bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling Nanoscale Ohmics in Carbon Supports of Fuel Cell Cathodes
Authors: Wan Charles Tai-Chieh , Darling Robert M. , Chiang Yet-Ming , Brushett Fikile R.
Published: May 2023

Reducing platinum (Pt) loading in polymer electrolyte fuel cells (PEFCs) while meeting performace requirements is critical to their widespread deployment. However, significant polarization losses manifest at higher current densities in cathodes with lower Pt content. The morphology of the carbon supports in PEFC cathodes affects the location of Pt deposition into the micropits or onto the surface of the carbon support, translating into different kinetic and transport resistances. In this work, we derive an agglomerate scale model that differentiates the sink terms for Pt on the surface and in the pits of carbon supports. We develop an approach to assess the impact of nanoscale ohmic resistance to Pt in the micropits arising from weakly ionic solution in the carbon support on PEFC performance. Effectiveness factors relating the actual reaction rate to the maximum reaction rate (had all the Pt been exposed) are derived and embedded into a one-dimensional catalyst layer model. Parameters in the catalyst layer model are tuned based on experimental local oxygen transport resistances. Subsequently, we estimate bounds for the micropore resistances based on geometric and physical arguments. Lastly, polarization curves are simulated to assess the effect of the micropore resistance in fully-humidified and oxygen-rich environments.
Crack Growth Rate at Oxygen Electrode/Electrolyte Interface in Solid Oxide Electrolysis Cells Predicted by Experiment Coupled Multiphysics Modeling
Authors: Jayapragasam Puvikkarasan , Wen Yeting , Cook Korey , Wrubel Jacob A. , Ma Zhiwen , Huang Kevin , Jin Xinfang
Published: May 2023

Solid oxide electrolysis cell (SOEC) is a very efficient hydrogen production technology, but the cell degradation is a serious limiting factor for its long-term implementation. Oxygen electrode (OE) delamination is reported to be the critical degradation mechanism. In this study, we present a methodology to understand the delamination failure of the OE due to chemical stress in a better perspective. Several OE configurations were tested: baseline strontium-doped lanthanum cobalt iron oxide (LSCF) single layer design and tantalum-doped strontium cobalt oxide (SCT) - LSCF bilayer designs with different SCT loadings. An electro-chemo-mechanical model is developed to associate the electrochemical behavior of the cell with solid mechanics for calculating crack growth of the cell during long term test. The bilayer configuration with SCT 20 wt% has better performance as it survived in the long-term life test with the least crack length. This study implies that an additional nano-coating of SCT over the OE have improved the species transport and oxygen evolution with reduced chemical stress. As the operating current density decreases, it takes longer time for the cell to reach the delamination with the same critical crack length of 6.5 μm (∼93% of the electrode/electrolyte interface length). Finally, it was concluded that chemical stress plays a significant role in interface delamination failure, however it may not be the only source of stresses at the interface.
Insights into the Path-Dependent Charge of Iridium Dissolution Products and Stability of Electrocatalytic Water Splitting
Authors: Dam An Phuc , Abuthaher Bassam Y. A. , Papakonstantinou Georgios , Sundmacher Kai
Published: May 2023

The electrocatalytic stability of the oxygen evolution reaction (OER) is challenging for the storage of fluctuating renewable energies using polymer electrolyte membrane water electrolyzers (PEMWEs). Investigations are commonly conducted in so-called half-cell setups and different OER-related dissolution pathways have been proposed. However, the orders of magnitude difference in dissolution rate between half-cells and PEMWE using membrane electrode assemblies (MEA) is not well understood. In this work, the charge-related absorption affinity of Iridium (Ir) dissolution products, from both half-cell and MEA setups, is investigated, using cation and anion exchange materials. In the half-cell, a roughly constant ratio of cationic to anionic dissolution species is indicative of a single, dominant OER-related Ir dissolution pathway. While Ir dissolved in half-cells is mainly cationic, the Ir species from the MEA appear mainly in anionic form. This can be explained by the transport conditions of different Ir ions inside the catalyst layer, influenced by their ionomer absorption affinity and the migration driving force. Based on this understanding, key influences of electrocatalytic stability of MEAs, the effect of confinement of dissolved Ir species and the stability discrepancy to half-cells are discussed.
Green Synthesis by Microwave Irradiation of TiO2 Using Cinnamomum verum and the Application in Photocatalysis
Authors: González-Anota Dante E. , Paredes-Carrera Silvia P. , Pérez-Gutierrez Rosa M. , Arciniega-Caballero Brandon , Borja-Urby Raul , Sánchez-Ochoa Jesús C. , Rojas-García Elizabeth
Published: May 2023

The extraction process of bioactives from the aqueous extract of cinnamon (Cinnamomum verum) was optimized using the Design Expert 11 program and analysis of variance (ANOVA) by considering the following parameters: cinnamon weight (g), power (W), and time (s) of microwave irradiation. The optimal conditions are cinnamon weight of 4.5 grams, time of 600 seconds, and power of 150 watts of microwave irradiation. With Cinnamomum verum extract under optimal conditions and titanium (IV) tetrachloride as a precursor, TiO2 nanostructures were synthesized using the sol-gel method assisted by microwave irradiation in the crystallization stage with a power and irradiation time of 150 W and 600 sec, respectively. Similarly, a sample without extract was synthesized under the same conditions. The following techniques characterized the materials: X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, UV-vis diffuse reflectance, Raman spectrometry, and high-resolution transmission electron microscopy (HRTEM). It was feasible to obtain nanocrystalline solids of TiO2 anatase phase with and without cinnamon extract; the particle size and the crystallinity were influenced by the bioactive agents during the synthesis (aqueous extract of Cinnamomum verum) and the synthesis method (microwave irradiation); a smaller crystal size, a smaller particle size, a higher crystalline order, and a lower band gap were achieved for the material synthesized with cinnamon extract compared to the material synthesized without extract and other methods. The synthesized materials were evaluated in the photodegradation of methyl orange (as a model of photodegradation), employing as reference parameters the commercial TiO2 brand Sigma-Aldrich phase anatase and the photolysis of the system. The amount of dye adsorbed in the tested materials was quantified, finding an equilibrium time of 15 min, where the TiO2 synthesized with Cinnamomum verum extract was the material that most adsorbed methyl orange at 7.5%. In the case of photodegradation, the TiO2 synthesized with cinnamon extract apparently promoted the total mineralization of methyl orange in 40 minutes of reaction, making it the best material of those evaluated in the photodegradation. In all cases, the degradation models were adjusted to a first-order kinetic model, where it was confirmed that the highest reaction rate corresponded to TiO2 synthesized with Cinnamomum verum.
Effects of an On‐Campus Meditation Course on Depression, Anxiety, Stress, and Sleep Quality among South Korean Paramedic Students
Authors: Yoo Yang Gyeong , Yun MiRa , Lee In-Soo , Kim Hyeyoung , Roh Sang Gyun , Yu Boas
Published: May 2023

Background. Paramedic students frequently face various stressful and challenging situations as they work in emergency medical settings. Currently, research studies on utilizing meditation courses as a part of the curriculum to improve the mental health of paramedic students in Korea are lacking. Methods. For this quasiexperimental study, a nonequivalent group pretest and post‐test research design was used. The study sample comprised 55 paramedic students from two similar‐sized universities in different locations: 27 in the experimental group and 28 in the control group. The experimental group participated in an eight‐week meditation course, while the control group did not receive any interventions during the same time period. Results. The results indicated that compared with the control group, the experimental group had significantly decreased anxiety (p = 0.047) and stress levels (p = 0.044) and improved sleep quality (p = 0.041). The change in depression levels did not significantly differ between the groups (p = 0.419). Conclusions. The inclusion of a meditation course within college curriculums for paramedic students is feasible and may benefit students in terms of stress, anxiety, and sleep quality.
Vehicular Crowdsensing with High-Mileage Vehicles: Investigating Spatiotemporal Coverage Dynamics in Historical Cities with Complex Urban Road Networks
Authors: Starace L. L. L. , Rocco Di Torrepadula F. , Di Martino S. , Mazzocca N.
Published: May 2023

Background. Vehicular crowdsensing (VCS) can be a cost-effective solution to gather data in urban environments, leveraging the onboard sensors of modern vehicles moving around the city. Many experimental studies have proven that high-mileage vehicles, such as taxis, can be effectively used for VCS. However, these studies have been mostly carried out in cities with regular, grid-based, road networks. Conversely, little work has been conducted to assess the suitability of VCS in cities with more complex urban road networks, such as historical ones. Goal. As a step towards filling this gap, the present study investigates the feasibility of using different-sized fleets of taxis to crowdsense information in the urban areas of the historical cities of Porto (Portugal) and Rome (Italy), whose road networks evolved over the centuries and feature a complex topology. Data and Methodology. This work leverages massive real-world datasets of taxi trajectories collected over three contiguous weeks in the cities of Porto and Rome to estimate the spatiotemporal coverage achievable by different-sized fleets of taxis if they were used for VCS. Indeed, using these trajectories, several simulations were conducted, considering four sizes of taxi fleets, ranging from 50 to 400 vehicles, for both cities. The achievable spatiotemporal road network coverage metrics were computed at a fine-grained scale of single road segments. Results. Results show that the achievable coverage in both historical cities exhibits very similar trends, with as few as 50 vehicles being capable of visiting a relevant part of the road network at least once in the considered time frame. As expected, increasing the number of involved vehicles improves spatial and temporal coverage. Still, time gaps between subsequent visits can be possibly inadequate for some VCS use cases. As a consequence, recruiting more vehicles and/or devising specialized routing/incentivization mechanisms might be necessary to achieve more comprehensive coverage of the urban road network.
Blockchain-Based Privacy-Preserving Sensor Data Sharing with Fine-Grained Authorization in Microgrid
Authors: Yu Jinhu , Han Yue , Zhang Kai , Chen Siyuan , Li Jinguo
Published: May 2023

Microgrid is a power system that includes various energy sources (e.g., solar panels and wind turbines), where a number of device status and sensing data are collected and transmitted by smart sensors. Based on sensing-as-a-service in microgrid, sensor owners and sensor data consumers can effectively perform data sharing operations. However, the state-of-the-art sensor data sharing works in microgrid have the following two limitations: (i) cannot support fine-grained authorization for sensor owners and sensor data consumers and (ii) fail to simultaneously consider confidentiality and authenticity for sensor data sharing. To address the problems, in this article, we propose a lightweight privacy-preserving sensing data sharing system with fine-grained authorization in microgrid. Technically, we employed attribute-based signature methodology to design a fined-grained authorization mechanism for sensor data users. Moreover, a lightweight hyper elliptic curve-based signcryption scheme is employed to provide confidentiality and authenticity for sensor data sharing. To clarify the feasibility of our proposed system, we implement the system and evaluate the performance. The experimental results show that the system achieves small communication and time overhead, as well as highly acceptable gas consumption of smart contract.
Attenuation of Sialylation Augments Antitumor Immunity and Improves Response to Immunotherapy in Ovarian Cancer
Authors: Cao Kankan , Zhang Guodong , Yang Moran , Wang Yiying , He Mengdi , Zhang Chen , Huang Yan , Lu Jiaqi , Liu Haiou
Published: May 2023

Aberrant sialylation functions as an important modulator of all steps of malignant transformation. Therefore, targeting sialylation regulators, such as sialyltransferases and neuraminidases, is a potential strategy for treating cancer. Here, we found that elevated α2,3-sialyltransferase III (St3gal3) was associated with dismal prognosis in high-grade serous ovarian carcinoma (HGSC). St3gal3 knockdown antagonized subcutaneous tumor growth in immunocompetent, but not immunodeficient mice, with enhanced accumulation of functional CD8+ T cells and antitumor immune gene signatures. St3gal3 knockdown inhibited intraperitoneal tumor growth and repolarized tumor-associated macrophages from a protumorigenic M2-like to a tumor-suppressive M1-like phenotype. In vitro, St3gal3 knockdown tumor cells guided bone marrow–derived macrophages (BMDM) toward the M1-like phenotype under both direct contact and distant Transwell coculture conditions. Depletion of macrophages rescued the suppressed tumor growth induced by St3gal3 knockdown and completely suppressed infiltration of functional CD8+ T cells that rely on macrophage-derived CXCL10. St3gal3 engendered an immunosuppressive HGSC microenvironment characterized by an abundance of pro-tumorigenic macrophages and reduced cytotoxic T-cell infiltration. In vivo, St3gal3 knockdown improved effectiveness of dual immune checkpoint blockade (ICB) with αPD-1 and αCTLA4 antibodies. Preclinical inhibition of sialylation with ambroxol resulted in decreased tumor growth and prolonged the survival of tumor-bearing mice, which was enhanced by the addition of dual ICB. These findings indicate that altered sialylation induced by St3gal3 upregulation promotes a tumor-suppressive microenvironment in HGSC and targeting α2,3-sialylation may reprogram the immunosuppressive tumor microenvironment and improve the efficacy of immunotherapy.

Significance:

Blocking sialylation augments antitumor immunity and enhances response to immune checkpoint blockade therapy, highlighting a potential therapeutic approach for treating patients with high-grade serous ovarian cancer.
Supplementary Material 1 from Uncoupling CD4+ TIL-Mediated Tumor Killing from JAK-Signaling in Melanoma
Authors: Draghi Arianna , Presti Mario , Jensen Agnete W.P. , Chamberlain Christopher A. , Albieri Benedetta , Rasmussen Anne-Christine K. , Andersen Mads H. , Crowther Michael D. , Svane Inge Marie , Donia Marco
Published: May 2023

Supplementary Figures and Tables
What Is Aristotle’s Metaphysics About?
Authors: Judson Lindsay
Published: May 2023

This paper argues that the discussion in which Aristotle engages in Metaphysics ΖΗ has the same starting-point as natural science: the principles of changing substances. These inquiries are nonetheless distinct because natural science uses these principles in its detailed investigations into natural substances, whereas ΖΗ reflect on the principles themselves. ΖΗ are an integral part of Aristotle’s inquiry into the principles of all substances, changing and unchanging: they are not merely preliminary to an inquiry into the latter kind. They are also an integral part of Aristotle’s ‘first philosophy’, alongside theology’s study of the nature and activity of unchanging substances.
‘Who Touched Me?’ Embodied Witness as Public Theology
Authors: Wivell Ruth
Published: May 2023

This article addresses how trauma might inform the way Mark’s account of the haemorrhaging woman is read, and what a Christology derived therefrom might offer to Christians who wish to witness to people’s traumatic and posttraumatic realities. If Christians and theologians are called to witness to others’ suffering and their attempts to make sense of it, then they need to be able to inhabit a space that draws forth stories of those disempowered and traumatized. In particular, this article explores these issues by addressing inter-related facets of Jesus the Christ in Mark 5:24–34 as he responds to the haemorrhaging woman and is involved in her healing. It is Jesus’s shift to witness – as he loses power and cognition – that brings about the hope of ongoing restoration of the woman’s body and spirit.
‘Flood this Nation with the Bible’: Rev. Godfridah Sumaili, Politics and the People’s Bible in Zambia
Authors: Kaunda Chammah J.
Published: May 2023

Ever since the Declaration of Zambia as a Christian nation in 1991, the Bible has become foundational in the public of life, and often cited in public debates. This article employs symbolic power as an analytical tool to examine Sumaili’s state theology of the Bible which politicized and reduced the Bible in the public into a state apparatus for defining, shaping, and determining the meaning and content for governing Zambia. It proposes a Pentecostal public theology of the people’s Bible as a site of struggle against politics of dehumanization, oppression, exploitation, and systematic inequalities.
Lost for Words: Samoa’s Constitutional Crisis and the Case for a Public Theology
Authors: Amosa Sam
Published: May 2023

The Samoan election of 2021 provoked a constitutional crisis. It brought to an end sixty years of political stability that had been determined by the interweaving of democratic ideals with indigenous cultural values and Christian principles. The election had led to a tie on the night and led to various legal appeals, protests and the reluctance of the Prime Minister of more than twenty years refusing to stand down. With one exception – the Roman Catholic Archbishop – the churches were silent, ‘lost for words’. The crisis happened at a time when the first wave of localized and contextual public theologies were beginning to appear in theological research. Their particular focus was on a range of other issues (mainly due to timing). Their emergence, nevertheless, invites a consideration of what such a public theology might look like in a society where there is no history of a prophetic voice and the cultural system of fa’aSamoa relies upon a principle of respect (which was violated during the crisis).
“Giving What They Hold Dear”: Safavid Diplomatic Gifts to Venice
Authors: Guliyev Ahmad
Published: May 2023

The exchange of gifts was an important aspect of the relations between the Safavid Empire and the Republic of Venice. Drawing on Venetian archival documents, the article aims to explore the nature and significance of Safavid diplomatic gift-giving to Venice in the first third of the seventeenth century. In particular, it examines the place and importance of precious objects in gift exchanges, looking at specific types of gifts given such as carpets, textiles, and weaponry. The article sheds light on the role religion played in the determination of a Shah’s choice of a gift to the Doge. Furthermore, this article examines how the diplomatic gifts from the Safavid rulers were viewed and conceived in Venice. Using a comparative perspective, the article explores the differences between the Safavid gift-giving strategies towards Venice and Ottomans. It reveals that the Safavids and Venetians had a common understanding of what was worthy of giving.
Science Counselors of the European Union – a Case Study of Science Diplomacy
Authors: Ruffini Pierre-Bruno
Published: May 2023

The posting of science attachés to diplomatic representations abroad is a tool particularly suited to the implementation of a science diplomacy strategy. The European Commission embarked on this practice by the end of the last century and today there are twelve science counselors stationed in European Union (EU) delegations. All of them were interviewed, and filled out a short survey, for this study. This article documents the particular profile and missions of the EU’s science counselors, to which no study has been devoted as such to date. The survey revealed their essential cross-cutting missions: promoting the research framework programs, and enhancing coordination with Member States’ science attachés. This article draws on interviewees’ statements and the existing literature in order to analyze and critically discuss the contribution of science counselors to the implementation of the EU’s science diplomacy and public diplomacy.
Tunisia’s Social Unrest: From July 2021 to Present
Authors: Mnasri Chamseddine
Published: May 2023

This paper is a critical examination of post-July 2021 Tunisia. It delves into four defining issues: first, the significant impact of President Kais Saied’s unexpected decision to suspend parliament and dismiss government on July 25, 2021; second, the various reactions to Saied’s move; third, the failed promises of Saied’s populist project in the face of an unprecedented political, economic, and social crisis; and fourth, drawing on resource mobilization theory, the paper will explain how the government’s policies have caused unprecedented social unrest, thereby sparking significant anti-government protests.
Conventionality Control and the Limits of Pro Persona Jurisprudence
Authors: Contesse Jorge
Published: May 2023

In Conventionality Control of Domestic Law: Constitutionalised International Adjudication and Internationalised Constitutional Adjudication, Yota Negishi advances a theory of conventionality control, a doctrine of interaction between international human rights law and national law, that puts at the center of such interaction the pro persona principle. This commentary analyses Negishi’s work, highlighting its major contributions and noting what it sees as problematic areas of the theory, in particular, the over reliance on the principle, and its use as a mechanism to allocate judicial competences. The commentary notes how the Inter-American Court of Human Rights’ use of the principle can explain some of its most expansive caselaw, a caselaw that has come under scrutiny by members of the Court and that deserves serious attention by legal scholars.
Conventionality Control Between International and Constitutional Law
Authors: Ragone Sabrina
Published: May 2023

This contribution addresses conventionality control in its double dimension, encompassing international law and constitutional law. It focuses on the comparative methodological issues when equating the Inter-American and the European systems of protection of human rights, taking into account the progressive “Europeanization” of the former’s case law. Then, it critically examines the question of judicial authority of domestic and international courts in multilevel systems, to raise a few points concerning the complex relationship between international courts and states.
Rejoinder from the Author
Authors: Negishi Yota
Published: May 2023

This rejoinder is to provide author’s answers to the questions posed by commentators. The first issues is the analytical scope and methods in comparison between the Inter-American and European Courts of Human Rights. The author particularly responds to the lack of analysis on social rights. The second issue is the political backlashes against the judicial control by human rights courts. The author replies that the role of “political”conventionality control complementing the judiciaries is of importance.
The Interplay of State Immunity and Contractual Forum Selection Clauses in Employment Cases: Return to Normalcy
Authors: Rossi Pierfrancesco
Published: May 2023

In Judgment No. 18801 of 2022, in the context of an employment dispute with a foreign State, the Corte di Cassazione declined to give effect to a contract clause conferring exclusive jurisdiction to the courts of the employer State and upheld Italian jurisdiction. With this decision, which was based on the limitations on party autonomy in respect to contracts of employment set forth in the EU Brussels I Regulation, the Court drastically departed from recent precedents where it had declined jurisdiction in the presence of similar contract clauses. Such precedents, in their turn, stood in stark contrast to the earlier jurisprudence of the Court, where jurisdiction had been affirmed based on the Brussels I Regulation. This contribution argues that this ruling constitutes a welcome and much-needed turnaround, bringing the Court’s case law back into line with EU law and the case law of the European Court of Justice and significantly improving the judicial protection afforded to employees of foreign States in Italy – a veritable return to normalcy in employment disputes with foreign States.
The nrrp as a “Self-Restraint” and as a Development of the (Spending) Conditionality Mechanism
Authors: Bartolucci Luca
Published: May 2023

The paper analyzes the conditionality mechanism triggered by the Next Generation EU and by the National Recovery and Resilience Plan. In particular, the interpretation used sees in the nrrp the last stage of the process of conditionality and as a development of the concept of external constraint. Finally, the nrrp is related to the monetary policies of the ecb and to the reform of European economic governance.
The Italian Right-Wing Government and the EU: an Interesting Case Study
Authors: Baraggia Antonia
Published: May 2023

The Italian general elections of September 2022 introduced several interesting novelties in Italian politics. Indeed, the election’s results – which marked the victory of a new governing coalition led by Brothers of Italy, a far-right party, together with the League, Forza Italia, and Noi Moderati – represent a turning point in Italian politics, a significant shift in the political spectrum. In this brief essay, I will tackle the implications of such a shift: after a quick overview of the constitutional guarantees of the Italian system, which, I argue, can protect Italian democracy from illiberal shifts, I will focus on one of the most interesting aspects of the new government, the attitude towards the EU and international law.
Power Spectrum of Dual Varieties of Graphene Allotropes
Authors: Abdullah M. M. , Nizam Rashid , Albargi Hasan B. , Ahmad Mohammad Zaki , Ahmad Javed , Khan Mohd. Farhan , Mustafa Jawed
Published: May 2023

Graphene is a well-known substance with multiple functions. It has potential applications in electronic and optoelectronic devices. Two graphene sheets have been selected for the present investigation: one graphene model and another with a Stone-Wales defect model. Both the graphenes
are heated at different temperatures with the help of the Nose-Hoover method up to 50000 steps. Then different potentials of each are calculated at different temperatures. It has been noted that each graphene first exhibits significant changes at various potentials before becoming consistent
at a specific temperature. Similarly, the total energy of both graphenes is calculated and presented. The phonon spectral densities of both models, viz., graphene and graphene with the Stone-Wales defect, were computed with the help of linear response theory. Four major peaks are observed
in each graphene and in the graphene with the Stone-Wales defect after heating at different temperatures. The presented peaks of graphene and graphene with the Stone-Wales defect are moving left with an increase in temperature. Further, the calculated peaks are decreasing in strength with
an increase in temperature. Before heating the carbon, atoms are tightly bound and can move up and down with full strength since the forces of attraction will be the same from every site of atom position. After heating, the positions of the atoms change, which changes the forces of attraction
at different sites. Thus, atoms are vibrating in a certain area only, or the atom breaks up from its parent.
Are Chest Radiographs or Ultrasound More Accurate in Predicting a Pneumothorax or Need for a Thoracostomy Tube in Trauma Patients?
Authors: DeLoach Joseph P. , Reif Rebecca J. , Smedley Westin A. , Klutts Garrett N. , Bhavaraju Avi , Collins Terry H. , Kalkwarf Kyle J.
Published: May 2023

Background

Historically, chest radiographs (CXR) have been used to quickly diagnose pneumothorax (PTX) and hemothorax in trauma patients. Over the last 2 decades, chest ultrasound (CUS) as part of Extended Focused Assessment with Sonography in Trauma (eFAST) has also become accepted as a modality for the early diagnosis of PTX in trauma patients.

Methods

We queried our institution’s trauma databases for all trauma team activations from 2021 for patients with eFAST results. Demographics, injury variables, and the following were collected: initial eFAST CUS, CXR, computed tomography (CT) scan, and thoracostomy tube procedure notes. We then compared PTX detection rates on initial CXR and CUS to those on thoracic CT scans.

Results

580 patients were included in the analysis after excluding patients without a chest CT scan within 2 hours of arrival. Extended Focused Assessment with Sonography in Trauma was 68.4% sensitive and 87.5% specific for detecting a moderate-to-large PTX on chest CT, while CXR was 23.5% sensitive and 86.3% specific. Extended Focused Assessment with Sonography in Trauma was 69.8% sensitive for predicting the need for tube thoracostomy, while CXR was 40.0% sensitive.

Discussion

At our institution, eFAST CUS was superior to CXR for diagnosing the presence of a PTX and predicting the need for a thoracostomy tube. However, neither test is accurate enough to diagnose a PTX nor predict if the patient will require a thoracostomy tube. Based on the specificity of both tests, a negative CXR or eFAST means there is a high probability that the patient does not have a PTX and will not need a chest tube.
Acute Outcomes of Cardiac Operations in Patients With Autoimmune Disorders: A National Analysis
Authors: Sakowitz Sara , Bakhtiyar Syed Shahyan , Kim Shineui , Ali Konmal , Verma Arjun , Chervu Nikhil , Sanaiha Yas , Benharash Peyman
Published: May 2023

Background

Accelerated atherosclerosis, inflammation, and valve pathology are known complications of autoimmune connective tissue diseases (AID). However, outcomes of coronary artery bypass graft surgery (CABG) or valve operations among these patients remain underexamined.

Methods

All adult hospitalizations for elective CABG or valve procedures were identified from the 2010-2019 Nationwide Readmissions Database. Autoimmune connective tissue disease was defined to include systemic lupus erythematosus (SLE), antiphospholipid syndrome (APLS), polymyalgia rheumatica (PMR), and other autoimmune AIDs. Entropy balancing was applied to generate balanced patient cohorts. Multivariable regression models were constructed to assess the independent associations between AID and outcomes of interest.

Results

Of ∼1 652 573 patients, 21 019 (1.3%) had AID (23.7% SLE, 17.2% APLS, 29.5% PMR, and 29.6% other). Autoimmune connective tissue disease patients were more frequently female (60.8 vs 33.1%, P < .001) and insured by Medicare (71.4 vs 62.2%, P < .001) and presented with a higher comorbidity index (5.2 ± 1.8 vs 4.1 ± 1.8, P < .001). Further, AID less frequently underwent isolated CABG (39.0 vs 52.3%) but more commonly isolated valve operations (41.9% vs 31.0%, P < .001), relative to non-AID. Following risk-adjustment, AID was not linked with increased odds of mortality or cardiac complications. However, AID was linked with a greater risk of thrombotic complications, blood transfusion, and non-elective readmission within 30 days, as well as a +$900 decrement in hospitalization costs.

Discussion

Autoimmune connective tissue disease patients demonstrated acceptable outcomes following CABG and valve procedures. However, novel prophylactic care pathways should be developed and instituted to address greater thrombotic and blood transfusion risk. Further investigation is needed to identify factors contributing to greater non-elective readmissions among these patients.
Geopolitical Transformation in Eastern Mediterranean; Restructuring Role of Greece and the Impact of Abraham Accord
Authors: Bakhshandeh Ehsan , Yeganeh Yasaman
Published: May 2023

After the Arab uprising of the early 2010s which changed the geopolitical shape of the Eastern Mediterranean, the Abraham Accords in 2020 marked the second most momentous development of the past decade, which drove more external players to the scene of geopolitics of the Mediterranean region. The Abraham Accords improved Israel’s relations with some Arab states of the Persian Gulf such as the UAE, Bahrain and Saudi Arabia and paved their way, under the full support of the United States, to heavily partake in geopolitical and geostrategic equations, mainly in energy and security nature, of the Eastern Mediterranean formulated mainly by Greece under the Neo-Democracy government. The present research explores the changing character of geopolitics in the Mediterranean and how Greece is playing its role in restructuring such a character. The findings of this research suggest that Greece is playing a prominent and leading role in transforming the geopolitics of the Eastern Mediterranean through security and energy initiatives for protection against possible aggression from Turkiye. Considering the supreme importance of the Mediterranean commercially and militarily for the United States, this article argues that the new design of geopolitics in the region is being shaped to protect Greece and Israeli interests in favour of the USA in the Eastern Mediterranean.
Relations Between Violence Exposure and Gun Carriage: Identifying Protective Factors Among African American Youth Living in Low-Income Urban Communities
Authors: Sullivan Terri N. , Ross Katherine M. , O’Connor Kelly E. , Walsh Colleen S. , Bishop Diane
Published: May 2023

This study identified risk, promotive, and protective factors for handgun carriage among 265 primarily African American adolescents ( Mage = 14.3) living in low-income urban areas. Community-based violent victimization and witnessing violence and in-person and cyber forms of peer victimization increased the probability of handgun carriage. Community collective efficacy, including caregiver-reported social connectedness and informal social control, and community developmental strengths/supports, including youth-reported community recognition for prosocial involvement and community developmental assets, moderated relations between both violent victimization and witnessing violence and handgun carriage. School developmental strengths/supports, including school developmental assets and family prosocial involvement in school, moderated relations between in-person and cyber victimization and handgun carriage. Family developmental strengths/supports, including family developmental assets and family recognition and opportunities for prosocial involvement, were associated with lower odds of handgun carriage. Study findings revealed distinct protective factors related to community violence exposure or peer victimization that can inform youth violence prevention efforts.
Promoting Access to Innovative Anticancer Medicines: A Review of Drug Price and National Reimbursement Negotiation in China
Authors: Mingge Xia , Jingyu Wen , Qi Liu , Zhe Zheng , Qing Ran
Published: May 2023

Providing universal access to high-cost medications like anticancer drugs is not an easy feat. Although basic medical insurance has covered over 95% of China’s population since 2012, reimbursement for high-priced medicines is limited. In 2015, the Chinese government proposed establishing an open and transparent price negotiation mechanism for some patented and expensive drugs, where oncology was among the prioritized areas. In 2016, three drugs (gefitinib, icotinib, and tenofovir disoprox) underwent negotiation with the government, eventually reducing their prices by over 50% so that they could be prioritized during reimbursement processes. Focusing on anticancer medicines, this study comprehensively summarizes the progress in drug price and national reimbursement negotiation in China. Furthermore, we investigated the changes and development regarding negotiated anticancer medicines from quantity negotiated, classification, indication coverage, utilization, and procurement spending. Our findings could provide a reference for follow-up negotiations and reimbursement policies for high-value anticancer medications in other countries. From 2016 to 2021, 82 anticancer medicines were newly incorporated into the national reimbursement drug list (NRDL) via 6 rounds of negotiation. The majority of these were innovative pharmaceutics (ie, protein kinase inhibitors (28) and monoclonal antibodies (13)). Drug pricing and national reimbursement negotiation led to a marked decrease in prices and a sharp increase in the utilization of negotiated anticancer medicines. Following negotiations, the defined daily doses (DDDs) of innovative anticancer medicines experienced remarkable growth. Their proportion in total anticancer drugs DDDs also increased from 3.4% in 2014 to 20.9% in 2019. However, although drug prices decreased substantially after the negotiations, insurance spending still showed an upward trend owing to the significant increase in utilization. This calls for the government to carefully monitor the rational use of these expensive medicines and explore innovative payment models.
Well-being Through Transformation: An Integrative Framework of Transformative Tourism Experiences and Hedonic Versus Eudaimonic Well-being
Authors: Huang Xingyu , Wang Peihao , Wu Laurie
Published: May 2023

Transformative tourism experiences are powerful life moments with the capacity to elevate individuals’ well-being. With the rise of transformative tourism and the growing attention to well-being, theoretical research is needed to outline the underlying processes that connect transformative tourism experiences with individual well-being. This study employed grounded theory to critically analyze a set of travel blogs that narrate individual tourists’ transformative tourism experiences. Specifically, we explored how sets of activities during transformative tourism (e.g., backpacker tourism, volunteer tourism, and study tours) contributed to travelers’ hedonic and eudaimonic well-being. We took psychological needs as processes of well-being realization to construct an integrated “activities–needs–well-being” conceptual framework to demonstrate how transformative tourism contributes to travelers’ hedonic and eudaimonic well-being.
Health Disparities in Appalachian and Other Rural Communities
Authors: Hash Kristina M. , Schreurs Bernard G. , Tolley Sheridan M. , Fiske Amy
Published: May 2023

Rural areas are home to a larger proportion of older adults and populations who age within these locales and suffer disproportionately from health, mental health, and economic disparities compared to their urban counterparts. This article will explore the disparities faced by persons that reside in rural communities across the lifespan. It will briefly discuss what is meant by rural. As a rural region at specific risk, the issues confronting those aging in Appalachia will be examined. Finally, best practices and future directions to combat health disparities among rural residents and elders will be discussed. This includes the Appalachian Gerontology Experiences: Advancing Diversity in Aging Research training program which recruits and trains minority and first-generation undergraduate students in aging and health disparity research.
Quantitative evaluation of structural complexity in Shengquan minefield based on improved local linear embedding algorithm
Authors: Zhai Peihe , Liu Yuxiang , Liu Tianhao , Shi Longqin , Lv Changxin
Published: May 2023

Mine water disaster is closely related to the geological structure of the mine. A scientific evaluation of the complexity of the minefield structure can greatly contribute to mining safety. In this study, we optimized the fault impact index in the study area and proposed an improved local linear embedding (LLE) algorithm by investigating the Shengquan coal mine. We analyzed the fault formation age and connectivity between faults in the study area, combined with topology theory, and based on previous studies. The mechanical properties of faults and the influence of small faults on the strata can be combined to derive a quantitative evaluation model of the structural complexity of mines. Based on the evaluation model, the study area was divided into a simple structural area, a medium structural area, and a complex structural area. By comparing the location of water inrush points in recent years with the three-dimensional high-density electrical exploration of the 21,304 working face, the effectiveness and rationality of structural complexity zoning were determined.
Experimental investigation on effect of loading rate on fracture behavior of coal-seam roof rock
Authors: Chen Lichao , Lyu Shuaifeng , Guo Zhang , Xiao Yuhang
Published: May 2023

The fracture behavior of coal-seam roof rock in coal mining is a key and controlling factor for the mode optimization of the artificial roof caving. However, the fracture mechanism of roof rock under loading is not clear. In the work, the split Hopkinson pressure bar (SHPB) experiment was carried out using semicircular bending samples from the sandstone of coal-seam roof rock in the Junger mining area of Inner Mongolia at the loading rate of 0.35–3.78 GPa·m0.5·s−1, and the dynamic fracture behavior and energy dissipation mechanism of samples under different loading rates were investigated. The result shows that the dynamic stress–strain process of the hard roof rock includes four stages: linear instantaneous compaction, linear elastic compression, failure, and fracture extension, in which the failure forms changes from brittle fracture to ductile fracture with the increase of loading rate. The mode I fracture toughness increases linearly under confining pressure. In addition, the propagation orientation of induced fractures is parallel to the loading direction, and the gravel in the samples can inhibit fracture extension, resulting in changing the fracture extension path. Further, the energy absorption efficiency of the samples during the fracture process decreases with the increase in the loading rate.
Effect of Maxillary Sinus Pneumatization on the Ease of Access to Prelacrimal Recess
Authors: Son Sang-Jun , Koo Hyung-Bon , Lee Jae-Hoon
Published: May 2023

Objective:

Prelacrimal recess approach can be used to access lesions of the anterior wall of the maxillary sinus (MS). Moreover, the longer the prelacrimal recess window distance (PLRWD), the easier it is to access the anterior wall. This study aimed to define the correlation between maxillary sinus pneumatization (MSP) and PLRWD, a previously defined anatomic factor predictive of the ease of prelacrimal recess approach (PLRA).

Methods:

In total, 506 sides of 253 participants were studied. In the axial image, the PLRWD, the distance between the anterior wall of the MS and the lacrimal duct, was measured through radioanatomical analysis and classified as type I (<3 mm), type II (3-7 mm), or type III (>7 mm). On the coronal image, the distance between the nasal floor and the lower end of the MS was measured. When MSP did not reach the nasal floor, it was classified as grade I, as grade II when MSP reached the nasal floor, and grade III when the MS was pneumatized below the nasal floor.

Results:

Type I included 115 sides (22.7%); type II, 277 sides (54.7%); and type III, 114 sides (22.5%). Grade I was observed in 58 sides (11.5%), grade II in 38 sides (7.5%), and grade III in 410 sides (81.0%). The mean PLRWD of grade I was 2.35 ± 2.41 mm, II was 3.37 ± 2.46 mm, and III was 5.55 ± 2.54 mm, showing a significant difference ( P < .001). Post hoc analysis showed significant differences in the mean PLRWD among grades I, II, and III. Two anatomical factors, the MSP and PLRWD, were positively correlated ( r = .507, P < .001).

Conclusions:

This study demonstrates a correlation between the feasibility of MSP and PLRA. Both MSP and PLRWD are essential diagnostic parameters for preoperative planning and better surgical outcomes.
“Children don’t think about these things”: Qualitative research on the relationship views and experiences of former unaccompanied refugee children
Authors: Anagnostaki Lida , Zaharia Alexandra
Published: May 2023

Αlthough unaccompanied refugee minors have sadly been and still are a part of the movements observed worldwide of hundreds of thousands of migrants fleeing persecution, violence and war, there seems to be limited research on their relationships from their viewpoint. The present study explored the relationship experiences of former unaccompanied refugee children (now older adults). During the Greek civil war (1944–1949) thousands of children between the ages of three to 14 were taken from their villages in Greece and settled as unaccompanied refugees in institutions in countries of the former Eastern Bloc. The research sought to gain a rich understanding of their views and experiences regarding personal relationships. Nine older adults (8 men and 1 woman), who were separated from their families when they were younger than 10 years of age, were interviewed. Their narratives were analyzed using interpretative phenomenological analysis (IPA). The themes that emerged from the analysis demonstrated that attachment ties to their parents were severely affected by separation raising questions as regards the existence of attachment representations, the importance of relationships seemed generally undermined, while the role of peers was accentuated. The participants’ resilience and coping mechanisms are also discussed.
Disseminated visceral Kaposi’s sarcoma after allogeneic hematopoietic stem cell transplantation: a case report
Authors: Wang RuMin , Li XueGuo , Xu YanFang , Zhang Ling , Mao Min , Wang Chun , Zhang DeZhi , Lang Tao
Published: May 2023

Cases of disseminated visceral Kaposi’s sarcoma (KS) after allogenic hematopoietic stem cell transplantation (HSCT) are very rare worldwide, and disseminated visceral KS is often rapidly progressive and life-threatening, especially in paediatric patients. Here, the case of a 6-year-old female patient with disseminated visceral KS after allogeneic HSCT for treating severe aplastic anaemia is presented. The authors encountered difficulties in making the diagnosis due to lack of experience, but the diagnosis was achieved relatively quickly and accurately using metagenomic next-generation sequencing. After tapering and withdrawal of immunosuppressant drugs, the patient's condition was controlled. In conclusion, although HSCT-related KS is very rare, it should be considered during differential diagnosis.