bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel multi-stable sinusoidal chaotic map with spectacular behaviors
Authors: Ali Ahmed M Ali , Sriram Sridevi , Natiq Hayder , Ahmadi Atefeh , Rajagopal Karthikeyan , Jafari Sajad
Published: August 2023

Chaotic behavior can be observed in continuous and discrete-time systems. This behavior can appear in one-dimensional nonlinear maps; however, having at least three state variables in flows is necessary. Due to the lower mathematical complexity and computational cost of maps, lots of research has been conducted based on them. This paper aims to present a novel one-dimensional trigonometric chaotic map that is multi-stable and can act attractively. The proposed chaotic map is first analyzed using a single sinusoidal function; then, its abilities are expanded to a map with a combination of two sinusoidal functions. The stability conditions of both maps are investigated, and their different behaviors are validated through time series, state space, and cobweb diagrams. Eventually, the influence of parameter variations on the maps’ outputs is examined by one-dimensional and two-dimensional bifurcation diagrams and Lyapunov exponent spectra. Besides, the diversity of outputs with varying initial conditions reveals this map’s multi-stability. The newly designed chaotic map can be employed in encryption applications.
Controllable double optical bistability via photon and phonon interaction in a hybrid optomechanical system
Authors: Wang Zhen , Li Heng-Mei , Yang Bao-Hua , Jiang Cheng , He Yong
Published: August 2023

Optical bistability has been studied theoretically in a multi-mode optomechanical system with two mechanical oscillators independently coupled to two cavities in addition to direct tunnel coupling between cavities. It is shown that the bistable behavior of the mean intracavity photon number in the right cavity can be tuned by adjusting the strength of the pump laser beam driving the left cavity. In addition, the mean intracavity photon number is relatively larger in the red sideband regime than that in the blue sideband regime. Moreover, we show that the double optical bistability of the intracavity photon in the right cavity and the two steady-state positions of the mechanical resonators can be observed when the control field power is increased to a critical value. In addition, the critical values for the observation of bistability and double bistability can be tuned by adjusting the coupling coefficient between the two cavities and the coupling rates between cavity mode and mechanical mode.
Identification of core ion cyclotron instabilities on HL-2A tokamak
Authors: Liu Linzi , Tong Ruihai , Zou Xiaolan , Chen Haotian , Chen Yang , Dong Guanqi , Hao Guangzhou , He Xiaoxue , Han Yuxiao , Ji Xiaoquan , Liang Anshu , Li Bo , Li Jiquan , Li Yonggao , Liu Liang , Shi Zhongbin , Wei Huiling , Xia Fan , Xiao Guoliang , Yin Jiao , Yu Deliang , Yuan Boda , Zhu Yiren , Zhong Wulyu , Xu Min ,   HL-2A team
Published: August 2023

Instabilities in multiplies of ion cyclotron frequency range are identified and termed as core ion cyclotron emission (ICE) in recent HL-2A neutral beam injection heated experiments. Characteristics of the core ICE are presented, including frequency dependence and harmonics features. The detected frequencies are found to agree well with the multiplies of the deuterium cyclotron frequency around the magnetic axis. Additionally, the core ICE exhibits a predominantly compressional property. Observations of distinct spectrum features and individual excitation of each harmonic have demonstrated that the core ICE harmonics are independent multiple modes. Notably, the variation of plasma current is a necessary condition for exciting the 4th harmonic ICE individually. The results suggest that the drive mechanism of core ICE varies between the different frequency ranges.
The Study of Geomagnetic Field Southeastern Part of an Najaf-Karbala Plateau, Central Iraq, by World Magnetic Model 2015
Authors: Ali Nibras F. , Al-Naji Ahmed Jawad , Al-Bermani Mohammed J. , Laftah Amer A.
Published: August 2023

In this paper numerical simulations of the Earth’s magnetic field in the south-eastern part of an Najaf-Karbala Plateau and to the north of the centre of An-Najaf governorate have been investigated using the WMM2015 model. The study area is located at (Latitude = 32.3180°-31.99°) N, (Longitude = 44.5160°-44.0690°) E, and ranging altitude between 20-90 m above sea level). The study area was divided into grid of (2000 points) by drawing parallel lines, the interspacing distance between two lines (1 Km). Each line would be divided into several nodes. The space between any two nodes about (0.25 Km), this is done by using Google earth program v.6, Collected the data were latitude, longitude, and elevation from sea level. The data applied by (WMM2015) model and the result data of earth magnetic field elements drawn by Surfer v.13 and converted to the contour map by using the gridding method to find the characteristics of Earth magnetic elements ( Total intensity (F), the East component(Y), Horizontal intensity (H), Down component(Z), the North component(X), Declination (D) ) and Inclination (I)). The contour maps of F, Y, and D have magnetic anomalies that observed the changing in the values in the north western part of the study area. This may be indicating the presence of magnetic anomalies as a result of the presence of subsurface rock structures caused by them, including base rocks or various faults.
Research prospects of graphene-based catalyst for seawater electrolysis
Authors: Li Xinyu , Liu Yingjie , Feng Yanhui , Tong Yunwei , Qin Zhenbo , Wu Zhong , Deng Yida , Hu Wenbin
Published: August 2023

Seawater has obvious resource reserve advantages compared to fresh water, and so the huge potential advantages for large-scale electrolysis of hydrogen production has been paid more attention to; but at the same time, electrolysis of seawater requires more stable and active catalysts to deal with seawater corrosion problems. Graphene-based materials are very suitable as composite supports for catalysts due to their high electrical conductivity, specific surface area, and porosity. Therefore, the review introduces the problems faced by seawater electrolysis for hydrogen production and the various catalysts performance. Among them, the advantages of catalysis of graphene-based catalysts and the methods of enhancement the catalytic performance of graphene are emphasized. Finally, the development direction of composite catalysts is prospected, hoping to provide guidance for the preparation of more efficient electrocatalysts for seawater electrolysis.
Analysis of temperature distribution in PV-integrated electrochemical flow cells
Authors: Santander Dorian , Whitley Shaun , Kim Jungmyung , Bae Dowon
Published: August 2023

Photovoltaic (PV)-integrated flow cells for electrochemical energy conversion and storage underwent a huge development. The advantages of this type of integrated flow cell system include the simultaneous storage of solar energy into chemicals that can be readily utilized for generating electricity. However, most studies overlook the practical challenges arising from the inherent heat exposure and consequent overheating of the reactor under the sun. This work aims to predict the temperature profiles across PV-integrated electrochemical flow cells under light exposure conditions by introducing a computational fluid dynamics–based method. Furthermore, we discuss the effects of the flow channel block architecture on the temperature profile to provide insights and guidelines for the effective remedy of overheating.
On the cosmetic crossing conjecture for special alternating links
Authors: Boninger Joe
Published: August 2023

We prove that a family of links, which includes all special alternating knots, does not admit non-nugatory crossing changes which preserve the isotopy type of the link. Our proof incorporates a result of Lidman and Moore [Trans. Amer. Math. Soc. 369 (2017), pp. 3639–3654] on crossing changes to knots with

L
L

-space branched double-covers, as well as tools from Scharlemann and Thompson’s [Comment. Math. Helv. 64 (1989), pp. 527–535] proof of the cosmetic crossing conjecture for the unknot.
Smooth Homotopy of Infinite-Dimensional 𝐶^{∞}-Manifolds
Authors: Kihara Hiroshi
Published: August 2023

In this paper, we use homotopical algebra (or abstract homotopical methods) to study smooth homotopical problems of infinite-dimensional

C

∞

C^{\infty }

-manifolds in convenient calculus. More precisely, we discuss the smoothing of maps, sections, principal bundles, and gauge transformations.

We first introduce the notion of hereditary

C
∞

C^\infty

-paracompactness along with the semiclassicality condition on a

C
∞

C^\infty

-manifold, which enables us to use local convexity in local arguments. Then, we prove that for

C
∞

C^\infty

-manifolds

M
M

and

N
N

, the smooth singular complex of the diffeological space

C
∞

(
M
,
N
)

C^\infty (M,N)

is weakly equivalent to the ordinary singular complex of the topological space

C

0

(
M
,
N
)

{\mathcal {C}^0}(M,N)

under the hereditary

C
∞

C^\infty

-paracompactness and semiclassicality conditions on

M
M

. We next generalize this result to sections of fiber bundles over a

C
∞

C^\infty

-manifold

M
M

under the same conditions on

M
M

. Further, we establish the Dwyer-Kan equivalence between the simplicial groupoid of smooth principal

G
G

-bundles over

M
M

and that of continuous principal

G
G

-bundles over

M
M

for a Lie group

G
G

and a

C
∞

C^\infty

-manifold

M
M

under the same conditions on

M
M

, encoding the smoothing results for principal bundles and gauge transformations.

For the proofs, we fully faithfully embed the category

C

∞

C^{\infty }

of

C

∞

C^{\infty }

-manifolds into the category

D

{\mathcal {D}}

of diffeological spaces and develop the smooth homotopy theory of diffeological spaces via a homotopical algebraic study of the model category

D

{\mathcal {D}}

and the model category

C

0

{\mathcal {C}^0}

of arc-generated spaces, also known as

Δ
\Delta

-generated spaces. Then, the hereditary

C
∞

C^\infty

-paracompactness and semiclassicality conditions on

M
M

imply that

M
M

has the smooth homotopy type of a cofibrant object in

D

{\mathcal {D}}

. This result can be regarded as a smooth refinement of the results of Milnor, Palais, and Heisey, which give sufficient conditions under which an infinite-dimensional topological manifold has the homotopy type of a

C
W

CW

-complex. We also show that most of the important

C
∞

C^\infty

-manifolds introduced and studied by Kriegl, Michor, and their coauthors are hereditarily

C
∞

C^\infty

-paracompact and semiclassical, and hence, results can be applied to them.
The incidence of translocation t(11;14) among patients with multiple myeloma in a single clinic
Authors: Jew Scott , Goldwater Marissa-Skye , Bujarski Sean , Regidor Bernard , Emamy-Sadr Marsiye , Swift Regina , Eades Benjamin , Said Jonathan , Berenson James R
Published: August 2023

Objectives

Data regarding bone marrow (BM) sampling and cytogenetic testing rates for identification of translocation (11q13;14q32) and their changes over time in a multiple myeloma (MM) population are limited. We analyzed these metrics at a clinic specializing in the treatment of MM.

Methods

A total of 760 BM aspirate samples from 351 patients were collected between August 2004 and October 2021. We analyzed BM sampling statistics, cytogenetic testing frequency, and the incidence rates for the t(11;14) translocation in a single clinic specializing in the treatment of MM.

Results

We report that most (54.4%) patients had only 1 aspirate collected; the main reason (64.6%) for BM collection was to confirm disease progression. Less than half (47.5%) of BM samples collected for evaluation of MM disease had cytogenetic testing, but the rates have markedly increased in recent years. Our data demonstrated an incidence rate of 19.3% for t(11;14).

Conclusions

This report suggests that some patients may need to retest for this genetic aberration due to the possibility of false negatives and the potential benefit of identifying the t(11;14) marker for patients who may be candidates for a highly effective targeted therapy consisting of the BCL-2 inhibitor venetoclax.
Evaluation of inpatient medication guidance from an artificial intelligence chatbot
Authors: Beavers Jennifer , Schell Ryan F , VanCleave Halden , Dillon Ryan C , Simmons Austin , Chen Huiding , Chen Qingxia , Anders Shilo , Weinger Matthew B , Nelson Scott D
Published: August 2023

Purpose

To analyze the clinical completeness, correctness, usefulness, and safety of chatbot and medication database responses to everyday inpatient medication-use questions.

Methods

We evaluated the responses from an artificial intelligence chatbot, a medication database, and clinical pharmacists to 200 real-world medication-use questions. Answer quality was rated by a blinded group of pharmacists, providers, and nurses. Chatbot and medication database responses were deemed “acceptable” if the mean reviewer rating was within 3 points of the mean rating for pharmacists’ answers. We used descriptive statistics for reviewer ratings and Kendall’s coefficient to evaluate interrater agreement.

Results

The medication database generated responses to 194 (97%) questions, with 88% considered acceptable for clinical correctness, 76% considered acceptable for completeness, 83% considered acceptable for safety, and 81% considered acceptable for usefulness compared to pharmacists’ answers. The chatbot responded to only 160 (80%) questions, with 85% considered acceptable for clinical correctness, 65% considered acceptable for completeness, 71% considered acceptable for safety, and 68% considered acceptable for usefulness.

Conclusion

Traditional search methods using a drug database provide more clinically correct, complete, safe, and useful answers than a chatbot. When the chatbot generated a response, the clinical correctness was similar to that of a drug database; however, it was not rated as favorably for clinical completeness, safety, or usefulness. Our results highlight the need for ongoing training and continued improvements to artificial intelligence chatbots for them to be incorporated reliably into the clinical workflow. With continued improvement in chatbot functionality, chatbots could be a useful pharmacist adjunct, providing healthcare providers with quick and reliable answers to medication-use questions.
The Longitudinal Relationship Between Concussion History, Years of American Football Participation, and Alcohol Use Among Former National Football League Players: an NFL-LONG Study
Authors: Lang Brittany , Kerr Zachary Yukio , Chandran Avinash , Walton Samuel R , Mannix Rebekah , Lempke Landon B , DeFreese J D , Echemendia Ruben J , Guskiewicz Kevin M , Meehan III William P , McCrea Michael A , Brett Benjamin L
Published: August 2023

Objective

Investigate the relationships between concussion history and years of football participation (repetitive head impact proxy) with alcohol use across multiple decades in former professional football players.

Methods

Participants (n = 348; mean age = 49.0 ± 9.4) completed health questionnaires in 2001 and 2019, which included self-reported concussion history and years of participation. Alcohol use frequency and amount per occasion were reported for three timepoints: during professional career, 2001, and 2019. Ordinal logistic regression models were fit to test associations of concussion history and years of participation with alcohol use at each timepoint.

Results

There were no significant associations between either concussion history or years of football participation with alcohol use (frequency and amount per occasion) at any timepoint. Effect estimates for concussion history and years of football participation with alcohol use were generally comparable across timepoints.

Conclusions

Later life alcohol use by former American football players is not associated with concussion history or years of exposure to football.
Clinical Results of Mentor MemoryGel Xtra Breast Implants From the GLOW Clinical Trial
Authors: Alderman Amy , Caplin David , Hammond Dennis C , Keane Alexandra , Turetzky Jay , Kane William J
Published: August 2023

Background

Mentor MemoryGel Xtra breast implants (Mentor Worldwide LLC, Irvine, CA) were designed to maintain the soft, natural feel of MemoryGel implants while increasing fullness and projection and minimizing wrinkling, rippling, and related complications through optimization of shell gel-fill.

Objectives

To measure 3-year safety and effectiveness of MemoryGel Xtra breast implants in the Mentor MemoryGel and MemoryShape Combined Cohort Clinical Study.

Methods

Participants were implanted with MemoryGel Xtra breast implants in a prospective, multicenter clinical trial. Rates of complications and reoperations were analyzed to assess device safety and BREAST-Q was employed to assess device effectiveness.

Results

Two hundred eighty-seven females receiving MemoryGel Xtra breast implants were enrolled. Complication rates in the primary augmentation cohort included rates of 1.5% for implant-related reoperation, 2.3% for explantation, and 1.5% for Baker grade III or IV capsular contracture. For the revisional augmentation cohort, these rates were 2.8% for implant-related reoperation, 4.3% for explantation, and 3.0% for capsular contracture. For the primary reconstruction cohort, these rates were 12.0% for implant-related reoperation, 12.3% for explantation, and 7.3% for capsular contracture. For the revisional reconstruction cohort, these rates were 7.1% for capsular contracture, with zero implant-related reoperations or explantations. There were no reports of infection or implant malposition or displacement in any of these cohorts. Each cohort showed significantly improved satisfaction with breasts and psychosocial and sexual well-being at 1 year following the primary procedure.

Conclusions

These data are consistent with legacy clinical data for MemoryGel and provide the first published safety and effectiveness data regarding the use of MemoryGel Xtra breast implants for breast augmentation and reconstruction.

Level of Evidence: 4
Robot-Assisted Latissimus Dorsi Flap Harvest for Partial Breast Reconstruction: Comparison With Endoscopic and Conventional Approaches
Authors: Eo Pil Seon , Kim Hyunbin , Lee Joon Seok , Lee Jeeyeon , Park Ho Yong , Yang Jung Dug
Published: August 2023

Background

Latissimus dorsi muscle flaps are widely utilized in breast reconstruction. Several methods have been introduced.

Objectives

The aim was to compare the outcomes of robot-assisted breast reconstruction with a latissimus dorsi muscle flap following partial mastectomy with the outcomes of conventional and endoscopic-assisted techniques.

Methods

In this prospective single-institution study, Korean females diagnosed with breast cancer who underwent partial mastectomy and breast reconstruction with a latissimus dorsi flap from March 2020 to December 2021 were included. The outcomes of surgery and patient satisfaction utilizing the conventional, endoscopic-assisted, and robot-assisted techniques were compared.

Results

In total, 57 patients were included in this study, among whom 20 underwent conventional reconstruction, and 17 and 20 patients underwent endoscopic and robotic surgery, respectively. There was no statistically significant difference between the 3 methods in postoperative opioid analgesic dosage (P = .459), hospitalization period (P = .225), or the average total amount of donor site drainage during hospitalization (P = .175). With regard to patient satisfaction after surgery, especially regarding the donor site scar, the conventional method showed a significantly lower score than the other 2 techniques.

Conclusions

Robot-assisted breast reconstruction with a latissimus dorsi muscle flap after partial mastectomy showed higher patient satisfaction than that for the conventional open method. Because robotic surgery is more convenient than the endoscopic technique, it is potentially a good alternative to conventional open or endoscopic surgery.

Level of Evidence: 4
DANGER analysis: risk-averse on/off-target assessment for CRISPR editing without a reference genome
Authors: Nakamae Kazuki , Bono Hidemasa
Published: August 2023

Motivation

The CRISPR-Cas9 system has successfully achieved site-specific gene editing in organisms ranging from humans to bacteria. The technology efficiently generates mutants, allowing for phenotypic analysis of the on-target gene. However, some conventional studies did not investigate whether deleterious off-target effects partially affect the phenotype.

Results

Herein, we present a novel phenotypic assessment of CRISPR-mediated gene editing: Deleterious and ANticipatable Guides Evaluated by RNA-sequencing (DANGER) analysis. Using RNA-seq data, this bioinformatics pipeline can elucidate genomic on/off-target sites on mRNA-transcribed regions related to expression changes and then quantify phenotypic risk at the gene ontology term level. We demonstrated the risk-averse on/off-target assessment in RNA-seq data from gene-edited samples of human cells and zebrafish brains. Our DANGER analysis successfully detected off-target sites, and it quantitatively evaluated the potential contribution of deleterious off-targets to the transcriptome phenotypes of the edited mutants. Notably, DANGER analysis harnessed de novo transcriptome assembly to perform risk-averse on/off-target assessments without a reference genome. Thus, our resources would help assess genome editing in non-model organisms, individual human genomes, and atypical genomes from diseases and viruses. In conclusion, DANGER analysis facilitates the safer design of genome editing in all organisms with a transcriptome.

Availability and implementation

The Script for the DANGER analysis pipeline is available at https://github.com/KazukiNakamae/DANGER_analysis. In addition, the software provides a tutorial on reproducing the results presented in this article on the Readme page. The Docker image of DANGER_analysis is also available at https://hub.docker.com/repository/docker/kazukinakamae/dangeranalysis/general.
Phylogeny and infrageneric classification of Clerodendrum (Lamiaceae)
Authors: Satthaphorn Jiratthi , Paton Alan J , Zuntini Alexandre R , Cowan Robyn S , Leeratiwong Charan
Published: August 2023

The infrageneric classification of the genus Clerodendrum (Lamiaceae) has been highly problematic due to different concepts and subdivisions being applied to the treatment of Asian, Australian, and African species. Earlier molecular phylogenetic studies based on Sanger sequencing and limited sampling have indicated that previous morphology-based infrageneric classifications are not congruent with the phylogeny due to morphological convergence in many lineages. Advances in high-throughput DNA sequencing provide more information allowing more robust phylogenetic reconstruction at larger scale. We present the first comprehensive phylogenetic study of Clerodendrum that includes representatives of all previously recognized infrageneric taxa and using targeted sequencing data obtained from the Angiosperms353 enrichment to resolve the phylogenetic relationships. In agreement with previous phylogenetic work, our phylogeny shows that Asian and Australian species form a sister clade to an African Clade. Clerodendrum is monophyletic with the exclusion of some tropical coastal species, including some Australian species, which fall within a clade containing Volkameria and New World genera. We recognize two subgenera: subgen. Clerodendrum for Asian and Australian species and the new subgen. Afroclerodendrum for African and Malagasy species. Our findings support an infrageneric classification of Clerodendrum with a total of 13 sections based on molecular phylogenetic evidence and morphology that clearly accommodate the Asian, remaining Australian, and African species. Of these, we propose three new sections: sect. Albiflora, sect. Fortunata and sect. Megaflora for clades presenting unique morphological characters. The sectional classification and taxonomic consequences are discussed.
Characteristics and Outcomes of US Veterans With Immunocompromised Conditions at High Risk of SARS-CoV-2 Infection With or Without Receipt of Oral Antiviral Agents
Authors: Gentry Chris A , Nguyen Phoi N , Thind Sharanjeet K , Kurdgelashvili George , Williams Riley J
Published: August 2023

Objectives

Molnupiravir and nirmatrelvir-ritonavir were the first oral antiviral agents to demonstrate reduced hospitalization or death in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but patients with immunocompromised conditions were not well-represented. The objective of this study was to characterize and compare the clinical outcomes of US veterans with immunocompromised conditions prescribed oral antivirals with those who did not receive oral antivirals for mild-to-moderate SARS-CoV-2 active infection.

Methods

This was a retrospective, observational, nationwide propensity-matched analysis of US veterans with immunocompromised conditions who developed documented SARS-CoV-2 infection. The primary outcome was the composite of any hospitalization or death within 30 days of diagnosis. Secondary outcomes included 30-day comparative rates of (1) any hospitalization, (2) death, (3) intensive care requirement, and (4) subset analyses of outcomes by oral antiviral used and vaccination status.

Results

The composite primary outcome was significantly lower in patients receiving oral antiviral therapy compared with those who did not (23/390 [5.9%] vs 57/390 [14.6%]; odds ratio, 0.37; 95% confidence interval, .22–.61). This difference was driven largely by fewer deaths in the oral antiviral group (1/390 [0.3%] vs 19/390 [4.9%]; odds ratio, 0.05; 95% confidence interval, .007–.38). There was no significant difference in rate of intensive care requirement. The composite outcome was improved in vaccinated patients (completing the first series or first booster dose) who received oral antiviral agents compared with those who did not receive oral antiviral agents. Compared with those prescribed nirmatrelvir-ritonavir, patients given molnupiravir were older, had a higher incidence of cautions/contraindications, greater prevalence of tobacco use, and more cardiovascular complications.

Conclusions

Use of molnupiravir or nirmatrelvir-ritonavir was associated with lower incidences of hospitalization or death within 30 days of diagnosis in US veterans with immunocompromised conditions, regardless of vaccination status. These findings support the use of either oral antiviral in this patient population.
Multiple paternity in the invasive spotted lanternfly (Hemiptera: Fulgoridae)
Authors: Belouard Nadège , Behm Jocelyn E
Published: August 2023

In biological invasions, multiple paternity can preserve genetic diversity over time and space and contribute to invasion success. Therefore, knowledge on the mating system of invasive species is essential to develop adequate management practices to mitigate their impact on ecosystems. The spotted lanternfly, Lycorma delicatula (White, 1845), is an invasive pest that has colonized more than 10 eastern US states in less than 10 yr. Multiple paternity may contribute to its success, but little is known about spotted lanternfly’s mating system. We explored the mating system using mated females and female–egg mass pairs sampled in the field. First, we assessed the existence of multiple mating by counting the number of spermatophores in the genital tract of all females. Second, we searched for genetic evidence for multiple paternity within egg masses by genotyping the female–egg mass pairs at 7 microsatellite loci. Third, we assessed whether multiple mating was correlated with female traits and distance from the introduction site. One to 3 spermatophores per female were found during dissections, confirming the existence of polyandrous female spotted lanternfly. We found genetic evidence for a minimum of 2 fathers in 4 egg masses associated with polyandrous females, validating multiple paternity in spotted lanternfly. Multiple paternity was associated with egg mass size, and multiple paternity was highest in populations closest to the original introduction site and decreased toward the invasion front. Multiple paternity may contribute to the invasion success of spotted lanternfly, and control efforts should consider the mating system and the implications of its spatial patterns.
Aortic valve visualization and pressurization device: a novel device for intraoperative evaluation of aortic valve repair procedures
Authors: Arabkhani Bardia , Sandker Stefan C , Braun Jerry , Hjortnaes Jesper , van Brakel Thomas J , Koolbergen Dave R , Klautz Robert J M , Hazekamp Mark G
Published: August 2023

OBJECTIVES

Aortic valve repair procedures are technically challenging, and current intraoperative evaluation methods often fail to predict the final echocardiographic result. We have developed a novel intraoperative aortic valve visualization and pressurization (AVP) device, enabling valve inspection under physiological conditions, and measuring aortic valve insufficiency (AI) during cardioplegic arrest.

METHODS

The AVP device is attached to the (neo)aorta, after any type of aortic valve repair, while the heart is arrested. The root is pressurized (60–80 mmHg) using a saline solution and an endoscope is introduced. The valve is inspected, and the amount of valvular leakage is measured. Postoperative ‘gold standard’ transesophageal echocardiogram measurements of AI are performed and compared against regurgitation volume measured.

RESULTS

In 24 patients undergoing valve-sparing root replacement, the AVP device was used. In 22 patients, postoperative echocardiographic AI was ≤ grade 1. The median leakage was 90 ml/min, IQR 60–120 ml/min. In 3 patients, additional adjustments after visual inspection was performed. In 2 patients, with complex anatomy, the valve was replaced. In one, after evaluation with the device, there was undesirable result visually and residual AI of 330 ml/min, and in another, 260 ml/min residual AI was measured and valve restriction on visual inspection.

CONCLUSIONS

The novel AVP device enables intraoperative evaluation of the valve under physiological conditions, while still on arrested heart, and allows for targeted adjustments. The AVP device can be an important aid for intraoperative evaluation of the aortic valve, during valve repair and valve-sparing procedures, thereby making the operative result more predictable and the operation more efficient.
Efficacy and complications of inoperable malignant distal biliary obstruction treatment by metallic stents: fully covered or uncovered?
Authors: Gu Jiangning , Guo Xiaoyi , Sun Yong , Fan Bin , Li Haoran , Luo Ting , Luo Haifeng , Liu Jiao , Gao Feng , Gao Yuan , Tan Guang , Liu Xiaoming , Yang Zhuo
Published: August 2023

Obstructive jaundice caused by malignant distal biliary obstruction is a common clinical symptom in patients with inoperable biliary–pancreatic cancer. Endoscopic retrograde cholangiopancreatography (ERCP)-guided stent implantation is an effective treatment for obstructive jaundice. Internal stent drainage is more physiologic and associated with a better quality of life than external stent drainage methods such as percutaneous transhepatic gallbladder drainage or percutaneous transhepatic cholangiodrainage. Self-expanding metallic stents, which may be covered and uncovered, are commonly used. However, some uncertainties remain regarding the selection of metallic stents, including drainage patency time, clinical effect, stent migration, and post-operative complications such as pancreatitis, bleeding, and cholecystitis. This review aims to summarize the current progress and controversies surrounding the use of covered or uncovered metallic stents in inoperable common biliary obstruction via ERCP.
Post-COVID trends in hospital financial performance: updated data from California paint an improved but challenging picture for hospitals and commercially insured patients
Authors: Melnick Glenn , Maerki Susan
Published: August 2023

The COVID-19 pandemic caused major disruptions to the operation and financing of US acute care hospitals. Previous research has documented early effects of the COVID pandemic on hospital financial performance. This paper updates the literature with current data on utilization and financial performance for a large sample of California hospitals covering the period 2017 through the end of 2022 and the first quarter of 2023. The data show that, while hospital overall utilization has largely returned to pre-COVID levels, patient mix has changed and financial performance still lags. Hospital net income margins remain below pre-COVID levels which could trigger price increases to commercially insured patients to offset continuing post-COVID financial shortfalls.
Promoting health in the digital environment: health policy experts’ responses to on-demand delivery in Aotearoa New Zealand
Authors: McKerchar Christina , Bidwell Susan , Curl Angela , Pocock Tessa , Cowie Matt , Miles Hannah , Crossin Rose
Published: August 2023

Services offering on-demand delivery of unhealthy commodities, such as fast food, alcohol and smoking/vaping products have proliferated in recent years. It is well known that the built environment can be health promoting or harmful to health, but there has been less consideration of the digital environment. Increased availability and accessibility of these commodities may be associated with increased consumption, with harmful public health implications. Policy regulating the supply of these commodities was developed before the introduction of on-demand services and has not kept pace with the digital environment. This paper reports on semi-structured interviews with health policy experts on the health harms of the uptake in on-demand delivery of food, alcohol and smoking/vaping products, along with their views on policies that might mitigate these harms. We interviewed 14 policy experts from central and local government agencies and ministries, health authorities, non-Government Organisations (NGOs) and university research positions in Aotearoa New Zealand using a purposive sampling strategy. Participants concerns over the health harms from on-demand services encompassed three broad themes—the expansion of access to and availability of unhealthy commodities, the inadequacy of existing restrictions and regulations in the digital environment and the expansion of personalized marketing and promotional platforms for unhealthy commodities. Health policy experts’ proposals to mitigate harms included: limiting access and availability, updating regulations and boosting enforcement and limiting promotion and marketing. Collectively, these findings and proposals can inform future research and public health policy decisions to address harms posed by on-demand delivery of unhealthy commodities.
Modular Gelfand Pairs and Multiplicity-Free Representations
Authors: Zhang Robin
Published: August 2023

Over algebraically closed fields of arbitrary characteristic, we prove a general multiplicity-freeness theorem for finitely-generated modules with commutative endomorphism rings. Using more lenient versions of projectivity and injectivity for modules, this gives a generalization of Gelfand’s criterion on the commutativity of Hecke algebras for Gelfand pairs and multiplicity-free triples. For representations of finite and profinite groups, Gelfand pairs over the complex numbers are therefore also Gelfand pairs over the algebraic closure of any finite field. Applications include the uniqueness of Whittaker models of Gelfand–Graev representations in arbitrary characteristic and the uniqueness of modular trilinear forms on irreducible representations of quaternion division algebras over local fields.
BCS Women at the UN
Authors:   BCS
Published: August 2023

The 67th session of the United Nations' Commission on the Status of Women (CSW67) took place in March 2023. Three BCS members were delegates and reported on some of the sessions.
The Evolution of the Sustainable, Intelligent City
Authors: Powell Grant
Published: August 2023

Grant Powell MBCS spoke to Professor Julie McGann, Head of the Adaptive Emergent Systems Engineering (AESE) group at the Imperial College London's Department of Computing to discuss how data-driven insights can help to develop greener, cleaner cities.
National point-prevalence survey of healthcare-associated infections and antimicrobial use: UK-PAS/UKHSA joint call to action for all paediatric services
Authors: Channon-Wells Samuel , Elmes Jocelyn , Muller-Pebody Berit , McGarrity Orlagh , Chappell Faye , Drysdale Simon B , Ashiru-Oredope Diane , Patel Sanjay , Demirjian Alicia
Published: August 2023

The negative impact of high antimicrobial use (AMU), antimicrobial resistance and healthcare-associated infections (HCAIs) on children is concerning. However, a lack of available paediatric data makes it challenging to design and implement interventions that would improve health outcomes in this population, and impedes efforts to secure additional resources. The upcoming 2023 national point-prevalence survey of HCAIs and AMU in hospitals, led by the UK Health Security Agency, is an opportunity to collect valuable information, which will enable healthcare providers and policy makers to optimize antimicrobial stewardship and infection prevention practices in all populations, including children. These data will facilitate benchmarking and sharing of best practice, internally, nationally and internationally. This is a joint call to action asking all healthcare professionals—particularly in paediatrics—to nominate a lead for their institution and participate in this survey, to ensure appropriate paediatric representation, and help protect children from these growing threats.
Observations of the association by early-juvenile western rock lobsterPanulirus cygnuswith seagrass assemblages (Decapoda: Achelata: Palinuridae)
Authors: Oh Daphne , Langlois Tim J , Brooker Michael A , Salinas Hugo , How Jason R , de Lestang Simon N
Published: August 2023

The fishery of the western rock lobster, Panulirus cygnusGeorge, 1962, is Australia’s most valuable wild-caught single-species fishery. Recruitment in some regions of the fishery was observed to be significantly lower than expected after the 2010/2011 West Australian marine heatwave that caused extensive disturbance of dominant coastal habitats. This event generated interest in the study of the factors influencing survival and recruitment of post-larval benthic P. cygnus after settlement. The habitat associations of the highly cryptic post-settlement early-juveniles were previously unknown, with only anecdotal observations of individuals within limestone crevices in nearshore habitats. Our study used early-juveniles derived from ongoing monitoring of puerulus settlement to examine their habitat association mechanism in mesocosm experiments. Comparison of common nearshore habitat assemblages (bare sand, limestone crevices, and seagrasses (Posidonia and Amphibolis) at varying seagrass densities) found that most early-juveniles associated strongly with Amphibolis assemblages at high stem densities (~2,100 stems m–2). A shift in association between Amphibolis fronds and stems at high stem density to Amphibolis-shaded sand and leaf debris at low stem density indicated active habitat selection by early-juveniles. Habitat choices were tested with the scents of prey items and habitat types within Amphibolis assemblages using Y-maze bioassays. No significant olfactory choices were found, suggesting that habitat associations may be driven by multiple cues. Our study provides new laboratory-based insights into the habitat association of early-juvenile P. cygnus and suggests changes in seagrass assemblage identity and density are likely to be important. Further experimentation is needed to define the cues driving these patterns. The impact of habitat change on recruitment in this important fishery remains unknown and should be an objective of future research.
Computational design towards energy efficient optimization in overconstrained robotic limbs
Authors: Gu Yuping , Wang Ziqian , Feng Shihao , Sun Haoran , Lu Haibo , Pan Jia , Wan Fang , Song Chaoyang
Published: August 2023

Legged robots are constantly evolving, and energy efficiency is a major driving factor in their design. However, combining mechanism efficiency and trajectory planning can be challenging. This work proposes a computational optimization framework for optimizing leg design during basic walking while maximizing energy efficiency. We generalize the robotic limb design as a four-bar linkage-based design pool and optimize the leg using an evolutionary algorithm. The leg configuration and design parameters are optimized based on user-defined objective functions. Our framework was validated by comparing it to measured data on our prototype quadruped robot for forward trotting. The Bennett robotic leg was advantageous for omni-directional locomotion with enhanced energy efficiency.
Mediating social support through sensor-based technologies for children’s health behavior change
Authors: Baldwin Joshua , Lee Joomi , Tate Allan D , Okitondo Christian D , Johnsen Kyle , Schmidt Michael D , Rathbun Stephen , Novotny Eric , Ahn Sun Joo (Grace)
Published: August 2023

Sensor-based technologies (SBTs) allow users to track biometric data and feature interactions that foster social support. The social support from SBTs can increase intrinsic motivation to engage in and sustain positive health behaviors. Guided by technological affordances and self-determination theory, this study tested the long-term efficacy of an ecosystem of SBTs to strengthen social support for children’s behavior change, children’s perceived relatedness, and positive physical activity (PA) attitudes. This ecosystem integrated Fitbits tracking each child’s PA, kiosks with virtual agents that synced with Fitbit data, and a messaging system for parents and children. Afterschool programs (N = 19) were randomly set with this ecosystem or a Fitbit with a computer for 6 months. Results suggested that parents of girls provided more social support to children via the ecosystem than parents of boys. Children’s perceived support from the virtual agent was positively associated with perceived relatedness and PA attitudes over time.
Identification of sex-specific markers based on gene expression in adult Colorado potato beetles
Authors: Warcup Kirsten , Torson Alex S , Yocum George D
Published: August 2023

The Colorado potato beetle, Leptinotarsa decemlineata, (Coleoptera: Chrysomelidae) is an economically important pest insect of potatoes. Understanding how the mechanisms driving its invasiveness vary between sexes will be critical for developing modern control methods. However, the currently available methods for sexing adult Colorado potato beetles are either inefficient or unsuitable for projects that require RNA as an input, like those measuring gene expression. Therefore, the development of simple molecular tools that are tailored to these studies is important. In this study, we used publicly available RNA-seq data to select 5 candidate genes for sex-specific markers in adult Colorado potato beetles. We confirmed that our 5 marker candidates exhibit a sex-specific expression pattern and can be used as PCR markers for sex determination. This method of sex detection will allow researchers to distinguish the sex of the individual with a simple PCR reaction using cDNA as the template and assign sex to RNA-seq samples post hoc.
Outcomes of lung oligometastasis in pancreatic cancer
Authors: Takeda Tsuyoshi , Sasaki Takashi , Ichinose Junji , Inoue Yosuke , Okamoto Takeshi , Mie Takafumi , Furukawa Takaaki , Kasuga Akiyoshi , Oba Atsushi , Matsuura Yosuke , Nakao Masayuki , Ozaka Masato , Mun Mingyon , Takahashi Yu , Sasahira Naoki
Published: August 2023

Objective

Pancreatic cancer with lung oligometastasis may have favourable overall survival. The aim of this study was to evaluate outcomes of pancreatic cancer with lung oligometastases including both synchronous and metachronous metastases.

Methods

Consecutive pancreatic cancer patients with lung metastasis treated at our institution between February 2015 and December 2021 were identified from our prospectively maintained database. Clinical characteristics and outcomes were compared and analysed according to the extent of lung metastases. Predictors for overall survival were analysed using the Cox proportional hazards model.

Results

A totoal of 171 patients were included (oligometastasis/polymetastasis/multi-organ metastasis: 34/50/87). Patients with oligometastases were more likely to undergo surgical resection (41% vs. 0% vs. 2%) and showed a longer median overall survival (41.3 vs. 17.6 vs. 13.1 months) compared with those with other types of metastases. Oligometastasis (hazard ratio, 0.43; 95% confidence interval, 0.24–0.76; P = 0.004) was identified as an independent factor predicting favourable overall survival in patients with lung-only metastasis. Disease status (synchronous vs. metachronous) was not associated with survival in patients with oligometastasis (29.4 vs. 41.3 months, P = 0.527) and polymetastasis (17.9 vs. 16.7 months, P = 0.545). Selected patients who underwent surgical resection showed a median overall survival of 52.7 months.

Conclusions

Patients with lung oligometastases presented a favourable prognosis. Surgical resection in selected patients was associated with a long median overall survival.
Efficacy and safety of dose-dense neoadjuvant chemotherapy with nab-paclitaxel followed by epirubicin and cyclophosphamide for operable breast cancer
Authors: Matsumoto Akiko , Jinno Hiromitsu , Naruse Saki , Isono Yuka , Maeda Yuka , Sato Ayana , Yamada Miki , Ikeda Tatsuhiko , Sasajima Yuko
Published: August 2023

Objective

Dose-dense chemotherapy has shown a better prognosis than standard interval chemotherapy in adjuvant settings for high-risk breast cancer. This study aimed to evaluate the efficacy and safety of dose-dense nanoparticle albumin-bound paclitaxel followed by dose-dense epirubicin and cyclophosphamide as neoadjuvant chemotherapy for human epidermal growth factor 2 (HER2)-negative operable breast cancer.

Methods

Patients with histologically confirmed stage I–III HER2-negative breast cancer were enrolled in this study. Patients received nanoparticle albumin-bound paclitaxel (260 mg/m2) followed by epirubicin (90 mg/m2) and cyclophosphamide (600 mg/m2) every 2 weeks with pegfilgrastim. The primary endpoint was the pathological complete response rate. Patients also underwent prophylactic management for peripheral neuropathy, which involved a combination of cryotherapy, compression therapy using elastic stockings and medications including goshajinkigan.

Results

Among the 55 patients enrolled in this study, 13 (23.6%) achieved pathological complete response, of whom 10/26 (38.5%) patients had triple-negative disease and 3/29 (10.3%) had luminal disease. The objective response was observed in 46 (83.6%) patients. Of the 36 patients who were initially planned for mastectomy, 11 (30.6%) underwent breast-conserving surgery after neoadjuvant chemotherapy. The most common grade 3–4 adverse events were myalgia (14.5%), fatigue (12.7%) and elevated transaminase levels (9.1%). No patients experienced febrile neutropenia. Eight (14.5%) patients discontinued treatments due to adverse events.

Conclusions

Neoadjuvant dose-dense biweekly nanoparticle albumin-bound paclitaxel followed by dose-dense epirubicin and cyclophosphamide was effective, especially in patients with triple-negative disease, and feasible with pegfilgrastim support.