bluuebunny/crossref_metadata_2025 huggingface dataset:
Postsurgical opioid prescribing among veterans using community care for orthopedic surgery at non-VA hospitals compared to a VA hospital with a transitional pain service: a retrospective cohort study
Authors: Buys Michael Jacob , Anderson Zachary , Bayless Kimberlee , Zhang Chong , Presson Angela P , Hales Julie , Brooke Benjamin Sands
Published: April 2024

Background

The USA provides medical services to its military veterans through Veterans Health Administration (VHA) medical centers. Passage of recent legislation has increased the number of veterans having VHA-paid orthopedic surgery at non-VHA facilities.

Methods

We conducted a retrospective cohort study among veterans who underwent orthopedic joint surgery paid for by the VHA either at the Salt Lake City VHA Medical Center (VAMC) or at non-VHA hospitals between January 2018 and December 2021. 562 patients were included in the study, of which 323 used a non-VHA hospital and 239 patients the VAMC. The number of opioid tablets prescribed at discharge, the total number prescribed by postdischarge day 90, and the number of patients still filling opioid prescriptions between 90 and 120 days after surgery were compared between groups.

Results

Veterans who underwent orthopedic surgery at a non-VHA hospital were prescribed more opioid tablets at discharge (median (IQR)); (40 (30–60) non-VHA vs 30 (20–47.5) VAMC, p<0.001) and in the first 90 days after surgery than patients who had surgery at the Salt Lake City VAMC (60 (40–120) vs 35 (20–60), p<0.001). Patients who had surgery at Salt Lake City VAMC were also significantly less likely to fill opioid prescriptions past 90 days after hospital discharge (OR (95% CI) 0.06 (0.01 to 0.48), p=0.007).

Conclusion

These results suggest that veterans who have surgery at a veterans affairs hospital with a transitional pain service are at lower risk for larger opioid prescriptions both at discharge and within 90 days after surgery as well as persistent opioid use beyond 90 days after discharge than if they have surgery at a community hospital.
Spatiotemporal changes in imaging features associated with diffuse idiopathic skeletal hyperostosis (DISH)
Authors: Fournier Dale E. , Battie Michele C. , Séguin Cheryle A.
Published: April 2024

Objectives

The purpose of our study was to characterise spatiotemporal features of disease progression in people with diffuse idiopathic skeletal hyperostosis (DISH), early-phase DISH, and those not meeting either criterion who had repeated CT scans of the thoracic spine.

Methods

A retrospective study was designed in collaboration with theRochester Epidemiology Projectto evaluate completeness of ectopic bridging across the thoracic spine and corresponding disease status over an average of 2.7 years (range from 0.2 to 15.0 years) in a cohort of 83 female and 74 male individuals.

Results

Over 15% of individuals displayed changes in imaging features over time that resulted in a revised diagnosis along the continuum of DISH. Early-phase DISH was marked by new involvement of previously unaffected motion segments, estimated to occur over 2.1 years. Advanced presentations of DISH were marked by increased prevalence of complete bridging (average two of three available motion segments), estimated to occur over 2.6–2.9 years. Localised nodules of ectopic mineralisation external to and within the intervertebral disc were regularly observed in early-phase DISH.

Conclusions

This is the first characterisation of spatiotemporal features across all phases of DISH, indicating that progression of DISH is characterised by distinct features at different phases along the disease continuum. Localised nodules of mineralisation in the spinal ligaments and within the intervertebral discs coincident with early phases of the disease may be a key factor in the pathogenesis of DISH.
Subleading power corrections for event shape variables in $$e^+ e^-$$ annihilation
Authors: Buonocore Luca , Grazzini Massimiliano , Guadagni Flavio , Rottoli Luca
Published: April 2024

We consider subleading power corrections to event shape variables in $$e^+e^-$$

e
+

e
-

collisions at the first order in the QCD coupling $$\alpha _{\textrm{S}}$$

α
S

. We start from the jettiness variable $$\tau _2$$

τ
2

and the $$y_{23}$$

y
23

resolution variable for the $$k_T$$

k
T

jet clustering algorithm and we analytically compute the corresponding cumulative cross section. We investigate the origin of the different power suppressed contributions in the two-jet limit and trace it back to their different coverage of the phase space. We extend our analysis to the case of thrust and of the C-parameter, and we finally discuss a class of observables that depend on a continuous parameter giving different weight to central and forward emissions and we evaluate the corresponding subleading power corrections.
A multiple-timing analysis of temporal ratcheting
Authors: Hashemi Aref , Gilman Edward T. , Khair Aditya S.
Published: April 2024

We develop a two-timing perturbation analysis to provide quantitative insights on the existence of temporal ratchets in an exemplary system of a particle moving in a tank of fluid in response to an external vibration of the tank. We consider two-mode vibrations with angular frequencies $$\omega $$
ω
and $$\alpha \omega $$

α
ω

, where $$\alpha $$
α
is a rational number. If $$\alpha $$
α
is a ratio of odd and even integers (e.g., $$\tfrac{2}{1},\,\tfrac{3}{2},\,\tfrac{4}{3}$$

2
1

,

3
2

,

4
3

), the system yields a net response: here, a nonzero time-average particle velocity. Our first-order perturbation solution predicts the existence of temporal ratchets for $$\alpha =2$$

α
=
2

. Furthermore, we demonstrate, for a reduced model, that the temporal ratcheting effect for $$\alpha =\tfrac{3}{2}$$

α
=

3
2

and $$\tfrac{4}{3}$$

4
3

appears at the third-order perturbation solution. More importantly, we find closed-form formulas for the magnitude and direction of the induced net velocities for these $$\alpha $$
α
values. On a broader scale, our methodology offers a new mathematical approach to study the complicated nature of temporal ratchets in physical systems.

Graphic abstract
Investigation of bound state energy spectra for fermionic particles in the presence of ultra generalized exponential hyperbolic potential model
Authors: Taş Ahmet
Published: April 2024

By considering the ultra generalized exponential hyperbolic potential, which covers many potential types, the solutions of the Dirac equation with spin/pseudo-spin symmetric limits are achieved. In both approaches, the relation giving the bound state energy eigenvalues is obtained in a closed form. By using these relations, the energy values are calculated numerically for both symmetry cases via the software program. In addition, it has been identified how the bound state energy eigenvalues depend on the parameters. Besides, the energy equations for the Schrödinger and Klein–Gordon particles in the limit states are derived.
Domain-invariant and Patch-discriminative Feature Learning for General Deepfake Detection
Authors: Zhang Jian , Ni Jiangqun , Nie Fan , Huang Jiwu
Published: April 2024

Hyper-realistic avatars in the metaverse have already raised security concerns about deepfake techniques; deepfakes involving generated video “recording” may be mistaken for a real recording of the people it depicts. As a result, deepfake detection has drawn considerable attention in the multimedia forensic community. Though existing methods for deepfake detection achieve fairly good performance under the intra-dataset scenario, many of them gain unsatisfying results in the case of cross-dataset testing with more practical value, where the forged faces in training and testing datasets are from different domains. To tackle this issue, in this article, we propose a novel Domain-Invariant and Patch-Discriminative feature learning framework—DI&PD. For image-level feature learning, a single-side adversarial domain generalization is introduced to eliminate domain variances and learn domain-invariant features in training samples from different manipulation methods, along with the global and local random crop augmentation strategy to generate more data views of forged images at various scales. A graph structure is then built by splitting the learned image-level feature maps, with each spatial location corresponding to a local patch, which facilitates patch representation learning by message-passing among similar nodes. Two types of center losses are utilized to learn more discriminative features in both image-level and patch-level embedding spaces. Extensive experimental results on several datasets demonstrate the effectiveness and generalization of the proposed method compared with other state-of-the-art methods.
Charting User Experience in Physical Human–Robot Interaction
Authors: Seifi Hasti , Bhatia Arpit , Hornbæk Kasper
Published: April 2024

Robots increasingly interact with humans through touch, where people are touching or being touched by robots. Yet, little is known about how such interactions shape a user’s experience. To inform future work in this area, we conduct a systematic review of 44 studies on physical human–robot interaction (pHRI). Our review examines the parameters of the touch (e.g., the role of touch, location), the experimental variations used by researchers, and the methods used to assess user experience. We identify five facets of user experience metrics from the questionnaire items and data recordings for pHRI studies. We highlight gaps and methodological issues in studying pHRI and compare user evaluation trends with the Human–Computer Interaction (HCI) literature. Based on the review, we propose a conceptual model of the pHRI experience. The model highlights the components of such touch experiences to guide the design and evaluation of physical interactions with robots and inform future user experience questionnaire development.
Algorithmic Subjectivities
Authors: Baumer Eric P. S. , Taylor Alex S. , Brubaker Jed R. , McGee Micki
Published: April 2024

This article considers how subjectivities are enlivened in algorithmic systems. We first review related literature to clarify how we see “subjectivities” as emerging through a tangled web of processes and actors. We then offer two case studies exemplifying the emergence of algorithmic subjectivities: one involving computational topic modeling of blogs written by parents with children on the autism spectrum and one involving algorithmic moderation of social media content. Drawing on these case studies, we then articulate a series of qualities that characterizes algorithmic subjectivities. We also compare and contrast these qualities with a number of related concepts from prior literature to articulate how algorithmic subjectivities constitute a novel theoretical contribution, as well as how it offers a focal lens for future empirical investigation and for design. In short, this article points out how certain worlds are being made and/or being made possible via algorithmic systems, and it asks Human–Computer Interaction (HCI) to consider what other worlds might be possible.
Share What You Already Know: Cross-Language-Script Transfer and Alignment for Sentiment Detection in Code-Mixed Data
Authors: Pahari Niraj , Shimada Kazutaka
Published: April 2024

Code-switching entails mixing multiple languages. It is an increasingly occurring phenomenon in social media texts. Usually, code-mixed texts are written in a single script, even though the languages involved have different scripts. Pre-trained multilingual models primarily utilize the data in the native script of the language. In existing studies, the code-switched texts are utilized as they are. However, using the native script for each language can generate better representations of the text owing to the pre-trained knowledge. Therefore, a cross-language-script knowledge-sharing architecture utilizing the cross-attention and alignment of the representations of text in individual language scripts was proposed in this study. Experimental results on two different datasets containing Nepali-English and Hindi-English code-switched texts, demonstrate the effectiveness of the proposed method. The interpretation of the model using the model explainability technique illustrates the sharing of language-specific knowledge between language-specific representations.
Learned Video Compression with Adaptive Temporal Prior and Decoded Motion-aided Quality Enhancement
Authors: Yang Jiayu , Yang Chunhui , Xiong Fei , Zhai Yongqi , Wang Ronggang
Published: April 2024

Learned video compression has drawn great attention and shown promising compression performance recently. In this article, we focus on the two components in the learned video compression framework, the conditional entropy model and quality enhancement module, to improve compression performance. Specifically, we propose an adaptive spatial-temporal entropy model for image, motion, and residual compression, which introduces a temporal prior to reduce temporal redundancy of latents and an additional modulated mask to evaluate the similarity and perform refinement. In addition, a quality enhancement module is proposed for predicted frame and reconstructed frame to improve frame quality and reduce the bitrate cost of residual coding. The module reuses decoded optical flow as a motion prior and utilizes deformable convolution to mine high-quality information from the reference frame in a bit-free manner. The two proposed coding tools are integrated into a pixel-domain residual coding–based compression framework to evaluate their effectiveness. Experimental results demonstrate that our framework achieves competitive compression performance in the low-delay scenario compared with recent learning-based methods and traditional H.265/HEVC in terms of Peak Signal-to-Noise Ratio (PSNR) and Multi-Scale Structural Similarity Index (MS-SSIM). The code is available at OpenLVC.
ELEV-VISION: Automated Lowest Floor Elevation Estimation from Segmenting Street View Images
Authors: Ho Yu-Hsuan , Lee Cheng-Chun , Diaz Nicholas , Brody Samuel , Mostafavi Ali
Published: April 2024

We propose an automated lowest floor elevation (LFE) estimation algorithm based on computer vision techniques to leverage the latent information in street view images. Flood depth-damage models use a combination of LFE and flood depth for determining flood risk and extent of damage to properties. We used image segmentation for detecting door bottoms and roadside edges from Google Street View images. The characteristic of equirectangular projection with constant spacing representation of horizontal and vertical angles allows extraction of the pitch angle from the camera to the door bottom. The depth from the camera to the door bottom was obtained from the depthmap paired with the Google Street View image. LFEs were calculated from the pitch angle and the depth. The testbed for application of the proposed method is Meyerland (Harris County, Texas). The results show that the proposed method achieved mean absolute error of 0.190 m (1.18 %) in estimating LFE. The height difference between the street and the lowest floor (HDSL) was estimated to provide information for flood damage estimation. The proposed automatic LFE estimation algorithm using street view images and image segmentation provides a rapid and cost-effective method for LFE estimation compared with the surveys using total station theodolite and unmanned aerial systems. By obtaining more accurate and up-to-date LFE data using the proposed method, city planners, emergency planners, and insurance companies could make a more precise estimation of flood damage.
Systematic Review and Psychometric Properties Analysis of First-, Middle-, and Top-Level Nurse Manager’s Core Competencies Instruments
Authors: Filomeno Lucia , Forte Daniela , Di Simone Emanuele , Di Muzio Marco , Tartaglini Daniela , Lommi Marzia , Ivziku Dhurata
Published: April 2024

Purpose. Healthcare organisations need to define the role of the nurse manager in light of recent global health developments. For this purpose, several core competencies essential for each hierarchical management level need to be assessed. Different measurement instruments have been developed to assess nurse managers’ competencies. This systematic review summarises the characteristics and psychometric properties of existing instruments measuring first-, middle-, and top-level nurse managers’ competencies. Methods. Following PRISMA guidelines for reporting and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines, 789 articles were retrieved from PubMed, Scopus, CINAHL, and APA PsycINFO databases with no time limitation. The review protocol was registered on PROSPERO (CRD42023425854). Results. Ten tools were identified, assessing one or more competencies among nurse managers: Competency Elements for Nurse Managers of Tertiary General Hospitals, NICA-NL, HCCI, I-FLNMMCS, NMCI, Chase Nurse Manager Competency Questionnaire, CASHN, Questionnaire for Head Nurses’ Managerial Competencies, Nurse Manager EBP Competency Scale, and the Home Healthcare Nurse Manager Assessment Tool. Conclusion. Following the COSMIN assessment, the Chase Nurse Manager Competency Instrument was the most comprehensive among the included instruments, and the CASHN questionnaire scored highest on methodological quality and level of evidence. These instruments can be used in clinical practice to evaluate competencies and as a basis for developing managerial training courses.
Corrosion Behavior of Candidate Structural Materials for Molten Salt Reactors in Flowing NaCl‐MgCl2
Authors: Kim Taeho , Shin Dong Jun , Yoon Dalsung , Choi Eun-Young , Lee Chang Hwa
Published: April 2024

Abstracts. A high‐temperature molten salt natural convection loop was designed and manufactured for chloride‐based salts. NaCl‐MgCl2 salt was prepared and injected into the loop. Corrosion coupons composed of SS304, SS316L, and high‐Ni alloys were also prepared as candidate structural materials for molten chloride salt reactors. After a corrosion experiment was conducted for 500 h, the salt was drained from the loop to the drain tank; inductively coupled plasma optical emission spectroscopy was used to investigate metal dissolution from the materials into the salt. The corroded materials were analyzed using scanning electron microscopy and energy‐dispersive X‐ray spectroscopy to calculate the corrosion rate. Materials exposed to NaCl‐MgCl2 molten salt showed varying levels of corrosion resistance. The high‐Ni alloy demonstrated the highest resistance, followed by SS316L and SS304. Furthermore, corrosion products were observed to migrate along the molten salt through natural convection, eventually depositing onto the surface of the high‐Ni alloy in the cold leg of the loop.
Temperature Control and Crack Prevention Measures for Concrete Ship Locks Subjected to Prolonged Casting Interruptions
Authors: Li Songhui , Luo Xiangyu , Zhang Guoxin , Liu Yi
Published: April 2024

During the construction of concrete ship locks, prolonged interruptions between the casting of the floor and lock wall are inevitable. In terms of mass concrete, long placement delays are one of the major reasons for the presence of cracks in newly placed concrete. Therefore, this study examines both the placement and structural characteristics of ship locks after long casting interruptions based on the mass concrete thermal stress theory to determine the major causal factors for cracks in newly poured concrete. Specifically, a block placement method is proposed to reduce thermal stress in newly placed concrete, and the temperature control and crack prevention capacities of the proposed method are verified using the finite element method. The development of the structure’s thermal stress under different temperature control measures is analyzed, finding that thermal stress in the lock walls can be effectively reduced by 50% through low‐temperature block casting. The results demonstrate that the proposed method can significantly reduce the internal thermal stress of newly placed concrete after prolonged casting interruptions, thereby highlighting its applicability for achieving effective temperature control and crack prevention in concrete ship locks.
Prioritising Actions for Improving Classroom Air Quality Based on the Analytic Hierarchy Process: Case Studies in China and the UK
Authors: Shu Ziyu , Yuan Feng , Wang Jie , Zang Jian , Li Baizhan , Shahrestani Mehdi , Essah Emmanuel , Awbi Hazim , Holland Mike , Fang Fangxin , Pain Christopher , Kumar Prashant , Zhong Hua , Short Alan , Linden Paul , Yao Runming
Published: April 2024

The air quality in classrooms significantly impacts school children’s health and learning performance. It has been reported worldwide that classroom air quality does not meet the required standard and actions are pledged for improvement. However, it poses a challenge for decision‐making in terms of prioritising taking‐up measures. The aim of this study is to propose a method of identifying the action measures for improving classroom air quality and prioritising them. Case studies in the UK and China were conducted, and the key measures were identified through literature studies, open‐ended questionnaire surveys, and workshop discussions, which are classified into three categories: B1, policy; B2, technology; and B3, information sharing. The analytical hierarchy process (AHP) is applied in the prioritisation of the action measures. A total of 138 teachers and parents from China and the UK participated in this case study. The genetic algorithm‐optimised Hadamard product (GAOHP) method is applied to justify the consistency ratio (CR) within the required threshold value in order to ensure the consistency of the subjective perception and the accuracy of comparative weights. The results show that item B2, technology, is the most desired measure by both Chinese and British parents and teachers, despite the deviation from the optimal choice in China and the UK. Among the proposed action measures, the UK respondents strongly expected air purifiers with natural ventilation as opposed to their Chinese counterparts preferring to share the real‐time status of classroom air quality. Our work will provide strong support for the subsequent selection of indoor air quality improvement strategies for schools.
Pott’s Paraplegia in a 2 Years Female: A Rare Presentation at an Early Age
Authors: Basnet Preeti , Joshi Anish , Karki Saurab , Thapa Anil Jung , Poudel Prayash , Sapkota Anugya , Shrestha Manoj , Pande Shreebridhi
Published: April 2024

Introduction. Potts disease is extrapulmonary skeletal tuberculosis mostly affecting the thoracolumbar spine. It destroys the disc space, adjacent vertebral bodies, and spinal elements, leading to cord compression and paraplegia. Methods. This is a case report study of a 29-month-old toddler who presented to our hospital with bilateral lower limb weakness. Results. On clinical, laboratory, and radiological examination, she was diagnosed with Pott’s spine, started on antitubercular therapy, and planned for surgery in her follow-up. Conclusion. Tuberculosis of the spine is still prevalent in developing countries, mainly in children. Complications of the disease can be devastating because of its ability to cause bone destruction, spinal deformity, and paraplegia. So, in a tuberculosis-endemic region, clinical suspicion should be there for Potts disease when a child presents with paraplegia of the lower limbs. Children can develop tuberculosis which can spread to the spine despite vaccination. The prognosis of spinal tuberculosis is improved by early diagnosis and rapid intervention.
Timing of Radiation Pneumonitis in Patients with Stage 3 Non-Small-Cell Lung Cancer Receiving Consolidation Durvalumab after Chemoradiation
Authors: Mushonga Melinda , Louie Alexander , Cheng Susanna , Tsao May N. , Ong Wee Loon , Cheung Patrick , Poon Ian , Zhang L. , Ung Yee C.
Published: April 2024

Purpose. Consolidation with durvalumab is standard of care in the management of unresectable stage 3 non-small-cell lung cancer (NSCLC) postchemoradiation, and pneumonitis is an independent potential treatment complication of both treatment strategies. This study seeks to determine the timing of radiation pneumonitis (RP) by receipt of durvalumab. In addition, we reviewed the preventative strategies guided by pathophysiology of pneumonitis. Methods. We identified patients with unresectable Stage 3 NSCLC who developed grade ≥2 RP after chemoradiotherapy. Time-to-RP was defined from date of completion of radiotherapy to date of radiological diagnosis of RP and accompanying clinical symptoms. Early RP was defined as RP within 2 months of completion of radiotherapy. Differences in time-to-RP by receipt of durvalumab were evaluated using Wilcoxon rank-sum test. Differences in those who had early vs late RP by receipt of durvalumab was evaluated using Fisher’s exact test. Logistic regression was used to evaluate patient and treatment factors associated with early RP. Results. Of the 144 patients with Stage 3 NSCLC who had definitive chemoradiotherapy, 31 (22%) developed grade ≥2 RP and were included in the study. There was one patient with grade 5 RP. The median age of the cohort was 67 years (range 41–87). The mean lung dose, V5Gy, and V20Gy were 15.8Gy (SD = 1.56), 60.14% (SD 2.73), and 29.96% (SD 1.82), respectively. Twelve (39%) patients received durvalumab. The median time-to-RP was 3.4 months (range: 1.7–7.2) and 2.3 months (range: 0.6–9.6) in patients who had durvalumab and no durvalumab, respectively (P=0.01). 83% (10/12) of patients who had durvalumab and 58% (11/19) of patients who did not have durvalumab had late RP (P=0.14). No other patient and treatment factors were associated with early RP. Conclusion. Patients on durvalumab may have late-onset RP; therefore, further studies with larger cohort of patients and development of new predictive models that incorporate evolving management are needed should preventative strategies of RP be considered in routine clinical practice.
Mechanical Behaviour of Glass Fibre-Reinforced Polymer/Polyvinyl Chloride Foam Cored Sandwich Structures
Authors: Kosgey Edwin Cheruiyot , Kanny Krishnan , Mwangi Festus Maina
Published: April 2024

This study focuses on the fabrication and analysis of the mechanical behaviour of unidirectional (UD) glass fibre-reinforced polymer (GFRP) facesheet and polyvinyl chloride (PVC) foam core sandwich structures fabricated by a vacuum-assisted resin infusion method (VARIM). These sandwich structures are commonly used in marine and wind turbine blade applications. To date, relatively little knowledge about the functional behaviour of UD GFRP compared to composites reinforced with bidirectional mats is available for day-to-day applications. The effects of the facesheet orientation, facesheet thickness, and core thickness on the mechanical behaviour of the specimens were examined. The UD fibres were oriented in cross-ply (0/90), angle-ply (+45/−45), and quasi-isotropic orientations. Various mechanical properties such as tensile, flexural, flatwise compression, and edgewise compression tests were examined. Characterization of the tensile properties of the facesheet showed that the cross-ply orientation had a higher strength than the angle-ply and quasi-isotropic orientations. The flexural load-carrying capacity of the cross-ply facesheet orientation was superior to the other orientations. The increase in the core thickness changed the flexural failure mode from face yield and core shear to core indentation. Flatwise compression (FWC) was tested to determine the core characteristics of the sandwich structure, and the peak loads of 4.90, 1.81, and 3.90 kN were obtained for 10-, 15-, and 20 mm core thicknesses, respectively. Edgewise compression (EWC) exhibited stable end crushing for thinner facesheet, whereas thicker facesheet showed core crushing and buckling. When the facesheet thickness was increased from 1.5 mm to 3 mm in the EWC, the buckling load increase ranged from 2.53% to 44.83% for core thicknesses 10-, 15-, and 20 mm, respectively.
Dynamics of Soil Physical and Chemical Properties under Different Current Land Use Types and Elevation Gradients in the Sala Watershed of Ari Zone, South Ethiopia
Authors: Debebe Woldeyes , Yirgu Teshome , Debele Mulugeta
Published: April 2024

The dynamics of soil physical and chemical properties have been increasing due to inappropriate land use and unsustainable land management practices in Ethiopia. This study aims to assess the dynamics of selected soil physical and chemical properties under different current land use types and altitudinal gradients in the Sala watershed of Ari Zone in South Ethiopia. In the study area, analyzing and understanding the dynamics of soil physicochemical properties under different land use types play a vital role in sustainable soil productivity. Before collecting a soil sample, land use types and altitudinal variations were surveyed in the study watershed. Three random strata were selected from the watershed, and the major adjacent land use types in each stratum were identified across elevation gradients. A total of 30 composite soil samples were collected from different land uses and elevations using a zigzag sampling technique at 0–20 cm soil depth from upland (12), midland (9), and lowland (9). Laboratory results showed that most soil physical and chemical properties had poor ratings in the watershed area. All soil properties were significantly affected by land use types and elevation factors (P<0.05), except for soil texture, TN, and CEC. Soil texture is highest in the upper and lower elevations of grazing land (61.3%) and shrubland (55.4%), while lowest in cultivated land (11.3%) and barren land (11.6%) at higher altitudes. The highest mean of soil texture was dominated by clay soil (55%) in shrubland followed by sand soil (50.30%) in the barren land and silt soil (20.06%) in cultivated land. Chemical soil properties (pH, SOM, TN, Av. P, Av. K, and CEC) were significantly varied under each land use type across altitudes. The results of this study showed that inappropriate land use and unsustainable agricultural practices had more significantly influenced the soil fertility status. Therefore, appropriate soil and water conservation measures should be implemented in the studied watershed to improve soil fertility and crop productivity.
Downregulated PDIA3P1 lncRNA Impairs Trophoblast Phenotype by Regulating Snail and SFRP1 in PE
Authors: Ding Zhengzheng , Wu Liuxin , Sun Yue , Zhu Yuanyuan , Zuo Qing , Yuan Li , Wang Cong , Sun Lizhou , Xu Yetao , Zhang Yuanyuan
Published: April 2024

Preeclampsia (PE) manifests as a pregnancy‐specific complication arising from compromised placentation characterized by inadequate trophoblast invasion. A growing body of evidence underscores the pivotal involvement of pseudogenes, a subset of long noncoding RNAs, in the pathological processes of PE. This study presents a novel finding, demonstrating a significant downregulation of the pseudogene PDIA3P1 in PE placental tissues compared to normal tissues. In vitro functional assays revealed that suppressing PDIA3P1 hindered trophoblast proliferation, invasion, and migration, concurrently upregulating the expression of secreted frizzled‐related protein 1 (SFRP1). Further exploration of the regulatory role of PDIA3P1 in PE, utilizing human trophoblasts, established that PDIA3P1 exerts its function by binding to HuR, thereby enhancing the stability of Snail expression in trophoblasts. Overall, our findings suggest a crucial role for PDIA3P1 in regulating trophoblast properties and contributing to the pathogenesis of PE, offering potential targets for prognosis and therapeutic intervention.
Questioning the Role of Carotid Artery Ultrasound in Assessing Fluid Responsiveness in Critical Illness: A Systematic Review and Meta-Analysis
Authors: Walker Samuel C. D. , Lipszyc Adam C. , Kilmurray Matthew , Wilding Helen , Akhlaghi Hamed
Published: April 2024

Background. A noninvasive and accurate method of identifying fluid responsiveness in hemodynamically unstable patients has long been sought by physicians. Carotid ultrasound (US) is one such modality previously canvassed for this purpose. The aim of this novel systematic review and meta-analysis is to investigate whether critically unwell patients who are requiring intravenous (IV) fluid resuscitation (fluid responders) can be identified accurately with carotid US. Methods. The protocol was registered with PROSPERO on the 30/11/2022 (ID number: CRD42022380284). Studies investigating carotid ultrasound accuracy in assessing fluid responsiveness in hemodynamically unstable patients were included. Studies were identified through searches of six databases, all run on 4 November 2022, Medline, Embase, Emcare, APA PsycInfo, CINAHL, and Cochrane Library. Risk of bias was assessed using the QUADAS-2 and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines. Results were pooled, meta-analysis was conducted where amenable, and hierarchical summary receiver operating characteristic models were established to compare carotid ultrasound measures. Results. Seventeen studies were included (n = 842), with 1048 fluid challenges. 441 (42.1%) were fluid responsive. Four different carotid US measures were investigated, including change in carotid doppler peak velocity (∆CDPV), carotid blood flow (CBF), change in carotid artery velocity time integral (∆CAVTI), and carotid flow time (CFT). Pooled carotid US had a pooled sensitivity, specificity, and AUROC with 95% confidence intervals (CI) of 0.73 (0.66–0.78), 0.82 (0.72–0.90), and 0.81 (0.78–0.85), respectively. ∆CDPV had sensitivity, specificity, and AUROC with 95% CI of 0.72 (0.64–0.80), 0.87 (0.73–0.94), and 0.82 (0.78–0.85), respectively. CBF had sensitivity, specificity, and AUROC with 95% CI of 0.70 (0.56–0.80), 0.80 (0.50–0.94), and 0.77 (0.78–0.85), respectively. Risk of bias and assessment was undertaken using the QUADAS-2 and GRADE tools. The QUADAS-2 found that studies generally had an unclear or high risk of bias but with low applicability concerns. The GRADE assessment showed that ∆CDPV and CBF had low accuracy for sensitivity and specificity. Conclusion. It appears that carotid US has a limited ability to predict fluid responsiveness in critically unwell patients. ∆CDPV demonstrates the greatest accuracy of all measures analyzed. Further high-quality studies using consistent study design would help confirm this.
Efficacy of Radiofrequency Diathermy versus Focused Ultrasound Therapy, Both Combined with Intermittent Pneumatic Compression, for Edematous Fibrosclerotic Panniculopathy Treatment: A Randomized Intrasubject Assessor‐Blind Trial
Authors: Mihaiescu-Ion V. , Moral-Munoz J. A. , Lucena-Anton D. , Martin-Vega F. J. , Rebollo-Salas M. , Carmona-Barrientos I. M.
Published: April 2024

Background. Edematous fibrosclerotic panniculopathy (EFP), commonly known as cellulite, is a cosmetic concern affecting a large percentage of women. Radiofrequency diathermy (RFD) and focused ultrasound (FUS) are noninvasive treatments proposed for the reduction of EFP. Objective. This study aimed to evaluate the efficacy of RFD versus FUS, both combined with intermittent pneumatic compression (IPC) for the treatment of EFP in female thighs. Methods. A randomized intrasubject assessor‐blind trial was conducted (NCT03474523) on 40 lower limbs of 20 women with EFP grades I, II, or III according to the Nürnberger & Müller scale. Each lower limb was randomly assigned to receive either seven RFD sessions or seven FUS sessions, both combined with IPC. Measurements were collected at baseline and post‐treatment, including lower limb circumferences at different levels, weight, grade of EFP, and physical activity level. Results. Both RFD and FUS treatments, both combined with IPC, showed significant intragroup reduction in thigh circumference measurements for RFD at 15 cm (p = 0.001), 20 cm (p = 0.024), and midpoint (p = 0.008) and for FUS at 15 cm (p = 0.001), 20 cm (p = 0.010), midpoint (p = 0.008), 30 cm (p = 0.020), and 40 cm (p = 0.048). No statistically significant differences were observed between the two treatments. Weight did not change with treatment, and physical activity levels did not significantly affect EFP improvement. Conclusion. Both RFD and FUS, combined with IPC, were effective noninvasive methods for treating EFP. This study found that there was no significant difference between RFD and FUS in terms of efficacy in reducing EFP in the thighs. Therefore, both techniques can be used to treat EFP from a clinical perspective. Further studies with objective measurements are required to confirm these results and to guide clinical decision‐making. This trial is registered with NCT03474523.
The Challenges of Distinguishing Different Causes of TMA in a Pregnant Kidney Transplant Recipient
Authors: Krelle A. , Price S. , Law M. M. , Kranz S. , Shamdasani P. , Kane S. , Unterscheider J. , Champion de Crespigny P.
Published: April 2024

Thrombotic microangiopathy (TMA) reflects a syndrome of endothelial injury characterised by microangiopathic haemolytic anaemia (nonimmune), thrombocytopenia, and often end-organ dysfunction. TMA disorders are well-recognised in kidney transplant recipients, often due to an underlying genetic predisposition related to complement dysregulation, or de novo due to infection, immunosuppression toxicity, or antibody-mediated rejection. In pregnancy, TMA disorders are most commonly due to severe pre-eclampsia or HELLP, but may also be due to thrombotic thrombocytopenic purpura (TTP) or complement-mediated (atypical) haemolytic uremic syndrome (aHUS). Complement dysregulation is being recognised as playing a role in the development of preeclampsia and HELLP syndrome in addition to aHUS. Due to overlapping clinical and laboratory features, diagnosis can be difficult and delays in treatment can be life-threatening for both mother and fetus. This report describes a 32 year-old female who had two successive wanted pregnancies. The first pregnancy was terminated at 22 weeks gestation due to presumed severe preeclampsia and fetal growth restriction in the context of known chronic kidney failure due to reflux nephropathy. A living-related kidney transplant was performed to improve the chances of pregnancy resulting in a live birth. A subsequent pregnancy was complicated by progressive kidney impairment and hypertension at 22 weeks gestation. Kidney biopsy showed TMA, but the etiology was unclear. This report highlights the diagnostic dilemma of TMA in a pregnant kidney transplant recipient and a role for the anti-C5 terminal complement blockade monoclonal antibody eculizumab, in pregnancy-associated TMA, especially at a peri-viable gestation.
Blockade of Discoidin Domain Receptor Signaling with Sitravatinib Reveals DDR2 as a Mediator of Neuroblastoma Pathogenesis and Metastasis
Authors: Rozen Esteban J. , Frantz William , Wigglesworth Kim , Vessella Theadora , Zhou Hong S. , Shohet Jason M.
Published: April 2024

Oncogene-driven expression and activation of receptor tyrosine kinases promotes tumorigenesis and contributes to drug resistance. Increased expression of the kinases discoidin domain receptor 2 (DDR2), RET Proto-Oncogene (RET), Platelet Derived Growth Factor Receptor Alpha (PDGFRA), KIT Proto-Oncogene (KIT), MET Proto-Oncogene (MET), and anaplastic lymphoma kinase (ALK) independently correlate with decreased overall survival and event free survival of pediatric neuroblastoma. The multikinase inhibitor sitravatinib targets DDR2, RET, PDGFRA, KIT, and MET with low nanomolar activity and we therefore tested its efficacy against orthotopic and syngeneic tumor models. Sitravatinib markedly reduced cell proliferation and migration in vitro independently of N-Myc proto-oncogene (MYCN), ALK, or c-Myc proto-oncogene status and inhibited proliferation and metastasis of human orthotopic xenografts. Oral administration of sitravatinib to homozygous Th-MYCN transgenic mice (Th-MYCN+/+) after tumor initiation completely arrested further tumor development with no mice dying of disease while maintained on sitravatinib treatment (control cohort 57 days median time to sacrifice). Among these top kinases, DDR2 expression has the strongest correlation with poor survival and high stage at diagnosis and the highest sensitivity to the drug. We confirmed on-target inhibition of collagen-mediated activation of DDR2. Genetic knockdown of DDR2 partially phenocopies sitravatinib treatment, limiting tumor development and metastasis across tumor models. Analysis of single-cell sequencing data demonstrated that DDR2 is restricted to mesenchymal-type tumor subpopulations and is enriched in Schwann cell precursor subpopulations found in high-risk disease. These data define an unsuspected role for sitravatinib as a therapeutic agent in neuroblastoma and reveal a novel function for DDR2 as a driver of tumor growth and metastasis.
Cell-free supernatant of Lactococcus lactis IDCC 2301 exerts anti-inflammatory effects in LPS-induced macrophages via NF-κB and MAPK signaling pathways
Authors: Lee M. , Chae S.A. , Lee Y.J. , Jeon H.J. , Hong S.-C. , Shin M. , Jung Y.H. , Yang J.
Published: April 2024

This study investigated the anti-inflammatory effects of cell-free supernatant of Lactococcus lactis IDCC 2301 on lipopolysaccharide (LPS)-induced RAW 264.7 macrophages. Expression of inflammatory mediators and cytokines, and the production of nitric oxide (NO) and prostaglandin E2 (PGE2) were qualitatively analysed. The expression of signal transductors in inflammatory cascades was quantified by western blot. Treatment with cell-free supernatant of L. lactis IDCC 2301 significantly decreased the mRNA expression levels of tumour necrosis factor (TNF-α) and interleukins including IL-1β and IL-6. The levels of inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX-2) were also remarkably reduced in LPS-induced macrophages after the treatment. Furthermore, L. lactis IDCC 2301 reduced the levels of both dephosphorylated and phosphorylated forms of nuclear factor-kappa B (NF-κB), IκB-α, extracellular signal-regulated kinases (ERK), c-Jun amino-terminal kinases (JNK), and p38 in LPS-induced RAW 264.7 cells. Therefore, L. lactis IDCC 2301 shows anti-inflammatory activity by suppressing the NF-κB and mitogen-activated protein kinase (MAPK) signaling pathways.
Longitudinal changes in bifidobacterial population during the first two years of life
Authors: An R. , Fontana F. , Van Daele E. , Ventura M. , Vlieger A. , van Elburg R.M. , Knol J. , Milani C. , Belzer C.
Published: April 2024

Early life microbiota encompasses of a large percentage of Bifidobacterium, while it is not sufficiently understood how the Bifidobacterium population develops after infant’s birth. Current study investigated the longitudinal changes in Bifidobacterium population during the first two years of life in 196 term born infants (1,654 samples) using 16S rRNA-23S rRNA internal transcribed spacer (ITS) sequence analysis. Throughout the first two years of life, Bifidobacterium breve, Bifidobacterium longum subsp. longum and Bifidobacterium adolescentis were most dominant and prevalent in the Bifidobacterium population, while B. breve had the highest relative abundance and prevalence during the first week of life and it was taken over by B. longum subsp. longum around two years after birth. Sampling time points, early antibiotic(s) exposure (effect only measurable within a month after birth), delivery mode (effect still detectable two-months after birth) and feeding mode (effect lasted until six months after birth), significantly contributed to the overall variation in the bifidobacterial population. From six months onwards, introducing of solid food and cessation of breastfeeding were accompanied with drastic changes in the composition in bifidobacterial population. Altogether, current study confirmed the effect of potential contributors to the longitudinal changes within the bifidobacterial population during the first two years of life.

Registered at https://clinicaltrials.gov: NCT02536560.
Emotions and Battlefield Medicine in the American Revolutionary War
Authors: Blakley Chris M.
Published: April 2024

This essay examines the expression of emotional states by frontline medics in the American Revolutionary War to understand how doctors felt about their role as caregivers during the Canada Campaign of 1775–76 and the Sullivan-Clinton Expedition of 1779. The first section queries how surgeons managed the emotional strain of caring for wounded and sick soldiers during the Invasion of Quebec. The journals of two doctors who expressed resentment and grief towards the officer corps during the invasion, Samuel Fisk Merrick and Lewis Beebe, are considered. In the second section, the essay focuses on the role that expressions of enthusiasm, particularly what scholars term settler colonial optimism, played in during a total war. Here another pair of doctors, Jabez Campfield and Ebenezer Elmer, afford insight into the hope surrounding land-grabbing felt by medics during the army’s genocidal campaign in western New York and Pennsylvania.
Descriptive Analysis of Outcomes After Onlay Ventral Hernia Repair in Obese Patients
Authors: Smullin Carolyn P. , Shenoy Rivfka S. , Blair Kevin J. , Chandler Charles F.
Published: April 2024

Objective

To determine outcomes after on lay large ventral hernia repair in obese patients.

Introduction

Large ventral hernia repairs (VHR) in obese patients remain a challenge. Obesity is a risk factor for intraoperative difficulties and postoperative complications. Recurrence rates after VHR in obese patients range between 12-50% versus 10% in nonobese patients. While results of laparoscopic techniques in VHR compare favorably to open, outcomes in correlation with obesity, technique, and defect size are less understood.

Methods

A single surgeon’s experience of 329 consecutive VHR between 2013-2022 was retrospectively reviewed. Inclusion criteria were obesity (BMI >30) and large hernia defects (>5 cm). A modified onlay technique was used which included component release and a lightweight monofilament polypropylene mesh. Primary outcome measures were hernia recurrence and wound complications.

Results

A total of 56 patients met inclusion criteria. Patients were majority male (n=30, 54%), with a median age of 58.5 years (inter quartile range (IQR) 33-83), and median BMI of 36 kg/m2 (IQR: 30-72). Median hernia defect size was 8 cm (IQR: 5-15). Twenty patients had undergone prior mesh repairs. Median follow-up was 52 months (IQR: 6 months-9 years). Two patients experienced recurrence (3.6%) and four experienced wound complications (four seromas, one panniculitis, 8.9%). No patients suffered flap ischemia or necrosis.

Conclusion

Obesity is a risk factor for poor outcomes after VHR. We developed a protocol for obese patients with large defects involving a modified onlay technique which demonstrates comparable results to other VHR techniques in obese patients.