bluuebunny/crossref_metadata_2025 huggingface dataset:
Intestinal inflammation, oxidative damage, and pathogenesis of intestinal Cryptosporidium in juvenile Asian sea bass (Lates calcarifer)
Authors: Jantrakajorn Sasibha , Keawchana Narissara , Sornying Peerapon , Khirilak Pokphon , Suyapoh Watcharapol
Published: October 2024

Piscine intestinal Cryptosporidium infection is a known cause of severe illness and mortality in juvenile Asian sea bass, with inflammation playing a central role. This inflammation triggers the generation of reactive oxygen species (ROS), leading to irreversible DNA damage and activation of apoptosis pathways. However, the specific impact of inflammation on ROS production, DNA damage, and apoptosis in this context remains unclear. This study investigated the pathogenic role of inflammation and ROS in causing DNA damage and cell apoptosis in piscine intestinal cryptosporidiosis. Forty‐four intestinal samples from 60‐ and 90‐day juvenile Asian sea bass were divided into four groups based on Cryptosporidium infection status. Histopathological evaluation and immunofluorescent analysis were conducted to assess ROS production, DNA damage, and cellular apoptosis markers. Results showed significantly higher inflammatory cell infiltration, intracellular ROS production, DNA damage, and cellular apoptosis in 60‐day infected fish compared to 90‐day infected fish. These findings underscore distinct responses in juvenile Asian sea bass to piscine intestinal cryptosporidiosis, highlighting severe inflammation, oxidative DNA damage, and cellular apoptosis, particularly in younger fish.
The purpose of metaphysics: Apology of excess
Authors: Yatsenko Olena
Published: October 2024

This article consistently elaborates the extra‐contextual nature of metaphysical knowledge. Metaphysicsis seen as a semantic construction of culture that produces a certain type of thinking, memory, and identification: that is, subjectivity, and sociality as an ethical and axiological model of interaction with the world and the Other. The paper argues that metaphysics is a kind of orientation in space and that culture is a semiotic way of world orientation, or collection of spaces into an intelligible structure, a specific characteristic of human existence in the universe. Indeed, metaphysics through the space of culture allows one to experience the universe empirically as unity, to assume the presence of meaning. Based on the analysis, the paper summarizes the definition of the phenomenon of culture as a specifically human way of mastering space and controlling time, consciousness as a topology of reflective practices, and virtual reality technology as a space of pure metaphysics.
Patient follow‐up after discharge from the paediatric intensive care unit: A scoping review
Authors: Micaëlli Delphine , Naudin Jérôme , Dauger Stéphane , Levy Michaël , Kerever Sébastien
Published: October 2024

Background

Most children admitted to a paediatric intensive care unit (PICU) now survive because of improvements in care. Many studies have identified the psychological, functional, cognitive and social impact of PICU admission on a child and their family. However, expert recommendations on follow‐up are lacking.

Aim

To identify the strategies of clinical follow‐up after PICU discharge performed from 2001 to 2021.

Study design

This scoping review was undertaken between January and April 2021 using three databases: PubMed, EMBASE and CINAHL. The search strategy consisted of a combination of keywords, including PICU, post‐PICU discharge and follow‐up in articles published between 2001 and 2021. The results are reported according to PRISMA‐ScR guidelines.

Results

Six‐hundred and fifty‐two articles were identified and 68 were analysed. Median age was 4.5 years and the two main reasons for PICU admission were cardiorespiratory failure and sepsis. Median length of PICU stay was 8 days. Most follow‐up was carried out by research units (88%), while 6% of studies reported follow‐up by a multidisciplinary PICU team. The most common follow‐up schedule included an assessment at PICU discharge, and then at 3, 6 and 12 months. Follow‐up for >1 year was reported in 20% of studies. One third of studies focused on follow‐up quality of life and neurological outcomes. Parental emotional impact was assessed in 7% of studies.

Conclusion

Follow‐up after PICU discharge was highly heterogeneous regarding timing, health care professionals involved and assessment methods. There is an urgent need for standardization and coordination of PICU follow‐up because of the increasing number of patients impacted by a PICU stay.

Relevance to Clinical Practice

Although most patients admitted to a paediatric intensive care unit (PICU) now survive; they may develop paediatric post‐intensive care syndrome (PICS‐P). To our knowledge, there are currently no clinical guidelines regarding follow‐up after PICU discharge. This review summarizes current approaches to follow‐up after PICU discharge, including how it is carried out, who is involved and what the main aims of assessment are.
«Los llamamos a todos», ritual de difuntos en la costa de Ecuador. Una propuesta metodológica para su análisis
Authors: Fons Virginia , Álvarez Litben Silvia Graciela
Published: October 2024

En este artículo se analiza en profundidad el ritual de muerte en la Península de Santa Elena, Ecuador, ilustrando al mismo tiempo un método para el análisis de los símbolos y de la ritualidad. Este ritual gira en torno a la mesa de difuntos, permitiendo entender cómo estas poblaciones consideran primordial establecer relación con las almas de sus parientes muertos y reafirmar así sus lazos sociales ancestrales y su razón de ser y existir. Sin embargo, es a través del método de análisis que proponemos que se descubrirán las aguas más profundas de este ritual en el que el juego de combinaciones entre las acciones rituales y los elementos simbolizados se irá desvelando. Así, la metodología de análisis mostrará cómo el ritual es en realidad un acto performativo que sirve para ficcionar lo que se vive a nivel de la experiencia humana.
Destino, Familia y Honor en el Medievo Nórdico: un análisis antropológico de la Volsunga Saga y su contexto social, de Mario Martín Páez
Authors: Pascual Sola Gonzalo
Published: October 2024

Puede resultar complejo encontrar en las bibliotecas de Antropología Social un libro que aborde desde esta disciplina la Edad Media, cuyas formas culturales han sembrado una mayor curiosidad entre filólogas e historiadores, reflejándose en las preguntas de investigación que dominan este campo. Si nos centramos en la Edad Media nórdica y sus estudios en el contexto español, son pocos los investigadores que han convertido esta época histórica en objeto de su análisis. Aunque esto no ha impedido una prolífica producción académica, los resultados han estado orientados hacia el interés particular de la Filología, especialmente en el campo de la traductología. A nivel internacional, y aunque desde los análisis de Victor Turner (1971) sobre la Njáls saga hayan favorecido las aproximaciones sociales a los estudios nórdicos, lo cierto es que son pocas las antropólogas que han dedicado una gran atención y mostrado un buen dominio intelectual sobre este contexto. Así, encontramos nombres como Kirsten Hastrup (1985), Gísli Pálsson (2004), Elisabeth Vestergaard (2002), Paul Durrenberger (1992) y, recientemente, Mario Martín Páez. Este joven investigador, escritor del libro aquí reseñado, ha logrado introducir preguntas de carácter antropológico que le han permitido explorar las formas culturales de Islandia y Noruega durante la Era Vikinga y la Edad Media, dinamizando las reflexiones en torno a la sociedad y la cultura dentro de los estudios nórdicos. Aunque el autor define su trabajo como eminentemente antropológico, su aproximación ha sido compaginada con el uso de fuentes históricas, recurriendo a herramientas y registros que tradicionalmente han sido más característicos de la historia y de la filología, lo que favorece un avance en los enfoques multidisciplinares y repercute tanto en el campo de las ciencias sociales como en el de los estudios nórdicos.
Metropolitan Intimacies. An Ethnography on the Poetics of Daily Life, de Francisco Cruces Villalobos
Authors: Sanmartín Arce Ricardo
Published: October 2024

Hace muchos años, en un país lejano solo en el tiempo, tuve que evaluar a un joven doctor como aspirante a una plaza en la Universidad de Salamanca. Su figura delgada y alta, coincidía elegantemente con una flauta que tocó para ejemplificar una parte de la etnografía en la que fundaba su investigación. Me sorprendió su actuación. Brindaba a quienes juzgábamos la prueba, una experiencia directa de lo que él había observado y registrado en su trabajo de campo. Ese acierto fenomenológico fue posible no solo por su previa formación musical, sino también por el ajustado uso de su sensibilidad para captar, en su raíz, el valor epistemológico de una etnografía que se obtenía desde una concepción antropológica que recordaba la visión de Evans-Pritchard sobre la Antropología Social como un arte.
Short-range C-signaling restricts cheating behavior during
Myxococcus xanthus
development
Authors: Hoang Y. , Franklin Joshua , Dufour Yann S. , Kroos Lee
Published: October 2024

Myxococcus xanthus
uses short-range C-signaling to coordinate multicellular mound formation with sporulation during fruiting body development. A
csgA
mutant deficient in C-signaling can cheat on wild type (WT) in mixtures and form spores disproportionately, but our understanding of cheating behavior is incomplete. We subjected mixtures of WT and
csgA
cells at different ratios to co-development and used confocal microscopy and image analysis to quantify the arrangement and morphology of cells. At a ratio of one WT to four
csgA
cells (1:4), mounds failed to form. At 1:2, only a few mounds and spores formed. At 1:1, mounds formed with a similar number and arrangement of WT and
csgA
rods early in development, but later the number of
csgA
spores near the bottom of these nascent fruiting bodies (NFBs) exceeded that of WT. This cheating after mound formation involved
csgA
forming spores at a greater rate, while WT disappeared at a greater rate, either lysing or exiting NFBs. At 2:1 and 4:1,
csgA
rods were more abundant than expected throughout the biofilm both before and during mound formation, and cheating continued after mound formation. We conclude that C-signaling restricts cheating behavior by requiring sufficient WT cells in mixtures. Excess cheaters may interfere with positive feedback loops that depend on the cellular arrangement to enhance C-signaling during mound building. Since long-range signaling could not likewise communicate the cellular arrangement, we propose that C-signaling was favored evolutionarily and that other short-range signaling mechanisms provided selective advantages in bacterial biofilm and multicellular animal development.

IMPORTANCE

Bacteria communicate using both long- and short-range signals. Signaling affects community composition, structure, and function. Adherent communities called biofilms impact medicine, agriculture, industry, and the environment. To facilitate the manipulation of biofilms for societal benefits, a better understanding of short-range signaling is necessary. We investigated the susceptibility of short-range C-signaling to cheating during
Myxococcus xanthus
biofilm development. A mutant deficient in C-signaling fails to form mounds containing spores (i.e., fruiting bodies) but cheats on C-signaling by wild type in starved cell mixtures and forms spores disproportionately. We found that cheating requires sufficient wild-type cells in the initial mix and can occur both before mound formation and later during the sporulation stage of development. By restricting cheating behavior, short-range C-signaling may have been favored evolutionarily rather than long-range diffusible signaling. Cheating restrictions imposed by short-range signaling may have likewise driven the evolution of multicellularity broadly.
A review of virus host factor discovery using CRISPR screening
Authors: See Wayne Ren , Yousefi Meisam , Ooi Yaw Shin
Published: October 2024

The emergence of genome-scale forward genetic screening techniques, such as Haploid Genetic screen and clustered regularly interspaced short palindromic repeats (CRISPR) knockout screen has opened new horizons in our understanding of virus infection biology. CRISPR screening has become a popular tool for the discovery of novel host factors for several viruses due to its specificity and efficiency in genome editing. Here, we review how CRISPR screening has revolutionized our understanding of virus-host interactions from scientific and technological viewpoints. A summary of the published screens conducted thus far to uncover virus host factors is presented, highlighting their experimental design and significant findings. We will outline relevant methods for customizing the CRISPR screening process to answer more specific hypotheses and compile a glossary of conducted CRISPR screens to show their design aspects. Furthermore, using flaviviruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as examples, we hope to offer a broad-based perspective on the capabilities of CRISPR screening to serve as a reference point to guide future unbiased discovery of virus host factors.
Atypical presentation of streptococcal toxic shock syndrome with uterine necrosis
Authors: Sun Moyan , Balaji Nivedha , Kilaru Vikas , Patel Dhaval
Published: October 2024

Streptococcal toxic shock syndrome (TSS) is a fulminant disease characterised by rapid progression to multiorgan failure. However, streptococcal TSS manifesting as uterine necrosis (UN) is unusual. Here, we present a case of a woman in her 30s with a constellation of symptoms, including abdominal pain, fatigue and fever. Despite an initially unclear clinical picture, she rapidly developed shock with radiographical evidence of intrabdominal arterial narrowing with spurious multiorgan infarctions and ischaemic colitis. Exploratory laparotomy uncovered unexpected UN requiring hysterectomy. Multiple complications ensued, marked by shock liver, acute renal failure, cutaneous desquamation and distal gangrene. This case highlights a unique presentation of streptococcal TSS as UN and emphasises the rapidly deteriorating nature of the disease.
Congenital saccular cyst of the larynx: a rare cause of stridor in a newborn infant
Authors: Nerurkar Sanjna Nilesh , Vora Shrenik , Koh Huiting Lynn , Chandran Suresh
Published: October 2024

Congenital saccular cyst of the larynx is a rare cause of presentation of stridor and respiratory distress in newborns. The clinical presentation of a saccular laryngeal cyst often overlaps with other common causes of stridor, such as laryngomalacia, presenting a diagnostic dilemma for clinicians. We present a case of a term newborn infant referred for evaluation of inspiratory stridor since birth. Microlaryngoscopy and bronchoscopy confirmed the presence of a large cystic mass obstructing the supraglottis. Marsupialisation of the cyst was performed with resolution of stridor, and histopathological examination confirmed the diagnosis of a saccular laryngeal cyst. Our case highlights the importance of considering congenital saccular laryngeal cysts, although rare, in the differential diagnoses of neonatal stridor. Prompt recognition, early endoscopic airway evaluation and surgical intervention are crucial to preventing potentially life-threatening airway obstruction in a newborn presenting with stridor.
Effect of weight-maintaining ketogenic diet on glycemic control and insulin sensitivity in obese T2D subjects
Authors: Merovci Aurora , Finley Brittany , Hansis-Diarte Andrea , Neppala Sivaram , Abdul-Ghani Muhammad A , Cersosimo Eugenio , Triplitt Curtis , DeFronzo Ralph A
Published: October 2024

Introduction

Low carbohydrate ketogenic diets have received renewed interest for the treatment of obesity and type 2 diabetes. These diets promote weight loss, improve glycemic control, and reduce insulin resistance. However, whether the improvements in glycemic control and insulin sensitivity are secondary to the weight loss or result from a direct effect of hyperketonemia is controversial.

Research design and methods

29 overweight obese subjects were randomized to one of three dietary interventions for 10 days: (1) Weight-maintaining standard diet; (2) Weight-maintaining ketogenic diet; (3) Weight-maintaining ketogenic diet plus supplementation with the ketone ester of beta-hydroxybutyrate (β-OH-B), 8 g every 8 hours. At baseline, all subjects had oral glucose tolerance test, 2-step euglycemic insulin clamp (20 mU/m2.min and 60 mU/m2.min) with titrated glucose and indirect calorimetry.

Results

Body weight, fat content, and per cent body fat (DEXA) remained constant over the 10-day dietary intervention period in all three groups. Plasma β-OH-B concentration increased twofold, while carbohydrate oxidation decreased, and lipid oxidation increased demonstrating the expected shifts in substrate metabolism with institution of the ketogenic diet. Glucose tolerance either decreased slightly or remained unchanged in the two ketogenic diet groups. Whole body (muscle), liver, and adipose tissue sensitivity to insulin remained unchanged in all 3 groups, as did the plasma lipid profile and blood pressure.

Conclusion

In the absence of weight loss, a low carbohydrate ketogenic diet has no beneficial effect on glucose tolerance, insulin sensitivity, or other metabolic parameters.
Association between physicians’ maldistribution and core clinical competency of resident physicians: a nationwide cross-sectional study
Authors: Shikino Kiyoshi , Nishizaki Yuji , Kataoka Koshi , Nojima Masanori , Shimizu Taro , Yamamoto Yu , Fukui Sho , Nagasaki Kazuya , Yokokawa Daiki , Kobayashi Hiroyuki , Tokuda Yasuharu
Published: October 2024

Objectives

With physician maldistribution recognised as a global issue, Japan implemented the physician uneven distribution (PUD) index as a strategic measure. Currently, there is a lack of objective assessment of core clinical competencies in regions influenced by varying levels of physician distribution. In this study, we objectively assess the core clinical competencies in regions affected by physician maldistribution and explore the relationship between the PUD index and the clinical competencies of resident physicians.

Design, setting and participants

In this cross-sectional study, we gathered data from the January 2023 General Medicine In-Training Examination (GM-ITE) survey. Participants included postgraduate year 1 and 2 resident physicians in Japanese hospitals mandating the GM-ITE or those who voluntarily took it. The GM-ITE scores of the resident physicians were assessed. The PUD index, a Japanese policy indicator, reflects regional physician disparities. A low PUD index signals a medical supply shortage compared with local demand. The trial registration number is 23-7.

Results

The high and low PUD index groups included 2143 and 1580 participants, respectively. After adjusting for relevant confounders, multivariate linear regression analyses revealed that the low PUD index group had significantly higher GM-ITE scores than the high PUD index group (adjusted coefficient: 1.14; 95% CI 0.62 to 1.65; p<0.001).

Conclusions

The study revealed no clinically differences in GM-ITE scores between residents in regions with disparate physician distributions, suggesting that factors beyond PUD may influence clinical competency. This finding prompts a re-evaluation of whether current assessment methodologies or educational frameworks fully support learning across varied community settings.
Exploration of patients’ and healthcare professionals’ perspectives on kidney failure risk and the use of the kidney failure risk equation in MULTIPle lOng-term condItions aNd frailTy (MULTIPOINT) study: a qualitative interview and focus group study protocol
Authors: Walker Heather , Sullivan Michael K , Jani Bhautesh Dinesh , Mark Patrick B , Gallacher Katie I
Published: October 2024

Introduction

Clinical guidelines recommend the use of the kidney failure risk equation (KFRE) to guide the referral of individuals with chronic kidney disease (CKD) to secondary kidney care services. People living with CKD frequently experience multiple long-term conditions (multimorbidity) and/or frailty. This may impact patients’ or carers’ perceptions of kidney failure in the context of other health problems and associated risks and emphasises the need for shared decision-making. This paper presents the research protocol for the exploration of patients’ and healthcare professionals’ perspectives on kidney failure risk and the use of the KFRE in the MULTIPle lOng-term condItions aNd frailTy study. This study aims to investigate patient and healthcare professionals’ perspectives and expectations of the use of KFRE in individuals with CKD and multimorbidity and/or frailty, with a focus on shared decision-making.

Methods and analysis

Analysis of semistructured interviews with adults who have CKD and multimorbidity and/or frailty and focus groups with healthcare professionals (who are involved in caring for patients with CKD). Framework analysis, underpinned by normalisation process theory, will be used to develop codes and explore themes from the interviews and focus groups. Patient and public involvement has been pivotal to the study conceptualisation and will continue to be embedded throughout the study.

Ethics and dissemination

The study protocol has undergone peer review by the NHS Greater Glasgow and Clyde Research and Innovation team and has been granted ethical approval in August 2023 by the NHS Health Research Authority following a favourable opinion from the West of Scotland Research Ethics Committee (REC) 3 (IRAS ID: 325848, REC reference: 23WS/0119, Protocol number GN22RE559).

The results of the research will be disseminated through peer-reviewed publications and conferences, as well as to patient and public involvement groups who have been involved in the study and through knowledge exchange events.
Mapping the landscape of mental health and long COVID: a protocol for scoping review
Authors: Adeyinka Daniel A , Amah Adelaide , Husband Alicia , Miller Lukas , Hedlund Dave , Alphonsus Khrisha B , Groot Gary
Published: October 2024

Introduction

Mental health concerns are prevalent among adult patients with long COVID (LC), but the current state of knowledge regarding mental health in the context of LC is not fully understood. The objective of this scoping review is to map and summarise the existing research on mental health conditions among LC patients and highlight the knowledge gaps. This review aims to provide a comprehensive overview of the evolving landscape of research in the area.

Methods and analysis

The concept of interest is mental health in adult LC patients. This scoping review will be guided by the Joanna Briggs Institute Manual for Evidence Synthesis and reported according to the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review guidelines. Using predefined search parameters, a comprehensive search of two electronic databases (Medline and APA PsycINFO) and grey literature sources identified 3104 potentially eligible articles published from 1 January 2020 to 4 April 2024. Following the removal of duplicates, 2767 articles were imported for screening in Covidence. The study selection process involves screening titles, abstracts and full text of potentially relevant articles, which will then be analysed using thematic analysis. Data will be extracted using a predefined extraction form.

Ethics and dissemination

Ethical approval is not required because this study does not involve human participants or primary data collection. The findings from this review will be disseminated through a peer-reviewed publication, conference presentations and professional networks. In addition, a summary of the results will be shared with patient partners and other relevant stakeholders.

Public health implications

The findings from this scoping review will contribute to a better understanding of mental health issues arising in LC patients and inform future research directions and public health interventions in this area.
Feasibility of a culturally adapted technology-delivered, family-based childhood obesity intervention for Latino/Hispanic families in rural Nebraska: the Hispanic Family Connections study protocol
Authors: Brito Fabiana Almeida , Alves Thais Favero , Santos Natalia , Michaud Tzeyu L , Eisenhauer Christine , De Leon Elisa Brosina , Squarcini Camila Fabiana Rossi , Kachman Stephen , Almeida Fabio , Estabrooks Paul
Published: October 2024

Introduction

Addressing childhood obesity risk factors like home environment, parental roles, excess weight, physical activity and healthy eating among Latino/Hispanic (L/H) families living in rural communities is an important priority. However, evidence supporting these interventions among L/H families living in rural communities is missing. Our trial will use cultural adaptation and implementation science frameworks to evaluate the feasibility of delivering a culturally appropriate family-based childhood obesity (FBCO) programme via an automated telephone system (interactive voice response) to L/H families in rural Nebraska.

Methods and analysis

A mixed-methods feasibility trial for L/H families with overweight or obese children. Aim 1 will focus on collaboratively adapting and evaluating all intervention materials to fit the rural L/H community profile better, including translation of materials to Spanish, culturally relevant content and images, and use of health communication strategies to address different levels of health literacy. In aim 2, a 6-month feasibility trial with contextual evaluation will randomise 48 dyads (parent and child) to either Family Connections (FC; n=29) or a waitlist standard-care group (n=29) to determine overall study reach, preliminary effectiveness in reducing child body mass index (BMI) z-scores, potential for programme adoption, implementation and sustainability through local health departments (RE-AIM outcomes). We will also evaluate health department perceptions of the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) constructs (innovation, context, recipient characteristics) and FC participants’ view of the intervention (ie, relative advantage, observability, trialability, complexity, compatibility). The study will answer three critical questions: (1) is a telephone-delivered FBCO programme in rural Nebraska culturally relevant, usable and acceptable by L/H families?; (2) is a telephone-delivered FBCO programme effective at reducing BMI z-scores in L/H children living in rural Nebraska? and (3) what real-world institutional and contextual factors influence the impact of the intervention and might affect its potential ability to sustainably engage a meaningful population of L/H families who stand to benefit?

Ethics and dissemination

This protocol was approved by the University of Nebraska Medical Center Institutional Review Board (IRB#:0745-20-EP). Dissemination of findings will occur through ClinicalTrials.gov, in scientific forums and to the local rural communities, pilot data to inform the design of a larger clinical trial.

Trial registration number

NCT04731506.
Association between ethnicity and emergency department visits in the last three months of life in England: a retrospective population-based study using electronic health records
Authors: Davies Joanna M , Leniz Javiera , Chua Kia-Chong , Williamson Lesley E , Bajwah Sabrina , Bolton Thomas , Bone Anna E , Hocaoglu Mevhibe , Verne Julia , Fraser Lorna K , Barclay Stephen , Murtagh Fliss E M , Higginson Irene J , Sleeman Katherine E
Published: October 2024

Introduction

Emergency department (ED) visits are distressing yet common in the last months of life and many could be avoided. The association between ethnicity and ED visits in the last months of life has rarely been studied in detail and the intersection with area-based deprivation and other risk factors is not known.

Methods

Population-based, retrospective cohort study, using electronic health records for adults who died from all causes in 2019 and 2020 in England.

Results

Of 566 930 deaths in 2020, 356 700 (62.9%) had at least one ED visit in the last 3 months of life. Most ethnic minority groups had more ED visits than white British people and differences were larger for visits out-of-hours. After adjusting for social and clinical factors, compared with white British people, the out-of-hours visit rate for people with Bangladeshi, Pakistani and Indian ethnicities was 17% (95% CI 6% to 28%), 19% (95% CI 12% to 27%) and 14% (95% CI 6% to 22%) higher for women, and 16% (95% CI 9% to 23%), 13% (95% CI 8% to 19%) and 6% (95% CI 0% to 12%) higher for men. The rate of visits was lower in 2020 than in 2019, but differences between ethnic groups were similar. For white British people, there is a clear social gradient—those who live in more deprived areas have a higher rate of ED visits—but this is not seen for most other ethnic groups.

Conclusion

People with Bangladeshi, Indian and Pakistani ethnicities have higher rates of ED visits in the last 3 months of life that are not fully explained by other social and clinical factors. This difference is driven by visits out-of-hours, which may indicate a need for better support. Future work should try to understand why some ethnic minority groups use ED more and how this relates to differences in needs, preferences and experiences.
The good, the bad and the ugly: What do we really do when we identify the best and the worst organisations?
Authors: Abel Gary A , Agniel Denis , Elliott Marc N
Published: October 2024

Identifying high and poorly performing organisations is common practice in healthcare. Often this is done within a frequentist inferential framework where statistical techniques are used that acknowledge that observed performance is an imperfect measure of underlying quality. Various methods are employed for this purpose, but the influence of chance on the degree of misclassification is often underappreciated. Using simulations, we show that the distribution of underlying performance of organisations flagged as the worst performers, using current best practices, was highly dependent on the reliability of the performance measure. When reliability was low, flagged organisations were likely to have an underlying performance that was near the population average. Reliability needs to reach at least 0.7 for 50% of flagged organisations to be correctly flagged and 0.9 to nearly eliminate incorrectly flagging organisations close to the overall mean. We conclude that despite their widespread use, techniques for identifying the best and worst performing organisations do not necessarily identify truly good and bad performers and even with the best techniques, reliable data are required.
Transumbilical access for neonatal vein of Galen malformation and pial arteriovenous fistula embolization
Authors: Bazil Maximilian Jeremy , Fifi Johanna T , Berenstein Alejandro , Shigematsu Tomoyoshi
Published: October 2024

Background

In the neonatal period, transfemoral access may be complicated by sheath size needed for embolization, especially if retreatment is required. A viable alternative is access through an umbilical artery (UA) which allows for preservation of the femoral artery for access in future intervention.

Methods

We conducted a retrospective study from January 2014 to March 2023, focusing on 19 vein of Galen malformation, dural arteriovenous (AV) fistula, and pial AV fistula cases treated via transumbilical (TU) access for endovascular embolization in neonates.

Results

TU access was achieved successfully in 20 out of 21 intended cases, with a 4 French sheath placed intraprocedurally in all instances. We observed a median retreatment time of 7 months for patients requiring subsequent femoral artery access, highlighting the importance of preserving femoral access for future interventions. There were no complications associated with TU access or sheath retention and no procedural mortality attributed to this approach. Despite intraprocedural and periprocedural complications of other etiologies (including post-procedural hemorrhages and fever requiring antibiotic treatment), the TU approach demonstrated overall safety and efficacy.

Conclusions

Our findings align with previous reports of TU access in vascular malformations, emphasizing its role as a vital technique in neonatal neurointervention. The TU approach offers advantages such as sparing femoral arteries for future treatments and potential applicability to other high-flow brain fistulas. Our study contributes to the growing body of evidence supporting the use of TU access in neonatal neuroendovascular interventions, underscoring its importance in managing complex vascular malformations in this vulnerable population.
Efficacy and safety of CT-P47 versus reference tocilizumab: 32-week results of a randomised, active-controlled, double-blind, phase III study in patients with rheumatoid arthritis, including 8 weeks of switching data from reference tocilizumab to CT-P47
Authors: Smolen Josef S , Trefler Jakub , Racewicz Artur , Jaworski Janusz , Zielińska Agnieszka , Krogulec Marek , Jeka Sławomir , Wojciechowski Rafał , Kolossa Katarzyna , Dudek Anna , Krajewska-Włodarczyk Magdalena , Hrycaj Paweł , Klimiuk Piotr Adrian , Burmester Gerd R , Kim SungHyun , Bae YunJu , Yang GoEun , Jung YooBin , Hong JiWoo , Keystone Edward
Published: October 2024

Objectives

To demonstrate efficacy equivalence of CT-P47 and EU-approved reference tocilizumab (r-TCZ) in patients with rheumatoid arthritis (RA).

Methods

This double-blind, phase III study randomised (1:1) patients to receive CT-P47 or r-TCZ (8 mg/kg) every 4 weeks until week 20 during treatment period (TP) 1. Prior to week 24 dosing, patients receiving r-TCZ were randomised (1:1) to continue r-TCZ or switch to CT-P47; patients receiving CT-P47 continued CT-P47 (TP2, 8 mg/kg every 4 weeks until week 48). The dual primary endpoints (for different regulatory requirements) were mean changes from baseline in Disease Activity Score in 28 joints (DAS28; erythrocyte sedimentation rate (ESR)) at week 12 and week 24. Efficacy equivalence was determined if CIs for the treatment difference were within predefined equivalence margins: (95% CI −0.6, 0.6 (analysis of covariance (ANCOVA)) at week 12 or 90% CI −0.6, 0.5 (ANCOVA with multiple imputation) at week 24). Additional efficacy, pharmacokinetic (PK) and safety endpoints, including immunogenicity, were investigated. Findings up to week 32 are presented.

Results

In TP1, 471 patients were randomised (234 CT-P47; 237 r-TCZ). The 95% and 90% CIs for the estimated treatment differences were contained within the predefined equivalence margins; the estimated difference in DAS28-ESR at week 12 was –0.01 (95% CI −0.26, 0.24) and at week 24 was −0.10 (90% CI −0.30, 0.10). Secondary efficacy endpoints, PKs and overall safety were comparable between groups up to week 32.

Conclusions

Efficacy equivalence, alongside comparable PK, safety and immunogenicity profiles, was determined between CT-P47 and r-TCZ in adults with RA, including after switching from r-TCZ to CT-P47.
Comorbidity burden on mortality in patients with systemic sclerosis
Authors: Fauthoux Thomas , Brisou Damien , Lazaro Estibaliz , Seneschal Julien , Constans Joel , Skopinski Sophie , Duffau Pierre , Blanchard Elodie , Contin-Bordes Cécile , Barnetche Thomas , Truchetet Marie-Elise
Published: October 2024

Introduction

Systemic sclerosis (SSc) is a serious life-threatening tissue disease. A significant aspect of its mortality arises from comorbid conditions. Our study aimed at mapping out the prevalence of these comorbidities and their relation to mortality, thus creating a ‘comorbidome’.

Methods

In our retrospective, single-centre observational study, we recorded each patient’s data, including demographic informations, vital stats and SSc-related organ involvement, along with the presence or absence of 14 predefined comorbidities. We also documented the dates of their initial and most recent visits. To construct survival curves, we used the Kaplan-Meier method, followed by a Cox regression model for multivariate analysis.

Results

Our study involved 400 participants, 74 of whom unfortunately passed away. It is important to note that three specific comorbidities showed significant correlation to mortality: neoplasia, cardiovascular diseases and polypharmacy, as well as two SSc-specific organ involvements (lung and cardiac).

Conclusion

Our research led to the successful creation of the SSc comorbidome. Comorbidities are a major concern for patients suffering from SSc, particularly cardiovascular diseases and neoplasms. Our study highlights the effects of polypharmacy. The resultant comorbidome offers a comprehensive and analytical perspective on this complex issue and underscores the inter-relatedness of the data. Our study, however, was limited by a small sample size. Therefore, to confirm our findings, validation on a larger scale is necessary. This could potentially contribute to the creation of a future mortality scoring tool.
Investigation on asymmetric dynamic response characteristics of anchored surrounding rock under blasting excavation of inclined layered rock tunnel
Authors: Yu Jianxin , Zhang Zhanshuo , Wu Guojun , Li Xiao , Tian Hongming
Published: October 2024

The dynamic response stability analysis of the anchored surrounding rock during blasting construction is crucial to ensure the safety of construction. Taking the Wuwan Tunnel in Luoyang as the engineering background, combined with methods such as physical simulation experiments, numerical simulation experiments, and on-site experiments, the asymmetric effects of layered rock mass on the surrounding rock and support structure during blasting excavation were studied. The asymmetric effects of tunnel blasting excavation on the surrounding rock and support system under the condition of a bedding angle of 30° were analyzed and summarized. The results indicate that when the blasting stress wave passes through the bedding plane, the stress wave will undergo significant attenuation. The strain generated by the anchor rod passing through the bedding plane exhibits asymmetry due to the reflection and weakening of the blasting stress wave after passing through the bedding plane.
Response of soil nitrogen mineralization, nitrification, and denitrification to milk vetch (Astragalus sinicus L.) application in a paddy field
Authors: Wang Limin , He Chunmei , Liu Cailing , Zheng Xiangzhou , Yu Juhua , Li Qinghua , Huang Yibin , Huang Dongfeng , Wang Fei
Published: October 2024

We conducted incubation experiments with paddy soil collected from a long-term field experiment to explore the effect of Chinese milk vetch ( Astragalus sinicus L., CMV) application on potential nitrogen (N) denitrification (PDA), nitrification (PNA), mineralization (PNM), soil chemical properties, microbial communities, enzyme activities, yields, and nutrient uptake of rice under different fertilization treatments. Five treatments were included: no chemical fertilizers (C0), chemical fertilizers (C100), Chinese milk vetch (M), CMV combined with 100% chemical fertilizers (MC100), and with 80% chemical fertilizers (MC80). Results showed that the M, MC100, and MC80 treatments significantly increased PNM and PNA compared with the C100 treatment ( P < 0.05). Meanwhile, the CMV application significantly increased total N, microbial biomass N, and carbon (C) concentrations, the abundances of the bacterial phylum Actinobacteria and the genera Bradyrhizobium, Mycobacterium, Streptomyces, and Reyranella, N-acetyl-glucosaminidase (NAG) activity, yields, and N nutrient uptake of rice grain compared with the C100 treatment ( P < 0.05). Correlation analyses indicated that grain yield and N uptake of rice, soil total N, microbial biomass C and N, the bacterial phylum Actinobacteria, the genera Bradyrhizobium, Mycobacterium, Streptomyces, Reyranella, and NAG were significantly correlated with PNM under different fertilization regimes, while microbial biomass C and N, Actinobacteria, Bradyrhizobium, and Reyranella were positively related to PNA ( P < 0.05). Together, the application of CMV alone or in combination with chemical fertilizers can improve soil properties and rice growth, which may accelerate N mineralization and nitrification in this soil.
Preserving quantum information in f(Q) non-metric gravity cosmology
Authors: Capozziello Salvatore , Lapponi Alessio , Luongo Orlando , Mancini Stefano
Published: October 2024

The effects of cosmological expansion on quantum bosonic states are investigated, using quantum information theory. In particular, a generic Bogoliubov transformation of bosonic field modes is considered and the state change on a single mode is regarded as the effect of a quantum channel. Properties and capacities of this channel are thus explored in the framework of f(Q) non-metric gravity. The reason is that non-metric gravity can be considered under the standard of gauge theories with all the advantages of such a formulation. As immediate result, we obtain that the information on a single-mode state appears better preserved, whenever the number of particles produced by the cosmological expansion is small. Specifically, we investigate a power law f(Q) model, leaving unaltered the effective gravitational coupling, and minimise the corresponding particle production. We thus show how to optimise the preservation of classical and quantum information, stored in bosonic mode states in the remote past. Finally, we compare our findings with those obtained in General Relativity.
A Decision Tree Mechanism for Microfluidic Sample Preparation for Digital Biochips
Authors: Saha Basudev , Majumder Mukta
Published: October 2024

Microfluidic technology has achieved a rapid technological advancement and become well admired in miniaturized laboratory works. Effectiveness of laboratory works such as protein and glucose analysis, and pharmaceutical study depends on convenient sample preparation. These processes involve dilution of the primary reactant with buffer fluid in an appropriate proportion to ensure error-free bioassay operations in the future. In this paper, a decision tree-based method is proposed to construct the mixing tree for exploring all possible combinations of concentration values to generate the target sample for different biochemical experiments. This work is also extended for multi-target sample preparation concurrently to reduce the sample preparation time and cost. The simulated result shows that the proposed technique not only reduces the mixing/dilution operations for single-target sample preparation but also minimizes the use of primary reactant compared to the contemporary approaches and an enhanced outcome is also achieved for multi-target sample production.
FRACTAL FEATURE MODELING: MULTI-DIMENSIONAL ATTENTION AND SPATIAL ADAPTIVE RELATIONSHIP LEARNING FOR PERSON RE-IDENTIFICATION
Authors: XIONG MINGFU , CHEN HANMEI , KARACA YELIZ , SAUDAGAR ABDUL KHADER JILANI , LEE IK HYUN , SER JAVIER DEL , MUHAMMAD KHAN
Published: October 2024

Person Re-identification (person Re-ID), as an intelligent video surveillance technology capable of retrieving the same person from different cameras, may bring about some challenges arising from the changes in the person’s poses, different camera views as well as occlusion. Recently, person Re-ID equipped with the attention mechanism has gradually emerged as one of the most active areas of study in the fields of computer vision and fractal feature modeling applications. Despite the upsurge in related research, existing fractal-attention-based methods still face two major challenges when recognizing different pedestrians in unpredictable realistic environments: (1) the adaptability of a single local attention feature to hostile scenes cannot be guaranteed, and (2) the existing methods originating from attention features usually rely on the line mapping or simple variants, which make it difficult to excavate the association relationships among pedestrians with similar appearance attributes. To address these issues, this paper proposes a simple effective fractal feature modeling method, named multi-dimensional attention and spatial adaptive relationship learning framework (MASARF) to explore the correlation between pedestrian bodies for person Re-ID. The proposed framework encompasses a multi-dimensional fractal-attention feature learning model (MDAM) and a dual-branch graph convolutional model (DGCM). In particular, the MDAM comprises the local and global attention modules, which are used to capture multi-dimensional attention features for each person. Subsequently, the DGCM is used to construct the nonlinear mapping association relationships among the various body regions for each person via a dual-branch graph convolutional optimization strategy. Extensive experiments were conducted using public person Re-ID datasets (Market-1501, DukeMTMC-reid, and CUHK-03). The results demonstrate that the performance of the proposed approach is superior to that of state-of-the-art methods between 2% and 10% at Rank-1 (mAP). Essential differences exist between our method and the existing methods in terms of feature extraction and relationship transformation, which provides the validation of its novelty in the person Re-ID domain.
GENERALIZED SYNCHRONIZATION OF A CLASS OF HETEROGENEOUS DRIVE RESPONSE NETWORKS WITH TIME DELAY BASED ON VARIABLE STRUCTURE CONTROL
Authors: WEI JIE , CHEN ZHIHUAN , QIAN KANG
Published: October 2024

In this study, the problem of synchronization of heterogeneous-driven response networks is introduced by using variable structure control strategy. First, the mathematical model of the heterogeneous-driven response network is described, and the development history of variable structure control is outlined. Second, considering the coupling time delay of the heterogeneous-driven response network, two types of variable structure controls are designed based on sliding mode control and soft variable structure control theories. Finally, the effectiveness of the two variable structure controls is verified through numerical simulation experiments, and a discussion on their advantages and disadvantages is provided.
Computational analysis of the conformable nonlinear Schrödinger equation with Kudryashov’s refractive index model and generalized non-local nonlinearity
Authors: Murad Muhammad Amin S.
Published: October 2024

This paper investigates the nonlinear conformable Schrödinger equation with nonlocal nonlinearities and Kudryashov’s arbitrary refractive index. The study employs the Uniform Method (UM) and the Extended Hyperbolic Function Method (EHFM) to derive various optical soliton solutions for this present conformable equation. To demonstrate the importance of the novel solutions, the paper presents two-dimensional, three-dimensional, and contour plots, illustrating kink-type, wave, bright, bell-shaped, and mixed dark–bright soliton solutions. Further, the impact of the fractional order parameter, temporal parameter, and nonlinearity coefficient on these optical solutions is analyzed, providing valuable insights into the conformable nonlinear Schrödinger model. The behavior of these optical solutions is analyzed through illustrative graphs that account for variations in the conformable order derivative, temporal parameter, and nonlinearity coefficient. The methodologies applied in this research show potential for broader application to various nonlinear Schrödinger equations in fields such as applied mathematics and nonlinear optics. The research suggests that these methods could be applied in the future to investigate other differential equations with fractional and integer orders across different fields of applied sciences. This study expands our understanding of nonlinear optics and has potential practical implications in various fields like optical signal processing, laser technology, and telecommunications.