bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Influencing the Intention to Pursue Surgery among Female Pre‐Medical Students: A Cross‐Sectional Study in Pakistan
Authors: Martins Russell Seth , Fatimi Asad Saulat , Ladak Shamila , Jehanzeb Hamzah , Saleh Raisa , Kumar Gaurav , Kaleem Shamama , Saad Muhammad , Akbar Inaara , Abbas Manzar , Nadeem Sarah , Malik Mahim A.
Published: May 2022

Background

While gender disparities in surgery are documented worldwide, it is unclear to what extent women consider surgery as a career before embarking on their medical school journey. This study aimed to report the percentage of pre‐medical women in Pakistan who intend to eventually specialize in surgery and assess the factors motivating and deterring this decision.

Methods

An online survey was conducted among female pre‐medical (high school) students across Pakistan. Multivariable logistic regression was performed to determine motivating and deterring factors associated with the intention to pursue surgery.

Results

Out of 1219 female high‐school students, 764 (62.7) intended to join medical school. Among these 764, only 9.8% reported an exclusive intent to pursue surgery, while just 20.3% reported considering other specialties in addition to surgery. Significant motivators to pursue surgery exclusively were the intellectual satisfaction of pursuing surgery (adjusted odds ratio: 2.302), having opportunities to travel internationally for work (2.300) and use cutting‐edge technology (2.203), interest in the specialty of surgery (2.031), the social prestige of becoming a surgeon (1.910), and considering one's personality well‐suited to surgery (1.888). Major deterrents included the lack of interest in surgery (adjusted odds ratio: 3.812), surgical education and training being too difficult (2.440) and lengthy (1.404), and the risk of aggressive behavior from patients (2.239).

Conclusion

Even before entering medical school, most female pre‐medical students have already decided against considering a future surgical career. Deterrents likely stem from women being pressured to conform to deep‐seated societal expectations to dedicate their time and energy to domestic responsibilities.
Intraoperative ultrasonography in laminectomy for degenerative cervical spondylotic myelopathy: a clinical and radiological evaluation
Authors: Biczok Annamaria , Fuetsch Manuel , Siller Sebastian , Patzig Maximilian , Tonn Joerg-Christian , Zausinger Stefan
Published: May 2022

Background

The incidence of cervical myelopathy due to spinal stenosis is constantly growing in an aging population. Especially in multisegmental disease, dorsal laminectomy is the intervention of choice. Intraoperative imaging with ultrasound might provide additional information about extent and sufficiency of spinal cord decompression.

Methods

In this prospective study, the width of the subarachnoid space was systematically measured by intraoperative ultrasound at predefined sites at the cranial and caudal edge of decompression in axial and sagittal reconstruction. These data were compared with corresponding sites on postoperative T2-weighted MRI imaging. In addition, the functional outcome was assessed by modified Japanese Orthopaedic Association (mJOA) score. A historical patient cohort treated without ultrasound-guided laminectomy served as control group.

Results

Altogether, 29 patients were included. According to mJOA score at last follow-up, 7/29 patients reported stable symptoms and 21/29 patients showed a substantial benefit with no or minor residual neurological deficits. One patient suffered from a new C5 palsy. Intraoperative ultrasound-guided posterior decompression provided excellent overview in all cases. Measurement of the width of the subarachnoid space acquired by intraoperative ultrasound and postoperative MRI images showed a very high correlation, especially at the cranial level (p < 0.001, r = 0.880). Bland–Altman analysis showed that most patients were within the 1.96 × SD limits of agreement throughout all measurements. No ultrasound procedure-related complications were observed. Compared to a historical cohort of 27 patients, no significant differences were found regarding functional outcome (p = 0.711).

Conclusion

Intraoperative sonography visualises the surgically achieved restoration of the subarachnoid space in good correlation with postoperative MRI and might serve as a fast, precise and reliable tool for intraoperative imaging in cervical laminectomy. However, we could not demonstrate a clinical benefit with regard to functional outcome.
Low-latency query compilation
Authors: Funke Henning , Mühlig Jan , Teubner Jens
Published: May 2022

Query compilation is a processing technique that achieves very high processing speeds but has the disadvantage of introducing additional compilation latencies. These latencies cause an overhead that is relatively high for short-running and high-complexity queries. In this work, we present Flounder IR and ReSQL, our new approach to query compilation. Instead of using a general purpose intermediate representation (e.g., LLVM IR) during compilation, ReSQL uses Flounder IR, which is specifically designed for database processing. Flounder IR is lightweight and close to machine assembly. This simplifies the translation from IR to machine code, which otherwise is a costly translation step. Despite simple translation, compiled queries still benefit from the high processing speeds of the query compilation technique. We analyze the performance of our approach with micro-benchmarks and with ReSQL, which employs a full translation stack from SQL to machine code. We show reductions in compilation times up to two orders of magnitude over LLVM and show improvements in overall execution time for TPC-H queries up to 5.5
$$\times $$
×
over state-of-the-art systems.
Regional variations in nephrology trainee confidence with clinical skills may relate to the availability of local training opportunities in the UK: results from a national survey
Authors: Selvaskandan Haresh , Baharani Jyoti , Hamer Rizwan
Published: May 2022

Background

The United Kingdom offers a standardised training program for nephrology fellows. However, local training opportunities vary resulting in mismatches between trainee interests and accessible opportunities. This may impact trainee confidence, satisfaction, and future service provision.

Methods

A survey assessing confidence with key procedures and sub-specialities was disseminated. Associations with region of training were probed using Chi square tests, with significance set at p < 0.0008 following a Bonferroni correction. Results were compared to trainee views on available opportunities for development.

Results

139 responses were received (32% response rate, demographics representative of the UK nephrology trainee cohort). Procedural independence varied from 98% for temporary femoral vascular catheters to 5% for peritoneal dialysis catheters (PDIs). Independence with inserting tunnelled vascular catheters varied with region (p < 0.0001). Trainees expressed a desire for formal training in kidney ultrasound scanning and PDIs, corresponding with procedures they had least opportunity to become independent with. Trainees felt least confident managing kidney disease in pregnancy. Suggestions for improving training included protected time for garnering sub-speciality knowledge, developing procedural skills and for experiencing practice in other nephrology units.

Conclusions

A mismatch between trainee interests and professional development opportunities exists, which may threaten trainee autonomy and impact patient care particularly with regards to peritoneal dialysis. Provisions to facilitate trainee directed development need to be made while balancing the rigors of service provision. Such measures could prove critical to promoting trainee well-being and preventing attrition within the nephrology workforce.
Biochar for agronomy, animal farming, anaerobic digestion, composting, water treatment, soil remediation, construction, energy storage, and carbon sequestration: a review
Authors: Osman Ahmed I. , Fawzy Samer , Farghali Mohamed , El-Azazy Marwa , Elgarahy Ahmed M. , Fahim Ramy Amer , Maksoud M. I. A. Abdel , Ajlan Abbas Abdullah , Yousry Mahmoud , Saleem Yasmeen , Rooney David W.
Published: May 2022

In the context of climate change and the circular economy, biochar has recently found many applications in various sectors as a versatile and recycled material. Here, we review application of biochar-based for carbon sink, covering agronomy, animal farming, anaerobic digestion, composting, environmental remediation, construction, and energy storage. The ultimate storage reservoirs for biochar are soils, civil infrastructure, and landfills. Biochar-based fertilisers, which combine traditional fertilisers with biochar as a nutrient carrier, are promising in agronomy. The use of biochar as a feed additive for animals shows benefits in terms of animal growth, gut microbiota, reduced enteric methane production, egg yield, and endo-toxicant mitigation. Biochar enhances anaerobic digestion operations, primarily for biogas generation and upgrading, performance and sustainability, and the mitigation of inhibitory impurities. In composts, biochar controls the release of greenhouse gases and enhances microbial activity. Co-composted biochar improves soil properties and enhances crop productivity. Pristine and engineered biochar can also be employed for water and soil remediation to remove pollutants. In construction, biochar can be added to cement or asphalt, thus conferring structural and functional advantages. Incorporating biochar in biocomposites improves insulation, electromagnetic radiation protection and moisture control. Finally, synthesising biochar-based materials for energy storage applications requires additional functionalisation.
Associations with sub-optimal clinic attendance and reasons for missed appointments among heterosexual women and men living with HIV in London
Authors: Howarth A R , Apea V , Michie S , Morris S , Sachikonye M , Mercer C H , Evans A , Delpech V C , Sabin C , Burns F M
Published: May 2022

Poor engagement in HIV care is associated with poorer health outcomes and increased mortality. Our survey examined experiential and circumstantial factors associated with clinic attendance among women (n = 250) and men (n = 106) in London with heterosexually-acquired HIV. While no associations were found for women, among men, sub-optimal attendance was associated with insecure immigration status (25.6% vs. 1.8%), unstable housing (32.6% vs. 10.2%) and reported effect of HIV on daily activities (58.7% vs. 40.0%). Among women and men on ART, it was associated with missing doses of ART (OR = 2.96, 95% CI:1.74–5.02), less belief in the necessity of ART (OR = 0.56, 95% CI:0.35–0.90) and more concern about ART (OR = 3.63, 95% CI:1.45–9.09). Not wanting to think about being HIV positive was the top reason for ever missing clinic appointments. It is important to tackle stigma and the underlying social determinants of health to improve HIV prevention, and the health and well-being of people living with HIV.
Auricular vagus nerve stimulator for closed-loop biofeedback-based operation
Authors: Dabiri Babak , Zeiner Klaus , Nativel Arnaud , Kaniusas Eugenijus
Published: May 2022

Auricular vagus nerve stimulation (aVNS) is a novel neuromodulatory therapy used for treatment of various chronic systemic disorders. Currently, aVNS is non-individualized, disregarding the physiological state of the patient and therefore making it difficult to reach optimum therapeutic outcomes. A closed-loop aVNS system is required to avoid over-stimulation and under-stimulation of patients, leading to personalized and thus improved therapy. This can be achieved by continuous monitoring of individual physiological parameters that serve as a basis for the selection of optimal aVNS settings. In this work we developed a novel aVNS hardware for closed-loop application, which utilizes cardiorespiratory sensing using embedded sensors (and/or external sensors), processes and analyzes the acquired data in real-time, and directly governs settings of aVNS. We show in-lab that aVNS stimulation can be arbitrarily synchronized with respiratory and cardiac phases (as derived from respiration belt, electrocardiography and/or photo plethysmography) while mimicking baroreceptor-related afferent input along the vagus nerve projecting into the brain. Our designed system identified > 90% of all respiratory and cardiac cycles and activated stimulation at the target point with a precision of ± 100 ms despite the intrinsic respiratory and heart rate variability reducing the predictability. The developed system offers a solid basis for future clinical research into closed-loop aVNS in favour of personalized therapy.
COVID19 epidemic outbreak: operating rooms scheduling, specialty teams timetabling and emergency patients' assignment using the robust optimization approach
Authors: Arab Momeni Mojtaba , Mostofi Amirhossein , Jain Vipul , Soni Gunjan
Published: May 2022

The health care system is characterized by limited resources, including the physical facilities as well as skilled human resources. Due to the extensive fixed cost of medical facilities and the high specialization required by the medical staff, the problem of resource scarcity in a health care supply chain is much more acute than in other industries. In the pandemic of the Coronavirus, where medical services are the most important services in communities, and protective and preventive guidelines impose new restrictions on the system, the issue of resource allocation will be more complicated and significantly affect the efficiency of health care systems. In this paper, the problem of activating the operating rooms in hospitals, assigning active operating rooms to the COVID-19 and non-COVID-19 patients, assigning specialty teams to the operating rooms and assigning the elective and emergency patients to the specialty teams, and scheduling their operations is studied by considering the new constraints of protective and preventive guidelines of the Coronavirus. To address these issues, a mixed-integer mathematical programming model is proposed. Moreover, to consider the uncertainty in the surgery duration of elective and emergency patients, the stochastic robust optimization approach is utilized. The proposed model is applied for the planning of operating rooms in the cardiovascular department of a hospital in Iran, and the results highlight the role of proper management in supplying sufficient medical resources effectively to respond to patients and scheduled surgical team to overcome the pressure on hospital resources and medical staff results from pandemic conditions.
Unsupervised statistical concept drift detection for behaviour abnormality detection
Authors: Friedrich Björn , Sawabe Taishi , Hein Andreas
Published: May 2022

Abnormal behaviour can be an indicator for a medical condition in older adults. Our novel unsupervised statistical concept drift detection approach uses variational autoencoders for estimating the parameters for a statistical hypothesis test for abnormal days. As feature, the Kullback–Leibler divergence of activity probability maps derived from power and motion sensors were used. We showed the general feasibility (min. F1-Score of 91 %) on an artificial dataset of four concept drift types. Then we applied our new method to our real–world dataset collected from the homes of 20 (pre–)frail older adults (avg. age 84.75 y). Our method was able to find abnormal days when a participant suffered from severe medical condition.
Long-term Energy Cost Labelling for Appliances: Evidence from a Randomised Controlled Trial in Ireland
Authors: Denny E.
Published: May 2022

Given the longevity of investments in energy-consuming products (such as household appliances, vehicles, and properties), underinvestment in energy efficiency can have long-lasting negative economic and environmental consequences. Previous research has indicated that underinvestment may be due to imperfect information in relation to the long-term benefits of investing in energy efficiency. This paper presents the results of a cluster randomised controlled trial examining an intervention which aims to overcome this information deficit by providing long-term energy cost information on appliances in an electrical retail chain in Ireland. Two treatments are considered: a label showing 10-year energy cost information based on typical usage for four appliance categories (fridge freezers, dishwashers, washing machines, and tumble dryers); and a second treatment which supplements this label with a QR code where consumers can gain personalised cost estimates based on their expected appliance usage. Results indicate that neither of the treatments resulted in an increase in the average energy efficiency of appliances sold. Also, engagement of customers with the QR code was extremely low. Given that the newly designed EU energy labels incorporate QR codes for personalisation, this low usage suggests that this element of the new labels may be ineffective in increasing the uptake of energy efficiency. Finally, a customer survey suggests that while the treatment increased the stated importance of energy efficiency in decision-making, this did not translate into an increase in efficiency of products purchased, i.e., stated preferences for energy efficiency did not translate into revealed purchasing preferences.
Expendable Lives: Race and Segmented Representation in the Politics of Crime and Criminal Justice in the United States
Authors: Xenakis Sappho , Cheliotis Leonidas K.
Published: May 2022

One of the most enduring debates in the study of the evolution of criminal justice policy in the United States concerns the role of public opinion. Two viewpoints have thus far dominated pertinent scholarship, with one claiming that criminal justice policy has been genuinely responsive to changes in public opinion, and the other suggesting that incumbent administrations have simulated responsiveness to public attitudes toward criminal justice which they strategically molded themselves. Drawing in part on political science literature that has as yet been little used within criminology, this article seeks to advance an alternative viewpoint. We argue that, in the context of American criminal justice policy since the 1970s, political responsiveness to public opinion has been neither genuine nor so much simulated as it has been what political scientists describe as “segmented”—that is, geared toward specific subgroups whose views are privileged for electoral reasons. Our analysis singles out for scrutiny the crucial period between the mid-1980s and mid-1990s and the alignment of criminal justice policymaking during those years with preferences held and promoted by lobby groups with strong financial incentives at the expense of disadvantaged minorities. In so doing, we combine foci and insights that have typically been accorded discrete consideration in prior critical scholarship, which allows us to demonstrate the aggregate effect that different lobbying activities can have on criminal justice, whether directly and by design or indirectly and by default.
Do pro-social video games promote moral activity?: an analysis of user reviews of Papers, Please
Authors: Cabellos Beatriz , Pozo Juan-Ignacio , Marín-Rubio Kevin , Sánchez Daniel L.
Published: May 2022

Video games are the digital entertainment resource most in demand by young people, which has led an increasing number of education experts to study their possible benefits. In particular, in this research, we set out to identify the potential of ‘Papers, Please’ to promote moral learning. Thus, we have tried to identify those objectives that go beyond the success in the video game and could favor moral learning. For this purpose, we have investigated what types of moral discourses arise from playing ‘Papers, Please’, a video game where you adopt the role of a customs inspector in a totalitarian state who must obtain the necessary money to fund their family. To do this, we analyzed the moral content of 1,560 player reviews. Results showed that only 4.94% of the reviews presented Moral Intuitions (moral content), which occurred more in the players who had played longer and had declared more Negative Emotions. As for the analysis of the Moral Intuitions, results showed that the players mainly made references to Care for both Family and Immigrants and point out the Authority of the State. However, Fairness/Cheating is less represented, despite the many events related to Immigrant discrimination. Through Exploratory Factor Analysis, we identified three dimensions, one of them pragmatic, oriented to success in the video game, and the others aimed at epistemic aspects beyond the objectives of the video game and that delve into the moral aspects of the game events. Hence, although spontaneous video game use is oriented toward pragmatic goals, ‘Papers, Please’ can guide players to think about the morality of the video game. Nevertheless, if we want to favor moral learning with ‘Papers, Please’, it is necessary to promote epistemic goals aimed at the explicitation of the morality that underlies the video game. To this end, we propose the application of scaffolding that favors these objectives.
Grounding and the Epistemic Regress Problem
Authors: Siscoe Robert Weston
Published: May 2022

Modal metaphysics consumed much of the philosophical discussion at the turn of the century, yielding a number of epistemological insights. Modal analyses were applied within epistemology, yielding sensitivity and safety theories of knowledge as well as counterfactual accounts of the basing relation. The contemporary conversation has now turned to a new metaphysical notion – grounding – opening the way to a fresh wave of insights by bringing grounding into epistemology. In this paper, I attempt one such application, making sense of the epistemic regress problem in terms of grounding. I argue that the relation that generates the epistemic regress is a grounding relation, showing that grounding can make sense of proposals by epistemic foundationalists and charting the course for similar applications to epistemic coherentism and epistemic infinitism. If it is right that grounding is involved in the epistemic regress, this points the way forward both for epistemologists and metaphysicians, revealing the prospects of solutions to the epistemic regress problem while providing grounding advocates with yet another example of grounding with which to theorize.
Social and emotional characteristics of girls and young women with DDX3X-associated intellectual disability: a descriptive and comparative study
Authors: Ng-Cordell Elise , Kolesnik-Taylor Anna , O’Brien Sinéad , Astle Duncan , Scerif Gaia , Baker Kate
Published: May 2022

DDX3Xvariants are a common cause of intellectual disability (ID) in females, and have been associated with autism spectrum disorder and emotional-behavioural difficulties. In this study, we compared phenotypic data for 23 females withDDX3Xvariants, to 23 females with ID and other genetic diagnoses. We found a wide range of adaptive, social and emotional function within theDDX3Xgroup. Autism characteristics did not differ betweenDDX3Xand comparison groups, while levels of anxiety and self-injurious behaviour (SIB) were significantly higher in theDDX3Xgroup. Within theDDX3Xgroup, adaptive function, autism characteristics, anxiety and SIB scores were positively correlated, with evidence for group-specific associations with SIB. Future work is warranted to explore the multilevel mechanisms contributing to social and emotional development in individuals withDDX3Xvariants.
Presence of the Absent Father: Perceptions of Family among Peacekeeper-Fathered Children in the Democratic Republic of Congo
Authors: Wagner Kirstin , Glaesmer Heide , Bartels Susan A. , Weber Sanne , Lee Sabine
Published: May 2022

The United Nations Missions in the Democratic Republic of Congo have faced heavy allegations of peacekeeper-perpetrated sexual exploitation and abuse. Reports indicate that sexual encounters between members of peacekeeping forces and female civilians have resulted in the birth of children; however, no conclusive information on these children exists to date. This is the first study to explore the perspectives of youth who were fathered and abandoned by peacekeepers. We analysed semi-structured interviews with 35 peacekeeper-fathered children (PKFC) regarding their perceptions of family in light of their fathers’ absence. The results show that PKFC’s lack of knowledge about their fathers significantly impacts their self-conception and social identity. Not relying on paternal support was perceived to exacerbate poverty while the inability to uncover paternal roots and family ties presented a barrier to cultural integration. Although increasingly reliant on their maternal family, PKFC received limited care from their mothers’ kin networks, causing some to compare their upbringing to that of orphans. The resulting divergence between participants’ ideals of family and their subjective life experiences created cognitive dissonance which was reduced through a situational attribution of neglect. PKFC without support mechanisms engaged in wishful thinking about relationships to their unknown fathers and increased the value of searching for them. Derived from their hope to overcome hardship, they saw the pursuit of ideal-typical family relations as the route to happiness and financial security. Based on the emotional presence of their absent fathers, we discuss family and identity-related challenges for PKFC and make recommendations for positive change.
Performance and acute procedural outcomes of the EnSite Precision™ cardiac mapping system for electrophysiology mapping and ablation procedures: results from the EnSite Precision™ observational study
Authors: Hsu Jonathan C. , Darden Douglas , Glover Benedict M. , Colley B. Judson , Steinberg Christian , Thibault Bernard , Jewell Coty , Bernard Michael , Tabereaux Paul B. , Siddiqui Usman , Li Jingyun , Horvath Eric E. , Cooper Daniel , Lin David
Published: May 2022

Background

The EnSite Precision™ cardiac mapping system (Abbott) is a catheter navigation and mapping system capable of displaying the three-dimensional (3D) position of conventional and sensor-enabled electrophysiology catheters, as well as displaying cardiac electrical activity as waveform traces and dynamic 3D maps of cardiac chambers. The EnSite Precision™ Observational Study (NCT-03260244) was designed to quantify and characterize the use of the EnSite Precision™ cardiac mapping system for mapping and ablation of cardiac arrhythmias in a real-world environment and evaluate procedural outcomes.

Methods

A total of 1065 patients were enrolled at 38 centers in the USA and Canada between 2017 and 2018 and were followed for 12 months post procedure for arrhythmia recurrence, medication use, and quality-of-life changes. Eligible subjects were adults undergoing a cardiac electrophysiology mapping and radiofrequency ablation procedure using the EnSite Precision™ System.

Results

A final cohort of 925 patients (64.3 years of age, 30.2% female) were analyzed. The primary procedural indication was atrial flutter in 48.1% (445/925), atrial fibrillation in 46.5% (430/925), and other arrhythmias in 5% (50/925). Electroanatomic mapping was performed in 81.5% (754/925) of patients. Mapping was stable throughout 79.8% (738/925) of procedures with initial mapping time of 8.6 min (IQR 4.7–15.0). Average mapping efficiency created with AutoMap or TurboMap was 164.9 ± 365.7 used points per minute. Median number of mapping points collected and used was 1752.5 and 811.0, respectively. Only 335/925 (36.2%) required editing and 66.0% (221/335) of these patients required editing of less than 10 points. Fluoroscopy was utilized in most cases (n = 811/925, 87.4%) with fluoroscopy time of 11.0 min (IQR 6.0–18.0). Overall median procedure time was 101.0 min (IQR 59.0–152.0). Acute procedural success was high for both atrial fibrillation (n = 422/430, 98.1%) and atrial flutter (n = 434/445, 97.5%).

Conclusion

In a real-world study analysis, use of the EnSite Precision™ mapping system was associated with high procedural stability, short mapping times, high point density requiring infrequent editing, low fluoroscopy time, and high prevalence of acute procedural success.
Prevalence and Impact of Fatigue in Children with Primary Immunodeficiency Disorders: a Quantitative Single-Center Study
Authors: Visser Eline , Fraaij Pieter , Hoogenboom Annemieke , Witkamp Erica , van der Knaap Linda , van Rossum Annemarie , Stol Kim , Vermont Clementien
Published: May 2022

Although fatigue is a common symptom in adult patients with primary immunodeficiencies (PID), data in pediatric patients are limited. The goal of this study is to estimate the prevalence and impact of fatigue in children with PID as reported by patients, parents, and health-care providers. A retrospective single-center observational study was performed. Prevalence of fatigue was measured by reviewing medical charts of 54 children in our department who are on immunoglobulin replacement therapy. Both prevalence and impact were also measured by the PedsQL-Multidimensional Fatigue Scale (MFS) in 27 patients and 32 of their parents. This is an age-appropriate questionnaire for self-report of fatigue symptoms in patients aged 5–18 years and for parent proxy reports for patients aged 2–18 years. General, cognitive, and sleep-rest fatigue was measured, and a total fatigue score was calculated. Means, standard deviation and Z scores were calculated using age-specific reference values. Intraclass correlation coefficients (ICC) were calculated for comparison of scores provided by parents vs children’s self-reported scores. Both chart review data and PedsQL-MFS showed fatigue rates of 65%. Pediatric PID patients of all ages had significantly lower scores on all subscales and total score of the PedsQL-MFS compared to healthy children, indicating greater perceived symptoms of fatigue. General fatigue was the most affected subscale in PID patients, suggesting that fatigue in these patients is mainly physical. Seventy-four percent of PID patients had a Z score lower than − 1 on the general fatigue subscale indicating severe fatigue. Child-parent concordance varied between 0.24 and 0.93. Our results show the feasibility of the PedsQL-MFS survey to evaluate the prevalence and severity of fatigue in children with PID and underscore the importance of this issue in our patient care.
Physicochemical and Antioxidant Properties of White (Fiano cv) and Red (Negroamaro cv) Grape Pomace Skin Based Films
Authors: Gorrasi Giuliana , Viscusi Gianluca , Gerardi Carmela , Lamberti Elena , Giovinazzo Giovanna
Published: May 2022

Grape pomace, as by-product of wine making, is a source of polyphenols, fibers, fatty acids, metals, and organic acids, which could be used as raw component for the production of sustainable materials. Novel biodegradable films based on pomaces, from Negroamaro (red) and Fiano (white), Italian grape cultivars, were fabricated. Physical, chemical and antioxidant properties of material produced were characterized. In particular, migration tests of phenols from pomace films to aqueous food simulant medium were investigated. Data obtained allowed to evaluate the antioxidant activity in terms of total phenol assay and Trolox Equivalent Antioxidant Capacity assay and phenols profile. The characterization of phenolic composition confirmed the peculiarity of some compounds such as anthocyanins (191.17 ± 10.3 μg/g film) in red skin pomace film (NPF) and a great amount of flavanols (76.36 ± 1.72 μg/g film) in white skin pomace film (FPF). Antioxidant activity of polyphenols resulted in active films and was confirmed in migration test with aqueous food simulants. Physical properties of produced films were then studied in terms of morphological, thermal, mechanical and barrier properties. Finally, in the framework of sustainability and circular economy, the presented data paves the way to the design and production of active materials for packaging application starting from a widely available by-product derived from wine-making chain.
Developing a knowledge ecosystem for large-scale research infrastructure
Authors: Rådberg Kamilla Kohn , Löfsten Hans
Published: May 2022

Large-scale research infrastructures (RIs), such as MAX IV and European Spallation Source in Lund, Sweden, are considered critical for advancing science and addressing social challenges. These research facilities are central to research, innovation, and education; in playing a key role in developing and disseminating knowledge and technology. In this study, we develop a conceptual framework of a knowledge ecosystem for large-scale RIs. The study is explorative, with primary data from 13 interviews with key informants from different stakeholders in academia, industry, and policy. Secondary data were obtained from reports from national agencies that develop and operate research facilities and from industrial and regional governmental reports, internal reports, newsletters, and information from the facilities’ websites. We find that academia, industry, and policy, together with four themes, have an effect on the value proposition of these facilities, on geographical distances (nodes), catalysts, platforms, and hubs. Therefore, they will affect the structure and design of a knowledge ecosystem. Our framework explains knowledge ecosystem structure and design.
Recent progress in drug development for fibrodysplasia ossificans progressiva
Authors: Meng Xinmiao , Wang Haotian , Hao Jijun
Published: May 2022

Fibrodysplasia Ossificans Progressiva (FOP) is a rare genetic disease caused by heterozygous missense mutations in Activin A receptor type I which is also known as Activin-like kinase 2 (ALK2), a type I receptor of Bone Morphogenetic Proteins(BMP). Patients with FOP usually undergo episodic flare-ups and the heterotopic ossification in soft and connective tissues. Molecular mechanism study indicates that Activin A, the ligand which normally transduces Transforming Growth Factor Beta signaling, abnormally activates BMP signaling through ALK2 mutants in FOP, leading to heterotopic bone formation. To date, effective therapies to FOP are unavailable. However, significant advances have recently been made in the development of FOP drugs. In this article, we review the recent advances in understanding the FOP mechanism and drug development, with a focus on the small-molecular and antibody drugs currently in the clinical trials for FOP treatment.
The Deception of Certainty: how Non-Interpretable Machine Learning Outcomes Challenge the Epistemic Authority of Physicians. A deliberative-relational Approach
Authors: Funer Florian
Published: May 2022

Developments in Machine Learning (ML) have attracted attention in a wide range of healthcare fields to improve medical practice and the benefit of patients. Particularly, this should be achieved by providing more or less automated decision recommendations to the treating physician. However, some hopes placed in ML for healthcare seem to be disappointed, at least in part, by a lack of transparency or traceability. Skepticism exists primarily in the fact that the physician, as the person responsible for diagnosis, therapy, and care, has no or insufficient insight into how such recommendations are reached. The following paper aims to make understandable the specificity of the deliberative model of a physician-patient relationship that has been achieved over decades. By outlining the (social-)epistemic and inherently normative relationship between physicians and patients, I want to show how this relationship might be altered by non-traceable ML recommendations. With respect to some healthcare decisions, such changes in deliberative practice may create normatively far-reaching challenges. Therefore, in the future, a differentiation of decision-making situations in healthcare with respect to the necessary depth of insight into the process of outcome generation seems essential.
Adjustable robust treatment-length optimization in radiation therapy
Authors: ten Eikelder S. C. M. , Ajdari A. , Bortfeld T. , den Hertog D.
Published: May 2022

Traditionally, optimization of radiation therapy (RT) treatment plans has been done before the initiation of RT course, using population-wide estimates for patients’ response to therapy. However, recent technological advancements have enabled monitoring individual patient response during the RT course, in the form of biomarkers. Although biomarker data remains subject to substantial uncertainties, information extracted from this data may allow the RT plan to be adapted in a biologically informative way. We present a mathematical framework that optimally adapts the treatment-length of an RT plan based on the acquired mid-treatment biomarker information, while accounting for the inexact nature of this information. We formulate the adaptive treatment-length optimization problem as a 2-stage problem, wherein the information about the model parameters gathered during the first stage influences the decisions in the second stage. Using Adjustable Robust Optimization (ARO) techniques we derive explicit optimal decision rules for the stage-2 decisions and solve the optimization problem. The problem allows for multiple worst-case optimal solutions. To discriminate between these, we introduce the concept of Pareto Adjustable Robustly Optimal solutions. In numerical experiments using lung cancer patient data, the ARO method is benchmarked against several other static and adaptive methods. In the case of exact biomarker information, there is sufficient space to adapt, and numerical results show that taking into account both robustness and adaptability is not necessary. In the case of inexact biomarker information, accounting for adaptability and inexactness of biomarker information is particularly beneficial when robustness (w.r.t. organ-at-risk (OAR) constraint violations) is of high importance. If minor OAR violations are allowed, a nominal folding horizon approach (NOM-FH) is a good performing alternative, which can outperform ARO. Both the difference in performance and the magnitude of OAR violations of NOM-FH are highly influenced by the biomarker information quality.
Spatiotemporal Distribution of Precipitates and Mineral Phase Transition During Biomineralization Affect Porosity–Permeability Relationships
Authors: Weinhardt Felix , Deng Jingxuan , Hommel Johannes , Vahid Dastjerdi Samaneh , Gerlach Robin , Steeb Holger , Class Holger
Published: May 2022

Enzymatically induced calcium carbonate precipitation is a promising geotechnique with the potential, for example, to seal leakage pathways in the subsurface or to stabilize soils. Precipitation of calcium carbonate in a porous medium reduces the porosity and, consequently, the permeability. With pseudo-2D microfluidic experiments, including pressure monitoring and, for visualization, optical microscopy and X-ray computed tomography, pore-space alterations were reliably related to corresponding hydraulic responses. The study comprises six experiments with two different pore structures, a simple, quasi-1D structure, and a 2D structure. Using a continuous injection strategy with either constant or step-wise reduced flow rates, we identified key mechanisms that significantly influence the relationship between porosity and permeability. In the quasi-1D structure, the location of precipitates is more relevant to the hydraulic response (pressure gradients) than the overall porosity change. In the quasi-2D structure, this is different, because flow can bypass locally clogged regions, thus leading to steadier porosity–permeability relationships. Moreover, in quasi-2D systems, during continuous injection, preferential flow paths can evolve and remain open. Classical porosity–permeability power-law relationships with constant exponents cannot adequately describe this phenomenon. We furthermore observed coexistence and transformation of different polymorphs of calcium carbonate, namely amorphous calcium carbonate, vaterite, and calcite and discuss their influence on the observed development of preferential flow paths. This has so far not been accounted for in the state-of-the-art approaches for porosity–permeability relationships during calcium carbonate precipitation in porous media.
Derjaguin and the DMT Theory: A Farewell to DMT?
Authors: Greenwood J. A.
Published: May 2022

There is a widespread belief that in the 1970s, two conflicting theories of the adhesion of a spherical particle to a substrate were published: the JKR and DMT theories. And that the dispute was resolved when Tabor introduced a parameter $$\mu$$
μ
, such that for small $$\mu$$
μ
, DMT was correct, while for large $$\mu$$
μ
, JKR was correct. We point out that there never were two theories of contact: the dispute was about the magnitude of the pull-off force (with an implication that since the DMT value was obtained by a thermodynamic method, it must be correct). And what Tabor actually said was simply that for large $$\mu$$
μ
, the neglect of surface forces in the JKR theory was acceptable, and that he distrusted the neglect of deformation by the large surface forces immediately outside the Hertzian contact in the DMT theory. We point out the errors in both the DMT/MDT thermodynamic method and the MDT force method (preferred by MDT) but also argue that once Derjaguin and his collaborators (MYD) established that Hertzian geometry does not occur, no theory based on that geometry should be taken seriously. Derjaguin’s well-merited fame rests on more important contributions.
Bayesian Inversion with Open-Source Codes for Various One-Dimensional Model Problems in Computational Mechanics
Authors: Noii Nima , Khodadadian Amirreza , Ulloa Jacinto , Aldakheel Fadi , Wick Thomas , François Stijn , Wriggers Peter
Published: May 2022

The complexity of many problems in computational mechanics calls for reliable programming codes and accurate simulation systems. Typically, simulation responses strongly depend on material and model parameters, where one distinguishes between backward and forward models. Providing reliable information for the material/model parameters, enables us to calibrate the forward model (e.g., a system of PDEs). Markov chain Monte Carlo methods are efficient computational techniques to estimate the posterior density of the parameters. In the present study, we employ Bayesian inversion for several mechanical problems and study its applicability to enhance the model accuracy. Seven different boundary value problems in coupled multi-field (and multi-physics) systems are presented. To provide a comprehensive study, both rate-dependent and rate-independent equations are considered. Moreover, open source codes (https://doi.org/10.5281/zenodo.6451942) are provided, constituting a convenient platform for future developments for, e.g., multi-field coupled problems. The developed package is written in MATLAB and provides useful information about mechanical model problems and the backward Bayesian inversion setting.
Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness
Authors: Mainali Shraddha , Aiyagari Venkatesh , Alexander Sheila , Bodien Yelena , Boerwinkle Varina , Boly Melanie , Brown Emery , Brown Jeremy , Claassen Jan , Edlow Brian L. , Fink Ericka L. , Fins Joseph J. , Foreman Brandon , Frontera Jennifer , Geocadin Romergryko G. , Giacino Joseph , Gilmore Emily J. , Gosseries Olivia , Hammond Flora , Helbok Raimund , Claude Hemphill J. , Hirsch Karen , Kim Keri , Laureys Steven , Lewis Ariane , Ling Geoffrey , Livesay Sarah L. , McCredie Victoria , McNett Molly , Menon David , Molteni Erika , Olson DaiWai , O’Phelan Kristine , Park Soojin , Polizzotto Len , Javier Provencio Jose , Puybasset Louis , Venkatasubba Rao Chethan P. , Robertson Courtney , Rohaut Benjamin , Rubin Michael , Sharshar Tarek , Shutter Lori , Sampaio Silva Gisele , Smith Wade , Stevens Robert D. , Thibaut Aurore , Vespa Paul , Wagner Amy K. , Ziai Wendy C. , Zink Elizabeth , I Suarez Jose ,   the Curing Coma Campaign collaborators
Published: May 2022

This proceedings article presents actionable research targets on the basis of the presentations and discussions at the 2nd Curing Coma National Institutes of Health (NIH) symposium held from May 3 to May 5, 2021. Here, we summarize the background, research priorities, panel discussions, and deliverables discussed during the symposium across six major domains related to disorders of consciousness. The six domains include (1) Biology of Coma, (2) Coma Database, (3) Neuroprognostication, (4) Care of Comatose Patients, (5) Early Clinical Trials, and (6) Long-term Recovery. Following the 1st Curing Coma NIH virtual symposium held on September 9 to September 10, 2020, six workgroups, each consisting of field experts in respective domains, were formed and tasked with identifying gaps and developing key priorities and deliverables to advance the mission of the Curing Coma Campaign. The highly interactive and inspiring presentations and panel discussions during the 3-day virtual NIH symposium identified several action items for the Curing Coma Campaign mission, which we summarize in this article.
Immediate versus staged revascularisation of non-culprit arteries in patients with acute coronary syndrome: a systematic review and meta-analysis
Authors: Vriesendorp P. A. , Wilschut J. M. , Diletti R. , Daemen J. , Kardys I. , Zijlstra F. , Van Mieghem N. M. , Bennett J. , Esposito G. , Sabate M. , den Dekker W. K.
Published: May 2022

Although there is robust evidence that revascularisation of non-culprit vessels should be pursued in patients presenting with an acute coronary syndrome (ACS) and multivessel coronary artery disease (MVD), the optimal timing of complete revascularisation remains disputed. In this systematic review and meta-analysis our results suggest that outcomes are comparable for immediate and staged complete revascularisation in patients with ACS and MVD. However, evidence from randomised controlled trials remains scarce and cautious interpretation of these results is recommended. More non-biased evidence is necessary to aid future decision making on the optimal timing of complete revascularisation.
Alcoholschade voor de drinker zelf en (anderen in) de maatschappij
Authors: Voogt Carmen , Vromans Linde , Kools Nathalie , van Hasselt Ninette
Published: May 2022

Samenvatting

Wereldwijd is alcoholgebruik een van de oorzaken van een groot deel van de (vermijdbare) ziektelast. Het heeft negatieve gevolgen voor de drinker zelf en voor (anderen in) de maatschappij. Zo hangt alcoholgebruik samen met ongeveer 200 verschillende aandoeningen en ziekten, waaronder verslaving, kanker en hart- en vaatziekten. Ook is alcoholgebruik gerelateerd aan risico’s, zoals verkeersongevallen, geweld en de fetal alcohol spectrum disorder. Hierbij is de schade veelal voor de ander. Dit artikel geeft op basis van een quickscan van de literatuur een beeld van de omvang van de schade die door alcoholgebruik wordt veroorzaakt, voor de drinker zelf en (anderen in) de maatschappij. Hoewel het beeld niet allesomvattend is, geeft deze quickscan wel een helder beeld van de huidige stand van de wetenschappelijke kennis.