bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating fractal dimensions: A comparative review and open source implementations
Authors: Datseris George , Kottlarz Inga , Braun Anton P. , Parlitz Ulrich
Published: October 2023

The fractal dimension is a central quantity in nonlinear dynamics and can be estimated via several different numerical techniques. In this review paper, we present a self-contained and comprehensive introduction to the fractal dimension. We collect and present various numerical estimators and focus on the three most promising ones: generalized entropy, correlation sum, and extreme value theory. We then perform an extensive quantitative evaluation of these estimators, comparing their performance and precision using different datasets and comparing the impact of features like length, noise, embedding dimension, and falsify-ability, among many others. Our analysis shows that for synthetic noiseless data, the correlation sum is the best estimator with extreme value theory following closely. For real experimental data, we found the correlation sum to be more strongly affected by noise vs the entropy and extreme value theory. The recent extreme value theory estimator seems powerful as it has some of the advantages of both alternative methods. However, using four different ways for checking for significance, we found that the method yielded “significant” low-dimensional results for inappropriate data like stock market timeseries. This fact, combined with some ambiguities we found in the literature of the method applications, has implications for both previous and future real-world applications using the extreme value theory approach, as, for example, the argument for small effective dimensionality in the data cannot come from the method itself. All algorithms discussed are implemented as performant and easy to use open source code via the DynamicalSystems.jl library.
Design and verification of a backward wave oscillation suppression circuit for the Ka-band gyrotron travelling-wave tube
Authors: Ma Yuan , Liu Guo , Lei Changbiao , Cao Yingjian , Wang Weijie , Wang Yu , Yao Yelei , Jiang Wei , Wang Jianxun , Luo Yong
Published: October 2023

Backward wave oscillation seriously degrades the stability of gyrotron travelling-wave tubes (gyro-TWTs), especially during high average/continuous wave operation. To solve this problem, a selective mode suppression structure (SMSS) based on the mode coupling principle is proposed and applied in the nonlinear beam–wave interaction region to suppress the parasitic TE11 mode. It is capable of obtaining a high power and improving the tube stability. Simulation results demonstrate that the SMSS can raise the starting current from 10 to 18 A and the starting pitch factor from 1.2 to 1.6. Based on this proposed circuit, a Ka-band TE01 mode gyro-TWT was designed, and the particle-in-cell simulation shows that it can achieve a saturated output power of over 150 kW from 29.7 to 31.7 GHz with a velocity spread of 2.2%. For verification, a SMSS is manufactured and cold tested. The measurement of S-parameters reveals that it can effectively suppress the parasitic TE11 mode.
Identification of magnetic state of transition metal dichalcogenides via photonic spin Hall effect
Authors: Da Haixia , Song Qi , Ye Huapeng , Yan Xiaohong
Published: October 2023

Monolayer transition metal dichalcogenides with magnetic exchange fields have been demonstrated to display the remarkable valley polarization and magnetooptical behaviors. However, the explorations of their photonic spin Hall effects are lacking. Here, we show that the reflected spin shift of monolayer transition metal dichalcogenides with magnetic exchange field is significantly different from that of the pristine one and it exhibits the distinctive dependence on the size of the magnetic exchange field. In addition, we can manipulate the reflected spin shift of monolayer transition metal dichalcogenides with the magnetic exchange field via its chemical potential. This work unravels the potential of the photonic spin Hall effect on identifying the magnetic state of monolayer transition metal dichalcogenides or the substrate, which might promote their potential applications in the spin photonic devices.
Work function of titanium thin layers
Authors: Horváth Ákos , Sulyok Attila , Dücső Csaba , Schiller Robert
Published: October 2023

The dependence of electron work function, Φ, on the thickness of Ti layers was investigated by making use of the Kelvin method under ambient conditions. Layers were produced by vacuum phase deposition and were analyzed by x-ray photoelectron spectroscopy and transmission electron microscopy. A quantum size effect was revealed finding work function to increase as the layer thickness, z, decreased below 4 nm. The extent of increase, ΔΦ, was understood in terms of a simple particle-in-a-box model arriving at the function ΔΦ=ℏ2π2/2mez2. This equation being free of any adjustable parameter, consisting only of the Planck constant and electron mass, seems to be a reasonable first approximation.
Compact superconducting transmon qubit circuits made of ultrathin NbN
Authors: Wei XingYu , Jiang JunLiang , Xu Wenqu , Guo Tingting , Zhang Kaixuan , Li Zishuo , Zhou Tianshi , Sheng Yifan , Cao Chunhai , Sun Guozhu , Wu Peiheng
Published: October 2023

We design and fabricate a compact superconducting qubit circuit made of nano-thick NbN film on a high-resistivity silicon substrate, carrying seven transmon qubits. By comparing with the conventional superconducting qubit circuits made of superconducting films with hundred-nanometer thickness, our superconducting qubit circuit has much smaller size in the readout circuit, whose resonator length is only about 1/20 of that in a conventional superconducting circuit. Transmons are measured and characterized in the frequency and time domains with different flux bias. The transition frequency f01 can be adjusted in the range of several GHz. The qubit circuits made of such nano-thick material with high kinetic inductance are promising in the integration of quantum circuits.
Field-free self-oscillation of magnetization enabled by the fieldlike spin-orbit torque
Authors: Wang Wen-Jie , Wang Ri-Xing , Wan Qiang , Cai Meng-Qiu , He Peng-Bin
Published: October 2023

Fieldlike spin-orbit torque, which behaves like a torque from a magnetic field, but relies on the current together with the damplike one, was recognized to influence magnetization switching. However, its role on magnetic oscillations remains to be explored. By linear stability analysis and energy averaging technique, we obtain analytic formulas for the stable boundaries of various states. Then, a phase diagram is constructed, which is controlled by the current and a tunable ratio β of the fieldlike torque to the dampinglike one. We find that some new stable, bistable and dynamic states come forth. Especially, a bias-field-free self-oscillation emerges for negative β, which enables the average energy balance between the dampinglike torque and the intrinsic damping. There occur two kinds of oscillations, analogous to the usual in-plane and out-of-plane precessions. If increasing the current, the frequency declines for the former, and subsequently rises for the latter. Varying β slightly affects the frequency range, but dramatically alters the adjustable range of current. In addition, the phase diagram indicates that the switching direction reverses with β stepping over −1/α with α being the damping constant, and the switching current decreases with ∣β∣ increasing.
Fabrication of shape-designable cartilage from human induced pluripotent stem cell-derived chondroprogenitors using a cell self-aggregation technique
Authors: Ota Tomoyuki , Takao Tomoka , Iwai Ryosuke , Moriwaki Takeshi , Kitaguchi Yohei , Fujisawa Yuki , Yamada Daisuke , Kimata Yoshihiro , Takarada Takeshi
Published: October 2023

With the advancement of tissue engineering technologies, implantable materials have been developed for use in facial plastic surgery, including auriculoplasty and rhinoplasty. Tissue-engineered cartilage comprising only cells and cell-produced extracellular matrix is considered valuable as there is no need to consider problems associated with scaffold absorption or immune responses commonly related to conventional artificial materials. However, it is exceedingly difficult to produce large-sized complex shapes of cartilage without the use of scaffolds. In this study, we describe the production of shape-designable cartilage using a novel cell self-aggregation technique (CAT) and chondroprogenitor cells derived from human induced pluripotent stem cells as the source. The method described does not require special equipment such as bio-3D printers, and the produced tissue can be induced into well-matured cartilage with abundant cartilage matrix in vitro. Using CAT, we were able to generate cartilage in the form of rings or tubes with adjustable inner diameter and curvature, over a range of several centimeters, without the use of scaffolds. The in vitro fabrication of shape-designable cartilage using CAT is a promising development in facial plastic surgery.
Assessment of Metakaolin Blended Palm Kernel Shell Solid Concrete Blocks as a Sustainable Building Material
Authors: John Nova , Tensing D , Vincent Sam Jebadurai S , Srisanthi V G
Published: October 2023

The effectiveness of Palm kernel shell (PKS) as a coarse aggregate substitute in metakaolin added solid concrete masonry blocks is examined in this paper. Control solid concrete blocks and Palm Kernel Shell (PKS) added concrete blocks with metakaolin were cast with sizes of 250mm × 200mm × 150mm and a mix ratio of 1:3:6 by varying the water-binder (w/b) ratio in 0.55, 0.60, and 0.65. The blocks were water cured for 28 days before batching, which was done per volume. There were 0%, 5%, 10%, 15%, 20%, 25% and 30% replacements of coarse aggregate with PKS, respectively. Slump tests were conducted on fresh concrete and the blocks were made using solid block making machine. At the end of 28 days curing period, compressive strength tests were conducted on hardened concrete blocks using a compression testing apparatus. The findings indicated that the slump height increased with the water-binder ratio but reduced with the proportion of PKS. For higher substitutions of coarse aggregate with PKS, favourable results are obtained with a w/b ratio of 0.60. According to IS: 2185 (Part 1) - 2005, solid concrete masonry blocks must possess a minimum compressive strength of 5N/mm2. Although several samples meet this requirement, the optimized sample in terms of strength was a block with 25% PKS replacement at a w/b ratio of 0.60. The density, water absorption, and initial rate of absorption of the optimized sample were found to be lower than those of the control samples, however, both samples exhibit a similar pattern in alternate wetting and drying tests.
Effect of sucrose on slag-fly ash-based alkali activated paste
Authors: Thomas Shobha Elizabeth , Sreeja S , Muhsin Lebba A , Ramaswamy K.P
Published: October 2023

One of the major concerns in the concrete industry is to improve the sustainability by adopting durable concrete with low energy intensity. This resulted in the remarkable progress on Alkali Activated Concrete (AAC). The AAC consists of a binder system made of a solid aluminosilicate source powder as precursor which needs to be activated by a solid or dissolved alkali activator. Considering the strength as well as durability, Alkali Activated Materials (AAM) has proved to be a novel material that could potentially replace the Ordinary Portland Cement (OPC). The properties of AAM including lower carbon footprint, valorization of industrial waste materials, sustainable as well as economical characteristics has resulted in an increased research interest. Among variety of precursors available, slag based AAM has the ability to acquire strength under ambient curing. But the factors keeping it away from a wide acceptance includes its fast setting as well as low workability. This paper describes the study on effect of sucrose, a bio-additive in slag-fly ash based AAM for improving its setting time and workability. From the experimental results, sucrose has been proven as a good retarder and helps to improve the workability.
Effect of borax in slag-fly ash-based alkali activated paste
Authors: Thomas Shobha Elizabeth , Muhsin Lebba A , Sreeja S , Ramaswamy K.P
Published: October 2023

Alkali Activated Concrete (AAC) uses source materials rich in aluminosilicates to gain the properties superior to OPC based concrete. Alkaline chemicals are used to activate reaction in aluminosilicate precursors. In this study a combination of Ground Granulated Blast Furnace Slag (BFS) and fly ash with low calcium content (class F) is used as precursor and the activator used to activate the precursor is a combination of NaOH pellets and sodium silicate solution. Research interest in alkali activated materials (AAM) has grown as a result of its unique characteristics, which include less greenhouse gas emissions during its production, effective utilization of industrial waste materials, and sustainable as well as economic attributes. However, its quick setting as well as poor workability are deterring its widespread popularity. Though borax has been identified as a good retarder for cement-based materials, its effect on the blast furnace slag-fly ash-based alkali activated system with respect to the control factors were less investigated. The setting time, penetration resistance and workability of Alkali Activated Paste (AAP) is studied to identify the effect of borax with respect to the control factors. The potential of borax in AAM to improve its workability qualities were studied. According to the experimental results obtained, borax is a good retarder for slag-fly ash-based AAP and it could improve workability.
A Regression-Based Approach for Assessing the Buckling Coefficient of Stiffened and Unstiffened Elements
Authors: Raja Lakshmi J , Vijaya Vengadesh Kumar J
Published: October 2023

Sustainable construction begins essentially by enabling the application of renewable and recyclable building materials. Cold-formed steel sections providing long-term sustainability and having a high strength-to-weight ratio are finding extensive application in the fields of construction and engineering. The Effective Width Method (EWM) and the Direct Strength Method (DSM) are the primary available analytical methods for the design of these sections. The design procedure for the buckling strength prediction of these analytical methods is inherently dependent on the critical buckling load, which in turn is influenced by the plate buckling coefficients. The plate buckling coefficient of either a stiffened or an unstiffened element is defined for varied boundary conditions and elemental stress ratios. Evaluating the design procedure for the critical buckling load, which is taken as the minimum of the elemental strengths, it was clearly evident that the analytical method yields highly conservative solutions. This conservative prediction is inherently caused by the application of individual plate buckling coefficients that fail to account for the inter-element interaction.

The present research strives to propose a regression-based method for the determination of the critical buckling load. The symbolic regression analysis with the aid of machine learning is opted for to obtain more precise and reliable mathematical solutions for the buckling coefficients. The inter-element interaction and varied loading conditions are assessed for their influence and are accounted for in the expressions of the buckling coefficient. More reliable and accurate buckling strength prediction results with a broader conceptual approach are postulated.
Prioritization of CMIP5 based climate models in simulating precipitation using multicriteria decision making methods
Authors: Saranya M S , Nair Vinish V
Published: October 2023

Selecting climate models that are accurate in simulating observed weather is a difficult task for impact modellers. For more reliable future projections, model selection is desirable. The effectiveness of nine GCM-RCM combinations in simulating precipitation over the Meenachil river basin in Kerala is examined in this study using data from the CORDEX-SA datasets. Four performance indicators—correlation coefficient (R), percentage bias (PBIAS), skill score (SS), and root mean square error (RMSE)—were used to evaluate the models’ simulation abilities. The models were ranked based on their ability to simulate observed climate data measured over a baseline period (1980–2005) using the TOPSIS (Technique for Order Preference by Similarity to an Ideal Solution) method and the PROMETHEE-2 (Preference Ranking Organisation Method of Enrichment Evaluation) method of multi-criteria decision making approaches. Rankings of GCM-RCM combinations were carried out in both scenarios of equal and varying weight. The results of the study found that the top three precipitation prediction models for the Meenachil river basin are GFDL-RCA4, GFDL-RegCM4, and CNRM-RCA4.
Jurisdictional decision-making about building codes for resiliency and sustainability post-fire
Authors: Ellery Megan , Javernick-Will Amy , Liel Abbie , Dickinson Katherine
Published: October 2023

The increasing frequency and size of wildfires across the U.S. motivates the growing need to identify how affected communities can rebuild sustainably and resiliently. This study examines the jurisdictional decision-making process surrounding one important class of sustainability and resiliency decisions, focusing on energy and wildfire building codes for housing reconstruction. Through 22 interviews with staff and elected officials in three jurisdictions impacted by Colorado’s Marshall Fire, we identify factors influencing decisions. Code decisions varied across jurisdictions and, in some cases, building codes were relaxed, while in other cases, increased resiliency and sustainability standards were adopted after the fire. Jurisdictions with more experience had more certainty regarding code costs and effectiveness, leading to more stringent code adoption. Thus, findings encourage jurisdictions to create rebuilding plans pre-disaster to reduce the impact of uncertainty in post-disaster decision-making. The data also indicate that while local jurisdictions are well-suited to work cooperatively with homeowners impacted by disasters to return to the community, the state can play a role by informing or mandating disaster plans or establishing minimum code requirements.
Treatment of Hidradenitis Suppurativa Evaluation Study (THESEUS): a prospective cohort study
Authors: Ingram John R , Bates Janine , Cannings-John Rebecca , Collier Fiona , Evans Judith , Gibbons Angela , Harris Ceri , Howells Laura , Hood Kerenza , Howes Rachel , Leighton Paul , Riaz Muhammad , Rodrigues Jeremy , Stanton Helen , Thomas Kim S , Thomas-Jones Emma
Published: October 2023

Background

Hidradenitis suppurativa (HS) is a chronic, painful disease affecting flexures and other skin regions, producing nodules, abscesses and skin tunnels. Laser treatment targeting hair follicles and deroofing of skin tunnels are standard HS interventions in some countries but are rarely offered in the UK.

Objectives

To describe current UK HS management pathways and influencing factors to inform the design of future randomized controlled trials (RCTs).

Methods

THESEUS was a nonrandomized 12-month prospective cohort study set in 10 UK hospitals offering five interventions: oral doxycycline 200 mg daily; oral clindamycin and rifampicin both 300 mg twice daily for 10 weeks, extended for longer in some cases; laser treatment targeting hair follicles; deroofing; and conventional surgery. The primary outcome was the combination of clinician-assessed eligibility and participant hypothetical willingness to receive each intervention. The secondary outcomes were the proportion of participants selecting each intervention as their final treatment option; the proportion who switch treatments; treatment fidelity; and attrition rates. THESEUS was prospectively registered on the ISRCTN registry: ISRCTN69985145.

Results

The recruitment target of 150 participants was met after 18 months, in July 2021, with two pauses due to the COVID-19 pandemic. Baseline demographics reflected the HS secondary care population: average age 36 years, 81% female, 20% non-White, 64% current or ex-smokers, 86% body mass index ≥ 25, 68% with moderate disease, 19% with severe disease and 13% with mild disease. Laser was the intervention with the highest proportion (69%) of participants eligible and willing to receive treatment, then deroofing (58%), conventional surgery (54%), clindamycin and rifampicin (44%), and doxycycline (37%). Laser was ranked first choice by the greatest proportion of participants (41%). Attrition rates were 11% and 17% after 3 and 6 months, respectively. Concordance with doxycycline was 52% after 3 months due to lack of efficacy, participant choice and adverse effects. Delays with procedural interventions were common, with only 43% and 26% of participants starting laser and deroofing, respectively, after 3 months. Uptake of conventional surgery was too small to characterize the intervention. Switching treatment was uncommon and there were no serious adverse events.

Conclusions

THESEUS has established laser treatment and deroofing for HS in the UK and demonstrated their popularity with patients and clinicians for future RCTs.
The Effect of Social Media on Elections: Evidence from The United States
Authors: Fujiwara Thomas , Müller Karsten , Schwarz Carlo
Published: October 2023

We study how social media affects election outcomes in the United States. We use variation in the number of Twitter users across counties induced by early adopters at the 2007 South by Southwest festival, a key event in Twitter’s rise to popularity. We show that this variation is unrelated to observable county characteristics and electoral outcomes before the launch of Twitter. Our results indicate that Twitter lowered the Republican vote share in the 2016 and 2020 presidential elections, but had limited effects on Congressional elections and previous presidential elections. Evidence from survey data, primary elections, and text analysis of millions of tweets suggests that Twitter’s relatively liberal content may have persuaded voters with moderate views to vote against Donald Trump.
Photoactivation of pheophorbide-a utilizing 670 nm LEDs elicits cancer suppressive effects in androgen-independent prostate cancer cellular models
Authors: Gheewala Taher , Ali Hussein Mohamed , Munirathinam Gnanasekar
Published: October 2023

Objectives

Prostate cancer (PCa) is the most commonly diagnosed cancer and the second leading cause of cancer death in men in the USA. Photodynamic therapy (PDT) is a state-of-the-art treatment that combines high selectivity with minor side effects. Pheophorbide-a (Pheo) is a natural pigment with a photosensitizer property. Our study delved into the impact of Pheo alone or Pheo-PDT combination on the androgen-independent metastatic prostate cancer (AIPC) cell lines DU-145 and C4-2. Furthermore, an in-depth examination has been conducted on the photocytotoxicity mechanism of Pheo-PDT in these specific cell lines.

Methods

In vitro studies were conducted using the AIPC cell lines. DU-145 and C4-2 cells were treated with Pheo at different concentrations for 60 min alone, or Pheo treatment followed by exposure to 670 nm illumination (60 mW/cm2 in 88 s pulses), producing 5 J/cm2 via portable light-emitting diode.

Key findings

Our results show that Pheo-PDT substantially inhibits cell viability, anchorage-independent growth, and migration capacities and induces autophagy and apoptosis via the over-production of reactive oxygen species that mediates endoplasmic reticulum stress in AIPC cell lines.

Conclusions

Our study highlights the potential benefits of Pheo-PDT in metastatic hormone-insensitive PCa cell lines. It paves the way for treating localized and locally advanced PCa as a possible candidate for castration-resistant prostate cancer.
Fast radio bursts trigger aftershocks resembling earthquakes, but not solar flares
Authors: Totani Tomonori , Tsuzuki Yuya
Published: October 2023

The production mechanism of repeating fast radio bursts (FRBs) is still a mystery, and correlations between burst occurrence times and energies may provide important clues to elucidate it. While time correlation studies of FRBs have been mainly performed using wait time distributions, here we report the results of a correlation function analysis of repeating FRBs in the 2D space of time and energy. We analyse nearly 7,000 bursts reported in the literature for the three most active sources of FRB 20121102A, 20201124A, and 20220912A, and find the following characteristics that are universal in the three sources. A clear power-law signal of the correlation function is seen, extending to the typical burst duration (∼ 10 msec) towards shorter time intervals (Δt). The correlation function indicates that every single burst has about a 10–60 per cent chance of producing an aftershock at a rate decaying by a power law as ∝ (Δt)−p with p = 1.5–2.5, like the Omori–Utsu law of earthquakes. The correlated aftershock rate is stable regardless of source activity changes, and there is no correlation between emitted energy and Δt. We demonstrate that all these properties are quantitatively common to earthquakes, but different from solar flares in many aspects, by applying the same analysis method for the data on these phenomena. These results suggest that repeater FRBs are a phenomenon in which energy stored in rigid neutron star crusts is released by seismic activity. This may provide a new opportunity for future studies to explore the physical properties of the neutron star crust.
Simulating supermassive black hole mass measurements for a sample of ultramassive galaxies using ELT/HARMONI high-spatial-resolution integral-field stellar kinematics
Authors: Nguyen Dieu D , Cappellari Michele , Pereira-Santaella Miguel
Published: October 2023

As the earliest relics of star formation episodes of the Universe, the most massive galaxies are the key to our understanding of the stellar population, cosmic structure, and supermassive black hole (SMBH) evolution. However, the details of their formation histories remain uncertain. We address these problems by planning a large survey sample of 101 ultramassive galaxies (z ≤ 0.3, |δ + 24°| < 45°, |b| > 8°), including 76 per cent ellipticals, 17 per cent lenticulars, and 7 per cent spirals brighter than MK ≤ −27 mag (stellar mass 2 × 1012 ≲ M⋆ ≲ 5 × 1012 M⊙) with ELT/HARMONI. Our sample comprises diverse galaxy environments ranging from isolated to dense-cluster galaxies. The primary goals of the project are to (1) explore the stellar dynamics inside galaxy nuclei and weigh SMBHs, (2) constrain the black hole scaling relations at the highest mass, and (3) probe the late-time assembly of these most massive galaxies through the stellar population and kinematical gradients. We describe the survey, discuss the distinct demographics and environmental properties of the sample, and simulate their HARMONI Iz-, Iz + J-, and H + K-band observations by combining the inferred stellar-mass models from Pan-STARRS observations, an assumed synthetic spectrum of stars, and SMBHs with masses estimated based on different black hole scaling relations. Our simulations produce excellent state-of-the-art integral field spectrography and stellar kinematics (ΔVrms ≲ 1.5 per cent) in a relatively short exposure time. We use these stellar kinematics in combination with the Jeans anisotropic model to reconstruct the SMBH mass and its error using a Markov chain Monte Carlo simulation. Thus, these simulations and modellings can be benchmarks to evaluate the instrument models and pipelines dedicated to HARMONI to exploit the unprecedented capabilities of ELT.
Microbiological contamination present in enteral tube feeding prepared in hospitals and/or at home: a systematic review
Authors: Kozow Julia Fernanda Costa , Rabito Estela Iraci , Kruger Jenifer Faria , Medeiros Caroline Opolski , da Costa Rayane Luizi , Beux Márcia Regina , Stangarlin-Fiori Lize
Published: October 2023

Context

The safety of enteral formulas is important to restore and maintain the health of patients.

Objective

A systematic review of the literature was conducted to assess the microbiological contamination present in enteral tube feeding prepared in hospitals and/or at home.

Data sources

A systematic search was conducted of the Medline, Scopus, BVS, CAPES/MEC, Embase, Science Direct, and SciELO databases and gray literature.

Data extraction

Eligible studies that analyzed the contamination of enteral formulas manipulated in hospitals and/or at home were selected; a quality assessment tool was used.

Data analysis

Twenty-three studies evaluated 1099 enteral formulations. Of these, 44.67% of enteral formulas (n = 491) exceeded the acceptable bacterial count. Samples of homemade enteral formulation preparations (86.03%; n = 191) had the highest bacterial counts, followed by mixed preparations (79.72%; n = 59), and commercial formulas (30.01%; n = 241). The number of samples of enteral formulations that exceeded the bacterial count at home was 70.79% (n = 160 at the hospital was 37.91% (n = 331). Total coliforms (82.68%; n = 406) and mesophilic aerobes (79.22%; n = 389) were the most common microorganisms. Samples with bacterial pathogens were also identified, with Bacillus cereus (4.07%; n = 20) and Listeria monocytogenes (3.66%; n = 18) being the most prevalent.

Conclusions

A high number of samples of enteral formulations exceeded the bacterial count, but the risk to patient’s health when consuming enteral tube feeding prepared in hospitals or at home may be low. This is because the bacteria present in the samples are not considered potential causes of disease but rather indicators of hygiene conditions.

Systematic Review Registration

PROSPERO registration no. CRD42022367573.
Through the Lens of the Social Determinants of Learning™: Experiences of Online Prenursing Students During the COVID-19 Pandemic
Authors: Jennings Leslie A. , Urban Regina W.
Published: October 2023

BACKGROUND

Prenursing students represent the future pipeline of nursing students, yet their perceptions of how COVID-19 affected their experience as prenursing students are unknown.

METHOD

Short-answer data (n = 289) in US prenursing students were collected in fall 2020. Deductive thematic analysis was applied according to the social determinants of learning (SDOL™) framework.

RESULTS

Participants verbalized fears of contracting COVID-19 (physical health) and difficulties with stress and anxiety (psychosocial health). Participants shared pandemic-related financial challenges (economic instability), changes in living situations (physical environment), and the lack of hoped-for social connections (social environment). Many struggled with focus; others confirmed their goals (self-motivation).

CONCLUSION

The SDOL framework can be utilized by educators to conceptualize the influence of the COVID-19 pandemic on the experiences of online prenursing students and leveraged to develop targeted interventions to improve students’ well-being as they apply to nursing programs.
Does a Preoperative Mental Health Diagnosis Affect Pain Management in Patients With Adolescent Idiopathic Scoliosis Undergoing Surgery?
Authors: Bennett James T. , Chung Hoon , Artz Nicolas , Abraham Vivek M. , Andrews Albert , Wells Douglas , Cardelia Marc , St. Remy Carl
Published: October 2023

Background:

Patients with adolescent idiopathic scoliosis (AIS) are typically treated surgically with posterior spinal fusion (PSF) when the curve continues to progress beyond 45 to 50 degrees. In adult patients, studies have shown that preoperative psychiatric diagnoses are associated with poorer clinical outcomes after lumbar spine surgery. This study aims to address whether a preoperative mental health disorder affects outcomes in pediatric patients with AIS treated with PSF.

Methods:

We conducted a retrospective study of pediatric patients with a history of AIS requiring operative treatment with PSF at a single center with a minimum of 2-year follow-up. These patients were split into 2 groups: a subset that had a mental health disorder (MHD), and a control group. The MHD subset included patients with anxiety disorder, major depressive disorder, bipolar disorder, manic disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, and stress disorder. The 2 groups were compared using independent student t-test and χ2 analysis.

Results:

A total of 417 patients were included in the study. Ninety-three patients were included in the MHD group, and 324 patients were included in the control group. The mean pain score for the MHD group was greater (3.93) compared with the control group (3.34). The PCA demands during inpatient stay for the MHD group were also greater (236.7) compared with the control group (140.0). There was no significant difference in the length of stay in the hospital between the MHD group (4.7 days) and the control group (4.6 days). There was a greater number of patients in the MHD cohort (25.8%) still using narcotic pain medication at first follow-up compared with the control group (12.0%).

Conclusion:

This study suggests that patients with AIS with a preoperative mental health disorder undergoing PSF experience more pain after surgery and require more pain medication during their recovery.

Level of Evidence:

III. This is a retrospective review of pediatric patients with adolescent idiopathic scoliosis and a preoperative mental health diagnosis and their pain management requirements during the recovery period from posterior spinal fusion.
A multicenter study of the clinicopathological characteristics and a risk prediction model of early-stage breast cancer with hormone receptor-positive/human epidermal growth factor receptor 2-low expression
Authors: Xin Ling , Wu Qian , Zhan Chongming , Qin Hongyan , Xiang Hongyu , Gao Min , Duan Xuening , Liu Yinhua , Ye Jingming ,   Chinese Society of Breast Surgery (CSBrS),   Chinese Society of Surgery of Chinese Medical Association
Published: October 2023

Background:

In light of the significant clinical benefits of antibody-drug conjugates in clinical trials, the human epidermal growth factor receptor 2 (HER2)-low category in breast cancers has gained increasing attention. Therefore, we studied the clinicopathological characteristics of Chinese patients with hormone receptor (HR)-positive/HER2-low early-stage breast cancer and developed a recurrence risk prediction model.

Methods:

Female patients with HR-positive/HER2-low early-stage breast cancer treated in 29 hospitals of the Chinese Society of Breast Surgery (CSBrS) from Jan 2015 to Dec 2016 were enrolled. Their clinicopathological data and prognostic information were collected, and machine learning methods were used to analyze the prognostic factors.

Results:

In total, 25,096 patients were diagnosed with breast cancer in 29 hospitals of CSBrS from Jan 2015 to Dec 2016, and clinicopathological data for 6486 patients with HER2-low early-stage breast cancer were collected. Among them, 5629 patients (86.79%) were HR-positive. The median follow-up time was 57 months (4, 76 months); the 5-year disease-free survival (DFS) rate was 92.7%, and the 5-year overall survival (OS) rate was 97.7%. In total, 412 cases (7.31%) of metastasis were observed, and 124 (2.20%) patients died. Multivariate Cox regression analysis revealed that T stage, N stage, lymphovascular thrombosis, Ki-67 index, and prognostic stage were associated with recurrence and metastasis (P <0.05). A recurrence risk prediction model was established using the random forest method and exhibited a sensitivity of 81.1%, specificity of 71.7%, positive predictive value of 74.1%, and negative predictive value of 79.2%.

Conclusion:

Most of patients with HER2-low early-stage breast cancer were HR-positive, and patients had favorable outcome; tumor N stage, lymphovascular thrombosis, Ki-67 index, and tumor prognostic stage were prognostic factors. The HR-positive/HER2-low early-stage breast cancer recurrence prediction model established based on the random forest method has a good reference value for predicting 5-year recurrence events.

Registritation:

ChiCTR.org.cn, ChiCTR2100046766
Treatment of Recurrent Low-grade Serous Ovarian Cancer With MEK Inhibitors
Authors: Kulkarni Anjali , Cooke Carly , Fazelzad Rouhi , Fung-Kee-Fung Michael , May Taymaa , Zigras Tiffany
Published: October 2023

Objective:

Low-grade serous ovarian cancer (LGSC) represents 5% of all epithelial ovarian cancers. They are characterized by indolent growth and KRAS and BRAF mutations, differing from high-grade serous ovarian cancer both clinically and molecularly. LGSC has low response rates to traditional systemic therapies, including chemotherapy and hormonal therapy. The objective of this systematic review was to appraise the literature describing the efficacy of MEK inhibitors in the treatment of LGSC.

Methods:

A comprehensive search was conducted of the following databases: Medline ALL, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Sciences, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICFRP), and International Standard Randomized Controlled Trials Number (ISRCTN) Registry. All studies investigating MEKi in the treatment of LGSC in the adjuvant or recurrent setting for patients 18 years of age or older were included. All titles/abstracts were then screened by 2 independent reviewers (A.K. and C.C.). The full-text articles were then screened. All disagreements were resolved by a third independent reviewer (T.Z.). Two independent reviewers (A.K. and C.C.) extracted data from the studies deemed eligible for final review.

Results:

A total of 2108 studies were identified in the initial search. Of these, a total of 4 studies met the eligibility criteria for systematic review. In these studies, 416 patients were treated with an MEKi alone. All patients included in the studies were being treated for LGSC in the recurrent setting. Varied results and efficacy of the MEKi were reported in each study.

Conclusions:

The results highlighted in this systematic review demonstrate varied responses to MEKi for recurrent LGSC. Further research is needed in this field comparing the efficacy to current therapies, as well as to further evaluate the safety and toxicity profile with long-term use of MEKi.
Retinal Vascular Occlusion and COVID-19 Diagnosis: A Multicenter Population-based Study
Authors: Li Jing-Xing , Cheng-Chung Wei James , Wang Yu-Hsun , Bair Henry , Hsu Shu-Bai , Lin Chun-Ju
Published: October 2023

Introduction:

Several ocular diseases have been reported in patients with coronavirus disease 2019 (COVID-19), especially retinal vascular occlusion. This study aims to examine the risk of retinal vascular occlusion following COVID-19 diagnosis.

Method:

This retrospective cohort study was based on 46 healthcare organizations in the United States using the TriNetX network. Individuals who had laboratory confirmation of COVID-19 from January 1, 2020 to December 31, 2021 were included. Multivariate analysis was adjusted on age, sex, race and comorbidities, and hazard ratio was calculated by Cox proportional hazard regression model.

Results:

1,460,634 paired individuals were enrolled for analysis. Patients with COVID-19 had a significantly higher risk of branch retinal vein occlusion (BRVO) (hazard ratio [HR] 1.27, 95% confidence interval [CI] 1.04−1.52) than those without COVID-19. The cumulative incidence rate of BRVO was also significantly higher in patients with COVID-19 compared with those without COVID-19 (log-rank p = 0.014). Within 12 weeks following COVID-19 diagnosis, transient effect of central retinal vein occlusion (HR 1.59, 95% CI 1.15−2.17) and BRVO (HR 2.11, 95% CI 1.51−2.95) were observed.

Conclusions:

This large-scale multicenter study demonstrated retinal vein occlusion may be associated with COVID-19.
Gallstones, cholecystectomy and the risk of pancreatic cancer: an updated systematic review and meta-analysis of cohort studies
Authors: Sun Na , Wang Xudong , Wei Jichao
Published: October 2023

The effect of gallstones and cholecystectomy on the development of pancreatic cancer has recently prompted many population-based studies. However, the results are controversial. We conducted an updated systematic review and meta-analysis to explore the causality among gallstones, cholecystectomy and pancreatic cancer. Cohort studies published in the PubMed, Web of Science, Embase, and Cochrane Library databases up to May 2023 were retrieved. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were analyzed using a random-effects model. We screened 1391 articles and included 16 studies. Gallstones were not associated with an increased risk of pancreatic cancer (P = 0.082), with only the Asian population (P = 0.011) showing an increased risk in the subgroup analysis. A markedly higher risk of pancreatic cancer was observed among patients with cholecystectomy (RR = 1.23; 95% CI, 1.07–1.41; P = 0.004; I2
 = 74.4%). The association remained significant in the Asian population (P = 0.004), in the subgroup analyses stratified by sex, lag period, and time interval since cholecystectomy, and when the models were adjusted for diabetes, smoking, and BMI. Interestingly, cholecystectomy due to gallstones (RR = 1.30; 95% CI, 1.14–1.48; P < 0.001; I2
 = 30.8%), rather than for unspecified reasons (P = 0.116), markedly increased the risk of pancreatic cancer. In conclusion, cholecystectomy due to gallstones, rather than gallstone formation, conferred an increased risk for pancreatic cancer. There was a higher risk for the Asian population for both gallstones and cholecystectomy.
Serum ferritin is associated with sarcopenia and predicts long-term survival for gastric cancer undergoing radical gastrectomy
Authors: Zhou Da , Zeng Chenghao , Zhang Li , Gao Xuejin , Li Guoli , Wang Xinying
Published: October 2023

Background

Gastric cancer (GC) is one of the most common malignant tumors, and its long-term overall survival (OS) still needs to be improved. This study aimed to elucidate the relationship between serum ferritin (SF) and sarcopenia and its ability to predict long-term OS for GC patients.

Methods

Clinicopathological data from GC patients who underwent radical gastrectomy were reviewed and received 3 years of follow-up after surgery. The correlation between SF and sarcopenia was determined by Spearman analysis. Factors used to establish a nomogram to predict the 3-year OS for GC were identified by multivariate Cox hazard analysis.

Results

We retrospectively identified 372 GC patients after surgery and randomly divided (3:1) into a training cohort and a validation cohort. The correlation coefficient between SF and sarcopenia was 0.323. GC patients with SF < 151.5 μg/L had a significantly longer 3-year OS. The variables of the nomogram include SF, sarcopenia, TNM stage system, and neoadjuvant chemotherapy. In the training cohort and validation cohort, the area under the time-dependent ROC curve was 0.81 and 0.791, respectively. The calibration curve and decision curve in different cohorts have good consistency. 3-year OS was significantly different among the three groups (log-rank P < 0.001) divided by calculating the nomogram score.

Conclusion

SF was positively correlated with sarcopenia, and the nomogram was a practical tool for predicting 3-year OS after radical gastrectomy, furthermore could be used to stratify the risk of 3-year OS in patients with GC.
Malignant gastrointestinal neuroectodermal tumor: a case report and literature review
Authors: Su Dan , Yang Hujuan , Zhao Ming , Zhou Hongying , Wu Jin , Zhao Zhongkuo , Zhong Jianguo , Xue Qian , Hong Yupeng , Sun Jie , Li Xiaoyi , Zhao Tongwei
Published: October 2023

Introduction and importance:

A malignant gastrointestinal neuroectodermal tumor (GNET) is an extremely rare primary malignant mesenchymal tumor of the gastrointestinal tract characterized by EWSR1 gene rearrangement. An optimal systemic treatment strategy for advanced/recurrent GNET has not yet been identified.

Case presentation:

A 24-year-old male patient was hospitalized with abdominal pain and underwent two operations for a tumor in his small intestine. Immunohistochemistry (IHC) showed strong expression of S-100 protein and SOX 10. Fluorescence in situ hybridization analysis and next-generation sequencing analysis indicated that there wereEWSRgene rearrangements and the presence ofEWSR-ATP1gene fusions, respectively. The diagnosis of GNET in the small intestine was confirmed by pathology. The young patient received the fifth-line of apatinib mesylate and the sixth-line of apatinib combined with temozolomide. The two apatinib-containing regimens showed stable disease and progression-free survival of 4.7 months and 3.1 months with single-agent apatinib or apatinib combined with temozolomide, respectively.

Clinical discussion:

To our best knowledge, this is the first report of malignant GNET treated with apatinib and temozolomide. Apatinib-containing regimens might has antineoplastic activity against GNET. The authors reviewed the relevant reports of previous GNET treatment, summarized the clinicopathological characteristics of GNET, and found that there are no reports of apatinib for backline treatment of GNET.

Conclusion:

Containing apatinib may provide an additional treatment option for patients with chemotherapy-resistant GNET tumors.
Caregivers' Perceptions of Ride-On Cars and Behavioral Changes for Young Children With Motor Delays
Authors: Huang Hsiang-Han , Tsai Wan-Ying , Lin Yu-Ni , Hung Ching-Ying , Chan Ai-Tzu
Published: October 2023

Purpose:

To investigate caregivers' perceptions of using a ride-on car (ROC) and observe behavioral changes in their children following ROC training and conventional therapy.

Methods:

The study included 37 toddlers with motor delays and their caregivers, divided into an ROC training group (27 participants) and a conventional therapy group (10 participants). A binary, multiple-choice, and open-ended questionnaire was administered before and after a 3-month intervention period.

Results:

Over 70% of caregivers had no experience using mobility devices before the intervention. Before the intervention, children's ability and age were key barriers to using mobility devices. After the intervention, caregivers in the ROC group were more inclined than those in the control group to allocate a larger budget for these devices.

Conclusions:

The findings highlight the importance of pediatric physical and occupational therapists working collaboratively with caregivers during such interventions and raising awareness about government subsidies and resources available for mobility devices.