bluuebunny/crossref_metadata_2025 huggingface dataset:
Circular motion and collisions of particles with magnetic dipole moment and electric charge in dipolar magnetosphere around Schwarzschild black holes
Authors: Khan Saeed Ullah , Abdurkhmonov Ozodbek , Rayimbaev Javlon , Ahmedov Saidmuhammad , Turaev Yunus , Muminov Sokhibjan
Published: June 2024

No-hair theorem indicates that black holes cannot have their own magnetic dipole moment. They can be weakly magnetized in binary systems with a neutron star companion and an accretion disc of charged particles. A simple model suggested by Petterson states that a current loop accreting a Schwarzschild black hole generates dipole-like magnetic fields in the outer region of the loop that are uniform in the inner region. This study considers circular motion and collisions of charged test particles with magnetic dipole moments in the inner and outer regions. First, we derive the effective potential taking into account the magnetic interactions between external magnetic fields with electric charge and the magnetic dipole moment of the particle. We investigate the possible innermost stable circular orbits (ISCOs) of the charged and magnetized particles orbiting the magnetized Schwarzschild black hole inside and outside the current loop. Finally, we explore the collisional processes of these particles near the black hole horizons, examining the effects of magnetic interactions on the critical angular momentum of particles that may collide and the center of mass energy of the colliding particles. We discuss astrophysical relevant objects with magnetic dipole moment and electric charge: magnetized neutron stars, white dwarfs, rotating stellar-mass black holes, electrons, and protons, and also estimate the interaction parameters for them.
Some Special Perfect c-Nonlinear Functions on ℤn
Authors: Wang Yan-Ping , Zhang Wei-Guo
Published: June 2024

The notion of [Formula: see text]-differential uniformity was proposed by Ellingsen et al., which generalizes the classical differential uniformity measuring the resistance against differential cryptanalysis. Since then, the research of functions with low [Formula: see text]-differential uniformity over finite fields attracted many researchers’ attention. However, it seems that there is no study of function with low [Formula: see text]-differential uniformity over integer rings modulo [Formula: see text]. In this paper, we give an extension of the [Formula: see text]-differential uniformity concept to rings of integers module some [Formula: see text], and we present several perfect [Formula: see text]-nonlinear polynomial functions on the integer ring [Formula: see text] for the different integer [Formula: see text].
Quality Prediction Analysis of Computer Image Visual Psychology Based on Analysis of the Color Composition
Authors: Kang Xiaoting , Zhang Bei
Published: June 2024

In visual art and design, color composition not only affects the aesthetic value of the work but also plays a deeper role in the psychological feelings and emotional reactions of the audience. The purpose of this study is to explore how color composition affects the prediction of the psychological quality of images so as to provide scientific guidance for artistic creation and design. By using the theories and methods of psychology, aesthetics and computer science, this study conducted a series of experiments and analyses to reveal the mechanism of different color configurations in visual perception and their impact on image quality evaluation. The relevant literature on color theory and visual psychology is understood, and the theoretical framework of the research is established. Then, using computer vision technology, a large number of images with different colors were evaluated for visual quality to obtain objective data. Viewers’ subjective evaluations of these images were collected to examine how color composition affects an individual’s visual experience and emotional response. Color saturation, contrast and tone matching have significant effects on the prediction of the visual psychological quality of images. Color configurations with high saturation and moderate contrast can enhance the appeal and viewing value of the image, while harmonious color combinations can help trigger a positive emotional response from the viewer. In addition, the study also found that individual differences, such as gender, age and cultural background, also affect the effect of color composition on the prediction of visual psychological quality.
Blockchain for Edge Computing in Smart Environments: Use Cases, Issues, and Challenges
Authors: Prabadevi B. , Deepa N. , Rajan S. Sudhagara , Srivastava Gautam
Published: June 2024

The Cenozoic era is the digital age where people, things, and any device with network capabilities can communicate with each other, and the Internet of Things (IoT) paves the way for it. Almost all domains are adopting IoT from smart home appliances, smart healthcare, smart transportation, Industrial IoT and many others. As the adoption of IoT increases, the accretion of data also grows. Furthermore, digital transformations have led to more security vulnerabilities, resulting in data breaches and cyber-attacks. One of the most prominent issues in smart environments is a delay in data processing while all IoT smart environments store their data in the cloud and retrieve them for every transaction. With increased data accumulations on the cloud, most smart applications face unprecedented delays. Thus, data security and low-latency response time are mandatory to deploy a robust IoT-based smart environment. Blockchain, a decentralized and immutable distributed ledger technology, is an essential candidate for ensuring secured data transactions, but it has a variety of challenges in accommodating resource-constrained IoT devices. Edge computing brings data storage and computation closer to the network’s edge and can be integrated with blockchain for low-latency response time in data processing. Integrating blockchain with edge computing will ensure faster and more secure data transactions, thus reducing the computational and communicational overhead concerning resource allocation, data transaction and decision-making. This paper discusses the seamless integration of blockchain and edge computing in IoT environments, various use cases, notable blockchain-enabled edge computing architectures in the literature, secured data transaction frameworks, opportunities, research challenges, and future directions.
A Deep Federated Learning-Based User Credit Evaluation Model Under Financial Internet of Things Scenarios
Authors: Gu Shaoyong , Chen Zhuo
Published: June 2024

With the rapid development of Internet of Things (IoT) technology and the digital transformation of the financial industry, the financial IoT is becoming an important trend in the future financial field. In the era of financial IoT, a large amount of data information is recorded by sensors and devices, which poses new challenges and opportunities for user credit evaluation. In this context, conventional deep learning-based user credit evaluation methods often cannot meet privacy needs. The paper combines the privacy security ability of federated learning with deep learning, and proposes a deep federated learning-based user credit evaluation model under financial IoT scenarios. First, a particle swarm optimization-based backpropagation neural network algorithm is formulated to extract user credit evaluation features, in order to obtain user behavior patterns and credit features. Then, the XGBoost algorithm is employed to output credit evaluation results. As for the training process, the thought of federated learning is integrated to distribute the model to individual participants. In such mode, the model can be updated and trained without exposing user data to the central cloud. The experiments are conducted on real-world data to assess the proposal’s performance. The results show that the proposed credit evaluation framework can achieve better accuracy, under the guarantee of user privacy.
Consistent and inconsistent generalizations of Martin’s Axiom, weak square and weak Chang’s Conjecture
Authors: Asperó David , Tananimit Nutt
Published: June 2024

We prove that the forcing axiom [Formula: see text] (stratified) implies [Formula: see text]. Using this implication, we show that the forcing axiom [Formula: see text] is inconsistent. We also derive weak Chang’s Conjecture from [Formula: see text] (stratified) and use this second implication to give another proof of the inconsistency of [Formula: see text].
Additive cyclic codes over 𝔽q3
Authors: Shi Minjia , Chu Shixiao , Özbudak Ferruh
Published: June 2024

Let [Formula: see text] be an arbitrary finite field and [Formula: see text] be an integer with [Formula: see text]. We study all [Formula: see text]-linear additive cyclic codes over [Formula: see text] of length [Formula: see text] systematically. This is much more complicated compared to the same task over [Formula: see text]. We obtain a canonical unique representation. We explicitly obtain the dual codes in the canonical form under the Euclidean and trace the Galois inner products. We characterize and construct large classes of complementary dual codes among [Formula: see text]-linear additive cyclic codes over [Formula: see text] of length [Formula: see text] under the trace Euclidean and the trace Galois inner products. We obtain interesting differences depending on the canonical representation and also on the inner products. We also study subfield subcodes and trace (onto [Formula: see text]) codes.
Investigations of Melt Flow Behavior of Aluminium Metal Particle-Reinforced HDPE Composites
Authors: Azeem Mohd , Singh Rupinder , Sokhal Gurpreet Singh
Published: June 2024

In this study, the process for the development of the high-density polyethylene (HDPE) and the Aluminium (Al) powder-reinforced composites has been outlined by the single screw extruder for the feedstock filament study. The filament has been prepared on the single screw extruder. The study is illustrated with two different stages: (a) melt flow index (MFI) of 10[Formula: see text]g HDPE reinforced (0%–50%) with varying concentrations of Al-powder and (b) extrusion of the filament utilizing the ratio of 75% HDPE and 25% Al-powder for distinguished experimental parameters. The result of this study suggests the best filament extrusion setting for the different heat-treated and nonheat-treated conditions for Young’s modulus. The extrusion parameters are [Formula: see text]C, [Formula: see text]C for heat-treated (HT) and nonheat-treated (NHT) conditions at a nozzle diameter of 1.75[Formula: see text]mm. The result has been supported by universal testing machine (UTM), scanning electron microscopy (SEM), X-ray diffraction (XRD) and differential scanning calorimetry (DSC). HDPE-Al-2 has the highest mechanical properties [Formula: see text]C at 6[Formula: see text]rpm heat treated. The crystallinity of the filament increased to 64% with the Al-powder reinforcement along with enhancement of the properties of Young’s modulus of heat-treated samples.
HCCL: Hierarchical Counterfactual Contrastive Learning for Robust Visual Question Answering
Authors: Hao Dongze , Wang Qunbo , Zhu Xinxin , Liu Jing
Published: June 2024

Despite most state-of-the-art models having achieved amazing performance in
Visual Question Answering (VQA)
, they usually utilize biases to answer the question. Recently, some studies synthesize counterfactual training samples to help the model to mitigate the biases. However, these synthetic samples need extra annotations and often contain noises. Moreover, these methods simply add synthetic samples to the training data to train the model with the cross-entropy loss, which cannot make the best use of synthetic samples to mitigate the biases. In this article, to mitigate the biases in VQA more effectively, we propose a
Hierarchical Counterfactual Contrastive Learning (HCCL)
method. Firstly, to avoid introducing noises and extra annotations, our method automatically masks the unimportant features in original pairs to obtain positive samples and create mismatched question-image pairs as negative samples. Then our method uses feature-level and answer-level contrastive learning to make the original sample close to positive samples in the feature space, while away from negative samples in both feature and answer spaces. In this way, the VQA model can learn the robust multimodal features and focus on both visual and language information to produce the answer. Our HCCL method can be adopted in different baselines, and the experimental results on VQA v2, VQA-CP, and GQA-OOD datasets show that our method is effective in mitigating the biases in VQA, which improves the robustness of the VQA model.
Adapting LoRa Ground Stations for Low-latency Imaging and Inference from LoRa-enabled CubeSats
Authors: Gadre Akshay , Machester Zachary , Kumar Swarun
Published: June 2024

Recent years have seen the rapid deployment of low-cost CubeSats in low-Earth orbit, many of which experience significant latency (several hours) from the time information is gathered to the time it is communicated to the ground. This is primarily due to the limited availability of ground infrastructure that is bulky to deploy and expensive to rent. This article explores the opportunity in leveraging the extensive terrestrial LoRa infrastructure as a solution. However, the limited bandwidth and large amount of Doppler on CubeSats precludes these LoRa links to communicate rich satellite Earth images—instead, the CubeSats can at best send short messages. This article details our experience in designing LoRa-based satellite ground infrastructure that requires software-only modifications to receive packets from LoRa-enabled CubeSats recently launched by our team. We present Vista, a communication system that adapts encoding onboard the CubeSat and decoding configuration on commercial LoRa ground stations to allow images to be communicated. We perform a detailed evaluation of Vista by leveraging wireless channel measurements from a recent CubeSat (2021), and show that Vista can achieve 55.55% lower latency in retrieving data with 12.02 dB improvement in packet retrieval in the presence of terrestrial interference. We then evaluate Vista on a case study on land-use classification over images transmitted over the CubeSat link to further demonstrate a 4.56 dB improvement in image PSNR and 1.38× increase in classification accuracy over baseline approaches.
Stability of a Ni/NiF2 Reference Electrode with a Metallic Membrane for Use in Molten Fluoride Salts
Authors: Newton Matthew , Meaders Tom , Steppan Jim , Bae Sangeun , Simpson Michael
Published: June 2024

In this study, an experimental high-temperature fluoride salt reference electrode (RE) developed by HiFunda LLC was tested in molten FLiNaK at 550 °C. The high-temperature reference electrode (HTRE), based on the Ni/NiF2 redox couple, was tested over a period of 13 d for short-term stability, long-term stability, and electrochemical analysis capabilities. The HTRE was tested using open circuit potentiometry (OCP), cyclic voltammetry (CV), square wave voltammetry (SWV), and electrochemical impedance spectroscopy (EIS). The HTRE reference potential was measured against changes in salt composition by increasing FeF2 concentrations in the melt across six additions from 0 to 0.1 mol% FeF2. The long-term stability of the electrode was then tested over ten days at a constant composition of 0.1 mol% FeF2. OCP, SWV, and CV were used to calculate an average potential drift between 7–10 mV per day. Using CV and SWV, the number of electrons transferred for iron reduction and the diffusion coefficient of Fe2+ were measured.
Optimizing Device Dimensions for Dual Material Junctionless Tree-FET: A Path to Improved Analog/RF Performance
Authors: Beebireddy Divya , Fatima Kaleem , L. Nirmala Devi
Published: June 2024

This comprehensive study delves into the intricate analysis of the electrical and analog/RF performance of the Dual Material (DM) junctionless (JL) Tree-FET. During the optimization process, various DC and analog/RF metrics were taken into account. It is observed that, as the gate length decreases (12 nm to 8 nm), there is an increment in drain induced barrier lowering (DIBL), switching ratio (Ion/Ioff), and subthreshold swing (SS). Conversely, reducing the size of TNS (and WNS) from 10 nm to 5 nm (and 20 nm to 10 nm, respectively) lead to notable improvements, with a 34.4% (21.01%) decrease in SS, 93.19% (58.86%) decrease in DIBL, and 98.6% (41.06%) increase in Ion/Ioff. Furthermore, the analog/RF performance metrics of the device is carefully examined across dimensional variations, revealing significant improvements at the optimal values. Additionally, the study extends to the evaluation of inverter circuit characteristics with DM JL Tree-FET. Remarkably, the static noise margin (SNM) and delay exhibit 337.3 mV and 3.053 ps, respectively, positioning the device as a prime candidate for applications demanding low power consumption and high-frequency operation in future technology nodes.
Students’ approaches to developing scientific communication skills
Authors: Faber E. S. Louise , Colthorpe Kay , Ainscough Louise , Kibedi Judit
Published: June 2024

This study identifies the approaches and resources that undergraduate science students use to develop their science communication skills. It reveals which of these approaches and resources predict improved academic performance in a written science communication assessment task. The findings point to the importance of explicit guidance, and engagement with teaching staff, in advancing the development of science communication skills.
Numerical Model Updating and Validation of a Truss Railway Bridge considering Train‐Track‐Bridge Interaction Dynamics
Authors: Ayubirad Mohammad Sadegh , Ataei Shervan , Tajali Mosabreza
Published: June 2024

Vibration‐based structural health monitoring (SHM) is crucial in assessing the integrity of large civil infrastructures. Developing an accurate finite element (FE) model that effectively reflects the dynamics of a full‐scale structure is essential for the success of vibration‐based SHM. This study introduces a comprehensive framework for FE model updating and validation of a truss railway bridge. The framework integrates operational modal analysis, a sensitivity‐based FE model updating approach, and the dynamics of train‐track‐bridge interaction (TTBI). The research focused on a 36‐meter‐long steel truss railway bridge, which underwent testing under both static and dynamic loads caused by train transit. For modal identification, the study utilized the covariance‐driven stochastic subspace identification (Cov‐SSI) method in conjunction with hierarchical density‐based spatial clustering of applications with noise (HDBSCAN). Results indicated that the sensitivity‐based FE model updating significantly enhanced model accuracy, reducing the average frequency errors from 11% to much lower 3%. In addition, the FE model was validated through static load tests using an EMD GT26 locomotive. In the dynamic validation phase, the vertical TTBI was modelled. Comparatively, the acceleration time histories from the TTBI model, exhibiting a normalized mean absolute error (nMAE) of 36%, aligned more closely with actual measurements than those from the basic moving load model, which had a higher nMAE of 45%. This framework provides an accurate numerical platform for load rating and SHM activities.
Transcutaneous Electrical Nerve Stimulation Integrated into Pants for the Relief of Postoperative Pain in Hip Surgery Patients: A Randomized Trial
Authors: Opolka Yohann , Sundberg Courage , Juthberg Robin , Olesen Amelie , Guo Li , Persson Nils-Krister , Ackermann Paul W.
Published: June 2024

Background. The effect of transcutaneous electrical nerve stimulation (TENS) on pain and impression of change was assessed during a 2.5‐hour intervention on the first postoperative days following hip surgery in a randomized, single‐blinded, placebo‐controlled trial involving 30 patients. Methods. Mixed‐frequency TENS (2 Hz/80 Hz) was administered using specially designed pants integrating modular textile electrodes to facilitate stimulation both at rest and during activity. The treatment outcome was assessed by self‐reported pain Numerical Rating Scale (NRS) and Patient Global Impression of Change (PGIC) scores at four time points. The ability to perform a 3‐meter walk test and the use of analgesics were also evaluated. Group comparison and repeated‐measure analysis were carried out using nonparametric statistics. Results. The active TENS group exhibited significantly higher PGIC scores after 30 minutes, which persisted throughout the intervention (all p ≤ 0.001). A reduction in NRS appeared after one hour of active TENS, persisting throughout the intervention (all p ≤ 0.05). The median group differences in pain ratings were greater than the minimum clinically important difference, and the analysis of pain trajectories confirmed clinical significance at the individual level. Moreover, patients in the active TENS group were more likely able to perform a 3‐meter walk test by the end of the intervention (p = 0.04). Analysis of the opioid‐sparing effect of TENS was inconclusive (p = 0.066). No postoperative surgical complications or TENS‐related side effects were observed during the study. Conclusion. Mixed‐frequency TENS integrated in pants could potentially be an interesting addition to the arsenal of treatments for multimodal analgesia following hip surgery. This trial is registered with NCT05678101.
A Novel Prehydrated Porcine‐Derived Acellular Dermal Matrix: A Histological and Clinical Evaluation
Authors: van Orten Andreas , Goetz Werner , Bilhan Hakan
Published: June 2024

It is well known that soft tissue quality and quantity around dental implants is of paramount importance for later peri‐implant health. For this purpose, the clinical and histological outcomes of the peri‐implant mucosa, following soft tissue augmentation for soft tissue improvement with a novel prehydrated porcine acellular dermal matrix graft (PPADMG) in conjunction with simultaneous implant placement, were evaluated in this case series. Twenty‐two patients were included in the study. They underwent a late implant placement protocol combined with PPADMG for soft tissue augmentation. A punch biopsy was taken at the time of uncovery of the submerged healed implant after a mean of 157 days healing time. Supracrestal soft tissue height (STH) was measured at the time of implant placement and uncovery. All sites showed a clinical increase in STH. The histological structure of the biopsies resembled a similar structure as found in the healthy oral mucosa. No unexpected tissue reactions could be found. Within the limits of this clinical and histological study, it may be concluded that STH improvement with this novel porcine‐derived acellular dermal matrix, in combination with simultaneous implant placement, is a viable option to create a peri‐implant tissue thickness and stability.
Yinchenhao Decoction Protects Against Acute Liver Injury in Mice With Biliary Acute Pancreatitis by Regulating the Gut Microflora–Bile Acids–Liver Axis
Authors: Zhao Xianlin , Wu Xiajia , Hu Qian , Yao Jiaqi , Yang Yue , Wan Meihua , Tang Wenfu
Published: June 2024

Background and Aims: Acute liver injury (ALI) often follows biliary acute pancreatitis (BAP), but the exact cause and effective treatment are unknown. The aim of this study was to investigate the role of the gut microflora–bile acids–liver axis in BAP‐ALI in mice and to assess the potential therapeutic effects of Yinchenhao decoction (YCHD), a traditional Chinese herbal medicine formula, on BAP‐ALI.

Methods: Male C57BL/6 mice were allocated into three groups: negative control (NC), BAP model, and YCHD treatment groups. The severity of BAP‐ALI, intrahepatic bile acid levels, and the gut microbiota were assessed 24 h after BAP‐ALI induction in mice.

Results: Our findings demonstrated that treatment with YCHD significantly ameliorated the severity of BAP‐ALI, as evidenced by the mitigation of hepatic histopathological changes and a reduction in liver serum enzyme levels. Moreover, YCHD alleviated intrahepatic cholestasis and modified the composition of bile acids, as indicated by a notable increase in conjugated bile acids. Additionally, 16S rDNA sequencing analysis of the gut microbiome revealed distinct alterations in the richness and composition of the microbiome in BAP‐ALI mice compared to those in control mice. YCHD treatment effectively improved the intestinal flora disorders induced by BAP‐ALI. Spearman’s correlation analysis revealed a significant association between the distinct compositional characteristics of the intestinal microbiota and the intrahepatic bile acid concentration.

Conclusions: These findings imply a potential link between gut microbiota dysbiosis and intrahepatic cholestasis in BAP‐ALI mice and suggest that YCHD treatment may confer protection against BAP‐ALI via the gut microflora–bile acids–liver axis.
Risk and Prognosis of Cancer in Patients with Obstructive Uropathy Compared with the General Danish Population
Authors: Nørgaard Mette , Körmendiné Farkas Dóra , Gotschalck Madeleine A. , Sørensen Henrik Toft
Published: June 2024

Background:

To examine whether obstructive uropathy is associated with increased risk of cancer and whether mortality differs between patients with cancer with and without obstructive uropathy.

Methods:

In a nationwide population-based Danish cohort study including 37,275 adult patients with a first-time hospital-related diagnosis of obstructive uropathy in 1996 to 2022, we assessed cumulative cancer incidence (risk) and standardized incidence ratios (SIR). Furthermore, we compared the mortality of 7,485 patients diagnosed with cancer after obstructive uropathy diagnosis with that of 69,785 patients with cancer without obstructive uropathy matched by age, sex, cancer site, stage, and calendar year of cancer diagnosis.

Results:

The 3-month risk of cancer after an obstructive uropathy diagnosis was 9.6%. The 3-month SIR was 34.2 [95% confidence interval (CI), 33.1–35.4] while the 1 to <5 year SIR was 1.2 (95% CI, 1.1–1.3). The 3-month SIRs were 82.7 (95% CI, 79.3–86.2) for urological cancer, 88.8 (95% CI, 79.8–98.5) for gynecological cancer, and 13.9 (95% CI, 12.0–15.9) for colorectal cancer. After 1 year of follow-up, the excess number of urological cancers decreased to 0.1 per 100 person-years, whereas we observed no excess risk of gynecological and colorectal cancers. The 5-year all-cause mortality following cancer was 64.1% (95% CI, 62.9–65.2) in patients with an obstructive uropathy diagnosis before cancer diagnosis and 53.2% (95% CI, 52.9–53.6) in those without.

Conclusions:

A first-time diagnosis of obstructive uropathy can be a clinical marker of underlying undiagnosed cancer and elevated mortality in relation to any cancer diagnosed after obstructive uropathy.

Impact:

These findings can inform the follow-up recommendations for obstructive uropathy.
Supplementary Figure 2 from Association of ESR1 Germline Variants with TP53 Somatic Variants in Breast Tumors in a Genome-wide Study
Authors: Tjader Nijole P. , Beer Abigail J. , Ramroop Johnny , Tai Mei-Chee , Ping Jie , Gandhi Tanish , Dauch Cara , Neuhausen Susan L. , Ziv Elad , Sotelo Nereida , Ghanekar Shreya , Meadows Owen , Paredes Monica , Gillespie Jessica L. , Aeilts Amber M. , Hampel Heather , Zheng Wei , Jia Guochong , Hu Qiang , Wei Lei , Liu Song , Ambrosone Christine B. , Palmer Julie R. , Carpten John D. , Yao Song , Stevens Patrick , Ho Weang-Kee , Pan Jia Wern , Fadda Paolo , Huo Dezheng , Teo Soo-Hwang , McElroy Joseph Paul , Toland Amanda E.
Published: June 2024

Supplementary Figure 2
Referral Patterns to Speech and Language Therapy in the UK before, during, and after the COVID-19 Pandemic: Dysphagia Compared with Communication Disorders
Authors: Yoshimatsu Yuki , Enderby Pamela Mary , Hansjee Dharinee , Smithard David G.
Published: June 2024

Introduction: Acquired swallowing impairment is a major public health issue that often leads to increased morbidity and slower recovery. Speech and language therapists (SLTs) have taken the lead in the assessment and treatment of dysphagia, which is reflected in guidelines where early intervention is recommended. This is in addition to the central role that SLTs play in the management of acquired communication impairments since research indicates that patients with communication difficulties benefit from early and intensive therapy by SLTs. This increasing demand for SLTs is expected to cause conflicting pressures in their workload and, therefore, beneficial to consider workforce planning. The aim of this study was to examine real-world data in the UK to investigate this issue regarding changes in referral patterns of patients with dysphagia and/or communication disorders to SLTs over time, to assist with workforce planning. Methods: We interrogated the Royal College of Speech and Language Therapists Online Outcome Tool, a national database, in this retrospective cohort study. We included patients evaluated between 2018 and 2022. We performed a subgroup analysis of patients aged ≥40 years who had a primary medical diagnosis of stroke. Data on age, primary diagnosis, time on caseload, primary Therapeutic Outcome Measure (TOM) scale and initial TOM score on impairment were examined. Results: From the database of 44,444 referrals to speech and language therapy, 5,254 referrals were included in the stroke and overall subgroup analyses. Referrals were 55.1% male, with a median age of 71 years. More than half (56.1%) of these referrals were for dysphagia. Referrals decreased during the COVID-19 pandemic but began to recover from 2021 onwards. The time on the SLT caseload has increased over the years from a median of 14 days (interquartile range [IQR] 0–56) in 2018 to 20 days (IQR: 3–81) in 2022. While there were more referrals to SLT services for assessment and management of dysphagia than for communication in the overall population, in the stroke subgroup, referrals for communication disorders outnumbered referrals for dysphagia from 2020 onwards. Additionally, the severity of impairment on referral increased over the years. Conclusion: Real-world data indicates that referrals to SLT services are changing over time to include more complex and severely impaired patients, with a demand for both swallowing and communication disorders. These findings should inform staff allocation and remodelling of education/training for SLTs to better meet clinical and public health needs. The retrospective nature of this study limits the strength and generalisability of these data, and this topic warrants further investigation.
A evolução da sociedade brasileira: alguns aspectos do processo histórico da formação social no Brasil
Authors: Novais Fernando A.
Published: June 2024

This article deals with the historical process o£ the social formation in Brazil trying to seize it in its specificity, that is, assuming it as determined by its insertion in the framework of the development of a wordwide capitalism and as marked by the presence of slavery, the basis of the first Brazilian social formation and the starting point for its further development.
Glycolytic PFKFB3 and Glycogenic UGP2 Axis Regulates Perfusion Recovery in Experimental Hind Limb Ischemia
Authors: Jaiyesimi Olukemi , Kuppuswamy Sivaraman , Zhang Guangwei , Batan Sonia , Zhi Wenbo , Ganta Vijay C.
Published: June 2024

BACKGROUND:

Despite being in an oxygen-rich environment, endothelial cells (ECs) use anaerobic glycolysis (Warburg effect) as the primary metabolic pathway for cellular energy needs. PFKFB (6-phosphofructo-2-kinase/fructose-2,6-biphosphatase)-3 regulates a critical enzymatic checkpoint in glycolysis and has been shown to induce angiogenesis. This study builds on our efforts to determine the metabolic regulation of ischemic angiogenesis and perfusion recovery in the ischemic muscle.

METHODS:

Hypoxia serum starvation (HSS) was used as an in vitro peripheral artery disease (PAD) model, and hind limb ischemia by femoral artery ligation and resection was used as a preclinical PAD model.

RESULTS:

Despite increasing PFKFB3-dependent glycolysis, HSS significantly decreased the angiogenic capacity of ischemic ECs. Interestingly, inhibiting PFKFB3 significantly induced the angiogenic capacity of HSS-ECs. Since ischemia induced a significant in PFKFB3 levels in hind limb ischemia muscle versus nonischemic, we wanted to determine whether glucose bioavailability (rather than PFKFB3 expression) in the ischemic muscle is a limiting factor behind impaired angiogenesis. However, treating the ischemic muscle with intramuscular delivery of D-glucose or L-glucose (osmolar control) showed no significant differences in the perfusion recovery, indicating that glucose bioavailability is not a limiting factor to induce ischemic angiogenesis in experimental PAD. Unexpectedly, we found that shRNA-mediated PFKFB3 inhibition in the ischemic muscle resulted in an increased perfusion recovery and higher vascular density compared with control shRNA (consistent with the increased angiogenic capacity of PFKFB3 silenced HSS-ECs). Based on these data, we hypothesized that inhibiting HSS-induced PFKFB3 expression/levels in ischemic ECs activates alternative metabolic pathways that revascularize the ischemic muscle in experimental PAD. A comprehensive glucose metabolic gene qPCR arrays in PFKFB3 silenced HSS-ECs, and PFKFB3-knock-down ischemic muscle versus respective controls identified UGP2 (uridine diphosphate-glucose pyrophosphorylase 2), a regulator of protein glycosylation and glycogen synthesis, is induced upon PFKFB3 inhibition in vitro and in vivo. Antibody-mediated inhibition of UGP2 in the ischemic muscle significantly impaired perfusion recovery versus IgG control. Mechanistically, supplementing uridine diphosphate-glucose, a metabolite of UGP2 activity, significantly induced HSS-EC angiogenic capacity in vitro and enhanced perfusion recovery in vivo by increasing protein glycosylation (but not glycogen synthesis).

CONCLUSIONS:

Our data present that inhibition of maladaptive PFKFB3-driven glycolysis in HSS-ECs is necessary to promote the UGP2-uridine diphosphate-glucose axis that enhances ischemic angiogenesis and perfusion recovery in experimental PAD.
Unveiling the Diagnostic Value of Strain Parameters Across All 4 Cardiac Chambers in Patients With Acute Myocarditis With Varied Ejection Fraction: A Cardiovascular Magnetic Resonance Feature‐Tracking Approach
Authors: Zhang Xinping , Wang Ce , Huang Yuantao , Zhang Shi‐jun , Xu Junqing
Published: June 2024

Background

This study assesses the diagnostic utility of strain parameters from cardiovascular magnetic resonance feature tracking across all cardiac chambers in patients with acute myocarditis, stratified by ejection fraction.

Methods and Results

Our cohort included 65 patients with acute myocarditis and 25 healthy controls; all underwent cardiac magnetic resonance imaging. Patients were divided into 2 groups based on left ventricular ejection fraction (EF)with a 55% cutoff: acute myocarditis with preserved EF, EF ≥55%, n=48; and acute myocarditis with reduced EF, EF <55%, n=17. The control group matched for age and sex. Cardiovascular magnetic resonance feature tracking evaluated strain parameters across all cardiac chambers. Both acute myocarditis with preserved EF and acute myocarditis with reduced EF groups showed significant decreases in left atrial peak early negative strain rate compared with controls. The acute myocarditis with reduced EF group had significantly reduced left ventricular circumferential strain relative to acute myocarditis with preserved EF and controls. Receiver operating characteristic curve analysis confirmed the diagnostic accuracy in distinguishing patients with acute myocarditis with preserved EF from controls, with left atrial peak early negative strain rate achieving 92.9% specificity, left ventricular circumferential strain demonstrating an area under the curve of 0.832, and similarly effective results for left ventricular longitudinal strain and right ventricular longitudinal strain. Additionally, left atrial peak early negative strain rate and left ventricular circumferential strain showed significant correlations with troponin I levels, indicating myocardial injury.

Conclusions

Cardiovascular magnetic resonance feature‐tracking–derived strain parameters, particularly left atrial peak early negative strain rate and left ventricular circumferential strain, effectively diagnose acute myocarditis across different EFs, enhancing diagnostic accuracy and facilitating early detection, notably in patients with preserved EF.
Heterogeneous Effects of Intensive Glycemic and Blood Pressure on Cardiovascular Events Among Diabetes by Living Arrangements
Authors: Kiyohara Kanta , Kondo Naoki , Iwami Taku , Yano Yuichiro , Nishiyama Akira , Node Koichi , Inagaki Nobuya , Duru O. Kenrik , Inoue Kosuke
Published: June 2024

Background

Although living alone versus with others is a key social element for cardiovascular prevention in diabetes, evidence is lacking about whether the benefit of intensive glycemic and blood pressure (BP) control differs by living arrangements. We thus aim to investigate heterogeneity in the joint effect of intensive glycemic and BP control on cardiovascular events by living arrangements among participants with diabetes.

Methods and Results

This study included 4731 participants with diabetes in the ACCORD‐BP (Action to Control Cardiovascular Risk in Diabetes‐Blood Pressure) trial. They were randomized into 4 study arms, each with glycated hemoglobin target (intensive, <6.0% versus standard, 7.0–7.9%) and systolic BP target (intensive, <120 mm Hg versus standard <140 mm Hg). Cox proportional hazard models were used to estimate the joint effect of intensive glycemic and BP control on the composite cardiovascular outcome according to living arrangements. At a mean follow‐up of 4.7 years, the cardiovascular outcome was observed in 445 (9.4%) participants. Among participants living with others, intensive treatment for both glycemia and BP showed decreased risk of cardiovascular events compared with standard treatment (hazard ratio [HR], 0.68 [95% CI, 0.51–0.92]). However, this association was not found among participants living alone (HR, 0.96 [95% CI, 0.58–1.59]).
P
for interaction between intensive glycemic and BP control was 0.53 among participants living with others and 0.009 among those living alone (
P
value for 3‐way interaction including living arrangements was 0.049).

Conclusions

We found benefits of combining intensive glycemic and BP control for cardiovascular outcomes among participants living with others but not among those living alone. Our study highlights the critical role of living arrangements in intensive care among patients with diabetes.
Sex Disparities in Resuscitation Quality Following Out of Hospital Cardiac Arrest
Authors: Delardes Belinda , Schwarz Jenna , Ralph Tara , Anderson David , Nehme Emily , Nehme Ziad
Published: June 2024

Background

Women are known to be disadvantaged compared with men in the early links of the Chain of Survival, receiving fewer bystander interventions. We aimed to describe sex‐based disparities in emergency medical service resuscitation quality and processes of care for out‐of‐hospital cardiac arrest.

Methods and Results

We conducted a retrospective analysis of patients who were nontraumatic with out‐of‐hospital cardiac arrest aged ≥16 years where resuscitation was attempted between March 2019 and June 2023. We investigated 18 routinely captured performance metrics and performed adjusted logistic and quantile regression analyses to assess sex‐based differences in these metrics. During the study period, 10 161 patients with out‐of‐hospital cardiac arrest met the eligibility criteria, of whom 3216 (32%) were women. There were no clinically relevant sex‐based differences observed in regard to external cardiac compressions; however, women were 34% less likely to achieve a systolic blood pressure >100 mm Hg on arrival at the hospital (adjusted odds ratio [AOR], 0.66 [95% CI, 0.47–0.92]). Furthermore, women had a longer time to 12‐lead ECG acquisition after return of spontaneous circulation (median adjusted difference, 1.00 minute [95% CI, 0.38–1.62]) and 33% reduced odds of being transported to a 24‐hour percutaneous coronary intervention‐capable facility (AOR, 0.67 [95% CI, 0.49–0.91]). Resuscitation was also terminated sooner for women compared with men (median adjusted difference, −4.82 minutes [95% CI, −6.77 to −2.87]).

Conclusions

Although external cardiac compression quality did not vary by sex, significant sex‐based disparities were seen in emergency medical services processes of care following out‐of‐hospital cardiac arrest. Further investigation is required to elucidate the underlying causes of these differences and examine their influence on patient outcomes.
Implementation of a Cell‐Enabled Remote Blood Pressure Monitoring Program During the Postpartum Period at a Safety‐Net Hospital
Authors: Mujic Ema , Parker Samantha E. , Nelson Kerrie P. , O'Brien Megan , Chestnut Idalis A. , Abrams Jasmine , Yarrington Christina D.
Published: June 2024

Background

Postpartum hypertension is a risk factor for severe maternal morbidity; however, barriers exist for diagnosis and treatment. Remote blood pressure (BP) monitoring programs are an effective tool for monitoring BP and may mitigate maternal health disparities. We aimed to describe and evaluate engagement in a remote BP monitoring program on BP ascertainment during the first 6‐weeks postpartum among a diverse patient population.

Methods and Results

A postpartum remote BP monitoring program, using cell‐enabled technology and delivered in multiple languages, was implemented at a large safety‐net hospital. Eligible patients are those with hypertensive disorders before or during pregnancy. We describe characteristics of patients enrolled from January 2021 to May 2022 and examine program engagement by patient characteristics. Linear regression models were used to calculate mean differences and 95% CIs between characteristics and engagement metrics. We describe the prevalence of patients with BP ≥140/or >90 mm Hg. Among 1033 patients, BP measures were taken an average of 15.2 days during the 6‐weeks, with the last measurement around 1 month (mean: 30.9 days), and little variability across race or ethnicity. Younger maternal age (≤25 years) was associated with less frequent measures (mean difference, −4.3 days [95% CI: −6.1 to −2.4]), and grandmultiparity (≥4 births) was associated with shorter engagement (mean difference, −3.5 days [95% CI, −6.1 to −1.0]). Prevalence of patients with BP ≥140/or >90 mm Hg was 62.3%, with differences by race or ethnicity (Black: 72.9%; Hispanic: 52.4%; White: 56.0%).

Conclusions

A cell‐enabled postpartum remote BP monitoring program was successful in uniformly monitoring BP and capturing hypertension among a diverse, safety‐net hospital population.
Impact of Defibrillator Electrode Placement on Outcome of Electrical Cardioversion of Atrial Fibrillation: A Pilot Observational Study
Authors: Madanat Luai , France Josh , Shoukri Nolan , Bilolikar Abhay N. , Walsh Daniel , Kutinsky Ilana , Gundlapalli Sujana , Zhao Lili , Goel Anil , Williamson Brian , Cami Elvis , Gallagher Michael , Bloomingdale Richard , Dixon Simon , Haines David , Mehta Nishaki
Published: June 2024

Background

Anterior–posterior electrode placement is preferred in electrical cardioversion of atrial fibrillation. However, the optimal anterior–posterior electrode position in relation to the heart is not studied.

Methods and Results

We performed a prospective observational study on patients presenting for cardioversion of atrial fibrillation. Electrodes were placed in the anterior–posterior position and shock was delivered in a step‐up approach (100 J→200 J→360 J). Fluoroscopic images were obtained, and distances were measured from points A, midanterior electrode; and B, midposterior electrode, to midpoint of the cardiac silhouette. Patients requiring one 100 J shock for cardioversion success (group I) were compared with those requiring >1 shock/100 J (group II). Logistic regression was used to determine the impact of electrode distance on low energy (100 J) cardioversion success. Computed tomography scans from this cohort were analyzed for anatomic landmark correlation to the cardiac silhouette. Of the 87 patients included, 54 (62%) comprised group I and 33 (38%) group II. Group I had significantly lower distances from the mid–cardiac silhouette to points A (5.0±2.4 versus 7.4±3.3 cm;
P
<0.001) and B (7.3±3.0 versus 10.0±3.8 cm;
P
=0.002) compared with group II. On multivariate analysis, higher distances from the mid–cardiac silhouette to point A (odds ratio, 1.33 [95% CI, 1.07–1.70];
P
=0.01) and B (odds rsatio, 1.24 [95% CI, 1.05–1.50];
P
=0.01) were independent predictors of low energy (100 J) cardioversion failure. Based on review of computed tomography scans, we suggest that the xiphoid process may be an easy landmark to guide proximity to the myocardium.

Conclusions

In anterior–posterior electrode placement, closer proximity to the cardiac silhouette predicts successful 100 J cardioversion irrespective of clinical factors.
Abbreviated Versus Standard Dual Antiplatelet Therapy Times After Percutaneous Coronary Intervention in Patients With High Bleeding Risk With Acute Coronary Syndrome: Insights From the SWEDEHEART Registry
Authors: Håkansson Anton , Koul Sasha , Omerovic Elmir , Andersson Jonas , James Stefan , Agewall Stefan , Mokhtari Arash , van Der Pals Jesper , Wester Axel , Szummer Karolina , Jernberg Tomas , Erlinge David , Mohammad Moman A.
Published: June 2024

Background

Dual antiplatelet therapy (DAPT) reduces ischemic events but increases bleeding risk, especially in patients with high bleeding risk (HBR). This study aimed to compare outcomes of abbreviated versus standard DAPT strategies in patients with HBR with acute coronary syndrome undergoing percutaneous coronary intervention.

Methods and Results

Patients from the SWEDEHEART (Swedish Web‐system for Enhancement and Development of Evidence‐Based Bare in Heart Disease Evaluated According to Recommended Therapies) registry with at least 1 HBR criterion who underwent percutaneous coronary intervention for acute coronary syndrome were identified and included. Patients were divided into 2 groups based on their planned DAPT time at discharge: 12‐month DAPT or an abbreviated DAPT strategy and matched according to their prescribed P2Y12 inhibitor at discharge. The primary outcome assessed was time to net adverse clinical events at 1 year, which encompassed cardiac death, myocardial infarction, ischemic stroke, or clinically significant bleeding. Time to major adverse cardiovascular events and the individual components of net adverse clinical events were considered secondary end points. A total of 4583 patients were included in each group. The most frequently met HBR criteria was age older than 75 years (65.6%) and Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy score ≥25 (44.6%) in the standard DAPT group and oral anticoagulant therapy (79.6%) and age 75 years and older (55.2%) in the abbreviated DAPT group. There was no statistically significant difference in net adverse clinical events (12.9% versus 13.1%; hazard ratio [HR], 0.99 [95% CI, 0.88–1.11],
P
=0.83), major adverse cardiovascular events (8.6% versus 7.9%; HR, 1.08 [95% CI, 0.94–1.25]), or their components between groups. The results were consistent among all of the investigated subgroups.

Conclusions

In patients with HBR undergoing percutaneous coronary intervention due to acute coronary syndrome, abbreviated DAPT was associated with comparable rates of net adverse clinical events and major adverse cardiovascular events to a DAPT duration of 12 months.