bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative MRI distinguishes different leukodystrophies and correlates with clinical measures
Authors: Stellingwerff Menno D. , Al-Saady Murtadha L. , Chan Kwok-Shing , Dvorak Adam , Marques José P. , Kolind Shannon , Schoenmakers Daphne H. , van Voorst Romy , Roosendaal Stefan D. , Barkhof Frederik , Wolf Nicole I. , Berkhof Johannes , Pouwels Petra J. W. , van der Knaap Marjo S.
Published: September 2024

Objectives

The leukodystrophy “vanishing white matter” (VWM) and “metachromatic leukodystrophy” (MLD) affect the brain's white matter, but have very different underlying pathology. We aim to determine whether quantitative MRI reflects known neuropathological differences and correlates with clinical scores in these leukodystrophies.

Methods

VWM and MLD patients and controls were prospectively included between 2020 and 2023. Clinical scores were recorded. MRI at 3 T included multi-compartment relaxometry diffusion-informed myelin water imaging (MCR-DIMWI) and multi-echo T2-relaxation imaging with compressed sensing (METRICS) to determine myelin water fractions (MWF). Multi-shell diffusion-weighted data were used for diffusion tensor imaging measures and neurite orientation dispersion and density imaging (NODDI) analysis, which estimates neurite density index, orientation dispersion index, and free water fraction. As quantitative MRI measures are age-dependent, ratios between actual and age-expected MRI measures were calculated. We performed the multilevel analysis with subsequent post-hoc and correlation tests to assess differences between groups and clinico-radiological correlations.

Results

Sixteen control (age range: 2.3–61.3 years, 8 male), 37 VWM (2.4–56.5 years, 20 male), and 14 MLD (2.2–41.7 years, 6 male) subjects were included. Neurite density index and MWF were lower in patients than in controls (p < 0.001). Free water fraction was highest in VWM (p = 0.01), but similar to controls in MLD (p = 0.99). Changes in diffusion tensor imaging measures relative to controls were generally more pronounced in VWM than in MLD. In both patient groups, MCR-DIMWI MWF correlated strongest with clinical measures.

Conclusion

Quantitative MRI correlates to clinical measures and yields differential profiles in VWM and MLD, in line with differences in neuropathology.

Key Points

QuestionCan quantitative MRI reflect known neuropathological differences and correlate with clinical scores for these leukodystrophies?

FindingQuantitative MRI measures, e.g., MWF, neurite density index, and free water fraction differ between leukodystrophies and controls, in correspondence to known histological differences.

Clinical relevanceMRI techniques producing quantitative, biologically-specific, measures regarding the health of myelin and axons deliver more comprehensive information regarding pathological changes in leukodystrophies than current approaches, and are thus viable tools for monitoring patients and providing clinical trial outcome measures.
Cardiac wasting in patients with cancer
Authors: Anker Markus S. , Rashid Ahmed Mustafa , Butler Javed , Khan Muhammad Shahzeb
Published: September 2024

Patients with cancer face a significant risk of cardiovascular death, regardless of time since cancer diagnosis. Elderly patients are particularly more susceptible as cancer-associated cardiac complications present in advanced stage cancer. These patients may often present with symptoms observed in chronic heart failure (HF). Cardiac wasting, commonly observed in these patients, is a multifaceted syndrome characterized by systemic metabolic alterations and inflammatory processes that specifically affect cardiac function and structure. Experimental and clinical studies have demonstrated that cancer-associated cardiac wasting is linked with cardiac atrophy and altered cardiac morphology, which impairs cardiac function, particularly pertaining to the left ventricle. Therefore, this review aims to present a summary of epidemiologic data and pathophysiological mechanisms of cardiac wasting due to cancer, and future directions in this field.
A cost-minimization analysis of anti-VEGFs for the treatment of neovascular age-related macular degeneration in the Netherlands
Authors: Quist Sara W. , Nab Hidde , Postma Maarten , Amarakoon Sankha , van Asten Freekje , Freriks Roel
Published: September 2024

Objective

Age-related macular degeneration (AMD) is the main cause of severe vision loss globally. Neovascular AMD (nAMD) is an advanced stage of AMD treated with anti-vascular endothelial growth factors (anti-VEGFs). Although anti-VEGF treatment is effective, the frequent intravitreal injections place a burden on patients, (in)formal caregivers, and clinics. This study assesses the health-economic impact of anti-VEGF agents with lower injection frequency that have the potential to reduce treatment burden and compares it to the standard of care.

Methods

We developed a cost-minimization model to evaluate the direct medical costs associated with first-line unilateral anti-VEGF treatment across a 3-year time horizon in the Netherlands. The analysis compared aflibercept 8 mg, aflibercept 2 mg, bevacizumab, faricimab, and ranibizumab. Our model adopted a treat-and-extend (T&E) regimen for aflibercept 2 mg, bevacizumab, and ranibizumab. For aflibercept 8 mg, a flexible regimen that was extendable up to 24 weeks was applied, while faricimab followed a flexible regimen that was extendable up to 16 weeks. Additionally, since list prices may vary from net prices, we calculated the break-even price for each anti-VEGF in comparison to bevacizumab, which is the recommended first-line treatment due to its low medication price.

Results

Based on list prices, aflibercept 8 mg led to the lowest treatment costs (€16,251 per patient over a 3-year time horizon), closely followed by bevacizumab (€17,616 per patient over a 3-year time horizon). Ranibizumab led to the highest per-patient costs (€31,746 over a 3-year time horizon). For bevacizumab, most costs were attributable to administration, while for the other anti-VEGFs, most were attributable to medication. Aflibercept 8 mg is cost-saving compared to bevacizumab at their medication prices at the time of writing. Aflibercept 2 mg, faricimab, and ranibizumab should be priced below €488, €591, and €75, respectively. To be cost-equal to bevacizumab with current list prices, anti-VEGFs should be administered with a maximum of 12.7 to 13.8 injections over a 3-year time horizon.

Conclusion

According to the injection frequency observed in clinical trials, aflibercept 8 mg would be the anti-VEGF that generates the lowest per-patient healthcare costs for the treatment of nAMD in the Netherlands after a treatment period of three years. Our study indicates that anti-VEGF drugs with a lower injection frequency might provide a cost-saving solution to the increasing burden of anti-VEGF treatment on the healthcare system.
Adaptive Weighted Multi-kernel Learning for Blast-Induced Flyrock Distance Prediction
Authors: Zhang Ruixuan , Li Yuefeng , Gui Yilin , Armaghani Danial Jahed , Yari Mojtaba
Published: September 2024

In the field of civil and mining engineering, blasting operations are widely and frequently used for rock excavation, However, some undesirable environmental problems induced by blasting operations cannot be ignored. Blast-induced flyrock is one important issue induced by blasting operation, which needs to be well predicted to identify the blasting zone’s safety zone. This study introduces an adaptive weighted multi-kernel learning model (AW-MKL) to provide an accurate prediction of blast-induced flyrock distance in Sungun Copper Mine site. The proposed model uses a combination of multi-kernel learning (MKL) approach and adaptive weighting strategy based on weighted Euclidean distance and modified local outlier factor (MLOF) to maximally improve the predictive ability of kernel ridge regression (KRR). To demonstrate the superiority of the proposed approach, six machine learning models were developed as comparisons, i.e., KRR, RF, GBDT, SVM, M5 Tree, MARS and AdaBoost. The outcomes of the proposed method achieved the highest accuracy in testing phase, with RMSE of 2.05, MAE of 0.98 and VAF of 99.92, which confirmed the strong predictive capability of the proposed AW-MKL in predicting blast-induced flyrock distance.
Die einheitliche Stelle im immissionsschutzrechtlichen Genehmigungsverfahren für Erneuerbare Energien-Anlagen
Authors: Saurer Johannes
Published: September 2024

Die Einführung der “einheitlichen Stelle” im immissionsschutzrechtlichen Genehmigungsverfahren
für Erneuerbare Energien-Anlagen in §10 Abs. 5a) BImSchG ist ein organisationsrechtliches Instrument
zum Ausbau erneuerbarer Energien. Der Aufsatz zeigt die Herkunft dieses Instruments aus dem Unionsrecht,
den Anwendungsbereich und die Rechtswirkungen.
Work-life balance on a farm with young children in Slovenia
Authors: Černič Istenič Majda
Published: September 2024

The challenges of work-life balance, gender equality in work and family life, and changing social norms‒responsible parenthood and safe and healthy working conditions‒have been widely discussed and addressed in literature, policy documents, and the media for decades. Since the early days of rural studies, the family farm has been widely recognized as a special unit of production, consumption, and lifestyle. However, the lifestyle of family farms, including work-life balance, has received little attention or consideration in policy and academic debates, particularly in Europe. Based on these observations, this paper discusses the results of two consecutive studies on working conditions on farms in Slovenia, with a focus on work-life balance in the case of maternity/parental leave on farms. The first study is based on structured interviews with 60 adult members of family farms of both genders conducted in 2018/2019, and the second study is based on semi-structured interviews with 23 farmers of both genders from different parts of the country, conducted in 2021/2022. The stories of the two groups of research participants are assessed and discussed against the background of the current scholarly debate on work-life balance in farming context and the recently adopted institutional framework for work-life balance in the European Union.
Some Worries About the Probability Account of the Feelings of (Un)Certainty
Authors: Spatan Sergiu
Published: September 2024

In recent papers, Peter Carruthers and others have argued that the feeling of uncertainty is not metacognitive (i.e., it is not elicited by second-order cognitive appraisals) but is elicited solely by first-order likelihood estimates—a probability account of the feeling of uncertainty. In this paper, I make a case for why a probability account is sufficient to explain neither the feeling of uncertainty nor the feeling of certainty in self-reflecting humans. I argue first that humans’ feelings of (un)certainty vary in ways that their probability estimates on the matter do not, and second that probability accounts elide the essentially epistemic nature of epistemic feelings.
Population-based FMR1 carrier screening among reproductive women
Authors: Ain Quratul , Hwang Ye Hyun , Yeung Daryl , Panpaprai Pacharee , Iamurairat Wiwat , Chutimongkonkul Wiboon , Trachoo Objoon , Tassone Flora , Jiraanont Poonnada
Published: September 2024

Purpose

Fragile X syndrome (FXS) is a neurodevelopmental disorder, caused by an CGG repeat expansion (FM, > 200 CGG) in the fragile X messenger ribonucleoprotein 1 (FMR1) gene. Female carriers of a premutation (PM; 55–200 CGG) can transmit the PM allele, which, depending on the CGG allele size, can expand to an allele in the FM range in the offspring.

Methods

Carrier screening for FMR1 PM is not available in Thailand. This study aimed to investigate the prevalence of PM carriers among Thai reproductive women at the tertiary hospital. A total of 1250 females participated in this study; ages ranged from 20 to 45 years, mean of 30 years (S.D. = 6.27).

Results

Two carriers of a premutation allele, with 32,62 and 32,69 CGG repeats respectively, were identified. This corresponds to 1 in 600 women or 0.17% of the population. Further, three women carrying a gray zone allele (45–54 CGG repeats) were identified (29,51; 29,49; and 30,47 CGG repeats) which equals to 1:400 women or 0.25% of the population. No FM case was detected.

Conclusions

This study heightens the importance of PM carrier screening of women of reproductive age, particularly for the higher risk of developing fragile X–associated primary ovarian insufficiency (FXPOI). Early identification of PM carrier status enhances family planning and fecundity alternatives and improves reproductive health outcomes leading to a better life.
Preparation and Characterization of Pyramids/Particles NiO/SnO2 Composite for Sorption and Separation of Molybdenum and Zirconium Ions from Some Synthetic Fission Products
Authors: Rizk Hoda E. , Rizk Soad E. , Labib Shiraz
Published: September 2024

Pyramids/particles of NiO/SnO2 composite (NS7) was produced by applying the sol–gel autocombustion method. The produced composite was investigated using different techniques, X-ray diffraction, Fourier-transform infrared, Raman spectroscopy, scanning electron microscope, dynamic light scattering, ultraviolet–visible absorbance spectroscopy, and BET surface area then was applied for the adsorption and separation of molybdenum and zirconium ions from lanthanum, strontium, and cesium. 3D pyramids of NiO and particles of SnO2 are confirmed in the composite with a homogeneous mesoporous structure. The composite has good affinity for zirconium and molybdenum ions with fast kinetics and Qmax of 27.1 and 33.3 mg/g, respectively, low affinity for lanthanum, and negligible affinity for strontium and cesium. The sorption mechanism is physical sorption and endothermic in nature. The adsorbed Zr(IV), Mo(VI), and La(III) ions were separated using the desorption process as the following sequence: First, 95 ± 2% (14.3 ppm) of the loaded La was desorbed by washing with double distilled water. Then 96 ± 2% (41.3 ppm) of the loaded Zr was recovered by 1 M potassium chloride without interfering ions. Finally, 98 ± 2% (42.88 ppm) of Mo is desorbed by 1 M sodium acetate solution. The NS7 composite can be reused five times successfully.
Implicit-Explicit Schemes for Compressible Cahn–Hilliard–Navier–Stokes Equations
Authors: Mulet Pep
Published: September 2024

The isentropic compressible Cahn–Hilliard–Navier–Stokes equations are a system of fourth-order partial differential equations that model the evolution of some binary fluids under convection. The purpose of this paper is the design of efficient numerical schemes to approximate the solution of initial-boundary value problems with these equations. The efficiency stems from the implicit treatment of the high-order terms in the equations. Our proposal is a second-order linearly implicit-explicit time stepping scheme applied in a method of lines approach, in which the convective terms are treated explicitly and only linear systems have to be solved. Some experiments are performed to assess the validity and efficiency of this proposal.
Normalizing flow sampling with Langevin dynamics in the latent space
Authors: Coeurdoux Florentin , Dobigeon Nicolas , Chainais Pierre
Published: September 2024

Normalizing flows (NF) use a continuous generator to map a simple latent (e.g. Gaussian) distribution, towards an empirical target distribution associated with a training data set. Once trained by minimizing a variational objective, the learnt map provides an approximate generative model of the target distribution. Since standard NF implement differentiable maps, they may suffer from pathological behaviors when targeting complex distributions. For instance, such problems may appear for distributions on multi-component topologies or characterized by multiple modes with high probability regions separated by very unlikely areas. A typical symptom is the explosion of the Jacobian norm of the transformation in very low probability areas. This paper proposes to overcome this issue thanks to a new Markov chain Monte Carlo algorithm to sample from the target distribution in the latent domain before transporting it back to the target domain. The approach relies on a Metropolis adjusted Langevin algorithm whose dynamics explicitly exploits the Jacobian of the transformation. Contrary to alternative approaches, the proposed strategy preserves the tractability of the likelihood and it does not require a specific training. Notably, it can be straightforwardly used with any pre-trained NF network, regardless of the architecture. Experiments conducted on synthetic and high-dimensional real data sets illustrate the efficiency of the method.
Review bombing: ideology-driven polarisation in online ratings: The case study of The Last of Us (part II)
Authors: Cantone Giulio Giacomo , Tomaselli Venera , Mazzeo Valeria
Published: September 2024

A review bomb is a surge in online reviews, coordinated by a group of people willing to manipulate public opinions. This is a study on a prominent case of review bombing (n = 51,120) of the video game The Last of Us Part II, challenging the assumption that review bombing should be framed solely as misinformation. The impact of fake reviews is substantially small. Ideology-driven ratings associated with a conservative ideology are followed by a grassroots counter-bombing from progressives, aimed at mitigating the effects of the negative ratings. These factions are very similar in other metrics. Preventive measures are proposed.
Characterizing High-Energy Solar Proton Events with Energies Below and Above 100 MeV
Authors: Ameri Dheyaa , Valtonen Eino , Al-Sawad Amjad , Vainio Rami
Published: September 2024

We analyzed 58 high-energy proton events that occurred during the years 1996 – 2022. In 32 out of the 58 (55%) events, the proton energies extended up to $\sim 68$
∼
68
 MeV but did not reach 100 MeV. In the remaining 26 events, the proton energies exceeded 100 MeV. We studied the differences in the characteristics of these proton events and their associations with solar and interplanetary phenomena to improve understanding proton sources and acceleration processes.

The coronal mass ejections (CMEs) associated with $>100$
>
100
 MeV proton events appeared to be, on average, more energetic than those associated with $< 100$
<
100
 MeV proton events. The peak and integrated fluxes (fluence) of the soft X-ray (SXR) flares were higher in > 100 MeV proton events, but there was almost no difference in the rise times of the flares. In a major part of the $> 100$
>
100
 MeV proton events, protons were released over the rise phase of the SXR flares, whereas in most of the $<100$
<
100
 MeV events the proton releases occurred after the peak of the SXR flares. We established limits for the CME speed VCME and SXR peak flux Fpk or total fluence Fi, which helped us to distinguish the events in the two groups. Solar eruptions with VCME$> 1000$
>
1000
 km s−1 and F$_{\mathrm{pk}} > 5 \cdot 10^{-5} $

>

pk

5
⋅

10

−
5

 W m−2 had a high probability to produce proton events of $> 100$
>
100
 MeV. On the other hand, eruptions with V$_{\mathrm{CME}} > 900$

>

CME

900
 km s−1 and F$_{i} <5 \cdot 10^{-4} $

<

i

5
⋅

10

−
4

 J m−2 and eruptions with V$_{ \mathrm{CME}} < 900$

<

CME

900
 km s−1 irrespective of the SXR total fluence were very likely to produce proton events of $< 100$
<
100
 MeV.

All proton events were associated with decametric Type III radio bursts, and most of them had Type II bursts associations either in metric or decametric–hectometric (DH) wavelengths or both. Both metric- and DH-Type II emissions were observed in 50% of $<100$
<
100
 MeV proton events while they were observed in 88% of $>100$
>
100
 MeV events. Our analysis showed that protons in most of the $>100$
>
100
 MeV events were released low in the corona ($\leq 3.0$
≤
3.0
R⊙) before the onsets of the DH-Type II radio bursts. Conversely, protons in most of the $<100$
<
100
 MeV events were released higher in the corona ($>3$
>
3
R⊙) and after the DH-Type II onsets.

We conclude that protons in most of the $> 100$
>
100
 MeV events are accelerated either by the flare reconnection processes or by shocks low in the corona and could undergo reacceleration higher in the corona in CME shocks manifested in DH-Type II radio emission. In the $<100$
<
100
 MeV events, protons are mainly accelerated in CME shocks at coronal heights $>3$
>
3
R⊙.
Monitoring of contamination by microplastics on sandy beaches at Vulcano Island (Sicily, Italy) by hyperspectral imaging
Authors: Cocozza Pietro , Serranti Silvia , Setini Andrea , Cucuzza Paola , Bonifazi Giuseppe
Published: September 2024

In this work, the monitoring and characterization of large microplastics (1–5 mm) collected from sandy beaches of Vulcano Island (Aeolian Islands, Sicily, Italy) were carried out for the first time. Microplastics were sampled from two beaches, “Gelso” and “Sabbie Nere,” in three different time periods. The following characteristics of microplastic samples were assessed: quantity, distribution, categories, color, polymer type, size, and shape parameters. The polymers were identified using hyperspectral imaging, whereas an automatic image analysis approach was employed to determine microplastics’ morphological and morphometrical attributes. Finally, the microplastic diversity integrated index was computed to obtain information on the potential emission sources of microplastics. It was found that the concentration of microplastics varies from 0.27 particles/kg_dw to 1.35 particles/kg_dw with fragment being the main collected category, with minor amount of pellet, foam, film, and filament. The predominant color of microplastics was by far white, followed by blue and yellow. The identified polymers were polyethylene and polypropylene followed by expanded polystyrene, polyamide, polystyrene, and polyethylene terephthalate. The morphological and morphometrical characterization highlighted a large variability for most size and shape parameters. Finally, the Microplastics Diversity Integrated Index results showed average indices compared to the literature, with higher values for the “Gelso” site (0.656), indicating a higher heterogeneity of sources, with respect to “Sabbie Nere” beach (0.530).
Emergent group understanding: Investigating intersubjectivity in sociotechnical interdependencies
Authors: Mørch Anders I. , Andersen Renate , Eie Siv , Mifsud Louise
Published: September 2024

Teaching with virtual worlds provides new means for collaborative learning but creates challenges for teachers in terms of IT skills. To address these challenges, we developed a teaching model for using virtual worlds in classroom practices and applied it to Minecraft in several rounds of design-based research experiments. Our conceptual framework combines ideas from software engineering (sociotechnical congruence) and social sciences (intersubjectivity and emergence). Empirically, we addressed the problem of how shared understanding evolves in computer-mediated learning activities. We video-recorded classroom activities and analyzed them using interaction analysis. The teaching model engaged the students in two interdependent processes, referred to as objects: (1) a social object (discussions) that led to a shared knowledge object (video-recorded role-play) and (2) a technology object (Minecraft buildings) for staging the role-play. Our findings include an empirical phenomenon that we call emergent group understanding, which arose from the complex social interactions between social and technology objects when Minecraft was used as a virtual world in a social studies classroom. This revealed two connected subprocesses: (1) a spontaneous act of providing information to assist learners in contextualizing their actions and interactions against a common background, and (2) setting localized goals to guide future actions and interactions. This finding extends previous research by identifying fine-grained processes of intersubjectivity that contribute to collaborative learning. More generally, our teaching model addresses the problem of balancing creative and instructional learning goals.
Effective lateral dispersion of momentum, heat and mass in bubbling fluidized beds
Authors: Gustafsson Gabriel , Castilla Guillermo Martinez , Pallarès David , Ström Henrik
Published: September 2024

The lateral dispersion of bed material in a bubbling fluidized bed is a key parameter in the prediction of the effective in-bed heat transfer and transport of heterogenous reactants, properties important for the successful design and scale-up of thermal and/or chemical processes. Computational fluid dynamics simulations offer means to investigate such beds in silico and derive effective parameters for reduced-order models. In this work, we use the Eulerian-Eulerian two-fluid model with the kinetic theory of granular flow to perform numerical simulations of solids mixing and heat transfer in bubbling fluidized beds. We extract the lateral solids dispersion coefficient using four different methods: by fitting the transient response of the bed to (1) an ideal heat or (2) mass transfer problem, (3) by extracting the time-averaged heat transfer behavior and (4) through a momentum transfer approach in an analogy with single-phase turbulence. The method (2) fitting against a mass transfer problem is found to produce robust results at a reasonable computational cost when assessed against experiments. Furthermore, the gas inlet boundary condition is shown to have a significant effect on the prediction, indicating a need to account for nozzle characteristics when simulating industrial cases.
Nutrition and Osteoporosis Prevention
Authors: Rizzoli René , Chevalley Thierry
Published: September 2024

Purpose of Review

Osteoporosis affects 50% of women and 20% of men after the age of 50. Fractures are associated with significant morbidity, increased mortality and altered quality of life. Lifestyle measures for fragility fracture prevention include good nutrition including adequate protein and calcium intakes, vitamin D sufficiency, and regular weight bearing physical exercise.

Recent Findings

Dietary protein is one of the most important nutritional considerations as it affects bone mineral density, trabecular and cortical microstructure, and bone strength. When calcium intake is sufficient, higher dietary protein intake is associated with lower risk of fracture. Dairy products are a valuable source of calcium and high quality protein. Dairy product consumption, particularly fermented dairy products, are associated with a lower risk of hip fracture and vegan diets are associated with increased fracture risk. Other dietary factors associated with reduced fracture risk include at least 5 servings per day of fruits and vegetables, regular tea drinking, adherence to a Mediterranean diet and other dietary patterns which provide fibers, polyphenols and fermented dairy products. Such dietary patterns may confer health benefits through their effect on gut microbiota composition and/or function.

A balanced diet including minerals, protein, fruits and vegetables is an important element in the prevention of osteoporosis and of fragility fracture.
The Pupillary Light-Off Reflex in Acute Disorders of Consciousness
Authors: Zarifkar Pardis , Othman Marwan H. , Hansen Karen Irgens Tanderup , Amiri Moshgan , Stückler Sarah Gharabaghi , Fabritius Maria Louise , Sigurdsson Sigurdur Thor , Hassager Christian , Birkeland Peter F. , Hauerberg John , Møller Kirsten , Kjaergaard Jesper , Larson Merlin D. , Kondziella Daniel
Published: September 2024

Background

In intensive care patients with disorders of consciousness, the pupillary light reflex is a measure of pupillary parasympathetic function. By contrast, the pupillary light-off reflex leads to pupil dilation in response to an abrupt change from light to darkness (“light-off”) and reflects combined parasympathetic and sympathetic pupillary function. To our knowledge, this reflex has not been systematically investigated in patients with disorders of consciousness. We hypothesized that the pupillary light-off reflex correlates with consciousness levels after acute brain injury.

Methods

From November 2022 to March 2023, we enrolled 100 study participants: 25 clinically unresponsive (coma or unresponsive wakefulness syndrome) and 25 clinically low-responsive (minimally conscious state or better) patients from the intensive care units of a tertiary referral center, and 50 age-matched and sex-matched healthy controls. Exclusion criteria were active or chronic eye disease. We used automated pupillometry to assess the pupillary light-off reflex and the pupillary light reflex of both eyes under scotopic conditions in all study participants.

Results

The pupillary light-off reflex was strongly correlated with consciousness levels (r = 0.62, p < 0.001), the increase in pupillary diameters being smallest in unresponsive patients (mean ± standard deviation 20% ± 21%), followed by low-responsive patients (mean ± standard deviation 47% ± 26%) and healthy controls (mean ± standard deviation 67% ± 17%; p < 0.001). Similar yet less pronounced patterns were observed for the pupillary light reflex. Twenty-one of 25 (84%) unresponsive patients had preserved pupillary light reflexes, but only seven (28%) had fully preserved pupillary light-off reflexes (p < 0.0001). Of these 7 patients, five (71%) regained awareness.

Conclusions

The pupillary light-off reflex may be more sensitive to consciousness levels than the pupillary light reflex. The clinical implications of this finding seem worthy of further investigation, particularly regarding possible benefits for neuromonitoring and prognostication after brain injury.
Effect of a controlled diaphragmatic breathing session on perceived pain and state anxiety in people with chronic pain
Authors: Serrano-Ibáñez Elena R. , Czub Marcin , Ortega Cordero Cristina , López-Martínez Alicia E. , Ramírez-Maestre Carmen , Piskorz Joanna , Zarazaga Rosa Esteve
Published: September 2024

Chronic pain conditions are frequently comorbid with anxiety problems. The controlled diaphragmatic breathing technique has been applied in both conditions. However, few studies have examined its efficacy in reducing perceived pain and state anxiety in the population with both pathologies. Thus, the study objective was to investigate the immediate effects of a single-session diaphragmatic breathing intervention on perceived pain and state anxiety in a group of people with chronic pain. We analyzed the influence of sociodemographic variables, dispositional anxiety, average pain during the last week, respiratory rate, and inhalation/exhalation ratio. The sample comprised 169 people with chronic pain from Spain and Poland who were evaluated before and after performing an online controlled diaphragmatic breathing task. The Wilcoxon test showed significant decreases in state anxiety and perceived pain. Linear regression analyses revealed an association between dispositional anxiety and pretest/posttest differences in state anxiety, as well as an association between both average pain in the last week and nationality and pretest/posttest differences in perceived pain. We conducted an exploratory analysis of the differences between both countries in the study variables. We discuss the results and the relevance of further studies on the efficacy of this technique in reducing perceived pain and state anxiety.
Breaking up with belongings: a pilot randomized controlled trial of an unguided web-based program to reduce overconsumption
Authors: Norberg Melissa M. , Matheson Angelica C. , Visvalingam Shanara , King Ronan D. , Olivier Jake , David Jonathan , McLellan Lauren F.
Published: September 2024

Numerous consumers engage in wasteful and unsustainable consumption despite knowing it is associated with several personal, social, economic, and environmental harms. To aid consumers in reducing consumption, we created Breaking up with Belongings (BB), a fully automated web-based intervention with a downloadable workbook. Eligible participants were recruited using social media ads. They were Australian residents, aged 18 or older, fluent in English, had consistent computer and internet access, and reported having excess possessions and/or having difficulty making intentional decisions about possessions. We assessed the feasibility, acceptability, and preliminary efficacy of this intervention compared to a waitlist (WL) control in a 3-month, parallel, two-arm pilot randomized controlled trial. Over three weeks, 171 individuals screened for this study; 96 were eligible and randomized to condition (48 BB group, 48 WL group). Three-quarters of participants provided follow-up data and accessed the program. The BB group found the program acceptable and outperformed the WL group on two primary outcomes (cautious shopping and clutter removal) and on all secondary outcomes (impulsive buying, expenditure, hoarding tendencies, clutter-related impairment, object attachment, and emotion regulation). These findings will be used to enhance the program’s effectiveness and broader applicability, which will be tested through a larger randomized controlled trial.
Lubrication antagonism mechanism of nano-MoS2 and soot particles in ester base oil
Authors: Zhong Chonglong , Hu Kunhong , Xu Yong , Hu Enzhu , Hu Xianguo
Published: September 2024

Spherical nano-MoS2 (S-MoS2) has excellent lubricating properties and potential application value in engine oil additives. Engine soot can enter the engine oil, so the tribological interaction between S-MoS2 and diesel combustion soot (DCS) should be investigated. In this study, DCS was used to simulate engine soot. The interaction was investigated in dioctyl sebacate (DOS), and the interaction mechanism was full characterized. Results showed that S-MoS2 and DCS had obvious antagonism effects on lubrication. The 0.5% S-MoS2 exhibited good lubricating properties in DOS, which could reduce friction by ∼22% and wear by ∼54%. However, after 0.5% S-MoS2 was added to the 0.5% DCS contaminated DOS, the lubrication performance was not improved and was even worse than that without S-MoS2. When S-MoS2 was added for DOS lubrication, a tribofilm containing MoS2 formed on the friction surface, but simultaneously adding 0.5% DCS resulted in the disappearance of the MoS2 tribofilm. Moreover, under the action of friction heat, DCS and S-MoS2 could form hard MoxCy, thereby increasing abrasive wear. Finally, a preliminary deantagonism method was provided. After 2.0% zinc isooctyl dithiophosphate was added to the above antagonistic system, the friction coefficient did not show visible changes, but the wear recovered to a level close to that when only S-MoS2 was added. The antiantagonism method is not very satisfactory and some more efficient methods need to be further explored.
How It Matters Who Makes Corporate Rules
Authors: Chan Jonathan , Lim Ernest
Published: September 2024

Corporate rules are often analysed without attending to the strengths and limitations of the body making, monitoring or implementing those rules. However, corporate rule-making and implementation bodies (RMIBs) over which policymakers have the most influence—legislatures, public regulatory agencies, stock exchanges, and private/professional bodies with a degree of self-regulatory autonomy—have an important bearing on the effectiveness of rules. This article advances a framework to understand how RMIBs influence the effectiveness of corporate rules by critically examining five core features of RMIBs: (a) their incentives for making and implementing the rules; (b) the nature and extent of regulatory competition; (c) available and relative resources; (d) rule-making speed and the certainty of their decisions; and (e) their legitimacy in the eyes of the regulated parties and relevant stakeholders. To illustrate the framework concretely, this article conducts case studies exploring how it matters who makes the rules on climate-related risks disclosure and in the UK’s recently enacted Financial Services and Markets Act 2023.
Decent deepfakes? Professional deepfake developers’ ethical considerations and their governance potential
Authors: Pawelec Maria
Published: September 2024

Policymakers and societies are grappling with the question of how to respond to deepfakes, i.e., synthetic audio-visual media which is proliferating in all areas of digital life– from politics to pornography. However, debates and research on deepfakes’ impact and governance largely neglect the technology’s sources, namely the developers of the underlying artificial intelligence (AI), and those who provide code or deepfake creation services to others, making the technology widely accessible. These actors include open-source developers, professionals working in large technology companies and specialized start-ups, and for deepfake apps. They can profoundly impact which underlying AI technologies are developed, whether and how they are made public, and what kind of deepfakes can be created. Therefore, this paper explores which values guide professional deepfake development, how economic and academic pressures and incentives influence developers’ (perception of) agency and ethical views, and how these views do and could impact deepfake design, creation, and dissemination. Thereby, the paper focuses on values derived from debates on AI ethics and on deepfakes’ impact. It is based on ten qualitative in-depth expert interviews with academic and commercial deepfake developers and ethics representatives of synthetic media companies. The paper contributes to a more nuanced understanding of AI ethics in relation to audio-visual generative AI. Besides, it empirically informs and enriches the deepfake governance debate by incorporating developers’ voices and highlighting governance measures which directly address deepfake developers and providers and emphasize the potential of ethics to curb the dangers of deepfakes.
Application of center for disease control and prevention standardized antimicrobial administration ratio to an Indian hospital
Authors: Sarma Smita , Borde Kalyani , Robinson Matthew , Rawat Neelam , Khurana Prerna , Singh Vyoma , Singh Padam , Mehta Yatin
Published: September 2024

Background:

Rigorous antibiotic stewardship is advised by international societies to combat rising antibiotic resistance. A major component of these programs is the metric used for antibiotic consumption measurement. A method for standardized antimicrobial administration ratio (SAAR) is suggested by the Centre for Disease Control & Prevention—National Healthcare Safety Network (NHSN).

Objectives:

We applied the SAAR method to calculate antibiotic consumption in a tertiary care hospital in India. We also validated a limited sampling approach to calculate SAAR.

Method:

The prospective study was conducted in three medical intensive care units over a period of 12 months. Monthly antibiotic consumption was measured by the hospital electronic records. Limited sampling was performed by weekly bedside review of the antibiotic orders. Formulae for SAAR calculation were derived from the NHSN guide. SAAR obtained by electronic records and limited sampling were compared to validate this approach.

Results:

SAAR was calculated as >1 for an Indian hospital (1.49 by electronic records and 1.43 by limited sampling approach). The difference between the two ratios was not statistically significant (P = .47).

Conclusions:

SAAR in our setting is 1.49, which is slightly higher than the NHSN benchmark. Antibiotic usage (AU) risk adjustment based on data from the NHSN might not be adequate for calculating SAAR for Indian hospitals. There is a need to perform AU risk factor analysis for Indian settings for better defining SAAR in Indian context. The limited sampling approach can be adapted for calculation of SAAR in settings with limited resources.
A far ultraviolet-C light technology is effective for decontamination of items in proximity to sinks and is enhanced by a far UV-C reflective surface
Authors: Kaple Claire E. , Memic Samir , Cadnum Jennifer L. , Varghese Martin Mathew , Hebrink Timothy J. , Donskey Curtis J.
Published: September 2024

Background:

Dispersal of gram-negative bacilli from sink drains has been implicated as a source of transmission in multiple outbreaks.

Methods:

In an acute care hospital, we assessed how often patient care supplies and other frequently touched items were within 1 meter of sink drains. We tested the efficacy of a ceiling-mounted far ultraviolet-C (UV-C) light technology for decontamination of sink bowls and surfaces near sinks with and without a wall-mounted film that reflects far UV-C light.

Results:

Of 190 sinks assessed, 55 (29%) had patient care supplies or other frequently touched items within 1 meter of the drain. The far UV-C technology reduced Pseudomonas aeruginosa, Enterobacter cloacae and Candida auris on steel disk carriers by ≥1.5 log10 colony-forming units (CFU) in 45 minutes. On inoculated real-world items, ≥1.9 log10 CFU reductions in P. aeruginosa were achieved on sites in line with the light source versus 0.4–1.8 log10 CFU reductions on shaded surfaces. The addition of the reflective surface significantly enhanced efficacy in shaded sites (P < 0.01).

Conclusions:

In a hospital setting, patient care supplies and other frequently touched items were often in proximity to sinks. The far UV-C light technology could potentially be useful for sink decontamination in high-risk areas.
Mechanism of enhanced impulse and entrainment of a pulsed jet through a flexible nozzle
Authors: Choi Daehyun , Park Hyungmin
Published: September 2024

The present experimental study shows that a nozzle with optimal flexibility can enhance the impulse and entrainment of a pulsed jet. Near the nozzle exit, vortex rings emanating from the flexible nozzle move faster because of the timely release of the elastic energy (stored during the expansion) to the jet, which is maximized at the structural stiffness that needs to be optimally tuned to the jet acceleration. The total circulation, hydrodynamic impulse and entrained fluid volume are enhanced substantially. Interestingly, we find that the same condition for optimal flexibility to maximize the hydrodynamic impulse and circulation of the primary vortex ring of the continuous jet (Choi & Park, J. Fluid Mech., vol. 949, 2022, A39) holds universally for the pulsed jet, indicating that abrupt jet termination is irrelevant to the impulse augmentation mechanism. Compared to the rigid counterpart, increments of the impulse (

${\sim }400\,\%$

) and entrainment (

${\sim }220\,\%$

) of a pulsed jet in the present study are considerably larger than those (

$200\,\%$

and

$50\,\%$

, respectively) in a continuous jet from previous studies, which is attributed to the significant suppression of negative pressure at the nozzle exit by the collapsing motion of the flexible nozzle in the phase with the jet-driven upstream propagation of the surface wave on the nozzle. This universal mechanism provides a guideline for a novel jet propulsor using a flexible nozzle, for example, for small-scale underwater robots.
The Pact of the Old Guard: Religion, Law, and Politics for a Russia at War
Authors: Stoeckl Kristina
Published: September 2024

This article examines the evolution of the Russian Orthodox Church’s identities and political alignments from the post-Soviet era to the present in three chronological phases. First, the author explores the church’s varied post-Soviet identities shaped by experiences of repression, collaboration, dissidence, and emigration from 1991 to approximately 2010. The author identifies key legislative and political developments between 2010 and 2021 that have aligned the Russian Orthodox Church with the autocratic state. Finally, the author analyzes the shifting stance of the Moscow Patriarchate on Ukraine from 2014 to 2022, including Patriarch Kirill’s support for Russia’s full-scale war against Ukraine since 2022, which is interpreted as a continuation of the church’s historical role as a collaborator during Soviet times. The author argues that the church’s contemporary role is confined to providing ritualistic and spiritual legitimization for state ideology, perpetuating a logic of authority, control, obedience, and dichotomous friend/enemy thinking reminiscent of Soviet-era security services. Through this analysis, the author reveals how the state and church leadership of the past decades has strategically positioned the church in preparation for conflict.
Latent class analysis of depressive symptoms and associations with suicidal thoughts, plans, and attempts among a large national sample
Authors: Mournet Annabelle M. , Kleiman Evan M.
Published: September 2024

Background

Depression is strongly associated with risk for suicidal behaviors. However, depression is a highly heterogeneous condition (i.e. there are more than 200 combinations of DSM-5-TR depressive symptoms to correspond to a depression diagnosis). Limited research to date has taken an empirical approach to see how people cluster together based on their classification of depressive symptoms and whether people in certain classes are more likely to report suicide outcomes than other classes. This analysis leverages the National Survey on Drug Use and Health and examines classes of depressive symptoms to explore differences in suicide-related outcomes by class among adults endorsing depressive symptoms (n = 41 969).

Methods

We used latent class analysis (LCA) to identify classes of individuals’ DSM-5 depressive symptoms presentation and then explored differences in suicide-related outcomes (i.e. suicide plans, suicide attempts) by the resulting classes.

Results

A four-class model was determined to optimize the fit criteria. Class 3 (high depressive symptoms) had significantly greater rates of suicide-related outcomes, followed by class 1 (high depressed mood and moderate worthlessness), with classes 4 and 2 having significantly lower rates of suicide-related outcomes.

Conclusions

The use of LCA provided valuable findings on the importance of leveraging both a multi-faceted assessment of depressive symptoms to identify cases where a high number of depressive symptoms are endorsed, and review of the specific symptoms endorsed. Worthlessness, in particular, may be of particular value to focus on within the context of suicide prevention.
Psychosis risk for lesbian, gay, and bisexual individuals: systematic review and meta-analysis
Authors: Selten Jean-Paul , Alrashed Hussam , Oh Hans , Blokland Gabriëlla A. M.
Published: September 2024

The social defeat hypothesis posits that low status and repeated humiliation increase the risk for psychotic disorders (PDs) and psychotic experiences (PEs). The purpose of this paper was to provide a systematic review of studies on risk of PDs and PEs among lesbian, gay, or bisexual (LGB) people and a quantitative synthesis of any difference in risk. PubMed, PsycINFO, Embase, and Web of Science were searched from database inception until January 30, 2024. Two independent reviewers assessed the eligibility and quality of studies, extracted effect sizes, and noted the results of mediation analyses. Using a random effects model we computed pooled odds ratios (ORs). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The search identified seven studies of PDs and six of PEs. As for PDs, the unadjusted (2.13; 95% confidence interval 0.72–6.34) and covariate-adjusted pooled OR (2.24; 1.72–3.53) were not significantly increased for LGB individuals. After exclusion of a study of limited quality, both the unadjusted pooled OR (2.77; 1.21–6.32) and the covariate-adjusted pooled OR (2.67; 1.53–4.66) were significantly increased. The pooled ORs were increased for PEs: unadjusted, pooled OR = 1.97 (1.47–2.63), covariate-adjusted, pooled OR = 1.85 (1.50–2.28). Studies of PE that examined the mediating role of several variables reported that the contribution of drug abuse was small compared to that of psychosocial stressors. The results of a study in adolescents suggested a protective effect of parental support. These findings suggest an increased psychosis risk for LGB people and support the social defeat hypothesis.