bluuebunny/crossref_metadata_2025 huggingface dataset:
Tin‐Lead Perovskite Solar Cells with Preferred Crystal Orientation by Buried Interface Approach
Authors: Xiong Jiaxing , Wang Qiuxiang , Xing Yanjun , Gan Xinlei , Zhu Wendong , Xuan Rong , Huang Like , Liu Xiaohui , Zhu Yuejin , Zhang Jing
Published: September 2024

Mixed tin‐lead perovskite solar cells (PSCs) have garnered much attention for their ideal bandgap and high environmental research value. However, poly (3,4‐ethylenedioxythiophene): poly (styrene sulfonate) (PEDOT: PSS), widely used as a hole transport layer (HTL) for Sn‐Pb PSCs, results in unsatisfactory power conversion efficiency (PCE) and long‐term stability of PSCs due to its acidity and moisture absorption. A synergistic strategy by incorporating histidine (HIS) into the PEDOT: PSS HTL is applied to simultaneously regulate the nucleation and crystallization of perovskite (PVK). HIS neutralizes the acidity of PEDOT: PSS and enhances conductivity. Especially, the coordination of the C═N and ‐COO− functional groups in the HIS molecule with Sn2+ and Pb2+ induces vertical growth of PVK film, resulting in the release of residual surface stress. Additionally, this strategy also optimizes the energy level alignment between the perovskite layer and the HTL, which improves charge extraction and transport. With these cooperative effects, the PCE of Sn‐Pb PSCs reaches 21.46% (1 sun, AM1.5), maintaining excellent stability under a nitrogen atmosphere. Hence, the buried interface approach exhibits the potential for achieving high‐performance and stable Sn‐Pb PSCs.
Bimetallic Sulfur‐Doped Nickel–Cobalt Selenides as Efficient Bifunctional Electrocatalysts for the Complete Decomposition of Water
Authors: Luo ZhongKe , Yi Hao , Yang ZiHan , Wang Chao
Published: September 2024

The creation and enhancement of non‐precious metal bifunctional catalysts with superior stability and stabilizing activity is necessary to achieve water splitting in alkaline media. The paper presents a method for preparing nickel–cobalt bimetallic selenides (NiCo‐Sex/CF) using a combination of hydrothermal and high‐temperature selenization techniques. NiCo‐Sex/CF shows great potential as a catalyst for water separation. The catalyst's electronic structure and active centre can be modified by double doping with sulfur and selenium, resulting in increased selectivity and activity under varying reaction conditions. This method also offers the benefits of a simple preparation process and applicability to a wide range of catalytic reactions. Experimental results demonstrate that an overpotential of 194 mV produces a current density of 10 mA cm−2 when using this electrocatalyst as an OER catalyst. When used as a HER catalyst, the electrocatalyst required an overpotential of only 76 mV to generate a current density of 10 mA cm−2.Furthermore, a voltage of 1.5 V can drive the overall decomposition of water to achieve a current density of 10 mA cm−2. This study highlights the potential of sulfur‐selenide double‐doped catalysts for both scientific research and practical applications.
Cathodoluminescent and Characteristic X‐Ray‐Emissive Rare‐Earth‐Doped Core/Shell Protein Labels for Spectromicroscopic Analysis of Cell Surface Receptors
Authors: Habermann Sebastian , Gerken Lukas R. H. , Kociak Mathieu , Monachon Christian , Kissling Vera M. , Gogos Alexander , Herrmann Inge K.
Published: September 2024

Understanding the localization and the interactions of biomolecules at the nanoscale and in the cellular context remains challenging. Electron microscopy (EM), unlike light‐based microscopy, gives access to the cellular ultrastructure yet results in grey‐scale images and averts unambiguous (co‐)localization of biomolecules. Multimodal nanoparticle‐based protein labels for correlative cathodoluminescence electron microscopy (CCLEM) and energy‐dispersive X‐ray spectromicroscopy (EDX‐SM) are presented. The single‐particle STEM‐cathodoluminescence (CL) and characteristic X‐ray emissivity of sub‐20 nm lanthanide‐doped nanoparticles are exploited as unique spectral fingerprints for precise label localization and identification. To maximize the nanoparticle brightness, lanthanides are incorporated in a low‐phonon host lattice and separated from the environment using a passivating shell. The core/shell nanoparticles are then functionalized with either folic (terbium‐doped) or caffeic acid (europium‐doped). Their potential for (protein‐)labeling is successfully demonstrated using HeLa cells expressing different surface receptors that bind to folic or caffeic acid, respectively. Both particle populations show single‐particle CL emission along with a distinctive energy‐dispersive X‐ray signal, with the latter enabling color‐based localization of receptors within swift imaging times well below 2 min per 2 while offering high resolution with a pixel size of 2.78 nm. Taken together, these results open a route to multi‐color labeling based on electron spectromicroscopy.
Periodic Flows in Microfluidics
Authors: Mudugamuwa Amith , Roshan Uditha , Hettiarachchi Samith , Cha Haotian , Musharaf Hafiz , Kang Xiaoyue , Trinh Quang Thang , Xia Huan Ming , Nguyen Nam‐Trung , Zhang Jun
Published: September 2024

Microfluidics, the science and technology of manipulating fluids in microscale channels, offers numerous advantages, such as low energy consumption, compact device size, precise control, fast reaction, and enhanced portability. These benefits have led to applications in biomedical assays, disease diagnostics, drug discovery, neuroscience, and so on. Fluid flow within microfluidic channels is typically in the laminar flow region, which is characterized by low Reynolds numbers but brings the challenge of efficient mixing of fluids. Periodic flows are time‐dependent fluid flows, featuring repetitive patterns that can significantly improve fluid mixing and extend the effective length of microchannels for submicron and nanoparticle manipulation. Besides, periodic flow is crucial in organ‐on‐a‐chip (OoC) for accurately modeling physiological processes, advancing disease understanding, drug development, and personalized medicine. Various techniques for generating periodic flows have been reported, including syringe pumps, peristalsis, and actuation based on electric, magnetic, acoustic, mechanical, pneumatic, and fluidic forces, yet comprehensive reviews on this topic remain limited. This paper aims to provide a comprehensive review of periodic flows in microfluidics, from fundamental mechanisms to generation techniques and applications. The challenges and future perspectives are also discussed to exploit the potential of periodic flows in microfluidics.
Dual‐Mode MXene‐Based Phase‐Change Composite Towards Enhanced Photothermal Utilization and Excellent Infrared Stealth
Authors: Zhu Xinbei , Liu Jingkai , Zhang Liyue , Zhao Weiwei , Cao Yiyu , Liu Xiaoqing
Published: September 2024

Solar thermal collectors based on phase change materials (PCMs) are important to promote the civilian use of sustainable energy. However, simultaneously achieving high photothermal efficiency and rapid heat transfer of the PCM carrier typically involves a high proportion of functional materials, contradicting a satisfying energy storage density. In this work, a surface‐engineered anisotropic MXene‐based aerogel (LMXA) integrated with myristic acid (MA) to produce phase change composites (LMXA‐MA) is reported, in which the laser‐treated surface composed of the hierarchically‐structured TiO2/carbon composites act as a light absorber to improve solar absorption (96.0%), while the vertical through‐hole structure allows for fast thermal energy transportation from surface to the whole. As a result, LMXA‐MA exhibits outstanding thermal energy storage (192.4 J·g−1) and high photothermal conversion efficiency (93.5%). Meanwhile, benefiting from the intrinsic low emissivity of MXene material, thermal radiation loss can be effectively suppressed by simply flipping LMXA‐MA, enabling a long‐term temperature control ability (605 s·g−1). The excellent heat storage property and switchable dual‐mode also endow it with an infrared stealth function, which maintains camouflage for more than 240 s. This work provides a prospective solution for optimizing photothermal conversion efficiency and long‐term thermal energy preservation from surface engineering and structural design.
A New Approach to Single‐Step Fabrication of TiOx‐CeOx Nanoparticles
Authors: Elis Marie , Tjardts Tim , Shondo Josiah Ngenev , Aliyeva Ainura , Vahl Alexander , Schürmann Ulrich , Strunskus Thomas , Faupel Franz , Aktas Cenk , Kienle Lorenz , Veziroglu Salih
Published: September 2024

Mixed metal oxide (MMO) nanoparticles (NPs) are hybrids consisting of two or more nanoscale metal oxides. Advantages of MMO NPs over single metal oxides include improved catalytic activity, enhanced electrical and magnetic properties, and increased thermal stability due to the synergy of the different oxide components. This study presents a novel fabrication route for TiO2‐CeO2 NPs enriched with oxygen vacancies using a Haberland‐type gas aggregation cluster source. The NPs, deposited from different segmented Ti/Ce targets under varying O2 addition, were examined with respect to final composition, morphology, and Ti, Ce surface oxidation states. Particle formation mechanisms are proposed for the observed morphologies. Additionally, available O2 during deposition and its impact on the formation of defective sites were investigated. Defective sites in TiO2‐CeO2 NPs were analyzed using transfer to X‐ray photoelectron spectroscopy and transmission electron microscopy without contact to ambient oxygen. The incorporation of Ce to the target exhibits synergistic effects on the synthesis process. Segmented Ti/Ce targets enable the deposition of a broad range of mixed oxide NPs with diverse compositions and morphologies at considerably enhanced deposition rates, which is vital for practical applications. The presented fabrication approach is expected to be applicable for a broad variety of MMO NPs.
AI‐Equipped Scanning Probe Microscopy for Autonomous Site‐Specific Atomic‐Level Characterization at Room Temperature
Authors: Diao Zhuo , Ueda Keiichi , Hou Linfeng , Li Fengxuan , Yamashita Hayato , Abe Masayuki
Published: September 2024

An advanced scanning probe microscopy system enhanced with artificial intelligence (AI‐SPM) designed for self‐driving atomic‐scale measurements is presented. This system expertly identifies and manipulates atomic positions with high precision, autonomously performing tasks such as spectroscopic data acquisition and atomic adjustment. An outstanding feature of AI‐SPM is its ability to detect and adapt to surface defects, targeting or avoiding them as necessary. It is also designed to overcome typical challenges such as positional drift and tip apex atomic variations due to the thermal effects, ensuring accurate, site‐specific surface analysis. The tests under the demanding conditions of room temperature have demonstrated the robustness of the system, successfully navigating thermal drift and tip fluctuations. During these tests on the Si(111)‐(7 × 7) surface, AI‐SPM autonomously identified defect‐free regions and performed a large number of current–voltage spectroscopy measurements at different adatom sites, while autonomously compensating for thermal drift and monitoring probe health. These experiments produce extensive data sets that are critical for reliable materials characterization and demonstrate the potential of AI‐SPM to significantly improve data acquisition. The integration of AI into SPM technologies represents a step toward more effective, precise and reliable atomic‐level surface analysis, revolutionizing materials characterization methods.
The Hydration Activity Enhancement Method of Mayenite in Ladle Slag: A Review
Authors: Duan Yiming , Chao Shuai , Zhang Xi , Li Junguo , Zhang Yaling , Gu Chunhui , He Jiale
Published: September 2024

As a byproduct of the steelmaking process, ladle slag has the potential to be used as an auxiliary cement material in the construction field. However, ladle slag generated after secondary refining is typically handled by air cooling and stacking, leading to the presence of the typical mineral phase mayenite (Ca12Al14O33, abbreviated as C12A7) in a crystalline form within the slag. This reduces its early hydration activity, which adversely affects the compressive strength of concrete and consequently lowers the resource utilization rate of ladle slag. Based on this, this article provides a comprehensive review of the generation process and composition of ladle slag. By discussing the hydration process and hydration products of the typical mineral phase C12A7 in ladle slag, as well as the mutual transformation of hydration products, it is shown that hydration products undergo transformation with increasing temperature. Compared to crystalline C12A7, amorphous, C12A7 exhibits excellent hydration activity. Building upon this, methods for amorphizing C12A7 are elucidated, wherein thermal activation or chemical activation is employed to alter the ordered arrangement of atoms within the crystal structure, thereby reducing the stability of the crystal structure to achieve amorphization of C12A7.
Study of the Effect of Initial Plate Temperature in Jet Impingement Cooling Process
Authors: Gadala Mohamed S. , Gomaa Abdulrahman , Aslam Fahad
Published: September 2024

The microstructure characteristics and the properties of rolled steels are significantly affected by the heat transfer and boiling phenomena occurring during the jet impingement cooling on run‐out tables (ROT). In this study, experiments are conducted using a full industrial‐scale ROT facility with rectangular plates made of low‐carbon stainless steel (type 316L). The plate is heated up to a temperature ranging from to , then rapidly impinged using a single circular water jet, and the temperature drop is captured using an infrared thermal camera (FLIR A615 25°–50 Hz type). The dissipated heat flux, estimated experimentally using a 2D inverse heat conduction analysis, ranges from 6.1 to 3.4 MW m−2 across different zones along the plate surface. The impact of different initial plate temperature on the boiling behavior is studied by developing a 2D‐computational fluid dynamics (CFD) model, and the results are closely aligned with the experimental findings. The results reveal that when estimating the heat flux from CFD simulations, the best accuracy is obtained when considering fluid temperature at a point close to the plate surface (about 1 μm above the surface). Furthermore, the maximum extracted heat flux (MHF) is significantly influenced by the initial temperature of the plate. Increasing the initial plate temperature from 500 to 900 °C led to an increase of 82% in the MHF in stagnation zone, and 137% increase in the parallel‐flow region. The CFD model presented in this study and the full calculation of the boiling curves numerically will pave the road for investigating various practical parameters in jet impingement cooling.
A robust antagonistically assembled triboelectric nanogenerator based on dead‐end closed pore through a one‐step improved phase separation
Authors: Chau Ngoc Mai , Hoang Gia Huy Nguyen , Huynh Dai Phu , Cao Xuan Viet , La Thi Thai Ha , Bui Van‐Tien
Published: September 2024

The ongoing global energy crisis presents a significant challenge all over the world. In this study, triboelectric nanogenerator (TENG) made of recyclable thermoplastic polycarbonate has been proposed as a promising environmentally friendly solution due to its potential capability to convert low‐frequency mechanical energy sources such as human motion and ocean waves into electricity with potential applications including powering wearable electronic devices and self‐powered sensors. We introduce an antagonistically structured TENG (A‐TENG) composed of honeycomb porous polycarbonate (hc‐PC) and convex‐patterned dimethylsiloxane, employing a novel one‐stage improved phase separation method. This A‐TENG overcomes the demerits of others thanks to its high surface contact area, simplified fabrication process, enhanced energy conversion efficiency, and cost‐effectiveness, requiring minimal investment. More importantly, this work utilized hc‐PC as a framework for slippery liquid‐infused porous surface (SLIPS) based TENG owing to the special honeycomb porous structure to impregnate silicon oil within pore arrays and mechanically support the whole system. The practical application of SLIPS‐TENG was demonstrated while deployed on the house rooftop to harvest raindrop energy and act as a rain detection sensor.
Bildung und Lernen als Aufbau von Wissens- und Denkstrukturen
Authors: Tanner Iris
Published: September 2024

Diese theoretische Grundlage und deren Bedeutung für den angeleiteten Wissenserwerb des Individuums wird in diesem Kapitel erläutert, indem zuerst auf Aeblis Konzept der unterstützten Wissenskonstruktion (vgl. Abschnitt 2.1.1) und auf den problemlösenden Unterricht (vgl. Abschnitt 2.1.2) eingegangen wird, bevor Vygotskys Sicht von Entwicklung (vgl. Abschnitt 2.1.3) behandelt wird.
Diskussion
Authors: Tanner Iris
Published: September 2024

Die vorliegende Untersuchung ist Teil des Forschungsprojektes „Didaktische Kommunikation und Bildungswirkungen im problemorientierten Mathematikunterricht“ (Reusser & Pauli, 2012) und untersuchte den Teildatensatz der tutoriellen Situationen bzw. der Gruppenunterrichtsgespräche im 1:4-Setting der schweizerisch-deutschen Videostudie (vgl. u. a. Klieme, Pauli & Reusser, 2006). Theoretischer Ausgangspunkt der ganzen Arbeit war die Annahme, dass nachhaltiges Lernen dann stattfindet, wenn die kognitiven Aufbauprozesse im Unterricht problemlösend erfolgen und die Lernenden substanzielle Äusserungen als Elemente von Lösungsschritten im Lehr-Lerngespräch aktiv beitragen, dass also produktive Lehr-Lerngespräche ein hohes Positioning aller Beteiligten brauchen. Es interessierte in der Arbeit folglich, ob sich die 38 Gruppengespräche der 1:4-Settings des Datensatzes in Bezug auf den Problemlöseprozess und die Interaktionskonstellation zwischen den Gruppen unterscheiden. Die Ergebnisse werden hier zusammengefasst und kritisch diskutiert (vgl. Kapitel 8.1). Danach folgt die Diskussion des methodischen Vorgehens (vgl. Kapitel 8.2), bevor Schlussfolgerungen für die pädagogische Praxis gezogen werden (vgl. Kapitel 8.3).
Electric dipole moments in 5+3 flavor weak effective theory
Authors: Kumar Jacky , Mereghetti Emanuele
Published: September 2024

Abstract

A fully generic treatment of electric dipole moments (EDMs) is presented in the CP-violating and flavor-conserving weak effective field theory (WET) with five flavors of quarks and three flavors of leptons. We systematically analyze leading contributions to EDMs originating from QCD and QED renormalization group running between the electroweak scale and low energy scales of about 2 GeV. We include the full one-loop anomalous dimension and a subset of two-loop corrections, as well as threshold corrections at the bottom, charm and τ masses. This allows us to derive master formulae in the space of generic WET for the neutron and proton EDMs, for EDMs of diamagnetic atoms, and for the precession frequencies constrained in molecular EDM experiments, from which bounds on the electron EDM are extracted. In particular, our master formulae capture the contributions of WET CP-violating operators with heavy quark and lepton flavors. As an application, we study EDM constraints on the Yukawa couplings of the Higgs boson, in both the linear and non-linear realizations of electroweak symmetry breaking.
Kac–Ward Solution of the 2D Classical and 1D Quantum Ising Models
Authors: Athanasopoulos Georgios , Ueltschi Daniel
Published: September 2024

We give a rigorous derivation of the free energy of (i) the classical Ising model on the triangular lattice with translation-invariant coupling constants and (ii) the one-dimensional quantum Ising model. We use the method of Kac and Ward. The novel aspect is that the coupling constants may have negative signs. We describe the logarithmic singularity of the specific heat of the classical model and the validity of the Cimasoni–Duminil-Copin–Li formula for the critical temperature. We also discuss the quantum phase transition of the quantum model.
Theoretische Grundlagen der klinischen Ethikberatung in der Psychiatrie
Authors: Gather Jakov , Scholten Matthé
Published: September 2024

Hintergrund

Im Rahmen klinischer Ethikberatung unterstützen Ethikberater*innen im Gesundheitswesen Professionelle in der Psychiatrie dabei, moralische Probleme zu identifizieren und zu analysieren.

Ziel der Arbeit

Darstellung von zentralen ethischen Grundbegriffen und Begründungsansätzen, die für die klinische Ethikberatung in der Psychiatrie von Relevanz sind.

Material und Methoden

Konzeptionelle und ethische Analyse.

Ergebnisse

Nach einer Unterscheidung von Moral, Ethik und Recht werden moralische von anderen Problemen abgegrenzt. Im Anschluss werden ethische Grundbegriffe geklärt und das Konzept des moralischen Stresses vorgestellt. Im Hinblick auf ethische Begründungsansätze werden philosophische ethische Theorien von medizinethischen Theorien, wie der Prinzipienethik und der Care-Ethik, abgegrenzt. Abschließend werden Rechtfertigungstests auf Grundlage des Schadensprinzips und des schwachen Paternalismus zur ethischen Entscheidungsfindung in Situationen von Eigen- oder Fremdgefährdung erläutert.

Diskussion

Die Kenntnis ethischer Grundbegriffe und Begründungsansätze ist wichtig für die Identifikation und Analyse moralischer Probleme in der Psychiatrie und sollte in der Ausbildung von Ethikberater*innen im Gesundheitswesen stärker vermittelt werden.
Forensische Radiologie
Authors: Grabherr Silke , Grimm Jochen
Published: September 2024

Hintergrund

In der Rechtsmedizin ist die Dokumentation von Befunden essenziell. Während einer Obduktion erfolgt dies zumeist durch die Fotografie. Jedoch gibt es zahlreiche Verletzungen, die auch bei einer klassischen Obduktion unentdeckt bleiben. In den letzten Jahren wuchs in zahlreichen Ländern zur Verbesserung der Befunddokumentation und zur Steigerung der Qualität der postmortalen Untersuchung der Stellenwert der forensischen Radiologie.

Methoden

Während viele Methoden, wie die konventionelle Röntgenbildgebung oder die Computertomographie (CT) relativ einfach in den postmortalen Bereich übernommen werden können, gibt es andere Methoden, die sich schwieriger anpassen lassen. So benötigt z. B. die Durchführung einer postmortalen Angiographie ein spezifisches Konzept, welches das Auffüllen des Blutgefäßsystems und das Zirkulieren eines Kontrastmittels erlaubt. Auch die Durchführung einer postmortalen Magnetresonanztomographie (MRT) ist eine Herausforderung, da der Bildkontrast stark von der Temperatur des zu untersuchenden Körpers abhängt. Beim Einsatz an lebenden Personen, im Bereich der „klinischen Rechtsmedizin“, gibt es weitere Elemente zu beachten. So stellt sich insbesondere die Frage, welche radiologischen Methoden ohne klinische Indikation für rein rechtsmedizinische Fragestellungen zulässig sind.

Schlussfolgerung

Dieser Übersichtsartikel soll die verschiedenen Methoden der forensischen Radiologie, ihre Einsatzbereiche sowie ihre Vor- und Nachteile erläutern. Außerdem werden wichtige historische Entwicklungen zum Einsatz der forensischen Radiologie und zu ihrer aktuellen Verbreitung im deutschsprachigen Raum sowie zu aktuellen und zukünftigen Entwicklungen beschrieben. Dank dieser Informationen und einer zusammenfassenden Übersichtstabelle können klare Hinweise und Empfehlungen zum Einsatz der forensischen Radiologie in der Praxis erhalten werden.
Removing cloud shadows from ground-based solar imagery
Authors: Chaoui Amal , Morgan Jay Paul , Paiement Adeline , Aboudarham Jean
Published: September 2024

The study and prediction of space weather entails the analysis of solar images showing structures of the Sun’s atmosphere. When imaged from the Earth’s ground, images may be polluted by terrestrial clouds which hinder the detection of solar structures. We propose a new method to remove cloud shadows, based on a U-Net architecture, and compare classical supervision with conditional GAN. We evaluate our method on two different imaging modalities, using both real images and a new dataset of synthetic clouds. Quantitative assessments are obtained through image quality indices (RMSE, PSNR, SSIM, and FID). We demonstrate improved results with regards to the traditional cloud removal technique and a sparse coding baseline, on different cloud types and textures.
Secretome and immune cell attraction analysis of head and neck cancers
Authors: Muijlwijk Tara , Wondergem Niels E. , Ekhlas Fatima , Remkes Naomi , Nijenhuis Dennis N. L. M. , Fritz Lennart , Ganzevles Sonja H. , Miedema Iris H. C. , Leemans C. René , Poell Jos B. , Brakenhoff Ruud H. , van de Ven Rieneke
Published: September 2024

Immune checkpoint inhibitors are approved for recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) but the response rate is only 13–18%. For an effective antitumor immune response, trafficking of immune cells to the tumor microenvironment (TME) is essential. We aimed to better understand immune cell migration as well as the involved chemokines in HNSCC. A transwell assay was used to study immune cell migration toward TME-conditioned medium. While T cell migration was not observed, conventional dendritic cell (cDC) migration was induced by TME-conditioned media. cDC migration correlated with various proteins in the TME secretome. CCL8, CXCL5, CCL13 and CCL7 were tested in validation experiments and addition of these chemokines induced cDC migration. Using single cell RNA-sequencing, we observed expression of CCL8, CXCL5, CCL13 and CCL7 in cancer-associated fibroblasts (CAFs). Depleting fibroblasts led to reduced cDC migration. Thus CAFs, while often seen as suppressors of antitumor immunity, play a role in attracting cDCs toward the head and neck cancer TME, which might be crucial for effective antitumor immunity and response to therapies. Indeed, we found RNA expression signatures of the indicated chemokines, cDC and CAF subpopulations, to be significantly higher in baseline tumor specimen of patients with a major pathological response to pre-surgical anti-PD-1 treatment compared to non-responding patients.
Adjuvant chemoradiotherapy plus pembrolizumab for locally advanced esophageal squamous cell carcinoma with high risk of recurrence following neoadjuvant chemoradiotherapy: a single-arm phase II study
Authors: Guo Jhe-Cyuan , Huang Ta-Chen , Kuo Hung-Yang , Lin Chia-Chi , Hsu Feng-Ming , Cheng Jason Chia-Hsien , Huang Yen-Lin , Hsieh Min-Shu , Huang Pei-Ming , Lee Jang-Ming , Wu Shu-Ling , Hsu Chih-Hung
Published: September 2024

Background

Adjuvant nivolumab reduces recurrence in patients with locoregional esophageal cancer who had pathological residual disease after neoadjuvant chemoradiotherapy and R0 resection. However, the efficacy of adjuvant anti-PD-1 therapy in patients at higher risk of recurrence remains unclear.

Methods

This phase II trial (ClinicalTrials.gov identifier: NCT03322267) enrolled patients with locally advanced esophageal squamous cell carcinoma (ESCC) received neoadjuvant chemoradiotherapy plus esophagectomy but still had various risk factors for recurrence, such as involved or close margins (≤ 1 mm), extranodal extension of the involved lymph nodes, and the ypN2-3 stage. Patients received adjuvant therapy composed of a course of cisplatin-based chemoradiotherapy and pembrolizumab (200 mg, IV every 3 weeks) for 18 cycles. The primary endpoint was 1-year relapse-free survival (RFS) rate.

Results

Twenty-five patients were enrolled. The risk factors were tumor margins of ≤ 1 mm (18 patients), extranodal extension of the involved lymph nodes (9 patients), and the ypN2-3 stage (9 patients). The median follow-up duration was 21.6 months (95% CI: 18.7–33.2). The rate of 1-year RFS was 60.0%. The median duration of RFS and overall survival was 14.3 (95% CI: 9.0–19.5) and 21.6 (95% CI: 0.0–45.5) months, respectively. Treatment-emergent adverse events of any grade and those of ≥ 3 grade occurred in 56% and 8% of all patients receiving cisplatin-based chemoradiotherapy and in 79.2% and 12.5% of those receiving pembrolizumab.

Conclusions

Adjuvant chemoradiotherapy followed by pembrolizumab is feasible and may be associated with improved 1-year RFS rate in patients at high risk of recurrence after trimodality therapy for locally advanced ESCC.

Trial registration number ClinicalTrials.gov (No. NCT03322267).
Baseline platelet count and long-term clinical outcomes in patients with acute venous thromboembolism: a prospective cohort study
Authors: Stuby Johann , Stalder Odile , Limacher Andreas , Righini Marc , Rodondi Nicolas , Tritschler Tobias , Méan Marie , Aujesky Drahomir
Published: September 2024

An abnormal platelet count (PC) is common in acute venous thromboembolism (VTE) but its relationship with clinical outcomes remains ill-defined. We aimed to explore the association between baseline PC and the long-term risk of clinically relevant outcomes in a prospective cohort of 991 patients with acute VTE. We classified patients into four PC groups: very low (< 100 G/l), low (≥ 100 to < 150 G/l), normal (≥ 150 G/l to ≤ 450 G/l), and high (> 450 G/l). The primary outcome was major bleeding (MB), secondary outcomes were recurrent VTE and overall mortality. We examined the association between PC and clinical outcomes, adjusting for confounders, competing risk for mortality, and periods of anticoagulation. After a median follow-up of 30 months, 132 (13%) of patients experienced MB, 122 (12%) had recurrent VTE, and 206 (21%) died. Compared to patients with a normal PC, patients with a very low PC had a sub-distribution hazard ratio (SHR) for MB of 1.23 (95% confidence interval [CI] 0.52–2.91) and those with a high PC a SHR of 1.87 (95%CI 0.82–4.29). Patients with a low PC had a twofold increased VTE recurrence risk (SHR 2.05, 95%CI 1.28–3.28). Patients with low and very low PC had a hazard ratio for mortality of 1.43 (95%CI 0.99–2.08) and of 1.55 (95%CI 0.80–2.99), respectively. Our findings do not suggest a consistent relationship between baseline PC and long-term clinical outcomes in patients with VTE.
Development and validation of a realistic type III esophageal atresia simulator for the training of pediatric surgeons
Authors: Arredondo Montero Javier , Pérez Riveros Blanca Paola , Bueso Asfura Oscar Emilio , Martín-Calvo Nerea , Pueyo Francisco Javier , López de Aguileta Castaño Nicolás
Published: September 2024

Background

The technical complexity and limited casuistry of neonatal surgical pathology limit the possibilities of developing the necessary technical competencies by specialists in training. Esophageal atresia constitutes the paradigm of this problem. The use of synthetic 3D models for training is a promising line of research, although the literature is limited.

Methods

We conceptualized, designed, and produced an anatomically realistic model for the open correction of type III oesophageal atresia. We validated it with two groups of participants (experts and non-experts) through face, construct, and content-validity questionnaires.

Results

The model was validated by nine experts and nine non-experts. The mean procedure time for the experts and non-experts groups was 34.0 and 38.4 min, respectively. Two non-experts did not complete the procedure at the designed time (45 min). Regarding the face validity questionnaire, the mean rating of the model was 3.2 out of 4. Regarding the construct validity, we found statistically significant differences between groups for the equidistance between sutures, 100% correct in the expert group vs. 42.9% correct in the non-expert group (p = 0.02), and for the item “Confirms that tracheoesophageal fistula closure is watertight before continuing the procedure”, correctly assessed by 66.7% of the experts vs. by 11.1% of non-experts (p = 0.05). Concerning content validity, the mean score was 3.3 out of 4 for the experts and 3.4 out of 4 for the non-experts.

Conclusions

The present model is a cost-effective, simple-to-produce, and validated option for training open correction of type III esophageal atresia. However, future studies with larger sample sizes and blinded validators are needed before drawing definitive conclusions.
Factors affecting gasless reduced-port laparoscopic myomectomy (GRP-LM) using a subcutaneous abdominal wall lifting method: a retrospective analysis of a large cohort of 966 cases in Japan
Authors: Ito Hiroe , Sagawa Yasukazu , Nakagawa Junko , Akaeda Tomoyoshi , Tsutsumi Kiyoaki , Isaka Keiichi
Published: September 2024

Objective

To evaluate the usefulness of gasless reduced-port laparoscopic myomectomy (GRP-LM) using a subcutaneous abdominal wall lifting method.

Methods

In GRP-LM, after lifting the abdominal wall by a subcutaneous abdominal wall lifting method, a 1.5-cm incision is made in the lateral abdomen, Lap Protector® is placed. The operation is performed by two surgeons, one who inserts multiple forceps from the Lap Protector and performs the operation, and an assistant who operates the laparoscope and uterine manipulator. The surgical outcome of GRP-LM and the factors that affect it were investigated.

Results

GRP-LM was performed in 966 patients. Complications (0.5%) and blood transfusions (0.3%) were remarkably rare, and there were no cases of conversion to open surgery. With regard to the correlation between the number of fibroids extracted and each factor, the number of fibroids extracted correlated with fibroid weight and operation time, but not with blood loss. The average number of sutures per case was 21, and the average suture and ligation time per suture was 77 s. Comparing the cost of GRP-LM with that of the conventional insufflation LM, a saving of $875 was possible with GRP-LM.

Conclusion

GRP-LM is a suitable for multiple fibroids, and is cosmetic and economical, because it allows rapid and reliable suture and ligation, despite having only one port for the procedure.
The influence of antenatal betamethasone timing on neonatal outcome in late preterm infants: a single-center cohort study
Authors: Brückner Thomas , Redlich Anke
Published: September 2024

Purpose

Many pregnancies continue after antenatal corticosteroid exposure. Since long-term effects on late preterm neonatal outcome remain controversial, it remains unknown whether pregnant women who are at risk for preterm birth during the late preterm period and had prior antenatal corticosteroid exposure would benefit from an additional course of antenatal corticosteroids. We evaluated the need for future trials on this topic by comparing short term effects from antenatal betamethasone to long-term effects. We also examined the value of a risk-adapted approach.

Methods

We observed neonatal outcomes in late preterm infants (34/0–36/0 weeks of gestation) who were exposed to antenatal betamethasone either up to 10 days prior birth (n = 8) or earlier in pregnancy (n = 89). We examined a real world population from the University Hospital Magdeburg (Germany) between 01 January 2012 and 31 December 2018, and a simulated high-risk population that was derived from the original data.

Results

The indicators for relevant adverse outcomes did not differ in the unselected population. In the simulated high-risk population, recent antenatal corticosteroid administration significantly reduced the incidence of relevant cardiorespiratory morbidities (OR = 0.00, p = 0.008), and reduced the number needed to treat from 3.7 to 1.5.

Conclusion

The superiority of recent antenatal corticosteroid administration in the late preterm period over earlier exposure strongly depended on the prevalence of respiratory disease. Before considering clinical trials on additional antenatal corticosteroid courses in the late preterm period, antenatal assessment tools to predict respiratory morbidity need to be developed.
Renal vascular lesions in childhood-onset lupus nephritis
Authors: Lin Kyle Ying-kit , Chan Eugene Yu-hin , Mak Yuen-fun , To Ming-chun , Wong Sze-wa , Lai Fiona Fung-yee , Ho Tsz-wai , Tong Pak-chiu , Lai Wai-ming , Yap Desmond Yat-hin , Ma Alison Lap-tak
Published: September 2024

Background

This study aimed to determine the clinical significance of renal vascular lesions (RVLs) in childhood-onset lupus nephritis (cLN).

Methods

We retrospectively reviewed all children with biopsy-proven cLN between 2004–2020 to evaluate the prevalence of RVLs on kidney biopsy and its associated factors and long-term outcomes. The composite kidney outcome was defined as advanced chronic kidney disease (CKD) stage 3–5, kidney failure and death.

Results

107 biopsies from 84 Chinese patients were analysed. RVLs were observed in 19 patients (22.6%), including non-inflammatory necrotizing vasculopathy (NNV, n = 6), thrombotic microangiopathy (TMA, n = 4), arterial sclerosis (AS, n = 3), concurrent NNV with AS (n = 4), concurrent NNV with TMA (n = 1) and concurrent true renal vasculitis with AS (n = 1).

The presence of RVLs was associated with lower estimated glomerular filtration rate (eGFR) (66.9 ± 40.3 vs. 95.6 ± 39.4 ml/min/1.73m2, p = 0.005), haemoglobin level (9.1 ± 1.9 vs. 10.4 ± 1.9 g/dL, p = 0.008) and platelet count (150.1 ± 96.4 vs. 217.2 ± 104.8 × 109/L, p = 0.01). LN classes and activity/chronicity indices were similar.

Patients with RVLs had poorer composite kidney outcomes, though not reaching statistical significance (log-rank test, p = 0.06). The presence of NNV was associated with inferior survival free from composite kidney outcome (log-rank test, p = 0.0018), compared to other forms of RVLs and those without RVLs. Univariate analysis revealed NNV (HR 7.08, 95% CI 1.67–30.03) was predictive of composite kidney outcome.

Conclusion

RVLs are present in one-fifth of cLN patients and are associated with severe presentation. NNV is associated with worse long-term kidney outcome. Routine evaluation of RVLs is warranted and should be incorporated into future classification criteria.

Graphical Abstract

A higher resolution version of the Graphical abstract is available as Supplementary information
Regression-based normative data for Corsi Span and Supraspan learning and recall among Italian adults
Authors: Facchin Alessio , Pegoraro Sara , Rigoli Mattia , Rizzi Ezia , Strina Veronica , Barera Sara , Castiglieri Giulia , Daini Roberta , Guarnerio Chiara
Published: September 2024

Introduction

The Corsi Block Tapping Test, or Corsi Span (CS), is a widely used task to measure visuospatial short-term and working memory. The same setup can be used to administer the Corsi SupraSpan Learning (CSSL) and Recall (CSSR), tests assessing visuospatial long-term memory. While the CS has relatively recent normative data, those of the CSSL are outdated For CSSR, no normative data are available. Given this critical lack, our study aimed to provide updated norms for CS, CSSL, and specifically for the recall delayed phase (CSSR).

Materials and methods

A sample of 340 healthy participants, aged between 20 and 89, took part in the study. Norms were developed using a regression approach and defined using rank equivalent scores and percentiles.

Results

Age and education influenced Corsi’s Span, while SupraSpan Learning and Recall were influenced by age, education, and span. The comparison with previous norms for Span and SupraSpan Learning shows a high level of agreement.

Conclusions

This study provides integrated norms to evaluate visuospatial memory in all aspects of immediate recall, long-term learning and delayed recall. Its use is needed to assess specific neuropsychological deficits, dissociate visuospatial versus verbal memory deficits and allow the evaluation of memory in patients with limited verbal abilities.
Advancing healthcare practice and education via data sharing: demonstrating the utility of open data by training an artificial intelligence model to assess cardiopulmonary resuscitation skills
Authors: Constable Merryn D. , Zhang Francis Xiatian , Conner Tony , Monk Daniel , Rajsic Jason , Ford Claire , Park Laura Jillian , Platt Alan , Porteous Debra , Grierson Lawrence , Shum Hubert P. H.
Published: September 2024

Health professional education stands to gain substantially from collective efforts toward building video databases of skill performances in both real and simulated settings. An accessible resource of videos that demonstrate an array of performances – both good and bad—provides an opportunity for interdisciplinary research collaborations that can advance our understanding of movement that reflects technical expertise, support educational tool development, and facilitate assessment practices. In this paper we raise important ethical and legal considerations when building and sharing health professions education data. Collective data sharing may produce new knowledge and tools to support healthcare professional education. We demonstrate the utility of a data-sharing culture by providing and leveraging a database of cardio-pulmonary resuscitation (CPR) performances that vary in quality. The CPR skills performance database (collected for the purpose of this research, hosted at UK Data Service’s ReShare Repository) contains videos from 40 participants recorded from 6 different angles, allowing for 3D reconstruction for movement analysis. The video footage is accompanied by quality ratings from 2 experts, participants’ self-reported confidence and frequency of performing CPR, and the demographics of the participants. From this data, we present an Automatic Clinical Assessment tool for Basic Life Support that uses pose estimation to determine the spatial location of the participant’s movements during CPR and a deep learning network that assesses the performance quality.
Disclosure and Experiences of HIV-Related Stigma among Adolescents and Young Adults Living with HIV in South Africa
Authors: Nice Johanna , Thurman Tonya R. , Luckett Brian , Zani Babalwa
Published: September 2024

Social networks expand rapidly in adolescence, increasing HIV status disclosure considerations and concerns for young people living with HIV, especially in settings where HIV-related stigma is prevalent. This study examines HIV disclosure and enacted stigma among adolescents and young adults living with HIV in South Africa. This study uses survey data from a sample of 1186 youth living with HIV, aged 14–24, and enrolled in peer support groups led by community-based organizations in KwaZulu Natal and Gauteng provinces, South Africa. Study participants completed a questionnaire on sociodemographic details, physical health, school attendance, who knew the individual’s HIV status, and experiences of HIV-related mistreatment. Mixed effects logistic regression examined the association between experiences of HIV-related mistreatment and factors that may inadvertently disclose one’s status, such as poor physical health and missed school, and knowledge of an individual’s HIV-positive status by their caregiver, household, friends, educators, and most recent sexual partner. Almost a quarter of the sample reported an experience of HIV-related mistreatment in the past six months. After controlling sociodemographic characteristics, missed school due to illness (AOR = 1.75, 95% CI = 1.27–2.43), and knowledge of HIV status by non-family members (AOR = 2.19, 95% CI = 1.60-3.00) were significantly associated with HIV-related mistreatment. Findings suggest that experiences of enacted stigma are common among youth and linked to poor physical health and knowledge of HIV status outside the family. Effective community-level stigma reduction interventions are urgently needed. In the meantime, adolescents need individualized disclosure counseling and support managing their physical health to prevent further inadvertent disclosure and discrimination.
Raising the bar: What determines the ambition level of corporate climate targets?
Authors: Privato Clara , Johnson Matthew P. , Busch Timo
Published: September 2024

Since the launch of the Science Based Targets initiative (SBTi), we have witnessed a steady increase in the number of companies committing to climate targets for large-scale reduction of greenhouse gas (GHG) emissions. While recent studies present various methodologies for establishing climate targets (e.g., sectoral decarbonization approach, near-term, long-term, net zero), we still don’t understand the explanatory factors determining the level of ambition companies demonstrate in target setting. In this paper, a two-stage qualitative study is conducted with a sample of 22 companies from five countries. First, these companies’ publicly disclosed climate targets are evaluated according to four target ambition criteria: target type, scope, timeframe, and temperature alignment. Secondly, multiple explanatory factors for target setting were identified during the content analysis of the interviews to see how present these factors appear in the ambition levels. Within companies with highly ambitious climate targets, the findings indicate that certain factors are highly present, including leadership engagement, continual management support, employee involvement, participation in climate initiatives, and stakeholder collaboration. Conversely, none of these key factors are highly present in companies with less ambitious climate targets. Rather, these companies strongly identify the initiating factors of market-related pressures and non-market stakeholder influence as being the driving forces behind their target setting. This paper contributes to the literature on corporate responses to climate change by expanding our understanding of explanatory factors for different corporate climate target ambition levels.
Towards malum prohibitum: crime deterrence strategies for reducing illicit antiquities trade
Authors: Koush Alesia
Published: September 2024

Fight against illegal antiquities trade has predominantly taken a reactive stance. This study operates with novel quantitative and qualitative data obtained through a survey and interviews with 42 law enforcement agents from 21 source and market countries. An empirical insight on illegal antiquities trade is provided, and a comprehensive reference framework of crime deterrence strategies is created. Incidence and efficiency rates of the identified strategies conceal that a law enforcement response at the market side, strengthened through policing, criminal prosecution, reverse of the burden of proof, market control and traceability, is deemed most effective deterrence-wise leveraging certainty of being caught, severity and celerity of punishment, the key mechanisms of Deterrence theory. By contrast, the existing international and EU legislation are considered inconsistent. The findings reveal the need for critically reviewing the current situation and defining a pathway for antiquities markets from malum non prohibitum environments to at least malum prohibitum climates: shaping proactive policy approaches through updated legislation and targeted crime deterrence and prevention activities to be applied mainly at the market side.