bluuebunny/crossref_metadata_2025 huggingface dataset:
“Real‐world” performance of the Confirm Rx™ SharpSense AF detection algorithm: UK Confirm Rx study
Authors: Gala Andre Briosa e , Pope Michael T. B. , Leo Milena , Sharp Alexander J. , Banerjee Abhirup , Field Duncan , Thomas Honey , Balasubramaniam Richard , Hunter Ross , Gardner Roy S. , Wilson David , Gallagher Mark M. , Ormerod Julian , Paisey John , Curzen Nick , Betts Timothy R.
Published: September 2024

Introduction

The novel Confirm Rx™ implantable cardiac monitor (ICM) with SharpSense™ technology incorporates a new P‐wave discriminator designed to improve AF detection. This study aimed to evaluate the diagnostic performance of the Confirm Rx™ ICM in detecting AF episodes of varying durations.

Methods

We conducted a multicenter retrospective analysis of consecutive patients implanted with a Confirm Rx™ ICM (v1.2) across nine UK hospitals, all with documented AF lasting at least 6 min. Electrocardiograms (ECGs) were manually adjudicated by cardiologists. To account for intra‐ and inter‐reviewer variability, a random sample of 10% of ECGs underwent additional review. Disagreements were resolved by a third reviewer. Diagnostic performance was determined by calculating the gross and patient‐averaged positive predictive value (PPV) for AF episodes of different duration. The source of false positive (FP) detection was also categorized.

Results

Overall, 16,230 individual ECGs from 232 patients were included. The median AF episode duration was 14 min. R‐wave amplitude remained stable during follow‐up (0.52 ± 0.27 mV [initial] vs. 0.54 ± 0.29 mV [end of follow‐up], p = .10). The gross and patient‐averaged PPV were 75.0% and 67.0%, respectively. Diagnostic performance (gross) increased with progressively longer AF episodes: 88.0% for ≥1 h, 97.3% for 6 h, and 100% for 24 h. The main source of FP during tachycardia was T‐wave oversensing (54.2%), while in non‐tachycardic episodes it was predominantly ectopy (71.2%). The AF burden precision was excellent (93.3%).

Conclusion

The Confirm Rx™ ICM diagnostic performance was modest for all AF episodes (75%), with accuracy increasing for longer AF episodes.
Stratigraphy and dating of Middle Pleistocene sediments from Rodderberg, Germany
Authors: Zolitschka Bernd , Preusser Frank , Zhang Junjie , Hogrefe Ines , Froitzheim Nikolaus , Böning Philipp , Schläfli Patrick , Bittmann Felix , Binot Franz , Frechen Manfred
Published: September 2024

The stratigraphy and dating of lacustrine sediments and loess derivatives from Rodderberg, a crater of the East Eifel Volcanic Field in Germany, is based on luminescence dating and incorporates radiocarbon ages, fingerprinting of key tephra layers of the East Eifel Volcanic Field (Rieden Tephra, Hüttenberg Tephra, Laacher See Tephra), pollen stratigraphy, varve counting data, and a correlative age–depth model. These methods yield a robust age–depth model for the last 258 ka. Beyond this, luminescence ages differ from tephra‐derived ages. In light of the apparent presence of the Rieden Tephra, the lowermost interglacial is assigned to Marine Isotope Stage (MIS) 11 or 420 ka. This provides a high‐resolution record of environmental conditions representing an analogue for the Holocene, characterized by a warming planet. However, new luminescence ages may indicate a younger age for basal sediments, with the lowermost interglacial representing MIS 9. Both age–depth models constrain regional environmental changes during the Middle Pleistocene controlled by global climate variations. For the hydrologically closed nature of the Rodderberg crater, with limited pathways for sediment inflow and erosional export, these results shed new light on the continuity of long Middle Pleistocene records.
Neural network segmentation of disc volume from magnetic resonance images and the effect of degeneration and spinal level
Authors: Markhali Milad I. , Peloquin John M. , Meadows Kyle D. , Newman Harrah R. , Elliott Dawn M.
Published: September 2024

Background

Magnetic resonance imaging (MRI) noninvasively quantifies disc structure but requires segmentation that is both time intensive and susceptible to human error. Recent advances in neural networks can improve on manual segmentation. The aim of this study was to establish a method for automatic slice‐wise segmentation of 3D disc volumes from subjects with a wide range of age and degrees of disc degeneration. A U‐Net convolutional neural network was trained to segment 3D T1‐weighted spine MRI.

Methods

Lumbar spine MRIs were acquired from 43 subjects (23–83 years old) and manually segmented. A U‐Net architecture was trained using the TensorFlow framework. Two rounds of model tuning were performed. The performance of the model was measured using a validation set that did not cross over from the training set. The model version with the best Dice similarity coefficient (DSC) was selected in each tuning round. After model development was complete and a final U‐Net model was selected, performance of this model was compared between disc levels and degeneration grades.

Results

Performance of the final model was equivalent to manual segmentation, with a mean DSC = 0.935 ± 0.014 for degeneration grades I–IV. Neither the manual segmentation nor the U‐Net model performed as well for grade V disc segmentation. Compared with the baseline model at the beginning of round 1, the best model had fewer filters/parameters (75%), was trained using only slices with at least one disc‐labeled pixel, applied contrast stretching to its input images, and used a greater dropout rate.

Conclusion

This study successfully trained a U‐Net model for automatic slice‐wise segmentation of 3D disc volumes from populations with a wide range of ages and disc degeneration. The final trained model is available to support scientific use.
Fine‐Tuning of Near‐Infrared Emission in Fe‐Activated Spinel Phosphors via the Synergistic Effect of Sites Inversion and Atomic Disorder
Authors: Ye Yulong , Yang Heyi , Liang Liang , Mao Qinan , Zhao Fangyi , Zhu Yiwen , Liu Meijiao , Zhong Jiasong
Published: September 2024

Achieving continuous tunability, high efficiency, and outstanding thermal stability of near‐infrared (NIR) phosphors remains challenging for optoelectronic device fields. To address this issue, a strategy is proposed based on the substitution of both cations and anions in the intermediate spinel structure, which successfully achieved fine‐tuning of NIR emission of Mg1+yGa2‐yO4‐yFy:Fe3+ phosphors with prominent optical characteristics. The NIR emission contains new luminescent centers with random O/F coordination and is successfully constructed. This co‐substitution promotes further inversion of the cationic sites and induces atomic disorder, changing the crystal coordination environment and making Fe3+ breakthrough the Laporte selection rule, enabling fine‐tuning of Fe3+ emissions in the range of 707–740 nm and broadening of the full width at half maximum by 30 nm. Moreover, the Mg1.15Ga1.85O3.85F0.15:Fe3+ phosphor reached a high quantum yield of 71.6% and presented excellent thermal stability with an emission intensity retention of 81% at 493 K. The emission of the fabricated NIR phosphor‐converted light‐emitting diodes also matched well with the photosensitive pigment Pfr, demonstrating its feasibility for plant growth lighting applications.
Self‐Powered Perovskite/Si Bipolar Response Photodetector for Visible and Near‐Infrared Dual‐Band Imaging and Secure Optical Communication
Authors: Bian Liukang , Cao Fengren , Zhao Han , Xiang Fei , Sun Haoxuan , Wang Meng , Li Liang
Published: September 2024

Vertically stacked wavelength modulation bipolar response photodetectors are expected to be applied in various fields because they enable bipolar detection and transmission within one device and do not require harsh operating conditions. However, the as‐reported bipolar devices either need to change the detection mode (flipping the device or applying external bias) or have limited application effects. In this study, a self‐powered FAPbI3/silicon hybrid visible and near‐infrared bipolar response photodetector is reported, and the bipolar response is tuned by controlling the transmittance and interface contact of transparent electrodes. Moreover, unlike for photosensitive layers such as perovskites or organic compounds, the preparation of electrodes does not involve solvents, and array devices with different electrodes can be prepared in microregions without affecting adjacent regions. Then, an encrypted communication system that requires comprehensive consideration of the positive and negative states of different transparent electrode‐based devices caused by 650‐nm visible and 940‐nm near‐infrared transmission signals are designed, increasing the difficulty of decryption. A dual‐band spectral imaging system that does not require additional voltage driving by combining the reflection of visible light and the penetration ability of near‐infrared light is implemented, ensuring miniaturization and high integration of the visual imaging system.
Deep learning solution of optimal reinsurance‐investment strategies with inside information and multiple risks
Authors: Peng Fanyi , Yan Ming , Zhang Shuhua
Published: September 2024

This paper investigates an optimal investment‐reinsurance problem for an insurer who possesses inside information regarding the future realizations of the claim process and risky asset process. The insurer sells insurance contracts, has access to proportional reinsurance business, and invests in a financial market consisting of three assets: one risk‐free asset, one bond, and one stock. Here, the nominal interest rate is characterized by the Vasicek model, and the stock price is driven by Heston's stochastic volatility model. Applying the enlargement of filtration techniques, we establish the optimal control problem in which an insurer maximizes the expected power utility of the terminal wealth. By using the dynamic programming principle, the problem can be changed to four‐dimensional Hamilton–Jacobi–Bellman equation. In addition, we adopt a deep neural network method by which the partial differential equation is converted to two backward stochastic differential equations and solved by a stochastic gradient descent‐type optimization procedure. Numerical results obtained using TensorFlow in Python and the economic behavior of the approximate optimal strategy and the approximate optimal utility of the insurer are analyzed.
Accommodating patients with obesity in ambulatory care: A clinical environment checklist
Authors: Boland Wesley , Li Wendy S. , Dilly Christen K.
Published: September 2024

Objective

Individuals with obesity face unique challenges when visiting healthcare providers, including inadequate equipment. These negative care experiences, often exacerbated by weight stigma, frequently lead to mistrust and reluctance to seek future care. Currently, few instruments exist to ensure that an ambulatory clinic is welcoming to patients with obesity. The following clinical environment checklist was created with an aim to identify weaknesses in accommodating individuals of size.

Methods

A checklist of equipment considered ideal for the care of patients with obesity was developed through a comprehensive review of the literature and feedback from office staff. Eight ambulatory clinics within an urban Midwest setting were assessed, focusing on their accommodations for patients with obesity. Feedback from clinic staff was incorporated to further refine the checklist.

Results

Common equipment deficiencies included extra‐large blood pressure cuffs, wheelchair‐accessible scales, 2XL gowns, and adequate seat dimensions in the waiting area. Healthcare workers reported moral distress for their patients when unable to provide proper care due to these limitations. Newly constructed clinics exhibited better‐equipped facilities for patients with obesity.

Conclusions

Many clinics lack proper equipment to accommodate patients with obesity, resulting in negative care experiences. This clinical environment checklist can identify problem areas and provide solutions to create more welcoming environments, encouraging future care‐seeking behaviors.
Parental smoking and respiratory outcomes in young childhood cancer survivors
Authors: Žarković Maša , Sommer Grit , Nigg Carina , Sláma Tomáš , Schneider Christine , Ansari Marc , von der Weid Nicolas , Schindera Christina , Kuehni Claudia E
Published: September 2024

Background

Passive exposure to cigarette smoke has negative effects on respiratory health. Childhood cancer survivors (CCS) are at increased risk for respiratory disease due to treatment regimens that may harm the respiratory system. The objective of this study was to assess the prevalence of parental smoking among CCS and investigate its association with respiratory outcomes.

Procedure

As part of the Swiss Childhood Cancer Survivor Study, between 2007 and 2022, we sent questionnaires to parents of children aged ≤16 years who had survived ≥5 years after a cancer diagnosis. Parents reported on their children's respiratory outcomes including recurrent upper respiratory tract infections (otitis media and sinusitis), asthma, and lower respiratory symptoms (chronic cough persisting >3 months, current and exercise wheeze), and on parental smoking. We used multivariable logistic regression to investigate associations between parental smoking and respiratory outcomes.

Results

Our study included 1037 CCS (response rate 66%). Median age at study was 12 years (interquartile range 10–14 years). Eighteen percent of mothers and 23% of fathers reported current smoking. CCS exposed to smoking mothers were more likely to have recurrent upper respiratory tract infections (OR 2.1; 95%CI 1.1–3.7) and lower respiratory symptoms (OR 2.0; 95%CI 1.1–3.7). We found no association with paternal smoking.

Conclusions

A substantial proportion of CCS in Switzerland have parents who smoke. Exposure to maternal smoking was associated with higher prevalence of upper and lower respiratory problems. Healthcare providers can support families by addressing caregiver smoking behaviors and providing referrals to smoking cessation programs.
Prenatal Phenotype of Alkuraya‐Kučinskas Syndrome: A Novel Case and Systematic Literature Review
Authors: Rice Stephanie M. , Varotsis Dante F. , Wodoslawsky Sascha , Critchlow Elizabeth , Liu Ruby , McLaren Rodney A. , Makhamreh Mona M. , Firman Brandy , Berger Seth I. , Al‐Kouatly Huda B.
Published: September 2024

Alkuraya‐Kučinskas syndrome (AKS) is an autosomal recessive multisystem disorder resulting from mutations in the BLTP1 gene, formerly known as KIAA1109. Primary manifestations include brain malformations, arthrogryposis, and clubfeet. Cardiac, renal, and ophthalmologic abnormalities may also be observed, while nonimmune hydrops is rare. We present a case of two novel BLTP1 canonical splice‐site variants in a fetus with multiple congenital anomalies, including hydrops, a kinked brainstem, and joint contractures. A systematic literature review was conducted to describe the prenatal phenotype of AKS, which was inspired by our case. Our systematic literature review of the prenatal phenotype in 19 cases, including our additional case, demonstrated joint contractures in 90% (18/20), ventriculomegaly in 60% (12/20), brainstem dysgenesis in 50% (10/20), cerebellar hypoplasia in 50% (10/20), parenchymal thinning with lissencephalic aspect in 60% (12/20), and facial dysmorphism in 70% (14/20) of reported AKS cases. In addition to our case, hydrops was reported in two other families. AKS should be considered in fetal presentations with characteristic features, especially brainstem kinking and joint contractures. Exome sequencing, including coverage of canonical intronic splice‐site variants, can clarify the diagnosis.

Trial Registration

ClinicalTrials.gov registration: NCT03911531
Where are the ethical guidelines? Examining the governance of digital technologies and AI in Nigeria
Authors: Alakitan Muhammed , Makinde Ebenezer
Published: September 2024

The Nigerian government, under the administrations of Muhammadu Buhari (2015–2023) and Bola Tinubu (2023–2027), has made continued attempts to harness the opportunities of digital technologies and artificial intelligence (AI) to boost economic growth and development. However, these technologies have also raised ethical and security concerns within their production and usage, requiring regulatory policies from the government. Within this context, this study examines the space for ethical guidelines and data protection in the Nigerian government's approach to digital technologies and AI. Through a review of digital technology policy documents, we show that the Buhari government prioritized policy‐driven approaches to digital technologies. On the other hand, Tinubu's administration has started with a policy‐and‐research approach that involves both the public and private sectors. However, despite these differences, this study argues that neither administration has paid much attention to the ethical guidelines of data, digital technologies, and AI. This study contributes to the global discourse on digital technology's social impacts, particularly in regions like Africa.
Structuring different manifestations of misinformation for better policy development using a decision tree‐based approach
Authors: Hägle Olivia , Escher Stephan , Heil Reinhard , Jahnel Jutta
Published: September 2024

The spread of false and misleading information in digital communication spaces has enormous potential for harm in democratic societies, but has so far been insufficiently addressed by policy makers. This problem has been exacerbated by recent technological developments such as deepfakes. But deepfakes, fake news, and disinformation are only manifestations of misinformation. It is therefore essential to establish a clear definition to develop an appropriate policy. Since misinformation is a hydra whose countless heads cannot be cut off by a single heroine, we conclude that an interdisciplinary approach is necessary to appropriately “regulate” the different dimensions of misinformation. Therefore, we develop a decision tree that allows us to structure the problem of misinformation. Since deepfakes are particularly well suited to characterize the various manifestations of misinformation, we use them as an application example to illustrate our decision‐tree‐based approach. Based on this systematization, it will be possible to identify the capabilities and limitations of strategies from different disciplines and to develop a bundle of measures to address the various manifestations of misinformation. The basic principles of this bundle of measures will already be outlined here.
SAVE YOUR INTERNET! The persuasion work of YouTube in the controversy over EU's digital market directive
Authors: Riise Madelen , Åm Heidrun , Spilker Hendrik S.
Published: September 2024

The introduction of EU's Digital Market Directive, especially the so‐called Article 13, caused a lot of controversy. A varied assembly of actors protested, including Internet activists, academics, NGO's such as Wikipedia, and owners of platforms for user generated content. They feared regulations would stifle the distribution of user generated content. Much of the protests revolved around the hashtag #saveyourinternet. In this article, we study the active role YouTube took in mobilizing protests to regulatory changes. Drawing on Platform Studies and Actor‐Network Theory, we aim at eliciting Big Tech's overt and covert strategies when they face new legal regulations effecting the rules of the market in which they operate. We problematize how YouTube enacts sources of power in the network society. Indeed, the most important driver of the #saveyourinternet campaign owned the network in which it spread. The article is a contribution to the on‐going discussion of Big Tech's influence on democratic decision‐making.
Validation of a laser visual feedback and core stability exercise programme to improve lateropulsion reduction and pushing intensity in stroke patients with pusher syndrome: A Delphi study
Authors: Barrios‐Franquesa Ana M. , Bagur‐Calafat Caritat , Girabent‐Farrés Montserrat , Varela‐Vásquez Luz Adriana , Medina‐Rincón Almudena
Published: September 2024

Background

The patient with pusher syndrome (PS) is characterized by showing postural control alterations due to a lack of perception of his own body in the space. It appears when the patient actively pushes with his unaffected limbs towards the injured side, reacting with resistance to passive straightening towards the midline. Between 10% and 50% of strokes present PS. Nowadays, there is no clearly defined treatment for PS.

Objective

To design and validate an exercise program using visual feedback and specific core stability exercises (FeViCoS) for the treatment of patients with PS.

Methods

Validation was conducted by expert consensus using the Delphi method. Thirteen neurorehabilitation experts participated in the process. An online questionnaire with 18 Likert‐type questions was used to evaluate the designed program. Consensus was considered reached if there was convergence between the quartile 1 and 3 values (RIQ = Q1‐Q3) or if the relative interquartile range (RIR) was less than 20%. The degree of agreement between experts was measured by calculating the Fleiss' kappa coefficient.

Results

A total of 2 rounds were required to achieve 97.44% consensus with 100% participation. The RIR was less than or equal to 20% for all questions. The Fleiss' kappa index (0.831) showed that the degree of agreement between experts was excellent.

Conclusion

Neurorehabilitation experts considered FeViCoS valid for the therapeutic approach to patients with PS. Expert consensus suggests a novel strategy in physical therapy clinical practice to improve balance and postural orientation in patients with subacute stroke and PS.
Structural Insight Into the Function of DnaB Helicase in Bacterial DNA Replication
Authors: Zhang Zhiming , Chen Jiang , Yao Maochun , Wang Ganggang
Published: September 2024

In bacteria, chromosome replication is achieved by the coordinations of more than a dozen replisome enzymes. Replication initiation protein DnaA melts DNA duplex at replication origin (oriC) and forms a replication bubble, followed by loading of helicase DnaB with the help of loader protein DnaC. Then the DnaB helicase unwinds the dsDNA and supports the priming of DnaG and the polymerizing of DNA polymerase. The DnaB helicase functions as a platform coupling unwinding, priming, and polymerizing events. The multiple roles of DnaB helicase are underlined by its distinctive architecture and dynamics conformations. In this review, we will discuss the assembling of DnaB hexamer and the conformational changes upon binding of various partners, DnaB in states of closed dilated (CD), closed constricted (CC), closed helical (CH), and open helical (OH) are discussed. These multiple interfaces among DnaB and partners are potential targets for inhibitors design and novel peptide antibiotics development.
Patterns of herbicide resistance in Raphanus raphanistrum revealed by comprehensive testing and statistical analysis
Authors: Busi Roberto , Flower Ken , Goggin Danica , Onofri Andrea
Published: September 2024

BACKGROUND

Raphanus raphanistrum causes $40 million total revenue losses annually in Western Australia partly due to its historically‐documented ability to evolve herbicide resistance to multiple modes of action. In this study, 376 field‐sampled populations of R. raphanistrum were tested for resistance to 21 herbicides applied at the recommended label rate. Eight treatments were herbicide mixtures with two, three or four modes of action.

RESULTS

A total of 7199 individual resistance tests were conducted across 4 years by screening approximately 104 000 individual seeds and seedlings. The mean survival of individuals within a population for all standalone herbicides was 9%, whereas survival was significantly decreased to 3.5% with a herbicide mixture. Some herbicides such as triasulfuron (herbicide Group 2), 2,4‐D (Group 4) or diflufenican (Group 12) were highly impacted by resistance, with frequencies of resistant populations being > 50%. Conversely, there was negligible resistance to glyphosate (Group 9) or protoporphyrinogen oxidase (PPO) inhibitors (tiafenacil, saflufenacil + trifludimoxazin, fomesafen: Group 14), and pre‐emergence herbicides (i.e., atrazine or mesotrione: Groups 5 and 27, respectively) remained largely effective. Binary, ternary or quaternary mixtures of Groups 4, 6, 12 and 27 herbicides reduced the frequency of high‐level resistant populations to 7.1%, 3.8% or 0%, respectively.

CONCLUSIONS

The cost‐effective control of R. raphanistrum remains a challenge due to herbicide resistance. Raphanus raphanistrum management relies heavily on herbicide uses not yet compromised by resistance, such as pre‐emergence herbicides (atrazine, fomesafen, mesotrione), glyphosate, and mixtures of two, three or four modes of action including bromoxynil, diflufenican, MCPA, picolinafen, pyrasulfotole and topramezone. Strategies that integrate effective herbicide use patterns, novel modes of action and efficiently‐mechanized non‐chemical weed control options (i.e., seed destructors) can completely constrain the selection of herbicide resistance in this highly adaptable species. © 2024 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Baseline sensitivity and physiological characteristics of natural product hinokitiol against Sclerotinia sclerotiorum
Authors: Zhang Mengwei , Ren Xingyu , Li Yuying , Wang Yaqiang , Li Yi , Ma Zhiqing , Wang Yong , Feng Juntao
Published: September 2024

BACKGROUND

Sclerotinia sclerotiorum, a pathogenic fungus of oilseed rape, poses a severe threat to the oilseed rapeseed industry. In this study, we evaluated the potential of the natural compound hinokitiol against S. sclerotiorum by determining its biological activity and physiological characteristics.

RESULTS

Our results showed that hinokitiol strongly inhibited the hyphae expansion of S. sclerotiorum, and its effective concentration of hyphae growing inhibition by 50% (EC50) against 103 S. sclerotiorum strains varied from 0.36 to 3.45 μg/mL, with an average of 1.23 μg/mL. Hinokitiol possessed better protective efficacy than therapeutic effects, and it exhibited no cross‐resistance between carbendazim. After treatment with hinokitiol, many vesicular protrusions developed on the mycelium with rough surface and thickened cell wall. Moreover, the cell membrane permeability and glycerol content increased, while the oxalic acid declined after hinokitiol treatment. In addition, hinokitiol induced membrane lipid peroxidation and improved the production of reactive oxygen species (ROS) in S. sclerotiorum. Importantly, real‐time quantitative polymerase chain reaction showed that cell wall and ROS synthesis‐related genes were significantly up‐regulated after hinokitiol treatment.

CONCLUSION

This study revealed that hinokitiol has good biological activity against S. sclerotiorum and could be considered as an alternative bio‐fungicide for the resistance management in controlling sclerotinia stem rot infected by S. sclerotiorum. These investigations provided new insights into understanding the toxic action of hinokitiol against pathogenic fungi. © 2024 Society of Chemical Industry.
Assessing the Effects of Inline Steam Treatment on the Geometric Characteristics of the Thermoformed Plastic‐Coated Fibre‐Based Products
Authors: Afshariantorghabeh Sanaz , Kärki Timo , Leminen Ville
Published: September 2024

Thermoforming of fibre‐based materials faces challenges due to their restrictive three‐dimensional formability and lack of compatibility between material properties and traditional thermoforming methods. Treatment techniques present an intriguing area of research to address the gap between material characteristics and process requirements. Therefore, this study examined the influence of inline steam treatment on the thermoforming of plastic‐coated fibre‐based materials with different product geometries. Three plastic‐coated paperboards were subjected to thermoforming, with and without steaming, and their thermoformability was assessed based on the maximum depth and draft angle of the samples. Following 7 s of steaming, the materials exhibited a moisture content 2–4 percentage points higher than that of the original setup, yielding a greater curling rate in the produced samples across different geometries. The curling rate was influenced by the tensile stiffness of the materials and was correlated with the size of the flat‐edge area in the studied geometries. Furthermore, findings revealed varying rates at which steaming affected different geometries. Steaming substantially enhanced the achieved depth for geometries where the material was incapable of reaching the mould without moisturization, particularly observed for smaller geometrical shapes. This improvement was linked to steaming, which enhanced pliability, facilitated material penetration, and increased the final depth. However, in geometries where the material could reach the mould without moisturization, steaming expanded the contact area but could also result in a greater spring‐back rate and reduced depth, potentially owing to the loss of elastic modulus by moisturization. Nevertheless, the rate of spring‐back did not consistently increase with steaming and could be influenced by various material‐related factors, including the properties, composition, preparation methods, and postforming drying. Despite depth changes, steaming consistently improved the obtained draft angles, indicating that the materials were drawn more efficiently to the sidewalls across all instances studied. Thus, this study underscored the importance of choosing appropriate materials and moulds for hydrothermal moisturization treatments in the thermoforming process.
Balloon pulmonary angioplasty for proximal chronic thromboembolic pulmonary hypertension in patients ineligible for pulmonary endarterectomy
Authors: Issard Justin , Fadel Elie , Dolidon Samuel , Gerardin Benoit , Fabre Dominique , Mitilian Delphine , Mercier Olaf , Jevnikar Mitja , Jais Xavier , Humbert Marc , Brenot Philippe
Published: September 2024

Balloon pulmonary angioplasty (BPA) to treat chronic thromboembolic pulmonary hypertension (CTEPH) is generally reserved for distal obstruction precluding pulmonary endarterectomy (PEA) but can be used in patients with proximal disease who are at high surgical risk or refuse surgery. This single‐center retrospective study compared BPA efficacy in patients with proximal versus distal CTEPH. Of the 478 patients, 36 had proximal disease, follow‐up was 11.6 months and mean number of BPA 6. After BPA, PVR, and mean pulmonary artery pressure decreased significantly in the proximal and distal groups (from 6.5 to 4.0 WU and 39 to 31 mmHg and from 7.6 to 3.8 WU and 44 to 31 mmHg, respectively, p < 0.001 for all comparisons). NYHA class also improved significantly in both groups, from 3 to 2, whereas the 6‐min walk distance, cardiac output, and serum NT pro‐BNP showed significant improvements only in the distal group. Thus, when PEA for CTEPH is technically feasible but not performed due to severe comorbidities or patient refusal, BPA can produce significant hemodynamic improvements, albeit less marked than in patients with distal disease. Better patient selection to BPA might improve outcomes in patients with proximal disease who are ineligible for PEA.
The impact of the Madden–Julian oscillation on extreme winter weather over the contiguous United States
Authors: Foskey Stephen R. , Sakaeda Naoko , Basara Jeffrey , Furtado Jason C.
Published: September 2024

Despite its substantial impacts on human society, winter weather is difficult to predict on subseasonal‐to‐seasonal (S2S) timescales. To improve its predictability at longer timescales, this study examines whether the Madden–Julian Oscillation (MJO) has a significant impact on the frequency of extreme winter weather (i.e., heavy accumulations of snow, ice pellets, and freezing rain) over the contiguous United States. We find an increased frequency of extreme winter weather in the Ohio Valley and Mid‐Atlantic regions when MJO enhanced convection is over Africa and the western Indian Ocean, due to imposed lower 850‐hPa temperatures associated with MJO teleconnections. More frequent subfreezing temperatures lead to an increased likelihood of frozen precipitation compared with liquid, increasing the frequency of extreme winter weather. The MJO also increases the frequency of winter weather in the Central Great Plains region of the United States when MJO enhanced convection is over the eastern Indian Ocean and the Maritime Continent. Rather than through effects on temperature, the likely mechanism of increased winter weather over this region is enhanced synoptic forcing that increases overall precipitation. These effects can be seen up to 15 days in advance, suggesting the utility of using the MJO in S2S forecasting of extreme winter weather.
Merkel Cell Polyomavirus—Pathophysiology and Treatment in the Era of Gene‐Targeted Therapies
Authors: Chokwassanasakulkit Trairong , McMillan Nigel A. J.
Published: September 2024

Merkel cell polyomavirus (MCPyV) is a significant contributor to the development of Merkel cell carcinoma (MCC), an aggressive skin cancer with high recurrence and a low survival rate. In fact, it is the deadliest skin cancer. The precise routes of transmission for MCPyV‐positive MCC remain unclear, but several factors may trigger its development. Conventional treatments for MCC are not highly effective, especially in patients with metastasis, with a clear need for new treatment options. Gene‐targeted therapies hold great promise for the treatment of MCC, including the use of siRNA and CRISPR/Cas (C/Cas) but critically none have yet been translated into clinical trials. Validating this approach is the fact that several siRNA products are already FDA licenced, while C/Cas has entered clinical trial, albeit for conditions other than MCC. There are many challenges that must be overcome to move from preclinical research to the clinic. In this review, we provide a comprehensive summary of the current understanding of MCC, with a particular focus on MCPyV‐positive MCC, and the status of gene‐targeted therapies. Additionally, we discuss the major obstacles that impede MCC research and explore future prospects.
Nanomaterials‐Based Approach for Photodynamic Therapy
Authors: Barik Sunita , Namdeo Pavan K. , Sharma Rahul Kumar
Published: September 2024

In recent years, all over the world mortality rate has been increasing drastically owing to cancer. This global challenge has aroused the researchers to develop novel technology. Among that, Photodynamic therapy (PDT) is an advanced therapeutic modality that can be used as an alternate to chemotherapy, and radiotherapy. PDT is drawing much researcher consideration as targeted cell can be killed straight forwardly by the use of it without aggressive damage to the adjacent cell. However, its application is restricted due to inherent limitations of the conventional photosensitizers (PSs) like lacking of tumor targeting capability, inadequate light penetration, restricted PS accumulation etc. Interestingly, owing to inherent optical property and tuneable ability, uses of nanoparticles (NPs) in PDT show a grand assure to conquer the limitations. Therefore, recently nanomaterial‐based PSs, whose physicochemical properties offer multifunctional and multimodal nanoplatform for various applications such as bioimaging, bioanalytical, and therapeutic etc. is gaining much more attention. In the present review, the basic concept of photodynamic therapy, its principle and types are discussed. Subsequently, role of different organic and inorganic‐based nanomaterials in photodynamic therapy to cure cancer are highlighted.
Tuning Surface Chemistry in 2D Layered BiOI by Facile Liquid‐Phase Exfoliation for Enhanced Photoelectrocatalytic Oxygen Evolution
Authors: Wang Mengjiao , Gallego Jaime , Pozzati Micaela , Gatti Teresa
Published: September 2024

BiOI is a promising photoelectrocatalyst for oxidation reactions. However, the limited photoelectrocatalytic (PEC) activity necessitates the development of new strategies to modify its surface chemistry and thus enhance functional properties. Herein, we present a simple method to increase photocurrent in a BiOI‐based photoanode by exfoliating microspheres of the oxyhalide produced through hydrothermal synthesis. Following exfoliation in isopropanol, the resulting layered BiOI‐based colloid contains a greater variety of species, including Bi2O2CO3, I3−, IO3−, Bi5+, and hydroxides, compared to the original BiOI. These additional species do not directly enhance the PEC oxygen evolution reaction (OER) performance. Instead, they are consumed or converted during PEC OER, resulting in more active sites on the photoelectrode and reduced resistance, which ultimately improves the water oxidation performance of the exfoliated BiOI. Over long‐term chronoamperometry, the exfoliated BiOI demonstrates a photocurrent twice as high as that of the BiOI microspheres. Analysis of the species after PEC OER reveals that the combination of IO3−, Bi5+, and I3− species on the BiOI is beneficial for charge transfer, thus enhancing the intrinsic PEC properties of the BiOI. This study offers new insights into the role of surface chemistry in determining PEC performance, aiding the optimization of 2D materials‐based photoelectrocatalysts.
Probabilistic treatment of IEC 61400‐1 standard based extreme wind events
Authors: Bierbooms Wim , Veldkamp Dick
Published: September 2024

The procedure to estimate the amplitude of the special wind events according to IEC 61400‐1 as proposed by Larsen is reviewed. Corrections are specified that yield larger amplitudes for the extreme operating gust (EOG) and the extreme coherent gust with simultaneous direction change (ECD). For the ECD case, distributions for longitudinal and lateral gust amplitudes are derived and applied in simulations to derive the load distribution, from which the 50‐year extreme load can be found. Results are compared with the calculation with the conventional ECD: In the example calculation, the 50‐year values of both blade root bending moment and tip deflection are smaller than the conventional values.
Notes on the Courtship and Captive Reproduction of the Southern Vietnam Box Turtle, Cuora picturata, at the Turtle Conservation Center in Cuc Phuong National Park, Vietnam
Authors: Augustine Lauren , Bednarski Chris , Nguyen Thuy Thu , Tran Hang Thi Ngoc , McCormack Timothy , Van Trinh Nguyen
Published: September 2024

Endemic to only three known provinces in South Central Vietnam, Cuora picturata have faced extensive collection pressures for the food, medicinal, and pet trades. Further exacerbating their decline is the lack of protected areas where wild populations exist, with only one known population occurring within a protected area. With threats to wild populations persisting, the development of an assurance colony has been prioritized for C. picturata. The Asian Turtle Program of Indo‐Myanmar Conservation has been operating the Turtle Conservation Center (TCC) in Cuc Phuong National Park since 1998. From 2020 to 2022, 24 C. picturata were acquired by the TCC from the illegal trade. With no ideal repatriation plan, these animals provided an opportunity for developing a captive assurance colony at the TCC to safeguard the species from extinction. As semi‐aquatic species, box turtles in the genus Cuora are a unique group that shows variations in habitat use and behavior between species. Herein, we documented some specific courtship behaviors not yet described for C. picturata, providing insight into the unique reproductive behaviors of this species.
Management of patients with reduced dihydropyrimidine dehydrogenase activity receiving combined 5-fluoruracil-/capecitabine-based chemoradiotherapy
Authors: Hoffmann E. , Toepell A. , Peter A. , Böke S. , De-Colle C. , Steinle M. , Niyazi M. , Gani C.
Published: September 2024

Background

5‑Fluoruracil (5-FU) and its oral prodrug capecitabine are mainstays in combined chemoradiotherapy regimens. They are metabolized by dihydropyrimidine dehydrogenase (DPYD). Pathogenic variants of the DPYD gene cause a reduction in DPYD activity, leading to possibly severe toxicities. Therefore, patients receiving 5‑FU-/capecitabine-based chemoradiotherapy should be tested for DPYD variants. However, there are limited clinical data on treatment adjustments and tolerability in patients with decreased DPYP activity receiving combined chemoradiotherapy. Therefore, a retrospective analysis of the toxicity profiles of patients with decreased DPYD activity treated at our center was conducted.

Materials and methods

For all patients receiving 5‑FU-/capecitabine-based chemo(radio)therapy at our department, DPYD activity was routinely tested. Genotyping of four DPYD variants (DPYD*2A, DPYD*13, c.2846A > T, and haplotype B3) was conducted according to the recommendation of the German Society for Hematooncology (DGHO) using TaqMan hydrolysis polymerase chain reaction (PCR; QuantStudy 3, Thermo FisherScientific, Darmstadt). DPYD variants and activity score as well as clinical data (tumor entity, treatment protocol, dose adjustments, and toxicity according to the Common Terminology Criteria for Adverse Events [CTCAE]) were assessed and reported.

Results

Of 261 tested patients, 21 exhibited DPYD variants, 18 of whom received chemoradiotherapy. All but one patient was treated for rectal or anal carcinoma. The observed rate of DPYD variants was 8.0%, and heterozygous haplotype B3 was the most common (5.75%). One patient exhibited a homozygous DPYD variant. DPYD activity score was at least 0.5 in heterozygous patients; chemotherapy dose was adjusted accordingly, with an applied dose of 50–75%. CTCAE grade 2 skin toxicity (50%) and grade 3 leukopenia (33.3%) were most common. One patient experienced a transient grade 4 increase in transaminases. All high-grade toxicities were manageable with supportive treatment and transient. No CTCAE grade 5 toxicities related to 5‑FU administration were observed.

Conclusion

With dose reduction in heterozygous patients, toxicity was within the range of patients without DPYD variants. Our clinical data suggest that dose-adapted 5‑FU-/capecitabine-chemoradiotherapy regimens can be safely considered in patients with heterozygous clinically relevant DPYD variants, but that the optimal dosage still needs to be determined to avoid both increased toxicity and undertreatment in a curative setting.
Generating synthetic high-resolution spinal STIR and T1w images from T2w FSE and low-resolution axial Dixon
Authors: Graf Robert , Platzek Paul-Sören , Riedel Evamaria Olga , Kim Su Hwan , Lenhart Nicolas , Ramschütz Constanze , Paprottka Karolin Johanna , Kertels Olivia Ruriko , Möller Hendrik Kristian , Atad Matan , Bülow Robin , Werner Nicole , Völzke Henry , Schmidt Carsten Oliver , Wiestler Benedikt , Paetzold Johannes C. , Rueckert Daniel , Kirschke Jan Stefan
Published: September 2024

Objectives

To generate sagittal T1-weighted fast spin echo (T1w FSE) and short tau inversion recovery (STIR) images from sagittal T2-weighted (T2w) FSE and axial T1w gradient echo Dixon technique (T1w-Dixon) sequences.

Materials and methods

This retrospective study used three existing datasets: “Study of Health in Pomerania” (SHIP, 3142 subjects, 1.5 Tesla), “German National Cohort” (NAKO, 2000 subjects, 3 Tesla), and an internal dataset (157 patients 1.5/3 Tesla). We generated synthetic sagittal T1w FSE and STIR images from sagittal T2w FSE and low-resolution axial T1w-Dixon sequences based on two successively applied 3D Pix2Pix deep learning models. “Peak signal-to-noise ratio” (PSNR) and “structural similarity index metric” (SSIM) were used to evaluate the generated image quality on an ablations test. A Turing test, where seven radiologists rated 240 images as either natively acquired or generated, was evaluated using misclassification rate and Fleiss kappa interrater agreement.

Results

Including axial T1w-Dixon or T1w FSE images resulted in higher image quality in generated T1w FSE (PSNR = 26.942, SSIM = 0.965) and STIR (PSNR = 28.86, SSIM = 0.948) images compared to using only single T2w images as input (PSNR = 23.076/24.677 SSIM = 0.952/0.928). Radiologists had difficulty identifying generated images (misclassification rate: 0.39 ± 0.09 for T1w FSE, 0.42 ± 0.18 for STIR) and showed low interrater agreement on suspicious images (Fleiss kappa: 0.09 for T1w/STIR).

Conclusions

Axial T1w-Dixon and sagittal T2w FSE images contain sufficient information to generate sagittal T1w FSE and STIR images.

Clinical relevance statement

T1w fast spin echo and short tau inversion recovery can be retroactively added to existing datasets, saving MRI time and enabling retrospective analysis, such as evaluating bone marrow pathologies.

Key Points

Sagittal T2-weighted images alone were insufficient for differentiating fat and water and to generate T1-weighted images.

Axial T1w Dixon technique, together with a T2-weighted sequence, produced realistic sagittal T1-weighted images.

Our approach can be used to retrospectively generate STIR and T1-weighted fast spin echo sequences.

Graphical Abstract
Bettlägerigkeit bei alten Menschen – eine Literaturübersicht
Authors: Berger Bianca , Graeb Fabian , Baumann Manfred , Reuther Sven
Published: September 2024

Hintergrund

Insbesondere alte Menschen sind von Mobilitätseinschränkungen betroffen und können den Prozess der allmählichen Ortsfixierung bis hin zur Bettlägerigkeit durchlaufen. Letztere geht mit weitreichenden Folgen für die Personen, die pflegerisch relevant sind, einher.

Ziele der Arbeit

Pflegerische Implikationen bezüglich des Phänomens der Bettlägerigkeit im Bereich der Langzeitpflege zu bündeln und Impulse für eine pflegewissenschaftliche Forschung zu geben.

Methode

Recherche in relevanten Fachdatenbanken (2003–2023) anhand der Kriterien eines Scoping-Reviews.

Ergebnisse

In Deutschland gibt es einen Expertenstandard zur Mobilitätsförderung, der Bettlägerigkeit und Ortsfixierung thematisiert. Aktuelle Studien zu diesen Phänomenen sind im deutschsprachigen Raum rar. Im internationalen Kontext werden diese hingegen intensiver beforscht, wobei der Fokus oft auf den Risikofaktoren für die Entstehung von Immobilität und deren negativen Folgen liegt. Die Publikationen konzentrieren sich auf die Reduktion dieser Faktoren, während die Lebensgestaltung im Bett sowie die Teilhabe und Partizipation der Betroffenen weniger Beachtung finden.

Diskussion

Die Komplexität von Bettlägerigkeit wird in der aktuellen Forschung nicht umfänglich abgebildet. Zur Entwicklung einer pflegerischen Perspektive sind Forschungsvorhaben, die Aspekte des Lebens im Bett und damit die Lebenswirklichkeit bettlägeriger Menschen sowie deren Möglichkeiten der Partizipation und Teilhabe stärker berücksichtigen, zentral.