bluuebunny/crossref_metadata_2025 huggingface dataset:
A Collateral study on Optimization of Pre-Engineered building with Tubular sectional connection
Authors: Disha J , Gourav K
Published: January 2023

Over the recent years, innumerable upheaval has been done in the field of steel construction industry, out of which pre-Engineered buildings (PEB) are one of the most remarkable ones. Pre-Engineered buildings are typical steel structures which are pre-fabricated and the designs are pre-determined which are contemplated to be more cost efficient, because of the tapered sections being utilized, in accordance with its bending moment requirement. These types of structures will not only be cost effective and environmentally friendly but also more flexible, thus eradicating the failure due to sequel of seismic forces. PEBs are generally industrial structures, which are designed for enormous spans. In this research work, the variation of structural behaviour of PEBs when it’s been embraced with considerably increased spans (30 m, 60 m and 90m) are compared and studied. In general, hot rolled tapered I-sections are used in erection of a PEB. Due to the inadequacy in connection configurations available, Pre- Engineered light weight cold form steel structures with tubular steel sectional connections are not well renowned. An attempt is also been made to bring out tubular sectional connections for the beam- rafter junction in all the PEBs deigned for 30 m, 60 m and 90m using E350 steel. Typical connections are proposed for both main frames and the gable frames of the PEB. The outcome of this study appears to be contended for at both the junctions in 30 m span and 60 m span, but 90 m main joint fails, due to the substantial bending moments developed across the major axis. So, these set of connections can be adopted for PEBs up to a moderate span, which helps in reducing the weight of steel that is been utilized in the construction, which successively foster sustainability.
Optimization of critical factors responsible for prestressed concrete bridge pier collapse
Authors: Sayyed Goushiya , Pawar Prashant
Published: January 2023

In this research, the Taguchi approach has been used to identify the crucial factors responsible for the failure of a reinforced concrete bridge pier in India. The Taguchi method’s orthogonal array L27 examines the effect of material dynamic response factors on the pier damage level. According to Taguchi’s design of experiments, five input criteria relating to reinforced concrete bridge materials properties have been chosen as controllable factors: concrete strength, rebar strength, damping ratio, isolator pier stiffness, and abutment stiffness. The nonlinear time history approach uses Midas- Civil for a 3-D finite element model of an existing bridge at Sangli, India. The research included bridge pier collapse as a performance criterion. The analysis of variance revealed that stiffness of abutment, stiffness of pier, and damping ratio for pier deck significantly impacted the pier collapse performance. The result shows that concrete strength and damping ratio are the essential parameters, with 42% and 41% of the total contribution to pier displacement, respectively. Therefore, it is concluded that the most critical material factors for pier collapse are abutment stiffness and pier stiffness, with a contribution of 53 % and 23%, respectively.
Assessing the Application of Lime and Foundry Sand in Soil Stabilization- A Lab Scale Approach
Authors: Naveen Prasad M , Jeya Sudha S , Nagarajan M
Published: January 2023

Strictly speaking, we are in the need of discerning best soil stabilizers to counteract the problems in soft soils. Stabilizers can improve the engineering properties of soil by making it to become more stable. This analysis aims to estimate the effect of foundry sand and lime in sundry proportions based on experimental work. This can be utilized as a modifier or stabilizer in the treatment of clay soil for road work and construction. Lime is obtained by heating limestone at proper temperature. Lime stabilization can be prosperously utilized for projects to improve poor sub grade and soils. Investigations are also done by adding foundry sand which is obtained from metal foundries. It can be used for soil stabilization which can also be an effective option in waste management and sustainable development in construction industry. The effectiveness in stabilizing soils is obtained from the results of standard proctor compaction test, unconfined compressive strength test, California bearing ratio test. As a result of comparison between the three proportions conducted at three days (0, 7, 14) the property of clay increases at the day of 14 and 10% Foundry Sand and 5% lime being one of the most effective proportions. This method includes the compaction of clay soil tested at appropriate quantities of the mix prepared with alternative days. This study proves to be an effective methodology to improve the soil stabilization. Lime and foundry sand has the higher potential to act as soil stabilizers.
Analysis of Skew Bridge-Slab Under IRC Vehicle Loading
Authors: Naik Pavankumar , Gourav K
Published: January 2023

Skew slab bridges are essential in mountainous areas because topographic restrictions prevented changing the alignment of the road also, crossings of roads and railroads. In simple supported bridges, the effect of skew may typically be ignored up to 15 degrees of skew, and the bridge can be constructed as a right-angled bridge. The behaviour of skew slab bridges more than 15 degrees is complicated hence the study on the behaviour of skew-bridge slab under IRC vehicle loading is carried out. About 70 different deck slab models are analyzed in STAAD Pro software with varying width from 1 to 4 lanes, and span lengths of 7.5m and 12m with for skew angles 0° to 50° in increment of 10°.The vehicle loads and positioning of vehicles are done as per IRC-6:2017 standard specifications. The results show that the bending moment and deflection in near edge beams decreases with increase in skew angle. In farer edge beam the bending moment increase till skew of 30° and deflection increases after skew of 30°. The longitudinal bending moment decreases with increase in skew angle. Transverse bending moments are prominent at near the corners that at the centre. The torsion moments are more concerned in slabs with small width and large span. Deflection decreases at all the parts of the slab as skew increases. The maximum deflection in free edges of the slab shifts towards the obtuse corners.
Analysis of Liquefaction Potential of Soils in Guntur Region (CRDA)
Authors: Rani Ch Sandhya , Ram Babu T S , Donavalli Jahnavi
Published: January 2023

In earthquake-prone areas that are susceptible, liquefaction is a severe natural hazard. Due to a rise in pore water pressure, soil liquefaction happens Due to the reduction in strength and stiffness of saturated and cohesion-less soil. By being rapidly loaded or shaken during an earthquake, soil can occasionally lose part of its strength. Liquefaction results in soil failures, which severely harm buildings supported on such grounds and incur large economic losses. Regarding the protection of both life and property, study of liquefaction potential is crucial. The aim of the study is to assess the liquefaction potential in the Guntur region. Understanding the liquefaction mechanism is necessary for a methodical approach to the improvement of capacities to evaluate the liquefaction potentiality of soil deposits & earth structures. So, utilizing the information from the (SPT), liquefaction analysis is done utilizing the strategy of the simplified approach described by Seed and Idriss. It is possible to determine a number of parameters, including reduction factor, cyclic stress ratio (CSR), cyclic resistance ratio (CRR), and liquefaction potential index. More detailed studies can be done by using software to acquire more accuracy.
Basics of computational fluid dynamics: An overview
Authors: Patil Digambar , Kadam Sachin
Published: January 2023

Computational fluid dynamics (CFD) deals with equations that control fluid motion. CFD has several applications in diverse technical domains. In this review paper, a discussion was made on the basics of CFD and its applications in multiple domains. To tackle the fluid problem, CFD has some said procedure that needs to be followed to arrive at the solution step. The first step is to write down a mathematical equation for fluid flow. These mathematical equations are a set of partial derivatives. Discretizing is the next step to deriving this equation concerning numerical equivalent. After that, the domain is divided into tiny grids, popularly known as meshing. The final step involves deciding whether boundary conditions align with the fluid problem. In all CFD standards, these three aspects play an essential role, i.e. (1) A pre-processor is responsible for creating geometry, mesh generation, and providing flow characteristics and boundary conditions to the standard code. (2) A flow solver is utilized to solve equations related to the fluid issue. Researchers commonly use flow solvers, including the finite element method, finite difference method, and finite volume method. (3) A post-processor gives the final display output graphically and understandably. According to most researchers, recent improvements in computational fluid dynamics have created low-cost opportunities. This paper helps to comprehend the CFD standards procedure to solve the fluid problem.
Proposing a Water Distribution Network Solution for an Arid Region Using the Criticality Tool
Authors: Patil Rajendra D , Kumavat Hemraj R , Girase Mandipsinh I , Patil Kuldeep P
Published: January 2023

Water is an essential component of our daily life. Water is delivered to our homes through a water distribution system. Various analyses are required to understand how various elements affect the network. We may run many scenarios on the network and examine the results using the Water Gems software. This software also helps to shorten the time it takes to figure out where a pipe has been damaged, allowing for more effective water saving. The analysis is carried out in order to improve the network’s efficiency. Changes in hydraulic parameters, physical parameters, and other variables can be determined using these analyses. The proposed water distribution network is Nimkhedi, Jalgaon. Criticality analysis is a method that analyzes every potential machine breakdown scenario and evaluates how those failures could impact the network overall. Clarifying what may be done to lower the risk connected with each resource can be done by doing a criticality analysis. A versatile tool to assess and determine the most important components of a water distribution network is provided by criticality to the user. The Smart Water Metering System is crucial for consumer convenience and water management.
A review of fresh and hardened properties of concrete reinforced with waste materials
Authors: Mandadapu Sai Nandan , Prabhakara Rao VN , Rani Ch Sandhya
Published: January 2023

The worlds demand on aggregates in construction is rapidly increasing from last few years, reason is mainly due to drastic economic growth of the Nations like Brazil, China, and India. Basically, this growth inspires the construction development and destruction activities. This study expresses the state of art of review on research of the industrial wastes which are polluting the environment. During the process of manufacture of several proportions and grades of concrete, non-conventional materials such as foundry sand from metal forging industry and tile dust produced by the tile industries were used to replace fine aggregate partial replacement of 10% - 50%, by weight of fine aggregate. It is found that compressive strength and flexural strength were increased up to 20% replacement of used foundry sand and 10% replacement of tiles dust with natural sand. Since the thickness of pavement slab is reduced, the cost of pavement construction is reduced almost 15% and 22% respectively for both type of alternative concrete mixes. Reuse of waste materials as a partial replacement of fine aggregate in concrete helps to achieve eco-friendly and sustainable development. Quarry dust is a flowable material used for ecofriendly waste for where the grade of conventional concrete is prepared. The mix of nano silica and GGBS with concrete (50 % GGBS, 46% OPC, and 4 % Nano Silica). The effects of reactive silicate and process variables like sodium content and molarity on the alkaline activation of various Nano clays and GGBS are investigated. Considering all the properties and materials partial substitution of 40% copper slag with fine aggregate is nearly equal to the strength of the conventional concrete. Among all other findings foundry sand and quarry dust of 20% and 10% proportions are used as a substitutional material in concrete got achieved adaptable strengths. In porous dam structures bentonite with high water cement ratio with aggregates produces flexible material used as a permeable layer.
Influence of various parameters on lifecycle cost of buildings with active energy efficiency measures.
Authors: Mokesh prabu E , Rakesh P
Published: January 2023

The energy consumption of the building sector has heightened significantly in recent times owing to rapid global urbanization. Energy efficiency measures (EEM) may become a legal obligation for construction in years ahead. This study proposes the execution of Active Energy Efficiency Measures (AEEM) in a hospital building model evolved in energy simulation software while designed for a warm and humid environment. A series of design models were developed for the study by considering temperature set-points, HVAC star rating, and roof area for solar plant as the varying parameters. Investors have been reluctant to adopt efficiency measures attributed to the rise in their capital costs. Therefore, the study performed a Lifecycle Cost Analysis (LCCA) and payback period computations for additional investments to implement EEM. The findings are presented in the form of a correlation study between percentages of annual energy savings, life-cycle cost reductions, and additional capital investments for the implementation of AEEM. Energy conservation strategies without any additional investments to obtain a good future return are also discussed. With the combination of varying parameters, energy savings of up to 38.66% and a reduction in Lifecycle Cost (LCC) of up to 17.25% are obtained. Comparisons of design models highlight the importance of performing energy simulations and LCCA prior to actually making an investment in energy efficiency strategies.
Effects of quantum resources and noise on the statistical complexity of quantum circuits
Authors: Bu Kaifeng , Koh Dax Enshan , Li Lu , Luo Qingxian , Zhang Yaobo
Published: January 2023

We investigate how the addition of quantum resources changes the statistical complexity of quantum circuits by utilizing the framework of quantum resource theories. Measures of statistical complexity that we consider include the Rademacher complexity and the Gaussian complexity, which are well-known measures in computational learning theory that quantify the richness of classes of real-valued functions. We derive bounds for the statistical complexities of quantum circuits that have limited access to certain resources and apply our results to two special cases: (a) stabilizer circuits that are supplemented with a limited number of T gates and (b) instantaneous quantum polynomial-time Clifford circuits that are supplemented with a limited number of CCZ gates. We show that the increase in the statistical complexity of a quantum circuit when an additional quantum channel is added to it is upper bounded by the free robustness of the added channel. Moreover, as noise in quantum systems is a major obstacle to implementing many quantum algorithms on large quantum circuits, we also study the effects of noise on the Rademacher complexity of quantum circuits. Finally, we derive bounds for the generalization error associated with learning from training data arising from quantum circuits.
Inexpensive monolithic additive manufacturing of silicone structures for bio-inspired soft robotic systems
Authors: Ovy S M Al Islam , Stano Gianni , Percoco Gianluca , Cianchetti Matteo , Tadesse Yonas
Published: January 2023

In soft robotics, the fabrication of extremely soft structures capable of performing bio-inspired complex motion is a challenging task. This paper introduces an innovative 3D printing of soft silicone structures with embedded shape memory alloy (SMA) actuators, which is completed in a single printing cycle from CAD files. The proposed custom-made 3D printing setup, based on the material extrusion (MEX) method, was used in conjunction with a cartesian pick and place robot (CPPR) to completely automate the fabrication of thick silicone skins (7 mm) with embedded shape memory alloy actuators. These structures were fabricated monolithically without any assembly tasks and direct human intervention. Taking advantage of the capability to 3D print different geometries, three different patterns were fabricated over the silicone skin, resulting in remarkable dynamic motions: an out-of-plane deformation (jumping of the structure from the x-y plane to the x-z plane) was achieved for the first-time employing silicone skin, to the best of the author’s knowledge. In addition, two process parameters (printing speed and build plate temperature) and the extruded silicone curing mechanisms were investigated to enhance the printing quality. This paper aims to advance the role of additive manufacturing in the field of soft robotics by demonstrating all the benefits that a low-cost, custom-made silicone 3D printer can bring to the table in terms of manufacturing soft bio-inspired structures.
Robust associations between white matter microstructure and general intelligence
Authors: Stammen Christina , Fraenz Christoph , Grazioplene Rachael G , Schlüter Caroline , Merhof Viola , Johnson Wendy , Güntürkün Onur , DeYoung Colin G , Genç Erhan
Published: January 2023

Few tract-based spatial statistics (TBSS) studies have investigated the relations between intelligence and white matter microstructure in healthy (young) adults, and those have yielded mixed observations, yet white matter is fundamental for efficient and accurate information transfer throughout the human brain. We used a multicenter approach to identify white matter regions that show replicable structure–function associations, employing data from 4 independent samples comprising over 2000 healthy participants. TBSS indicated 188 voxels exhibited significant positive associations between g factor scores and fractional anisotropy (FA) in all 4 data sets. Replicable voxels formed 3 clusters, located around the left-hemispheric forceps minor, superior longitudinal fasciculus, and cingulum–cingulate gyrus with extensions into their surrounding areas (anterior thalamic radiation, inferior fronto-occipital fasciculus). Our results suggested that individual differences in general intelligence are robustly associated with white matter FA in specific fiber bundles distributed across the brain, consistent with the Parieto-Frontal Integration Theory of intelligence. Three possible reasons higher FA values might create links with higher g are faster information processing due to greater myelination, more direct information processing due to parallel, homogenous fiber orientation distributions, or more parallel information processing due to greater axon density.
Gravity matters for the neural representations of action semantics
Authors: Xiong Ziyi , Tian Yu , Wang Xiaosha , Wei Kunlin , Bi Yanchao
Published: January 2023

The dynamic relationship between the neural representation of action word semantics and specific sensorimotor experience remains controversial. Here, we temporarily altered human subjects’ sensorimotor experience in a 15-day head-down tilt bed rest setting, a ground-based analog of microgravity that disproportionally affects sensorimotor experiences of the lower limbs, and examined whether such effector-dependent activity deprivation specifically affected the neural processes of comprehending verbs of lower-limb actions (e.g. to kick) relative to upper-limb ones (e.g. to pinch). Using functional magnetic resonance imaging, we compared the multivoxel neural patterns for such action words prior to and after bed rest. We found an effector-specific (lower vs. upper limb) experience modulation in subcortical sensorimotor-related and anterior temporal regions. The neural action semantic representations in other effector-specific verb semantic regions (e.g. left lateral posterior temporal cortex) and motor execution regions were robust against such experience alterations. These effector-specific, sensorimotor-experience-sensitive and experience-independent patterns of verb neural representation highlight the multidimensional and dynamic nature of semantic neural representation, and the broad influence of microgravity (hence gravity) environment on cognition.
Effects of Supplemented Mediterranean Diets on Plasma-Phospholipid Fatty Acid Profiles and Risk of Cardiovascular Disease after 1 Year of Intervention in the PREDIMED Trial
Authors: Razquin Cristina , Ruiz-Canela Miguel , Wernitz Andreas , Toledo Estefania , Corella Dolores , Alonso-Gómez Ángel , Fitó Montse , Gómez-Gracia Enrique , Estruch Ramón , Fiol Miquel , Lapetra José , Serra-Majem Lluis , Ros Emilio , Arós Fernando , Salas-Salvadó Jordi , Schulze Matthias B , Martinez-Gonzalez Miguel A
Published: January 2023

Background

Plasma fatty acids (FAs) have been associated with cardiovascular disease (CVD) risk. Diet and endogenous metabolism influence the FA profile of the plasma phospholipid (PL) fraction. In the PREDIMED trial, we examined 1-year changes in the FA profile of plasma PL according to a nutritional intervention with Mediterranean diets, either supplemented with extra-virgin olive oil (MedDiet + EVOO) or mixed nuts (MedDiet + nuts), in a high cardiovascular risk population. We also analyzed if 1-year changes in PL FAs were associated with subsequent cardiovascular risk.

Methods

We included 779 participants in our case-cohort study: 185 incident cases and 594 participants in the subcohort (including 31 overlapping cases). The end point was the incidence of CVD. We measured the FAs of plasma PL at baseline and after 1 year of intervention.

Results

MedDiet + EVOO increased C17:0 and C20:3n9 in linear regression models [β coefficientperSD : 0.215 (95% CI, 0.032–0.399) and 0.271 (0.107–0.434), respectively] and decreased 16:1n7 and C22:4n6 [βperSD: −0.239 (95% CI, −0.416 to −0.061) and −0.287 (95% CI, −0.460 to −0.113), respectively] vs the control group. MedDiet + nuts increased C18:3n3 [βperSD: 0.382 (95% CI, 0.225 – 0.539)], C18:2n6 [βper SD: 0.250 (95% CI, 0.073 — 0.428)], C18:0 [βperSD: 0.268 (95% CI, 0.085—0.452)], and C22:0 [βper SD: 0.216 (95% CI, 0.031—0.402)]; and decreased the sum of six n6 FAs [βper SD: −0.147 (95% CI, −0.268 to −0.027)] vs the control group. The 1-year increase in C18:2n6 was inversely associated with the subsequent CVD risk (HRperSD: 0.64 (95% CI, 0.44–0.92)).

Conclusions

MedDiet interventions changed n6 FAs and C16:1n7c; other changes were specific for each group: MedDiet + EVOO increased C17:0 and C20:3n9, and MedDiet + Nuts C18:3n3, C18:2n6, C18:0, and C22:0 FAs.
ESDE-MIE fellowship: a descriptive analysis of the first experiences
Authors: Talavera-Urquijo Eider , Gantxegi Amaia , Garbarino Giovanni M , Capovilla Giovanni , van Boxel Gijs I , Grimminger Peter P , Luyer Misha D , Markar Sheraz R , Svendsen Lars B , van Hillegersberg Richard
Published: January 2023

Esophageal resection is a high-risk and technically demanding procedure, with a long proficiency-gain curve. The European Society Diseases of the Esophagus (ESDE)-Minimally Invasive Esophagectomy (MIE) training program was launched in 2018 for European surgeons willing to train and to begin a career undertaking MIE. The aim of this study was to evaluate the first experience of the ESDE-MIE fellowship and relate this to the initially predetermined core principles and objectives of the program. Between October 2021 and May 2022, the participating fellows, in collaboration with the ESDE Educational Committee, initiated a survey to assess the outcome and experience of these fellowships. Data from each individual fellowship were analysed and reported in a descriptive manner. Between 2018 and 2022, in total, five fellows have completed the ESDE-MIE fellowship program. Despite the COVID-19 outbreak just the year after its launch, predetermined clinical and research goals were achieved in all cases. Each of the fellows were able to assist in a median of 40 (IQR 27–69) MIE and/or Robot assisted (RA)MIE procedures, of a total median of 115 (IQR 83–123) attended Upper GI cases. After the fellowship, MIE has been fully adopted by the fellows who returned to their home institutions as Upper GI surgeons. The fellowship was concluded by the European Union of Medical Specialists (UEMS) Multidisciplinary Joint Committee (MJC) certification in Upper GI Surgery, which was successfully obtained by all who took part. Based on the experience of the first five fellows, the ESDE-MIE training fellowship meets with the expected needs even despite the COVID-19 outbreak in 2019. Furthermore, these fellows have returned home and integrated MIE into their independent surgical practice, affirming the ability of this program to train the next generation of MIE surgeons, even in the most challenging of circumstances.
Contemporary outcomes of esophageal and gastroesophageal junction neuroendocrine tumors
Authors: Poston Lauren M , Gupta Shreya , Alvarado Christine E , Sinopoli Jillian , Vargas Leonidas T , Linden Philip A , Towe Christopher W
Published: January 2023

Adenocarcinoma and squamous cell esophageal cancers have been extensively studied in the literature. Esophageal neuroendocrine (NET)/carcinoid tumors are less commonly studied and have only been described in small series. The purpose of this study was to describe the demographics and natural history of esophageal NETs, as well as optimal treatments. We hypothesized that surgical resection would be the best treatment of esophageal NETs. The National Cancer Database was used to identify adult patients with esophageal or gastroesophageal junction (GEJ) cancer from 2004 to 2018. Patients were characterized as carcinoid/NET, adenocarcinoma, or squamous cell cancer. Clinical and demographic characteristics were compared between the histology groups. The primary outcome was overall survival, which was assessed by multivariable Cox analysis. Multivariable Cox analysis was also used to analyze factors associated with survival among NET patients who underwent surgery. Among 206,321 patients with esophageal cancer, 1,563 were NETs (<0.01%). Relative to the other two histologies, NETs were associated with younger age, female sex, and advanced clinical stage at diagnosis. Multivariate analysis suggested that NETs were less likely to be treated with surgical resection (OR 0.51, P < 0.001). Nonetheless, surgical resection was associated with improved survival (HR 0.64, P = 0.003). Among patients with NETs who received surgery, neoadjuvant therapy was associated with improved overall survival (HR 0.38, P = 0.013). NET of the esophagus presents with more advanced disease than other common histologies. Among patients with nonmetastatic cancer, surgical resection appears to be the best treatment. Neoadjuvant systemic therapy may offer survival benefit, but future studies are necessary.
Thioguanine is Effective as Maintenance Therapy for Inflammatory Bowel Disease: A Prospective Multicentre Registry Study
Authors: Simsek Melek , Schepers Femke , Kaplan Sigal , van Asseldonk Dirk , van Boeckel Petra , Boekema Paul , Dijkstra Gerard , Fidder Herma , Gisbertz Ingrid , Hoentjen Frank , Jharap Bindia , Kubben Frank , de Leest Marleen , Meijssen Maarten , Petrak Ana , van de Poel Else , Russel Maurice , van Bodegraven Adriaan A , Mulder Chris J J , de Boer Nanne
Published: January 2023

Background and Aims

Thioguanine is a well-tolerated and effective therapy for inflammatory bowel disease [IBD] patients. Prospective effectiveness data are needed to substantiate the role of thioguanine as a maintenance therapy for IBD.

Methods

IBD patients who previously failed azathioprine or mercaptopurine and initiated thioguanine were prospectively followed for 12 months starting when corticosteroid-free clinical remission was achieved (Harvey–Bradshaw Index [HBI] ≤ 4 or Simple Clinical Colitis Activity Index [SCCAI] ≤ 2). The primary endpoint was corticosteroid-free clinical remission throughout 12 months. Loss of clinical remission was defined as SCCAI > 2 or HBI > 4, need of surgery, escalation of therapy, initiation of corticosteroids or study discontinuation. Additional endpoints were adverse events, drug survival, physician global assessment [PGA] and quality of life [QoL].

Results

Sustained corticosteroid-free clinical remission at 3, 6 or 12 months was observed in 75 [69%], 66 [61%] and 49 [45%] of 108 patients, respectively. Thioguanine was continued in 86 patients [80%] for at least 12 months. Loss of response [55%] included escalation to biologicals in 15%, corticosteroids in 10% and surgery in 3%. According to PGA scores, 82% of patients were still in remission after 12 months and QoL scores remained stable. Adverse events leading to discontinuation were reported in 11%, infections in 10%, myelo- and hepatotoxicity each in 6%, and portal hypertension in 1% of patients.

Conclusion

Sustained corticosteroid-free clinical remission over 12 months was achieved in 45% of IBD patients on monotherapy with thioguanine. A drug continuation rate of 80%, together with favourable PGA and QoL scores, underlines the tolerability and effectiveness of thioguanine for IBD.
Deep Learning in Population Genetics
Authors: Korfmann Kevin , Gaggiotti Oscar E , Fumagalli Matteo
Published: January 2023

Population genetics is transitioning into a data-driven discipline thanks to the availability of large-scale genomic data and the need to study increasingly complex evolutionary scenarios. With likelihood and Bayesian approaches becoming either intractable or computationally unfeasible, machine learning, and in particular deep learning, algorithms are emerging as popular techniques for population genetic inferences. These approaches rely on algorithms that learn non-linear relationships between the input data and the model parameters being estimated through representation learning from training data sets. Deep learning algorithms currently employed in the field comprise discriminative and generative models with fully connected, convolutional, or recurrent layers. Additionally, a wide range of powerful simulators to generate training data under complex scenarios are now available. The application of deep learning to empirical data sets mostly replicates previous findings of demography reconstruction and signals of natural selection in model organisms. To showcase the feasibility of deep learning to tackle new challenges, we designed a branched architecture to detect signals of recent balancing selection from temporal haplotypic data, which exhibited good predictive performance on simulated data. Investigations on the interpretability of neural networks, their robustness to uncertain training data, and creative representation of population genetic data, will provide further opportunities for technological advancements in the field.
Cohort Trajectories by Age and Gender for Informal Caregiving in Europe Adjusted for Sociodemographic Changes, 2004 and 2015
Authors: Rodrigues Ricardo , Rehnberg Johan , Simmons Cassandra , Ilinca Stefania , Zólyomi Eszter , Vafaei Afshin , Kadi Selma , Jull Janet , Phillips Susan P , Fors Stefan
Published: January 2023

Objectives

We present a dynamic view of gender patterns in informal caregiving across Europe in a context of sociodemographic transformations. We aim to answer the following research questions: (a) has the gender gap in informal caregiving changed; (b) if so, is this due to changes among women and/or men; and (c) has the gender care gap changed differently across care regimes?

Methods

Multilevel growth curve models are applied to gendered trajectories of informal caregiving of a panel sample of 50+ Europeans, grouped into 5-year cohorts and followed across 5 waves of the Survey of Health, Ageing and Retirement in Europe survey, stratified by sex and adjusted for several covariates.

Results

For men in cohorts born more recently, there is a decrease in the prevalence of informal care outside the household, whereas cohort trajectories for women are mostly stable. Prevalence of care inside the household has increased for later-born cohorts for all without discernible changes to the gender care gap. Gender care gaps overall widened among later-born cohorts in the Continental cluster, whereas they remained constant in Southern Europe, and narrowed in the Nordic cluster.

Discussion

We discuss the cohort effects found in the context of gender differences in employment and care around retirement age, as well as possible demographic explanations for these. The shift from care outside to inside the household, where it mostly consists of spousal care, may require different policies to support carers, whose age profile and possible care burden seem to be increasing.
The politics of press astrology in wartime Britain, 1939–42
Authors: Parken Oliver
Published: January 2023

This article explores the politics of popular press astrology between 1939 and 1942. Charting the astrological content of the News of the World, The People, the Sunday Dispatch, the Sunday Express and the Sunday Pictorial, it unearths connections between predictions and wider themes of morale and press freedoms during the war. The article argues that these predictions, which were largely aimed at female readers, were, on balance, morale-boosting. Fears over the impact of press astrology speak to anxieties over the influence of popular newspapers in wartime among officials and contemporary researchers.
Inflammatory Bowel Disease Among Canadian Children: Comparison Between Children of Non-European Descent and Children of European Descent
Authors: Jeong Jocelyn , Walters Thomas D , Huynh Hien Q , Lawrence Sally , Mack David R , Deslandres Colette , Otley Anthony , El-Matary Wael , Sherlock Mary , Griffiths Anne M , Wine Eytan , Jacobson Kevan , Church Peter , Carroll Matthew W , Benchimol Eric I , Brill Herbert , Critch Jeff , Bax Kevin , Jantchou Prévost , Rashid Mohsin , Kaplan Gilaad G , Seow Cynthia H , Novak Kerri , deBruyn Jennifer C
Published: January 2023

Background

Inflammatory bowel disease (IBD) phenotypes may differ between countries and ancestral groups. The study aim was to examine ancestry and subtype variations of children newly diagnosed with IBD.

Methods

Children newly diagnosed with IBD enrolled into the Canadian Children Inflammatory Bowel Disease Network inception cohort study were categorized into 8 ancestral groups. Prospectively collected data at diagnosis and follow-up were compared between ancestral groups.

Results

Among 1447 children (63.2% Crohn’s disease, 30.7% ulcerative colitis), 67.8% were European, 9.4% were South Asian, 3.8% were West Central Asian and Middle Eastern, 2.3% were African, 2.2% were East/South East Asian, 2.0% were Caribbean/Latin/Central/South American, 9.9% were mixed, and 2.6% were other. Children of African descent with ulcerative colitis had an older age of diagnosis compared with children of European descent (median 15.6 years vs 13.3 years; P = .02). Children of European descent had a higher proportion of positive family history with IBD (19.3% vs 12.1%; P = .001) compared with children of non-European descent. Children of European descent also had a lower proportion of immigrants and children of immigrants compared with children of non-European descent (9.8% vs 35.9%; P < .0001; and 3.6% vs 27.2%; P < .0001, respectively) .

Conclusions

Important differences exist between different ancestral groups in pediatric patients with IBD with regard to age of diagnosis, family history, and immigrant status. Our study adds to the knowledge of the impact of ancestry on IBD pathogenesis.
Documentation quality of patient-directed discharge and early warning interactions in an adult inpatient service
Authors: Jeyaraju Maniraj , Salvatori Cristiana Grace , George Nivya , Schmalzle Sarah Ann
Published: January 2023

Documentation quality of patient–physician discussion, assessment, and intervention at the time of patient-directed discharges (elopement and ‘against medical advice’ discharges) is found to be poor in available studies and, importantly, may be a proxy for quality of care delivered. Less is known about the patient–physician interactions and documentation at the time a patient vocalizes the desire to leave early (‘early warning interaction’) prior to a patient-directed discharge. This was a cohort study comprising a retrospective chart review of patients leaving ‘against medical advice’ from an inpatient internal medicine—infectious disease service at a tertiary medical center from 01 July 2020 to 24 September 2021. Documentation quality was assessed using 11 extractable factors detailing patient–physician conversation elements from the assess, investigate, mitigate, explain, and document framework, plus related interventions pertinent to patient safety and care optimization. Descriptive statistics were mainly utilized with inferential statistics and regression models as appropriate. Fifty-two patients left against medical advice and 49 eloped; 11% had an early warning interaction. Aggregate documentation quality scores at early warning interaction (13%), ‘against medical advice’ discharge (42%), and at elopement (31%) were low. Half of the suggested documentation elements were recorded in no patients. The overall documentation quality was poor, suggesting the need for further training and interventions to facilitate more thorough documentation.
The Past, Present, and Future(s) of Feminist Foreign Policy
Authors: Achilleos-Sarll Columba , Thomson Jennifer , Haastrup Toni , Färber Karoline , Cohn Carol , Kirby Paul
Published: January 2023

Almost a decade after Sweden first declared that it would follow a feminist foreign policy (FFP), a further eleven countries from across Europe, North and South America, and North and West Africa have adopted, or have signaled an interest in potentially adopting, an FFP in the future. These developments have been accompanied by a growing body of feminist scholarship. Although still in its infancy, this literature can generally be divided between more normative accounts and those that are empirically focused, with particular attention paid to the FFPs of Sweden and Canada. Yet, few studies compare FFPs’ uptake across different countries and regions, examine its connections to longer histories of ideas around women and gender, or unpack the policy intersections FFP (tentatively) engages. Contributing to these different areas, Part I provides an overview of the history of FFP, interrogates FFP in the context of Foreign Policy Analysis, and explores what FFP can achieve in the current (liberal) global system. Part II turns to consider policy intersections in relation to the climate crisis, migration, militarism, and bodies. Thinking through its origins, policy intersections, and potential future(s), the contributors to this Forum explore FFP's multiple and contested future(s). Ultimately, the Forum takes stock of this feminist turn in foreign policy at a critical point in its development and considers what future possibilities it may hold.
“Mm-hm,” “Uh-uh”: are non-lexical conversational sounds deal breakers for the ambient clinical documentation technology?
Authors: Tran Brian D , Latif Kareem , Reynolds Tera L , Park Jihyun , Elston Lafata Jennifer , Tai-Seale Ming , Zheng Kai
Published: January 2023

Objectives

Ambient clinical documentation technology uses automatic speech recognition (ASR) and natural language processing (NLP) to turn patient–clinician conversations into clinical documentation. It is a promising approach to reducing clinician burden and improving documentation quality. However, the performance of current-generation ASR remains inadequately validated. In this study, we investigated the impact of non-lexical conversational sounds (NLCS) on ASR performance. NLCS, such as Mm-hm and Uh-uh, are commonly used to convey important information in clinical conversations, for example, Mm-hm as a “yes” response from the patient to the clinician question “are you allergic to antibiotics?”

Materials and Methods

In this study, we evaluated 2 contemporary ASR engines, Google Speech-to-Text Clinical Conversation (“Google ASR”), and Amazon Transcribe Medical (“Amazon ASR”), both of which have their language models specifically tailored to clinical conversations. The empirical data used were from 36 primary care encounters. We conducted a series of quantitative and qualitative analyses to examine the word error rate (WER) and the potential impact of misrecognized NLCS on the quality of clinical documentation.

Results

Out of a total of 135 647 spoken words contained in the evaluation data, 3284 (2.4%) were NLCS. Among these NLCS, 76 (0.06% of total words, 2.3% of all NLCS) were used to convey clinically relevant information. The overall WER, of all spoken words, was 11.8% for Google ASR and 12.8% for Amazon ASR. However, both ASR engines demonstrated poor performance in recognizing NLCS: the WERs across frequently used NLCS were 40.8% (Google) and 57.2% (Amazon), respectively; and among the NLCS that conveyed clinically relevant information, 94.7% and 98.7%, respectively.

Discussion and Conclusion

Current ASR solutions are not capable of properly recognizing NLCS, particularly those that convey clinically relevant information. Although the volume of NLCS in our evaluation data was very small (2.4% of the total corpus; and for NLCS that conveyed clinically relevant information: 0.06%), incorrect recognition of them could result in inaccuracies in clinical documentation and introduce new patient safety risks.
MIMIC-IV on FHIR: converting a decade of in-patient data into an exchangeable, interoperable format
Authors: Bennett Alex M , Ulrich Hannes , van Damme Philip , Wiedekopf Joshua , Johnson Alistair E W
Published: January 2023

Objective

Convert the Medical Information Mart for Intensive Care (MIMIC)-IV database into Health Level 7 Fast Healthcare Interoperability Resources (FHIR). Additionally, generate and publish an openly available demo of the resources, and create a FHIR Implementation Guide to support and clarify the usage of MIMIC-IV on FHIR.

Materials and Methods

FHIR profiles and terminology system of MIMIC-IV were modeled from the base FHIR R4 resources. Data and terminology were reorganized from the relational structure into FHIR according to the profiles. Resources generated were validated for conformance with the FHIR profiles. Finally, FHIR resources were published as newline delimited JSON files and the profiles were packaged into an implementation guide.

Results

The modeling of MIMIC-IV in FHIR resulted in 25 profiles, 2 extensions, 35 ValueSets, and 34 CodeSystems. An implementation guide encompassing the FHIR modeling can be accessed at mimic.mit.edu/fhir/mimic. The generated demo dataset contained 100 patients and over 915 000 resources. The full dataset contained 315 000 patients covering approximately 5 840 000 resources. The final datasets in NDJSON format are accessible on PhysioNet.

Discussion

Our work highlights the challenges and benefits of generating a real-world FHIR store. The challenges arise from terminology mapping and profiling modeling decisions. The benefits come from the extensively validated openly accessible data created as a result of the modeling work.

Conclusion

The newly created MIMIC-IV on FHIR provides one of the first accessible deidentified critical care FHIR datasets. The extensive real-world data found in MIMIC-IV on FHIR will be invaluable for research and the development of healthcare applications.
Undermining Desire: Reducing Unhealthy Choices by Highlighting Short-Term (vs. Long-Term) Costs
Authors: Stillman Paul E , Woolley Kaitlin
Published: January 2023

What motivates consumers to avoid unhealthy behaviors (e.g., consuming sugar, energy drinks, and fast food)? Traditional interventions and lay intuition suggest that to motivate themselves, consumers can consider the negative long-term health consequences of their decisions. Yet, consumers still struggle to avoid unhealthy behaviors. Seven experiments (N = 4,021) offer a different approach. We find that considering short-term costs of unhealthy behaviors (e.g., irritability or indigestion after eating sugar) better curbs these behaviors than considering long-term costs or no costs. We theorize that short-term costs are more effective at reducing unhealthy behavior because they are more strongly associated with the act of consumption, both in terms of immediate timing and perceived likelihood of costs occurring. As such, short-term costs are better at undermining the reason for consuming unhealthily: anticipated enjoyment of the consumption experience. We test this process by (a) demonstrating mediation via increased association strength and subsequent decreased anticipated enjoyment, (b) manipulating the association strength between consumption and costs (i.e., same cost realized sooner vs. later), and (c) demonstrating moderation via consumers’ goal for eating unhealthily. These results identify a powerful but underutilized self-regulation strategy—emphasizing short-term costs of unhealthy consumption—with implications for consumers and marketers.
Multilevel longitudinal analysis of social networks
Authors: Koskinen Johan , Snijders Tom A B
Published: January 2023

Stochastic actor-oriented models (SAOMs) are a modelling framework for analysing network dynamics using network panel data. This paper extends the SAOM to the analysis of multilevel network panels through a random coefficient model, estimated with a Bayesian approach. The proposed model allows testing theories about network dynamics, social influence, and interdependence of multiple networks. It is illustrated by a study of the dynamic interdependence of friendship networks and minor delinquency. Data were available for 126 classrooms in the first year of secondary school, of which 82 were used, containing relatively few missing data points and having not too much network turnover.
A wide-field view on multiple stellar populations in 28 Milky Way globular clusters
Authors: Leitinger E , Baumgardt H , Cabrera-Ziri I , Hilker M , Pancino E
Published: January 2023

The majority of Galactic globular clusters (GCs) contain multiple stellar populations displaying specific chemical abundance variations. In particular, GCs generally contain a ‘primordial’ population with abundances similar to field stars, along with an ‘enriched’ population exhibiting light element anomalies. In this paper, we present a homogeneous and wide-view analysis of multiple stellar populations in 28 Galactic GCs. By using a combination of HST photometry together with wide-field, ground-based photometry we are able to analyse between 84 per cent and 99 per cent of all stars in each cluster. For each GC, we classify stars into separate sub-populations using the well-established CUBI colour index, and investigate the spatial distributions of these populations. Our results show that dynamically young GCs can contain either centrally concentrated enriched or primordial populations, or no centrally concentrated population. Dynamically old GCs show fully mixed populations as expected. The existence of clusters born with centrally concentrated primordial (and homogeneously mixed) populations exacerbates the mass-budget problem facing many cluster formation scenarios. The diversity in these results also highlights the need for additional theories that can account for the wide variety of initial conditions that we find. We finally investigate the enriched star fraction as a function of different global parameters in our GC sample, using also data for young and low-mass clusters from the Small- and Large Magellanic Clouds and confirm earlier results that the enriched star fraction strongly correlates with the initial mass of a cluster.