bluuebunny/crossref_metadata_2025 huggingface dataset:
Data‐driven dual‐loop control for platooning mixed human‐driven and automated vehicles
Authors: Lan Jianglin
Published: July 2023

This paper considers controlling automated vehicles (AVs) to form a platoon with human‐driven vehicles (HVs) under consideration of unknown HV model parameters and propulsion time constants. The proposed design is a data‐driven dual‐loop control strategy for the ego AVs, where the inner loop controller ensures platoon stability and the outer loop controller keeps a safe inter‐vehicular spacing under control input limits. The inner loop controller is a constant‐gain state feedback controller solved from a semidefinite program using the online collected data of platooning errors. The outer loop is a model predictive control that embeds a data‐driven internal model to predict the future platooning error evolution. The proposed design is evaluated on a mixed platoon with a representative aggressive reference velocity profile, the SFTP‐US06 drive cycle. The results confirm efficacy of the design and its advantages over the existing single loop data‐driven model predictive control in terms of platoon stability and computational cost.
Service design for solutions to the United Nations Sustainable Development Goals
Authors: Coutts Nick
Published: July 2023

While large organisations use technology and innovation to automate processes that reduce employment, startup companies can create employment. While there is little data about survival rates and reasons for failure, a lack of process and decisions based on assertion and assumption may be important factors may be important factors. Only a small number of startups survive for more than twelve months and so their potential for social, economic and environmental impact is limited.

To increase the rate of startup survival and so increase associated employment, as well as other positive impacts, this paper describes a systemic process for startups to use to assess their progress, in which decision quality is based on evidence at frequent check points. To do this a confidence score is assigned to the evidence and a vector created through the decision check points to indicate the rate of value creation with a trend for defined objectives. Based on this evidence, progress can be assessed objectively.
The Relationship between Intra-Operative Transfusions and Nadir Hematocrit on Post-Operative Outcomes after Cardiac Surgery
Authors: Goldberg Joshua B. , Shann Kenneth G. , Fitzgerald David , Fuller John , Paugh Theron A. , Dickinson Timothy A. , Paone Gaetano , Prager Richard L. , Likosky Donald S.
Published: July 2023

Uncertainty exists regarding the optimal strategy for the management of anemia in the setting of cardiac surgery. We sought to improve our understanding of the role of intra-operative hematocrit (HCT) and transfusions on peri-operative outcomes following cardiac surgery. A total of 18,886 patients undergoing on-pump cardiac surgery were identified from a multi-institutional registry including surgical and perfusion data. Patients were divided into four groups based on their intra-operative nadir HCT (<21 or ≥21) and whether or not they received intra-operative red blood cell (+RBC or −RBC) transfusions. Outcomes were adjusted for the Society of Thoracic Surgeons predicted risk of mortality (PROM), pre-operative HCT, and medical center. Regardless of nadir HCT cohort, those who received a transfusion had higher PROM relative to patients who did not receive a transfusion. The mean PROM was significantly higher among those HCT ≥21 + RBC (5.3%) vs. HCT ≥ 21 − RBC (1.9%), p < .001. Similarly, the PROM was significantly higher among HCT <21 + RBC (5.1%) vs. those HCT <21 − RBC (3.1%), p < .001. Adjusted outcomes demonstrated an increased impact of RBC transfusions on adverse outcomes irrespective of nadir HCT including stroke (p < .001), renal failure (p < .001), prolonged ventilation (p < .001), and mortality (p < .001). This study demonstrates that transfusions have a more profound effect on post-operative cardiac surgery outcomes than anemia.
Use of Cardiopulmonary Bypass for Management of Massive Air Embolism During Hysteroscopic Metroplasty
Authors: Amirghofran Ahmad Ali , Nick Narjes , Amiri Mina , Hemmati Rahim
Published: July 2023

The patient was a 32-year-old woman who presented with infertility secondary to uterine didelphys. Hysteroscopic metroplasty was chosen as the corrective surgical procedure for this anatomical defect. During the surgical repair, the patient developed a massive air embolism (MAE) leading to hypotension, arrhythmia, and cardiogenic shock. Resuscitation was started by placing the patient in the right-side up position, and emplacement of central venous catheter, but it was unsuccessful. The decision was then made to bypass the patient's cardiopulmonary system to effectively treat the MAE. Cannulation was done via femoral vein and artery. During cardiopulmonary bypass (CPB), the MAE was quickly eliminated, oxygen saturation was normalized, and the patient was hemodynamically stabilized. The surgical repair was successfully completed and the patient was decannulated and recovered without any incident.
Suspected Heparin-Induced Thrombocytopenia in Patients Receiving Extracorporeal Membrane Oxygenation
Authors: Natt Bhupinder , Hypes Cameron , Basken Robyn , Malo Joshua , Kazui Toshinobu , Mosier Jarrod
Published: July 2023

Heparin-induced thrombocytopenia (HIT) is an immune reaction usually secondary to unfractionated heparin. Anticoagulation management is critical in patients while on extracorporeal membrane oxygenation (ECMO) to prevent thromboembolism and for the optimal functioning of the circuit. We identified five patients with respiratory failure at our hospital managed with ECMO in the last 2 years that were treated for HIT. A brief clinical course and their management are discussed. We also briefly review the literature for best evidence for management of such patients.
Bloodless Repair of Aortic Arch with Dual Aortic Cannulation in a Jehovah’s Witness Patient
Authors: Valleley Melinda S. , Glogowski Kimberly R. , Duncan Kim F. , Dutoit Andrea , Hagedorn Corinna
Published: July 2023

Various methods for surgical repair of the aortic arch are described throughout the literature with many focused on cannulation techniques and degree of systemic cooling in an effort to reduce postoperative morbidities. Despite advancements in techniques, this surgery is still often associated with higher levels of blood loss and subsequent allogenic blood transfusions. Although blood products can be safely transfused to the majority of patients undergoing repair of the aortic arch, the complexity and risk is further multiplied when the patient is of Jehovah’s Witness faith and refuses blood transfusions. This paper will detail our technique of surgical repair of the aortic arch in a Jehovah’s Witness patient with dual aortic cannulation and our multidisciplinary approach to avoiding blood products.
TEG-Directed Transfusion in Complex Cardiac Surgery: Impact on Blood Product Usage
Authors: Fleming Kevin , Redfern Roberta E. , March Rebekah L. , Bobulski Nathan , Kuehne Michael , Chen John T. , Moront Michael
Published: July 2023

Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. All patients who underwent complex cardiac surgery, defined as open multiple valve repair/replacement, coronary artery bypass grafting with open valve repair/replacement, or aortic root/arch repair before and after implementation of TEG were identified and retrospectively analyzed. Minimally invasive cases were excluded. Patient characteristics and blood use were compared with t test and chi-square test. A generalized linear model including patient characteristics, preoperative and postoperative lab values, and autotransfusion volume was used to determine the impact of TEG on perioperative, postoperative, and total blood use. In total, 681 patients were identified, 370 in the pre-TEG period and 311 patients post-TEG. Patient demographics were not significantly different between periods. Mean units of red blood cells, plasma, and cryoprecipitate were significantly reduced after TEG was implemented (all, p < .0001); use of platelets was reduced but did not reach significance. Mean units of all blood products in the perioperative period and over the entire stay were reduced by approximately 40% (both, p < .0001). Total proportion of patients exposed to transfusion was significantly lower after introduction of TEG (p < .01). Controlling for related factors on multivariate analysis, such as preoperative laboratory values and autotransfusion volume, use of TEG was associated with significant reduction in perioperative and overall blood product transfusion. TEG-directed management of blood product administration during complex cardiac surgeries significantly reduced the units of blood products received perioperatively but not blood usage more than 24 hours after surgery. Overall, fewer patients were exposed to allogenic blood. The use of TEG to guide blood product administration significantly impacted transfusion therapy and associated costs.
Aggressive B-Zell-Lymphome
Authors: Vetter Christine
Published: July 2023

Bereits jetzt sind die Heilungsraten in der Erstlinientherapie bei den aggressiven B-Zell-Lymphomen mit rund 70 % erfreulich hoch. Weitere Fortschritte versprechen sich die Experten beim 25. Münchner LymphomWorkshop: „Hämatoonkologie: Was hat sich getan in 25 Jahren?“ von therapeutischen Neuerungen, speziell von bispezifischen Antikörpern und/oder einer CAR-T-Zell-Therapie.
Tumorassoziierte Fatigue
Authors: Krome Susanne
Published: July 2023

Etwa ein Viertel aller Tumorpatienten leidet noch Monate bis Jahre nach abgeschlossener Behandlung an einem krebsbedingten chronischen Erschöpfungssyndrom (CCFS: „chronic cancer-related fatigue“). Behandlungsprogramme adressieren unterschiedliche Schwerpunkte des multifaktoriellen Krankheitsbilds. Eine Studie, veröffentlicht im Fachjpurnal Supportive Care in Cancer untersuchte, welche Moderatorvariablen die Effektivität von 3 webbasierten Interventionen beeinflussten.
Management febriler Chemotherapie-induzierter Neutropenien
Authors: Kretzschmar Alexander
Published: July 2023

Hämatogene Infektionen (HI) mit resistenten gramnegativen Bakterien, insbesondere Enterobacterales und Pseudomonas aeruginosa (3GC-R), gehören zu den gefürchteten Komplikationen bei Patienten mit Chemotherapie-induzierter Neutropenie. Die Mortalität steigt in diesen Fällen proportional zur Dauer der febrilen Neutropenie. Aus diesem Grund ist eine empirische antibiotische Therapie (EAT) angezeigt, auch um den Bedarf von Reserve-Antibiotika wie Carbapenemen zu reduzieren. Eine retrospektive Studie ergab jetzt, dass mithilfe eines bakteriologischen Monitorings der Verbrauch von Carbapenemen um 82,9 % eingespart werden könnte. In die Studie eingeschlossen waren 372 Hochrisikopatienten mit hämatologischen Malignomen und Episoden einer febrilen Chemotherapie-induzierten Neutropenie.
Häufiger als gedacht: Nichtklarzellige Nierenzellkarzinome
Authors: Arnheim Katharina
Published: July 2023

Nichtklarzellige Nierenzellkarzinome stellen rund 30 % aller malignen Nierentumoren und sind damit nicht so selten, wie vielfach angenommen. Die Studienlage ist bislang dürftig.
Adjuvante Therapie des Nierenzellkarzinoms
Authors: Arnheim Katharina
Published: July 2023

Die (neo-)adjuvante Therapie des Nierenzellkarzinoms (RCC) mit Checkpoint-Inhibitoren (CPI) wurde mittlerweile in 4 Studien umfassend geprüft. 3 dieser Studien gingen negativ aus. Aber dennoch: Die enttäuschenden Ergebnisse schwächen die Daten der positiven Studie KEYNOTE-564 mit Pembrolizumab nicht – der Einsatz des CPI in der adjuvanten Behandlung des RCC bleibt gerechtfertigt.
Trotz Zervixkarzinom Mutter werden
Authors: Klein Friederike
Published: July 2023

Der Altersgipfel der Neuerkrankungen liegt beim Zervixkarzinom in der reproduktiven Lebensphase. Beim frühen Zervixkarzinom und bestehendem Kinderwunsch sollen den Betroffenen fertilitätserhaltende Therapieoptionen angeboten werden. Wann und wie das möglich ist, diskutierten Experten der Kommission Uterus in der Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) in München.
Metastasiertes kolorektales Karzinom
Authors: Krome Susanne
Published: July 2023

In der randomisierten Studie MODUL erhielten nichtprogrediente Erkrankte mit einem metastasierten kolorektalen Karzinom (mCRC) nach der Induktion eine auf das individuelle molekulargenetische Profil abgestimmte Erhaltungstherapie. Die Studiengruppe um Ducreux et al. veröffentlichte nun die Ergebnisse von 3 aus 4 Kohorten.
Frühes HR-positives Mammakarzinom
Authors: Arnheim Katharina
Published: July 2023

Mit Ribociclib hat sich in der Phase-III-Studie NATALEE ein weiterer CDK4/6-Inhibitor in der adjuvanten Therapie des frühen HR-positiven (HR +), HER2-negativen (HER –) Brustkrebs bewährt.
Characterisation of nematode larvae found in a vulnerable native Australian fish, the southern pygmy perch, Nannoperca australis Günther
Authors: Shamsi Shokoofeh , Pearce Luke , Zhu Xiaocheng
Published: July 2023

Context The southern pygmy perch (Nannoperca australis) is an endemic freshwater fish in Australia that is facing population decline and is listed as endangered or vulnerable in several states. Aims The aim of this study was to investigate the presence of parasites in the southern pygmy perch population and provide insights into their effect on the health and conservation of the species. Methods In total, 81 southern pygmy perch specimens were examined for parasite infections, followed by characterisation of the parasites. Key results The postmortem examination of the fish specimens did not show any visible parasites. However, through the incubation method, nematode larvae were discovered in 14 fish (mean intensity 1.6, mean abundance 0.28). Conclusions This study represents the first report of nematode larvae belonging to the genus Spiroxys in Australia, specifically in the southern pygmy perch. These findings highlighted the presence of parasite infections in the endangered southern pygmy perch and underscored the importance of conducting further research on parasites and their potential effect on the health and conservation of this species. Implications The discovery of nematode larvae in the southern pygmy perch raises concerns about the potential effects of parasites on the population.
Defining openness in teachers’ ‘open’ questions
Authors: Rapanta Chrysi
Published: July 2023

Extensive research has focused on analysing teacher-student discourse within whole-class dialogic interactions, and several descriptive tools have been proposed so far to cover possible variations. However, what still remains unanswered is what types of teacher questions are ‘better’ than others. To answer this question, I propose a pragmatic analysis of teacher-student interaction based on the criteria of authenticity and dialogicity. The analysis focuses on two types of dialogue moves, ‘information-seeking’ and ‘inquiry’ moves and their subtypes, as assessed on the basis of their degree of dialogicity, emerging from the dialogue sequence in which the moves are situated. The discussion focuses on how such a normative analysis of interaction can help teachers guide more productive dialogues with their students.
Quantum general covariance
Authors: Gaß Christian , Gracia-Bondía José M , Rehren Karl-Henning
Published: July 2023

The structure of quantum interactions with fields of helicity two (‘gravitons’) is strongly constrained by three principles: positivity (Hilbert space), covariance, and locality of observables. To fulfil them simultaneously, some (non-observable) fields need to be non-local. We work with string-localized fields. The results then follow from the condition that entities closely related to observables, like the

S

-matrix, be local and string-independent. They in particular reproduce the interactions dictated by general covariance in classical field theory. Graviton-matter couplings are consistent only when the graviton self-interaction is taken into account as well.

Science is not a collection of truths; it is a continuous exploration of mysteries

—Freeman Dyson
Preparation of layered manganese dioxide nanoparticles by microwave discharge in liquid: a simple, rapid and direct synthetic method
Authors: Sun Xiaohang , Sun Jiabao , Wang Qiuying , Sun Shaohua , Sun Bing
Published: July 2023

Manganese dioxide is one of the key materials in battery, adsorption media, and catalytic materials in the environmental field because of its excellent properties. In this investigation, new synthetical technology—the microwave discharge plasma in liquid method was used directly to make manganese dioxide with potassium permanganate (KMnO4) solution. The synthesis was realized in one step by the microwave discharging plasma in potassium permanganate aqueous solution without using any dispersants or stabilizers. The reduction time was very short, it only takes 3 min to complete the reduction of the 0.2 mmol l−1 potassium permanganate solution for the formation of MnO2. The structure characteristics and adsorption-desorption curves were studied by X-ray diffractometer (XRD), transmission electron microscopy and x-ray photoelectron spectroscopy, XRD, etc. it was found that the synthesized manganese dioxide nano-sheet had a layered structure and a large specific surface area (248.89 m2 g−1). The methylene blue was used to validate the effectiveness of the prepared manganese dioxide. The results showed that the synthesized manganese dioxide had good adsorption and photocatalytic properties. In conclusion, the microwave liquid-phase discharge plasma is a very effective reduction method with potential development.
Laser light scattering (LLS) to observe plasma impact on the adhesion of micrometer-sized particles to a surface
Authors: Shefer D , Nikipelov A , van de Kerkhof M , Banine V , Beckers J
Published: July 2023

Laser light scattering (LLS) method, combined with a long-distance microscope was utilized to detect micrometer-sized particles on a smooth substrate. LLS was capable to detect individual particle release, shrink, or fragmentation during exposure to a plasma or a gas jet. In-situ monitoring of hundreds of particles was carried out to investigate the effect of hydrogen plasma exposure on particle adhesion, morphology, and composition. LLS was calibrated with monodisperse melamine resin spheres with known sizes of 2.14 µm, 2.94 µm, and 5.26 µm in diameter. The lowest achievable noise level of approximately 3% was demonstrated for counting 5.26 µm spherical melamine particles. The accuracy for melamine particle size measurements ranged from 50% for 2.14 µm particles to 10% for 5.26 µm particles. This scatter was taken as the imprecision of the method. Size distribution for polydisperse particles with known refractive index was obtained by interpolating to an effective scattering cross-section of a sphere using Mie theory. While the Abbe diffraction limit was about 2 µm in our system, the detection limit for Si particles in LLS according to Mie approximation was assessed to about 3 µm, given the limitations of the laser flux, microscope resolution, camera noise, and particle composition. Additionally, the gradual changes in forward scattering cross-sections for Si particles during the exposure to the hydrogen plasma were consistent with Si etching reported in the literature.
Interaction effect of adjacent pores on plasma generation inside pores of porous catalysts
Authors: Shang Kefeng , Fu Mengji , Morent Rino , Peng Bangfa , Lu Na , Jiang Nan , Li Jie
Published: July 2023

A study on the influence of pore characteristics on the microdischarge plasma inside pores of catalyst is important for understanding plasma catalysis mechanism. This article focuses on the effect of pore interaction on plasma production in pores including electron density, electron temperature, and total ion density, etc. These parameters are calculated by solving the electron energy density conservation equation, electron convection diffusion equation, heavy species conservation equation and Poisson equation. The numerical simulation results show that the distribution of electron density, electron temperature and electric field in and near a pore is apparently affected by the adjacent pore, namely, the time-averaged electron density, total ion density and ionization rate in a pore increase with the pore spacing in the range of 8–150 μm because the loss of electrons to the wall due to the adjacent pore decreases with the increasing pore spacing, but there is an opposite law for the time-averaged electron temperature and electric field in a pore; moreover, the pore spacing presents more apparent effect on the plasma generation in a smaller pore and at higher applied voltage, indicating stronger interactions between pores at these conditions. The simulation results show that the pore characteristics of porous catalysts including pore spacing and pore diameter may affect the degradation of pollutants in plasma catalysis processes. The study is important for understanding the plasma catalysis mechanisms, especially the influence mechanism of pore interaction on microdischarge in porous catalysts.
Preparation of magnetically separable and low-cost MC-FePd3 NPs with enhanced catalytic activity in the reduction of p-nitrophenol
Authors: Liu Yuxing , Wang Guozhen , Ma Wangrui , Feng Ningning , Tong Jiaxin , Kang Xinke , Hu Tao , Wu Haiyan , Yang Quan , Xie Jianping
Published: July 2023

To obtain a magnetically separable, low-cost and highly efficient reduction catalyst, microbial carbon-loaded bimetallic palladium/iron nanoparticles (MC-FePd3 NPs) were synthesized in this study by using waste yeast residue doped with iron during the preparation process of microbial carbon-loaded monometallic palladium nanoparticles (MC-Pd NPs). The morphology, crystal structure, magnetic properties and catalytic performance of MC-FePd3 NPs for the reduction of p-nitrophenol (p-NP) were investigated by various characterization techniques, such as SEM-EDS, TEM, XRD, PPMS-9 and UV–vis spectroscopy. The catalytic experiments showed that the MC-FePd3 NPs prepared under pyrolysis conditions at 700 °C had an apparent rate constant of 1.85 × 10−1 s−1 which is better than the rate constants of MC-Pd NPs and other palladium-based nanocatalytic materials reported so far. The amount of palladium used in the synthesis of MC-FePd3 NPs was half that of MC-Pd NPs. The catalyst exhibited soft magnetic ordering behavior and still showed a catalytic efficiency of 97.4% after five consecutive reaction cycles. Furthermore, employing MC-FePd3 NPs reduces the costs of catalyst preparation and use in production. MC-FePd3 NPs with efficient catalytic properties, facile magnetic separation and recyclability, and low costs of preparation and use have considerable potential for industrial applications.
Performance assessment of variant UNet-based deep-learning dose engines for MR-Linac-based prostate IMRT plans
Authors: Tseng Wenchih , Liu Hongcheng , Yang Yu , Liu Chihray , Furutani Keith , Beltran Chris , Lu Bo
Published: July 2023

Objective. UNet-based deep-learning (DL) architectures are promising dose engines for traditional linear accelerator (Linac) models. Current UNet-based engines, however, were designed differently with various strategies, making it challenging to fairly compare the results from different studies. The objective of this study is to thoroughly evaluate the performance of UNet-based models on magnetic-resonance (MR)-Linac-based intensity-modulated radiation therapy (IMRT) dose calculations. Approach. The UNet-based models, including the standard-UNet, cascaded-UNet, dense-dilated-UNet, residual-UNet, HD-UNet, and attention-aware-UNet, were implemented. The model input is patient CT and IMRT field dose in water, and the output is patient dose calculated by DL model. The reference dose was calculated by the Monaco Monte Carlo module. Twenty training and ten test cases of prostate patients were included. The accuracy of the DL-calculated doses was measured using gamma analysis, and the calculation efficiency was evaluated by inference time. Results. All the studied models effectively corrected low-accuracy doses in water to high-accuracy patient doses in a magnetic field. The gamma passing rates between reference and DL-calculated doses were over 86% (1%/1 mm), 98% (2%/2 mm), and 99% (3%/3 mm) for all the models. The inference times ranged from 0.03 (graphics processing unit) to 7.5 (central processing unit) seconds. Each model demonstrated different strengths in calculation accuracy and efficiency; Res-UNet achieved the highest accuracy, HD-UNet offered high accuracy with the fewest parameters but the longest inference, dense-dilated-UNet was consistently accurate regardless of model levels, standard-UNet had the shortest inference but relatively lower accuracy, and the others showed average performance. Therefore, the best-performing model would depend on the specific clinical needs and available computational resources. Significance. The feasibility of using common UNet-based models for MR-Linac-based dose calculations has been explored in this study. By using the same model input type, patient training data, and computing environment, a fair assessment of the models’ performance was present.
Evaluation of a new radiochromic film dosimeter, Gafchomic EBT4, for VMAT, SABR and HDR treatment delivery verification
Authors: Palmer Antony L , Nash David , Polak Wojciech , Wilby Sarah
Published: July 2023

Objective. To evaluate a new film for radiotherapy dosimetry, Gafchromic EBT4, compared to the current EBT3. To evaluate dose-response and verify test cases in MV external beam and HDR brachytherapy. Approach. Three lots (batches) of EBT4 and three lots of EBT3 films were calibrated at 6 MV over 0–1200 cGy range, using FilmQAPro software. Signal-to-noise of pixel value, reported dose (RD), and factors affecting dosimetry accuracy were evaluated (rotation of the film at scanning, energy response and post-exposure darkening). Both films were exposed to clinical treatment plans (VMAT prostate, SABR lung, single HDR source dwell, and ‘pseudo’ 3-channel HDR cervix brachytherapy). Film-RD was compared to TPS-calculated dose. Main results. EBT4 calibration curves had characteristics more favourable than EBT3 for radiation dosimetry, with improved signal to noise in film-RD of EBT4 compared to EBT3 (increase of average 46% in red and green channels at 500 cGy). Film rotation at scanning and post-exposure darkening was similar for the two films. The energy response of EBT4 is similar to EBT3. For all clinical case studies, EBT4 provided better agreement with the TPS-planned doses than EBT3. VMAT prostate gamma 3%/3 mm passing rate, EBT4 100.0% compared to EBT3 97.9%; SABR lung gamma 2%/2 mm, EBT4 99.6% and EBT3 97.9%; HDR cervix gamma 3%/2 mm, EBT4 97.7% and EBT3 95.0%. Significance. These results show EBT4 is superior to EBT3 for radiotherapy dosimetry validation of TPS plan delivery. Fundamental improvements in noise profile and calibration curve are reported for EBT4. All clinical test cases showed EBT4 provided equivalent or smaller difference in measured dose to TPS calculated dose than EBT3. Baseline data is presented on the achievable accuracy of film dosimetry in radiotherapy using the new Gafchromic EBT4 film.
Suppression of P-I-N forward leakage current in tunnel field-effect transistor
Authors: Ahmad Syed Afzal , Alam Naushad , Ahmad Shameem
Published: July 2023

In this paper, we propose a tunnel field-effect transistor (TFET) architecture for the suppression of P-I-N forward leakage current. The P-I-N forward leakage current is attributed to the drift-diffusion mechanism under the forward-bias condition; thereby, the gate loses all of its control over the channel. In the proposed device architecture, the source region is bifurcated into sub-regions (referred to as P+ and P++) with different p-type doping concentrations. We introduce an electrostatic source (ES) electrode over the oxide, which encapsulates the lowly doped (P+) source region. The ES is shorted to the source electrode, implying that a positive voltage at the source terminal causes the ES to turn positive, resulting in a decrement in the P+ characteristics in the source region. On the other hand, the increment in voltage causes the P+ source region to become an intrinsic region, thus minimizing the chances of the P-I-N diode becoming forward biased. In the proposed device architecture, by tuning the work function values of the ES, the P-I-N forward leakage current is suppressed by 3–6 orders of magnitude at the cost of the ON-state current loss of 3–10-fold of magnitude. Considering the detrimental impact of P-I-N forward leakage current in circuits, this small penalty on the part of the ON-state current is worth accepting for the significant reduction in parasitic P-I-N forward leakage current. We believe that the proposed technique will pave the way for widespread use of TFETs in logic circuits.
Spin-active single photon emitters in hexagonal boron nitride from carbon-based defects
Authors: Pinilla Fernanda , Vásquez Nicolás , Chacón Ignacio , Maze Jerónimo R , Cárdenas Carlos , Munoz Francisco
Published: July 2023

Most single photon emitters in hexagonal boron nitride have been identified as carbon substitutional defects, forming donor-acceptor systems. Unlike the most studied bulk emitters (i.e. color centers in diamond), these defects have no net spin, or have a single unpaired spin. By means of density functional calculations, we show that two non-adjacent carbon substitutional defects of the same type (i.e. CB-CB, and CN-CN), can have a triplet groundstate. In particular, one of such defects has a zero phonon line energy of 2.5 eV, and its triplet state is nearly 0.5 eV more stable than its singlet. The mechanism behind the destabilization of the singlet state is related to a larger electrostatic repulsion of a symmetric wave function in a charged lattice.
A functionality switchable meta-device: from perfect reflection to perfect absorption
Authors: Shah Aqib Raza , Naveed Muhammad Ashar , Ijaz Sumbel , Rahim Arbab Abdur , Zubair Muhammad , Massoud Yehia , Mehmood Muhammad Qasim
Published: July 2023

Tunable meta-devices trigger immense interest in many applications like biosensing, thermal camouflage, radiative cooling, thermal emitting, infrared imaging, and energy harvesting. This paper presents a polarization-independent broadband tunable absorbing and reflecting meta-device using a phase change material Germanium-Antimony-Tellurium (GST). The proposed design manifests high absorptivity >80% over a broadband range of wavelength spanning the mid-IR regime. Furthermore, by changing the phase of GST material from crystalline to amorphous with the help of external stimuli, the absorbance of the device was reduced to almost zero in the range from 4μm to 12μm. To previse the angular constancy of the meta-absorber, the absorptivity was scrutinized under different incidence angles in both transverse magnetic (TM) and transverse electric (TE) polarizations which manifested the robustness of the proposed meta-absorber. As a result, the proposed absorber has tunable broadband absorbance and angular stability, which proclaim great potential in applications such as thermal camouflage, radiation detection, thermal emitter, and stealth technology, etc.
Namikawa-Weyl groups of affinizations of smooth Nakajima quiver varieties
Authors: Wu Yaochen
Published: July 2023

We give a description of the Namikawa-Weyl group of affinizations of smooth Nakajima quiver varieties based on combinatorial data of the underlying quiver, and compute some explicit examples. This extends a result of McGerty and Nevins for quiver varieties associated to Dynkin quivers.
Predictive coding and stochastic resonance as fundamental principles of auditory phantom perception
Authors: Schilling Achim , Sedley William , Gerum Richard , Metzner Claus , Tziridis Konstantin , Maier Andreas , Schulze Holger , Zeng Fan-Gang , Friston Karl J , Krauss Patrick
Published: July 2023

Mechanistic insight is achieved only when experiments are employed to test formal or computational models. Furthermore, in analogy to lesion studies, phantom perception may serve as a vehicle to understand the fundamental processing principles underlying healthy auditory perception. With a special focus on tinnitus—as the prime example of auditory phantom perception—we review recent work at the intersection of artificial intelligence, psychology and neuroscience. In particular, we discuss why everyone with tinnitus suffers from (at least hidden) hearing loss, but not everyone with hearing loss suffers from tinnitus.

We argue that intrinsic neural noise is generated and amplified along the auditory pathway as a compensatory mechanism to restore normal hearing based on adaptive stochastic resonance. The neural noise increase can then be misinterpreted as auditory input and perceived as tinnitus. This mechanism can be formalized in the Bayesian brain framework, where the percept (posterior) assimilates a prior prediction (brain’s expectations) and likelihood (bottom-up neural signal). A higher mean and lower variance (i.e. enhanced precision) of the likelihood shifts the posterior, evincing a misinterpretation of sensory evidence, which may be further confounded by plastic changes in the brain that underwrite prior predictions. Hence, two fundamental processing principles provide the most explanatory power for the emergence of auditory phantom perceptions: predictive coding as a top-down and adaptive stochastic resonance as a complementary bottom-up mechanism.

We conclude that both principles also play a crucial role in healthy auditory perception. Finally, in the context of neuroscience-inspired artificial intelligence, both processing principles may serve to improve contemporary machine learning techniques.
Changes in family practice work management in Zagreb due to the COVID-19 pandemic
Authors: Jug Juraj , Hodak Kristian
Published: July 2023

Background

Since the COVID-19 pandemic has impacted family medicine practice (FMP) workload, we aimed to determine changes in the structure of work of FMPs in the number and type of consultations, check-ups, administrative, preventive, and other diagnostic-therapeutic procedures (DTPs) during the COVID-19 pandemic (2021 and 2022) compared to 2019.

Methods

In this cross-sectional study, 172 FMPs from Zagreb (39%) were analysed based on monthly work reports for March and April of 2019, 2021, and 2022. Before being analysed, all noted DTPs were divided into 5 main groups (administration, telephone and e-mail consultations, check-ups, face-to-face consultations, preventive work, and other DTPs).

Results

In 2021 the number of check-ups and face-to-face consultations dropped by 36.20%, whereas the total number of telephone and e-mail consultations, patients per day, and DTPs done per day increased by 120.12%, 6.67%, and 13.76%, respectively. The amount of administrative work rose only in 2022 by 17.58% along with other procedures which significantly impacted the share of medical work: 42.84% in 2019, 49.58% in 2021, and 46.79% in 2022. Around two-thirds of FMPs made home visits (3 to 4 visits monthly) and performed electrocardiography (6 to 7 tests monthly) independently of the analysed year.

Conclusion

Analysing 39% of FMPs in Zagreb we found a significant workload change during the COVID pandemic, especially in the excessive increase of telephone and e-mail consultations. The already small number of examinations, diagnostic, preventive procedures, and home visits, further decreased with the arrival of the pandemic and did not significantly recover in 2022, as was expected.
GlycoDraw: a python implementation for generating high-quality glycan figures
Authors: Lundstrøm Jon , Urban James , Thomès Luc , Bojar Daniel
Published: July 2023

Glycans are essential to all scales of biology, with their intricate structures being crucial for their biological functions. The structural complexity of glycans is communicated through simplified and unified visual representations according to the Symbol Nomenclature for Glycans (SNFGs) guidelines adopted by the community. Here, we introduce GlycoDraw, a Python-native implementation for high-throughput generation of high-quality, SNFG-compliant glycan figures with flexible display options. GlycoDraw is released as part of our glycan analysis ecosystem, glycowork, facilitating integration into existing workflows by enabling fully automated annotation of glycan-related figures and thus assisting the analysis of e.g. differential abundance data or glycomics mass spectra.
AAV9-mediated SMN gene therapy rescues cardiac desmin but not lamin A/C and elastin dysregulation in Smn
2B/− spinal muscular atrophy mice
Authors: Brown Sharon J , Šoltić Darija , Synowsky Silvia A , Shirran Sally L , Chilcott Ellie , Shorrock Hannah K , Gillingwater Thomas H , Yáñez-Muñoz Rafael J , Schneider Bernard , Bowerman Melissa , Fuller Heidi R
Published: July 2023

Structural, functional and molecular cardiac defects have been reported in spinal muscular atrophy (SMA) patients and mouse models. Previous quantitative proteomics analyses demonstrated widespread molecular defects in the severe Taiwanese SMA mouse model. Whether such changes are conserved across different mouse models, including less severe forms of the disease, has yet to be established. Here, using the same high-resolution proteomics approach in the less-severe Smn2B/− SMA mouse model, 277 proteins were found to be differentially abundant at a symptomatic timepoint (post-natal day (P) 18), 50 of which were similarly dysregulated in severe Taiwanese SMA mice. Bioinformatics analysis linked many of the differentially abundant proteins to cardiovascular development and function, with intermediate filaments highlighted as an enriched cellular compartment in both datasets. Lamin A/C was increased in the cardiac tissue, whereas another intermediate filament protein, desmin, was reduced. The extracellular matrix (ECM) protein, elastin, was also robustly decreased in the heart of Smn2B/− mice. AAV9-SMN1-mediated gene therapy rectified low levels of survival motor neuron protein and restored desmin levels in heart tissues of Smn2B/− mice. In contrast, AAV9-SMN1 therapy failed to correct lamin A/C or elastin levels. Intermediate filament proteins and the ECM have key roles in cardiac function and their dysregulation may explain cardiac impairment in SMA, especially since mutations in genes encoding these proteins cause other diseases with cardiac aberration. Cardiac pathology may need to be considered in the long-term care of SMA patients, as it is unclear whether currently available treatments can fully rescue peripheral pathology in SMA.
The Psychology of Poverty: A Replication Based on Zimbabwe's Harmonised Social Cash Transfer Programme
Authors: Ibrahim Marwa , Chen Yunwei , Pereira Audrey , Musa Takondwa , Bathia Dharini , Handa Sudhanshu
Published: July 2023

We perform a scientific replication of a recent paper in this journal that reports evidence from Malawi that an unconditional cash transfer programme affects psychological states, such as life satisfaction and subjective well-being, as well as economic decisions involving intertemporal choice. Using data from Zimbabwe, we find similar results. Together, these two studies are the first from outside a laboratory setting that support the idea that poverty can have psychological effects that in turn influence intertemporal choice in a way that perpetuates poverty. These results, if found to hold in diverse settings, open up the policy space for a broader range of interventions that could reduce the number of people living in poverty. As this is a relatively new idea in economics with important policy implications, replicating these results in other settings is important before they can be widely generalised.
A comprehensive assessment of redox balance in small for gestational age newborns and their mothers
Authors: Senat Almila , Tas Emre Erdem , Eroglu Hasan , Bal Ceylan , Yavuz Ayse Filiz , Yucel Aykan , Erel Ozcan , Ersoz Arzu
Published: July 2023

Objective

The objective of this study was to assess oxidative stress in small for gestational age (SGA) newborns and their mothers by evaluating intra- and extracellular thiol homeostasis and the quantification of major oxidants and antioxidants.

Methods

A total of 75 mothers and their 75 newborns (43 SGA) were enrolled in this study. Thiol-disulfide homeostasis, serum myeloperoxidase, catalase, total oxidant, and antioxidant status were analyzed. Additionally, erythrocytic glutathione (GSH) homeostasis was measured.

Results

Although native and total thiol levels were decreased, disulfide levels were increased in SGA groups. Additionally, myeloperoxidase activity and total oxidant status levels were significantly elevated whereas total antioxidant status levels and enzymatic antioxidant systems were diminished in SGA groups. Similarly, intra-erythrocytic GSH homeostasis was shifted in favor of oxidants in SGA groups.

Conclusion

Our results demonstrate that insufficient antioxidant systems in mothers and a robust source of oxidative stress in SGA might contribute to the pathophysiology of SGA births.
Listening for What Matters
Authors: Weiner, MD Saul J. , Schwartz, PhD Alan
Published: July 2023

Listening for What Matters: Avoiding Contextual Errors in Health Care, 2nd edition (LFWM2) provides a comprehensive overview of research and quality improvement efforts to address the problem of inattention to patient life context during clinical encounters that undermine effective care. Such “contextual errors” occur when patient care plans that are otherwise consistent with research evidence for managing a particular clinical condition are, nevertheless, inappropriate for a particular individual based on their life situation, or patient context. Prescribing a medication a patient can’t afford and proposing a treatment plan they don’t have the skills or resources to follow when alternative options are available are examples of contextual error. Identifying contextual errors requires listening in on visits, by employing either unannounced standardized patients (undercover actors) or real patients who volunteer to audio-record encounters. LFWM2 synthesizes nearly two decades of published research employing these unconventional methods to demonstrate how they yield critical and otherwise inaccessible information about physician performance at contextualizing care, including its implication for patients’ health-care outcomes and unnecessary care. The authors also describe studies testing clinical decision support tools in the electronic medical record, medical student and resident trainee educational interventions, and an audio recording–based quality improvement program within the Department of Veterans Affairs to prevent contextual errors. They argue that, ultimately, a greater recognition among payers and the general public of the implications of contextual errors on quality of care and costs is essential to the widespread adoption of methods for identifying and preventing contextual errors.
Americaâs New Vaccine Wars
Authors: Navin Mark C. , Attwell Katie
Published: July 2023

This book illustrates the significance of recent efforts to abolish nonmedical exemptions to childhood vaccine mandates. These legislative changes replace pro-vaccine persuasion with an ultimatum: Either vaccinate your children or they cannot attend school or daycare. The book explores the ethics and politics of this new kind of public health coercion. It examines the history of immunization, vaccine mandates, and conflicts about public health policies. It also analyzes California’s efforts to exclude unvaccinated children from school and daycare following the Disneyland measles outbreak of 2014. The book uses original interviews with key California policymakers and activists to explain the development and execution of that state’s new vaccination policies and to illuminate similar immunization policy developments elsewhere. This book is a story about how political and community actors fought to exclude unvaccinated children from school in the face of significant opposition and failing public health institutions. It unpacks the meaning and impact of these efforts for broader debates about immunization governance throughout America and the world, including conflicts about coercive public health measures during the COVID-19 pandemic.
A multicentre, large-scale, observational study of tocilizumab in patients with giant cell arteritis in Japan
Authors: Harigai Masayoshi , Miyamae Takako , Hashimoto Hideyuki , Umetsu Kosei , Yamashita Katsuhisa , Nakaoka Yoshikazu
Published: July 2023

Objectives

In clinical trials, tocilizumab (TCZ) is efficacious in patients with giant cell arteritis (GCA). This study evaluated the real-world tolerability and effectiveness of TCZ in Japanese patients with GCA.

Methods

In this multicentre, prospective, Phase 4, large-scale, observational study, patients with GCA (with no TCZ treatment 6 months before the study) were recruited from 71 centres across Japan. Patients received subcutaneous TCZ 162 mg weekly (observation period, 52 weeks).

Results

Of the 117 patients [female, 70.1%; mean age, 74.2 years; mean disease duration, 1.4 years; treated for new-onset GCA, 71.8%; presence of large-vessel lesions (LVLs), 61.5%; previous immunosuppressant use, 28.2%; glucocorticoids at baseline, 95.7% (mean: 22.4 mg/day)], 38.5% reported adverse events. The most common adverse events of special interest were neutropaenia and leukopaenia (7.7%), followed by serious infection (6.0%). The relapse-free proportion was 85.0%; relapse after remission, 6.0%; and no remission, 9.0%. At the last observation, 94.2% of relapse-free patients received a concomitant glucocorticoid dose of <10 mg/day. Fatigue, headache, neck pain, and absence of LVLs were positively associated with the relapse.

Conclusions

TCZ was effective and well tolerated in Japanese patients with GCA and may be an effective treatment option combined with glucocorticoids.
The impact of adolescent suicide on clinicians: a mixed-methods study
Authors: Keightley P , Foster T , Eggins K , Reay R E
Published: July 2023

Background

Clinician reactions to client suicide may include shock, grief, guilt, self-doubt, shame, anger, and fears of blame and medico-legal consequences. Clinicians will often differ in their reactions to the suicide and the type of supports required. Adolescent suicide-specific literature is limited.

Aims

We sought to explore clinician reactions and perceptions of support following child and adolescent suicide.

Methods

One hundred and fifteen staff working for a Child and Adolescent Mental Health Service were invited to complete an online survey with quantitative and qualitative components, and an in-depth semi-structured interview. Results were presented to teams for reflection and further feedback.

Results

Eight clinicians participated in the semi-structured interview, and 33 in the online survey. Thirteen were the primary clinician, and 21 were part of a multi-disciplinary team when a client suicided. Respondents were predominantly female, from a range of disciplines. Fifty per cent of primary clinicians found the support good to very good. The rest were neutral. However, 26% of team members found support poor to very poor. Clinicians reported questioning their clinical effectiveness and chosen vocation. Some reported a need to disconnect or withdraw to preserve motivation and empathy for the work. They received significant support from their team, and teams were very anxious for the well-being of primary clinicians.

Conclusions

Health services must find ways of helping staff feel that their sense of vocation is valued and nurtured. These strategies will likely include fostering team cohesiveness and mutual support and allowing opportunities to temporarily step back and recover after challenging experiences.