bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of rural living environment improvement programs on the subjective well-being of rural residents in China
Authors: Pan Dan , Yu Yi , Ji Kaiwen
Published: May 2024

Increasing people’s subjective well-being (SWB) remains a critical challenge for all countries. However, few studies have been dedicated to examining the influence of environmental governance programs on SWB, especially in developing and non-democratic societies. This paper aims to fill this void by taking the Rural Living Environment Improvement (RLEI) program in China—the largest rural living environment governance program in history, as an example to understand the role of environmental governance programs in SWB in the world’s biggest developing and non-democratic country. Based on 3747 individual samples from the China Labor-force Dynamics Survey database, we found that RLEI can significantly improve rural residents’ SWB. This effect remains significant after using the propensity score matching method and the instrumental variable approach to address potential selection bias and endogenous problems. The indirect analysis shows that RLEI can increase rural residents’ SWB mainly through improving their income, consumption expenditure, and health. Compared with rural sewage and livestock manure RLEI programs, rural waste RLEI program has a greater enhanced impact on rural residents’ SWB. The monetary value of RLEI based on the life satisfaction approach shows that the resulting improvement in rural residents’ SWB created by RLEI is almost equivalent to the effect of household income. While the monetary value of rural sewage, livestock manure, and rural waste RLEI program is equivalent to 1.2, 3.67, and 1.1 times the effect of household income. Heterogeneity analysis indicates that RLEI has a greater positive impact on SWB for junior and old-aged, low-educated, Midwestern and Northeastern, and working rural residents.
US nuclear agency struggles with production and costs
Authors: Kramer David
Published: May 2024

The National Nuclear Security Administration must cope with resurgent geopolitical threats accentuated by Vladimir Putin’s nuclear saber-rattling.
Climate change drives extinction—and always has
Authors: Lopatka Alex
Published: May 2024

Rising temperatures may threaten species regardless of the traits that they have, according to a new paleoclimate and paleobiology analysis.
TMT-based quantitative proteomic analysis of serum from domestic sheep in early pregnancy
Authors: Ren Yujun , Wang Zhunxuan , Sun Yishan , Gong Hongbin , Xie Su , Gao Ruonan , Chen Xin , Li Qingchun , Lu Shihao , Huang Tao , Yang Min
Published: May 2024

Context Timely pregnancy diagnosis is critical for reducing non-production days and improving the reproductive efficiency of sheep flocks. Aims The aim of this study was to investigate the serum proteomic profile of ewes in different gestational stages and explore the potential of differentially expressed proteins as biomarkers for early gestation. Methods Serum samples were collected from two groups: pregnant sheep (n = 4) and non-pregnant sheep (n = 4) on Day 14 after mating. The differentially expressed proteins were detected using tandem mass-tag (TMT) labelling with liquid chromatography tandem-mass spectrometry. The differentially expressed proteins were confirmed using enzyme-linked immunosorbent assay (ELISA). Furthermore, six selected proteins were evaluated in ewes (n = 35) on Day 14 from mating by using ELISA to assess their potential as biomarkers for early pregnancy. Receiver-operating characteristic (ROC) curves were used to analyse the diagnostic accuracy of these proteins. Key results Twenty proteins, of a total of 555 proteins detected, showed differential expression between pregnant and non-pregnant sheep. From the ROC-curve data, CHI3L1 (AUC = 0.992), PSMB4 (AUC = 0.976) and LGALS3BP (AUC = 0.844) had high predictive value in the diagnosis of early pregnancy. Conclusions In this study, CHI3L1, PSMB4 and LGALS3BP were found to be differentially expressed proteins in the serum of pregnant sheep. Therefore, these three proteins carry a high probability as candidate biomarkers for early gestational embryo attachment in ewes. Implications Early pregnancy diagnosis enables timely identification of non-pregnant ewes, resulting in optimised resource allocation and enhanced economic benefits for farmers by reducing production costs.
A generalized cross ratio
Authors: Pilla Michael
Published: May 2024

In one complex variable, the cross ratio is a well-known quantity associated with four given points in the complex plane that remains invariant under linear fractional maps. In particular, if one knows where three points in the complex plane are mapped under a linear fractional map, one can use this invariance to explicitly determine the map and to show that linear fractional maps are

3
3

-transitive. In this paper, we define a generalized cross ratio and determine some of its basic properties. In particular, we determine which hypotheses must be made to guarantee that our generalized cross ratio is well defined. We thus obtain a class of maps that obey similar transitivity properties as in one complex dimension, under some more restrictive conditions.
The Cesàro operator
Authors: Ross William
Published: May 2024

This paper surveys the various aspacts of the Cesàro operator with a special emphasis on the Hilbert space setting of

ℓ
2

\ell ^2

. We include a discussion of summability methods of Fourier series, the Cesàro matrix and integral operator, and the Cesàro operator on the Hilbert space

ℓ
2

\ell ^2

. In this setting of

ℓ
2

\ell ^2

we cover the spectral properties of the Cesàro operator as well as a treatment of its hyponormality (via posinormal operators) and subnormality (via a multiplication operator of Kriete and Trutt). Using the results of Kriete and Trutt, we describe the commutant of the Cesàro operator as well as its bounded square roots. The Cesàro operator has a rich lattice of invariant subspaces whose description remains unknown and we suspect might never be fully understood. We survey some results which display the complexity of these invariant subspaces and provide the reader with several paths forward for further discussion. Though the Cesàro operator was originally explored in the

ℓ
2

\ell ^2

and Hardy space settings, it has been explored in various other settings such as the general Hardy spaces as well as the Bergman spaces. Finally, we explore some of the so-called generalized Cesàro operator which are classes of integral operators on the Hardy spaces that connect to many areas of classical function theory.
Optimal representability results of PI-algebras: nilpotency, growth and chain conditions
Authors: Greenfeld Be’eri , Rowen Louis , Small Lance
Published: May 2024

We investigate representability results for PI-algebras satisfying various chain conditions and examine their optimality. We show that a Noetherian PI-algebra, whose quotient by the radical is finite over its center, is representable. We derive several applications and give a counterexample to this representability result when Noetherianity is relaxed to ACC on ideals, even within the class of affine algebras of linear growth. This example has radical cubed zero, and we show that if the radical squared is zero then such a counterexample cannot exist. We then modify our construction to yield a non-representable semiprimary PI-algebra with radical cubed zero, proving the tightness of a result of Amitsur, Rowen and Small, which was left open by Rowen and Small. We conclude with a discussion of the remaining open problems.
Algebraic groups with good reduction and the genus problem
Authors: Rapinchuk Igor
Published: May 2024

We first provide an overview of several results dealing with the genus of a division algebra and highlight the role of ramification in its analysis. We then give a survey of recent developments on the genus problem for simple algebraic groups and its connections to the analysis of groups with good reduction.
Genus 1 curves in Severi–Brauer surfaces
Authors: Saltman David
Published: May 2024

In a talk at the Banff International Research Station in 2015, Asher Auel asked questions about genus one curves in Severi-Brauer varieties

S
B
(
A
)

SB(A)

. More specifically, he asked about the smooth cubic curves in Severi-Brauer surfaces, that is, in

S
B
(
D
)

SB(D)

where

D

/

F

D/F

is a degree three division algebra. Even more specifically, he asked about the Jacobian,

E
E

, of these curves. In this paper we give a version of an answer to both these questions, describing the surprising connection between these curves and properties of the algebra 

A
A

. Let

F
F

contain

ρ
\rho

, a primitive third root of one. Since

D

/

F

D/F

is cyclic, it is generated over

F
F

by

x
,
y

x,y

such that

x
y
=
ρ

y
x

xy = \rho {yx}

and we call

x
,
y

x,y

a skew commuting pairs. The connection mentioned above is between the Galois structure of the three torsion points

E
[
3
]

E[3]

and the Galois structure of skew commuting pairs in extensions

D

⊗
F

K

D \otimes _F K

. Given a description of which

E
E

arise, we then describe, via Galois cohomology, which

C
C

arise.
Uniform error estimate of an asymptotic preserving scheme for the Lévy-Fokker-Planck equation
Authors: Sun Weiran , Wang Li
Published: May 2024

We establish a uniform-in-scaling error estimate for the asymptotic preserving (AP) scheme proposed by Xu and Wang [Commun. Math. Sci. 21 (2023), pp. 1–23] for the Lévy-Fokker-Planck (LFP) equation. The main difficulties stem not only from the interplay between the scaling and numerical parameters but also the slow decay of the tail of the equilibrium state. We tackle these problems by separating the parameter domain according to the relative size of the scaling parameter

ε
\varepsilon

: in the regime where

ε
\varepsilon

is large, we design a weighted norm to mitigate the issue caused by the fat tail, while in the regime where

ε
\varepsilon

is small, we prove a strong convergence of LFP towards its fractional diffusion limit with an explicit convergence rate. This method extends the traditional AP estimates to cases where uniform bounds are unavailable. Our result applies to any dimension and to the whole span of the fractional power.
Higher order embeddings via the basepoint-freeness threshold
Authors: Caucci Federico
Published: May 2024

In this note, we relate the basepoint-freeness threshold of a polarized abelian variety, introduced by Jiang and Pareschi, with

k
k

-jet very ampleness. Then, we derive several applications of this fact, including a criterion for the

k
k

-very ampleness of Kummer varieties.
Small bowel lipoma and intussusception: a case report
Authors: Alam Fahreyar , Chikukuza Stewart , Okkeh Omar , Tsvetkov Filip , Hanif Zulfiqar , Lawrence John , Payne Richard
Published: May 2024

Intussusception is defined as the telescoping of bowel into itself. Intussusception is the leading cause of bowel obstruction in children, but it is rare in adults [1, 2]. It has a pathological intramural or extramural lead point. In adults, it accounts for 1%–5% of cases of bowel obstruction [3, 4]. Unlike presentation in the paediatric population of cramping abdominal pain, bloody mucus, and palpable mass in right iliac fossa, presentation in adults can be more varied and non-specific [1, 4]. Hence, diagnosis of small bowel intussusception (SBI) can be challenging, requiring a higher degree of clinical suspicion [5]. While cases of paediatric intestinal intussusception are often primary, most adult cases are secondary to structural lesions [5]. This case is of a 57-year-old lady who presented with SBI secondary to a small bowel lipoma (SBL), reflecting the importance of considering SBL as a differential in the causes of SBI.
Fecal proteolytic profiling of pediatric inflammatory bowel disease: A pilot study
Authors: Haak Wieke , Jagt Jasmijn Z. , de Meij Tim G. J. , Bikker Floris J. , Brand Henk S. , de Boer Nanne K. H. , Kaman Wendy E.
Published: May 2024

Colonoscopy is the gold standard for diagnosing inflammatory bowel disease (IBD). However, this invasive procedure has a high burden for pediatric patients. Previous research has shown elevated fecal amino acid concentrations in children with IBD versus controls. We hypothesized that this finding could result from increased proteolytic activity. Therefore, the aim of this study was to investigate whether fecal protease‐based profiling was able to discriminate between IBD and controls. Protease activity was measured in fecal samples from patients with IBD (Crohn's disease (CD) n = 19; ulcerative colitis (UC) n = 19) and non‐IBD controls (n = 19) using a fluorescence resonance energy transfer (FRET)‐peptide library. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of each FRET‐peptide substrate. Screening the FRET‐peptide library revealed an increased total proteolytic activity (TPA), as well as degradation of specific FRET‐peptides specifically in fecal samples from IBD patients. Based on level of significance (p < .001) and ROC curve analysis (AUC > 0.85), the fluorogenic substrates W‐W, A‐A, a‐a, F‐h, and H‐y showed diagnostic potential for CD. The substrates W‐W, a‐a, T‐t, G‐v, and H‐y showed diagnostic potential for UC based on significance (p < .001) and ROC analysis (AUC > 0.90). None of the FRET‐peptide substrates used was able to differentiate between protease activity in fecal samples from CD versus UC. This study showed an increased fecal proteolytic activity in children with newly diagnosed, treatment‐naïve, IBD. This could lead to the development of novel, noninvasive biomarkers for screening and diagnostic purposes.
Negative Pressure Wound Therapy for Gas Gangrene of the Fingertip with Prolonged Infection
Authors: Okamoto Yasufumi , Maeda Kazuhiro , Yukawa Mitsuhito , Nishimura Reiji , Nagamine Yuji , Hadano Yuka , Mandai Ayano , Udaka Jun , Miyawaki Takeshi , Saito Mitsuru
Published: May 2024

Background:

We encountered a case of infected soft tissue defect of the fingertip treated using negative pressure wound therapy (NPWT). The development of NPWT was started in the early 1990s, and it is a relatively new treatment method included in insurance coverage in Japan in 2010. NPWT is used for intractable wounds; some reports have examined its use on infected wounds. However, to the best of our knowledge, no study has examined its use on infected fingertip wounds.

Methods:

A patient with an infected soft tissue defect in the fingertip whose epithelialization period was prolonged despite continued antibiotic therapy was treated using NPWT in combination.

Results:

After NPWT was started, signs of infection and wound granulation were good. Additionally, completion of epithelialization was confirmed 7 weeks after NPWT started.

Conclusions:

Conventionally, skin flap or graft by hand surgeons have been performed on fingertip soft tissue defects with infection. NPWT does not require specialized and advanced surgical techniques; treatment for infected soft tissue defects can be administered by anyone if they have the required skills. In conclusion, NPWT may be considered a suitable alternative when treatment options such as flaps and skin grafts are not feasible.
Effects of intrarenal pelvic infusion of tumour necrosis factor-α and interleukin 1-β on reno-renal reflexes in anaesthetised rats
Authors: Abdulla Mohammed H. , AlMarabeh Sara , Bolger Tom , Lucking Eric F. , O’Halloran Ken D. , Johns Edward J.
Published: May 2024

Objective:

Reno-renal reflexes are disturbed in cardiovascular and hypertensive conditions when elevated levels of pro-inflammatory mediators/cytokines are present within the kidney. We hypothesised that exogenously administered inflammatory cytokines tumour necrosis factor alpha (TNF-α) and interleukin (IL)-1β modulate the renal sympatho-excitatory response to chemical stimulation of renal pelvic sensory nerves.

Methods:

In anaesthetised rats, intrarenal pelvic infusions of vehicle [0.9% sodium chloride (NaCl)], TNF-α (500 and 1000 ng/kg) and IL-1β (1000 ng/kg) were maintained for 30 min before chemical activation of renal pelvic sensory receptors was performed using randomized intrarenal pelvic infusions of hypertonic NaCl, potassium chloride (KCl), bradykinin, adenosine and capsaicin.

Results:

The increase in renal sympathetic nerve activity (RSNA) in response to intrarenal pelvic hypertonic NaCl was enhanced during intrapelvic TNF-α (1000 ng/kg) and IL-1β infusions by almost 800% above vehicle with minimal changes in mean arterial pressure (MAP) and heart rate (HR). Similarly, the RSNA response to intrarenal pelvic adenosine in the presence of TNF-α (500 ng/kg), but not IL-1β, was almost 200% above vehicle but neither MAP nor HR were changed. There was a blunted sympatho-excitatory response to intrapelvic bradykinin in the presence of TNF-α (1000 ng/kg), but not IL-1β, by almost 80% below vehicle, again without effect on either MAP or HR.

Conclusion:

The renal sympatho-excitatory response to renal pelvic chemoreceptor stimulation is modulated by exogenous TNF-α and IL-1β. This suggests that inflammatory mediators within the kidney can play a significant role in modulating the renal afferent nerve-mediated sympatho-excitatory response.
Effectiveness of a two-component nutritional strategy for blood pressure control in individuals with hypertension users of a public health system: a randomized controlled clinical trial
Authors: Bersch-Ferreira Angela C. , Machado Rachel H.V. , de Oliveira Júlia S. , Santos Renato H.N. , da Silva Lucas R. , Mota Luis G.S. , Pagano Raira , Sady Erica R.R. , Miyada Débora H.K. , Valeis Nanci , Martins Pedro N. , de Almeida Jussara C. , Marchioni Dirce M.L. , Lara Enilda M.S. , Gherardi-Donato Edilaine C.S. , Quinhoneiro Driele , Carvalho Ana Paula P.F. , Machado Malaine M.A. , Gedda Lana P.F. , Ferro Camila M.B. , Carvalho Ana Clara M.S. , Feoli Ana Maria P. , Walker Marthina S. , Pinto Sônia L. , Silva Kellen C. , Bruscato Neide M. , Moriguchi Emilio H. , Penafort Andreza M. , Santiago Rafaelle A. , Osório Denise R.D. , Rower Helena B. , Barbosa Marina R. , da Silva Joao Gabriel S.T. , Weber Bernardete , Cavalcanti Alexandre B. , Marcadenti Aline
Published: May 2024

Objective:

To evaluate the effectiveness of a nutritional strategy based on two components and adapted for the public health system on blood pressure, cardiometabolic features, self-care, qualify of life and diet quality in individuals with hypertension.

Methods:

NUPRESS was an open-label, parallel-group, superiority randomized controlled clinical trial in which participants at least 21 years with hypertension and poorly controlled blood pressure were randomly assigned (1 : 1 allocation ratio) to either an individualized dietary prescription according to nutritional guidelines (control group, n = 205); or a two-component nutrition strategy, including a goal-directed nutritional counseling and mindfulness techniques (NUPRESS [intervention] group, n = 205). Primary outcomes were SBP (mmHg) after 24 weeks of follow up and blood pressure control, defined as either having SBP more than 140 mmHg at baseline and achieving 140 mmHg or less after follow-up or having SBP 140 mmHg or less at baseline and reducing the frequency of antihypertensive drugs in use after follow-up.

Results:

In total, 410 participants were randomized and submitted to an intention-to-treat analysis regarding primary outcomes. Both groups decreased blood pressure, but after adjusting for baseline values, there was no significant difference between them on SBP [intervention-control difference: -0.03 (-3.01; 2.94); P = 0.98] nor blood pressure control [odds ratio 1.27 (0.82; 1.97); P = 0.28]. No differences between groups were also detected regarding secondary and tertiary outcomes.

Conclusion:

There was no difference between a two-component nutritional strategy and an established dietary intervention on blood pressure in participants with hypertension.
Combined vaccines against angiotensin II receptor type 1 and alpha 1D-adrenergic receptor for hypertension
Authors: Wu Jiacheng , Wu Zhijie , Kuang Wenlong , Shi Dingyang , Yang Yulu , Li Xin , Huang Jianwu , Li Xuehan , Liao Yuhua , Zhou Zihua , Qiu Zhihua
Published: May 2024

Purpose:

Compared with monotherapy, combination therapy with multiple antihypertensive drugs has demonstrated superior efficacy in the management of hypertension. The aim of this study was to explore the efficacy of multitarget combined vaccines in achieving simultaneous antihypertensive and target organ protection effects.

Methods:

Our team has developed ATRQβ-001 and ADRQβ-004 vaccines targeting Ang II type 1 receptor (AT1R) and α1D-adrenergic receptor (α1D-AR), respectively. In NG-nitroarginine methyl ester (l-NAME) + abilities spontaneously hypertensive rats (SHRs) model, SHRs were simultaneously inoculated with ATRQβ-001 and ADRQβ-004 vaccines. Histological and biochemical analyses were performed to evaluate the antihypertensive effects and target organ protection of the ATRQβ-001 and ADRQβ-004 combined vaccines in comparison with those of the single vaccine.

Results:

Both ATRQβ-001 and ADRQβ-004 vaccines induced robust antibody production, resulting in persistent high antibody titers in rats. Notably, the combined administration of both vaccines significantly decreased SBP in SHRs compared with treatment with a single vaccine, both before and after l-NAME administration. Furthermore, the combined vaccine regimen demonstrated superior efficacy in protecting against vascular remodeling, myocardial hypertrophy and fibrosis, and kidney injury in SHRs. Mechanistically, the combined vaccines exhibited significantly downregulated the expression of angiotensin II type 1 receptor (AT1R) and α1D-adrenergic receptor (α1D-AR). Importantly, no apparent immune-related adverse effects were observed in animals immunized with the combined vaccines.

Conclusion:

Preliminary findings from this investigation suggest that co-administration of the novel ATRQβ-001 and ADRQβ-004 vaccines holds potential as a groundbreaking therapeutic strategy for managing hypertension.
Hyperuricemia and gout enhanced the risk of long-term mortality in hypertension: insights from the National Health and Nutrition Examination Survey 2007–2018
Authors: Che Jinhang , Tong Jin , Kuang Xue , Zheng Caiyin , He Na , Liu Zengzhang
Published: May 2024

Background:

Asymptomatic hyperuricemia (HUA) and normouricemic gout are common in clinic but recommendations for them in hypertension management are absent. The present study aims to simultaneously evaluate the effect of HUA and gout on long-term mortality in hypertension.

Methods:

Individuals from 2007–2018 National Health and Nutrition Examination Survey were enrolled. Hazard ratios and 95% confidence intervals (CIs) were calculated with the aid of the Cox proportional-hazards model. The restricted cubic spline (RCS) analysis was made to show the dose–response relationship between uric acid and mortality. All-cause mortality and cardiovascular mortality were compared using the Kaplan–Meier curve with a log-rank test.

Results:

Thirty thousand eight hundred and nineteen eligible individuals were included, of which 5841 suffered from HUA and 1476 suffered from gout. During a median follow-up of 7.25 (95% CI 7.18–7.32) years, 2924 (6.8%) patients died, including 722 (1.6%) cases of cardiovascular death. Hypertensive patients with HUA and gout showed 1.34 and 1.29 times higher all-cause mortality compared with those without HUA or gout. For hypertensive patients without gout, HUA was significantly associated with higher risk of all-cause [1.27 (1.13, 1.43)] and cardiovascular [1.80 (1.44, 2.24)] mortality compared with normouricemia. However, for hypertensive patients without HUA, gout was associated with a higher mortality but not statistically significant. A J-shaped relationship was found between serum uric acid and mortality.

Conclusion:

HUA and gout are additive risk factors for all-cause and cardiovascular mortality in hypertension. Furthermore, asymptomatic HUA is significantly associated with poor long-term prognosis but normouricemic gout is not.
Longitudinal study of birthweight, blood pressure, and markers of arterial stiffness in children age six among the TIDES cohort
Authors: Long Sara E. , Sood Shefali , Kanesa-Thasan Anish , Kahn Linda G. , Urbina Elaine M. , Barrett Emily S. , Nguyen Ruby H. , Bush Nicole R. , Swan Shanna H. , Sathyanarayana Sheela , Trasande Leonardo
Published: May 2024

Objective:

Although some studies have observed an association between birthweight and cardiovascular disease in adulthood, fewer have investigated whether birthweight is linked to cardiovascular health in early childhood. This study assesses the association between birthweight and cardiovascular outcomes in children 6 years of age.

Study Design:

Birthweight, blood pressure (BP), and markers of arterial stiffness in children, including brachial artery distensibility and carotid-femoral pulse wave velocity (cfPWV), were obtained from 324 participants in The Infant Development and the Environment Study, a prospective multisite pregnancy cohort. Birthweight was converted into sex-specific birthweight-for-gestational-age (bw/ga) z-scores based on the INTERGROWTH-21st standard. Following 2017 American Academy of Pediatrics guidelines, SBP and DBP were transformed into sex, age, and height-specific z-scores. Associations between birthweight and cardiovascular outcomes were assessed using nested multivariable linear regression models among the overall and sex-stratified samples.

Results:

Among the overall sample, bw/ga z-score was positively associated with cfPWV [b = 0.11 m/s, 95% confidence interval (CI): 0.01 m/s, 0.21 m/s] in crude and adjusted models. No associations between birthweight and cardiovascular outcomes were detected among the sex-stratified analyses.

Conclusion:

Overall, birthweight was not related to cardiovascular outcomes in children 6 years old. However, infants born with a higher birthweight may be at risk for higher cfPWV in childhood. Early intervention in pregnant people at risk of delivering high birthweight infants may be warranted if results are replicated.
Drug Promotions Between Ethics, Regulations, and Financial Interests
Authors: Astărăstoae Vasile , Rogozea Liliana M. , Leaşu Florin Gabriel , Roşca Stefan
Published: May 2024

Background:

The promotion of the latest medicines produced by the pharmaceutical industry is an important issue both from an ethical point of view (the level of accessibility, the way research is carried out) and from the point of view of marketing and especially from the lobbying issues raised.

Areas of Uncertainty:

The ethical dilemmas raised by the promotion of new drugs revolve between the need to discover new molecules important for treating a wide range of diseases and the need to establish a battery of ethical rules, absolutely necessary for regulations in the field to be compliant with all ethical principles.

Data Sources:

A literature search was conducted through PubMed, MEDLINE, Plus, Scopus, and Web of Science (2015–2023) using combinations of keywords, including drugs, medical publicity, and pharma marketing plus ethical dilemma.

Ethics and Therapeutic Advances:

The promotion of medicines is governed by advertising laws and regulations in many countries, including at EU level, based on the need for countries to ensure that the promotion and advertising of medicines is truthful, based on information understood by consumers. The ethical analysis of the issues raised is more necessary and complex as the channels used for promotion are more accessible to the population, and the information, easier to obtain, can be the cause of increased self-medication and overeating. Large amounts of money invested in the development of new molecules, but also the risk of scientific fraud through manipulation of data during clinical trials, selective or biased publication of information can have repercussions on the health of the population.

Conclusions:

The development of new pharmaceutical molecules is necessary to intervene and treat as many conditions as possible, but marketing must not neglect the observance of ethical principles. The promotion of medicines should be the attribute especially of the medical staff, which should also be a mandatory part of the mechanism for approving the marketing methods and means used by the pharmaceutical companies.
Favorable Outcome of High-grade Endometrial Stromal Sarcoma in an Adolescent
Authors: Hu Benjamin , Howitt Brooke E. , Cizek Stephanie , Diver Elisabeth , Hiniker Susan , Crane Jacquelyn , Daldrup-Link Heike , Spunt Sheri L.
Published: May 2024

High-grade endometrial stromal sarcoma is a rare and aggressive soft tissue tumor characterized by YWHAE::NUTM2A/B translocations, diagnosis at a median of 50-60 years, and a poor prognosis (overall survival 30%-40%). We describe a 16-year-old patient with high-grade endometrial stromal sarcoma and regional nodal and pulmonary metastases who is a long-term survivor after grossly complete tumor resection, intensive chemotherapy, and pelvic radiotherapy. We discovered a previously undescribed YWHAE::NUTM2E translocation in the tumor. Our patient’s favorable outcome suggests that intensive multimodality therapy with curative intent is appropriate for young patients with high-grade endometrial stromal sarcoma and highlights the importance of fertility preservation.
Embedding Nursing Ethics Within Teaching Strategies in Nurse Residency Programs
Authors: West Rebecca S. , Axel-Adams Robyn M. , Wocial Lucia D.
Published: May 2024

Exposing new nurses to theoretical teaching strategies that help them to navigate the ethical challenges in clinical practice is essential for retention and long-term job satisfaction. This article explores the rationale for teaching ethics content in nurse residency programs and ways to navigate ethical decision-making in the clinical setting. Examples of evidence-informed teaching strategies that enhance knowledge retention and reduce the gap between ethical theory and practice are included.
68Ga-DOTATOC Pictorial Essay of Various Recurrent Meningiomas Rejected for Treatment With 177Lu-DOTATATE
Authors: Moreau Aurélie , Maureille Aurélien , Kryza David
Published: May 2024

We report the cases of 4 patients treated for recurrent meningiomas of various grades. Pretreatment 68Ga-DOTATOC PET/CT was performed prior to screening for vectorized internal radiotherapy with 177Lu-DOTATATE or prior external radiotherapy to aid contouring. None of these patients had sufficient uptake to be eligible for 177Lu-DOTATATE or reliable contouring. Most recurrences were grades II and III, suggesting a loss of physiological somatostatin receptor overexpression in these tumors. Therefore, the benefit of treatment with 177Lu-DOTATATE in the current indication is questionable. In the absence of a validated systemic treatment, and considering a few case reports, treatment with 177Lu-PSMA could be investigated as an additional vectorized internal radiotherapy option.
Does the Internet Provide Quality Information on Metoidioplasty? Using the Modified Ensuring Quality Information for Patients Tool to Evaluate Artificial Intelligence–Generated and Online Information on Metoidioplasty
Authors: Hirpara Milan M. , Amin Luv , Aloyan Toni , Shilleh Najla , Lewis Priya
Published: May 2024

Background

Public interest in gender affirmation surgery has surged over the last decade. This spike in interest, combined with extensive free online medical knowledge, has led many to the Internet for more information on this complicated procedure. This study aimed to evaluate the quality of online information on metoidioplasty.

Methods

Google Trends in searches on “metoidioplasty” from 2004 to present were assessed. “metoidioplasty” was searched on three popular search engines (Google, Yahoo, and Bing), and the first 100 websites from each search were extracted for inclusion (Fig. 1). Exclusion criteria included duplicates, websites requiring fees, photo libraries, and irrelevant websites. Websites were assigned a score (out of 36) using the modified Ensuring Quality Information for Patients (EQIP) instrument, which grades patient materials based on content (18), identification (6), and structure (12). ChatGPT was also queried for metoidioplasty-related information and responses were analyzed using EQIP.

Results

Google Trends analysis indicated relative search interest in “metoidioplasty” has more than quadrupled since 2013(Fig. 2). Of the 93 websites included, only 2 received an EQIP score greater than 27 (6%). Website scores ranged from 7 to 33, with a mean of 18.6 ± 4.8. Mean scores were highest for websites made by health departments (22.3) and lowest for those made by encyclopedias and academic institutions (16.0). Websites with the highest frequency were research articles, web portals, hospital websites, and private practice sites, which averaged scores of 18.2, 19.7, 19.0, and 17.8, respectively. Health department sites averaged the highest content points (11.25), and academic institutions averaged the lowest (5.5). The average content point across all websites was 7.9 of 18. ChatGPT scored a total score of 29: 17 content, 2 identification, and 10 structures. The artificial intelligence chatbot scored the second highest score among all included online resources.

Conclusions

Despite the continued use of search engines, the quality of online information on metoidioplasty remains exceptionally poor across most website developers. This study demonstrates the need to improve these resources, especially as interest in gender-affirming surgery continues to grow. ChatGPT and other artificial intelligence chatbots may be efficient and reliable alternatives for those seeking to understand complex medical information.
Geospatial and Socioeconomic Disparities Influencing the Management of Craniosynostosis
Authors: Belza Caitlyn C. , Sheahan Lucy , Blum Jessica , Becker Miriam , Oca Michael , Lopes Kelli , Gosman Amanda A.
Published: May 2024

Background

Various social determinants of health have been described as predictors of clinical outcomes for the craniosynostosis population. However, literature lacks a granular depiction of socioeconomic factors that impact these outcomes, and little is known about the relationship between patients' proximity to the care center and management of the condition.

Methods/Design

This study retrospectively evaluated patients with craniosynostosis who presented to a tertiary children's hospital between 2000 and 2019. Outcomes of interest included age at presentation for surgery, incidence of reoperation, and length of follow-up. Patient addresses were geocoded and plotted on two separate shapefiles containing block group information within San Diego County. The shapefiles included percent parental educational attainment (bachelor's degree or higher) and median household income from 2010. The year 2010 was chosen for the shapefiles because it is the median year of data collection for this study. Multivariate linear, logistic, and polynomial regression models were used to analyze the relationship between geospatial and socioeconomic predictors and clinical outcomes.

Results

There were 574 patients with craniosynostosis included in this study. The mean ± SD Haversine distance from the patient's home coordinates to the hospital coordinates was 107.2 ± 321.2 miles. After adjusting for the suture fused and insurance coverage, there was a significant positive correlation between distance to the hospital and age at index surgery (P = 0.018). There was no correlation between distance and incidence of reoperation (P = 0.266) or distance and duration of follow-up (P = 0.369). Using the same statistical adjustments, lower parental percent educational attainment and lower median household income correlated with older age at index surgery (P = 0.008 and P = 0.0066, respectively) but were not correlated with reoperation (P = 0.986 and P = 0.813, respectively) or duration of follow-up (P = 0.107 and P = 0.984, respectively).

Conclusions

The results offer evidence that living a greater distance from the hospital and socioeconomic disparities including parental education and median household income may serve as barriers to prompt recognition of diagnosis and timely care in this population. However, the geospatial and socioeconomic factors studied do not seem to hinder incidence of reoperation or length of follow-up, suggesting that, once care has been initiated, longitudinal outcomes may be less impacted.
Unveiling the Hidden Discrepancies Between Medicare Physician Reimbursement Rates and Inflation Across Different Surgical Specialties
Authors: Stoffel Victoria , Camacho Justin M. , Heeb Connor , Cui Saishi , Shim Jalene Y. , Pacella Salvatore J. , Gosman Amanda A. , Reid Chris M.
Published: May 2024

Objective

This study aimed to analyze the trends of Medicare physician reimbursement from 2011 to 2021 and compare the rates across different surgical specialties.

Background

Knowledge of Medicare is essential because of its significant contribution in physician reimbursements. Previous studies across surgical specialties have demonstrated that Medicare, despite keeping up with inflation in some areas, has remained flat when accounting for physician reimbursement.

Study Design

The Physician/Supplier Procedure Summary data for the calendar year 2021 were queried to extract the top 50% of Current Procedural Terminology codes based on case volume. The Physician Fee Schedule look-up tool was accessed, and the physician reimbursement fee was abstracted. Weighted mean reimbursement was adjusted for inflation. Growth rate and compound annual growth rate were calculated. Projection of future inflation and reimbursement rates were also calculated using the US Bureau of Labor Statistics.

Results

After adjusting for inflation, the weighted mean reimbursement across surgical specialties decreased by −22.5%. The largest reimbursement decrease was within the field of general surgery (−33.3%), followed by otolaryngology (−31.5%), vascular surgery (−23.3%), and plastic surgery (−22.8%). There was a significant decrease in median case volume across all specialties between 2011 and 2021 (P < 0.001).

Conclusions

This study demonstrated that, when adjusted for inflation, over the study period, there has been a consistent decrease in reimbursement for all specialties analyzed. Awareness of the current downward trends in Medicare physician reimbursement should be a priority for all surgeons, as means of advocating for compensation and to maintain surgical care feasible and accessible to all patients.
Modern Trends in Nasal Bone Fractures and the Effect of Social Distancing
Authors: Hoerter Jacob E. , Huynh Pauline P. , Doshi Abhishek , McKinnon Louis , Liang Jonathan
Published: May 2024

Objectives:

To assess differences in demographics, incidence, and cause of nasal bone fractures (NBFs) between pre–coronavirus disease 2019 (COVID-19) and COVID-19 eras.

Methods:

The National Electronic Injury Surveillance System was queried for adult NBF. Two sample t tests and Wald χ2 tests were used to identify changes across the 2012 to 2019 period and 2020 to 2021 period (age, sex, race, location, disposition, and product).

Results:

There was a total of 523,259 (95% CI: 445,082–601,436) emergency department (ED)–treated adult NBFs in the United States. There was a greater incidence of NBF during COVID-19 (61,621 annual cases; 95% CI: 61,572–61,669) compared with pre–COVID-19 (50,773 annual cases; 95% CI: 50,195–51,351; P < 0.01). Fewer patients with NBF were discharged after ED evaluation during COVID-19 (79.46%; 95% CI: 74.45%–83.70%) compared with before (84.41%; 95% CI: 82.36%–86.28%; P = 0.049, t test). During COVID-19, there was a decrease in sport-associated NBFs, such as basketball [2.36% (95% CI: 1.71%–3.27%) versus 5.21% (95% CI: 4.20%–6.45%), P < 0.01] and baseball [1.18% (95% CI: 0.82%–1.69%) versus 2.22% (95% CI: 1.80%–2.74%), P<0.01], but an increase in fall (66.34% versus 75.02%), alcohol (7.04% versus 12.89%), and drug-associated (0.47% versus 5.70%) NBFs (all P < 0.001).

Conclusion:

A greater incidence of NBFs has been observed since the start of the COVID-19 pandemic without significant changes in sex or race. Nasal bone fractures during COVID-19 were less likely to be related to sports or discharged from the ED and more likely to be associated with drugs and alcohol. Changes in sociobehavioral patterns during these unprecedented times may account for post–COVID-19 NBF etiologic drift.

Level of Evidence:

Level II—retrospective cohort study.
Physical and social warmth
Authors: Koppang Haavard , Harem Thorvald , Mayiwar Lewend , Pineda Jaime
Published: May 2024

The concept of a warm person has played a key role in western social psychological research, particularly in how people perceive others. Williams and Bargh (2008; Study 1) found that individuals holding a cup of warm beverage perceived the individuals they faced as psychologically warmer than those who held a cup of cold beverage. In this article, we set out to replicate and extend these findings by exploring whether various factors modify the effect of physical and social warmth. Specifically, we tested three moderating variables: participants’ awareness of the purpose of the experiment, warmth of participants’ personality and the target person’s gender. We found no main effect of physical warmth, and very little evidence for any moderating effects. It is clear from this and other recent studies that the embodiment effect is not simple to replicate and, therefore, is difficult to exploit for practical purposes.
Spiking neural networks for nonlinear regression
Authors: Henkes Alexander , Eshraghian Jason K. , Wessels Henning
Published: May 2024

Spiking neural networks (SNN), also often referred to as the third generation of neural networks, carry the potential for a massive reduction in memory and energy consumption over traditional, second-generation neural networks. Inspired by the undisputed efficiency of the human brain, they introduce temporal and neuronal sparsity, which can be exploited by next-generation neuromorphic hardware. Energy efficiency plays a crucial role in many engineering applications, for instance, in structural health monitoring. Machine learning in engineering contexts, especially in data-driven mechanics, focuses on regression. While regression with SNN has already been discussed in a variety of publications, in this contribution, we provide a novel formulation for its accuracy and energy efficiency. In particular, a network topology for decoding binary spike trains to real numbers is introduced, using the membrane potential of spiking neurons. Several different spiking neural architectures, ranging from simple spiking feed-forward to complex spiking long short-term memory neural networks, are derived. Since the proposed architectures do not contain any dense layers, they exploit the full potential of SNN in terms of energy efficiency. At the same time, the accuracy of the proposed SNN architectures is demonstrated by numerical examples, namely different material models. Linear and nonlinear, as well as history-dependent material models, are examined. While this contribution focuses on mechanical examples, the interested reader may regress any custom function by adapting the published source code.
A typology of family caregiving for older immigrants: perspectives from care receivers and care providers
Authors: Hierofani Patricia Yocie , van Riemsdijk Micheline
Published: May 2024

Purpose

As populations are ageing and the global average life expectancy is rising, the provision of care for older people is an increasingly salient issue. This paper aims to focus on family-provided care for older immigrants, examining how older immigrants and care providers experience and construct family caregiving.

Design/methodology/approach

Based on interviews with care recipients, family care providers, municipal staff and representatives for migrant organisations in Sweden, this study presents a typology of family caregiving for older immigrants.

Findings

The authors found three caregiving types, namely, solely family-provided care and a combination of family care and public care (predominantly one or the other). The decision to select family-provided or publicly-funded care depends on personal and institutional factors.

Originality/value

The paper makes three empirical contributions to the literature on care provision for older immigrants. Firstly, this study provides insights into the structural and personal factors that shape care-giving arrangements for older immigrants. Secondly, this study examines the perspectives of care recipients and care providers on family-provided care. Care expectations differ between both groups and sometimes result in intergenerational disagreement. Thirdly, in terms of institutional support, this study finds that the Swedish state’s notion of individual needs does not match the needs of immigrant elderly and their caregivers. The paper places the care types in a broader discussion about eldercare provision in the Swedish welfare state, which has experienced a decline in publicly funded care services and an increase in family caregiving in the past 30 years. In addition, it addresses questions of dignified ageing from a minority perspective.
The impact of artificial intelligence on economic development
Authors: Trabelsi Mohamed Ali
Published: May 2024

Purpose

This paper reviews recent research on the expected economic effects of developing artificial intelligence (AI) through a survey of the latest publications, in particular papers and reports issued by academics, consulting companies and think tanks.

Design/methodology/approach

Our paper represents a point of view on AI and its impact on the global economy. It represents a descriptive analysis of the AI phenomenon.

Findings

AI represents a driver of productivity and economic growth. It can increase efficiency and significantly improve the decision-making process by analyzing large amounts of data, yet at the same time it creates equally serious risks of job market polarization, rising inequality, structural unemployment and the emergence of new undesirable industrial structures.

Practical implications

This paper presents itself as a building block for further research by introducing the two main factors in the production function (Cobb-Douglas): labor and capital. Indeed, Zeira (1998) and Aghion, Jones and Jones (2017) suggested that AI can stimulate growth by replacing labor, which is a limited resource, with capital, an unlimited resource, both for the production of goods, services and ideas.

Originality/value

Our study contributes to the previous literature and presents a descriptive analysis of the impact of AI on technological development, economic growth and employment.