bluuebunny/crossref_metadata_2025 huggingface dataset:
Human movement detection and classification capabilities using passive Wi-Fi based radar
Authors: Razali Hidayatusherlina , Abd Rashid Nur Emileen , Nasarudin Muhammad Nazrin Farhan , Ismail Nor Najwa , Ismail Khan Zuhani , Enche Ab Rahim Siti Amalina , Megat Ali Megat Syahirul Amin , Zakaria Nor Ayu Zalina
Published: April 2024

Human detection and classification via Wi-Fi transmission have received a lot of attention in recent years as crucial facilitators in security and human-computer interaction (HCI). The passive Wi-Fi radar (PWR) system used by previous researchers applied cross-ambiguity function (CAF) and CLEAN algorithms to process the detected signals. This paper explores the feasibility and viability of a PWR system in detecting and classifying human movements without utilizing CAF and CLEAN algorithms. The movements are performed by four participants but with comparable body sizes and heights. Three daily human movements are investigated namely walking, bending, and sitting, with each participant performing each movement 24 times, providing a total of 96 samples per activity. The system is evaluated based on the consistency of the signal pattern in a frequency domain and the percentage accuracy is assessed using an artificial neural network (ANN) classifier and trained using a leave-one-out cross-validation (LOOCV) method. The frequency domain results reveal that the signals are consistent, with no noticeable variations or changes in the voltage intensity or shape of the main lobe. The classification of the movements shows that the classifier has an overall accuracy of 97.6%.
Solar PV based seventeen level reduced switch symmetrical multilevel inverter topology fed induction motor
Authors: Gajula Ujwala , Manivannan Kalpanadevi , Reddy Nomula Malla
Published: April 2024

Multilevel inverters have received a lot of interest in recent years due to their ability to deliver more voltage levels than typical two-level inverters. Because of this property, multilevel inverters can produce output waveforms that closely resemble sinusoidal waveforms, lowering harmonic distortion dramatically. The emergence of reduced switch symmetrical multilevel inverter topologies has developed the curiosity of many different power conversion systems. These new topologies offer numerous advantages, including greater output voltage quality, fewer harmonic distortions, and increased power conversion efficiency. The inclusion of these inverters in the feeding of induction motors is one of their many prominent uses. A 17 levels of multi-level inverter (MLI) topology is presented with reduced switch count and harmonic reduction for power quality improvement. The inverter is fed by isolated equal photovoltaic panels which act as direct current or DC source. To reduce complexity, switching pulses are generated using hybrid pulse width modulation technique which is designed as controller. Through the use of MATLAB/Simulink, the performance assessment of a unique cascaded multilevel inverter-based reduced switch symmetrical inverter feeding an induction motor drive has been verified. The harmonic distortion with reduced switches obtained is 7.47% which is comparatively less than when compared with conventional cascaded H-bridge topology.
Computer simulation of open-circuit fault-tolerant boost rectifier based on SPMC
Authors: Hayroman Muhammad Hakiem , Baharom Rahimi , Abdul Munim Wan Noraishah Wan , Muhammad Khairul Safuan
Published: April 2024

This paper presents a computer simulation of an open-circuit fault-tolerant boost rectifier based on a single-phase matrix converter using MATLAB/ Simulink. The proposed converter employs a fault identification technique to identify the faulty switch by generating a binary code extracted from the output voltage, magnitude of inductor current, and cycle of the input power supply. Upon identifying the faulty switch, the current is redirected to any available path through operational switches by controlling the switching devices. The aim is to ensure uninterrupted power supply from the source to the load. The paper includes a detailed analysis of the fault identification technique and the options for rerouting the current path. The outcomes of this paper are simulated using MATLAB/Simulink.
Least mean square based adaptive control of active power filter
Authors: Chander Ramavath , Rao Edara Venkata Chandra Sekhara , Vidyasagar Erukula
Published: April 2024

The proposed control scheme is based on the least mean square (LMS) algorithm. The LMS algorithm is employed to estimate the necessary reference tracking current for the active power filter (APF). The proposed control scheme aims to enhance the dynamic response of the APF and minimize steady-state error. The weights of the LMS technique are calculated based on the estimated current of the APF. This algorithm is employed to minimize the error difference between the desired system output and its actual output, known as the mean square error (MSE). The estimated weights are utilized to modify the reference current weights, enabling them to follow the intended current of the APF. The online adaption of the LMS method involves the real-time adjustment of the weights. The performance of the LMS-based APF control is evaluated through a simulation study in MATLAB/Simulink, where it is compared with the conventional control method.
Investigation of bidirectional three-phase four-leg converter with LCL filter
Authors: Dobroskok Nikita A. , Stotckaia Anastasiia D. , Migranov Ruslan M. , Lavrinovskiy Victor S. , Yurievich Perevalov Yurii , Melnikov Artem S. , Parmenov Vyacheslav , Maslennikov Nazar V.
Published: April 2024

A three-phase four-leg bidirectional power converter used as an input stage of an energy storage system using the inductance (L), capacitance (C), and inductance (L) or LCL filter on the grid side is considered. The article provides a variant of the three-phase four-leg bidirectional converter control system implementation based on 3D space vector pulse-width modulation and per-phase voltage control. A brief analysis of the applied control algorithms of the three-phase four-leg bidirectional converter in inverter and rectifier modes is given. A computer model has been built to investigate the operating modes of the converters of the designated class with both balanced and unbalanced load. Studies were carried out by computer modeling methods in order to optimize the parameters of the LCL filter on the grid side with bidirectional energy exchange. Optimal LCL filter parameters and modulation frequencies are determined for the developed converter, providing acceptable quality indicators when operating in bidirectional mode.
Hybrid renewable/grid power systems, an essential for base transceiver station penetration in Rural Nigeria
Authors: Ebiega Godslove I. , Dugeri Terdoo M. , Irefu Ovis D.
Published: April 2024

The energy crisis in Nigeria has continued to impede the rapid expansion of the telecommunication industry, whose operating expenditure is galloping due to over-dependence on diesel generators as an alternative source of power to its base transceiver station (BTS). This fossil-fuel power source has also increased the industry’s carbon footprint. As a solution to these problems, the objective of this work is to provide a sustainable and quality hybrid DC power supply system for BTS that would increase access to information and communication technology or ICT infrastructure. This involves the integration of solar & wind energy with the grid. The sizing of the hybrid sub-systems was designed & simulated using MATLAB Simulink to test for functionality. A prototype of the design system was then implemented with the results showing an average power output that guarantees 21 hours/day of supply. By installing this hybrid system of 1.3 kW, approximately 2.55 kg of diesel (C10H20) would be un-utilized by one BTS, thereby preventing 3.6 kg of CO2 from been emitted to the atmosphere daily. Extrapolating these values shows 930.75 kg of diesel can be saved and reduce 1314 kg of CO2 emission within a year. Hence eliminating the need for diesel-backup generator for a grid connected or non-grid BTS sited in rural areas.
A Li-ion battery charger based on LDO regulator with pre-charge mode in 180 nm CMOS technology
Authors: Ouremchi Mounir , El Khadiri Karim , Qjidaa Hassan , Jamil Mohammed Ouazzani
Published: April 2024

This paper presents a novel Li-Ion battery charger that utilizes a low-dropout (LDO) regulator and incorporates four control modes: low constant current mode, pre-charge current mode, fast constant current mode, and constant voltage mode. The charger aims to meet specific criteria such as high precision, high efficiency, and small form factor. Through simulation results, the following specifications were obtained using a 1.8 V supply in a 0.18 μm complementary metal–oxide–semiconductor (CMOS) technology: a trickle current of 124.7 mA, a pre-charge current of 466.94 mA, a maximum charge current of 1.06 A, and a charge voltage of 4.21 V. The proposed charger demonstrates an efficiency of 92%.
Comparative study of passive magnetic bearing using four ring magnets: a critical review
Authors: Chaojun Yang , Wondimu Amberbir , Salau Ayodeji Olalekan
Published: April 2024

Researchers on reducing energy losses caused by friction in small-scale wind turbines. This is crucial because a significant amount of energy is wasted due to friction in the main roller bearing. In order to overcome this, the concept of levitation has gained popularity. Levitation is achieved by employing the repelling forces between two opposing poles of a permanent magnet (PM), significantly reducing friction between the turbine stator and rotor. As a result, the overall energy production of the turbine increases. The use of passive permanent magnet bearings has several disadvantages, such as limited load-bearing capacity and rigidity. To address these limitations, we conducted numerical studies on four different configurations in order to enhance load-bearing capacity and stiffness. The results showed that the radial configuration outperformed the axial-type configuration in terms of stiffness and load-bearing capabilities in all four arrangements. Furthermore, it was revealed that radial passive magnetic bearings with adequate air gaps are not only more efficient but also less expensive than employing iron cores at the rear and between ring magnets for small-scale wind turbines.
Controlling parameters proportional integral derivative of DC motor using a gradient-based optimizer
Authors: Aribowo Widi , Rahmadian Reza , Widyartono Mahendra , Wardani Ayusta Lukita , Prapanca Aditya , Abualigah Laith
Published: April 2024

In this paper, a gradient-based optimizer (GBO) algorithm is presented to optimize the parameters of a proportional integral derivative (PID) controller in DC motor control. The GBO algorithm which mathematically models and mimics is inspired by the gradient-based Newton method. It was developed to address various optimization issues. To determine the performance of the proposed method, a comparison method with the ant colony optimization (ACO) method. It was compared using the integral of time multiplied absolute error (ITAE). They are most popularly used in the literature. From the test results, the proposed method is promising and has better effectiveness. The proposed method, namely GBO-PID, shows the best performance.
Performance evaluation of BLDC motor drive mounted in aerial vehicle (drone) using adaptive neuro-fuzzy
Authors: Rao Gurrala Madhusudhana , Prasanna B. Lakshmi , Rayudu Katuri , Kondaiah Vempalle Yeddula , Thrinath Boyanasetti Venkata Sai , Gopal Talla Venu
Published: April 2024

The development of autonomous drones equipped with cameras and various sensors has paved the way for their application in agriculture and perimeter security. These aerial drones require specific power, acceleration, high torque, and efficiency to meet the demands of agricultural tasks, utilizing built-in brushless DC (BLDC) motors. However, a common challenge drone’s face is maintaining the desired speed for extended periods. Enhancing the performance of BLDC motors through advanced controllers is crucial to address this issue. This research paper proposes optimizing the size and speed of brushless DC motors for aerial vehicles using an adaptive fuzzy inference system and supervised learning techniques. When these drones carry loads, the BLDC motors must dynamically adjust the drone's speed. During this phase, the motors must control their speed and torque using artificial intelligence controllers like adaptive neuro-fuzzy inference systems (ANFIS) to enhance the drone's functionality, resilience, and safety. This research has conducted analyses focused on improving the performance of BLDC motors explicitly personalized for unmanned aerial vehicle (UAVs). The proposed method will be implemented using MATLAB/Simulink, expecting to significantly enhance the BLDC motor's performance compared to conventional controllers. Comparative analyses will be conducted between traditional and ANFIS controllers to validate the effectiveness of the proposed approach.
An illustrated catalog of Disteniidae (Coleoptera: Chrysomeloidea) type specimens deposited at the Museu de Zoologia da Universidade de São Paulo
Authors: Botero Juan Pablo , Casari Sônia A. , Santos-Silva Antonio
Published: April 2024

The type specimens of the family Disteniidae Thomson, 1861 (Coleoptera) housed at the Museu de Zoologia, Universidade de São Paulo (MZSP) are cataloged and illustrated. Photos of dorsal and ventral habitus, labels, and complete label data of all the specimens are provided. There are 147 specimens belonging to 70 names: 33 primary types, 31 holotypes, and two lectotypes; and 114 secondary types, 52 paratypes, and two paralectotypes. Elytrimitatrix (Grossifemora) Santos-Silva & Hovore, 2007 is the genus with the greatest number of species with type material, 21 species, followed by Cometes Lepeletier & Audinet-Serville, 1828 and Novantinoe Santos-Silva & Hovore, 2007 with 15 and 13 species, respectively.
Carta ao Mestre Jorge O. Caron
Authors: Cônsoli Reinaldo
Published: April 2024

Sem resumo.
Cecilia Salles: Da crítica genética à teoria crítica dos processos de criação
Authors: Dourado Patrícia , Dias Wagner Miranda
Published: April 2024

The Manuscrítica review joins, with this special edition, the celebrations of Cecilia Salles' 30 years of contributions to the area of ​​Creation Processes and the development of the Critical Theory of Creation Processes, the result of the author's search for theoretical paths in integration with its practices. We bring togetherin this publication contributions from new and old students of Cecilia Salles over these more than 30 years, in the Communication and Semiotics Program at PUC-SP, in the Literature and Literary Criticism Program at PUC-SP and in the Master's Degree in Creation Processes from the University of Algarve, as well as professors and researchers from other institutions who had contact with the theorist's work and sent their contributions. Artists and scholars of creative processes in the most diverse areas, spread across various parts of Brazil and the world, and who reveal themselves here in the intercession of creative processes and in dialogue with Salles' theory. The "creation network" mentioned by Salles (2006) has a beautiful materialization in this commemorative edition.
Criação e subjetividade no processo de construção do artista Maxwell Alexandre
Authors: Carlin Mariana Henriques Duarte
Published: April 2024

The article aims to reflect on the complex network that shapes the construction process of the artist Maxwell Alexandre, supported by the critical theory of the creation process, by Cecilia Almeida Salles. The choice of this artist is justified by the fact that his work moves between the traditional arts circuit and digital networks with fluidity and boldness, which allows him to identify redundancies, ambiguities and disruptions that reveal his originality. The article points to the formulation that the set of shared practices of the artist Maxwell Alexandre, as creative agent and complex subject, constitutes his poetic project in permanent expansion.
Escola Dinâmica de Escritores de Mario Bellatin - rede de criação coletiva em escrita literária
Authors: Paiva Cristina
Published: April 2024

Nesse artigo iremos realizar uma discussão sobre a Escola Dinâmica de Escritores (EDDE), criada e dirigida pelo escritor peruano-mexicano Mario Bellatin na Cidade do México, a partir da Crítica de Processos Criativos de Cecília Almeida Salles. Em nossa análise, observamos que a EDDE se estrutura como um espaço coletivo de criação literária a partir do espelhamento de princípios criativos do escritor Mario Bellatin, por ele sistematizados e organizados na forma de conteúdos e atividades práticas. Dessa forma, a escola se fundamenta em valores que coincidem com as “tendências do processo” de Bellatin, mas, ainda assim, abre-se para a participação e contribuição de professores e alunos, incorporando em sua dinâmica o imprevisto, o acaso e a não-linearidade. Por isso, ela mesma pode ser lida como uma grande rede em construção, conforme conceituado por Salles. Com esse estudo, pretendemos, de maneira ampla, iniciar uma discussão sobre oficinas de criação como espaços privilegiados na análise e discussão dos caminhos da criação artística contemporânea em sua interface com proposições para seu ensino, assim como contribuir para o desenvolvimento de reflexões teóricas sobre processos de criação artística no campo da Crítica de Processos Criativos de Cecília Almeida Salles.
Confluências e ressonâncias da Teoria Crítica dos Processos de Criação de Cecilia Salles nas trilhas da literatura: relato sobre Encadeamentos
Authors: Amaral Beatriz Helena Ramos
Published: April 2024

The purpose of this article is to revisit the formulation route of the critical theory of creation processes of Cecilia Almeida Salles, highlighting some basic topics, and to reflect about them, through the analysis of its resonances on the work of creative agents and researchers. Firstly, we present a brief introduction of Salles’s critical theory of creation processes. Then, we highlight the confluence points of its foundations and the research on the creative process of Encadeamentos (poetry), analysed by Anna Luiza Campanhã de Camargo Arruda Bauer, as well as our research on Edgard Braga’s (poet / artist) and Paulo César Pinheiro’s (composer, poet, novelist and playwriter) literary works, emphasizing the repercussion of creation networks on artistic praxis.
Nós-em-obra, em-fluxo, em-incorporação.
Authors: Dias Kenia
Published: April 2024

O objetivo desse artigo é abordar  processos de criação em artes cênicas a partir da análise de trechos do diário de montagem da peça Nós do Grupo Galpão (MG) e do diário de whatsApp da Prática Aisthesis (DF). Para tanto, proponho analisá-los e relacioná-los em uma perspectiva processual, dinâmica, móvel e que está para além do armazenamento de informações, mas inseridos na complexa relação e mobilidade entre obra e processo. A reflexão é, também, sobre a manutenção dos processos nas obras a partir da ideia de fluxos, gerúndios e corporalidades presentes nas trajetórias de criação. O diálogo teórico se fundamenta nas pesquisas de criação em rede alavancadas por Cecília Salles nas quais destaca as pluralidades de pontos de vista e o aspecto relacional nos processos de criação, assim como, nos estudos de Diana Taylor que questiona e fortalece as relações entre arquivo e repertório.
Cinema, Theater and Covid-19: the Creative Process of “Even Though it is Night”
Authors: Simão Diogo
Published: April 2024

The article proposes an analysis of the group creation of the short film Even though it is night, with a special focus on the materials raised by the multidisciplinary approach and the setbacks caused by the Covid-19 pandemic. Based on the theoretical perspectives elaborated by Cecilia Salles, this genetic analysis also extends to geographical, social, temporal, ethical, and referential contextualization. It highlights artistic practices and positions of creators who influenced this creation, such as Peter Brook, João Canijo, or Yorgos Lanthimos.
Cardiac Magnetic Resonance Feature-Tracking Identifies Preclinical Abnormalities in Hypertrophic Cardiomyopathy Sarcomere Gene Mutation Carriers
Authors: Negri Francesco , Sanna Giuseppe Damiano , Di Giovanna Giulia , Cittar Marco , Grilli Giulia , De Luca Antonio , Dal Ferro Matteo , Baracchini Nikita , Burelli Massimo , Paldino Alessia , Del Franco Annamaria , Pradella Silvia , Todiere Giancarlo , Olivotto Iacopo , Imazio Massimo , Sinagra Gianfranco , Merlo Marco
Published: April 2024

BACKGROUND:

Assessing myocardial strain by cardiac magnetic resonance feature tracking (FT) has been found to be useful in patients with overt hypertrophic cardiomyopathy (HCM). Little is known, however, of its role in sarcomere gene mutation carriers without overt left ventricular hypertrophy (subclinical HCM).

METHODS:

Thirty-eight subclinical HCM subjects and 42 healthy volunteers were enrolled in this multicenter case-control study. They underwent a comprehensive cardiac magnetic resonance study. Two-dimensional global radial, circumferential, and longitudinal strain of the left ventricle (LV) were evaluated by FT analysis.

RESULTS:

The subclinical HCM sample was 41 (22–51) years old and 32% were men. FT analysis revealed a reduction in global radial strain (29±7.2 versus 47.9±7.4;
P
<0.0001), global circumferential strain (−17.3±2.6 -versus -20.8±7.4;
P
<0.0001) and global longitudinal strain (−16.9±2.4 versus −20.5±2.6;
P
<0.0001) in subclinical HCM compared with control subjects. The significant differences persisted when considering the 23 individuals free of all the structural and functional ECG and cardiac magnetic resonance abnormalities previously described. Receiver operating characteristic curve analyses showed that the differential diagnostic performances of FT in discriminating subclinical HCM from normal subjects were good to excellent (global radial strain with optimal cut-off value of 40.43%: AUC, 0.946 [95% CI, 0.93–1.00]; sensitivity 90.48%, specificity 94.44%; global circumferential strain with cut-off, −18.54%: AUC, 0.849 [95% CI, 0.76–0.94]; sensitivity, 88.10%; specificity, 72.22%; global longitudinal strain with cut-off, −19.06%: AUC, 0.843 [95% CI, 0.76–0.93]; sensitivity, 78.57%; specificity, 78.95%). Similar values were found for discriminating those subclinical HCM subjects without other phenotypic abnormalities from healthy volunteers (global radial strain with optimal cut-off 40.43%: AUC, 0.966 [95% CI, 0.92–1.00]; sensitivity, 90.48%; specificity, 95.45%; global circumferential strain with cut-off, −18.44%: AUC, 0.866 [95% CI, 0.76–0.96]; sensitivity, 92.86%; specificity, 77.27%; global longitudinal strain with cut-off, −17.32%: AUC, 0.838 [95% CI, 0.73–0.94]; sensitivity, 90.48%; specificity, 65.22%).

CONCLUSIONS:

Cardiac magnetic resonance FT-derived parameters are consistently lower in subclinical patients with HCM, and they could emerge as a good tool for discovering the disease during a preclinical phase.
Historical Redlining and Heart Failure Outcomes Following Hospitalization in the Southeastern United States
Authors: Fields Nicole D. , Tristan Urrutia Andrea , Morris Alanna A. , Kramer Michael R. , Lewis Tené T. , Patel Shivani A.
Published: April 2024

Background

Historical redlining, a discriminatory lending practice, is an understudied component of the patient risk environment following hospital discharge. We investigated associations between redlining, patient race, and outcomes following heart failure hospitalization.

Methods and Results

We followed a hospital‐based cohort of Black and White patients using electronic medical records for acute heart failure hospitalizations between 2010 and 2018 (n=6800). Patient residential census tracts were geocoded according to the 1930s Home Owners' Loan Corporation map grades (A/B: best/still desirable, C: declining, D: redlined). We used Poisson regression to analyze associations between Home Owners' Loan Corporation grade and 30‐day outcomes (readmissions, mortality, and their composite). One‐third of patients resided in historically redlined tracts (n=2034). In race‐stratified analyses, there was a positive association between historically declining neighborhoods and composite readmissions and mortality for Black patients (risk ratio [RR], 1.24 [95% CI, 1.003–1.54]) and an inverse association between redlined neighborhoods and 30‐day readmissions among White patients (RR, 0.58 [95% CI, 0.39–0.86]). Examining racial disparities across Home Owners' Loan Corporation grades, Black patients had higher 30‐day readmissions (RR, 1.86 [95% CI, 1.31–2.65]) and composite readmissions and mortality (RR, 1.32 [95% CI, 1.04–1.65]) only in historically redlined neighborhoods.

Conclusions

Historical redlining had potentially mixed impacts on outcomes by race, such that residing in less desirable neighborhoods was associated with an elevated risk of an adverse outcome following heart failure hospitalization in Black patients and a reduced risk in White patients. Moreover, racial disparities in patient outcomes were present only in historically redlined neighborhoods. Additional research is needed to explore observed heterogeneity in outcomes.
γ‐Glutamyl Transferase and Long‐Term Survival in the SYNTAXES Trial: Is It Just the Liver?
Authors: Ninomiya Kai , Serruys Patrick W. , Garg Scot , Kageyama Shigetaka , Kotoku Nozomi , Masuda Shinichiro , Revaiah Pruthvi C. , O'leary Neil , Kappetein Arie Pieter , Mack Michael J. , Holmes David R. , Davierwala Piroze M. , Mohr Friedrich W. , Thuijs Daniel J. F. M. , Onuma Yoshinobu ,   for the SYNTAX Extended Survival (SYNTAXES) Investigators
Published: April 2024

Background

Recently, machine learning algorithms have identified preprocedural γ‐glutamyl transferase (GGT) as a significant predictor of long‐term mortality after coronary revascularization in the SYNTAX (Synergy Between PCI [Percutaneous Coronary Intervention] With Taxus and Cardiac Surgery) trial. The aim of the present study is to investigate the impact of preprocedural GGT on 10‐year all‐cause mortality in patients with complex coronary artery disease after revascularization.

Methods and Results

The SYNTAX trial was a randomized trial comparing PCI with coronary artery bypass grafting in 1800 patients with complex coronary artery disease. The present report is a post hoc subanalysis of the SYNTAXES (Synergy Between PCI With Taxus and Cardiac Surgery Extended Survival) trial, an investigator‐driven extended 10‐year follow‐up of the SYNTAX trial. The association between preprocedural GGT and 10‐year all‐cause mortality was investigated. The mean values of GGT for men and women were 43.5 (SD, 48.5) and 36.4 (SD, 46.1) U/L, respectively. In multivariable Cox regression models adjusted by traditional risk factors, GGT was an independent predictor for all‐cause death at 10‐year follow‐up, and each SD increase in log‐GGT was associated with a 1.24‐fold risk of all cause death at 10‐year follow‐up (95% CI, 1.10–1.40). According to previously reported sex‐related GGT thresholds, patients with higher GGT level had a 1.74‐fold risk of all‐cause death at 10‐year follow‐up (95% CI, 1.32–2.29) compared with patients with lower GGT level.

Conclusions

Preprocedural GGT is an independent predictor of 10‐year mortality after coronary revascularization in patients with complex coronary artery disease. In patients with elevated GGT, strong secondary prevention may be required after revascularization and must be studied prospectively.

Registration

URL:
https://clinicaltrials.gov/study/NCT03417050
.
Validation of TRI‐SCORE for Outcome Prediction After Isolated Tricuspid Valve Surgery in Asian Patients
Authors: Kim Dae‐Young , Kim Jihoon , Cho Iksung , Kim Eun Kyoung , Hong Geu‐Ru , Ha Jong‐Won , Park Sung‐Ji , Shim Chi Young
Published: April 2024

Background

TRI‐SCORE was recently developed in Europe as a risk model for predicting in‐hospital death after isolated tricuspid valve surgery. We aimed to validate TRI‐SCORE in an Asian population and investigate its value for predicting long‐term outcomes.

Methods and Results

The TRI‐SCORE was calculated for 202 patients (65±11 years, 61% women, 81% functional tricuspid regurgitation) who underwent isolated tricuspid valve surgery for severe tricuspid regurgitation at 2 Korean centers and was based on 8 parameters: age, New York Heart Association class, right‐sided heart failure signs, furosemide daily dose, glomerular filtration rate, bilirubin, left ventricular ejection fraction, and moderate/severe right ventricular dysfunction. The primary outcome was all‐cause death during follow‐up; the secondary outcome was in‐hospital death. During a median follow‐up duration of 50 (interquartile range, 21–82) months after isolated tricuspid valve surgery, 23 (11.4%) patients experienced the primary outcome, and 7 (3.5%) patients experienced the secondary outcome. Observed all‐cause death and in‐hospital death increased by up to 50% in those with higher scores. Patients with the primary outcome had a higher TRI‐SCORE (4.5±2.4 versus 2.9±2.1;
P
=0.001) than those without. The TRI‐SCORE showed a significant association with the primary outcome (concordance index, 0.77, cutoff value, 4) and in‐hospital death (area under the curve, 0.84; cutoff value, 3). Using the Kaplan–Meier analysis, patients with a high TRI‐SCORE exhibited a poor outcome for all‐cause death at follow‐up (log‐rank
P
<0.001) and in‐hospital death (log‐rank
P
=0.004).

Conclusions

TRI‐SCORE was validated in an Asian population and helped predict long‐term outcomes after isolated tricuspid valve surgery.
Disulfiram Reduces Atherosclerosis and Enhances Efferocytosis, Autophagy, and Atheroprotective Gut Microbiota in Hyperlipidemic Mice
Authors: Traughber C. Alicia , Timinski Kara , Prince Ashutosh , Bhandari Nilam , Neupane Kalash , Khan Mariam R. , Opoku Esther , Opoku Emmanuel , Brubaker Gregory , Shin Junchul , Hong Junyoung , Kanuri Babunageswararao , Ertugral Elif G. , Nagareddy Prabhakara R. , Kothapalli Chandrasekhar R. , Cherepanova Olga , Smith Jonathan D. , Gulshan Kailash
Published: April 2024

Background

Pyroptosis executor GsdmD (gasdermin D) promotes atherosclerosis in mice and humans. Disulfiram was recently shown to potently inhibit GsdmD, but the in vivo efficacy and mechanism of disulfiram's antiatherosclerotic activity is yet to be explored.

Methods and Results

We used human/mouse macrophages, endothelial cells, and smooth muscle cells and a hyperlipidemic mouse model of atherosclerosis to determine disulfiram antiatherosclerotic efficacy and mechanism. The effects of disulfiram on several atheroprotective pathways such as autophagy, efferocytosis, phagocytosis, and gut microbiota were determined. Atomic force microscopy was used to determine the effects of disulfiram on the biophysical properties of the plasma membrane of macrophages. Disulfiram‐fed hyperlipidemic apolipoprotein E
−/−
mice showed significantly reduced interleukin‐1β release upon in vivo Nlrp3 (NLR family pyrin domain containing 3) inflammasome activation. Disulfiram‐fed mice showed smaller atherosclerotic lesions (~27% and 29% reduction in males and females, respectively) and necrotic core areas (~50% and 46% reduction in males and females, respectively). Disulfiram induced autophagy in macrophages, smooth muscle cells, endothelial cells, hepatocytes/liver, and atherosclerotic plaques. Disulfiram modulated other atheroprotective pathways (eg, efferocytosis, phagocytosis) and gut microbiota. Disulfiram‐treated macrophages showed enhanced phagocytosis/efferocytosis, with the mechanism being a marked increase in cell‐surface expression of efferocytic receptor MerTK. Atomic force microscopy analysis revealed altered biophysical properties of disulfiram‐treated macrophages, showing increased order‐state of plasma membrane and increased adhesion strength. Furthermore, 16sRNA sequencing of disulfiram‐fed hyperlipidemic mice showed highly significant enrichment in atheroprotective gut microbiota
Akkermansia
and a reduction in atherogenic
Romboutsia
species.

Conclusions

Taken together, our data show that disulfiram can simultaneously modulate several atheroprotective pathways in a GsdmD‐dependent as well as GsdmD‐independent manner.
Current Trends in Hypertension Identification and Management: Insights from the National Health and Nutrition Examination Survey (NHANES) Following the 2017 ACC/AHA High Blood Pressure Guidelines
Authors: Heaton Joseph , Alshami Abbas , Imburgio Steven , Mararenko Anton , Schoenfeld Matthew , Sealove Brett , Asif Arif , Almendral Jesus
Published: April 2024

Background

Hypertension is a global health issue associated with increased cardiovascular morbidity and mortality. This study aimed to investigate contemporary hypertension identification and management trends following the 2017 American College of Cardiology/American Heart Association guidelines.

Methods and Results

Data from the National Health and Nutrition Examination Survey conducted from 2017 to 2020 were analyzed. Participants between 20 and 79 years of age were included. Participants were stratified into different treatment groups based on indication and guideline adherence. Descriptive statistics were used to compare medication use, diagnosis rates, and blood pressure control. A total of 265 402 026 people met the inclusion criteria, of which 19.0% (n=50 349 209) were undergoing guideline antihypertensive management. In the guideline antihypertensive management group, a single antihypertensive class was used to treat 45.7% of participants, and 55.2% had uncontrolled blood pressure. Participants not undergoing guideline antihypertensive management qualified for primary prevention in 11.5% (n=24 741 999) of cases and for secondary prevention in 2.4% (n=5 070 044) of cases; of these, 66.3% (n=19 774 007) did not know they may have hypertension and were not on antihypertensive medication.

Conclusions

Adherence to guidelines for antihypertensive management is suboptimal. Over half of patients undergoing guideline treatment had uncontrolled blood pressure. One‐third of qualifying participants may not be receiving treatment. Education and medical management were missing for 2 in 3 qualifying participants. Addressing these deficiencies is crucial for improving blood pressure control and reducing cardiovascular event outcomes.
Broad brain networks support curiosity-motivated incidental learning
of naturalistic dynamic stimuli with and without monetary
incentives
Authors: Meliss Stefanie , Tsuchiyagaito Aki , Byrne Phoenix , van Reekum Carien , Murayama Kou
Published: April 2024

Curiosity—the intrinsic desire to know—is a concept central to the human mind and knowledge acquisition. Experimental studies on information-seeking have found that curiosity facilitates memory encoding and exhibits similar rewarding properties as extrinsic rewards/incentives, by eliciting a dopaminergic response in the reward network. However, it is not clear whether these findings hold with more naturalistic dynamic stimuli and how the joint effect of curiosity and extrinsic incentive manifests in learning and neural activation patterns. Herein, we presented participants with videos of magic tricks across two behavioural (N1 = 77, N2 = 78) and one fMRI study (N = 50) and asked them to rate subjective feelings of curiosity, while also performing a judgement task that was incentivised for the half of participants. Incidental memory for the magic trick was tested a week later. The integrated results showed that both curiosity and availability of extrinsic incentives enhanced encoding but did not interact with each other. However, curiosity influenced only high-confidence recognition memory, whereas extrinsic incentives affected memory regardless of confidence, suggesting the involvement of different encoding mechanisms. Analysis of the fMRI data using the intersubject synchronisation framework showed that, while the effects of curiosity on memory were located in the hippocampus and dopaminergic brain areas, neither the effects of curiosity nor incentives themselves were found in the often-implicated reward network. Instead, they were associated with cortical areas involved in processing uncertainly and attention. These results challenge a traditional focus on reward networks in curiosity and highlight the involvement of broader brain networks.
A systematic assessment of Leporinus tigrinus (Characiformes: Anostomidae) using morphological and molecular data
Authors: BOARETTO MARIANA PASCOAL , SOUZA-SHIBATTA LENICE , BIRINDELLI JOSÉ L. O.
Published: April 2024

Leporinus tigrinus was described based on specimens collected in the rio Tocantins basin, and was only recently recorded at the rio Xingu, rio Tapajós and upper rio Paraná basins. So far, no study has compared specimens of all these distinct drainages focusing on understanding whether all these populations truly belong to a single species or may consist instead in a species complex. Our study focused on investigating the intraspecific variation within Leporinus tigrinus using morphological and molecular data. Both morphology and molecular analyses support that all samples belong to a single species widespread in the rio Araguaia, rio Tocantins, rio Xingu and rio Tapajós. In addition, the population occurring at upper rio Paraná is considered to be allochthonous, originating from the rio Araguaia/Tocantins. A comprehensive morphological description of the species, including osteological illustrations and descriptions are provided, as well as a comparative diagnosis with similar-looking species.
Introduction to Special Issue “Morality in Political and Public Debates. What is Beyond Moral Framing?”
Authors: Szabó Gabriella , Samoilenko Sergei A.
Published: April 2024

This special issue seeks to address this gap by presenting a comprehensive collection of both theoretical and practical insights into moral language, argumentation, and evaluations within politicized environments. Our overarching objective encompasses three main facets. We investigate how studies in communication, media, and behavioral sciences can contribute to the understanding of morality. The special issue also evaluates the ways in which interdisciplinary approaches shed light on the evolving dynamics of moral politics, including the formation of in-group and out-group identities. Finally, the contributions scrutinize the extent to which contemporary understandings of public discourse and socio-political tensions enrich discourse on morality. Rather than merely presenting isolated instances of public moralization and its consequences, this special issue initiates a timely and much-needed scholarly dialog concerning the public discourse and sentiments surrounding moral issues.
Overnight In-House Critical Care Resource Intensivist Improves General Surgery Resident Education
Authors: Zhang Jeanette , Warner Rachel , Sheffield Abby , Hodge Sarah , Crandall Marie , Skarupa David
Published: April 2024

24/7 critical care staffing has become more commonplace, and their impact on resident training must be carefully considered. At our institution, the Critical Care Resource Intensivist (CCRI) model was implemented to provide in-house dedicated faculty responsible solely for the provision of critical care overnight. An anonymous survey was distributed to all general surgery residents to evaluate CCRI’s impact on education and autonomy. Descriptive statistics were completed for quantitative data. Qualitative analysis of free text responses was completed to identify consensus themes. Responses from 26 residents demonstrated they associated CCRI with improved resident education, supervision, and patient care, without limiting autonomy. Qualitative analysis yielded 7 themes, reflecting improvements in patient care and safety, progression of care, operations and procedures, improved education, availability, and independence, but noted potential for conflict. Our findings show 24/7 dedicated intensivist staffing can enhance general surgery resident education without limiting autonomy.
Causes and Timing of Unplanned ICU Admissions Among Trauma Patients at a Level 1 Trauma Center
Authors: Jensen Stephanie , Gallagher Robert , Sing Ronald , Torres Fajardo Rafael
Published: April 2024

Background

Unexpected ICU admissions are a key quality metric in trauma care. The purpose of this study is to identify the most common causes of unplanned ICU admissions among trauma patients at an ACS-verified level 1 trauma center.

Methods

A retrospective review was conducted of all trauma patients with unplanned admission to the ICU at a level 1 trauma center between 2019 and 2021. Unplanned ICU admissions were categorized into (1) “bounce-backs,” patients previously admitted to the ICU and (2) “upgrades,” patients who had not previously been cared for in the ICU.

Results

Of 300 unexpected ICU transfers, bounce-backs accounted for 69% and upgrades 31%. The most common injuries were traumatic brain injuries (40%) and rib fractures (41.3%). In-hospital mortality rate was 10% and did not significantly differ between bounce-backs and upgrades (12 vs 5%, P = .92). Respiratory distress was the most common cause of transfer (41.1%), followed by neurologic (29.6%) and cardiovascular decline (21.2%). Patients were on average 928 mL fluid positive 72 hours prior to transfer (t > 0, P < .0001), and 295 mL fluid positive in the 24 hours prior to transfer (t > 0, P .0003). Patients transferred for respiratory distress were no more fluid over-balanced than those transferred for other reasons.

Conclusion

We found a large percent of unplanned transfers occurring within 48 hours of admission or transfer out of the ICU suggesting under-triage as a leading cause of bounce-backs and upgrades. Respiratory distress was the leading cause of transfer. These findings highlight opportunities for targeted interventions.
The Financial Implications of a Single-Use Device Reprocessing Program at a Tertiary Referral Center Surgical Department
Authors: Englander Katherine , Cox Kaitlyn , Smith Teagen , Diab Adbul , Ganam Samer , Sujka Joseph , DuCoin Christopher
Published: April 2024

The operating room has been identified as one of the primary contributors to waste and energy expenditure in the health care system. The primary objective of our study was to evaluate the efficacy of single-use device reprocessing and report the cost savings, waste diversion, and reduction in carbon emissions. Data was collected from January 2021 to April 2023. Medline collected the data for analysis and converted it from an Excel file format to SPSS (Version 27) for analysis. Descriptive frequencies were used for data analysis. We found a mean monthly cost savings of $16,051.68 and a mean 700.68 pounds of waste a month diverted, resulting in an estimated yearly saving of $2354.29 in disposal costs and a reduction of 1112.65 CO2e emissions per month. This program has made significant contributions to cost savings and environmental efforts.
Deconstructing the Operative Times of Robotic Pancreaticoduodenectomy
Authors: Ross Sharona , Sucandy Iswanto , Vasanthakumar Padma , Espeut Abigail , Christodoulou Maria , Pattilachan Tara M. , Rosemurgy Alexander
Published: April 2024

Introduction

Despite numerous benefits offered, robotic procedures take longer than “open” procedures. With the intent to reduce operative duration, we examined the degree each operative step contributes to operative duration in robotic pancreaticoduodenectomy.

Materials and Methods

With IRB approval, we prospectively followed 88 patients to determine the duration of robotic pancreaticoduodenectomy, and the duration of 12 key steps. Each operative step was regressed against the operation date, from most distant to most recent operation date. Data are presented as median (mean ± SD) for illustrative purposes.

Results

Patients were 73 (71 ± 10.2) years old; 53% were men. Total time patient spent in the operating room was 471 (488 ± 93.3) minutes. Total operative time was 399 (421 ± 90.7) minutes. Total console time was 293 (297 ± 68.0) minutes. The 3 longest portions of the operation were (1) mobilization of the specimen and specimen extraction; (2) construction of the duodenojejunostomy; and (3) closure.

Conclusion

A third of the operative time is spent off the console. Over half of the steps required more than 20 minutes each to complete. Since robotic operations are associated with shorter LOS and without increased complication rates relative to “open” operations, salutary benefit can be gained by decreasing operative times of robotic procedures. Operative duration is an important metric that needs to be addressed. We need to target the most time-consuming steps, and break them into smaller pieces, to reach optimal efficiency and provide the benefits of decreased operative duration to the patients, hospitals, and providers.
Opportunity for a Community Health Fair Model of Bleeding Control Training
Authors: DePolo Nicole , Dellen Matthew , Hughes Elizabeth , Ike Andre , Lum Sharon , Mukherjee Kaushik , Turay David , Burruss Sigrid
Published: April 2024

Background

Traumatic hemorrhage is a prevalent cause of death nationally, with >50% of civilian deaths estimated to be preventable with more timely intervention. This study investigated the efficacy of training large and diverse audiences in bleeding control methods including tourniquets in community health fair settings.

Methods

A booth was utilized for bleeding control training at community health fairs via direct demonstrations of pressure, wound packing, and commercial and improvised tourniquet application followed by hands-on practice. Participants self-rated their perceived abilities while instructors rated the participant competency.

Results

117 community members participated during two fairs, though not every person completed every portion of the training. Average age was 33 (range 6-82) and the majority were female (65.0%). There was no difference in self-perceived skill compared to trainer grading of participant’s ability to identify life-threatening bleeding (112 (97.4%) vs 106 (97.2%); P = 1), apply pressure (113 (98.3%) vs 106 (97.2%); P = .68), and pack a wound (102 (88.7%) vs 92 (84.4%); P = .43). No difference in difficulty was noted in placing commercial vs improvised tourniquets (16 (43%) vs 14 (45%); P = .87). However, participants were overconfident in their ability to place tourniquets compared to trainer grading, respectively (112 (98.2%) vs 100 (91.7%; P = .03)).

Discussion

Community fair classes provide opportunities to train large and diverse audiences in bleeding control techniques. However, participants overestimated their ability to appropriately apply tourniquets. Further investigation is needed into best educational approaches to optimize the impact of bleeding control kits that have been distributed in multiple states.
Drug dependence and prescribing ketamine for treatment-resistant depression in Australia and New Zealand
Authors: Carroll Alistair , Bayes Adam , Montebello Mark , Brett Jonathan , Arunogiri Shalini , Saunders John B , Loo Colleen K
Published: April 2024

Ketamine is a restricted and regulated medication in Australia and New Zealand, which has implications when considering treatment for patients with treatment-resistant depression and a history of illicit drug use, abuse or dependence. Regulations governing prescription of ketamine for treatment-resistant depression vary between jurisdictions in Australia and New Zealand, though most restrict use in those with drug dependence. There is substantial variation in definitions of drug dependence used in each jurisdiction, and between the legal and clinical definitions, with the latter specified in the current International Classification of Diseases, Eleventh Revision and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This paper reviews the literature assessing the risk of ketamine misuse and dependence in patients with a history of illicit drug use, abuse or dependence and presents recommendations for psychiatrists who prescribe ketamine in such patients with treatment-resistant depression.