bluuebunny/crossref_metadata_2025 huggingface dataset:
Unusual trajectory of a bullet from the shoulder to the brain: an emergency department perspective on finding a missing bullet
Authors: Anwar Zofishan , Shakeel Erum , Waheed Shahan , Baqir Muhammad
Published: May 2024

Terminal ballistics continues to struggle with bullet trajectory reconstruction and interpretation. This is a case of a young man presented with a very unusual trajectory of a bullet from the left shoulder to the brain parenchyma. The single wound and altered mentation prompted a CT head and neck scan, which revealed a retained bullet in the brain parenchyma, traversing from the left shoulder, across the neck and into the brain without causing significant damage to vital organs. We managed the patient conservatively. Emergency physicians dealing with gunshot injuries should thoroughly search for the bullet in cases where only a single wound is present and the bullet is missing, and they should have a basic understanding of the ballistics to understand the mechanism and injury pattern sustained by the bullet. This atypical ballistic trajectory scenario emphasises the need to exercise vigilance in accurately predicting the trajectory when the ballistic route is unknown.
O11 Using a professional patient mystery shop to evaluate management of recently diagnosed HSV-2, compared with data from a national questionnaire
Authors: Cannon Rebecca , Foley Elizabeth , Khatun Azra , Patel Rajul
Published: May 2024

Introduction

In 2014, the British Association of Sexual Health and HIV updated guidelines detailing the expected management of Anogenital Herpes type 2 (HSV-2). This study aims to evaluate counselling given to patients with HSV-2 and determine how clinicians are dealing with sensitive topics that arise during these consultations.

Methods

210 UK Genito-Urinary Medicine (GUM) clinics were sent an anonymous questionnaire, the results of which were analysed and compared with current guidelines. A pilot mystery shopping study, involving a patient with a reported recent HSV-2 diagnosis, was performed in 3 UK GUM Clinics. Details of each consultation were graded as A (acceptable), U (unacceptable) or C (a cause for concern) by a panel of 6 experts.

Results

Analysis of the returned questionnaires showed inconsistencies in answers between clinicians and guidelines. The advice given during the visits was graded 69.7% A, 16.8% C and 13.5% U. Staff performed well with providing emotional support and guiding patients to extra materials (84.5% A) but did significantly less well on topics such as disclosure (65.9% A, p=0.0025), transmission (71.8% A, p=0.032) and pregnancy (53.9% A, p=0.000013) (Pearson’s Chi-squared test).

Discussion

The study has exposed some short falls in clinical practice, which should be addressed by future guidelines and education events at BASHH, should they be supported by a larger-scale study. Returning anonymised data to participating clinics may allow them to deal with discrepancies in their practice.
P086 Routine HIV testing in primary care: does targeted training work?
Authors: Perez Katrina
Published: May 2024

Introduction

Late diagnosis of HIV infection remains a major barrier to tackling HIV. UK HIV testing guidelines recommend universal testing of all new registrants attending general practice (GP) where local HIV prevalence exceeds 2/1000. HIV prevalence in our city was 1.1/1000 with pockets of high prevalence centred on 6 zones of deprivation. We targeted GP practices in these areas to undertake routine HIV testing after in-house training and ascertained healthcare professionals’ (HCP’s) views in relation to HIV testing in primary care before and after training.

Methods

13 GP practices in 6 high prevalence areas were approached alongside public health to undertake routine HIV testing, with remuneration and training, delivered as a lecture and discussion. Pre and post -training questionnaires were done assessing attitudes and knowledge around testing.

Results

7 GP practices accepted. Pre and post training responses (49 in total) reported increased confidence around when to offer testing (40%), discussing testing (20%), and awareness of national guidelines (63%). Increased numbers offered tests to MSM (39%), patients from high risk countries (29%), and for indicator conditions (14%). The number of HCP’s offering testing in the preceding month increased by 20%. Reasons for declining testing remained unchanged (83% self-perceived low risk, 50% stigma concerns) as were practical barriers which were predominantly time restraints.

Discussion

Targeted training improved key areas of understanding and built confidence around routine HIV testing among local GP practices. Perceived barriers to testing and reasons that patients declined testing remained unaltered after training.
O16 Acceptability, uptake and impact of online home-sampling for stis in hampshire, UK: a service evaluation
Authors: Williams Sarah , Scholfield Clare , Nadarzynski Tom , Symonds Ynez , Kidsley Sally
Published: May 2024

Introduction

Home-sampling offers cost-effective and equitable approaches, allowing hard-to-reach populations to remotely access screening for sexually transmitted infections (STIs). We aimed to evaluate a pilot home-sampling service - its utilisation, acceptability and impact on clinic attendance and service delivery, notably its capacity to direct 10% of asymptomatic clinic attenders to the online service.

Methods

We ran descriptive statistics on six-month data (Sep 2015–Mar 2016) on STI kit requests and completion in Hampshire, and conducted trend analysis to examine the impact on attendances. Overall acceptability was assessed via online feedback survey and in-depth interviews with service users.

Results

In total, 4,305 kits were requested and 1974 (48%) were returned, with 15% providing insufficient blood samples. After analysis, 73 samples were positive (1 HIV, 1 syphilis, 5 Hepatitis-B, 53 Chlamydia, and 13 Gonorrhoea). There was no significant reduction in asymptomatic attendances since the introduction of the service (p=0.12). While 95% would use the online service again and 93% would recommend it to family and friends, 39% reported difficulties taking blood samples.

Discussion

Online home-sampling is an acceptable method of screening for STIs. The overall positivity rates are comparable to those reported in the clinic. However, the introduction of the online home-sampling might not reduce clinic attendances, due to the novelty aspects of the service. Further development of online screening needs to increase kit return rate and educate service users on more effective ways of providing sufficient samples for blood analysis.
P122 Delivering system transformation through collaboration between online and terrestrial sexual health services
Authors: Sa Joia de , Howroyd Chris , Holdsworth Gillian , Turner Katy , Baraitser Paula , Menon-Johansson Anatole , Brady Michael
Published: May 2024

Introduction

Online sexual health services could shift demand for asymptomatic testing from clinics to relieve pressure and reduce cost. An online service collaborated with clinicians in two London boroughs to facilitate this through new service pathways.

One clinic developed a triage system directing asymptomatic attenders to order directly via the online service using tablets in the clinic with self-sampling packs prepared immediately to take away. Two clinics offered a ‘weblink’ card signposting those attending during busy periods to the online service. This study describes and evaluates these new pathways to re-direct demand.

Methods

We used routinely collected testing data to analyse uptake. We compared the populations who used new pathways (weblink, ‘tablet-in-clinic’) with those resident in the same area accessing the online service without signposting or triage (organic users).

Results

In a 6-month period, there were 8,987 orders from organic users, 1,280 orders through ‘weblink’ and 1,555 orders from ‘tablet-in-clinic’ users. Weblink users had a lower kit return rate (62.7%) compared with ‘tablet-in-clinic’ and organic users (71.4%; 71.9%). Positivity rates for any infection were higher among weblink (8.6%) and ‘tablet-in-clinic’ users (8.2%) compared with organic users (6.1%). In this period, 157 service users ordering through weblink or ‘tablet-in-clinic’ ordered their next test through the organic route.

Discussion

Collaborative strategies to increase uptake of online services can be effective. These can increase capacity but may reduce user choice. Further work on predictive triage and targeted support for users switching service modality could enhance this offer.
P145 London sexual health transformation programme
Authors: Cleary Mary , O’Sullivan Jonathan
Published: May 2024

Introduction

The London Sexual Health Transformation Programme (LSHTP) is a partnership of 32 London Boroughs working to deliver a new collaborative commissioning model for open access sexual health services. The programme has facilitated cross London joint working to set up new services, agree new pricing mechanisms and ensure coordinated expert clinical specifications for all services, producing better outcomes for patients and better value for commissioners.

Methods

To deliver this transformation the programme set up three distinct work streams: developing a new pan London e-services model for sexual health to better signpost patients to the right services and provide home testing kits where clinically justified; developing a new pricing mechanism that supports flexibility and planning; and supporting sub regional groups to re commission face to face services with a new agreed clinical specification to support overall system transformation objectives.

Results

Transformed services; a new online offering, and a new London wide clinically agreed service specification. Improved resident access and experience. Patients will no longer need to attend a clinic if they don’t wish to but will access expert advice, triage and testing in their home or safe space elsewhere. Saved approximately £30 – 40m through collaborative commissioning and patient channel shift away from expensive clinic attendance where it is not needed Built and maintained partnerships across London. It has been a major achievement to construct and sustain a collaborative of 32 London boroughs involved in this programme.

Discussion

Is collaboration the way forward for effective commissioning?
P150 Partnerships between services can support survivors of sexual abuse, violence and exploitation
Authors: Harding Rebecca , Phattey Jara , Thompson Lisa , Langham Yvonne , Caswell Rachel
Published: May 2024

Introduction

The ASC Clinic (Abuse Survivors Clinic) offers specialised services to patients who have been affected by sexual violence. It is provided by Umbrella NHS Sexual Health Service and third sector partner RSVP (the Rape and Sexual Violence Project). The ASC offers emotional and medical support to survivors of sexual exploitation, coercion, abuse and violence. This is a review of the experience gained in the first year.

Methods

A retrospective review of the electronic case notes for all patients who attended the ASC, November 2015-2106.

Results

46 female, 8 male, 1 transgender attended with 6 <18years. The majority of patients (41) were referred by Sexual Health staff, and others were from SARC (9), RSVP (1), another hospital (1), and 1 patient self-referred. One of the patients was experiencing on-going sexual violence at the time of attendance, 18 had experienced it within the past month, 14 between 1 month and 1 year before being seen, and 22 more than 1 year previously. Nearly all (5) of the under 18-year olds were referred to Safeguarding teams, and 9 of the adults. The majority accepted services from both partner agencies. 128 appointments were made with 63 attendances (DNA rate 49%).

Discussion

We are increasingly aware of the numbers of people who have experienced sexual violence. The ASC provides a dedicated service for this vulnerable group. The innovative approach of working with the third sector helps combine experience and expertise enabling more holistic care. Further work is needed to improve clinic accessibility and to evaluate patient experience.
P184 Adherence to pcp prophylaxis guidelines in hiv positive patients
Authors: Drake Jessie , Cunningham Mathew , Gilleece Yvonne
Published: May 2024

Introduction

Pneumocystis Pneumonia (PCP) prophylaxis is often continued despite acceptable CD4 counts in HIV positive individuals on antiretroviral (ARV) treatment. Both BHIVA and EACS guidelines advise discontinuing prophylaxis if the CD4 count is >200 cells/mm3 for 3 months, EACS additionally states that prophylaxis should be stopped if the patient has a CD4 count of 100-200 and an undetectable Viral Load (VL) for 3 months.

Methods

We analysed the case notes of all individuals actively receiving Co-trimoxazole prophylaxis prescriptions, and assessed clinical details, CD4 count and VL data to decide whether their continued prescription was in accordance with current guidelines.

Results

We identified 32 patients, 27 male, currently on Co-trimoxazole prophylaxis. 18 individuals (56%) met the criteria for continuing PCP prophylaxis. Of the remaining 14, 3 individuals were on immunosuppressive medications for co-morbidities, and were therefore appropriately receiving prophylaxis. 11 of 32 individuals (34%) were found to be receiving Co-trimoxazole despite meeting guidance for discontinuing prophylaxis. 8 of these patients met the BHIVA guidelines, while an additional 3 met the EACS guidelines.

Discussion

Our results suggest a significant number of individuals currently receiving PCP prophylaxis could stop. This would reduce their pill burden and minimise the effects of polypharmacy, as well as reduce cost to the NHS. Clinicians should therefore regularly review the need to continue PCP prophylaxis.
P216 Evaluating a motivational interviewing clinic for behaviour change
Authors: Grundy-Bowers Matthew , Dosekun Olamide , Osborn Nick
Published: May 2024

Introduction

A service was set up to support patients in behaviour change, staffed by motivational interviewing trained nurses and workers from a voluntary drugs service.

Methods

An evaluation was undertaken of the service. Between 16.09.15 and 09.11.16 at total of 101 patients were booked into the service: 53 were referred to the nurses and 48 referred to the drug worker (some were referred to both). A total of 30 patient notes were selected at random and data extracted.

Results

Of the 101 patients 4 were female and 97 were male (aged 21 to 63 years old). 3 were bisexual, 5 heterosexual, the remainder MSM and 5 were sex workers. Of the 12 HIV-positive patients, all were on treatment and undetectable. In the 12-months prior to referral 15 had been diagnosed with at least 1 STI and 8 had received PEPSE (2 receiving 2 courses). Reasons for attendance; chemsex (20), substance use (7), alcohol (1) risky sexual (1) not documented (1). 19 patients had been seen within 3 attendances (range 1 to 11) and the majority did not require onward referral (n=21).

Discussion

There was a high DNA rate within the service which is common among this patient type. 8 patients reduced or stopped the behaviour that they were referred for. 9 of the 15 diagnosed with an STI prior to referral did not have an STI documented in their notes post referral. This shows that MI based programmes have utility in supporting vulnerable patients desiring behaviour change.
P221 Spotting child sexual exploitation (CSE) risks in a small rural cohort; what to look out for and how to effectively share information
Authors: Pearce Amy , Dent Rosie , Palmer Joanne , Keane Frances
Published: May 2024

Introduction

Recognition of CSE is a vital part of our work. We host a monthly multiagency safeguarding meeting (SM), alongside social services, children in care (CIC) team and hospital safeguarding. All children with high risk behaviours/vulnerabilities who have attended in the previous month are discussed including children in care, those current self-harming and those disclosing grooming or sexual assault. We will explore other factors contributing to CSE risk and demonstrate the value of the multiagency SM to care.

Methods

Review of records of 90 adolescents 13-17 attending between 01/08/16 – 30/09/16. Demographics, safeguarding concerns and SM outcomes were recorded. Results were analysed using SPSS and Pearsons/Fishers tests.

Results

84% (76) were female. 13% (12) were aged ≤15. In this group a history of involuntary sex was associated with both the use of recreational drugs (p=0.002) and any diagnosis of a mental health condition (p=0.020). 12 patients were discussed at the SM. New information was shared between partner organisations in 75% (9) cases. Further results for risky behaviours can be seen in Table 1.

Abstract P221 Table 1

Spotting CSE

Yes (%)No (%)History of involuntary sex21(25.6)61(74.4)History of grooming1(1.2)82(98.8)Sent/Received sexually explicit photos5(8.8)52(91.2)Met partners on internet/social media6(10.7)50(89.3)Previous or current self-harm33(37.6)53(62.4)Known to Social Services20(22.8)68(77.2)

Discussion

Discussion at the SM improves the care of vulnerable children by identifying those at risk and improving multiagency care planning. Mental health problems or illicit drug use should prompt careful evaluation for CSE risk.
O32 Ethnicity and sexual behaviours – the association between ethnicity and sexual risk behaviours reported by heterosexual men and women in a gum setting
Authors: Coyle Rachel , Miltz Ada , Sewell Janey , Phillips Andrew , Speakman Andrew , Ivens Daniel , Sadiq Tariq , Dhar Jyoti , Taylor Stephen , Sherr Lorraine , Collins Simon , Elford Jonathon , Lampe Fiona , Rodger Alison
Published: May 2024

Introduction

In the UK people of black ethnicity experience a disproportionate burden of HIV and STI. We aimed to assess the association of ethnicity with sexual risk behaviours (SRB) and sexual health among heterosexual men and women.

Methods

AURAH is a cross-sectional questionnaire study of people without HIV, recruited in 20 GUM clinics in England 2013–14. We assessed the association of ethnicity with (i) condomless sex with non-regular partner(s) (CLS-NR); (ii) ≥2 new partners in the last year (2NPLY); and (iii) STI diagnosis in the past year (STI) using modified poisson regression adjusted for age, study region, education and relationship status.

Results

1075 heterosexual men (n=451) and women (n=624) completed questionnaires. Ethnicity was as follows: 513 (48.4%) black/mixed African (BA), 159 (15.0%) black/mixed Caribbean (BC), 288 (27.1%) white ethnicity (WE), 101 (9.5%) other ethnicity (OE).

Abstract O32 Table 1

AURAH

Adjusted PR (95%CI)CLS–NR2NPLYSTI within last yearWomen: White BA BC OE10.65(0.49–0.85)0.78(0.55–1.10)0.66(0.39–1.13)10.36(0.27–0.48)
0.39(0.25–0.61)
0.60(0.37–0.99)10.92(0.61–1.38)1.47(0.95–2.28)1.23(0.68–2.23)Men: White BA BC OE11.05(0.83–1.32)1.02(0.73–1.44)0.69(0.43–1.09)10.77(0.62–0.96)0.85(0.62–1.16)1.29(1.03–1.61)11.14(0.75–1.73)1.76(1.10–2.82)0.59(0.24–1.43)

Compared with WE women BA women were less likely to report CLS-NR, BA and BC women were less likely to report 2NPLY, and BC women were more likely to report STI. In men CLS-NR did not vary significantly by ethnicity. BA men were less likely to report 2NPLY and BC men were more likely to report STI compared with WE men.

Discussion

The prevalence of SRBs was lower in black ethnicity women, but history of STI was more prevalent among BC women. Similarly, higher STI history in BC men was not consistent with ethnic variation in SRB. Additional factors, e.g. sexual networks, may be important determinants of sexual health.
P002 Assessing the impact of individualised treatment: an individual-based mathematical modelling study of antimicrobial resistant neisseria gonorrhoeae transmission, diagnosis and treatment in men who have sex with men
Authors: Zienkiewicz Adam , Homer Martin , Christensen Hannah , Hill Darryl , Horner Paddy , Woodford Neil , Fifer Helen , Hughes Gwenda , Turner Katherine
Published: May 2024

Introduction

Antimicrobial resistant (AMR) gonorrhoea is a global public health threat. In London, diagnoses in men who have sex with men (MSM) have more than quadrupled from 2010 to 2015. Importantly, our last-line treatment (ceftriaxone) is used in first-line dual therapy. However, over half of tested isolates are still sensitive to older drugs, e.g. ciprofloxacin. Discriminatory point-of-care tests (POCT) to detect drug sensitivity are under development, enabling individualised treatment decisions.

Methods

An individual-based transmission model of gonorrhoea infection in MSM was developed, incorporating ciprofloxacin-sensitive and resistant strains, using novel heuristic approach to capture partnership dynamics. We explored different strategies to improve treatment selection including a) discriminatory POCT, b) partner treatment based on index case susceptibility, and c) variably delayed positivity testing prior to treatment (pre-screening).

Results

The flexible model structure enabled us to credibly simulate London gonorrhoea transmission dynamics - assuming 2–10% prevalence and 10–50 daily diagnoses per 100,000 MSM. Simulations show that a) using POCT to detect ciprofloxacin sensitive infections resulted in a 70% decrease in ceftriaxone doses, and b) using index case sensitivity profile to direct treatment of partners could reduce ceftriaxone use by 27%.

Discussion

POCT are likely to dramatically reduce reliance on ceftriaxone. In the meantime, we could use existing data more informatively. If lab turnaround times are fast enough, index case sensitivity profiles could be used to select effective treatments for partners. This new framework addresses limitations of previous models and provides a flexible platform for exploring control options for AMR gonorrhoea.
Multipath Load Balancing in MANET via Hybrid Intelligent Algorithm
Authors: Biradar Manjula A. , Mallapure Sujata
Published: May 2024

The Mobile Adhoc Network (MANET) is a vital network that is vulnerable to energy and security restrictions. Because of node mobility, building a routing protocol to offers an effective and acceptable means of routing data with minimum packet loss, less energy consumption, and extending network lifetime has become a difficult challenge in MANETs. Most of the current MANET routing protocols lack the strategy of precise load-balancing. A recent survey on load distribution in MANET shows shortest-path MANET routing protocols using centrally located nodes in many routes. Since few nodes have to carry excessive loads, congestion increases, leading to undesirable effects such as long delays, lower packet delivery, and higher routing overhead, which shows the need for proper balancing models. In this work, multipath load balancing with the proposed NUSOA is used in MANETs to reduce energy usage and packet loss. Here, the data packets are distributed through gateway nodes, which are selected by the various features such as path cost, link cost, residual energy, and distance. Proposed hybrid optimisation termed as Namib Updated Shepherd Optimisation Algorithm (NUSOA) which is the mixture of both Namib Beetle Optimisation (NBO) and Shuffled Shepherd Optimisation Algorithm (SSOA) to choose optimal gateway nodes. Moreover, the optimal path is chosen based on load balancing with the constraints of congestion detection and node availability of the path using the proposed hybrid optimisation.
Population dynamics and palaeoenvironmental inferences of Turonian planktonic foraminiferal assemblages from SE Tanzania and ODP Site 762 (Exmouth Plateau, eastern Indian Ocean)
Authors: Huber Brian T. , Petrizzo Maria Rose , MacLeod Kenneth G.
Published: May 2024

The Tanzania Drilling Program (TDP) recovered hemipelagic sediments from land-based boreholes that yielded extraordinarily well-preserved, diverse Turonian foraminifera. Reliable oxygen and carbon isotopic analyses through most of the Turonian Stage and biostratigraphic data were documented. This study compares Turonian foraminiferal population dynamics and associated geochemical proxy records among the TDP boreholes with correlative records from Ocean Drilling Program Site 762 (Exmouth Plateau, eastern Indian Ocean). The two regions were separated by ∼12° latitude and ∼5000 km of ocean, with the Indian continental plate located between. Taxonomic turnover is similar and is nearly simultaneous in both regions across the transition from the
Helvetoglobotruncana helvetica
Zone to the
Falsotruncana maslakovae
Zone (∼93.0 Ma). Changes include overlapping extinctions of all helvetoglobotruncanids, most dicarinellids and one species of
Praeglobotruncana
and subsequent first appearances of marginotruncanid and falsotruncanid species. Increased abundance of biserial planktonic foraminifera is recorded at multiple TDP sites and at Site 762 across the contact of the
Fa. maslakovae
and
Huberella huberi
zones
c.
0.5 Myr after the
Hv. helvetica
/
Fa. maslakovae
transition. Geochemical records at the two sites do not indicate associated palaeoenvironmental changes in surface water conditions that would explain coordinated changes in species composition on opposites sides of the Indian Ocean.
Interactive Rendering of Caustics using Dimension Reduction for Manifold Next-Event Estimation
Authors: Granizo-Hidalgo Ana , Holzschuch Nicolas
Published: May 2024

Specular surfaces, like water surfaces, create caustics by focusing the light being refracted or reflected. These caustics are very important for scene realism, but also challenging to render: to compute them, we need to find the exact path connecting two points through a specular reflective or refractive surface. This requires finding the roots of a complicated function on the surface. Manifold-Exploration methods find these roots using the Newton-Raphson method, but this involves computing path derivatives at each step, which can be challenging. We show that these roots lie on a curve on the surface, which reduces the dimensionality of the search. This dimension reduction greatly improves the search, allowing for interactive rendering of caustics. It also makes implementation easier, as we do not need to compute path derivatives.
A Bibliometric Review of Large Language Models Research from 2017 to 2023
Authors: Fan Lizhou , Li Lingyao , Ma Zihui , Lee Sanggyu , Yu Huizi , Hemphill Libby
Published: May 2024

Large language models (LLMs), such as OpenAI's Generative Pre-trained Transformer (GPT), are a class of language models that have demonstrated outstanding performance across a range of natural language processing (NLP) tasks. LLMs have become a highly sought-after research area because of their ability to generate human-like language and their potential to revolutionize science and technology. In this study, we conduct bibliometric and discourse analyses of scholarly literature on LLMs. Synthesizing over 5,000 publications, this article serves as a roadmap for researchers, practitioners, and policymakers to navigate the current landscape of LLMs research. We present the research trends from 2017 to early 2023, identifying patterns in research paradigms and collaborations. We start with analyzing the core algorithm developments and NLP tasks that are fundamental in LLMs research. We then investigate the applications of LLMs in various fields and domains, including medicine, engineering, social science, and humanities. Our review also reveals the dynamic, fast-paced evolution of LLMs research. Overall, this article offers valuable insights into the current state, impact, and potential of LLMs research and its applications.
Point-of-Care Detection of HER2 and CA 15-3 in Breast Cancer Patients: Dual-Channel Biosensor Implementation
Authors: Wan Hsiao-Hsuan , Zhu Haochen , Chiang Chao-Ching , Xia Xinyi , Li Jian-Sian , Ren Fan , Tsai Cheng-Tse , Liao Yu-Te , Chou Tai-Cheng , Neal Dan , Esquivel-Upshaw Josephine F.
Published: May 2024

Breast cancer remains a considerable health challenge, affecting numerous individuals annually. This research introduces an innovative method for detecting breast cancer utilizing dual-channel test strips capable of simultaneously assessing two key biomarkers—HER2 and CA 15-3. The test strip utilized in this study is not only cost-effective but also entirely non-invasive. The reusable device employs a printed circuit board with metal-oxide-semiconductor field-effect transistor amplification and Arduino-based control to convert voltage signals from test strips into digital readings efficiently. The device utilizes double-pulse measurement instead of direct current, effectively mitigating the screening effect. The detection limit for both biomarkers is exceptionally low at 10−15 g ml−1, surpassing commercial enzyme-linked immunoassay kits by four orders of magnitude. The sensor demonstrates remarkable sensitivity, with 78/dec for HER2 and 56/dec for CA 15-3. Human sample tests were conducted to validate the efficacy of the dual-channel strip, successfully distinguishing between healthy and cancerous groups. The results reveal significant p-values for both HER2 and CA 15-3 tests, underscoring the significance of this research. Note that this is a rapid testing process, completed in less than 2 s. These findings offer a promising avenue for swift and accurate breast cancer detection, furnishing crucial insights for early diagnosis and subsequent treatment.
Reduced incretin receptor trafficking upon activation enhances glycemic control and reverses obesity in diet-induced obese mice
Authors: Bauri Rathin , Bele Shilpak , Edelli Jhansi , Reddy Neelesh C. , Kurukuti Sreenivasulu , Devasia Tom , Ibrahim Ahamed , Rai Vishal , Mitra Prasenjit
Published: May 2024

Replacement of the tryptophan cage (Trp-cage) with the C-terminal oxyntomodulin undecapeptide along with the tyrosine substitution at the amino terminus converts the selective glucagon-like peptide-1 receptor (GLP-1R) agonist exendin-4 to a novel GLP-1R and GIPR dual agonist I-M-150847. Reduced internalization of incretin receptors upon activation by the GLP-1R and GIPR dual agonist I-M-150847 promotes iterative receptor signaling that enhances the incretin effect and reverses obesity.
Value of Intracardiac Echocardiography in the Interventional Closure of Patent Foramen Ovale with Adjacent Atrial Septal Defect
Authors: Zhu Boqian , Zhu Tao , Fan Jianing , Zhang Xiaochun
Published: May 2024

Objective. This study aimed to investigate the application value of intracardiac echocardiography (ICE) in transcatheter closure of a patent foramen ovale (PFO) combined with an adjacent atrial septal defect (ASD). Methods. This retrospective study included five patients with PFO combined with adjacent ASD who underwent transcatheter closure and were admitted to the Zhongshan Hospital of Fudan University from June to September 2023. General conditions, ultrasound and ICE findings, and operative data were recorded and followed up for 2–6 months. Results. Of the five patients, two and three had embolic stroke of undetermined source and migraine, respectively, aged 45.6 ± 12.0 years. All patients underwent successful transcatheter closure via the PFO tunnel under the guidance of ICE, without complications or new stroke, and showed significantly reduced migraine at the follow-up. Conclusion. In patients with PFO combined with adjacent ASD, closure of a PFO tunnel could be successfully achieved under ICE guidance; its clinical efficacy was accurate and worthy of promotion.
A Numerical Study on the Influence of Bolt Corrosion on the Long‐Term Behavior of Steel–Concrete Composite Beams
Authors: Niu Yalei , Qu Chen , Feng Qingxing
Published: May 2024

This study establishes a numerical model for beam‐type steel–concrete composite specimens considering the corrosion of anchor bolts, with which studies the long‐term deformation performance of the components under sustained load. The experimental results were compared with the calculated values obtained by combining the effective modulus method according to the CEB‐FIP 1990 code and the ACI 209R code. Then a comparison with the calculation method of shrinkage and creep in standards (Standard Creep Method (SCM)) is made, and it shows that by supplementing the degradation of interface stiffness due to corrosion (using the defined modulus method (DMM)), the simulation results match better with the experimental results, confirming that this approach is suitable for analyzing the long‐term load conditions of anchor bolt corrosion. Furthermore, based on the defined modulus method, the long‐term behavior of composite beams under different loads and varying corrosion rates is studied.
Adapting to the Digital Age: An Evaluation of Online Learning Strategies in Public Health and Social Care Education
Authors: Hossain Muhammad , Anglin Morris , Safi Ayazullah , Ahmed Tajbir , Khan Salim
Published: May 2024

Introduction. The global shift towards digital education in the wake of the COVID-19 pandemic has reshaped the landscape of higher education. Public health and social care programmes have adapted to this transformation, embracing online learning strategies to engage students. This study focuses on the assessment of online learning experiences in public health and social care education, particularly during the post-COVID-19 period. Materials and Methods. This qualitative study employed semi-structured interviews and focus groups with 49 university students in England. These phases, conducted both in person and via video, were audio and video recorded and transcribed verbatim. A purposive sampling technique was employed to gather data, and framework analysis facilitated data management and interpretation. Results. The presentation highlights three main themes and 12 accompanying sub-themes that capture the clear preferences of students for both in-person and online learning methods. The findings elucidate the merits and demerits of online learning strategies in contrast to traditional face-to-face classes. Online classes offer distinct advantages in terms of flexibility, cost-effectiveness, time efficiency, and technological proficiency. However, they also bring to the fore concerns related to social isolation, mental health challenges, technical challenges, and distractions within the home environment. Conclusion. Considering the global transition to digital education, this study contributes to the dynamic discourse surrounding online learning in the post-COVID-19 era. The diverse preferences expressed by students highlight the importance of personalised and flexible teaching methods in online education, underlining the need for adaptability and inclusivity to meet the diverse needs of today’s learners.
Effects of Tannin Supplementation in Diet on the Resistance to Ammonia Stress of Pacific White Shrimp Litopenaeus vannamei
Authors: Zhang Xiuhong , Gong Han , Chen Ping , Wang Jiajia , Chen Zhao , Chang Zhiqiang , Li Jitao
Published: May 2024

Tannin (TA), as a natural phenolic compound with strong antioxidant activity, has been used as a feed additive for various animals. In this study, we fed a diet containing 800 mg/kg of tannin on Litopenaeus vannamei for 56 days and then subjected to acute ammonia stress for 48 hr to investigate the effect of dietary tannin on the ammonia stress response of L. vannamei through transcriptomic and metabolomic analysis. The transcriptome analysis indicated that ammonia stress‐induced differential expression of 4,185 genes, while tannin‐fed shrimp only had 964 differentially expressed genes. Compared with the TA_0 group, 59 pathways were significantly altered, and the pathways of “starch and sucrose metabolism,” “retinol metabolism,” “arachidonic acid metabolism,” “lysosome,” and “amino sugar and nucleotide sugar metabolism” were highly enriched in the TS_0 group. Compared with the TS_0 group, six pathways were significantly altered, and the pathways of “dilated cardiomyopathy,” “complement and coagulation cascades,” “cardiac muscle contraction,” “fructose and mannose metabolism,” “cGMP‐PKG signaling pathway,” and “beta‐alanine metabolism” were significantly enriched in the TS_800 group. Metabolomic analysis showed that a total of 107 differential metabolites (DMs) were identified in the TS_0 vs. TA_0 group, while 75 DMs were identified in the TS_800 vs. TS_0 group. Based on KEGG annotation, it was found that a large amount of DM was significantly enriched in amino acid metabolism pathways in the TS_0 group, including “arginine and proline metabolism,” “alanine, aspartic acid, and glutamic acid metabolism,” “β‐Alanine metabolism and tyrosine metabolism” indicated that tannins affect the metabolism of amino acids. The integration of DEGs and DMs indicates that dietary tannins highly alter the digestion and absorption functions of proteins, as well as the biosynthesis and metabolism of amino acids. This study provides new insights into the adaptation of Pacific white shrimp to ammonia stress and the addition of tannins to feed to enhance immune function.
Machine Learning Algorithms for Predicting Energy Consumption in Educational Buildings
Authors: Elhabyb Khaoula , Baina Amine , Bellafkih Mostafa , Deifalla Ahmed Farouk
Published: May 2024

In the past few years, there has been a notable interest in the application of machine learning methods to enhance energy efficiency in the smart building industry. The paper discusses the use of machine learning in smart buildings to improve energy efficiency by analyzing data on energy usage, occupancy patterns, and environmental conditions. The study focuses on implementing and evaluating energy consumption prediction models using algorithms like long short‐term memory (LSTM), random forest, and gradient boosting regressor. Real‐life case studies on educational buildings are conducted to assess the practical applicability of these models. The data is rigorously analyzed and preprocessed, and performance metrics such as root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE) are used to compare the effectiveness of the algorithms. The results highlight the importance of tailoring predictive models to the specific characteristics of each building’s energy consumption.
The Effect of Feeding with Chironomid and Artemia on Fatty Acids and Amino Acids Profiles in Persian Sturgeon (Acipenser persicus) Larvae
Authors: Efatpanah Iraj , Falahatkar Bahram , Sajjadi Mir Masoud , Monsef Shokri Maryam
Published: May 2024

This study aimed to examine the effect of various live foods on the fatty acids (FAs) and amino acids (AAs) profiles in Persian sturgeon (Acipenser persicus) larvae. One thousand and two hundred larvae were cultured in circular concrete tanks, and four treatments were administered as: (1) Artemia + Daphnia, (2) Artemia, (3) Artemia + Chironomid, and (4) Chironomid. Each treatment was considered as three replicates over an 11‐day period. At the end of the experiment, treatment 1 (Artemia + Daphnia) showed the highest average weight of larvae, and the lowest weight was observed in treatment 4 (Chironomid). Survival rate ranged from 83.84% to 88.86% and no significant difference was observed among the groups (P  > 0.05). Among Artemia‐fed larvae, the predominant FAs were docosahexaenoic acid (DHA), oleic acid (ω9), and monounsaturated fatty acids (MUFA), while saturated fatty acids (SFA) and polyunsaturated fatty acids (PUFA) (ω3 + ω6) were present in a lesser proportion (P  < 0.05). In larvae fed with Artemia and Daphnia, the predominant proportions were observed in SFAs, eicosapentaenoic acid (EPA), ω3, DHA + EPA, and the n3/n6 ratio, all registering the highest percentages. Conversely, MUFA, ω6, and the DHA/EPA ratio displayed the lowest percentages (P  < 0.05). Moreover, larvae fed with Artemia exhibited higher levels of ω6, PUFA (ω3 + ω6), and DHA/EPA ratio. In contrast, larvae fed with Chironomid showed lower levels of EPA, DHA + EPA, and n3/n6 ratio (P  < 0.05). Among larvae fed with Chironomid, solely the DHA/EPA ratio exhibited a higher value compared to larvae fed with Artemia and Daphnia (P  < 0.05). The amount of leucine in fish fed Artemia + Daphnia was more than the other treatments (P  < 0.05). This study revealed a significant difference in amino acids composition among various live foods (P  < 0.05), but no significant difference in AAs was observed in the body of Persian sturgeon larvae (P  > 0.05). The results of this study suggest that the Persian sturgeon larvae possess the ability to maintain a balanced state of AAs. It is also evident that the FA profile of different live foods can affect the overall FA levels in the body of Persian sturgeon larvae, ultimately contributing to the enhancement of fish survival rate and growth.
Development of Seismic Fragility Functions for Reinforced Concrete Buildings Using Damage‐Sensitive Features Based on Wavelet Theory
Authors: Panahi Boroujeni Minoo , Zareei Seyed Alireza , Birzhandi Mohammad Sadegh , Zafarani Mohammad Mahdi
Published: May 2024

In this study, wavelet‐based damage‐sensitive features are employed to derive the seismic fragility functions/curves for reinforced concrete moment‐resisting frames. Two different wavelet transform functions, namely, Bior3.3 and Morlet mother wavelet families, were applied to absolute acceleration time histories of building frames to extract the wavelet‐based and refined wavelet‐based damage‐sensitive features (i.e., DSF and rDSF). The accuracy of seismic assessments and certainty in predicting structural behavior strongly depend on the specific optimal intensity measures selected, reliability of wavelet‐based damage‐sensitive features, and some such intensity measures as PGA, PGV, PGD, Sa, and Sdi as the conventionally utilized measures to detect the damage state of a structure. These measures were examined against their statistical properties of efficiency, practicality, proficiency, coefficient of determination, and sufficiency to select the appropriate optimal intensity measures, which were then used to drive the fragility curves disclosing the failure or other damage states of interest. For the purposes of this study, three different concrete moment‐resisting frames with four‐, eight‐, and twelve‐story building frames were adopted for implementing the proposed approach. The findings demonstrate that the wavelet‐based damage‐sensitive features (DSFs/rDSF) simultaneously satisfy all the statistical properties cited above. This is evidenced by the low variance and dispersions observed in the frame damage state predictions by the fragility functions derived from the wavelet‐based DSF when compared with those derived from the classical fragility analyses such as spectral acceleration at the first mode period of the structure. A final aspect of the study concerns the superior performance and efficiency of the fragility curves derived by the Bior3.3 wavelet‐based DSF over those derived from Morlet wavelet‐based DSF.
A Proof-of-Concept Study of Sequential Treatment with the HDAC Inhibitor Vorinostat following BRAF and MEK Inhibitors in BRAF
V600-Mutated Melanoma
Authors: Embaby Alaa , Huijberts Sanne C.F.A. , Wang Liqin , Leite de Oliveira Rodrigo , Rosing Hilde , Nuijen Bastiaan , Sanders Joyce , Hofland Ingrid , van Steenis Charlaine , Kluin Roelof J.C. , Lieftink Cor , Smith Christopher G. , Blank Christian U. , van Thienen Johannes V. , Haanen John B.A.G. , Steeghs Neeltje , Opdam Frans L. , Beijnen Jos H. , Huitema Alwin D.R. , Bernards Rene , Schellens Jan H.M. , Wilgenhof Sofie
Published: May 2024

Purpose:

The development of resistance limits the clinical benefit of BRAF and MEK inhibitors (BRAFi/MEKi) in BRAFV600-mutated melanoma. It has been shown that short-term treatment (14 days) with vorinostat was able to initiate apoptosis of resistant tumor cells. We aimed to assess the antitumor activity of sequential treatment with vorinostat following BRAFi/MEKi in patients with BRAFV600-mutated melanoma who progressed after initial response to BRAFi/MEKi.

Patients and Methods:

Patients with BRAFi/MEKi-resistant BRAFV600-mutated melanoma were treated with vorinostat 360 mg once daily for 14 days followed by BRAFi/MEKi. The primary endpoint was an objective response rate of progressive lesions of at least 30% according to Response Evaluation Criteria in Solid Tumors 1.1. Secondary endpoints included progression-free survival, overall survival, safety, pharmacokinetics of vorinostat, and translational molecular analyses using ctDNA and tumor biopsies.

Results:

Of the 26 patients with progressive BRAFi/MEKi-resistant BRAFV600-mutated melanoma receiving treatment with vorinostat, 22 patients were evaluable for response. The objective response rate was 9%, with one complete response for 31.2 months and one partial response for 14.9 months. Median progression-free survival and overall survival were 1.4 and 5.4 months, respectively. Common adverse events were fatigue (23%) and nausea (19%). ctDNA analysis showed emerging secondary mutations in NRAS and MEK in eight patients at the time of BRAFi/MEKi resistance. Elimination of these mutations by vorinostat treatment was observed in three patients.

Conclusions:

Intermittent treatment with vorinostat in patients with BRAFi/MEKi-resistant BRAFV600-mutated melanoma is well tolerated. Although the primary endpoint of this study was not met, durable antitumor responses were observed in a minority of patients (9%).
IL3-Driven T Cell–Basophil Crosstalk Enhances Antitumor Immunity
Authors: Wei Jian , Mayberry Colleen L. , Lv Xiaoting , Hu Fangyan , Khan Taushif , Logan Natalie A. , Wilson John J. , Sears John D. , Chaussabel Damien , Chang Chih-Hao
Published: May 2024

Cytotoxic T lymphocytes (CTL) are pivotal in combating cancer, yet their efficacy is often hindered by the immunosuppressive tumor microenvironment, resulting in CTL exhaustion. This study investigates the role of interleukin-3 (IL3) in orchestrating antitumor immunity through CTL modulation. We found that intratumoral CTLs exhibited a progressive decline in IL3 production, which was correlated with impaired cytotoxic function. Augmenting IL3 supplementation, through intraperitoneal administration of recombinant IL3, IL3-expressing tumor cells, or IL3-engineered CD8+ T cells, conferred protection against tumor progression, concomitant with increased CTL activity. CTLs were critical for this therapeutic efficacy as IL3 demonstrated no impact on tumor growth in Rag1 knockout mice or following CD8+ T-cell depletion. Rather than acting directly, CTL-derived IL3 exerted its influence on basophils, concomitantly amplifying antitumor immunity within CTLs. Introducing IL3-activated basophils retarded tumor progression, whereas basophil depletion diminished the effectiveness of IL3 supplementation. Furthermore, IL3 prompted basophils to produce IL4, which subsequently elevated CTL IFNγ production and viability. Further, the importance of basophil-derived IL4 was evident from the absence of benefits of IL3 supplementation in IL4 knockout tumor-bearing mice. Overall, this research has unveiled a role for IL3-mediated CTL–basophil cross-talk in regulating antitumor immunity and suggests harnessing IL3 sustenance as a promising approach for optimizing and enhancing cancer immunotherapy.

See related Spotlight, p. 798