bluuebunny/crossref_metadata_2025 huggingface dataset:
Coil sketching for computationally efficient MR iterative reconstruction
Authors: Oscanoa Julio A. , Ong Frank , Iyer Siddharth S. , Li Zhitao , Sandino Christopher M. , Ozturkler Batu , Ennis Daniel B. , Pilanci Mert , Vasanawala Shreyas S.
Published: October 2023

Purpose

Parallel imaging and compressed sensing reconstructions of large MRI datasets often have a prohibitive computational cost that bottlenecks clinical deployment, especially for three‐dimensional (3D) non‐Cartesian acquisitions. One common approach is to reduce the number of coil channels actively used during reconstruction as in coil compression. While effective for Cartesian imaging, coil compression inherently loses signal energy, producing shading artifacts that compromise image quality for 3D non‐Cartesian imaging. We propose coil sketching, a general and versatile method for computationally‐efficient iterative MR image reconstruction.

Theory and Methods

We based our method on randomized sketching algorithms, a type of large‐scale optimization algorithms well established in the fields of machine learning and big data analysis. We adapt the sketching theory to the MRI reconstruction problem via a structured sketching matrix that, similar to coil compression, considers high‐energy virtual coils obtained from principal component analysis. But, unlike coil compression, it also considers random linear combinations of the remaining low‐energy coils, effectively leveraging information from all coils.

Results

First, we performed ablation experiments to validate the sketching matrix design on both Cartesian and non‐Cartesian datasets. The resulting design yielded both improved computatioanal efficiency and preserved signal‐to‐noise ratio (SNR) as measured by the inverse g‐factor. Then, we verified the efficacy of our approach on high‐dimensional non‐Cartesian 3D cones datasets, where coil sketching yielded up to three‐fold faster reconstructions with equivalent image quality.

Conclusion

Coil sketching is a general and versatile reconstruction framework for computationally fast and memory‐efficient reconstruction.
Determination of electromagnetic traveling path in polymer/multi‐walled carbon nanotube nanocomposite foams and analysis by Taguchi technique
Authors: Azerang Bashar , Azdast Taher , Doniavi Ali , Hasanzadeh Rezgar
Published: October 2023

The attenuation of electromagnetic (EM) energy with polymeric nanocomposite foams is significant because the microwave energy is diminished by multiscattering of EM into microcellular structure. In this study, acrylonitrile butadiene styrene (ABS) and multi‐walled carbon nanotubes (MWCNTs) nanocomposite foams were fabricated via a chemical foaming in an injection‐molding process. It was demonstrated that the skin depth in foamed ABS/MWCNT specimens was fallen dramatically compared to their solid counterparts. The diminution of skin depth for foamed ABS/1 wt% of MWCNT nanocomposite was 21.7% compared to solid pure ABS. The reflectance of pure ABS was decreased by foaming but it was increased in foamed ABS/MWCNT nanocomposite. The absorption of microwave was improved by foaming and adding MWCNTs in ABS matrix. The utmost value of the experimental absorption shielding effectiveness (SEA. experimental), 14.26 dB, was found for the foamed ABS/1 wt% of MWCNT, holding pressure of 2 s and cooling time of 60 s F8, at 8.7 GHz. It was demonstrated that traveling path of EM wave was prolonged by the introduction of microcellular structure in ABS/MWCNT nanocomposite. Moreover, the contribution of MWCNT, holding pressure time, and cooling time to traveling path were achieved 76.7%, 8.5%, and 7.3%, respectively.

Highlights

ABS/MWCNTs nanocomposite foams were fabricated by chemical foaming process.

Skin depth in foamed nanocomposite samples was fallen compared to solids.

Reflectance of pure ABS was decreased by foaming.

Absorption of microwave was improved by foaming and MWCNTs.

Traveling path of EM wave was prolonged by microcellular structure.
Enhancing flame retardancy of poly(lactic acid) with a novel fully biobased flame retardant synthesized from phytic acid and cytosine
Authors: Qin Wangping , Zhang Ruike , Fu Yan , Chang Jie
Published: October 2023

In order to reduce environmental pollution and improve material safety, biobased flame‐retardant polymers are gradually becoming a new trend. We synthesized a fully biobased flame retardant called PACY by reacting phytic acid (PA) and cytosine (CY) in water, and then mixed the flame retardant with biodegradable poly(lactic acid) (PLA) to obtain composites, characterizing the performance of the composites by microscopic morphology, thermal properties, flame‐retardant performance and so on. The test results showed that the PLA composite with 2 wt% PACY (PLA/2PACY) achieved UL‐94V‐1 and the PLA composite with 4 wt% PACY (PLA/4PACY) had a limiting oxygen index of 23.6%. Compared to pure PLA, PLA/4PACY had good flame retardancy with 12% less peak heat release and 19% less total heat release. Analysis of the flame‐retardant mechanism showed that PACY could promote the formation of a graphitized carbon layer after burning PLA, therefore enhancing the flame‐retardant properties of PLA. Through a thermal stability study, it was found that the temperature required for PACY mass loss of 5% was 275 °C and the residual weight reached 38% at 750 °C, which indicated high thermal stability and residual carbon rate. The addition of PACY also improved the thermal conductivity of PLA, with that of PLA/4PACY being 3.84 times higher than that of pure PLA. In addition, the tensile strength, flexural modulus, maximum force during impact and maximum energy received during fracture of PLA/4PACY increased by 3.3%, 8.1%, 29.2% and 17.5% respectively over pure PLA, effectively improving the mechanical properties of PLA. Overall, a fully biobased flame retardant was synthesized for improving the fire resistance of PLA degradable polymers. © 2023 Society of Industrial Chemistry.
Challenges in bridging the gap between protein structure prediction and functional interpretation
Authors: Varadi Mihaly , Tsenkov Maxim , Velankar Sameer
Published: October 2023

The rapid evolution of protein structure prediction tools has significantly broadened access to protein structural data. Although predicted structure models have the potential to accelerate and impact fundamental and translational research significantly, it is essential to note that they are not validated and cannot be considered the ground truth. Thus, challenges persist, particularly in capturing protein dynamics, predicting multi‐chain structures, interpreting protein function, and assessing model quality. Interdisciplinary collaborations are crucial to overcoming these obstacles. Databases like the AlphaFold Protein Structure Database, the ESM Metagenomic Atlas, and initiatives like the 3D‐Beacons Network provide FAIR access to these data, enabling their interpretation and application across a broader scientific community. Whilst substantial advancements have been made in protein structure prediction, further progress is required to address the remaining challenges. Developing training materials, nurturing collaborations, and ensuring open data sharing will be paramount in this pursuit. The continued evolution of these tools and methodologies will deepen our understanding of protein function and accelerate disease pathogenesis and drug development discoveries.
A dynamical Gaussian, lognormal, and reverse lognormal Kalman filter
Authors: Van Loon Senne , Fletcher Steven J.
Published: October 2023

We derive a generalization of the Kalman filter that allows for non‐Gaussian background and observation errors. The Gaussian assumption is replaced by considering that the errors come from a mixed distribution of Gaussian, lognormal, and reverse lognormal random variables. We detail the derivation for reverse lognormal errors and extend the results to mixed distributions, where the number of Gaussian, lognormal, and reverse lognormal state variables can change dynamically every analysis time. We test the dynamical mixed Kalman filter robustly on two different systems based on the Lorenz 1963 model, and demonstrate that non‐Gaussian techniques generally improve the analysis skill if the observations are sparse and uncertain, compared with the Gaussian Kalman filter.
Assessing environmental impacts of response strategies for sustainable food system transformation
Authors: Yang Jing , Gao Lei , Liu Qi , Guo Zhaoxia
Published: October 2023

The global food system is recognized as the largest source of pressure on the Earth's stability, and there is a pressing need for a swift global transformation toward a sustainable food system, which is also crucial for achieving the Sustainable Development Goals (SDGs) and the Paris Agreement goals. While various response strategies have been developed to achieve the sustainable food system, it remains unclear how different response strategies and their combinations interactively affect global environmental functions. Here, we use a system dynamics‐based integrated assessment model to quantitatively assess the effects of five representative response strategies, which are well‐recognized to be potential for achieving a sustainable food system, and their combinations on the global environment. We use six boundary indicators, corresponding to six key Earth system processes and indicating the safe‐operating spaces of the global food system, to define the global environmental performance. Our results show that the effects of response strategies may have a synergistic effect or counterbalance. While some individual strategies are sufficient to maintain certain boundary indicators within their safe zones, only the combination of all strategies can simultaneously prevent all boundary indicators from entering high‐risk zones. More coordinated solutions within and outside the global food system are required to restore all boundary indicators to their safe zones.
The dynamic impact assessment of clean energy and green innovation in realizing environmental sustainability of G‐20
Authors: Aneja Ranjan , Yadav Manisha , Gupta Sanjeev
Published: October 2023

In the context of the growth and development process, stability in environmental quality has remained a challenging issue to sustainable development, as several environmental problems, such as climate conditions, anthropogenic global warming, deforestation, and escalating degradation of water and air quality, depict a rising trend. In the contemporary materialistic paradigm, attaining a high economic growth rate while ensuring sustainable consumption of natural resources is impossible. The world needs to attain an economic growth rate that confirms sustainability in natural resource consumption and exploitation of resources introduced severe alert about the sustainability of such trajectory progress as an increase in economic growth upsurges natural reserve usage and energy demand, which leads to environmental deprivation. Both theoretical and empirical literature support that green or clean energy sources could significantly sustain environmental quality and foster economic growth. The recent literature assessed the role of green technology in promoting environmental sustainability. It emphasizes that green innovations are the most competent method to carry the competent use of resources, thereby reducing environmental degradation. Therefore, the main aim of this study is to analyze the impact of economic growth, clean energy, technological innovations, natural resources depletion, and green and sustainable technology on the environmental degradation of G‐20 nations in the frame spanning from 1992 to 2018. The results of cross‐sectional‐autoregressive‐distributed lag (CS‐ARDL) model estimation indicate the presence of a long‐run association between economic growth, number of filled applications for patents, development of environment‐related technologies as a percentage of all technologies, natural resources rents (NRR) as a percentage of GDP, renewable energy consumption, trade openness and environment degradation of G‐20 nations. This study re‐confirmed the Environmental Kuznets Curve (EKC) hypothesis for selected nations. Further, the study's findings revealed that cleaner energy and technological innovations, mainly green technology, play a significant role in sustaining the environmental conditions of these selected countries. Moreover, the degree of natural resource depletion directly impacts environmental degradation (CO₂ emission, total greenhouse gases emission and ecological footprints) in selected nations. The study underscores the importance of promoting clean energy, green technology, and sustainable practices to balance economic growth and environmental preservation and provides policymakers in G‐20 nations with valuable policy recommendations.
The role of governance in girl‐child education: Insights on the odds against Nigerian women in leadership
Authors: Fagbemi Fisayo , Oke Dorcas Funmilola , Akinyele Olawale Daniel
Published: October 2023

It is widely recognized that prioritizing female education is the global best investment. This is because the promotion of girls' access to education is essential for increasing women's formal economic opportunities and their participation in public decision‐making in the long term. Thus, understanding the nexus between governance and women empowerment becomes central for developing new thinking and addressing prevailing challenges. The study, therefore, examines the impact of governance effectiveness on school enrolment, primary, female (% gross) in Nigeria between 1996 and 2020, using autoregressive distributed lag (ARDL) bounds testing approach to cointegration and vector error correction mechanism (VECM) for the assessment of long‐run causality. Results show that governance effectiveness has a significant and positive effect on female primary school enrolment in the long run and in the short run. In addition, findings indicate that there exists bidirectional causality between the effectiveness of governance and female primary school enrolment, suggesting that these indicators are interconnected as they could influence each other. While it is recognized that government policies seem to have failed to redress the norms, societal values, and behaviors that contribute to the perpetuation of inequalities in education enrolment, good governance could further stimulate capacity development, thereby enhancing girl‐child education.
SARS‐CoV‐2 Protein Nanoparticle Vaccines Formed In Situ From Lyophilized Lipids
Authors: Jiao Yang , Huang Wei‐Chiao , Chiem Kevin , Song Yiting , Sun Jingyu , Chothe Shubhada K. , Zhou Shiqi , Luo Yuan , Mabrouk Moustafa T. , Ortega Joaquin , Kuchipudi Suresh V. , Martinez‐Sobrido Luis , Lovell Jonathan F
Published: October 2023

The receptor binding domain (RBD) of the SARS‐CoV‐2 Spike (S) glycoprotein is an appealing immunogen, but associated vaccine approaches must overcome the hapten‐like nature of the compact protein and adapt to emerging variants with evolving RBD sequences. Here, a vaccine manufacturing methodology is proposed comprising a sterile‐filtered freeze‐dried lipid cake formulation that can be reconstituted with liquid proteins to instantaneously form liposome‐displayed protein nanoparticles. Mannitol is used as a bulking agent and a small amount of Tween‐80 surfactant is required to achieve reconstituted submicron particles that do not precipitate prior to usage. The lipid particles include an E. coli‐derived monophosphoryl lipid A (EcML) for immunogenicity, and cobalt porphyrin‐phospholipid (CoPoP) for antigen display. Reconstitution of the lipid cake with aqueous protein results in rapid conversion of the RBD into intact liposome‐bound format prior to injection. Protein particles can readily be formed with sequent‐divergent RBD proteins derived from the ancestral or Omicron strains. Immunization of mice elicits antibodies that neutralize respective viral strains. When K18‐hACE2 transgenic mice are immunized and challenged with ancestral SARS‐CoV‐2 or the Omicron BA.5 variant, both liquid liposomes displaying the RBD and rapid reconstituted particles protect mice from infection, as measured by the viral load in the lungs and nasal turbinates.
Atomically Doped 2D Black Phosphorus for Efficient and Stable Perovskite Solar Cells
Authors: Bati Abdulaziz S. R. , Myagmarsereejid Purevlkham , Fronzi Marco , Fan Kaicai , Liu Porun , Zhong Yu Lin , Burn Paul L. , Gentle Ian R. , Shaw Paul E. , Batmunkh Munkhbayar
Published: October 2023

Controlled functionalization of 2D black phosphorus (BP) nanosheets provides unique opportunities to tune their chemical, physical, and electronic properties. Herein, the preparation of single‐atom nickel‐doped BP (Ni–BP) sheets using a simple solution‐based strategy is reported. Using the Ni–BP sheets as a passivation layer on top of a perovskite film leads to standard perovskite solar cells (PSCs) with improved performance. The standard n–i–p PSCs with the Ni–BP interlayer achieve maximum power conversion efficiencies of over 22%, with negligible hysteresis and a modest improvement in stability when subjected to different testing conditions. The perovskite films prepared with Ni–BP sheets‐based passivation are found to have reduced defect densities as well as improved charge‐transfer properties and carrier lifetimes. Density‐functional theory calculations support the experimental results through showing that the atomic Ni‐doping increases the work function of the BP interlayer, enabling better hole extraction, as well as increasing the surface hydrophobicity of the BP layer, hence reducing water sorption into the perovskite film.
Design and Photonics of Merocyanine Dyes
Authors: Kulinich Andrii V. , Ishchenko Alexander A.
Published: October 2023

Merocyanines, thanks to their easily adjustable electronic structure, appear to be the most versatile and promising functional dyes. Their D–π–A framework offers ample opportunities for custom design through variations in both donor/acceptor end‐groups and the π‐conjugated polymethine chain, and leads to a broad range of practical properties, including noticeable solvatochromism, high polarizability/hyperpolarizabilities, and the ability to sensitize various physicochemical processes. Accordingly, merocyanines are applied and extensively studied in various fields, such as light‐converting materials for optoelectronics, nonlinear optics, optical storage, solar cells, fluorescent probes, and antitumor agents in photodynamic therapy. This review encompasses both classical and novel more important publications on the structure–property relationships in merocyanines, with particular emphasis on the results by A.  I. Kiprianov and his followers in Institute of Organic Chemistry in Kyiv, Ukraine.
Changing Democratic Citizenship
Authors: Mazzoleni Oscar
Published: October 2023

Territorial approaches to democratic politics can help gain a better understanding of the rise of Western nation-building in the nineteenth and twentieth centuries, which has long been studied separately from the history of the modern state and democracy. This chapter demonstrates how a territorial approach to politics can facilitate a discussion of the concepts of population, people and citizenship in an era of global migration.
A Global Territorial Crisis
Authors: Mazzoleni Oscar
Published: October 2023

The COVID-19 pandemic was a global territorial crisis. This chapter will discuss the impact of lockdown measures and restrictions on society, government and territoriality in European countries. We will delve into how these measures changed the role of territorial states, how they reproduced or exacerbated social inequalities, how they affected the flows of goods and people and how they related to the dynamics between institutional powers and the emergence of ideological-political controversies about the political responses to the pandemic.
Holonomic representation of biadjoint scalar amplitudes
Authors: de la Cruz Leonardo
Published: October 2023

Abstract

We study tree-level biadjoint scalar amplitudes in the language of D-modules. We construct left ideals in the Weyl algebra D that allow a holonomic representation of n-point amplitudes in terms of the linear partial differential equations they satisfy. The resulting representation encodes the simple pole and recursive properties of the amplitude.
On protected defect correlators in 3d $$ \mathcal{N} $$ ≥ 4 theories
Authors: Guerrini Luigi
Published: October 2023

Abstract

We study and compute supersymmetric observables for line defects in 3d $$ \mathcal{N} $$
N
≥ 4 theories. Our setup is a novel supersymmetric configuration involving line operators and local operators living on a linked circle. The algebra of the local operators is described by a topological quantum mechanics. For operators belonging to conserved current multiplets, we propose an exact formula for their correlation functions based on a Ward identity for integrated correlators. Our formula gives a general recipe to compute the bremsstrahlung function for any $$ \frac{1}{3} $$

1
3

-BPS lines in $$ \mathcal{N} $$
N
= 6 SCFTs. We apply our relation to the $$ \frac{1}{2} $$

1
2

-BPS Wilson loop in the ABJM model, showing the validity of previous computations. Furthermore, our construction allows us to explore higher points correlators. As an example, we compute the two-point function of the stress tensor multiplet correlators in ABJM theory in the presence of the Wilson line. We also present some perturbative checks of our formulae.
Insights on the current semi-leptonic B-decay discrepancies — and how Bs → μ+μ−γ can help
Authors: Guadagnoli Diego , Normand Camille , Simula Silvano , Vittorio Ludovico
Published: October 2023

Abstract

Bs → μ+μ−γ, measured at high q2 as a partially reconstructed decay, can probe the origin of the existing discrepancies in semi-leptonic b → s and b → c decays. We perform a complete study of this possibility. We start by reassessing the alleged discrepancies, with a focus on a unified EFT description. Using the SMEFT, we find that the tauonic Wilson coefficient required by R(D(*)) implies a universal muonic Wilson coefficient of precisely the size required by semi-muonic BR data and, separately, by semi-muonic angular analyses. We thus identify reference scenarios. Importantly, Bs → μ+μ−γ offers a strategy to access them without being affected by the long-distance issues that hamper the prediction of semi-leptonic B decays at low q2. After quantifying to the best of our knowledge the Bs → μ+μ−γ experimental over the long haul, we infer the Bs → μ+μ−γ sensitivity to the couplings relevant to the anomalies. In the example of the real-δC9,10 scenario, we find significances below 3σ. Such figure is to be compared with other single-observable sensitivities that one can expect from e.g. BR and angular data, whether at low or high q2, and not affected by long-distance issues such as narrow resonances or intermediate charmed di-meson rescattering.
Real-time diagram technique for instantonic systems
Authors: Kolganov Nikita
Published: October 2023

Abstract

The Schwinger-Keldysh diagram technique is usually involved in the calculation of real-time in-in correlation functions. In the case of a thermal state, one can analytically continue imaginary-time Matsubara correlation functions to real times. Nevertheless, not all real-time correlation functions usually can be obtained by such procedure. Moreover, numerical analytic continuation is an ill-posed problem. Thus, even in the case of a thermal state one may need for the Schwinger-Keldysh formalism. If the potential of a system admits degenerate minima, instantonic effects enter the game, so one should also integrate over the instantonic moduli space, including the one, corresponding to the imaginary time translational invariance. However, the Schwinger-Keldysh closed time contour explicitly breaks such invariance. We argue, that this invariance must be recovered, and show, how it can be done. After that, we construct an extension of the Schwinger-Keldysh diagram technique to instantonic systems and demonstrate it on the example of the first few-point correlation functions.
Exploring causality in braneworld/cutoff holography via holographic scattering
Authors: Mori Takato , Yoshida Beni
Published: October 2023

Abstract

Holography with branes and/or cutoff surfaces presents a promising approach to studying quantum gravity beyond asymptotically anti-de Sitter spacetimes. However, this generalized holography is known to face several inconsistencies, including potential violations of causality and fundamental entropic inequalities. In this work, we address these challenges by investigating the bulk scattering process and its holographic realization. Specifically, we propose that the information on a brane/cutoff surface Q propagates according to the induced light cones originating from a fictitious asymptotic boundary behind Q, rather than the conventional ones originating from a point on Q. Additionally, we establish the validity of the connected wedge theorem for generalized holography with induced light cones. We also demonstrate that entropic inequalities remain valid within the induced causal diamonds. While the induced light cone seemingly permits superluminal signaling, we argue that this causality violation can be an artifact of state preparation for radially propagating excitations, rather than local operator excitations on Q.
Modular factorization of superconformal indices
Authors: Jejjala Vishnu , Lei Yang , van Leuven Sam , Li Wei
Published: October 2023

Abstract

Superconformal indices of four-dimensional $$ \mathcal{N} $$
N
= 1 gauge theories factorize into holomorphic blocks. We interpret this as a modular property resulting from the combined action of an SL(3, ℤ) and SL(2, ℤ) ⋉ ℤ2 transformation. The former corresponds to a gluing transformation and the latter to an overall large diffeomorphism, both associated with a Heegaard splitting of the underlying geometry. The extension to more general transformations leads us to argue that a given index can be factorized in terms of a family of holomorphic blocks parametrized by modular (congruence sub)groups. We find precise agreement between this proposal and new modular properties of the elliptic Γ function. This leads to our conjecture for the “modular factorization” of superconformal lens indices of general $$ \mathcal{N} $$
N
= 1 gauge theories. We provide evidence for the conjecture in the context of the free chiral multiplet and SQED and sketch the extension of our arguments to more general gauge theories. Assuming the validity of the conjecture, we systematically prove that a normalized part of superconformal lens indices defines a non-trivial first cohomology class associated with SL(3, ℤ). Finally, we use this framework to propose a formula for the general lens space index.
Black Holes and the loss landscape in machine learning
Authors: Kumar Pranav , Mandal Taniya , Mondal Swapnamay
Published: October 2023

Abstract

Understanding the loss landscape is an important problem in machine learning. One key feature of the loss function, common to many neural network architectures, is the presence of exponentially many low lying local minima. Physical systems with similar energy landscapes may provide useful insights. In this work, we point out that black holes naturally give rise to such landscapes, owing to the existence of black hole entropy. For definiteness, we consider 1/8 BPS black holes in $$ \mathcal{N} $$
N
= 8 string theory. These provide an infinite family of potential landscapes arising in the microscopic descriptions of corresponding black holes. The counting of minima amounts to black hole microstate counting. Moreover, the exact numbers of the minima for these landscapes are a priori known from dualities in string theory. Some of the minima are connected by paths of low loss values, resembling mode connectivity. We estimate the number of runs needed to find all the solutions. Initial explorations suggest that Stochastic Gradient Descent can find a significant fraction of the minima.
Return‐to‐performance in elite soccer players after Achilles tendon ruptures: a study using a weighted plus/minus metric and matched‐control analysis
Authors: Diniz Pedro , Lacerda Diogo , Mendes Bruno , Pereira Hélder , Ferreira Frederico Castelo , Kerkhoffs Gino M. M. J.
Published: October 2023

Purpose

Studies have shown decreased match participation and shortened careers in athletes suffering Achilles tendon ruptures (ATRs), but assessment using a true performance metric is lacking. Plus/minus (PM) metrics provide a practical and objective approach to player performance assessment and are commonly used in other sports. This study aimed to quantify and compare individual player performance variations in elite football league players who sustained ATRs and returned to play within 1 year compared to those without ATRs, using a PM metric.

Methods

Player and team data were sourced from Transfermarkt.com. Male players sustaining ATRs between 2007 and 2018 were identified through injury reports. A control group (CTRL) was matched by position, age, height, and league, with a 6:1 ratio of controls to ATR subjects. The day of injury was considered “time zero”. Year ‐1 corresponds to the 360 days preceding injury, and Year 1 to the interval between 360 and 720 days after. Performance in the player’s main team was evaluated using a previously validated weighted PM metric. Only data from Year ‐1 and Year 1 were used for ATR versus CTRL group comparisons. Statistical significance was set at p < 0.05.

Results

The ATR group included 125 athletes. Data from more than 76,000 matches were analyzed. No statistically significant differences in net weighted PM metric between Year ‐1 and Year 1 were found.

Conclusion

No differences were found between athletes suffering from ATRs and controls regarding the weighted PM metric.

Level of evidence

III.
Functional positioning principles for image‐based robotic‐assisted TKA achieved a higher Forgotten Joint Score at 1 year compared to conventional TKA with restricted kinematic alignment
Authors: Kafelov Moussa , Batailler Cécile , Shatrov Jobe , Al‐Jufaili Jihad , Farhat Jawhara , Servien Elvire , Lustig Sébastien
Published: October 2023

Purpose

Few comparative studies assessed the current concept of individualised alignment for total knee arthroplasty (TKA) and their outcomes at mid‐term. This study aimed to evaluate the functional outcomes at 1 year of primary TKA performed with a functional positioning technique based on an image‐based robotic‐assisted system, compared to conventional TKA performed with a restricted kinematic alignment technique.

Methods

This retrospective comparative study included 100 primary TKAs performed with functional positioning principles using an image‐based robotic‐assisted system. A control group included 100 primary TKAs with the same posterior‐stabilised implant as the robotic group but performed with manual instrumentation and restricted kinematic alignment technique. In the robotic group, the mean age was 69.2 years old ± 7.9; the mean body mass index was 29.7 kg/m2 ± 4.6. The demographic characteristics were similar between both groups. Kujala score, Forgotten Joint Score (FJS), Knee Society Score (KSS) knee and KSS function were collected 12 months postoperatively. Normally distributed continuous variables were compared using the Student t test. For non‐normally distributed continuous variables, the Mann–Whitney test was used.

Results

FJS was significantly higher in the robotic group (76.3 ± 13 vs. 68.6 ± 16.9 in the conventional group; p = 0.026). At a 1‐year follow‐up, there was no significant difference in the KSS knee and KSS function scores and the Kujala score between both groups. The mean KSS knee score was 90.8 ± 11.4 in the robotic group versus 89.4 ± 9.6 in the conventional group (p = 0.082). The mean KSS function score was 91.4 ± 12.3 versus 91.3 ± 12.6, respectively (p = 0.778).

Conclusion

Functional positioning principles using an image‐based robotic‐assisted system achieved a higher Forgotten Joint Score 1 year after TKA compared to restricted kinematic alignment. Personalised alignment and implant positioning are interesting paths to improve the functional outcomes after TKA.

Level of evidence

III.
Surgical Outcomes and Quality of Care Among Adult Appendicitis Patients: A Comparative Study of Tertiary Care Hospitals and Regional Hospitals
Authors: Hsiao Ya‐Wen , Hsiao Chih‐Yang , Huang John , Lai Peng‐Sheng , Chen Po‐Yen
Published: October 2023

Background

Acute appendicitis is one of the most common abdominal emergencies, with management approaches that vary depending on the available resources and setting. However, there is a lack of studies on the differences of surgical outcomes and quality of care between tertiary care hospitals and regional hospitals.

Methods

This multicenter retrospective study included 2158 consecutive adult patients between January 2014 and June 2018 at three hospitals. The patient cohort was divided into regional hospital group (N = 1223) and tertiary care hospital group (N = 935). Baseline characteristics and perioperative outcomes were compared, and factors associated with surgical delay and postoperative complication were investigated.

Results

Patients in tertiary care hospital group had longer surgical waiting time (17.3 vs. 12.0 h, p < 0.001), higher risks of surgical delay exceeding 24 h (OR = 2.94, 95% CI 2.17–4.01, p < 0.001), longer operation time (64 vs. 50 min, p < 0.001), more appendix perforation (22.4 vs. 13.3%, p < 0.001), and higher hospital cost compared with regional hospital group. In multivariate analysis, factors associated with surgical delay were tertiary care hospital (OR = 2.94, 95% CI 2.18–4.01, p < 0.001) and delay diagnosis (OR = 18.7, 95% CI 11.7–30.1, p < 0.001), while those associated with postoperative complications were older age (OR = 1.02, 95% CI 1.00–1.04, p = 0.013), male sex (OR = 2.38, 95% CI 1.11–5.52, p = 0.031), surgical delay (OR = 2.99, 95% CI 1.30–6.47, p = 0.007), and appendix perforation (OR = 5.61, 95% CI 2.72–11.85, p < 0.001).

Conclusions

Patients at tertiary care hospitals had longer waiting time, more surgical delays, and appendix perforations, and these were risk factors of postoperative complications. Establishing an effective referral system to redirect appendicitis patients with less complex medical histories from tertiary care hospitals to regional hospitals may enhance the quality of patient care and outcomes, while also reducing medical costs.
The Impact of Age on the Post‐operative Outcomes in Patients Undergoing Resection for Oesophageal and Gastric Cancer
Authors: Law Cameron , Bhimani Nazim , Mitchell David , Yu Mia Yue , Chan Priscilla , Leibman Steven , Smith Garett
Published: October 2023

Background

Within our ageing population, there is an increasing number of elderly patients presenting with oesophagogastric cancer. Resection remains the mainstay of curative treatment however it has substantial morbidity. The aim of this study was to assess whether age was an independent predictor of resection related complications in our unit.

Methods

A retrospective cohort study of prospectively collated data from 2002 to 2020 of patients undergoing resection for oesophageal and gastric cancers was analysed. Patients aged over 75 and 75 and under were compared for peri‐operative morbidity (via the Clavien‐Dindo classification), length of stay (LOS), unplanned readmission, 30‐ and 90‐day mortality, and use of neoadjuvant therapy.

Results

Data for 466 consecutive patients undergoing oesophagogastric resection (277 oesophagectomy and 189 gastrectomy) were available for analysis. 22% of patients were aged over 75 (14% (39/277) of the oesophagectomy cohort, 34% (65/189) of the gastrectomy cohort). Oesophagectomy patients over 75 were more likely to develop post‐operative complications, particularly cardiac or thromboembolic, (69.2%) than those in the younger cohort (50.4%, p = 0.029). There was no difference in complication rates between the younger and older patients undergoing gastrectomy (29.0% vs. 33.9% p = 0.495). The 30‐ and 90‐day mortality rates were 1.4% (n = 4) and 2.5% (n = 7), respectively, for the oesophagectomy cohort and 1.1% (n = 2) and 1.6% (n = 3) for the gastrectomy cohort, with no difference between age groups.

Conclusion

In this series, we found that patients over the age of 75 were able to undergo oesophageal and gastric resection with curative intent with acceptable post‐operative morbidity and mortality.
Wie denken Psychotherapeut*innen in Deutschland über die Durchführung von Traumatherapie?
Authors: Gossmann Katharina , Rosner Rita , Barke Antonia
Published: October 2023

Hintergrund und Zielsetzung

Es findet sich eine mangelhafte Umsetzung von traumafokussierten Behandlungsrationalen in der psychotherapeutischen Praxis. Ein Grund kann die Einstellung der Behandelnden gegenüber der Durchführung von Traumatherapie sein; diese soll im Rahmen dieser Studie abgebildet werden. Zusätzlich werden diverse Therapeut*innencharakteristika als mögliche Einflussfaktoren berücksichtigt.

Methode

In der Studie wurden die Daten von 1326 approbierten oder sich in Ausbildung befindenden Psychotherapeut*innen analysiert. In die deutschlandweite Online-Umfrage wurden verschiedene Fachrichtungen und Behandlungsschwerpunkte (Kinder und Jugendliche vs. Erwachsene) aufgenommen. Die Einstellung gegenüber traumafokussierter Psychotherapie wurde auf 4 visuellen Analogskalen (Behandlungsbereitschaft, Kompetenzerleben, Befürchtungen, Wahrscheinlichkeit einer baldigen Durchführung) erfasst.

Ergebnisse

Es zeigte sich eine insgesamt günstige durchführungsbezogene Einstellung gegenüber Traumatherapie. Relevante Korrelate waren die Zahl der Therapien pro Woche, der Ausbildungsstatus, die psychotherapeutische Fachrichtung und traumafokussierte Zusatzqualifikationen.

Schlussfolgerung

Die Ergebnisse deuten darauf hin, dass die Einstellung von Psychotherapeut*innen zu Traumatherapie signifikant mit einigen Therapeut*innencharakteristika zusammenhängt, obwohl sie insgesamt günstig ausgeprägt ist. Vor allem der hochsignifikante Zusammenhang mit traumafokussierter Zusatzqualifikation impliziert die Notwendigkeit weiterer Studien zur Überprüfung kausaler Zusammenhänge zwischen Training und durchführungsbezogener Einstellung. Dieses Ergebnis verdeutlicht auch die Relevanz von Disseminationsprojekten für traumafokussierte Therapie.
Multiple sclerosis: time for early treatment with high-efficacy drugs
Authors: Selmaj Krzysztof , Cree Bruce A. C. , Barnett Michael , Thompson Alan , Hartung Hans-Peter
Published: October 2023

This review addresses current changes in the approach to treating patients with multiple sclerosis (MS). The widely practiced approach of utilizing agents with lower treatment efficacy (LETA) at onset with subsequent escalation has been challenged by new data suggesting that MS patients derive greater benefit when therapy is initiated with high-efficacy treatment agents (HETA). Several recent studies compared treatment efficacy and safety of early administration of HETA versus LETA. The results of randomized, double blind, phase III studies with LETA as a control arm and population-based larger and longer studies using propensity scoring, marginal structural modeling and weighted cumulative exposure analysis support the benefit of early treatment with HETA. Patients initiating their treatment with HETA, regardless of prognostic factors and MRI burden at baseline, showed significantly lower annualized relapse rate (ARR) and reduced disability progression in follow-up periods of up to 10–15 years. Moreover, the safety profile of recently approved HETA ameliorates concerns about off-target effects associated with a number of earlier high-efficacy drugs. Patient perception has also changed with an increasing preference for medication profiles that both improve symptoms and prevent disease progression. Accumulating data from randomized studies and the results of large population-based studies demonstrating short-term and longer-term patient benefits support the view that HETA should be more widely used. The adoption of early treatment with HETA capitalizes on a window of opportunity for anti-inflammatory drugs to maximally impact disease pathology and heralds a sea change in clinical practice toward pro-active management and away from a philosophy routed in generating clinical benefit as a consequence of treatment failure.
Machine learning using multimodal and autonomic nervous system parameters predicts clinically apparent stroke-associated pneumonia in a development and testing study
Authors: Nelde Alexander , Krumm Laura , Arafat Subhi , Hotter Benjamin , Nolte Christian H. , Scheitz Jan F. , Klammer Markus G. , Krämer Michael , Scheib Franziska , Endres Matthias , Meisel Andreas , Meisel Christian
Published: October 2023

Background

Stroke-associated pneumonia (SAP) is a preventable determinant for poor outcome after stroke. Machine learning (ML) using large-scale clinical data warehouses may be able to predict SAP and identify patients for targeted interventions. The aim of this study was to develop a prediction model for identifying clinically apparent SAP using automated ML.

Methods

The ML model used clinical and laboratory parameters along with heart rate (HR), heart rate variability (HRV), and blood pressure (BP) values obtained during the first 48 h after stroke unit admission. A logistic regression classifier was developed and internally validated with a nested-cross-validation (nCV) approach. For every shuffle, the model was first trained and validated with a fixed threshold for 0.9 sensitivity, then finally tested on the out-of-sample data and benchmarked against a widely validated clinical score (A2DS2).

Results

We identified 2390 eligible patients admitted to two-stroke units at Charité between October 2020 and June 2023, of whom 1755 had all parameters available. SAP was diagnosed in 96/1755 (5.5%). Circadian profiles in HR, HRV, and BP metrics during the first 48 h after admission exhibited distinct differences between patients with SAP diagnosis vs. those without. CRP, mRS at admission, leukocyte count, high-frequency power in HRV, stroke severity at admission, sex, and diastolic BP were identified as the most informative ML features. We obtained an AUC of 0.91 (CI 0.88–0.95) for the ML model on the out-of-sample data in comparison to an AUC of 0.84 (CI 0.76–0.91) for the previously established A2DS2 score (p < 0.001). The ML model provided a sensitivity of 0.87 (CI 0.75–0.97) with a corresponding specificity of 0.82 (CI 0.78–0.85) which outperformed the A2DS2 score for multiple cutoffs.

Conclusions

Automated, data warehouse-based prediction of clinically apparent SAP in the stroke unit setting is feasible, benefits from the inclusion of vital signs, and could be useful for identifying high-risk patients or prophylactic pneumonia management in clinical routine.
The association between number of steps and the ambulatory blood pressure during leisure vs. work hours among cleaners
Authors: Poulsen Vivian Rueskov , Baumann Mathilde , Korshøj Mette
Published: October 2023

Purpose

The physical activity paradox states occupational physical activity (OPA) to be hazardous and leisure time physical activity (LTPA) to be beneficial for health. Yet, the acute effects of OPA and LTPA on cardiovascular risk factors are sparsely investigated. The aim of this study was to investigate the acute effects on ambulatory blood pressure (ABP) from steps/hour during work and leisure time among cleaners.

Methods

Data were obtained from a cluster randomized worksite intervention among 91 cleaners in Denmark and included a questionnaire, objective physical measurements, ABP (measured across 24 h), and steps/hour (measured during work and leisure time). A preliminary linear regression analysis was conducted as a mixed model including random intercept and slope, allowing for both within- and between-participant variability. We adjusted for sex, age, job seniority, medication use, smoking, self-reported fitness and BMI. Changes in ABP (mmHg) were estimated per 100 steps/hour.

Results

The number of steps taken was not associated with ABP during either work or leisure. Moreover, the ABP did not seem to differ between exposure to steps taken during work (systolic − 0.42 mmHg, 95% Confidence Interval (CI): − 1.10–0.25, diastolic − 0.03 mmHg, 95% CI, − 0.45–0.39) and leisure time (systolic -0.47 mmHg, 95% CI, − 1.66–0.72, diastolic 0.25 mmHg, 95% CI, − 0.46–0.97).

Conclusion

Our findings show no significant association between steps/hour and ABP and no contrasting effects between work and leisure time. These mechanisms fostering the divergent results need to be further investigated to improve the understanding of the physical activity paradox.
Nurturing the next generation of pediatric physician scientists: the Padova Physician Scientist Research Training for pediatric residents
Authors: Galderisi Alfonso , Bressan Silvia , Da Dalt Liviana , Perilongo Giorgio , Baraldi Eugenio
Published: October 2023

Less than 2% of physicians complete a research training (PhD) after the residency with a declining trend in those pursuing a clinical scientist pathway in pediatrics. The exposure to research methodology during the clinical training may play a role in engaging the next generations of pediatric physician scientist. Herein, we describe the experience of the Padova Physician Scientist Research Training (PPSRT) of the pediatric residency program at the University of Padova. The PPSRT was addressed to residents attending PGY2 to PGY4 of the pediatric program and consisted of two cores: a general one including in person or virtual lectures about research methodology in pediatrics including design of a clinical trial, writing of a scientific paper and statistical methods, and a subspecialties core for the discussion of research challenges in each area and the scientific writing activities. The perceived barriers to a research training and an evaluation of the program were assessed by an anonymized questionnaire. Sixty-four out 150 residents registered for the research training with 62/64 completing the two cores. The major perceived barrier to research during clinical training was the absence of protected time (89%) followed by the lack of specific funds (37%). The group activities lead to the publication of 24 papers.

    Conclusion: This is the first experience in the Italian pediatric training of a dedicated research program within the frame of postgraduate medical education. Our report highlights the need for protected time to promote research interest and nurture a new generation of physician scientists.

What is Known:• Training to medical research is not part of residency program.• The declining trend of physician scientists might be reverted by early exposure to research methodology and challenges during residency.

What is New:• An early exposure to research training during pediatric residency increases the research engagement of pediatric residents.• The lack of protected time for research is perceived as the major barrier to research training during residency.