bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding Physiological Changes of the Muscle in Compartment Syndrome
Authors: Caruso Veronica , Saboori Parisa , Walker Graham
Published: February 2023

Compartment Syndrome is experienced as chronic or acute pain of muscle compartments within extremities of the human body. It is a biological condition that is related to and diagnosed by large changes in the intramuscular compartment pressure (IMCP). Acute Compartment Syndrome (ACS) is known to be caused by injury local to the compartment, such as a bone fracture or extreme external impact. Chronic Exertional Compartment Syndrome (CECS) however has no known cause. Subsequent to swelling and increased IMCP, the pathophysiology of symptoms is explained, but the initial cause is unknown. In this study, data of various muscle properties was collected, and data analyses were run to determine significant correlating factors of muscles most affected by CECS. It is observed that affected muscles possess larger fiber length when at rest and undergo larger changes in tendon length (i.e. tendon slack) upon movement. During CECS, the cross-sectional area (CSA) of the muscle also increases due to increased blood perfusion, and subsequently the IMCP will increase. It is proven that there is a direct relationship between CECS and IMCP, but the physiological changes in the muscle, as well as external effects such as gait, are still being speculated.
Variation of Power Output From an OTEC Power Plant Based on Longterm Sea Surface Temperature Data Analysis
Authors: Costa Melvin , Prasad Reemal , Ali Muzammil , Khan M. G. M. , De Ramon N'Yeurt Antoine , Ahmed Mohammed Rafiuddin
Published: February 2023

Though natural resources are abundantly available for utilization of renewable energy sources, many Pacific Island countries continue to rely on fossil fuels. The use of fossil fuels is known to significantly contribute to climate change. Heavy reliance on fossil fuels also hinders the economic development of most of the Pacific Island Countries. To overcome these issues, the energy sector in Fiji is aiming to generate 100% of the required energy using renewables by 2036. One of the viable options which can contribute to this goal is Ocean Thermal Energy Conversion (OTEC) power. The standard OTEC cycle is a modified Carnot cycle and has low efficiency due to the small temperature difference it works with. In this work, we carried out resource assessment around Fiji to identify potential locations where an OTEC power plant can be installed as well as the conceptual design of a 1 MW net power OTEC plant and the variations in power output due to change in surface seawater temperatures (SSTs). Seawater temperature data (in-situ) between 2012–2022 for three locations were obtained and their seasonal, monthly, and diurnal variations were analysed to study the variation of power generation potential. The analysis shows that during the summer season (November to April), a higher temperature difference is available which results in higher power output and efficiency compared to the winter season. The maximum monthly average temperature difference between the surface and the deep sea (4°C) was recorded for March 2022 with a difference of 25.7°C in Suva. The winter month of August in 2015, had the minimum average temperature difference of 20.1°C in Beqa. The maximum surface temperature recorded during the measurement period was nearly 30.5°C (Suva). The analysis of diurnal variation of hourly averaged temperature showed an interesting trend of essentially constant temperature round the clock with the maximum recorded at 4 am. The net power was calculated for the 3 locations for seasonal, monthly and hourly variations. The net power that was estimated to be 1.15 MW for the maximum monthly average temperature, was reduced by about 63% for the minimum. Similarly, the gross power ranged between 1.7 to 2.4 MW for the temperature range. The net power loss increased from 5% to 16% for a drop in 0.5°C in SST from 30°C to 24°C.
Using Actor-Critic Reinforcement Learning for Control and Flight Formation of Quadrotors
Authors: Torres Edgar , Xu Lei , Sardarmehni Tohid
Published: February 2023

This paper introduces a near-optimal controller for the control of quadrotors. A quadrotor is described as a complex, twelve-state system. The paper simplifies the controller by considering it as two levels, the upper-level (kinematics) six-state controller and the lower-level (kinetics) twelve-state controller. An actor-critic optimal controller generates the desired velocities in the upper-level control, and its parameters are tuned by reinforcement learning. The desired velocities are generated using the upper-level controller, which is then used to solve for the lower-level control algebraically. Simulation results are provided to show the effectiveness of the solution.
Novel Digital Twin Concept for Industrial Application. Study Case: Propulsion Drive System
Authors: Jegorov Sergei , Rassõlkin Anton , Rjabtšikov Viktor , Ibrahim Mahmoud , Kuts Vladimir
Published: February 2023

This paper introduces a novel concept of interconnecting components of Digital Twins using ROS2 and micro-ROS frameworks. Authors of the research argue that middleware implementation plays the most important role in the performance of Digital Twins and its robustness must be ensured for reliable real-time operation between components of Digital Twins. Propulsion Drive System Digital Twin is presented where a permanent magnet synchronous motor testbench is interconnected with a virtual counterpart based on the motor’s analytical model for calculation of the motor’s angular velocity and torque. The interface between the motor of the Propulsion Drive System and its virtual counterpart is implemented on a basis of a microcontroller running micro-ROS, with ROS2 acting as a fundamental middleware. The suggested method of connecting components of Digital Twins is tested through a round-trip time latency test. Results of the latency test indicate that the proposed concept is suitable for Digital Twin technologies in industrial applications. At the end of the paper, the authors discuss possible future developments and use cases of the suggested concept.
The interactive effects of traffic sound and window views on indoor soundscape perceptions in the residential area
Authors: Lu Yichun , Tan Johann Kay Ann , Hasegawa Yoshimi , Lau Siu-Kit
Published: February 2023

Environmental noise has long been considered one of the unwelcome aspects of urban life at home. An increasing number of scholars have studied improving indoor acoustic comfort by using the soundscape approach. However, much uncertainty still exists about the relationship between the audio-visual environment and indoor soundscape perception. The current study investigates the interaction effects of traffic sound and window views on indoor soundscape perceptions in residential contexts. Thirty-two participants were presented with 51 scenarios (a combination of 17 window views and three aural stimuli) and requested to assess their soundscape perceptions in a VR experiment. Results showed that traffic noise could moderate the impact of nature, road, and building views on pleasantness, while it can also moderate the effect of water sound and road view on eventfulness. In particular, natural window views were found not to lead to a more pleasant indoor soundscape necessarily; natural window views even decrease the pleasantness of indoor soundscape in the case of heavy traffic noise outside the window. Besides, overall visual indicators, including complexity and openness, have an interactive effect with traffic sound on pleasantness. Last, pleasantness is found to be associated with the appropriateness of indoor soundscape.
Do associations of physical activity and sedentary behaviour with cardiovascular disease and mortality differ across socioeconomic groups? A prospective analysis of device-measured and self-reported UK Biobank data
Authors: Paudel Susan , Ahmadi Matthew , Phongsavan Philayrath , Hamer Mark , Stamatakis Emmanuel
Published: February 2023

Objective

To examine if individual-level and area-level socioeconomic status (SES) modifies the association of moderate-to-vigorous physical activity (MVPA), domain-specific physical activity and sedentary behaviour with all-cause mortality (ACM) and incident cardiovascular disease (CVD).

Methods

We used self-reported (International Physical Activity Questionnaire short form) and accelerometer-measured physical activity and sedentary behaviour data from the UK Biobank. We created an individual-level composite SES index using latent class analysis of household income, education and employment status. The Townsend Index was the measure of area-level SES. Cox proportional hazards regression models stratified across SES were used.

Results

In 328 228 participants (mean age 55.9 (SD 8.1) years, 45% men) with an average follow-up of 12.1 (1.4) years, 18 033 deaths and 98 922 incident CVD events occurred. We found an increased ACM risk of low physical activity and high sedentary behaviour and an increased incident CVD risk of low accelerometer-measured moderate-to-vigorous physical activity (ACCEL_MVPA) and high sitting time. We observed statistically significant interactions for all exposures in ACM analyses by individual-level SES (p<0.05) but only for screen time in area-level SES–ACM analysis (p<0.001). Compared with high self-reported moderate-to-vigorous physical activity (IPAQ_MVPA), adjusted ACM HRs for low IPAQ_MVPA were 1.14 (95% CI 1.05 to .25), 1.15 (95% CI 1.06 to 1.24) and 1.22 (95% CI 1.13 to 1.31) in high, medium and low individual-level SES, respectively. There were higher detrimental associations of low ACCEL_MVPA with decreasing area-level SES for both outcomes and of high screen time with ACM in low area-level SES.

Conclusion

We found modest evidence suggesting that the detrimental associations of low MVPA and high screen time with ACM and incident CVD are accentuated in low SES groups.
Association between integrase strand transfer inhibitor use with insulin resistance and incident diabetes mellitus in persons living with HIV: a systematic review and meta-analysis
Authors: Mulindwa Frank , Kamal Habiba , Castelnuovo Barbara , Byonanebye Dathan M , Schwarz Jean-Marc , Bollinger Robert , Brusselaers Nele
Published: February 2023

Whether integrase strand transfer inhibitors (INSTIs) are associated with a higher risk of incident type 2 diabetes mellitus (DM) than other antiretroviral therapies (ART) needs to be established.

MEDLINE, Embase, Web of Science, and ClinicalTrials.gov registries were searched for studies published between 1 January 2000 and 15 June 2022. Eligible studies reported incident DM or mean changes in insulin resistance measured by Homeostatic Model for Insulin Resistance (HOMA-IR) in patients on INSTIs compared with other ARTs. We performed random-effects meta-analyses to obtain pooled relative risks (RRs) with 95% CIs.

A total of 16 studies were pooled: 13 studies meta-analyzed for incident diabetes with a patient population of 72 404 and 3 for changes in HOMA-IR. INSTI therapy was associated with a lower risk of incident diabetes in 13 studies (RR 0.80, 95% CI 0.67 to 0.96, I2=29%), of which 8 randomized controlled trials demonstrated a 22% reduced risk (RR 0.88, 95% CI 0.81 to 0.96, I2=0%). INSTIs had a lower risk compared with non-nucleoside reverse transcriptase inhibitors (RR 0.75, 95% CI 0.63 to 0.89, I2=0%) but similar to protease inhibitor-based therapy (RR 0.78, 95% CI 0.61 to 1.01, I2=27%). The risk was lower in studies with longer follow-up (RR 0.70, 95% CI 0.53 to 0.94, I2=24%) and among ART-naïve patients (RR 0.78, 95% CI 0.65 to 0.94, I2=3%) but increased in African populations (RR 2.99, 95% CI 2.53 to 3.54, I2=0%).

In conclusion, exposure to INSTIs was not associated with increased risk of DM, except in the African population. Stratified analyses suggested reduced risk among ART-naïve patients and studies with longer follow-up.

International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42021273040.
Effects of beta-hydroxy beta-methyl butyrate calcium combined with exercise therapy in patients with cardiac disease: a study protocol for clinical trial
Authors: Ikeda Takashi , Miyazawa Ryo , Inoue Eisuke , Iso Yoshitaka , Nakamura Daisuke , Abe Satoko , Hachisu Mitsugu , Tashiro Naonori , Iguchi Akihiro , Aimoto Kenji , Nakamura Shoko , Ichikawa Hiroo
Published: February 2023

Introduction

The current treatment for heart disease consists of exercise therapy in addition to pharmacotherapy, nutritional support and lifestyle guidance. In general, nutritional support focuses on protein, salt and energy restrictions, with no active protein or amino acid intake in cases involving moderate or higher renal failure. From this perspective, patients with cardiac disease are at high risk of frailty.

Beta-hydroxy beta-methyl butyrate (HMB) is a metabolite of leucine. HMB is widely used for muscle strengthening and can be safely ingested even by patients with renal failure. The proposed study protocol will investigate the effects of HMB-calcium (HMB-Ca) administered in combination with comprehensive cardiac rehabilitation for muscle strength, muscle mass and cardiac function in patients with cardiac disease during the convalescent period. The primary outcome will be knee extensor strength. Secondary outcomes will be gross isometric limb strength and skeletal muscle mass.

Methods and analysis

This study will be a single-blinded, randomised, controlled trial with parallel comparisons between two groups. The study period will be 60 days from the start of outpatient cardiac rehabilitation. Participants will be randomly divided into two groups: an HMB group consuming HMB-Ca one time per day for 60 days; and a Placebo group consuming reduced maltose once one time per day for 60 days. Exercise therapy will be performed by both groups.

Ethics and dissemination

The study protocol will be published in a peer-reviewed journal. Ethics approval was provided by the Showa University Clinical Research Review Board.

Trial registration number

jRCTs031220139; Japan Registry of Clinical Trails.
Developing a tool to measure enactment of complex quality improvement interventions in healthcare
Authors: MacEachern Lauren , Ginsburg Liane R , Hoben Matthias , Doupe Malcolm , Wagg Adrian , Knopp-Sihota Jennifer A , Cranley Lisa , Song Yuting , Estabrooks Carole A , Berta Whitney
Published: February 2023

Quality improvement (QI) projects are common in healthcare settings and often involve interdisciplinary teams working together towards a common goal. Many interventions and programmes have been introduced through research to convey QI skills and knowledge to healthcare workers, however, a few studies have attempted to differentiate between what individuals ‘learn’ or ‘know’ versus their capacity to apply their learnings in complex healthcare settings. Understanding and differentiating between delivery, receipt, and enactment of QI skills and knowledge is important because while enactment alone does not guarantee desired QI outcomes, it might be reasonably assumed that ‘better enactment’ is likely to lead to better outcomes. This paper describes the development, application and validation of a tool to measure enactment of core QI skills and knowledge of a complex QI intervention in a healthcare setting. Based on the Institute for Healthcare Improvement’s Model for Improvement, existing QI assessment tools, literature on enactment fidelity and our research protocols, 10 indicators related to core QI skills and knowledge were determined. Definitions and assessment criteria were tested and refined in five iterative cycles. Qualitative data from four QI teams in long-term care homes were used to test and validate the tool. The final measurement tool contains 10 QI indicators and a five-point scale. Inter-rater reliability ranged from good to excellent. Usability and acceptability among raters were considered high. This measurement tool assists in identifying strengths and weaknesses of a QI team and allows for targeted feedback on core QI components. The indicators developed in our tool and the approach to tool development may be useful in other health related contexts where similar data are collected.
Violence in the pain clinic: the hidden pandemic
Authors: Fawzy Yousof , Siddiqui Zia , Narouze Samer , Potru Sudheer , Burgart Alyssa M , Udoji Mercy A
Published: February 2023

Workplace violence is any physical assault, threatening behavior or other verbal abuse directed toward persons at work or in the workplace. The incidence of workplace violence in healthcare settings in general and more specifically the pain clinic is thought to be underestimated due to hesitancy to report, lack of support from management and healthcare systems, and lack of institutional policies as it relates to violence from patients against healthcare workers. In the following article, we explore risk factors that place clinicians at risk of workplace violence, the cost and impact of workplace violence, how to build a violence prevention program and lastly how to recover from violence in the practice setting.
Prenatal Exercise and Cardiovascular Health (PEACH) study: impact of meal timing and pre-exercise blood glucose values on glycemic responses to acute exercise in pregnancy
Authors: Skow Rachel J , Steinback Craig D , Davenport Margie H
Published: February 2023

We retrospectively analyzed data from 28 participants engaging in moderate-intensity aerobic exercise (265 sessions; 25–40 min) between 18–34 weeks gestation (NCT 02948439). The mean change in blood glucose (BG) from pre- to post-acute exercise session was −1.0 ± 1.2 mmol/L. Pre-exercise BG significantly predicted the change in BG ( p < 0.001), even when controlling for meal timing, exercise duration, and gestational age. Hypoglycemia only occurred in 3% of sessions. Therefore, in healthy pregnancy the change in BG during exercise is small and primarily related to pre-exercise BG values.
Short-term response of soil aggregate stability and labile carbon to contour tillage, diversion terrace, grassed waterway, and tile drainage implementation
Authors: Driscoll Bryan A. , Krzic Maja , Comeau Louis-Pierre , Eskelson Bianca N.I. , Li Sheng
Published: February 2023

Soil degradation has been of great concern for New Brunswick's potato farmers, especially on sloped land and shallow soils. In this study, we evaluated the initial response of labile soil carbon (C) fractions (permanganate oxidizable C (POXC) and particulate organic C (POC)) and aggregate stability to two integrated best management practices (BMPIs) composed of the following individual practices: diversion terraces (DT), grassed waterways (GW), and contour tillage (CT) (i.e., DTGW) and DT, GW, CT, and tile drainage (TD) (i.e., DTGW + TD), relative to CT that served as a control. The more water was regulated in the field, the greater the increase in labile C; where DTGW and DTGW + TD gained 19.8% and 50.6% of POXC, respectively, while CT lost 11.2% of POXC. There was an increase in mineral associated organic matter C in the terraced BMPIs, despite the high amount of tillage events that took place during potato cultivation. Two BMPIs had no effect on aggregate stability, most likely due to the short duration of this initial monitoring study that spanned just over two growing seasons. Even though there were no improvements in soil structure, our findings showed that some stabilization of soil C is possible even during the initial two seasons following BMPI implementation.
Digital quantum simulation of quantum gravitational entanglement with IBM quantum computers
Authors: Sabín Carlos
Published: February 2023

We report the digital quantum simulation of a hamiltonian involved in the generation of quantum entanglement by gravitational means. In particular, we focus on a pair of quantum harmonic oscillators, whose interaction via a quantum gravitational field generates single-mode squeezing in both modes at the same time, a non-standard process in quantum optics. We perform a boson-qubit mapping and a digital gate decomposition specific for IBM quantum devices. We use error mitigation and post-selection to achieve high-fidelity, accessing a parameter regime out of direct experimental reach.
Algorithm 1035: A Gradient-based Implementation of the Polyhedral Active Set Algorithm
Authors: Hager William W. , Zhang Hongchao
Published: February 2023

The Polyhedral Active Set Algorithm (PASA) is designed to optimize a general nonlinear function over a polyhedron. Phase one of the algorithm is a nonmonotone gradient projection algorithm, while phase two is an active set algorithm that explores faces of the constraint polyhedron. A gradient-based implementation is presented, where a projected version of the conjugate gradient algorithm is employed in phase two. Asymptotically, only phase two is performed. Comparisons are given with IPOPT using polyhedral-constrained problems from CUTEst and the Maros/Meszaros quadratic programming test set.
Complement in the Brain: Contributions to Neuroprotection, Neuronal Plasticity, and Neuroinflammation
Authors: Bohlson Suzanne S. , Tenner Andrea J.
Published: February 2023

The complement system is an ancient collection of proteolytic cascades with well-described roles in regulation of innate and adaptive immunity. With the convergence of a revolution in complement-directed clinical therapeutics, the discovery of specific complement-associated targetable pathways in the central nervous system, and the development of integrated multi-omic technologies that have all emerged over the last 15 years, precision therapeutic targeting in Alzheimer disease and other neurodegenerative diseases and processes appears to be within reach. As a sensor of tissue distress, the complement system protects the brain from microbial challenge as well as the accumulation of dead and/or damaged molecules and cells. Additional more recently discovered diverse functions of complement make it of paramount importance to design complement-directed neurotherapeutics such that the beneficial roles in neurodevelopment, adult neural plasticity, and neuroprotective functions of the complement system are retained.
The Effectiveness of New Digital Technologies in Increasing Physical Activity Levels and Promoting Active and Healthy Ageing: A Narrative Review
Authors: Greco Gianpiero , Poli Luca , Clemente Filipe Manuel , Francesco Fischetti , Cataldi Stefania
Published: February 2023

Active healthy ageing (AHA) is a goal that several world organisations promote and is essential for modern societies where the average age is increasing. Physical activity (PA), including exercise, is a central aspect of achieving this goal, even though a high percentage of the population has high levels of sedentariness and low levels of PA. Therefore, this narrative review aimed to summarise and critically evaluate the existing literature that investigates technology-induced changes in PA levels and the possibility that these may produce active lifestyles, promoting AHA; this is unclear in the apparently healthy older adult population. Training protocols delivered via a website, similar to mobile applications, seem capable of increasing not only physical fitness but also PA levels, at least in the short term. Wearable active tracker devices (WATs), alone or together with websites, can lead to an increase in step count and average daily moderate PA in outdoor environments, as well as in specifically designed applications. Technology that can offer virtual physical games is an effective strategy to promote PA by overcoming certain barriers that may limit its practice in apparently healthy older adults. Currently, information and communication technologies (ICTs), and more generally new digital technologies, show great potential in increasing PA levels and reducing sedentary levels, at least in the short term. The heterogeneity of the proposed interventions and the frequent lack of follow-ups do not allow us to evaluate the effectiveness in the long term, which is crucial for the AHA process.
Gamma-Glutamyl Transferase: A Friend against Cholestatic Itch? A Retrospective Observational Data Analysis in Patients with Extrahepatic Cholestasis
Authors: Haijer Floris W. , Van Vliet Cornelis B. , Brusse-Keizer Marjolein G. J. , Van der Palen Job A. M. , Kerbert-Dreteler Marjo J. , Kolkman Jeroen J.
Published: February 2023

Background and Aim of This Study. Itch frequently occurs in patients with chronic cholestasis. However, it remains unclear why some patients do and others do not develop pruritus. In addition, drug treatment is frequently ineffective. We repeatedly observed that cholestatic patients without itch had a relatively high serum gamma-glutamyl transpeptidase (GGT), relative to their serum bilirubin. The aim of this study was to validate this clinical observation. Methods. We included 235 patients with chronic extrahepatic cholestasis due to pancreatic cancer, cholangiocarcinoma, or papillary carcinoma. Results. GGT was significantly higher in patients without pruritus (median 967, IQR 587–1571) compared to patients with pruritus (median 561 IQR 266–1084 IU/l) (

p
<
0.01

). In contrast, median alkaline phosphatase (AP) was 491 U/L (IQR; 353–684) in patients with pruritus and was not significantly different from 518 U/L (IQR; 353–726) in patients without pruritus (

p
=
0.524

). Direct bilirubin was significantly higher in patients with pruritus compared to patients without pruritus (168 μmol/L (IQR; 95–256) vs. 120 μmol/L (IQR; 56.75–185.5)) (

p
<
0.01

). After correcting for the extent of cholestasis via direct bilirubin, the negative association between GGT and pruritus remained significant and became stronger (

p
<
0.001

). Conclusion. Serum GGT activity is inversely associated with the presence of cholestatic itch in patients with chronic extrahepatic cholestasis.
Logistic Regression Analysis of Clinical Characteristics for
Differentiation of Chronic Obstructive Pulmonary Disease
Severity
Authors: Guo Shuaixing
Published: February 2023

Background. This study aimed to investigate the predictive
value of general clinical data, blood test indexes, and ventilation function
test indexes on the severity of chronic obstructive pulmonary disease (COPD).
Methods. A total of 141 clinical characteristics of COPD
patients admitted to our hospital were collected. A mild-to-moderate group and a
severe group were classified depending on the severity of COPD, and their
baseline data were compared. The predictive factors of severe COPD were analyzed
by univariate and multivariate logistic regression, and the nomogram model of
severe COPD was constructed. The clinical variables, including gender, height,
weight, body mass index (BMI), age, course, diabetes, hypertension, smoking
history, WBC, NEUT, lymphocyte count (LY), MONO, eosinophil count (EOS), PLT,
mean platelet volume (MPV), platelet distribution width (PDW), partial pressure
of oxygen (PaO2), and PaCO2, were collected.
Results. There were 67 mild-to-moderate COPD patients and
74 severe COPD patients in this study cohort. Severe COPD had a higher white
blood cell count (WBC), neutrophil count (NEUT), monocyte count (MONO), platelet
count (PLT), neutrophil to lymphocyte ratio (NLR), and a lower partial pressure
of carbon dioxide (PaCO2). Univariate logistic regression analysis
showed that WBC, NEUT, MONO, PLT, and NLR were contributing factors of severe
COPD, while PaCO2 was an unfavorable factor of severe COPD. Enter,
forward, backward, and stepwise multivariate logistic regression analyses all
showed that NEUT and PLT were independent contributing factors to severe COPD.
Moreover, the nomogram model had good predictive ability, with an area under the
curve (AUC) of the receiver operating characteristic (ROC) curve being 0.881.
Good calibration and clinical utility were validated through the calibration
plot and the decision curve analysis (DCA) plot, respectively.
Conclusion. The severity of COPD was correlated with NEUT
and PLT, and the nomogram model based on these factors had good predictive
performance.
Differentiation of Small Gastrointestinal Stromal Tumor and Gastric Leiomyoma with Contrast‐Enhanced CT
Authors: Yan Mingyan , Liu Yubao , You Honglian , Zhao Yanbo , Jin Jun , Wang Jing
Published: February 2023

Objective. The value of multiphase contrast‐enhanced CT in differentiating gastrointestinal stromal tumors (GISTs) and gastric leiomyomas (GLMs) which were ≤3 cm was evaluated using machine learning. Methods. A retrospective analysis was conducted on 45 cases of small gastric wall submucosal tumors (including 22 GISTs and 23 GLMs) with pathologically confirmed diameter ≤3 cm and completed multiphase CT‐enhanced scan images. The CT features including tumor location, maximum diameter, shape, margins, growth pattern, plain/enhanced CT value, cystic degeneration, calcification, ulcer, progressive reinforcement, perilesional lymph nodes, and the CT value ratio of the tumor to the aorta at the same level in the enhanced phase III scan of the two groups were evaluated. Tumor location and maximum diameter were automatically evaluated by machine learning. Results. The GISTs and GLMs with a diameter ≤3 cm showed clear margins, uniform density on plain scan CT, and progressive homogeneous enhancement. The age of the GISTs is greater than that of the GLMs group. The plain scan CT value of the GISTs group was lower than that in the GLMs group. In the GISTs group, the lesions were mostly located in the fundus (68.18%), showing a mixed growth pattern (54.55%), and in the GLMs group, most lesions were located in the cardia (47.82%), showing an intraluminal growth pattern (95.65%). The abovementioned differences were statistically significant. Conclusions. Contrast‐enhanced CT has limited value in differentiating small GISTs from GLMs, which are ≤3 cm. Older age (>49.0 years), a low plain CT value (<42.5 Hu), mixed growth inside and outside the cavity, and noncardiac location tended to be the criteria for the diagnosis of small GISTs of the gastric wall.
Soluble Epoxide Hydrolase Inhibitor TPPU Alleviates Nab-Paclitaxel-Induced Peripheral Neuropathic Pain via Suppressing NF-κB Signalling in the Spinal Cord of a Rat
Authors: Wei Xing , Jia Lijun , Zhou Yaqing , Li Weimiao , Shan Changyou , Zhang Shuqun , Zhao Yonglin
Published: February 2023

Objective. Paclitaxel-induced peripheral neuropathy (PIPN) is a debilitating and difficult-to-treat side effect of paclitaxel. Soluble epoxide hydrolase (sEH) can rapidly metabolize the endogenous anti-inflammatory mediators’ epoxyeicosatrienoic acids (EETs) to dihydroxyeicosatrienoic acids. This study aimed to assess whether the sEH inhibitor N-(1-(1-oxopropy)-4-piperidinyl]-N′-(trifluoromethoxy) phenyl)-urea (TPPU) plays a critical role in PIPN of rats and provides a new target for treatment. Methods. A Sprague–Dawley male rat model of PIPN induced by nab-paclitaxel was established. Rats were randomly divided into a control group, nab-paclitaxel group, and nab-paclitaxel + TPPU (sEH inhibitor) group, with 36 rats in each group. The effects of the sEH inhibitor TPPU on behavioural assays, apoptosis, glial activation, axonal injury, microstructure, and permeability of the blood-spinal cord barrier were detected, and the underlying mechanisms were explored by examining the expression of NF-κB signalling pathways, inflammatory cytokines, and oxidative stress. Results. The results showed that the mechanical and thermal pain thresholds of rats were decreased after nab-paclitaxel treatment, accompanied by an increased expression of axonal injury-related proteins, enhanced cell apoptosis, aggravated destruction of vascular permeability, intense glial responses, and elevated inflammatory cytokines and oxidative stress in the L4-L6 spinal cord. TPPU restored the mechanical and thermal thresholds, decreased cell apoptosis, alleviated axonal injury and glial responses, and protected vascular permeability by increasing the expression of tight junction proteins. TPPU relieved PIPN by inhibiting the activation of the sEH and NF-κB signalling pathways by decreasing the levels of inflammatory cytokines and oxidative stress. Conclusion. These findings support a role for sEH in PIPN and suggest that the inhibition of sEH represents a potential new therapeutic target for PIPN.
Experiences of Close Relatives of Older Adults in Need of a Nursing Home: It Is We Who Manage Their Fragile Daily Life
Authors: Spang Lisa , Holmefur Marie , Pettersson Cecilia , Lidström-Holmqvist Kajsa
Published: February 2023

Home-based care is expanding, and we need to know more about what kind of support older adults need and how such support should be designed. One way to gain more knowledge is to study the experiences that underlie a nursing home application. However, older adults in need of nursing homes are often too weak to participate in research. Thus, this study aimed to describe the experiences of close relatives of the daily life of older adults in need of a nursing home. A qualitative approach was used, where fifteen relatives of nursing home applicants in central Sweden were interviewed using a study-specific interview guide. The interviews were analysed using thematic analysis. The findings are presented in one main theme “Being the person who manages a fragile life situation” with three underlying themes: Balancing and fulfilling expectations, striving to achieve a status quo, experiencing a breaking point, a change is inevitable, and waiting and moving into a nursing home, a period of tension. The main theme describes how the participants contributed to managing the older adults’ life situation and acted as a representative in contacts with health and social care. They tried to offer support in their daily life but over time experienced a breaking point when ageing in place was no longer sustainable, resulting in a nursing home application. The rationale for a nursing home application was often a combination of the older adult’s own wishes and the fact that their relatives felt there was a combined need for extensive care and physical proximity to staff, which cannot be provided in ordinary housing. Sometimes the decision to apply was also based on relatives no longer having the capacity to continue managing an older adult’s fragile situation.
Combination of a New Oral Demethylating Agent, OR2100, and Venetoclax for Treatment of Acute Myeloid Leukemia
Authors: Kamachi Kazuharu , Ureshino Hiroshi , Watanabe Tatsuro , Yoshida-Sakai Nao , Fukuda-Kurahashi Yuki , Kawasoe Kazunori , Hoshiko Toshimi , Yamamoto Yuta , Kurahashi Yuki , Kimura Shinya
Published: February 2023

The standard treatment for elderly patients with acute myeloid leukemia (AML) is venetoclax (Ven), a BCL-2–selective inhibitor, combined with hypomethylating agents (HMA) such as azacitidine or decitabine. This regimen results in low toxicity, high response rates, and potentially durable remission; however, because of low oral bioavailability, these conventional HMAs must be administered intravenously or subcutaneously. A combination of oral HMAs and Ven would provide a therapeutic advantage over parenteral administration of drugs and improve quality of life by reducing the number of hospital visits. Previously, we showed the promising oral bioavailability and antileukemia effects of a new HMA, OR2100 (OR21). Here, we investigated the efficacy and underlying mechanism of OR21 when used in combination with Ven to treat AML. OR21/Ven showed synergistic antileukemia effects in vitro, and significantly prolonged survival without increasing toxicity in a human leukemia xenograft mice model. RNA sequencing following combination therapy revealed downregulation of VAMP7, which is involved in autophagic maintenance of mitochondrial homeostasis. Combination therapy led to accumulation of reactive oxygen species, leading to increased apoptosis. The data suggest that the combination of OR21 plus Ven is a promising candidate oral therapy for AML.

Significance:

The standard treatment for elderly patients with AML is Ven combined with HMAs. OR21, a new oral HMA plus Ven showed synergistic antileukemia effects in vitro and vivo, suggesting that the combination of OR2100 plus Ven is a promising candidate oral therapy for AML.
New Media Platforms for Teaching and Networking: Emerging Global Opportunities for Breast Surgeons
Authors: Khosla Muskaan , Vidya Raghavan , Kothari Ashutosh , Gulluoglu Bahadir M.
Published: February 2023

Background: The framework of breast care is changing rapidly due to the increasing success of systemic therapies for breast cancer, and consequently, surgeons need to adapt themselves to the changing role of surgery in its management. Real-world evidence indicates that breast cancer patient-related outcomes are better if they are managed by specialized physicians and surgeons. On the other hand, the curriculum for the training of breast surgeons is expanding and includes skills that involve newer surgical techniques and nonsurgical technologies. De-escalation of surgery and also the fact that quality of life is becoming one of the priorities in breast cancer management require breast surgeons to be competent in all aspects of multidisciplinary management. Classical teaching including master-apprentice relation-based training is no more sufficient to satisfy the expectations of the trainees. However, on the other hand, the sources for contemporary postgraduate education are relatively scarce when considering these fast changes in the field. Therefore, there is a continuing quest among breast surgeons for finding ways to maintain their professional development. Summary: Classrooms and operating theaters without walls that came with the internet boom brought substantial opportunities for breast surgeons. Platforms such as BreastGlobal, Breastics24 h, Global Breast Hub, Oncoplastic Academy-Brazil, ibreastbook, Virtual Breast Oncoplastic Surgical Simulator, and CluBreast helped surgeons who needed to get contemporary training and interaction for their professional continuous development. Networking sites such as YouTube, Facebook, and Twitter are also among the social media platforms for professional groups to interact. National and global breast surgery societies also provide periodical online meetings and congresses for their members in order to satisfy the ongoing demand for training, interaction, and networking. Therefore, web-based platforms helped many surgeons from different parts of the world who could not afford to travel or did not have time to attend the necessary meetings due to their limited time and resources. Moreover, these online programs may have also encouraged surgeons to pursue specialized training in breast surgery which in turn should be expected to increase the quality of breast care in their countries. Key Messages: The platforms have downsides such as practical training and role modeling are limited and the opportunity of receiving real-time feedback on skills requirements lacks and networking would not be productive as expected. Nevertheless, web-based platforms require certain technology and infrastructure which still could not be provided everywhere.
Nacionalismo de exportação: Portinari, identidade brasileira e os Estados Unidos (1935-1942)
Authors: Nastari Danielle Misura
Published: February 2023

Candido Portinari trilhou trajetória gloriosa nos Estados Unidos entre 1935 e 1942, marcada por obras emblemáticas elaboradas para este país: Café, os painéis do pavilhão brasileiro na Feira Mundial de Nova York e os murais da Biblioteca do Congresso. Examinamos o caráter único e experimental dessas representações de Brasil elaboradas por Portinari para a América do Norte – quase todas patrocinadas pelo Estado Novo –, bem como sua recepção pelo público estadunidense. Esta investigação fundamenta-se em fontes primárias do período, especialmente correspondências, memorandos institucionais, textos críticos e artigos de periódicos. As obras analisadas são um breviário dos conceitos de brasilidade fomentados nos Estados Unidos pela pintura nacional durante a Política da Boa Vizinhança e esclarecem a promoção do Brasil ali nesse período.
Entre a atenção e o devaneio: Cézanne tardio e a visualidade que emerge no limiar do século XX
Authors: Beccari Marcos Namba
Published: February 2023

Este artigo propõe uma reflexão acerca do papel emblemático que o Cézanne tardio veio a assumir mediante a visualidade que emerge no limiar do século XX. Após uma breve descrição sobre o viés teórico aqui adotado (história da visualidade), delineio o modo pelo qual a obra tardia de Cézanne pretendia demonstrar uma continuidade entre a atenção e o devaneio, ainda que por meio de uma desestabilização paradigmática da visão. Por fim, argumento que tal desestabilização assinala duas instâncias distintas: de um lado, alude a um modelo iminente de automatismo passivo da visão; de outro, suscita novas possibilidades perceptivas pautadas na singularidade irrepetível da visão.
Pompeyo trogo y la representación de los galos en las historiae philippicae
Authors: Moreno Agustín
Published: February 2023

El artículo propone un estudio de la representación de los galos en Pompeyo Trogo. En la primera parte, se presenta un repaso de las investigaciones al respecto desde el estado de la cuestión de Urban de 1982. En la segunda, se analiza el material que nos ha llegado de las Historia Philippicae sobre dicho pueblo. Finalmente, en la tercera, se sugiere una lectura personal sobre el tema vinculada con la noción de autoetnografía, que puede ayudar a explicar mejor las particularidades que allí se advierten.
Entre o scriptorium e o palácio: fé e fidelidade na autoria das crônicas de Alfonso X (1272-1284)
Authors: Bonaldo Rodrigo Bragio
Published: February 2023

Este artigo questiona o credenciamento de informações não evidentes. Para tanto, problematizo o conceito medieval de fides a partir da oscilação semântica entre fé e de fidelidade. Definido pelos medievais como saber do necessário mas não evidente, indago a produção da fides (crença) e a suspensão da descrença nas palavras e ações do rei autor Alfonso X de Castela (s. XIII). O argumento a ser explorado sustenta que a fidelidade ao rei dependia da transferência de sacralidade operada nesses dois movimentos, os quais nos levam a dois lugares concretos: o scriptorium e o palácio.
Associations of Serum Carotenoids With Risk of All‐Cause and Cardiovascular Mortality in Hypertensive Adults
Authors: Zhu Xu , Cheang Iokfai , Tang Yuan , Shi Mengsha , Zhu Qingqing , Gao Rongrong , Liao Shengen , Yao Wenming , Zhou Yanli , Zhang Haifeng , Li Xinli
Published: February 2023

Background

Systemic oxidative stress is involved in the development of hypertension, whereas carotenoids are a group of natural antioxidants. Our study aims to evaluate the relationships between the serum concentrations of major carotenoids and mortality in hypertensive adults.

Methods and Results

Data on 5 serum carotenoids from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 2001–2006 were included. Outcome measures (all‐cause and cardiovascular mortality) were identified from the National Death Index through December 31, 2019. Multiple Cox proportional hazards regression and restricted cubic spline analyses were performed to determine the association between carotenoid levels and outcomes. A total of 8390 hypertensive adults were included in the analysis. At a median follow‐up duration of 16.6 years, all‐cause and cardiovascular mortality occurred in 4005 (47.74%) and 1205 (14.36%) participants, respectively. Compared with the lowest quartiles, the highest quartiles of 5 major serum carotenoids were associated with lower risk of all‐cause mortality, with multivariable‐adjusted hazard ratios (HRs) of 0.63 (95% CI, 0.56–0.71) for α‐carotene, 0.70 (95% CI, 0.61–0.80); for β‐carotene, 0.67 (95% CI, 0.58–0.76); for β‐cryptoxanthin, 0.74 (95% CI, 0.64–0.86) for lycopene; and 0.72 (95% CI, 0.63–0.83) for lutein/zeaxanthin. For cause‐specific mortality, this association with the fourth quartile of serum carotenoids was evident for a reduced rate of cardiovascular mortality, with a 32% reduction for α‐carotene (HR, 0.68 [95% CI, 0.55–0.86]), a 29% reduction for β‐cryptoxanthin (HR, 0.71 [95% CI, 0.56–0.89]), and a 26% reduction for lycopene (HR, 0.74 [95% CI, 0.59–0.94]), but not for β‐carotene and lutein/zeaxanthin. In addition, we found that serum α‐carotene, β‐carotene, β‐cryptoxanthin, and lutein/zeaxanthin levels were nonlinearly related to all‐cause mortality with inflection points of 2.43, 8.49, 5.12, and 14.17 μg/dL, respectively. Serum α‐carotene, β‐cryptoxanthin, and lutein/zeaxanthin concentrations showed nonlinear associations with cardiovascular mortality with inflection points of 2.31, 5.26, and 15.40 μg/dL, respectively.

Conclusions

Findings suggest that higher serum carotenoid concentrations were associated with lower risks of all‐cause and cardiovascular mortality in hypertensive adults.
Metadata as a Methodological Commons: From Aboutness Description to Cognitive Modeling
Authors: Liu Wei , Fu Yaming , Liu Qianqian
Published: February 2023

Metadata is data about data, which is generated mainly for resources organization and description, facilitating finding, identifying, selecting and obtaining information①. With the advancement of technologies, the acquisition of metadata has gradually become a critical step in data modeling and function operation, which leads to the formation of its methodological commons. A series of general operations has been developed to achieve structured description, semantic encoding and machine-understandable information, including entity definition, relation description, object analysis, attribute extraction, ontology modeling, data cleaning, disambiguation, alignment, mapping, relating, enriching, importing, exporting, service implementation, registry and discovery, monitoring etc. Those operations are not only necessary elements in semantic technologies (including linked data) and knowledge graph technology, but has also developed into the common operation and primary strategy in building independent and knowledge-based information systems.

In this paper, a series of metadata-related methods are collectively referred to as ‘metadata methodological commons’, which has a lot of best practices reflected in the various standard specifications of the Semantic Web. In the future construction of a multi-modal metaverse based on Web 3.0, it shall play an important role, for example, in building digital twins through adopting knowledge models, or supporting the modeling of the entire virtual world, etc. Manual-based description and coding obviously cannot adapted to the UGC (User Generated Contents) and AIGC (AI Generated Contents)-based content production in the metaverse era. The automatic processing of semantic formalization must be considered as a sure way to adapt metadata methodological commons to meet the future needs of AI era.
Emended description of Zamia sandovalii (Cycadales: Zamiaceae), the cliff-dwelling cycad from Atlántida, Honduras
Authors: HAYNES JODY L. , Schutzman Bart
Published: February 2023

Zamia sandovalii is an acaulescent, cremnophilous cycad with long, pendulous leaves endemic to the Department of Atlántida, Honduras. The original description, though valid, is lacking a thorough and robust elaboration of its characteristics, which is provided here. Also included here is a treatise on its taxonomic and biogeographic affinities and a diagnostic key to the Z. splendens species complex as circumscribed herein.