bluuebunny/crossref_metadata_2025 huggingface dataset:
Accelerating Linear Congruential Generators with Carbon Nanotube Field-Effect Transistors
Authors: Yogapriya B , Sahithi P , Mathan N , Muthiah M A , Ravi T
Published: November 2024

In the era of technological advancements, safeguarding information privacy has become paramount across sectors like defense, finance, healthcare, and more. At the heart of these security measures lies cryptography, a field that necessitates the efficient processing and secure storage of data. Our project focuses on the optimization of Linear Congruential Generators (LCG), pivotal for cryptographic applications and pseudorandom number generation. Here it has been pioneered the implementation of LCG using Carbon Nanotube Field-Effect Transistor (CNTFET) technology, targeting the reduction of leakage power through the innovative application of sleep techniques. This advanced approach not only embodies a leap towards minimizing energy consumption but also enhances the overall performance and reliability of cryptographic systems. By integrating sleep modes into the CNTFET-based LCG design, our methodology significantly curtails leakage power without compromising the generator’s efficiency or output quality. The successful implementation and synthesis of this design, employing cutting-edge CNTFET technology, underscore the potential for substantial improvements in power efficiency while maintaining high standards of security and randomness essential for cryptographic algorithms.
Design of 8T DTMOS Schmitt Trigger SRAM Cell for IOT Applications
Authors: Pandey Neeta , Singh Mann Aditya , Setia Abhay
Published: November 2024

Internet of things (IoT) based systems require power-efficient circuits to raise the battery lifeline. This study presents a single-ended 8T SRAM cell. The core of the proposed 8T SRAM cell is composed of a Schmitt-Trigger circuit which a dynamic body bias technique is applied to a standard CMOS inverter through a feedback mechanism, whereby the threshold voltages of two MOSFETs can be changed, thus changing the switching voltage. Read operation of the proposed cell is conducted using the shared footer per word transistor. The write path is cut-off during the read operation, improving RSNM. A transmission gate placed in the cell core is used to cut the feedback path during write operation. To prove superiority of the proposed cell it is compared with four state-of-the-art SRAM cells under identical conditions on Cadence Virtuoso using 45nm technology at VDD=0.8 V. The proposed circuit shows a 135.74 % improvement in terms of RSNM and a 44.04 % improvement in terms of peak-to-peak power compared to the 6T DTMOS Cell.
Compressive strength study of fibre reinforced concrete
Authors: Bhavani Sai Kumar Y V , Padmapriya R
Published: November 2024

Materials play a vital role in the development of human life. Environmental and sustainable development concerns have seriously affected the development and applications of materials. Due to the advancement of rapid growth, it leads to the utilization of more materials, which leads to the depletion of natural materials. So, this leads the researchers to focus on the materials that have less impact on the environment. This study focuses on the compressive strength-based study of M30-grade fiber-reinforced concrete, partially replacing cement with flyash, fine aggregate with cocopeat, and adding coir fiber as a fiber. In recent times, there has been a tremendous increase in the usage of several natural fibers because of their low cost, ease of processing, and environmental friendliness. Due to their availability and eco friendliness, they are used in the development of fiber-reinforced concrete to improve its strength. The experiment entails casting and curing of different concrete mixtures for 3, 7, and 28 days with varying percentages of coconut fiber and cocopeat, 30% replacement of cement with flyash, and performing compressive strength tests in accordance with IS standards. Test results show adding 1% of coir fiber attains more strength in comparison with normal concrete and concrete with partial replacement of cement with fly ash and fine aggregate with cocopeat.
Absorption and emission maxima prediction of fluorescent organic materials using optimized neural network models
Authors: Dev Mahato Kapil
Published: November 2024

The aim of the study is to predict the absorption and emission maxima from the given dataset, which consists of 3066 fluorescent organic materials. To fulfill this requirement, five optimized neural network models are employed. Out of them, the wide neural network (WNN) model outperformed the other models on validation as well as test results. The results were obtained on the basis of three evaluation parameters: mean absolute error (MAE), root mean squared error (RMSE), and the coefficient of determination (R2). According to the validation scores, the WNN was the best-predictive model with MAE-18.05 nm, RMSE-28.93 nm, and R2-89.55%, and MAE-29.58 nm, RMSE-42.62 nm, and R2-78.87% for absorption and emission maxima, respectively. On the other hand, on the basis of tested scores, the WNN was the best-predictive model with MAE-19.35 nm, RMSE-29.33 nm, and R2-92.14%, and MAE-29.17 nm, RMSE-41.87 nm, and R2-79.46% for absorption and emission maxima, respectively. The presented automated method does not require an extensive understanding of computer programming to estimate the absorption and emission maxima. The absorption and emission maxima may be predicted, which helps with the design of new fluorescent organic materials and their many uses in electronics, chemistry, materials science, medicine, and other areas.
Effect of Fibre Reinforcement on Compressive Strength and Compressive Modulus of Epoxy Granite
Authors: Ubale Deepak D , Shah Abhijeet P
Published: November 2024

The main focus of the paper is to study the effect of fibre reinforcement on compressive strength and compressive modulus of epoxy granite. To investigate the effect of fibre reinforcement, two compositions were considered likes 20% Epoxy and 80% Granite without fibre reinforcement and 20% Epoxy, 75% Granite and 5% fibre reinforcement. Based on the literature studied, three types of fibre were considered viz. steel fibre, carbon fibre and basalt fibre. Three specimens of each type of fibre i.e. nine specimens and three specimens without fibre reinforcement were prepared. The obtained maximum compressive strength and compressive modulus of epoxy granite without reinforcement is 91.70 MPa and 3.5 GPa for the composition of 20% epoxy and 80% granite. The observed maximum compressive strength of 78.57 MPa for 20% epoxy and 75% granite with 5% carbon fibre reinforcement epoxy granite (CFEG) which is much higher than steel fibre reinforced epoxy granite (SFEG) with 20% epoxy and 75% granite and basalt fibre reinforced epoxy granite (BFEG) with 20% epoxy and 75% granite. The computed compressive modulus is 2.7 GPa for SFEG with 5% fibre which greater than CFEG and BFEG with the same fibre content.
Feedback control for plants with time delay
Authors: Perev Kamen
Published: November 2024

The paper considers the problem of feedback control design for plants with time delay. The role of the feedback is presented showing its ability to restrict the uncertainty in the plant model. The conditional feedback control structure is introduced and its properties for restricting model uncertainty are discussed. The presence of local feedback makes the conditional feedback structure pertinent for its usage when the plant contains a time delay element. The time delay model is replaced by its Pade series approximation. The key idea is to consider the time delay model as perturbation around its Pade series approximation. This fact allows utilizing the rational function expression in the procedure of controller design, thus avoiding using the irrational function of the time delay for this purpose. It is shown that the conditional feedback control structure gives an alternative than the Smith predictor method for controller design of plants with time delay e
−θs
in their structure. The efficiency of the presented method is demonstrated by a numerical example.
Gathering information for the external parameters of Permanent Magnet Synchronous Motor using Hall sensors and applying linear interpolation
Authors: Hristov Kamen
Published: November 2024

This paper presents review of a method for receiving information for the rotational speed using the signal gathered from Hall sensors. They are widely used, because of their high performance in the whole operating range. There are shown models and substructures developments and simulation results in Matlab/Simulink.
Electric field in a conductive medium – modelling and application
Authors: Iatcheva Ilona , Darzhanova Denitsa , Petkova Nikolina
Published: November 2024

The paper presents some specific features of an electric field in a conductive medium, a theoretical base for numerical field modelling using the finite element method and its application in simulation of the processes in real electromagnetic systems. Application examples are presented, concerning simulations of the processes, taking part in contact resistance welding and insulation in the presence of conductive inclusions.
Discrete Analysis of Electrical Circuit with Sources of Rectangular Pulses
Authors: Georgiev Zhivko , Trushev Ivan , Chervenkov Atanas
Published: November 2024

Discrete transients and stationary process are described in series RC-circuits when the supplied voltage contains periodic rectangular pulses. The analysis is performed using z - transformation to obtain analytical dependencies for the capacitive voltage in any time of the rectangular pulses. The approach is used for discrete analysis of various circuits in which rectangular pulses have different characteristics. The calculated capacitive voltages by the obtained discrete dependencies are identical, compared to the results obtained by SPICE simulation. The method proposed in the present work allows, together with the transient process, to investigate the corresponding stationary process. Cases of stable and unstable transients are shown.
High α-SMA expression in the tumor stroma is associated with adverse clinical parameters in mismatch repair–proficient colorectal cancers only
Authors: Sculthorpe Declan J , Denton Amy , Fadhil Wakkas , Rusnita Dewi , Ilyas Mohammad , Mukherjee Abhik
Published: November 2024

Objectives

As mismatch repair status confers differential prognosis in colorectal cancers, this study aimed to determine associations of α–smooth muscle actin (α-SMA) protein expression in mismatch repair–proficient (pMMR) and mismatch repair–deficient (dMMR) colorectal tumors with clinicopathologic and prognostic features.

Methods

Tissue microarrays from patients with colorectal cancer, immunostained with α-SMA, were assessed through digital image analysis. Total (n = 962), pMMR (n = 782), and dMMR (n = 156) stromal H-scores were assessed for associations with clinicopathologic and survival data.

Results

Higher α-SMA expression was correlated with pMMR status (P = 5.2223 × 10–8). In the pMMR subgroup, higher α-SMA stromal expression at the tumor periphery was correlated with higher T stage (P = .002), perineural invasion (P = .038), infiltrative tumor edge (P = .01), involved nodal status (P = .036), metastases (P = .013), synchronous metastases (P = .007), recurrence (P = .004), and both 3-year and 5-year survival (P = .018). dMMR tumors showed no significant correlations with α-SMA staining.

Conclusions

The findings highlight that immunostaining with α-SMA in pMMR colorectal tumors, especially at the tumor periphery, has the potential to identify patients with adverse prognostic features. Digital assessment of α-SMA may offer improved objectivity, accuracy, economy of time, and risk stratification for management.
Bayesian clustering of high-dimensional data via latent repulsive mixtures
Authors: Ghilotti L , Beraha M , Guglielmi A
Published: November 2024

Model-based clustering of moderate or large dimensional data is notoriously difficult. We propose a model for simultaneous dimensionality reduction and clustering by assuming a mixture model for a set of latent scores, which are then linked to the observations via a Gaussian latent factor model. This approach was recently investigated by Chandra et al. (2023). The authors use a factor-analytic representation and assume a mixture model for the latent factors. However, performance can deteriorate in the presence of model misspecification. Assuming a repulsive point process prior for the component-specific means of the mixture for the latent scores is shown to yield a more robust model that outperforms the standard mixture model for the latent factors in several simulated scenarios. The repulsive point process must be anisotropic to favour well-separated clusters of data, and its density should be tractable for efficient posterior inference. We address these issues by proposing a general construction for anisotropic determinantal point processes. We illustrate our model in simulations as well as a plant species co-occurrence dataset.
‘A lot of social workers don’t seem to understand or realize the harm that they cause’: Disabled young people’s experiences with sexual well-being in social work practice
Authors: Goulden Ami
Published: November 2024

Young disabled people are disproportionately excluded from equal control, access, and choices concerning their sexual and reproductive rights. While sexual citizenship is founded on a rights-based approach and is closely connected with social work values such as empowerment and entitlement to full participation, many social workers do not include dimensions of sexual well-being in their scope of practice. This phenomenological study explores how social workers address the intersection of sexual well-being and disability from the perspectives of young disabled people. A total of twenty-four semi-structured interviews were carried out with individuals between the ages of 17 and 24 in Ontario, Canada, who identify themselves as disabled and have had prior interactions with a social worker. Social workers adopting risk-averse approaches negatively impacted the trust between young people and their social workers. Young people expressed their discontent with sexual well-being being deprioritized in practice, as participants considered dimensions of sexual well-being to be closely related to their physical, mental, and emotional health. Participants overwhelmingly reported that social workers should discuss sexual well-being with service users using sex-positive perspectives. The findings highlight the importance of holistic and comprehensive social work practices, including sexual well-being and sex-positive perspectives.
Current and Future Strategies for the Prevention and Treatment of Cytomegalovirus Infections in Transplantation
Authors: Heldman Madeleine R , Boeckh Michael J , Limaye Ajit P
Published: November 2024

Successful prevention and treatment of cytomegalovirus (CMV) infection remains a central focus of clinical care in solid organ transplantation (SOT) and allogeneic hematopoietic cell transplantation (HCT). Over the past 5 years, pivotal clinical trials have created new paradigms in CMV prevention, including diverging approaches in HCT and SOT. We review recent advances in CMV risk assessment and progress in antiviral and immune-based strategies for CMV prevention and treatment. We highlight approaches to optimize CMV-specific immunity through vaccination, monoclonal antibodies, and virus-specific T cells. Observational studies and interventional trials of commercially available CMV cell-mediated immunity assays for refining preventive and treatment strategies are summarized. Finally, we discuss the importance of enhancing CMV-specific immunity to mitigate the negative impacts of CMV in different transplant settings. CMV infections in recipients of chimeric antigen receptor-T (CAR-T) cell therapies and other immunocompromised populations are growing areas of importance that are beyond the scope of this review.
Left ventricular volume as a predictor of exercise capacity and functional independence in individuals with normal ejection fraction
Authors: Rowe Stephanie , L’Hoyes Wouter , Milani Mauricio , Spencer Luke , Foulkes Stephen , Paratz Elizabeth , Janssens Kristel , Stassen Jan , Delpire Boris , Pauwels Rik , Moura-Ferreira Sara , Falter Maarten , Bekhuis Youri , Herbots Lieven , Haykowsky Mark J , Claessen Guido , La Gerche Andre , Verwerft Jan
Published: November 2024

Aims

Low cardiorespiratory fitness (CRF) is associated with functional disability, heart failure, and mortality. Left ventricular (LV) end-diastolic volume (LVEDV) has been linked with CRF, but its utility as a diagnostic marker of low CRF has not been tested.

Methods and results

This multi-centre international cohort examined the relationship between LV size on echocardiography and CRF [peak oxygen uptake (peak VO2) from cardiopulmonary exercise testing] in individuals with LV ejection fraction ≥50%. Absolute and body surface area–indexed LVEDV (LVEDVi) were tested as predictors of low CRF and functional disability (peak VO2 <1100 mL/min or <18 mL/kg/min) and compared against candidate measures of cardiac structure and function. A total of 2876 individuals (309 endurance athletes, 251 healthy non-athletes, 1969 individuals with unexplained dyspnoea, and 347 individuals with heart failure with preserved ejection fraction) were included. For the entire cohort, LVEDV had the strongest univariable association with peak VO2 [R2 = 0.45, standardized (std) β = 0.67, P < 0.001] and remained the strongest independent predictor of peak VO2 after adjusting for age, sex, and body mass index (std β = 0.30, P < 0.001). Left ventricular end-diastolic volume was better in identifying low CRF than most established echocardiographic measures [LVEDV area under the receiver operating characteristic curve (AUC) 0.72; LVEDVi AUC 0.71], but equivalent to the E/eʹ ratio. The probability of achieving a peak VO2 below the functional independence threshold was highest for smaller ventricular volumes, with LVEDV and LVEDVi of 88 mL and 57 mL/m2 providing the optimal cut-points, respectively.

Conclusion

Small resting ventricular size is associated with a higher probability of low CRF and functional disability. Left ventricular size is the strongest independent echocardiographic predictor of CRF across the health–disease continuum.
Current Challenges, Solutions, and Novel Directions in Research and Clinical Care: Proceedings From the 14th Annual International Workshop on HIV and Aging
Authors: Baim-Lance Abigail , Cooley Sarah , Yoo-Jeong Moka , Ances Beau , Duque Gustavo , Ellis Ronald J , Flexner Charles , Pence Brian W , Plankey Michael , Mullins John David , Sun Jing , Thames April D , Margolick Joseph B , Moore David J , Erlandson Kristine M
Published: November 2024

Integrating antiretroviral therapy into HIV care dramatically extended the lifespan for people living with HIV. Improving the health span requires understanding aging, HIV, associated comorbid conditions, and concurrent treatments. The 14th annual International Workshop on HIV and Aging on October 26–27, 2023 included podium presentations on: Sarcopenia: Biology, Pathophysiology, Prevention and Treatment; Long-acting ART; Central Nervous System (CNS) complications; Asymptomatic Neurocognitive Impairment (ANI); Mental Health; Loneliness; and Resilience. Presentations highlighted persistent concerns for people living with HIV including sarcopenia and frailty, mental health, loneliness, and cognition. Presenters encouraged prioritizing mental health treatment, reducing social isolation, and research on resiliency.
The Evolution in Dementia Caregiving Research: NIA’s Catalyst Role
Authors: Ory Marcia G , Stevens Alan B
Published: November 2024

This article celebrates the National Institute on Aging (NIA)’s successes over the past 50 years in advancing the science base and informing the need for and response to dementia caregiving. In parallel with other public and private efforts, insightful NIA leadership supported by funding initiatives established the field of dementia caregiving research. In support of the health and well-being of family caregivers, NIA was a catalyst of innovation that led to numerous evidence-based caregiving interventions informed by basic research on care tasks and consequences. As evidence of the impending burden of dementia care on US families mounted, NIA-funded multidisciplinary collaboratives of researchers generated comprehensive models of family caregiving across diverse populations. Today, the dementia caregiving evidence base is shaping public policy and making possible dementia caregiving support services in health systems and community-based organizations. NIA continues to support the scientific study of dementia caregiving with a collaboration of leading scientists and by making available state-of-the-art datasets and encouraging standardized research methodologies. NIA’s leadership in the field of dementia caregiving research has never been more significant, as the number of persons living with dementia in the United States approaches 7 million and the value of family caregiving is estimated to be $350 billion.
Digital recognition: cybersecurity and internet infrastructure in UAE–Israel diplomacy
Authors: Hassib Bassant , Shires James
Published: November 2024

The 2020 Israel–UAE Abraham Accords normalized these states' relations, with heavy emphasis on digital technologies. International Relations theories of recognition, however, hardly consider the role digital technologies play in establishing recognition between states. What role, then, did digital technologies play in this landmark shift in UAE–Israel recognition? This article uses three aspects of digital technologies in the UAE–Israel case—cybersecurity cooperation, cloud computing, and subsea cables—to inductively develop three propositions regarding the role of digital technologies in state recognition. First, states use digital technologies—and private sector companies that own and operate them—as diplomatic lubrication: a means to navigate around and overcome difficult diplomatic relationships, building momentum towards recognition. Second, digital competition between states leads them to conform their national economic structures towards global technology companies in similar ways, thereby recognizing each other as equal participants in a global market—which we term market-oriented homogenization. Third, states involved in transnational internet infrastructure projects together develop technical working practices, interests, and dependencies that facilitate diplomatic recognition—which we term infrastructural integration. Building on these three propositions, we put forward an overall concept of ‘digital recognition’ to capture their common theme: the influence of digital technologies, their owners or their operators on state recognition.
The influence of human and marine wildlife presence on white shark behaviour in nearshore areas
Authors: Monteforte Kim I , Butcher Paul A , Morris Stephen G , Tucker James P , Griffin Kingsley J , Kelaher Brendan P
Published: November 2024

The co-occurrence of people and sharks within nearshore areas raises concerns about human safety. Unprovoked shark bites are one of the most renowned negative human–wildlife encounters. White sharks (Carcharodon carcharias) are implicated in most fatal unprovoked shark bites globally, but there is limited knowledge of white shark behaviour in the presence of people. We used drone-based methods to analyse human–shark and wildlife–shark interactions. We found a higher probability of a white shark interaction with a nearby person (0.81) in comparison to an animal (0.65). Fishers had the highest, and swimmers had the lowest probability of a white shark interaction. White sharks exhibited investigative behaviour in most interactions, with directional changes towards a nearby person or animal in 85.9% and 94.0% of interactions, respectively. There was a higher probability for white sharks to increase their speed towards animals (0.16) than people (0.01). The likelihood of white sharks altering their speed or direction when people were present depended on human activity. Overall, our study highlighted the value of drone technology in providing insights into white shark behaviour. It also supported the contention that, while people and white sharks coexist within nearshore areas, the probability of a negative human–wildlife encounter remains low.
Sex, sexual orientation, and gender identity data collection across electronic health record platforms: a national cross-sectional survey
Authors: Streed Carl G , Navarra Maylene , Beach Lauren B , Phillips Gregory , Hackenberger Paige N , Jordan Sumanas
Published: November 2024

Objectives

To assess the current state of sex, sexual orientation, and gender identity (SSOGI) data collection options in US electronic health record (EHR) platforms.

Materials and Methods

We utilized an anonymous survey distributed via purposive snowball sampling to assess EHR platforms across the United States.

Results

Of 90 surveys started, 41 (45.6%) were completed and used for data analysis. Respondents represented a geographically diverse sample of health care centers across the United States. EPIC was the most used EHR platform (70.7%) followed by Cerner (9.8%). Across reported platforms, a majority utilized structured fields to collect and document patient SSOGI data (n = 25, 61.0%). There was variability across platforms regarding SSOGI data elements collected. No platform collected all recommended SSOGI data elements.

Discussion

Significant variation exists across EHR platforms and across health care settings using the same EHR platform.

Conclusion

National standards need to be followed for SSOGI data collection in EHR platforms.
Validation of an LC–MS–MS method for analysis of 58 drugs of abuse in oral fluid and method comparison with an established LC–HRMS method
Authors: Zheng Yufang , Axelsson Magnus A.B , Andresen Bergström Moa
Published: November 2024

Liquid chromatography–mass spectrometry (LC–MS) methods for detection of multiple drugs of abuse (DoA) in oral fluid (OF) samples are being implemented in many clinical routine laboratories. Therefore, there is a need to develop new multianalyte methods with simple sample pretreatment and short analysis times. The purpose of this work was to validate a method detecting 58 DoA to be used with two different OF sampling kits, the saliva collection system (SCS) from Greiner Bio-One and Quantisal from Immunalysis, using the same sample pretreatment and analytical method. A set of 110 samples collected with the SCS kit was further compared to an high-resolution mass spectrometry (LC–HRMS) method in another laboratory. The method was successfully validated, with precision and accuracy of ≤15% and z-scores of <2 for external controls. Using a sensitive LC–MS–MS instrument, the detection limits were <1 µg/l in neat oral fluid. In the comparative study between the LC–MS–MS and LC–HRMS methods using SCS samples, a good agreement was observed. Discrepancies were limited to lower concentration ranges, attributable to differences in cut-off thresholds between the methods. This work contributes to the development of LC–MS multianalyte methods for OF samples, which are suitable for clinical routine laboratories.
On probabilistic and causal reasoning with summation operators
Authors: Ibeling Duligur , Icard Thomas , Mossé Milan
Published: November 2024

Ibeling et al. (2023, Annals of Pure and Applied Logic, 103339) axiomatize increasingly expressive languages of causation and probability, and Mossé et al. (2024, The Review of Symbolic Logic, 17, 106–131) show that reasoning (specifically the satisfiability problem) in each causal language is as difficult, from a computational complexity perspective, as reasoning in its merely probabilistic or ‘correlational’ counterpart. Introducing a summation operator to capture common devices that appear in applications—such as the $do$-calculus of Pearl (Causality. Cambridge University Press, 2009) for causal inference, which makes ample use of marginalization—van der Zander et al. (The hardness of reasoning about probabilities and causality. In Proceedings of the Thirty-Second International Joint Conference on Artificial Intelligence, IJCAI-23, E. Elkind, ed., pp. 5730–5738. International Joint Conferences on Artificial Intelligence Organization. Main Track. 2023) extend these earlier complexity results to causal and probabilistic languages with marginalization. We complete this extension, fully characterizing the complexity of probabilistic and causal reasoning with summation, demonstrating that these again remain equally difficult. Surprisingly, allowing free variables for random variable values results in a system that is undecidable, so long as the ranges of these random variables are unrestricted. We finally axiomatize these languages featuring marginalization (or more generally summation), resolving open questions posed by Ibeling et al. (2023, Annals of Pure and Applied Logic, 103339).
The Patient Who Begs You to Fix Their Pain
Authors: Cianfrini Leanne R.
Published: November 2024

This chapter will explore concepts involved when patients take a more passive approach to their pain management. The important role of positive and negative patient expectations on outcomes will be reviewed, in addition to concepts such as health-related locus of control, intrinsic vs. extrinsic motivation, and pain self-efficacy. Early alignment of patient expectations with what can realistically be achieved is strongly encouraged. Guidance will be provided on how to avoid reactance/resistance and help patients toward ownership of their symptoms with a more effective approach involving shared decision-making and self-management. Examples of helpful persuasive messages and motivational interviewing techniques will be provided.
The Depressed/Suicidal Patient
Authors: Richardson Elizabeth J.
Published: November 2024

This chapter discusses depression and suicidality in the patient with chronic pain and factors that increase a patient’s vulnerability to both. Patient-specific factors that are static and those that are modifiable will also be outlined. This chapter will also discuss clinician strategies for identifying when and how to assess for depression and suicidal ideation in the context of chronic pain. Specific in-office self-report screening measures will be identified as well as effective methods of questioning the physician can employ in face-to-face evaluations to evaluate depression and assess suicidality. Examples of an organized protocol of care for the suicidal patient is also reviewed. Lastly, this chapter will outline methods for communicating a recommendation for a referral to mental health that minimizes resistance from the patient.
The Anxious Patient
Authors: Cianfrini Leanne R.
Published: November 2024

This chapter provides an overview of clinical anxiety disorders, reviews the high prevalence of anxiety symptoms in patients with chronic pain, and offers a reminder that even nonpathological worry can have an impact on pain and overall health. Certain phobic experiences such as a needle phobia or claustrophobia may compromise patient care. Components of the Fear Avoidance Model will be reviewed, as well as the impact of fear of movement on treatment outcomes. Constructive communication options will be provided to help calm the anxious individual during an office appointment. Vetted self-management resources for stress and anxiety that you can share with your patients will also be summarized, including some simple relaxation techniques.
The Characterization of Ancient Methanococcales Malate Dehydrogenases Reveals That Strong Thermal Stability Prevents Unfolding Under Intense γ-Irradiation
Authors: Madern Dominique , Halgand Frédéric , Houée-Levin Chantal , Dufour Anne-Béatrice , Coquille Sandrine , Ansanay-Alex Salomé , Sacquin-Mora Sophie , Brochier-Armanet Céline
Published: November 2024

Malate dehydrogenases (MalDHs) (EC.1.1.1.37), which are involved in the conversion of oxaloacetate to pyruvate in the tricarboxylic acid cycle, are a relevant model for the study of enzyme evolution and adaptation. Likewise, a recent study showed that Methanococcales, a major lineage of Archaea, is a good model to study the molecular processes of proteome thermoadaptation in prokaryotes. Here, we use ancestral sequence reconstruction and paleoenzymology to characterize both ancient and extant MalDHs. We observe a good correlation between inferred optimal growth temperatures and experimental optimal temperatures for activity (A-Topt). In particular, we show that the MalDH present in the ancestor of Methanococcales was hyperthermostable and had an A-Topt of 80 °C, consistent with a hyperthermophilic lifestyle. This ancestor gave rise to two lineages with different thermal constraints: one remained hyperthermophilic, while the other underwent several independent adaptations to colder environments. Surprisingly, the enzymes of the first lineage have retained a thermoresistant behavior (i.e. strong thermostability and high A-Topt), whereas the ancestor of the second lineage shows a strong thermostability, but a reduced A-Topt. Using mutants, we mimic the adaptation trajectory toward mesophily and show that it is possible to significantly reduce the A-Topt without altering the thermostability of the enzyme by introducing a few mutations. Finally, we reveal an unexpected link between thermostability and the ability to resist γ-irradiation-induced unfolding.
COG database update 2024
Authors: Galperin Michael Y , Vera Alvarez Roberto , Karamycheva Svetlana , Makarova Kira S , Wolf Yuri I , Landsman David , Koonin Eugene V
Published: November 2024

The Clusters of Orthologous Genes (COG) database, originally created in 1997, has been updated to reflect the constantly growing collection of completely sequenced prokaryotic genomes. This update increased the genome coverage from 1309 to 2296 species, including 2103 bacteria and 193 archaea, in most cases, with a single representative genome per genus. This set covers all genera of bacteria and archaea that included organisms with ‘complete genomes’ as per NCBI databases in November 2023. The number of COGs has been expanded from 4877 to 4981, primarily by including protein families involved in bacterial protein secretion. Accordingly, COG pathways and functional groups now include secretion systems of types II through X, as well as Flp/Tad and type IV pili. These groupings allow straightforward identification and examination of the prokaryotic lineages that encompass—or lack—a particular secretion system. Other developments include improved annotations for the rRNA and tRNA modification proteins, multi-domain signal transduction proteins, and some previously uncharacterized protein families. The new version of COGs is available at https://www.ncbi.nlm.nih.gov/research/COG, as well as on the NCBI FTP site https://ftp.ncbi.nlm.nih.gov/pub/COG/, which also provides archived data from previous COG releases.
REGULATOR OF FATTY ACID SYNTHESIS proteins regulate de novo fatty acid synthesis by modulating hetACCase distribution
Authors: Zhou Lijuan , Du Ying , Zhang Manqi , Li Jincheng , Zhao Yue , Hu Xuechun , He Kunrong , Cao Fuliang , Ye Yajin
Published: November 2024

In plants, heteromeric acetyl-CoA carboxylase (hetACCase) initiates de novo fatty acid synthesis (FAS) by generating malonyl-CoA in the first committed step of this process. hetACCase activity is precisely regulated to meet the cellular demand for acyl chains during the plant life cycle. In this study, we performed a systematic coexpression analysis of hetACCase and its regulators in Arabidopsis (Arabidopsis thaliana) to better understand the regulatory mechanism of hetACCase. Our analysis uncovered REGULATOR OF FATTY ACID SYNTHESIS 1 (RFS1), whose expression is positively correlated with that of other regulators of hetACCase. The RFS gene family encodes two plastid inner envelope membrane proteins with undiscovered roles. Further analysis revealed that RFS1 colocalizes and directly interacts with CARBOXYLTRANSFERASE INTERACTOR 1 (CTI1). CRISPR/Cas9-mediated knockouts of RFSs exhibit enhanced hetACCase activity, higher FAS rates, and increased fatty acid contents, with particularly marked accumulation of absolute triacylglycerol levels in leaves, similar to cti mutants. The mutations of rfs and cti alter the plastid membrane distribution pattern of α-CT, leading to reduced hetACCase activity on the membrane, which could potentially be the original mechanism through which RFSs restrain hetACCase activity. Thus, we reveal a unique regulatory module that regulates de novo FAS and a genetic locus that may contribute to breeding of improved oil crops.
How well do different COVID-19 vaccines protect against different viral variants? A systematic review and meta-analysis
Authors: Hoang Thi Ngoc Anh , Byrne Aisling , Quach Ha-Linh , Bannister-Tyrrell Melanie , Vogt Florian
Published: November 2024

While the efficacy of coronavirus disease 2019 (COVID-19) vaccines has been evaluated in numerous trials, comprehensive evidence on how protection by different vaccines has varied over time remains limited. We aimed to compare protective effects of different vaccines against different viral variants. To achieve this, we searched Medline, Cochrane Library and Embase for randomized controlled trials assessing the efficacy of COVID-19 vaccines. Forest plots using Mantel–Haenszel and random-effects models were generated showing risk ratios (RRs) and 95% CIs by vaccines and variants. We included 36 studies with 90 variant-specific primary outcomes. We found a RR of 0.26 (95% CI 0.21 to 0.31) against all variants overall, with the highest protective effects against the wild-type (RR 0.13; 95% CI 0.10 to 0.18), followed by Alpha (RR 0.26; 95% CI 0.18 to 0.36), Gamma (RR 0.34; 95% CI 0.21 to 0.55), Delta (RR 0.39; 95% CI 0.28 to 0.56) and Beta (RR 0.49; 95% CI 0.40 to 0.62) variants. Nucleic acid vaccines showed the highest protection levels against all variants (RR 0.11; 95% CI 0.08 to 0.15), followed by protein subunit, inactivated virus and viral vector. In conclusion, we found high but heterogenous levels of protection for most COVID-19 vaccines, with decreasing protective effects for vaccines based on traditional technologies as SARS-CoV-2 variants emerged over time. Novel nucleic acid-based vaccines offered substantially higher and more consistent protection.
Let Them Have the Cities: Inflation, Collapse, and Retreat in the Postwar Survivalist West
Authors: Hubble Miles E
Published: November 2024

Before our contemporary label of “prepper,” and preceding the widespread adoption of “survivalist” in the late 1970s, those who sought self-sufficiency and security in remote locales of the American continent were known as “retreaters.” Anticipating catastrophes—chiefly hyperinflation, nuclear war, and urban chaos—violent enough to rend the social fabric of an increasingly decadent United States, these retreaters fled the swelling cities for the imagined security of the rural West to ride out the impending apocalypse. This article argues that one of the most salient and overlooked prime movers of the survivalist movement was a pervasive economic anxiety, metastasizing with the rampant stagflation of the 1970s. Drawing, for the first time, on twenty-five years of survivalist books, pamphlets, and newsletters, this paper shows that the secular eschatology of survivalism demands study if historians are to attain a clearer picture of the intellectual heritage of radical right millenarian visions from the late twentieth century up to the present day.
Injuries Following COVID-19 Infection in Academy-level Male Youth Soccer Players
Authors: Brougham Kyle , Warren Jonathan R. , Noe McKenna , Lee Brian R. , Margherio Shannon , Roberson James , Harvey Brian
Published: November 2024

Background:

Injury epidemiology data are key to injury prevention strategy development. Most such data surrounding the COVID-19 pandemic compare team injury data during the pandemic to that before the pandemic; few investigate injuries by infection status and even less involve academy-level organizations. We hypothesized that in male youth developmental academy-level soccer players, the rate of injury would be higher following COVID-19 infection than in the uninfected.

Methods:

Retrospective cohort study involving 141 male youth athletes from a single midwestern US developmental soccer academy during the spring 2022 soccer season. Injury data was gathered prospectively and analyzed retrospectively. Injury rate (incidence per 1000 playing hours), type, location, severity, mechanism, and mode of play were compared between COVID-19-positive and -negative athletes.

Results:

Thirty-four (24.11%) of 141 athletes tested positive for COVID-19. Of those 34, 20 (58.8%) sustained at least 1 injury, totaling 30 injuries. Of the 107 (75.89%) uninfected athletes, 30 (28.04%) sustained at least 1 injury, totaling 37 injuries. COVID-19-positive athletes sustained injuries at higher rates (7.10, 95% CI: 4.79-10.14) than uninfected athletes (2.71, 95% CI: 1.91-3.74), with an infected to uninfected adjusted injury rate ratio of 2.08 (95% CI: 1.20-3.59, P=0.008). COVID-19 positive players were 2.78 times more likely to sustain an injury following their infection than uninfected players (95% CI: 1.14-6.96, P=0.026). There were no significant differences in injury type (P=0.515), location (P=0.319), severity (P=0.679), mechanism (P=0.225), or mode of play (P=0.557) between groups.

Conclusions:

Among academy-level youth soccer athletes, injury rate increased significantly after COVID-19 infection; injury patterns were similar.

Level of Evidence:

II – Retrospective cohort study
High Preoperative Expectations May Not Need to be Feared
Authors: Wick Joseph , Jelen Preston , Wick Katherine , Dawson John , Swanberg Berit , Mueller Benjamin , Ramos Omar , Schwender James , Shafa Eiman , Mehbod Amir , Beauchamp Eduardo , Mullaney Kevin , Pinto Manuel , Perra Joseph , Carlson Bayard , Garvey Timothy A.
Published: November 2024

Study Design.

Retrospective study design.

Objective.

Evaluate correlations between preoperative expectations for pain improvement and 12-month functional outcomes and satisfaction following 1–2-level primary anterior cervical surgery.

Summary of Background Data.

Limited data exists evaluating correlations between patients’ preoperative expectations for pain relief and subsequent functional and satisfaction outcomes following primary anterior cervical surgery. Understanding correlations between expectations and outcomes may help identify patients most likely to benefit from surgery.

Materials and Methods.

Patients who underwent 1–2-level primary anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty for degenerative disease between 2016 and 2021 were included. All patients had 12-month Neck Disability Index (NDI) data. Preoperative expectations for pain relief were collected at the initial clinic visit using 5-point Likert scales. Preoperative and 12-month postoperative satisfaction were recorded using 7-point Likert scales. Covariates include age, sex, procedure type, smoking status, opioid use, worker’s compensation/litigation, body mass index, and indication (radiculopathy vs. myelopathy). Linear regression models were constructed to assess the 12-month NDI change score versus pain relief expectations. Additional regression models assessed expectations versus achievement of minimum clinically important difference at 3 and 12 months and satisfaction at 12 months.

Results.

198 ACDF (56.1% female, median age 57) and 52 CDR patients (55.8% female, median age 51) were included. Regression models found no significant correlations between pain relief expectations and degree of NDI score improvement at the 12-month postoperative timepoint or minimum clinically important difference achievement at the 3- and 12-month postoperative timepoints. There was no association between preoperative expectations and 12-month satisfaction. However, greater preoperative dissatisfaction was significantly associated with greater 12-month improvement in NDI score.

Conclusion.

Preoperative pain relief expectations were not associated with functional outcomes or satisfaction following 1–2 level primary ACDF or CDR at 12-month follow-up. Patients’ dissatisfaction with their preoperative spinal condition was significantly associated with greater 12-month NDI improvement. Assessing preoperative satisfaction may help identify those most likely to benefit from surgery.
Atezolizumab/bevacizumab and lenvatinib for hepatocellular carcinoma: A comparative analysis in a European real-world cohort
Authors: de Castro Tiago , Welland Sabrina , Jochheim Leonie , Leyh Cathrine , Shmanko Kateryna , Finkelmeier Fabian , Jeliazkova Petia , Jefremow Andre , Gonzalez-Carmona Maria A. , Kandulski Arne , Roessler Daniel , Ben Khaled Najib , Enssle Stefan , Venerito Marino , Fründt Thorben W. , Schultheiß Michael , Djanani Angela , Pangerl Maria , Maieron Andreas , Wirth Thomas C. , Marquardt Jens U. , Greil Richard , Fricke Christina , Günther Rainer , Schmiderer Andreas , Bettinger Dominik , Wege Henning , Scheiner Bernhard , Müller Martina , Strassburg Christian P. , Siebler Jürgen , Ehmer Ursula , Waidmann Oliver , Weinmann Arndt , Pinter Matthias , Lange Christian M. , Saborowski Anna , Vogel Arndt
Published: November 2024

Background:

Immunotherapy-based combinations are currently the standard of care in the systemic treatment of patients with HCC. Recent studies have reported unexpectedly long survival with lenvatinib (LEN), supporting its use in first-line treatment for HCC. This study aims to compare the real-world effectiveness of LEN to atezolizumab/bevacizumab (AZ/BV).

Methods:

A retrospective analysis was conducted to evaluate the effectiveness and safety of frontline AZ/BV or LEN therapy in patients with advanced HCC across 18 university hospitals in Europe.

Results:

The study included 412 patients (AZ/BV: n=207; LEN: n=205). Baseline characteristics were comparable between the 2 treatment groups. However, patients treated with AZ/BV had a significantly longer median progression-free survival compared to those receiving LEN. The risk of hepatic decompensation was significantly higher in patients with impaired baseline liver function (albumin-bilirubin [ALBI] grade 2) treated with AZ/BV compared to those with preserved liver function. Patients with alcohol-associated liver disease had poorer baseline liver function compared to other etiologies and exhibited a worse outcome under AZ/BV.

Conclusions:

In this real-world cohort, survival rates were similar between patients treated with LEN and those treated with AZ/BV, confirming that both are viable first-line options for HCC. The increased risk of hepatic decompensation in patients treated with AZ/BV who have impaired baseline liver function underscores the need for careful monitoring. Future trials should aim to distinguish more clearly between metabolic dysfunction–associated steatotic liver disease and alcohol-associated liver disease.