bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Social Support, Perceived Stress, and Psychological Distress Mediate the Relationship Between Social Problem‐Solving and Suicidality in People With Gender Dysphoria?
Authors: Eskin Mehmet , Turan Şenol
Published: December 2024

Individuals with gender dysphoria (GD) often exhibit suicidal inclinations. In the present study, we investigated the scope of suicidal ideation and attempts and the roles of perceived social support, stress, and psychological distress in mediating social problem‐solving and suicidality in individuals with GD. Two hundred and five adults with GD (110 GD assigned female at birth [AFAB]; 95 GD assigned male at birth [AMAB]) completed a self‐report survey including questions about suicide ideation and attempts, as well as the General Health Questionnaire (GHQ‐12), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale (PSS), and Social Problem‐Solving Inventory‐Revised (SPSI‐R). We utilized correlation, regression, and mediation analyses to assess models. Overall, both suicidal ideation (for AFAB = 61.8%; for AMAB = 61.1%; p = 0.91) and suicide attempts (for AFAB = 43.6%; for AMAB = 37.9%; p = 0.41) were common in individuals with GD. The two groups did not differ in GHQ‐12, PSS, and SPSI‐R total scale scores, but AMAB scored lower on the MSPSS total score. Perceived social support, perceived stress, and psychological distress partially mediated social problem‐solving and suicidal ideation, whereas perceived stress and psychological distress fully mediated social problem‐solving and suicide attempts. There is a need to develop interventions to improve the psychological well‐being of people with GD. Current results suggest that problem‐solving therapy may effectively suit the need to manage suicidality in people with GD.
Advancing Large Language Models for Spatiotemporal and Semantic Association Mining of Similar Environmental Events
Authors: Tian Yuanyuan , Li Wenwen , Hu Lei , Chen Xiao , Brook Michael , Brubaker Michael , Zhang Fan , Liljedahl Anna K.
Published: December 2024

Retrieval and recommendation are two essential tasks in modern search tools. This paper introduces a novel retrieval‐reranking framework leveraging large language models to enhance the spatiotemporal and semantic associated mining and recommendation of relevant, unusual climate and environmental events described in news articles and web posts. This framework uses advanced natural language processing techniques to address the limitations of traditional manual curation methods in terms of high labor costs and lack of scalability. Specifically, we explore an optimized solution to employ cutting‐edge embedding models for semantically analyzing spatiotemporal events (news) and propose a Geo‐Time Re‐ranking strategy that integrates multi‐faceted criteria including spatial proximity, temporal association, semantic similarity, and category‐instructed similarity to rank and identify similar spatiotemporal events. We apply the proposed framework to a dataset of four thousand local environmental observer network events, achieving top performance on recommending similar events among multiple cutting‐edge dense retrieval models. The search and recommendation pipeline can be applied to a wide range of similar data search tasks dealing with geospatial and temporal data. We hope that by linking relevant events, we can better aid the general public to gain enhanced understanding on climate change and its impact on different communities.
An Automated Identification Method for Place Spoofing Toponyms
Authors: Kang Mengjun , Jiang Leyi , Li Bozhao , Su Shiliang , Weng Min , Zhao Fei
Published: December 2024

Place spoofing toponyms (PSTs) are intentionally misleading toponyms that convey false meanings that are inconsistent with the real scenarios they represent. At present, the negative impact of PSTs on politics and the economy, especially in pursuit of commercial profits in the making of lofty toponyms, is becoming increasingly serious. It is difficult for some government departments to distinguish PSTs efficiently and comprehensively via manual methods. Therefore, there are three aspects in the creation of PSTs that require optimization to facilitate the task: semantic unit segmentation, vector representation, and classification algorithms. This paper proposes an automated method for identifying PSTs. It employs a Transformer model trained on manually labeled semantic units to perform word segmentation, utilizes a pretrained language model to generate word vectors, and employs TextRCNN for short text classification. The automated method was evaluated with 60,000 toponyms from Wuhan, China, and the results show that the weighted F1 is 97.48%, with high precision and recall, which could serve as a reference for toponym management by government departments.
Development of criteria to optimize manual smear review of automated complete blood counts using a machine learning model
Authors: Hayes Jennifer M. , Hayes Mitchell R. , Friedrichs Kristen R. , Simmons Heather A.
Published: December 2024

Background

Manual blood smear review (MSR) to complement automated CBC results is a labor‐intensive process. Efforts have been made to use criteria based on automated hematology analyzer data to identify samples warranting MSR. These efforts have coincided with the emergence of modern data science and machine learning.

Objective

In this study, we aim to determine if machine learning can reduce manual smear review (MSR) rates while meeting or exceeding the performance of traditional MSR criteria.

Method

9938 automated CBCs with paired MSRs were performed on samples from rhesus and cynomolgus macaques. The definition of a positive (abnormal) smear was determined. Two expert‐derived MSR criteria were created: criteria adapted from published, standardized human laboratory criteria (Adapted International Consensus Guidelines[aICG]) and internally generated criteria (Center Consensus Guidelines [CCG]). An ensemble machine learning model was trained on an independent subset of the data to optimize the balanced accuracy of classification, a combined measure of sensitivity and specificity. The resulting machine learning model and the two expert‐derived MSR criteria were applied to a test dataset, and their performance compared.

Results

aICG criteria demonstrated high sensitivity (80.8%) and MSR rate (74.2%) while CCG criteria demonstrated lower sensitivity (57.1%) and MSR rate (36.1%). The machine learning model integrated with CCG criteria had a superior combination of both sensitivity (76.8%) and MSR rate (45.1%) achieving a false negative rate of 1.6%.

Conclusion

Machine learning in combination with expert‐derived criteria can optimize the selection of samples for MSR thus decreasing MSR rates and labor efforts required for CBC performance.
Do Incentives Mediate the Willingness of Civil Defence Force Volunteer Members to Respond in Pandemic and Stay as Volunteers?
Authors: Salleh Siti Hasliah , Mohamed Yusof Nor Ashikin , Mohamed Saleh Ba Qutayan Shadiya , Saimy Intan Sazrina
Published: December 2024

During the COVID-19 pandemic, Malaysia opened over thirty Low-Risk COVID-19 Quarantine and Treatment Centre (PKRC). These PKRCs needed many volunteers to help first responders with non-medical services and patient management. Luckily many new volunteers signed up for this risky work. These volunteer hours were paid. How willing are they to volunteer? Will they stay? Did the incentive mediate volunteering and staying? To illuminate, this research was done. 391 respondents involved. They were the volunteers registered with the Civil Defence Force (the Force). They were chosen by voluntary sampling technique. An online survey was used for data collection. The survey instrument contains two main variables: willingness to respond and intention to stay, and a mediator: incentives. The instrument adapted the Expectancy Theory of Motivation and the Extended Parallel Process Model. The study found that their willingness to respond during pandemics was at a moderate level. Their intention to stay, however, is low. The availability of incentives has been identified as a significant mediator in influencing volunteers' willingness to respond during pandemics and retain them as Civil Defence Force volunteer members. This was significant because many people lost their jobs when the pandemic occurred. Their job alternative at that time was paid volunteering. Thus, it is relevant for the government to offer incentives if a huge number of volunteers is required during a long-term disaster.
Experimental Study on the Performance of Biohythane Combustion in a Porous Radiant Burner Operated on Submerged Mode
Authors: Dash Kishan , Acharya Saroj Kumar , Samantaray Sikata
Published: December 2024

Present energy consumption and environmental conditions have motivated researchers to explore renewable and alternative energy sources for cooking. Biohythane is a renewable fuel, that can be prepared by purifying biomethane and biohydrogen along with CO2, generated from the anaerobic digestion of biological sources like food waste and cow dung. The current research aims to analyze the combustion performances of biohythane in a double-layered porous radiant burner (PRB) made of silicon carbide and ceramic matrix. The experiment was conducted in the PRB by varying the input fuel range (thermal load) of 200–400 kW/m2, and the biohydrogen percentage of 5–20 in the biohythane for lean fuel–air mixture conditions. It was observed that the PRB performed steadily within the equivalence ratio of 0.55–0.76 and offered radiation efficiency of 41.39–89.93%, CO of 11–84 ppm, and NOX of 4–6.1 ppm. As the biohydrogen percentage increases from 5–20 in the biohythane, the temperature, radiation efficiency, and NOX have increased but the CO has decreased. Further, the temperature and NOX emission have increased due to the increase in thermal load and equivalence ratio, but the CO emission has increased with the increase in thermal load only and decreased due to the increase in equivalence ratio in the PRB. Moreover, the radiation efficiency has increased due to the increase in equivalence ratio only. Overall, the PRB offers efficient combustion of biohythane in the range of a low fuel–air combination.
Time-Dependent Wave Motion in a Running Stream Due to Initial Disturbances in Magnetohydrodynamics
Authors: Hossain Selina , Biswas Riyam , Nandi Koushik , De Soumen
Published: December 2024

The generation of two-dimensional time-dependent magnetohydrodynamic surface waves in a flowing stream is investigated in this paper. The waves here arise from some initial disturbances at the free surface of an electrically conducting field-free fluid, which is of finite depth. It is also assumed that a constant magnetic field exists outside the air–water interface. With the help of linearized theory, the present problem is modeled as an initial boundary value problem, and the Laplace–Fourier transform techniques are primarily used to obtain the form of free surface elevation through infinite integrals. These integrals are then interpreted asymptotically for large time t and distance x from the origin, using the method of stationary phase. Dispersion relation, phase, and group velocities are also studied. Numerical results of the asymptotic form of free surface elevation are obtained in a number of figures for different values of current speed, Alfven velocity, and various types of initial disturbances. Graphical representations demonstrate that the presence of a magnetic field has a significant effect on wave motion.
Annual Energy Analysis of a Building-Integrated Semitransparent Photovoltaic Thermal Façade
Authors: Hazarika Puja , Shyam  , Kalita Pankaj , Gaur Ankita
Published: December 2024

This study numerically examines the performance of a building-integrated semitransparent photovoltaic thermal (BiSPVT) façade in Srinagar, India's weather conditions. The primary objective is to explore the façade's potential to reduce building energy consumption while enhancing the electrical efficiency of photovoltaic (PV) modules by effectively cooling their surfaces through adjacent air circulation. A 1-D thermal model, implemented in matlab, analyzes the façade's performance under distinct weather conditions: clear day, hazy day, hazy and cloudy day, and fully cloudy day. The assessment of climatic conditions considers their impact on both building-integrated photovoltaic (BIPV) cell temperature and the annual energy output in a steady-state, considering the fluctuations in thermal losses. Results reveal the highest electrical efficiency of 18.9% and an overall thermal efficiency of 57.58% in January. Annually, the BiSPVT façade system generated 121.22 kWh/m2 of electrical energy, 61.06 kWh/m2 of thermal energy, 366.23 kWh/m2 of overall thermal energy, and 122.36 kWh/m2 of useful exergy. These findings offer insight into the reduction in the utilization of conventional sources of energy due to sustainable building design and renewable energy utilization.
Lead-free dielectric thin films: Synthesis of Ag(Nb1−xTax)O3 via reactive dc magnetron sputtering
Authors: Kölbl L. , Mehrabi M. , Griesser T. , Munnik F. , Mitterer C.
Published: December 2024

Growing environmental concerns have driven the switch from lead-containing dielectric perovskite ceramics to lead-free alternatives such as silver niobate tantalate [Ag(Nb1−xTax)O3], where tantalum (Ta) substitution for niobium (Nb) enhances energy-storage density. Thin film deposition presents a promising way for fabricating these materials for use in capacitors. In this study, Ag(Nb1−xTax)O3 (0 ≤ x ≤ 0.5) thin films are synthesized via combinatorial reactive dc magnetron sputtering from metallic targets. The chemical and phase compositions of the films are comprehensively analyzed using scanning electron microscopy coupled with energy dispersive x-ray spectroscopy, elastic recoil detection analysis, Rutherford backscattering spectrometry, x-ray diffraction, Raman spectroscopy, and x-ray photoelectron spectroscopy. The findings demonstrate that reactive dc magnetron sputtering is a feasible technique for producing complex perovskite oxide thin films with customized chemical composition and microstructure. By enhancing the understanding of the Ag(Nb1−xTax)O3 material system, this study aims to contribute to the development of environmentally benign high-performance dielectrics that could replace lead-based ceramics in energy-storage applications.
The Lambert diffuse reflection model revisited
Authors: Svensson U. Peter , Savioja Lauri
Published: December 2024

The Lambert diffuse reflection model is used widely in computerized prediction of sound in rooms as well as for outdoor scenarios. One seemingly surprising consequence of the model was pointed out by Borish [J. Audio Eng. Soc. 34, 539–545 (1986)]: A diffusely reflecting, non-absorbing wall seems to give a 3 dB stronger reflection than a specularly reflecting wall for a source and receiver along the same plane normal. Similar observations have been made by others, and it is usually commented that the two reflection types distribute the reflected energy in different directions. The aspect of energy conservation does not seem to have been sorted out entirely. It is shown here that the difference between an omnidirectional receiver, like a microphone, and a surface element receiver, which can give the total reflected power, explains the claim. Analytic solutions and numerical evaluations of the well-known integrals for a single infinite wall confirm that energy conservation is indeed maintained and also lead to a spatial distribution of the Lambert reflection strength, which differs substantially from the previously published values. The special case can serve as a useful benchmark test of implementations of diffuse reflections, which follow Lambert's law.
Rapid and accurate testing for urinary tract infection: new clothes for the emperor
Authors: Moreland Robert B. , Brubaker Linda , Tinawi Lana , Wolfe Alan J.
Published: December 2024

Urinary tract infection (UTI) is among the most common infections in clinical practice. In some cases, if left untreated, it can lead to pyelonephritis and urosepsis. In other cases, UTI resolves without treatment. Clinical diagnosis is typically based on patient symptoms and/or urinalysis, including urine dipsticks. The standard urine culture method is sometimes employed to identify the suspected urinary pathogen (uropathogen) and/or guide antimicrobial choice, but results are rarely available before 24 h. The standard urine culture method also misses fastidious, anaerobic, and slow-growing uropathogens and rarely reports polymicrobial infections. The unexplained combination of negative urine cultures with persistent urinary tract symptoms is distressing to both patients and clinicians. Given the broad appreciation of the advantages provided by rapid testing (e.g., for COVID-19 or influenza A), a rapid, accurate diagnostic test is needed to deliver timely treatment to patients seeking care for UTI that optimizes antibiotic stewardship. Herein, we discuss progress being made toward an accessible, timely (i.e., within hours), accurate assay with results that are clinically useful for the treating clinician within the timeframe of the infection (i.e., the growth rate of the pathogen(s)). New and emerging uropathogens often overlooked by current diagnostic techniques are also reviewed.
Radiogenic heat production provides a thermal threshold for Archean cratonization process
Authors: Korhonen Fawna J. , Kelsey David E. , Ivanic Tim J. , Blereau Eleanore R. , Smithies R.H. , De Paoli Matthew C. , Fielding Imogen O.H.
Published: December 2024

A striking feature of the Yilgarn craton at the current erosional level is an abundance of late K-rich granites with radiogenic heat production elevated far above global crustal averages. Extrapolated back in time, the total thickness and contribution to crustal heat production and heat flow from these granites were greater, implying that the deeper crustal sources must also have had elevated radiogenic heat production. Through back-calculated and time-integrated one-dimensional thermal modeling underpinned by geological and geochemical constraints for the model crustal columns, we find that elevated radiogenic heat production provided a significant internal driver for prolonged crustal melting and eventual cratonization of the Yilgarn craton. Our results show that elevated thermal gradients driven by high heat production thermally primed the mid- and deep crust at or above the threshold for large-volume partial melting over long periods of time, as evidenced in the magmatic rock record. This would have been amplified by any additional heat that may have been provided by the mantle melting processes that punctuated the geological history. Over time, advective movement of progressively more radiogenic heat production to the shallower crust would have resulted in two complementary outcomes: progressively refractory deep crust and long-term cooling. The widespread granite “bloom” at 2650−2600 Ma records the final time at which the crust was fertile enough to melt in large volumes and the thermal gradient was hot enough to intersect the solidus. The magnitude of radiogenic heat production in the Yilgarn craton has been underestimated in previous studies, resulting in an underappreciation of the importance of its contribution to internal drivers of magmatism and ultimately cratonization.
Supplemental Material: Contrasting mechanisms and timescales of subduction and exhumation as recorded by Paleoproterozoic and late Paleozoic high-pressure granulites in the North China Craton
Authors: Li Shan-Shan , al. et
Published: December 2024

Figure S1: Compositional diagrams in the HPGs. Classification diagram (A) and (B) for amphibole, (C) for clinopyroxene. Figure S2: Zircon chondrite-normalized REE diagrams. (A) and (B) for the Paleoproterozoic HPGs, (C) and (D) for the meta-rondhjemite samples. Figure S3: Zircon chondrite-normalized REE diagrams for the Late Paleozoic HPGs. Figure S4: Monazite chondrite-normalized REE diagrams for the meta-trondhjemite samples. Table S1: Representative mineral compositions for all studied samples. Table S2: Bulk-rock compositions derived from X-ray fluorescence analysis. Table S3: Bulk-rock compositions utilized in petrological modelling (molar percentages of oxides). Table S4: LA-ICP-MS zircon U-Pb data. Table S5: LA-ICP-MS monazite U-Pb data. Table S6: LA-ICP-MS zircon and monazite trace element data. Table S7: Compilation exhumation velocity data of oceanic crustal rock from Chicheng, TNCO, CAOB, East Antarctica, and the Himalaya.
Supplemental Material: Terrestrial paleoclimate transition associated with continental weathering and drift during the Aptian–Albian of East Asia
Authors: Jia Jianliang , al. et
Published: December 2024

Table S1: Climate indicators from element and isotope geochemistry, and clay and carbonate minerals from boreholes FY-2, FY-1, and DY-1 in the Fuxin Basin. Table S2: Palynomorph assemblage from borehole FY-2 in the Fuxin Basin. Figure S1: Correlated sequence stratigraphy and sedimentary facies with positions of measured samples in the Fuxin Basin from borehole FY-2 in the west (A), FY-1 in the center (B), and DY-1 in the east (C) (modified after Jia et al., 2021). Figure S2: Diagrams of Al2O3 and TiO2 and δ13C and δ18O values for organic-rich mudrocks from boreholes FY-2 (A, D), FY-1 (B, E), and DY-1 (C, F). Figure S3. Microscopic characteristics of carbonate minerals observed in SEM (A) and thin section images (B) of organic-rich mudrocks from borehole FY-2. 
Behavioral Features and Blood Enzyme Activity in Offspring of Rats Conceived from an Alcohol-Intoxicated Father
Authors: Sudakov Sergey K. , Bogdanova Natalya G. , Nazarova Galina A. , Zolotov Nikolai N.
Published: December 2024

Quite often, conception of a child occurs after consuming small doses of alcohol. However, effect of this factor on offspring has not been studied at all. The aim of this study was to examine the level of motor activity, anxiety-like and depressive-like behavior, sensitivity to analgesic effect of ethanol, as well as activity of the enzymes DPP-IV, PEP, and ADG in the blood of rats whose fathers received ethanol immediately before mating. As a result of the conducted experiments, it was found that the males conceived by the intoxicated fathers have significant differences in behavior compared to control animals. Thus, motor activity in the rats conceived by males under the influence of alcohol was 2-2.5 times less intense; they exhibited decreased severity of the anxiety-like and depressive-like behavior. In such animals, activity of DPP-IV and ADG was increased and activity of PEP in the blood was reduced. In the rats conceived by the fathers under the influence of alcohol, analgesic effect of ethanol was decreased, and there was also reduction in response of the activities of ADG, DPP-IV, and PEP enzymes to ethanol administration. It is assumed that a single use of ethanol by male rats immediately before mating leads to the decrease in methylation of the paternal inherited genes in offspring. As a result, activity of a number of enzymes could change, which leads to the change in the balance of neuropeptides involved in mediation of animal behavior.
Low-Molecular Neurotrophin-3 Mimetics with Different Patterns of Postreceptor Signaling Activation Attenuate Differentially Morphine Withdrawal in Rats
Authors: Kolik Larisa G. , Konstantinipolsky Mark A. , Nikolaev Sergey V. , Logvinov Ilya O. , Antipova Tatyana A. , Gudasheva Tatiana A.
Published: December 2024

The accumulated evidence suggests that varying levels of tyrosine kinase receptor signaling pathway activity may regulate opiate-associated neuroadaptation of noradrenergic system. Neurotrophin-3 (NT-3) interacts with tropomyosin receptor kinases (TRKs), binding mainly to TRKC receptors, which are expressed within noradrenergic neurons in the blue spot (locus coeruleus, LC). Considering the difficulties in delivering full-length neurotrophins to the CNS after systemic administration, low-molecular mimetics of loop 4 in NT-3, hexamethylenediamide bis-(N-monosuccinyl-L-asparaginyl-L-asparagine) (GTS-301), and hexamethylenediamide bis-(N-γ-oxybutyryl-L-glutamyl-L-asparagine) (GTS-302), activating TRKC and TRKB receptors, were synthesized. The aim of the study is comparative examination of the effects of NT-3 dipeptide mimetics on the signs of morphine withdrawal in outbred white rats with opiate dependence, as well as investigation of activation of postreceptor signaling pathways by the mimetics. Dipeptides GTS-301 and GTS-302 after acute administration at doses of 0.1, 1.0, and 10.0 mg/kg (i.p., intraperitoneal) had a dose-dependent effect on the specific morphine withdrawal symptoms with the most effective dose being 1.0 mg/kg. Maximum decrease in the total index of morphine withdrawal syndrome for GTS-301 was 31.3% and for GTS-302 – 41.4%. Unlike GTS-301, GTS-302 weakened mechanical allodynia induced by morphine withdrawal, reducing tactile sensitivity. When studying activation of the postreceptor signaling pathways by the NT-3 mimetics in the HT-22 hippocampal cell culture, a different pattern of postreceptor signaling was shown: GTS-302 (10−6 M), similar to NT-3, activates all three MAPK/ERK, PI3K/AKT/mTOR, and PLCγ1 pathways, while GTS-301 (10−6 M) triggers only MAPK/ERK and PLCγ1 pathways. Thus, the identified features of attenuation of the morphine withdrawal syndrome in the rats under GTS-301 and GTS-302 effects could be associated with different activation pattern of the postreceptor pathways.
Pulmonary artery peak Doppler velocity as an estimator of systemic blood flow and predictor of intraventricular haemorrhage in preterm infants: a multicentre prognostic accuracy study
Authors: Terroba-Seara Sandra , Oulego-Erroz Ignacio , Palanca-Arias Daniel , Galve-Pradel Zenaida , Delgado-Nicolás Sara , Pérez-Pérez Alicia , Rodríguez-Ozcoidi Jorge , Lavilla-Oíz Ana , Bravo María Carmen , La Banda-Montalvo Leticia , Méndez-Abad Paula , Zafra-Rodríguez Pamela , Rodeño Fernandez Lorena , Montero-Gato Jon , Bustamante-Hervás Carmen , Vega-Del-Val Cristina , Rodríguez-Fanjul Javier , Mayordomo-Colunga Juan , Alegría-Echauri Iosune
Published: December 2024

Objectives

(1) To assess how main pulmonary artery peak Doppler velocity (MPAVpeak) correlates with right ventricular output (RVO) and superior vena cava flow (SVCf), (2) to assess the reproducibility of MPAVpeak and (3) to test the prognostic accuracy of MPAVpeak to predict high-grade intraventricular haemorrhage (IVH) or death at seventh day of life.

Design

Prospective cohort study.

Setting

Nine third-level neonatal units in Spain.

Patients

Preterm infants <33 weeks of gestational age who had standardised measurements of MPAVpeak, RVO and SVCf at 6, 12 and 24 hours of life.

Main outcome measures

High-grade IVH or death at seventh day of life.

Results

One hundred and ninety preterm infants with a median (IQR) gestational age and birth weight of 29.7 weeks (27.1–31.8) and 1152 g (892–1491), respectively, were included. High-grade IVH or death at seventh day of life occurred in 24 (12.6%). MPAVpeak was strongly correlated with RVO (Spearmanrho0.826–0.843). MPAVpeak discriminated well for low RVO (<120 mL/kg/min) at 6 (AUROC, area under the receiver operating characteristic curve=0.90), 12 (AUROC 0.94) and 24 hours (AUROC 0.86). Observer reproducibility was better for MPAVpeak (inter-observer limits of agreement ±8.4%) compared with RVO (±18.8%) and SVCf (±32.2%). The prognostic accuracy of MPAVpeak to predict high-grade IVH or death was good (AUROC >0.75) and non-inferior to RVO and SVCf (DeLong’s test p>0.05).

Conclusions

MPAVpeak is an adequate marker of systemic blood flow with high reproducibility and acceptable prognostic accuracy in preterm infants below 33 weeks of gestational age during the first day of life.
Outcomes of staged conjunctival flap and corneal transplantation for infectious keratitis resistant to medical treatment
Authors: Kilian Raphael , Pellegrini Marco , Yu Angeli Christy , de Ruvo Valentino , Salgari Niccolò , Busin Massimo
Published: December 2024

Background/Aims

To explore the outcomes of conjunctival flap (CF) followed by keratoplasty in patients with severe infectious keratitis (IK) unresponsive to medical treatment.

Methods

This is a retrospective monocentric study including 29 eyes of 29 patients with IK resistant to antibiotic treatment associated with stromal ulcer deepening to ≥50% of corneal thickness. All eyes underwent Gundersen’s CF procedure and penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK) or mushroom keratoplasty (MK), at least 4 months thereafter. Outcome measures included corrected distance visual acuity (CDVA), endothelial cell count (ECC), graft survival and complications.

Results

IK healed in all eyes following CF. The mean time interval between CF and keratoplasty was 16.3±16.1 months. 55% of patients underwent PK, 35% MK and 10% DALK. Mean follow-up duration was 39.6±34.3 months. At the last available follow-up, a CDVA≥20/200 was obtained in 50%, 33.3% and 70% of cases, respectively after PK, DALK and MK. Mean annual endothelial cell loss was 24.5% following PK and 10.7% following MK. Overall, graft failure occurred in 75% of cases after PK, 100% after DALK and 20% after MK. The most frequent complications were endothelial decompensation without immunological rejection (34.5%, after 31.1±25.1 months) and graft rejection (17.2%, after 10.2±7.9 months, all in the PK group).

Conclusion

CF surgery followed by staged keratoplasty represents an alternative therapeutic approach to avoid high-risk keratoplasty ‘a chaud’ in cases of severe IK.
RESILIENCE (Retrospective Linkage Study of Autoimmune Encephalitis): protocol for an Australian retrospective cohort study of outcomes in autoimmune encephalitis using data linkage techniques
Authors: Halliday Amy Jean , Lambert Katrina , Bundell Christine , McLean-Tooke Andrew , Gillis David , Prain Kerri M , Bryson Greg , Gillinder Lisa , Brown David , Ramanathan Sudarshini , Dale Russell , Brilot Fabienne , Jordan Nerissa , Lawn Nicholas , Lai Alan , Boyd James ,   Australian Adult Comprehensive Epilepsy Centres Consortium, Camacho Ximena , D’Souza Wendyl Jude
Published: December 2024

Introduction

The autoimmune encephalitides (AE) are a heterogeneous group of neurological disorders with significant morbidity and healthcare costs. Despite advancements in understanding their pathophysiology, uncertainties persist regarding long-term prognosis and optimal management. This study aims to address these gaps, focusing on immunotherapeutic strategies, neoplastic associations and functional outcomes.

Methods and analysis

The Retrospective Linkage Study of Autoimmune Encephalitis project will use data linkage techniques to establish a retrospective 10-year population cohort of Australian patients with AE. Two cohorts will be analysed, the Reference Cohort (clinically confirmed AE cases obtained from hospital medical records, n=145) and the Operationally Defined Cohort (AE cases identified through administrative coding data, n≈5000). Univariate statistical methods will identify candidate coding elements for use in the operational case definition and multivariate models and evaluation methods used to identify and internally validate the optimal coding algorithms. The two study cohorts will be analysed separately due to the high likelihood of overlap. Primary outcomes include relapse rate, prevalence and control of epilepsy, cognitive disability, poor educational attainment, delayed tumour diagnosis and mortality. Statistical analyses, including random mixed-effects regression models, will assess treatment effects, covariates and outcomes.

Ethics and dissemination

This project has been approved by the leading investigators’ institutional Human Research Ethics Committee (HREC), the St Vincent’s Hospital Melbourne HREC, as well as the Australian Institute of Health and Welfare HREC and relevant jurisdictional HRECs where required. The dissemination of findings through peer-reviewed publications and patient advocacy channels will maximise the impact of this research.
Factors associated with declining a menstrual cup among female students and their parents in Ugandan secondary schools: a cross-sectional study
Authors: Mugenyi Levicatus , Tembo Mandikudza , Nelson Kate Andrews , Thomas Katherine A , Kansiime Catherine , Lagony Stephen , Mpaata Alex Muleyi , Belfield Sophie , Nakalema Shamirah , Akech Agnes , Torondel-Lopez Belen , Weiss Helen A
Published: December 2024

Introduction

A greater choice of menstrual products may improve menstrual health (MH). This study assessed factors associated with declining consent to receive a menstrual cup by parents and female students participating in a MH intervention trial in Ugandan schools.

Methods

We analysed baseline data from a cluster-randomised trial evaluating the effectiveness of a multicomponent MH intervention among female students in 60 Ugandan secondary schools. Parental consent and student assent to receive a menstrual cup and training on its use was sought separately from consent from other trial activities. Random-effects logistic regression models were used to estimate adjusted OR (aOR) and 95% CIs for factors associated with (i) parents or guardians declining the cup and (ii) students declining the cup using hierarchical conceptual frameworks.

Results

The baseline trial population comprised 3705 post-menarchal students (mean age 15.6 (SD 0.9 years), of whom 2048 (55.3%) were day students. Among the parents of the 3635 participants aged <18 years, 1566 (43.1%) declined consent for their student to receive the cup. This was higher in Wakiso District than in Kalungu District (52.9% vs 8.0%, p<0.001). Parental decline of the cup differed by ethnicity, and this association varied between districts (p=0.004). Overall, 20.5% students declined the cup (Kalungu 21.1%, Wakiso 20.2%, p=0.62). Student decline of the cup was higher among day than boarding students (aOR=1.40, 95% CI 1.07 to 1.84), those with academic performance above the median score (aOR=1.29, 95% CI 1.01 to 1.65), those whose menstrual practice needs score was above the median (aOR=1.36, 95% CI 1.08 to 1.72) and those with more negative attitudes to MH (aOR=1.46, 95% CI 1.16 to 1.83).

Conclusion

Among Ugandan students and their parents, declining consent to receive a menstrual cup varied by district and ethnicity as well as academic performance and menstrual-related factors. A contextual understanding of the barriers for uptake of the menstrual cup is needed to guide future interventions.

Trial registration number

ISRCTN45461276.
Systematic review of prognostic models for predicting recurrence and survival in patients with treated oropharyngeal cancer
Authors: Dretzke Janine , Abou-Foul Ahmad K , Albon Esther , Hillier Bethany , Scandrett Katie , Price Malcolm J , Moore David J , Mehanna Hisham , Nankivell Paul
Published: December 2024

Objectives

This systematic review aims to evaluate externally validated models for individualised prediction of recurrence or survival in adults treated with curative intent for oropharyngeal cancer.

Design

Systematic review.

Setting

Hospital care.

Methods

Systematic searches were conducted up to September 2023 and records were screened independently by at least two reviewers. The Prediction model Risk Of Bias ASsessment Tool was used to assess risk of bias (RoB). Model discrimination measures (c-indices) were presented in forest plots. Clinical and methodological heterogeneity precluded meta-analysis.

Results

Fifteen studies developing and/or evaluating 25 individualised risk prediction models were included. The majority (77%) of c-indices for model developments and validations were ≥0.7 indicating ‘good’ discriminatory ability for models predicting overall survival. For disease-specific measures, most (73%) c-indices for model development were also ≥0.7, but fewer (40%) were ≥0.7 for external validations. Comparisons across models and outcome measures were hampered by heterogeneity. Only two studies directly compared models in the same cohort. Since all models were subject to a high RoB, primarily due to concerns with the analysis, the trustworthiness of the findings remains uncertain. Concerns included a lack of accounting for potentially missing data, model overfitting or competing risks as well as small event numbers. There were fewer concerns related to the participant, predictor and outcome domains, although reporting was not always detailed enough to make an informed decision. Where human papilloma virus (HPV) status and/or a radiomics score were included as a variable, models had better discriminative ability.

Conclusions

There were no models assessed as being at low RoB. Given that HPV status or a radiomics score appeared to improve model discriminative performance, further external validation of existing models to assess generalisability should focus on models that include HPV status as a variable. Development and validation of future models should be considered in HPV+ or HPV− cohorts separately to ensure representativeness.

PROSPERO registration number

CRD42021248762.
Association of sarcopenia, ambient air pollution and cognitive function in a community-dwelling middle-aged and elderly Korean population: a community-based cohort study
Authors: Lee Jane J , Woo Hae Dong , Kim Ji Hyun , Jung Eun Ju , Lee Kyoungho
Published: December 2024

Objectives

To investigate the association of sarcopenia, exposure to medium-term to long-term ambient particulate matter 2.5 µm and 10 µm (PM2.5and PM10) pollution and cognitive function in a community-dwelling cohort of middle-aged and older adults in South Korea.

Design

A community-based prospective cohort study.

Setting

In the Korean Genome and Epidemiology Study (KoGES).

Participants

The participants were drawn from the seventh follow-up visit conducted between 2015 and 2016 in the KoGES community-based Ansung cohort who had participated in an ageing substudy.

Outcome measures

Cognitive function was evaluated by the Korean version of the Mini-Mental State Examination (K-MMSE) and decreased cognitive function was defined as a K-MMSE score of 23 or less.

Results

Of the 2274 participants (mean age 70.1 years, 58.3% women and mean annual PM2.5and PM10levels of 30.7 and 52.2 μg/m3, respectively), 8.7% (n=197) were sarcopenic, 35.8% (n=814) were possible sarcopenic and 55.5% (n=1263) were non-sarcopenic. The predictors of sarcopenia included body mass index, cognitive function, age, marital status, hypertension and physical activity. Exposure to PM2.5and PM10for an average duration of 1 month to 3 years was not selected as a predictor of sarcopenia. Participants with sarcopenia were associated with lower cognitive scores (β=−1.51, p<0.0001) and decreased cognitive function compared with those without sarcopenia (OR 2.34, 95% CI 1.56 to 3.52). Exposure to medium-term and long-term PM2.5or PM10was not associated with sarcopenia. The effect modification of PM exposure on the association between sarcopenia and cognitive function was generally not detected.

Conclusions

In this community-based observational cohort study of KoGES participants aged 50 years and older, sarcopenia was associated with decreased cognitive function. However, medium-term to long-term exposure to PM2.5or PM10was not associated with sarcopenia and did not modify the relationship between sarcopenia and cognitive function.
Phase I-IIa clinical trial to evaluate the safety, feasibility and efficacy of the use of a palate mucosa generated by tissue engineering for the treatment of children with cleft palate: the BIOCLEFT study protocol
Authors: España-López Antonio , Fernández-Valadés Ricardo , Cubiles Elisa , Garzón Ingrid , Martin-Piedra Miguel Angel , Carriel Víctor , Campos Fernando , Martínez-Plaza Adoración , Vallejo Daniel , Liceras-Liceras Esther , Chato-Astrain Jesús , García-García Oscar Dario , Sánchez-Porras David , Ávila-Fernández Paula , Etayo-Escanilla Miguel , Quijano Blanca , Aguilar Elisabet , Campos Antonio , Carmona Gloria , Alaminos Miguel
Published: December 2024

Introduction

The current gold standard treatment for patients with orofacial clefts is surgical repair of the palatal defect (uranostaphylorrhaphy), which is associated with growth defects and hypoplasia of the maxillofacial structures. This trial aims to evaluate the potential of a bioengineered artificial palate mucosa, created through tissue engineering with autologous stromal and epithelial cells and nanostructured fibrin–agarose biomaterials, to enhance treatment outcomes for patients with unilateral cleft lip and palate.

Methods and analysis

This phase I-IIa clinical trial aims to evaluate the feasibility and biosafety of a procedure involving grafting bioartificial palate mucosa onto the areas of denudated bone in patients undergoing uranostaphylorrhaphy. The control patients will undergo standard surgical treatment. Five patients will be included in the first biosafety phase. In the second phase, 10 patients will be randomly assigned to the intervention or control group (1:1). The intervention group will undergo standard surgical treatment followed by the application of autologous bioartificial palate mucosa. Feasibility will be analysed at the time of surgery. Nine postimplant visits will be scheduled over a 2-year follow-up period, in which local and systemic biosafety will be investigated by determining graft evolution, including signs of necrosis, rejection, inflammation and patient factors. Preliminary signs of efficiency will be explored by sequentially evaluating craniomaxillofacial development, hearing impairment, speech capability and quality of life of the family. The research will be published in journals and posted in the relevant repositories when available.

Ethics and dissemination

This study has been approved by the Committee of Ethics in Research with Medicinal Products (CEIm) and authorised by the Spanish Medicines Agency (AEMPS). The results of this study will be published in peer-reviewed journals.

Trial registration number

NCT06408337; ClinicalTrials.gov: EuclinicalTrials. eu: 2023-506913-23-00.
Ethical reflection of Chinese scientists on the dual-use concerns of emerging medical biotechnology
Authors: Wang Xiaonan , Huang Mingtao , Shao Hui , Li Kun , Zhai Xiaomei
Published: December 2024

Emerging medical biotechnology typically exhibits a ‘dual-use’ nature, which, while promoting human well-being, concurrently presents potential risks of misuse or abuse, thereby posing significant threats. Globally, including in China, emerging medical biotechnology is developing rapidly. To understand the views and perspectives of Chinese scientists on dual-use concerns, this empirical study conducted semistructured qualitative interviews with researchers (n=14) from various specialties within the Chinese medical field, analysing their perspectives and ethical considerations regarding dual-use concerns. The findings of this study reveal a spectrum of attitudes among interviewees towards the exploration and application of emerging medical biotechnology, ranging from aggressive to conservative. This tension reflects the complexity and challenges of seeking a balance between promoting scientific innovation and maintaining ethical boundaries. Furthermore, while there is a consensus among scientists that the development and application of biotechnology encompass both risks and benefits, their stances on weighing these factors differ, reflecting how risk perception is influenced by professional limitations. Moreover, although scientists recognise the indispensability of both self-regulation and external oversight in practice, they also exhibit misunderstandings in ethical cognition and misinterpretations of regulatory measures. In light of these findings, it is imperative for us to urgently fortify national regulatory mechanisms and the construction of legal and ethical frameworks while also enhancing the ethical awareness and risk assessment capabilities of researchers. These measures are crucial for minimising the potential risks associated with dual use and fostering the sustainable and responsible development of emerging medical biotechnology.
Kindness: Poor cousin or equal kin to Compassion and Empathy in the Healthcare Literature? A Scoping Review
Authors: Macklin Nicki , Wilkinson-Meyers Laura , Dowell Anthony
Published: December 2024

Objective

This scoping review seeks to understand how kindness, compassion and empathy are defined and conceptualised within existing healthcare services literature.

Introduction

Little consensus exists on how healthcare literature defines and conceptualises kindness. Kindness is often conflated with the terms compassion and empathy, which both have more prominence in the literature. However, evidence would suggest that all three terms are indeed different. To advance kindness as a key tenet of quality improvement and human experience outcomes in healthcare, a consensual definition must be established in the evidence base.

Methods

We reviewed published research identified using search queries across five databases and one search engine. Studies were included in this review if the definition, measurement and/or conceptualisation of kindness, empathy and/or compassion were stated objectives of the work and the research was directly relevant to healthcare settings.

Results

1348 results were screened, and with additional snowballing of some articles for relevant references, 107 progressed to full-text screening. Forty-two articles were subsequently included in this scoping review. By synthesising this evidence, we establish key commonalities and differences for kindness, compassion and empathy. We present a model for understanding how empathy, compassion and kindness can be viewed on a stimulus–response–action continuum. We also explore the definitional challenges expressed by many authors who call for these terms to be treated as separate concepts.

Conclusions

This review evidence demonstrates that kindness, compassion and empathy have clear themes that stand them apart, and they occupy different places on the stimulus–response–action continuum. Importantly, kindness deserves its own place in literature as a primary concept, not as a second tier to compassion or empathy. By comparing each term, these positions are now highlighted. They can help us to more articulately define, conceptualise and value kindness, compassion and empathy for their unique contributions to the humanity of healthcare