bluuebunny/crossref_metadata_2025 huggingface dataset:
La hiérarchisation des priorités d’autogestion à l’adolescence dans le cadre de la polypathologie allergique : une étude qualitative exploratoire
Authors: Brégeon Aurore , Cifuentes Flor , Lombart Bénédicte , Wanin Stéphanie , Gagnayre Rémi , Morsa Maxime
Published: December 2023

Introduction : La polypathologie entraîne une priorisation accrue des modalités d’autogestion. Si le phénomène est théorisé chez les adultes, l’influence des particularités de l’adolescence dans la hiérarchisation des priorités reste inconnue. Objectifs : Notre recherche, contextualisée aux maladies atopiques, vise à explorer les facteurs influençant la priorisation de comportements favorables à la santé chez les adolescents. Méthode : 15 adolescents ont participé à un entretien individuel semi-directif puis cinq d’entre eux à un focus groupe. L’analyse des résultats a été réalisée à partir d’un construit théorique convoquant le Health Belief Model de Rosenstock & Becker et le modèle du sens commun de Leventhal. Résultats : Les principaux facteurs influençant la priorisation semblent être l’ampleur de la menace perçue et la qualité de l’environnement social. À distance d’une anaphylaxie ou d’un passage en réanimation, l’impact des pathologies dans la vie devient un facteur très influant. Discussion : L’exploration des facteurs de priorisation relevés dans la littérature chez les adultes semble pouvoir s’appliquer aux adolescents, leurs comportements s’en rapprochant. La nature des pathologies allergiques rend probablement davantage compte des différences observées que la période de l’adolescence. Conclusion : Le construit théorique, la puissance des facteurs dans la priorisation et leurs interactions reste à valider.
Die iliakale Endofibrose im Hochleistungssport - eine diagnostische interdisziplinäre Herausforderung
Authors: Regus Susanne , Schoeffl Isabelle , Knetsch Joachim , Schoeffl Volker , Haase Konstantin
Published: December 2023

Hintergrund Die iliakale Endofibrose (IE) ist eine seltene arterielle Erkrankung bei Ausdauerathleten, insbesondere Radrennfahrern und Triathleten. Die Diagnostik gilt als Herausforderung, die Latenz vom Beginn erster Symptome bis zur Diagnosestellung beträgt oft mehrere Jahre. An diagnostischen Möglichkeiten sind die Bestimmung des Knöchel-Arm-Dopplerindex (ankle brachial index, ABI) nach maximaler Belastung als ein nicht invasives Verfahren sowie die Duplexsonografie, Schichtbildgebung und die invasive Angiografie zu nennen. Ziel dieser Arbeit ist es, diese zeitliche Verzögerung bis zur korrekten Diagnosestellung seit Erstbeschreibung im Jahr 1985 bis zum Jahr 2021 genauer zu analysieren sowie die wichtigsten diagnostischen Mittel für die Praxis herauszuarbeiten.

Methode Durchführung einer Literaturrecherche gemäß den PRISMA-Kriterien in den Datenbanken PubMed, Web of Science und Cochrane, ergänzt durch eine Suche in Google Scholar bis zum 18.10.2021.

Ergebnisse Es wurden 133 Publikationen identifiziert, die sich thematisch mit der IE bei Ausdauersportlern beschäftigten. In 42 Publikationen (40 Fallberichte und 2 klinische Studien) wurde die Diagnose intraoperativ bestätigt, in 32 (32/43; 74,4%) wurden Aussagen über die Dauer vom Auftreten der ersten Symptome bis zur Diagnosestellung gemacht (Mittelwert 45, Median 36 Monate). Diese Latenz war über den gesamten Beobachtungszeitraum von 1985–2021 konstant, ohne Trend zur Verkürzung. In 24 Arbeiten (24/43; 56%) wurde detailliert über Ergebnisse der ABI-Bestimmung sowie der weiterführenden Diagnostik berichtet. In allen Fällen kam es zu einem Abfall des ABI- Wertes auf weniger als 0,66 (in 5 Fallberichten bereits in Ruhe, in 19 nach Belastung), wohingegen die weiterführende Diagnostik mittels Duplexsonografie, DSA, MRA oder CTA in 3 Fällen (3/24; 12,5%) keinen auffälligen Befund ergab und in 14 Fällen (14/24; 58,3%) eine allenfalls geringgradige Stenosierung zeigte.

Schlussfolgerung Ein Abfall des ABI nach Belastung ist die zuverlässigste Methode, um die iliakale Endofibrose zu diagnostizieren. Es empfiehlt sich, diese nicht invasive und einfach durchführbare Untersuchung in die Leistungsdiagnostik gefährdeter hochambitionierter Ausdauerathleten zu integrieren, um im Idealfall durch eine frühzeitige Diagnosestellung irreversible Gefäßwandschäden zu verhindern sowie die vermutete hohe Dunkelziffer an unerkannten Fällen zu reduzieren.
Osteoporose Update
Authors: Thomasius Friederike
Published: December 2023

Im Osteoporose Update wird auf relevante, aktuelle, d. h. mit Fokus auf
in den letzten 6 Monaten publizierten Paper, eingegangen, die in Zusammenhang
mit Empfehlungen der Leitlinie gestellt werden. Nun ist im September die
überarbeitete Leitlinie 2023 zur Prophylaxe, Diagnostik und Therapie der
Osteoporose bei postmenopausalen Frauen und bei Männern ab dem
50.Lebensjahr veröffentlicht worden [1], sodass sich dieses Leitlinien
Update mit den wesentlichen Neuerungen der komplett überarbeiteten
Leitlinie 2023 im Vergleich zur Leitlinie 2017 beschäftigt.
Langkettige Omega-3-Fettsäuren EPA und DHA
Authors: Bayer Wolfgang , Mahler Annette , Schmidt Karlheinz , Willmann Matthias
Published: December 2023

Eine Supplementierung mit den langkettigen Omega-3-Fettsäuren
Eicosapentaensäure (EPA) und Docosahexaensäure (DHA)
könnte sich bei vielen Erkrankungen positiv auswirken oder in der
Primärprävention günstig sein. Zur Verordnung bzw. bei
der Beratung der Patienten empfiehlt es sich, den Fettsäurestatus
festzustellen und die Erfolge der Substitution zu kontrollieren.
Biochemische Marker des Knochenstoffwechsels im Blickwinkel
knochenrelevanter Erkrankungen
Authors: Dimai Hans Peter , Obermayer-Pietsch Barbara
Published: December 2023

Das knöcherne Skelett unterliegt zeitlebens einem intensiven Umbau,
welcher sich unter anderem laborchemisch durch Messung von im Blut
zirkulierenden Substraten des Knochenanbaus und Knochenabbaus quantifizieren
lässt. Diese Substrate werden in ihrer Gesamtheit häufig unter
dem Begriff „Knochenumbauparameter“ oder „biochemische
Marker des Knochenumsatzes“ zusammengefasst. Sie können direkt
dem Stoffwechsel knochenspezifischer Zellen entstammen, wie etwa die Alkalische
Phosphatase (ALP), das Osteocalcin (OC) oder die Tartrat-resistente saure
Phosphatase (TRAP), oder im Rahmen des Knochenabbaus aus der organischen
Knochenmatrix freigesetzt werden, wie zum Beispiel das C-terminale oder
N-terminale Telopeptid des Typ-1 Kollagens (CTX, NTX). Für eine
erhebliche Anzahl unterschiedlicher Erkrankungen konnte in den vergangenen
Jahren und Jahrzehnten ein Effekt auf den Knochenstoffwechsel, und somit auf die
entsprechenden Knochenumbauparameter, nachgewiesen werden. Hierbei stehen
Erkrankungen, welche eine Beschleunigung des Knochenumsatzes bewirken jenen
gegenüber, welche zu einer Verlangsamung desselben führen. Die
Messung von Knochenumbauparametern im Blut und somit die Information
über das Ausmaß des Knochenumbaus können
unterstützend für therapeutische Maßnahmen herangezogen
werden. Die diagnostische Bedeutung oder der diagnostische Mehrwert der
Knochenumbauparameter bleiben hierbei allerdings auf einige wenige Ausnahmen
beschränkt.
Relativistic ultrafast electron diffraction at high repetition rates
Authors: Siddiqui K. M. , Durham D. B. , Cropp F. , Ji F. , Paiagua S. , Ophus C. , Andresen N. C. , Jin L. , Wu J. , Wang S. , Zhang X. , You W. , Murnane M. , Centurion M. , Wang X. , Slaughter D. S. , Kaindl R. A. , Musumeci P. , Minor A. M. , Filippetto D.
Published: December 2023

The ability to resolve the dynamics of matter on its native temporal and spatial scales constitutes a key challenge and convergent theme across chemistry, biology, and materials science. The last couple of decades have witnessed ultrafast electron diffraction (UED) emerge as one of the forefront techniques with the sensitivity to resolve atomic motions. Increasingly sophisticated UED instruments are being developed that are aimed at increasing the beam brightness in order to observe structural signatures, but so far they have been limited to low average current beams. Here, we present the technical design and capabilities of the HiRES (High Repetition-rate Electron Scattering) instrument, which blends relativistic electrons and high repetition rates to achieve orders of magnitude improvement in average beam current compared to the existing state-of-the-art instruments. The setup utilizes a novel electron source to deliver femtosecond duration electron pulses at up to MHz repetition rates for UED experiments. Instrument response function of sub-500 fs is demonstrated with < 100 fs time resolution targeted in future. We provide example cases of diffraction measurements on solid-state and gas-phase samples, including both micro- and nanodiffraction (featuring 100 nm beam size) modes, which showcase the potential of the instrument for novel UED experiments.
How neural networks learn to classify chaotic time series
Authors: Corbetta Alessandro , de Jong Thomas Geert
Published: December 2023

We tackle the outstanding issue of analyzing the inner workings of neural networks trained to classify regular-vs-chaotic time series. This setting, well-studied in dynamical systems, enables thorough formal analyses. We focus specifically on a family of networks dubbed large Kernel convolutional neural networks (LKCNNs), recently introduced by Boullé et al. [403, 132261 (2021)]. These non-recursive networks have been shown to outperform other established architectures (e.g., residual networks, shallow neural networks, and fully convolutional networks) at this classification task. Furthermore, they outperform “manual” classification approaches based on direct reconstruction of the Lyapunov exponent. We find that LKCNNs use qualitative properties of the input sequence. We show that LKCNN models trained from random weight initialization, end in two most common performance groups: one with relatively low performance (0.72 average classification accuracy) and one with high classification performance (0.94 average classification accuracy). Notably, the models in the low performance class display periodic activations that are qualitatively similar to those exhibited by LKCNNs with random weights. This could give very general criteria for identifying, a priori, trained weights that yield poor accuracy.
Families of non-tiling domains satisfying Pólya’s conjecture
Authors: Freitas P. , Salavessa I.
Published: December 2023

We show the existence of classes of non-tiling domains satisfying Pólya’s conjecture in any dimension, in both the Euclidean and non-Euclidean cases. This is a consequence of a more general observation asserting that if a domain satisfies Pólya’s conjecture eventually, that is, for a sufficiently large order of the eigenvalues, and may be partioned into p non-overlapping isometric sub-domains, with p arbitrarily large, then there exists an order p0 such that for p larger than p0 all such sub-domains satisfy Pólya’s conjecture. In particular, this allows us to show that families of sectors of domains of revolution with analytic boundary, and thin cylinders satisfy Pólya’s conjecture, for instance. We also improve upon the Li–Yau constant for general cylinders in the Dirichlet case.
Direct creation of interacting quasi-one-dimensional Bose–Einstein condensate through fast evaporative cooling
Authors: Du Huiying , Li Yuqing , Wang Yunfei , Wu Jizhou , Liu Wenliang , Li Peng , Fu Yongming , Ma Jie , Xiao Liantuan , Jia Suotang
Published: December 2023

Preparation of atomic Bose–Einstein condensate (BEC) with tunable interactions in a quasi-one-dimensional (quasi-1D) optical trap is essential for both the observation of bright matter-wave solitons and the quantum simulation based on the discrete atomic momentum states. However, the quasi-1D BEC has been obtained by a complex process, which includes the creation of a three-dimensional BEC and its adiabatic transform into a quasi-1D trap. Here, we report the direct creation of a quasi-1D BEC of 133Cs atoms by the fast evaporative cooling of ultracold atoms prepared by the degenerated Raman sideband cooling. We produce the pure BEC of up to 5.5×104 atoms in a quasi-1D optical trap with an evaporative time of 6 s. We demonstrate the anisotropic expansion of the atomic cloud after the release from the quasi-1D trap and study the dependence of both the phase space density and the temperature on the number of atoms in the trap during the evaporative cooling. Our study facilitates the promising applications of quasi-1D interacting atomic gases.
Planetary influences on the solar cycle: A nonlinear dynamics approach
Authors: Muñoz Juan M. , Wagemakers Alexandre , Sanjuán Miguel A. F.
Published: December 2023

We explore the effect of some simple perturbations on three nonlinear models proposed to describe large-scale solar behavior via the solar dynamo theory: the Lorenz and Rikitake systems and a Van der Pol–Duffing oscillator. Planetary magnetic fields affecting the solar dynamo activity have been simulated by using harmonic perturbations. These perturbations introduce cycle intermittency and amplitude irregularities revealed by the frequency spectra of the nonlinear signals. Furthermore, we have found that the perturbative intensity acts as an order parameter in the correlations between the system and the external forcing. Our findings suggest a promising avenue to study the sunspot activity by using nonlinear dynamics methods.
Motion of a two-dimensional neutrally buoyant circular particle in two-sided lid-driven cavity flow with thermal convection
Authors: Zhang Yunxin , Li Chenggong , Ye Mao
Published: December 2023

Understanding the interaction between a cold particle and confined fluid flow is of practical importance in many industrial applications. In this work, the motion of a two-dimensional circular neutrally buoyant particle in thermal flows in the two-sided lid-driven cavity has been numerically investigated by the lattice Boltzmann model with immersed boundary method. We examined the effects of Grashof number (Gr) and Reynolds number (Re) of cavity on the motion of particle in the range of 104 ≤ Gr ≤ 107 and 500 ≤ Re ≤ 3000. It is found that the motion of the cold particle in the cavity flow manifests four different modes, driven by the competition between buoyancy-driven natural convection and lid-driven forced convection. With the increase in Gr or the decrease in Re, the motion of the cold particle would evolve from modes I to IV. We further obtained the diagram of motion modes of the cold particle with regard to Gr and Re. And a power law correlation that relates the critical Gr to Re of the cavity is proposed and capable of well predicting the transition of particle motion modes.
Modulating the ferromagnetism of Fe3GeTe2 with 3d transition metal adsorption and strain-engineering
Authors: Yuan Miaojia , Lei Zesen , Zhao Lei , Tan Ruishan , Guo Meng , Jing Tao , Sun Qilong
Published: December 2023

Two-dimensional ferromagnetic materials hold great promise to develop energy-efficient magnetoelectric memory devices and next-generation spintronics. However, one of the crucial challenges for these materials is the realization of tunable magnetocrystalline anisotropy (MCA) to balance thermal stability and energy efficiency. Here, we systematically study the adsorption effects of 3d transition metals (3d-TMs) on the electronic structure and magnetic property of the Fe3GeTe2 (FGT) monolayer. The adsorption systems exhibit different ground state configurations depending on the adatoms, while the controlled perpendicular magnetic anisotropy has also been achieved. Notably, the Mn/FGT system can maintain the out-of-plane magnetic orientation with a changing amplitude of MCA energy up to 3.057 erg/cm2 as the external strain varies from −4% to 1%. In contrast, the Fe/FGT structure undergoes spin reorientation from in-plane to out-of-plan magnetization with a distinct modification behavior of MCA. We elucidate that the underlying atomistic mechanism mainly arises from the alteration of Fe-derived 3d-orbital states in response to the strain effect, leading to competitive changes in the different coupling states. These findings can not only provide useful guidance to optimize two-dimensional magnets for fundamental research but also reveal the promising potential of TMs/FGT materials for the development of ultra-low energy spintronic devices.
Mechanical properties of cubic boron nitride and diamond at dynamical pressure and temperature
Authors: Kastuar Srihari M. , Liu Zhong-Li , Najmaei Sina , Ekuma Chinedu E.
Published: December 2023

We report the mechanical properties of cubic boron nitride (c-BN) and diamond under the combined impact of dynamical pressure and temperature, calculated using ab initio molecular dynamics. Our study revealed a pronounced sensitivity of the mechanical properties of c-BN to applied pressure. Notably, c-BN undergoes a brittle-to-ductile transition at ∼220 GPa, consistent across various dynamical temperatures, while diamond exhibits no such transition. Furthermore, the Vickers hardness profile for c-BN closely mirrors that of diamond across a spectrum of temperature–pressure conditions, highlighting c-BN's significant mechanical robustness. These results underscore the superior resilience and adaptability of c-BN compared to diamond, suggesting its potential as an ideal candidate for applications in extreme environments.
Flexural wave illusion on a curved plate
Authors: Zhao Pengfei , Luo Liyou , Liu Yongquan , Li Jensen
Published: December 2023

Manipulating elastic waves using a transformation approach is challenging due to the complex constitutive relationship. However, for flexural waves, approximated as scalar waves, two straightforward approaches emerge based on geometric curvature and plate thickness. Here, we develop transformation theory to establish equivalence between curved plates of different shapes and thickness profiles. Introducing tailor-made thickness profiles on a given curved shape enables illusion effects, where flexural waves propagate as if on a flat plate or on another curved plate with a totally different configuration. Numerical simulations and experimental field mapping confirm the effectiveness of these illusions. Our approach to flexural wave illusion finds applications in structural designs with material and shape constraints and holds the potential for absorption or vibration control, wavefront shaping, chaotic dynamics, and topology control.
Annealing temperature dependence of the bulk spin–orbit torque in CoPt film
Authors: Liang Mengfan , Song Yan , Yuan Junjie , Chen Haoran , Chen Jianhui , Che Renchao , Zhang Jincang , Wu Yizheng , Luo Yongming , Wang Ningning
Published: December 2023

The recent discovery of bulk spin–orbit torques (SOTs) in magnetic single layers has attracted much recent attention. However, currently, it remains elusive as to how to understand and how to tune such bulk SOTs. In this study, we study the tunability of the bulk SOTs in the CoPt films, by the annealing temperature. Our results show that the field-free switching can be realized after annealing and optimized at 450 °C. The switching performance is consistent with the out-of-plane SOT efficiency, which also appears after annealing and maximized at 450 °C. The crystal-axis dependence of the switching performance reveals that besides the threefold modulation by the crystal-axis, the switching ratio also contains a contribution that is independent of the crystal-axis, which is different from that in single-crystal films. Our results can help the understanding of the mechanism of SOT and point to the developing of SOT devices.
Manipulation of hot-carrier cooling dynamics in CsPbBr3 quantum dots via site-selective ligand engineering
Authors: Li Hui , Zhang Jiachen , Zhang Qun
Published: December 2023

Prolonging the lifetime of photoinduced hot carriers in lead–halide perovskite quantum dots (QDs) is highly desirable because it can help improve the photovoltaic conversion efficiency. Ligand engineering has recently become a promising strategy to achieve this; nevertheless, mechanistic studies in this field remain limited. Herein, we propose a new scenario of ligand engineering featuring Pb2+/Br− site-selective capping on the surface of CsPbBr3 QDs. Through joint observations of temperature-dependent photoluminescence, ultrafast transient absorption, and Raman spectroscopy of the two contrasting model systems of CsPbBr3 QDs (i.e., capping with organic ligand only vs hybrid organic/inorganic ligands), we reveal that the phononic regulation of Pb–Br stretching at the Br-site (relative to Pb-site) leads to a larger suppression of charge–phonon coupling due to a stronger polaronic screening effect, thereby more effectively retarding the hot-carrier cooling process. This work opens a new route for the manipulation of hot-carrier cooling dynamics in perovskite systems via site-selective ligand engineering.
Optimizing the conjugated structure of aromatic polyurea for high-temperature capacitive energy storage
Authors: Zhao Zhonghua , Feng Yang , Yang Liuqing , Zhang Shuo , Liu Xia , Zhang Yan , Li Mingru , Li Shengtao
Published: December 2023

Polymer dielectrics that can operate under simultaneous electric and thermal extremes are urgently needed in advanced electrical and electronic devices. However, the high thermal stability of polymers is typically endowed by the conjugated aromatic backbones, leading to enhanced conduction loss and poor energy storage density. Herein, we regulate the bridge linkages between adjacent benzene rings to simultaneously improve the thermal stability and optimize the conjugated structure of polyurea (PU), thereby achieving high-temperature energy storage performance. With the introduction of ether, methylene, and isopropyl structural units, the dihedral angles between adjacent benzene planes gradually increase, enabling PU to achieve excellent energy density (Ue) and charge–discharge efficiency (η) with suppressed leakage conduction and improved breakdown strength. The optimal PU with isopropyl moiety achieves an attractive Ue of 5.1 and 2.1 J/cm3 with η above 90% at 30 and 150 °C, respectively. This work provides a facile strategy to improve the energy storage performance of aromatic polymers by optimizing the interaction between adjacent conjugated benzene planes.
Orbital-optimized density functional calculations of molecular Rydberg excited states with real space grid representation and self-interaction correction
Authors: Sigurdarson Alec E. , Schmerwitz Yorick L. A. , Tveiten Dagrún K. V. , Levi Gianluca , Jónsson Hannes
Published: December 2023

Density functional calculations of Rydberg excited states up to high energy are carried out for several molecules using an approach where the orbitals are variationally optimized by converging on saddle points on the electronic energy surface within a real space grid representation. Remarkably good agreement with experimental estimates of the excitation energy is obtained using the generalized gradient approximation (GGA) functional of Perdew, Burke, and Ernzerhof (PBE) when Perdew–Zunger self-interaction correction is applied in combination with complex-valued orbitals. Even without the correction, the PBE functional gives quite good results despite the fact that corresponding Rydberg virtual orbitals have positive energy in the ground state calculation. Results obtained using the Tao, Perdew, Staroverov, and Scuseria (TPSS) and r2SCAN meta-GGA functionals are also presented, but they do not provide a systematic improvement over the results from the uncorrected PBE functional. The grid representation combined with the projector augmented-wave approach gives a simpler and better representation of diffuse Rydberg orbitals than a linear combination of atomic orbitals with commonly used basis sets, the latter leading to an overestimation of the excitation energy due to confinement of the excited states.
Are women-who-have-sex-with-women an ‘at-risk’ group for cervical cancer? An exploratory study of women in Aotearoa New Zealand
Authors: Ellis Sonja J.
Published: December 2023

Background International research consistently indicates that women-who-have-sex-with-women (WSW) are less likely to engage in cervical screening than heterosexual women. In the main, studies have explored rates of engagement and highlighted some reasons for non-engagement. This study extends on this work by exploring perceptions among sexual minority women (WSW) for lower rates of engagement among WSW more generally and is the first study on this topic undertaken in Aotearoa New Zealand. Methods A sample of 177 self-identified WSW domiciled in New Zealand completed an online survey about their engagement in cervical screening, reasons for engaging (or not) in cervical screening, and perceptions of why SMW might be less likely to engage in cervical screening. Results Fewer than half of participants had engaged in cervical screening every 3 years as recommended, with women who had only ever had sex with other women being significantly less likely to have engaged in screening. A lack of clear information about risk relative to sexual history, heteronormativity, and the invasive nature of screening were the dominant reasons for lower engagement among WSW. Conclusions A legacy of misinformation, and endemic heteronormativity in public health messaging around cervical screening is a significant barrier to engagement in screening for WSW. To increase engagement in screening among WSW, public health information needs to specifically address the needs of WSW.
Biosymbiotic platform for chronic long-range monitoring of biosignals in limited resource settings
Authors: Stuart Tucker , Farley Max , Amato Julia , Thien Ryan , Hanna Jessica , Bhatia Aman , Clausen David Marshall , Gutruf Philipp
Published: December 2023

Remote patient monitoring is a critical component of digital medicine, and the COVID-19 pandemic has further highlighted its importance. Wearable sensors aimed at noninvasive extraction and transmission of high-fidelity physiological data provide an avenue toward at-home diagnostics and therapeutics; however, the infrastructure requirements for such devices limit their use to areas with well-established connectivity. This accentuates the socioeconomic and geopolitical gap in digital health technology and points toward a need to provide access in areas that have limited resources. Low-power wide area network (LPWAN) protocols, such as LoRa, may provide an avenue toward connectivity in these settings; however, there has been limited work on realizing wearable devices with this functionality because of power and electromagnetic constraints. In this work, we introduce wearables with electromagnetic, electronic, and mechanical features provided by a biosymbiotic platform to realize high-fidelity biosignals transmission of 15 miles without the need for satellite infrastructure. The platform implements wireless power transfer for interaction-free recharging, enabling long-term and uninterrupted use over weeks without the need for the user to interact with the devices. This work presents demonstration of a continuously wearable device with this long-range capability that has the potential to serve resource-constrained and remote areas, providing equitable access to digital health.
Multimodal interactions drive chromatin phase separation and compaction
Authors: Ukmar-Godec Tina , Cima-Omori Maria-Sol , Yerkesh Zhadyra , Eswara Karthik , Yu Taekyung , Ramesh Reshma , Riviere Gwladys , Ibanez de Opakua Alain , Fischle Wolfgang , Zweckstetter Markus
Published: December 2023

Gene silencing is intimately connected to DNA condensation and the formation of transcriptionally inactive heterochromatin by Heterochromatin Protein 1α (HP1α). Because heterochromatin foci are dynamic and HP1α can promote liquid–liquid phase separation, HP1α-mediated phase separation has been proposed as a mechanism of chromatin compaction. The molecular basis of HP1α-driven phase separation and chromatin compaction and the associated regulation by trimethylation of lysine 9 in histone 3 (H3K9me3), which is the hallmark of constitutive heterochromatin, is however largely unknown. Using a combination of chromatin compaction and phase separation assays, site-directed mutagenesis, and NMR-based interaction analysis, we show that human HP1α can compact chromatin in the absence of liquid–liquid phase separation. We further demonstrate that H3K9-trimethylation promotes compaction of chromatin arrays through multimodal interactions. The results provide molecular insights into HP1α-mediated chromatin compaction and thus into the role of human HP1α in the regulation of gene silencing.
Melting climates shrink North American small mammals
Authors: Searing Katherina B. , Lomolino Mark V. , Rozzi Roberto
Published: December 2023

Mammals play important ecological roles in terrestrial ecosystems, with their particular niches and their impacts on energy flow and nutrient cycling being strongly influenced by one of their most fundamental traits—their body size. Body size influences nearly all of the physiological, behavioral, and ecological traits of mammals, and thus, shifts in body size often serve as key mechanisms of adaptation to variation in environmental conditions over space and time. Along with shifts in phenology and distributions, declining body size has been purported to be one of the three universal responses to anthropogenic climate change, yet few studies have been conducted at the spatial and temporal scales appropriate to test this claim. Here, we report that in response to warming of terrestrial ecosystems across North America over the past century, small mammals are decreasing in body size. We further estimate that by 2100 (when global temperatures may have risen some 2.5 to 5.5 °C since 1880), the total anthropogenic decline in body mass of these ecologically and economically important species may range from 10 to 21%. Such shifts in body size of the great multitudes of small mammal populations are, in turn, likely to have major impacts on the structural and functional diversity of terrestrial assemblages across the globe.
Design and experimental realization of multifunctional anisotropic metasurface for efficient polarization manipulation in microwave frequencies
Authors: Qureshi Ubaid Ur Rahman , Hu Bin , Basir Shahid , Ahmad Munzza , Jalal Abdul , Ismail Khan M
Published: December 2023

This paper presents the realization of a multifunction anisotropic metasurface capable of operating as both a half-waveplate and a quarter-waveplate in the C, X, and Ku bands. The numerical and experimental results demonstrate the metasurface is able to convert linear and circular polarizations to their respective cross-polarizations, as well as achieve linear-to-circular and circular-to-linear polarization conversions in the microwave frequency regime. Notably, the metasurface maintains high conversion efficiencies for both half-wave and quarter-wave plate operations, even when subjected to variations in the incidence angle. The underlying physical mechanism is elucidated through the analysis of eigen values, surface current distribution and the retrieval of effective physical parameters. The proposed metasurface is useful for communication and polarization manipulation devices due to its simple construction, compact size, angular stability, and multi-functionality.
Analytical modelling and reliability analysis of charge plasma-assisted Mg2Si/Si heterojunction doping less DGTFET for low-power switching applications
Authors: Goyal Preeti , Srivastava Garima , Madan Jaya , Pandey Rahul , Gupta R S
Published: December 2023

Fabrication of tunnel field effect transistor (TFET) confronts various challenges, one of which is random dopant fluctuation (RDF), which diminishes the benefits associated with low subthreshold swing (SS) and high ION/IOFF ratio. By conducting physics-based 2D analytical modelling, this paper proposes a magnesium silicide/silicon (Mg2Si/Si) heterojunction-based doping less double gate tunnel field effect transistor (HB-DL-DGTFET). This work utilizes the concept of charge plasma to tackle the issues of RDF. The analytical analysis in this study is based upon the determination of the center-channel potential by solving 2D Poisson’s equation, considering appropriate boundary conditions. Here, surface potential, electric field, energy bands, drain current and threshold voltage are extracted mathematically. In addition to the aforementioned parameters, several other analog performance parameters like transconductance, drain conductance, device efficiency, intrinsic gain, output resistance and channel resistance have also been studied in this context. The analytical findings have been duly validated using the ATLAS TCAD device simulator. Furthermore, this work focuses on exploring proposed device reliability through an investigation of, the influence of interface trap charges (ITC), present at the Si/SiO2 interface. The study analyses ITC's impact on analog performance and the obtained results are compared with that of conventional doping less DGTFET (C-DL-DGTFET). The simulation results reveal that HB-DL-DGTFET exhibits greater immunity against ITC. Thus, validating the potential of HB-DL-DGTFET as a superior candidate for low-power switching applications.
Machine learning-based prediction of Q-voter model in complex networks
Authors: Pineda Aruane M , Kent Paul , Connaughton Colm , Rodrigues Francisco A
Published: December 2023

In this article, we consider machine learning algorithms to accurately predict two variables associated with the Q-voter model in complex networks, i.e. (i) the consensus time and (ii) the frequency of opinion changes. Leveraging nine topological measures of the underlying networks, we verify that the clustering coefficient (C) and information centrality emerge as the most important predictors for these outcomes. Notably, the machine learning algorithms demonstrate accuracy across three distinct initialization methods of the Q-voter model, including random selection and the involvement of high- and low-degree agents with positive opinions. By unraveling the intricate interplay between network structure and dynamics, this research sheds light on the underlying mechanisms responsible for polarization effects and other dynamic patterns in social systems. Adopting a holistic approach that comprehends the complexity of network systems, this study offers insights into the intricate dynamics associated with polarization effects and paves the way for investigating the structure and dynamics of complex systems through modern methods of machine learning.
Post-operative outcomes and identification of risk factors for complications after emergency intestinal stoma surgery – a multi-centre retrospective study
Authors: MacDonald Scott , Wong Li-Siang , Ng Hwei Jene , Quasim Tara , Moug Susan
Published: December 2023

Aim

Approximately 4000 patients undergo emergency intestinal stoma surgery annually in the UK. Stoma-related complications (SRCs) are heterogenous but have previously been sub-categorised into ‘early’ or ‘late-SRCs’. Early-SRCs include: skin excoriation; stoma necrosis; and high-output and generally occur within 30 days post-operatively. Late-SRCs include: para-stomal herniae; retraction; and prolapse. There is a paucity of research investigating risk factors for SRCs within the emergency cohort.

This paper aims to describe the incidence of SRCs after emergency intestinal surgery and to identify potential risk factors for SRCs.

Methods

Consecutive patients undergoing emergency intestinal stoma surgery (colostomy, ileostomy or jejunostomy) were identified prospectively from 3 acute hospital sites over 3 years from the ELLSA (Emergency Laparotomy and Laparoscopic Scottish Audit) database. Patients were followed up for a minimum of 1 year. A multi-variate logistic regression model was used to identify risk factors for early and late-SRCs.

Results

n=455 patients were included (Median follow-up-19 months; Age(median) 64 years; Male:Female-0.52;56.7% ileostomies). 54.1% of patients experienced early-SRCs and 51% experienced late-SRCs. n=219 (48.1%) of patients had their stoma sited pre-operatively. Risk factors for early-SRCs included end ileostomy formation (OR 3.51(2.24-5.49), p<0.001), while pre-operative stoma-siting was found to be protective (OR 0.53(0.35-0.83), p=0.005). Patient obesity (OR 3.11(1.92-5.03), p<0.001) and re-operation for elective complications (OR 4.18(2.01-8.69), p<0.001) were risk factors for late-SRCs.

Conclusion

Stoma-related complications after emergency surgery are common. Pre-operative stoma siting is the only truly modifiable risk factor to reduce SRCs, and further research should be aimed at methods of improving this in the emergency setting.
Assessment for the risk of malnutrition and nutritional support in older emergency laparotomy patients: a clinical audit
Authors: Windle Angela , Nair Sherena , Ispoglou Theocharis , Burke Dermot
Published: December 2023

Aims

Patients undergoing urgent abdominal surgery should undergo an assessment of the risk of malnutrition upon admission using the Malnutrition Universal Screening Tool (MUST). This assessment should trigger a response when patients are categorised as high-risk. This clinical audit aimed to determine whether older patients included in the National Emergency Laparotomy Audit (NELA) were identified as being at risk of malnutrition and whether they received appropriate nutritional support to address deficiencies if they were classed as high-risk as per the recommendations of the NICE (2017) guidelines.

Methods

Patients entered into the NELA database at a single NHS trust who were over 65 or older between January 1, 2021, and December 31, 2022, were included. The patient records were reviewed for the MUST score upon admission, and the presence of nutritional supplementation prescriptions, or dietetic referrals following the identification of a high-risk MUST score of 2 or above.

Results

Out of the 300 older NELA patients included in this clinical audit, 98% had a recorded MUST score. Between them, 114 patients had a high-risk MUST score, but 35% of these high-risk patients did not undergo a dietetic review. Additionally, 24% of high-risk patients received neither oral nor parenteral supplementation.

Conclusions

High-risk MUST scores in older NELA patients are readily available to surgical teams within the electronic patient record but do not consistently lead to interventions addressing nutritional deficiencies and nutritional screening is not currently included in NELA.
Prescription Practice Protocol of Antibiotics in A&E for Acute Diverticulitis in DGH: A Closed Loop Audit
Authors: Thapa Nabin , Kalaskar Shrinivas , Atif Qurrat Al Ain
Published: December 2023

Aim of the study

To examine the level of adherence, of local antibiotics prescription practice, for Diverticulitis to NICE guidelines 2019.

Introduction

Acute diverticulitis is an inflammation of a diverticulum, a sac-like protrusion from the colon wall, due to micro-perforation. Based on clinical and radiological findings they are classified as complicated and uncomplicated diverticulitis. As per nice guidelines, diverticulitis can be managed on the basis of classification,

Method

Retrospect data collection for 3 months, for each cycle, was done from the surgical on-call take list and reviewed the management of diverticulitis. Patients with a confirmed diagnosis of acute diverticulitis by Ct scan were only included in the study.

Results

In our 1st cycle of study, we found that our practice was not competent with NICE guidelines and 98% of patients were treated with antibiotics despite their requirement.

We made a local guideline in association with NICE guidelines for the management of acute diverticulitis and organized teaching sessions and did templates presentation in various wards.

In 2nd cycle of the study 71% of the patient was treated with antibiotic and 71% were in need of antibiotics as per NICE guideline.

Conclusion

We are now 100% compliant with NICE guidelines in antimicrobial prescription in acute diverticulitis.
How Patients who needed CT scans on an ambulatory basis are scanned and reviewed in a major teaching hospital
Authors: Pha Sai Yan
Published: December 2023

Aim

This study focuses on the status of service provision for Emergency General Surgical patients requiring Ambulatory CT scans at a major teaching hospital.

Method

CT scans that took place between May 2023 – July 2023 where patients who received scans were reviewed and categorized between Urology and EGS.

Results

During the 13-week study, we were able to scan 233 patients (17.92 scans per week) in total between both specialties where 82 scans were for EGS patients (35%).

All of these patients were reviewed by a member of the EGS team before they were booked for ambulatory scans at an allotted time and date where patients were scanned at an average of 2.15 days after initial review.

After the scan, the patients are reviewed in the Ambulatory Clinic with their results where decisions were made. 93% of the patients were seen on the same day after the scan. Most wait was 11 days due to delay of scanning.

Of all the scans 75% of the scans are for common indication for scans in an Ambulatory setting. Indication for scanNumberDiverticular20Post-operative collections14Appendicitis11Non-specific abdominal pain10Hernias8

Conclusion

After symptomatic management, scanning and reviewing patients on an ambulatory pathway is effective in both receiving scans in a timely manner as well as making timely appropriate decisions regarding their cause of presentation. It also helps reducing the number of patients going into the acute team.
Percutaneous Cholecystostomy for acute calculous cholecystitis. Analysis of complications.
Authors: Castillo Ana Maria Gonzalez , De Miguel Palacio Maite , Rodríguez Andrea Rabasa , Ramos Maria Martin , Manzano Amalia Pelegrina , Fernandez Estela Membrilla
Published: December 2023

Aims

Acute cholecystitis (AC) is the second most frequent pathology in Surgical Emergencies.Laparoscopic cholecystectomy (LC) is the gold standard treatment, but not all patients are fit for surgery.

Percutaneous Choleystostomy (PC) is an alternative to LC but has high comorbidity and the efficacy of bridge therapy is still in debate. This study aims to analyse the complications of non-surgical treatment in AC.

Methods

Single-centre retrospective study of 1652 adults with AC during 2011 to 2022, including baseline demographic characteristics, comorbidity severity defined as Charlson Comorbidity Index (CCI), ASA Score, Tokyo Guidelines’ severity classification. The primary outcome is to study the complications of non-surgical treatment.

Results

The 94,6% of the series had LC. Only 88 patients received NST, and were 12 yearls old older, had a higher CCI and the 44% were severe cholecystitis the 83% were pure-cholecystitis, and 44% were successfully treated with antibiotics alone. A 55% needed a PC, in 7 patients was for resuscitation before surgery. The Hospital stay was 6 days longer and the 45% had a complication. The mortality was 11%. Risk factors for complications were severe cholecystitis, diabetes, and age over 70. Only 3 patients were studied with a cholangiography before remove the drainage. The recurrence was 28%.

Conclusions

NST has a high complication rate, it should be only for a diminutive subgroup of patients with an AC. A severe cholecystitis, diabetes, and age over 70 are risk factors for complications. Resucitative cholecystostomy could be an option in selective patients.
Do patients with acute diverticulitis need to be in the hospital? - Implementation of an @Home treatment pathway to reduce admissions
Authors: Batra Suketu , Winterborn Rebecca , Saunders Lucinda , Pullyblank Anne
Published: December 2023

Aims

Acute complicated diverticulitis is often treated as an in-patient, despite few needing intervention. Virtual wards are designed to treat patients at home. The aim was to develop an NHS@Home service for acute diverticulitis to reduce hospital admissions.

Methods

A retrospective review of patients with diverticulitis examined daily WCC & CRP, analgesia and IV antibiotic requirements, NEWS2 & pain scores. This was used to develop an @Home treatment protocol. In this, patients with CT-confirmed diverticulitis +/- localized perforation <3cm, NEWS2 <2, Pain score <5, and CRP <200 were given one dose of IV antibiotics, then oral antibiotics at home with thrice-a-day observations and daily bloods. Discharge was nurse-led on day 2 or 3 with criteria for re-admission.

Results

Of 42 admissions, mean WCC was 12.7, mean CRP was 171 if perforated, and 85 if not. All NEWS2 scores were <2 and mean pain score was 3.

65% of patients (28/42) had no perforation on CT. Most patients (60.5%) did not require opioid analgesia, mean IV antibiotic treatment duration was 2.5 days and mean LOS was 3.75 days.

Only 6/42 patients (14.28%) had a collection.

In all patients, WCC was static or reduced during admission but CRP increased in a third.

35 patients were treated on the Diverticulitis@Home Pathway in the first 4 months with one readmission.

The pathway was used to standardize colonic imaging according to guidelines. As a result, 60% (36/61) of endoluminal imaging previously ordered by clinicians was canceled.

Conclusion

An @home diverticulitis pathway is safe, effective and saves bed days.
Long term outcomes after negative appendicectomy: does morbidity justify mandatory pre-operative confirmation of appendicitis prior to surgery?
Authors: Hammett Felix , Nasir Uzair , Singh Gautam , Ghoneima Ahmed , Saha Arin
Published: December 2023

Aims

Negative appendicectomy is sometimes described as a quality indicator of an acute surgical service. Previous studies have suggested that negative appendicectomy carries an unacceptably high risk of morbidity and advocate pre-operative imaging to confirm a diagnosis in all cases, despite the resource implications this policy carries. This study quantified long term morbidity after negative appendicectomy.

Methods

This retrospective cohort study identified all patients who underwent appendicectomy for suspected appendicitis from June 2010 to August 2015 at a single centre. Patients with a histologically normal appendix were identified and their notes were interrogated to record outcomes; median follow-up was 10.6 (range, 8 – 13) years. Complications after surgery were classified using the Clavien-Dindo system.

Results

1914 patients had an appendicectomy. 181 patients (9.5%) had a negative appendicectomy. There were 40 re-admissions after surgery; half (20 patients) were within 30 days. The most common causes of re-admission were ongoing symptoms with no identifiable cause (15 patients, 37.5%) or post-operative pain (9 patients (22.5%). Overall post-operative complication rate was 11 patients (6.1%). Of these, 6 patients had Grade 1 or 2 complications, 5 patients (3%) had Grade 3 complications (return to theatre for infection, bleeding or hernia) and none had Grade 4 or 5 complications. There was no mortality.

Conclusions

There is low short and long-term morbidity after negative appendicectomy which suggests that routine pre-operative imaging to confirm a diagnosis of appendicitis before surgery is unwarranted. The concerns around complications after negative appendicectomy appear unjustified and should not be a quality indicator.