bluuebunny/crossref_metadata_2025 huggingface dataset:
Flexible Working Arrangements (FWAs) in Malaysia: The Missing Component of the Right to Disconnect
Authors: Shaari SC , Amirul SR
Published: May 2023

Flexible Working Arrangements (FWAs), particularly working from home, are important to maintain a better work-life balance. The government of Malaysia has recently amended the Employment Act 1955 (Act 266) by incorporating the right of the employees to request for FWAs. However, the authors submit that the policymakers should have incorporated the right to disconnect (RTD) in the recent amendment. Thus, it is the objective of this article to explore the provisions of RTD as recently accepted in France and a few European Union (EU) countries; and the possibility of introducing the RTD into Malaysian legislation. In accomplishing the aim of this article, a doctrinal legal research methodology is deployed. It is submitted here that despite incorporating the FWAs in the Employment Act 1955, the policymakers should have embedded RTD as well. Otherwise, the employees’ work-life balance is at stake. It is concluded that man-made law is not sacrosanct. It must be modified over time to suit the changes in society. The findings will help in advancing the existing body of knowledge and give some ideas to the policymakers, especially the officers at the Ministry of Human Resources and the trade union officials.
The Restrictions on the Beach Tourism Destination Development as an Effort for Environmental Preservation
Authors: Pawestri A. , Wahyuliana I. , Nugroho L. D.
Published: May 2023

Tourism development on the one hand provides an increase in economic value, on the other hand, it raises environmental problems. Especially in beach tourist destinations. The emergence of many rides, redundant buildings in addition to core buildings such as prayer rooms and toilets, increases environmental problems and reduces comfort. This research aims, firstly, that the need to maintain and preserve the environment is one of human rights and secondly a form of restriction on the development of the development of beach tourist destinations to maintain environmental sustainability and the authenticity of tourist destinations. To answer these problems, this research uses normative legal research methods with a complementary statutory approach, concept approach and case approach. The research results obtained, first, tourism development must maintain environmental sustainability. Because a good living environment is part of human rights as a whole. Protecting and preserving the environment is also an obligation. Second, in the development of tourism, especially in beach tourism destinations, it is very necessary to pay attention to the principles of sustainable tourism development, one of the pillars is environmental preservation. By not carrying out excessive development, maintaining authenticity, to avoid long-term damage. So there needs to be restrictions on development.
Building Smart People In Overcoming Poverty In The Kendeng Mountain Area, Banyumas Regency
Authors: Tobirin T , Harsanto BT , Wahyuningrat W , Indiahono D
Published: May 2023

This article examines the Gunung Kendeng Area as a poor area, where the village does not have a source of village income, depending on its residents managing the village, as a result of which it is less than optimal in development and public services. The focus of this research is collaboration in developing villages through participatory roles in new perspectives in managing villages. This research method uses participatory action research with an approach and assistance to villagers. The data collection method is an in-depth Focus Group Discussion (FGD) interview, and data analysis using interactive analysis. The results of this study show that the Gunung Kendeng Area is a Janggolan Village Area that does not have village cash land and the original income of the village is minimal. However, rural communities have potential with high participation rates, a spirit of mutual aid, good social care, and organized social networks. Awareness to build networks and cooperation between stakeholders began to be established in poverty reduction.
Placing biofabrication into the context of human disease modeling
Authors: Zhang Yu Shrike , Alvarez Mario Moisés , Trujillo-de Santiago Grissel
Published: May 2023

The field of biofabrication has seen tremendous advances in the past decade. More recently, the emerging role of biofabrication in allowing faithful generation of models of human tissues in their healthy and diseased states has been demonstrated and has rapidly expanded. These biomimetic models are potentially widely applicable in a range of research and translational areas including but not limited to fundamental biology studies as well as screening of chemical compounds, such as therapeutic agents. The United States Food and Drug Administration Modernization Act 2.0, which now no longer requires animal tests before approving human drug trials, will likely further boost the field in the years to come. This Special Issue, with a collection of 11 excellent research articles, thus focuses on showcasing the latest developments of biofabrication towards human disease modeling, spanning from 3D (bo)printing to organ-on-a-chip as well as their integration.
Comparison of Different Modeling Approaches for Prescription Opioid Use and Its Association With Adverse Events
Authors: Kurteva Siyana , Abrahamowicz Michal , Beauchamp Marie-Eve , Tamblyn Robyn
Published: May 2023

Previous research linking opioid prescribing to adverse drug events has failed to properly account for the time-varying nature of opioid exposure. This study aimed to explore how the risk of opioid-related emergency department visits, readmissions, or deaths (composite outcome) varies with opioid dose and duration, comparing different novel modeling techniques. A prospective cohort of 1,511 hospitalized patients discharged from 2 McGill-affiliated hospitals in Montreal, 2014–2016, was followed from the first postdischarge opioid dispensation until 1 year after discharge. Marginal structural Cox proportional hazards models and their flexible extensions were used to explore the association between time-varying opioid use and the composite outcome. Weighted cumulative exposure models assessed cumulative effects of past use and explored how its impact depends on the recency of exposure. The patient mean age was 69.6 (standard deviation = 14.9) years; 57.7% were male. In marginal structural model analyses, current opioid use was associated with a 71% increase in the hazard of opioid-related adverse events (adjusted hazard ratio = 1.71, 95% confidence interval: 1.21, 2.43). The weighted cumulative exposure results suggested that the risk cumulates over the previous 50 days of opioid consumption. Flexible modeling techniques helped assess how the risk of opioid-related adverse events may be associated with time-varying opioid exposures while accounting for nonlinear relationships and the recency of past use.
Managing DNACPR Recommendations in Residential Care: Towards Improved Training for Social Care and Capacity Professionals
Authors: Fitton Emily , Kuylen Margot , Wyllie Aaron , Michalowski Sabine , Bhatt Vivek , Martin Wayne
Published: May 2023

The use of ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) recommendations has come under scrutiny during the COVID-19 pandemic, and the Care Quality Commission (CQC) has issued a call for new standards, guidance and training. One group for whom new training is required is ‘capacity professionals’ working in and with residential care facilities. These professionals (including Independent Mental Capacity Advocates and Best Interests Assessors) typically have a social work background and have specialist training regarding the 2005 Mental Capacity Act, the provisions of which have a direct relevance to DNACPR recommendations. We report on a survey and focus groups that probed the experiences of this professional group during the pandemic. We recruited 262 participants by approaching civil society organisations in which capacity professionals are well represented; twenty-two participated in follow-on focus groups. We used manifest content analysis and descriptive statistics to analyse the results. Our findings contribute to an emerging picture of what transpired in residential care homes during the first year of the pandemic and help to provide an empirical and normative basis for the development of the new guidance and training for which the CQC has called.
Immune checkpoint inhibitors and their interaction with proton pump inhibitors–related interstitial nephritis
Authors: Miao Jing , Herrmann Sandra M
Published: May 2023

Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy and outcomes, leading to an expanding use in millions of patients worldwide. However, they can cause a spectrum of immune-related adverse events (irAEs). Essentially, any organs can be affected by irAEs, which have emerged as therapy-limiting side effects. In the kidneys, ICI-associated acute interstitial nephritis (ICI-AIN) leads to acute kidney injury (AKI) in 2%–5% of patients on ICI therapy. AKI associated with ICI therapy pathologically presents with AIN in nearly 90% of the cases, but the pathophysiology of ICI-AIN remains to be defined. The generation of autoreactive T cells in patients receiving AIN-inducible drugs, such as proton pump inhibitors (PPIs), is one of the leading theories, supported by a higher incidence of ICI-AIN in patients on these AIN-inducible drugs. In this review, we will discuss our understanding of the incidence, potential pathophysiological mechanisms, clinical presentations, risk factors, diagnosis, and management of PPI-related AIN and its interaction with ICI therapy.
Safety and efficacy of pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) in patients with glomerular diseases who received rituximab
Authors: Sciascia Savino , Rilat Maria Letizia Antonietta , Fenoglio Roberta , Foddai Silvia Grazietta , Radin Massimo , Cecchi Irene , Cinnirella Giacoma , Crosasso Paola , Guidetti Maria Gabriella , Barinotti Alice , Baldovino Simone , Menegatti Elisa , Roccatello Dario
Published: May 2023

Background

Patients on B-cell-depleting agents may have a suboptimal response to vaccination, placing them at a higher risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or suffering from a more severe prognosis. Indeed, available data on pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) in subjects with glomerular diseases (GDs) who received rituximab are limited.

Methods

We conducted a prospective study analysing the safety and efficacy of tixagevimab/cilgavimab for pre-exposure prophylaxis in patients with GDs who received rituximab in the previous 12 months. The rates of symptomatic infections and hospitalizations were compared with those for patients with GD treated with rituximab who refused to receive tixagevimab/cilgavimab.

Results

Tixagevimab/cilgavimab was administered to 22 patients (12 females, mean age 58.4 ± 19.6 years) with GD diagnoses including membranous nephropathy, lupus nephritis, anti-neutrophil cytoplasmic antibody–associated vasculitis and focal segmental glomerulosclerosis. No patient treated with tixagevimab/cilgavimab experienced symptomatic infection with SARS-CoV-2 during the follow-up (mean observation time of follow-up was 112 ± 23 days), while 11 of 28 controls (39.3%) reported a symptomatic infection (P = .0001), requiring hospitalization in 2 cases. Reported adverse events were mild, namely self-limiting headache [4], discomfort at the injection site [3], flu-like symptoms/myalgia [3] and fever [1]. No serious adverse events (e.g. cardiac events, anaphylaxis) were reported.

Conclusion

Pre-exposure prophylaxis with tixagevimab/cilgavimab seems safe and lowered the risk of symptomatic SARS-CoV-2 infection by ≈40% in vaccinated subjects with GD who received anti-CD20 therapy. Possible applications in the subset of patients who need immunosuppressive therapy, especially with rituximab, in a pandemic setting might be envisaged.
Can we reverse arterial stiffness by intervening on CKD-MBD biomarkers?
Authors: Vervloet Marc G
Published: May 2023

The increased cardiovascular risk of chronic kidney disease may in part be the consequence of arterial stiffness, a typical feature of kidney failure. Deranged homeostasis of minerals and hormones involved (CKD-MBD), are also strongly associated with this increased risk. It is well established that CKD-MBD is a main driver of vascular calcification, which in turn worsens arterial stiffness. However, there are other contributors to arterial stiffness in CKD than calcification. An overlooked possibility is that CKD-MBD may have detrimental effects on this potentially better modifiable component of arterial stiffness. In this review, the individual contributions of short-term changes in calcium, phosphate, PTH, vitamin D, magnesium, and FGF23 to arterial stiffness, in most studies assessed as pulse wave velocity, is summarized. Indeed, there is evidence from both observational studies and interventional trials that higher calcium concentrations can worsen arterial stiffness. This, however, has not been shown for phosphate, and it seems unlikely that, apart from being a contributor to vascular calcification and having effects on the microcirculation, phosphate has no acute effect on large artery stiffness. Several interventional studies, both by infusing PTH and by abrupt lowering PTH by calcimimetics or surgery, virtually ruled out direct effects on large artery stiffness. A well-designed trial using both active and nutritional vitamin D as intervention found a beneficial effect for the latter. Unfortunately, the study had a baseline imbalance and other studies did not support its finding. Both magnesium and FGF23 do not seem do modify central arterial stiffness.
Relative apical sparing in cardiac amyloidosis is not always explained by an amyloid gradient
Authors: De Gaspari Monica , Sinigiani Giulio , De Michieli Laura , Della Barbera Mila , Rizzo Stefania , Thiene Gaetano , Iliceto Sabino , Perazzolo Marra Martina , Mele Donato , Basso Cristina , Cipriani Alberto
Published: May 2023

Aims

Myocardial longitudinal strain (LS) by two-dimensional (2D) speckle-tracking echocardiography has a diagnostic and prognostic role in cardiac amyloidosis (CA). Typically, the apical segments of the left ventricle (LV) are less affected by LS abnormalities, a finding called relative apical sparing (RELAPS). Whether a variable burden of CA might explain the RELAPS remains unknown.

We aimed to evaluate the extent, distribution, and deposition pattern of amyloid in autopsy hearts of CA patients and to correlate the histopathology findings with 2D echocardiography.

Methods and results

This is a retrospective study of whole heart specimens of CA patients who died and underwent autopsy and 2D echocardiography. Amyloid burden quantification was assessed by histomorphometry in each segment at different LV levels. The LS analysis results were compared with the amyloid burden and the base-to-apex distribution.

Histopathology investigation of 27 hearts with CA [immunoglobulin light chains (AL) 17 cases and transthyretin (ATTR) 10 cases] demonstrated an amyloid base-to-apex gradient. In 11 CA patients with 2D echocardiography, analysis of LS and histological amyloid burden allowed to identify different patterns: RELAPS (8 cases, 73%), with (2) or without (6) amyloid gradient, normal or mildly reduced LS with diffuse low amyloid (2, 18%), and severely reduced LS with diffuse high amyloid (1, 9%).

Conclusion

The typical RELAPS pattern at echocardiography is not always explained by a base-to-apex gradient of amyloid burden at histopathology, suggesting that RELAPS might be an epiphenomenon of complex interactions among amyloid infiltration, myocardial structure, and adaptation.
Bacterial extracellular electron transfer in plant and animal ecosystems
Authors: Stevens Eric , Marco Maria L
Published: May 2023

Extracellular electron transfer (EET) is a bioelectrochemical process performed by electrochemically active bacteria (EAB) found in host-associated environments, including plant and animal ecosystems and fermenting plant- and animal-derived foods. Through direct or mediated electron transfer pathways, certain bacteria use EET to enhance ecological fitness with host-impacting effects. In the plant rhizosphere, electron acceptors support the growth of EAB such as Geobacter, cable bacteria, and some clostridia that can result changing iron and heavy metal uptake by plants. In animal microbiomes, EET is associated with diet-derived iron in the intestines of soil-dwelling termites, earthworms, and beetle larvae. EET is also associated with the colonization and metabolism of some bacteria in human and animal microbiomes, such as Streptococcus mutans in the mouth, Enterococcus faecalis and Listeria monocytogenes in the intestine, and Pseudomonas aeruginosa in the lungs. During the fermentation of plant tissues and bovine milk, lactic acid bacteria like Lactiplantibacillus plantarum and Lactococcus lactis may use EET to increase their growth and food acidification, as well as decrease environmental oxidation–reduction potential. Thus, EET is likely an important metabolic pathway for host-associated bacteria and has implications for ecosystem function, health and disease, and biotechnological applications.
Association Between Serum GDF15 Concentration and Total Mortality in Community-Dwelling Japanese Older Populations: The Involvement of Renal Dysfunction
Authors: Fujita Yasunori , Shinkai Shoji , Taniguchi Yu , Miura Yuri , Tanaka Masashi , Ohsawa Ikuroh , Kitamura Akihiko , Ito Masafumi
Published: May 2023

Background

Serum growth differentiation factor 15 (GDF15) is associated with age-related adverse outcomes. However, renal function has not been thoroughly evaluated in studies addressing the association between GDF15 and mortality. We aimed to clarify whether GDF15 is associated with total mortality after carefully controlling renal function markers.

Methods

We divided 1 801 community-dwelling Japanese older adults into quartiles according to their serum GDF15 concentrations. The correlation of GDF15 with renal function and inflammation markers was assessed by calculating Spearman correlation coefficients. Cumulative survival rates of the quartiles were estimated. In a Cox regression analysis adjusted for confounders, the association between GDF15 and mortality was evaluated. The discriminative capacity of GDF15 for the prediction of mortality was assessed with receiver-operating characteristic analysis.

Results

GDF15 was correlated with cystatin C (r = 0.394), β2-microglobulin (r = 0.382), C-reactive protein (r = 0.124), and interleukin-6 (r = 0.166). The highest GDF15 quartile showed poor survival compared to the others. Older adults with higher GDF15 were associated with an increased mortality risk, independent of demographics and clinically relevant variables (hazard ratio [95% confidence interval]: 1.98 [1.09–3.59]). This significant association disappeared when additionally adjusted for cystatin C (1.65 [0.89–3.05]) or β2-microglobulin (1.69 [0.91–3.12]). The ability to predict mortality was approximately comparable between GDF15 (area under the curve: 0.667), cystatin C (0.691), and β2-microglobulin (0.715).

Conclusions

Serum GDF15 is associated with total mortality in older Japanese after adjustment for major confounders. The increased mortality risk in older adults with higher GDF15 may be partly attributed to decreased renal function.
The Infectious Diseases Specialist, At Risk of Extinction
Authors: Reece Rebecca , Beckwith Curt G
Published: May 2023

The results of the Infectious Diseases (ID) fellowship match over the past decade have raised concerns that the future of our specialty is in peril, despite the unprecedented demand for ID expertise as exemplified by the COVID-19 pandemic. While there was a modest increase in ID fellowships applicants attributable to the pandemic, the disappointing 2023 match results indicate that the increase was short-lived. Multiple factors contribute to low interest in ID including but not only low salaries relative to other specialties. Solutions to grow the ID workforce are urgently needed and are critical to the public health of this nation.
Application of metagenomic next-generation sequencing in the diagnosis and resistome analysis of community-acquired pneumonia pathogens from bronchoalveolar lavage samples
Authors: Chen Shenglin , Hou Chenrui , Kang Yutong , Li Dan , Rong Jianrong , Li Zhenjun
Published: May 2023

Aims

To perform a prospective diagnostic study exploring the clinical utility of metagenomic next-generation sequencing (mNGS) in diagnosing community-acquired pneumonia (CAP), and revealing resistome differences in bronchoalveolar lavage fluid (BALF) from CAP patients with varying severity of admission base on Pneumonia Patient Outcomes Research Team (PORT) risk classes.

Methods and results

We compared the diagnostic performances of mNGS and conventional testing for the detection of pathogens in BALF from 59 CAP patients, and performed resistome differences analysis of metagenomic data from 59 BALF samples, namely, 25 from CAP patients with PORT score I (I group), 14 from CAP patients with PORT score II (II group), 12 from CAP patients with PORT score III (III group), and 8 from CAP patients with PORT score IV (IV group). The diagnostic sensitivities of mNGS and conventional testing for the detection of pathogens in BALF in patients with CAP were 96.6% (57/59) and 30.5% (18/59), respectively. There was a significant difference in the overall relative abundance of resistance genes between the four groups (P = 0.014). The results of principal coordinate analysis based on Bray–Curtis dissimilarities showed that there were significant differences in the composition of resistance genes among the I, II, III, and IV groups (P = 0.007). A large number of antibiotic resistance genes, such as those affiliated with multidrug, tetracycline, aminoglycoside, and fosfomycin resistance, were enriched in the IV group.

Conclusions

In conclusion, mNGS has a high diagnostic value in CAP. There were significant differences present in microbiota resistance to antibiotics in BALF from CAP patients in different PORT risk classes, which should attract enough attention.
Regional Anesthesia and Acute Pain Management for Adult Patients with Burns
Authors: Wardhan Richa , Fahy Brenda G
Published: May 2023

Patients with burns suffer from excruciating pain, thus presenting unique challenges to the hospital staff involved in their care. Any hospital system may be involved in managing smaller and less serious burns, but patients with more complicated issues are often transferred to a burn center. This article will review the pathophysiological evolution of pain immediately after burn injury to emphasize the role of complex inflammatory pathways involved in the progression of burn pain. This review also focuses on managing acute pain using a combined multimodal and regional pain management approach. Finally, we attempt to address the continuum from acute to chronic pain management and the strategies used to minimize and manage the progression to chronic pain. Chronic pain remains a debilitating outcome of burn injury, and this article discusses efforts to mitigate this complication. Available options for pain treatment are important to discuss, as current drug shortages may limit medications that can be used.
Structural Change within the Services Sector and the Future of Cost Disease
Authors: Duernecker Georg , Herrendorf Berthold , Valentinyi Ákos
Published: May 2023

In his seminal work, Baumol observed that developed economies suffer from cost disease, i.e., aggregate productivity growth falls because structural change reallocates production to services with low productivity growth. We document that cost disease importantly contributed to the productivity growth slowdown in the postwar U.S. To assess how severe cost disease may become, we build a model of structural change among the goods sector and broad services sectors. Calibrating the model to the postwar U.S. implies that broad categories of services are substitutes and the services with low productivity growth do not take over production. Simulating the calibrated model forward implies that future cost disease will be less severe than the past one.
Strangulated diverticulum: a new acute complication of small bowel diverticulosis
Authors: Pajtak Renata , Ramadan Abdullah , Strauss Paul
Published: May 2023

Complicated jejunal diverticulosis is a difficult entity to diagnose, which can cause significant morbidity and mortality. We present the case of an 88-year-old female who presented with a unique complication of small bowel diverticulosis progressing to a strangulated diverticulum requiring emergency surgery. We present the case of an 88-year-old female who presented with abdominal pain associated with a new mass on a background of perforated diverticulitis and previous laparoscopic abdominal surgeries for division of adhesions. Due to high suspicion for the mass containing necrotic bowel, the patient was taken directly to theatre for an exploratory laparotomy and was found to have ischaemic small bowel secondary to a strangulated jejunal diverticulum. When evaluating the acute abdomen consideration should be given to the diagnosis of a strangulated jejunal diverticulum causing ischaemic small bowel, with a view to expedite to emergency surgery as the primary treatment.
Mechanical indications for inflatable penile prosthesis revision: analysis and implications for revision surgery
Authors: Smelser Ashton M , VanDyke Maia E , Nealon Samantha W , Badkhshan Shervin , Langford Brian T , Peedikayil Josh , El-Eishy Al-Frooq , Monaghan Thomas F , Sanders Sarah C , Franzen Bryce P , Morey Allen F
Published: May 2023

Background

Despite technical advancements, inflatable penile prostheses (IPPs) are inherently at risk of mechanical failure given their nature as hydraulic devices.

Aim

To characterize IPP component failure location at the time of device revision and stratify by manufacturer: American Medical Systems (Boston Scientific [BSCI]) and Coloplast (CP).

Methods

A retrospective review of penile prosthesis cases from July 2007 to May 2022 was conducted, identifying men who underwent revision surgery. Cases were excluded if documentation did not denote the cause of failure or the manufacturer. Mechanical indications for surgery were categorized by location (eg, tubing, cylinder, or reservoir leak; pump malfunction). Nonmechanical revisions were excluded (component herniation, erosion, or crossover). Categorical variables were assessed with Fisher exact or chi-square analysis; Student t-test and Mann-Whitney U test were used for continuous variables.

Outcomes

Primary outcomes included specific location of IPP mechanical failure among BSCI and CP devices and time to mechanical failure.

Results

We identified 276 revision procedures, 68 of which met inclusion criteria (46 BSCI and 22 CP). Revised CP devices were longer than BSCI devices (median cylinder length, 20 vs 18 cm; P < .001). Log-rank analysis revealed a similar time to mechanical failure between brands (P = .096). CP devices failed most often due to tubing fracture (19/22, 83%). BSCI devices had no predominant site of failure. Between manufacturers, tubing failure was more common in CP devices (19/22 vs 15/46 for BSCI, P < .001), while cylinder failure was more common among BSCI devices (10/46 vs 0/22 for CP, P = .026).

Clinical Implications

The distribution of mechanical failure is significantly different between BSCI and CP devices; this has implications regarding the approach to revision surgery.

Strengths and Limitations

This is the first study to directly compare when and where mechanical failure occurs in IPPs and to compare the 2 main manufacturers head-to-head. This study would be strengthened by being repeated in a multi-institutional fashion to provide more robust and objective evaluation.

Conclusion

CP devices commonly failed at the tubing and rarely elsewhere, while BSCI devices showed no predominant failure site; these findings may inform decision making regarding revision surgery.
An Analytic Equation for Assessing the Thickness of Titanium Nitride Coatings by Energy Dispersive X-ray Spectroscopy in the Scanning Electron Microscope
Authors: Cruz Juan Pablo Nicolás , Garzón Carlos Mario , Recco Abel André C
Published: May 2023

In this study, a methodology for assessing the thickness of titanium nitride (TiN) coatings by energy dispersive X-ray spectroscopy (EDS) in the scanning electron microscope is explored. A standardless method is applied, where the film thickness (th) is related to the microscope accelerating voltage (V0), the type of substrate and the ratio between the more intense peaks in the EDS spectrum, arising from both the substrate and the coating (afterwards called the I-ratio, IR). Three different substrates covered with TiN were studied, namely, silicon, glass, and stainless steel. Monte Carlo simulations enabled to state an analytic equation, which allows assessing the coating thickness as follows:th=thcr⋅exp[−βIR1/n]where IR = Iksubstrate/Ikcoating, thcr (critical thickness) is the largest coating thickness, which is assessable at a fixed V0, β is a multiplication factor, and n is an exponent, where thcr, β and n are assessable from V0 and substrate type. Interpolation via the equation presented, using reference thicknesses, allowed thickness predictions with around 80% of datapoints differing less than around 2% from the reference value. A procedure for detecting variations as low as 1.0% in coating thickness regarding the nominal thickness is presented.
The Metallic Sounds: A Microanalytical Study on the Production of Armenian Church Bells from Iran
Authors: Oudbashi Omid , Khoobroo Zeinab , Khachatour Zoya
Published: May 2023

There are a considerable number of church bells in museums, examples include the museum of the Vank Cathedral and the Treasury of Armenian Music in New Julfa, both located in Isfahan, Iran. These objects were collected from different Armenian churches and cathedrals in Iran and were dated to ca. 400–100 years ago. Due to the long history of Armenians in Iran and their important role in its cultural and architectural development, study of the production technologies they utilized is a subject of interest for art historians and scientists. Three metallic bells from the Treasury of Armenian Music in New Julfa were selected for a multianalytical study to investigate their manufacturing methods, using micro-XRF, scanning electron microscopy–energy dispersive X-ray spectroscopy (SEM–EDS), and metallography techniques. The results showed that the bells were produced with a binary tin bronze alloy with 13 to 20 wt% of tin, classified as either low-tin or high-tin bronze, depending on the concentration. The analysis showed a two-phase cast microstructure consisting of the α solid solution with significant amounts of interdendritic α + δ eutectoid. The results also indicate that the bells are cast first, but some evidence of complementary thermomechanical operations is visible in their microstructure.
Senior Aviator Medical Qualification Status
Authors: Wallace Scott A
Published: May 2023

Introduction

Aviation personnel are expensive to train and challenging for the services to retain because of lucrative opportunities in the civilian aviation sector and a desire among pilots for agency. The military services’ retention efforts have typically utilized a combination of high continuation pays and longer service commitments of up to 10 years following initial training. One area that the services have overlooked in their attempts to retain senior aviators is quantifying and reducing medical disqualifications. Much as aging aircraft require increasing maintenance to retain full operational capability, so may pilots and other aircrew members.

Materials and Methods

This article reports on a prospectively collected cross-sectional research study evaluating the medical status of senior aviation personnel who reported being considered or selected for command. The study was deemed exempt from human subjects research by the Institutional Review Board and a waiver of Health Insurance Portability and Accountability Act was granted. The study, which collected data at the Pentagon Flight Medical Clinic over 1 year, used a chart review of routine medical encounters and flight physicals to collect descriptive data. The goals of the study were to establish the prevalence of medically disqualifying conditions, assess the association between disqualifying conditions and age, and generate hypotheses for further research. Logistic regression of waiver need was performed for variables including prior waivers, waiver count, service, platform, age, and gender. ANOVA of readiness percentages vs. DoD targets were assessed between the services individually and in aggregate.

Results

The study demonstrated medical readiness rates among command-eligible senior aviators ranging from 74% for the Air Force to 40% for the Army with the Navy and Marine Corps in the middle. The sample was insufficiently powered to demonstrate differences in readiness between the services; however, the population as a whole was significantly below the DoD’s readiness target of >90% (P = .000).

Conclusions

None of the services met the DoD minimum readiness target of 90%. Markedly higher readiness was observed in the Air Force, the only service with a medical screening incorporated into its command selection process, but this difference was not statistically significant. Waivers increased with age and musculoskeletal concerns were common. A larger prospective cohort study should be considered to further elucidate and confirm the findings of this study. If further research confirms these findings, consideration should be made of screening command applicants for medical readiness.
Three approaches for the classification of protoneutron star oscillation modes
Authors: Rodriguez M C , Ranea-Sandoval Ignacio F , Chirenti C , Radice D
Published: May 2023

The future detection of gravitational waves (GWs) from a Galactic core-collapse supernova will provide information on the physics inside protoneutron stars (PNS). In this work, we apply three different classification methods for the PNS non-radial oscillation modes: Cowling classification, Generalized Cowling Nomenclature (GCN), and a classification based on modal properties (CBMP). Using PNS models from 3D simulations of core-collapse supernovae, we find that in the early stages of the PNS evolution, typically 0.4 s after the bounce, the Cowling classification is inconsistent, but the GCN and the CBMP provide complementary information that helps to understand the evolution of the modes. In the GCN, we note several avoided crossings as the mode frequencies evolve at early times, while the CBMP tracks the modes across the avoided crossings. We verify that the strongest emission of GWs by the PNS corresponds to the f mode in the GCN, indicating that the mode trapping region alternates between the core and the envelope at each avoided crossing. At later times, approximately 0.4 s after the bounce, the three classification methods present a similar description of the mode spectrum. We use our results to test universal relations for the PNS modes according to their classification and find that the behaviour of the universal relations for f and p modes is remarkably simple in the CBMP.
Interplanetary scintillation and pulsar pulse statistics
Authors: Tyul’bashev S A , Chashei I V , Kitaeva M A
Published: May 2023

The effect of interplanetary plasma on pulsed pulsar radiation passing through is considered. The pulses of two rotating radio transients (J0609+16 and J1132+25) and a pulsar (B0320+39) detected on the Large Phased Array (Pushchino observatory) were analysed. It is shown that in observations at the frequency of 111 MHz, on elongations of 20°–40°, both an increase and a decrease in the number of received pulses are observed. The change in the number of pulses is explained by the distortion of the energy distribution of pulses due to interplanetary scintillation. These changes in the number of observed pulses are in qualitative agreement with the expected dependence of the scintillation index on the observed sources elongation. Analytical expressions are obtained that allow estimating the effective modulation index from observations of individual pulses for the power distribution of pulses by energy.
Capromys pilorides (Rodentia: Echimyidae)
Authors: Caballero Silva Hansel , Mancina Carlos A
Published: May 2023

Capromys pilorides (Say, 1822), Desmarest’s hutia, is one of the world’s largest rodents; body mass of adults typically exceeds 3 kg. It occurs only on Cuba, although fossil remains from the late Quaternary Period have been found on the Cayman Islands. Capromys pilorides is widely distributed throughout the Cuban archipelago where it occurs at elevations from sea level to 1,200 m. Capromys pilorides can be terrestrial or arboreal depending on habitat and has a generalist phytophagous diet. It forms social groups and has a polygynous mating system. The conservation status of Capromys pilorides was most recently assessed in 2008, and it is currently listed as “Least Concern” (LC) by the International Union for Conservation of Nature and Natural Resources Red List of Threatened Species.
A single-cell map of antisense oligonucleotide activity in the brain
Authors: Mortberg Meredith A , Gentile Juliana E , Nadaf Naeem M , Vanderburg Charles , Simmons Sean , Dubinsky Dan , Slamin Adam , Maldonado Salome , Petersen Caroline L , Jones Nichole , Kordasiewicz Holly B , Zhao Hien T , Vallabh Sonia M , Minikel Eric Vallabh
Published: May 2023

Antisense oligonucleotides (ASOs) dosed into cerebrospinal fluid (CSF) distribute broadly throughout the central nervous system (CNS). By modulating RNA, they hold the promise of targeting root molecular causes of disease and hold potential to treat myriad CNS disorders. Realization of this potential requires that ASOs must be active in the disease-relevant cells, and ideally, that monitorable biomarkers also reflect ASO activity in these cells. The biodistribution and activity of such centrally delivered ASOs have been deeply characterized in rodent and non-human primate (NHP) models, but usually only in bulk tissue, limiting our understanding of the distribution of ASO activity across individual cells and across diverse CNS cell types. Moreover, in human clinical trials, target engagement is usually monitorable only in a single compartment, CSF. We sought a deeper understanding of how individual cells and cell types contribute to bulk tissue signal in the CNS, and how these are linked to CSF biomarker outcomes. We employed single nucleus transcriptomics on tissue from mice treated with RNase H1 ASOs against Prnp and Malat1 and NHPs treated with an ASO against PRNP. Pharmacologic activity was observed in every cell type, though sometimes with substantial differences in magnitude. Single cell RNA count distributions implied target RNA suppression in every single sequenced cell, rather than intense knockdown in only some cells. Duration of action up to 12 weeks post-dose differed across cell types, being shorter in microglia than in neurons. Suppression in neurons was generally similar to, or more robust than, the bulk tissue. In macaques, PrP in CSF was lowered 40% in conjunction with PRNP knockdown across all cell types including neurons, arguing that a CSF biomarker readout is likely to reflect ASO pharmacodynamic effect in disease-relevant cells in a neuronal disorder. Our results provide a reference dataset for ASO activity distribution in the CNS and establish single nucleus sequencing as a method for evaluating cell type specificity of oligonucleotide therapeutics and other modalities.
Microbial sensing in the intestine
Authors: Wan Tingting , Wang Yalong , He Kaixin , Zhu Shu
Published: May 2023

The gut microbiota plays a key role in host health and disease, particularly through their interactions with the immune system. Intestinal homeostasis is dependent on the symbiotic relationships between the host and the diverse gut microbiota, which is influenced by the highly co-evolved immune–microbiota interactions. The first step of the interaction between the host and the gut microbiota is the sensing of the gut microbes by the host immune system. In this review, we describe the cells of the host immune system and the proteins that sense the components and metabolites of the gut microbes. We further highlight the essential roles of pattern recognition receptors (PRRs), the G protein-coupled receptors (GPCRs), aryl hydrocarbon receptor (AHR) and the nuclear receptors expressed in the intestinal epithelial cells (IECs) and the intestine-resident immune cells. We also discuss the mechanisms by which the disruption of microbial sensing because of genetic or environmental factors causes human diseases such as the inflammatory bowel disease (IBD).
Exploration of Somatosensory Function of Patients With Acute Nonspecific Neck Pain, Through Quantitative Sensory Testing and Self-reported Symptoms
Authors: Bontinck Jente , Chys Marjolein , Coppieters Iris , Meeus Mira , Cagnie Barbara
Published: May 2023

Objectives:

Adaptations in somatosensory function characterize several chronic pain conditions, including nonspecific neck pain (NNP). Early signs of central sensitization (CS) contribute to pain chronification and poor treatment responses after conditions such as whiplash injury and low back pain. Despite this well-established association, the prevalence of CS in patients with acute NNP, and accordingly, the potential impact of this association, is still unclear. Therefore, this study aimed to investigate whether changes in somatosensory function occur during the acute phase of NNP.

Methods:

This cross-sectional study compared 35 patients with acute NNP with 27 pain-free individuals. All participants completed standardized questionnaires and an extensive multimodal Quantitative Sensory Testing protocol. A secondary comparison was made with 60 patients, with chronic whiplash-associated disorders, a population wherein CS is well-established.

Results:

Compared with pain-free individuals, pressure pain thresholds (PPTs) in remote areas and thermal detection and pain thresholds were unaltered. However, patients with acute NNP showed lower cervical PPTs and conditioned pain modulation, higher temporal summation, Central Sensitization Index scores, and pain intensity. Compared with the group with chronic whiplash-associated disorders, PPTs did not differ at any location, yet the Central Sensitization Index scores were lower.

Discussion:

Changes in somatosensory function occur already in acute NNP. Local mechanical hyperalgesia demonstrated peripheral sensitization, while enhanced pain facilitation, impaired conditioned pain modulation, and self-reported symptoms of CS suggest adaptations in pain processing already early in the stage of NNP.
Prevalence and Risk Factors for Chronic Postsurgical Pain after Cardiac Surgery: A Single-center Prospective Cohort Study
Authors: Xiao Maggie Z. X. , Khan James S. , Dana Elad , Rao Vivek , Djaiani George , Richebé Philippe , Katz Joel , Wong Dorothy , Clarke Hance
Published: May 2023

Background

Chronic postsurgical pain is a common complication of surgery. The role of psychologic risk factors like depression and anxiety is substantially understudied in cardiac surgery. This study sought to identify perioperative factors associated with chronic pain at 3, 6, and 12 months after cardiac surgery. The authors hypothesize that baseline psychologic vulnerabilities have a negative influence on chronic postsurgical pain.

Methods

The authors prospectively collected demographic, psychologic, and perioperative factors in a cohort of 1,059 patients undergoing cardiac surgery at the Toronto General Hospital between 2012 and 2020. Patients were followed and completed chronic pain questionnaires at 3, 6, and 12 months after surgery.

Results

The study included 767 patients who completed at least one follow-up questionnaire. The incidence of postsurgical pain (more than 0 out of 10) at 3, 6, and 12 months after surgery was 191 of 663 (29%), 118 of 625 (19%), and 89 of 605 (15%), respectively. Notably, among patients reporting any pain, the incidence of pain compatible with a neuropathic phenotype increased from 56 of 166 (34%) at 3 months to 38 of 97 (39%) at 6 months and 43 of 67 (64%) at 12 months. Factors associated with postsurgical pain scores at 3 months include female sex, pre-existing chronic pain, previous cardiac surgery, preoperative depression, baseline pain catastrophizing scores, and moderate-to-severe acute pain (4 or more out of 10) within 5 postoperative days.

Conclusions

Nearly one in three patients undergoing cardiac surgery reported pain at 3 months of follow-up, with approximately 15% reporting persistent pain at 1 yr. Female sex, pre-existing chronic pain, and baseline depression were associated with postsurgical pain scores across all three time periods.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Examining regulatory focus in the acceleration and deceleration of engagement and exhaustion cycles among nurses
Authors: Paustian-Underdahl Samantha C. , Halbesleben Jonathon R. B. , Carlson Dawn S. , Hamadi Hanadi Y.
Published: May 2023

Background

Given that emotional exhaustion and nurse engagement have significant implications for nurse well-being and organizational performance, determining how to increase nurse engagement while reducing nurse exhaustion is of value.

Purpose

Resource loss and gain cycles, as theorized in conservation of resources theory, are examined using the experience of emotional exhaustion to evaluate loss cycles and work engagement to evaluate gain cycles. Furthermore, we integrate conservation of resources theory with regulatory focus theory to examine how the ways in which individuals approach work goals serves as a facilitator to the acceleration and deceleration of both of these cycles.

Methodology/Approach

Using data from nurses working in a hospital in the Midwest United States at six time points spanning over 2 years, we demonstrate the accumulation effects of the cycles over time using latent change score modeling.

Results

We found that prevention focus was associated with the accelerated accumulation effects of emotional exhaustion and that promotion focus was associated with the accelerated accumulation effects of work engagement. Furthermore, prevention focus attenuated the acceleration of engagement, but promotion did not influence the acceleration of exhaustion.

Conclusion

Our findings suggest that individual factors such as regulatory focus are key to helping nurses to better control their resource gain and loss cycles.

Practice Implications

We provide implications for nurse managers and health care administrators to help encourage promotion focus and suppress prevention focus in the workplace.