bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary test results of LGADs from Teledyne e2v for the LHC’s High-Luminosity upgrade
Authors: Mulvey J. , Allport P. , Bell R. , Bortoletto D. , Gazi M. , Gonella L. , Jordan D. , Kopsalis I. , McMahon S. , Plackett R. , Stefanov K. , Villani E.G. , Watkins M.
Published: October 2022

This paper presents initial testing of the first batch of LGAD sensors fabricated by Teledyne e2v in collaboration with the University of Birmingham, University of Oxford, Rutherford Appleton Laboratory and the Open University. Wafers with different energy and dose of the gain layer implant have been characterised with IV, CV and gain measurements. The same set of measurements were made using PiN diodes fabricated on the same wafer as a reference. Results are in-line with expectations and with LGADs produced at more established vendors. Preliminary results suggests Te2v LGADs have a moderate gain in the order of 10 to 50 before irradiation at operational voltages well below breakdown, as required for optimal timing resolution.
Towards MightyPix, an HV-MAPS for the LHCb Mighty Tracker upgrade
Authors: Hammerich J.
Published: October 2022

The Mighty Tracker is a proposed upgrade to the downstream tracking system of LHCb for operations at luminosities of up to 1.5 × 1034 cm−2 s−1 starting with the LHC Run 5 data taking period. It foresees the replacement of the most central area of the current scintillating fibre tracker with High Voltage CMOS (HV-CMOS) pixel sensors. Due to the increased luminosity, occupancy will be too high for track reconstruction in the fibre tracker and the fibres would no longer withstand the radiation damage. HV-CMOS sensors have demonstrated a significant radiation tolerance and good performance making them an ideal choice of technology for the LHCb experiment. Monolithic Active Pixel Sensors (MAPS) fabricated in HV-CMOS processes provide fast charge collection via drift and allow the implementation of the readout on the same die as the sensitive volume. Due to the use of commercial processes, these sensors can be fabricated at low cost as no hybridisation with bump bonds is required. Since they are not fully depleted, the inactive volume can be reduced by thinning to achieve a total die thickness of 50 to 100 microns. A dedicated sensor called the MightyPix is developed for this programme. It is based on the HV-MAPS families MuPix and ATLASPix and tailored to the requirements of LHCb. To demonstrate the feasibility of this technology for the LHCb environment, prototypes have been irradiated. These sensors are tested in terms of efficiency, time resolution and power dissipation in temperature controlled environments.
Inter-pad dead regions of irradiated FBK Low Gain Avalanche detectors
Authors: Darby B. , Mazza S.M. , McKinney-Martinez F. , Padilla R. , Sadrozinski H.F.-W. , Seiden A. , Schumm B. , Wilder M. , Zhao Y. , Arcidiacono R. , Cartiglia N. , Ferrero M. , Mandurrino M. , Sola V. , Staiano A. , Cindro V. , Kranberger G. , Mandiz I. , Mikuz M. , Zavtranik M. , Boscardin M. , Della Betta G.F. , Ficorella F. , Pancheri L. , Paternoster G.
Published: October 2022

Low Gain Avalanche Detectors (LGADs) are a type of thin silicon detector with a highly doped gain layer. LGADs manufactured by Fondazione Bruno Kessler (FBK) were tested before and after irradiation with neutrons. In this study, the inter-pad dead regions (IPDRs), defined as the width of the distances between pads, were measured with a TCT laser system. The response of the laser was tuned using β-particles from a 90Sr source. These insensitive “dead zones” are created by a protection structure to avoid breakdown, the Junction Termination Extension (JTE), which separates the pads. The effect of neutron radiation damage at 1.5 × 1015 neq/cm2, and 2.5 × 1015 neq/cm2 on IPDRs was studied. These distances are compared to the nominal distances given from the vendor, it was found that at the high fluence there is a better matching of the insensitive region to the designed inter-pad region.
Beam physics design of a 30-MW beam transport to the target for an accelerator-driven subcritical system
Authors: Yee-Rendon Bruce , Meigo Shin-ichiro , Kondo Yasuhiro , Tamura Jun , Nakano Keita , Maekawa Fujio , Iwamoto Hiroki , Sugawara Takanori , Nishihara Kenji
Published: October 2022

The Japan Atomic Energy Agency's accelerator-driven
subcritical system (JAEA-ADS) proposes the reduction of nuclear
waste through the transmutation of minor actinides. The JAEA-ADS
drives a 30-MW proton beam to a spallation target to produce
neutrons for a subcritical 800-MWth reactor. The beam must be
transported from the end of the linear accelerator (linac) to the
target located inside the reactor core with high beam power
stability and low peak density to ensure beam window integrity,
which is a primary concern for the ADS project. Additionally, the
design of the beam transport to the target (BTT) must be compatible
with the established reactor design, and the elements that comprise
the BTT must facilitate the maintenance and replacement of the fuel
and the beam window. To this end, a robust-compact BTT design was
developed through massive multiparticle simulations. First, the beam
optics was optimized to guarantee beam window feasibility
requirements by providing a low peak density of less than
0.3 μA/mm2. Then, beam stability was evaluated and
improved by a simultaneous application of input beam and element
errors. The input beam errors were based on the beam degradation
obtained by implementing fast fault compensation in the linac, which
is a key strategy to attain high-reliability operation. The results
show that the BTT design fulfills reactor and beam window
requirements for JAEA-ADS.
Eddy current and structural analysis of the beam pipe for the BRing dipole magnet
Authors: Lu J.Q. , Ma L.Z. , Yao Q.G. , You W. , Zhang X. , Chen Y.Q. , Zhao L.X. , Lv M.B. , Wu W. , Yang W.J.
Published: October 2022

Fast-ramping magnets will be used in the Booster Ring
(BRing) of the High-Intensity Heavy Ion Accelerator Facility (HIAF),
which is proposed by the Institute of Modern Physics (IMP), Chinese
Academy of Sciences (CAS). The dipole magnet will provide the field
quality from the injection field of 0.0496 T up to the maximum
value of 1.5786 T, with the maximum ramping rate of 12 T/s. The
ramping magnetic field induces eddy currents that give rise to eddy
loss and large force on the beam pipe, field delay and sextupole
field appear to affect the field quality provided by the BRing
dipole. An in-detail understanding of these effects is an essential
aspect of the design. Based on the finite-element analysis, a
simplified model by use uniform background magnetic field was used
to the transient simulations, eddy current and the forces on the
pipe at different times on the beam pipe were performed. This paper
presents the results obtained for the eddy loss and magnetic field
delay for different wall thicknesses. Then, mechanical design
details are presented, and also stress distribution, the deformation
in the beam pipe. The analysis results revealed that the eddy
current and thus the field delay and eddy current-induced Lorentz
force scales linearly with the derivative of the magnetic field and
the thickness of the pipe. The power losses that cause heating of
the pipe is linear with the square of the derivative of the magnetic
field and the thickness of the pipe.
Computational ghost imaging with PSF-guiding deep learning through various unknown turbid scattering media
Authors: Chen Ke , Xiao Hongyuan , Cheng Xuemin , Ziqi Gao , Wang Anqi , Hu Yao , Hao Qun
Published: October 2022

Achieving high signal-to-noise ratio (SNR) imaging through scattering media is challenging. Computational ghost imaging with deep learning (CGIDL) has unique advantages for solving this challenge. However, image reconstruction cannot be guaranteed due to low correlation between real signal and training dataset, when the CGIDL is applied in different unknown scattering media. Point spread function (PSF) determines the quality of CGIDL reconstruction, linking the mathematical features of the scene and the quality of reconstruction. In this study, an innovative CGIDL technology based on the measured PSF method is proposed to improve the correlation between real signal and training dataset. When five new turbid scattering media with unknown scattering strength are introduced, classification of PSF enables high SNR imaging through various turbid scattering media.
Mosquitoes Eating Mosquitoes: HowToxorhynchites amboinensis,Psorophora ciliata, andSabethes cyaneus(Diptera: Culicidae) Capture Prey
Authors: Hancock Robert G , Boyd Taylor , MacFadden Shannon , Sowders Aaron , Foster W A , Lounibos L P
Published: October 2022

High-speed microcinematography was used to elucidate the details of prey capture by the larvae of three predatory mosquito species. The obligate predators Toxorhynchites amboinensis and Psorophora ciliata exhibited a high degree of convergence as both utilize three essential elements: 1) abdominally-generated hemostatic pressure to propel the head towards the prey; 2) lateral palatal brushes (LPB) opening and fanning into anterior-directed basket-like arrangements; 3) simultaneously with the LPB-basket formation, the wide opening of sharp-toothed mandibles. Thus, LPBs and mandibles are used for prey capture by both species. The facultative predator Sabethes cyaneus utilizes a vastly different prey-capture mechanism that involves ventro-lateral body arching and scooping of prey with axially pointed siphons into the grasp of open maxillae bearing elongate apical teeth. Prey consumption, which is typically incomplete in this species, then involves the action of teeth on the mandibles which cut into the held prey. Although prey consumption is incomplete, simple experiments show that Sa. cyaneus do gain nutritionally from consuming mosquito larvae and that they do discriminate heterospecific from conspecific larvae and actively approach heterospecific mosquito prey. These findings indicate that independent evolutionary pathways have produced diverse predatory behaviors and morphologies in aquatic environments where the immature stages of mosquitoes co-occur.
Enhanced recovery after surgery recommendations for renal transplantation: guidelines
Authors: Tan Jaimee H S , Bhatia Kailash , Sharma Videha , Swamy Mruthunjaya , van Dellen David , Dhanda Raman , Khambalia Hussein
Published: October 2022

Background

Enhanced Recovery After Surgery (ERAS) protocols are now widely practiced in major surgery, improving postsurgical outcomes. Uptake of these programmes have been slow in kidney transplantation due to challenges in evaluating their safety and efficacy in this high-risk cohort. To date, there are no unified guidance and protocols specific to ERAS in kidney transplantation surgery. This paper aims to summarise current evidence in the literature and develop ERAS protocol recommendations for kidney transplantation recipients.

Methods

PubMed, Cochrane, Embase and Medline databases were screened for studies relevant to ERAS protocols in kidney transplantation, up to August 2021. A secondary search was repeated for each ERAS recommendation to explore the specific evidence base available for each section of the protocol. Randomised controlled trials, case-control and cohort studies were included. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework was used to evaluate the quality of evidence available and recommendations.

Results

We identified six eligible studies with a total of 1225 participants. All studies found a reduction in length of hospital stay without affecting readmission rates. The evidence behind specific pre-operative, intra-operative and post-operative interventions included in current ERAS protocols are reviewed and discussed.

Conclusion

Compared to other surgical specialties, the evidence base for ERAS in kidney transplantation remains lacking, with further room for research and development. However, significant improvements to patient outcomes are already possible with application of the currently available evidence. This has shown that ERAS in kidney transplantation surgery is safe and feasible, with improved postoperative outcomes.
Increased intra-abdominal haemorrhage after thoracic endovascular aortic replacement in patients with concomitant blunt aortic injuries and abdominal trauma: a National Trauma Data Bank analysis
Authors: Lu Yu-Chieh , Yu Sheng-Yueh , Fu Chih-Yuan , Bajani Francesco , Bokhari Marissa , Mis Justin , Poulakidas Stathis , Bokhari Faran
Published: October 2022

OBJECTIVES

The role of thoracic endovascular aortic replacement (TEVAR) in patients with concomitant blunt thoracic aortic injury (BTAI) and blunt abdomen trauma (BAT) was evaluated using nationwide real-world data. The risk of post-TEVAR abdominal haemorrhage was studied.

METHODS

Patients with BTAI and BAT in the National Trauma Data Bank were retrospectively studied. Propensity score matching was used to evaluate the effect of TEVAR in delayed abdominal surgeries for haemostasis and the delayed need for blood transfusion. A multivariable logistic regression analysis was used to evaluate the independent risk factors for delayed intra-abdominal haemorrhage in these patients.

RESULTS

A total of 928 concomitant BTAI and BAT patients were studied (TEVAR versus non-TEVAR, 206 vs 722). After a well-balanced propensity score matching analysis, patients who received TEVAR had significantly more delayed abdominal surgeries for haemostasis (7.7% vs 4.5%, standardized mean difference = 0.316) and delayed need for blood transfusion (11.6% vs 7.1%, standardized mean difference = 0.299) than those who did not. The multivariable logistic regression analysis showed that TEVAR increased the need for delayed abdominal surgeries (odds ratio = 2.026, P = 0.034). Among the patients who underwent TEVAR, the patients with delayed abdominal surgeries for haemostasis had a significantly higher proportion of severe abdominal injury (abdominal Abbreviated Injury Scale score of 4 or 5) than patients without delayed abdominal surgeries for haemostasis (31.6% vs 15.5%, P = 0.038).

CONCLUSIONS

Patients with concomitant BTAI and BAT had a higher risk of intra-abdominal haemorrhage after TEVAR, especially patients with severe abdominal trauma.
Orthodontic treatment quality evaluated by partially automated digital IOTN and PAR index determination: a retrospective multicentre study
Authors: Coenen Franziska A , Bartz Jenny R , Niederau Christian , Craveiro Rogerio B , Knaup Isabel , Wolf Michael
Published: October 2022

Background

Orthodontic therapy aims to treat misaligned teeth and jaws to improve dental occlusion as well as the function and aesthetics of the masticatory system. Continuous data collection to check treatment quality is of great importance for the constant optimization of orthodontic care.

Objective

The aim of this retrospective multicentre cohort study was to systematically determine the outcome and quality of orthodontic treatment by applying the internationally established Index of Orthodontic Treatment Need (IOTN) and Peer Assessment Rating (PAR) index in multiple clinical settings for a representative number of patient cases.

Materials and methods

A total of 1509 consecutive orthodontic patient cases (treatment completion between January 2018 and December 2020) from three representative orthodontic centres (University clinic, city office, small town office) were analysed in a multicentre study. The pre- and post-treatment casts were scanned, digitally measured, and partially automatically evaluated using the IOTN and PAR indices.

Results

A statistically significant improvement in occlusion was observed for medically necessary treatment of IOTN grades 4 and 5 in 97.30 per cent of the analysed cases and for treatment-requiring grades 2 and 3 in 94.08 per cent of the analysed cases. The average percentage PAR improvement was 76.51 per cent. 72.50 per cent of cases showed improvement of more than 70 per cent. The mean PAR index score was reduced from 28.19 ± 9.49 to 6.22 ± 5.41 points.

Conclusion

The present data demonstrate that orthodontic treatment is efficient in inducing significant improvement of malocclusions in general and has a high success rate with severe dysgnathia.
Culturomic-, metagenomic-, and transcriptomic-based characterization of commensal lactic acid bacteria isolated from domestic dogs using Caenorhabditis elegans as a model for aging
Authors: Kang An Na , Mun Daye , Ryu Sangdon , Jae Lee Jeong , Oh Sejong , Kyu Kim Min , Song Minho , Oh Sangnam , Kim Younghoon
Published: October 2022

In tandem with the fast expansion of the pet-economy industry, the present aging research has been noticing the function of probiotics in extending the healthy lifetime of domestic animals. In this study, we aimed to understand the bacterial compositions of canine feces and isolating lactic acid bacteria (LAB) as commensal LAB as novel potential probiotics for the use of antiaging using Caenorhabditis elegans surrogate animal model. Under an anaerobic, culturomic, and metagenomic analysis, a total of 305 commensal LAB were isolated from diverse domestic dogs, and four strains, Lactobacillus amylolyticus, L. salivarius, Enterococcus hirae, and E. faecium, made prominence as commensal LAB by enhancing C. elegans life span and restored neuronal degeneration induced by aging by upregulating skn-1, ser-7, and odr-3, 7, 10. Importantly, whole transcriptome results and integrative network analysis revealed extensive mRNA encoding protein domains and functional pathways of naturally aging C. elegans were examined and we built the gene informatics basis. Taken together, our findings proposed that a specific gene network corresponding to the pathways differentially expressed during the aging and selected commensal LAB as potential probiotic strains could be provided beneficial effects in the aging of domestic animals by modulating the dynamics of gut microbiota.
Exploring the Past to Inform the Future to Optimize the Pharmacokinetics of Vancomycin in Children With Severe Burn Injuries
Authors: Sherwin Catherine M , Tran Nam K , Sullivan Kevin , Wead Stephanie , Birnbaum Angela K , Avachat Charul , Healy Daniel P , Kagan Richard J
Published: October 2022

Sepsis remains one of the leading causes of death among pediatric patients with burn injuries. Despite limited vancomycin pharmacokinetic (PK) information within this population, it is widely used to treat severe burn injuries. Those with severe burns are at risk of nephrotoxicity, with an incidence of acute kidney injury (AKI) over 50%. Delivering an effective vancomycin dose and avoiding unnecessary toxicity is essential for improved patient outcomes. This was a retrospective analysis of 115 children aged 0.2 months to 18 years with severe burns, >10% total body surface area. Vancomycin was given via intravenous infusion; blood samples were drawn between 6- and 12-hour postinfusion. A population pharmacokinetic model was developed using nonlinear mixed-effect modeling (Monolix, version 2016R1). A one-compartment model described a steady-state volume of distribution (V), dependent on weight. Vancomycin clearance (CL) was influenced by age and estimated creatinine clearance (CrCL). The study population’s (median age = 4 years, median weight = 20 kg, median total body surface area (%TBSA) = 40%) median V and CL were calculated to be 1.25 L/kg (95% CI, 1.04–1.46) and 0.15 L/h/kg (95% CI, 0.126–0.165), respectively. The PK model was explicitly developed to characterize the impact of physiological changes in children under 18 years of age and the percentage of the burn surface area using limited data. The analysis determined that weight, age, and estimated CrCL were important covariates in predicting vancomycin PK with high variability in CL and V.
Public health opportunities resulting from sufficient HPV vaccine supply and a single-dose vaccination schedule
Authors: Kreimer Aimée R , Cernuschi Tania , Rees Helen , Brotherton Julia M L , Porras Carolina , Schiller John
Published: October 2022

Many countries with the highest burdens of cervical cancer have not yet offered human papillomavirus (HPV) vaccines to most of their age-eligible girls, who as adults also have limited or no access to effective cervical cancer screening or treatment. There are now 2 complementary developments that could make HPV vaccines more accessible and affordable: 1) the current and projected increases in HPV vaccine supply; and 2) the permissive recommendation for single-dose HPV vaccination schedules. This change in policy paired with the healthier HPV vaccine supply is an incredible opportunity to facilitate rapid access and expansion of HPV vaccination. Female adolescent vaccination including multiage cohorts must be prioritized. In the coming decades, this is the most cost-effective approach to avert millions of projected cervical cancer cases, which account for most HPV-related cancers globally.
Dialectica logical principles: not only rules
Authors: Trotta Davide , Spadetto Matteo , de Paiva Valeria
Published: October 2022

Gödel’s Dialectica interpretation was designed to obtain the consistency of Peano arithmetic via a proof of consistency of Heyting arithmetic and double negation. In recent years, proof theoretic transformations (the so-called proof interpretations) based on Gödel’s Dialectica interpretation have been used systematically to extract new content from proofs and so the interpretation has found relevant applications in several areas of mathematics and computer science. Following our previous work on ‘Gödel fibrations’, we present a (hyper)doctrine characterization of the Dialectica, which corresponds exactly to the logical description of the interpretation. To show that, we derive the soundness of the interpretation of the implication connective, as expounded on by Spector and Troelstra, in the categorical model. This requires extra logical principles, going beyond intuitionistic logic, namely Markov Principle and the Independence of Premise principle, as well as some choice. We show how these principles are satisfied in the categorical setting, establishing a tight (internal language) correspondence between the logical system and the categorical framework. We make sure that this tight correspondence extends to the use of the principles above, instead of the weaker rules we had proved earlier on. This tight correspondence should come handy not only when discussing the traditional applications of the Dialectica but also when dealing with newer uses in modelling games or concurrency theory.
Canadian Evangelicalism
Authors: Flatt Kevin N.
Published: October 2022

Evangelicalism came to Canada with American and British settlers and missionaries beginning in the 1760s. In a society of newcomers with Protestant heritages but few established religious institutions, evangelicalism was able to spread rapidly, with Baptists and Methodists taking the lead in the Maritimes and Upper Canada, respectively. Canadian Protestants in this period were divided about several interrelated doctrinal and practical issues, making two poles distinguishable, with radical evangelicals on one end of the spectrum. Evangelicals held a range of views, however, and learned to channel early revivalism into disciplined institutional patterns. By the 1820s, most Protestants in Canada were converging toward a broad evangelical consensus. In keeping with the interpretations of Charles Taylor and other scholars, early evangelicals were able to outpace other religious groups (like the state-supported Anglicans) in Canada’s emerging “Age of Mobilization” partly because of their nimble structures and voluntarist ethos.
Particular Baptists
Authors: Haykin Michael A. G.
Published: October 2022

During the first few decades of the long eighteenth century, the English Particular Baptist community found itself in the grip of a seemingly inexorable decline, the reasons for which included doctrinal, social, and cultural issues. While there were significant sectors of spiritual vitality, especially in the West Country as a result of the impact of Bristol Baptist Academy, widespread revival did not come until the final three decades of the century. Links with the earlier Evangelical Revival that had been largely concentrated within Anglicanism, a movement of prayer for spiritual awakening that began in 1784, the influence of the writings of the American divine Jonathan Edwards, and the theology of Andrew Fuller led to significant renewal that gave birth to the modern missionary movement.
Print Culture
Authors: Whelan Timothy
Published: October 2022

The study of print culture and the history of the book in the eighteenth century has benefited significantly in the past three decades from studies that have placed varying degrees of emphasis on the three key components of print culture—author, publisher, and reader—and their interwoven relationships. This scholarship has also spurred new research on the literary and print culture of evangelical Anglicans, Methodists, Quakers, Calvinistic Methodists, Baptists, Moravians, and Independents in Great Britain and America, including specific studies related to the transatlantic nature of the printing histories of Philip Doddridge and Jonathan Edwards. This chapter seeks to further this discussion by exploring three areas of eighteenth-century evangelical print culture in England: the interplay between readers, writers, and producers with informal and formal sources; the ecclesiastical/topographical reconstruction of reading/selling communities of chapel-goers and neighboring (and usually like-minded) booksellers; and the interaction of these two elements in the publishing history of one representative text, Samuel James’s An Abstract of the Gracious Dealings of God with Several Eminent Christians (1760).
Samson Occom, Joseph Johnson, and New England Native American Evangelicalism
Authors: Wyss Hilary E. , Trujillo Anthony
Published: October 2022

Samson Occom and his son-in-law, Joseph Johnson, were arguably two of the most enmeshed Indigenous figures of early New England’s missionary circles and produced radically nativist spaces and languages within and beside the discourses of White evangelical religion. Highly visible through their writings and their relationships with prominent evangelical figures, this chapter explores the deep investments Occom and Johnson made in education, religion, and politics in New and Old England while also gesturing toward the silences obscuring Indigenous peoples in English records and in the colonial imagination. Passionately convinced that Christianity had something real and important to offer their Native kin, these Mohegan men spent their lives traversing the Northeast, the Atlantic world, and the precarious terrain between Native and colonial spaces. By foregrounding these Indigenous figures rather than the Euro-American religious leaders and missionaries in religious histories of the Northeast especially among Native nations, the authors propose a reorientation for New England’s evangelical movement, putting Indigeneity and the Indigenous figures who left an indelible mark on the Native and colonial religious landscape of the eighteenth century at the center.
Role of the Physical Therapist in Cystic Fibrosis Care
Authors: Stanford Gemma , Daniels Tracey , Brown Catherine , Ferguson Katie , Prasad Ammani , Agent Penny , Gates Alison , Morrison Lisa
Published: October 2022

In looking back on 2020 and 2021, this Perspective reflects on the monumental impacts of the rollout of cystic fibrosis (CF) transmembrane conductance regulator highly effective modulator therapies and the COVID-19 pandemic on the management of CF. Advancements in the clinical management of people with CF have been both enormous and rapid, and physical therapists specializing in the care of people with CF have been at the forefront of driving this evolution in care. This year sees the 30th anniversary of the UK Association of Chartered Physiotherapists in Cystic Fibrosis and, as is inevitable in reaching such milestones, thoughts have turned to origins, role, impacts, and the future. With the changing demographics of the population of people with CF after the introduction of highly effective modulator therapies, potentially with fewer secondary complications, the future role of the physical therapist who specializes in CF is in question. This Perspective reflects on and highlights the role of physical therapy within CF and provides insights into how physical therapists and respiratory therapists can evolve their roles to ensure relevance for the future.
Education and Opportunity during the First World War. Post-compulsory Study at the Harris Institute, Preston, 1914–18
Authors: Vernon Keith , Wilkinson Oliver
Published: October 2022

Education during the First World War is generally overlooked. Schooling was seriously undermined by the demands of war, and the principal educational measure to emerge from the war offered little recompense. Similarly, studies of education and opportunity in the early twentieth century pass quickly over the war years and the 1918 Education Act to focus on the inter-war period. This article argues that an important sector of education, that of part-time, post-compulsory vocational education, has not received due recognition as a factor during the war, and in studies of social mobility more broadly. Through a close analysis of student cohorts who attended the Harris Institute in Preston, we show that there were significant new opportunities arising during the war. Different kinds of students, notably younger people, women, and from poorer backgrounds, took advantage of the expanding opportunities. Combining details of students’ courses of study with evidence of their family and occupational backgrounds, gives insights into the aspirations of these working people to advance their careers, move into new sectors of work, or broaden their cultural horizons.
Persistent Cancer-Related Fatigue After Breast Cancer Treatment Predicts Postural Sway and Postexertional Changes in Sit-to-Stand Strategy
Authors: Wechsler Stephen , Kneiss Janet , Adams Benjamin , Wood Magee Lisa J.
Published: October 2022

Background:

Chemotherapy-induced peripheral neuropathy (CIPN) is considered a primary mechanism of imbalance among women diagnosed with breast cancer. Recent evidence, however, suggests that cancer-related fatigue (CRF) may also influence balance.

Purpose:

Examine the contributions of CRF and CIPN to static and dynamic balance before and after a period of fatiguing exercise.

Methods:

This is a secondary analysis of data examining functional differences between women with breast cancer with and with no persistent CRF. Postural sway was measured during static standing and the rising phase of an instrumented sit-to-stand before and after exercise. Regression analyses were performed to determine how CRF and severity of CIPN predicted sway and how much variance was attributable to each.

Results:

Greater CRF predicted increased pre-, P = .04, and postexertional, P = .02, static sway in the anterior-posterior plane. Cancer-related fatigue accounted for 10.5% and 9.5% of the variance in pre- and postexertional sway (respectively) compared with the 0.9% and 1.4% accounted for by CIPN severity, which was not a significant predictor. After exercise, greater CRF predicted smaller, more conservative, anterior weight shifting during the instrumented sit-to-stand, P = .01, and accounted for 6.6% of the variance in sway compared with 3% attributed to CIPN, which was not a significant predictor.

Limitations:

This analysis is limited by its small and demographically homogenous sample.

Conclusions:

These results suggest that CRF may influence balance independent of CIPN symptoms. While CIPN remains a risk factor for imbalance in this population, CRF warrants consideration in clinical practice and research as a mechanism of postural instability.
Modern preoperative evaluation in ambulatory surgery – who, where and how?
Authors: Filipovic Mark G. , Schwenter Aline , Luedi Markus M. , Urman Richard D.
Published: October 2022

Purpose of review

Ambulatory surgery is increasingly performed in medically complex patients. This dynamic environment requires new approaches to ensure cost-effective, efficient, and ultimately safe preoperative evaluation of the patient. This review investigates recent advances in the assessment of ambulatory patients, with a special focus on patient screening, digital communication, and multidisciplinary team evaluation.

Recent findings

Identifying suitable candidates for ambulatory surgery relies on a variety of medical, surgical, and institutional factors. Identification of high-risk patients and optimization of their treatment can be achieved through multidisciplinary protocols specific to the local institution and in line with current guidelines. Virtual assessment may be sufficient for most patients and provide an efficient evaluation strategy and high patient satisfaction. Prescreening can be supported by preoperative nursing teams.

The increasing complexity of treatment provided in day surgery offers a unique opportunity to highlight the importance of anesthesiology staff as perioperative caregivers. Preoperative evaluation serves as a central junction to integrate a variety of surgical, medical, and institutional factors to provide safe, satisfactory, and efficient care for patients. Implementing technological innovation to streamline and facilitate this process is paramount.
Application of user-centered co-design principles to address barriers in therapeutic drug monitoring
Authors: Wong Sherilyn , Davis Aaron , Selby Philip R. , Khoo Richie , Gwilt Ian , Stocker Sophie L. , Ward Michael B. , Reuter Stephanie E.
Published: October 2022

Background:

Different software applications have been developed to support healthcare professionals in individualized drug dosing. However, their translation into clinical practice is limited, partly because of poor usability and integration into workflow, which can be attributed to the limited involvement of healthcare professionals in the development and implementation of drug dosing software. This study applied co-design principles to inform the design of a drug dosing software to address barriers in therapeutic drug monitoring (TDM) using vancomycin as an example.

Methods:

Three workshops (face-to-face and online) were conducted by design researchers with pharmacists and prescribers. User journey storyboards, user personas, and prototyping tools were used to explore existing barriers to practice and opportunities for innovation through drug dosing software design. A prototype of the software interface was developed for further evaluation.

Results:

Healthcare professionals (11 hospital pharmacists and 6 prescribers) with ≥2 years of clinical experience were recruited. Confidence and software usability emerged as the main themes. Participants identified a lack of confidence in vancomycin dosing and pharmacokinetic understanding and difficulty in accessing practice guidelines as key barriers that could be addressed through software implementation. Accessibility to information (e.g., guidelines and pharmacokinetic resources) and information presentation (e.g., graphical) within the dosing software were dependent on the needs and experience of the user. A software prototype with a speedometer-dial visual to convey optimal doses was well received by participants.

Conclusion:

The perspectives of healthcare professionals highlight the need for drug dosing software to be user-centred and adaptable to the needs and workflow of end users. Continuous engagement with stakeholders on tool usability, training, and education is needed to promote the implementation in practice.
Indian physicians' attitudes and practice regarding menopause and its management: a focus group discussion
Authors: Lathia Tejal , Selvan Chitra , Namjoshi Shraddha , Chawak Shweta , Kelada Lauren , Chittem Mahati
Published: October 2022

Objectives

To explore Indian physicians' attitudes and practice toward menopause and its management. To contribute to the larger project aimed at developing communication skills and decision aids for Indian physicians and women.

Methods

Using a cross-sectional design, purposive sampling, and a qualitative methodology, 10 Indian physicians (female, 6; male, 4; mean age, 51.5 years) who were practicing either endocrinology or gynecology were recruited to participate in a virtual focus group discussion. Questions explored physicians' attitudes toward menopause and their approach toward addressing menopause and related concerns with their patients. The focus group was analyzed using qualitative content analysis.

Results

Three main themes emerged: (1) “The only way to get over it is to accept it”: Attitudes toward menopause, (2) “More than menopausal hormone therapy, it is empathy that's required”: Physiological and psychological symptom management and (3) Matching the empathic intent with skills: A need for training in the management of menopause.

Conclusions

The study findings underscore the need to introduce Indian physicians to empathic communication skills training, involve, and educate physicians about the international and national clinical guidelines regarding menopausal hormone therapy and alternative therapies, and techniques for distress screening and early referrals.

Video Summary

http://links.lww.com/MENO/B17.
Menstrual cycle phase, menopausal transition stage, self-reports of premenstrual syndrome and symptom severity: observations from the Seattle Midlife Women's Health Study
Authors: Mitchell Ellen Sullivan , Woods Nancy Fugate
Published: October 2022

Objective

The aim of this study was to determine the effects of menstrual cycle phases (postmenses and premenses), self-report of premenstrual syndrome (PMS), late reproductive stages (LRS1 and LRS2), and early menopausal transition (EMT) stage (Stages of Reproductive Aging Workshop [STRAW]) on severity of five symptom groups.

Methods

A subset of Seattle Midlife Women's Health Study participants (n = 290) in either LRS1 or LRS2 or EMT (STRAW+10 criteria) provided daily symptom data for at least one full menstrual cycle during the first year of the study and reported current PMS. Symptom severity was rated (1-4, least to most severe) in the daily diary for five symptom groups (dysphoric mood, neuromuscular, somatic, vasomotor, and insomnia) identified earlier with the same sample (Maturitas 1996;25:1-10). A three-way analysis of variance was used to test for within- and between-participants effects on symptom severity.

Results

Stage had no effect on severity for any of the five symptom groups. Dysphoric mood and neuromuscular and somatic symptom severity (but not vasomotor or insomnia severity) differed significantly across menstrual cycle phases, increasing from postmenses to premenses. Current PMS and premenses cycle phase had significant interactive effects on dysphoric mood and neuromuscular symptoms, but there were no significant interaction effects on somatic, vasomotor, or insomnia symptom severity.

Conclusions

Dysphoric mood, neuromuscular, and somatic symptoms exhibit cyclicity and are influenced by current PMS. Late reproductive stages and EMT stage do not have significant effects on the five symptom groups. Vasomotor or insomnia symptoms do not exhibit significant cyclicity from postmenses to premenses and are not affected by current PMS. Future studies of symptom cyclicity and reproductive aging including daily symptom data across an entire menstrual cycle in samples including women in late menopausal transition stage are essential to capture the effects of both cyclicity and self-reported PMS to capture symptom severity reports at their peak.
Vibrio Septicemia Diagnosed With Next-Generation Sequencing: A Case Report
Authors: Chen Zutao , Liu Xiao , Wang Yajuan , Yao Yunhai
Published: October 2022

Vibrio vulnificus and Vibrio parahaemolyticus are marine Gram-negative bacilli that can cause septicemia and gastrointestinal and wound infections. Early suspicion, diagnosis and appropriate antibiotic therapy for those infections are essential as delay can adversely affect the outcome. Here, we report a patient who developed a V. vulnificus and V. parahaemolyticus infection after contact with a fishing net. The cause of infection was finally diagnosed by metagenomic next-generation sequencing. The patient required an emergency amputation of the upper- and middle-third of the right upper limb.
Title: Cataract Surgery in Patients with Underlying Keratoconus: A Focused Review
Authors: Gonzalez-Salinas Roberto , Franco Jovany Jeomar , Reyes-Luis José Luis , Sánchez-Huerta Valeria , de Wit-Carter Guillermo , Hernández-Quintela Everardo , Pineda Roberto
Published: October 2022

An underlying diagnosis of keratoconus (KCN) can complicate cataract surgery. Herein, the results of a focused review of the literature pertaining to cataract surgery in patients with KCN are detailed. Topics essential for the appropriate management of this patient population are discussed. First, the individual and shared epidemiology and pathophysiology of cataract and KCN are reviewed. Then, the theory and approach to intraocular lens (IOL) power calculation are discussed, highlighting particularities and pitfalls of this exercise when performed in patients with KCN. Finally, several special—although not uncommon—management scenarios and questions are addressed, such as surgical planning in cases where corneal stabilization or tissue replacement interventions are also necessitated.
Comparison of Bivalirudin Versus Heparin for Anticoagulation During Extracorporeal Membrane Oxygenation
Authors: Hasegawa Daisuke , Sato Ryota , Prasitlumkum Narut , Nishida Kazuki , Keaton Brian , Acquah Samuel O. , Im Lee Young
Published: October 2022

The effect and safety of bivalirudin compared with heparin in patients undergoing extracorporeal membrane oxygenation (ECMO) remains unclear. Therefore, we conducted a systematic review and meta-analysis to compare the effectiveness and safety of heparin and bivalirudin in patients who underwent ECMO. We searched Embase, the Cochrane Central Register of Controlled Trials, and MEDLINE. Inclusion criteria included patients (1) undergoing ECMO and (2) receiving bivalirudin or heparin. We excluded studies where the majority of patients switched heparin to bivalirudin or vice versa during the clinical course. The primary outcome was short-term mortality. We presented the results of all analyses with the use of random-effects models. Eleven studies reported short-term mortality. The use of bivalirudin was associated with significantly lower short-term mortality, compared with heparin (odds ratio: 0.71, 95% confidence interval, 0.55–0.92; p = 0.01, I
2 = 7%). In this meta-analysis of observational studies, the use of bivalirudin was associated with significantly lower short-term mortality, compared with heparin. Further prospective studies are warranted to clarify this finding.
Optimizing outcomes for men with severe infertility
Authors: Marinaro Jessica A.
Published: October 2022

Purpose of review

To evaluate recent evidence related to optimizing outcomes for men with severe infertility, including effect of ejaculatory abstinence interval on semen parameters and assisted reproductive technology (ART) outcomes, and impact of cryopreservation on surgically retrieved testicular sperm obtained from men with nonobstructive azoospermia (also referred to as azoospermia due to spermatogenic dysfunction).

Recent findings

Recent evidence strongly suggests that a short abstinence interval improves sperm motility and ART outcomes. Similarly, recent studies have concluded that using fresh vs. frozen testicular sperm results in higher live birth rates.

Although the World Health Organization currently recommends a 2- to 7-day ejaculatory abstinence period, this interval is based more on the need to standardize semen parameters than clinical outcomes. In fact, recent evidence suggests that shorter abstinence consistently improves sperm motility and ART outcomes for infertile men. Similarly, recent studies have reported an improvement in live birth rates with fresh (vs. frozen) testicular sperm, though their retrospective design and lack of intention to treat analyses makes it difficult to draw strong conclusions. Although additional, well designed studies are needed, providers may be able to leverage these techniques in their practice to improve outcomes for some infertile men.
Serum Neurofilament Light in Neurosyphilis: A Pilot Study
Authors: Marra Christina M. , Sahi Sharon K. , Tantalo Lauren C. , Zetterberg Henrik
Published: October 2022

Background

Lumbar puncture is recommended for individuals with syphilis who have neurological symptoms; however, symptoms have poor sensitivity for predicting symptomatic neurosyphilis. Neurofilament light chain (NfL) is a marker for neuroaxonal injury; cerebrospinal fluid concentrations are higher in symptomatic neurosyphilis than in uncomplicated syphilis or asymptomatic neurosyphilis.

Methods

Serum NfL was quantified in 20 individuals with uncomplicated syphilis, 10 with asymptomatic neurosyphilis and 10 with symptomatic neurosyphilis using an ultrasensitive single-molecule array assay; it was repeated a median of 12.5 months after neurosyphilis therapy. Serum NfL concentration was age-adjusted using a published formula.

Results

Age-adjusted serum NfL concentration was significantly higher in symptomatic neurosyphilis compared with each of the other 2 groups. It was above the highest value in uncomplicated syphilis in 1 of 10 participants with asymptomatic neurosyphilis and 3 of 10 with symptomatic neurosyphilis. Serum NfL concentration increased in 1 participant with asymptomatic neurosyphilis with possible treatment failure.

Conclusions

If confirmed in a larger study, serum NfL may be a useful adjunct for identifying central nervous system infection by Treponema pallidum.
International Smuggling of Illicit Drugs by Body Concealment at a Tertiary Hospital in Istanbul
Authors: Kaplan Onur , Sogut Ozgur
Published: October 2022

Smuggling of illicit substances by internal concealment has recently become a preferred method of international drug trade. The drug carriers are known as body packers. This study aimed to assess the demographic features and outcomes of body packers admitted to a referral center in Istanbul. Data were retrospectively evaluated from January 2017 to December 2019 from suspected body packers who were referred to the emergency department of a tertiary-care university by Istanbul Airport narcotics police due to suspected concealment of illicit drugs. Eighty-one cases were identified and included in this study. Of these, 71 subjects were confirmed to be body packers by radiological methods. The 15 women and 56 men had a mean age of 35 years. The most common nationality of the body packers was Nigerian, followed by Turkish and South African. Cocaine was the most commonly smuggled packet, followed by hashish, and heroin. All body packers were conservatively managed using laxatives or watchful waiting. No cases required surgical retrieval of packets. Abdominal radiography and computed tomography are useful tools for the evaluation of suspected body packers. The use of improved packaging material by smugglers and complications due to surgery and endoscopy make the conservative approach preferred.