bluuebunny/crossref_metadata_2025 huggingface dataset:
Liegetrauma: retrospektive Analyse einer Patientenkohorte aus einer universitären Notaufnahme
Authors: Hüser Christoph , Hackl Matthias , Suárez Victor , Gräff Ingo , Bernhard Michael , Burst Volker , Adler Christoph
Published: April 2022

Hintergrund

Bisher fehlen Versorgungsdaten für Patienten mit Liegetrauma (LT).

Methode

Deskriptive retrospektive Analyse aller rettungsdienstlich mit einem LT der Notaufnahme des Universitätsklinikums Köln von 07.2018 bis 12.2020 zugeführten Patienten.

Ergebnis

Insgesamt konnten 50 Patienten mit LT (Altersmedian 76 Jahre, Liegedauer im Median 13,5 h) im Untersuchungszeitraum identifiziert werden. Die zugrunde liegende Ursache für das LT war in 40 % primär neurologisch (ischämischer Schlaganfall: 20 %, intrakranielle Blutung: 16 %, Epilepsie: 4 %), in 12 % eine Intoxikation und in 10 % ein häusliches Trauma. Häufige assoziierte Diagnosen waren Infektionen (52 %), Traumafolgen (22 %), Exsikkose (66 %), akute Nierenfunktionsstörung (20 %), schwere Rhabdomyolyse (Kreatininkinase ≥ 5000 U/l, 21 %) und schwere Hypothermie < 32 °C (20 %). Insgesamt wurden 69 % der Patienten auf einer Intensivstation aufgenommen und die Krankenhausletalität betrug 50 %.

Schlussfolgerung

Das LT beschreibt einen Patientenzustand, bei dem infolge vielfältiger Ursachen plötzlich die eigenständige Mobilisierung und ein selbstständiges Hilfeholen verhindert werden und dadurch weitere Gesundheitsschäden entstehen. Bei diesem Syndrom sind Gewebsschäden als Folge des Liegens keine notwendige Voraussetzung für das Vorliegen eines LT. Aufgrund der hohen Morbidität und Letalität sollten diese Patienten in einem nichttraumatologischen Schockraum aufgenommen werden.
Extrakorporale Reanimation – Kriterien, Bedingungen, Outcome
Authors: Magnet Ingrid , Poppe Michael
Published: April 2022

Für ausgewählte Patienten, in denen die konventionelle kardiopulmonale Reanimation (cCPR) erfolglos bleibt, sprechen die europäischen Leitlinien zur Reanimation 2021 erstmals eine Empfehlung zur extrakorporalen Reanimation (eCPR) als mögliche Rettungstherapie aus. Die eCPR wird im therapierefraktären Kreislaufstillstand etabliert, um Diagnostik und Therapie reversibler Ursachen, wie Herzinfarkt, Lungenembolie, akzidentielle Hypothermie, Intoxikationen mit herzwirksamen Substanzen und akute Hypoxie, zu ermöglichen. Selektionskriterien für eCPR umfassen prognostische Reanimationsfaktoren, wie beobachteter Kreislaufstillstand, Start von Reanimationsmaßnahmen in < 5 min, schockbarer Erstrhythmus, Zeichen effektiver cCPR wie Lebenszeichen während der Reanimation, anhaltendes Kammerflimmern, intermittierende Phasen von Spontankreislauf oder anhaltendes endtidales CO2 > 10 mm Hg, Patientenalter und Gesundheitszustand. Die Zeitspanne vom Kreislaufstillstand bis zur eCPR ist eine der wichtigsten Determinanten für neurologisch gutes Überleben und sollte < 60 min liegen. Für die Einhaltung dieser Zielvorgabe muss eine entschlossene „Load-and-Go“-Strategie mit frühzeitiger Patientenselektion und raschem Transport unter mechanischer cCPR in ein eCPR-Zentrum verfolgt werden, oder es wird versucht, die eCPR präklinisch zum Einsatz zu bringen. Zwei randomisierte kontrollierte eCPR-Studien demonstrierten Überlebensraten von 43 % bzw. 31,5 % bei Patienten mit anhaltendem Kammerflimmern bzw. kardialem Kreislaufstillstand. Ob diese Ergebnisse außerhalb einzelner hochspezialisierter Zentren anwendbar sind, ist wie die Frage nach der besten präklinischen und innerklinischen Strategie Gegenstand zukünftiger Studien.
Current status of the management of isolated syndesmotic injuries in Germany
Authors: Mutschler Manuel , Naendrup Jan-Hendrik , Pfeiffer Thomas R. , Jaecker Vera , Arbab Dariusch , Shafizadeh Sven , Buchhorn Tomas
Published: April 2022

Introduction

Although non-fracture-related syndesmotic injuries of the ankle are relatively rare, they may lead to poor clinical outcome if initially undiagnosed or managed improperly. Despite a variety of literature regarding possibilities for treatment of isolated syndesmotic injuries, little is known about effective applications of different therapeutic methods in day-to-day work. The aim of this study was to assess the current status of the treatment of isolated syndesmotic injuries in Germany.

Materials and methods

An online-questionnaire, capturing the routine diagnostic workup including clinical examination, radiologic assessment and treatment strategies, was sent to all members of the German Society of Orthopedic Surgery and Traumatology (DGOU) and Association of Arthroscopic and Joint Surgery (AGA). Statistical analysis was performed using Microsoft excel and SPSS.

Results

Each question of the questionnaire was on average answered by 431 ± 113 respondents. External rotation stress test (66%), squeeze test (61%) and forced dorsiflexion test (40%) were most commonly used for the clinical examination. In the diagnostic workup, most clinicians relied on MRI (83%) and conventional X-ray analysis (anterior–posterior 58%, lateral 41%, mortise view 38%). Only 15% of the respondents stated that there is a role for arthroscopic evaluation for the assessment of isolated syndesmotic injuries. Most frequently used fixation techniques included syndesmotic screw fixation (80%, 42% one syndesmotic screw, 38% two syndesmotic screws), followed by suture-button devices in 13%. Syndesmotic screw fixation was mainly performed tricortically (78%). While 50% of the respondents stated that syndesmotic screw fixation and suture-button devices are equivalent in the treatment of isolated syndesmotic injuries with respect to clinical outcome, 36% answered that syndesmotic screw fixation is superior compared to suture-button devices.

Conclusions

While arthroscopy and suture-button devices do not appear to be widely used, syndesmotic screw fixation after diagnostic work-up by MRI seems to be the common treatment algorithm for non-fracture-related syndesmotic injuries in Germany.
Occurrence of adjacent segment fractures after surgical treatment of an osteoporotic vertebral fracture: a retrospective comparison between two different treatment methods
Authors: Aboud Nazeer , Eckardt Niklas , Kamp Marcel A. , Senft Christian , Schwarz Falko
Published: April 2022

Introduction

Osteoporotic vertebral fractures are a major healthcare problem. Vertebral cement augmentation (VCA) is frequently used as a minimally invasive surgical approach to manage symptomatic fractures. However, there is a potential risk of adjacent segment fracture (ASF), which may require second surgery. The addition of transcutaneous screw-fixation with cement augmentation superior and inferior to the fracture [Hybrid transcutaneous screw fixation (HTSF)] might represent an alternative treatment option to reduce the incidence of ASF.

Materials and methods

We retrospectively compared surgery time, hospital stay, intraoperative complication rate and the occurrence of ASF with the need for a surgical treatment in a cohort of 165 consecutive patients receiving either VCA or HTSF in our academic neurosurgical department from 2012 to 2020. The median follow-up was 52.3 weeks in the VCA-group and 51.9 in the HTSF-group.

Results

During the study period, 93 patients underwent VCA, and 72 had HTSF. Of all patients, 113 were females (64 VCA; 49 HTSF) and 52 were males (29 VCA; 23 HTSF). The median age was 77 years in both groups. Median surgery time was 32 min in the VCA-group and 81 min in the HTSF-group (p < 0.0001). No surgery-related complications occurred in the VCA-group with two in the HTSF-group (p = 0.19). ASF was significantly higher in the VCA-group compared to HTSF (24 [26%] vs. 8 [11%] patients; p < 0.02). The proportion of patients requiring additional surgery due to ASF was higher in the VCA-group (13 vs. 6%), but this difference was not statistically significant (p = 0.18). Median hospital stay was 9 days in the VCA-group and 11.5 days in the HTSF-group (p = 0.0001).

Conclusions

Based on this single-center cohort study, HTSF appears to be a safe and effective option for the treatment of osteoporotic vertebral compression fractures. Surgical time and duration of hospital stay were longer in the HTSF-group, but the rate of ASF was significantly reduced with this approach. Further studies are required to ascertain whether HTSF results in superior long-term outcomes or improved quality of life.
Comparison of the diagnostic performance of NBI, Laser-BLI and LED-BLI: a randomized controlled noninferiority trial
Authors: Higurashi Takuma , Ashikari Keiichi , Tamura Shigeki , Takatsu Tomohiro , Misawa Noboru , Yoshihara Tsutomu , Ninomiya Yuki , Okamoto Yuki , Taguri Masataka , Sakamoto Taku , Oka Shiro , Nakajima Atsushi , Tanaka Shinji , Matsuda Takahisa
Published: April 2022

Background and aims

New image-enhanced endoscopy (IEE), blue Light Imaging (LED-BLI) is launched in USA and Europe, whereas Blue Laser Imaging (Laser-BLI) is available only Asian and some countries. No studies have directly compared the diagnostic accuracy of narrow band imaging (NBI), Laser-BLI and LED-BLI for colorectal tumors. The present study aimed to compare the diagnostic accuracy of the three methods for colorectal tumor using the NBI international colorectal endoscopic (NICE) classification and the Japanese NBI Expert Team (JNET) classifications.

Methods

This was a multi-center evaluator-blinded, randomized control trial of patients who underwent endoscopic colorectal tumor resection. The patients were randomly assigned to NBI, Laser-BLI or LED-BLI. Cropped images were sent to blinded external evaluators and diagnosed according to NICE and JNET classifications. The diagnostic accuracy of each endoscopy system was compared with non-inferiority test.

Results

A total of 619 colonic tumors were resected from 230 patients and evaluated by external four evaluators. The diagnostic accuracy of NBI for NICE 1, NICE 2, NICE 3 was 90.6%, 90.3% and 99.5%, respectively and for JNET 1, JNET 2A, JNET 2B and JNET 3, it was 94.6%, 72.0%, 79.2% and 99.1%, respectively. In non-inferiority test, Laser-BLI and LED-BLI revealed non-inferiority to NBI in all NICE and JNET categories (p<0.001).

Conclusions

Laser-BLI and LED-BLI had high diagnostic accuracy and non-inferiority of NBI, especially for hyperplastic polyp/sessile serrated lesion and low-grade dysplasia. This is first trial to compare the diagnostic accuracy with NBI, Laser-BLI and LED-BLI and useful to understand the position of each IEE. This trial was registered as UMIN000032107.
RockGPT: reconstructing three-dimensional digital rocks from single two-dimensional slice with deep learning
Authors: Zheng Qiang , Zhang Dongxiao
Published: April 2022

Random reconstruction of three-dimensional (3D) digital rocks from two-dimensional (2D) slices is crucial for elucidating the microstructure of rocks and its effects on pore-scale flow in terms of numerical modeling, since massive samples are usually required to handle intrinsic uncertainties. Despite remarkable advances achieved by traditional process-based methods, statistical approaches and recently famous deep learning-based models, few works have focused on producing several kinds of rocks with one trained model and allowing the reconstructed samples to approximately satisfy certain given properties, such as porosity. To fill this gap, we propose a new framework with deep learning, named RockGPT, which is composed of VQ-VAE and conditional GPT, to synthesize 3D samples based on a single 2D slice from the perspective of video generation. The VQ-VAE is utilized to compress high-dimensional input video, i.e., the sequence of continuous rock slices, to discrete latent codes and reconstruct them. In order to obtain diverse reconstructions, the discrete latent codes are modeled using conditional GPT in an autoregressive manner, while incorporating conditional information from a given slice, rock type, and porosity. We conduct two experiments on five kinds of rocks, and the results demonstrate that RockGPT can produce different kinds of rocks with a single model, and the porosities of reconstructed samples can distribute around specified targets with a narrow range. In a broader sense, through leveraging the proposed conditioning scheme, RockGPT constitutes an effective way to build a general model to produce multiple kinds of rocks simultaneously that also satisfy user-defined properties.
The Role of Scientific Expertise in COVID-19 Policy-making: Evidence from Four European Countries
Authors: Hodges Ron , Caperchione Eugenio , van Helden Jan , Reichard Christoph , Sorrentino Daniela
Published: April 2022

Immense uncertainty and the need for drastic interventions cause politicians to rely heavily on scientific advice for underpinning or legitimating their COVID-19 decision-making. This paper explores the role of scientific advice in this policy field in Germany, Italy, the Netherlands and the UK. It shows that scientific advice is based on the disciplinary, mainly medical, backgrounds of advisors but is also influenced by social and economic values, which are core to what politicians find important. During the pandemic a growing gap between scientific advice and political decisions is observed.
Mobile money, traditional financial services and firm productivity in Africa
Authors: Konte Maty , Tetteh Godsway Korku
Published: April 2022

Despite the successful adoption of mobile money in sub-Saharan Africa, there is limited empirical evidence on how mobile money interacts with traditional financial services and the implications of this interaction for firm performance. In this paper, we investigate the effects of mobile money use and access to traditional financial services on labour productivity and test whether mobile money can accentuate the impact of traditional financial services on productivity. Using firm-level data from the World Bank Enterprise Survey across 14 sub-Saharan African countries, we find a significant effect of access to traditional financial services on firm labour productivity but no robust significant direct effect of mobile money use on labour productivity. However, when access to traditional financial services, particularly access to bank capital, is combined with mobile money, there is a productivity improvement. We find similar evidence in the sample of small and medium-sized enterprises. The productivity gain from combining mobile money use with traditional financial service is also found within firms from East Africa and especially firms from other regions where mobile money is emerging, but uptake is relatively low. Overall, the evidence suggests that mobile money can heighten the effects of traditional finance, and we attribute this effect to a reduction in transaction costs. The findings in this paper support that both mobile money and traditional financial services should be promoted at the firm level.
Regional entrepreneurial ecosystems: learning from forest ecosystems
Authors: O’Connor Allan , Audretsch David
Published: April 2022

Despite the emerging body of literature on entrepreneurial ecosystems (EEs), theoretical development is still in its infancy. In this article, we explicitly draw upon the analogy of forest ecosystems (FEs) with an EE to extrapolate the regional entrepreneurial ecosystem (REE) as an alternate conceptual framework. The REE considers a region’s socioeconomic activity and the stability of its performance as a whole, influenced by partitioned interests of economics, social arrangements, physical environment, knowledge and the technology that each contributes to the community’s industry and economic order. We contend that it is when an EE is defined by a regional dimension that it is analogous to the study of forests. In this REE analysis, neither the entrepreneur nor their firm are the unit of analysis, but it is the change and stability of the regional socioeconomic ecosystem itself that becomes the priority. Scholars, interested in the effects of entrepreneurship, can learn from ecological studies to more fully grasp the interplay between compositional, structural, and functional elements and specifically how entrepreneurs account for change dynamics.
3D Shape Analysis Through a Quantum Lens: the Average Mixing Kernel Signature
Authors: Cosmo Luca , Minello Giorgia , Bronstein Michael , Rodolà Emanuele , Rossi Luca , Torsello Andrea
Published: April 2022

The Average Mixing Kernel Signature is a novel spectral signature for points on non-rigid three-dimensional shapes. It is based on a quantum exploration process of the shape surface, where the average transition probabilities between the points of the shape are summarised in the finite-time average mixing kernel. A band-filtered spectral analysis of this kernel then yields the AMKS. Crucially, we show that opting for a finite time-evolution allows the signature to account for a mixing of the Laplacian eigenspaces, similar to what is observed in the presence of noise, explaining the increased noise robustness of this signature when compared to alternative signatures. We perform an extensive experimental analysis of the AMKS under a wide range of problem scenarios, evaluating the performance of our descriptor under different sources of noise (vertex jitter and topological), shape representations (mesh and point clouds), as well as when only a partial view of the shape is available. Our experiments show that the AMKS consistently outperforms two of the most widely used spectral signatures, the Heat Kernel Signature and the Wave Kernel Signature, and suggest that the AMKS should be the signature of choice for various compute vision problems, including as input of deep convolutional architectures for shape analysis.
Development of a semi-structured database for back-analysis of the foundation stiffness of offshore wind monopiles
Authors: Stuyts Bruno , Weijtjens Wout , Devriendt Christof
Published: April 2022

Offshore wind turbines founded on monopiles are highly dynamic structures in which the stiffness of the soil adjacent to the monopile controls the natural frequency of the structure. As the loading regime and ground conditions surrounding the foundation are subject to considerable uncertainty, adaptable digital twins of the offshore structures are valuable as they allow the use of in-field monitoring data for model updating. As soil conditions and water depths are rarely uniform across a wind farm site, each structure is expected to behave differently. To back-analyse structural performance, geotechnical and structural data needs to be retrieved at every foundation location. A serverless cloud-based application was developed to allow quick and reliable storage and retrieval of geotechnical and structural data. The database was combined with an API layer to allow parametric data retrieval for back-analyses and digital twin updating across an entire wind farm. As the web application is hosted in the cloud, the data can be accessed through simple HTTP requests by authenticated users working offshore, in the office or remote. The performance of this solution is illustrated with a case study in which foundation stiffness across an entire wind farm site is parametrically calculated and updated.
Co-dependency and Enmeshment — a Fusion of Concepts
Authors: Bacon Ingrid , Conway Jeff
Published: April 2022

Co-dependency and enmeshment have been used interchangeably in psychological and psychotherapeutic practice. The commentary offers a discussion on the conceptual development of both concepts, highlighting the historical differences and similarities. It suggests that there are specific schemas and modes which operate within the scope of both concepts. The Bacon & Conway - CODEM Model 2022. is introduced to describe the schemas and modes associated with enmeshment and co-dependency. The conceptual model of enmeshment and co-dependency is offered with the intention to help the reader to identify and find ways to address these patterns. A fictional clinical case scenario was offered to illustrate the discussion. Further research is currently being developed to offer a robust empirical base for the model proposed.
Medical expenditures for fragility hip fracture in Japan: a study using the nationwide health insurance claims database
Authors: Mori Takahiro , Komiyama Jun , Fujii Tomoko , Sanuki Masaru , Kume Keitaro , Kato Genta , Mori Yukiko , Ueshima Hiroaki , Matsui Hiroki , Tamiya Nanako , Sugiyama Takehiro
Published: April 2022

Using the nationwide health insurance claims database in Japan, we estimated total annual medical expenditures for fragility hip fracture across the population at 329.2 billion yen (2.99 billion US dollars). Long-term care expenditures were not included. Fragility hip fracture imposes a considerable health economic burden on society in Japan.

Purpose

Fragility hip fracture imposes a substantial health economic burden on society globally. We aimed to estimate medical expenditures for fragility hip fracture using the nationwide health insurance claims database in Japan.

Methods

We included adults aged 60 and over without prior hip fracture who were admitted for fragility hip fracture (i.e., femoral neck or extracapsular) between October 2014 and October 2015 (13 months). Fragility hip fracture was identified through newly assigned disease codes for fracture and procedure codes associated with the fracture. As a proxy for medical expenditures per patient, incremental payments were calculated (i.e., the difference between the total payments 6 months before and after fragility hip fracture). The total payments included health insurance reimbursements and copayments for inpatient and outpatient services. Long-term care expenditures were not included in this study.

Results

We identified 142,361 individuals (28,868 male and 113,493 female) with fragility hip fracture. Mean medical expenditures for fragility hip fracture per patient were 2,550,000 yen (¥) (23,180 US dollars [$]; ¥110 = $1) in male and ¥2,494,000 ($22,670) in female patients, respectively. Total annual medical expenditures for fragility hip fracture across the population were 329.2 billion yen (2.99 billion US dollars): 67.96 billion yen (620 million US dollars) in male and 261.24 billion yen (2.37 billion US dollars) in female patients, respectively.

Conclusion

This is the first study to estimate medical expenditures for hip fracture using the nationwide health insurance claims database, which represents almost all health insurance claims in Japan. Fragility hip fracture inflicts a considerable health economic burden on society in Japan.
Segregation Neutralised Steels: Microstructural Banding Elimination from Dual-Phase Steel Through Alloy Design Accounting for Inherent Segregation
Authors: Slater Carl , Bandi Bharath , Dastur Pedram , Davis Claire
Published: April 2022

Banding in commercial dual-phase steels, such as banded ferrite and pearlite or ferrite and martensite microstructures, is inherited from segregation during solidification in continuously cast material, predominantly from Mn segregation, and subsequent rolling. The banded microstructures lead to anisotropic mechanical properties which is generally undesirable. This paper presents an alloy design approach (termed “segregation neutralised” steels) to remove banding of the second phase by utilising co-segregation of both austenite and ferrite stabilisers to reduce local variability in second phase stability. The new composition proposed also considers achieving the same strength levels through maintaining the same second phase fraction, grain size and solid solution strengthening increments. Phase field modelling has been used to predict the segregation and phase transformation behaviours for a commercial composition dual-phase steel and the new composition segregation neutralised steel. A 5 kg laboratory alloy production route (casting, hot rolling and coiling simulation, cold rolling and annealing) has shown that the banded structure seen in commercial dual-phase steels is accurately reproduced and that banding has been reduced dramatically in both the hot rolled condition as well as after cold rolling and annealing in the new segregation neutralised steel. Chemical analysis has shown that in the segregation neutralised alloy the second phase distribution shows no correlation to the segregation bands, due to the achieved balance in austenite and ferrite stabilisers.
More than Just a Monolayer: the Multifaceted Role of Endothelial Cells in the Pathophysiology of Atherosclerosis
Authors: Mussbacher Marion , Schossleitner Klaudia , Kral-Pointner Julia B. , Salzmann Manuel , Schrammel Astrid , Schmid Johannes A.
Published: April 2022

Purpose of the Review

In this review, we summarize current insights into the versatile roles of endothelial cells in atherogenesis.

Recent Findings

The vascular endothelium represents the first barrier that prevents the entry of lipoproteins and leukocytes into the vessel wall, thereby controlling two key events in the pathogenesis of atherosclerosis. Disturbance of endothelial homeostasis increases vascular permeability, inflammation, and cellular trans-differentiation, which not only promotes the build-up of atherosclerotic plaques but is also involved in life-threatening thromboembolic complications such as plaque rupture and erosion. In this review, we focus on recent findings on endothelial lipoprotein transport, inflammation, cellular transitions, and barrier function.

By using cutting-edge technologies such as single-cell sequencing, epigenetics, and cell fate mapping, novel regulatory mechanisms and endothelial cell phenotypes have been discovered, which have not only challenged established concepts of endothelial activation, but have also led to a different view of the disease.
The Impact of Meal Timing on Risk of Weight Gain and Development of Obesity: a Review of the Current Evidence and Opportunities for Dietary Intervention
Authors: Davis Rochelle , Rogers Michelle , Coates Alison M. , Leung Gloria K. W. , Bonham Maxine P.
Published: April 2022

Purpose of Review

The aim of this short review is to provide an updated commentary on the current literature examining the impact of meal timing on obesity and weight gain in adults. The potential mechanisms, including novel and emerging factors, behind timing of food intake across the 24-h period in the development of obesity, and dietary strategies manipulating meal timing to ameliorate weight gain are also explored.

Recent Findings

Dietary patterns that feature meal timing outside of the regular daytime hours can contribute to circadian disruption as food is metabolised in opposition to internal daily rhythms and can feedback on the timekeeping mechanisms setting these rhythms. Epidemiological evidence examining the impact of late meal timing patterns is beginning to suggest that eating at night increases the risk of weight gain over time. Mechanisms contributing to this include changes to the efficiency of metabolism across the day, and dysregulation of appetite hormone and gut microbiota by mis-timed meals.

When meals are eaten, in relation to the time of day, is increasingly considered of importance when implementing dietary change in order to address the growing burden of obesity, although further research is required in order to determine optimal patterns.
Studying the Microstructure, Physical and Mechanical Properties of Al Matrix Reinforced with Bi-Modal Particles Coated with Either Ni or Cu
Authors: Fadel Ghada , Mohamed Lamiaa Z. , Elkady Omayma A. , Elhabak Aiea A. , Adly Mahmoud A. , Abolkassem Shimaa A.
Published: April 2022

Powder metallurgy was used to fabricate Al/(SiC-Y2O3)/Ag/Cu or Ni nanocomposite. The ratio of SiC to Y2O3 was 50:50. SiC-Y2O3 particles were coated with 10 wt% nano-Ag, followed by coating with another layer of 10% nano-Ni or nano-Cu by an electroless chemical deposition technique. All samples were compacted by a uniaxial press under 480 MPa and then sintered in a vacuum furnace at 600 °C for 1 h holding time. Coated samples with nano-Cu have the highest densification values. The microstructure of nano-Cu-coated composites is more homogenous than nano-Ni ones. X-ray diffraction analysis (XRD) indicated the presence of Al peaks as a major phase, and Al3NiSi and AlCu intermetallics are detected. Also, traces of SiC and Y2O3 peaks are recorded. Hardness results showed that (SiC-Y2O3)/ nano-Ag/nano-Cu samples have higher hardness values than nano-Ni samples. Also, both the electrical and thermal conductivities are higher for nano-Cu-coated samples than for nano-Ni coated ones.
The Effects of a Tailored Mindfulness-Based Program on the Positive Mental Health of Resident Physicians—a Randomized Controlled Trial
Authors: Aeschbach Vanessa M. , Fendel Johannes C. , Göritz Anja S. , Schulze-Marmeling Charlotte , Schmidt Stefan
Published: April 2022

Objectives

Medical residency is a challenging phase that puts the mental health of resident physicians at risk. This study explores the effects of a tailored mindfulness-based program on the positive mental health of resident physicians.

Methods

We conducted a longitudinal randomized controlled trial with an active control group. The intervention group took part in an 8-week mindfulness-based program (MBP) that included a course book and was followed by a 4-month maintenance phase. The control group only received the course book for self-study. Participants were assessed at 0, 2, 6, and 12 months. Assessments included self-report measures (positive affect, life-satisfaction, self-compassion, flourishing, self-esteem, feeling loved, self-attributed mindfulness, time perception, “Muße” (i.e., feeling at ease and free of pressure), thriving at work, job satisfaction, self-efficacy, self-esteem), as well as Goal Attainment Scaling.

Results

A total of 147 resident physicians were randomly assigned to either the intervention or the control group. In linear mixed models, we found small to medium effects for the interaction of time × group across various time points for self-compassion, flourishing, mindfulness, Muße, thriving at work, and indirect negative affect with effect sizes ranging between d = 0.25 and 0.88. Goal Attainment Scaling revealed a greater goal attainment in the intervention group compared to the control group (d = 1.50).

Conclusions

We conclude that a tailored MBP may improve certain aspects of resident physicians’ positive mental health.

Trial Registration

DRKS00014015 05/24/2018.
Energy efficiency and Jevons' paradox in OECD countries: policy implications leading toward sustainable development
Authors: Yu Zhang , Ponce Pablo , Irshad Ateeq Ur Rehman , Tanveer Muhammad , Ponce Katerine , Khan Abdul Rehman
Published: April 2022

Energy consumption is defined as one of the main determinants of environmental degradation. Therefore, this issue becomes one of the main points of debate to achieve sustainable development. This research examines how a set of economic factors determine the energy consumption in Organization for Economic Cooperation and Development countries, for which second-generation econometric methods have been used that control cross-sectional dependence issues. Therefore, the results, using nonlinear methods, suggest the presence of Jevons' paradox in these countries. However, under the Jevons' paradox scenario, technological innovation becomes a factor that mitigates energy demand. Contrary to the foreign direct investment that contributes significantly to the increase in energy consumption, from the results found, some policy implications are derived in the framework of achieving sustainable development.
Phenytoin-loaded bioactive nanoparticles for the treatment of diabetic pressure ulcers: formulation and in vitro/in vivo evaluation
Authors: Sheir Marwa M. , Nasra Maha M. A. , Abdallah Ossama Y.
Published: April 2022

Drug repurposing offers the chance to explore the full potential of existing drugs while reducing drug development time and costs. For instance, the anticonvulsant drug phenytoin (PHT) has been investigated for its wound healing properties. However, its poor solubility and variability of doses used topically limit its use. Hence, the aim of this study was to improve the properties and wound healing efficacy of PHT for the treatment of diabetic bedsores. PHT was encapsulated, using a modified ionic gelation method, in either positively or negatively charged chitosan-alginate nanoparticles (NPs), which possess previously demonstrated wound healing potential. These NPs were characterized by transmission electron microscopy, differential scanning calorimetry, and Fourier-transform infrared spectroscopy. PHT-loaded NPs were evaluated in vivo for their pressure ulcers’ healing potential using diabetic rats. The prepared NPs, especially the positively charged particles, exhibited superior wound healing efficacy compared to PHT suspension, with respect to healing rates, granulation tissue formation, tissue maturation, and collagen content. The positively charged NPs resulted in a 56.54% wound closure at day 7, compared to 37% for PHT suspension. Moreover, skin treated with these NPs showed a mature dermis structure with skin appendages, which were absent in all other groups, in addition to the highest collagen content of 63.65%. In conclusion, the use of a bioactive carrier enhanced the healing properties of PHT and allowed the use of relatively low doses of the drug. Our findings suggest that the prepared NPs offer an effective antibiotic-free delivery system for diabetic wound healing applications.

Graphical Abstract
Resources and reserves in a carbon-constrained world
Authors: Cook Peter J.
Published: April 2022

For many years, definition and production of non-renewable resources has been crucial to meeting industrial and societal demands for energy and materials. In the evolving energy transition, the priority is to meet not only the world’s increasing energy requirements but also societal expectations of net zero by 2050 or sooner. Renewable energy will play a key role in achieving this, but this will require key and critical minerals and materials, whether for use in wind turbines or for building new energy distribution systems. Fossil fuels will continue to be used for some energy and industrial processes and increasingly for the production of hydrogen. Essential to the energy transition will be ongoing assessment of resources and reserves, including of critical minerals, geological sites for CO2 and H2, carbon-based and carbon-free fuels. Some of the principles underpinning the traditional use of the terms reserves and resources can be usefully applied to provide rigour and uniformity to the assessment of renewable energy opportunities. Carbon offsets, negative emissions and recycling will also be used to achieve net zero. Whatever the energy transition pathway that countries choose to take, knowledge of and ready access to non-renewable resources and reserves will be essential to achieving a clean energy future.
On a class of p(x)-Laplacian-like Dirichlet problem depending on three real parameters
Authors: El Ouaarabi Mohamed , Allalou Chakir , Melliani Said
Published: April 2022

This research establishes the existence of weak solution for a Dirichlet boundary value problem involving the p(x)-Laplacian-like operator depending on three real parameters, originated from a capillary phenomena, of the following form: $$\begin{aligned} \displaystyle \left\{ \begin{array}{ll} \displaystyle -\Delta ^{l}_{p(x)}u+\delta \vert u\vert ^{\alpha (x)-2}u=\mu g(x, u)+\lambda f(x, u, \nabla u) &{} \mathrm {i}\mathrm {n}\ \Omega ,\\ \\ u=0 &{} \mathrm {o}\mathrm {n}\ \partial \Omega , \end{array}\right. \end{aligned}$$

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u
)

+
λ
f

(
x
,
u
,
∇
u
)

i
n

Ω
,

u
=
0

o
n

∂
Ω
,

where $$\Delta ^{l}_{p(x)}$$

Δ

p
(
x
)

l

is the p(x)-Laplacian-like operator, $$\Omega $$
Ω
is a smooth bounded domain in $$\mathbb {R}^{N}$$

R

N

, $$\delta ,\mu $$

δ
,
μ

, and $$\lambda $$
λ
are three real parameters, and $$p(\cdot ),\alpha (\cdot )\in C_{+}(\overline{\Omega })$$

p

(
·
)

,
α

(
·
)

∈

C
+

(

Ω
¯

)

and g, f are Carathéodory functions. Under suitable nonstandard growth conditions on g and f and using the topological degree for a class of demicontinuous operator of generalized $$(S_{+})$$

(

S
+

)

type and the theory of variable-exponent Sobolev spaces, we establish the existence of a weak solution for the above problem.
Consistent Quantification of Precipitate Shapes and Sizes in Two and Three Dimensions Using Central Moments
Authors: Schleifer Felix , Müller Moritz , Lin Yueh-Yu , Holzinger Markus , Glatzel Uwe , Fleck Michael
Published: April 2022

Computational microstructure design aims to fully exploit the precipitate strengthening potential of an alloy system. The development of accurate models to describe the temporal evolution of precipitate shapes and sizes is of great technological relevance. The experimental investigation of the precipitate microstructure is mostly based on two-dimensional micrographic images. Quantitative modeling of the temporal evolution of these microstructures needs to be discussed in three-dimensional simulation setups. To consistently bridge the gap between 2D images and 3D simulation data, we employ the method of central moments. Based on this, the aspect ratio of plate-like particles is consistently defined in two and three dimensions. The accuracy and interoperability of the method is demonstrated through representative 2D and 3D pixel-based sample data containing particles with a predefined aspect ratio. The applicability of the presented approach in integrated computational materials engineering (ICME) is demonstrated by the example of γ″ microstructure coarsening in Ni-based superalloys at 730 °C. For the first time, γ″ precipitate shape information from experimental 2D images and 3D phase-field simulation data is directly compared. This coarsening data indicates deviations from the classical ripening behavior and reveals periods of increased precipitate coagulation.
Natural selection according to Darwin: cause or effect?
Authors: Bradley Ben
Published: April 2022

In the 1940s, the ‘modern synthesis’ (MS) of Darwinism and genetics cast genetic mutation and recombination as the source of variability from which environmental eventsnaturally selectthe fittest, such ‘natural selection’ constituting the cause of evolution. Recent biology increasingly challenges this view by casting genes as followers and awarding the leading role in the genesis of adaptations to the agency and plasticity of developing phenotypes—making natural selection a consequence of other causal processes. Both views of natural selection claim to capture the core of Darwin’s arguments inOn the Origin of Species. Today, historians largely concur with the MS’s reading ofOriginas a book aimed to prove natural selection thecause(vera causa) of adaptive change. This paper finds the evidence for that conclusion wanting. I undertake to examine the context and meaning of all Darwin’s known uses of the phrasevera causa, documenting in particular Darwin’s resistance to the pressure to prove natural selection avera causain letters written early in 1860.His resistance underlines the logical dependence of natural selection, anunobservablephenomenon, on the causal processes producing theobservableevents captured by the laws of inheritance, variation, and the struggle for existence, established in Chapters 1–3 ofOrigin.
Flexible Example-Based Program Synthesis on Tree-Structured Function Compositions
Authors: Mucsányi Bálint , Gyarmathy Bálint , Czapp Ádám , Pintér Balázs
Published: April 2022

We introduce a flexible program synthesis system whose task is to predict function compositions that transform given inputs to their corresponding given outputs. We process input lists in a sequential manner, allowing the system to generalize to a wide range of input lengths. We separate the operator and the operand in the lambda functions of the used higher order functions to achieve significantly wider numeric parameter ranges compared to the previous works. The evaluations show that this approach is competitive with state-of-the-art systems, while it is much more flexible in terms of the input length, the parameters of the lambda functions, and the integer range of the inputs and outputs. We extend the system to handle tree-structured function compositions by introducing two additional functions (, copy) and the ability to represent unfinished function compositions during the synthesis process. The extended system achieves state-of-the-art results while synthesizing complex function compositions with multiple forks. We believe that flexibility in these aspects is an important step towards solving real-world problems with example-based program synthesis.
Correction to: On Initial Data Problem for a Periodic Two-Component b-Family System
Authors: Wang Xiaohuan
Published: April 2022

In affiliation 1, the name of the institution has been corrected to "Nanjing University of Information Science and Technology". The original article has been corrected.
Low rates of antibiotic use among ambulatory patients with coronavirus disease 2019 (COVID-19)
Authors: Smith Alison G.C. , Wilber Eli , Rebolledo Paulina A. , Sharp Joseph , Kandiah Sheetal , Graciaa Daniel S. , Kempker Russell R.
Published: April 2022

We assessed the prevalence of antibiotic prescriptions among ambulatory patients tested for coronavirus disease 2019 (COVID-19) in a large public US healthcare system and found a low overall rate of antibiotic prescriptions (6.7%). Only 3.8% of positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) tests were associated with an antibiotic prescription within 7 days.
Emergency Medical Services Demand: An Analysis of County-Level Social Determinants
Authors: Déziel Jackson D
Published: April 2022

Objectives:

Variations in the demand for Emergency Medical Services (EMS) exist when observed at a local level. This unspecified heterogeneity leads to an investigation of social factors contributing to EMS demand.

Methods:

Data for this study were collected from publicly available EMS reports from Florida and Oklahoma for 2009 - 2015. Health and social data were gathered from County health rankings and roadmap reports. Data were combined into a single dataset, and pooled ordinary-least-squares models with time-fixed effects were utilized for tests of inference. EMS call volume was log-transformed to derive a semi-elasticity function.

Results:

A total of 874 county-year observations were analyzed. Increases in poor/fair health (95% CI: 0.6% - 3.9%), binge drinking (95% CI: 1.6% - 3.5%), teen birth rate (95% CI: 1.1% - 5.2%), unemployment rate (95% CI: 0.5% - 3.9%), and violent crime rate (95% CI: 1.0% - 3.0%) were associated with an increase in the EMS demand rate.

Conclusion:

The data supports the notion that some community measures have an effect on EMS demand as counties with higher levels of poor health, binge drinking, teen births, unemployment, and violent crime saw higher EMS demand. These factors may have been treated as spurious, or overlooked by policy makers and EMS leadership.
Has Zika Been Forgotten? Findings From Nationwide Survey on Knowledge, Attitudes, and Mosquito Preventive Practices in Malaysia
Authors: Wong Li Ping , Alias Haridah , Lee Hai Yen , AbuBakar Sazaly
Published: April 2022

Objective:

The aim of this study is to assess knowledge and attitudes toward Zika virus disease (ZVD) as well as mosquito prevention practices in Malaysia at a nationwide level.

Methods:

Computer-assisted telephone interviews (CATI) were conducted between June 2019 and February 2020.

Results:

There are gaps in knowledge about the symptoms, mode of transmission, and risk of microcephaly. The mean for the Zika-related knowledge score was 5.9 (SD ± 4.4) out of a possible score of 14. The majority perceived little or no risk of getting ZVD (75.0%) and 75.5% were a little or not at all worried about ZVD. A high proportion reported the use of insect sprays or mosquito coils to prevent mosquito bites; however, a relatively lower proportion of people reported fixing mosquito netting on doors and windows, and using mosquito bed nets. The mean for the mosquito prevention practices score was 11.9 (SD ± 4.7) out of a possible score of 27. Important factors influencing mosquito prevention practices include household income, environment factors, risk perception, and Zika-related knowledge.

Conclusion:

Zika prevention measures should be targeted in priority toward residents in lower socioeconomic neighborhoods. Campaigns should focus on messages highlighting the high risk of getting dengue.
Winter Storms and Unplanned School Closure Announcements on Twitter: Comparison Between the States of Massachusetts and Georgia, 2017–2018
Authors: Evans Haley I. , Handberry Maya T. , Muniz-Rodriguez Kamalich , Schwind Jessica S. , Liang Hai , Adhikari Bishwa B. , Meltzer Martin I. , Fung Isaac Chun-Hai
Published: April 2022

Objective:

This project aimed to quantify and compare Massachusetts and Georgia public school districts’ 2017–2018 winter-storm-related Twitter unplanned school closure announcements (USCA).

Methods:

Public school district Twitter handles and National Center for Education Statistics data were obtained for Georgia and Massachusetts. Tweets were retrieved using Twitter application programming interface. Descriptive statistics and regression analyses were conducted to compare the rates of winter-storm-related USCA.

Results:

Massachusetts had more winter storms than Georgia during the 2017–2018 winter season, but Massachusetts school districts posted winter-storm-related USCA at a 60% lower rate per affected day (adjusted rate ratio, aRR = 0.40, 95% confidence intervals, CI: 0.30, 0.52) than Georgia school districts after controlling for the student enrollments and Twitter followers count per Twitter account. A 10-fold increase in followers count was correlated with a 118% increase in USCA rate per affected day (aRR = 2.18; 95% CI: 1.74, 2.75). Georgia school districts had a higher average USCA tweet rate per winter-storm-affected day than Massachusetts school districts. A higher number of Twitter followers was associated with a higher number of USCA tweets per winter-storm-affected day.

Conclusion:

Twitter accounts of school districts in Massachusetts had a lower tweet rate for USCA per winter-storm-affected days than those in Georgia.
Futures of Europe: The City of London’s Commodity Exchanges, the European Economic Community, and the Global Regulation of Futures Trading (1960s–1980s)
Authors: Bertilorenzi Marco
Published: April 2022

Since the mid-1970s, the U.S. commodity futures exchanges have increasingly been the focus of tight government regulation, which resulted in strong control by a specific agency: the Commodity Futures Trading Commission. In Europe, the regulation of futures diverged from the U.S. model. No regulation at the communitarian level was implemented; at the national level, the United Kingdom emerged as a model of self-regulation of commodity markets. This article explores the historical causes behind this lack of regulation in Europe, placing it in the context of global commodity trading and arguing that the European regulation of futures trading was reshaped by a dialogue established between the European Commission and big players of commodity futures trading in the City of London. Since the mid-1960s, the City of London has become a pivotal global market venue for commodity futures, which has increasingly attracted players from abroad, thanks to its financial integrity and self-regulatory model. Both established London merchants and emerging players in the global trade of financial products cooperated to stave off any attempt at regulating the London futures exchanges. The inference here is that those attempts were instrumental in setting the conditions leading to the regulatory fragmentation that still characterizes futures trading in the global market.