bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual Port MIMO Slot Antenna with Meander Line for C-and Partial X-Band
Authors: Singh Aditya Kumar , Dwivedi Ajay Kumar , Varma Kalidindi Naga Venkata Suresh , Singh Vivek , Yadav R.S
Published: March 2023

In this communication, a wideband 2-Port Multiple-Input-Multiple-Output (MIMO) antenna of the dimension of 0.13 λ0 × 0.68 λ0 × 0.02 λ0 mm3 (λ0, measured at a lower frequency is 4.43 GHz) is investigated for the C-band and Partial X-Band Applications. The concept of defective ground is introduced to enhance the impedance bandwidth by engraving the rectangular slots. In the proposed configuration a mender line is incorporated as a decoupling network between the antenna elements to enhance the isolation. The quarter wavelength long stepped impedance matched transmission line is used to excite the proposed configurations. The percentage impedance bandwidth of the proposed antenna is 83%. To explore the diversity of the MIMO system the ECC, DG, TARC, and CCL are reported. Excellent agreement between simulation and measured results is obtained, justifying the MIMO antenna's applicability for wireless applications.
The adherence to and utility of the Global Initiative for Chronic Obstructive Lung Disease guidelines for treating COPD among pulmonary specialists: A retrospective analysis
Authors: Alabi Fortune O , Alkhateeb Hadaya A , Zibanayi Mukudzeishe Talent , Garces Jica , DeBarros Kayla M , Benel Pierina S Barletti , Garcia Kayla , James Randall K
Published: March 2023

Background: Despite the evidence-based guidelines promoted by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), the overuse of prescription drugs to manage COPD, particularly inhaled corticosteroids (ICS), remains a persistent challenge. In this real-world study, we evaluated how patients with COPD were divided into ABCD groups based on the 2017 GOLD guidelines, determined the rate of adherence to the GOLD treatment recommendations, described the rate of ICS usage, and determined the rate of triple therapy (TT) prescription.
Methods: The charts of 2291 patients diagnosed with COPD were retrospectively analyzed, of which 1438 matched the eligibility criteria.
Results: The average patient age was 69.6 ± 10.9 years; 52% of patients were female. The average COPD assessment test (CAT) score was 18.3 ± 9.1. The ABCD breakdown was as follows: group A 19.5%, group B 64.1%, group C 1.8%, and group D 14.6%. All groups, except group D, showed discordance in COPD treatment relative to the proposed GOLD guidelines. Only 18.9% of group A and 26% of group B were treated in concordance with the guidelines. TT was primarily used in group D (63.3%) and overused in groups A (30.6%) and B (47.8%). ICS was overused in all groups, particularly in groups A (56.2%) and B (67.3%).
Conclusion: Studies from the last decade have consistently revealed a lack of conformity between what physicians prescribe and what GOLD guidelines recommend. The excessive usage of ICS, which continues despite all the associated adverse effects and the attributable costs, is concerning. The awareness of GOLD guidelines among primary care physicians (PCPs) and respiratory specialists needs to be improved.
Assessment of Reporting Quality in Randomized Controlled Trials of Acupuncture Combined with Other Treatments for Facial Paralysis with CONSORT Statement and STRICTA Standard
Authors: Gu Yena , Zhou Wenhui , Ding Xueying , Yu Zelin , Chen Junkang , Su Caixia , Xuan Lihua
Published: March 2023

Objective: The current study aims to assess the reporting quality and its correlation with randomized controlled trials (RCTs) on acupuncture associated with other treatments for facial paralysis.
Methods: Original articles were retrieved from the China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal Database (VIP), the Wanfang Database (WF), SinoMed, PubMed, and the Web of Science (WOS). The literature was published between 2020 and 2021 in Chinese and English.
Results: A total of 22 articles were included, and the reporting rate of CONSORT items for 22 RCTs ranged from 16.22% to 40.54%. There were 23 entries with a reporting rate below 10%. Additionally, the reporting rate of STRICTA entries for the 22 RCTs ranged from 41.18% to 94.12%. Of all the STRICTA entries, five entries reported rates below or equal to 50%. No literature complies with the CONSORT statement, and none satisfies the STRICTA standard.
Conclusion: The quality of randomized controlled trials of acupuncture combined with other treatments for facial paralysis was generally low. The future trial design of acupuncture and other methods for facial paralysis should be standardized to improve the reporting quality based on the CONSORT statement and the STRICTA standard.
Polymeric nature of tandemly repeated genes enhances assembly of constitutive heterochromatin in fission yeast
Authors: Yamamoto Tetsuya , Asanuma Takahiro , Murakami Yota
Published: March 2023

Heterochromatin has been thought to be assembled by phase separation of chromatin. However, a fission yeast has only three chromosomes and the heterochromatin of this organism is not likely to be assembled by phase separation, which is a collective phenomenon of many chains. Motivated by our recent experiments that demonstrate that the tandemly repeated genes become heterochromatin, we constructed a theory of heterochromatin assembly by taking into account the connectivity of these genes along the chromatin in the kinetic equations of small RNA production and histone methylation, which are the key biochemical reactions involved in the heterochromatin assembly. Our theory predicts that the polymeric nature of the tandemly repeated genes ensures the steady production of small RNAs because of the stable binding of nascent RNAs produced from the genes to RDRC/Dicers at the surface of nuclear membrane. This theory also predicts that the compaction of the tandemly repeated genes suppresses the production of small RNAs, consistent with our recent experiments. This theory can be extended to the small RNA-dependent gene silencing in higher organisms.
A Conceptual Blockchain-Based Framework for Secure Industrial IoT Remote Monitoring: Proof of Concept
Authors: Ghaderi Mohammad Reza , Ghahyazi Ali Eghbali
Published: March 2023

There is currently a lot of research going on using blockchain in Industrial Internet of Things (IIoT) applications. Secure real-time data monitoring is one of the requirements of IIoT. Although blockchain is a suitable platform for secure remote monitoring in IIoT due to its features, however, if the goal is real time monitoring, then the issue of data packet loss can be raised as a challenge. In this study, we present a conceptual platform based on Hyperledger Fabric blockchain (HFB) for secure real time remote monitoring in IIoT. To prove this concept, we implemented an HFB network consisting of a number of machines and monitored simulated data packets. By conducting various experiments, we evaluated the performance of the HFB network for secure real time data monitoring in terms of data packet loss. The results of the experiments show that in blockchain-based real-time monitoring, the generation period of transactions should be greater than or equal to the block generation time to avoid the packet loss in the network. The results of the research can be used in the practical implementation of blockchain-based real-time industrial data monitoring in IIoT systems.
Flipped online teaching of histology and embryology with design thinking: Design, practice and reflection
Authors: Guo Yan , Wang Xiaomei , Gao Yang , Yin Haiyan , Ma Qun , Chen Ting
Published: March 2023

Background
Flexible hybrid teaching has become the new normal of basic medical education in the postepidemic era. Identifying ways to improve the quality of curriculum teaching and achieve high-level talent training is a complex problem that urgently needs to be solved. Over the course of the past several semesters, the research team has integrated design thinking (DT) into undergraduate teaching to identify, redesign and solve complex problems in achieving curriculum teaching and professional talent training objectives.
Methods
After attempting online and offline hybrid traditional teaching, the aim of the research is to study the positive attempt of online flipped teaching using two selected course chapters. The research team redesigned the curriculum and evaluation method involved in teaching these chapters and implemented them in accordance with this new curriculum, aiming at the problems uncovered in the initial attempts. Thus, the curriculum and questionnaire should have shown improvement, and iterative products should have been applied in a timelier manner in the later attempts at flipped teaching. The selected sample comprised the Jining Medical College (JNMC) undergraduate oral (112 students) and nursing (44 students) classes. Student performance was measured according to the questionnaire results, student feedback and course grades. GraphPad Prism software was used for data analysis, and the statistical method was conducted by multiple or unpaired t test.
Results
Most students report a positive attitude towards the teaching model, and nearly 80% of students reported exercising multiple abilities while learning the material. This further iteration of the design scheme improves the teaching effect of online flipped classrooms. The exam scores for flipped teaching chapters increase markedly in flipped classrooms, and the difference is statistically significant.
Conclusion
Online flipped teaching is an effective means of integrating DT into the flexible and mixed teaching of Health Education (HE), and it can effectively enhance students' learning input and cultivate students' autonomous learning ability. This research reshapes the approach to classroom teaching through the deep integration of modern information technology into educational philosophy. Future work should explore the optimal proportion by which to appropriately expand the scope of flipped teaching content.
Diagnostic and predictive values of ferroptosis-related genes in heart failure
Authors: Li Sheng , Guo Yanli , Zhang Aimei , Ma Ketao , Wang Li
Published: March 2023

Background: Heart failure is a complex clinical syndrome, and there is growing evidence that ferroptosis is related to heart failure. This study sought to identify a new diagnostic model for ferroptosis-related genes in heart failure patients and analyze the signature genes associated with ferroptosis in heart failure.
Methods: The ferroptosis-related genes were found on the FerrDbwebsite, and the heart failure microarray datasets (GSE5406, GSE57338, GSE1145) were screened from the GEO database. The "limma" package in R software was then used to analyze the ferroptosis-related differentially expressed genes (DEGs), and functional enrichment analysis was carried out for ferroptosis-related DEGs. The differentially expressed ferroptosis-related genes were then screened using LASSO regression and SVM-RFE algorithms. The intersection was then used to get the signature genes. The signature genes served as the foundation for the diagnostic model. The diagnostic model was created using a nomogram and receiver operating characteristic curve (ROC), and the model's precision was assessed. The expression of the signature genes' signaling pathways was examined using GSEA. The CIBERSORT algorithm was then used to analyze immune cell infiltration and correlation analysis in the immune systems of heart failure patients. Finally, the testing set was used to evaluate the diagnostic and predictive value of signature genes in heart failure.
Results: The training set (GSE5406) was used to screen 127 ferroptosis-related differentially expressed genes, including 44 up-regulated and 83 down-regulated genes. Ferroptosis was significantly enriched for genes that were differentially expressed according to KEGG analysis, and oxidative stress was significantly enriched in genes according to GO-BP analysis. A diagnostic model and nomogram were successfully constructed based on the five differential genes with an area under the curve (AUC):0.952 (95% CI: 0.894-0.993), using the diagnostic model to differentiate between the normal control group and the heart failure group. Five ferroptosis-related differential genes (BECN1, SLC39A14, QSOX1, DAZAP1, TMSB4X) were screened and identified. Additionally, CD4-naive T cells were discovered to be related to heart failure patients. Finally, the diagnostic performance in the testing set (GSE57338, GSE1145) was confirmed, further demonstrating the accuracy and reliability of the study's findings.
Conclusion: A novel diagnostic model with significant value for heart failure was successfully established after five ferroptosis-related genes were screened and identified. Additionally, it might be beneficial for treating patients with heart failure and aid in understanding the part ferroptosis plays in the pathogenesis of the condition.
Depression and Self-Esteem Among Afghan School-Going Adolescents
Authors: Neyazi Ahmad , Padhi Bijaya Kumar , Ahmadi Mahsa , Rangelova Vanya , Mohammadi Ab. Qadim , Neyazi Mehrab , Griffiths Mark D.
Published: March 2023

Background: During the period of adolescence, several major developmental changes occur that can have significant impact on an individual’s brain structure and functioning through their entire life. The present study examined the association between depression and self-esteem alongside specific sociodemographic factors among school-going adolescents living under the rule of Taliban.
Methods: A cross-sectional survey study was conducted with adolescents (n=452) from 20 randomly selected public primary, secondary and high schools of Herat province (Afghanistan) out of the 86 schools registered in Herat Education Department.
Results: Two-thirds of adolescents reported depression symptoms (65.3%) and 86.3% reported poor self-esteem. Multiple regression analysis indicated that (i) mother's education level was significantly associated with depression symptoms and (ii) low-income economic status was significantly associated with self-esteem.
Conclusion: As well as being one of the few studies in Afghanistan, the present study is one of the very few to assess the association between class group, self-esteem, and depression symptoms. These findings may be used by healthcare authorities and school administrators to raise awareness and implement strategies to facilitate self-esteem among school school-going adolescents.
Adsorption of Rose Bengal dye from waste water onto modified biomass
Authors: Hassan Mohammed G. , Wassel Magdy A. , Gomaa Hosni A. , Elfeky Ahmed S.
Published: March 2023

The adsorption of rose Bengal dye (RB) from aqueous solution investigated in this work. Unmodified and modified nano orange peel has been praised for their extraordinary capacity to bind with dyes. Nano raw orange peel (OP) underwent carbonization to obtain nano orange peel activated carbon (AC). Nano activated carbon coated with nano chitosan (Cs) to obtain nano chitosan/activated carbon (AC/Cs) which decorated with carboxylated multi-walled carbon nanotubes (MWCNTs-COOH) via polymer crosslinking method to create unique featured and the most effective composite (OP/AC/Cs/MWCNTs). These materials tested using FTIR, XRD, SEM and TEM. Herein, for nano raw orange peel and nano composite, batch experiments studied the effect of the RB dye initial concentration, pH of the medium, temperature. Furthermore, sorption isotherms, kinetics and thermodynamics were investigated. Additionally, thermodynamic calculations are made for parameters such as entropy (ΔS), enthalpy (ΔH), standard free energy (ΔG), sticking probability (S*) and activation energy (Ea). For the acquired data, Langmuir isotherm and pseudo-second order models were the preferred fitting. Also, the adsorption of rose Bengal dye is exothermic and spontaneous.
Planning a Reliable Hospital-Wide Cleaning Workforce
Authors: Joe Viana , Daniel Gartner
Published: March 2023

Background: Every year, tens of thousands of patients die world-wide because of infections associated with the health system. One source of hospital-acquired infections which reportedly have reached prevalence levels of 7-10%, are poor hygiene measures. These can be addressed, among others, by scheduling a reliable hospital cleaning workforce, responsive to hospital requirements and safety standards.
Methods: To model the problem, we develop a hybrid simulation model which captures features such as variation in demand as well as cleaning durations. Our model enables us to evaluate the current workforce schedule from a collaborating European hospital using a variety of performance metrics (e.g., waiting time for ad-hoc cleaning jobs) and levels of detail (e.g., response time broken down by time of day). Using a mixed-integer linear programming approach, we generate alternative schedules.
Results: Our results indicate substantial improvements as compared to current planning: While the baseline workforce planning model with 13 cleaners sometimes fails to adequately cope with the demand, the demand coverage can be improved substantially with reshuffling the same number of cleaners.
Conclusions: Using our simulation model and the MIP approach, hospital managers can provide a more reliable and safer environment for patients and staff.
Refining the serum miR-371a-3p test for viable germ cell tumor detection: identification and definition of an indeterminate range
Authors: Lafin John , Scarpini Cinzia , Amini Armon , Konneh Bendu , Howard Jeffrey , Gerald Thomas , Nuno Michelle , Piao Jin , Savelyeva Anna , Wang Zhaohui , Gagan Jeffrey , Jia Liwei , Lewis Cheryl , Murray Sarah , Sawa Yun , Margulis Vitaly , Woldu Solomon , Strand Douglas , Coleman Nicholas , Amatruda James , Frazier Lindsay , Murray Matthew , Bagrodia Aditya
Published: March 2023

Circulating miR-371a-3p has excellent performance in the detection of viable (non-teratoma) GCT pre-orchiectomy; however, its ability to detect occult disease is understudied. To refine the serum miR-371a-3p assay in the minimal residual disease setting we compared performance of raw (Cq) and normalized (∆Cq, RQ) values from prior assays, and validated interlaboratory concordance by aliquot swapping. Revised assay performance was determined in a cohort of 32 patients suspected of occult retroperitoneal disease. Assay superiority was determined by comparing resulting receiver-operator characteristic (ROC) curves using the Delong method. Pairwise t-tests were used to test for interlaboratory concordance. Performance was comparable when thresholding based on raw Cq vs. normalized values. Interlaboratory concordance of miR-371a-3p was high, but reference genes miR-30b-5p and cel-miR-39-3p were discordant. Introduction of an indeterminate range of Cq 28–35 with a repeat run for any indeterminate improved assay accuracy from 0.84 to 0.92 in a group of patients suspected of occult GCT. We recommend that serum miR-371a-3p test protocols are updated to a) utilize threshold-based approaches using raw Cq values, b) continue to include an endogenous (e.g., miR-30b-5p) and exogenous non-human spike-in (e.g., cel-miR-39-3p) microRNA for quality control, and c) to re-run any sample with an indeterminate result.
Impact of low-dose prasugrel on platelet reactivity in chronic phase of post-percutaneous coronary intervention (CHAPERON): a prospective cohort study
Authors: Fukase Tatsuya , Doi Shinichiro , Dohi Tomotaka , Koike Takuma , Nishio Ryota , Yasuda Hidetoshi , Takeuchi Mitsuhiro , Takahashi Norihito , Chikata Yuichi , Endo Hirohisa , Nishiyama Hiroki , Okai Iwao , Iwata Hiroshi , Okazaki Shinya , Daida Hiroyuki , Suwa Satoru , Minamino Tohru , Miyauchi Katsumi
Published: March 2023

Purpose Asians often face the problems of clopidogrel resistance and East Asian paradox. This study aimed to evaluate the effects of P2Y12 inhibitors, including low-dose prasugrel 2.5 mg, on the P2Y12 reaction unit (PRU)

in the chronic phase after percutaneous coronary intervention (PCI). Methods A total of 348 patients were studied. PRU was measured 6-12 months after PCI and subsequently, 6 months later using a P2Y12 assay, respectively. This study evaluated the proportion of bleeding risk (PRU ≤85) and ischemic risk (PRU ≥239) as primary endpoints, and the prediction of bleeding risk and ischemic risk using multivariable logistic regression analysis. Results At baseline, 136 patients (39%) received prasugrel 3.75 mg, 48 patients (14%) received prasugrel 2.5 mg, and 164 patients (47%) received clopidogrel 75 mg. Clopidogrel 75 mg had a significantly higher proportion of ischemic risk within one year after PCI than the other groups, and was an independent predictor for ischemic risk with reference of prasugrel 3.75 mg. In addition, switching from clopidogrel 75 mg to prasugrel 2.5 mg significantly lowered and aggregated the PRU value. Whereas, dose reduction of prasugrel had a significantly lower proportion of bleeding risk over one year after PCI than the continuation of prasugrel 3.75 mg, and was an independent predictor for bleeding risk with reference of continuation of prasugrel 3.75 mg. Conclusions Prasugrel 2.5 mg has a lower ischemic risk and a more stable PRU value compared with clopidogrel treatment. Prasugrel also contributes to a decline in bleeding risk with concomitant dose reduction.
Trial registration : University Hospital Medical Information Network (UMIN),
ID : UMIN000029541, Date : October 16, 2017 (https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000033395)
Phyllosticta taxa from northern Thailand and southern European Russia: a novel species and four new host records
Authors: Gomdola Deecksha , Jayawardena Ruvishika Shehali , McKenzie Eric H.C. , Bulgakov Timur S. , Wanasinghe Dhanushka N. , Huanraluek Naruemon , Hyde Kevin David
Published: March 2023

Phyllosticta is a cosmopolitan group of fungi found on various host plants, occurring as pathogens, endophytes and saprobes. Diseases caused by Phyllosticta commonly include leaf and fruit spots that affect economically important plants. The genus is characterized mainly by aseptate and hyaline conidia and ascospores. However, its conidia are surrounded by a mucilaginous sheath, with a single mucoid apical appendage while ascospores exhibit a mucoid cap at both ends. Given that many Phyllosticta taxa are cryptic and share similar morphological features, it is arduous to depict taxonomically relevant characters solely on the basis of morphological and ecological features. Coupled with morphological description, multi-locus phylogenetic analyses of species comprising complexes are used to broadly describe this genus and understand species boundaries. Despite several published taxonomic revisions and enumerations of Phyllosticta species, there is still considerable confusion when identifying these taxa. Herein, we introduce a new species (P. chiangmaiensis) and three new host records (P. capitalensis) in Thailand, and one new host and country record (P. citribrasiliensis) in Russia. We provide an updated phylogenetic tree, including all Phyllosticta species with sequence data.
Increased serum level of IL-1β is associated with sarcopenia in elderly people
Authors: Xu Qun , Li Fangzhou , Shen Shanshan , Yu Xiyan , Zhou Jun , Chen Xujiao
Published: March 2023

Background

Sarcopenia is characterized by a decline in muscle mass, strength and physical performance with age, which can cause many hazards to the elderly. The etiology of sarcopenia is complex and diverse, including chronic inflammation and neuromuscular junction damage. The pathogenesis of sarcopenia is still unclear. This study attempts to identify biomarkers related to sarcopenia from the above two aspects.

Methods

From March 2019 to March 2020, we conducted a cross-sectional epidemiological survey of 127 elderly patients at Zhejiang Hospital affiliated to Zhejiang University. This study compared demographic data, living habits, nutritional status, disease status, frailty grade and anthropometric data of sarcopenia and non-sarcopenia participants, and measured serum interleukin-6(IL-6), Interleukin-10(IL-10), Interleukin-1β(IL-1β) and C-terminal agrin fragment(CAF) levels using commercial ELISA kits.

Results

Our study revealed significant differences in age, marital status, coronary heart disease, cerebrovascular disease, nutritional status, frailty, and body mass index(BMI) in the elderly between the sarcopenia and nonsarcopenia groups. IL-1β levels in the sarcopenia group were significantly higher than those in the non-sarcopenia group. Moreover, IL-1β was associated with sarcopenia, low skeletal muscle index (SMI), low grip strength, and and low gait speed. IL-6 was associated with low grip strength, and IL-10 was associated with low grip strength, and and low gait speed. CAF was associated with low grip strength. In multivariate analysis, IL-1β was the independent risk factor for sarcopenia low grip strength and low gait speed, and CAF was the independent risk factors for low grip strength.

Conclusion

The results of the present study suggest that plasma level of IL-1β maybe a promising biomarker for sarcopenia but further study is needed to comfirm the findings and the physiological role of IL-1β in sarcopenia.
Clinical assessment and Continuum of Care of chronic hepatitis B patients in a Subsaharan African setting
Authors: Eloumou Servais Albert Fiacre Bagnaka , Nga Tatiana Winnie Bekolo , Djapa Guy Roger Nsenga , Ndam Antonin Ndjitoyap , Gouajio Gael Gilles Aghoagni , Ngongang Kevine Sorele Kapgang , Malongue Agnes , Noah Dominique Noah , Andoulo Firmin Ankouane , Tzeuton Christian , Namme Henry Luma
Published: March 2023

Background: Chronic Hepatitis B (CHB) infection is a major public health problem in the world. Cameroon has a high prevalence, estimated at about 11.2%. In Cameroon the management of CHB remains very challenging. The study aims at assessing the clinical assessment and the steps of the Continuum of Care (CoC) of chronic hepatitis B patients.
Methods: A hospital based retrospective cohort study reviewing files of CHB patients who attended care from January 2014- December 2017 in the Douala General Hospital, a tertiary hospital in Cameroon. The CoC was assessed As follows step 1- enrolment in care, step 2-basic work up done, step 3- antiviral treatment uptake, step 4- viral load suppression.
Descriptive statistics was used to represent proportions, the Kaplan Meier curve estimated retention in care and multivariate analysis identified independent association with treatment uptake.
Results: The mean age at diagnosis was 33.7 (±12.0) years, males were predominant with 59.4%. The characteristics of the CoC were as follows: were enrolled in care 1033 patients, 492 (47.6%) completed the basic work up, were initiated on treatment 121 (11.7%); and viral load suppression was achieved in 53 (5.1%). Sociodemographic characteristics such as male gender (aOR: 2.1, CI: 1.2- 3.5), older age > 34 years (aOR 0.03, CI: 0.003-0.33), having a medical insurance (aOR: 5.7, CI: 3.0-10.9) were independently associated with treatment uptake.
Conclusion: The study clearly showed a decreasing proportions of patients at various steps of the CoC, with treatment uptake mostly influenced by some sociodemographic factors. The real need to develop strategies to improve the CoC of CHB in Cameroon is therefore very apparent.
Development and validation of a model predicting patient-reported shoulder function after arthroscopic rotator cuff repair in a Swiss setting
Authors: Stojanov Thomas , Aghlmandi Soheila , Müller Andreas Marc , Scheibel Markus , Flury Matthias , Audigé Laurent
Published: March 2023

Background. Prediction models for outcomes after orthopedic surgery provide patients with evidence-based post-operative outcome expectations. Our objectives were (1) to identify prognostic factors associated with the post-operative shoulder function outcome of the Oxford Shoulder Score (OSS) and (2) to develop and validate a prediction model for post-operative OSS.
Methods. Patients undergoing arthroscopic rotator cuff repair (ARCR) were prospectively documented at a Swiss orthopedic tertiary care center. The first primary ARCR in adult patients with a partial or complete rotator cuff tear were included between October 2013 and June 2021. Twenty-two potential prognostic factors were used for prediction model development. Three sets of factors were compared in terms of overall performance (using Akaike’s Information Criterion and model bias) and discriminative ability (using R squared and Root Mean Squared Error).
Results. A complete-case analysis of 1,310 patients was performed. Set 3 retained the following factors: age, sex, American Society of Anesthesiologists (ASA) classification, number of pre-operative steroid infiltrations, baseline OSS, baseline level of depression and anxiety, infraspinatus tear, tendon delamination and acromioclavicular joint resection. Linear regression and Tobit models had similar performance on both the training (R squared = 0.201 and 0.201, respectively) and test sets (R squared = 0.119 and 0.123, respectively). The Tobit model was slightly more consistent than the linear regression model after bootstrap validation (R squared = 0.189 compared to 0.161).
Conclusion. A prediction model for patients undergoing ARCR was developed to provide patients and surgeons with individualized expectations for post-operative shoulder function outcomes.
Resection in the coexistence of lung cancer and chronic obstructive pulmonary disease.
Authors: INAN Kubilay , YILDIZ Özgur Ömer
Published: March 2023

Background:
The aim of this study is to evaluate the surgical perspective on the coexistence of chronic obstructive pulmonary disease (COPD) and lung cancer.
Methods:
Lung cancer and COPD are two diseases with high morbidity and mortality rates worldwide. In the present study, we present our experience with a total of 21 patients with both COPD and lung cancer who underwent surgical treatment in our center. This retrospective study included 21 patients with COPD and lung cancer who underwent preoperative pulmonary rehabilitation between 2019 and 2020 in our center. Statistical analyses were performed with SPSS version 15 package program.
Results:
This study included a total of 21 patients. The disease duration for patients diagnosed with COPD was 2–9 years. Positive correlations were noted between time since COPD diagnosis and intensive and nonintensive care hospitalization durations (p < 0.05). A positive correlation was noted between preoperative pulmonary rehabilitation period and clinic stay (p = 0.05).
Conclusion:
Meticulous preoperative evaluation in patients with both COPD and lung cancer is crucial to avoid negative outcomes. Furthermore, preoperative pulmonary rehabilitation increases the chance of resection for patients with COPD and should be considered.
Perspectives on consciousness in patients with disorders of consciousness from brain injury: Group concept mapping study across clinic, research, and families
Authors: Blond Niklas , Andersen Lise Marie , Wæhrens Eva Elisabeth , Høybye Mette Terp
Published: March 2023

Background
An effective healthcare system is dependent on interactions between clinic, research, and patient/relatives. Such interactions may at their core be challenged by misalignments of concepts and the practices that constitute them. The concept of consciousness and what is experienced and understood as signs of consciousness in patients with severe acquired brain injury is one of these potential areas of misalignment.
Different perspectives and experiences of consciousness are challenging the delivery of care and the high-stake decision-making process on the potential withdrawal of treatment. The enhanced uncertainties call for reflections on how consciousness is perceived and identified by key stakeholders in current clinical encounters and practice.
The study provides a first step towards a future framework for the difficult process of decision-making concerning a segment of patients with disorders of consciousness (DoC).
Methods
The study empirically explores the actual experiences and conceptions of consciousness in relation to patients with DoC from the perspectives of researchers, health professionals, and relatives of patients, to understand the challenges of the diversity of understandings of consciousness. Engaging the stakeholders by employing Group Concept Mapping methodology, the study developed a situated conceptual map, which reflects nuances and importance of perspectives on and signs of consciousness.
Results
The conceptual mapping demonstrates an extensive overlap in perspectives on consciousness among participants, prioritizing signs that are observable at the bedside.
Based on the analysis of rating of perspectives and a validation workshop a situated conceptual map was develop to guide conceptual alignment when encountering divergent perspectives on consciousness in patients with DoC.
Conclusions
The study highlights the importance of repeatable signs of consciousness observed at the bedside and the patient’s ability to participate in social interactions, while also considering the importance of non-clinically observable signs of consciousness.
The COVID-19 Pandemic and Its Impact on Health Experiences of Asylum Seekers to the United States
Authors: Singer Elizabeth , Molyneux Kevin Kevin , Gogerly-Moragoda Mahalya , Kee Dustin , Baranowski Kim Baranowski
Published: March 2023

Background
The COVID-19 pandemic exacerbated preexisting barriers to accessing healthcare and social services faced by asylum seekers to the United States. This study aimed to uncover the impact of the first year of the COVID-19 pandemic on asylum seekers, including socio-economic stressors and access to medical information, healthcare, and testing.
Method
We conducted 15 semi-structured, in-depth interviews with adult asylum seekers to the U.S. and systematically analyzed the resulting transcripts using a consensual qualitative research approach.
Results
The transcripts yielded six domains: (1) knowledge and understanding of COVID-19; (2) attitudes and practices relating to COVID-19 precautions; (3) experience of COVID-19 symptoms; (4) current physical and mental health; (5) access to and interaction with health care; (6) discrimination based on asylum status.
Conclusions
Although participants had knowledge about COVID-19’s communicability and regularly used masks, their living conditions frequently hindered their ability to quarantine and isolate, and their lack of insurance was often a deterrent to them seeking medical care. Notably, immigration status was not a significant factor discouraging participants from seeking care during the pandemic. The findings build on existing knowledge about this community and may help define areas where support and services can be expanded in current and future pandemics.
Difficulty in the diagnosis of pancreatic cancer based on the initial CT report: A retrospective study
Authors: Shionoya Kento , Koizumi Kazuya , Masuda Sakue , Makazu Makomo , Kubota Jun , Jinushi Ryuhei , Kimura Karen
Published: March 2023

Background
The role of computed tomography (CT) in the initial diagnosis of pancreatic cancer (PC) is well-known. CT reports made by radiologists are important as not all patients with PC are examined by specialists; however, some cases are not identified based on CT reports. Diagnosis via imaging of PC is sometimes difficult, and the diagnostic rate of PC and other pancreatic diseases can vary across radiologists. This study examined the diagnostic rate of PC in initial CT reports and the details of cases with diagnostic difficulties.
Methods
Clinical data of 198 patients with histologically diagnosed PC were retrospectively collected between January 2018 and April 2022. Out of these contrast-enhanced CT was performed in 192 cases (124 men and 68 women) and these cases were examined.
Results
In the reports, PC was not reported as the main diagnosis in 18 patients (9.4%; 11 men and 7 women; mean age, 69.7 years). Among these 18 cases, intrapancreatic mass lesions were detected in 3 (1.6%), indirect findings such as bile duct/pancreatic duct stenosis or dilation were detected in 5 (2.6%), and no PC-related findings were found in 10 (5.2%). The specialists suspected PC in 15 of these 18 cases based on initial CT reports. Seventeen cases were confirmed by endoscopic ultrasound-fine needle aspiration (EUS-FNA) and one by biopsy after upper gastrointestinal endoscopy.
Conclusions
To improve accuracy of the diagnosis of the PC, it is important that specialists provide feedback to diagnostic radiologists regarding the findings they did not report. Additionally, non-specialists should be aware of the importance to seek the advice of specialists when such indirect findings or any kind of pancreatic mass are present. EUS-FNA should be performed by specialists when there is clinical information which indicates pancreatic disease of any kind.
Immuno-oncologic profiling of pediatric CNS tumors reveals major clinical significance of the tumor immune microenvironment
Authors: Levine Adrian , Nobre Liana , Das Anirban , Milos Scott , Bianchi Vanessa , Johnson Monique , Fernandez Nicholas , Stengs Lucie , Ryall Scott , Ku Michell , Rana Mansuba , Laxer Benjamin , Sheth Javal , Sbergio Stefanie-Grace , Fedoráková Ivana , Ramaswamy Vijay , Bennett Julie , Tabori Uri , Siddaway Robert , Hawkins Cynthia
Published: March 2023

With the increasing use of immunotherapy in cancer, understanding the tumor immune microenvironment (TIME) has become increasingly important. There has been great success in treatment of some pediatric high-grade gliomas with immune checkpoint inhibition, however overall, the immune microenvironment in pediatric brain tumors remains poorly understood. Accordingly, we developed a clinical immune-oncology gene expression assay and used it to profile a diverse range of pediatric brain tumors with detailed clinical and molecular annotation, including a total of 1379 cases. Our findings demonstrate the critical importance of understanding the TIME to guide the prognosis and management of pediatric brain tumors. In pediatric low-grade gliomas we identified distinct patterns of immune activation with prognostic significance in BRAF V600E mutant tumors. In pediatric high-grade gliomas, we observed elevated inflammation and T cell infiltrates in tumors that have historically been considered immune cold, as well as genomic correlates of inflammation levels. In our cohort of mismatch repair deficient high-grade gliomas treated with immune checkpoint inhibition, we found that high tumor inflammation signature was a significant predictor of treatment response. Furthermore, we demonstrated the potential for multimodal biomarkers to improve the treatment stratification of these patients. Importantly, while overall patterns of immune activation were observed for histologically and genomically defined tumor types, there was nonetheless significant variability within each diagnostic entity, indicating that the immune response must be evaluated as an independent feature. In sum, in addition to the histology and molecular profile, this work establishes the importance of assessing and reporting on the tumor immune microenvironment as an essential axis of cancer diagnosis in the era of personalized medicine.
Stabilizer codes for Open Quantum Systems
Authors: Pereira Francisco Revson F. , Mancini Stefano , Guardia Giuliano G. La
Published: March 2023

The Lindblad master equation describes the evolution of a large variety of open quantum systems. An important property of some open quantum systems is the existence of decoherence-free subspaces. A quantum state from a decoherence-free subspace will evolve unitarily. However, there is no procedural and optimal method for constructing a decoherence-free subspace. In this paper, we develop tools for constructing decoherence-free stabilizer codes for open quantum systems governed by Lindblad master equation. This is done by pursuing an extension of the stabilizer formalism beyond the celebrated group structure of Pauli error operators. We then show how to utilize decoherence-free stabilizer codes in quantum metrology in order to attain the Heisenberg limit scaling with low computational complexity.
Differential and phase-diverse electrooptic modulators
Authors: Ordouie Ehsan , Jiang Tianwei , Zhou Tingyi , Juneghani Farzaneh Arab , Eshaghi Mahdi , Vazimali Milad Gholipour , Fathpour Sasan , Jalali Bahram
Published: March 2023

Bandwidth and noise are fundamental considerations in all communication and signal processing systems. The group-velocity dispersion of optical fibers creates nulls in their frequency response, limiting the bandwidth and hence the temporal response of communication and signal processing systems. Intensity noise is often the dominant optical noise source for semiconductor lasers in data communication. In this paper, we propose and demonstrate a new class of electrooptic modulators that is capable of mitigating both of these problems. Fabricated in thin-film lithium niobate, the modulator simultaneously achieves phase diversity and differential operations. The former compensates for the dispersion penalty of the fiber, and the latter overcomes the intensity noise and other common mode fluctuations. Applications of the so-called four-phase electrooptic modulator in time-stretch data acquisition and in optical communication are demonstrated.
Low Intensity mental health Support via a Telehealth Enabled Network for adults with diabetes (LISTEN): Protocol for a hybrid type 1 effectiveness implementation trial
Authors: Holloway Edith E , Gray Shikha , Mihalopoulos Catherine , Versace Vincent L , Gautier Roslyn Le , Chatterton Mary Lou , Hagger Virginia , Halliday Jennifer , Henshaw Kim , Harrap Benjamin , Manallack Sarah , Black Taryn , Bruggen Natasha Van , Hines Carolyn , O’Neil Adrienne , Skinner Timothy C , Speight Jane , Hendrieckx Christel
Published: March 2023

Background
Mental health problems are common among people with diabetes. However, evidence-based strategies for the prevention and early intervention of emotional problems in people with diabetes are lacking. Our aim is to assess the real-world effectiveness, cost-effectiveness, and implementation of a Low Intensity mental health Support via a Telehealth Enabled Network (LISTEN), facilitated by diabetes health professionals (HPs).
Methods
A hybrid type I effectiveness-implementation trial, including a two-arm parallel randomised controlled trial, alongside mixed methods process evaluation. Recruited primarily via the National Diabetes Services Scheme, Australian adults with diabetes (N = 394) will be eligible if they are experiencing elevated diabetes distress. Participants are randomised (1:1 ratio) to LISTEN - a brief, low-intensity mental health support program based on a problem-solving therapy framework and delivered via telehealth (intervention) or usual care (web-based resources about diabetes and emotional health). Data are collected via online assessments at baseline (T0), 8 weeks (T1) and 6 months (T2, primary endpoint) follow-up. The primary outcome is between group differences in diabetes distress at T2. Secondary outcomes include the immediate (T1) and longer-term (T2) effect of the intervention on psychological distress, general emotional well-being, and coping self-efficacy. A within-trial economic evaluation will be conducted. Implementation outcomes will be assessed using mixed methods, according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Data collection will include qualitative interviews and field notes.
Discussion
It is anticipated that LISTEN will reduce diabetes distress among adults with diabetes. The pragmatic trial results will determine whether LISTEN is effective, cost-effective, and should be implemented at scale. Qualitative findings will be used to refine the intervention and implementation strategies as required.
Trial registration
: This trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN: ACTRN12622000168752) on the 1 February, 2022.
Differential impact of transfusion guidelines on blood transfusion practices within a health network
Authors: Balafas Spyros , Gagliano Vanessa , Serio Clelia , Guidugli Giuglia , Saporito Andrea , Gabutti Luca , Ferrari Paolo
Published: March 2023

Whether clinical practice guidelines have a significant impact on practice is unclear. The effect of guideline recommendations on clinical practice often a lags behind the date of publication. We evaluated by means of a data-driven approach if and when the guidelines on red blood cell transfusions (RBCTs) issued by Swiss Smarter Medicine in 2016 had an impact on RBCTs practice within a hospital network, where awareness of guidelines was promoted mainly among internal medicine specialties. Data on RBCTs performed in a Swiss hospital network from January 2014 to April 2021 were analyzed by hospital site and specialty to assess whether guidelines led to a decrease in inappropriate RBCTs. RBCTs were defined as “inappropriate” if patients had a hemoglobin level ≥ 70g/L without or ≥ 80g/L with significant cardiovascular comorbidities. Changes in the rate of inappropriate transfusions were analyzed with an advanced statistical approach that included generalized additive models. Overall prior to March 2017 there were more inappropriate than appropriate RBCTs, but after October 2017 the opposite could be observed. A change-point in the time trend was estimated from transfusion data to occur in the time interval between March and October 2017. This change was mainly driven by practice changes in the medical wards, while no significant change was observed in the critical care, surgical and oncology wards. Change in practice varied by hospital site. In conclusion, our results show that a significant change in the RBCTs practice at the hospital level occurred approximately 18 months after national guidelines were issued.
Winds of star clusters significantly contribute to the Galactic cosmic-ray population
Authors: Peron Giada , Casanova Sabrina , Gabici Stefano , Baghmanyan Vardan , Aharonian Felix
Published: March 2023

Cosmic rays are energetic nuclei that permeate the entire Galactic disk. Their existence requires the presence of powerful particle accelerators. While Galactic supernova explosions may supply the required energy, there is growing evidence that they cannot explain all of the observed properties of cosmic rays, such as their maximum particle energy and isotopic composition.
Among Galactic objects, winds from stellar clusters meet the energetic requirement and provide a suitable environment for particle acceleration. The recent detection of some of these objects in γ-rays confirms that they indeed harbor high-energy particles.
However, as most supernovae explode inside stellar clusters, it is difficult to distinguish the contribution of winds to particle acceleration. Here we report the detection of young star clusters in the nearby Vela molecular ridge star forming region. The young age of the systems guarantees an unbiased estimate of the stellar CR luminosity free from any supernova or pulsar contamination and allows us to draw conclusions on the acceleration efficiency and the total power supplied by these objects.
We demonstrate that much more than 1\% of the wind mechanical power is converted into CRs and conclude that a non-negligible fraction of the CR population is contributed by stellar clusters.