bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and economic implications of false-positive heparin-induced thrombocytopenia immunoassays: utility of the 4T score
Authors: Dweck Bradley , Pane Mallory , Nguyen Veronica , Sharma Shalini , Monhollen Alec , Malireddy Sankirthana , Whiteley Andrew
Published: June 2024

Heparin-induced thrombocytopenia (HIT) is a prothrombotic condition induced by platelet-activating IgG antibodies that recognize PF4/heparin complexes. Diagnosis of HIT relies on enzyme immunologic assays (EIAs) and functional assays [serotonin release assay (SRA)]. Our institution uses a latex immunoturbidimetric assay (LIA), which has shown a positive-predictive value (PPV) of 55.6%, and a negative-predictive value (NPV) of 99.7%. The low PPV of EIAs/LIAs, in combination with the clinical delay in obtaining results of a SRA, commonly leads to a false-positive diagnosis of HIT and inappropriate treatment. We performed a single-institution retrospective study at a large tertiary center to assess patient management decisions and economic costs following a false-positive HIT (LIA) test. This study found an 89.5% incidence of false-positive HIT (LIA) tests. 97.4% of patients underwent anticoagulation changes. 69.6% of patients were switched to argatroban. Of patients with a false-positive HIT immunoassay (LIA), 42 (40.7%) patients were on a prophylactic dose of anticoagulation at the time of HIT (LIA) positivity, of which 22 (52.4%) were switched to full anticoagulation with either argatroban or fondaparinux. Of the 22 patients switched to full anticoagulation, 15 (68%) had low-probability 4T scores. Seven (8.8%) of patients had bleeding events after HIT (LIA) positivity. All seven patients were switched to argatroban from a full-dose heparin anticoagulation. Five of the seven patients were considered major bleeds. Utilization of argatroban incurred substantial costs, estimated at approximately $73 000 for false-positive HIT cases. False-positive HIT (LIA) tests contribute to unwarranted anticoagulation changes, increased bleeding risks, and substantial healthcare costs. Incorporating the 4T score into diagnostic algorithms may help mitigate these risks by guiding appropriate clinical decisions. Future research should focus on refining diagnostic approaches and standardizing management strategies to improve patient outcomes and cost-effectiveness in HIT diagnosis and management.
Beyond one-size-fits-all in cardiogenic shock: impella, extracorporeal membrane oxygenation or tailored use of mechanical circulatory support?
Authors: Rob Daniel , Belohlavek Jan
Published: June 2024

Purpose of review

This article offers an overview of recent randomized controlled trials (RCTs) testing the efficacy of veno-arterial extracorporeal membrane oxygenation (VA ECMO) and microaxial flow pump (mAFP) in treating cardiogenic shock, including findings from the DanGer shock trial. It summarizes the clinical implications and limitations of these studies and key decision-making considerations for cardiogenic shock device use.

Recent findings

Despite important limitations in all published RCTs, the routine use of VA ECMO for acute myocardial infarction related cardiogenic shock did not demonstrate benefit and should be reserved for selected patients with extreme forms of cardiogenic shock. Conversely, mAFP (Impella CP) appears promising for cardiogenic shock due to ST elevation myocardial infarction. A stepwise approach – initial mAFP use for cardiogenic shock with left ventricular failure, supplemented by VA ECMO if mAFP is inadequate or if severe right ventricular failure is present – may be preferable, but requires validation through RCTs. High complication rates in device arms underscore the need for careful patient selection, preventive strategies, education for centers and operators, and further research.

Recent trials offer insights into mechanical circulatory support in cardiogenic shock, but their real-world applicability is limited. Despite potential benefits, the use of VA ECMO and mAFP is associated with significant complication rates, emphasizing the need for personalized use.
Sarcina ventriculi in association with gastric ulcer: a case report
Authors: Simkhada Ankita , Acharya Pritha , Shrivastav Shreya
Published: June 2024

Sarcina ventriculi is a species of Gram-positive bacteria which has been reported in patients with delayed gastric emptying as well as in association with cases of gastric ulcer and gastric carcinoma. Although it has been reported frequently in veterinary cases as a cause of fatal diseases, the exact pathogenesis in humans has yet to be identified. We report here a case of an elderly male who presented with haematemesis following which an upper gastrointestinal endoscopy was done and a gastric ulcer was revealed. Histopathological examination revealed S. ventriculi in association with the ulcer.
Prevalence of SARS-CoV-2 virus in saliva, stool, and urine samples of COVID-19 patients in Bihar, India
Authors: Meghna Nupur , Archana Archana , Bhushan Divendu , Kumar Abhyuday , Sarfraz Asim , Naik Bijaya Nanda , Pati Binod Kumar
Published: June 2024

Introduction. The coronavirus illness caused by SARS-CoV-2 can cause multiple organ involvement, with varying degrees of severity. Besides inhalation as a route for transmission, feco-oral has also been proposed. Its transmission to sewage systems is a growing public health issue.

Objective. To detect SARS-CoV-2 RNA in non-respiratory samples (saliva, urine, and stool) collected from COVID-19 cases, in Bihar.

Methods. This cross-sectional observational study was conducted from January 2021 to March 2022 on human non-respiratory samples. A total of 345 samples including saliva (116), stool (97), and urine (132) were collected from 143 COVID-19 cases. Samples were analysed for SARS-CoV-2 by multiplex RT-PCR targeted against E, ORF 1ab, and RdRp genes.

Results. In this study, out of 143 cases, a total of 107 (74.8 %) were positive for SARS-CoV-2 RNA in at least one of the non-respiratory samples.

Conclusion. There is a high prevalence of SARS-CoV-2 virus in non-respiratory samples.
Direct Observation of Spin Current Oscillation in a Ferromagnet
Authors: Du Mengyao , Min Huiqian , Xia Ke , Hou Dazhi , Wang Lei , Qiu Zhiyong
Published: June 2024

Spin current is a crucial element in spintronics, and its diffusion in materials is typically characterized by monotonic decay. However, when the material hosting the spin current is also a magnet, the spin current is expected to exhibit spatial oscillations, the observation of which remains elusive. Here, we demonstrate the spatial oscillation of a spin current in a nickel film by measuring the thickness-dependent inverse spin Hall effect in Ni/YIG bilayers. The inverse spin Hall current in nickel is found to oscillate with its film thickness, in contrast to nonmagnetic materials, and that the oscillation period quantitatively agrees with theoretical predictions based on differences in the Fermi wave vector between majority and minority carriers. Our findings reveal a previously hidden behavior of spin-transport dynamics and identify a new degree of freedom for manipulating spin current, with potential implications for future spintronic devices.

Published by the American Physical Society
2024
Unveiling factors influencing the duration of arbitration practice in the Tanzania construction industry
Authors: Luvara Valentine George Mruma , Benjamin Moses
Published: June 2024

Purpose

Most construction projects are undertaken with the incentive of some form of profit which in business attracts disputes that key disputing parties intend to resolve through mechanisms such as arbitration as early as possible so that they may advance with other activities associated with the project. However, this intention is regularly unfulfilled, disappointing the parties with late arbitration resolution. This study, therefore, explored the duration influencing factors (DIFs) facing arbitration practice in the Tanzania construction industry.

Design/methodology/approach

A concurrent convergence mixed methods approach was used where a total of 12 DIFs were identified from the literature, and data were then collected from 39 construction arbitrators, 8 semi-structured interviews and 4 documentary reviews. Descriptive and inferential statistics were employed for quantitative data and directed content analysis for the qualitative data.

Findings

Results show that contrary to most people’s convictions, delays in arbitration are regularly caused by the disputing parties rather than the arbitrating party or the authority. The study identified cooperation amongst the tribunal parties, poor accuracy and submission of documents and material evidences, late payment of arbitration fees, and skills, experience, reputation and profession of the arbitrator to be the most critical factors that cause late arbitration resolution.

Originality/value

The use of mixed methods concurrent triangulation convergence approach provides a unique contribution to knowledge by highlighting how the efficacy of arbitration in time performance could be further developed through understanding the critical factors that drive the proceedings duration in the Tanzania construction industry.
Study of hooked fiber in cotton yarn based on tracer fiber method
Authors: Chu Xiangting , Gao Jian , Zhang Hongdou , Lu Huiwen , Liu Xinjin , Su Xuzhong
Published: June 2024

Purpose

Through the tracer fiber method, we strive to more accurately obtain the hook degree, straightening degree, percentage and other characteristic indexes. In order to intuitively represent the hook state from sliver to yarn, and feed back production information in combination with quality test.

Design/methodology/approach

Taking the cotton fiber as an example, the hooked fibers were studied by using the tracer fiber method. Tracer fibers were made from cotton-type viscose fibers. Tracer fibers and combed cotton fibers were uniformly mixed for many times and used to produce the card sliver, semi-drawn sliver, drawn sliver, roving and yarn. With the help of ZF-20D ultraviolet analyzer, geometric parameters of hooked fibers were measured, and characterization indexes were calculated. And hook indexes and quality indexes were compared.

Findings

By redefining and reclassifying hooked fibers, the change of hooked fibers in the process was tracked and characterized carefully. Some hooks in card sliver are straightened but not eliminated, and will form longer zero-angled hooks in the subsequent process. The straightening degree and number of zero-angled hooks affect the evenness CV mainly.

Originality/value

The characterization of hooked fibers is important for reducing hooked fibers and spinning high quality yarns. There is no uniform standard for the characterization of hooked fibers at present. Most studies are about relationship between process and hook in carding and drawing. There is no research on hooked fibers in the whole spinning process. In the paper, hooked fibers were redefined and reclassified, the change of hooked fibers in the process was tracked and characterized carefully.
Thriving in diversity: the role of inclusive leadership and workplace inclusion in enhancing satisfaction with life among Indian IT employees
Authors: Jha Indu Nath , Pal Durba , Sarkar Subhadip
Published: June 2024

Purpose

In the dynamic landscape of the modern business world, the pursuit of employee well-being and satisfaction with life (SWL) has gained prominence. Yet, few studies exist on SWL among Indian working professionals. This study aims to investigate the impact of inclusive leadership (IL) on the employees’ SWL. Moreover, employing a mediation approach, the study also reveals the mediating role of workplace inclusion (WI) and career satisfaction (CS) in the relationship between IL and SWL.

Design/methodology/approach

The study involves a cross-sectional quantitative approach, drawing upon a sample of 279 professionals belonging to the Indian IT sector by administering standardized questionnaires. Data were analyzed using PLS through SmartPLS4.0 software.

Findings

The findings reveal a fully complementary mediating role of WI and CS in the IL–SWL relationship, supporting the hypothesized mediation model.

Research limitations/implications

This finding implies that leaders, with their inclusive behavior, can significantly influence employees’ SWL when accompanied by a sense of inclusiveness and CS among employees. The study offers valuable insights for organizations and leaders seeking to enhance employee satisfaction in the IT sector, emphasizing the significance of career-focused and inclusive practices in the workplace through leadership to promote a fulfilling workplace.

Originality/value

This study represents a pioneering effort to integrate the relationship between IL and SWL within the Indian context, going beyond the existing literature on WI and SWL. Additionally, the research model explores the influence of WI and CS in the IL–SWL relationship, a novel approach that has not been previously investigated.
Patient–physician perception gaps in setting treatment goals and communication including shared decision making: Results from the survey illuminating dialogues and insights in onychomycosis management (IDIOM survey)
Authors: Tsunemi Yuichiro , Otsuka Atsushi , Nonaka Yusuke
Published: June 2024

Onychomycosis, an infectious disease affecting the nails, can spread within oneself and to others, potentially leading to functional disabilities, therefore achieving a complete cure is necessary. Additionally, shared decision making (SDM) has been gaining attention in the treatment of various diseases in recent years. This study aimed to uncover the realities of patient–physician communication and perception in onychomycosis treatment, particularly in setting treatment goals and the SDM process for selecting therapeutic agents. We conducted a web‐based survey of both patients and dermatologists to identify issues in the decision‐making process for onychomycosis treatment. The survey revealed several communication challenges between patients and dermatologists regarding onychomycosis treatment. First, a notable percentage of dermatologists do not prioritize a complete cure for onychomycosis in their treatment goals. Second, the dermatologists' treatment explanations tended to emphasize risks, information necessary for appropriate decision‐making was not adequately conveyed to patients, and SDM practice was insufficient (the mean scores of SDM‐Q‐9 and SDM‐Q‐Doc were 49.0 and 70.9, respectively). Third, dermatologists overestimated the reluctance of older patients to take oral medications. Dermatologists should recognize their patients' expectations for a complete cure for onychomycosis and choose a therapeutic agent that meets patients' needs. Furthermore, dermatologists should explain the benefits and risks of treatment options in a balanced manner, strive for improved patient–physician communication, and aim for a complete cure by administering suitable treatment.
“Isolation by Gentes with Asymmetric Migration” shapes the genetic structure of the common cuckoo in China
Authors: WANG Ning , SHAN Chengbin , CHEN Dan , HU Yunbiao , SUN Yuehua , WANG Ying , LIANG Bin , LIANG Wei
Published: June 2024

Amid coevolutionary arms races between brood parasitic birds and their diverse host species, the formation of host‐specific races, or gentes, has drawn significant research focus. Nevertheless, numerous questions about gentes evolutionary patterns persist. Here, we investigated the potential for gentes evolution across multiple common cuckoo (Cuculus canorus) populations parasitizing diverse host species in China. Using maternal (mitochondrial and W‐linked DNA) and biparental (autosomal and Z‐linked DNA) markers, we found consistent clustering of cuckoo gentes (rather than geographical populations) into distinct clades in matrilineal gene trees, indicating robust differentiation. In contrast, biparental markers indicated intermixing of all gentes, suggesting asymmetric gene flow regardless of geography. Unlike the mitonuclear discordance commonly resulting from incomplete lineage sorting, adaptive introgression, or demographic disparities, the observed pattern in brood parasitic cuckoos might reflect biased host preferences between sexes. We hereby present the “Isolation by Gentes with Asymmetric Migration” model. According to this model, the maternal line differentiation of the common cuckoo in China is potentially driven by host preferences in females, whereas males maintained the integrity of the cuckoo species through random mating. To achieve this, cuckoo males could perform flexible migration among gentes or engage in early copulation with females before reaching the breeding sites, allowing female cuckoos to store sperm from various gentes. Future studies collecting additional samples from diverse cuckoo gentes with overlapping distribution and investigating the migratory and copulation patterns of each sex would enhance our understanding of sex‐biased differentiation among cuckoo populations in China.
Afterlives of the Persian Gifts to Versailles
Authors: Happe Samantha
Published: June 2024

The fate of diplomatic gifts after their presentation can reveal patterns of instability and shifting narratives on the items themselves and how they were perceived and received at the time. Often, these important pieces of material evidence disappear or are decontextualised from their exchange. This has been the case with the Persian embassy to Louis XIV's court at Versailles in 1715, where the gifts that were presented to the Sun King were thought to have been lost. This paper traces the afterlives of two of the gifted items: a string of pearls and two gold boxes of mumia. Each of these gifts were retained by the French administration and can be tracked through the eighteenth century. Their journeys reveal much about their evolving significances and the re‐evaluations that occurred once they entered the French collections.
Interventional oncology in children: Where are we now?
Authors: Patel Premal Amrishkumar , Muñoz Fernando Gómez
Published: June 2024

Paediatric Interventional Oncology (IO) lags behind adult IO due to a scarcity of specific outcome data. The suboptimal way to evolve this field is relying heavily on adult experiences. The distinct tumour types prevalent in children, such as extracranial germ cell tumours, sarcomas, and neuroblastoma, differ strongly from those found in adults, presenting a completely different biological behaviour. Compounding this challenge, paediatric interventional radiology often employs adapted or off‐label techniques, potentially compromising optimal outcomes. This review outlines the present indications for interventional radiology in paediatric cancer, from biopsy to supportive care, including complication management. It emphasises the role of locoregional approaches, and explores the status of common paediatric oncological diseases, highlighting areas where IO has made progress identifying potential opportunities for future advancements in this evolving field.
Comparison of Yoga with exercise in ankylosing spondylitis on mobility and functional capacity
Authors: Acharya Nhehern Navin , Venkatesan Prem , Karvannan Harikesavan , Balebail Gopalakrishna Dharmanand
Published: June 2024

Aim

To compare the effects of Yoga with traditional exercise on the mobility and functional capacity of individuals with ankylosing spondylitis (AS).

Methods

The participants of the study were recruited at the rheumatology department, adhering to the study's inclusion and exclusion criteria. Participants were randomized into two groups (Group A – Yoga, and Group B – exercise).The candidates participated in an 8‐week intervention consisting of 3 weekly sessions of either Yoga or Exercise intervention. Outcomes were collected at pre‐treatment, at 8 weeks, and at 12 weeks.

Results

The within‐group comparison showed an improvement in all outcome measures with p < .05 between post‐treatment and the follow‐up. In the yoga group, there was an improvement in the measures of BASMI (p = .001), BASFI (p = .005), PSQI (p = .021), CE (p = .053) and NPRS (p = .001). Similarly, in the exercise group, there was an improvement in BASMI (p = .002), BASFI (p = .003), PSQI (p = .010), CE (p = .004) and NPRS (p = .001). In the between group comparison at post‐treatment, there were no statistically significant differences in BASMI (yoga = 3.0 ± 1.50, exercise = 2.3 ± 1.38), PSQI (yoga = 5.3 ± 1.50, exercise = 4.9 ± 1.17) and NPRS (yoga = 1.3 ± 2.22, exercise = 0.4 ± 0.50) CE (yoga = 4.0 ± 1.18, exercise = 3.4 ± 0.96), BASFI (yoga = 1.8 ± 2.14, exercise = 2.1 ± 1.87).

Conclusion

The results demonstrated a statistically significant improvement in within‐group scores of mobility, functional capacity, sleep quality and pain in AS patients of both intervention programs but there were no significant differences between the groups.
Reducing the postpartum length of stay: Implications for emergency department presentations at a tertiary women's hospital
Authors: Francis Alaina R. , Gordon Hannah G. , Mooney Samantha
Published: June 2024

Aims

Postpartum length of stay (LOS) in Australian hospitals has reduced over the past three decades. Although a reduction in LOS likely reduces hospital costs in the immediate postpartum period, there is concern that this is increasing the burden on emergency services, domiciliary staff and primary care providers. The aims were to determine whether the recent reduction in LOS at an Australian tertiary obstetric hospital resulted in a change in emergency department (ED) presentations by women in the first six weeks postpartum, and newborns within the first 28 days of life.

Methods

We conducted a cross‐sectional cohort study of all newborns ≤28 days of age and women ≤6 weeks postpartum who presented to the ED during four comparable time periods (2019–2022) at an Australian tertiary obstetric hospital. Logistic regression was used to determine the relationship between neonatal and maternal postpartum ED presentations and year of birth.

Results

Reduced postpartum LOS was associated with a significant increase in maternal and neonatal presentations to the ED (odds ratio (OR): 1.15 (95% confidence interval (CI): 1.08–1.23), and OR: 1.11 (95% CI: 1.03–1.19), respectively). For every 100 births, an extra six women and three neonates presented to the ED for postpartum care in 2022 compared with 2019. There was no difference in maternal or neonatal admissions throughout the study periods.

Conclusion

The increase in maternal and neonatal ED presentations associated with reduced LOS should prompt reassessment of postnatal practice and encourage further research into allocation of in‐hospital resources and postpartum education.
The heart rate response to the 6‐min walk test in atrial fibrillation patients with or without beta‐blockers: Referring to patients with sinus rhythm
Authors: Xie Feng , Jiang Zhenzhen , Zhu Bo , Li Juxiang , Wu Yanqing , Su Hai
Published: June 2024

Background

The aim was to evaluate the effect of beta‐blockers (BB) on the response of heart rate (HR) to 6‐min walk test (6MWT) in atrial fibrillation (AF) and whether the AF patients treated with BB have a similar HR response to 6MWT as the AF and sinus rhythm (SR) patients without BB treatment at the same resting HR level.

Methods

The before–after study involving 74 AF patients was to evaluate the effect of BB treatment (pre‐BB and with BB). The comparison study included 74 BB‐treated AF patients (with BB), 74 matched AF patients without BB (no BB), and 74 SR patients. The percentage increase amplitude of HR (HR‐PIA) in 6MWT was calculated: [(the exercise HR − the resting HR)/(the resting HR)] × 100%.

Results

The before–after study showed that BB treatment decreased the resting and mean exercise HR (98.6 ± 15.2 vs. 85.5 ± 11.2 bpm and 121.3 ± 17.3 vs. 109.0 ± 16.7 bpm) during 6MWT. The comparison study demonstrated that against the SR, the AF with BB and no BB groups have higher mean exercise HR‐PIA (28.2 ± 17.1% and 22.0 ± 9.6%, vs. 6.9 ± 3.7%) when their resting HR is similar. Moreover, the mean exercise HR‐PIA was also significantly higher in the with BB group than in the no BB group.

Conclusion

In AF patients with relatively higher resting HR, BB treatment could decrease the resting and exercise HR during 6MWT. However, BB treatment could not effectively attenuate the exercise HR rise as compared with AF without BB treatment, even with similar resting HR levels.
Routine use of MSI testing in colorectal cancer using a proposed algorithm
Authors: Ringgaard Marie Ley , Steiniche Torben , Krag Søren Palmelund
Published: June 2024

Fifteen percent of all colorectal cancers have detectable defects in the mismatch repair system (dMMR). MMR status is used to identify possible Lynch Syndrome (LS) and to determine prognosis and choice of treatment. Two standard techniques for determining MMR status are immunohistochemistry (IHC) and analysis for microsatellite instability (MSI) by PCR. Recently, our department introduced Idylla™ MSI assay as an alternative option to IHC, and as part of this, we introduced a decision algorithm. The purpose of this study was to review the use of the new method and our algorithm and to assess possible false‐positive results. Retrospectively, we identified 629 cases of colorectal cancer in which either IHC (336 cases) or Idylla™ MSI (293 cases) was performed. Similar results were obtained by the two methods. IHC detected dMMR in 55 cases (16%) and Idylla™ MSI in 52 cases (18%). In all 52 cases of MSI, subsequent IHC was performed. One case was not confirmed by IHC, but was confirmed by another PCR‐based method. Overall, we found that the Idylla™ MSI works well as a screening method for dMMR with no false‐positive cases detected. The proposed algorithm was useful and easily applicable.
Optimization of orofacial cleft imaging protocols using device‐specific low‐dose cone‐beam computed tomography
Authors: Shujaat Sohaib , Vasconcelos Karla de Faria , Kesztyüs Artúr , Fontenele Rocharles Cavalcante , Oliveira‐Santos Nicolly , Nagy Krisztian , Shaheen Eman , Jacobs Reinhilde
Published: June 2024

Objective

The aim of this study was to present optimized device‐specific low‐dose cone‐beam computed tomography (CBCT) protocols with sufficient image quality for pre‐surgical diagnostics and three‐dimensional (3D) modelling of cleft defects.

Methods

Six paediatric skulls were acquired, and an artificial bony cleft was created. A high‐resolution CBCT scan acted as a reference standard (Accuitomo 170, Morita, Kyoto, Japan) for comparing eight low‐dose protocols of Newtom VGi‐evo (QR Verona, Cefla, Verona, Italy), which included Eco and Regular protocols with different field of views (FOVs). Delineation of lamina dura, cementoenamel junction (CEJ), trabecular bone and bony bridge were assessed. A 3D model of the defect was also evaluated.

Result

The dose area product of low‐dose protocols ranged from 31 to 254 mGy*cm2. Despite the dose difference of up to eight times between applied protocols, trabecular bone and CEJ exhibited appropriate image quality in all scans. However, Regular small FOV protocols (5 × 5 and 8 × 5 cm2), for both lamina dura and bony bridge, demonstrated a significant improvement in image quality compared to Eco FOV counterparts. Based on 3D defect analysis, no significant difference existed between low‐dose protocols and the reference standard.

Conclusion

The findings highlight the possibility of achieving a considerable reduction (up to eight times) in the radiation dose using low‐dose CBCT protocols while maintaining sufficient image quality for assessing anatomical structures and 3D modelling in cleft cases.
Enteric neuropathy and the vagus nerve: Therapeutic implications
Authors: Bonaz Bruno
Published: June 2024

Enteric neuropathies are characterized by abnormalities of gut innervation, which includes the enteric nervous system, inducing severe gut dysmotility among other dysfunctions. Most of the gastrointestinal tract is innervated by the vagus nerve, the efferent branches of which have close interconnections with the enteric nervous system and whose afferents are distributed throughout the different layers of the digestive wall. The vagus nerve is a key element of the autonomic nervous system, involved in the stress response, at the interface of the microbiota‐gut‐brain axis, has anti‐inflammatory and prokinetic properties, modulates intestinal permeability, and has a significant capacity of plasticity and regeneration. Targeting these properties of the vagus nerve, with vagus nerve stimulation (or non‐stimulation/ pharmacological methods), could be of interest in the therapeutic management of enteric neuropathies.
Global outlook on affordability of biotherapeutic drugs
Authors: Rathore Anurag S. , Gardner Peter J. , Chhabra Hemlata , Raman Ruchir
Published: June 2024

Although biotherapeutic drugs have the potential of transforming the management of many life‐threatening diseases, their affordability and accessibility remain an issue. This study offers an overview of the global affordability of biotherapeutic products. For this, prices for 10 representative biotherapeutic products were examined in 40 countries, including high‐income countries (HICs), upper middle‐income countries (UMICs), lower middle‐income countries (LMICs), and low‐income countries (LICs). The affordability of these biotherapeutics was calculated based on the World Health Organization/Health Action International (WHO/HAI) method. As expected, affordability was found to be better in HICs, followed by UMICs, LMICs, and finally, LICs. Furthermore, based on the trend of per capita income, we predict that in UMICs and LMICs, the affordability of high molecular weight biologics will worsen by 1.5× and 2× by 2030, respectively, and further by 4× and 6× by 2040. On the other hand, affordability will stay nearly the same for people living in HICs in the coming decades. Our analysis suggests that it is imperative that measures be taken to make this class of products more affordable and accessible. Governments can contribute by creating conducive policies. Global institutions like the WHO can play a significant role as well. Finally, manufacturers need to invest in and implement manufacturing innovations.
Modeling habitat suitability of wild rice (Zizania spp.) to inform restoration efforts in Michigan, U.S.A.
Authors: Panda Abha , Lishawa Shane , Tallant Jason , Fegan Danielle
Published: June 2024

Wild rice (Zizania aquatica and Zizania palustris) has been an integral component of Michigan wetlands for thousands of years, but is disappearing today due to habitat loss. Identifying suitable habitats and associated environmental conditions for wild rice viability is a critical step toward guiding ongoing restoration efforts statewide. To this end, we used maximum entropy (Maxent), a presence‐only species distribution model, to characterize habitat preferences of wild rice in Michigan and identify suitable habitats for restoration. Extant wild rice occurrences were mapped alongside 11 environmental variables using Maxent to determine probabilities of occurrence throughout the state. The Maxent model (AUC > 0.9) predicted the highest probabilities of wild rice occurrence in the western and southwestern regions of the state. Climatic variables, biotic interactions, and anthropogenic disturbances were all found to influence wild rice occurrence, with land cover, lower May precipitation, and minimum winter temperatures having the highest contributions to model predictions. The results of this study suggest that statewide restoration of wild rice in Michigan may be possible, although localized differences in environmental conditions should be accounted for when selecting restoration sites. With further refinement and the inclusion of more key environmental predictors of wild rice viability, habitat suitability models such as the one created in this study may be powerful and effective tools in guiding wild rice restoration efforts nationally.
Iron deficiency among Japanese whole‐blood donors measured by serum ferritin
Authors: Odajima Takeshi , Tsuno Nelson H. , Ishimaru Fumihiko , Okubo Rie , Murakami Junko , Kitsukawa Kaori , Ikuta Katsuya , Matsuzaki Koji , Muroi Kazuo , Satake Masahiro , Kino Shuichi
Published: June 2024

Background and Objectives

A more restrictive blood donation criterion has been applied in Japan, with a maximum volume of whole blood (WB) donation of 400 mL, allowing twice a year for female donors and thrice a year for male donors. However, iron deficiency was as high as 20.5% among female donors prior to donation, increasing to 37.7% after blood donation. More than 20 years have passed since then, so we set out to investigate the present situation.

Materials and Methods

A total of 2659 (male/female: 1496/1163) donors of 400 mL WB who gave informed consent to join the study were enrolled. Serum ferritin (sFer) of first‐time/reactivated (FT/RA) donors were compared with those of repeat donors, according to gender and age; those who returned for subsequent donations during the study period were also followed up.

Results

About one‐third of FT/RA female donors had iron deficiency, possibly reflecting its high incidence among the general population. Interestingly, although sFer levels were low among pre‐menopausal FT/RA female donors, these values were not much different in repeat donors, whereas significant differences were observed between FT/RA and repeat donors among post‐menopausal females and in most age groups among males. As expected, donors with a normal initial sFer (≥26 ng/mL) recovered faster than those with a low initial sFer.

Conclusion

Female donors, especially, have iron deficiency even before donation, and the rate increased compared to what was found previously. Measures to prevent iron deficiency of blood donors is required, and studies are going on in Japan.
Finite Element Analysis of Crack Growth in Steel Rails Subjected to Non-Uniform Residual Stresses: Shelling to Detail Fracture
Authors: Kizildemir Sena , Nied Herman F.
Published: June 2024

Rail transportation is a critical component of the modern transportation infrastructure. However, railroad rails are prone to various defects that can compromise their safety and reliability.

One of the most substantial risks to the safe operation of rail transportation involves the propagation of internal transverse rail defects, commonly referred to as detail fractures. Interestingly, these transverse fractures typically start from flat subsurface cracks that run parallel to the rail’s running surface and are usually referred to as “shell” defects. The shell defect is situated just a few millimeters below the surface of the rail crown.

It is hypothesized that transverse detail fatigue cracks form when a new vertical crack emerges from the existing shell crack and grows at a right angle to the original defect, eventually becoming a detail fracture. Detail fractures can grow to a critical size due to cyclic bending stresses in the rail, and this can result in catastrophic rail failures. Unfortunately, these fractures can reach a critical size without any noticeable damage on the visible outer surface of the rail.

Transverse detail fractures have been the subject of extensive research and attention within the rail industry for several decades. However, only a few studies have examined the origin of detail fractures and what causes these types of cracks to transition from initial shell defects.

In this paper, 3-D finite element crack growth simulations are used to model these distinctly different fracture geometries, to determine the role that “non-uniform” residual stresses, from the roller straightening process, may play in the transition from shell to detail crack. The modeling of crack propagation in 3-D, requires the computation of stress intensity factors around the entire crack front as the crack shape continuously changes. Under general, mixed mode, loading conditions, an initially planer crack, i.e., shell crack, will not remain in the plane, but will grow in a complex three-dimensional sense. Since the crack shape and direction continuously changes during the 3-D fatigue simulation, adaptive meshing must be employed for the accurate calculation of the stress intensity factors along the crack front.

The main results from this study should provide a better understanding of the mechanisms behind the transition from shell cracks to detail fractures in railroad rails and may be useful in the development of more effective inspection and maintenance practices for railroad operators, reducing the risk of unexpected failures and improving the safety and reliability of railroad systems.
Using SmartRock to Assess Railroad Ballast Vertical Acceleration in Large-Scale Triaxial Test Under Varied Loading Pulses
Authors: Huang Shihao , Qian Yu
Published: June 2024

Railroad ballast serves to transfer moving train loads to the subgrade and maintain track stability. The profile of repeated train loading is observed to be irregular and periodical with a rest time caused by the nature of railway cars. The cyclic loading pulses applied in large-scale triaxial testing are then simplified with varying rest times in prior research, but this simplification leaves its effect on the response of ballast movement ambiguous. In this study, SmartRock, an intelligent sensor, is employed in large-scale triaxial tests to examine the vertical acceleration of ballast under various loading pulses. An index called cyclic loading duration ratio (CLDR) is introduced to establish the correlation between vertical accelerations and loading pulses. The findings suggest that there are settling acceleration and rebound acceleration under various loading pulses. With the decreasing of CLDR, both accelerations show a clear growth, and their growth rates are highly dependent on the applied deviator stress. Besides, under CLDR = 0.05, the ballast particles tend to vibrate with the high deviator stress. These insights are crucial for making informed decisions about waveform selection in future triaxial testing.
IEC 61850 and its Capabilities in Protection Systems
Authors: Gholizadeh Navid , Yousefnejad Soheil
Published: June 2024

This research paper delves into the capabilities of the IEC 61850 standard in terms of protection systems within the context of the electrical grid. The paper begins with an overview of the general architecture of the grid and the Wide Area Network, which encompasses all stages of power generation, distribution, and consumption. An introduction to the IEC 61850 substation automation standard is then provided, followed by an explanation of the necessary background information, including communication systems and the OSI data model. The study tests the assumption that Ethernet is suitable for real-time communication and fault tolerance in the network [9]. The paper concludes that the IEC 61850 standard is expected to enable seamless communication among devices that can understand its data model, reducing the need for wiring and enabling the use of the bandwidth of the station LAN for GOOSE and GSSE signals. However, the study also reveals that not all vendors and distribution companies are fully familiar with the IEC 61850 standard and as a result, legacy protocols continue to be used in many networks.
Performance of a Mobile, Non-Contacting, Reference-Free Prototype System for RNT and Rail Stress Measurements
Authors: Rizos Dimitris C. , Stinson Brittany , Penna Caio , Gedney Brennan , Naseri Reza
Published: June 2024

The use of Continuous Welded Rail (CWR) has become the industry standard in railroad tracks around the world due to the many advantages compared to the jointed rail. CWR, however, is susceptible to the development of internal forces in the rail due to thermal effects that can lead to track buckling or rail breaks. Railroads manage the internal stresses in the rail by setting, monitoring, and adjusting the rail neutral temperature (RNT) which is the temperature at which the rail is in a stress-free state. The existing methods in the industry to measure RNT are contacting, destructive, disruptive to railroad operations, and/or ineffective. The author has introduced a novel technique for estimating RNT that is based on shape and deformation measurements of the rail at different temperatures. The first generation of the prototype system acquired the said measurements using 3D Digital Image Correlation (StereoDIC) technology from a stationary platform. The second generation of the prototype comprises a moving platform and integrates a 3D laser profiler system for shape measurements. This paper and presentation discuss the unique challenges and solutions associated with mounting the system on a moving platform, along with the new testing protocol. The performance of the new mobile system is first assessed through laboratory studies in the indoor rail track testing facility at USC. Subsequently, the system is implemented and validated in the field. This paper presents the validation studies and discusses the performance of the system in the laboratory and the field along with the next steps in the development and implementation to practice.
Railroad Track and Wheel Defect Detection With Onboard Condition Monitoring System
Authors: Pams Jeffery , Tarawneh Constantine , Montoya Joe , Wilson Brent , Cantu Lee , Alkhaldi Hashem
Published: June 2024

In the railroad industry, it was estimated by the Federal Railroad Administration’s (FRA) Office of Safety Analysis that over 1,000 train derailments occur every year in the United States, with a significant amount being caused by mechanical failures such as defects within the wheels and tracks. The use of wireless onboard health monitoring technologies as opposed to wayside detection systems has been receiving a lot of attention considering recent catastrophic derailments. Through research, development, and implementation of onboard condition monitoring systems by the University Transportation Center for Railway Safety (UTCRS) and HUM Industrial Technology, Inc., a promising method to detect wheel and track defects has been field tested in freight revenue service. HUM’s onboard condition monitoring system, which includes the Boomerang (the onboard module with a suite of sensors), and the Gateway (the wireless communication module), has improved the visibility of data pertaining to the operating conditions of railcars by measuring vibration data generated by the bearings, wheels, and wheel-track interactions. By correlating these data to measured vehicle speed and GPS locations, the data pertinent to wheel and track aberrations can be parsed and verified against known defect signatures of each component or track. After conducting field tests, the technology was able to detect and locate surface defects on the railroad track at key locations as identified by GPS positioning. By utilizing the Gateway’s real-time GPS tracking, a track defect was identified within 10 feet of the GPS timestamped location of the anomalous impact data. Additionally, the wheel impact data indicated that two wheels had wheel impact load readings at low speeds that correlated with prior data generated on a 2-inch wheel flat from a previous field study. After removing and inspecting the two wheelsets, one wheel was identified with multiple distributed defects, and another wheel was found to contain a wheel flat, characteristic of a skidded wheel. This study highlights the capabilities of onboard condition monitoring systems for determining not only in-situ wheel defects, but extrapolations to track defects and low-speed defect monitoring as well.
Optimized Vibration-Based Health Metrics for Freight Rail Bearings
Authors: Pams Jeffery , Tarawneh Constantine , Rocha Dylan , Wilson Brent , Cantu Lee , Alkhaldi Hashem , Diaz Alberto
Published: June 2024

In the railroad industry, monitoring the condition of freight railcar bearings in-service is carried out through two primary systems: wayside hot bearing detectors (HBDs) and trackside acoustic detection systems (TADS). However, these systems face challenges in accurately assessing bearing fatigue and distress, especially during the initial stages of defect development. To address this, the University Transportation Center for Railway Safety (UTCRS) research team developed a vibration-based onboard monitoring technology. Unlike existing methods, this system continuously monitors in-service bearings, offering precise health assessments. It utilizes calibrated vibration thresholds based on correlations between bearing operating speeds and vibration signatures for healthy and defective bearings. Additionally, the system identifies faulty components in tapered-roller bearings through frequency domain analysis. To maintain the accuracy of the onboard sensors in detecting defective components, the thresholds are periodically reassessed by employing regression analysis to establish revised thresholds that incorporate the latest vibration data collected from the laboratory testing of healthy and faulty bearings. These revised thresholds can enhance the health monitoring of in-service bearings, enabling rail operators to identify issues early, schedule maintenance, and prevent costly and unnecessary train stoppages. The advanced methodologies proposed by the UTCRS aim to improve bearing health monitoring in the railroad industry, ultimately reducing catastrophic derailments and associated human and capital losses.
Evaluating the Puncture Resistance of the DOT-113 Tank Car for Liquified Natural Gas Service
Authors: Kirkpatrick Steven W.
Published: June 2024

Over the past two decades there has been significant research on improving the safety of hazardous material (HAZMAT) transport in railroad tank cars. This research was a collaborative effort of both the government and industry and motivated by significant rail accident/derailment events with HAZMAT releases. The research included both testing to measure the impact and puncture resistance of tank cars and the development of analysis methodologies capable of predicting the impact behaviors for a wide range of conditions. Consequently, a significantly improved understanding of the factors that improve HAZMAT tank car safety has been achieved and important analysis methodologies developed for evaluation of tank car puncture resistance.

The knowledge gained from these research programs supported the development of improved regulations for HAZMAT tank cars. These include the March 2009 regulations on poison inhalation hazard (PIH) tank cars (Federal Register, 74 FR 1769) and July 2015 regulations on high-hazard flammable tank cars (Federal Register, 80 FR 26643).

More recently, the Federal Railroad Administration (FRA) sponsored research to perform full-scale impact testing and analysis of cryogenic tank car designs, primarily supporting the transport of Liquid Natural Gas (LNG) by rail. This led to the Pipeline and Hazardous Materials Safety Administration (PHMSA) July 2020 ruling that allows transport of LNG in DOT-113C120W9 tank cars (Federal Register, 85 FR 44994). Subsequent to the rulemaking on the DOT-113 tank car for LNG service, there was still significant public interest in performing additional evaluations of the safety of LNG transport by rail. In September 2023, PHMSA suspended the authorization for LNG transportation in rail tank cars to allow for further investigation (Federal Register, 88 FR 60356).

The objective of this study was to evaluate the puncture risk of the DOT-113 LNG tank car. The approach was to first apply the existing tank car impact and material test data from the FRA research program to develop and validate a detailed impact and puncture analysis methodology. This analysis methodology was then applied to assess the puncture resistance of the DOT-113 LNG tank car under a range of impact scenarios. These scenarios included various impactors and impact conditions (normal and oblique impacts to the shell) as well as impacts on the tank head. The results of these puncture analyses are then used to assess the relative puncture resistance of the DOT-113 LNG tank car to a range of other HAZMAT tank car designs that were previously evaluated using the same methodology.

The results of this investigation show that the DOT-113 LNG tank car has a high level of puncture resistance relative to other HAZMAT tank cars over a wide range of impact conditions.