bluuebunny/crossref_metadata_2025 huggingface dataset:
Multicultural Perspectives in Driving Instructor Education and Driving Schools for Professional Drivers in Norway
Authors: Blixen Tatjana Bru , Fegri Kai Andre , Hellne-Halvorsen Ellen Beate
Published: October 2023

This study aims to examine how a multicultural perspective is integrated into the driving instructor education and education of professional drivers in driving schools in Norway. Many of the public transit bus drivers and drivers of other commercial motor vehicles are immigrants and second language users. The study centers on investigating the training experiences of driving instructor trainers and driving instructors on how prospective drivers with an immigrant background attend training and gain a professional license. Our perspective is on second language and cultural challenges within driving instructor education and driving schools for professional drivers. The study uses individual interviews of driving instructor trainers and driving instructors in driving schools. These educational programs are seen in light of official documents such as curricula and Norwegian road traffic regulations. The results show that driving instructors and driving instructor trainers are attentive to multilingualism and multiculturalism in their teaching, and that they do perceive common challenges with language and culture. Both driving instructors and driving instructor trainers attempt to solve the challenges, but to varying degrees, depending on the individual trainer. Driving instructor trainers call for more training in the topic and are currently working on implementing multilingual and multicultural issues in new curricula for driving instructor education.
Important Encounters for Education and Employment
Authors: Eliasson Eva
Published: October 2023

Support from other people has been identified as one of the key factors facilitating migrants’ access to their previous vocational area in their new country (Eliasson et al., J Educ Work 35(8): 828–842). In this text, migrants’ descriptions of encounters that have influenced their paths to education or employment are studied in depth. The encounters are analysed through theories of social identity construction (Jenkins, Social identity, 2004) and from a class, gender, and ethnicity perspective. The material consists of 20 interviews with migrants who have a professional education from their home country and have gained access to their previous vocational area in Sweden. The result shows that encounters can lead to direct access to education and workplaces, but also function as support and encouragement that strengthen the migrant’s fighting spirit. In other words, successful encounters may lead to successful inclusion into working life. Aspects of ethnicity and profession (class) are visible in the analysis of the encounters, while gender is less visible since the respondents are working in traditionally masculine- or feminine-coded sectors. Resistance to other people’s negative constructions of the respondents’ identities is visible in many narratives, which also seems important to their persistence in job searching.
Revival of Optical Computing
Authors: Tanida Jun
Published: October 2023

Optical computing is a general term for high-performance computing technologies that effectively use the physical properties of light. With the rapid development of electronics, its superiority as a high-performance computing technology has diminished; however, there is momentum for research on new optical computing. This study reviews the history of optical computing, clarifies its diversity, and provides suggestions for new developments. Among the methods proposed thus far, those considered useful for utilizing optical technology in information systems are introduced. Subsequently, the significance of optical computing in the modern context is considered and directions for future development is presented.
Brain-Inspired Reservoir Computing Models
Authors: Katori Yuichi
Published: October 2023

This chapter presents an overview of brain-inspired reservoir computing models for sensory-motor information processing in the brain. These models are based on the idea that the brain processes information using a large population of interconnected neurons, where the dynamics of the system can amplify, transform, and integrate incoming signals. We discuss the reservoir predictive coding model, which uses predictive coding to explain how the brain generates expectations regarding sensory input and processes incoming signals. This model incorporates a reservoir of randomly connected neurons that can amplify and transform sensory inputs. Moreover, we describe the reservoir reinforcement learning model, which explains how the brain learns to make decisions based on rewards or punishments received after performing a certain action. This model uses a reservoir of randomly connected neurons to represent various possible actions and their associated rewards. The reservoir dynamics allow the brain to learn which actions lead to the highest reward. We then present an integrated model that combines these two reservoir computing models based on predictive coding and reinforcement learning. This model demonstrates how the brain integrates sensory information with reward signals to learn the most effective actions for a given situation. It also explains how the brain uses predictive coding to generate expectations about future sensory inputs and accordingly adjusts its actions. Overall, brain-inspired reservoir computing models provide a theoretical framework for understanding how the brain processes information and learns to make decisions. These models have the potential to revolutionize fields such as artificial intelligence and neuroscience, by advancing our understanding of the brain and inspiring new technologies.
Nonlinear Dynamics and Computing in Recurrent Neural Networks
Authors: Suzuki Hideyuki
Published: October 2023

Nonlinearity is a key concept in the design and implementation of photonic neural networks for computing. This chapter introduces the fundamental models and concepts of recurrent neural networks, with a particular focus on their nonlinear dynamics. We review several types of nonlinear dynamics that emerge in symmetrically connected recurrent neural networks, in which the energy function plays a crucial role. In addition, we introduce the concepts of reservoir computing, covering fundamental models and physical reservoir computing. Overall, this chapter provides a foundation for the theoretical aspects in the subsequent chapters of this book, which explore a variety of photonic neural networks with nonlinear spatiotemporal dynamics.
Fluorescence Energy Transfer Computing
Authors: Nishimura Takahiro
Published: October 2023

This chapter presents the concept and implementation of fluorescence energy transfer computing, specifically utilizing Förster resonance energy transfer (FRET) between molecular fluorophores and quantum dots. FRET is a non-radiative form of excitation energy transfer that depends on the configuration and optical properties of molecular fluorophores and quantum dots. By designing energy flows through FRET, signal processing can be implemented to perform desired operations. Because the phenomenon occurs at the nanometer scale, miniaturization of information devices can be expected. This chapter reviews the concepts of FRET computing and the implementation of FRET computing devices. Then, a framework of DNA scaffold logic, which systematically handles FRET-based logic operations, is described. Finally, the idea of a FRET network is discussed as a method for enhancing FRET computing performance.
The Paradox of Urban Diversity and Cohesion
Authors: Ikeda Sanford
Published: October 2023

What fosters spontaneous complexity in a city? What are the conditions that enable the emergence of complex social order? Where do effective action spaces and innovations appear and why? Chapter 3 argued that increasing the scope and design of central planning lowers the spontaneity and complexity of a city. This chapter examines in greater detail why that happens by addressing the question of how certain physical elements of a living city work together to spontaneously generate the diversity necessary for a complex urban order.
Social Networks and Action Space in Cities
Authors: Ikeda Sanford
Published: October 2023

This chapter builds on Jacobs’s insights into social networks as a cohesive force in cities. It introduces social-network concepts into market-process economics, links it to Jacobsian economics, and grounds them both on a common social theory. In doing so, it further develops the concepts of Jacobs Density and action space.
A Living City Is Messy (and What Not to Do About It)
Authors: Ikeda Sanford
Published: October 2023

A living city is an incubator of ideas and a congenial place for entrepreneurial discovery, innovation, and economic development. Such creativity emerges from trial and error, which entails not only successes but also failure, conflict, and disappointment. Great cities, like flesh-and-blood people, can also be very unpleasant, annoying, and sometimes dangerous. Indeed, any city that aspires to greatness will have something to offend everyone. This chapter looks at the sources of these unpleasant by-products, reviews efforts by some prominent figures in modernist urban planning and design influenced by “cartesian rationalism,” and critiques them within the Jacobsian-cum-market-process framework.
Fixing Cities
Authors: Ikeda Sanford
Published: October 2023

This chapter looks beyond the ambitious, large-scale, utopian visions of twentieth-century urban designers to smaller-scale “micro-interventions,” including building codes, rent regulation, housing subsidies, smart growth, New Urbanism, and zoning. It then examines their consequences, especially their unintended consequences, from a Market Urbanist perspective.
Intra‐operative laxity and balance impact 2‐year pain outcomes in TKA: a prospective cohort study
Authors: Wakelin Edgar A. , Ponder Corey E. , Randall Amber L. , Koenig Jan A. , Plaskos Christopher , DeClaire Jeffrey H. , Lawrence Jeffrey M. , Keggi John M.
Published: October 2023

Purpose

The objective of this study was to determine if intra‐operatively measured joint gaps are associated with 2‐year pain outcomes in total knee arthroplasty (TKA) and whether balance and laxity windows could be defined throughout flexion to optimize 2‐year pain outcomes. Our hypothesis is that intra‐operative joint gaps are associated with 2 year post‐operative pain outcome.

Methods

A prospective study investigating 310 robotically assisted TKAs was performed. Final intra‐operative joint gap data were recorded using a digital tensioner and component alignment data were recorded by the robotics system. Patient demographics and Knee Injury and Osteoarthritis Outcome Score (KOOS) were recorded pre‐operatively and KOOS and Hospital for Special Surgery (HSS) satisfaction were recorded at 2 years post‐op. A random search Simulated Annealing (SANN) optimisation algorithm was used to determine global optimum laxity and balance windows at different flexion angles which maximized the 2‐year KOOS pain scores. The windows were combined to determine the impact of achieving optimal laxity and balance throughout flexion. To improve clinical utility, boundaries identified by the SANN algorithm were rounded to the nearest 0.5 mm before statistical analysis.

Results

Laxity and balance windows were defined in extension (Med lax: ‐2.0 to 2.5 mm, Lat lax: ‐0.5 to 2.5 mm, Balance: ‐3.0 to 0.0 mm), mid‐flexion (Med lax: ‐1.0 to 2.5 mm, Lat lax: ‐0.5 to 3.0 mm, Balance: ‐2.0 to 2.0 mm), and flexion (Med lax: ‐2.0 to 3.5 mm, Lat lax: ‐2.0 to 1.5 mm, Balance: ‐3.0 to 3.0 mm). When all windows were satisfied, the greatest difference in KOOS pain score was observed (100.0 vs 94.4, p < 0.0001). The highest percentage of knees satisfying the Patient Acceptable Symptom State (PASS) for KOOS pain was also observed in knees which satisfied all windows compared to knees which did not (93% vs 71%, p = 0.0009). The proportion of knees which satisfy the PASS threshold decreased in knees which only satisfied 1–3 (29%) or 4–6 (69%) windows (p ≤ 0.0018). No optimal windows were found between component alignment and KOOS pain outcome (p ≥ 0.1180). High satisfaction was found across all groups (≥ 95%).

Conclusion

Intra‐operatively measured joint gaps are associated with all KOOS sub‐score outcomes at 2 years after TKA. Optimal windows for a clinically relevant improvement in post‐operative KOOS pain were defined for laxity and balance but not for alignment indicating balance may have a greater impact on outcome than alignment.

Level of evidence

II.
A spaced retraining schedule with 2‐day interval improves the acquisition and retention of simulation‐based basic arthroscopic skills
Authors: Yang Weihao , Li Wei , Guo Congyue , Wang Zihe , Wu Shangxing , Feng Lei , Yang Zhouwen , Xie Xiaobo , Tian Jing
Published: October 2023

Purpose

To compare the effect of three differently spaced retraining schedules (1‐day, 2‐day, and 1‐week intervals) on the acquisition of basic arthroscopic skills and skill retention after 3 months.

Methods

Thirty orthopaedic residents without arthroscopic experience were enrolled in a double‐blind, randomised, parallel‐controlled trial. Spaced retaining schedules were divided into massed training and retraining phases. Participants were required to obtain perfect scores in all tasks on the simulator in the massed training phase, followed by a pretest to evaluate the training effect. During the retraining phase, participants were randomly assigned to Groups A (1‐day interval), B (2‐day interval) or C (1‐week interval). A posttest was used to evaluate the effect of different retraining patterns. Follow‐up evaluations were conducted at 1 week, 1 month and 3 months after the completion of spaced retraining schedules to measure skill retention. One‐way ANOVA and paired‐sample t tests were used for statistical analysis.

Results

Significant between‐group differences in diagnostic arthroscopy (137.0 ± 24.8 vs. 140.1 ± 21.3 vs. 175.3 ± 27.4 s, P(A−C) = 0.005, P(B−C) = 0.010) and loose body removal (193.1 ± 33.9 vs. 182.0 ± 32.1 vs. 228.7 ± 42.9 s, P(B−C) = 0.025) completion times were observed. No significant differences were found in other posttest metrics. An assessment of skill retention after the 3‐month follow‐up (Evaluation 3) showed significant differences in diagnostic arthroscopy completion time (202.5 ± 53.3 vs. 172.0 ± 27.2 vs. 225.5 ± 42.1 s, P(B−C) = 0.026). No significant differences were found in other Evaluation 3 metrics.

Conclusion

The 2‐day retraining schedule was the most effective for the acquisition and retention of basic arthroscopic skills and could be integrated into arthroscopic skills curricula. After a 3‐month follow‐up, residents who followed this schedule showed better skill retention than those who followed the 1‐week interval schedule.

Level of evidence

Level I.
Volatilomes of human infection
Authors: Fitzgerald Shane , Holland Linda , Ahmed Waqar , Piechulla Birgit , Fowler Stephen J. , Morrin Aoife
Published: October 2023

The human volatilome comprises a vast mixture of volatile emissions produced by the human body and its microbiomes. Following infection, the human volatilome undergoes significant shifts, and presents a unique medium for non-invasive biomarker discovery. In this review, we examine how the onset of infection impacts the production of volatile metabolites that reflects dysbiosis by pathogenic microbes. We describe key analytical workflows applied across both microbial and clinical volatilomics and emphasize the value in linking microbial studies to clinical investigations to robustly elucidate the metabolic species and pathways leading to the observed volatile signatures. We review the current state of the art across microbial and clinical volatilomics, outlining common objectives and successes of microbial-clinical volatilomic workflows. Finally, we propose key challenges, as well as our perspectives on emerging opportunities for developing clinically useful and targeted workflows that could significantly enhance and expedite current practices in infection diagnosis and monitoring.

Graphical Abstract
Understanding the diagnosis of superior mesenteric artery syndrome: analysis of the location of duodenal impression on upper gastrointestinal studies
Authors: Caterine Scott , Patil Nikhil S. , Takrouri Heba , Issenman Robert M. , Stein Nina R. , Donnellan John , Yikilmaz Ali
Published: October 2023

Background

Upper gastrointestinal (GI) contrast studies are frequently requested to aid superior mesenteric artery syndrome diagnosis, a rare entity. Compression of the third duodenal part is expected to be mid-to-left of the midline where the superior mesenteric artery arises from the aorta; however, a duodenal impression to the right of the midline due to normal anatomic impression by the inferior vena cava (IVC) is often encountered and frequently misdiagnosed.

Objective

The purpose of this study was to determine the frequencies of (1) normal right-of-midline duodenal impressions and (2) mid-to-left of midline compressions in upper GI studies in a tertiary pediatric referral center.

Materials and methods

All upper GI studies performed at our institution over 2 years were retrospectively evaluated to determine whether the duodenum had vertical duodenal impression to the right of the vertebral midline, mid-to-left of the vertebral midline, or no identifiable duodenal impression at all.

Results

In total, 538 upper GI studies were included in this analysis. A total of 275 male and 247 female patients between 0 and 17 years of age (median: 6 years, range: 1 month-17 years) were included. Of 538 total upper GI studies, there were 240 studies (44.6%) with a right-of-midline impression. There were only 10 studies (1.9%) with a mid-to-left of midline compression, and 9/10 also showed a concurrent right-sided impression sign.

Conclusion

Right-of-midline duodenal impression is a normal anatomic finding caused by the IVC and should not be confused with superior mesenteric artery syndrome. In the presence of an appropriate clinical context, proximal duodenal dilation, “to-and-fro” motion of contrast, and duodenal impression at mid-to-left of midline, a diagnosis of superior mesenteric artery syndrome should be considered.

Graphical Abstract
Cardiac [99mTc]Tc-hydroxydiphosphonate uptake on bone scintigraphy in patients with hereditary transthyretin amyloidosis: an early follow-up marker?
Authors: Tingen H. S. A. , Tubben A. , Bijzet J. , van den Berg M. P. , van der Meer P. , Houwerzijl E. J. , Muntinghe F. L. H. , van der Zwaag P. A. , Glaudemans A. W. J. M. , Oerlemans M. I. F. J. , Knackstedt C. , Michels M. , Hirsch A. , Hazenberg B. P. C. , Slart R. H. J. A. , Nienhuis H. L. A.
Published: October 2023

Purpose

There is a need for early quantitative markers of potential treatment response in patients with hereditary transthyretin (ATTRv) amyloidosis to guide therapy. This study aims to evaluate changes in cardiac tracer uptake on bone scintigraphy in ATTRv amyloidosis patients on different treatments.

Methods

In this retrospective cohort study, outcomes of 20 patients treated with the transthyretin (TTR) gene silencer patisiran were compared to 12 patients treated with a TTR-stabilizer. Changes in NYHA class, cardiac biomarkers in serum, wall thickness, and diastolic parameters on echocardiography and NYHA class during treatment were evaluated.

Results

Median heart/whole-body (H/WB) ratio on bone scintigraphy decreased from 4.84 [4.00 to 5.31] to 4.16 [3.66 to 4.81] (p < .001) in patients treated with patisiran for 29 [15–34] months. No changes in the other follow-up parameters were observed. In patients treated with a TTR-stabilizer for 24 [20 to 30] months, H/WB ratio increased from 4.46 [3.24 to 5.13] to 4.96 [ 3.39 to 5.80] (p = .010), and troponin T increased from 19.5 [9.3 to 34.0] ng/L to 20.0 [11.8 to 47.8] ng/L (p = .025). All other parameters did not change during treatment with a TTR-stabilizer.

Conclusion

A change in cardiac tracer uptake on bone scintigraphy may be an early marker of treatment-specific response or disease progression in ATTRv amyloidosis patients.
Efficient single-crystal 4-N,N-dimethylamino-4-N-methyl-stilbazolium tosylate (DAST) on the optical, piezoelectric coefficient and structure of P(VDF-HFP) copolymer for energy conversion systems
Authors: Habib A. , Metwally M. M. , Fahmy T.
Published: October 2023

Poly(vinylidene fluoride-co-hexafluoropropylene) P(VDF-HFP) doped with 4-N,N-dimethylamino-4-N-methyl-stilbazolium tosylate (DAST) composites with various concentrations of DAST dye is prepared using the casting method. The crystal structure and optical properties of the pure and P(VDF-HFP)/DAST composites with various contents of DAST dye are investigated using various techniques such as UV–Vis spectroscopy, X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR) and polarized optical microscopy (POM). The analysis of XRD data and FTIR spectra revealed that the β-fraction has been improved in the composite samples with increasing the content of DAST dye. Analysis of UV spectra displayed that the optical band gap of P(VDF-HFP) pure copolymer is 5.41 eV and has been reduced to be 3.75 eV for P(VDF-HFP)/10 wt% DAST that will be suitable for efficient systems of energy conversion and multijunction-based layer solar cells. Also, it is found that the nonlinear and linear optical parameters of the composite samples are DAST dye-dependent. Thermally stimulated depolarization current (TSDC) technique has been applied to investigate the dipolar and space charge relaxations of the composites. Moreover, it is observed that the pyroelectricity and piezoelectricity are enhanced with increasing the content of DAST dye. The highest content of the DAST dye showed maximum values of the pyroelectric and the piezoelectric coefficients of ~ 4 × 10–5 C/m2 K and ~ 34 pC/N at stress of 6.27 × 105 Pa, respectively. Our results of the polymer/dye composites give an opportunity of a promising material for flexible piezoelectricity devices used in many potential applications and energy harvesting systems.
Development of application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers
Authors: Leitner Lukas , Hauer Georg , Rasic Laura , Clar Clemens , Leithner Andreas , Sadoghi Patrick
Published: October 2023

Purpose

The aim was to compare total knee arthroplasty (TKA) between countries with regard to epidemiologic data and surgical technique by the use of worldwide registers and compare findings with a previous report after one decade.

Methods

A systematic search was carried out in November 2022 and compared to previous reports from 2010. We extracted data regarding implanted TKAs, patients’ age distribution, procedure types, fixation and revision rates. After identification of 28 national arthroplasty registers, 8of them, namely Australia, Canada, Denmark, England and Wales, New Zealand, Norway, Scotland and Sweden, offered sufficient data and were included in final analysis.

Results

A large variation was found in the annual number of implantations per 100,000 inhabitants with a range from 77 to 210.2 (mean 132.8). The fixation type varied strongly as well, e.g. over 95% of totally cemented TKAs in Sweden versus 61.2% cemented fixation in Denmark. Another significant difference was the use of patellar resurfacing in TKA, ranging from 47.3% (Canada) using a patellar button in TKA to less than 5% (Sweden). Within the period of one decade, the mean overall number of annual implantations increased (10%), whilst relative number of revisions decreased, the use of cemented TKA decreased from 87 to 74%, and the use of patella button remained largely inhomogeneous.

Conclusion

Comparison of arthroplasty registers revealed large differences regarding the annual number of primary TKAs per inhabitant as well as primary TKA procedure types with an increase of annual implantations, decrease of relative number of revisions, and a decrease of the use of cemented systems over the period of one decade.
Multi-stage subduction-related metasomatism recorded in whiteschists from the Dora-Maira Massif, Western Alps
Authors: Harris Benedict J. R. , De Hoog Jan C. M. , Halama Ralf , Schertl Hans-Peter , Chen Yi-Xiang
Published: October 2023

Whiteschists from the Dora-Maira massif (Western Alps, Italy) are Mg and K-rich metasomatised granites which experienced ultra-high-pressure metamorphism and fluid–rock interaction during Alpine continental subduction. The sources and timing of fluid infiltration are a source of significant debate. In this study, we present boron (B) isotopes and other fluid-mobile trace-element (FME) concentrations in various generations of phengite from whiteschists and their country rock protoliths to investigate the sources and timing of metasomatic fluid influx. Reconstructed bulk rock concentrations based on modal data and mineral compositions indicate that significant amounts B and other FME were added to the rock during prograde metamorphism, but that this fluid influx postdates the main Mg metasomatic event. High B concentrations (150–350 $$\upmu$$
μ
g/g) and light $${\delta^{\text{11}}}\text{B}$$

δ
11

B

values (− 16 to −4 ‰) recorded in phengite point to a B-rich sediment-derived fluid as the main source of B in the whiteschists. Further redistribution of FME during metamorphism was associated with breakdown of hydrous minerals, such as talc, phlogopite, and ellenbergerite. The source of the Mg-rich fluids cannot be constrained based on the B data in phengite, since its signature was overprinted by the later main B metasomatic event. Rare tourmaline-bearing whiteschists record additional information about B processes. Tourmaline $${\delta^{\text{11}}}\text{B}$$

δ
11

B

values (− 6 to +1 ‰) are in isotopic equilibrium with similar fluids to those recorded in most phengite, but phengites in tourmaline-bearing samples record anomalous B isotope compositions that reflect later redistribution of B. This study demonstrates the utility of in situ analyses in unravelling complex fluid–rock interaction histories, where whole-rock analyses make it difficult to distinguish between different stages of fluid–rock interaction. Polymetasomatism may result in decoupling of different isotopic systems, thus complicating their interpretation. The Dora-Maira whiteschists interacted with multiple generations of fluids during subduction and therefore may represent a long-lived fluid pathway.
Rates of diabetic retinopathy among cluster analysis—identified type 2 diabetic mellitus subgroups
Authors: Scott Rachel A. , Lu Vivian I. , Grove Nathan , Patnaik Jennifer L. , Manoharan Niranjan
Published: October 2023

Purpose

To determine whether phenotypic clustering of patients with diabetes mellitus (DM) is associated with more advanced diabetic retinopathy (DR).

Methods

Retrospective cohort study of 495 patients with no prior DR treatment seen at a tertiary care clinic 2014–2020. Four previously identified clusters from Ahlqvist’s 2018 paper were reproduced utilizing baseline hemoglobin A1c, body mass index, and age at DM diagnosis. Age-adjusted Cox proportional hazard ratios were used to compare clusters with reference as the lowest risk cluster.

Results

All four type 2 DM clusters were replicated with our cohort. There was a significant difference in racial distribution among clusters (p = 0.018) with severe insulin-resistant diabetes (SIRD) having the higher percentage of Caucasians and lower percentage of Hispanics compared to other groups and a higher percentage of African Americans comprising the severe insulin-deficient diabetes (SIDD) cluster than other groups. Rates of proliferative diabetic retinopathy were higher in mild obesity-related diabetes (MOD) (28%), SIDD (24%), mild age-related diabetes (MARD) (20%), and lowest in SIRD (7.9%), overall p = 0.004. Rates of vitreous hemorrhage were higher in MOD (p = 0.032) and MARD (0.005) compared to SIRD.

Conclusion

Baseline clinical measures may be useful in risk stratifying patients for progression to retinopathy requiring intervention.
Technological advancements in surgical laparoscopy considering artificial intelligence: a survey among surgeons in Germany
Authors: Lünse Sebastian , Wisotzky Eric L. , Beckmann Sophie , Paasch Christoph , Hunger Richard , Mantke René
Published: October 2023

Purpose

The integration of artificial intelligence (AI) into surgical laparoscopy has shown promising results in recent years. This survey aims to investigate the inconveniences of current conventional laparoscopy and to evaluate the attitudes and desires of surgeons in Germany towards new AI-based laparoscopic systems.

Methods

A 12-item web-based questionnaire was distributed to 38 German university hospitals as well as to a Germany-wide voluntary hospital association (CLINOTEL) consisting of 66 hospitals between July and November 2022.

Results

A total of 202 questionnaires were completed. The majority of respondents (88.1%) stated that they needed one assistant during laparoscopy and rated the assistants’ skillfulness as “very important” (39.6%) or “important” (49.5%). The most uncomfortable aspects of conventional laparoscopy were inappropriate camera movement (73.8%) and lens condensation (73.3%). Selected features that should be included in a new laparoscopic system were simple and intuitive maneuverability (81.2%), automatic de-fogging (80.7%), and self-cleaning of camera (77.2%). Furthermore, AI-based features were improvement of camera positioning (71.3%), visualization of anatomical landmarks (67.3%), image stabilization (66.8%), and tissue damage protection (59.4%). The reason for purchasing an AI-based system was to improve patient safety (86.1%); the reasonable price was €50.000–100.000 (34.2%), and it was expected to replace the existing assistants’ workflow up to 25% (41.6%).

Conclusion

Simple and intuitive maneuverability with improved and image-stabilized camera guidance in combination with a lens cleaning system as well as AI-based augmentation of anatomical landmarks and tissue damage protection seem to be significant requirements for the further development of laparoscopic systems.
Validating an advanced smartphone application for thermal advising in cold environments
Authors: Eggeling Jakob , Rydenfält Christofer , Halder Amitava , Toftum Jørn , Nybo Lars , Kingma Boris , Gao Chuansi
Published: October 2023

The ClimApp smartphone application was developed to merge meteorological forecast data with personal information for individualized and improved thermal warning during heat and cold stress and for indoor comfort in buildings. For cold environments, ClimApp predicts the personal thermal stress and strain by the use of the Insulation REQuired model that combines weather and personal physiological data with additional consideration of the Wind Chill index based on the local weather forecast. In this study, we validated the individualized ClimApp index relative to measurements and compared it with the Universal Temperature Climate Index (UTCI). To this aim, 55 participants (27 females) were exposed to at least 1 h in an outdoor environment of 10 °C or below (average 1.4 °C air temperature, 74.9% relative humidity, and 4.7 m/s air velocity) inputting their activity level and clothing insulation as instructed by ClimApp. The UTCI and ClimApp indices were calculated and compared to the participants’ perceived thermal sensation. The ClimApp index root mean square deviation (RMSD) was below the standard deviation of the perceived thermal sensation which indicates a valid prediction and the UTCI RMSD was higher than the standard deviation which indicates an invalid prediction. The correlation of ClimApp and UTCI to the perceived thermal sensation was statistically significant for both models.
A paper biosensor for overcoming matrix effects interfering with the detection of sputum pyocyanin with competitive immunoassays
Authors: Adrover-Jaume Cristina , Clemente Antonio , Rodríguez-Urretavizcaya Bárbara , Vilaplana Lluïsa , Marco M. Pilar , Rojo-Molinero Estrella , Oliver Antonio , de la Rica Roberto
Published: October 2023

Detecting sputum pyocyanin (PYO) with a competitive immunoassay is a promising approach for diagnosing Pseudomonas aeruginosa respiratory infections. However, it is not possible to perform a negative control to evaluate matrix-effects in competitive immunoassays, and the highly complex sputum matrix often interferes with target detection. Here, we show that these issues are alleviated by performing competitive immunoassays with a paper biosensor. The biosensing platform consists of a paper reservoir, which contains antibody-coated gold nanoparticles, and a substrate containing a competing recognition element, which is a piece of paper modified with an albumin-antigen conjugate. Detection of PYO with a limit of detection of 4.7·10−3 µM and a dynamic range between 4.7·10−1 µM and 47.6 µM is accomplished by adding the sample to the substrate with the competing element and pressing the reservoir against it for 5 min. When tested with patient samples, the biosensor was able to qualitatively differentiate spiked from non-spiked samples, whereas ELISA did not show a clear cut-off between them. Furthermore, the relative standard deviation was lower when determining sputum with the paper-based biosensor. These features, along with a mild liquefaction step that circumvents the use of harsh chemicals or instruments, make our biosensor a good candidate for diagnosing Pseudomonas infections at the bedside through the detection of sputum PYO.

Graphical Abstract
How often is prophylactic parastomal mesh placement performed after rectal resection without sphincter preservation? An analysis of German nationwide hospital discharge data among 41,697 patients
Authors: Paasch C. , Kobelt E. , Lünse S. , Heisler S. , Lorenz R. , Hunger R. , Mantke R.
Published: October 2023

Purpose

The European Hernia Society guidelines of parastomal hernias, published in 2017, strongly recommend prophylactic synthetic non-absorbable mesh upon the construction of a permanent end colostomy to reduce the incidence of parastomal hernias. This study aims to evaluate the implementation of the guidelines in Germany.

Methods

This is a retrospective multicentric analysis conducted in December 2022 at the University Hospital Brandenburg an der Havel. Anonymous data on rectal resection without sphincter preservation in the period 2010–2020 were extracted from the German nationwide hospital discharge data set. Individuals with a hernia and < 18 years old were excluded. Another exclusion criterion was a performed colectomy or proctocolectomy with an ileoanal pouch and placement of an absorbable mesh. The primary endpoint was the annual rate of prophylactic parastomal mesh placement following rectal resection without sphincter preservation in Germany. Cases reporting both non-absorbable mesh placement and rectal resection without sphincter preservation were considered prophylactic mesh insertions.

Results

A total of 41,697 patients received a rectal resection without sphincter preservation and without non-absorbable mesh placement. Among these individuals, 27,089 were male and 14,608 were female. The rate of reoperations (3.1%) and the length of hospital stay (25.3 days ± 19.32) remained almost constant during these 10 years. The rate of prophylactic mesh placement was increasing from 0.2% (n = 8) in 2010 to 6.4% (n = 198) in 2020.

Conclusions

Currently, only the minority of patients who have undergone rectal resection without sphincter preservation receive prophylactic mesh insertion.
Fuzzy Observables: from Weak Markov Kernels to Markov Kernels
Authors: Beneduci Roberto
Published: October 2023

We provide a proof based on transfinite induction that every weak Markov kernel is equivalent to a Markov kernel. We only assume the space where the weak Markov kernel is defined to be second countable and metrizable. That generalizes some previous results where the kernel is required to be defined on a standard Borel space (which is second countable and completely metrizable) and the framework is the theory of stochastic operators. This property of weak Markov kernels is at the root of the characterization of a commutative POVM as the fuzzification of a spectral measure through a Markov kernel. As a result, the characterization of commutative POVMs is also generalized. We then revisit the relationships between weak Markov kernels, Markov kernels, commutative POVMs and fuzzy observables.
Linking Up Bell Beakers in the Iberian Peninsula
Authors: Jiménez-Puerto Joaquín , Aubán Joan Bernabeu
Published: October 2023

Many studies in complexity theory employ agent-based models whose interactions can be expressed as networks. In such models, the pattern of interactions between actors is crucial, and the network topology that emerges from the raw data can be characterized through many metrics. One tool previously used in archaeology studies has the potential to deal with networks in social contexts at different scales of analysis: social network analysis (SNA). This discipline has been applied successfully in a wide range of archaeological problems, providing valuable insights and a different perspective. It also could be helpful to quantify concepts associated with social complexity, such as robustness or resilience. In this work, we propose some methodologic possibilities for consideration in the phase definition of the adaptive cycle model (ACM), using SNA tools. To illustrate the process, we will present a case study from the Copper Age in the Iberian Peninsula: the Bell Beaker phase.
The suitability of common reed (Phragmites australis) for load-bearing structural materials
Authors: Albrecht Kaspar , Neudecker Felix , Veigel Stefan , Bodner Sabine , Keckes Jozef , Gindl-Altmutter Wolfgang
Published: October 2023

Besides wood, the most widely used natural structural material, dicotyledonous fibre plants such as flax or hemp, and monocotyledonous grasses such as cereal straw or bamboo have been shown to be suitable for application in materials. Common reed is a less well-characterised plant resource in this regard. Therefore, common reed stems were characterised in uniaxial tension in the present study, aiming at acquiring basic information about the mechanical characteristics of this material. Furthermore, laboratory-scale composite beams were manufactured and tested in bending. Compared to wood species with similar density, common reed stem walls showed a comparable average modulus of elasticity of 8 GPa and a very good average tensile strength of 150 MPa. After a mild alkali pre-treatment, reed showed excellent adhesive bonding, enabling the manufacture of high-density composite beams with roughly 130 MPa bending strength and 12–13 GPa modulus of elasticity. Same as untreated common reed stem walls, also reed biocomposite beams compared very favourably with established wood-based materials of similar structure, density, and adhesive content. In summary, it was thus demonstrated that common reed is a highly suitable raw material for bio-based load-bearing structural materials.
Family, a racialized space: A phenomenological approach to examining Afghan refugee families’ language policies in Norway
Authors: Mirvahedi Seyed Hadi
Published: October 2023

In this paper, I put forward and apply a phenomenological understanding of body and embodied experience to examine refugee families’ identity (trans)formation and language ideologies and practices. In particular, Kitarō Nishida’s (1870–1945) notion of historical body was adopted to investigate how Afghan refugee families’ lived experiences of forced mobility and life in different countries before their settlement in Norway influence their own as well as their children’s raciolinguistic and cultural/national identities, which in turn, affect their language ideologies and practices. Based on a thematic analysis of the interviews conducted with parents in three families, it was found that, having left Afghanistan at a young age with no hope to return to as well as their forced stays in different countries, Afghan parents have not developed a strong Afghan national identity. This embodied experience was entangled with painful emotions as well that resulted in the parents’ desire for their children to develop strong attachment to Norway and a Norwegian identity. Yet, parents’ wish does not seem to readily realize because the racial differences become an important marker of identity for the children as they grow up and enter the society, leading them to seek their roots. The study contributes to our better understanding of the complexities and nuances of transnational populations’ language ideologies and practices as well as identification and integration processes into the host society.
Inclusiveness of Access Policies to Maternity Care for Migrant Women Across Europe: A Policy Review
Authors: Pařízková Alena , Clausen Jette Aaroe , Balaam Marie-Clare , Haith-Cooper Melanie , Roosalu Triin , Migliorini Laura , Kasper Anne
Published: October 2023

Introduction

Despite the interconnectedness of the European Union, there are significant variations in pregnant women’s legal status as migrants and therefore their ability to access maternity care. Limited access to maternity care can lead to higher morbidity and mortality rates in migrant women and their babies. This study aimed to investigate and compare maternal health access policies and the context in which they operate across European countries for women who have migrated and are not considered citizens of the host country.

Methods

The study adopted a mixed-methods research design exploring policies on migrant women’s access to maternity care across the migration regimes. Data were extracted from legal documents and research reports to construct a new typology to identify the inclusiveness of policies determining access to maternity care for migrant women.

Results

This study found inconsistency in the categorisation of migrants across countries and significant disparities in access to maternity care for migrant women within and between European countries. A lack of connection between access policies and migration regimes, along with a lack of fit between policies and public support for migration suggests a low level of path dependency and leaves space for policy innovation.

Discussion

Inequities and inconsistencies in policies across European countries affect non-citizen migrant women’s access to maternity care. These policies act to reproduce structural inequalities which compromise the health of vulnerable women and newborns in reception countries. There is an urgent need to address this inequity, which discriminates against these already marginalised women.
Application of molecular imprinting approach for alkaloids analysis in food and nutraceuticals: review and perspective
Authors: Emara Samy , Kamal Maha , Sallam Ibrahim E. , Serag Ahmed , Farag Mohamed A.
Published: October 2023

Alkaloids are major dietary components well known for their pharmacological activities. Herbal matrices require extensive processing due to their high level of complexity in order to isolate their alkaloidal contents. Molecularly imprinted polymers (MIPs) are tailored receptors with a highly specific molecular recognition, which is the most important function of receptors. They can hence be utilized in applications wherein selective binding activities are of significance, such as solid phase extraction (SPE), chromatographic separation and chemical sensors. This review presents on recent applications of MIPs to analyze alkaloids in plants and bio-fluid samples as well as herbal formulations. We discuss the development of nano-sized MIPs for various applications, particularly in biomimetic sensors for electrochemical detection of various alkaloids. Due to its easier phase separation compared to common MISPEs, magnetic MISPEs were also discussed in order to explore the potential benefits of this approach for further phytochemical applications.
The impact of the transversus abdominis plane block (TAP) on stress response measured through the complete blood– derived inflammatory markers
Authors: Espadas-González Lorena , Usón-Casaús Jesús M. , Pastor-Sirvent Nieves , Santella Massimo , Ezquerra-Calvo Javier , Pérez-Merino Eva M
Published: October 2023

This study aims to evaluate the effect of the transversus abdominis plane (TAP) block on the blood cells and the inflammatory markers neutrophil– to– lymphocyte ratio (NLR), platelet– to– lymphocyte ratio (PLR), and systemic immune– inflammation index (SII) after the laparoscopic ovariectomy (LapOV) in dogs. 72 healthy bitches undergoing LapOV were randomly allocated to the no– TAP group of dogs under inhaled anesthesia (IA), the TAP– S group (IA and TAP with saline), and the TAP– B group (IA and TAP with bupivacaine). The NLR, PLR, and SII were calculated 1 h before ovariectomy (T0) and at 2−3 h (T1), 6−8 h (T2), and 20−24 h (T3) post– surgery. The number of dogs requiring postoperative analgesic rescue with buprenorphine and the doses administered in each group were recorded. Significant changes were observed in all groups’ postoperative NLR, PLR, and SII over time. Between groups, no differences were observed in any of the ratios at any control point (NLR at T0−T3:p = 0.17, 0.36, 0.80, and 0.95; PLR at T0−T3:p = 0.70, 0.62, 0.21, 0.87; SII at T0−T3:p = 0.29, 0.65, 0.09, and 0.34). A significantly lower number of dogs required analgesic rescue in the TAP-B group (p = 0.0001) and a lower number of doses were administered (p = 0.001). There is no difference in the inflammatory response measured through the complete blood– derived inflammatory markers after the LapOV in dogs when the postoperative pain is managed entirely with opioids or with the TAP block with bupivacaine. The hydrodissection associated with the TAP block technique does not increase the inflammatory response.
Evaluation of modified coblation endoscopic lingual lightening in multilevel surgery for obstructive sleep apnea hypopnea syndrome: an open intervention study
Authors: Duan Xiangqiang , Zhu Minhui , Zhang Caiyun , Li Meng , Cai Yupeng , Chen Shicai , Zheng Hongliang
Published: October 2023

Purpose

To evaluate the efficacy and safety of modified coblation endoscopic lingual lightening to address retrolingual obstruction in multilevel surgery for obstructive sleep apneae (OSA).

Methods

Patients with OSA due to retropalatal and retrolingual obstructions were enrolled. Group 1 consisted of patients who underwent modified coblation endoscopic lingual lightening combined with H-uvulopalatopharyngoplasty, while group 2 comprised patients treated by H-uvulopalatopharyngoplasty alone. Objective parameters and subjective evaluations were recorded preoperatively and at 6 months postoperatively.

Results

The mean (standard deviation) apnea-hypopnea index (AHI) declined from 51.5 (18.9) to 14.3 (7.2) in group 1, and from 51.7 (15.8) to 28.5 (16.9) in group 2. The mean (standard deviation) percentage change in AHI was higher in group 1 than in group 2 (73.2 [10.9] vs. 48.9 [22.4], P < 0.01). The surgical response rate differed significantly between groups 1 and 2 (88.5 [23/26] vs. 46.7 [14/30], P < 0.01). Other outcomes, including the lowest oxygen saturation, Epworth Sleepiness Scale score, snoring visual analog scale score, and subjective improvement rate, were also significantly better in group 1 than in group 2.

Conclusion

Without increasing complications, modified coblation endoscopic lingual lightening significantly improved surgical outcomes as part of multilevel surgery in patients with OSA due to multilevel obstruction.