bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybridizing Particle Swarm Optimization and Differential Evolution for the Mobile Robot Global Path Planning
Authors: Tang Biwei , Zhu Zhanxia , Luo Jianjun
Published: May 2016

Global path planning is a challenging issue in the filed of mobile robotics due to its complexity and the nature of non-deterministic polynomial-time hard (NP-hard). Particle swarm optimization (PSO) has gained increasing popularity in global path planning due to its simplicity and high convergence speed. However, since the basic PSO has difficulties balancing exploration and exploitation, and suffers from stagnation, its efficiency in solving global path planning may be restricted. Aiming at overcoming these drawbacks and solving the global path planning problem efficiently, this paper proposes a hybrid PSO algorithm that hybridizes PSO and differential evolution (DE) algorithms. To dynamically adjust the exploration and exploitation abilities of the hybrid PSO, a novel PSO, the nonlinear time-varying PSO (NTVPSO), is proposed for updating the velocities and positions of particles in the hybrid PSO. In an attempt to avoid stagnation, a modified DE, the ranking-based self-adaptive DE (RBSADE), is developed to evolve the personal best experience of particles in the hybrid PSO. The proposed algorithm is compared with four state-of-the-art evolutionary algorithms. Simulation results show that the proposed algorithm is highly competitive in terms of path optimality and can be considered as a vital alternative for solving global path planning.
Opportunistic Salpingectomy to Reduce the Risk of Ovarian Cancer
Authors: Gremmels Becket , O’Brien Dan , Cataldo Peter J. , Slosar John Paul , Repenshek Mark , Brown Douglas ,   The National Catholic Bioethics Center
Published: May 2016

Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine whether the benefits are proportionate to the risks in a particular case.
Pope Francis, Mercy, and the Meaning of Marriage
Authors: Coleman Gerald D. ,   The National Catholic Bioethics Center
Published: May 2016

Pope Francis has called for the Church to be a sign of mercy and hope to the world. Mercy stands at the center of the Gospel, and the family is a fundamental seat of mercy within the culture, responsible for bestowing the most valuable of God’s gifts, human life. Because of its mission to bestow life, marriage is necessarily a “lifelong covenant of love and fidelity between a man and a woman” (Francis). As the Church upholds the view of marriage exclusively as the union of a man and a woman who are capable of reaching the deepest kind of unity, she also affirms that persons of the same sex can achieve unity in meaningful ways. Upholding the traditional, comprehensive view of marriage does not belittle the dignity of homosexual persons, because all are our brothers and sisters.
Beyond Susceptible and Resistant, Part III: Treatment of Infections due to Gram-Negative Organisms Producing Carbapenemases
Authors: Narayanan Navaneeth , Johnson Linda , MacDougall Conan
Published: May 2016

Carbapenemases are enzymes that are capable of inactivating all or almost all beta-lactam antimicrobial agents. These enzymes are frequently coexpressed with other resistance mechanisms to non–beta-lactams, leading to extremely drug-resistant pathogens. Once a curiosity, these enzymes have spread into organisms that are among the most common causes of infection, such as Klebsiella pneumoniae and Escherichia coli. Identification of these organisms has proved challenging for clinical microbiology laboratories, leading to revisions in susceptibility standards for carbapenems. Although currently a rare cause of infection in children, these carbapenem-resistant Enterobacteriaceae (CRE) are becoming endemic in a variety of healthcare settings. Management of infections due to CRE is complicated by a lack of effective treatment options and clinical data on their effectiveness. Treatment of CRE infections in children is particularly challenging because therapeutic options for CRE lack adequate data on dosing and safety in children. Use of unconventional combination treatment regimens, including agents to which the organism is resistant in vitro, may provide some benefit in the treatment of severe CRE infection. Fortunately, several agents with the potential for treatment of CRE infections have been recently approved or are in late clinical development, although few data will be available in the short term to inform use in children.
Response of Iron Deficiency Anemia to Intravenous Iron Sucrose in Pediatric Inflammatory Bowel Disease
Authors: Danko Istvan
Published: May 2016

OBJECTIVES: The objective of this retrospective study was to evaluate the safety and efficacy of intravenous iron sucrose (IS) in iron deficient children with inflammatory bowel disease (IBD) in remission.

METHODS: Electronic medical records at a university based pediatric children's hospital were searched for patients in age range 0 to 18 years with diagnosis of IBD and treatment with IS over a 1-year period. Response to IS treatment was assessed by posttreatment changes in ferritin, hemoglobin (Hb), and mean corpuscular volume (MCV). Patients with recorded symptoms of active disease were excluded from analysis of treatment response.

RESULTS: Twelve patients were identified by the search criteria, 10 with Crohn's disease (CD), 2 with ulcerative colitis (UC). Data represent 8 patients in remission, 7 with CD and 1 with UC, who received a total of 34 IS infusions. Iron sucrose was administered in cycles of 2 infusions, 2.5 to 3.5 mg/kg/dose (maximum 200 mg), 1 week apart. Mean ferritin increased from 21.4 ± 9.2 to 52.9 ± 10.1 ng/mL (p = 0.0005), Hb from 10.9 ± 0.4 to 11.3 ± 0.3 g/dL (p = 0.02), and MCV from 76.9 ± 2 to 79.4 ± 2 fl (p = 0.006). Iron sucrose treatment normalized ferritin in 6 of 7, Hb in 2 of 8, and MCV in 2 of 5 patients with low pretreatment levels. No adverse effects were recorded.

CONCLUSIONS: Two IS infusions of 2.5 to 3.5 mg/kg/dose (maximum 200 mg), given 1 week apart normalized ferritin levels in most pediatric IBD patients in remission without adverse effects. Further studies are needed to determine optimal dosing schedules.
Faceted Inuit-European contact in southern Labrador
Authors: Stopp Marianne P.
Published: May 2016

Archaeological evidence from three sites excavated or tested between 2009 and 2013 is shown to be valuable for interpreting the diverse nature of the early Inuit-European contact zone in southern Labrador. Beginning in the late 17th century, French and then English archival records for the region describe relations with Inuit that were motivated by trade but that repeatedly devolved into violence. Indeed, if only the historical records were available we would learn little of the range of Inuit responses to colonialism other than its context of aggression. The archaeological data, in contrast, decolonize this history and point to a more nuanced contact landscape than suggested by the written records, with clues to varied cultural intersections, and Inuit resilience and persistence.
English-Inuit hostilities at Cape Charles (Labrador) in 1767
Authors: Rollmann Hans J.
Published: May 2016

In 1767, three English fishers associated with Nicholas Darby’s fishing and trading enterprise in southern Labrador were killed by Inuit. In response to this violence, a contingent of British soldiers from newly established York Fort pursued the alleged perpetrators, killed several, and captured others. Among the captives was an Inuk woman named Mikak as well as the future first Moravian Inuk convert, the youth Karpik. The hostilities of 1767 cannot be fully explored merely by following the narrative of colonial authorities and traders. If the Moravian records are consulted, the notorious murder near Cape Charles in 1767 appears to have had a more complex causation than has hitherto been suggested, one that may include some European culpability in these events. Instead of the unprovoked murder of three Europeans by Inuit during a robbery, it may have been a violent act of self-defence to prevent the theft of Inuit trading goods by English fishers. Whatever the original motivation for the killings of Nicholas Darby’s men may have been, the 1767 melee remains an important historical event in Labrador, which occurred during a decade that saw British legal and administrative changes reshape European relations with Inuit and a lasting Moravian presence on Labrador’s north coast established.
L’héritage culturel inuit au Labrador méridional au XIXe siècle
Authors: Charest Paul
Published: May 2016

Dans le cadre de cet article, la sous-aire culturelle du Labrador méridional comprend les régions du Sud-Labrador, du détroit de Belle-Isle et de la Basse-Côte-Nord du golfe du Saint-Laurent. Après avoir documenté la présence historique d’Inuit et de Métis euro-inuit dans cette région au XIXe siècle, l’héritage culturel inuit maintenu et transmis à cette période est exposé en huit thèmes: le mode de vie généraliste; le double habitat et la transhumance; le groupe résidentiel; la maison de tourbe; l’économie du phoque; l’économie commerciale; les moyens de transport; les vêtement et accessoires en peau de phoque. Cet héritage culturel inuit combiné à l’héritage amérindien et à l’héritage euro-canadien a contribué à façonner la culture métisse unique qui est celle du Labrador méridional.
Being and becoming Inuit in Labrador
Authors: Kennedy John C.
Published: May 2016

Longitudinal research enables discussion of some of the consequences of Aboriginal organizations and identity politics for the Inuit and mixed Inuit-European peoples of Labrador. Newfoundland and Labrador Indians formed the province of Newfoundland and Labrador’s first Aboriginal organization, soon followed by a second, Inuit organization. The mixed Inuit-European “Settlers” (or Kablunângajuit) of northern Labrador initially preferred the Indian organization but were pressured to join and later would dominate the Inuit organization. Moreover, under the 2003 Inuit land claim, Kablunângajuit would legally be considered Inuit. Further south, people of similar mixed Inuit-European ancestry who long denied their Aboriginal roots would organize as Metis. Concurrent with the more than 40 years of identity politics, summarized by this paper, were major international and regional socio-economic changes that saw people move from local to distant work, creating new contexts for identity management. The paper shows how identity politics has changed relations of power and identity, has increased the numbers of people who are legally Inuit or aspire to be so, and, more generally, empowers Aboriginal people to shape their future.
La tolérance des juges à la fraude fiscale : un inconscient d’institution
Authors: Spire1 Alexis , Weidenfeld Katia
Published: May 2016

Cette contribution vise à montrer que la régulation de la fraude fiscale par l’institution judiciaire traduit une tolérance, en partie inconsciente, des acteurs qui en sont chargés. Pour en analyser les mécanismes, on s’intéresse aux discours et aux pratiques des procureurs et des magistrats chargés d’assurer le suivi pénal des dossiers que leur transmet l’administration fiscale. Tous se disent convaincus de la nécessité de lutter contre cette forme de délinquance en col blanc, mais s’abstiennent d’utiliser tous les moyens dont ils disposent pour que la pénalisation de la fraude fiscale débouche sur des sanctions effectives. Il en découle une indulgence qui contraste avec la posture d’intransigeance adoptée par l’institution judiciaire dans d’autres domaines. Pour comprendre les ressorts de cette impunité fiscale, nous proposons une approche qui tient compte de la singularité de ce délit et du profil social de ceux qui le commettent, en considérant à la fois les contraintes institutionnelles qui s’imposent aux magistrats et les représentations qui les rendent acceptables.
Réaction sociale et criminalité en col blanc
Authors: Reeves-Latour1 Maxime
Published: May 2016

Depuis les premiers travaux de Sutherland sur le crime en col blanc, les études ont maintes fois révélé comment la criminalité des élites est soumise à l’indifférence récurrente du public, des médias et des autorités publiques. L’article cherche à réviser cette image persistante dans la documentation scientifique. Le texte retrace premièrement l’évolution des réprobations publiques et des tentatives de contrôle de ce type de criminalité auxxesiècle, aux États-Unis et au Canada. L’article propose ensuite de réviser la conception très réactive que les chercheurs entretiennent à propos des réformes issues des scandales et autres affaires. La deuxième section propose en ce sens un modèle intégratif qui permet de mieux saisir le caractère dynamique et contextualisé des réformes législatives et institutionnelles destinées à l’encadrement et au contrôle des délinquances en col blanc. Afin d’illustrer la fécondité du modèle proposé, la troisième section de l’article se penche sur l’analyse d’un récent scandale dans la province de Québec. Émergeant vers la fin des années 2000, ce dernier trouve son origine dans de vastes complots criminels recensés au sein du milieu de la construction de la province, dans lequel firmes en construction, firmes de génie-conseil et élus politiques furent impliqués dans divers actes de corruption, de trucage des appels d’offres et de manipulations frauduleuses. Il y est illustré que ce scandale s’inscrit dans une tendance plus générale de contrôle et de sensibilisation accrue du public envers les crimes en col blanc relevés au coeur de ce scandale. Alors que le mouvement provoque des réactions populaires et des réorganisations institutionnelles sans précédent dans la province, les opportunités liées au développement de ce champ de recherche encore négligé en criminologie apparaissent plus nombreuses que jamais pour le chercheur.
Quand la « délinquance des élites1 » contribue au savoir criminologique
Authors: Nagels2 Carla
Published: May 2016

Dans l’histoire de la discipline criminologique, la définition de son objet a toujours été au centre de nombreux débats. Si la discipline s’est historiquement divisée en deux paradigmes – d’abord le paradigme du passage à l’acte et plus tardivement celui de la réaction sociale –, depuis plusieurs années, on voit émerger des théories criminologiques qui réinvestissent de manière originale l’étude des comportements transgressifs. L’objectif de cet article est de montrer comment les recherches menées autour de la criminalité en col blanc (white-collar crime) contribuent à approfondir le projet scientifique de la criminologie, d’une part, en déplaçant les frontières peu claires entre conduites licites et conduites illicites, d’autre part, en investiguant d’autres pistes de réponses possibles aux transgressions pourtant avérées. Enfin, l’article se conclut par l’exploration de la valeur heuristique du concept d’illégalismes forgé par Michel Foucault qui permet d’analyser conjointement les comportements transgressifs et les réponses sociales apportées à ces comportements afin de dépasser le paradoxe soulevé par Alvaro Pires.
Unipolar distributions of junctional Myosin II identify cell stripe boundaries that drive cell intercalation throughout Drosophila axis extension
Authors: Tetley Robert J , Blanchard Guy B , Fletcher Alexander G , Adams Richard J , Sanson Bénédicte
Published: May 2016

Convergence and extension movements elongate tissues during development. Drosophila germ-band extension (GBE) is one example, which requires active cell rearrangements driven by Myosin II planar polarisation. Here, we develop novel computational methods to analyse the spatiotemporal dynamics of Myosin II during GBE, at the scale of the tissue. We show that initial Myosin II bipolar cell polarization gives way to unipolar enrichment at parasegmental boundaries and two further boundaries within each parasegment, concomitant with a doubling of cell number as the tissue elongates. These boundaries are the primary sites of cell intercalation, behaving as mechanical barriers and providing a mechanism for how cells remain ordered during GBE. Enrichment at parasegment boundaries during GBE is independent of Wingless signaling, suggesting pair-rule gene control. Our results are consistent with recent work showing that a combinatorial code of Toll-like receptors downstream of pair-rule genes contributes to Myosin II polarization via local cell-cell interactions. We propose an updated cell-cell interaction model for Myosin II polarization that we tested in a vertex-based simulation.
5-hydroxymethylcytosine marks regions with reduced mutation frequency in human DNA
Authors: Tomkova Marketa , McClellan Michael , Kriaucionis Skirmantas , Schuster-Boeckler Benjamin
Published: May 2016

CpG dinucleotides are the main mutational hot-spot in most cancers. The characteristic elevated C>T mutation rate in CpG sites has been related to 5-methylcytosine (5mC), an epigenetically modified base which resides in CpGs and plays a role in transcription silencing. In brain nearly a third of 5mCs have recently been found to exist in the form of 5-hydroxymethylcytosine (5hmC), yet the effect of 5hmC on mutational processes is still poorly understood. Here we show that 5hmC is associated with an up to 53% decrease in the frequency of C>T mutations in a CpG context compared to 5mC. Tissue specific 5hmC patterns in brain, kidney and blood correlate with lower regional CpG>T mutation frequency in cancers originating in the respective tissues. Together our data reveal global and opposing effects of the two most common cytosine modifications on the frequency of cancer causing somatic mutations in different cell types.
InGaAs triangular barrier photodiodes for high-responsivity detection of near-infrared light
Authors: Sugimura Kazuya , Ohmori Masato , Noda Takeshi , Kojima Tomoya , Kado Sakunari , Vitushinskiy Pavel , Iwata Naotaka , Sakaki Hiroyuki
Published: May 2016

InGaAs triangular barrier (TB) structures of various barrier thicknesses have been formed on InP substrates. With them, we have fabricated TB photodiodes that yield a very high responsivity of 2.3 × 104 A/W at 100 K for the 1312 nm light of 320 fW power. By passivating the diode surface with polyimide, the dark current has been markedly reduced. Diodes with thicker barriers show higher sensitivity and responsivity, reflecting the enhancement of the barrier lowering effect by photogenerated holes.
Elemental isomerization processes for a photochromic diarylethene film based on carrier injection toward all-electrically operable organic memory
Authors: Tsujioka Tsuyoshi , Yamamoto Kazuki
Published: May 2016

We propose a basic concept of all-electrically operable organic memory with a photochromic diarylethene (DAE) film based on a transistor structure, in which the DAE memory layer is recordable, erasable, and nondestructively readable by an electrical method. To realize such memory, we investigated each elementary process for recording, erasing, or nondestructive reading by current injection and electrostatic methods for the DAE layer. Both ring-opening and ring-closure isomerization reactions were confirmed for the injection of both carriers (electrons and holes). Hole injection induced ring-opening reaction only. These reaction modes can be utilized in the recording and erasing modes. Since no reactions for electron injection and current modulation based on photoisomerization were observed, electron current injection can be applied to nondestructive readout.
Transmission, reflection, and absorption spectroscopy of graphene microribbons in the terahertz region
Authors: Suzuki Satoru , Takamura Makoto , Yamamoto Hideki
Published: May 2016

Both transmission and reflection spectra were obtained from graphene microribbons on a SiC substrate, which resonantly coupled with terahertz light through plasmon excitation. An absorption spectrum was also derived from the transmission and reflection spectra. Absorption by the confined intraband plasmons reached 5–10%/layer, which is considerably larger than the wavelength-independent interband absorption of 2.3%/layer. The absorption was found to be larger when the microribbons/substrate sample was illuminated from the back surface than from the ribbon surface because of an interference effect at the surface.
First demonstration of X-ray mirrors using focused ion beam
Authors: Numazawa Masaki , Ezoe Yuichiro , Ishikawa Kumi , Ogawa Tomohiro , Sato Mayu , Nakamura Kasumi , Takeuchi Kazuma , Terada Masaru , Ohashi Takaya , Mitsuda Kazuhisa , Kelley Ron , Murata Kaoru
Published: May 2016

We report on novel X-ray mirrors fabricated with a focused ion beam for future astronomical missions. We fabricated a test sample from a silicon wafer by forming six slits whose sidewalls were used as X-ray reflection surfaces. The six slits were designed with a size of 25 × 300 × 170 µm3 and with different inclination angles of 0 and ±1°. We examined X-ray reflection using three slits with different inclination angles at Al Kα 1.49 keV. Consequently, we demonstrated X-ray reflection from all the three slits. All the sidewalls have multiangular components with a microroughness of ∼1 nm rms. ∼30–45% of the total surface area is effective for X-ray reflection. We confirmed that the inclination angles are consistent with the designed values.
Consensus on a Patient-Centered Definition of Atopic Dermatitis Flare
Authors: Drucker Aaron M. , Thibau Isabelle J. C. , Mantell Bryan , Dainty Katie N. , Wyke Matthew , Smith Begolka Wendy
Published: September 2024

Importance

Flare is a term commonly used in atopic dermatitis (AD) care settings and clinical research, but little consensus exists on what it means. Meanwhile, flare management is an important unmet research and treatment need. Understanding how various therapies might comparatively improve AD flares as a measure of treatment effectiveness may facilitate shared decision-making and enable assessment of effectiveness within and outside clinical settings.

Objective

To identify patient-reported attributes associated with an AD flare to develop a patient-centered, consensus-based working definition.

Design, Setting, and Participants

This consensus survey study used a modified eDelphi method involving consensus-building focus groups and a survey conducted from January 10 through October 24, 2023. Focus groups were conducted virtually, and the online survey was advertised to National Eczema Association members. US adults aged 18 years or older with AD were recruited via convenience sampling.

Exposure

Lived experience of AD.

Main Outcomes and Measures

The main outcome was consensus on which attributes of AD to include in a patient-centric definition of flare. Using a rating scale (range, 1-9), consensus for the modified eDelphi statement rating was defined as at least 70% of participants rating a statement as 7 to 9 (critical to a flare definition) and less than 15% rating it as 1 to 3 (not important).

Results

Twenty-six participants with AD who completed focus group activities (24 aged 18-44 years [92.3%] and 2 aged 45-64 years [7.7%]; 18 women [69.2%]) and 631 participants with AD (mean [SD] age, 45.5 [18.1] years; 533 women [84.5%]) who completed the survey were included in the analysis. Fifteen statements reached consensus from the focus groups, and of those, 12 reached consensus from survey participants. More than half (334 of 631 [52.9%]) of survey participants reported alignment with their health care practitioner on what a flare is, and most (478 of 616 [77.6%]) reported that a patient-centered definition would be useful when communicating with their health care practitioner about their condition.

Conclusions and Relevance

In this study, participants with AD reached consensus on what an AD flare means from the patient perspective. This understanding may improve research and care by addressing this key patient-centered aspect of evaluating treatment effectiveness.
Brief Cognitive Behavioral Therapy for Suicidal Inpatients
Authors: Diefenbach Gretchen J. , Lord Kayla A. , Stubbing Jessica , Rudd M. David , Levy Hannah C. , Worden Blaise , Sain Kimberly S. , Bimstein Jessica G. , Rice Tyler B. , Everhardt Kate , Gueorguieva Ralitza , Tolin David F.
Published: September 2024

Importance

Suicide risk is elevated after discharge from inpatient level of care. Empirically supported inpatient suicide prevention treatments are needed.

Objective

To determine whether adding an inpatient version of brief cognitive behavioral therapy for suicide prevention to treatment as usual reduces postdischarge suicide attempts, suicidal ideation, and psychiatric readmissions and to determine whether substance use disorder moderates treatment effects.

Design, Setting, and Participants

This randomized clinical trial compared treatment as usual (n = 106) to treatment as usual plus brief cognitive behavioral therapy for inpatients (n = 94) at a private psychiatric hospital in Connecticut. Follow-up assessments were completed monthly for 6 months postdischarge. Participants were enrolled from January 2020 through February 2023. Inpatients admitted following a suicidal crisis (past-week suicide attempt or ideation with plan on admission and attempt within previous 2 years) were included. Medical records of consecutive admissions (n = 4137) were screened, 213 were study eligible and randomized, and 200 were analyzed. A total of 114 participants (57.0%) completed 6-month follow-up assessments. Data from medical records were also obtained through 6-month follow-up.

Intervention

Up to 4 individual sessions of brief cognitive behavioral therapy for suicide prevention designed for inpatients.

Main Outcomes and Measures

Suicide attempts and readmissions were assessed via blind interviews and medical record review. Suicidal ideation was assessed via self-report.

Results

The mean (SD) age among 200 analyzed participants was 32.8 (12.6) years; 117 participants were female and 83 were male. Brief cognitive behavioral therapy–inpatient reduced the occurrence of suicide attempt over 6 months postdischarge by 60% (odds ratio, 0.40; 95% CI, 0.20-0.80; number needed to treat, 7) in the entire patient group, and the rate of psychiatric readmissions by 71% (rate ratio, 0.29; 95% CI, 0.09-0.90) in those without a substance use disorder. The effect of treatment condition on suicidal ideation was less clear, although post hoc analyses indicated less severe suicidal ideation following brief cognitive behavioral therapy–inpatient vs treatment as usual at 1 and 2 months postdischarge.

Conclusions and Relevance

Brief cognitive behavioral therapy–inpatient reduced 6-month postdischarge suicide reattempts and rate of readmissions when added to treatment as usual. Substance use disorder moderated the treatment’s effect on readmission rates. Treatment effects on suicidal ideation were less clear. Implementation research is needed to facilitate dissemination. Additional research is also needed to optimize outcomes for individuals with substance use disorders.

Trial Registration

ClinicalTrials.gov Identifier: NCT04168645
Prioritization of Psychopathological Symptoms and Clinical Characterization in Psychiatric Diagnoses
Authors: Leucht Stefan , van Os Jim , Jäger Markus , Davis John M.
Published: September 2024

Importance

Psychiatry mainly deals with conditions that are mediated by brain function but are not directly attributable to specific brain abnormalities. Given the lack of concrete biological markers, such as laboratory tests or imaging results, the development of diagnostic systems is difficult.

Observations

This narrative review evaluated 9 diagnostic approaches. The validity of the DSM and the International Classification of Disorders (ICD) is limited. The Research Domain Criteria is a research framework, not a diagnostic system. The clinical utility of the quantitatively derived, dimensional Hierarchical Taxonomy of Psychopathology is questionable. The Psychodynamic Diagnostic Manual Version 2 follows psychoanalytic theory and focuses on personality. Unlike the personality assessments in ICD-11 or DSM-5’s alternative model, based on pathological extremes of the big 5 traits (extraversion, agreeableness, openness, conscientiousness, and neuroticism), it lacks foundation in empirical evidence. Network analytic approaches are intriguing, but their complexity makes them difficult to implement. Staging would be easier if individually predictive biological markers were available. The problem with all these new approaches is that they abstract patient experiences into higher-order constructs, potentially obscuring individual symptoms so much that they no longer reflect patients’ actual problems.

Conclusions and Relevance

ICD and DSM diagnoses can be questioned, but the reality of psychopathological symptoms, such as hallucinations, depression, anxiety, compulsions, and the suffering stemming from them, cannot. Therefore, it may be advisable to primarily describe patients according to the psychopathological symptoms they present, and any resulting personal syndromes, embedded in a framework of contextual clinical characterization including personality assessment and staging. The DSM and ICD are necessary for reimbursement, but they should be simplified and merged. A primarily psychopathological symptoms–based, clinical characterization approach would be multidimensional and clinically useful, because it would lead to problem-oriented treatment and support transdiagnostic research. It should be based on a universally used instrument to assess psychopathology and structured clinical characterization.
Teaching Bleeding Control and Building Trust With a Community Affected by Firearm Injuries
Authors: Stadeli Kathryn M. , Mohamed Farah B. , Agoubi Lauren L. , Dahiye Abdifatah , Serrano Elina , Haji-Eda Maymuna , Vavilala Monica S.
Published: September 2024

This survey study evaluates a program for increasing bystander bleeding control skills, improving self-efficacy for bleeding control, and building trust between community participants and first responders in a Somali community in the US affected by firearm-related deaths.
Electronic Surgical Consent Delivery Via Patient Portal to Improve Perioperative Efficiency
Authors: Trang Karen , Decker Hannah C. , Gonzalez Andrew , Pierce Logan , Shui Amy M. , Melton-Meaux Genevieve B. , Wick Elizabeth C.
Published: September 2024

Importance

Many health systems use electronic consent (eConsent) for surgery, but few have used surgical consent functionality in the patient portal (PP). Incorporating the PP into the consent process could potentially improve efficiency by letting patients independently review and sign their eConsent before the day of surgery.

Objective

To evaluate the association of eConsent delivery via the PP with operational efficiency and patient engagement.

Design, Setting, and Participants

This mixed-methods study consisted of a retrospective quantitative analysis (February 8 to August 8, 2023) and a qualitative analysis of semistructured patient interviews (December 1, 2023, to January 31, 2024) of adult surgical patients in a health system that implemented surgical eConsent. Statistical analysis was performed between September 1, 2023, and June 6, 2024.

Main Outcomes and Measures

Patient demographics, efficiency metrics (first-start case delays), and PP access logs were analyzed from electronic health records. Qualitative outcomes included thematic analysis from semistructured patient interviews.

Results

In the PP-eligible cohort of 7672 unique patients, 8478 surgical eConsents were generated (median [IQR] age, 58 [43-70] years; 4611 [54.4%] women), of which 5318 (62.7%) were signed on hospital iPads and 3160 (37.3%) through the PP. For all adult patients who signed an eConsent using the PP, patients waited a median (IQR) of 105 (17-528) minutes to view their eConsent after it was electronically pushed to their PP. eConsents signed on the same day of surgery were associated with more first-start delays (odds ratio, 1.59; 95% CI, 1.37-1.83; P < .001). Themes that emerged from patient interviews included having a favorable experience with the PP, openness to eConsent, skimming the consent form, and the importance of the discussion with the surgeon.

Conclusions and Relevance

These findings suggest that eConsent incorporating PP functionality may reduce surgical delays and staff burden by allowing patients to review and sign before the day of surgery. Most patients spent minimal time engaging with their consent form, emphasizing the importance of surgeon-patient trust and an informed consent discussion. Additional studies are needed to understand patient perceptions of eConsent, PP, and barriers to increased uptake.
Genome-Derived Ampullary Adenocarcinoma Classifier and Postresection Prognostication
Authors: Ecker Brett L. , Seier Kenneth , Eckhoff Austin M. , Tortorello Gabriella N. , Allen Peter J. , Balachandran Vinod P. , Blackburn Nicola , D’Angelica Michael I. , DeMatteo Ronald P. , Blazer Daniel G. , Drebin Jeffrey A. , Fisher William E. , Fortuna Danielle , Gill Anthony J. , Gingras Marie-Claude , Kingham T. Peter , Lee Major K. , Lidsky Michael E. , Nussbaum Daniel P. , Overman Michael J. , Samra Jaswinder S. , Shen Ronglai , Sigel Carlie S. , Soares Kevin C. , Vollmer Charles M. , Wei Alice C. , Zani Sabino , Roses Robert E. , Gonen Mithat , Jarnagin William R.
Published: September 2024

Importance

Ampullary adenocarcinoma (AA) is characterized by clinical and genomic heterogeneity. A previously developed genomic classifier defined biologically distinct phenotypes with greater accuracy than standard histologic classification. External validation is needed before routine clinical use.

Objective

To test external validity of the prognostic value of the hidden genome classifier of AA.

Design, Setting, and Participants

This retrospective cohort study took place at 6 international academic institutions. Consecutive patients (n = 192) who underwent curative-intent resection of histologically confirmed AA were included. The data were analyzed from January 2005 through July 2020.

Exposures

The multilevel meta-feature regression model previously trained on a prospectively sequenced cohort of 3411 patients (1001 pancreatic adenocarcinoma, 165 distal bile duct adenocarcinoma, and 2245 colorectal adenocarcinoma) was applied to AA sequencing data to quantify the relative proportions of parental cell of origin.

Main Outcome and Measures

Genomic classification was correlated with immunohistologic subtype (intestinal [INT] or pancreatobiliary [PB]) and with overall survival (OS), using the log-rank test and Cox proportional hazard models.

Results

Among 192 patients with AA (median age, 69.0 [IQR, 60.0-74.0] years and 134 were male [64%]), concordance between immunohistologic and genomic subtypes was 55%. Most INT subtype tumors were categorized into the colorectal genomic subtype (43 of 57 [72.9%]). Of the 114 PB subtype tumors, 29 had a pancreatic genomic profile (25.4%) and 24 had a distal bile duct genomic profile (21.1%). Whereas the standard immunohistologic subtypes were not associated with survival (log rank P = .26), predicted genomic probabilities were correlated with survival probability. Genomic scores with higher colorectal probability were associated with higher survival probability; higher pancreatic and distal bile duct probabilities were associated with lower survival probability.

Conclusions and Relevance

The AA genomic classifier is reproducible with available molecular testing in a diverse international cohort of patients and improves stratification of the divergent clinical outcomes beyond standard immunohistologic classification. These data provide a molecular classification that may be incorporated into clinical trials for prospective validation.
Targeting the CLK2/SRSF9 splicing axis in prostate cancer leads to decreased ARV7 expression
Authors: Van Goubergen Jasper , Peřina Miroslav , Handle Florian , Morales Elisa , Kremer Anika , Schmidt Oliver , Kristiansen Glen , Cronauer Marcus V. , Santer Frédéric R.
Published: September 2024

In advanced prostate cancer (PC), in particular after acquisition of resistance to androgen receptor (AR) signaling inhibitors (ARSI), upregulation of AR splice variants compromises endocrine therapy efficiency. Androgen receptor splice variant‐7 (ARV7) is clinically the most relevant and has a distinct 3′ untranslated region (3′UTR) compared to the AR full‐length variant, suggesting a unique post‐transcriptional regulation. Here, we set out to evaluate the applicability of the ARV7 3′UTR as a therapy target. A common single nucleotide polymorphism, rs5918762, was found to affect the splicing rate and thus the expression of ARV7 in cellular models and patient specimens. Serine/arginine‐rich splicing factor 9 (SRSF9) was found to bind to and increase the inclusion of the cryptic exon 3 of ARV7 during the splicing process in the alternative C allele of rs5918762. The dual specificity protein kinase CLK2 interferes with the activity of SRSF9 by regulating its expression. Inhibition of the Cdc2‐like kinase (CLK) family by the small molecules cirtuvivint or lorecivivint results in the decreased expression of ARV7. Both inhibitors show potent anti‐proliferative effects in enzalutamide‐treated or ‐naive PC models. Thus, targeting aberrant alternative splicing at the 3′UTR of ARV7 by disturbing the CLK2/SRSF9 axis might be a valuable therapeutic approach in late stage, ARSI‐resistant PC.
Tractography of sensorimotor pathways in dyskinetic cerebral palsy: Association with motor function
Authors: Caldú Xavier , Reid Lee B. , Pannek Kerstin , Fripp Jurgen , Ballester‐Plané Júlia , Leiva David , Boyd Roslyn N. , Pueyo Roser , Laporta‐Hoyos Olga
Published: September 2024

Objectives

Neuroimaging studies of dyskinetic cerebral palsy (CP) are scarce and the neuropathological underpinnings are not fully understood. We delineated the corticospinal tract (CST) and cortico‐striatal‐thalamocortical (CSTC) pathways with probabilistic tractography to assess their (1) integrity and (2) association with motor functioning in people with dyskinetic CP.

Methods

Diffusion weighted magnetic resonance images were obtained for 33 individuals with dyskinetic CP and 33 controls. Fractional anisotropy (FA) and mean diffusivity (MD) for the CST and the CSTC pathways were compared between groups. Correlation analyses were performed between tensor metric values and motor function scores of participants with dyskinetic CP as assessed by the Gross Motor Function Classification System (GMFCS), the Bimanual Fine Motor Function (BFMF), and the Manual Ability Classification System (MACS).

Results

White matter integrity in both the CST and the CSTC pathways was reduced in people with dyskinetic CP. The GMFCS, MACS and, less commonly, the BFMF were associated with FA and, particularly, MD in most portions of these pathways.

Interpretation

The present study advances our understanding of the involvement of white matter microstructure in sensorimotor pathways and its relationship with motor impairment in people with dyskinetic CP. Our results are consistent with well‐described relationships between upper limb function and white matter integrity in the CST and CSTC pathways in other forms of CP. This knowledge may ultimately help prognosis and therapeutic programmes.
Endogenous tPA levels: A biomarker for discriminating hemorrhagic stroke from ischemic stroke and stroke mimics
Authors: Jauquet Melissa , Gagnepain Pierre , La Porte Estelle , Thiebaut Audrey M. , Rochey Ambre , Legros Helene , Laine Baptiste , Berthelot Marion , Roussel Valerie , Montaner Joan , Casolla Barbara , Vivien Denis , Lemarchand Eloise , Macrez Richard , Roussel Benoit D.
Published: September 2024

Objective

Stroke is the leading cause of death and disability. Timely differentiation between ischemic stroke, hemorrhagic stroke, and stroke mimics is critical for tailored treatment and triage. To accelerate the identification of stroke's subtype, we propose to use the levels of circulating tPA as a biomarker.

Methods

Biostroke is an observational study performed at the Caen Hospital. We quantified tPA levels in 110 patients with ischemic strokes, 30 patients with hemorrhagic strokes, and 67 stroke mimic patients upon their arrival at the emergency. Two logistic regression models were formulated: one with parameters measurable in an ambulance (Model A) and one with parameters measurable at the hospital (Model H). These models were both tested with or without plasma tPA measurements. Our initial assessment involved evaluating the effectiveness of both models in distinguishing between hemorrhagic strokes, ischemic strokes, and stroke mimics within our study cohort.

Results

Plasmatic tPA levels exhibit significant distinctions between hemorrhagic, ischemic, and mimic stroke patients (1.8; 2.5; 2.4 ng/mL, respectively). The inclusion of tPA in model A significantly enhances the classification accuracy of hemorrhagic patients only, increasing identification from 0.67 (95% CI, 0.59 to 0.75) to 0.78 (95% CI, 0.7 to 0.85) (p = 0.0098). Similarly, in model H, classification accuracy of hemorrhagic patients significantly increased with the addition of tPA, rising from 0.75 (95% CI, 0.67 to 0.83) without tPA to 0.86 (95% CI, 0.81 to 0.91) with tPA (p = 0.024).

Interpretations

Our findings underscore the valuable role of tPA levels in distinguishing between stroke subtypes.
Tailoring Interfacial Dipole Molecules to Mitigate Carrier and Energy Losses in Perovskite Solar Cells
Authors: Wang Deng , Li Yongchun , Li Wenjing , Pan Weichun , Li Ruoshui , Wang Shibo , Liu Fengli , Lan Zhang , Wu Jihuai , Huang Enmin , Guo Xugang , Liu Xuping , Li Qinghua
Published: September 2024

Interface engineering has become the mainstream for improving the performance of perovskite solar cells (PSCs). Interfacial dipole (ID) molecules have emerged as a feasible and effective strategy to alleviate the charge carrier loss and energy loss in PSCs. Here, the three symmetrical donor–acceptor interfacial dipole molecules (named PzT, PzTE, and PzTN) are designed and synthesized with identical hole transport backbone and different anchoring groups. The ID molecule is introduced into the interface between the perovskite layer and the hole transport layer. The dipole moments of ID molecules regulate the surface work function and energy‐level alignment of perovskites, improve charge extraction, and reduce energy loss at the interface. Meanwhile, the anchoring groups of ID molecules coordinate with the defects on the surface of PVK and HTL, reduce interfacial trap state density and charge accumulation, and mitigate the carrier non‐radiative recombination losses. As a result, PzTN‐modified PSC achieved a champion power conversion efficiency of 25.34% with a photovoltage of 1.176 V and a fill factor (FF) of 83.27%, accompanied by almost undetectable hysteresis and excellent operating stability. This research demonstrates a feasible strategy for efficient and stable PSCs by interfacial dipole molecules.
Hierarchically Structured Biodegradable Microspheres Promote Therapeutic Angiogenesis
Authors: Hendow Eseelle K. , Iacoviello Francesco , Casajuana Ester Mar , Pellet‐Many Caroline , Day Richard M.
Published: September 2024

Promoting neovascularization is a prerequisite for many tissue engineering applications and the treatment of cardiovascular disease. Delivery of a pro‐angiogenic stimulus via acellular materials offers several benefits over biological therapies but has been hampered by interaction of the implanted material with the innate immune response. However, macrophages, a key component of the innate immune response, release a plurality of soluble factors that can be harnessed to stimulate neovascularization and restore blood flow to damaged tissue. This study investigates the ability of biodegradable poly(D,L‐lactic‐co‐glycolic acid) (PLGA) microspheres to restore tissue perfusion in a hind limb model of ischaemia. Microspheres exhibiting a hierarchical porous structure are associated with an increase in blood flow at day 21 post‐implantation compared with solid microspheres composed of the same polymer. This corresponds with an increase in blood vessel density in the surrounding tissue. In vitro simulation of the foreign body response observed demonstrates M2‐like macrophages incubated with the porous microspheres secreted increased amounts of vascular endothelial growth factor (VEGF) compared with M1‐like macrophages providing a potential mechanism for the increased neovascularization. The results from this study demonstrate implantable biodegradable porous microspheres provide a novel approach for increasing neovascularization that could be exploited for therapeutic applications.
Physical Virtualization of a GFET for a Versatile, High‐Throughput, and Highly Discriminating Detection of Target Gas Molecules at Room Temperature
Authors: Zanotti Michele , Freddi Sonia , Sangaletti Luigi
Published: September 2024

An e‐nose is built on a single graphene field effect transistor (GFET), based on a graphene/Si3N4/p‐Si stack of layers. Multichannel data acquisition, enabling to mimic the architecture of a sensor array, is achieved by steering the gate potential, thus yielding a virtual array of 2D chemiresistors on a single sensing layer. This setting allows for the detection of volatile compounds with a remarkable discrimination capability, boosted by intensive machine learning analysis and accuracy maximization through the choice of the number of virtual sensors. Sensing of gas phase NH3 is tested, along with a set of possible interferents, and discrimination of NH3+NO2 mixtures is successfully probed. High throughput in terms of sensitivity is achieved by tracking the shift of the minimum of the GFET transfer curve versus NH3 concentration. With this readout scheme, a 20‐fold sensitivity increase over a 5–50 ppm range is registered to the same layer used as a chemiresistor. High discrimination capability is probed by leveraging machine learning algorithms, from principal component analysis (PCA) to Uniform Manifold Approximation and Projection (U‐MAP) and, finally, to a Deep Neural Networks (DNN) where input neurons are the virtual sensors created by the gate voltage driving. For the tested case, the DNN maximum accuracy is achieved with 21 virtual sensors.
Gold(III) Catalysis in Ionic Liquids: The Case Study of Coumarin Synthesis
Authors: Ravera Francesco , Martinsen Holmsen Marte Sofie , Sgarbossa Paolo , Bourissou Didier , Biffis Andrea
Published: September 2024

Well‐defined (P,C)‐cyclometalated Au(III) complexes proved to be able to catalyze the synthesis of coumarins by intramolecular hydroarylation of a broad range of aryl propiolates under mild and practical conditions (0.1–2 mol% catalyst, 25–40 °C, 1–24 hours). The use of an ionic liquid as reaction solvent allowed to drastically decrease the amount of Brönsted acid used to unlock the catalyst regeneration step. The effect of the nature of the acid additive and of the ionic liquid anion have been assessed. Preliminary results on the extension of this methodology to the cyclization of aryl propargyl ethers are also presented.