bluuebunny/crossref_metadata_2025 huggingface dataset:
Graphs with at most two moplexes
Authors: Dallard Clément , Ganian Robert , Hatzel Meike , Krnc Matjaž , Milanič Martin
Published: May 2024

A moplex is a natural graph structure that arises when lifting Dirac's classical theorem from chordal graphs to general graphs. The notion is known to be closely related to lexicographic searches in graphs as well as to asteroidal triples, and has been applied in several algorithms related to graph classes, such as interval graphs, claw‐free, and diamond‐free graphs. However, while every noncomplete graph has at least two moplexes, little is known about structural properties of graphs with a bounded number of moplexes. The study of these graphs is, in part, motivated by the parallel between moplexes in general graphs and simplicial modules in chordal graphs: unlike in the moplex setting, properties of chordal graphs with a bounded number of simplicial modules are well understood. For instance, chordal graphs having at most two simplicial modules are intervals. In this work, we initiate an investigation of ‐moplex graphs, which are defined as graphs containing at most moplexes. Of particular interest is the smallest nontrivial case , which forms a counterpart to the class of interval graphs. As our main structural result, we show that, when restricted to connected graphs, the class of 2‐moplex graphs is sandwiched between the classes of proper interval graphs and cocomparability graphs; moreover, both inclusions are tight for hereditary classes. From a complexity‐theoretic viewpoint, this leads to the natural question of whether the presence of at most two moplexes guarantees a sufficient amount of structure to efficiently solve problems that are known to be intractable on cocomparability graphs, but not on proper interval graphs. We develop new reductions that answer this question negatively for two prominent problems fitting this profile, namely, 
Graph Isomorphism and 
Max‐Cut. On the other hand, we prove that every connected 2‐moplex graph contains a Hamiltonian path, generalising the same property of connected proper interval graphs. Furthermore, for graphs with a higher number of moplexes, we lift the previously known result that graphs without asteroidal triples have at most two moplexes to the more general setting of larger asteroidal sets.
Spanning even trees of graphs
Authors: Jackson Bill , Yoshimoto Kiyoshi
Published: May 2024

A tree is said to be even if all pairs of vertices of degree one in are joined by a path of even length. We conjecture that every ‐regular nonbipartite connected graph has a spanning even tree and verify this conjecture when has a 2‐factor. Well‐known results of Petersen and Hanson et al. imply that the only remaining unsolved case is when is odd and has at least bridges. We investigate this case further and propose some related conjectures.
Sex concordance between physicians and patients and discharge opioid prescribing
Authors: Rambachan Aksharananda , Joshi Mihir , Auerbach Andrew D. , Fang Margaret C.
Published: May 2024

Inpatient pain management is challenging for clinicians and inequities are prevalent. We examined sex concordance between physicians and patients to determine if discordance was associated with disparate opioid prescribing on hospital discharge. We examined 15,339 hospitalizations from 2013 to 2021. Adjusting for patient, clinical, and hospitalization‐level characteristics, we calculated the odds of a patient receiving an opioid on discharge and the days of opioids prescribed across all hospitalizations and for patients admitted with a common pain diagnosis. We did not find an overall association between physician–patient sex concordance and discharge opioid prescriptions. Compared to concordant sex pairs, patients in discordant pairs were not significantly less likely to receive an opioid prescription (odds ratio: 1.04; 95% confidence interval [CI]: 0.95, 1.15) and did not receive significantly fewer days of opioids (2.1 fewer days of opioids; 95% CI: −4.4, 0.4). Better understanding relationships between physician and patient characteristics is essential to achieve more equitable prescribing.
Finite element analysis of kangaroo astragali: A new angle on the ankle
Authors: Murphy Peter J. , Rowe Andre J. , Rayfield Emily J. , Janis Christine M.
Published: May 2024

Using finite element analysis on the astragali of five macropodine kangaroos (extant and extinct hoppers) and three sthenurine kangaroos (extinct proposed bipedal striders) we investigate how the stresses experienced by the ankle in similarly sized kangaroos of different hypothesized/known locomotor strategy compare under different simulation scenarios, intended to represent the moment of midstance at different gaits. These tests showed a clear difference between the performance of sthenurines and macropodines with the former group experiencing lower stress in simulated bipedal strides in all species compared with hopping simulations, supporting the hypothesis that sthenurines may have utilized this gait. The Pleistocene macropodine Protemnodon also performed differently from all other species studied, showing high stresses in all simulations except for bounding. This may support the hypothesis of Protemnodon being a quadrupedal bounder.
White Matter Hyperintensity is Associated with Malignant Cerebral Edema in Ischemic Stroke Treated with Thrombectomy
Authors: Wei Lihua , Zhao Xiaolin , Luo Jiaqi , Xiao Mengxuan , Li Bingbing , Zhu Zhiliang , Fan Huanhuan , Lu Wenting , Lin Zhenzhou , Wu Yongming , Pan Suyue , Liu Xianghong , Ji Zhong , Huang Kaibin
Published: May 2024

Background

White matter hyperintensity (WMH) burden may lead to poor clinical outcomes after endovascular thrombectomy (EVT). But the relationship between WMH burden and cerebral edema (CED) is unclear.

Purpose

To examine the association between WMH burden and CED and functional outcome in patients treated with EVT.

Study Type

Retrospective.

Subject

344 patients with acute anterior circulation large‐vessel occlusion stroke who received EVT at two comprehensive stroke centers. Mean age was 62.6 ± 11.6 years and 100 patients (29.1%) were female.

Field Strength/Sequence

3T, including diffusion‐weighted imaging and fluid‐attenuated inversion recovery (FLAIR) images.

Assessment

The severity of WMH was evaluated using the Fazekas scale on a FLAIR sequence before EVT. The severity of CED was assessed using CED score (three for malignant cerebral edema [MCE]) and net water uptake (NWU)/time on post‐EVT cranial CT. The impact of WMH burden on MCE, NWU/time, and 3‐month poor outcome (modified Rankin scale >2) after EVT were assessed.

Statistical Tests

Pearson's chi‐squared test, Fisher exact test, 2‐tailed t test, Mann–Whitney U test, multivariable logistic regression, multivariate regression analysis, Sobel test. A P value <0.05 was considered statistically significant.

Results

WMH burden was not significantly associated with MCE and parenchymal hemorrhage (PH) in the whole population (P = 0.072; P = 0.714). WMH burden was significantly associated with an increased risk of MCE (OR, 1.550; 95% CI, 1.128–2.129), higher NWU/time (Coefficient, 0.132; 95% CI, 0.012–0.240), and increased risk of 3‐month poor outcome (OR, 1.434; 95% CI, 1.110–1.853) in the subset of patients without PH. Moreover, the connection between WMH burden and poor outcome was partly mediated by CED in patients without PH (regression coefficient changed by 29.8%).

Data Conclusion

WMH burden is associated with CED, especially MCE, and poor outcome in acute ischemic stroke patients treated with EVT. The association between WMH burden and poor outcome may partly be attributed to postoperative CED.

Level of Evidence

3.

Technical Efficacy

Stage 5.
Incremental Prognostic Value of Left Atrial Strain in Patients With Suspected Myocarditis and Preserved Left Ventricular Ejection Fraction
Authors: Chen Yan , Zhang Nan , Zhao Wenjing , Sun Zhonghua , Liu Jiayi , Liu Dongting , Wen Zhaoying , Xu Lei
Published: May 2024

Background

Analysis of left atrial (LA) strain and left atrioventricular coupling index (LACI) have prognostic value in cardiovascular diseases. However, the prognostic value of LA strain and LACI in patients with suspected myocarditis and preserved left ventricular ejection fraction (LVEF) is unclear.

Purpose

To investigate the prognostic value of LA strain and LACI in patients with suspected myocarditis and preserved LVEF in comparison with conventional MRI outcome predictors.

Study Type

Retrospective.

Population

One hundred sixty‐five patients with clinically suspected myocarditis and preserved LVEF with available follow‐up data.

Field Strength/Sequence

Steady‐state free precession cine and phase‐sensitive inversion recovery segmented gradient echo late gadolinium enhancement sequences at 3.0 T.

Assessment

Left ventricular (LV) and LA strain were evaluated using feature tracking. LACI was calculated as the ratio of LA and LV volumes at LV end‐diastole. Patients were followed‐up with the primary endpoint being major adverse cardiovascular events (MACE).

Statistical Tests

Independent‐samples t‐test and Mann–Whitney U test to compare patients with and without MACE, receiver operating characteristic (ROC) curve analysis to define high/low risk groups, Kaplan–Meier survival analysis and Cox proportional hazards regression to assess prognosis. A P value of <0.05 was considered statistically significant.

Results

The associations of LV strain parameters (including global radial, circumferential, and longitudinal strain) and LACI with MACE were not significant (P = 0.511, 0.108, 0.148, and 0.847, respectively). An optimal LA conduit strain (Ԑe) cutoff value of 10.4% was identified to best classify patients into low‐ and high‐risk groups. Only Ԑe was significantly associated with MACE in both univariable (hazards ratio [HR] 0.936, 95% confidence interval [CI] 0.884–0.991) and multivariable Cox survival analyses (HR 0.937, 95% CI 0.884–0.994).

Data Conclusion

LA conduit strain has prognostic value in patients with suspected myocarditis and preserved LVEF, incremental to conventional MRI outcome predictors, whereas LACI was not associated with MACE occurrence.

Evidence Level

3

Technical Efficacy

Stage 2
An open‐set method for automatic recognition of low probability of intercept radar waveforms based on reciprocity points learning
Authors: Liu Zhilin , Wang Jindong , Ge Qidong , Yang Bo , Li Yinlong , Zhang Hengwei
Published: May 2024

Deep learning‐based methods for Low Probability of Intercept radar waveform recognition typically assume that the signal to be recognized belongs to a known and finite set of classes. However, in practical scenarios, the electromagnetic signal environment is open and there may be a large number of unknown signals, making such methods difficult to apply. To address this issue, a novel open‐set recognition method based on reciprocal points is proposed. This approach uses a neural network to extract a high‐dimensional time‐frequency feature map of the signal, and measures the difference between the known and unknown signals by computing the distance between the feature vector and the reciprocal points. This allows the model to correctly identify known class signals while simultaneously detecting unknown signals. Experimental results show that the proposed method achieves open‐set recognition of Low Probibability of Intercept radar signals. On test signals with signal‐to‐noise ratios ranging from 6 dB to 15 dB, the model achieves nearly 100% accuracy in identifying known class signals and more than 90% accuracy in detecting unknown signals.
Impact of medication dosage on Helicobacter pylori eradication rates among pediatric patients
Authors: Andrews Christine , Herzlinger Michael , Riaz Muhammad , Liu Enju , Chan Christina , Bonilla Silvana
Published: May 2024

Objectives

Helicobacter pylori rates of eradication to common first‐line regimens continue to decline globally. Prescription of the appropriate medication dosage is an important consideration, particularly in the pediatric population due to medication weight‐based dosing. Limited data is available on the impact of guideline‐recommended weight‐based dosing on the successful eradication of H. pylori in children.

Methods

Retrospective study of patients with histologic evidence of H. pylori from two pediatric tertiary care centers in New England. We excluded patients who were not treated or those missing eradication data. We compared the eradication rates of patients prescribed recommended weight‐based dosages, duration, and frequency of treatment with those who were not.

Results

One hundred forty‐four patients were included. The overall eradication rate was 73.6% (106/144). All treatment regimens were properly prescribed for 14 days. There was a high rate of improper weight‐based dosing: proton pump inhibitor (PPI) 31.2% (45/144), amoxicillin 31.7% (39/123), metronidazole (MET) 19.4% (12/62), clarithromycin (CLA) 23.9% (22/70), tetracycline 50% (6/12), bismuth 26.1% (6/23). When PPIs were properly weight‐dosed, there was a 78.8% eradication rate that dropped to 62.2% with suboptimal dosing (p = 0.036, odds ratio [OR]: 2.26, confidence interval [CI]: 1.04−4.87). When amoxicillin was properly weight‐dosed, successful eradication was achieved in 81% versus only 53.8% when improperly dosed (p = 0.002; OR: 3.64, CI: 1.58−8.37). There was no statistically significant impact on eradication rates with improper weight‐based dosing of MET, CLA, tetracycline, or bismuth.

Conclusion

Proper weight‐based dosing of amoxicillin and PPI is important for the successful eradication of H. pylori among children in the New England area.
Raman spectroscopy‐based molecularly imprinted polymer sensor for sensitive detection of lysophosphatidic acid in serum
Authors: Tarannum Nazia , Kumar Deepak , Yadav Akanksha , Yadav Anil K.
Published: May 2024

Lysophosphatidic acid (LPA) has significant potential as a biomarker for diagnosis of ovarian cancer in female patients because it is present throughout all phases of the illness. Regrettably, there is not a clinically useful test for this biomarker yet. In this work, an ultra‐detection of LPA molecule by Raman spectroscopy‐based molecularly imprinted polymer (MIP) in serum samples is reported. β‐CD was synthesized to facilitate the collection of Raman spectroscopy and combined with MIP to denote it as β‐CD‐MIP for the adsorption of LPA with high sensitivity and selectivity. Linear regression model in serum samples shows peaks at 1100 and 1116 cm−1, respectively. A satisfactory linear fit was seen with LPA concentration log I = 3.7 log C + 1255.74 and with spiked serum log I = 4.6 log C + 327.22, respectively. The literature survey suggests the threshold LPA level in healthy person is 1.50 μM/L whereas the LPA level rises in patients with benign ovarian cancer tumor as 7.90 μM/L. This LPA level rises to 16.99 μM/L in ovarian cancer patients. On the basis of the band intensity, the limit of detection of the β‐CD‐MIP sensor for LPA was recorded as 0.003 μM/L. The binding constant of β‐CD‐MIP for LPA in serum was 0.031–0.003 μM/L, respectively. β‐CD‐MIP gel was optimized, characterized, and successfully applied on spiked serum samples. The findings of this research show that this substrate has a lot of potential for ultradetection of trace amounts of LPA molecule from the serum samples. The MIP sensor is robust, recyclable, efficient, and selective.
Crowdfunding's impact on small business performance through exploitative and exploratory search strategies: An entrepreneurial resourcefulness perspective
Authors: Sarfo Christian , Zhang Jing A. , O'Kane Paula , O'Kane Conor
Published: May 2024

Drawing on the entrepreneurial resourcefulness perspective, this study examines how crowdfunding engagement affects small business performance. We theorize that crowdfunding engagement serves resourcefully to enhance small business performance. Moreover, we hypothesize that exploratory and exploitative search act as effective mechanisms through which crowdfunding engagement increases small business performance. We further posit that the effects of crowdfunding engagement on small business performance are contingent on environmental dynamism. We utilize a quantitative approach, specifically partial least squares structural equation modeling (PLS‐SEM), for analyzing our data. Using a sample of 310 small businesses in Ghana, the findings from PLS‐SEM support our theorization, showing that both exploratory and exploitative search positively mediate the effects of crowdfunding engagement on small business performance, while environmental dynamism negatively moderates such effects. Our findings provide important theoretical and practical implications.
Evaluating the role of level 3 axillary lymph node dissection in metastatic melanoma: Can we predict involvement?
Authors: Parker Lily M. , Beekman Kate E. , DePalo Danielle K. , Elleson Kelly M. , Zager Jonathan S.
Published: May 2024

Background and Objectives

MSLT‐2 and DECOG‐SLT established that immediate complete axillary lymph node dissection (CLND) did not correlate with an increase in melanoma‐specific survival when compared with active ultrasound observation in patients with sentinel lymph node (SLN)‐positive disease. After those trials, there was a shift toward performing CLND only for clinically node‐positive disease. With these changes, we sought to determine the role of level III axillary lymph nodes in bulky disease and how the use of neoadjuvant therapy may impact the rate of positivity in level III axillary nodes.

Methods

We performed a retrospective chart review on all patients who underwent axillary CLND for cutaneous melanoma by one surgeon at an academic center from 2014 to 2022. These patients underwent CLND based on either having SLN+ disease or having clinically palpable or radiographically bulky disease.

Results

Of 95 patients included, there were 7 (7.3%) patients with level III positivity. One was SLN+ (1.0%), while 3 (3.1%) had bulky disease and neoadjuvant therapy, and 3 (3.1%) had bulky disease without neoadjuvant therapy. No preoperative factors were identified that predicted level III involvement. After performing CLND, the patients who had clinically palpable or radiographically bulky disease and neoadjuvant therapy had higher percent necrosis of nodes in levels I and II but not III. At 5 years, overall survival and recurrence‐free survival were improved in those without level III involvement (58% and 64%, respectively) when compared to those with level III involvement (41% and 50%), though this was not statistically significant.

Conclusions

Further study may identify better prognostic factors for level III positivity, allowing for the possibility of dissecting only levels I and II or even replacing CLND with targeted node dissections.
Risk of adverse events in patients with bullous pemphigoid treated with oral corticosteroids in the United States
Authors: Silverberg Jonathan I. , Yang Feifei , Alemao Evo , Zhao Jing , Crivera Concetta , Patel Hetal V. , Lin Iris , Mangold Aaron R.
Published: May 2024

Background

The potential association of long‐term oral corticosteroid (OCS) use with adverse events (AEs) in patients with bullous pemphigoid (BP) is not well characterized in a real‐world setting.

Objectives

To evaluate the effect of OCS use and treatment duration on the incident AEs in patients with BP.

Methods

This retrospective cohort study used medical and pharmacy claims and patient enrollment data from IQVIA PharMetrics® Plus from 2006−2021. Eligible patients had a diagnosis of BP between 1 January 2006 and 30 June 2020 (≥2 claims for BP ≥ 30 days apart). Patients in the OCS cohort also had a claim for OCS use, ≥7.5 mg daily dose of prednisone or equivalent, and no claims for a nonoral systemic corticosteroid (CS) at any time during the study period. A control cohort of patients with BP not using OCS was also selected. Relative risk ratios were estimated between the incidence of AEs in OCS users with different exposure durations (short‐term, <30 days; medium‐term, 30−90 days; long‐term, >90 days) and nonusers by Poisson regression, after adjusting for age, sex, prior drug use, and baseline Charlson Comorbidity Index score within the follow‐up period.

Results

At the 1‐year follow‐up, long‐term OCS users had a higher incidence of infections, cataract, osteoporosis, heart failure, depression or anxiety, and diabetes compared with OCS nonusers (p < 0.05). Furthermore, compared with nonusers, long‐term users had increased 1‐year risks (risk ratio; 95% confidence interval) for heart failure (2.27; 1.50−3.44), diabetes (2.05; 1.30−3.24), osteoporosis (1.72; 1.23−2.41), and infection (1.50; 1.13−1.99). Long‐term OCS users also had increased 1‐year risks for heart failure (2.00; 1.21−3.28) and osteoporosis (1.70; 1.16−2.50) compared with short‐term OCS users.

Conclusions

Long‐term OCS use (≥7.5 mg) in patients with BP was associated with an increased risk of AEs. Study findings demonstrate a need for steroid‐sparing options with an improved safety profile.
Modified double‐pulley fixation provides better reduction of bone fragments and union compared to single‐point fixation in bony Bankart lesions
Authors: Qu Di , Fu Haitao , Shen Youliang , Zhang Jing , Zhang Dongfang , Jiang Qi , Qi Chao
Published: May 2024

Purpose

The purpose of this study was to compare clinical scores and imaging outcomes of bony Bankart lesions that underwent single‐point and modified double‐pulley fixation after at least 2 years of follow‐up.

Methods

Patients who underwent surgery to treat bony Bankart injuries were included and divided into groups A and B. A total of 69 patients were included (32 in group A and 37 in group B). Patients in group A underwent arthroscopic modified double‐pulley fixation and patients in group B underwent arthroscopic single‐point fixation. Three‐dimensional computed tomography (3D‐CT) was used to assess glenoid reduction one day after surgery. Postoperative bony union was assessed using 3D‐CT and multiplanar reconstruction images 6 months after surgery. Constant–Murley, Rowe rating system, visual analogue scale and University of California at Los Angeles and American Shoulder and Elbow Surgeons scores were recorded before and after surgery.

Results

In terms of imaging measurements, there was no significant group difference in the preoperative size of the glenoid defect, the size of the bony fragment or the expected postoperative size of the glenoid defect. The sizes of the actual postoperative glenoid defects differed significantly between the groups (p = 0.027), as did the absolute difference between the expected and actual glenoid defect sizes (p < 0.001). At 6 months postoperatively, 50.0% of group A patients and 24.3% of group B patients exhibited complete bony union (p = 0.027); the rates of partial union were 37.5% and 56.8%, respectively. At the final follow‐up, all clinical scores were significantly better than the preoperative scores (all p < 0.05), with no significant group differences (not significant).

Conclusions

The use of the modified double‐pulley technique with two anchors to treat bony Bankart injuries provides a better reduction of bone fragments than single‐point fixation with two anchors and was associated with a higher rate of early bone union.

Level of Evidence

Level III.
Computed tomography Scan Size Analysis of stapedius and tensor tympani muscles in middle ear myoclonic tinnitus
Authors: Velasco Gianfranco , Cho Hyun Jae , Seo Young Jun , Lim Ji Hyung , Han Jae Sang , Seo Jae Hyun , Park Shi Nae
Published: May 2024

Objectives

To analyze the sizes of the stapedius and tensor tympani (TT) muscles using a temporal bone CT (TBCT) scan in patients with middle ear myoclonic tinnitus (MEMT) and investigate their value for the diagnosis of this rare cause of tinnitus.

Methods

Medical records and TBCT of patients with MEMT or vascular tinnitus (VT) at Seoul St. Mary's Hospital from January 2012 to December 2022 were reviewed. The stapedius and TT muscles were analyzed.

Results

Thirty‐eight patients with unilateral MEMT and 39 patients with VT were included. More males were in the MEMT group compared to the VT group (MEMT: n = 24, VT: n = 8, p = .001). The mean age of the MEMT group was younger compared to the VT group (MEMT: 35 ± 12 years, VT: 44 ± 14.3 years, p = .005). The mean BMI for the MEMT group was less than the VT group (MEMT: 22.3 ± 2.5, VT: 24.8 ± 4.36, p = .010). The mean length and width of the stapedius in the MEMT group were larger than those of the VT group (Length MEMT: 1.47 ± 0.60 mm, VT: 0.98 ± 0.24 mm, p = .001; Width MEMT: 0.89 ± 0.32 mm, VT: 0.72 ± 0.19 mm, p = .009). The mean length and width of the TT in the MEMT group were larger than that of the VT group (Length MEMT: 3.10 ± 0.50 mm, VT: 2.27 ± 0.42, p = .001; Width MEMT: 2.02 ± 0.36, VT: 1.75 ± 0.26 p = .001).

Conclusion

The mean length and width of the stapedius and TT muscles measured in the MEMT group were longer and wider than the VT group. This suggests the use TBCT scan as a diagnostic tool for MEMT. Further studies with a larger study group to validate the results of this study are recommended.

Level of Evidence: 4.
Reliability and validity of the Arabic version of the brief version of the Questionnaire of Olfactory Disorders
Authors: Alsaleh Saad , Alfallaj Rayan , Almousa Hisham , Alsubaie Nawaf , Akkielah Yara , Mesallam Tamer A. , Sumaily Ibrahim
Published: May 2024

Background

An accessible self‐assessment questionnaire is needed to evaluate quality of life in olfactory dysfunction. The need to address this gap led to the development of the brief version of the Questionnaire of Olfactory Disorders (brief QOD), which holds particular value in the context of telemedicine.

Objectives

The aim of this study is to examine the reliability and validity of the Arabic brief QOD.

Methods

This study included 307 patients suffering from olfactory dysfunction as well as a control group filled a questionnaire including demographic information, the olfaction Visual Analog Scale (VAS), the Sino‐nasal Outcome Test 22 (SNOT‐22) questionnaire, and the Arabic version of the brief QOD. The Arabic brief QOD's reliability was assessed using Cronbach's α to measure internal consistency. To evaluate test–retest reliability, the intraclass correlation coefficient (ICC) was employed. The discriminative ability: score differences between the two groups were analyzed. The validity Arabic brief QOD was evaluated by comparing it to the olfaction VAS.

Results

The Cronbach's α coefficients were 0.757 for Questionnaire of Olfactory Disorders‐Parosmia (QOD‐P), 0.832 Questionnaire of Olfactory Disorders‐quality of life (QOD‐QoL), and 0.817 Questionnaire of Olfactory Disorders‐visual analog scale (QOD‐VAS). The reliability of the overall brief QOD was 0.93. The ICC exceeded the acceptable threshold of 0.7, indicating strong test–retest reliability. The highest correlation was observed between the SNOT‐22 and QOD total scores (r = 0.552 and p < .001) as well as between SNOT‐22 and QOD VAS (r = 0.512 and p < .001).

Conclusion

Excellent validity and reliability have been shown for the Arabic brief QOD as a self‐assessment tool assessing quality of life among olfactory dysfunction patients.

Level of evidence

NA.
Iatrogenic pharyngo‐esophageal diverticulum post‐anterior cervical discectomy and fusion: A case report and review of literature
Authors: AlHashim Mohammed , AlDohailan Fatima , AlGhuneem Aishah , AlDandan Ahmed , AlHaddad Mohammed
Published: May 2024

Objectives

The purpose of this study is to report a case of iatrogenic pharyngoesophageal diverticulum post‐anterior cervical discectomy and fusion (ACDF) surgery, its management and management of postoperative complications. We also did a thorough review of literature about iatrogenic pharyngoesophageal diverticulum which is a rarely encountered complication occurring after a commonly performed surgery; ACDF.

Methods

Here we describe a case of iatrogenic pharyngoesophageal diverticulum post‐ACDF surgery. In this paper we also make comparisons to the 23 cases reported in the literature in terms of: presentations, clinical findings, management courses, and complications. This study was approved by the Institution Review Board of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. (Ref. no.: IRB‐2023‐01‐473). The reported subject provided written informed consent before initiation of this study.

Results

Our case is a 45‐year‐old male with a history of ACDF surgery 8 years ago. He presented with dysphagia and regurgitations which started 1 year after ACDF. He was labeled as a case of Zenker's diverticulum and underwent multiple failed open and endoscopic surgeries prior to presenting to us. Upon presenting to our center, barium swallow showed the pharyngoesophageal diverticulum. Patient definitive diagnosis of iatrogenic rather than Zenker's diverticulum was established intra‐operatively with esophagoscopy which revealed exposed hardware inside the diverticulum. He underwent open diverticulectomy and diverticulopexy. Postoperatively he developed pharyngocutanous fistula and right vocal fold palsy, both successfully managed conservatively.

Conclusion

Iatrogenic Pharyngoesophageal diverticulum is a rare complication following ACDF, however prolonged dysphagia shall warrant further investigation by contrast studies. Open diverticulectomy with muscle reinforcement is a good management modality. Due to the complicated anatomy secondary to previous operations, we recommend conservative management for patients with postoperative pharyngocutaneous fistula.
Tools for telehealth: A correlational analysis of app‐based hearing testing
Authors: Adkins David , Phuong Anthea , Shinn Jennifer , Cline Trey , Hyland Jordan , Bush Matthew L.
Published: May 2024

Objective

Telehealth evaluation of hearing is rapidly evolving; however, the lack of consensus on the most accurate remote hearing test application has made hearing evaluation complicated. The objective of this study was to evaluate the correlation between the pure tone audiometry results obtained from app‐based hearing testing programs and a traditional audiogram.

Methods

A prospective within‐subject and between‐subject study design was used to correlate audiogram results between app‐based hearing programs and a traditional audiogram. All participants completed a traditional audiogram, 1 commercial app‐based test (ShoeBox), 2 consumer app‐based tests (EarTrumpet and Hearing Test and Ear Age Test [HTEAT]), and a Hearing Handicap Inventory screening version (HHI‐S). Testing was conducted in an acoustically controlled environment (traditional) and a quiet room (app‐based hearing tests).

Results

A total of 39 participants were enrolled in the study (21 with normal hearing and 18 with hearing loss). In patients with normal hearing, only the commercial hearing testing app (ShoeBox) had a statistically significant pure tone average correlation in both ears with traditional audiometry (Right ear—r = 0.7, p = .005, Left ear—r = 0.66, p = .001). Both consumer and commercial apps had statistically significant correlations with both ears in patients with hearing loss (ranging from r = 0.62 to r = 0.9). Regarding accuracy within 10 dB of the pure tone average of the traditional audiogram of all tested ears, the commercial app‐based test was accurate in 94% for all ears (normal and hearing loss), while consumer app‐based tests were between 14% and 36% for all ears. The HHI‐S indicated no hearing impairment in 95% of those with normal hearing and indicated hearing impairment in 89% of those with hearing loss.

Conclusion

Commercial‐grade app‐based pure tone audiometry demonstrates overall strong correlation and accuracy with traditional audiometry. The HHI‐S assessment remains a valid and useful tool to predict normal hearing and hearing impairment.

Level of Evidence

2
Recycling of Polydicyclopentadiene Enabled with N‐Coordinated Boronic Ester Bonds
Authors: Hu Jiawei , Gao Yuan , Teng Jianglu , Li Lei , Zhang Tao , Zheng Sixun
Published: May 2024

In this contribution, the transformation of polydicyclopentadiene (PDCPD) from thermoset into vitrimer is introduced. First, two N‐coordinated diboronic diols are successfully synthesized via the reaction of N,N,N‐tri(2‐hydroxyethyl)amine and/or N,N,N“,N”‐tetrakis(2‐hydroxyethyl)ethylene diamine with 4‐(hydroxymethyl) phenylboronic acid and then they are transformed into two N‐coordinated cyclic boronic diacrylates. The latter two dienes carrying electron‐withdrawing substituents are used for the ring opening insertion metathesis copolymerization (ROIMP) of dicyclopentadiene to afford the crosslinked PDCPD. In the crosslinked PDCPD networks, N‐coordinated cyclic boronic ester bonds are integrated. It is found that the as‐obtained PDCPD networks displayed the excellent reprocessing properties. In the meantime, the fracture toughness is significantly improved. Owing to the inclusion of N‐coordinated cyclic boronic ester bonds, the modified PDCPDs have the thermal stability much superior to plain PDCPD. The results reported in this work demonstrate that PDCPD can successfully be transformed into the vitrimers via the introduction of N‐coordinated cyclic boronic ester bonds.
Synchronization of stochastic complex networks based on privacy protection
Authors: Xu Yuhua , Wu Xiaoqun , Xie Chengrong , Gao Qingwu
Published: May 2024

As one of the security issues, privacy protection (PP) has become a research hotspot. The paper studies the synchronization problem of stochastic networks based on PP. First, a synchronization standard for stochastic network with delay is given based on PP. Second, a finite‐time (FnT) synchronization criterion for stochastic network without delay is given based on PP. The PP function of continuous time‐varying function is designed to mask the real state of the controlled complex network before converging to the real value in FnT and infinite time. Finally, the effectiveness of the method discussed in this article was verified through simulation examples.
Traveling waves in a model of calcium ions influx via mechanically stimulated membrane channels
Authors: Kazmierczak Bogdan , Volpert Vitaly
Published: May 2024

We consider the problem of existence and properties of pulse solutions to a system of equations modeling fast calcium waves in long cells. These waves have the speed up to 1000 
m/s. They propagate via the inflow of calcium ions from the extracellular space through the mechanically stimulated membrane channels. The channels open due to mechano‐chemical interaction, in which stretching of the cell's membrane at a point opens the calcium channels at neighboring points due to the forces exerted by the actomyosin network. The existence of homoclinic solutions is based on the celebrated exchange lemma, which cannot be applied straightforwardly due to some specificities of the model equations.
Environmentally Friendly Synthesis of Polymer Nanoparticles in a Packed Reactor Using Glass Beads
Authors: Yamamoto Tetsuya , Morino Ayumi , Kanda Hideki , Seki Ayumu , Ishigami Toru
Published: May 2024

Polymeric particles less than 100 nm in size (polymer nanoparticles), which are useful in the fields of medicine and so on, are synthesized through emulsion polymerization, wherein surfactants are essential for maintaining their dispersion stability, contaminating particle surfaces and causing high environmental pollution. The soap‐free emulsion polymerization (SFEP) of styrene in a packed reactor using microglass beads enables the synthesis of polymer nanoparticles without surfactants. Ultraviolet irradiation is used for radical polymerization using an initiator during the SFEP of styrene. The reaction space in the packed reactor is controlled by the size of glass beads to be filled in the reactor. A decrease in the size of the glass beads narrows the reaction space, causing the average polystyrene particle size to reach 27.3 nm and suppress convection flow by the wall of the glass beads, thereby limiting particle motion and preventing particle growth through particle collisions.
Physics‐constrained symbolic model discovery for polyconvex incompressible hyperelastic materials
Authors: Bahmani Bahador , Sun WaiChing
Published: May 2024

We present a machine learning framework capable of consistently inferring mathematical expressions of hyperelastic energy functionals for incompressible materials from sparse experimental data and physical laws. To achieve this goal, we propose a polyconvex neural additive model (PNAM) that enables us to express the hyperelastic model in a learnable feature space while enforcing polyconvexity. An upshot of this feature space obtained via the PNAM is that (1) it is spanned by a set of univariate basis functions that can be re‐parametrized with a more complex mathematical form, and (2) the resultant elasticity model is guaranteed to fulfill the polyconvexity, which ensures that the acoustic tensor remains elliptic for any deformation. To further improve the interpretability, we use genetic programming to convert each univariate basis into a compact mathematical expression. The resultant multi‐variable mathematical models obtained from this proposed framework are not only more interpretable but are also proven to fulfill physical laws. By controlling the compactness of the learned symbolic form, the machine learning‐generated mathematical model also requires fewer arithmetic operations than its deep neural network counterparts during deployment. This latter attribute is crucial for scaling large‐scale simulations where the constitutive responses of every integration point must be updated within each incremental time step. We compare our proposed model discovery framework against other state‐of‐the‐art alternatives to assess the robustness and efficiency of the training algorithms and examine the trade‐off between interpretability, accuracy, and precision of the learned symbolic hyperelastic models obtained from different approaches. Our numerical results suggest that our approach extrapolates well outside the training data regime due to the precise incorporation of physics‐based knowledge.
Do demographic factors impact plant knowledge and plant awareness disparity?
Authors: Linderwell Sarah , Hargiss Christina L. M. , Norland Jack
Published: May 2024

Since 1999, plant blindness, now known as plant awareness disparity (PAD), has gained great awareness. However, no study to date has explored the impact of multiple demographic factors, including those of an indigenous population, in understanding plant knowledge. Specifically, this study assessed how race, gender, rurality, and college type of general biology students influenced their self‐perceived plant knowledge and where that knowledge was learned. A total of 702 students across six different colleges, including three tribal and three non‐tribal colleges, completed the survey. The survey included demographic questions, five‐point Likert questions, and choose all that apply questions to assess students’ confidence in their plant knowledge, plant identification skills, where they learned that plant knowledge, and from whom they learned it. College type (tribal vs. non‐tribal) and race (American Indian/Alaskan Native vs. White) showed little differences across most analyses. However, rurality (rural vs. urban) and gender (male vs. female) were often significantly different (p ≤ 0.05). Similar findings were reflected in confidence in identifying specific plant categories. In most cases, participants disagreed when answering that they were confident in identifying categories of plants, with the only exception being gardening. The types of plants participants knew the most about were food, herbs, and foraging plants, which corresponded with gardening and foraging being the activities that taught them most about plants. Parent(s)/guardian(s) were the most important source of plant knowledge followed by school. The information in this study can aid educators, resource managers, and researchers in improving education, curriculum, and PAD.
Cumulative lifetime violence, social determinants of health, and cannabis use disorder post‐cannabis legalization in a community sample of men: An intersectional perspective
Authors: O'Donnell Sue , Scott‐Storey Kelly , Malcolm Jeannie , Vincent Charlene D. , Wuest Judith
Published: May 2024

Despite Canada having the highest disease burden globally for cannabis use disorder (CUD) and violence being ubiquitous in men's lives, little is known about how intersections among social determinants of health (SDOH) and cumulative lifetime violence severity (CLVS) influence CUD in men post‐cannabis legalization. Using data collected in a survey with a national community sample of 597 men who self‐identified as having experienced violence, we conducted a latent profile analysis using 11 subscales of the CLVS‐44 scale and explored differential associations between CLVS profiles and CUD considering SDOH covariates. Four profiles were distinguished by intersections among CLVS‐44 subscale severity and roles as target and perpetrator. CLVS profiles were significantly associated with CUD in the unadjusted model and in the adjusted model where age, adverse housing, and education were significant covariate controls. In the adjusted model, CUD was differentially associated with CLVS profiles and significantly higher in Profile 4 (highest severity target and perpetrator) than in Profile 1 (lowest severity target, no perpetration). Chi‐square tests showed significant intersection between adverse housing, younger age, Profile 4 CLVS, and moderate to severe CUD among cannabis users. These results reveal the importance of understanding simultaneous intersections among indicators of CLVS in determining profiles of lifetime violence. Also critical are intersections among CLVS profiles and significant covariates as a basis for trauma‐ and violence‐informed care for CUD that prioritizes men most disadvantaged by this convergence and attends to individual and structural health disparities at practice and policy levels.
Using the morphometric approach to analyze artificially modified crania from the late fifth millennium BCE settlement of Chega Sofla, southwestern Iran
Authors: Alirezazadeh Mahdi , Vahdati Nasab Hamed , Moghaddam Abbas
Published: May 2024

There have been archaeological and ethnographic reports of artificially modified crania from all continents. Archaeological excavations at the late fifth millennium BCE cemetery of Tol‐e Chega Sofla, located southwest of the Iranian plateau, also revealed these crania. This paper uses the morphometric approach to study Tol‐e Chega Sofla's modified crania. The outlines of normal and modified crania of Chega Sofla and Khuzestan residents' specimens were considered. How accurate is the morphometric approach in identifying and recognizing Chega Sofla's modified skulls from normal ones? Can it recognize small variations in the skull's morphology, such as the flattening of the squamous part of the occipital bone? The results of this method can be compared with descriptive studies. Finally, it is shown that the morphometric approach based on Elliptic Fourier Analysis can identify the deformed skull of Chega Sofla and its intensity, as well as the flattening of the squamous part of the occipital bone.
A case of a giant Bailey type I lateral cervical cyst
Authors: Seki Soju , Nishiura Akira , Kishino Fumika , Yokota Yusuke , Isomura Emiko Tanaka , Tanaka Susumu
Published: May 2024

Background

Lateral cervical cysts are among the most frequent branchial anomalies of the neck, although they rarely become large.

Case presentation

The present case involved a 32‐year‐old man with swelling of the right side of the neck. Pre‐operative CT findings showed a low CT value on the right side of the neck. Lateral cervical cyst removal was performed under general anesthesia, and the excision was 100 mm × 70 mm × 30 mm, which is the largest ever reported removal of a Bailey type I lateral cervical cyst.

Conclusion

The patient had a good clinical course, with no post‐operative recurrence.
Exploring autonomous and controlled motivations for nature contact to maximise health benefits
Authors: Astell‐Burt Thomas , Navakatikyan Michael , White Mathew P. , Feng Xiaoqi
Published: May 2024

Increasing evidence indicates contact with nature supports mental, physical and social health. However, beyond a widely reported number of barriers to nature contact, the constellation of motivations for human contact with nature is under‐theorised and under‐studied.

We begin to develop indicators of autonomous and controlled motivations for nature contact informed by self‐determination theory. These include intrinsic motivation (i.e. enjoyment), integrated regulation (alignment with identify and life goals), identified regulation (a means to an end), introjected regulation (emotional reasons like guilt avoidance) and external regulation (such as peer pressure). We compare these motivation indices in a nationally representative sample of 5082 adults in Australia in 2022 with the Nature Relatedness Scale (NR6), and also test associations between them and five outcomes: time spent in nature, smartphone use in nature, interest in nature prescriptions, physical activity and self‐rated health. Statistical analyses were adjusted for potential confounding.

Results demonstrate people have complex mixtures of motivations with varying potency for visiting natural settings and the extent to which those motives are autonomous or controlled matters for what they do, and the benefits accrued. For example, our analyses show that more direct considerations of intrinsic, integrated and identified forms of autonomous motivation have superior explanatory power than the NR6 for time spent in nature, interest in nature prescriptions, adherence to physical activity recommendations and self‐rated health.

External regulations emphasising peer approval were associated not only with no additional time in nature but also with more distractive activities when in natural environments, as defined by more smartphone and social media use while there. While introjected regulations emphasising guilt avoidance were associated with increased nature contact, they were similarly associated with time spent on smartphones and social media when in natural environments, which has been shown to undermine restoration.

Synthesis and applications: We need to formally measure autonomous and controlled motivations for nature contact to better understand both why some people visit natural environments, and whether they are mindfully maximising the health benefits of those experiences. This will help to inform robust nature‐based interventions that are acceptable, effective and sustainable for everyone.

Read the free Plain Language Summary for this article on the Journal blog.