bluuebunny/crossref_metadata_2025 huggingface dataset:
Mid-term outcomes of physician-modified endograft therapy for complex aortic aneurysms
Authors: Shibata Tsuyoshi , Mitsuoka Hiroshi , Iba Yutaka , Hashizume Kenichi , Hongo Norio , Yasuhara Kiyomitsu , Kuwada Noriaki , Katada Yoshiaki , Hashiguchi Hitoki , Uzuka Takeshi , Murai Yuta , Nakajima Tomohiro , Nakazawa Junji , Kawaharada Nobuyoshi
Published: March 2024

OBJECTIVES

Our goal was to evaluate early and mid-term outcomes of physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms from 10 Japanese aortic centres.

METHODS

From January 2012 to March 2022, a total of 121 consecutive adult patients who underwent physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms were enrolled. We analysed early and mid-term postoperative outcomes, including postoperative complications and mortality.

RESULTS

The pararenal and thoraco-abdominal aortic aneurysm groups included 62 (51.2%) and 59 (48.8%) patients, respectively. The overall in-hospital mortality rate was 5.8% (n  =  7), with mortality rates of 3.2% (n  =  2) and 8.5% (n  =  5) in pararenal and thoraco-abdominal aortic aneurysm groups, respectively (P = 0.225). Type IIIc endoleaks occurred postoperatively in 18 patients (14.9%), with a significantly higher incidence (P = 0.033) in the thoraco-abdominal aortic aneurysm group (22.0%, n  =  13) than in the other group (8.1%, n  =  5). Major adverse events occurred in 7 (11.3%) and 14 (23.7%) patients in pararenal and thoraco-abdominal aortic aneurysm groups (P = 0.074), respectively. The mean follow-up period was 24.2 months. At the 3-year mark, both groups differed significantly in freedom from all-cause mortality (83.3% and 54.1%, P = 0.004), target aneurysm-related mortality (96.8% and 82.7%, P = 0.013) and any reintervention (89.3% and 65.6%, P = 0.002). Univariate and multivariate regression analyses demonstrated that ruptures, thoraco-abdominal aortic aneurysms and postoperative type IIIc endoleaks were associated with an increased risk of all-cause mortality.

CONCLUSIONS

The mid-term outcomes of physician-modified endografting for pararenal and thoraco-abdominal aortic aneurysms were clinically acceptable and comparable with those in other recently published studies. Notably, pararenal and thoraco-abdominal aortic aneurysms represent distinct pathological entities with different postoperative outcomes.
Bayesian deep neural network for low-carbon scheduling strategy planning of V2G
Authors: Wang Fei , Jiang Bin , Hu Linlin , Jin Hao , Yu Qi , Shi Ye
Published: March 2024

With the increasing adoption of electric vehicles, the Vehicle-to-Grid (V2G) model has become crucial in integrating renewable energy generation. However, challenges exist in developing grid scheduling strategies that are tailored to different regions, as well as in quantifying the economic benefits and carbon emissions associated with such scheduling. To address these issues, our study proposed a novel V2G low-carbon scheduling strategy planning method based on Bayesian neural networks. Initially, we established a stochastic V2G model that incorporated grid and electric vehicle scheduling, along with a mathematical model that captured the random behavior of EV users, enabling us to capture the essential characteristics of scheduling planning. Subsequently, we employed an enhanced Bayesian deep neural network to learn and assimilate these scheduling planning characteristics, allowing for the provision of a grid scheduling strategy that ranks economic benefits based on weighted priorities. Furthermore, we conducted simulation experiments within the coverage area of the Internet of Things in Energy (IoTE) to gather scheduling characteristics. The experimental results demonstrated that our method outperformed other deep learning models in terms of voltage amplitude stability during the grid scheduling process, showcasing superior robustness and accuracy. Moreover, we evaluated the economic benefits of the scheduling model and compared it with the original V2G scheduling model. The findings revealed that our model exhibited higher economic benefits and lower carbon emissions. Considering the future challenges of low-carbon urban planning, our method holds significant potential in terms of grid scheduling economic benefits and carbon emission indicators.
Eight Times Four Bialgebras of Hypergraphs, Cointeractions, and Chromatic Polynomials
Authors: Ebrahimi-Fard Kurusch , Fløystad Gunnar
Published: March 2024

The bialgebra of hypergraphs, a generalization of W. Schmitt’s Hopf algebra of graphs [25], is shown to have a cointeracting bialgebra structure, giving a double bialgebra in the sense of L. Foissy, who has recently proven [15] that there is then a unique double bialgebra morphism to the double bialgebra structure on the polynomial ring ${\mathbb Q}[x]$. We show that the associated polynomial is the hypergraph chromatic polynomial. Moreover, hypergraphs occur in quartets: There is a dual, a complement, and a dual complement hypergraph. These correspondences are involutions and give rise to three other double bialgebras, and three more chromatic polynomials. In addition to these two quartets of bialgebras we give six more, including recent bialgebras of hypergraphs introduced by M. Aguiar and F. Ardila [1] and by L. Foissy [17].
A Bivalent Adenovirus-Vectored Vaccine Induces a Robust Humoral Response, but Does Not Protect Cynomolgus Macaques Against a Lethal Challenge With Sudan Virus
Authors: van Tol Sarah , Fletcher Paige , Feldmann Friederike , Mukesh Reshma K , Port Julia R , Gallogly Shane , Schulz Jonathan E , Rhoderick Joseph F , Makinson Rebecca , Carmody Aaron , Myers Lara , Lovaglio Jamie , Smith Brian J , Okumura Atsushi , Shaia Carl , Saturday Greg , Marzi Andrea , Lambe Teresa , Munster Vincent J , van Doremalen Neeltje
Published: March 2024

The most recent Sudan virus (SUDV) outbreak in Uganda was first detected in September 2022 and resulted in 164 laboratory-confirmed cases and 77 deaths. There are no approved vaccines against SUDV. Here, we investigated the protective efficacy of ChAdOx1-biEBOV in cynomolgus macaques using a prime or a prime-boost regimen. ChAdOx1-biEBOV is a replication-deficient simian adenovirus vector encoding SUDV and Ebola virus (EBOV) glycoproteins (GPs). Intramuscular vaccination induced SUDV and EBOV GP-specific immunoglobulin G responses and neutralizing antibodies. Upon challenge with SUDV, vaccinated animals showed signs of disease like those observed in control animals, and no differences in survival outcomes were measured among all 3 groups. Viral load in blood samples and in tissue samples obtained after necropsy were not significantly different between groups. Overall, this study highlights the importance of evaluating vaccines in multiple animal models and demonstrates the importance of understanding protective efficacy in both animal models and human hosts.
Single-cell genomics of a bloom-forming phytoplankton species reveals population genetic structure across continents
Authors: Gollnisch Raphael , Ahrén Dag , Rengefors Karin
Published: March 2024

The study of microbial diversity over time and space is fundamental to the understanding of their ecology and evolution. The underlying processes driving these patterns are not fully resolved but can be studied using population genetic approaches. Here we investigated the population genetic structure of Gonyostomum semen, a bloom-forming phytoplankton species, across two continents. The species appears to be expanding in Europe, whereas similar trends are not observed in the USA. Our aim was to investigate if populations of Gonyostomum semen in Europe and in the USA are genetically differentiated, if there is population genetic structure within the continents, and what the potential drivers of differentiation are. To this end, we used a novel method based on single-amplified genomes combined with Restriction-site Associated DNA sequencing that allows de novo genotyping of natural single-cell isolates without the need for culturing. We amplified over 900 single-cell genomes from 25 lake populations across Europe and the USA and identified two distinct population clusters, one in Europe and another in the USA. Low genetic diversity in European populations supports the hypothesized recent expansion of Gonyostomum semen on this continent. Geographic population structure within each continent was associated with differences in environmental variables that may have led to ecological divergence of population clusters. Overall, our results show that single-amplified genomes combined with Restriction-site Associated DNA sequencing can be used to analyze microalgal population structure and differentiation based on single-cell isolates from natural, uncultured samples.
Democracy and Markets in a Partially Globalized World: Local and Global Financial Market Responses to Elections in Developing Countries
Authors: Cunha Raphael
Published: March 2024

Global market responses to elections are at the core of debates about financial globalization in developing countries. While existing research focuses on the ability of global markets to reward and punish national governments, much less is known about the role of domestic finance. I argue that domestic financial markets (1) react more strongly to elections than global markets due to excessive exposure to political risk at home and (2) lead global market responses to elections where domestic investors have an information advantage. I find support for these hypotheses using data on country fund pricing for major emerging markets between 1988 and 2015. The results show swifter and more dramatic reactions by domestic investors, which are transmitted to international markets. The findings underscore the underappreciated role of domestic investors in state-market relations under limited globalization.
Peribacillus frigoritoleransT7-IITJ, a potential biofertilizer, induces plant growth-promoting genes ofArabidopsis thaliana
Authors: Marik Debankona , Sharma Pinki , Chauhan Nar Singh , Jangir Neelam , Shekhawat Rajveer Singh , Verma Devanshu , Mukherjee Manasi , Abiala Moses , Roy Chandan , Yadav Pankaj , Sadhukhan Ayan
Published: March 2024

Aims

This study aimed to isolate plant growth and drought tolerance-promoting bacteria from the nutrient-poor rhizosphere soil of Thar desert plants and unravel their molecular mechanisms of plant growth promotion.

Methods and results

Among our rhizobacterial isolates, Enterobacter cloacae C1P-IITJ, Kalamiella piersonii J4-IITJ, and Peribacillus frigoritolerans T7-IITJ, significantly enhanced root and shoot growth (4˗5-fold) in Arabidopsis thaliana under PEG-induced drought stress. Whole genome sequencing and biochemical analyses of the non-pathogenic bacterium T7-IITJ revealed its plant growth-promoting traits, viz., solubilization of phosphate (40−73 µg/ml), iron (24 ± 0.58 mm halo on chrome azurol S media), and nitrate (1.58 ± 0.01 µg/ml nitrite), along with production of exopolysaccharides (125 ± 20 µg/ml) and auxin-like compounds (42.6 ± 0.05 µg/ml). Transcriptome analysis of A. thaliana inoculated with T7-IITJ and exposure to drought revealed the induction of 445 plant genes (log2fold-change > 1, FDR < 0.05) for photosynthesis, auxin and jasmonate signalling, nutrient uptake, redox homeostasis, and secondary metabolite biosynthesis pathways related to beneficial bacteria-plant interaction, but repression of 503 genes (log2fold-change < −1) including many stress-responsive genes. T7-IITJ enhanced proline 2.5-fold, chlorophyll 2.5˗2.8-fold, iron 2-fold, phosphate 1.6-fold, and nitrogen 4-fold, and reduced reactive oxygen species 2˗4.7-fold in plant tissues under drought. T7-IITJ also improved the germination and seedling growth of Tephrosia purpurea, Triticum aestivum, and Setaria italica under drought and inhibited the growth of two plant pathogenic fungi, Fusarium oxysporum, and Rhizoctonia solani.

Conclusions

P. frigoritolerans T7-IITJ is a potent biofertilizer that regulates plant genes to promote growth and drought tolerance.
Assessing the impact of transitioning to 11th revision of the International Classification of Diseases (ICD-11) on comorbidity indices
Authors: Nikiema Jean Noel , Thiam Djeneba , Bayani Azadeh , Ayotte Alexandre , Sourial Nadia , Bally Michèle
Published: March 2024

Objectives

This study aimed to support the implementation of the 11th Revision of the International Classification of Diseases (ICD-11). We used common comorbidity indices as a case study for proactively assessing the impact of transitioning to ICD-11 for mortality and morbidity statistics (ICD-11-MMS) on real-world data analyses.

Materials and Methods

Using the MIMIC IV database and a table of mappings between the clinical modification of previous versions of ICD and ICD-11-MMS, we assembled a population whose diagnosis can be represented in ICD-11-MMS. We assessed the impact of ICD version on cross-sectional analyses by comparing the populations’ distribution of Charlson and Elixhauser comorbidity indices (CCI, ECI) across different ICD versions, along with the adjustment in comorbidity weighting.

Results

We found that ICD versioning could lead to (1) alterations in the population distribution and (2) changes in the weight that can be assigned to a comorbidity category in a reweighting initiative. In addition, this study allowed the creation of the corresponding ICD-11-MMS codes list for each component of the CCI and the ECI.

Discussion

In common with the implementations of previous versions of ICD, implementation of ICD-11-MMS potentially hinders comparability of comorbidity burden on health outcomes in research and clinical settings.

Conclusion

Further research is essential to enhance ICD-11-MMS usability, while mitigating, after identification, its adverse effects on comparability of analyses.
Empirical Asset Pricing with Many Test Assets
Authors: Lönn Rasmus , Schotman Peter C
Published: March 2024

We formulate the problem of estimating risk prices in a stochastic discount factor (SDF) model as an instrumental variables regression. The IV estimator allows efficient estimation for models with non-traded factors and many test assets. Optimal instruments are constructed using a regularized sparse first stage regression. In a simulation study, the IV estimator is close to the infeasible GMM estimator in a setting with many assets. In an empirical application, the tracking portfolio for consumption growth appears strongly correlated with consumption news. It implies that consumption is a priced factor for the cross-section of excess equity returns. A similar regularized regression, projecting the SDF on test assets, leads to an estimate of the Hansen–Jagannathan distance, and identifies portfolios that maximally violate the pricing implications of the model.
Should Longtermists Recommend Hastening Extinction Rather Than Delaying It?
Authors: Pettigrew Richard
Published: March 2024

Longtermists argue we should devote much of our resources to raising the probability of a long happy future for sentient beings. But most interventions that raise that probability also raise the probability of a long miserable future, even if they raise the latter by a smaller amount. If we choose by maximising expected utility, this isn’t a problem; but, if we use a risk-averse decision rule, it is. I show that, with the same probabilities and utilities, a risk-averse decision theory tells us to hasten human extinction, not delay it. What’s more, I argue that morality requires us to use a risk-averse decision theory. I present this not as an argument for hastening extinction, but as a challenge to longtermism.
Existential Risk, Astronomical Waste, and the Reasonableness of a Pure Time Preference for Well-Being
Authors: Beard S J , Kaczmarek Patrick
Published: March 2024

In this paper, we argue that our moral concern for future well-being should reduce over time due to important practical considerations about how humans interact with spacetime. After surveying several of these considerations (around equality, special duties, existential contingency, and overlapping moral concern) we develop a set of core principles that can both explain their moral significance and highlight why this is inherently bound up with our relationship with spacetime. These relate to the equitable distribution of (1) moral concern in a universe that we can only causally affect in one temporal direction; (2) access to the benefits from using spacetime as a resource; and (3) the burdens of care given (1) and (2). We conclude by considering the practical implications of our argument and find that, while it is often assumed that a preference for present over future well-being weakens the case for existential risk mitigation, this likely is not the case.
TCP transcription factor StAST1 represses potato tuberization by regulating tuberigen complex activity
Authors: Sun Xiaomeng , Wang Enshuang , Yu Liu , Liu Shengxuan , Liu Tiantian , Qin Jun , Jiang Peng , He Shuangshuang , Cai Xingkui , Jing Shenglin , Song Botao
Published: March 2024

Potato (Solanum tuberosum L.) is cultivated worldwide for its underground tubers, which provide an important part of human nutrition and serve as a model system for belowground storage organ formation. Similar to flowering, stolon-expressed FLOWERING LOCUS T-like (FT-like) protein SELF-PRUNING 6A (StSP6A) plays an instrumental role in tuberization by binding to the bZIP transcription factors StABI5-like 1 (StABL1) and StFD-like 1 (StFDL1), causing transcriptional reprogramming at the stolon subapical apices. However, the molecular mechanism regulating the widely conserved FT-bZIP interactions remains largely unexplored. Here, we identified a TCP transcription factor StAST1 (StABL1 and StSP6A-associated TCP protein 1) binding to both StSP6A and StABL1. StAST1 is specifically expressed in the vascular tissue of leaves and developing stolons. Silencing of StAST1 leads to accelerated tuberization and a shortened life cycle. Molecular dissection reveals that the interaction of StAST1 with StSP6A and StABL1 attenuates the formation of the alternative tuberigen activation complex (aTAC). We also observed StAST1 directly activates the expression of potato GA 20-oxidase gene (StGA20ox1) to regulate GA responses. These results demonstrate StAST1 functions as a tuberization repressor by regulating plant hormone levels; our findings also suggest a mechanism by which the widely conserved FT-FD genetic module is fine-tuned.
Why do police consider leaving the profession?: The interplay between job demand stress, burnout, psychological distress, and commitment
Authors: Drew Jacqueline M , Sargeant Elise , Martin Sherri
Published: March 2024

Policing worldwide is facing a staffing and retention crisis. If the staffing exodus continues, communities will be left with too few police and large cohorts of inexperienced new recruits on the job. Drawing on 2,669 survey responses collected as part of a national study of law enforcement officers across the USA, we test an integrated theoretical model of the predictors of turnover intentions. We computed a path model using structural equation modelling, finding that job demand stressors (including trauma, organizational, and operational stressors), burnout, psychological distress, and commitment (including organizational commitment and occupational commitment) all play important roles in explaining the intentions of officers to exit the policing profession. Based on the study findings, the importance of trauma, organizational and operational job demand stress, and the differential impact of organizational and occupational commitment on police turnover intentions is established. Addressing burnout and psychological distress through a wellness agenda is likely to assist in stemming the outflow of officers from policing. The current study makes a significant empirical and practical contribution to the small body of existing police turnover research. The current research guides police leaders on the critical factors that must be considered when developing strategies and initiatives that aim to positively impact on the retention of officers within policing.
Safeguarding healthcare professionals from sexual harassment in the workplace: urgent need for effective training and education
Authors: Xiao Yu , Liu Liang , Zhang Zhou
Published: March 2024

Sexual harassment (SH) is a particularly harmful type of harassment that can inflict lasting psychological harm on victims. Within the healthcare sector, it negatively impacts teamwork, communication, and potentially compromises patient care. While concerns about workplace SH, including in healthcare, are long-standing, the #MeToo movement has brought renewed scrutiny to this issue since late 2017. Despite increased awareness, evidence suggests that SH remains prevalent in healthcare settings and shows no signs of decline over time. Therefore, there is an urgent need for effective training and intervention measures to enhance the identification of potential sexually offensive behaviors, thus fostering a work environment characterized by respect and inclusivity.
El Cuento del Destino: Latino Voters, Demographic Determinism, and the Myth of an Inevitable Democratic Party Majority
Authors: Corral Álvaro J , Leal David L
Published: March 2024

According to the “demography as destiny” theory, growing minority populations (which predominantly support Democrats) and the declining White population (which mostly votes Republican) will move politics and policy in more progressive directions. Latino voters are central to this account, but our critical analysis argues that such demographic determinism, which we call el cuento del destino, should be reconsidered. First, we argue that an overinvestment in the demography as destiny narrative causes distortions in party strategies; Democrats have been overconfident, and Republicans underconfident, about their abilities to secure the support of Latino voters. We examine trends in Latino voting behavior and partisan affiliation during and after the Trump years to show how the demographic narrative drives both parties to adopt suboptimal electoral strategies. Second, this narrative may also have implications for democracy itself, because misunderstandings about demographic determinism have led some Republicans to mistakenly worry that free and fair elections will inevitably lead to their party's electoral oblivion. Third, we interrogate the assumptions of the demography as destiny narrative, arguing that the political implications of Latino population growth are unclear and that the nature of Latino identity remains an open question. We conclude by describing the likely future of the Latino electorate as one characterized by growing partisan and political heterogeneity—including greater support for conservative politics—and suggest how the field of Latino politics might better understand such dynamics.
Humans in charge of trading robots: the first experiment
Authors: Asparouhova Elena , Bossaerts Peter , Cai Xiaoqin , Rotaru Kristian , Yadav Nitin , Yang Wenhao
Published: March 2024

We present results from an experiment where participants have access to automated trading algorithms, which they may deploy at will while still trading manually. Treatments differ in whether robots must not be halted, deployment is compulsory, or robots can be halted and replaced at will. We hypothesize that robot trading would reduce mispricing, and that the effect would be more pronounced as commitment degree increases. Yet, compared to manual trading only, we observe equally large and frequent mispricing and, in early trading, significantly higher bid–ask spreads and more frequent flash crashes/price surges. Participants earn more, provided they combine robot and manual trading. Compared to evidence from archival data, we find significantly higher use of liquidity-taking robots. We attribute this to the inability, in the field, to identify the presence of liquidity takers when they happen not to trade.
Research on the influence of power frequency magnetic field of pantograph on pacemaker wearers’ health in high-speed EMU
Authors: Tian Rui , Li Wei-Xuan , Lu Mai , Yu Li , Zhang Jia-Qi
Published: March 2024

When the popular means of transportation—high-speed trains meet the increasing rate of pacemaker implantation year by year, the research on the magnetic field environment on the health of pacemaker wearers in the carriage becomes an urgent problem. In this work, models of an electric multiple unit carriage with a pantograph as well as passengers with pacemakers were built by using COMSOL Multiphysics software. The B, Ein and Jin of human heart and other tissues, and the induced voltage (Vin) at the pacemaker electrode were calculated under the pantograph operating condition, so as to assess the effect of its magnetic field on the health of pacemaker wearers. The results showed that Bmax in the carriage without passengers is 121.246 μT, occurs near the window. In the carriage, the Bmax, Ein max and Jin max of heart and body, Vin at the pacemaker electrode of the passenger next to the window are greater than that in the middle of the carriage. The Bmax, Ein max and Jin max of passengers’ heart are 11.301μT, 1.613 mV/m and 139.030 μA/m2, respectively. The Bmax, Ein max and Jin max of passengers’ body are 12.597μT, 0.788 mV/m and 75.299 μA/m2, respectively. The maximum value of Vin at the tip of the pacemaker electrode of the passengers’ is 0.048 mV. The Bmax, Ein max in all tissues of passengers are much smaller than the basic limits of electromagnetic exposure to the public set by the International Commission on Non-Ionizing Radiation. Vin at the electrode tip of passengers’ pacemakers are less than the perception sensitivity set by the International Organization for Standardization. This work illustrated that the magnetic field generated by the pantograph is within the recognized accepted limits for passengers with pacemakers, but we still recommended that passengers wearing pacemakers should stay as far away from windows as possible.
How Segregation Ruins Inference: A Sociological Simulation of the Inequality Equilibrium
Authors: Mijs Jonathan J B , Usmani Adaner
Published: March 2024

Why do many people underestimate economic and racial inequality and maintain that theirs is a meritocratic society? Existing work suggests that people are rationalizing, misinformed, or misled. This article proposes an additional explanation: Inequality itself makes economic and racial disparities difficult to understand. In unequal societies, individuals establish their networks at formative institutions patterned by class and race. As a result, they unwittingly condition on key causal pathways when making descriptive and causal inferences about inequality. We use a simple agent-based model to show that, under circumstances typical to highly stratified societies, individuals will underestimate the extent of economic and racial inequality, downplay the importance of inherited advantages, and overestimate the relative importance of individual ability. Moreover, we show that they will both underestimate the extent of racial discrimination and overestimate its relative importance. Because segregated social worlds bias inference in these ways, all individuals (rich and poor) have principled reasons to favor less redistribution than they would if their social worlds were more integrated.
Evaluation of cerebral autoregulation of oxygen by NIRS method during postnatal transition period in term and late preterm newborns without resuscitation requirement
Authors: Ertekin Omer , Buyuktiryaki Mehmet , Isik Sehribanu , Okur Nilufer , Oguz Serife Suna
Published: March 2024

BACKGROUND

Pulse oximetry is commonly used to monitor arterial oxygen saturation and heart rate during the transition period and reference intervals have been determined. However, the effect of the change in arterial oxygen saturation on tissue oxygenation does not seem to be the same. So, a non-invasive method for monitoring cerebral or regional tissue oxygenation will be potentially useful for vulnerable infants. This study aims to evaluate the effectiveness of cerebral autoregulation in the first 10 min after delivery in term and late preterm newborns without resuscitation requirement.

METHODS

Cerebral tissue oxygen saturation was measured in the first 10 min after birth with near-infrared spectroscopy (NIRS) from the left forehead. Peripheral oxygen saturation was measured with pulse oximetry from the right hand and cerebral fractional tissue oxygen extraction was calculated.

RESULTS

Nineteen late preterms and 20 term infants were included in the study. There was no statistically significant difference between median cerebral tissue oxygen saturation and cerebral fractional tissue oxygen extraction values of late preterm and term infants (p < 0.001). There was a strong inverse relationship between cerebral tissue oxygen saturation and cerebral fractional tissue oxygen extraction (p < 0.001).

CONCLUSIONS

In late preterm infants similar to term infants, arterial oxygen saturation and cerebral tissue oxygen saturation increased with time, but inverse reduction of cerebral fractional tissue oxygen extraction showed the presence of an active autoregulation in the brain. This can be interpreted as the ability of the brain to protect itself from hypoxia by regulating oxygen uptake during normal fetal-neonatal transition process. A larger scale multi-center randomized control trial is now needed to further inform practice.
Thiosulfinate Tolerance Gene Clusters Are Common Features of Burkholderia Onion Pathogens
Authors: Paudel Sujan , Zhao Mei , Stice Shaun P. , Dutta Bhabesh , Kvitko Brian H.
Published: March 2024

Burkholderia gladioli pv. alliicola, B. cepacia, and B. orbicola are common bacterial pathogens of onion. Onions produce organosulfur thiosulfinate defensive compounds after cellular decompartmentalization. Using whole-genome sequencing and in silico analysis, we identified putative thiosulfinate tolerance gene (TTG) clusters in multiple onion-associated Burkholderia species similar to those characterized in other Allium-associated bacterial endophytes and pathogens. Sequence analysis revealed the presence of three Burkholderia TTG cluster types, with both Type A and Type B being broadly distributed in B. gladioli, B. cepacia, and B. orbicola in both the chromosome and plasmids. Based on isolate natural variation and generation of isogenic strains, we determined the in vitro and in vivo contribution of TTG clusters in B. gladioli, B. cepacia, and B. orbicola. The Burkholderia TTG clusters contributed to enhanced allicin tolerance and improved growth in filtered onion extracts by all three species. TTG clusters also made clear contributions to B. gladioli foliar necrosis symptoms and bacterial populations. Surprisingly, the TTG cluster did not contribute to bacterial populations in onion bulb scales by these three species. Based on our findings, we hypothesize onion-associated Burkholderia may evade or inhibit the production of thiosulfinates in onion bulb tissues.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
The Lipid Intensive Drug Therapy for Sepsis Phase II Pilot Clinical Trial*
Authors: Guirgis Faheem W. , Black Lauren Page , Henson Morgan , Bertrand Andrew , DeVos Elizabeth , Ferreira Jason , Gao Hanzhi , Wu Samuel S. , Leeuwenburgh Christiaan , Moldawer Lyle , Moore Frederick , Reddy Srinivasa T.
Published: March 2024

OBJECTIVES:

Low cholesterol levels in early sepsis patients are associated with mortality. We sought to test if IV lipid emulsion administration to sepsis patients with low cholesterol levels would prevent a decline or increase total cholesterol levels at 48 hours.

DESIGN:

Phase II, adaptive, randomized pilot clinical trial powered for 48 patients.

SETTING:

Emergency department or ICU of an academic medical center.

PATIENTS:

Sepsis patients (first 24 hr) with Sequential Organ Failure Assessment greater than or equal to 4 or shock.

INTERVENTIONS:

Patients meeting study criteria, including screening total cholesterol levels less than or equal to 100 mg/dL or high-density lipoprotein cholesterol (HDL-C) + low-density lipoprotein cholesterol (LDL-C) less than or equal to 70 mg/dL, were randomized to receive one of three doses of lipid emulsion administered twice in 48 hours or no drug (controls). The primary endpoint was a change in serum total cholesterol (48 hr – enrollment) between groups.

MEASUREMENTS AND MAIN RESULTS:

Forty-nine patients were enrolled and randomized. Two patients randomized to lipid emulsion were withdrawn before drug administration. Data for 24 control patients and 23 lipid emulsion patients were analyzed. The mean change in total cholesterol from enrollment to 48 hours was not different between groups and was 5 mg/dL (sd 20) for lipid emulsion patients, and 2 mg/dL (sd 18) for control patients (p = 0.62). The mean changes in HDL-C and LDL-C were similar between groups. Mean change in triglycerides was elevated in lipid emulsion patients (61 mg/dL, sd 87) compared with controls (20 mg/dL, sd 70, p = 0.086). The 48-hour change in SOFA score was –2 (interquartile range [IQR] –4, –1) for control patients and –2 (IQR –3, 0) for lipid emulsion patients (p = 0.46).

CONCLUSIONS:

Administration of IV lipid emulsion to early sepsis patients with low cholesterol levels did not influence change in cholesterol levels from enrollment to 48 hours.
Microlearning
Authors: Cronin Jessica , Durham Marianne L.
Published: March 2024

With an overall rise in technology adoption, the information-seeking behaviors of today have become instant and single-focused, and demand convenience for learning and the acquisition of knowledge. Digital technologies expand the reach of learning and allow for the development of innovative and creative methods of teaching. The use of microlearning has been gaining popularity in academic and professional development settings and corporate training. Currently, there is no standardized definition of microlearning. Using Walker and Avant's method of concept analysis, a comprehensive overview of microlearning is provided through identifying the concept and describing its uses, attributes, exemplary cases, antecedents, consequences, and empirical referents. Seven attributes associated with microlearning are single focus, bite-sized, asynchronistic, accessibility, flexibility, interactivity, and multimodal delivery. A proposed definition is a self-directed, on-demand, teaching strategy where small single-focused interactive content is presented to learners asynchronously, using technologies that accommodate multimodal delivery, and access where and when convenient for the learner. This analysis will assist informatics and nursing educators in understanding how microlearning, as a strategy, fits into the electronic learning landscape, is supported by digital technologies, and adds portability to leverage in an on-demand asynchronous way providing targeted learning for use in all areas of clinical practice.
Examining Associations Between Baseline Health-Related Quality of Life and Depression and Physical Functioning Improvement Following Pulmonary Rehabilitation
Authors: Coleman Sulamunn R. M. , Menson Katherine E. , Katz Brian R. , DeSarno Michael J. , Gaalema Diann E.
Published: March 2024

Purpose:

This study examined whether health-related quality of life (HRQL) and depression assessed prior to pulmonary rehabilitation (PR) participation (ie, at baseline) predicted change in 6-min walk distance (6MWD) from baseline to end of PR.

Methods:

Patients with pulmonary disease were consecutively referred/enrolled in a PR program from 2009-2022 (N = 503). Baseline 6MWD was assessed along with self-report measures of HRQL (St George’s Respiratory Questionnaire [SGRQ]) and depression (Geriatric Depression Scale [GDS]). The SGRQ total score was used to assess overall HRQL, and SGRQ subscales assessed pulmonary symptoms, activity limitations, and psychosocial impacts of pulmonary disease. Multiple linear regression was used to examine whether baseline SGRQ scores and depression predicted Δ6MWD.

Results:

Baseline SGRQ total score (F
(1,389)= 8.4, P= .004) and activity limitations (F
(1,388)= 4.8, P= .03) predicted Δ6MWD. Patients with an SGRQ activity limitation score ≤ 25th percentile showed the most 6MWD improvement (mean = 79.7 m, SE = 6.7), and significantly more improvement than participants scoring between the 50-75th percentiles (mean = 54.4 m, SE = 6.0) or >75th percentile (mean = 48.7 m, SE = 7.5). Patients scoring between the 25-50th percentiles (mean = 70.2 m, SE = 6.1) did not differ significantly from other groups. The SGRQ symptoms and impacts subscales were unrelated to Δ6MWD (F
(1,388)= 1.2-1.9, P> .05), as was depression (F
(1,311)= 0.0, P > .85).

Conclusions:

Patients with greater HRQL at baseline may experience greater physical functioning improvement following PR. Additional support for patients with lower HRQL (eg, adjunctive self-management interventions) may enhance PR outcomes, particularly for patients who report greater activity limitations. Alternatively, early referral to PR (ie, when less symptomatic) may also benefit physical function outcomes.
A Review of High-Intensity Interval Training in Heart Transplant Recipients
Authors: Nytrøen Kari , Rolid Katrine
Published: March 2024

Objective:

This review reports how exercise-based rehabilitation strategies have developed over the past decades, and it specifically focuses on the effectiveness, safety, and implementation of high-intensity interval training (HIIT). It provides an overview of the historical progression, main research findings, and considerations surrounding HIIT as the preferred exercise modality for recipients of heart transplant (HTx).

Review Methods:

The review includes a timeline of studies spanning from 1976-2023. The 2017 Cochrane systematic review on exercise‐based cardiac rehabilitation in recipients of HTx serves as the main knowledge base (≥2015). Additionally, literature searches in PubMed/Medline and ClinicalTrials.gov have been performed, and all reviews and studies reporting the effects of moderate- to high-intensity exercise in recipients of HTx, published in 2015 or later have been screened.

High-intensity interval training has gained prominence as an effective exercise intervention for recipients of HTx, demonstrated by an accumulation of performed studies in the past decade, although implementation in clinical practice remains limited. Early restrictions on HIIT in HTx recipients lacked evidence-based support, and recent research challenges these previous restrictions. High-intensity interval training results in greater improvements and benefits compared with moderate-intensity continuous training in the majority of studies. While HIIT is now regarded as generally suitable on a group level, individual assessment is still advised. The impact of HIIT involves reinnervation and central and peripheral adaptations to exercise, with variations in recipent responses, especially between de novo and maintenance recipients, and also between younger and older recipients. Long-term effects and mechanisms behind the HIIT effect warrant further investigation, as well as a focus on optimized HIIT protocols and exercise benefits.
Existing and Emerging Technologies for Therapeutic Monitoring of Lithium
Authors: Pedraza-Sanabria Santiago , Dodd Seetal , Giraldo-Cadavid Luis Fernando , Whittingham Karen , Bustos Rosa-Helena
Published: March 2024

Background/Purpose

Lithium is an effective psychoactive drug. It has a narrow therapeutic margin, with subtherapeutic levels or intoxication commonly occurring. Therapeutic drug monitoring (TDM) of lithium has several barriers. This scoping review aims to describe and analyze existing and emerging technologies for lithium TDM and to describe the lithium quantification parameters (precision, accuracy, detection limit) attributed to each technology.

Method

PubMed, Scopus, Web of Science, and Google Scholar were searched. Studies that described lithium quantification and complied with PRISMA-ScR guidelines were included. Articles selection was conducted by 2 researchers. Good precision was defined if its relative standard deviation <3%; acceptable, from 3% to 5%; and low, >5%. Accuracy was considered good if the error <5%; acceptable, 5%1 to 0%; and low if it was >10%.

Results

Of the 2008 articles found, 22 met the inclusion criteria. Of these, 14 studies concerned laboratory devices, in which precision was found to be low in one third of cases, and half had good precision. Accuracy of one third was good, another third was low, and the remaining third did not report accuracy. The other 8 studies concerned portable devices, in which precision was low in more than 60% of the cases and good in 25% of the studies. Accuracy was low in 50% of the cases, and good in just over a third. Limits of detection included the therapeutic range of lithium in all studies.

Conclusions

Among emerging technologies for lithium TDM, precision and accuracy remain a challenge, particularly for portable devices.
Murdered Indigenous Women: A Comparison Study of Victim and Perpetrator Patterns and Characteristics
Authors: Petreca Victor G. , Dowdell Elizabeth B. , Harding Shari L. , Mars Mak , Pudvah Emily , Jeune Johany , Burgess Ann W.
Published: March 2024

Introduction

The rate of violent crimes against Indigenous people, including murder and rape, is significantly higher than national averages. Even more concerning, Indigenous women and girls represent a large proportion of murdered and missing individuals in the United States. In addition to the murder rate of Indigenous women being higher than the national average, they are significantly more likely to experience rape or other types of sexual violence. The main goal of this study was to gain a better understanding of cases involving the homicide of Indigenous women and identify patterns associated with the violence committed against them.

Methods

Cases of Indigenous women between the ages of 18 and 55 years were pulled from the database. Cases were coded and analyzed for information pertaining to victim, perpetrator, and crime characteristics. Descriptive analysis and test of association were performed.

Results/Findings

There was a statistical association between the nature of the relationship between perpetrators and victims and whether the crime occurred on a reservation, the race/ethnicity of the perpetrator, a victim's history of domestic violence, and the method and motive of murder.

Discussion/Conclusion

Indigenous women are at an increased risk of victimization, including intimate partner violence and homicide. They also represent a group that has been marginalized, receiving little attention from the media, clinicians, researchers, and policy makers. The findings in this study highlight specific factors that may help to mitigate risk factors and/or enhance culturally competent clinical and forensic nursing practice.
Machine learning based peri-surgical risk calculator for abdominal related emergency general surgery: a multicenter retrospective study
Authors: Chen Biao , Sheng Weiyong , Wu Zhixin , Ma Bingqing , Cao Nan , Li Xushu , Yang Jia , Yuan Xiaowei , Yan Lizhao , Zhu Gaobo , Zhou Yuanhong , Huang Zhonghua , Zhu Meiwei , Ding Xuehui , Du Hansong , Wan Yanqing , Gao Xuan , Cheng Xing , Xu Peng , Zhang Teng , Tao Kaixiong , Shuai Xiaoming , Cheng Ping , Gao Yong , Zhang Jinxiang
Published: March 2024

Background:

Currently, there is a lack of ideal risk prediction tools in the field of emergency general surgery (EGS). The American Association for the Surgery of Trauma recommends developing risk assessment tools specifically for EGS-related diseases. In this study, we sought to utilize machine learning (ML) algorithms to explore and develop a web-based calculator for predicting five perioperative risk events of eight common operations in EGS.

Method:

This study focused on patients with EGS and utilized electronic medical record systems to obtain data retrospectively from five centers in China. Five ML algorithms, including Random Forest (RF), Support Vector Machine, Naive Bayes, XGBoost, and Logistic Regression, were employed to construct predictive models for postoperative mortality, pneumonia, surgical site infection, thrombosis, and mechanical ventilation >48 h. The optimal models for each outcome event were determined based on metrics, including the value of the Area Under the Curve, F1 score, and sensitivity. A comparative analysis was conducted between the optimal models and Emergency Surgery Score (ESS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and American Society of Anesthesiologists (ASA) classification. A web-based calculator was developed to determine corresponding risk probabilities.

Result:

Based on 10 993 patients with EGS, we determined the optimal RF model. The RF model also exhibited strong predictive performance compared with the ESS, APACHE II score, and ASA classification. Using this optimal model, the authors developed an online calculator with a questionnaire-guided interactive interface, catering to both the preoperative and postoperative application scenarios.

Conclusions:

The authors successfully developed an ML-based calculator for predicting the risk of postoperative adverse events in patients with EGS. This calculator accurately predicted the occurrence risk of five outcome events, providing quantified risk probabilities for clinical diagnosis and treatment.
The adverse impact of perioperative body composition abnormalities on outcomes after split liver transplantation: a multicenter retrospective cohort study
Authors: Chen Hao , Hu Zhihang , Xu Qingguo , He Chiyu , Yang Xinyu , Shen Wei , Lin Zuyuan , Li Huigang , Zhuang Li , Cai Jinzhen , Lerut Jan , Zheng Shusen , Lu Di , Xu Xiao
Published: March 2024

Background:

Split liver transplantation (SLT) increases graft availability, but it’s safe and effective utilization is insufficiently documented. This study aimed to investigate the association between perioperative body composition abnormalities and outcomes in adult SLT.

Materials and methods:

Two hundred forty recipients who underwent SLT in three centers were enrolled in this retrospective cohort study. Body composition abnormalities including sarcopenia, myosteatosis, visceral obesity, and sarcopenic obesity were evaluated at baseline and 1 month after surgery using computed tomography. Their impact on outcomes including early allograft dysfunction, early complications, ICU stay, graft regeneration rate, and survival was analyzed.

Results:

Recipients with sarcopenia or myosteatosis had a higher risk of early allograft dysfunction, higher early complication rate, and longer length of ICU stay (all P<0.05), while there was no difference in graft regeneration rate. Recipient and graft survival were significantly worse for recipients with body composition abnormalities (all P<0.05). In multivariable Cox-regression analysis, sarcopenia [hazard ratio (HR)=1.765, P=0.015], myosteatosis (HR=2.066, P=0.002), and visceral obesity (HR=1.863, P=0.008) were independently associated with shorter overall survival. Piling up of the three factors increased the mortality risk stepwise (P<0.001). Recipients experienced skeletal muscle loss and muscle fat infiltration 1 month after surgery. Postoperative worsening sarcopenia (HR=2.359, P=0.009) and myosteatosis (HR=1.878, P=0.026) were also identified as independent risk factors for mortality.

Conclusion:

Sarcopenia, myosteatosis, and their progression negatively affect outcomes including early allograft dysfunction, early complications, ICU stay and survival after SLT. Systemic evaluation and dynamic monitoring of body composition are valuable.