bluuebunny/crossref_metadata_2025 huggingface dataset:
The Hope of the Earth
Authors: Moltmann Jürgen
Published: August 2024

As a tribute to the German theologian Jürgen Moltmann, who died on 3 June 2024 in Tübingen, Germany, this issue of The Ecumenical Review is publishing a chapter from his book Hope in These Troubled Times, launched during Moltmann's last visit to the World Council of Churches in 2019. This chapter offers a critique of a theological approach that puts the human being at the centre of the relationship toward nature, an approach that has become questionable because of the ecological crisis. Instead, this chapter argues for a paradigm shift from placing the human being at the centre of the world to a cosmic integration of humanity, from the arrogance of global dominion to cosmic humbleness, from a distinction between God and the world to a mutual participation of a “world in God” and “God in the world.”
Traversing the land‐sea interface: A climate change risk assessment of terrestrially breeding marine predators
Authors: Sojitra Milan , Corney Stuart , Hemer Mark , Hamilton Sheryl , McInnes Julie , Thalmann Sam , Lea Mary‐Anne
Published: August 2024

Terrestrially breeding marine predators have experienced shifts in species distribution, prey availability, breeding phenology, and population dynamics due to climate change worldwide. These central‐place foragers are restricted within proximity of their breeding colonies during the breeding season, making them highly susceptible to any changes in both marine and terrestrial environments. While ecologists have developed risk assessments to evaluate climate risk in various contexts, these often overlook critical breeding biology data. To address this knowledge gap, we developed a trait‐based risk assessment framework, focusing on the breeding season and applying it to marine predators breeding in parts of Australian territory and Antarctica. Our objectives were to quantify climate change risk, identify specific threats, and establish an adaptable assessment framework. The assessment considered 25 criteria related to three risk components: vulnerability, exposure, and hazard, while accounting for uncertainty. We employed a scoring system that integrated a systematic literature review and expert elicitation for the hazard criteria. Monte Carlo sensitivity analysis was conducted to identify key factors contributing to overall risk. We identified shy albatross (Thalassarche cauta), southern rockhopper penguins (Eudyptes chrysocome), Australian fur seals (Arctocephalus pusillus doriferus), and Australian sea lions (Neophoca cinerea) with high climate urgency. Species breeding in lower latitudes, as well as certain eared seal, albatross, and penguin species, were particularly at risk. Hazard and exposure explained the most variation in relative risk, outweighing vulnerability. Key climate hazards affecting most species include extreme weather events, changes in habitat suitability, and prey availability. We emphasise the need for further research, focusing on at‐risk species, and filling knowledge gaps (less‐studied hazards, and/or species) to provide a more accurate and robust climate change risk assessment. Our findings offer valuable insights for conservation efforts, given that monitoring and implementing climate adaptation strategies for land‐dependent marine predators is more feasible during their breeding season.
WHAT ARE “TEMPORALITIES” IN HISTORY?
Authors: Hölscher Lucian
Published: August 2024

The question of which “temporalities” underpinned historical processes in the past has increasingly become the focus of historical interest in recent years. In his brilliantly written study of Prussian history, Time and Power: Visions of History in German Politics, from the Thirty Years’ War to the Third Reich, Christopher Clark attempts to answer this question by turning to four Prussian statesmen and politicians who each followed different temporalities in their private and public lives. The benefit of his study lies not least in a better understanding of the concept of “temporality” and its significance for historical processes.
Cardioneuroablation can be an effective strategy to treat glossopharyngeal neuralgia‐related sinus bradycardia and pauses
Authors: Liu Nana , Prasad Rohan , Iyer Indiresha , Sheikh Shehryar , Turka Jashanjit , Dweik Loai , Bain Mark , Santangeli Pasquale , Chung Mina K.
Published: August 2024

Introduction

Cardioneuroablation (CNA) has proven effectiveness in addressing hypervagotonia symptoms, such as neurocardiogenic syncope.

Methods and Results

In this case, we present the first‐time application of CNA in a case of vago‐glossopharyngeal neuralgia (VGPN). A 59‐year‐old female with near‐syncope, sinus bradycardia, and sinus pauses triggered by recurrent right‐sided neck pain was diagnosed with VGPN. The patient underwent successful treatment with carbamazepine and CNA. Subsequent follow‐up revealed the sustained absence of sinus bradycardia or pauses, even upon neck pain resurgence after discontinuing carbamazepine.

Conclusion

In this patient, CNA successfully prevented pauses associated with VGPN, avoiding permanent pacemaker implantation.
Does neoadjuvant therapy contribute to increased risk in anastomotic leakage of esophageal cancer? A network meta‐analysis
Authors: Zhou Da , Chen Donglai , Song Peidong , Hu Zihao , Xu Sukai , Zhu Rongying , Chen Yongbing
Published: August 2024

Aim

Conflicting results have been reported about the impact of neoadjuvant therapy on anastomotic leakage (AL) after esophagectomy. We aimed to unravel the potential effect of neoadjuvant therapy on AL after esophagectomy through a network meta‐analysis.

Methods

A Bayesian network meta‐analysis was performed by retrieving relevant literature from PubMed, EMbase, The Cochrane Library and Web of Science Core Collection. Randomized clinical trials (RCTs) and retrospective studies (RS) comparing the following treatment modalities were included: neoadjuvant chemoradiation (nCRT), neoadjuvant chemotherapy (nCT), neoadjuvant radiotherapy (nR), neoadjuvant immunochemotherapy (nICT), and surgery alone (SA). Subgroup analyses by radiation dose, examined lymph nodes (ELN), route of reconstruction, site of anastomosis, and surgical approach were also conducted.

Results

A total of 62 studies with 12,746 patients were included for the present study, among which 17 were RCTs. There were no significantly statistical differences observed among the five treatment modalities in AL for both RCTs (nCRT‐nICT: risk ratio 1.51, 95% confidence interval 0.52–4.4; nCT‐nICT: 1.71, 0.56–5.08; nICT‐nR: 0.79, 0.12–8.02; nICT‐SA: 0.59, 0.2–1.84) and RS (nCRT‐nICT: odds ratio 1.53, 95% confidence interval 0.84–2.84; nCT‐nICT: 1.56, 0.87–2.88; nICT‐SA: 0.6, 0.31–1.12; nICT‐nR: 1.08, 0.09–36.02). Subgroup analysis revealed that no significant difference in AL was observed among the five treatment modalities except for the impact of nCRT versus nCT (0.21, 0.05–0.73) on AL with a radiation dose ≥41.4 Gy.

Conclusions

Neoadjuvant therapy do not significantly increase the incidence of AL after esophagectomy. Administration of irradiation with a moderate dose is not associated with elevated risk in AL. Clinicians can be less apprehensive about prescribing nCRT.
The role of nurses' adherence to clinical safety guidelines in linking nurse practice environment to missed nursing care
Authors: Labrague Leodoro J. , Al Sabei Sulaiman , AbuAlRub Raeda , Burney Ikram , Al Rawajfah Omar
Published: August 2024

Introduction

While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care.

Methods

This descriptive, cross‐sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale.

Results

A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (β = 2.492,p < 0.001) and a lower frequency of missed nursing care (β = −0.2919,p = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (β = −0.055,p < 0.001).

Conclusion

Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care.

Clinical Relevance

Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.
Metformin Radiosensitizing Effect on Hypoxic Oral Squamous Cell Carcinoma Cells by GAPDH and TAGLN2
Authors: Santos Eloá Mangabeira , Farias Lucyana Conceição , Guimarães Talita Antunes , Santos Eliane Macedo Sobrinho , de Jesus Sabrina Ferreira , de Souza Marcela Gonçalves , de Souza Pericles Crisostomo , Santiago Luiza , D'Angelo Marcos Flávio Silveira Vasconcelos , De‐Paula Alfredo Maurício Batista , Santos Sérgio Henrique Sousa , Guimarães André Luiz Sena
Published: August 2024

Objective

Tumor hypoxia is associated with a poorer prognosis in cancer patients and can diminish the efficacy of radiation therapy (RT). This study investigates the potential of metformin to enhance radiosensitivity in hypoxic cancer cells.

Methods

Preliminary experiments were conducted to validate the impact of hypoxia on radiation response. Reactive oxygen species (ROS) levels, cell migration, and cell death were assessed in hypoxic, radiated cells treated with metformin. Proteomic and ontological analyses were employed to identify molecular targets associated with the radiosensitizing effect of metformin. Proteomic and ontological findings were validated through patient samples and in vitro studies.

Results

Metformin amplified cell death, induced DNA fragmentation, decreased cell migration, and elevated ROS levels in hypoxic, radiated cells. Proteomic analyses revealed that GAPDH and TAGLN2 were identified as pivotal targets linked to the radiosensitizing effect of metformin. Oral cancer patients exhibited elevated levels of TAGLN2 and reduced levels of GAPDH. Metformin downregulated TAGLN2 and upregulated GAPDH in hypoxic, radiated cells. Additionally, metformin reduced levels of mutated p53.

Conclusions

This study suggests that metformin can enhance radiosensitivity in hypoxic cells, operating through modulation of GAPDH and TAGLN2. Furthermore, metformin effectively reduces mutated p53 levels in radiated cells under hypoxic conditions.
A qualitative study of end‐stage liver disease and liver transplant referral practices among primary care providers in nonurban America
Authors: Madabhushi Vashisht V. , Wright Matthew , Orozco Gabriel , Murphy Allison , Garcia Antonio R. , Pope Natalie , Mei Xiaonan , Cocca Alexandra , Gedaly Roberto , Gupta Meera
Published: August 2024

Purpose

In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider's (PCP's) office. Patients with end‐stage liver disease (ESLD) in rural communities experience lower rates of wait‐listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY).

Methods

The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes.

Findings

From the focus group interviews, three themes were identified: medical culture, gaps in knowledge, and bias against those with self‐induced causes of ESLD. Each theme illuminated barriers to referral for transplant evaluation.

Conclusions

Knowledge gaps, attitudes in medical culture, and biases surrounding ESLD and LTX referral exist in community medicine practice. This highlights the importance of education, resources, and facilitation of LTX referral processes for PCPs.
Transcriptional cascades during fasting amplify gluconeogenesis and instigate a secondary wave of ketogenic gene transcription
Authors: Goldberg Dana , Buchshtab Nufar , Charni‐Natan Meital , Goldstein Ido
Published: August 2024

Background and Aims

During fasting, bodily homeostasis is maintained due to hepatic production of glucose (gluconeogenesis) and ketone bodies (ketogenesis). The main hormones governing hepatic fuel production are glucagon and glucocorticoids that initiate transcriptional programs aimed at supporting gluconeogenesis and ketogenesis.

Methods

Using primary mouse hepatocytes as an ex vivo model, we employed transcriptomic analysis (RNA‐seq), genome‐wide profiling of enhancer dynamics (ChIP‐seq), perturbation experiments (inhibitors, shRNA), hepatic glucose production measurements and computational analyses.

Results

We found that in addition to the known metabolic genes transcriptionally induced by glucagon and glucocorticoids, these hormones induce a set of genes encoding transcription factors (TFs) thereby initiating transcriptional cascades. Upon activation by glucocorticoids, the glucocorticoid receptor (GR) induced the genes encoding two TFs: CCAAT/enhancer‐binding protein beta (C/EBPβ) and peroxisome proliferator‐activated receptor alpha (PPARα). We found that the GR‐C/EBPβ cascade mainly serves as a secondary amplifier of primary hormone‐induced gene programs. C/EBPβ augmented gluconeogenic gene expression and hepatic glucose production. Conversely, the GR‐PPARα cascade initiated a secondary transcriptional wave of genes supporting ketogenesis. The cascade led to synergistic induction of ketogenic genes which is dependent on protein synthesis. Genome‐wide analysis of enhancer dynamics revealed numerous enhancers activated by the GR‐PPARα cascade. These enhancers were proximal to ketogenic genes, enriched for the PPARα response element and showed increased PPARα binding.

Conclusion

This study reveals abundant transcriptional cascades occurring during fasting. These cascades serve two separated purposes: the amplification of the gluconeogenic transcriptional program and the induction of a gene program aimed at enhancing ketogenesis.
The central and peripheral corneal response to short‐term hypoxia
Authors: Iqbal Asif , Fisher Damien , Alonso‐Caneiro David , Collins Michael J. , Vincent Stephen J.
Published: August 2024

Purpose

To quantify the magnitude and recovery of central and limbal corneal oedema induced by short‐term unilateral eyelid closure without contact lens wear.

Methods

The left eye of 10 adults with healthy corneas was patched using a folded eye pad for 30 min. High‐resolution optical coherence tomography images (which captured the limbal and central corneal regions simultaneously) were obtained before patching, immediately after eye opening and again at 1, 2, 5, 6, 9, 10, 14 and 15 mins after eyelid opening. Oedema was measured from the limbus (scleral spur) to the central cornea (thinnest corneal location) along the horizontal meridian.

Results

A greater amount of limbal oedema was noted (mean [SD] 3.84 [1.79] %) compared to the central cornea (2.48 [0.61] %; p = 0.04) after 30 mins of unilateral eyelid closure. Both central and limbal corneal oedema recovered rapidly following eyelid opening, with no significant differences in the rate of corneal recovery between corneal locations (p = 0.90).

Conclusions

Short‐term unilateral eyelid closure resulted in ~55% more relative oedema in the limbal region compared to the central cornea. Rapid recovery of oedema and corneal overshoot (thinning beyond the baseline corneal thickness) was observed within 1–2 min of eyelid opening for both central and peripheral regions.
Optimizing Outcomes in Distal Tibial Deformity Correction: The Role of Supramalleolar Osteotomy with Computer‐assisted Hexapod External Fixator
Authors: Yang Xiaosong , Du Hui , Yin Xinghua , Gong Xiaofeng , Wang Yan , Li Ying , Sun Ning , Lai Liangpeng , Li Wenjing , Li Heng , Li Xing , He Xiaotian , Wu Yong
Published: August 2024

Objective

Distal tibial deformities can significantly impact patients if left uncorrected, often leading to pain, alterations in gait, and the eventual development of post‐traumatic arthritis. The criteria for surgical correction in these patients continues to be a subject of debate, while supramalleolar osteotomy (SMO) is an effective method for correcting distal tibial deformities. The purpose of this study was to evaluate and compare the clinical results of SMO using internal fixation or using computer‐assisted hexapod external fixator in the treatment of distal tibial deformity.

Methods

A retrospective study was conducted on 290 patients who underwent SMO between June 2015 and January 2023. Forty‐four patients met the inclusion and exclusion criteria. Among the participants, 19 underwent SMO combined with a computer‐assisted hexapod external fixator, while 25 received SMO with plate and screw internal fixation. The tibial anterior surface (TAS) angle, tibial lateral surface (TLS) angle, the tibiotalar (TT) angle and the talocrural (TC) angle were assessed on weight‐bearing X‐ray films. Functional assessments were performed according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle‐hindfoot score.

Results

The study followed patients for an average duration of 31.7 ± 15.3 months, with a range from 12 to 67 months. Successful bone union was achieved in all cases. For patients treated with the computer‐assisted hexapod external fixator, significant improvements were observed: the mean deviation in sagittal plane deformity parameters decreased from 14.3 ± 10.4 degrees preoperatively to 2.8 ± 3.8 degrees postoperatively (p < 0.05). Similarly, coronal plane deformity parameters showed a reduction from 25.9 ± 22.5 degrees preoperatively to 5.9 ± 11.0 degrees postoperatively (p < 0.05). The AOFAS ankle‐hindfoot score improved markedly from 66.0 ± 14.9 to 86.1 ± 11.7 points (p < 0.05). For patients undergoing internal fixation, the absolute difference in coronal plane parameters improved from 15.4 ± 12.6 degrees preoperatively to 3.7 ± 3.4 degrees postoperatively (p < 0.05). A significant enhancement in AOFAS ankle‐hindfoot score was also noted, increasing from 68.3 ± 14.3 points to 79.4 ± 13.5 points (p < 0.05). There were no significant differences in gender, side, follow‐up time, postoperative deviation of deformity, pre‐ or postoperative AOFAS between the two groups.

Conclusion

In conclusion, comprehensive preoperative planning of SMO combined with either internal fixation or a hexapod external fixator for treating distal tibial deformities can achieve satisfactory outcomes. The utilization of a computer‐assisted hexapod external fixator facilitates a gradual and precise correction process, which proved to be an effective and relatively safe method.
Helix breakage during left bundle pacing area implantation
Authors: Santoro Amato , Taddeucci Simone
Published: August 2024

A left bundle pacing stimulation pacemaker was implanted using stylet driver lead. The screw incarceration occurred after positioning of the lead. The screw rupture occurred during lead retraction; the distal portion of the screw remained incarcerated at the interventricular septum.
Pepino mosaic virus: Recombination, spatiotemporal divergence and codon usage
Authors: He Mei , He Cheng‐Qiang , Ding Nai‐Zheng
Published: August 2024

Pepino mosaic virus (PepMV, species Potexvirus pepini) is a potexvirus of economic significance. The pathogen has become a serious threat to tomato (Solanum lycopersicum) worldwide. To gain more insights into the molecular epidemiology and evolution of PepMV, recombination analysis was carried out. Nine chimeric sequences were identified, including one probably involving host‐to‐virus gene flow. Based on the coat protein (CP) gene, PepMV isolates were classified into six genotypes and the phylogeography was reconstructed. Bayesian coalescent analysis applied to the dated genomic sequences suggested that PepMV started to expand in the early 17th century and evolved at a moderate rate. Ancestral state reconstruction supported the South American origin of PepMV. Codon usage bias analysis showed that PepMV genes had influences in addition to compositional constraints. In codon usage, PepMV is fairly similar to S. lycopersicum. Moreover, PepMV recapitulates the host's remarkable suppression of CpG and UpA dinucleotides.
Unconfined gravity current interactions with orthogonal topography: Implications for combined‐flow processes and the depositional record
Authors: Keavney Ed , Peakall Jeff , Wang Ru , Hodgson David M. , Kane Ian A. , Keevil Gareth M. , Brown Helena C. , Clare Michael A. , Hughes Mia J.
Published: August 2024

Turbidity current behaviour is affected by interactions with seafloor topography. Changes in flow dynamics will depend on the orientation and gradient of the topography, and the magnitude and rheology of the incoming flow. A better understanding of how unconfined turbidity currents interact with topography will improve interpretations of the stratigraphic record, and is addressed herein using three‐dimensional flume tank experiments with unconfined saline density currents that enter a horizontal basin before interacting with a ramp orientated perpendicular to flow direction. The incoming flow parameters remained constant, whilst the slope angle was independently varied. On a 20° slope, superelevation of the flow and flow stripping of the upper, dilute region of the flow occurred high on the slope surface. This resulted in a strongly divergent flow and the generation of complex multidirectional flows (i.e. combined flows). The superelevation and extent of flow stripping decreased as the slope angle increased. At 30° and 40°, flow reflection and deflection, respectively, are the dominant flow process at the base of slope, with the reflected or deflected flow interacting with the parental flow, and generating combined flows. Thus, complicated patterns of flow direction and behaviour are documented even on encountering simple, planar topographies orientated perpendicular to flow direction. Combined flows in deep‐water settings have been linked to the interaction of turbidity currents with topography and the formation of internal waves with a dominant oscillatory flow component. Here, combined flow occurs in the absence of an oscillatory component. A new process model for the formation and distribution of hummock‐like bedforms in deep‐marine systems is introduced. This bedform model is coupled to a new understanding of the mechanics of onlap styles (draping versus abrupt pinchout) to produce a spatial model of gravity‐current interaction, and deposition, on slopes to support palaeogeographical reconstructions.
Critiquing Indian Middle‐Class Principles of Mobility: Examining Transgender Representation in Post‐Millennial OTT Media in India
Authors: Subramanian Prerna
Published: August 2024

This literature review critically examines the need to incorporate critiques of urban, middle‐class, Hindu, upper‐caste mediated regulation of transgender mobility within media analyses of transgender representation in contemporary films and other streaming (OTT) media in India. The essay explores how the real and imagined/narrative mobility of marginalized groups, such as Dalit women, Muslim women, sex workers, and transgender communities, has been historically disciplined by the cultural and political practices of the upper‐caste Hindu middle class family. Material‐discursive practices of this class upper‐caste, middle‐class Hindu family shape and get shaped by gendered and caste‐coded interests of neoliberal productivity and heteropatriarchal respectability, determining the ideal geographies of the city and the relational cartographies of the nation. Films and media also get influenced by and shape these discursive practices by prioritizing a middle‐class sense of place in their worldmaking efforts. The narrative schema of such cultural production designs the movement of characters in such a way that they move in directions considered recognizable, legible and acceptable for the Indian middle class family. The primary aim of this review is to delineate the literature on spatial imaginaries of the middle class family and how the cultural practices of this class imagine and render legible the marginalized, allowing for a critical analysis of the co‐production of middle‐class spatial control and transgender visibility in cultural texts like that of contemporary streaming media. Furthermore, this study explores the emplacement of the marginalized as evident in critiques of representations of Dalit, Muslim, and sex worker communities in Indian cinema, emphasizing the necessity of applying similar analyses to trans representation. This spatially sensitive critique is crucial for understanding transgender struggles in India, highlighting the importance of examining middle‐class spatial imaginaries that shape trans representation and the politics of regulated transgender (im)mobilities.
Improvement of self‐administration experience with a new injection device: Real‐life experience with risankizumab in patients with psoriasis
Authors: Brunasso Alexandra Maria Giovanna , Salvi Ilaria , Sorbara Stefania , Muracchioli Andrea , De Col Elena , Baldari Manuela , Parodi Aurora , Cozzani Emanuele , Burlando Martina
Published: August 2024

Background

Trypanophobia or “needle phobia” represents a potential hindrance to the effective management of chronic diseases whenever an injectable therapy might be required, especially in case of frequent administrations. Psoriasis, a chronic dermatologic disease, can be effectively treated with biologic drugs administered subcutaneously. Thankfully, anti‐IL‐23 drugs require few administrations per year and are available in prefilled pens that hide the needle, thus representing a convenient option in patients with trypanophobia.

Methods

An observational multicentric study was conducted on patients with moderate‐to‐severe psoriasis who were treated with 75 mg × 2 risankizumab prefilled syringe therapy for more than 6 months and reported a loss of efficacy measured by the Psoriasis Area and Severity Index (PASI) from PASI 90 to PASI 75 attributed to a reduction of adherence due to trypanophobia. The patients were switched to 1 prefilled pen of risankizumab 150 mg and asked to fill out the Self‐Injection Assessment Questionnaire (SIAQ) before and after the injection at week 0 and at the following administration after 12 weeks. Subjects scored each item of the SIAQ on a 5‐point scale, scores were later transformed from 0 (worst experience) to 10 (best experience).

Results

Twenty‐two patients were enrolled. The mean SIAQ predose domain scores were 5.5 for feelings about injection, 6.2 for self‐confidence, and 6.4 for satisfaction with self‐injection. After dose scores were higher (> 8.5) for each of the six domains at Week 0 and even higher after 12 weeks (> 9.0).

Conclusions

User‐friendly devices, such as prefilled pens, and a lower number of injections improved patient satisfaction in a group of patients with psoriasis on treatment with biologic drugs. We believe that treatment adherence could be positively influenced by such changes in the way of administration of a biologic treatment.
Perspectives on donor‐derived infections from the Notify Library
Authors: Len Oscar , Greenwald Melissa A , Navarro Aurora , Petrisli Evangelia , Carella Claudia , Grossi Paolo Antonio , Feltrin Giuseppe , Cardillo Massimo
Published: August 2024

It is impossible to eliminate the potential for transmission of donor‐derived infections (DDI) when using medical products of human origin (MPHO). However, a thoughtful and systematic approach to donor evaluation can mitigate the risk. Prevention is a key issue, and physicians must maintain a high index of suspicion and remain vigilant in evaluating MPHO donors or recipients, as well as stay current on emerging infections. Biovigilance is the systematic monitoring of serious adverse reactions and events (SARE) that ensures the quality and safety of MPHO in transplantation. The Notify Library with its 2808 references is an available didactic tool that could support physicians in donor or recipient evaluation, inform biovigilance activity, and benefit the international scientific community. It provides free access to a large collection of many different types of SARE, identified mainly through the review of published articles and case reports from national or regional surveillance programs. The Notify Library includes many well‐documented records of SARE in the field of DDI, representing a useful tool for assessing SARE associated with transplantation. It is continuously updated with new records, especially when a new type of incident is first reported. All types of described incidents may have educational value while guiding detection, investigation, or risk management. Sharing the lessons learned from these incidents represents an important educational opportunity that can help improve organ donation processes and achieve higher standards of quality and safety.
Navigating the Asia‐Pacific region plasma therapies landscape: Insights from the 2023 Asia‐Pacific Plasma Leaders' Network meetings
Authors: Bhatnagar Sonu , Burnouf Thierry , Prevot Johan , Faber Jean‐Claude , Büechel René , Maryuningsih Yuyun Siti , Khanh Bach Quoc , Mai Nguyen Thi , Nakanishi Hideo , Kataoka Masako
Published: August 2024

The Asia‐Pacific Plasma Leaders' Network (APPLN) plays a crucial role in addressing the regional shortage of plasma‐derived medicinal products (PDMPs), particularly in low‐ and middle‐income countries (LMICs). It provides a platform for experts to share their expertise and drive multi‐stakeholder collaborations. While several PDMPs are acknowledged by the World Health Organization (WHO) as life‐saving therapeutics on the Model List of Essential Medicine for treating various chronic and acute life‐threatening diseases, there are still many inadequacies in the availability and affordability of PDMPs. These challenges arise from insufficient domestic supplies of plasma suitable for fractionation, as well as a lack of technical and financial capabilities to implement contract or domestic plasma fractionation programmes. At two separate dialogue forums organized by the APPLN in 2023, experts discussed the unmet needs of PDMPs for individuals living with haemophilia and immunodeficiencies in the region. They also highlighted the limited access to early diagnosis and patient‐centred care in several LMICs. To address these issues, there is an urgent need to increase the availability of high‐quality domestic plasma for fractionation. Adopting a stepwise approach to utilize unused recovered plasma and establishing contract fractionation programmes could be viable strategies to potentially enhance PDMP availability in LMICs. However, achieving this goal requires improving existing domestic infrastructures for blood collection, implementing adequate policy reforms and fostering competent local leadership. Ultimately, there is no ‘one‐size‐fits‐all’ strategy for securing safe plasma proteins for all patients in need. Collaborative efforts are essential for achieving progressive self‐sufficiency in PDMPs.
Radiographic and computed tomographic findings of intrathoracic ectopic liver in a dog
Authors: Jeong Jeongyun , Chang Jupill , Lee Seunghee , Kim Kyuchang , Kim Jaehwan , Eom Kidong
Published: August 2024

A 5‐year‐old spayed female Maltese was referred due to a suspected diaphragmatic hernia. Radiography revealed a soft tissue mass in the right caudal thorax with loss of diaphragm cupola dome‐shape. A diaphragmatic hernia was considered, but surgical exploration revealed an intact diaphragm and unremarkable liver lobes. CT after a surgical inspection showed all intact liver lobes and intrathoracic mass connected to the liver. The intrathoracic mass was retracted to the abdomen by incising the diaphragm. Histopathologic examination revealed hepatocellular vacuolar degeneration, indicating an intrathoracic ectopic liver. Intrathoracic ectopic liver should be included in the differential diagnosis when diaphragmatic hernia is suspected in radiography.
The Theory of Gradual Landing of Public Opinion During Crises
Authors: Alkarni Ali A.
Published: August 2024

Public opinion is under consideration not only in the media but also in other fields, such as political science, social studies, and psychology, especially with the growing crises affecting institutions and countries during the 20th and 21st centuries. It is noticeable that there are few theories that explain many of the phenomena associated with public opinion, especially in the era of modern communication technologies and social media. This gap necessitated the development of a theory of gradual landing in public opinion during crises. This theory was developed by reviewing extensive literature on public opinion, crisis management, and media theory related to public opinion. The theory deals with four major variables: event, media, audience, and the parties involved in the conflict or crisis. These variables encompass the mechanisms that determine the paths on the rise and decline of public opinion issues. This theory integrates the degree of the significance of the topic and the media's interest. This theory helps identify various cases of rise and decline in the level of interest in public opinion within society.
Comparison of Laminar and Turbulent K–Omega Shear Stress Transport Models Under Realistic Boundary Conditions Using Clinical Data for Arterial Stenosis
Authors: Al-Rawi Mohammad , Belkacemi Djelloul , Al-Jumaily Ahmed M.
Published: August 2024

Early diagnosis of cardiovascular diseases (CVDs), including arterial stenosis, enables targeted treatments that reduce CVD mortality. It is vital to improve the accuracy of early diagnostic tools. Current computational studies of stenosis use mathematical models, such as laminar and k–omega shear stress transport (SST) models, available in ansys (Fluent and CFX), openfoam, and comsol software packages. Users can adjust boundary conditions, such as inlet velocity and outlet pressure using user-defined functions (UDFs) with different expressions and constant values. However, currently there is no rule over what to impose at these boundaries, and previous studies have used various assumptions, such as rigid artery wall, one-way fluid–structure interaction (FSI) or two-way FSI, and the blood's Newtonian or non-Newtonian material properties. This variety in construction has associated deviations of the models from the clinical data and lessens the value of the models as potential diagnostic or predictive tools for medical practitioners. In this study, we examine arterial stenosis models, with severities of 20%, 40%, and 50%, compared with the healthy artery analyzed in terms of strain energy to the artery wall. Additionally, we investigate elastic walls using one-way FSI, comparing with laminar and k–omega SST. These boundary conditions are based on clinical data. The results regarding the strain energy (mJ) behavior along the artery wall show that the k–omega SST model outperforms the laminar model for short arterial segments and under the Newtonian assumption with a no-slip boundary wall and turbulent flow.
A Multivariable Numerical Investigation of Wavy-Based Microchannel Heat Sink Geometry Toward Optimal Thermal Performance
Authors: Eltaweel Ahmed , Hassan Ibrahim
Published: August 2024

This research provides a comprehensive multivariable comparative investigation of the effect of various microchannel configurations on their thermal performance. Three-dimensional fluid flow and heat transfer simulations are performed with different arrangements of the channel's width tapering and cross-sectional aspect ratio with an emphasis on the synergistic proven effects of geometrical parameters in innovatory combinations. Results confirm that wavy channels are significantly superior to straight channels in terms of thermal performance due to the creation of secondary flow (Dean Vortices), which improves the processes of advective mixing and, therefore, overall heat transfer characteristics with minimal pumping power penalty. Width tapering of wavy channels also shows better thermal resistance than untapered wavy channels producing almost 10% thermal resistance improvement. The study indicates a significant dependency of thermal performance on the cross-sectional aspect ratio of the channel, which suggests that there are ideal tapering and aspect ratio conditions. An innovative wavy-tapered microchannel heat sink has been introduced, featuring an optimal parametric configuration and directionally alternating coolant flow. This design results in additional thermal resistance improvement by 15% and significantly improves substrate temperature distribution uniformity. Overall, the results demonstrate the superior potential of the configuration for high-end electronics cooling tasks. These results provide interpretive insight into microchannel heat sink design and optimization.
Study on the Influence of Volute Throat Jet on Excitation Vibration Alleviation of Radial Turbine Blade
Authors: Yu Xiaoshun , Li Yanzhao , Liu Zhen , Yin Bo , Wang Leilei
Published: August 2024

Turbine blade fracture, resulting from high-cycle fatigue (HCF), is the most commonly observed failure mode of turbochargers. In a vaneless turbine, the radial turbine blade is susceptible to HCF under excessive aerodynamic excitation due to the flow field distortion caused by the volute tongue. The present study explores a technique to mitigate blade excitation by reducing pressure disturbance in the volute tongue area. The gas with higher pressure in the inlet section of the volute is transferred to the low-static pressure area upstream of the volute tongue through a throat jet hole. The usage of high-pressure gas improved the homogeneity of the flow field near the volute tongue. The study investigates the mitigation of high-pressure gas jet on turbine blade excitation, the impact of jet hole geometry on the suppression effect of the blade vibration, and the effect of high-pressure jet on turbine performance using numerical simulation of unsteady flow fields. The results indicate that the jet flow has a substantial impact on dampening the blade vibrations. The harmonic pressure amplitude at the monitor point located within the high blade vibration amplitude region is reduced by up to 56%. Generalized pressure analysis reveals that the aerodynamic excitation of the turbine blades is significantly reduced. Experimental evidence verifies the effectiveness of the jet hole scheme in reducing blade vibration. Moreover, the jet hole has a negligible effect on turbine efficiency. However, there is a degree of increased stress in the volute tongue with a jet hole which needs to be evaluated in engineering applications.
Guideline for Large-Scale Analysis of Centrifugal Blower Using Wall-Resolved Large Eddy Simulation
Authors: Tsukamoto Kazuhiro , Kato Chisachi
Published: August 2024

To reduce the number of prototypes during product design and accurately predict unsteady phenomena occurring at off-design points, a method for accurately predicting the performance of centrifugal blowers through numerical analysis is required. This article presents a guideline for accurately predicting the performance of centrifugal blowers using compressible flow analysis with large eddy simulation (LES). In LES analysis, it is important to have a grid resolution that resolves the minimum vortex scale near the wall (referred to as wall-resolved LES) and to consider detailed geometry such as the length of the suction pipe. The calculations in this study used a model blower, which is a scale model of a single-stage centrifugal blower for use in industrial plants. The model blower was experimentally measured for various parameters such as the blower pressure coefficient, the static-pressure-rise coefficients of the impeller and vane-less diffuser, the shaft power, and the pressure fluctuations at the inlet of the impeller and the inlet of the vane-less diffuser. The results of these measurements were compared with those obtained from the wall-resolved LES. The study confirmed that the accuracy of performance prediction can be improved to less than a 4.0% error in the blower pressure coefficient at both design and off-design operating points by resolving the minimum vortex scale with 14.6 billion-grid elements and considering the detailed geometry.
Regulatory Challenges in AI/ML-Enabled Medical Devices: A Scoping Review and Conceptual Framework
Authors: Kaladharan Sanju , Manayath Dhanya , Gopalakrishnan Rejikumar
Published: August 2024

Amidst rapid advancements in artificial intelligence and machine learning-enabled medical devices (AI/ML-MD), this article investigates the regulatory challenges highlighted in the current academic literature. Using a PRISMA-guided scoping review, 18 studies were selected for in-depth analysis to highlight the multifaceted issues in regulating AI/ML-MD. The study's findings are organized into key themes: adaptive AI/ML, usability and stakeholder engagement, data diversity and use, health disparities, synthetic data use, regulatory considerations, medicolegal issues, and cybersecurity threats. The scoping review reveals numerous challenges associated with the regulation of AI/ML-based medical devices, reflecting various sustainability pillars. The study advocates for integrating sustainability principles into the materiovigilance ecosystem of AI/ML-MD and proposes a novel sustainable ecosystem for AI/ML-MD materiovigilance. This proposed ecosystem incorporates social, economic, and environmental sustainability principles to create a comprehensive and balanced regulatory approach. By presenting a thorough analysis of regulatory challenges, the study provides policymakers with a nuanced understanding of the complex landscape surrounding these technologies. This insight enables the development of informed strategies and solutions to address regulatory gaps and ensure the safe and effective integration of AI/ML-MD into healthcare systems.
Effect of Adding N2/H2O to Ethylene Laminar Diffusion Flame on Soot Formation
Authors: Luo Guang , Zhang Yindi , Liu Bing , Liu Jiani , Xu Bidong , Adjei Takyi Shadrack
Published: August 2024

The method of adding exhaust gas to fuel to reduce soot and nitrogen oxide (NOX) is called exhaust gas recirculation (EGR). This article was carried out to investigate the effect of adding N2 and H2O to the fuel side to dilute ethylene on soot generation in laminar diffusion flame by combining experiment and numerical simulation. In the experiment, the flame was optically detected, and the volume fraction of soot and temperature was reconstructed. The numerical simulation adopts a simplified GRI-Mech 3.0 ethylene 23-step combustion reaction mechanism. It introduces virtual species FX (F1H2O, F2H2O, F3H2O) to isolate the effects of H2O addition on thermal, transport, chemical, and density effects. The results show that the numerical values agree well with the experimental results. At the same dilution ratio, the direct involvement of H2O in the reaction affects the flame temperature and intermediate products, leading to a more significant suppressing effect on soot than N2 dilution. After decoupling the effects of H2O, it was found that there are two main reasons for the decrease of soot caused by the addition of H2O. The first is the dilution effect and thermal effect, which hinder the hydrogen extraction C2H2 addition (HACA) reaction by reducing the concentration of intermediate component C2H2, greatly inhibiting the surface growth rate of soot, and playing a decisive role in reducing the formation of soot. The second is the chemical effect, which mainly enhances the oxidation process of soot by increasing the concentration of OH free radicals during combustion through the elementary reaction OH + H2 ↔ H + H2O. Additionally, the degree of influence of various effects on soot was qualitatively determined as follows: dilution effect > chemical effect > thermal effect > density effect > transport effect.
Interplay Between Nucleation and Kinetics in Dynamic Twinning
Authors: Chua Janel , Agrawal Vaibhav , Walkington Noel , Gazonas George , Dayal Kaushik
Published: August 2024

In this work, we apply a phase-field modeling framework to elucidate the interplay between nucleation and kinetics in the dynamic evolution of twinning interfaces. The key feature of this phase-field approach is the ability to transparently and explicitly specify nucleation and kinetic behavior in the model, in contrast to other regularized interface models. We use this to study two distinct problems where it is essential to explicitly specify the kinetic and nucleation behavior governing twin evolution. First, we study twinning interfaces in 2D. When these interfaces are driven to move, we find that significant levels of twin nucleation occur ahead of the moving interface. Essentially, the finite interface velocity and the relaxation time of the stresses ahead of the interface allow for nucleation to occur before the interface is able to propagate to that point. Second, we study the growth of needle twins in antiplane elasticity. We show that both nucleation and anisotropic kinetics are essential to obtain predictions of needle twins. While standard regularized interface approaches do not permit the transparent specification of anisotropic kinetics, this is readily possible with the phase-field approach that we have used here.
Numerical Analysis for Cutting a Subsea Bundle
Authors: Chanaa Ahmad , Ivanovic Ana , Hastings Astley
Published: August 2024

The decommissioning of subsea bundles presents a significant challenge to the industry. Bundles are unique to the North Sea with more than 70 bundles currently in use with diameters reaching 1400 mm. The 1992 Convention for the Protection of the Marine Environment of the North East Atlantic, which is the international treaty governing offshore decommissioning in the North East Atlantic, presumes that all installations will be removed and the London Convention prohibits dumping at sea so the decommissioning of subsea bundles is a legal requirement. This study identifies that cutting and lifting subsea bundles is the best option for decommissioning bundles and is the first use of finite element analysis to design such a tool to cut bundles and determine the forces required. This modeling of the hydraulic shear indicates that the required shearing force is 18.65 MN when using a blade with a 60-deg cutting angle and a 180-deg shape angle. The modeling further demonstrates that the shearing force varies with the cutting and shape angles. On the other hand, the modeling for the guillotine cutter indicates a required shearing force of 19 MN. This analysis demonstrates the parameters required to design a subsea bundle-cutting tool and is the first step toward developing a practical tool for decommissioning subsea bundles.