bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators to guideline-recommended care of benign paroxysmal positional vertigo in the ED: a qualitative study using the theoretical domains framework
Authors: Bradshaw Sally , Graco Marnie , Holland Anne 
Published: February 2023

BackgroundBenign paroxysmal positional vertigo (BPPV) is a common presentation to the ED. Evidence suggests low adherence to guideline-recommended care, but the reasons underlying this are poorly understood. This study used the theoretical domains framework (TDF) to explore the barriers and facilitators to medical and physiotherapy clinical practices in the management of BPPV in an Australian metropolitan ED.MethodsFrom May to December 2021, semistructured interviews were conducted with 13 medical staff and 13 physiotherapists who worked at an ED in Melbourne, Australia. Interviews used the TDF to explore the perceived barriers and facilitators to the delivery of guideline-recommended assessment and treatment techniques for BPPV. Data were analysed thematically to identify relevant domains and generate themes and belief statements.ResultsFifteen belief statements representing eight domains of the TDF were identified as key factors in the management of BPPV in the ED. The most prominent domains wereknowledgeandskillsdue to their conflicting belief statements between professions concerning education, skill development and self-confidence;memory, attention and decision processesfor the perceived complexity of the presentation including difficulty recalling diagnostic and treatment techniques; andenvironmental context and resourcesfor their shared belief statements concerning time and workload pressures. The availability of vestibular physiotherapy was considered both a barrier and facilitator to the delivery of recommended care by medical staff, but a barrier to independent practice as it unintentionally limited the opportunities for skill development in medical staff.ConclusionSeveral modifiable barriers and facilitators to the management of BPPV in the ED have been identified. Differences were observed between the professional groups, and these findings will guide a future intervention to improve the use of guideline-recommended assessment and treatment techniques for BPPV in ED.
CD103 and CD39 coexpression identifies neoantigen-specific cytotoxic T cells in colorectal cancers with low mutation burden
Authors: van den Bulk Jitske , van der Ploeg Manon , Ijsselsteijn Marieke E , Ruano Dina , van der Breggen Ruud , Duhen Rebekka , Peeters Koen C M J , Fariña-Sarasqueta Arantza , Verdegaal Els M E , van der Burg Sjoerd H , Duhen Thomas , de Miranda Noel F C C 
Published: February 2023

BackgroundExpression of CD103 and CD39 has been found to pinpoint tumor-reactive CD8+T cells in a variety of solid cancers. We aimed to investigate whether these markers specifically identify neoantigen-specific T cells in colorectal cancers (CRCs) with low mutation burden.Experimental designWhole-exome and RNA sequencing of 11 mismatch repair-proficient (MMR-proficient) CRCs and corresponding healthy tissues were performed to determine the presence of putative neoantigens. In parallel, tumor-infiltrating lymphocytes (TILs) were cultured from the tumor fragments and, in parallel, CD8+T cells were flow-sorted from their respective tumor digests based on single or combined expression of CD103 and CD39. Each subset was expanded and subsequently interrogated for neoantigen-directed reactivity with synthetic peptides. Neoantigen-directed reactivity was determined by flow cytometric analyses of T cell activation markers and ELISA-based detection of IFN-γ and granzyme B release. Additionally, imaging mass cytometry was applied to investigate the localization of CD103+CD39+cytotoxic T cells in tumors.ResultsNeoantigen-directed reactivity was only encountered in bulk TIL populations and CD103+CD39+(double positive, DP) CD8+T cell subsets but never in double-negative or single-positive subsets. Neoantigen-reactivity detected in bulk TIL but not in DP CD8+T cells could be attributed to CD4+T cells. CD8+T cells that were located in direct contact with cancer cells in tumor tissues were enriched for CD103 and CD39 expression.ConclusionCoexpression of CD103 and CD39 is characteristic of neoantigen-specific CD8+T cells in MMR-proficient CRCs with low mutation burden. The exploitation of these subsets in the context of adoptive T cell transfer or engineered T cell receptor therapies is a promising avenue to extend the benefits of immunotherapy to an increasing number of CRC patients.
The relationship between sleep, pain,and musculoskeletal injuries in US Army Soldiers
Authors: Ritland Bradley M , Judkins J L , Naylor J A , Kardouni J R , Pasiakos S M , Jayne J M 
Published: February 2023

IntroductionThe purpose of this study was to investigate the relationship between sleep and pain in military personnel and to determine if metrics of sleep and pain intensity differ between the injured and uninjured in this population.MethodsActive-duty US Army Soldiers (n=308; 26.8±6.5 years, 82% male) from the 2nd Infantry Division, Joint Base Lewis-McChord, Washington, and 101st Airborne Division, Fort Campbell, Kentucky, completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and questionnaires about current musculoskeletal injuries and pain intensity (0=no pain to 10=worst imaginable pain). Pearson correlation coefficients were used to assess the association between pain and sleep. Differences in sleep and pain between injured and uninjured participants were determined using an analysis of covariance.ResultsPain intensity was positively correlated with sleep quality (global PSQI score, r=0.337, p<0.001) and daytime sleepiness (ESS score, r=0.163, p=0.005), and negatively associated with sleep duration (r=−0.118, p=0.039). Injured participants accounted for 37.7% (n=116) of the study population. Injured participants reported greater pain intensity (3.7±2.5 vs 1.3±1.9, p<0.001), were older (28.5±7.4 years vs 25.8±5.7 years, p=0.001) and in the service longer (6.3±6.3 years vs 4.6±4.7 years, p=0.013) than uninjured participants. Injured participants had higher global PSQI scores (9.0±4.1 vs 6.4±3.4, p<0.001), including each of the seven PSQI components (all p<0.050), and reported sleeping less per night than uninjured participants (5.7±1.3 hours vs 6.1±1.2 hours, p=0.026).ConclusionThese data demonstrate that pain intensity is associated with sleep in active-duty US Army Soldiers and that those who report a musculoskeletal injury, regardless of age and time in service, report poorer sleep quality, shorter sleep durations, and greater levels of pain than uninjured Soldiers.
Atrial functional mitral regurgitation: prevalence, characteristics and outcomes from the National Echo Database of Australia
Authors: Moonen Avalon , Ng Martin K C , Playford David , Strange Geoff , Scalia Gregory M , Celermajer David S 
Published: February 2023

AimsAtrial functional mitral regurgitation (AFMR) is characterised by left atrial and consequent mitral annular dilatation causing mitral regurgitation. AFMR is likely to become more common with population ageing, alongside increases in atrial fibrillation and heart failure with preserved ejection fraction; conditions causing atrial dilatation. Here, we aim to define the prevalence and characterise the patient and survival characteristics of AFMR in the National Echocardiographic Database of Australia (NEDA).Methods and results14 004 adults with moderate or severe FMR were identified from NEDA. AFMR or ventricular FMR (VFMR) was classified by LA size, LV size and LVEF. AFMR was found in 40% (n=5562) and VFMR in 60% (n=8442). Compared with VFMR, the AFMR subgroup were significantly older (mean age 78±11 years), with a higher proportion of females and of AF. Participants were followed up for a median of 65 months (IQR 36–116 months). After adjustment for age, sex, AF, and pulmonary hypertension, the prognosis for VFMR was significantly worse than for AFMR (HR 1.57, 95% CI 1.47 to 1.68 for all-cause and 1.73, 95% CI 1.60 to 1.88, p<0.001 for both). After further adjustment for LVEF, mortality rates were similar in VFMR and AFMR patients (HR 0.93, p=NS), though advancing age and pulmonary hypertension remained independently associated with prognosis.ConclusionsAFMR is a common cause of significant functional MR that predominantly affects elderly female patients with AF. Advancing age and pulmonary hypertension independently associated with survival in FMR. Prognosis was better in AFMR compared with VFMR; however, this difference was accounted for by LV systolic impairment and not by MR severity.
Impact of early age at menopause on disease outcomes in postmenopausal women with rheumatoid arthritis: a large observational cohort study of Korean patients with rheumatoid arthritis
Authors: Park Eun Hye , Kang Eun Ha , Lee Yun Jong , Ha You-Jung 
Published: February 2023

ObjectivesTo assess the differences in clinical outcomes between patients with rheumatoid arthritis (RA) with early menopause (EM) (<45 years) and usual menopause (UM) (≥45 years) and to identify the impact of EM on longitudinal changes in RA activity and patient-reported outcomes (PROs).MethodsWe recruited 2878 postmenopausal women with RA from the Korean Observational Study Network for Arthritis. Patients were examined at baseline and for 5 consecutive years using the Simplified Disease Activity Index (SDAI), Health Assessment Questionnaire–Disability Index (HAQ-DI) and other PROs. Generalised estimating equation (GEE) analyses were performed among patients with a baseline SDAI of >11 to evaluate the impact of EM on longitudinal changes in RA activity and PROs.ResultsThe EM group (n=437) was younger than the UM group (n=2441), but the RA duration was similar between the two groups. The EM group was more educated and more likely to be seronegative at enrolment. Moreover, the EM group demonstrated higher disease activity and worse PROs for global assessment, fatigue, sleep disturbance and health-related quality of life (HRQoL) (all p<0.05) at baseline. The GEE model revealed that EM significantly influenced the rate of SDAI change (β=1.265, p=0.004) after adjusting for age, RA duration, biologics use and SDAI at baseline. The EM group was also significantly associated with increased HAQ-DI scores and decreased EQ-5D-utility values during the 5-year follow-up period.ConclusionPatients with RA and EM demonstrate higher disease activity and poorer HRQoL. Furthermore, EM significantly affects the longitudinal changes in disease activity and PROs in patients with RA.
Plastic multilayered closure versus orthopedic surgeon closure after spinal instrumentation in pediatric neuromuscular scoliosis
Authors: Ezeokoli Ekene U , Tamma Poornima L , Borici Neritan , Inneh Ifeoma , Buchanan Edward P , Smith Brian G 
Published: February 2023

ObjectiveTo compare wound complication rates between orthopedic closure (OC) and plastic multilayered closure (PMC) in patients undergoing primary posterior spinal fusion for neuromuscular scoliosis (NMS). We hypothesize that multilayered closure will be associated with better postoperative outcomes.MethodsWe collected data on pediatric patients diagnosed with NMS who underwent first time spinal instrumentation between 1 January 2018 and 31 May 2021. Patient demographics, length of surgery, spinal levels fused and operative variables, wound complication rate, treatments, and need for wound washout were reviewed in depth and recorded.ResultsIn total, 86 patients were reviewed: 46 with OC and 40 with PMC. There was a significant increase in operating room (OR) time with PMC compared with OC (6.7±1.2 vs 7.3±1.3, p=0.016). There was no difference in complication rate, mean postoperative day of complication or unplanned return to the OR for OC and PMC, respectively. There was a slightly significant increase in the number of patients going home with a drain in the PMC cohort compared with the OC cohort (2.1% vs 15%, p=0.046).ConclusionsPMC demonstrated longer OR times than OC and did not demonstrate a statistically significant reduction in wound complications or unplanned returns to the OR. However, other studies have demonstrated statistical and clinical significance with these variables. Surgical programs should review internal patient volumes and outcomes for spinal fusion in NMS patients and consider if PMC after spinal fusions in pediatric patients with NMS or other scoliosis subtypes is an appropriate option in their institution to minimize postoperative wound complications.
Performance Analysis of IEEE 802.11p Protocol in IoV under Error-Prone Channel Conditions
Authors: Li Suoping , Li Hongli , Gaber Jaafar , Yang Sa , Yang Qian 
Published: February 2023

The complexity of the channel condition in the Internet of vehicles (IoV) may increase the bit error rate (BER) of the intelligent vehicle terminals, resulting in data transmission failures or errors. Therefore, it is necessary to improve the performance of communication protocols under error-prone channel conditions. This article investigates the influence of the access categories’ (ACs) performance with channel errors by using four

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to cause service differentiation based on the enhanced distributed channel access (EDCA) mechanism of the IEEE 802.11p. To address the error-prone characteristics of the channel and unsaturated traffic conditions, a three-dimensional Markov model is developed first, followed by an analysis of the characteristics and mutual transition probabilities of the seven classes of states in the model, and then, the steady-state equations of the system are developed to derive the steady-state distribution to study system performance. The model considers the backoff phase, the freezing of the backoff counter, the retransmission limit, the probability of collisions occurring, the size of the maximum and minimum contention window, and the number of interframe intervals. These parameters are chosen to meet the requirements for the protocol to operate, while also preventing overestimation of throughput and avoiding having packets being served all the time. We derive expressions for the throughput and delay of

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under the conditions of error channels and unsaturated traffic. The impact of channel errors on the throughput and delay of

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is evaluated by numerical simulation. Numerical results show that too many stations in the system will increase the average access delay and decrease throughput. The increase in BER will seriously decrease the performance of high-priority

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. The throughput of the

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is also modeled to vary with frame length and BER, and the variation curves of the optimal frame lengths for

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and

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were obtained.
Small-Molecule–Mediated Stabilization of PP2A Modulates the Homologous Recombination Pathway and Potentiates DNA Damage-Induced Cell Death
Authors: Avelar Rita A. , Armstrong Amy J. , Carvette Gracie , Gupta Riya , Puleo Noah , Colina Jose A. , Joseph Peronne , Sobeck Alexander M. , O'Connor Caitlin M. , Raines Brynne , Gandhi Agharnan , Dziubinski Michele L. , Ma Daniel S. , Resnick Kimberly , Singh Sareena , Zanotti Kristine , Nagel Christa , Waggoner Steven , Thomas Daffyd G. , Skala Stephanie L. , Zhang Junran , Narla Goutham , DiFeo Analisa 
Published: February 2023

Abstract
High-grade serous carcinoma (HGSC) is the most common and lethal ovarian cancer subtype. PARP inhibitors (PARPi) have become the mainstay of HGSC-targeted therapy, given that these tumors are driven by a high degree of genomic instability (GI) and homologous recombination (HR) defects. Nonetheless, approximately 30% of patients initially respond to treatment, ultimately relapsing with resistant disease. Thus, despite recent advances in drug development and an increased understanding of genetic alterations driving HGSC progression, mortality has not declined, highlighting the need for novel therapies. Using a small-molecule activator of protein phosphatase 2A (PP2A; SMAP-061), we investigated the mechanism by which PP2A stabilization induces apoptosis in patient-derived HGSC cells and xenograft (PDX) models alone or in combination with PARPi. We uncovered that PP2A genes essential for cellular transformation (B56α, B56γ, and PR72) and basal phosphatase activity (PP2A-A and -C) are heterozygously lost in the majority of HGSC. Moreover, loss of these PP2A genes correlates with worse overall patient survival. We show that SMAP-061–induced stabilization of PP2A inhibits the HR output by targeting RAD51, leading to chronic accumulation of DNA damage and ultimately apoptosis. Furthermore, combination of SMAP-061 and PARPi leads to enhanced apoptosis in both HR-proficient and HR-deficient HGSC cells and PDX models. Our studies identify PP2A as a novel regulator of HR and indicate PP2A modulators as a therapeutic therapy for HGSC. In summary, our findings further emphasize the potential of PP2A modulators to overcome PARPi insensitivity, given that targeting RAD51 presents benefits in overcoming PARPi resistance driven by BRCA1/2 mutation reversions.
Portrait Map Art Generation By Asymmetric Image-to-Image Translation
Authors: Zhang Yuxin , Tang Fan , Dong Weiming , Le Thi-Ngoc-Hanh , Xu Changsheng , Lee Tong-Yee 
Published: February 2023

AbstractThe authors propose a deep neural network–based algorithm to automatically generate portrait map art (PMA), a modern art form created by British portrait artist Ed Fairburn. The authors formulate the generation of PMA as an adaptive dual-to-single image translation problem. The authors’ proposed model analyzes the appearance of one portrait and one map image using two encoder networks and utilizes their hidden encodings as representations of the portrait and map image to generate new PMA using a decoder network. An adaptive style harmonization module is proposed to fuse the two hidden encodings. Optimized by cycle-consistency constraint, the model can produce new PMA images without baselines.
Moist Thermodynamics of Convectively Coupled Waves over the Western Hemisphere
Authors: Mayta Víctor C. , Adames Ángel F. 
Published: February 2023

Abstract
Convectively coupled waves (CCWs) over the Western Hemisphere are classified based on their governing thermodynamics. It is found that only the tropical depressions (TDs; TD waves) satisfy the criteria necessary to be considered a moisture mode, as in the Rossby-like wave found in an earlier study. In this wave, water vapor fluctuations play a much greater role in the thermodynamics than temperature fluctuations. Only in the eastward-propagating inertio-gravity (EIG) wave does temperature govern the thermodynamics. Temperature and moisture play comparable roles in all the other waves, including the Madden–Julian oscillation over the Western Hemisphere (MJO-W). The moist static energy (MSE) budget of CCWs is investigated by analyzing ERA5 data and data from the 2014/15 observations and modeling of the Green Ocean Amazon (GoAmazon 2014/15) field campaign. Results reveal that vertical advection of MSE acts as a primary driver of the propagation of column MSE in westward inertio-gravity (WIG) wave, Kelvin wave, and MJO-W, while horizontal advection plays a central role in the mixed Rossby gravity (MRG) and TD wave. Results also suggest that cloud radiative heating and the horizontal MSE advection govern the maintenance of most of the CCWs. Major disagreements are found between ERA5 and GoAmazon. In GoAmazon, convection is more tightly coupled to variations in column MSE, and vertical MSE advection plays a more prominent role in the MSE tendency. These results along with substantial budget residuals found in ERA5 data suggest that CCWs over the tropical Western Hemisphere are not represented adequately in the reanalysis.

Significance Statement
In comparison to other regions of the globe, the weather systems that affect precipitation in the tropical Western Hemisphere have received little attention. In this study, we investigate the structure, propagation, and thermodynamics of convectively coupled waves that impact precipitation in this region. We found that slowly evolving tropical systems are “moisture modes,” i.e., moving regions of high humidity and precipitation that are maintained by interactions between clouds and radiation. The faster waves are systems that exhibit relatively larger fluctuations in temperature. Vertical motions are more important for the movement of rainfall in these waves. Last, we found that reanalysis and observations disagree over the importance of different processes in the waves that occurred over the Amazon region, hinting at potential deficiencies on how the reanalysis represents clouds in this region.
Studies on thermoset blend of bismaleimide having multiple swivel groups and biscyanate ester
Authors: J Dhanalakshmi , S Siva Kaylasa Sundari , S Sivaprakash , Vijayakumar CT 
Published: February 2023

The materials 2,2-bis [4-(4-maleimidophenoxy phenyl)] propane (BMIX) and bisphenol-A based cyanate ester (BCY) were synthesized. The monomers BMIX and BCY were physically blended (BMCY) in 1:1 mol ratio. The materials BMIX, BCY and BMCY were thermally polymerized and the structural characterisation of the materials was done using Fourier transform infrared spectrophotometer (FTIR). The curing characteristics of BMIX, BCY and its blend (BMCY) were investigated using differential scanning calorimeter (DSC). The blend BMCY shows considerable differences in the thermal curing behaviour as evidenced by the DSC studies. Blending BCY with BMIX drastically reduces the melting temperature, curing onset temperature and the amount of heat liberated during thermal curing. The thermal stabilities of the crosslinked network polymers (PBMIX, PBCY and PBMCY) were investigated using thermogravimetric analyser (TGA). Detailed TGA studies indicated that the PBMCY shows better thermal stability than the PBMIX and PBCY. The DSC and TG curves indirectly hint about the possible reaction between BMIX and BCY during thermal curing. Woven glass fibre reinforced laminates were prepared using BMIX, BCY and BMCY by solution impregnation followed by drying and compression moulding. The glass laminate having BMCY as the matrix resin showed much better mechanical property (tensile strength) compared to the laminate made using BMIX as the matrix resin.