bluuebunny/crossref_metadata_2025 huggingface dataset:
Precise evaluation of blood flow patterns in human carotid bifurcation based on high‐frame‐rate vector flow imaging
Authors: Hong Shaofu , Dong Yinghui , Song Di , Liu Mengmeng , Gao Wenjing , Li Weiyue , Wan Yong , Du Yigang , Xu Jinfeng , Dong Fajin
Published: May 2023

Purpose

To investigate the feasibility of high‐frame‐rate vector flow imaging (HiFR‐VFI) compared to ultrasound color Doppler flow imaging (CDFI) for precisely evaluating flow characteristics in the carotid bifurcation (CB) of presumed healthy adults.

Methods

Forty‐three volunteers were assessed for flow characteristics and their extensions using HiFR‐VFI and CDFI in CBs. The flow patterns were classified according to the streamlines in HiFR‐VFI and quantitatively measured using an innovative turbulence index (Tur‐value). Interobserver agreement was also assessed.

Results

HiFR‐VFI was consistent with CDFI in detecting laminar and nonlaminar flow in 81.4% of the cases; however, in 18.6% of the cases, only HiFR‐VFI identified the nonlaminar flow. HiFR‐VFI showed a larger extension of complex flow (0.37 ± 0.26 cm2) compared to CDFI (0.22 ± 0.21 cm2; p < 0.05). The flow patterns were classified into four types: 3 type‐I (laminar flow), 35 type‐II (rotational flow), 27 type‐III (reversed flow), and 5 type‐IV (complex flow). The Tur‐value of type‐IV (50.03 ± 14.97)% is larger than type‐III (44.57 ± 8.89)%, type‐II (16.30 ± 8.16)%, and type‐I (1.48 ± 1.43)% (p < 0.05). Two radiologists demonstrated almost perfect interobserver agreement on recognizing the change of streamlines (κ = 0.81, p < 0.001). The intraclass correlation coefficient of the Tur‐value was 0.98.

Conclusion

HiFR‐VFI can reliably characterize complex hemodynamics with quantitative turbulence measurement and may be an auxiliary diagnostic tool for assessing atherosclerotic arterial disease.
A new case with the recurrent PURA p.(Phe233del) pathogenic variant: Expansion of the phenotype and review of the literature
Authors: Ben Issa Abir , Ben Ayed Ikhlas , Jallouli Olfa , Souissi Amal , Bouchaalla Wafa , Ben Said Mariem , Mallouli Salma , Masmoudi Saber , Charfi Triki Chahnez , Hadj Kacem Hassen , Kammoun Fatma
Published: May 2023

In the process of neuronal development, the protein Purα (encoded by the PURA gene) is essential for neuronal proliferation, dendritic maturation, and the transportation of mRNA to translation sites. Mutations in the PURA gene may alter normal brain development and impair neuronal function, contributing to developmental delays and seizures. Recently, PURA syndrome is described as developmental encephalopathy with or without epilepsy, neonatal hypotonia, feeding difficulties, global developmental delay, and severe intellectual disability. In our study, we aimed to perform a genetic analysis by whole exome sequencing (WES) in a Tunisian patient presented with developmental and epileptic encephalopathy to provide a molecular explanation for the developed phenotype. We collected, also, clinical data of all PURA p.(Phe233del) patients reported yet and compared the clinical features with those of our patient. Results revealed the presence of the known PURA c.697_699del, p.(Phe233del) variant. Our studied case shares some clinical features including hypotonia, feeding difficulties, severe developmental delay, epilepsy, and language delay (nonverbal) but presents a radiological finding undescribed before. Our finding defines and expands the phenotypic and genotypic spectrum of the PURA syndrome supporting the absence of reliable genotype–phenotype correlations and the existence of a highly variable, wide‐ranging clinical spectrum.
Cultural differences in intertemporal decision making: A comparison between Chile and China
Authors: Raineri Andrés , Kausel Edgar , Jin Zhang , Chamorro Natalia
Published: May 2023

A cross‐cultural comparison is made of delay discounting in samples of participants from Chile and China. Comparisons are made based on previous literature that suggests that individuals from an Asian culture should be willing to postpone delayed rewards more than are individuals from a Latin American culture. To test the cross‐cultural validity of a hyperbolic discounting model, the model was fitted to both data sets. Additionally, a self‐enhancement measure was evaluated as a potential mediator between culture of origin and delay discounting. Seventy‐eight college students from China and 120 college students from Chile, with similar demographic backgrounds, discounted hypothetical monetary outcomes using an adjusting‐amount titration procedure. Additionally, participants completed a self‐enhancement measure. Age, academic major, gender, and grade point average were controlled. Chilean participants discounted much more steeply than Chinese nationals did. No support was obtained for the mediation of self‐enhancement between culture of origin and degree of delay discounting. In both samples, delay discounting was better described by a hyperboloid than an exponential function, the only exception being the $10,000 condition in which the medians for Chilean participants' present subjective value were equally well explained by a hyperboloid and an exponential function.
Benchmarking blood collection tubes and processing intervals for extracellular vesicle performance metrics
Authors: Dhondt Bert , Pinheiro Cláudio , Geeurickx Edward , Tulkens Joeri , Vergauwen Glenn , Van Der Pol Edwin , Nieuwland Rienk , Decock Anneleen , Miinalainen Ilkka , Rappu Pekka , Schroth Gary , Kuersten Scott , Vandesompele Jo , Mestdagh Pieter , Lumen Nicolaas , De Wever Olivier , Hendrix An
Published: May 2023

The analysis of extracellular vesicles (EV) in blood samples is under intense investigation and holds the potential to deliver clinically meaningful biomarkers for health and disease. Technical variation must be minimized to confidently assess EV‐associated biomarkers, but the impact of pre‐analytics on EV characteristics in blood samples remains minimally explored. We present the results from the first large‐scale EV Blood Benchmarking (EVBB) study in which we systematically compared 11 blood collection tubes (BCT; six preservation and five non‐preservation) and three blood processing intervals (BPI; 1, 8 and 72 h) on defined performance metrics (n = 9). The EVBB study identifies a significant impact of multiple BCT and BPI on a diverse set of metrics reflecting blood sample quality, ex‐vivo generation of blood‐cell derived EV, EV recovery and EV‐associated molecular signatures. The results assist the informed selection of the optimal BCT and BPI for EV analysis. The proposed metrics serve as a framework to guide future research on pre‐analytics and further support methodological standardization of EV studies.
Trends in the morbidity and mortality of coronavirus disease 2019 in different ethnic groups and gender in a large Brazilian city
Authors: Nascimento João Henrique Fonseca do , Andrade André Bouzas de , Gusmão‐Cunha André , Cunha Andréa Mendonça Gusmão
Published: May 2023

As the coronavirus disease 2019 (COVID‐19) outbreak spread, evidence has emerged that gender and race would bear a disproportionate impact on the morbimortality of COVID‐19. Here, we conducted a retrospective observational study using the TabNet/Departamento de informática do sistema único de saúde platform of the city of São Paulo. COVID‐19 records from March 2020 through December 2021 were included, and we evaluated the temporal trends of confirmed cases and case fatality rate by gender and ethnicity. Statistical analysis was performed using the R‐software and BioEstat‐software, considering p < 0.05 significant. From March/2020 to December/2021, 1 315 160 COVID‐19 confirmed cases were recorded (57.1% females), and 2973 deaths were due to COVID‐19. Males presented higher median mortality (0.44% vs. 0.23%; p < 0.05) and intensive care unit (ICU) admission rates (0.34% vs. 0.20%; p < 0.05). Men were also associated with a higher risk of death (risk ratio [RR] = 1.28; p < 0.05) and a higher chance of requiring ICU care (RR = 1.29; p < 0.05). Black ethnicity was associated with a higher risk of death (RR = 1.19; p < 0.05). White patients were more likely to require ICU admission (RR = 1.13; p < 0.05), whereas Browns were associated with a protective effect (RR = 0.86; p < 0.05). Furthermore, men presented a higher chance of death than women across the three major ethnic groups: Whites (RR = 1.33; p < 0.05), Blacks (RR = 1.24; p < 0.05), and Browns (RR = 1.35; p < 0.05). In this study of COVID‐19 in São Paulo, men were associated with worse outcomes, including in the three major ethnicities in the population. Blacks exhibited a higher risk of death, Whites were more likely to require intensive care, and Browns were at protection from ICU hospitalization.
The effect of exercise post vertebral augmentation in osteoporotic patients: A systematic review and meta‐analysis
Authors: Than Christian A. , Adra Maamoun , Curtis Tom J. , Shi Ao , Kim Grace E. , Nakanishi Hayato , Matar Reem H. , Brown J. Mark M. , Dannawi Zaher , Beck Belinda R.
Published: May 2023

This meta‐analysis investigated the effects of exercise on Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores following vertebroplasty or kyphoplasty in osteoporotic fractures. A literature search of PubMed, EMBASE (Elsevier), CiNAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and Web of Science was conducted from database inception to October 6, 2022. Eligible studies reported osteoporosis patients over 18 years of age with a diagnosis of at least one vertebral fracture via radiography or clinical assessment. This review was registered in PROSPERO (ID: CRD42022340791). Ten studies met the eligibility criteria (n = 889). VAS scores at baseline were 7.75 (95% CI: 7.54, 7.97, I2 = 76.11%). Following initiation of exercise, VAS scores at the endpoint of 12 months were 1.91 (95% CI: 1.53, 2.29, I2 = 92.69%). ODI scores at baseline were 68.66 (95% CI: 56.19, 81.13, I2 = 85%). Following initiation of exercise, ODI scores at the endpoint of 12 months were 21.20 (95% CI: 14.52, 27.87, I2 = 99.30). A two‐arm analysis demonstrated improved VAS and ODI for the exercise group compared to non‐exercise control at 6 months (MD = −0.70, 95% CI: −1.08, −0.32, I2 = 87% and MD = −6.48, 95% CI: −7.52, −5.44, I2 = 46%, respectively) and 12 months (MD = −0.88, 95% CI: −1.27, −0.49, I2 = 85% and MD = −9.62, 95% CI: −13.24, −5.99, I2 = 93%). Refracture was the only adverse event reported and occurred almost twice as frequently in the non‐exercise group than in the exercise group. Exercise rehabilitation post vertebral augmentation is associated with improved pain and functionality, particularly after 6 months of exposure, and may reduce refracture rate.
Reconstructive Spectrum Analyzer with High‐Resolution and Large‐Bandwidth Using Physical‐Model and Data‐Driven Model Combined Neural Network
Authors: Wan Yangyang , Fan Xinyu , Xu Bingxin , He Zuyuan
Published: May 2023

Most neural networks (NNs) used for reconstructive spectrum analyzers (RSAs) rely on data‐driven training strategies, which can be time‐consuming due to the need for a large training dataset with a limited amount of output channels. Here, a specially designed NN is proposed for a reconstructive wavemeter based on temporal speckle obtained from a whispering gallery mode (WGM) resonator. By combining a physical model and data‐driven model, it only takes 10 µs to obtain a reference speckle for the generation of a training dataset. The WGM resonator‐based wavemeter assisted by the NN uses only one photo‐detector to obtain a temporal speckle, achieving a spectral resolution of 3.2 fm. The number of output channels reaches 2300, which is the largest dynamic range achieved by an NN in RSA without the need for re‐training. It demonstrates that the proposed NN has capability to resolve unseen spectrum with multi‐tone wavelengths. Moreover, the proposed network exhibits better robustness in long‐time measurement compared to data‐driven model based networks. This opens up new possibilities for NN design methods in RSA, without the need for a large training dataset, by incorporating a physical model to achieve high‐resolution, high‐dynamic‐range, and fast‐speed spectrum measurement.
Comprehensive DNA methylation profiling of Barrett's esophagus and esophageal adenocarcinoma in Japanese patients
Authors: Shijimaya Takuya , Tahara Tomomitsu , Yamazaki Jumpei , Matsumoto Yasushi , Nakamura Naohiro , Takahashi Yu , Tomiyama Takashi , Fukui Toshiro , Shibata Tomoyuki , Naganuma Makoto
Published: May 2023

Molecular mechanisms of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) remain unclear in Japanese patients. Japanese EACs frequently have underlying short length BE: short‐segment BE (SSBE), for which, neoplastic potential remains unclear. We performed comprehensive methylation profiling of EAC and BE in Japanese patients, mostly comprised with SSBE. Using three different groups of biopsies obtained from non‐neoplastic BE from patients without cancer (n = 50; N group), with EAC (n = 27; ADJ group) and EAC (n = 22; T group), methylation statuses of nine candidate genes (N33, DPYS, SLC16A12, CDH13, IGF2, MLF1, MYOD1, PRDM5, and P2RX7) were examined by the bisulfite pyrosequencing. Reduced representation bisulfite sequencing was performed to characterize the genome‐wide methylation status in 32 samples (12 from N, 12 ADJ, and 8 from T groups). In the candidate approach, methylation levels of N33, DPYS, and SLC16A12 were higher in ADJ and T groups compared to that in N group. The ADJ group was an independent factor for higher DNA methylation in non‐neoplastic BE. The genome‐wide approach demonstrated an increase of hypermethylation from ADJ to T groups relative to N group near the transcription start sites. Among gene groups hypermethylated in ADJ and T groups (n = 645) and T group alone (n = 1438), 1/4 and 1/3 were overlapped with downregulated genes in the microarray data set, respectively. Accelerated DNA methylation is observed in EAC and underlying BE in Japanese patients, mostly comprised with SSBE, highlighting the potential impact of methylation in early carcinogenesis.
Cognitive Deficits in Parkinson's Disease Are Associated with Neuronal Dysfunction and Not White Matter Lesions
Authors: Schröter Nils , Bormann Tobias , Rijntjes Michel , Blazhenets Ganna , Berti Raissa , Sajonz Bastian E.A. , Urbach Horst , Weiller Cornelius , Meyer Philipp T. , Rau Alexander , Frings Lars
Published: May 2023

Background

Cognitive deficits considerably contribute to the patient's burden in Parkinson's disease (PD). While cognitive decline is linked to neuronal dysfunction, the additional role of white matter lesions (WML) is discussed controversially.

Objective

To investigate the influence of WML, in comparison to neuronal dysfunction, on cognitive deficits in PD.

Methods

We prospectively recruited patients with PD who underwent neuropsychological assessment using the Mattis Dementia Rating Scale 2 (DRS‐2) or Parkinson Neuropsychometric Dementia Assessment (PANDA) and both MRI and PET with [18F]fluorodeoxyglucose (FDG). WML‐load and PD cognition‐related covariance pattern (PDCP) as a measure of neuronal dysfunction were read out. Relationship between cognitive performance and rank‐transformed WML was analyzed with linear regression, controlling for the patients’ age. PDCP subject scores were investigated likewise and in a second step adjusting for age and WML load.

Results

Inclusion criteria were met by 76 patients with a mean (± SD) age of 63.5 ± 9.0 years and disease duration of 10.7 ± 5.4 years. Neuropsychological testing revealed front executive and parietal deficits and a median DRS‐2 score of 137 (range 119–144)/144 and PANDA score of 22 (range 3–30)/30. No association between WML and cognition was observed, whereas PDCP subject scores showed a trend‐level negative correlation with the DRS‐2 (P = 0.060) as well as a negative correlation with PANDA (P = 0.049) which persisted also after additional correction for WML (P = 0.039).

Conclusion

The present study indicates that microangiopathic WML do not have a relevant impact on neurocognitive performance in PD whereas neuronal dysfunction does.
Exploring activity landscapes with extended similarity: is Tanimoto enough?
Authors: Dunn Timothy B. , López‐López Edgar , Kim Taewon David , Medina‐Franco José L. , Miranda‐Quintana Ramón Alain
Published: May 2023

Understanding structure‐activity landscapes is essential in drug discovery. Similarly, it has been shown that the presence of activity cliffs in compound data sets can have a substantial impact not only on the design progress but also can influence the predictive ability of machine learning models. With the continued expansion of the chemical space and the currently available large and ultra‐large libraries, it is imperative to implement efficient tools to analyze the activity landscape of compound data sets rapidly. The goal of this study is to show the applicability of the n‐ary indices to quantify the structure‐activity landscapes of large compound data sets using different types of structural representation rapidly and efficiently. We also discuss how a recently introduced medoid algorithm provides the foundation to finding optimum correlations between similarity measures and structure‐activity rankings. The applicability of the n‐ary indices and the medoid algorithm is shown by analyzing the activity landscape of 10 compound data sets with pharmaceutical relevance using three fingerprints of different designs, 16 extended similarity indices, and 11 coincidence thresholds.
Technical note: The design and validation of a multi‐modality lung phantom
Authors: Bowen Donald L. , Touchet Tyler J. , Maitland Duncan J. , McDougall Mary P.
Published: May 2023

Background

Clinically relevant models that enable certain tasks such as calibration of medical imaging devices or techniques, device validation, training healthcare professionals, and more are vital to research throughout the medical field and are referred to as phantoms. Phantoms range in complexity from a vile of water to complex designs that emulate in vivo properties.

Purpose

Specific phantoms that model the lungs have focused on replication of tissue properties but lack replication of the anatomy. This limits the use across multiple imaging modalities and for device testing when anatomical considerations as well as tissue properties are needed. This work reports a lung phantom design utilizing materials that accurately mimic the ultrasound and magnetic resonance imaging (MRI) properties of in vivo lungs and includes relevant anatomical equivalence.

Methods

The tissue mimicking materials were selected based on published studies of the materials, through qualitative comparisons of the materials with ultrasound imaging, and quantitative MRI relaxation values. A PVC ribcage was used as the structural support. The muscle/fat combined layer and the skin layer were constructed with various types of silicone with graphite powder added as a scattering agent where appropriate. Lung tissue was mimicked with silicone foam. The pleural layer was replicated by the interface between the muscle/fat layer and the lung tissue layer, requiring no additional material.

Results

The design was validated by accurately mimicking the distinct tissue layers expected with in vivo lung ultrasound while maintaining tissue‐mimicking relaxation values in MRI as compared to reported values. Comparisons between the muscle/fat material and in vivo muscle/fat tissue demonstrated a 1.9% difference in T1 relaxation and a 19.8% difference in T2 relaxation.

Conclusions

Qualitative US and quantitative MRI analysis verified the proposed lung phantom design for accurate modeling of the human lungs.
Prostate perfusion mapping using Fourier‐transform based velocity‐selective arterial spin labeling: Choice of cutoff velocity and comparison with brain
Authors: Liu Dapeng , Zhu Dan , Xu Feng , Sedaghat Farzad , Qin Qin
Published: May 2023

Purpose

To develop velocity selective arterial spin labeling (VSASL) protocols for prostate blood flow (PBF) and prostate blood volume (PBV) mapping.

Methods

Fourier‐transform based velocity‐selective inversion and saturation pulse trains were utilized in VSASL sequences to obtain blood flow and blood volume weighted perfusion signal, respectively. Here four cutoff velocities (Vcut = 0.25, 0.50, 1.00, and 1.50 cm/s) for PBF and PBV mapping sequences were evaluated with a parallel implementation in brain for measuring cerebral blood flow (CBF) and cerebral blood volume (CBV) with identical 3D readout. This study was performed at 3T on eight young and middle‐aged healthy subjects comparing both perfusion weighted signal (PWS) and temporal SNR (tSNR).

Results

In contrast to CBF and CBV, the PWS of PBF and PBV were rather unobservable at Vcut of 1.00 or 1.50 cm/s and both PWS and tSNR of PBF and PBV considerably increased at the lower Vcut, indicating that blood moves much slower in prostate than in brain. Similar to the brain results, the tSNR of PBV‐weighted signal was about two to four times over the corresponding values of PBF‐weighted signal. The results also suggested a trend of reduced vascularity within prostate during aging.

Conclusion

For prostate, a low Vcut of 0.25–0.50 cm/s seemed necessary for both PBF and PBV measurements to obtain adequate perfusion signal. As in brain, PBV mapping yielded a higher tSNR than PBF.
Embedded Trefftz discontinuous Galerkin methods
Authors: Lehrenfeld Christoph , Stocker Paul
Published: May 2023

In Trefftz discontinuous Galerkin methods a partial differential equation is discretized using discontinuous shape functions that are chosen to be elementwise in the kernel of the corresponding differential operator. We propose a new variant, the embedded Trefftz discontinuous Galerkin method, which is the Galerkin projection of an underlying discontinuous Galerkin method onto a subspace of Trefftz‐type. The subspace can be described in a very general way and to obtain it no Trefftz functions have to be calculated explicitly, instead the corresponding embedding operator is constructed. In the simplest cases the method recovers established Trefftz discontinuous Galerkin methods. But the approach allows to conveniently extend to general cases, including inhomogeneous sources and non‐constant coefficient differential operators. We introduce the method, discuss implementational aspects and explore its potential on a set of standard PDE problems. Compared to standard discontinuous Galerkin methods we observe a severe reduction of the globally coupled unknowns in all considered cases, reducing the corresponding computing time significantly. Moreover, for the Helmholtz problem we even observe an improved accuracy similar to Trefftz discontinuous Galerkin methods based on plane waves.
Nursing students' learning commitment, self‐efficacy and grit during the COVID 19 pandemic: Quantitative empirical research on adaptation to college life
Authors: Jin Juhyun , An Hyeran
Published: May 2023

Aims

To examine the learning commitment, self‐efficacy, grit and adaptation to college life among Korean nursing students, under the prolonged COVID‐19 situation, and identify the factors that affect their adaptation to college life.

Design

A cross‐sectional study.

Methods

The participants were 247 nursing students. The instruments used in the study were the Learning Commitment Scale for Adults, Self‐Efficacy Scale, Grit Scale and Campus Life Adaptation Scale (developed for Korean nursing students). A multiple linear regression analysis was conducted using SPSS 23.0.

Results

Adaptation to college life had significant positive correlations with learning commitment, self‐efficacy and grit. Moreover, self‐efficacy and learning commitment were key correlators for adapting to college life.
ChatGPT use could change views on academic misconduct
Authors: McCarthy Claudine
Published: May 2023

CLEARWATER, FLORIDA — Student and faculty use of ChatGPT has quickly become one of the biggest controversies in higher education. As detractors resist the free, online text‐generating tool like the plague and others delight in its exciting possibilities, ChatGPT is taking the world by storm, threatening to upend long‐standing concepts of plagiarism, authorship, ownership, and learning, according to intellectual property expert Jacob Rooksby, J.D., Ph.D., Professor and Dean of the Gonzaga University School of Law, and IP Optimization Strategist with FIG. 1 Patents, PLLC. He spoke at Stetson University's annual National Conference on Law and Higher Education.
Efficacy and safety of modified fasting therapy for weight loss in 2054 hospitalized patients
Authors: Liu Taoli , Ye Ziheng , Feng Jiahao , Zhang Li , Chen Hongda , Chen Xianhua , Cai Fangjie , Zhang Gengpeng , Lai Jicai , Ye Zhiyu , Cao Nan , Mo Binyan , Li Zhiling , Wang Ning , Lin Yuejia , Zhang Tingying , Yang Yu , Hu Jianguo , Yan Ling , Zheng Zilong , Song Wei , Liang Haifang , Qin Jian
Published: May 2023

Objective

The aim of this study was to evaluate the efficacy and safety of modified fasting therapy, and a retrospective study was conducted to analyze changes in clinical indicators of hospitalized fasting patients.

Methods

A total of 2054 hospitalized fasting patients were enrolled in this observational study. All participants underwent 7 days of modified fasting therapy. The clinical efficacy biomarkers, safety indicators, and body composition were measured before and after fasting.

Results

The modified fasting therapy reduced body weight, BMI, abdominal circumference, systolic blood pressure, and diastolic blood pressure significantly. Blood glucose and indicators of body composition were improved to various extents (all p < 0.05). There was a small increase in liver function, kidney function, uric acid, electrolytes, blood count, coagulation, and uric biomarkers. Subgroup analysis results showed that cardiovascular diseases benefited from modified fasting therapy.

Conclusions

At present this study is the largest retrospective population‐based study about modified fasting therapy. The results from 2054 patients showed that the modified fasting therapy lasting 7 days was efficient and safe. It led to improvements in physical health and body weight‐associated indicators, as well as body composition and relevant cardiovascular risk factors.
Assessment and management of iatrogenic withdrawal syndrome and delirium in pediatric intensive care units across Europe: An ESPNIC survey
Authors: Sperotto Francesca , Ramelet Anne‐Sylvie , Daverio Marco , Mondardini Maria Cristina , von Borell Florian , Brenner Sebastian , Tibboel Dick , Ista Erwin , Pokorna Paula , Amigoni Angela ,   The Analgosedation CONSORTIUM on behalf of the Pharmacology Section and the Nurse Science Section of the European Society for Paediatric and Neonatal Intensive Care
Published: May 2023

Introduction

Analgesia and sedation are essential for the care of children in the pediatric intensive care unit (PICU); however, when prolonged, they may be associated with iatrogenic withdrawal syndrome (IWS) and delirium. We sought to evaluate current practices on IWS and delirium assessment and management (including non‐pharmacologic strategies as early mobilization) and to investigate associations between the presence of an analgosedation protocol and IWS and delirium monitoring, analgosedation weaning, and early mobilization.

Methods

We conducted a multicenter cross‐sectional survey‐based study collecting data from one experienced physician or nurse per PICU in Europe from January to April 2021. We then investigated differences among PICUs that did or did not follow an analgosedation protocol.

Results

Among 357 PICUs, 215 (60%) responded across 27 countries. IWS was systematically monitored with a validated scale in 62% of PICUs, mostly using the Withdrawal Assessment Tool‐1 (53%). The main first‐line treatment for IWS was a rescue bolus with interruption of weaning (41%). Delirium was systematically monitored in 58% of PICUs, mostly with the Cornell Assessment of Pediatric Delirium scale (48%) and the Sophia Observation Scale for Pediatric Delirium (34%). The main reported first‐line treatment for delirium was dexmedetomidine (45%) or antipsychotic drugs (40%). Seventy‐one percent of PICUs reported to follow an analgosedation protocol. Multivariate analyses adjusted for PICU characteristics showed that PICUs using a protocol were significantly more likely to systematically monitor IWS (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.01–3.67) and delirium (OR 2.00, 95% CI 1.07–3.72), use a protocol for analgosedation weaning (OR 6.38, 95% CI 3.20–12.71) and promote mobilization (OR 3.38, 95% CI 1.63–7.03).

Conclusions

Monitoring and management of IWS and delirium are highly variable among European PICUs. The use of an analgosedation protocol was associated with an increased likelihood of monitoring IWS and delirium, performing a structured analgosedation weaning and promoting mobilization. Education on this topic and interprofessional collaborations are highly needed to help reduce the burden of analgosedation‐associated adverse outcomes.
Ultrathin Defective Nanosheet Subunit ZnIn2S4 Hollow Nanoflowers for Efficient Photocatalytic Hydrogen Evolution
Authors: Ding Shuoping , Medic Igor , Steinfeldt Norbert , Dong Tianao , Voelzer Tim , Haida Simon , Rabeah Jabor , Hu Juncheng , Strunk Jennifer
Published: May 2023

Constructing hierarchical and ultrathin‐structured metal sulfides is beneficial for achieving high‐efficiency hydrogen evolution catalysts. Herein, ZnIn2S4 (ZIS) hollow nanoflowers (HNFs) composed of ultrathin nanosheets are creatively synthesized via a facile trisodium citrate‐mediated and stirring‐assisted solvothermal method. Experimental results reveal that the synergy effect of ethanol, trisodium citrate, and continuous stirring during solvothermal synthesis process play a significant role in optimizing microstructure as well as physicochemical properties of as‐prepared ZIS samples. Importantly, the fabricated ZIS HNFs with the thinnest nanosheets (2.28 nm) manifest the highest average photocatalytic hydrogen generation rate of 301.5 μmol h−1, which is 2.3 times higher than that of the pristine ZIS microspheres composed of nanoparticles with Pt as the cocatalyst and triethanolamine (TEOA) as the sacrificial agent and outperforms most reported ZnIn2S4‐based materials under similar testing conditions. Moreover, the optimized sample also shows a hydrogen generation rate of 0.53 μmol h−1.in pure water without any cocatalyst. This controllable agitation of the reaction mixture during the hydro/solvothermal synthesis process offers an eco‐friendly and scalable approach for tuning the microstructure of nanomaterials with enhanced performance for various applications.
Ultrafine Pd Nanoparticles Encapsulated in Mesoporous TiO2 Region Selectively Confined in Bamboo Microchannels: An Ultrastable Continuous‐Flow Catalytic Hydrogenation Microreactor
Authors: Li Jingpeng , Ma Rumin , Yao Sisi , Qin Daochun , Lu Yun , Chen Yuhe , Jiang Zehui , Yang Dongjiang
Published: May 2023

Plant‐based flow microreactors with natural channel structures, renewable properties, and environmental friendliness have increasingly gained popularity in heterogeneous catalysis. However, firmly immobilizing the catalysts simultaneously with ease and adaptability, maintaining great effectivity and long‐term stability, is still a fundamental challenge. Herein, a highly efficient and ultrastable bamboo‐based catalytic microreactor (CMR) containing mesoporous TiO2 (M‐TiO2)‐encapsulating ultrafine Pd nanoparticles (NPs) is constructed for the continuous‐flow hydrogenation of nitroaromatics. The fabrication of the Pd‐TiO2 catalysts in required bamboo microchannels (Pd‐TiO2/B CMR) mainly involves a two‐step region‐selective synthetic strategy with ultra‐low chemical usage, fast preparation, and low catalyst loading (0.007 wt%). The M‐TiO2 films: 1) provide abundant oxygen vacancies and enough open cavities to facilitate the growth of Pd NPs; 2) improve Pd dispersion and reduce particle size; 3) allow diffusion of reactants, and 4) induce strong metal‐support interactions for enhanced catalytic activity and stability. The optimized Pd‐TiO2/B CMR demonstrates high efficiency (>97%) and excellent stability (1,000 h) for the continuous‐flow hydrogenation of nitroaniline, even under intermittent operation (12 h on/12 h off for five cycles) or in a real aqueous matrix (>200 h), making it a promising candidate for Pd‐catalyzed hydrogenation.
The effect of foreign knowledge acquisition on international performance: The mediating roles of international orientation and business model innovation
Authors: Adomako Samuel
Published: May 2023

Research on how business model innovation (BMI) in international markets affects international performance continues to proliferate. However, existing research is sparse on primary predictors of this relationship. Drawing upon knowledge creation theory, this article investigates a serial mediation model that supports the role of the indirect effects of foreign knowledge acquisition (FKA) via international orientation (IO) and BMI on international performance. Utilizing time‐lagged survey data from multiple respondents in Ghana (N = 352), the results revealed that high levels of FKA enhance BMI via increased IO, and BMI ultimately improves international performance. Implications relating to theory and practice are discussed.
Development and performance of a machine learning‐based tool that predicts influent flow to a WRF 72 h in advance and integrates with existing wet weather nutrient management protocols
Authors: Bilyk Katya , Roostaei Javad , Bailey Erika
Published: May 2023

Influent flow to the 75 mgd Neuse River Resource Recovery Facility (NRRRF) was modeled using machine learning. The trained model can predict hourly flow 72 h in advance. This model was deployed in July 2020, and has been in operation over two and a half years. The model's mean absolute error in training was 2.6 mgd, and mean absolute error has ranged from 10 to 13 mgd in deployment for any point during the wet weather event when predicting 12 h in advance. As a result of this tool, plant staff have optimized the use of their 32 MG wet weather equalization basin, using it approximately 10 times and never exceeding its volume.

Practitioner Points

A machine learning model was developed to predict influent flow to a WRF 72 h in advance.

Selecting the appropriate model, variables, and properly characterizing the system are important considerations in machine learning modeling.

This model was developed using free open source software/code (Python) and deployed securely using an automated Cloud‐based data pipeline.

This tool has been in operation for over 30 months and continues to make accurate predictions.

Machine learning combined with subject matter expertise can greatly benefit the water industry.
Prediction of biogas production in anaerobic digestion of a full‐scale wastewater treatment plant using ensembled machine learning models
Authors: Sun Jiasi , Xu Yanran , Nairat Shaker , Zhou Jianpeng , He Zhen
Published: May 2023

Anaerobic digestion (AD) of sludge is a key approach to recover useful bioenergy from wastewater treatment and its stable operation is important to a wastewater treatment plant (WWTP). Because of various biochemical processes that are not fully understood, AD operation can be affected by many parameters and thus modeling AD processes becomes a useful tool for monitoring and controlling their operation. In this case study, a robust AD model for predicting biogas production was developed using ensembled machine learning (ML) model based on the data from a full‐scale WWTP. Eight ML models were examined for predicting biogas production and three of them were selected as metamodels to create a voting model. This voting model had a coefficient of determination (R2) at 0.778 and a root mean square error (RMSE) of 0.306, outperformed individual ML models. The Shapley additive explanation (SHAP) analysis revealed that returning activated sludge and temperature of wastewater influent were important features, although they affected biogas production in different ways. The results of this study have demonstrated the feasibility of using ML models for predicting biogas production in the absence of high‐quality data input and improving model prediction through assembling a voting model.

Practitioner Points

Machine learning is applied to model biogas production from anaerobic digesters at a full‐scale wastewater treatment plant.

A voting model is created from selected individual models and exhibits better performance of predication.

In the absence of high quality data, indirect features are identified to be important to predicting biogas production.
Organizational Conflicts in the Adoption of Continuous Software Engineering
Authors: Klotins Eriks , Talbert-Goldstein Elliot
Published: May 2023

Software is a critical component of nearly every product or service. Improvements in software can lead to substantial competitive advantages. At the same time, software and surrounding engineering teams have become increasingly complex.

The adoption of continuous integration and delivery is a recent trend to radically improve software release speed. However, its adoption is far from straightforward. Specifically, rethinking processes, organizational culture, ways of working, and business models require buy-in from diverse stakeholders that may have conflicting objectives. Such situations are explored by organizational conflict research.

This paper reports on early lessons from an ongoing research project in continuous software engineering, specifically investigating adoption challenges from an organizational conflict perspective. We identify catalysts, symptoms, and outcomes of organizational conflicts hindering the adoption process.

We conclude that predictable conflicts emerge when adopting continuous engineering. Engineers, managers, and other teams can proactively prepare for and allocate resources to resolve them. Proper analysis and management can help avoid wasted time, impeding processes, and frustration.
Versicherungstechnische Risiken in der Berufsunfähigkeitsversicherung
Authors: Strobel Jürgen
Published: May 2023

Erstmals nach mehr als zwei Jahrzehnten hat die Deutsche Aktuarvereinigung wieder die Veröffentlichung neuer Rechnungsgrundlagen für die Berufsunfähigkeitsversicherung angekündigt. Dies gibt Anlass, die Entwicklung der relevanten Wahrscheinlichkeiten in den vergangenen Jahrzehnten zu analysieren und insbesondere herauszuarbeiten, welche Einflussfaktoren die Veränderungen bestimmt haben. Mit Blick in die Zukunft können daraus insbesondere Informationen über das Änderungsrisiko gewonnen werden, dem die Rechnungsgrundlagen in dieser Lebensversicherungs-Teilsparte in besonderer Weise unterworfen sind.
Cyber-Kumulrisiko
Authors: Cremer Frank , Materne Stefan
Published: May 2023

Während die Frequenz und die finanziellen Auswirkungen von Cyber-Schäden immer größere Dimensionen annehmen, haben Versicherer das volle Ausmaß dieses Risikos noch nicht verstanden. Für die Versicherungsbranche nimmt der Aspekt des Kumulrisikos eine zentrale Rolle ein. Aus diesem Grund werden die Bedeutung und Besonderheiten des Cyber-Kumulrisikos erarbeitet und der Status quo gemäß der Diskussion in der Literatur sowie der Erfahrungen aus der Praxis analysiert. Abschließend werden die Grenzen der Versicherbarkeit von Cyber-Kumulrisiken diskutiert, wie auch Möglichkeiten des versicherungstechnischen Risikotransfers.
Steuerrecht und Versicherungswirtschaft − ein Risiko eigener Art
Authors: Axer Jochen
Published: May 2023

Versicherungswirtschaft und Staat versuchen mit unterschiedlichen Mitteln und Ressourcen, Lebensrisiken abzusichern. Fiskalische Belastungen von Versicherungsunternehmen, Vertrieb und Versicherungsnehmern führen zu einer Einengung der privatwirtschaftlich organisierten Risikovorsorge. Besonderheiten der Versicherungsbranche aufgrund ihres in die Zukunft gerichteten Geschäftsmodells bedürfen einer steuerlichen Begleitung, die sich der gesellschaftlichen Funktion und des Geschäftsmodells der Versicherer bewusst ist.

Die jeweilige Sachbehandlung berührt ein gesellschaftliches Grundverständnis − nämlich entweder den Menschen eine vorausschauende Eigenvorsorge abzuverlangen und diese dann aber auch zu ermöglichen (ohne dass der Staat zusätzliche unverträgliche Lasten aufbürdet) − oder aber den Staat als permanenten „Retter in der Not“ anzusehen (der dann aber zuständig für alles und jedweden ist). Die Versicherungswirtschaft wird sich immer darum bemühen müssen, ihr privatwirtschaftliches Modell als überlegen und „gerechter“, aber gleichzeitig als die staatliche Absicherung entlastend zu verdeutlichen; die Schnittstelle zur Steuerbelastung wird hierbei jederzeit eine wichtige Rolle spielen.
Optimierung von Testprozessen und Anforderungsmanagement
Authors: Schnur Bernd
Published: May 2023

Die digitale Transformation bedingt nicht nur Veränderungen in den Produkten und Prozessen der Unternehmen, sondern auch in den dabei unterstützenden Informationstechnologien. In diesem Zusammenhang sollten vorhandene Optimierungspotenziale bei der Entwicklung und Einführung neuer Software ausgeschöpft werden. Hier können entsprechende Standards zu Verbesserungen von Aufgaben und Projekten in den Anforderungsphasen sowie beim Testen von Anwendungssystemen beitragen. Die in diesem Kontext bekanntesten Standards sind ISTQB und IREB (einschließlich ihrer Zertifizierungsschemata), mit denen Optimierungspotenziale in den Testprozessen und den Prozessen des Anforderungsmanagements realisiert werden können.
Zum Schluss: Die Arche Noah aus Sicht der Seekaskoversicherung
Authors: Reimers-Rawcliffe Lutz
Published: May 2023

Risiko und Versicherungsbedarf sind durchaus keine neuen Fragestellungen. Daher wurde an dieser Stelle exemplarisch die Arche Noah als ein erstes Anwendungsbeispiel für die Seekaskoversicherung skizziert.
Klima- und Nachhaltigkeitsrisiken in der Versicherungswirtschaft
Authors: Heep-Altiner Maria , Rohlfs Torsten , Berg Marcel , Schmidt Jan-Philipp
Published: May 2023

Aufgrund der Studienlage muss der Klimawandel im Sinne einer durch den Menschen kausal bewirkten Erderwärmung als gegeben angesehen werden. Dabei sind diese Auswirkungen keineswegs homogen: Je nach Szenario sind verschiedene geografische Regionen, Bevölkerungsgruppen oder Industriezweige ganz unterschiedlich betroffen. Gerade im Bereich der Versicherungen ergeben sich hier große Risiken, aber durchaus auch vielfältige Chancen, wobei nach Auswertung verschiedener wissenschaftlicher Studien in Kombination mit geeigneten qualitativen Ansätzen eine erste Quantifizierung der Effekte vorgenommen werden kann. Dabei sind die Risiken des Klimawandels generell im größeren Kontext der Nachhaltigkeitsrisiken eingebettet, die neben sozialen Aspekten auch die Aspekte einer nachhaltigen Geschäftsführung umfassen.
Grenzen der Versicherbarkeit
Authors: Arenz Jonas , Bierwirth Max , Schüssler Robin , Tribull-Potapczuk Ken , Weis Benedikt , Winkler Erik
Published: May 2023

Die Corona-Pandemie hat auch die Versicherungswirtschaft unvorbereitet getroffen. Dabei hat sich gezeigt, dass konventionelle Versicherungen nicht geeignet sind, Extremrisiken wie die Pandemie zu versichern.

Es existieren jedoch bereits Versicherungskonzepte, welche andere Extremrisiken abdecken. Es kann grundsätzlich zwischen vollständig staatlich organisierten Konzepten, Public-Private-Partnerships (PPP) und rein privatwirtschaftlich organisierten Konzepten unterschieden werden. Nach sorgfältiger Analyse erscheint hier das PPP-3-Layer-Modell, das sich durch die Kombination aus staatlichem und privatwirtschaftlichem Risikotransfer auszeichnet, als bestes Versicherungskonzept, um die Schäden durch eine Pandemie zu versichern.
Gesellschaftliche Integration aus gesellschaftstheoretischer Sicht
Authors: Lüthi Katharina
Published: May 2023

Ausdifferenzierte und komplexe Gesellschaftssysteme haben keine kollektive Handlungsfähigkeit. Die Erhöhung der kollektiven Handlungsfähigkeit stellt ein Kernelement der Initiative Lernen vor Ort dar mit der Annahme, dass »Bildungsstationen und Bildungsangebote wie ein stimmiges, integriertes System aufeinander bezogen und abgestimmt« sein sollen. Die zweite Annahme besteht darin, dass durch diese Abstimmung »das Lernen im gesamten Lebenslauf erfolgreich sein kann«.
Gesellschaftliche Integration aus pädagogischer Sicht
Authors: Lüthi Katharina
Published: May 2023

Bisher unbeleuchtet blieb das Verhältnis zwischen System- und Sozialintegration. Mit Blick auf die Frage, welchen Beitrag ein kommunales Bildungsmanagement zur System- und Sozialintegration im Rahmen des Programms Lernen vor Ort leistet, bedarf es einer Klärung dieses Verhältnisses. Diese Klärung erfolgt nun mit dem Konzept der Vermittlung aus pädagogischer Sicht.
Gesellschaftliche Integration aus Sicht von Organisation
Authors: Lüthi Katharina
Published: May 2023

Das Brückenprinzip Organisation lese ich als Form der Dienstleistungsorganisation bei der Wohlfahrtsproduktion. Der Akteur Politik spielt dabei eine herausragende Rolle, der andere Subsysteme zum einen vielfach adressiert und zum anderen von diesen mit Erwartungen angesprochen wird
Ein Bildungsmanagement auf kommunaler Ebene als Prozess- und Strukturinnovator
Authors: Lüthi Katharina
Published: May 2023

Das BMK tritt als Subjekt der Erziehung auf dem Feld des politischen Diskurses (LG) auf. Als Vertreter des sozial-kulturellen Systems investiert es Verständigungskraft ins politische System, um eine positive Kultur für die Grundidee eines Strukturprogramms zu schaffen. In gemischten Gremien entwickelt es ein kreisweites Übergangsmanagement und transferiert Bildungsberatung im Bereich der frühen Bildung.
Linear power corrections to single top production processes at the LHC
Authors: Makarov Sergei , Melnikov Kirill , Nason Paolo , Ozcelik Melih A.
Published: May 2023

Abstract

We discuss the linear power corrections to the electroweak production of top quarks at the LHC using renormalon calculus. We show how such non-perturbative corrections can be obtained using the Low-Burnett-Kroll theorem, which provides the first subleading term to the expansion of the real-emission amplitudes around the soft limit. We demonstrate that there are no linear power corrections to the total cross sections of arbitrary processes of a single top production type provided that these cross sections are expressed in terms of a short-distance top quark mass. We also derive a universal formula for the linear power corrections to generic observables that involve the top-quark momentum.
Black hole to cosmic horizon microstates in string/M theory: timelike boundaries and internal averaging
Authors: Silverstein Eva
Published: May 2023

Abstract

In this note, we resolve an apparent obstacle to string/M theory realizations of dS observer patch holography, finding a new role for averaging in quantum gravity. The solvable $$ T\overline{T} $$
T

T
¯

(+Λ2) deformation recently provided a detailed microstate count of the dS3 cosmic horizon, reproducing the refined Gibbons-Hawking entropy computed by Anninos et al. along with the correct radial bulk geometry. On the gravity side, the deformation brings in the boundary to just outside a black hole horizon, where it is indistinguishable from the dS cosmic horizon, enabling a continuous passage to a bounded patch of dS. In string/M theory, the relationship between AdS/CFT and dS involves uplifts that change the internal topology, e.g. replacing an internal sphere $$ \mathbbm{S} $$
S
with an internal hyperbolic space ℍ (and incorporating varying warp and conformal factors). We connect these two approaches, noting that the differences in the extra dimensions between AdS black hole and dS solutions are washed out by internal averaging in the presence of a timelike boundary skirting the horizon. This helps to motivate a detailed investigation into the possibility of such timelike boundaries in (A)dS solutions of string/M theory, and we take initial steps toward suitable generalizations of Liouville walls as one approach.