bluuebunny/crossref_metadata_2025 huggingface dataset:
Attention feature fusion methodology with additional constraint for ovarian lesion diagnosis on magnetic resonance images
Authors: Wang Shuai , Xu Xiaojuan , Du Huiqian , Chen Yan , Mei Wenbo
Published: August 2022

Purpose

It is challenging for radiologists and gynecologists to identify the type of ovarian lesions by reading magnetic resonance (MR) images. Recently developed convolutional neural networks (CNNs) have made great progress in computer vision, but their architectures still need modification if they are used in processing medical images. This study aims to improve the feature extraction capability of CNNs, thus promoting the diagnostic performance in discriminating between benign and malignant ovarian lesions.

Methods

We introduce a feature fusion architecture and insert the attention models in the neural network. The features extracted from different middle layers are integrated with reoptimized spatial and channel weights. We add a loss function to constrain the additional probability vector generated from the integrated features, thus guiding the middle layers to emphasize useful information. We analyzed 159 lesions imaged by dynamic contrast‐enhanced MR imaging (DCE‐MRI), including 73 benign lesions and 86 malignant lesions. Senior radiologists selected and labeled the tumor regions based on the pathology reports. Then, the tumor regions were cropped into 7494 nonoverlapping image patches for training and testing. The type of a single tumor was determined by the average probability scores of the image patches belonging to it.

Results

We implemented fivefold cross‐validation to characterize our proposed method, and the distribution of performance matrics was reported. For all the test image patches, the average accuracy of our method is 70.5% with an average area under the curve (AUC) of 0.785, while the baseline is 69.4% and 0.773, and for the diagnosis of single tumors, our model achieved an average accuracy of 82.4% and average AUC of 0.916, which were better than the baseline (81.8% and 0.899). Moreover, we evaluated the performance of our proposed method utilizing different CNN backbones and different attention mechanisms.

Conclusions

The texture features extracted from different middle layers are crucial for ovarian lesion diagnosis. Our proposed method can enhance the feature extraction capabilities of different layers of the network, thereby improving diagnostic performance.
Association of medial gastrocnemius adiposity with poststroke severe malnutrition and functional performance of activities of daily living in older patients: A prospective analysis
Authors: Shimizu Akio , Nozoe Masafumi , Ohno Tomohisa , Nomoto Akiko , Shigematsu Takashi , Fujishima Ichiro
Published: August 2022

Background

Relationships among medial gastrocnemius intramuscular adipose tissue, nutrition status, and functional outcomes of patients after a stroke are unknown. This study was conducted to determine the relationship between nutrition status and gastrocnemius intramuscular adipose tissue and whether medial gastrocnemius intramuscular adipose tissue affects functional outcomes of older patients after a stroke.

Methods

This prospective cohort study included 217 patients with stroke. Nutrition status was evaluated by the Global Leadership Initiative on Malnutrition. The medial gastrocnemius intramuscular adipose tissue was assessed using ultrasound echographic intensity. Multivariate linear regression analysis was used to determine the relationship between nutrition status at admission and medial gastrocnemius intramuscular adipose tissue. Furthermore, we examined the influence of medial gastrocnemius intramuscular adipose tissue on the Functional Independence Measure (FIM)–motor score at discharge and FIM‐motor efficiency, which indicates FIM‐motor changes during the hospital stay.

Results

Severe malnutrition had a positive influence on medial gastrocnemius intramuscular adipose tissue on the nonparalyzed side (β = 0.175; P = 0.044). Additionally, the medial gastrocnemius intramuscular adipose tissue on the nonparalyzed side was negatively correlated with the FIM‐motor score at discharge (β = −0.102; P = 0.005) and FIM‐motor efficiency (β = −0.273; P = 0.005).

Conclusions

This study clarified the factors that contribute to a higher medial gastrocnemius intramuscular adipose tissue content on the nonparalyzed side and the effect of the higher adipose tissue content on functional outcomes.
Low Tucker rank tensor completion using a symmetric block coordinate descent method
Authors: Yu Quan , Zhang Xinzhen , Chen Yannan , Qi Liqun
Published: August 2022

Low Tucker rank tensor completion has wide applications in science and engineering. Many existing approaches dealt with the Tucker rank by unfolding matrix rank. However, unfolding a tensor to a matrix would destroy the data's original multi‐way structure, resulting in vital information loss and degraded performance. In this article, we establish a relationship between the Tucker ranks and the ranks of the factor matrices in Tucker decomposition. Then, we reformulate the low Tucker rank tensor completion problem as a multilinear low rank matrix completion problem. For the reformulated problem, a symmetric block coordinate descent method is customized. For each matrix rank minimization subproblem, the classical truncated nuclear norm minimization is adopted. Furthermore, temporal characteristics in image and video data are introduced to such a model, which benefits the performance of the method. Numerical simulations illustrate the efficiency of our proposed models and methods.
Exploration of novel fiber‐metal laminates sandwich structures with cellulosic ramie woven core
Authors: Ng Lin Feng , Yahya Mohd Yazid , Mustafa Zaleha
Published: August 2022

The ever‐growing use of eco‐friendly cellulosic fibers in composite materials has triggered the interest in adopting such fibers in fiber‐metal laminates. Ramie is one of the cellulosic fibers that show high mechanical strength and stiffness. This work aims to explore the feasibility of encapsulating woven ramie core in fiber‐metal laminates. The sandwich laminates and composites were fabricated using the hot molding compression method. Tensile, flexural, Charpy impact and quasi‐static indentation tests were carried out to identify the mechanical performance of fiber‐metal laminates based on woven ramie core. Meanwhile, the mechanical tests were also performed on the composite laminates and woven ramie fabrics for comparison purposes. Based on the findings obtained, ramie fiber‐reinforced metal laminates exhibited eminent absolute and specific mechanical properties compared to their associated ramie fabrics and ramie fiber‐based composites. The specific tensile strength of metal laminates is 3.80% and 50.56% higher than that of ramie fabrics and composite laminates. It was also found that the specific flexural and impact strengths of metal laminates are 70.02% and 89.12%, respectively, greater than those of composite laminates. In terms of quasi‐static indentation, metal laminates displayed specific energy absorption of 35.25 J/g/cm3, which is 388.23% greater than composite laminates. These findings corroborated the addition of aluminum skin layers provided the laminated structures with superior absolute and specific mechanical properties. Thus they could be an alternative material to be used in transportation sectors to improve energy efficiency and mechanical performance.
High performance optical and electrical properties of zinc oxide reinforced poly(diphenylamine) nanocomposites for optoelectronic applications
Authors: Furhan  , Ramesan Manammel Thankappan
Published: August 2022

Polymer nanocomposites with good optical, crystalline, morphological, thermal, dielectric, and electrical properties were synthesized using poly(diphenylamine) (PDPA) and zinc oxide (ZnO) nanoparticles. The redshift in the UV absorption edges of composites indicates that ZnO nanoparticles have been successfully incorporated into the PDPA matrix. The lowest optical bandgap energy and maximum refractive indices were observed in 7 wt% loadings. The narrowing of the avearge chain spacing detected by X‐ray diffraction (XRD) proved that ZnO had an impact on the structure of PDPA. Scanning electron microscopy (SEM) images show homogeneous dispersion of spherically shaped ZnO nanoparticles at lower filler loadings. The glass transition temperature of the nanocomposites was greatly enhanced with the addition of nanoparticles analyzed by differential scanning calorimetry. The electrical and dielectric properties improved with temperature and nanoparticle loadings up to 7 wt%. The analysis of impedance spectra and the decreasing radius of semi‐circular arcs in the Nyquist plot manifests the existence of temperature‐dependent conductivity and relaxation phenomenon. The experimental values of DC conductivities were correlated with different theoretical conductivity models and the McCullough model was found to be the most promising one to explain the increased DC conductivity of the PDPA/ZnO nanocomposites.
Effects of molecular weight and annealing conditions on the essential work of fracture of polycarbonate
Authors: Nishitsuji Shotaro , Sato Toshiki , Ishikawa Masaru , Inoue Takashi , Ito Hiroshi
Published: August 2022

The effects of annealing conditions and molecular weight on the energies required for cracking and plastic deformation were investigated by the essential work of fracture (EWF) method. We found that the energy required for plastic deformation, βwp, regardless of the molecular weight, decreased upon annealing, and the energy required for cracking, we, did not change. On the basis of these results, it is suggested that annealing affects βwp because the density fluctuation is amplified by annealing, and as a result, the strain in the plastic region is concentrated. Moreover, both βwp and we increased with the molecular weight because the increase of molecular weight increases the number of entanglements formed by a molecular chain. In addition, comparing the values of the J‐integral (Jc), we found that we obtained from the EWF and Jc was almost the same, indicating that we obtained from the EWF also involves the energy required for plastic deformation when the deformation around the notch changes from biaxial stretching to uniaxial stretching.
Commercialization of microcavity plasma devices and arrays: Systems for VUV photolithography and nanopatterning, disinfection of drinking water and air, and biofilm deactivation for medical therapeutics
Authors: Kim Jinhong , Mironov Andrey E. , Cho Jin H. , Sievers Dane S. , Herring Cyrus M. , Park Sehyun , Sun Peter P. , Liang Zhihu , Chen Wenyuan , Park Sung‐Jin , Eden J. Gary
Published: August 2022

A little more than two decades after the introduction of the first microcavity plasma devices, a growing body of commercial products based on the remarkable properties of these low‐temperature, atmospheric plasmas is now available. Following a brief review of early microplasma lamp development, this article describes microplasma‐based devices and systems currently being manufactured for applications in photolithography, photopatterning, and other nanofabrication processes, such as atomic layer deposition, spectroscopic identification and analysis of materials (including wide bandgap crystals), the disinfection of drinking water in off‐grid communities, deactivating COVID‐19 and other pathogens in air and on surfaces in public spaces, and vacuum ultraviolet lamps for driving atomic clocks. The microplasma‐based treatment of otitis media in the human ear will also be discussed.
Development of in vivo HDX‐MS with applications to a TonB‐dependent transporter and other proteins
Authors: Lin Xiaoxuan , Zmyslowski Adam M. , Gagnon Isabelle A. , Nakamoto Robert K. , Sosnick Tobin R.
Published: August 2022

Hydrogen‐deuterium exchange mass spectrometry (HDX‐MS) is a powerful tool that monitors protein dynamics in solution. However, the reversible nature of HDX labels has largely limited the application to in vitro systems. Here, we describe a protocol for measuring HDX‐MS in living Escherichia coli cells applied to BtuB, a TonB‐dependent transporter found in outer membranes (OMs). BtuB is a convenient and biologically interesting system for testing in vivo HDX‐MS due to its controllable HDX behavior and large structural rearrangements that occur during the B12 transport cycle. Our previous HDX‐MS study in native OMs provided evidence for B12 binding and breaking of a salt bridge termed the Ionic Lock, an event that leads to the unfolding of the amino terminus. Although purified OMs provide a more native‐like environment than reconstituted systems, disruption of the cell envelope during lysis perturbs the linkage between BtuB and the TonB complex that drives B12 transport. The in vivo HDX response of BtuB's plug domain (BtuBp) to B12 binding corroborates our previous in vitro findings that B12 alone is sufficient to break the Ionic Lock. In addition, we still find no evidence of B12 binding‐induced unfolding in other regions of BtuBp that could enable B12 passage. Our protocol was successful in reporting on the HDX of several endogenous E. coli proteins measured in the same measurement. Our success in performing HDX in live cells opens the possibility for future HDX‐MS studies in a native cellular environment.

IMPORTANCE

We present a protocol for performing in vivo HDX‐MS, focusing on BtuB, a protein whose native membrane environment is believed to be mechanistically important for B12 transport. The in vivo HDX‐MS data corroborate the conclusions from our previous in vitro HDX‐MS study of the allostery initiated by B12 binding. Our success with BtuB and other proteins opens the possibility for performing additional HDX‐MS studies in a native cellular environment.
Introducing a new model based on electronegativity equalization principle for the analysis of the natural bond orbital reactivity in the c‐DFT background
Authors: Sánchez‐Márquez Jesús , Zorrilla Cuenca David , Fernández Núñez Manuel , García Hernández Víctor Jesus
Published: August 2022

Previous studies presented two independent models based on the equalization of electronegativity and on an alternative operative formula for the Fukui function. The current paper presents modifications to these models to obtain a new model for calculating the local energy derivatives (electronic chemical potential, local electronic hardness and local hypersoftness) and density (Fukui and dual descriptor indices) in natural bond orbitals for the study of chemical reactivity from the perspective of these orbitals (local electrophilicity and local maximum charge variation have also been deduced). We have radically changed the way of partitioning the electron density because the atomic model cannot distinguish between bonding and non‐bonding electron pairs, or between electrons with different types of bonds, however, this is possible with the model based on bond orbitals. In this respect, this model is ideal for organic reactions because of their correspondence with Lewis structures, which are simple but very useful for representing reaction mechanisms.
Expanding the calibration range of compound‐specific chlorine isotope analysis by the preparation of a 37Cl‐enriched tetrachloroethylene
Authors: Buchner Daniel , Martin Philipp R. , Scheckenbach Johannes , Kümmel Steffen , Gelman Faina , Haderlein Stefan B.
Published: August 2022

Rationale

The recent development of reliable GC/qMS methods for δ37Cl compound‐specific stable isotope analysis (CSIA) paves the way for dual carbon–chlorine isotope analysis of chlorinated ethenes and thus allows deeper insights into underlying transformation processes/mechanisms. A two‐point calibration is indispensable for the precise and correct conversion of raw data to the international δ37ClSMOC scale. The currently available calibration standards for tetrachloroethylene (PCE) span only a very narrow range from −2.52‰ (EIL2) to +0.29‰ (EIL1), which is considerably smaller than observed δ37Cl isotope enrichment in (bio‐)transformation studies (up to 12‰).

Methods

We describe the preparation and evaluation of a new 37Cl‐enriched PCE standard to avoid bias in δ37Cl CSIA arising from extrapolation beyond the calibration range. The preparation comprised: (i) partial PCE reduction by zero‐valent zinc in a system of PCE, ethanol (initial volume ratio 3/5) and trace amounts of water followed by (ii) liquid–liquid extraction and (iii) a subsequent fractional distillation to purify the 37Cl‐enriched PCE.

Results

The obtained PCE (PCEenriched) showed a purity of 98.8% (mole fraction) and a δ37ClSMOC value of +10.8 ± 0.5‰. The evaluation of an experimental dataset with and without extrapolation showed no significant variation.

Conclusions

The new PCE standard (PCEenriched) expands the calibration range to 13.3‰ (previously 2.8‰) and thus prevents potential bias introduced by extrapolation beyond the calibration range.
Controllable States and Porosity of Cu‐Carbon for CO2 Electroreduction to Hydrocarbons
Authors: Wang Jing , Chen Yangshen , Zhang Shishi , Yang Chao , Zhang Jun‐Ye , Su Yaqiong , Zheng Gengfeng , Fang Xiaosheng
Published: August 2022

The electrocatalytic carbon dioxide reduction reaction (CO2RR) to value‐added chemical products is an effective strategy for both greenhouse effect mitigation and high‐density energy storage. However, controllable manipulation of the oxidation state and porous structure of Cu‐carbon based catalysts to achieve high selectivity and current density for a particular product remains very challenging. Herein, a strategy derived from Cu‐based metal‐organic frameworks (MOFs) for the synthesis of controllable oxidation states and porous structure of Cu‐carbon (Cu‐pC, Cu2O‐pC, and Cu2O/Cu‐pC) is demonstrated. By regulating oxygen partial pressure during the annealing process, the valence state of the Cu and mesoporous structures of surrounding carbon are changed, leads to the different selectivity of products. Cu2O/CuO‐pC with the higher oxidation state exhibits FEC2H4 of 65.12% and a partial current density of −578 mA cm−2, while the Cu2O‐pC shows the FECH4 over 55% and a partial current density exceeding −438 mA cm−2. Experimental and theoretical studies indicate that porous carbon‐coated Cu2O structures favor the CH4 pathway and inhibit the hydrogen evolution reaction. This work provides an effective strategy for exploring the influence of the various valence states of Cu and mesoporous carbon structures on the selectivity of CH4 and C2H4 products in CO2RR.
Transparent Conductive Oxide Sputtering Damage on Contact Passivation in Silicon Heterojunction Solar Cells with Hydrogenated Nanocrystalline Silicon
Authors: Qiu Depeng , Duan Weiyuan , Lambertz Andreas , Eberst Alexander , Bittkau Karsten , Rau Uwe , Ding Kaining
Published: August 2022

Mitigating the adverse effect of transparent conductive oxide (TCO) sputtering on the passivation quality of the heterojunction contact is very critical for achieving high‐efficiency silicon heterojunction (SHJ) solar cells. Herein, n‐type ultra‐thin (5 nm) nanocrystalline silicon (nc‐Si:H) is utilized as a contact layer in rear‐junction SHJ solar cells. It is revealed that the TCO sputtering damage on the contact layer is caused by the ion bombardment during the sputtering process and cannot be fully recovered by low‐temperature annealing. A more severe passivation deterioration is observed for the devices with nc‐Si:H(n) having a higher microstructure factor. This result is explained by an increased ion penetration depth in the porous nc‐Si:H film. By applying denser nc‐Si:H(n) in SHJ solar cells, the front silicon film stack shows more resilience to sputter damage, yielding a remarkable cell performance on the M2‐size wafer with certificated power conversion efficiency (η) of 23.87%. The sputter damage on nc‐Si:H by TCO in SHJ solar cells is explored in depth for the first time from the perspective of silicon thin films.
Granular Flow Modeling of Galvanized Steel Scrap Injection into the HIsarna Iron‐Making Reactor
Authors: Hosseini Ashkan , Georgopoulos Evangelos , Dihman Vinod , Hage Johannes , Meijer Koen , Zeilstra Christiaan , Offerman Erik , Yang Yongxiang
Published: August 2022

Galvanized steel scrap flow and injection into the HIsarna reactor are investigated using discrete element method (DEM). The scrap particle is fed into the reactor through an inclined chute and hits the slag surface where the zinc content is evaporated and solid particles melt. A DEM model is setup and validated using experimental data obtained from the exact plant‐scale chute geometry and scrap particles. Using the DEM model, the effect of chute inclination, injection elevation, injection mode (batch and continuous), batch size, and flowrate on particle distribution and exerted pressure on the slag surface are investigated. It is found that continuous mode of injection is the most suitable method to increase the spread of particles and also to reduce the exerted pressure on the slag surface. Placing dent‐like obstacles at the tip of the chute significantly increases the impact area, especially for batchwise injection, thus reducing force and pressure on the slag surface that minimizes the risk of liquid splash. Larger particle impact area is also beneficial to obtain higher zinc evaporation rate from particle surface and also to minimize the slag surface temperature disturbance.
Preparative high‐performance liquid chromatography: Isolation of natural chemical compounds for identification and characterization
Authors: Niculau Edenilson. S. , Oliveira Daniel. A. B. , Almeida Natália. F.
Published: August 2022

The identification and characterization of natural products generally require the isolation of pure compounds employing chromatographic techniques associated with extensive sample preparation. Preparative high‐performance liquid chromatography often allows the isolation of simple and complex natural compounds by using little sample preparation or from crude extracts. Thus, this article discusses the main fundamentals of this powerful technique, as well as discusses several applications that show the isolation of natural products from plants, bacteria, fungi, and marine organisms (algae, ascidian, bacteria, sponges, and fungi).
Safe passage of American Eels through a novel hydropower turbine
Authors: Watson Sterling , Schneider Abraham , Santen Leon , Deters Katherine A. , Mueller Robert , Pflugrath Brett , Stephenson John , Deng Z. Daniel
Published: August 2022

Objective

Study the effects of downstream passage through a novel turbine designed for fish safety, the Restoration Hydro Turbine (RHT), on American Eels Anguilla rostrata in a recirculating turbine test facility.

Methods

A 55‐cm‐diameter RHT was operated under 10 m of hydraulic head and 667 revolutions/min. In total, 131 eels were passed through the turbine and 43 eels were used as experimental controls (length = 33.9–65.5 cm). High‐speed video of passage through the runner region was captured for 89% of turbine‐passed eels, and injury and behavioral effects were recorded immediately before and after passage, as well as after a 48‐h holding period. A subset of 37 eels was additionally examined with X‐ray imaging for internal injuries.

Result

The 48‐h survival rate for both treatment and control groups was 100%, with no major internal or external injuries present after the holding period.

Conclusion

This is a substantial improvement over eel survival rates through conventional Kaplan and Francis turbines, which may range from 40% to 95%, and suggests that hydropower turbines designed for safe downstream fish passage could be implemented without major impacts to eels.
“Step Outside”: A portrait of an exemplary rural K‐8 science educator
Authors: Hammack Rebekah , Stanton Christine Rogers , Boyle Judith
Published: August 2022

This study uses portraiture methodology to co‐construct and share the story of a nationally recognized rural K‐8 science teacher with more than 30 years of teaching experience. Our analysis and synthesis revealed one central theme “Step Outside” and three subthemes: (1) Step Outside of the rural classroom, (2) Step Outside of the K‐8 teacher's comfort zone, and (3) Step Outside of science silos, that have been central to the teacher's personal and professional journey. Examining the ways, these subthemes have intersected across the career of an exceptional rural teacher offers valuable insight to the development of teacher identity and how it shapes practice and research, especially within marginalized contexts such as K‐8 science education and rural settings.
A narrative review on the role of carbon nanoparticles in oncology
Authors: Watt Meghan M. , Moitra Parikshit , Sheffield Zach , Ostadhossein Fatemeh , Maxwell Elizabeth A. , Pan Dipanjan
Published: August 2022

The lymphatic system is the first site of metastasis for most tumors and is a common reason for the failure of cancer therapy. The lymphatic system's anatomical properties make it difficult to deliver chemotherapy agents at therapeutic concentrations while avoiding systemic toxicity. Carbon nanoparticles offer a promising alternative for identifying and transporting therapeutic molecules. The larger diameter of lymphatic vessels compared to the diameter of blood vessels, allows carbon nanoparticles to selectively enter the lymphatic system once administered subcutaneously. Carbon nanoparticles stain tumor‐draining lymph nodes black following intratumoral injection, making them useful in sentinel lymph node mapping. Drug‐loaded carbon nanoparticles allow higher concentrations of chemotherapeutics to accumulate in regional lymph nodes while decreasing plasma drug accumulation. The use of carbon nanoparticles for chemotherapy delivery has been associated with lower mortality, fewer histopathology changes in vital organs, and lower serum concentrations of hepatocellular enzymes. This review will focus on the ability of carbon nanoparticles to target the lymphatics as well as their current and potential applications in sentinel lymph node mapping and oncology treatment regimens.

This article is categorized under:

Implantable Materials and Surgical Technologies > Nanoscale Tools and Techniques in Surgery
Forest Bioeconomy, Climate Change and Managing the Change
Authors: Hetemäki Lauri , Kangas Jyrki
Published: August 2022

In order to realise Agenda 2030, or the United Nations’ Sustainable Development Goals, and the Paris Climate Agreement, the business-as-usual model––the policies, production and consumption habits we have been following thus far––will not work. Instead, it is necessary to change the existing economic model and how we advance societal well-being. Here, we argue that a forest-based bioeconomy will be a necessary, albeit insufficient, part of this transformation. The European forest-based sector has significant potential to help in mitigating climate change. However, there is no single way to do this. The means to accomplish this are diverse, and these measures also need to be tailored to regional settings. Moreover, the climate mitigation measures should be advanced in synergy with the other societal goals, such as economic and social sustainability. Climate mitigation in the forest- based sector requires a holistic perspective.
Climate-Smart Forestry Case Study: Finland
Authors: Peltola Heli , Heinonen Tero , Kangas Jyrki , Venäläinen Ari , Seppälä Jyri , Hetemäki Lauri
Published: August 2022

Finland is the most forested country in the EU – forests cover 74–86% of the land area, depending on the definition and source. Increasing carbon sequestration from the atmosphere, and by storing it in forests (trees and soil) will be one important part of the Finnish climate smart forestry strategy. However, just maximizing the carbon storage of forests may not be the best option in the long run, although it may provide the best climate-cooling benefits in the short term. This is because the increasing risks of large-scale natural disturbances may turn forests, at least partially, into carbon sources. The climate change adaptation and mitigation should therefore be considered simultaneously. Different adaptation and risk management actions will be needed in Finnish forests in the coming decades to increase forest resilience to multiple damage risks. This could be done, for example, by increasing the share of mixtures of conifers and broadleaves forests instead of monocultures. Yet, the CSF strategy should also include the production of wood-based products that act as long-term carbon storage and/or substitute for more GHG-emission-intensive materials and energy. Doing this in a way which also enhances biodiversity and sustainable provisioning of multiple ecosystem services, is a key. Moreover, increasing forest land – for example, by planting on abandoned or low-productivity agricultural land, especially on soils with a high peat content – would enhance climate change mitigation.
The Way Forward: Management and Policy Actions
Authors: Hetemäki Lauri , Kangas Jyrki , Asikainen Antti , Jänis Janne , Seppälä Jyri , Venäläinen Ari , Peltola Heli
Published: August 2022

Along with the evidence and analyses expounded on in this book, this chapter provides conclusions and suggestions concerning policy implications. These are based on a perspective that calls attention to the need for a holistic approach to look at the nexus of forests, the bioeconomy and climate change. Moreover, it is emphasised that, given the different uses of forests and the scarcity of forest resources, it makes sense to try to find ways to maximise synergies and minimise trade-offs between the different usages of forests. The forest-based sector contributes to climate-change mitigation via three channels––forests are a carbon sink, forest-based products can substitute for fossil-based products, and these products can store carbon for up to centuries. However, achieving these mitigation potentials in the future depends on forests being made resilient to the changing climate. Therefore, mitigation and adapting forests to climate change are married, both needing to be advanced simultaneously. Globally and in the EU, around 80–90% of the CO2 emissions originate from the use of coal, oil and natural gas. Consequently, the core issue in the fight against climate change is the phasing out of fossil-based products. Reaching this goal will not be possible without substituting also forest-based bioproducts for the purposes we are using oil, coal and gas for today. In the EU, this implies paying more attention to the need to develop new innovations in the forest bioeconomy, improve the resource efficiency and circularity of the bioproducts already available, and monitor the environmental sustainability of the bioeconomy.
Planetary Boundaries and the Role of the Forest-Based Sector
Authors: Hetemäki Lauri , Seppälä Jyri
Published: August 2022

‘Planetary boundaries’ is a concept that has been introduced by Earth system scientists to refer particularly to anthropogenic pressures on the Earth system that have reached a scale where abrupt global environmental change can no longer be excluded. In the planetary boundaries discussion, climate change plays a central role due to its overarching impacts on all the other planetary boundaries. For example, climate change critically impacts biodiversity and land-use changes. Consequently, climate change shapes policies, strategies and actions at the global, continental, national, regional and individual levels. The main policy through which the EU is seeking to address climate change and direct the region to live within the planetary boundaries is the European Green Deal (EGD), launched in 2019. The EGD clearly acknowledges the role forests can play in sinking carbon and suggests measures to enhance forest restoration and conservation. However, it falls short of recognising the role that the forest-based bioeconomy can also play in achieving the EGD objectives. History shows that European forests can simultaneously increase the carbon sink, biodiversity and wood production.
Forest Biomass Availability
Authors: Anttila Perttu , Verkerk Hans
Published: August 2022

The forest-based bioeconomy relies on using forests as a source of raw material for producing materials and energy, as well as for a variety of other ecosystem services. The uses of forests and wood are many and, to some extent, competing. Can a limited resource simultaneously and sustainably provide raw materials for products, feedstock for energy production, and other ecosystem services? Over one-third of the land area in the EU is covered by forests, but there are large differences between the member states regarding both forest area and growing stock of wood. The harvesting of roundwood has been steadily increasing. In addition to roundwood, other tree parts, as well as residues from forest industries and post-consumer wood, are being used for both materials and energy production. There are non-negligible uncertainties regarding the future availability of forest biomass in the context of climate change, as well as difficulties to concern all the relevant constraints on biomass supply in relation to availability assessments and the difficult-to-predict effects of policies. Despite the above, it can be concluded that there is still potential to increase the utilisation of forest biomass in most of the EU regions, but this might affect the provisioning of other important ecosystem services.
Dynamic Consent als Umsetzungsmechanismus von Datensouveränität
Authors: Hummel Patrik , Braun Matthias , Augsberg Steffen , Ulmenstein Ulrich von , Dabrock Peter
Published: August 2022

Die Einwilligung stellt im deutschen wie im europäischen Recht die wichtigste Voraussetzung (Erlaubnistatbestand) für den Umgang mit personenbezogenen Daten dar. Mit Blick auf die Datenqualität und Repräsentativität kann ein striktes Einwilligungserfordernis ein Hemmnis für datenintensive Forschung darstellen. Ein Versuch mit diesem Dilemma umzugehen besteht darin, datenschutzrechtliche Standards bereichsbezogen aufzuspalten: Während (Gesundheits-)Versorgung auf einem Informed oder Narrow Consent basiert, wäre in der Forschung ein Broad Consent oder gar eine von der Einwilligung gelöste Verwendung zulässig. Wer grundrechtlich vorzugswürdig weiterhin primär auf ein einwilligungsbasiertes Regelungskonzept setzt (Opt-in-Modell), muss nach Mechanismen fragen, um Einwilligungsentscheidungen so treffen zu können, dass fortlaufende Kontrolle ermöglicht wird. Das verdeutlicht, warum es attraktiv ist, das Modell eines Dynamic Consent zu entfalten und kontextsensibel weiterzuentwickeln. Für eine robuste Umsetzung des Dynamic Consent bedarf es zugleich Delegationsmöglichkeiten. Der Einsatz sog. Datentreuhänder gehört zu den prominenten Vorschlägen, wie unter Big-Data-Bedingungen ein adäquater Datenschutz gewährleistet werden kann.
Governance-Ansätze
Authors: Hummel Patrik , Braun Matthias , Augsberg Steffen , Ulmenstein Ulrich von , Dabrock Peter
Published: August 2022

Wir haben argumentiert, dass Datensouveränität die Befähigung von Akteuren zu informationeller Freiheitsgestaltung durch Kontrolle der Verwendung sie betreffender Daten bezeichnet (Kap. 1). Im Anschluss haben wir den Dynamic Consent als Umsetzungsmechanismus von Datensouveränität vorgeschlagen (Kap. 2). Im Folgenden fokussieren wir vier miteinander in Wechselwirkung stehende Governance-Ebenen (siehe Abb. 3.1), auf denen Datensouveränität im deutschen Gesundheitssystem ermöglicht und gestärkt werden kann: Hard Law (3.1), Soft Law (3.2), Teilhabe (3.3) und IT (3.4).
Flipped Learning
Authors: Lee Jihyun
Published: August 2022

Flipped learning (FL) began as a local trial strategy in a US high school in 2012 and in less than 10 years has exploded in popularity, among both educational practitioners and researchers, and has now been extensively recognized and implemented at all levels of education across the world. This chapter will discuss what is known from current FL literature, what the practical implications are from this literature, what gaps exist within FL research and between FL research and practices, and how those gaps should be addressed. This chapter begins with the definition and continues discussing history and supporting theories of flipped learning and its effectiveness, affecting factors, challenges, and possible solutions from current literature. In addition, as a modified version of traditional flipped learning, a fully online flipped learning model, bichronous online learning, and HyFlex learning are introduced. This chapter concludes with future research directions.
Comparison of dry and liquid carbon dioxide cutting conditions based on machining performance and life cycle assessment for end milling GFRP
Authors: Khanna Navneet , Rodríguez Adrián , Shah Prassan , Pereira Octavio , Rubio-Mateos Antonio , de Lacalle Luis Norberto López , Ostra Txomin
Published: August 2022

In the present scenario, citizens’ concern about environment preservation creates a necessity to mature more ecological and energy-efficient manufacturing processes and materials. The usage of glass fiber reinforced polymer (GFRP) is one of the emerging materials to replace the traditional metallic alloys in the automotive and aircraft industries. However, it has been comprehended to arise a sustainable substitute to conventional emulsion-based coolants in machining processes for dropping the destructive effects on the ecosystem without degrading the machining performance. So, in this study, the comparison of the two sustainable cutting fluid approaches, i.e., dry and LCO2, has been presented based on machining performance indicators like temperature, modulus of cutting force, tool wear, surface roughness, power consumption, and life cycle assessment (LCA) analysis for end milling of GFRP. The cutting condition of LCO2 has been found to be superior in terms of machining performance by providing 80% of lower cutting zone temperature, tool wear, 5% lower modulus of cutting force, and reduced surface roughness with 9% lower power consumption that has been observed in the case of LCO2 in comparison with dry machining. However, to compress the CO2 for converting in liquid form, a higher amount of energy and natural resources is consumed resulting in a higher impact on the environment in comparison with dry machining. Considering the 18 impact categories of ReCiPe midpoint (H) 2016, 95% higher values of impacts have been observed in the case of LCO2 in comparison with dry machining.
Imaging of heart disease in women: review and case presentation
Authors: Mikail Nidaa , Rossi Alexia , Bengs Susan , Haider Achi , Stähli Barbara E. , Portmann Angela , Imperiale Alessio , Treyer Valerie , Meisel Alexander , Pazhenkottil Aju P. , Messerli Michael , Regitz-Zagrosek Vera , Kaufmann Philipp A. , Buechel Ronny R. , Gebhard Cathérine
Published: August 2022

Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide. Although major diagnostic and therapeutic advances have significantly improved the prognosis of patients with CVD in the past decades, these advances have less benefited women than age-matched men. Noninvasive cardiac imaging plays a key role in the diagnosis of CVD. Despite shared imaging features and strategies between both sexes, there are critical sex disparities that warrant careful consideration, related to the selection of the most suited imaging techniques, to technical limitations, and to specific diseases that are overrepresented in the female population. Taking these sex disparities into consideration holds promise to improve management and alleviate the burden of CVD in women. In this review, we summarize the specific features of cardiac imaging in four of the most common presentations of CVD in the female population including coronary artery disease, heart failure, pregnancy complications, and heart disease in oncology, thereby highlighting contemporary strengths and limitations. We further propose diagnostic algorithms tailored to women that might help in selecting the most appropriate imaging modality.
Pulmonary embolism response team (PERT) implementation and its clinical value across countries: a scoping review and meta-analysis
Authors: Hobohm Lukas , Farmakis Ioannis T. , Keller Karsten , Scibior Barbara , Mavromanoli Anna C. , Sagoschen Ingo , Münzel Thomas , Ahrens Ingo , Konstantinides Stavros
Published: August 2022

Background

Over the last years, multidisciplinary pulmonary embolism response teams (PERTs) have emerged to encounter the increasing variety and complexity in the management of acute pulmonary embolism (PE). We aimed to systematically investigate the composition and added clinical value of PERTs.

Methods

We searched PubMed, CENTRAL and Web of Science until January 2022 for articles designed to describe the structure and function of PERTs. We performed a random-effects meta-analysis of controlled studies (PERT vs. pre-PERT era) to investigate the impact of PERTs on clinical outcomes and advanced therapies use.

Results

We included 22 original studies and four surveys. Overall, 31.5% of patients with PE were evaluated by PERT referred mostly by emergency departments (59.4%). In 11 single-arm studies (1532 intermediate-risk and high-risk patients evaluated by PERT) mortality rate was 10%, bleeding rate 9% and length of stay 7.3 days [95% confidence interval (CI) 5.7–8.9]. In nine controlled studies there was no difference in mortality [risk ratio (RR) 0.89, 95% CI 0.67–1.19] by comparing pre-PERT with PERT era. When analysing patients with intermediate or high-risk class only, the effect estimate for mortality tended to be lower for patients treated in the PERT era compared to those treated in the pre-PERT era (RR 0.71, 95% CI 0.45–1.12). The use of advanced therapies was higher (RR 2.67, 95% CI 1.29–5.50) and the in-hospital stay shorter (mean difference − 1.6 days) in PERT era compared to pre-PERT era.

Conclusions

PERT implementation led to greater use of advanced therapies and shorter in-hospital stay. Our meta-analysis did not show a survival benefit in patients with PE since PERT implementation. Large prospective studies are needed to further explore the impact of PERTs on clinical outcomes.

Registration

Open Science Framework 10.17605/OSF.IO/SBFK9.

Graphical abstract
Clinical characteristics, causes and predictors of outcomes in patients with in-hospital cardiac arrest: results from the SURVIVE-ARREST study
Authors: Hannen Laura Erika Maria , Toprak Betül , Weimann Jessica , Mahmoodi Bahara , Fluschnik Nina , Schrage Benedikt , Roedl Kevin , Söffker Gerold , Kluge Stefan , Issleib Malte , Blankenberg Stefan , Kirchhof Paulus , Clemmensen Peter , Sinning Christoph , Zengin-Sahm Elvin , Becher Peter Moritz
Published: August 2022

Introduction

In-hospital cardiac arrest (IHCA) is acutely life-threatening and remains associated with high mortality and morbidity. Identifying predictors of mortality after IHCA would help to guide acute therapy.

Methods

We determined patient characteristics and independent predictors of 30-day in-hospital mortality, neurological outcome, and discharge/referral pathways in patients experiencing IHCA in a large tertiary care hospital between January 2014 and April 2017. Multivariable Cox regression model was fitted to assess predictors of outcomes.

Results

A total of 368 patients with IHCA were analysed (median age 73 years (interquartile range 65–78), 123 (33.4%) women). Most patients (45.9%) had an initial non-shockable rhythm and shockable rhythms were found in 20.9%; 23.6% of patients suffered from a recurrent episode of cardiac arrest. 172/368 patients died within 30 days (46.7%). Of 196/368 patients discharged alive after IHCA, the majority (72.9%, n = 143) had a good functional neurological outcome (modified Rankin Scale ≤ 3 points). In the multivariable analysis, return of spontaneous circulation without mechanical circulatory support (hazard ratio (HR) 0.36, 95% confidence interval (CI) 0.21–0.64), invasive coronary angiography and/or percutaneous intervention (HR 0.56, 95% CI 0.34–0.92), and antibiotic therapy (HR 0.87, 95% CI 0.83–0.92) were associated with a lower risk of 30-day in hospital mortality.

Conclusion

In the present study, IHCA was survived in ~ 50% in a tertiary care hospital, although only a minority of patients presented with shockable rhythms. The majority of IHCA survivors (~ 70%) had a good neurological outcome. Recovery of spontaneous circulation and presence of treatable acute causes of the arrest are associated with better survival.

Graphical abstract

Clinical Characteristics, Causes and Predictors of Outcomes in Patients with In-Hospital Cardiac Arrest: Results from the SURVIVE-ARREST Study. Abbreviations: CPR, cardiopulmonary resuscitation; IHCA, In-hospital cardiac arrest; MCS, mechanical circulatory support; PCI, percutaneous coronary intervention; ROSC, return of spontaneous circulation; SBP, systolic blood pressure.
A retrospective analysis of controlled active motion (CAM) versus modified Kleinert/Duran (modKD) rehabilitation protocol in flexor tendon repair (zones I and II) in a single center
Authors: Wirtz C. , Leclère F. M. , Oberfeld E. , Unglaub F. , Vögelin E.
Published: August 2022

Introduction

The aim of this study was to analyze primary flexor tendon repair results in zones I and II, comparing the rupture rate and clinical outcomes of the controlled active motion (CAM) protocol with the modified Kleinert/Duran (mKD) protocol.

Materials and methods

Patients who underwent surgery with traumatic flexor tendon lacerations in zones I and II were divided in three groups according to the type of rehabilitation protocol and period of management: group 1 included patients who underwent CAM rehabilitation protocol with six-strand Lim and Tsai suture after May 2014. Group 2 and 3 included patients treated by six-strand Lim Tsai suture followed by a modified Kleinert/Duran (modK/D) protocol with additional place and hold exercises between 2003 and 2005 (group 2) and between 2011 and 2013 (group 3).

Results

Rupture rate was 4.7% at 12 weeks in group 1 (3/63 flexor tendon repairs) compared to 2% (1/51 flexor tendon repairs) in group 2 and 8% in group 3 (7/86 flexor tendon repairs). The grip strength at 12 weeks was significantly better in group 2 compared to the group 1 (35 kg/25 kg,p = 0.006). The TAM in group 1 [113° (30–175°)] was significantly worse (p < 0.001) than the TAM in group 2 [141° (90–195°)] but with similar extension deficits in both groups. The assessment of range of motion by the original Strickland classification system resulted in 20% excellent and 15% good outcomes in the CAM group 1 compared with 42% and 36% in the modK/D group 2. Subanalysis demonstrated improvement of good/excellent results according to Strickland from 45% at 3 months to 63.6% after 6-month follow-up in the CAM group.

Conclusion

The gut feeling that lead to change in our rehabilitation protocol could be explained by the heterogenous bias. A precise outcome analysis of group 1 could underline that in patients with complex hand trauma, nerve reconstruction, oedema or early extension deficit, an even more intensive and individual rehabilitation has to be performed to achieve better TAM at 6 or 12 weeks. Our study explicitly demonstrated a significant better outcome in the modK/D group compared to CAM group. This monocenter study is limited by its retrospective nature and the low number of patients.