bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing an approach to prevent life‐threatening bleeding: Guidance on forming a campus initiative
Authors: Caulkins Elizabeth , Johnston Katheryn Courville , Deal Belinda , Swanberg Amanda , Barnes Glenn A. , Bowen Jessica
Published: January 2024

A community that is trained to respond to life‐threatening bleeding can reduce the risk of death from trauma and violence. Stop The Bleed is a nationally recognized, free, 1‐hour bleeding control training designed for laypersons. Implementing a campuswide Stop the Bleed initiative can be daunting, yet vital to creating a safe, prepared campus. Guidance is offered by faculty, staff, and students from a Stop the Bleed initiative at a public university in the southern United States. This guide provides real‐life examples and recommendations based on experience. Utilization of population health nursing students is a fundamental component of success.
Physics-Informed Fully Convolutional Networks for Forward Prediction of Temperature Field and Inverse Estimation of Thermal Diffusivity
Authors: Zhu Tong , Zheng Qiye , Lu Yanglong
Published: January 2024

Physics-informed neural networks (PINNs) are a novel approach to solving partial differential equations (PDEs) through deep learning. They offer a unified manner for solving forward and inverse problems, which is beneficial for various engineering problems, including heat transfer analysis. However, traditional PINNs suffer from low accuracy and efficiency due to the fully-connected neural network framework and the method to incorporate physical laws. In this paper, a novel physics-informed learning architecture, named physics-informed fully convolutional networks (PIFCNs), is developed to simultaneously solve forward and inverse problems in thermal conduction. The use of fully convolutional networks (FCNs) significantly reduces the density of connections. Thus, the computational cost is reduced. With the advantage of the nodal-level match between inputs and outputs in FCNs, the output solution can be used directly to formulate discretized PDEs via a finite difference method, which is more accurate and efficient than the traditional approach in PINNs. The results demonstrate that PIFCNs can flexibly implement Dirichlet and Neumann boundary conditions to predict temperature distribution. Remarkably, PIFCNs can also estimate unknown thermal diffusivity with an accuracy exceeding 99%, even with incomplete boundaries and limited sampling data. The results obtained from PIFCNs outperform those obtained from PINNs.
Caffeine Does Not Alter Performance, Perceptual Responses, and Oxidative Stress After Short Sprint Interval Training
Authors: Bernardo Mauro F. , Enes Alysson , Rezende Elisangela F. , Okuyama Alexandre R. , Alves Ragami C. , de Andrade Murilo , Macedo Ana Carolina G. , de Barros Marcelo Paes , Candow Darren G. , Forbes Scott C. , Souza-Junior Tácito P.
Published: January 2024

Despite the abundance of research investigating the efficacy of caffeine supplementation on exercise performance, the physiological and biochemical responses to caffeine supplementation during intermittent activities are less evident. This study investigated the acute effects of caffeine supplementation on measures of exercise performance, ratings of perceived exertion, and biomarkers of oxidative stress induced by an acute bout of sprint interval training. In a randomized crossover design, 12 healthy males (age: 26 ± 4 years, height: 177.5 ± 6 cm, body mass: 80.7 ± 7.6 kg) ingested 6 mg/kg of caffeine or placebo 60 min prior to performing sprint interval training (12 × 6 s “all-out sprints” interspersed by 60 s of rest). Performance scores and ratings of perceived exertion were assessed after every sprint. Blood samples were collected before supplementation, prior to and following each sprint, and 5 and 60 min after the last sprint. Caffeine had no effect on any performance measures, ratings of perceived exertion, or biomarkers of oxidative stress (p > .05). In conclusion, caffeine supplementation does not improve performance or decrease oxidative stress after an acute bout of sprint interval training.
Examining the Feasibility of a Mindfulness Flow Program for the Hong Kong Archers
Authors: Lo Ka K. , Tse Mimi M.Y. , Chung Joanne W.Y. , Law Queenie P.S. , Sun Fenghua
Published: January 2024

Mindfulness-based interventions have gained popularity among elite athletes, but their effectiveness in enhancing archery performance has been inconsistent. This study examined the feasibility of a 12-week mindfulness flow program (MFP) specifically designed for the archers and assessed the effect of the MFP on shooting performance. Twelve members of the Hong Kong Archery Team voluntarily participated in the present study. Their shooting performance, anxiety, mindfulness, and flow state were assessed before and after the MFP intervention. The results showed that the MFP was highly feasible, with 100% attendance. The athletes highly enjoyed the MFP sessions (mean rating: 7.9/10). Improved shooting performance, increased mindfulness, and flow state levels, and reduced anxiety were also observed after the intervention. These findings suggest a positive reception from and potential benefits for athletes. However, it is suggested to conduct additional research using randomized controlled trials to explore the program’s effects and applicability in enhancing sports performance.
Separation of photoionization and measurement-induced delays
Authors: Han Meng , Ji Jia-Bao , Leung Chung Sum , Ueda Kiyoshi , Wörner Hans Jakob
Published: January 2024

Photoionization of matter is one of the fastest electronic processes in nature. Experimental measurements of photoionization dynamics have become possible through attosecond metrology. However, all experiments reported to date contain a so-far unavoidable measurement-induced contribution, known as continuum-continuum (CC) or Coulomb-laser-coupling delay. In traditional attosecond metrology, this contribution is nonadditive for most systems and nontrivial to calculate. Here, we introduce the concept of mirror symmetry–broken attosecond interferometry, which enables the direct and separate measurement of both the native one-photon ionization delays and the CC delays. Our technique solves the longstanding challenge of experimentally isolating these two contributions. This advance opens the door to the next generation of accurate measurements and precision tests that will set standards for benchmarking the accuracy of electronic structure and electron-dynamics methods.
Endogenous retroviruses shape pluripotency specification in mouse embryos
Authors: de la Rosa Sergio , del Mar Rigual María , Vargiu Pierfrancesco , Ortega Sagrario , Djouder Nabil
Published: January 2024

The smooth and precise transition from totipotency to pluripotency is a key process in embryonic development, generating pluripotent stem cells capable of forming all cell types. While endogenous retroviruses (ERVs) are essential for early development, their precise roles in this transition remains mysterious. Using cutting-edge genetic and biochemical techniques in mice, we identify MERVL-gag, a retroviral protein, as a crucial modulator of pluripotent factors OCT4 and SOX2 during lineage specification. MERVL-gag tightly operates with URI, a prefoldin protein that concurs with pluripotency bias in mouse blastomeres, and which is indeed required for totipotency-to-pluripotency transition. Accordingly, URI loss promotes a stable totipotent-like state and embryo arrest at 2C stage. Mechanistically, URI binds and shields OCT4 and SOX2 from proteasome degradation, while MERVL-gag displaces URI from pluripotent factor interaction, causing their degradation. Our findings reveal the symbiotic coevolution of ERVs with their host cells to ensure the smooth and timely progression of early embryo development.
Phenome- and genome-wide analyses of retinal optical coherence tomography images identify links between ocular and systemic health
Authors: Zekavat Seyedeh Maryam , Jorshery Saman Doroodgar , Rauscher Franziska G. , Horn Katrin , Sekimitsu Sayuri , Koyama Satoshi , Nguyen Trang T. , Costanzo Maria C. , Jang Dongkeun , Burtt Noël P. , Kühnapfel Andreas , Shweikh Yusrah , Ye Yixuan , Raghu Vineet , Zhao Hongyu , Ghassemi Marzyeh , Elze Tobias , Segrè Ayellet V. , Wiggs Janey L. , Del Priore Lucian , Scholz Markus , Wang Jay C. , Natarajan Pradeep , Zebardast Nazlee
Published: January 2024

The human retina is a multilayered tissue that offers a unique window into systemic health. Optical coherence tomography (OCT) is widely used in eye care and allows the noninvasive, rapid capture of retinal anatomy in exquisite detail. We conducted genotypic and phenotypic analyses of retinal layer thicknesses using macular OCT images from 44,823 UK Biobank participants. We performed OCT layer cross-phenotype association analyses (OCT-XWAS), associating retinal thicknesses with 1866 incident conditions (median 10-year follow-up) and 88 quantitative traits and blood biomarkers. We performed genome-wide association studies (GWASs), identifying inherited genetic markers that influence retinal layer thicknesses and replicated our associations among the LIFE-Adult Study (N= 6313). Last, we performed a comparative analysis of phenome- and genome-wide associations to identify putative causal links between retinal layer thicknesses and both ocular and systemic conditions. Independent associations with incident mortality were detected for thinner photoreceptor segments (PSs) and, separately, ganglion cell complex layers. Phenotypic associations were detected between thinner retinal layers and ocular, neuropsychiatric, cardiometabolic, and pulmonary conditions. A GWAS of retinal layer thicknesses yielded 259 unique loci. Consistency between epidemiologic and genetic associations suggested links between a thinner retinal nerve fiber layer with glaucoma, thinner PS with age-related macular degeneration, and poor cardiometabolic and pulmonary function with a thinner PS. In conclusion, we identified multiple inherited genetic loci and acquired systemic cardio-metabolic-pulmonary conditions associated with thinner retinal layers and identify retinal layers wherein thinning is predictive of future ocular and systemic conditions.
Effects and mechanisms of glyphosate as phosphorus nutrient on element stoichiometry and metabolism in the diatom
Phaeodactylum tricornutum
Authors: Wang Cong , Li Jiashun , Li Sihan , Lin Senjie
Published: January 2024

The ability to utilize dissolved organic phosphorus (DOP) gives phytoplankton competitive advantages in P-limited environments. Our previous research indicates that the diatom
Phaeodactylum tricornutum
could grow on glyphosate, a DOP with carbon-phosphorus (C-P) bond and an herbicide, as sole P source. However, direct evidence and mechanism of glyphosate utilization are still lacking. In this study, using physiological and isotopic analysis, combined with transcriptomic profiling, we demonstrated the uptake of glyphosate by
P. tricornutum
and revealed the candidate responsible genes. Our data showed a low efficiency of glyphosate utilization by
P. tricornutum
, suggesting that glyphosate utilization costs energy and that the alga possessed an herbicide-resistant type of 5-enolpyruvylshikimate-3-phosphate (EPSP) synthase. Compared to the P-limited cultures, the glyphosate-grown
P. tricornutum
cells up-regulated genes involved in DNA replication, cell growth, transcription, translation, carbon metabolism, and many genes encoding antioxidants. Additionally, cellular C and silicon (Si) increased remarkably while cellular nitrogen (N) declined in the glyphosate-grown
P. tricornutum
, leading to higher Si:C and Si:N ratios, which corresponded to the up-regulation of genes involved in the C metabolism and Si uptake and the down-regulation of those encoding N uptake. This has the potential to enhance C and Si export to the deep sea when P is limited but phosphonate is available. In sum, our study documented how
P. tricornutum
could utilize the herbicide glyphosate as P nutrient and how glyphosate utilization may affect the element content and stoichiometry in this diatom, which have important ecological implications in the future ocean.

IMPORTANCE

Glyphosate is the most widely used herbicide in the world and could be utilized as phosphorus (P) source by some bacteria. Our study first revealed that glyphosate could be transported into
Phaeodactylum tricornutum
cells for utilization and identified putative genes responsible for glyphosate uptake. This uncovers an alternative strategy of phytoplankton to cope with P deficiency considering phosphonate accounts for about 25% of the total dissolved organic phosphorus (DOP) in the ocean. Additionally, accumulation of carbon (C) and silicon (Si), as well as elevation of Si:C ratio in
P. tricornutum
cells when grown on glyphosate indicates glyphosate as the source of P nutrient has the potential to result in more C and Si export into the deep ocean. This, along with the differential ability to utilize glyphosate among different species, glyphosate supply in dissolved inorganic phosphorus (DIP)-depleted ecosystems may cause changes in phytoplankton community structure. These insights have implications in evaluating the effects of human activities (use of Roundup) and climate change (potentially reducing DIP supply in sunlit layer) on phytoplankton in the future ocean.
Four-factor prothrombin complex concentrate versus andexanet alfa for the reversal of traumatic brain injuries
Authors: Sadek Erin , Curtiss William , Andrews Jessica , Hecht Jason
Published: January 2024

Background

Andexanet alfa was approved in 2018 for reversal of direct oral anticoagulants but due to issues of cost and access, four-factor prothrombin complex concentrate (4F-PCC) continues to be used for this indication. The objective of this study is to evaluate outcomes of reversal with these agents in patients with isolated traumatic brain injuries (TBI).

Methods

This is a retrospective review of 35 trauma centres from 2014 to 2021. Patients were included with an Abbreviated Injury Scale (AIS)>2 for head and having received andexanet alfa or 4F-PCC within 24 hours of admission. Patients were excluded if P2Y12 inhibitor use or AIS>2 outside of head. Primary outcome includes rate of mortality/hospice at hospital discharge. Secondary outcomes include a composite of serious hospital complications. A subgroup analysis of severe TBI patients (AIS head 4 or 5) was completed. Multivariable logistic regression was used to account for differences in comorbidities and TBI severity.

Results

4F-PCC was given to 265 patients with another 59 receiving andexanet alfa. Patients in the andexanet alfa group were more likely to have an AIS head score of 5 (47.5% vs 26.1%; p<0.005). After adjusting for severity of TBI and comorbidities with regard to mortality/hospice, there were 15 (25.4%) patients in the andexanet alfa group and 49 (18.5%) in the 4F-PCC group (OR 1.34; 95% CI 0.67 to 2.71). This remained consistent when looking at severe TBI patients with 12 (28.6%) andexanet alfa patients and 37 (28.7%) 4F-PCC patients (OR 0.93 (95% CI 0.40 to 2.16)). Severe hospital complications were also similar between groups with 5 (8.5%) andexanet alfa patients as compared with 21 (7.9%) 4F-PCC patients (OR 1.01; 95% CI 0.36 to 2.88).

Conclusion

There was no firm conclusion on the treatment effect in mortality/hospice or serious complications among isolated TBI patients reversed with 4F-PCC as compared with andexanet alfa.
Adult Autism Research Priorities and Conceptualization in Computing Research: Invitation to Co-lead with Autistic Adults
Authors: Morgado Ramirez Dafne Zuleima , Barbareschi Giulia , Holloway Cathy
Published: January 2024

Autism research is primarily targeted toward children and at normalizing autistic traits. We conducted a literature review of computing research on adult autism, focusing on identifying research priorities set by autistic adults and their allies, determining participation levels, identifying how autism is conceptualized, and the types of technologies designed and their purposes. We found: (1) that computing research in adult autism is neither representative of older and non-binary adults nor of autistic adults living outside the USA and Europe; (2) a lack of technologies geared towards the priorities set by autistic adults and their allies; and (3) that computing research primarily views adult autism as a medical deficit and builds design solutions and technologies that follow this marginalizing narrative. We discuss the status quo and provide recommendations for computing researchers to encourage research built on user needs and that is respectful of autistic adults.
Package Arrival Time Prediction via Knowledge Distillation Graph Neural Network
Authors: Zhang Lei , Liu Yong , Zeng Zhiwei , Cao Yiming , Wu Xingyu , Xu Yonghui , Shen Zhiqi , Cui Lizhen
Published: January 2024

Accurately estimating packages’ arrival time in e-commerce can enhance users’ shopping experience and improve the placement rate of products. This problem is often formalized as an Origin-Destination (OD)-based ETA (i.e., estimated time of arrival) prediction task, where the delivery time is estimated mainly based on sender and receiver addresses and other context information. One inherent challenge of the OD-based ETA problem is that the delivery time highly depends on the actual delivery trajectory which is unknown at the time of prediction. In this article, we tackle this challenge by effectively exploiting historical delivery trajectories. We propose a novel Knowledge Distillation Graph neural network-based package ETA prediction (KDG-ETA) model, which uses knowledge distillation in the training phase to distill the knowledge of historical trajectories into OD pair embeddings. In KDG-ETA, a multi-level trajectory graph representation model is proposed to fully exploit trajectory information at the node-level, edge-level, and path-level. Then, the OD representations embedded with trajectory knowledge are combined with context embeddings from feature extraction module for delivery time prediction using an adaptive attention module. KDG-ETA consistently outperforms existing state-of-the-art OD-based ETA prediction methods on three real-world Alibaba datasets, reducing the Mean Absolute Error (MAE) by 3.0%–39.1% as demonstrated in our extensive empirical evaluation.
Isothermal Microcalorimetry Analysis of Li/β-MnO2 Discharge
Authors: Arnot David J. , Vila Mallory N. , Takeuchi Esther S. , Marschilok Amy C. , Takeuchi Kenneth J.
Published: January 2024

Despite widespread use over several decades, the lithium/manganese dioxide (Li/MnO2) discharge mechanism is not completely understood owing to the structural complexity of the material. However, an improved understanding could lead to broader adoption as a primary and even secondary cathode material. Here, we examine the discharge of single-phase β-MnO2 using isothermal microcalorimetry for the first time. Equilibrium voltage and entropy changes are characterized over the entire discharge range and used to rationalize the results. These measurements are supplemented by electrochemical impedance and X-ray diffraction data that give the clearest picture of the β-MnO2 lithiation process to date. We find that the first half of discharge is dominated by a two-phase reaction to form Li0.5MnO2 followed by single-phase insertion to a composition of Li1.0MnO2, which confirms prior first-principles calculations. The tetragonal β-MnO2 lattice undergoes asymmetric expansion from Jahn-Teller distorted Mn3+ to form an orthorhombic LiMnO2 phase which retains the 1 × 1 tunnel structure. Microcalorimetry results suggest the presence of parasitic reactions occurring during the second half of discharge, which could arise from decomposition of electrolyte or release and reaction of residual water retained in the structure.
Assessing Hydropower Potential in Nepal’s Sunkoshi River Basin: An Integrated GIS and SWAT Hydrological Modeling Approach
Authors: Bhattarai Rinki , Mishra Binaya Kumar , Bhattarai Deepa , Khatiwada Dipendra , Kumar Pankaj , Meraj Gowhar
Published: January 2024

This study assessed the hydropower potential of a mountain watershed within the Sunkoshi River basin in Sindhupalchok, Nepal, utilizing geographic information systems (GIS) and the soil and water assessment tool (SWAT) hydrological model. Topographical, soil, land use, meteorological, and discharge data were employed to assess the study area for the appropriateness of hydropower generation. SWAT was utilized to delineate the Sunkoshi basin into 23 distinct subbasins and involved the creation of a detailed river network, incorporating various hydrological attributes including stream links, stream order, stream length, and slope gradient. After that, it was employed to simulate river discharges within these subbasins. The Sequential Uncertainty Fitting Version 2 (SUFI-2) algorithm, integrated within the SWAT Calibration and Uncertainty Program (SWAT-CUP), was employed to calibrate and validate the model. This step involved the adjustment of 25 selected parameters to enhance the model’s accuracy and reliability in representing the hydrological processes of the Sunkoshi basin. Model performance was assessed utilizing three well-established efficiency criteria: coefficient of determination (R2 = 0.79), Nash–Sutcliffe efficiency (NSE = 0.73), and percent bias (PBIAS = 17.59). The study identified 36 sites across streams of order 3, 4, and 5 as having potential for hydropower generation. The hydropower potential at each identified site was evaluated using estimated stream flow and topographical head at various probability of exceedance (PoE) levels (40%, 45%, 50%, and 60%). The aggregate hydropower potential of the basin was quantified, yielding a potential of 371.30 MW at a 40% PoE. The findings suggest that an integrated approach combining SWAT-based hydrological modeling within a GIS can accurately assess a river basin’s hydropower potential and provide insights into further evaluation of the comprehensive environmental assessment of the fragile Himalayan watersheds.
Data from Treatment Response, Tumor Infiltrating Lymphocytes and Clinical Outcomes in Inflammatory Breast Cancer–Treated with Neoadjuvant Systemic Therapy
Authors: De Schepper Maxim , Nguyen Ha-Linh , Richard François , Rosias Louise , Lerebours Florence , Vion Roman , Clatot Florian , Berghian Anca , Maetens Marion , Leduc Sophia , Isnaldi Edoardo , Molinelli Chiara , Lambertini Matteo , Grillo Federica , Zoppoli Gabriele , Dirix Luc , Punie Kevin , Wildiers Hans , Smeets Ann , Nevelsteen Ines , Neven Patrick , Vincent-Salomon Anne , Larsimont Denis , Duhem Caroline , Viens Patrice , Bertucci François , Biganzoli Elia , Vermeulen Peter , Floris Giuseppe , Desmedt Christine
Published: January 2024

Abstract
Inflammatory breast cancer (IBC) is a rare (1%–5%), aggressive form of breast cancer, accounting for approximately 10% of breast cancer mortality. In the localized setting, standard of care is neoadjuvant chemotherapy (NACT) ± anti-HER2 therapy, followed by surgery. Here we investigated associations between clinicopathologic variables, stromal tumor-infiltrating lymphocytes (sTIL), and pathologic complete response (pCR), and the prognostic value of pCR. We included 494 localized patients with IBC treated with NACT from October 1996 to October 2021 in eight European hospitals. Standard clinicopathologic variables were collected and central pathologic review was performed, including sTIL. Associations were assessed using Firth logistic regression models. Cox regressions were used to evaluate the role of pCR and residual cancer burden (RCB) on disease-free survival (DFS), distant recurrence-free survival (DRFS), and overall survival (OS). Distribution according to receptor status was as follows: 26.4% estrogen receptor negative (ER−)/HER2−; 22.0% ER−/HER2+; 37.4% ER+/HER2−, and 14.1% ER+/HER2+. Overall pCR rate was 26.3%, being highest in the HER2+ groups (45.9% for ER−/HER2+ and 42.9% for ER+/HER2+). sTILs were low (median: 5.3%), being highest in the ER−/HER2− group (median: 10%). High tumor grade, ER negativity, HER2 positivity, higher sTILs, and taxane-based NACT were significantly associated with pCR. pCR was associated with improved DFS, DRFS, and OS in multivariable analyses. RCB score in patients not achieving pCR was independently associated with survival. In conclusion, sTILs were low in IBC, but were predictive of pCR. Both pCR and RCB have an independent prognostic role in IBC treated with NACT.
Significance:
IBC is a rare, but very aggressive type of breast cancer. The prognostic role of pCR after systemic therapy and the predictive value of sTILs for pCR are well established in the general breast cancer population; however, only limited information is available in IBC. We assembled the largest retrospective IBC series so far and demonstrated that sTIL is predictive of pCR. We emphasize that reaching pCR remains of utmost importance in IBC.
Resisting Normality with Cultural Accessibility and Slow Technology
Authors: Johnson Megan A. , Chandler Eliza , Rice Carla
Published: January 2024

Although the COVID-19 virus continues to circulate, there is an increasing insistence that the world “return to normal.” In this paper the authors resist this pull to normalcy and the way it devalues the knowledges, vitality, and livelihoods of disabled people. They examine the crip technoscience practices used during the 2022 digital gathering Practicing the Social: Entanglements of Art and Social Justice, situating them as examples of cultural accessibility that engage with slow technology to provoke crip(ped) ways of being in time. They argue that sustained engagement with cultural accessibility offers a different path through the pandemic, one that centers access and resists the way necropolitics devalues disabled life.
The History and Afterlife of Marx’s ‘Primitive Accumulation’
Authors: Jaffe Aaron D.
Published: January 2024

This paper develops ‘primitive accumulation’ prior to and then in Karl Marx’s œuvre. By exploring the concept in Adam Smith and Sir James Steuart the paper highlights early influences on Marx’s evolving constructions. Marx’s construction in the Grundrisse begins with a logical determination much like Smith’s and moves, by drawing on Steuart, towards a socio-historical determination of a transitional violence. In Capital, ‘primitive accumulation’ still retains its transitional structure and delimited history, but it also points to the oppressive afterlife of the processes of primitive accumulation. The political key to ‘primitive accumulation’ in Capital flows from determining primitive accumulation as temporally bounded, but having an afterlife in the oppressive social reproduction of capitalist societies. Against deriving political stakes through extended readings of ‘primitive accumulation’, this paper shows that an ‘originating’ view is textually accurate in a way that centres rather than sidelines the social reproduction of oppressions in capitalist societies.
A Theory for the Balance between Warm Rain and Ice Crystal Processes of Precipitation in Mixed-Phase Clouds
Authors: Phillips Vaughan T. J.
Published: January 2024

Mixed-phase clouds contain both supercooled cloud liquid and ice crystals. In principle, precipitation may be initiated either by the liquid phase or by the ice phase. Ice crystals may grow by vapor diffusion to become snow (“ice crystal process”), forming “cold” precipitation. Equally, cloud droplets, when large enough, coalesce to form “warm” precipitation by the “warm rain process.” Warm rain could be supercooled and freeze as “warm” graupel. In the present paper, a new simplified theoretical analysis is provided to examine the microphysical system consisting of three species of hydrometeor, namely, cloud liquid, “cold ice” (crystals, snow), and “warm rain” (frozen or supercooled). This is obtained by nondimensionalizing and simplifying the evolution equations for the mass of each species. Analytical formulas are given for equilibria. Feedback analysis shows that the sign of the feedback is linked to the abundance of precipitation, with a neutral surface in the 3D phase space. The system’s precipitation amount explodes while in the initial unstable regime, crossing the neutral surface and approaching the equilibrium point that is a stable attractor. Positive and negative feedbacks are elucidated. In a standard case, the cold ice mass is about 1000 times larger than the warm rain mass. To illustrate the physical behavior of the theory, sensitivity tests are performed with respect to environmental conditions (e.g., aerosol, updraft speed) and microphysical parameters (e.g., riming and sedimentation rates for cold ice). Cold ice prevails, especially in fast ascent, due to its low bulk density, favoring slow sedimentation and a wide cross-sectional area for riming.

Significance Statement

The theory elucidates how the ice phase can prevail in the precipitation from any mixed-phase clouds with supercooled cloud liquid and crystals. The ice phase radically suppresses cloud liquid by riming when active and “wins” the competition against coalescence. This prevalence of ice is shown to arise from the low bulk density of snow. The cloud is viewed as a system of negative and positive feedbacks that prevail in realms of stability and instability in a 3D phase space.
The application value of deep learning in the background of precision medicine in glioblastoma
Authors: Chen Pengyu , Wang Ping , Gao Bo
Published: January 2024

Introduction: Glioblastoma is a highly malignant central nervous system tumor, World Health Organization Ⅳ, glioblastoma is the most common primary malignancy, due to its own specificity and complexity, different patients often benefit from the current conventional treatment regimen because of different molecular subtypes, in the context of precision medicine, the application of deep learning to identify the salient features of tumors on brain imaging, prognostic predictive assessment combined with clinical data to maximize the benefits of each patient from the treatment regimen is a non-invasive and feasible regimen. Methods: We conducted a comprehensive review of the existing literature on the role of deep learning in glioblastomas, covering molecular classification and diagnosis, prognosis assessment. Results: Data based on a variety of magnetic resonance imaging sequences, genetic information, and clinical combinations enable noninvasive predictive tumor diagnosis of glioblastoma and assess overall survival and treatment response accuracy. For images, standardized image acquisition and data extraction techniques can be effectively translated into learning models for clinical practice. However, it must be recognized that interventions in the treatment of glioblastoma using deep learning are still in their infancy, and the robustness of the model is challenged, as the current total number of glioblastoma samples is insufficient for large-scale experimental methods, which is directly related to the difficulty of application of the model. Conclusion: Compared to radiomics and shallow machine learning, deep learning can be a more robust, non-invasive, and effective approach, providing more valuable information as clinicians develop personalized medical protocols for glioblastoma patients.
Genetic background of juniper (Juniperus spp.) consumption predicted by fecal near-infrared spectroscopy in divergently selected goats raised in harsh rangeland environments
Authors: Mulim Henrique A. , Walker John W. , Waldron Daniel F. , Quadros Danilo G. , Benfica Lorena F. , de Carvalho Felipe E. , Brito Luiz F.
Published: January 2024

Background

Junipers (Juniperus spp.) are woody native, invasive plants that have caused encroachment problems in the U.S. western rangelands, decreasing forage productivity and biodiversity. A potential solution to this issue is using goats in targeted grazing programs. However, junipers, which grow in dry and harsh environmental conditions, use chemical defense mechanisms to deter herbivores. Therefore, genetically selecting goats for increased juniper consumption is of great interest for regenerative rangeland management. In this context, the primary objectives of this study were to: 1) estimate variance components and genetic parameters for predicted juniper consumption in divergently selected Angora (ANG) and composite Boer x Spanish (BS) goat populations grazing on Western U.S. rangelands; and 2) to identify genomic regions, candidate genes, and biological pathways associated with juniper consumption in these goat populations.

Results

The average juniper consumption was 22.4% (± 18.7%) and 7.01% (± 12.1%) in the BS and ANG populations, respectively. The heritability estimates (realized heritability within parenthesis) for juniper consumption were 0.43 ± 0.02 (0.34 ± 0.06) and 0.19 ± 0.03 (0.13 ± 0.03) in BS and ANG, respectively, indicating that juniper consumption can be increased through genetic selection. The repeatability values of predicted juniper consumption were 0.45 for BS and 0.28 for ANG. A total of 571 significant SNP located within or close to 231 genes in BS, and 116 SNP related to 183 genes in ANG were identified based on the genome-wide association analyses. These genes are primarily associated with biological pathways and gene ontology terms related to olfactory receptors, intestinal absorption, and immunity response.

Conclusions

These findings suggest that juniper consumption is a heritable trait of polygenic inheritance influenced by multiple genes of small effects. The genetic parameters calculated indicate that juniper consumption can be genetically improved in both goat populations.
Effect of inflammation on association between cancer and coronary artery disease
Authors: Sun Mingzhuang , Zhu Shaoning , Wang Yihao , Zhao Yawei , Yan Kaixin , Li Xiaolong , Wang Xueting , He Changjian , Ding Chunhua , Chen Yundai , Sun Zhijun , Hu Shunying
Published: January 2024

Background

Cancer and coronary artery disease (CAD) is reported to often co-exist in same individuals, however, whether cancer is directly associated with anatomical severity of CAD is rarely studied. The present study aimed to observe the relationship between newly diagnosed cancer and anatomical severity of CAD, moreover, to investigate effect of inflammation on the relationship of cancer with CAD.

Methods

374 patients with newly diagnosed cancer who underwent coronary angiography (CAG) were enrolled. Through 1:3 propensity score matching (PSM) to cancer patients based on the age and gender among 51,106 non-cancer patients who underwent CAG, 1122 non-cancer patients were selected as control patients. Anatomical severity of CAD was assessed using SYNTAX score (SXscore) based on coronary angiographic image. SXscore ≤ 22 (highest quartile) was defined as SX-low, and SXscore > 22 as SX-high. The ratio of neutrophil to lymphocyte count (NLR) was used to describe inflammation level. Association between cancer and the anatomical severity of CAD was investigated using logistic regression.

Results

Univariate logistic regression analysis showed a correlation between cancer and anatomical severity of CAD (OR: 1.419, 95% CI: 1.083–1.859; P = 0.011). Cancer was associated with increased risk of SX-high after adjusted for common risk factors of CAD (OR: 1.598, 95% CI: 1.172–2.179, P = 0.003). Significant association between cancer and SX-high was revealed among patients with high inflammation (OR: 1.656, 95% CI: 1.099–2.497, P = 0.016), but not among patients with low inflammation (OR: 1.530, 95% CI: 0.973–2.498, P = 0.089).

Conclusions

Cancer was associated with severity of CAD, however, the association between the two diseases was significant among patients with high inflammation rather than among patients with low inflammation.
Reality of treatment for severely injured patients: are there age-specific differences?
Authors: Maek Teresa , Fochtmann Ulrike , Jungbluth Pascal , Pass Bastian , Lefering Rolf , Schoeneberg Carsten , Lendemans Sven , Hussmann Bjoern
Published: January 2024

Background

Major trauma and its consequences are one of the leading causes of death worldwide across all age groups. Few studies have conducted comparative age-specific investigations. It is well known that children respond differently to major trauma than elderly patients due to physiological differences. The aim of this study was to analyze the actual reality of treatment and outcomes by using a matched triplet analysis of severely injured patients of different age groups.

Methods

Data from the TraumaRegister DGU® were analyzed. A total of 56,115 patients met the following inclusion criteria: individuals with Maximum Abbreviated Injury Scale > 2 and < 6, primary admission, from German-speaking countries, and treated from 2011–2020. Furthermore, three age groups were defined (child: 3–15 years; adult: 20–50 years; and elderly: 70–90 years). The matched triplets were defined based on the following criteria: 1. exact injury severity of the body regions according to the Abbreviated Injury Scale (head, thorax, abdomen, extremities [including pelvis], and spine) and 2. level of the receiving hospital.

Results

A total of 2,590 matched triplets could be defined. Traffic accidents were the main cause of severe injury in younger patients (child: 59.2%; adult: 57.9%). In contrast, low falls (from < 3 m) were the most frequent cause of accidents in the elderly group (47.2%). Elderly patients were least likely to be resuscitated at the scene. Both children and elderly patients received fewer therapeutic interventions on average than adults. More elderly patients died during the clinical course, and their outcome was worse overall, whereas the children had the lowest mortality rate.

Conclusions

For the first time, a large patient population was used to demonstrate that both elderly patients and children may have received less invasive treatment compared with adults who were injured with exactly the same severity (with the outcomes of these two groups being opposite to each other). Future studies and recommendations should urgently consider the different age groups.
‘There’s a will, but not a way’: Norwegian GPs’ experiences of collaboration with child welfare services – a grounded theory study
Authors: Øverhaug Oda Martine Steinsdatter , Laue Johanna , Vis Svein Arild , Risør Mette Bech
Published: January 2024

Background

Adverse childhood experiences can have immediate effects on a child’s wellbeing and health and may also result in disorders and illness in adult life. General practitioners are in a good position to identify and support vulnerable children and parents and to collaborate with other agencies such as child welfare services. There is a need for better integration of relevant services. The aim of this study is to explore GPs’ experiences of the collaboration process with child welfare services.

Method

This is a qualitative grounded theory study, with data consisting of ten semi-structured interviews with general practitioners across Norway.

Results

The doctors’ main concern was: ‘There’s a will, but not a way’. Three subordinate stages of the collaboration process were identified: (I) Familiar territory, with a whole-person approach to care by the doctor. (II) Unfamiliar territory, when child welfare becomes involved. Here, a one-way window of information and a closed door to dialogue perpetuate the doctors’ lack of knowledge about child welfare services and uncertainty about what is happening to their patients. (III) Fragmented territory, where doctors experience lost opportunities to help and missing pieces in the patient’s history.

Conclusion

General practitioners are willing to contribute to a collaborative process with child welfare, but this is hampered by factors such as poor information flow and opportunities for dialogue, and limited knowledge of the partner. This implies lost opportunities for doctors to help families and contribute their knowledge and potential actions to a child welfare case. It can also impede whole-person care and lead to fragmentation of patient pathways. To counteract this, electronic two-way communication could enable a collaborative process and relationships that enhance coordination between the parties. Making space for all parties and their individual roles was considered important to create a positive collaborative environment.
The prevalence and impact of sarcopenia in older cardiac patients undergoing inpatient cardiac rehabilitation – results from a prospective, observational cohort pre-study
Authors: Steinmetz Carolin , Krause Laura , Sulejmanovic Samra , Kaumkötter Sabrina , Mengden Thomas , Grefe Clemens , Knoglinger Ernst , Reiss Nils , Brixius Klara , Bjarnason-Wehrens Birna , Schmidt Thomas , von Haehling Stephan , Sadlonova Monika , von Arnim Christine A. F. , Heinemann Stephanie
Published: January 2024

Background

The prevalence of sarcopenia and its impact in older patients undergoing inpatient cardiac rehabilitation (iCR) after cardiac procedure has been insufficiently studied. The main aim of this study was to evaluate the prevalence of sarcopenia and quantify the functional capacity of older sarcopenic and non-sarcopenic patients participating in iCR.

Methods

Prospective, observational cohort study within the framework of the ongoing multicenter prehabilitation study “PRECOVERY”. A sample of 122 patients ≥75 years undergoing iCR after cardiac procedure were recruited in four German iCR facilities and followed up 3 months later by telephone. At iCR (baseline), the Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F) questionnaire was used to identify sarcopenic patients. In addition, Katz-Index, Clinical Frailty Scale (CFS), handgrip strength (HGS), Short Physical Performance Battery (SPPB) and 6-minute walk distance (6MWD) measured functional capacity and frailty at baseline. Outcomes were prevalence of sarcopenia and the correlation of sarcopenia to functional capacity and frailty at baseline as well as the SARC-F score at follow-up. The Wilcoxon test was applied for pre-post-test analysis. Correlation between sarcopenia and 6MWD, SPPB score and HGS was tested with the eta coefficient with one-way ANOVA.

Results

Complete assessments were collected from 101 patients (79.9 ± 4.0 years; 63% male). At baseline, the mean SARC-F score was 2.7 ± 2.1; 35% with sarcopenia. Other baseline results were Katz-Index 5.7 ± 0.9, CFS 3.2 ± 1.4, HGS 24.9 ± 9.9 kg, SPPB score 7.5 ± 3.3 and 6MWD 288.8 ± 136.5 m. Compared to baseline, fewer patients were sarcopenic (23% versus 35%) at follow-up. In the subgroup of sarcopenic patients at baseline (n = 35), pre-post comparison resulted in a significant SARC-F improvement (p = 0.017). There was a significant correlation between sarcopenia measured by SARC-F and poor results in the assessments of functional capacity (p < 0.001; r > 0.546).

Conclusions

The prevalence of sarcopenia in older patients at iCR after cardiac procedure is high (35%) and remains high at follow-up (23%). Sarcopenia screening is important since the diagnosis of sarcopenia in these patients correlates significantly with poor functional capacity. The results indicate that these patients may benefit from prehabilitation aimed at improving perioperative outcomes, increasing functional capacity and mitigating adverse effects.

Trial registration

German Clinical Trials Register (DRKS;http://www.drks.de; DRKS00032256). Retrospectively registered on 13 July 2023.
Mitochondrial disturbance related to increased caspase-1 of CD4+T cells in HIV-1 infection
Authors: Yu Fengting , Ma Chengjie , Jin Xia , Zhao Hongxin , Xiao Jiang , Li Li , Song Shujing , Xie Xiaohui , Yang Siyuan , Tang Yunxia , Wang Linghang , Zhang Fujie
Published: January 2024

Background

In HIV-1 infection, more than 95% of CD4+T cells die of caspase-1 mediated pyroptosis. What governs the increased susceptibility of CD4+T cells to pyroptosis is poorly understood.

Methods

Blood samples were obtained from 31 untreated HIV-infected patients (UNT), 29 antiretroviral therapy treated HIV-infected patients (ART), and 21 healthy control donors (HD). Plasma levels of IL-18 and IL-1β, caspase-1 expression, mitochondrial mass (MM) and mitochondrial fusion/fisson genes of CD4+T subsets were measured.

Results

A significantly higher IL-18 level in plasma and MM level of CD4+T cells were found in HIV-infected patients (UNT and ART) compared to HD, and the MMhigh phenotype was manifested, related to increased caspase-1 expression. Moreover, the increased MM was more pronounced in the early differentiated and inactivated CD4+T cells. However, higher MM was not intrinsically linked to T cell differentiation disorder or excessive activation of the CD4+T cells. Mechanistically, the increased MM was significantly correlated with an elevated level of expression of the mitochondrial fusion gene mitofusin1.

Conclusion

An increase in MM was associated with heightened sensitivity of CD4+T cells to pyroptosis, even in early differentiated and inactivated CD4+T cells, in patients with HIV-1 infection, regardless of whether patients were on antiretroviral therapy or not. These new revelations have uncovered a previously unappreciated challenge to immune reconstitution with antiretroviral therapy.
Oritavancin as sequential therapy for Gram-positive bloodstream infections
Authors: Texidor Williams Monier , Miller Matthew A. , Molina Kyle C. , Krsak Martin , Calvert Barbara , Hart Caitlin , Storer Marie , Fish Douglas N.
Published: January 2024

Background

Oritavancin, a long-acting lipoglycopeptide approved for use in acute bacterial skin and skin structure infections, has limited data evaluating use in serious infections due to Gram-positive organisms. We aimed to assess the effectiveness and safety of oritavancin for consolidative treatment of Gram-positive bloodstream infections (BSI), including infective endocarditis (IE).

Methods

We conducted a retrospective cohort study evaluating adult patients admitted to University of Colorado Hospital from March 2016 to January 2022 who received ≥ 1 oritavancin dose for treatment of Gram-positive BSI. Patients were excluded if the index culture was drawn at an outside facility or were > 89 years of age. The primary outcome was a 90-day composite failure (clinical or microbiological failure) in those with 90-day follow-up. Secondary outcomes included individual components of the primary outcome, acute kidney injury (AKI), infusion-related reactions (IRR), and institutional cost avoidance.

Results

Overall, 72 patients were included. Mean ± SD age was 54 ± 16 years, 61% were male, and 10% had IE. Organisms most commonly causing BSI were Staphylococcus aureus (68%, 17% methicillin-resistant), followed by Streptococcus spp. (26%), and Enterococcus spp. (10%). Patients received standard-of-care antibiotics before oritavancin for a median (IQR) of 11 (5–17) days. Composite failure in the clinically evaluable population (n = 64) at 90-days occurred in 14% and was composed of clinical and microbiological failure, which occurred in 14% and 5% of patients, respectively. Three patients (4%) experienced AKI after oritavancin, and two (3%) experienced an IRR. Oritavancin utilization resulted in earlier discharge for 94% of patients corresponding to an institutional cost-avoidance of $3,055,804 (mean $44,938/patient) from 1,102 hospital days saved (mean 16 days/patient).

Conclusions

The use of oritavancin may be an effective sequential therapy for Gram-positive BSI to facilitate early discharge resulting in institutional cost avoidance.