bluuebunny/crossref_metadata_2025 huggingface dataset:
Approaching 100% Comprehensive Utilization Rate of Ultra‐Stable Zn Metal Anodes by Constructing Chitosan‐Based Homologous Gel/Solid Synergistic Interface
Authors: Zhang Zicheng , Wang Xiangwen , Ke Jiaqi , Du Wencheng , Lv Zeheng , Tang Yongchao , Ye Minghui , Zhang Yufei , Liu Xiaoqing , Yang Yang , Wen Zhipeng , Li Cheng Chao
Published: January 2024

Aqueous Zn–metal batteries are considered promising candidates for next‐generation energy storage. However, low zinc utilization rate (ZUR) and limited cycle life are still hinder its commercial application because of severe parasitic side effects. Herein, inspired by the wound healing process, an innovative electrode recovery technology is developed to improve the comprehensive ZUR and prolong the cycling life through repetitive rejuvenation of zinc anode by designing chitosan‐based homologous gel/solid synergistic electrolyte. The designed synergistic electrolyte, consisting of protonated chitosan gel electrolyte and Zn‐chitosan solid electrolyte, exhibits superior zinc ion diffusion capability and low free‐water activity, leading to dendrite‐free Zn deposition and HER inhibition. Moreover, through proton neutralization and zinc ion complexation, the formulated electrolyte can implement the rejuvenation of zinc anode by smoothing interfacial defects and eliminating parasitic byproducts. Consequently, the gel/solid synergistic electrolyte displays reversible Zn plating/stripping chemistry for 4000 cycles with high average Coulombic efficiency (99.8%) and realizes comprehensive ZUR of 97.4% through four iterations of electrode recover under extreme conditions (20 mA cm−2, 31.5% Zn depth of discharge), noticeably higher than zinc electrode with no recover (11.8%). Furthermore, the superiority of customized synergistic electrolyte is further demonstrated by coupling with I2 cathode and achieving impressive 36 000 stable cycles.
Mechanochemically Reprogrammed Interface Orchestrates Neutrophil Bactericidal Activity and Apoptosis for Preventing Implant‐Associated Infection
Authors: Chu Guangyu , Guan Ming , Jin Jiale , Luo Yao , Luo Zhiyuan , Shi Tingwang , Liu Tao , Zhang Chunlei , Wang Yue
Published: January 2024

The onset of implant‐associated infection (IAI) triggers a cascade of immune responses, which are initially dominated by neutrophils. Bacterial aggregate formation and hypoxic microenvironment, which occur shortly after implantation, may be two major risk factors that impair neutrophil function and lead to IAI. Here, the implant surface with phytic acid–Zn2+ coordinated TiO2 nanopillar arrays (PA–Zn@TiNPs) and oxygen self‐supporting CaO2 nanoparticles, named as CPZTs, is mechanochemically reprogrammed. The engineered CPZTs interface integrates multiple properties to inhibit the formation of nascent biofilm, encompassing antibacterial adhesion, mechanobactericidal effect, and chemobiocidal effect. Meanwhile, continuous oxygenation fuels the neutrophils with reactive oxygen species (ROS) for efficient bacterial elimination on the implant surface and inside the neutrophils. Furthermore, this surface modulation strategy accelerates neutrophil apoptosis and promotes M2 macrophage‐mediated osteogenesis both in vitro and in a rat model of IAI. In conclusion, targeting neutrophils for immunomodulation is a practical and effective strategy to prevent IAI and promote bone–implant integration.
Ultra‐Long‐Lived Red TADF‐CDs: Solid‐State Synthesis, Time‐Dependent Phosphorescence Color And Luminescent Mechanism
Authors: Sun Jie , Sun Zhongqiao , Wang Ziru , Wang Nan , Han Yide , Zhang Lin , Zhang Bingsen , Zhang Xia
Published: January 2024

Constructing an ultra‐long‐lived red thermally activated delayed fluorescence carbon dots (TADF‐CDs) with time‐dependent phosphorescence colors (TDPC) in both solid and aqueous is still a challenge. Herein, a red TADF‐CDs, constructed via. a modified solid‐state pyrolysis strategy, show the phosphorescence emissions at 595, 670, and 725 nm with the afterglow lifetime longer than most of reported red TADF‐materials. In addition, the resulting CDs trigger the TDPC activity while the emission colors changed from red to green both in solid state and in aqueous suspension. The synergistic effects of boron‐hybridization in the seed CDs and the additional C═O groups generated in urea‐assisted pyrolysis, result in a stronger spin‐orbit coupling (SOC) between the 1(n, π*) and the 3(π, π*), the mitigated energy gap (ΔEST) and the non‐radiative relaxations of triplet excited states. The TDPC performance endow the resulting TADF‐CDs the usability in advance information security with enhanced‐security‐level encryption strategy.
‘The power to SAY what I want to and it gets written down’: Situating children's and adults' voices and silence in participatory research
Authors: Little Sabine , Raine Hannah , Choo Ailin , Joshi Ronia , Qarni Shanza J. , Sukri Ayden , Horton Grace , Pakravesh Sarah
Published: January 2024

This paper, co‐authored between three adults and five children aged 8–11, adopts a ‘collaborative writing as inquiry’ approach to examine and discuss the authors' experiences of a participatory research project through the lens of critical dialectical pluralism. In the original project, children formed two ‘young advisory panels’, one online, comprising children from all over England, and one in a primary school in a suburban area in North England, informing and collaborating on the creation of 45 educational activities supporting critical digital literacy. Rather than focusing on the original research itself, the paper focuses on making a methodological contribution, through detailed and collaborative reflections on notions such as agency, power and control. Over a period of four 60 to 90 min‐long meetings once the actual research was completed, adult and child authors considered their respective roles in the project, as well as detailing their understanding of the project as a whole. In co‐framing our perceptions of participatory research, we problematise adult anxieties and highlight the importance of exploring ‘silence as voice’, arguing for an extension to participatory research projects, going beyond the research itself and creating a ‘third space’ which is un/familiar to all participants, openly inviting engagement with discomfort and normalising uncertainty.
Body composition is associated with postoperative complications in perihilar cholangiocarcinoma
Authors: Wang Guanwu , Mantas Anna , Heij Lara R. , Al‐Masri Tarick M. , Liu Dong , Heise Daniel , Schmitz Sophia M. , Olde Damink Steven W. M. , Luedde Tom , Lang Sven A. , Ulmer Tom F. , Neumann Ulf P. , Bednarsch Jan
Published: January 2024

Background

Perihilar cholangiocarcinoma (pCCA) is a malignant tumor of the hepatobiliary system which is still associated with a challenging prognosis. Postoperative complications play a crucial role in determining the overall prognosis of patients with pCCA. Changes in body composition (BC) have been shown to impact the prognosis of various types of tumors. Therefore, our study aimed to investigate the correlation between BC, postoperative complications and oncological outcome in patients with pCCA.

Methods

All patients with pCCA who underwent curative‐intent surgery for pCCA between 2010 and 2022 were included in this analysis. BC was assessed using preoperative computed tomography and analyzed with the assistance of a 3D Slicer software. Univariate and multivariate binary logistic regression analyses were conducted to examine the relationship between BC and clinical characteristics including various measurements of postoperative complications and Cox regressions and Kaplan–Meier analysis to evaluate oncological risk factors in the study cohort.

Results

BC was frequently altered in patients undergoing curative‐intent liver resection for pCCA (n = 204) with 52.5% of the patients showing obesity, 55.9% sarcopenia, 21.6% sarcopenic obesity, 48.5% myosteatosis, and 69.1% visceral obesity. In multivariate analysis, severe postoperative complications (Clavien‐Dindo ≥3b) were associated with body mass index (BMI) (Odds ratio (OR) = 2.001, p = 0.024), sarcopenia (OR = 2.145, p = 0.034), and myosteatosis (OR = 2.097, p = 0.017) as independent predictors. Furthermore, sarcopenia was associated with reduced overall survival (OS) in pCCA patients (sarcopenia vs. no‐sarcopenia, 21 months vs. 32 months, p = 0.048 log rank).

Conclusions

BC is highly associated with severe postoperative complications in patients with pCCA and shows tendency to be associated impaired overall survival. Preoperative assessment of BC and interventions to improve BC might therefore be key to improve outcome in pCCA patients undergoing surgical therapy.
The influence of “bad news” and “neutral/good news” on patients' perception of physician empathy during oncology consultations
Authors: Tranberg Mattias , Ekedahl Henrik , Fürst Carl Johan , Engellau Jacob
Published: January 2024

Objectives

Being met with empathy increases information sharing, treatment coherence, and helps patients to recover faster. However, we do not know how the content of the conversation about disease progression, new treatments, or other issues concerning serious illness affects patients' perceptions of the physician's empathy, and thus, the quality of the conversation. This study aimed to test the hypothesis that patients will rate their physician lower following a “bad news” consultation using the consultation and relational empathy (CARE) measure.

Methods

A total of 186 outpatients from the Department of Oncology were recruited for this study. After meeting with a patient, the physician filled out a form, placing the patient in either the “bad news” group, or the “neutral/good news” group along with information about the patient and the consultation. The patient was given the CARE measure after the visit.

Results

The patients who had received bad news rated their physicians a significantly lower score on the CARE measure, even though the effect size was small, than those who had neutral/good news. On average, bad news consultations were 11 min longer.

Conclusions

Physicians need to be aware of the patients' need to be known and understood, in addition to having skills to attend to emotional cues and concerns, since the current study's finding could be a sign either of the content being projected onto the physician or that the physician is focused on the message rather than on the patient.
Curcumin, its derivatives, and their nanoformulations: Revolutionizing cancer treatment
Authors: Ahmad Iftikhar , Ahmad Sameer , Ahmad Ausaf , Zughaibi Torki A. , Alhosin Mahmoud , Tabrez Shams
Published: January 2024

Curcumin is a natural compound derived from turmeric and can target malignant tumor molecules involved in cancer propagation. It has potent antioxidant activity, but its effectiveness is limited due to poor absorption and rapid elimination from the body. Various curcumin derivatives have also shown anticancer potential in in‐vitro and in‐vivo models. Curcumin can target multiple signaling pathways involved in cancer development/progression or induce cancer cell death through apoptosis. In addition, curcumin and its derivatives could also enhance the effectiveness of conventional chemotherapy, radiation therapy and reduce their associated side effects. Lately, nanoparticle‐based delivery systems are being developed/explored to overcome the challenges associated with curcumin's delivery, increasing its overall efficacy. The use of an imaging system to track these formulations could also give beneficial information about the bioavailability and distribution of the nano‐curcumin complex. In conclusion, curcumin holds significant promise in the fight against cancer, especially in its nanoform, and could provide precise delivery to cancer cells without affecting normal healthy cells.
Acoustic micro‐beam vortex generator for flow actuation inside droplets
Authors: Sánchez‐Saldaña Diego , Fernandino Maria , Dorao Carlos A.
Published: January 2024

Controlling acoustic streaming inside a droplet has excellent potential for enabling fluid and particle operations such as mixing, separation, and aggregation in various applications. Most concepts for generating surface acoustic waves are based on the placement of an interdigitated transducer at the side of a droplet, thus externally acting on the droplet. In this case, the flow structure inside the droplet is controlled by the relatively large scale of the interdigitated transducer compared to the droplet, thus limiting the local control of the flow. One possibility to overcome this drawback is to reduce the size of the actuator such that a highly focused ultrasound transducer can induce localized acoustic streaming in space. Here, we introduce a micro‐spiral interdigitated transducer smaller than a droplet size that can generate micro‐size vortices inside the droplet. This step enables a new way of controlling the flow inside the droplet, facilitating mixing, separation, aggregation, and patterning of particles. We study the characteristics of the acoustic streaming and the potential application of the flow for the separation and patterning of particles. The simplicity of the concept provides in‐droplet particle manipulation toolsets for many applications such as biosensing, microbiology, and point‐of‐care devices.
Institutional experience with total pharyngectomy reconstruction: Exploring the role of the salivary bypass tube
Authors: Smith Sullivan , Lee Yunmin , Borrowdale Richard , Thorpe Eric , Pittman Amy
Published: January 2024

Background

There is a lack of consensus regarding the effectiveness of salivary bypass tubes during total pharyngectomy reconstruction to prevent pharyngocutaneous fistula or pharyngoesophageal stricture.

Methods

Our study examined tubed free flap reconstruction outcomes for total pharyngectomy defects over 11 years at a single tertiary referral center. We compared postoperative fistula and stricture rates between two groups: those with salivary bypass tubes inserted during reconstruction and those without.

Results

Among 36 patients, 26 had radial forearm, and 10 had anterolateral thigh free flap reconstruction. 53% received salivary bypass tubes. However, the tubes did not significantly reduce the relative risks of fistula or stricture. Notably, neck dissection during total pharyngectomy was associated with increased fistula incidence. Minor salivary bypass tube‐related complications affected 21% of subjects.

Conclusion

The role of salivary bypass tubes in total pharyngectomy reconstruction remains uncertain.
A minimal interventive protocol using antimicrobial photodynamic therapy on teeth with molar incisor hypomineralization: A case report
Authors: Vieira Letícia Diniz Santos , Mandetta Amanda Rafaelly Honório , Bortoletto Carolina Carvalho , Sobral Ana Paula Taboada , Motta Lara Jansiski , Mesquita Ferrari Raquel Agnelli , Duran Cinthya Cosme Gutierrez , Horliana Anna Carolina Ratto Tempestini , Fernandes Kristianne Porta Santos , Bussadori Sandra Kalil
Published: January 2024

Molar incisor hypomineralization (MIH) is a qualitative developmental defect of enamel that occurs during the mineralization phase. Patients with MIH have increased risk of caries, hypersensitivity, and restoration failures. The present case report describes the treatment of a 10‐year‐old patient exhibiting two teeth with atypical carious lesions. A minimal interventive protocol was instituted combining antimicrobial photodynamic therapy and the selective chemical–mechanical removal of the carious tissue using the product Papacárie Duo®. This protocol is promising for the decontamination and control of hypersensitivity in teeth with MIH.
Pilot study of a telehealth intervention for personalized self‐management for eating symptoms after gastroesophageal cancer surgery
Authors: Kim Jae Y. , Love Madeleine , Woo Yanghee , Campos Beatriz , Yu Adern , Chang Justin , Erhunmwunsee Loretta , Krouse Robert S. , Melstrom Laleh , Sun Virginia
Published: January 2024

Background and Objectives

Following gastric and esophageal cancer surgery, patients often experience significant, prolonged eating‐related symptoms. One promising approach to help patients improve their eating‐related quality of life (QOL) is through self‐management coaching to aid in diet modification. We performed a randomized pilot study of a nutritionist‐led telehealth intervention for the self‐management of eating after gastroesophageal cancer surgery.

Methods

Patients who were within 30 days of resuming oral intake after undergoing surgery for gastric and/or esophageal cancer were consented and then randomized to the intervention or usual care. The intervention was performed by a nutritionist trained in self‐management coaching and delivered in four telehealth sessions over 4 months. The following outcomes were measured at baseline and at 6 months after baseline: QOL (EORTC QLQC30), weight, body mass index, and sarcopenia.

Results

Fifty‐three patients were enrolled. 22/27 usual care and 21/26 intervention patients completed the study for a retention rate of 81%. Differences between the intervention and control groups were not statistically significant, but the intervention group had indications of greater improvements in overall QOL as measured by EORTC QLQC30 Summary Score (8.7 vs. 2.3, p = 0.17) as well as greater improvements in 4/5 functional domains (p > 0.3). The intervention group also had slightly more weight gain (6 kg vs. 3 kg, p = 0.3) and less sarcopenia (3/16 vs. 9/18, p = 0.07).

Conclusions

This pilot study demonstrated the feasibility and acceptability of a telehealth intervention for self‐management of eating symptoms after gastroesophageal cancer surgery. There were trends toward improved overall QOL in the intervention group. A larger study is needed to validate the results.
Mohr ohne Chromat
Authors: Osswald Samuel , Zell Lukas , Friedrich Jens , Oetken Marco
Published: January 2024

Der Chloridgehalt einer Lösung lässt sich über die Titration nach Mohr bestimmen. Den Endpunkt zeigt farbiges schwerlösliches Silberchromat. Chromat ist allerdings genotoxisch und daher nicht problemlos in der Schule zu nutzen. Doch es gibt ungefährliche Alternativen.
Problem oder Chance
Authors: Kirchhoff Tobias
Published: January 2024

Für Chemieunternehmen, die einzelne Chemikerin und den einzelnen Chemiker verändert sich im Nachhaltigkeitsbereich viel, darunter neue Berichtspflichten und Chemikalienverordnungen. Wer sich früh damit beschäftigt, kann wachsen. Sonst gehen Kunden und Anschluss verloren.
Design method of variable slippage coefficient non‐geodesic filament‐wound composite pressure vessels
Authors: Wang Yutao , Xu Haojie , Song Hao , Li Kangmei , Hu Jun
Published: January 2024

Previous studies on the design methods of filament winding paths for composite pressure vessels have mainly focused on geodesic and constant slippage coefficient non‐geodesic patterns, neglecting the design of variable slippage coefficients along the fiber path. In this paper, a design method of variable slippage coefficient non‐geodesic filament wound composite pressure vessels is proposed. The study begins by establishing a meridian rotation mapping model and deriving fiber path equations on the shell surface. Subsequently, the fiber paths, curvature characteristics, slippage coefficients, and shell stress responses of the shell under variable geometrical parameters are simulated and analyzed. Next, the winding parameters are optimized while considering bandwidth and stable winding constraints. The optimal winding parameters are determined, and filament winding simulations are conducted on composite pressure vessels. Results demonstrate the feasibility of the proposed method for variable slippage coefficient fiber path winding mode, providing a new and effective filament winding path design approach for composite pressure vessels.

Highlights

Establishment of meridian rotation mapping model and simulation of shell fiber paths under variable geometric parameters.

The fiber paths, curvature characteristics, slippage coefficients, and winding angles of the shell under variable geometrical parameters are simulated and analyzed.

Stress response analysis of shells based on Tsai‐Wu failure criterion and classical lamination theory stress field dimensionless modeling.

Construction of winding parameter optimization strategies and bandwidth error evaluation based on stable winding and fiber bandwidth constraints.

Simulation of variable slippage coefficient non‐geodesic filament winding for composite pressure vessels with different parameters.
Provider moral distress in caring for tracheostomy and ventilator dependent children: A single institution cross‐sectional evaluation
Authors: Redmann Andrew J. , Hart Catherine K. , Smith Matthew M. , Martin Carrie , Borschuk Adrienne P. , Cortezzo DonnaMaria E. , Benscoter Dan
Published: January 2024

Objective

To determine levels of moral distress in a pediatric unit caring for patients with tracheostomy/ventilator dependence.

Hypothesis

Moral distress will be significant in a dedicated pediatric trach/vent unit.

Methods

The Moral Distress Survey‐Revised (MDS‐R) is a 21‐question survey measuring moral distress in pediatrics. The MDS‐R was anonymously distributed to medical degree/doctor of osteopathy (MD/DOs), advanced practice practitioners (APPs), registered nurses (RNs), and respiratory therapists (RTs) in a unit caring for tracheostomy/ventilator dependent patients. Descriptive statistics, bivariate and multivariate analysis were performed.

Results

Response rate was 48% (61/127). Mean MDS‐R score was 83 (range 43–119), which is comparable to reported levels in the pediatric intensive care unit (ICU). APPs had the highest median rate of moral distress (112, interquartile range [IQR], 72–138), while MD/DOs had the lowest median score (49, IQR, 43–77). RNs and RTs had MDS‐R scores between these two groups (medians of 91 and 84, respectively).

Conclusions

Moral distress levels in a unit caring for long term tracheostomy and ventilator dependent patients are high, comparable to levels in pediatric ICUs. APPs. APPs had higher levels of distress compared to other groups. This may be attributable to the constant stressors of being the primary provider for complex patients, especially in a high‐volume inpatient setting.
One‐step Sintering Synthesis of Ni3Se2‐Ni Electrode with Robust Interfacial Bonding for Ultra‐stable Hydrogen Evolution Reaction
Authors: Zhao Yang , Cui Manman , Zhang Bin , Wei Shizhong , Shi Xiaoqian , Shan Kangning , Ma Jiping , Zhou Guangmin , Pang Huan
Published: January 2024

Exploring efficient and robust self‐supporting hydrogen evolution reaction (HER) electrodes using simple, accessible, and low‐cost synthetic processes is crucial for the commercial application of water electrolysis at high current densities. Ni‐based self‐supporting electrodes are widely studied owing to their low cost and good catalytic performance. However, to date, the preparation of Ni‐based electrodes requires multistep and complex preparation processes. In this study, a novel one‐step in situ sintering method to synthesize mechanically stable and highly active Ni3Se2‐Ni electrodes with well‐controlled morphologies and structures is developed. Their excellent performance and durability can be attributed to the numerous highly active nano‐Ni3Se2 catalysts embedded on the surface of the Ni skeleton, the excellent conductivity of the interconnected conductive network, and the strong interfacial bonding between Ni3Se2 and Ni. As a result, the Ni3Se2‐Ni600 electrode can operate stably at 85 and 400 mA cm−2 for more than 800 and 300 h, respectively. Moreover, the Ni3Se2‐Ni600 electrode displays outstanding stability for over 500 h in a commercial two‐electrode system. This study provides a feasible one‐step synthesis method for low‐cost, high‐efficiency metal selenide‐metal self‐supporting electrodes for water electrolysis.
Oxidation Kinetics and Mechanism of TiC with Simulated Blast‐Furnace Gases
Authors: Zhang Guopeng , Shen Fengman , Zhang Shen , Zheng Haiyan , Gao Qiangjian , Jiang Xin
Published: January 2024

A high amount of TiO2 in the blast‐furnace slag during the smelting of vanadium‐bearing titanomagnetite can generate TiC, resulting in poor metallurgical properties of the slag. Based on this background, the oxidation of TiC by CO2 in the blast‐furnace gas and its kinetics are discussed in this article, to achieve control over the generation of TiC. The results show that TiC is oxidized by the CO2 in the blast‐furnace gas, generating TiO2. The oxidation rate increases upon increasing the oxidation temperature, at all oxidation stages in the same atmosphere. At a given temperature, a higher volume fraction of CO2 in the atmosphere is conducive to the faster oxidation of TiC. The oxidation of TiC is mainly controlled by the interfacial chemical reaction at the initial stage and by the mixed control of the interfacial chemical reaction and internal diffusion at a later stage.
High‐Temperature Oxidation Behavior of Cr‐Si Alloyed Press‐Hardened Steel in Comparison with 22MnB5 Steel
Authors: Zhang Tianfang , Wang Lingyu , Li Zhao , Wang Luning , Wang Fei , Xu Wei
Published: January 2024

In the present study, a Cr–Si‐alloyed coating‐free press‐hardened steel (CF–PHS) is investigated and compared with the conventional 22MnB5 steel through a 60 min oxidation experiment at 1000–1200 °C. Compared to the 22MnB5 steel, the CF–PHS exhibits lower weight gain at 1000–1150 °C but a higher weight gain at 1200 °C. In the results, using scanning electron microscopy, energy‐dispersive spectroscopy, and X‐ray diffraction, it is revealed that the outer oxide layer of the CF–PHS consisted of Fe2O3 and Fe3O4, while its inner oxide layer is enriched with FeCr2O4 and Fe2SiO4—crucial for the oxidation resistance of the CF–PHS. The outer oxide layer of 22MnB5 comprises Fe2O3, Fe3O4, and FeO, while the inner layer contains low concentrations of Cr and Si. The mechanism of superior high‐temperature oxidation resistance of CF–PHS compared to 22MnB5 at 1000–1150 °C reveals that the existence of FeCr2O4 and Fe2SiO4 inhibits the diffusion of Fe2+ and O2−, effectively hindering the oxidation progress. Moreover, the oxidation resistance of the CF–PHS at 1200 °C deteriorates owing to the melting of Fe2SiO4 at 1200 °C, which significantly accelerates the diffusion of Fe2+ and O2−, thus exacerbating the oxidation of CF–PHS.
Investigation of Micromechanical Properties of Martensite and Ferrite Microphases in a 35CHGSA Medium‐Si Low‐Alloy Steel
Authors: Khajesarvi Ali , Ghasemi Banadkouki Seyed Sadegh , Somani Mahesh C. , Kömi Jukka , Sajjadi Seyed Abdolkarim
Published: January 2024

The purpose of this study is to understand in detail the micromechanical behavior of martensite and ferrite microphases in a medium‐Si 35CHGSA dual‐phase (DP) steel by varying the martensite volume fractions (MVF) and ferrite phase constituents. Light microscopy combined with microhardness measurements is supplemented by field‐emission scanning electron microscopy, electron backscatter diffraction, transmission electron microscopy, and X‐ray diffraction in order to evaluate the micromechanical behavior of martensite and ferrite microphases in relation to the evolving microstructure. The experimental observations illustrate that ferrite microhardness diminishes sharply from 352 to 217 HV5g with the change in ferrite volume fraction (FVF) from 3 to 13%, beyond which it increases abnormally to 245 HV5g with a further increase in VF to 15%. The martensite microhardness too varies significantly depending on the progress of ferrite formation in the intercritical range. The hardness drops with further increase in FVF as a result of longer holding times. These observations are rationalized in part to the mutual interaction of martensite with ferrite, and the variation of martensite and ferrite alloying concentrations, developed as a result of ferrite formation during intercritical holding at 720 °C.
Secrecy, War, and Communication: Challenges and Strategies of the General-Government of the State of Brazil in the Second Half of the Seventeenth Century
Authors: Araújo Hugo André Flores Fernandes
Published: January 2024

This chapter aims to identify the consequences of seizing correspondence at sea and the subsequent revealing of state secrets in seventeenth-century Brazil. The wars of the colonial empires of the early modern era highlight the centrality of overseas territories in these disputes. The conflict against the Dutch West India Company in the South Atlantic (1630–1654) demonstrates how the Portuguese had to deal with problems arising from the invasion and the constant attack on navigation routes, which affected communication and commerce. The present analysis uses a set of sources: correspondence issued by Governors-general, orders, regiments, instructions, ciphered letters, and printed leaflets. The study of the Portuguese policies of secrecy allows us to understand the role strategies employed to secure privacy and secrecy by Portuguese authorities. This chapter also proposes that the sea enabled and challenged notions of privacy at the state level, evidentiating how colonial disputes in this in-between space demanded secrecy.
Protection of the Earth Habitats with Space Tools
Authors: Fiore Fabrizio , Ivanovski Stavro
Published: January 2024

Sustainability and prevention are intimately connected. In the field of environmental management is it clearly necessary to move from policies that intervene after the fact to treat damage, to interventions aimed at preventing that damage.
Introduction
Authors: Al-Kuwari Shaikha H.
Published: January 2024

This chapter highlights the objectives, general themes, and theoretical drive behind this book. It discusses the relationship between culture and illness with a focus on the Kleinman explanatory model of illness and how it can be used to improve healthcare services. In addition, the chapter discusses the methodological development in studying the cultural beliefs of illnesses.
Research Setting and Design
Authors: Al-Kuwari Shaikha H.
Published: January 2024

This chapter is dedicated to the research setting, which is Dearborn, MI. It explains why Dearborn is an ideal place to build the Arab American cultural model of diabetes. This chapter will take the reader on a journey that will make them experience life in Dearborn and how it looks from the people there to its streets and houses. This chapter argues that Dearborn is not like any other place in the Middle East; it is a unique city, where a combination of Middle Eastern countries is represented in the same place. In addition, this chapter discusses the data collection process and how the Arab American cultural beliefs model of diabetes was built. It includes two stages of data collection, where the data were collected in the first stage using participant observations as well as semi-structured and structured interviews and a cultural consensus survey was used in the second stage. The chapter also includes details related to the sampling techniques and data analysis tools.
Arab Americans’ Cultural Beliefs of Diabetes
Authors: Al-Kuwari Shaikha H.
Published: January 2024

This chapter discusses the results from the participant observation and semi-structured and structured interviews. It outlines the first stage of building the cultural beliefs model of diabetes. This chapter answers the following questions from the Arab American point of view: (a) What are the causes of diabetes; (b) what are the symptoms of diabetes; and (c) what are the treatments of diabetes? In addition, this chapter will include issues related to who is susceptible to diabetes? the fear of having diabetes, the severity of diabetes, the experience of fasting in Ramadan with diabetes, the role of family in providing care, diabetes health-seeking behaviors, and diabetes healthcare access.
What is Next?
Authors: Al-Kuwari Shaikha H.
Published: January 2024

The chapter discusses the possible real application of the Arab American cultural beliefs model of diabetes and how medical professionals can use it to gain a better understanding of patients’ cultural knowledge. This chapter argues that the current culturally competent healthcare services provided in hospitals—if any—have missing links. Using cultural beliefs models of illness built using cultural consensus models as part of cultural competence techniques can enhance medical professionals’ understanding of their patients’ cultures.
The factor structure of exchange rates volatility: global and intermittent factors
Authors: Caporin Massimiliano , Rodríguez-Caballero C. Vladimir , Ruiz Esther
Published: January 2024

In this paper, we consider a fractionally integrated multi-level dynamic factor model (FI-ML-DFM) to represent commonalities in the hourly evolution of realized volatilities of several international exchange rates. The FI-ML-DFM assumes common global factors active during the 24 h of the day, accompanied by intermittent factors, which are active at mutually exclusive times. We propose determining the number of global factors using a distance among the intermittent loadings. We show that although the bulk of common dynamics of exchange rates realized volatilities can be attributed to global factors, there are non-negligible effects of intermittent factors. The effect of the COVID-19 on the realized volatility comovements is stronger on the first global-in-time factor, which shows a permanent increase in the level. The effects on the second global factor and on the intermittent factors active when the EU, UK and US markets are operating are transitory lasting for approximately a year after the pandemic starts. Finally, there seems to be no effect of the pandemic neither on the third global factor nor on the intermittent factor active when the markets in Asia are operating.
How subjective CT image quality assessment becomes surprisingly reliable: pairwise comparisons instead of Likert scale
Authors: Hoeijmakers Eva J. I. , Martens Bibi , Hendriks Babs M. F. , Mihl Casper , Miclea Razvan L. , Backes Walter H. , Wildberger Joachim E. , Zijta Frank M. , Gietema Hester A. , Nelemans Patricia J. , Jeukens Cécile R. L. P. N.
Published: January 2024

Objectives

The aim of this study is to improve the reliability of subjective IQ assessment using a pairwise comparison (PC) method instead of a Likert scale method in abdominal CT scans.

Methods

Abdominal CT scans (single-center) were retrospectively selected between September 2019 and February 2020 in a prior study. Sample variance in IQ was obtained by adding artificial noise using dedicated reconstruction software, including reconstructions with filtered backprojection and varying iterative reconstruction strengths. Two datasets (each n = 50) were composed with either higher or lower IQ variation with the 25 original scans being part of both datasets. Using in-house developed software, six observers (five radiologists, one resident) rated both datasets via both the PC method (forcing observers to choose preferred scans out of pairs of scans resulting in a ranking) and a 5-point Likert scale. The PC method was optimized using a sorting algorithm to minimize necessary comparisons. The inter- and intraobserver agreements were assessed for both methods with the intraclass correlation coefficient (ICC).

Results

Twenty-five patients (mean age 61 years ± 15.5; 56% men) were evaluated. The ICC for interobserver agreement for the high-variation dataset increased from 0.665 (95%CI 0.396–0.814) to 0.785 (95%CI 0.676–0.867) when the PC method was used instead of a Likert scale. For the low-variation dataset, the ICC increased from 0.276 (95%CI 0.034–0.500) to 0.562 (95%CI 0.337–0.729). Intraobserver agreement increased for four out of six observers.

Conclusion

The PC method is more reliable for subjective IQ assessment indicated by improved inter- and intraobserver agreement.

Clinical relevance statement

This study shows that the pairwise comparison method is a more reliable method for subjective image quality assessment. Improved reliability is of key importance for optimization studies, validation of automatic image quality assessment algorithms, and training of AI algorithms.

Key Points

• Subjective assessment of diagnostic image quality via Likert scale has limited reliability.

• A pairwise comparison method improves the inter- and intraobserver agreement.

• The pairwise comparison method is more reliable for CT optimization studies.

Graphical Abstract
Reader bias in breast cancer screening related to cancer prevalence and artificial intelligence decision support—a reader study
Authors: Al-Bazzaz Hanen , Janicijevic Marina , Strand Fredrik
Published: January 2024

Objectives

The aim of our study was to examine how breast radiologists would be affected by high cancer prevalence and the use of artificial intelligence (AI) for decision support.

Materials and method

This reader study was based on selection of screening mammograms, including the original radiologist assessment, acquired in 2010 to 2013 at the Karolinska University Hospital, with a ratio of 1:1 cancer versus healthy based on a 2-year follow-up. A commercial AI system generated an exam-level positive or negative read, and image markers. Double-reading and consensus discussions were first performed without AI and later with AI, with a 6-week wash-out period in between. The chi-squared test was used to test for differences in contingency tables.

Results

Mammograms of 758 women were included, half with cancer and half healthy. 52% were 40–55 years; 48% were 56–75 years. In the original non-enriched screening setting, the sensitivity was 61% (232/379) at specificity 98% (323/379). In the reader study, the sensitivity without and with AI was 81% (307/379) and 75% (284/379) respectively (p < 0.001). The specificity without and with AI was 67% (255/379) and 86% (326/379) respectively (p < 0.001). The tendency to change assessment from positive to negative based on erroneous AI information differed between readers and was affected by type and number of image signs of malignancy.

Conclusion

Breast radiologists reading a list with high cancer prevalence performed at considerably higher sensitivity and lower specificity than the original screen-readers. Adding AI information, calibrated to a screening setting, decreased sensitivity and increased specificity.

Clinical relevance statement

Radiologist screening mammography assessments will be biased towards higher sensitivity and lower specificity by high-risk triaging and nudged towards the sensitivity and specificity setting of AI reads. After AI implementation in clinical practice, there is reason to carefully follow screening metrics to ensure the impact is desired.

Key Points

• Breast radiologists’ sensitivity and specificity will be affected by changes brought by artificial intelligence.

• Reading in a high cancer prevalence setting markedly increased sensitivity and decreased specificity.

• Reviewing the binary reads by AI, negative or positive, biased screening radiologists towards the sensitivity and specificity of the AI system.

Graphical abstract
The clinical outcome of emergency superficial temporal artery-to-middle cerebral artery bypass in acute ischemic stroke with large vessel occlusion
Authors: Guo Lei , Yang Li , Li Chunling , Zeng Yi , Xu Ruxiang , Wang Zhengyu , Jiang Chonggui
Published: January 2024

The role of superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass in acute ischemic stroke (AIS) is contentious, with no evidence in patients with AIS and large vessel occlusion (AIS-LVO). We conducted a cohort study to assess emergency STA-MCA outcomes in AIS-LVO and a meta-analysis to evaluate STA-MCA outcomes in early AIS treatment. From January 2018 to March 2021, we consecutively recruited newly diagnosed AIS-LVO patients, dividing them into STA-MCA and non-STA-MCA groups. To evaluate the neurological status and outcomes, we employed the National Institutes of Health Stroke Scale (NIHSS) during the acute phase and the modified Rankin Scale (mRS) during the follow-up period. Additionally, we conducted a meta-analysis encompassing all available clinical studies to assess the impact of STA-MCA on patients with AIS. In the cohort study (56 patients), we observed more significant neurological improvement in the STA-MCA group at two weeks (p = 0.030). However, there was no difference in the clinical outcomes between the two groups. Multivariable logistic regression identified the NIHSS at two weeks (OR: 0.840; 95% CI: 0.754–0.936, p = 0.002) as the most critical predictor of a good outcome. Our meta-analysis of seven studies indicated a 67% rate for achieving a good outcome (mRS < 3) at follow-up points (95% CI: 57%–77%, I2 = 44.1%). In summary, while the meta-analysis suggested the potential role of STA-MCA bypass in mild to moderate AIS, our single-center cohort study indicated that STA-MCA bypass does not seem to improve the prognosis of patients who suffer from AIS-LVO.
Food for Soul—Older Immigrants’ Food Habits and Meal Preferences After Immigration: A Systematic Literature Review
Authors: Lillekroken Daniela , Bye Asta , Halvorsrud Liv , Terragni Laura , Debesay Jonas
Published: January 2024

There are few primary studies that focused on the older immigrants’ food habits and meal preferences after immigration and settlement in a new country. A comprehensive database search for literature was conducted in May 2021 and upgraded in September 2021. Ten databases (Medline (Ovid), EMBASE (Ovid), PsycInfo (Ovid), Cinahl (EBSCOhost), Food Science Source (EBSCOhost), SocIndex (EBSCOhost), Social Care Online, Applied Social Sciences Index & Abstracts (ASSIA), Web of Science and Google Scholar), were scanned for original, peer-reviewed papers published in English. The review was conducted and reported in accordance with the PRISMA 2020 guidelines and SWiM items. Out of 3069 records, 10 papers were included for thematic synthesis. A data synthesis across all studies resulted in three main findings: (i) the significance of food in maintaining cultural identity, (ii) the continuity of traditional food culture and (iii) adapting to the host country’s food culture. Although different forms of dietary acculturation occur throughout life, older immigrants often want to maintain their traditional food habits and meal preferences. For them, traditional eating habits offer comfort and security by serving as a means of identifying who they are and reminding them where they have come from. Public health and social services play an important role in providing cultural nutritional care to older immigrants; therefore, this issue should be carefully addressed by professionals and future research.

Registration: The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 27 September 2022 with registration number CRD42022358235.
Molecular detection of Shiga toxin and extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates from sheep and goats
Authors: Ramatla Tsepo , Tutubala Mpho , Motlhaping Tshepang , de Wet Lara , Mokgokong Prudent , Thekisoe Oriel , Lekota Kgaugelo
Published: January 2024

Background

The Shiga toxin (Stx)-producing Escherichia coli (STEC) have become important global public health concerns. This study investigated the prevalence, antimicrobial resistance profile, and extended-spectrum beta-lactamase-producing E. coli in sheep and goat faeces.

Methods and results

A total of 53 E. coli isolates were confirmed by PCR targeting the uidA [β-D glucuronidase] gene. The Shiga toxin genes stx1 and stx2, as well as bfpA, vir, eaeA, lt and aafII virulence genes, were detected in this study. Of the 53 isolates confirmed to be STEC, 100% were positive for stx2 and 47.2% for stx1. Three isolates possessed a combination of stx1 + stx2 + eaeA, while four isolates harboured stx1 + stx2 + vir virulence genes. The isolates displayed phenotypic antimicrobial resistance against erythromycin (66.04%), colistin sulphate (43.4%), chloramphenicol (9.4%) and ciprofloxacin (1.9%). A total of 28.8% of the strains were phenotypically considered ESBL producers and contained the beta-lactamase bla

CTX-M-9
and bla

CTX-M-25
gene groups. A larger proportion of the E. coli strains (86.8%) contained the antibiotic sulphonamide resistant (sulII) gene, while 62.3%, 62.3%, 52.8%, 43.4%, 41.5%, 20.8%, 18.9%, 11.3%, 11.3%, 9.4%, 9.4% and 5.7% possessed mcr-4, floR, mcr-1, tet(A), sulI, tet(O), tet(W), parC, mcr-2, ampC 5, qnrS and ermB genes, respectively. Thirteen isolates of the ESBL-producing E. coli were considered multi-drug resistant (MDR). One Shiga toxin (stx2) and two beta-lactamase genes (bla

CTX-M-9
and bla

CTX-M-25
groups) were present in 16 isolates. In conclusion, the E. coli isolates from the small stock in this study contained a large array of high antibiotic resistance and virulence profiles.

Conclusions

Our findings highlight the importance of sheep and goats as sources of virulence genes and MDR E. coli. From a public health and veterinary medicine perspective, the characterization of ESBL producers originating from small livestock (sheep and goats) is crucial due to their close contact with humans.
ANMCO (Italian Association of Hospital Cardiologists) scientific statement: obesity in adults—an approach for cardiologists
Authors: Di Fusco Stefania Angela , Mocini Edoardo , Gulizia Michele Massimo , Gabrielli Domenico , Grimaldi Massimo , Oliva Fabrizio , Colivicchi Furio
Published: January 2024

Obesity is a complex, chronic disease requiring a multidisciplinary approach to its management. In clinical practice, body mass index and waist-related measurements can be used for obesity screening. The estimated prevalence of obesity among adults worldwide is 12%. With the expected further increase in overall obesity prevalence, clinicians will increasingly be managing patients with obesity. Energy balance is regulated by a complex neurohumoral system that involves the central nervous system and circulating mediators, among which leptin is the most studied. The functioning of these systems is influenced by both genetic and environmental factors. Obesity generally occurs when a genetically predisposed individual lives in an obesogenic environment for a long period. Cardiologists are deeply involved in evaluating patients with obesity. Cardiovascular risk profile is one of the most important items to be quantified to understand the health risk due to obesity and the clinical benefit that a single patient can obtain with weight loss. At the individual level, appropriate patient involvement, the detection of potential obesity causes, and a multidisciplinary approach are tools that can improve clinical outcomes. In the near future, we will probably have new pharmacological tools at our disposal that will facilitate achieving and maintaining weight loss. However, pharmacological treatment alone cannot cure such a complex disease. The aim of this paper is to summarize some key points of this field, such as obesity definition and measurement tools, its epidemiology, the main mechanisms underlying energy homeostasis, health consequences of obesity with a focus on cardiovascular diseases and the obesity paradox.

Level of evidence V: report of expert committees.