bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectives of Resident and Attending Ophthalmologists on Common Ethical Dilemmas in Research
Authors: Miller Sarah C. , Tsou Brittany C. , Fliotsos Michael J. , Legault Gary L. , Wang Jiangxia , Mondzelewski Todd J. , Munson Patrick D. , Lorch Alice , Green Laura K. , Kim Won I. , Pelton Ron W. , Woreta Fasika A. , Justin Grant A.
Published: November 2023

Purpose To assess how resident and attending ophthalmologists perceive and evaluate ethically controversial scenarios regarding mentorship, authorship, and ethics compliance that may occur during research involving residents.

Methods An online survey was developed and contained 14 controversial vignettes based on common research scenarios that can occur when conducting research with trainees. The scenarios were designed to capture issues regarding three themes: mentorship, authorship, and compliance with ethical guidelines. Resident and attending ophthalmologists at eight military and civilian academic residency programs in the United States were invited to participate. Respondents used a Likert scale to assess the ethicality of the situations in addition to self-reported demographic characteristics.

Results The response rate was 35.6% (77/216), consisting of 37.7% (n = 29) residents and 62.3% (n = 48) attendings. More attending ophthalmologists responded than residents (p = 0.004). Many respondents identified controversies around compliance (67.3%) and authorship (57.1%) as unethical, whereas situations regarding mentorship were largely viewed as neutral to ethical (68.0%). Responses to two scenarios, one regarding mentorship and one regarding authorship, significantly differed between residents and attendings (p = 0.001 and p = 0.022, respectively).

Conclusion Academic ophthalmologists' perceptions of the ethicality of common research scenarios varied. There is a need for more prescriptive guidelines for authorship and mentorship ethics at all training levels to ensure consistency, fairness, and integrity of research.
Arthroscopic-assisted Distal Radius Fracture Fixation for Dorsoulnar Corner Fragments Using a Locked, Hooked Kirschner-Wire Technique
Authors: Ross Mark , White Matthew J. , Smith Nicholas
Published: November 2023

Background Distal radius fractures with dorso-ulnar corner fragments (DUC) pose a surgical challenge due to limited visualization and the risk of hardware prominence. Traditional approaches often result in inadequate reduction and fixation, leading to suboptimal clinical outcomes.

Description of Technique In this study, we introduce an arthroscopic-assisted approach for the fixation of distal radius fractures with DUC fragments. The technique utilizes locked, hooked K-wires to provide a low-profile dorsal capturing mechanism. We outline the step-by-step procedure, which includes pre-operative planning, volar plate application, and arthroscopic reduction of DUC fragments.

Materials and Methods We applied this technique to a 60-year-old female patient with an unstable intra-articular distal radius fracture and a DUC fragment. Closed reduction was initially attempted, followed by arthroscopic-assisted reduction and internal fixation using the locked, hooked K-wire technique.

Results Our technique has demonstrated its ability to withstand early movement rehabilitation protocols without fixation loss, enabling early mobilization. A custom thermoplastic splint was worn for 6 weeks, with favorable supination/pronation and wrist flexion/extension outcomes at clinical review.

Conclusions Arthroscopic-assisted fixation with locked, hooked K-wires offers a reliable solution for accurately reducing challenging DUC fragments in distal radius fractures. This approach complements standard distal radius fixation systems, providing a low-profile dorsal capturing mechanism and addressing the issue of hardware prominence, ultimately improving clinical outcomes.
Combined Arthroscopic Wafer Procedure and Triangular Fibrocartilage Complex Debridement versus Ulnar Shortening Diaphyseal Osteotomy in Management of Ulnar Impaction Syndrome: A Randomized Clinical Trial
Authors: El-Tayar Ahmed , El-Ghandour Samir , Ghazal Adel , Rakha Ibrahim , Sallam Asser
Published: November 2023

Background The literature presents great challenge in comparing the arthroscopic wafer procedure (AWP) versus ulnar shortening osteotomy (USO) in the treatment of ulnar impaction syndrome (UIS).

Purpose We aimed primarily to compare the clinical and functional outcomes of AWP with triangular fibrocartilage complex (TFCC) debridement versus USO in the management of UIS.

Methods The study was conducted as a randomized clinical trial including 43 patients with UIS whose ulna variance was less than 4 mm. Patients were randomly allocated to either the AWP group (21 patients) who underwent AWP and TFCC debridement or the USO group (22 patients) who underwent diaphyseal USO. Patients were followed up for at least 12 months. The primary outcome measure was the Modified Mayo Wrist (MMW) score. The Disabilities of the Arm, Shoulder, and Hand (DASH) score, the mean operative time, postoperative complications, and patient satisfaction were our secondary outcomes.

Results Radiological correction of variance was achieved in all patients. The mean operative time was significantly shorter in the AWP group. The postoperative MMW and DASH scores were better in the AWP group than in the USO group. Fewer complications occurred in the AWP group (1 of 21 patients) compared with the USO group (3 of 22 patients).

Conclusions AWP with TFCC debridement is a reliable and safe method for the management of UIS with a positive variance of less than 4 mm with better clinical and functional results than diaphyseal USO.

Type of study/level of evidence Therapeutic type II.
Zinc Supplementation in Very Low Birth Weight Infants: A Randomized Controlled Trial
Authors: Sahin Suzan , Sari Fatma N. , Bidev Duygu , Bozkurt Ozlem , Dizdar Evrim A. , Oguz Serife S.
Published: November 2023

Objective Preterm infants have high zinc (Zn) requirements and are generally believed to be in a negative Zn balance in the early period of life. In this study, we aimed to investigate the effect of high-dose Zn supplementation in very low birth weight (VLBW: infants with birth weight < 1.5 kg) infants on feeding intolerance and development of mortality and/or morbidities including necrotizing enterocolitis (NEC) and late-onset sepsis (LOS).

Study Design This is a prospective randomized trial. VLBW preterm infants with gestational age of <32 weeks were randomly allocated on the seventh day of life to receive extra amount of supplemental Zn along with the enteral feedings (9 + 3 mg), besides regular low-dose supplementation (3 mg), from enrollment until discharge. Outcome measures were feeding intolerance, NEC (stage ≥ 2), LOS, and mortality.

Results A total of 195 infants (97 from study group and 98 from control group) were analyzed. A total of 46 (47.4%) infants in the study group and 64 (65.3%) infants in the control group ended up with feeding intolerance (p = 0.012). NEC was observed in 11 infants (11.2%) in the control group and only 1 infant (1%) in the study group (p = 0.003). There was a negative correlation between high-dose Zn supplementation and number of culture-proven LOS episodes (p = 0.041). This significance was also present for clinical sepsis, being higher in the control group (p = 0.029). No relationship between high-dose Zn supplementation and mortality and other morbidities (hemodynamically significant patent ductus arteriosus, bronchopulmonary dysplasia, retinopathy of prematurity, and severe intraventricular hemorrhage) was observed.

Conclusion Zn supplementation for VLBW infants is found to be effective to decrease feeding intolerance, NEC, and LOS episodes in this vulnerable population. Current data support the supplementation of VLBW infants with higher than regular dose of Zn.

Key Points
In eigener Sache: kma Kompass geht in die zweite Staffel
Authors: Hofmann Lisa-Marie
Published: November 2023

Ab dem 14. November 2023 startet die zweite Staffel unseres Podcasts kma Kompass. In fünf Folgen dreht sich zusammen mit Host Jeremy Dähn diesmal alles um das Krankenhaus der Zukunft und die Frage, wie wir diese Zukunft gemeinsam erreichen.
BVMed Herbstumfrage: MDR bremst Innovationen aus
Authors: Hollmig Luisa-Maria
Published: November 2023

Im Bereich Medizintechnologien gehört Deutschland zur Weltspitze. Vor allem kleine und mittelständische Unternehmen zählen zu den Innovationstreibern. Forschungsinvestitionen gehen jedoch zurück – Hauptgrund ist die überbürokratische MDR.
BMC-Kongress steht bevor: Wie sieht das Krankenhaus der Zukunft aus?
Authors: Nowacki Bianca
Published: November 2023

Kaum ein Thema erhöht den Veränderungsdruck auf die Akteure im Gesundheitswesen so sichtbar wie die Krankenhausreform. Entwicklungs- und Investitionsperspektiven hin zu einer integrierten und patientenzentrierten Versorgung sind nun gefragt.
Marktgeschehen: MedTech Branche unter Druck
Authors: Rößing Sabine
Published: November 2023

Es sind gerade keine einfachen Zeiten für die deutsche Industrie. Die massiven Preisanstiege für Energie, hohe Lohnabschlüsse aufgrund der Inflation sowie teurere Kredite bremsen Investitionen, auch in der Medizintechnikindustrie. Die Branche blickt mit gemischten Gefühlen in die Zukunft. Vor allem der Brüsseler Regulierungseifer macht ihr das Leben schwer.
Innovationsfonds: Tradierte Strukturen bremsen neue Ideen aus
Authors: Hohnstein Aileen
Published: November 2023

Als Motor für eine Verbesserung der Patientenversorgung wird der Innovationsfonds des Gemeinsamen Bundesausschusses beschrieben. Dennoch kämpfen viele der Projekte damit, bewährte neue Strukturen nach Abschluss der Förderphase in die Regelversorgung zu überführen. Verfehlt der Innovationsfonds also sein Ziel einer besseren Gesundheitsversorgung durch Innovationen? Wir haben nachgefragt.
Diagnostik: Mut zu künstlicher Intelligenz
Authors: Bernhardt Michael , Schwegel Philipp , Stamm Dorothee
Published: November 2023

Künstliche Intelligenz ist die vierte industrielle Revolution – und spätestens seit ChatGPT in aller Munde. Doch insbesondere das Gesundheitswesen in Deutschland hinkt hinterher und hat es bisher nicht einmal geschafft, flächendeckend die elektronische Patientenakte einzuführen.
Operationsroboter: Die Aufholjagd hat begonnen
Authors: Kucera Martin
Published: November 2023

Der globale Marktwert der chirurgischen Robotik wird bis zum Jahr 2030 auf 16,51 Milliarden Dollar geschätzt. Deshalb drängen immer mehr Anbieter in diesen Markt und wollen die Vormachtstellung des Da Vinci brechen. Die OP-Roboter haben mittlerweile sogar das Gebiet der Supermikrochirurgie erobert.
Sterilgutaufbereitung: Technischer Helfer mit großem Potenzial
Authors: Grobosch Susanne
Published: November 2023

Personalmangel in Kombination mit dem Zwang zur Kostensenkung führen zu einer erhöhten Fehlerquote im Sterilisationsprozess in Krankenhäusern. Hierzu forschte nun ein interdisziplinäres Konsortium.
Living Lab: Eine Spielwiese für Innovationen
Authors: Hollmig Luisa-Maria
Published: November 2023

Wie kann die Gesundheitsversorgung von morgen aussehen? Viele Tools und nützliche Helfer versprechen mehr Qualität in der Patientenversorgung und eine Entlastung für das Personal. Ob sie den Test im hektischen Krankenhausalltag bestehen, wird am Living Lab der Mannheimer Universitätsmedizin erprobt.
Vorhaltevergütung 2.0: Konzept zwischen Vision, Dystopie und Happy End
Authors: Schmid Andreas , Schlüchtermann Jörg , Ulrich Volker
Published: November 2023

In den aktuellen Bemühungen um eine Reform der Krankenhausvergütung deutet vieles darauf hin, dass der gewählte Weg einen hohen administrativen Aufwand mit sich bringt und trotzdem nur einen Teil der Erwartungen erfüllen kann. Dabei gibt es weniger komplexe Alternativen, die durchaus anschlussfähig zu den bisherigen Planungen sind.
Lichtblick: Kinderintensivmedizin neu denken
Authors: Hohnstein Aileen
Published: November 2023

Dieser Artikel ist nur als PDF-Dokument verfügbar.
Impact of ECAP processing on dislocation density and subgrain size in a ti6al4V alloy prepared by direct energy deposition
Authors: Trojanová Z. , Daniš S. , Halmešová K. , Džugan J. , Drozd Z. , Máthis K. , Lukáč P. , Valiev R. Z.
Published: November 2023

Ti6Al4V alloy billets were additively manufactured by direct energy deposition and then equal channel angularly pressed (ECAPed) at 700 °C. The originally prepared α′ martensite microstructure was completely converted to an equiaxed fine grain structure during ECAP processing. The α′ martensite decomposed into α + β dual phase structure. The dislocation density in the deposited and ECAPed samples was measured by X-ray profile analysis in samples of two orientations. The dislocation density estimated in the deposition plane was found to be higher than that estimated perpendicularly. This difference is probably a consequence of the internal stresses generated in the samples during the deposition process. A similar anisotropy in dislocation density and crystallite size was found in the ECAPed samples. Lattice constants were measured for the α′ martensite and α phase of the ECAPed alloy. The crystallite size distribution was found to be moderately different for samples cut parallel and perpendicular to the extrusion direction.
Creation of a heterogeneous grain structure is a condition for increasing the low-temperature ductility of nanocrystalline hcp metals
Authors: Moskalenko V. A. , Smirnov A. R. , Smolianets R. V. , Pohribna Yu. M.
Published: November 2023

The paper considers the influence of a heterogeneous (bimodal) grain structure on the ductility characteristics of commercial purity titanium in a wide range of low temperatures (4.2–395 K) as a strategy for optimizing mechanical properties within the framework of the “strength–plasticity” ratio. Using titanium as an example, the physical mechanism for increasing the low-temperature ductility of hcp nanocrystalline metals with a heterogeneous grain size distribution is explained by a combination of several processes: an increase in the activity of intragrain dislocation slip, dynamic grain growth under tensile stresses, and activation of nanotwinning in submicron-sized grains.
“Metallization” of semimetals by an external electric field
Authors: Boyko Yu. I. , Bogdanov V. V. , Nazyrov Z. F. , Vovk R. V. , Grinyov B. V.
Published: November 2023

The paper considers the possibility of changing the energy spectrum of the electronic subsystem of semimetals from a non-degenerate to a degenerate state under the action of an external electric field. This “metallization” of semimetals is achieved by increasing the concentration of free electrons in the external field. The work also considers the possible transition of “metallized” semimetals to the superconducting state. The evaluations made show that for the size of the sample R ≤ 100 nm and for the magnitude of the field source voltage U ≈ 10 V, “metallized” semimetals and their solid solutions can undergo transition to a superconducting state at temperatures Tc ≥ 100 K, which is an order of magnitude higher than the characteristic temperature value Tc for classic metals.
Peculiarities of obtaining nanocomposites with organic additives and consolidated nanomaterials with given properties
Authors: Nerubatskyi V. P. , Gevorkyan E. S. , Vovk R. V. , Krzysiak Z. , Nazyrov Z. F. , Morozova O. M. , Hordiienko D. A.
Published: November 2023

The work presents the results of the creation of consolidated nanomaterials and composite ceramics using modern methods of consolidation of ceramic materials for the synthesis of powder precursors and specified phases that self-reinforce ceramic matrices. The method of mechanosynthesis and electroconsolidation is used. The results of the use of these trends for the creation of promising composite materials are given. The use of mechanochemical synthesis of β-SiC nanoparticles in nanoreactors, involving the organic-inorganic complex (–CH3)–(SiO2)n and the modification of refractory filler powders and carbon bonds using silicon alkoxide and related gels, has been demonstrated to enable the production of composite materials. These materials are composed of SiC, WC, and ZrO2, exhibiting a minimum bending strength of 650 MPa and crack resistance ranging from 6.5–7.9 MPa m0.5. Furthermore, this method can also produce periclase-carbon materials known for their exceptional resistance to oxidation and slag.
Mechanical properties of Al–Fe–Cr aluminum matrix composites in the temperature range 77–573 K
Authors: Iefimov M. O. , Chugunova S. I. , Goncharova I. V. , Goncharuk V. A. , Golubenko A. A. , Grinkevych K. E. , Tkachenko I. V. , Luk’yanov O. I.
Published: November 2023

The mechanical behavior of Al–Fe–Cr aluminum matrix composites strengthened by nanoquasicrystalline and/or crystalline phases was studied in the temperature range of 77–573 K. The strength characteristics and elongation to fracture during tensile tests of Al94Fe2.5Сr2.5Ti1, Al94Fe2Cr2Ti2, Al94Fe2.5Сr2.5Ti0.7Zr0.3 alloys were determined. It was established that the Al94Fe2Cr2Ti2 composite alloy has the highest strength (σb ≥ 3.87 GPa) among wrought aluminum alloys with satisfactory plasticity (elongation to fracture δ ≥ 5% at 293 K) at the temperature of 573 K. Tribological tests have shown that the wear resistance of Al–Fe–Cr aluminum matrix composites is significantly higher in the case of lubrication than when dry friction occurs. In lubrication, the friction force is almost 5 times less as well. The Al94Fe2Cr2Ti2 composite is optimal by the combination of mechanical and tribological properties among the studied alloys due to the strengthening of the aluminum matrix by nanoparticles with both crystalline and quasicrystalline structures.
Numerical simulation study of steel wire winding split ultra-high pressure die
Authors: Liu Zhiwei , Guo Song , Yang Caihua , Ding Feng
Published: November 2023

In this paper, a new type of large-cavity two-anvil ultra-high pressure die structure is proposed to solve the problem that the large-scale of the two-anvil ultra-high pressure die is limited by the difficulty in machining the large-size tungsten carbide. The die is mainly composed of an internal split cylinder with an inner cone and its support ring and the external steel wire winding layer. The stress distribution and cavity dimensional stability of the split cylinder are studied by using the finite element method and compared with those of the integral cylinder. This suggests that although the cavity-dimensional stability of the split ultra-high pressure die is reduced, the split ultra-high pressure die has greater advantages in improving the pressure-bearing capacity, processing, and manufacturing.
Piston-cylinder cell made of Ni–Cr–Al alloy for magnetic susceptibility measurements under high pressures in pulsed high magnetic fields
Authors: Nihongi Katsuki , Kida Takanori , Narumi Yasuo , Kurita Nobuyuki , Tanaka Hidekazu , Uwatoko Yoshiya , Kindo Koichi , Hagiwara Masayuki
Published: November 2023

We developed a metallic pressure cell made of 56Ni–40Cr–4Al (Ni–Cr–Al) alloy for use with a non-destructive pulse magnet and a magnetic susceptibility measurement apparatus with a proximity detector oscillator (PDO) in pulsed magnetic fields of up to 51 T under pressures of up to 2.1 GPa. Both the sample and sensor coil of the PDO were placed in the cell so that the magnetic signal from Ni–Cr–Al would not overlay the intrinsic magnetic susceptibility of the sample. A systematic investigation of the Joule heating originating from metallic parts of the pressure cell revealed that the increase in sample temperature is negligible at 1.4 K in magnetic fields of up to 40 T in the field-ascending process for the maximum applied magnetic field of 51 T. The effectiveness of our apparatus was demonstrated by investigating the pressure dependence of the magnetization process of the triangular-lattice antiferromagnet Ba3CoSb2O9.
The observation of avalanche-like transport during confinement power degradation in Heliotron J
Authors: Kin F. , Inagaki S. , Nagasaki K. , Luo M. , Minami T. , Ohshima S. , Kobayashi S. , Kado S. , Konoshima S. , Mizuuchi T. , Marushchenko N.
Published: November 2023

In this study, we observe avalanche-like electron thermal transport in Heliotron J under plasma conditions that exhibit power degradation to the central electron cyclotron heating (ECH). The newly installed GHz sampling electron cyclotron emission diagnostic allows for the observation of the long-distance radial propagation of electron temperature fluctuations. We find that the electron temperature fluctuations are associated with avalanches, because the Te fluctuations (i) propagate from the core to the edge with a speed comparable to the diamagnetic drift velocity, (ii) exhibit a 1/f power-law scaling in the frequency spectrum and a Hurst exponent close to 1, and (iii) dominate in the ECH deposition location and spread to the edge as the heating power increases. Furthermore, the electron heat avalanches can spread to the scrape off layer region when they are enhanced, i.e., the Te fluctuations correlate with the Dα emission, which also has a frequency spectrum that scales with a 1/f power law.
Hemodynamic analysis of coil filled patient-specific middle cerebral artery aneurysm using porous medium approach
Authors: Panneerselvam Nisanth Kumar , Sudhir B. J. , Kannath Santhosh K. , Patnaik B. S. V.
Published: November 2023

Cerebral aneurysms are bulges of an artery, which could be life-threatening when ruptured. Depending on their size, shape, and location, they need to be managed either through clipping or an endovascular coiling intervention. When coiled, reduced hemodynamic activity enables the coil to get thrombosed and achieve flow stasis. However, some coils delivered into the aneurysm tend to prolapse into the parent vessel and cause stroke due to obstruction and embolization. The recurrence of an aneurysm after endovascular coiling is of concern in the treatment of wide necked aneurysms. The initial packing density or improper coiling of the aneurysm and its relation to recurrence remains uncertain. This study investigates the influence of reduction in coil fill volume and packing density on the aneurysm recurrence using hemodynamic parameters by analyzing its flow features. Finite element method based commercial computational fluid dynamics solver is employed for performing patient-specific simulations for the coil filled aneurysm. The present approach uses porous medium based formulation. The numerical simulations show that any reduction below the optimal coil fill volume and packing density inside the aneurysm increases the velocity magnitude, wall shear stress, time-averaged wall shear stress, and spatial gradient of wall shear stress and reduces the relative residence time. The hemodynamic parameters and flow features suggest that a reduction in the coil packing density inside the aneurysm increases the chances of aneurysm recurrence. Hence, an assessment on how to achieve optimal coil fill volume and packing density is critical in reducing the risk of aneurysm recurrence.
Full polarization reversal at room temperature in unsubstituted AlN
Authors: Hasegawa Kota , Shimizu Takao , Ohsawa Takeo , Sakaguchi Isao , Ohashi Naoki
Published: November 2023

Room temperature ferroelectricity in unsubstituted AlN films is studied to examine the role of cation substitution into wurtzite materials. AlN and (Al0.7Sc0.3)N films deposited on (111) 0.5 wt. % Nb-doped SrTiO3 have a (0001)-orientation with different in-plane lattice alignments with respect to those of the substrate, depending on the composition and the deposition temperature. The AlN films deposited at 450 °C showed complete ferroelectric switching above 140 °C but local polarization switching at room temperature because a dielectric breakdown occurred before complete switching, while full polarization reversal was observed at all measurement temperatures for (Al0.7Sc0.3)N. Low-temperature deposition, such as at 250 °C, significantly enhanced the dielectric breakdown field and also increased leakage current. As a result, sufficient polarization switching at room temperature was observed in the AlN film deposited at 250 °C. Positive-up/negative-down pulse measurements showed remanent polarization of 150 μC/cm2 and a coercive field of 8.3 MV/cm, in agreement with the theoretical value and temperature dependence observed for the AlN film deposited at 450 °C. The observed coercive field value lies on the line composed of the previously reported data in Sc concentration dependence. This tendency implies that the reduction in the coercive field is primarily attributable to the alteration of crystal lattice anisotropy caused by Sc.
Linking Sky-plane Observations of Moving Objects
Authors: Tonry John L.
Published: November 2023

The Asteroid Terrestrial-impact Last Alert System (ATLAS) observes the visible sky every night in search of dangerous asteroids. With four (soon five) sites ATLAS is facing new challenges for scheduling observations and linking detections to identify moving asteroids. Flexibility in coping with diverse observation sites and times of detections that can be linked is critical, as is optimization of observing time for coverage versus depth. We present new algorithms to fit orbits rapidly to sky-plane observations, and to test and link sets of detections to find the ones which belong to moving objects. The PUMA algorithm for fitting orbits to angular positions on the sky executes in about a millisecond, orders of magnitude faster than the methods currently in use by the community, without sacrifice in accuracy. The PUMA software should be generally useful to anyone who needs to test many sets of detections for consistency with a real orbit. The PUMALINK algorithm to find linkages among sets of detections has similarities to other approaches, notably HelioLinC, but it functions well at asteroid ranges of a small fraction of an astronomical unit. PUMALINK is fast enough to test 10 million possible tracklets against one another in a half hour of computer time. Candidate linkages are checked by the PUMA library to test that the detections correspond to a real orbit, even at close range, and the false alarm rate is manageable. Sky surveys that produce large numbers of detections from large numbers of exposures may find the PUMALINK software helpful. We present the results of tests of PUMALINK on three data sets which illustrate PUMALINK’s effectiveness and economy: 2 weeks of all ATLAS detections over the sky, 2 weeks of special ATLAS opposition observations with long exposure time, and 2 weeks of simulated LSST asteroid observations. Detection probabilities of linkages must be traded against false alarm rate, but a representative choice for PUMALINK might be 90% detection probability for real objects while keeping the false alarm rate below 10% for a 100:1 population of false:real. Although optimization of the tradeoffs between detection probability, execution time, and false alarm rate is application specific and beyond the scope of this paper, we provide guidance on methods to distinguish false alarms from correct linkages of real objects.
A machine-learning approach to setting optimal thresholds and its application in rolling bearing fault diagnosis
Authors: Tang Yao-Chi , Li Kuo-Hao
Published: November 2023

Bearings are one of the critical components of any mechanical equipment. They induce most equipment faults, and their health status directly impacts the overall performance of equipment. Therefore, effective bearing fault diagnosis is essential, as it helps maintain the equipment stability, increasing economic benefits through timely maintenance. Currently, most studies focus on extracting fault features, with limited attention to establishing fault thresholds. As a result, these thresholds are challenging to utilize in the automatic monitoring diagnosis of intelligent devices. This study employed the generalized fractal dimensions to effectively extract the feature of time-domain vibration signals of bearings. The optimal fault threshold model was developed using the receiver operating characteristic curve, which served as the baseline of exception judgment. The extracted fault threshold model was verified using two bearing operation experiments. The experimental results revealed different damaged positions and components observed in the two experiments. The same fault threshold model was obtained using the method proposed in this study, and it effectively diagnosed the abnormal states within the signals. This finding confirms the effectiveness of the diagnostic method proposed in this study.
Identification of eczema clusters and their association with filaggrin and atopic comorbidities: analysis of five birth cohorts
Authors: Haider Sadia , Granell Raquel , Curtin John A , Holloway John W , Fontanella Sara , Hasan Arshad Syed , Murray Clare S , Cullinan Paul , Turner Stephen , Roberts Graham , Simpson Angela , Custovic Adnan
Published: November 2023

Background

Longitudinal modelling of the presence/absence of current eczema through childhood has identified similar phenotypes, but their characteristics often differ between studies.

Objectives

To demonstrate that a more comprehensive description of longitudinal pattern of symptoms may better describe trajectories than binary information on eczema presence.

Methods

We derived six multidimensional variables of eczema spells from birth to 18 years of age (including duration, temporal sequencing and the extent of persistence/recurrence). Spells were defined as consecutive observations of eczema separated by no eczema across 5 epochs in five birth cohorts: infancy (first year); early childhood (age 2–3 years); preschool/early school age (4–5 years); middle childhood (8–10 years); adolescence (14–18 years). We applied Partitioning Around Medoids clustering on these variables to derive clusters of the temporal patterns of eczema. We then investigated the stability of the clusters, within-cluster homogeneity and associated risk factors, including FLG mutations.

Results

Analysis of 7464 participants with complete data identified five clusters: (i) no eczema (51.0%); (ii) early transient eczema (21.6%); (iii) late-onset eczema (LOE; 8.1%); (iv) intermittent eczema (INT; 7.5%); and (v) persistent eczema (PE; 11.8%). There was very-high agreement between the assignment of individual children into clusters when using complete or imputed (n = 15 848) data (adjusted Rand index = 0.99; i.e. the clusters were very stable). Within-individual symptom patterns across clusters confirmed within-cluster homogeneity, with consistent patterns of symptoms among participants within each cluster and no overlap between the clusters. Clusters were characterized by differences in associations with risk factors (e.g. parental eczema was associated with all clusters apart from LOE; sensitization to inhalant allergens was associated with all clusters, with the highest risk in the PE cluster). All clusters apart from LOE were associated with FLG mutations. Of note, the strongest association was for PE [relative risk ratio (RRR) 2.70, 95% confidence interval (CI) 2.24–3.26; P < 0.001] followed by INT (RRR 2.29, 95% CI 1.82–2.88; P < 0.001).

Conclusions

Clustering of multidimensional variables identified stable clusters with different genetic architectures. Using multidimensional variables may capture eczema development and derive stable and internally homogeneous clusters. However, deriving homogeneous symptom clusters does not necessarily mean that these are underpinned by completely unique mechanisms.
Psoriasiform mycosis fungoides: a clinical and prognostic retrospective cohort study
Authors: Jung Joon Min , Cho Hye Soo , Kim Gyeong Hoon , Won Chong Hyun , Chang Sung Eun , Park Chan Sik , Lee Mi Woo , Lee Woo Jin
Published: November 2023

The psoriasiform manifestation of mycosis fungoides (MF) was identified in 17.5% of patients in this study. Psoriasiform MF had a shorter prediagnosis period than the other subtypes. Psoriasiform MF was associated with advanced stage, lymph node involvement and large cell transformation, and was thus also associated with poor survival.
Beremagene geperpavec (B-VEC) gene therapy for the treatment of cutaneous wounds in patients with dystrophic epidermolysis bullosa: a critically appraised research paper
Authors: Doolan Brent J , McGrath John A , Mellerio Jemima E
Published: November 2023

Dystrophic epidermolysis bullosa (DEB) is a rare inherited blistering skin disease that causes lifelong, slow-to-heal wounds, which predispose patients to chronic inflammation, scarring and an increased risk of developing squamous cell carcinoma. Management is largely supportive with no approved corrective therapies currently available. We critically appraise the phase III clinical trial reported by Guide et al., investigating the topical application of beremagene geperpavec on cutaneous wounds in DEB.
Digital biobanks are underutilized in dermatology and create opportunities to reduce the burden of skin disease
Authors: Jumonville Ghislaine , Hong David , Khan Atlas , DeWan Andrew , Leal Suzanne M , Weng Chunhua , Petukhova Lynn
Published: November 2023

Digital biobanks that integrate genetic data with health data captured by digital sources are used routinely to discover genes, biomarkers, gene–environment interactions and pharmacogenetic relationships across many clinical areas. There remain many opportunities in dermatology to further use biobank data to increase our knowledge about the genetic architecture of skin disease, to resolve disease mechanisms that can be modulated by medical interventions and to discover genetically derived disease relationships that inform on drug repurposing and adverse events. Such knowledge promises to reduce the global burden of skin disease and facilitates the development of tailored medical care.
Comparison of outcomes of azathioprine, leflunomide and allergen avoidance in patients with patch test-positive pigmented contact dermatitis: a randomized comparative study
Authors: Sinha Surabhi , Sardana Kabir , Panesar Sanjeet , Dorjay Konchok , Malhotra Purnima
Published: November 2023

Background

Pigmented contact dermatitis (PCD) is a noneczematous form of allergic contact dermatitis characterized by dermal hyperpigmentation. Allergen avoidance is the cornerstone of therapy, but it is difficult to achieve. The use of immunosuppressives seems rational, but data are lacking.

Objectives

To compare outcomes with azathioprine (AZA), leflunomide and allergen avoidance (AA) in patients with PCD.

Methods

A comparative study was conducted on 28 patients with patch test-positive PCD who were randomly allocated to one of three treatment groups: AZA 2 mg kg–1 daily for 24 weeks + AA (n = 10); leflunomide (LEF) 20 mg daily for 24 weeks + ­AA (n = 8); AA alone (n = 10). Patients were followed up for an additional 24 weeks. The Dermal Pigmentation Area and Severity Index (DPASI) score and Hindi Melasma Quality of Life scale (MELASQOL) were used to assess hyperpigmentation and quality of life (QoL). respectively.

Results

Hair colorants (n = 12) and paraphenylenediamine (n = 8) were the most common allergens. Mean (SD) DPASI score decreased from 30.97 (3.69), 32.35 (3.90) and 31.86 (3.47) to 13.78 (4.25), 21.67 (2.99) and 20.64 (3.82) at 48 weeks in the three groups, respectively (P < 0.001); the maximum percentage decline was seen with AZA (56%). Mean (SD) MELASQOL score was reduced in the three treatment groups from 48.0 (6.46), 46.75 (3.69) and 46.6 (4.65) to 19.6 (6.98), 24.5 (5.80) and 24.0 (5.49), respectively, at 48 weeks (P < 0.001). Reductions in DPASI and Hindi MELASQOL scores were significantly correlated. The most frequent adverse event was transaminitis in both the AZA and LEF groups.

Conclusions

Patients on AZA achieved a statistically significantly greater reduction in DPASI and MELASQOL score; therefore, AZA may fulfil an unmet need in PCD treatment. An objective reduction in hyperpigmentation was paralleled by an improvement in QoL score, reiterating the need for active management of this disease.
Competition Law and Policy in the Global South: Power, Coercion and Distribution
Authors: Waked Dina I
Published: November 2023

Countries in the Global South have adopted competition laws and pursued competition policies very similar to countries in the North. This arrangement can be traced to various coercive powers at play—from trading partners in the North, international organizations to development banks, among others. As a result, the adopted laws are often unsuitable to the local needs of the countries in the South and their enforcement policies are often shaped by global pressure. This has alienated countries in the Global South from pursuing competition enforcement policies that could be empowering to their firms, consumers and communities at large. One way to resist and challenge these coercive powers is to pursue alternative competition policies, not alien to the Western nations themselves. In these alternative configurations, competition laws are squared with goals of industrialization and distributive equality. Pursuing these alternative competition goals challenges the dominance of the static model of competition policy aiming to achieve allocative efficiency. Examples from many places around the world are illustrated to show how competition policy, at crucial times of their development, were broadened to encompass an industrial agenda. The latter, more suitable for countries in the South, is discussed as a means of counter-coercion. It is discussed alongside an elaborate program for distribution to assure that the benefits of industrialization do not befall upon only a few. The aim of such a distributive program, built into competition enforcement, is to bring social justice concerns within the purview of competition policy.
Gastroesophageal reflux disease following laparoscopic vertical sleeve gastrectomy and laparoscopic roux-en-Y gastric bypass: meta-analysis and systematic review of 5-year data
Authors: Memon Muhammed A , Osland Emma , Yunus Rossita M , Alam Khorshed , Hoque Zahirul , Khan Shahjahan
Published: November 2023

To compare 5-year gastroesophageal reflux outcomes following Laparoscopic Vertical Sleeve Gastrectomy (LVSG) and Laparoscopic Roux-en-Y gastric bypass (LRYGB) based on high quality randomized controlled trials (RCTs). We conducted a sub-analysis of our systematic review and meta-analysis of RCTs of primary LVSG and LRYGB procedures in adults for 5-year post-operative complications (PROSPERO CRD42018112054). Electronic databases were searched from January 2015 to July 2021 for publications meeting inclusion criteria. The Hartung-Knapp-Sidik-Jonkman random effects model was utilized to estimate weighted mean differences where meta-analysis was possible. Bias and certainty of evidence was assessed using the Cochrane Risk of Bias Tool 2 and GRADE. Four RCTs were included (LVSG n = 266, LRYGB n = 259). An increase in adverse GERD outcomes were observed at 5 years postoperatively in LVSG compared to LRYGB in all outcomes considered: Overall worsened GERD, including the development de novo GERD, occurred more commonly following LVSG compared to LRYGB (OR 5.34, 95% CI 1.67 to 17.05; p = 0.02; I2 = 0%; (Moderate level of certainty); Reoperations to treat severe GERD (OR 7.22, 95% CI 0.82 to 63.63; p = 0.06; I2 = 0%; High level of certainty) and non-surgical management for worsened GERD (OR 3.42, 95% CI 1.16 to 10.05; p = 0.04; I2 = 0%; Low level of certainty) was more common in LVSG patients. LVSG is associated with the development and worsening of GERD symptoms compared to LRYGB at 5 years postoperatively leading to either introduction/increased pharmacological requirement or further surgical treatment. Appropriate patient/surgical selection is critical to minimize these postoperative risks.
Heterogeneity in parental time with children: trends by gender and education between 1961 and 2012 across 20 countries
Authors: Balbo Nicoletta , Casarico Alessandra , Sommacal Alessandro , Altintas Evrim
Published: November 2023

This article investigates the level and dynamics of heterogeneity in parental childcare time using data from the Multinational Time Use Study across 20 countries over five decades. Applying the Gini coefficient as the main summary measure of the dispersion in the distribution at the country level, we show that heterogeneity in paternal time has been higher than that in maternal time throughout the last half-century. The gap has narrowed over the last decade, mainly due to a reduction in paternal time heterogeneity. This pattern is observed not only across countries over time but also within those countries for which we have repeated observations. We also show relevant socio-economic variations. Heterogeneity among low-educated mothers started to be systematically above that of high-educated mothers in the 1970s. In the group of fathers, heterogeneity has always been higher for the low-educated and it has been on the rise in the last decade. Results of a counterfactual analysis suggest that the main driver of the trends in paternal timne heterogeneity is the reduction in the share of fathers who do not provide any childcare, especially among the low-educated.
Potassium intake: the Cinderella electrolyte
Authors: O’Donnell Martin , Yusuf Salim , Vogt Liffert , Mente Andrew , Messerli Franz H
Published: November 2023

Dietary guidelines recommend intake targets for some essential minerals, based on observational and experimental evidence relating mineral intake levels to health outcomes. For prevention of cardiovascular disease, reducing sodium intake and increasing potassium intake are the principal tools. While reducing sodium intake has received greatest public health priority, emerging evidence suggests that increasing potassium intake may be a more important target for cardiovascular prevention. Increased potassium intake reduces blood pressure and mitigates the hypertensive effects of excess sodium intake, and the recent large Phase III SSaSS trial reported that increasing potassium intake (and reducing sodium intake) in populations with low potassium intake and high sodium intake, through salt substitution (25% KCl, 75%NaCl), reduces the risk of stroke in patients at increased cardiovascular risk. As key sources of potassium intake include fruit, vegetables, nuts, and legumes, higher potassium intake may be associated with healthy dietary patterns. The current review makes the case that increasing potassium intake might represent a more advantageous dietary strategy for prevention of cardiovascular disease. Future research should focus on addressing the independent effect of potassium supplementation in populations with low or moderate potassium intake, and determine effective strategies to increase potassium intake from diet.
Disparities in donor heart acceptance between the USA and Europe: clinical implications
Authors: Wayda Brian , Angleitner Philipp , Smits Jacqueline M , van Kins Arne , Berchtold-Herz Michael , De Pauw Michel , Erasmus Michiel E , Gummert Jan , Hartyanszky Istvan , Knezevic Ivan , Laufer Guenther , Milicic Davor , Rega Filip , Schulze P Christian , van Caeneghem Olivier , Khush Kiran K , Zuckermann Andreas O
Published: November 2023

Background and Aims

Given limited evidence and lack of consensus on donor acceptance for heart transplant (HT), selection practices vary widely across HT centres in the USA. Similar variation likely exists on a broader scale—across countries and HT systems—but remains largely unexplored. This study characterized differences in heart donor populations and selection practices between the USA and Eurotransplant—a consortium of eight European countries—and their implications for system-wide outcomes.

Methods

Characteristics of adult reported heart donors and their utilization (the percentage of reported donors accepted for HT) were compared between Eurotransplant (n = 8714) and the USA (n = 60 882) from 2010 to 2020. Predictors of donor acceptance were identified using multivariable logistic regression. Additional analyses estimated the impact of achieving Eurotransplant-level utilization in the USA amongst donors of matched quality, using probability of acceptance as a marker of quality.

Results

Eurotransplant reported donors were older with more cardiovascular risk factors but with higher utilization than in the USA (70% vs. 44%). Donor age, smoking history, and diabetes mellitus predicted non-acceptance in the USA and, by a lesser magnitude, in Eurotransplant; donor obesity and hypertension predicted non-acceptance in the USA only. Achieving Eurotransplant-level utilization amongst the top 30%–50% of donors (by quality) would produce an additional 506–930 US HTs annually.

Conclusions

Eurotransplant countries exhibit more liberal donor heart acceptance practices than the USA. Adopting similar acceptance practices could help alleviate the scarcity of donor hearts and reduce waitlist morbidity in the USA.
Mendelian randomization for cardiovascular diseases: principles and applications
Authors: Larsson Susanna C , Butterworth Adam S , Burgess Stephen
Published: November 2023

Large-scale genome-wide association studies conducted over the last decade have uncovered numerous genetic variants associated with cardiometabolic traits and risk factors. These discoveries have enabled the Mendelian randomization (MR) design, which uses genetic variation as a natural experiment to improve causal inferences from observational data. By analogy with the random assignment of treatment in randomized controlled trials, the random segregation of genetic alleles when DNA is transmitted from parents to offspring at gamete formation is expected to reduce confounding in genetic associations. Mendelian randomization analyses make a set of assumptions that must hold for valid results. Provided that the assumptions are well justified for the genetic variants that are employed as instrumental variables, MR studies can inform on whether a putative risk factor likely has a causal effect on the disease or not. Mendelian randomization has been increasingly applied over recent years to predict the efficacy and safety of existing and novel drugs targeting cardiovascular risk factors and to explore the repurposing potential of available drugs. This review article describes the principles of the MR design and some applications in cardiovascular epidemiology.
Phylogenetically related soil actinomycetes distinguish isolation sites by their metabolic activities
Authors: Kopecky Jan , Kamenik Zdenek , Omelka Marek , Novotna Jitka , Stefani Tommaso , Sagova-Mareckova Marketa
Published: November 2023

Soil environments are inhabited by microorganisms adapted to its diversified microhabitats. The metabolic activity of individual strains/populations reflects resources available at a particular spot, quality of which may not comply with broad soil characteristics. To explore the potential of individual strains to adapt to particular micro-niches of carbon sources, a set of 331 Actinomycetia strains were collected at ten sites differing in vegetation, soil pH, organic matter content and quality. The strains were isolated on the same complex medium with neutral pH and their metabolites analyzed by UHPLC and LC-MS/MS in spent cultivation medium (metabolic profiles). For all strains, their metabolic profiles correlated with soil pH and organic matter content of the original sites. In comparison, strains phylogeny based on either 16S rRNA or the beta-subunit of DNA-dependent RNA polymerase (rpoB) genes was partially correlated with soil organic matter content but not soil pH at the sites. Antimicrobial activities of strains against Kocuria rhizophila, Escherichia coli, and Saccharomyces cerevisiae were both site- and phylogeny-dependent. The precise adaptation of metabolic profiles to overall sites characteristics was further supported by the production of locally specific bioactive metabolites and suggested that carbon resources represent a significant selection pressure connected to specific antibiotic activities.