bluuebunny/crossref_metadata_2025 huggingface dataset:
Design of an In Vitro Semicircular Canal Model and Its Use for the Study of Canalithiasis
Authors: Lu Shien , Zhang Wenxuan , Wang Zhi , Jiang Yani , Bian Yixiang
Published: May 2023

Canalithiasis is a common vestibular system disorder, which may lead to a specific form of vertigo known as BPPV or top-shelf vertigo. In this paper, based on the actual geometric parameters of the human semicircular canal, we designed a four-fold in vitro one-dimensional semicircular canal model using technologies such as three-dimensional printing, image processing, and target tracking. We investigated the essential characteristics of the semicircular canal, such as the time constant of the cupula and the relationship between the number, density, and size of the canalith and the cupular deformation during canalith settlement. The results showed a linear relationship between the number and size of the canalith and the amount of cupular deformation. We also found that when the number of canaliths reached a particular scale, the interaction between the canaliths exerted an additional disturbance on the cupular deformation (“Z” twist). In addition, we explored the latency time of the cupula during canalith settlement. Finally, we verified that the canaliths had little effect on the frequency characteristics of the semicircular canal by a sinusoidal swing experiment. All the results validate the reliability of our 4-fold in vitro one-dimensional semicircular canal model.
Semi-Numerical Investigation of Boundary Layer Flow and Heat Transfer of Magnetohydrodynamics Nano-Fluid Flow in Presence of Chemical Reaction Over a Non-Isothermal Porous Medium
Authors: Awati Vishwanath B. , Goravar Akash , N. Mahesh Kumar
Published: May 2023

The technical brief presents, analysis of boundary layer flow and heat transfer in nanofluids under the influence of magnetic field, thermal radiation and chemical reaction over non-isothermal stretching surface through permeable porous medium. The self-similarity equations obtained from governing equations are solved using shifted Chebyshev and Haar wavelet collocation methods. The prescribed surface temperature, prescribed heat flux cases and impact of various flow governing parameters are discussed in detail. The established results are compared with earlier results and are comparable.
Hit, Miss, or Error? Predicting Errors in Design Decision Making for Radically Innovative Ideas Using Individual Attributes
Authors: Peng Aoran , Miller Scarlett R.
Published: May 2023

Researchers and practitioners alike agree that for companies to survive and thrive they must develop and support radical innovation. However, these ideas are complex and risky, and not all succeed. Because of this, decision makers are often left to make hard decisions in terms of which ideas can move on and which are abandoned. The goal of this article was to provide evidence on the impact of individuals’ preferences for creativity on the effectiveness of their decision making for radical ideas using principles from signal detection theory (SDT). To do this, we used data from a previous study of 2252 idea evaluations by engineering students and classified these decisions based on SDT to see if we could predict the likelihood of occurrence of hit (correct identification), miss (type 1 error), false alarm (type II error), and correct rejection. The results showed that lower levels of risk tolerance resulted in an increased likelihood that a hit occurred. On the other hand, higher levels of motivation resulted in an increased likelihood of a type I error occurring, or that an individual would more likely neglect a good idea that had a high chance of future success. Finally, increased risk tolerance resulted in an increased likelihood that type II error occurred, or that an individual would expend resources on an idea with limited likelihood of success. The results serve as empirical evidence on decision making in radically innovative tasks and provide a methodology for studying decision making in innovative design.
Design and Analysis of a Reconfigurable Hybrid Robot for Machining of Large Workpieces
Authors: Xu Lingmin , Chai Xinxue , Ding Ye
Published: May 2023

Large workpieces are important components of core equipment in aerospace and other fields, where the machining mainly focuses on the surfaces and inner cavities. However, it may be unsuitable for existing machining robots to directly achieve integrated machining, that is, not only the high-precision surface machining but also the machining of different inner cavities in a limited space. To satisfy these machining requirements, a new reconfigurable hybrid robot (RHR) is proposed, called the 3PRR-3PSS-UPU RHR, for machining the surface and inner cavity of large workpieces (where P, P, R, S, and U stand for the actuated prismatic joint, passive prismatic joint, revolute joint, spherical joint, and universal joint, respectively). The proposed RHR consists of two parallel manipulators (PMs), in which one is a spatial 3PRR PM with one translational degree-of-freedom (DOF) and the other is a 3PSS-UPU reconfigurable PM (RPM) with different configurations of two rotational and one translational (2R1T) DOFs using locking equipment, which is the main advantage of the designed robot. The inverse kinematics and singularities of two PMs are analyzed. The stiffness performance of the spatial 3PRR PM is compared with that of a moving slider with one translational DOF. By evaluating the workspace and motion/force transmissibility, the kinematic performance of two PMs is presented using several local and global indices, followed by the dimensional optimization of link parameters. Based on the structural characteristics and excellent performance, it can be inferred that the 3PRR-3PSS-UPU RHR has great potential for machining large workpieces.
Optimization of Geometrical Parameters of a Solar Collector Coupled With a Thermal Energy Storage System
Authors: Sebbar E. H. , Oubenmoh S. , Ait Msaad A. , Hamdaoui S. , Mahdaoui M. , El Rhafiki T.
Published: May 2023

Solar thermal collector is a device that converts solar radiation into useful thermal energy (heat). This technology has become mature and cost-effective. However, because its input comes from an intermittent source (sun), its production is variable during the day; also it is vulnerable to climatic conditions. To adopt this technology, it is therefore necessary to invest in energy storage means or to use a secondary energy source. In this work, a solar thermal collector has been studied and modeled. The objective of this study consists of: first, analyze the impact of the geometrical form of the absorbing surface on the solar collector's thermal performance. Three geometries are tested, namely flat, triangular, and corrugated. The solar collector is evaluated under a hot climate considering the meteorological data of Er-rachidia city (Morocco). The second part of the present study consists of integrating a latent heat storage system using phase change materials (PCMs) to store part of the heat and exploit it during the night. Integrating PCM in this system is a relevant technique to overcome the problem of intermittency of solar energy. Moreover, according to the findings of this study, a significant improvement of the solar collector thermal performance has been reached. The reduction of the missed thermal energy is from 5.6485 kW h to 4.4566 kW h with the use of PCM and the corrugated surface.
Perspective on electromagnetically induced transparency vs Autler–Townes splitting
Authors: Sanders Barry C.
Published: May 2023

Electromagnetically induced transparency and Autler–Townes splitting are two distinct yet related effects. These phenomena are relevant to quantum technologies, including quantum memory, quantum switching, and quantum transduction. Here, the similarities and differences between these phenomena along historical and conceptual lines are discussed and their realizations on various physical platforms including atomic gases, superconducting circuits, and optomechanics are elaborated. In particular, the author clarifies two approaches to assessing which phenomenon is observed based on a black-box approach of modeling the output, given a particular input vs analyzing the underpinning physics. Furthermore, the author highlights the ability to effect a continuous transition between the two seemingly disparate phenomena.
Growth mechanisms of interfacial carbon layers at the epitaxial Al2O3(0001)/Cu(111) interface as application for epitaxial film lift-off
Authors: Tsai Hung-Chieh , Marien Brecht , Chancerel François , De Gendt Stefan , Brems Steven
Published: May 2023

The growth of interfacial carbon (IFC) layers at the epitaxial sapphire/metal interface could unlock the transfer process for large-scale epitaxial thin films, such as graphene. To assess the feasibility of the application of IFC, understanding of the growth mechanisms of IFC layers at the epitaxial metal/sapphire interface is required. In this study, atmospheric pressure chemical vapor deposition is used to directly synthesize wafer-scale multilayer carbon at the interface between the Al2O3(0001) substrate and epitaxial Cu(111) layer. Characterization by Raman spectroscopy, AFM, and XRD, indicates the IFC layers exhibit low defect density and sp2 bonding character. Furthermore, IFC as thick as 100 nm could be synthesized. The effect of the partial pressure of reaction gases is systematically investigated, and a growth mechanism is proposed based supported by experimental observations and simulation results. Finally, a mechanical lift-off of a Cu(111) film with the aid of the IFC layer is demonstrated as a proof-of-concept application.
Detecting moving targets in active sonar echograph of harbor environment using robust high-order flux tensor
Authors: Wei Zhuoqun , Han Yina , Liu Qingyu , Zhao Shuang , Song Jun
Published: May 2023

An important goal of an active sonar system is to detect and track underwater intruders such as frogmen, unmanned underwater vehicles, etc. Unfortunately, the intruders appear visually as a small fluctuating “blob” against the high-level fluctuating background caused by multipath propagation and reverberation in the harbor environment, making it difficult to be distinguished. Classical motion features well developed in computer vision cannot cope with an underwater environment. Thus, this paper presents a robust high-order flux tensor (RHO-FT) to characterize the small underwater moving targets against high-level fluctuating background. According to the dynamic behavior of active clutter from real-world harbor environment, we first classify it into two main types: (1) dynamic clutter but with relatively consistent spatial-temporal variation in a certain neighborhood; (2) sparkle clutter presenting completely random flashing. Then starting from the classical flux tensor, we develop a statistical high-order computation to handle the former followed by a spatial-temporal connected component to suppress the latter to achieve higher robustness. Experiments on a set of real-world harbor datasets demonstrate the effectiveness of our RHO-FT.
Broadband properties of potential and kinetic energies in an oceanic waveguide
Authors: Flamant Julien , Bonnel Julien
Published: May 2023

The energetic properties of an acoustic field can be quantified through the potential (Ep) and kinetic (Ek) energies. This article derives broadband properties of Ep and Ek in an oceanic waveguide, with restriction to a far-field context under which the acoustic field can be described by a set of propagating trapped modes. Using a set of reasonable assumptions, it is analytically demonstrated that, when integrated over a wide enough frequency-band, Ep = Ek everywhere in the waveguide, except at four specific depths: z = 0 (sea surface), z = D (seafloor), z = zs (source depth), and z=D−zs (mirrored source depth). Several realistic simulations are also presented to show the relevance of the analytical derivation. It is notably illustrated that, when integrated over third-octave bands, Ep≃Ek within 1 dB everywhere in the far-field waveguide, except in the first few meters of the water column (on a dB scale, no significant difference is found between Ep and Ek for z = D, z = zs, and z=D−zs).
Direction-of-arrival estimation in half-space from single sample array snapshot
Authors: Iwami Takahiro , Sawai Ken-ichi , Omoto Akira
Published: May 2023

Most existing direction-of-arrival (DOA) estimation algorithms are intended for single-frequency use. However, the majority of real sound fields are wideband, and the application of these techniques then becomes computationally expensive. In this paper, a fast DOA estimation method for use with wideband sound fields is constructed from only a single observation of the array signal based on the properties of a space of spherically band-limited functions. The proposed method can be applied to any element arrangement and spatial dimensions, and the computational load is only dependent on the number of microphones in the array. However, because this method does not use time information, forward-backward identification of the arriving waves is not possible. Therefore, the proposed DOA estimation method is limited to a half-space. Numerical simulations of multiple sound waves arriving from a half-space show that the proposed method offers good processing performance when applied to pulse-like broadband sound fields. The results also indicate that the method is capable of tracking DOAs in real time, even when these DOAs vary rapidly.
An Exploratory Investigation of Personality in Counter-Strike: Global Offensive
Authors: Birch Phil D.J. , Greenlees Lottie , Sharpe Benjamin T.
Published: May 2023

Personality traits can provide insightful predictions relating to thoughts, feelings, and behavior. The aim of the present study was to examine differences in personality traits across in-game rank in Counter-Strike: Global Offensive (CS:GO). A total of 95 CS:GO players from the United Kingdom and North America were classified using CS:GO in-game rank and grouped into high, moderate, and low in-game rank. The NEO-Five-Factor Inventory questionnaire was utilized to measure the Big Five Personality traits. Using one-way multivariate analysis of variance with follow-up tests of discriminant analysis, our main finding was that high in-game rank players reported significantly lower levels of neuroticism and significantly higher levels of conscientiousness than both moderate and low in-game rank players. The present study offers preliminary evidence elucidating personality differences across in-game rank in CS:GO players.
Draft Genome Sequences of
Tsukamurella
sp. 8F and 8J Strains Isolated from Social Wasps (Vespidae; Polistinae: Epiponini)
Authors: Rojas-Villalta Dorian , Núñez-Montero Kattia , Pizarro-Cerdá Javier , Chavarría-Pizarro Laura
Published: May 2023

Strains of the genus
Tsukamurella
were isolated from
Polybia
sp. social wasps from Costa Rica. Draft genome sequences from both isolates were obtained of ~4.5 Mb in length and with 68% GC content.
Penicillium
molds impact the transcriptome and evolution of the cheese bacterium
Staphylococcus equorum
Authors: Ye Ruby , Tomo Christopher , Chan Neal , Wolfe Benjamin E.
Published: May 2023

The observation that
Penicillium
molds can inhibit the growth of
Staphylococcus
was a catalyst for the antibiotic revolution. Considerable attention has been paid to purified
Penicillium
metabolites that inhibit bacteria, but little is known about how
Penicillium
species impact the ecology and evolution of bacteria in multispecies microbial communities. Here, we investigated how four different species of
Penicillium
can impact global transcription and evolution of a widespread
Staphylococcus
species (
S. equorum
) using the cheese rind model microbiome. Through RNA sequencing, we identified a core transcriptional response of
S. equorum
against all five tested
Penicillium
strains, including upregulation of thiamine biosynthesis, fatty acid degradation, and amino acid metabolism as well as downregulation of genes involved in the transport of siderophores. In a 12-week evolution experiment where we co-cultured
S. equorum
with the same
Penicillium
strains, we observed surprisingly few non-synonymous mutations across
S. equorum
populations evolved with the
Penicillium
species. A mutation in a putative DHH family phosphoesterase gene only occurred in populations evolved without
Penicillium
and decreased the fitness of
S. equorum
when co-cultured with an antagonistic
Penicillium
strain. Our results highlight the potential for conserved mechanisms of
Staphylococcus–Penicillium
interactions and demonstrate how fungal biotic environments may constrain the evolution of bacterial species.

IMPORTANCE

Fungi and bacteria are commonly found co-occurring both in natural and synthetic microbiomes, but our understanding of fungal–bacterial interactions is limited to a handful of species. Conserved mechanisms of interactions and evolutionary consequences of fungal–bacterial interactions are largely unknown. Our RNA sequencing and experimental evolution data with
Penicillium
species and the bacterium
S. equorum
demonstrate that divergent fungal species can elicit conserved transcriptional and genomic responses in co-occurring bacteria.
Penicillium
molds are integral to the discovery of novel antibiotics and production of certain foods. By understanding how
Penicillium
species affect bacteria, our work can further efforts to design and manage
Penicillium
-dominated microbial communities in industry and food production.
Prevalence and Clinical Consequences of Colistin Heteroresistance and Evolution into Full Resistance in Carbapenem-Resistant Acinetobacter baumannii
Authors: Kon Hadas , Hameir Amichay , Nutman Amir , Temkin Elizabeth , Keren Paz Alona , Lellouche Jonathan , Schwartz David , Weiss David S. , Kaye Keith S. , Daikos George L. , Skiada Anna , Durante-Mangoni Emanuele , Dishon Benattar Yael , Yahav Dafna , Daitch Vered , Bernardo Mariano , Iossa Domenico , Friberg Lena E. , Theuretzbacher Ursula , Leibovici Leonard , Dickstein Yaakov , Pollak Dina , Mendelsohn Sigal , Paul Mical , Carmeli Yehuda , Paul Mical , Dishon Benattar Yael , Dickstein Yaakov , Bitterman Roni , Zayyad Hiba , Koppel Fidi , Zak-Doron Yael , Altunin Sergey , Andria Nizar , Neuberger Ami , Stern Anat , Petersiel Neta , Raines Marina , Karban Amir , Leibovici Leonard , Yahav Dafna , Eliakim-Raz Noa , Zusman Oren , Elbaz Michal , Atamna Heyam , Daitch Vered , Babich Tanya , Carmeli Yehuda , Nutman Amir , Adler Amos , Levi Inbar , Daikos George L. , Skiada Anna , Pavleas Ioannis , Antoniadou Anastasia , Kotsaki Antigoni , Durante-Mangoni Emanuele , Andini Roberto , Iossa Domenico , Bernardo Mariano , Cavezza Giusi , Bertolino Lorenzo , Giuffre Giuseppe , Giurazza Roberto , Ruocco Giuseppe , Galdo Maria , Murino Patrizia , Cristinziano Adriano , Corcione Antonio , Zampino Rosa , Mouton Johan , Friberg Lena , Theuretzbacher Ursula
Published: May 2023

To our knowledge, this is the first large-scale study to report on HR in Gram-negative bacteria. We described the prevalence of colistin HR in a large sample of carbapenem-resistant
A. baumannii
isolates, the evolution of many colistin HR isolates to a resistant phenotype following colistin exposure and withdrawal, and the clinical consequences of colistin HR.
Coupled alkaline high-Nb mafic rocks and adakitic granodiorites: Products of Neoproterozoic back-arc extension at the western margin of the Yangtze Block, South China
Authors: Huang Bin , Wang Wei , Zhao Jun-Hong , Khattak Nimat Ullah , Huang Si-Fang , Lu Gui-Mei , Xue Er-Kun , Sun Li
Published: May 2023

The newly identified Neoproterozoic Yuanmou high-Nb mafic and adakitic rocks at the western margin of the Yangtze Block in South China are investigated for petrogenesis and geodynamic implications. Zircon U-Pb ages show the adakitic granodiorite host and mafic microgranular enclaves (MMEs) were synchronously emplaced at 811−806 Ma, and were cut by an 802 ± 11.5 Ma mafic dike. The medium-grained granodiorites consist mainly of plagioclase, quartz, K-felspar, biotite, and amphibole. High SiO2 (62.8−67.5 wt%), Al2O3 (13.1−16.8 wt%) contents, high Sr/Y (17.4−49.0), and (La/Yb)N (16.3−52.6) but low Y (6.83−16.1 ppm) and Yb (0.74−1.82 ppm) concentrations of the granodiorites point toward their calc-alkaline and adakitic nature. Further, their high Dy/Yb (1.52−2.31) and Gd/Y (2.35−4.43) and low K2O/Na2O (0.22−0.48) and Th/La (0.14−0.20) ratios, constant bulk rock εNd(t) (−0.5 to −1.5) and zircon εHf(t) (0.0 to +2.3) values, suggest that the granodiorites were derived from partial melting of a mafic lower crustal source. The MMEs in the granodiorites and mafic dike intrusions are composed of amphibole, plagioclase, clinopyroxene, and olivine, and have similar chemical compositions, such as high Nb (15.7−41.9 ppm) and TiO2 (2.13−3.39 wt%) contents and high Nb/U (18.7−30.9) values, akin to alkaline high-Nb basalts (HNB). Their variable Ba/Nb (7.68−79.2), Nb/Zr (0.09−0.16), high Nb/Th (5.47−6.68), and low Th/Zr (0.01−0.03) and La/Nb (1.03−1.37) ratios indicate a mantle source modified by melts derived from subducted oceanic crust and sediments. The Yuanmou HNB with high εNd(t) (+4.8 to +6.9) were probably generated during back-arc extension by decompression melting of a mantle source metasomatized by adakitic slab melts formed during earlier stages of the subduction. This implies that the location of the back-arc was far from the subducted oceanic slab, possibly due to a slab rollback process. In this scenario, HNB intrusions provided the heat for partial melting and adakitic melt formation in the mafic lower crust. The model suggests that the Yuanmou and other similar associations of HNBs and adakitic rocks emplaced along the western margin of the Yangtze Block are products of a widespread Neoproterozoic back-arc extension.
Healthcare system’s preparedness to provide cardiovascular and diabetes-specific care in the context of geopolitical crises in Burkina Faso: a trend analysis from 2012 to 2018
Authors: Cissé Kadari , Samadoulougou Sékou , Kaboré Jean , Somda Paulin , Zongo Augustin , Traoré Soumaïla , Zabsonre Patrice , Yombi Jean Cyr , Kouanda Seni , Kirakoya-Samadoulougou Fati
Published: May 2023

Objective

This study aimed to evaluate the trends of the availability and readiness of the healthcare system to provide cardiometabolic (cardiovascular diseases (CVD) and diabetes) services in Burkina Faso in multiple political and insecurity crises context.

Design

We performed a secondary analysis of repeated nationwide cross-sectional studies in Burkina Faso.

Data source

Four national health facility survey data (using WHO Service Availability and Readiness Assessment (SARA) tool) conducted between 2012 and 2018 were used.

Participants

In 2012, 686 health facilities were surveyed, 766 in 2014, 677 in 2016 and 794 in 2018.

Primary and secondary outcome measures

The main outcomes were the availability and readiness services indicators defined according to the SARA manual.

Results

Between 2012 and 2018, the availability of CVD and diabetes services significantly increased (67.3% to 92.7% for CVD and 42.5% to 54.0% for diabetes). However, the mean readiness index of the healthcare system to manage CVD decreased from 26.8% to 24.1% (p for trend <0.001). This trend was observed mainly at the primary healthcare level (from 26.0% to 21.6%, p<0.001). For diabetes, the readiness index increased (from 35.4% to 41.1%, p for trend=0.07) during 2012–2018. However, during the crisis period (2014–2018), both CVD (27.9% to 24.1%, p<0.001) and diabetes (45.8% to 41.1%, p<0.001) service readiness decreased. At the subnational level, the readiness index for CVD significantly decreased in all regions but predominantly in the Sahel region, which is the main insecure region (from 32.2% to 22.6%, p<0.001).

Conclusion

In this first monitoring study, we found a low level and decreased trend of readiness of the healthcare system for delivering cardiometabolic care, particularly during the crisis period and in conflicted regions. Policymakers should pay more attention to the impact of crises on the healthcare system to mitigate the rising burden of cardiometabolic diseases.
Catalytic effect of multisource feedback for trauma team captains: a mixed-methods prospective study
Authors: Allen Leah , Hall Andrew K , Braund Heather , Chaplin Timothy
Published: May 2023

Objectives

To evaluate the impact and feasibility of multisource feedback compared with traditional feedback for trauma team captains (TTCs).

Design

A mixed-methods, non-randomised prospective study.

Setting

A level one trauma centre in Ontario, Canada.

Participants

Postgraduate medical residents in emergency medicine and general surgery participating as TTCs. Selection was based on a convenience sampling method.

Intervention

Postgraduate medical residents participating as TTCs received either multisource feedback or standard feedback following trauma cases.

Main outcome measures

TTCs completed questionnaires designed to measure the self-reported intention to change practice (catalytic effect), immediately following a trauma case and 3 weeks later. Secondary outcomes included measures of perceived benefit, acceptability, and feasibility from TTCs and other trauma team members.

Results

Data were collected following 24 trauma team activations: TTCs from 12 activations received multisource feedback and 12 received standard feedback. The self-reported intention for practice change was not significantly different between groups initially (4.0 vs 4.0, p=0.57) and at 3 weeks (4.0 vs 3.0, p=0.25). Multisource feedback was perceived to be helpful and superior to the existing feedback process. Feasibility was identified as a challenge.

Conclusions

The self-reported intention for practice change was no different for TTCs who received multisource feedback and those who received standard feedback. Multisource feedback was favourably received by trauma team members, and TTCs perceived multisource feedback as useful for their development.
Protocol for development of an assessment tool for competency of ECG interpretation: expert consensus by the RAND/UCLA appropriateness method and cross-sectional testing using multidimensional item response theory
Authors: Inaba Shinji , Yamamoto Kazumichi , Kaga Tomohiro , Wannous Muhammad , Sakata Masatsugu , Yamaguchi Osamu , Furukawa Toshi A
Published: May 2023

Introduction

Although the ECG is an important diagnostic tool in medical practice, the competency of ECG interpretation is considered to be poor. Diagnostic inaccuracy involving the misinterpretation of ECG can lead to inappropriate medical judgements and cause negative clinical outcomes, unnecessary medical testing and even fatalities. Despite the importance of assessing ECG interpretation skills, there is currently no established universal, standardised assessment tool for ECG interpretation. The current study seeks to (1) develop a set of items (ECG questions) for estimating competency of ECG interpretation by medical personnel by consensus among expert panels following a process based on the RAND/UCLA Appropriateness Method (RAM) and (2) analyse item parameters and multidimensional latent factors of the test set to develop an assessment tool.

Methods and analysis

This study will be conducted in two steps: (1) selection of question items for ECG interpretation assessment by expert panels via a consensus process following RAM and (2) cross-sectional, web-based testing using a set of ECG questions. A multidisciplinary panel of experts will evaluate the answers and appropriateness and select 50 questions as the next step. Based on data collected from a predicted sample size of 438 test participants recruited from physicians, nurses, medical and nursing students, and other healthcare professionals, we plan to statistically analyse item parameters and participant performance using multidimensional item response theory. Additionally, we will attempt to detect possible latent factors in the competency of ECG interpretation. A test set of question items for ECG interpretation will be proposed on the basis of the extracted parameters.

Ethics and dissemination

The protocol of this study was approved by the Institutional Review Board of Ehime University Graduate School of Medicine (IRB number: 2209008). We will obtain informed consent from all participants. The findings will be submitted for publication in peer-reviewed journals.
Early clinical outcome prediction based on the initial National Early Warning Score + Lactate (News+L) Score among adult emergency department patients
Authors: Jo Sion , Jeong Taeoh , Park Boyoung
Published: May 2023

Background

The National Early Warning Score + Lactate (NEWS+L) Score has been previously shown to outperform NEWS alone in prediction of mortality and need for critical care in a small adult ED study. We validated the score in a large patient data set and constructed a model that allows early prediction of the probability of clinical outcomes based on the individual’s NEWS+L Score.

Methods

In this retrospective study, we included all adult patients who visited the ED of a single urban academic tertiary-care university hospital in South Korea for five consecutive years (1 January 2015 to 31 December 2019). The initial (<1 hour) NEWS+L Score is routinely recorded electronically at our ED and was abstracted for each visit. The outcomes were hospital death or a composite of hospital death and intensive care unit admission at 24 hours, 48 hours and 72 hours. The data set was randomly split into train and test sets (1:1) for internal validation. The area under the receiver operating characteristic curve (AUROC) value and area under the precision and recall curve (AUPRC) value were evaluated and logistic regression models were used to develop an equation to calculate the predicted probabilities for each of these outcomes according to the NEWS+L Score.

Results

After excluding 808 patients (0.5%) from 149 007 patients in total, the study cohort consisted of 148 199 patients. The mean NEWS+L Score was 3.3±3.8. The AUROC value was 0.789~0.813 for the NEWS+L Score with good calibration (calibration-in-the-large=−0.082~0.001, slope=0.964~0.987, Brier Score=0.011~0.065). The AUPRC values of the NEWS+L Score for outcomes were 0.331~0.415. The AUROC and AUPRC values of the NEWS+L Score were greater than those of NEWS alone (AUROC 0.744~0.806 and AUPRC 0.316~0.380 for NEWS). Using the equation, 48 hours hospital mortality rates for NEWS+L Score of 5, 10 and 15 were found to be 1.1%, 3.1% and 8.8%, and for the composite outcome 9.2%, 27.5% and 58.5%, respectively.

Conclusion

The NEWS+L Score has acceptable to excellent performance for risk estimation among undifferentiated adult ED patients, and outperforms NEWS alone.
Inequalities in the impact of having a chronic disease on entering permanent paid employment: a registry-based 10-year follow-up study
Authors: van de Ven David , Robroek Suzan J W , Burdorf Alex , Schuring Merel
Published: May 2023

Background

This study aimed to investigate among unemployed persons (1) the impact of having a chronic disease on entering paid employment and obtaining a permanent contract and (2) whether these associations differed by educational attainment.

Methods

Register data from Statistics Netherlands on employment status, contract type, medication and sociodemographic characteristics were linked. Dutch unemployed persons between 18 and 64 years (n=667 002) were followed up for 10 years (2011–2020). Restricted mean survival time analyses (RMSTs) were used to investigate differences in average months until entering paid employment and until obtaining a permanent contract between persons with and without cardiovascular diseases, inflammatory conditions, diabetes, respiratory illness, common mental disorders and psychotic disorders. Interaction terms were included for education.

Results

One-third of the unemployed persons at baseline entered paid employment during follow-up. Persons with chronic diseases spent more months in non-employment compared with persons without chronic diseases (difference ranging from 2.50 months (95% CI 1.97 to 3.03 months) to 10.37 months (95% CI 9.98 to 10.77 months)), especially for persons with higher education. Conditional on entering paid employment, the time until a permanent contract was longer for persons with cardiovascular diseases (4.42 months, 95% CI 1.85 to 6.99 months), inflammatory conditions (4.80 months, 95% CI 2.02 to 7.59 months) and diabetes (8.32 months, 95% CI 4.26 to 12.37 months) than for persons without these diseases. These latter differences were similar across educational attainment.

Conclusions

Having a chronic disease is a barrier to entering permanent paid employment. The findings underline the need to prevent chronic diseases and promote an inclusive workforce.
Serum neurofilament light chain levels at attack predict post-attack disability worsening and are mitigated by inebilizumab: analysis of four potential biomarkers in neuromyelitis optica spectrum disorder
Authors: Aktas Orhan , Hartung Hans-Peter , Smith Michael A , Rees William A , Fujihara Kazuo , Paul Friedemann , Marignier Romain , Bennett Jeffrey L , Kim Ho Jin , Weinshenker Brian G , Pittock Sean J , Wingerchuk Dean M , Cutter Gary , She Dewei , Gunsior Michele , Cimbora Daniel , Katz Eliezer , Cree Bruce A
Published: May 2023

Objective

To investigate relationships between serum neurofilament light chain (sNfL), ubiquitin C-terminal hydrolase L1 (sUCHL1), tau (sTau) and glial fibrillary acidic protein (sGFAP) levels and disease activity/disability in neuromyelitis optica spectrum disorder (NMOSD), and the effects of inebilizumab on these biomarkers in N-MOmentum.

Methods

N-MOmentum randomised participants to receive inebilizumab or placebo with a randomised controlled period (RCP) of 28 weeks and an open-label follow-up period of ≥2 years. The sNfL, sUCHL1, sTau and sGFAP were measured using single-molecule arrays in 1260 scheduled and attack-related samples from N-MOmentum participants (immunoglobulin G (IgG) autoantibodies to aquaporin-4-positive, myelin oligodendrocyte glycoprotein-IgG-positive or double autoantibody-negative) and two control groups (healthy donors and patients with relapsing–remitting multiple sclerosis).

Results

The concentration of all four biomarkers increased during NMOSD attacks. At attack, sNfL had the strongest correlation with disability worsening during attacks (Spearman R2=0.40; p=0.01) and prediction of disability worsening after attacks (sNfL cut-off 32 pg/mL; area under the curve 0.71 (95% CI 0.51 to 0.89); p=0.02), but only sGFAP predicted upcoming attacks. At RCP end, fewer inebilizumab-treated than placebo-treated participants had sNfL>16 pg/mL (22% vs 45%; OR 0.36 (95% CI 0.17 to 0.76); p=0.004).

Conclusions

Compared with sGFAP, sTau and sUCHL1, sNfL at attack was the strongest predictor of disability worsening at attack and follow-up, suggesting a role for identifying participants with NMOSD at risk of limited post-relapse recovery. Treatment with inebilizumab was associated with lower levels of sGFAP and sNfL than placebo.

Trial registration number

NCT02200770.
Cerebral enhancement in MOG antibody-associated disease
Authors: Elsbernd Paul , Cacciaguerra Laura , Krecke Karl N , Chen John J , Gritsch David , Lopez-Chiriboga A Sebastian , Sechi Elia , Redenbaugh Vyanka , Morris Padraig P , Carter Jonathan L , Wingerchuk Dean M , Tillema Jan-Mendelt , Valencia-Sanchez Cristina , Thakolwiboon Smathorn , Pittock Sean J , Flanagan Eoin P
Published: May 2023

Introduction

Limited data exist on brain MRI enhancement in myelin-oligodendrocyte-glycoprotein (MOG) antibody-associated disease (MOGAD) and differences from aquaporin-4-IgG-positive-neuromyelitis-optica-spectrum-disorder (AQP4+NMOSD), and multiple sclerosis (MS).

Methods

In this retrospective observational study, we identified 122 Mayo Clinic MOGAD patients (1 January 1996–1 July 2020) with cerebral attacks. We explored enhancement patterns using a discovery set (n=41). We assessed enhancement frequency and Expanded Disability Status Scale scores at nadir and follow-up in the remainder (n=81). Two raters assessed T1-weighted-postgadolinium MRIs (1.5T/3T) for enhancement patterns in MOGAD, AQP4+NMOSD (n=14) and MS (n=26). Inter-rater agreement was assessed. Leptomeningeal enhancement clinical correlates were analysed.

Results

Enhancement occurred in 59/81 (73%) MOGAD cerebral attacks but did not influence outcome. Enhancement was often patchy/heterogeneous in MOGAD (33/59 (56%)), AQP4+NMOSD (9/14 (64%); p=0.57) and MS (16/26 (62%); p=0.63). Leptomeningeal enhancement favoured MOGAD (27/59 (46%)) over AQP4+NMOSD (1/14 (7%); p=0.01) and MS (1/26 (4%); p<0.001) with headache, fever and seizures frequent clinical correlates. Ring enhancement favoured MS (8/26 (31%); p=0.006) over MOGAD (4/59 (7%)). Linear ependymal enhancement was unique to AQP4+NMOSD (2/14 (14%)) and persistent enhancement (>3 months) was rare (0%–8%) across all groups. Inter-rater agreement for enhancement patterns was moderate.

Conclusions

Enhancement is common with MOGAD cerebral attacks and often has a non-specific patchy appearance and rarely persists beyond 3 months. Leptomeningeal enhancement favours MOGAD over AQP4+NMOSD and MS.
Musculoskeletal injuries in US Air Force Tactical Air Control Party trainees: an 11-year longitudinal retrospective cohort study and presentation of a musculoskeletal injury classification matrix
Authors: Hando Ben R , Bryant J , Pav V , Haydu L , Hogan K , Mata J , Butler C
Published: May 2023

Introduction

Little is known of the epidemiology of musculoskeletal injuries (MSKIs) in US Air Force Special Warfare (AFSPECWAR) Tactical Air Control Party trainees. The purpose of this longitudinal retrospective cohort study was to (1) report the incidence and type of MSKI sustained by AFSPECWAR trainees during and up to 1 year following training, (2) identify factors associated with MSKI, and (3) develop and present the MSKI classification matrix used to identify and categorise injuries in this study.

Methods

Trainees in the Tactical Air Control Party Apprentice Course between fiscal years 2010–2020 were included. Diagnosis codes were classified as MSKI or non-MSKI using a classification matrix. Incidence rates and incidence proportion for injury types and regions were calculated. Measures were compared for differences between those who did and did not sustain an MSKI during training. A Cox proportional hazards model was used to identify factors associated with MSKI.

Results

Of the 3242 trainees, 1588 (49%) sustained an MSKI during training and the cohort sustained MSKIs at a rate of 16 MSKI per 100 person-months. Overuse/non-specific lower extremity injuries predominated. Differences were seen in some baseline measures between those who did and did not sustain an MSKI. Factors retained in the final Cox regression model were age, 1.5-mile run times and prior MSKI.

Conclusion

Slower run times and higher age were associated with an increased likelihood of MSKI. Prior MSKI was the strongest predictor of MSKI during training. Trainees sustained MSKIs at a higher rate than graduates in their first year in the career field. The MSKI matrix was effective in identifying and categorising MSKI over a prolonged (12-year) surveillance period and could be useful for future injury surveillance efforts in the military or civilian settings. Findings from this study could inform future injury mitigation efforts in military training environments.
Tirofiban combined with Aspirin in the Treatment of Acute Penetrating Artery Territory Infarction (STRATEGY): protocol for a multicentre, randomised controlled trial
Authors: Liao Xiaoling , Feng Shuo , Wang Yicong , Pan Yuesong , Chen Weiqi , Qu Hui , Zhao Xingquan , Liu Liping , Wang Yongjun , Wang Yilong
Published: May 2023

Background

Perforating artery territorial infarction (PAI) caused by branch atheromatous disease (BAD) is prone to recurrence and early progression without an effective and well-documented antiplatelet treatment regimen. Tirofiban, an adjunctive antiplatelet agent, has shown great potential to treat acute ischaemic stroke. However, whether the combination of tirofiban and aspirin can improve the prognosis of PAI remains unclear.

Aim

To explore an effective and safe antiplatelet regimen for reducing the risk of recurrence and early neurological deterioration (END) in PAI caused by BAD by comparing the tirofiban and aspirin combination with placebo and aspirin combination.

Methods

Tirofiban combined with Aspirin in the Treatment of Acute Penetrating Artery Territory Infarction (STRATEGY) trial is an ongoing multicentre, randomised, placebo-controlled trial in China. Eligible patients shall be randomly assigned to receive standard aspirin with tirofiban or placebo on the first day and standard aspirin from days 2 to 90. The primary endpoint is a new stroke or END within 90 days. The primary safety endpoint is severe or moderate bleeding within 90 days.

Discussion

The STRATEGY trial will assess whether tirofiban combined with aspirin is effective and safe in preventing recurrence and END in patients with PAI.

Trial registration number

NCT05310968.
An overlooked market: loose cigarettes, informal vendors and their implications for tobacco taxation
Authors: Gallien Max , Occhiali Giovanni , Ross Hana
Published: May 2023

Objective

To examine the features of markets for loose cigarettes in several low-income and middle-income countries and their effects on tobacco control policies, particularly taxation.

Design

An analysis of survey data targeting people who smoke in two African, one Southeast Asian and two South Asian countries and retailers across 16 African countries to study loose cigarette markets and examine how prices in these markets move relative to the prices for cigarette packs.

Results

Markets for loose cigarettes are large, and their consumer base tends to differ from the wider population of people who smoke. Loose cigarette prices are on average higher than those of cigarettes bought in packs, and they respond differently to tax increases, at least partially due to a denomination effect.

Conclusions

The features of the loose cigarette markets present a challenge for tobacco control policy, especially tobacco tax policy. One way to overcome this challenge is to aim for large, rather than incremental, tax increases.
Array of cryogenic calorimeters to evaluate the spectral shape of forbidden $$\beta $$-decays: the ACCESS project
Authors: Pagnanini L. , Benato G. , Carniti P. , Celi E. , Chiesa D. , Corbett J. , Dafinei I. , Di Domizio S. , Di Stefano P. , Ghislandi S. , Gotti C. , Helis D. L. , Knobel R. , Kostensalo J. , Kotila J. , Nagorny S. , Pessina G. , Pirro S. , Pozzi S. , Puiu A. , Quitadamo S. , Sisti M. , Suhonen J. , Kuznetsov S. ,   The ACCESS Collaboration
Published: May 2023

The ACCESS (Array of Cryogenic Calorimeters to Evaluate Spectral Shapes) project aims to establish a novel technique to perform precision measurements of forbidden $$\beta $$
β
-decays, which can serve as an important benchmark for nuclear physics calculations and represent a significant background in astroparticle physics experiments. ACCESS will operate a pilot array of cryogenic calorimeters based on natural and doped crystals containing $$\beta $$
β
-emitting radionuclides. In this way, natural (e.g. $$^{113}$$

113

Cd and $$^{115}$$

115

In) and synthetic isotopes (e.g. $$^{99}$$

99

Tc) will be simultaneously measured with a common experimental technique. The array will also include further crystals optimised to disentangle the different background sources, thus reducing the systematic uncertainty. In this paper, we give an overview of the ACCESS research program, discussing a detector design study and promising results of $$^{115}$$

115

In.
Modelling Uncertainty in Architectures of Parametric Component-Based Systems
Authors: Pittou Maria , Rahonis George
Published: May 2023

In this paper, we propose a logic-based characterization of uncertainty in architectures of parametric component-based systems, where the parameter is the number of instances of each component type. For this, we firstly introduce an extended propositional interaction logic over De Morgan algebras and we show that its formulas can encode the uncertainty of several architectures applied in systems with a finite number of components. In turn, we introduce a first-order extended interaction logic over De Morgan algebras which is applied for modelling uncertainty in the interactions of well-known parametric architectures. Moreover, we prove that the equivalence problem for a large class of formulas of that logic is decidable in doubly exponential time by providing an effective translation to fuzzy recognizable series. For any such formula over a totally ordered De Morgan algebra, we further prove that we can compute in exponential time the set of sequences of parametric fuzzy interactions which ensure the trustworthiness of the formula according to a particular threshold.
Anti-plane fracture behavior of n nano-cracks emanating from a magnetoelectrically semi-permeable regular n-polygon nano-hole in magnetoelectroelastic materials
Authors: Wu Zhilin , Liu Guanting , Yang Dongsheng
Published: May 2023

Based on Gurtin–Murdoch surface/interface model and complex potential theory, by constructing a new conformal mapping function, the fracture behavior on n nano-cracks emanating from a n-polygon nano-hole under far-field anti-plane mechanical load, inplane electrical load and magnetic load is studied. The analytical solutions of stress intensity factor, electric displacement intensity factor and magnetic induction intensity factor at the crack tip are given under the boundary conditions of magnetoelectrically semi-permeable. In addition, numerical examples show that when considering the surface effect, the stress field intensity factor, electric displacement intensity factor and magnetic induction intensity factor have obvious size-dependence. The results of this paper show that when the defect size increases to a certain extent, the influence of the surface effect begins to decrease, and finally tends to the results of classical elastic theory.
On invariants of surfaces in the 3-sphere
Authors: Kurihara Hiroaki
Published: May 2023

In this paper we study isotopy classes of closed connected orientable surfaces in the standard [Formula: see text]-sphere. Such a surface splits the [Formula: see text]-sphere into two compact connected submanifolds, and by using their Heegaard splittings, we obtain a [Formula: see text]-component handlebody-link. In this paper, we first show that the equivalence class of such a 2-component handlebody-link up to attaching trivial [Formula: see text]-handles can recover the original surface. Therefore, we can reduce the study of surfaces in the [Formula: see text]-sphere to that of [Formula: see text]-component handlebody-links up to stabilizations. Then, by using [Formula: see text]-families of quandles, we construct invariants of [Formula: see text]-component handlebody-links up to attaching trivial [Formula: see text]-handles, which lead to invariants of surfaces in the [Formula: see text]-sphere. In order to see the effectiveness of our invariants, we will also show that our invariants can distinguish certain explicit surfaces in the [Formula: see text]-sphere.
A Novel Framework for Securing ECDH Encrypted DICOM Pixel Data Stored Over Cloud Using IPFS
Authors: Prabu Shankar K. C. , Prayla Shyry S.
Published: May 2023

The future holds the possibility of hospitals sharing medical images obtained through non-invasive systems to patients remotely. The advent of cloud and the storage and deployment of medical healthcare images in the cloud has resulted in the increased need for application of Cryptographic techniques to protect them from unauthorized access and malicious attacks. The Digital Imaging and Communication in Medicine (DICOM) standard is more compatible across medical imaging instruments globally. The pixel data of DICOM images requires more privacy and security. A novel ECDS based cryptographic approach is suggested to encrypt the original DICOM image as well as the ROI pixel data extracted from DICOM images. Results computed experimentally have proved that medical image encryption via ECDH is more robust, efficient and faster than existing medical image encryption schemes.