bluuebunny/crossref_metadata_2025 huggingface dataset:
Targeting belongingness among older people through engagement in senior centres: intervention development study in Denmark
Authors: Langergaard Sofie , Evans Rhiannon , Andreasen Jane , Petersen Kirsten Schultz , Overgaard Charlotte
Published: April 2024

Adults often experience a loss of social relations and sense of belonging in later life, leading to the risk of social isolation. Municipal senior centres offer a potential site for intervention, as they provide social communities targeting older people. However, not all older people find it easy to access these social communities due to experiencing physical and/or psychosocial frailties and could therefore continue to experience a decline in social relations and sense of belonging, which potentiates poor physical and psychosocial health and well-being. To date, there are limited evidence-based interventions in Denmark. The present article describes the development of an intervention to increase belongingness and decrease social isolation among older people with frailties who attend Danish municipal senior centres. The development process was conducted with reference to the INDEX (IdentifyiNg and assessing different approaches to DEveloping compleX intervention) guidance. The development process resulted in a 6-month supportive intervention, consisting of four elements: skills development workshops for all staff members; a start conversation including frailty screening; allocation of a ‘buddy’ among existing service users; and monthly follow-up conversations with staff members. This theory-informed approach can progress to feasibility testing and outcome evaluation in order to generate an evidence base. Concurrently, the article reflects on current guidance for intervention development and how it may be used and optimized to strengthen developmental processes in the future.
Watching the sunrise on our ocean planet in a new era of marine science
Authors: Schofield Oscar
Published: April 2024

Over the last 30 years, ocean sciences have been undergoing a technological revolution. Changes include the transition of autonomous platforms from being interesting engineering projects to being critical tools for scientists studying a range of processes at sea. My career has benefitted immensely from these technical innovations, allowing me to be at sea (virtually) 365 days a year and operate ocean networks globally. While these technical innovations have opened many research doors, many aspects of oceanography are unchanged. In my experience, working/talking/scheming with scientists is most effective face-to-face. Despite the growing capabilities of robotic platforms, we will still need to go to sea on ships to conduct critical experiments. As the responsibilities of scientists expand with mandated outreach efforts, I strongly urge young scientists to leverage the expertise of Broader Impact professionals, who are increasingly available to our community, in order to maximize the effectiveness and efficiency of our outreach efforts. Given the increasing observations of change occurring in the ocean, our work is ever-more important while still being fun. I am blessed to have had a career as an oceanographer exploring this planet.
Short-term power grid load forecasting based on optimized VMD and GA-BP
Authors: Wang Xiaojun , Li Xiaoming , Wang Jian , Gao Jun , Xin Lingling
Published: April 2024

The present article proposes an enhanced hybrid neural network model that combines variational mode decomposition (VMD) and genetic algorithm-backpropagation (GA-BP) to tackle the accurate prediction task of nonstationary and nonlinear power demand data. In comparison to existing methods, this study employs the North Gallic Hawk Optimization (NGO) algorithm to preliminarily ensure the optimization of the number of VMD modes, K and the penalty factor, α. Furthermore, it utilizes the envelope entropy criterion to determine the minimum optimal VMD components for predicting low-order spectral features vectors. Building upon this, the GA-BP optimization method establishes prediction models for the NGO-VMD model’s individual components. When compared with traditional methods, the GA-BP model exhibits significant advantages in terms of rapid convergence, fewer iterations and high prediction accuracy. Empirical results demonstrate that this approach holds promising prospects for practical application in power demand prediction. In comparison to traditional model predictive performance, the root mean square error is reduced by 60.36% and the mean absolute percentage error by 44.34%, providing robust support to enhance prediction accuracy and promote sustainable development of power systems.
Short-term electricity load forecasting based on CEEMDAN-FE-BiGRU-Attention model
Authors: Hu Haoxiang , Zheng Bingyang
Published: April 2024

Intending to address the volatility and intricacy of power load data, a novel method for short-term power load forecasting is presented, utilizing the CEEMDAN-FE-BiGRU-Attention model. This paper introduces the innovative adaptive noise fully integrated Empirical Mode decomposition (CEEMDAN) algorithm, which effectively decomposes the sequence into modal components of various frequencies and residual components. This decomposition serves to reduce the complexity inherent in the original time series. Subsequently, the fuzzy entropy (FE) algorithm is employed to calculate the time complexity of each component, allowing for the reconstruction of different scale sequences, thereby enhancing computational efficiency. Finally, the sequences of varying scales are input into the bidirectional recurrent neural network (BiGRU) model, incorporating the attention mechanism for prediction. Notably, the prediction accuracy of the BiGRU model with attention mechanism surpasses that of the baseline GRU model for multifeature time series, resulting in a significant improvement in prediction accuracy. Experimental findings demonstrate that the proposed model outperforms traditional approaches, enabling better capture of the variation trends in power load data while reducing time series complexity. Moreover, the proposed model exhibits a remarkable reduction in mean absolute percentage error and root mean square error values by 90.24% and 85.05%, respectively, when compared to the single BiGRU-Attention model. This enhancement enhances the accuracy of power load prediction. These innovative methodologies endow the power load forecasting method proposed in this paper with greater potential and viability for real-world applications.
The material selection method for functional packaging of electromechanical products based on low carbon and cost constraint
Authors: Chenjie Gong , Feng Xu , Senyi Wang , Kaiwang Xia
Published: April 2024

Packaging is an important but easily overlooked part of the study of low-carbon lifecycle of electromechanical products, but with the significant growth of the express delivery business, the carbon emissions caused by packaging are increasingly noteworthy. In order to explore the carbon emissions of packaging lifecycle, the electromechanical products are used as the packaging object to discuss the connotation of functional packaging, low-carbon design boundary and research methods of packaging lifecycle and establish the calculation models of carbon footprint and cost of packaging lifecycle and the evaluation method of material selection. The case study of gasoline engines shows that material selection plays a decisive role in the packaging of electromechanical products based on low carbon and cost constraints.
Seasonal performance research of heat-source tower systems using different work materials
Authors: Mao Yifan , Li Yongcun , Wen Xiantai , Yuan Xiaolei , Wu Zhaofan
Published: April 2024

The heat-source tower system has been evaluated in an enthalpy difference laboratory. This study analyzes the seasonal performance under various operating situations and fluid quality. In the summer and fall seasons, water is used as the circulating fluid in the tower. In the spring and winter seasons, glycol solution is used as the circulating fluid. Some parameters of the heat-source tower (e.g. the temperature of the solution inlet and outlet, the flow rate of the solution inlet and outlet, the temperature of the air inlet and outlet, the inlet air volume and the moisture content of the inlet air) are considered and measured to obtain its heat transfer characteristics. The simulation model of heat-source tower is constructed based on the mechanism of heat and mass transfer. This model is validated by the experimental results. The heat exchange and latent heat exchange of the system are analyzed under different parameters, as well as the variation law of inlet and outlet temperature and moisture content differences. The results show that the system has solution moisture absorption during winter operation. However, for every 9000 m3/h increase in air volume, the rate of solution dilution decreases between 9 and 43%. The rate of solution dilution is reduced by 11–31% for every 1°C in addition to the inlet solution temperature. Meanwhile, the heat dissipation in summer is about 2.8 times of the heat dissipation in winter.
The Changing Face of Nuclear Proliferation
Authors: Kaplow Jeffrey M
Published: April 2024

A rich literature has identified a number of important drivers of nuclear proliferation. Most of this work, however, treats the determinants of proliferation as constant over the entire nuclear age—the factors leading to proliferation are assumed to be the same in 2010 as they were in 1945. But there are reasons to suspect that the drivers of proliferation have changed over this time: nuclear technology is easier to come by, the global strategic environment has shifted, and the nuclear nonproliferation regime has come into being. To examine changes in the dynamics of nuclear proliferation, I adapt a cross-validation technique frequently used in the machine learning literature. I create a rolling window of training data with which statistical models of proliferation are built, and I then test the predictive power of these models against data from other time periods. The result of this analysis is a temporal map of how the determinants of proliferation have changed over time. My findings suggest that the underlying dynamics of nuclear proliferation have indeed shifted, with important implications both for the literature on nuclear proliferation and for policymakers interested in limiting the future spread of nuclear weapons.
Comrades in Arms? Rebel Leadership Roles and Coups in Rebel Regimes
Authors: Ashley Sean Paul
Published: April 2024

Why do some winning rebel groups build loyal postwar militaries, while others do not? Surprisingly, though victorious rebel political and military elites cooperate successfully to seize sovereign power, they often struggle to share it. In roughly one-third of rebel regimes, military elites attempt to depose their leaders through military coups. I contend that postwar coup risk is primarily shaped by the wartime roles of rebel leaders. Rebel leaders that occupy a frontline role—exposing themselves to the hazards of the conflict theater—establish regimes less likely to suffer postwar coups. Frontline leaders win greater prestige and stronger legitimacy among military audiences. Further, frontline leaders’ greater proximity to their military commanders allows them to develop institutional structures that more effectively reduce military autonomy. However, remote leaders, who are absent from the conflict theater, exercise weaker postwar control over the armed forces, resulting in greater coup risk. I find support for this theory using original cross-national data on all rebel regimes and the wartime roles of victorious rebel leaders between 1945 and 2010. A controlled case comparison of civil–military relations in two rebel regimes—Guinea-Bissau and Uganda—further illustrates the mechanisms tying wartime roles to postwar coups.
Performance evaluation of aged asphalt rejuvenated with waste cooking oil on rheological and chemical characteristics
Authors: Li Yan , He Yinzhang , Hu Qinshi , Li Zhe , Zhang Jiupeng , Zhao Xiaokang
Published: April 2024

This study investigates the influence of varying aging processes on the rheological behavior and microscopic features of bio-based recycled asphalt, focusing on the utilization of waste cooking oil (WCO) as a rejuvenator. The research evaluates the rheological and fatigue characteristics of the modified binder, alongside a detailed microscopic analysis to determine the molecular composition changes in both aged and recycled asphalt. The incorporation of WCO was found to compromise rutting performance slightly, yet significantly enhance fatigue resistance and reduce susceptibility to low-temperature cracking. With the progression of aging, an increased dosage of WCO effectively mitigated the negative impacts, bringing the molecular composition and functional groups of the aged asphalt closer to that of the original material. Despite these improvements, a full restoration to the asphalt’s original properties remained elusive. These findings underscore the potential of waste bio-oil as a sustainable resource for enhancing the durability and environmental friendliness of asphalt pavements.
PMC-LLaMA: toward building open-source language models for medicine
Authors: Wu Chaoyi , Lin Weixiong , Zhang Xiaoman , Zhang Ya , Xie Weidi , Wang Yanfeng
Published: April 2024

Objective

Recently, large language models (LLMs) have showcased remarkable capabilities in natural language understanding. While demonstrating proficiency in everyday conversations and question-answering (QA) situations, these models frequently struggle in domains that require precision, such as medical applications, due to their lack of domain-specific knowledge. In this article, we describe the procedure for building a powerful, open-source language model specifically designed for medicine applications, termed as PMC-LLaMA.

Materials and methods

We adapt a general-purpose LLM toward the medical domain, involving data-centric knowledge injection through the integration of 4.8M biomedical academic papers and 30K medical textbooks, as well as comprehensive domain-specific instruction fine-tuning, encompassing medical QA, rationale for reasoning, and conversational dialogues with 202M tokens.

Results

While evaluating various public medical QA benchmarks and manual rating, our lightweight PMC-LLaMA, which consists of only 13B parameters, exhibits superior performance, even surpassing ChatGPT. All models, codes, and datasets for instruction tuning will be released to the research community.

Discussion

Our contributions are 3-fold: (1) we build up an open-source LLM toward the medical domain. We believe the proposed PMC-LLaMA model can promote further development of foundation models in medicine, serving as a medical trainable basic generative language backbone; (2) we conduct thorough ablation studies to demonstrate the effectiveness of each proposed component, demonstrating how different training data and model scales affect medical LLMs; (3) we contribute a large-scale, comprehensive dataset for instruction tuning.

Conclusion

In this article, we systematically investigate the process of building up an open-source medical-specific LLM, PMC-LLaMA.
Large language models facilitate the generation of electronic health record phenotyping algorithms
Authors: Yan Chao , Ong Henry H , Grabowska Monika E , Krantz Matthew S , Su Wu-Chen , Dickson Alyson L , Peterson Josh F , Feng QiPing , Roden Dan M , Stein C Michael , Kerchberger V Eric , Malin Bradley A , Wei Wei-Qi
Published: April 2024

Objectives

Phenotyping is a core task in observational health research utilizing electronic health records (EHRs). Developing an accurate algorithm demands substantial input from domain experts, involving extensive literature review and evidence synthesis. This burdensome process limits scalability and delays knowledge discovery. We investigate the potential for leveraging large language models (LLMs) to enhance the efficiency of EHR phenotyping by generating high-quality algorithm drafts.

Materials and Methods

We prompted four LLMs—GPT-4 and GPT-3.5 of ChatGPT, Claude 2, and Bard—in October 2023, asking them to generate executable phenotyping algorithms in the form of SQL queries adhering to a common data model (CDM) for three phenotypes (ie, type 2 diabetes mellitus, dementia, and hypothyroidism). Three phenotyping experts evaluated the returned algorithms across several critical metrics. We further implemented the top-rated algorithms and compared them against clinician-validated phenotyping algorithms from the Electronic Medical Records and Genomics (eMERGE) network.

Results

GPT-4 and GPT-3.5 exhibited significantly higher overall expert evaluation scores in instruction following, algorithmic logic, and SQL executability, when compared to Claude 2 and Bard. Although GPT-4 and GPT-3.5 effectively identified relevant clinical concepts, they exhibited immature capability in organizing phenotyping criteria with the proper logic, leading to phenotyping algorithms that were either excessively restrictive (with low recall) or overly broad (with low positive predictive values).

Conclusion

GPT versions 3.5 and 4 are capable of drafting phenotyping algorithms by identifying relevant clinical criteria aligned with a CDM. However, expertise in informatics and clinical experience is still required to assess and further refine generated algorithms.
Determination of β-Galactooligosaccharides (GOS) in Infant Formula: Collaborative Study, Final Action 2021.01
Authors: Cuany Denis , Austin Sean
Published: April 2024

Background

We previously published a method for the determination of β-galactooligosaccharides (GOS) in infant formula and adult nutritionals, which is currently First Action AOAC Method 2021.01. In this study, reproducibility data were collected to support the promotion of the method to Final Action.

Methods

A collaborative study was organized in which 14 laboratories from eight different countries participated. Initially, laboratories were requested to analyze two practice samples and request guidance from the study director in case of issues. Successful laboratories proceeded to analyze seven samples (six infant formula and one adult nutritional) received as blind duplicates.

Results

Thirteen laboratories reported acceptable results for practice sample 1. Practice sample 2 could only be delivered to eight of the laboratories due to restrictions at customs. The 13 laboratories successfully analyzing practice sample 1 were requested to continue with the analysis of the multilaboratory trial (MLT) samples. Laboratory 14 was unable to solve some technical difficulties, so their data could not be used. Out of the seven samples tested, results for six infant formulas met the requirements of the AOAC Standard Method Performance Requirements (SMPR®) 2014.003, with repeatability (RSDr) ranging from 1.4 to 4.7% and reproducibility (RSDR) ranging from 8.1 to 11.6%. The adult nutritional sample returned results outside the range of the SMPR, having an RSDr of 9.9%, higher than the SMPR target of ≤6%, and an RSDR of 12.1%, just above the SMPR target of ≤12%.

Conclusion

The method described is suitable for the determination of GOS in infant formula.

Highlight

A method is described which is suitable for the determination of GOS in infant formula.
Trace mineral source and chromium propionate supplementation affect performance and carcass characteristics in feedlot steers
Authors: Spears Jerry W , Loh Huey Yi , Lloyd Karen E , Heldt Jeff S , Engle Terry E
Published: April 2024

Angus-crossbred steers (n = 400; 369.7 ± 7.6 kg) were used to determine the influence of trace mineral (TM) source and chromium propionate (Cr Prop) supplementation on performance, carcass characteristics, and ruminal and plasma variables in finishing steers. Steers were blocked by body weight (BW) and randomly assigned within block to treatments in a 2 × 2 factorial arrangement, with factors being: 1) TM source (STM or HTM) and 2) Cr supplementation (0 or 0.25 mg Cr/kg DM, −Cr or + Cr, respectively). Treatments consisted of the addition of: 1) sulfate TM (STM; 90, 40, and 18 mg/kg DM of Zn, Mn, and Cu, respectively), 2) STM and 0.25 mg Cr/kg DM from Cr Prop, 3) hydroxychloride TM (HTM; 90, 40, and 18 mg/kg DM of Zn, Mn, and Cu, respectively), and 4) HTM and 0.25 mg Cr/kg DM from Cr Prop. Each treatment consisted of 10 replicate pens with 10 steers per pen. Body weights were obtained on consecutive days at the initiation and termination of the 154-d study. Steers were fed a steam-flaked corn-based finishing diet. Ractopamine hydrochloride was fed for the last 31 d of the study. Ruminal fluid and blood samples were obtained from one steer per pen on days 28 and 84 for ruminal volatile fatty acids (VFA) and plasma TM and glucose analysis. Steers were slaughtered at the end of the study and individual carcass data were collected. No Cr × TM source interactions (P = 0.48) were detected. Steers supplemented with HTM had greater (P = 0.04) hot carcass weight (HCW), dressing percentage (DP), longissimus muscle (LM) area, and USDA yield grade (YG), and tended (P = 0.12) to have greater average daily gain (ADG) than those receiving STM. Average daily gain, gain:feed, dressing percentage, and longissimus muscle area were greater (P = 0.04) for + Cr steers compared to—Cr steers. Hot carcass weight tended (P = 0.06) to be greater for + Cr steers. Ruminal acetate concentrations at 28 d were lesser (P = 0.01) for HTM vs. STM steers, and greater (P = 0.04) for + Cr steers compared to—Cr steers. Plasma concentrations of Zn, Cu, and Mn were not affected by TM source or Cr supplementation. Steers supplemented with Cr had greater (P = 0.05) plasma glucose concentrations than—Cr steers at 28 but not at 84 d. Results of this study indicate replacing STM with HTM improved carcass characteristics in finishing steers, and Cr Prop supplementation improved steer performance and carcass characteristics.
The inflammatory injury of porcine small intestinal epithelial cells induced by deoxynivalenol is related to the decrease in glucose transport
Authors: Tang Xiaopeng , Zeng Yan , Xiong Kangning , Li Meijun
Published: April 2024

The present study aimed to investigate the effects of deoxynivalenol (DON) stimulation on inflammatory injury and the expression of the glucose transporters sodium-dependent glucose transporter 1 (SGLT1) and glucose transporter protein 2 (GLU2) in porcine small intestinal epithelial cells (IPEC-J2). Additionally, the study aimed to provide initial insights into the connection between the expression of glucose transporters and the inflammatory injury of IPEC-J2 cells. DON concentration and DON treatment time were determined using the CCK‑8 assay. Accordingly, 1.0 µg/mL DON and treatment for 24 h were chosen for subsequent experiments. Then IPEC-J2 cells were treated without DON (CON, N = 6) or with 1 μg/mL DON (DON, N = 6). Lactate dehydrogenase (LDH) content, apoptosis rate, and proinflammatory cytokines including interleukin (IL)-1β, Il-6, and tumor necrosis factor α (TNF-α) were measured. Additionally, the expression of AMP-activated protein kinase α1 (AMPK-α1), the content of glucose, intestinal alkaline phosphatase (AKP), and sodium/potassium-transporting adenosine triphosphatase (Na+/K+-ATPase) activity, and the expression of SGLT1 and GLU2 of IPEC-J2 cells were also analyzed. The results showed that DON exposure significantly increased LDH release and apoptosis rate of IPEC-J2 cells. Stimulation with DON resulted in significant cellular inflammatory damage, as evidenced by a significant increase in proinflammatory cytokines (IL-1β, IL-6, and TNF-α). Additionally, DON caused damage to the glucose absorption capacity of IPEC-J2 cells, indicated by decreased levels of glucose content, AKP activity, Na+/K+-ATPase activity, AMPK-α1 protein expression, and SGLT1 expression. Correlation analysis revealed that glucose absorption capacity was negatively correlated with cell inflammatory cytokines. Based on the findings of this study, it can be preliminarily concluded that the cell inflammatory damage caused by DON may be associated with decreased glucose absorption.
Characterization of iso-LSD metabolism using human liver microsomes in comparison to LSD and its applicability as urinary biomarker for LSD consumption
Authors: Ng Xue Qin , Goh Evelyn Mei Ling , Hamzah Asimah , Yao Yi Ju , Moy Hooi Yan
Published: April 2024

Urinalysis of lysergic acid diethylamide (LSD) poses a challenge due to its rapid metabolism, resulting in little to no LSD detectable in urine. Instead, its primary metabolite, 2-oxo-3-hydroxy-LSD, is predominantly detected. In this study, we observed several urine profiles with iso-LSD detected together with 2-oxo-3-hydroxy-LSD. Iso-LSD is derived from illicit preparation of LSD as a major contaminant, and it was detected at higher abundance than LSD and 2-oxo-3-hydroxy-LSD in certain urine samples. Therefore, the metabolism of iso-LSD and its potential as a viable urinary biomarker for confirming LSD consumption is of interest. For metabolism studies, LSD and iso-LSD were incubated in human liver microsomes (HLMs) at 0 min, 60 min and 120 min to characterize their metabolites using LC–QTOF-MS. For urinary analysis, 500 µL of urine samples underwent enzymatic hydrolysis and clean-up using supported-liquid extraction (SLE) prior to analysis by LC–QTOF-MS. From HLM incubation study of LSD, the metabolites detected were dihydroxy-LSD, 2-oxo-LSD, N-desmethyl-LSD (nor-LSD) and 2-oxo-3-hydroxy-LSD with LSD levels decreasing significantly throughout all time points, consistent with the existing literatures. For HLM study of iso-LSD, metabolites eluting at retention times after the corresponding metabolites of LSD were detected, with iso-LSD levels showing only a slight decrease throughout all time points, due to a slower metabolism of iso-LSD compared to LSD. These findings corroborate with the urinalysis of 24 authentic urine samples, where iso-LSD with 2-oxo-3-hydroxy-LSD was detected in the absence of LSD. Based on our findings, iso-LSD is commonly detected in urine (18 out of 24 samples) sometimes with traces of possible 2-oxo-3-hydroxy-iso-LSD. The slower metabolism and high detection rate in urine make iso-LSD a viable urinary biomarker for confirming LSD consumption, especially in the absence of LSD and/or 2-oxo-3-hydroxy-LSD.
Driving under the influence of cocaine and MDMA: Relationship between blood concentrations and results from clinical test of impairment
Authors: Heide Gunhild , Jamt Ragnhild Elén Gjulem , Fainberg-Sandbu Jonas , Øiestad Åse Marit Leere , Høiseth Gudrun
Published: April 2024

The general use of cocaine is increasing in recent years, while the trend for 3,4-methylenedioxymethamphetamine (MDMA) is less clear. The relationship between blood concentrations and impairment is poorly understood, which complicates interpretation. The aims of this study were to report prevalence and blood concentrations of cocaine and MDMA in drugged drivers, and to investigate the relationship between blood concentrations and impairment. Samples of whole blood were collected from apprehended drivers in the period 2000–2022, and a clinical test of impairment (CTI) was simultaneously performed. The samples were initially analyzed for cocaine and MDMA using gas chromatography–mass spectrometry (until 2009 and 2012, respectively), and later using ultra-high-performance liquid chromatography–tandem mass spectrometry. Overall, cocaine was detected in 2,331 cases and MDMA in 2,569 cases. There were 377 and 85 mono cases of cocaine and MDMA, respectively. In the mono cases, the median cocaine concentration was 0.09 mg/L (range: 0.02–1.15 mg/L), and 54% of the drivers were clinically impaired. The median MDMA concentration was 0.19 mg/L (range: 0.04–1.36 mg/L), and 38% were clinically impaired. There was a statistically significant difference in the median cocaine concentration between drivers assessed as not impaired (0.07 mg/L) and drivers assessed as impaired (0.10 mg/L) (P = 0.009). There was also a significant effect of the blood concentration of cocaine (adjusted odds ratio [aOR] = 6.42, 95% confidence interval [CI] = 1.13–36.53, P = 0.036) and driving during the evening/night-time (aOR = 2.17, 95% CI = 1.34–3.51, P = 0.002) on the probability of being assessed as impaired on the CTI. No significant differences were found for MDMA. Many drivers are not assessed as impaired on a CTI following cocaine or especially MDMA use. For cocaine, a relationship between blood concentrations and impairment was demonstrated, but this could not be shown for MDMA.
Chiral analysis of amphetamine, methamphetamine, MDMA and MDA enantiomers in human hair samples
Authors: Bickel Julian , Szewczyk Anne , Aboutara Nadine , Jungen Hilke , Müller Alexander , Ondruschka Benjamin , Iwersen-Bergmann Stefanie
Published: April 2024

A novel analytical method was developed for the simultaneous quantification of the R/S-enantiomers of amphetamine, methamphetamine, MDA and MDMA in hair samples using liquid chromatography-tandem mass spectrometry (LC–MS-MS). This method involved a straightforward derivatization step with dansyl chloride and the use of a chiral column, enabling the separation and quantification of all eight enantiomers in a single analysis. The method exhibited excellent linearity across a concentration range of 0.03–3.00 ng/mg for each enantiomer. Precision and accuracy were within acceptable limits, with bias and relative standard deviation (RSD) values consistently below 6% and 9%, respectively. Selectivity and specificity assessments confirmed the absence of any interference from contaminants or co-extracted drugs. The method demonstrated high sensitivity, with limits of detection (LOD) below 8 pg/mg and limits of quantification (LOQ) below 19 pg/mg for all analytes. Extraction recovery exceeded 79%, and matrix effects were minimal for all analytes. Processed sample stability evaluations revealed consistent results with deviations below 11% for all analytes. Application of the method to 32 authentic human hair samples provided valuable insights into amphetamine use patterns, allowing differentiation between medical amphetamine consumption and illicit use based on enantiomeric composition. Additionally, the method detected co-use of methamphetamine, MDA or MDMA in some samples, highlighting its applicability in drug monitoring and real-life case scenarios within a forensic institute. This innovative analytical approach offers a sensitive and selective method for enantiomeric differentiation of amphetamine, methamphetamine, MDA and MDMA in human hair samples, providing a valuable tool for forensic and clinical investigations.
Distance to Burn Center Does Not Impact Long-term Anxiety and Depression Risk Following Burn Injury
Authors: Risinger William B , Dye Crystal N , Thompson Spencer K , Uma Chinweotuto V , Keeven David D , Nash Nicholas A , Smith Jason W , Bozeman Matthew C
Published: April 2024

Burn injury predisposes patients to significant psychological morbidity, including anxiety, depression, and posttraumatic stress. Adding to the burden of injury, patients often require transfer to specialized burn centers located far from home. We hypothesized that greater distances between a patient’s home address and the treating burn center would increase the rate of postinjury anxiety and depression. From January 2021 to June 2023, patients who were admitted to our American Burn Association verified center and seen for posthospitalization follow-up were identified. Demographics, burn characteristics, and follow-up anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-2) screening scores were reviewed. Comparisons between patients with positive and negative screens were performed using univariate analysis followed by logistic regression. Linear regression was used to evaluate the relationship between distance to the burn center and incremental screening scores. Of the 272 patients identified, 35.6% and 27.9% screened positive for anxiety and depression, respectively. The distance to burn center was not greater among patients with positive screens. Likewise, no statistically significant linear relationship was found between distance to the burn center and incremental screening scores. Morphine milligram equivalents on the last day of hospitalization (P = .04) and a prior psychiatric history (P < .001) all predicted postinjury anxiety. Total body surface area burned (P = .02) and a prior psychiatric history (P = .02) predicted postinjury depression. The distance between a patient’s home and the treating burn center does not alter anxiety and depression rates following burn injury, further supporting the transfer of patients to specialized centers.
The Burden of Burns: An Analysis of Public Health Measures
Authors: Ivanko Anastasiya , Garbuzov Anna E , Schoen Jonathan E , Kearns Randy , Phillips Bart , Murata Erica , Danos Denise , Phelan Herb A , Carter Jeffrey E
Published: April 2024

Accurate analysis of injuries is paramount when allocating resources for prevention, research, education, and legislation. As burn mortality has improved over recent decades, the societal burden of burn injuries has grown ambiguous to the public while a scarcity of investigational funding for survivors has led to a gap in understanding lifelong sequela. We aim to compare national references reporting the incidence of burn injuries in the United States. The American Burn Association Burn Injury Summary Report (ABA-BISR), American Burn Association Fact Sheet, Centers for Disease Control and Prevention (CDC) Web-based Injury Statistics Query and Reporting (WISQARS) database, the CDC National Center for Health Statistics’ National Hospital Ambulatory Medical Care Survey (NHAMCS), National Inpatient Sample (NIS), National Emergency Department Sample (NEDS), and commercially available claims databases were queried for 2020 or the most recent data available. The BISR estimated 30,135 burn admissions in 2022. The 2016 ABA Fact Sheet reported 486,000 burns presented to US emergency departments (ED). In 2020, CDC’s WISQARS database reported 3,529 fatal, and 287,926 non-fatal, burn injuries. The 2020 NEDS reported 438,185 ED visits while the 2020 NIS estimated 103,235 inpatients. The NHAMCS reported 359,000 ED visits for burn injuries in the same period, and an analysis of ICD-10 burn codes demonstrated over 698,555 claims. Our study demonstrates a large variability in the reported incidence of burn injury by the ABA, CDC, national samples, and claims databases. Per our analyses, we estimate that 600,000 individuals annually suffer a burn injury which merits emergent care in the United States.
Review of Breast Imaging in Transgender and Gender-Diverse Patients: Gender-Affirming Care, Histopathologic Findings, Breast Cancer Risk, and Screening Recommendations
Authors: Chowdhury Ajmain , Saad Eddin Assim , Kim Hsieh Su , Policeni Fabiana C
Published: April 2024

Gender diversity, especially pertaining to transgender and gender-diverse (TGD) populations, is often stigmatized. A small but not insignificant number of adults in the United States identify as TGD, including transgender, nonbinary, and other gender identities than cisgender. Accessing health care remains a significant challenge for TGD individuals because many health care systems adhere to a gender binary model and many TGD individuals experience negative interactions when interfacing with health care. There is also a scarcity of literature addressing their unique health care needs, limiting our current understanding of breast cancer risks and screening recommendations for TGD patients. This article reviews important considerations when providing care to TGD patients. It covers background information on gender identity and sexuality, explores gender-affirming care, discusses histopathologic findings of breast biopsy specimens, examines breast cancer risks, and presents current breast cancer screening recommendations for TGD patients. Education on TGD breast cancer risks and screening and creating a standardized screening protocol for TGD patients who may receive gender-affirming care through hormonal and surgical therapies could help improve their health care equity and access.
An Emergency Department-based system intervention to improve osteoporosis screening for older adults at high-risk of fracture
Authors: Jackson Lesley E , Skains Rachel M , Mudano Amy , Techarukpong Norma , Booth James S , Saag Kenneth G , Fraenkel Liana , Danila Maria I
Published: April 2024

Falls and osteoporosis are risk factors for fragility fractures. Bone mineral density (BMD) assessment is associated with better preventative osteoporosis care, but it is underutilized by those at high fracture risk. We created a novel electronic medical record (EMR) alert-driven protocol to screen patients in the Emergency Department (ED) for fracture risk and tested its feasibility and effectiveness in generating and completing referrals for outpatient BMD testing after discharge. The EMR alert was configured in 2 tertiary-care EDs and triggered by the term “fall” in the chief complaint, age (≥65 years for women, ≥70 years for men), and high fall risk (Morse score ≥ 45). The alert electronically notified ED study staff of potentially eligible patients. Participants received osteoporosis screening education and had BMD testing ordered. From November 15, 2020 to December 4, 2021, there were 2,608 EMR alerts among 2,509 patients. We identified 558 patients at high-risk of fracture who were screened for BMD testing referral. Participants were excluded for: serious illness (N = 141), no documented health insurance to cover BMD testing (N = 97), prior BMD testing/recent osteoporosis care (N = 58), research assistant unavailable to enroll (N = 53), concomitant fracture (N = 43), bedridden status (N = 38), chief complaint of fall documented in error (N = 38), long-term care residence (N = 34), participation refusal (N = 32), or hospitalization (N = 3). Of the 16 participants who had BMD testing ordered, 7 scheduled and 5 completed BMD testing. EMR alerts can help identify subpopulations who may benefit from osteoporosis screening, but there are significant barriers to identifying eligible and willing patients for screening in the ED. In our study targeting an innovative venue for osteoporosis care delivery, only about 1% of patients at high-risk of fracture scheduled BMD testing after an ED visit. Adequate resources during and after an ED visit are needed to ensure that older adults participate in preventative osteoporosis care.
Surgical and radiological perspectives for the spinal accessory nerve passing through a fenestrated internal jugular vein: case series and literature review
Authors: Guarino Pierre , Tesauro Paolo , Giordano Leone , Caporale Claudio Donadio , Presutti Livio , Mattioli Francesco
Published: April 2024

The preservation of the spinal accessory nerve represents a key goal in head and neck oncologic surgery during selective neck dissection. This study aims to illustrate the anatomical variants of the XI cranial nerve, delving into the relationship between the spinal nerve and the internal jugular vein, as well as the surgical implications. Two cases of patients who underwent oncologic surgery with neck dissection are described. Both cases found the spinal accessory nerve passing through the fenestration of the internal jugular vein. Alongside this case series, an independent literature review was conducted using the Medline and PubMed databases. In the majority of cases (67% – 96%), the spinal accessory nerve traces a lateral course to the internal jugular vein. Less frequently, the XI cranial nerve courses medial to the internal jugular vein. More rarely, as described in this case series, the nerve crosses through the fenestration of the vein (0.48% – 3.3%).
A case of possible transfusion-acquired malaria in Zaragoza, Spain
Authors: Beltrán-Rosel Antonio , Ligero-López Jorge , Domingo-Morera José María , López-Alonso Beatriz , Ferreira-Ferreira Ingrid , Boquera-Albert Amparo , Rubio-Muñoz José Miguel
Published: April 2024

We present the case of a 75-year-old patient diagnosed with malaria, a native of Zaragoza, Spain, despite having no travel history to malaria-endemic regions. Following an extensive investigation, transfusion emerged as the most probable mode of transmission.
Residual water losses mediate the trade-off between growth and drought survival across saplings of 12 tropical rainforest tree species with contrasting hydraulic strategies
Authors: Ziegler Camille , Cochard Hervé , Stahl Clément , Foltzer Louis , Gérard Bastien , Goret Jean-Yves , Heuret Patrick , Levionnois Sébastien , Maillard Pascale , Bonal Damien , Coste Sabrina
Published: April 2024

Knowledge of the physiological mechanisms underlying species vulnerability to drought is critical for better understanding patterns of tree mortality. Investigating plant adaptive strategies to drought should thus help to fill this knowledge gap, especially in tropical rainforests exhibiting high functional diversity. In a semi-controlled drought experiment using 12 rainforest tree species, we investigated the diversity in hydraulic strategies and whether they determined the ability of saplings to use stored non-structural carbohydrates during an extreme imposed drought. We further explored the importance of water- and carbon-use strategies in relation to drought survival through a modelling approach. Hydraulic strategies varied considerably across species with a continuum between dehydration tolerance and avoidance. During dehydration leading to hydraulic failure and irrespective of hydraulic strategies, species showed strong declines in whole-plant starch concentrations and maintenance, or even increases in soluble sugar concentrations, potentially favouring osmotic adjustments. Residual water losses mediated the trade-off between time to hydraulic failure and growth, indicating that dehydration avoidance is an effective drought-survival strategy linked to the ‘fast–slow’ continuum of plant performance at the sapling stage. Further investigations on residual water losses may be key to understanding the response of tropical rainforest tree communities to climate change.
Military Blood Supply and Distribution in USCENTCOM
Authors: Hall Andrew , Olsen Cara , Comes Ryan , McDaniel Steven , Carrillo Michael , Wilson Ramey , Hanson Matthew
Published: April 2024

In expeditionary environments, the consistent availability of blood for casualty care is imperative yet challenging. Responding to evidence and the specific needs of its expeditionary context, the US Central Command (USCENTCOM) prioritized supplying stored low titer O whole blood (LTOWB) to its units from March, 2023 onward. A strategy was devised to set minimal LTOWB on-hand supply benchmarks, determined by the number of operating beds and point of injury teams. This transition led to a 54% reduction in orders for packed red blood cells. As a countermove, the Armed Services Blood Program (ASBP) enhanced LTOWB production at a conversion rate 2:1 from packed red blood cell to LTOWB. Consequently, there was a decline in expired blood products, and fulfillment rates for blood requests are projected to reach 100% consistently. This paper delves into the intricacies of the expeditionary blood supply, the rationale behind the LTOWB transition, the devised allocation strategy, and the subsequent impacts of this change.
Emergency Department Use Among Combat and Non-Combat Post-9/11 Military Veterans
Authors: Carvalho Christopher J , Dalton Aaron L , Boothroyd Derek , Urech Tracy H , Vashi Anita A
Published: April 2024

Introduction

Most post-9/11 Veterans have completed at least 1 combat deployment—a known factor associated with adverse health outcomes. Such Veterans are known to have unmet health care needs, and the emergency department (ED) may serve as a safety net, yet little is known about whether combat status is associated with more frequent ED use. We sought to evaluate the relationship between combat status and frequency of ED use among post-9/11 Veterans and assess the most common reasons for ED visits.

Materials and Methods

This retrospective cohort study consisted of post-9/11 Veterans who enrolled in U.S. Department of Veterans Affairs (VA) care between fiscal years (FYs) 2005 and 2015. Data were obtained from the VA Corporate Data Warehouse. Incidence rates for ED visits for combat and non-combat Veterans were compared from FY 2010 to 2019 using zero-inflated negative binomial regression. The most frequent reasons for ED visits were determined using International Classification of Diseases codes. This study was approved by the Stanford Institutional Review Board.

Results

Among 1.3 million Veterans included in analyses, 70.4% had deployed to a combat zone. The mean (SD) age of our cohort was 32.6 (5.0) years and 83.5% of Veterans were male. After controlling for other factors, combat Veterans had 1.84 times the rate of ED visits compared to non-combat Veterans (95% CI, 1.83-1.85). Only combat Veterans had a mental health-related ED visit (suicidal ideations) among the top 3 reasons for ED presentation.

Conclusions

Those who deployed to a combat zone had a significantly higher rate of ED use compared to those who did not. Further, mental health-related ED diagnoses appeared to be more prevalent in combat Veterans. These findings highlight the unique health care needs faced by combat Veterans and emphasize the importance of tailored interventions and support services for this specific population.
On the origin of globular clusters in a hierarchical universe
Authors: De Lucia Gabriella , Kruijssen J M Diederik , Trujillo-Gomez Sebastian , Hirschmann Michaela , Xie Lizhi
Published: April 2024

We present an end-to-end description of the formation of globular clusters (GCs) combining a treatment for their formation and dynamical evolution within galaxy haloes with a state-of-the-art semi-analytic simulation of galaxy formation. Our approach allows us to obtain exquisite statistics to study the effect of the environment and assembly history of galaxies, while still allowing a very efficient exploration of the parameter space. Our reference model, including both efficient cluster disruption during galaxy mergers and dynamical friction of GCs within the galactic potential, accurately reproduces the observed correlation between the total mass in GCs and the parent halo mass. A deviation from linearity is predicted at low-halo masses, which is driven by a strong dependence on morphological type: bulge-dominated galaxies tend to host larger masses of GCs than their later-type counterparts. While the significance of the difference might be affected by resolution at the lowest halo masses considered, this is a robust prediction of our model and a natural consequence of the assumption that cluster migration into the halo is triggered by galaxy mergers. Our model requires an environmental dependence of GC radii to reproduce the observed low-mass mass distribution of GCs in our Galaxy. At GC masses $\gt 10^6\, {\rm M}_\odot$, our model predicts fewer GCs than observed, due to an overly aggressive treatment of dynamical friction. Our model reproduces well the metallicity distribution measured for Galactic GCs, even though we predict systematically younger GCs than observed. We argue that this adds further evidence for an anomalously early formation of the stars in our Galaxy.