bluuebunny/crossref_metadata_2025 huggingface dataset:
Soil erosion estimation in a catchment with implemented soil and water conservation measures
Authors: Wang He , Ji Xiang , Wang Xiaopeng , Zhang Yue , Jiang Fangshi , Huang Yanhe , Lin Jinshi
Published: September 2024

The variations in soil erosion significantly impact regional ecological security. Under rapid urbanisation, extensive ecological restoration and climate change, soil erosion development in the red soil region of southern China is ambiguous. Therefore, this study investigated the current (1980s–2020) and future (2050) erosion characteristics in a typical soil erosion control catchment (Changting section catchment) in this region by using the Cellular Automata Markov model and CMIP6 data to predict future scenarios and the Revised Universal Soil Loss Equation to estimate soil erosion. The results showed significant changes in the vegetation coverage of major land uses from 1980s to 2020, which was mainly caused by continuous soil and water conservation (SWC). The land use subtypes that were obtained by reclassifying land use based on the threshold of vegetation cover on soil erosion control, reflect a continuous transformation from those with poor SWC effectiveness to those with great SWC effectiveness. Therefore, the estimated soil erosion intensity continued to decrease from 1980s to 2020, and the contribution of land use/land cover (LULC) impacts ranged from 74%–195%. However, predictions of land use subtypes indicated that LULC may be stable after 2020; thus, soil erosion changed little when the climate was almost unchanged in 2050. Under climate change scenarios, soil erosion may increase by 111%–121%, and the contribution of precipitation impacts was 63%–66%. The major driving factor of soil erosion changes may shift from LULC to precipitation after 2020. Therefore, in the future, the potential for reducing soil erosion by vegetation restoration may be limited, and more engineering measures should be applied to address the erosion risk caused by climate changes. This study provides prospects for land use/land cover and soil erosion in the red soil region of southern China.
Exploiting the synergy of SARIMA and XGBoost for spatiotemporal earthquake time series forecasting
Authors: Kaushal Arush , Gupta Ashok Kumar , Sehgal Vivek Kumar
Published: October 2024

Earthquakes are vibrations that occur on the surface of earth, generating fires, ground shaking, tsunamis, landslides and cracks. These incidents can cause severe damage and loss of life. Accurate earthquake forecasts are critical for anticipating and mitigating these hazards, which can avoid damage to buildings and infrastructure and save lives. To address the challenges given by earthquakes probabilistic nature, this paper presents a hybrid SARIMA–XGBoost approach to earthquake magnitude prediction. The suggested technique consists of a two‐step process: an exploration phase that uses exploratory data analysis, which includes descriptive statistics and data visualisation, and a prediction phase that focusses on forecasting future earthquakes. Using a large significant earthquake dataset spanning 1965–2023, the study intends to gain insights and lessons for more effective earthquake prediction methods. Further, in a comparison analysis, the results of SARIMA‐XGBoost model are compared to those of traditional ARIMA and SARIMA models. The results highlight the superior performance of the hybrid SARIMA–XGBoost model, showcasing a mean absolute error (MAE) of 0.038, a mean squared error (MSE) of 0.0040, and a root mean squared error (RMSE) of 0.068. These metrics collectively underscore the model's enhanced accuracy in forecasting earthquake magnitudes. The notably low values of MAE, MSE and RMSE indicate that our hybrid approach significantly improves prediction accuracy compared to alternative models. By integrating SARIMA's time series (TS) analysis with XGBoost's machine learning (ML) capabilities, the hybrid model reduces forecasting errors more effectively, demonstrating its clear advantage in precision.
Detection and Prediction of Toxic Aluminum Concentrations in High-Priority Salmon Rivers in Nova Scotia
Authors: Hart Kristin A. , Trueman Benjamin , Halfyard Edmund A. , Sterling Shannon M.
Published: October 2024

Elevated concentrations of toxic cationic aluminum (Ali) are symptomatic of terrestrial and freshwater acidification and are particularly toxic to salmonid fish species such as Atlantic salmon (Salmo salar). Speciated metal samples are rarely included in standard water monitoring protocols, and therefore the processes affecting Ali dynamics in freshwater remain poorly understood. Previous analysis of Ali concentrations in Nova Scotia (Canada) rivers found that the majority of study rivers had concentrations exceeding the threshold for aquatic health, but a wide-scale survey of Ali in Nova Scotia has not taken place since 2006 (Dennis, I. F., & Clair, T. A., 2012, Canadian Journal of Fisheries and Aquatic Sciences, 69(7), 1174–1183). The observed levels of dissolved aluminum in Atlantic salmon (Salmo salar) rivers of Atlantic Canada have potential serious and harmful effects for aquatic populations. We present the findings of the first large-scale assessment of the Ali status of Nova Scotia rivers in 17 years; we measured Ali concentrations and other water chemistry parameters at 150 sites throughout the Southern Uplands region of Nova Scotia from 2015 to 2022. We found that Ali concentrations exceeded toxic thresholds at least once during the study period at 80% of the study sites and that Ali concentrations increased during the study period at all four large-sample study sites. Modeling of relationships between Ali concentrations and other water chemistry parameters showed that the most important predictors of Ali are concentrations of the dissolved fractions of Al, iron, titanium, and calcium, as well as dissolved organic carbon and fluoride. We developed a fully Bayesian linear mixed model to predict Ali concentrations from a test data set within 15 μg/L. This model may be a valuable tool to predict Ali concentrations in rivers and to prioritize areas where Ali should be monitored. Environ Toxicol Chem 2024;43:2545–2556. © 2024 The Author(s). Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
Cocoa Pod Husk Meal as a Feed Ingredient for Livestock
Authors: Mael Sandy Hoffman
Published: September 2024

Cocoa pod husk (CPH) is a by‐product of cocoa. Whilst this by‐product is converted into animal feed in some countries, it is largely left to decompose and cause environmental issues in most South Pacific countries, including Vanuatu. The husk represent 70%–80% of the whole fruit. Its use as animal feed is limited by the presence of antinutritional factors, of which, theobromine is the most prominent. Other antinutritional factors include tannin and phytate. Feeding value of the CPH is improved by reducing these antinutritional factors through broiling, alkaline, and microbial treatment. Exogenous feed enzymes are used to hydrolyze crude fiber. Up to 10% of this by‐product is included in broiler feed and 15% with supplementation of exogenous feed enzymes in layer feed. In pigs, up to 20% can be included into diets of both the sow and growing pig. In ruminants, up to 35% can be used in cattle diet if treated with urea, molasses and/or fermented. The by‐product is widely used as an ingredient and/or energy/protein sources in Africa and Asia. There is scanty literature on its use in the South Pacific countries. In this review, I compiled existing literature on its chemical composition, use in livestock and poultry diets, and existing strategies to improve feeding value. The aim of this review is to project cocoa pod husk meal (CPHM) as a potential feed ingredient as well as energy/protein sources for livestock and poultry in the South Pacific countries, including Vanuatu.
Evaluation of whey protein coating containing free and Pickering emulsion forms of Trachyspermum copticum L. essential oil on quality of refrigerated beef
Authors: Saghari Vida , Jalali Hossein , Shariatifar Nabi , Ziaolhagh Seyedhamidreza
Published: September 2024

The purpose of the present research was to prepare a novel biodegradable coating of whey protein (whey) and essential oil of Trachyspermum copticum L. (forms of free (EO) and Pickering emulsion (NEO)) to improve the shelf life of beef. In this study, various microbiological, chemical, and sensory analyses were performed. The results showed that after 18 days, the highest and lowest microbiological counts were related to control samples and whey‐NEO treatments, respectively. The total viable count (TVC) was 8.2 and 6.8 log CFU/g, the total psychrotrophic count (TPC) was 8.5 and 6.7 log CFU/g, and the lactic acid bacteria (LAB) count was 7.7 and 6.5 log CFU/g for control and whey‐NEO treatments, respectively. Chemical analysis of whey‐NEO treatment and control sample were 6.3 and 7.5 for pH, 9.8 and 13.9 meq/kg for PV (peroxide value), 5.45 and 8.85 mg/kg for TBARS (thiobarbituric acid reactive substances), and 25.1 and 39.4 mgN/100 g for TVB‐N (total volatile basic nitrogen), respectively. The best result was associated with the whey‐NEO treatment; consequently, coatings with whey and EO Pickering emulsion should be considered as a potential active coating in the meat industry.
Characterizing second line and beyond therapies for primary central nervous system lymphomas
Authors: Primeaux Brian , Luo Chelsea , Yeung Erin K. , Linger Caitlin , Chen Sheree , Do Bryan
Published: September 2024

Primary central nervous system (CNS) lymphoma (PCNSL) is a rare and aggressive lymphoma that affects the CNS without other systemic involvement. High‐dose methotrexate (HDMTX)‐based regimens are recommended frontline treatment, followed by consolidation with either high‐dose chemotherapy, whole brain radiation (WBRT) +/− sequential temozolomide (TMZ), or autologous stem cell transplant (autoSCT). Despite advancements with HDMTX and rituximab, up to half of patients will relapse. Treatment for relapsed or refractory (R/R) disease varies widely as preferred regimens are not well‐established. Our study aimed to provide real‐world characterization of R/R PCNSL therapies. The secondary objective was characterization of consolidation methods after frontline treatment. This retrospective, descriptive analysis included 54 adult PCNSL patients that received a HDMTX‐based frontline regimen between 4/1/2016 and 7/1/2022. Patients receiving HDMTX for the purpose of secondary CNS lymphoma, non‐B cell origin PCNSL, and intraocular lymphoma were excluded. Thirty‐one patients (57%) received consolidation therapy with rituximab and high‐dose cytarabine (R‐HDAC), WBRT, or both. Thirteen patients (24%) proceeded with autoSCT. Twenty‐five patients had disease progression, with 17 patients receiving second line treatment. The second line treatments were WBRT (24%), clinical trial (18%), rituximab with lenalidomide (R2; 18%), re‐induction with HDMTX‐based regimens (18%), ibrutinib with rituximab (12%) and R‐HDAC (12%). Seven patients progressed, and all received third line treatment. Treatments varied, including R2; ibrutinib +/− HDMTX; rituximab, methotrexate, and cytarabine; R‐HDAC; R‐nivolumab; and WBRT. Five patients received a fourth line regimen of R +/− lenalidomide, R‐HDMTX, or nivolumab monotherapy. Regimens used for the three patients who received fifth line treatment and beyond included R‐TMZ and pembrolizumab monotherapy in addition to previously described regimens. Regimen selection is varied and highly dependent on physician preference and patient factors, including clinical trial eligibility, prior therapies, performance status, organ function, and treatment intent. Prospective clinical trials are needed to guide optimal management.
A new treatment approach of toripalimab in combination with concurrent platinum‐based chemoradiotherapy for locally advanced cervical cancer: A phase II clinical trial
Authors: Chen Jie , Shi Jinming , Cao Yuanjie , Li Chen , Li Junyi , Yuan Zhiyong
Published: September 2024

This study investigated the efficacy and safety of toripalimab in combination with concurrent platinum‐based chemoradiation in patients with untreated locally advanced cervical cancer. Eligible patients received toripalimab 240 mg once every 3 weeks in combination with concurrent platinum‐based chemoradiotherapy, followed by the maintenance of toripalimab once every 6 weeks up to 1 year. The primary endpoint was objective response rate (ORR). Secondary endpoints included 2‐year and 3‐year progression‐free survival (PFS) rates, 3‐year overall survival (OS) rate, and safety. Biomarker analysis of PD‐L1 expression and genomic mutational analysis by next‐generation sequencing were conducted, as well as PD‐L1 expression on tumor biopsies. A total of 82 patients were enrolled. The median follow‐up was 21 months (range, 5.2–44.5 months). The ORR and disease control rate were both 87.8% among the 82 patients. Median PFS and OS were not reached. A trend toward longer PFS was observed in the populations with a PD‐L1 combined positive score ≥10, low tumor mutation burden and loss of heterozygosity in human leukocyte antigen (HLA LOH) detected populations. A total of 37 patients experienced treatment‐related adverse events, of which 17 (20.7%) patients experienced grade 3 or higher adverse events. Collectively, toripalimab plus concurrent platinum‐based chemoradiotherapy showed promising antitumor efficacy with acceptable safety profiles in patients with untreated locally advanced cervical cancer.
Menstrual management using the etonogestrel implant in individuals with intellectual disabilities in Joinville, Brazil
Authors: Braga Giordana Campo , Zarabia Carla Josene , da Trindade Adriana Kelly Soares de S. , Vieira Carolina Sales
Published: October 2024

Objective

This study aimed to describe the use of etonogestrel (ENG) implants for menstrual management (i.e., management of bleeding and symptoms associated with menstruation) in individuals with intellectual disabilities.

Methods

This study retrospectively analyzed a cohort of individuals with intellectual disabilities who began using ENG implants between 2003 and 2018, in Joinville, Brazil. We collected sociodemographic, clinical, and reproductive data from the medical records, along with information related to ENG implant use.

Results

In total, 369 implants were placed in 130 individuals with intellectual disabilities. The median age at the first implant was 20 (interquartile range [IQR], 17–26) years, and 43.8% of the patients were adolescents. By December 2018, 90 patients had received two or more subsequent implants. The median duration of current ENG implant use was 19 (IQR, 12.8–22) months. More than 40% of the patients had comorbidities, with epilepsy being the most common. During the use of the current implant, 80% of the patients had a favorable bleeding profile (no bleeding or ≤1 bleeding episode per month), and 53.8% (70/130) had no bleeding within 3 months before their last medical visit. Among patients experiencing dysmenorrhea and premenstrual syndrome (PMS), 79% (64/81) and 82% (54/66) reported complete improvement, respectively. The premature implant removal rate was 8.9% (33/369). Unfavorable bleeding was the main reason for premature implant removal (20 out 33 removals).

Conclusions

ENG implants might be a suitable option for individuals with intellectual disabilities who require management of menstrual bleeding and symptoms associated with menstruation. Most patients had a favorable bleeding profile and experienced significant improvements in dysmenorrhea and PMS, contributing to the high continuation rates of ENG implants.
Anticoagulant therapy in pregnant women with mechanical and bioprosthetic heart valves
Authors: Rhemtula Haroun A. , Schapkaitz Elise , Jacobson Barry , Chauke Lawrence
Published: September 2024

Objective

The aim of the present study was to review maternal and fetal outcomes in pregnant women with prosthetic heart valves.

Methods

A retrospective record review of pregnant women with prosthetic heart valves on anticoagulation was performed at the Specialist Cardiac Antenatal Clinic, Johannesburg South Africa from 2015 to 2023.

Results

Fifty pregnancies with mechanical heart valves and three with tissue valves, on anticoagulation for comorbid atrial fibrillation were identified. The majority were of African ethnicity at a mean age of 33 ± 6 years. Anti‐Xa adjusted enoxaparin was commenced at 10.5 ± 5.6 weeks' gestation until delivery in 48 (90.6%) pregnancies and warfarin was continued in five (9.4%) pregnancies. The live birth rates on enoxaparin and warfarin were 56.3% (95% confidence interval [CI]: 42.3–69.3) and 20.0% (95% CI: 2.0–64.0), respectively. There were 12 (22.6%) miscarriages at a mean of 11.3 ± 3.7 weeks' gestation, four (7.5%) intrauterine fetal deaths on warfarin and two (3.8%) warfarin embryopathy/fetopathy. The rates of antepartum/secondary postpartum bleeding and primary postpartum bleeding were 29.4% (95% CI: 18.6–43.1) and 5.9% (95% CI: 1.4–16.9), respectively. Maternal complications included anemia (n = 11, 20.8%), arrhythmia (n = 2, 3.8%), heart failure (n = 2, 3.8%) and paravalvular leak (n = 2, 3.8%). There was one (1.9%) mitral valve thrombosis and one (1.9%) stuck valve in pregnancies who defaulted warfarin prior to pregnancy. There were no maternal deaths.

Conclusion

Multidisciplinary management of pregnant women with prosthetic heart valves with anti‐Xa adjusted low molecular weight heparin throughout pregnancy represents an effective anticoagulation option for low‐middle‐income countries.
Short and sweet: Comparing strategies for the reduction of questionnaires on self‐criticism and social safeness while preserving construct validity
Authors: Passarelli Marcello , Casetta Laura , Rizzi Luca , Chiorri Carlo , Cassina Francesca , Voi Sandro , Rocco Diego
Published: September 2024

Measuring psychological traits with standardised questionnaires is an essential component of clinical practice and research; however, patients and participants risk fatigue from overly long and repetitive measures. When developing the short form of a questionnaire, the most widely used method for selecting an item subset uses factor analysis loadings to identify the items most closely related to the psychological construct being measured. However, this approach will tend to select highly correlated, homogeneous items and might therefore restrict the breadth of the construct examined. In this study, we will present Yarkoni's genetic algorithm for scale reduction and compare it with the classical scale reduction method. The algorithm will be applied to the shortening of three instruments for measuring self‐compassion and social safeness (two unidimensional measures and a three‐factor measure). We evaluated the shortened scales using correlation with long‐form scores, internal reliability and the change in the correlations observed with other related constructs. Findings suggested that the classical method preserves internal reliability, but Yarkoni's genetic algorithm better maintained correlations with other constructs. An additional qualitative assessment of item content showed that the latter method led to a more heterogeneous selection of items, better preserving the full complexity of the constructs being measured.
Simultaneous robotic hemicolectomy and robotic partial nephrectomy via a posterior approach
Authors: Ishida Masaru , Yamada Toru , Takeuchi Rei , Jin Yuta , Katsumata Kaori , Saito Takafumi , Arai Masashi , Sanjo Tansei , Anno Tadatsugu , Egawa Tomohisa
Published: September 2024

Introduction

Advances in diagnostic technologies have resulted in an increase in patients with synchronous cancers. We report robotic hemicolectomy and robotic partial nephrectomy via a posterior approach.

Case presentation

A 72‐year‐old woman presented with synchronous ascending colon and right kidney cancers. We performed simultaneous robotic right hemicolectomy and robotic right partial nephrectomy. The renal tumor was located in a posterior and mid‐lower pole of the kidney, we positioned the ports similar to the retroperitoneal approach and to gain a confronting approach to the tumor.

Conclusion

Considering preoperative evaluations and intraoperative conditions comprehensively, it is essential to flexibly adapt to the appropriate surgical position and port arrangement to perform the surgery with consideration for oncological principles.
Developments in public meteorological services
Authors: Malcorps H
Published: September 2024

National Meteorological Services were founded during the second half of the nineteenth century, after the development of basic meteorological instruments and the discovery of physical laws. In the past, meteorology took rapid advantage of technical developments. The expansion of meteorological resources was mainly due to the ascent of navigation and aeronautics. From 1960 on, the development of meteorological services became more and more influenced by non‐technical aspects such as international cooperation, concern for the environment and efforts towards rolling back the activities of the state. As a consequence of the general tendency to roll back the state, all the public services have to reconsider their role and their cooperation with other public services.
Forecasting thunderstorm initiation in north‐west Europe using thermodynamic indices, satellite and radar data
Authors: Collier C G , Lilley R B E
Published: September 2024

A climatology of the occurrence of thunderstorms over north‐west Europe is described based upon an analysis of synoptic data, polar‐orbiting satellite infrared imagery and high‐resolution sferics data. The close relationship of thunderstorm initiation to orography, storm movements and the location of maximum storm intensity are illustrated. A number of instability indices derived from radiosonde data obtained from stations throughout north‐west Europe are objectively assessed both singularly and in combination. It is recommended that a forecast rule be used based upon taking the occurrence of a thunderstorm to be likely when any one of the indices indicates the occurrence of a thunderstorm. Additional methods of forecasting the location of thunderstorms using satellite data and techniques based upon the objective recognition of appropriate conceptual models are discussed. This leads to a proposed approach to a thunderstorm forecasting system to address the specific needs of operational hydrology.
Pascal's uncertainty principle: Managing drug–drug interactions when the risks are unclear
Authors: Hansten Philip D. , Gomez‐Lumbreras Ainhoa , Villa‐Zapata Lorenzo , Malone Daniel C.
Published: September 2024

Therapeutic decision‐making (TDM) often occurs under conditions of scientific uncertainty, including decisions on how to manage the majority of drug–drug interactions (DDIs). The existence of many DDIs is not firmly established, and there is an unfortunate tendency to make decisions based on the binary assessment of whether or not a particular DDI is real, rather than taking a more probabilistic and holistic approach to TDM. There also seems to be an undue fear of making a Type I error (assuming the DDI is real when it is not) while ignoring the often much greater risk of a Type II error (assuming the DDI is not real, when it is). Thus, a more rational TDM process for such DDIs is needed. In his famous “Wager,” philosopher‐mathematician Blaise Pascal made a probabilistic argument for believing in God. Instead of considering probability in isolation, Pascal linked the probability of God's existence with the severity of the outcome (an eternity in Hell for non‐believers) and also added a third factor—the ease with which the risk can be avoided. We propose a novel paradigm for TDM that uses all three of Pascal's steps: probability, severity, and avoidability. We present several specific DDI examples to demonstrate how Pascal's Uncertainty Principle can help pharmacists make clinical management decisions for these DDIs. We suggest that this process be called “Pascal's Uncertainty Principle” rather than “Pascal's Wager,” because it can be used to make rational decisions in the presence of uncertainty in many non‐theological situations. This process reinforces the value of philosophical training for pharmacy students.
Resources for innovative learning of anatomy and foot ossification: Graphic design and virtual reality
Authors: Moreno‐Marin Ana Cristina , Pardo Rios Manuel , Lopezosa‐Reca Eva , Molina García Cristina , Díaz‐Miguel Salvador , Gómez‐Martín Beatriz , Cobos‐Moreno Paula
Published: September 2024

Introduction

This study addresses the ossification process of the foot, a topic of great relevance within podiatry courses. Understanding the chronology of foot bone formation is essential for evaluating pathological processes and establishing appropriate therapeutic actions to improve patient quality of life. The main objectives of this work are to understand the ossification process of the foot bones and to propose an appropriate didactic methodology for effective learning of this process.

Materials and Methods

The individual ossification sequences of the foot bones were established and virtually recreated to make these processes more didactic and usable as teaching aids. The literature search was conducted using the PRISMA statement, focusing on terms, such as “bone ossification,” “foot,” and “bone development,” and included relevant studies from medical databases.

Results

Updating the ossification ages and providing previously unavailable visual teaching material offers a useful tool for improving the teaching of this subject. It was found that, in general, the tarsal bones show significant differences in ossification ages between sexes, with later and slower ossification in males. These differences are statistically analyzed and presented in detailed comparative tables.

Conclusions

The use of innovative teaching tools, such as virtual anatomical models, helps students to better understand the ossification process of foot bones. Implementing these tools in the podiatry curriculum not only facilitates knowledge acquisition but also enhances the quality of teaching and, consequently, the future clinical practice of students.
Neuroimaging Findings From Cerebral Structure and Function in Coronary Artery Disease
Authors: Wang Wanbing , Zhang Xinghua , Lyu Jinhao , Duan Qi , Yan Fei , Li Runze , Xing Xinbo , Li Yanhua , Lou Xin
Published: September 2024

An increasing number of evidence suggests that bidirectional communication between the cardiovascular system and the central nervous system (CNS), known as the heart–brain interaction, is crucial in understanding the impact of coronary artery disease (CAD) on brain health. The multifactorial role of CAD in the brain involves processes such as inflammation, oxidative stress, neuronal activity, neuroendocrine imbalances, and reduced cerebral perfusion, leading to various cerebral abnormalities. The mechanisms underlying the relationship between CAD and brain injury are complex and involve parallel pathways in the CNS, endocrine system, and immune system. Although the exact mechanisms remain partially understood, neuroimaging techniques offer valuable insights into subtle cerebral abnormalities in CAD patients. Neuroimaging techniques, including assessment of neural function, brain metabolism, white matter microstructure, and brain volume, provide information on the evolving nature of CAD‐related cerebral abnormalities over time. This review provides an overview of the pathophysiological mechanisms of CAD in the heart–brain interaction and summarizes recent neuroimaging studies utilizing multiparametric techniques to investigate brain abnormalities associated with CAD. The application of advanced neuroimaging, particularly functional, diffusion, and perfusion advanced techniques, offers high resolution, multiparametric capabilities, and high contrast, thereby allowing for the early detection of changes in brain structure and function, facilitating further exploration of the intricate relationship between CAD and brain health.

Level of Evidence

5

Technical Efficacy

Stage 3
Open or closed: Experience of head and neck radiotherapy masks – A mixed‐methods study
Authors: Lundin Erik , Axelsson Sofia , Ohlsson‐Nevo Emma
Published: September 2024

Introduction

In radiotherapy for head and neck cancer, a mask is used to immobilise the head and shoulders. An open mask that does not cover the face is expected to cause less anxiety, but there is need to further investigate the patients' experience of open versus closed masks. Therefore, the aim of this study is to evaluate patient preferences for open or closed masks and whether an open mask can reduce discomfort and anxiety for patients.

Methods

Twenty participants were treated in alternating weeks using open and closed masks. Their distress was evaluated through semi‐structured interviews and patient‐reported outcome measures.

Results

When using the open mask, it took longer to position the patient correctly. The closed mask felt more confining and could induce a sense of claustrophobia. Participants employed both internal and external strategies to cope with the stressful situation. The Hospital Anxiety and Depression Scale (HADS) showed a significant reduction in anxiety over time during the treatment period, but no significant difference between the masks. When participants chose which mask to use for the final treatments, 12 chose the open mask, while 8 chose the closed mask. In addition to the 20 analysed participants, two participants withdrew from the study because they could only tolerate the open mask, one due to anxiety and the other due to swelling.

Conclusions

The open mask seems to provide a less confined experience but may lead to greater difficulties in achieving the correct treatment position. While both masks can be viable options for most patients, some cannot tolerate closed masks but do tolerate open masks.
Diagnosis of 42 Cases of Intrauterine Twin Pregnancy Complicated With Ectopic Pregnancy
Authors: Zheng Mingxiang , Wen Yi , Wang Hengxu , Peng Yangqin , Fei Gong , Hui Chen , Ouyang Yan , Li Xihong
Published: September 2024

Objectives

The coexistence of intrauterine twin pregnancy and ectopic pregnancy (EP), known as heterotopic pregnancy, is a rare but potentially life‐threatening condition. In this study, we aimed to investigate the pregnancy outcomes in women with intrauterine twin pregnancies complicated with EP after assisted reproductive technology.

Methods

This retrospective study analyzed the medical records of 42 women diagnosed with intrauterine twin pregnancies complicated with EP via ultrasound or surgery at our hospital between January 2005 and December 2020. We collected data on patient general characteristics, high‐risk factors, clinical symptoms, ultrasound features, treatment methods, and pregnancy outcomes.

Results

Among the 42 included women, 47.6% (20/42) had a history of tubal surgery, while 52.4% (22/42) and 47.6% (20/42) received the transfer of 2 and 3 embryos, respectively. In terms of treatment, 21.4% (9/42) women received expectant management, whereas 78.6% (33/42) underwent surgical treatment, with laparoscopic surgery accounting for 71.4% (30/42). Tracking the pregnancy outcomes revealed a live birth rate of 81.0% (34/42) and a full‐term birth rate of 50.0% (21/42). The preterm birth rate was 31.0% (13/42), with a breakdown of 1 singleton (7.7%, 1/13) and 12 twin births (92.3%, 12/13) among the total 13 premature deliveries. Among the neonates, 33.3% (14/42) were singletons and 47.6% (20/42) twins. Caesarean section accounted for 31 out of 34 deliveries (91.2%).

Conclusions

Though the incidence of EP in twin pregnancies has declined in the last decade, early diagnosis and proper management are still crucial for favorable outcomes in twin pregnancies with EP.
Kids are not just small adults: An attempt to validate pediatric tablet‐based digits in noise testing
Authors: Dunlap Allyson , McBride Morgan , Tuominen Alison , Roby Brianne , Redmann Andrew , Meyer Abby , Herd Hannah , Meyer Cassandra , Chinnadurai Sivakumar , Finch Michael , Jayawardena Asitha D. L.
Published: September 2024

Objective

The objective of this study is to investigate whether conductive hearing loss (CHL) can be differentiated from sensorineural hearing loss in children ages 3–18 using a diotic and antiphasic digits‐in‐noise (DIN) tablet‐based test using existing adult cut‐off criteria.

Methods

A blinded multi‐institutional prospective cohort of 64 children aged 3–18 scheduled for an audiometric soundbooth evaluation with a pediatric audiologist and a same‐day otolaryngologist examination were recruited for the study. Following a conventional audiogram, the subjects underwent diotic (same‐phased stimuli) and antiphasic (out‐of‐phase stimuli) DIN testing on a HearX Samsung Galaxy tablet with over‐the‐ear headphones, for a total of 128 measurements. DIN test results were compared with soundbooth audiometry using known adult “cut off criteria.”

Results

A logistic regression analysis adjusted for demographics (age, sex) and race was performed to compare CHL determination from DIN testing to CHL determination with soundbooth audiometry. The results showed 50% agreement with a p‐value of .753. The determinations based on combined DIN testing agreed with each other 33% of the time and had a p‐value of .373. Otologic pathology and age were not predictive of outcome.

Conclusion

This preliminary analysis of DIN testing indicated that DIN and audiometric testing completed in a soundbooth were not significantly predictive of one another in the population of children aged 3–18 when using the adult cut‐off criteria for CHL differentiation. Given these findings, further testing is required in children to determine pediatric specific cut‐off values.
A MAUDE database analysis on the new generation of active bone conduction hearing implants
Authors: Lein Alexander , Baumgartner Wolf‐Dieter , Landegger Lukas D. , Riss Dominik , Thurner Thomas , Liu David T. , Kosec Andro , Vyskocil Erich , Brkic Faris F.
Published: September 2024

Objective

To analyze medical device reports (MDR) submitted to the Food and Drug Administration's (FDA) Manufacturer and User Device Facility Experience (MAUDE) database to identify adverse events (AEs) in patients implanted with novel active bone conduction hearing implants (BCIs).

Methods

We conducted a search of the FDA MAUDE database on the newest generation of BCIs. Data were collected concerning device malfunctions, patient injuries, factors triggering these incidents, and the subsequent actions taken.

Results

In total, 93 (16.7%) device malfunctions and 465 (83.3%) patient injuries with 358 subsequent interventions were identified, resulting in 558 AEs. Although the absolute AE number per device cannot be identified, the following trends were detected: Among the 494 AEs associated with OSI200, 55 (11.1%) reported device malfunctions and 454 (88.9%) cited patient injuries. Out of the 64 AEs linked to BCI602, 28 (59.4%) were associated with malfunctions, whereas 26 (40.6%) involved patient injuries. The most frequently reported particular AEs for the OSI200 were infection (n = 171, 34.6%), extrusion of the device (n = 107, 21.7%), and pain (n = 51, 10.3%). Conversely, no device output (n = 20, 31.3%) and loss of osseointegration (n = 7, 10.9%) were the most reported AEs for the BCI602. Various AEs led to 214 explanations and 77 revision surgeries. Sixty‐seven AEs reported conservative treatment.

Conclusion

The current study provides an overview of the most commonly reported complications with new active BCIs. Although providing an overview, given the limitations of the FDA MAUDE database, our results have to be interpreted with caution.

Level of Evidence

4.
Extreme plasticity in the photosystem composition of a low‐light Prochlorococcus ecotype in response to iron and light
Authors: Zhang Xin , Sunda William G. , Hong Haizheng , Shi Dalin
Published: September 2024

Light affects the cellular iron (Fe) requirement of phytoplankton because of its presence in major photosynthetic proteins. Thus, interactions between variable Fe concentrations and light intensities could restrict photosynthetic carbon fixation in the ocean. Here we show a narrowing of the optimal light range for growth of a marine cyanobacterium, Prochlorococcus strain NATL1A, a member of LLI ecotype, under Fe limitation. The response of the cells to variations in Fe and light involved differential changes in the cellular content of low‐Fe photosystem II (PSII) and Fe‐rich photosystem I (PSI), and associated up to 23‐fold changes in PSII : PSI ratios, showing an unprecedented extreme plasticity of the photosynthetic apparatus. Our study demonstrated the physiological effects of Fe and light interactions on this low‐light‐adapted Prochlorococcus strain, and increases our understanding of the reasons for the wide distribution of this and possibly other Prochlorococcus strains in the ocean.
Synergistic Mechanoluminescence and Mechanochromism Via Triboelectrification‐Induced Eu3+/Eu2+ Redox Shuttle
Authors: Du Rong‐Kai , He Xu‐Lin , Xiao Tai‐Zhong , Xiang Yue‐Fei , Zhong Lei , Zhou Lei , Zhang Jun‐Cheng , Yao De‐Qiang , Sun Tian‐Ying , Wu Ming‐Mei
Published: September 2024

Materials capable of simultaneously achieving both mechanoluminescence (ML) and luminescent mechanochromism (L‐MC) hold great promise in smart stimuli‐responsive applications. However, single‐phase and single‐doped inorganic ML materials with pronounced L‐MC behavior are exceptionally rare because of their single luminescent center. This study investigates a unique L‐MC phenomenon in a series of novel triboelectrification‐induced ML materials, Sr5(PO4)3X:Eu3+ (X = F, Cl, Br). These materials exhibit the in situ ionic valence state transition and excitation behaviors of the Eu3+‐Eu2+ ion pair by utilizing the inherent properties of triboelectrification and cause significant differences in the emission spectra during the photoluminescence and ML process. The redox reactions of Eu ions in the ML process are influenced by the synergistic action of the Eu3+‐Eu2+ redox shuttle (suitable redox potential), triboelectrification (driving force), and Sr ion vacancies (catalysts). Hence, this study presents direct experimental evidence for the underlying mechanism of ML and advances the development and applications of triboelectrification‐induced ML materials.
Heterogeneous Catalysts Catalyzed Photo‐Atom Transfer Radical Polymerization (Photo‐ATRP)
Authors: Chen Guanying , Guo Xiaoyu , Hu Bo , Lei Lin
Published: September 2024

Photo‐ATRP technique has garnered significant attention due to its multitude of advantages, including its ability to be conducted under mild reaction conditions, user‐friendly nature, and exceptional efficiency in polymerization. The heterogeneous photocatalysts not only exhibit exceptional quantum efficiency, but also possess a versatile bandgap that can be finely adjusted to accommodate a wide range of absorption wavelengths within the visible light spectrum, thereby emphasizing their potential for efficient recovery and reuse. The utilization of a variety of heterogeneous photocatalysts in photo‐ATRP presents notable benefits for numerous applications, such as the lack of any remaining substances, simplicity in usage, and potential for reuse. This review focuses on recent progress in photo‐ATRP utilizing a wide variety of heterogeneous photocatalysts, encompassing metal semiconductor nanoparticles, quantum dot, upconversion nanoparticles, metal–organic frameworks, covalent–organic frameworks, conjugated microporous polymers, hypercrosslinked polymer, and carbon‐based materials.
Dystonic Tremor as Main Clinical Manifestation of SCA21
Authors: Yahya Vidal , Baiata Claudio , Monfrini Edoardo , Correia Sandrine , Brescia Gloria , Di Fonzo Alessio , Moro Elena
Published: September 2024

Background

Spinocerebellar ataxia type 21 (SCA21) is a rare inherited neurological disorder characterized by motor, cognitive, and behavioral disturbances, caused by autosomal dominant TMEM240 variants.

Objectives

To identify the genetic cause of a dystonic tremor with autosomal dominant inheritance.

Methods

Six subjects of a multi‐generational French family affected by tremor and dystonia were studied. Each patient underwent a comprehensive clinical assessment and a whole‐exome sequencing analysis.

Results

All six subjects presented with early‐onset prominent hand dystonic tremor and multifocal/generalized dystonia, secondarily developing mild cerebellar ataxia. The younger generation showed more pronounced cognitive and behavioral impairment. The known pathogenic TMEM240 c.509C>T (p.P170L) variant was found in heterozygosis in all subjects.

Conclusions

Dystonic tremor can represent the core clinical feature of SCA21, even in absence of overt cerebellar ataxia. Therefore, TMEM240 pathogenic variants should be considered disease‐causing in subjects displaying dystonic tremor, variably associated with ataxia, parkinsonism, neurodevelopmental disorders, and cognitive impairment.
Awareness of protections can boost transgender well‐being
Authors: Enos Gary
Published: September 2024

The often‐heated policy environment around transgender and nonbinary individuals has had a demonstrated negative impact on these individuals' mental health, but results of a new study have identified a potential protective factor for transgender adults.
MHA: Community‐focused MH programs promoting equity
Authors: Canady Valerie A.
Published: September 2024

Community‐based programs are critical to improving equitable access to mental well‐being around the country and to achieving important outcomes for communities, according to panelists at a Mental Health America conference session on Sept. 20 in Washington, D.C. (see related story beginning on page 1).
A vision transformer‐based deep transfer learning nomogram for predicting lymph node metastasis in lung adenocarcinoma
Authors: Chen Chuanyu , Luo Yi , Hou Qiuyang , Qiu Jun , Yuan Shuya , Deng Kexue
Published: September 2024

Background

Lymph node metastasis (LNM) plays a crucial role in the management of lung cancer; however, the ability of chest computed tomography (CT) imaging to detect LNM status is limited.

Purpose

This study aimed to develop and validate a vision transformer‐based deep transfer learning nomogram for predicting LNM in lung adenocarcinoma patients using preoperative unenhanced chest CT imaging.

Methods

This study included 528 patients with lung adenocarcinoma who were randomly divided into training and validation cohorts at a 7:3 ratio. The pretrained vision transformer (ViT) was utilized to extract deep transfer learning (DTL) feature, and logistic regression was employed to construct a ViT‐based DTL model. Subsequently, the model was compared with six classical convolutional neural network (CNN) models. Finally, the ViT‐based DTL signature was combined with independent clinical predictors to construct a ViT‐based deep transfer learning nomogram (DTLN).

Results

The ViT‐based DTL model showed good performance, with an area under the curve (AUC) of 0.821 (95% CI, 0.775–0.867) in the training cohort and 0.825 (95% CI, 0.758–0.891) in the validation cohort. The ViT‐based DTL model demonstrated comparable performance to classical CNN models in predicting LNM, and the ViT‐based DTL signature was then used to construct ViT‐based DTLN with independent clinical predictors such as tumor maximum diameter, location, and density. The DTLN achieved the best predictive performance, with AUCs of 0.865 (95% CI, 0.827–0.903) and 0.894 (95% CI, 0845–0942), respectively, surpassing both the clinical factor model and the ViT‐based DTL model (p < 0.001).

Conclusion

This study developed a new DTL model based on ViT to predict LNM status in lung adenocarcinoma patients and revealed that the performance of the ViT‐based DTL model was comparable to that of classical CNN models, confirming that ViT was viable for deep learning tasks involving medical images. The ViT‐based DTLN performed exceptionally well and can assist clinicians and radiologists in making accurate judgments and formulating appropriate treatment plans.
Prevalence of sarcopenic obesity among older adults in communities of China: A multicenter, cross‐sectional study
Authors: Yang Jing , Wang Yu , Shi Xiaodong , Liu Yan , Ge Sheng , Li Shengqi , Wang Yueming , Li Fei , Suryawanshi Pranali , Chen Wei
Published: September 2024

Background

This study investigated the prevalence of sarcopenic obesity (SO) among older adults in Chinese communities and its association with chronic diseases.

Methods

We conducted a post‐hoc analysis of a 2014–2015 multicenter cross‐sectional study involving adults aged ≥60 years from three representative cities in China. The Asian Working Group for Sarcopenia diagnostic criteria and Chinese local cutoffs were employed to define SO. Data on medical history, lifestyle, quality of life, and cognitive function were collected.

Results

The overall prevalence of SO was 3.58% in men and 2.88% in women among 2821 participants. There was a notable increase in prevalence with age, with rates reaching 6.58% for men and 4.40% for women aged 70–79 years. In the group aged ≥80 years, the prevalence rate increased significantly, reaching 13.16% for men and 18.18% for women. Those with SO had higher body mass index (25.29 ± 1.55 kg/m² vs 24.16 ± 2.48 kg/m²; P < 0.001) and triceps skinfold thickness (21.17 ± 5.93 mm vs 19.34 ± 6.87 mm; P < 0.05) than the normal group. The prevalence of cardiovascular disease (15.38% vs 6.59%; P < 0.01), hypertension (56.04% vs 38.93%; P < 0.01), and stroke (7.69% vs 2.25%; P < 0.01) was also significantly higher in the SO group. Logistic regression showed that those with SO were more likely to have cardiac disease (odds ratio [OR] = 2.20; P = 0.016) and stroke (OR = 2.61; P = 0.039).

Conclusion

The prevalence of SO increases with age among the older adult population in China, notably after age 80 years. SO individuals were more likely to have cardiac disease and stroke. It is important to focus on early identification and management strategies.
Navigating the Discrepancy: How Cost of Living (COL) Adjustments Impact Otolaryngology Residents' Salaries
Authors: Nanu Douglas P. , Tiwana Hardeep S. , Akella Deepthi S. , Nguyen Shaun A. , Khan Sofia , Carr Michele M.
Published: October 2024

Objective

To compare differences in otolaryngology residents' salaries in different cities and states before and after adjusting for the cost of living.

Study Design

Cross‐sectional analysis.

Setting

Accreditation Council for Graduate Medical Education (ACGME) otolaryngology residency program websites.

Methods

US otolaryngology residency programs were identified via the ACGME database in December 2023. Stipends posted by each residency program were compared to the cost of living (COL) for related states and major cities. A baseline value of 100 was used as the mean COL, values over 100 indicate above‐mean COL. The weighted salary by state and cities for postgraduate year (PGY) 1 to 5 combined was expressed as mean (SD). Comparisons between salaries before and after adjustment for the COL were assessed using t tests.

Results

The mean otolaryngology residency stipend across the nation, by city, was $70,572 (n = 1290, range: $58,100‐$93,402; SD = $8370), with a post‐COL adjustment mean stipend of $64,055 (range: $39,193‐$76,674, SD = $10,094, p < .001). Otolaryngology residents in Manhattan, New York State faced a mean decrease from $89,282 to $39,193 (−56%) post‐COL adjustments. Following that were Boston and Los Angeles programs which saw a −$26,402 (−32%) and −$24,761 (−32%) mean decrease after COL adjustments, respectively.

Conclusion

Otolaryngology residents in high‐cost areas experience significant salary reductions because of COL adjustments, resulting in financial strain. Residents in such regions endure increased financial pressure compared to those in low‐cost areas, as current salaries fail to align with living expenses.