bluuebunny/crossref_metadata_2025 huggingface dataset:
Trajectory planning of tire laser engraving orthogonal robot based on an improved multi-objective grasshopper optimization algorithm
Authors: Liu Wei , Xu Chunjie , Zhang Qi , Wan Yidong
Published: January 2024

The traditional tire laser engraving robots have the low and stable running capability and discontinuous motion trajectory during operation, leading to long running time, high energy consumption, and uneven operation. In order to solve these problems, this paper proposes an orthogonal robot trajectory planning method based on an improved multi-objective grasshopper optimization algorithm (IMOGOA) with the orthogonal robot as the research object. Firstly, this paper used the quintic non-uniform rational b-splines (NURBS) curves to construct the trajectory. Secondly, the optimization objectives of the orthogonal robot’s running time, energy consumption, and smoothness were used to obtain the Pareto optimal solution by using the IMOGOA to establish the objective function. Then, the optimization method was simulated and analyzed, and the optimal solution was selected to compare with the rest of the non-dominated solution sets. The simulation results showed that the proposed method reduced the running time by 33.68%, improved the energy consumption and smoothness performance by 34.48% and 56.58%, and achieved multi-objective comprehensive optimization of the orthogonal robot. Thus, the effectiveness and feasibility of the proposed method were verified. Finally, a tire laser engraving orthogonal robot experimental platform was built for physical verification experiments. The experimental results showed that the experimental trajectory deviated from the simulated trajectory by only 5.63%, further proving the proposed method’s practicality.
The modeling and analysis of operating characteristics and temperature drift of deflector jet servo valve under the wide temperature range
Authors: Xiaoxue Liu , Yaobao Yin , Shuwei Zheng , Tao Jia , Qiang Xiao
Published: January 2024

The Deflector Jet Servo Valve (DJSV) holds a crucial role within the electro-hydraulic servo system, as its performance directly influences the equipment reliability. DJSV operates within a wide temperature range, and the temperature fluctuations result in the magnetomotive force variations of the permanent magnets and changes in the working air gaps, which influence the operating characteristics of the torque motor and contribute to temperature drift. Consequently, a theoretical model is proposed to comprehensively analyze the impact of these factors on the operating characteristics and temperature drift of the DJSV. The results indicate that as the temperature increases, the magnetic flux of working air gap decreases, while the temperature drift increases. Additionally, among the five initial air gap errors discussed, a centrosymmetric error of less than 0.02 l can significantly reduce the temperature drift. The proposed modeling and analysis method of temperature drift can be used to guide the design and analysis of DJSV in wide temperature range.
Data-driven design of model-free control for reference model tracking based on an ultra-local model: Application to vehicle yaw rate control
Authors: Yahagi Shuichi , Kajiwara Itsuro
Published: January 2024

Lateral vehicle dynamics control is important for autonomous driving. This paper presents a data-driven design of model-referenced model-free control (DD-MR-MFC) based on an ultra-local model for vehicle yaw rate control. The characteristics of lateral vehicle dynamics systems depend on vehicle velocities and weights. For this system, fixed proportional–integral–derivative (PID) controllers cannot provide the desired control performance. Additionally, although model-based control can be applied to lateral vehicle dynamics, the modeling process is time-consuming. To efficiently design controllers that can realize the desired performance, we adopt a model-free approach. In this study, the control law of practical MR-MFC is derived by extending the traditional MFC based on an ultra-local model and using a data-driven design method. The MFC approach can be applied to nonlinear systems with few parameters, and the data-driven method provides optimized parameters from single-experiment time-series data without the need for repeated experiments and system model to be controlled. Additionally, the processing cost is considerably low because the controller parameter can be obtained using least-square methods. The effectiveness of the proposed method is verified using a multibody vehicle simulator. The yaw rate tracking performance is examined under different velocities and loads. Results showed that the root-mean-square error of the proposed method is approximately 1/100th of that when using a fixed PID controller optimized using a data-driven method.
The effect of respiratory muscle training on respiratory muscle strength, diaphragm thickness/mobility, and exercise capacity in patients with systemic lupus erythematosus and associated shrinking lung syndrome
Authors: Sari Fulden , Oskay Deran , Tufan Abdurrahman
Published: January 2024

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that can impact any organ in the body. The pathophysiology of shrinking lung syndrome (SLS), a rare pulmonary complication of SLE, remains unknown. The objective of the current case series was to investigate the effects of inspiratory muscle training (IMT) on diaphragm thickness/mobility, respiratory muscle strength, peripheral muscle thickness/strength, and functional exercise capacity in patients with SLE and associated SLS. Three patients with SLE were included in the case series. Respiratory muscle strength, peripheral muscle strength, peripheral muscle thickness, diaphragm muscle thickness, diaphragm muscle mobility, functional exercise capacity, and pulmonary function test were assessed. A significant improvement has been determined in respiratory muscle strength, functional exercise capacity, peripheral muscle strength, peripheral muscle thickness, diaphragm muscle thickness, and diaphragm muscle mobility. This is the first case series showing the beneficial effects of IMT on respiratory muscle strength, diaphragm thickness/mobility, peripheral muscle thickness/strength, and exercise capacity in patients with SLE.
“100 Things I Wish Someone Would Have Told Me”: Everyday Challenges Parents Face While Caring for Their Children With a Tracheostomy
Authors: Sherman Jules , Bower Kyle L. , Eskandanian Kolaleh
Published: January 2024

Equitable access to appropriate care, emergency department services, and in-home support aids are needed to minimize the occurrences of adverse events that have a significant impact on families. However, many families of children with medical complexity (CMC) lack consistent care due to issues of health inequity. We conducted 11 qualitative interviews with primary caregivers who were asked about their experiences of providing care to children who have a tracheostomy and are supported by multiple life-saving machines at home. Guided by ecological systems theory, we identified three themes that contextualize the lived experiences of the participants who expressed needs that arose from poor interactions within the mesosystem. Findings convey participant frustrations that result from insufficient support, ineffective training, and inadequate healthcare coverage. Although each theme is organized systematically to emphasize specific concerns within the mesosystem, together these themes emphasize the inextricable relationship between daily needs with systemic barriers to care. We provide a discussion of these needs with a broader context that also impacts the perceived quality of care among families managing the needs of their children who are supported by life-saving technology. By addressing existing challenges and identifying opportunities for improvement within the healthcare system, we seek to contribute to the collective effort of advocating for ethical systemic change on behalf of CMC and their families.
Creating Local “Citizen's Governance Spaces” in Austerity Contexts : Food Recuperation and Urban Gardening in Montréal (Canada) as Ways to Pragmatically Invent Alternatives
Authors: Bherer Laurence , Dufour Pascale , Montambeault Françoise
Published: January 2024

While there is a growing interest in citizen-led initiatives, there is still no consensus on how to situate them, especially in relation to state institutions. On the one hand, citizen-led initiatives are seen as being co-opted by formal institutions in a context of austerity. On the other hand, these initiatives are often presented as “spaces of resistance” to neoliberalism, or as political acts of reclaiming the city. Mapping and tracing urban gardening and dumpster diving from their grassroots emergence to their inclusion in the institutional world through a two-level analysis, we show that individuals and loosely organized collectives involved in such initiatives are embedded in complex relationships with local institutions and third sector organizations that do, in turn, structure their practice and its consequences. The two-level analysis we propose follows this process: it is through interactions and relationships with other “practitioners” and with their social and institutional environment that these urban social practices gradually institutionalize.
Effects of a typical shear dependent viscosity on analytical elastohydrodynamic lubrication film thickness predictions: A critical issue for the classical approach
Authors: Bair Scott , Habchi Wassim
Published: January 2024

Many engineering estimates of the film thickness in the concentrated contacts of real machines have come from extrapolations of measurements of elastohydrodynamic lubrication film thickness performed in glass on steel elastohydrodynamic rigs. Such estimates are likely to have large errors due to shear dependence of viscosity. The classical film thickness formulas employed have not been validated except for some Newtonian reference liquids at room temperature because the real pressure-viscosity response measured in viscometers has been ignored. A blend of polyalpha olefin base oils with mild shear-thinning has been employed in a line contact calculation to assess the effects of shear-dependent viscosity on the power-law exponents of the classical film thickness formula. The exponents on the pressure-viscosity coefficient and on the elastic modulus of the solids are not sensitive to the non-Newtonian effect. The exponents on ambient pressure viscosity and velocity are slightly reduced by shear-thinning. The exponents on pressure and scale are substantially increased by the shear dependence. The usual practice of measuring film thickness in an elastohydrodynamic rig to obtain an effective “[Formula: see text]-value” to use in a classical Newtonian film thickness formula will overstated the film thickness of a liquid which is shear dependent in the elastohydrodynamic lubrication inlet.
Predicting students’ thermal sensation votes in university libraries taking into account their mood states
Authors: Zhang Dadi , Hou Huiying (Cynthia) , Tsang Tsz-Wun , Mui Kwok-Wai , Wong Ling-Tim
Published: January 2024

This study examined the effect of mood states on students’ thermal sensations within a university library comprising quiet-study and group-study rooms. Through concurrent subjective and objective assessments over five consecutive workdays, this study investigated the influence of psychological factors, particularly mood states, in influencing thermal sensations. This study addressed a paucity of prior research in library settings where both independent and collaborative studies have been undertaken. Subjective data (i.e. personal information, thermal assessment and mood states) via questionnaires and objective data (i.e. air temperature, radiant temperature, relative humidity and air velocity) via on-site measurements were collected during five working days. Statistical analyses (ANOVA, t-test, correlations and regression) indicated that male students and those with bad feelings (e.g. hostile and upset) reported significantly higher thermal sensation votes (TSVs) ( p < 0.05) compared to females and those with neutral/good feelings (0.4–0.5 difference out of 7). Two predictive models for TSV were developed for males and females, considering factors like body mass index (BMI), operative temperature and mood states. This research offers insights for designing specific study environments to improve thermal comfort, fostering students’ well-being and guiding future initiatives in this area.
Mechanical performances of printed carbon fiber-reinforced PLA and PETG composites
Authors: Ammar Sirine , Ben Fraj Boutheina , Hentati Hamdi , Saouab Abdelghani , Ben Amar Mounir , Haddar Mohamed
Published: January 2024

In this study, the 3D printing technology was adopted to produce carbon fiber-reinforced polylactic acid and polyethylene terephthalate glycol composites. Fused deposition modeling process was conducted at different settings of printing parameters, specifically, raster angle, printing speed, and extrusion temperature. Each of the selected printing parameters has a key role in making the best-printed part in terms of layer-by-layer deposition quality and mechanical performance. To examine how these process parameters affect the behavior of the printed parts, tensile tests were performed and mechanical properties were assessed. It was reported that the printing orientation, characterized by the raster angle, can be identified as the determining factor to define the fracture mode. Composite parts printed with 0° raster angle, aligning with the tensile loading path, exhibit the highest levels of stiffness and ductility. Ductile and brittle fractures corresponding to 0° and 90° raster angles, respectively, were illustrated through optical observations of failure profiles. Furthermore, the tensile test indicates that higher printing speed leads to a significant deterioration in mechanical performances, notably reducing the stiffness of the printed structures. Scanning electron microscopy analysis confirmed that increasing the printing speed results in greater porosity within the structure, thereby weakening its mechanical strength. Regarding the extrusion temperature, it was shown that elevating it enhances the mechanical characteristics of the printed parts, particularly in terms of strength and ductility. Referring to microstructural observations, this outcome is attributed to the improved adhesion between the deposited layers and the reduction in porosity at high extrusion temperature.
Experimental and numerical study on the shock characteristics of an electric switchboard with wire rope isolators in naval ships
Authors: Park Young-IL , Kang Min-Su , Kim Myung-Hyun , Choi Jungho , Kim Jeong-Hwan
Published: January 2024

Naval vessels face significant challenges owing to vibrations and shocks originating from diverse sources. Maintaining high levels of vibration and shock resistance in ship equipment is crucial to prevent damage and ensure proper functionality in demanding environments. This study experimentally and numerically investigates the shock characteristics of an electric switchboard on a naval ship using wire rope isolators (WRIs). Following the MIL-S-901D standard, impact tests were conducted using a test model. A simplified WRI model was constructed based on a previous study using the finite element method. The tests were performed in the vertical and 30° inclined orientations, and the experimental and simulation results were compared. Although an overall agreement was observed between the two, some inconsistencies were noted. These discrepancies were attributed to the inaccurate representation of the WRI. The dynamic stiffness of the WRI derived from the vibration tests conducted in this study may not be suitable for impact tests. Additionally, the modelled WRI in the simulation, as a 1D spring element with different support points, differed from the experimental setup, possibly causing localized effects that influenced the stress distribution. This study emphasizes the importance of refined WRI modelling for accurate shock simulations and offers insights into enhancing the shock resistance of naval ship equipment.
Designing a Multinational Smartphone App Survey during COVID-19: Rewards, Risks, and Recommendations
Authors: Davidson Jennifer C. , Karadzhov Dimitar , Wilson Graham
Published: January 2024

Cost-effective and user-friendly, mobile phone-assisted methods have remained underutilized in qualitative social science research. The scarce methodological guidance, together with recruitment and ethical challenges, has arguably stifled advancements in this area. COVID-19 exposed the need to better equip researchers with the expertise and tools to conduct remote research effectively. In 2020, we designed and launched a smartphone survey application to collect real-time data from children’s sector professionals across the globe regarding best practices in, and challenges to, responding to the pandemic. In this short article, we reflect on the efficiency, quality, and acceptability afforded by the smartphone app survey, and outline recommendations for enhancing rigor and feasibility. We also present data snippets illustrating the positive impact of participation on respondents—a seldom-documented aspect of app-based research. Altogether, we advocate a flexible, pragmatic, and user-centered study and app design that aligns with respondents’ specific, situational needs, and preferences.
Upside-Down Gore Excluder as an Endoprosthesis for Aortoiliac Aneurysm Exclusion: A Retrospective Multicenter Study
Authors: ‘t Mannetje Yannick W. , Reijnen Michel M.P.J. , Zeebregts Clark J. , Akkersdijk George P. , Derom Alex , Dolmans Dennis E.J.G.J. , Jahrome Ommid K , de Jong Sylvia C. , ‘t Mannetje Yannick W. , Meekel Jorn P. , Reijnen Michel M.P.J. , Rijbroek Bram , Schlejen Peter M. , van der Steenhoven Timothy J. , Tielliu Ignace F.J. , Tournoij Erik , Vierhout Bastiaan P. , Wikkeling Otmar R.M. , Witte Marianne E. , Yeung Kak K. , Centrum Zaans Medisch , Zeebregts Clark J.
Published: January 2024

Objective:

The upside-down configuration of a Gore Excluder contralateral leg endoprosthesis has been used to overcome diameter differences in the endovascular treatment of aortoiliac aneurysms. Our goal was not to describe the technique but to study the applicability and safety.

Material and methods:

Patients were retrospectively enrolled. The indication and details of the procedure were at the discretion of the treating physicians. A case report form was completed including baseline characteristics, indication for treatment, procedural data, and outcomes during follow-up.

Results:

A total of 31 subjects were enrolled with a range of indications, including 3 patients treated in the emergency setting (9.7%). In 64.5% (n=20), it was a primary intervention for a common iliac aneurysm (n=10), internal iliac aneurysm (n=4), or abdominal aortic aneurysm (n=6). In 11 subjects (35.5%), treatment was performed after previous aortoiliac interventions, including anastomotic iliac artery aneurysm (n=5), type III endoleak (n=3), and endograft thrombus (n=3). Median follow-up was 13 months (range=1-142 months). During follow-up, 2 patients required an upside-down contralateral leg–related secondary intervention, one for an occlusion and another for a type Ia endoleak. There was no type Ib or III endoleak, and no migration, kinking/stenosis, or conversion to open repair was observed. The aneurysm-related mortality was 3.3% (n=1).

Conclusion:

An upside-down contralateral leg is a valuable technique that can be used to achieve adequate aneurysm exclusion or resolve complications. It is associated with a limited number of complications.

Clinical impact

This article studies the use of an upside-down iliac endograft. We describe a wide range of indications in which this previously published technique has been applied. In elective and acute settings and as primary and revision intervention an upside-down iliac endograft was performed successfully. Furthermore, follow-up data is presented showing the effectiveness of the technique. Knowledge of this procedure is a valuable addition to the skillset of every interventionalist.
“My Blood, You Know, My Biology Being out There…”: Consent and Participant Control of Biological Samples
Authors: Passmore Susan Racine , Gerbitz Abigail , Hancock Gregory R. , Evans Laura , Green-Harris Gina , Edwards Dorothy Farrar , Jackson Tyson , Thomas Stephen B.
Published: January 2024

The widespread and persistent underrepresentation of groups experiencing health disparities in research involving biospecimens is a barrier to scientific knowledge and advances in health equity. To ensure that all groups have the opportunity to participate in research and feel welcome and safe doing so, we must understand how research studies may be shaped to promote inclusion. In this study, we explored the decision to participate in hypothetical research scenarios among African American adults (n = 169) that varied on the basis of four attributes (form of consent, reason for research, institutional affiliation and race of the researcher). Findings indicate that participants were largely willing to contribute to biobanks but significantly preferred opportunities where they had control over the use of their biological samples through tiered or study-specific forms of consent. Broad consent procedures, although common and perhaps preferred by participants with high trust in researchers, may amount to an exclusionary practice.
Structural optimization of laminated leaf-like piezoelectric wind energy harvesters based on topological method
Authors: Wang Mingming , Wang Weiyuan , Li Qiuhong
Published: January 2024

In this paper, a series of leaf-like piezoelectric elements are proposed by using laminated structure of polypropylene (PP) and Polyvinylidene fluoride (PVDF) film to collect wind energy through vortex induced vibration. Topology optimization based on solid isotropic material with penalization method is employed in seeking optimal configurations of the elements. The PP and PVDF layer were set as optimization variables respectively to obtain topological layouts that would be equivalent to maximizes the overall strain energy as the objective function. Four simple shapes of piezoelectric elements with different topological configurations are manufactured and tested in wind tunnel to estimate the energy harvesting capabilities. The experimental results show that the reinforcement optimized long trapezoid model has the highest open-circuit output voltage of 4.01 V and output power of 6.125 μW at the wind speed of 12 m/s. For the optimization of piezoelectric materials, the short trapezoid model can reach the open circuit output voltage of 2.061 V and output power of 1.158 μW. It indicated that the topology optimization can indeed improve the energy harvesting efficiency of the piezoelectric element. However, this method is not universal at present, which means that the external shape of the model will influence the performance of the relevant optimization results.
Deficient mismatch repair/microsatellite unstable colorectal cancer: therapeutic advances and questions
Authors: Cervantes Baptiste , André Thierry , Cohen Romain
Published: January 2024

The microsatellite instability (MSI) phenotype is related to a deficiency of the DNA mismatch repair (dMMR) system and is observed in 5% of metastatic colorectal cancers (mCRCs). MSI/dMMR phenotype testing should be routine for all CRCs regardless of stage. Two complementary techniques with a high concordance (90–97%) allow us to determine the MSI/dMMR status of a tumor: immunohistochemistry and polymerase chain reaction. Since 2020 and the results of the phase III KEYNOTE 177 trial, pembrolizumab [anti-programmed cell death protein 1 (PD1)] is the new standard of care in first-line MSI/dMMR mCRC. To date, no combination of chemtotherapy ± targeted therapy with immune checkpoint inhibitors (ICIs) has been validated in the management of MSI/dMMR mCRC, and it is not known whether this combination would be beneficial. It is also unclear whether dual therapy with two ICIs is more effective than monotherapy. Several phase III trials are ongoing to answer these questions. Despite a high response rate and long-term benefit of a first line by anti-PD1, 30–50% of patients with MSI/dMMR mCRC experience an early or secondary progression. There are currently no validated predictive biomarkers of anti-PD1 ± anti-cytotoxic T lymphocyte antigen-4 resistance in patients with MSI/dMMR mCRC. In case of early progression on ICIs, the first two questions to consider are the possibility of pseudoprogression and the correct diagnosis of MSI/dMMR status. To date, there are no data on the use of adjuvant ICIs for MSI/dMMR resected colon cancers. By contrast, data are accumulating regarding the efficacy of neoadjuvant ICIs, with at least two-thirds of patients in the different trials in pathological complete response, making it possible to envisage ‘Watch and wait’ strategies in future.
Garcinia Biflavonoid 1 from Garcinia kola Ameliorates Glycolipid Metabolism Disorder in Type 2 Diabetic db/db Mice
Authors: Fu Ting-Dan , Zhang Wen-Li , Zhang Ying , Deng Chang-Sheng , Qi Wang , Xu Qin , Song Jian-Ping , Guo Wen-Feng , Yang Rui-Yi , Huang Xin-An
Published: January 2024

Background: Garcinia kola is recommended in African folk medicine for the treatment of diabetes and its associated complications. In this study, we investigated the effects of Garcinia biflavonoid 1 (GB1), an active chemical component of Garcinia kola, on blood glucose and lipid in db/db mice with type 2 diabetes. Methods: Db/db mice were divided into 4 groups: vehicle, low-dose GB1 (50 mg/kg), high-dose GB1 (100 mg/kg), and rosiglitazone, and treated for 4 weeks. Body weight, fasting blood glucose (FBG), fasting insulin, oral glucose tolerance test (OGTT), insulin tolerance test (ITT), hepatic glycogen, serum and liver biochemical parameters, and histological morphology of the pancreas, heart, and kidneys were evaluated. Results: GB1 significantly reduced FBG, the area under the curve value of OGTT and ITT, and the homeostasis model assessment of insulin resistance, increased the homeostasis model assessment of β-cell function, quantitative insulin sensitivity check index, and the level of hepatic glycogen. Lower triglyceride and free fatty acid level, and a lower triglyceride-glucose index were also observed in the GB1 groups. In addition, no significant changes in alanine aminotransferase and aspartate aminotransferase levels, or in the histopathology of the pancreas, heart, or kidney were observed after GB1 treatment. Conclusion: These findings indicate that GB1 exerts an antidiabetic effect in db/db mice, by improving hyperglycemia, insulin resistance, and lipid dysregulation without evidence of adverse reactions.
MicroRNA-125b Is a Potential Predictor of Surgical Outcomes in Chronic Rhinosinusitis with Nasal Polyps
Authors: Gata Anda , Leucuta Daniel-Corneliu , Budisan Liviuta , Raduly Lajos , Trombitas Veronica E. , Berindan-Neagoe Ioana , Albu Silviu
Published: January 2024

Background

Despite advances in surgical techniques, recurrence rates after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyps (CRSwNP) remain high and difficult to predict.

Objective

This study aimed to evaluate the potential role of microRNA 125b (miR-125b) in predicting disease evolution following ESS.

Methods

We conducted a prospective study including patients undergoing first ESS for CRSwNP in our department between January 2020 and November 2021. We determined miR-125b levels from nasal polyps and pursued a standardized follow-up for at least 18 months for each patient.

Results

A total of 86 patients were included in the study. Higher postoperative endoscopy scores were associated with more severe disease at presentation on computed tomography scan, presence of concomitant asthma, and higher values of miR-125b. Even after multivariate repeated measures analysis and adjustments for confounders, miR-125b remained statistically significant. Moreover, miR-125 was the most important factor in predicting disease evolution at 18 months.

Conclusion

A clear, robust relation between nasal polyp control evaluated through objective measures and miR-125b values was observed. This finding indicates the potential role of miR-125b in predicting the course of the disease following ESS.
Is it possible to ‘legally desegregate’ sheltered employment? General comment no. 8 of the committee on the rights of persons with disabilities and the Benelux countries
Authors: Wouters Mathias
Published: January 2024

In 2022, the UN Committee on the Rights of Persons with Disabilities issued General Comment No. 8 on the right of persons with disabilities to work and employment. The general comment most notably recommends States parties to expeditiously phase out segregated employment, including sheltered workshops. After covering the contents of the general comment on this issue in Section I, this contribution argues that the Committee does not take into account that sheltered employment is a complex notion and that domestic sheltered employment systems can evolve. Since General Comment No. 8 outlaws segregated (sheltered) employment, the question becomes, can sheltered employment be legally desegregated, and hence does not have to be expeditiously phased out? Section III illustrates, based on examples from the Benelux countries, that domestic sheltered employment systems do not necessarily exhibit the distinguishing features of segregated employment, as described in General Comment No. 8. Section IV explains that this leaves the CRPD Committee with a decision to make. It could assert that sheltered employment is ipso facto segregated employment, which is to be phased out. It could also draw on its non-exhaustive list of the distinguishing features of segregated employment to incite States parties to at least desegregate sheltered employment legally if they decide not to phase it out entirely.
Aortic arch calcification increases major adverse cardiac event risk, modifiable by echocardiographic left ventricular hypertrophy, in end-stage kidney disease patients
Authors: Chao Chia-Ter , Liao Min-Tser , Wu Chung-Kuan
Published: January 2024

Background:

The factors affecting cardiovascular risk associated with vascular calcification in patients with chronic kidney disease are less well addressed. Distinct risk factors may contribute synergistically to this elevated cardiovascular risk in this population.

Objectives:

We aimed to determine whether echocardiographic left ventricular hypertrophy (LVH) affects the risk of major adverse cardiac events (MACE) associated with vascular calcification in end-stage kidney disease (ESKD) patients.

Methods:

In this retrospective cohort study, ESKD patients underwent chest radiography and echocardiography to assess aortic arch calcification (AoAC) and LVH, respectively, and were classified into three groups accordingly: non-to-mild AoAC without LVH, non-to-mild AoAC with LVH, and moderate-to-severe AoAC. The risks of MACE, cardiovascular mortality, and overall mortality were assessed using Cox proportional hazard analysis.

Results:

Of the 283 enrolled ESKD patients, 44 (15.5%) had non-to-mild AoAC without LVH, 117 (41.3%) had non-to-mild AoAC with LVH, and 122 (43.1%) had moderate-to-severe AoAC. After 34.1 months, 107 (37.8%) participants developed MACE, including 6 (13.6%), 40 (34.2%), and 61 (50%) from each respective group. Those with moderate-to-severe AoAC (Hazard ratio, 3.72; 95% confidence interval, 1.58–8.73) had a significantly higher risk of MACE than did those with non-to-mild AoAC without LVH or with non-to-mild AoAC and LVH (Hazard ratio, 2.73; 95% confidence interval, 1.16–6.46). A similar trend was observed for cardiovascular and overall mortality.

Conclusion:

Echocardiographic LVH could modify the risk of adverse cardiovascular events associated with vascular calcification in ESKD patients. Interventions aiming to ameliorate both morbidities might be translated into a lower MACE risk in this population.
Challenges in diagnosis and management of central airway obstruction: Case series
Authors: Le-Khac Bao , Nguyen-Dang Khoa , Vu-Hoai Nam , Nguyen-Thanh Nam , Duong-Minh Ngoc , Tran-Ngoc Thai-Hoa , Nguyen-Ho Lam
Published: January 2024

Central airway obstruction often presents with respiratory symptoms identical to those of common respiratory diseases. Diagnosis of central airway obstruction is challenging in clinical practice, especially misdiagnosed as asthma or chronic obstructive pulmonary disease in case of “normal” chest X-ray. Here, we reported five central airway obstruction cases: the first and fourth cases misdiagnosed as asthma, the second masquerading as chronic obstructive pulmonary disease exacerbation, the third diagnosed incorrectly with non-resolving pneumonia, and the fifth misdiagnosed as chronic obstructive pulmonary disease. We then analyzed diagnostic clues potentially useful to differentiate central airway obstruction from asthma/chronic obstructive pulmonary disease. A multidisciplinary approach to manage central airway obstruction is essential, particularly selecting judiciously the method of respiratory support due to the high risk of completed airway collapse or obstruction during interventional period.
Dengue fever complicated with ST elevation myocardial infarction with atypical features: A case report
Authors: Kashyap Ashutosh , Bhatta Laxmi Raj , Bhatta Bhuwan , Nepali Prakash , Gyawali Pratigya , Rajak Ashik , Dhakal Sarita
Published: January 2024

Dengue fever is an arboviral infection whose presentation ranges from a mild febrile illness to a multisystem complicated syndrome. We report a case of 58-year-old female presenting with fever, myalgia, arthralgia, and vomiting who was found to be infected with dengue and had electrocardiography changes revealing ST-segment elevation myocardial infarction, a rare manifestation in dengue. Dengue fever can affect the cardiovascular system leading to conduction abnormalities, hypotension, arrhythmias, myocarditis, cardiomyopathy, and occasionally myocardial infarction, which has been reported in only a few case reports prior to this. The differentiation between myocarditis and myocardial infarction is essential for which echocardiography and coronary angiography can be helpful. It is essential to keep an eye on the cardiovascular complications in a dengue patient as the presentation can be quite subtle with devastating consequences.
Dengue fever presenting with acute pancreatitis: A case report
Authors: Kashyap Ashutosh , Dhamala Manoj , Dahal Ashish , Obaidullah  , Ghimire Saurav
Published: January 2024

Acute pancreatitis is an acute inflammation of the pancreas, with subsequent involvement of surrounding tissues and organ systems. Viral etiology of acute pancreatitis is uncommon; however, multiple viruses have been implicated. Dengue virus has also been found responsible for acute pancreatitis, with possible etiologies linked to direct viral invasion, autoimmune mechanism, or as a complication of dengue shock syndrome. We present a case of a 24-year-old female who presented with epigastric pain and vomiting in the background of a febrile illness and was later diagnosed with mild acute pancreatitis complicating dengue fever.
Digital Innovations for Occupational Safety: Empowering Workers in Hazardous Environments
Authors: Dodoo Joana Eva , Al-Samarraie Hosam , Alzahrani Ahmed Ibrahim , Lonsdale Maria , Alalwan Nasser
Published: January 2024

Background:

The quest to increase safety awareness, make job sites safer, and promote decent work for all has led to the utilization of digital technologies in hazardous occupations. This study investigated the use of digital innovations for safety and health management in hazardous industries. The key challenges and recommendations associated with such use were also explored.

Method:

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, a total of 48 studies were reviewed to provide a framework for future pathways for the effective implementation of these innovations.

Findings:

The results revealed four main categories of digital safety systems: wearable-based systems, augmented/virtual reality-based systems, artificial intelligence-based systems, and navigation-based systems. A wide range of technological, behavioral, and organizational challenges were identified in relation to the key themes.

Conclusion:

Outcomes from this review can inform policymakers and industrial decision-makers about the application of digital innovations for best safety practices in various hazardous work conditions.
A Pandemic in Review: The Impact on Surgical Volume of Cleft Lip and Palate
Authors: Shah Pearl , Ahmed Asim , Moody Robert , Thawanyarat Kometh , Navarro Yelissa , Collar John , Holmes Kathryne , Yu Jack
Published: January 2024

Introduction:

We seek to evaluate the financial impact of the COVID-19 pandemic on pediatric craniomaxillofacial surgeries for cleft lip and/or palate. These surgeries are carefully timed for optimal outcomes, but the pandemic necessitated postponement or cancellation of elective procedures. Our study quantifies the decline in cases and associated charges at a single academic medical center before and after the pandemic.

Methods:

After receiving Institutional Review Board approval, we analyzed the financial billing data of 83 patients who underwent cleft lip and/or palate repair at an academic medical center. The caseload and charges incurred in the year before the COVID-19 pandemic (March 2019 to February 2020) were compared to the 2 years following the pandemic’s onset (March 2020 to February 2022). Statistical analysis was conducted using paired t-tests and the Wilcoxon signed-rank.

Results:

In the year following the onset of the pandemic, we observed a significant decrease in the number of cleft lip and/or palate repairs performed per month (from 2.75 to 1.42 per month, P-value .021) and a decrease in per-month charges for these procedures ($13 334.75 to $7237.17 per month, P-value .036). However, when examining data over the 2 years post-COVID, these differences no longer remain statistically significant ( P-value .25 for cases and P-value .32 for charges), indicating a return to pre-COVID baseline.

Conclusion:

There was a statistically significant decrease in cleft lip/palate repair surgeries in the 12 months following the start of the COVID-19 pandemic. Both the caseload and total charges decreased after March 2020, with a subsequent return to baseline after 2 years. These findings emphasize that the pandemic had a transient impact on pediatric craniomaxillofacial surgical volume at our institution. While acknowledging our study’s external validity, we advocate for a nuanced approach, with flexible staffing crucial in facilitating a swift return to normal elective volumes.
Complete responses in AL amyloidosis are unequal: the impact of free light chain mass spectrometry in AL amyloidosis
Authors: Bomsztyk Joshua , Ravichandran Sriram , Giles Hannah V. , Wright Nicola , Berlanga Oscar , Khwaja Jahanzaib , Mahmood Shameem , Wisniowski Brendan , Cohen Oliver , Foard Darren , Gilbertson Janet , Rauf Muhammad U. , Starr Neasa , Martinez-Naharro Ana , Venneri Lucia , Whelan Carol , Fontana Marianna , Hawkins Philip N. , Gillmore Julian D. , Lachmann Helen , Harding Stephen , Pratt Guy , Wechalekar Ashutosh D.
Published: January 2024

Amyloidogenic serum free light chains (sFLCs) drive disease progression in AL amyloidosis. Matrix-assisted laser desorption/ionization time of flight mass spectrometry–based FLC assay (FLC-MS) has greater sensitivity than conventional sFLC assays allowing for the detection of serological residual disease. We report the utility of FLC-MS in a large series of patients with AL amyloidosis assessing the impact of FLC-MS negativity after treatment on overall survival (OS) and organ response rates. Serum samples were analyzed using FLC-MS at diagnosis and at 6 and 12 months after treatment. The impact of FLC-MS negativity over standard hematologic responses on survival and organ response was assessed. A total of 487 patients were included; 290 (59%) and 349 (71.5%) had cardiac and renal involvement, respectively. There was 100% concordance between the light chain (LC) fibril type and LC isotype identified by FLC-MS. At 6 and 12 months, 81 (16.6%) and 101 (20.7%) were FLC-MS negative. Of those achieving a conventional hematologic complete response (CR) at 6 and 12 months, 45 (27.7%) and 64 (39%) were FLC-MS negative. At 12 months, median OS for CR + FLC-MS negative was not reached vs 108 months in CR + FLC-MS positive (P = .024). At 12 months, 70% of patients with FLC-MS negativity (vs 50% FLC-MS positive) achieved a cardiac response (P = .015). In a multivariate analysis, FLC-MS negativity at 12 months was an independent predictor of better outcomes. FLC-MS can detect persistent monoclonal light chains in a significant proportion of patients in a conventional hematologic CR. FLC-MS assessment promises to be a new standard for response assessment in AL amyloidosis.
Arterio-occlusive events among patients with chronic myeloid leukemia on tyrosine kinase inhibitors
Authors: Veltmaat Lukas , Cortes Jorge
Published: January 2024

Tyrosine kinase inhibitors (TKIs) are standard therapy for patients with chronic myeloid leukemia. Each of these drugs has a specific profile of tyrosine kinases that they inhibit and, although all are clinically effective, they each have unique toxicity profiles. With the introduction of ponatinib, arterio-occlusive events were first noted and later found to occur with all TKIs to various extents. The recognition of this “class effect” was delayed considering ponatinib was introduced 10 years after the introduction of imatinib. The reasons for the delay in identification of this class effect are likely multifaceted. Importantly, there is an inconsistency in adverse event reporting criteria among the major clinical trials of the various TKIs, likely resulting in mixed reporting of arterio-occlusive events. Reporting events based on a frequency threshold, lack of sufficient follow-up, attempts at causality attribution, and the primary focus on molecular response may all have played an additional role. Considering the increasing rate of arterio-occlusive events over time, the termination of many trials after only 5 years prevents full assessment of the impact of these events. A comprehensive evaluation of TKI adverse effects using uniform Medical Dictionary for Regulatory Activities terms and comprehensive adjudication of these events may be helpful in better assessing the real risk for patients with each TKI. Future clinical trials should use a uniform and comprehensive approach to reporting adverse events without attempting to assign causality to the study drug.
Land use alters cross-ecosystem transfer of high value fatty acids by aquatic insects
Authors: Ohler Katharina , Schreiner Verena C. , Reinhard Lukas , Link Moritz , Liess Matthias , Brack Werner , Schäfer Ralf B.
Published: January 2024

Background

Many aquatic insects emerge as adults from water bodies to complete parts of their life cycle in terrestrial ecosystems and are potential prey for riparian predators. The benefits of riparian predators from aquatic insects include higher contents of long-chain polyunsaturated fatty acids (PUFA) compared to terrestrial insects. Aquatic insects are therefore considered a high-quality food. Food containing high levels of PUFA can enhance growth and immune response of spiders. However, agricultural stressors like nutrient increase, pesticides and habitat degradation can affect the biomass of aquatic insects and in turn the diet of spiders. Studies quantifying the influence of land use on fatty acid (FA) profiles of emergent aquatic insects and riparian predators are lacking. We quantified differences in exports of FA, saturated FA, monounsaturated FA, and PUFA, FA profiles of aquatic insects and spiders between forested and agricultural sites over the primary emergence period within one year. The FA export to the riparian food web is crucial to understand energy fluxes between ecosystems. Furthermore, we monitored environmental variables to identify associations between agricultural stressors and FA profiles of aquatic insects and spiders.

Results

We found differences in FA export and profiles of aquatic insects between land-use types. The quantity of total FA export via aquatic insects was lower in agricultural sites (95% CI 1147–1313 µg m−2) in comparison to forested sites (95% CI 1555–1845 µg m−2), while the biomass export was higher in agricultural sites. Additionally, in spring the PUFA export was significantly lower (up to 0.06 µg d−1 m−2) in agricultural than forested sites. Agricultural stressors explained only little variation in the FA profiles of aquatic insects, e.g., 4% for caddisflies and 12% for non-biting midges. Percentage of shading and pool habitats were identified as most important variables explaining the variation in FA profiles.

Conclusion

The quality of aquatic insects as food source for riparian spiders was smaller in agricultural than forested sites, which can decrease the fitness of riparian predators. To improve our capacity to predict potential adverse effects in the riparian food web, future studies should identify the mechanisms underlying a lower PUFA content.
Ventral tegmental area dopaminergic circuits participates in stress-induced chronic postsurgical pain in male mice
Authors: Liu Weizhen , Wang Wang , Wang Ziliang , Xing Ying
Published: January 2024

Background

Chronic postsurgical pain (CPP) markedly impairs patients’ quality of life. Research has shown that chronic stress may extend incisional nociception in male mice. Dopaminergic (DAergic) neurons in the ventral tegmental area (VTA) are integral to stress-related mental disorders (including major depressive disorder, anxiety disorders, and PTSD) and pain. However, the impact of chronic social defeat stress (CSDS) on mesolimbic dopamine (DA) transmission in the development of CPP is yet to be established. It remains uncertain whether the dopamine signals in the rostral anterior cingulate cortex (rACC), which regulate pain, derive from the VTA. This study aims to explore the role of VTA-rACC dopaminergic circuits in a mouse model of CPP induced by CSDS.

Methods

We conducted CSDS on C57BL/6 J wild-type male mice (n = 12–16 mice/group) and DAT-cre male mice (n = 10–12 mice/group). After 10 days of CSDS, a left posterior plantar incision was made to establish a mouse model of CPP. Paw withdrawal thresholds (PWTs) were evaluated using Von-Frey fibre stimulation. The open field test (OFT) and elevated plus maze test (EPM) were used to assess pain-related negative emotions. We used immunofluorescence staining and Western Blot to analyse D1, D2, c-Fos, and TH expression. DAergic fibre projections in the VTA-rACC neural pathway were traced using retrograde tracing and immunofluorescence staining. Optogenetics and Chemogenetics were employed to manipulate DAergic neurons in the VTA and their axons in the rACC.

Results

The ipsilateral PWTs in male C57BL/6 J mice significantly decreased after surgery, returning to baseline after seven days. Conversely, in CSDS mice, ipsilateral PWTs remained reduced for at least 30 days post-incision. A significant reduction in TH-positive neurons expressing c-Fos in the VTA of CPP mice was observed 15 days post-incision. Activating DAergic neurons significantly improved ipsilateral PWTs and locomotor performance in the OFT and EPM in CPP mice post-incision. Additionally, D1 expression in the rACC was found to decrease in CPP mice, and this reduction counteracted the increase in PWTs caused by activating DAergic neuron axon terminals in the rACC.

Conclusion

CSDS results in chronicity of postsurgical nociception and anxiety-like negative emotions, with alterations in DA transmission playing a role in CPP. Specific activation of DAergic neurons mitigates nociceptive responses and anxiety-like bahaviors, possibly mediated by D1 receptors in the rACC.