bluuebunny/crossref_metadata_2025 huggingface dataset:
TOP-PIC: a new tool to optimize pharmacotherapy and reduce polypharmacy in patients with incurable cancer
Authors: Strassl Irene , Windhager Armin , Machherndl-Spandl Sigrid , Buxhofer-Ausch Veronika , Stiefel Olga , Weltermann Ansgar
Published: March 2023

Purpose

Polypharmacy is a significant problem in patients with incurable cancer and a method to optimize pharmacotherapy in this patient group is lacking. Therefore, a drug optimization tool was developed and tested in a pilot test.

Methods

A multidisciplinary team of health professionals developed a “Tool to Optimize Pharmacotherapy in Patients with Incurable Cancer” (TOP-PIC) for patients with a limited life expectancy. The tool consists of five sequential steps to optimize medications, including medication history, screening for medication appropriateness and drug interactions, a benefit–risk assessment using the TOP-PIC Disease-based list, and shared decision-making with the patient. For pilot testing of the tool, 8 patient cases with polypharmacy were analyzed by 11 oncologists before and after training with the TOP-PIC tool.

Results

TOP-PIC was considered helpful by all oncologists during the pilot test. The median additional time required to administer the tool was 2 min per patient (P < 0.001). For 17.4% of all medications, different decisions were made by using TOP-PIC. Among possible treatment decisions (discontinuation, reduction, increase, replacement, or addition of a drug), discontinuation of medications was the most common. Without TOP-PIC, physicians were uncertain in 9.3% of medication changes, compared with only 4.8% after using TOP-PIC (P = 0.001). The TOP-PIC Disease-based list was considered helpful by 94.5% of oncologists.

Conclusions

TOP-PIC provides a detailed, disease-based benefit–risk assessment with recommendations specific for cancer patients with limited life expectancy. Based on the results of the pilot study, the tool seems practicable for day-to-day clinical decision-making and provides evidence-based facts to optimize pharmacotherapy.
Social media bot detection with deep learning methods: a systematic review
Authors: Hayawi Kadhim , Saha Susmita , Masud Mohammad Mehedy , Mathew Sujith Samuel , Kaosar Mohammed
Published: March 2023

Social bots are automated social media accounts governed by software and controlled by humans at the backend. Some bots have good purposes, such as automatically posting information about news and even to provide help during emergencies. Nevertheless, bots have also been used for malicious purposes, such as for posting fake news or rumour spreading or manipulating political campaigns. There are existing mechanisms that allow for detection and removal of malicious bots automatically. However, the bot landscape changes as the bot creators use more sophisticated methods to avoid being detected. Therefore, new mechanisms for discerning between legitimate and bot accounts are much needed. Over the past few years, a few review studies contributed to the social media bot detection research by presenting a comprehensive survey on various detection methods including cutting-edge solutions like machine learning (ML)/deep learning (DL) techniques. This paper, to the best of our knowledge, is the first one to only highlight the DL techniques and compare the motivation/effectiveness of these techniques among themselves and over other methods, especially the traditional ML ones. We present here a refined taxonomy of the features used in DL studies and details about the associated pre-processing strategies required to make suitable training data for a DL model. We summarize the gaps addressed by the review papers that mentioned about DL/ML studies to provide future directions in this field. Overall, DL techniques turn out to be computation and time efficient techniques for social bot detection with better or compatible performance as traditional ML techniques.
Explainable reinforcement learning for broad-XAI: a conceptual framework and survey
Authors: Dazeley Richard , Vamplew Peter , Cruz Francisco
Published: March 2023

Broad-XAI moves away from interpreting individual decisions based on a single datum and aims to provide integrated explanations from multiple machine learning algorithms into a coherent explanation of an agent’s behaviour that is aligned to the communication needs of the explainee. Reinforcement Learning (RL) methods, we propose, provide a potential backbone for the cognitive model required for the development of Broad-XAI. RL represents a suite of approaches that have had increasing success in solving a range of sequential decision-making problems. However, these algorithms operate as black-box problem solvers, where they obfuscate their decision-making policy through a complex array of values and functions. EXplainable RL (XRL) aims to develop techniques to extract concepts from the agent’s: perception of the environment; intrinsic/extrinsic motivations/beliefs; Q-values, goals and objectives. This paper aims to introduce the Causal XRL Framework (CXF), that unifies the current XRL research and uses RL as a backbone to the development of Broad-XAI. CXF is designed to incorporate many standard RL extensions and integrated with external ontologies and communication facilities so that the agent can answer questions that explain outcomes its decisions. This paper aims to: establish XRL as a distinct branch of XAI; introduce a conceptual framework for XRL; review existing approaches explaining agent behaviour; and identify opportunities for future research. Finally, this paper discusses how additional information can be extracted and ultimately integrated into models of communication, facilitating the development of Broad-XAI.
Resistance to ceftazidime-avibactam in a KPC-2–producing Klebsiella pneumoniae caused by the extended-spectrum beta-lactamase VEB-25
Authors: Findlay Jacqueline , Poirel Laurent , Bouvier Maxime , Gaia Valeria , Nordmann Patrice
Published: March 2023

Carbapenem-resistant Enterobacterales, including KPC-producing Klebsiella pneumoniae, represent a major threat to public health due to their rapid spread. The beta-lactam/beta-lactamase inhibitor (BL/BLI) combination ceftazidime-avibactam (CAZ-AVI) has recently been introduced and shown to exhibit excellent activity toward multidrug-resistant KPC-producing Enterobacterales strains. However, CAZ-AVI-resistant K. pneumoniae isolates are being increasingly reported, mostly corresponding to producers of KPC variants that confer resistance to CAZ-AVI but at a cost of carbapenem resistance. We have characterized here, both phenotypically and genotypically, a clinical CAZ-AVI- and carbapenem-resistant KPC-2 K. pneumoniae isolate co-producing the inhibitor-resistant extended-spectrum beta-lactamase VEB-25.
The long-term efficacy of transoral incisionless fundoplication with Medigus Ultrasonic Surgical Endostapler (MUSE) for gastroesophageal reflux disease
Authors: Shen Shien , Yu Ge , Guo Xingya , Zong Guanzhao , Wang Chuanyang , Bao Jingpiao , Chen Jiahui , Cheng Zhiyuan , Xiao Wenqin , Shen Jie , Jiang Weiliang , Wan Rong
Published: March 2023

Background

To evaluate the long-term efficacy of transoral incisionless fundoplication (TIF) with Medigus Ultrasonic Surgical Endostapler (MUSE) for gastroesophageal reflux disease (GERD).

Methods

A total of 16 patients with proton pump inhibitor-dependent gastroesophageal reflux disease had undergone TIF by MUSE in Shanghai General Hospital （Shanghai, China）from March 2017 to December 2018. Patients were followed up at 6 months, and the GERD-health-related quality of life (GERD-HRQL) questionnaire score, the GERD questionnaire (GERD-Q) score, high-resolution esophageal manometry (HREM) and 24 h esophageal pH parameters, the Hill grade of the gastroesophageal flap valve (GEFV) and daily Proton pump inhibitor (PPI) consumption before and after procedure were compared. Patients also were followed up at 3 years and 5 years using a structured questionnaire via phone which evaluated symptoms of reflux, dose of PPI medication and side effects.

Results

Follow-up data were collected from 13 patients, ranging from 38 to 63 months, 53 months on average. 10/13 patients reported symptomatic improvement and daily PPI consumption was stopped or halved in 11/13. After procedure, the mean scores of GERD-HRQL and GERD-Q were significantly increased. The mean DeMeester score, the mean acid exposure time percentage and the mean number of acid reflux episodes were significantly lower. The mean rest pressure at lower esophageal sphincter (LES) had no significant difference.

Conclusion

TIF by MUSE has significant efficacy in the treatment of PPI-dependent GERD, which can improve symptoms and life quality of patients, and reduce the acid exposure time for long-term. Chictr.org.cn.

Trial Registration

ChiCTR2000034350.
A fuzzy-DEA water sustainability index: an application in European Union water risk hotspots
Authors: de Castro Pardo Mónica , Martín Martín José María , Guaita Martínez José Manuel , Ribeiro Soriano Domingo Enrique
Published: March 2023

The current global freshwater crisis threatens the present and future supply of water as a resource for humans. The scarcity of drinking water and the dependence of the food industry on water-intensive supply chains require the urgent development of strategies to analyze and guarantee the water sustainability of countries. This study proposes a fuzzy-data envelopment analysis composite index that measures, from a benchmarking approach, water sustainability by simultaneously considering capacity and resilience, and captures the uncertainty associated with time series variations in three scenarios: pessimistic, indifferent and optimistic. We present and apply an index based on five indicators of capacity and five indicators of resilience in ten European Union countries water risk hotspots. The results in terms of capacity presented a higher variability due to the strong growth in the exploitation of water resources in Greece, Spain, France, Italy and Portugal. The most sustainable countries in terms of capacity were Bulgaria and Estonia in a pessimistic and an indifferent scenario and France and Bulgaria in an optimistic scenario. In terms of resilience, Belgium and Portugal were the most sustainable countries. When considering capacity and resilience together, some countries such as Bulgaria and Estonia lost positions in the ranking, with Belgium occupying the first position. Some countries, such as Bulgaria, could see the sustainability of their water resources compromised in a scenario of economic development if they do not improve their governance and water productivity constraints.
Dynamical Non-compensatory Multidimensional IRT Model Using Variational Approximation
Authors: Tamano Hiroshi , Mochihashi Daichi
Published: March 2023

Multidimensional item response theory (MIRT) is a statistical test theory that precisely estimates multiple latent skills of learners from the responses in a test. Both compensatory and non-compensatory models have been proposed for MIRT: the former assumes that each skill can complement other skills, whereas the latter assumes they cannot. This non-compensatory assumption is convincing in many tests that measure multiple skills; therefore, applying non-compensatory models to such data is crucial for achieving unbiased and accurate estimation. In contrast to tests, latent skills will change over time in daily learning. To monitor the growth of skills, dynamical extensions of MIRT models have been investigated. However, most of them assumed compensatory models, and a model that can reproduce continuous latent states of skills under the non-compensatory assumption has not been proposed thus far. To enable accurate skill tracing under the non-compensatory assumption, we propose a dynamical extension of non-compensatory MIRT models by combining a linear dynamical system and a non-compensatory model. This results in a complicated posterior of skills, which we approximate with a Gaussian distribution by minimizing the Kullback–Leibler divergence between the approximated posterior and the true posterior. The learning algorithm for the model parameters is derived through Monte Carlo expectation maximization. Simulation studies verify that the proposed method is able to reproduce latent skills accurately, whereas the dynamical compensatory model suffers from significant underestimation errors. Furthermore, experiments on an actual data set demonstrate that our dynamical non-compensatory model can infer practical skill tracing and clarify differences in skill tracing between non-compensatory and compensatory models.
A practical framework for the cryopreservation of palm species
Authors: Nguyen Van-Anh , Nguyen Phuong Thao , Le Minh-An , Bazrafshan Amirhossein , Sisunandar Sisunandar , Kalaipandian Sundaravelpandian , Adkins Steve W. , Nguyen Quang Thien
Published: March 2023

Palms (Arecaceae) contribute remarkable economic and environmental values to human life. However, many elite and commercial palm species are becoming critically endangered and demand immediate action to preserve their genetic resources. Cryopreservation has established itself as the definitive in vitro conservation method for recalcitrant-seeded species, such as those within the Arecaceae. Progress in this area has moved steadily forward over the last three decades with the development of various techniques for different explants and palm genotypes and for molecular testing methods to ensure genetic fidelity is maintained in the regenerants. There remains a key challenge to properly identify the components that will enable the long-term conservation of palms using cryopreservation. This review methodically analyzes the state-of-the-art cryopreservation techniques developed for palms and places them within a practical framework. This framework encompasses four underlying components, namely the tissue culture approaches required, the recalcitrant nature of the palm seed, the cryobiology and cryogenic techniques required, and fidelity assessment after cryopreservation. Through a critical analysis of this framework, further optimization of palm cryopreservation protocols and more fundamental studies on the physiological and molecular changes in cryopreserved palm tissues are recommended. The present review helps to showcase a multi-decade global attempt to preserve these mostly recalcitrant species through ex situ collections. From a conservationist’s perspective, this review hopes to stimulate awareness for further concerted efforts in the conservation of rare and endangered plant families. Meanwhile, from a managerial perspective, this work serves to inform decision-makers of the global research effort underway to improve key components of the cryopreservation program for palm species and to encourage funding bodies to appropriately allocate resources to these much-needed research areas.
Energy Consumption and Greenhouse Gas Emissions of High-Carbon Ferrochrome Production
Authors: Wei Wenjing , Samuelsson Peter B. , Jönsson Pär G. , Gyllenram Rutger , Glaser Björn
Published: March 2023

This work presents a process model developed based on mass and energy conservation to assess high carbon ferrochrome production from cradle to gate through four supply routes: (1) a conventional submerged arc furnace (SAF), (2) a closed submerged arc furnace with preheating (CSAF+PH), (3) a closed submerged arc furnace with 60% prereduction (CSAF+PR60%) and (4) a direct-current arc furnace (DCAF). The energy requirements are between 40 and 59 GJ/t FeCr (74–111 GJ/t Cr), and the greenhouse gas (GHG) emissions range between 1.8 and 5.5 tCO2-eq/t FeCr (3.3–10.3 tCO2-eq/t Cr). The upgrading of coal-powered SAF process to a closed furnace CSAF+PH and CSAF+PR60% contributes to an emission reduction of 23% and 18%, respectively. Moreover, the use of hydro-powered electricity leads to a further emission reduction of 68% and 47%, respectively. For CSAF+PR process, the GHG emissions can be reduced by 14% when increasing the pre-reduction ratio from 30% to 80% and decreased by 10% when charging hotter feed from 100 °C to 1000 °C. The proposed process model is feasible in generating site-specific inventory data and allowing for parameter studies as well as supporting companies to improve the transparency of the environmental performance in the FeCr value chain.
Nurturing Italian Geo-palaeontological Heritage with Virtual Palaeontology: Preliminary Report of Its Application in Two Natural History Museums
Authors: Bartolini-Lucenti Saverio , Rook Lorenzo
Published: March 2023

In this manuscript, we present a preliminary report on the use of virtual palaeontology methodologies in two natural history museums in central Italy, the Geology and Paleontology Museum of Florence and the Civic Museum of Natural Sciences of Faenza. Despite the differences between the museums (in terms of history, type and size of the collections, etc.), the use of surface and computed tomography (CT) scans has allowed the acquisition of a consistent amount of data to create digital copies of selected specimens and to plan several future projects sparked from the use of these methodologies. Our first step focused on the selection of the scanning sample: type and historically relevant specimen in the case of the Florence museum, and fragile and relevant specimens for the Faenza museum from a local yet internationally known site, Cava Monticino, dated to the Late Miocene. The scanning techniques included the use of three high-resolution scanners, with different specifications, to acquire surface data and a medical scanner to obtain CT scans. The outputs of the surface scans were excellent digital copies of the specimens, whereas tomography allowed the first investigations and visualisations of the presence of embedded bones in the fossiliferous blocks of Cava Monticino. The resulting 3D and raw data represent invaluable resources that the two museums are currently planning to implement in their exhibitions using digital visualisation devices and techniques (e.g. AR web apps, touchscreens) or 3D-printed touchable specimens.
Gezondheidsbevordering bij mensen met een psychische aandoening en/of licht verstandelijke beperking vraagt visie, scholing en samenwerking van sociaal werkers en verpleegkundigen
Authors: Brunekreeft-Budding Arina , van den Berg-van Haaften Gerda , Oversluizen-van Rijn Nellie , Noordegraaf Martine , Kroeze Willemieke
Published: March 2023

Samenvatting

Het belang van gezondheidsbevordering bij mensen met een psychische aandoening en/of een licht verstandelijke beperking in de langdurige zorg is groot. De sociaal werker en verpleegkundige hebben beiden een rol in gezondheidsbevordering bij deze doelgroep. Uit praktijksignalen blijkt dat professionals hierin knelpunten ervaren. Literatuuronderzoek naar deze knelpunten leverde geen resultaten op. Om te onderzoeken welke knelpunten professionals tegenkomen in het werken aan gezondheidsbevordering in de ambulante setting, is aan de hand van zes interviews een verkennend kwalitatief onderzoek uitgevoerd. De resultaten geven inzicht in persoonlijke en omgevingsfactoren die een rol spelen, in het spanningsveld dat professionals ervaren tussen eigen regie en professionele verantwoordelijkheid, in de wisselende aandacht die gezondheidsbevordering krijgt vanuit de organisatie en in de begeleiding van de professionals. In het algemeen wordt gezondheidsbevordering gerelateerd aan fysieke gezondheid, wat vragen oproept over de kennis over gezondheidsbevordering en de (brede) visie op gezondheid. Ook geeft het onderzoek inzicht in de knelpunten die in de samenwerking worden ervaren, onder andere de uitdaging om als professional aan de juiste informatie te komen, het geringe contact met andere disciplines en het samenwerken binnen de versnipperde financieringsstructuren. Dit verkennende onderzoek geeft het signaal dat meer praktijkgericht onderzoek naar gezondheidsbevordering bij deze doelgroep nodig is.
Hydrogeochemical characterization of groundwater resources in Wadi Araba Basin, Southern Jordan
Authors: El-Naqa Ali , Al Adas Amani Abu
Published: March 2023

Groundwater quality is an important factor that determines its usage for drinking and irrigational use. This study was carried out along the quaternary alluvial aquifer which extends along Wadi Araba groundwater basins, in southern Jordan. Chemical and physical parameters were measured and analyzed for thirty-seven groundwater samples collected from twenty-one wells in the study area during two periods in the year 2019; the spring season (April–May) was represented by fourteen samples and the autumn season (August–September) represented by twenty-three samples were collected to determine its suitability for drinking and irrigational purposes. The groundwater in the study area is generally of low alkalinity with an average pH value of less than 8 for both spring and autumn seasons. The water of the area is excessively mineralized due to salinity, and the increase in water salinity of the southern Wadi Araba basin is less expressed than in the northern part. The hydrochemical characterization shows that most wells of the study area are characterized by HCO3–Ca–Mg and HCO3–SO4–Ca–Mg types in the eastern escarpments of Wadi Araba (i.e., recharge area) and Cl–SO4–Na and Cl–Na types in the discharge area. There is no substantial change in the hydrochemical composition during the two seasons. Based on the Piper diagram, most of the groundwater samples (91.8%) belong to class “E” as “earth alkaline water with increased portions of alkalis with prevailing sulfate and chloride.” The Durov diagram reveals that most groundwater samples (62.2%) lay in the water genesis “field 6” which indicates that the water may be related to the reverse ion exchange of Na–Cl. The chemical composition of the water samples was compared with the drinking water standards of the World Health Organization and the Jordanian Standard. Groundwater from this area was not suitable to be a source for direct drinking based on total hardness and total dissolved solids. The dominant cation is sodium, while the dominant anion is chloride. The calculations of saturation indices for the two sampling campaigns for different minerals showed negative values of (SI) for carbonates minerals (anhydrite, gypsum, sylvite, and halite). This suggests that the groundwater in the alluvial aquifer is undersaturated with respect to these minerals in most of the study area. This is indicative of the fact that these minerals are undergoing the process of dissolution. The mineral saturation indices suggest that the dominating hydrochemical processes were dissolutions of evaporite minerals (halite and gypsum), carbonate minerals (such as calcite, dolomite, and rhodochrosite), the manganese oxide minerals (such as jarosite-K, hausmannite, pyrochroite, and pyrolusite) and reverse ion exchange.
Feasibility of Integrating Bimetallic Au-Ag Non-Alloys Nanoparticles Embedded in Reduced Graphene Oxide Photodetector
Authors: Rohizat Nurul Syazwani , Mohamad Ismail Muhammad Nur Syafiq , Ahmad Fahri Muhammad Aiman Saufi , Tan Chee Leong , Zakaria Rozalina
Published: March 2023

To coordinate the resonant wavelength of the plasmonic nanoparticles (NPs), the emission band of the reduced graphene oxide (rGO) photodetector at the NIR-region is crucial for the optimal plasmon-enhanced luminescence in the device. In contrast to monometallic NPs, where limits the dimensions and extended resonant wavelength, we integrated an Au-Ag bimetallic NPs (BMNPs) to enable resonance tuning at the longer wavelength at the excitation source of 785 nm. These features showed an increase in radiative recombination rates as well as the quantum yield efficiency of the device. The BMNPs were produced from the dewetting process of 600 °C and 500 °C, both at 1 min after the deposition thickness layer of Au (8 nm) and Ag (10 nm) on the Si substrate using the electron-beam evaporation process. Our BMNPs-rGO photodetector exhibited the responsivity of 2.25 · A W−1, Jones of specific detectivity of 2.45×1011Jones, and external quantum efficiency (EQE) of 356%. The rise time and fall time for the photodetector were 32 ns and 186 ns, respectively. This work provided an essential information to enable the versatile plasmon-enhanced application in 2-dimensional (2D) material optoelectronic devices.
Influence of the WAAM process and design aspects on residual stresses in high-strength structural steels
Authors: Wandtke K. , Schroepfer D. , Scharf-Wildenhain R. , Haelsig A. , Kannengiesser T. , Kromm A. , Hensel J.
Published: March 2023

Wire arc additive manufacturing (WAAM) enables the efficient production of weight-optimized modern engineering structures. Further increases in efficiency can be achieved by using high-strength structural steels. Commercial welding consumables for WAAM are already available on the market. Lack of knowledge and guidelines regarding welding residual stress and component safety during production and operation leads to severely limited use for industry applications. The sensitive microstructure of high-strength steels carries a high risk of cold cracking; therefore, residual stresses play a crucial role. For this reason, the influences of the material, the WAAM process, and the design on the formation of residual stresses and the risk of cold cracking are being investigated. The material used has a yield strength of over 800 MPa. This strength is adjusted via solid solution strengthening and a martensitic phase transformation. The volume expansion associated with martensite formation has a significant influence on the residual stresses. The focus of the present investigation is on the additive welding parameters and component design on their influence on hardness and residual stresses, which are analyzed by means of X-ray diffraction (XRD). Reference specimens (hollow cuboids) are welded fully automated with a systematic variation of heat control and design. Welding parameters and AM geometry are correlated with the resulting microstructure, hardness, and residual stress state. Increased heat input leads to lower tensile residual stresses which causes unfavorable microstructure and mechanical properties. The component design affects heat dissipation conditions and the intensity of restraint during welding and has a significant influence on the residual stress.
Synergy between ketamine and ketogenic diet in anorexia nervosa, and other neurobehavioral disorders
Authors: Scolnick Barbara , Beckwith Caroline
Published: March 2023

Through serendipity, we observed an apparent synergy between adopting a ketogenic diet and receiving ketamine infusions that led to complete and durable remission in two patients with chronic enduring anorexia nervosa. Both patients had struggled with the disorder for over a decade. We offer a hypothesis, based on glutamate to explain this synergy, and hope it stimulates further research.
Review of the evolution and prevention of friction, wear, and noise for water-lubricated bearings used in ships
Authors: Zhang Zhuo , Ouyang Wu , Liang Xingxin , Yan Xinping , Yuan Chengqin , Zhou Xincong , Guo Zhiwei , Dong Conglin , Liu Zhenglin , Jin Yong , Xiao Jinhua
Published: March 2023

With the development of green tribology in the shipping industry, the application of water lubrication gradually replaces oil lubrication in stern bearings and thrust bearings. In terms of large-scale and high-speed ships, water-lubricated bearings with high performance are more strictly required. However, due to the lubricating medium, water-lubricated bearings have many problems such as friction, wear, vibration, noise, etc. This review focuses on the performance of marine water-lubricated bearings and their failure prevention mechanism. Furthermore, the research of marine water-lubricated bearings is reviewed by discussing its lubrication principle, test technology, friction and wear mechanism, and friction noise generation mechanism. The performance enhancement methods have been overviewed from structure optimization and material modification. Finally, the potential problems and the perspective of water-lubricated bearings are given in detail.
Professional Identity and Motivation for Medical School in First-Year Medical Students: A Cross-sectional Study
Authors: Faihs Valentina , Heininger Susanne , McLennan Stuart , Gartmeier Martin , Berberat Pascal O. , Wijnen-Meijer Marjo
Published: March 2023

Background

Professional identity formation (PIF) is a life-long process, starting even before professional education. High levels of motivation for medical school are essential for effective learning and academic success. Both are key factors in future physicians’ professional and personal development, and according to self-determination theory, professional identity (PI) and students’ levels of motivation could be closely linked. Therefore, we sought to investigate whether PI and strength of motivation for medical school are associated in new medical students.

Methods

In a cross-sectional survey, all new medical students in Munich, Germany, were asked to complete the Macleod Clark Professional Identity Scale (MCPIS-9) and the Strength of Motivation for Medical School-Revised questionnaire (SMMS-R) as well as to provide information about age, gender, and waiting time before starting medical school.

Results

Eight hundred eleven out of 918 new medical students participated in the survey. A positive correlation between the MCPIS-9 and the SMMS-R (p < 0.001) was found. Female students showed higher scores in the SMMS-R (p < 0.05) and the SMMS-R-subscale Readiness to Start (p < 0.001). The amount of waiting semesters showed a positive correlation with the total SMMS-R score (p < 0.01) as well as with the subscales Readiness to Start and Persistence (both p < 0.001).

Discussion

We found an association between PI and strength of motivation for medical school in a large cohort of new medical students. Female gender and more waiting semesters were associated with higher levels of self-perceived motivation and higher scores on the SMMS-R-subscale Readiness to Start. More research is needed to better understand this topic to further improve medical education.
Design and Performance Study of an Ultrasonic Bone Scalpel with Composite Horn Structure
Authors: Wu Jieping , Yang Yong , Yang Zhao , Chen Cong , Huang Shuai
Published: March 2023

The ultrasonic bone scalpel was often used in all kinds of clinical orthopedic surgery as a new type of medical instrument. Based on the working theory of the ultrasonic bone scalpel and combined with the design method of a quarter wavelength transducer and horn, this study proposed an optimization design method for the ultrasonic bone scalpel with a composite horn structure. The structure of the ultrasonic bone scalpel was simplified, and its length was shortened. Finite element analysis, modal analysis, and harmonic response analysis were used to optimize the design of the ultrasonic bone scalpel. The performance of the ultrasonic bone scalpel was explored through impedance analysis, amplitude measurement, temperature measurement, and cutting tests, and the feasibility of the design was verified through torque analysis. The results showed that when the torque force was 4.0 N, the resonance frequency of the ultrasonic bone scalpel was 30,540 Hz, and the maximum amplitude of the ultrasonic bone scalpel could reach 62 μm. After spray cooling, the maximum surface temperature of the rear end cover was reduced from 51.8 to 36.3 ℃, the maximum surface temperature of the composite horn was reduced from 71 to 45.3 ℃, and the maximum surface temperature of the cutter head was reduced from 101 to 46.1 ℃, demonstrating a good cooling effect. Under 89 Voltage, the optimal cutting force for cutting chicken leg bones was 0.1 N, the optimal cutting force for cutting pork ribs was 0.3 N, and the cutting process showed tissue selectivity.
Interaction of the fundamental frequencies of a torsional cantilever nanobeam and spring mass system single degree of freedom (SDOF) under axial load, including buckling
Authors: Moutlana Malesela K. , Adali Sarp
Published: March 2023

In this study we present the interactions of the fundamental frequencies of a nanomanufacturing coupled system by exploring the natural frequencies of the subsystems. These nanomanufacturing subsystems function in concert, e.g., a cantilever beam with spring-mass. The individual subsystems are studied under free vibration to generate the natural and buckling frequencies. These subsystems, when under free vibration, generate unique local natural frequencies that interact to form a unique global natural frequency. This allows for greater control and improved sensitivity for scanning and shaping nano surfaces, by allowing selective variation of the local frequency of one system to influence the global system frequencies. In this investigation, a nanobeam with arbitrary boundary conditions is used to model the system and the effects on the parameters of interest are studied. Euler–Bernoulli theory is applied in conjunction with Eringen’s theory of nonlocal continuum theory to model the small-scale effects due to the size of the beam under consideration. The coupled equations are solved using separation of variables for the local and global frequencies. The nanobeam is restrained with an adjustable torsional spring and pin at one end. The boundary condition at the free end is a spring-mass system with axial load. Altering the torsional, transverse spring stiffness and mass increases or decreases the natural frequencies. The motions of the beam and the tip-mass generates a frequency response during contact interactions. The tip response frequency is used to determine the maximum displacements (penetration depth) and accelerations (contact forces) in a sample during nanomanufacturing.
Development of a multiphase perfusion model for biomimetic reduced-order dense tumors
Authors: Akash Mohammad Mehedi Hasan , Chakraborty Nilotpal , Mohammad Jiyan , Reindl Katie , Basu Saikat
Published: March 2023

Dense fibrous extracellular constitution of solid tumors exerts high resistance to diffusive transport into it; additionally, the scarcity of blood and lymphatic flows hinders convection. The complexity of fluidic transport mechanisms in such tumor environments still presents open questions with translational end goals. For example, clinical diagnosis and targeted drug delivery platforms for such dense tumors can ideally benefit from a quantitative framework on plasma uptake into the tumor. In this study, we present a computational model for physical parameters that may influence blood percolation and penetration into simple biomimetic solid tumor geometry. The model implements three-phase viscous-laminar transient simulation to mimic the transport physics inside a tumor-adhering blood vessel and measures the constituent volume fractions of the three considered phases, viz. plasma, RBCs (red blood cells, also known as “erythrocytes”), and WBCs (white blood cells, also known as “leukocytes”) at three different flow times, while simultaneously recording the plasma pressure and velocity at the entry point to the tumor’s extracellular space. Subsequently, to quantify plasma perfusion within the tumor zone, we proposed a reduced-order two-dimensional transport model for the tumor entry zone and its extracellular space for three different fenestra diameters: 0.1, 0.3, and 0.5 µm; the simulations were two-phase viscous-laminar transient. The findings support the hypothesis that plasma percolation into the tumor is proportional to the leakiness modulated by the size of fenestra openings, and the rate of percolation decays with the diffusion distance.
The SOFM-based city-type identification and scan of 231 cities in the APEC region
Authors: Zhu Li , Wang Chen
Published: March 2023

Cities play an important role in global and regional sustainable development, which has led to the focus of research and assessment work. In this paper, our work extends the focus on city centers and the areas that support their operation. The method applies the Self-organizing feature map (SOFM), and city natural environment and development indicators are used to identify 231 APEC (Asia–Pacific Economic Cooperation) cities due to the critical influence of APEC cities on the global economy and sustainable development. Nine city types were obtained. This work, which looks at the achievements of the region's rapid development, shows that the performance of cities in emerging economies reflecting city per capita and efficiency indicators still needs to be further improved, even for international metropolises. In the global efforts to achieve the development goals of the SDGs, the methods and results of APEC city-type identification can provide the basis and inspiration for more work and help to build a widely connected knowledge network.
How do taxi usage patterns vary and why? A dynamic spatiotemporal analysis in Beijing
Authors: Wang Jiaoe , Du Fangye , Huang Jie , Liu Yu
Published: March 2023

Existing studies lack attention to taxi usage dynamics, considering its trip proportion over other travel modes and its influencing factors at fine spatiotemporal resolutions. To fill these gaps, we propose a method for examining taxi usage in a grid of 1 km × 1 km cells per hour during a one-day cycle in Beijing. This method measures the differences between taxi trips from taxi trajectory data and mobile signaling data in the same week in January 2017. To explain the spatiotemporal variation in taxi usage, multiple linear models were used to investigate taxi usage dynamics with alternative transport modes, socioeconomic factors, and built environments. In summary, this study proposes to develop an indicator to measure taxi usage using multiple data sources. We confirm that taxi usage dynamics exist in both temporal and spatial dimensions. In addition, the effects of taxi usage factors vary over each hour in a one-day cycle. These findings are useful for urban planning and transport management, in which the dynamic interactions between taxi demand and distribution of facilities should be included.
Dexmedetomidine infusion in the management of acute ischemic stroke undergoing endovascular recanalization: a retrospective observational study
Authors: Vincenzo Pota , Francesco Coletta , Crescenzo Sala , Antonio Tomasello , Francesco Coppolino , Vittoria Iorio , Maurizio Del Prete , Pasquale Sansone , Beatrice Passavanti Maria , Romolo Villani , Caterina Pace Maria
Published: March 2023

Background and purpose

Stroke is defined as a sudden onset of a neurological deficit caused by an acute focal injury to the central nervous system due to a vascular cause. It represents the second leading cause of death, the third leading cause of disability worldwide and the primary cause of disability in the elderly. Ischemic strokes are the most common (≈85%), the rest (≈15%) are hemorrhagic strokes, that include cerebral and subarachnoid. One of the commonly procedure used in patients with large-vessel occlusion is intra-arterial (IA) recanalization. Moderate conscious sedation (CS) and general anesthesia (GA) with intubation are the most used anesthesia techniques for patients with acute ischemic stroke undergoing endovascular recanalization.

Methods

In this retrospective observational study, we analyzed data of registry before and after we have changed our sedation protocol from remifentanil/propofol (P/R group) infusion in total intravenous anesthesia (TIVA) to intravenous infusion of dexmedetomidine alone (D group). The primary endpoint was to determine the rate of conversion from CS to GA for each group. The secondary outcomes were the incidence of complications (bradycardia, hypotension, tachycardia, hypertension).

Results and conclusion

12 patients in P/R group need the conversion from CS to GA while only 5 patients in D group. There weren't significant differences between the 2 groups respect to heart rate (HR), peripheral oxygen saturation (SpO2) during the procedure, for the good neurological outcome (mRS score < 3, p > .05) and NIHSS score after 48 h (p > .05). There were several organizational and economic advantages with the conscious sedation procedure, such as reduction of occupation time in the operating room and reduction of postoperative Intensive Care Unit (ICU) stay.
Use of expert consensus to develop a shared list of procedures with potential for aerosol generation during the coronavirus disease 2019 (COVID-19) pandemic
Authors: Pepe Dana E. , Mehrotra Preeti , Bruno-Murtha Lou Ann , Colgrove Robert , Doron Shira , Duncan Robert , Ellison Richard , Haessler Sarah , Hooper David C. , Klompas Michael , Pierre Cassandra M. , Sandora Thomas J. , Shenoy Erica S. , Wright Sharon B.
Published: March 2023

The coronavirus disease 2019 (COVID-19) pandemic highlighted the lack of agreement regarding the definition of aerosol-generating procedures and potential risk to healthcare personnel. We convened a group of Massachusetts healthcare epidemiologists to develop consensus through expert opinion in an area where broader guidance was lacking at the time.
Pekin ducks are motivated to lay in their preferred nest substrate
Authors: Barrett Lorelle , Maloney Shane K , Blache Dominique
Published: March 2023

Nest design is one factor contributing to floor-laying in farmed poultry. We investigated: (i) if ducks (Anas platyrhynchos) prefer a particular nest substrate; and (ii) how important that preference is to them, indicated by stress-induced hyperthermia, egg albumen corticosterone, and behaviour. Twelve female ducks that were trained in a push-door task had temperature data loggers implanted. Preference testing identified the most and least preferred nest substrates between sawdust, astroturf, and hemp fibres. A behavioural demand test then required the ducks to use push-doors to access nests containing either the most or least preferred substrate. The preferred substrate door was loaded with increasing weight (0–120% of bodyweight, four nights per workload) and eventually blocked to prevent nest access. The least preferred substrate door remained unweighted. The overall rank order of substrate preferences was sawdust > hemp > astroturf. Six of the 12 birds pushed all workloads and attempted to push the blocked door. The area under the curve (AUC) of hyperthermia was larger when the preferred substrate door was blocked compared with 0%. The AUC did not differ between nights 2–4 of the blocked door compared with night 1. Egg albumen corticosterone was unaffected. We conclude that laying Pekin ducks prefer manipulatable nest substrates and accessing one is important enough to pay a cost. The results indicate that a manipulatable substrate should be provided to commercially farmed nesting ducks.
The March on Rome revisited. Silences, historians and the power of the counter-factual
Authors: Foot John
Published: March 2023

This historiographical article will argue that the March on Rome (October–November 1922) was the end point of a serious and at that point unique insurrectionary project, which followed three intense years of Fascist violence (where the state had rarely if ever taken on the Fascists, and had often colluded passively or actively with them). It was accompanied by violence and constant threats of further violence, in Rome and across Italy. It was in no way a bluff – but also stood as a warning to all those who still imagined that Fascism could be opposed, on the streets, in parliament, or at the ballot box. The violence hit bystanders, but was also targeted at the private homes of communists, socialists and hated liberals, and at centres of urban resistance in Rome itself. This article will look in detail at the ways historians have understood the March on Rome, and systematically removed the violence from that event, ignored the March itself and played down the role of thesquadristi. It will also look at the powerful role of a ‘what if’ counter-factual which has dominated most accounts of the March on Rome to date, with some recent exceptions.
Exploration of possible sex bias in acute social stress research: a semi-systematic review
Authors: Rrapaj Artemida , Landau Anne M. , Winterdahl Michael
Published: March 2023

Stress can have a significant impact on the daily lives of individuals and can increase vulnerability to a number of medical conditions. This study aims to estimate the ratio of male to female participants in acute social stress research in healthy individuals. We examined original research articles published over the last 20 years. Each article was screened to determine the total number of female and male participants. We extracted data from 124 articles involving a total of 9539 participants. A total of 4221 (44.2%) participants were female, 5056 (53.0%) were male and 262 (2.7%) were unreported. Articles incorporating only females were significantly underrepresented compared to articles incorporating only males. Forty articles (63.5%) which presented data from both females and males, failed to analyse and interpret the results by sex, a significant methodological limitation. In conclusion, in the literature published over the last 20 years, female participants are significantly underrepresented. In the studies where females are represented, severe methodological limitations are apparent. Researchers should be conscious of sexual dimorphism, menstrual phase and use of hormonal contraception, which may impact the interpretation of their results.
Expanding our thinking about discrete emotions and politics
Authors: Redlawsk David P.
Published: March 2023

In recent decades, political psychologists have given a lot of attention to the role of emotions in politics. While there have been several different research programs, the dominant paradigm has been set by affective intelligence theory (AIT), developed by George Marcus, Russell Neuman, and Michael Mackuen. AIT has helped explain many puzzles in understanding how emotions influence political decisions, as any good paradigm should. At the same time, I argue it has also had the effect of limiting broader research into the range of discrete emotions, especially contempt. While recognizing the value of AIT, I call for more research that goes beyond its boundaries, showing through several recent studies how a focus on the additional effects of contempt can improve our understanding of voter decision-making.
Aircraft program motion along a predetermined trajectory Part 1. Mathematical modelling
Authors: Blajer W. , Parczewski J.
Published: March 2023

A mathematical model is presented of the aircraft program flight along a predetermined trajectory, with or without a specified speed history. Moreover, the aircraft is constrained to coordinated turns, which implies zero value of sideslip angle. The final equations of program motion are derived as a set of differential/algebraic equations. The aircraft control input ensuring the exact realisation of program constraints results from the transient dynamic solution of the equations of program motion. A simple numerical illustration is included.
Aircraft program motion along a predetermined trajectory Part II. Numerical simulation with application of spline functions to trajectory definitions
Authors: Blajer W.
Published: March 2023

Aspects of numerical simulation of aircraft program flight along a predetermined trajectory are presented. An emphasis is laid on the problem of describing the required trajectory by means of a succession of defined points. A spline function method is used for interpolation and smoothing routines. Some numerical illustrations of aircraft trajectory flight simulation (only planar motion) are demonstrated and discussed.