bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluoride removal and its impact on oral health in Sri Lanka's dry zone: Discussion and recommendation
Authors: Thilakarathne Bodhipaksha Krishna Geethani , Schensul Stephen , Weeragoda Sujithra K. , Weerasooriya Rohan , Jern Ng Wun
Published: March 2023

Fifty percent of the dry zone areas in Sri Lanka have fluoride levels above 1 ppm. This paper discusses the ground conditions and recommends an appropriate range of fluoride in drinking water which can support preventive practices for improving the oral health of children 8‐years old and younger. In efforts to address the Chronic Kidney Disease of Unknown etiology (CKDU), water treatment to reduce contaminant level in potable water has been implemented. Such treatment would also remove fluoride and has resulted in potable water with various fluoride levels, depending on concentrations in the raw water. While it is important to reduce fluoride levels, it is important to have appropriate residual levels for prevention of dental caries. It needs, however, to be noted fluoride in excess can cause dental fluorosis. In Sri Lanka's dry zone areas increasing prevalence of dental fluorosis with decreasing prevalence of dental caries has been noted. Consumption of tea and powdered milk could increase total intake of fluoride. Fluoridated toothpaste, when used properly, may, however, result in negligible intake of fluoride. Sri Lanka's hot tropical climate which results in substantial intake of fluids reinforces the need to consider reduction in water fluoride. Consideration of local studies and international standards indicate fluoride levels should be in the range of 0.225–0.500 ppm. In the range of 0.225–0.500 ppm, the prevalence of dental fluorosis and caries was only 14% and 8%, respectively, in an endemic district. When fluoride levels are above 0.500 ppm, the issue of dental fluorosis shall need to be addressed. When levels are below 0.225 ppm, oral health care services shall need to be directed at preventing dental caries.
Tolerance limits for mixture‐of‐normal distributions with application to COVID‐19 data
Authors: Wang Hsiuying
Published: March 2023

Tolerance intervals (TIs) are widely used in various applications including manufacturing engineers, clinical research, and pharmaceutical industries. TIs can be used to construct limits of control charts for monitoring quality characteristics. For manufacturing processes where multiple factors may contribute to defects or multiple‐stream processes, a mixture distribution of several suitable probabilistic models may be a better choice than a simple distribution for modeling the data. TIs for the normal mixture distribution have been studied in the literature. This article reviews the TIs of the normal mixture distribution, the applications of the mixture distribution, and the control charts of the mixture distribution. A rule for constructing modified two‐sided TIs of the normal mixture distribution is summarized, and this rule may be extended to construct modified two‐sided TIs for general mixture distributions. The feasibility of using TIs to build control charts for mixture distributions is also discussed. A real data example of coronavirus disease 2019 is used to illustrate the method by linking the TI to control charts.

This article is categorized under:

Statistical Learning and Exploratory Methods of the Data Sciences > Clustering and Classification
Upright Posture and Gendered Styles of Body Movements in The Mill on the Floss
Authors: Class Monika
Published: March 2023

George Eliot predicates the two principal characters of her second novel,The Mill on the Floss(1860), not on fixed traits but on gendered differences in styles of body movement. This chapter approaches the interplay of medicine and mobility through the lens of the feminist phenomenology of perception, situating Eliot’s configuration of the gendered scripts of posture in the proto-orthopaedic discourse of Victorian disciplinary power. The comparison of the characters’ growth into manhood and womanhood showcases Tom Tulliver’s increasing compliance with correct masculine posture and his sister Maggie’s persistent tomboyism in adulthood. Monika Class contends that Eliot’s realist novel engages critically with Victorian postural standards and thus conveys the link of medical and moral norms in a vision towards variable, and even untamed, gender identities. Above all, the configuration of the heroine expands the Victorian repertoire of feminine body movement.
Quantization and variational problem of the Gubser-Rocha Einstein-Maxwell-Dilaton model, conformal and non-conformal deformations, and its proper thermodynamics
Authors: Chagnet Nicolas , Balm Floris , Schalm Koenraad
Published: March 2023

Abstract

We show that the strongly coupled field theory holographically dual to the Gubser-Rocha anti-de-Sitter Einstein-Maxwell-Dilaton theory describes not a single non-trivial AdS2 IR fixed point, but a one-parameter family. It is dual to a local quantum critical phase instead of a quantum critical point. This result follows from a detailed analysis of the possible quantizations of the gravitational theory that is consistent with the thermodynamics of the analytical Gubser-Rocha black hole solution. The analytic Gubser-Rocha black hole is only a 2-parameter subset of all possible solutions, and we construct other members numerically. These new numerical solutions correspond to turning on an additional scalar charge. Moreover, each solution has multiple holographic interpretations depending on the quantization chosen. In one particular quantization involving a multitrace deformation the scalar charge is a marginal operator. In other quantizations where the marginal multitrace operator is turned off, the analytic Gubser-Rocha black hole does not describe a finite temperature conformal fluid.
Non-monotonicity of the first eigenvalue for the 3D magnetic Robin Laplacian
Authors: Miranda Germán
Published: March 2023

Previous works provided several counterexamples to monotonicity of the lowest eigenvalue for the magnetic Laplacian in the two-dimensional case. However, the three-dimensional case is less studied. We use the results obtained by Helffer, Kachmar, and Raymond to provide one of the first counterexamples in 3D. Considering the magnetic Robin Laplacian on the unit ball with a constant magnetic field, we show the non-monotonicity of the lowest eigenvalue asymptotics when the Robin parameter tends to $$+\infty $$

+
∞

.
The power of desktop scanning electron microscopy with elemental analysis for analyzing urinary stones
Authors: Costa-Bauzá A. , Grases F. , Julià F.
Published: March 2023

The aim of this paper is to present a protocol for the routine morphocompositional study of kidney stones in a clinical setting, and to demonstrate that it is a simple and useful approach that can reliably determine the etiology of all types of kidney stones. Our routine study of kidney stones consists of a combination of stereoscopic microscopy, scanning electron microscopy, and infrared spectroscopy. The usefulness of such a procedure is demonstrated by its application to several illustrating examples. The protocol applied here is reliable and fast, and does not require multiple infrared spectroscopic analyses for most non-homogeneous samples. It also provides the identification of components that are present in very small proportions, the characteristics of internal and external structures, and information about areas with biological structures, such as renal tubules. It should be noted that results are obtained in a relatively short time and with high reliability. The detailed morphocompositional study of a urinary calculus is essential for establishing the diagnosis and etiology and for initiating the treatment of a patient with renal lithiasis, because there is a relationship between the specific characteristics of a stone and the specific etiology of the disease. The increasing number of treatments available for patients with different types of renal calculi makes improvements in diagnosis and determination of stone etiology, such as the procedure described here, more important now than ever.
Metabolic tumour and nodal response to neoadjuvant chemotherapy on FDG PET-CT as a predictor of pathological response and survival in patients with oesophageal adenocarcinoma
Authors: Moore Jonathan L. , Subesinghe Manil , Santaolalla Aida , Green Michael , Deere Harriet , Van Hemelrijck Mieke , Lagergren Jesper , Chicklore Sugama , Maisey Nick , Gossage James A. , Kelly Mark , Baker Cara R. , Davies Andrew R. ,   On behalf of the Guy’s and St Thomas’ Oesophago-gastric Research Group, Jacques A. , Griffin N. , Goh V. , Ngan S. , Owczarczyk K. , Sita-Lumsden A. , Qureshi A. , Chang F. , Mahadeva U. , Gill-Barman B. , George S. , Ong M. , Waters J. , Cominos M. , Sevitt T. , Hynes O. , Tham G. , Dunn J. M. , Zeki S. S.
Published: March 2023

Objectives

2-deoxy-2[18F]Fluoro-d-glucose (FDG) PET-CT has an emerging role in assessing response to neoadjuvant therapy in oesophageal cancer. This study evaluated FDG PET-CT in predicting pathological tumour response (pTR), pathological nodal response (pNR) and survival.

Methods

Cohort study of 75 patients with oesophageal or oesophago-gastric junction (GOJ) adenocarcinoma treated with neoadjuvant chemotherapy then surgery at Guy’s and St Thomas’ NHS Foundation Trust, London (2017–2020). Standardised uptake value (SUV) metrics on pre- and post-treatment FDG PET-CT in the primary tumour (mTR) and loco-regional lymph nodes (mNR) were derived. Optimum SUVmax thresholds for predicting pathological response were identified using receiver operating characteristic analysis. Predictive accuracy was compared to PERCIST (30% SUVmax reduction) and MUNICON (35%) criteria. Survival was assessed using Cox regression.

Results

Optimum tumour SUVmax decrease for predicting pTR was 51.2%. A 50% cut-off predicted pTR with 73.5% sensitivity, 69.2% specificity and greater accuracy than PERCIST or MUNICON (area under the curve [AUC] 0.714, PERCIST 0.631, MUNICON 0.659). Using a 30% SUVmax threshold, mNR predicted pNR with high sensitivity but low specificity (AUC 0.749, sensitivity 92.6%, specificity 57.1%, p = 0.010). pTR, mTR, pNR and mNR were independent predictive factors for survival (pTR hazard ratio [HR] 0.10 95% confidence interval [CI] 0.03–0.34; mTR HR 0.17 95% CI 0.06–0.48; pNR HR 0.17 95% CI 0.06–0.54; mNR HR 0.13 95% CI 0.02–0.66).

Conclusions

Metabolic tumour and nodal response predicted pTR and pNR, respectively, in patients with oesophageal or GOJ adenocarcinoma. However, currently utilised response criteria may not be optimal. pTR, mTR, pNR and mNR were independent predictors of survival.

Key Points

• FDG PET-CT has an emerging role in evaluating response to neoadjuvant therapy in patients with oesophageal cancer.

• Prospective cohort study demonstrated that metabolic response in the primary tumour and lymph nodes was predictive of pathological response in a cohort of patients with adenocarcinoma of the oesophagus or oesophago-gastric junction treated with neoadjuvant chemotherapy followed by surgical resection.

• Patients who demonstrated a response to neoadjuvant chemotherapy in the primary tumour or lymph nodes on FDG PET-CT demonstrated better survival and reduced rates of tumour recurrence.
Morphing Triangle Contact Representations of Triangulations
Authors: Angelini Patrizio , Chaplick Steven , Cornelsen Sabine , Da Lozzo Giordano , Roselli Vincenzo
Published: March 2023

A morph is a continuous transformation between two representations of a graph. We consider the problem of morphing between contact representations of a plane graph. In an $${\mathcal {F}}$$
F
-contact representation of a plane graph G, vertices are realized by internally disjoint elements from a family $${\mathcal {F}}$$
F
of connected geometric objects. Two such elements touch if and only if their corresponding vertices are adjacent. These touchings also induce the same embedding as in G. In a morph between two $${\mathcal {F}}$$
F
-contact representations we insist that at each time step (continuously throughout the morph) we have an $${\mathcal {F}}$$
F
-contact representation. We focus on the case when $$\mathcal {F}$$
F
is the family of triangles in $$\mathbb {R}^2$$

R

2

that are the lower-right half of axis-parallel rectangles. Such RT-representations exist for every plane graph and right triangles are one of the simplest families of shapes supporting this property. Moreover, they naturally correspond to 3-orientations. Thus, they provide a natural case to study regarding morphs of contact representations of plane graphs. We characterize the pairs of RT-representations admitting a morph between each other via the respective 3-orientations. Our characterization leads to a polynomial-time algorithm to decide whether there is a morph between two RT-representations of an n-vertex plane triangulation, and, if so, computes a morph with $${\mathcal {O}}(n^2)$$

O
(

n
2

)

steps. Each of these steps is a linear morph moving the endpoints of each triangle at constant speed along straight-line trajectories. Our characterization also implies that for 4-connected plane triangulations there is a morph between every pair of RT-representations where the “top-most” triangle in both representations corresponds to the same vertex.
A coupled mathematical model between bone remodeling and tumors: a study of different scenarios using Komarova’s model
Authors: Ramtani Salah , Sánchez Juan Felipe , Boucetta Abdelkader , Kraft Reuben , Vaca-González Juan Jairo , Garzón-Alvarado Diego A.
Published: March 2023

This paper aims to construct a general framework of coupling tumor–bone remodeling processes in order to produce plausible outcomes of the effects of tumors on the number of osteoclasts, osteoblasts, and the frequency of the bone turnover cycle. In this document, Komarova’s model has been extended to include the effect of tumors on the bone remodeling processes. Thus, we explored three alternatives for coupling tumor presence into Komarova’s model: first, using a “damage” parameter that depends on the tumor cell concentration. A second model follows the original structure of Komarova, including the tumor presence in those equations powered up to a new parameter, called the paracrine effect of the tumor on osteoclasts and osteoblasts; the last model is replicated from Ayati and collaborators in which the impact of the tumor is included into the paracrine parameters. Through the models, we studied their stability and considered some examples that can reproduce the tumor effects seen in clinic and experimentally. Therefore, this paper has three parts: the exposition of the three models, the results and discussion (where we explore some aspects and examples of the solution of the models), and the conclusion.
Decolonial scientific education to combat ‘science for domination’
Authors: Kato Danilo Seithi , Galamba Arthur , Monteiro Bruno Andrade Pinto
Published: March 2023

In this article, we argue that mainstream science education is contaminated by neoliberal values and functions in the service of political domination and exploitation and that a neoliberal and exploitative science education does not contribute to the building of a sustainable and just world. The work from Paulo Freire and Enrique Dussel underpin the tenets of decolonial pedagogies. We draw on their work to analyze how decolonial pedagogies have been developed in Latin America. We carried out a literature review in Brazil and found two different ways of approaching decoloniality in science education: (a) studies that start from hybrid, interstitial spaces, as an enunciative locus that allows the construction of other logics of thought and (b) studies dedicated to denouncing the colonial power project from an anti-racist education that contests coloniality and oppression. We present examples of Freirean educational practices and proposals in science education that illustrate how decolonial pedagogies can reveal the coloniality of power/being/knowledge and potentialities of intercultural dialogues. We conclude with an explanation of how and why Freirean dialogicity and affection can counter science for domination.
Effect of cyclic loading on the mobilization of unit base resistance of model piles jacked in sand
Authors: Galvis-Castro Ayda C. , Tovar-Valencia Ruben D. , Prezzi Monica , Salgado Rodrigo
Published: March 2023

This paper reports the results of a series of monotonic compressive and cyclic load tests performed on a closed-ended jacked model pile installed in a half-cylindrical calibration chamber with image analysis capabilities. The monotonic compressive load tests were carried out before and after performing a displacement-controlled cyclic load test to determine the impact of cycling on unit base resistance. Digital images of the sand and the model pile were taken during cyclic loading and processed using the digital image correlation (DIC) technique to obtain the cumulative displacement and strain fields in the sand domain. The results show that the ultimate unit base resistance can drop significantly after cycling. The magnitude of the drop in ultimate unit base resistance depends on both the magnitude of the cyclic displacement amplitude and the number of cycles. However, the unit base resistance at plunging increases after large-displacement half-amplitude cycling. The increase in unit base resistance at plunging after cycling is linked to the flow of sand particles to the zone below the conical base, the occurrence of sand particle crushing, and the dilative behavior of the sand outside a bulb of crushed particles formed during cyclic loading. The processed DIC data show that for cyclic displacement half-amplitudes ∆wcyclic less than or equal to 0.25 mm (0.0007B), the cumulative radial and vertical displacements in the soil domain normalized by ∆wcyclic are negligible. Values of ∆wcyclic greater than 0.25 mm produce normalized displacements in the soil domain that increase as the cyclic displacement amplitude increases.
Modular lightweight robot system for aircraft production using a generic OPC UA skill concept
Authors: Koch Philip , Rawal Parth , Töpfer Nico , Haß Tim , Böhlmann Christian , Hintze Wolfgang
Published: March 2023

There is a continuing trend in the aircraft industry to automate production. In order to be able to react to shortages of skilled workers, high order fluctuations and machine breakdowns, cost-effective, mobile and flexible systems are required to support the workers. This paper focuses on the integration of existing skill-based engineering concepts into production using standard OPC Unified Architecture interface, where production systems can be built quickly by simply interconnecting modules. The interconnected modules together form higher level subsystems enabling reusability of the individual modules as well as the assembled subsystems across several use cases. The approach is evaluated on a production related mobile robot system, whose task is to drive to the workstation, reference the component and drill holes in a vertical tail plane section of an aircraft. All devices from different suppliers contain skill-based modules based on standards defined by OPC Foundation and communicate via OPC UA-based Client/Server communication.
MACHINA, the Movable Accelerator for Cultural Heritage In-situ Non-destructive Analysis: project overview
Authors: Taccetti F. , Castelli L. , Chiari M. , Czelusniak C. , Falciano S. , Fedi M. , Giambi F. , Mandò P. A. , Manetti M. , Massi M. , Mazzinghi A. , Ruberto C. , Ronzino P. , Bini I. , Frati S. , Benetti F. , Cestelli Guidi M. , Ciatti M. , Frosinini C. , Rossi S. , Mathot S. , Anelli G. , Cipolla G. , Grudiev A. , Lombardi A. , Milne E. , Montesinos E. , Pommerenke H. , Scibor K. , Vretenar M. , Giuntini L.
Published: March 2023

Over the years, transportable instrumentation for cultural heritage (CH) in situ measurements has noticeably widespread, due to logistic, economical and safety reasons. Ion beam analysis, a powerful set of analytical techniques, of great importance for CH, is instead carried out by using fixed instrumentation. To overcome this limit, the Italian national Institute of Nuclear Physics (INFN), CERN (European Centre for Nuclear Research) and the Opificio delle Pietre Dure (OPD), started MACHINA, the “Movable Accelerator for CH In-situ Non-destructive Analysis: the new generation of accelerators for art” to build a transportable accelerator, compact, with strongly reduced weight, absorbed power and cost. MACHINA will be installed at the OPD and dedicated to CH. It will be moved to major conservation centres and museums, when needed. The INFN-CERN proposal, approved in December 2017, became operative in February 2018. 2018 was dedicated to the acquisition of material/instrumentations, to set up both a dummy accelerator (to test the vacuum system) and a vacuum chamber (to test the source). Due to COVID, in 2020 and 2021 the experimental work was slowed down, but we kept developing the control electronics/software and built the second-generation supporting structure. The HF-RFQ power supplies were integrated in October 2021. At the rise of 2022, after conditioning the cavities, we tested the system and in March 2022 we got the first extracted 2-MeV proton beam. In this paper, we present the structure of the MACHINA system, the approach followed and the main solutions adopted, with a special focus on the control system, and finally the first experimental results.
Self-Organization Through Semiosis
Authors: Beekman Wim , Jochemsen Henk
Published: March 2023

This article deals with the question of how self-organization in living organisms is realized. Self-organization may be observed in open systems that are out of equilibrium. Many disequilibria-conversion phenomena exist where free energy conversion occurs by spontaneously formed engines. However, how is self-organization realized in living entities? Living cells turn out to be self-organizing disequilibria-converting systems of a special kind. Disequilibrium conversion is realized in a typical way, through employing information specifying protein complexes acting as nano engines. The genetic code enables processing of information—derived from coding DNA—to produce these molecular machines. Hence, information is at the core of living systems. Two promising approaches to explaining living cells containing sequences carrying information are mentioned. Also discussed is the question of whether a second concept of self-organization—namely, the Kantian concept—applies.
Development of acute lung injury or acute respiratory distress syndrome after subarachnoid hemorrhage, predictive factors, and impact on prognosis
Authors: Wu Jiang , Gao Wei , Zhang Hongrong
Published: March 2023

Acute lung injury or acute respiratory distress syndrome (ALI/ARDS) is a common complication after aneurysmal subarachnoid hemorrhage (aSAH), and is associated with worse neurologic outcomes and longer hospitalization. However, the effect of ALI/ARDS in SAH has not been well elucidated. The purpose of this study was to determine the incidence of ALI/ARDS in a cohort of patients with SAH and to determine the risk factors for ALI/ARDS and their impact on patient prognosis. We performed a retrospective analysis of 167 consecutive patients with aSAH enrolled. ALI/ARDS patients were rigorously adjudicated using North American-European Consensus Conference definition. Regression analyses were used to test the risk factors for ALI/ARDS in patients with SAH. A total of 167 patients fulfilled the inclusion criteria, and 27% patients (45 of 167) developed ALI. Among all 45 ALI patients, 33 (20%, 33 of 167) patients met criteria for ARDS. On multivariate analysis, elderly patients, lower glasgow coma scale (GCS), higher Hunt-Hess grade, higher simplified acute physiology score (SAPS) II score, pre-existing pneumonia, gastric aspiration, hypoxemia, and tachypnea were the strongest risk factor for ALI/ARDS. Patients with ALI/ARDS showed worse clinical outcomes measured at 30 days. Development of ALI/ARDS was associated with a statistically significant increasing the odds of tracheostomy and hospital complications, and increasing duration of mechanical ventilation, intensive care unit (ICU) length and hospitalization stay. Development of ALI/ARDS is a severe complication of SAH and is associated with a poor clinical outcome, and further studies should focus on both prevention and management strategies specific to SAH-associated ALI/ARDS.
In Depth Analysis of Power Balance, Handling, and the Traction Subsystem of an Articulated Skid-Steering Robot for Sustainable Agricultural Monitoring
Authors: Botta Andrea , Cavallone Paride , Baglieri Lorenzo , Colucci Giovanni , Tagliavini Luigi , Quaglia Giuseppe
Published: March 2023

This paper reports on the energy balance test performed on Agri.Q, an eight-wheel articulated robot intended to be a sustainable monitoring tool within the precision agriculture paradigm, and proposes an in-depth analysis of the traction subsystem in order to develop an appropriate traction allocation strategy to improve navigation through hilly or mountainous crops. Tests were conducted on the contribution of the orientable photovoltaic panel to the mission duration and overall sustainability, showing that a suitable mission plan, including dedicated charging phases, could significantly increase the robot’s operating time. A series of simulations of circular trajectories of different curvature and at different longitudinal velocities on flat ground were performed, with the aim of mapping the robot’s behaviour at steady state. The results of the simulations were analysed, paying particular attention to the required torques, manoeuvrability and forces exchanged on the ground. The simulations conducted demonstrated and extended previous results obtained on similar robotic architectures, which suffer from significant understeer behaviour due to significant lateral wheel slip during turning. They also showed the limitations of currently employed traction motors, but also the advantages of a proper traction allocation strategy involving the rear module.

Article highlights.

Agri.Q energy balance tests have been carried out to assess its endurance and sustainability

The traction and handling behaviours of Agri.Q were mapped and discussed in detail in order to improve them

Agri.Q has proven to be a basis for the future implementation of precision agriculture to advance the SDGs
3D spheroid culture to examine adaptive therapy response in invading tumor cells
Authors: Weiss Felix , Atlasy Nader , van Reijmersdal Vince , Stunnenberg Henk , Hulsbergen-Veelken Cornelia , Friedl Peter
Published: March 2023

3D in vitro culture models of cancer cells in extracellular matrix (ECM) have been developed to investigate drug targeting and resistance or, alternatively, mechanisms of invasion; however, models allowing analysis of shared pathways mediating invasion and therapy resistance are lacking. To evaluate therapy response associated with cancer cell invasion, we here used 3D invasion culture of tumor spheroids in 3D fibrillar collagen and applied Ethanol-Ethyl cinnamate (EtOH-ECi) based optical clearing to detect both spheroid core and invasion zone by subcellular-resolved 3D microscopy. When subjected to a single dose of irradiation (4 Gy), we detected significant cell survival in the invasion zone. By physical separation of the core and invasion zone, we identified differentially regulated genes preferentially engaged in invading cells controlling cell division, repair, and survival. This imaging-based 3D invasion culture may be useful for the analysis of complex therapy-response patterns in cancer cells in drug discovery and invasion-associated resistance development.
Impact of a monthly antimicrobial stewardship quality assurance tool for elevated vancomycin levels
Authors: Knack Olivia C. , Landayan Alice M. , Williams Kelsey N. , Amaya Lee M. , Gauthier Timothy P.
Published: March 2023

Objective:

We sought to determine the value of an audit-and-feedback monitoring method in facilitating meaningful practice changes to improve vancomycin dosing and monitoring.

Design:

Retrospective, multicenter, before-and-after implementation observational quality assurance initiative.

Setting:

The study was conducted in 7 not-for-profit, acute-care hospitals within a health system in southern Florida.

Methods:

The preimplementation period (September 1, 2019, through August 31, 2020) was compared to the postimplementation period (September 1, 2020, through May 31, 2022). All vancomycin serum-level results were screened for inclusion. The primary end point was the rate of fallout, defined as vancomycin serum level ≥25 µg/mL with acute kidney injury (AKI) and off-protocol dosing and monitoring. Secondary end points included the rate of fallout with respect to AKI severity, rate of vancomycin serum levels ≥25 µg/mL, and average number of serum-level evaluations per unique vancomycin patient.

Results:

In total, 27,611 vancomycin levels were analyzed from 13,910 unique patients. There were 2,209 vancomycin serum levels ≥25 µg/mL (8%) among 1,652 unique patients (11.9%). AKI was identified in 379 unique patients (23%) with a vancomycin levels ≥25 µg/mL. In total, 60 fallouts (35.2%) occurred in the 12-month preimplementation period (∼5 per month) and 41 fallouts (19.6%) occurred in the 21-month postimplementation period (∼2 per month; P = .0006). Failure was the most common AKI severity in both periods (risk: 35% vs 24.3%, P = .25; injury: 28.3% vs 19.5%, P = .30; failure: 36.7% vs 56%, P = .053). Overall, the number of evaluations of vancomycin serum levels per unique patient remained consistent throughout both periods (2 vs 2; P = .53).

Conclusions:

Implementation of a monthly quality assurance tool for elevated outlier vancomycin levels can improve dosing and monitoring practices resulting in enhanced patient safety.
Bacterial contamination on used face masks among nursing home healthcare personnel
Authors: Nightingale Madison , Mody Manali , Rickard Alexander H. , Cassone Marco
Published: March 2023

Objectives:

Since the beginning of the COVID-19 pandemic, face masks have been worn by many in public areas and for prolonged periods by healthcare workers (HCWs). This may facilitate bacterial contamination and transmission to and from patients in nursing homes where clinical care areas with strict precautions and residential and activity areas are interconnected. We assessed and compared bacterial mask colonization in HCWs belonging to different demographic categories and professions (clinical and nonclinical) and among HCWs who had worn the mask for different periods of time.

Design, setting and participants:

We conducted a point-prevalence study of 69 HCW masks at the end of a typical work shift in a 105-bed nursing home serving postacute care and rehabilitation patients. Information collected about the mask user included profession, age, sex, length of time the mask was worn, and known exposure to patients with colonization.

Results:

In total, 123 distinct bacterial isolates were recovered (1–5 isolates per mask), including Staphylococcus aureus from 11 masks (15.9%) and gram-negative bacteria of clinical importance from 22 masks (31.9%). Antibiotic resistance rates were low. There were no significant differences in the number of clinically important bacteria among masks worn more or less than 6 hours, and there were no significant differences among HCWs with different job functions or exposure to colonized patients.

Conclusions:

Bacterial mask contamination was not associated with HCW profession or exposure and did not increase after 6 hours of mask wearing in our nursing home setting. Bacteria contaminating HCW masks may differ from those colonizing patients.
Community interaction in open business models: how IoT companies can handle community-generated innovation
Authors: Send Hendrik , Hölzner Heike , Hassan Mehera
Published: March 2023

We investigate how four internet of things (IoT) companies perceive the large quantity of community-generated content as a significant source of innovation. We study the extent to which these companies are willing to align their internal organisation to cope with the external community dynamics and define beneficial modes of collaboration for all involved stakeholders. Four IoT companies adopting open-source hardware principles were selected as case studies. The data collection was based on 18 interviews highlighting both the perspectives of the companies and their corresponding communities and the opinions of key experts in the domain. In our findings, we illustrate the different manifestations of open business models and the companies’ concrete approaches to working with external stakeholders. It is shown that companies with a business history more clearly claim sovereignty over their strategic decisions in a community-infused model, while, on the other hand, the community-based companies pursue a community-led strategy.
The incidence, duration, risk factors, and age-based variation of missed opportunities to diagnose pertussis: A population-based cohort study
Authors: Evans Nicholas J. , Arakkal Alan T. , Cavanaugh Joseph E. , Newland Jason G. , Polgreen Philip M. , Miller Aaron C.
Published: March 2023

Objective:

To estimate the incidence, duration and risk factors for diagnostic delays associated with pertussis.

Design:

We used longitudinal retrospective insurance claims from the Marketscan Commercial Claims and Encounters, Medicare Supplemental (2001–2020), and Multi-State Medicaid (2014–2018) databases.

Setting:

Inpatient, emergency department, and outpatient visits.

Patients:

The study included patients diagnosed with pertussis (International Classification of Diseases [ICD] codes) and receipt of macrolide antibiotic treatment.

Methods:

We estimated the number of visits with pertussis-related symptoms before diagnosis beyond that expected in the absence of diagnostic delays. Using a bootstrapping approach, we estimated the number of visits representing a delay, the number of missed diagnostic opportunities per patient, and the duration of delays. Results were stratified by age groups. We also used a logistic regression model to evaluate potential factors associated with delay.

Results:

We identified 20,828 patients meeting inclusion criteria. On average, patients had almost 2 missed opportunities prior to diagnosis, and delay duration was 12 days. Across age groups, the percentage of patients experiencing a delay ranged from 29.7% to 37.6%. The duration of delays increased considerably with age from an average of 5.6 days for patients aged <2 years to 13.8 days for patients aged ≥18 years. Factors associated with increased risk of delays included emergency department visits, telehealth visits, and recent prescriptions for antibiotics not effective against pertussis.

Conclusions:

Diagnostic delays for pertussis are frequent. More work is needed to decrease diagnostic delays, especially among adults. Earlier case identification may play an important role in the response to outbreaks by facilitating treatment, isolation, and improved contact tracing.
Complex-network analysis of high-frequency combustion instability in a model single-element rocket engine combustor
Authors: Kawano Kazuki , Gotoda Hiroshi , Nabae Yusuke , Ohmichi Yuya , Matsuyama Shingo
Published: March 2023

We study the spatio-temporal dynamics of high-frequency combustion instability in a model single-element rocket combustor using an acoustic energy flux-based spatial network. The acoustic energy source collapses by the formation of small communities with weak connection when the flame edge is attached to the injector rim. In contrast, large communities with strong connection are formed in the shear layer between the oxygen and hydrogen jets when the flame edge is detached from the injector rim, which has a significant impact on driving combustion instability. The switching between the attachment and detachment of the flame edge during combustion instability can be explained by the spectral-clustering-based transition network constructed from the pressure and flow velocity of the hydrogen jet at the injector exit, and the temperature near the injector rim.
Evidence-based insecticide resistance in South American tomato leaf miner,Phthorimaea absoluta(Meyrick) under laboratory selection
Authors: Prasannakumar N. R. , Jyothi N. , Prasadbabu K. , Ramkumar G. , Asokan R. , Saroja S. , Sridhar V.
Published: March 2023

The South American tomato moth,Phthorimaea absoluta(Meyrick), is one of the key pests of tomato in India. Since its report in 2014, chemical control has been the main means of tackling this pest, both in the open field and protected cultivation. Despite regular insecticidal sprays, many outbreaks were reported from major tomato-growing regions of South India during 2019–2020. A study was conducted to investigate the effect of insecticide resistance on biology, biochemical enzymes, and gene expression in variousP. absolutafield populationsviz., Bangalore, Kolar, Madurai, Salem, and Anantapur to commonly used insecticides such as flubendiamide, cyantraniliprole, and indoxacarb. Increased levels of insecticide resistance ratios (RR) were recorded inP. absolutapopulations of different locations. A significant increase in cytochrome P450 monooxygenase (CYP/MFO) and esterase levels was noticed in the resistant population compared to susceptible one. Through molecular studies, we identified four new CYP genesviz., CYP248f (flubendiamide), CYP272c, CYP724c (cyantraniliprole), and CYP648i (indoxacarb). The expression levels of these genes significantly increased as the folds of resistance increased from G1 to G20 (generation), indicating involvement of the identified genes in insecticide resistance development inP. absoluta. In addition, the resistant populations showed decreased fecundity, increased larval development period, and adult longevity, resulting in more crop damage. The information generated in the present study thus helps in understanding the development of insecticide resistance byP. absolutaand suggests the farmers and researchers to use insecticides wisely by adopting insecticide resistance management as a strategy under integrated pest management.
Sonority sequencing and its relationship to articulatory timing in Georgian
Authors: Crouch Caroline , Katsika Argyro , Chitoran Ioana
Published: March 2023

This work asks how the syllable as a unit is delimited in space and time. To do this we bring together two theoretical approaches to the syllable: a sonority-based approach which emphasizes spatial organization, and the coupled oscillator model (Nam, Goldstein & Saltzman 2009) which emphasizes temporal organization. Many languages present challenges to these theories, and here we focus on Georgian, which is problematic for both approaches, as Georgian permits onset clusters of up to seven consonants and of any sonority shape. Specifically, this study examines the relationship between gestural overlap and sonority shape in Georgian via electromagnetic articulography. Drawing on data from three speakers, we examine gestural overlap in two-consonant onsets that vary in sonority shape and order of place of articulation. Using two measures of gestural overlap, we find (i) long lag between consonant gestures, which we suggest is language-specific and (ii) that lag is largest in sonority rises and smallest in sonority falls. These results suggest that neither phonemic recoverability nor a hierarchical effect of increasingly open constrictions is the primary motivator behind inter-consonantal timing. Instead, the high degree of overlap in sonority falls ensures their tautosyllabic parse, which would otherwise be threatened by intrusive vocoids. Thus, we argue that recoverability of the syllable as a unit is the major motivating factor behind the timing patterns observed, and that syllables emerge not solely from either spatial or temporal properties, but from the interplay of the two.
Divine and mortal loves
Authors: Preston-Roedder Ryan
Published: March 2023

‘If the concept of God has any validity or any use’, James Baldwin writes in The Fire Next Time, ‘it can only be to make us larger, freer, and more loving. If God cannot do this, then it is time we got rid of Him.’ This article is a meditation on Baldwin's claim. I begin by presenting Baldwin's account of a grave danger that characterizes our social lives – a source of profound estrangement from ourselves and from one another. I draw on the work of the theologian Howard Thurman in order to explain how faith in a loving God can enable us to cope with this danger in a manner that may render us, in some sense, larger, freer, and more loving. Finally, I sketch Baldwin's account of how we might cope with this danger not by relying on God's love, but rather by relying in certain ways on our love for one another.
Engaging with Joanna Leidenhag's Minding Creation: Theological Panpsychism and the Doctrine of Creation
Authors: McKirland Christa L. , Fuimaono Eugene
Published: March 2023

This article appreciatively reviews Joanna Leidenhag's work Minding Creation: Theological Panpsychism and the Doctrine of Creation while also responding critically to some aspects of Leidenhag's approach and content. The authors acknowledge several strengths of Leidenhag's work, then turn to how a panpsychic framework comports with Christa L. McKirland's recent work in theological anthropology. Finally, Eugene Fuimaono proposes areas of expansion for Leidenhag to consider – specifically as this relates to the value of engaging indigenous perspectives.
Comparative analysis of biochemical, hormonal, and mineral compositions of preovulatory and cystic ovarian follicles in buffalo during the non-breeding season
Authors: Kumar Brijesh , Kumawat B.L. , Khan F.A. , Das G.K. , Maurya S.K. , Chandra P. , Vandana  , Singh Jai , Sachan Vikas , Jan M.H. , Narayanan K.
Published: March 2023

This study is a comparative analysis of the biochemical, hormonal, and mineral compositions of follicular fluid in preovulatory and cystic follicles of water buffalo (Bubalus bubalis). In total, reproductive tracts from 215 buffalo along with intact ovaries were collected randomly from an abattoir. The incidence of cystic conditions found in this study was 3.72% (8/215), involving the right ovary in 62.5% of instances and the left ovary in 37.5% of instances during the non-breeding season. Follicular fluid was aspirated from preovulatory follicles (12–15 mm diameter, oestrogen-active, follicular phase or stage IV corpus luteum on one of the two ovaries, n = 10) and cystic follicles (at least 20 mm diameter, no corpus luteum on any one of the two ovaries, n = 8). The follicular fluid samples were assayed for biochemical components (uric acid, creatinine, blood urea nitrogen, cholesterol, total protein, glucose, ascorbic acid, and alkaline phosphatase), hormones (progesterone, estradiol, and insulin), and minerals (calcium, magnesium, phosphorus, copper, zinc, and cobalt). Cystic follicles had greater (P < 0.05) concentrations of creatinine, blood urea nitrogen, cholesterol, progesterone, copper, zinc, and cobalt, and lesser (P < 0.05) concentrations of uric acid, glucose, ascorbic acid, estradiol, insulin, calcium, magnesium, and phosphorus compared with preovulatory follicles. These results indicated the marked differences in follicular fluid composition between preovulatory and cystic follicles in buffalo. Some of the changes were indicative of oxidative stress and disturbed steroidogenesis, two important mechanisms shown to be associated with cystic ovarian disease in various species. Further studies are warranted to investigate whether these differences are directly or indirectly involved in the formation of cystic follicles or are mere manifestations of the condition.
Early spontaneous closure of large arterial ducts in two term neonates with Ebstein anomaly after failed attempts of transcatheter closure
Authors: Haddad Raymond N. , Bonnet Damien , Malekzadeh-Milani Sophie
Published: March 2023

In neonatal Ebstein’s anomaly of the tricuspid valve, prolonged ductal patency in patients without anatomic pulmonary valve atresia can be deleterious. Circular shunts may develop in patients with different degrees of pulmonary and tricuspid insufficiency. Closure of the arterial duct may result in haemodynamic improvement in particular scenarios. The transcatheter approach is a valuable closure alternative despite some technical difficulties in large-sized arterial ducts and low birth weight neonates. Herein, we report on two consecutive term newborns with Ebstein’s anomaly and large arterial ducts in whom mechanical stimulus of the arterial duct during failed attempts of transcatheter closure led after two days to definitive closure followed by good clinical outcomes.
When old institutions pay off: a new entrepreneurial state in South Korea and its limit in incorporating small firms into semiconductor production
Authors: Yang Nareum , Yun Ji-Whan
Published: March 2023

This study discusses why South Korea has not always succeeded in the ‘entrepreneurial state’ approach – defined as policy efforts to move away from the old developmental state model to a new industrial system of innovation in which small- and medium-sized enterprises (SMEs) are incorporated – by focusing on the limitation of new semiconductor industrial policies of the former Moon Jae-in government (2017–2022). Conventionally, many scholars have exclusively ascribed this limitation to large businesses' (chaebol's) practice of in-house production. Building upon historical institutionalism and its concept of increasing returns, alternatively, we shift attention to the way the Moon government played its entrepreneurial role. We argue that, as the government sought increasing returns from the developmental state idea and institution, the likelihood of wider SME incorporation decreased. Nationalism enabled the government to control the policymaking process but made it difficult to obtain new information through policy contestation. The government depended on developmental alliance to increase policy visibility through the chaebol's capabilities, but demands of small firms were downplayed. This study proposes to construct a more theoretical framework with which to explain how the old political economy model affects new entrepreneurial goals.
“A Contingent ‘Yes’” Revisited
Authors: Mansbridge Jane
Published: March 2023

Reading these essays gave me a thrill of excitement like the one I felt on hearing that the #MeToo movement had extended even into China. The ideas in this Critical Perspectives collection go much deeper into the nature of and reasons for descriptive representation than I could two decades ago. Anne Phillips (1995) and Melissa Williams (1998), the two pioneers in this field who produced analyses far more thorough than mine, would, I think, agree with me on this. So would Iris Marion Young, whose early challenge in a talk over lunch inspired me to puzzle out my own take on the problem.
Moving beyond “Contingent”: Descriptive Representation by and for Indigenous Peoples
Authors: Greaves Lara , Curtin Jennifer
Published: March 2023

When Jane Mansbridge’s (1999) article was first submitted, more than 80% of the world’s parliaments featured less than 20% women (IPU 2015). Calculating the parliamentary presence of ethnic and cultural minorities and Indigenous peoples has proved more difficult (Protsyk 2010). This is despite the adoption of two United Nations Declarations, on the Rights of Persons Belonging to National or Ethnic, Religious and Linguistic Minorities (1992) and on the Rights of Indigenous Peoples in 2007. In Aotearoa New Zealand, the representation of women and Māori (the Indigenous peoples) was comparatively better than global averages. In 1996, 29% of parliamentarians were women and 14% were Māori. By 2020, these figures had increased to 48% and 21%, respectively, while in the cabinet, women made up 40% of ministers and Māori accounted for 25%. Reported as the country’s historically most diverse parliament and cabinet (Curtin 2020), it appears that both new (proportional representation) and old (reserved seats for Māori) institutional mechanisms had achieved near proportionality, and a heterogeneity of experiences, potentially enhancing opportunities for deliberation.