bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic accuracy of Cipto Triage Method in the emergency department
Authors: Habib Hadiki , Prabowo Yogi , Sulistio Septo , Albar Imamul Aziz , Mulyana Radi Muharris , Nurlaelah Siti , Desviati Eva , Setiani Erni , Arifin Arifin , Matondang Erni Siska Sarifah , Rasmawati Rasmawati , Arlando Choga Ilham , Sumaryanto Sumaryanto , Sutoyo Tommi Juliandi , Lutfi Fery , Fatriani Fatriani , Kusuma Endar 
Published: March 2023

Background: The Cipto Triage Method (CTM) is a method developed in Indonesia for assessing the clinical acuity of emergency department patients. To evaluate the accuracy of the CTM, this study compared triage decisions using the CTM performed by nurses to the triage decisions performed by emergency medical officers (EMO). Methods: This cross-sectional diagnostic accuracy study was performed in a single-centre referral hospital in Jakarta, Indonesia. Adult patients who attended the emergency department (ED) met the inclusion criteria. Trauma cases, pregnancy, and psychiatric disorders were excluded. All eligible patients underwent triage assessment based on CTM by a triage nurse and were then referred to the ED treatment zone for triage assessment performed by an EMO. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio were calculated. Results: Between April and July 2022, 902 participants were randomly selected. The overall accuracy of the triage assessment of the index test was 84.7%, and the PPV of resuscitation and urgent triage was very good (90.5% and 84.5%, respectively). In the non-urgent category, the PPV was acceptable (72%), but the NPV was very good (92.2%). Conclusions: Nurse-based triage assessment using CTM in the ED had very good diagnostic accuracy in determining clinical acuity.
Systemic treatment with cigarette smoke extract affects zebrafish visual behaviour, intraocular vasculature morphology and outer segment phagocytosis
Authors: Gómez Sánchez Alicia , Colucci Patrizia , Moran Ailis , Moya López Alexandro , Colligris Basilio , Álvarez Yolanda , Kennedy Breandán N. 
Published: March 2023

Introduction: Cigarette smoking adversely affects multiple aspects of human health including eye disorders such as age-related macular degeneration, cataracts and dry eye disease. However, there remains a knowledge gap in how constituents of cigarette smoke affect vision and retinal biology. We used zebrafish to assess effects of short-term acute exposure to cigarette smoke extract (CSE) on visual behaviour and retinal biology. Methods: Zebrafish larvae with a developed visual system at three days post-fertilization (dpf) were exposed to CSE for 4, 24 or 48 hours. Visual behaviour, hyaloid vasculature morphology, retinal histology, oxidative stress gene expression and outer segment phagocytosis were investigated using visual behavioural optokinetic and visual motor response assays (OKR and VMR), microscopy (light, fluorescence and transmission electron microscopy), and real-time PCR. Results: In zebrafish larvae, 48 hours of CSE treatment resulted in significantly reduced visual behaviour. Larvae treated with 10, 15 or 20 μg/mL CSE showed an average of 13.7, 10.7 or 9.4 saccades per minute, respectively, significantly lower compared with 0.05% DMSO controls (p=0.0093, p=0.0004 and p<0.0001, respectively) that exhibited 19.7 saccades per minute. The diameter of intraocular vessels increased from 4.12 μm in 0.05% DMSO controls to 5.69 μm in the 20 μg/mL CSE-treated larvae (p≤0.0001). Biometry analysis highlighted a significant axial length elongation in 20 μg/mL CSE-treated larvae (216.9 μm, p<0.0001) compared to 0.05% dimethyl sulfoxide (DMSO) controls (205.1 μm). Larvae exposed to 20 μg/mL CSE had significantly (p=0.0002) higher numbers of RPE phagosomes compared to vehicle controls (0.1425 and 0.093 phagosomes/μm RPE, respectively). Conclusions: Zebrafish larvae with a developed visual system display apparent defects in visual behaviour and retinal biology after acute exposure to CSE, establishing a valuable in vivo model to investigate ocular disorders related to cigarette smoke.
A genome-wide association study of childhood adiposity and blood lipids
Authors: O'Nunain Katie , Sanderson Eleanor , Holmes Michael V , Davey Smith George , Richardson Tom G 
Published: March 2023

Background: The rising prevalence of childhood obesity and dyslipidaemia is a major public health concern due to its association with morbidity and mortality in later life. Previous studies have found that genetic variants inherited at birth can begin to exert their effects on cardiometabolic traits during the early stages of the lifecourse. Methods: In this study, we have conducted genome-wide association studies (GWAS) for eight measures of adiposity and lipids in a cohort of young individuals (mean age 9.9 years, sample sizes=4,202 to 5,766) from the Avon Longitudinal Study of Parents and Children (ALSPAC). These measures were body mass index (BMI), systolic and diastolic blood pressure, high- density and low-density lipoprotein cholesterol, triglycerides, apolipoprotein A-I and apolipoprotein B. We next undertook functional enrichment, pathway analyses and linkage disequilibrium (LD) score regression to evaluate genetic correlations with later-life cardiometabolic diseases. Results: Using GWAS we identified 14 unique loci associated with at least one risk factor in this cohort of age 10 individuals (P<5x10-8), with lipoprotein lipid-associated loci being enriched for liver tissue-derived gene expression and lipid synthesis pathways. LD score regression provided evidence of various genetic correlations, such as childhood systolic blood pressure being genetically correlated with later-life coronary artery disease (rG=0.26, 95% CI=0.07 to 0.46, P=0.009) and hypertension (rG=0.37, 95% CI=0.19 to 0.55, P=6.57x10-5), as well as childhood BMI with type 2 diabetes (rG=0.35, 95% CI=0.18 to 0.51, P=3.28x10-5). Conclusions: Our findings suggest that there are genetic variants inherited at birth which begin to exert their effects on cardiometabolic risk factors as early as age 10 in the life course. However, further research is required to assess whether the genetic correlations we have identified are due to direct or indirect effects of childhood adiposity and lipid traits.
Regular smoking of male ancestors in adolescence and fat mass in young adult grandchildren and great-grandchildren
Authors: Gregory Steven , Suderman Matthew , Northstone Kate , Pembrey Marcus , Watkins Sarah , Iles-Caven Yasmin , Golding Jean 
Published: March 2023

Background: Previous studies using the Avon Longitudinal Study of Parents and Children (ALSPAC) have shown that if men commenced smoking prior to the onset of puberty their sons, their granddaughters and great-granddaughters were more likely to have excess fat (but not lean) mass during childhood, adolescence and early adulthood. In this study we assess associations between ancestral smoking during adolescence (ages 11–16 years) with fat and lean mass of subsequent generations at two ages. Methods: We analysed data on exposures of grandparents and great-grandparents collected by ALSPAC. The outcomes were the fat masses of their grandchildren and great-grandchildren measured at ages 17 and 24. Measures of lean mass were used as controls. Adjustment was made for 8–10 demographic factors using multiple regression. Results: We found associations between adolescent smoking of the paternal grandfathers and the adjusted fat mass of their grandchildren, but no associations with the grandchildren’s lean mass. Grandchildren at age 17 had an average excess fat mass of +1.65 [95% CI +0.04, +3.26] Kg, and at age 24 an average excess of +1.55 [95% CI -0.27, +3.38] Kg. Adolescent smoking by the maternal grandfather showed similar, but weaker, associations: at 17 an average excess fat mass of +1.02 Kg [95% CI -0.20, +2.25] Kg, and at 24 an average excess of +1.28 [95% CI -0.11, +2.66] Kg. There were no pronounced differences between the sexes of the children. For the great-grandparents there were few convincing results, although numbers were small. Conclusions: We have shown associations between grandfathers’ smoking in adolescence and increased fat (but not lean) mass in their children. Confirmation of these associations is required, either in a further data set or by demonstrating the presence of supportive biomarkers.
Recovery of metagenomic data from the Aedes aegypti microbiome using a reproducible snakemake pipeline: MINUUR
Authors: Foo Aidan , Cerdeira Louise , Hughes Grant L. , Heinz Eva 
Published: March 2023

Background: Ongoing research of the mosquito microbiome aims to uncover novel strategies to reduce pathogen transmission. Sequencing costs, especially for metagenomics, are however still significant. A resource that is increasingly used to gain insights into host-associated microbiomes is the large amount of publicly available genomic data based on whole organisms like mosquitoes, which includes sequencing reads of the host-associated microbes and provides the opportunity to gain additional value from these initially host-focused sequencing projects. Methods: To analyse non-host reads from existing genomic data, we developed a snakemake workflow called MINUUR (Microbial INsights Using Unmapped Reads). Within MINUUR, reads derived from the host-associated microbiome were extracted and characterised using taxonomic classifications and metagenome assembly followed by binning and quality assessment. We applied this pipeline to five publicly available Aedes aegypti genomic datasets, consisting of 62 samples with a broad range of sequencing depths. Results: We demonstrate that MINUUR recovers previously identified phyla and genera and is able to extract bacterial metagenome assembled genomes (MAGs) associated to the microbiome. Of these MAGS, 42 are high-quality representatives with >90% completeness and <5% contamination. These MAGs improve the genomic representation of the mosquito microbiome and can be used to facilitate genomic investigation of key genes of interest. Furthermore, we show that samples with a high number of KRAKEN2 assigned reads produce more MAGs. Conclusions: Our metagenomics workflow, MINUUR, was applied to a range of Aedes aegypti genomic samples to characterise microbiome-associated reads. We confirm the presence of key mosquito-associated symbionts that have previously been identified in other studies and recovered high-quality bacterial MAGs. In addition, MINUUR and its associated documentation are freely available on GitHub and provide researchers with a convenient workflow to investigate microbiome data included in the sequencing data for any applicable host genome of interest.
Optimizing over an Ensemble of Trained Neural Networks
Authors: Wang Keliang , Lozano Leonardo , Cardonha Carlos , Bergman David 
Published: March 2023

We study optimization problems where the objective function is modeled through feedforward neural networks with rectified linear unit (ReLU) activation. Recent literature has explored the use of a single neural network to model either uncertain or complex elements within an objective function. However, it is well known that ensembles of neural networks produce more stable predictions and have better generalizability than models with single neural networks, which motivates the investigation of ensembles of neural networks rather than single neural networks in decision-making pipelines. We study how to incorporate a neural network ensemble as the objective function of an optimization model and explore computational approaches for the ensuing problem. We present a mixed-integer linear program based on existing popular big-M formulations for optimizing over a single neural network. We develop a two-phase approach for our model that combines preprocessing procedures to tighten bounds for critical neurons in the neural networks with a Lagrangian relaxation-based branch-and-bound approach. Experimental evaluations of our solution methods suggest that using ensembles of neural networks yields more stable and higher quality solutions, compared with single neural networks, and that our optimization algorithm outperforms (the adaption of) a state-of-the-art approach in terms of computational time and optimality gaps. History: Andrea Lodi, Area Editor for Design & Analysis of Algorithms—Discrete.
Patients' experience of robotic-assisted surgery: a qualitative study
Authors: Moloney Rita , Coffey Alice , Coffey Calvin , O'Brien Brid 
Published: March 2023

Background: The use of robotic-assisted surgery (RAS) has increased considerably since its introduction in 2001, with RAS now being widely accepted as a surgical modality. Current literature surrounding RAS focuses on the surgical team's experience rather than the patient's perspective, with limited qualitative research on post-RAS patient experience. Aim: To explore patient-reported experience following RAS. Methods: Twelve semi-structured telephone interviews were conducted. Interviews were audio recorded with data transcribed verbatim and analysed using thematic analysis. Findings: Themes included: factors specific to the robotic modality and psychological factors. Participant concerns emanated from their experience of a lack of pre-operative preparation, resulting in feelings of anxiety and some negative perceptions of RAS. Conclusion: Given the limited time for patient preparation for RAS, work developing patient information that is also patient-led would be of benefit. Pre-operative preparation is a key nursing role’ and further research could explore nurses' experiences of preparing patients for RAS, facilitators and barriers to providing optimum patient preparation in this context.
Nutritional assessment and quality of life in patients with non-small cell lung cancer undergoing immunotherapy
Authors: Konstantinidis Theocharis , Fragkioudaki Chrysi , Patelarou Evridiki , Zografakis-Sfakianakis Michail , Naoum Symeon , Tsatsou Ioanna , Kalemikerakis Ioannis , Govina Ourania 
Published: March 2023

Background: Patients with metastatic non-small cell lung cancer (NSCLC) often experience severe eating disorders and other problems because of rapid disease progression and various therapies, which significantly affect their quality of life (QoL). Aims: This study aimed to assess the nutritional status and QoL of patients with NSCLC at the start of immunotherapy and 3 months later. Methods: This study used a prospective, observational, consecutive sampling approach and was carried out between July 2018 and August 2019. The convenience sample comprised 60 patients treated in the oncology ward and the day care department of a public hospital in Greece. Their nutritional status was assessed using the Mini Nutritional Assessment questionnaire and their QoL using the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire and its QLQ-LC13 module. They were evaluated at the start of immunotherapy (phase I) and 3 months later (phase II). Findings: Of the initial 60 patients, 25% had died and 23.3% declined to participate by phase II. Of the 31 patients (51.7%) who completed the study, 64.5% had been assessed as malnourished at phase I; at phase II, this had decreased to 32.3%, so nutritional status appeared to have significantly improved. There were also significant improvements between phases I and II in global health status/QoL, as well as in the physical, roles, emotional and social dimensions. Additionally, all nine symptoms of QLQ-C30 significantly decreased, while the QLQ-LC13 showed significant improvements in dyspnoea, alopecia and pain in parts of the body other than the chest, arm or shoulder. Conclusion: Metastatic NSCLC patients' QoL and nutritional status significantly improved after 3 months' immunotherapy.
Palliative care clinical nurse specialists leading enhanced supportive care in hepatopancreatobiliary cancer
Authors: Benson Sinead , Wong Helen , Olsson-Brown Anna , Coyle Seamus , Monnery Daniel 
Published: March 2023

Background: Integration of care between palliative care and oncology can improve patient outcomes and is increasingly recommended. Enhanced supportive care (ESC), led and delivered by palliative care clinical nurse specialists, is a potential model to achieve this but evidence about it is lacking. Aim: This research aimed to evaluate a nurse-led integrated ESC model within hepatopancreatobiliary cancer care. Method: Some 101 patients with hepatopancreatobiliary cancer were supported by integrated ESC delivered in a co-located clinic. Data on symptoms and quality of life were collected prospectively. Survival data and chemotherapy use were retrospectively analysed following minimum follow-up, using a matched control technique. Results: Patients receiving ESC exhibited less severe symptoms and better mood over time. They also had less aggressive treatment towards the end of life, receiving 31% less chemotherapy than controls with comparable survival. Conclusion: An integrated, nurse-led ESC model can be effective in improving outcomes for patients with hepatopancreatobiliary cancer.
Out-of-hours community palliative care: a national survey of hospice providers
Authors: Fee Anne , Hasson Felicity , Slater Paul , Payne Sheila , McConnell Tracey , Finlay Dori-Anne , McIlfatrick Sonja 
Published: March 2023

Background: Community-based palliative out-of-hours services operate outside normal working hours. However, little is known about the provision and delivery of such care. Aim: The aim of this study was to describe types of provision and delivery of out-of-hours palliative care services provided by UK hospices. Methods: Survey questionnaires were emailed to 150 adult hospices in the UK. Quantitative data were analysed using SPSS and qualitative data subjected to thematic analysis. Findings: Responding hospices (n=57) provided the following types of support: telephone advice 72% (n=41); care at home 70% (n=40); and rapid response 35% (n=20). There were variations between services regarding referral mechanisms, availability and workforce, and integration with statutory services was limited. Conclusion: Variation in the type of provision and delivery of out-of-hours palliative care services alongside limited integration with statutory care have contributed to inequity of access to community-based palliative care, and potentially suboptimal patient and informal caregiver outcomes.
Design and 3D printing of the Powell lens for sub-terahertz imaging
Authors: Bezziou Boufateh , Lazoul Mohamed , Boutemedjet Ayoub , Garet Frédéric 
Published: March 2023

The aim behind this work is to design and manufacture a beam shaping lens for active terahertz imaging systems that boosts their performance in terms of sensitivity and image quality. The proposed beam shaper is based on an adaptation of the original optical Powell lens, where a collimated Gaussian beam is converted into a uniform flattop intensity beam. The design model for such a lens was introduced, and its parameters were optimized by a simulation study conducted using COMSOL Multiphysics software. The lens was then fabricated using a carefully chosen material [polylactic acid (PLA)] through a 3D printing process. The manufactured lens was implemented in an experimental setup to validate its performance using a continuous-wave sub-terahertz source around 100 GHz. Experimental results demonstrated a high-quality flattop beam maintained along the propagation path, which is highly recommended for terahertz and millimeter-wave active imaging systems to produce high-quality images.
Digitale Identitäten in der physischen Welt: Eine Abwägung von Privatsphäreschutz und Praktikabilität
Authors: Roland Michael , Höller Tobias , Mayrhofer René 
Published: March 2023

ZusammenfassungAnforderungen an Datenschutz und Informationssicherheit, aber auch an Datenaktualität und Vereinfachung bewirken einen kontinuierlichen Trend hin zu plattformübergreifenden ID-Systemen für die digitale Welt. Das sind typischerweise föderierte Single-Sign-On-Lösungen großer internationaler Konzerne wie Apple, Facebook und Google. Dieser Beitrag beleuchtet die Frage, wie ein dezentrales, offenes, globales Ökosystem nach dem Vorbild des Single-Sign-On für die digitale, biometrische Identifikation in der physischen Welt aussehen könnte. Im Vordergrund steht dabei die implizite Interaktion mit vorhandener Sensorik, mit der Vision, dass Individuen in der Zukunft weder Plastikkarten noch mobile Ausweise am Smartphone mit sich führen müssen, sondern ihre Berechtigung für die Nutzung von Diensten rein anhand ihrer biometrischen Merkmale nachweisen können. Während diese Vision bereits jetzt problemlos durch Systeme mit einer zentralisierten Datenbank mit umfangreichen biometrischen Daten aller Bürger*innen möglich ist, wäre ein Ansatz mit selbstverwalteten, dezentralen digitalen Identitäten erstrebenswert, bei dem die Nutzer*in in den Mittelpunkt der Kontrolle über ihre eigene digitale Identität gestellt wird und die eigene digitale Identität an beliebigen Orten hosten kann. Anhand einer Analyse des Zielkonflikts zwischen umfangreichem Privatsphäreschutz und Praktikabilität, und eines Vergleichs der Abwägung dieser Ziele mit bestehenden Ansätzen für digitale Identitäten wird ein Konzept für ein dezentrales, offenes, globales Ökosystem zur privaten, digitalen Authentifizierung in der physischen Welt abgeleitet.
Ist das die Wallet der Zukunft?
Authors: Krauß Anna-Magdalena , Sellung Rachelle A. , Kostic Sandra 
Published: March 2023

ZusammenfassungHeutzutage werden digitale Identitäten oft unsicher umgesetzt und sind mit der Erstellung von vielen unterschiedlichen Accounts durch Nutzende verbunden. Das soll langfristig durch die Nutzung sogenannter Digital Identity Wallets verbessert werden. Diese Wallets ermöglichen die Verwaltung und Nutzung von digitalen Identitäten sowie Nachweisdokumenten. Dazu gehören unter anderem Nachweise wie der Führerschein, der Bibliotheksausweis oder auch Flugtickets. Alle diese Daten können gemeinsam in einer Wallet-App auf den Endgeräten der Nutzenden gespeichert werden. Die Nutzenden verwalten ihre Daten eigenständig und entscheiden selbst darüber, welche und wie viele Daten sie über sich preisgeben wollen.Aktuelle Forschungen zeigen allerdings, dass die bisher entwickelten Wallets Usability-Probleme aufweisen, sodass Nutzende nur schwer das Konzept dieser Wallets greifen können. Zudem weisen heutige digitale Dienstleistungen zahlreiche Hürden auf, welche den Einsatz von digitalen Identitäten erschweren.In diesem Beitrag wird basierend auf einer Wallet-Analyse und User-Experience-Anforderungen ein Konzeptvorschlag für eine nutzungsfreundlichere Wallet vorgestellt, bei der die Nutzenden im Mittelpunkt stehen. So sieht dieses Konzept einen umfangreicheren Funktionsumfang im Vergleich zu aktuellen Wallet Umsetzungen vor, mit dem Ziel die Wallet stärker den Bedürfnissen der Nutzenden anzupassen. Darunter fallen Funktionen wie die Kommunikation zwischen Wallet und Dienstanbieter ohne die Notwendigkeit des Teilens von Kontaktdaten, die Option der Dauervollmachten zur Freigabe von Daten, die Möglichkeit der Verwaltung von Daten in Vertretung anderer Personen sowie die Organisation der eigenen Daten.