bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Focus: The Development and Description of a Palette of Transmasculine Voices
Authors: Dolquist Devin V. , Munson Benjamin
Published: March 2024

Purpose:

The study of gender and speech has historically excluded studies of transmasculine individuals. Consequently, generalizations about speech and gender are based on cisgender individuals. This lack of representation hinders clinical training and clinical service delivery, particularly by speech-language pathologists providing gender-affirming communication services. This letter describes a new corpus of the speech of American English–speaking transmasculine men, transmasculine nonbinary people, and cisgender men that is open and available to clinicians and researchers.

Method:

Twenty masculine-presenting native English speakers from the Upper Midwestern United States (including cisgender men, transmasculine men, and transmasculine nonbinary people) were recorded, producing three sets of speech materials: Consensus Auditory–Perceptual Evaluation of Voice sentences, the Rainbow Passage, and a novel set of sentences developed for this project. Acoustic measures vowels (overall formant frequency scaling, vowel–space dispersion, fundamental frequency, breathiness), consonants (voice onset time of word-initial voiceless stops, spectral moments of word-initial /s/), and the entire sentence (rate of speech) that were made.

Results:

The acoustic measures reveal a wide range for all dependent measures and low correlations among the measures. Results show that many of the voices depart considerably from the norms for men's speech in published studies.

Conclusion:

This new corpus can be used to illustrate different ways of sounding masculine by speech-language pathologists performing gender-affirming communication services and by higher education teachers as examples of diverse ways of sounding masculine.
Dynamic modelling and a dual vector modulated improved model predictive control with auto tuning feature of active front‐end converters for distributed energy resources
Authors: Debnath Rajdip , Gupta Gauri Shanker , Kumar Deepak , Tripathi Prabhat R. , El‐Saadany Ehab F. , Fendzi Mbasso Wulfran , Kamel Salah
Published: March 2024

The operational performance of grid‐connected active front‐end converters (AFEs) faces challenges arising from the intricate interplay among phase‐locked loop (PLL) non‐linearities, grid impedance, and conventional control strategies, resulting in compromised stability. This study introduces a refined approach to dynamic model predictive control (MPC) by integrating recursive least squares (RLS) for the precise estimation of physical model parameters, thereby addressing stability concerns. Unlike conventional methodologies, the proposed enhanced RLS‐based MPC approach, equipped with an auto‐tuning feature, allows for the design of controllers without a prerequisite understanding of exact external dynamics. Notably, this technique exhibits exceptional disturbance rejection capabilities. The evaluation of the cost function at each sampling interval facilitates the determination of optimal switching states based on predicted variables. Gate pulses for the switches of the AFEs are generated accordingly. Employing a simulation platform, the proposed control structure's performance across varied conditions is comprehensively assessed, encompassing alterations in grid impedance and system non‐linearities. The method adeptly integrates inherent non‐linearities within the system, showcasing exceptional robustness in diverse dynamic scenarios. To further substantiate the efficacy of the proposed control system over conventional approaches, simulation results are validated using a laboratory hardware platform equipped with Typhoon HIL and dSPACE real‐time emulators, providing tangible evidence of the proposed control system's effectiveness in real‐world hardware setups. The multifaceted approach, encompassing precise parameter estimation, predictive control, auto‐tuning, disturbance rejection, robust design, and real‐time evaluation, collectively establishes a resilient foundation for enhancing and maintaining the overall stability of the system across diverse operating scenarios.
INTEGRAL view of GRB 221009A
Authors: Savchenko Volodymyr , Ubertini Pietro , Bazzano Angela , Craig Rodi James , Jourdain Elisabeth , Roques Jean-Pierre , Martin-Carrillo Antonio , Hanlon Lorraine , Mereghetti Sandro , Tiengo Andrea , Laurent Philippe , Gotz Diego , Ferrigno Carlo , Kuulkers Erik
Published: March 2024

The gamma-ray burst GRB 221009A is among the most luminous of its kind and its proximity to Earth has made it an exceptionally rare observational event. The International Gamma-ray Astrophysics Laboratory (INTEGRAL) was in an optimal aspect position to use its all-sky instruments for recording the prompt emission and early gamma-ray afterglow in unprecedented detail. Following the initial detection, a swiftly scheduled follow-up observation allowed for the hard X-ray afterglow time and spectral evolution to be observed for up to almost a week. The INTEGRAL hard X-ray and soft gamma-ray observations have started to bridge the energy gap between the traditionally well-studied soft X-ray afterglow and the high-energy afterglow observed by Fermi/LAT. We discuss the possible implications of these observations for follow-ups of multi-messenger transients with hard X-ray and gamma-ray telescopes.
Time evolution of the galactic B - ρ relation: The impact of the magnetic field morphology
Authors: Konstantinou A. , Ntormousi E. , Tassis K. , Pallottini A.
Published: March 2024

Context. One of the indicators most frequently used to characterize the magnetic field’s influence on star formation is the relation between the magnetic field strength and the gas density (the B − p relation), usually expressed as a power law of the form B ∝ ρκ. The value of κ is an indication of the dynamical importance of the magnetic field during gas compression.

Aims. In this work, we investigate the role of the global magnetic field morphology on a galaxy’s B − ρ relation, as well as the evolution of the relation over time.

Methods. We developed magnetohydrodynamic simulations of Milky Way-like galaxies that include gravity, star formation, and supernova feedback. The models take into account nonequilibrium chemistry up to H2 formation, which is used to fuel star formation. We considered two different initial magnetic field morphologies: one completely ordered (toroidal) and the other completely random. Using these models, we studied the dynamical importance of the magnetic field through the plasma ß and the B − ρ relation.

Results. For both magnetic morphologies, low-density regions are thermally supported, while high-density regions are magnetically dominated. Equipartition is reached earlier and at lower densities in the toroidal model. However, the B − ρ relation varies, even within the same galaxy, as it consistently includes two different branches for a given density, with κ ranging from about 0.2 to 0.8. The mean value of κ for each model also varies significantly over time, which supersedes the differences between the two models.

Conclusions. While our findings suggest that the magnetic field morphology does influence the galactic B − ρ relation, its impact is transient in nature since time-averaged differences between the models fall within the large temporal scatter. The context and time-dependent nature of the B − ρ relation underscore the need for comprehensive research and observations to understand the intricate role of magnetic fields in star formation processes across diverse galactic environments.
ALMA view of the L1448-mm protostellar system on disk scales: CH3OH and H13CN as new disk wind tracers
Authors: Nazari P. , Tabone B. , Ahmadi A. , Cabrit S. , van Dishoeck E. F. , Codella C. , Ferreira J. , Podio L. , Tychoniec Ł. , van Gelder M. L.
Published: March 2024

Protostellar disks are known to accrete; however, the exact mechanism that extracts the angular momentum and drives accretion in the low-ionization “dead” region of the disk is under debate. In recent years, magnetohydrodynamic (MHD) disk winds have become a popular solution. Even so, observations of these winds require both high spatial resolution (~10 s au) and high sensitivity, which has resulted in only a handful of MHD disk wind candidates to date. In this work we present high angular resolution (~30 au) ALMA observations of the emblematic L1448-mm protostellar system and find suggestive evidence for an MHD disk wind. The disk seen in dust continuum (~0.9 mm) has a radius of ~23 au. Rotating infall signatures in H13CO+ indicate a central mass of 0.4 ± 0.1 M⊙ and a centrifugal radius similar to the dust disk radius. Above the disk, we identify rotation signatures in the outflow traced by H13CN, CH3OH, and SO lines and find a kinematical structure consistent with theoretical predictions for MHD disk winds. This is the first detection of an MHD disk wind candidate in H13CN and CH3OH. The wind launching region estimated from cold MHD wind theory extends out to the disk edge. The magnetic lever arm parameter would be λϕ ≃ 1.7, in line with recent non-ideal MHD disk models. The estimated mass-loss rate is approximately four times the protostellar accretion rate (Ṁacc ≃ 2 × 10−6M⊙ yr−1) and suggests that the rotating wind could carry enough angular momentum to drive disk accretion.
Radial evolution of the accuracy of ballistic solar wind backmapping
Authors: Dakeyo J.-B. , Badman S. T. , Rouillard A. P. , Réville V. , Verscharen D. , Démoulin P. , Maksimovic M.
Published: March 2024

Context.Solar wind backmapping is a technique employed to connect in situ measurements of heliospheric plasma structures to their origin near the Sun. The most widely used method is ballistic mapping, which neglects the effects of solar wind acceleration and corotation and instead models the solar wind as a constant radial outflow whose speed is determined by measurements in the heliosphere. This results in plasma parcel streamlines that form an Archimedean spiral (the Parker spiral) when viewed in the solar corotating frame. This simplified approach assumes that the effects of solar wind acceleration and corotation compensate for each other in the deviation of the source longitude. Most backmapping techniques so far considered magnetic connectivity from a heliocentric distance of 1 au to the Sun.

Aims.We quantify the angular deviation between different backmapping methods that depends on the location of the radial probe and on the variation in the solar wind speed with radial distance. We assess these differences depending on source longitude and solar wind propagation time.

Methods.We estimated backmapping source longitudes and travel times using (1) the ballistic approximation (constant speed), (2) a physically justified method using the empirically constrained acceleration profile Iso-poly, derived from Parker solar wind equations and also a model of solar wind tangential flows that accounts for corotational effects. We compared the differences across mapped heliocentric distances and for different asymptotic solar wind speeds.

Results.The ballistic method results in a Carrington longitude of the source with a maximum deviation of 4″ below 3 au compared to the physics-based mapping method taken as reference. However, the travel time especially for the slow solar wind could be underestimated by 1.5 days at 1 au compared to non-constant speed profile. This time latency may lead to an association of incorrect solar source regions with given in situ measurements. Neglecting corotational effects and accounting for acceleration alone causes a large systematic shift in the backmapped source longitude.

Conclusions.Incorporating both acceleration and corotational effects leads to a more physics-based representation of the plasma trajectories through the heliosphere compared to the ballistic assumption. This approach accurately assesses the travel time and provides a more realistic estimate of the longitudinal separation between a plasma parcel measured in situ and its source region. Nonetheless, it requires knowledge of the radial density and Alfvén speed profiles to compute the tangential flow. Therefore, we propose a compromise for computing the source longitude that employs the commonly used ballistic approach and the travel times computed from the derived radial acceleration speed profile. Moreover, we conclude that this approach remains valid at all radial distances we studied and is not limited to data obtained at 1 au.
H2CO and CS in diffuse clouds: Excitation and abundance
Authors: Gerin Maryvonne , Liszt Harvey , Pety Jérôme , Faure Alexandre
Published: March 2024

Context. Diffuse interstellar clouds present an active chemistry despite their relatively low density and the ubiquitous presence of far-UV radiation.

Aims. To provide constraints on the chemical processes responsible for the observed columns of organic species, we used the NOEMA interferometer to observe the sight line toward NRAO150 (B0355+508) in the 2 mm spectral window.

Methods. We targeted the low excitation lines of ortho H2 CO (21,1–11,0) and para H2 CO (20,2–10,1) as well as the nearby transitions of CS (3–2) and c-C3H2 (31,2–22,1), (41,4–30,3), and (22,0–11,1). We combined these data with previous observations of the same sight line to determine the excitation conditions, column densities, and abundances relative to H2 in the different velocity components. We performed non-LTE radiative transfer calculations including collision cross sections with ortho and para H2 and with electrons. New collision cross sections with electrons were computed for ortho and para formaldehyde.

Results. All targeted lines were detected. The c-C3H2 line profiles are very similar to those of HCO+ and CCH, while the CS absorption features are narrower and mostly concentrated in two main velocity components at VLSR = −17.2 and −10.4 km s−1. H2CO absorption lines present an intermediate pattern with absorption in all velocity components but larger opacities in the two main velocity components. The ortho-to-para ratios of H2CO and c-C3H2 are consistent with the statistical value of three. While the excitation temperature of all c-C3H2 velocity components is consistent with the Cosmic Microwave Background (CMB), the two strong components detected in CS show a clear excess over the CMB indicating that CS resides at higher densities than other species along this particular sightline, n(H2) ~ 2500 cm−3 while n(H2) < 500 cm−3 for the other velocity components. We detected faint absorption from o-H213CO and C34S allowing us to derive isotopic ratios: o-H2CO/o-H213CO = 61 ± 12 and C32S/C34S = 24 ± 6. The excitation of the 11,0−11,1 line of formaldehyde at 4.8 GHz is sensitive to the electron fraction and its excitation temperature is predicted to be lower than the CMB at low and moderate electron fractions (x(e) < 6 × 10−5), and to rise above the CMB at high electron fractions (x(e) > 10−4).
Maximum entropy modelling to identify optimal locations for an IMTA system comprisingSparus aurata, Mytilus galloprovincialis and Ulva rigidaon Europe’s Atlantic coastline
Authors: Hughes Conchúr , King Jonathan W.
Published: March 2024

Meeting the resource demand for an increasing human population has led to the emergence of the aquaculture industry as the fastest growing sector for food production worldwide. Modern finfish aquaculture has raised environmental concerns and, to address this, Integrated Multi-Trophic Aquaculture (IMTA) has gained popularity as a means to minimise environmental impacts. This is done by culturing extractive species alongside fed species to utilise excess nutrients and enhance their own growth. The current study, based within the Atlantic Area of Europe, identified suitable habitats for the three speciesSparus aurata, Mytilus galloprovincialisandUlva rigida, for use in a new IMTA system. Models were created using MaxEnt software and input into GIS software (ArcMap 10.8.1) for analysis. For all species, the AUC results in the model were >0.9, with values of 0.931 (S. aurata), 0.928 (M. galloprovincialis) and 0.939 (U. rigida), demonstrating significant predictive power. Jackknife testing of the model for each species identified the mean sea surface temperature (°C) and Chlorophyll A (mg m–3) concentration as the two most important variables. The model showed that areas of >50% suitability could be found throughout the study area, although the most suitable sites were in coastal areas in more southern latitudes. To identify the feasibility of establishing an IMTA system in different areas, the shipping density, MPA status and the locations of harbours were added to the maps for further consideration. Using this study, and the species-specific information identified by the model, the aquaculture industry will be better equipped to identify potential IMTA sites and integrate these systems into the EU market for sustainable production.
Perfect plasticity versus damage: an unstable interaction between irreversibility and Γ-convergence through variational evolutions
Authors: Bonhomme Élise
Published: March 2024

This paper addresses the question of the interplay between relaxation and irreversibility through quasi-static evolutions in damage mechanics, by inquiring the following question: can the quasistatic evolution of an elastic material undergoing a rate-independent process of plastic deformation be derived as the limit model of a sequence of quasi-static brittle damage evolutions? This question is motivated by the static analysis performed in [J.-F. Babadjian et al. Commun. Pure Appl. Math. 74 (2021) 1803–1854], where the authors have shown how the brittle damage model introduced by Francfort and Marigo (see [G.A. Francfort and J.-J. Marigo, Eur. J. Mech. A Solids 12 (1993) 149–189, G.A. Francfort and J.-J. Marigo, J. Mech. Phys. Solids 46 (1998) 1319–1342]) can lead to a model of Hencky perfect plasticity. Problems of damage mechanics being rather described through evolution processes, it is natural to extend this analysis to quasi-static evolutions, where the inertia is neglected.We consider the case where the medium is subjected to time-dependent boundary conditions, in the one-dimensional setting. The idea is to combine the scaling law considered in [J.-F. Babadjian, et al. Commun. Pure Appl. Math. 74 (2021) 1803–1854] with the quasi-static brittle damage evolution introduced in [G.A. Francfort and A. Garroni, Arch. Rational Mech. Anal. 182 (2006) 125–152] by Francfort and Garroni, and try to understand how the irreversibility of the damage process will be expressed in the limit evolution. Surprisingly, the interplay between relaxation and irreversibility is not stable through time evolutions. Indeed, depending on the choice of the prescribed Dirichlet boundary condition, the effective quasi-static damage evolution obtained may not be of perfect plasticity type.
Magnetorheological fluids: A comprehensive review
Authors: Chauhan Vinod , Kumar Ashwani , Sham Radhey
Published: March 2024

The magnetorheological (MR) fluids contain magnetic micro-sized iron particles, non-magnetic-based fluid, and some additives in order to mitigate sedimentation and agglomeration. The various carrier fluids used in the preparation of MR fluids are mineral oil, silicon oil, castor oil, soybean oil, kerosene, synthetic oils, honge oil, organic oil, water-based oils, etc. However, for obtaining better vibration control, silicone oil is the most preferred one due to its higher viscosity index, lower friction characteristics, higher flash point, and higher shear strength. The MR fluids have various application areas such as dampers, prosthetic knees, valves, brakes, clutches, finishing processes etc. The dampers containing MR fluids are used in automobile cushioning for enhancing passenger comfort and MR suspensions significantly improve steering stability in vehicles. In case of MR brakes, the braking torque on the rotating disks is controlled using the generated shear stress. The carbonyl iron (CI) particles exhibit better rheological characteristics as compared to electrolytic iron (EI) particles. The use of MR fluids produces stable and natural limb movement in orthoses, lower limb prostheses, and exoskeletons. The MR fluids also prove to be very significant in polishing applications. There are various issues with preparation methods and difficulties in the storage of MR fluids. The problems encountered in the synthesis of MR fluids include sedimentation, agglomeration, in-use thickening, corrosion, erosion, etc. The impact of particle proportion, particle shapes, and size has been influential in evaluating MR characteristics. The viscosity and shear stress of MR fluid have been mitigated at higher values of temperature and even CI particles get oxidized at higher temperatures. The CI particles as compared to EI particles are the majority favourable particles used for dispersing state within the MR fluids due to their higher value of saturation magnetization, more availability, and lesser cost. The small-sized particles led to lower wettability, whereas larger-sized particles accounted for an increased sedimentation rate. The currently available MR fluids cost is still on the higher side and the preparation of economical MR fluid is still a big challenge for the researchers. The MR fluids storage is also a big concern. The future scope of MR fluid may be in heavy industries such as nuclear, shipbuilding, oil and gas, space and aviation, etc. to achieve the desired damping response.
Comparison of Neuromuscular Fatigue in Powerlifting Paralympics in
Different Training Methods
Authors: Getirana-Mota Márcio , Aidar Felipe J. , Ribeiro Neto Frederico , Santos Taísa Pereira , Almeida-Neto Paulo Francisco de , Cabral Breno Guilherme de Araújo Tinôco , Vieira-Souza Lucio Marques , D. Garrido Nuno , Reis Victor M. , Souza Raphael Fabricio
Published: March 2024

Mean propulsive velocity (MPV) has been associated with neuromuscular fatigue;
however, its suitability for strength training in Paralympic powerlifting (PP)
remains uncertain. The objective of this work was to evaluate the MPV in two
training methods (traditional-TRAD and eccentric-ECC). Eleven PP athletes were
evaluated pre, during the intervention and post intervention at a load of 80% of
the 1RM for TRAD and 110%–80% of 1 RM for ECC. The results demonstrated that
there was no significant neuromuscular fatigue for the TRAD (~5% performance
loss), as well as no significant decline in MPV during the intervention. For the
ECC, there is a significant reduction in MPV before and after training (~12%
loss of performance). A difference between TRAD and ECC after the intervention
was also identified (0.87 m/s±0.22, 95% CI 0.72–1.02 vs. 0.72±0.20, 95% CI
0.59–0.86 p=0.042, F(3.30)=10.190, η2p=0.505 - very high effect). During the
intervention for ECC, no significant decline in MPV was observed. The results of
this study suggest that the mechanical indices of MPV do not seem to be
effective indicators of neuromuscular fatigue in the sample studied or in the
context of this specific training regime, being more indicated as a control of
training volume.
Biomechanical Stability of Femoral Neck System for Pauwels Type III Femoral Neck Fractures Based on Different Reduction Quality
Authors: Huang Daoqiang , Wang Xiaoping , Chen Bingze , Hu Zhiqiang , Feng Weili
Published: March 2024

To further investigate the biomechanics of a femoral neck system (FNS) for Pauwels type
III femoral fractures based on three different reductions.

We constructed three different reduction (anatomical reduction, negative buttress
reduction, and positive buttress reduction) models of Pauwels type III femoral neck
fractures. Then, three cannulated screws (3CS), dynamic hip screws (DHS), dynamic hip screws
combined with an anti-rotation screw (DHS + ARS), one-hole femoral neck system (1HFNS), and
two-hole femoral neck system (2HFNS) were assembled with the reduction models, respectively,
to simulate the internal fixation surgical procedure. All models had a load of 2100 N in
line with the femoral mechanical axis applied. The implant stress, the head and implant
displacements, and the rotational angles of all models were recorded and analyzed.

Compared to 3CS and 2HFNS, 1HFNS had higher implant stress (higher than 92.5 MPa and
46.3 MPa, respectively) and displacement (higher than 0.9 mm and 0.8 mm, respectively) in
the anatomical reduction. 2HFNS exhibited the highest stress values (225.5 MPa) in the
anatomical reduction but the lowest values (159.8 MPa) in the positive buttress reduction
when compared to the other implants. 2HFNS showed the best rotational stability in the
negative and positive buttress reduction (rotational angels of 0.8° and 0.6°,
respectively).

Based on the outcome of this computational study, it might be concluded that 2HFNS was
an alternative fixation for the treatment of Pauwels type III femoral neck fracture,
especially when anatomical reduction cannot be perfectly attained. More relevant clinical
and biomechanical studies are needed in the future.
Comparative evaluation of a language model and human specialists in the application of European guidelines for the management of inflammatory bowel diseases and malignancies
Authors: Waterman Matti , Gorelik Yuri , Ghersin Itai , Weisshof Roni , Koifman Eduard , Bar-Yoseph Haggai , Ben Hur Dana , Maza Itay , Hasnis Erez , Nasser Roni , Ovadia Baruch , Dror Zur Dikla
Published: March 2024

Background Society guidelines on colorectal dysplasia screening, surveillance, and endoscopic management in inflammatory bowel disease (IBD) are complex, and physician adherence to them is suboptimal. We aimed to evaluate the use of ChatGPT, a large language model, in generating accurate guideline-based recommendations for colorectal dysplasia screening, surveillance, and endoscopic management in IBD in line with European Crohn’s and Colitis Organization (ECCO) guidelines.

Methods 30 clinical scenarios in the form of free text were prepared and presented to three separate sessions of ChatGPT and to eight gastroenterologists (four IBD specialists and four non-IBD gastroenterologists). Two additional IBD specialists subsequently assessed all responses provided by ChatGPT and the eight gastroenterologists, judging their accuracy according to ECCO guidelines.

Results ChatGPT had a mean correct response rate of 87.8%. Among the eight gastroenterologists, the mean correct response rates were 85.8% for IBD experts and 89.2% for non-IBD experts. No statistically significant differences in accuracy were observed between ChatGPT and all gastroenterologists (P=0.95), or between ChatGPT and the IBD experts and non-IBD expert gastroenterologists, respectively (P=0.82).

Conclusions This study highlights the potential of language models in enhancing guideline adherence regarding colorectal dysplasia in IBD. Further investigation of additional resources and prospective evaluation in real-world settings are warranted.
Using a customized GPT to provide guideline-based recommendations for management of pancreatic cystic lesions
Authors: Klein Amir , Khamaysi Iyad , Gorelik Yuri , Ghersin Itai , Arraf Tarek , Ben-Ishay Offir
Published: March 2024

Background and study aims Rising prevalence of pancreatic cysts and inconsistent management guidelines necessitate innovative approaches. New features of large language models (LLMs), namely custom GPT creation, provided by ChatGPT can be utilized to integrate multiple guidelines and settle inconsistencies.

Methods A custom GPT was developed to provide guideline-based management advice for pancreatic cysts. Sixty clinical scenarios were evaluated by both the custom GPT and gastroenterology experts. A consensus was reached between experts and review of guidelines and the accuracy of recommendations provided by the custom GPT was evaluated and compared with experts.

Results The custom GPT aligned with expert recommendations in 87% of scenarios. Initial expert recommendations were correct in 97% and 87% of cases, respectively. No significant difference was observed between the accuracy of custom GPT and the experts. Agreement analysis using Cohen's and Fleiss' Kappa coefficients indicated consistency among experts and the custom GPT.

Conclusions This proof-of-concept study shows the custom GPT's potential to provide accurate, guideline-based recommendations for pancreatic cyst management, comparable to expert opinions. The study highlights the role of advanced features of LLMs in enhancing clinical decision-making in fields with significant practice variability.
Synthesis of Fused-Ring Pyrrolizine Derivatives via a Copper-Catalyzed Radical Cascade Cyclization
Authors: Ding Dong , Ji Ya-Fei , Xu Xiao-Bo , Hao Li-Qiang , Liu Xian , Wang Yang-Yang , Yang Zhao-Zi-Yuan , Yu Xiao
Published: March 2024

Herein, an atom-economic method for the synthesis of fused-ring pyrrolizine derivatives by a cycloaddition reaction of easily accessible N-substituted pyrrole-2-carboxaldehydes with N-substituted maleimides in the presence of di-tert-butyl peroxide has been successfully developed. A total of 23 compounds were obtained by using this method, with a maximum yield of 72%, providing a practical and efficient method for the synthesis of tricyclic pyrrolizine frameworks.
Künstliche Intelligenz bei lamellierenden Keratoplastiken
Authors: Siebelmann Sebastian , Hayashi Takahiko , Matthaei Mario , Bachmann Björn O. , Stammen Johannes , Cursiefen Claus
Published: March 2024

Das Training von künstlicher Intelligenz (KI) wird auch in der Vorderabschnittschirurgie populärer. Zunehmend werden auch Studien zu lamellierenden Keratoplastiken veröffentlicht. Insbesondere die Möglichkeit der nicht invasiven und hochauflösenden Bildgebungstechnologie der optischen Kohärenztomografie prädestiniert die lamellierenden Keratoplastiken zur Anwendung von KI. Obwohl technisch einfach durchführbar, existieren bisher nur wenige Studien zum Einsatz von KI zur Optimierung lamellierender Keratoplastiken. Die vorhandenen Studien konzentrieren sich dabei vor allem auf die Vorhersagewahrscheinlichkeit eines Rebubblings bei DMEK und DSAEK bzw. auf deren Transplantatadhärenz sowie auf die Formation einer Big Bubble bei der DALK. Zudem ist die automatisierte Erfassung von Routineparametern wie Hornhautödem, Endothelzelldichte oder Größe der Transplantatablösung mittels KI inzwischen möglich. Die Optimierung der lamellierenden Keratoplastiken mittels KI birgt ein großes
Potenzial. Dennoch bestehen Limitationen der veröffentlichten Algorithmen insofern, dass diese bisher nur eingeschränkt zwischen Zentren, Chirurgen sowie unterschiedlichen Geräteherstellern übertragbar sind.
Iodosulfonylation of [1.1.1]Propellane
Authors: Cheng Dongping , Li Jing-Hua , Chen Mengke , Ling Min , Huang Zhiwei
Published: March 2024

An efficient disubstituted functionalization of [1.1.1]propellane has been developed. The protocol utilizes sulfonyl hydrazides and N-iodosuccinimide, enabling the introduction of iodine and sulfonyl groups into bicyclo[1.1.1]pentane (BCP) in moderate to excellent yields. It has the advantages of simple operation, mild conditions, and broad substrate scope.
Preoperative Serum Thyroglobulin Levels Predict Radioiodine Therapy
Outcome in Papillary Thyroid Microcarcinoma Patients
Authors: Cheng Xian , Fan Yijun , Ye Wanzhong , Xu Shichen , Wu Jing , Gao Wenjing , Bao Jiandong , Yu Huixin , Zhang Li
Published: March 2024

Our previous study showed that elevated preoperative thyroglobulin (pre-Tg) level
predicted the risk of developing radioiodine refractory in PTC patients. In the
present study, we aimed to evaluate the prognostic value of pre-Tg in papillary
thyroid microcarcinoma (PTMC). After a specific inclusion and exclusion criteria
were applied, a total of 788 PTMCs were enrolled from Jiangyuan Hospital
affiliated to Jiangsu Institute of Nuclear Medicine between Jan 2015 and Dec
2019. Among them, 107 PTMCs were treated with radioiodine therapy (RAIT) and the
response to therapy was grouped as excellent response (ER), and non-excellent
response (NER: indeterminate response, IDR and biochemical incomplete response,
BIR). Multivariable logistic regression was used to identify predictors for the
response of RAIT in PTMCs. Higher pre-Tg levels were detected in PTMCs with RAIT
as compared with PTMCs without RAIT (p=0.0018). Higher levels of pre-Tg were
also found in patients with repeated RAIT as compared with patients with single
RAIT (p<0.0001). Furthermore, pre-Tg level was higher in PTMC with IDR (n=16)
and much higher in BIR (n=9) as compared with patients with ER (n=82, p=0.0003)
after RAIT. Multivariate analysis showed that pre-Tg level over 16.79 ng/ml [OR:
6.55 (2.10–20.39), p=0.001] was the only independent predictor for NER in PTMC
with RAIT. We found that high level of pre-Tg predicted a poor RAIT outcome in
PTMC. Our finding explores a prospective way in identifying high-risk PTMCs with
poor response to RAIT.
Outcomes of Deep Inferior Epigastric Artery Perforator (DIEP) Flap in Indian Population—A Prospective Single-Institute Study
Authors: Marwah Annika , Chandrappa Ashok Basur , Vasudevan Srikanth , Rao Ananteshwar Y.N. Yelambalase , Sreekumar Dinkar , Shetty Pooja , Bharathkar Serena , SP Somashekhar
Published: March 2024

Introduction Breast reconstruction has become integral part of breast cancer treatment. Deep inferior epigastric perforator (DIEP)-based flap is considered the gold standard in autologous breast reconstruction.

Aims and Objectives The aim of this study was to evaluate the patient satisfaction and the incidence of complications in DIEP flaps in an Indian setup for breast reconstruction.

Materials and Methods This is a prospective, nonrandomized study at a single institute—Manipal Hospitals, Old Airport Road, Bangalore. Eligible patients were women aged between 28 and 60 years with primary breast cancer requiring mastectomy and radiotherapy, who consented for DIEP flap reconstruction.

Results The study includes subjects who had autologous breast reconstruction after mastectomy with DIEP flap between January 2019 and August 2021 that included 31 patients with a minimum follow-up of 2 years. Four flaps were turbocharged and 17 flaps were superdrained primarily. The average operative time for the whole procedure by adopting a two-team approach is 353.8 ± 43.793 minutes. About 94.1% patients had excellent aesthetic score results. Six patients developed mastectomy flap necrosis, one had fat necrosis that was managed conservatively, whereas one patient had donor site re-exploration for hematoma. We had no DIEP flap necrosis, seroma, flap site hematoma, or flap failure. Physical well-being module of Breast-Q indicated an average of 83 points, psychosocial well-being module indicated 80 points, whereas sexual scores reverted an average of 77 points. Among satisfaction module, aesthetic outcomes for breast showed an average of 94 points, whereas the donor site had 96 points. Satisfaction with information, surgeon, medical staff each gained more than 87 points.

Conclusion Breast reconstruction with DIEP flap yields good aesthetic outcomes and quality of life in Indian population. The incidence of fat necrosis, flap and donor site complications is less over time and will enhance the patient satisfaction score further.
Longitudinal Volume Assessment of Reconstructed Breast Using Three-Dimensional Measurement: How Do DIEP and LD Flap Change Immediately after Surgery?
Authors: Utsunomiya Hiroki , Tanaka Ryutaro , Akamine Shuryo , Kusano Taro , Kuroki Tomoaki , Kadomatsu Koichi
Published: March 2024

Background The deep inferior epigastric perforator (DIEP) and latissimus dorsi (LD) flaps are two widely used autologous breast reconstructions. Despite studies on flap-volume changes, the time of the first measurement is not immediately after surgery. Therefore, this study aimed to investigate the change in volume over time from the immediate postoperative period using a three-dimensional (3D) scanner.

Methods Patients who underwent breast reconstruction with a DIEP or LD flap between October 2019 and December 2020 at Showa University Koto Toyosu Hospital were included. The Kinect 3D scanner was used to measure the reconstructed and healthy breast volumes immediately after surgery and at 1, 3, 6, and 12 months. The control group was the healthy side, and the volumes obtained at each time point and ratios (to the immediate postoperative period) were calculated and analyzed using a linear mixed model.

Results Of the 25 patients and 26 breasts examined, the postoperative increase in volume ratios was statistically significant in the DIEP flap group, except for the sixth month, but decreased significantly in the LD group. Compared with the control group, the volume ratio was significantly higher up to 3 months in the DIEP flap group and decreased significantly after 3 months in the LD flap group.

Conclusions The volume of the LD flap continued to decrease immediately after surgery, whereas the volume of the DIEP flap increased by 10% up to 1M. Therefore, this increase in volume should be taken into consideration in studies where the initial measurements were not taken immediately after surgery.
Pulmonary Hypertension in Connective Tissue Diseases Other than Systemic Sclerosis
Authors: Budhram Brandon , Weatherald Jason , Humbert Marc
Published: March 2024

Pulmonary hypertension (PH) is a known complication of certain connective tissue diseases (CTDs), with systemic sclerosis (SSc) being the most common in the Western world. However, PH in association with non-SSc CTD such as systemic lupus erythematous, mixed connective tissue disease, and primary Sjögren's syndrome constitutes a distinct subset of patients with inherently different epidemiologic profiles, pathophysiologic mechanisms, clinical features, therapeutic options, and prognostic implications. The purpose of this review is to inform a practical approach for clinicians evaluating patients with non-SSc CTD-associated PH.

The development of PH in these patients involves a complex interplay between genetic factors, immune-mediated mechanisms, and endothelial cell dysfunction. Furthermore, the broad spectrum of CTD manifestations can contribute to the development of PH through various pathophysiologic mechanisms, including intrinsic pulmonary arteriolar vasculopathy (pulmonary arterial hypertension, Group 1 PH), left-heart disease (Group 2), chronic lung disease (Group 3), chronic pulmonary artery obstruction (Group 4), and unclear and/or multifactorial mechanisms (Group 5). The importance of diagnosing PH early in symptomatic patients with non-SSc CTD is highlighted, with a review of the relevant biomarkers, imaging, and diagnostic procedures required to establish a diagnosis.

Therapeutic strategies for non-SSc PH associated with CTD are explored with an in-depth review of the medical, interventional, and surgical options available to these patients, emphasizing the CTD-specific considerations that guide treatment and aid in prognosis. By identifying gaps in the current literature, we offer insights into future research priorities that may prove valuable for patients with PH associated with non-SSc CTD.
Glanzmann Thrombasthenia 10 Years Later: Progress Made and Future Directions
Authors: Nurden Alan T. , Nurden Paquita
Published: March 2024

Glanzmann thrombasthenia (GT) is the most common inherited platelet disorder (IPD) with mucocutaneous bleeding and a failure of platelets to aggregate when stimulated. The molecular cause is insufficient or defective αIIbβ3, an integrin encoded by the ITGA2B and ITGB3 genes. On activation αIIbβ3 undergoes conformational changes and binds fibrinogen (Fg) and other proteins to join platelets in the aggregate. The application of next-generation sequencing (NGS) to patients with IPDs has accelerated genotyping for GT; progress accompanied by improved mutation curation. The evaluation by NGS of variants in other hemostasis and vascular genes is a major step toward understanding why bleeding varies so much between patients. The recently discovered role for glycoprotein VI in thrombus formation, through its binding to fibrin and surface-bound Fg, may offer a mechanosensitive back-up for αIIbβ3, especially at sites of inflammation. The setting up of national networks for IPDs and GT is improving patient care. Hematopoietic stem cell therapy provides a long-term cure for severe cases; however, prophylaxis by monoclonal antibodies designed to accelerate fibrin formation at injured sites in the vasculature is a promising development. Gene therapy using lentil-virus vectors remains a future option with CRISPR/Cas9 technologies offering a promising alternative route.
Risk Factors and Outcomes for Recurrent Pediatric In-Hospital Cardiac Arrest: Retrospective Cohort Study from the American Heart Association's Get with the Guidelines-Resuscitation Registry
Authors: Frazier Maria E. , Brown Stephanie R. , O'Halloran Amanda , Raymond Tia , Kleinman Monica E. , Sutton Robert M. , Roberts Joan , Tegtmeyer Ken , Wolfe Heather A. , Nadkarni Vinay , Dewan Maya ,   for the American Heart Association's Get With The Guidelines®- Resuscitation Investigators
Published: March 2024

Objective We aimed to describe the risk factors and outcomes of recurrent in-hospital cardiac arrest (IHCA) in a large pediatric cohort.

Methods A retrospective cohort study of patients ≤18 years from the American Heart Association's Get With The Guidelines®-Resuscitation Registry with single or recurrent IHCA who achieved return of spontaneous circulation and were not placed on extracorporeal membrane oxygenation with their initial IHCA were included. Patients were categorized into two groups for analysis: (1) single IHCA or (2) recurrent ICHA. Initial IHCAs from each category were analyzed and compared. Continuous variables were expressed as medians with interquartile ranges and compared via rank sum test. Categorical variables were expressed as percentages and compared via chi square test. Outcomes were assessed in a matched cohort.

Results A total of 10,019 patients, 2,225 (22.2%) experienced a recurrent IHCA. Recurrent IHCA patients were more likely to be medical cardiac (21.3 vs. 19%; p = 0.01) or trauma patients (7.5 vs. 5.3%; p < 0.001) and have higher acuity (27.8 vs. 22.7%; p < 0.001). Initial IHCA for recurrent IHCA patients were more likely to occur in the pediatric intensive care unit (44.2 vs. 39.6%; p < 0.001) or cardiac intensive care unit (11.5 vs. 9.5%; p = 0.006) versus other inpatient locations. There was no difference in initial IHCA duration between groups. After matching, patients with a recurrent IHCA had a lower rate of survival to hospital discharge (42.1 vs. 65.3%; p < 0.001).

Conclusion In a matched cohort, patients with recurrent IHCA had lower rates of survival compared with those with a single IHCA. Higher acuity and intensive care unit location during initial IHCA event were associated with increased risk for recurrent IHCA.
Analysis of influencing factors for housing construction technology in Desakota Village and town communities in China
Authors: Li Zhixing , He Xin , Ding Zhuojun , Hossain Md. Mehrab , Rifat Md. Tanvir Rahman , Sobuz Md. Habibur Rahman , Zhao Yafei
Published: March 2024

Rapid urbanization has reformed the peripheries of China’s main cities during the last four decades. The rural areas have been constantly developed through infrastructure development in recent days which introduces a newly semi-urban region referred to as Desakota. The purpose of this research is to discover potential influencing factors of housing construction technology in desakotas of China which needs to be assessed for the implementation of Desakotas forming globally. In this study, a total of six key primary factors and twenty key secondary factors have been shortlisted, which were surveyed by 120 respondents. After the statistical analysis, it is seen that one primary factor, “Architectural and engineering mechanical factors” has been ranked top. Moreover, “Cost, financial and economic evaluation and Analysis of the impact of the natural environment on buildings” both ranked top among twenty secondary factors. This study adds to the body of knowledge by revealing the primary contributing elements for the first time that need to be taken into consideration in the rural and town communities of desakotas in China. The study results could help stakeholders, construction firms, academicians, researchers, and the government to focus their efforts and resources on the significant changes in the Desakotas in preparation for rapid urban development.
Hamiltonian Monodromy via spectral Lax pairs
Authors: Gutierrez Guillen G. J. , Sugny D. , Mardešić P.
Published: March 2024

Hamiltonian Monodromy is the simplest topological obstruction to the existence of global action-angle coordinates in a completely integrable system. We show that this property can be studied in a neighborhood of a focus-focus singularity by a spectral Lax pair approach. From the Lax pair, we derive a Riemann surface which allows us to compute in a straightforward way the corresponding Monodromy matrix. The general results are applied to the Jaynes–Cummings model and the spherical pendulum.
Numerical study of the suppression of magnetic reconnection onset with injected plasma
Authors: Yu Jiacheng , Zhong Jiayong , Ping Yongli , An Weiming
Published: March 2024

In this study, we perform two simulations with different plasma injection times. These simulations use the experimental setup of double-coil target-driven magnetic reconnection. The injected plasma is introduced as an external factor influencing the suppression of magnetic reconnection. Under the influence of the injected plasma, the magnetic field cannot pile up in the current sheet because the magnetic force and thermal pressure on both sides have decreased. As a result, under the combined influence of these factors, the current sheet cannot become sufficiently thin and reconnection is suppressed. Consequently, the terms for electron inertia and the non-diagonal components of the electron pressure tensor, which contribute to the reconnection electric field, are all smaller due to a reduction of the magnetic flux in the current sheet. The study provides a plausible experimental scheme for studying the onset of magnetic reconnection in the laboratory. It may also potentially provide new ideas for investigating the onset of magnetic reconnection in different environments, such as turbulent magnetic reconnection in Earth's magnetosheath.
Neutralizing coffee-ring effect using gradual structures for uniform particle distribution
Authors: Wang Jie , Li Zhenghao , Shang Xiaoyi , Li Zhenqing , Du Lin , Zhang Dawei
Published: March 2024

The coffee-ring effect is a process that takes place when a tiny drop of liquid-containing particles disappears, resulting in a distinct deposit around the edge of the spill resembling a ring. One of the primary causes of this effect is the uneven distribution of particles due to dissimilar evaporation rates on the droplet surface and contact line pinning effects. In this research, a microwell with a gradual structure has been developed to regularize the slippery Wenzel wettability of the surface and control the particle distribution. The mobility and pinning of droplet contact lines during the evaporation process are greatly influenced by this structure. The uniform curvature of the sidewall structure is predisposed to contact line depinning and thus helps the sliding of droplets to further neutralize the coffee-ring effect. Contact line pinning is predominantly observed at the corners of the structure, which are encircled by the ends and bottoms of the microwell's sidewalls. The curvature changes at this point, enhancing van der Waals' forces and resulting in a uniform monolayer of sediment being deposited at the microwell's bottom. The restraining efficacy of microwells of gradual structure on coffee rings with polystyrene spheres was confirmed, and the impact of microwell diameter, particle diameter, and loading efficacy on particle deposition distribution was investigated. The results show that the gradient configuration permits a single layer and even distribution of particles, enabling the sediment's dimensions to be anticipated and evaluated.