bluuebunny/crossref_metadata_2025 huggingface dataset:
A comprehensive assessment of the prolonged febrile neutropenia evaluation in pediatric oncology patients
Authors: Whitehurst Daniel A. , Friedman Debra L. , Zhao Zhiguo , Sarma Asha , Snyder Elizabeth , Dulek Daniel E. , Banerjee Ritu , Kitko Carrie L. , Esbenshade Adam J.
Published: December 2023

Background

Pediatric oncology patients with prolonged (≥96 hours) febrile neutropenia (absolute neutrophil count < 500/μL) often undergo an evaluation for invasive fungal disease (IFD) and other infections. Current literature suggests that beta‐D‐glucan (BDG), galactomannan, bronchoalveolar lavage (BAL), and computed tomography (CT) scans (sinus, chest, and abdomen/pelvis) may help determine a diagnosis in this population.

Methods

In a retrospective cohort study of all cancer/stem cell transplant patients (diagnosed 2005‐2019) from one pediatric hospital, all episodes with prolonged febrile neutropenia or IFD evaluations (defined as sending a fungal biomarker or performing a CT scan to assess for infection) were identified.

Results

In total, 503 episodes met inclusion criteria and 64% underwent IFD evaluations. In total, 36.4% of episodes documented an infection after initiation of prolonged febrile evaluation, most commonly Clostridioides difficile colitis (6.4%) followed by a true bacterial bloodstream infection (BSI) (5.2%), proven/probable IFD (4.8%), and positive respiratory pathogen panel (3.6%). There was no difference in sinus CTs showing sinusitis (74% vs 63%, p = 0.46), whereas 32% of abdomen/pelvis CTs led to a non‐IFD diagnosis, and 25% of chest CTs showed possible pneumonia. On chest CT, the positive predictive value (PPV) for IFD was 19% for nodules and 14% for tree and bud lesions. BDG had a PPV of 25% for IFD and GM 50%. BAL diagnosed IFD once and pneumocystis jirovecii pneumonia twice.

Conclusions

Chest CTs and abdomen/pelvis CTs provide clinically relevant information during the prolonged febrile neutropenia evaluation, whereas BDG, galactomannan, BAL, and sinus CTs have less certain utility.
Tensile‐after‐ablation progressive damage and the failure mechanism of 2.5D woven composites with crack pores
Authors: Yang Wentao , Dong Fang , Zhang Diantang
Published: December 2023

2.5D woven structures are of interest in new thermal protection systems for their excellent interlayer properties and structural stability. In this paper, dense (CDP) and lightweight (CLP) carbon/phenolic 2.5D woven composites were prepared. Quasi‐static tensile experiments were performed on the specimens before ablation (TCDP‐0, TCLP‐0) and after ablation for 30 s (TCDP‐30, TCLP‐30). A quarter macro–meso hybrid model that takes into account the degradation of material properties after ablation and ablative crack pores was innovatively proposed. The predicted tensile elastic modulus is within 9% error from the experimental results. The results show that TCDP‐30 and TCLP‐30 have rapid damage expansion and lethal injury at smaller displacements than the pre‐ablation specimens. The displacement of the maximum load point of TCDP‐30 is 38.7% lower than that of TCLP‐30. The forms of damage in TCDP‐30 are dominated by matrix fragmentation and matrix cracks. The damage forms of TCLP‐30 are dominated by debonding and delamination.

Highlights

Micro‐CT was used to collect matrix fabrication defects and ablative crack pores defect.

A quarter macro–meso hybrid model that takes into account the degradation of material properties after ablation and ablative crack pore was innovatively proposed.

The tensile failure mechanism of the material after ablation was revealed by the combination of experiment and numerical method.
Fusing trial data for treatment comparisons: Single vs multi‐span bridging
Authors: Shook‐Sa Bonnie E. , Zivich Paul N. , Rosin Samuel P. , Edwards Jessie K. , Adimora Adaora A. , Hudgens Michael G. , Cole Stephen R.
Published: December 2023

While randomized controlled trials (RCTs) are critical for establishing the efficacy of new therapies, there are limitations regarding what comparisons can be made directly from trial data. RCTs are limited to a small number of comparator arms and often compare a new therapeutic to a standard of care which has already proven efficacious. It is sometimes of interest to estimate the efficacy of the new therapy relative to a treatment that was not evaluated in the same trial, such as a placebo or an alternative therapy that was evaluated in a different trial. Such dual‐study comparisons are challenging because of potential differences between trial populations that can affect the outcome. In this article, two bridging estimators are considered that allow for comparisons of treatments evaluated in different trials, accounting for measured differences in trial populations. A “multi‐span” estimator leverages a shared arm between two trials, while a “single‐span” estimator does not require a shared arm. A diagnostic statistic that compares the outcome in the standardized shared arms is provided. The two estimators are compared in simulations, where both estimators demonstrate minimal empirical bias and nominal confidence interval coverage when the identification assumptions are met. The estimators are applied to data from the AIDS Clinical Trials Group 320 and 388 to compare the efficacy of two‐drug vs four‐drug antiretroviral therapy on CD4 cell counts among persons with advanced HIV. The single‐span approach requires weaker identification assumptions and was more efficient in simulations and the application.
Prevalence and Burden of Vitiligo in Africa, the Middle East and Latin America
Authors: Al Hammadi Anwar , Silva de Castro Caio Cesar , Parmar Nisha V. , Ubogui Javier , Hatatah Nael , Ahmed Haytham Mohamed , Llamado Lyndon
Published: December 2023

Vitiligo is a common chronic autoimmune disorder characterized by skin and hair depigmentation that affects 0.5%–2.0% of the global population. Vitiligo is associated with diminished quality of life (QoL) and psychosocial burden. The burden of vitiligo may vary based on skin tone and cultural differences as well as geographical variations in disease awareness, societal stigma, healthcare systems and treatment options. Data on the burden and management of vitiligo in Africa, the Middle East and Latin America are scarce. Literature searches using terms covering vitiligo in Africa, the Middle East and Latin America were conducted using PubMed to identify relevant publications that focused on disease prevalence and burden, QoL and psychosocial impact and disease management between 2011 and 2021. Most of the reviewed studies were conducted in the Middle East, and most Latin American studies were from Brazil. Most studies involved small patient numbers and may not be generalizable. Reported prevalence of vitiligo ranged from 0.18% to 5.3% in Africa and the Middle East, and from 0.04% to 0.57% in Latin America. In several studies, prevalence was higher among female participants. Generally, non-segmental vitiligo was the dominant clinical variant identified and the age at onset varied widely across studies. Common comorbidities include autoimmune diseases such as Hashimoto's thyroiditis, alopecia areata and diabetes. Few treatment guidelines exist in these regions, with the exceptions of guidelines published by the Brazilian and Argentinian Societies of Dermatology. There is a clear unmet need for large epidemiological studies with uniform methodology to accurately ascertain the true prevalence of vitiligo in Africa, the Middle East and Latin America. Additional data on vitiligo burden and management in Africa and Latin America are also needed, along with local disease management guidelines that consider genetic variation, psychosocial burden and socioeconomic diversity in all 3 regions.
Shaping Graphene Superconductivity with Nanometer Precision
Authors: Cortés‐del Río Eva , Trivini Stefano. , Pascual José I. , Cherkez Vladimir , Mallet Pierre , Veuillen Jean‐Yves , Cuevas Juan. C. , Brihuega Iván
Published: December 2023

Graphene holds great potential for superconductivity due to its pure 2D nature, the ability to tune its carrier density through electrostatic gating, and its unique, relativistic‐like electronic properties. At present, still far from controlling and understanding graphene superconductivity, mainly because the selective introduction of superconducting properties to graphene is experimentally very challenging. Here, a method is developed that enables shaping at will graphene superconductivity through a precise control of graphene‐superconductor junctions. The method combines the proximity effect with scanning tunnelling microscope (STM) manipulation capabilities. Pb nano‐islands are first grown that locally induce superconductivity in graphene. Using a STM, Pb nano‐islands can be selectively displaced, over different types of graphene surfaces, with nanometre scale precision, in any direction, over distances of hundreds of nanometres. This opens an exciting playground where a large number of predefined graphene‐superconductor hybrid structures can be investigated with atomic scale precision. To illustrate the potential, a series of experiments are performed, rationalized by the quasi‐classical theory of superconductivity, going from the fundamental understanding of superconductor‐graphene‐superconductor heterostructures to the construction of superconductor nanocorrals, further used as “portable” experimental probes of local magnetic moments in graphene.
Bioinformatics analyses and experimental validation of the role of phagocytosis in low‐grade glioma
Authors: Fei Mingyang , Lu Chunlin , Feng Baozhi , Sun Jiaao , Wang Jie , Sun Fei , Dong Bin
Published: December 2023

Background

Phagocytosis is of vital importance in tumor immune response. The alteration of phagocytosis in low‐grade glioma (LGG) has not been investigated.

Methods

The mRNA, copy number variation, single nucleotide variation, and methylation levels of phagocytosis‐related genes were summarized in pan‐cancer. Non‐negative matrix factorization clustering was utilized to identify two LGG subtypes. LASSO regression analysis was performed to construct a phagocytosis‐related prognostic signature (PRPS). Immune characteristics, immunotherapy response, and targeted‐drug sensitivity were further explored. The phagocytosis activity in glioma was evaluated using scRNA‐seq data. Multiplex immunohistochemical (m‐IHC) technology was performed to identify the tumor‐infiltrating immune cells in LGG.

Results

The phagocytosis‐related genes altered obviously in pan‐cancer compared with corresponding normal tissues. Two LGG subtypes were obtained and the subtype with poor prognosis was combined with lower tumor purity, more active immune‐related pathways, increasing infiltration of CD4+ T cells, CD8+ T cells, and natural killer (NK) cells, decreasing infiltration of macrophages, mast cells, and neutrophils, distinct pathway activity and cell death status, greater response to immunotherapy, and higher sensitivity to cyclophosphamide, erlotinib, gefitinib, lapatinib, and sorafenib. In addition, a PRPS involving 10 genes (i.e., SLC11A1, CAMK1D, PLA2G5, STAP1, ALOX15, PLCG2, SFTPD, AZU1, RAB27A, and LAMTOR2) was constructed to estimate the risk level of each LGG sample and high risk LGG patients had poor prognosis, upregulated infiltration of neutrophil, macrophage, Treg, and myeloid dendritic cell, down regulated infiltration of monocyte and NK cell, and increasing expression of large number of immune checkpoint genes. The phagocytosis activity is notably active in monocyte/macrophage. The m‐IHC results confirmed increased infiltration of macrophages and neutrophils in LGG samples with high SLC11A1 expression.

Conclusion

The molecular characteristics of phagocytosis were revealed and the PRPS laid the foundation for personalized therapy in LGG.
Russia in a changing climate
Authors: Javeline Debra , Orttung Robert , Robertson Graeme , Arnold Richard , Barnes Andrew , Henry Laura , Holland Edward , Omelicheva Mariya , Rutland Peter , Schatz Edward , Schenk Caress , Semenov Andrei , Sperling Valerie , McIntosh Sundstrom Lisa , Troitskiy Mikhail , Twigg Judyth , Wengle Susanne
Published: December 2023

Climate change will shape the future of Russia, and vice versa, regardless of who rules in the Kremlin. The world's largest country is warming faster than Earth as a whole, occupies more than half the Arctic Ocean coastline, and is waging a carbon‐intensive war while increasingly isolated from the international community and its efforts to reduce greenhouse gas emissions. Officially, the Russian government argues that, as a major exporter of hydrocarbons, Russia benefits from maintaining global reliance on fossil fuels and from climate change itself, because warming may increase the extent and quality of its arable land, open a new year‐round Arctic sea route, and make its harsh climate more livable. Drawing on the collective expertise of a large group of Russia‐focused social scientists and a comprehensive literature review, we challenge this narrative. We find that Russia suffers from a variety of impacts due to climate change and is poorly prepared to adapt to these impacts. The literature review reveals that the fates of Russia's hydrocarbon‐dependent economy, centralized political system, and climate‐impacted population are intertwined and that research is needed on this evolving interrelationship, as global temperatures rise and the international economy decarbonizes in response.

This article is categorized under:

Policy and Governance > National Climate Change Policy

Trans‐disciplinary Perspectives > National Reviews

Trans‐disciplinary Perspectives > Regional Reviews
Predictive risk model of recurrence of acute diverticulitis after the first episode
Authors: Pastor‐Mora Juan Carlos , Fortea‐Sanchís Carlos , Coret‐Franco Alba , García‐Martínez Juan Antonio , Cosa‐Rodriguez Rebeca , Nomdédeu‐Guinot Jesus , Gibert‐Gerez Juan , Laguna‐Sastre Manuel , Llueca Antoni
Published: December 2023

Introduction

The recurrence of acute diverticulitis (AD) of the colon is frequent and leads to hospital readmissions and the need for elective surgery in selected cases. It is important to individualize risk factors and develop predictive tools for their identification.

Materials and methods

This prospective observational study included 368 patients who were diagnosed with AD between 2016 and 2021 in a tertiary general university hospital during their first episode and who had a good response to antibiotic, percutaneous, or peritoneal lavage treatment. Univariate and multivariate Cox regression analyses of the variables associated with recurrence were performed. Subsequently, a predictive risk score was developed and validated through survival studies.

Results

After a median follow‐up of 50 months, there were 71 (19.3%) cases of recurrence out of a total of 368 patients. The mean time of recurrence was 15 months, and 73.3% of cases of recurrence occurred before 2 years of follow‐up. Recurrence was independently associated with presentation with colonic perforation in the antimesenteric location (HR 3.67 95% CI [1.59–8.4]) and a CRP level greater than 100 mg/dl (HR 1.69 95% CI [1.04–2.77). A score with 5 variables was created that differentiated two risk groups: intermediate risk (0–3 points), with 19% recurrence and high risk (more than 3 points), with 42% recurrence.

Conclusions

The risk of recurrence after the first episode of diverticulitis can be estimated using predictive scores. The detection of high‐risk patients facilitates the individualization of follow‐up and treatment.
Marine Protected Area Expansion and Country-Level Age-Standardized Adult Mortality
Authors: Haque Sabrina S. , Bennett Baylin J. , Brewer Thomas D. , Morrissey Karyn , Fleming Lora E. , Gribble Matthew O.
Published: December 2023

Many countries have adopted targets to increase marine protected areas (MPAs) to limit the degradation of water bodies. Although there is evidence that MPAs can conserve marine life and promote biodiversity, there are limited data on the human health implications of MPAs. Using panel data from 1990, 2000, and 2014, we estimated the country-level associations between MPAs (i.e., percentage of territorial waters designated as marine reserves) and age-standardized mortality (i.e., age-standardized probability of dying between 15 and 60 years from all-causes among ages 15–60/100,000 population) by sex, among 110 countries. We fit mixed-effects linear regression models of mortality as a function of current MPA coverage, gross domestic product growth, year, the prior extent of MPA, electricity coverage, governance, and country-level random effects. We observed a significant inverse association between current MPA coverage and adult mortality. For each 5-percentage-point increase in current MPA coverage, a country had 0.982 times the geometric means of female and male mortality [geometric mean ratio: 0.982 (95% CI 0·976, 0·988)] conditional on past %MPA coverage and other modeled variables. The model showed no significant residual association of mortality with past %MPA conditional on current %MPA and other modeled variables. This is one of the first studies to show a positive association between increasing marine conservation and human health. This macro-level study suggests there may be important co-benefits for human health from expanding MPAs that merit further investigation.
Disentanglement of Resting State Brain Networks for Localizing Epileptogenic Zone in Focal Epilepsy
Authors: Ye Shuai , Bagić Anto , He Bin
Published: December 2023

The objective of this study is to extract pathological brain networks from interictal period of E/MEG recordings to localize epileptic foci for presurgical evaluation. We proposed here a resting state E/MEG analysis framework, to disentangle brain functional networks represented by neural oscillations. By using an Embedded Hidden Markov Model, we constructed a state space for resting state recordings consisting of brain states with different spatiotemporal patterns. Functional connectivity analysis along with graph theory was applied on the extracted brain states to quantify the network features of the extracted brain states, based on which the source location of pathological states is determined. The method is evaluated by computer simulations and our simulation results revealed the proposed framework can extract brain states with high accuracy regarding both spatial and temporal profiles. We further evaluated the framework as compared with intracranial EEG defined seizure onset zone in 10 patients with drug-resistant focal epilepsy who underwent MEG recordings and were seizure free after surgical resection. The real patient data analysis showed very good localization results using the extracted pathological brain states in 6/10 patients, with localization error of about 15 mm as compared to the seizure onset zone. We show that the pathological brain networks can be disentangled from the resting-state electromagnetic recording and could be identified based on the connectivity features. The framework can serve as a useful tool in extracting brain functional networks from noninvasive resting state electromagnetic recordings, and promises to offer an alternative to aid presurgical evaluation guiding intracranial EEG electrodes implantation.
Influence of a Short Course of Ritonavir Used as Booster in Antiviral Therapies Against SARS-CoV-2 on the Exposure of Atorvastatin and Rosuvastatin
Authors: Krohmer Evelyn , Rohr Brit Silja , Stoll Felicitas , Gümüs Katja S. , Bergamino Mariano , Mikus Gerd , Sauter Max , Burhenne Jürgen , Weiss Johanna , Meid Andreas D. , Czock David , Blank Antje , Haefeli Walter E.
Published: December 2023

Purpose

Early antiviral treatment with nirmatrelvir/ritonavir is recommended for SARS-CoV-2-infected patients at high risk for severe courses. Such patients are usually chronically ill and susceptible to adverse drug interactions caused by ritonavir. We investigated the interactions of short-term low-dose ritonavir therapy with atorvastatin and rosuvastatin, two statins commonly used in this population.

Method

We assessed exposure changes (area under the concentration–time curve (AUC∞) and maximum concentration (Cmax)) of a single dose of 10 mg atorvastatin and 10 mg rosuvastatin before and on the fifth day of ritonavir treatment (2 × 100 mg/day) in healthy volunteers and developed a semi-mechanistic pharmacokinetic model to estimate dose adjustment of atorvastatin during ritonavir treatment.

Results

By the fifth day of ritonavir treatment, the AUC∞ of atorvastatin increased 4.76-fold and Cmax 3.78-fold, and concurrently, the concentration of atorvastatin metabolites decreased to values below the lower limit of quantification. Pharmacokinetic modelling indicated that a stepwise reduction in atorvastatin dose during ritonavir treatment with a stepwise increase up to 4 days after ritonavir discontinuation can keep atorvastatin exposure within safe and effective margins. Rosuvastatin pharmacokinetics were only mildly modified; ritonavir significantly increased the Cmax 1.94-fold, while AUC∞ was unchanged.

Conclusion

Atorvastatin doses should likely be adjusted during nirmatrelvir/ritonavir treatment. For patients on a 20-mg dose, we recommend half of the original dose. In patients taking 40 mg or more, a quarter of the dose should be taken until 2 days after discontinuation of nirmatrelvir/ritonavir. Patients receiving rosuvastatin do not need to change their treatment regimen.

Trial Registration

EudraCT number: 2021–006634-39.

DRKS00027838.
The capture probability of Dawn into ground-track resonances with Vesta
Authors: Boumchita Wail , Feng Jinglang
Published: December 2023

The Dawn spacecraft approached the asteroid Vesta and descended from a high-altitude mission orbit to a low-altitude mission orbit using low-thrust propulsion. During this descent, the spacecraft crossed the 2:3 and 1:1 ground-track resonances with Vesta, which posed a risk of capture that might strongly perturb the spacecraft’s orbit. This study analyzes the effects of these resonances on the spacecraft’s orbital elements and estimates the probability of capture into it through Monte Carlo simulations. Specifically, a comprehensive investigation is performed to assess the effects of 1:1 and 2:3 ground-track resonances on the semimajor axis, eccentricity, and inclination. The dynamical model includes the gravitational field of Vesta using a spherical harmonics approximation up to the fourth degree and order and the low-thrust acceleration that is assumed to be opposite to the spacecraft’s velocity vector direction. It is observed that the eccentricity evolution is mostly influenced by the 2:3 ground-track resonance which results in a large variation when the spacecraft crosses that ground-track resonance, while the semimajor axis and inclination are mostly influenced by the 1:1 ground-track resonance. Then, the probability of capture into 1:1 ground-track resonance is found to have a negative correlation with the spacecraft’s thrust magnitude and the probability of capture into 2:3 ground-track resonance is found to arise as the spacecraft’s mass increases. It is found that for circular orbits below a certain inclination value the spacecraft’s trajectory is subject to the “automatic entry into libration” phenomenon, due to the singularity in the Hamiltonian function. This research contributes to the design of successful transfer strategies when crossing resonance for future missions.
Psychotropic Medication Use in Children and Youth with Autism Enrolled in Medicaid
Authors: Rast Jessica E. , Tao Sha , Schott Whitney , Shea Lindsay L. , Brodkin Edward S. , Kerns Connor M. , Leonard Charles E. , Murray Michael J. , Lee Brian K.
Published: December 2023

Children with autism frequently present with complex mental health diagnoses and psychotropic medications are often a component of comprehensive biopsychosocial treatment plans for these conditions. The purpose of this study is to provide rates and patterns of psychotropic medication use, and predictors thereof, in children and youth with autism enrolled in Medicaid across the US. This study examined national Medicaid claims from 2008 to 2016 of all children and youth with autism ages 0–21 years enrolled in Medicaid. Psychotropic medication use was examined across several child and youth characteristics, including age, co-occurring mental health conditions, sex, and race and ethnicity. About half of children and youth with autism enrolled in Medicaid had at least one psychotropic prescription in a year, a number that decreased slightly across the study period due to decreases in the prescription of antipsychotics. As new medications for autism or co-occurring conditions are developed and deployed, and as the understanding of the characteristics of the population of children with autism evolves, studying rates of medication usage helps to understand utilization patterns and differences in access to quality care.
The Impact of Surface Passivation on Kapitza Resistance at the Interface Between a Semiconductor and Liquid Nitrogen
Authors: Mohammadian Babak , McCulloch Mark A. , Sweetnam Thomas , Gilles Valerio , Piccirillo Lucio
Published: December 2023

Cooling electronic devices to cryogenic temperatures (< 77 K) is crucial in various scientific and engineering domains. Efficient cooling involves the removal of heat generated from these devices through thermal contact with either a liquid cryogen or a dry cryostat cold stage. However, as these devices cool, thermal boundary resistance, also known as Kapitza resistance, hinders the heat flow across thermal interfaces, resulting in elevated device temperatures. In transistors, the presence of passivation layers like silicon nitride (SiN) introduces additional interfaces that further impede heat dissipation. This paper investigates the impact of passivation layer thickness on Kapitza resistance at the interface between a solid device and liquid nitrogen. The Kapitza resistance is measured using a capacitance thermometer that has been passivated with SiN layers ranging from 0 to 240 nm. We observe that Kapitza resistance increases with increasing passivation thickness.
The Time-Dependent Symbol of a Non-homogeneous Itô Process and Corresponding Maximal Inequalities
Authors: Rickelhoff Sebastian , Schnurr Alexander
Published: December 2023

The probabilistic symbol is defined as the right-hand side derivative at time zero of the characteristic functions corresponding to the one-dimensional marginals of a time-homogeneous stochastic process. As described in various contributions to this topic, the symbol contains crucial information concerning the process. When leaving time-homogeneity behind, a modification of the symbol by inserting a time component is needed. In the present article, we show the existence of such a time-dependent symbol for non-homogeneous Itô processes. Moreover, for this class of processes, we derive maximal inequalities which we apply to generalize the Blumenthal–Getoor indices to the non-homogeneous case. These are utilized to derive several properties regarding the paths of the process, including the asymptotic behavior of the sample paths, the existence of exponential moments and the finiteness of p-variationa. In contrast to many situations where non-homogeneous Markov processes are involved, the space-time process cannot be utilized when considering maximal inequalities.
Ensuring the accuracy of indirect nonlinear dynamic reduced-order models
Authors: Xiao Xiao , Hill Thomas L. , Neild Simon A.
Published: December 2023

Numerous powerful methods exist for developing reduced-order models (ROMs) from finite element (FE) models. Ensuring the accuracy of these ROMs is essential; however, the validation using dynamic responses is expensive. In this work, we propose a method to ensure the accuracy of ROMs without extra dynamic FE simulations. It has been shown that the well-established implicit condensation and expansion (ICE) method can produce an accurate ROM when the FE model’s static behaviour are captured accurately. However, this is achieved via a fitting procedure, which may be sensitive to the selection of load cases and ROM’s order, especially in the multi-mode case. To alleviate this difficulty, we define an error metric that can evaluate the ROM’s fitting error efficiently within the displacement range, specified by a given energy level. Based on the fitting result, the proposed method provides a strategy to enrich the static dataset, i.e. additional load cases are found until the ROM’s accuracy reaches the required level. Extending this to the higher-order and multi-mode cases, some extra constraints are incorporated into the standard fitting procedure to make the proposed method more robust. A curved beam is utilised to validate the proposed method, and the results show that the method can robustly ensure the accuracy of the static fitting of ROMs.
What do emergency department pharmacist practitioners know and understand about patient safeguarding? A qualitative study
Authors: Greenwood Daniel , Steinke Douglas , Martin Sandra , Norton Gary , Tully Mary P.
Published: December 2023

Background

Pharmacists with additional clinical skills now work in UK emergency departments. Known as Emergency Department Pharmacist Practitioners, the role was developed in response to a shortage of physicians and nurses. They carry out activities typical of traditional hospital pharmacists, but also novel ‘practitioner’ activities such as examining patients, and acting as designated care provider. The role includes a responsibility to safeguard patients from harm. Professional competence, i.e. to safeguard patients, is underpinned by knowledge of the subject, but also knowledge application.

Aim

To investigate what Emergency Department Pharmacist Practitioners know and understand about safeguarding vulnerable children and adults.

Method

Thirteen Emergency Department Pharmacist Practitioners were interviewed to explore their knowledge and understanding of safeguarding. Interview questions were developed from review of relevant literature, as were vignettes with variables identified and altered to produce different scenarios. Template analysis was used to code data to a priori themes for each of the stages of the initial safeguarding process, and new themes that emerged throughout the process.

Results

Six themes were identified in addition to the four a priori themes. Overall, participants frequently described how safeguarding concerns are both recognised and responded to, but seemed more comfortable when responding to medicines related concerns. Factors thought to influence the safeguarding process included: resources and setting; and education, training and experiential learning; and culture.

Conclusion

While Emergency Department Pharmacist Practitioners interviewed were aware of the safeguarding process, there were some misconceptions as to the roles of different healthcare workers in this process.
The effectiveness of ibandronate in reducing the risk of nonvertebral fractures in women with osteoporosis: systematic review and meta-analysis of observational studies
Authors: Alves Carlos , Mendes Diogo , Penedones Ana , Oliveira Tânia , Donato António , Batel-Marques Francisco
Published: December 2023

Background

Ibandronate is effective in reducing the risk of vertebral fractures, but experimental evidence offers conflicting results regarding nonvertebral fractures. Real-world evidence has been published evaluating the anti-nonvertebral fracture effect of ibandronate.

Aim

This meta-analysis of observational studies assessed the effectiveness of ibandronate in reducing the risk of nonvertebral fractures in women with osteoporosis.

Method

Pubmed/Embase databases were searched for observational studies. Risks of nonvertebral fractures and hip fractures were the outcomes. Meta-analyses were performed pooling rate ratios (RRs), using random-effects models. Data were reanalysed in sensitivity analyses considering Knapp–Hartung method and Bayesian random-effects.

Results

Six cohort studies were included. Overall, once-monthly 150 mg oral ibandronate reduced the risk of nonvertebral fractures (RR 0.84; 95% CI 0.76–0.94). Similar results were obtained when the comparison was restricted to once-monthly 150 mg risedronate, but no differences were found when the comparator was other oral bisphosphonates (weekly alendronate/risedronate). Ibandronate didn’t significantly change the risk of hip fractures (RR 1.25; 95% CI 0.89–1.76). The risk of hip fracture was comparable between once monthly, 150 mg oral ibandronate and other oral bisphosphonates. Intravenous ibandronate was not effective in reducing hip fractures comparing to intravenous zoledronate. The low number of studies diminished the robustness of sensitivity analyses.

Conclusion

Results suggest that once-monthly 150 mg oral ibandronate may be as effective as other oral bisphosphonates in reducing the risk of nonvertebral fractures. However, uncertainty associated to the small number of included studies, which are characterized by heterogeneous demographics and methodologies, precluded definitive conclusions.
Validation of the brain injury associated visual impairment - impact questionnaire (BIVI-IQ)
Authors: Hepworth L. R. , Kirkham J.J. , Perkins E. , Helliwell B. , Howard C. , Liptrot M. , Tawana S. , Wilson E. , Rowe F. J.
Published: December 2023

Purpose

The Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to assess the impact of post-stroke visual impairment. The development of the questionnaire used robust methods involving stroke survivors and clinicians. The aim of this study was to assess the validity of the BIVI-IQ in a stroke population.

Methods

Stroke survivors with visual impairment were recruited from stroke units, outpatient clinics and non-healthcare settings. Participants were asked to complete questionnaire sets on three separate occasions; the BIVI-IQ at each visit with additional questionnaires at baseline and visit 2. Vision assessment and anchor questions from participants and clinicians were collected. The analysis included assessment of missing data, acceptability, Rasch model analysis, test–retest reliability, construct validity (NEI VFQ-25, EQ-5D-5L) and responsiveness to change.

Results

316 stroke survivors completed at least one questionnaire of the 326 recruited. Mean age was 67 years and 64% were male. Adequate fit statistics to the Rasch model were reached (χ2 = 73.12, p = 0.02) with two items removed and thresholds of two adjusted, indicating validity and unidimensionality. Excellent test–retest reliability was demonstrated (ICC = 0.905) with a 3-month interval. Construct validity was demonstrated with a strong significant correlation to the NEI VFQ-25 (r = 0.837, p < 0.01). The BIVI-IQ also demonstrated responsiveness to change with significant differences identified between groups based on participant and clinician anchor questions (X2 = 23.29, p < 0.001; X2 = 24.56, p < 0.001).

Conclusion

The BIVI-IQ has been shown to be valid and practical for ‘everyday’ use by clinicians and researchers to monitor vision-related quality of life in stroke survivors with visual impairment.
The Lucy Thermal Emission Spectrometer (L’TES) Instrument
Authors: Christensen P. R. , Hamilton V. E. , Mehall G. L. , Anwar S. , Bowles H. , Chase S. , Farkas Z. , Fisher T. , Holmes A. , Kubik I. , Lazbin I. , O’Donnell W. , Ortiz C. , Pelham D. , Rogers S. , Shamordola K. , Tourville T. , Woodward R.
Published: December 2023

The Lucy Thermal Emission Spectrometer (L’TES) will provide remote measurements of the thermophysical properties of the Trojan asteroids studied by the Lucy mission. L’TES is build-to-print hardware copy of the OTES instrument flown on OSIRIS-REx. It is a Fourier Transform spectrometer covering the spectral range 5.71–100 μm (1750–100 cm−1) with spectral sampling intervals of 8.64, 17.3, and 34.6 cm−1 and a 7.3-mrad field of view. The L’TES telescope is a 15.2-cm diameter Cassegrain telescope that feeds a flat-plate Michelson moving mirror mounted on a linear voice-coil motor assembly to a single uncooled deuterated l-alanine doped triglycine sulfate (DLATGS) pyroelectric detector. A significant firmware change from OTES is the ability to acquire interferograms of different length and spectral resolution with acquisition times of 0.5, 1, and 2 seconds. A single ∼0.851 μm laser diode is used in a metrology interferometer to provide precise moving mirror control and IR sampling at 772 Hz. The beamsplitter is a 38-mm diameter, 1-mm thick chemical vapor deposited diamond with an antireflection microstructure to minimize surface reflection. An internal calibration cone blackbody target, together with observations of space, provides radiometric calibration. The radiometric precision in a single spectrum is ≤2.2 × 10−8 W cm−2 sr−1 /cm−1 between 300 and 1350 cm−1. The absolute temperature error is <2 K for scene temperatures >75 K. The overall L’TES envelope size is 37.6 × 29.0 × 30.4 cm, and the mass is 6.47 kg. The power consumption is 12.6 W average. L’TES was developed by Arizona State University with AZ Space Technologies developing the electronics. L’TES was integrated, tested, and radiometrically calibrated on the Arizona State University campus in Tempe, AZ. Initial data from space have verified the instrument’s radiometric and spatial performance.
Dynamic Transport and Distribution of Organic Pollutants in Water and Sediments of the Rur River
Authors: Schwanen Christina A. , Kronsbein Pia M. , Balik Berna , Schwarzbauer Jan
Published: December 2023

The distribution and fate of organic pollutants within different compartments of a river system are determined by several key effects and drivers. Within the scope of this study, the aqueous and sedimentary compartments have been analyzed complementary to understand transport and accumulation pathways and to determine temporospatial effects. The bi-annual campaigns allow general statements to be made about relevant processes and effects on pollutant distribution. GC/MS non-target screenings revealed that there is only a minor group of contaminants that occur both in the water and in the riverbed. Nevertheless, for both phases, the main contamination with organic compounds occurred in the anthropogenic, middle to lower course of the river with loads up to 18.3 kg/d (2,4,7,9-tetramethyl-5-decyne-4,7-diol, TMDD) in the water and amounts up to 3.3 mg/gTOC (ƩEPA16 polycyclic aromatic hydrocarbons, PAHs) in the riverbed. Main emission sources were comparable, resulting in a high, almost constant contamination level which also contributes to the pollution of the superior, receiving river. Indeed, the pollution transport of the aqueous and sedimentary phases was closely connected, but with slight temporal and spatial heterogeneities. For the aqueous compartment, seasonal effects were identified while a remarkable change in riverbed contamination occurred due to an extreme flood event. However, dams within the catchment system cause a disconnection of the transport of lipophilic and hydrophilic substances. Overall, the combined investigation of different phases is an important aspect for a comprehensive view of river and environmental contamination.
Accuracy of formula-based volume and image segmentation-based volume in calculation of preoperative cystic jaw lesions’ volume
Authors: El-beblawy Yasmein Maher , Bakry Ahmed Mohamed , Mohamed Maha Eshaq Amer
Published: December 2023

Objective

The aim of this study was to assess the accuracy of formula-based volume measurements and the 3D volume analysis with different software packages in the calculation of preoperative cystic jaw lesions’ volume. The secondary aim was to assess the reliability and the accuracy of 3 imaging software programs for measuring the cystic jaw lesions' volume in CBCT images.

Materials and methods

This study consisted of two parts: an in vitro part using 2 dry human mandibles that were used to create simulated osteolytic lesions to assess the accuracy of the volumetric analysis and formula-based volume. As a gold standard, the volume of each bone defect was determined by taking an impression using rapid soft silicone (Vinylight) and then quantifying the volume of the replica. Afterward, each tooth socket was scanned using a high-resolution CBCT. A retrospective part using archived CBCT radiographs that were taken from the database of the outpatient clinic of the oral and maxillofacial radiology department, Faculty of Dentistry, Minia University to assess the reliability of the 3 software packages. The volumetric data set was exported for volume quantification using the 3 software packages (MIMICS-OnDemand and InVesalius software). Also, the three greatest orthogonal diameters of the lesions were calculated, and the volume was assessed using the ellipsoid formula. Dunn’s test was used for pair-wise comparisons when Friedman’s test was significant. The inter-examiner agreement was assessed using Cronbach’s alpha reliability coefficient and intra-class correlation coefficient.

Results

Regarding the results of the retrospective part, there was a statistically significant difference between volumetric measurements by equation and different software (P value < 0.001, Effect size = 0.513). The inter-observer reliability of the measurements of the cystic lesions using the different software packages was very good. The highest inter-examiner agreement for volume measurement was found with InVesalius (Cronbach’s alpha = 0.992). On the other hand, there was a statistically significant difference between dry mandible volumetric measurements and Gold Standard. All software showed statistically significantly lower dry mandible volumetric measurements than the gold standard.

Conclusion

Computer-aided assessment of cystic lesion volume using InVesalius, OnDemand, and MIMICS is a readily available, easy to use, non-invasive option. It confers an advantage over formula-based volume as it gives the exact morphology of the lesion so that potential problems can be detected before surgery. Volume analysis with InVesalius software was accurate in determining the volume of simulated periapical defects in a human cadaver mandible as compared to true volume. InVesalius software proved that open-source software can be robust yet user-friendly with the advantage of minimal cost to use.
Timeshifting strategies for carbon-efficient long-running large language model training
Authors: Jagannadharao Akshaya , Beckage Nicole , Nafus Dawn , Chamberlin Scott
Published: December 2023

Language models play a vital role in various natural language processing tasks, but their training can be computationally intensive and lead to significant carbon emissions. In this study, we explore the effectiveness of timeshifting strategies to mitigate the environmental impact of long-running large language models (LLMs). We develop a simulation tool that estimates carbon emissions for LLMs, enabling developers to make informed decisions prior to running their workloads. By leveraging historical carbon intensity data from WattTime, we investigate the potential benefits and limitations of timeshifting in different locations, considering diverse energy profiles. Our findings demonstrate that timeshifting can substantially reduce emissions, but it is highly dependent on the region’s carbon intensity and energy mix. We present insights into the trade-offs between emissions reduction and workload runtime, acknowledging the need for further advancements in carbon-aware computing practices. Our research contributes to the growing field of sustainable computing and encourages developers to adopt environmentally conscious strategies in language model training.
Functionalities of electrochemical fluoroquinolone sensors and biosensors
Authors: Nepfumbada Collen , Mthombeni Nomcebo H. , Sigwadi Rudzani , Ajayi Rachel F. , Feleni Usisipho , Mamba Bhekie B.
Published: December 2023

Fluoroquinolones (FQs) are a class of broad-spectrum antimicrobial agents that are used to treat variety of infectious diseases. This class of antibiotics was being used for patients exhibiting early symptoms of a human respiratory disease known as the COVID-19 virus. As a result, this outbreak causes an increase in drug-resistant strains and environmental pollution, both of which pose serious threats to biota and human health. Thus, to ensure public health and prevent antimicrobial resistance, it is crucial to develop effective detection methods for FQs determination in water bodies even at trace levels. Due to their characteristics like specificity, selectivity, sensitivity, and low detection limits, electrochemical biosensors are promising future platforms for quick and on-site monitoring of FQs residues in a variety of samples when compared to conventional detection techniques. Despite their excellent properties, biosensor stability continues to be a problem even today. However, the integration of nanomaterials (NMs) could improve biocompatibility, stability, sensitivity, and speed of response in biosensors. This review concentrated on recent developments and contemporary methods in FQs biosensors. Furthermore, a variety of modification materials on the electrode surface are discussed. We also pay more attention to the practical applications of electrochemical biosensors for FQs detection. In addition, the existing challenges, outlook, and promising future perspectives in this field have been proposed. We hope that this review can serve as a bedrock for future researchers and provide new ideas for the development of electrochemical biosensors for antibiotics detection in the future.
Mesenchymal Stem Cell Therapy in Acute Intracerebral Hemorrhage: A Dose-Escalation Safety and Tolerability Trial
Authors: Durand Nisha C. , Kim H. G. , Patel Vishal N. , Turnbull Marion T. , Siegel Jason L. , Hodge David O. , Tawk Rabih G. , Meschia James F. , Freeman W. David , Zubair Abba C.
Published: December 2023

Background

We conducted a preliminary phase I, dose-escalating, safety, and tolerability trial in the population of patients with acute intracerebral hemorrhage (ICH) by using human allogeneic bone marrow–derived mesenchymal stem/stromal cells.

Methods

Eligibility criteria included nontraumatic supratentorial hematoma less than 60 mL and Glasgow Coma Scale score greater than 5. All patients were monitored in the neurosciences intensive care unit for safety and tolerability of mesenchymal stem/stromal cell infusion and adverse events. We also explored the use of cytokines as biomarkers to assess responsiveness to the cell therapy. We screened 140 patients, enrolling 9 who met eligibility criteria into three dose groups: 0.5 million cells/kg, 1 million cells/kg, and 2 million cells/kg.

Results

Intravenous administration of allogeneic bone marrow–derived mesenchymal stem/stromal cells to treat patients with acute ICH is feasible and safe.

Conclusions

Future larger randomized, placebo-controlled ICH studies are necessary to validate this study and establish the effectiveness of this therapeutic approach in the treatment of patients with ICH.