bluuebunny/crossref_metadata_2025 huggingface dataset:
Neue Leitlinien der European Society of Hypertension
Authors: van der Giet Markus
Published: November 2023

Eine gute Blutdruckeinstellung ist bei der chronischen Nierenfunktionsstörung (CKD: Chronic Kidney Disease) unerlässlich, um vor allem die Progression der Nierenfunktionsverschlechterung zu reduzieren und auch die sehr hohe kardiovaskuläre Mortalität und Morbidität positiv zu beeinflussen. In zahlreichen Studien konnte gezeigt werden, dass eine systolische Blutdruckeinstellung < 140 mmHg unerlässlich ist, um Patienten mit CKD zu helfen. Deshalb wird in den aktuellen Empfehlungen der European Society of Hypertension (ESH) für Patienten mit CKD empfohlen, den Blutdruck auf jeden Fall < 140 mmHg systolisch abzusenken. Bei jüngeren Patienten (< 65. Lebensjahr), bei Patienten mit hohem kardiovaskulärem Risiko oder bei Patienten mit begleitender Albuminurie sollte der systolische Blutdruck < 130 mmHg gesenkt werden, sofern der Patient dies toleriert. Basis aller Therapie sind Allgemeinmaßnahmen, insbesondere die Kontrolle des Salzkonsums. Zur medikamentösen Blutdruckeinstellung sollte das Renin-Angiotensin-System (RAS) mit einem ACE-Hemmer oder Sartan blockiert werden, wobei eine frühe duale Kombinationstherapie mit einem Kalzium-Kanal-Hemmer oder einem Diuretikum angestrebt werden sollte. Nach einer Eskalation auf maximal tolerable Medikationsdosierungen ist eine Triple-Therapie aus einer RAS-Blockade plus Kalzium-Kanal-Blocker plus Diuretikum notwendig. Ist der Blutdruck immer noch nicht kontrolliert, dann kommen bei der wahren Therapieresistenz β-Blocker, α1-Blocker, zentral wirksame Medikamente oder auch Spironolacton zum Einsatz, wobei bei einer Nierenfunktion < 45 ml/min/1,73 m2 ein hohes Risiko für eine Hyperkaliämie entsteht.
Gradient-impedance metafluids enable broadband water-air sound signal transmission
Authors: Shapiro Maura
Published: November 2023

An impedance matching layer reduces sound wave reflection at the water surface to further marine exploration and minimize underwater sound pollution.
Photoluminescence enhancement of aluminum ion intercalated MoS2 quantum dots
Authors: Kuang Yanmin , He Wenli , Zhu Zhichao , Chen Yaru , Ma Dongwei , Wang Xiaojuan , Guo Lijun , He Yulu , Chi Zhen , Ran Xia , Xie Luogang
Published: November 2023

Low photoluminescence (PL) quantum yield of molybdenum disulfide (MoS2) quantum dots (QDs) has limited practical application as potential fluorescent materials. Here, we report the intercalation of aluminum ion (Al3+) to enhance the PL of MoS2 QDs and the underlying mechanism. With detailed characterization and exciton dynamics study, we suggest that additional surface states including new emission centers have been effectively introduced to MoS2 QDs by the Al3+ intercalation. The synergy of new radiative pathway for exciton recombination and the passivation of non-radiative surface traps is responsible for the enhanced fluorescence of MoS2 QDs. Our findings demonstrate an efficient strategy to improve the optical properties of MoS2 QDs and are important for understanding the regulation effect of surface states on the emission of two dimensional sulfide QDs.
Structure–function relationships for squid skin-inspired wearable thermoregulatory materials
Authors: Liu Panyiming , Leung Erica M. , Badshah Mohsin Ali , Moore Christopher S. , Gorodetsky Alon A.
Published: November 2023

Wearable thermoregulatory technologies have attracted widespread attention because of their potential for impacting individual physiological comfort and for reducing building energy consumption. Within this context, the study of materials and systems that can merge the advantageous characteristics of both active and passive operating modes has proven particularly attractive. Accordingly, our laboratory has drawn inspiration from the appearance-changing skin of Loliginidae (inshore squids) for the introduction of a unique class of dynamic thermoregulatory composite materials with outstanding figures of merit. Herein, we demonstrate a straightforward approach for experimentally controlling and computationally predicting the adaptive infrared properties of such bioinspired composites, thereby enabling the development and validation of robust structure–function relationships for the composites. Our findings may help unlock the potential of not only the described materials but also comparable systems for applications as varied as thermoregulatory wearables, food packaging, infrared camouflage, soft robotics, and biomedical sensing.
Incentivizing free riders improves collective intelligence in social dilemmas
Authors: Tchernichovski Ofer , Frey Seth , Jacoby Nori , Conley Dalton
Published: November 2023

Collective intelligence challenges are often entangled with collective action problems. For example, voting, rating, and social innovation are collective intelligence tasks that require costly individual contributions. As a result, members of a group often free ride on the information contributed by intrinsically motivated people. Are intrinsically motivated agents the best participants in collective decisions? We embedded a collective intelligence task in a large-scale, virtual world public good game and found that participants who joined the information system but were reluctant to contribute to the public good (free riders) provided more accurate evaluations, whereas participants who rated frequently underperformed. Testing the underlying mechanism revealed that a negative rating bias in free riders is associated with higher accuracy. Importantly, incentivizing evaluations amplifies the relative influence of participants who tend to free ride without altering the (higher) quality of their evaluations, thereby improving collective intelligence. These results suggest that many of the currently available information systems, which strongly select for intrinsically motivated participants, underperform and that collective intelligence can benefit from incentivizing free riding members to engage. More generally, enhancing the diversity of contributor motivations can improve collective intelligence in settings that are entangled with collective action problems.
Barriers for the performance of graph neural networks (GNN) in discrete random structures
Authors: Gamarnik David
Published: November 2023

Recently, graph neural network (GNN)-based algorithms were proposed to solve a variety of combinatorial optimization problems [M. J. Schuetz, J. K. Brubaker, H. G. Katzgraber,
Nat. Mach. Intell.
4
, 367–377 (2022)]. GNN was tested in particular on randomly generated instances of these problems. The publication [M. J. Schuetz, J. K. Brubaker, H. G. Katzgraber,
Nat. Mach. Intell.
4
, 367–377 (2022)] stirred a debate whether the GNN-based method was adequately benchmarked against best prior methods. In particular, critical commentaries [M. C. Angelini, F. Ricci-Tersenghi,
Nat. Mach. Intell.
5
, 29–31 (2023)] and [S. Boettcher,
Nat. Mach. Intell.
5
, 24–25 (2023)] point out that a simple greedy algorithm performs better than the GNN. We do not intend to discuss the merits of arguments and counterarguments in these papers. Rather, in this note, we establish a fundamental limitation for running GNN on random instances considered in these references, for a broad range of choices of GNN architecture. Specifically, these barriers hold when the depth of GNN does not scale with graph size (we note that depth 2 was used in experiments in [M. J. Schuetz, J. K. Brubaker, H. G. Katzgraber,
Nat. Mach. Intell.
4
, 367–377 (2022)]), and importantly, these barriers hold regardless of any other parameters of GNN architecture. These limitations arise from the presence of the overlap gap property (OGP) phase transition, which is a barrier for many algorithms, including importantly local algorithms, of which GNN is an example. At the same time, some algorithms known prior to the introduction of GNN provide best results for these problems up to the OGP phase transition. This leaves very little space for GNN to outperform the known algorithms, and based on this, we side with the conclusions made in [M. C. Angelini, F. Ricci-Tersenghi,
Nat. Mach. Intell.
5
, 29–31 (2023)] and [S. Boettcher,
Nat. Mach. Intell.
5
, 24–25 (2023)].
Development of an automatic reading recognition system for liquid-in-glass thermometers based on deep learning
Authors: Ding Guanzhi , Liang Zixi , Peng Shuisheng , Fan Changxiang , Guo Jing
Published: November 2023

The reading recognition system based on computer vision technology can improve the reading efficiency and accuracy of liquid-in-glass thermometers (LiGTs), and avoid the error caused by the human-eye reading method. Due to the requirement of a large field of view in the reading recognition process, the targets of LiGTs in the image are small and the accuracy of traditional computer vision (TCV) methods is undesirable. In addition, the potential shadow lines and the meniscus bottom on the image of LiGTs can also affect the robustness of the accuracy of the TCV methods. Around these issues, this paper develops an automatic reading recognition system for LiGTs based on deep learning, which aims to improve the accuracy of automatic reading recognition. Specifically, the cameras in our system are assisted in acquiring ideal images of LiGTs through the back-light illumination and lifting mechanism. Then a multi-task attention network and a general alignment processing module are designed for reading recognition on images of LiGTs. Experimental results on two self-built thermometer datasets prove that the system designed in this study can accurately recognize the temperature reading of LiGTs, and the performance of the proposed method outperforms other reading recognition methods.
On some collinear configurations in the planar three-body problem
Authors: Tsygvintsev Alexei
Published: November 2023

In this paper, we further investigate the planar Newtonian three-body problem with a focus on collinear configurations, where either the three bodies or their velocities are aligned. We provide an independent proof of Montgomery’s result (Montgomery 2007Ergod. Theory Dyn. Syst.27311–40), stating that apart from the Lagrange’s solution, all negative energy solutions to the zero angular momentum case result in syzygies, i.e. collinear configurations of positions. The concept of generalised syzygies, inclusive of velocity alignments, was previously explored by the author for bounded solutions in Tsygvintsev (2023C. R. Acad. Sci., Paris361331–5). In this study, we broaden our scope to encompass negative energy cases and provide new bounds. Our methodology builds upon the elementary Sturm–Liouville theory and the Wintner-Conley ‘linear’ form of the three-body problem, as previously explored in the works of Albouy and Chenciner (1997Invent. Math.131151–84); Albouy (2004Mutual Distances in Celestial Mechanics(Lectures at Nankai Institute)); Chenciner (2013Acta Math. Vietnam.38165–86).
Tuning quantum pathway interference in two-color laser photoemission using DC bias
Authors: Zhou Yang , Zhang Peng
Published: November 2023

Coherent control of quantum systems depends on the manipulation of quantum interference through external fields. In this work, we investigate the effects of DC bias field on coherent control of quantum pathways in two-color laser photoemission using exact analytical solutions of the one-dimensional time dependent Schrödinger equation. Increasing DC bias lowers and narrows the surface potential barrier, shifting the dominant emission to lower order multiphoton photoemission, photo-assisted tunneling and then direct tunneling. Those lower order photon absorption processes result in fewer possible pathways, and therefore modulation of photoemission current can be suppressed as DC field increases. It is shown that a maximum modulation depth of 99.4% can be achieved for a gold emitter at local DC bias F
0 = 0.5 V nm−1, fundamental (800 nm) laser field F
1 = 2.6 V nm−1 and second harmonic laser field F
2 = 0.25 V nm−1 . For a given set of input parameters, the total photoemission consists of different k-photon processes, each of which has their own different multiple possible pathways and interference effects. However, the quantum pathways and their interference for the dominant k-photon process and for the total photoemission probability show the same trends. This study demonstrates strong flexibility in tuning two-color lasers induced photoemission using a DC bias and provides insights into coherent control schemes of general quantum systems.
Near-field enhancement by waveguide-plasmon polaritons in a nonlocal metasurface
Authors: Zang Xiaorun , Shevchenko Andriy
Published: November 2023

Localized surface plasmons in metal nanoparticles are widely used in nano-optics to confine and enhance optical fields. It has been previously shown that, if the nanoparticles are distributed periodically, an additional enhancement can be achieved by coupling the localized surface plasmons to the diffraction orders of the lattice, forming surface lattice resonances. In this work, we study an even further improvement of the near-field enhancement by placing a metal-dielectric slab waveguide beneath the lattice of the particles to excite coupled waveguide-plasmon polaritons. These excitations can extend over many periods of the lattice, making the metasurface highly nonlocal. We numerically demonstrate that the approach can provide a significant extra increase in the near-field intensity—by a factor of 80 over that produced by a single-particle plasmon resonance and by 7 over the lattice-resonance enhancement. The described enhancement mechanism can be used to design extraordinarily efficient nonlocal optical metasurfaces for many applications, including surface-enhanced Raman spectroscopy, fluorescence spectroscopy, nonlinear optics, and solar energy harvesting.
Electrical resistivity and the Hall effect in the doped Mott-Hubbard material with strong spin-charge coupling
Authors: Korovushkin Maxim M
Published: November 2023

The kinetic characteristics of the doped Mott-Hubbard material are considered within the realistic spin-fermion model which takes into account the strong spin-charge coupling. The kinetic equation constructed on the basis of the mechanism of carrier scattering on the spin fluctuations is solved using the multi-moment method, which allows one to analyze the temperature behavior of nonequilibrium distribution function in the problems of electrical resistivity ρ and the Hall coefficient R

H
. The calculated dependences ρ(T) and R

H
(T) for the underdoped and optimally doped regimes demonstrate good qualitative agreement with the experimental data. In particular, the Hall coefficient calculated for the underdoped regime reproduces the experimentally observed sharp drop and even a change in sign at low temperatures.
A deep dive into structural, electronic, optical, and mechanical properties of ATiO3 (A = Ba, Th): DFT insights
Authors: Solayman Md , Islam Md Rafiqul , Sarker Md Amran , Sharme Razia Khan , Momin Md Al , Islam Md Rasidul , Khan Asif Abdullah
Published: November 2023

Different physical characteristics (structural, optical, electronic, and mechanical) of ThTiO3 were explored using DFT and compared to BaTiO3. ThTiO3 has been determined to be mechanically and thermodynamically stable based on the simulation results, which were validated using the Born stability criteria and formation energy. Furthermore, a significant modification in the traits of ThTiO3 has been revealed compared to BaTiO3. For example, after the complete substitution of Ba by Th, in the case of GGA-PBE, the band gap increases from 1.82 eV to 3.37 eV, while in the case of HSE-06, it increases from 3.254 eV to 4.21 eV, also converting from indirect to direct bandgap. Not only that, but ThTiO3 has become an n-type degenerate semiconductor from a conventional semiconductor, which assures potential applications in tunnel diodes, high-frequency transistors, photocatalysts, etc. ThTiO3 is an appropriate material for capacitors, optoelectronic, and high k nanoelectronics devices based on the high dielectric constant value, which is higher than BaTiO3. Moreover, with Th substitution, BaTiO3 transitioned from brittle to ductile, which ensures its suitability for industrial machining processes. Furthermore, this substitution also improved the material’s anisotropic behavior, as the Zener Anisotropy value for ThTiO3 is also higher than BaTiO3. We believe this investigation will open another door in the field of materials for microelectronics and optoelectronics enthusiasts.
The Brukner-Zeilinger invariants in terms of (N, M) − POVMs
Authors: Tang Liang , Wu Fan , Mo Zhi-wen , Bai Ming-qiang
Published: November 2023

Brukner–Zeilinger invariants, including invariant information and invariant uncertainty, play a remarkable role in quantum information theory. Recently, a broad class of symmetric informationally complete measurements is presented, which contains a general symmetrical information complete POVMs and mutually unbiased measurements (2022, Phys. Rev. A
105, 042 209). Based on this important measurement and variance, we further analyze the internal relationship between Brukner–Zeilinger invariants in detail. The results maybe provide a method to explain the importance of Brukner–Zeilinger invariants.
Decay of ALP condensates via gravitation-induced resonance
Authors: Brandenberger Robert , Kamali Vahid , Ramos Rudnei O.
Published: November 2023

Oscillating scalar field condensates induce small amplitude
oscillations of the Hubble parameter which can induce a decay of the
condensate due to a parametric resonance instability [1]. We
show that this instability can lead to the decay of the coherence of
the condensate of axion-like particle (ALP) fields during the
radiation phase of standard cosmology for rather generic ALP parameter
values, with possible implications for certain experiments aiming to search
for ALP candidates. As an example, we study the application of this
instability to the QCD axion. We also study the magnitude of the
induced entropy fluctuations.
An Analysis of the Fragmentation of Observing Time At the Muztagh-Ata Site
Authors: Gu Wen-Bo , Xu Jing , Feng Guo-Jie , Zhang Xuan , Wang Le-Tian , Wang Xin-Liang , Esamdin Ali , Shen Li-Xian
Published: November 2023

Cloud cover plays a pivotal role in assessing observational conditions for astronomical site-testing. Except for the fraction of observing time, its fragmentation also wields a significant influence on the quality of nighttime sky clarity. In this article, we introduce the function

Γ
∈

0
,
1

, designed to comprehensively capture both the fraction of available observing time and its continuity. Leveraging in situ measurement data gathered at the Muztagh-Ata site between 2017 and 2021, we showcase the effectiveness of our approach. The statistical result illustrates that the Muztagh-Ata site affords approximately 122 nights that were absolutely clear and 205 very good nights annually, corresponding to Γ ≥ 0.9 and Γ ≥ 0.36 respectively.
Investigation of alpha-particle transport by Alfvén eigenmodes in CFETR using a simplified diffusion model
Authors: Ren Zhen-Zhen , Fu G.Y. , Shen Wei , Chen Yang , Yang Jin-Hong , Wang Wei-Hua
Published: November 2023

The aim of this work is to analyze the alpha particle transport induced by Alfvén eigenmodes (AEs) based on the latest design of China Fusion Engineering Test Reactor (CFETR). Firstly, the stability of AEs is analyzed in order to understand the physical characteristics of AEs in CFETR with latest design parameters. AEs driven by alpha particles are analyzed using the gyrokinetic ion/fluid electron hybrid code GEM. The transport of alpha particles is investigated using a reduced energetic particle transport model based on the resonance broadened quasi-linear model. GEM results show that AEs with many toroidal mode numbers can be destabilized simultaneously by alpha particles in CFETR, and the toroidal mode number of the most unstable mode is

n
=
8

. It is found that the excitation threshold of the alpha particle central beta for the

n
=
8

mode is substantially below the expected alpha particle beta value of CFETR. All these results indicate that AEs can be driven strongly in CFETR plasmas. Furthermore, simulation results using the reduced transport model show that, due to multiple unstable AEs, the alpha particle density decreases in the core and alpha particles are transported from the core region (

r

/

a
<
0.35

) to the outer region (

r

/

a
>
0.35

). In addition, we find that the minimum value of the safety factor

q

min

and the central beta value of alpha particle have significant effects on the alpha particle transport, and the AE-induced alpha particle transport level becomes lower with smaller linear growth rates. Finally, it is found that the radial range of the redistributed alpha particle density profile depend on the

q

min

radial location.
Screening for cancer beyond recommended upper age limits: views and experiences of older people
Authors: Smith Jenna , Dodd Rachael H , Naganathan Vasi , Cvejic Erin , Jansen Jesse , Wallis Katharine , McCaffery Kirsten J
Published: November 2023

Background

Internationally, screening programmes and clinical practice guidelines recommend when older adults should stop cancer screening using upper age limits, but it is unknown how older adults view these recommendations.

Objective

To examine older adults’ views and experiences about continuing or stopping cancer screening beyond the recommended upper age limit for breast, cervical, prostate and bowel cancer.

Design

Qualitative, semi-structured interviews.

Setting

Australia, telephone.

Subjects

A total of 29 community-dwelling older adults (≥70-years); recruited from organisation newsletters, mailing lists and Facebook advertisements.

Methods

Interviews were audio-recorded, transcribed and analysed thematically using Framework Analysis.

Results

Firstly, older adults were on a spectrum between trusting recommendations and actively deciding about cancer screening, with some who were uncertain. Secondly, participants reported limited in-depth discussions with health professionals about cancer screening. In primary care, discussions were focused on checking they were up to date with screening or going over results. Discussions mostly only occurred if older adults initiated themselves. Finally, participants had a socially- and self-constructed understanding of screening recommendations and potential outcomes. Perceived reasons for upper age limits were cost, reduced cancer risk or ageism. Risks of screening were understood in relation to their own social experiences (e.g. shared stories about friends with adverse outcomes of cancer treatment or conversations with friends/family about controversy around prostate screening).

Conclusions

Direct-to-patient information and clinician support may help improve communication about the changing benefit to harm ratio of cancer screening with increasing age and increase understanding about the rationale for an upper age limit for cancer screening programmes.
Imminent fall risk after fracture
Authors: Schene Merle R , Wyers Caroline E , Driessen Annemariek M H , Souverein Patrick C , Gemmeke Marle , van den Bergh Joop P , Willems Hanna C
Published: November 2023

Rationale

Adults with a recent fracture have a high imminent risk of a subsequent fracture. We hypothesise that, like subsequent fracture risk, fall risk is also highest immediately after a fracture. This study aims to assess if fall risk is time-dependent in subjects with a recent fracture compared to subjects without a fracture.

Methods

This retrospective matched cohort study used data from the UK Clinical Practice Research Datalink GOLD. All subjects ≥50 years with a fracture between 1993 and 2015 were identified and matched one-to-one to fracture-free controls based on year of birth, sex and practice. The cumulative incidence and relative risk (RR) of a first fall was calculated at various time intervals, with mortality as competing risk. Subsequently, analyses were stratified according to age, sex and type of index fracture.

Results

A total of 624,460 subjects were included; 312,230 subjects with an index fracture, matched to 312,230 fracture-free controls (71% females, mean age 70 ± 12, mean follow-up 6.5 ± 5 years). The RR of falls was highest in the first year after fracture compared to fracture-free controls; males had a 3-fold and females a 2-fold higher risk. This imminent fall risk was present in all age and fracture types and declined over time. A concurrent imminent fracture and mortality risk were confirmed.

Conclusion/Discussion

This study demonstrates an imminent fall risk in the first years after a fracture in all age and fracture types. This underlines the need for early fall risk assessment and prevention strategies in 50+ adults with a recent fracture.
Surviving Violence, Ambiguity and Oneself: The Experience of Child Protection Workers in Chile
Authors: Garcia-Meneses Javiera , Collins Mary Elizabeth
Published: November 2023

The challenges of contemporary child welfare practice are well documented in many countries worldwide. The current study enhances this work by reporting the lived experiences of child welfare workers in Chile, who negotiate their practice in a strained political and organisational context. A qualitative methodology was used to understand the complexities of the survival strategies of these workers. Data were collected via multiple individual interviews and group workshop sessions with six workers of different Chilean National Service for Minors’ collaborating organisations. Through a constructivist grounded theory analysis, we identify three major complexities that shape and construct the strategies of survival that the Chilean child welfare workers deploy in a neo-liberalised labour context: (1) Surviving a violent labour context (precariousness and dehumanisation); (2) surviving labour ambiguities (fractures and resistance) and (3) surviving oneself (pain-filled and violence executors’ bodies). We discuss these findings in the context of the scholarly literature and offer implications for policy and macro practice to alter the work conditions of this professional field.
Human herpesvirus 6A and axonal injury before the clinical onset of multiple sclerosis
Authors: Grut Viktor , Biström Martin , Salzer Jonatan , Stridh Pernilla , Jons Daniel , Gustafsson Rasmus , Fogdell-Hahn Anna , Huang Jesse , Butt Julia , Lindam Anna , Alonso-Magdalena Lucia , Bergström Tomas , Kockum Ingrid , Waterboer Tim , Olsson Tomas , Zetterberg Henrik , Blennow Kaj , Andersen Oluf , Nilsson Staffan , Sundström Peter
Published: November 2023

Recent research indicates that multiple sclerosis is preceded by a prodromal phase with elevated levels of serum neurofilament light chain (sNfL), a marker of axonal injury. The effect of environmental risk factors on the extent of axonal injury during this prodrome is unknown. Human herpesvirus 6A (HHV-6A) is associated with an increased risk of developing multiple sclerosis. The objective of this study was to determine if HHV-6A serostatus is associated with the level of sNfL in the multiple sclerosis prodrome, which would support a causative role of HHV-6A.

A nested case-control study was performed by crosslinking multiple sclerosis registries with Swedish biobanks. Individuals with biobank samples collected before the clinical onset of multiple sclerosis were included as cases. Controls without multiple sclerosis were randomly selected, matched for biobank, sex, sampling date and age. Serostatus of HHV-6A and Epstein-Barr virus was analysed with a bead-based multiplex assay. The concentration of sNfL was analysed with single molecule array technology. The association between HHV-6A serology and sNfL was assessed by stratified t-tests and linear regressions, adjusted for Epstein-Barr virus serostatus and sampling age. Within-pair ratios of HHV-6A seroreactivity and sNfL were calculated for each case and its matched control. To assess the temporal relationship between HHV-6A antibodies and sNfL, these ratios were plotted against the time to the clinical onset of multiple sclerosis and compared using locally estimated scatterplot smoothing regressions with 95% confidence intervals (CI).

Samples from 519 matched case-control pairs were included. In cases, seropositivity of HHV-6A was significantly associated with the level of sNfL (+11%, 95% CI 0.2–24%, P = 0.045) and most pronounced in the younger half of the cases (+24%, 95% CI 6–45%, P = 0.007). No such associations were observed among the controls. Increasing seroreactivity against HHV-6A was detectable before the rise of sNfL (significant within-pair ratios from 13.6 years versus 6.6 years before the clinical onset of multiple sclerosis).

In this study, we describe the association between HHV-6A antibodies and the degree of axonal injury in the multiple sclerosis prodrome. The findings indicate that elevated HHV-6A antibodies both precede and are associated with a higher degree of axonal injury, supporting the hypothesis that HHV-6A infection may contribute to multiple sclerosis development in a proportion of cases.
Meanings of Aging in the Right Place for Older Clients of a Temporary Housing Program
Authors: Canham Sarah L , Weldrick Rachel , Mahmood Atiya , Patille Rachelle , Erisman Morgan Cruz
Published: November 2023

Background and Objectives

The concept of aging in place is acknowledged as the preference of older adults, yet without consideration of the intersections of diversity in later life, it is critiqued as unattainable, unrealistic, or even undesirable. This gave rise to the exploration of what is needed to age in the right place (AIRP). Building on existing research, we examined the meaning of AIRP to older adults (aged 55+ years) who have experienced homelessness.

Research Design and Methods

We conducted photovoice interviews with 11 residents of a temporary housing program in Metro Vancouver (Canada).

Results

Using thematic analysis, we organized meanings of AIRP according to (1) Where one lives—the physical and social environment, (2) Where one goes and what one does, and (3) How one feels in “the right place.”

Discussion and Implications

Participants meanings’ of AIRP are applied to Maslow’s hierarchy of needs. That is, when basic needs of shelter are met, participants’ considerations of “the right place to age” extend beyond affordable housing to include feeling safe and comfortable in one’s home and neighborhood and having access to meaningful engagement and activities—both in vibrant urban districts and naturescapes—enabled by affordable transportation. Our examination of what AIRP means to this group of older adults broadens current conceptualizations. Given the increase in homelessness among older adults, it is imperative that policymakers and practitioners are cognizant of meanings of AIRP so diverse older adults can not only age in place, but can thrive in the right place.
The High Priest of Blind Zeal: Milton, Montelion and mockery
Authors: Prizeman Steven
Published: November 2023

A long-standing debate about the relationship between the poet John Milton and his nephew John Phillips has been undermined by inaccuracies in the bibliographical record and the failure of scholars to identify relevant passages in Phillips’s writings. This article brings new evidence with specific reference to A Satyr Against Hypocrites (1655), containing an overlooked attack upon Milton; the Montelion almanacs (1660, 1661, 1662), establishing that all were authored by Phillips, each containing disparaging remarks about Milton; and Don Juan Lamberto (1660–1), confirming Phillips’s authorship and revealing a hitherto unrecognized satirical attack upon Milton.
Impact of Opioid Use on the Natural History of Inflammatory Bowel Disease: Prospective Longitudinal Follow-up Study
Authors: Riggott Christy , Fairbrass Keeley M , Selinger Christian P , Gracie David J , Ford Alexander C
Published: November 2023

Background

Opioid use is increasingly prevalent amongst patients with inflammatory bowel disease (IBD), but whether opioids have deleterious effects, or their use is merely linked with more severe disease, is unclear. We conducted a longitudinal follow-up study examining this issue.

Methods

Data on demographics, gastrointestinal and psychological symptoms, quality of life, and opioid use were recorded at baseline. Data on healthcare use and adverse disease outcomes were obtained from a review of electronic medical records at 12 months. Characteristics at baseline of those using opioids and those who were not were compared, in addition to occurrence of flare, prescription of glucocorticosteroids, treatment escalation, hospitalization, or intestinal resection during the 12 months of follow-up.

Results

Of 1029 eligible participants, 116 (11.3%) were taking opioids at baseline. Medium (odds ratio [OR], 4.67; 95% confidence interval [CI], 1.61-13.6) or high (OR, 8.03; 95% CI, 2.21-29.2) levels of somatoform symptom-reporting and use of antidepressants (OR, 2.54; 95% CI, 1.34-4.84) or glucocorticosteroids (OR, 6.63; 95% CI, 2.26-19.5; P < .01 for all analyses) were independently associated with opioid use. Following multivariate analysis, opioid users were significantly more likely to undergo intestinal resection (hazard ratio,  7.09; 95% CI, 1.63 to 30.9; P = .009), particularly when codeine or dihydrocodeine were excluded (hazard ratio, 42.9; 95% CI, 3.36 to 548; P = .004).

Conclusions

Opioid use in IBD is associated with psychological comorbidity and increased risk of intestinal resection, particularly in stronger formulations. Future studies should stratify the risk of individual opioids, so that robust prescribing algorithms can be developed and assess whether addressing psychological factors in routine IBD care could be an effective opioid avoidance strategy.
TLR7 activation of age-associated B cells mediates disease in a mouse model of primary Sjögren's disease
Authors: Punnanitinont Achamaporn , Kasperek Eileen M , Zhu Chengsong , Yu Guan , Miecznikowski Jeffrey C , Kramer Jill M
Published: November 2023

Primary Sjögren's disease (pSD) (also referred to as Sjögren's syndrome) is an autoimmune disease that primarily occurs in women. In addition to exocrine gland dysfunction, pSD patients exhibit B cell hyperactivity. B cell–intrinsic TLR7 activation is integral to the pathogenesis of systemic lupus erythematosus, a disease that shares similarities with pSD. The role of TLR7-mediated B cell activation in pSD, however, remains poorly understood. We hypothesized that age-associated B cells (ABCs) were expanded in pSD and that TLR7-stimulated ABCs exhibited pathogenic features characteristic of disease. Our data revealed that ABC expansion and TLR7 expression were enhanced in a pSD mouse model in a Myd88-dependent manner. Splenocytes from pSD mice showed enhanced sensitivity to TLR7 agonism as compared with those derived from control animals. Sort-purified marginal zone B cells and ABCs from pSD mice showed enhanced inflammatory cytokine secretion and were enriched for antinuclear autoantibodies following TLR7 agonism. Finally, IgG from pSD patient sera showed elevated antinuclear autoantibodies, many of which were secreted preferentially by TLR7-stimulated murine marginal zone B cells and ABCs. These data indicate that pSD B cells are hyperresponsive to TLR7 agonism and that TLR7-activated B cells contribute to pSD through cytokine and autoantibody production. Thus, therapeutics that target TLR7 signaling cascades in B cells may have utility in pSD patients.
Epistemic injustice in education: exploring structural approaches, envisioning structural remedies
Authors: Nikolaidis A C
Published: November 2023

Since the publication of Miranda Fricker’s seminal book Epistemic Injustice, philosophy of education scholarship has been mostly limited to analyses of culprit-based epistemic injustice in education. This has left structural manifestations relatively underexplored with great detriment to those who are most vulnerable to experience such injustice. This paper aims to address this oversight and open avenues for further research by exploring approaches to theorizing structural epistemic injustice in education and envisioning efficacious remedies. The author identifies three approaches: one that focusses on educational institutions; one that focusses on institutional processes that impact educational outcomes; and one that focusses on epistemological processes that are internal to education. Whilst the approaches differ as to their explanatory power and ease of implementation, it is argued that all three demonstrate that epistemic injustice in education is often the result of structural factors which cannot be attributed to individual epistemic agents. The author concludes by suggesting that educational philosophers must examine each of these approaches in greater depth to make significant progress in disrupting the impact of epistemic injustice in education.
Intraindividual difference in estimated GFR by creatinine and cystatin C, cognitive trajectories and motoric cognitive risk syndrome
Authors: Wang Jinqi , Liu Yueruijing , Jin Rui , Zhao Xiaoyu , Wu Zhiyuan , Han Ze , Xu Zongkai , Guo Xiuhua , Tao Lixin
Published: November 2023

Background

Intraindividual differences between estimated glomerular filtration rate (eGFR) based on cystatin C (eGFRcys) and creatinine (eGFRcr) can convey important clinical information regarding health status. However, the clinical implications of these differences (eGFRdiff) for risk of cognitive decline and motoric cognitive risk (MCR) syndrome remains unclear. We aimed to investigate the longitudinal associations of eGFRdiff with cognitive trajectories and incident MCR.

Methods

Based on the China Health and Retirement Longitudinal Study, we identified two study subcohorts: one for cognitive trajectory follow-up (6423 participants, 2011–2018) and another for incident MCR follow-up (2477 participants, 2011–2015). The eGFRdiff was defined as eGFRcys − eGFRcr. Adjusted ordinal and binary logistic regression models were separately used to assess the associations of eGFRdiff with cognitive trajectories and incident MCR. We also performed discordance analyses for eGFRdiff versus eGFRcys, eGFRcr or eGFR based on both creatinine and cystatin C (eGFRcys-cr).

Results

In the first subcohort, four distinct 7-year cognitive trajectories were identified. Each 1 standard deviation (SD) higher eGFRdiff (value for eGFRcys − eGFRcr) was associated with a lower risk of poorer cognitive trajectories {odds ratio 0.909 [95% confidence interval (CI) 0.877–0.942]}. In the second subcohort, 121 participants developed incident MCR after a 4-year follow-up. Each 1-SD higher eGFRdiff (value for eGFRcys − eGFRcr) was linked with a 25.3% (95% CI 16.6–33.2) decreased risk for MCR. The above associations persisted in individuals with normal kidney function. Additionally, the risk for cognitive decline and incident MCR was more strongly associated with eGFRcys than eGFRcr and eGFRcys-cr. For the discordance analyses, the ‘discordantly high eGFRdiff/low eGFR’ group but not the ‘discordantly low eGFRdiff/high eGFR’ exhibited a significantly lower risk of poorer cognitive trajectories and MCR compared with the concordant group.

Conclusions

A large negative difference between eGFRcys and eGFRcr (eGFRcys < eGFRcr) was associated with a higher risk of cognitive decline and incident MCR. The eGFRdiff could capture additional valuable risk information beyond eGFRcys, eGFRcr and eGFRcys-cr.
Spatial architecture of high-grade glioma reveals tumor heterogeneity within distinct domains
Authors: Moffet Joel J D , Fatunla Oluwaseun E , Freytag Lutz , Kriel Jurgen , Jones Jordan J , Roberts-Thomson Samuel J , Pavenko Anna , Scoville David K , Zhang Liang , Liang Yan , Morokoff Andrew P , Whittle James R , Freytag Saskia , Best Sarah A
Published: November 2023

Background

High-grade gliomas (HGGs) are aggressive primary brain cancers with poor response to standard regimens, driven by immense heterogeneity. In isocitrate dehydrogenase (IDH) wild-type HGG (glioblastoma, GBM), increased intratumoral heterogeneity is associated with more aggressive disease.

Methods

Spatial technologies can dissect complex heterogeneity within the tumor ecosystem by preserving cellular organization in situ. We employed GeoMx digital spatial profiling, CosMx spatial molecular imaging, Xenium in situ mapping and Visium spatial gene expression in experimental and validation patient cohorts to interrogate the transcriptional landscape in HGG.

Results

Here, we construct a high-resolution molecular map of heterogeneity in GBM and IDH-mutant patient samples to investigate the cellular communities that compose HGG. We uncovered striking diversity in the tumor landscape and degree of spatial heterogeneity within the cellular composition of the tumors. The immune distribution was diverse between samples, however, consistently correlated spatially with distinct tumor cell phenotypes, validated across tumor cohorts. Reconstructing the tumor architecture revealed two distinct niches, one composed of tumor cells that most closely resemble normal glial cells, associated with microglia, and the other niche populated by monocytes and mesenchymal tumor cells.

Conclusions

This primary study reveals high levels of intratumoral heterogeneity in HGGs, associated with a diverse immune landscape within spatially localized regions.
The effects of organic food on human health: a systematic review and meta-analysis of population-based studies
Authors: Jiang Bibo , Pang Jinzhu , Li Junan , Mi Lijuan , Ru Dongmei , Feng Jingxi , Li Xiaoxu , Zhao Ai , Cai Li
Published: November 2023

Context

Although the nutritional composition of organic food has been thoroughly researched, there is a dearth of published data relating to its impact on human health.

Objective

This systematic review aimed to examine the association between organic food intake and health effects, including changes in in vivo biomarkers, disease prevalence, and functional changes.

Data Sources

PubMed, EMBASE, Web of Science, the Cochrane Library, and ClinicalTrials.gov were searched from inception through Nov 13, 2022.

Data Extraction

Both observational and interventional studies conducted in human populations were included, and association between level of organic food intake and each outcome was quantified as “no association,” “inconsistent,” “beneficial correlation/harmful correlation,” or “insufficient”. For outcomes with sufficient data reported by at least 3 studies, meta-analyses were conducted, using random-effects models to calculate standardized mean differences.

Data Analysis

Based on the included 23 observational and 27 interventional studies, the association between levels of organic food intake and (i) pesticide exposure biomarker was assessed as “beneficial correlation,” (ii) toxic metals and carotenoids in the plasma was assessed as “no association,” (iii) fatty acids in human milk was assessed as “insufficient,” (iv) phenolics was assessed as “beneficial”, and serum parameters and antioxidant status was assessed as “inconsistent”. For diseases and functional changes, there was an overall “beneficial” association with organic food intake, and there were similar findings for obesity and body mass index. However, evidence for association of organic food intake with other single diseases was assessed as “insufficient” due to the limited number and extent of studies.

Conclusion

Organic food intake was found to have a beneficial impact in terms of reducing pesticide exposure, and the general effect on disease and functional changes (body mass index, male sperm quality) was appreciable. More long-term studies are required, especially for single diseases.

Systematic Review Registration

PROSPERO registration no. CRD42022350175.
Basic principles of dental local anaesthetic injections
Authors: Meechan John G , Robb Nigel D , Seymour Robin A
Published: November 2023

The transmission of nociceptive impulses from tooth to brain can be blocked at any point on the neural pathway from the dental pulp to the cerebral cortex. When using local anaesthesia in dentistry the nerve is usually anaesthetized at one of two positions. These locations are either close to the nerve ending at the apex of the tooth or along the trunk of the nerve. The principal method of depositing solution close to the nerve ending is known as ‘infiltration anaesthesia’. The intraligamentary and intraosseous techniques described in Chapter 9 are specific methods within the category of infiltration anaesthesia. The deposition of local anaesthetic drugs around the nerve trunk is called ‘regional block anaesthesia’.
Transmucosal sedation
Authors: Meechan John G , Robb Nigel D , Seymour Robin A
Published: November 2023

Transmucosal sedation is a technique in which the sedative agent is administered to the patient by absorption across a mucosal surface, other than the traditional surfaces such as gastric and intestinal mucosa. The mucosal surfaces that have been investigated in dentistry are: There is considerable interest in the transmucosal (and indeed the transdermal) administration of drugs. Transmucosal administration is not new, and indeed many readers will be familiar with the concept of glyceryl trinitrate tablets that are used in the treatment of angina being placed under the tongue. Opioid anal gesics, such as buprenorphine (Temgesic), have also been available for sublingual administration for a number of years. Newer applications of this method of drug administration include nitrate skin patches, again for the treatment of angina, and nicotine skin patches for those who wish to give up smoking.
Monitoring the sedated dental patient
Authors: Meechan John G , Robb Nigel D , Seymour Robin A
Published: November 2023

The main aim of sedation is to decrease the patient’s awareness of what is happening to them in the dental surgery, either because anxiety prevents them coping with it, or the procedure is innately unpleasant. The other effect of decreasing the patient’s awareness of their surroundings is to lower their awareness of what is happening within them. This can result in the patient not recognizing if they are feeling unwell. Thus, the dental team must assume the responsibility for monitoring the patient’s clinical condition. It is assumed that the team will be used to a degree of clinical monitoring of patients that are treated under local anaesthesia alone. However, this needs to be more rigorous and formalized when the patient is under sedation.
Some Geometry
Authors: Higgins Peter M
Published: November 2023

In this chapter I aim to provide demonstrations of a few of the more famous results of Euclidean geometry, including the theorem of Pythagoras and some of the Circle Theorems. The proofs remain as surprising and delightful today as they were thousands of years ago, and we can be sure that our own distant progeny will also be charmed by their elegance. I will begin with Pythagoras. This theorem links geometry and algebra like no other single fact. It gives an algebraic hold on the physical notion of distance and so its presence is felt throughout mathematics and physics—the Theory of Special Relativity, for instance, rests upon it.
Chance and Games of Chance
Authors: Higgins Peter M
Published: November 2023

If your little daughter returns from school saying that two children in her class both had birthdays today and asks, ‘Isn’t that amazing’? then the mathematically correct answer to her question is, ‘No, that is not amazing, it is to be expected every once in a while.’ Although this is not the way you might advise a parent to respond, it will be interesting to see why it is so, for the correct answer is surprising.