bluuebunny/crossref_metadata_2025 huggingface dataset:
Powder coarsening mechanisms of Ti-6Al-4 V with multiple build cycles in laser powder bed fusion
Authors: Du Xi
Published: September 2024

Laser powder bed fusion (LPBF) is an additive manufacturing process which can produce complex 3D parts from digital models. The performance of parts fabricated by LPBF is largely dependent on the characteristics of the powder feedstock, in particular, the particle size distribution. The coarsening of powder particles may limit the potential for reusing powder in further builds, as consistency in powder quality is crucial for ensuring consistent parts performance when using reused powder, especially in aerospace applications. However, there is a lack of systematic understanding regarding the causes and nature of powder coarsening in LPBF. In this work, the characteristics of powder samples from different locations in the build chamber during LPBF were studied to understand the particle size evolution and determine the origin of coarsening, which has not been previously reported. Meanwhile, powder coarsening was found to have a detrimental effect on the relative density and surface quality of as-built parts, highlighting the importance of exploring the mechanisms of powder coarsening and finding ways to control it in LPBF. The relationship between powder in key locations in the build chamber and its effect on powder coarsening has been established. Layer thickness is identified as a critical factor in causing powder coarsening due to the fine powder size characteristic in the powder bed. Spatter, in its various forms, plays a direct or indirect role in powder coarsening. Sintered powders resulting from spatter and the laser scanning borders of as-built parts were observed to contribute to the powder coarsening. Therefore, three main mechanisms (layer thickness, spatter, sintered powder) associated with the powder coarsening are therefore proposed. This work provides insight and potential solutions to control powder coarsening and maintain consistent parts performance.
The ultrasonic vocalization (USV) syllable profile during neonatal opioid withdrawal and a kappa opioid receptor component to increased USV emissions in female mice
Authors: Wingfield Kelly K. , Misic Teodora , Jain Kaahini , McDermott Carly S. , Abney Nalia M. , Richardson Kayla T. , Rubman Mia B. , Beierle Jacob A. , Miracle Sophia A. , Sandago Emma J. , Baskin Britahny M. , Lynch William B. , Borrelli Kristyn N. , Yao Emily J. , Wachman Elisha M. , Bryant Camron D.
Published: September 2024

Rationale

Opioid use during pregnancy can lead to negative infant health outcomes, including neonatal opioid withdrawal syndrome (NOWS). NOWS comprises gastrointestinal, autonomic nervous system, and neurological dysfunction that manifest during spontaneous withdrawal. Variability in NOWS severity necessitates a more individualized treatment approach. Ultrasonic vocalizations (USVs) in neonatal mice are emitted in isolation as a stress response and are increased during opioid withdrawal, thus modeling a negative affective state that can be utilized to test new treatments.

Objectives

We sought to identify the behavioral and USV profile, brainstem transcriptomic adaptations, and role of kappa opioid receptors in USVs during neonatal opioid withdrawal.

Methods

We employed a third trimester-approximate opioid exposure model, where neonatal inbred FVB/NJ pups were injected twice-daily with morphine (10mg/kg, s.c.) or saline (0.9%, 20 ul/g, s.c.) from postnatal day(P) 1 to P14. This protocol induces reduced weight gain, hypothermia, thermal hyperalgesia, and increased USVs during spontaneous morphine withdrawal.

Results

On P14, there were increased USV emissions and altered USV syllables during withdrawal, including an increase in Complex 3 syllables in FVB/NJ females (but not males). Brainstem bulk mRNA sequencing revealed an upregulation of the kappa opioid receptor (Oprk1), which contributes to withdrawal-induced dysphoria. The kappa opioid receptor (KOR) antagonist, nor-BNI (30 mg/kg, s.c.), significantly reduced USVs in FVB/NJ females, but not males during spontaneous morphine withdrawal. Furthermore, the KOR agonist, U50,488h (0.625 mg/kg, s.c.), was sufficient to increase USVs on P10 (both sexes) and P14 (females only) in FVB/NJ mice.

Conclusions

We identified an elevated USV syllable, Complex 3, and a female-specific recruitment of the dynorphin/KOR system in increased USVs associated with neonatal opioid withdrawal severity.
Lelliottia wanjuensis sp. nov. Isolated from Korean Lettuce in Wanju, South Korea
Authors: Lee Jiyeon , Tai Eewon , Jeong Sunyoung , Kim Ile , Kim Bo-Eun , Jeong Myeong-In , Oh Kwang-Kyo , Biere Natalia , Franz Charles M. A. P. , Cho Gyu-Sung
Published: September 2024

Ten Gram stain-negative, oxidase-negative, catalase-positive, rod-shaped strains were isolated from lettuce in the city Wanju in South Korea. Comparative 16S rRNA gene analysis and multilocus sequence analysis indicated that the strains grouped closely together with all other Lelliottia (L.)-type strains. The average nucleotide identity (ANI) comparisons of the isolates showed a high relationship between the strains, as the ANI values of all strains ranged from 91.01 to 91.31% when compared to the L. jeotgali-type strain PFL01T. All isolates showed the highest genomic DNA sequence similarity to the L. jeotgali PFL01T strain at 43.3% when compared with digital DNA–DNA hybridization (dDDH). Strain V104_15T of the proposed novel Lelliottia species showed 91.2% and 43.3% similarity with the most closely related L. jeotgali PFL01T-type strain in the ANI and dDDH comparisons, respectively. Strain V104_15T could not grow at 45 °C and 7% NaCl, while L. jeotgali PFL01T strain could grow at both these conditions. Strain V104_15T showed ß-glucosidase activity but not α-glucosidase activity, while the L. jeotgali PFL01T strain was α-glucosidase positive but ß-glucosidase negative. The major cellular fatty acids of strain V104_15T were C16:0 and cyclo-C17:0 including summed features. The mol % G + C content of the genomic DNA of strain V104_15T was 55.74%. Phenotypic and biochemical characteristics, as well as the phylogenomic analysis indicated that the strain V104_15T represents a novel species of the genus Lelliottia, for which the name Lelliottia wanjuensis sp. nov. is proposed. The type strain is V104_15T (= LMG 32996 T = DSM 115585 T).
Back on track – digital health applications to treat back pain of rheumatic patients? Results of a qualitative interview study
Authors: Boy Katharina , May Susann , Labinsky Hannah , Morf Harriet , Heinze Martin , Leipe Jan , Kuhn Sebastian , Schett Georg , Knitza Johannes , Muehlensiepen Felix
Published: September 2024

Non-specific low back pain (NLBP) is prevalent among patients with rheumatic conditions. Digital health applications (DiGAs) provide reimbursed, personalized home treatment for patients, promising to overcome limitations of traditional healthcare systems. However, the adoption and effectiveness of back pain-specific DiGAs in rheumatology are not well understood. This study aims to explore the experiences and perspectives of a diverse group of rheumatology stakeholders regarding the use of DiGAs for back pain management. Qualitative interviews and a focus group discussion were conducted with a wide range of stakeholders including rheumatic patients, rheumatologists, nurses and DiGA producers. The data were analysed using qualitative content analysis. The study included 15 interviews (10 rheumatic patients, 4 rheumatologists, 1 DiGA producer) and 1 focus group with mixed participants (n = 12). Most stakeholders valued the instant access to personalized and effective back pain treatment provided by DiGAs. Patients appreciated the flexibility and ease of use of DiGAs which can be used anywhere and anytime. Concerns were raised about insufficient guidance regarding correct execution of exercises, which was seen as potentially dangerous and unsettling for patients. Healthcare professionals (HCPs) highlighted barriers, such as the lack of reimbursement, time constraints, and inadequate DiGA-specific education as barriers to prescribing DiGAs. Additionally, poor patient onboarding often led to delays, increased skepticism, and premature discontinuation of therapy. Stakeholders emphasized the challenges of current care driven by a shortage of HCPs and generally supported usage of back pain DiGAs. Various barriers and solution approaches were identified to enhance the performance, usability, and implementation of DiGAs in rheumatology.
Patient-reported outcomes after one-stage neourethral reconstruction in transmen with phalloplasty-associated strictures and fistulas
Authors: Schuettfort Victor M. , Graf Rebecca R. , Vetterlein Malte W. , Ludwig Tim A. , Gild Philipp , Marks Phillip , Soave Armin , Dahlem Roland , Fisch Margit , Riechardt Silke
Published: September 2024

Introduction

Urethral strictures and fistulas arising after gender-affirming surgery in transmen require meticulous management strategies. This study evaluates the safety and efficacy of urethral reconstruction and patient satisfaction post-surgery.

Methods

A retrospective analysis examined peri- and postoperative data from transmen undergoing urethral reconstruction for urethral fistula and/or strictures at the distal urethral anastomosis between December 2017 and April 2023. Follow-up involved clinical examinations, uroflowmetry, and voiding cystourethrography. Patient satisfaction and quality of life were assessed using USS PROM and ICIQ-S questionnaires.

Results

Among 25 patients, 88% (n = 23) had urethral fistulas, and 48% (n = 12) had urethral strictures. 41% of fistula patients also had strictures, while 75% of stricture patients had concurrent fistulas. Previous surgeries for fistula or stricture repair were noted in 26% of cases. Techniques for stricture included modified flap (50%), buccal oral mucosal grafting (33%), and primary anastomosis (17%). Post-operative urethrogram revealed urethral strictures in 15% (n = 3) and urinary extravasation in an equal number. Postoperative uroflow parameters showed improvement (Qmax 18 ml/s, Qave 7.9 ml, time 37 s, volume 332 ml). Perioperative complications were low (n = 6, 24%), all grade one (Clavien-Dindo). Follow-up revealed that 33% required another surgical intervention. The mean six-item LUTS score was 6.7 (SD 3.9). Mean ICIQ-S overall satisfaction score was 8.6 (SD 1.6) and outcome score was 20 (SD 2.8).

Discussion

Our study found a significant recurrence rate of urethral strictures and fistulas post-surgery. Despite this, patient satisfaction remains high and complications are generally low-grade, highlighting the importance of expert surgical intervention.
Changing times: trends in risk classification, tumor upstaging, and positive surgical margins after radical prostatectomy - results from a contemporary National Cancer Database study
Authors: Freitas Pedro F. S. , Blachman-Braun Ruben , Soodana-Prakash Nachiketh , Williams Adam D. , Ritch Chad R. , Punnen Sanoj , Gonzalgo Mark L. , Parekh Dipen , Nahar Bruno
Published: September 2024

Purpose

Recent advancements in screening, prostate MRI, robotic surgery, and active surveillance have influenced the profile of patients undergoing radical prostatectomy (RP). We sought to examine their impact on trends in clinicodemographic, risk classification, and adverse pathology in men undergoing surgery.

Methods

We queried the National Cancer Database for clinicodemographic, risk group, and pathology data in men undergoing upfront RP between 2006 and 2020. Patients were categorized by NCCN risk groups, and trends were assessed among 2006–2010, 2011–2015, and 2016–2020 periods. Endpoints included rates of pT3, positive surgical margins (PSM), pathologic upstaging, and Gleason grade group (GG) upgrading.

Results

610,762 patients were included. There were significant increases in African Americans (9.8–14.1%), comorbidities (2.1–5.2% with Charlson scores > 1), and robot-assisted RP (78–84%). Over the three time periods, high-risk cases increased from 15 to 20 to 27%, and intermediate-risk from 54 to 51 to 60%. Overall rates of pT3 rose from 20 to 38%, and PSM from 20 to 27% (p < 0.001). Pathologic upstaging increased in low (6–15%), intermediate (20–33%), and high-risk groups (42–58%) –p < 0.001. Gleason upgrading rose in low-risk (45–59%, p < 0.001), with slight reductions in the intermediate and high-risk groups.

Conclusions

Recent trends in RP indicate a shift towards more advanced disease, evidenced by increasing rates of pT3, PSM, and pathologic upstaging across all NCCN risk groups. These findings emphasize the need for a careful balance in applying fascia and nerve-sparing techniques to avoid compromising oncological safety.
Assessing diastolic function using CMR as an alternative to echocardiography: age- and gender-related normal reference values
Authors: Cirener Lilly Charlotte , Körperich Hermann , Barth Peter , Racolta Anca , Piran Misagh , Burchert Wolfgang , Weber Oliver M. , Eckstein Jan
Published: September 2024

Background

Impaired diastolic function is associated with a variety of diseases such as myocarditis or dilated cardiomyopathy. Currently, echocardiography is the standard method for assessing diastolic function. Recently, it has been postulated that cardiovascular magnetic resonance (CMR) is an at least equivalent or superior alternative to echocardiography. To assess CMR-based age- and gender-dependent diastolic functional normal reference values, pulmonary venous and transmitral blood-flow parameters were examined in heart-healthy test persons.

Methods and results

Flow-sensitive phase-contrast CMR imaging was performed in the right upper pulmonary vein (RUPV) and at the level of the mitral valve (MV) in 183 healthy subjects (age 10–70 years; 97 women, 86 men). The data was distributed as evenly as possible across all groups. Strong age-dependence was observed for PV S/D; r = 0.718, p < 0.001 (Pearson product–moment correlation) and for transmitral MV E/A; ρ = −0.736, p < 0.001 (Spearman’s Rho correlation). Moderate age-dependence was found for PV slope D-wave; r = 0.394, p < 0.001. Except for MV slope E-wave (male −292 cm/s2 interquartile range (IQR) {−338; −243} vs. female −319 ± 82 cm/s2; p = 0.047), no gender-related differences were observed. In a subgroup (N = 100), CMR data were compared with echocardiographic data. Strong correlation was found between CMR and echocardiography for PV S/D; r = 0.545, p < 0.001 and MV E/A; ρ = 0.692, p < 0.001.

Conclusion

Diastolic functional parameters change with age, while gender-differences are small. CMR and echocardiography showed similar PV S/D and MV E/A ratios, making CMR a promising alternative for assessing diastolic function.

Graphical abstract
Clinical significance of posterior talofibular ligament injury in chronic lateral ankle instability
Authors: Nakasa Tomoyuki , Ikuta Yasunari , Kawabata Shingo , Sakurai Satoru , Moriwaki Dan , Ishibashi Saori , Silan Asyumaredha Asril , Adachi Nobuo
Published: September 2024

Purpose

Although arthroscopic repair of the anterior talofibular ligament (ATFL) is widely performed, the effect of posterior talofibular ligament (PTFL) injury on clinical outcomes remains unclear. This study aimed to evaluate the magnetic resonance imaging (MRI) findings of the PTFL in chronic lateral ankle instability (CLAI) and determine whether the presence or absence of PTFL injury affected the postoperative outcomes of arthroscopic ATFL repair.

Materials and methods

Forty ankles of 35 patients who underwent arthroscopic repair for CLAI were included in this study as the experimental group, together with 25 ankles of 24 patients without CLAI as the control group. The PTFL thickness (PTFLT) and PTFL cross-sectional area (PTFLCSA) were measured using MRI and compared between the control and CLAI groups. The clinical outcomes of arthroscopic repair were compared between ankles with and without PTFL injuries.

Results

The mean PTFLT and PTFLCSA values were significantly higher in the CLAI group than in the control group. The PTFLT and PTFLCSA in the PTFL injury group were significantly larger than those in the non-injury group in the CLAI group. Postoperatively, there were no significant differences in clinical scores and talar tilt angles on stress radiographs between ankles with and without PTFL injury; however, instability recurrence was frequently observed in ankles with PTFL injury (32.1%) compared to the ankles without PTFL injury (16.7%). Poor-quality ATFL remnant, ATFL inferior fascicle, and calcaneofibular ligament injuries were frequently observed in ankles with PTFL injuries.

Conclusions

Our findings indicate that PTFL injury is highly associated with CLAI but it does not affect postoperative clinical scores. However, postoperative instability recurrence was more often observed in ankles with PTFL injuries, given that they frequently have poor-quality ATFL remnants and CFL injuries.

Evidence level

Level III
Hidradenitis suppurativa and female infertility: a pilot study conducted amongst 110 dermatological patients
Authors: Medianfar Cecilia Egede , Kursawe Larsen Christoffer , Saunte Sara Karoline , Saunte Ditte Marie Louise , Jemec Gregor Borut Ernst , Andersen Rune Kjærsgaard
Published: September 2024

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with severe consequences on quality of life. One aspect of this is that HS has been linked to an increased risk of infertility, but as data is still limited, it is not known if the association reflects causality. We performed a cross-sectional study of 161 female participants included at Zealand University Hospital, Roskilde, Denmark. Data regarding basic demographics, infertility, pregnancies, sexual function, and known factors with impact on fertility was collected. Logistic regressions were performed to analyze the association between HS and infertility, adjusting for factors that influence fertility. The study population consisted of 55 patients with HS, 55 patients with other dermatological diseases (ODD), and 51 healthy controls (HC). The HS group had a higher BMI, lower sexual function, and a higher tobacco use. We found no significant difference between the three groups in terms of whether they had children, the number of children they had, infertility, or whether they had received fertility treatments. The logistic analyses found no correlation between HS and infertility, and adjusting for factors affecting infertility did not alter this result. This study did not find a significant difference in infertility between patients with HS compared to those with ODD or HC. This result was not affected by adjustments for other factors known to influence fertility. Interestingly, the lower sexual function in the HS group did not appear to influence their desire or ability to conceive.
Age and sex differences in outpatient antipsychotic prescriptions for schizophrenia: a claims data study
Authors: Ramin Tabea , Peter Jens-Uwe , Schneider Michael , Heinze Martin , Riedel Oliver , Langbein Sophie Hanna , Haug Ulrike , Zolk Oliver
Published: September 2024

Most studies on antipsychotic efficacy and safety, including sex differences, focus on young schizophrenia patients. However, with an aging population, the number of older schizophrenia patients is increasing. This group faces challenges due to varying treatment responses and higher risks of adverse reactions, and guidelines often lack specific recommendations due to insufficient trials. Therefore, we investigated how age and sex influence antipsychotic prescribing practices in schizophrenia using the German Pharmacoepidemiological Research Database (GePaRD). We included patients diagnosed with schizophrenia (ICD-10 code F20.X) who had been prescribed at least one antipsychotic on an outpatient basis in at least two consecutive quarters in 2020, analyzing prescription data for 49,681 patients. Key findings include a notable preference for second-generation antipsychotics (SGAs) across all age groups, especially in younger patients, possibly due to their perceived better tolerability and efficacy. Treatment intensity with SGAs (expressed as the defined daily doses of SGAs per patient in 2020) initially increased with age, peaked among 35- to 44-year-olds, and then decreased, with the lowest treatment intensity in patients aged 65 years and older. The prescription patterns of specific SGAs and first-generation antipsychotics varied across age groups, highlighting the complexity of treatment decisions in schizophrenia management. Sex differences in prescription frequency and treatment intensity were also observed. The basic recommendation of the guideline to consider sex and age when prescribing antipsychotics therefore appears to be followed. Whether this prescribing practice is really optimal for older male and female schizophrenia patients, however, still needs to be proven in clinical trials.
A new activity model for biotite and its application
Authors: Dachs Edgar , Benisek Artur
Published: September 2024

A new activity model for biotite is formulated in the system K2O-FeO-MgO-Al2O3-SiO2-H2O-TiO2-O2 (KFMASHTO), which extends that for the KFMASH system by introducing a titanium-biotite and a ferric-biotite end-member (tbio: K(TiMg2)[(O)2(AlSi3)O10] and fbio: K(Fe3+Mg2)[(OH)2(Al2Si2)O10]), as well as a pyrophyllite end-member (pyp: Al2[(OH)2Si4O10]) that accounts for the presence of octahedral excess-Al in natural biotites. Phonon calculations applying density functional theory (DFT) using the software Castep yielded the standard entropies of tbio and fbio as Sotbio = 328.06 J/(mol·K) and Sofbio = 301.69 J/(mol·K), and their heat capacity functions. From experimental phase-equilibrium data, the enthalpy of formation value of tbio was constrained as $$\Delta {H}_{f,tbio}^{o}$$

Δ

H

f
,
t
b
i
o

o

= −6124.68 ± 3.33 kJ/mol. Natural data were used to derive $$\Delta {H}_{f,fbio}^{o}$$

Δ

H

f
,
f
b
i
o

o

= −5935.3 ± 6.6 kJ/mol. The single-defect DFT method was applied to parameterize important macroscopic mixing properties (macro-W’s) involving tbio and pyp end-members in the model (fbio was treated ideal). Castep-derived microscopic interaction energies (micro-w’s) are presented herein for KFMASH-biotite. The octahedral same-site (M1) Mg–Al mixing micro-w (wMgAl(M1)), the same-site tetrahedral Si-Al mixing parameter (wSiAl(T1)) and the related cross-site term are: wMgAl(M1) = 82.5 kJ/mol, wSiAl(T1) = 95.6 kJ/mol (two T1-sites) and $${w}_{MgAlAlSi(M1T1)}=$$

w

M
g
A
l
A
l
S
i
(
M
1
T
1
)

=

175.1 kJ/mol. The linear combination of these micro-w’s gives a macroscopic Wphleas = 18.8 kJ/mol, that is not transferable to other mineral groups. Micro w’s for Mg-Fe mixing in biotite (wMgFe(M1), wMgFe(M2),$${w}_{MgMgFeFe(M1M2)}$$

w

M
g
M
g
F
e
F
e
(
M
1
M
2
)

), are all close to ideality. The biotite activity model of this study is thus a first example of next-generation activity models that use DFT- and thus physically based micro-w’s and reassembled macro-W’s for petrological calculations. Test calculations on 5 samples from low- to high-grade metamorphic environments covering metapelite to greywacke bulk-compositions using Perple_X suite of programs illustrate the performance of the new biotite activity model. Computed mineral-chemistries are in all cases in better agreement with measured compositions than resulting from published activity models of biotite.
Prevalence of relevant early complications during the first 24 h on a normal ward in patients following PACU care after medium and major surgery: a monocentric retrospective observational study
Authors: Wurth Anouk , Hackert Thilo , Böckler Dittmar , Feisst Manuel , Haag Sabine , Weigand Markus A. , Brenner Thorsten , Schmoch Thomas
Published: September 2024

Purpose

Even today, it remains a challenge for healthcare professionals to decide whether a clinically stable patient who is recovering from uncomplicated medium or major surgery would benefit from a postoperative intensive care unit (ICU) admission, or whether they would be at least as adequately cared for by a few hours of monitoring in the post-operative care unit (PACU).

Methods

In this monocentric retrospective observational study, all adult patients who (I) underwent medium or major surgery between 1 January 1 2014 and 31 December 2018 at the Heidelberg University Surgical Center, and (II) were monitored for 1–12 h in the PACU, and then (III) transferred to a normal ward (NW) immediately thereafter were included. At the end of the PACU stay, each patient was cleared by both a surgeon and an anesthesiologist to be transferred to a NW. The first objective of this study was to determine the prevalence of relevant early complications (RECs) within the first 24 h on a normal ward. The secondary objective was to determine the prevalence of RECs in the subgroup of included patients who underwent partial pancreaticoduodenectomy.

Results

A total of 10,273 patients were included in this study. The prevalence of RECs was 0.50% (confidence interval [CI] 0.40–0.60%), with the median length of stay in the PACU before the patient’s first transfer to a NW being 285 min (interquartile range 210–360 min). In the subgroup of patients who underwent partial pancreaticoduodenectomy (n = 740), REC prevalence was 1.1% (CI = 0.55–2.12%).

Conclusion

Based on a medical case-by-case assessment, it is possible to select patients who after a PACU stay of only up to 12 h have a low risk of emergency readmission to an ICU within the 24 h following the transfer to the NW. Continued research will be needed to further improve transfer decisions in such low-risk subgroups.
Shiga toxin-producing Escherichia coli infection as a precipitating factor for atypical hemolytic-uremic syndrome
Authors: Mortari Gabriele , Bigatti Carolina , Gaffi Giulia Proietti , Lionetti Barbara , Angeletti Andrea , Matarese Simona , Verrina Enrico Eugenio , Caridi Gianluca , Lugani Francesca , Vellone Valerio Gaetano , Chiarenza Decimo Silvio , La Porta Edoardo
Published: September 2024

Background

Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy characterized by intravascular hemolysis. It can be classified as either typical, primarily caused by Shiga toxin-producing Escherichia coli (STEC) infection, or as atypical HUS (aHUS), which results from uncontrolled complement activation.

Methods

We report the case of a 9-year-old boy with aHUS due to compound heterozygous complement factor H-related genes (CFHR) 1/3 and CFHR1–CFHR4 deletions, leading to the development of anti-complement factor H (CFH) autoantibodies. The patient presented nephrological and neurological thrombotic microangiopathy with STEC positivity. Additionally, we provide an extensive literature review of aHUS cases initially classified as typical.

Results

A total of 11 patients were included, 73% of whom were pediatric. Kidney replacement therapy was required in 73% of patients. The recurrence rate was 55%. All cases were found positive for pathological variants of the complement system genes. The most commonly implicated gene was CFH, while the CFHR genes were involved in 36% of cases, although none exhibited anti-CFH autoantibodies. Anti-complement therapy was administered in 54% of cases, and none of the patients who received it early progressed to kidney failure.

Conclusions

STEC infection does not exclude aHUS diagnosis, and early use of anti-complement therapy might be reasonable in life-threatening conditions. Genetic testing can be helpful in patients with atypical presentations and can confirm the necessity of prolonged anti-complement therapy.

Graphical Abstract
Forecasting thermal stress for sports tourists at the 2026 FIFA World Cup
Authors: Craig Christopher , Karabas Ismail
Published: September 2024

This study explores thermal stress conditions (i.e. heat, humidity, sunlight exposure) sports tourists can expect when attending the 2026 FIFA World Cup. Sports tourism’s growth is driven by international mega-events like FIFA World Cups and Olympic Games. With planning ongoing for the 2026 FIFA World Cup football (soccer) tournament, what remains unstudied are the heat conditions spectators can expect at the 16 host stadiums in the United States, Mexico, and Canada. The inquiry is important considering (1) the tournament is taking place in warm-weather months of June and July, (2) thermal stress contributes to heat-related illnesses like heat stroke, and (3) many destination-bound tourists will be at elevated risk to heat. Accordingly, we report historical and forecasted thermal stress levels documenting expected conditions at each host stadium. Notably, forecasts indicate worsening thermal stress compared to long-term means, providing support for the study’s methodology. Practical implications and limitations are provided.
Stratified equatorial flows in cylindrical coordinates with surface tension
Authors: Gheorghe Cristina , Stan Andrei
Published: September 2024

This paper considers a mathematical model of steady flows of an inviscid and incompressible fluid moving in the azimuthal direction. The water density varies with depth and the waves are propagating under the force of gravity, over a flat bed and with a free surface, on which acts a force of surface tension. Our solution pertains to large scale equatorial dynamics of a fluid with free surface expressed in cylindrical coordinates. We also prove a regularity result for the free surface.
Hydrophenoxylation of alkynes by gold catalysts: a mini review
Authors: Ramos Miguel , Solà Miquel , Poater Albert
Published: September 2024

Context

The field of chemistry has significantly evolved, with catalysis playing a crucial role in transforming chemical processes. From Valerius’ use of sulfuric acid in the sixteenth century to modern advancements, catalysis has driven innovations across various industries. The introduction of gold as a catalyst marked a pivotal shift, expanding its applications beyond ornamentation to homogeneous catalysis. Gold’s unique properties, such as its electrophilic nature and flexibility, have enabled its use in synthesizing complex molecules, including those in nanomedicine and sustainable chemical processes. The development of gold-based complexes, particularly in hydroalkoxylation and hydroamination reactions, showcases their efficiency in forming carbon–oxygen bonds under mild conditions. Recent studies on dual gold catalysis and heterobimetallic complexes further highlight gold’s versatility in achieving high turnover rates and selectivity. This evolution underscores the potential of gold catalysis in advancing environmentally sustainable methodologies and enhancing the scope of modern synthetic chemistry. The debate about the nature of monogold and dual-gold catalysis is open.

Methods

DFT calculations have played a key role in promoting the activation of alkynes, in particular the hydrophenoxylation of alkynes by metal-based catalysts. They not only help identify the most efficient and selective catalysts but also aid in screening for those capable of performing a dual metal catalytic mechanism. The most commonly used functionals are BP86 and B3LYP, with the SVP and 6-31G(d) basis sets employed for geometry optimizations, and M06 with TZVP or 6-311G(d,p) basis sets used for single-point energy calculations in a solvent. Grimme dispersion correction has been explicitly added either in the solvent single point energy calculations or in the gas phase geometry optimizations or in both. To point out that M06 implicitly includes part of this dispersion scheme.
Assessing a decade of leukaemia-related premature mortality costs: impact on productivity loss in Spain
Authors: Darbà Josep , Ascanio Meritxell , Agüera Ainoa
Published: September 2024

Introduction

Cancer mortality is one of the dominant causes of productivity loss; and within all cancer sites, blood cancer is the fourth most common cause of death in Spain. Thus, its impacts in work productivity are a major concern and represent a high social impact. The aim of this study was to evaluate the productivity losses resulting from of premature deaths due to leukaemia in Spain.

Methods

The productivity costs stemming from premature mortality due to leukaemia were estimated using the human capital method. Information pertaining to mortality rates, typical incomes, and joblessness figures was gathered throughout a decade-long period spanning from 2012 to 2021.

Results

Leukaemia caused 40% of haematological malignancies losses. It represented a 3.39% of all cancer-related deaths. In addition, it was responsible for 7,851 years of potential productive life lost (YPLPLL) in 2021, and productivity losses of €4,206.52 million over the 10-year period. All these numbers are relevant for Spain as will help on a more efficient distribution of resource.

Conclusions

These productivity losses obtained, highlight the burden of leukaemia on the Spanish population, providing novel data on the number of deaths, trends and productivity losses for this type of cancer. This evaluation offers fresh insights that can aid policymakers in efficiently distributing resources, thereby lessening the economic burden it imposes on individuals of working age.
Marine organisms transported by seabirds may contribute significantly to Arctic charr diet in coastal High-Arctic lakes
Authors: Svenning Martin-A. , Borgstrøm Reidar
Published: September 2024

The rich marine resources along the western coast of Spitsbergen (Svalbard) have given rise to colonies of breeding seabirds, which likely represent an important vector of nutrient transport from marine to terrestrial environments. These seabirds may also supply additional nutrients to lakes via their droppings, while bathing and/or when being attacked by other birds during flight to their nest sites. To study the importance of such droppings in the diet of freshwater fish, we sampled Arctic charr by gillnetting during a three-week period in the oligotrophic Lake Arresjøen in northwestern Svalbard. Marine fish and invertebrates made up more than 12% of the dry weight of the stomach contents of Arctic charr larger than 24 cm captured in the littoral zone. This suggests that the seabird transport of marine organisms contributes directly to the diet of Arctic charr in coastal High-Arctic lakes, but this contribution may also give a higher load of mercury and polychlorinated compounds.
On the Fueter–Sce theorem for generalized partial-slice monogenic functions
Authors: Xu Zhenghua , Sabadini Irene
Published: September 2024

In a recent paper, we introduced the concept of generalized partial-slice monogenic functions. The class of these functions includes both monogenic functions and slice monogenic functions with values in a Clifford algebra. In this paper, we establish a version of the Fueter–Sce theorem in this new setting, which allows to construct monogenic functions in higher dimensions starting from generalized partial-slice monogenic functions. We also prove that an alternative construction can be obtained by using the dual Radon transform. It turns out that these two constructions are closely related to the generalized CK-extension.
Controls on mesophotic carbonate facies and sediment distribution across the Maltese shelf, central Mediterranean Sea
Authors: Bialik Or M. , Coletti Giovanni , Berndt Christian , Schmidt Mark , Micallef Aaron
Published: September 2024

Although ~ 20% of global carbonate production occurs on extra-tropical carbonate depositional systems, our understanding of these environments still lags behind that of tropical ones. The Maltese shelf in the central Mediterranean offers an opportunity to study in situ facies distribution and the factors controlling it in a light-dominated setting. The investigated region of the Maltese shelf visually exhibits three main depositional environments: seagrass meadows, sand flats and rhodolith and maerl beds. While visually distinctive, the grain composition of the sediments does not provide a clear differentiation of the three environments but rather a gradient. This gradient is marked by increasing grain size with water depth, a transition from green to red calcareous algae and an increase in the fraction of low magnesium calcite of total carboantes. While some of these features can be explained by changes in light availability, other factors are also in play. Baffling by seafloor vegetation and currents, storms and internal waves inducing sediment reworking appear to play important roles in governing the sediment texture and composition across the Maltese shelf. The role of seagrass meadows in regulating production and accumulation rates of carbonates appears to be of greater importance in Mediterranean C-type carbonate factories than in southern Atlantic ones and this could be an important marker to identify them in the geological record.
M.D. meets machine: the symbiotic future of surgical learning
Authors: Łajczak Paweł , Janiec Julita , Żerdziński Krzysztof , Jóźwik Kamil , Nowakowski Przemysław , Nawrat Zbigniew
Published: September 2024

Background

The rapidly expanding field of robot-assisted surgery necessitates a parallel evolution in surgical education. A surgeon introduced to the telemanipulator control system can count on technological support that increases precision and supports decisions made during surgery. Generally, the surgeon (operator) is an integral part of the robot, so the synergy of this cooperation may bring the expected progress in access to high-quality services for many patients.

Methods

This review explores the current state of robotic surgery education, analyzing its limitations and established applications. Additionally, it delves into promising future directions, including the potential of artificial intelligence and advancements in training methods.

Results

This review identifies key challenges and highlights innovative strategies such as virtual reality simulation and cadaveric training. Furthermore, it emphasizes the importance of developing standardized national curricula to ensure consistent training quality.

Conclusion

This review emphasizes the need for a robust educational framework to equip surgeons with the necessary skills for safe and effective robotic surgery integration. The use of high-tech tools also requires the use of innovative educational methods. By embracing innovative technologies and prioritizing a standardized curriculum, we can ensure that the future of surgical training empowers surgeons and ultimately improves patient outcomes.
Clinical and sociodemographic determinants of older breast cancer survivors’ reports of receiving advice about exercise
Authors: Wojcik Kaitlyn M. , Wilson Oliver W. A. , Kamil Dalya , Rajagopal Padma Sheila , Schonberg Mara A. , Jayasekera Jinani
Published: September 2024

Purpose

Exercise offers various clinical benefits to older breast cancer survivors. However, studies report that healthcare providers may not regularly discuss exercise with their patients. We evaluated clinical and sociodemographic determinants of receiving advice about exercise from healthcare providers among older breast cancer survivors (aged ≥65 years).

Methods

We used data from the Surveillance, Epidemiology, and End Results cancer registries linked to the Medicare Health Outcomes Survey (MHOS) from 2008 to 2015. We included female breast cancer survivors, aged ≥65 years, who completed the MHOS survey ≥2 years after a breast cancer diagnosis in a modified Poisson regression to identify clinical and sociodemographic determinants of reportedly receiving advice about exercise from healthcare providers.

Results

The sample included 1,836 breast cancer survivors. The median age of the sample was 76 years (range: 72–81). Overall, 10.7% of the survivors were non-Hispanic Black, 10.1% were Hispanic, and 69.3% were non-Hispanic White. Only 52.3% reported receiving advice about exercise from a healthcare provider. Higher body mass index (BMI) and comorbid medical history that included diabetes, cardiovascular, or musculoskeletal disease were each associated with a higher likelihood of receiving exercise advice. Lower education levels, lower BMI, and never having been married were each associated with a lower likelihood of receiving exercise advice.

Conclusions

Nearly half of breast cancer survivors aged ≥65 years did not report receiving exercise advice from a healthcare provider, suggesting interventions are needed to improve exercise counseling between providers and survivors, especially with women with lower educational attainment who have never been married.
Thermal removal of binder from waste glass wool intended for recycling
Authors: Rywotycki Marcin , Cebo-Rudnicka Agnieszka , Szajding Artur , Kąc Sławomir , Rikardsen Mads , Heggelund Johan , Tretel Pawel , Jerzak Wojciech
Published: September 2024

Glass wool waste constitutes a large amount of waste both in the production process and after the demolition of buildings. The storage of these materials in landfills is associated with their large volume and low mass which results from their low density. Considering the principle of a life cycle assessment, the possibility of recycling this type of waste should be ensured. The basic problem with the recycling process is the removal of the binder that connects the glass wool fibres before returning it to the production process. The paper presents the results of research on the process of heat treatment of glass wool with various temperatures and heating rates. The process of sinter formation and the possibilities of avoiding their formation were analysed. For this purpose, a series of tests in the field of thermal analysis were carried out, in which the temperature ranges in which heat was released were identified. Furthermore, a series of tests were carried out on cube samples with dimensions of 20 × 20 × 20 mm in a chamber furnace. Based on the research conducted, assumptions were developed for the heat treatment process of glass wool waste, which allows the removal of organic substances and prevents the formation of sinters.
Beneficent Intelligence: A Capability Approach to Modeling Benefit, Assistance, and Associated Moral Failures Through AI Systems
Authors: London Alex John , Heidari Hoda
Published: September 2024

The prevailing discourse around AI ethics lacks the language and formalism necessary to capture the diverse ethical concerns that emerge when AI systems interact with individuals. Drawing on Sen and Nussbaum’s capability approach, we present a framework formalizing a network of ethical concepts and entitlements necessary for AI systems to confer meaningful benefit or assistance to stakeholders. Such systems enhance stakeholders’ ability to advance their life plans and well-being while upholding their fundamental rights. We characterize two necessary conditions for morally permissible interactions between AI systems and those impacted by their functioning, and two sufficient conditions for realizing the ideal of meaningful benefit. We then contrast this ideal with several salient failure modes, namely, forms of social interactions that constitute unjustified paternalism, coercion, deception, exploitation and domination. The proliferation of incidents involving AI in high-stakes domains underscores the gravity of these issues and the imperative to take an ethics-led approach to AI systems from their inception.
Data-driven learning and control of nonlinear system dynamics
Authors: Becerra-Mora Yeyson A. , Acosta José Ángel
Published: September 2024

This work falls into the field of discovering the dynamic equations of stabilizable nonlinear systems, via a learning-and-control algorithm to process the data sets of trajectories previously obtained. To this end, an interlaced method to learn and control nonlinear system dynamics from a set of demonstrations is proposed, under a constrained optimization framework for the unsupervised learning process. The nonlinear system is modeled as a mixture of Gaussians and Sontag’s formula together with its associated Control Lyapunov Function is proposed for learning and control. Lyapunov stability and robustness in noisy data environments are guaranteed, as a result of the inclusion of control in the learning-optimization problem. The performances are validated through a well-known dataset of demonstrations with handwriting complex trajectories, succeeding in all of them and outperforming previous methods under bounded disturbances, possibly coming from inaccuracies, imperfect demonstrations, or noisy datasets. As a result, the proposed interlaced solution yields a good performance trade-off between reproductions and robustness. Therefore, this work sheds some more light on the automatic discovery of nonlinear dynamics from noisy raw data.
Machine learning-based climate risk sharing for an insured loan in the tourism industry
Authors: Carannante Maria , D’amato Valeria , Fersini Paola , Forte Salvatore
Published: September 2024

Higher risks for commercial banks correspond to lower probability of access to financing transactions. Climate change risk strongly impacts bank loan supply. In particular, in the tourism industry, it is noteworthy that lenders charge higher interest rates for mortgages that face a greater risk of rising sea levels. As loans are one of the most important businesses for commercial banks, innovative strategies can lead to the design of a composite bank loan supply for building resilience, especially against physical climate risk. In this work, we propose a new tool, which is an insured loan relying on a climate change risk-sharing mechanism, where we develop a bioclimatic composite indicator based on machine learning naïve technique.
Physical and Chemical Evolution of PTFE-α-Al2O3 Composites Versus 304 SS Tribofilms During Dry Sliding
Authors: Haque Faysal M. , Junk Christopher P. , Sidebottom Mark A.
Published: September 2024

Polytetrafluoroethylene (PTFE) is renowned for its remarkably low friction coefficient (µ ~ 0.1) yet exhibits notably high wear rates (K ~ 104) in dry sliding applications. To mitigate this, various metallic and non-metallic fillers have been explored, consistently demonstrating a reduction in wear rates of unfilled PTFE between 10 and 104 times. Among these fillers, α-Al2O3 is one of the most extensively studied materials. 5 wt% of α-Al2O3 filler into PTFE yields a composite material, PTFE- α-Al2O3, characterized by a wear rate a staggering 104 times lower than unfilled PTFE. This reduction in wear has been attributed to the formation of tribofilms on the PTFE composite and metal counterbody material. These tribofilms emerge due to the interaction between broken fluropolymer chains and environmental water and oxygen. This interaction results in the creation of carboxylate salt groups, which subsequently react with metal/metal oxide particles (both from the counterbody and the metal filler) to form tribofilms. Despite numerous studies scrutinizing the chemical composition of the tribofilms pre- and post-test, the chemical development of these films has remained largely unexplored. In this study, the authors utilize attenuated total reflection infrared spectroscopy (ATR-IR), transmission infrared (IR) spectroscopy, optical microscopy, and stylus profilometry to observe tribofilm development. A thorough topographical and chemical description of the tribofilm is provided via these techniques. The ratio of carboxylate salt groups directly corresponds with improved wear performance and these changes are very local to the worn polymer surface. This discovery contributes to a deeper understanding of the tribological behavior of PTFE-α-Al2O3 composites.

Graphical Abstract