bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of artificial intelligence–based clinical decision support system’s performance in reducing the fine needle aspiration rate of thyroid nodules: A pilot study
Authors: Barnes Amy , White Rebecca , Venables Heather , Lam Vincent , Vaidhyanath Ram
Published: December 2024

Introduction:

This pilot study aims to evaluate the clinical impact of artificial intelligence–based decision support, Koios Decision Support™, on the diagnostic performance of ultrasound assessment of thyroid nodules, and as a result to avoid fine needle aspiration.

Methods:

This retrospective pilot study was conducted on ultrasound images of thyroid nodules investigated with fine needle aspiration from January 2022 to December 2022. Orthogonal ultrasound images of thyroid nodules, previously investigated with fine needle aspiration, were compared with the Koios Decision Support™ suggestion to perform fine needle aspiration. Surgical histology was used as ground truth.

Results:

A total of 29 patients (76% women) with a mean age of 48 ± 16.5 years were evaluated, n = 15 (52%) were histologically proven benign and n = 14 (48%) were malignant. In the benign group, Koios Decision Support™ suggested avoidable fine needle aspiration in n = 8 (53%). In the malignant group, Koios Decision Support™ suggested follow-up or no fine needle aspiration in n = 2 (14%). Sensitivity is 85.7% ( n = 12) ( p = 0.027), whereas specificity is 53.3% ( n = 8) ( p = 0.027). The positive predictive value is 63.2% ( n = 12), negative predictive value is 80% ( n = 8), false-negative value is 20% ( n = 2) and false-positive value is 36.8% ( n = 7). Based on artificial intelligence decision, one cancer would have been missed.

Conclusion:

Artificial intelligence can improve specificity without significantly compromising sensitivity. There was a suggested reduction in the fine needle aspiration rate, in the histologically proven benign nodules, by 53%. This had no statistical significance, likely due to the small population, however, it is thought to be the largest study to date. Further investigation with wider-ranging studies is suggested.
EXPRESS: Exploring the role of visual similarity in parafoveal processing: Insights from the Flanking Letter Lexical Decision Task.
Authors: BROSSETTE Brice , LETE BERNARD
Published: December 2024

This study explores the impact of visually similar flanking stimuli on central target words using the Flanking Letter Lexical Decision (FLLD) task. Specifically, we investigated whether visual similarity effects can explain orthographic relatedness effects observed in previous FLLD tasks. By employing non-reversal mirror letters as visual flankers, we compared their influence on response times to traditional orthographic-related and orthographic-unrelated conditions. Results confirmed the known facilitative effect of orthographic-related flankers on response times (ROCK ROCK ROCK). However, mirror-related conditions showed no facilitative effect (ROCK ROCK ROCK), as evidenced by a Bayesian analysis indicating no significant differences between mirror-related and mirror-unrelated (STEP ROCK STEP). These findings suggest that low-level visual information in the parafovea does not contribute to the processing of the foveal word in tasks requiring specific word identification. The study concludes that only parafoveal information with relevant linguistic content is spatially pooled across target and flankers during word identification tasks. This research highlights the need to consider task-specific attentional demands and the linguistic relevance of parafoveal information in understanding visual and orthographic processing in reading.
Next-generation immunotherapy: igniting new hope for lung cancer
Authors: Li Molly S. C. , Chan Andrew L. S. , Mok Kevin K. S. , Chan Landon L. , Mok Tony S. K.
Published: December 2024

Adoption of immunotherapy has completely transformed the treatment landscape of cancer. Patients with advanced cancer treated with immunotherapy may benefit from durable tumor response and long-term survival. The most widely used immunotherapy in solid tumors is anti-programmed-death (ligand) protein (PD-(L)1), which is now an integral part of non-small cell lung cancer (NSCLC) treatment irrespective of histological cell types and tumor stage. However, the vast majority of patients with advanced NSCLC treated with anti-PD-(L)1 still develop therapeutic resistance, and the prognosis after anti-PD-(L)1 resistance is poor. Resistance mechanisms to PD-1 blockade are often complex and encompass a combination of defects within the cancer-immunity cycle. These defects include failure in antigen presentation and T-cell priming, presence of co-inhibitory immune checkpoints, inability of immune cells to infiltrate the tumor, and presence of immunosuppressive tumor microenvironment. Recently, advances in drug design, genomic sequencing, and gene editing technologies have led to development of next-generation immunotherapies that may potentially overcome these resistance mechanisms. In this review, we will discuss the anti-PD-(L)1 resistance mechanism landscape in NSCLC and four novel modalities of immunotherapy in detail, namely novel immune checkpoint inhibitor and targeted therapy combinations, bispecific antibodies, cancer vaccine, and cell therapy. These novel therapeutics have all demonstrated early clinical data in NSCLC treatment and may work synergistically with each other to restore anticancer immunity. In addition, we share our perspectives on the future promises and challenges in the transformation of these novel immunotherapies to standard clinical care.
Patient perspectives on treatment-related toxicities and therapeutic drug monitoring with tyrosine kinase inhibitors for the treatment of non-small-cell lung cancer
Authors: Gulikers Judith , Bruinsma Jeroen , Schoenmaekers Janna , Dursun Safiye , Tjan-Heijnen Vivianne , van Geel Robin , Croes Sander , Hendriks Lizza
Published: December 2024

Background:

Tyrosine kinase inhibitors (TKIs) have significantly improved treatment-related outcomes of patients with oncogene-driven non-small-cell lung cancer (NSCLC). TKIs are usually well tolerated and used for a prolonged time, although experienced toxicity varies between patients. It is unclear whether patients report all (low grade) toxicities and how these impact their daily lives. The use of therapeutic drug monitoring (TDM) to, for example, manage toxicities is increasingly applied, but there is limited insight into the patient perspective regarding TDM. This qualitative study aims to explore patient perspectives on TKI toxicity and TDM.

Methods:

Five semi-structured focus group interviews were held, each with three to four patients with NSCLC using a TKI and their (care) partners. Two researchers independently performed a directive content analysis.

Results:

In total, 16 patients and 12 (care) partners participated. Experienced treatment-related toxicities were encountered limitedly and patients felt no boundaries discussing these with their treatment team. However, symptoms were sometimes not reported as they were doubted as treatment related. The concept of TDM-guided dosing to, for example, reduce TKI exposure to account for dosing outside the therapeutic window resulted in feelings of uncertainty regarding treatment efficacy. Patients emphasized the need for thorough research and frequent check-ups to ensure treatment efficacy.

Conclusion:

Perceived TKI-related toxicities seem limited, although the treatment team should pay attention to symptoms not directly described by patients as treatment related. In general, patients are open to implement TDM-guided dosing, but only if thorough scientific evidence demonstrates retained or enhanced safety and efficacy.
Clozapine/norclozapine plasma level ratio and cognitive functioning in patients with schizophrenia spectrum disorders: a systematic review
Authors: Moscou Timo T. , Veerman Selene R. T.
Published: December 2024

Background:

Extant research on cognitive functioning in treatment-resistant schizophrenia (TRS) is limited and of poor quality. Cognitive impairments in patients with schizophrenia spectrum disorders (SSD) significantly influence quality of life. In patients with TRS, clozapine (CLO) is not consistently associated with improved cognitive functioning. The active metabolite n-desmethylclozapine (norclozapine (NCLO)) potentially exerts procognitive effects due to cholinergic and glutamatergic activity. Unfortunately, research on CLO/NCLO ratio and cognitive functioning is even more scarce.

Objectives:

To review the literature on the effect of the CLO/NCLO ratio on cognitive functioning in patients with SSD.

Design:

This is a systematic review.

A search was carried out in the electronic databases Embase, PsycINFO, PubMed, Cochrane and the Cochrane Controlled Register of Trials with no restrictions in language or publication year.

Results:

We identified 15 relevant studies (longitudinal, k = 4; cross-sectional, k = 11). The study population consisted of adult clozapine users ( n = 953) with varying degrees of treatment resistance. Specific cognitive domains and overall cognitive functioning were assessed using various neuropsychological tests and a composite score, respectively. Eleven studies were considered of fair quality (longitudinal: k = 2, cross-sectional: k = 9). In one longitudinal study, a negative causal relationship was found between the CLO/NCLO ratio and attention/vigilance and a negative correlation between social cognition and the composite score ( n = 11). No significant correlations were found between the CLO/NCLO ratio and the cognitive domains processing speed, reasoning/problem solving, or for working memory ( k = 1, n = 11), verbal learning ( k = 1, n = 43) or visual learning ( k = 2, n = 54). Study designs and populations were heterogeneous, and the analysis of confounding factors was limited and inconsistent.

Conclusion:

Clinical evidence is too scarce to support the hypothesis of a procognitive effect of NCLO. Personalised CLO treatment by modulating the CLO/NCLO ratio remains a distant prospect. Recommendations for future CLO research and anticipated limitations are discussed.

Trial registration:

This systematic review was preregistered with PROSPERO (CRD42023385244).
HIV preexposure prophylaxis and postexposure prophylaxis in women: a comprehensive guide for healthcare providers
Authors: Vora Niam , Badowski Melissa E.
Published: December 2024

Great disparities and inequities in the delivery and acceptance of human immunodeficiency virus (HIV) prevention exist globally among women. Various barriers, such as societal stigma, low perceived risk, relationship dynamics, and lack of education on routes of HIV transmission can cause low utilization in HIV preexposure prophylaxis (PrEP) adoption and use. In addition, socioeconomic and structural factors, such as financial burden, lack of provider knowledge and willingness to prescribe, absence of insurance coverage, and limited access to healthcare services are additional barriers to PrEP use among cisgender women. The goal of this review is to highlight current and prospective PrEP options, attitudes, and views of PrEP use among cisgender women and healthcare providers, and the role of PrEP in special populations of cisgender women.
Where is the Global South? Northern Visibilities in Digital Activism Research
Authors: Özkula Suay M. , Reilly Paul J.
Published: December 2024

The seemingly global nature of English-language hashtags often obscures activism from outside the Global North (GN). This systematic review explores geographic representation in this field ( N = 315 articles) through an investigation of case study location, author affiliation, methods of data collection and analysis, and researched social media platforms. The results show a preponderance of GN/Majority cases and non-region-specific social media groupings such as hashtag publics, particularly in research employing digital methods. As such, extant research in the field has disproportionately produced what we term Northern Visibilities—groups and movements based in GN countries (above all the United States) and platforms popular within them. We use the findings of the review to critically interrogate notions of the Global South in digital social research and provide recommendations for rectifying geopolitical underrepresentation and promoting more inclusive research practice.
The Threshold Effects of National Governance Quality on the Earnings Management – Performance Nexus: Evidence From Dynamic Panel Threshold Regression
Authors: Mensah Emmanuel , Boachie Christopher
Published: December 2024

The present study revisits the relationship between earnings management (EM) and firm performance, employing a nonlinear threshold approach and introducing national governance quality (NGQ) as a potential threshold variable. This study demonstrates how NGQ at the country level influences the impact of EM on firms’ performance at the micro level. Utilizing dynamic frameworks with data encompassing 52 firm samples across nine sub-Saharan African countries spanning from 2007 to 2019, the study reveals that the beneficial impact of EM on performance materializes when NGQ falls below a certain threshold. Beyond this threshold, the influence of EM becomes marginal or occasionally adverse on firm performance. As a result, we suggest that policymakers in Africa and other emerging and developing economies consider the estimated nonlinear relationship between EM and firm performance, as well as the NGQ threshold, when devising governance strategies. It is also imperative to consider institutional quality when making investment decisions and to promote rigorous standards for earnings management and institutional issues.

JEL Classification: C24, C33, C38, G30, G34, M41.
A Textual Analysis of the Chinese Global Talent Management Policy: From a Policy Instruments Perspective
Authors: Yueyue Cai , Nordin Nor Akmar , Panatik Siti Aisyah
Published: December 2024

Business will prosper if the environment is conducive to talent gathering. If the environment is nurturing and transformative for workers, it will attract and retain global talent. This study clarifies China’s global talent management policies through a quantitative analysis of the content of global talent management policy texts. We selected two dimensions to explore, namely, policy instrument types and management functions, and constructed a quantitative analysis framework of global talent management policy texts in China. Utilizing the Chinalawinfo Pkulaw Database, which is jointly launched by Peking University and Chinalawinfo Co. Ltd., the keywords “global talent,” “foreign experts,” and “foreign employees” were searched and a total of 145 relevant policy texts were selected. Based on the results, we recommend that for the formulation of future policies of global talent management, the frequency of using policy instruments of customs and traditions should be increased. Additionally, we should promote the integration and cross-cultural adaptation of global talent and strengthen the recognition of foreigners within Chinese culture.
What development lessons can be learned from Chinese mobilities? Trends in Argentinean students’ mobility to China
Authors: Andres Mercedes Victoria , Perrotta Daniela
Published: December 2024

The Chinese experience offers valuable lessons for other emerging countries, particularly in leveraging international student mobility for development. The return from overseas students in China has significantly contributed to the country´s growth, presenting a Global South alternative to the dominant, Global North-driven model of internationalisation. This study explores the differentiated impacts of higher education internationalisation on the Global North and the Global South, emphasizing how international mobility and overseas knowledge acquisition can foster development. Using a qualitative approach, including documentary analysis and an interview with a former Argentinean Minister of Science and Technology, we examine the mobility of Argentinean students to China through unilateral and bilateral scholarships (2009-2023) and the RAICES repatriation program (2008-2023). Our goal is to draw lessons from China´s experience and the role of its returnees, focusing on the dynamics of South-South student mobility. Our findings indicate that Argentinean students in China predominantly pursue studies in social sciences and language, fields with narrow contributions to development and the knowledge-based economy, such as engineering, science and technology. Conversely, the RAICES program has prioritised repatriating professionals in fields like natural sciences, health, and biology, mainly from the Global North countries. The limited developmental contribution of Argentinean student mobility to China underscores the need for a more strategic approach to fostering South-South internationalisation that aligns with national development goals.
Esketamine infusion as treatment for chronic endometriosis-associated pain? Study protocol for a randomized controlled trial (EASYlight-study)
Authors: de Koning Rozemarijn , Dahan Albert , Metzemaekers Jeroen , van Cosburgh Jurjan , van den Akker-van Marle Elske , Jansen Frank Willem , Blikkendaal Mathijs , Twijnstra Andries
Published: December 2024

Current treatment options for chronic endometriosis-associated pain are often inadequate, resulting in a rise in opioid consumption in this population. Given its analgesic, anti-inflammatory, and anti-depressive properties, esketamine may be a promising alternative treatment option. While esketamine is globally used in the treatment of chronic pain conditions, no clinical trials have been conducted to investigate the efficacy of esketamine infusion to alleviate chronic endometriosis-associated (pelvic) pain. Therefore, the objective of this double-blinded randomized controlled trial (RCT) is to assess the efficacy of 8-h infusion with esketamine versus placebo (saline) to reduce chronic endometriosis-associated pain symptoms. Secondary study objectives include pain scores, quality of life, depressive symptoms, health care utilization, productivity loss, cost-effectiveness, side effects, treatment experience, and pain coping and cognition. Premenopausal women (aged ⩾18 years) diagnosed with endometriosis (peritoneal, ovarian, deep, or adenomyosis), with an indication for laparoscopic endometriosis resection surgery and who suffer from chronic pelvic pain (NRS score ⩾6) will be eligible for inclusion. In total, we aim to include 56 participants, with a follow-up of 12 weeks. Digital questionnaires will be sent at baseline and 4, 8, and 12 weeks after the day of infusion.

Trial registration number

The EASYlight study is registered as “EASYlight-NEK” in the Clinical Trials Register (NCT06161805)
AI Integration for Communication Skills: A Conceptual Framework in Education and Business
Authors: Phan The Anh
Published: December 2024

This article presents a conceptual framework for integrating artificial intelligence (AI) to enhance communication skills in educational and business settings. By examining the dual role of AI as both an enabler and a challenge, the article highlights AI’s capacity for personalized learning, skill development, and efficiency in communication tasks. It also addresses potential issues such as academic integrity, data reliability, and ethical considerations. This framework aims to guide institutions and organizations in adopting AI responsibly, ensuring that human-centered communication remains integral to AI-enhanced environments.
Promises and Limitations in District Digital Capacity for Education During COVID-19
Authors: Miller Emily E.N. , Pedersen Sarah
Published: December 2024

The roles of technology and education were at the forefront throughout the COVID-19 pandemic. This mixed-methods study examines the role of the three levels of the digital divide (i.e., access, capability, and outcomes) during the COVID-19 pandemic in Kentucky. We create and analyze a new multifaceted measure of district-level digital capacity to examine the role of prior investments in technological infrastructure and the relationship with student scores in reading, math, and the ACT exam. Increased investment in digital preparedness leading up to the pandemic was protective against decreases in test scores. However, nonmetropolitan and Appalachian areas did not experience the same benefits from their digital capacity investments compared with their metropolitan counterparts. Using interview data from the summer of 2021 with 16 educators predominantly from Appalachian school districts, we discuss why these efforts to bridge the digital divide were hindered by larger, systematic challenges faced by their students.
China’s Arrival in the Great Sanctions Game: A Learnt Response, Made by America
Authors: Tzinieris Sarah , Chauhan Rishika
Published: December 2024

This article examines the development of China’s sanctions legislation in an era of strategic competition. Beijing’s new sanctions regime is informed by its experience as a sanctionee, with much of the new legislation almost directly mirrored on sanctions enacted against China by the West. The article seeks to account for Beijing’s interest in pursuing a formalised approach, employing four explanatory ‘models’, namely national security threats; retaliatory economic competition; status-seeking and prestige; and domestic constituents. The article argues that, despite China creating a new legislative framework, Beijing will continue to implement informal tactics for the most part, while employing formal measures in a targeted and measured way. Ultimately this two-pronged approach delivers a highly effective and adaptable toolkit of statecraft for China as an ascending power. However, there are normative implications for the orderly conduct of global trade and political cooperation as more states enter a great sanctions race.
What Factors Influenced Young Adults to Vote in the 2020 Presidential Election?
Authors: Yun Hye-Young , Graham Sandra
Published: December 2024

Using data drawn from a racially/ethnically diverse sample of participants ( N = 1,489; 52% female; Mage_T1: 18.10; 34% Latino, 21% White, 20% Asian, 11% Black, 11% multiracial/multiethnic, and 3% other), we conducted a binary logistic regression to identify which factors during adolescence and early adulthood were associated with voting behavior in the 2020 presidential election. There were three main findings. First, young adults who had more cross-racial/ethnic friendships and those who participated in volunteer activities during their senior year of high school were more likely to vote. Second, having cross-racial/ethnic friendships and endorsing self-transcendence values (benevolence, universalism) in early adulthood were positively associated with voting behavior, even when controlling for high school factors. Third, those who endorsed self-enhancement values were more likely to vote when they had more cross-racial/ethnic friendships during high school. Implications for voting patterns among young adults in future presidential elections are discussed.
Caste and Sale Market: A Study of Economic Discrimination in Business Enterprises of Andhra Pradesh
Authors: Mathangi Samuyelu
Published: December 2024

This article attempts to analyse the issue of caste discrimination, with a special focus on the experience of business enterprises in the Guntur district of Andhra Pradesh. It tries to examine the discrimination faced by scheduled caste business owners (SCBOs) of the non-farm sector, especially of business enterprises in the sale market, based on a field study conducted in Guntur district. The study is based on a sample of 225 respondents, comprising 150 Scheduled Caste (SC) and 75 non-SC/Scheduled Tribe (ST) business owners. A structured questionnaire was followed for the interview. The objective of this article is to understand the nature and pattern of discrimination existing among business owners. In the present day, even though SCBOs are allowed in business enterprises, they still face economic discrimination in markets. The present study has found that there is an existence of discrimination in the sale market as about 61.7% of respondents reported that their caste background affects their sales and access to the common market. The immediate impact of discrimination is evident from the existing disparities in profits between SCBOs and other business owners (OBOs). If identity negatively affects profit expectations, the chance of survival in small business will be very low for the underprivileged group. This is why, this article seeks to examine whether caste background affects the profitability of businesses significantly or not?
Politics of Resistance: Political Reservation for Women in Nagaland, India
Authors: Buragohain Sujata
Published: December 2024

Gender quota opens politics to women and ensures full and equal participation of women in politics. However, the initiative is not an end itself to ensure the representation of women in politics. In 2017, Nagaland witnessed the protest against the thirty-three per cent reservation for women in the urban local body (ULB) after the government’s decision to conduct local election. The article seeks to understand the negligible presence of women representation in the political sphere despite having better gender indicators compared to national average in terms of education, literacy rate and employment in Nagaland, India. Based on the empirical research, it explores the various reasons for resisting the implementation of thirty-three per cent reservation for women in ULB elections. Since the formation of Nagaland as a state in 1963, nineteen women have stood in the assembly election. None of them have won in the election till the year 2022. Even though women are completely absent in the institutional forum, there is a resistance against the implementation of the policy. In its continued exploration, the article discusses the impact of group rights on the women in accessing liberty.
Acute Submacular Hemorrhage Resulting from Neovascular Age-Related Macular Degeneration in a Monocular Patient
Authors: Iftikhar Mustafa , Hsu S. Tammy , Vajzovic Lejla , Hadziahmetovic Majda
Published: December 2024

Purpose: To present the management and outcomes of a case of acute submacular hemorrhage due to neovascular age-related macular degeneration (nAMD). Methods: A single case was retrospectively evaluated. Results: A 79-year-old man with a history of submacular hemorrhage from nAMD and persistent disease activity in the left eye presented with acute submacular hemorrhage in his better-seeing right eye, which was previously closely monitored for an extrafoveal serous pigment epithelial detachment without exudation. The patient received intravitreal antivascular endothelial growth factor (anti-VEGF) and subsequently had pars plana vitrectomy with subretinal tissue plasminogen activator and gas tamponade. After 5 days of face-down positioning, the hemorrhage was successfully displaced from the fovea. Recurrent disease activity 2 weeks postoperatively prompted intensive biweekly anti-VEGF therapy. By postoperative month 5, the patient’s visual acuity improved from 20/400 to 20/70 OD. Conclusions: This case highlights the importance of close monitoring of patients with nAMD exhibiting aggressive disease as well as the efficacy of prompt surgical intervention and increased anti-VEGF frequency for large submacular hemorrhages.
Insight into pharmacy students’ perspectives on mandatory COVID-19 vaccines in schools and healthcare settings
Authors: Ahmed Fahamina , Ottallah Saja , Siddiqui Azeem , Smith Candice , Borghol Amne
Published: December 2024

Background:

The COVID-19 pandemic has had an extreme global impact, transforming our daily lives, educational systems, and healthcare systems. Healthcare workers’ views on mandatory vaccination and experience with vaccines may play a pivotal role in vaccination rates and public health policy.

Objectives:

The purpose of this study is to uncover the perspectives of pharmacy students, at Xavier University of Louisiana, concerning COVID-19 vaccination mandates in educational institutions and healthcare environments, specifically the ethical, legal, and logistical dimensions. Furthermore, it will also assess the varying perceptions of vaccine safety and its impact on herd immunity while analyzing demographic characteristics.

Design:

A questionnaire survey.

Methods:

This cross-sectional study was conducted among students at Xavier University of Louisiana College of Pharmacy. Data were collected from the students using an online, anonymous questionnaire system named QualtricsXM. The survey was distributed to all 291 XULACOP students through email, text message, and GroupMe as a web link or QR code from August 25th to August 31st, 2023. Demographic data collected in the survey included age range, gender, and race/ethnicity. The 16-question survey assessed the students’ understanding, opinions, and experiences regarding COVID-19 vaccines and mandates.

Results:

The study sample included 151 students, reflecting a 52% response rate. Approximately, half of the study respondents believe the vaccine should be mandatory for the public, which was associated with opinions about students believing COVID-19 vaccines should be mandatory for school admissions were seven times more likely (OR = 7.33) and students believing mandatory vaccination infringes on personal freedom were 26% less likely (OR = 0.26) to support mandatory COVID-19 vaccines for the public( p = 0.000). When analyzing demographic characteristics, there was a significant difference in outcome between Black and non-Black students in their belief about mandatory vaccination for herd immunity ( p = 0.016).

Conclusion:

The findings of this study indicate that half of the students support making the vaccine mandatory for the public. However, significant concerns about personal freedom and individual rights were expressed by those who opposed this view. Varying pharmacy student opinions among demographic groups on vaccine mandates and understanding the factors influencing these differences can offer valuable insights into public health policy.
You’re not welcome! Violence and support for an open grazing ban policy in Kaduna, Nigeria
Authors: Tuki Daniel
Published: December 2024

This study examines the effect of victimization and religious affiliation on support for a policy banning the open grazing of livestock in the northern Nigerian state of Kaduna. This policy, which aims to reduce the incidence of conflicts between nomadic herders and sedentary farmers, has been implemented to varying degrees in some states across Nigeria. Kaduna is a suitable case study for investigating these relationships because, despite having the third-highest incidence of farmer–herder conflicts out of Nigeria’s 36 states, the state government has not implemented an open grazing ban policy there. The regression results show that victimization by herders increases the likelihood of supporting the policy. On average, Muslims are more supportive of the policy than Christians. The higher support among Muslims is quite surprising because most of the respondents who have been victimized by herders are Christians. Muslims might be more supportive of an open grazing ban policy due to a contagion effect: the common religion of Islam that they share with nomadic herders could lead to the attribution of blame for farmer–herder conflicts to Muslims, making them more eager to see an end to the conflict. This eagerness might be what leads to increased support for an open grazing ban policy.

JEL Codes: D74, N57, Z12
Seismic performance assessment of base isolation systems in five hospitals during the Mw7.8 and Mw7.6 2023 earthquakes in Southeast Turkey
Authors: Kaatsız Kaan , Alıcı F. Soner , Sucuoğlu Halûk , Tanışer Sadun , Kale Özkan
Published: December 2024

The February 6, 2023, Kahramanmaraş earthquakes (Mw7.8 and Mw7.6) in Southeast Turkey ruptured a 300 km section of the East Anatolian Fault, resulting in severe ground motions. These two strong earthquakes occurred 9 hours apart and were followed by large-magnitude aftershocks. Strong ground motions from the Kahramanmaraş earthquakes were recorded by more than 280 strong motion stations.

Nine base-isolated hospital buildings located at distances less than 50 km from the ruptured fault were subjected to strong ground shaking. This paper examines five of the nine hospitals for which seismic isolation designs were available to the authors. The ground motions acting on these hospital buildings were recorded by strong motion stations situated in close proximity. Consequently, the February 6 earthquakes have presented a unique opportunity to assess the seismic performance of base isolation systems during severe earthquakes. All five hospitals were equipped with double spherical sliding (friction pendulum) seismic isolation devices.

Subsequently, the authors conducted site visits to the hospitals following the February 6 earthquakes and collected data on maximum and residual response displacements at their isolation levels, as well as on the seismic response of structural and nonstructural components. The maximum response displacements measured at the isolation levels are compared with the maximum displacements calculated by nonlinear response history analysis under the ground motions recorded at the strong motion stations in close proximity to the hospitals.
Is the use of antibiotic stewardship measures in the context of specialized outpatient palliative care sensible and feasible? An interview-based study
Authors: Kaiser Ulrich , Kaiser Florian , Schmidt Jörg , Vehling-Kaiser Ursula , Hitzenbichler Florian
Published: December 2024

Background

Specialized outpatient palliative care (SAPV) is a component of palliative care in Germany, which assists approximately 10% of palliative patients. The majority of these patients have a malignant disease and are at increased risk of complications or severe infection. Antibiotic stewardship (ABS) measures are implemented to optimize antibiotic administration; however, there is little data available in this area, particularly for SAPV. Therefore, we examined the extent to which ABS measures can be meaningfully used or implemented in SAPV.

Methods

After establishing a corresponding interview guide, 15 experts from specialized areas were interviewed on this subject by the Institute for Market Research in Healthcare Munich (IMIG) through audio-registered individual interviews. The interviews were analyzed using the qualitative content analysis method according to Mayring.

Results

All 15 experts participated. The primary benefits cited were greater safety in the prescription and decision-making process for antibiotics in the areas of SAPV and improved quality of life. The implementation of continuous ABS measures for SAPV was considered difficult in some cases and linked to certain prerequisites, such as supportive advice from existing systems. The possibility of further training for SAPV members in the area of ABS was considered particularly advantageous.

Conclusions

The implementation of ABS measures in SAPV is feasible in principle; however, it is difficult to implement under the current conditions. Close cooperation with an existing external ABS expert/team will be helpful. This will provide more security for a small, but relevant proportion of SAPV patients, and for the SAPV team treating them.
Intravascular ultrasound-guided reentry wiring with tip-detection technique for chronic total occlusion of lower extremity artery disease
Authors: Hayakawa Naoki , Miwa Hiromi , Tsuchida Yasuyuki , Ichihara Shinya , Maruta Shunsuke , Kushida Shunichi
Published: December 2024

Background

Endovascular therapy is an effective method for revascularization in lower extremity artery disease, but treating chronic total occlusion (CTO) remains challenging. This is particularly true for patients with severe calcification, poor run-off in below-the-knee arteries, or limited access sites, where even guidewire (GW) passage can be difficult and bidirectional approaches are often not feasible. The tip-detection (TD) method has been reported as a useful technique in coronary artery CTO interventions, allowing real-time visualization of the GW tip direction. Here, we applied the TD technique for peripheral CTO intervention.

Case presentation

Case 1 involved a 71-year-old man with a right toe ulcer. Angiography revealed total occlusion from the right anterior tibial artery (ATA) to the proximal dorsalis pedis artery. While attempting IVUS-guided parallel wiring, the GW could not advance through the intraplaque route because of severe calcification. We intentionally advanced the GW and IVUS into the subintimal space of the ATA to bypass the calcified lesion and performed IVUS-guided reentry using the TD technique in the distal ATA, where calcification was less severe. The second GW successfully passed through the intraplaque of the distal ATA and into the true lumen of the dorsalis pedis artery. Case 2 involved a 60-year-old man with bilateral intermittent claudication. Angiography revealed severe stenosis of the right common iliac artery (CIA) and CTO of the left CIA. Because of anatomical limitations and access site challenges, the antegrade approach for the left CIA was unsuccessful, and retrograde intraluminal wiring was difficult because of flexion and calcification. We advanced the GW and IVUS into the subintimal space and performed IVUS-guided reentry using the TD technique to access the true lumen of the proximal CIA. Finally, bilateral VBX stent grafts were implanted using the kissing stent technique.

Conclusions

IVUS-guided reentry wiring with the TD technique may offer a useful solution for passing complex peripheral CTO lesions in cases where only a uni-directional approach is feasible.
A Robust joint coverless image steganography scheme based on two independent modules
Authors: Ren Chang , Wu Bin
Published: December 2024

With the development of deep learning technology, great progress has been made in the field of coverless steganography based on deep learning technology, including some selection-based steganography methods that use deep learning technology and all generation-based steganography methods, however both of which have their limitations. The former is difficult to meet actual communication requirements in terms of communication capacity and completeness due to the limit of the algorithm. Due to the irreversibility of the process of generating secret images from message codeword, the recovery accuracy of the latter is very poor. To this end, this paper designs a robust joint coverless image steganography scheme called Joint Coverless Image Steganography (JoCS). Firstly, this paper proposes the Semantic Factorization Fitting module (SeFF) and the Transform Domain Steganography module (TrDS). The former adds the secret message to the input vector of the low resolution layer in the StyleGAN generator network, which establishs a mapping rule between message codeword and the coarse feature of the generated image, and then the extractor is used to fit the above mapping rule, which has excellent robustness and completeness; the latter encodes the main content area of the image based on the encoder in VQGAN, and then adds secret message to the latent vector of the encoded image, which achieves the steganography in the latent domain of the image. Secondly, we demonstrate the independence between two modules and the advantages of connecting two modules. By using the image generated in the SeFF module as the cover image in the TrDS module, secondary steganography of a single image is achieved, based on which we design the JoCS scheme. The results show that our scheme breaks through the communication capacity limit in the selection-based coverless methods while guaranteeing 100% completeness, excellent image quality and outstanding robustness against various image attacks. Moreover, our scheme exhibits strong security against detection by multiple steganalysis tools and excellent practicality in practical communication. Finally, this paper also discusses the following three points as further elaboration of the scheme: (1) the advantages of the mapping rule in the SeFF module (2) the verification of the independence between the two modules (3) the flexibility of the joint steganography scheme.
Symbolic model order reduction: a new state feedback approach for simplified control and verification
Authors: Mostafa Ali Karim , Mohamed Mostafa S. , Taher Dorrah Hassen
Published: December 2024

Symbolic model order reduction (SMOR) is an efficient technique for simplifying high dynamics models with a large number of states into fewer states by eliminating states with minimal impact and focusing the control design process on the dominant states. The reduction process facilitates the control design, and the resulting controller is verified using both the full and reduced models. In this study, a new symbolic model order reduction (SMOR) methodology is proposed, based on a state-feedback technique. The model is derived symbolically, and the contribution of each state to the input signal, along with the corresponding gains, is calculated symbolically as a function of the model’s physical parameters. Ultimately, the dominant and non-dominant states are identified, and the non-dominant states are eliminated. It is important to note that the physical parameters of the system remain in the reduced model to maintain a one-to-one correspondence, ensuring that both the inputs and outputs of the reduced model match those of the original model. The gains are calculated based on the reduced model, and the control law is verified using both the full and reduced models in the proposed algorithm and the Model Reducer Tool from MATLAB to ensure the effectiveness of the proposed methodology.
Survival Impacts of Mitochondrial Status in Esophageal Squamous Cell Carcinoma Patients
Authors: Sugawara Kotaro , Sakashita Shingo , Fukuda Takashi , Murakami Chiaki , Oka Daiji , Amori Gulanbar , Ishibashi Kumiko , Kobayashi Yasuhito , Kanda Hiroaki , Motoi Noriko
Published: December 2024

Background

Little is known about the survival impacts of mitochondrial status in esophageal squamous cell carcinoma (ESCC) patients who undergo neoadjuvant chemotherapy (NAC) followed by surgery.

Methods

In total, 260 pre-NAC samples from ESCC patients were analyzed. Mitochondrial status was estimated employing an objective, immunohistochemistry-based system (Mito-score). Mito-scores were dichotomized according to the median value of our cohort. We also evaluated the immune microenvironment (CD4, CD8, Foxp3, HLA class-1, Ki-67 and programmed death ligand-1) on pre-NAC specimens. Multivariate Cox hazards models were applied to determine independent predictors of poor overall survival (OS).

Results

Patients with cT3–4 tumors had higher Mito-scores than those with cT1–2 tumors (p = 0.06), and good responders to NAC had significantly higher Mito-scores than poor responders to NAC (p = 0.04). CD8 cells and Ki-67 expression were significantly higher in Mito-high than Mito-low tumors (p = 0.017 and p < 0.001, respectively). Patients with low Mito-scores had significantly poorer OS than those with high Mito-scores (3-year OS: 57.6% vs. 68.2%; p = 0.03). A survival difference by Mito-score was evident in cStage III–IV patients (3-year OS: low 50.6% vs. high 66.1%; p = 0.006). Multivariable analysis revealed that a low Mito-score (hazard ratio 1.59, 95% confidence interval 1.12–2.24; p = 0.009) as well as pT3–4 disease (p < 0.001) and pN2–3 disease (p < 0.001) were independently associated with poor OS outcomes.

Conclusions

A low Mito-score before NAC had a significant survival impact in ESCC patients, especially in those with advanced disease. Mitochondrial status might be associated with tumor aggressiveness and responsiveness to NAC, thereby possibly affecting the survival outcomes of ESCC patients.
Feasibility of Lobectomy in Selected Patients with Unilateral N1b Papillary Thyroid Cancer
Authors: Li Danxia , Zhang Guojun , Li Xinna , Xu Shuo , Sun Haiqing , Liu Yang , Wu Guochang , Zheng Haitao , Zhang Xiaoli , Zheng Guibin
Published: December 2024

Background

Total thyroidectomy (TT) is usually recommended for unilateral papillary thyroid cancer (PTC) with lateral lymph node metastasis (LLNM), but no significant improvement in recurrence-free survival (RFS) is seen upon treatment. As an initial surgery, lobectomy may have advantages in appropriately selected unilateral PTC with ipsilateral LLNM.

Objective

This study aimed to explore the feasibility of lobectomy for selected unilateral PTC with ipsilateral LLNM.

Methods

From January 2014 to December 2021, we retrospectively reviewed patients with PTC and LLNM who were treated at our center. Patients preoperatively diagnosed with unilateral PTC and ipsilateral LLNM were recruited. Overall, 102 patients who chose lobectomy as their initial surgery were included in the lobectomy group and 96 patients who chose TT were included in the control group, defined as the TT group.

Results

The mean follow-up time of the lobectomy group was 47.5 ± 22.2 months. Patients in the lobectomy group had a significantly lower rate of hypoparathyroidism than those in the TT group (0% vs. 11.5%; p < 0.001). RFS after lobectomy was comparable with that after TT according to Kaplan–Meier curve analysis (log-rank p = 0.80). Lobectomy achieved a significantly lower incidence of unsatisfactory TSH control than TT (5.9% vs. 20.8%; p = 0.006).

Conclusions

Lobectomy may be an appropriate initial therapy for selected unilateral PTC with ipsilateral LLNM. A randomized prospective study with long-term follow-up is warranted.
Impact of sub-basalt thrust systems on the Faroe continental shelf for the late Paleoproterozoic–Cenozoic tectonic evolution of the margin.
Authors: Koehl Jean-Baptiste P. , Jolley David W. , Peace Alexander L. , Muñoz-Barrera Jhon M. , Foulger Gillian R.
Published: December 2024

Background The Faroe margin in the northeastern Atlantic is segmented by margin-orthogonal, WNW–ESE-striking lineaments extending several hundred kilometers out to the continent–ocean transition. Despite several earlier studies speculating that these features are the product of reactivation of pre-Cenozoic basement-seated structures at depth, the thick Cenozoic volcano-sedimentary sequences deposited along the margin mask the underburden, thus rendering the identification and interpretation of such structures and resolving the pre-Cenozoic history of the area challenging. The present study documents for the first time the existence of margin-orthogonal basement-seated thrust systems and describes their detailed geometry, kinematics, and tectonic evolution. Methods We interpreted basement-seated tectonic structures on seismic reflection data from TGS on the Faroe Platform and the Wyville–Thomson and Munkagrunnur ridges using the newly established seismic facies of major thrust systems. Results The data show that the Wyville–Thomson Ridge, Munkagrunnur Ridge, and Faroe Platform are cored by WNW–ESE-striking thrust systems hundreds of kilometers long and 30–50 km wide, showing dominantly top-SSW kinematics. The thrusts were reworked into NE–SW-striking folds during the Caledonian Orogeny and controlled the formation of Caledonian thrusts, which in turn controlled the formation of post-Caledonian faults. The pre-Caledonian nature of the WNW–ESE-striking thrusts and their geometry and kinematics suggest a relationship with late Paleoproterozoic Laxfordian shear zones onshore northern Scotland and the continuation of the coeval Nagssugtoqidian Orogen in southeastern Greenland, the Ammassalik Belt. The thrust systems also align with the Tornquist Zone in eastern Europe and the North Sea, thus suggesting either that they controlled the formation of the Tornquist Zone or a possibly much longer (Paleoproterozoic?) tectonic history for the Tornquist Zone. Conclusions The Faroe Island margin is crosscut by late Paleoproterozoic Laxfordian–Nagssugtoqidian thrust systems, which controlled further tectonic development of the margin.