bluuebunny/crossref_metadata_2025 huggingface dataset:
Is patient‐reported symptom onset associated with odontogenic infection severity?
Authors: Neal Timothy W. , Schlieve Thomas
Published: February 2024

Introduction

The purpose of this study was to determine if there is a relation between odontogenic infection severity score (OISS) and the time interval from patient‐reported symptom onset to emergency department (ED) presentation. The working hypothesis was that higher OISSs would be found in patients who developed symptoms and delayed ED presentation compared with patients who presented earlier.

Materials and Methods

The study population was composed of consecutive patients who were admitted to the University of Texas Southwestern Medical Center and surgically treated in the operating room for severe odontogenic infections from January 2016 to December 2020. Odontogenic infection severity was measured using a numerical severity index. Three cohort groups were predefined to evaluate the relation between patient‐reported symptom onset in days and OISS.

Results

There were 115 patients who met the inclusion and exclusion criteria. There was no significant difference in the OISSs between the three cohorts. In patients who received antibiotics prior to ED presentation, there was no difference in OISS. Male sex and diabetes diagnosis were related to higher OISSs.

Conclusions

Patient‐reported symptom onset is unrelated to OISS in patients treated surgically for severe odontogenic infections. Other patient‐specific factors such as diabetes diagnosis are related to higher OISSs.
Patient‐related Predictors for the Functional Outcome of SuperPATH Hemiarthroplasty versus Conventional Approach Hemiarthroplasty: A Systematic Review and Meta‐regression Analysis of Randomized Controlled Trials
Authors: Ramadanov Nikolai , Voss Maximilian , Hable Robert , Prill Robert , Hakam Hassan Tarek , Salzmann Mikhail , Dimitrov Dobromir , Becker Roland
Published: February 2024

Specialist literature lacks evidence that explores associations between patient characteristics and the beneficial treatment effect of SuperPATH hemiarthroplasty (HA) compared with conventional approach (CA) HA. To investigate and identify patient‐related predictors of the effect size of the short‐term functional outcome of SuperPATH HA and CA HA by performing a systematic review and meta‐regression analysis of randomized controlled trials (RCTs). A systematic search of literature was performed in PubMed, CNKI, CENTRAL of The Cochrane Library, Clinical trials, and Google Scholar until August 25, 2023. For the continuous outcome parameter Harris hip score (HHS) ≤1 week and 3 months postoperatively, mean differences (MDs) with 95% confidence intervals (CIs) were calculated. A meta‐regression analysis was based on random‐effects meta‐analysis using the Hartung–Knapp–Sidik–Jonkman method for continuous covariates. A total of five RCTs with 404 patients were found. The following predictors of HHS ≤1 week postoperatively were identified: patient age (predictor estimate = 1.29; p < 0.01), patient age groups (predictor estimate = 14.07; p < 0.01), time to mobilization (predictor estimate = 5.51; p < 0.01). The following predictors of HHS 3 months postoperatively were identified: incision length (predictor estimate = −2.12; p < 0.01); intraoperative blood loss (predictor estimate = 0.02; p < 0.01). Patient age, time to mobilization, incision length, and intraoperative blood loss were identified as predictors of the effect size of early postoperative functional outcome as measured by HHS. Elderly patients, particularly those over 70 years of age, appear to benefit from SuperPATH HA. Based on these findings, and taking into account our limitations, we recommend that the use of minimally invasive SuperPATH HA in elderly patients should be more widely considered and not limited to elective THA patients.
Fractional excretion of total protein in patients with nephrotic syndrome
Authors: Shimizu Shoichi , Saito Hiroshi , Takahashi Shori , Morohashi Tamaki , Hamada Riku , Hataya Hiroshi , Kondo Yoshiaki , Morioka Ichiro
Published: February 2024

Background

The urine protein to creatinine ratio (UPCR) correlates well with the 24‐h urine protein test (24‐h UPT) and is a reliable indicator of proteinuria. However, in nephrotic syndrome, the correlation between the UPCR and the 24‐h UPT tends to decrease. To address this, we introduced the fractional excretion of total protein (FETP), which reflects serum total protein and creatinine levels because severe hypoproteinemia and/or elevated serum creatinine levels tend to occur under these conditions. The 24‐h UPT corrected for body surface area (BSA) (24‐h UPT/BSA) was used to take body size into consideration. The correlation coefficients for 24‐h UPT/BSA and FETP and 24‐h UPT/BSA and UPCR were calculated. The statistical significance of the differences between these coefficients was also calculated.

Methods

Thirty‐six pediatric patients with nephrotic syndrome were included in this study. The FETP was calculated as total protein clearance/creatinine clearance (%). Correlation coefficients were calculated for 24‐h UPT/BSA and FETP and 24‐h UPT/BSA and UPCR. The statistical significance of the differences between these coefficients was also calculated.

Results

The mean ± standard error of FETP was 0.11% ± 0.013%. The correlation coefficients of FETP and UPCR with 24‐h UPT/BSA were 0.91 and 0.81, respectively. The FETP demonstrated a significantly stronger correlation with 24‐h UPT/BSA than with UPCR (p = 0.01).

Conclusions

The FETP correlated more strongly with 24‐h UPT/BSA than with UPCR in patients with nephrotic syndrome. The FETP is a reliable indicator of proteinuria in nephrotic syndrome, especially in patients with severe hypoproteinemia or elevated serum creatinine levels.
Inequality and Market Concentration: New Evidence from Australia
Authors: Hotchin Lachlan , Leigh Andrew
Published: February 2024

Are excessively concentrated markets inequitable as well as inefficient? We explore this issue by analyzing the degree of market concentration in the industries where Australia's wealthiest made their fortunes. Compared with the economy at large, we find that top wealth holders have tended to make their fortunes in industries with a higher‐than‐average degree of market concentration. Top wealth shares have grown substantially, and from 1990 to 2020, there appears to have been an increase in the propensity of top wealth holders to make their fortunes in highly concentrated industries.
Long‐term tillage impact on soil phosphorus under different crop sequences
Authors: Giannini Ana Paula , Andriulo Adrián Enrique , Wyngaard Nicolás , Irizar Alicia Beatriz
Published: February 2024

Management practices, such as tillage and cropping diversification, influence soil phosphorus (P) dynamics. The aim was to evaluate the long‐term effect of tillage systems (no tillage, NT; vertical tillage, VT; conventional tillage, CT) on total (TP) and extractable (Pe) soil P distribution under different crop sequences (corn–wheat/soybean, C–W/S; wheat/soybean, W/S; corn–corn, C–C; soybean–soybean, S–S). TP and Pe were measured up to 50 cm deep. The TP distribution was associated to soil organic carbon (SOC) (r = .89, p < .01) and tend to increase near soil surface under NT as compared with CT and VT. The Pe was sensitive to the crop residues pattern of accumulation and their quality in the topsoil. Crop sequences that included corn had lower Pe concentration under NT. Conversely, in W/S, Pe concentration was lower under VT with no differences between NT and CT and, in S–S sequence, there were no differences in Pe concentration. However, under NT the increase in the above‐ground biomass in sequences without corn (p < .001) increased Pe concentration in 0–5 cm layer, while the opposite occurs in sequences with corn (p < .06). In S–S under NT, the low crop residue input (1.6 Mg of dry matter ha−1) and the high Pe concentration in 0–5 cm layer (40 mg kg−1) might increase the risk of P loss to adjacent ecosystems. Intensified sequences presented more negative P balances than corn/soybean monoculture. This study demonstrates that it's necessary to develop management strategies that improve P supply in synchrony with the crop demand and decrease P loss, while keeping productivity.
Mapping soil corrosivity potential to exclusion fencing using pedotransfer functions and open‐source soil data
Authors: Stiglingh Andrea D. , Mosley Luke M. , Smernik Ronald J. , Fitzpatrick Robert W.
Published: February 2024

Soil corrosivity is a term used to describe the corroding susceptibility (risk) of metal infrastructure in different soil environments. Soil corrosivity mapping is a crucial step in identifying potentially problematic, high‐maintenance fence lines and can help improve fence longevity by identifying soil environments where the use of more expensive, corrosion‐resistant materials would be more cost‐effective in the long term. Soil corrosion damage sustained on exclusion fences can be a serious management issue for conservation programs and initiatives, as it weakens the fence netting and provides opportunities for invasive animal migration and occupation (e.g. feral cats and foxes) into areas of high conservation value. The increasing accessibility of geospatial analysis software and the availability of open‐source soil data provide land managers with the opportunity to implement digital soil databases and pedotransfer functions to produce fence corrosion risk maps using commonly measured soil attributes. This paper uses open‐source government agency soil data (shapefiles) to map fence corrosion risk in the southern part of the Yorke Peninsula in South Australia, with the intention to assist with the installation of a new barrier (exclusion) fence as part of the Marna Banggara rewilding project. The risk classifications (low, moderate and high risk) made by this map were compared with rates of zinc corrosion (μm/year zinc loss) observed at field sites and correctly predicted the amount of fence damage sustained at five of the eight sites. The mapping approach outlined in this study can be implemented by environmental managers in other areas to inform strategies for enhancing fence longevity.
Repressed Memories (of Sexual Abuse Against Minors) and Statutes of Limitations in Europe: Status Quo and Possible Alternatives
Authors: Deferme Driek , Otgaar Henry , Dodier Olivier , Körner André , Mangiulli Ivan , Merckelbach Harald , Sauerland Melanie , Panzavolta Michele , Loftus Elizabeth F.
Published: February 2024

One of the most heated debates in psychological science concerns the concept of repressed memory. We discuss how the debate on repressed memories continues to surface in legal settings, sometimes even to suggest avenues of legal reform. In the past years, several European countries have extended or abolished the statute of limitations for the prosecution of sexual crimes. Such statutes force legal actions (e.g., prosecution of sexual abuse) to be applied within a certain period of time. One of the reasons for the changes in statutes of limitations concerns the idea of repressed memory. We argue that from a psychological standpoint, these law reforms can be detrimental, particularly when they are done to endorse unfounded psychological theories. The validity of testimonies is compromised many years after the alleged facts, and abolishing the statute of limitations increases the chance that even more (false) recovered memories of abuse might enter the courtroom. We propose solutions to these changes such as establishing an independent expert committee evaluating claims of sexual abuse.
The Influence of a Culturally Informed Suicide Prevention Training on School Mental Health Professionals’ Beliefs
Authors: Brown Emily C. , Edwin Mary
Published: February 2024

Youth suicide is a significant public health concern in the United States, and students from culturally minoritized groups may be at higher risk of suicidality and suicide ideation. As key stakeholders in comprehensive suicide prevention efforts, school mental health professionals need targeted professional development to help them address the mental health needs of all their students. The study aimed to pilot the Culturally Responsive Suicide Prevention in Schools (CRSPiS) professional development session and evaluate its impact on school mental health professionals’ beliefs about the influence of culture on suicidal thoughts, behaviors, communication, and response. A pre-and post-training design was used. Professionals attended the pilot of a structured 3-hour professional development session. Immediately after the training school mental health professionals who participated in the CRSPiS session reported stronger beliefs in the influence of culture on suicide ideation and response. Participants’ beliefs did not vary by previous hours of suicide training and years of experience. CRSPiS training may help improve professionals’ ability to respond to suicide and conduct assessments in culturally relevant ways.
The Paradigm Shift in Education in Big Data Era: Exploring the Intersection of Historical Assessment Frameworks and AI-Powered Assessment Methods in Education
Authors: Du Kuixi , Geiger Jonathon , Killen Tommie , Porta Abril Escobal , O'Brien Thomas
Published: February 2024

This paper delves into the dynamic intersection between traditional assessment processes and AI-powered technology assessment models within the expansive landscape of the big data era. Tracing the origins of large-scale standardized testing, from Francis Galton's pioneering intelligence testing proposals to the subsequent development of norm-referenced testing (NRT) by Alfred Binet and Theodore Simon, the historical trajectory underscores the evolution towards authentic assessment paradigms such as computerized adaptive testing (CAT) and performance-based assessment (PBA). These shifts reflect a broader aim of equipping educators with tools to measure student learning effectively and foster continuous learning beyond the confines of the classroom. However, despite the proliferation of methods integrating big data and AI technologies in educational settings, a discernible gap persists between technological capabilities and their practical implementation in education, notably in the realm of student assessment and evaluation. This gap highlights challenges in enhancing assessment accuracy and reliability, evaluating non-cognitive skills, and delivering personalized feedback. The introduction of AI-powered technologies like ChatGPT raises ethical considerations regarding fairness, privacy, and bias, necessitating responsible and equitable deployment.This paper addresses fundamental research questions concerning the historical influences on assessment frameworks, the role of AI-powered technology in driving paradigm shifts, and the ethical considerations surrounding its application. Through a comprehensive literature review, it explores the potential of AI technology to enhance assessment accuracy and reliability while advocating for its responsible use. Despite the challenges posed by traditional assessment processes and AI-powered technology assessment models, educators continually strive to improve student learning and readiness for lifelong learning.By celebrating the invaluable contributions of educators, we can shift the narrative surrounding assessment practices towards a more positive and supportive environment, fostering ethical and innovative uses of AI-powered technology. This celebration serves as inspiration for future research and development in assessment, emphasizing the importance of building upon educators’ innovative practices to shape the future of assessment in the big data era.
Bullying y cyberbullying: diferencias de sexo en víctimas, agresores y observadores
Authors: Chocarro Edurne
Published: February 2024

Objetivo. Identificar si existen diferencias entre sexos en conductas de bullying y cyberbullying entre los adolescentes de La Rioja. Método. La muestra estuvo constituida por 979 adolescentes, 50.45% varones y 49.6% mujeres, entre los 13 y los 18 años de edad, a quienes se les aplicó la batería Cyberbullying Screening para explorar el acoso entre iguales. Resultados. Los resultados evidenciaron que: (a) hay un mayor porcentaje de mujeres víctimas de bullying y cyberbullying; (b) los chicos dijeron ser más agresores que las chicas, tanto en conductas de bullying como de cyberbullying; (c) las mujeres dicen observar más conductas debullying y cyberbullying que los varones, siendo significativa la diferencia con respecto a este último; y (d) el porcentaje de víctimas de agresiones cara a cara y cyberbullying se asemeja entre mujeres y varones, siendo no significativa la diferencia. Conclusión. Estos datos evidencian que los varones son más agresores, mientras que las mujeres son mayormente víctimas, por ello, es importante tener presente la diferencia de roles de género y su implicación en los programas de prevención.
Stress Representations for Tensor Basis Neural Networks: Alternative Formulations to Finger–Rivlin–Ericksen
Authors: Fuhg Jan N. , Bouklas Nikolaos , Jones Reese E.
Published: February 2024

Data-driven constitutive modeling frameworks based on neural networks and classical representation theorems have recently gained considerable attention due to their ability to easily incorporate constitutive constraints and their excellent generalization performance. In these models, the stress prediction follows from a linear combination of invariant-dependent coefficient functions and known tensor basis generators. However, thus far the formulations have been limited to stress representations based on the classical Finger–Rivlin–Ericksen form, while the performance of alternative representations has yet to be investigated. In this work, we survey a variety of tensor basis neural network models for modeling hyperelastic materials in a finite deformation context, including a number of so far unexplored formulations which use theoretically equivalent invariants and generators to Finger–Rivlin–Ericksen. Furthermore, we compare potential-based and coefficient-based approaches, as well as different calibration techniques. Nine variants are tested against both noisy and noiseless datasets for three different materials. Theoretical and practical insights into the performance of each formulation are given.
Band-Limited Vibrotactile Noise Enhances Fingertip Haptic Sensation
Authors: Chamnongthai Komi , Li Zhu , Endo Takahiro
Published: February 2024

This paper presents a method to enhance the haptic sensation of the fingertip by applying a vibrotactile noise to the wrist, an application of stochastic resonance. This sensation is known to improve when a sufficiently large noise is propagated to the fingertip. However, it is reduced when a large noise that humans can perceive is applied to the wrist. Therefore, this paper uses band-limited noise consisting of frequencies necessary to activate specific mechanoreceptors required for specific tasks. This allows us to apply a sufficiently large but still imperceptible noise to the wrist. On the basis of this procedure, we propose a method of improving the haptic sensation of the fingertip. Further, we conduct experiments to confirm the validity of the proposed method.
The Effects of Projectile Leading Edge and Aspect Ratio on the Deflection Efficiency of Planetary Scale Hypervelocity Impacts
Authors: DeCoster Mallory E. , Le Tony , Graninger Dawn , King Patrick , Stickle Angela
Published: February 2024

The influence of mission design parameters on the deflection efficiency of hypervelocity kinetic impacts remains an open question. With the upcoming impact of NASA’s Double Asteroid Redirection Test (DART), great interest exists in understanding how to optimize the deflection of a potentially hazardous object. In this work, we investigate the influence of projectile geometry on three-deflection efficiency observable using 2D simulations with the CTH hydrocode. We vary both the angle between the target and leading edge of the projectile in addition to the aspect ratio, to understand the projectile geometry effects on a kinetic impact. We show evidence for a projectile geometry effect on deflection efficiency observables that is highly dependent on the target material composition, where an enhancement of 5% in β is achieved in strong targets (cohesion=10 MPa), and 28% in weak targets (cohesion=100 Pa). The deflection efficiency is positively correlated to 𝛼 and the projectile aspect ratio, where the sphere and tall rod emerged as the most efficient projectiles in strong and weak targets.
Modeling Lunar Impact Flashes Using Numerical Shock Hydrodynamics and Radiative Transfer
Authors: King Patrick K. , Cahill Joshua T. S. , Ericksen Peter S. , Graninger Dawn M. , Rainey Emma S. G. , Stickle Angela M. , Wilson John P.
Published: February 2024

Lunar impact flashes are a rich source of data on highintensity, high-velocity impacts in the absence of significant atmosphere. Studies of these flashes have established that the source of much of the radiation emitted by the flash is through thermal emission from hot condensed debris produced by the impact. Here we present a quantitative forward flash model that uses high-fidelity simulations of the hypervelocity impact that are then handed off to a full radiative transfer code to calculate its radiative evolution and flash intensity. Our method uses machine learning methods to calculate the state of the debris cloud close to its radiating state. As a case study, a lunar flash observed during the January 2019 lunar eclipse is compared to a lunar flash generated using our method under the conditions estimated for that impact.
Development of Analysis Techniques for Non-Spherical Hypervelocity Impacts
Authors: Miller Joshua E. , Davis Bruce A. , McCandless Robert J. , Delgado Alberto , Henderson Donald J. , Pardo Arturo , Rodriguez Daniel , Sandy Marcus S.
Published: February 2024

Advanced steps have been made to develop techniques to manufacture, accelerate to orbital speeds, and diagnose the orientation for projectiles representative of the collected debris from the DebriSat experiment. This model validation work has enabled the development of numerical models of metallic, Whipple shields. Using these developed numerical models, work has begun on developing ballistic performance corrections to existing ballistic-limit equations for future use in threat assessments with an environment definition that includes nonspherical orbital debris. As described here, a slightly decreased performance is expected for a specific Whipple shield; however, much is left to do for additional projectile fineness ratios and shield characteristics.
Jet Penetration from Scaled Shaped Charges: Theory and Experiment
Authors: David W. Price , Ernest J. Harris , Frances G. Daykin
Published: February 2024

Shaped charge (SC) jets are used in many aspects of warfare, particularly to penetrate steel armor, but they can also be formed inadvertently in explosively-driven experiments and this can cause a severe problem for the containment of such experiments. The very penetrative nature of these jets means that they can pose a significant risk to the integrity of the infrastructure surrounding an experiment containing explosives such as a steel containment vessel or concrete firing chamber, and this risk needs to be mitigated. In some cases, notably when experiments are conducted in vessels, the space available for the fielding of mitigation systems is limited and so the size of any jetstopper must be optimum. In addition to this, mitigation materials can be costly and generate waste and so, to ensure that this is as low as reasonably practical, the amount of material in the jet mitigation must be minimized. Also, experiments that can generate jetting threats can vary in size and our predictive capability must be able to deal with this. Overall, this requires a good understanding of the penetration of jets from SCs of various sizes into targets, which in turn requires a good understanding of jet formation, inadvertent or otherwise, and a reliable method of modelling these jets and predicting the likely penetration.
Triangulating Impact Location in 3D Printable Concrete using Fiber Bragg Grating Sensors
Authors: Weiner Garrett , Wurst Gunnar , Lessmeister Tony , Sherizadeh Taghi , Mulligan Phillip
Published: February 2024

3D printing, a form of additive manufacturing, is quickly gaining popularity as a means of production in applications ranging from the consumer hobbyist up to the demands of industry. Since its realization in 2009, concrete-based 3D printing has been steadily moving closer to commercial use. As an innovative technology, layered concrete deposition lacks any significant history concerning safety and durability, particularly when subjected to stressors, such as impacts [1]. When considering 3D printing as a method of construction, resilience to structural deformation is critical to determine long-term viability, especially for structures erected in unvaryingly hostile environments. Quickly and accurately assessing the integrity of a structure that has been impacted is paramount to making versatile, additively manufactured concrete structures. With that in mind, this paper lays the groundwork for using a mesh of FBG (Fiber Bragg Grating) sensors imbedded in a 3D printable concrete mixture to recognize impacts in real-time and triangulate their exact position.
Preliminary Results of a Technology for ON-ORBIT Micrometeroid and Debris Characterization
Authors: Chocron Sidney , Enriquez-Vargas Roberto , Hackney Drew , Carpenter Alexander J. , Portillo Daniel J. , Walker James D. , Koets Michael A. , Rose Randy , Grimm Robert , McBee Ryan
Published: February 2024

SwRI is developing a technology that will enable detection and characterization of micrometeoroid orbital debris (MMOD) while on-orbit. The technology includes an instrumented aluminum panel that can be installed on a satellite and, with the appropriate sensor and software suite, is able to detect and characterize impacts during the mission. The stress waves produced by the impact on the panel will be selected on-board by the software, treated, and sent to the ground for further analysis. The selection process will be directed by an algorithm that will be developed based on the experimental campaign and stress wave theory.

CTH computer simulations in 2D and 3D were performed to study the viability and design the technology. Fully instrumented witness panels are being tested (August 2022) under hypervelocity impact using SwRI’s 0.17 in caliber two-stage light-gas gun. The small-scale panels were placed in the target tank to be impacted multiple times at velocities up to 6 km/s by a 3-mm al6061-T6 sphere. As expected, the strain magnitude depends on the distance to the impact point and, in general, decreases with distance.
Innovative Fragmentation Modeling for Hypervelocity Impacts of Debris
Authors: Collé Anthony , Limido Jérôme , Puillet Christian , Unfer Thomas
Published: February 2024

The increase in the number of debris in orbit and the increase in the number of nano satellites in orbit leads to the need to better understand the debris likely to be generated by these nano satellites: either by explosion from an internal energy source, or by explosion following an impact by a large external debris. The aim of this research is to explore innovative fragmentation modelling solutions implemented in Impetus Afea Solver in the context of hypervelocity impacts of debris. Thus, through this work, a complete and detailed study of complex structures under hypervelocity impacts is successfully performed with the γ-SPH-ALE Solver. Thanks to its robustness and accuracy, Impetus can properly reproduce the experimental results. Particularly, the influence of the impact velocity on the multi-impact and perforation of a secondary plate is correctly handled as well as the behavior of a complete nanosatellite structure. The combination with an efficient fragment detection algorithm makes it possible to perform an accurate fragment analysis on the fly, and to exploit the data with in-house codes. In addition, the benefit from GPU acceleration significantly reduces the computation times with respect to classical SPH approaches allowing to meet industrial needs and to consider real orbital structures.
Organizational Socialization in Professional Sport: The National Basketball Association’s Rookie Transition Program
Authors: Beattie Mark A.
Published: February 2024

Launched in 1986, the National Basketball Association’s (NBA) Rookie Transition Program (RTP) is the longest running program of its kind in U.S. professional sports. Jointly administered by the NBA and National Basketball Players Association, the RTP is designed to ease the transition of first-year players to the league. Over the course of 4 days, RTP participants engage with current and former NBA players, coaches, administrators, and other league stakeholders on topics that range from personal finance, to mental health, to social justice advocacy. Organizational scholars might describe the NBA RTP as an element of the league’s onboarding, or organizational socialization, strategy. In this case, students will reflect on their own socialization experiences as organizational newcomers before analyzing the components of the NBA RTP. Finally, students will apply what they learn through this case to design the agenda of a future NBA RTP.
Preparing the Athletic Trainer for Interprofessional Collaborative Practice: A Report From the Association for Athletic Training Education-Research Network
Authors: Manspeaker Sarah A. , Young Justin P. , Wilkins Nicole A. , Clements Chad , Hankemeier Dorice A. , Williams Richelle M. , Walker Stacy E. , Eberman Lindsey E.
Published: February 2024

Contemporary health care emphasizes interprofessional collaborative practice (IPCP), described as when providers from two or more professions work together to achieve the highest-quality patient care. Historically, athletic trainers have naturally collaborated with physicians, in part due to our defined scope of practice, but more importantly as a benefit to achieving positive patient outcomes. Athletic trainers also collaborate with nurses, physical therapists, physician assistants, and other health care professionals when providing care to physically active patients and populations. Due to the oftentimes continuous contact with patients while engaging these other health care professionals, athletic trainers are well suited to expand their interprofessional collaborations to other disciplines and serve as key stakeholders in the IPCP team. To assist in this expansion of IPCP, there are several professional organizations and a substantial body of literature focusing on effective engagement in IPCP that can serve as resources for athletic training. This commentary will address the background of IPCP and the relevance of the athletic trainer within the interprofessional team, as well as identify resources for additional information.
“Doing What’s Best for Me”: A Cultural Values Comparison of Social Media Responses to Kyrie Irving’s COVID-19 Vaccination Status
Authors: Guo Sitong , Billings Andrew C. , Jackson Joshua R. , Chou Suyu
Published: February 2024

In October 2021, National Basketball Association player Kyrie Irving was banned from competing for the Brooklyn Nets because of his resistance to being vaccinated for COVID-19. Two months later, the Nets softened that stance and allowed Irving to participate in road games. This study examines two prongs of the social media response to Irving’s vaccination status. A total of 12,000 posts were collected from the U.S.-based Twitter (now known as X; 6,000) and the Chinese-based Weibo (6,000), covering the first week of coverage of Irving and the Nets’ announcement. Results showed that Hofstede’s cultural dimensions help explain the theme differences, with Twitter’s comments reflecting more individualistic notions and lower power distance than Weibo. Moreover, Twitter users focused more on opinion-based expression themes, while Weibo users avoided commenting on the COVID-19 policy. These findings contribute to the literature by identifying the role culture plays in people’s response to a social issue.
Hydrolytic endonucleolytic ribozyme (HYER) is programmable for sequence-specific DNA cleavage
Authors: Liu Zi-Xian , Zhang Shouyue , Zhu Han-Zhou , Chen Zhi-Hang , Yang Yun , Li Long-Qi , Lei Yuan , Liu Yun , Li Dan-Yuan , Sun Ao , Li Cheng-Ping , Tan Shun-Qing , Wang Gao-Li , Shen Jie-Yi , Jin Shuai , Gao Caixia , Liu Jun-Jie Gogo
Published: February 2024

Ribozymes are catalytic RNAs with diverse functions including self-splicing and polymerization. This work aims to discover natural ribozymes that behave as hydrolytic and sequence-specific DNA endonucleases, which could be repurposed as DNA manipulation tools. Focused on bacterial group II-C introns, we found that many systems without intron-encoded protein propagate multiple copies in their resident genomes. These introns, named HYdrolytic Endonucleolytic Ribozymes (HYERs), cleaved RNA, single-stranded DNA, bubbled double-stranded DNA (dsDNA), and plasmids in vitro. HYER1 generated dsDNA breaks in the mammalian genome. Cryo–electron microscopy analysis revealed a homodimer structure for HYER1, where each monomer contains a Mg
2+
-dependent hydrolysis pocket and captures DNA complementary to the target recognition site (TRS). Rational designs including TRS extension, recruiting sequence insertion, and heterodimerization yielded engineered HYERs showing improved specificity and flexibility for DNA manipulation.
Grounded language acquisition through the eyes and ears of a single child
Authors: Vong Wai Keen , Wang Wentao , Orhan A. Emin , Lake Brenden M.
Published: February 2024

Starting around 6 to 9 months of age, children begin acquiring their first words, linking spoken words to their visual counterparts. How much of this knowledge is learnable from sensory input with relatively generic learning mechanisms, and how much requires stronger inductive biases? Using longitudinal head-mounted camera recordings from one child aged 6 to 25 months, we trained a relatively generic neural network on 61 hours of correlated visual-linguistic data streams, learning feature-based representations and cross-modal associations. Our model acquires many word-referent mappings present in the child’s everyday experience, enables zero-shot generalization to new visual referents, and aligns its visual and linguistic conceptual systems. These results show how critical aspects of grounded word meaning are learnable through joint representation and associative learning from one child’s input.
Photosensitization enables Pauson-Khand–type reactions with nitrenes
Authors: Li Fang , Zhu W. Felix , Empel Claire , Datsenko Oleksandr , Kumar Adarsh , Xu Yameng , Ehrler Johanna H. M. , Atodiresei Iuliana , Knapp Stefan , Mykhailiuk Pavel K. , Proschak Ewgenij , Koenigs Rene M.
Published: February 2024

The Pauson-Khand reaction has in the past 50 years become one of the most common cycloaddition reactions in chemistry. Coupling two unsaturated bonds with carbon monoxide, the transformation remains limited to CO as a C
1
building block. Herein we report analogous cycloaddition reactions with nitrenes as an N
1
unit. The reaction of a nonconjugated diene with a nitrene precursor produces bicyclic bioisosteres of common saturated heterocycles such as piperidine, morpholine, and piperazine. Experimental and computational mechanistic studies support relaying of the diradical nature of triplet nitrene into the π-system. We showcase the reaction’s utility in late-stage functionalization of drug compounds and discovery of soluble epoxide hydrolase inhibitors.
Mechanism of 2′-fucosyllactose degradation by human-associated
Akkermansia
Authors: Padilla Loren , Fricker Ashwana D. , Luna Estefani , Choudhury Biswa , Hughes Elizabeth R. , Panzetta Maria E. , Valdivia Raphael H. , Flores Gilberto E.
Published: February 2024

Among the first microorganisms to colonize the human gut of breastfed infants are bacteria capable of fermenting human milk oligosaccharides (HMOs). One of the most abundant HMOs, 2′-fucosyllactose (2′-FL), may specifically drive bacterial colonization of the intestine. Recently, differential growth has been observed across multiple species of
Akkermansia
on various HMOs including 2′-FL. In culture, we found growth of two species,
A. muciniphila
Muc
T
and
A. biwaensis
CSUN-19,on HMOs corresponded to a decrease in the levels of 2′-FL and an increase in lactose, indicating that the first step in 2′-FL catabolism is the cleavage of fucose. Using phylogenetic analysis and transcriptional profiling, we found that the number and expression of fucosidase genes from two glycoside hydrolase (GH) families, GH29 and GH95, vary between these two species. During the mid-log phase of growth, the expression of several GH29 genes was increased by 2′-FL in both species, whereas the GH95 genes were induced only in
A. muciniphila
. We further show that one putative fucosidase and a β-galactosidase from
A. biwaensis
are involved in the breakdown of 2′-FL. Our findings indicate that the plasticity of GHs of human-associated
Akkermansia
sp. enables access to additional growth substrates present in HMOs, including 2′-FL. Our work highlights the potential for
Akkermansia
to influence the development of the gut microbiota early in life and expands the known metabolic capabilities of this important human symbiont.

IMPORTANCE

Akkermansia
are mucin-degrading specialists widely distributed in the human population.
Akkermansia biwaensis
has recently been observed to have enhanced growth relative to other human-associated
Akkermansia
on multiple human milk oligosaccharides (HMOs). However, the mechanisms for enhanced growth are not understood. Here, we characterized the phylogenetic diversity and function of select genes involved in the growth of
A. biwaensis
on 2′-fucosyllactose (2′-FL), a dominant HMO. Specifically, we demonstrate that two genes in a genomic locus, a putative β-galactosidase and α-fucosidase, are likely responsible for the enhanced growth on 2′-FL. The functional characterization of
A. biwaensis
growth on 2′-FL delineates the significance of a single genomic locus that may facilitate enhanced colonization and functional activity of select
Akkermansia
early in life.
Swine influenza A virus isolates containing the pandemic H1N1 origin matrix gene elicit greater disease in the murine model
Authors: Curran Shelly J. , Griffin Emily F. , Ferreri Lucas M. , Kyriakis Constantinos S. , Howerth Elizabeth W. , Perez Daniel R. , Tompkins S. Mark
Published: February 2024

Since the 1990s, endemic North American swine influenza A viruses (swFLUAVs) contained an internal gene segment constellation, the triple reassortment internal gene (TRIG) cassette. In 2009, the H1N1 pandemic (pdmH1N1) virus spilled back into swine but did not become endemic. However, the pdmH1N1 contributed the matrix gene (pdmM) to the swFLUAVs circulating in the pig population, which replaced the classical swine matrix gene (swM) found in the TRIG cassette, suggesting the pdmM has a fitness benefit. Others have shown that swFLUAVs containing the pdmM have greater transmission efficiency compared to viruses containing the swM gene segment. We hypothesized that the matrix (M) gene could also affect disease and utilized two infection models, resistant BALB/c and susceptible DBA/2 mice, to assess pathogenicity. We infected BALB/c and DBA/2 mice with H1 and H3 swFLUAVs containing the swM or pdmM and measured lung virus titers, morbidity, mortality, and lung histopathology. H1 influenza strains containing the pdmM gene caused greater morbidity and mortality in resistant and susceptible murine strains, while H3 swFLUAVs caused no clinical disease. However, both H1 and H3 swFLUAVs containing the pdmM replicated to higher viral titers in the lungs and pdmM containing H1 viruses induced greater histological changes compared to swM H1 viruses. While the surface glycoproteins and other gene segments may contribute to swFLUAV pathogenicity in mice, these data suggest that the origin of the matrix gene also contributes to pathogenicity of swFLUAV in mice, although we must be cautious in translating these conclusions to their natural host, swine.

IMPORTANCE

The 2009 pandemic H1N1 virus rapidly spilled back into North American swine, reassorting with the already genetically diverse swFLUAVs. Notably, the M gene segment quickly replaced the classical M gene segment, suggesting a fitness benefit. Here, using two murine models of infection, we demonstrate that swFLUAV isolates containing the pandemic H1N1 origin M gene caused increased disease compared to isolates containing the classical swine M gene. These results suggest that, in addition to other influenza virus gene segments, the swFLUAV M gene segment contributes to pathogenesis in mammals.
Supplemental Material: Juvenile hafnium isotopic compositions recording a late Carboniferous–Early Triassic retreating subduction in the southern Central Asian Orogenic Belt: A case study from the southern Alxa
Authors: Zheng Rongguo , al. et
Published: February 2024

Analytical methods, U–Pb geochronological data, zircon Lu–Hf-O isotopic compositions, whole-rock major and trace element data are presented in the Supplemental Material.
Cardiac rehabilitation: the gateway for secondary prevention
Authors: Khadanga Sherrie , Savage Patrick , Keteyian Steven , Yant Blair , Gaalema Diann , Ades Philip
Published: February 2024

Cardiac rehabilitation (CR) is a multidisciplinary supervised programme which typically consists of tailored exercise and education on lifestyle management and risk factor modification in cardiac patients. Participation in CR reduces morbidity and mortality, while improving quality of life following major cardiovascular events. Despite the benefits of CR, it is underutilised, generally in the 20%–30% range for eligible patients. Participation and adherence rates are particularly suboptimal in vulnerable populations, such as those of lower socioeconomic status and women. Interventions such as automated referral to CR or hybrid/virtual programmes can increase enrolment to CR. This review summarises the components of CR and provides recommendations for providers regarding participation and adherence. To better engage a larger proportion of CR-eligible patients, CR programmes may need to expand or adjust ways to deliver secondary prevention.
Random expert sampling for deep learning segmentation of acute ischemic stroke on non-contrast CT
Authors: Ostmeier Sophie , Axelrod Brian , Liu Yongkai , Yu Yannan , Jiang Bin , Yuen Nicole , Pulli Benjamin , Verhaaren Benjamin F J , Kaka Hussam , Wintermark Max , Michel Patrik , Mahammedi Abdelkader , Federau Christian , Lansberg Maarten G , Albers Gregory W , Moseley Michael E , Zaharchuk Gregory , Heit Jeremy J
Published: February 2024

Background

Outlining acutely infarcted tissue on non-contrast CT is a challenging task for which human inter-reader agreement is limited. We explored two different methods for training a supervised deep learning algorithm: one that used a segmentation defined by majority vote among experts and another that trained randomly on separate individual expert segmentations.

Methods

The data set consisted of 260 non-contrast CT studies in 233 patients with acute ischemic stroke recruited from the multicenter DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) trial. Additional external validation was performed using 33 patients with matched stroke onset times from the University Hospital Lausanne. A benchmark U-Net was trained on the reference annotations of three experienced neuroradiologists to segment ischemic brain tissue using majority vote and random expert sampling training schemes. The median of volume, overlap, and distance segmentation metrics were determined for agreement in lesion segmentations between (1) three experts, (2) the majority model and each expert, and (3) the random model and each expert. The two sided Wilcoxon signed rank test was used to compare performances (1) to 2) and (1) to (3). We further compared volumes with the 24 hour follow-up diffusion weighted imaging (DWI, final infarct core) and correlations with clinical outcome (modified Rankin Scale (mRS) at 90 days) with the Spearman method.

Results

The random model outperformed the inter-expert agreement ((1) to (2)) and the majority model ((1) to (3)) (dice 0.51±0.04 vs 0.36±0.05 (P<0.0001) vs 0.45±0.05 (P<0.0001)). The random model predicted volume correlated with clinical outcome (0.19, P<0.05), whereas the median expert volume and majority model volume did not. There was no significant difference when comparing the volume correlations between random model, median expert volume, and majority model to 24 hour follow-up DWI volume (P>0.05, n=51).

Conclusion

The random model for ischemic injury delineation on non-contrast CT surpassed the inter-expert agreement ((1) to (2)) and the performance of the majority model ((1) to (3)). We showed that the random model volumetric measures of the model were consistent with 24 hour follow-up DWI.
Patients on vitamin K treatment: is switching to direct-acting oral anticoagulation cost-effective? A target trial on a prospective cohort
Authors: Aebersold Helena , Foster-Witassek Fabienne , Aeschbacher Stefanie , Beer Juerg H , Blozik Eva , Blum Manuel , Bonati Leo , Conte Giulio , Coslovsky Michael , De Perna Maria Luisa , Di Valentino Marcello , Felder Stefan , Huber Carola A , Moschovitis Giorgio , Mueller Andreas , Paladini Rebecca E , Reichlin Tobias , Rodondi Nicolas , Stauber Annina , Sticherling Christian , Szucs Thomas D , Conen David , Kuhne Michael , Osswald Stefan , Schwenkglenks Matthias , Serra-Burriel Miquel
Published: February 2024

Aims

Direct-acting oral anticoagulants (DOACs) have, to a substantial degree, replaced vitamin K antagonists (VKA) as treatments for stroke prevention in atrial fibrillation (AF) patients. However, evidence on the real-world causal effects of switching patients from VKA to DOAC is lacking. We aimed to assess the empirical incremental cost-effectiveness of switching patients to DOAC compared with maintaining VKA treatment.

Methods

The target trial approach was applied to the prospective observational Swiss-AF cohort, which enrolled 2415 AF patients from 2014 to 2017. Clinical data, healthcare resource utilisation and EQ-5D-based utilities representing quality of life were collected in yearly follow-ups. Health insurance claims were available for 1024 patients (42.4%). Overall survival, quality-of-life, costs from the Swiss statutory health insurance perspective and cost-effectiveness were estimated by emulating a target trial in which patients were randomly assigned to switch to DOAC or maintain VKA treatment.

Results

228 patients switching from VKA to DOAC compared with 563 patients maintaining VKA treatment had no overall survival advantage over a 5-year observation period (HR 0.99, 95% CI 0.45, 1.55). The estimated gain in quality-adjusted life years (QALYs) was 0.003 over the 5-year period at an incremental costs of CHF 23 033 (€ 20 940). The estimated incremental cost-effectiveness ratio was CHF 425 852 (€ 387 138) per QALY gained.

Conclusions

Applying a causal inference method to real-world data, we could not demonstrate switching to DOACs to be cost-effective for AF patients with at least 1 year of VKA treatment. Our estimates align with results from a previous randomised trial.