bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary Flow Management by Combination Therapy of Hemostatic Clipping and Balloon Angioplasty for Right Ventricular-Pulmonary Artery Shunt in Hypoplastic Left Heart Syndrome
Authors: Shigemitsu Yusuke , Kondo Maiko , Kurita Yoshihiko , Fukushima Yosuke , Kawamoto Yuya , Hirai Kenta , Hara Mayuko , Kanazawa Tomoyuki , Iwasaki Tatsuo , Kasahara Shingo , Kataoka Koichi , Tsukahara Hirokazu , Baba Kenji
Published: July 2024

Controlling pulmonary blood flow in patients who have undergone Norwood palliation, especially early postoperatively, is challenging due to a change in the balance of systemic and pulmonary vascular resistance. We applied a combination therapy of clipping and balloon angioplasty for right ventricle—pulmonary artery (RV-PA) shunt to control pulmonary blood flow, but the influence of the combination therapy on the PA condition is uncertain. Retrospectively analysis was conducted of all infants with hypoplastic left heart syndrome who had undergone Norwood palliation with RV-PA shunt at Okayama University Hospital from January 2008 to September 2022. A total of 50 consecutive patients underwent Norwood palliation with RV-PA shunt in this study period. Of them, 29 patients underwent RV-PA shunt flow clipping, and the remaining 21 had unclipped RV-PA shunt. Twenty-three patients underwent balloon angioplasty for RV-PA shunt with clips. After balloon angioplasty, oxygen saturation significantly increased from 69 (59–76)% to 80 (72–86)% (p < 0.001), and the narrowest portion of the clipped conduit significantly improved from 2.8 (1.8–3.4) to 3.8 (2.9–4.6) mm (p < 0.001). In cardiac catheterizations prior to Bidirectional cavo-pulmonary shunt (BCPS), there were no significant differences in pulmonary-to-systemic flow ratio (Qp/Qs), ventricular end-diastolic pressure, Nakata index, arterial saturation, mean pulmonary artery pressure and pulmonary vascular resistance index. On the other hand, in Cardiac catheterizations prior to Fontan, Nakata index was larger in the clipped group (p = 0.02). There was no statistically significant difference in the 5-year survival between the two groups (clipped group 96%, unclipped group 74%, log-rank test: p = 0.13). At least, our combination therapy of clipping and balloon angioplasty for RV-PA shunt did not negatively impact PA growth. Although there is a trend toward better but not statistically significant difference in outcomes in the clipped group compared to the non-clipped group, this treatment strategy may play an important role in improving outcomes in hypoplastic left heart syndrome.
Exploring the viability of Virtual Reality as a teaching method for knee aspiration
Authors: Singh Mantaj , Smitham Peter , Jain Suyash , Day Christopher , Nijman Thomas , George Dan , Neilly David , de Blasio Justin , Gilmore Michael , Gill Tiffany K. , Proudman Susanna , Nimon Gavin
Published: July 2024

Knee arthrocentesis is a simple procedure commonly performed by general practitioners and junior doctors. As such, doctors should be competent and comfortable in performing the technique by themselves; however, they need to be adequately trained. The best method to ensure practitioner proficiency is by optimizing teaching at an institutional level, thus, educating all future doctors in the procedure. However, the Coronavirus Disease 19 (COVID-19) pandemic caused significant disruption to hospital teaching for medical students which necessitated investigating the effectiveness of virtual reality (VR) as a platform to emulate hospital teaching of knee arthrocentesis. A workshop was conducted with 100 fourth year medical students divided into three Groups: A, B and C, each receiving a pre-reading online lecture. Group A was placed in an Objective Structured Clinical Examination (OSCE) station where they were assessed by a blinded orthopaedic surgeon using the OSCE assessment rubric. Group B undertook a hands-on practice station prior to assessment, while Group C received a VR video (courtesy of the University of Adelaide’s Health Simulation) in the form of VR headset or 360° surround immersion room and hands-on station followed by the OSCE. Upon completion of the workshop, students completed a questionnaire on their confidence with the procedure and the practicality of the VR station. OSCE scores were compared between Groups B and C to investigate the educational value of VR teaching. On average, students with VR headsets reported higher confidence with the procedure and were more inclined to undertake it on their own. Students in Group C who used the VR station prior to assessment scored higher than the non-VR Groups (Group A, 56%; Group B, 67%; Group C 83%). Students in Group A had statistically significant results on average compared to those in Group B (t(69) = 3.003, p = 0.003), as do students in Group B compared to Group C (t(62) = 5.400, p < 0.001). Within Group C students who were given VR headsets scored higher than immersion room students. The VR headset was beneficial in providing students with a representation of how knee arthrocentesis may be conducted in the hospital setting. While VR will not replace conventional in-hospital teaching, given current technological limitations, it serves as an effective teaching aid for arthrocentesis and has many other potential applications for a wide scope of medicine and surgical training.
Evaluating the Accuracy and Impact of the ESR-iGuide Decision Support Tool in Optimizing CT Imaging Referral Appropriateness
Authors: Luxenburg Osnat , Vaknin Sharona , Wilf-Miron Rachel , Saban Mor
Published: July 2024

Radiology referral quality impacts patient care, yet factors influencing quality are poorly understood. This study assessed the quality of computed tomography (CT) referrals, identified associated characteristics, and evaluated the ESR-iGuide clinical decision support tool’s ability to optimize referrals. A retrospective review analyzed 300 consecutive CT referrals from an acute care hospital. Referral quality was evaluated on a 5-point scale by three expert reviewers (inter-rater reliability κ = 0.763–0.97). The ESR-iGuide tool provided appropriateness scores and estimated radiation exposure levels for the actual referred exams and recommended exams. Scores were compared between actual and recommended exams. Associations between ESR-iGuide scores and referral characteristics, including the specialty of the ordering physician (surgical vs. non-surgical), were explored. Of the referrals, 67.1% were rated as appropriate. The most common exams were head and abdomen/pelvis CTs. The ESR-iGuide deemed 70% of the actual referrals “usually appropriate” and found that the recommended exams had lower estimated radiation exposure compared to the actual exams. Logistic regression analysis showed that non-surgical physicians were more likely to order inappropriate exams compared to surgical physicians. Over one-third of the referrals showed suboptimal quality in the unstructured system. The ESR-iGuide clinical decision support tool identified opportunities to optimize appropriateness and reduce radiation exposure. Implementation of such a tool warrants consideration to improve communication and maximize patient care quality.
School Dropout, Absenteeism and Coverage of Sexual and Reproductive Health Services in South Africa: Are Those Most at Risk Reached?
Authors: McClinton Appollis Tracy , Mathews Catherine , Lombard Carl , Jonas Kim
Published: July 2024

School attendance or completion is important for adolescents’ development. Adolescents who drop out or are regularly absent from school are at higher risk of adverse sexual and reproductive health (SRH) outcomes. However, there is little evidence evaluating SRH service coverage among adolescents in and out of school. In the context of a large-scale combination HIV and pregnancy prevention intervention funded by the Global Fund, we compared the SRH intervention coverage and SRH risks among adolescent girls who dropped out of school with those who were still in school or who had completed grade 12 in South Africa. Among those still in school, we compared the SRH intervention coverage and SRH risk profiles of those with high versus low or no absenteeism. In 2017 to 2018, we conducted a household survey of adolescent girls aged 15 to 19 years in six of the ten combination intervention districts. Of 2515 participants, 7.6% had dropped out of school. Among the 1864 participants still in school, 10.8% had high absenteeism. Ever having had sex, and condomless sex were more prevalent among dropouts compared with non-dropouts. Dropouts were more likely to access SRH services such as condoms and contraceptives, except the combination prevention intervention services which were more likely to reach those who had not dropped out and were equally likely to reach those in school with high versus low/no absenteeism. Combination SRH prevention programmes can improve the accessibility of SRH services for adolescents in school/who complete school.
Consumer Disposition Toward Fairness in Agri-Food Chains (FAIRFOOD): Scale Development and Validation
Authors: Del Prete Margherita , Golossenko Artyom , Gorton Matthew , Tocco Barbara , Samoggia Antonella
Published: July 2024

Fairness in agri-food supply chains receives increasing consumer, industry, and political attention but is currently under-conceptualized and lacks appropriate frameworks for measurement. Therefore, building on a theoretically grounded conceptualization of consumer dispositions toward fairness in agri-food supply chains, we developed and validated a 14-item fairness measurement scale (FAIRFOOD). The scale comprises of four dimensions (economic, environmental, social, and informational) which are manifestations of the same construct (higher-order structure). We empirically validate the scale and its reliability using four studies and eight independent samples from Italy (n = 1386) and the UK (n = 1379). The findings reveal that FAIRFOOD is related, yet distinct from theoretically relevant constructs such as ethical consumption and pro-environment behavior. The FAIRFOOD scale is a strong predictor of outcomes such as willingness to purchase Fairtrade certified products, as well as boycott and negative Word of Mouth intentions if a brand treats other supply chain actors unfairly. Regarding business strategy, rather than focusing on one dimension of fairness independently, managers should adopt a holistic approach, devising initiatives that address all four dimensions in tandem.
Natural mercury exposure of European insectivorous bats may exceed a recognized toxicity threshold
Authors: Bandouchova Hana , Novotna Kruzikova Kamila , Zukal Jan , Linhart Petr , Sedlackova Jana , Veitova Lucie , Kalocsanyiova Vendula , Pikula Jiri , Svobodova Zdenka
Published: July 2024

Heavy metals are an important group of toxic substances harmful for many organisms. Of these, mercury is one of the most monitored in the environment. Several matrices are used for the monitoring of environmental load, including a range of organisms; bats, however, have only been examined rarely. Insectivorous bats are apex predators threatened by several human interventions in their natural environment, including heavy metal pollution. The aim of this study was to analyze the content of total mercury in the fur, flight membrane, and pectoral muscle of greater mouse-eared bats (Myotis myotis). Total mercury concentrations were also measured in carabid beetles from the catch locality Zastávka u Brna. Samples were obtained from 43 bat carcasses at two different localities in the Czech Republic (Zastávka u Brna, Malá Morávka). Total mercury content varied between 1.76–72.20 µg/g in fur, 0.04–0.14 µg/g in skin, and 0.05–0.20 µg/g in muscle. Total mercury values in the fur of some individuals from Malá Morávka exceeded the recognized toxicity limit. Furthermore, there was a significant difference (p < 0.001) in content of total mercury in fur between localities, and there was a clear effect of age on concentrations in fur, skin, and muscle, the concentrations being significantly correlated (fur and skin rs = 0.783; fur and muscle rs = 0.716; skin and muscle rs = 0.884). These findings confirm the usefulness of fur samples from living bats for biomonitoring mercury burden in the environment.
The density of Meissner polyhedra
Authors: Hynd Ryan
Published: July 2024

We consider Meissner polyhedra in $$\mathbb {R}^3$$

R

3

. These are constant width bodies whose boundaries consist of pieces of spheres and spindle tori. We define these shapes by taking appropriate intersections of congruent balls and show that they are dense within the space of constant width bodies in the Hausdorff topology. This density assertion was essentially established by Sallee. However, we offer a modern viewpoint taking into consideration the recent progress in understanding ball polyhedra and in constructing constant width bodies based on these shapes.
Chitosan, Glutamic Acid/Monocarboxylic Cobalt-Phthalocyanine, and Carboxymethyl Cellulose as Innovative Antimicrobial Amide Biocomposites
Authors: Abd El-Ghaffar M. A. , Hashem M. S. , Youssef Elham A. M. , Abdel-Aziz Mohamed S.
Published: July 2024

In this study, new efficient antimicrobial hybrid amide biocomposites were developed through the condensation of chitosan with monocarboxylic cobalt-phthalocyanine (MC-CoPc) and carboxymethyl cellulose (CMC), individually, as well as chitosan/(MC-CoPc)/glutamic acid and chitosan/(MC-CoPc)/CMC using a Dean and Stark apparatus in the presence of xylene as an aprotic solvent for 4 h until the required amount of water was collected. The resulting hybrid amide biopolymer chitosan condensation adducts were filtered, air-dried, washed several times with ethanol, and subsequently dried in an electric oven at 40 °C for 24 h. The hybrid amide chitosan biocomposites were characterized through spectrophotometric methods, including Fourier-transform infrared spectroscopy (FT-IR), ultraviolet–visible spectroscopy (UV–visible), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), and antimicrobial analyses against gram-positive and gram-negative bacteria, yeast, and fungi. The results confirmed the formation of hybrid chitosan amide biocomposites with very good antimicrobial properties. The efficiency of these hybrid biocomposites can be ranked as follows: chitosan/(MC-CoPc)/glutamic acid > chitosan/(MC-CoPc)/CMC > chitosan/(MC-CoPc) > chitosan/CMC. These results highlight the potential of these hybrid amide biocomposites as highly efficient antimicrobial materials suitable for use in drug delivery systems and other biomedical applications.
Re-thinging Embodied and Enactive Psychiatry: A Material Engagement Approach
Authors: Malafouris Lambros , Röhricht Frank
Published: July 2024

Emerging consensus among enactivist philosophers and embodied mind theorists suggests that seeking to understand mental illness we need to look out of our skulls at the ecology of the brain. Still, the complex links between materiality (in broadest sense of material objects, habits, practices and environments) and mental health remain little understood. This paper discusses the benefits of adopting a material engagement approach to embodied and enactive psychiatry. We propose that the material engagement approach can change the geography of the debate over the nature of mental disorders and through that help to develop theoretical and practical insights that could improve management and treatment for various psychiatric conditions. We investigate the potential role of Material Engagement Theory (MET) in psychiatry using examples of aetiologically different mental illnesses (schizophrenia and dementia) in respect of their shared phenomenological manifestations, focusing particularly on issues of memory, self-awareness, embodiment and temporality. The effective study of socio-material relations allows better understanding of the semiotic significance and agency of specific materials, environments and technical mediations. There is unrealised potential here for creating new approaches to treatment that can broaden, challenge or complement existing interventions and practices of care.
Purely periodic continued fractions and graph-directed iterated function systems
Authors: Panti Giovanni
Published: July 2024

We describe Gauss-type maps as geometric realizations of certain codes in the monoid of nonnegative matrices in the extended modular group. Each such code, together with an appropriate choice of unimodular intervals in $${{\,\textrm{P}\,}}^1\mathbb {R}$$

P

1

R

, determines a dual pair of graph-directed iterated function systems, whose attractors contain intervals and constitute the domains of a dual pair of Gauss-type maps. Our framework covers many continued fraction algorithms (such as Farey fractions, Ceiling, Even and Odd, Nearest Integer, $$\ldots $$
…
) and provides explicit dual algorithms and characterizations of those quadratic irrationals having a purely periodic expansion.
‘We Often Forget It Was a Disaster’: Cross-Curricular Teacher Collaboration to Develop a Curriculum Unit on the Titanic Disaster
Authors: Park Wonyong , Shaby Neta , Newman Rachele
Published: July 2024

There is a growing emphasis on integrating school subjects and cross disciplinary boundaries to address local and global challenges, particularly when teaching about complex and sensitive issues such as disasters. This study explores how the integration of science and history can facilitate learning about disasters through a cross-curricular teacher professional development project in England. Seven teachers (four history, three science) from state-funded secondary schools and two museum educators in Southampton, UK collaborated with university researchers over eight months to develop a curriculum unit on the Titanic disaster for Key Stage 3 pupils (aged 11–14). Through a qualitative analysis of teacher feedback, workshop recordings and artefacts, and interviews, we illustrate the teachers’ initial excitement at the prospect of cross-curricular integration and how this excitement was then tempered by practical and logistical challenges that prevented their integration ideas from materialising into the curriculum unit. Nevertheless, teachers found that the CPD helped them to see and attend to the connections across the curriculum. Teachers rediscovered Titanic as a tragic event with historical significance for local students, which needs to be taught with reverence and ethical sensitivity. Using the Titanic disaster as an example, the study points to the potential for cross-curricular integration and teacher collaboration in teaching about disasters holistically in secondary schools.
Topgrafting as a tool in operational Scots pine breeding
Authors: Heuchel Alisa , Hall David , Almqvist Curt , Wennström Ulfstand , Persson Torgny
Published: July 2024

Effective breeding requires multiplying desired genotypes, keeping them at a convenient location to perform crosses more efficiently, and building orchards to generate material for reforestation. While some of these aims can be achieved by conventional grafting involving only rootstock and scion, topgrafting is known to deliver all in a shorter time span. In this study, Scots pine scions were grafted onto the upper and lower tree crowns in two clonal archives with the aim of inducing early female and male strobili production, respectively. Their survival rates and strobili production were analyzed with generalized linear mixed models. Survival was low (14%) to moderate (41%), and mainly affected by the topgraft genotype, interstock genotype, crown position and weather conditions in connection with the grafting procedure. Survival was not affected by the cardinal position in the crown (south or north). Male flowering was ample three years after grafting and reached 56% in the first year among live scions, increasing to 62 and 59% in consecutive years. Female flowering was scarce and was 9% at first, later increasing to 26 and 20% of living scions but was strongly affected by the topgraft genotype. In one subset of scions, female flowering was observed 1 year after grafting. Overall, flowering success was mainly affected by the topgraft and interstock genotypes, and secondary growth of scions. This is one of few reports on topgrafting in functional Scots pine clonal archives.
Injury incidence in golf—a systematic review and meta-analysis
Authors: Kuitunen Ilari , Ponkilainen Ville T.
Published: July 2024

Objective

There is a lack of comprehensive analysis of injuries in golf per exposure time. Thus, the aim was to report the pooled incidence of injuries in golf.

Methods

We searched PubMed, Scopus, SPORTDiscus, and Web of Science databases in March 2024 for this systematic review and meta-analysis. We included observational studies reporting the number of injuries per exposure time. A random-effects model was used to calculate the pooled injury incidence per 1000 athlete exposures (18 holes of golf) with 95% confidence intervals (CI). Incidences were separately analyzed for men, women, amateurs, professionals, and special athletes.

Results

A total of 999 studies were screened, 29 full texts were assessed, and 7 studies with 269,754 athlete exposures were included. Seven studies assessed the overall incidence of injury, and the pooled estimate was 2.5 per 1000 athlete exposures (CI 0.9–7.5). The incidence was higher in special athletes (21.0, CI 7.7–45.1; one study) than among professionals (8.5, CI 7.6–9.4; one study), or in amateurs (1.3, CI 0.5–4.0; five studies). The injury incidence was 2.6 per 1000 athlete exposures (CI 0.7–9.6; four studies) in women and 1.4 per 1000 athlete exposures (CI 0.4–5.2; three studies) in men. A sensitivity analysis without special athletes had an incidence of 1.9 (CI 0.7–4.9; six studies).

Conclusion

The injury incidence in golf is 2.5 injuries per 1000 athlete exposures (18 holes of golf). Reporting was limited as only one study reported injuries per exposure time in professionals, and in total, only seven studies were found. More research is needed in all levels and age groups to better estimate the injury incidence and associated risk factors in golf.
New insights into chronic inducible urticaria
Authors: Muñoz Melba , Kiefer Lea Alice , Pereira Manuel P. , Bizjak Mojca , Maurer Marcus
Published: July 2024

Purpose of Review

Chronic inducible urticaria (CIndU) is a group of long-persisting and challenging to manage diseases, characterized by recurrent wheals and angioedema induced by definite triggers. In this review, we address recent findings on CIndU pathogenesis, diagnosis as well as its treatment, and we discuss novel potential targets that may lead to the development of more effective therapies for CIndU patients.

Recent Advances

Meaningful advances in the understanding of its pathogenesis have been reported in the last decades. Novel CIndU-specific patient-reported outcome measures enable a closer and better evaluation of patients.

CIndU is a hard-to-treat disease that highly impairs quality of life (QoL) of affected patients. Provocation tests allow to diagnose CIndU subtypes. The only licensed and recommended treatment for CIndU are second generation non-sedating H1-antihistamines, which lack efficacy in many cases. Omalizumab off-label use has been assessed in all types of CIndU with overall good outcomes. Promising emerging therapies currently assessed in chronic spontaneous urticaria are paving the path for novel treatments for CIndU
Insights into insulin analog cross-reactivity: a comparative study of Siemens Atellica and LC-MS/MS
Authors: Li Jieli , Hatten-Beck Maya , Lee Jason K. Y. , Hoofnagle Andrew N.
Published: July 2024

Background

To address the challenges posed by inconsistent detection of analog insulin in commercially available insulin immunoassays, resulting in potential discrepancies in clinical findings and misdiagnosis during the investigation of factitious hypoglycemia., we aimed to evaluate the ability of the Siemens Atellica automated immunoassay to detect insulin analogs compared with LC-MS/MS.

Methods

Five insulin analogs were analyzed at 10 ng/mL spiked into serum samples, with recombinant human insulin as positive controls. Insulin and C-peptide assays were performed using Siemens Atellica and LC-MS/MS. Recovery rates were calculated.

Results

Siemens Atellica immunoassay demonstrated robust cross-reactivity (92–121%) of insulin analogs. In contrast, glargine was detected by LC-MS/MS but other analogs were not observed (<10% recovery).

Conclusion

Our results indicate that the insulin assay conducted on the Siemens Atellica platform could be used to diagnose factitious hypoglycemia by detecting the specific insulin analogs involved. The findings from our studies indicate the suitability of this method for clinical laboratory use in cases where factitious hypoglycemia is under consideration as a potential diagnosis. Clinicians should take these results into account when interpreting insulin measurements, particularly in instances where insulin analog overdose is suspected.
Chaos Control and Synchronization of a New Fractional Laser Chaotic System
Authors: Eshaghi Shiva , Kadkhoda Nematollah , Inc Mustafa
Published: July 2024

In this article, we introduce a new fractional laser chaotic system derived from the Lorenz–Haken equations. We investigate the complex dynamics of the proposed system consisting chaos, stability, control and synchronization of chaos. Moreover, we numerically reveal the nonlinear dynamics of the fractional laser chaotic system through the phase portraits, time histories and bifurcation diagrams. Also, we indicate the chaotic behaviors of the system by means of Lyapunov exponents, bifurcation diagrams versus all parameters along the state variables, phase portraits and time histories with different trajectories and initial conditions. The necessary conditions to eliminate the chaotic vibration of the system are obtained via the feedback control procedure. Meanwhile, a synchronization mechanism based on the feedback control technique is achieved for coupled fractional laser chaotic systems. Furthermore, we show that the fractional derivative order is very effective on reducing the irregular and chaotic behaviors of the system.
Neutrophil extracellular traps-related lncRNAs prognostic signature for gastric cancer and immune infiltration: potential biomarkers for predicting overall survival and clinical therapy
Authors: Yang Shuhan , Liang Jiahui , Wang Xin , Qi Yijun , Chan Shixin , Song Yonghu , Pei Xiaohan , Ren Zhiyao
Published: July 2024

Gastric cancer (GC) is one of the most common digestive tract malignant tumors in the world. At the time of initial diagnosis, it frequently presents with local or distant metastasis, contributing to poor prognosis in patients. Neutrophil extracellular traps (NETs) constitute a mechanism employed by neutrophils that is intricately associated with tumor progression, prognosis, and response to immunotherapy and chemotherapy. Despite this, the specific involvement of NETs-related long non-coding RNAs (lncRNAs) in gastric cancer remains unclear. A prognostic model for NETs-related lncRNAs was constructed through correlation analysis, COX regression analysis, and least absolute shrinkage and selection operator regression (LASSO) analysis. The predictive performance of the model was assessed using Kaplan–Meier survival curves, receiver operating characteristic (ROC) curves, facilitating the exploration of the relationship between disease onset and prognosis in gastric cancer. Additionally, differences in the tumor microenvironment and response to immunotherapy among gastric cancer patients across high- and low-risk groups were analyzed. Furthermore, a prognostic nomogram integrating the risk score with relevant clinicopathological parameters was developed. The prognostic prediction model for gastric cancer, derived from NETs-related lncRNAs in this study, demonstrates robust prognostic capabilities, serving as a valuable adjunct to traditional tumor staging. This model holds promise in offering novel guidelines for the precise treatment of gastric cancer, thereby potentially improving patient outcomes.
New Surgical Approaches to Scoliosis Repair in Pediatric Patients—Implications for Anesthetic Management
Authors: Ferschl Marla B. , Shibata Gail , Wong Jocelyn
Published: July 2024

Purpose of Review

The treatment of pediatric scoliosis has evolved over time. Newer treatment modalities provide alternative options for patients that optimize outcomes. In this manuscript, we will review pediatric scoliosis and focus on the anesthetic management techniques for its surgical correction.

Recent Findings

Many modifications to the surgical repair of scoliosis have occurred since the procedure was first performed in the 1960s. Improved surgical equipment and imaging techniques have improved outcomes for posterior spinal fusion. Many centers are now employing anterior spinal tethering procedures. In all cases, anesthetic techniques have been refined over time to improve pre-, intra-, and post-operative management.

Innovative surgical approaches and novel anesthetic protocols have impacted the management of patients with scoliosis. Future research is needed to further refine techniques.
Enhancing Human Comfort in eVTOL Aircraft Assisted by Control Moment Gyroscopes
Authors: Bhalla Sameer , Kim Donghoon , Choi Daegyun
Published: July 2024

This study investigates the integration of Control Moment Gyroscopes (CMGs) to enhance the comfort of human occupants in electric Vertical Take-Off and Landing (eVTOL) aircraft. Our study encompasses not only the development of a dynamic model for the eVTOL by integrating the CMGs but also the implementation of backstepping sliding mode-based controllers for translation and attitude control. To simulate realistic disturbance scenarios, wind disturbance models and a motor dynamics model are considered to replicate practical rotor responses. To validate the performance of the proposed approach, comprehensive Monte-Carlo simulations under varying wind conditions are performed. In particular, the aircraft oscillations are analyzed in the frequency domain to focus on a specific frequency that causes human discomfort. The simulation results demonstrate that the use of CMGs not only alleviates oscillations induced by wind disturbances with low power consumption but also significantly enhances passenger comfort.
Building collaboration and trust in emergency preparedness: a model for planning collaboration exercises
Authors: Elvegård Rune , Andreassen Natalia , Badu James
Published: July 2024

Collaborative preparedness exercises are essential in emergency management. In this conceptual paper, we examine the planning processes of emergency preparedness collaborative exercises, aiming to develop a model that enhances learning, collaboration, communication, and trust among participants. We propose a model that guides the planning of collaborative preparedness exercises, focusing on creating and maximizing knowledge among participants. The model emphasizes the importance of defining clear learning objectives, selecting engaging scenarios, and incorporating flexible exercise designs to improve effectiveness. By systematically integrating communication and trust-building strategies across planning, execution, debriefing, and evaluation phases, the model seeks to foster a collaborative environment conducive to shared learning and decision-making. This conceptual study contributes to the literature by offering a structured approach to exercise planning that could enhance the competencies of emergency preparedness organizations and improve collaborative efforts in crisis management. Future research could apply this model in practice and empirically evaluate its impact on emergency preparedness exercises across various sectors.
Enhancing Educational Technology in Lectures for School Students with Learning Disabilities: A Comprehensive Analysis
Authors: Adjiovski Benjamin , Bogatinoska Dijana Capeska , Ismajloska Mersiha , Malekian Reza
Published: July 2024

Learning disabilities present formidable obstacles for children in their educational journeys, often overlooked or misunderstood. This research aims to address two critical issues: the differentiation between learning and intellectual disabilities, and the resistance of teachers to integrating technology into education. In response, a comprehensive approach was adopted. Firstly, a mobile application was developed to screen for potential learning disabilities, offering teachers insights into individual student challenges and personalized lecture adaptations. Secondly, a quasi-experimental pretest–posttest study was conducted, comparing student performance following traditional and technologically supported lectures. Results from the study revealed significant score improvements among students identified as potentially having learning disabilities when exposed to technologically supported lectures. Conversely, students not identified as potential cases remained within the normal range of performance. These findings underscore the potential of technology to enhance educational outcomes for children with learning disabilities while highlighting the importance of recognizing and addressing these challenges in educational settings. By bridging the gap between identification and intervention, this research contributes to a more inclusive and effective educational environment.
Gesundheit, Psychiatrie und Klimakatastrophe
Authors: Adelmann Georg
Published: July 2024

Was ist zu diesem Thema bereits bekannt?

Die schwerwiegenden Folgen der Klimakatastrophe für die psychische Gesundheit sind klar. Die besondere Betroffenheit von Menschen mit psychiatrischen Diagnosen z.B. bei Extremwetterereignissen betont auch die Fachliteratur.

Wie wird eine neue Perspektive eingebracht?

Die Zusammenschau von Klimaaktivismus, Psychiatriesystem und Resilienz des Gesundheits- und Gesellschaftssystems angesichts der zunehmenden sozialökologischen Krisen wird versucht.

Was sind die Auswirkungen für die Praxis?

Aktiv werden gegen ein Verschlimmern der Krisen und für ein resilientes, macht- und diskriminierungssensibles Miteinander auf der Arbeit, privat und politisch schützt die Gesundheit aller.
Green Hospital – eine Vision
Authors: Voß Thomas
Published: July 2024

Was ist zu diesem Thema bereits bekannt?

Alle reden vom Green Hospital und wissen, dass wir handeln müssen, um dem Klimawandel und dem dramatischen Verlust an Biodiversität entgegenzuwirken. Aber die Konkurrenz mit Problemen wie Finanzierung, Arbeitskräftemangel und Bürokratie ist groß.

Wie wird eine neue Perspektive eingebracht?

Die LWL-Kliniken Münster und Lengerich engagieren sich schon seit Jahren für nachhaltige Unternehmensführung. Der Beitrag zeigt, dass sehr viel machbar ist, wenn man will und die Beschäftigten mitnimmt.

Was sind die Auswirkungen für die Praxis?

Führung und Beschäftigte engagieren sich gemeinsam, die Entwicklung der CO2-Bilanz ist beeindruckend. Die Kliniken werden in der Öffentlichkeit positiv wahrgenommen.
Development of the Exercise-Related Outcome Expectancies Questionnaire for Adolescents (EOEQ-A)
Authors: Borgolte Katharina , Pinquart Martin
Published: July 2024

Abstract: Under 30 % of adolescents achieve the recommended daily physical activity by the World Health Organization. Social cognitive theory by Bandura claims that outcome expectancies influence sport behavior. Therefore, the aim of this study was to develop a questionnaire that captures sports-related expectancies of adolescents, as such questionnaires have been developed for adults only and adults and adolescents may differ in their outcome expectancies. In the first study, 46 adolescents were asked about their expectancies regarding sports with open-ended questions. The answers were used to formulate items of the Exercise-Related Outcome Expectancies Questionnaire for Adolescents (EOEQ-A). In the second study, factor structure and reliability were tested in a sample of 452 10- to 19-year-old adolescents ( M = 15.09, SD = 2.46). Factor analysis suggests four factors: (a) psychological, (b) negative, (c) physical, and (d) social outcome expectancies. In a subsample of competitive athletes, an additional scale with competition-related items was devised. This questionnaire was found to be a reliable method for assessing sports-related outcome expectancies.
Multi‐Scale Seismic Imaging of the Ridgecrest, CA, Region With Waveform Inversion of Regional and Dense Array Data
Authors: Li Guoliang , Ben‐Zion Yehuda
Published: July 2024

We develop an inversion procedure for deriving multi‐scale velocity models with waveform inversions of earthquake and ambient noise data at multi‐frequency bands recorded by regional and dense sensor configurations. The method is applied for the area around the 2019 Ridgecrest earthquake rupture zones, utilizing data recorded by regional stations and dense 2D and 1D arrays with station spacings of ∼5 km and ∼100 m, respectively. Starting with regional Vp, Vs models and locations of Ridgecrest aftershocks, the velocity models and event locations are improved iteratively by inversions of waveforms recorded by regional stations and the 2D array, using a minimum spectral element size of ∼600 m. Waveforms from local events recorded by dense 1D arrays across the M7.1 rupture zone with frequencies of up to 10 Hz are used to resolve small‐scale features of the rupture zone and shallow crust with a local spectral element size of 80 m. The refined models provide self‐consistent descriptions of the rupture zone and the shallow crust embedded in the regional structures. The results reveal pronounced low Vs and high Vp/Vs in the M6.4 and M7.1 rupture zones coinciding with concentrations of seismicity, and also around the Garlock fault and in several local basins. We also observe clear velocity contrasts across the Garlock fault with polarity reversals along strike and with depth. The obtained multi‐scale velocity models can be used to improve derivations of earthquake source properties, simulations of dynamic ruptures and ground motions, and the understanding of fault and tectonic processes in the region.
Trends and Drivers of Terrestrial Sources and Sinks of Carbon Dioxide: An Overview of the TRENDY Project
Authors: Sitch Stephen , O’Sullivan Michael , Robertson Eddy , Friedlingstein Pierre , Albergel Clément , Anthoni Peter , Arneth Almut , Arora Vivek K. , Bastos Ana , Bastrikov Vladislav , Bellouin Nicolas , Canadell Josep G. , Chini Louise , Ciais Philippe , Falk Stefanie , Harris Ian , Hurtt George , Ito Akihiko , Jain Atul K. , Jones Matthew W. , Joos Fortunat , Kato Etsushi , Kennedy Daniel , Klein Goldewijk Kees , Kluzek Erik , Knauer Jürgen , Lawrence Peter J. , Lombardozzi Danica , Melton Joe R. , Nabel Julia E. M. S. , Pan Naiqing , Peylin Philippe , Pongratz Julia , Poulter Benjamin , Rosan Thais M. , Sun Qing , Tian Hanqin , Walker Anthony P. , Weber Ulrich , Yuan Wenping , Yue Xu , Zaehle Sönke
Published: July 2024

The terrestrial biosphere plays a major role in the global carbon cycle, and there is a recognized need for regularly updated estimates of land‐atmosphere exchange at regional and global scales. An international ensemble of Dynamic Global Vegetation Models (DGVMs), known as the “Trends and drivers of the regional scale terrestrial sources and sinks of carbon dioxide” (TRENDY) project, quantifies land biophysical exchange processes and biogeochemistry cycles in support of the annual Global Carbon Budget assessments and the REgional Carbon Cycle Assessment and Processes, phase 2 project. DGVMs use a common protocol and set of driving data sets. A set of factorial simulations allows attribution of spatio‐temporal changes in land surface processes to three primary global change drivers: changes in atmospheric CO2, climate change and variability, and Land Use and Land Cover Changes (LULCC). Here, we describe the TRENDY project, benchmark DGVM performance using remote‐sensing and other observational data, and present results for the contemporary period. Simulation results show a large global carbon sink in natural vegetation over 2012–2021, attributed to the CO2 fertilization effect (3.8 ± 0.8 PgC/yr) and climate (−0.58 ± 0.54 PgC/yr). Forests and semi‐arid ecosystems contribute approximately equally to the mean and trend in the natural land sink, and semi‐arid ecosystems continue to dominate interannual variability. The natural sink is offset by net emissions from LULCC (−1.6 ± 0.5 PgC/yr), with a net land sink of 1.7 ± 0.6 PgC/yr. Despite the largest gross fluxes being in the tropics, the largest net land‐atmosphere exchange is simulated in the extratropical regions.
Impact of Marine Shipping Emissions on Ozone Pollution During the Warm Seasons in China
Authors: Zheng Songci , Jiang Fei , Feng Shuzhuang , Liu Huan , Wang Xiaoyuan , Tian Xudong , Ying Chuanyou , Jia Mengwei , Shen Yang , Lyu Xiaopu , Guo Hai , Cai Zhe
Published: July 2024

As China's land‐based anthropogenic emissions are decreasing, the impact of marine shipping emissions (MSEs) on the atmosphere, especially in coastal areas, deserves further attention. This study investigates the impact of MSEs on MDA8 ozone (O3) levels during the warm seasons of 2017 in China, considering different seasons and synoptic patterns. The results indicate that the average impact of MSEs on O3 decreases from offshore to inland, peaking at over 29.0 ppb at sea and 13.8 ppb along the coast of mainland China. Influenced by precursor emissions, meteorology and other factors, MSEs contribute differently to O3 in Beijing‐Tianjin‐Hebei (BTH), Yangtze River Delta (YRD) and Pearl River Delta (PRD), with contributions of 3.0, 5.2, and 4.9 ppb, respectively, and ranging from 2.7 to 7.3 ppb in 13 coastal port cities. The O3 impacts of MSEs are higher on polluted days than on clean days, especially during onshore winds. In the BTH, MSEs increase O3 by 5.5 ppb on polluted days and 3.0 ppb on clean days with northeast winds from the Bohai Sea. In the YRD, MSEs increase O3 by 9.4 ppb on polluted days and 7.3 ppb on clean days with southeast winds. MSEs significantly increase O3 levels in the PRD by 11.0 ppb on polluted days and 5.0 ppb on clean days with southeast winds. Although the emission inventories, initial and boundary conditions, etc. may introduce uncertainties, our results still provide useful information for O3 pollution management in coastal cities as a reasonable way to track mass contributions.
Voice signals database of ALS patients with different dysarthria severity and healthy controls
Authors: Dubbioso Raffaele , Spisto Myriam , Verde Laura , Iuzzolino Valentina Virginia , Senerchia Gianmaria , Salvatore Elena , De Pietro Giuseppe , De Falco Ivanoe , Sannino Giovanna
Published: July 2024

This paper describes a new publicly-available database of VOiCe signals acquired in Amyotrophic Lateral Sclerosis (ALS) patients (VOC-ALS) and healthy controls performing different speech tasks. This dataset consists of 1224 voice signals recorded from 153 participants: 51 healthy controls (32 males and 19 females) and 102 ALS patients (65 males and 37 females) with different severity of dysarthria. Each subject’s voice was recorded using a smartphone application (Vox4Health) while performing several vocal tasks, including a sustained phonation of the vowels /a/, /e/, /i/, /o/, /u/ and /pa/, /ta/, /ka/ syllable repetition. Basic derived speech metrics such as harmonics-to-noise ratio, mean and standard deviation of fundamental frequency (F0), jitter and shimmer were calculated. The F0standard deviation of vowels and syllables showed an excellent ability to identify people with ALS and to discriminate the different severity of dysarthria. These data represent the most comprehensive database of voice signals in ALS and form a solid basis for research on the recognition of voice impairment in ALS patients for use in clinical applications.
Intelligent breast cancer diagnosis with two-stage using mammogram images
Authors: Yaqub Muhammad , Jinchao Feng , Aijaz Nazish , Ahmed Shahzad , Mehmood Atif , Jiang Hao , He Lan
Published: July 2024

Breast cancer (BC) significantly contributes to cancer-related mortality in women, underscoring the criticality of early detection for optimal patient outcomes. Mammography is a key tool for identifying and diagnosing breast abnormalities; however, accurately distinguishing malignant mass lesions remains challenging. To address this issue, we propose a novel deep learning approach for BC screening utilizing mammography images. Our proposed model comprises three distinct stages: data collection from established benchmark sources, image segmentation employing an Atrous Convolution-based Attentive and Adaptive Trans-Res-UNet (ACA-ATRUNet) architecture, and BC identification via an Atrous Convolution-based Attentive and Adaptive Multi-scale DenseNet (ACA-AMDN) model. The hyperparameters within the ACA-ATRUNet and ACA-AMDN models are optimized using the Modified Mussel Length-based Eurasian Oystercatcher Optimization (MML-EOO) algorithm. The performance is evaluated using a variety of metrics, and a comparative analysis against conventional methods is presented. Our experimental results reveal that the proposed BC detection framework attains superior precision rates in early disease detection, demonstrating its potential to enhance mammography-based screening methodologies.
Circular economy reinforcement through molecular fabrication of textile wastes with microbial synthesized ZnO nanoparticles to have multifunctional properties
Authors: Darwesh Osama M. , Matter Ibrahim A. , Al-Balakocy Naser G. , Abo-Alkasem Mohamed I.
Published: July 2024

The fibrous wastes generated from the mills of textile production can be recycled and converted into high add-values products to be implemented in several applications. The current study aimed to employ commercial free cellulase enzyme to partially hydrolyze (activate) the polyester cotton blended (PET/C) fibrous wastes by creation functional groups such as OH and COOH on their surfaces. The activated fibrous wastes were then modified by coating with ZnO nanoparticles (ZnO-NPs) biosynthesized by actinobacterial cultures free supernatant. The isolate was identified as Streptomyces pseudogriseolus with accession number of OR574241. The conditions that influence the actino-synthesis of ZnO-NPs were optimized and the product was characterized using spectroscopic vision, FTIR, XRD, TEM and SEM. The characteristic ZnO peaks were obviously observed by EDX analysis with 0.38 and 0.75% (wt%), respectively. TEM analyses proved the nanoscale of ZnO-NPs (5–15 nm) which was followed by cytotoxic evaluation for the produced NPs. Fortunately, the tested actino-ZnO-NPs didn’t have any cytotoxicity against human normal fibroblast cell line (BJ1), which means that the product can be safely used in a direct-contact with human skin. The treated PET/C blended waste fabrics coated with ZnO-NPs showed high antimicrobial activity and ultraviolet protection values after functionalization by cellulase. EDX analysis demonstrates the presence of Zn peaks on the coated fabrics compared with their absence in blank and control samples, while SEM images showed the formation of a thin layer of ZnO-NPs on the fabric surface. The obtained smart textile can be applied several needed sectors.