bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introducing double fortified salt in social safety net programmes in Madhya Pradesh and Gujarat in India: Success factors, challenges and lessons learned
Authors: Tsang Becky L. , Deshpande Shilpa , Varghese Mini , Jain Sakshi , de Romana Daniel Lopez , Chadha Manpreet 
Published: June 2024

AbstractDouble fortified salt (DFS; with iron and iodine) was introduced in social safety net programmes (SSNPs) in Madhya Pradesh (MP) and Gujarat states in 2018. Nutrition International (NI) provided critical support for the intervention. An impact evaluation in MP found high DFS uptake, exceeding 90%. Conduct a process evaluation of the DFS programmes in MP and Gujarat states to identify success factors, challenges, and recommend considerations for scale‐up. Twenty‐eight qualitative interviews were conducted with NI staff, national and state level government officials, and DFS producers in 2022. Enabling environmental factors included national‐level support for food fortification, consensus that anaemia was essential to address, and institutional trust in NI for technical assistance. In programme implementation, the primary challenges were reports of black specks in DFS and the darkening of food cooked with DFS. NI supported the government in improving handling practices, ensuring a regular and stable supply, introducing quality monitoring efforts and launching targeted behaviour change communication (BCC) campaigns regarding the value of DFS. Long‐term implementation of the programmes is a weak point, as DFS production is more expensive than iodised salt, there is no existing market outside of institutional demand, and BCC must be long‐term, high‐quality, and requires resourcing for continued high uptake among SSNP beneficiaries. Strong government buy‐in and technical support along the supply chain to address quality issues and beneficiary acceptance were key factors for the successful introduction of DFS. Comparative studies of DFS programmes should be conducted to improve confidence in the success factors that lead to high DFS uptake.
365‐day sectional work zone schedule optimization for road networks considering economies of scale and user cost
Authors: Nakazato Yuto , Mizutani Daijiro 
Published: June 2024

AbstractThis study proposes a methodology for deriving the optimal work zone schedule for the annual routine maintenance planning in an infrastructure asset management system considering the (i) economies of scale in work zone costs due to work zone synchronization and (ii) user costs across the road network with traffic assignments. A key aspect of the proposed methodology is the ability to derive in detail optimal work zone schedules of realistic‐scale road networks in 100 m sections for 365 days, which is beneficial in practice. To this end, an optimization model of the work zone schedule is newly formulated as a mixed‐integer programming (MIP) problem, and a novel bilevel solution method for the model utilizing the conventional solver Gurobi Optimizer with MIP algorithms such as root relaxation, dual simplex, barrier methods, and cutting planes is proposed. In application examples, the proposed methodology is applied to two real‐world road networks, which confirms that the optimal work zone schedule can be obtained in 313.7 s for a network with 2640, 100 m, sections and in 168,180 s (46 h and 43 min) for a network with 5038, 100 m, sections.
A physics‐informed deep reinforcement learning framework for autonomous steel frame structure design
Authors: Fu Bochao , Gao Yuqing , Wang Wei 
Published: June 2024

AbstractAs artificial intelligence technology advances, automated structural design has emerged as a new research focus in recent years. This paper combines finite element method (FEM) and deep reinforcement learning (DRL) to establish a physics‐informed framework, named FrameRL, for automated steel frame structure design. FrameRL models the design process of steel frames as a reinforcement learning (RL) process, enabling the agent to simulate a structural engineer's role, interacting with the environment to learn the methods and policies for structural design. Through computer experiments, it is demonstrated that FrameRL can design a safe and economical structure within 1 s, significantly faster than manual design processes. Furthermore, the design performance of FrameRL is compared with traditional optimization algorithms in three typical design cases and a high‐rise steel frame case, demonstrating that FrameRL can efficiently complete structural design based on learned design experiences and policies.
A bi‐level emergency evacuation traffic optimization model for urban evacuation problem
Authors: Liu Yanyue , Zhang Zhao , Mo Lei , Yu Bin , Li Zhenhua 
Published: June 2024

AbstractThis paper introduces a pioneering bi‐level emergency evacuation traffic optimization model (BEETOM), crafted to expedite the evacuation process within urban road networks. The innovative upper‐level model offers simultaneous optimization of evacuation departure times and routes, while the lower‐level model focuses on refining traffic signal timing to mitigate delays and queue formation across intersections. To enhance the model's computational efficiency, a distributed solving algorithm is introduced, marking a significant stride in optimization technology. Implemented in two evacuation case studies, the BEETOM model showcases its profound impact by reducing total evacuation time by 6% to 20%. More impressively, it achieves a substantial decrease in both the average travel time and delays experienced by evacuees during evacuation, ranging from 7% to an astonishing 60%. This remarkable efficacy underscores the model's capability to devise highly effective evacuation strategies, particularly valuable for managing large‐scale emergencies or terrorist incidents in urban settings. The BEETOM model stands as a significant contribution to urban emergency management, offering a strategic tool to significantly enhance evacuation efficiency and safety.
Self‐appropriation in nurse engagement: Facilitating the development of expert nurses using Benner and Lonergan
Authors: Healy Caitlin 
Published: June 2024

AbstractExpert nurses, as described by the work of Patricia Benner, are at the peak of clinical nursing practice and vitally important in ensuring the best possible patient care and clinical outcomes. The development of Benner's theory and its relationship with the Dreyfus model of skill acquisition provides context for understanding the progression necessary for expert development. Contemporary healthcare challenges present implications to the development of advancing levels of nursing practice. Engagement has been identified as critical to achieving expert practice. I propose the incorporation of the philosophical framework of self‐appropriation from Benard Lonergan as a strategy to develop internal engagement in nurses to facilitate expert practice. I outline the synergy between Benner's theory and the work of Lonergan, which provide overlap and opportunity to overcome barriers to developing expert nursing practice. In the challenging climate of healthcare, there is an obligation to promote engagement and facilitate expert nurse development, necessary for patient outcomes as well as clinical role models, preceptors, and leaders to guide future nurses.
Uniportal Full‐endoscopic Foraminotomy for Lumbar Foraminal Stenosis: Clinical Characteristics and Functional Outcomes
Authors: Yu Lingjia , Dong Huajun , Tan Haining , Xie Xuehu , Liu Ning , Zhang Guoqiang , Li Xiang , Yang Yong , Zhu Bin 
Published: June 2024

ObjectiveUniportal full‐endoscopic foraminotomy offers a promising alternative to conventional surgical methods for individuals afflicted by lumbar foraminal stenosis. This study aims to evaluate the efficacy and clinical outcomes of uniportal full‐endoscopic foraminotomy in patients diagnosed with lumbar foraminal stenosis.MethodsA comprehensive retrospective analysis was conducted on individuals who underwent full‐endoscopic foraminotomy in our medical center, between January 2018 and December 2019. The investigation encompassed the demographic data of patients and key clinical metrics such as the visual analogue scale of leg (VAS‐L) and back pain (VAS‐B), Oswestry disability index (ODI) scores, the Short Form‐36 Health Survey physical component summary (SF‐36 PCS) and the mental component summary (SF‐36 MCS), as well as modified MacNab grades, were systematically assessed and compared. Furthermore, radiological parameters: Coronal Cobb angle (CCA), Intervertebral angle changes (IAC), Disc height index (DHI), the foraminal cross‐sectional area (FCSA) and the FCSA enlargement ratio were also compared. A variety of statistical analyses including Student t‐test, chi‐square tests, Fisher's exact tests, Pearson's and Spearman's correlation analyses, and Interclass Correlation Coefficients (ICCs) were employed.Results64 patients, including 34 males and 30 females were enrolled. The mean follow‐up period extended to 22.66 ± 7.05 months. Distribution by affected segments revealed 26.6% at L4‐5, 67.1% at L5‐S1 level, and 6.25% at both L4‐L5 and L5‐S1 levels. At the final follow‐up, VAS‐L decreased from 7.26 ± 1.19 to 1.37 ± 1.25, while VAS‐B decreased from 6.95 ± 0.54 to 1.62 ± 1.13 (p < 0.001). ODI score also demonstrated a substantial decrease from 74.73 ± 8.68 to 23.27 ± 8.71 (p < 0.001). Both SF‐36 PCS and SF‐36 MCS scores improved significantly (p < 0.001). Modified MacNab criteria revealed 58 excellent‐good patients (90.7%), and 6 fair‐poor patients (9.3%). No significant differences were founded in the CCA (p = 0.1065), IAC (p = 0.5544), and DHI (p = 0.1348) between pre‐operation and the final follow‐up. However, the FCSA significantly increased from 73.41 ± 11.75 to 173.40 ± 18.62 mm2 (p < 0.001), and the enlargement ratio was 142.9% ± 49.58%. Notably, the final follow‐up FCSA and the FCSA enlargement ratio were found to be larger in the excellent and good group compared to the fair and poor group, according to the modified MacNab criteria.ConclusionThe utilization of uniportal full‐endoscopic foraminotomy has demonstrated its safety and efficacy in addressing lumbar foraminal stenosis. The clinical success of this procedure appears to be closely associated with the radiological decompression of the intervertebral foramen area. Importantly, the application of this technology does not seem to compromise the overall stability of the lumbar region.
The founding ground of Turkism‐Turanism in the Early Republican Period: Atsiz Mecmua
Authors: Bölükbaşı Yusuf Ziya , Bilici İlhan 
Published: June 2024

AbstractThis study focuses on the division and conflict during the formative phase of Turkish nationalism in the Early Republican Period. Turkish nationalism, the founding ideology of Türkiye, was oriented towards identity and state building, and it developed an ethno‐secular vision. In contrast, Turkism‐Turanism nationalism, emerging from civilian circles, adopted a critical stance towards the official ideology and the prevailing understanding of ideology during that period, as evidenced by Atsız Mecmua. Using discourse analysis, this study examines prominent themes in Atsız Mecmua, such as anthropological Turkishness, Turanism, militarism, and a holistic approach to history. Conversely, communism in its ideological sense and identities other than Turkish were depicted as the other. Atsız Mecmua attempted to foster a new conception of nationalism to challenge Kemalist nationalism, seeking to forge Turkish unity through militarism and a fascist state model.
How much should we still worry about QTc prolongation in rifampicin-resistant tuberculosis? ECG findings from TB-PRACTECAL clinical trial
Authors: Motta Ilaria , Cusinato Martina , Ludman Andrew J. , Lachenal Nathalie , Dodd Matthew , Soe Moe , Abdrasuliev Tleubergen , Usmanova Ruzilya , Butabekov Ilhomjon , Nikolaevna Tigay Zinaida , Liverko Irina , Parpieva Nargiza , Moodliar Ronelle , Solodovnikova Varvara , Kazounis Emil , Nyang'wa Bern-Thomas , Fielding Katherine L. , Berry Catherine 
Published: June 2024

ABSTRACT

Regimens for the treatment of rifampicin-resistant tuberculosis currently rely on the use of QT-prolonging agents. Using data from the randomized controlled trial, TB-PRACTECAL, we investigated differences in QTcF among participants in the three interventional arms: BPaL (bedaquiline, pretomanid, and linezolid), BPaLC (BPaL with clofazimine), and BPaLM (BPaL with moxifloxacin). Additionally, we assessed whether age, body mass index, and country were causally associated with QTcF prolongation. The trial included participants from South Africa, Uzbekistan, and Belarus. A
post hoc
analysis of electrocardiogram data was undertaken. Random effects regression was used to model QTcF longitudinally over 24 weeks and causal frameworks guided the analysis of non-randomized independent variables. 328 participants were included in BPaL-based arms. The longitudinal analysis of investigational arms showed an initial QTcF steep increase in the first week. QTcF trajectories between weeks 2 and 24 differed slightly by regimen, with highest mean peak for BPaLC (QTcF 446.5 ms). Overall, there were 397 QTcF >450 ms (of 3,744) and only one QTcF >500 ms. The odds of QTcF >450 ms among participants in any investigational arm, was 8.33 times higher in Uzbekistan compared to Belarus (95% confidence interval: 3.25–21.33). No effect on QTcF prolongation was found for baseline age or body mass index (BMI). Clinically significant QTc prolongation was rare in this cohort of closely monitored participants. Across BPaL-based regimens, BPaLC showed a slightly longer and sustained effect on QTcF prolongation, but the differences (both in magnitude of change and trajectory over time) were clinically unimportant. The disparity in the risk of QTc prolongation across countries would be an important factor to further investigate when evaluating monitoring strategies.

CLINICAL TRIALS

This study is registered with

ClinicalTrials.gov
as
NCT02589782

.
Host and fungal factors both contribute to cryptococcosis-associated hyperammonemia (cryptammonia)
Authors: Baker Rosanna P. , Schachter Maria , Phillips Steven , Kandiah Sheetal , Farrque Mirza , Casadevall Arturo , Kandiah Prem A. 
Published: June 2024

ABSTRACT

Cryptococcus neoformans
and
Cryptococcus gattii
are both known urease producers and have the potential to cause hyperammonemia. We hypothesized that the risk of hyperammonemia is increased by renal failure, burden of cryptococcal infection, and fungal strain characteristics. We performed a retrospective review of plasma ammonia levels in patients with cryptococcal infections. Risk factors for hyperammonemia were statistically compared between patients with and without hyperammonemia (>53 µmol/L). Cryptococcal cells from three patients included in the study were recovered from our biorepository. Strain characteristics including urease activity, ammonia production, growth curves, microscopy, melanin production, and M13 molecular typing were analyzed and compared with a wild-type (WT)
C. neoformans
strain. We included 29 patients, of whom 37.9% had hyperammonemia, 59% had disseminated cryptococcal infection (DCI), and 41% had isolated central nervous system infection. Thirty-eight percent of patients had renal failure and 28% had liver disease. Renal failure was associated with 4.4 times (95% confidence interval [CI] 1.5, 13.0) higher risk of hyperammonemia. This risk was higher in DCIs (RR 6.2, 95% CI 1.0, 40.2) versus isolated cryptococcal meningitis (RR 2.5, 95% CI, 0.40, 16.0). Liver disease and cryptococcal titers were not associated with hyperammonemia.
C. neoformans
from one patient with extreme hyperammonemia demonstrated a 4- to 5-fold increase in extracellular urease activity, slow growth, enlarged cell size phenotypes, and diminished virulence factors. Hyperammonemia was strongly associated with renal failure in individuals with DCI, surpassing associations with liver failure or cryptococcal titers. However, profound hyperammonemia in one patient was attributable to high levels of urease secretion unique to that cryptococcal strain. Prospective studies are crucial to exploring the significance of this association.

IMPORTANCE

Cryptococcus
produces and secretes the urease enzyme to facilitate its colonization of the host. Urease breaks down urea into ammonia, overwhelming the liver’s detoxification process and leading to hyperammonemia in some hosts. This underrecognized complication exacerbates organ dysfunction alongside the infection. Our study investigated this intricate relationship, uncovering a strong association between the development of hyperammonemia and renal failure in patients with cryptococcal infections, particularly those with disseminated infections. We also explore mechanisms underlying increased urease activity, specifically in strains associated with extreme hyperammonemia. Our discoveries provide a foundation for advancing research into cryptococcal metabolism and identifying therapeutic targets to enhance patient outcomes.
Temporal relationships between blood glucose, lipids and BMI, and their impacts on atherosclerosis: a prospective cohort study
Authors: Jin Shanshan , Liu Junyi , Jia Yubing , Sun Changhao , Na Lixin 
Published: June 2024

ObjectivesThis study aimed to explore the temporal relationship between blood glucose, lipids and body mass index (BMI), and their impacts on atherosclerosis (AS).DesignA prospective cohort study was designed.Setting and participantsA total of 2659 subjects from Harbin Cohort Study on Diet, Nutrition and Chronic Non-communicable Diseases, and aged from 20 to 74 years were included.Primary and secondary outcome measuresBody weight, height, fasting blood glucose (FBG) and 2-hour postprandial glucose (2-h PG), blood lipids including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) were measured at baseline and follow-up. Brachial ankle pulse wave velocity (baPWV) was examined at follow-up as a marker of AS risk. Logistic regression analysis, cross-lagged path analysis and mediation analysis were performed to explore the temporal relationships between blood glucose, lipids and BMI, and their impacts on AS risk.ResultsLogistic regression analysis indicated that increased FBG, 2-h PG, TC, TG, LDL-c and BMI were positively associated with AS risk, while increased HDL-c was negatively associated with AS risk. The path coefficients from baseline blood parameters to the follow-up BMI were significantly greater than those from baseline BMI to the follow-up blood parameters. Mediation analysis suggested that increased FBG, 2-h PG, TC, TG and LDL-c could increase AS risk via increasing BMI, the effect intensity from strong to weak was LDL-c>TC>TG>FBG>2 h PG, while increased HDL-c could decrease AS risk via decreasing BMI.ConclusionsChanges in blood glucose and lipids could cause change in BMI, which mediated the impacts of blood glucose and lipids on AS risk. These results highlight the importance and provide support for the early and comprehensive strategies of AS prevention and control.
What are the experiences and psychosocial needs of female survivors of domestic violence in Afghanistan? A qualitative interview study in three Afghan provinces
Authors: Kaul Anjuli , Saboor Lamba , Ahmad Ayesha , Mannell Jenevieve , Paphitis Sharli Anne , Devakumar Delan 
Published: June 2024

ObjectivesThis study aimed to qualitatively explore (1) the experiences of female survivors of domestic abuse and mental health problems in Afghanistan; (2) how female survivors of violence and abuse, male members of the community and service providers perceive and respond to mental health and domestic violence in Afghanistan and (3) the provision of mental health services for female survivors of violence and abuse in Afghanistan, including the barriers and challenges faced around accessing mental health services.DesignQualitative interviews and framework thematic analysis.SettingKabul, Bamyan and Nangarhar in Afghanistan.Participants60 female survivors of domestic abuse, 60 male community members and 30 service providers who work with female survivors of domestic abuse.ResultsExperiences of multiple and compounding traumatic experiences of violence, armed conflict, and complex and competing psychosocial concerns were common among the female survivor participants. All female survivor participants reported experiencing negative mental health outcomes in relation to their experiences of violence and abuse, which were further precipitated by widespread social stigma and gender norms. Support and service provision for female survivors was deemed by participants to be insufficient in comparison to the amount of people who need to access them.ConclusionsThere are many risks and barriers women face to disclosing their experiences of violence and mental health problems which restrict women’s access to psychological support. Culturally relevant services and trauma-informed interventions are necessary to respond to these issues. Service providers should be trained to effectively recognise and respond to survivors’ mental health needs.
Prognostic and clinicopathological value of Ki-67 in patients with oesophageal squamous cell carcinoma: a systematic review and meta-analysis
Authors: Wang Yanyan , Dai Menglu , Chen Xu 
Published: June 2024

ObjectivesThe relationship between Ki-67 expression and the prognosis of patients with oesophageal squamous cell carcinoma (ESCC) has been extensively studied. However, their findings were inconsistent. Consequently, the present meta-analysis was performed to identify the precise value of Ki-67 in predicting the prognosis of ESCC.DesignThe current meta-analysis was carried out in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Data sourcesElectronic databases of PubMed, Embase, Web of Science and Cochrane Library were systematically searched until 26 September 2023.Statistical methodsPooled HRs and corresponding 95% CIs were calculated to estimate the role of Ki-67 in predicting overall survival (OS) and disease-free survival (DFS) in ESCC. Between-study heterogeneity was evaluated using Cochrane’s Q test and I2statistics. Specifically, significant heterogeneities were identified based on p<0.10 on the Q statistic test or I2>50% so the random-effects model should be used; otherwise, the fixed-effects model should be used. The relationship between Ki-67 and clinicopathological characteristics of ESCC was evaluated by combining ORs with their corresponding 95% CIs.Results11 articles with 1124 patients were included in the present meta-analysis. Based on our analysis, increased Ki-67 expression was markedly associated with poor OS (HR 1.62, 95% CI 1.15 to 2.28, p=0.006) and DFS (HR 1.72, 95% CI 1.22 to 2.43, p=0.002) in ESCC. Moreover, subgroup analysis revealed that Ki-67 upregulation significantly predicted OS and DFS when a Ki-67 threshold of >30% was used. Nonetheless, Ki-67 was not significantly associated with sex, T stage, N stage, TNM stage, tumour differentiation or tumour location.ConclusionsIn the present meta-analysis, high Ki-67 expression significantly predicted OS and DFS in patients with ESCC, especially when Ki-67>30% was used as the threshold. These results suggest that Ki-67 could serve as an effective and reliable prognostic indicator for ESCC.