bluuebunny/crossref_metadata_2025 huggingface dataset:
Figure 2 from Activation of Cell-Intrinsic Signaling in CAR-T Cells via a Chimeric IL7R Domain
Authors: Vorri Stamatia C. , Holl Natalie J. , Leeming Michael , Apostolova Petya , Marple Andrew , Ravich Jonas W. , Canbaz Ata , Rahnama Ruyan , Choe Jun , Modi Arjun , Fearnow Adam D. , Walsh Scott T.R. , Pearce Erika L. , Varadhan Ravi , Bonifant Challice L.
Published: September 2024

T cells with IL7 pathway activation expand and circulate in vivo. A, Schematic of experimental design. NSG mice were injected on day 0 with 107 T cells expressing a ffLuc reporter. BLI was conducted biweekly, and peripheral blood collected on days 15 and 30. One group of mice was treated with ffLuc-only–modified T cells and intraperitoneal injections of IL7 daily from day 1 to 21. B, BLI monitoring T-cell expansion. C, Quantified radiance per mouse. Thick solid line, median BLI; dotted lines, individual values per mouse. D, Calculated doubling time of T-cell products with 95% confidence interval represented. E, T cells (CD3+GFP+) detected in peripheral blood on days 15 and 30 after injection. Thick solid line, median; dotted lines, individual values per mouse. Comparison between treatment cohorts on day 30 vs. no treatment: *, P < 0.05; ***, P < 0.001. F, Concentration of human IL7 in murine plasma detected with ELISA. For the intraperitoneally injected mice on day 15, blood was collected 1 hour after IL7 injection. (n = 5 mice per group). hIL7, human IL7; NSG, NOD/SCIDγ; NT, nontransduced; PB, peripheral blood.
Dermoscopic Evaluation of Nail Changes in Patients with End-Stage Renal Disease on Regular Hemodialysis
Authors: Galal Sara A. , Kotb Hend G. , Kamel Radwa O.M. , Elsadek Hala M. , Hafiz Hala S.A. , Nassef Eman M. , Kasim Sammar A. , Akab Samah M. , Abdel Sattar Ahmed S. , Ahmed Laila A.
Published: September 2024

Introduction: Chronic renal failure can impact various body systems, including the skin and its appendages. Patients with uremic conditions have been observed to experience a variety of nail changes. This study was conducted to evaluate the presence and type of fingernail changes in patients with end-stage renal failure (ESRF) on regular hemodialysis (HD) by nail dermoscopy. Methods: A total of 100 patients with ESRF on regular HD three times a week. Nails were examined by dermoscopy for the presence of subtle nail changes. Results: Nail changes were found in 91% of patients, while 9% did not have nail changes. The most common dermoscopic findings were as follows; scales in lateral nail fold in 91% of the patients, dry cuticle in 84%, onychoschizia in 72%, and longitudinal striation in 69%. There was no significant relation between nail changes and sex, duration of HD, and albumin level. Conclusion: Patients with end-stage renal disease on HD are more likely to experience nail disorders. Scales in LNF, dry cuticle, onychoschizia, longitudinal striation, terry’s nails, and half-and-half nails were the most common nail changes in HD patients.
Pharmakologische Interventionen für die Behandlung des obstruktiven Schlafapnoesyndroms
Authors: Liu Jin , Yang Xiaolan , Li Guangcai , Liu Peijun
Published: September 2024

Das obstruktive Schlafapnoesyndrom (OSAS) betrifft 13–33% der Männer und 6–9% der Frauen weltweit und stellt erhebliche Behandlungsherausforderungen dar, einschließlich der schlechten Einhaltung des kontinuierlichen positiven Atemwegsdrucks (CPAP) und der verbleibenden übermäßigen Schläfrigkeit (RES). Diese Übersichtsarbeit zielt darauf ab, das aufkommende Interesse an pharmakologischen Behandlungen für das OSAS zu erläutern, wobei der Schwerpunkt auf den jüngsten Fortschritten in diesem Bereich liegt. Es wurde eine gründliche Analyse umfangreicher klinischer Studien mit verschiedenen Medikamenten, einschließlich selektiver Dopamin-Wiederaufnahmehemmer, selektiver Noradrenalinhemmer und kombinierter Antimuskarinika und Orexin-Agonisten, durchgeführt. Diese Studien konzentrierten sich auf die Verbesserung der Atemmetriken und der Schlafqualität bei Personen, die vom OSAS betroffen sind. Die untersuchten pharmakologischen Wirkstoffe zeigten das Potenzial zur Verbesserung der primären Ergebnisse, insbesondere des Apnoe-Hypopnoe-Index (AHI) sowie der Epworth-Schläfrigkeitsskala (ESS). Diese Verbesserungen deuten auf eine verbesserte Schlafqualität und Symptombehandlung bei OSAS-Patienten hin. Mit einem tieferen Verständnis des OSAS entwickeln sich pharmakologische Interventionen in eine vielversprechende Richtung für ein effektives Management. Diese Übersichtsarbeit bietet einen umfassenden Überblick über den aktuellen Stand der Arzneimittelforschung zum OSAS und hebt das Potenzial dieser Behandlungen bei der Bewältigung der komplexen Herausforderungen der Erkrankung hervor.
Is Magnetic Resonance Imaging Able to Provide Specific Diagnoses? A Case Report of Clear Cell Sarcoma of Soft Tissue in the First Metacarpal of the Hand
Authors: Li Yunxin , Huang Ranran , Wang Aijie , Zhang Guowei , Su Yongbin
Published: September 2024

Introduction: Clear cell sarcoma (CCS) of the soft tissue is a type of tumor that primarily affects the deep soft tissues of the extremities and trunk. We report a case of CCS of soft tissue arising in the first metacarpal of the hand, focusing on the imaging features of CCS combined with the clinicopathological and immunological results. Case Presentation: In this case, computed tomography images showed a soft tissue mass at the first metacarpal, with heterogeneous density, unclear boundaries, and bone destruction. On magnetic resonance imaging (MRI), the mass showed slightly higher signal intensity on T1-weighted images and mixed hyperintensity on T2-weighted images, with inhomogeneous enhancements. On both T1-weighted and T2-weighted sequences, there were some hypointense strips. No significant enhancements were found in these hypointense strips. Conclusion: We suggest that hypointense strips on MRI should lead to the inclusion of CCS in differential diagnoses.
Paclitaxel/Ramucirumab versus Paclitaxel in 2nd-Line Therapy of Advanced Esophageal Squamous Cell Carcinoma: Randomized Phase II IKF-AIO-RAMOS Trial
Authors: Scheck Magdalena K. , Goetze Thorsten O. , Ettrich Thomas J. , Schmalenberg Harald , Clemens Michael , Mahlberg Rolf , Heeg Steffen , Kanzler Stephan , Hapke Gunnar , Thuss-Patience Peter , Kestler Angelika , Treschl Anne , Heidel Stefan , Schiemer Moritz , Sookthai Disorn , Junge Sabine , Pauligk Claudia , Al-Batran Salah-Eddin , Lorenzen Sylvie
Published: September 2024

Introduction: In squamous cell carcinoma of the esophagus (ESCC), therapeutical options in 2nd-line treatment are scarce with immune checkpoint inhibition being the only approved one. Ramucirumab/paclitaxel is an approved 2nd-line treatment in metastatic esophagogastric adenocarcinoma. We assessed safety and efficacy of ramucirumab/paclitaxel for ESCC. Methods: This prospective, randomized, open-label, multicenter, phase II trial evaluated paclitaxel (80 mg/m2 days 1, 8, 15) plus ramucirumab (8 mg/kg days 1, 15) (investigational arm A) versus paclitaxel alone (80 mg/m2 days 1, 8, 15) (standard arm B), both q4w, in advanced/metastatic ESCC refractory or intolerant to fluoropyrimidine and platinum-based drugs. Primary endpoint was overall survival (OS) rate at 6 months. Results: From 3/2019 to 4/2021, 21/186 planned patients were included (arm A 11 patients; arm B 10 patients) in 9 German centers. Due to slow accrual, the study was terminated prematurely. OS at 6 months was 72.7% for ramucirumab/paclitaxel and 50.0% for paclitaxel. The study design did not allow statistical comparison of the arms. PFS (3.8 vs. 3.5 months), OS (12.1 vs. 9.2 months), ORR (18.2% vs. 20.0%) and DCR (54.5% vs. 60.0%) were comparable in both arms. Most common treatment-related adverse events (TRAEs) in arm A were leucopenia (54.5%), fatigue (27.3%), and peripheral sensory neuropathy (18.2%). 27.3% in arm A and 50.0% in arm B had TRAEs ≥ grade 3. Conclusion: Ramucirumab/paclitaxel shows an acceptable tolerability and numerically improved OS at 6 months. Due to the small number of patients, the current trial must be considered exploratory and more data are needed in this indication.
Causal Relationships between Gut Microbiotas, Blood Metabolites, and Neuroendocrine Tumors: A Mediated Mendelian Randomization Study
Authors: Cao ZheXu , Huang JiangSheng , Long Xia
Published: September 2024

Introduction: Neuroendocrine tumors (NETs) are a heterogeneous group of epithelial tumors originating from different anatomical sites, and identifying the gut microbiota and metabolic mechanisms involved in the onset of NETs may help to develop appropriate disease prevention and monitoring strategies. Methods: We employed a mediated two-sample Mendelian randomization (MR) approach, analyzing gut microbiota from German studies and NET datasets from the 10th round of the FinnGen project. Mediation analyses were conducted using the metabolites dataset from the Canadian Longitudinal Study of Aging (CLSA) and the TwinsUK study. Instrumental variables were chosen according to established MR criteria and analyzed using the Wald ratio, inverse-variance weighted (IVW), MR-Egger, and weighted median methods. To ensure robustness, sensitivity analyses were performed using Cochrane’s Q, Egger’s intercept, MR-PRESSO, and leave-one-out methods. Results: Causal relationships were identified between the genetic determinants of 6, 5, 2, 1, 2, 3 gut microbiotas and the risk of colorectal, lung, pancreatic, rectum, small intestine, and stomach NETs. Similarly, the genetic determinants of 4, 6, 1, 5, 10, and 7 metabolites were found to be causally related to the risk of colorectal, lung, pancreatic, rectum, small intestine, and stomach NETs, respectively. Through Wald ratio and IVW methods, we preliminarily identified 957 microbiota-metabolite pairs with significant causal associations and formed 13 mediated relationships between the impact of gut microbiotas on NETs. Conclusion: Our study suggests that gut microbiotas and its derived metabolites may contribute to the onset of NET, offering a novel insight into the disease’s pathogenesis.
Genetic Variance in Heparan Sulfation Is Associated With Salt Sensitivity
Authors: Oppelaar Jetta J. , Ferwerda Bart , Romman Mohamed A. , Sahebdin Ghazalah N. , Zwinderman Aeilko H. , Galenkamp Henrike , Boekholdt S. Matthijs , van den Born Bert-Jan H. , Olde Engberink Rik H.G. , Vogt Liffert
Published: September 2024

BACKGROUND:

High heritability of salt sensitivity suggests an essential role for genetics in the relationship between sodium intake and blood pressure (BP). The role of glycosaminoglycan genes, which are crucial for salinity tolerance, remains to be elucidated.

METHODS:

Interactions between 54 126 variants in 130 glycosaminoglycan genes and daily sodium excretion on BP were explored in 20 420 EPIC-Norfolk (European Prospective Investigation Into Cancer in Norfolk) subjects. The UK Biobank (n=414 132) and the multiethnic HELIUS study (Healthy Life in an Urban Setting; n=2239) were used for validation. Afterward, the urinary glycosaminoglycan composition was studied in HELIUS participants (n=57) stratified by genotype and upon dietary sodium loading in a time-controlled crossover intervention study (n=12).

RESULTS:

rs2892799 in
NDST3
(heparan sulfate N-deacetylase/N-sulfotransferase 3) showed the strongest interaction with sodium on mean arterial pressure (false discovery rate 0.03), with higher mean arterial pressure for the C allele in high sodium conditions. Also, rs9654628 in
HS3ST5
(heparan sulfate-glucosamine 3-sulfotransferase 5) showed an interaction with sodium on systolic BP (false discovery rate 0.03). These interactions were multiethnically validated. Stratifying for the rs2892799 genotype showed higher urinary expression of N-sulfated heparan sulfate epitope D0S0 for the T allele. Conversely, upon dietary sodium loading, urinary D0S0 expression was higher in participants with stable BP after sodium loading, and sodium-induced effects on this epitope were opposite in individuals with and without BP response to sodium.

CONCLUSIONS:

The C allele of rs2892799 in
NDST3
exhibits higher BP in high sodium conditions when compared with low sodium conditions, whereas no differences were detected for the T allele. Concomitantly, both alleles demonstrate distinct expressions of D0S0, which, in turn, correlates with sodium-mediated BP elevation. These findings underscore the potential significance of genetic glycosaminoglycan variation in human BP regulation.
Affluence, Vividness, and Blame
Authors: McElwee Brian , Gabriel Iason
Published: September 2024

Most affluent people do little to aid those living in severe poverty. In this paper, we consider the extent to which such people are blameworthy for their inaction. We argue for three main claims. First, we cannot convincingly appeal to the phenomenon of non-culpable moral ignorance to argue that the affluent are not seriously blameworthy for their inaction: affluent people are either not ignorant, or else they are culpably ignorant. Second, however, a parallel phenomenon of non-culpable lack of vivid awareness does have some purchase in mitigating blame. Although this diminishes blame to some degree, significant blame is still appropriate, given that vivid awareness is to some extent under our control. Thirdly, there is good reason to believe that expressions of appropriate blame, which could alert us to moral wrongdoing, are systematically suppressed regarding global poverty. Therefore, the absence of blame doesn’t indicate the absence of blameworthy behaviour.
A new miniaturized species of leaf chameleon, genus Brookesia, from a littoral forest fragment in eastern Madagascar
Authors: RAKOTOARISON ANDOLALAO , HASINIAINA ALIDA FRANKLINE , GLAW FRANK , VENCES MIGUEL
Published: September 2024

The number of species of miniaturized chameleons of the genus Brookesia, subgenus Evoluticauda, known to science has witnessed a dramatic increase over the past 15 years, due to the discovery of multiple microendemic species of very strong genetic divergence. So far, no described Evoluticauda species are known from the littoral forest of Madagascar’s east coast, one of the most threatened habitat types of the island. Here, we report on the discovery of a new species of Evoluticauda occurring in the littoral forest at Ankanin’ny Nofy, a touristic site at about sea level and close to Vohibola forest where probably the same species occurs. The new species, Brookesia nofy sp. nov., is sister to B. ramanantsoai which occurs in mid-altitude and highland forests (800–1300 m a.s.l.) at a similar latitude of eastern Madagascar, but differs from this species by an enormous genetic divergence in both mitochondrial and nuclear genes (8.1–9.4% uncorrected pairwise distance in the 16S rRNA gene, 1.8–2.5% in c-mos), a relatively shorter tail, a different arrangement of cephalic ridges, and probably smaller body size and relatively larger head. The discovery of B. nofy sp. nov. emphasizes the importance of conserving Madagascar’s last remaining fragments of littoral forest.
Cumulonimbus Clouds Convert a Smaller Fraction of CAPE into Kinetic Energy in a Warmer Atmosphere
Authors: Peters John M. , Chavas Daniel R. , Lebo Zachary J. , Su Chun-Yian
Published: September 2024

This study investigates how entrainment’s diluting effect on cumulonimbus updraft buoyancy is affected by the temperature of the troposphere, which is expected to increase by the end of the century. A parcel model framework is constructed that allows for independent variations in the temperature (T), the entrainment rate ε, the free-tropospheric relative humidity (RH), and the convective available potential energy (CAPE). Using this framework, dilution of buoyancy is evaluated with T and RH independently varied and with CAPE either held constant or increased with temperature. When CAPE is held constant, buoyancy decreases as T increases, with parcels in warmer environments realizing substantially smaller fractions of their CAPE as kinetic energy (KE). This occurs because the increased moisture difference between an updraft and its surroundings at warmer temperatures drives greater updraft dilution. Similar results are found in midlatitude and tropical conditions when CAPE is increased with temperature. With the expected 6%–7% increase in CAPE per kelvin of warming, KE only increases at 2%–4% K−1 in narrow updrafts but tracks more closely with CAPE at 4%–6% in wider updrafts. Interestingly, the rate of increase in the KE with T becomes larger than that of CAPE when the later quantity increases at more than 10% K−1. These findings emphasize the importance of considering entrainment in studies of moist convection’s response to climate change, as the entrainment-driven dilution of buoyancy may partially counteract the influence of increases in CAPE on updraft intensity.

Significance Statement

Cumulonimbus clouds mix air with their surrounding environment through a process called entrainment, which controls how efficiently environmental energy is converted into upward speed in thunderstorm updrafts. Our research shows that warmer temperatures will exacerbate the moisture difference between cumulonimbus updrafts and their surroundings, leading to greater mixing and less efficient conversion of environmental energy into updraft speeds. This effect should be considered in future research that investigates how climate change will affect cumulonimbus clouds.
Assessing the Spurious Impacts of Ice-Constraining Methods on the Climate Response to Sea Ice Loss Using an Idealized Aquaplanet GCM
Authors: Lewis Neil T. , England Mark R. , Screen James A. , Geen Ruth , Mudhar Regan , Seviour William J. M. , Thomson Stephen I.
Published: September 2024

Coupled climate model simulations designed to isolate the effects of Arctic sea ice loss often apply artificial heating, either directly to the ice or through modification of the surface albedo, to constrain sea ice in the absence of other forcings. Recent work has shown that this approach may lead to an overestimation of the climate response to sea ice loss. In this study, we assess the spurious impacts of ice-constraining methods on the climate of an idealized aquaplanet general circulation model (GCM) with thermodynamic sea ice. The true effect of sea ice loss in this model is isolated by inducing ice loss through reduction of the freezing point of water, which does not require additional energy input. We compare the results of freezing point modification experiments with experiments where sea ice loss is induced using traditional ice-constraining methods and confirm the result of previous work that traditional methods induce spurious additional warming. Furthermore, additional warming leads to an overestimation of the circulation response to sea ice loss, which involves a weakening of the zonal wind and storm-track activity in midlatitudes. Our results suggest that coupled model simulations with constrained sea ice should be treated with caution, especially in boreal summer, where the true effect of sea ice loss is weakest, but we find the largest spurious response. Given that our results may be sensitive to the simplicity of the model we use, we suggest that devising methods to quantify the spurious effects of ice-constraining methods in more sophisticated models should be an urgent priority for future work.

Significance Statement

The potential effects of Arctic sea ice loss on midlatitude weather have been investigated using climate models where sea ice loss is artificially induced, without increasing greenhouse gas concentrations. Recently, this approach has been challenged because the artificial heating used to melt sea ice may also have direct effects on climate, which are not caused by sea ice loss. We run simulations with a simplified climate model that allows us to separate the “spurious” direct effects of the artificial heating from the “true” effect of sea ice loss. In our simulations, the responses of temperature and atmospheric circulation are amplified by spurious effects. Consequently, we argue that previous studies using more complex climate models may overestimate the effect of sea ice loss on climate.
Analysis of BRAF Gene Mutation in Hashimoto’s Thyroiditis With Multifocal Papillary Thyroid Carcinoma
Authors: Wang Feng , Su Yanling , Yao Xiyu , Liu Jie , Ke Qingxian
Published: September 2024

Background

Thyroid cancer (TC) is a highly prevalent malignant tumor of the head and neck. Papillary thyroid carcinoma (PTC) is the primary pathological type of TC, accounting for more than 80% of all TCs. BRAF mutations are closely associated with PTC. However, the relationship among HT, PTC, and BRAF mutations has not yet been clarified. We aimed to investigate the BRAF mutation in Hashimoto’s thyroiditis (HT) with PTC.

Methods

A total of 72 patients with multifocal PTC were included and grouped based on surgical pathology examination. Group A (n = 32) had pure multifocal PTC and Group B (n = 40) had HT with multifocal PTC. Various features were compared: BRAF mutation, multifactorial analysis of BRAF mutations, pathological features in patients with HT and multifocal PTC, and multifactorial analysis of factors affecting HT with multifocal PTC.

Results

Significant differences were seen in thyroid peroxidase antibody levels, central lymph node metastasis, extra-thyroidal invasion, main and non-main lesion diameters, and BRAF mutation positivity ( P < 0.05). Patients with the BRAF mutation had significantly higher rates of extra-thyroidal invasion and lymph node metastasis than those without the BRAF mutation ( P < 0.05). Logistic regression analysis showed that BRAF mutation and main lesion nodule diameter were independent risk factors affecting extra-thyroidal invasion and central lymph node metastasis in patients with HT and multifocal PTC ( P < 0.05).

Discussion

BRAF mutations were more prevalent and closely associated with extra-thyroidal invasion and central lymph node metastasis in patients with HT and multifocal PTC.
Effect of temperature on the mechanical behavior of pvc foams
Authors: Hoo Fatt Michelle S , Vedire Anudeep R , Pakala Akshay K
Published: September 2024

Experiments were conducted to characterize the mechanical behavior of Divinycell PVC foams over a wide range of environmental temperatures, from −60 to +80°C. Transversely isotropic properties of the foams, including modulus, strength, and ductility, were found to vary with temperatures between the ductile-to-brittle transition temperature (−60 to −50°C) and just under the glass transition temperature (95 to 100°C). The elastic modulus and yield strength decreased linearly as the temperature increased from −60 to +80°C. Compressive strength also decreased steadily with increasing temperature over the entire temperature range. In contrast, tensile and shear strengths only showed a significant decrease in values as the temperature rose above 23°C (room temperature). Below 23°C, there was a minor change in tensile and shear strengths. Tensile and shear ductility decreased sharply as the temperature decreased from +80°C to −40°C and stabilized between −60 and −40°C, which is close to the ductile-to-brittle transition region. Fractography of the tensile and shear fracture surfaces confirmed brittle fracture at −60°C and ductile tearing at +60°C. Equations were derived to predict modulus, yield strength, compressive, tensile and shear strengths, and ductility at any temperature in terms of room temperature values.
“Video is only one little perspective”: Officer perceptions of body-worn cameras in a small community-oriented agency
Authors: Yang Fei
Published: September 2024

This paper examines officer perceptions of body-worn cameras (BWCs) through semi-structured in-depth interviews with officers across ranks in a small community-oriented police agency. Giving voice to officers in a small agency, this study broadens prior knowledge gained from big agency studies and deepens existing understanding of officer perceptions of BWCs beyond a binary classification (either support or resistance). This approach provides a useful angle for scholars to bridge some gaps in the current literature and informs practitioners on how to improve policies for better utilization of BWCs in daily policing operations.
Post-elicitation Wait Time in the Japanese University English as a Foreign Language Classroom
Authors: Smith Benjamin Neil , King Jim
Published: September 2024

This study investigates the average wait time (WT) – how long a teacher waits following an elicitation – and its relationship with student response length (RL) within Japanese university English as a foreign language classes. It also discusses the perspectives of members of this community towards questioning and WT. Previous studies correlate longer WTs with longer responses but none have been conducted in Japan, and very little in second language (L2) classrooms. Data were collected from observing classes and interviewing teachers and students at a medium-ranked private university. The average WT was around 1.5 seconds and no correlation between WT and RL was found. Various factors which may limit the direct effect of WT on RL were identified, including L2 target language limitations and preferred teaching techniques. Although teachers saw potential for longer responses, they did not believe that WT would increase participation or encourage student–student discourse. Students generally agreed, although they expressed a desire for more open-ended questions requiring longer answers. Like prior studies, the average WT was higher than in first language research. While the lack of correlation between WT and RL differed from prior research, the complexity of WT as a classroom variable is further highlighted.
Central Europe: bringing a forgotten realm to Global International Relations
Authors: Zemanová Štěpánka , Druláková Radka
Published: September 2024

In recent decades, intensive attempts emerged to introduce a new Global International Relations (GIR) research programme related to the post-colonial critique of western dominance and its efforts to overcome the current geopolitics of knowledge. Even though several regional and national approaches have been included in GIR, the integration of semiperipheral IR thinking is only in its early stages. Some of them still remain almost neglected within the GIR context. In response to this challenge, this paper aims to introduce the IR thinking produced in Central Europe (CE) by four semi-peripheral nations – Czechs, Hungarians, Poles and Slovaks – into the GIR framework. It highlights the specifics of the region that should be reflected in GIR as a genuinely global discipline. We address the specific position of Central Europe close to the West but, for various reasons, never fully integrated into its core and the related epistemological uncertainty of how to study regional realities. Simultaneously, we search for those regional CE ideas that would be more generally applicable in the study of international relations and, at the same time, mirror the unique experience of an area with not only close ties to the West in terms of civilisation but also a long tragic history.
Effect of prior cold rolling on the dry wear performance of GCr15 bearing steel with multiphase microsturcture
Authors: Qian Dongsheng , Li Tianqi , Wang Feng , Deng Jiadong
Published: September 2024

In this work, the effect of cold rolling on the wear performance of GCr15 bearing steel with multiphase microstructure has been investigated. The microstructural observation shows that prior cold rolling facilitates to the dissolution of carbides during austenitization. With the increase of cold rolling reduction, the residual austenite content is increased after multiphase heat treatment. The wear results indicate that friction coefficient as well as wear rate distinctly decreases with the increase of rolling reduction. It is also found that the transformation of martensite from residual austenite induced by wear stress increases the surface compressive stress and hardness for the rolled specimens, thereby leading to the enhancement of dry wear resistance.
Emergency laparotomy and endoscopic gastrostomy in patients on extra-corporeal membrane oxygenation (ECMO) support
Authors: Gómez Gonzalo A , Vinck Eric E , Matallana Rogelio , Tobón Marcela P , Orrego Ana M , Cardona-Bernal Susana , Rivas Ubaldo E , Quintero Alejandro , Escobar José J , Uribe Juan D , Giraldo Nelson D
Published: September 2024

Introduction

An infrequent yet known complication of ECMO is abdominal compartment syndrome requiring emergency laparotomy. Also, the need for prolonged enteral nutrition while on ECMO may require endoscopic gastrostomy to maintain adequate nutritional status. Here we describe our experience with emergency laparotomy and endoscopic gastrostomy in patients on ECMO support.

Methods

We retrieved patient histories from our clinical archives and performed a retrospective description of all patients taken to an emergency laparotomy or endoscopic gastrostomy while on ECMO support at our cardiovascular referral center from July 2019 through June 2024.

Results

During the research period of 5 years a total of 401 patients were placed on ECMO support for either cardiogenic shock or respiratory failure. A total of 27 (7%) patients required an abdominal intervention while on ECMO. 14 (3.5%) patients required emergency laparotomy and 13 (3.2%) of patients required endoscopic gastrostomy tube placement. Overall 30-day mortality of all patients requiring a general surgery procedure while on ECMO support was 33%.

Conclusion

ECMO support can result in many complications despite its many benefits. Patients who require emergency laparotomy while on ECMO have lower survival-to-discharge and higher mortality at 30 days. Endoscopic gastrostomy however, can be safely performed on ECMO with little to no bleeding complications despite anticoagulation.
Monocentric prospective study to valid multidisciplinary diagnostic and therapeutic approach for Nutcracker syndrome
Authors: John Gwenaël , Wilhelm Frederic , Magnus Louis , Burgaud Mathilde , Leterrier Tristan , Rouyer Olivier , Thiel Hélène , Nicolini Philippe , Chabrot Pascal , Thaveau Fabien
Published: September 2024

Background: Nutcracker syndrome (NCS) is defined as left renal vein (LRV) compression by the superior mesenteric artery. NCS diagnosis is rendered complex by confounding symptoms. The study objective was to perform a prospective observational analysis of the diagnostic and therapeutic criteria of the patients with suspected NCS. When NCS diagnosis was confirmed, transposition of the LRV was carried out by mini-invasive robotic surgery (MIRS). Method: All patients addressed to the vascular surgery department for suspicion of NCS between January 2022 and June 2023 were included in the study. Patients were subsequently assessed by means of a computed tomography scan, dynamic duplex ultrasound and phlebography associated with an occlusion test of the left gonadic vein (LGV). Diagnostic criteria included aorto-mesenteric angle, LGV diameter and reflux, velocity ratios and diameters and the reno-caval gradient. Result: Thirty two patients aged 37 ± 14 years had suspicion of NCS. Twenty presented an aorto-mesenteric angle below 20°, twenty three had a LGV diameter greater than 5 mm and twenty two of the latter patients also had LGV reflux. A significant reno-caval gradient greater than 5 mmHg was found in ten cases, thereby consolidating NCS diagnosis. Overall, thirteen patients neither presented NCS or pelvic varicosities; eight had pelvic congestion syndrome without NCS and were successfully treated by embolization. Eleven patients with confirmed NCS underwent LRV transposition in the inferior vena cava (IVC). Eight of the latter patients received a complementary pelvic varicosity embolization 2 days later. Two months post-operation 100% of transposed LRV were permeable as assessed by duplex ultrasound controls and all of these patients reported an improvement of symptoms. Conclusion: An innovative multidisciplinary decisional algorithm establishes certitude in NCS diagnosis which can subsequently be treated radically by MIRS.
No compromise in solution quality: Speeding up belief-dependent continuous partially observable Markov decision processes via adaptive multilevel simplification
Authors: Zhitnikov Andrey , Sztyglic Ori , Indelman Vadim
Published: September 2024

Continuous Partially Observable Markov Decision Processes (POMDPs) with general belief-dependent rewards are notoriously difficult to solve online. In this paper, we present a complete provable theory of adaptive multilevel simplification for the setting of a given externally constructed belief tree and Monte Carlo Tree Search (MCTS) that constructs the belief tree on the fly using an exploration technique. Our theory allows to accelerate POMDP planning with belief-dependent rewards without any sacrifice in the quality of the obtained solution. We rigorously prove each theoretical claim in the proposed unified theory. Using the general theoretical results, we present three algorithms to accelerate continuous POMDP online planning with belief-dependent rewards. Our two algorithms, SITH-BSP and LAZY-SITH-BSP, can be utilized on top of any method that constructs a belief tree externally. The third algorithm, SITH-PFT, is an anytime MCTS method that permits to plug-in any exploration technique. All our methods are guaranteed to return exactly the same optimal action as their unsimplified equivalents. We replace the costly computation of information-theoretic rewards with novel adaptive upper and lower bounds which we derive in this paper, and are of independent interest. We show that they are easy to calculate and can be tightened by the demand of our algorithms. Our approach is general; namely, any bounds that monotonically converge to the reward can be utilized to achieve a significant speedup without any loss in performance. Our theory and algorithms support the challenging setting of continuous states, actions, and observations. The beliefs can be parametric or general and represented by weighted particles. We demonstrate in simulation a significant speedup in planning compared to baseline approaches with guaranteed identical performance.
The European Statistics Awards for Nowcasting: A New Approach to Engage with the Scientific Community and to Foster Improved Timeliness of Official Statistics
Authors: Zając Agnieszka , Karlberg Martin , Museux Jean-Marc
Published: September 2024

The European Statistics Awards Programme is a multiannual program for engaging with, and tapping into the potential of, the research and innovation community at large. This is achieved through competitions with pecuniary prizes for the best performers. One of the strands within that program offers awards for the accurate nowcasting of monthly time series of interest to policymakers. This paper presents the design of the nowcasting competition as well as the performance of the best entries of the first annual round. In terms of accuracy, the competition has generated promising results—which do however need further fine-tuning before being possible to deploy in statistical production. The competitions feature a particular prize for submissions having a potential for scaling up to regular statistical production—and in response to this, teams have submitted ample documentation (including code). The awards program should also generate experience that the official statistics community can learn from. This paper demonstrates how the multi-annual nature of the program has allowed various design changes to be implemented for the last nowcasting round. The main work now lies ahead: the paper outlines the plans for further developing the most promising competition contributions, potentially leading to new Eurostat experimental statistics products.
Effect of Cs2O-containing refining slag on the purity of ultra-clean steel for ultra-fine saw wire
Authors: Chen Changyong , Sun Meng , Ran Mingze , Zhang Mina , Dong Zihui , Wang Yi , Li Yang , Jiang Zhouhua
Published: September 2024

The influence of Cs2O-containing refining slag on the purity of steel for ultra-fine saw wire has been studied in this article. The result indicated that a small amount of Cs2O can significantly improve the capability of low-basicity refining slag to purify molten steel. In detail, the number and size of inclusions decreased dramatically when Cs2O was added to the refining slag. Additionally, the composition of most inclusions is controlled within the low melting point region. However, it will reduce the capability of low-basicity refining slag to purify molten steel if the content of Cs2O exceeds 10 wt%. Cs2O changes the ability of low-basicity refining slag to remove inclusions by changing the slag's viscosity and microstructure. The viscosity of refining slag increased gradually with the mass fraction of Cs2O in the slag increasing, and the disparity of viscosity values between different experimental groups increased sharply with temperature decreasing. Furthermore, the viscosity curve of Cs2O-containing slag developed a turning point, that is, the speed of viscosity increasing raised sharply at the turning point, while this phenomenon cannot be found in a normal experiment group without Cs2O. The detection results of the Raman spectrum show that the three-dimensional network of slag increased greatly with the content of Cs2O in the slag increasing gradually.
Effect of P2O5 on the viscous flow and crystallisation behaviour of slag in the double slag converter steelmaking process
Authors: Yang Gao , Meng Xiangning , Yang Rui , Zeng Ruiqi , Li Wei
Published: September 2024

In the current study, the effect of P2O5 on the viscous flow and crystallisation behaviour of slag in the double slag converter steelmaking process was investigated in laboratory. The results indicated that with the increase of P2O5 content, the softening temperature, hemispherical temperature and flowing temperature of steelmaking slag showed a decreasing trend, however, the viscosity increased. The FactSage thermodynamic software was used to predict the types and contents of crystallisation phases in the crystallisation process of steelmaking slag. It showed that with the increase of P2O5 content, the precipitation content of Ca5P2SiO12 increased, while the precipitation content of melilite decreased. The composition and microstructure of crystallisation phases were analysed using X-ray diffraction and scanning electron microscopy. The phase composition did not change with the increase of P2O5 content, but the diffraction peak intensity of each crystallisation phase was different. Besides, the precipitation of phosphorus-enriched phase was enhanced with the increase of P2O5 content.
Multi-Scale Study on the Effect of Snowmelt Salt on the Interface Adhesion of Rubberized Asphalt–Steel Slag
Authors: Zhang Le , Liu Yang , Wang Lan , Xue Zhihua
Published: September 2024

To explore the effect of snowmelt agent on the adhesion of the rubberized asphalt–steel slag interface, the adhesion of the rubberized asphalt–steel slag interface under different concentrations of snowmelt agent was studied. The macroscopic fracture characteristics of the steel slag-rubberized asphalt mixture under different concentrations of snowmelt salt were studied. The surface energy of steel slag and rubberized asphalt after the action of different concentrations of snowmelt salt was tested at the microscopic scale, and then their adhesion was calculated. It was used to study the microscopic surface interaction under the action of snowmelt agents. At the molecular scale, the interface models of rubberized asphalt–NaCl solution–Ca3SiO5 were constructed, and the interaction between steel slag and asphalt under different concentrations of snowmelt agent was studied. The results show the following: when the concentration of snowmelt agent is 8%–12%, the fracture of the rubberized asphalt–steel slag mixture is more inclined to brittle fracture, and the failure speed is faster; the adhesion of steel slag-rubberized asphalt is weakened under the action of the snowmelt agent, but it can still maintain good adhesion; before the concentration of snowmelt agent reached saturation, the adhesion property of steel slag-rubberized asphalt decreases with the increase of snowmelt agent concentration; when the concentration of snowmelt agent reached saturation, NaCl precipitates and adheres to the molecular surface of steel slag, which enhances the interaction between steel slag and rubberized asphalt; the inflection point with salt concentration is related to the solvent precipitated from the solution.
A 2-Day Postpartum CBT-Based Training for Nurses
Authors: Campbell Madisyn , Haber-Evans Erika , Hicks Amanda , Van Lieshout Ryan J
Published: September 2024

Background

Public health nurses (PHNs) are often a first point of contact for postpartum individuals seeking mental health support, but report limited training related to mental health.

Purpose

To determine whether a two-day cognitive behavioral therapy (CBT)-based training program focused on postpartum maternal mental health can improve PHN perceptions of their ability to deliver CBT techniques, their confidence working with distressed clients, and with managing client resistance to treatment recommendations.

Methods

A convenience sample of 45 PHNs working in the Family Health Division of Niagara Region Public Health in Ontario, Canada were assessed before and after they received a two-day CBT-based training program. Before attending training, PHNs reported their current professional position, years of experience working in public health, and any previous mental health training. Their confidence in delivering CBT techniques, working with distressed clients, and with managing client resistance to treatment recommendations was assessed pre- and post-training. Participants also rated their satisfaction with the training.

Results

Statistically significant improvements were seen in confidence using CBT techniques, and in supporting and managing distressed or resistant clients. The two-day training was highly rated overall by participants. Medium to large effect sizes were found for changes in confidence-related questions.

Conclusions

Providing PHNs with brief CBT-based mental health-related training can increase their confidence in this aspect of their practice, and could potentially improve the quality of care they provide.
Pioneering Pathways: Unveiling the Impact of School Education in Cultivating an Entrepreneurial Spirit among Secondary School Students
Authors: Mumtaz Uzma , Siddiqui Daniya , Ahmad Naseeb
Published: September 2024

Entrepreneurship education is a vital part of the education system. It has been shown that entrepreneurship education has a positive impact on the development of a start-up culture among students. However, the great majority of young people in India, who possess latent entrepreneurial potential, are leaving college without the fundamental skills required for entrepreneurship. The study examines student’s capacity for entrepreneurship and the provision of entrepreneurship instruction in higher education. This study aims to examine and assess the connections between several internal characteristics found in Ajzen’s (1991) model and secondary school students’ inclination towards entrepreneurship. The results highlight students’ positive attitudes about entrepreneurship, which are evident in their subjective norms, personal attitudes and sense of behavioural control over starting a business. In addition, the study shows a gap in higher education’s entrepreneurship curriculum in contrast to students’ growing entrepreneurial potential.
Effect of Compliance to Ventilator Bundle Care in Decreasing Ventilator-associated Pneumonia Rates in a Neonatal Intensive Care Unit: A Quality Improvement Initiative
Authors: Suman Sunistha , Singh Srijan
Published: September 2024

Purpose

Prevention of ventilator-associated pneumonia (VAP) can be achieved by a group of evidence-based interventions known as the “VAP bundle.” In this study, we observed the effect of increasing compliance to bundle care in reducing VAP rates.

Methods

We did a quality improvement (QI) study in an outborn level 3 neonatal intensive care unit (NICU) enrolling 95 neonates less than 28 days of life; and receiving ventilator care for more than 2 days of hospitalization in NICU. A standardized VAP bundle was implemented with the goal of decreasing VAP rates in NICU. A total of 45 neonates were enrolled in the pre-bundle study group (Group I) and 50 in post-bundle study group (Group II).

Results

Average bundle compliance increased to 62.26 ± 8.31% in Group II from a baseline compliance value of 52.6 ± 6.87% in Group I ( P < .05). VAP rate was reduced from 37.6 per 1000 MV days (Mechanical Ventilation days) to 25.5 per 1000 MV days ( P < .05).

Conclusion

Increased compliance to ventilator bundle care leads to a decreased VAP rate resulting in shortening of the MV days per case, decreasing duration of hospital stay, and reducing antibiotic course duration, thereby better employing the health care resources in neonatal care.
Surgical Exploration for Intestinal Perforation in Extreme Preterm Neonates
Authors: Bhat Zubair Ahmad , Varikkottil Mohamed Muneer , Pournami Femitha , Thomas Reju J , Kolisambeevi Arif Abdulsalam , Jain Naveen
Published: September 2024

Gastrointestinal perforation and peritonitis in preterm infants are most often due to necrotizing enterocolitis. These neonates are usually critically ill with multiorgan involvement and pose a challenge with regard to timing for definitive surgery. Peritoneal drainage is only a temporizing measure. Meticulous pre- and intra-op stabilization is mandatory for timely surgery. We describe a sick 710 g neonate where the perforation was the aftermath of intestinal obstruction from a mid-small bowel intussusception. This lays emphasis on considering other differentials for hollow viscus perforation even in extreme preterm neonates; these require surgical exploration and correction. The baby recovered well after primary resection anastomosis and several weeks of intensive care.
Reduction Cranioplasty in Cases of Hydrocephalic Macrocephaly: Pearls and Pitfalls of Computer-Assisted Surgery
Authors: Best David L. , Nyabuto Elizabeth , Lee Kevin C. , Reynolds Renée M. , Markiewicz Michael R.
Published: September 2024

Reduction cranioplasty may be indicated to address functional or cosmetic sequelae of hydrocephalic macrocephaly. With the advent of CAD/CAM digital workflow, surgeons can design and fabricate craniotomy guides, templates, and models that allow for precise cranial reconstruction. Although there are several advantages of virtual planning, pre-determined surgical plans may limit intraoperative flexibility, requiring surgeons to troubleshoot errors in pre-operative planning or model design. The purpose of this report is to present a series of cases demonstrating our institution's technique for single-stage reduction cranioplasty using a CAD/CAM workflow. This report will highlight the benefits and challenges associated with a contemporary digital workflow for reduction cranioplasty.