bluuebunny/crossref_metadata_2025 huggingface dataset:
Health, wellbeing and nutritional impacts after 2 years of free school meals in New Zealand
Authors: McKelvie-Sebileau Pippa , Swinburn Boyd , Glassey Rachael , Tipene-Leach David , Gerritsen Sarah
Published: August 2023

In 2020, a government-funded healthy school lunch program was introduced in a quarter of New Zealand schools, selected due to high levels of socio-economic barriers. This study assesses the impact of the introduction of the school lunch program from family (whānau), student and school principal perspectives. Across four schools, we conducted five focus groups (two with secondary students and three with family members) and four school principal interviews. Participating schools represented a range of contexts: primary and secondary, schools with cooks in on-site kitchens and schools receiving meals delivered by external caterers. Thematic analysis was used to develop themes describing the health, wellbeing and nutritional impact of the program. Family participants were 82% Indigenous Māori and self-identified as having ‘borderline’ (73.5%) or no financial security (8.8%). Seven positive impact themes were identified: improved food security, enhanced equity, increased appreciation of healthy foods for students, enhanced mana (wellbeing) for all, reduced financial hardship/stress for families, opportunities for nutritional learning and recognition that appreciation and uptake happen over time. Four negative impact themes were identified: low uptake that created food waste, perception that healthy food is not palatable for students, lack of knowledge of the program and loss of agency for students. This is the largest intervention in nutrition and food security for children implemented in New Zealand since the 1930's. The first 2 years have offered wellbeing and financial benefits for students and families, particularly when school environments promote uptake. More involvement of students and family members in the program planning is essential.
The Whole is Greater Than the Sum of Its Parts: Large-scale Phenomena Arising from Small-scale Biophysical Processes
Authors: Wheeler Jeanette D , Chan Kit Yu Karen
Published: August 2023

Synopsis

The symposium “Large-scale biological phenomena arising from small-scale biophysical processes” at the SICB 2023 Annual General Meeting focused on the cross-disciplinary exploration of emergent phenomena in biology. Interactions between cells or organisms at small scales within a system can govern patterns occurring at larger scales in space, time, or biological complexity. This theme recurs in many sub-disciplines of biology, including cell and developmental biology, evolution, and ecology. This symposium, and the associated special issue introduced here, showcases a wide range of cross-disciplinary collaborations among biologists, physicists, and engineers. Technological advancements in microscopy and microfluidics, as well as complementary advances in mathematical modeling and associated theory demonstrate the timeliness of this issue. This introduction seeks to provide useful background information to place the studies within this issue in a broader biophysical context and highlight similarities in ideas and approaches across systems and sub-disciplines. We hope to demonstrate that cross-disciplinary research linking small-scale biophysics to larger-scale emergent phenomena can help us understand problems ranging from single-cell behaviors to tissue formation and function, evolution of form, and the dynamics of communities.
Late erosion of Amplatzer Septal Occluder device 9 years after the implantation: a case report
Authors: Koumallos Nikolaos , Aggeli Costantina , Milas Theodoros , Tsioufis Kostantinos
Published: August 2023

Cardiac erosion is a rare but life-threatening complication after the interventional closure of an atrial septal defect. We present the case of a patient who developed cardiac erosion 9 years after the placement of an Amplatzer Septal Occluder. The patient presented to our hospital with symptoms of tamponade. Surgical exploration revealed a tear in the roof of the left atrium. To our knowledge, this is one of the most delayed presentations reported. In these cases, diagnosis is difficult and a level of clinical suspicion is demanded.
The added value of text from Dutch general practitioner notes in predictive modeling
Authors: Seinen Tom M , Kors Jan A , van Mulligen Erik M , Fridgeirsson Egill , Rijnbeek Peter R
Published: August 2023

Objective

This work aims to explore the value of Dutch unstructured data, in combination with structured data, for the development of prognostic prediction models in a general practitioner (GP) setting.

Materials and methods

We trained and validated prediction models for 4 common clinical prediction problems using various sparse text representations, common prediction algorithms, and observational GP electronic health record (EHR) data. We trained and validated 84 models internally and externally on data from different EHR systems.

Results

On average, over all the different text representations and prediction algorithms, models only using text data performed better or similar to models using structured data alone in 2 prediction tasks. Additionally, in these 2 tasks, the combination of structured and text data outperformed models using structured or text data alone. No large performance differences were found between the different text representations and prediction algorithms.

Discussion

Our findings indicate that the use of unstructured data alone can result in well-performing prediction models for some clinical prediction problems. Furthermore, the performance improvement achieved by combining structured and text data highlights the added value. Additionally, we demonstrate the significance of clinical natural language processing research in languages other than English and the possibility of validating text-based prediction models across various EHR systems.

Conclusion

Our study highlights the potential benefits of incorporating unstructured data in clinical prediction models in a GP setting. Although the added value of unstructured data may vary depending on the specific prediction task, our findings suggest that it has the potential to enhance patient care.
Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using a Time-Driven Activity-Based Costing Method: A Single-Center Study
Authors: Ali Aamir , Phillips Jordana , Ljuboja Damir , Shehab Syed , Pisano Etta D , Kaplan Robert S , Sarwar Ammar
Published: August 2023

Objective

Measuring the cost of performing breast imaging is difficult in healthcare systems. The purpose of our study was to evaluate this cost using time-driven activity-based costing (TDABC) and to evaluate cost drivers for different exams.

Methods

An IRB-approved, single-center prospective study was performed on 80 female patients presenting for breast screening, diagnostic or biopsy exams from July 2020 to April 2021. Using TDABC, data were collected for each exam type. Included were full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), contrast-enhanced mammography (CEM), US and MRI exams, and stereotactic, US-guided and MRI-guided biopsies. For each exam type, mean cost and relative contributions of equipment, personnel and supplies were calculated.

Results

Screening MRI, CEM, US, DBT, and FFDM costs were $249, $120, $83, $28, and $30. Personnel was the major contributor to cost (60.0%–87.0%) for all screening exams except MRI where equipment was the major contributor (62.2%). Diagnostic MRI, CEM, US, and FFDM costs were $241, $123, $70, and $43. Personnel was the major contributor to cost (60.5%–88.6%) for all diagnostic exams except MRI where equipment was the major contributor (61.8%). Costs of MRI-guided, stereotactic and US-guided biopsy were $1611, $826, and $356. Supplies contributed 40.5%–49.8% and personnel contributed 30.7%–55.6% to the total cost of biopsies.

Conclusion

TDABC provides assessment of actual costs of performing breast imaging. Costs and contributors varied across screening, diagnostic and biopsy exams and modalities. Practices may consider this methodology in understanding costs and making changes directed at cost savings.
A stitch of CD9 saves nine: CD9+ tissue-resident memory T cells in Sjogren's syndrome and autoimmunity
Authors: Li Dan , Zhang Song
Published: August 2023

This editorial underscores the role of CD9+ tissue-resident memory (Trm) cells in autoimmune diseases, specifically in Sjogren's syndrome, and points to potential implications for better understanding the nature of recurrent autoimmune flares. New findings from Chang et al. highlight the presence and functional role of CD8+ Trm cells in inflamed labial glands in Sjogren's syndrome patients. This, together with the noted expression of CD9 in these Trm cells, opens a new research avenue into the mechanistic understanding of autoimmune diseases. The editorial also emphasizes the need for further studies to answer pressing questions related to CD9+ Trm cell function and their role in autoimmune diseases.
Structural basis for the selective methylation of 5-carboxymethoxyuridine in tRNA modification
Authors: Yoo Jaehun , Lee Jangmin , Kim Jungwook
Published: August 2023

Posttranscriptional modifications of tRNA are widely conserved in all domains of life. Especially, those occurring within the anticodon often modulate translational efficiency. Derivatives of 5-hydroxyuridine are specifically found in bacterial tRNA, where 5-methoxyuridine and 5-carboxymethoxyuridine are the major species in Gram-positive and Gram-negative bacteria, respectively. In certain tRNA species, 5-carboxymethoxyuridine can be further methylated by CmoM to form the methyl ester. In this report, we present the X-ray crystal structure of Escherichia coli CmoM complexed with tRNASer1, which contains 5-carboxymethoxyuridine at the 5′-end of anticodon (the 34th position of tRNA). The 2.22 Å resolution structure of the enzyme-tRNA complex reveals that both the protein and tRNA undergo local conformational changes around the binding interface. Especially, the hypomodified uracil base is flipped out from the canonical stacked conformation enabling the specific molecular interactions with the enzyme. Moreover, the structure illustrates that the enzyme senses exclusively the anticodon arm region of the substrate tRNA and examines the presence of key determinants, 5-carboxymethoxyuridine at position 34 and guanosine at position 35, offering molecular basis for the discriminatory mechanism against non-cognate tRNAs.
Reconstructing interfacial manganese deposition for durable aqueous zinc–manganese batteries
Authors: Hu Yida , Liu Zhexuan , Li Lanyan , Guo Shan , Xie Xuefang , Luo Zhigao , Fang Guozhao , Liang Shuquan
Published: August 2023

Low-cost, high-safety, and broad-prospect aqueous zinc−manganese batteries (ZMBs) are limited by complex interfacial reactions. The solid−liquid interfacial state of the cathode dominates the Mn dissolution/deposition process of aqueous ZMBs, especially the important influence on the mass and charge transfer behavior of Zn2+ and Mn2+. We proposed a quasi-eutectic electrolyte (QEE) that would stabilize the reversible behavior of interfacial deposition and favorable interfacial reaction kinetic of manganese-based cathodes in a long cycle process by optimizing mass and charge transfer. We emphasize that the initial interfacial reaction energy barrier is not the main factor affecting cycling performance, and the good reaction kinetics induced by interfacial deposition during the cycling process is more conducive to the stable cycling of the battery, which has been confirmed by theoretical analysis, quartz crystal microbalance with dissipation monitoring, depth etching X-ray photon-electron spectroscopy, etc. As a result, the QEE electrolyte maintained a stable specific capacity of 250 mAh g−1 at 0.5 A g−1 after 350 cycles in zinc−manganese batteries. The energy density retention rate of the ZMB with QEE increased by 174% compared to that of conventional aqueous electrolyte. Furthermore, the multi-stacked soft-pack battery with a cathodic mass load of 54.4 mg maintained a stable specific capacity of 200 mAh g−1 for 100 cycles, demonstrating its commercial potential. This work proves the feasibility of adapting lean-water QEE to the stable aqueous ZMBs.
Determinants of public sector efficiency: a panel database from a stochastic frontier analysis
Authors: Apeti Ablam Estel , Bambe Bao-We-Wal , Lompo Aguima Aime Bernard
Published: August 2023

This article provides a large dataset on PSE using a parametric approach, and covering 158 countries of all income levels, over the period 1990–2017. The analysis includes four sectors: education, health, infrastructure, and public administration. We further consider three efficiency indicators regarding the ‘Musgravian’ tasks for government: allocation, distribution, and stabilization. After computing the efficiency scores for our sample countries, we examine their determinants using a wide range of economic and institutional factors. Our key findings are that trade globalization, factor productivity, and institutional quality seem to be important determinants of total PSE. The results remain robust to alternative specifications and methods. Finally, we provide additional evidence by exploring the sensitivity of the main determinants to different country groups, considering the level of economic development, geographical regions, and fragile states.
Real-World Impact of Adjuvant Anti-HER2 Treatment on Characteristics and Outcomes of Women With HER2-Positive Metastatic Breast Cancer in the ESME Program
Authors: Le Du Fanny , Carton Matthieu , Bachelot Thomas , Saghatchian Mahasti , Pistilli Barbara , Brain Etienne , Loirat Delphine , Vanlemmens Laurence , Vermeulin Thomas , Emile George , Gonçalves Anthony , Ung Mony , Robert Marie , Jaffre Anne , Desmoulins Isabelle , Jouannaud Christelle , Uwer Lionel , Marc Ferrero Jean , Mouret-Reynier Marie-Ange , Jacot William , Chevrot Michaël , Delaloge Suzette , Diéras Véronique
Published: August 2023

Background

Although adjuvant cancer treatments increase cure rates, they may induce clonal selection and tumor resistance. Information still lacks as whether (neo)adjuvant anti-HER2 treatments impact the patterns of recurrence and outcomes of HER2-positive (HER2+) metastatic breast cancer (MBC). We aimed to assess this in the large multicenter ESME real-world database.

Patients and Methods

We examined the characteristics and outcomes (overall survival (OS) and progression-free survival under first-line treatment (PFS1)) of HER2+ patients with MBC from the French ESME program with recurrent disease, as a function of the previous receipt of adjuvant trastuzumab. Multivariable analyses used Cox models adjusted for baseline demographic, prognostic factors, adjuvant treatment received, and disease-free interval.

Results

Two thousand one hundred and forty-three patients who entered the ESME cohort between 2008 and 2017 had a recurrent HER2+ MBC. Among them, 56% had received (neo)adjuvant trastuzumab and 2.5% another anti-HER2 in this setting. Patients pre-exposed to trastuzumab were younger, had a lower disease-free interval, more HR-negative disease and more metastatic sites. While the crude median OS appeared inferior in patients exposed to adjuvant trastuzumab, as compared to those who did not (37.2 (95%CI 34.4-40.3) versus 53.5 months (95% CI: 47.6-60.1)), this difference disappeared in the multivariable model (HR = 1.05, 95%CI 0.91-1.22). The same figures were observed for PFS1.

Conclusions

Among patients with relapsed HER2+ MBC, the receipt of adjuvant trastuzumab did not independently predict for worse outcomes when adjusted to other prognostic factors.
Pre-existing Interstitial Lung Abnormalities and Immune Checkpoint Inhibitor-Related Pneumonitis in Solid Tumors: A Retrospective Analysis
Authors: Horiuchi Kohei , Ikemura Shinnosuke , Sato Takashi , Shimozaki Keitaro , Okamori Satoshi , Yamada Yoshitake , Yokoyama Yoichi , Hashimoto Masahiro , Jinzaki Masahiro , Hirai Ikuko , Funakoshi Takeru , Mizuno Ryuichi , Oya Mototsugu , Hirata Kenro , Hamamoto Yasuo , Terai Hideki , Yasuda Hiroyuki , Kawada Ichiro , Soejima Kenzo , Fukunaga Koichi
Published: August 2023

Background

Immune checkpoint inhibitors (ICIs) have demonstrated efficacy over previous cytotoxic chemotherapies in clinical trials among various tumors. Despite their favorable outcomes, they are associated with a unique set of toxicities termed as immune-related adverse events (irAEs). Among the toxicities, ICI-related pneumonitis has poor outcomes with little understanding of its risk factors. This retrospective study aimed to investigate whether pre-existing interstitial lung abnormality (ILA) is a potential risk factor for ICI-related pneumonitis.

Materials and Methods

Patients with non-small cell lung cancer, malignant melanoma, renal cell carcinoma, and gastric cancer, who was administered either nivolumab, pembrolizumab, or atezolizumab between September 2014 and January 2019 were retrospectively reviewed. Information on baseline characteristics, computed tomography findings before administration of ICIs, clinical outcomes, and irAEs were collected from their medical records. Pre-existing ILA was categorized based on previous studies.

Results

Two-hundred-nine patients with a median age of 68 years were included and 23 (11.0%) developed ICI-related pneumonitis. While smoking history and ICI agents were associated with ICI-related pneumonitis (P = .005 and .044, respectively), the categories of ILA were not associated with ICI-related pneumonitis (P = .428). None of the features of lung abnormalities were also associated with ICI-related pneumonitis. Multivariate logistic analysis indicated that smoking history was the only significant predictor of ICI-related pneumonitis (P = .028).

Conclusion

This retrospective study did not demonstrate statistically significant association between pre-existing ILA and ICI-related pneumonitis, nor an association between radiologic features of ILA and ICI-related pneumonitis. Smoking history was independently associated with ICI-related pneumonitis. Further research is warranted for further understanding of the risk factors of ICI-related pneumonitis.
Gardening and the Power of Engagement with Nature for Mental Well-Being
Authors: Brook Isis
Published: August 2023

The evidence is now well established that natural environments, nearby nature, and activities engaging with plants can improve mental well-being. This chapter will outline the literature that addresses, for example, therapeutic horticulture, increasing green spaces in urban environments, and prescribing time in nature. The literature reveals a picture of the helpfulness of plants and gardening activities for those with mental health problems, but also the requirement of nearby nature for everyone. The concepts examined here, such as the reasonable person model, nature deficit disorder, attention restoration, and biophilia, support the idea that some contact with nature is a human requirement. The processes involved in the human/plant relationship are examined through participant accounts in the literature and interrogation of the aesthetic elements involved in the experiential nature of gardening. Aesthetic engagement, and the shifts in our focus from self to world that it can bring about, present a speculative answer to why gardening can bring about positive and helpful mental states that support well-being.
An Aesthetics of Relating and Its (Therapeutic) Potentials
Authors: Fürholzer Katharina , Pröll Julia
Published: August 2023

In light of ongoing biomedical processes of globalization closely linked with the emergence of ‘medicoscapes’, the proposed article focusses on issues of transcultural psychiatry and intercultural psychotherapy from the viewpoint of literary criticism. Drawing on the importance (Critical) Medical Humanities recently attached to culture—and its crucial impact on (mental) illness experience—the main purpose of this paper is to relate, in a postcolonial theoretical framework, Western and non-Western conceptions of mental illness, health, and cure in order to explore the emerging contact zones and to overcome the unproductive ‘othering’ of medical exoticism considering non-Western forms of healing and therapy as mere curiosities. As key link we will consider the (trans-)cultural technique of narrating (life) stories as it appears in an anglophone and francophone corpus of (not only migrant) literature. As some sort of ‘third space’ or ‘contact zone’, literature, especially when governed by a migratory aesthetics of relating, can be seen as a constant reminder of the irreducible heterogeneity of (medical) cultures as well as a negotiating space that not only builds bridges between the ‘self’ and the ‘other’ but encourages to undertake a salutary ‘self-limitation’ of hegemonic (bio-)medical paradigms, as can be shown, for instance, by productive fictional ‘sinicizations’ of Western psychoanalysis.
Mirror. Lens. PuzzleBox. Metaphor.
Authors: Goldbloom Bloch William
Published: August 2023

Jorge Luis Borges, a brilliant autodidact, was a philosophic essayist, poet, literary theorist, and writer of remarkable short stories that contributed to the founding of a unique brand of scientific and mathematical magical realism. He was neither a scientist nor a mathematician, yet his short stories have inspired scientists and mathematicians—practitioners—in four distinct intertwined ways. First, his work acts as a mirror: many of the characters find themselves in a crisis of profound despair when confronted with the fundamental unknowability of the universe or imaginative representations thereof. Practitioners find ample opportunity to empathize! Second, the stories act as lens into interesting subjects and substantial ideas for practitioners to focus on. Third, many practitioners are drawn to intricate puzzles for recreation; Borges’s short stories appeal to that sensibility. Finally, the stories serve as bridges from practitioners to other audiences by providing a rich store of striking metaphors.
Esoteric Physiology and Subtle Body Systems
Authors: Hayes Glen A.
Published: August 2023

In this chapter, the author considers some of the numerous systems of esoteric physiology to be found in Hindu and Buddhist tantra—often known as the “yogic body” or “subtle body.” This alternative body has been construed in many different ways in tantric traditions, but it is typically of an esoteric nature, is accessed and inhabited via initiation and other ritual processes, is connected to breathing processes, reveals secret knowledge and magical powers, and is regarded as a microcosm. The author considers how esoteric physiology is best understood through Gavin Flood’s concept of the “entextualization of the body,” which allows us to consider the contexts and uses of specific subtle body systems. Flood demonstrates that the systems of the subtle body are not discrete ontological entities (as often claimed by modern yoga practitioners) but rather the expression of cosmologies and ritual systems in specific texts.
Metaphysical Idealists in Britain
Authors: Thomas Emily
Published: August 2023

Idealists agree that reality is somehow mental, holding, say, that reality comprises consciousness or spirit. Idealism can be developed in many different ways and, before the distinctive movement known as “British idealism” emerged, other idealisms were present in Britain. This chapter offers the first-ever study of female idealists in nineteenth-century Britain. It identifies six pertinent women, and focuses on three of them, exploring the idealist metaphysics of Constance Naden, Victoria Welby, and Arabella Buckley. It situates their idealisms in the context of Victorian metaphysics; shows that each developed a different kind of idealism, drawing on varied sources from Kant to Herbert Spencer; and contrasts their idealisms with one another.
Performance, Technology, and the Good Life
Authors: Roholt Tiger
Published: August 2023

This chapter explores the relations between musical instruments, performance, sociality, and well-being by drawing upon Albert Borgmann’s philosophy of technology. In-passing, Borgmann categorizes musical instruments as “focal things.” He does not consider the implications of this characterization; this chapter does. Borgmann does not place musical performance in the associated category, “focal practice”; this chapter does. Among the benefits of examining performance and instruments through Borgmann’s framework, we are given the conceptual tools for understanding just how some technologies make a positive contribution to performance (in terms of what the author calls “technological paraphernalia”) and just how other technologies threaten the focal practice of performance (what Borgmann calls “technological devices”). More broadly, Borgmann has a unique way of articulating what it is to treat performance and instruments as ends in themselves rather than as means. Through this articulation, we see that performance and instruments can contribute to a good life through what Borgmann calls “centering.”
Critical Listening and Authorial Agency as Radical Practices of Care
Authors: Bylica Kelly
Published: August 2023

Listening is often a unidirectional practice in North American music education, one that is used as a functional tool to help uncover the “right” or “best” answer to a posed question. Listening, however, can also be reframed as a multidimensional process wherein viewpoints and possibilities that represent the plurality of the world are explored. Through practical examples, this chapter considers the ways in which listening in both musical and dialogical encounters can serve as opportunities to honor and engage with the voices and experiences of students. When viewed as an opportunity to inquire into difference, such practices can help both students and educators question taken-for-granted norms, engage in musical risk-taking, and work toward more complex understandings of their experiences together through music.
France
Authors: Ruiz Fabri Hélène , Stoppioni Edoardo
Published: August 2023

Understanding what international law represents in France today requires understanding a complex set of layers and meanings. It is necessary to take a historical perspective and grasp the fundamental historical role that France played in forming international law as a power able to shape it according to its own political needs at certain periods in time. But it is also necessary to investigate the way international law exists in the everyday life of the national legal system: while different national constitutional systems implied an evolution from a strong dualism to a subtle monism, national judges introduced nuances in the textual option, most notably with the reassertion of the constitution’s primacy. Finally, international law operates in France through a set of traditions which translate into the methods that lawyers use to understand international law, the ways they are educated, and colouring the French approaches to international law.
Evolution of Modern Literature and Film
Authors: Sobchuk Oleg
Published: August 2023

The evolution of complex narratives, such as fictional books or films, is a fairly new area of cultural-evolutionary research. It gained momentum only recently, when researchers got access to large datasets of literature, movies, and other kinds of storytelling, allowing us to discover long-lasting historical trends and regularities. This chapter, first, discusses a theoretical question: in what sense do narratives evolve? More precisely, it focuses not on the transmission of stories themselves, but on the evolution of narrative forms, or techniques of storytelling. Then, the chapter proceeds to describing how content-based, or hedonic, selection influences the evolution of narrative forms—and briefly, the role of several other evolutionary mechanisms, such as drift and accumulation of innovations. Finally, the chapter schematically presents the methods used for studying the evolution of literature and film at a large scale: from manual coding to text mining and other computational techniques.
Sexual posttraumatic stress among investigators of child sexual abuse material
Authors: Gewirtz-Meydan Ateret , Mitchell Kimberly J , O’Brien Jennifer E
Published: August 2023

The current study aims to examine the sexual posttraumatic stress symptoms (sexual PTSS) among investigators of child sexual abuse material (CSAM). Previous findings indicated that sexual PTSS has a unique impact on mental health and well-being compared with traditional PTSS, highlighting a gap in the literature on how exposure to CSAM affects investigators, including their sexual lives. This study sought to fill this gap by examining the sexual PTSS of CSAM investigators. The sample included 500 participants (61% male and 37.4% female) who were police investigators, forensic examiners, and others connected with the criminal justice system across the USA. Participants answered questions about their CSAM exposure and mental health (depression, anxiety, PTSS, and sexual PTSS). The study found that the content of CSAM, mental health symptomatology, being a female investigator, and live streaming of CSAM were associated with increased sexual PTSS. The results suggest that viewing CSAM may affect the sexual response of some investigators and that certain aspects of the job may increase the risk of sexual PTSS. The study highlights the need for wellness programs to provide support related to the possible effects of CSAM on investigators’ sexual response.
Using machine learning to diagnose relativistic electron distributions in the Van Allen radiation belts
Authors: Killey S , Rae I J , Chakraborty S , Smith A W , Bentley S N , Bakrania M R , Wainwright R , Watt C E J , Sandhu J K
Published: August 2023

The behaviour of relativistic electrons in the radiation belt is difficult to diagnose as their dynamics are controlled by simultaneous physical processes, some of which may be still unknown. Signatures of these physical processes are difficult to identify in large amounts of data; therefore, a machine learning approach is developed to classify energetic electron distributions which have been driven by different mechanisms. A series of unsupervised machine learning tools have been applied to 7 yrs of Van Allen Probe Relativistic Electron-Proton Telescope data to identify six different typical types of plasma conditions, each with a distinctly shaped energy-dependent pitch angle distribution (PAD). The PADs at lower energies have shapes as expected from previous studies – either butterfly, pancake, or flattop, providing evidence that machine learning has been able to reliably classify the relativistic electrons in the radiation belts. Further applications of this technique could be applied to other space plasma regions, and data sets from inner heliospheric missions such as Parker Solar Probe and Solar Orbiter, to planetary magnetospheres and the JUICE mission. Understanding PADs across the heliosphere enables researchers to determine the physical mechanisms that drive pitch angle evolution and investigate their spatial and temporal dependence and physical properties.
NEURIM PHARMACEUTICALS (1991) LTD v GENERICS (UK) LTD (No. 2)
Authors:   Patents Court
Published: August 2023

H1 Patents — European patents — Pharmaceuticals — Insomnia treatments — Melatonin — Validity — Concurrent proceedings before EPO — European Patent (UK) held valid by Patents Court — Patent later revoked by the EPO Technical Board of Appeal — Second action brought in relation to patent granted on divisional application — Preliminary issues — Issue estoppel — Winner’s appeals — Permission to appeal refused — Abuse of process — Competition law — Case management
The first report of Champsosaurus lindoei (Choristodera: Champsosauridae) from the Campanian of the United States: anatomical, phylogenetic, and palaeoecological significance
Authors: Dudgeon Thomas W , Mallon Jordan C , Evans David C
Published: August 2023

Although the neochoristodere Champsosaurus is well documented in Campanian deposits of western North America, species-diagnostic remains from these strata are restricted to the Dinosaur Park Formation of Alberta, Canada. Here, we describe an exceptionally well-preserved specimen of Champsosaurus lindoei from the Two Medicine Formation of Montana, USA—one of the few occurrences of the genus within the formation, and the first confirmed occurrence of C. lindoei outside of Dinosaur Provincial Park and its vicinity. This specimen preserves previously unknown aspects of this species, including the pes, tail, and integument, allowing for the first detailed postcranial description in this taxon. The integumentary impressions preserved on the ventral surface are the largest described thus far for Champsosaurus, supporting previous suggestions that Champsosaurus scales increase in size ventrally. We also conducted the first species-level phylogeny for Champsosaurus, where we recovered a pectinate tree topology with Palaeocene species as the sister taxa to older Maastrichtian and Campanian species, and provide further evidence for at least three lineages of Champsosaurus surviving the Cretaceous-Palaeogene (K-Pg) extinction. Finally, the recovery of the specimen from the semi-arid upland deposits of the Two Medicine Formation suggests that Champsosaurus may have been better able to withstand drier environments than previously thought.
Current Perspectives on Pressure Injuries in Persons with Dark Skin Tones from the National Pressure Injury Advisory Panel
Authors: Black Joyce , Cox Jill , Capasso Virginia , Bliss Donna Z. , Delmore Barbara , Iyer Vignesh , Massaro Jacqueline , Munro Cassendra , Pittman Joyce , Ayello Elizabeth A.
Published: August 2023

Background

Pressure injury (PI) development is multifactorial. In patients with dark skin tones, identifying impending PIs by visual skin assessment can be especially challenging. The need for improved skin assessment techniques, especially for persons with dark skin tones, continues to increase. Similarly, greater awareness of the need for inclusivity with regard to representation of diverse skin colors/tones in education materials is apparent.

Objective

To provide current perspectives from the literature surrounding skin assessment and PI development in patients with dark skin tones.

Methods

The following elements will be discussed through the lens of skin tone: (1) historical perspectives of PI staging from the National Pressure Injury Advisory Panel, (2) epidemiology of PI, (3) anatomy and physiology of the skin, (3) skin tone assessment and measurement, (4) augmented visual assessment modalities, (5) PI prevention, (6) PI healing, (7) social determinants of health, and (8) gaps in clinician education.

Conclusions

This article highlights the gap in our clinical knowledge regarding PIs in patients with dark skin tones. Racial disparities with regard to PI development and healing are especially clear among patients with dark skin tones. Skin tone color assessment must be standardized and quantifiable in clinical education, practice, and research. This work is urgently needed, and support from private and governmental agencies is essential.
Enterovirus Central Nervous System Infection in Infancy, the Value of Routine Testing
Authors: Giva Sheiniz , Barry Rachel , Drew Richard J. , Geoghegan Sarah
Published: August 2023

Background:

Human nonpolio enterovirus (EV) is a major cause of infection in neonates and infants; however, the clinical presentation and cerebrospinal fluid findings vary significantly. Infection caused by EV in patients under 1 year of age can present with a broad clinical spectrum, from fever to severe systemic and/or neurological disease.

Methods:

Retrospective cohort analysis of infants with EV central nervous system (CNS) infection presenting to a tertiary center between January 2017 and December 2022. We recorded patient demographics, parent-reported symptoms at presentation, and blood and cerebrospinal fluid (CSF) testing at presentation.

Results:

Seventy-eight patients were included in the final study. Forty-one percent of infants with an EV CNS infection had a normal CSF white blood cell count. Clinical presentation was similar in infants with and without CSF pleocytosis. Median C-reactive protein was higher in cases of EV CNS infection without pleocytosis.

Conclusion:

EV CNS infection commonly presents without CSF pleocytosis. Testing for EV should be considered in febrile infants with no source regardless of CSF parameters.
Who Hurt You at Work? Results From a Nationwide Survey of Association Between Absenteeism and Workplace Violence, Stratified by Perpetrator
Authors: Lee Na-Rae , Lee Kyung-Jae , Lee June-Hee
Published: August 2023

Objective

This study aimed to determine the association between workplace violence and sickness absenteeism.

Methods

We analyzed the data from the fifth and sixth waves of the Korean Working Conditions Surveys. Individuals younger than 18 years and self-employed or unpaid family workers were excluded. Descriptive statistics, χ2 tests, and multiple logistic regression analysis were conducted.

Results

After adjusting for sociodemographic, occupational, and job-related characteristics, we found that the workers who had experienced workplace violence had higher rates of sickness absenteeism, especially when the perpetrator of violence was a coworker.

Conclusions

Daily contact with the perpetrator at the workplace can cause distress and recollection of painful memories; thus, the aftermath of being harassed inside the workplace can be even more devastating than the event itself. A sensitive approach to recognizing the perpetrators of violence is needed.
Sonomyography for Control of Upper-Limb Prostheses: Current State and Future Directions
Authors: Engdahl Susannah M. , Acuña Samuel A. , Kaliki Rahul R. , Sikdar Siddhartha
Published: August 2023

Problem Statement

Despite the recent advancements in technology, many individuals with upper-limb loss struggle to achieve stable control over multiple degrees of freedom in a prosthesis. There is an ongoing need to develop noninvasive prosthesis control modalities that could improve functional patient outcomes.

Proposed Solution

Ultrasound-based sensing of muscle deformation, known as sonomyography, is an emerging sensing modality for upper-limb prosthesis control with the potential to significantly improve functionality. Sonomyography enables spatiotemporal characterization of both superficial and deep muscle activity, making it possible to distinguish the contributions of individual muscles during functional movements and derive a large set of independent prosthesis control signals. Using sonomyography to control a prosthesis has shown great promise in the research literature but has not yet been fully adapted for clinical use. This article describes the implementation of sonomyography for upper-limb prosthesis control, ongoing technological development, considerations for deploying this technology in clinical settings, and recommendations for future study.

Clinical Relevance

Sonomyography may soon become a clinically viable modality for upper-limb prosthesis control that could offer prosthetists an additional solution when selecting optimal treatment plans for their patients.
Triage Value of Cervical Exfoliated Cell DNA Ploidy Analysis in Cervical High-Risk Human Papillomavirus–Positive Women
Authors: Chu Boliang , Dong Jie , Chen Yingying , Ru Xiaofang , Zhang Wenwen , Chen Yun , Zhang Xiaoxing , Cheng Xiaodong
Published: August 2023

Objective

This study aimed to investigate the triage value obtained in DNA ploidy analysis of cervical exfoliated cells in women with high-risk human papillomavirus (HR-HPV)-positive status in the primary screening of cervical cancer.

Methods

The authors selected 3,000 HR-HPV–positive women for cervical exfoliated cell sampling and conducted DNA ploidy analysis, liquid-based cytology (LBC), colposcopy, and cervical biopsy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of high-grade squamous intraepithelial lesion (HSIL)-positive detection between DNA ploidy analysis and LBC were compared according to histopathology diagnosis as the golden criteria, and the efficacy of predicting HSIL-positive immediate risk was evaluated.

Results

A total of 2,892 HR-HPV–positive women were enrolled in the investigation. For HSIL+ women, the DNA ploidy group showed a significantly higher sensitivity (CIN2+: 79.21% vs 65.35%, p = .022; CIN3+: 81.48% vs 70.37%, p = .013), lower specificity (CIN2+: 85.00% vs 96.59%, p < .001; CIN3+: 84.14% vs 93.41%, p < .001), and lower PPV (CIN2+: 16.23% vs 29.33%, p = .001; CIN3+: 8.92% vs 16.89%, p = .002) compared with the LBC group, whereas the NPV showed no significant difference. Compared with LBC alone in diagnosing HSIL, DNA ploidy combined with LBC showed higher specificity (CIN2+: 99.21% vs 96.59%, p = .003; CIN3+: 96.48% vs 93.41%, p < .001) and higher PPV (CIN2+: 41.35% vs 29.33%, p = .022; CIN3+: 24.81% vs 16.89%, p = .028), whereas no significant difference was observed in the sensitivity (CIN2+: 54.46% vs 65.35%, p = .063; CIN3+: 61.11% vs 70.37%, p = .221) and NPV (p > .05). Among the HR-HPV–positive women positive for DNA ploidy, the imminent risk of CIN2+ and CIN3+ were 15.62% and 8.92%, respectively, above the threshold for the colposcopy positive rate. Among the positive cases both for DNA ploidy and the LBC result of negative for intraepithelial lesion or malignancy, the immediate risk of CIN3+ was 3.31%, below the threshold for colposcopy positive rate. Besides, for women with LBC result of ASC-US and above, the immediate risk of CIN3+ was greater than 4%.

Conclusions

The DNA ploidy analysis can be used as an effective triage method for HR-HPV–positive women during the primary screening of cervical cancer, although it can provide higher specificity when combined with LBC and reduce the referral rate for colposcopy.
Content Validity of a High-Fidelity Surgical Middle Ear Simulator: A Randomized Prospective International Multicenter Trial
Authors: Youner Emily R. , Chillakuru Yeshwant R. , Xu Helen , Dedmon Matthew , Labadie Robert , Djalilian Hamid , Mahboubi Hossein , Westerberg Brian , Vaisbuch Yona , Blevins Nikolas , Chen Joseph , Lin Vincent , Joyce Morgan G. , Moncada Paola X. , Dabiri Sasan , Gurgel Richard K. , Kouhi Ali , Monfared Ashkan S.
Published: August 2023

Objective

After demonstration of face validity of a surgical middle ear simulator (SMS) previously, we assessed the content validity of the simulator with otolaryngology residents.

Study Design

Multicenter randomized prospective international study.

Setting

Four academic institutions.

Methods

Novice participants were randomized into control, low-fidelity (LF), and high-fidelity (HF) groups. Control and LF produced 2 recordings from 2 attempts, and HF produced 4 recordings from 10 attempts, with trials 1, 4, 7, and 10 used for scoring. Three blinded experts graded videos of the simulated stapedectomy operation using an objective skills assessment test format consisting of global and stapedotomy-specific scales.

Results

A total of 152 recordings from 61 participants were included. Baseline characteristics did not differ significantly between groups. Depending on the step of the operation, inter-rater reliability ranged from 24 to 90%. For LF and HF, years of training was significantly associated with improved scores in certain objective skills assessment test subparts. HF outperformed the control group on stapes and global scores (p < 0.05). The HF group demonstrated improvement in global score over trials, but plateaued after four trials. Scores varied greatly for participants from different institutions in certain operative steps, such as transecting incudostapedial joints, likely due to differences in instrumentation and time elapsed since manufacture.

Conclusion

Practice with SMS led to better performance in both global and stapes-specific scores. Further studies are needed to examine construct validity and to create otology-appropriate grading systems. Variables like instrumentation and decline in flexibility of the simulator after 12 months greatly affect performance on the simulator.
Application of Field Sterility to Safely Reduce Cost and Waste in Cleft Surgery
Authors: Taub Peter J. , Oleru Olachi , Mandelbaum Max G. , Seyidova Nargiz
Published: August 2023

Background:

Healthcare spending in the United States remains a major concern, requiring reforms to control spending and curtail costs. Medical supply is one of the largest expenses for hospitals and strategies should be utilized to reduce nonbeneficial service delivery, which increases cost without concomitant increase in value. Introduction of field sterility is one of the potential strategies that has been applied in several surgical disciplines to improve cost-efficiency by reducing overuse of resources and decreasing enormous medical waste. Of course, this must be applied without a diminution in safety.

Methods:

The PubMed, Medline, and Cochrane databases from 1980 to 2022 were used to review literature. Key words included “cleft surgery and field sterility,” “sterile gloves and oral surgery,” “oral surgery and field sterility,” “sterile techniques and cleft palate surgery,” “sterile versus nonsterile gloves,” “sterile and non-sterile gloves and minor surgery,” “skin laceration repair and sterile techniques,” “sterile gloves and wound suture,” “surgical site infection and field sterility,” “operating room versus clinical setting,” “operating rooms economics and hand surgery,” and “main operating room versus ambulatory.”

Results:

The literature search yielded 827 articles. Following evaluation of titles, abstracts, and manuscript contents, 23 articles were ultimately included, of which 10 discussed field sterility and cost-efficiency for cutaneous procedures, 9 hand surgery, and 4 oral surgery. There was no study evaluating field sterility application in cleft surgery. In the reviewed studies, no statistical significance was observed in surgical site infection (SSI) with substantial cost savings and medical waste reduction when hand procedures were performed in ambulatory settings with field sterility compared to the main operating room (OR). Furthermore, no difference was observed for SSI in wound closure, excision of skin lesions, or Mohs micrographic surgery when nonsterile gloves were used.

Conclusion:

The incidence of infection following most cleft-related procedures remains low. As such, the application of field sterility may be ideal for this setting. The cost and waste associated with standard operating protocols are not warranted for many cleft procedures.