bluuebunny/crossref_metadata_2025 huggingface dataset:
Alkyl ketene dimer modification of thermomechanical pulp promotes processability with polypropylene
Authors: Hosseini Seyedehsan , Nilsson Robin , Ström Anna , Larsson Anette , Westman Gunnar
Published: October 2023

Alkyl ketene dimers (AKDs) are known to efficiently react with cellulose with a dual polarity in their structure: a polar component and a nonpolar component. AKD of three different carbon chain lengths, 4, 10, and 16 carbons have been synthesized, and thermomechanical pulp (TMP) fibers were modified by them. The modification of TMP fibers with AKD resulted in an increased water contact angle, showing the presence of the AKDs on the TMP fibers and a new carbonyl peak in the IR spectra, suggesting modification of the TMP fibers with AKD groups. Calculating the Hansen solubility parameters of AKD and AKD conjugated to TMP in polypropylene (PP) indicates improved compatibility, especially of longer chain AKD and TMP AKD. The rheological studies of the composites showed that the AKD with the longest carbon chain decreases the melt viscosity of the PP‐TMP‐AKD composite, which combined with the shape and the color of the extruded composite filaments indicates improved flow properties and reduced stress build up during processing. The research findings demonstrate the ability of AKD to enhance the dispersibility and compatibility of natural fibers with PP.
Comparison of the main pathogenic microorganisms of various common oral diseases in children and adults
Authors: Zhou Siqi , He Tong‐Chuan , Zhang Yuxin , Zhang Hongmei
Published: October 2023

The microorganisms in the human body gradually change and maintain a dynamic balance with the development of physiology and pathology. Oral microbiota is one of the most important microbiota in human body. It is not only closely related to the occurrence and development of oral diseases, but also plays an important role in the overall health. In childhood, the population of oral microorganisms is relatively small, but with the growth of age and tooth development, the species and quantity of oral microorganisms are gradually increasing. Different oral diseases also have their corresponding main microorganisms, and these dominant microorganisms change at different stages of the disease. In this review, we summarized and compared the main pathogenic microorganisms of several common oral diseases in children and adults. In addition, the possible association and difference between adults and children of the main pathogenic microorganisms in different stages of the same or different diseases are also discussed in order to provide research data for the development and diagnosis of common oral diseases in children and adults.
Psychosocial services for pediatric oncology patients in low‐ and middle‐income countries from health care providers' perspectives: A survey‐based report from the SIOP Global Health Network Psychosocial Working Group
Authors: Schneider Nicole M. , Rossell Nuria , Khan Muhammad Saghir
Published: October 2023

Objectives

While pediatric cancer survival rates have improved in high‐income countries, they remain much lower in low‐ and middle‐income countries (L/MICs). While much focus in recent years has been on remediating the survivorship gap, less is known about the psychosocial needs and availability of psychosocial services for this population.

Methods

A questionnaire was created by the SIOP Global Health Network Psychosocial Working Group to assess psychosocial needs and services in L/MIC. The questionnaire was distributed to pediatric oncology professionals, both in‐person at the SIOP Annual Congress in Lyon (2019) conference and then electronically. Individuals not part of SIOP were also invited to participate via social media posts.

Results

Sixty‐six respondents from 31 countries completed the questionnaire. The majority of participants were physicians, followed by nurses. Participants from low‐ and lower‐middle‐income countries (L/LMICs) perceived patients as having higher rates of anxiety and caregivers as having higher rates of depression as compared to those in upper‐middle‐income countries (UMICs). Across all L/MICs represented, 85% of physicians reported that psychosocial issues sometimes, frequently, or always affect their clinical obligations. Participants reflected on the availability of professionals who treat mental health concerns; the availability of social workers, psychologists, and non‐professional volunteers differed significantly between L/LMICs and UMICs. Treatment abandonment and myths/disinformation were highlighted as the most pressing psychosocial priorities.

Conclusion

Our study highlights pediatric oncology providers' perceptions of psychosocial concerns. Based on responses, proposals for minimum standards of care are made, as well as the importance of training existing providers and funding additional psychosocially‐focused professionals.
Illness uncertainty and quality of life in patients with advanced cancer and their family caregivers: An actor‐partner interdependence model analysis
Authors: Guan Ting , Chapman Mimi V. , de Saxe Zerden Lisa , Zimmer Catherine , Braden Carrie Jo , Rizo Cynthia F. , Northouse Laurel , Song Lixin
Published: October 2023

Objective

The relationship between illness uncertainty and quality of life (QOL) has been examined for either the patient or caregiver, but not among the patient‐caregiver dyads. This study examined relationships between illness uncertainty and QOL among patients with advanced cancer and family caregivers.

Methods

We conducted a secondary analysis of data from a randomized clinical trial that examined the effects of a dyadic‐based intervention on psychological outcomes for patients with advanced cancer and family caregivers (N = 484 dyads). Illness uncertainty and QOL were measured using the shorten version of the Mishel Uncertainty in Illness Scale for Adult and the Functional Assessment of Cancer Therapy, respectively. The actor–partner interdependence model was used to examine whether an individual's uncertainty (either a patient's or caregiver's) was associated with their own QOL (i.e., an actor effect) and/or their partner's QOL (i.e., a partner effect).

Results

Significant actor effects included a negative association between patients' uncertainty and their own QOL (b = −0.422; p < 0.001) and a negative association between caregivers' uncertainty and their own QOL (b = −0.408; p < 0.001). In terms of partner effects, patients' uncertainty was negatively associated with caregivers' QOL (b = −0.095; p < 0.01). No partner effect was found for caregivers, suggesting that caregivers' uncertainty was not related to patients' QOL.

Conclusions

Study findings support targeted interventions offered to both patients and their family caregivers to manage their illness uncertainty and improve their QOL.
Cardiorespiratory monitoring with a wireless and nonadhesive belt measuring diaphragm activity in preterm and term infants: A multicenter non‐inferiority study
Authors: Scholten Anouk W. J. , Zhan Zhuozhao , Niemarkt Hendrik J. , Vervoorn Marieke , van Leuteren Ruud W. , de Jongh Frans H. , van Kaam Anton H. , Heuvel Edwin R. van den , Hutten Gerard J.
Published: October 2023

Introduction

We determined if the heart rate (HR) monitoring performance of a wireless and nonadhesive belt is non‐inferior compared to standard electrocardiography (ECG). Secondary objective was to explore the belt's respiratory rate (RR) monitoring performance compared to chest impedance (CI).

Method

In this multicenter non‐inferiority trial, preterm and term infants were simultaneously monitored with the belt and conventional ECG/CI for 24 h. HR monitoring performance was estimated with the HR difference and ability to detect cardiac events compared to the ECG, and the incidence of HR‐data loss per second. These estimations were statistically compared to prespecified margins to confirm equivalence/non‐inferiority. Exploratory RR analyses estimated the RR trend difference and ability to detect apnea/tachypnea compared to CI, and the incidence of RR‐data loss per second.

Results

Thirty‐nine infants were included. HR monitoring with the belt was non‐inferior to the ECG with a mean HR difference of 0.03 beats per minute (bpm) (standard error [SE] = 0.02) (95% limits of agreement [LoA]: [−5 to 5] bpm) (p < 0.001). Second, sensitivity and positive predictive value (PPV) for cardiac event detection were 94.0% (SE = 0.5%) and 92.6% (SE = 0.6%), respectively (p ≤ 0.001). Third, the incidence of HR‐data loss was 2.1% (SE = 0.4%) per second (p < 0.05). The exploratory analyses of RR showed moderate trend agreement with a mean RR‐difference of 3.7 breaths/min (SE = 0.8) (LoA: [−12 to 19] breaths/min), but low sensitivities and PPV's for apnea/tachypnea detection. The incidence of RR‐data loss was 2.2% (SE = 0.4%) per second.

Conclusion

The nonadhesive, wireless belt showed non‐inferior HR monitoring and a moderate agreement in RR trend compared to ECG/CI. Future research on apnea/tachypnea detection is required.
Spraying performance of umbrella wind‐field‐type atomization and its application to parameter optimization
Authors: Li Shaobo , Li Jianping , Zhang Ruirui , Yu Shaomeng , Wang Pengfei , Liu Hongjie , Yang Xin
Published: October 2023

BACKGROUND

We designed an umbrella wind‐field‐type anti‐drift spraying device to improve droplet deposit in the fruit tree canopy, reduce spray drift between fruit tree rows, and avoid uneven droplet deposit in the canopy.

RESULTS

We used Computational Fluid Dynamics combined with wind field tests to optimize the parameters of the anti‐drift spray device, and the results showed that airflow velocity at the outlet of the device after optimization was 24.5 m s−1, which is 48% higher than that before optimization (16.5 m s−1) airflow velocity. We designed wind tunnel tests and field tests to analyze the anti‐drift characteristics of the anti‐drift spraying device. Wind tunnel test results showed that the side airflow velocity, outlet diameter, spray distance, and spray drift ratio were correlated. The mathematical models established by vertical and horizontal multifactor orthogonal tests were significant (P < 0.05, R2 0.947, 0.878, respectively). The results of the field tests showed that side airflow, velocity spray pressure and outlet diameter had significant effects on the droplet deposit characteristics (in descending order: the side airflow velocity, spray pressure, and outlet diameter). The maximum droplet deposit was 6.34 μL cm−2 when the side airflow velocity was 2 m s−1, the spray pressure was 0.4 MPa, and the outlet diameter was 70 mm2. When the side airflow velocity exceeded 2 m s−1, the outlet diameter and spray pressure had to be reduced to ensure better droplet deposit.

CONCLUSION

The results indicated that the umbrella wind field could reduce spray drift and ineffective deposit in off‐target areas and provides a reference for the comprehensive analysis of the spray drift deposit law. © 2023 Society of Chemical Industry.
Sublethal concentrations of pymetrozine reduce Sogatella furcifera transmission of Southern rice black‐streaked dwarf virus
Authors: Yu Jing , Zhong Yuqi , Dai Changgeng , Hou Maolin
Published: October 2023

BACKGROUND

The transmission of plant viruses is closely associated with the specific probing behaviors of the vectors. Pymetrozine is a pyridine azomethine insecticide that interferes with nervous regulation of feeding behavior of piercing‐sucking insects. This study aimed to evaluate the potential of sublethal concentrations of pymetrozine in reducing the transmission of Southern rice black‐streaked dwarf virus (SRBSDV) by the planthopper Sogatella furcifera.

RESULTS

Laboratory assays showed that both acquisition and inoculation rates of SRBSDV decreased significantly in the planthoppers feeding on plants treated with lethal concentrations 10% and 50% (LC10 and LC50) pymetrozine compared with the insects feeding on the control plants, for which significant effects of pymetrozine concentration and time post‐treatment were detected. Honeydew excretion of the planthoppers showed significant reduction with increasing concentration of the insecticide but no significant association with time post‐treatment. Electrical penetration graph recordings revealed that total durations of each waveform in both acquisition and inoculation were significantly affected by pymetrozine treatment, with total durations of non‐probing (NP), penetration initiation (N1), and extracellular activity (N3) elongated whereas those of salivation (N2) and phloem‐related activities (N4‐a and N4‐b) shortened. Additionally, both acquisition and inoculation rates were significantly lower at 168 h than at 6 h post‐treatment.

CONCLUSION

The results indicate that sublethal concentrations of pymetrozine reduce SRBSDV transmission, which is associated with reduction in feeding and alteration in probing behaviors characterized by the prolonged non‐probing, penetration initiation and extracellular activity and shortened salivation and phloem‐related activities. © 2023 Society of Chemical Industry.
Design Simulation of Chalcogenide Absorber‐Based Heterojunction Solar Cell Yielding Manifold Enhancement in Efficiency
Authors: Islam Md Tasirul , Thakur Awalendra Kumar
Published: October 2023

A large efficiency improvement, ≈4.5 times, in a solar cell based on earth‐abundant low‐cost SnS absorber with configuration glass/Mo/SnS/CdS/i‐ZnO/AZO/Al is reported in sharp contrast to prior experimental reports in the literature. Efficiency enhancement is attributed to tailored design at the absorber/buffer interface implemented via two‐step design modification vis‐à‐vis experimental benchmark. Design tailoring using simulation comprises substitution of sulfur composition in SnS by Se followed by replacing CdS buffer layer with wide bandgap, nontoxic Zn (O, S). The effect of sulfur composition variation by Se (i.e., SnS1−xSex) indicates an optimal Se mole fraction (x = 0.4) exhibiting maximum efficiency. In addition, optimization of the thickness, carrier density, and bulk defect density of the SnS1−xSex absorber result in an improved design. Replacing CdS buffer layer by ZnO1−ySy in SnS absorber‐based solar cell results in substantial improvement in device parameters; open circuit voltage (VOC) of ≈86% and current density (JSC) of ≈78% due to optimal band alignment at the SnS1−xSex/ZnO1−ySy heterojunction. It occurs when the sulfur mole fraction is 60% in the absorber layer and 70% in the buffer layer causing efficiency to rise to ≈17.87%. An optimal design comprising all the parameters including metal back contact work function, series and shunt resistance deliver an efficiency of ≈19.2%.
A Threshold‐Voltage and Drain–Source Current Model for Double‐Channel AlxGa1−xN/GaN/AlyGa1−yN/GaN High‐Electron‐Mobility Transistors
Authors: Cai Jing , Yao Ruo-He , Liu Yu-Rong , Geng Kui-Wei
Published: October 2023

A physics‐based threshold voltage and drain–source current model based on double‐channel AlxGa1−xN/GaN/AlyGa1−yN/GaN high‐electron‐mobility transistors (HEMTs) is proposed in this article. Electrons limited in the potential well are derived from ionized donor‐like surface states of the AlxGa1−xN layer. Accumulated 2D electron gases (2DEGs) and positive charges left are equivalent to planar plate capacitors and further form electric fields, weakening the polarization fields in barrier layers. The physical properties of the dual‐channel HEMT are considered holistically rather than two separate and independent single heterojunctions. The effect of the charges and 2DEGs distributed in lower layers on the upper channel is contained in our model as well. Subsequently, a drain–source current model is proposed through coupling the critical electric field with the threshold voltage (VTH). The influence of channel length modulation, short channel effect, self‐heating effect, and kink effect is involved in this model. The accuracy of the proposed models is verified by comparison with technology computer‐aided design simulations and the experimental results. Proposed models can greatly describe the output characteristics, the transmission characteristics, and the relationship between VTH and device parameters of double‐channel AlGaN/GaN HEMTs.
Generalized sliding event‐triggered control for dissipative performance of Markov switching dynamic systems
Authors: Zhao Can , Cao Jinde , Shi Kaibo , Tang Yiqian , Zhong Shouming , Zhong Qishui , Abdel‐Aty Mahmoud
Published: October 2023

In this paper, a generalized sliding event‐triggered control for the closed‐loop Markov switching systems (CLMSSs) is studied. It is proved that the system is driven to the designed sliding mode surface under a given sliding mode controller. A generalized sliding event‐triggered controller is developed to obtain strictly dissipative performance of CLMSSs, in which the combination of sliding mode control and event‐triggering protocol makes the control performance more efficient and generalized. Further, two dissipative criteria for CLMSSs are established. Finally, the results of numerical simulations give a witness for the effectiveness of the given theorems and methods.
Photo‐Rechargeable Asymmetric Supercapacitors Exceeding Light‐to‐Charge Storage Efficiency over 21% under Indoor Light
Authors: Aftabuzzaman Md. , Masud  , Zhou Haoran , Kim Hyung Mun , Kang Yongku , Kim Hwan Kyu
Published: October 2023

Photo‐rechargeable energy storage devices are appealing for substantial research attention because of their possible applications in the Internet of Things (IoT) and low‐powered miniaturized portable electronics. However, due to the incompatibility of the photovoltaics and energy storage systems (ESSs), the overall light‐to‐storage efficiency is limited under indoor light conditions. Herein, a porous carbon scaffold MnO‐Mn3O4/C microsphere‐based monolithic dye‐sensitized photo‐rechargeable asymmetric supercapacitor (DSPC) is fabricated. The integrated DSPC has a high areal specific capacitance of 281.9 mF cm−2 at the discharge rate of 0.01 mA cm−2. The light‐to‐electrical conversion efficiency of the DSSC is 27.6% under the 1000 lux compact fluorescent lamp (CFL). The DSPC shows an outstanding light‐to‐charge storage efficiency of 21.6%, which is higher than that reported ever. Furthermore, the fabricated polymer gel electrolyte‐based quasi‐solid state (QSS) DSPC shows similar overall conversion efficiency with superior cycling capability. This work shows a convenient fabrication process for a wireless power pack of interest with outstanding performance.
Synthesis and application of dual‐layer metal‐organic framework as a fiber coating based on copper‐based metal‐organic framework @ zeolitic imidazolate framework‐8 for solid‐phase microextraction of some selected parabens and their quantification using high performance liquid chromatography
Authors: Mohammed Abeer Fadhil , Ghani Milad , Raoof Jahan Bakhsh
Published: October 2023

Herein, the zeolitic imidazolate framework‐8 template was accommodated onto the surface of a pencil graphite substrate through the electrodeposition system. Then, Zn in the zeolitic imidazolate framework‐8 was replaced with Cu atoms via the galvanic replacement procedure. The modified template was used for the synthesis of another metal‐organic framework (copper‐benzene di carboxylic acid) by a solvothermal method. The prepared fiber was characterized by field emission‐scanning electron microscopy, Fourier transform infrared spectroscopy, and X‐ray diffraction technique. Then, it was employed for direct immersion solid‐phase microextraction of methyl, ethyl, and butyl parabens. Various factors, such as the pH of the sample solution, stirring rate, desorption volume, the concentration of salt, extraction time, and desorption time, were selected and optimized. Under the optimized condition (extraction time = 30 min, desorption time = 2 min, desorption volume = 200 μL, salt concentration = 0% w/v, sample solution pH = 3.0, and stirring rate = 700 rpm), the linearity of the method was in the range of 1–200 μg/L (r2 > 0.9926). The limits of detection and quantification fall between 0.28–0.65 μg/L and 0.91–1.98 μg/L, respectively. The analysis of selected parabens in toothpaste and hand and face lotion, were also done using the suggested methodology.
Deep learning‐based high‐dimensional multiple regression estimator for chest x‐ray image classification in rapid cardiomegaly screening
Authors: Chen Pi‐Yun , Lin Chia‐Hung , Peng Hung‐Yao , Zhang Feng‐Zhou , Kan Chung‐Dann
Published: October 2023

Chest x‐ray (CXR) examination is a common first‐line, non‐invasive, and rapid screening method in clinical examinations. The posteroanterior (PA) and anteroposterior (AP) view modes can both be used to detect related cardiopulmonary diseases, such as pneumonitis, tuberculosis, pulmonary fibrosis, lung tumors, and cardiomegaly. Compared with cardiac computed tomography and cardiac magnetic resonance imaging methods, CXR examination has a short scanning duration and costs less, and is suitable for routine and follow‐up health examinations. Cardiomegaly is an asymptomatic disease in the early stage and cannot be detected through electrocardiography measurements. Thus, early cardiomegaly classes detections, such as cardiac hypertrophy and ventricular dilatation, can help make decisions regarding drug treatments and surgeries. In addition, an automatic assistive tool is required to differentiate between normal individuals and those with cardiomegaly to address the problem of manual inspection and labor shortage. Hence, PA view‐based CXR classification is used to develop a deep learning (DL)‐based high‐dimensional multiple regression analysis (MRA) model for CXR image classification in rapid cardiomegaly screening. This multilayer network model uses a two‐channel three‐layer convolution‐normalization‐pooling process with two‐dimensional (2D) multi convolution operations to enhance images and to extract feature patterns; and then a one‐dimensional feature conversion is used to estimate the four coordinate points of the maximal horizontal cardiac diameter (MHCD) and maximal horizontal thoracic diameter (MHTD), which can be used to estimate cardiothoracic ratio and detect cardiomegaly. For experimental tests, the training and testing datasets are collected from the National Institutes of Health CXR Image Database (Clinical Center, USA), and 10‐fold cross‐validation was used for model evaluation in terms of precision (%), recall (%), accuracy (%), and F1 score. These indexes are used to evaluate the feasibility of the proposed MRA estimator. In addition, the performances of the proposed model are compared with those of conventional DL‐based multilayer classifiers.
Wind speed variability across the UK between 1957 and 2011
Authors: Watson S. J. , Kritharas P. , Hodgson G. J.
Published: October 2023

By using surface data from 57 UK meteorological stations, a national [British Atmospheric Data Centre (BADC)‐57] and regional wind index for the UK has been calculated for the period 1983–2011. For a subset of seven stations, an additional national index (BADC‐7) has been calculated for the period 1957–2011. The indices show an annual variability of 4% over their respective periods, corresponding to a variation in typical wind turbine capacity factor of 7%. These indices are compared with indices calculated from other sources, namely an index generated using a gridded dataset of observed values interpolated across the UK, an index calculated from an area bounding the UK using the ERA‐40 re‐analysis dataset, indices calculated from bilinear interpolation of the ERA‐40 re‐analysis dataset to the 57 and 7 stations and another independent UK wind index. The indices show variation in trends, with all showing some level of decline with the exception of that generated using the ERA‐40 re‐analysis dataset averaged over the UK, which shows a significant increase. The various indices show varying degrees of agreement with correlation coefficients, after trends are removed, ranging between 0.611 and 0.979. The effect of changes in site exposure, instrument bias and measuring height was considered for the BADC‐7 and BADC‐57 indices. The change in instrument measurement height appears to have a significant biasing effect, and it is likely that this along with changes in exposure at urban sites has caused the decline in annual wind speeds observed for some of the indices. There does not appear to be evidence for significant changes in large‐area (mesoscale) surface roughness. The correlation between annual mean wind speeds at the seven surface station sites used to calculate the BADC‐7 index is seen to be quite weak, indicating very localized variations in inter‐annual variability. When regional differences in the index are investigated, it is seen that wind speeds show a very slight decline across the UK in all regions except the south‐east, which shows a slight increase. The greatest decrease is seen in the north‐west. These changes are in the same direction as the tentative predictions given by climate models for future changes in wind speed across the UK, although the uncertainty is large given the large degree of inter‐annual variation. Copyright © 2013 John Wiley & Sons, Ltd.
QCD resummation of dijet azimuthal decorrelations in pp and pA collisions
Authors: Gao Mei-Sen , Kang Zhong-Bo , Shao Ding Yu , Terry John , Zhang Cheng
Published: October 2023

Abstract

We study the azimuthal angular decorrelations of dijet production in both proton-proton (pp) and proton-nucleus (pA) collisions. By utilizing soft-collinear effective theory, we establish the factorization and resummation formalism at the next-to-leading logarithmic accuracy for the azimuthal angular decorrelations in the back-to-back limit in pp collisions. We propose an approach where the nuclear modifications to dijet production in pA collisions are accounted for in the nuclear modified transverse momentum dependent parton distribution functions (nTMDPDFs), which contain both collinear and transverse dynamics. This approach naturally generalizes the well-established formalism related to the nuclear modified collinear parton distribution functions (nPDFs). We demonstrate strong consistency between our methodology and the CMS measurements in both pp and pA collisions, and make predictions for dijet production in the forward rapidity region in pA collisions at LHC kinematics and for mid-rapidity kinematics at sPHENIX. Throughout this paper, we focus on the application of this formalism to a simultaneous fit to both collinear and transverse momentum dependent contributions to the transverse momentum dependent distributions.
The AdS Virasoro-Shapiro amplitude
Authors: Alday Luis F. , Hansen Tobias
Published: October 2023

Abstract

We present a constructive method to compute the AdS Virasoro-Shapiro amplitude, order by order in AdS curvature corrections. At kth order the answer takes the form of a genus zero world-sheet integral involving weight 3k single-valued multiple polylogarithms. The coefficients in our ansatz are fixed, order by order, by requiring: crossing symmetry; the correct supergravity limit; the correct structure of poles, determined by dispersive sum rules; and the dimensions of the first few Konishi-like operators, available from integrability. We explicitly construct the first two curvature corrections. Our final answer then reproduces all localisation results and all CFT data available from integrability, to this order, and produces a wealth of new CFT data for planar $$ \mathcal{N} $$
N
= 4 SYM at strong coupling.
Efficacy and Safety Outcomes for Acute Ischemic Stroke Patients Treated with Intravenous Infusion of Tirofiban After Emergent Carotid Artery Stenting
Authors: Garayzade Rana , Berlis Ansgar , Schiele Stefan , Ertl Michael , Schneider Hauke , Müller Gernot , Maurer Christoph J.
Published: October 2023

Introduction

Emergent stenting of the extracranial internal carotid artery (ICA) in stroke patients requires antiplatelet therapy to prevent in-stent thrombosis with a higher risk of intracranial haemorrhage.

Aim of the Study

Assess the efficacy and safety of emergent carotid stenting with intravenous tirofiban in acute ischemic stroke patients.

Methods

Primary endpoint: symptomatic hemorrhage. Secondary endpoints: 90-day functional outcome and mortality.

Results

Of the 62 patients, 21 (34%) received tirofiban as a single antiplatelet, and 41 (66%) received combined therapy. Premedication with anticoagulants and antiplatelets was significantly more frequent in the tirofiban-only group. The rate of symptomatic haemorrhage was significantly lower in the tirofiban-only group than in the combined group (4.8% vs. 27%, p = 0.046). The patients with tirofiban alone had a significantly better functional outcome at day 90 than the combined group (52% vs. 24%, p = 0.028). Mortality was equal (24%) in both groups. Pre-interventional NIHSS score (p = 0.003), significant blood pressure fluctuations (p = 0.012), tandem occlusion (p = 0.023), and thrombolysis (p = 0.044) showed relevant influence on the rate of symptomatic hemorrhage in the entire patient cohort.

Conclusions

A single antiplatelet therapy with tirofiban regardless of the premedication may improve the functional outcome in patients with stroke due to acute extracranial carotid lesion and emergent carotid stenting with lower rates of serious intracranial haemorrhage.

For patients with high pre-interventional NIHSS score, tandem occlusion and after pre-interventional thrombolysis, caution is advised. Additionally, strict blood pressure monitoring should be conducted during the first 72 h after intervention.
Evaluation zur Zufriedenheit mit und Be‑/Entlastung durch ein hausarztzentriertes Demenzversorgungsmodell: Frühe Information und Hilfen bei Demenz (FIDEM) in Göttingen
Authors: Demmer Iris , Belz Michael , Oberbach Lea , Hummers Eva , Wiltfang Jens , Bartels Claudia
Published: October 2023

Hintergrund

FIDEM (Frühe Informationen und Hilfen bei Demenz) ist ein sektorenübergreifendes, hausarztzentriertes Netzwerkmodell zur nachhaltigen Verbesserung der ambulanten Versorgungssituation von Demenzbetroffenen und ihren Angehörigen durch gezielte und aufsuchende Vermittlung an nichtärztliche Versorger.

Ziel der Arbeit

Beschreibung der Implementierung von FIDEM in Göttingen und explorative Evaluation des Projekts hinsichtlich Zufriedenheit sowie Be‑/Entlastung der teilnehmenden Kooperationspartner (TN).

Material und Methoden

FIDEM wurde 2017 in Göttingen etabliert. Quartiersbezogene Netzwerke bestanden aus hausärztlichen und nichtärztlichen Kooperationspartnern (Ergotherapeuten, Pflegeberatungsstellen, Anbieter zur Unterstützung im Alltag, ambulante Pflege, Selbsthilfe). TN wurden zum FIDEM-Vermittlungspfad geschult. Im Rahmen halbjährlicher Netzwerktreffen wurde die Evaluation des Versorgungsmodells zu o. g. Aspekten mit einem selbst entwickelten Fragebogen im Zeitraum 08/2017 bis 10/2019 durchgeführt.

Ergebnisse

In sieben Netzwerken nahmen bis Oktober 2019 29 Hausarztpraxen und 46 nichtärztliche Kooperationseinrichtungen teil. In die Evaluation wurden n = 80 Personen (n = 22 TN aus Hausarztpraxen, n = 58 nichtärztliche TN) einbezogen. Es ergaben sich hohe Zufriedenheitswerte auf allen Skalen (M von 7,22–7,87 bei einem möglichen Maximalwert von „10“), teils höher ausgeprägt bei den TN aus Hausarztpraxen. Alle Berufsgruppen gaben eine generelle Entlastung durch die Teilnahme an, diese war bei den Hausarztpraxen signifikant stärker ausgeprägt (alle p-Werte < 0,001).

Diskussion

FIDEM konnte außerhalb einer geförderten Modellprojektphase in Göttingen implementiert werden. Hohe Zufriedenheit und die Angabe von Entlastung sprechen für eine Fortführung mit einer vollumfänglichen Evaluation und – unter der Voraussetzung positiver Ergebnisse – für eine Verstetigung des Versorgungsmodells und einen Transfer in weitere Landkreise in Deutschland.
Less wear in deep‐dished mobile compared to fixed bearing total knee arthroplasty of the same design at 5‐year follow‐up: a randomised controlled model‐based Roentgen stereophotogrammetric analysis trial
Authors: Kalaai S. , Most J. , van Dun B. , Kaptein B. L. , Tilman P. B. J. , Boonen B. , Schotanus M. G. M.
Published: October 2023

Purpose

The aim of this prospective randomised controlled study was to compare wear characteristics and functional outcome between deep‐dished mobile bearing (MB) and fixed bearing (FB) cemented total knee arthroplasty (TKA). We hypothesised that deep‐dished MB reduces polyethylene wear and improves patient‐reported outcome measures.

Methods

A total of 50 patients were randomised to receive a MB or FB tibia component of the same cemented TKA design. Patients were evaluated over a 5‐year follow‐up period. Medial and lateral wear were assessed using model‐based Roentgen Stereophotogrammetric Analysis (RSA) and compared with the direct postoperative minimal joint space measurement. Functional outcome was assessed by the clinician‐derived KSS and OKS, WOMAC, LEAS, and FJS‐12. All data were derived using a general linear mixed model.

Results

At 5‐year follow‐up, decreased wear in the MB compared to the FB group was observed on the lateral side (0.07 ± 0.17 mm, p = 0.026), but not on the medial side (0.31 ± 0.055 mm, p = 0.665). Functional outcomes improved with a statistical significant effect over time, with no significant differences between groups (all p > 0.17).

Conclusion

This model‐based RSA study with 5‐year follow‐up showed that cemented deep‐dished MB reduced lateral polyethylene wear as compared to FB in a single TKA system, whilst clinical outcomes were comparable. Longer follow‐up is needed to establish clinical implications of these altered wear patterns and determine type of wear.

Level of evidence

Level 1 randomised controlled trial.
Sharp Besov capacity estimates for annuli in metric spaces with doubling measures
Authors: Björn Anders , Björn Jana
Published: October 2023

We obtain precise estimates, in terms of the measure of balls, for the Besov capacity of annuli and singletons in complete metric spaces. The spaces are only assumed to be uniformly perfect with respect to the centre of the annuli and equipped with a doubling measure.
Fake paper identification in the pool of withdrawn and rejected manuscripts submitted to Naunyn–Schmiedeberg’s Archives of Pharmacology
Authors: Wittau Jonathan , Celik Serkan , Kacprowski Tim , Deserno Thomas M. , Seifert Roland
Published: October 2023

Honesty of publications is fundamental in science. Unfortunately, science has an increasing fake paper problem with multiple cases having surfaced in recent years, even in renowned journals. There are companies, the so-called paper mills, which professionally fake research data and papers. However, there is no easy way to systematically identify these papers. Here, we show that scanning for exchanged authors in resubmissions is a simple approach to detect potential fake papers. We investigated 2056 withdrawn or rejected submissions to Naunyn–Schmiedeberg’s Archives of Pharmacology (NSAP), 952 of which were subsequently published in other journals. In six cases, the stated authors of the final publications differed by more than two thirds from those named in the submission to NSAP. In four cases, they differed completely. Our results reveal that paper mills take advantage of the fact that journals are unaware of submissions to other journals. Consequently, papers can be submitted multiple times (even simultaneously), and authors can be replaced if they withdraw from their purchased authorship. We suggest that publishers collaborate with each other by sharing titles, authors, and abstracts of their submissions. Doing so would allow the detection of suspicious changes in the authorship of submitted and already published papers. Independently of such collaboration across publishers, every scientific journal can make an important contribution to the integrity of the scientific record by analyzing its own pool of withdrawn and rejected papers versus published papers according to the simple algorithm proposed in the present paper.
First experience with real-time magnetic resonance imaging-based investigation of respiratory influence on cardiac function in pediatric congenital heart disease patients with chronic right ventricular volume overload
Authors: Röwer Lena Maria , Radke Karl Ludger , Hußmann Janina , Malik Halima , Eichinger Monika , Voit Dirk , Wielpütz Mark Oliver , Frahm Jens , Klee Dirk , Pillekamp Frank
Published: October 2023

Background

Congenital heart disease (CHD) is often associated with chronic right ventricular (RV) volume overload. Real-time magnetic resonance imaging (MRI) enables the analysis of cardiac function during free breathing.

Objective

To evaluate the influence of respiration in pediatric patients with CHD and chronic RV volume overload.

Methods and materials

RV volume overload patients (n=6) and controls (n=6) were recruited for cardiac real-time MRI at 1.5 tesla during free breathing. Breathing curves from regions of interest reflecting the position of the diaphragm served for binning images in four different tidal volume classes, each in inspiration and expiration. Tidal volumes were estimated from these curves by data previously obtained by magnetic resonance-compatible spirometry. Ventricular volumes indexed to body surface area and Frank-Starling relationships referenced to the typical tidal volume indexed to body height (TTVi) were compared.

Results

Indexed RV end-diastolic volume (RV-EDVi) and indexed RV stroke volume (RV-SVi) increased during inspiration (RV-EDVi/TTVi: RV load: + 16 ± 4%; controls: + 22 ± 13%; RV-SVi/TTVi: RV load: + 21 ± 6%; controls: + 35 ± 17%; non-significant for comparison). The increase in RV ejection fraction during inspiration was significantly lower in RV load patients (RV load: + 1.1 ± 2.2%; controls: + 6.1 ± 1.5%; P=0.01). The Frank-Starling relationship of the RV provided a significantly reduced slope estimate in RV load patients (inspiration: RV load: 0.75 ± 0.11; controls: 0.92 ± 0.02; P=0.02).

Conclusion

In pediatric patients with CHD and chronic RV volume overload, cardiac real-time MRI during free breathing in combination with respiratory-based binning indicates an impaired Frank-Starling relationship of the RV.

Graphical Abstract
Breast Implant Capsule-Associated Squamous Cell Carcinoma: A Systematic Review and Case Presentation
Authors: Badri Danniel , Copertino Nicolas
Published: October 2023

Breast implant capsule-associated squamous cell carcinoma is exceedingly rare, with only eleven previously published cases. The present study systematically reviews the current literature and describes an additional case in a 56-year-old patient who had undergone previous breast implant augmentation with textured silicone implants 22 years prior. Systematic review of the literature demonstrated a scarcity of reported cases, yielding only eleven other incidences. Symptomatology for this patient involved pain, swelling, and erythema of the right breast prior to eventual surgery. Magnetic resonance imaging reporting extensive oedema and a large periprosthetic effusion with lobulated changes. The patient proceeded with bilateral capsulectomies and histology demonstrated moderately differentiated squamous cell carcinoma, areas of squamous metaplasia, and a chronic inflammatory cell infiltrate. Postoperatively, a positron-emission tomography scan showed no concerning uptake of fluorodeoxyglucose and no evidence of metastatic disease. The patient proceeded to a right-sided total mastectomy and axillary lymph node biopsy. Final histology demonstrated remnant well-differentiated squamous cell carcinoma, whilst five lymph nodes were negative of disease. The patient received postoperative radiation therapy. A clinical history of swelling and pain appears to be a common presentation for this condition. Aspirations of periprosthetic collections containing squamous cells should be considered concerning for neoplasm. The presence of squamous metaplasia within the specimen provides some credence for transformation to invasive carcinoma mediated through chronic inflammation. The presence of perineural invasion would be worth reporting in future cases as it may confer similar risk characteristics as in cutaneous squamous cell carcinoma. A finding of remnant carcinoma during completion mastectomy provides support for an aggressive approach to surgical resection.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Ultra-processed foods, dietary diversity and micronutrient intakes in the Australian population
Authors: Houshialsadat Zeinab , Cediel Gustavo , Sattamini Isabela , Scrinis Gyorgy , Machado Priscila
Published: October 2023

Purpose

This cross-sectional study aimed to assess the association between ultra-processed foods consumption and dietary diversity and micronutrient intake in Australia.

Methods

As part of the Nutrition and Physical Activity Survey (2011–2012), 12,153 participants aged 2 years and above were recruited and interviewed. Dietary intake data were collected by two 24-h dietary recalls using the Automated Multiple-Pass Method. The NOVA classification system was used to group the food items based on the extent and purpose of industrial food processing. The mean micronutrient contents were calculated for the total diet, and for two diet fractions; one made up entirely of ultra-processed foods (NOVA group 4) and the other consisting of all non-ultra-processed foods (aggregation of NOVA food groups 1 to 3). The mean micronutrient content in the ultra-processed and non-ultra-processed food diet fractions were compared. Dietary diversity was measured using the ten Food Group Indicators (FGI) of the Food and Agriculture Organization and was defined as the sum number of FGIs per individual. Multiple linear regression models were used to assess the association between the quintiles of energy contribution of ultra-processed foods, dietary diversity, and micronutrient intake.

Results

A negative association was found between quintiles of energy contribution of ultra-processed foods and dietary diversity (β = − 0.43; p < 0.001). The overall micronutrient content was lower in the diet fraction dominated by ultra-processed foods compared to the non-ultra-processed food diet fraction in the study population. The dietary contents of vitamins A, E, C, B9, B12, zinc, calcium, iron, magnesium, potassium, and phosphorus were reduced significantly with increased consumption of ultra-processed foods, even after adjustment for sociodemographic factors and dietary diversity.

Conclusion

The quintiles of energy contribution of ultra-processed foods were negatively associated with dietary diversity and micronutrient intake in Australia.
Sex-driven neighborhood effects on herbivory in the dioecious Mediterranean palm Chamaerops humilis L.
Authors: Muñoz-Gallego Raquel , Wiegand Thorsten , Traveset Anna , Fedriani Jose M.
Published: October 2023

Although it is well recognized that the strength of plant–herbivore interactions can vary with the plant sex, the distance, and the density of conspecific neighbors, no study has yet assessed their combined influence. Here, we filled this knowledge gap by focusing on the dioecious palm Chamaeropshumilis L., and its two main herbivores, the invasive moth Paysandisiaarchon Burmeister and the feral goat Caprahircus L. We evaluated levels and spatial patterns of herbivory, as well as those of plant size and number of inflorescences in two palm populations in Mallorca (Balearic Islands, Spain). Our spatial point pattern analyses revealed that palms not affected by moth herbivory or goat florivory were spatially aggregated, goats fed more strongly upon inflorescences in palms with more neighbors, but they consumed more leaves in isolated palms. Interestingly, we could reveal for the first time that plant sex is a key plant trait modulating neighborhood effects. For instance, whereas aggregated female palms experienced lower intensity of goat florivory than isolated ones, male palms showed the opposite pattern. Palm size and number of inflorescences also showed sex-related differences, suggesting that sexual dimorphism is a key driver of the observed neighborhood effects on herbivory. Our study highlights the importance of considering relevant plant traits such as sex when investigating plant neighborhood effects, calling for further research to fully understand the dynamics governing plant–herbivore interactions in dioecious systems.
Selection of surgical modality for massive splenomegaly in children
Authors: Li Yong , Wang Congjun , Chen Weilong , Chen Chao , Tang Xianming , Wang Hong , Chen Jiabo , Liu Qiang , Li Wei , Li Yanqiang , Chen Peng , Luo Yige , Su Cheng
Published: October 2023

Background

Laparoscopic splenectomy (LS), a treatment for both benign and malignant splenic diseases, can prove technically challenging in patients with massive splenomegaly. In particular, the optimal surgical modality for treating massive splenomegaly in children remains controversial.

Methods

The clinicopathologic data of 289 pediatric patients undergoing splenectomy for massive splenomegaly were studied in a retrospective analysis. Accordingly, the patients were classified into the LS surgery group and open splenectomy (OS) surgery group. In the laparoscopy cohort, they were separated into two subgroups according to the method of surgery: the multi-incision laparoscopic splenectomy (MILS) and the single-incision laparoscopic splenectomy (SILS) surgery groups, respectively. Patient demographics, clinical data, surgery, complications, and postoperative recovery underwent analysis. Concurrently, we compared the risk of adverse laparoscopic splenectomy outcomes utilizing univariable and multivariable logistic regression.

Results

The total operation time proved remarkably shorter in the OS group in contrast to the LS group (149.87 ± 61.44 versus 188.20 ± 52.51 min, P < 0.001). Relative to the OS group, the LS group exhibited lowered postoperative pain scores, bowel recovery time, and postoperative hospitalization time (P < 0.001). No remarkable difference existed in post-operation complications or mortality (P > 0.05). Nevertheless, the operation duration was remarkably longer in the SILS surgery group than in the MILS surgery group (200 ± 46.11 versus 171.39 ± 40.30 min, P = 0.02). Meanwhile, the operative duration of MILS and SILS displayed a remarkable positive association with splenic length. Moreover, the operative duration of SILS displayed a remarkable positive association with the age, weight, and height of the sick children. Splenic length proved an independent risk factor of adverse outcomes (P < 0.001, OR 1.378).

Conclusions

For pediatric patients with massive splenomegaly who can tolerate prolonged anesthesia and operative procedures, LS surgery proves the optimal treatment regimen. SILS remains a novel surgery therapy which may be deemed a substitutional surgery approach for treating massive splenomegaly.