bluuebunny/crossref_metadata_2025 huggingface dataset:
Representing the drivers of lifestyle change in Integrated Assessment Models using theories from environmental psychology: introducing the Motivation, Agency, and Past Behaviour (MAP) framework
Authors: van Valkengoed Anne M. , Perlaviciute Goda , Steg Linda
Published: February 2025

Sustainable lifestyle changes are an important demand-side solution to reducing CO2 emissions. While sustainable lifestyles are increasingly included in integrated assessment models, modellers have so far not managed to realistically model what drives changes in lifestyles. Important questions about the feasibility and likelihood of lifestyle change, and how lifestyle changes can be accelerated or promoted thus go unanswered. Environmental psychology is a discipline dedicated to understanding environmental behaviour, and its theories and findings could therefore be instrumental to informing the modelling of lifestyle change in integrated assessment models. Yet, we identify two barriers currently hindering the systematic integration of this knowledge into integrated assessment modelling. The first barrier is plurality: there are many theories and findings that are potentially relevant to modelling lifestyle change, but guidance is lacking on which to apply when. The second barrier is ambiguity: many theories in psychology are not precise enough to unambiguously translate them into a mathematical model. To overcome the barrier of plurality, we introduce the Motivation, Agency, and Past behaviour (MAP) framework, which summarises and integrates the insights of 8 prominent behavioural theories used in environmental psychology and that can be used to determine which theories and determinants are most relevant for specific modelling applications. To overcome the barrier of ambiguity, we identify three areas where the precision of theorizing in environmental psychology can be improved, namely definitions and consistent use of constructs, the specification of relationships between constructs, and describing the strength and boundary conditions of these relationships. We urge for closer collaborations between modellers and environmental psychologists to successfully model the drivers and impacts of sustainable lifestyle change.
Micro/nano-manufacturing of bioinspired blood-repellent surfaces for extreme application in surgical electrodes
Authors: Li Kaikai , Xie Yingxi , Shen Pengyu , Yu Min , Gao Jiao , Bi Junming , Wang Long , Lu Longsheng
Published: February 2025

Surgical electrodes are frequently associated with disadvantages such as high surface adhesion and severe thermal damage to tissues, which threaten operation quality and patient safety. In this study, by mimicking the micromorphology and bio-anti-adhesion of shark skin, we propose a strategy that utilises nanoscale aluminium oxide (Al2O3) films deposited on bioinspired shark skin (BSS) microstructures to design a composite surface (Al2O3@BSS) and integrate it onto both flat sides of the surgical electrodes. Micro/nano-manufacturing of the Al2O3@BSS surface was sequentially accomplished using nanosecond laser texturing, atomic layer deposition, and low-temperature annealing, endowing it with excellent blood-repellent properties. Visualisation experiments revealed that the tensile stress gradient of the blood coagulum with increasing thickness under a thermal field prompted it to separate from the Al2O3@BSS surface, resulting in anti-adhesion. Furthermore, it was observed for the first time that Al2O3 films can transiently excite discharge along a dielectric surface (DADS) to ablate tissues while suppressing Joule heat, thereby minimising thermal damage. A combination of ex vivo tissue and living mouse experiments demonstrated that the Al2O3@BSS electrodes exhibited optimal comprehensive performance in terms of anti-adhesion, damage minimisation, and drag reduction. In addition, the Al2O3@BSS electrode exhibited remarkable antibacterial efficacy against Escherichia coli and Staphylococcus aureus. The proposed strategy can meet the extreme application requirements of surgical electrodes to improve operation quality and offer valuable insights for future studies.
Towards quality controllable strategies in wire-arc directed energy deposition
Authors: Gao Hanqi , Li Hengrui , Shao Dandan , Fang Naiwen , Miao Yugang , pan zengxi , Li Huijun , Zhang Bo , Peng Zhike , Wu Bintao
Published: February 2025

Wire-arc directed energy deposition (wire-arc DED) enables the fabrication of large-scale metal components with rapid manufacturing ability and diverse material selection, making it a compelling technology in industries and defenses. However, challenges in both macroscale and microscale defects still limit printed component widespread applications. Recent advances in automatic and intelligent technologies have brought a range of quality controllable strategies to the forefront. This review covers these new strategies to the printing component, including path planning, process monitoring, auxiliary processes and post processing, while discussing the expectation for structure and quality improvement. In addition, the work brings new areas of intelligent wire-arc DED development, including advances in digital twin, visualization and human-processing interaction to promote its performance. It is anticipated that a focus on intelligent system will be key to enabling smart and high-quality manufacturing for future wire-arc DED.
Optimal high-order super-twisting sliding mode controller based on multi-objective equilibrium optimizer to accurately track maximum power point of photovoltaic system
Authors: Abertavi Abdollah , Jabbari Masoud , Solookinejad Ghahraman
Published: February 2025

The Photovoltaic (PV) system has been recently attained a considerable interest around the world due to their sustainability, limitlessness and cleanliness. Despite that, the PV system must be equipped with an accurate and robust tracker to enhance its operational efficiency using maximum power point tracking (MPPT) control system. In virtue of inefficient performance of traditional MPPT controller, high fluctuation occurs around the MPP during irradiation and temperature variations. To reach an exact and reliable solution, Sliding Mode Controller (SMC)-based MPPT as a robust and non-linear tracker has been structured. But, the chattering phenomenon in conventional SMC can considerably impact on the controller tracking performance and system stability. Hence, this paper proposes a novel high-order super-twisting SMC (HOSTSMC)-based incremental conductance strategy as MPPT controller of PV system to accurately and smoothly track MPP with low chattering ripple and steady-state error under varying irradiation and temperature conditions. The imprecise adjustment of controller parameters according to the several objectives cannot lead to correct result. So, the MPPT control scheme is improved by the multi-objective equilibrium optimizer (MOEO) thanks to its exploration-exploitation dominance technique. To evaluate the performance of proposed MPPT controller, it has been compared with conventional incremental conductance-based MPPT, SMC-based MPPT and fuzzy SMC-based MPPT. The chattering ripple percentage (|PPV,max-PPV,min|/Pref*100) has been respectively extracted 0.0467%, 0.207%, 0.473% and 0.234% for proposed HOSTSMC controller, Fuzzy-SMC controller, conventional SMC controller and conventional incremental conductance, and also steady-state deviation percentage (|PPV-Pref|/Pref*100) has been respectively attained 0.3681%, 0.403%, 0.624% and 0.971% for these mentioned controllers. At last, both the prominent factors have clearly validated the high tracking performance of HOSTSMC-based incremental conductance with low steady-state deviation and chattering ripple as compared to other controllers.
Design of Compact and High-Performance SRAM Cell in QCA Technology for Next-Generation Memories
Authors: Rathore Nitesh Kumar , Beohar Ankur , Singh Pooran
Published: February 2025

The most significant high-speed memory used in random access memories (RAMs) is static random-access memory (SRAM). SRAM is fast and robust but confronts design issues in sub-nanoscale complementary metal oxide semiconductors (CMOS), including leakage current, area, and stability. A different technology that can be utilized as an alternative to overcome the limitations of traditional SRAM is Quantum-dot Cellular Automata (QCA) technology. In this work, a QCA-based SRAM cell is implemented using three 3-input majority gates and an inverter which significantly improves the minimal waste area, layout area, overall cell counts, QCA cost, and the clock delay (latency). The layout has 25 cell counts with an SRAM cell size of 0.02µm2 and a clock latency of 0.5 phases. Compared to a standard existing design, our proposed circuit achieves an improvement of 76% in cell counts, 84.6% in SRAM cell area, and 98.7% in QCA cost, demonstrating its potential for cost-efficient applications in modern electronic devices.
Thermal analysis on the impact of different velocity calculation methods for microchannel liquid cooling system in GPUs
Authors: Praveen S.M. , A Rammohan
Published: February 2025

Recently, computational tasks are carried out by GPUs which consists of hundreds of cores that compute at higher speeds to provide systematic results. The computational power of GPUs suffers significant disadvantage in the form of heat emission. Traditional liquid cooling methods circulate the working fluid at constant velocity irrespective of the temperature raised. To mitigate the effects of improper cooling, the research focuses on analysing liquid cooling system for GPUs where Ethylene Glycol 40 was circulated through 20 microchannels at different velocities and thermal behaviour was analysed using a CFD analysis software. The paper aims to provide a clarity on the methods to calculate velocity for simulation approach. The velocity was calculated using two distinct approaches, the first approach uses the mass flow rate equation and second approach uses Reynolds number equation considering laminar flow. On assuming three different values for mass flow rate and Reynolds number, the velocity of the fluid is calculated. For Mass Flow rate of 0.1 g/s, 0.2 g/s and 0.3 g/s, the obtained velocities were 0.01886 m/s, 0.03773 m/s and 0.05659 m/s respectively. For Reynolds number of 10, 20 and 30, the obtained velocities were 0.04 m/s, 0.09 m/s and 0.1422 m/s respectively. The analysis proved that at lower velocities, the working fluid was not effective in carrying the heat but at higher velocities the temperature reduction was higher; displaying the ability of the coolant to absorb heat depending on the velocity. With the temperature data from the simulation, the heat transfer rates were calculated as 10352.4049 J, 7948.3535 J, 7711.2185 J, 6719.9088 J, 5318.3105 J, 3976.2213 J for 0.01886 m/s, 0.03773 m/s, 0.04 m/s, 0.05659 m/s, 0.09 m/s and 0.1422 m/s respectively. The analysis concludes that by changing the velocity of the working fluid, the thermal management system can work effectively under different scenarios.
Process Philosophy
Authors: Bruskin Signe
Published: February 2025

Theoretically, the phenomenon of micro change stems from process philosophy and is the primary theoretical approach throughout the book. This chapter unfolds the process philosophical approach highly inspired by Heraclitus and his view of the world as everything is always in a state of becoming and flux. He inspired, among others, Whitehead, who further developed the philosophy of becoming. This perspective is permeated by the idea of change as fluid, ever changing, pervasive, and existing in the micro processes of the organization. Thus, change must be understood as a matter of experience, always in an ever-changing position as it can be reinterpreted in time.
Computing Paul
Authors: White Benjamin L
Published: February 2025

This chapter describes how the development of inferential statistics and complex computing algorithms contributed to the scientificity of stylometric inquiries into the authorship of the Pauline Epistles. It shows how, over time, the measurement of univariate features gave way to complex multivariate features that were being measured in multidimensional space. In the computer era, fewer and fewer biblical scholars were engaged with the developments in computational stylistics. Rather, the older, simpler, and outdated studies of the nineteenth and early twentieth centuries were often referenced by biblical scholars, while novel work was pursued by mathematicians and computer scientists proficient enough to harness the new tools. The chapter describes how even with shinier, flashier tools many of the ideological and historiographical problems that beset the studies described in the previous chapter have continued into the computer era, where there is no consistent finding on the Pauline authorship question.
How States Die
Authors: Lemke Douglas
Published: February 2025

In How States Die, Douglas Lemke investigates patterns associated with the deaths of states. He broadens the focus from sovereign states to include territorial contenders, and from externally imposed deaths to include states dying from internal processes. How States Die tests hypotheses about state death from a wide range of theories: state making theory, theories about international norms, geopolitics, realism, and the English school. Some of the findings support the conventional wisdom (power politics are unrelated to state death but buffer states are especially likely to die), some force reformulations of the conventional wisdom (the norm against conquest is associated with longer life only for territorial contenders), and some are completely new (conflict experiences are powerful correlates of state death). In addition to offering a new way to study state death, Lemke’s combination of types of states and consideration of both internal and external political processes offers a new way to study international relations more broadly.
Introduction
Authors: Salje Léa
Published: February 2025

This introductory chapter introduces and motivates interest in the target phenomenon of the book: articulatory self-knowledge, or the familiar phenomenon of sometimes having to put one’s thought into words before one can know what it is. The rest of the chapter sets out the book’s framework assumptions, and provides a short overview of the chapters to come.
Moderate Deflationism
Authors: Salje Léa
Published: February 2025

Chapter 4 proposes, motivates, and defends a moderate deflationist view of articulatory self-knowledge. It begins by considering and rejecting radical deflationism, a view that denies the existence of any content-bearing mental state at the start of the process altogether. This leaves us with an apparent dilemma: either there is a thought at the start of the process (which lands us with the inflationist views already rejected) or there isn’t (which lands us with radical deflationism). The rest of the chapter works out the details of a moderate deflationist account of the target phenomenon that gets us out of this dilemma. What is posited at the outset is not a complete and determinate thought, but neither is it denied that there is a thought there at all. I elucidate this ‘middle-way’ view, and show how it meets the deflationist challenge of Chapter 1.
Authority, Obedience, and Defiance
Authors: Eisaman Maus Katharine
Published: February 2025

The nature and extent of authority—the question of who gets to govern whom, and why—is one of the most pressing concerns of the period. The first part of this chapter discusses the cultural importance of these matters: the commonplaces about natural and political hierarchies, and the challenges to those commonplaces. This overview serves as an introduction to the discussion, later in the chapter, of masque, tragedy, and tragicomedy: three genres which reach a peak of achievement in the early seventeenth century, and which engage deeply with the issues of rule and subjection. While masque tends to celebrate royal power and other related forms of dominion, tragedy typically critiques them; tragicomedy combines the two forms to interesting and complex effect. The chapter discusses masques by Ben Jonson, George Chapman, Aurelian Townshend, Thomas Carew, and John Milton; tragedies by William Shakespeare, Thomas Middleton, Ben Jonson, George Chapman, John Webster, James Shirley, John Ford, Cyril Tourneur, John Fletcher, and Elizabeth Cary; and tragicomedies by John Marston, William Shakespeare, John Fletcher, Philip Massinger, and William D’Avenant.
Intellect and Expression
Authors: Eisaman Maus Katharine
Published: February 2025

The early seventeenth century saw a burgeoning of writing in prose. There is not really a single ‘tradition’ of English prose in this period, but instead a very diverse and sprawling array of works. This chapter provides an overview of some of the more ‘literary’ kinds of early seventeenth-century prose. It is organized with several subheadings. ‘Intellectual Prose’ includes works by Francis Bacon, Robert Burton, John Donne, Thomas Browne, and Isaak Walton. ‘A Tale of Three Romances’ considers James Barclay’s Argenis, Mary Wroth’s Urania, and Kenelm Digby’s Loose Fantasies. ‘The Prose of Everyday Life’ discusses Thomas Dekker’s pamphlets and the ‘characters’ of Joseph Hall and Thomas Overbury. ‘Memoir and Biography’ discusses memoirs by Edward Herbert, Ann Clifford, Samuel Rogers, Tobie Matthew, and Dorothy Waugh, and biographies by Fulke Greville and Isaak Walton.
Sorry, Not Sorry?
Authors: Salomone-Sehr Jules
Published: February 2025

Denying blameworthiness after apologizing seems fishy. “Sorry, not sorry” is what this might sound like. Yet, this fact conflicts with another fact about apologies, namely, that we routinely apologize for blameless conduct. There is, thus, a puzzle regarding what it is that an apology must admit about one’s involvement in the apologized-for conduct for the apology to be fitting. This chapter solves this puzzle by arguing that in cases where our agency is blamelessly implicated in harmful conduct, apologies are fitting only if they involve an admission of responsibility—where the responsibility in question does not entail blameworthiness.
26 Topical antimicrobial treatment of mesh for the reduction of surgical site infections after hernia repair: a systematic review and meta-analysis
Authors: Bontekoning Nathan , Huizing Nathalie J , Timmer Allard S , Groenen Hannah , de Jonge Stijn W , Boermeester Marja A
Published: February 2025

Aim

Use of mesh is essential in hernia repair. A common complication after hernia repair is surgical site infection (SSI), which poses a risk in spreading to the mesh, possibly causing mesh infection. Topical antimicrobial pretreatment of mesh may potentially reduce SSI risk in hernia repair and has shown promising results in in vitro and in vivo studies. Clinical evidence, however, is more important. This systematic review aims to provide an overview of available clinical evidence for antimicrobial pretreated mesh in hernia repair surgery to reduce SSI.

Methods

We report in accordance with PRISMA guidelines. CENTRAL, EMBASE, CINAHL and PubMed were searched up to October 2023 for studies that investigated the use of antimicrobial (pre)treated mesh on SSI incidence in adults undergoing hernia repair. The primary outcome was SSI incidence. We also collected data on pathogen involvement, hernia recurrence, and mesh infection. A meta-analysis on SSI risk and GRADE-assessment was performed of eligible studies.

Results

We identified 11 eligible studies (n = 2660 patients); five randomized trials and six cohort studies. Investigated interventions included pre-coated mesh, antibiotic carriers, mesh soaked or irrigated with antibiotic or antiseptic solution. Meta-analysis showed no significant reduction in SSI for antibiotic pretreated polypropylene mesh (RR 0.76 [95% c.i. 0.27; 2.09]; I2 50%).

Conclusions

Data on topical mesh (pre)treatment to reduce SSI risk after hernia repair is limited. Very low certainty evidence from randomized trials shows no significant benefit for antibiotic mesh pretreatment for SSI reduction, but data are imprecise due to optimal information size not being met.
34 Colonic perforation and ischemia in acute pancreatitis
Authors: Gergel Michal , Kucera Adam , Lancz-Klikacova Anita
Published: February 2025

Introduction

Management of complicated acute pancreatitis (AP) has changed significantly in the last decades, especially in terms of step-up approach introduction, delayed surgery, early enteral feeding, restrictions in antibiotic prophylaxis and volume therapy. Severe colonic complications—ischemia and perforation—remain a rare but extremely challenging complication of severe acute pancreatitis. World literature reports mostly about individual case reports, and there is no current guideline for treatment of this complication.

Methods

Records of Bratislava University Hospital were searched for all treated cases of acute pancreatitis in a 15 years period (2009–2023). In the next step, all patients who required major abdominal surgery for complications of acute pancreatitis were selected, and their surgery records were analyzed for signs of colon ischemia and/or colon perforation. Data on surgical therapy, previous surgeries, outcome, interval since the onset of AP and hospital length were collected.

Results

1386 cases of AP were treated in the analyzed period (735 males, 53%). 35 (2.53%) required major surgery. In seven of these (5 males, 2 females, age 27–71) AP associated colonic ischemia and/or perforation occurred. 5 of these patients died, 2 survived (female 27 years, male 40 years). Colonic resection with ileostomy was performed in 4 cases, simple ileostomy in 3 cases. 1 case was diagnosed by CT scan, the resting 6 were diagnosed during surgery. The period of occurrence since the onset of AP varied from 1day to 8 months. Hospital stay varied from 18 days to 230 and 256 days (both survivors). In 3 cases, colonic complication occurred in the early phase of AP (within the first 7 days). In 4 cases colonic complication was observed during the first surgery.

Conclusion

Our data underwrite huge variability and rareness of this issue, hindering statistical analysis and consensus on universal recommendation. Colonic perforation should be considered following sepsis outbreak during the early aseptic phase of AP, as well as following backsets during the course of the disease. Due to its rareness and severity, colonic perforation and ischemia remains a dark field in the management of AP. Early onset perforation might be a pitfall of strict guideline adherence—delayed CT staging, restriction of antibiotics and early enteral feeding, as well as delayed open surgery.
37 Do biological markers play a role on the postoperative early management of organ-space surgical site infections (OS-SSI)?: A systematic review
Authors: Castells Júlia , Juvany Montserrat , Guirao Xavier
Published: February 2025

Aim

Considering postoperative OS-SSI, were there differences in terms of antibiotics initiation/source control/healing/morbidity-mortality between patients for whom biological markers (C-reactive protein: CRP, procalcitonin: PCT, and lactate: LAC) were applied as a clinical guide and those treated conventionally?

Methods

Systematic review on PubMed with Cochrane recommendations and PRISMA reporting method regarding the use of the three biological markers (CRP, PCT, LAC) on elective abdominal surgery and their correlation to OS-SSI/ intraabdominal infection: IAI/ anastomotic leakage: AL (the three terms were considered indistinctly) from 01 January 1990, to 12 December 2022.

Results

Sixty-four studies were initially included. Fifteen out of 64 were discarded due to poor initial screening related to the subject of the review. Surprisingly, only two out of the 49 studies answered the key question. Both studies were retrospective and considered CRP in the early management of OS-SSI on elective colorectal surgery. The first one demonstrated that patients followed by CRP protocols who developed anastomotic leakage (AL) had fewer requirements for a surgical procedure. The second study proved that patients with AL for whom CRP guidelines were applied were diagnosed and treated one day earlier. However, there were many studies (especially on elective colorectal surgery) that showed a correlation between biological markers and AL. Twenty-nine studies corresponded to higher postoperative CRP levels and AL. The best evidence was from three meta-analyses and one systematic review that identified CRP levels on the third postoperative day (less than 150 mg/l) as a marker to successfully rule out AL in 97% of patients, allowing for their safe discharge. Another meta-analysis correlated PCT levels on the fifth postoperative day to AL, suggesting that this biomarker might be somewhat delayed in the diagnosis of AL. There was preliminary evidence on lactate levels on discarding AL in combination with other biomarkers, suggesting inadequate intraoperative resuscitation of patients. There was less evidence on bariatric surgery, with five identified studies. The highest evidence was from two meta-analyses that correlated high levels of CRP on the first postoperative day on elective and laparoscopic surgery with AL; CRP levels less than 61 mg/l discarded AL in 98% of patients.

Conclusions

Although CRP protocols in postoperative and elective abdominal surgeries have been widely used (especially on colorectal surgery), there is a lack of evidence about their efficacy on improving postoperative outcomes related to OS-SSI. More studies are needed on this field. However, CRP levels are correlated to AL not only on colorectal surgery but also on bariatric surgery.
16 Open abdomen: analysis of indications, relation with peritonitis, outcomes and prognostic factors for mortality in non-traumatic patients
Authors: Cazador-Labat Miriam , Pelegrina-Manzano Amalia , Morera-Grau Alex , García-Ron Adrián , González-Castillo Ana María , Membrilla-Fernández Estela
Published: February 2025

Aim

The open abdomen (OA) is a surgical technique originally employed in critically traumatic patients, and later extended to other non-traumatic aetiologies, mostly peritonitis, vascular emergencies, or acute pancreatitis. Indications and results of OA in non-traumatic patients have not been rigorously described. The study aimed to analyse and report indications, prognostic factors of mortality, and the outcomes of OA in non-traumatic patients, with emphasis on peritonitis.

Methods

Single-center retrospective study of 94 OA patients from 2008 to 2021. The decision to perform OA relied either on the surgeon's judgment or mainly on the presence of at least one trauma OA criterion: hypotension (systolic blood pressure ≤70 mmHg), massive transfusion, coagulopathy (INR ≥ 1.7), acidosis (pH < 7.25), and hypothermia (<35°C). Statistical tests were performed to analyse survival and identify morbidity and mortality prognostic factors. Observed outcomes were compared to those predicted by preoperative using the Age-adjusted Charlson Comorbidity Index (ACCI) and postoperative using the Sequential Organ Failure Assessment score (SOFA score).

Results

OA was performed for peritonitis (n = 54), vascular emergencies (n = 23), pancreatitis (n = 11), abdominal compartmental syndrome (n = 2), and intestinal fistulas (n = 4). The overall 90-day mortality was 55.3% (n = 52), 55.5% (n = 29) were from the peritonitis group. The multivariate analysis emphasizes the major role of altered physiology in mortality. Although 71.05% of peritoneal fluid cultures were positive, being E. faecium (n = 13, 14.3%), P. aeruginosa (n = 12, 13.2%) the most common germs. mortality did not seem to be associated with positive peritoneal cultures or to a particular group of germs. Even though there were not statistically significant differences in the distribution of mortality peritonitis and acute pancreatitis may benefit most from the damage control and OA. approach.

Conclusions

OA can be a reliable treatment for critically ill patients with non-traumatic abdominal emergencies, especially in peritonitis and pancreatitis. Age, comorbidities, multi-organ failure and altered physiology are parameters whose effects seem to be associated with a worse survival rate. High mortality does not appear to be associated neither to positive peritoneal cultures nor to any particular group of germs.
31 Concerning a case: innovative approach to managing sepsis from an infected breast prosthesis
Authors: Blay Lidia , Malagón Paloma , Vilà Jordi , Aranda Daniel , Pascual Iciar , Claret Rosa , Cardona Pere Joan , Carrasco Cristian , Humaran Daniel , Julián Joan Francesc
Published: February 2025

We present a 45-year-old patient with right breast neoplasia and BRCA2 genetic mutation. She is discussed in a multidisciplinary breast cancer committee and was considered to be a candidate for bilateral skin and nipple sparing mastectomy with sentinel lymph node biopsy. The surgery was performed endoscopically through lateral incisions of 3.5 cm in the axillary midline. During surgery, the presence of retroareolar tumor cells was found, requiring a new retroareolar resection to ensure the anterior margin and to maintain the nipple-areola complex. The immediate postoperative course was favorable and the patient was discharged after 48 hours. In outpatient follow-ups, drainage is monitored, and necrotic tissue is observed exclusively in the nipple during ambulatory check-ups, with satisfactory progress. At 15 days drainage is removed in the right breast, but the patient reconsults at 48 hours due to pain in the breast, erythema in the drainage orifice and slight increase in volume in the lower outer quadrant and center of the breast. Drainage is performed by puncture and purulent material is analized and the patient is admitted with intravenous antibiotherapy. During 5 days the patient presented progressive worsening with increased erythema, pain, fever and sepsis in analytical (>20 000 leukocytes and CRP >400 mg/l) so it is proposed to explant the prosthesis. The patient refuses to have the prosthesis removed and requests conservative management, refusing the explant even with the vital risk involved. In front of a competent patient, an attempt of ‘prosthesis conservative’ management was decided, performing surgery with intense washing of the mastectomy cavity, Friedrich of necrotic plaque with direct suture and prosthesis placement with previous drainage, washed with betadine, prontosan and antibiotherapy + sensitive antifungals according to initial antibiogram. She was hospitalized for 10 days with antibiotics and endovenous antifungal well tolerated, with progressive improvement and discharge with oral antibiotics and control in external consultations. The patient maintains good evolution with normalization of her septic status and good aesthetic result. The pathological anatomy showed free surgical margins.
43 A challenging management of a Y graft mycotic pseudoaneurysm in a simultaneous pancreas-kidney transplant recipient
Authors: Geropoulos Georgios , Colucci Nicola , Amin Irum , Russell Neil , Kosmoliapsis Vasilis
Published: February 2025

Introduction

The incidence of allograft artery mycotic pseudoaneurysms after kidney and pancreas transplantation is less than 1%. Natural history of vascular mycotic aneurysms is characterized by their tendency to rupture causing major bleeding, leading to graft loss and increased mortality rate.

Case Report

A 45-years old patient was transferred to the intensive care unit of our hospital following a massive upper gastrointestinal bleeding, pyrexia and hemodynamic compromise. Medical background included a simultaneous pancreas-kidney transplant (SPK) back in 2020, followed by rejection and repeated pancreatic transplant (PTA) alone one year after. Abdominal computerized tomography imaging showed a thrombosed graft superior mesenteric artery, with concomitant active bleeding from the splenic limb of the arterial Y graft, due to a mycotic pseudoaneurysm ruptured into the bowel. The bleeding was initially managed with an endovascular stenting of the right common iliac artery, determining an inevitable graft ischemia. Blood cultures isolated Bacteroides sp. so, the patient was started on board spectrum antibiotics (piperacillin/tazobactam) based on the culture sensitivities. Following resuscitation, the patient went to theatre two days after for a graft pancreatectomy, including the aneurysmal Y graft. An iliac artery vascular repair was then performed. The endovascular stent was removed during the procedure. The cultures of the pancreatic graft, vessels and stent were positive for enterococcus faecium, leading to adding vancomycin to the already existed antibiotic regimen. The patient received in total four weeks of intravenous and oral antibiotics. His postoperative course was uneventful and was discharged on the 14th postoperative day.

Educational Highlights

Pancreatic graft arterial pseudoaneurysms is an uncommon as well as quite serious complication following a combined kidney and pancreas transplantation. Initial management of pseudoaneurysms should rely on early diagnosis while endovascular repair could be an acceptable bridging therapy along with long term antibiotics. Surgical management involve removing the infected vessels and perform arterial reconstruction aiming preservation of the graft. However, in some cases graft pancretectomy is deemed necessary to control the ongoing resistant sepsis or findings of ischemic graft.
Trichophyton indotineae infection with toenail onychomycosis
Authors: Jabet Arnaud , Monfort Jean-Benoît , Hennequin Christophe , Fekkar Arnaud , Piarroux Renaud , Normand Anne-Cécile
Published: February 2025

We report a case of Trichophyton indotineae infection with toenail onychomycosis. This is only the second reported case of T. indotineae onychomycosis in the literature. We highlight its clinical features and therapeutic implications.
Sequence-dependent predictive coding during the learning and rewiring of skills
Authors: Takács Ádám , Vékony Teodóra , Pedraza Felipe , Haesebaert Frederic , Tillmann Barbara , Beste Christian , Németh Dezső
Published: February 2025

In the constantly changing environment that characterizes our daily lives, the ability to predict and adapt to new circumstances is crucial. This study examines the influence of sequence and knowledge adaptiveness on predictive coding in skill learning and rewiring. Participants were exposed to two different visuomotor sequences with overlapping probabilities. By applying temporal decomposition and multivariate pattern analysis, we dissected the neural underpinnings across different levels of signal coding. The study provides neurophysiological evidence for the influence of knowledge adaptiveness on shaping predictive coding, revealing that these are intricately linked and predominantly manifest at the abstract and motor coding levels. These findings challenge the traditional view of a competitive relationship between learning context and knowledge, suggesting instead a hierarchical integration where their properties are processed simultaneously. This integration facilitates the adaptive reuse of existing knowledge in the face of new learning. By shedding light on the mechanisms of predictive coding in visuomotor sequences, this research contributes to a deeper understanding of how the brain navigates and adapts to environmental changes, offering insights into the foundational processes that underlie learning and adaptation in dynamic contexts.
Label-Free Intracellular Temperature Measurement by Integrating Raman Imaging and Deep Learning
Authors: Takahashi Hiroaki , Kajimoto Shinji , Irikura Ohsuke , Nakabayashi Takakazu
Published: February 2025

We developed a label-free method for visualizing intracellular temperature distribution using Raman image analysis with deep learning. Analysis of the entire region of the O-H stretching band of water using deep learning achieves an accuracy of ∼0.2°C, allowing intracellular temperature mapping without any preprocessing such as fluorescent labeling. Experiments using photoexcitation of carbon nanotubes attached to living cells demonstrate that this method can obtain transient changes in the temperature distribution within a cell.
Optimizing the accession-level quantity of seeds to put into storage to minimize seed (gene)bank regeneration or re-collection
Authors: Hay Fiona R , Baum (née Whitehouse) Katherine J , Oyatomi Olaniyi , Wolkis Dustin
Published: February 2025

Seed (gene)banking is an effective way to conserve cultivated and wild plant diversity. However, long-term funding is not always consistently sufficient, and there is a need to both strengthen the effectiveness of genebank operations and maximize cost efficiency. One way to control the cost of maintaining a germplasm collection is to optimize the quantity of seeds per accession that is placed into storage, depending on the expected length of time a seed lot will remain above the viability threshold, expected rates of use for distribution and viability testing and on the requirement to ensure a reserve. Here, we express this as an equation, which can be applied to cultivated species and adjusted to different scenarios, but also to inform decisions about use of accessions of wild species where the number of seeds available is limited, a common scenario for wild-species conservation seed banks. For many crop genebanks, given the expected longevity of seeds, it would be worthwhile to increase the number of seeds produced and processed for storage. This would also help to diminish the risk of genetic drift due to frequent cycles of regeneration but would have implications in terms of how accessions are regenerated, in particular, how many plants are used for regeneration and the size of storage facilities. The equation we present can also be rearranged and used to plan how to allocate seeds for testing and use when the number of seeds available is limited. This may have particular relevance for species conservation seed banks.
Perioperative management and inflammatory marker monitoring in a cardiac surgery patient treated with Tocilizumab: A case report of successful surgical aortic valve replacement
Authors: Toyama Masashi , Nakayama Masato , Uemura Tomonari , Kurahashi Shingo , Sato Bunmei
Published: February 2025

Background

Interleukin (IL)-6 is associated with wound healing and infection response. Tocilizumab (TCZ) is a monoclonal antibody against the IL-6 receptor, interfering with its signalling pathway. However, reports on patients treated with TCZ undergoing cardiac surgery are limited.

Case Summary

A 73-year-old man with Castleman disease, treated with TCZ, underwent surgical aortic valve replacement via median sternotomy for aortic valve regurgitation with exertional shortness of breath. Comprehensive measures for preventing surgical site infection along with close examination were implemented during the perioperative period. TCZ was discontinued 26 days before surgery and resumed 30 days after surgery, during which plasma IL-6 levels decreased. There was no evidence of infection or exacerbation of Castleman disease. Vascular endothelial growth factor levels increased before an increase in C-reactive protein levels following hospital discharge and prior to TCZ resumption.

Discussion

Meticulous perioperative management with a multidisciplinary approach is crucial during the cessation of TCZ for cardiac surgery. Changes in vascular endothelial growth factor levels may serve as an early predictor of underlying disease exacerbation after TCZ cessation for surgery.
Development of chronic obstructive pulmonary disease after a tuberculosis episode in a large, population-based cohort from Eastern China
Authors: Wang Jianbing , Yu Luhua , Yang Zongming , Shen Peng , Sun Yexiang , Shui Liming , Tang Mengling , Jin Mingjuan , Chen Bin , Ge Yang , Lin Hongbo , Shen Ye , Chen Kun , Martinez Leonardo
Published: February 2025

Background

Although smoking is considered the primary cause of chronic obstructive pulmonary disease (COPD), there is a growing realization that there may be important secondary risk factors. Tuberculosis may lead to lung impairment; however, whether residual lung damage results in clinically significant, long-term outcomes, independent of smoking, has not been well studied. We aimed to investigate the association between tuberculosis and the subsequent development of COPD using a large, population-based cohort study.

Methods

We conducted a longitudinal cohort study within the Chinese Electronic Health Records Research in Yinzhou study between 2009 and 2021. We followed participants free of COPD at the beginning of the study, and investigated whether previous or current tuberculosis was an important risk factor. Tuberculosis was recorded based on the Chinese National Disease Reporting system which includes all diagnosed cases at the city, provincial and national levels. We assessed the relationship between tuberculosis and COPD using multivariable survival models, adjusting for demographic and lifestyle characteristics, education level, comorbidities and use of medications.

Results

Among 477 046 participants, 198 882 were eligible for inclusion in our analysis. In a multivariable model, pulmonary tuberculosis and all tuberculosis were associated with a 2.57-fold [95% confidence interval (CI), 2.31–2.87)] and 1.67-fold (95% CI, 1.48–1.90) increased COPD risk, respectively. Stronger associations of pulmonary tuberculosis and all tuberculosis with COPD were seen in participants who were elderly, or with lower body mass index or education level (Pinteraction<0.001). People with tuberculosis were at an increased risk of COPD if they were current smokers [adjusted hazard ratio (aHR), 1.40; 95% CI, 1.02–1.93] or non-smokers (aHR, 1.72; 95% CI, 1.50–1.98).

Conclusions

Persons who developed tuberculosis were at much greater risk of developing COPD, even accounting for smoking and other potential confounders.
Mechanical analysis and model test of large-scale highway billboard under wind load
Authors: Liu Minghui , Wu Zhuojia
Published: February 2025

This study analyzes the mechanical behavior of large-scale highway billboards under lateral wind loads using finite element analysis and model testing. It emphasizes the importance of improving the torsion resistance of billboard structures to mitigate potential failures during high wind conditions. The research identifies the most critical wind load directions across three scenarios and examines the relationship between structural stiffness, mass distribution, and failure modes. The findings offer valuable insights for optimizing the design of highway billboards, particularly in enhancing their wind resistance. These results serve as a reference for engineering designs.
Lung Immune Challenge Study Protocol: Controlled Exposure to Inhaled Resiquimod (R848) to Study Mechanisms of Inflammation
Authors: Jha Akhilesh , Fisk Marie , Forrester Jamie , Galloway Jacqui , Joseph Jade , Staples Robyn , Sylvester Karl P
Published: February 2025

This study aims to develop a human lung immune challenge model using inhaled Resiquimod (R848), a Toll-like receptor (TLR)7/8 agonist, to investigate inflammatory mechanisms involved in the human respiratory mucosa in health and disease. This approach seeks to induce innate immune anti-viral responses in the lungs and blood, with a suitable dose of inhaled R848 that is clinically tolerable. The study will include healthy volunteers and individuals with asthma. The primary outcome is a change in CXCL10, a biomarker representative of anti-viral responses, at 24 hours post-exposure. Secondary outcomes include changes in lung function, physiological parameters, and inflammatory markers, including C-reactive protein (CRP) and eosinophil counts.

This trial involves a single ascending dose, randomized, single-blind, placebo-controlled design. Participants will receive R848 via nebulization in escalating doses from 0.1 to 100 µg/mL, or saline placebo. Safety assessments include spirometry, vital signs, and blood samples to monitor systemic and lung-specific immune responses. The study will contribute to understanding immune pathways in asthma and provide a platform for testing novel anti-inflammatory therapeutics. The protocol has been approved by relevant ethics committees and will be disseminated via peer-reviewed publications and open-access data repositories.
Impact of sleep deprivation on monocyte subclasses and function
Authors: Al-Rashed Fatema , Alsaeed Halemah , Akhter Nadeem , Alabduljader Haya , Al-Mulla Fahd , Ahmad Rasheed
Published: February 2025

The relationship between sleep deprivation, obesity, and systemic inflammation is a critical area of investigation due to its significant impact on health. While it is established that poor sleep adversely affects obesity and metabolic syndromes, the specific mechanisms, particularly subclinical inflammation independent of obesity, remain unclear. This study investigates how sleep quality influences monocyte subclass distribution and its association with systemic inflammation across a spectrum of body mass index categories. In our cohort study, 237 healthy participants were categorized by body mass index. Participants' dietary intake, physical activity, and sleep patterns were objectively tracked through wearable ActiGraph GT3X accelerometer. The data showed that obese individuals had significantly lower sleep quality and higher chronic low-grade inflammation. Nonclassical monocytes increased significantly in obesity, correlating with reduced sleep quality and elevated proinflammatory cytokines. Although body mass index emerged as a significant factor in driving inflammation, mediation analyses further defined that sleep disruption independently contributes to inflammation, regardless of obesity status. Controlled sleep deprivation experiments confirmed these findings, demonstrating reversible increases in nonclassical monocytes expression. This study highlights the importance of sleep quality in regulating immune responses and inflammation in obesity, suggesting that improving sleep quality could reduce inflammation and improve health outcomes.
UFL1 promotes survival and function of virtual memory CD8 T cells
Authors: Bhatt Brinda , Kumar Kunal , Shi Huidong , Ganesan Dhasarathan , Anazodo Francis , Rathakrishnan Aravind , Zhu Huabin , Wanna Andrew , Jiang Chen , Jayavelu Tamilselvan , Lokeshwar Vinata Bal , Pacholczyk Rafal , Munn David H , Sheridan Brian S , Moskophidis Demetrius , Li Honglin , Singh Nagendra
Published: February 2025

In naïve mice, a fraction of CD8 T cells displaying high affinity for self-MHC peptide complexes develop into virtual memory T (TVM) cells. Due to self-reactivity, TVM cells are exposed to persistent antigenic stimulation, a condition known to induce T cell exhaustion. However, TVM cells do not exhibit characteristics similar to exhausted CD8 T (TEX) cells. Here, we tested the role of the UFL1, E3 ligase of the ufmylation pathway in TVM cells. We show that UFL1 prevents the acquisition of epigenetic, transcriptional, and phenotypic changes in TVM cells that are similar to TEX cells and thus promote their survival and function. UFL1-deficient TVM cells failed to protect mice against Listeria infection. Epigenetic analysis showed higher BATF activity in UFL1-deficient TVM cells. Deletion of BATF and not PD1 decreased inhibitory molecules expression and restored the survival and function of UFL1-deficient TVM cells. Our findings demonstrate a key role of UFL1 in inhibiting the exhaustion of TVM cells and promoting their survival and function.