bluuebunny/crossref_metadata_2025 huggingface dataset:
When things get MESI: The Manipulation Experiments Synthesis Initiative—A coordinated effort to synthesize terrestrial global change experiments
Authors: Van Sundert Kevin , Leuzinger Sebastian , Bader Martin K.‐F. , Chang Scott X. , De Kauwe Martin G. , Dukes Jeffrey S. , Langley J. Adam , Ma Zilong , Mariën Bertold , Reynaert Simon , Ru Jingyi , Song Jian , Stocker Benjamin , Terrer César , Thoresen Joshua , Vanuytrecht Eline , Wan Shiqiang , Yue Kai , Vicca Sara
Published: January 2023

Responses of the terrestrial biosphere to rapidly changing environmental conditions are a major source of uncertainty in climate projections. In an effort to reduce this uncertainty, a wide range of global change experiments have been conducted that mimic future conditions in terrestrial ecosystems, manipulating CO2, temperature, and nutrient and water availability. Syntheses of results across experiments provide a more general sense of ecosystem responses to global change, and help to discern the influence of background conditions such as climate and vegetation type in determining global change responses. Several independent syntheses of published data have yielded distinct databases for specific objectives. Such parallel, uncoordinated initiatives carry the risk of producing redundant data collection efforts and have led to contrasting outcomes without clarifying the underlying reason for divergence. These problems could be avoided by creating a publicly available, updatable, curated database. Here, we report on a global effort to collect and curate 57,089 treatment responses across 3644 manipulation experiments at 1145 sites, simulating elevated CO2, warming, nutrient addition, and precipitation changes. In the resulting Manipulation Experiments Synthesis Initiative (MESI) database, effects of experimental global change drivers on carbon and nutrient cycles are included, as well as ancillary data such as background climate, vegetation type, treatment magnitude, duration, and, unique to our database, measured soil properties. Our analysis of the database indicates that most experiments are short term (one or few growing seasons), conducted in the USA, Europe, or China, and that the most abundantly reported variable is aboveground biomass. We provide the most comprehensive multifactor global change database to date, enabling the research community to tackle open research questions, vital to global policymaking. The MESI database, freely accessible at doi.org/10.5281/zenodo.7153253, opens new avenues for model evaluation and synthesis‐based understanding of how global change affects terrestrial biomes. We welcome contributions to the database on GitHub.
Dimensional Characterization of Groundwater Oblique Flow Problems with Heat Transport
Authors: Jiménez‐Valera José Antonio , Alhama Francisco
Published: January 2023

A dimensional study of two problems in which groundwater flow is oblique has been carried out in order to characterize the vertical profiles of temperature along the domain affected by the flow, determining an input region in which the profiles depend on the horizontal position followed by a region in which profiles only depend on the vertical component of the flow. In the first problem, the horizontal and vertical components of velocity are constant. In the second scenario, the oblique flow of groundwater is generated because in the boundary conditions, the hydraulic potentials present a constant value. From the discriminated dimensional analysis of the mathematical model (governing equations and boundary conditions), the dependencies of the unknowns of greatest interest, characteristic lengths for the development of temperature‐depth profiles, velocity profiles and the temperature field, with the dimensionless groups deduced are established. Once these dependencies have been verified, they are graphically represented by means of curves and surfaces as universal solutions to these problems. Based on these universal solutions an inverse problem protocol for estimating water flows from temperature measurements is proposed. The use of universal graphs of the two proposed scenarios avoids the large number of numerical simulations that this type of problem required.
‘No one's ever said anything about sleep’: A qualitative investigation into mothers' experiences of sleep in children with epilepsy
Authors: Cook Georgia , Gringras Paul , Hiscock Harriet , Pal Deb K. , Wiggs Luci
Published: January 2023

Introduction

Sleep problems in children with epilepsy (CWE) are common. However, little is known about parental experiences and feelings about managing sleep in their CWE. To provide the most appropriate services' provision, it is essential that the lived experience of parents of this patient group and the issues and problems that they face in managing their child's sleep is understood.

Method

In 2018, nine mothers of CWE (aged 5–15 years) were interviewed about their perceptions and experiences around their child's sleep, sleep problems and their management, the impact of sleep difficulties on the child and their family and available support.

Results

Four themes were identified that represented the nature of the child's sleep problems, including settling and night‐waking issues, parasomnias and child anxiety around sleep. Seven themes represented mothers' experiences of managing their child's sleep and any associated problems, including the longstanding challenging nature of child sleep issues, management strategies adopted, challenges related to managing sleep over time, the link between sleep and seizures, the negative impact of poor sleep on daytime functioning, role of antiseizure medication and maternal concerns about child sleep. One theme represented the perceived lack of information, help and support available.

Conclusions

Findings suggest there are unmet needs in supporting parents to deal with sleep, sleep problems and their management in CWE.

Patient or Public Contribution

This individual study was conducted under the umbrella of the CASTLE research programme (see https://castlestudy.org.uk/). Parents who have lived experience of parenting a child with epilepsy were co‐applicants for the programme and were involved in the original conception, aims, design and funding application for the research programme (including the project reported in this paper) and advised on project design. Mothers of CWE who have lived experience of managing sleep and sleep problems in their child were participants who shared their experiences through the interviews, which formed the data of the current study.
Apatite oxynitride phosphor (Mg,Y)5Si3(O,N)13:Ce3+,Mn2+: A single‐phased host with solar‐like and efficient emission
Authors: Wu Yanzheng , Li Weiqiang , Zheng Yifan , Xu Yiqin , Wen Dawei , Molokeev Maxim S. , Pan Zaifa
Published: January 2023

During pursuing high color rendering index for full‐color‐emitting phosphor, low quantum efficiency (QE) is usually accompanying. We intend to elevate the luminescence efficiency when realizing a solar‐like spectra distribution, by constructing apatite structure oxynitride, inheriting high covalence and rigidity from oxynitride, and suitable multiple cation sites from oxyapatite compounds. Full‐color‐emitting apatite structure oxynitride phosphor (Mg,Y)5Si3(O,N)13:Ce3+,Mn2+ has been prepared, and the crystal sites’ occupancies of activators in this host were favorable for white emission. (Mg,Y)5Si3(O,N)13:Ce3+,Mn2+ phosphor shows whole visible light with emission wavelength ranging from 370 to 750 nm, matching the spectra of sunlight quite well. The fabricated white light‐emitting diode lamp demonstrated the distinctive overall performance of QE and chromaticity properties (Ra and R9). Furthermore, correlated color temperature is tunable from cool nature to warm white. The obtained lamp possesses the feature of less blue light hazard and high saturation of red degree, compared with the commercial YAG‐based lamp.
Perceptions of Black and White individuals sentenced for violent and nonviolent crimes
Authors: Bass Annabelle , Choi Jihye , Dickter Cheryl L.
Published: January 2023

The US judicial system is rife with racial discrimination against Black individuals at every stage. The current study aimed to examine perceptions of individuals accused of crimes and perceptions of sentencing decisions. Furthermore, we aimed to examine whether implicit and explicit racial bias would affect these perceptions. White university students (n = 157) and noncollege adults (n = 224) viewed fictitious electronic case records for Black and White target individuals convicted of a nonviolent drug crime or a violent assault crime. They rated the targets on positive and negative traits and completed measures of explicit and implicit racial bias. Findings indicated that university student participants rated the White targets more negatively and less positively than the Black targets across both crimes. The nonuniversity sample rated the Black targets more negatively than the White targets for the violent crime. On ratings of deservingness of incarceration and fairness of the sanction, participants had similar perceptions for Black and White targets. Furthermore, participants in our studies who reported greater explicit bias also evaluated the Black target less positively, more negatively, as more violent, and as more deserving of incarceration. More negative implicit bias was significantly associated with less positive evaluations of the Black target and greater endorsement that the target deserved incarceration. These findings have implications for criminal justice and judicial reform.
HRAS mutation positive multiple myeloma in the type 2 CALR mutation positive essential thrombocythemia: A case report
Authors: Lewandowski Krzysztof , Kopydłowska Agata , Kanduła Zuzanna , Sankowski Bartłomiej , Machnicki Marcin , Barańska Marta , Gwóźdź‐Bąk Kinga , Kubicki Tadeusz , Płotka Anna , Przysiecka Łucja , Dworacki Grzegorz , Kozłowski Piotr , Stokłosa Tomasz
Published: January 2023

Out of BCR‐ABL negative myeloproliferative neoplasm (MPNPh−) patients, 3%–14% display a concomitant monoclonal gammopathy of unknown significance (MGUS). In most cases, the diagnosis of plasma cell dyscrasia is either synchronous with that of MPNPh− or occurs later on. We present a 50‐year‐old patient with type 2 CALR Lys385Asnfs*47 mutation positive essential thrombocythemia (ET) who developed symptomatic multiple myeloma (MM) 13 years after the diagnosis of ET during PEG‐INF2α treatment. The NGS study performed at the time of the MM diagnosis revealed the HRAS Val14Gly/c.41T〉G mutation and the wild type CALR, JAK2 and MPL gene sequence. In the presented case, the complete molecular remission of ET was achieved after 16 months of PEG‐INF2α treatment. The origin of MM cells in MPNPh− patients remains unknown. Published data suggests that type 2 CALRins5 up‐regulate the ATF6 chaperone targets in hematopoietic cells and activate the inositol‐requiring enzyme 1α‐X‐box‐binding protein 1 pathway of the unfolded protein response (UPR) system to drive malignancy. It cannot be excluded that endoplasmic reticulum stress induced by the increased ATF6 resulted in an abnormal redox homeostasis and proteostasis, which are factors linked to MM. The presented case history and the proposed mechanism of mutant CALR interaction with UPR and/or ATF6 should initiate the discussion about the possible impact of the mutant CALR protein on the function and genomic stability of different types of myeloid cells, including progenitor cells.
Long‐term efficacy and safety of 1% glycopyrronium bromide cream in patients with severe primary axillary hyperhidrosis: Results from a Phase 3b trial
Authors: Szeimies Rolf‐Markus , Abels Christoph , Kilic Ana , Reich Hubert , Berger Birgit , Schulze zur Wiesche Erik , Schramm Katharina , Litzka Leonie , Heimstaedt‐Muskett Susanne , Masur Clarissa
Published: January 2023

Background

Primary axillary hyperhidrosis (PAHH) strongly affects the patient's quality of life. To date, topical treatment options are limited. One percent glycopyrronium bromide (GPB) showed promising efficacy and safety in a pivotal 4‐week Phase 3a study.

Objectives

To assess efficacy and safety of topical 1% GPB cream in patients with severe PAHH in a long‐term study of 72 weeks versus baseline.

Methods

This was a long‐term, open‐label, Phase 3b trial for 72 weeks including 518 patients with severe PAHH. Patients were treated with 1% GPB cream once daily for 4 weeks, followed by a flexible dosing scheme (min. twice per week, max. once daily). Primary endpoint was the absolute change in sweat production from baseline to week 12. Further study endpoints included assessment of the severity of PAHH and the impact on quality of life.

Results

Total median sweat production decreased by 119.30 mg (−65.6%, both median) until week 12. Absolute change in sweat production from baseline to week 12 in logarithmic values was statistically significant (p < 0.0001). Patients' quality of life was improved at all study time points compared to baseline, as assessed by Hyperhidrosis Quality of Life Index and Dermatology Life Quality Index (p < 0.0001). Treatment was safe and locally well‐tolerated with only few mild to moderate adverse drug reactions (ADRs). Dry mouth and application site erythema were the most common reported ADRs.

Conclusions

Treatment with 1% GPB cream over 72 weeks significantly reduces sweat production and improves quality of life in patients with severe PAHH. One percent GPB cream is well‐tolerated and provides an effective treatment option for long‐term use in patients with severe PAHH.
Generalized pustular psoriasis: A global Delphi consensus on clinical course, diagnosis, treatment goals and disease management
Authors: Puig Lluís , Choon Siew Eng , Gottlieb Alice B. , Marrakchi Slaheddine , Prinz Jörg C. , Romiti Ricardo , Tada Yayoi , von Bredow Dorothea , Gooderham Melinda
Published: January 2023

Background

Generalized pustular psoriasis (GPP) is a rare and highly heterogeneous skin disease, characterized by flares of neutrophilic pustules and erythema. As a rare disease with few clinical studies and no standardized management approaches, there is a paucity of knowledge regarding GPP.

Objectives

Conduct a Delphi panel study to identify current evidence and gain advanced insights into GPP.

Methods

A systematic literature review was used to identify published literature and develop statements categorized into four key domains: clinical course and flare definition; diagnosis; treatment goals; and holistic management. Statements were rated on a Likert scale by a panel of dermatologists in two rounds of online questionnaires; the threshold for consensus was agreement by ≥80%.

Results

Twenty‐one panellists reached consensus on 70.9%, 61.8%, 100.0% and 81.8% of statements in the ‘clinical course and flare definition’, ‘diagnosis’, ‘treatment goals’ and ‘holistic management of GPP’ domains, respectively. There was clear consensus on GPP being phenotypically, genetically and immunologically distinct from plaque psoriasis. Clinical course is highly variable, with an extensive range of complications. Clinical and histologic features supporting GPP diagnosis reached high levels of agreement, and although laboratory evaluations were considered helpful for diagnosis and monitoring disease severity, there was uncertainty around the value of individual tests. All acute and long‐term treatment goals reached consensus, including rapid and sustained clearance of pustules, erythema, scaling and crust, clearance of skin lesions and prevention of new flares. Potential triggers, associated comorbidities and differential diagnoses achieved low rates of consensus, indicating that further evidence is needed.

Conclusions

Global consensus between dermatologists was reached on clinically meaningful goals for GPP treatment, on key features of GPP flares and on approaches for assessing disease severity and multidisciplinary management of patients. On this basis, we present a management algorithm for patients with GPP for use in clinical practice.
Outlier detection in dermatology: Performance of different convolutional neural networks for binary classification of inflammatory skin diseases
Authors: Schielein Maximilian C. , Christl Joshua , Sitaru Sebastian , Pilz Anna Caroline , Kaczmarczyk Robert , Biedermann Tilo , Lasser Tobias , Zink Alexander
Published: January 2023

Background

Artificial intelligence (AI) and convolutional neural networks (CNNs) represent rising trends in modern medicine. However, comprehensive data on the performance of AI practices in clinical dermatologic images are non‐existent. Furthermore, the role of professional data selection for training remains unknown.

Objectives

The aims of this study were to develop AI applications for outlier detection of dermatological pathologies, to evaluate CNN architectures' performance on dermatological images and to investigate the role of professional pre‐processing of the training data, serving as one of the first anchor points regarding data selection criteria in dermatological AI‐based binary classification tasks of non‐melanoma pathologies.

Methods

Six state‐of‐the‐art CNN architectures were evaluated for their accuracy, sensitivity and specificity for five dermatological diseases and using five data subsets, including data selected by two dermatologists, one with 5 and the other with 11 years of clinical experience.

Results

Overall, 150 CNNs were evaluated on up to 4051 clinical images. The best accuracy was reached for onychomycosis (accuracy = 1.000), followed by bullous pemphigoid (accuracy = 0.951) and lupus erythematosus (accuracy = 0.912). The CNNs InceptionV3, Xception and ResNet50 achieved the best accuracy in 9, 8 and 6 out of 25 data sets, respectively (36.0%, 32.0% and 24.0%). On average, the data set provided by the senior physician and the data set provided in accordance with both dermatologists performed the best (accuracy = 0.910).

Conclusions

This AI approach for the detection of outliers in dermatological diagnoses represents one of the first studies to evaluate the performance of different CNNs for binary decisions in clinical non‐dermatoscopic images of a variety of dermatological diseases other than melanoma. The selection of images by an experienced dermatologist during pre‐processing had substantial benefits for the performance of the CNNs. These comparative results might guide future AI approaches to dermatology diagnostics, and the evaluated CNNs might be applicable for the future training of dermatology residents.
“Yield” to the time‐brain dilemma: The case for neuroimaging in delirium
Authors: Reznik Michael E. , Rudolph James L.
Published: January 2023

This editorial comments on the article by McDonald et al. in this issue.
Toward a low‐carbon and circular building sector: Building strategies and urbanization pathways for the Netherlands
Authors: van Oorschot Janneke , Sprecher Benjamin , Rijken Bart , Witteveen Pieter , Blok Merlijn , Schouten Nico , van der Voet Ester
Published: January 2023

Buildings are an important part of society's environmental impacts, both in the construction and in the use phase. As the energy performance of buildings improve, construction materials become more important as a cause of environmental impact. Less attention has been given to those materials. We explore, as an alternative for conventional buildings, the use of biobased materials and circular building practices. In addition to building design, we analyze the effect of urbanization. We assess the potential to close material cycles together with the material related impact, between 2018 and 2050 in the Netherlands. Our results show a limited potential to close material cycles until 2050, as a result of slow stock turnover and growth of the building stock. At present, end‐of‐life recycling rates are low, further limiting circularity. Primary material demand can be lowered when shifting toward biobased or circular construction. This shift also reduces material related carbon emissions. Large‐scale implementation of biobased construction, however, drastically increases land area required for wood production. Material demand differs strongly spatially and depends on the degree of urbanization. Urbanization results in higher building replacement rates, but constructed dwellings are generally small compared to scenarios with more rural developments. The approach presented in this work can be used to analyze strategies aimed at closing material cycles in the building sector and lowering buildings' embodied environmental impact, at different spatial scales.
Tranexamic acid in melasma: A focused review on drug administration routes
Authors: Konisky Hailey , Balazic Eliza , Jaller Jose A. , Khanna Urmi , Kobets Kseniya
Published: January 2023

Background

Melasma is a disorder of hyperpigmentation and vascularization often found in women between the ages of 20 and 40. The pathogenesis is unknown, but melasma often occurs in sun‐exposed areas of the face, forearms, and back. Risk factors include family history, increased estrogen/progesterone, certain medications, and UV exposure. Melasma is typically treated with topical hydroquinone (HQ); however, it is often refractory to treatment. Tranexamic acid (TXA) is a plasmin inhibitor used off‐label in the treatment of melasma. TXA can be administered orally, topically, or intralesionally.

Aims

The purpose of this review is to characterize the wide variety of TXA delivery methods for melasma treatment and the efficacy of these methods compared with traditional treatments.

Patients/Methods

A comprehensive PubMed and Embase search was conducted in May 2022 using the phrases tranexamic acid and melasma. Forty‐six articles were included in this review.

Results

Oral, intralesional, and topical TXA is safe and effective treatments for melasma. They have been studied in a variety of randomized controlled trials and have been compared with several traditional treatments. Overall, MASI scores in patients using TXA in any form improved.

Conclusions

Oral TXA was found to be the most effective, especially in cases of refractory melasma; however, it caused GI upset and menstrual irregularities in many patients. The pro‐thrombotic nature of this drug must be considered before safely prescribing to patients. Intralesional injections and microneedling with topical TXA were found to be effective alternatives to oral treatment. Lastly, topical TXA alone was found to be the least effective method but can be combined with other cosmeceuticals to improve outcomes. Topical TXA was also found to be better tolerated than hydroquinone, a traditional topical melasma treatment.
Alopecia areata and pattern hair loss (androgenetic alopecia) on social media – Current public interest trends and cross‐sectional analysis of YouTube and TikTok contents
Authors: Gupta Aditya K. , Polla Ravi Shruthi , Wang Tong
Published: January 2023

Background

With an ever‐growing influence of social media in healthcare, concurrent with increased emphasis on patient autonomy and shared decision‐making, dermatologists treating hair loss need to be cognizant of online interest trends and the types of information disseminated across popular platforms.

Objectives

To evaluate recent health‐related interest trends and assess engagement, quality, and accuracy of alopecia areata (AA) and pattern hair loss (PHL, androgenetic alopecia) contents on social media.

Methods

Relative search volumes (RSVs) were extracted from Google Trends using the search category ‘alopecia areata’ and ‘pattern hair loss’. Eighty matching videos on TikTok and YouTube were also extracted and characterized. Viewer engagement was estimated using the engagement ratio, and quality and accuracy were assessed using DISCERN and Dy et al. Accuracy Scale (DAS).

Conclusions

AA‐related contents on TikTok discussing personal experiences of female subjects were significantly more engaging. DISCERN and DAS scoring showed significantly higher quality and accuracy in videos created by healthcare providers on YouTube, but not TikTok, which could in part be related to YouTube videos being longer. RSV fluctuations corresponding to news in popular culture had high impact. Sponsorship disclosures were generally not reported in product promotional videos.
13CO2 labelling as a tool for elucidating the mechanism of cuticle development: a case of Clusia rosea
Authors: Kubásek Jiří , Kalistová Tereza , Janová Jitka , Askanbayeva Balzhan , Bednář Jan , Šantrůček Jiří
Published: January 2023

The plant cuticle is an important plant‐atmosphere boundary, the synthesis and maintenance of which represents a significant metabolic cost. Only limited information regarding cuticle dynamics is available.

We determined the composition and dynamics of Clusia rosea cuticular waxes and matrix using 13CO2 labelling, compound‐specific and bulk isotope ratio mass spectrometry. Collodion was used for wax collection; gas exchange techniques to test for any collodion effects on living leaves.

Cutin matrix (MX) area density did not vary between young and mature leaves and between leaf sides. Only young leaves incorporated new carbon into their MX. Collodion‐based sampling discriminated between epicuticular (EW) and intracuticular wax (IW) effectively. Epicuticular differed in composition from IW. The newly synthetised wax was deposited in IW first and later in EW. Both young and mature leaves synthetised IW and EW. The faster dynamics in young leaves were due to lower wax coverage, not a faster synthesis rate. Longer‐chain alkanes were deposited preferentially on the abaxial, stomatous leaf side, producing differences between leaf sides in wax composition.

We introduce a new, sensitive isotope labelling method and demonstrate that cuticular wax is renewed during leaf ontogeny of C. rosea. We discuss the ecophysiological significance of the new insights.
The temporal and spatial dimensions of plant–soil feedbacks
Authors: Chung Y. Anny
Published: January 2023

Feedbacks between plants and soil microbes form a keystone to terrestrial community and ecosystem dynamics. Recent advances in dissecting the spatial and temporal dynamics of plant–soil feedbacks (PSFs) have challenged longstanding assumptions of spatially well‐mixed microbial communities and exceedingly fast microbial assembly dynamics relative to plant lifespans. Instead, PSFs emerge from interactions that are inherently mismatched in spatial and temporal scales, and explicitly considering these spatial and temporal dynamics is crucial to understanding the contribution of PSFs to foundational ecological patterns. I propose a synthetic spatiotemporal framework for future research that pairs experimental and modeling approaches grounded in mechanism to improve predictability and generalizability of PSFs.
Pilot longitudinal kidney transplant transition program promotes peer connections and transition readiness
Authors: Caron Rachel , Richardson Kelsey L
Published: January 2023

Background

Adolescents who have received a kidney transplant are at high risk of graft rejection and transplant‐related comorbidities around the time of transition from pediatric to adult care. While there has been a progress in tracking transition readiness, further work is needed to prepare adolescents for healthcare transitions. We describe a longitudinal cohort‐based transition curriculum designed to prepare kidney transplant recipients for adult transplant care.

Methods

Adolescent kidney transplant recipients aged 17 and older participated in the pilot cohort of the 2‐year transition curriculum. Session topics included communication with the healthcare team, insurance, job skills, reflective practice, reproductive health, medications, and adult clinic introduction. Surveys were given to obtain narrative feedback, assess participant self‐management behavior, and track curriculum knowledge.

Results

Each participant attended an average of two sessions, with 18 out of 30 eligible adolescents participating in at least one session. After transitioning to a virtual platform, there was increased attendance of participants who live greater than 150 miles from the transplant center. Adolescents highlighted the value of the program's group structure to relate to and learn from other participants.

Conclusions

The pilot transition program successfully provided adolescent kidney transplant recipients the opportunity to learn alongside their peers and gain interdisciplinary knowledge to prepare for healthcare transition. The program converted to a virtual platform during the COVID‐19 pandemic, with increased accessibility for participants who live further from the transplant center. Group‐based programming for adolescents should be enhanced to further prepare them for transitions to adult medicine.
The response of high density turbidity currents and their deposits to an abrupt channel termination at a slope break: Implications for channel–lobe transition zones
Authors: Wilkin Jonathan , Cuthbertson Alan , Dawson Sue , Stow Dorrik , Stephen Karl , Nicholson Uisdean , Penna Nadia
Published: January 2023

The transition between the slope and basin floor is typically marked by a slope break, in some cases causing channels to terminate and turbidity currents to undergo a loss of confinement. It is thus essential to understand how these slope breaks and losses of confinement influence the hydrodynamic evolution of turbidity currents and impact their depositional variability within natural scale channel mouth settings. Flume experiments, utilizing Shields scaling, are conducted to study how channel slope angle (3°, 6° and 9°) and initial suspended sediment concentrations (12 to 18% by volume) impact the hydrodynamics and deposit geometries of high density turbidity currents, subject to a simultaneous break of slope and loss of confinement. Measured velocity and concentration profiles indicate that turbidity currents are supercritical, with mean velocities between 0.80 m s−1 and 1.04 m s−1 and depth‐averaged basal concentrations between 9.2% and 23.9%, yielding bed shear velocities between 0.050 m s−1 and 0.064 m s−1. Upon encountering the slope break and loss of confinement, turbidity currents exhibit increases to their densimetric Froude numbers and shear velocities. This is due primarily to two factors: firstly, turbidity currents continue to accelerate during an initial period of velocity lag as their residual momentum gradually dissipates; and, secondly, expansion via flow relaxation collapses their structure towards the bed. The corresponding depositional geometries of these processes reveal that turbidity currents produce elongate channel–lobe transition zones that disconnect channel and basin deposits. The length to width ratios of channel–lobe transition zones decrease as the initial sediment concentrations of turbidity currents increase, while a reduction in the channel slope break angle reduces their length to width ratios. Corresponding, lobe elements are observed to increase in length, width and thickness with increasing initial sediment concentrations, while a reduction in channel slope break angle reduces their dimensions due to enhanced slope deposition.
A global examination of clinical ladder programs – A synthesis of commonalities and opportunities for standardization
Authors: Slagle Amanda , Wakim Nada , Gray Sarah E.
Published: January 2023

Background

Clinical ladder programs (CLPs) have been part of the nursing profession for nearly 4 decades. However, the structure and implementation of CLPs vary widely throughout healthcare systems. CLPs are a valuable factor in nurse retention and employee satisfaction initiatives, but globally replicating and measuring their impact is difficult due to lack of standardization.

Aim

To identify opportunities for global standardization of CLPs through a systematic review of published evidence and facility‐sourced CLPs applications and program documents.

Method

This study used a systematic literature search and scan of existing programs from facilities within the United States (US), Lebanon, and Ghana obtained through professional ties and organizational membership.

Results

Seventy‐nine articles were screened with 30 studies identified for inclusion, plus 20 CLPs from the US and international facilities. Identified commonalities were the lack of consistency in the number of clinical levels across the CLPs, eligibility requirements and application process, reward and recognition, lack of emphasis on technology and informatics, and missed opportunities to use CLPs to drive a culture of safety. The administrative burden of the programs and the time required by the nurse to complete the CLP application were rarely referenced.

Linking Evidence to Action

The lack of consistency between facilities and across the healthcare sectors limits the measurable impact CLPs have on the nursing profession. Recommendations for practice include developing a standardized professional development framework. A standardized framework will encourage adoption of a retention tool that will provide the profession with a measurable method to demonstrate the value it brings to patient care. Providing guidance to health care facilities in low‐ and middle‐income countries on the implementation of a professional development framework will assist in closing the global gap of professional development opportunities for nurses.
A steerable non-paraxial Gaussian beam expansion for a steerable parametric array loudspeaker
Authors: Zhuang Tao , Zhong Jiaxin , Niu Feng , Karimi Mahmoud , Kirby Ray , Lu Jing
Published: January 2023

A steerable parametric array loudspeaker (PAL) aims to steer a highly directional audio beam without the need to mechanically rotate the source. The Gaussian beam expansion (GBE) method is often used to model PALs because it is a computationally efficient approach, however the method relies on a paraxial approximation that can result in significant inaccuracies at large steering angles. To address this limitation, a steerable non-paraxial GBE is proposed in this article, where the mainlobe of the steered ultrasonic beam is included in the calculation by rotating the coordinate system. A non-paraxial approximation is then used to improve the accuracy of the method when integrating the virtual audio sources. The numerical results obtained using the proposed method are compared against those using the conventional GBE, as well as an exact solution. For a typical configuration, it is shown that for a conventional GBE the prediction error can be more than 30 dB at large angles, whereas the proposed method reduces this to less than 1 dB. The advantage of the proposed method is more significant at large steering angles, low audio frequencies, and those locations outside of the paraxial region. This improvement in performance is achieved with a computational cost that remains the same as the conventional GBE.
Multi-objective optimization for generation of personal sound zone
Authors: Cheng Jiazheng , Gao Hao , Pan Keyu , Feng Xuelei , Shen Yong
Published: January 2023

Personal Sound Zone (PSZ) allows listeners to enjoy their individual sound without being disturbed by sound from other zones. Acoustic contrast, signal distortion, and array effort are the most frequently used metrics for measuring the performance of a PSZ system. However, usually, the three metrics cannot be optimized at the same time. A trade-off between the three metrics has to be made when designing a PSZ system. In this paper, two generalized methods based on multi-objective optimization are proposed for dealing with all possible trade-off problems between the three metrics in PSZ. Optimality analysis of the two proposed methods is taken, and the relationship between the two proposed methods is investigated. Numerical simulations are presented to validate the efficacy and flexibility of the two proposed methods.
Bearing a grudge—How human natural killer cells remember past insults
Authors: Mace Emily M.
Published: January 2023

Natural killer (NK) cell pathogen-specific memory is selected and maintained in the absence of antigen receptor rearrangement.
Transfacial venous embolisation of a spontaneous indirect paediatric caroticocavernous fistula
Authors: Deepalam Saikanth Reddy , Reddy Kankara Shreyas , Menezes Clyde Richard , Goddu Govindappa Sharath Kumar
Published: January 2023

We present a rare case of a spontaneous indirect caroticocavernous fistula (CCF) in an early adolescent, who exhibited a 1-month history of redness, decrease in vision and proptosis of the right eye without a history of trauma or connective tissue disorder. An MRI of the brain and orbit and a digital subtraction angiography confirmed the diagnosis of Barrow type D CCF. The same was then treated with coiling and a liquid embolising agent using the transfacial venous route, resulting in complete obliteration. Reduction in conjunctival congestion with mild improvement in visual acuity was noted postprocedure. Complete recovery was noted at the 6-month follow-up visit. CCF, though rare in the paediatric population, should be highly considered in the differential diagnosis when the above-mentioned complaints are present. Early diagnosis and intervention have favourable outcomes.
When I use a word . . . . Medical anniversaries in 2023
Authors: Aronson Jeffrey K
Published: January 2023

My list of 66 medically related anniversaries for 2023 (events in years ending ’23 and’73) includes: ● foundation of the Chelsea Physic Garden (1673); ● foundation of
The Lancet
by Thomas Wakley (October 1823); ● Roe v Wade (1973); ● Twenty five births include: Hans Berger, German neurologist; Aimé Bonpland, French physician and botanist; Alexis Carrel, French surgeon and Nobel prize winner; Lloyd Conover, American pharmaceutical chemist; Félix d'Herelle, French-Canadian microbiologist; Théodore de Mayerne, Swiss physician; Carl Djerassi, American pharmaceutical chemist and novelist; Sigismund Elsholtz, German physician, botanist, and alchemist; Daniel Gajdusek, American virologist; Beatrix Hamburg, American psychiatrist; Richard Mead, English physician; Arthur Jensen, American educational psychologist; Otto Loewi, German pharmacologist; Georg Balthasar Metzger, German physician and scientist; William P Murphy Jr, American physician and inventor of medical devices; William Petty, English physician and political economist; Arnold S Relman, American physician and editor; Caspar Schamberger, German surgeon; Giovanni Antonio Scopoli, Italian physician and scientist; Ludwik Teichmann, Polish physician and anatomist; Alfred Russell Wallace, English naturalist; and Thomas Young, English scientist and polymath; ● Thirteen deaths include: Francis Anthony, English apothecary, physician, and alchemist; Matthew Baillie, Scottish physician and pathologist; John Caius, English physician; Regnier De Graaf, Dutch physician, physiologist, and anatomist; Walter Rudolf Hess, Swiss physiologist; Edward Jenner, English physician; Dickinson W Richards, American physician; Wilhelm Röntgen, German physicist; Antony van Leeuwenhoek, Dutch microscopist; Justus von Liebig, German chemist; and Selman Waksman, Ukrainian-American biochemist; ● Eleven biomedical texts published, written by Avicenna, Persian physician, astronomer, and philosopher; Gaspard Bauhin, Swiss botanist; William Budd, English physician; Aleixeu de Abreu, Portuguese physician and tropical pathologist; John Lelamour, English schoolmaster; Lucretius, Roman poet and philosopher; Marcello Malpighi, Italian physician; Girolamo Mercuriale, Italian physician; Raymond Pearl, American biologist; Costanzo Varolio, Italian anatomist and physician; Charles White, English physician; and Wilhelm Wundt, German physiologist; ● compilation of the
Lelamour Herbal
by John Lelamour, English schoolmaster (1373); ● anatomical, biochemical, haematological, microbiological, and physiological observations by Gasparus Aselli, Italian physician; Gerhard Henrik Armauer Hansen, Norwegian physician; William Prout, English chemist, physician, and theologian; Gaston Ramon, French biologist; Hilaire-Marin Rouelle, French chemist; and Antony van Leeuwenhoek, Dutch microscopist; ● Foundation of the pharmaceutical companies Novo Nordisk in Denmark (1923) and Sanofi in France (1973); ● Nobel prizes awarded to Banting and Macleod (1923) and to von Frisch, Lorenz, and Tinbergen (1973).
Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study
Authors: George Cindy , Hill Jillian , Nqebelele Unati , Peer Nasheeta , Kengne Andre P
Published: January 2023

Objective

To evaluate the viability of leveraging an existing screening programme (the South African Diabetes Prevention Programme (SA-DPP)) to screen for chronic kidney disease (CKD), by assessing the yield of CKD cases among those participating in the programme.

Design

Observational study conducted between 2017 and 2019.

Setting

16 resource–poor communities in Cape Town, South Africa.

Participants

690 participants, aged between 25 and 65 years, identified as at high risk for type 2 diabetes mellitus (T2DM) by the African Diabetes Risk Score.

Primary outcome measure

The prevalence of CKD among those participating in the SA-DPP.

Results

Of the 2173 individuals screened in the community, 690 participants underwent further testing. Of these participants, 9.6% (n=66) and 18.1% (n=125) had screen-detected T2DM and CKD (defined as an estimated glomerular filtration rate (eGFR) of<60 mL/min/1.73 m2and/or albumin-to-creatinine ratio >3 mg/mmol), respectively. Of those with CKD, 73.6% (n=92), 17.6% (n=22) and 8.8% (n=11) presented with stages 1, 2 and 3, respectively. Of the participants with an eGFR <60 mL/min/1.73 m2, 36.4% had no albuminuria and of those with normal kidney function (eGFR ≥90 mL/min/1.73 m2), 10.2% and 3.8% had albuminuria stages 2 and 3, respectively. Of those with T2DM and hypertension, 22.7% and 19.8% had CKD, respectively.

Conclusion

The fact that almost one in five participants identified as high risk for T2DM had CKD underscores the value of including markers of kidney function in an existing screening programme. By using an opportunistic approach to screen high-risk individuals, those with CKD can be identified and appropriately treated to reduce disease progression.
Oesophageal squamous papilloma in paediatric population: a single-centre case series
Authors: Hernández-Almeida Pamela , Vásconez-Muñoz Fabián , Vásconez-Montalvo Andrea , Montalvo-Flores Nelson , Redrobán-Armendariz Ligia , Aymacaña-Albán Edison
Published: January 2023

Purpose

Oesophageal squamous papilloma (OSP) is a rare epithelial lesion with an unclear aetiology, found incidentally in upper gastrointestinal endoscopy (UGE). We evaluate the epidemiology, general features and endoscopic and histological characteristics of OSP in children in a single centre.

Methods

We conducted a retrospective search of 3568 medical records of children under 18 years old who underwent UGE between 2004 and 2022, at Hospital Metropolitano de Quito, Ecuador. We described the general features of 15 patients diagnosed with OSP. Histopathology reports were analysed, including a chromogenic in situ hybridisation (CISH) for human papillomavirus (HPV) 6/11.

Results

OSP was diagnosed in 15 patients between 10 and 16 years of age, with an estimated prevalence of 0.4%. The gender ratio male to female was 1:1.1. Most patients (n=14) underwent UGE due to abdominal pain. Lesions were found predominantly in the upper and lower part of the oesophagus; 12 patients had isolated lesions, and none of the lesions tested positive for HPV on CISH 6/11 analysis. Additionally,Helicobacter pyloriand eosinophilic oesophagitis (EoE) were diagnosed in one patient each.

Conclusion

Our study describes the clinical features of paediatric OSP in a single centre. The prevalence was similar to that in the adult population but higher than in other paediatric populations, and none of our patients had HPV.
Impact of atrial fibrillation on the treatment effect of bridging thrombolysis in ischemic stroke patients undergoing endovascular thrombectomy: a multicenter international cohort study
Authors: Loo Jing Hong , Leow Aloysius ST , Jing Mingxue , Sia Ching-Hui , Chan Bernard PL , Seet Raymond CS , Teoh Hock-Luen , Meyer Lukas , Fiehler Jens , Papanagiotou Panagiotis , Kastrup Andreas , Mpotsaris Anastasios , Maus Volker , Yapici Furkan , Simonato Davide , Gabrieli Joseph D , Cester Giacomo , Bhogal Pervinder , Spooner Oliver , Nikola Christos , Joshi Abhishek , Lee Tsong-Hai , Wu Jiale , Chen Yimin , Yang Shuiquan , Sharma Vijay Kumar , Tan Benjamin YQ , Yeo Leonard LL
Published: January 2023

Background

The role of bridging intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT) in the treatment of acute ischemic stroke (AIS) remains debatable. Atrial fibrillation (AF) associated strokes may be associated with reduced treatment effect from IVT. This study compares the effect of bridging IVT in AF and non-AF patients.

Methods

This retrospective cohort study comprised anterior circulation large vessel occlusion (LVO) AIS patients receiving EVT alone or bridging IVT plus EVT within 6 hours of symptom onset. Primary outcome was good functional outcome defined as modified Rankin Scale (mRS) 0–2 at 90 days. Secondary outcomes were successful reperfusion defined as expanded Thrombolysis In Cerebral Infarction (eTICI) grading ≥2b flow, symptomatic intracerebral hemorrhage (sICH), and in-hospital mortality.

Results

We included 705 patients (314 AF and 391 non-AF patients). The mean age was 68.6 years and 53.9% were male. The odds of good functional outcomes with bridging IVT was higher in the non-AF (adjusted odds ratio (aOR) 2.28, 95% CI 1.06 to 4.91, P=0.035) compared with the AF subgroups (aOR 1.89, 95% CI 0.89 to 4.01, P=0.097). However, this did not constitute a significant effect modification by the presence of AF on bridging IVT (interaction aOR 0.12, 95% CI −1.94 to 2.18, P=0.455). The rate of successful reperfusion, sICH, and mortality were similar between bridging IVT and EVT for both AF and non-AF patients.

Conclusion

The presence of AF did not modify the treatment effect of bridging IVT. Further individual patient data meta-analysis of randomized trials may shed light on the comparative efficacy of bridging IVT in AF versus non-AF LVO strokes.
Opsoclonus–myoclonus syndrome caused by organophosphate poisoning
Authors: Haridas Aalaya , Ravi Pradeep
Published: January 2023

Opsoclonus–myoclonus syndrome is a combination of involuntary, arrhythmic, conjugate saccadic eye movements with myoclonus. The most common cause in adults is paraneoplastic encephalitis. Rarer causes include infections such as scrub typhus, and toxins such as organophosphates and cocaine. Organophosphates are one of the common poisonings in tropical countries such as India, causing both central and peripheral nervous system manifestations. We describe a middle-aged male farmer with unexplained altered consciousness and respiratory depression. After 2 days, he developed opsoclonus–myoclonus, and then bronchorrhoea and bradycardia, raising suspicion of organophosphate poisoning. After we had identified a very low serum cholinesterase concentration, he disclosed having consumed organophosphates.
A Bar-Natan homotopy type
Authors: Sano Taketo
Published: January 2023

A spatial refinement of Bar-Natan homology is given, that is, for any link diagram [Formula: see text] we construct a CW-spectrum [Formula: see text] whose reduced cellular cochain complex gives the Bar-Natan complex of [Formula: see text]. The stable homotopy type of [Formula: see text] is a link invariant and is described as the wedge sum of the “canonical sphere spectra”. We conjecture that the quantum filtration of Bar-Natan homology also lifts to the spatial level, and that it leads us to a cohomotopical refinement of the [Formula: see text]-invariant.