bluuebunny/crossref_metadata_2025 huggingface dataset:
Unsupervised machine learning for the classification of astrophysical X-ray sources
Authors: Pérez-Díaz Víctor Samuel , Martínez-Galarza Juan Rafael , Caicedo Alexander , D’Abrusco Raffaele
Published: January 2024

The automatic classification of X-ray detections is a necessary step in extracting astrophysical information from compiled catalogues of astrophysical sources. Classification is useful for the study of individual objects, statistics for population studies, as well as for anomaly detection, that is, the identification of new unexplored phenomena, including transients and spectrally extreme sources. Despite the importance of this task, classification remains challenging in X-ray astronomy due to the lack of optical counterparts and representative training sets. We develop an alternative methodology that employs an unsupervised machine learning approach to provide probabilistic classes to Chandra Source Catalog sources with a limited number of labelled sources, and without ancillary information from optical and infrared catalogues. We provide a catalogue of probabilistic classes for 8756 sources, comprising a total of 14 507 detections, and demonstrate the success of the method at identifying emission from young stellar objects, as well as distinguishing between small- and large-scale compact accretors with a significant level of confidence. We investigate the consistency between the distribution of features among classified objects and well-established astrophysical hypotheses such as the unified active galactic nucleus model. This provides interpretability to the probabilistic classifier. Code and tables are available publicly through GitHub. We provide a web playground for readers to explore our final classification at https://umlcaxs-playground.streamlit.app.
The miniJPAS survey. Multiwavelength exploration of detected Extreme Emission Line Galaxies
Authors: Breda Iris , Amarantidis Stergios , Vilchez José M , Pérez-Montero Enrique , Kehrig Carolina , Iglesias-Páramo Jorge , Arroyo-Polonio Antonio , Fernández-Ontiveros Juan A , Delgado Rosa M González , Díaz-García Luis A , Abramo Raul , Alcaniz Jailson , Benítez Narciso , Bonoli Silvia , Cenarro Javier A , Cristóbal-Hornillos David , Dupke Renato , Ederoclite Alessandro , Hernán-Caballero Antonio , López-Sanjuan Carlos , Marín-Franch Antonio , de Oliveira Claudia Mendes , Moles Mariano , Sodré Laerte , Taylor Keith , Varela Jesús , Vázquez-Ramió Héctor
Published: January 2024

Extreme Emission Line Galaxies (EELGs) stand as remarkable objects due to their extremely metal poor environment and intense star formation. Considered as local analogues of high-redshift galaxies in the peak of their star-forming activity, they offer insights into conditions prevalent during the early Universe. Assessment of their stellar and gas properties is therefore of critical importance, which requires the assembly of a considerable sample, comprehending a broad redshift range. The Javalambre-Physics of the Accelerating Universe Astrophysical Survey (JPAS) plays a significant role in assembling such a sample, encompassing ∼8000 $\rm deg^2$ and employing 54 narrow-band optical filters. The present work describes the development and subsequent application of the tools that will be employed in the forthcoming JPAS spectrophotometric data, allowing for the massive and automated characterization of EELGs that are expected to be identified. This fully automated pipeline (requiring only the object coordinates from users) constructs Spectral Energy Distributions (SEDs) by retrieving virtually all the available multiwavelength photometric data archives, employs SED fitting tools, and identifies optical emission lines. It was applied to the sample of extreme line emitters identified in the miniJPAS Survey, and its derived physical properties such as stellar mass and age, coupled with fundamental relations, mirror results obtained through spectral modelling of SDSS spectra. Thorough testing using galaxies with documented photometric measurements across different wavelengths confirmed the pipeline’s accuracy, demonstrating its capability for automated analysis of sources with varying characteristics, spanning brightness, morphology, and redshifts. The modular nature of this pipeline facilitates any addition from the user.
Chandra/HETG Doppler velocity measurements in stellar coronal sources
Authors: Bozzo E , Huenemoerder D P , Falanga M , Paltani S , Costantini E , de Plaa J , Gu L
Published: January 2024

Stellar coronal sources have been observed in the past not only for their astrophysical interest in the field of binary system evolution and interaction but also for their invaluable roles as benchmarks for plasma spectral models and as calibration sources for high resolution spectroscopic X-ray instruments. These include the gratings on-board Chandra and XMM-Newton, as well as the new generation of high resolution capable-detectors recently flown on-board XRISM and planned for the future also onboard the Athena and the LEM missions. In our previous paper exploiting Chandra/HETG observations of the prototypical coronal source Capella, it has been shown that the centroid energies of the many X-ray emission lines detected in the spectrum of this object change as a function of time due to the Doppler modulation within the binary. This is an effect that needs to be corrected while performing calibrations of high-resolution X-ray instruments. In this paper, we extend our previous work on Capella to other known stellar coronal sources that have been observed with the Chandra/HETG (11 objects in total). We measure in several objects clear trends in the velocity shifts along the orbit of the primary star, meaning that in these sources one of the two star components is largely dominating the high energy emission. In a number of systems the trend in the velocity shift is not obvious. This can be ascribed to the fact that both stellar components contribute significantly to the X-ray emission.
The contribution of massive haloes to the matter power spectrum in the presence of AGN feedback
Authors: van Loon M L , van Daalen Marcel P
Published: January 2024

The clustering of matter, as measured by the matter power spectrum, informs us about cosmology, dark matter, and baryonic effects on the distribution of matter in the universe. Using cosmological hydrodynamical simulations from the cosmo-OWLS and BAHAMAS simulation projects, we investigate the contribution of power in haloes with various masses, to the full power spectrum, as well as the power ratio between baryonic and dark matter only (DMO) simulations for a matched (between simulations) and an unmatched set of haloes. We find that the presence of AGN feedback suppresses the power on all scales for haloes of all masses examined (1011.25 ≤ M500, crit ≤ $10^{14.75}\, \mathrm{M_\odot }/h$), by ejecting matter from within $r_{500,\mathrm{c}}\,$ to $r_{200,\mathrm{m}}\,$ and potentially beyond in massive haloes (M500, crit ≳ $10^{{13}}\, \mathrm{M_\odot }/h$), and likely impeding the growth of lower-mass haloes as a consequence. A lower AGN feedback temperature changes the behaviour of high-mass haloes (M500, crit ≥ $10^{{13.25}}\, \mathrm{M_\odot }/h$), damping the effects of AGN feedback at small scales, $k\, {{\gtrsim }}\, {{4}}\, h\mathrm{\, Mpc^{-1}}$. For $k\, {{\lesssim }}\, {{3}}\, h\mathrm{\, Mpc^{-1}}$, group-sized haloes ($10^{{14\pm 0.25}}\, \mathrm{M_\odot }/h$) dominate the power spectrum, while on smaller scales the combined contributions of lower-mass haloes to the full power spectrum rise above that of the group-sized haloes. Finally, we present a model for the power suppression due to feedback, which combines observed mean halo baryon fractions with halo mass fractions and halo-matter cross-spectra extracted from DMO simulations to predict the power suppression to per cent level accuracy down to $k\, {{\approx }}\, {{10}}\, h\mathrm{\, Mpc^{-1}}$ without any free parameters.
Long-term outcome of kidney function in patients with ANCA-associated vasculitis
Authors: Sanchez-Alamo Beatriz , Moi Laura , Bajema Ingeborg , Berden Annelies , Flossmann Oliver , Hruskova Zdenka , Jayne David , Wester-Trejo Maria , Wallquist Carin , Westman Kerstin
Published: January 2024

Background

Kidney involvement is common in anti-neutrophil cytoplasm antibody–associated vasculitis (AAV) and the prognosis is determined by the severity of kidney damage. This study focused on long-term kidney outcomes, defining possible risk factors and comparing the performance of three different histological classifications to predict outcomes for patients with AAV.

Methods

The dataset included 848 patients with newly diagnosed AAV who participated in seven randomized controlled trials (RCTs) (1995–2012). Follow-up information was obtained from questionnaires sent to the principal investigators of the original RCTs.

Results

The cumulative incidence of end-stage kidney disease (ESKD) at 5 and 10 years was 17% and 22%, respectively. Patients who developed ESKD had reduced patient survival compared with those with preserved kidney function (hazard ratio 2.8, P < .001). Comparing patients with AAV and kidney involvement with a matched general population, patients with AAV had poor survival outcomes, even in early stages of chronic kidney disease. The main cause of death was infection followed by cardiovascular disease in patients developing ESKD and malignancy in those who did not. Some 34% of patients with initial need for dialysis recovered kidney function after treatment. Thirty-five out of 175 in need of kidney replacement therapy (KRT) during follow-up received a kidney transplant with good outcome; there was 86% patient survival at 10 years.

In the subcohort of 214 patients with available kidney biopsies, three scoring systems were tested: the Berden classification, the Renal Risk Score and the Mayo Clinic Score. The scores highlighted the importance of normal glomeruli and severe glomerulosclerosis on kidney survival (P < .001 and P = .001, respectively). The Renal Risk Score demonstrated a moderate prediction of kidney survival (area under the curve 0.79; standard error 0.03, 95% confidence interval 0.71–0.83).

Conclusions

Early diagnosis of AAV is extremely important. Even milder forms of kidney involvement have an impact on the prognosis. Patients in need of KRT had the lowest survival rates, but kidney transplantation has shown favorable outcomes for eligible AAV patients. The three histologic scoring systems were all identified as independent prognostic factors for kidney outcome.
Psychometric Properties of the FTCD and Brief WISDM: Support for Validity in a Legal-System-Involved Sample
Authors: Bontemps Andrew P , Piper Megan E , Cropsey Karen L
Published: January 2024

Introduction

The Fagerström test for cigarette dependence (FTCD) and Brief Wisconsin index of smoking dependence motives (WISDM) are widely used measures of smoking dependence. The FTCD was previously found to have 1-factor and 2-factor structures and Brief WISDM has been found to have an 11-factor and 11-factor hierarchical structure. As such, the current study sought to further investigate the psychometric properties of the FTCD and Brief WISDM with a novel criminal-legal system-involved sample using both a factor-analytic and an item response theory (IRT) approach.

Aims and Methods

Data from 517 criminal-legal system-involved adults (ie, 18 years of age or older) who smoke from Alabama, USA were analyzed. Confirmatory factor analyses (CFA) were conducted on 1-factor and 2-factor structures of the FTCD and 1-factor, 11-factor, and 11-factor hierarchical structures of the Brief WISDM. IRT analyses investigating item discrimination and threshold parameters were also conducted on the brief WISDM.

Results

The CFA showed poor fit for a single-factor structure and mixed results for two 2-factor results for the FTCD. CFA also showed poor fit for a single-factor and mixed results for the 11-factor model. Initial IRT investigations using the 11-factor model showed strong item discrimination, but non-ordered threshold parameters.

Conclusions

Two-factor structures for the FTCD and the 11-factor model for the Brief WISDM were partially supported in a criminal-legal population, suggesting continued support for the multidimensional structure of the measures. Additionally, exploratory IRT analyses suggested good discrimination across the use spectrum for the Brief WISDM.

Implications

The Fagerström Test of Cigarette Dependence (FTCD) and Brief Wisconsin index of smoking dependence motives (WISDM) are two widely used measures of nicotine dependence, though previous research has shown mixed results for their internal consistency and factor structure. The current study used a unique sample of criminal-legal-involved participants who generally have moderate to high levels of nicotine dependence. The current study found that the FTCD displayed poor internal consistency, a poor fit for a single-factor model, but mixed support for two two-factor models. The Brief-WISDM was found to have strong internal consistency, a poor fit for a single-factor model, but mixed fit for an 11-factor model and good item discrimination.
Birds that breed exclusively on islands have smaller clutches
Authors: Jezierski Michał T
Published: January 2024

The “island syndrome” refers to similarity in the biology of island organisms, but its generality is questionable, as the scope of species and traits examined are often limited. Here, I show that birds breeding exclusively on islands (breeding island endemics) evolved smaller clutches, using a dataset of 4,530 bird species. Using an inclusive definition of a breeding island endemic, which also encompasses migratory species and seabirds, I examine the evolution of clutch sizes in island breeding species using phylogenetic generalized linear models. Across disparate phylogenetic hypotheses, and after accounting for biological and geographical co-variables, I show that breeding island endemic landbirds (470 species) evolved smaller clutch sizes than continental breeding species (3,818 species). I show that the evolution of clutch size follows the expectations of the island syndrome, as among breeding island endemic landbirds there is a positive relationship between clutch size and breeding range area. Finally, I reinforce the view that the island syndrome is a general pattern in birds, spanning diverse phylogenetic and ecological groups, by showing that in a seabird-only dataset (242 species), breeding island endemic seabirds show evolution of smaller clutch sizes. In a model of the full dataset of both landbirds and seabirds (4,530 species) there was no evidence of an interaction of being a seabird with breeding island endemicity, showing that seabirds and landbirds respond in the same way. This study, using more than 40% of all bird species, provides the first evidence of a general evolutionary response in a life history trait, clearly showing the island syndrome as a general evolutionary tendency associated with island environments.
Rural Decline and Spatial Voting Patterns
Authors: Lago Ignacio , Lago-Peñas Santiago
Published: January 2024

How does rural decline affect electoral politics? A well-known argument is that the growing geographical polarisation of populations between prospering major cities and declining hinterlands is emerging as a cleavage of electoral politics in developed countries. But prior work has focussed on specific outcomes of rural decline rather than examining whether the geographical distribution of political attitudes and behaviours within countries has become more uneven in the last decades. Using a measure of party nationalisation capturing spatial differences in electoral support across districts in OECD countries over the last 60 years, we find that a declining rural population increases differences in the geographical distribution of partisan support within countries. Nationalisation determines a party’s orientation toward distribution of public resources and support for region-specific interests.
Comparing planktonic heliozoan abundance in deep and shallow basins of Lake Biwa: exploring optimal growth temperature, food resources and habitat use
Authors: Yoshida Junya , Deb Soumya , Nakano Shin-ichi
Published: January 2024

Heliozoans are ambush protists that inhabit most limnetic systems. However, ecological information about planktonic heliozoans is still limited. In this study, we investigated seasonal changes in planktonic heliozoan abundance in the deep northern and shallow southern basins of Lake Biwa at pelagic stations between August 2020 and December 2021. We compared planktonic heliozoan abundance levels between the two basins and examined the relationship between heliozoan abundance and environmental variables. In both basins, high levels of planktonic heliozoan abundance were detected in autumn, winter and spring. In the south basin, there was a significant positive correlation between planktonic heliozoan abundance and chlorophyll a concentration as well as the abundance of the diatoms Aulacoseira granulata and Aulacoseira ambigua. These results suggest that planktonic heliozoans directly or indirectly consume diatoms and that heliozoan abundance is subjected to bottom-up control. Furthermore, planktonic heliozoan abundance in the south basin was higher than that in the north basin, possibly due to the presence of waterweeds, which can serve as habitat for heliozoans, and the redistribution of planktonic heliozoans through resuspension from lake bottom sediments.
Polyploid plants take cytonuclear perturbations in stride
Authors: Sloan Daniel B , Conover Justin L , Grover Corrinne E , Wendel Jonathan F , Sharbrough Joel
Published: January 2024

Hybridization in plants is often accompanied by nuclear genome doubling (allopolyploidy), which has been hypothesized to perturb interactions between nuclear and organellar (mitochondrial and plastid) genomes by creating imbalances in the relative copy number of these genomes and producing genetic incompatibilities between maternally derived organellar genomes and the half of the allopolyploid nuclear genome from the paternal progenitor. Several evolutionary responses have been predicted to ameliorate these effects, including selection for changes in protein sequences that restore cytonuclear interactions; biased gene retention/expression/conversion favoring maternal nuclear gene copies; and fine-tuning of relative cytonuclear genome copy numbers and expression levels. Numerous recent studies, however, have found that evolutionary responses are inconsistent and rarely scale to genome-wide generalities. The apparent robustness of plant cytonuclear interactions to allopolyploidy may reflect features that are general to allopolyploids such as the lack of F2 hybrid breakdown under disomic inheritance, and others that are more plant-specific, including slow sequence divergence in organellar genomes and preexisting regulatory responses to changes in cell size and endopolyploidy during development. Thus, cytonuclear interactions may only rarely act as the main barrier to establishment of allopolyploid lineages, perhaps helping to explain why allopolyploidy is so pervasive in plant evolution.
Ectopic assembly of an auxin efflux control machinery shifts developmental trajectories
Authors: Aliaga Fandino Ana Cecilia , Jelínková Adriana , Marhava Petra , Petrášek Jan , Hardtke Christian S
Published: January 2024

Polar auxin transport in the Arabidopsis (Arabidopsis thaliana) root tip maintains high auxin levels around the stem cell niche that gradually decrease in dividing cells but increase again once they transition toward differentiation. Protophloem differentiates earlier than other proximal tissues and employs a unique auxin “canalization” machinery that is thought to balance auxin efflux with retention. It consists of a proposed activator of PIN-FORMED (PIN) auxin efflux carriers, the cAMP-, cGMP- and Calcium-dependent (AGC) kinase PROTEIN KINASE ASSOCIATED WITH BRX (PAX); its inhibitor, BREVIS RADIX (BRX); and PHOSPHATIDYLINOSITOL-4-PHOSPHATE-5-KINASE (PIP5K) enzymes, which promote polar PAX and BRX localization. Because of a dynamic PAX–BRX–PIP5K interplay, the net cellular output of this machinery remains unclear. In this study, we deciphered the dosage-sensitive regulatory interactions among PAX, BRX, and PIP5K by their ectopic expression in developing xylem vessels. The data suggest that the dominant collective output of the PAX–BRX–PIP5K module is a localized reduction in PIN abundance. This requires PAX-stimulated clathrin-mediated PIN endocytosis upon site-specific phosphorylation, which distinguishes PAX from other AGC kinases. An ectopic assembly of the PAX–BRX–PIP5K module is sufficient to cause cellular auxin retention and affects root growth vigor by accelerating the trajectory of xylem vessel development. Our data thus provide direct evidence that local manipulation of auxin efflux alters the timing of cellular differentiation in the root.
ETHYLENE RESPONSE FACTOR 070 inhibits flowering in Pak-choi by indirectly impairing BcLEAFY expression
Authors: Yu Zhanghong , Chen Xiaoshan , Li Yan , Shah Sayyed Hamad Ahmad , Xiao Dong , Wang Jianjun , Hou Xilin , Liu Tongkun , Li Ying
Published: January 2024

APETALA2/ethylene responsive factors respond to ethylene and participate in many biological and physiological processes, such as plant morphogenesis, stress resistance, and hormone signal transduction. Ethylene responsive factor 070 (BcERF070) is important in flowering. However, the underlying molecular mechanisms of BcERF070 in floral transition in response to ethylene signaling have not been fully characterized. Herein, we explored the function of BcERF070 in Pak-choi [Brassica campestris (syn. Brassica rapa) ssp. chinensis]. Ethylene treatment induced BcERF070 expression and delayed flowering in Pak-choi. Silencing of BcERF070 induced flowering in Pak-choi. BcERF070 interacted with major latex protein-like 328 (BcMLP328), which forms a complex with helix-loop-helix protein 30 (BcbHLH30) to enhance the transcriptional activity of BcbHLH30 on LEAFY (BcLFY), ultimately promoting flowering. However, BcERF070 impaired the BcMLP328–BcbHLH30 complex activation of LEAFY (BcLFY), ultimately inhibiting flowering in Pak-choi. BcERF070 directly promoted the expression of the flowering inhibitor gene B-box 29 (BcBBX29) and delayed flowering by reducing FLOWERING LOCUS T (BcFT) expression. These results suggest that BcERF070 mediates ethylene-reduced flowering by impairing the BcMLP328–BcbHLH30 complex activation of BcLFY and by directly promoting the gene expression of the flowering inhibition factor BcBBX29 to repress BcFT expression. The findings contribute to understanding the molecular mechanisms underlying floral transition in response to ethylene in plants.
Stability in Large Markets
Authors: Jagadeesan Ravi , Vocke Karolina
Published: January 2024

In matching models, pairwise-stable outcomes do not generally exist without substantial restrictions on both preferences and the topology of the network of contracts. We address the foundations of matching markets by developing a matching model with a continuum of agents that allows for arbitrary preferences and network structures. We show that pairwise-stable outcomes are guaranteed to exist. When agents can interact with multiple other counterparties, pairwise stability is too weak of a solution concept, and we argue that a refinement of it called tree stability is the most appropriate solution concept in this setting. Our main results show that tree-stable outcomes exist for arbitrary preferences and network topologies.
Holding Period Effects in Dividend Strip Returns
Authors: Golez Benjamin , Jackwerth Jens
Published: January 2024

We estimate short-term dividend strip prices from 27 years of S&P 500 index options data (1996-2022). We use option-implied interest rates when estimating strip prices and longer holding period returns to mitigate measurement error. We find that Sharpe ratios for short-term strips are similar to or higher than Sharpe ratios for the market. Short-term strips also have a low market beta and a positive alpha. Over the business cycle, realized term premiums (ie, the difference between market and strip returns) and the term structure of Sharpe ratios move countercyclically, whereas the term structure of alphas moves procyclically.
The Centenary of the Leprosy Relief Association (Lepra)—a moment for celebration and reflection
Authors: Allen Irene , Lockwood Diana N , Hay Roderick J
Published: January 2024

The year 2024 is the Centenary of the foundation of the Leprosy Relief Association (Lepra), formerly the British Empire Leprosy Relief Association (BELRA). The name of the organization changed to the LEProsy Relief Association (LEPRA) in 1976 but has been known as Lepra since 2008. Over the years it has worked closely with members and office holders of the Royal Society of Tropical Medicine and Hygiene. Its work has encompassed activities from the earliest initiatives to ensure appropriate living conditions for those with the disease to the development of leprosy chemotherapy. However, this has now evolved into a strong partnership between the UK- and India-based Lepra hubs, which are carrying out research and public health initiatives ranging from elimination of prejudice against those with leprosy to adopting the recently launched WHO programme for skin NTDs to facilitate integrated control and management regimens. The fight against leprosy has always been a partnership between a wide variety of disease-specific NGOs, health-care workers and international health agencies. The story of Lepra illustrates the central role of these partnerships and national as well as international collaboration.
Unilateral periocular spasm
Authors: Walker Clay
Published: January 2024

Hemifacial spasm is an uncontrollable, recurrent facial muscular contraction that typically occurs on one side of the face, cannot be suppressed, and can last the entire day and during sleep. The most common underlying cause of facial nerve compression is an enlarged or abnormal tracking blood vessel at the brainstem level. Clinical diagnoses are frequently based on a patient's medical history and physical examination. Before deciding on a course of action, however, an electromyogram and MRI are performed to determine the underlying cause. Due to its high effectiveness (success rates of 85% to 95%) and low frequency of adverse reactions, botulinum toxin is the preferred therapy for hemifacial spasm and can provide transient symptomatic alleviation. Surgical microvascular decompression is a therapeutic approach that targets the underlying cause of this condition and has an average success rate of 85%.
The weapons of mass destruction-civil support team PA
Authors: Radi Joshua K. , Dent Robert A. , Allen Cesar A. , Anderson Jeffrey A. , Atkins John B. , Kozlik John
Published: January 2024

The weapons of mass destruction-civil support team (WMD-CST) physician associate/assistant (PA) is an autonomous PA who balances military and civilian roles to achieve mission success and support the safety of the US public. This article by multiple WMD-CST PAs across the nation describes the WMD-CST PA profession and how traditional PA roles continue to advance.
Which patients with COPD need an inhaled corticosteroid?
Authors: Boylan Paul M.
Published: January 2024

Inhaled bronchodilators are recommended to treat patients with any category of chronic obstructive pulmonary disease (COPD). Clinical practice guidelines conditionally recommend inhaled corticosteroids (ICS) for patients with eosinophilic COPD phenotypes, patients who experience hospitalizations for or frequent severe exacerbations of COPD, and patients with comorbid asthma. This article outlines which patients with COPD may benefit from an ICS.
Improving the Timing of Acute Care Insulin Delivery
Authors: Cohen Sara , Clark Rebecca R. S.
Published: January 2024

Local problem:

Variations in nursing practice were observed across our hospital, a 520-bed acute care teaching facility in the northeast United States, regarding the timing and frequency of insulin administration in adult patients with diabetes. Chart audits noted that RNs administered insulin more than one hour after blood glucose results were obtained 97% of the time. In addition, insulin was given at bedtime only 37% of the time.

Purpose:

The purpose of this quality improvement (QI) project was to improve the care of inpatients requiring insulin by implementing protocols and adjusting practice to align with best practice recommendations.

Methods:

The clinical nurse education specialist met with a team of staff nurses, providers, nurse leaders, and patient care technicians (PCTs) to formulate protocols and design interventions to ensure improvements in the quality of care for inpatients with diabetes. A sequence of education sessions and an online learning module were developed and assigned to nurses and PCTs to address knowledge gaps, specifically in the pharmacodynamics and safe administration of insulin, as well as how best to provide care to patients with diabetes. Monthly adherence data were disseminated to nurse leaders and educators and reviewed with clinical staff at daily safety huddles and staff meetings. Additional interventions to enhance nursing practice in caring for patients with diabetes included ensuring both bedtime insulin administration and timely insulin delivery. This project began in May 2017 and ended five years later.

Results:

Two weeks after initial education sessions began in May and June 2017, the frequency of giving bedtime insulin based on the order set and according to the patient's blood glucose levels rose from 37% to 82%, and adherence to best practice protocols continued until final chart audits were performed in May 2022. The frequency of giving insulin less than one hour after obtaining blood glucose results improved from 3% to 64% between October and December 2019, and increased to a sustained level above the project's 92% goal two years later.

Conclusion:

Protocol development, targeted education, and audits with feedback led to improved care delivery for patients requiring insulin and increased nursing confidence.
Direct Gloving May Improve Adherence to Infection Prevention Practices
Authors: Rosenberg Karen
Published: January 2024

According to this study:
Automated Insulin Delivery Improves Glucose Control in Pregnancy Complicated by Type 1 Diabetes
Authors: Rosenberg Karen
Published: January 2024

According to this study:
Strength Training Is Beneficial for Knee Health
Authors: Rosenberg Karen
Published: January 2024

According to this study:
Heparin for Women With Recurrent Miscarriage and Inherited Thrombophilia (ALIFE2): An International Open-Label, Randomised Controlled Trial
Authors: Quenby Siobhan , Booth Katie , Hiller Louise , Coomarasamy Arri , de Jong Paulien G. , Hamulyák Eva N. , Scheres Luuk J. , van Haaps Thijs F. , Ewington Lauren , Tewary Shreeya , Goddijn Mariëtte , Middeldorp Saskia
Published: January 2024

(Abstracted from Lancet 2023;402:54–61)

Inherited thrombophilia is implicated as a cause of recurrent pregnancy loss, defined as the loss of 2 or more pregnancies. Heparin is the standard treatment for acquired thrombophilia but is not recommended in cases of recurrent pregnancy loss and inherited thrombophilia.
Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage
Authors: Gallos I. , Devall A. , Martin J. , Middleton L. , Beeson L. , Galadanci H. , Al-beity F. Alwy , Qureshi Z. , Hofmeyr G.J. , Moran N. , Fawcus S. , Sheikh L. , Gwako G. , Osoti A. , Aswat A. , Mammoliti K.-M. , Sindhu K. N. , Podesek M. , Horne I. , Timms R. , Yunas I. , Okore J. , Singata-Madliki M. , Arends E. , Wakili A. A. , Mwampashi A. , Nausheen S. , Muhammad S. , Latthe P. , Evans C. , Akter S. , Forbes G. , Lissauer D. , Meher S. , Weeks A. , Shennan A. , Ammerdorffer A. , Williams E. , Roberts T. , Widmer M. , Oladapo O. T. , Lorencatto F. , Bohren M. A. , Miller S. , Althabe F. , Gülmezoglu M. , Smith J. M. , Hemming K. , Coomarasamy A.
Published: January 2024

(Abstracted from N Engl J Med 2023;389:11–21)

Postpartum hemorrhage (PPH) is a serious complication of childbirth, and delays in diagnosis and treatment can cause major complications or fatalities. One method of early detection is a blood-collection drape, possibly in conjunction with other tests and treatments.
Maternal and Neonatal Complications Following Kielland's Rotational Forceps Delivery: A Systematic Review and Meta-analysis
Authors: Giacchino Tara , Karkia Rebecca , Ahmed Hasib , Akolekar Ranjit
Published: January 2024

(Abstracted from BJOG 2023;130:856–864)

Fetal malposition as labor advances can contribute to many risks and adverse outcomes. One method of management is Kielland rotational forceps delivery (KRFD); previous research has yielded conflicting evidence about the safety and effectiveness of KRFD compared with other delivery methods.
Long-Term Neurological Morbidity Among Children Delivered by Vacuum Extraction—A National Cohort Study
Authors: Ulfsdottir Hanna , Ekéus Cecilia , Tedroff Kristina , Åberg Katarina , Järnbert-Pettersson Hans
Published: January 2024

(Abstracted from Acta Obstet Gynecol Scand 2023;102:843–853)

Many factors during pregnancy and childbirth influence long term neurological outcomes, but some controllable factors have not been studied extensively; one of these factors is vacuum extraction (VE) as a method of assisted childbirth. This study was designed as the first nationwide cohort study examining VE and its impact on long-term neurological morbidity, and its aim was to assess the risks of neonatal mortality, cerebral palsy (CP), and epilepsy in children delivered by VE.
Trends in State-Level Maternal Mortality by Racial and Ethnic Group in the United States
Authors: Fleszar Laura G. , Bryant Allison S. , Johnson Catherine O. , Blacker Brigette F. , ARavkin Aleksandr , Baumann Mathew , Dwyer-Lindgren Laura , Kelly Yekaterina O. , Maass Kelsey , Zheng Peng , Roth Gregory A.
Published: January 2024

(Abstracted from JAMA 2023;330(1):52–61)

Recent evidence shows that maternal mortality is higher in the United States than any high-income country and that it is increasing. Previous research on this topic has been limited by inconsistent terminology, definitions, and methods.
Cervical Pessary for Prevention of Preterm Birth in Individuals With a Short Cervix: The TOPS Randomized Clinical Trial
Authors: Hoffman Matthew K. , Clifton Rebecca G. , Biggio Joseph R. , Saade George R. , Ugwu Lynda G. , Longo Monica , Bousleiman Sabine Z. , Clark Kelly , Grobman William A. , Frey Heather A. , Chauhan Suneet P. , Dugoff Lorraine , Manuck Tracy A. , Chien Edward K. , Rouse Dwight J. , Simhan Hyagriv N. , Esplin M. Sean , Macones George A.
Published: January 2024

(Abstracted from JAMA 2023;330(4):340–348)

Preterm delivery remains a public health issue, affecting many pregnant patients and their infants each year. There are a number of causes and associations with preterm delivery, with some that are identifiable and treatable and some that are not; one association that has been well established is the connection between preterm birth (PTB) and a short cervix.
Primary Human Papillomavirus Testing and Other New Technologies for Cervical Cancer Screening
Authors: Einstein Mark H. , Zhou Nancy , Gabor Lisa , Sahasrabuddhe Vikrant V.
Published: January 2024

(Abstracted from Obstet Gynecol 2023;142(5):1036–1043)

Cervical cancer screening has saved millions of lives over the past 7 decades. Never-screened or underscreened women currently account for more than half of all cervical cancer cases in the United States.
Cost-of-illness and Economic Evaluation of Interventions in Children and Adolescents with Chronic Pain
Authors: Kitschen Anne , Wahidie Diana , Meyer Dorothee , Rau Lisa-Marie , Ruhe Ann-Kristin , Wager Julia , Zernikow Boris , Sauerland Dirk
Published: January 2024

Objectives:

Chronic pain in children and adolescents (CPCA) is widespread with an increasing prevalence. It is associated with a decreased quality of life and an increased parental work loss. Accordingly, CPCA may pose a substantial economic burden for patients, healthcare payers, and society. Therefore, this systematic review aims to synthesize (1) the results of existing cost-of-illness studies (COIs) for CPCA and (2) the evidence of economic evaluations (EEs) of interventions for CPCA.

Methods:

The systematic literature search was conducted in EMBASE, MEDLINE, PsycINFO, NHS EED, and HTA Database until February 2023. Title, abstract and full-text screening were conducted by two researchers. Original articles reporting costs related to CPCA published in English or German were included. Study characteristics, cost components, and costs were extracted. The quality of studies was assessed using standardized tools. All costs were adjusted to 2020 purchasing power parity US dollars (PPP-USD).

Results:

Fifteen COIs and 10 EEs were included. Mean annual direct costs of CPCA ranged from PPP-USD 603 to PPP-USD 16,271, with outpatient services accounting for the largest share. Mean annual indirect costs ranged from PPP-USD 92 to PPP-USD 12,721. All EEs reported a decrease of overall costs in treated patients.

Discussion:

The methodology across studies was heterogeneous limiting the comparability. However, it is to conclude that CPCA is associated with high overall costs, which were reduced in all EEs. From a health economic perspective, efforts should address the prevention and early detection of CPCA followed by a specialized pain treatment.
Mucin-1–Targeted Chimeric Antigen Receptor T Cells Are Effective and Safe in Controlling Solid Tumors in Immunocompetent Host
Authors: Zhou Ru , Wu Shu-ta , Yazdanifar Mahboubeh , Williams Chandra , Sanders Alexa , Brouwer Cory , Maher John , Mukherjee Pinku
Published: January 2024

The chimeric antigen receptor (CAR) T-cell therapy in solid epithelial tumors has been explored, however, with limited success. As much of the preclinical work has relied on xenograft models in immunocompromised animals, the immune-related efficacies and toxicities may have been missed. In this study, we engineered syngeneic murine CAR T cells targeting the tumor form of human mucin-1 (tMUC1) and tested the MUC1 CAR T cells' efficacy and toxicity in the immunocompetent human MUC1-expressing mouse models. The MUC1 CAR T cells significantly eliminated murine pancreatic and breast cancer cell lines in vitro. In vivo, MUC1 CAR T cells significantly slowed the mammary gland tumor progression in the spontaneous PyVMT×MUC1.Tg (MMT) mice, prevented lung metastasis, and prolonged survival. Most importantly, there was minimal short or long-term toxicity with acceptable levels of transient liver toxicity but no kidney toxicity. In addition, the mice did not show any signs of weight loss or other behavioral changes with the treatment. We also report that a single dose of MUC1 CAR T-cell treatment modestly reduced the pancreatic tumor burden in a syngeneic orthotopic model of pancreatic ductal adenocarcinoma given at late stage of an established tumor. Taken together, these findings suggested the further development of tMUC1-targeted CAR T cells as an effective and relatively safe treatment modality for various tMUC1-expressing solid tumors.
The Effect of Endotracheal Suctioning on Pain in Conscious Adult Patients in Intensive Care Unit
Authors: Gulsoy Zuhal , Ozdemir Kol Iclal
Published: January 2024

Background and Purpose

Pain assessment and management are an important issue to ensure the comfort of patients in the intensive care unit, and reducing pain is an important nursing intervention. Therefore, it is important to evaluate pain correctly. For correct pain management, it is necessary to correctly determine the presence and severity of pain. The study was conducted to determine whether endotracheal suctioning was painless and whether the Behavioral Pain Scale (BPS) was an accurate assessment tool to assess pain during endotracheal suctioning.

Methods

This study is a prospective clinical study. Thirty-two patients were endotracheal suctioned using the same technique by the same person, and their before-procedure BPS and visual analog scale (VAS) scores were recorded. The study was conducted in the anesthesia and reanimation intensive care unit of a university hospital between December 12, 2020, and April 14, 2021.

Results

The before-procedure BPS and VAS scores indicated no pain. There was an increase in the procedure BPS score, whereas the VAS score did not change.

Conclusions

Endotracheal suctioning did not cause pain in conscious patients when the procedure was performed with the correct catheter in accordance with the guideline. In addition, it can be said that BPS is not sufficient to evaluate pain, but the reason for its high level is because endotracheal suctioning is an uncomfortable procedure. Of course, more studies and further studies are needed for a clear result.

It is important for health care professionals to relieve or reduce the pain of patients during the endotracheal aspiration procedure. In addition, the presence and severity of pain associated with the endotracheal aspiration procedure should be accurately measured. This study is registered in ClinicalTrials.gov with the IDNCT04634474.

The data that support the findings of this study are available from the corresponding author upon reasonable request.
The Relationship Between the Humor Styles of Nurses and Psychological Well-Being During the COVID-19 Pandemic Period
Authors: Kantarci Bahar , Kaya Soylu Fadime
Published: January 2024

Background

The previous studies have revealed that the psychological state of nurses, who work in the front line, is negatively affected by the situations that created high pressure such as epidemics and disasters in the past.

Objectives

The aim of the study was to determine some characteristics that affect nurses' humor styles and psychological well-being during the COVID-19 pandemic period, and to determine the relationship between humor styles and psychological well-being.

Method

The research was conducted in a cross-sectional study. The sample of the study consists of 260 nurses from a city in eastern Turkey. The data have been collected by using a personal information form, the Humor Styles Scale, and the Psychological Well-Being Scale in the study. Frequency, arithmetic mean, minimum and maximum, correlation analysis t test in the independent groups, 1-way analysis of variance, Mann-Whitney U test, and Kruskal-Wallis test have been used in the analysis of the data. This study aligns with the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

Results

It is determined that the mean age of the nurses is 28.35 ± 6.19 years, and the age range is between 20 and 47 years. It is determined that there is a statistically significant positive relationship between “self-improving humor” and “participatory humor,” which are among the harmonious/positive humor styles of the nurses, and the total Psychological Well-Being Scale score (P < .05). It is determined that there is a statistically significant negative relationship between “aggressive humor,” which is one of the inharmonious/negative humor styles, and the total Psychological Well-Being Scale score (P < .05).

Discussion

The results support that nurses' use of self-enhancing and participatory humor contributes to psychological well-being.
Aortic Regurgitation
Authors: El Hussein Mohamed Toufic , Job Dona , Hakkola Jonah
Published: January 2024

Aortic regurgitation (AR) is a valvular disease characterized by retrograde blood flow from the aorta to the left ventricle. Various etiologies result in either an acute or chronic clinical presentation of AR and affect the severity of disease progression. Acute AR is a medical emergency caused by sudden increases in left ventricular volume. Immediate surgical intervention, vasoactive agents, and antibiotics are crucial for management. Chronic AR progresses gradually, leading to heart failure symptoms due to left ventricular remodeling. Diagnoses of both acute and chronic AR rely on electrocardiography, chest radiographs, and echocardiography. Cardiac magnetic resonance imaging may be incorporated in chronic AR diagnosis. Medical management of chronic AR aims to control hypertension and delay left ventricular dysfunction. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and potentially calcium-channel blockers are recommended for chronic AR. β-Blockers are cautioned against because of their potential negative effects. This article emphasizes the importance of early diagnosis and prompt surgical intervention in AR. This review provides a comprehensive overview of the pathophysiology and clinical manifestations of acute and chronic AR and a medication regimen for treating chronic AR in the adult population.
Does hormone therapy exacerbate other venous thromboembolism risk factors?
Authors: Porterfield Laura , Davis John W. , Weller Susan C. , Chen Lu , Wilkinson Gregg
Published: January 2024

Objective

Postmenopausal symptoms in women at higher risk for venous thromboembolism (VTE) due to comorbidities are often undertreated because of concerns that hormone therapy (HT) may increase VTE risk; however, it is unclear how much HT impacts risk of VTE when compared with other risk factors.

Methods

This is a case-control study in a commercial claims database from 2007 to 2019. Women aged 50 to 64 years (n = 223,949) were classified as cases if they had an International Classification of Diseases code indicating an acute VTE plus a filled prescription for an anticoagulant, placement of intravascular vena cava filter, or death within 30 days of diagnosis. Controls were matched 10:1 to each case by index date and age. Risk factors and comorbidities present within the year before index were examined. Exposure was defined as a HT prescription within 60 days before index.

Results

There were 20,359 VTE cases and 203,590 matched controls. A conditional logistic regression indicated that the greatest risks for VTE were from metastatic cancer (odds ratio [OR], 13.66; 95% CI, 12.64-14.75), hospitalization/surgery (OR, 8.51; 95% CI, 8.09-8.96), trauma (OR, 3.52; 95% CI, 3.32-3.73), comorbidity burden (OR, 3.51; 95% CI, 3.34-3.69), history of hypercoagulable condition (OR, 3.10; 95% CI, 2.87-3.36), and varicose veins (OR, 2.87; 95% CI, 2.56-3.22). Regarding hormone exposure, we observed ORs of 1.51 (95% CI, 1.43-1.60) for any recent hormone exposure; 1.13 (95% CI, 1.04-1.23; number needed to harm, 4,274) for unopposed estrogen menopausal HT; 1.23 (95% CI, 1.10-1.38; number needed to harm, 2,440) for combined menopausal HT; and 5.22 (95% CI, 4.67-5.84) for combined hormonal contraceptives compared with no recent HT exposure.

Conclusions

Hormone therapy exposure did not appear to adversely influence other risk factors, and exposure generally played a minor role in VTE risk. Contraceptives, however, were a strong risk factor.