bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing pregnancy care and institutional delivery in rural Mali: a secondary baseline analysis of a cluster-randomised trial
Authors: Ghosh Rakesh , Konipo Aminata (Nene) , Treleaven Emily , Rozenshteyn Sasha , Beckerman Jessica , Whidden Caroline , Johnson Ari , Kayentao Kassoum , Liu Jenny
Published: April 2024

Objective

The vast majority of the 300 000 pregnancy-related deaths every year occur in South Asia and sub-Saharan Africa. Increased access to quality antepartum and intrapartum care can reduce pregnancy-related morbidity and mortality worldwide. We used a population-based cross-sectional cohort design to: (1) examine the sociodemographic risk factors and structural barriers associated with pregnancy care-seeking and institutional delivery, and (2) investigate the influence of residential distance to the nearest primary health facility in a rural population in Mali.

Methods

A baseline household survey of Malian women aged 15–49 years was conducted between December 2016 and January 2017, and those who delivereda baby in the 5 years preceding the survey were included. This study leverages the baseline survey data from a cluster-randomised controlled trial to conduct a secondary analysis. The outcomes were percentage of women who received any antenatal care (ANC) and institutional delivery; total number of ANC visits; four or more ANC visits; first ANC visit in the first trimester.

Results

Of the 8575 women in the study, two-thirds received any ANC in their last pregnancy, one in 10 had four or more ANC visits and among those that received any ANC, about one-quarter received it in the first trimester. For every kilometre increase in distance to the nearest facility, the likelihood of the outcomes reduced by 5 percentage points (0.95; 95% CI 0.91 to 0.98) for any ANC; 4 percentage points (0.96; 95% CI 0.94 to 0.98) for an additional ANC visit; 10 percentage points (0.90; 95% CI 0.86 to 0.95) for four or more ANC visits; 6 percentage points (0.94; 95% CI 0.94 to 0.98) for first ANC in the first trimester. In addition, there was a 35 percentage points (0.65; 95% CI 0.56 to 0.76) decrease in likelihood of institutional delivery if the residence was within 6.5 km to the nearest facility, beyond which there was no association with the place of delivery. We also found evidence of increase in likelihood of receiving any ANC care and its intensity increased with having some education or owning a business.

Conclusion

The findings suggest that education, occupation and distance are important determinants of pregnancy and delivery care in a rural Malian context.

Trial registration number

NCT02694055.
Reducing wait times and medical costs for patients: the physiotherapy-led Spine Triage and Rehabilitation (STAR) Clinic
Authors: Wong Walter-Soon-Yaw , Sun Cara Min , Koh Hun Yi , Tan Linus Ren Hao , Huang Yilun
Published: April 2024

The Sengkang General Hospital Orthopaedic Spine Outpatient Service is facing a growing challenge of increasing number of referrals and waiting times, placing a significant burden on the system. Primary care referrals have an average wait time of 61.1 days, with 34.5%f patients waiting longer than 60 days from referral to appointment, to see a spine physician.

Back pain is a very common presentation, with the vast majority resolving after conservative management which commonly includes analgesia, physiotherapy and reassurance. Unfortunately, many referrals from primary care involve patients who have yet to explore the avenues of conservative management with 90% of our referrals being managed without surgery. Globally, triage services in Western countries conducted by allied health professionals have shown to be an effective method at addressing the escalating wait times with high satisfaction rates. We have endeavoured to emulate this within our department through the implementation of the Spine Triage and Rehabilitation (STAR) Clinic. The STAR clinic aims to empower physiotherapists with the ability to triage patients into surgical and non-surgical categories with their primary physiotherapy expertise to reduce waiting times and increase outpatient capacity.

More than 300 patients were recruited, and their progress was tracked over 13 months under the four Ss of: waiting timeS, cost Savings, Safety and patient Satisfaction. This pilot study has been overwhelmingly positive, with significantly reduced waiting times and high cost savings, without any compromise on patient safety and satisfaction.
Influence of vitamin D supplementation on growth, body composition, pubertal development and spirometry in South African schoolchildren: a randomised controlled trial (ViDiKids)
Authors: Middelkoop Keren , Micklesfield Lisa , Stewart Justine , Walker Neil , Jolliffe David A , Mendham Amy E , Coussens Anna K , Nuttall James , Tang Jonathan , Fraser William D , Momand Waheedullah , Cooper Cyrus , Harvey Nicholas C , Wilkinson Robert J , Bekker Linda-Gail , Martineau Adrian R
Published: April 2024

Objective

To determine whether weekly oral vitamin D supplementation influences growth, body composition, pubertal development or spirometric outcomes in South African schoolchildren.

Design

Phase 3 double-blind randomised placebo-controlled trial.

Setting

Socioeconomically disadvantaged peri-urban district of Cape Town, South Africa.

Participants

1682 children of black African ancestry attending government primary schools and aged 6–11 years at baseline.

Interventions

Oral vitamin D3(10 000 IU/week) versus placebo for 3 years.

Main outcome measures

Height-for-age and body mass index-for-age, measured in all participants; Tanner scores for pubertal development, spirometric lung volumes and body composition, measured in a subset of 450 children who additionally took part in a nested substudy.

Results

Mean serum 25-hydroxyvitamin D3concentration at 3-year follow-up was higher among children randomised to receive vitamin D versus placebo (104.3 vs 64.7 nmol/L, respectively; mean difference (MD) 39.7 nmol/L, 95% CI 37.6 to 41.9 nmol/L). No statistically significant differences in height-for-age z-score (adjusted MD (aMD) −0.08, 95% CI −0.19 to 0.03) or body mass index-for-age z-score (aMD −0.04, 95% CI −0.16 to 0.07) were seen between vitamin D versus placebo groups at follow-up. Among substudy participants, allocation to vitamin D versus placebo did not influence pubertal development scores, % predicted forced expiratory volume in 1 s (FEV1), % predicted forced vital capacity (FVC), % predicted FEV1/FVC, fat mass or fat-free mass.

Conclusions

Weekly oral administration of 10 000 IU vitamin D3boosted vitamin D status but did not influence growth, body composition, pubertal development or spirometric outcomes in South African schoolchildren.

Trial registration numbers

ClinicalTrials.govNCT02880982, South African National Clinical Trials Register DOH-27-0916-5527.
Oncolytic herpes simplex virus expressing IL-2 controls glioblastoma growth and improves survival
Authors: Bommareddy Praveen K , Wakimoto Hiroaki , Martuza Robert L , Kaufman Howard L , Rabkin Samuel D , Saha Dipongkor
Published: April 2024

Background

Glioblastoma (GBM), a highly immunosuppressive and often fatal primary brain tumor, lacks effective treatment options. GBMs contain a subpopulation of GBM stem-like cells (GSCs) that play a central role in tumor initiation, progression, and treatment resistance. Oncolytic viruses, especially oncolytic herpes simplex virus (oHSV), replicate selectively in cancer cells and trigger antitumor immunity—a phenomenon termed the “in situ vaccine” effect. Although talimogene laherparepvec (T-VEC), an oHSV armed with granulocyte macrophage-colony stimulating factor (GM-CSF), is Food and Drug Administration (FDA)-approved for melanoma, its use in patients with GBM has not been reported. Interleukin 2 (IL-2) is another established immunotherapy that stimulates T cell growth and orchestrates antitumor responses. IL-2 is FDA-approved for melanoma and renal cell carcinoma but has not been widely evaluated in GBM, and IL-2 treatment is limited by its short half-life, minimal tumor accumulation, and significant systemic toxicity. We hypothesize that local intratumoral expression of IL-2 by an oHSV would avoid the systemic IL-2-related therapeutic drawbacks while simultaneously producing beneficial antitumor immunity.

Methods

We developed G47Δ-mIL2 (an oHSV expressing IL-2) using the flip-flop HSV BAC system to deliver IL-2 locally within the tumor microenvironment (TME). We then tested its efficacy in orthotopic mouse GBM models (005 GSC, CT-2A, and GL261) and evaluated immune profiles in the treated tumors and spleens by flow cytometry and immunohistochemistry.

Results

G47Δ-mIL2 significantly prolonged median survival without any observable systemic IL-2-related toxicity in the 005 and CT-2A models but not in the GL261 model due to the non-permissive nature of GL261 cells to HSV infection. The therapeutic activity of G47Δ-mIL2 in the 005 GBM model was associated with increased intratumoral infiltration of CD8+T cells, critically dependent on the release of IL-2 within the TME, and CD4+T cells as their depletion completely abrogated therapeutic efficacy. The use of anti-PD-1 immune checkpoint blockade did not improve the therapeutic outcome of G47Δ-mIL2.

Conclusions

Our findings illustrate that G47Δ-mIL2 is efficacious, stimulates antitumor immunity against orthotopic GBM, and may also target GSC. OHSV expressing IL-2 may represent an agent that merits further exploration in patients with GBM.
Long-term clinical and radiological effectiveness and safety of ultralow doses of rituximab in rheumatoid arthritis: observational extension of the REDO trial
Authors: den Broeder Nathan , Verhoef Lise , de Man Yaël A , Kok Marc R , Thurlings Rogier , van der Weele Wilfred , van den Bemt Bart JF , van den Hoogen Frank HJ , van der Maas Aatke , den Broeder Alfons A
Published: April 2024

Background

The REDO trial (REtreatment with Rituximab in RhEmatoid arthritis: Disease Outcome after Dose Optimisation) showed similar disease activity for retreatment with ultralow doses (200 mg and 500 mg per 6 months) compared with standard low-dose rituximab (RTX, 1000 mg per 6 months). We performed an observational extension study of the REDO trial to assess long-term effectiveness.

Methods

Patients from the REDO trial were followed from start of the trial to censoring in April 2021. RTX use was at the discretion of patient and rheumatologist using treat to target. The primary outcome was disease activity (disease activity score in 28 joints C-reactive protein (DAS28-CRP)), analysed using a longitudinal mixed model by original randomisation and time-varying RTX dose. The original DAS28-CRP non-inferiority (NI) margin of 0.6 was used. RTX dose and persistence, safety and radiological outcomes were also assessed.

Findings

Data from 126 of 142 REDO patients was collected from 15 December 2016, up to 30 April 2021. Drop-outs continued treatment elsewhere (n=3) or did not consent (n=13).

Disease activity did not differ by original randomisation group: 1000 mg mean DAS28-CRP (95% CI) of 2.2 (2.0 to 2.5), 500 mg 2.3 (2.1 to 2.4) and 200 mg 2.4 (2.2 to 2.5). Lower time-varying RTX dose was associated with higher DAS28-CRP (0.22 (95% CI 0.05 to 0.40) higher for 200 mg/6 months compared with 1000 mg/6 months), but remained within the NI-margin. RTX persistence was 93%. Median RTX dose was 978 mg (IQR 684–1413) per year, and no association was found between RTX dose and adverse events or radiological damage.

Interpretation

Long-term use of ultralow doses of RTX is effective in patients with rheumatoid arthritis responding to standard dose RTX.
Association of clinical response criteria and disease activity levels with axial spondyloarthritis core domains: results from two phase 3 randomised studies, BE MOBILE 1 and 2
Authors: Navarro-Compán Victoria , Ramiro Sofia , Deodhar Atul , Mease Philip J , Rudwaleit Martin , de la Loge Christine , Fleurinck Carmen , Taieb Vanessa , Mørup Michael F , Massow Ute , Kay Jonathan , Magrey Marina
Published: April 2024

Objective

To assess how achievement of increasingly stringent clinical response criteria and disease activity states at week 52 translate into changes in core domains in patients with non-radiographic (nr-) and radiographic (r-) axial spondyloarthritis (axSpA).

Methods

Patients in BE MOBILE 1 and 2 achieving different levels of response or disease activity (Assessment of SpondyloArthritis International Society (ASAS) and Ankylosing Spondylitis Disease Activity Score (ASDAS) response criteria, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50)) at week 52 were pooled, regardless of treatment arm. Associations between achievement of these endpoints and change from baseline (CfB) in patient-reported outcomes (PROs) measuring core axSpA domains, including pain, fatigue, physical function, overall functioning and health, and work and employment, were assessed.

Results

Achievement of increasingly stringent clinical efficacy endpoints at week 52 was generally associated with sequentially greater improvements from baseline in all PROs. Patients with nr-axSpA achieving ASAS40 demonstrated greater improvements (CfB) than patients who did not achieve ASAS40 but did achieve ASAS20, in total spinal pain (−5.3 vs −2.8, respectively), Functional Assessment of Chronic Illness-Fatigue subscale (12.7 vs 6.7), Bath Ankylosing Spondylitis Function Index (−3.9 vs −1.8), European Quality of Life 5-Dimension 3-Level Version (0.30 vs 0.16), Work Productivity and Activity Impairment-axSpA presenteeism (−35.4 vs −15.9), overall work impairment (−36.5 vs −12.9), activity impairment (−39.0 vs −21.0) and sleep (9.0 vs 3.9). Results were similar for ASDAS and BASDAI50. Similar amplitudes of improvement were observed between patients with nr-axSpA and r-axSpA.

Conclusions

Patients treated with bimekizumab across the full axSpA disease spectrum, who achieved increasingly stringent clinical response criteria and lower disease activity at week 52, reported larger improvements in core axSpA domains.
Gastrointestinal complications after cardiac surgery
Authors: Schwarzova Klara , Damle Sameer , Sellke Frank William , Robich Michael Phillip
Published: April 2024

Gastrointestinal complications after cardiac surgery are relatively rare entities but carry a high mortality. We identified over 70 articles written since 2010 using the PubMed database. We included 40 in our review. The most common complications include paralytic ileus, gastrointestinal bleeding, and bowel ischemia. Patients who undergo cardiac procedures are at risk for poor perfusion of the gastrointestinal tract and, thus, at risk for resulting complications. Risk factors for these complications include peri-operative use of vasopressors, prolonged operative time, and the time of cardiopulmonary bypass. Presentation of gastrointestinal complications tends to differ as patients after open heart surgery can remain intubated, and exams can be limited. Early recognition and aggressive therapy are paramount. We aim to provide a review that will help the reader get familiar with the most common gastrointestinal complications that can negatively affect outcomes after cardiac surgery.
Milling characteristics of SiCp/2024Al composites thin-walled part based on movable auxiliary support
Authors: Gao Zhijie , Zhu Peng , Yang Shu , Wei Zuoshan , Wang Qitong , Zhou Li
Published: April 2024

Due to milling force and milling heat, thin-walled parts are highly susceptible to deformation and even scrap. In this paper, a method of milling thin-walled part based on the movable auxiliary support was proposed. The ABAQUS software was employed to simulate the milling of thin-walled SiCp/2024Al composite part, while the movement of the auxiliary support was simulated using the secondary development subroutine VDLOAD. The influences of the magnitude and area of the movable auxiliary support on the surface temperature, deformation, and residual stress of the workpiece were investigated by single factor method. The results showed that, with the increasing of the magnitude and area of the movable auxiliary support, both surface temperature and deformation of the thin-walled part decrease. The tensile residual stress decreases and gradually changes to compressive residual stress. Interestingly, when the magnitude exceeds 20 MPa or the area exceeds 100 mm2, the deformation of the thin-walled part continues to decrease, but the middle of the thin-walled part is concave toward the milling cutter. It is worth noting that the effect of area on the residual stress does not show a clear regularity. Thus, the reasonable auxiliary support can reduce deformation and stability in the milling of thin-walled parts and the results of the study can provide a theoretical basis for optimizing the milling process of thin-walled parts.
Watermass architecture of the Ordovician–Silurian Yangtze Sea (South China) and its palaeogeographical implications
Authors: Wang Xinqian , Zhan Chen , Algeo Thomas J. , Shen Jun , Liu Zhanhong
Published: April 2024

The South China Craton experienced large changes in climate, eustasy and environmental conditions during the Late Ordovician Hirnantian Ice Age, but their impact on the watermass architecture of the Yangtze Sea has not yet been thoroughly evaluated. Here, we reconstruct the salinity–redox structure of the Yangtze Sea based on five Upper Ordovician–Lower Silurian shale successions representing a lateral transect from a deep-water area of the Inner Yangtze Sea (IYS; Shuanghe section) across the shallow Hunan–Hubei Arch (Pengye, Jiaoye and Qiliao sections) to the relatively deep-water Outer Yangtze Sea (OYS; Wangjiawan section). Carbon isotope (

δ

13
C
org
) profiles show that the Guanyinqiao Bed (recording the peak Hirnantian glaciation) thins and is less completely preserved at sites on the flanks of the Hunan–Hubei Arch than in deeper water areas to the SW and NE, reflecting bathymetric influences. Watermass salinities were mainly marine at Shuanghe and brackish at the other four study sites, with little variation among Interval I (pre-glaciation), Interval II (Hirnantian glaciation) and Interval III (post-glaciation). Redox proxies document mainly euxinia at Shuanghe and Wangjiawan and suboxia at the other sites during Interval I, with shifts towards more reducing (mostly euxinic) conditions at most sites during Intervals II and III, which shows that all the study sections were deep enough to remain below the redoxcline during the glacio-eustatic lowstand. Two features of the Shuanghe section mark it as being unusual: it alone exhibits fully marine salinities, implying greater proximity to the open ocean than the other four sites, and it exhibits an especially large shift towards more reducing conditions during Interval III (i.e. the post-Hirnantian transgression), implying greater water depths. These features are difficult to reconcile with the standard palaeogeographical model for the Ordovician–Silurian South China Craton, which is characterized by a geographically enclosed and restricted IYS and a more open OYS, arguing instead for the SW end of the IYS to have been connected to the global ocean and the OYS to have been a restricted oceanic cul-de-sac. A review of sedimentological and facies data for the IYS region suggests that our re-interpretation of the Ordovician–Silurian palaeogeography of the South China Craton is viable, although further vetting of this hypothesis is needed.

Supplementary material:
The dataset and the full crossplot of Sr/Ba v. CaO for this study are available at
https://doi.org/10.6084/m9.figshare.c.7170648

Thematic collection:
This article is part of the Chemical Evolution of the Mid-Paleozoic Earth System and Biotic Response collection available at:
https://www.lyellcollection.org/topic/collections/chemical-evolution-of-the-mid-paleozoic-earth-system
Tracing a remnant of subducted Indian felsic crust: insights from zircon studies
Authors: Mukherjee Barun Kumar , Saha Tania
Published: April 2024

Zircon is a common mineral in nature that survives varied pressure and temperature conditions in the subduction process. It has excellent ability to reveal progressive metamorphic history and, hence, is useful in reconstructing the subduction tectonics in collisional orogenic belts. In the Tso Morari Gneiss of the Indus Suture Zone, Himalaya, eclogite boudins have registered the imprint of subduction-related ultrahigh-pressure (UHP) metamorphism; this imprint is, however, missing in the host gneisses. To search for the missing link, zircons of the gneisses were studied. The zircon overgrowth and the numerous mineral inclusions indicate the metamorphic responses of the gneisses. The Raman spectra of minerals show the cores of the zircon consist of apatite and quartz and the surrounding overgrowth preserves quartz–coesite, c-polymorphs and other metamorphic minerals. The distribution pattern of these minerals in the zircons is consistent with the Th/U ratios ranging from 0.30 to 0.01, recognizing the inner magmatic and outer metamorphic domains. The U–Pb ages from the inner magmatic (at
c.
500 Ma) and from the outer metamorphic growth (at
c.
45–42 Ma) suggest the former is the protolith age and the latter the metamorphic age of the gneisses. The tectonic interpretation reveals the subduction of Indian felsic crust to UHP depth (>100 km) at
c.
45 Ma.

Supplementary material
: Raman spectra of C-inclusions in the zircon of Tso Morari Gneiss are available at
https://doi.org/10.6084/m9.figshare.c.7168228

Thematic collection:
This article is part of the Mesozoic and Cenozoic tectonics, landscape and climate change collection available at:
https://www.lyellcollection.org/topic/collections/mesozoic-and-cenozoic-tectonics-landscape-and-climate-change
Security, Privacy, and Decentralized Trust Management in VANETs: A Review of Current Research and Future Directions
Authors: AlMarshoud Mishri , Sabir Kiraz Mehmet , H. Al-Bayatti Ali
Published: April 2024

Vehicular Ad Hoc Networks (VANETs) are powerful platforms for vehicular data services and applications. The increasing number of vehicles has made the vehicular network diverse, dynamic, and large-scale, making it difficult to meet the 5G network’s demanding requirements. Decentralized systems are interesting and provide attractive services because they are publicly available (transparency), have an append-only ledger (robust integrity protection), remove single points of failure, and enable distributed key management and communication in a peer-to-peer network. Researchers dedicated substantial efforts to advancing vehicle communications, however conventional cryptographic mechanisms are insufficient which enabled us to look at decentralized technologies. Therefore, we revisit decentralized approaches with VANETs. Endpoint devices hold a wallet which may incorporate threshold key management methods like MPC wallets, HD Wallets, or multi-party threshold ECDSA/EdDSA/BLS. We also discuss trust management approaches and demonstrate how decentralization can improve integrity, security, privacy, and resilience to single points of failure. We also conduct a comprehensive review, comparing them with current requirements, and the latest authentication and secure communication architectures, which require the involvement of trusted but non-transparent authorities in certificate issuance/revocation. We highlight the limitations of these schemes from PKI deployment and recommend future research, particularly in the realm of quantum cryptography.
Adapting Neural Networks at Runtime: Current Trends in At-Runtime Optimizations for Deep Learning
Authors: Sponner Max , Waschneck Bernd , Kumar Akash
Published: April 2024

Adaptive optimization methods for deep learning adjust the inference task to the current circumstances at runtime to improve the resource footprint while maintaining the model’s performance. These methods are essential for the widespread adoption of deep learning, as they offer a way to reduce the resource footprint of the inference task while also having access to additional information about the current environment. This survey covers the state-of-the-art at-runtime optimization methods, provides guidance for readers to choose the best method for their specific use-case, and also highlights current research gaps in this field.
SigFormer: Sparse Signal-guided Transformer for Multi-modal Action Segmentation
Authors: Liu Qi , Liu Xinchen , Liu Kun , Gu Xiaoyan , Liu Wu
Published: April 2024

Multi-modal human action segmentation is a critical and challenging task with a wide range of applications. Nowadays, the majority of approaches concentrate on the fusion of dense signals (i.e., RGB, optical flow, and depth maps). However, the potential contributions of sparse IoT sensor signals, which can be crucial for achieving accurate recognition, have not been fully explored. To make up for this, we introduce a
S
parse s
i
gnal-
g
uided Transformer (
SigFormer
) to combine both dense and sparse signals. We employ mask attention to fuse localized features by constraining cross-attention within the regions where sparse signals are valid. However, since sparse signals are discrete, they lack sufficient information about the temporal action boundaries. Therefore, in SigFormer, we propose to emphasize the boundary information at two stages to alleviate this problem. In the first feature extraction stage, we introduce an intermediate bottleneck module to jointly learn both category and boundary features of each dense modality through the inner loss functions. After the fusion of dense modalities and sparse signals, we then devise a two-branch architecture that explicitly models the interrelationship between action category and temporal boundary. Experimental results demonstrate that SigFormer outperforms the state-of-the-art approaches on a multi-modal action segmentation dataset from real industrial environments, reaching an outstanding F1 score of 0.958. The codes and pre-trained models have been made available at
https://github.com/LIUQI-creat/SigFormer
.
Natural and Engineered Guide RNA–Directed Transposition with CRISPR-Associated Tn7-Like Transposons
Authors: Hsieh Shan-Chi , Peters Joseph E.
Published: April 2024

CRISPR–Cas (clustered regularly interspaced short palindromic repeats–CRISPR-associated nuclease) defense systems have been naturally coopted for guide RNA–directed transposition on multiple occasions. In all cases, cooption occurred with diverse elements related to the bacterial transposon Tn7. Tn7 tightly controls transposition; the transposase is activated only when special targets are recognized by dedicated target-site selection proteins. Tn7 and the Tn7-like elements that coopted CRISPR–Cas systems evolved complementary targeting pathways: one that recognizes a highly conserved site in the chromosome and a second pathway that targets mobile plasmids capable of cell-to-cell transfer. Tn7 and Tn7-like elements deliver a single integration into the site they recognize and also control the orientation of the integration event, providing future potential for use as programmable gene-integration tools. Early work has shown that guide RNA–directed transposition systems can be adapted to diverse hosts, even within microbial communities, suggesting great potential for engineering these systems as powerful gene-editing tools.
Integrating Upper-Limb Prostheses with the Human Body: Technology Advances, Readiness, and Roles in Human–Prosthesis Interaction
Authors: Huang He (Helen) , Hargrove Levi J. , Ortiz-Catalan Max , Sensinger Jonathon W.
Published: April 2024

Significant advances in bionic prosthetics have occurred in the past two decades. The field's rapid expansion has yielded many exciting technologies that can enhance the physical, functional, and cognitive integration of a prosthetic limb with a human. We review advances in the engineering of prosthetic devices and their interfaces with the human nervous system, as well as various surgical techniques for altering human neuromusculoskeletal systems for seamless human–prosthesis integration. We discuss significant advancements in research and clinical translation, focusing on upper limbprosthetics since they heavily rely on user intent for daily operation, although many discussed technologies have been extended to lower limb prostheses as well. In addition, our review emphasizes the roles of advanced prosthetics technologies in complex interactions with humans and the technology readiness levels (TRLs) of individual research advances. Finally, we discuss current gaps and controversies in the field and point out future research directions, guided by TRLs.
Periodic Open Cellular Structures in Chemical Engineering: Application in Catalysis and Separation Processes
Authors: Eckendörfer Lisa , Rudolf Dominik , Brix Andreas , Börnhorst Marion , Freund Hannsjörg
Published: April 2024

Periodic open cellular structures (POCS) represent a promising new class of structured internals as next-generation catalyst supports in reactors or structured packing elements in separation columns. POCS feature a well-defined morphology and can be fabricated with high reproducibility even for complex geometries by means of additive manufacturing. This results in a uniform and easily controllable flow field, which allows for adjusting the heat and mass transport processes to realize optimal process conditions. We review the fundamentals of POCS, including design and manufacturing as well as transport phenomena for single- and multiphase systems. Moreover, we review recent POCS applications in reaction and separation processes and consider promising future application fields. The exceptional transport characteristics of POCS facilitate the design of highly efficient, flexible, resilient, and safe processes, which is key for achieving process intensification toward a sustainable future.
Boosting Hydrogen Production through Water Splitting: N, Ni, and N-Ni Doped ZnO Photocatalysts
Authors: Maulana Frendi , Engge Yohanes , Nurhuda Muhammad , Istiroyah  , Hakim Lukman , Juwono Alamsyah M.
Published: April 2024

This work investigates the potential of N, Ni, and N-Ni-doped ZnO as photocatalysts for hydrogen production through water splitting. Sonochemical techniques were used to synthesize these materials. In contrast to undoped or singly-doped ZnO, N-Ni-double-doped ZnO demonstrated a significantly narrower band gap (2.89 eV) and smaller crystallites (21.60 nm). This led to a remarkable doubling in the hydrogen production rate under UV-visible light irradiation. The combined effect of N and Ni doping effectively promotes efficient charge separation and enhanced light absorption, resulting in significantly increased photocatalytic activity. Furthermore, N-Ni-ZnO demonstrates exceptional stability, retaining over 95% of its initial activity after five cycles. This work paves the way for the development of cost-effective and scalable photocatalysts for sustainable solar hydrogen production.
Medium-chain triglyceride-specific appetite is regulated by the β-oxidation of medium-chain fatty acids in the liver
Authors: Maruyama Tsugunori , Matsui Sho , Kobayashi Ryosuke , Horii Takuro , Oguri Yasuo , Tsuzuki Satoshi , Horie Takahiro , Ono Koh , Hatada Izuho , Sasaki Tsutomu
Published: April 2024

Whether and how medium-chain triglyceride (MCT) intake is regulated remains unknown. Here, we showed that mice can discriminate between MCTs and LCTs. Hepatic β-oxidation participates in MCT-specific appetite, and hypothalamic galanin may be one of the factors that regulate MCT intake. Because of the antiobesity effects of MCTs, studying MCT-specific appetite may help combat obesity by promoting the intake of MCTs instead of LCTs.
Inhibition of Crif1 protects fatty acid-induced POMC neuron-like cell-line damage by increasing CPT-1 function
Authors: Regina-Ferreira Lara , Valdivieso-Rivera Fernando , Angelim Monara K. S. C. , Menezes dos Reis Larissa , Furino Vanessa O. , Morari Joseane , Maia de Sousa Lizandra , Consonni Sílvio Roberto , Sponton Carlos H. , Moraes-Vieira Pedro M. , Velloso Lício A.
Published: April 2024

Saturated fats can damage hypothalamic neurons resulting in positive energy balance, and this is mitigated by mild cellular stress; however, the mechanisms behind this protective effect are unknown. Using a proopiomelanocortin cell line, we show that under exposure to a high concentration of palmitate, the partial inhibition of the mitochondrial protein Crif1 results in protection due to a metabolic shift warranted by the increased expression and activity of the mitochondrial fatty acid transporter CPT-1.
Analysis of Supercapacitors in Renewable Energy Systems for Managing Power Fluctuations
Authors: Mbendane Banele , Abe Bolanle , Richards Coneth
Published: April 2024

Environmental decarbonization drives the world to find better ways to generate and store energy. Sustainable energy in the form of solar and wind is explored with the use of conventional energy storage systems (batteries) to close the gap. Green energy generation is weather‐dependent, leading to power output fluctuations, and the short‐term variability in irradiance adversely affects the system’s energy output and reliability. Standalone operation of a generating system necessitates a storage energy unit that manages transient loading and effectively shares power between the load and energy storage. This article presents an approach to managing energy fluctuations when renewable energy sources fluctuate, this occurs when short‐term variability in irradiance, and transient loading occurs. The approach uses supercapacitors as a short‐term energy storage solution. The proposed configuration has the following key advantages: effective power sharing, rapid charge, and discharge cycles in supercapacitors result in voltage restoration under transient conditions. The performance of the system is confirmed in MATLAB/Simulink. The proposed study confirms that integrating supercapacitors with PV systems does provide significant power oscillation management when sudden variations occur in renewable sources. A practical test was performed using smaller components following the same concept, and the results supported the hypothesis. The results show that the output voltage is managed when oscillation in irradiance occurs. This is seen in the simulation without supercapacitors when the output voltage fluctuates between 100 and 450 V within the first second of the simulation; however, with the introduction of SC, the voltage becomes stable and maintains an output of 620 V within 0.02 seconds. This is further supported by the experimental outcomes where almost 50% of the solar panel is covered and the output voltage is maintained.
Enveloping Dual Banach Algebras and Approximate Properties
Authors: Razi N. , Pourabbas A.
Published: April 2024

Suppose that A is a Banach algebra and FA is its enveloping dual Banach algebra, we show that FA is approximately contractible (approximately amenable) if A has the same property. Also, we study the relation between the pseudoamenability of FA and the pseudoamenability of the second dual A∗∗ and we also characterize approximate biflatness and approximate biprojectivity of FA associated with approximate biflatness and approximate biprojectivity of the second dual A∗∗.
Older People’s Understandings and Experiences of Using Health and Social Care Services under COVID‐19 Lockdown Restrictions in Aotearoa, New Zealand
Authors: Sayat Mikayla , Morgan Tessa , Wiles Janine , Morgan Kathryn , Gott Merryn
Published: April 2024

Internationally, the COVID‐19 pandemic resulted in changes to services as governments funneled health‐related funding and resources into stopping the spread of COVID‐19. At the same time, older people were singled out as an “at‐risk” group, which prompted caution from both older people and governments to limit their exposure to COVID‐19. It remains unclear what the impact this has had on older people’s routine health and social care access, and how older people themselves viewed these changes. This analysis investigates older people’s understanding and experiences of using health and social care services under the COVID‐19 lockdown restrictions in 2020. This analysis draws from a wider, letter‐writing study that received 748 letters from 854 participants aged 70 years and older who were living in New Zealand during the COVID‐19 lockdowns. Just over half of letter writers described access to health and social care services. Informed by Penchansky and Thomas’ 5 A’s of the access framework, we conducted a thematic analysis of this subsample of letters (n = 404). This analysis identified four broad categories relating to access to health and social care services under COVID‐19 lockdown restrictions: (a) the system‐wide strangeness of physically accessing services, (b) accommodation of services, (c) availability of resources and personnel, and (d) enhanced quality of those included by services. Rather than passively accepting changes, older people adapted to restrictions by drawing on their available materials and social resources. We conclude this analysis with suggestions for improving future interventions and policies to better older people’s access to health and social care during times of crisis.
A Novel Method for Tracking Neck Motions Using a Skin-Conformable Wireless Accelerometer: A Pilot Study
Authors: Huang Le , Chun Keum San , Yu Lian , Lee Jong Yoon , Soetikno Alan , Chen Hope , Jeong Hyoyoung , Barrett Joshua , Martell Knute , Kang Youn , Patel Alpesh A , Xu Shuai
Published: April 2024

Introduction: Cervical spine disease is a leading cause of pain and disability. Degenerative conditions of the spine can result in neurologic compression of the cervical spinal cord or nerve roots and may be surgically treated with an anterior cervical discectomy and fusion (ACDF) in up to 137,000 people per year in the United States. A common sequelae of ACDF is reduced cervical range of motion (CROM) with patient-based complaints of stiffness and neck pain. Currently, tools for assessment of CROM are manual, subjective, and only intermittently utilized during doctor or physical therapy visits. We propose a skin-mountable acousto-mechanic sensor (ADvanced Acousto-Mechanic sensor; ADAM) as a tool for continuous neck motion monitoring in postoperative ACDF patients. We have developed and validated a machine learning neck motion classification algorithm to differentiate between eight neck motions (right/left rotation, right/left lateral bending, flexion, extension, retraction, protraction) in healthy normal subjects and patients. Methods: Sensor data from 12 healthy normal subjects and 5 patients were used to develop and validate a Convolutional Neural Network (CNN). Results: An average algorithm accuracy of 80.0 ± 3.8% was obtained for healthy normal subjects (94% for right rotation, 98% for left rotation, 65% for right lateral bending, 87% for left lateral bending, 89% for flexion, 77% for extension, 50% for retraction, 84% for protraction). An average accuracy of 67.5 ± 5.8% was obtained for patients. Discussion: ADAM, with our algorithm, may serve as a rehabilitation tool for neck motion monitoring in postoperative ACDF patients. Sensor-captured vital signs and other events (extubation, vocalization, physical therapy, walking) are potential metrics to be incorporated into our algorithm to offer more holistic monitoring of patients after cervical spine surgery.
Conceptualizing Self-Harm through the Experiences of Psychogeriatric Experts
Authors: Van Hove Lisa , Baetens Imke , Vanderstichelen Steven
Published: April 2024

Introduction: Fewer studies thus far have focused on self-harm and its specific forms among older adults. Moreover, the limited available literature applies varying terminology. The categorization of self-harm used in younger populations may not be as appropriate for this population. This means that less is known about this phenomenon in older adults. The current study aimed to reduce this gap. Methods: Nine Flemish psychogeriatric experts participated in a semi-structured interview. Transcripts were thematically analyzed. Results: Themes emerging from the interviews suggest that self-harm in older adults may also include distinct elements, such as the omission of certain behaviours and engagement in indirect self-harm to cause bodily harm. According to the experts, self-harm may be engaged in to cope with emotions, express life fatigue, hasten death, and communicate a cry for help. Discussion: Self-harm is prevalent in older adults, and some characteristics may be specific to self-harm in an older age group. These findings may enable clinicians to be more alert to self-harm in older adults and consequently prevent serious suicidal behaviour. More research is needed to further uncover this phenomenon.
Sex Differences in Case Fatality of Aneurysmal Subarachnoid Hemorrhage: A Systematic Review
Authors: Asikainen Aleksanteri , Korja Miikka , Kaprio Jaakko , Rautalin Ilari
Published: April 2024

Introduction: Aneurysmal subarachnoid hemorrhage (SAH) is more common in women than in men, contrary to most cardiovascular diseases. However, it is unclear whether the case fatality rate (CFR) of SAH also differs by sex. Thus, we performed a systematic review to address the relationship between sex and SAH CFRs. Methods: We conducted a systematic literature search in PubMed, Scopus, and Cochrane library databases. We focused on population-based studies that included both nonhospitalized and hospitalized SAHs and had either reported 1-month (28–31 day) SAH CFRs separately for men and women or calculated risk estimates for SAH CFR by sex. For quality classification, we used the Cochrane Collaboration Handbook and Critical Appraisal Skills Program guidelines. We pooled the study cohorts and calculated relative risk ratios (RRs) with 95% confidence intervals (CIs) for SAH death between women and men using a random-effects meta-analysis model. Results: The literature search yielded 5,592 initial publications, of which 33 study cohorts were included in the final review. Of the 33 study cohorts, only three reported significant sex differences, although the findings were contradictory. In the pooled analysis of all 53,141 SAH cases (60.3% women) from 26 countries, the 1-month CFR did not differ (RR = 0.99 [95% CI: 0.93–1.05]) between women (35.5%) and men (35.0%). According to our risk-of-bias evaluation, all 33 study cohorts were categorized as low quality. The most important sources of bias risks were related to the absence of proper confounding control (all 33 study cohorts), insufficient sample size (27 of 33 study cohorts), and poor/unclear diagnostic accuracy (27 of 33 study cohorts). Conclusion: Contrary to SAH incidence rates, the SAH CFRs do not seem to differ between men and women. However, since none of the studies were specifically designed to examine the sex differences in SAH CFRs, future studies on the topic are warranted.
Comparison of Submental Surface Electromyography during Dry Swallow between Irradiated Head and Neck Cancer Survivors and Normal Individuals
Authors: Varghese Janet Jaison , Aithal Venkataraja U. , Sharan Krishna , Devaraja K. , Philip Serin Jiya , Guddattu Vasudeva , Rajashekhar Bellur
Published: April 2024

Introduction: This study compared the submental surface electromyography (sEMG) duration and amplitude during dry swallowing between irradiated head and neck cancer (HNC) survivors and age-matched normal individuals. Further, the relationship between submental and infrahyoid sEMG in the irradiated HNC group was explored. Method: Forty participants (20 HNC survivors and 20 age-matched normal individuals) participated in this study. The HNC survivors had completed organ preservation cancer treatment (at least 1-month post-treatment). They were on a complete oral diet without enteral supplementation (FOIS score> 4). Submental and infrahyoid sEMG activity was calculated for three trials of saliva swallow for each participant using sEMG. The duration and amplitude parameters considered were: onset duration – duration from the onset of swallowing to the maximum amplitude, offset duration – duration from the maximum amplitude to the end of the swallowing activity, total duration, and maximum amplitude. Results: The study found that irradiated HNC survivors exhibited prolonged temporal measures, particularly in the offset duration, which suggested a delayed descent of the hyolaryngeal complex during swallowing. Additionally, the HNC group showed a positive correlation between submental and infrahyoid sEMG. Furthermore, it was observed that the rate of increase in the duration of submental sEMG during subsequent swallowing was greater in HNC survivors which could be due to reduced salivation. Conclusion: Compared to age-matched normal individuals, irradiated HNC survivors manifest alterations in the submental muscle activities during dry swallowing as measured using sEMG. The temporal and amplitude changes are likely to have arisen as a consequence of postradiation changes.
Clinical and Pathological Features of Pilomatrixoma in Children: A Retrospective Study
Authors: Fu Hongyang , Shen Changbing , Wu Bo , Wang Tingting , Wu Jiutong , Li Yaqin , Ding Juan , Gao Jing
Published: April 2024

Introduction: Pilomatrixoma is a benign skin neoplasm that is common in children and is often misdiagnosed. This study aimed to summarize the clinical and pathological features of pilomatrixoma in children. Methods: Data on demographic information, clinical and pathological features, diagnosis, and treatment of 171 patients with pilomatrixoma from Shenzhen Baoan Women’s and Children’s Hospital were collected and analyzed retrospectively. Results: The mean age of the patients was 5.7 (standard deviation [SD] = 3.9) years old, and there were 2 age peaks (≤1 year old, 5–11 years old) and 2 age valleys (2–4 years old, ≥12 years old). The mean disease course was 9.3 (SD = 14.1) months, 69.0%, 86.5%, and 95.3% of the patients’ disease course in 6 months, 12 months, and 24 months, respectively. The mean tumor volume was 0.6 (SD = 1.0) cm3, and 81.3% of the patients’ tumor volume ≤1.0 cm3. Tumors were distributed sequentially in the head and neck (77.2%), upper limbs (12.9%), trunk (7.6%), and lower limbs (2.3%). The correct rates of clinical and ultrasonic diagnosis were 50.9% and 38.6%, respectively. The two most common pathological features of pilomatrixoma were shadow cells (99.4%) and basaloid cells (94.7%). There were no significant differences in age, disease course, or tumor volume between the male and female patients (p > 0.05). The age and tumor volume of the patients in different body parts were significantly different (P1 = 3.10E−05 and P2 = 5.60E−05, respectively). The correlation between the disease course and tumor volume was positively significant (p ≤ 0.05). There was a significant correlation between the disease course and tumor volume in patients with tumors at upper limbs (p = 0.03). Conclusion: The age of children with pilomatrixoma presented 2 peaks and 2 valleys. Most patients had disease courses in 24 months and with tumor volumes ≤1.0 cm3. The correct rates of clinical and ultrasonic diagnosis were relatively low. The head and neck were the most common distribution sites of pilomatrixoma, and shadow cells and basaloid cells were the most common pathological features. The tumor volume was positively correlated with disease course in patients with pilomatrixoma.