observed in the female subgroup than those in the male subgroup (p=0.011 for interaction).

Conclusions

hsCRP had a non-linear association with FEV1/FEV6 and a linear negative association with FEV1%pred in individuals with normal hsCRP values. hsCRP can be used to predict FEV1%pred, which can be used to predict the development of chronic obstructive pulmonary disease. hsCRP has a stronger association with lung function in women than that in men.

Trial registration number

NCT03532893.
Subarachnoid iodine leakage on dual-energy computed tomography after mechanical thrombectomy is associated with malignant brain edema
Authors: Ogata Atsushi , Ogasawara Kuniaki , Nishihara Masashi , Takamori Ayako , Furukawa Takashi , Ide Toshihiro , Ito Hiroshi , Yoshioka Fumitaka , Nakahara Yukiko , Masuoka Jun , Koike Haruki , Irie Hiroyuki , Abe Tatsuya
Published: March 2024

Background

Dual-energy computed tomography (DE-CT) can differentiate between hemorrhage and iodine contrast medium leakage following mechanical thrombectomy (MT) for acute ischemic stroke (AIS). We determined whether subarachnoid hemorrhage (SAH) and subarachnoid iodine leakage (SAIL) on DE-CT following MT were associated with malignant brain edema (MBE).

Methods

We analyzed the medical records of 81 consecutive anterior circulation AIS patients who underwent MT. SAH or SAIL was diagnosed via DE-CT performed immediately after MT. We compared the procedural data, infarct volumes, MBE, and modified Rankin scale 0–2 at 90 days between patients with and without SAH and between patients with and without SAIL. Furthermore, we evaluated the association between patient characteristics and MBE.

Results

A total of 20 (25%) patients had SAH and 51 (63%) had SAIL. No difference in diffusion-weighted imaging (DWI)-infarct volume before MT was observed between patients with and without SAH or patients with and without SAIL. However, patients with SAIL had larger DWI-infarct volumes 1 day following MT than patients without SAIL (95 mL vs 29 mL; p=0.003). MBE occurred in 12 of 81 patients (15%); more patients with SAIL had MBE than patients without SAIL (22% vs 3%; p=0.027). Severe SAIL was significantly associated with MBE (OR, 12.5; 95% CI, 1.20–131; p=0.006), whereas SAH was not associated with MBE.

Conclusion

This study demonstrated that SAIL on DE-CT immediately after MT was associated with infarct volume expansion and MBE.
Early technique switch following failed passes during mechanical thrombectomy for ischemic stroke: should the approach change and when?
Authors: Martins Pedro N , Nogueira Raul G , Tarek Mohamed A , Dolia Jaydevsinh N , Sheth Sunil A , Ortega-Gutierrez Santiago , Salazar-Marioni Sergio , Iyyangar Ananya , Galecio-Castillo Milagros , Rodriguez-Calienes Aaron , Pabaney Aqueel , Grossberg Jonathan A , Haussen Diogo C
Published: March 2024

Background

Fast and complete reperfusion in endovascular therapy (EVT) for ischemic stroke leads to superior clinical outcomes. The effect of changing the technical approach following initially unsuccessful passes remains undetermined.

Objective

To evaluate the association between early changes to the EVT approach and reperfusion.

Methods

Multicenter retrospective analysis of prospectively collected data for patients who underwent EVT for intracranial internal carotid artery, middle cerebral artery (M1/M2), or basilar artery occlusions. Changes in EVT technique after one or two failed passes with stent retriever (SR), contact aspiration (CA), or a combined technique (CT) were compared with repeating the previous strategy. The primary outcome was complete/near-complete reperfusion, defined as an expanded Thrombolysis in Cerebral Infarction (eTICI) of 2c–3, following the second and third passes.

Results

Among 2968 included patients, median age was 66 years and 52% were men. Changing from SR to CA on the second or third pass was not observed to influence the rates of eTICI 2c–3, whereas changing from SR to CT after two failed passes was associated with higher chances of eTICI 2c–3 (OR=5.3, 95% CI 1.9 to 14.6). Changing from CA to CT was associated with higher eTICI 2c–3 chances after one (OR=2.9, 95% CI 1.6 to 5.5) or two (OR=2.7, 95% CI 1.0 to 7.4) failed CA passes, while switching to SR was not significantly associated with reperfusion. Following one or two failed CT passes, switching to SR was not associated with different reperfusion rates, but changing to CA after two failed CT passes was associated with lower chances of eTICI 2c–3 (OR=0.3, 95% CI 0.1 to 0.9). Rates of functional independence were similar.

Conclusions

Early changes in EVT strategies were associated with higher reperfusion and should be contemplated following failed attempts with stand-alone CA or SR.
Oat protein modulates cholesterol metabolism and improves cardiac systolic function in high fat, high sucrose fed rats
Authors: Bouchard Jenny , Raj Pema , Yu Liping , Sobhi Babak , Malalgoda Maneka , Malunga Lovemore , Netticadan Thomas , Joseph Thandapilly Sijo
Published: March 2024

Oats are recognized to provide many health benefits that are mainly associated with its dietary fibre, β-glucan. However, the protein derived from oats is largely understudied with respect to its ability to maintain health and attenuate risk factors of chronic diseases. The goal of the current study was to investigate the metabolic effects of oat protein consumption in lieu of casein as the protein source in high fat, high sucrose (HF/HS) fed Wistar rats. Four-week-old rats were divided into three groups and were fed three different experimental diets: a control diet with casein as the protein source, an HF/HS diet with casein, or an HF/HS diet with oat protein for 16 weeks. Heart structure and function were determined by echocardiography. Blood pressure measurements, an oral glucose tolerance test, and markers of cholesterol metabolism, oxidative stress, inflammation, and liver and kidney damage were also performed. Our study results show that incorporation of oat protein in the diet was effective in preserving systolic heart function in HF/HS fed rats. Oat protein significantly reduced serum total and low-density lipoprotein cholesterol levels. Furthermore, oat protein normalized liver HMG-CoAR activity, which, to our knowledge, is the first time this has been reported in the literature. Therefore, our research suggests that oat protein can provide hypocholesterolemic and cardioprotective benefits in a diet-induced model of metabolic syndrome.
Chromatin- and nucleosome-associated features in liquid biopsy: implications for cancer biomarker discovery
Authors: Penny Lucas , Main Sasha C. , De Michino Steven D. , Bratman Scott V.
Published: March 2024

Cell-free DNA (cfDNA) from the bloodstream has been studied for cancer biomarker discovery, and chromatin-derived epigenetic features have come into the spotlight for their potential to expand clinical applications. Methylation, fragmentation, and nucleosome positioning patterns of cfDNA have previously been shown to reveal epigenomic and inferred transcriptomic information. More recently, histone modifications have emerged as a tool to further identify tumor-specific chromatin variants in plasma. A number of sequencing methods have been developed to analyze these epigenetic markers, offering new insights into tumor biology. Features within cfDNA allow for cancer detection, subtype and tissue of origin classification, and inference of gene expression. These methods provide a window into the complexity of cancer and the dynamic nature of its progression. In this review, we highlight the array of epigenetic features in cfDNA that can be extracted from chromatin- and nucleosome-associated organization and outline potential use cases in cancer management.
Seasonal Phragmites australis classification in Long Point National Wildlife Area wetlands using a remotely piloted aircraft system and random forest machine learning
Authors: Hrynyk Morgan , Behnamian Amir , Banks Sarah , Chen Zhaohua , Harmer Taylor , Kirby Patrick , White Lori , Pasher Jon , Duffe Jason
Published: March 2024

This study produced a high-accuracy remotely piloted aircraft system (RPAS) imagery classification method for identifying the invasive reed Phragmites australis ( Cav.) Trin. Ex Steud subsp. australis using random forest (RF) machine learning. RPAS imagery was collected in the spring and fall of 2019 using a fixed-wing RPAS equipped with a visible spectrum camera (eBee X, S.O.D.A. 3D; senseFly) in Long Point, Ontario, Canada. Imagery was used to produce separate early and late season classifications and a bi-temporal classification which used imagery from both dates. The overall accuracy achieved for each was 97%, 96%, and 91%, respectively. Digital surface models (DSMs) were the most important variable for identifying Phragmites in all classifications due to their greater height when compared to surrounding herbaceous vegetation. The bi-temporal classification, which utilized change in DSM value during the growing season, resulted in an estimated 47.8% new growth of Phragmites and appeared to capture sparse growth better than traditional classification differencing alone. This study highlights the promising use of high-resolution DSMs produced from RPAS imagery to classify invasive Phragmites and monitor within-year patch expansions.
Searches for the light invisible axion-like particle in $$K^{+} \rightarrow \pi ^{+}\pi ^{0} a$$ decay
Authors: Sadovsky A. S. , Filin A. P. , Akimenko S. A. , Artamonov A. V. , Blik A. M. , Bychkov V. N. , Donskov S. V. , Filippov S. N. , Gorin A. M. , Gushchin E. N. , Inyakin A. V. , Kekelidze G. D. , Khaustov G. V. , Kholodenko S. A. , Khudyakov A. A. , Kolosov V. N. , Kravtsov V. I. , Kudenko Yu. G. , Kulik A. V. , Kurshetsov V. F. , Lishin V. A. , Lysan V. M. , Medynsky M. V. , Obraztsov V. F. , Okhotnikov A. V. , Polyakov V. A. , Polyarush A. Yu. , Romanovsky V. I. , Rykalin V. I. , Samoylenko V. D. , Tiurin I. S. , Uvarov V. A. , Yushchenko O. P. , Zalikhanov B. Zh.
Published: March 2024

A high-statistics data sample of the $$K^{+}$$

K
+

decays is recorded by the OKA collaboration. A missing mass analysis is performed to search for a light invisible pseudoscalar axion-like particle (ALP) a in the decay $$K^{+} \rightarrow \pi ^{+} \pi ^{0} a$$

K
+

→

π
+

π
0

a

. No signal is observed, and the upper limits for the branching ratio of the decay are calculated. The $$90\%$$

90
%

confidence level upper limit changes from $$2.5\cdot 10^{-6}$$

2.5
·

10

-
6

to $$2\cdot 10^{-7}$$

2
·

10

-
7

for the ALP mass from 0 to 200 MeV/$$c^{2}$$

c
2

, except for the region of $$\pi ^{0}$$

π
0

mass, where the upper limit is $$4.4\cdot 10^{-6}$$

4.4
·

10

-
6

.