bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of biodegradable poly(butylene adipate‐co‐terephthalate) and poly(lactic acid) plastic degradation on soil ecosystems
Authors: Dissanayake Pavani Dulanja , Withana Piumi Amasha , Sang Mee Kyung , Cho Yoora , Park Jeyoung , Oh Dongyeop X. , Chang Scott X. , Lin Carol Sze Ki , Bank Michael S. , Hwang Sung Yeon , Ok Yong Sik
Published: April 2024

Despite that biodegradable plastics are perceived as environmentally friendly, there is a lack of comprehensive understanding of their fate in soil. Current Environmental, Social, and Governance (ESG) frameworks, along with new UNEP regulations on plastic pollution, necessitate scientific information on plastic degradation in soils for developing sustainable biodegradable plastics. In this study, we examined the degradation rates of two biodegradable plastics, poly(butylene adipate‐co‐terephthalate) (PBAT) and poly(lactic acid) (PLA), in a laboratory microcosm experiment using uncontaminated soil, with PBAT or PLA added at 8.3% (w/w). Our aim was to further understand the impact of these plastic types on soil properties and microbial communities under different incubation temperatures. Both PBAT and PLA treatments elevated cumulative CO2 efflux compared with the control soil incubated at 25 and 58°C. After 33 weeks, 9.2% and 6.1% of the added PBAT and PLA degraded, respectively, at 58°C, while only 2.3% of PBAT and 1.7% of PLA degraded at 25°C, implying slower degradation rates of PBAT and PLA under the lower temperature. Degradation at 58°C increased total soil carbon by 0.6%, 1.9%, and 4.3% for Control, PBAT, and PLA, respectively, and soil electrical conductivity by 0.17, 0.33, and 2.38 dS m−1, respectively, but decreased soil pH. Microbial diversity and richness decreased under thermophilic conditions at 58°C compared with that at 25°C. We conclude that the degradation of PBAT and PLA varies with environmental condition, and influences soil properties.
Adult-onset acute rheumatic fever with chorea and carditis
Authors: Jayasekara Hasara , Wickramarathne Janitha Sampath , Jayasinghe Peduru Arachchige
Published: April 2024

Rheumatic fever is a major cause of cardiovascular morbidity and mortality in low-income and middle-income countries, and it usually occurs at a young age. Adult-onset acute rheumatic fever is a rare condition and usually represents a recurrence of childhood-onset disease. We report a case of an elderly man presenting with rheumatic carditis and rheumatic chorea subsequently diagnosed with adult-onset rheumatic fever.
The diagnostic pathway for patients with interstitial lung disease: a mixed-methods study of patients and physicians
Authors: Grant-Orser Amanda , Pooler Charlotte , Archibald Nathan , Fell Charlene , Ferrara Giovanni , Johannson Kerri A , Kalluri Meena
Published: April 2024

Objectives

The diagnostic process for patients with interstitial lung diseases (ILD) remains complex. The aim of this study was to characterise the diagnostic care pathway and identify barriers and potential solutions to access a timely and accurate ILD diagnosis.

Design

This mixed-method study was comprised of a quantitative chart review, patient and physician surveys and focus groups.

Results

Chart review was completed for 97 patients. Median time from symptom onset to ILD diagnosis was 12.0 (IQR 20.5) months, with 46% diagnosed within 1 year. Time from first computed tomography (CT) scan to respirology referral was 2.4 (IQR 21.2) months. Referrals with a prior CT were triaged sooner than referrals without (1.7±1.6 months vs 3.9±3.3 months, p=0.013, 95% CI 0.48 to 2.94). On patient surveys (n=70), 51% felt that their lung disease was not recognised early enough. Commonly reported challenges to timely diagnosis included delayed presentation to primary care, initial misdiagnoses and long wait-times for specialists. Forty-five per cent of physicians (n=20) identified diagnostic delays, attributed to delayed presentations to primary care (58%), initial misdiagnoses (67%) and delayed chest imaging (75%). Themes from patient and respirologist focus groups included patient-related, healthcare provider-related and system-related factors leading to delays in diagnosis.

Conclusions

This mixed-methods study identified patient and system-related factors that contribute to diagnostic delays for patients with ILD, with most delays occurring prior to respirology referral. ILD awareness and education, earlier presentation to primary care, expedited access to chest imaging and earlier referral to respirology may expedite diagnosis.
A novel constitutive law of confined grouted rock bolt under pull-out load based on a fully nonlinear bond–slip model
Authors: Li Yingchun , Tian Haiyang , Li Danqi
Published: April 2024

Rock bolts are widely applied in deep underground excavations for rock reinforcement. Here, a constitutive model that quantifies the pull-out load–displacement relationship of the grouted rock bolt has been developed though theoretically analyzing the load transfer behaviour along the bolt–grout interface. An improved nonlinear continuously yielding criteria was employed as a bond–slip model where the role of confining pressure playing in slip was accounted. The performance of the proposed constitutive model was demonstrated by comparing with three sets of laboratory pull-out tests on the fully grouted rock bolts under different confining pressure levels (including a short-encapsulated pull-out test designed in our laboratory). The input parameters in the model were determinable within the laboratory environment. The analytical simulation results of pull-out load–displacement performance, the axial stress in the rock bolt and shear stress along the bolt–grout interface agreed well with the laboratory data. We also found that the confining pressure significantly affects the critical embedment length, and the higher the confining pressure, the shorter the critical embedment length. The findings enrich the understanding on the mechanical properties of grouted rock bolts and hence aid the rock engineers in rock reinforcement design in underground excavations.
Massive gravity from a first-quantized perspective
Authors: Fecit Filippo
Published: April 2024

In this work, we investigate the BRST quantization of the massive $${\mathcal {N}}=4$$

N
=
4

supersymmetric spinning particle, with a twofold purpose: exploring different approaches to give mass to spinning particle models and formulating a first-quantized theory for massive gravity on both flat and curved spacetime. The main contribution of this study is the development of a worldline formulation of the linear theory of massive gravity, namely of the Fierz–Pauli theory, on a curved spacetime; such a theory describes the propagation of massive spin 2 particle on a non-flat background. Our results suggest that achieving the nilpotency of the BRST charge requires an Einstein spacetime with vanishing cosmological constant as the only viable consistent background. In the course of the analysis, we take the $${\mathcal {N}}=2$$

N
=
2

supersymmetric worldline as an exemplificative model, correctly producing the Proca theory on curved spacetime. Our analysis shows that the associated BRST system uniquely selects the minimal coupling to the background curvature.
Using the Kaniadakis horizon entropy in the presence of neutrinos to alleviate the Hubble and $$ S_{8} $$ tensions
Authors: Yarahmadi Muhammad , Salehi Amin
Published: April 2024

The $$H_{0}$$

H
0

tension stands as a prominent challenge in cosmology, serving as a primary driver for exploring alternative models of dark energy. Another tension arises from measurements of the $$ S_{8} $$

S
8

parameter, which is characterize the amplitude of matter fluctuations in the universe. In this study, we address the alleviation of both the Hubble tension and $$ S_{8} $$

S
8

tension by incorporating Kaniadakis horizon entropy. We investigate two scenarios to explore the impact of this entropy on cosmological parameters. In the first scenario, utilizing modified Friedmann equations through Kaniadakis entropy, we estimate the values of $$H_{0}$$

H
0

and $$ S_{8} $$

S
8

. In the subsequent scenario, we introduce the neutrino term and assess its effect on mitigating the Hubble and $$ S_{8} $$

S
8

tensions. Our findings reveal that when considering the first scenario, the results closely align with Planck’s 2018 outcomes for Hubble and $$ S_{8} $$

S
8

tensions. Moreover, with the inclusion of neutrinos, these tensions are alleviated to approximately 2$$\sigma $$
σ
, and the $$ S_{8} $$

S
8

value is in full agreement with the results from the KiDS and DES survey. Furthermore, we impose a constraint on the parameter K in each scenario. Our analysis yields $$K = 0.12\pm 0.41$$

K
=
0.12
±
0.41

for Kaniadakis entropy without neutrinos and $$K = 0.39\pm 0.4$$

K
=
0.39
±
0.4

for the combined dataset considering Kaniadakis entropy in the presence of neutrinos. We demonstrate that the value of K may be affected by neutrino mass, which can cause energy transfer between different parts of the universe and alter the Hubble parameter value.
Innovative Cultural Transmission Paths Analysis for Local Opera Based on Data Mining
Authors: Yan Jie
Published: April 2024

With the rapid development of society and cultural diversity, local opera, as a representative of traditional art, faces dual challenges of inheritance and innovation. The inheritance of traditional Chinese opera often relies on oral instruction, but in modern society, this method is no longer suitable for the rapidly changing cultural environment. The purpose of this study is to explore in depth the innovative cultural dissemination path of local opera through data mining techniques. This paper uses data mining techniques to explore and analyze the inheritance of innovative culture in local opera, and to study the inheritance paths. This paper proposes a data mining-based method for analyzing and identifying the paths of inheritance of innovative culture in local opera. This paper focuses on two aspects of technology clustering and technology theme association, and the research paths are divided into flexible clustering based on data enhancement and technology evolution path identification based on theme extraction. Firstly, the heritage changes of dating tunes are discussed. Secondly, the unique artistic esthetics of the dating tune is compared with the artistic characteristics of Henan opera and the three-stringed book. Through the research and learning experience of the Dai Yongqu, it is easier to thoroughly understand the artistic essence and cultural connotation of the Dai Yongqu, and that exposure to the Dai Yongqu is a process of touching traditional culture. In the text clustering section, the data co-occurrence frequency matrix is constructed based on the results of multiple clustering, transforming the problem of determining the number of clusters into a co-occurrence frequency problem with semantic information of the text, thus achieving the purpose of flexible clustering on demand. In a comparison with existing methods, the text representation method using data-enhanced coding achieves better semantic coding results. The flexible clustering method can differentiate the data better than the clustering method with a defined number of clusters and obtains clustering results with high intra-class similarity and high inter-class differentiation.
Application of micropolar fluid model to blood flow through catheterized artery with stenosis and thrombosis
Authors: Ashfaq Muhammad , Asghar Zeeshan , Nie Yufeng , Shatanawi Wasfi
Published: April 2024

This paper presents a model of nonisothermal blood flow through a diseased arterial segment due to the presence of stenosis and thrombosis. The rheological properties of the blood in the annulus are captured by utilizing micropolar fluid model. The equation describing the blood flow and heat transfer is developed under the assumption that stenosis growth into the lumen of the artery is small as compared to the average radius of the artery. Biological processes like intimal proliferation of cells or changes in artery caliber may be activated by small growths that cause moderate stenotic blockages. Closed-form solutions for temperature, velocity, resistance impedance and wall shear stress are obtained and then utilized to estimate the impact of various physical parameters on micropolar blood flow. Graphs are plotted to illustrate variations in temperature, velocity, shear stress at the wall and resistance impedance against different controlling parameters. The results are also validated via the bvp4c approach.
A MODERN TRAVELING WAVE SOLUTION FOR CAPUTO-FRACTIONAL KLEIN–GORDON EQUATIONS
Authors: EL-AJOU AHMAD , SAADEH RANIA , BURQAN ALIAA , ABDEL-ATY MAHMOUD
Published: April 2024

This research paper introduces a novel approach to deriving traveling wave solutions (TWSs) for the Caputo-fractional Klein–Gordon equations. This research presents a distinct methodological advancement by introducing TWSs of a particular time-fractional partial differential equation, utilizing a non-local fractional operator, specifically the Caputo derivative. To achieve our goal, a novel transformation is considered, that converts a time-fractional partial differential equation into fractional ordinary differential equations, enabling analytical solutions through various analytical methods. This paper employs the homotopy analysis method to achieve the target objectives. To demonstrate the efficiency and applicability of the proposed transform and method, two examples are discussed and analyzed in figures.
QUANTIFYING ROUGH FRACTURE BEHAVIORS IN GAS-BEARING COAL SEAM: A FULLY COUPLED FRACTAL ANALYSIS
Authors: ZHOU ZHOU , WAN ZHIJUN , LIU GUANNAN , YU BOMING , YE DAYU , WEI MINGYAO
Published: April 2024

In gas-bearing coal seam mining projects, the pivotal considerations encompass the assessment of gas migration, emission trends, and coal seam stability, which are crucial for ensuring both the safety and efficiency of the project. The accurate evaluation of the nonlinear evolution of the fracture network, acting as the primary conduit for gas migration and influenced by mining disturbances, coal seam stress, overlying strata pressure, and gas pressure, emerges as a key determinant in gauging coal seam stress and safety. To address the industry challenge of quantitatively assessing the complex behaviors of fracture networks during gas-bearing coal seam extraction, this study introduces a novel, interdisciplinary fractal analysis model. Drawing upon fractal theory for classical porous media, four fractal parameters capable of quantitatively characterizing the microscopic behaviors of fractures are proposed and defined as functions of permeability. Subsequently, the gas pressure in gas-bearing coal seams, coal seam deformation and stress, in-situ stress, overlying strata pressure, and adsorption–desorption effects are comprehensively coupled and applied to the classic gas-bearing coal seam at the Jianxin Coal Mine’s 4301 working face in Shaanxi, China. Upon the robust validation of the proposed model, the present computational results reveal: (1) the proposed micro-parameters adeptly characterize the number, roughness, tortuosity, and length of fractures in gas-bearing coal seams; (2) a larger fractal dimension of fractures leads to increased coal seam stress and strain, while the fractal dimensions of fracture tortuosity and roughness are inversely proportional to coal seam stress and strain; (3) these fractal parameters directly induce evolutionary changes in gas seepage behavior, leading to varying degrees of mechanical property evolution in the coal seam. When [Formula: see text] and [Formula: see text] increased from 1.2 to 1.8, the maximum change in coal seam deformation was 16.9% and 13.8%, respectively, and when [Formula: see text] increases from 0.03 to 0.12, the coal seam deformation changes by 15.1%. This represents a quantitative characterization unattainable by previously published coal seam analysis models, including mainstream fractal computation models.
Continuity of the relative entropy of resource
Authors: Lami Ludovico , Shirokov Maksim
Published: April 2024

We present a criterion to establish the local continuity of the relative entropy of resource, i.e. the relative entropy distance to the set of free states, in any quantum resource theory. Several basic corollaries of this criterion are presented. Applications to the relative entropy of entanglement in multipartite quantum systems are considered. It is shown, in particular, that local continuity of any relative entropy of multipartite entanglement follows from local continuity of the quantum mutual information.
Interpreting symplectic linear transformations in a two-qubit phase space
Authors: Wootters William K.
Published: April 2024

For the continuous Wigner function and for certain discrete Wigner functions, permuting the values of the Wigner function in accordance with a symplectic linear transformation is equivalent to performing a certain unitary transformation on the state. That is, performing this unitary transformation is simply a matter of moving Wigner-function values around in phase space. This result holds in particular for the simplest discrete Wigner function defined on a [Formula: see text] phase space when the Hilbert-space dimension [Formula: see text] is odd. It does not hold for a [Formula: see text] phase space if the dimension is even. Here we show, though, that a generalized version of this correspondence does apply in the case of a two-qubit phase space. In this case, a symplectic linear permutation of the points of the phase space, together with a certain reinterpretation of the Wigner function, is equivalent to a unitary transformation.
Workers’ Remittances to Sub-Saharan Africa: Do Institutional Quality and Financial Development Matter?
Authors: Olanipekun Dayo Benedict
Published: April 2024

This paper examines the effects of institutions and financial development on workers’ remittances in sub-Saharan Africa. To achieve the objectives, a two-step system generalized method of moment (GMM) was utilized on a panel dataset of 38 countries in the region from 2005 to 2022. Empirical findings from the study reveal that some institutional indicators, namely, control of corruption, government effectiveness, political stability and rule of law have a significant impact in attracting remittances to SSA. Further evidence reveals that financial development indicators notably domestic credit to the private sector and domestic credit to the private sector by banks have a significant impact on remittances inflow in the region. Financial development indicators are found to complement some of the institutional indicators, such as control of corruption, political stability, government effectiveness, and rule of law on the inflow of remittances to the region. Government efforts should be geared toward improving the institutional framework and ensuring financial market development to increase the amount of remittances inflow to the region.
Alpha-Glucosidase Inhibition, Antioxidant Activities, and Molecular Docking Study of Krom Luang Chumphon Khet Udomsak, a Thai Traditional Remedy
Authors: Limcharoen Thanchanok , Chaniad Prapaporn , Chonsut Piriya , Punsawad Chuchard , Juckmeta Thana , Konyanee Atthaphon , Rais Ichwan Ridwan , Sangkaew Surat
Published: April 2024

Krom Luang Chumphon Khet Udomsak remedy (KKR) has traditionally been used as an alternative treatment, particularly for hyperglycemia; however, its therapeutic efficacy has not been scientifically validated. Thus, this study aims to investigate the potential inhibitory and antioxidant effects of α-glucosidase enzyme and characterize the chemical profile of KKR extracts using gas chromatography-mass spectrometry (GC-MS). The investigation highlights both KKR extracts as potent inhibitors of α-glucosidase, with the ethanolic extract of KKR (KKRE) displaying an IC50 value of 46.80 µg/mL and a noncompetitive mode of action. The combination of ethanolic and aqueous extracts of KKR (KKRE and KKRA, respectively) with acarbose exhibited a synergistic effect against the α-glucosidase. The KKRE extract displayed strong scavenging effects in the DPPH assay (IC50 156.3 µg/mL) and contained significant total phenolic (172.82 mg GAE/g extract) and flavonoid (77.41 mg QE/g extract) contents. The major component of KKRE is palmitic acid (15.67%). Molecular docking revealed that the major compounds interacted with key amino acid residues (ASP215, GLU277, HIS351, ASP352, and ARG442), which are crucial for inhibiting α-glucosidase. Notably, campesterin had a more significant influence on α-glucosidase than acarbose, with low binding energy. These findings underscore the significance of KKR in traditional medicine and suggest that it is promising treatment for diabetes mellitus. Further studies using animal model will provide valuable insights for advancing this research.
Analysis of Bladder Cancer Staging Prediction Using Deep Residual Neural Network, Radiomics, and RNA-Seq from High-Definition CT Images
Authors: Zhou Yao , Zheng Xingju , Sun Zhucheng , Wang Bo
Published: April 2024

Bladder cancer has recently seen an alarming increase in global diagnoses, ascending as a predominant cause of cancer-related mortalities. Given this pressing scenario, there is a burgeoning need to identify effective biomarkers for both the diagnosis and therapeutic guidance of bladder cancer. This study focuses on evaluating the potential of high-definition computed tomography (CT) imagery coupled with RNA-sequencing analysis to accurately predict bladder tumor stages, utilizing deep residual networks. Data for this study, including CT images and RNA-Seq datasets for 82 high-grade bladder cancer patients, were sourced from the TCIA and TCGA databases. We employed Cox and lasso regression analyses to determine radiomics and gene signatures, leading to the identification of a three-factor radiomics signature and a four-gene signature in our bladder cancer cohort. ROC curve analyses underscored the strong predictive capacities of both these signatures. Furthermore, we formulated a nomogram integrating clinical features, radiomics, and gene signatures. This nomogram’s AUC scores stood at 0.870, 0.873, and 0.971 for 1-year, 3-year, and 5-year predictions, respectively. Our model, leveraging radiomics and gene signatures, presents significant promise for enhancing diagnostic precision in bladder cancer prognosis, advocating for its clinical adoption.
Numerical Analysis of Free Play-Induced Aeroelastic Phenomena: A Numerical Approach With Adaptive Step Size Control
Authors: Qijing Yu , Yafen Zhang , Yidan Wang
Published: April 2024

This study presents a detailed numerical analysis of nonlinear aeroelastic behavior in a two degree of freedom (DOF) model, focusing on plunge and pitch motions and employing the continuation method (CM) with an adaptive step size control algorithm. The research incorporates free-play nonlinearity at the plunge hinge, a common structural nonlinearity in aeronautics that can induce detrimental limit cycle oscillations (LCOs) during flight. By examining three scenarios—linear response, unhindered plunge motion, and nonlinear stiffness behavior—the study assesses the effects of free play on flutter and LCO phenomena, including discontinuity-induced bifurcations like grazing bifurcation. Additionally, the study explores parameter variation for nonlinear flutter analysis, revealing the dynamics of grazing bifurcation and its impact on LCO behavior. The research also demonstrates the method’s superior accuracy in flutter speed estimation and mode-switching identification, despite higher computational demands. The findings underscore the diminishing influence of nonlinear free-play behavior on LCO amplitude, providing insights with significant implications for aeroelastic design and aircraft safety.
Efficacy of an Internet- and Mobile-Based Intervention for Subclinical Anxiety and Depression (ICare Prevent) with Two Guidance Formats: Results from a Three-Armed Randomized Controlled Trial
Authors: Zarski Anna-Carlotta , Weisel Kiona K. , Berger Thomas , Krieger Tobias , Schaub Michael P. , Berking Matthias , Görlich Dennis , Jacobi Corinna , Ebert David D.
Published: April 2024

Introduction: Limited research exists on intervention efficacy for comorbid subclinical anxiety and depressive disorders, despite their common co-occurrence. Internet- and mobile-based interventions (IMIs) are promising to reach individuals facing subclinical symptoms. Objective: This study aimed to evaluate the efficacy of a transdiagnostic and self-tailored IMI in reducing subclinical anxiety and depressive symptom severity with either individualized (IG-IMI) or automated (AG-IMI) guidance compared to a waitlist control group with care-as-usual access (WLC). Methods: Participants included 566 adults with subclinical anxiety (GAD-7 ≥ 5) and/or depressive (CES-D ≥16) symptoms, who did not meet criteria for a full-syndrome depressive or anxiety disorder. In a three-arm randomized clinical trial, participants were randomized to a cognitive behavioral 7-session IMI plus booster session with IG-IMI (n = 186) or AG-IMI (n = 189) or WLC (n = 191). Primary outcomes included observer-rated anxiety (HAM-A) and depressive (QIDS) symptom severity 8 weeks after randomization assessed by blinded raters via telephone. Follow-up outcomes at 6 and 12 months are reported. Results: Symptom severity was significantly lower with small to medium effects in IG-IMI (anxiety: d = 0.45, depression: d = 0.43) and AG-IMI (anxiety: d = 0.31, depression: d = 0.32) compared to WLC. No significant differences emerged between guidance formats in primary outcomes. There was a significant effect in HAM-A after 6 months favoring AG-IMI. On average, participants completed 85.38% of IG-IMI and 77.38% of AG-IMI. Conclusions: A transdiagnostic, self-tailored IMI can reduce subclinical anxiety and depressive symptom severity, but 12-month long-term effects were absent. Automated guidance holds promise for enhancing the scalability of IMIs in broad prevention initiatives.
Erythrocyte Alloimmunization and Autoimmunization in the Pediatric Population: A Multicenter, Cross-Sectional Study in Central China
Authors: Wang Yongjun , Yang Yuanqing , Li Zhengfeng , Li Wei , Hu Hongbin , Zhao Ding
Published: April 2024

Background: Erythrocyte alloantibodies and autoantibodies complicate transfusion. However, the prevalence of erythrocyte alloimmunization and autoimmunization has not been estimated in the Chinese pediatric population. Therefore, we investigated the prevalence of erythrocyte alloimmunization and autoimmunization in the Chinese pediatric population with the aim of developing a reasonable transfusion management policy in children from China. Methods: This study included 30,603 pediatric inpatients who were admitted to three tertiary hospitals in central China from May 2020 to October 2022. Antibody screening was carried out with a three-cell panel by column agglutination technology, and samples with positive screening were analyzed for antibody specificity with a 16-cell identification panel. Clinical details of the patients were collected to identify associations with antibody formation. Results: The alloimmunization rate was 0.55% (169/30,603), and the autoimmunization rate was 0.14% (43/30,603). Alloantibodies comprised 80.09% of the antibodies. The most frequent alloantibodies were anti-M (58.77%), anti-E (9.48%), and anti-P1 (4.27%). Autoantibodies comprised 19.91% of antibodies. Age (p = 0.000), sex (p = 0.016), geographical area (p = 0.000), ABO blood group (p = 0.008), and diagnosis (p = 0.000) were independent risk factors for antibody formation. The risk of antibody formation at the ages of 0–28 days and 1–3 months was zero (odds ratio = 0.000). The antibody distribution was significantly different by age (p = 0.000) and diagnosis (p = 0.000). Conclusion: Repeat pre-transfusion testing for infants less than 4 months of age can be omitted for no risk of antibody formation. MNS system antibodies, especially anti-M, are prominent in younger children, and this decreases with age. Provision of extended phenotype-matched transfusion for Rh system antigens, especially antigen E, is necessary in children to control erythrocyte alloimmunization. The presence of antibodies with high evanescence rates in the pediatric population suggests the pressing need for nationwide shared transfusion records to avoid hemolytic transfusion reactions in children.
Management of Pediatric Cavum Cysts: A Scoping Review and a Single Institution Case Series
Authors: Rafka Habib Emil , Shaw Eric Scot , Saway Brian Fabian , Slade Daniel , Kelly Thomas Harold , Eskandari Ramin
Published: April 2024

Introduction: Pediatric cavum cysts are a rare yet complicated pathology to manage. The literature is scarce, primarily consisting of case series, and lacking a consensus regarding clear management. In this scoping review, we aimed to compile existing information in the literature regarding the management of pediatric cavum cysts across the last 10 years. We also present our management of 19 patients, the largest case series to date, highlighting knowledge gaps surrounding the management of this salient pathology. Methods: A literature search using PubMed and SCOPUS was conducted using the following search terms: (pediatric) AND (Cavum septum pellucidum) OR (cavum vergae) OR (cavum velum interpositum) AND (management). Eligibility criteria included peer-reviewed publication published in the last 10 years, pediatric population, cavum cyst, and English language. A retrospective search was conducted for all pediatric cavum cysts between 2013 and 2023 at our institution. Clinical and radiographic characteristics as well as intervention and outcome data were collected for both the scoping review and our cases. Results: 330 total articles were populated using our search. 12 articles met our inclusion criteria. 41.7% (n = 5) of the articles were case series, 33.3% (n = 4) were case reports, 8.3% (n = 1) was a technical article, 8.3% (n = 1) was a systematic review, and 8.3% (n = 1) was a case questionnaire. Resolution of symptoms was noted in all articles of our scoping review, regardless of treatment modality. The average age in our case series was 9.84 years old and average age at diagnosis was 5.53 years old. 6 patients (31.6%) were female and 13 patients (68.4%) were male. 2 out of the 19 patients (10.5%) were surgically treated. Conclusion: There is no clear consensus on the management of cavum cysts. A prospective, multicenter study is needed to create standardized pediatric cyst management guidelines. The current thought is that surgical intervention should be saved for those patients with obstructive hydrocephalus and signs of intracranial hypertension.
Mammakarzinom: Der Nutzen einer verkürzten Therapiedauer mit Trastuzumab
Authors: Witzel Isabell
Published: April 2024

We present the final analysis of the phase III noninferiority, randomized ShortHER trial comparing 9 weeks versus 1 year of adjuvant trastuzumab with chemotherapy in patients with human epidermal growth factor receptor 2–positive (HER2+) early breast cancer (BC). Women with HER2+ BC were randomly assigned to anthracycline-taxane combinations plus 1-year trastuzumab (arm A, long) or 9-week trastuzumab (arm B, short). Here, we report the second coprimary end point overall survival (OS), updated disease-free survival (DFS), and outcomes according to hormone receptor status, age, and nodal status. At a median follow-up of 9 years, 10-year DFS is 77% versus 78% in the long versus short arm, respectively. Ten-year OS is 89% versus 88% in the long versus short arm, respectively. 10-year DFS rates in the long versus short arm according to nodal status are N0 81% versus 85%; N1-3 77% versus 79%; and N4+ 63% versus 53%. Ten-year OS rates in long versus short arm according to nodal status are N0 89% versus 95%%; N1-3 92% versus 89%; and N4+ 84% versus 64%. The updated analysis of the ShortHER trial shows that 1-year trastuzumab is the standard treatment for patients with HER2+ early BC as noninferiority cannot be claimed. However, numerically, the differences for the patients at low or intermediate risk (N0/N1-3) is negligible, while patients with N4+ have a clear benefit with 1-year trastuzumab .
Validation of the Persian Version of the Palin Parent Rating Scales
Authors: Bafrooei Ebrahim Barzegar , Darouie Akbar , Maroufizadeh Saman , Farazi Morteza
Published: April 2024

Introduction: The Palin Parent Rating Scale (Palin PRS) is a structured questionnaire filled out by parents of children who stutter. It is designed to assess the effects of stuttering on both the children and their parents. The goal of this study was to translate the Palin PRS into Persian and to evaluate its validity and reliability for application in preschool children who stutter. Methods: This research was conducted from August 2021 to December 2022, involving 139 parents of children who stutter. The parents completed the Palin PRS and provided their demographic data. Descriptive statistics were used to examine the floor and ceiling effects on all subscales of the Palin PRS. The internal consistency of the scale was assessed using Cronbach’s alpha method, while the intraclass correlation coefficient (ICC) was calculated to determine its test-retest reliability. An exploratory factor analysis was also performed to clarify the factor structure of the scale. Results: The exploratory factor analysis results were highly consistent with the factor structure found in the original version. No floor or ceiling effects were observed for the factors of the Palin PRS. The three factors of the Persian version of the Palin PRS (P-Palin PRS) showed good internal consistency (Cronbach’s alpha >0.8) and excellent test-retest reliability (ICC >0.9). Additionally, normative scores were derived by converting raw scores into Stanine scores. Conclusion: The P-Palin PRS showed strong reliability, thereby establishing it as a suitable instrument for evaluating how parents perceive the effects of stuttering on their children and themselves. Further research may explore its application in diverse clinical settings and populations.
El espacio categorial de las prácticas parentales: una revisión sistemática
Authors: Bautista-Castro Luis René
Published: April 2024

(analytical)This paper identified dimensions of meaning of the field called parental practices. For this, a systematicreview was carried out, using the Prisma standard, which yielded 66 characteristics identified in 62 articles examined from 2017 to 2022. These characteristics were pre-coded, finding 18 categories,transformed into 14 axes, corresponding to 3 general properties of social practices: power, sanction, and exchange. This configured a coordinate system that was called a categorical space, that was later submitted to evaluation by expert judges, who conceptualized in favor of its pertinence and relevance. The results are discussed in terms of the contribution of the space presented to addressparental positioning as an alternative way of undertaking research and future intervention in the area.
Keywords: Parenting practices; Child-rearing; Familiar relationships; Prisma.
High Variability of Body Mass Index Is Independently Associated With Incident Heart Failure
Authors: Liu Chang , Chiang Yiyun , Hui Qin , Zhou Jin J. , Wilson Peter W. F. , Joseph Jacob , Sun Yan V.
Published: April 2024

Background

Heart failure (HF) is a serious condition with increasing prevalence, high morbidity, and increased mortality. Obesity is an established risk factor for HF. Fluctuation in body mass index (BMI) has shown a higher risk of cardiovascular outcomes. We investigated the association between BMI variability and incident HF.

Methods and Results

In the UK Biobank, we established a prospective cohort after excluding participants with prevalent HF or cancer at enrollment. A total of 99 368 White participants with ≥3 BMI measures during >2 years preceding enrollment were included, with a median follow‐up of 12.5 years. The within‐participant variability of BMI was evaluated using standardized SD and coefficient of variation. The association of BMI variability with incident HF was assessed using Fine and Gray's competing risk model, adjusting for confounding factors and participant‐specific rate of BMI change. Higher BMI variability measured in both SD and coefficient of variation was significantly associated with higher risk in HF incidence (SD: hazard ratio [HR], 1.05 [95% CI, 1.03–1.08],
P
<0.0001; coefficient of variation: HR, 1.07 [95% CI, 1.04–1.10],
P
<0.0001).

Conclusions

Longitudinal health records capture BMI fluctuation, which independently predicts HF incidence.
External Validation of a Risk Score Model for Predicting Major Clinical Events in Adults After Atrial Switch
Authors: Albertini Mathieu , Santens Beatrice , Fusco Flavia , Sarubbi Berardo , Gallego Pastora , Rodriguez‐Puras Maria‐Jose , Prokselj Katja , Kauling Robert Martijn , Roos‐Hesselink Jolien , Labombarda Fabien , Van De Bruaene Alexander , Budts Werner , Waldmann Victor , Iserin Laurence , Woudstra Odilia , Bouma Berto , Ladouceur Magalie
Published: April 2024

Background

A risk model has been proposed to provide a patient individualized estimation of risk for major clinical events (heart failure events, ventricular arrhythmia, all‐cause mortality) in patients with transposition of the great arteries and atrial switch surgery. We aimed to externally validate the model.

Methods and Results

A retrospective, multicentric, longitudinal cohort of 417 patients with transposition of the great arteries (median age, 24 years at baseline [interquartile range, 18–30]; 63% men) independent of the model development and internal validation cohort was studied. The performance of the prediction model in predicting risk at 5 years was assessed, and additional predictors of major clinical events were evaluated separately in our cohort. Twenty‐five patients (5.9%) met the major clinical events end point within 5 years. Model validation showed good discrimination between high and low 5‐year risk patients (Harrell C index of 0.73 [95% CI, 0.65–0.81]) but tended to overestimate this risk (calibration slope of 0.20 [95% CI, 0.03–0.36]). In our population, the strongest independent predictors of major clinical events were a history of heart failure and at least mild impairment of the subpulmonary left ventricle function.

Conclusions

We reported the first external validation of a major clinical events risk model in a large cohort of adults with transposition of the great arteries. The model allows for distinguishing patients at low risk from those at intermediate to high risk. Previous episode of heart failure and subpulmonary left ventricle dysfunction appear to be key markers in the prognosis of patients. Further optimizing risk models are needed to individualize risk predictions in patients with transposition of the great arteries.
Sleep Patterns and Traditional Cardiovascular Health Metrics: Joint Impact on Major Adverse Cardiovascular Events in a Prospective Cohort Study
Authors: You Si , Zhang Hai‐Feng , Zhang Shao‐Ling , Gao Qing‐Yuan , Cai Yang‐Wei , Huang Ze‐Gui , Wu Yu‐Biao , Chen Yang‐Xin , Wang Jing‐Feng , Gao Jing‐Wei , Liu Pin‐Ming
Published: April 2024

Background

This study examines the association between traditional cardiovascular health (CVH) metrics and major adverse cardiovascular events (MACE) incidence in individuals with diverse sleep patterns.

Methods and Results

We analyzed data from 208 621 participants initially free of cardiovascular disease (CVD) in the UK Biobank study. Sleep patterns were assessed using scores for chronotype, duration, insomnia, snoring, and daytime dozing. Traditional CVH scores were derived from the Life's Simple 7 metrics. Cox proportional hazards multivariate regression assessed associations between distinct combinations of CVH and sleep scores and MACE, including nonfatal myocardial infarction, nonfatal stroke, and CVD mortality. Over a mean follow‐up of 12.73 years, 9253 participants experienced incident MACE. Individuals with both a healthy sleep pattern and ideal CVH levels had the lowest MACE risk compared with those with a poor sleep pattern and poor CVH levels (hazard ratio, 0.306 [95% CI, 0.257–0.365];
P
<0.001). Elevated CVH scores were associated with a reduced risk of MACE across different sleep patterns. Similar trends were observed for individual MACE components, heart failure, and all‐cause mortality. These findings remained robust in sensitivity analyses and across various subgroups.

Conclusions

In individuals without known CVD, maintaining a favorable sleep pattern and achieving optimal CVH levels, as measured by traditional metrics, were associated with the lowest MACE risk. Enhanced CVH significantly reduced CVD risk, even in individuals with a poor sleep pattern. These results emphasize the importance of considering multiple dimensions of sleep health alongside CVH to mitigate CVD risk.

Registration

URL:
https://www.ukbiobank.ac.uk
; Unique identifier: 91090.
Initial eGFR Changes with SGLT2 Inhibitor in Patients With Type 2 Diabetes and Associations With the Risk of Abnormal Serum Potassium Level
Authors: Kao Yi‐Wei , Chao Tze‐Fan , Chen Shao‐Wei , Cheng Yu‐Wen , Chan Yi‐Hsin , Chu Pao‐Hsien
Published: April 2024

Background

Both high and low levels of serum potassium measurements are linked with a higher risk of adverse clinical events among patients with type 2 diabetes. The study was aimed at evaluating the implications of the various degrees of initial estimated glomerular filtration rate (eGFR) change on subsequent serum potassium homeostasis following sodium–glucose cotransporter‐2 inhibitor (SGLT2i) initiation among patients with type 2 diabetes.

Methods and Results

We used medical data from a multicenter health care provider in Taiwan and recruited 5529 patients with type 2 diabetes with baseline/follow‐up eGFR data available after 4 to 12 weeks of SGLT2i treatment from June 1, 2016, to December 31, 2018. SGLT2i treatment was associated with an initial mean (SEM) eGFR decline of −3.5 (0.2) mL/min per 1.73 m
2
in overall study participants. A total of 36.7% (n=2028) of patients experienced no eGFR decline, and 57.9% (n=3201) and 5.4% (n=300) of patients experienced an eGFR decline of 0% to 30% and >30%, respectively. Patients with an initial eGFR decline of >30% were associated with higher variability in consequent serum potassium measurement when compared with those without an initial eGFR decline. Participants with a pronounced eGFR decline of >30% were associated with a higher risk of hyperkalemia ≥5.5 (adjusted hazard ratio,4.59 [95% CI, 2.28–9.26]) or use of potassium binder (adjusted hazard ratio, 2.65 [95% CI, 1.78–3.95]) as well as hypokalemia events <3.0 mmol/L (adjusted hazard ratio, 3.21 [95% CI, 1.90–5.42]) or use of potassium supplement (adjusted hazard ratio, 1.87 [95% CI, 1.37–2.56]) following SGLT2i treatment after multivariate adjustment.

Conclusions

Physicians should be aware that the eGFR trough occurs shortly, and consequent serum potassium changes following SGLT2i initiation.
Text Message–Based Assessment of 90‐Day Modified Rankin Scale After Stroke
Authors: Abbasi Mohammad Hossein , Yuan Kristy , Kasner Scott E. , McPartland Ellen , Owens Karrima C. , Sloane Kelly L.
Published: April 2024

Background

The modified Rankin Scale (mRS) is commonly used to measure disability after stroke, traditionally assessed through telephone or in‐person evaluation. Here, we investigated the validity of mRS assessment through an automated text messaging system based on the simplified mRS questionnaire as an alternative method to traditional methods of assessment.

Methods and Results

A total of 250 patients admitted to 3 hospitals within the University of Pennsylvania Health System with ischemic or hemorrhagic stroke were enrolled. Participants received automated text messages sent 48 hours before their outpatient appointment at about 90 days after stroke. The mRS scores were assigned on the basis of participant responses to 2 to 4 text questions eliciting yes/no responses. The mRS was then evaluated in person or by telephone interview for comparison. Responses were compared with κ. A total of 142 patients (57%) completed the study. The spontaneous response rate to text messages was 46.5% and up to 72% with an additional direct in‐person or phone call reminder. Agreement was substantial (quadratic‐weighted κ=0.87 [95% CI, 0.83–0.89]) between responses derived from the automated text messaging and traditional interviews. Agreement for distinguishing functional independence (mRS 0–1) from dependence (mRS 2–5) was substantial (unweighted κ=0.79 [95% CI, 0.69–0.90]).

Conclusions

An automated text messaging system is a feasible method for remotely obtaining the mRS after stroke and a potential alternative to traditional in‐person or telephone assessment. Further studies are needed to evaluate the generalizability of text message–based approaches to stroke outcome measurement.
Impact of Social Vulnerability on Cardiac Arrest Mortality in the United States, 2016 to 2020
Authors: Gonuguntla Karthik , Chobufo Muchi Ditah , Shaik Ayesha , Patel Neel , Penmetsa Mouna , Sattar Yasar , Thyagaturu Harshith , Sama Carlson , Alharbi Anas , Chan Paul S. , Balla Sudarshan
Published: April 2024

Background

Cardiac arrest is 1 of the leading causes of morbidity and mortality, with an estimated 340 000 out‐of‐hospital and 292 000 in‐hospital cardiac arrest events per year in the United States. Survival rates are lower in certain racial and socioeconomic groups.

Methods and Results

We performed a county‐level cross‐sectional longitudinal study using the Centers for Disease Control and Prevention's Wide‐Ranging Online Data for Epidemiologic Research multiple causes of death data set between 2016 and 2020 among individuals of all ages whose death was attributed to cardiac arrest. The Social Vulnerability Index is a composite measure that includes socioeconomic vulnerability, household composition, disability, individuals from racial and ethnic minority groups status and language, and housing and transportation domains. We examined the impact of social determinants on cardiac arrest mortality stratified by age, race, ethnicity, and sex in the United States. All age‐adjusted mortality rate (cardiac arrest AAMRs) are reported as per 100 000. Overall cardiac arrest AAMR during the study period was 95.6. The cardiac arrest AAMR was higher for men compared with women (119.6 versus 89.9) and for the Black population compared with the White population (150.4 versus 92.3). The cardiac arrest AAMR increased from 64.8 in counties in quintile 1 of Social Vulnerability Index to 141 in quintile 5, with an average increase of 13% (95% CI, 9.8%–16.9%) in AAMR per quintile increase.

Conclusions

Mortality from cardiac arrest varies widely, with a >2‐fold difference between the counties with the highest and lowest social vulnerability, highlighting the differential burden of cardiac arrest deaths throughout the United States based on social determinants of health.