bluuebunny/crossref_metadata_2025 huggingface dataset:
Wastewater Surveillance of SARS-CoV-2 in Zambia: An Early Warning Tool
Authors: Shempela Doreen Mainza , Muleya Walter , Mudenda Steward , Daka Victor , Sikalima Jay , Kamayani Mapeesho , Sandala Dickson , Chipango Chilufya , Muzala Kapina , Musonda Kunda , Chizimu Joseph Yamweka , Mulenga Chilufya , Kapona Otridah , Kwenda Geoffrey , Kasanga Maisa , Njuguna Michael , Cham Fatim , Simwaka Bertha , Morrison Linden , Muma John Bwalya , Saasa Ngonda , Sichinga Karen , Simulundu Edgar , Chilengi Roma
Published: June 2024

Wastewater-based surveillance has emerged as an important method for monitoring SARS-CoV-2. This study investigated the presence of SARS-CoV-2 in wastewater in Zambia. We conducted a longitudinal study in the Copperbelt and Eastern provinces of Zambia from October 2023 to December 2023 during which 155 wastewater samples were collected. The samples were subjected to three different concentration methods, namely bag-mediated filtration, skimmed milk flocculation, and polythene glycol-based concentration assays. Molecular detection of SARS-CoV-2 nucleic acid was conducted using real-time PCR. Whole genome sequencing was conducted using Illumina COVIDSEQ assay. Of the 155 wastewater samples, 62 (40%) tested positive for SARS-CoV-2. Of these, 13 sequences of sufficient length to determine SARS-CoV-2 lineages were obtained and two sequences were phylogenetically analyzed. Various Omicron subvariants were detected in wastewater including BA.5, XBB.1.45, BA.2.86, and JN.1. Some of these subvariants have been detected in clinical cases in Zambia. Interestingly, phylogenetic analysis positioned a sequence from the Copperbelt Province in the B.1.1.529 clade, suggesting that earlier Omicron variants detected in late 2021 could still be circulating and may not have been wholly replaced by newer subvariants. This study stresses the need for integrating wastewater surveillance of SARS-CoV-2 into mainstream strategies for monitoring SARS-CoV-2 circulation in Zambia.
Visual Reasoning and Multi-Agent Approach in Multimodal Large Language Models (MLLMs): Solving TSP and mTSP Combinatorial Challenges
Authors: Elhenawy Mohammed , Abutahoun Ahmad , I.Alhadidi Taqwa , Jaber Ahmed , Ashqar Huthaifa I. , Jaradat Shadi A. A. , Abdelhay Ahmed , Glaser Sebastien , Rakotonirainy Andry
Published: June 2024

: Multimodal Large Language Models (MLLMs) harness comprehensive knowledge spanning text, images, and audio to adeptly tackle complex problems, including zero-shot in-context learning scenarios. This study explores the ability of MLLMs in visually solving the Traveling Salesman Problem (TSP) and Multiple Traveling Salesman Problem (mTSP) using images that portray point distributions on a two-dimensional plane. We introduce a novel approach employing multiple specialized agents within the MLLM framework, each dedicated to optimizing solutions for these combinatorial challenges. Our experimental investigation includes rigorous evaluations across zero-shot settings and introduces innovative multi-agent zero-shot in-context scenarios. The re-sults demonstrated that both multi-agent models—Multi-Agent 1, which includes the Initializer, Critic, and Scorer agents, and Multi-Agent 2, which comprises only the Initializer and Critic agents—significantly improved solution quality for TSP and mTSP problems. Multi-Agent 1 ex-celled in environments requiring detailed route refinement and evaluation, providing a robust framework for sophisticated optimizations. In contrast, Multi-Agent 2, focusing on iterative re-finements by the Initializer and Critic, proved effective for rapid decision-making scenarios. These experiments yield promising outcomes, showcasing the robust visual reasoning capabilities of MLLMs in addressing diverse combinatorial problems. The findings underscore the potential of MLLMs as powerful tools in computational optimization, offering insights that could inspire further advancements in this promising field.
Progression-Free Survival and Treatment-Free Interval in Head and Neck Cancer With Long-Term Response to Nivolumab: Timing of Active Discontinuation
Authors: Matsuo Mioko , Masuda Muneyuki , Yamauchi Moriyasu , Hashimoto Kazuki , Kogo Ryunosuke , Sato Masanobu , Masuda Shogo , Nakagawa Takashi
Published: June 2024

The optimal timing for actively discontinuing immune checkpoint inhibitor therapy in long-term responders with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) remains unresolved. We conducted a retrospective study of 246 patients with R/M HNSCC treated with nivolumab to determine the optimal timing to actively discontinue nivolumab therapy. We examined the point at which progression-free survival (PFS) plateaued in all cases. We compared the prognosis of 19 (7.7%) ongoing cases and 227 (92.3%) discontinued cases and analyzed treatment duration and treatment-free interval (TFI). The 6-year overall survival was 11.8% (median, 12.1), and the 6-year PFS was 15.3% (median, 3.0). The PFS curve remained stable for 3 years. The median duration of nivolumab treatment was 2.9 months (range, 0.03–81.9): Ongoing group, 41.8 (5.6–81.9); Decision group, 36.8 (4.0–70.1); Toxicity group, 30.6 (2.8–64.8); and progressive disease group, 2.0 (0.03–42.9). TFI in the Decision group was 15.1 months (0.6–61.6) and 30.6 months (2.8–64.8) in the Toxicity group. Limited number of long-term responders in R/M HNSCC cases treated with nivolumab exists. Given that PFS plateaued at 3 years, we propose that the optimal duration of treatment for this subset of patients is 3 years.
Product Evaluation of a Topical Live Probiotic Serum for Skin Health
Authors: JAIN ROHIT , VOSS ABIGAIL , ROSARIO JESSICA , HALE JOHN
Published: June 2024

Background: Micrococcus luteus is a commensal bacterial member on the human skin and is essential in keeping the balance among the various microbial flora of the skin. M. luteus strain Q24 or BLIS Q24TM was isolated from the skin of a healthy human adult and has been identified to produce a unique antimicrobial spectrum that is inhibitory towards pathogenic bacteria associated with many skin diseases such as acne. It has been developed as a probiotic with potential applications in improving overall skin health.Aim: This study aimed to evaluate the perceived changes in skin quality following topical application of a formulation containing skin commensal probiotic BLIS Q24TM. Materials and methods: A 28-day study involving 100 adult participants with self-reported normal skin with occasional blemishes or breakouts, topically applied a serum formulation containing BLIS Q24TM to the face. Participants quantitatively evaluated the probiotic serum effect on their skin at baseline Day 0 and then again on Day 10, 20 and 28 of the application. In addition, participants maintained a photo diary to record the perceived changes to their skin.Results: A total of 96 participants completed this research. In comparison to the baseline (Day 0), within 10 days, a significant reduction in blackheads (48%), oiliness (48%), blemishes (57%), dry areas (23%), redness/rosacea (45%) and flaky and rough skin (38%) were reported. The probiotic serum was also effective in a significant reduction in fine lines and wrinkles (38%), whiteheads (41%), pimples (55%), age spots (29%), and acne (21%) by the end of 28 days of probiotic application. Overall, there’s agreement that probiotic serum delivers or exceeds consumer expectations from the concept and performs just as well, or better, than their regular moisturiser.Conclusions: An approach of delivering a live probiotic packaged in an innovative formula to improve several skin conditions in otherwise healthy individuals was found to be successful. This study highlights that a serum formulation containing BLIS Q24TM has a positive impact on skin health with it being effective topically in reducing the appearance of skin blemishes, oiliness, wrinkles, redness, and dryness. BLIS Q24TM offers the potential for the prevention of skin health-related issues and routine maintenance of skin microbiome for healthy skin.
An Initial Approach of Multiple Linear Regression in CO2-water Relative Permeability Prediction for Carbon Storage Projects
Authors: Yu Ying
Published: June 2024

This work discusses the feasibility of multiple linear regression in predicting water/CO2 relative permeability using training and testing datasets from two nearby wells, separately, of the Lower Cretaceous Lakota Sandstone, Jurassic Hulett Sandstone, and Pennsylvanian Minnelusa Formation at the Dry Fork Station site. The outcome is promising as the predicted and measured relative permeability data are decently comparable. Yet, whether this approach could be generally applicable needs more delicate models and larger training datasets to be determined.
In Vivo Approaches to Understand Arrhythmogenic Cardiomyopathy: Perspectives on Animal Models
Authors: Risato Giovanni , Brañas Casas Raquel , Cason Marco , Bueno Marinas Maria , Pinci Serena , De Gaspari Monica , Visentin Silvia , Rizzo Stefania , Thiene Gaetano , Basso Cristina , Pilichou Kalliopi , Tiso Natascia , Celeghin Rudy
Published: June 2024

Arrhythmogenic cardiomyopathy (AC) is a hereditary cardiac disorder characterized by the gradual replacement of cardiomyocytes with fibrous and adipose tissue, leading to ventricular wall thinning, chamber dilation, arrhythmias, and sudden cardiac death. Despite advances in treatment, disease management remains challenging. Animal models, particularly mice and zebrafish, have become invaluable tools for understanding AC's pathophysiology and testing potential therapies. Mice models, although useful for scientific research, cannot fully replicate the complexity of the human AC. However, they have provided valuable insights into gene involvement, signalling pathways, and disease progression. Zebrafish offer a promising alternative to mammalian models, despite the phylogenetic distance, due to their economic and genetic advantages. By combining animal models with in vitro studies, researchers can comprehensively understand AC, paving the way for more effective treatments and interventions for patients and improving their quality of life and prognosis.
Sensor-based and Visual Behavioral Profiling of Dry Holstein Cows Presenting Distinct Median Core Body Temperature
Authors: Ferri Bonmann Nicolle Francine , Delamanha Mendonca Luis Gustavo , Sellmer Ramos Isabella , Fritz Rebecca , Gamarra Caio , Duhatschek Dougulas , Saraiva Raphael , Scanavez Alexandre , Sakomoto Belem Thiago , Lucy Mathew C. , Nascimento Moraes Joao Gabriel
Published: June 2024

The consequences of heat stress during the dry period can extend into the postpartum period, affecting health and productivity in the subsequent lactation. We hypothesized that cows with distinct core body temperatures (CBT) would exhibit disparate behaviors associated with different degrees of heat generation or dissipation. The primary objective was to investigate behavioral differences of dry Holstein cows (n=50) classified as high-temperature (HT) or low-temperature (LT) based on median CBT during the summer months using visual observations and accelerometer technology. A secondary objective was to investigate the transcriptome of white blood cells (WBC) collected from a subgroup of HT and LT cows (n=5; per group). Minor behavior differences were observed during the visual observations (performed for a total of 16h/cow). Based on the accelerometer data, HT cows displayed higher periods of high activity and lower periods of inactivity prepartum and diminished rumination time postpartum than LT cows. There were 16 differently expressed genes (DEG) in WBC of HT than LT cows. Despite the low number, several of the identified DEGs have been previously associated with heat stress. Results indicate that CBT and patterns of activity prepartum may serve as valuable predictors for identifying dairy cows with distinct tolerance to heat stress.
Clinical and Economic Impacts of Optical Coherence Tomography prior to Cataract Surgery in a Low-to-Middle-Income Country
Authors: Inkarbekov Mansur , Kulmaganbetov Mukhit , Bazarbekova Galiya , Baiyrkhanova Almagul , Thompson Benjamin
Published: June 2024

Integrating optical coherence tomography (OCT) into the pre-surgical stage of cataract management holds significant clinical and economic potential, particularly in low-to-middle-income countries like Kazakhstan. This study aimed to evaluate these impacts by prospectively recruiting 124 patients, aged 70±8 years, from two ophthalmology surgical centers in Almaty, Kazakhstan. Patients undergoing phacoemulsification of cataracts with monofocal intraocular lens (IOL) implantation between January and December 2022 were divided into two groups: the OCT group (n=75) received pre-operative OCT, while the Control group (n=49) did not. Visual acuity (VA) was measured pre- and post-surgery, and the cost-effectiveness of the surgical strategies was analyzed. The OCT group experienced a significantly greater improvement in VA (-0.647±0.232 logMAR) compared to the Control group (-0.543±0.244 logMAR), with a notable interaction between time and group (F(df) = 217.2, p < 0.001). Additionally, pre-existing concomitant diseases were diagnosed in 25.3% of cases in the OCT group and 28.6% in the Control group. The economic analysis revealed that the integration of OCT facilitated multiple surgeries in one appointment, thereby reducing overall costs. These findings suggest that implementing OCT in the pre-surgical stage of cataract management can significantly enhance visual outcomes and decrease the cost of ophthalmology services in Kazakhstan.
Patient Outcomes in Resected Combined Hepatocellular Cholangiocarcinoma (cHCC-ICC) and Intrahepatic Cholangiocarcinoma: A Single Center Study
Authors: Lin Rick Y. , Kahramangil Doga , Ozer Muhammet , George Thomas J. , Nassour Ibrahim , Hughes Steven J. , Zarrinpar Ali , Sahin Ilyas
Published: June 2024

Combined hepatocellular cholangiocarcinoma (cHCC-ICC) is a rare malignancy that involves a combination of features of hepatocellular carcinoma and intrahepatic cholangiocarcinoma (ICC). cHCC-ICC is generally considered to exhibit a more aggressive clinical course compared to ICC; however, its risk factors and outcomes remain largely undefined. A single-center retrospective study of 82 patients diagnosed with ICC or cHCC-ICC from June 2011 and January 2023, all of whom underwent surgical resection. Our analysis included 70 patients with resected ICC and 12 with resected cHCC-ICC. The overall survival (OS) for the entire cohort was 21.6 months, with a recurrence-free survival (RFS) of 11.8 months. The cHCC-ICC group had significantly higher levels of AST and ALT (AST median 206 vs. 46; ALT median 165.5 vs. 48; p=0.012 and p=0.013, respectively), whereas the ICC group had higher alkaline phosphatase (median 66 vs. 104; p=0.03). CA 19-9 values (p=0.02) were higher in the ICC group, while AFP values were higher in the cHCC-ICC group (p=0.0004). The cHCC-ICC group had a significantly higher rate of recurrence (83% vs. 47%, p=0.028) with a significantly decreased RFS (4.7 months vs. 12.4 months; log-rank p=0.007). cHCC-ICC is a rare entity that needs to be further studied to improve patient outcomes. Our study showed that RFS is lower in the cHCC-ICC group as compared to ICC patients alone. Further studies are warranted and possibly suggest the need for more aggressive initial treatment strategies in patients diagnosed with cHCC-ICC.
Changes in Soil C, N, and P Concentrations and Stocks After Caatinga Natural Regeneration Over Degraded Pasture Area From Brazilian Semiarid
Authors: Silva Luiz Filipe dos Santos , Pessoa Luiz Guilherme Medeiros , Silva Emanuelle Maria da , Freire Maria Betânia Galvão dos Santos , De Souza Eduardo Soares , Oresca Denizard , Silva José Orlando Nunes da , Junior Genival Barros , Cezar Bezerra Alan , Santos Eduardo Silva dos
Published: June 2024

The conversion of caatinga vegetation areas into pastures in the Brazilian semiarid region has depleted soil fertility due to degradation. The natural regeneration of the caatinga has been the alternative adopted to restore soil fertility. However, the real effectiveness of this practice in re-covering organic carbon (SOC) and nutrient stocks is unknown. This work evaluated the effect of natural regeneration of the caatinga vegetation on the restoration of levels and stocks of SOC, N, and P as a strategy to maintain the sustainability of the environment. We collected soil samples every 5 cm, up to 20 cm deep, in areas of degraded pasture, caatinga in regeneration (10 years), and regenerated caatinga (35 years) to evaluate the levels and stocks of SOC, N, and P. The depth sig-nificantly affects the levels and stocks of SOC, N, and P. Stocks and levels of SOC, N, and P were higher in regenerated caatinga > regenerating caatinga > degraded pasture. The regenerated caatinga increased SOC, N, and P stocks by 115%, 110%, and 117%, respectively, compared to the degraded pasture. Although 35 years of regeneration of the caatinga has improved soil fertility, the levels and stocks of SOC, N, and P remain low.
Hybrid Solid Polymer Electrolytes Based on Epoxy Resins, Ionic Liquid and Ceramic Nanoparticles for Structural Applications
Authors: Muñoz Bianca K. , Lozano Martín Jorge , Sanchez Maria , Ureña Alejandro
Published: June 2024

Solid polymer electrolytes and composite polymer electrolytes serve as crucial components in all-solid-state energy storage devices. Structural batteries and supercapacitors present a promising alternative for electric vehicles, integrating structural functionality with energy storage capability. However, despite their potential, these applications are hampered by various challenges, particularly in the realm of developing new solid polymer electrolytes that require more investigations. In this study, novel solid polymer electrolytes and composite polymer electrolytes were synthesized using epoxy resin blends, ionic liquid, lithium salt, and alumina nanoparticles, and subsequently characterized. Among the formulations tested, the optimal system, designated as L70P30ILE40Li1MAl2 and containing 40 wt.% of ionic liquid and 5.7 wt.% of lithium salt, exhibited exceptional mechanical properties. It displayed a remarkable storage modulus of 1.2 GPa and reached ionic conductivities of 0.085 mS/cm at 60°C. Furthermore, a proof-of-concept supercapacitor was fabricated, demonstrating the practical application of the developed electrolyte system.
From Mountains to Data: Low-Cost Weather Stations in Kyrgyzstan’s Challenging Terrain
Authors: Zennaro Marco , Soltobaev Aziz , Sultanov Talant , Moldobekov Bolot , Pietrosemoli Ermanno
Published: June 2024

Kyrgyzstan, a landlocked nation in Central Asia, is characterized by its rugged mountainous terrain, which covers approximately 90% of its land area. This unique geography poses specific challenges related to climate vulnerability. To address these challenges, we propose a comprehensive approach that involves gathering meteorological data and making it accessible to decision-makers. By leveraging LoRaWAN communication technology, which efficiently transmits sparse and low-speed data over long distances while minimizing power consumption, we can enhance climate resilience. The Internet Society Kyrgyz Chapter, in collaboration with the International Centre for Theoretical Physics (ICTP) and the Central Asia Institute for Applied Geosciences (CAIAG), has initiated the installation of meteorological sensors and disaster mitigation devices, including river water level sensors, terrain moisture sensors, and tilt detectors. These sensors collect critical data, which is stored within the country on an ad hoc server. Stakeholders can access this data according to their specific requirements. This paper outlines the criteria for selecting the deployed equipment and provides details on the installation process at pilot sites, along with the challenges encountered during project execution.
Double Polarized Optical Link for Mobile Networks
Authors: Berceli Tibor , Badraoui Nada
Published: June 2024

The demand for improved service in mobile networks is always increasing. That means signal transmission with higher capacity is required. To achieve that goal a combined optical and wireless link using double polarization multiplexing has been developed. A high quality signal transmission is achieved by applying high polarization extinction ratio. The new concept is validated by experiments varying the bit rate and fiber length. A signal with 12 Gbit/s bit rate was transmitted over a 25 km long combined link with about 1.10-8 bit error rate. That result is much better than the already published data which were measured on links transmitting information with 2.5 Gbit/s bit rate. The polarization multiplexing technique is very practical for capacity enhancement in a specific section of an existing optical fiber by inserting a new link into it without deploying a new fiber.
The Effect of Profitability, Liquidity, Leverage, Firm Size, Operating Capacity, and Retained Earnings Towards Financial Distress: Evidence from Energy Companies
Authors: Adityaningrum Fatimah , Widyaningrum Mei Nia , Mahirun Mahirun
Published: June 2024

This research aims to anticipate the possibility of financial distress by analyzing fundamental company financial factors such as profitability, liquidity, leverage, firm size, operating capacity and retained earnings ratio, specifically in energy sector companies listed on the Indonesia Stock Exchange in 2018-2022. The type of research carried out is causal associative research. This research data uses secondary quantitative panel data. The population in this study are energy companies listed on the Indonesia Stock Exchange in the 2018-2022 period. This sector was selected due to indications that energy companies were facing financial difficulties during the pandemic, as evidenced by several energy companies being delisted from the stock exchange. The sampling technique used was purposive sampling, obtaining 58 companies as research samples with five years of observation, resulting in 290 total observation data. The technique used for analysis is logistic regression with the help of EViews 13 software. The results of this study show that liquidity, firm size, and retained earnings hurt financial distress, while leverage has a positive effect on financial distress. Meanwhile, profitability and operating capacity do not affect financial distress. This research provides empirical evidence about the factors that influence financial distress and contributes to the signaling theory application literature in predicting bankruptcy conditions through financial distress analysis. Thus, this research could be a consideration for stakeholders when making decisions.
Learning Difficulties of Essay Written Among Language Preparation Female Students Ar-Raayah University Sukabumi
Authors: Mukhlishoh Mukhlishoh , El-Haq Arini , Aziz Abdul , Khanif Muhammad , Ramlan Nur Cholis Slamet
Published: June 2024

Mastery of essay written is mastery of Arabic entirely, because in it there is the application of elements of Arabic, especially vocabulary and compositions. This study aims to: 1) Knowing the types of difficulties or problems faced by Language Preparation Female Students Ar- Raayah University in learning essay written. 2) Reveal the cause of the problem to get a solution from the cause. 3) Reveal the effect of these difficulties in learning essay written. The method used in this research is a case study method through a qualitative approach, and the data collected is analyzed by various methods, namely interviews, observation, sorting, presenting and drawing conclusions. The results of the study were: 1) The types of difficulties faced by Language Preparation Female Students Ar- Raayah University in learning essay written were some of them faced difficulties in expressing what came to mind into writing, difficulties in connecting ideas, and difficulty in selecting some vocabulary, difficulty in applying grammar and spelling. 2) The causes of difficulties in learning essay written are due to a lack of understanding of the text, a lack of linguistic balance, and the influence of the mother tongue and the language of the environment. 3) Difficulty learning essay written affects academic achievement, writing academic research, and the existence of negative behavior about essay written. The conclusion of the study shows the importance of eliminating these difficulties by overcoming their causes to assist female students in learning Essay Written in improving academic achievement, writing good academic research, and avoiding negative behaviors from learning essay written.
Keywords: Difficulty, Learning, Essay Written, Arabic, STIBA Ar-Raayah
Phenomena of the Seven Textual Standards in Literary Texts (Utilization of Cohesion in “Kalila and Dimna”)
Authors: Ariffain Muhammad Haziq , Binti Yaacob Sholehah
Published: June 2024

Since the text linguistics study was invented, its role as a tool of text analysis may not fully recognized. Besides, it mostly covered the study of contemporary text, though it was used by some scholars in analysing of Arabic classical texts. Yet, some scholars were refused to use it as it was seemed not suit on literary study field. Meanwhile, there were rhetorical study which can be focused on that field. Unfortunately, researcher was seeing this in a opposite side. Whereas there is a scholar named Robert de Beaugerande who invented and standardized the standard way of text analysing so called the Seven Standards of Textuality and develop them on English linguistic studies. Thus, by knowing their significance in linguistic studies, this study aims to approach one of the Seven Standards which is Cohesion and study it practically on the “Kalīla wa Dimna” as classical literary texts, seeking for the linguistic values of texts and prove the effectiveness of study. The result of this reserch is that the seven textual standards established by Robert de Beaugrand have many functions that are important during the study of written texts, especially while analyzing them within the framework of as-sabk, which is one of the most important criteria in text formation and interpretation.
Keywords: Textual Linguistic Study, Text Analysis, Cohesion, Classical Texts, Kalila wa Dimna
Magma chamber longevity on Mars and its controls on crustal structure and composition
Authors: Chatterjee Arka , Huber Christian , III James Head , Bachmann Olivier
Published: June 2024

In volcanically active planetary bodies, the depths and longevity of crustal magma storage critically control eruptibility and crustal composition. A paucity of relevant observations and models has challenged our understanding of the development of crustal magma storage systems in Mars and their role in the apparent lack of evolved compositions. Here, we use numerical modelling, together with recent results from the InSight mission, to study the evolution of crustal magma chambers on Mars and conditions that promote their growth and eruptibility. We find that the Martian crust can be divided, by depth, into three major domains. For Elysium Planitia (the InSight landing site), at depths ≤15km (~1.5kbar), trapped magma pods are small, short-lived, with high diking potential, hindering the production of evolved compositions. While depths >25km (~2.5kbar) can host long-lived magma chambers, 15-25km (~2 ± 0.5kbar) marks a transition where magma chambers could grow while concurrently expelling magma. Interestingly, this narrow depth window overlaps with the depth of an intra-crustal discontinuity reported by InSight, suggesting a possible magmatic origin for the discontinuity. We further show that the crustal thermal gradient strongly controls this transition depth, indicating the possible variability of the domain depths in different terrains. Our results also support the likelihood of deep-seated magmatism beneath the seismically active Cerberus Fossae, suggesting that magmatism continues to play a major role in shaping the Martian crust.
Level of clinical competency and associated factors of nursing students in Ethiopia: systematic review and meta-analysis
Authors: workneh Moges , Kassa Molla , Mihrete Setegn , Belege Fekadeselassie , Nigussie Jemberu , Goshiy Debrnesh , Biset Gebeyaw
Published: June 2024

Background:Assessing the clinical level of competency in nursing students is crucial as it represents the ultimate goal of nursing education. Poor competency result in low performance and can be influenced by various factors. Thus, the aim of this study was to identify level of clinical competency and associated factors of nursing students in Ethiopia
Methods:systematic review and meta-analysis was employed. Searching strategy was conducted from January up to march 2024 from Web of Science, PubMed and Google Scholar. The quality of studies was assessed using PRISMA checklist. A meta-analysis was performed using R Studio with the meta package Version 1.4.1106.
Results: in total, 145 studies were identified through database search, and only 7 studies were included in the meta-analysis representing 1937 nursing students. The pooled effect size of clinical competency of nursing students was 28%. Three factors were found to be associated with clinical competency: a positive clinical learning environment, student confidence in performing procedures, and effective staff-student interaction. The effect sizes of these factors were 6.30, 2.23, and 7.76, respectively.
Conclusion and recommendation: The clinical competency of nursing students was 28%, and it was associated with clinical learning environment, student confidence in performing procedures, and staff-student interaction. Nursing education programs should focus on enhancing students' competency levels by addressing specific factors.
(PROSPERO) International prospective register of systematic reviews: CRD42022367057
Integrative Neuro-social cognitive Strategy Programme for Instilling REcovery (INSPIRE): a Community-Based Cognitive Remediation Trial-Study Procotol
Authors: Tan Bhing-Leet , Tan Noel , Koh Vanessa , Poh Lin , Medalia Alice
Published: June 2024

Background
Adults with schizophrenia experience a range of neurocognitive problems that affect their daily functioning. Evidence for the efficacy of cognitive remediation in schizophrenia has been established, but its implementation in under-resourced community-based settings is less well-studied. In recent years, interventions have also focused on the strategy-learning approach in favor of drill-and-practice. Moreover, there is an increasing recognition to address social cognition and negative symptoms alongside neurocognition.
This study attempts to carry out cognitive remediation in a community mental health setting. The Neuropsychological and Educational Approach to Remediation (NEAR) is used as the cognitive remediation intervention. Neurocognitive and social cognitive games will be introduced during the computer-assisted cognitive exercises sessions. In addition, the instructional technique will foster the use of metacognition and cognitive strategies. Moreover, metamotivation training will be the focus of some bridging sessions to enhance motivation to engage in goal-directed learning behaviors.
The aims of the study are to 1) investigate the effects of cognitive remediation on neurocognition, social cognition and functional outcomes of participants with schizophrenia/schizoaffective disorders in community mental health settings; and 2) explore the mediators for change (eg: metamotivation, metacognition and negative symptoms) in cognitive performance and functional outcomes.
Methods
This randomized controlled trial will be conducted in three Singapore Anglican Community Services (SACS) centers, where standard psychiatric rehabilitation is delivered. Participants who are randomized to the experimental arm will receive cognitive remediation and psychiatric rehabilitation, while those randomized to the control arm will receive standard psychiatric rehabilitation only. Cognitive remediation is carried out three times a week for 12 weeks. It consists of computer-assisted cognitive exercises, as well as bridging groups to aid transfer of learning to daily living. Baseline, post-intervention and eight-week follow-up measurements will be collected. Group by time differences in cognitive performance, negative symptoms, metamotivation, metacognition, functioning and recovery will be analyzed across the three time points. Mediators for improvement in cognitive performance and functioning will also be explored.
Discussion
Findings of this research will add to the body of knowledge about the key therapeutic ingredients within a strategy-based cognitive remediation program and improve its implementation within under-resourced community settings.
Trial registration: this study has been registered with ClinicalTrials.gov (ID: NCT06286202). Date of registration: 29 February 2024. Date of last update: 21 May 2024.
Enhancing hexavalent chromium removal using amino-functionalized manganese oxide (birnessite) for improved adsorption efficiency
Authors: Slek Yassine , Amarray Amina , Salmi Mehdi , rharib Meryem El , Zaroual Zaina , Ghachtouli Sanae El
Published: June 2024

This study investigates the use of functionalized manganese oxide (K-MnO2-NH2) for removing Cr(VI) ions, a notably hazardous heavy metal contaminant,, from wastewater. The synthesis of K-MnO2-NH2 occurred in two steps followed by comprehensive characterization using various techniques, confirming its formation as pure-phase. The material demonstrated a high chromium removal efficiency (up to 90% at pH 2) attributed primarily to the introduction of amine groups through functionalization with 3-aminopropyltriethoxysilane (APTES). These amine groups create active sites displaying a strong affinity towards Cr(VI) ions. Kinetic studies suggest a chemical reaction governs the adsorption process, while thermodynamic data indicate it to be exothermic. Freundlich isotherm best describes the adsorption behaviour compared to Langmuir and Temkin models. K-MnO2-NH2 effectively removed Cr(VI) from real wastewater, achieving a removal efficiency of around 41% and causing a visible discoloration. Remarkably, the material exhibits excellent reusability, maintaining over 80% removal efficiency after five cycles without any regeneration procedures. This innovative approach provides a sustainable and efficient method for removing Cr(VI) from wastewater, showcasing the considerable potential of K-MnO2-NH2 in environmental remediation and water purification efforts.
Exploring Thirst Incidence and Risk Factors in Patients Undergoing General Anesthesia after Extubation Based on ERAS Principles
Authors: Zeng Zhihe , Lu Xinge , Sun Ye , Xiao Zhaoyang
Published: June 2024

Background
This study aims to comprehend the levels of dry mouth and thirst in patients after general anesthesia, and to identify the factors influencing them.
Methods
The study included all patients transferred to the Post Anesthesia Care Unit (PACU) at the Second Affiliated Hospital of Dalian Medical University between August 2021 and November 2021 after undergoing general anesthesia. A thirst numeric rating scale was utilized to conduct surveys, enabling the assessment of thirst incidence and intensity. Statistical analysis was performed to explore patient thirst levels and the associated factors.
Results
The study revealed a thirst incidence rate of 50.8%. Among the thirst intensity ratings, 71.4% of patients experienced mild thirst, 23.0% reported moderate thirst, and 5.6% expressed severe thirst. Single-factor statistical analysis of potential risk factors among the enrolled cases indicated that gender, history of coronary heart disease, surgical duration, intraoperative fluid volume, intraoperative blood loss, intraoperative urine output, and different surgical departments were linked to post-anesthetic thirst in patients undergoing general anesthesia. Multifactorial Logistic regression analysis highlighted age, gender, history of coronary heart disease, fasting duration, and intraoperative fluid volume as independent risk factors for post-anesthetic thirst in patients undergoing general anesthesia. Moreover, age, gender, history of coronary heart disease, and intraoperative fluid volume were also identified as risk factors for varying degrees of thirst.
Conclusion
The incidence and intensity of post-anesthetic thirst after general anesthesia are relatively high. Their occurrence is closely associated with age, gender, history of coronary heart disease, fasting duration, and intraoperative fluid volume.
Oral microbiome components predict response to neoadjuvant chemotherapy in triple-negative breast cancer patients
Authors: Fu Xiaoyan , Huang Ze , Liu Ziteng , Li Zongyan , Yang Qingyu , Li Haiyan
Published: June 2024

Background
The oral microbiome, as a crucial biomarker and regulator in cancer development and response to treatment, has gradually gained attention among researchers. However, its impact on breast cancer remains poorly understood. The influence of oral microbiome on the chemotherapy sensitivity of triple-negative breast cancer (TNBC) and its molecular mechanism are still unclear, and further confirmation is needed to determine whether it can be used as a biomarker for predicting chemotherapy sensitivity in TNBC.
Results
We observed significant differences in the composition of oral microbiome among patients with varying chemotherapy sensitivities for TNBC patients, as well as notable changes in oral microbiome after chemotherapy in patients with favorable responses to treatment. Our analysis revealed that chemotherapy sensitivity patients had higher levels of Lactobacillus and Neisseria components, while exhibiting lower levels of Clostridium components. After chemotherapy, there was an increase in Clostridium and Microbacillus components among patients with positive responses, along with a decrease in Streptococcus and Neisseria components. Conversely, no significant differences were observed in the microbiota of patients with poor responses after undergoing chemotherapy. Biomarkers were selected for the response-prediction classifier, which yielded an area under the curve value of 77.3% (95%CI: 60.5%-94.2%).
Conclusion
Oral microbiome can serve as a potential biomarker for predicting neoadjuvant chemotherapy sensitivity in triple-negative breast cancer due to its simplicity, non-invasiveness, and repeatability.
Enhancing Children’s Numeracy and Executive Function Skills via Explicit Integration: A Randomized Controlled Trial
Authors: Scerif Gaia , Sugevic Jelena , Andrews Hannah , Blakey Emma , Gattas Sylvia , Godfrey Amy , Hawes Zachary , Howard Steven , Kent Liberty , Merkley Rebecca , O'Connor Rosemary , O'Reilly Fionnuala , Simms Victoria
Published: June 2024

Executive functions (EF) are crucial to regulating learning and are predictors of emerging mathematics. However, interventions that integrate to improve mathematics remain poorly understood. 193 four-year-olds (mean age = 3 years:11 months pre-intervention; 111 female, 69% White) were assessed 5 months apart, with 103 children randomized to an integrated EF and mathematics intervention. We hypothesized that the intervention would improve mathematics scores more than practice-as-usual. Multi-level modelling and network analyses were applied to the data. The intervention group improved more than the control group in overall numeracy, even when we controlled for differences across settings in EF and mathematics enhancing practices. EF and mathematics measures showed greater interconnectedness between EF and mathematics post-intervention. In addition, disadvantaged children in the intervention group made greater gains than in the control group. Our findings emphasize the need to consider EFs in their integration with co-developing functions, and in their educational and socio-economic context.
Cervical cancer risk stratification based on nationwide electronic health data: a retrospective modelling and validation study from Estonia
Authors: Tisler Anna , MA Andres Võrk , Tammemägi Martin , Ojavee Sven Erik , Raag Mait , Šavrova Aleksandra , Nygard Mari , Nygard Jan , Stankunas Mindaugas , Kivite-Urtane Anda , Uusküla Anneli
Published: June 2024

Transitioning to an individualized risk-based approach can significantly enhance cervical cancer screening programs.
We aimed to derive and internally validate a prediction model for assessing the risk of cervical intraepithelial neoplasia grade 3 or higher (CIN3+) and cancer in women eligible for screening. This retrospective study utilized data from the Estonian electronic health records, including 517,884 women from the health insurance database and linked health registries. We employed Cox proportional hazard regression, incorporating reproductive and medical history variables (14 covariates), and utilized the least absolute shrinkage and selection operator (LASSO) for variable selection. A 10-fold cross-validation for internal validation of the model was used. The main outcomes were the performance of discrimination and calibration.
Over the 8-year follow-up, we identified 1,326 women with cervical cancer and 5,929 with CIN3+, with absolute risks of 0.3% and 1.1%, respectively. The prediction model for CIN3+ and cervical cancer had good discriminative power and was well calibrated Harrell's C of 0.74 (0.73 - 0.74) (calibration slope 0.99 (0.94 - 1.03) and 0.67 (0.66 - 0.69) (calibration slope 0.96 (0.88 - 1.04) respectively. A developed model based on nationwide electronic health data showed potential utility for risk stratification to supplement screening efforts.
Integrated transcriptome and targeted metabolome analyses provide insights into flavonoid biosynthesis in kiwifruit (Actinidia chinensis)
Authors: Mao Jipeng , Gao Zhu , Wang Xiaoling , Yao Dongliang , Lin Mengfei , Chen Lu
Published: June 2024

So far, a variety of metabolite components of kiwifruit have been elucidated. However, the identification and analysis of flavonoids in different tissue of kiwifruit are rarely carried out. In this study, we performed transcriptome and metabolome analyses of roots (Gkf_R), stems (Gkf_T), leaves (Gkf_L) and fruits (Gkf_F) to provide insights into the differential accumulation and regulation mechanisms of flavonoids in kiwifruit. Results showed that total of 301 flavonoids were identified, and in four tissues with the different accumulation trends, and a large proportion of flavonoids with high accumulation in Gkf_L and Gkf_R. A total of 84 genes have been identified involved in the flavonoid biosynthesis pathway, and the expression level of five LAR, two DFR, and one HCT were significantly correlated with the accumulation of 16 flavonoids and co-localized in the flavonoid biosynthesis pathway. In addition, a total of 2,362 transcription factors were identified, mainly included MYB, bHLH, ERF, bZIP and WRKY, among which the expression level of bHLH74, RAP2.3L/4L/10L, MYB1R1 and WRKY33 were significantly correlated with 25, 56, 43 and 24 kinds of flavonoids. Our research will enrich the metabolomic data, provide useful information for the directed genetic improvement and application in the pharmaceutical industry of kiwifruit.
Relationship and factors of technical efficiency and quality of hospital care: the federal state system of Germany
Authors: Vrabková Iveta , Vaňková Ivana , Lee Sabrina
Published: June 2024

The healthcare system utilises parameters like quality, efficiency, and equality (availability), creating a flexible system in which one parameter reacts to another to a certain extent. This research reacts to these facts, often discussed by experts as well as the general public. It aims to determine the relationship between technical efficiency and quality of hospital care in the context of the federal states of Germany and approximate the influence of selected external factors on their results. The inquiry involves 64 homogeneous production units, i.e., 16 federal states, in 2018–2021. It is therefore a macroeconomic view of the technical efficiency of the units examined and the quality of hospital care within the context of external conditions. Four variables were selected for the evaluation of the DEA input-oriented model (CRS, VRS) – 2 inputs (number of patients per 1 physician, number of patients per 1 nurse) and 2 outputs (number of hospitalised patients per 1 bed, number of days of treatment per 1 bed). The quality of hospital care was analysed based on the results of the nationwide survey of satisfaction of hospital patients. The following factors were selected to investigate the influence of the factors on the results of technical efficiency and quality: number of public hospitals, number of non-profit hospitals, number of private hospitals, number of persons up to the age of 15, number of persons aged over 65. The results showed that the relationship between technical efficiency and quality is inverse in most DMUs. Different results were observed in the city states of Berlin, Bremen, and Hamburg. The results of the tobit model showed that 84% of the net technical efficiency of the hospitals depends on the proportion of limit population groups (the age groups 65 + and up to the age of 15) within the population of the state in question. The results of the influence of external factors on patient satisfaction scores can be explained at the rate of 32%.
JEL Classification E23, I10, C02
The Tale of Two Ions Na+ and Cl- : Unraveling Onion Plant Responses to Varying Salt Treatments
Authors: Romo-Pérez M. L. , Weinert C. H. , Egert B. , Kulling S. E. , Zörb C.
Published: June 2024

Background Exploring the adaptive responses of onions (Allium cepa L.) to salinity reveals a critical challenge for this salt-sensitive crop. While previous studies have concentrated on the effects of sodium (Na+), this research highlights the substantial yet less-explored impact of chloride (Cl−) accumulation. Two onion varieties were subjected to treatments with different sodium and chloride containing salts to observe early metabolic responses without causing toxicity.Results The concentrations of both ions were increased; with Cl− exhibiting a more pronounced effect on metabolic profiles than Na+. Onions adapt to salinity by altering organic acid concentrations, which are critical for essential functions such as energy production and stress response. The landrace Birnförmige exhibited more effective regulation of its Na+/K+ balance and a milder response to Cl− compared to the hybrid Hytech. Metabolic alterations were analyzed using advanced techniques, revealing specific responses in leaves and bulbs to Cl− and Na+ accumulation.Conclusion The comprehensive study provides new insights into onion ion regulation and stress adaptation, emphasizing the importance of considering both ions, Na+ and Cl− when assessing plant responses to salinity.