bluuebunny/crossref_metadata_2025 huggingface dataset:
A bi‐level optimization model and improved algorithm for wind farm layout
Authors: Song Erping
Published: August 2024

Wind farm can obtain the maximize profit by optimizing micro‐locations and cables. The factors that affect profit include the power output of wind turbines, cost and et al., where power output is affected by wake effect, cable cost is related to the length and type of collector cable. The profit is calculated on the premise that the costs and power loss of collector cable are determined. Obviously, there is a hierarchical relationship between the above problems. Therefore, a bi‐level optimization model with constraints is constructed in this paper, where the upper‐level objective function is the maximum profit, and the lower‐level objective functions are consists of minimum the cable cost and the power loss of collector cable; Moreover, an improved algorithm (IDEDA), based on differential evolution and Dijkstra, is used to optimize above model; Finally, simulation experiments are carried out for IDEDA and four algorithms for two different wind conditions, and the results show that IDEDA performs better compared to the other four algorithms in terms of profit and cable cost.
Collaborative forecasting management model for multi‐energy microgrid considering load response characterization
Authors: Bao Huiyu , Sun Yi , Peng Jie , Qian Xiaorui , Wu Peng
Published: August 2024

Multi‐energy microgrids (MEMG) have become an effective means of integrated energy management due to their unique advantages, including area independence, diverse supply, flexibility, and efficiency. However, the uncertain deviation of the renewable energy generators (REGs) output and the uncertain deviation of the multiple energy load response cumulatively lead to the deterioration of the MEMG model performance. To address these issues, this article proposes a cooperative forecasting management model for MEMG that considers multiple uncertainties and load response knowledge characterization. The model combines a multi‐energy load prediction model with a management model based on deep reinforcement learning. It proposes multiple iterations of data, fits the dynamic environment of MEMG by continuously improving the long short‐term memory (LSTM) neural network based on knowledge distillation (KD) architecture, and then optimizes the MEMG state space by considering the knowledge of load response characteristics, Furthermore, it combines multi‐agent deep deterministic policy gradient (MADDPG) with horizontal federated (hF) learning to co‐train multi‐MEMG, addressing the issues of training efficiency during co‐training. Finally, the validity of the proposed model is demonstrated by an arithmetic example.
Statistical study of the peak and fluence spectra of solar energetic particles observed over four solar cycles
Authors: Wang Yubao , Guo Jingnan
Published: August 2024

Context. Solar energetic particles (SEPs) are an important space radiation source, especially for the space weather environment in the inner heliosphere. The energy spectrum of SEP events is crucial both for evaluating their radiation effects and for understanding their acceleration process at the source region, along with their propagation mechanism.

Aims. In this work, we investigate the properties of the SEP peak flux spectra and the fluence spectra and their potential formation mechanisms using statistical methods. We aim to advance our understanding of SEP acceleration and propagation mechanisms.

Methods. Employing a dataset from the European Space Agency’s Solar Energetic Particle Environment Modelling (SEPEM) program, we obtained and fit the peak-flux and fluence proton spectra of more than a hundred SEP events from 1974 to 2018. We analyzed the relationship among the solar activity, X-ray peak intensity of solar flares, and the SEP’s spectral parameters.

Results. Based on the assumption that the initial spectrum of accelerated SEPs generally displays a power-law distribution and that the diffusion coefficient has a power-law dependence on the particle energy, we can assess both the source and propagation properties using the observed SEP event peak flux and fluence energy spectra. We confirm that the spectral properties of SEPs are influenced by the solar source and the interplanetary conditions, whereas their transportation process can be influenced by different phases of solar cycle.

Conclusions. This study provides an observational perspective on the double power-law spectral characteristics of the SEP energy spectra, revealing their correlation with the adiabatic cooling and diffusion processes during the particle propagation from the Sun to the observer. This result contributes to forging a deeper understanding of the acceleration and propagation of SEP events, in particular, the possible origins of the double power law.
KASHz+SUPER: Evidence of cold molecular gas depletion in AGN hosts at cosmic noon
Authors: Bertola E. , Circosta C. , Ginolfi M. , Mainieri V. , Vignali C. , Calistro Rivera G. , Ward S. R. , Lopez I. E. , Pensabene A. , Alexander D. M. , Bischetti M. , Brusa M. , Cappi M. , Comastri A. , Contursi A. , Cicone C. , Cresci G. , Dadina M. , D’Amato Q. , Feltre A. , Harrison C. M. , Kakkad D. , Lamperti I. , Lanzuisi G. , Mannucci F. , Marconi A. , Perna M. , Piconcelli E. , Puglisi A. , Ricci F. , Scholtz J. , Tozzi G. , Vietri G. , Zamorani G. , Zappacosta L.
Published: August 2024

The energy released by active galactic nuclei (AGN) has the potential to heat or remove the gas of the ISM, thus likely impacting the cold molecular gas reservoir of host galaxies at first, with star formation following as a consequence on longer timescales. Previous works on high-z galaxies, which compared the gas content of those without identified AGN, have yielded conflicting results, possibly due to selection biases and other systematics. To provide a reliable benchmark for galaxy evolution models at cosmic noon (z = 1 − 3), two surveys were conceived: SUPER and KASHz, both targeting unbiased X-ray-selected AGN at z > 1 that span a wide bolometric luminosity range. In this paper we assess the effects of AGN feedback on the molecular gas content of host galaxies in a statistically robust, uniformly selected, coherently analyzed sample of AGN at z = 1 − 2.6, drawn from the KASHz and SUPER surveys. By using targeted and archival ALMA data in combination with dedicated SED modeling, we retrieve CO and far-infrared (FIR) luminosity as well as M* of SUPER and KASHz host galaxies. We selected non-active galaxies from PHIBBS, ASPECS, and multiple ALMA/NOEMA surveys of submillimeter galaxies in the COSMOS, UDS, and ECDF fields. By matching the samples in redshift, stellar mass, and FIR luminosity, we compared the properties of AGN and non-active galaxies within a Bayesian framework. We find that AGN hosts at given FIR luminosity are on average CO depleted compared to non-active galaxies, thus confirming what was previously found in the SUPER survey. Moreover, the molecular gas fraction distributions of AGN and non-active galaxies are statistically different, with the distribution of AGN being skewed to lower values. Our results indicate that AGN can indeed reduce the total cold molecular gas reservoir of their host galaxies. Lastly, by comparing our results with predictions from three cosmological simulations (TNG, Eagle, and Simba) filtered to match the properties of observed AGN, AGN hosts, and non-active galaxies, we confirm already known discrepancies and highlight new discrepancies between observations and simulations.
X-ray spectropolarimetry of the bright atoll Serpens X-1
Authors: Ursini F. , Gnarini A. , Bianchi S. , Bobrikova A. , Capitanio F. , Cocchi M. , Fabiani S. , Farinelli R. , Kaaret P. , Matt G. , Ng M. , Poutanen J. , Ravi S. , Tarana A.
Published: August 2024

We present simultaneous X-ray polarimetric and spectral observations of the bright atoll source Ser X-1 carried out with the Imaging X-ray Polarimetry Explorer (IXPE), NICER, and NuSTAR. We obtain an upper limit of 2% (99% confidence level) on the polarization degree in the 2–8 keV energy band. We detect four type-I X-ray bursts, two of which during the IXPE observation. This is the first time that has IXPE observed type-I X-ray bursts, and it allows us to place an upper limit on their polarization degree; however, due to the limited total number of counts in each burst, we obtain a relatively high upper limit (80%). We confirm the presence of reflection features in the X-ray spectrum, notably a broad iron line. Fitting the data with a relativistic reflection model, we derive a disk inclination of 25°. The spectral and polarization properties are comparable with other atolls observed by IXPE, suggesting a similar accretion geometry, and the relatively low polarization is consistent with the low inclination.
S2k-Leitlinie „Harninkontinenz bei geriatrischen Patienten“ – Teil 2: Patientenfragebögen und Assessmentinstrumente
Authors: Becher Klaus , Kirschner-Hermanns Ruth , Bojack Barbara , Drews Claudia , Wiedemann Andreas
Published: August 2024

Einleitung 1/2023 wurde das dritte Update der seit 2005 bei der
AWMF (Arbeitsgemeinschaft wissenschaftlich-medizinischer Fachgesellschaften) gelisteten und
fortlaufend aktualisierten Leitlinie „Harninkontinenz bei geriatrischen Patienten – Diagnostik
und Therapie“ durch die interdisziplinäre Arbeitsgruppe „Harninkontinenz“ der Deutschen
Gesellschaft für Geriatrie (DGG) publiziert. Aus dieser Leitlinie, die als offizielle
Leitlinie DGG akkreditiert ist, stellt der vorliegende Artikel das Kapitel „Assessments“
dar.

Methodik In einem strukturierten Bewertungsprozess identifizierte eine Literaturrecherche zunächst die vorhandene Literatur im Kontext des „geriatrischen Patienten“, wie er als zumeist über 70jährig und multimorbid oder über 80jährig durch die Fachgesellschaften definiert ist. Primäre Berücksichtigung fanden randomisierte, doppelblinde, plazebokontrollierte Studien sowie bereits vorhandene Leitlinien zum Thema. Wo keine solchen Untersuchungen vorlagen oder aus methodischen Gründen prinzipiell nicht durchführbar sind, wurden auch Publikationen anderer Designs (nicht randomisierte Untersuchungen, Fallkontrollstudien) zur Leitlinienerstellung herangezogen. Die daraus resultierenden Leitlinienempfehlungen wurden einem strukturierten Abstimmungsprozess unterzogen und abschließend Deligierten relevanter Fachgesellschaften vorgelegt.

Ergebnisse Nach der Arbeitsgruppe „Assessments“ der Dt.
Gesellschaft für Geriatrie lassen sich Assessments in 3 Phasen einteilen: in einem ersten
Schritt werden Patienten auf geriatrischen Handlungsbedarf hin untersucht. Nach dieser
„Screeningphase“ erfolgt im positiven Falle eine systematische Untersuchung aller Ressourcen
wie Selbsthilfefähigkeit, Mobilität, Kognition, Ernährung, Sensorik, Schlaf, Kontinenz und
andere durch das sog. „comprehensive geriatric assessment“ oder das Basisassessment. Prototyp
eines solchen Assessments ist der Barthel-Index. Stellen sich hier Auffälligkeiten ein,
erfolgt die weitere Untersuchung eines solchen Bereiches durch ein spezielles Assessment wie
z. B. die Mini-Mental-State-Examination für die Kognition oder der ICI-Q für die
Kontinenz.

Schlussfolgerungen Wegen der hohen Inzidenz der Harninkontinenz einerseits und der typischen, mit dem Thema verbundenen Scham, ist ein regelhaftes Screening auf eine Harninkontinenz durch Anamnese in Verbindung mit strukturierten Assessments sinnvoll. Diese können bereits erste Hinweise auf die Inkontinenzform liefern.
The variation in post-endoscopy upper gastrointestinal cancer rates among endoscopy providers in England and associated factors: a population-based study
Authors: Kamran Umair , Evison Felicity , Morris Eva Judith Ann , Brookes Matthew J , Rutter Matthew David , McCord Mimi , Adderley Nicola J , Trudgill Nigel
Published: August 2024

Background Post-endoscopy upper gastrointestinal cancer (PEUGIC) is an important key performance indicator for endoscopy quality. We examined variation in PEUGIC rates among endoscopy providers in England and explored associated factors.

Methods The was a population-based, retrospective, case–control study, examining data from National Cancer Registration and Analysis Service and Hospital Episode Statistics databases for esophageal and gastric cancers diagnosed between 2009 and 2018 in England. PEUGIC were cancers diagnosed 6 to 36 months after an endoscopy that did not diagnose cancer. Associated factors were identified using multivariable logistic regression analyses.

Results The national PEUGIC rate was 8.5%, varying from 5% to 13% among endoscopy providers. Factors associated with PEUGIC included: female sex (odds ratio [OR] 1.29 [95%CI 1.23–1.36]); younger age (age >80 years, OR 0.52 [0.48–0.56], compared with ≤60 years); increasing comorbidity (Charlson score >4, OR 5.06 [4.45–5.76]); history of esophageal ulcer (OR 3.30 [3.11–3.50]), Barrett’s esophagus (OR 3.21 [3.02–3.42]), esophageal stricture (OR 1.28 [1.20–1.37]), or gastric ulcer (OR 1.55 [1.44–1.66]); squamous cell carcinoma (OR 1.50 [1.39–1.61]); and UK national endoscopy accreditation status – providers requiring improvement (OR 1.10 [1.01–1.20]), providers never assessed (OR 1.24 [1.04–1.47]).

Conclusion PEUGIC rates varied threefold among endoscopy providers, suggesting unwarranted differences in endoscopy quality. PEUGIC was associated with endoscopy findings known to be associated with upper gastrointestinal cancer and a lack of national endoscopy provider accreditation. PEUGIC variations suggest an opportunity to raise performance standards to detect upper gastrointestinal cancers earlier and improve outcomes.
Impact of Patient Safety Bundle and Team-Based Training on Obstetric Hypertensive Emergencies
Authors: Grogan Laura , Peterson Erika , Flatley Megan , Domeyer-Klenske Amy
Published: August 2024

Objective Hypertensive disorders of pregnancy, defined as chronic (<20 weeks) or gestational (>20 weeks), are a leading cause of pregnancy-related mortality in the United States. Hypertensive disorders of pregnancy had increased prevalence from 13.3 to 15.9% among delivery hospitalizations between 2017 and 2019. The objective of this project was to increase the percentage of obstetric patients with hypertensive emergency who received evidence-based treatment within 60 minutes at a single academic center.

Study Design Data were collected before and after the implementation of a hypertension patient safety bundle. Each occurrence of hypertensive emergency was assessed to determine if evidence-based intervention occurred within 60 minutes, and if the intervention steps were successfully followed. Bundle implementation included creation of a standardized order set and interdisciplinary team-based simulations. Baseline data compared 250 preimplementation to 250 postimplementation interventions. The quality improvement interdisciplinary team reevaluated data monthly and incorporated process improvements through Plan-Do-Study-Act (PDSA) cycles to achieve a goal of 80% of patients receiving evidence-based treatment within 60 minutes.

Results A total of 1,025 hypertensive emergencies were identified in 543 patients. Prior to the protocol on average 64% of patients received evidence-based, timely treatment. After implementation of this bundle and several PDSA cycles, we sustained >80% of patients receiving target treatment for the final 6 months of data collection. The leading deviations were “no medication given” and “incorrect medication.” Improvements in order set accessibility and repeated team-based trainings led to improvement in these identified protocol deviations.

Conclusion Implementation of a patient safety bundle led to a sustained 6-month improvement in the percentage of patients receiving appropriate treatment of obstetric hypertensive emergency within 60 minutes of the first severe hypertension measurement. Processes that may have helped achieve this outcome included standardized order sets, team awareness of institutional data, and team-based simulations.

Key Points
Diabetes and Early Development: Epigenetics, Biological Stress, and Aging
Authors: Wang Guanglei , Shen Wei-Bin , Chen Anna Wu , Reece E. Albert , Yang Peixin
Published: August 2024

Pregestational diabetes, either type 1 or type 2 diabetes, induces structural birth defects including neural tube defects and congenital heart defects in human fetuses. Rodent models of type 1 and type 2 diabetic embryopathy have been established and faithfully mimic human conditions. Hyperglycemia of maternal diabetes triggers oxidative stress in the developing neuroepithelium and the embryonic heart leading to the activation of proapoptotic kinases and excessive cell death. Oxidative stress also activates the unfolded protein response and endoplasmic reticulum stress. Hyperglycemia alters epigenetic landscapes by suppressing histone deacetylation, perturbing microRNA (miRNA) expression, and increasing DNA methylation. At cellular levels, besides the induction of cell apoptosis, hyperglycemia suppresses cell proliferation and induces premature senescence. Stress signaling elicited by maternal diabetes disrupts cellular organelle homeostasis leading to mitochondrial dysfunction, mitochondrial dynamic alteration, and autophagy impairment. Blocking oxidative stress, kinase activation, and cellular senescence ameliorates diabetic embryopathy. Deleting the mir200c gene or restoring mir322 expression abolishes maternal diabetes hyperglycemia-induced senescence and cellular stress, respectively. Both the autophagy activator trehalose and the senomorphic rapamycin can alleviate diabetic embryopathy. Thus, targeting cellular stress, miRNAs, senescence, or restoring autophagy or mitochondrial fusion is a promising approach to prevent poorly controlled maternal diabetes-induced structural birth defects. In this review, we summarize the causal events in diabetic embryopathy and propose preventions for this pathological condition.

Key Points
Vascular Placental Pathology and Cardiac Structure in Stillborn Fetuses
Authors: Freedman Alexa A. , Cersonsky Tess E.K. , Pinar Halit , Goldenberg Robert L. , Silver Robert M. , Ernst Linda M.
Published: August 2024

Objective Adverse pregnancy outcomes, including preterm birth and preeclampsia, are associated with worse cardiovascular outcomes for offspring. Examination of the placenta is important for understanding how the prenatal period shapes long-term cardiovascular health. We sought to investigate the association between placental vascular malperfusion and fetal cardiac structure.

Study Design Data obtained from the Stillbirth Collaborative Research Network included stillbirths with placental pathology and autopsy. Stillbirths were classified in two ways: based on the severity of placental maternal vascular malperfusion (MVM) and based on the cause of death (MVM, fetal vascular malperfusion [FVM], or acute infection/controls). Organ weight and heart measures were standardized by gestational age (GA) and compared across groups.

Results We included 329 stillbirths in the analysis by MVM severity and 76 in the analysis by cause of death (COD). While z-scores for most organ weights/heart measures were smaller when COD was attributed to MVM as compared with FVM or controls, heart weight and brain weight z-scores did not differ by COD (p > 0.05). In analyses accounting for body size, the difference between heart and body weight z-score was −0.05 (standard deviation [SD]: 0.53) among those with MVM as a COD and −0.20 (SD: 0.95) among those with severe MVM. Right and left ventricle thicknesses and tricuspid, pulmonary, mitral, and aortic valve circumferences were consistently as expected or larger than expected for GA and body weight. In the analysis investigating the severity of MVM, those with the most severe MVM had heart measures that were as expected or larger than expected for body weight while those with only mild to moderate MVM had heart measures that were generally small relative to body weight.

Conclusion When assessed as COD or based on severity, MVM was associated with heart measures that were as expected or larger than expected for GA and body weight, indicating possible heart sparing.

Key Points
The Implications of a “Flat” Oral Glucose Tolerance Test Curve in Pregnancy
Authors: Lopian Miriam , Segal Ella , Neiger Ran , Many Ariel , Kashani Ligumsky Lior
Published: August 2024

Objective This study aimed to determine whether pregnant women who have “flat” oral glucose tolerance test (OGTT) curves in pregnancy are at increased risk of maternal or neonatal adverse outcomes.

Study Design We conducted a retrospective cohort study of the perinatal outcomes of pregnant women whose 100-g OGTT curve was “flat,” defined by a fasting serum glucose level below 95 mg/dL and the remaining values below 100 mg/dL. We compared their perinatal outcomes to women whose OGTT curve was “normal.” The primary outcomes compared were the prevalence of macrosomic and small for gestational age (SGA) neonates. Secondary outcomes included hypertensive disorders of pregnancy (HDP), prelabor anemia, thrombocytopenia, intrauterine fetal demise, placental abruption, indicated induction of labor, meconium-stained amniotic fluid, mode of delivery, postpartum hemorrhage, blood product transfusion, postpartum readmission, neonatal gender, gestational age at delivery, preterm birth, birth weight, low birth weight, umbilical artery pH < 7.1, Apgar score <7 at 5 minutes, neonatal intensive care unit admission, neonatal respiratory and infectious morbidity, and hypoglycemia. Composite adverse maternal and neonatal outcomes were also evaluated.

Results There were 1,060 patients in the study group and 10,591 patients in the control group. Patients with a flat OGTT were younger (28.3 vs. 29.8, p < 0.001) and less likely to be over 35 years old (14.1 vs. 23.4%, p < 0.001). They had a reduced risk of delivering a macrosomic neonate (11.4 vs. 15.1%, OR = 0.7 [0.58–0.89], p = 0.001) and having an unplanned cesarean delivery (7.5 vs. 10.2%, OR = 0.8 [0.58–0.96], p = 0.002). There was no difference in the rate of composite adverse maternal (14.0 vs. 15.4%, OR = 0.9 [0.7–1.0], p = 0.1) or neonatal outcome (5.3 vs. 4.5%, OR = 1.2 [0.9–1.5], p = 0.15). Neonates had a slightly lower mean birth weight (3,474 vs. 3,505 g, p = 0.04) but the rate of SGA was similar in the two groups (2.5 vs. 1.8%, OR = 1.3 [0.9–2.0], p = 0.08).

Conclusion Pregnant women whose OGTT curve is flat have a lower risk of delivering macrosomic neonates and undergoing unplanned cesarean delivery and are not at increased risk of adverse maternal or neonatal outcomes. More research is required to evaluate the relationship between different OGTT curves and the fetal growth rate.

Key Points
Social Determinants of Health and Diabetes in Pregnancy
Authors: Field Christine , Wang Xiao-Yu , Costantine Maged M. , Landon Mark B. , Grobman William A. , Venkatesh Kartik K.
Published: August 2024

Social determinants of health (SDOH) are the conditions in which people are born, grow, work, live, and age. SDOH are systemic factors that may explain, perpetuate, and exacerbate disparities in health outcomes for different populations and can be measured at both an individual and neighborhood or community level (iSDOH, nSDOH). In pregnancy, increasing evidence shows that adverse iSDOH and/or nSDOH are associated with a greater likelihood that diabetes develops, and that when it develops, there is worse glycemic control and a greater frequency of adverse pregnancy outcomes. Future research should not only continue to examine the relationships between SDOH and adverse pregnancy outcomes with diabetes but should determine whether multi-level interventions that seek to mitigate adverse SDOH result in equitable maternal care and improved patient health outcomes for pregnant individuals living with diabetes.

Key Points
Cross-lingual Natural Language Processing on Limited Annotated Case/Radiology Reports in English and Japanese: Insights from the Real-MedNLP Workshop
Authors: Yada Shuntaro , Nakamura Yuta , Wakamiya Shoko , Aramaki Eiji
Published: August 2024

Background Textual datasets (corpora) are crucial for the application of natural language processing (NLP) models. However, corpus creation in the medical field is challenging, primarily because of privacy issues with raw clinical data such as health records. Thus, the existing clinical corpora are generally small and scarce. Medical NLP (MedNLP) methodologies perform well with limited data availability.

Objectives We present the outcomes of the Real-MedNLP workshop, which was conducted using limited and parallel medical corpora. Real-MedNLP exhibits three distinct characteristics: (1) limited annotated documents: the training data comprise only a small set (∼100) of case reports (CRs) and radiology reports (RRs) that have been annotated. (2) Bilingually parallel: the constructed corpora are parallel in Japanese and English. (3) Practical tasks: the workshop addresses fundamental tasks, such as named entity recognition (NER) and applied practical tasks.

Methods We propose three tasks: NER of ∼100 available documents (Task 1), NER based only on annotation guidelines for humans (Task 2), and clinical applications (Task 3) consisting of adverse drug effect (ADE) detection for CRs and identical case identification (CI) for RRs.

Results Nine teams participated in this study. The best systems achieved 0.65 and 0.89 F1-scores for CRs and RRs in Task 1, whereas the top scores in Task 2 decreased by 50 to 70%. In Task 3, ADE reports were detected by up to 0.64 F1-score, and CI scored up to 0.96 binary accuracy.

Conclusion Most systems adopt medical-domain–specific pretrained language models using data augmentation methods. Despite the challenge of limited corpus size in Tasks 1 and 2, recent approaches are promising because the partial match scores reached ∼0.8–0.9 F1-scores. Task 3 applications revealed that the different availabilities of external language resources affected the performance per language.
Disparities in Delirium across the Continuum of Care and Associations with Social Determinants of Health
Authors: Khanna Anu , Govil Malvika , Ayele Nohamin , Saadi Altaf
Published: August 2024

Disparities exist in the identification, treatment, and management of delirium. These disparities can be most holistically and comprehensively understood by using a social–ecological model—which acknowledges multilevel impacts including individual, interpersonal, organizational, community, and policy-level factors—as well as a social determinant of health framework, that considers nonmedical factors that influence health outcomes. This narrative review leverages both frameworks to identify and discuss existing literature pertaining to the intersection of these social risk factors and delirium, focusing specifically on disparities due to racial and/or ethnic identity, language ability, and socioeconomic differences. We also look at disparities and the potential role of these social risk factors throughout the continuum of care, including prehospitalization, hospitalization, and posthospitalization factors. Understanding and analyzing the role of these inequities is critical to ensuring better health outcomes for patients at risk of and/or with delirium.
Overview of Unilateral and Bilateral Pediatric Facial Paralysis: Workup, Treatment, and Frontiers
Authors: Wiebe Jordan E. , Mulenga Chilando , Crabtree Jordan R. , Hussain Arif , Borschel Gregory H.
Published: August 2024

Pediatric facial nerve paralysis can present significant challenges based on its various etiologies, unique approach to treatment options, and overall outcomes. It can impact both the child and parent when regarding function, appearance, and psychosocial implications. The etiology of facial nerve palsy can include congenital, traumatic, iatrogenic, and idiopathic causes. In some, the paralysis is transient while others have permanent loss of function. A thorough evaluation and differential diagnosis are essential to guide treatment planning. The purpose of this paper is to review facial paralysis in children with a focus on surgical management.
The Effect of Self-Reported Race on Noninvasive Prenatal Screening Test Characteristics
Authors: Mitra Anjali N. , Dingel Aleksei , Kolarova Teodora , MacKinnon Hayley J. , Katz Ronit , Lockwood Christina M. , Shree Raj
Published: August 2024

Objective Low fetal fraction (FF) on cell-free DNA (cfDNA)-based noninvasive prenatal screening (NIPS) is a common etiology for indeterminate results. As maternal Black race is implicated as a risk factor for low FF and more indeterminate results, we sought to evaluate this association.

Study Design This was a single-institution, retrospective cohort study of cfDNA-based NIPS performed between May 2017 and May 2022 with complete clinical data abstraction. We compared FF, indeterminate rates, and total cfDNA concentration among self-reported Black, White, and Other groups from NIPS results from 2017 to 2022 with full clinical data abstraction. Using linear regression and interaction testing, we evaluated associations between self-reported race, FF, indeterminate rate, and total cfDNA concentration.

Results In total, 1,591 participants met the inclusion criteria; 70.8% (n = 1,126) self-identified as White, 6.9% (n = 110) as Black, and 22.3% (n = 355) self-identified with another race. Mean FF was not different between the White, Black, or Other groups (11.8 vs. 11.2 vs. 11.7%, respectively, p = 0.52). This remained true after adjusting for body mass index (BMI), gestational age (GA) at draw, and fetal sex (all p > 0.17). Interaction testing for FF and total cfDNA by race with BMI, GA at draw, and fetal sex demonstrated no effect modification.

Conclusion In our population, maternal self-identified race, particularly Black race, does not affect FF. Biological plausibility for race-based differences on clinical tests requires ongoing thoughtful consideration.

Key Points
Impact of Inpatient Patient–Provider Language Concordance on Exclusive Breastfeeding Rates Postpartum
Authors: Abbate Alexandra M. , Saucedo Alexander M. , Ghartey Jeny , López Julia , Alvarez Miriam , Hall Emily , Avshman Elaine , Okafor Odera , Olshavsky Megan , Harper Lorie M. , Cahill Alison G.
Published: August 2024

Objective Studies outside of obstetrics suggest that patient–provider language concordance may impact the efficacy of educational interventions and overall patient satisfaction. Many pregnant patients who present to the hospital for delivery with initial plans to exclusively breastfeed ultimately leave the hospital supplementing with formula. We aim to examine the impact of language concordance between patients and their primary bedside nurse during the delivery hospitalization period on the relationship between intended and actual feeding practices for term newborns of primiparous patients at a single institution.

Study Design This is a single-center, prospective cohort of primiparous patients with term, singleton gestations admitted for delivery between February 2022 and January 2023. Participants completed a predelivery survey on arrival and a postpartum survey before hospital discharge. The primary outcome was the association between nurse–patient language concordance and postpartum exclusive breastfeeding. Multiple logistic regression analysis was performed to assess the primary outcome, and p-values < 0.05 were considered significant.

Results Overall, 108 participants were surveyed, of which 84 (77.8%) noted language concordance with their primary nurse and 24 (22.2%) reported language discordance. The race/ethnicity, language spoken at home, reported plans to return to work, WIC (special supplemental nutrition program for women, infants, and children) enrollment, and prenatal feeding plan variables revealed significant differences in reported language concordance. Following adjustment for patient-reported prenatal feeding plan, patients who reported language concordance with their primary nurse were significantly more likely to exclusively breastfeed in the immediate postpartum period (adjusted odds ratio, 5.60; 95% confidence interval, 2.06–16.2).

Conclusion Patients who reported language concordance with their primary nurse were significantly more likely to breastfeed exclusively in the immediate postpartum period. These findings highlight that language concordance between patients and bedside health care providers may contribute to initiating and continuing exclusive breastfeeding during the peripartum period.

Key Points
Clinical Outcome of Patients with Epithelioid Glioblastoma Harboring BRAFV600E Mutation; A Single Institution Experience
Authors: Subramanian Preethi , Das Anindita , Chilukuri Srinivas , Rajendran Adhithyan , Patil Sushma , Mullapally Sujith Kumar , Krishna Uday , Kumar Roopesh , Jalali Rakesh
Published: August 2024

Purpose Epithelioid glioblastoma (GBM) is a rare variant of GBM. The study aimed to look into clinicopathological details and outcomes of patients with epithelioid GBM harboring BRAFV600E mutation from a single institution.

Methods Ten cases of epithelioid GBM diagnosed over the past 5 years were reviewed. All patients underwent surgical resection followed by adjuvant treatment as per protocol after initial diagnosis. Of these, seven patients were planned to redo surgery, reradiation, BRAF with MEK inhibitors, and bevacizumab based on clinical condition, magnetic resonance imaging findings, and progression-free survival after their recurrence. Four recurrent patients had received dabrafenib and trametinib.

Results All tumor locations were supratentorial. The median follow-up was 2.3 years and the median time to recurrence was 19 months from the diagnosis (range 4–36 months). Four recurrent patients received BRAF + MEK inhibitors. One patient who started dabrafenib and trametinib experienced local progression after 33 months, followed by lung and bone metastasis. One patient died due to multiple subacute hemorrhages, who was a known case of congenital vascular malformations, and two patients remained disease-free after a year and 2 years.

Conclusion Epithelioid GBM is a very rare, but well-documented entity. Therefore, careful preoperative imaging and detailed evaluation of genetic studies including BRAF V600E mutation are necessary for accurate diagnosis and appropriate selection of treatment for epithelioid GBM. Dabrafenib plus trametinib showed clinically meaningful activity in patients with BRAF V600E mutation-positive recurrent high-grade glioma.
Therapeutic Plasma Exchange for a Critically Ill Late Preterm Infant with Multisystem Inflammatory Syndrome of Children: A Case Report and Review of the Literature
Authors: Saglik Adviye Cakil , Yilmaz Semerci Seda , Aygun Erhan , Gemici Hakan , Topal Neval , Buyukkale Gokhan
Published: August 2024

Multisystem inflammatory syndrome of children (MIS-C) is a clinical picture that entered the medical nomenclature after the coronavirus disease 2019 pandemic. Although it primarily affects older children, there have been a limited number of cases reported during the neonatal period. Herein we present a patient, a late preterm infant, with severe MIS-C-related cerebral sinus venous thrombosis who was successfully treated with therapeutic plasma exchange. Practitioners can consider therapeutic plasma exchange as a safe and effective option for the treatment of critically ill MIS-C cases.
StreetTalk: exploring energy insecurity in New York City using a novel street intercept interview and social media dissemination method
Authors: Sprague Nadav L. , Fan Isabel B. , Dandeneau Michelle , Hernandez Perez Jorge Fabian , Birmingham Jordyn , De Los Santos Daritza , Riddick Milan I. , Meltzer Gabriella Y. , Siegel Eva L. , Hernández Diana
Published: August 2024

This study introduces StreetTalk, an original qualitative research methodology inspired by social media influencers, to investigate perceptions and experiences of energy insecurity among New York City (NYC) residents. Briefly, energy insecurity is defined as difficulty meeting household energy needs due to affordability, housing quality, outages and coping strategies. This present study employs dynamic short-form interviews with 34 participants from all five NYC boroughs of diverse economic, and racial/ethnic backgrounds. Thematic analysis of video-recorded interviews revealed six major energy insecurity-related categories: (1) conservation and trade-offs, (2) physical inefficiencies, (3) thermal agency, (4) response to the bill, (5) disappointment and distrust in energy-related authorities, and (6) desire for and barriers to clean energy adoption. These themes provide insight into NYC residents’ experiences with energy insecurity and are consistent with prior research. Beyond new scholarly insights, this study introduces StreetTalk, an innovative qualitative research methodology emphasizing rapid data collection and dissemination through social media platforms, including TikTok, Instagram, Facebook, and YouTube (@hotandcold_nyc). Taking advantage of modern technology and modes of communication, the research team was able to effectively break down barriers to academic research consumption as the videos achieved substantial engagement, with almost 200,000 views and impressions within the first year of launching this novel street-based data collection and social media dissemination campaign.
Using ejecta measurement simulations to predict real-life results
Authors: Green Leigh Ann
Published: August 2024

Photon Doppler Velocimetry offers a simpler, more comprehensive approach for measuring ejecta.
Contact topology and electromagnetism: The Weinstein conjecture and Beltrami-Maxwell fields
Authors: Goto Shin-itiro
Published: August 2024

We draw connections between contact topology and Maxwell fields in vacuo on three-dimensional closed Riemannian submanifolds in four-dimensional Lorentzian manifolds. This is accomplished by showing that contact topological methods can be applied to reveal topological features of a class of solutions to Maxwell’s equations. This class of Maxwell fields is such that electric fields are parallel to magnetic fields. In addition these electromagnetic fields are composed of the so-called Beltrami fields. We employ several theorems resolving the Weinstein conjecture on closed manifolds with contact structures and stable Hamiltonian structures, where this conjecture refers to the existence of periodic orbits of the Reeb vector fields. Here a contact form is a special case of a stable Hamiltonian structure. After showing how to relate Reeb vector fields with electromagnetic 1-forms, we apply a theorem regarding contact manifolds and an improved theorem regarding stable Hamiltonian structures. Then a closed field line is shown to exist, where field lines are generated by Maxwell fields. In addition, electromagnetic energies are shown to be conserved along the Reeb vector fields.
Source shape estimation for neutron imaging systems using convolutional neural networks
Authors: Saavedra Gary , Geppert-Kleinrath Verena , Danly Chris , Durocher Mora , Wilde Carl , Fatherley Valerie , Mendoza Emily , Tafoya Landon , Volegov Petr , Fittinghoff David , Rubery Michael , Freeman Matthew S.
Published: August 2024

Neutron imaging systems are important diagnostic tools for characterizing the physics of inertial confinement fusion reactions at the National Ignition Facility (NIF). In particular, neutron images give diagnostic information on the size, symmetry, and shape of the fusion hot spot and surrounding cold fuel. Images are formed via collection of neutron flux from the source using a system of aperture arrays and scintillator-based detectors. Currently, reconstruction of fusion source geometry from the collected neutron images is accomplished by solving a computationally intensive maximum likelihood estimation problem via expectation maximization. In contrast, it is often useful to have simple representations of the overall source geometry that can be computed quickly. In this work, we develop convolutional neural networks (CNNs) to reconstruct the outer contours of simple source geometries. We compare the performance of the CNN for penumbral and pinhole data and provide experimental demonstrations of our methods on both non-noisy and noisy data.
Design and development of the magnetic diagnostic systems for the first operational phase of the SMART tokamak
Authors: Pozo F. Puentes-del , Vicente-Torres P. , Cruz-Zabala D. J. , Munaretto S. , Garcia-Munoz M. , Viezzer E. , Mancini A. , Rodriguez-Gonzalez A. , Sanchez-Gamino J. , Segado-Fernandez J.
Published: August 2024

A set of magnetic diagnostics has been designed, manufactured, and calibrated for the first operational phase of the small aspect ratio tokamak. The sensor suite comprises of Rogowski coils; 2D magnetic probes; and poloidal, saddle, and diamagnetic flux loops. A set of continuous Rogowski coils has been manufactured for the measurement of plasma current and induced eddy currents in conductive elements. A set of flux loops and magnetic probes will be used as input for the reconstruction of the magnetohydrodynamic equilibrium. The quantity and position of these sensors have been verified to be sufficient with synthetic equilibrium reconstructions using the equilibrium fitting code and baseline scenarios computed with the Fiesta code. These sensors will also be used as input for the real-time control system, and magnetic probes will be used for the detection of plasma instabilities. The calibration procedure for the magnetic probes is described, and the results are shown. The signal conditioning and data acquisition systems are described.
Tuning bandgap and controlling oxygen vacancy in BiFeO3 via Ba(Fe1/2Nb1/2)O3 substitution for enhanced bulk ferroelectric photovoltaic response in Al/BFO–BFN/Ag solar cell
Authors: Venkidu L. , Raja N. , Venkidu Vasundharadevi , Sundarakannan B.
Published: August 2024

The generation of above-bandgap photovoltage, referred to as the anomalous photovoltaic effect (APV), is an extraordinary characteristic sought after property in bulk ferroelectric photovoltaic devices. Despite the fact that the relatively narrow bandgap of BiFeO3 (BFO) (2.7 eV) induces a comparatively larger generation of photocurrent than other ferroelectric photovoltaic, it falls short in producing an anomalous photovoltage (Eg ≪ Voc) and exhibits leaky ferroelectric hysteresis due to unavoidable oxygen vacancies. This work revealed a reduction in oxygen vacancies through the substitution of Ba(Fe1/2Nb1/2)O3 in BFO, leading to improved structural, morphological, synchrotron XPS, and electrical properties. This reduction in oxygen vacancies has resulted in an impressive above-bandgap photovoltage (APV) of 4.41 V for 80BFO–20BFN with greater ferroelectric polarization (Pr = 20.45 μC/cm2) observed at the co-existence of polar and non-polar phases. Moreover, both theoretical and experimental optical analyses have demonstrated a significant decrease in the bandgap to 1.92 eV, effectively extending the visible region close to 653 nm. As a result, a larger population of photoexcited charge carriers is generated, enabling the attainment of a high current density (Jsc) of 0.75 μA/cm2 under 100 mW/cm2 light irradiation.
Late-stage boundary layer transition mechanisms: A vorticity point of view
Authors: Suryanarayanan Saikishan , Goldstein David B. , Brown Garry L.
Published: August 2024

Mechanisms that ultimately lead to the enhanced wall shear stress toward the end of transition to turbulence in a zero-pressure gradient boundary layer are examined for two different transition routes using direct numerical simulations. This paper examines, using a vorticity point of view, late-stage transition mechanisms in roughness induced transition produced by distributed roughness, and a classical transition caused by a large amplitude Tollmien–Schlichting (TS) wave interacting with free stream disturbances adding to the recent insights on discrete roughness induced transition [Suryanarayanan et al., “Roughness induced transition: A vorticity point of view,” Phys. Fluids 31(2), 024101 (2019)]. The Reynolds stress is written in terms of vorticity fluxes, and large negative values of the vorticity flux term associated with the correlation of the spanwise velocity and wall-normal vorticity, w′ωy′¯, are observed in the late-stage transition in all cases. A decrease in wall shear stress is observed when near-wall spanwise motion is suppressed, whereas suppression of spanwise motion far away from the wall does not immediately alter wall shear stress; this observation further supports the finding that w′ωy′¯ is the dominant term that increases wall shear stress during transition. w′ωy′¯ is demonstrated to be correlated with streamwise vorticity near the wall, and this mechanism is illustrated by studying the evolution of a streamwise vortex in a Couette flow.
Harnessing two-dimensional electron gas in oxide heterostructures for integrated neuromorphic architecture and logic operations on a single chip
Authors: Gupta Anshu , Vashist Amit , Chakraverty Suvankar
Published: August 2024

Neuromorphic electronics, inspired by the complexity of the biological brain, hold promise for revolutionizing information technology by enabling more efficient computing paradigms. Here, we report the potential of oxide heterostructure materials as building blocks for synapses in neuromorphic computer networks. Our approach involves utilizing two-dimensional electron gas (2DEG) within the oxide heterostructure EuO–KTaO3 (KTO), which exhibits optoelectronic properties essential for emulating key cognitive functions such as sensory perception, learning, and memory. The 2DEG at the EuO–KTO interface demonstrates the ability to switch from volatile to nonvolatile resistive states as the gate voltage sweeps using an optical signal as stimuli, unlike memristors using compliance current. Our single device not only accurately replicates the short- and long-term plasticity seen in biological synapses but also performs logic gate operations, enhancing its versatility and functionality.
Dynamics of the Cl + CH3CN reaction on an automatically-developed full-dimensional ab initio potential energy surface
Authors: Tóth Petra , Szűcs Tímea , Győri Tibor , Czakó Gábor
Published: August 2024

A full-dimensional analytical potential energy surface (PES) is developed for the Cl + CH3CN reaction following our previous work on the benchmark ab initio characterization of the stationary points. The spin–orbit-corrected PES is constructed using the Robosurfer program and a fifth-order permutationally invariant polynomial method for fitting the high-accuracy energy points determined by a ManyHF-based coupled-cluster/triple-zeta-quality composite method. Quasi-classical trajectory simulations are performed at six collision energies between 10 and 60 kcal mol−1. Multiple low-probability product channels are found, including isomerization to isonitrile (CH3NC), but out of the eight possible channels, only the H-abstraction has significant reaction probability; thus, detailed dynamics studies are carried out only for this reaction. The cross sections and opacity functions show that the probability of the H-abstraction reaction increases with increasing collision energy (Ecoll). Scattering angle, initial attack angle, and product relative translational energy distributions indicate that the mechanism changes with the collision energy from indirect/rebound to direct stripping. The distribution of initial attack angles shows a clear preference for methyl group attack but with different angles at different Ecoll values. Post-reaction energy distributions show that the energy transfer is biased toward the products’ relative translational energy instead of their internal energy. Rotational and vibrational energy have about the same amount of contribution to the internal energy in the case of both products (HCl and CH2CN), i.e., both of them are formed with high rotational excitations. HCl is produced mostly in the ground vibrational state, while a notable fraction of CH2CN is formed with vibrational excitation.