bluuebunny/crossref_metadata_2025 huggingface dataset:
Impatiently Waiting: Women Managers, Professionalism, Psychological Costs, and the Reduction of ER Wait Times
Authors: McCrea Austin M.
Published: August 2024

Administrative burden has emerged as a key theoretical framework for understanding onerous, burdensome, and slow citizen-state interactions. While most work to-date focuses on how the political process generates burdens, how citizens experience burdens, and how burdens affect street-level bureaucrats, this manuscript focuses on the understudied link between management and administrative burden. This link is essential to understanding administrative burden because burdens are often reflected in bureaucratic logics, standard operating procedures, and other administrative tools—all facets of an organization which management possesses some power over. This manuscript develops an argument which links the literature on gendered management, representative bureaucracy, and sex-based selection with reduction in wait times (a dimension ripe with psychological costs) since women in management positions tend to be more relational, transformational, and process-oriented than men, all behavioral characteristics which may link onto administrative burdens in predictable ways. An empirical test linking women managers to a reduction of wait times in Florida emergency departments reveals that hospitals managed by women observe lower wait times, on average, across four out of six interrelated processes. Supplemental analyses examine the link between professionalism and gender and find that women with a health background are effective in reducing some of the most complex dimensions of waiting.
Parametric Study on Transversely Cracked Precast Prestressed Concrete Bridge Deck Girders with Rectangular Voids
Authors: Gunasekaran Dachina , Andrawes Bassem
Published: August 2024

Transverse cracks in precast prestressed concrete (PPC) bridge deck girders cause a notable increase in strand stresses and adversely affect the cracked girder’s capacity and durability. This numerical study analyzes the impact of transverse cracks on the behavior of PPC bridge deck girders by relating the crack width to the residual capacity, stresses, and load rating of the cracked girders. A non-linear finite element (FE) model is developed to understand the behavior and predict the stresses in an in-service PPC bridge deck girder damaged by a transverse crack. The residual capacity and built-up stresses obtained from the FE model are used in the load rating analysis of the cracked PPC bridge deck girder. A parametric study is conducted to understand the effect of the influencing parameters, such as the girder geometry and material properties, on the damaged girder’s behavior. For an 838 mm × 914 mm PPC deck girder, the statistically significant parameters are found to be the span length ( L), strand diameter ( db), and skew angle ([Formula: see text]). From the numerical analysis of the in-service PPC bridge deck girder, the load rating is predicted to be governed by the capacity for the existing 0.25 mm crack. In the parametric study of the 838 mm × 914 mm PPC deck girder, the inventory rating factor of the prestressing strands in tension is predicted to decrease linearly for crack width up to 0.64 mm, while the capacity inventory rating factor is predicted to decrease by up to 73.8% for the crack width of 0.64 mm.
CHA2DS2-VASc Score as Predictor of New-Onset Atrial Fibrillation and Mortality in Critical COVID-19 Patients
Authors: Ioannidis Panagiotis S. , Sileli Maria , Kerezidou Eleni , Kamaterou Myrto , Iasonidou Christina , Kapravelos Nikos
Published: August 2024

Background

Pre-existing and new-onset atrial fibrillation (NOAF) is a common arrhythmia in COVID-19 patients and is related to increased mortality. CHA2DS2-VASc score was initially developed to evaluate thromboembolic risk in patients with AF. Moreover, it predicted adverse outcomes in other clinical conditions, including SARS-CoV-2 infection. We aimed to evaluate the association of CHA2DS2-VASc with NOAF, ICU length of stay (LOS) and mortality in critically ill COVID-19 patients. We also examined the relationship of NOAF with mortality. We reviewed the literature to describe the link between cardiovascular risk factors and inflammatory response of severe COVID-19.

Methods and results

We retrospectively studied 163 COVID-19 patients admitted to a level 3 general ICU from March 2020 to April 2022. Patients were of advanced age (median 64 years, IQR 56.5-71) and the majority of them were male (67.5%). Regarding NOAF, we excluded 12 patients with AF history. In this group, CHA2DS2VASc score was significantly elevated (3 IQR (1-4) versus 1 IQR (1-2.75), p = 0.003). Specifically, three components of CHA2DS2VASc were notably increased: age (p < 0.001), arterial hypertension (p = 0.042) and stroke (p = 0.047). ICU mortality was raised in the NOAF group [75.8% versus 34.8%, p < 0.001 OR 5.87, 95% CI (2.43, 14.17)]. This was significant even after adjusting for ICU clinical scores (APACHE II and SOFA). About mortality in the entire sample, survivors were younger (p = 0.001). Non-survivors had greater APACHE II (p = 0.04) and SOFA (p = 0.033) scores. CHA2DS2VASc score was positively associated with mortality [p = 0.031, OR 1.28, 95% CI (1.03, 1.6)]. ICU length of stay was associated with mortality (p = 0.016) but not with CHA2DS2VASc score (p = 0.842).

Conclusions

NOAF and CHA2DS2VASc score were associated with higher mortality in COVID-19 ICU patients. CHA2DS2VASc score was also associated with NOAF but not with ICU LOS.
Exploration and Practice of Introducing the Pharmaceutical Care Network Europe Classification System to Psychiatric Drugs
Authors: Shi Menglan , Ma Yan , Li Hong , Li Fangjie , Shen Shujuan
Published: August 2024

This research aims to summarize and discuss issues related to psychiatric drugs by using the classification system of the Pharmaceutical Care Network Europe (PCNE) and to provide a reference for the development and direction of clinical pharmacists’ work in the future. Psychiatric patients who were hospitalized in our hospital from Janurary 2023 to December 2023 were enrolled. Drug-related problems (DRPs) were evaluated using the PCNE classification system (version 9.0). The types, causes, intervention plans, acceptance of intervention plans, and statuses of DRPs were analyzed. A total of 362 patients were included, covering 405 DRP cases, with an average DRP of 1.12 for each patient. All 405 DRP cases underwent interventions, with a success rate of 83.46%. The main categories of related drugs were psychotropic drugs (70.37%), anti-infective drugs (8.89%), and cardiovascular system drugs (5.19%). The main DRPs were possible adverse drug events (21.24%), poor treatment effects (69.14%), and unnecessary medication treatment (9.63%). The main causes of DRPs were inappropriate drug selection (18.52%), inappropriate combinations of drugs (16.05%), and excessive drug dosage (13.58%). The PCNE classification system helps clinical pharmacists improve their ability to identify and solve DRPs faced by psychiatric departments, improve pharmaceutical care efficiency, and ensure rational drug use.
Digital infrastructure construction and regional mineral resource dependence in China: Heterogeneous characteristics and transmission mechanisms from mining industry
Authors: Zhang Hengshuo , Qian Xuesheng , Bing Yan
Published: August 2024

The emergence of the digital economy has challenged many of the theories of traditional environmental resource economics. As an emerging production factor, data have a significant impact and substitutability with digital technology on fossil energy utilization, which also makes the impact of digital infrastructure construction (DIG) on the allocation of mineral resources easily underestimated. This study is based on China's DIG and explores its impact on regional mineral resource dependence (NRD) in 30 provinces of China. We find that, with a 1% increase in DIG, NRD declines by 7.6%, with a lag effect between the two. The analysis of heterogeneous characteristics revealed the heterogeneous effects and dissimilation roles of DIG's effect on NRD. In terms of heterogeneous effects, in regions with high levels of resource endowment and low digital-economy contributions, DIG's empowering effects were more obvious. In terms of dissimilation roles, the facility foundation has played a more prominent role than digital access. We also find that, enhancing resource allocation efficiency, innovation output efficiency, and energy utilization efficiency can mediate the effects of DIG on NRD. Our findings can offer policy insights for reducing NRD to promote high-quality DIG, achieving differentiated digital empowerment patterns, and building multichannel resource reduction paths. This work also has reference value for green transformation in other developing countries and resource-based industries under the 2030 sustainable development goals.
Sero-Kinship: How Young People Living With HIV/AIDS Survive in Southeast Nigeria
Authors: Uzim Elochukwu Ernest , Igwe Ijeoma , Lee Po-Han
Published: August 2024

Research on the lived experiences of HIV survivors, including young people living with HIV, has primarily emphasized broader sociocultural concerns, such as stigmatization and cultural attitudes toward sexuality and gender, while giving less attention to the interconnectedness of these issues with the mental well-being of those affected by the illness. This study, drawing on relational ethnography including observations and interviews at four antiretroviral-administering healthcare facilities in Enugu State, southeast Nigeria, explores how young people living with HIV strive toward viral suppression and how they develop collaborative psychosocial support along with the global efforts in eradicating the HIV epidemic. We found that, in and between themselves, young people living with HIV weave for themselves a network of relationships, though discreetly, to foster and encourage survivorship. Such relatedness, where mutual trust and support have emerged and rebuilt HIV survivors’ faith in a livable life, forms what we conceptualize as “sero-kinship.” That is, sero-kinship, which focuses on how people create and change meanings in their everyday lives that ultimately contribute to controlling HIV and treatment management, forms an essential foundation on which a life with HIV becomes thinkable, bearable, then manageable, and acceptable.
An Interpretative Phenomenological Analysis That Seeks to Describe and Understand the Personal Experience of Burnout in General Practitioners
Authors: McCammon Leonard Charles , Gillen Patricia , McLaughlin Derek , Kernohan W. George
Published: August 2024

Minimal research has explored the personal experience of burnout in doctors from any medical speciality. Consequently, we aimed to provide a relatable description and understanding of this globally recognised problem. We employed an interpretative phenomenological analysis (IPA) of face-to-face interviews with seven general practitioners (GPs) in Northern Ireland, having selected interviewees best able to speak about burnout. We sought to understand how these GPs understood their burnout experiences. Our participants’ continuous work involved more than their busy weekdays and also working on supposedly off evenings and weekends. In addition, draining intrusive thoughts of work filled most, if not all, of their other waking moments. There was no respite. Work was ‘always there.’ Being constantly busy, they had no time to think or attend to patients as doctors. Instead, participants were going through the motions like GP automatons. Their effectiveness, efficiency, and caring were failing, while their interactions with patients had changed as they tried to conserve their now-drained energy and empathy. There was no time left for their families or themselves. They now “existed” to continuously work rather than “living” their previous, more balanced lives that at one time included enjoying being a doctor. Worryingly, participants were struggling, isolated, and vulnerable, yet unwilling to speak to someone they trusted. We intend our burnout narrative to promote discussion between medical colleagues and assist in its recognition by GPs and other doctors. Our findings warn against working excessively, prioritising work ahead of family and oneself, and self-isolation rather than seeking necessary support.
Cost Analysis of Routine Histopathologic Evaluation of Specimens Following Total Ankle Arthroplasty
Authors: Padilla Jorge A. , Andriani Nicholas , Papalia Aidan , Huyke-Hernández Fernando , Cohn Randy M. , Bitterman Adam D.
Published: August 2024

Background:

Routine histopathologic examination of orthopaedic surgical specimens is a standard practice at many institutions. Previous studies have demonstrated that this practice seldom altered patient management for several orthopaedic procedures. As a result, the value of such practices has come into question. The purpose of this study is to determine the cost-effectiveness of routine histopathologic analysis of specimens obtained during total ankle arthroplasty (TAA).

Methods:

A retrospective analysis was performed of patients who underwent uncomplicated primary TAA at a large, academic, health system between January 2015 and December 2021. The postoperative histopathologic diagnoses were compared with the respective patient’s preoperative clinical and intraoperative diagnoses. The prevalence of concordant, discrepant, and discordant diagnoses was determined. Cost-effectiveness analysis was conducted to assess the financial implications of obtaining routine specimens for histopathologic examination for TAA.

Results:

A total of 85 TAAs were identified in 85 individual patients and were included in the present study. A total of 172 specimens were sent for routine histopathologic review. On histopathologic analysis, a final diagnosis was confirmed in 82 (96.5%) of the total specimens reviewed. A discrepant diagnosis was discovered in 3 (3.5%; 2 cases of gout/pseudogout and 1 case of osteonecrosis) cases and 0 (0%) discordant diagnoses were discovered, corresponding to positive and negative predictive values of 97% and 100%, respectively The total estimate of costs incurred for the routine analysis of all specimens included in the study was between $12 299.20 and 17 846.00. The estimated cost to establish each discrepant diagnosis ranged between $4099.73 and $5948.67, and the cost for a discordant diagnosis was unable to be established.

Conclusion:

Routine histopathologic analysis of specimens obtained during TAA rarely revealed a discordant diagnosis and resulted in no alterations to patients’ plan of care. Furthermore, the additional costs of routine histopathologic examination are significant. As such, it is recommended that such interventions in TAA should be performed on a per-case basis at the operating surgeon’s discretion.
Ocular and adnexal injuries after two major earthquakes in Turkey on February 6, 2023
Authors: Şensoy Melike , Bayram Nurettin , Sensoy Eyupcan , Sonmez Kenan
Published: August 2024

Purpose

This study aimed to determine the forms of ocular and adnexal injuries and to examine the treatment modalities applied after two major earthquakes in Turkey on February 6, 2023.

Methods

Following the earthquakes, the medical records of 34 patients admitted with emergency ophthalmic complaints to Hatay Training and Research Field Hospital and Etlik City Hospital were retrospectively reviewed. Of these patients, 35 eyes of 34 individuals diagnosed with earthquake-related ocular and adnexal injuries were included in the study. Demographic characteristics were recorded, including ocular and adnexal findings, treatment modalities, and postoperative complications.

Results

Of the patients, 16 (47.1%) were female, and 18 (52.9%) were male. The mean age was 37.38 ± 17.3 years. The mean time from the earthquake to the first admission to the hospital was 3.82 ± 1.78 days. Initial and final best-corrected visual acuities (BCVA) were 0.54 ± 0.66 logMAR and 0.22 ± 0.41 logMAR, respectively ( p = 0.0003). The initial and final BCVA of 2 eyes was no light perception. The most common forms of ocular/periocular injury associated with earthquakes were eyelid laceration (n:25, 71.4%) and orbital fracture (n:17, 48.6%). The most common accompanied systemic trauma was extremity/rib fractures (38.2). The most frequently performed surgery was the primary repair of the eyelid/canalicular (n:17, 48.6%).

Conclusion

While earthquake-related ocular and adnexal traumas are relatively uncommon, understanding the specific injury types, promptly identifying cases requiring urgent intervention, and mastering effective treatment modalities are essential for minimizing the risk of severe permanent visual impairment in these patients.
Diabetic retinopathy screening with confocal fundus camera and artificial intelligence - assisted grading
Authors: Piatti A. , Rui C. , Gazzina S. , Tartaglino B. , Romeo F. , Manti R. , Doglio M. , Nada E. , Giorda C.B.
Published: August 2024

Purpose

Screening for diabetic retinopathy (DR) by ophthalmologists is costly and labour-intensive. Artificial Intelligence (AI) for automated DR detection could be a clinically and economically alternative. We assessed the performance of a confocal fundus imaging system (DRSplus, Centervue SpA), coupled with an AI algorithm (RetCAD, Thirona B.V.) in a real-world setting.

Methods

45° non-mydriatic retinal images from 506 patients with diabetes were graded both by an ophthalmologist and by the AI algorithm, according to the International Clinical Diabetic Retinopathy severity scale. Less than moderate retinopathy (DR scores 0, 1) was defined as non-referable, while more severe stages were defined as referable retinopathy. The gradings were then compared both at eye-level and patient-level. Key metrics included sensitivity, specificity all measured with a 95% Confidence Interval.

Results

The percentage of ungradable eyes according to the AI was 2.58%. The performances of the AI algorithm for detecting referable DR were 97.18% sensitivity, 93.73% specificity at eye-level and 98.70% sensitivity and 91.06% specificity at patient-level.

Conclusions

DRSplus paired with RetCAD represents a reliable DR screening solution in a real-world setting. The high sensitivity of the system ensures that almost all patients requiring medical attention for DR are referred to an ophthalmologist for further evaluation.
Reproducibility of SIMPLE classification for diabetic retinopathy screening and its comparison to current Italian guidelines
Authors: Donati Maria Carla , Cifarelli Lorenzo , Morelli Alberto , Alonzo Ludovica , Tartaro Ruggero , Sasso Paola , Maceroni Martina , Minnella Angelo Maria , Rizzo Stanislao , Mannucci Edoardo , Vitale Valentina , Curran Katie , Peto Tunde , Giansanti Fabrizio , Virgili Gianni
Published: August 2024

Purpose

To evaluate the reproducibility of SIMPLE (Single field Image Multi Parameters defined Lesions Extent), a new Diabetic Retinopathy (DR) classification for screening of 45° single field fundus pictures of patients with diabetes (PwDM), assessing DR, Diabetic Maculopathy (DMac) and referral rate agreement and comparing it to current Italian Guidelines (IG).

Materials and methods

We conducted a retrospective, observational, multicentre study, collecting 1000 retinal 45° single field images of PwDM obtained during routine visits in two diabetes clinics. Three ophthalmologists evaluated each image, determining the presence and number of specific DR lesions and then assigning a stage according to the current IG for screening. SIMPLE staging was performed automatically via Excel software, based on the pre-specified DR characteristics observed by the graders. We analysed intra-centre, inter-centre and total inter-grader agreement for DR and DMac stage and referral rate of the two classifications.

Results

Agreement amongst the three graders was consistently higher when using SIMPLE classification than when using current IG classification. For DR, kappa (k) was 0.86 with IG and 0.95 with SIMPLE classification; for DMac, k-IG was 0.78, while k-SIMPLE was 0.96; concordance on the referral rate was 0.91 with IG and 0.99 with SIMPLE. Similar results were obtained in sub-analyses for the evaluation of intra-centre and inter-centre concordance.

Conclusions

Our results suggest that the new SIMPLE classification has an excellent reproducibility amongst graders, comparable or superior to the current IG for DR screening proposed in 2015, improving the standardisation of the decision on referability.
High Expression of SRSF10 Promotes Colorectal Cancer Progression by Aberrant Alternative Splicing of RFC5
Authors: Xu Shuai , Zhong Fangmin , jiang Junyao , Yao Fangyi , Li Meiyong , Tang Mengxin , Cheng Ying , Yang Yulin , Wen Wen , Zhang Xueru , Huang Bo , Wang Xiaozhong
Published: August 2024

Background

Colorectal cancer (CRC) remains a global health concern with persistently high incidence and mortality rates. However, the specific pathogenesis of CRC remains poorly understood. This study aims to investigate the role and pathogenesis of serine and arginine rich splicing factor 10 (SRSF10) in colorectal cancer.

Methods

Bioinformatics analysis was employed to predict SRSF10 gene expression in CRC patients. Functional experiments involving SRSF10 knockdown and overexpression were conducted using CCK8, transwell, scratch assay, and flow cytometry. Additionally, the PRIdictor website was utilized to predict the SRSF10 interaction site with RFC5. The identification of different transcripts of SRSF10-acting RFC5 pre-mRNA was achieved through agarose gel electrophoresis.

Result

The knockdown of SRSF10 inhibited the proliferation and migration ability of CRC cells, while promoting apoptosis and altering the DNA replication of CRC cells. Conversely, when SRSF10 was highly expressed, it enhanced the proliferation and migration ability of CRC cells and caused changes in the cell cycle of colorectal cancer cells. This study revealed a change in the replicating factor C subunit 5 (RFC5) gene in colorectal cancer cells following SRSF10 knockdown. Furthermore, it was confirmed that SRSF10 increased RFC5 exon2-AS1(S) transcription variants, thereby promoting the development of colorectal cancer through AS1 exclusion to exon 2 of RFC5.

Conclusion

In summary, this study demonstrates that SRSF10 promotes the progression of colorectal cancer by generating an aberrantly spliced exclusion isoform of AS1 within RFC5 exon 2. These findings suggest that SRSF10 could serve as a crucial target for the clinical diagnosis and treatment of CRC.
Wearable-Based Kinematic Analysis of Upper-Limb Movements During Daily Activities Could Provide Insights into Stroke Survivors’ Motor Ability
Authors: Lee Sunghoon Ivan , Liu Yunda , Vergara-Díaz Gloria , Pugliese Benito Lorenzo , Black-Schaffer Randie , Stoykov Mary Ellen , Bonato Paolo
Published: August 2024

Background

Frequent and objective monitoring of motor recovery progression holds significant importance in stroke rehabilitation. Despite extensive studies on wearable solutions in this context, the focus has been predominantly on evaluating limb activity. This study aims to address this limitation by delving into a novel measure of wrist kinematics more intricately related to patients’ motor capacity.

Objective

To explore a new wearable-based approach for objectively and reliably assessing upper-limb motor ability in stroke survivors using a single inertial sensor placed on the stroke-affected wrist.

Methods

Seventeen stroke survivors performed a series of daily activities within a simulated home setting while wearing a six-axis inertial measurement unit on the wrist affected by stroke. Inertial data during point-to-point upper-limb movements were decomposed into movement segments, from which various kinematic variables were derived. A data-driven approach was then employed to identify a kinematic variable demonstrating robust internal reliability, construct validity, and convergent validity.

Results

We have identified a key kinematic variable, namely the 90th percentile of movement segment distance during point-to-point movements. This variable exhibited robust reliability (intra-class correlation coefficient of .93) and strong correlations with established clinical measures of motor capacity (Pearson’s correlation coefficients of .81 with the Fugl-Meyer Assessment for Upper-Extremity; .77 with the Functional Ability component of the Wolf Motor Function Test; and −.68 with the Performance Time component of the Wolf Motor Function Test).

Conclusions

The findings underscore the potential for continuous, objective, and convenient monitoring of stroke survivors’ motor progression throughout rehabilitation.
Developing a tool for assessing and communicating the expected difficulty of performing a tracheostomy
Authors: Clymo Jonathon , Dean Mike , Lambert Chris , Rollin Matthew
Published: August 2024

There are no guidelines for assessing and communicating the expected difficulty of a tracheostomy, leading to difficulties planning a percutaneous approach in intensive care or referring onwards to surgical teams. A Delphi process was used to develop a tool containing metrics which are relevant for either specialty and can be universally assessed by both. Palpable tracheal rings, prior surgery or radiotherapy to the anterior neck, uncorrectable clotting or platelet dysfunction, ability to extend the neck freely, and overlying vessels visible, palpable or on imaging were all found to be relevant. It is hoped this tool will aid communication between specialties.
Reducing Unnecessary Instruments in Tonsil Hemorrhage Trays at a Canadian Tertiary Care Center: A Quality Improvement Project
Authors: Van Osch Kylen , Madou Edward , Belisle Sheena , Strychowsky Julie E.
Published: August 2024

Background

In the emergency department (ED), there are pre-assembled tonsillar hemorrhage trays for management of post-tonsillectomy hemorrhage and peritonsillar abscess. After use, the tray is sent to the medical device reprocessing (MDR) department for decontamination, sterilization, and re-organization, all at a significant cost to the hospital and environment.

Objective

The goal of this project was to reduce unnecessary instruments on the tonsil hemorrhage tray by 30% by 1 year and report on the associated cost and carbon dioxide (CO2) emissions savings.

Methods

This quality improvement project was framed according to the Institute for Healthcare Improvement’s Model for Improvement. ED and Otolaryngology–Head & Neck Surgery staff and residents were surveyed to determine which instruments on the tonsil hemorrhage trays were used regularly. Based on results, a new tray was developed and compared to the old tray using MDR data and existing CO2 emissions calculations.

Results

Tray optimization resulted in a total cost reduction from $1092.63 to $330.21 per tray per year, decreased processing time from 12 to 6-8 minutes per tray, and decreased CO2 emissions from 6.11 to 2.85 kg per year for the old versus new tray, respectively. Overall, the new tray contains half the number of instruments, takes half the time to assemble, produces 50% less CO2 emissions, and will save the hospital approximately $100,000 over 10 years.

Conclusion

Healthcare costs and environmental sustainability are collective responsibilities. Surgical and procedure tray optimization is a simple, effective, and scalable form of eco-action.
Inhibitory activities of Aruncus dioicus alkaloidal glycosides against protein tyrosine phosphatase 1B and α-glucosidase: A methodical theory-experiment investigation
Authors: Nguyen Phi-Hung , Bui Thanh Q. , Tran Thi-Tuyen , Bui Thi-Thuc , Do Thi-Thuy , To Dao-Cuong , Tran Manh Hung , Quy Phan Tu , Co Nguyen Quang , Phu Nguyen Vinh , Ai Nhung Nguyen Thi
Published: August 2024

Objective: Aruncus dioicus has been known by the scientific literature and folk experiences for its diverse biological activities, including anti-hyperglycemic effects. Methodology: The aerial parts of the plant collected from Quan Lan Island (Vietnam) were subjected to a methodical theory-experiment investigation for its chemical composition and biological potentials. Results: Firstly, experimental isolation and spectroscopic characterization identified the compositional compounds, ie sambunigrin (1), prunasin (2), uridine (3), and adenosine (4). Secondly, their elucidated structures were predicted with promising bio-chemo-pharmacological potentiality by different computational platforms, ie: docking simulation (docking scores < 10 kcal.mol−1); quantum calculation (dipole moments < 3 Debye); QSARIS model (satisfying Lipinski's rule of five); SwissADME model (satisfying Pires’ interpretations). Finally, the compounds (1-4) were under accumulative purification and in vitro tests against diabetes-related enzymes, ie: protein tyrosine phosphatase 1B (1 with lowest IC50 value 0.39 ± 0.26 μM, 2 with no activity) and α-glucosidase (1 with lowest IC50 value 44.89 ± 0.93 μM, 2 with no activity); also, the inhibitory kinetics based on Lineweaver-Burk and Dixon plot experiments revealed the competitive inhibition mode of 1 against PTP1B ( Ki value 0.49 μM). Conclusions: Altogether, the results obtained suggest that A. dioicus and its bioactive compounds, especially sambunigrin (1), uridine (3), and adenosine (4), could be considered as a natural source for further research and development of anti-diabetic agents.
Evaluating concrete material models for blast analysis using 3D finite element analysis
Authors: Saleem Omair Bin , Varma Amit H , Bruhl Jakob C
Published: August 2024

Blast loads are extremely detrimental to structural elements of a building and can result in minor damage to complete failure of a building. Finite element analysis (FEA) is an effective tool to study the behavior of structural elements exposed to blast loading. The focus of this study was to evaluate the performance of three concrete material models available in LS-DYNA and compare the results to experimental results from blast loaded reinforced concrete (RC) panel supported on four sides (two-way bending). Concrete material models chosen for this study were Winfrith (MAT_84-85), Karagozian & Case (MAT_072R3), and Continuous Surface Cap Model (MAT_159). These are widely used in finite element modeling related to civil structures and can account for strain rate dependent properties. Each concrete material model was implemented with and without strain rate effects. The finite element model had concrete material as solid elements and steel reinforcement material as beam elements with simply supported boundary conditions. Results from two different blast loading methods are presented: (1) blast pulse load curve from experimental data (2) blast input by defining type, location, and amount of explosive in terms of TNT. The finite element models were evaluated by comparing fundamental period, peak displacement, and residual displacement to experimental results. In this study, the model using MAT_072R3 most closely matched experimental behavior in comparison to MAT_84-85 and MAT_159. Additional discussion is presented about: (1) single degree of freedom (SDOF) analysis, (2) comparison of numerical and experimental crack patterns, and (3) behavior of concrete material models accounting for compressive and tensile dynamic increase factors (DIFs).
Beyond artificial intelligence controversies: What are algorithms doing in the scientific literature?
Authors: Munk Anders Kristian , Jacomy Mathieu , Ficozzi Matilde , Jensen Torben Elgaard
Published: August 2024

Mounting critique of the way AI is framed in mainstream media calls for less sensationalist coverage, be it jubilant or apocalyptic, and more attention to the concrete situations in which AI becomes controversial in different ways. This is supposedly achieved by making coverage more expert-informed. We therefore explore how experts contribute to the issuefication of AI through the scientific literature. We provide a semantic, visual network analysis of a corpus of 1M scientific abstracts about machine learning algorithms and artificial intelligence. Through a systematic quali-quantitative exploration of 235 co-word clusters and a subsequent structured search for 18 issue-specific queries, for which we devise a novel method with a custom-built datascape, we explore how algorithms have agency. We find that scientific discourse is highly situated and rarely about AI in general. It overwhelmingly charges algorithms with the capacity to solve problems and these problems are rarely about algorithms in their origin. Conversely, it rarely charges algorithms with the capacity to cause problems and when it does, other algorithms are typically charged with the capacity to solve them. Based on these findings, we argue that while a more expert-informed coverage of AI is likely to be less sensationalist and show greater attention to the specific situations where algorithms make a difference, it is unlikely to stage AI as particularly controversial. Consequently, we suggest conceptualising AI as a political situation rather than something inherently controversial.
Protest and Resistance: Conceptualizing a Blackamerican Institutional Schema and the Contemporary Relevance of Pre-Brown Educators
Authors: Wright James , Karnopp Jennifer
Published: August 2024

In the century following emancipation, Blackamericans developed robust and effective schools despite limited resources. Unfortunately, their successes and contributions to the education system are often overlooked. This interdisciplinary theoretical paper draws on historiographies of segregated school systems, examining the struggles of Blackamerican educators within segregated education systems through the lenses of coloniality and institutional work. This examination reveals a distinct Blackamerican institutional schema rooted in community, guiding educators in navigating structural and systemic dynamics that shape educational opportunities and successfully challenge dominant white education standards. We discuss the coloniality of schooling, a structural framework, and a mindset that continues to undergird our contemporary education system and then draw attention to an alternative perspective. Our goal is to work toward more inclusive and equitable education systems by recognizing and acknowledging the protest and resistance of Blackamerican educators, their contributions to alternative epistemologies, and the mindsets that guided their actions.
Incidence and nationwide estimates of cryptogenic ischemic stroke or TIA eligible for prolonged cardiac rhythm monitoring
Authors: Béjot Yannick , Duloquin Gauthier , Guenancia Charles
Published: August 2024

Introduction:

Current guidelines indicate prolonged cardiac rhythm monitoring for atrial fibrillation screening in patients with cryptogenic ischemic stroke (IS) or transient ischemic attack (TIA). This study aimed to assess the incidence of cryptogenic IS/TIA eligible for such investigation, and to estimate the number of patients potentially concerned in whole France annually.

Methods:

All cryptogenic acute IS/TIA cases ⩾35 years old were retrieved from the population-based Dijon Stroke Registry, France (2013–2020). Patients eligible for prolonged cardiac rhythm monitoring were defined after excluding those who died in-hospital or within the first 30 days, or with preexisting major impairment. Annual incidence rates of eligible cryptogenic IS/TIA were calculated by age groups and sex. The total number of eligible patients in France was estimated by standardization to age- and sex-specific incidence.

Results:

Among 2811 IS/TIA patients recorded in the Dijon Stroke Registry, 1239 had cryptogenic IS/TIA of whom 1045 were eligible for prolonged cardiac rhythm monitoring (517 IS and 528 TIA, mean age 73.6 ± 14.6 years old, 55.4% women). Crude incidence rates of eligible cryptogenic IS/TIA were 169/100,000 per year (95% CI: 159–179) in overall sexes, 83/100,000 per year (95% CI: 76–91) for IS, and 85/100,000 per year (95% CI: 78–93) for TIA. The total number of patients with cryptogenic IS/TIA eligible for prolonged cardiac rhythm monitoring in France was estimated to be 66,125 (95% CI: 65,622–66,630) for the calendar year 2022, including 32,764 (95% CI: 32,410–33,120) with IS and 33,361 (95% CI: 33,004–33,721) with TIA.

Conclusions:

This study demonstrated a high incidence of cryptogenic IS/TIA eligible for prolonged cardiac rhythm monitoring. Estimates at a national level pointed out the large number of patients who may require access to such atrial fibrillation screening, with attention to be paid on regarding organization of care networks and related costs.
Probabilistic seismic hazard analysis for the Dominican Republic
Authors: Johnson Kendra , Chartier Thomas , Pagani Marco , Perez Yesica , Guzmán Vladimir , Roque de Medina Maria Betania , Styron Richard , Yepes-Estrada Catalina
Published: August 2024

The Dominican Republic experiences moderate to high seismic hazard mostly caused by oblique convergence at the Caribbean/North American plate boundary that manifests as subduction zones, less-pronounced subduction-like trenches with thrust faulting, long strike-slip faults parallel to the plate boundary, and onshore deformation. Historical earthquakes have damaged the Dominican Republic’s large cities and those in neighboring Haiti, once requiring relocation. Given this, the Dominican Republic joined the “Training and Communication for Earthquake Risk Assessment” (TREQ) project funded by the United States Agency for International Development, which aimed to increase earthquake risk assessment capacity in Latin American cities. The TREQ project was the basis for developing an openly available probabilistic seismic hazard model for the Dominican Republic. The input model was developed from two main datasets: a homogenized earthquake catalog and an active faults database that combines results of recent local projects with a global database. The seismic source characterization used these to constrain source geometries and occurrence rates for active shallow crustal earthquakes, subduction interfaces and subduction-like thrusts, and intraslab earthquakes. Shallow crustal earthquakes, including those on subduction-like thrusts, are modeled by smoothed seismicity and fault sources, the latter using pre-defined geometries that permit multi-fault ruptures. Seismicity on the Puerto Rico Trench subduction interface is modeled as a fault source, while intraslab sources use pre-defined gridded ruptures inside the intraslab volume. The source characterization applies epistemic uncertainties to modeling assumptions affecting occurrence rates and maximum magnitudes. The ground motion characterization used residual analyses from past regional projects as a basis, updating some components with more recent ground motion models. Computed hazard results reinforce those from recent studies in terms of geographical hazard patterns and levels. For 475-year return periods, peak ground acceleration (PGA) in Santiago de los Caballeros reaches 0.50 g, controlled by the Septentrional Fault, while all tectonic region types contribute to the PGA 0.31 g computed for Santo Domingo.
Beat-AML 2024 ELN–refined risk stratification for older adults with newly diagnosed AML given lower-intensity therapy
Authors: Hoff Fieke W. , Blum William G. , Huang Ying , Welkie Rina Li , Swords Ronan T. , Traer Elie , Stein Eytan M. , Lin Tara L. , Archer Kellie J. , Patel Prapti A. , Collins Robert H. , Baer Maria R. , Duong Vu H. , Arellano Martha L. , Stock Wendy , Odenike Olatoyosi , Redner Robert L. , Kovacsovics Tibor , Deininger Michael W. , Zeidner Joshua F. , Olin Rebecca L. , Smith Catherine C. , Foran James M. , Schiller Gary J. , Curran Emily K. , Koenig Kristin L. , Heerema Nyla A. , Chen Timothy , Martycz Molly , Stefanos Mona , Marcus Sonja G. , Rosenberg Leonard , Druker Brian J. , Levine Ross L. , Burd Amy , Yocum Ashley O. , Borate Uma M. , Mims Alice S. , Byrd John C. , Madanat Yazan F.
Published: August 2024

Although the 2022 European LeukemiaNet (ELN) acute myeloid leukemia (AML) risk classification reliably predicts outcomes in younger patients treated with intensive chemotherapy, it is unclear whether it applies to adults ≥60 years treated with lower-intensity treatment (LIT). We aimed to test the prognostic impact of ELN risk in patients with newly diagnosed (ND) AML aged ≥60 years given LIT and to further refine risk stratification for these patients. A total of 595 patients were included: 11% had favorable-, 11% intermediate-, and 78% had adverse-risk AML. ELN risk was prognostic for overall survival (OS) (P < .001) but did not stratify favorable- from intermediate-risk (P = .71). Within adverse-risk AML, the impact of additional molecular abnormalities was further evaluated. Multivariable analysis was performed on a training set (n = 316) and identified IDH2 mutation as an independent favorable prognostic factor, and KRAS, MLL2, and TP53 mutations as unfavorable (P < .05). A “mutation score” was calculated for each combination of these mutations, assigning adverse-risk patients to 2 risk groups: −1 to 0 points (“Beat-AML intermediate”) vs 1+ points (“Beat-AML adverse”). In the final refined risk classification, ELN favorable- and intermediate-risk were combined into a newly defined “Beat-AML favorable-risk” group, in addition to mutation scoring within the ELN adverse-risk group. This approach redefines risk for older patients with ND AML and proposes refined Beat-AML risk groups with improved discrimination for OS (2-year OS, 48% vs 33% vs 11%, respectively; P < .001), providing patients and providers additional information for treatment decision-making.
Sex, tissue, and mitochondrial interactions modify the transcriptional response to rapamycin in Drosophila
Authors: Raynes Yevgeniy , Santiago John C. , Lemieux Faye A. , Darwin Leah , Rand David M.
Published: August 2024

Background

Many common diseases exhibit uncontrolled mTOR signaling, prompting considerable interest in the therapeutic potential of mTOR inhibitors, such as rapamycin, to treat a range of conditions, including cancer, aging-related pathologies, and neurological disorders. Despite encouraging preclinical results, the success of mTOR interventions in the clinic has been limited by off-target side effects and dose-limiting toxicities. Improving clinical efficacy and mitigating side effects require a better understanding of the influence of key clinical factors, such as sex, tissue, and genomic background, on the outcomes of mTOR-targeting therapies.

Results

We assayed gene expression with and without rapamycin exposure across three distinct body parts (head, thorax, abdomen) of D. melanogaster flies, bearing either their native melanogaster mitochondrial genome or the mitochondrial genome from a related species, D. simulans. The fully factorial RNA-seq study design revealed a large number of genes that responded to the rapamycin treatment in a sex-dependent and tissue-dependent manner, and relatively few genes with the transcriptional response to rapamycin affected by the mitochondrial background. Reanalysis of an earlier study confirmed that mitochondria can have a temporal influence on rapamycin response.

Conclusions

We found significant and wide-ranging effects of sex and body part, alongside a subtle, potentially time-dependent, influence of mitochondria on the transcriptional response to rapamycin. Our findings suggest a number of pathways that could be crucial for predicting potential side effects of mTOR inhibition in a particular sex or tissue. Further studies of the temporal response to rapamycin are necessary to elucidate the effects of the mitochondrial background on mTOR and its inhibition.
“Psychiatric emergency consultations of minors: a qualitative study of professionals’ experiences”
Authors: So P. , Nooteboom LA. , Vullings RM. , Mulder CL. , Vermeiren RRJM.
Published: August 2024

Background

Psychiatric emergency assessment of minors can be a complex process, especially for professional staff who are not specifically trained in handling child and adolescent emergency patients. As minors cannot usually express their feelings and experiences as well as adults, it is difficult to form an accurate picture of their condition and to determine what kind of emergency care is needed, for instance whether or not a psychiatric emergency admission is necessary. We lack insight in what professionals at emergency departments need to adequately assess these minors and their families. The aim of this study was to explore staff members’ experiences with assessing minors and explore recommendations for improving their ability to provide appropriate support.

Methods

Guided by a topic list with open-ended questions, we conducted 11 semi-structured interviews with staff working at psychiatric emergency services. Thematic analysis enabled us to identify five main themes: (1) young age and the crucial role of parents; (2) professionals’ feelings, especially uncertainty; (3) psychiatric emergency admissions and the alternatives to them; (4) regional differences in organization and tasks; and (5) options for improving care.

Results

The staff interviewed all agreed that it was often complicated and time consuming to take full responsibility when assessing minors with serious and urgent psychiatric problems. Most found it difficult to determine which behaviors were and were not age-appropriate, and how to handle systemic problems during the assessment. When assessing minors and their families in crisis, this led to uncertainty. Professionals were especially insecure when assessing children under age 12 and their families, feeling they lacked the appropriate knowledge and routine.

Conclusion

Customized expertise development and improved regional embedding of the psychiatric emergency service in the child and adolescent services will reduce professionals’ uncertainty and improve psychiatric emergency care for minors.
Tissue surface adaptation and retention of digital obturator after one year of use
Authors: khalaf Khadija Mohamed Abd El Salam , Rashad Hoda Mohamed Amin , Mostafa Tamer Mohamed Nasr
Published: August 2024

Background

Effect of aging on tissue adaptability and retention of digital obturator is still under investigation.

Methods

A maxillary Armany (class I) epoxy reference model was scanned to fabricate digital obturator fabricated from milled Co-Cr framework and 3D printed bulb. A color map of the scanned reference and digital obturator was made using Geomagic software to evaluate the accuracy of fit before and after cyclic loading using ROBOTA chewing simulator at 37,500, 75,000 and 150,000 cycles to simulate clinically 3-, 6- and 12-months chewing condition. Insertion-removal condition simulating the placement and removal of the obturator was done using repeated 360, 720 and 1440 cycles and retention was evaluated before and after the repeated cycles. Data were collected, tabulated and statistically analyzed using Statistical Package for Social Sciences (IBM SPSS Statistics 26). Student t-test and multi variable ANOVA test were used to detect significance. P-value < 0.05 was considered significant difference.

Results

For retention test: There was a significant difference between baseline and 3, 6 and12 months. For the tissue surface adaptation test: There was significant difference at all measured areas (P-value < 0.05) before and after application of load.

Conclusion

digitally designed and fabricated obturator was highly retentive and has excellent tissue surface adaptation upon fabrication, After application of load; reduction of retention and lack of tissue adaptation were resulted.

The clinical implication

of this manuscript is that digital obturator can be used successfully with the shortcomings of loosening retention and adaptation afterwhile. So, clinical trials should investigate the clinical acceptance of these shortcomings.