bluuebunny/crossref_metadata_2025 huggingface dataset:
Parental attitudes, beliefs, and practices related to firearm storage: a qualitative study
Authors: Schenck Christopher , Wilson Meghan , Tiyyagura Gunjan , Bechtel Kirsten
Published: December 2022

Background

Firearm injury is a leading cause of death among children. Safer firearm storage practices are associated with a reduced risk of childhood suicide and unintentional firearm death. However, these practices are underutilized. The objective of this study was to characterize parental attitudes and beliefs related to firearm storage and identify facilitators and barriers to safer storage practices.

Methods

Semi-structured, qualitative interviews were conducted to identify motivations for using different storage methods among parents who kept firearms in southern Connecticut. The constant comparative method was used to code interview transcripts and derive themes directly from the data.

Results

Twenty participants completed the study. 60% were male, 90% were white, and all were between 32 and 53 years old. 85% of participants stored firearms locked, 60% unloaded, 65% kept ammunition locked or did not keep ammunition in their home, and 45% stored ammunition separate from firearms. The following themes were identified: (1) firearm storage must be compatible with a specific context of use; (2) some parents engage in higher-risk storage because they believe it is adequate to reduce the risk of injury; (3) firearm practices are influenced by one’s social network and lived experience; (4) parents who own firearms may be amenable to changing storage practices; and (5) parents’ conceptualization of firearm injury prevention is multimodal, involving storage, education, and legislation.

Conclusions

Parents who keep firearms value convenience and utility, which may be at odds with safer storage practices; however, some may be amenable to adopting safer practices. Family and peer relationships, education, and legislation represent important facilitators of storage practices. Understanding parental attitudes and beliefs on firearm storage may inform future interventions to improve storage practices.
Effects of the COVID-19 pandemic on the pediatric emergency department: a single institution experience
Authors: Masler Isabella V. , Shah Nipam , Duerring Shea A. , Monroe Kathy R.
Published: December 2022

Background

The COVID-19 pandemic resulted in drastic decreases in volume for most pediatric emergency departments (ED). Injuries have persisted and there is concern that injuries may have increased during the pandemic. This study evaluates the impact of the COVID-19 pandemic on ED patient trends at a freestanding children’s hospital.

Results

Despite an average annual increase of 1100 patients per year between 2017 and 2019, this ED saw a decrease of over 25,000 patients in 2020. The number of trauma alerts increased from 341 in 2017 to 571 in 2020 and those numbers remained stable (568–571) in 2020 compared to 2019. The percent of total volume accounted for by trauma alerts increased from 0.65 to 1.2% between 2019 and 2020 (following the trend of 0.48% in 2017 to 0.56% in 2018). Historically, motor vehicle crashes account for the majority of the trauma alerts, though the number of trauma alerts from firearm-related injuries increased from 36 per year in 2018 to 44 in 2019 to 66 (12% of total trauma alerts) in 2020.

Conclusions

While total volumes of patients being seen decreased, the number of trauma alerts remained stable resulting in an increased percentage of trauma alert patients. This indicates that severe injuries requiring trauma alert activation did not diminish during the pandemic. These trends have implications for prevention as well as implications for ED staffing. Changing trends in types of severe injuries are noted.
All-terrain vehicle exposure and the association of certified training on adolescent safety behaviors and crash experiences
Authors: Jennissen Charles A. , Champoux Katharine L. , Hoogerwerf Pamela J. , Wetjen Kristel M. , Mulford Lauren J. , Schaeffer Sienna E. , Okoro Uche E. , Denning Gerene M.
Published: December 2022

Background

Certified training courses in all-terrain vehicle (ATV) operation are recommended, but little has been published regarding how they affect riding behaviors. Our objectives were to determine adolescents’ ATV riding exposures, crashes and injuries, and the association of completing certified ATV training on riding behaviors.

Methods

Respondents completed an anonymous paper survey at 30 school districts approximately one year after participating in the Safety Tips for ATV Riders (STARs) program. Survey data were compiled using Qualtrics™. Frequency, chi-square, Fisher’s exact test, and logistic regression analyses were performed using SAS, V.9.4.

Results

4,891 students completed the survey from Fall 2012–Fall 2019. Respondents were 10–18 years old, and similar numbers of participants were male and female. Fifty-nine percent lived in town, 18% on a farm, and 22% in the country but not on farm. Forty-two percent reported their families owned an ATV. Seventy-seven percent had ridden an ATV, 40% of whom reported riding at least weekly. The vast majority (94%) used ATVs for recreation and 49% used them for work purposes. In the previous year, 22% of riders reported having been in a crash, with 7% of crash victims requiring medical attention for injuries. Greater crash likelihood was seen in males, recreational riders, more frequent riders, competitive racers and those who had ridden with passengers or on roads. Only 8% of riders had completed certified ATV safety training (note, STARs is not a certification program). Those whose families owned ATVs, more frequent riders, and public park users had greater likelihoods of course completion. Relative to their peers, respondents who completed a certification course had higher proportions that always/almost always wore helmets (39% vs. 20%, p < 0.0001) and lower proportions that never/almost never wore helmets (29% vs 58%, p < 0.0001), had ridden with passengers (63% vs. 96%, p < 0.0001), and had driven on public roads (41% vs 50%, p = 0.0065).

Conclusions

ATV safety training certification among Iowa adolescents in the study was infrequent but those that received training reported higher helmet use, less riding with passengers, and less driving on public roads. These data suggest completing safety training certification may promote safer riding behaviors among youth.
Intra- and inter-operator variability in MRI-based manual segmentation of HCC lesions and its impact on dosimetry
Authors: Covert Elise C. , Fitzpatrick Kellen , Mikell Justin , Kaza Ravi K. , Millet John D. , Barkmeier Daniel , Gemmete Joseph , Christensen Jared , Schipper Matthew J. , Dewaraja Yuni K.
Published: December 2022

Purpose

The aim was to quantify inter- and intra-observer variability in manually delineated hepatocellular carcinoma (HCC) lesion contours and the resulting impact on radioembolization (RE) dosimetry.

Methods

Ten patients with HCC lesions treated with Y-90 RE and imaged with post-therapy Y-90 PET/CT were selected for retrospective analysis. Three radiologists contoured 20 lesions manually on baseline multiphase contrast-enhanced MRIs, and two of the radiologists re-contoured at two additional sessions. Contours were transferred to co-registered PET/CT-based Y-90 dose maps. Volume-dependent recovery coefficients were applied for partial volume correction (PVC) when reporting mean absorbed dose. To understand how uncertainty varies with tumor size, we fit power models regressing relative uncertainty in volume and in mean absorbed dose on contour volume. Finally, we determined effects of segmentation uncertainty on tumor control probability (TCP), as calculated using logistic models developed in a previous RE study.

Results

The average lesion volume ranged from 1.8 to 194.5 mL, and the mean absorbed dose ranged from 23.4 to 1629.0 Gy. The mean inter-observer Dice coefficient for lesion contours was significantly less than the mean intra-observer Dice coefficient (0.79 vs. 0.85, p < 0.001). Uncertainty in segmented volume, as measured by the Coefficient of Variation (CV), ranged from 4.2 to 34.7% with an average of 17.2%. The CV in mean absorbed dose had an average value of 5.4% (range 1.2–13.1%) without PVC while it was 15.1% (range 1.5–55.2%) with PVC. Using the fitted models for uncertainty as a function of volume on our prior data, the mean change in TCP due to segmentation uncertainty alone was estimated as 16.2% (maximum 48.5%).

Conclusions

Though we find relatively high inter- and intra-observer reliability overall, uncertainty in tumor contouring propagates into non-negligible uncertainty in dose metrics and outcome prediction for individual cases that should be considered in dosimetry-guided treatment.
A meta-analysis of climatic conditions and whitefly Bemisia tabaci population: implications for tomato yellow leaf curl disease
Authors: Lobin Kanta Kumar , Jaunky Vishal Chandr , Taleb-Hossenkhan Nawsheen
Published: December 2022

Background

Tomato yellow leaf curl disease (TYLCD), which is caused by the genusBegomovirus, is basically transmitted by the vector whitefly,Bemisia tabaci(B. tabaci). It remains a destructive disease of tomato across the world. The disease is present in many tomato growing countries, and it has a broad geographical distribution. The population and distribution of the vector are therefore an important factor in disease spread. This study assesses the determinants of the relationship between climatic factors and whitefly population. A thorough search of relevant papers was first initiated, and eventually 16 articles with 142 estimates were selected. A meta-regression analysis, especially the random-effects model with a restricted maximum likelihood (REML) estimator, was applied.

Results

Summarization of effect sizes revealed a mean effect size for the study ofr = 0.15. The forest plot suggested a significant amount of study heterogeneity. No evidence of significant publication bias was uncovered. The meta-analysis revealed that the population of whiteflies was significantly related to climatic independent variables such as maximum and minimum temperature and rainfall. Other factors such as altitude, number of symptoms, pesticide policy, type of soil, number of references, impact factor and publication status were found to significantly influence the effect sizes.

Conclusions

Whiteflies are playing a major role in spreading the TYLCD. Several factors were identified to have a significant impact on the climatic conditions-whitefly population nexus. Since climatic factors, altitude, existing pesticide laws and type of soil were found to have a significant impact on the effect sizes, agricultural management policies could be enacted by specifically considering those factors in a view to minimize the impact of whiteflies. In general, all the above factors could be considered in strategy to manage TYLCD.
CELSIUS: an international project providing integrated, systematic, cost-effective large-scale IoT solutions for improving energy efficiency of medium- and large-sized buildings
Authors: Ma Zheng , Santos Athila Quaresma , Shaker Hamid Reza , Yussof Salman , Eriksen Poul Møller , Hornum Jens , Jørgensen Bo Nørregaard
Published: December 2022

Worldwide, buildings consume about 40 percent of the overall energy resources and contribute to an average of 30 percent of the global carbon emission. Hence, technologies for improving the energy efficiency of buildings play an essential role in the global fight against climate change. The CELSIUS project aims to improve the energy efficiency and indoor climate of medium to large sized commercial and public buildings by developing an integrated system solution that consists of (1) an IoT-enabled and cloud-based platform for monitoring and diagnostics of building energy performance and indoor climate quality, (2) a middleware software platform for cost-effective large-scale deployment of wireless sensors and gateways, and (3) an IoT network management platform for cost-efficient life-cycle maintenance of sensors and gateways. The integrated system solution will be deployed and demonstrated in a 6000 m2 building in Aarhus, Denmark, and an 18,000 m2 building in Kuala Lumpur, Malaysia. By choosing buildings located in different climate zones on different continents allows the developed system solution to be tested under realistic conditions for the international export market.
Anomaly detection in quasi-periodic energy consumption data series: a comparison of algorithms
Authors: Zangrando Niccolò , Fraternali Piero , Petri Marco , Pinciroli Vago Nicolò Oreste , Herrera González Sergio Luis
Published: December 2022

The diffusion of domotics solutions and of smart appliances and meters enables the monitoring of energy consumption at a very fine level and the development of forecasting and diagnostic applications. Anomaly detection (AD) in energy consumption data streams helps identify data points or intervals in which the behavior of an appliance deviates from normality and may prevent energy losses and break downs. Many statistical and learning approaches have been applied to the task, but the need remains of comparing their performances with data sets of different characteristics. This paper focuses on anomaly detection on quasi-periodic energy consumption data series and contrasts 12 statistical and machine learning algorithms tested in 144 different configurations on 3 data sets containing the power consumption signals of fridges. The assessment also evaluates the impact of the length of the series used for training and of the size of the sliding window employed to detect the anomalies. The generalization ability of the top five methods is also evaluated by applying them to an appliance different from that used for training. The results show that classical machine learning methods (Isolation Forest, One-Class SVM and Local Outlier Factor) outperform the best neural methods (GRU/LSTM autoencoder and multistep methods) and generalize better when applied to detect the anomalies of an appliance different from the one used for training.
Survey data on university students’ experience of energy control, indoor comfort, and energy flexibility in campus buildings
Authors: Ma Zheng
Published: December 2022

Due to large energy consumption and equipped building control systems, the majority of campus buildings have the potential to increase energy efficiency and provide energy flexibility. Among the three main types of occupants in the campus buildings (researchers/teachers, students, administration/management), students spend most of their time on learning activities in the campus buildings, and the energy performance can influence their learning performance. Therefore, this paper conducts a questionnaire targeting student occupants at a large engineering faculty in a Danish university to investigate occupants’ experience of energy control, indoor comfort, and options of energy flexibility in campus buildings. In total, 267 fully completed and usable questionnaires were received. The dataset is available in.xlsx format, and the questionnaire that was used to collect the data is also provided together.
Non-intrusive load monitoring techniques for the disaggregation of ON/OFF appliances
Authors: Castangia Marco , Urbanelli Angelica , Abraha Girmay Awet , Camarda Christian , Macii Enrico , Patti Edoardo
Published: December 2022

Nowadays, Non-Intrusive Load Monitoring techniques are sufficiently accurate to provide valuable insights to the end-users and improve their electricity behaviours. Indeed, previous works show that commonly used appliances (fridge, dishwasher, washing machine) can be easily disaggregated thanks to their abundance of electrical features. Nevertheless, there are still many ON/OFF devices (e.g. heaters, kettles, air conditioners, hair dryers) that present very poor power signatures, preventing their disaggregation with traditional algorithms. In this work, we propose a new online clustering method exploiting both operational features (peak power, duration) and external features (time of use, day of week, weekday/weekend) in order to recognize ON/OFF devices. The proposed algorithm is intended to support an existing disaggregation algorithm that is already able to classify at least 80% of the total energy consumption of the house. Thanks to our approach, we improved the performance of our existing disaggreation algorithm from 80% to 87% of the total energy consumption in the monitored houses. In particular, we found that 85% of the clusters were identified by only using operational features, while external features allowed us to identify the remaining 15% of the clusters. The algorithm needs to collect on average less than 40 operations to find a cluster, which demonstrates its applicability in the real world.
Simulation of a Cellular Energy System including hierarchies and neighborhoods
Authors: Dengler Gabriel , Bazan Peter , German Reinhard
Published: December 2022

The massive use of small energy resources and storage units causes a transition from a traditionally centralized to a decentralized energy system. To structure and coordinate the emerging changes in the energy system, the concept of Energy Cells (ECs) was developed. Several ECs can be combined to form a hierarchically superordinate EC. These hierarchically superordinate ECs can in turn be combined and thus form a complex hierarchy. An EC encapsulates coherent parts of an energy system and can communicate as well as exchange energy with other ECs at a different or the same level. It follows the idea of local balance of energy provision and demand. A network of ECs forms a Cellular Energy System (CES). In this paper, we develop a concept for modeling and simulating a CES. We accomplish this by beginning with atomic components like consumers, producers, and storage units and aggregating them with Hierarchical Controllers (HCs). Such a hierarchically structured energy system is part of various proposals. However, we are able to add neighborhood relations by introducing Local Controllers (LCs). This is more realistic and also opens many degrees of freedom for control strategies in such a system. Following the recursive structure of the CES itself, we define recursive functions for visiting the CES architecture and realizing various control strategies. We evaluate our approach in a series of partially randomized scenarios, showing notable differences in the performance of the CES regarding different control strategies in a larger example. We also provide a theoretical analysis of the computational complexity of the suggested approach.
A hierarchical and modular agent-oriented framework for power systems co-simulations
Authors: De Vizia Claudia , Macii Alberto , Patti Edoardo , Bottaccioli Lorenzo
Published: December 2022

During the last decades, numerous simulation tools have been proposed to faithfully reproduce the different entities of the grid together with the inclusion of new elements that make the grid “smart”. Often, these domain-specific simulators have been then coupled with co-simulation platforms to test new scenarios. In parallel, agent-oriented approaches have been introduced to test distributed control strategies and include social and behavioural aspects typical of the consumer side. Rarely, simulators of the physical systems have been coupled with these innovative techniques, especially when social and psychological aspects have been considered. In order to ease the re-usability of these simulators, avoiding re-coding everything from scratch, we propose a hierarchical and modular agent-oriented framework to test new residential strategies in the energy context. If needed, the presented work enables the user to select the desired level of details of the agent-based framework to match the corresponding physical system without effort to test very different scenarios. Moreover, it allows adding on top of the physical data, behavioural aspects. To this end, the characteristics of the framework are first introduced and then different scenarios are described to demonstrate the flexibility of the proposed work: (i) a first stand-alone scenario with two hierarchy levels, (ii) a second co-simulation scenario with a photovoltaic panel simulator and (iii) a third stand-alone scenario with three hierarchy levels. Results demonstrate the flexibility and ease of use of the framework, allowing us to compare several scenarios and couple new simulators to build a more and more complex environment. The framework is in the early stages of its development. However, thanks to its properties in the future it could be extended to include new actors, such as industries, to get the full picture.
Application of energy informatics in Danish research projects
Authors: Howard Daniel Anthony , Ma Zheng , Jørgensen Bo Nørregaard
Published: December 2022

To enable sound scientific research in future energy informatics projects, it is necessary to obtain an overview of the current state of the research field to identify unaddressed gaps and challenges. Therefore, this paper aims to investigate the research trends and achievements within energy informatics in a Danish context within the last three decades. This paper reviews 207 energy informatics projects collected until the second quarter of 2022. Quantitative analysis results show that most projects have focused on applying energy informatics through energy-aware control of end-user consumption. The qualitative review finds an emphasis on data usage and end-users which aligns with the quantitative review. Furthermore, it tends to focus on specific end-users, e.g., buildings and heat pumps. Four overall recommendations are established: (I) Increased emphasis on research for sector coupling to aid in unlocking energy system flexibility, (II) project data value chain output, focusing on structuring and managing the data to make it applicable for future re-use, (III) utilizing industrial loads and incorporating an end-user perspective, (IV) inclusion of research institutions for the improved overall output of the projects through interdisciplinary solutions.
Agent-based modeling (ABM) for urban neighborhood energy systems: literature review and proposal for an all integrative ABM approach
Authors: Vuthi Petrit , Peters Irene , Sudeikat Jan
Published: December 2022

Advancing the energy transition in real-world urban settings is attracting interest within interdisciplinary research communities. New challenges for local energy balancing arise particularly in urban neighborhoods where densely populated buildings are facing the needs of the heat transition, an increasing use of battery-electric vehicles and an expansion of renewable energies. Agent-based modeling (ABM) is a suitable approach for addressing various interlinked aspects like market mechanisms and processes, technology adoption, different stakeholder roles and the formulation of policy measures. In this work, we analyze peer-reviewed, open-access literature on ABM for energy neighborhoods and discuss key modeling aspects like model purpose and outcome, the logic of agents and decision-making, the treatment of space and time, and empirical grounding. These ABM allow the study of local market mechanisms, local renewable energy generation, microgrids, the unfolding of heat transition, neighborhood mobility and the evaluation of policies like regulation and financial incentives. We find a lack of integrated neighborhood energy assessments that simultaneously look at the different energy forms and applications: heating, electricity, and mobility. We present a consolidated ABM concept that integrates these sectors. Thus, our work contributes to the advancement of ABM and to the understanding of how to promote the transition to a decarbonized society in urban settings.
Improving anomaly detection in SCADA network communication with attribute extension
Authors: Anwar Mahwish , Lundberg Lars , Borg Anton
Published: December 2022

Network anomaly detection for critical infrastructure supervisory control and data acquisition (SCADA) systems is the first line of defense against cyber-attacks. Often hybrid methods, such as machine learning with signature-based intrusion detection methods, are employed to improve the detection results. Here an attempt is made to enhance the support vector-based outlier detection method by leveraging behavioural attribute extension of the network nodes. The network nodes are modeled as graph vertices to construct related attributes that enhance network characterisation and potentially improve unsupervised anomaly detection ability for SCADA network. IEC 104 SCADA protocol communication data with good domain fidelity is utilised for empirical testing. The results demonstrate that the proposed approach achieves significant improvements over the baseline approach (average $$F_{1}$$

F
1

 score increased from 0.6 to 0.9, and Matthews correlation coefficient (MCC) from 0.3 to 0.8). The achieved outcome also surpasses the unsupervised scores of related literature. For critical networks, the identification of attacks is indispensable. The result shows an insignificant missed-alert rate ($$0.3\%$$

0.3
%

on average), the lowest among related works. The gathered results show that the proposed approach can expose rouge SCADA nodes reasonably and assist in further pruning the identified unusual instances.
A framework for quantifying forest wildfire hazard and fuel treatment effectiveness from stands to landscapes
Authors: Hood Sharon M. , Varner J. Morgan , Jain Theresa B. , Kane Jeffrey M.
Published: December 2022

Background

Wildland fires are fundamentally landscape phenomena, making it imperative to evaluate wildland fire strategic goals and fuel treatment effectiveness at large spatial and temporal scales. Outside of simulation models, there is limited information on how stand-level fuel treatments collectively contribute to broader landscape-level fuel management goals. Our objective here is to present a framework designed to measure fuel treatment effectiveness from stands to landscapes to inform fuel treatment planning and improve ecological and social resilience to wildland fire.

Results

Our framework introduces the concept of a fuel management regime, an iterative and cumulative evaluation from the stand to the landscape of fire hazard, fuel treatments, and wildland fire behavior and effects. We argue that the successfulness of fuel treatments within this regime must be evaluated based on pre-treatment fire hazard and post-wildland fire fuel treatment outcomes over large spatial and temporal scales. Importantly, these outcomes can be evaluated from the stand level to across a landscape through time, based on preidentified management objectives that define condition-based criteria that account for social values and environmental and ecological indicators used to determine the effectiveness of fuel treatments within a fuel management regime.

Conclusions

Evaluating the cumulative ability of fuel treatments to change landscape patterns of fire behavior and effects is challenging. By quantifying fire hazard, followed by evaluating outcomes of wildfires on environmental and ecological indicators and social values, it becomes possible to assess how individual fuel treatments placed within the context of a fuel management regime are effective based on desired conditions that address management objectives. This conceptual framework offers a much-needed middle-ground planning, monitoring, and reporting approach between overly simplistic annual reporting summaries of the area treated, number of fires, and burned area and detailed fire simulation modeling outcomes by putting individual treatments and fires in the context of current and desired vegetative conditions and social values. Our fuel treatment effectiveness framework examines the state of fuels through the lens of fire hazard and connects fuels to subsequent fire behavior and effects over time and space. The framework provides a way to focus regional and national fuel management planning efforts toward creating fuel management regimes that increase social and ecological resilience from wildfire.
Chlorogenic acid modulates the ubiquitin–proteasome system in stroke animal model
Authors: Shah Murad-Ali , Kang Ju-Bin , Koh Phil-Ok
Published: December 2022

Background

Chlorogenic acid, a phenolic compound, has potent antioxidant and neuroprotective properties. The ubiquitin–proteasome system is an important regulators of neurodevelopment and modulators of neuronal function. This system is associated with neurodevelopment and neurotransmission through degradation and removal of damaged proteins. Activation of the ubiquitin–proteasome system is a critical factor in preventing cell death. We have previously reported a decrease in the activity of the ubiquitin–proteasome system during cerebral ischemia. This study investigated whether chlorogenic acid regulates the ubiquitin–proteasome system in an animal stroke model. In adult rats, middle cerebral artery occlusion (MCAO) surgery was performed to induce focal cerebral ischemia. Chlorogenic acid (30 mg/kg) or normal saline was injected into the abdominal cavity 2 h after MCAO surgery, and cerebral cortex tissues were collected 24 h after MCAO damage.

Results

Chlorogenic acid attenuated neurobehavioral disorders and histopathological changes caused by MCAO damage. We identified the decreases in ubiquitin C-terminal hydrolase L1, ubiquitin thioesterase OTUB1, proteasome subunit α type 1, proteasome subunit α type 3, and proteasome subunit β type 4 expression using a proteomics approach in MCAO animals. The decrease in these proteins was alleviated by chlorogenic acid. In addition, the results of reverse transcription-polymerase chain reaction confirmed these changes. The identified proteins were markedly reduced in MCAO damage, while chlorogenic acid prevented these reductions induced by MCAO. The decrease of ubiquitin–proteasome system proteins in ischemic damage was associated with neuronal apoptosis.

Conclusions

Our results showed that chlorogenic acid regulates ubiquitin–proteasome system proteins and protects cortical neurons from neuronal damage. These results provide evidence that chlorogenic acid has neuroprotective effects and maintains the ubiquitin–proteasome system in ischemic brain injury.
Assessment of diaphragmatic role in dyspneic patients with pleural effusion
Authors: Shalaby Heba Mohamed , Ezzelregal Hieba Gamal
Published: December 2022

Background

Dyspnea that is caused by pleural effusion and affects patients’ quality of life may not be resolved after lung expansion following pleural tapping. This study aims to investigate the role that changes in the diaphragmatic shape and movement play in the development of dyspnea in those patients.

Methods

Thirty patients with pleural effusions and dyspnea were evaluated before and at 24 h after therapeutic thoracentesis. The primary outcomes are to investigate changes in diaphragmatic shape and movement before and after thoracentesis by chest ultrasound to evaluate factors causing effusion-related dyspnoea, while the secondary outcomes are firstly to investigate the effect of pleural effusion on the cardiorespiratory, functional, and diaphragmatic variables in causing dyspnea and secondly to detect the percentages and demographics of patients who experience post-drainage dyspnea improvement.

Results

Thirty patients with age >18 years old who had moderate to massive pleural effusion (either of benign or malignant etiology), with breathlessness were recruited from the Chest Department, Ultrasonography Unit, Ain-Shams University Hospitals. Almost all (96.7%) of the studied patients experienced shortness of breath with a mean modified Borg Score of 5.13 ± 1.78, tapping of varying amounts of pleural fluid ranging from 1000 to 2000 ml.

There is a highly significant improvement in the diaphragmatic excursion, with non-significant improvement in diaphragmatic shape, although nonsignificant correlation between diaphragmatic excursion and functional parameters (M. Borg score, spirometry, and 6MWD: 6-min walk distance), but a significant negative correlation between diaphragmatic excursion and amount of drained effusion (P value 0.045 and 95% CI for OR 1.041–36.779). 63.3% of patients experienced dyspnea improvement after thoracocentesis, and they showed highly significant improvements in M. Borg dyspnea score, spirometry, pulse rate, respiratory rate, 6MWD, and blood oxygen saturation.

Conclusion

In this study, we conclude that the improvement of the diaphragmatic excursion was negatively correlated with the amount of drained effusion, but no significant correlation was detected with the functional parameters and effusion-related indices that may be caused by the small sample size of the study.
Sexual and gender identity and note-leaving among adult suicide decedents in the USA
Authors: O'Rourke Holly P. , Hilley Chanler D. , Lowell Emily , Sheehan Connor M.
Published: December 2022

Background

Suicide is one of the leading causes of preventable death in the USA, representing a critical public health threat. Suicide risks differ for different populations. In particular, the sexual and gender minority (SGM) population remains at increased risk for suicide. One of the circumstances that may differ for SGM and non-SGM individuals is the propensity to leave a suicide note. Information regarding note-leaving may be helpful in informing suicide prevention and intervention.

Aims

This study documents the differences in note-leaving in SGM individuals compared with non-SGM individuals, using recent data from the National Violent Death Reporting System (N= 98 515) and accounting for important covariates.

Method

We fit a logistic regression model with SGM status and covariates predicting note-leaving in suicide.

Results

SGM decedents were 1.508 times more likely to leave a note than their non-SGM counterparts, controlling for demographic, mental health and substance use covariates.

Conclusions

These findings highlight the importance of tailoring suicide prevention and intervention efforts to meet the needs of SGM populations.
Endocrine disease history and the risk of postpartum depression
Authors: Rasmussen Marie-Louise H. , Poulsen Gry J. , Videbech Poul , Wohlfahrt Jan , Melbye Mads
Published: December 2022

Background

Previous research has suggested that some women are at increased risk of postpartum depression (PPD) because of an extra sensitivity to fluctuating hormones before and after parturition. This may particularly apply to women with endocrine disease, characterised by a less than optimal capability to self-regulate the hormonal feedback system.

Aims

To investigate if women with endocrine disease history are at increased risk of developing PPD.

Method

Based on information from Danish national registers, this nationwide cohort study included 888 989 deliveries (1995–2018). Endocrine disease history was defined as thyroid disease, pre-pregnancy diabetes, polycystic ovary syndrome and/or previous gestational diabetes within 10 years before pregnancy start. PPD was defined as use of antidepressants and/or hospital contact for depression within 6 months after childbirth.

Results

Among 888 989 deliveries, 4.1% had a history of endocrine disease and 0.5% had a PPD episode. Overall, women with an endocrine disease history had a 42% (risk ratio 1.42, 95% CI 1.24–1.62) higher risk of PPD when compared with women with no endocrine disease. However, we also found the reverse association, whereby women with a PPD history had a 50% (hazard ratio 1.5, 95% CI 1.4–1.6) higher risk of endocrine disease when compared with women with no PPD history.

Conclusions

Women with endocrine disease history had a 40% higher risk of PPD compared with women with no endocrine disease. More attention should be given to pregnant women with endocrine disease history to increase awareness of early signs of PPD. The bi-directionality of the association points to a common underlying factor.
Triple X syndrome: Psychiatric disorders and impaired social functioning as a risk factor
Authors: Otter Maarten , Campforts Bea C. M. , Stumpel Constance T. R. M. , van Amelsvoort Thérèse A. M. J. , Drukker Marjan
Published: December 2022

Background

Women with triple X syndrome (TXS) have an extra X chromosome. TXS appeared to be associated with psychiatric disorders in biased or underpowered studies.

Aim

This study aims to describe the prevalence of psychiatric disorders in adults with TXS in a relatively large and less biased group of participants.

Method

In this cross-sectional study, data were collected from 34 women with TXS (mean age = 32.9; s.d. = 13.1) and 31 controls (mean age = 34.9; s.d. = 13.7). Psychiatric disorders were assessed using the MINI International Neuropsychiatric Interview (MINI) and the adult behavior checklist (ABCL). Trait and state anxiety were assessed using the State–Trait Anxiety Inventory.

Results

In the TXS group, MINI results showed a higher prevalence of major depressive episodes (43.3%), psychotic disorders (29.4%), and suicidality (23.5%). Only 50% of the TXS group earned a normal score for the total syndrome score using the ABCL. In addition, levels of trait anxiety were higher in the TXS group. Only three women in each group received psychotropic medication. Impaired social functioning appeared to represent a major risk factor in TXS as regards psychotic, affective disorders, trait anxiety, and low self-esteem.

Conclusions

Women with TXS are vulnerable to developing psychiatric disorders, and women with both TXS and impaired social functioning are even more vulnerable.
Identifying Nonpatient Authors of Patient Portal Secure Messages in Oncology: A Proof-of-Concept Demonstration of Natural Language Processing Methods
Authors: Benda Natalie C. , Rogers Christopher , Sharma Mohit , Narain Wazim , Diamond Lisa C. , Ancker Jessica , Seier Kenneth , Stetson Peter D. , Sulieman Lina , Armstrong Misha , Peng Yifan
Published: December 2022

PURPOSE

Patient portal secure messages are not always authored by the patient account holder. Understanding who authored the message is particularly important in an oncology setting where symptom reporting is crucial to patient treatment. Natural language processing has the potential to detect messages not authored by the patient automatically.

METHODS

Patient portal secure messages from the Memorial Sloan Kettering Cancer Center were retrieved and manually annotated as a predicted unregistered proxy (ie, not written by the patient) or a presumed patient. After randomly splitting the annotated messages into training and test sets in a 70:30 ratio, a bag-of-words approach was used to extract features and then a Least Absolute Shrinkage and Selection Operator (LASSO) model was trained and used for classification.

RESULTS

Portal secure messages (n = 2,000) were randomly selected from unique patient accounts and manually annotated. We excluded 335 messages from the data set as the annotators could not determine if they were written by a patient or proxy. Using the remaining 1,665 messages, a LASSO model was developed that achieved an area under the curve of 0.932 and an area under the precision recall curve of 0.748. The sensitivity and specificity related to classifying true-positive cases (predicted unregistered proxy-authored messages) and true negatives (presumed patient-authored messages) were 0.681 and 0.960, respectively.

CONCLUSION

Our work demonstrates the feasibility of using unstructured, heterogenous patient portal secure messages to determine portal secure message authorship. Identifying patient authorship in real time can improve patient portal account security and can be used to improve the quality of the information extracted from the patient portal, such as patient-reported outcomes.
Improved gauge-unfixing formalism through a prototypical second-class system
Authors: Ananias Neto J. , Morais W. D. , Thibes R.
Published: December 2022

We contextualize the improved gauge-unfixing (GU) formalism within a rather general prototypical second-class system, obtaining a corresponding first-class equivalent description enjoying gauge invariance which can be applied to several situations. The prototypical system is chosen to represent a considerable class of relevant models in field theory. By considering the improved version of the GU formalism, we show that any gauge-invariant function can be obtained in terms of a specific deformation in phase space, benefiting thus from the fact that no auxiliary variables are needed in the process. In this way, the resulting converted first-class system is constructed out of the same original canonical variables, preserving the number of degrees of freedom. We illustrate the technique with an application to the nonlinear sigma model.
Instantaneous tunneling of relativistic massive spin-0 particles
Authors: Flores Philip Caesar , Galapon Eric A.
Published: December 2022

The tunneling time problem studied earlier in Phys. Rev. Lett., 108 (2012) 170402, using a non-relativistic time-of-arrival (TOA) operator predicted that tunneling time is instantaneous. This raises the question whether instantaneous tunneling time is a consequence of using a non-relativistic theory. Here, we extend the analysis by proposing a formalism on the construction of relativistic TOA operators for spin-0 particles in the presence of an interaction potential V (q) via quantization. We then construct the corresponding barrier traversal time operator, and impose the condition that the barrier height V

o
is less than the rest mass energy of the particle. We show that only the above-barrier energy components of the incident wavepackets momentum distribution contribute to the barrier traversal time while the below-barrier components are transmitted instantaneously.
Boosting thermodynamic performance by bending space-time
Authors: Ferketic Emily E. , Deffner Sebastian
Published: December 2022

Black holes are arguably the most extreme regions of the universe. Yet, they are also utterly inaccessible to experimentation, and even just indirect observation poses significant technical challenges. The phenomenological approach of thermodynamics is uniquely suited to explore at least some of the physical properties of such scenarios, and this has motivated the study of so-called holographic engines. We show that the efficiency of an endoreversible Brayton cycle is given by the Curzon-Ahlborn efficiency, if the engine is fueled by a 2-dimensional ideal gas; and that the efficiency is higher, if the working medium is a (2 + 1)-dimensional BTZ black hole. These findings may be relevant not only in the quest to unlock the mysteries of black holes, but also for potential technological applications of graphene.
Thoracic Outlet Syndrome Part II: Consensus on the Management of Neurogenic Thoracic Outlet Syndrome by the European Association of Neurosurgical Societies’ Section of Peripheral Nerve Surgery
Authors: Rochkind Shimon , Ferraresi Stefano , Denisova Natalia , Garozzo Debora , Heinen Christian , Alimehmeti Ridvan , Capone Crescenzo , Barone Damiano G. , Zdunczyk Anna , Pedro Maria T. , Antoniadis Gregor , Kaiser Radek , Dubuisson Annie , Pondaag Willem , Kretschmer Thomas , Rasulic Lukas , Dengler Nora F.
Published: December 2022

BACKGROUND:

In the first part of this report, the European Association of Neurosurgical Societies' section of peripheral nerve surgery presented a systematic literature review and consensus statements on anatomy, classification, and diagnosis of thoracic outlet syndrome (TOS) along with a subclassification system of neurogenic TOS (nTOS). Because of the lack of level 1 evidence, especially regarding the management of nTOS, we now add a consensus statement on nTOS treatment among experienced neurosurgeons.

OBJECTIVE:

To document consensus and controversy on nTOS management, with emphasis on timing and types of surgical and nonsurgical nTOS treatment, and to support patient counseling and clinical decision-making within the neurosurgical community.

METHODS:

The literature available on PubMed/MEDLINE was systematically searched on February 13, 2021, and yielded 2853 results. Screening and classification of abstracts was performed. In an online meeting that was held on December 16, 2021, 14 recommendations on nTOS management were developed and refined in a group process according to the Delphi consensus method.

RESULTS:

Five RCTs reported on management strategies in nTOS. Three prospective observational studies present outcomes after therapeutic interventions. Fourteen statements on nonsurgical nTOS treatment, timing, and type of surgical therapy were developed. Within our expert group, the agreement rate was high with a mean of 97.8% (± 0.04) for each statement, ranging between 86.7% and 100%.

CONCLUSION:

Our work may help to improve clinical decision-making among the neurosurgical community and may guide nonspecialized or inexperienced neurosurgeons with initial patient management before patient referral to a specialized center.
Sevoflurane-induced amnesia is associated with inhibition of hippocampal cell ensemble activity after learning
Authors: Kameyama Akiyo , Asai Hirotaka , Nomoto Masanori , Ohno Shuntaro , Ghandour Khaled , Ohkawa Noriaki , Saitoh Yoshito , Yamazaki Mitsuaki , Inokuchi Kaoru
Published: December 2022

General anesthesia could induce amnesia, however the mechanism remains unclear. We hypothesized that suppression of neuronal ensemble activity in the hippocampus by anesthesia during the post-learning period causes retrograde amnesia. To test this hypothesis, two experiments were conducted with sevoflurane anesthesia (2.5%, 30 min): a hippocampus-dependent memory task, the context pre-exposure facilitation effect (CPFE) procedure to measure memory function and in vivo calcium imaging to observe neural activity in hippocampal CA1 during context exploration and sevoflurane/home cage session. Sevoflurane treatment just after context pre-exposure session impaired the CPFE memory, suggesting sevoflurane induced retrograde amnesia. Calcium imaging showed sevoflurane treatment prevented neuronal activity in CA1. Further analysis of neuronal activity with non-negative matrix factorization, which extracts neural ensemble activity based on synchronous activity, showed that sevoflurane treatment reduced the reactivation of neuronal ensembles between during context exploration just before and one day after sevoflurane inhalation. These results suggest that sevoflurane treatment immediately after learning induces amnesia, resulting from suppression of reactivation of neuronal ensembles.
Impacts and mechanisms of CO2 narcosis in bumble bees: narcosis depends on dose, caste and mating status and is not induced by anoxia
Authors: Cressman Anna , Amsalem Etya
Published: December 2022

Carbon dioxide (CO2) is commonly used to immobilize insects and to induce reproduction in bees. However, despite its wide use and potential off-target impacts, its underlying mechanisms are not fully understood. Here, we used Bombus impatiens to examine whether CO2 impacts are mediated by anoxia and whether these mechanisms differ between female castes or following mating in queens. We examined the behavior, physiology and gene expression of workers, mated queens and virgin queens following exposure to anoxia, hypoxia, full and partial hypercapnia, and controls. Hypercapnia and anoxia caused immobilization, but only hypercapnia resulted in behavioral, physiological and molecular impacts in bees. Recovery from hypercapnia resulted in increased abdominal contractions and took longer in queens. Additionally, hypercapnia activated the ovaries of queens, but inhibited those of workers in a dose-dependent manner and caused a depletion of fat-body lipids in both castes. All responses to hypercapnia were weaker following mating in queens. Analysis of gene expression related to hypoxia and hypercapnia supported the physiological findings in queens, demonstrating that the overall impacts of CO2, excluding virgin queen ovaries, were unique and were not induced by anoxia. This study contributes to our understanding of the impacts and the mechanistic basis of CO2 narcosis in insects and its impacts on bee physiology.

This article has an associated ECR Spotlight interview with Anna Cressman.