bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of and factors associated with the use of gender-affirming hormonal therapy outside the reference regimen among transgender people in a community-led clinic in Metro Manila, Philippines: a retrospective cross-sectional study
Authors: Eustaquio Patrick C , Dela Cruz Jan Dio Miguel , Araña Yanyan , Rosos Bubbles , Rosadiño John Danvic T , Pagtakhan Ronivin G , Regencia Zypher Jude G , Baja Emmanuel S
Published: September 2023

Objectives

We aimed to describe the gender-affirming hormonal therapy (GAHT) intake behaviour and regimen and the factors associated with the use of hormones inconsistent with reference GAHT regimen among transgender people in the Philippines.

Design

Cross-sectional study.

Setting

Transgender community clinic in Metro Manila, Philippines from March 2017 to December 2019.

Participants

Gender-affirming care-seeking individuals of at least 18 years old, who self-identified as transgender or non-binary, and who self-reported current or previous use of GAHT at baseline consult.

Primary outcome measures

Reported drugs and/or administration routes not congruent with the World Professional Association for Transgender Health Standard of Care eighth edition were classified as hormone use outside the reference regimen.

Results

253 transgender people reported current or previous intake of GAHT. Many trans women and transfeminine people (TWTFP; 58.9%, 86/146) reported using oral contraceptive pills (OCPs), whereas most trans men (TM; 73.8%, 79/107) reported injecting testosterone esters. Furthermore, 59.7% (151/253) used hormones outside the reference regimen, widely using OCP and anabolic steroids among TWTFP and TM, respectively. TWTFP (crude prevalence ratio, PR, 3.52; 95% CI 2.35 to 5.49) and those who take unprescribed GAHT (crude PR 2.37; 95% CI 1.08 to 6.68) were more likely to use hormones outside the reference regimen than TM and taking healthcare provider-prescribed GAHT, respectively. On adjusting for covariates, the prevalence of using hormones outside the reference regimen was approximately three times higher (adjusted PR 3.22; 95% CI 2.09 to 5.12) among TWTFP than TM.

Conclusion

Trans people act on their high unmet gender-affirming care needs by taking unprescribed GAHT, many outside the reference regimen. Structural changes in the health system are warranted, including strengthened community-based self-administration practices.
Cross-sectional analysis of factors associated with medication adherence in western Kenya
Authors: Gala Pooja , Kamano Jemima H , Vazquez Sanchez Manuel , Mugo Richard , Orango Vitalis , Pastakia Sonak , Horowitz Carol , Hogan Joseph W , Vedanthan Rajesh
Published: September 2023

Objectives

Poor medication adherence in low-income and middle-income countries is a major cause of suboptimal hypertension and diabetes control. We aimed to identify key factors associated with medication adherence in western Kenya, with a focus on cost-related and economic wealth factors.

Setting

We conducted a cross-sectional analysis of baseline data of participants enrolled in the Bridging Income Generation with Group Integrated Care study in western Kenya.

Participants

All participants were ≥35 years old with either diabetes or hypertension who had been prescribed medications in the past 3 months.

Primary and secondary outcome measures

Baseline data included sociodemographic characteristics, wealth and economic status and medication adherence information. Predictors of medication adherence were separated into the five WHO dimensions of medication adherence: condition-related factors (comorbidities), patient-related factors (psychological factors, alcohol use), therapy-related factors (number of prescription medications), economic-related factors (monthly income, cost of transportation, monthly cost of medications) and health system-related factors (health insurance, time to travel to the health facility). A multivariable analysis, controlling for age and sex, was conducted to determine drivers of suboptimal medication adherence in each overarching category.

Results

The analysis included 1496 participants (73.7% women) with a mean age of 60 years (range 35–97). The majority of participants had hypertension (69.2%), 8.8% had diabetes and 22.1% had both hypertension and diabetes. Suboptimal medication adherence was reported by 71.2% of participants. Economic factors were associated with medication adherence. In multivariable analysis that investigated specific subtypes of costs, transportation costs were found to be associated with worse medication adherence. In contrast, we found no evidence of association between monthly medication costs and medication adherence.

Conclusion

Suboptimal medication adherence is highly prevalent in Kenya, and primary-associated factors include costs, particularly indirect costs of transportation. Addressing all economic factors associated with medication adherence will be important to improve outcomes for non-communicable diseases.

Trial registration number

NCT02501746.
Organisational challenges of pain management in neonatal intensive care unit: a qualitative study
Authors: Neshat Hanieh , Hassankhani Hadi , Jabraeili Mahnaz , Negarandeh Reza
Published: September 2023

Objectives

Despite credible evidence, optimal neonates’ pain management in the neonatal intensive care unit (NICU) is a challenging issue. In this regard, the organisational context is an essential factor. The existing challenges vary depending on the context, and investigating them can help to improve the quality of care. The study aimed to explore organisational challenges to neonates’ pain management in the NICU.

Methods

This qualitative study included 31 nurses and physicians in the NICU of Children’s Hospital, Tabriz, Iran. Data collection was done through individual and focus group interviews. For data analysis, we used conventional content analysis.

Results

The identified challenges included organisational culture (poor interprofessional collaboration and low parental participation), organisational structure (lack of unified approach in relieving pain and limited supervision for pain management) and organisational resources (lack of time due to high workload and inadequate educational programmes).

Conclusions

Many organisational factors consistently affect neonatal pain management. Adopting some approaches to enhance the cooperation of treatment team members, holding educational programmes, proper organisational supervision and implementing a unified neonatal-based pain management programme could improve neonatal pain management.
HIDDEN2: Study protocol for the hospital deep vein thrombosis detection study in patients with cancer receiving palliative care
Authors: Kitson Terri , Osborne Emma , Noble Simon , Pease Nikki , Alikhan Raza , Bryant Catherine , Groves Tristan , Wallace Rebecca , Walker Sarah , Seddon Kathy , Smith Deb , Raisanen Lawrence , Smith Joanna , Thomas Ian , Upton Laura , Casbard Angela
Published: September 2023

Introduction

Medical patients, admitted acutely to hospital, are at risk of venous thromboembolism (VTE). Clinical guidelines advise thromboprophylaxis prophylaxis for those at high risk of VTE. VTE is a common sequela of cancer, but guidelines take little consideration of cancer as an independent risk factor and their utility in palliative care patients is unclear. The hospice inpatient deep vein thrombosis (DVT) detection study (HIDDen) reported a 28% prevalence of asymptomatic iliofemoral DVT in hospice patients of poor performance status (PS) and prognosis, calling into question the utility of thromboprophylaxis in the palliative care setting. However, the majority of cancer inpatients receiving palliative care are admitted to hospital through the acute medical setting, yet their risk factors for VTE may differ from those admitted to hospices.

Objective

To better understand the prevalence and behaviours of VTE in patients with cancer receiving palliative care who are admitted as an acute medical emergency.

Design

Multicentre, observational cohort study.

Setting

Secondary care acute hospitals in South Wales, UK.

Patients

We plan to recruit 232 patients≥18 years old with a diagnosis of incurable cancer, and/or receiving palliative or best supportive care who are admitted acutely to hospital. Patients will be followed up for a maximum of 6 months following registration.

Primary outcome

Presence of lower extremity DVT.

Secondary outcomes

Symptom burden attributed to DVT or pulmonary embolism, patient PS, patient demographics and development of new VTE within 90 days of registration.

Analysis

The study statistical analysis plan will document analysis, methodology and procedures.

Ethics and dissemination

Ethical approval was obtained from the Wales Research Ethics Committee, reference 22/WA/0037 (IRAS 306352)—the main trial results will be analysed as soon as practically possible and the publication shared with investigators and on sponsor website; applications to access trial data will be subject to sponsor review process.
Exploring barriers and enablers to simulation-based training in emergency departments: an international qualitative study (BEST-ED Study)
Authors: Jee Marcus , Murphy Ella , Umana Etimbuk , O'Connor Paul , Khamoudes Daniel , McNicholl Brian , O’Donnell John J , James Binchy
Published: September 2023

Introduction

Simulation-based training (SBT) has gained significant traction within emergency medicine. The growing body of evidence describes the benefits that SBT can bring. However, identifying barriers and enablers when establishing successful SBT programmes in busy emergency departments (EDs), and ensuring longevity of such programmes, can be difficult.

Objective

We aim to identify barriers and enablers to SBT in busy EDs.

Methods

We explored and analysed the thoughts, experience and opinions of professionals involved in SBT and organisational support. 32 participants across 15 international sites were invited to a semistructured interview process. We included participants from a variety of backgrounds, from clinical staff to management staff. Transcribed interview data was classified and coded based on capability, opportunity and motivation behaviour (COM-B) domains and analysed based on theoretical domains framework. Frequency of the most mentioned thematic domain among participants is reported.

Results

The interview data revealed several common themes, including the following: knowledge and skills (90%), support and leadership (96%), mental barriers (87.5%), local culture (96.6%), dedicated space (65.2%), time constraints (46.8%), social influence (87.5%), education (90.6%), professional development (68.75%), exams (59.3%) and personal goals (93.75%). Management staff was observed to prioritise resource, staffing and flow, while the clinical cohort tended to focus on specialty and personal development when it came to simulation training in the ED.

Conclusion

Potential barriers and enablers to SBT and in situ simulation for EDs were identified through interviews conducted in this study. The central themes in terms of barriers and enablers were local culture, leadership, individual needs, resources and optimisation. A tailored approach is vital for establishing a successful SBT and in situ simulation programme.
HPV prevalence and genotype distribution among 38 056 women in Weifang, China: a cross-sectional study
Authors: Liu Mengmeng , Zhang Xuguang , Guo Lulu , Sun Wanli , Jiang Xuanli
Published: September 2023

Objectives

Human papillomavirus (HPV) infection is closely associated with cervical cancer, especially the persistent infection of high-risk HPV (HR-HPV) genotypes. Therefore, investigating the HPV prevalence, age-specific, genotype distribution and the impact of the COVID-19 pandemic among large populations was essential for HPV screening and optimising vaccination.

Design

This was a cross-sectional study.

Methods

A total of 38 056 cervical epithelial cell specimens were collected in Weifang city from January 2018 to December 2022. The study was divided into seven age groups based on the age of the participants. HPV genotype testing was performed by using a commercial kit which is designed for the detection of 23 HPV genotypes.

Result

A total of 8998 women were infected with HPV, with an overall positive rate of 23.64% (8998/38 056). Single infection of HPV was dominant among different age groups, which accounted for 71.33% of total infections. The most prevalent genotype was HR-HPV 16 (4.33%), followed by 52, 58, 53 and 68. Low-risk HPV (LR-HPV) 42 exhibited the highest prevalence (2.19%) among six LR-HPV genotypes, representing a novel finding. There was a significant difference in the prevalence across different age groups (p<0.01), with the highest prevalence in the group under 25 years old. During the 3 year COVID-19 breakout period, the number of HPV samples received in 2020, 2021 and 2022 was reduced by 24.03%, 14.79% and 24.76%, respectively. In 2018–2022, the annual prevalence varied between 21.09% and 25.30%, with a decreasing trend, while the prevalence of HR-HPV 39, 56, 31 and LR-HPV 42 increased.

Conclusion

This study indicates a high-HPV infection rate and age-specific distribution characteristics of HPV genotype infections, as well as analyses of the impact of the COVID-19 outbreak on the HPV prevalence, which provides an epidemiological basis for the control and prevention of HPV infection in this region.
Impact of medical students’ socioeconomic backgrounds on medical school application, admission and migration in Japan: a web-based survey
Authors: Suzuki Yasuyuki , Tsunekawa Koji , Takeda Yuko , Cleland Jennifer , Saiki Takuya
Published: September 2023

Objectives

The aim of this study was to clarify and compare the socioeconomic backgrounds of medical students with those of other health professions and non-health faculty students in an era of increasing inequity in Japanese society.

Design

This was a quantitative nationwide study. Data were collected by a cross-sectional web-based anonymous questionnaire.

Setting

Data from years 3 and 4 medical, health professions and non-health faculty students across Japan were collected in 2021.

Participants

Participants were 1991 students from medical schools, 224 from dental, 419 from pharmacy, 326 from nursing, 144 from other health professions and 207 from non-health faculties.

Results

The proportion of high-income families (>18 million yen: ca. US$140 000) among medical students was 25.6%, higher than that of pharmacy (8.7%) and nursing students (4.1%) (p<0.01). One-third of medical students had a physician parent, more common than in non-medical students (p<0.01). Students who only applied to public medical schools and a regional quota ‘Chiiki-waku’ students with scholarship had lower family income and physician parents compared with those who applied to private medical schools (p<0.01), but they still had higher physician parents compared with non-medical students (p<0.01). Logistic regression revealed that having a physician parent (p<0.01), aspiring to the present profession during elementary school (p<0.01) and private upper secondary school graduation (p<0.01) predicted the likelihood of studying medicine. There were regional differences of backgrounds among medical students, and 80% of medical students with urban backgrounds intended to work in urban localities after graduation.

Conclusions

This study provides evidence that medical students in Japan hail from urban and higher income classes and physicians’ families. This finding has implications for the health workforce maldistribution in Japan. Widening the diversity of medical students is essential for solving physician workforce issues and meeting broad healthcare needs.
Comorbidities, symptoms and end-of-life medication use in hospitalised decedents before and during the COVID-19 pandemic: a retrospective regional cohort study in Ottawa, Canada
Authors: Lawlor Peter , Cohen Leila , Adeli Samantha Rose , Besserer Ella , Gratton Valérie , Murphy Rebekah , Warmels Grace , Bruni Adrianna , Kabir Monisha , Noel Chelsea , Heidinger Brandon , Anderson Koby , Arsenault-Mehta Kyle , Wooller Krista , Lapenskie Julie , Webber Colleen , Bedard Daniel , Enright Paula , Desjardins Isabelle , Bhimji Khadija , Dyason Claire , Iyengar Akshai , Bush Shirley H , Isenberg Sarina , Tanuseputro Peter , Vanderspank-Wright Brandi , Downar James , Parsons Henrique
Published: September 2023

Objective

To compare comorbidities, symptoms and end-of-life (EoL) palliative medication (antisecretories, opioids, antipsychotics and sedatives) use among decedents before and during the COVID-19 pandemic.

Design

In a retrospective cohort study, decedent records in three acute care hospitals were abstracted, generating a prepandemic (November 2019–February 2020) group (pre-COVID) and two intrapandemic (March–August 2020, wave 1) groups, one without (COVID-ve) and one with COVID-19 infection (COVID+ve). Control group decedents were matched 2:1 on age, sex and care service (medicine/intensive care unit (ICU)) with COVID+ve decedents.

Setting

Three regional acute care teaching hospitals in Ottawa, Canada

Participants

Decedents (N=425): COVID+ve (n=85), COVID-ve (n=170) and pre-COVID (n=170).

Main outcome measures

Data were abstracted regarding demographics, admission comorbidities and symptoms, and EoL medication use; opioid doses were standardised to parenteral morphine equivalent daily dose (MEDD), and the predictors of upper quartile MEDD in the last 24 hours of life were examined in multivariable logistic regression with adjusted ORs (aORs) and 95% CIs.

Results

The prevalence of dementia (41% vs 28% and 26%, p=0.03), breathlessness (63.5% vs 42% and 47%, p<0.01), cough (40% vs 27% and 19%, p<0.01) and fever (54% vs 9% and 13.5%) was higher in COVID+ve versus pre-COVID and COVID-ve groups, respectively. The median (IQR) of MEDD over the last 72 hours of life was 16.7 (9–36.5) vs 13.5 (5.7–21.8) and 10.5 (5.3–23.8) for COVID+ve versus pre-COVID and COVID-ve groups, respectively, (p=0.007). Male sex, COVID+ve grouping, ICU death and high-flow nasal cannula use predicted upper quartile MEDD dose, aORs (95% CIs): 1.84 (1.05 to 3.22), 2.62 (1.29 to 5.3), 5.14 (2.47 to 10.7) and 1.93 (1.05 to 3.52), respectively. COVID+ve group decedents used highest lorazepam and propofol doses.

Conclusions

COVID-19 decedents, particularly those in ICU, required higher EoL opioid and sedating medication doses than matched prepandemic or intrapandemic controls. These findings should inform and guide clinical practice.
Protocol for the Paediatric Otorrhoea Study (POSt): a multi-methods study to understand the burden of paediatric otorrhoea in the UK
Authors: Heward Elliot , Dempsey James , Lunn Judith , Molloy John , Isba Rachel , Carr Matthew , Ashcroft Darren , Hay Alastair D , Nichani Jaya R , Bruce Iain A
Published: September 2023

Introduction

Paediatric otorrhoea (PO) refers to the leakage of fluid through a perforation in the ear drum, resulting from an infection of the middle ear of a child or young person (CYP). PO frequently results in hearing loss which may lead to developmental delay, restricted communication and reduced educational attainment.

Epidemiological information for PO is largely derived from low-income countries. The aim of this study will be to establish the incidence of PO within the UK and to understand the impact of PO on CYP and their families’ everyday lives. It will build the foundations for a randomised controlled trial investigating the best antibiotic treatment for PO.

Methods and analysis

The study will consist of two work packages. (1) Data from the Clinical Practice Research Datalink (CPRD), January 2005 to July 2021, will be used to determine the incidence of patient presentations with PO to primary care in the UK. It will also explore the current antimicrobial prescribing practice for PO in primary care. (2) Thirty semi-structured interviews will be conducted from 13 July to 31 October 2023 with CYP and their parents/carers to help identify the impact of PO on everyday life, the patient journey and how service users define treatment success. Three medical professional focus groups will be used to understand the current management practice, how treatment success is measured and acceptability to randomise patients. Thematic analysis will be used.

Ethics and dissemination

The Health Research Authority, The Health and Social Care Research Ethics Committee (23/NI/0082) and the CPRD’s research data governance panel (22_002508) reviewed this study. Results will be disseminated at medical conferences, in peer-reviewed journals and via social media. The study will cocreate a webpage on healthtalk.org, with the Dipex Charity, about PO to ensure members of the public can learn more about the condition.

Trial registration number

ISRCTN46071200.
Diagnosis of cauda equina syndrome in the emergency department
Authors: Metcalfe David , Hoeritzauer Ingrid , Angus Michelle , Novak Alex , Hutton Mike , Woodfield Julie
Published: September 2023

Cauda equina syndrome (CES) is a spinal emergency that can be challenging to identify from among the many patients presenting to EDs with low back and/or radicular leg pain. This article presents a practical guide to the assessment and early management of patients with suspected CES as well as an up-to-date review of the most important studies in this area that should inform clinical practice in the ED.
Airflow rates and breathlessness recovery from submaximal exercise in healthy adults: prospective, randomised, cross-over study
Authors: Brew Andrew , O’Beirne Sarah , Johnson Miriam J , Ramsenthaler Christina , Watson Peter J , Rubini Philip A , Fagan Michael J , Swan Flavia , Simpson Andrew
Published: September 2023

Objectives

Facial airflow from a hand-held fan may reduce breathlessness severity and hasten postexertion recovery. Data from randomised controlled trials are limited and the optimal airflow speed remains unknown. We aimed to determine the effect of different airflow speeds on recovery from exercise-induced breathlessness.

Methods

A prospective, randomised, cross-over design. Ten healthy participants (seven male; mean age 29±4 years; height 175±9 cm; body mass 76.9±14.1 kg) completed six bouts of 4 min of exercise. During the first 5 min of a 20 min recovery phase, participants received one of five airflow speeds by holding a fan ~15 cm from their face, or no fan control, administered in random order. Fan A had an internal blade, and fan B had an external blade. Breathlessness was measured using a numerical rating scale (NRS) at minute intervals for the first 10 min, and facial skin temperature was recorded using a thermal imaging camera (immediately postexertion and 5 min recovery).

Results

Nine participants completed the trial. A significant main effect for airflow speed (p=0.016, ηp
2
=0.285) and interaction effect for airflow speed over time (p=0.008, ηp
2
=0.167) suggest that the airflow speed modifies breathlessness during recovery from exercise. Fan speeds of 1.7 m/s or greater increased the speed of recovery from breathlessness compared with control (p<0.05) with the highest airflow speeds (2.5 m/s and 3.3 m/s) giving greatest facial cooling.

Conclusion

Higher airflow rates (1.7 m/s or greater) reduced self-reported recovery times from exercise-induced breathlessness and reduced facial temperature .
Simple, minimally invasive technique for ovariohysterectomy in the dog
Authors: Pukacz M. , Kienzle B. , Braun J.
Published: September 2023

A simple method of minimally invasive surgery for ovariohysterectomy in the dog, without the use of laparoscopic equipment, was trialled. Fifty‐nine client owned dogs of different breeds admitted for elective ovariohysterectomy were entered into the study. The tip of the left uterine horn and ovary were pulled into a cranial midline portal with the aid of a spay hook. The ovarian pedicle and the tip of the uterine horn were ligated and the ovary was dissected. The uterine horn was pulled backwards from a second midline portal, just cranial of the pubic bone, until the cervix was visible. After ligation and dissection of the cervix, the right uterine horn was pulled from the cranial portal until the right ovary was visible and could also be dissected. All 59 dogs underwent the intended procedure (mean duration 59 minutes, range 30 to 88 minutes). No haemorrhaging occurred during surgery and no serious complications were reported during the postoperative period.
The DL Advocate: playing the devil’s advocate with hidden systematic uncertainties
Authors: Golutvin Andrei , Iniukhin Aleksandr , Mauri Andrea , Owen Patrick , Serra Nicola , Ustyuzhanin Andrey
Published: September 2023

We propose a new method based on machine learning to play the devil’s advocate and investigate the impact of unknown systematic effects in a quantitative way. This method proceeds by reversing the measurement process and using the physics results to interpret systematic effects under the Standard Model hypothesis. We explore this idea with two alternative approaches: the first one relies on a combination of gradient descent and optimisation techniques, its application and potentiality is illustrated with an example that studies the branching fraction measurement of a heavy-flavour decay. The second method employs reinforcement learning and it is applied to the determination of the $$P_{5}^{'}$$

P

5

′

angular observable in $$B^0 \rightarrow K^{*0} {\mu ^+\mu ^-}$$

B
0

→

K

∗
0

μ
+

μ
-

decays. We find that for the former, the size of a hypothetical hidden systematic uncertainty strongly depends on the kinematic overlap between the signal and normalisation channel, while the latter is very robust against possible mismodellings of the efficiency.
Anisotropic ultra-compact object in Serrano–Liska gravity model
Authors: Prasetyo I. , Belfaqih I. H. , Suroso A. , Sulaksono A.
Published: September 2023

We implement a recent model proposed by Serrano–Liska (SL) (Alonso-Serrano and Liška, JHEP, 12:196, 2020) to study the ultra-compact star properties. The matter in the interior star is modeled by the quark model, deducted from QCD theory equipped with anisotropic pressure. Anisotropy is used to increase the compactness of the stars. We intend to see the signature of the “quantum gravity” effect through the SL model in ultra-compact stars. The SL model was motivated by quantum correction appearing in the black hole by adding a logarithmic term in gravity entropy used to derive the effective Einstein field equation. We expect this correction term in the SL model also affects ultra-compact star properties. The SL model with coupling constant$${\tilde{c}}$$c~in logarithmic term equipped with spherically symmetric metric yields correction terms$$\mathscr {O}({\tilde{c}})$$O(c~)that can be expressed by a function$$\varXi (r)$$Ξ(r). The$$\varXi (r)$$Ξ(r)function vanishes at the star’s exterior. We found that the mass-radius relation prediction by the SL model with anisotropic matter deviates from the one predicted by the standard Tolman–Oppenheimer–Volkoff (TOV) equation for$${\tilde{c}}\ge 10^7$$c~≥107m$$^2$$2. We also have a sufficiently deep enough effective potential to produce a quasi-normal mode. We obtain the echo frequency of 15.2 kHz using maximum anisotropic pressure contribution and$${\tilde{c}}= 10^7$$c~=107m$$^2$$2. Because the corresponding effective potential is almost indistinguishable from that of GR, this echo frequency value can be indistinguishable to one of GR, but not comparable to the result from GW170817 data analysis, i.e., 72 Hz. To circumvent this problem, we can decrease the value of echo frequency by increasing the magnitude of$${\tilde{c}}$$c~to orders of magnitude than$${\tilde{c}}= 10^7$$c~=107m$$^2$$2. On the other hand, too large a strength from the logarithmic correction term is not physically favored because we learn from the black hole case that the logarithmic term is expected to be smaller than that of the Bekenstein term. Therefore, more precise gravitation echo measurements are crucial to understand this issue.
Multi muon/anti-muon signals via productions of gauge and scalar bosons in a $$U(1)_{L_\mu - L_\tau }$$ model at muonic colliders
Authors: Das Arindam , Nomura Takaaki , Shimomura Takashi
Published: September 2023

We discuss the discovery potential of a promising signals, $$3 \times \mu ^+ \mu ^-$$

3
×

μ
+

μ
-

at a $$\mu ^+ \mu ^-$$

μ
+

μ
-

collider and $$\mu ^+ \mu ^+ \mu ^+ \mu ^+ \mu ^- \mu ^- $$

μ
+

μ
+

μ
+

μ
+

μ
-

μ
-

at a $$\mu ^+ \mu ^+$$

μ
+

μ
+

collider, that are obtained via production of $$Z'$$

Z
′

and a new scalar boson $$\phi $$
ϕ
in a spontaneously broken local $$U(1)_{L_\mu - L_\tau }$$

U

(
1
)

L
μ

-

L
τ

model. We consider the $$Z'$$

Z
′

associated production from the process $$\mu ^+ \mu ^- \rightarrow \phi Z'$$

μ
+

μ
-

→
ϕ

Z
′

in addition to a muonphilic $$Z'$$

Z
′

fusion process $$\mu ^+ \mu ^\pm \rightarrow \phi \mu ^+ \mu ^\pm $$

μ
+

μ
±

→
ϕ

μ
+

μ
±

. The scalar boson is associated with $$U(1)_{L_\mu - L_\tau }$$

U

(
1
)

L
μ

-

L
τ

symmetry breaking and dominantly decays into $$Z' Z'$$

Z
′

Z
′

mode. We carry out numerical simulation analysis for signal and background processes to estimate a discovery significance for different benchmark points. It is shown that our signal can be observed with integrated luminosity less than $$\mathcal {O}(100)$$

O
(
100
)

fb$$^{-1}$$

-
1

for both $$\mu ^+ \mu ^-$$

μ
+

μ
-

and $$\mu ^+ \mu ^+$$

μ
+

μ
+

colliders with more than 5-$$\sigma $$
σ
significance.
Synthesis of tantalum nanoparticles by laser ablation in liquid method and investigating the effect of electric field on the structural properties
Authors: Yousefi Maryam , Hantehzadeh Mohammad Reza , Hossein Sari Amir
Published: September 2023

In this research, tantalum nanoparticles were prepared by the laser ablation method and the effect of an electric field on their structural properties was investigated. The optical absorption spectra were studied to comprehend the optical properties of nanoparticles. Size and morphology of nanoparticles are illustrated by TEM images. The average size of tantalum nanoparticles is 19 and 45[Formula: see text]nm for synthesized samples without and with electric fields, respectively. By applying an electric field, the morphology of nanoparticles changed from spherical to tangled shapes. XRD analysis showed the crystalline structure of nanoparticles. The investigation of bending and stretching of molecular functional groups and the measurement of the hydrodynamic radius were done by FTIR, RAMAN and DLS analyses, respectively. FTIR, RAMAN, XRD and DLS analyses confirm the structure. EDX spectra confirmed the existence of ingredients. The stability of colloidal is indicated by zeta potential analysis. Photoluminescence spectra reveal nanoparticle properties. As the electric field increases, the size of nanoparticles increased, morphology changes from spherical, and oxidation increases.
Comparison about the treatment of bronchial asthma by traditional Chinese medicine from various nationalities in China
Authors: Cao Yuxue
Published: September 2023

This paper discusses the understanding of traditional Chinese medicine, Uyghur medicine, Tibetan medicine and Mongolian medicine on bronchial asthma, and discusses the causes and pathogenesis, syndrome differentiation, treatment principles and treatment drugs, respectively. It compares the similarities and differences of different ethnic groups’ traditional medicines on bronchial asthma treatment, so as to help each ethnic group learn from each other and further improve their understanding of asthma.
First Price Auction is 1-1/
e
2
Efficient
Authors: Jin Yaonan , Lu Pinyan
Published: September 2023

We prove that the
PoA
of
First Price Auctions
is 1-1/
e
2
≈ 0.8647, closing the gap between the best known bounds [0.7430, 0.8689].
A Comprehensive Survey on Automatic Knowledge Graph Construction
Authors: Zhong Lingfeng , Wu Jia , Li Qian , Peng Hao , Wu Xindong
Published: September 2023

Automatic knowledge graph construction aims at manufacturing structured human knowledge. To this end, much effort has historically been spent extracting informative fact patterns from different data sources. However, more recently, research interest has shifted to acquiring conceptualized structured knowledge beyond informative data. In addition, researchers have also been exploring new ways of handling sophisticated construction tasks in diversified scenarios. Thus, there is a demand for a systematic review of paradigms to organize knowledge structures beyond data-level mentions. To meet this demand, we comprehensively survey more than 300 methods to summarize the latest developments in knowledge graph construction. A knowledge graph is built in three steps: knowledge acquisition, knowledge refinement, and knowledge evolution. The processes of knowledge acquisition are reviewed in detail, including obtaining entities with fine-grained types and their conceptual linkages to knowledge graphs; resolving coreferences; and extracting entity relationships in complex scenarios. The survey covers models for knowledge refinement, including knowledge graph completion, and knowledge fusion. Methods to handle knowledge evolution are also systematically presented, including condition knowledge acquisition, condition knowledge graph completion, and knowledge dynamic. We present the paradigms to compare the distinction among these methods along the axis of the data environment, motivation, and architecture. Additionally, we also provide briefs on accessible resources that can help readers to develop practical knowledge graph systems. The survey concludes with discussions on the challenges and possible directions for future exploration.
Multi-aspect Understanding with Cooperative Graph Attention Networks for Medical Dialogue Information Extraction
Authors: Lin Rui , Fan Jing , Wu Haifeng
Published: September 2023

Medical dialogue information extraction is an important but challenging task for Electronic Medical Records. Existing medical information extraction methods ignore the crucial information of sentence and multi-level dependency in dialogue, which limits their effectiveness for capturing essential medical information. To address these issues, we present a novel Multi-aspect Understanding with Cooperative Graph Attention Networks for Medical Dialogue Information Extraction to capture multi-aspect sentence information and multi-level dependency information from the dialogue. First, we propose the multi-aspect sentence encoder to capture various features from different perspectives. Second, we propose double graph attention networks to model the dependency features from intra-window and inter-window, respectively. Extensive experiments on a benchmark dataset have well-validated the effectiveness of the proposed method.
GNN-based Advanced Feature Integration for ICS Anomaly Detection
Authors: L(y)u Shuaiyi , Wang Kai , Wei Yuliang , Liu Hongri , Fan Qilin , Wang Bailing
Published: September 2023

Recent adversaries targeting the Industrial Control Systems (ICSs) have started exploiting their sophisticated inherent contextual semantics such as the data associativity among heterogeneous field devices. In light of the subtlety rendered in these semantics, anomalies triggered by such interactions tend to be extremely covert, hence giving rise to extensive challenges in their detection. Driven by the critical demands of securing ICS processes, a Graph-Neural-Network (GNN) based method is presented to tackle these subtle hostilities by leveraging an ICS’s advanced contextual features refined from a universal perspective, rather than exclusively following GNN’s conventional local aggregation paradigm. Specifically, we design and implement the Graph Sample-and-Integrate Network (GSIN), a general chained framework performing node-level anomaly detection via advanced feature integration, which combines a node’s local awareness with the graph’s prominent global properties extracted via process-oriented pooling. The proposed GSIN is evaluated on multiple well-known datasets with different kinds of integration configurations, and results demonstrate its superiority consistently on not only anomaly detection performance (e.g., F1 score and AUPRC) but also runtime efficiency over recent representative baselines.
The Use and Prospects of Nonlethal Methods in Entomology
Authors: Lövei Gábor L. , Ferrante Marco
Published: September 2023

Arthropods are declining globally, and entomologists ought to be in the forefront of protecting them. However, entomological study methods are typically lethal, and we argue that this makes the ethical status of the profession precarious. Lethal methods are used in most studies, even those that aim to support arthropod conservation. Additionally, almost all collecting methods result in bycatch, and a first step toward less destructive research practices is to minimize bycatch and/or ensure its proper storage and use. In this review, we describe the available suite of nonlethal methods with the aim of promoting their use. We classify nonlethal methods into ( a) reuse of already collected material, ( b) methods that are damaging but not lethal, ( c) methods that modify behavior, and ( d) true nonlethal methods. Artificial intelligence and miniaturization will help to extend the nonlethal methodological toolkit, but the need for further method development and testing remains.
A Life Outside
Authors: Koehl M.A.R.
Published: September 2023

How do the morphologies of organisms affect their physical interactions with the environment and other organisms? My research in marine systems couples field studies of the physical habitats, life history strategies, and ecological interactions of organisms with laboratory analyses of their biomechanics. Here, I review how we pursued answers to three questions about marine organisms: ( a) how benthic organisms withstand and utilize the water moving around them, ( b) how the interaction between swimming and turbulent ambient water flow affects where small organisms go, and ( c) how hairy appendages catch food and odors. I also discuss the importance of different types of mentors, the roadblocks for women in science when I started my career, the challenges and delights of interdisciplinary research, and my quest to understand how I see the world as a dyslexic.
Expansion of Anticomplement Therapy Indications from Rare Genetic Disorders to Common Kidney Diseases
Authors: Miwa Takashi , Sato Sayaka , Golla Madhu , Song Wen-Chao
Published: September 2023

Complement constitutes a major part of the innate immune system. The study of complement in human health has historically focused on infection risks associated with complement protein deficiencies; however, recent interest in the field has focused on overactivation of complement as a cause of immune injury and the development of anticomplement therapies to treat human diseases. The kidneys are particularly sensitive to complement injury, and anticomplement therapies for several kidney diseases have been investigated. Overactivation of complement can result from loss-of-function mutations in complement regulators; gain-of-function mutations in key complement proteins such as C3 and factor B; or autoantibody production, infection, or tissue stresses, such as ischemia and reperfusion, that perturb the balance of complement activation and regulation. Here, we provide a high-level review of the status of anticomplement therapies, with an emphasis on the transition from rare diseases to more common kidney diseases.
An Ultrathin Polarization Free Asterick-Shaped Metamaterial Absorber with Quad-Band Characteristics
Authors: Kumar Singh Raghvenda , Gupta Ashish , Yadav Akash , Gupta Nishchay , Tyagi Utkarsh
Published: September 2023

In this paper, a quad-band absorber is proposed and developed, which is exhibiting ultrathin and polarization insensitive behaviour. It has been designed to be operated in S, C, and Ku bands with absorptions peaks at more than 95%. The proposed absorber is implemented on a FR4 glass epoxy laminate with an equivalent electrical thickness of 0.0108 λ0, where λ0 is the wavelength corresponding to the lowest frequency of operation. This confirms the ultrathin nature of the structure. The absorption performance of the proposed structure has been characterized under normal and oblique incidences followed by their experimental verification. Presented results demonstrate highly polarization-independent behavior of the proposed absorber due to its symmetric geometry. Also, the electromagnetic field distributions have been studied to acquire better insight of the absorption mechanism corresponding to distinct elements present in the structure. It is characterized in terms of its behavior as metamaterial, which ensures the miniaturization. The proposed absorber is suitable to be used in applications like radar cross section reduction, stealth technology, radio frequency identification, and electromagnetic compatibility.
A Rare Case Report of Thyroglossal Duct Cyst Carcinoma Coexisting with Thyroid Carcinoma in an Adolescent
Authors: Mylopotamitaki Kleanthi , Klonaris Dionisios , Kazamias Georgios , Simandirakis Christos , Vourliotaki Irene , Karakostas Efthimios
Published: September 2023

Background. Thyroglossal duct cysts (TDC) represent approximately 70% of all congenital neck masses, and up to 1% of them contain thyroid tissue malignancies. Clinical presentation of TDC carcinomas is usually indistinguishable from benign tumors preoperatively, and differential diagnosis can be challenging. We present a rare case of TDC carcinoma concurrent with thyroid cancer in an adolescent. Case Presentation. A 16-year-old Caucasian female, otherwise healthy, was referred with a painless, gradually expanding lump on the neck. Physical examination revealed a well-circumscribed, moderately hard, tender mass of the anterior neck midline anteroinferior to the hyoid bone. Imaging findings suggested TDC as the most likely diagnosis. The patient had a Sistrunk procedure under general anesthesia. Histopathological findings diagnosed a BRAFV600E-positive papillary thyroid carcinoma (PTC) in a TDC. A thyroid gland and neck ultrasound revealed a highly suspicious finding for malignancy right level VI lymph node, which was not confirmed by fine needle aspiration cytology (FNAC). Under general anesthesia, total thyroidectomy and central compartment lymph node neck dissection were performed. Histopathological findings revealed a thyroid parenchymal locus of PTC, as well as three lymph nodes infiltrated by PTC. The patient received adjuvant radioactive iodine ablation (RAI) therapy and is closely followed. Conclusion. TDC carcinomas in conjunction with thyroid carcinomas in young patients are rare. Preoperative diagnosis can be challenging, as the vast majority of neck masses in young patients are benign in nature, and most malignant tumors lack specific clinical features. The diagnostic accuracy of FNAC is considered unsatisfactory due to its frequently cystic nature. Definitive diagnosis is based on histopathological findings. Clinicians should maintain a high level of suspicion for coexisting thyroid malignancies. Although surgical extirpation of the malignancy is considered standard of care, the treatment of TDC cancer should always be individualized by a multidisciplinary team.
Pi‐Score: An Estimation Strategy of the Class Prior in Positive‐Unlabeled Learning for Electrical Insulator Defect Detection with Incomplete Annotations
Authors: Pang Fengqian , Jia Chenghan , Li Yue , Lei Chunyue , Chen Xi
Published: September 2023

Insulators in high‐voltage power systems serve as brackets for overhead lines and prevent these wires from becoming grounded. Due to long‐term exposure to a harsh environment, it is indispensable to apply periodic inspection for defective insulators, facilitating the timely overhaul of insulators. In the field of object detection, convolutional neural networks (CNNs) have been introduced and have achieved good performance. Therefore, various CNN‐based detectors are applied to the insulator detection task. Because collecting ideal annotations is time‐consuming and labor‐intensive, research with imperfect annotations has drawn more attention. However, fewer insulator defect detection approaches account for this imperfect annotation problem. This paper focuses on a novel and challenging insulator defect detection scenario: a part of the insulators in datasets is unannotated and viewed as the background. We introduce positive‐unlabeled (PU) learning to solve the problem of incomplete annotation for insulator defect detection. To further improve PU learning, a Pi‐Score algorithm is proposed to estimate class prior, a crucial parameter in PU loss. Our designed framework is built on Faster R‐CNN and incorporates the improved PU learning in the region proposal network. Experimental results on the Insulator Defect Image Dataset (IDID) demonstrate that the proposed framework achieved an average precision (AP) metric that is approximately 1%–2% higher than the positive–negative mainstream detectors with varying degrees of missing annotation. Meanwhile, the proposed framework obtained 0.33 and 0.47 higher AP metrics than the mainstream PU detectors with complete and half of IDID’s annotations.
Intravenous Administration of Human Umbilical Cord Mesenchymal Stromal Cells Leads to an Inflammatory Response in the Lung
Authors: Hernandez Pichardo Alejandra , Wilm Bettina , Liptrott Neill J. , Murray Patricia
Published: September 2023

Mesenchymal stromal cells (MSCs) administered intravenously (IV) have shown efficacy in preclinical models of various diseases. This is despite the cells not reaching the site of injury due to entrapment in the lungs. The immunomodulatory properties of MSCs are thought to underlie their therapeutic effects, irrespective of whether they are sourced from bone marrow, adipose tissue, or umbilical cord. To better understand how MSCs affect innate immune cell populations in the lung, we evaluated the distribution and phenotype of neutrophils, monocytes, and macrophages by flow cytometry and histological analyses after delivering human umbilical cord-derived MSCs (hUC-MSCs) IV into immunocompetent mice. After 2 hr, we observed a significant increase in neutrophils, and proinflammatory monocytes and macrophages. Moreover, these immune cells localized in close proximity to the MSCs, suggesting an active role in their clearance. By 24 hr, we detected an increase in anti-inflammatory monocytes and macrophages. These results suggest that the IV injection of hUC-MSCs leads to an initial inflammatory phase in the lung shortly after injection, followed by a resolution phase 24 hr later.
A New Methodology for Optimal Design of Hybrid Vibration Control Systems (MR + TMD) for Buildings under Seismic Excitation
Authors: Brandão Francisco Da Silva , Miguel Letícia Fleck Fadel
Published: September 2023

This study proposes a new methodology, based on the optimization procedure by a metaheuristic algorithm, for designing a hybrid vibration control system to mitigate the dynamic response of buildings under nonstationary artificial earthquakes (NSAEs). For illustration purposes, a 10-story shear building is studied. The hybrid control system involves the use of an MR damper (MR) and a tuned mass damper (TMD) located in different places of the structure. To describe the behavior of the MR, the modified Bouc–Wen model (MBW) was used. To calculate the damping force of the MR, the clipped optimal control associated with linear quadratic regulator (LQR), CO-LQR, was considered. The optimization was performed using the whale optimization algorithm (WOA) and seismic load generated by the Kanai–Tajimi spectrum. Different control scenarios were evaluated: MR-OFF, MR-ON, CO-LQR, STMD, and CO-LQR (MR + TMD) to determine the best control scenario that can effectively control the structure. Overall, the optimized hybrid control scenario (MR + TMD) was the only one able to adapt all story drifts to the control criterion of the consulted normative. Then, CO-LQR (MR + TMD), designed via the methodology proposed in this work, proved to be the best alternative to control the seismic response of this building.