bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring staff experiences and perceptions of patient‐perpetrated violence in hospital settings: A qualitative study
Authors: Sammut Dana , Lees‐Deutsch Liz , Ali Luul , Imasogie Jennifer , Nkundo Lavinia , Hallett Nutmeg
Published: May 2024

Aims

To explore hospital staff experiences and perceptions of patient‐perpetrated violence.

Design

Descriptive qualitative study.

Methods

Twelve semi‐structured interviews (June–August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non‐clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens.

Results

Three themes were identified: violence as (un)predictable, violence as (un)preventable and the cumulative toll of violence. In making sense of why patients become violent, participants described different ‘types’ of aggressive patients and variably attributed behaviours to situation, disposition or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of ‘resilience’ and reflecting on its role in their responses to escalating situations.

Conclusions

Many hospital staff are resigned to the inevitability of violence. The concept of staff ‘resilience’ following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the UK.

Implications for the Profession

Efforts to address violence against healthcare staff need to be power‐conscious, ensuring that accountability is distributed across multiple levels.

Reporting Method

This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ).

Patient or Public Contribution

No patient or public contribution.
Angiopoietin‐like 4 is upregulated by amphiregulin and activates cell proliferation and migration through p38 kinase in head and neck squamous cell carcinoma
Authors: Kumar Ajay , Asiedu Emmanuel , Hefni Eman , Armstrong Cheryl , Menon Deepak , Ma Tao , Sands Lauren , Mbadugha Eberechi , Sodhi Akrit , Schneider Abraham , Montaner Silvia
Published: May 2024

Background

Angiopoietin‐like 4 is a molecular hallmark that correlates with the growth and metastasis of head and neck squamous cell carcinoma, one of the most prevalent cancers worldwide. However, the molecular mechanisms by which angiopoietin‐like 4 promotes head and neck squamous cell carcinoma tumorigenesis are unclear.

Methods

Using well‐characterized cell lines of head and neck squamous cell carcinoma development, including human normal oral keratinocytes, dysplastic oral keratinocytes, oral leukoplakia‐derived oral keratinocytes, and head and neck squamous cell carcinoma cell lines, HN13, HN6, HN4, HN12, and CAL27, we investigated the signaling pathways upstream and downstream of angiopoietin‐like 4‐induced head and neck squamous cell carcinoma tumorigenesis.

Results

We found that both epidermal growth factor receptor ligands, epithelial growth factor, and amphiregulin led to angiopoietin‐like 4 upregulation in normal oral keratinocytes and dysplastic oral keratinocytes and cooperated with the activation of hypoxia‐inducible factor‐1 in this effect. Interestingly, amphiregulin and angiopoietin‐like 4 were increased in dysplastic oral keratinocytes and head and neck squamous cell carcinoma cell lines, and amphiregulin‐induced activation of cell proliferation was dependent on angiopoietin‐like 4. Although both p38 mitogen‐activated protein kinases (p38 MAPK) and protein kinase B (AKT) were activated by angiopoietin‐like 4, only pharmacological inhibition of p38 MAPK was sufficient to prevent head and neck squamous cell carcinoma cell proliferation and migration. We further observed that angiopoietin‐like 4 promoted the secretion of interleukin 11 (IL‐11), interleukin 12 (IL‐12), interleukin‐1 alpha (IL‐1α), vascular endothelial growth factor, platelet‐derived growth factor (PDGF), and tumour necrosis factor alpha (TNF‐α), cytokines and chemokines previously implicated in head and neck squamous cell carcinoma pathogenesis.

Conclusion

Our results demonstrate that angiopoietin‐like 4 is a downstream effector of amphiregulin and promotes head and neck squamous cell carcinoma development both through direct activation of p38 kinase as well as paracrine mechanisms.
Biomechanical Properties of Novel Porous Scaffold Core and Hollow Lateral Hole Pedicle Screws: A Comparative Study in Bama Pigs
Authors: Hu Yong , Chen Xijiong , Chu Zhentao , Luo Linwei , Gan Zhiwei , Zhong Jianbin , Yuan Zhenshan , Zhu Bingke , Dong Weixin
Published: May 2024

Objective

Screw loosening is a common complication of internal fixation of pedicle screw. Therefore, the development of a pedicle screw with low loosening rate and high biosafety is of great clinical significance. This study aimed to investigate whether the application of a porous scaffold structure can improve the stability of pedicle screws by comparing the biomechanical properties of novel porous scaffold core pedicle screws (PSCPSs) with those of hollow lateral hole pedicle screws (HLHPSs) in a porcine lumbar spine.

Methods

Thirty‐two pedicle screws of both types were implanted bilaterally into the L1–4 vertebrae of four Bama pigs, with our newly designed PSCPSs on the right and HLHPSs on the left. All the Bama pigs were sacrificed 16 weeks postoperatively, and the lumbar spine was freed into individual vertebrae. Biomechanical properties of both the pedicle screws were evaluated using pull‐out tests, as well as cyclic bending and pull‐out tests, while the mechanical properties were assessed using three‐point bending tests. The data generated were statistically analyzed using paired‐sample t‐tests and two independent sample t‐tests.

Results

We found that the maximal pull‐out forces before and after cyclic bending of the PSCPSs (1161.50 ± 337.98 N and 1075.25 ± 223.33 N) were significantly higher than those of the HLHPSs (948.38 ± 194.32 N and 807.13 ± 242.75 N) (p < 0.05, p < 0.05). In 800 cycles of the bending tests, neither PSCPS nor HLHPS showed loosening or visible detachment, but their maximal pull‐out forces after cyclic bending tests decreased compared to those in cycles without cyclic bending tests (7.43% and 14.89%, respectively), with no statistical significance (p > 0.05 and p > 0.05, respectively). Additionally, both screws buckled rather than broke in the three‐point bending tests, with no statistically significant differences between the maximal bending load and modulus of elasticity of the two screws (p > 0.05 and p > 0.05, respectively).

Conclusions

Compared with the HLHPSs, the PSCPSs have greater pull‐out resistance and better fatigue tolerance with appropriate mechanical properties. Therefore, PSCPSs theoretically have significant potential for clinical applications in reducing the incidence of loosening after pedicle screw implantation.
The Effect of Clavicular Tunnel Position on Reduction Loss in Patients with Acute Acromioclavicular Joint Dislocations Operated with a Single‐Bundle Suspensory Loop Device
Authors: Senel Ahmet , Eren Murat , Batur Omer Cihan , Kaya Oguz , Sert Selman , Key Sefa
Published: May 2024

Objective

The treatment of acromioclavicular joint (ACJ) dislocations offers numerous options, and ongoing debates persist regarding their comparative effectiveness. Among these options, the suspensory loop device (SLD) is one of the most favored treatment modalities. Despite the observed high reduction loss rate associated with SLD, the treatment yields favorable clinical outcomes. This study aimed to investigate the clinical outcomes of patients with acute type 3 and 5 ACJ dislocations who underwent open and arthroscopic procedures using a single‐bundle SLD, and to evaluate the effect of clavicular tunnel position on reduction loss.

Methods

Thirty‐seven eligible patients diagnosed with acute type 3 and type 5 ACJ dislocation who underwent open and arthroscopic surgery with a single‐bundle SLD between January 2015 and March 2022 were evaluated retrospectively. Demographic data and radiological measurements including coracoclavicular (CC) interval, clavicle length (CL), and implant distance (ID) were recorded. The ID/CL ratio was calculated and a value between 0.17 and 0.24 was considered as “acceptable implant position”. Reduction loss and other complications were noted. Patients were divided into two groups: open (Group 1) and arthroscopic (Group 2). Constant Murray Score (CMS) and Visual Analog Scale (VAS) were used for clinical and functional outcomes. Non‐parametric tests were used for statistical analysis of variables.

Results

The study included six females (16.2%) and 31 males (83.8%) with a mean age of 40.2 ± 14.7 years (range: 20–75). The mean follow‐up period was 22.3 ± 16.7 months (range: 6–72). The average time from trauma to surgery was 6.3 ± 5.3 days (range: 1–18). At the last follow‐up, the CMS was 89.3 ± 8.8 and the VAS score was 2.1 ± 0.9. The mean ID/CL ratio was 0.19 ± 0.1 and 19 patients (51.4%) were between 0.17 and 0.24. Reduction loss was observed in nine patients (24.3%). There were no significant differences between Group 1 and Group 2 regarding operation time (p = 0.998), ID/CL ratio (p = 0.442), reduction loss (p = 0.458), CMS (p = 0.325), and VAS score (p = 0.699). Of the 28 patients without reduction loss, 16 had an ID/CL ratio between 0.17 and 0.24 (p = 0.43). Furthermore, within the 0.17–0.24 interval, CMS was higher with an average of 91.8 ± 5.1 compared to the other intervals (p = 0.559).

Conclusion

The clinical and functional outcomes of acute type 3 and type 5 ACJ dislocation operated open and arthroscopically with single‐bundle SLD are similar and satisfactory. A clavicular tunnel position in the range of 0.17–0.24 (ID/CL ratio) is recommended to maintain postoperative reduction.
An observational study of gastric contents in pediatric patients with long bone fracture using gastric ultrasound
Authors: Soneru Codruta N. , Reviere Anna N. , Petersen Timothy R. , Paluska Matthew R. , Davis Donnis DeQuan , Falcon Ricardo J.
Published: May 2024

Background

The retention of gastric contents at surgery presentation is a risk factor for perioperative aspiration. A preoperative fasting (nil per os; NPO) interval is widely used to reduce this risk, but this approach is based on assumptions about the prevalence of typical gastric emptying rates. We assessed NPO guidelines' reliability with ultrasound (US) imaging and suction in pediatric patients presenting for single long‐bone fracture repair after appropriate NPO intervals, when nearly all should have had empty stomachs.

Aims and Methods

This prospective cross‐sectional observational study comprised 200 pediatric surgical patients. As their NPO times varied by food/drink type, we defined “weighted NPO units” as the lowest multiple of elapsed recommended NPO times between consumption and surgery for each type of food or drink. We used US to image the stomach and its contents before anesthesia induction, followed by gastric suction. We evaluated the relationships between weighted NPO units, US gastric contents grade, opioid analgesic dosage and timing, and suctioned volume.

Results

Despite meeting typical NPO standards (median 14 h fasting), many patients retained nontrivial quantities of gastric contents at surgery. Weighted NPO units did not exhibit statistically‐significant relationships with either suctioned volume or US grade. However, suctioned volume did correspond well to US grade.

Conclusion

NPO status may be a less reliable predictor of gastric contents at anesthesia induction in this patient population than has been assumed. Bedside US screening appears to provide more useful information for the planning of airway management.
Trust, collaboration, and participation in governance: A Nordic perspective on public administrators' perceptions of citizen involvement
Authors: Vento Isak
Published: May 2024

This study analyzes public administrators' trust in citizens' capacities to participate in governance, their collaborative tendency, and the association between these factors and public administrators' willingness to implement citizen involvement efforts. The purpose of the study is to examine whether public administrators' trust in citizens' participatory capacities predicts a willingness to implement citizen participation efforts within the central administration of a Nordic welfare country. The central administration of Finland presents a counter case to previous studies, which have mostly focused on the United States. A unique survey of administrators, operationalized similarly to previous studies, was conducted, and analysis of the data provides both confirmatory and novel insights. The analysis finds that administrators' trust in citizens' participatory capacities strongly predicts their willingness to implement citizen participation initiatives. However, this relation can significantly decrease or increase depending on the degree to which administrators value the procedural legitimacy of collaborative governance.
Soil tillage reduction as a climate change mitigation strategy in Mediterranean cereal‐based cropping systems
Authors: Fiorentini Marco , Orsini Roberto , Zenobi Stefano , Francioni Matteo , Rivosecchi Chiara , Bianchini Marco , di Tella Biagio , D'Ottavio Paride , Ledda Luigi , Santilocchi Rodolfo , Deligios Paola
Published: May 2024

According to climate change projections, global temperatures would increase by 2°C by 2070, and agriculture is expected to be among the most affected sectors, particularly intensive field crops like cereals. Therefore, researchers need to investigate the most cost‐effective agricultural strategies that can prevent production losses and ensure global food security. This study aimed to identify the limiting factors of durum wheat (Triticum turgidum L. subsp. Durum (Desf.) Husn.) yield production under Mediterranean conditions. Durum wheat yield data of over 5 years (2017–2022), from a 30‐year rainfed long‐term experiment conducted in the ‘Pasquale Rosati’ experimental farm of the Polytechnic University of Marche in Agugliano, Italy (43°32’ N, 13°22′ E, 100 a.s.l.) on Calcaric Gleyic Cambisols with a silt‐clay texture, were analysed and compared with the recorded thermo‐pluviometric trend. The field trial included two soil managements (no tillage vs. conventional tillage) and three Nitrogen (N) fertilization levels (0, 90, and 180 kg N ha−1). The most important driver for durum wheat production was N fertilization. However, in the absence of N fertilization, no tillage showed a higher yield (+1.2 t ha−1) than conventional tillage due to the accumulation of organic matter in the soil. When wheat was fertilized with 90 kg N ha−1, no tillage resulted in 25% yield more than conventional tillage (+1.2 t ha−1), but this occurred only when the increase in temperatures was constant from January until harvest (this happened in 3 of 5 years of monitoring). The non‐constant increase in temperature from January to wheat harvest may hamper crop phenological development and reduce the potential yield. The highest fertilization rate (180 Kg N ha−1) resulted in the highest wheat yields regardless of soil management and thermo‐pluviometric trends (5.78 t ha−1). After N fertilization and soil management, the minimum and maximum temperature in February and the maximum temperature in April were crucial for durum wheat production under Mediterranean condition. When there is non‐constant increase in temperature from January to wheat harvest no‐tillage should be preferred over conventional tillage because wheat yields did not reduce under no tillage. Thus, agricultural policies that support the switch from conventional tillage to no‐tillage management should be promoted to enable food security in Mediterranean environments.
How do transfusion services manage patients taking therapies such as anti‐CD38 and anti‐CD47 known to interfere with red blood cell compatibility testing?
Authors: Murphy Michael F. , Rajbhandary Srijana , Carayiannis Sharon , Cohn Claudia S.
Published: May 2024

Background

Drugs such as daratumumab (Darzalex, anti‐CD38) and Hu5F9‐G4 (magrolimab, anti‐CD47) may interfere with red blood cell compatibility testing as CD38 and CD47 are expressed on red blood cells.

Study Design and Methods

A survey of AABB member transfusion services was undertaken to understand their experiences of managing patients taking therapeutic monoclonal antibodies that are known to interfere with blood grouping and compatibility testing.

Results

The survey was distributed to the contact person at US‐based AABB member transfusion services. The response rate was 27%. 172 of 240 (72%) indicated they had difficulties in performing compatibility testing in patients taking daratumumab and 66 of 91 (73%) reported difficulties in performing compatibility testing in patients taking magrolimab. Actions taken to provide compatible blood for these patients included referral of all samples to a reference center, blood group pheno/genotyping the patient in advance of starting the drug, treating reagent cells with 0.2 M dithiothreitol and using K‐negative red cell units for patients taking daratumumab, and Gamma‐clone (Immucor) anti‐IgG for indirect antiglobulin testing for patients taking magrolimab. Lack of communication from clinical services about drug treatment was identified as a concern.

Conclusion

The results of the survey demonstrate that transfusion services are having challenges with the transfusion management of patients taking therapeutic monoclonal antibodies, and further education is needed.
Mechanical Deformation in Lithium-Ion Battery Electrodes: Modeling and Experiment
Authors: Foster J. M. , Hahn Y. , Patanwala H. , Oancea V. , Sahraei E.
Published: May 2024

Models that can accurately describe deformation and stress in lithium-ion batteries are required to inform new device designs that can better withstand mechanical fatigue. Developing such models is particularly challenging because (i) there is a need to capture several different materials including active materials, binders, current collectors, and separators, and (ii) the length scales of interest are highly disparate (ranging from a few microns, relevant to active material particles, up to centimeters, relevant to whole devices). In this study, we present a continuum mechanical model that resolves individual active material particles of a nickel-manganese-cobalt-oxide cathode, and predicts the mechanical response of the cathode coating as a whole. The model is validated by comparison with experimental tests which mimic industrial-scale electrode calendaring, and then a parametric study is conducted to provide insight into the roles of the material and geometric properties of the electrode's constituents on the cathode's overall behavior.
A Feature Extraction Method for Prognostic Health Assessment of Gas Compressor Valves
Authors: Chesnes Jacob J. , Nelson Daniel A. , Kolodziej Jason R.
Published: May 2024

This article presents features derived from the pressure–volume (PV) diagram that is useful in estimating different valve faults in reciprocating compressors with a strong potential of remaining useful life prediction. The PV diagram is expected to deviate depending on valve wear conditions. Common valve degradation scenarios are explored in this work (leakage, seat wear, and spring fatigue) and are located in the suction and discharge assemblies of a Dresser-Rand ESH-1 compressor commonly used in the petrochemical industry. The proposed method estimates well-understood physical phenomena, the polytropic exponent on the compression, and expansion phase as well as the discharge and suction valve loss power and uses them as features for a quadratic discriminant analysis. The features are created through in-cylinder pressure, suction pressure, discharge pressure, and crank angle measurements collected on a single-stage, dual-acting compressor operating on air with wear precisely machined and seeded into the poppets of the inlet and outlet valves. A very high classification accuracy is achieved in distinguishing the wear types, severity, and location with strong prognostic trends.
A Hybrid Actuator Model for Efficient Guided Wave-Based Structural Health Monitoring Simulations
Authors: Sharma Sanjay , Mesnil Olivier , Recoquillay Arnaud , Chapuis Bastien
Published: May 2024

Simulation has been recognized as a promising option to reduce the time and costs associated with determining probability of detection curves to demonstrate the performance of guided wave-based structural health monitoring (GW-SHM) systems. Time-domain transient spectral finite element schemes have been used for large GW-SHM simulation campaigns, but the most common piezoelectric transducer model used for actuation, the pin force model, has limitations in terms of its range of validity. This is because the excitation frequency for the pin force model has only been validated far below the first electromechanical resonance frequency of the piezoelectric transducer mainly due to not considering the normal stress and dynamics of the transducer. As a result, the value of simulation tools for performance demonstrations may be limited. To address this limitation, this paper introduces a hybrid actuator model that integrates frequency-dependent complex interfacial stresses in both the shear and normal directions, computed using finite elements. These surface stresses are compatible with time-domain transient spectral finite element schemes, enabling their seamless integration without compromising the required performance for conducting intensive simulation campaigns. The proposed hybrid actuator model undergoes validation through a combination of simulation and experimental studies. Additionally, a comprehensive parametric study is conducted to assess the model’s validity across a wide range of excitation frequencies. The results demonstrate the accurate representation of the transduction signal above the piezoelectric transducer’s first free electromechanical resonance frequency.
Effect of Cavity Shapes on the Lubrication Performance of High Precision Static and Dynamic Thrust Bearing Under Eccentric Load
Authors: Yu Xiaodong , Lin Yanlong , Wang Peng , Lan Zhiyuan , Shao Mingjuan , Li Lu , Li Enzhao , Yang Xinyi , Dai Ruichun , Jia Wentao , Wang Junfeng , Jiao Jianhua , Jiang Hui
Published: May 2024

The oil cavity shapes, which represent the spatial structures for storing lubricant in static and dynamic thrust bearings, and offset distances, defined as the horizontal distances between the load center and the bearing rotational axis under eccentric loads, directly impact the flow mode of lubricant, pressure, and temperature distribution during bearing operation, so these are the key factors that influence the lubrication performance and the accuracy of bearings. The equations for flow and load-carrying capacity of the sector, runway, and double rectangular cavities are derived, and mathematical models are established for different cavities at various tilt positions. Then pressure and temperature fields at different offset distances are analyzed. As the offset distances increase, there is a corresponding increase in the maximum pressures within the sector, runway, and double rectangular cavities by 90.5 kPa, 93.3 kPa, and 30.9 kPa, but average pressures show only minor fluctuations. Concurrently, the maximum temperatures within these cavity shapes are observed to increase by 0.5 K, 0.6 K, and 0.8 K, respectively. The results show that appropriate offset distance can improve the lubrication performance. The runway cavity has the highest load-carrying capacity among the three cavity shapes, while the sector cavity experiences the slightest temperature increase. As the temperature increase in all three cavity shapes is small, the runway cavity exhibits superior performance. The error between simulation and experimental results is less than 10%, which verifies the correctness of the simulation method.
Monitoring Within-Individual Dose–Response Relationships in Professional Soccer Players: The Importance of Fitness Level
Authors: Rabbani Alireza , Ermidis Giorgios , Clemente Filipe Manuel , Anderson Liam
Published: May 2024

Purpose: To (1) examine within-individual player dose–response associations between selected training-load measures and changes in aerobic fitness level via submaximal exercise heart rate (HRex%) and (2) measure the relationships between these dose–response associations with basal HRex% (to study the influence of fitness level on dose–response relationship). Methods: During an in-season phase, selected training-load measures including total minutes, total distance, mechanical work (the sum number of accelerations and decelerations > 3 m2), high metabolic load distance, and Edwards’ training impulse were collected via Global Positioning System and heart-rate sensors for analyzing accumulated load. A submaximal warm-up test was used repeatedly before and after 9 phases to elicit HRex% and track fitness changes at an individual level. Results: Negative to positive extensive ranges of within-individual associations were found among players for different metrics (r = −.84 to .89). The relationship between pooled HRex% (basal fitness) and dose–response correlations showed inverse very large (r = −.71) and large (r = −.65) values for accumulated weekly minutes and distance. However, moderate values were found for all other measures (r = −.35 to −.42). Conclusions: Individual players show extensive different ranges of dose–response associations with training measures. The dose–response association is influenced by players’ fitness level, and players with lower fitness levels show stronger inverse relationships with accumulated minutes and total distance.
Whole-genome sequence of the strictly anaerobic bacterial strain SANA belonging to the family
Gottschalkiaceae
, isolated from a xenic culture of an anaerobic protist
Authors: Kondo Ryuji , Kataoka Takafumi
Published: May 2024

An anaerobic bacterial strain SANA was isolated from a xenic culture of an anaerobic heterolobosean protist which was obtained from a saline lake in Japan. Its draft genome comprises 1 circular chromosome (3,490,293 bp), harboring 3,275 predicted protein-coding and 73 tRNA-encoding genes and 8 rRNA operons.
A retrospective study on intracranial mixed infection with tuberculous meningitis in Shenzhen, China
Authors: Fang Mutong , Li Sinian , Mao Zhi , Liu Xuhui , Wang Xiaomin , Lu Shuihua
Published: May 2024

Tuberculous meningitis (TBM) is a prevalent global intracranial infection and the most lethal and disabling form of tuberculosis. TBM with mixed intracranial infections is clinically rare but has a higher mortality rate. To investigate the clinical characteristics of TBM with mixed intracranial infections, demographic and clinical data of TBM and pulmonary tuberculosis (PTB) patients admitted to Shenzhen Third People’s Hospital between January 2015 and October 2022 were collected anonymously. A total of 207 cases of TBM were diagnosed, of which 16 cases (7.73%) were TBM with mixed intracranial infections. The overall mortality rate of TBM cases was 16.4%, while the mortality rate of TBM cases with mixed intracranial infections was as high as 35.7%. Compared to simple TBM cases, TBM cases with mixed intracranial infections had severer clinical symptoms. The percentage of human immune deficiency virus (HIV)-positive TBM cases with mixed intracranial infections reached up to 68.8%. HIV co-infection, CD4
+
/CD8
+
T-cell counts less than 1, cranial nerve impairment, paralysis, cerebral infarction, PRO less than 450 mg/L, WBC less than 10 × 10
6
/L, and CL more than 120 mmol/L were risk factors for TBM cases with mixed intracranial infections. Compared to PTB, HIV co-infection, CD4
+
T cell less than 550 /uL, and age less than 45 years were risk factors for TBM, and TBM was associated with higher mortality rates. Our study provides additional data to better understand single TBM and TBM with mixed intracranial infections. More than two-thirds of TBM cases with mixed intracranial infections were HIV-positive. Clinicians should consider the possibility of multiple infections in people with TBM/HIV co-infection.

IMPORTANCE

TBM can cause severe neurological damage and death, and TBM with mixed intracranial infections can exacerbate the damage and poor prognosis of the disease. TBM with mixed intracranial infections is a rare disease, which has led to an incomplete understanding of its clinical features. This study investigated the clinical features of TBM and its associated factors by comparing the characteristics of TBM with mixed intracranial infections, single TBM and pulmonary tuberculosis. This information will help to improve the understanding of TBM, diagnostic accuracy and treatment outcomes.
Supplemental Material: Triassic granitic magmatism in the Lancangjiang zone in southwestern China associated with Paleo-Tethys evolution and its control on tin mineralization
Authors: Zheng Mingjun , al. et
Published: May 2024

Table S1: Zircon U-Pb isotopic data for the Daguanshan granites. Table S2: Cassiterite U-Pb isotopic data for the Hongmaoling deposit. Table S3: Trace elements (ppm), Tzr (°C), and ΔFMQ values of zircons from the Daguanshan granites and Triassic tin-mineralized granite in Peninsular Malaysia. Table S4: Major (wt%) and trace elements (ppm) of the Daguanshan granites. Table S5: Whole-rock Sr-Nd isotopic compositions of the Daguanshan granites. Table S6: Zircon Hf isotopes from the Daguanshan hornblende-biotite granite and muscovite granite. 
Obtaining Plasma–Dust Clouds from Meteoritic Matter, its Analogs and Simulants of Lunar Regolith Using Microwave Discharge
Authors: Borzosekov V. D. , Akhmadullina N. S. , Sokolov A. S. , Gayanova T. E. , Rezaeva A. D. , Stepakhin V. D. , Konchekov E. M. , Malakhov D. V. , Voronova E. V. , Nugaev I. R. , Logvinenko V. P. , Knyazev A. V. , Letunov A. A. , Kharlachev D. E. , Obraztsova E. A. , Morozova T. I. , Zaitsev M. A. , Ishchenko A. V. , Weinstein I. A. , Grohovsky V. I. , Shishilov O. N. , Skvortsova N. N.
Published: May 2024

Abstract—

In the experiment, plasma–dust clouds were obtained from the substance of the Tsarev meteorite, a simulant of lunar regolith LMS-1D and ilmenite concentrate using a microwave discharge in powder media. For each of the samples, the dynamics of the development of the discharge and the formation of a plasma–dust cloud with subsequent relaxation after the end of the microwave pulse were recorded. From the emission spectra of the plasma and the surface of a solid body, the temperatures of the gas, electrons and surface were determined. A comparison of the phase and elemental composition of the initial samples and samples after exposure to plasma showed that there is no significant change in the composition. However, scanning electron microscopy results clearly indicate spheroidization of the original angular and irregularly shaped particles. The appearance of spherical particles is also observed, the dimensions of which are larger than the linear dimensions of the particles in the original sample. The results obtained indicate the possibility of using such experiments to study chemical and plasma-chemical processes of synthesis and modification of substances under conditions of plasma–dust clouds encountered in space phenomena.
Cardiac resynchronisation therapy in the presence of left-to-right intracardiac shunting: more good than harm?
Authors: Kyu Kyu , Seow Swee Chong , Wong Raymond , Kojodjojo Pipin
Published: May 2024

An elderly Chinese man with moderately impaired left ventricular function, left bundle branch block and ST-elevation myocardial infarction complicated by ventricular septal rupture had class IV heart failure symptoms refractory to medical and surgical interventions. As a treatment of last resort, a cardiac resynchronisation therapy (CRT) pacemaker was implanted apprehensively, as preoperative concerns were raised whether CRT could exacerbate left-to-right shunting, hence negating the potential benefits of CRT. Introduction of CRT significantly improved the patient's haemodynamic status and symptoms, allowing for successful discharge home. To the best of our knowledge, this is the first report of a patient with severely symptomatic acute heart failure, widened QRS and active left-to-right intracardiac shunting, treated successfully with CRT.
Autolytic recanalisation of a thrombotic artery
Authors: Wood Alice , Hudson Ian , Roberts Elved
Published: May 2024

This case describes a patient who presented with an occluded and ectatic right coronary artery. Initial aspiration and, later, guide catheter thrombectomy, liberated large volumes of thrombus but did not appear to restore significant flow. Thrombolysis in myocardial infarction (TIMI) 3 flow was, however, evident 2 weeks later, demonstrating the combined effect of vigorous thrombectomy and autolysis on a heavily thrombotic section of coronary artery.
NSAID-induced pyloric stenosis leading to oesophageal intramucosal dissection
Authors: Tey Kai Rou , Kemmerly Thomas , Banerjee Bhaskar
Published: May 2024

We describe a rare case of a 75-year-old woman with significant non-steroidal anti-inflammatory drug (NSAID) use who presented with haematemesis. Upper endoscopy revealed a large (9 cm) intramucosal dissection of the oesophagus without extension into the gastro-oesophageal junction and a severely narrowed pylorus. We postulate that she developed pyloric stenosis due to peptic ulcer disease from chronic NSAID use. This then led to gastro-oesophageal reflux. Undigested pills in the refluxate had contacted oesophageal mucosa, leading to pill-induced oesophageal injury. This, along with vomiting, is postulated to have led to the oesophageal intramucosal dissection. She improved with conservative medical management with a clear liquid diet and proton pump inhibitors, and a follow-up upper endoscopy 1 week later showed recovery of the previously seen intramucosal dissection.
Automatic detection of cardiac conditions from photos of electrocardiogram captured by smartphones
Authors: Wong Chun-Ka , Lau Yuk Ming , Lui Hin Wai , Chan Wai Fung , San Wing Chun , Zhou Mi , Cheng Yangyang , Huang Duo , Lai Wing Hon , Lau Yee Man , Siu Chung Wah
Published: May 2024

Background

Researchers have developed machine learning-based ECG diagnostic algorithms that match or even surpass cardiologist level of performance. However, most of them cannot be used in real-world, as older generation ECG machines do not permit installation of new algorithms.

Objective

To develop a smartphone application that automatically extract ECG waveforms from photos and to convert them to voltage-time series for downstream analysis by a variety of diagnostic algorithms built by researchers.

Methods

A novel approach of using objective detection and image segmentation models to automatically extract ECG waveforms from photos taken by clinicians was devised. Modular machine learning models were developed to sequentially perform waveform identification, gridline removal, and scale calibration. The extracted data were then analysed using a machine learning-based cardiac rhythm classifier.

Results

Waveforms from 40 516 scanned and 444 photographed ECGs were automatically extracted. 12 828 of 13 258 (96.8%) scanned and 5399 of 5743 (94.0%) photographed waveforms were correctly cropped and labelled. 11 604 of 12 735 (91.1%) scanned and 5062 of 5752 (88.0%) photographed waveforms achieved successful voltage-time signal extraction after automatic gridline and background noise removal. In a proof-of-concept demonstration, an atrial fibrillation diagnostic algorithm achieved 91.3% sensitivity, 94.2% specificity, 95.6% positive predictive value, 88.6% negative predictive value and 93.4% F1 score, using photos of ECGs as input.

Conclusion

Object detection and image segmentation models allow automatic extraction of ECG signals from photos for downstream diagnostics. This novel pipeline circumvents the need for costly ECG hardware upgrades, thereby paving the way for large-scale implementation of machine learning-based diagnostic algorithms.
The effect of cutoff dependence on heavy quark spin symmetry partners
Authors: Yıldırım Duygu
Published: May 2024

Hadron spectroscopy is revealed by observing heavy resonances. Among various explanations of the internal structure of these hadronic states, hadronic molecules play a unique role. For hadronic molecules, which are associated with meson–meson or meson–baryon interactions, the [Formula: see text] cutoff is a significant factor in determining the composite states’ binding energies and overall properties. The cutoff becomes important when it comes to the location of hadronic molecules’ masses because it influences the predictions. From this perspective, in the light of cutoff dependency, heavy quark spin partners of near-threshold the [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] resonances, which are considered as hadronic molecules, are examined.
Fabrication and application of two-dimensional tungsten disulfide thin film
Authors: Kuan Chieh-Yu , Chang Sheng-Po , Liou Guan-Yuan , Chang Shun-Hsyung , Chang Shoou-Jinn
Published: May 2024

To form a tungsten disulfide film, a tungsten trioxide film is deposited first and then hydrogen sulfide is injected into the furnace tube to sulfide the tungsten trioxide film in a high-temperature environment. Due to the need to accurately control the thickness of tungsten trioxide, the power of the RF sputtering machine was reduced as much as possible in a stable condition in the experiment and the bias voltage during each process was monitored. In this experiment, a sapphire substrate and a silicon substrate with 200[Formula: see text]nm silicon dioxide are used. Then use optical instruments such as Raman optics, ellipsometers and high-resolution electron transmission microscopes, atomic force microscopes and other instruments for further measurement. The analysis results show that we have successfully made tungsten disulfide films of different thicknesses. Moreover, two-dimensional tungsten disulfide thin film has a response to light, gas and pH and related devices have been successfully fabricated in experiments. Among them, comparing the single-layer film and the double-layer film, the film quality of the double-layer film is better. The quality of the film grown on the sapphire substrate is also better than the quality of the film grown on the silicon dioxide substrate.
Conductive polymer composites-enable self-sensing twisted string actuators
Authors: Xu Chanchan , Dong Shuai , Ma Yifan , Zhan Jingwei , Wang Xiaojie
Published: May 2024

Twisted string actuators (TSAs) are innovative linear soft actuators that can mimic natural muscle contraction. However, obtaining feedback on their stroke requires cumbersome external sensors that compromise their compliance. We addressed this by developing self-sensing strings using conductive polymer composites (CPCs). The CPC strings exhibit electrical resistance changes in response to strain, enabling stroke sensing by the strings themselves. We fabricated CPCs strings with varying concentrations of multi-walled carbon nanotubes (MWCNTs). Characterization revealed excellent conductivity, tensile strength exceeding 30 N, tunable strain sensitivity via MWCNTs concentration variation, as well as stable and repeatable strain-dependent resistance changes. Optimization via a high-strength core fiber enabled the CPCs strings to withstand over 6[Formula: see text]kg loading with enhanced stroke and minimal resistance variation. We achieved at least a 97.8% linear correlation between resistance change rate and contraction rate in twisting experiments. This research provides a self-contained stroke sensor compatible with high-load soft TSAs, overcoming limitations of external sensors. The simple yet effective sensing mechanism could spur adoption of TSA in robotics.
Fluorescein@NH2-UiO-66 Probe for Ratiometric Fluorescence Sensing of Trace Phosphate in Water
Authors: Ding Yu , Li Yaru , Chakir Soufian , Mei Jun , Wang Xianbiao
Published: May 2024

Phosphate pollution leads to deterioration in water quality, posing a serious threat to human health. Therefore, it is important to develop a highly selective and sensitive fluorescent probe for phosphate detection. Here, we report a novel ratiometric fluorescent probe, Fluorescein@NH2-UiO-66 (denoted as Flu@NH2-UiO-66), for the trace detection of phosphate in water. Specifically, during the in situ solvothermal synthesis of Flu@NH2-UiO-66, fluorescein molecules were encapsulated into the cavities of the metal-organic framework. Furthermore, the encapsulation amount of fluorescein was controlled by adjusting the acidity of the system. The Flu@NH2-UiO-66 (60 H+) sample, prepared with a 60:1 molar ratio of acetic acid to the metal center exhibited distinct dual fluorescence signal peaks. The probe showed a highly selective fluorescence response to phosphate. Within a range of 0–20 μM phosphate concentration, the probe demonstrated excellent linear detection capability with a detection limit of 0.37 μM. Moreover, the mechanism of fluorescence enhancement can be attributed to the addition of phosphate, which greatly increases the UV absorbance of the probe. This study developed a novel ratiometric fluorescent probe capable of rapid, sensitive, and stable detection of trace phosphate, which is of great significance for environmental management.
GPR30 alleviated subarachnoid hemorrhage-induced blood-brain barrier dysfunction by activating the PI3K/Akt and Nrf2/HO-1 pathways
Authors: Peng Jun , He Jun , Hu Xiqi , Xia Ying
Published: May 2024

The PI3K/Akt and Nrf2/HO-1 pathways might be potential mechanisms by which GPR30 protected the integrity of the BBB in SAH models. Therefore, treatment of SAH with GPR30 activator might be a promising therapeutic strategy.
Exogenous ketone esters as a potential therapeutic for treatment of sarcopenic obesity
Authors: Deemer Sarah E. , Roberts Brandon M. , Smith Daniel L. , Plaisance Eric P. , Philp Andrew
Published: May 2024

Identifying effective treatment(s) for sarcopenia and sarcopenic obesity is of paramount importance as the global population advances in age and obesity continues to be a worldwide concern. Evidence has shown that a ketogenic diet can be beneficial for the preservation of muscle quality and function in older adults, but long-term adherence is low due in part to the high-fat (≥80%), very low carbohydrate (<5%) composition of the diet. When provided in adequate amounts, exogenous ketone esters (KEs) can increase circulating ketones to concentrations that exceed those observed during prolonged fasting or starvation without significant alterations in the diet. Ketone esters first emerged in the mid-1990s and their use in preclinical and clinical research has escalated within the past 10–15 years. We present findings from a narrative review of the existing literature for a proposed hypothesis on the effects of exogenous ketones as a therapeutic for preservation of skeletal muscle and function within the context of sarcopenic obesity and future directions for exploration. Much of the reviewed literature herein examines the mechanisms of the ketone diester ( R, S-1,3-butanediol diacetoacetate) on skeletal muscle mass, muscle protein synthesis, and epigenetic regulation in murine models. Additional studies are needed to further examine the key regulatory factors producing these effects in skeletal muscle, examine convergent and divergent effects among different ketone ester formulations, and establish optimal frequency and dosing regimens to translate these findings into humans.
CHD2 Regulates Neuron–Glioma Interactions in Pediatric Glioma
Authors: Zhang Xu , Duan Shoufu , Apostolou Panagiota E. , Wu Xiaoping , Watanabe Jun , Gallitto Matthew , Barron Tara , Taylor Kathryn R. , Woo Pamelyn J. , Hua Xu , Zhou Hui , Wei Hong-Jian , McQuillan Nicholas , Kang Kyung-Don , Friedman Gregory K. , Canoll Peter D. , Chang Kenneth , Wu Cheng-Chia , Hashizume Rintaro , Vakoc Christopher R. , Monje Michelle , McKhann Guy M. , Gogos Joseph A. , Zhang Zhiguo
Published: May 2024

High-grade gliomas (HGG) are deadly diseases for both adult and pediatric patients. Recently, it has been shown that neuronal activity promotes the progression of multiple subgroups of HGG. However, epigenetic mechanisms that govern this process remain elusive. Here we report that the chromatin remodeler chromodomain helicase DNA-binding protein 2 (CHD2) regulates neuron–glioma interactions in diffuse midline glioma (DMG) characterized by onco-histone H3.1K27M. Depletion of CHD2 in H3.1K27M DMG cells compromises cell viability and neuron-to-glioma synaptic connections in vitro, neuron-induced proliferation of H3.1K27M DMG cells in vitro and in vivo, activity-dependent calcium transients in vivo, and extends the survival of H3.1K27M DMG-bearing mice. Mechanistically, CHD2 coordinates with the transcription factor FOSL1 to control the expression of axon-guidance and synaptic genes in H3.1K27M DMG cells. Together, our study reveals a mechanism whereby CHD2 controls the intrinsic gene program of the H3.1K27M DMG subtype, which in turn regulates the tumor growth-promoting interactions of glioma cells with neurons.

Significance: Neurons drive the proliferation and invasion of glioma cells. Here we show that chromatin remodeler chromodomain helicase DNA-binding protein 2 controls the epigenome and expression of axon-guidance and synaptic genes, thereby promoting neuron-induced proliferation of H3.1K27M diffuse midline glioma and the pathogenesis of this deadly disease.
Molecular Pathways and Cellular Subsets Associated with Adverse Clinical Outcomes in Overlapping Immune-Related Myocarditis and Myositis
Authors: Siddiqui Bilal A. , Palaskas Nicolas L. , Basu Sreyashi , Dai Yibo , He Zhong , Yadav Shalini S. , Allison James P. , Sheth Rahul A. , Tummala Sudhakar , Buja Maximilian , Bhattacharjee Meenakshi B. , Iliescu Cezar , Rawther-Karedath Anishia , Deswal Anita , Wang Linghua , Sharma Padmanee , Subudhi Sumit K.
Published: May 2024

Immune checkpoint therapies (ICT) can induce life-threatening immune-related adverse events, including myocarditis and myositis, which are rare but often concurrent. The molecular pathways and immune subsets underlying these toxicities remain poorly understood. To address this need, we performed single-cell RNA sequencing of heart and skeletal muscle biopsies obtained from living patients with cancers treated with ICTs and admitted to the hospital with myocarditis and/or myositis (overlapping myocarditis plus myositis, n = 10; myocarditis-only, n = 1) or ICT-exposed patients ruled out for toxicity utilized as controls (n = 9). All biopsies were obtained within 96 hours of clinical presentation. Analyses of 58,523 cells revealed CD8+ T cells with a cytotoxic phenotype expressing activation/exhaustion markers in both myocarditis and myositis. Furthermore, the analyses identified a population of myeloid cells expressing tissue-resident signatures and FcγRIIIa (CD16a), which is known to bind IgG and regulate complement activation. Immunohistochemistry of affected cardiac and skeletal muscle tissues revealed protein expression of pan-IgG and complement product C4d, which were associated with the presence of high-titer serum autoantibodies against muscle antigens in a subset of patients. We further identified a population of inflammatory IL1B+TNF+ myeloid cells specifically enriched in myocarditis and associated with greater toxicity severity and poorer clinical outcomes. These results provide insight into the myeloid subsets present in human immune-related myocarditis and myositis tissues and nominate new targets for investigation into rational treatments to overcome these high-mortality toxicities.

See related Spotlight by Fankhauser et al., p. 954