bluuebunny/crossref_metadata_2025 huggingface dataset:
Immersive virtual reality-based rehabilitation for subacute stroke: a randomized controlled trial
Authors: Huang Qianqian , Jiang Xixi , Jin Yun , Wu Bo , Vigotsky Andrew D. , Fan Linyu , Gu Pengpeng , Tu Wenzhan , Huang Lejian , Jiang Songhe
Published: November 2023

Objective

Few effective treatments improve upper extremity (UE) function after stroke. Immersive virtual reality (imVR) is a novel and promising strategy for stroke UE recovery. We assessed the extent to which imVR-based UE rehabilitation can augment conventional treatment and explored changes in brain functional connectivity (FC) that were related to the rehabilitation.

Methods

An assessor-blinded, parallel-group randomized controlled trial was performed with 40 subjects randomly assigned to either imVR or Control group (1:1 allocation), each receiving rehabilitation 5 times per week for 3 weeks. Subjects in the imVR received both imVR and conventional rehabilitation, while those in the Control received conventional rehabilitation only. Our primary and secondary outcomes were the Fugl-Meyer assessment’s upper extremity subscale (FMA-UE) and the Barthel Index (BI), respectively. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed to assess the effectiveness of the trial. For both the FMA-UE/BI, a one-way analysis of covariance (ANCOVA) model was used, with the FMA-UE/BI at post-intervention or at follow-up, respectively, as the dependent variable, the two groups as the independent variable, baseline FMA-UE/BI, age, sex, site, time since onset, hypertension and diabetes as covariates.

Results

Both ITT and PP analyses demonstrated the effectiveness of imVR-based rehabilitation. The FMA-UE score was greater in the imVR compared with the Control at the post-intervention (mean difference: 9.1 (95% CI 1.6, 16.6); P = 0.019) and follow-up (mean difference:11.5 (95% CI 1.9, 21.0); P = 0.020). The results were consistent for BI scores. Moreover, brain FC analysis found that the motor function improvements were associated with a change in degree in ipsilesional premotor cortex and ipsilesional dorsolateral prefrontal cortex immediately following the intervention and in ipsilesional visual region and ipsilesional middle frontal gyrus after the 12-week follow-up.

Conclusions

ImVR-based rehabilitation is an effective tool that can improve the recovery of UE functional capabilities of subacute stroke patients when added to standard care. These improvements were associated with distinctive brain changes at two post-stroke timepoints. The study results will benefit future patients with stroke and provide evidence for a promising new method of stroke rehabilitation.

Trial registration

ClinicalTrials.gov identifier: NCT03086889.
Multistage stochastic dominance: an application to pension fund management
Authors: Kopa Miloš , Moriggia Vittorio , Vitali Sebastiano
Published: November 2023

A pension fund manager typically decides the allocation of the pension fund assets taking into account a long-term sustainability goal. Many asset and liability management models, in the form of multistage stochastic programming problem, have been proposed to help the pension fund manager to define the optimal allocation given a multi-objective function. The recent literature proposes univariate stochastic dominance constraints to guarantee that the optimal strategy is able to stochastically dominate a benchmark portfolio. In this work we extend previous results (i) considering alternative types of multivariate stochastic dominance that appear more suitable in a multistage framework, (ii) proposing a way to measure the economic cost of introducing stochastic dominance constraints, (iii) proposing a sort of augmented stochastic dominance through a safety margin. Numerical results show the difference between the alternative ways to interpret and apply the multivariate stochastic dominance. These results are evaluated thanks to the proposed economic cost of the stochastic dominance constraints and either in presence or not of a safety margin.
Comparison of the transformation of organic matter flux through a raised bog and a blanket bog
Authors: Glatzel Stephan , Worrall Fred , Boothroyd Ian M. , Heckman Katherine
Published: November 2023

This study has proposed that organic matter transfer and transformation into and through a peatland is dominated by preferential loss of carbohydrates and the retention of lignin-like molecules. Here we used elemental analysis and thermogravimetric analysis to analyse the biomass, litter, peat soil profile, particulate organic matter, and dissolved organic matter fluxes sampled from a continental raised bog in comparison a maritime blanket bog. The macromolecular composition and thermodynamic analysis showed that in the raised bog there had been little or no transformation of the organic matter and the accumulation was rapid with comparatively little transformation with only 13% loss of cellulose by 1 m depth compared to 92% removal of cellulosic material in the blanket bog. The lack of transformation is reflected in a difference in long term carbon accumulation rates between raised and blanket bog sites. We propose that raised bogs, with their lack of a stream outfall, have high stable water tables that mean the pore water become thermodynamically closed and reactions cease higher in the peat profile than in a blanket bog where sloping sites mean a frequent flushing of pore water and discharge of water leading to fluctuating water tables, flushing of reaction products and pore spaces remaining open.
2D data processing with MIMOS II
Authors: Pawlak Justus , Beyki Mohammad , Jahns Moritz , Bauer Friedrich , Sindelar Ralf , Patzke Robert , Renz Franz
Published: November 2023

The miniaturized Mössbauer-spectrometer (MIMOS II), originally devised by Göstar Klingelhöfer, is further developed by the Renz group at the Leibniz University Hanover in cooperation with the Hanover University of Applied Sciences and Arts. A new processing unit with a two-dimensional (2D) data acquisition was developed by M. Jahns. The advantage of this data acquisition is that no thresholds need to be set before the measurement. The energy of each photon is determined and stored with the velocity of the drive. After the measurement, the relevant area can be selected for the Mössbauer spectrum. Now we have expanded the evaluation unit with a power supply for a MIMOS drive and a MIMOS PIN detector. So we have a very compact MIMOS transmissions measurement setup. With this setup it is possible to process the signals of two detectors serially. Currently we are working on a parallel signal processing.
Evaluating the Effectiveness of Social Transfer Policies on Poverty for Children with Previous Experience in Poverty
Authors: Bárcena-Martín Elena , Blanco-Arana M. Carmen , Pérez-Moreno Salvador
Published: November 2023

This paper assesses the effectiveness of social benefit programs on children who had prior experience with poverty across 27 European countries in the years following the Great Recession (2012–2015). Even though social benefit functions might contribute to alleviating child poverty, our findings highlight that child poverty differs not only across social benefit functions, but also between children with and without previous experience in poverty. While living in a country with comparatively high family/children’s benefits is associated with lower child poverty risk, these benefits do not significantly prevent children from being poor when they have been in poverty in the past year. By contrast, old-age/survivor benefits appear to be strongly associated with a lower risk of poverty for children with previous experience in poverty. This is particularly noticeable in multigenerational households, especially in countries that provide limited support for families with children and allocate significant expenditure to pension benefits. This finding remains consistent even when using lower poverty thresholds.
Temporal silhouette: validation of stream clustering robust to concept drift
Authors: Iglesias Vázquez Félix , Zseby Tanja
Published: November 2023

Stream clustering is required in applications where data is generated continuously or periodically and must be processed considering its temporal nature. In the absence of a ground truth, internal validation is the only option to evaluate the quality of performances. Traditional internal validation is commonly used also in stream clustering, even in spite of the fact that it becomes inconsistent in the event of data evolution. Recent trends opt for incremental approaches, but these are closer to change detection rather than validation methods and limit themselves by imposing online validation on online analysis. In this work we study the impact of concept drift in the validation of stream clustering and propose the Temporal Silhouette index, therefore making internal validation conform to streaming data. We conduct tests with more than 200 datasets and contrast performances of four popular stream clustering algorithms with seven validation methods (three static internal, three incremental internal, one external) and the proposed index. Results show the suitability of the Temporal Silhouette index for stream clustering validation in the event of concept drift and different types of outliers. The demand for reliable unsupervised learning in applications that process data in streams is ever-increasing, and such reliability inevitably requires the use of validation. This fact highlights the significance of the novel approach proposed in this work.
Experimentally verified analytical models for the dynamic response of perovskite solar cells using measured I–V and C–V characteristics
Authors: Ismail Zahraa S. , Sawires Eman F. , Amer Fathy Z. , Abdellatif Sameh O.
Published: November 2023

Perovskite solar cells (PSC) have gained significant attention recently due to their high efficiency and potential for low-cost fabrication. Understanding the dynamic behavior of these cells is crucial for optimizing their performance and stability. In this paper, we propose experimentally verified analytical models for the dynamic response of perovskite solar cells. The models are developed based on the measured current–voltage ($$I-V$$

I
-
V

) and capacitance–voltage ($$C-V$$

C
-
V

) characteristics obtained from experiments. The study introduces the first fully analytical model for the dynamic response of perovskite solar cells, considering single, double, and triple diode models with three polynomials $$C-V$$

C
-
V

fitting functions. The analytical models are fed by experimental measured data and coefficients and pot-processed by an equilibrium optimizer. The proposed methodology was investigated using five batches of cesium lead chloride perovskite solar cells, with a power conversion efficiency of around 16.35% ±   0.32%. The suggested analytical model with an equilibrium optimizer showed a significant capability to predict the cell circuit parameters with a root-mean-square error below 0.00103, as the minimum error recorded so far in PSCs.
Connexive Negation
Authors: Estrada-González Luis , Nicolás-Francisco Ricardo Arturo
Published: November 2023

Seen from the point of view of evaluation conditions, a usual way to obtain a connexive logic is to take a well-known negation, for example, Boolean negation or de Morgan negation, and then assign special properties to the conditional to validate Aristotle’s and Boethius’ Theses. Nonetheless, another theoretical possibility is to have the extensional or the material conditional and then assign special properties to the negation to validate the theses. In this paper we examine that possibility, not sufficiently explored in the connexive literature yet.We offer a characterization of connexive negation disentangled from the cancellation account of negation, a previous attempt to define connexivity on top of a distinctive negation. We also discuss an ancient view on connexive logics, according to which a valid implication is one where the negation of the consequent is incompatible with the antecedent, and discuss the role of our idea of connexive negation for this kind of view.
More on Williams on Ethical Knowledge and Reflection
Authors: Moore A. W.
Published: November 2023

This essay is concerned with Bernard Williams’ contention in Ethics and the Limits of Philosophy that, in ethics, reflection can destroy knowledge. I attempt to defend this contention from the charge of incoherence. I do this by taking seriously the idea that ethical knowledge is knowledge from an ethical point of view. There nevertheless remains an issue about whether the contention is consistent with ideas elsewhere in Williams’ own work, in particular with what he says about knowledge in Descartes. In an earlier essay I argued that it is not. In a subsequent essay I indicated that I had changed my mind and gave a more sympathetic account of Williams’ contention. In this essay I set out the issues and say some more about my change of mind.
Evaluation of a smartphone electrocardiograph in healthy foals and comparison to standard base-apex electrocardiography
Authors: Bindi Francesca , Vezzosi Tommaso , Sala Giulia , Freccero Francesca , Marmorini Paola , Bonelli Francesca , Sgorbini Micaela
Published: November 2023

Smartphone-based technology for ECG recording has recently spread as a complementary tool for electrocardiographic screening and monitoring in adult horses and in other animal species. The present study aimed to assess the feasibility and accuracy of a smartphone-based ECG in healthy foals. This was a prospective observational study (authorization n. 45,865/2016) including 22 foals aged less than 21 days. A reference standard base-apex ECG (rECG) was acquired, and a smartphone ECG (sECG) was recorded immediately after by using a smartphone-based single lead electrocardiograph. All ECG tracings were evaluated in a blind fashion by a single board-certified cardiologist, who judged whether the tracings were acceptable for interpretation and performed ECG measurements and diagnosis. The Spearman correlation coefficient, the Cohen’s k test and the Bland-Altman test were used to assess the agreement between sECG and rECG. All sECG tracings were acceptable for interpretation. All foals showed sinus rhythm on both rRCG and sECG tracings, with perfect agreement in heart rate classification (κ = 0.87; p < 0.001). No clinically relevant differences were found in the assessment of waves and intervals duration. Concerning P wave and QRS complex polarity, the percentage of agreement between rECG and sECG was 78% and 83%, respectively. About ECG tracing quality, rECG and sECG showed a substantial agreement (κ = 0.624; p < 0.001). In conclusion, the smartphone-based ECG device tested in the present study recorded good quality single-lead ECG tracings in foals, reliable for heart rate and ECG measurements, but different polarity of P waves and QRS complexes was found in some foals in comparison to rECG.
Der Mensch ist doch eher wie ein Regenwurm. Wertfrage und Naturbegriff in einer Soziologie der Nachhaltigkeit
Authors: Haselbach Dieter , Vosse Corinna
Published: November 2023

Sowohl das Postulat der Werturteilsfreiheit (soziologischer) Wissenschaft als auch die begriffliche Grundentscheidung zu einer konstruktivistischen Soziologie steht einer Soziologie der Nachhaltigkeit im Weg. Für eine den ökologischen Problemen angemessenere Grundbegrifflichkeit wird eine an Spinoza angelehnte Anthropologie begründet und darauf basierend ein Paradigmenwechsel für die soziologische Nachhaltigkeitsforschung vorgeschlagen.
Improvement of outpatient service processes: a case study of the university of Hong Kong-Shenzhen hospital
Authors: Chen Jingsong , Alturas Bráulio
Published: November 2023

Purpose

This work presents a case study of the University of Hong Kong-Shenzhen Hospital (HKU-SZH), which was the first to implement an outpatient appointments registration system. The research question is to determine which factors influence patient satisfaction most.

Methods

The study provides an anatomy of the hospital outpatient process through various methods and theories, including a literature review, field research, expert consultation, business process improvement (BPI) theory and information technology, with the aim of identifying the objectives and strategies of the hospital for improving its outpatient process. A quantitative analysis was performed using a questionnaire survey to identify the defects and weaknesses of the current model. The principles, methods and techniques of BPI theory are used to analyse various problems existing in the outpatient process and the extent of their influence. A structural equation model has been established for scientific and quantitative analysis, which can help identify the goals of optimization and measure improvement in the outpatient process and patient satisfaction.

Results

It was determined the source of inefficiency of the current outpatient service process. By means of outpatient process improvement, the study aims to increase the hospital’s efficiency and raise the level of patient satisfaction so that it may enhance its comprehensive competence. In addition, an effective and operable methodology will be generated, which is expected to serve as a reference for other hospitals to improve their operation and management.

Conclusions

It was found that service attitude, service value and waiting time have a significant influence on patient satisfaction.
A Summer Research Experience to Increase Diversity in Healthcare: a 4-Year Follow-up Study
Authors: Afghani Behnoosh , Dayag Herschell Valenova
Published: November 2023

This report describes the educational follow-up of the college coaches who participated in our Summer Research Programs from 2012 through 2019. Our program was successful as all the 45 college coaches submitted a total of 54 abstracts to a regional conference, and 100% of them were accepted for publication. On follow-up in 2023, most of the college coaches, including women and those from minority backgrounds, were enrolled or graduated from a health professional school or worked in a healthcare setting. Despite our small study population, our research program can serve as a model to increase diversity in healthcare and science fields.
Digital competences in research: creativity and entrepreneurship as essential predictors for teacher training
Authors: Guillén-Gámez Francisco D. , Ruiz-Palmero Julio , Gómez-García Melchor
Published: November 2023

The first purpose of this study was to analyse the digital research competences of higher education teaching staff, depending on whether the level of creativity of the teacher to initiate new research projects and their level of entrepreneurial spirit was low/good. Following, it was analysed whether the use of different emerging technologies significantly affect the digital skills of teachers in research work; and to know in what order the use of these emerging technologies or the combination of several of them affect the digital competences of teachers. A ex post facto design was used with a sample of 1740 Higher Education teachers. Digital skills were measured using the instrument of Guillén-Gámez et al. (Educ Inf Technol 10.1007/s10639-023-11895-2, 2023). The levels of creativity and entrepreneurship were analyzed with dichotomous variables from a 10-point Likert scale (less than 7 points-low level, greater than or equal to 7-good level). The results showed that, although teachers possessed an adequate level of digital research skills, this could vary depending on transversal skills such as creativity and entrepreneurship, with large differences when these skills were at a basic level. Furthermore, depending on whether teachers had research experience in XR technology, cryptocurrencies, facial authentication systems, wearables or robotics, amongst others, this significantly affected the level of digital competence in research. The added value of this study lies on the one hand, in the fact that there are hardly any studies that analyse this subject; and on the other hand, the implications that this could have for institutions to launch training initiatives for their teaching staff in emerging technologies, as well as in transversal competences in any disciplinary field.
Engineering Strategies for Suppressing the Shuttle Effect in Lithium–Sulfur Batteries
Authors: Li Jiayi , Gao Li , Pan Fengying , Gong Cheng , Sun Limeng , Gao Hong , Zhang Jinqiang , Zhao Yufei , Wang Guoxiu , Liu Hao
Published: November 2023

Lithium–sulfur (Li–S) batteries are supposed to be one of the most potential next-generation batteries owing to their high theoretical capacity and low cost. Nevertheless, the shuttle effect of firm multi-step two-electron reaction between sulfur and lithium in liquid electrolyte makes the capacity much smaller than the theoretical value. Many methods were proposed for inhibiting the shuttle effect of polysulfide, improving corresponding redox kinetics and enhancing the integral performance of Li–S batteries. Here, we will comprehensively and systematically summarize the strategies for inhibiting the shuttle effect from all components of Li–S batteries. First, the electrochemical principles/mechanism and origin of the shuttle effect are described in detail. Moreover, the efficient strategies, including boosting the sulfur conversion rate of sulfur, confining sulfur or lithium polysulfides (LPS) within cathode host, confining LPS in the shield layer, and preventing LPS from contacting the anode, will be discussed to suppress the shuttle effect. Then, recent advances in inhibition of shuttle effect in cathode, electrolyte, separator, and anode with the aforementioned strategies have been summarized to direct the further design of efficient materials for Li–S batteries. Finally, we present prospects for inhibition of the LPS shuttle and potential development directions in Li–S batteries.
Urologische Notfälle: akuter Harnverhalt
Authors: Bausch Kathrin , Feicke Antje , Seifert Hans Helge
Published: November 2023

Der akute Harnverhalt ist ein häufiger urologischer Notfall und äussert sich als plötzliche Unfähigkeit, spontan zu urinieren, typischerweise assoziiert mit Schmerzen im unteren Bauchbereich. Obwohl die häufigste Ursache eine durch eine benigne Prostatavergrösserung („benign prostate enlargement“ [BPE]) verursachte mechanische Blasenauslassobstruktion („benign prostate obstruction“ [BPO]) ist, kann die Ätiologie vielfältig und multifaktoriell sein. Die Behandlung aller Arten von Harnverhalt zielt darauf ab, die Blase zu entlasten und die zugrunde liegende Ursache des Harnverhalts zu mildern. Dies kann in der Regel in der Notaufnahme ohne sofortige urologische Konsultation durch eine Katheterisierung der Blase erreicht werden; jedoch können bestimmte klinische Merkmale und die langfristige Therapie der Ursache eine fachurologische Abklärung erfordern. Dieser Artikel bietet einen Überblick über die häufigsten Ursachen des akuten Harnverhaltes sowie die Diagnostik und Therapie von Harnverhalten bei Männern und Frauen in der Notaufnahme.
Nitric Acid Pretreatment Applied to a Refractory Gold-Tellurides Ore
Authors: Argumedo-Jimenez Carlos , Chaverra Dairo E. , Restrepo-Baena Oscar J.
Published: November 2023

This paper presents the results obtained by processing a gold and silver telluride mineral concentrate from a mine in Colombia. An acid wash, also known as acidification, was carried out, followed by oxidation with nitric acid as a pretreatment. Cyanidations of the pretreatment residues were carried out and the results were compared with results from cyanidations of base materials. The removal of carbonates in the acidification, a tellurium extraction close to 90% during the pretreatment, and a 30% improvement in the gold recovery compared to the conventional process were achieved.
Time, Resentment, and Forgiveness: Impact on the Well-Being of Older Adults
Authors: Almeida Bernardo , Cunha Carla
Published: November 2023

The present study explores how resentment and forgiveness can affect older people and how resentment can be alleviated or intensified over time. The investigation is based on a qualitative methodology, using life history interviews, carried out in two moments. Data were collected from 20 individuals over 65 years old. Data were subject to thematic content analysis. The results point to different negative impacts of resentment on well-being and different positive impacts of forgiveness. Our results suggest that over time a set of variables influence the experience of forgiving. Subsequent studies are needed to investigate these variables and validate intervention plans focused on forgiveness among older population.
Large positive magnetoresistance and high mobility in topological insulator candidate LaP
Authors: Wu Desheng , Luo Jianlin
Published: November 2023

We reported herein the single crystal growth and the comprehensive study of basic physical properties including electronic transport, magnetic, specific heat of topological insulator candidate LaP. Single crystal LaP of rock salt type structure was synthesized by Sn flux method. Under low temperature and high magnetic field of $T= 2$
T
=
2
 K and $B= 9$
B
=
9
T, large positive magnetoresistance (LMR) of 500% was discovered. The Hall effect measurements show that the conduction carriers are dominated by holes among the temperature range from 300 K to 2 K, the carrier concentration $n_{h} =4.94\times 10^{19}$

n
h

=
4.94
×

10

19

cm−3 and $n_{e} =5.02\times 10^{16}$

n
e

=
5.02
×

10

16

cm−3 and the mobility of LaP reached as high as $\mu _{h}=1.57\times 10^{4}$

μ
h

=
1.57
×

10

4

cm2 V−1 S−1 and $\mu _{e} = 1.55\times 10^{3}$

μ
e

=
1.55
×

10

3

cm2 V−1 S−1 obtained at 2 K, which can be explained by multiband model physics like other topological quantum material systems with large MR. LaP shows diamagnetism over a wide temperature range from 2 K to 300 K without any magnetic phase transition by susceptibility measurements. No evidence of phase transitions from 2 K to 300 K was observed in the specific heat measurement. The electronic specific heat coefficient is obtained 0.538 m J mol−1 K−2 for LaP single crystal, which responds to a small electron density state near the Fermi level. Our results would be helpful in renewing interest in studying emergent phenomena arisen from topological semimetals. LaP offers a platform for understanding the interactions between large magnetoresistance, high mobility and topological band structure.
Temporal variations, sources, and regional transport of carbonaceous species in PM2.5 in a northern China city: the role of domestic heating
Authors: Sun Yuewei , Xin Ke , Ai Jing , Huang Huiying , Zhang Lingyun , Qin Weihua , Yu Qing , Chen Jing
Published: November 2023

Domestic heating is an important source of carbonaceous aerosols in northern China in winter. The seasonal variations, sources, and regional transport of carbonaceous species in PM2.5 in Yuncheng in the winter and summer of 2020–2021 were investigated in this study, with a particular focus on the role of domestic heating. Meanwhile, the pollution characteristics of carbonaceous aerosols in Beijing in winter were also investigated for comparison. The mass concentrations of organic carbon (OC) and elemental carbon (EC) and their contributions to PM2.5 were significantly enhanced during the heating period compared to other sampling periods in Yuncheng, however, no obvious differences were observed before and during the heating periods in Beijing. Source apportionment results showed that the heating related emission (50.9%) was the dominant source of total carbon in Yuncheng in the heating period, while vehicular emission (49.6%) was dominant in summer. Combing the positive matrix factorization (PMF) and potential source contribution function (PSCF) analysis, it was concluded that both local and regional heating activities contributed highly to carbonaceous aerosols in Yuncheng. It would be therefore of great environmental benefits to promote the clean residential heating transition in Yuncheng and other similar cities.

Graphical Abstract
Do the Humanities Create Knowledge?
Authors: Haufe Chris
Published: November 2023

There is in certain circles a widely held belief that the only proper kind of knowledge is scientific knowledge. This belief often runs parallel to the notion that legitimate knowledge is obtained when a scientist follows a rigorous investigative procedure called the 'scientific method'. Chris Haufe challenges this idea. He shows that what we know about the so-called scientific method rests fundamentally on the use of finely tuned human judgments directed toward certain questions about the natural world. He suggests that this dependence on judgment in fact reveals deep affinities between scientific knowledge and another, equally important, sort of comprehension: that of humanistic creative endeavour. His wide-ranging and stimulating new book uncovers the unexpected unity underlying all our efforts – whether scientific or arts-based – to understand human experience. In so doing, it makes a vital contribution to broader conversation about the value of the humanities in an increasingly STEM-saturated educational culture.
Prevalence, risk factors, and outcomes associated with delayed second doses of antibiotics in sepsis at a large academic medical center
Authors: Cook Meghan E. , Schuler Brian R. , Schontz Michael J. , McLaughlin Kevin C. , Lupi Kenneth E. , DeGrado Jeremy R. , Rhee Chanu
Published: November 2023

Objective:

To evaluate the prevalence, risk factors, and clinical impact of delays in second doses of antibiotics in patients with sepsis.

Design:

Single-center, retrospective, observational study.

Setting:

Large teaching hospital.

Patients:

Adult patients who triggered an electronic sepsis alert in the emergency department (ED), received ≥2 doses of vancomycin or an antipseudomonal beta-lactam, and were discharged with an ICD-10 sepsis code.

Methods:

We assessed the prevalence of delays in second doses of antibiotics by ≥25% of the recommended dose interval and conducted multivariate regression analyses to assess for risk factors for delays and in-hospital mortality.

Results:

The cohort included 449 patients, of whom 123 (27.4%) had delays in second doses. In-hospital death occurred in 31 patients (25.2%) in the delayed group and 71 (21.8%) in the non-delayed group (p = 0.44). On multivariate analysis, only location in a non-ED unit at the time second doses were due was associated with delays (OR 2.75, 95% CI 1.20–6.32). In the mortality model, significant risk factors included malignant tumor, respiratory infection, and elevated Sequential Organ Failure Assessment (SOFA) score but not delayed second antibiotic doses (OR 1.19, 95% CI 0.69–2.05). In a subgroup analysis, delayed second doses were associated with higher mortality in patients admitted to non-intensive care units (ICUs) (OR 4.10, 95% CI 1.32–12.79).

Conclusions:

Over a quarter of patients with sepsis experienced delays in second doses of antibiotics. Delays in second antibiotic doses were not associated with higher mortality overall, but an association was observed among patients admitted to non-ICUs.
Natural Kinds: The Expendables
Authors: Papale François , Montminy David
Published: November 2023

Theoreticians that defend a form of realism regarding natural kinds minimally entertain the belief that the world features divisions into kinds and that the natural kind concept is a useful tool for philosophy of science. The objective of this paper is to challenge these assumptions. First, we challenge realism toward natural kinds by showing that the main arguments for their existence, which rely on the epistemic success of natural kinds, are unsatisfactory. Second, we show that, whether they exist or not, natural kinds are expendable when it comes to describing and analyzing scientific explanations accurately.
Factors Associated With Delayed Pre-Hospital Times During Trauma-Related Mass Casualty Incidents: A Systematic Review
Authors: Alruqi Fayez , Aglago Elom K. , Cole Elaine , Brohi Karim
Published: November 2023

Objective:

Critically injured patients have experienced delays in being transported to hospitals during Mass Casualty Incidents (MCIs). Extended pre-hospital times (PHTs) are associated with increased mortality. It is not clear which factors affect overall PHT during an MCI. This systematic review aimed to investigate PHTs in trauma-related MCIs and identify factors associated with delays for triaged patients at incident scenes.

Methods:

This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Web of Science, CINAHL, MEDLINE, and EMBASE were searched between January and February 2022 for evidence. Research studies of any methodology, and grey literature in English, were eligible for inclusion. Studies were narratively synthesized according to Cochrane guidance.

Results:

Of the 2025 publications identified from the initial search, 12 papers met the inclusion criteria. 6 observational cohort studies and 6 case reports described a diverse range of MCIs. PHTs were reported variably across incidents, from a median of 35 minutes to 8 hours, 8 minutes. Factors associated with prolonged PHT included: challenging incident locations, concerns about scene safety, and adverse decision-making in MCI triage responses. Casualty numbers did not consistently influence PHTs. Study quality was rated moderate to high.

Conclusion:

PHT delays of more than 2 hours were common. Future MCI planning should consider responses within challenging environments and enhanced timely triage decision-making.
Managing plastic pollution in the Arctic ocean: An integrated quantitative flux estimate and policy study
Authors: Dewey Sarah , Mackie Sarah
Published: November 2023

Plastic pollution in the Arctic marine system is sparsely quantified, and few enforceable policies are in place to ameliorate the issue. With an inflow-outflow budget for the Arctic Ocean, we identify gateways through which plastic enters and exits the Arctic marine system. While estimating the flux of plastic through rivers, sea ice, and ocean, we also quantify marine plastic pollution from Arctic shipping and fishing. Plastic fluxes are calculated using horizontal volume fluxes of water and ice and combining them with plastic waste concentration data; flux from fishing and shipping is generated through combining waste estimates with estimated ship traffic. We estimate that fishing and shipping contribute 105 tonnes of plastic flux per annum, compared to 10−1 tonnes per annum from river inflow. The ocean has a far smaller net outflow, dwarfed by that of ice, at 10−8 to 10−7 and 10−5 to 10−3 tonnes per annum, respectively. We examine how a suite of proposed policy interventions would quantitatively change those concentrations, and how the current governance environment makes each feasible; we find interventions targeting vessel traffic most effective. These interventions include a prohibition on the use of certain plastics in fishing as well as a Polar Code permitting scheme.
Germination niche of a pioneer woody species (Manihot grahamii hook.): a strategy of seed heat stimulation to cope with disturbance in dry subtropical forests
Authors: Zeballos Sebastián R. , Venier Paula , Pereyra Mariana , Simian Denise , Funes Guillermo
Published: November 2023

Light and temperature conditions trigger germination in specific temporal windows and microhabitats, thus determining the germination niche of plant species. Manihot species grow in fire-prone ecosystems and their seeds show heat tolerance. Successful establishment in disturbed environments might be related to seed attributes that allow seeds to cope with or avoid stressful environments. We studied some characteristics of the germination niche of Manihot grahamii, a pioneer woody species present in dry subtropical forests of central Argentina, to understand its successful establishment in disturbed environments. We evaluated the germination ecology of the seeds of M. grahamii with the aims to (1) characterize seed traits (viability, mass and moisture content); (2) determine whether it has dormancy and if it is physical or physiological; (3) evaluate the effect of several pre-treatments (gibberellic acid, after ripening, dry prechilling and dry prechilling + warm) on seed dormancy; and (4) assess the effect of different environmental events of high temperatures on the germination process simulating two treatments: fire intensities (with three levels of heat shock) and a gap temperature. M. grahamii seeds have large mass (0.24 g), low moisture content (8%), physiological dormancy, negative photoblastic behaviour and high heat tolerance. Dormancy was alleviated and seeds became insensitive to light when they were exposed to pre-treatments of dry prechilling + warm and high-temperature treatments. This germination strategy promotes secure germination timing into the rainy season on undisturbed habitats as well as a cue for competition-released gaps which in turn favour recruitment in open, disturbed and dry habitats, respectively. In the context of global change, with an increasing habitat fragmentation and fire frequency, M. grahamii could become more abundant and extend its geographic distributional range in central Argentina.
The quality of death and dying of patients with advanced cancer in hospice care in Uganda and Kenya
Authors: Goombs Mary , Mah Kenneth , Namisango Eve , Luyirika Emmanuel , Mwangi-Powell Faith , Gikaara Nancy , Chalklin Lesley , Rydall Anne , Zimmermann Camilla , Hales Sarah , Wolofsky Kayla , Tilly Alyssa , Powell Richard A. , Rodin Gary
Published: November 2023

Objectives

Minimal information is available about the quality of dying and death in Uganda and Kenya, which are African leaders in palliative care. We investigated the quality of dying and death in patients with advanced cancer who had received hospice care in Uganda or Kenya.

Methods

Observational study with bereaved caregivers of decedents (Uganda: n = 202; Kenya: n = 127) with advanced cancer who had received care from participating hospices in Uganda or Kenya. Participants completed the Quality of Dying and Death questionnaire and a measure of family satisfaction with cancer care (FAMCARE).

Results

Quality of Dying and Death Preparation and Connectedness subscales were most frequently rated as good to almost perfect for patients in both countries (45.5% to 81.9%), while Symptom Control and Transcendence subscales were most frequently rated as intermediate (42.6% to 60.4%). However, 35.4% to 67.7% of caregivers rated overall quality of dying and overall quality of death as terrible to poor. Ugandan caregivers reported lower Preparation, Connectedness, and Transcendence (p < .001). Controlling for covariates, overall quality of dying was associated with better Symptom Control in both countries (p < .001) and Transcendence in Uganda (p = .010); overall quality of death, with greater Transcendence in Uganda (p = .004); and family satisfaction with care, with better Preparation in Uganda (p = .004).

Significance of results

Findings indicate strengths in spiritual and social domains of the quality of dying and death in patients who received hospice care in Uganda and Kenya, but better symptom control is needed to improve this outcome in these countries.
Seeing the Light in Self-Reported Glare
Authors: Johnston Elisha , Reise Steven P. , Spritzer Karen L. , Hays Ron D.
Published: November 2023

Abstract: We conducted a secondary analysis to evaluate two glare items versus a composite score from the two items in a sample of 544 patients (38% women; Mdn = 29 years old; 13% high school education or less) before and after eye surgery. The first question was from a National Eye Institute (NEI) survey and the second question included a definition and picture of glare. At baseline, 28% of participants reported glare on the NEI item versus 39% on the question with the definition and picture. There was 76% agreement between the two questions ( K = .46). Three months after baseline, there was no change in the percentage of participants who reported glare on the NEI question (27%), but a significant decrease in participants reporting glare on the question with the definition and picture (38% at baseline to 25% 3 months later). A 2-item glare scale was more reliable and highly correlated with multi-item measures of halos and starbursts than the individual items. Change in the scale was more strongly associated than the items with the change in satisfaction with vision and with satisfaction with surgery. The scale may provide a better indicator of glare than either item alone.
Carbon Dating Reveals the Timing of Puerto Rican Cave Art
Authors: van Deelen Grace
Published: November 2023

New dates from cave art pigment add to evidence that Indigenous Puerto Ricans inhabited the island for millennia.
Adding Oxygen to a Lake to Explore Methane Emissions
Authors: Stanley Sarah
Published: November 2023

A rare whole-lake experiment suggests that in some cases, low-oxygen conditions may have a smaller impact on methane release to the atmosphere than previously thought.
An Investigation on the Ionospheric Response to the Volcanic Explosion at Hunga Ha'apai in 2021
Authors: Qiu Shican , Zhang Zhanming , Soon Willie , Velasco Herrera Victor Manuel , Dou Xiankang
Published: November 2023

The Hunga Ha'apai volcano eruption (20.536°S, 175.382°W in Tonga), which started intermittently around December 2021 and most violently erupted on 15 January 2022, is considered to be the largest volcanic outbreak in recent decades. In this research, we derived the ionospheric total electron content (TEC) over Sanya (18.400°N, 109.600°E), Wuhan (30.530°N, 114.610°E), and Mohe (53.500°N, 122.370°E), from the Global Navigation Satellite System observations. Then we investigated the coupling between the volcano eruption and ionosphere through the TEC variations. The TEC anomaly decayed from about 10 days before main eruption of the Hunga Ha'apai volcano, and showed obvious fluctuations during the eruption phase. The TEC anomaly propagated periodically, with its autocorrelation‐analyzed period of about 16.5 hr during the intermittent outbreak and about 8 hr during the main outbreak phase. Its independently derived wavelet‐analyzed periods are about 9.4 hr during the intermittent outbreak and about 9.4 and 18.8 hr during the main outbreak phase. The propagation is mainly expressed in low frequencies, with energy concentrated in the range of 0–10−3 Hz. This study highlights that the preeruption activities may play an important role in the coupling between the volcanic eruption and ionosphere disturbances.
B-cell and antibody responses to SARS-CoV-2: infection, vaccination, and hybrid immunity
Authors: Lapuente Dennis , Winkler Thomas H. , Tenbusch Matthias
Published: November 2023

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 prompted scientific, medical, and biotech communities to investigate infection- and vaccine-induced immune responses in the context of this pathogen. B-cell and antibody responses are at the center of these investigations, as neutralizing antibodies (nAbs) are an important correlate of protection (COP) from infection and the primary target of SARS-CoV-2 vaccine modalities. In addition to absolute levels, nAb longevity, neutralization breadth, immunoglobulin isotype and subtype composition, and presence at mucosal sites have become important topics for scientists and health policy makers. The recent pandemic was and still is a unique setting in which to study de novo and memory B-cell (MBC) and antibody responses in the dynamic interplay of infection- and vaccine-induced immunity. It also provided an opportunity to explore new vaccine platforms, such as mRNA or adenoviral vector vaccines, in unprecedented cohort sizes. Combined with the technological advances of recent years, this situation has provided detailed mechanistic insights into the development of B-cell and antibody responses but also revealed some unexpected findings. In this review, we summarize the key findings of the last 2.5 years regarding infection- and vaccine-induced B-cell immunity, which we believe are of significant value not only in the context of SARS-CoV-2 but also for future vaccination approaches in endemic and pandemic settings.
Extended X-ray absorption fine structure of dynamically-compressed copper up to 1 terapascal
Authors: Sio H. , Krygier A. , Braun D. G. , Rudd R. E. , Bonev S. A. , Coppari F. , Millot M. , Fratanduono D. E. , Bhandarkar N. , Bitter M. , Bradley D. K. , Efthimion P. C. , Eggert J. H. , Gao L. , Hill K. W. , Hood R. , Hsing W. , Izumi N. , Kemp G. , Kozioziemski B. , Landen O. L. , Le Galloudec K. , Lockard T. E. , Mackinnon A. , McNaney J. M. , Ose N. , Park H.-S. , Remington B. A. , Schneider M. B. , Stoupin S. , Thorn D. B. , Vonhof S. , Wu C. J. , Ping Y.
Published: November 2023

Large laser facilities have recently enabled material characterization at the pressures of Earth and Super-Earth cores. However, the temperature of the compressed materials has been largely unknown, or solely relied on models and simulations, due to lack of diagnostics under these challenging conditions. Here, we report on temperature, density, pressure, and local structure of copper determined from extended x-ray absorption fine structure and velocimetry up to 1 Terapascal. These results nearly double the highest pressure at which extended x-ray absorption fine structure has been reported in any material. In this work, the copper temperature is unexpectedly found to be much higher than predicted when adjacent to diamond layer(s), demonstrating the important influence of the sample environment on the thermal state of materials; this effect may introduce additional temperature uncertainties in some previous experiments using diamond and provides new guidance for future experimental design.
Unraveling the optoelectronic properties of CoSbx intrinsic selective solar absorber towards high-temperature surfaces
Authors: Taranova Anastasiia , Akbar Kamran , Yusupov Khabib , You Shujie , Polewczyk Vincent , Mauri Silvia , Balliana Eleonora , Rosen Johanna , Moras Paolo , Gradone Alessandro , Morandi Vittorio , Moretti Elisa , Vomiero Alberto
Published: November 2023

The combination of the ability to absorb most of the solar radiation and simultaneously suppress infrared re-radiation allows selective solar absorbers (SSAs) to maximize solar energy to heat conversion, which is critical to several advanced applications. The intrinsic spectral selective materials are rare in nature and only a few demonstrated complete solar absorption. Typically, intrinsic materials exhibit high performances when integrated into complex multilayered solar absorber systems due to their limited spectral selectivity and solar absorption. In this study, we propose CoSbx (2 < x < 3) as a new exceptionally efficient SSA. Here we demonstrate that the low bandgap nature of CoSbx endows broadband solar absorption (0.96) over the solar spectral range and simultaneous low emissivity (0.18) in the mid-infrared region, resulting in a remarkable intrinsic spectral solar selectivity of 5.3. Under 1 sun illumination, the heat concentrates on the surface of the CoSbx thin film, and an impressive temperature of 101.7 °C is reached, demonstrating the highest value among reported intrinsic SSAs. Furthermore, the CoSbx was tested for solar water evaporation achieving an evaporation rate of 1.4 kg m−2 h−1. This study could expand the use of narrow bandgap semiconductors as efficient intrinsic SSAs with high surface temperatures in solar applications.