bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Palliative Care Improves Uptake of Advance Care Planning Among Patients With Advanced Cancers
Authors: Cohen Michael G. , Althouse Andrew D. , Arnold Robert M. , White Douglas , Chu Edward , Rosenzweig Margaret , Smith Kenneth J. , Schenker Yael
Published: April 2023

Background: Palliative care specialists are experts in conducting advance care planning (ACP) but are a limited resource. Oncology nurses often have special relationships with their patients and thus may be poised to provide primary palliative care. We sought to determine the impact of a nurse-led primary palliative care intervention on ACP uptake among patients with advanced cancer. Methods: We performed a secondary analysis of a cluster randomized controlled trial examining the impact of nurse-based primary palliative care. In the parent trial, patients with advanced cancer received either monthly primary palliative care visits with trained nurses within their cancer center or standard care. Nurses in the intervention arm received special training in ACP. ACP uptake was assessed at enrollment and 3 months later evaluating (1) whether an end-of-life conversation (EOLC) occurred with one’s oncologist, and (2) completion of an advance directive (AD). Multivariable logistic regression tested differences in ACP uptake by treatment arm adjusted for age, religious importance, education, time with current oncologist, and performance status. Results: Of 672 patients enrolled, 182/336 (54%) patients in the intervention arm and 196/336 (58%) in the standard care arm lacked an EOLC at baseline and completed the 3-month assessment. Of those, 82/182 (45.1%) patients in the intervention arm and 29/196 (14.8%) in the standard care arm reported having an EOLC at 3 months (adjusted odds ratio, 5.28; 95% CI, 3.10–8.97; P<.001). Similarly, 111/336 (33%) patients in the intervention arm and 105/336 (31%) in the standard care arm lacked an AD at baseline and completed the 3-month assessment. Of those, 48/111 (43.2%) patients in the intervention arm and 19/105 (18.1%) in the standard care arm completed an AD over the study period (adjusted odds ratio, 3.68; 95% CI, 1.89–7.16; P<.001). Conclusions: Nurse-led primary palliative care increased ACP uptake among patients with advanced cancer. Training oncology nurses embedded within community cancer centers to provide primary palliative care may help improve ACP access.
MB ChB fifth-year student response to e-learning in orthopaedic surgery during COVID-19
Authors: Gamieldien H , Kruger NA , Dey R
Published: April 2023

Background. With the onset of the COVID-19 pandemic and the subsequent country-wide lockdown, South African (SA) universities were forced to quickly adapt to teaching that minimised or eliminated in-person contact. The pandemic period necessitated rapid changes to the way in which learning occurs and resulted in significant shifts in the academic environment. There is limited evidence in the literature to support e-learning in undergraduate orthopaedic training. This is the first study of its kind evaluating e-learning in orthopaedic surgery in a middle-to-low-income country.Objectives. To identify the University of Cape Town fifth-year MB ChB cohort’s attitudes towards the e-learning component of blended learning during the COVID-19 pandemic. It also aimed to investigate whether e-learning facilitates comparable levels of confidence and results among students and face-to-face methods.Methods. Multi-year cross-sectional survey analysis was completed by retrospectively analysing the students’ end-of-block evaluations and end-of-block marks. Responses from the cohorts between 2016 and 2020 were compared.Results. Regarding course definition, workload, course organisation, intended preparation and course presentation, the 2020 cohort’s responses were similar to those of previous years. The 2020 cohort agreed that the e-learning material was relevant; this response was higher than in previous years. They also agreed that the online practical sessions were useful and that the course stimulated more interest. Significantly, they also strongly agreed that the online course was easier to attend and participate in than in previous years. The 2020 cohort perceived the end-of-block assessment to be somewhat unreasonable; however, this cohort yielded similar grades compared with previous cohorts. Subjectively, the students’ responses to e-learning were positive, as many of them welcomed the usefulness and stimulation of online media as a study tool. Students felt that more time should be made available to work through online material and that there was incongruity between the content taught and the content of the end-of-block assessments.Conclusion. Subjectively, the students’ responses to e-learning were positive, as many of them welcomed the usefulness and stimulation of online media. With comparable outcomes in terms of student confidence and final marks (compared with traditional teaching only), it further encouraged a move towards formulating a novel blended learning curriculum. With these positive findings, we were able to explore the possibilities of developing an e-learning course curriculum incorporating international blended learning practices, using locally sourced SA evidence-based literature to provide orthopaedic teaching relevant to our unique setting.
Medicine and the Law
Authors: Prinsen Larisse
Published: April 2023

Medico-legal claims in the South African health sector have markedly increased since approximately 2007. This is noteworthy as money spent on these claims from the public health budget, is money which should have been spent on the healthcare priorities identified in the National Department of Health Strategic Plan. As such, it becomes important to understand why these claims have shown drastic increases. This piece therefore discusses the causes of increased claims which include clinical errors, maladministration and mismanagement; the legal profession’s contribution to the problem; legal developments and patient awareness as well as some other additional causes. Possible solutions are also offered such as those related to the NDOH and National Core Standards and Ideal Clinic initiative quality of care standards; improving the healthcare system and quality of care; better distinguishing between valid and invalid or fraudulent claims, the possible role of fit-for-purpose legislation and a reconsideration of compensation methods.
Understanding the impact of the COVID‑19 pandemic on healthcare services for adults during three waves of COVID‑19 infections: A South African private sector experience
Authors: Nematswerani N , Steenkamp L , Haneef S , Naidoo RM , Fonn S
Published: April 2023

Background. Since the onset of the COVID‑19 pandemic, healthcare resources have been repurposed to focus on COVID‑19. Resourcereallocation and restrictions to movement that affected general access to care may have inadvertently resulted in undue disruptions in the continuum of care for patients requiring non-COVID‑19 healthcare services.Objectives. To describe the change in pattern of health service use in the South African (SA) private sector.Methods. We conducted a retrospective study of a nationwide cohort of privately insured individuals. An analysis of claims data wasperformed for non-COVID‑19 related healthcare services provided from April 2020 to December 2020 (year 1 of COVID‑19) andApril 2021 to December 2021 (year 2 of COVID‑19) relative to the same period in 2019 prior to the COVID‑19 pandemic in SA. Over andabove plotting the monthly trends, we tested for statistical significance of the changes using a Wilcoxon test given the non-normality of all the outcomes.Results. Between April and December 2020, relative to the same period in 2021, and also relative to the same period in 2019, we found a 31.9% (p<0.01) and a 16.6% (p<0.01) reduction in emergency room visits, respectively; a 35.9% (p<0.01) and 20.5% (p<0.01) reduction in medical hospital admissions; a 27.4% (p=0.01) and 13.0% (p=0.03) reduction in surgical hospital admissions; a 14.5% (p<0.01) and 4.1% (p=0.16) reduction in face-to-face general practitioner consultations for chronic members; a 24.9% (p=0.06) and 5.2% (p=0.54) reduction in mammography for female members; a 23.4% (p=0.03) and 10.8% (p=0.09) reduction in Pap smear screenings for female members; a 16.5% (p=0.08) and 12.1% (p=0.27) reduction in colorectal cancer registrations and an 18.2% (p=0.08) and 8.9% (p=0.07) decrease in all oncology diagnoses. Uptake of telehealth services throughout the healthcare delivery system increased by 5 708% in 2020 compared with 2019, and 36.1% for 2021 compared with 2020.Conclusion. A significant reduction in emergency room visits, hospital admissions and utilisation of primary care services was observed since the start of the pandemic. Further research is required to understand if there are long-term consequences of delayed care. An increase in the use of digital consultations was observed. Research on their acceptability and effectiveness may open new modalities of care, which may have cost- and time-saving benefits.
El registro horario como mecanismo de control del derecho a la desconexión digital
Authors: Martín Vales Priscila
Published: April 2023

La irrupción de las tecnologías de la información y de la comunicación en las relaciones laborales, unido a la descentralización productiva y de personas, la autonomía de las personas trabajadoras, la hiperflexibilidad, la fragmentación y la reducción de las horas de trabajo, ha conllevado el surgimiento de nuevas modalidades de relaciones laborales y, con ellas, nuevas controversias que han de ser paliadas por el legislador y la negociación colectiva y, en su defecto, por los juzgados y tribunales. Una de sus características es que se han visto difuminados los conceptos de horario y jornada laboral, y, en consecuencia, su afectación en el disfrute real y efectivo del derecho al descanso, a través del derecho a la desconexión digital. Tal transgresión puede producir, a su vez, consecuencias negativas en la conciliación de la vida familiar y laboral, la seguridad y salud laboral y, en definitiva, al trabajado decente. Cuestión que conlleva la necesaria y correcta aplicación del control del registro horario por el empleador para garantizar el disfrute del derecho al descanso efectivo. Por ello, el objetivo del presente estudio es el análisis de la configuración legal, tanto internacional como nacional, y así intentar dar respuesta a los diversos interrogantes que se plantean en las nuevas relaciones laborales de la sociedad 4.0, y, en mayor medida, en relación con el registro horario como instrumento garantizador del derecho a la desconexión digital.
High comprehensive performance superconducting nanowire single photon detector
Authors: Xi Ling-Ling , Yang Xiao-Yan , Zhang Tian-Zhu , Xiao You , You Li-Xing , Li Hao ,   State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of  Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China,   Center for Excellence in Superconducting Electronics, Chinese Academy of Sciences, Shanghai 200050, China,   University of Chinese Academy of Sciences, Beijing 100039, China
Published: April 2023

Superconducting nanowire single photon detector (SNSPD) has been widely used in quantum communication, quantum computing and other fields because of its excellent timing jitter and response speed. However, due to the mutual restraint of the technical parameters of SNSPD nanowires, there are technical challenges to further improve the comprehensive performance of SNSPD, and thus limiting its application on a large scale. Combining high detection efficiency with high timing performance is still an outstanding challenge. In this work, we report the SNSPD with 12-μm small active area, which has high speed, high efficiency, low jitter and broadband absorption. Au/SiO2 membrane cavity, which is determined by finite element analysis simulation, is used to widen the optical response bandwidth. And it is easier to process and improve the alignment accuracy at the same time. The flat substrate is more conducive to the growth of superconducting thin films, so flattening process is introduced. Device package is also optimized to match smaller detector. Self-aligned packaging makes optical alignment more convenient and time-saving. Special optical fibers with small mode-field diameters can reduce the negative effect of the detector on optical coupling. The detector can achieve a maximum SDE of 82% at the central wavelength of 1310 nm and the temperature of 2.2 K, and the SDE of more than 65% in the wavelength range of 1200–1600 nm, with DCR of 70 cps. The detector also exhibits a count rate of 40 MHz@3 dB and a timing jitter of 38 ps, which is significantly improved compared with 23-μm active area detector. Furthermore, the minimum timing jitter of 22 ps can be obtained by using cryogenic amplifier readout. In this work, high comprehensive performance detector is developed, which provides an important technical reference for practical and product SNSPD.
Tales of the unexpected
Authors: Aponte Santiago Nicole , Konecki Stephanie , Porter Lauren , Virk Harvinder
Published: April 2023

A single event can completely change the direction of a career in science; four researchers share their stories.
Beware of predatory publishing – but also of low-quality blacklists
Authors: Frantsvåg Jan Erik
Published: April 2023

We should be wary of low-quality journals and predatory OA publishing. But we should also know which sources’ judgement to trust. Is the new website Predatory Reports a trustworthy source of information?
Research on the Role and Mechanism of Digital Economy Boosting Rural Revitalization Under the Background of Big Data
Authors: Qin Jian
Published: April 2023

The digital economy is an important product of the information technology revolution. With the advent of the big data era, the digital economy is having an increasingly significant impact on traditional economies. Rural revitalization is an important strategy for the current economic development in China, and the digital economy can provide new development opportunities for rural revitalization. This paper reviews the relevant research on the digital economy and rural revitalization, analyzes the role and mechanism of the digital economy in promoting rural revitalization. The results show that the role of the digital economy in rural revitalization lies in promoting agricultural modernization, promoting rural industrial upgrading, improving rural infrastructure, and enhancing rural social services. The mechanism by which the digital economy promotes rural revitalization mainly includes policy support, technological innovation, capital investment, and talent cultivation. This paper aims to provide theoretical basis and practical guidance for the application of the digital economy in rural revitalization.
Prediction of Coronary Artery Disease using Ankle Brachial Pressure Index in Patients with Diabetes Mellitus: A Cross-sectional Study
Authors: Sharma Manvi , Bhatnagar Mini , Meelu Abhinav , Patel Ronak , Uppal Sanchit
Published: April 2023

Introduction: Diabetes mellitus confers a tenfold risk of cardiovascular disease due to atherosclerosis. Screening a large number of patients for Coronary Artery Disease (CAD) in susceptible population groups is required. Ankle Brachial Pressure Index (ABPI) is a non invasive tool for identifying atherosclerosis and peripheral artery disease and can be used in large population studies. Hence the present study attempted to assess the applicability of ABPI as a tool for prediction of CAD in diabetic patients. Aim: To calculate the ABPI in patients of diabetes mellitus and to assess the association of ABPI value with presence of CAD, duration of CAD and with the microvascular complications of diabetes mellitus. Materials and Methods: This cross-sectional study was conducted at MMIMSR, Mullana from December 2019 to July 2021. A 100 patients suffering from type 2 diabetes mellitus for more than five years duration were included. Patients were divided into two groups based on the presence or absence of CAD. ABPI was calculated in each patients and its correlation was assessed with CAD and association with microvascular complications of diabetes mellitus. The correlation assessed using Pearson correlation test. The mean was compared in with respect to independent t-test (for two groups). Results: Out of 100 patients there were 78 males and 22 females of mean age 60.64±10.97 years. Microvascular complications were present in 35% cases. Past history of CAD was present in 58%, stroke in 9%, hypertension in 15% and chronic kidney disease in 8%. Electrocardiogram (ECG) changes of CAD were observed in 56% while 2D-ECHO showed Regional Wall Motion Abnormality (RWMA) in 57 cases while 18 had angiographic evidence. Mean ABPI was 0.79 and 1.17 in the CAD and non CAD group respectively which was significant. A negative correlation was observed with ABPI and duration of CAD in years with Pearson correlation value of-0.260 (p-value 0.049). Conclusion: ABPI was also found to be negatively correlated with the duration of CAD and was significantly lower in diabetic patients with microvascular complications of diabetes. ABPI had a senstivity of 84.5% and specificity of 90.5% in prediction of CAD in patients suffering from diabetes.
PARTICIPATORY BUDGETING AS A FORM OF RESIDENTS’ CO-DECISION ON THE ALLOCATION OF LOCAL FUNDS: A CASE STUDY OF THE CITY OF PRZEMYŚL
Authors: GRZEBYK Mariola , STEC Małgorzata , HEJDUKOVA Pavlina
Published: April 2023

Participatory budgeting, also called civic budgeting, is a major instrument to facilitate engagement in local government affairs and foster social awareness among residents. It consists in involving residents in the allocation of a pool of public funds made available by local authorities. The purpose of this article is to assess the implementation of participatory budgeting in the city of Przemyśl, Podkarpackie Province, between 2013 and 2022. The assessment methods are desk research based on publicly available data, and interviews with city hall staff. The study confirms that the implementation of participatory budgeting made it possible to achieve the overarching goal of the project, which was to increase engagement by encouraging citizens to participate in public life and co-decide on the allocation of public funds.
Microstructure Characteristics of the Compound Layer Cracked during Grinding on QPQ‐Treated Cr‐Containing Steel Shafts
Authors: Min Yongan , Jiao Xuzhi , Shao Li , Chen Zhuo , Jiang Ziwei
Published: April 2023

Cr‐containing structural steels with quench‐polish‐quench (QPQ)‐treated surfaces are noticed having higher grinding cracking tendency compared to plain carbon steels. Herein, the compound layers of QPQ‐treated shafts produced from 20Cr and 40Cr steels by performing XRD, SEM, EDS, and microindentation measurements are investigated. The differences between the compound layers on the shafts with and without cracks are compared in morphology and element distribution. It is revealed that the basic reason of grinding cracking is the imperfect compound layer with serious porosities. The formation of serious porosities is mainly due to the inhibition of the outward diffusion of the nitrogen molecules from the nitride layer. Stronger nitride‐forming element Cr is considered to strengthen this inhibition.
Achieving a Strong Friction‐Lap Joint of Continuous Carbon‐Fiber‐Reinforced Plastic/Aluminum Alloy via a Surface Laser‐Processing Pretreatment
Authors: Jiang Chunyang , Wu Lihui , Liu Fengchao , Xue Peng , Xiao Bolv , Ni Dingrui , Ma Zongyi , Chang Yunlong
Published: April 2023

It is difficult to achieve high‐strength joints of metals to carbon‐fiber‐reinforced plastics (CFRPs) with high contents of continuous fibers with the poor fluidity. Herein, a special designed laser‐processing pretreatment is conducted on the surface of 5052Al, and friction‐lap joining (FLJ) is employed to join pretreated 5052Al to the CFRP with 50%–55% fiber content. The maximal tensile shear force and strength reach 4.06 kN and 18.04 MPa, respectively, with an increment of 72% compared to the untreated sample. It is the first time to achieve the high‐strength joint of Al alloys to CFRPs with high contents of continuous fibers via FLJ. The joining area and adhesion work are quantified by theoretical calculations, and the residual stresses are visualized by finite‐element analysis. The laser‐processing pretreatment changes the plain Al alloy surface structure into the rough and porous structure, largely increasing the mechanical interlocking effect of the joint, and also changes the Al alloy surface wetting behavior and increases the adhesion work from 59.66 to 81.17 mN m−1. That largely changes the chemical reaction feature between the CFRP and Al alloy, resulting in their tight bonding. In addition, the residual stresses weaken, which further improve the tight bonding effect.
Deciphering the Differences in Ambident Reactivity between the Cyanate, Thiocyanate Ions, and their P‐ and As‐Containing Analogues
Authors: Horváth Ádám , Lőrincz Balázs D. , Benkő Zoltán
Published: April 2023

Although the cyanate and thiocyanate anions belong to the most known textbook examples of ambident nucleophiles, the electronic factors that determine their markedly differing reactivities are still unclear. The recently discovered P‐ and As‐containing [PCX]− and [AsCX]− analogues (X: O, S, Se), whose ambident nature is practically unexplored, may serve as ideal basis for comparison to clarify these differences. This study presents comprehensive theoretical investigations on the nucleophilic behaviours of the whole set of so far known [ECX]− (E: N, P, As, X: O, S, Se) anions, aiming for a systematic understanding of the reactivity patterns and identifying the factors that govern the nucleophilic substitutions. The results indicate that the SN2 reactions of the O‐containing [ECO]− ions are thermodynamically preferred at the pnictogen centres E, while the kinetic contributions are only substantial for the N‐containing [NCX]− anions. The ambident reactivities of the congeners that contain N or O significantly differ from those with P, As, S, or Se heteroatoms, in line with the inert s‐orbital effect, characteristic for the heavier elements. By analysing the electronic structures and bonding patterns of the anions and relevant transition state structures, clear explanations are offered for the differing reactivities of the whole set of [ECX]− anions. To serve for synthetic investigations, possible outcomes of nucleophilic substitutions are predicted, and the target molecules are expected to be versatile and useful synthons.
Effect of supplier cost stickiness on environmental, social, and governance: Moderating role of customer bargaining power
Authors: Chen Li‐Yu , Wang Teng‐Shih
Published: April 2023

Firms with high selling, general, and administrative (SG&A) cost stickiness may maintain environmental, social, and governance (ESG) performance, and customer firms that account for a large proportion of supplier firms' sales (main customers) have considerable bargaining power regarding sales terms. In this study, we examine the effect of SG&A cost stickiness of supplier firms on their ESG performance. We further examine the moderating effect of a customer's bargaining power on the relationship between cost stickiness and ESG performance. The findings reveal that supplier firms with high cost stickiness have higher ESG performance, whereas supplier firms with main customers have lower ESG investments. The influence of main customer firms mitigates the positive relationship between the SG&A cost stickiness and ESG investment of supplier firms. In additional analysis, we obtain consistent conclusions for large firms and firms with high production efficiency.
A novel robust maximum power extraction framework for sustainable PV system using incremental conductance based MRAC technique
Authors: Singh Deepak Kumar , Akella Ashok Kumar , Manna Saibal
Published: April 2023

This study proposes a maximum power point tracking (MPPT) approach with two components: an Incremental Conductance (INC) MPPT for reference voltage regulation and a Model Reference Adaptive Controller (MRAC) for adjusting the duty cycle of the DC‐DC converter switch. A robustness test is performed on the system considering real‐world situations that involve an abrupt change in atmospheric conditions with load uncertainties. The probabilistic load distribution analysis is accomplished through levels of uncertainty (i.e., Probabilistic DOWN and UP) to guarantee the operation of the proposed INC‐MRAC controller while generating unexpected disturbances in the system. Using MATLAB/Simulink, the performances of the novel INC‐MRAC MPPT are comparatively analyzed with PO, INC, VSSPO, and ANN under realistic case studies in seven states. After comparative analysis, it is evident that the proposed MPPT offers less tracking time, i.e., 3.8 ms, to track maximum power point (MPP) with negligible steady‐state oscillation and ripples. It is about 3, 7, 9, and 10 times faster than ANN, VSSPO, INC and PO, respectively. Moreover, the tracking efficiency of the proposed controller is up to 99.63% as well as overall efficiency of the system is more than 98%. The tracking power loss and error rate in finding MPP for the proposed controller is the lowest among all state‐of‐the‐art MPPT approaches. Finally, the effectiveness of the proposed INC‐MRAC approach is experimentally validated by employing a real‐time simulator OPAL‐RT (OP4510). The study helps in environmental protection and participation in sustainable development.
Analysis of the interaction between surface water and groundwater using gaseous tracers in a dynamic test at a riverbank filtration intake
Authors: Kotowski Tomasz , Najman Joanna , Nowobilska‐Luberda Aleksandra , Bergel Tomasz , Kaczor Grzegorz
Published: April 2023

We discuss a study designed to elucidate the genesis and inflow conditions at riverbank filtration wells located on a mountain river. This article seeks to identify the most important drivers of spatio‐temporal dynamics of water flow in the hyporheic exchange zone, in natural conditions and conditions disturbed by the water abstraction. In our study we try to contribute to further understanding the dynamics of groundwater mixing with river water in the hyporheic exchange zone. We focus on understanding river/aquifer interactions at the scale of reach of an intake, especially the unidirectional water flows induced by water abstraction. To understand these issues, a two‐day field hydrogeological experiment was conducted based on a pumping test of increasing intensity. At each pumping stage, groundwater and river samples were collected to determine the concentration of noble gases, CFCs, SF6, stable isotope content, and the chemical composition of the water. The study results indicate a short pressure propagation time (of the order of several hours) between the intake and the river, which already results in the inflow of water from the river–aquifer mixing zone at low rates of water abstraction by the intake. As pumping rates increase, the conditions of mixing and inflow of water to individual wells stabilize or approach stabilized conditions in less than 1–2 days. The share of river water in the water flux flowing into the intake does not exceed 12%, whereas the ratio of river water to groundwater in the mixing zone is estimated at 1 to 7 or more. The range of the river‐aquifer mixing zone may reach up to 170 m from the river and this range can be identified with a good approximation as coinciding with the range of the zone of hyporheic exchange in the study area.
Reconsidering the effectiveness of low‐dose aspirin in prevention of pre‐eclampsia among otherwise low risk twin gestations: A historical cohort study
Authors: Toussia‐Cohen Shlomi , Zaslavsky‐Paltiel Inna , Farhi Adel , Brantz Yael , Maymon Dror , Meyer Raanan , Yinon Yoav , Lerner‐Geva Liat , Mazaki‐Tovi Shali , Tsur Abraham
Published: April 2023

Objective

To investigate the effectiveness of low‐dose aspirin (LDA) in the prevention of pre‐eclampsia (PE) among otherwise low‐risk twin gestations.

Methods

A historical cohort study consisting of all pregnant individuals with dichorionic diamniotic (DCDA) twin pregnancy who delivered between 2014 and 2020. Patients treated with LDA were matched by a 1:4 ratio to individuals who were not treated with LDA by age, body mass index and parity.

Results

During the study period, 2271 individuals carrying DCDA pregnancies delivered at our center. Of these, 404 were excluded for one or more additional major risk factors. The remaining cohort consisted of 1867 individuals of whom 142 (7.6%) were treated with LDA and were compared with a 1:4 matched group of 568 individuals who were not treated. The rate of preterm PE did not differ significantly between the two groups (18 [12.7%] in the LDA group vs. 55 [9.7%] in the no‐LDA group; P = 0.294, adjusted odds ratio 1.36, 95% confidence interval 0.77–2.40). There were no other significant between‐group differences.

Conclusions

Low‐dose aspirin treatment in pregnant individuals with DCDA twin gestations without additional major risk factors was not associated with a reduction in the rate of preterm PE.
Changes in sensorimotor cortex oscillatory activity by orexin‐A in the ventrolateral preoptic area of the hypothalamus reflect increased muscle tone
Authors: Mavanji Vijayakumar , Teske Jennifer A. , Kotz Catherine M. , Pellizzer Giuseppe
Published: April 2023

Orexin‐A (OXA) is a hypothalamic neuropeptide implicated in the regulation of wakefulness, appetite, reward processing, muscle tone, motor activity, and other physiological processes. The broad range of systems affected stems from the widespread projections of orexin neurons toward multiple brain regions regulating numerous physiological processes. Orexin neurons integrate nutritional, energetic, and behavioral cues and modulate the functions of target structures. Orexin promotes spontaneous physical activity (SPA), and we recently showed that orexin injected into the ventrolateral preoptic area (VLPO) of the hypothalamus increases behavioral arousal and SPA in rats. However, the specific mechanisms underlying the role of orexin in physical activity are unknown. Here we tested the hypothesis that OXA injected into the VLPO alters the oscillatory activity in the electroencephalogram (EEG) to reflect an increased excitability of the sensorimotor cortex, which may explain the associated increase in SPA. The results showed that OXA increased wakefulness following injections into the VLPO. In addition, OXA altered the power spectrum of the EEG during the awake state by decreasing the power of 5–19 Hz oscillations and increasing the power of >35 Hz oscillations, which are markers of increased sensorimotor excitability. Consistently, we found that OXA induced greater muscle activity. Furthermore, we found a similar change in power spectrum during slow‐wave sleep, which suggests that OXA altered the EEG activity in a fundamental way, even in the absence of physical activity. These results support the idea that OXA increases the excitability of the sensorimotor system, which may explain the corresponding increase in awake time, muscle tone, and SPA.
Diminishing the catalyst concentration in the Cu(0)‐RDRP and ATRP synthesis of well‐defined low‐molecular weight poly(glycidyl methacrylate)
Authors: Janata Miroslav , Čadová Eva , Johnson Jeffery W. , Raus Vladimír
Published: April 2023

Low‐molecular weight (MW) solvent‐borne functional (meth)acrylic polymers find an important use in coating resins. However, when preparing such polymers through copper‐mediated reversible‐deactivation radical polymerization (RDRP), contamination with colored copper species and the use of expensive ligands represent significant obstacles from the industrial application viewpoint. Here, we investigated the possibilities of diminishing the catalyst levels in metallic coper‐mediated RDRP (Cu(0)‐RDRP) and atom transfer radical polymerization (ATRP) of a widely used functional monomer, glycidyl methacrylate (GMA), targeting a low MW of approximately 3000. Both Cu wire‐ and powder‐catalyzed Cu(0)‐RDRP provided well‐defined, low‐MW poly(GMA) at quantitative conversions when using an inexpensive PMDETA ligand in DMSO. However, only with Cu powder, the contamination of the final polymerization mixture with Cu species could be efficiently diminished to ≤66 ppm while maintaining the polymerization control. Additionally, the in situ block copolymerization was successfully demonstrated, furnishing a poly(GMA)‐b‐poly(MMA) mixture containing only 39 ppm of Cu in a process facilitated by the intrinsic reductive properties of the GMA's epoxide groups. Significantly, the targeted low‐MW poly(GMA) could also be synthesized by low‐catalyst‐concentration ATRP (CuBr/PMDETA system), obtaining well‐defined polymers with quantitative conversions at ca 50 ppm of Cu in the final mixture, both at r.t. and 50 °C.
From a continuous thermal profile to a stepped one: The effect of run of river hydropower plants on the river thermal regime
Authors: Bonacina Luca , Mezzanotte Valeria , Fornaroli Riccardo
Published: April 2023

Both reservoirs and run of river power plants affect the thermal regime of rivers but despite the higher number of the latter few studies have focused on their effect. In this study, we investigated the water thermal regime of Serio River (Northern Italy), a subalpine river regulated by a reservoir and characterized by a cascade system of run of river power plants. Water temperature has been monitored continuously for more than 4 years at the extremes of 4 stretches subjected to water diversion and thermal alterations have been quantified. Our results show that hydroelectric power plants act locally causing a considerable thermal alteration that increases with the distance from the diversion weir. Indeed, within the by‐passed stretch, the rate of warming doubles the natural gradient (0.47°C/km vs. 0.19°C/km annually) with peaks in summer (0.73–0.90°C/km on average). By contrast, the run of river power plants keep the water temperature almost constant in the diversion channels. Thus, a cascade system of run of river plants shifts the overall riverine thermal regime from a continuous to a “stepped” longitudinal profile. Results highlight that the thermal effects of run of rivers plants are not negligible and should be considered and monitored continuously. Since there are thousands of hydropower plants powered by flowing waters it is time to consider their thermal impacts in environmental flow policies and bioassessment programs.
IrPd Nanoalloy‐Structured Bifunctional Electrocatalyst for Efficient and pH‐Universal Water Splitting
Authors: Yang Xing , Wu Zihe , Xing Zhenyu , Yang Chengdong , Wang Weiwen , Yan Rui , Cheng Chong , Ma Tian , Zeng Zhiyuan , Li Shuang , Zhao Changsheng
Published: April 2023

The lack of high efficiency and pH‐universal bifunctional electrocatalysts for water splitting to hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) hinders the large‐scale production of green hydrogen. Here, an IrPd electrocatalyst supported on ketjenblack that exhibits outstanding bifunctional performance for both HER and OER at wide pH conditions is presented. The optimized IrPd catalyst exhibits a specific activity of 4.46 and 3.98 A mgIr−1 in the overpotential of 100 and 370 mV for HER and OER, respectively, in alkaline conditions. When applied to the anion exchange membrane electrolyzer, the Ir44Pd56/KB catalyst shows a stability of >20 h at a current of 250 mA cm−2 for water decomposition, indicating promising prospects for practical applications. Beyond offering an advanced electrocatalyst, this work also guides the rational design of desirable bifunctional electrocatalysts for HER and OER by regulating the microenvironments and electronic structures of metal catalytic sites for diverse catalysis.
Artificial Intelligence and Creativity
Authors: Earnshaw Rae , Liggett Susan
Published: April 2023

Collaboration can increase creativity when the interactions are supportive and facilitative. In the real world this could be a group discussion or a collaboration on a particular artwork or project. The computer is increasingly in the loop on these collaborations because it can bring together both local and distant collaborators. In addition, the artwork or project can be displayed on computer screens and the partners can discuss it and work together in real-time. The computer program may also be able to make suggestions to the partners about design options, just as spell-checkers can make suggestions to authors about the grammar and spelling in an article or paper they are writing. The software works in the background and can add value to the overall process of creation, whether this is for a document or an artwork. In this case, the software is working according to pre-determined rules. If the program is allowed to modify itself by taking in input from its own processes, then the rules may change as the program is running. This may be useful in some situations but not in others. The increasing use of artificial intelligence techniques in science, technology, and the arts is reviewed and assessed, and the implications for creativity are presented.
Identification of levoglucosan degradation pathways in bacteria and sequence similarity network analysis
Authors: Kaur Arashdeep , Scott Nichollas E. , Herisse Marion , Goddard-Borger Ethan D. , Pidot Sacha , Williams Spencer J.
Published: April 2023

Levoglucosan is produced in the pyrolysis of cellulose and starch, including from bushfires or the burning of biofuels, and is deposited from the atmosphere across the surface of the earth. We describe two levoglucosan degrading Paenarthrobacter spp. (Paenarthrobacter nitrojuajacolis LG01 and Paenarthrobacter histidinolovorans LG02) that were isolated from soil by metabolic enrichment using levoglucosan as the sole carbon source. Genome sequencing and proteomics analysis revealed the expression of a series of genes encoding known levoglucosan degrading enzymes, levoglucosan dehydrogenase (LGDH, LgdA), 3-keto-levoglucosan β -eliminase (LgdB1) and glucose 3-dehydrogenase (LgdC), along with an ABC transporter cassette and an associated solute binding protein. However, no homologues of 3-ketoglucose dehydratase (LgdB2) were evident, while the expressed genes contained a range of putative sugar phosphate isomerases/xylose isomerases with weak similarity to LgdB2. Sequence similarity network analysis of genome neighbours of LgdA revealed that homologues of LgdB1 and LgdC are generally conserved in a range of bacteria in the phyla Firmicutes, Actinobacteria and Proteobacteria. One group of sugar phosphate isomerase/xylose isomerase homologues (named LgdB3) was identified with limited distribution that is mutually exclusive with LgdB2, and we propose that they may fulfil a similar function. LgdB1, LgdB2 and LgdB3 adopt similar predicted 3D folds, suggesting overlapping function in processing intermediates in LG metabolism. Our findings highlight diversity within the LGDH pathway, through which bacteria utilize levoglucosan as a nutrient source.
Response and resistance to cladribine in patients with advanced systemic mastocytosis: a registry-based analysis
Authors: Lübke Johannes , Naumann Nicole , Metzgeroth Georgia , Kreil Sebastian , Brand Timo , Horny Hans-Peter , Sotlar Karl , Cross Nicholas C. P. , Fabarius Alice , Valent Peter , Hofmann Wolf-Karsten , Reiter Andreas , Schwaab Juliana
Published: April 2023

We sought to evaluate the efficacy of the purine analogue cladribine in 79 patients with advanced systemic mastocytosis (AdvSM) using data from the ‘German Registry on Disorders of Eosinophils and Mast Cells (GREM)’. The overall response rate according to modified Valent criteria (46 evaluable patients) for first- (1L) and second-line (2L) cladribine treatment was 41% (12/29) and 35% (6/17, P = 0.690), respectively, and the median overall survival (OS, all patients evaluable) was 1.9 years (n = 48) and 1.2 years (n = 31; P = 0.311). Univariate and multivariable analyses of baseline and on-treatment parameters identified diagnosis of mast cell leukemia (hazard ratio [HR] 3.5, 95% confidence interval [CI, 1.3–9.1], P = 0.012), eosinophilia ≥ 1.5 × 109/L (HR 2.9 [CI 1.4–6.2], P = 0.006) and < 3 cycles of cladribine (HR 0.4 [CI 0.2–0.8], P = 0.008) as independent adverse prognostic parameters for OS. There was no impact of other laboratory (anemia, thrombocytopenia, serum tryptase) or genetic markers (mutations in SRSF2, ASXL1 or RUNX1) on OS. In consequence, none of the recently established prognostic scoring systems (MARS, IPSM, MAPS or GPSM) was predictive for OS. Modified Valent criteria were superior to a single factor-based response assessment (HR 2.9 [CI 1.3–6.6], P = 0.026). In conclusion, cladribine is effective in 1L and 2L treatment of AdvSM. Mast cell leukemia, eosinophilia, application of < 3 cycles and a lack of response are adverse prognostic markers.
German specialists treating testicular cancer follow different guidelines with resulting inconsistency in assessment of retroperitoneal lymph-node metastasis: clinical implications and possible corrective measures
Authors: Schoch Justine , Haunschild Kathrin , Strauch Angelina , Nestler Kai , Schmelz Hans , Paffenholz Pia , Pfister David , Persigehl Thorsten , Heidenreich Axel , Nestler Tim
Published: April 2023

Background

Testicular germ cell tumors (GCTs) are aggressive but highly curable tumors. To avoid over/undertreatment, reliable clinical staging of retroperitoneal lymph-node metastasis is necessary. Current clinical guidelines, in their different versions, lack specific recommendations on how to measure lymph-node metastasis.

Objective

We aimed to assess the practice patterns of German institutions frequently treating testicular cancer for measuring retroperitoneal lymph-node size.

Methods

An 8‐item survey was distributed among German university hospitals and members of the German Testicular Cancer Study Group.

Results

In the group of urologists, 54.7% assessed retroperitoneal lymph nodes depending on their short-axis diameter (SAD) (33.3% in any plane, 21.4% in the axial plane), while 45.3% used long-axis diameter (LAD) for the assessment (42.9% in any plane, 2.4% in the axial plane). Moreover, the oncologists mainly assessed lymph-node size based on the SAD (71.4%). Specifically, 42.9% of oncologists assessed the SAD in any plane, while 28.5% measured this dimension in the axial plane. Only 28.6% of oncologists considered the LAD (14.3% in any plane, 14.3% in the axial plane). None of the oncologists and 11.9% of the urologists (n = 5) always performed an MRI for the initial assessment, while for follow-up imaging, the use increased to 36.5% of oncologists and 31% of urologists. Furthermore, only 17% of the urologists, and no oncologists, calculated lymph-node volume in their assessment (p = 0.224).

Conclusion

Clear and consistent measurement instructions are urgently needed to be present in all guidelines across different specialistic fields involved in testicular cancer management.
C-terminal frameshift variant of TDP-43 with pronounced aggregation-propensity causes rimmed vacuole myopathy but not ALS/FTD
Authors: Ervilha Pereira Pedro , Schuermans Nika , Meylemans Antoon , LeBlanc Pontus , Versluys Lauren , Copley Katie E. , Rubien Jack D. , Altheimer Christopher , Peetermans Myra , Debackere Elke , Vanakker Olivier , Janssens Sandra , Baets Jonathan , Verhoeven Kristof , Lammens Martin , Symoens Sofie , De Paepe Boel , Barmada Sami J. , Shorter James , De Bleecker Jan L. , Bogaert Elke , Dermaut Bart
Published: April 2023

Neuronal TDP-43-positive inclusions are neuropathological hallmark lesions in frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). Pathogenic missense variants in TARDBP, the gene encoding TDP-43, can cause ALS and cluster in the C-terminal prion-like domain (PrLD), where they modulate the liquid condensation and aggregation properties of the protein. TDP-43-positive inclusions are also found in rimmed vacuole myopathies, including sporadic inclusion body myositis, but myopathy-causing TDP-43 variants have not been reported. Using genome-wide linkage analysis and whole exome sequencing in an extended five-generation family with an autosomal dominant rimmed vacuole myopathy, we identified a conclusively linked frameshift mutation in TDP-43 producing a C-terminally altered PrLD (TDP-43p.Trp385IlefsTer10) (maximum multipoint LOD-score 3.61). Patient-derived muscle biopsies showed TDP-43-positive sarcoplasmic inclusions, accumulation of autophagosomes and transcriptomes with abnormally spliced sarcomeric genes (including TTN and NEB) and increased expression of muscle regeneration genes. In vitro phase separation assays demonstrated that TDP-43Trp385IlefsTer10 does not form liquid-like condensates and readily forms solid-like fibrils indicating increased aggregation propensity compared to wild-type TDP-43. In Drosophila TDP-43p.Trp385IlefsTer10 behaved as a partial loss-of-function allele as it was able to rescue the TBPH (fly ortholog of TARDBP) neurodevelopmental lethal null phenotype while showing strongly reduced toxic gain-of-function properties upon overexpression. Accordingly, TDP-43p.Trp385IlefsTer10 showed reduced toxicity in a primary rat neuron disease model. Together, these genetic, pathological, in vitro and in vivo results demonstrate that TDP-43p.Trp385IlefsTer10 is an aggregation-prone partial loss-of-function variant that causes autosomal dominant vacuolar myopathy but not ALS/FTD. Our study genetically links TDP-43 proteinopathy to myodegeneration, and reveals a tissue-specific role of the PrLD in directing pathology.
Quality-of-life outcomes with endoscopic and microscopic type I tympanoplasty—a prospective cohort study
Authors: Pap István , Kovács Márton , Bölcsföldi Barbara , Szakács Zsolt , Gerlinger Imre , Imreh Bence , Csongor Alexandra , Warta Vilmos , Szanyi István
Published: April 2023

Purpose

Endoscopic type I tympanoplasty was originally introduced in the 1990s and the extensive spread of this practice can be easily observed. The conventional technique performed involves the repair of a tympanic membrane perforation and is defined as microscopic type I tympanoplasty. The aim of this study is the comparison of quality-of-life (QoL) outcomes with endoscopic to that with microscopic type I tympanoplasty.

Methods

All patients, or in the case of children with the aid of a parent, were asked to complete a novel QoL questionnaire drafted by our study group. The analysis was performed with descriptive statistics—mean, SD and relative frequency—and with a mixed model (generalized least squares fit). A two-sided p value of < 0.05 was regarded as statistically significant.

Results

A total of 83 patients completed the questionnaire, 38 in the endoscopic group and 45 in the microscopic group. Every question represented a different. A statistically significant result was found in favor of the endoscopic approach regarding average hospitalization rate (p = 0.003) and cosmetic outcomes (p = 0.015). No statistically significant difference was otherwise observed between the groups.

Conclusions

Based on our prospective cohort study, the QoL outcomes of endoscopic type I tympanoplasty in terms of postoperative pain, headache, nausea, vomiting, dizziness, taste disorder and hearing were comparable to the microscopic type I tympanoplasty. In regard to cosmetics, an increase in desirable results was achieved in the endoscopic group, particularly the average hospitalization rate proved to be statistically significantly lower than in the microscopic group.