bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of Cancer Genomics in the United States: Views of Payers and Other Stakeholders on Challenges and the Role of Payers in Solutions
Authors: Trosman Julia R. , Weldon Christine B. , Kurian Allison W. , Mrig Emily , Phillips Kathryn A.
Published: February 2025

PURPOSE

Genomic testing is crucial in cancer risk identification, diagnosis, and treatment. However, health care implementation is challenging, even for tests covered by insurance. US payers are important health care participants and may contribute to addressing implementation challenges. We explored whether and how payers consider their role in genomic test implementation, and the perspectives of nonpayer stakeholders on payers' participation.

METHODS

We conducted a group interview with private payers (N = 12) to elucidate views on their role in genomic test implementation, implementation challenges, and potential solutions. Subsequently, we conducted individual interviews (N = 10) with nonpayer stakeholders—five cancer advocacy groups and five medical societies working in cancer, examining their reactions to payer input and capturing additional ideas. Qualitative research methods were used to frame the study and analyze results.

RESULTS

Payers considered cancer genomics implementation important and expressed willingness and ability to be involved. They articulated specific challenges relevant to them, including underutilization of covered tests in clinical practice, inequitable test use, and inconsistencies across guidelines, and suggested specific solutions to collaborate on with other stakeholders. Stakeholders viewed payers' participation in implementation as appropriate and feasible, expressed willingness to work with payers where relevant, and concurred with the key challenges noted by payers. Stakeholders' agreement with payers' solutions varied, but they offered additional ideas for addressing challenges.

CONCLUSION

Both payers and other stakeholders considered payers' role in addressing genomics implementation challenges appropriate and feasible, and offered specific avenues for payer participation. Our findings inform efforts by payers and other stakeholders to address broad health care implementation. They may also help precision oncology professionals, cancer centers, and health systems to frame their own implementation efforts and influence a broader policy and implementation agenda.
Consequences of Medicare Advantage for Beneficiaries and Politics: Revisiting The Delegated Welfare State
Authors: Campbell Andrea Louise , Morgan Kimberly J.
Published: February 2025

The Delegated Welfare State (Morgan and Campbell 2011) explored the causes and possible consequences of the 2003 Medicare reform boosting private managed care plans in the delivery of Medicare benefits. In this paper, we review scholarship on beneficiary experience (access, costs, outcomes) and political feedbacks arising from the delegated governance reform to evaluate whether predictions about consumer behavior and policy entrenchment have manifested. We find that beneficiary experiences and satisfaction do not differ significantly between Medicare Advantage and traditional Medicare, and MA plans’ managed care techniques have cut per beneficiary spending. However, MA remains costlier to the federal government, per beneficiary, because of the outsized payments received by plan providers. Officials have failed to rectify these overpayments because of policy feedback effects – the empowerment of lobbying groups with a stake in the program and beneficiary support for it. Growing dependence on private plans to deliver health insurance for a large and politically influential constituency, senior citizens, has rendered government officials and elected politicians reluctant to imperil this market and the happiness of beneficiaries.
The Evolution of Medicare: Challenges, Responses, and Prospects
Authors: Glied Sherry , Frank Richard , Lui Brendan
Published: February 2025

The Medicare program has provided a near-universal source of health care coverage for America's elderly since 1965. Over its 60-year history, the program has evolved to cover a greater share of the population and pay for an increasing share of the nation's health care bills. As Medicare has grown, so too have its challenges. The traditional Medicare program has failed to keep pace with a rapidly changing health care sector and demographic shifts. Constrained by its own benefit design, Medicare has allowed privately-contracted health plans (Medigap, Medicare Advantage) to provide much needed yet inadequate remedies to the program's shortcomings. After briefly recounting Medicare's origins, we discuss how the program's founding statutes have hindered its ability to respond to new and growing challenges along the dimensions of cost-sharing, cost containment, and benefit design. We then propose a three-pronged approach to reforming Medicare's benefit structure. We argue that a simplified enrollment process, a single benefit that brings together the program's constituent parts (Part A, Part B, and Part D), and a new organizational structure for care delivery based on the program's experience with Accountable Care Organizations (ACOs), will together create a robust foundation that can sustain the Medicare program into the future.
Direct neutrophil and T cell contact with macrophages induces release of phagosomally processed PAMPs via eructophagy
Authors: Nguyen Jenny A. , Orsetti Tanis L. , Vernon Philip , Greene Catherine J. , McKenna Neil , Yates Robin M.
Published: February 2025

Macrophages play a pivotal role in clearing debris and microbes from the microenvironment via phagocytosis and orchestrating local inflammation. While mostly understood to be through the synthesis and secretion of soluble mediators such as cytokines and eicosanoids, it has been recently proposed that macrophages can release previously phagocytosed and processed PAMPs and DAMPs into the local microenvironment via a process termed eructophagy, and that these, in turn, can activate recently vicinal leukocytes. Additionally, it has been commonly observed that local macrophages physically interact with other leukocytes, such as neutrophils and T cells, recruited to sites of inflammation. This study demonstrated that eructophagy in macrophages is significantly induced during physical interaction with neutrophils and T cells, which is mediated by ICAM1 on macrophages and LFA1 on neutrophils/T cells. Notably, ICAM1 activation alone is sufficient to trigger eructophagy in macrophages and is dependent on Lyn kinase. Through this mechanism, it is proposed that neutrophils and lymphocytes can influence their own activation by interacting with local macrophages containing PAMP-containing phagolysosomes, which subsequently triggers PAMP release into the local microenvironment through eructophagy.
How Competitive Is the Stock Market? Theory, Evidence from Portfolios, and Implications for the Rise of Passive Investing
Authors: Haddad Valentin , Huebner Paul , Loualiche Erik
Published: February 2025

The conventional wisdom in finance is that competition is fierce among investors: if a group changes its behavior, others adjust their strategies such that nothing happens to prices. We estimate a demand system with flexible strategic responses for institutional investors in the US stock market. When less aggressive traders surround an investor, she adjusts by trading more aggressively. However, this strategic reaction only counteracts two-thirds of the impact of the initial change in behavior. In light of these estimates, the rise in passive investing over the last 20 years has made the demand for individual stocks 11 percent more inelastic. (JEL G11, G14, G23, G41)
He said ‘I will ask you questions’: A case study of interpreter impact on rapport building in an authentic sign language interpreter-mediated police-suspect interview
Authors: Skinner Robert , Napier Jemina , Boser Ursula
Published: February 2025

In police-suspect interviews it has been argued that rapport building and management plays a vital role in collecting good quality evidence. How rapport building and management is achieved in the presence of an interpreter is an understudied topic. To examine how the interpreter manages this feature of communication we present an interdisciplinary case study analysis of an authentic police-suspect interview involving a deaf suspect, a British Sign Language interpreter and two police officers. Discourse-based interpreting research has determined that interpreters are participants within the interpreter-mediated interaction, and that a high level of discursive expertise and sensitivity is a necessary skill for interpreters working in police interview settings. For this study we draw on policing research to apply a rapport model used in police interviews, and on interpreting studies to examine the interpreter’s use of expanded renditions (Wadensjö, 1998) and source attribution (Metzger, 1999) and the interpreter’s impact on rapport building. These rendition types contain what appears to be conscious or unconscious additions to the source message that seem to support the suspect’s ability to understand the interpreted message but, in some cases, potentially jeopardise the officer’s rapport building strategies. The examples we provide demonstrate the delicate balance needed because expansions to meaning, repetitions or source attribution utilised by the interpreter may lead to unintentional coercive outcomes.
Simultaneous interpreting in healthcare: A Survey-based study on the frequency of use and nature of encounters
Authors: Sultanic Indira , Tamarit-Galdón Marc
Published: February 2025

Simultaneous interpreting in healthcare settings is typically reserved for emergency situations only. Nevertheless, this technique or mode of interpreting is employed in a variety of medical settings and situations outside of the emergency department. This study explores the frequency of simultaneous interpreting encounters in healthcare settings, and the nature of appointments or interpreted events during which this mode of interpreting might be called for, negotiated or chosen by the interpreter, and utilized. The findings are based on a survey of 662 practicing, professional healthcare interpreters in the United States who have used the simultaneous interpreting technique at least once, or during a series of clinical and non-clinical encounters.
Distributionally Robust Optimal Allocation with Costly Verification
Authors: Bayrak Halil İbrahim , Koçyiğit Çağıl , Kuhn Daniel , Pınar Mustafa Çelebi
Published: February 2025

Allocation with Costly Verification under Ambiguity

In “Distributionally Robust Optimal Allocation with Costly Verification,” Bayrak, Koçyiğit, Kuhn, and Pınar examine the mechanism design problem faced by a principal allocating a single good to one of several agents with costly verification and without monetary transfers, adopting a distributionally robust optimization perspective. Each agent desires the good and generates value for the principal, who does not initially know these values but can verify them at a cost. This problem arises in various scenarios, such as a venture capitalist selecting a start-up for funding or a procurement manager choosing a supplier. Many such allocation problems occur infrequently, leaving the principal with limited knowledge about the distribution of the agents’ values. The authors model these allocation problems as distributionally robust mechanism design problems, explicitly addressing distributional ambiguity. They introduce the first robustly (and Pareto-robustly) optimal mechanisms in the literature. These mechanisms are not only robust but also simple and interpretable.
Improving Flipped Academic Advising: Designing Materials for the Technology-Based Higher Education Landscape
Authors: Paschke Jaron D. , Ditta Annie S.
Published: February 2025

This study investigated best practices in creating and providing advising materials to students in an asynchronous online environment (i.e., flipped advising). Specifically, we examined the effects of creating advising tutorials in different modalities (i.e., text vs. video), and providing learning support via a pre-tutorial before engaging with the flipped advising content (i.e., pre-tutorial vs. no pre-tutorial). We found a significant interaction of these factors such that participants who watched video tutorials benefitted from having a pre-tutorial, but those who read text tutorials were hindered by the pre-tutorial. These results suggest that pre-tutorials warrant additional investigation, especially in the context of technology-driven flipped academic advising.
Career Advising in a VUCA Environment
Authors: Shaffer Leigh S. , Zalewski Jacqueline M.
Published: February 2025

Recent developments in the knowledge-driven, postindustrial economy have radically affected college students’ prospects for entering and completing successful careers. In this volatile, uncertain, complex, and ambiguous (VUCA) environment, fewer organizations find profitability in hiring, training, and retaining workers. Over the last 20 years, traditional careers, with lifelong security and opportunities for financial success, have been systematically replaced by a contract with workers who maintain their own employability. In addition, college degrees no longer assure graduates of having marketable knowledge and skills, and so traditional career advising yields limited results in a VUCA environment. This is the first in a series of articles outlining a human capital approach to career advising that addresses the challenges of a VUCA environment.
A Local Transition Adaptive Structured Mesh Generation Method for Finite Difference Time Domain Simulation
Authors: Cao Zixuan , Mou Chunhui , Wang Chenghao , Chen Juan , Li Shaolong , Zhao Cuirong , Yin Yuemeng
Published: February 2025

In this paper, a local transition adaptive structured mesh generation method is proposed for finite difference time domain (FDTD) simulation. This innovative approach can automatically identify the location of the medium interfaces and boundaries based on the triangular facet of the target, and subsequently divide the entire computational domain into numerous subregions. In the subregions, uniform mesh lines are initially placed in accordance with the numerical requirement of FDTD method. Subsequently, part of these meshes are refined based on target structure. Finally, local transition processing is performed for meshes with large variations at the boundaries of neighboring subregions, so that there is no rapid change in mesh size in the boundary position. Different from the existing automatic non-uniform mesh generation methods, the method proposed only adds transition meshes at the medium interfaces and boundaries instead of placing global gradient meshes, so it can greatly reduce the mesh quantity and simplify the mesh generation process. Two classical models of inverted-F antenna and cross-slot frequency selective surface are employed as examples to verify the validity of our method. Simulation results demonstrate that this generation method can achieve nearly equivalent simulation accuracy as the global gradient mesh generation method with a markedly reduced number of meshes.
Novel Design for Four-port Metamaterial SRR-loaded MIMO Antenna for 5G and Wireless Communication Applications
Authors: Rajakumar M. , Meena M.
Published: February 2025

In this paper, a new high-polarization metamaterial structure design for a multiple-input, multiple-output (MIMO) antenna with robust isolation is introduced. The antenna design satisfies the requirements of C-band and S-band wireless communication networks up to sub-6 GHz 5G applications. The novel design of the antenna gets three frequency bands—5.8 GHz, 3.4 GHz, and 2.57 GHz—to be taken into consideration. After the integration of metamaterial components and without use of any further decoupling techniques, high isolation of more than 20 dB is achieved. By suppressing the propagation of surface waves, low-band resonators can reduce the mutual coupling between two higher bands. Ultimately, the initial coupling is canceled out using a split-ring resonator (SRR) to minimize coupling in the low band. The stated MIMO antenna has a maximum return loss of -13, -18, and -21 dB and a mutual coupling of -13, -18, and -21 dB. It covers the 2.5, 3.4, and 5.8 GHz bands, which are used for WLAN, LTE, and 5G. Within acceptable bounds, the envelope correlation coefficient is less than 0.01 and the total active reflection coefficient is less than -10 dB. The performance of MIMO antennas is observed practically and reported.
Innovations in noninvasive sensory stimulation treatments to combat Alzheimer’s disease
Authors: Park Jung M. , Tsai Li-Huei
Published: February 2025

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder affecting millions worldwide. There is no known cure for AD, highlighting an urgent need for new, innovative treatments. Recent studies have shed light on a promising, noninvasive approach using sensory stimulation as a potential therapy for AD. Exposing patients to light and sound pulses at a frequency of 40 hertz induces brain rhythms in the gamma frequency range that are important for healthy brain activity. Using this treatment in animal models, we are now beginning to understand the molecular, cellular, and circuit-level changes that underlie improvements in disease pathology, cognition, and behavior. A mechanistic understanding of the basic biology that underlies the 40-hertz treatment will inform ongoing clinical trials that offer a promising avenue of treatment without the side effects and high costs typically associated with pharmacological interventions. Concurrent advancements in neurotechnology that can also noninvasively stimulate healthy brain rhythms are illuminating new possibilities for alternative therapies. Altogether, these noninvasive approaches could herald a new era in treating AD, making them a beacon of hope for patients, families, and caregivers facing the challenges of this debilitating condition.
New solutions for antibiotic discovery: Prioritizing microbial biosynthetic space using ecology and machine learning
Authors: Medema Marnix H. , van Wezel Gilles P.
Published: February 2025

With the explosive increase in genome sequence data, perhaps the major challenge in natural-product-based drug discovery is the identification of gene clusters most likely to specify new chemistry and bioactivities. We discuss the challenges and state-of-the-art of antibiotic discovery based on ecological principles, genome mining and artificial intelligence.
Intergenerational continuity of protective parenting practices in Dhaka, Bangladesh
Authors: Jasmine Umme Habiba , Nduna Mzikazi , Nkala-Dlamini Busisiwe
Published: February 2025

Intergenerational transmission of parenting practices is a new dimension of research in Bangladesh. This study used a social cognitive theory framework along with a theory of urbanization and a theory of modernization to examine the continuity of protective parenting practices across two generations. A cross-sectional hermeneutic phenomenological study design was followed from a social constructivist paradigm. Eleven maternal grandmothers (G1) and 11 mothers (G2) were purposively selected from Mirpur, Dhaka, Bangladesh. Data were collected through semi-structured, in-depth interviews. The mothers learned protective parenting practices from the grandmother generation through direct instruction, experience, observation, and modeling within an interaction of various social elements. Protective parenting practices were found to be essential and persisted with some modifications despite modernization. Based on the findings, a process model of intergenerational continuity of parenting practices has been offered, which depicts intergenerational learning within a transitional social context.
Evaluation of knowledge and awareness of diabetes in higher secondary level students of Kaski district: A cross-sectional study
Authors: Pandit Arpana , Sapkota Biswash , Poudel Nishan , Karki Renu , Poudel Bharat , Lamichhane Ramakanta
Published: February 2025

Studies have shown that the knowledge of diabetes among adults in Nepal is poor. This study aimed to evaluate the knowledge regarding diabetes in secondary level (i.e., Grade 11 and 12) science students. We assessed the student’s knowledge and awareness regarding diabetes through self-administered questionnaires consisting of 26 questions associated with symptoms, treatment, prevention, and complications of diabetes. Eight higher secondary schools with science streams in Kaski district were selected. A total of 561 students were in the study. Almost all the students (96%) expressed that they had heard about diabetes but only 37% of students correctly indicated the risk factors of it. One-fourth of the total students were able to distinguish between type 1 and type 2 diabetes. Only 13% of students knew about the third type of diabetes, i.e., gestational diabetes. Nearly 47% of students had a wrong perception that diabetes cannot be prevented or delayed. Though early diagnosis of diabetes is essential to prevent complications, only 61% knew about this fact. In our study, 26% of respondents had a family history of diabetes. Overall, 53% showed poor knowledge, 44% showed average knowledge and only 3% showed good knowledge regarding diabetes. The study showed that the gender of the participants and the type of college (government or private) they were studying had no significant relationship with the knowledge level regarding diabetes. However, family history and educational level (class 11 or 12) showed a positive relationship with the level of knowledge regarding diabetes. Students had good knowledge regarding the symptoms of diabetes but had poor knowledge about risk factors, complications, and prevention strategies for diabetes. Overall diabetes knowledge was inadequate in the students, indicating that there is a necessity for urgent action to enhance students’ knowledge regarding diabetes.
Molecular screening and dynamics simulation reveal potential phytocompounds in Swertia chirayita targeting the UspA1 protein of Moraxella catarrhalis for COPD therapy
Authors: Uddin Md. Moin , Chowdhury Md. Shydhur Rahman , Hossain Md. Arju , Ahsan Asif , Hossain Md. Tanvir , Barik Abdul , Hossen Md. Arif , Amin Md. Faisal , Abir Rafsan , Alam Mohammad Shah , Rahman Md Habibur , Hoque M. Nazmul
Published: February 2025

Chronic obstructive pulmonary disease (COPD) is a global health burden, with Moraxella catarrhalis significantly contributing to acute exacerbations and increased healthcare challenges. This study aimed to identify potential drug candidates in Swertia chirayita, a traditional Himalayan medicinal plant, demonstrating efficacy against the ubiquitous surface protein A1 (UspA1) of M. catarrhalis through an in-silico computational approach. The three-dimensional structures of 46 phytocompounds of S. chirayita were retrieved from the IMPPAT 2.0 database. The structures underwent thorough analysis and screening, emphasizing key factors such as binding energy, molecular docking performance, drug-likeness, and toxicity prediction to assess their therapeutic potential. Considering the spectrometry, pharmacokinetic properties, docking results, drug likeliness, and toxicological effects, five phytocompounds such as beta-amyrin, calendol, episwertenol, kairatenol and swertanone were identified as the inhibitors of the UspA1 in M. catarrhalis. UspA1 demonstrated binding affinities of –9.1 kcal/mol for beta-amyrin, –8.9 kcal/mol for calendol, –9.4 kcal/mol for episwertenol, –9.6 kcal/mol for kairatenol, and –9.0 kcal/mol for swertanone. All of these affinities were stronger than that of the control drug ceftobiprole, which had a binding score of –6.6 kcal/mol. The toxicity analysis confirmed that all five compounds are safe potential therapeutic options, showing no toxicity or carcinogenicity. We also performed a 100 ns molecular dynamics simulation of the phytocompounds to analyze their stability and interactions as protein-ligand complexes. Among the five screened phytocompounds, beta-amyrin and episwertenol exhibited favorable characteristics, including stable root mean square deviation values, minimal root mean square fluctuations, and consistent radius of gyration values. Throughout the simulations, intermolecular interactions such as hydrogen bonds and hydrophobic contacts were maintained. Additionally, the compounds demonstrated strong affinity, as indicated by negative binding free energy values. Taken together, findings of this study strongly suggest that beta-amyrin and episwertenol have the potential to act as inhibitors against the UspA1 protein of M. catarrhalis, offering promising prospects for the treatment and management of COPD.
Changes in the distribution of the tear film lipid layer after intensive pulsed light combined with meibomian gland expression in patients with meibomian gland dysfunction
Authors: Lee Yongwoo , Lee Sung Woo , Yun Ji Kyu , Han So Young , Choi Chul Young
Published: February 2025

Purpose

This study aimed to investigate changes in dry eye disease (DED) parameters and tear film lipid layer distribution after intensive pulse light (IPL) combined with meibomian gland expression (MGX) in patients with meibomian gland dysfunction (MGD).

Methods

This retrospective study included 218 patients diagnosed with MGD who underwent IPL combined with MGX. Various DED parameters, including tear film lipid layer thickness (LLT), were measured using a Placido disc tear film analyzer and slit lamp. Inferior corneal images were quantified and divided into upper, lower, nasal, and temporal quadrants, with further subdivision into six parts from top to bottom using Python.

Results

The ocular surface disease index, meibomian gland expressibility, and quality scores significantly improved after three treatment sessions. Slit-lamp-measured DED parameters also improved, excluding the fluorescein-stained tear meniscus height. Redness in the nasal limbal and bulbar conjunctivae significantly decreased. The mean LLT tended to increase after treatment. LLT in the upper half of the images, but not in the lower half, increased significantly, with the difference in LLT between the two halves decreasing significantly from 34.46 ±  15.73 to 30.27 ±  14.63 nm (p =  0.031). When the vertical distribution was analyzed by further subdivision into six equal parts from top to bottom, the average difference in LLT decreased in the uppermost segment after treatment.

Conclusion

IPL combined with MGX reduced the vertical distribution of lipids in patients with MGD by reducing lower tear film lipid layer stasis. Thus, the Placido disc tear film analyzer is a useful tool for analyzing lipid layer distribution in MGD.
The impact of perinatal maternal stress on the maternal and infant gut and human milk microbiomes: A scoping review
Authors: Ryan Niamh , O’Mahony Siobhain , Leahy-Warren Patricia , Philpott Lloyd , Mulcahy Helen
Published: February 2025

Background

Perinatal maternal stress, which includes both psychological and physiological stress experienced by healthy women during pregnancy and the postpartum period, is becoming increasingly prevalent. Infant early exposure to adverse environments such as perinatal stress has been shown to increase the long-term risk to metabolic, immunologic and neurobehavioral disorders. Evidence suggests that the human microbiome facilitates the transmission of maternal factors to infants via the vaginal, gut, and human milk microbiomes. The colonization of aberrant microorganisms in the mother’s microbiome, influenced by the microbiome-brain-gut axis, may be transferred to infants during a critical early developmental period. This transfer may predispose infants to a more inflammatory-prone microbiome which is associated with dysregulated metabolic process leading to adverse health outcomes. Given the prevalence and potential impact of perinatal stress on maternal and infant health, with no systematic mapping or review of the data to date, the aim of this scoping review is to gather evidence on the relationship between perinatal maternal stress, and the human milk, maternal, and infant gut microbiomes.

Methods

This is an exploratory mapping scoping review, guided by the Joanna Briggs Institute’s methodology along with use of the Prisma Scr reporting guideline. A comprehensive search was conducted using the following databases, CINAHL Complete; MEDLINE; PsycINFO, Web of Science and Scopus with a protocol registered with Open Science Framework DOI 10.17605/OSF.IO/5SRMV.

Results

After screening 1145 papers there were 7 paper that met the inclusion criteria. Statistically significant associations were found in five of the studies which identify higher abundance of potentially pathogenic bacteria such as Erwinia, Serratia, T mayombie, Bacteroides with higher maternal stress, and lower levels of stress linked to potentially beneficial bacteria such Lactococcus, Lactobacillus, Akkermansia. However, one study presents conflicting results where it was reported that higher maternal stress was linked to the prevalence of more beneficial bacteria.

Conclusion

This review suggests that maternal stress does have an impact on the alteration of abundance and diversity of influential bacteria in the gut microbiome, however, it can affect colonisation in different ways. These bacterial changes have the capacity to influence long term health and disease. The review analyses data collection tools and methods, offers potential reasons for these findings as well as suggestions for future research.
Needs, rationale, and outcomes of leadership education in neurosurgery
Authors: Skulsampaopol Janissardhar , Shitsama Sylvia , Ming Yu , Hansasuta Ake , Cusimano Michael D.
Published: February 2025

Background

Surgeons are expected to lead teams/organizations to achieve optimal patient outcomes; however, few receive formal education in leadership. The goals of the study were to: 1) assess the unmet needs and gaps in leadership education for neurosurgeons and residents/fellows; 2) identify factors associated with availability of leadership education, access to leadership positions and the similarities/differences across geographic regions and institutional type; 3) describe the associations between gender and leadership; 4) determine the impact of leadership education.

Methods

International survey of 657 neurosurgeons, residents/fellows. A series of univariate analysis and multivariate were conducted to assess the association between specific variables and leadership outcomes.

Results

Almost half (48%) indicated that leadership education did not exist in their organization. This lack was more notable in non-academic centers (p < 0.001), among neurosurgeons with less than 5 years of work experience (p = 0.03), and respondents from South America (p = 0.02). Nearly two-thirds (61.1%) reported never having leadership training. Significantly fewer respondents in the age range 35–44 years old (p = 0.02), those working in the Middle East (p = 0.02), neurosurgeons with work experience less than 5 years (p = 0.004), working in non-academic center (p = 0.02) attended leadership training. In contrast to the differences seen across geographic regions and types of institutions, overall, the proportions of males and females having access to leadership training and being offered leadership positions were similar. Among participants, 87.1% of those with leadership training were offered leadership roles, compared to 65.5% of those without leadership training (p <  0.001). Additionally, participants with leadership training experienced a burnout rate of 29.2%, whereas those without leadership training had a higher rate of burnout of 40.5% (p =  0.02).

Conclusions

There is a pressing need to develop educational opportunities for leadership in neurosurgery, especially for younger neurosurgeons, neurosurgeons working in non-academic centers, in countries and non-academic institutions where leadership education is less accessible. Leadership education is associated with increased numbers of neurosurgical leaders at all levels as well as reduced levels of burnout.
Development and application of a binary medium bond contact model for calcareous sands
Authors: Cheng Qifen , Zhang Ge
Published: February 2025

In the construction process of islands and reefs in the South China Sea, calcareous sand, as an important foundation and building material, has been widely used in engineering practice. It is crucial to explore the mechanical properties of calcareous sands to ensure the stability and maintenance of these islands and reefs. To study the effects of the bonding progressive failure on its macroscopic mechanical properties, a binary media bonding contact model is developed. This model can describe the gradual deterioration process of the intergranular cementation. Additionally, a discrete elemental contact subroutine (DLL) is created by C++ language program for the particle flow program (PFC2D) to utilize. The compression and direct shear testing of single contact was subjected. The computational accuracy of the proposed binary media contact model was confirmed by the comparison of the theoretical and numerical results. The biaxial shear discrete element simulations were conducted to study the behaviors of calcareous sand under different confining pressure conditions. The stress-strain curves obtained are in good agreement with the experimental results. The results show that the proposed binary media bonding contact model can accurately reflects the mechanical properties of calcareous sand. Based on calibrated discrete element contact mesoscopic parameters, the biaxial shear discrete element numerical simulations with different damage parameters were carried out. The effects of damage parameters on the stress-strain curves and shear strength are discussed. The evolution of effective coordination number, fabric anisotropy and force chain number are also analyzed. The research results can provide a basis for the study of macro-micromechanical properties of calcareous sand
Antibiogram profile of Enterococcus faecalis and Enterococcus faecium in chicken meat from supermarkets in Sleman District, Indonesia
Authors: Nurrahmat Andi Muhamad Isra , Susetya Heru , Putri Khrisdiana
Published: February 2025

Background and Aim: Enterococci are commensal bacteria in the digestive tract of poultry and serve as indicators of fecal contamination. Their significance in veterinary and human medicine arises from their ability to acquire antibiotic-resistance genes, posing a potential public health risk. Poultry meat, a major protein source in Indonesia, can act as a reservoir for Enterococcus species, transferring antibiotic-resistant strains to humans through food handling. Despite rigorous hygiene standards in supermarket supply chains, limited studies have assessed contamination levels. This study aimed to identify Enterococcus species from supermarket chicken meat in Sleman District, Yogyakarta, Indonesia, and evaluate their antibiotic resistance profiles.

Materials and Methods: Chicken breast samples were randomly collected from three Supermarkets (A, B, and C). Bacterial isolation was performed using buffered peptone water and enterococcosel agar. Presumptive colonies were confirmed by polymerase chain reaction for genus and species identification. Antibiotic susceptibility was assessed using the Kirby–Bauer disk diffusion method against ampicillin (AMP), tetracycline (TET), erythromycin (ERY), and vancomycin (VAN).

Results: A total of 269 Enterococcus isolates were confirmed, including 163 Enterococcus faecium (EFM), 92 Enterococcus faecalis (EFS), and 14 other Enterococcus species. Resistance to AMP, TET, and ERY in EFM was 12.12%, 57.57%, and 66.67%, respectively, while resistance in EFS was 4.54%, 31.82%, and 63.63%. No isolates showed resistance to VAN. Multidrug resistance (MDR) was observed in 60.60% of EFM and 36.36% of EFS isolates.

Conclusion: Despite high susceptibility to AMP and VAN, resistance to TET and ERY was prevalent. The presence of MDR isolates underscores the need for continuous surveillance of antibiotic resistance in Enterococcus species within the food chain. This study highlights the necessity of further research with expanded sampling and antibiotic panels to assess the dissemination of antibiotic resistance genes and potential public health risks.

Keywords: antibiotic resistance, Enterococcus, food safety, multidrug resistance, supermarket chicken.
Synthesis and Biological Assessment of Novel Pyridine-Pyrazole Hybrids: Molecular Docking and Antioxidant Studies
Authors: Phayde Sai Prasad D. , Vagish C.B.
Published: February 2025

In this study, pyridine-appended pyrazole derivatives were synthesized through chalcone formation using 3-acetylpyridine and 3-pyridine-carboxaldehyde, followed by reaction with substituted phenyl hydrazines under mild conditions. The methodology offered good yields and easy purification via column chromatography. The structural characterization was performed using 1H NMR, 13C NMR and mass spectrometry. Density functional theory (DFT) studies at the B3LYP/6-31G level provided insights into electronic properties, including HOMO-LUMO energy gaps and molecular electrostatic potential (MEP), predicting the biological interactions. Biological evaluation using the DPPH radical scavenging assay confirmed significant antioxidant activity, highlighting the potential of these compounds in the medicinal chemistry.
Biological Activities and Docking Simulation of Newer Dipodal Benzopyrazines based Azine Scaffold
Authors: Sudewad Maroti , Yeole Sachin , Jadhav Maheshkumar , Kathwate Santosh , More Rahul , Tayade Kundan
Published: February 2025

In this study, novel benzopyrazine-based motif 2-((2,3-bis(4-bromophenyl)quinoxalin-6-yl)(phenyl)-methylene)-1-((2,3-bis(4-bromophenyl)-quinoxalin-7-yl)(phenyl)methylene)hydrazine (compound 2) was synthesized and characterized. Among the tested microbes, compound 2 has demonstrated potent activity against the bacterial strains B. subtilis and B. megaterium (with MICs of 31.25 and 15.62, respectively), as well as the fungal strains R. oryzae, P. chrysogenum and A. niger (with MICs of 31.25, 62.5 and 62.5, respectively). Compound 2 (1 mg/mL) was also found to be a potent DPPH-reducing agent as compared to ascorbic acid. In vitro hemolytic assay revealed negligible activity (within 5% permissible limit) as compared to positive control Triton-X 100. Molecular docking studies indicated that compound 2 binds to the GyrB ATP-binding site through hydrogen bonds, hydrophobic interactions, and π-cation interactions, demonstrating favourable in silico interaction energy scores. Exploration of DFT shows that HOMO & LUMO are mainly located around the benzene rings and nitrogen atoms rather than bromine.
Novel non-invasive and quantitative assessment of the renal function of transplanted kidneys using Doppler ultrasonography with the vascular index of superb microvascular imaging
Authors: Bae Sung Hwan , Lee Eun Ji , Hwang Jiyoung , Hong Seong Sook , Chang Yun-Woo , Nam Boda
Published: February 2025

Purpose: This study assessed the reproducibility and clinical value of the vascular index (VI), derived from superb microvascular imaging (SMI) using Doppler ultrasonography, for evaluating renal function in transplanted kidneys.Methods: This retrospective study included 63 renal transplant patients who underwent grayscale and Doppler ultrasonography with SMI from January 2022 to February 2023. The VI of the transplanted kidneys was measured using three methods (VIbox, VIF1, VIF2). The VI was compared across chronic kidney disease (CKD) groups categorized by estimated glomerular filtration rate (eGFR) and Kidney Disease: Improving Global Outcomes (KDIGO) CKD risk groups based on eGFR and albuminuria. The correlation between VI and renal function was evaluated. Univariate and multivariate linear regression analyses were used to identify predictors of eGFR.Results: Significant differences in VI were observed among CKD groups based on eGFR (VIbox, P=0.001; VIF1, P<0.001; VIF2, P<0.001) and KDIGO CKD groups based on eGFR and albuminuria (VIbox, P=0.039; VIF1, P=0.001; VIF2, P<0.001). VIF1 and VIF2 demonstrated moderate/high correlations with eGFR (r=0.627, P<0.001 and r=0.657, P<0.001, respectively) and serum creatinine (r=-0.626, P<0.001 and r=-0.649, P<0.001, respectively). VIbox moderately correlated with eGFR (r=0.445, P<0.001). Multivariate regression identified the urine albumincreatinine ratio (ACR) (adjusted odds ratio [aOR], 1.122; 95% confidence interval [CI], -0.007 to, 0.000; P=0.030) and VIF2 (aOR, 1.114; 95% CI, 0.466 to 1.235; P<0.001) were independently associated with eGFR.Conclusion: The VI measured by drawing a region of interest along the border of the transplanted kidney in SMI (VIF2) is highly reproducible and correlates well with eGFR. Both VIF2 and ACR independently predict eGFR.
Hubungan Early Warning Scoring System dengan Mortalitas Pasien COVID-19 di Rumah Sakit Universitas Indonesia
Authors: Listiana Saetia , Adnan Nurhayati
Published: February 2025

Background: Tingkat mortalitas COVID-19 di Indonesia sebesar 2,7%, angka ini merupakan yang tertinggi di Asia Tenggara. Pasien COVID-19 yang mengalami perburukan di rumah sakit seperti masuk ICU dan kematian sebanyak 15-20%. Perubahan klinis pasien sebelum terjadinya perburukan dan kematian tidak disadari oleh 27,06% tenaga kesehatan. Menurut WHO, EWS dapat digunakan untuk mendeteksi perburukan pasien lebih awal, namun penelitian yang dilakukan untuk melihat hubungan EWS dengan kematian COVID-19 masih terbatas. Tujuan penelitian ini adalah untuk mengetahui besar risiko highrisk EWS dengan kejadian kematian serta probabilitas kesintasan pada pasien COVID-19 yang dirawat di RS UI.Methods: Penelitian ini menggunakan desain studi kohort retrospektif. Populasi pada penelitian ini adalah seluruh pasien COVID-19 yang dirawat inap di RS UI pada periode Maret – Desember 2020. Penelitian ini menggunakan total sampling. Jumlah sampel pada penelitian ini adalah 740 orang yang terdiri dari 137 orang pada kelompok terpapar dan 603 kelompok tidak terpapar. Analisis kesintasan dilakukan dengan menggunakan Kaplan Meier sedangkan analisis multivariat dilakukan dengan cox regresi.Result: Probabilitas kesintasan pasien COVID-19 yang di rawat di RS UI sampai dengan 72 hari pengamatan sebesar 47,4%. Besar risiko pasien COVID-19 yang memiliki highrisk EWS untuk terjadi kematian sebesar 5,32 (95% CI= 3,26-8,69).Conclusion : Tenaga kesehatan diharapkan dapat mendeteksi perburukan pasien sedini mungkin agar bisa dilakukan intervensi lebih awal untuk mencegah kematian pada pasien COVID-19.
The Rabin-Keisler theorem and the sizes of ultrapowers
Authors: Honzík Radek
Published: February 2025

Recall the Rabin-Keisler theorem which gives a lower bound κω for the size of proper elementary extensions of complete structures of size κ, provided that κ is an infinite cardinal below the first measurable cardinal. We survey – and at places clarify and extend – some facts which connect the Rabin-Keisler theorem, sizes of ultrapowers, combinatorial properties of ultrafilters, and large cardinals.
Synthesis and characterization of amine-functionalized mesoporous carbon nanomaterial from biowaste
Authors: Abinaya Kannan , Raveendran Muthurajan , Prasanthrajan Mohan , Sharmila D Jeya Sundara , Kalaimagal Thiyagarajan , Sudha Manickam , Rajeshkumar Ravichandran
Published: February 2025

Garlic (Allium sativum) is widely cultivated and consumed, making it one of the most important crops in the world. India is the second largest producer next to China. The garlic peels from the garlic processing industry are often discarded as agricultural waste. These wastes are rich in carbon precursors, making them an ideal feedstock for mesoporous carbon nanomaterial (MCN) synthesis. Pyrolysis is the top-down approach to synthesizing the nanomaterial, which involves heating organic materials such as garlic peel waste that breaks into smaller compounds, resulting in a mixture of gases and carbon-rich solid residues (bio-char). The amine-functionalization was performed over the mesoporous surface and confirmed by the shifts in zeta potential value from – 31.6 mV to + 22 mV to increase the surface charge density. Similarly, the Brunauer Emmett Teller (BET) analyzer confirmed the reduction in the pore diameter from 12.5 nm to 7.41 nm due to amine functionalization. Furthermore, the synthesized MCN were thoroughly characterized using advanced analytical techniques, providing comprehensive insights into their size, shape, surface functional groups, crystallinity and porosity. This study transformed agricultural waste into high-value materials (MCN), reducing environmental impact and promoting resource efficiency.
Fully Automated Correlated Time Series Forecasting in Minutes
Authors: Wu Xinle , Wu Xingjian , Zhang Dalin , Zhang Miao , Guo Chenjuan , Yang Bin , Jensen Christian S.
Published: February 2025

Societal and industrial infrastructures and systems increasingly leverage sensors that emit correlated time series. Forecasting of future values of such time series based on recorded historical values has important benefits. Automatically designed models achieve higher accuracy than manually designed models. Given a forecasting task, which includes a dataset and a forecasting horizon, automated design methods automatically search for an optimal forecasting model for the task in a manually designed search space, and then train the identified model using the dataset to enable the forecasting. Existing automated methods face three challenges. First, the search space is constructed by human experts, rending the methods only semi-automated and yielding search spaces prone to subjective biases. Second, it is time consuming to search for an optimal model. Third, training the identified model for a new task is also costly. These challenges limit the practicability of automated methods in real-world settings. To contend with the challenges, we propose a fully automated and highly efficient correlated time series forecasting framework where the search and training can be done in minutes. The framework includes a data-driven, iterative strategy to automatically prune a large search space to obtain a high-quality search space for a new forecasting task. It includes a zero-shot search strategy to efficiently identify the optimal model in the customized search space. And it includes a fast parameter adaptation strategy to accelerate the training of the identified model. Experiments on seven benchmark datasets offer evidence that the framework is capable of state-of-the-art accuracy and is much more efficient than existing methods.
Substructure-Aware Log Anomaly Detection
Authors: Tang Yanni , Zhang Zhuoxing , Zhao Kaiqi , Fang Lanting , Li Zhenhua , Chen Wu
Published: February 2025

System logs, recording critical information about system operations, serve as indispensable tools for system anomaly detection. Graph-based methods have demonstrated superior performance compared to other methods in capturing the interdependencies of log events. However, existing methods often neglect the complex substructure patterns of nodes within log graphs, making it challenging to capture the subtle alteration in event type, structure, and the location of exceptions that indicate node anomalies. To address this limitation, this paper proposes a novel framework called Substructure-aware Log Anomaly Detection at Code File Level (SLAD). It first introduces a Monte Carlo Tree Search strategy tailored specifically for log anomaly detection to discover representative substructures. Then, SLAD incorporates a substructure distillation way to enhance the efficiency of anomaly inference based on the representative substructures. After that, we introduce a soft pruning to obtain key substructure for nodes. Experimental results show SLAD outperforms all baselines. Particularly, SLAD demonstrates at least 15 times faster than substructure-based graph learning methods in anomaly inference.