bluuebunny/crossref_metadata_2025 huggingface dataset:
Ectopic Posterior Pituitary and Its Associations with Extrapituitary Intracranial Anomalies
Authors: Alagappan Alamelu , Nayak Manoj Kumar , Sahoo Biswajit , Naik Suprava , Deep Bag Nerbadyswari , Bhoi Sanjeev
Published: June 2024

Posterior pituitary ectopia is a very rare entity in the development of the pituitary gland. Several factors and multiple genes are associated with this entity causing both pituitary and extrapituitary abnormalities. Pituitary abnormalities can be various endocrine problems and extrapituitary abnormalities can be optic nerves and cerebellar hypoplasia, heterotopia, and abnormal vessels. This pictorial review represents the imaging manifestations of extrapituitary intracranial anomalies that can be associated with posterior pituitary ectopia.
Klinik-Vergleichsportale: Mehr Qualität durch Konkurrenz
Authors: Pabst Inga
Published: June 2024

Wochenlang wurde gerätselt, ob der lange angekündigte Klinik-Atlas pünktlich starten würde. Während Bundesgesundheitsminister Pro. Karl Lauterbach (SPD) sich viel Zeit ließ, brachten andere Anbieter eigene Klinikverzeichnisse in Stellung. Vom verbesserten Informationsangebot profitiert der Patient.
Rechtskolumne: Anrufung des Bundesverfassungsgerichts bei Krankenhausschließung?
Authors: Rybak Christian
Published: June 2024

Krankenhausschließungen betreffen nicht nur die Gesundheitsversorgung einer Region, sondern haben auch erhebliche sozioökonomische Auswirkungen. Umso wichtiger sind klare rechtliche Vorgaben, an denen sich derartige Entscheidungen zu messen haben.
St. Vincenz-Kliniken: Ein steiniger Weg
Authors: Rößing Sabine
Published: June 2024

Im vergangenen Sommer stellte die St. Vincenz Krankenhaus GmbH einen Antrag auf Insolvenz in Eigenverantwortung. Ein schwerer Schritt, denn es drohte der Verlust des Krankenhauses. Um die katholische Trägerschaft nicht zu verlieren, nahmen die Vincentinerinnen viele Hürden auf sich.
Klinik-Sanierer: „Ein Insolvenzverfahren ist keine Sterbebegleitung“
Authors: Kohrs Jens
Published: June 2024

Dr. Rainer Eckert hat schon viele Kliniksanierungen erlebt. Aktuell begleitet der Fachanwalt für Insolvenzrecht ein Dutzend gerichtliche Verfahren gleichzeitig. „Zügig und gründlich“ geht er am liebsten vor, schneidet auch gerne tiefer. Im kma Gespräch erklärt er, was er darunter versteht.
Krankenhausreform: Entwurf beschlossen trotz großer Kritik
Authors: Heeser Alexandra
Published: June 2024

Zahlreiche Gesprächsrunden mit Ländern, Verbänden, Experten und Kommunen hat der Bund hinter sich. Der Referentenentwurf zur Krankenhausreform wurde vom Kabinett erst mit Verspätung am 15. Mai gebilligt. Doch es herrscht weiterhin Uneinigkeit – vor allem von Länder- und Kassenseite.
Terror und Krieg: Auf den Ernstfall nur bedingt vorbereitet
Authors: Doelfs Guntram
Published: June 2024

Der Krieg in der Ukraine, chinesische Drohungen gegen Taiwan, der eskalierende Nahostkonflikt – längst tobt global ein neuer Systemkonflikt. Deutschland muss sich plötzlich mit Terror, Kriegsszenarien und hybrider Kriegsführung beschäftigen. Das deutsche Gesundheitswesen ist dafür nicht gerüstet.
IT-Sicherheitsvorgaben: Ohne C5 dürfen keine Patientendaten in die Cloud
Authors: Maier-Johnson Daniel , Gross Benedict
Published: June 2024

Das gerade verabschiedete Digitalgesetz (DigiG) gibt strenge Vorgaben zur Cybersicherheit vor. Leistungserbringer und Softwareanbieter müssen sich neuen Anforderungen stellen.
Klinikmarkt: Wie will Helios noch wachsen, Herr Möller?
Authors: Rößing Sabine
Published: June 2024

Robert Möller soll Helios neu aufstellen. Im Gespräch mit kma schildert der CEO, warum der Konzern trotz Krise im Markt wächst, die geplante Vorhaltefinanzierung kleine Kliniken nicht sichert – und warum Behandlungsqualität entscheidend für weiteres Wachstum ist.
Universität Bayreuth: Planetary Health Studium an der Schnittstelle von Umwelt, Klimaschutz und Gesundheit
Authors: Lörzing Romina , Haderer Marika , Nagel Eckhard
Published: June 2024

Mit interdisziplinären Masterstudiengängen wird an der Universität Bayreuth die nächste Generation von Fachkräften ausbildet, um transformative Lösungen für eine nachhaltigere Zukunft zu gestalten.
Lichtblick: Für einen guten Start ins Leben
Authors: Hohnstein Aileen
Published: June 2024

Dieser Artikel ist nur als PDF-Dokument verfügbar.
Excavating sexual difference in language and thinking
Authors: Koshy Abey
Published: June 2024

The essay questions the predominant perception of human thinking as a gender-neutral enterprise. It holds that sexual difference is deeply engrained in language and thinking, regardless of the biological sexual identities of those who express those thoughts. The essay critiques the traditional thought for superficially linking the meaning of sexuality with biological gender. It opposes the characterisation of masculine thinking as man’s thinking and feminine thinking as woman’s. Masculine language expressions can sometimes happen from women writers, and male thinkers sometimes produce feminine writings. Biological bodily sexual identity is not a pointer to the psychical sexual behaviour of humans. Psychoanalytic gender theories explaining the inessentiality of human sexuality help this work to demonstrate that man’s and woman’s sex identities are arbitrarily produced by language. It exposes the process of the emergence of sexual difference in the human psyche, language, and thinking. To do that, this study anchors primarily on the reflections of Lacan, Nietzsche, and Saussure. Lacanian psychoanalysis is used as the theoretical source to explain the role of language in forming masculine and feminine identities. Nietzsche’s prioritisation of the value of natural existence, sensuality, and beauty over abstract truths propagated by masculine metaphysics enables us to explain how feminine experience differs from the masculine conception of truth. Saussure’s linguistic theory, which challenged the masculine representative function of language, is used to justify the essay’s claim that ‘affects’ created on the human body by objects of the world are the source of feminine linguistic expression. ‘Affects’ produce bodily intensities, from which new linguistic signs, metaphors, images, and idioms are formed, leading to imaginative reactivation of instinctual libidinal drives, which is considered the source of sexually different thinking.
Induced abortion among adolescent girls and young women: should geography matter in Ghana?
Authors: Okyere Joshua , Kyei-Arthur Frank , Agyekum Martin Wiredu , Agbadi Pascal , Yeboah Isaac
Published: June 2024

Globally, there has been a slight reduction in abortion rates. However, abortion rates have increased in other major regions, including sub-Saharan Africa. Induced abortion rates vary by ecological zone and place of residence, and it is prevalent among women aged 15–24. This study examined the predictors of induced abortion in ecological zones by place of residence among adolescent girls and young women aged 15–24. The 2017 Ghana Maternal and Health Survey, which is a nationally representative household survey dataset, was used for this study. This analysis is restricted to 3194 Adolescent Girls and Young Women (AGYW) aged 15–24 years. A two-level multilevel binary logistic regression model was used to analyze the individual and contextual level characteristics associated with induced abortion. The results show that the prevalence rate of induced abortion among adolescent girls and young women is 26.0%. After adjusting for individual and community level factors, ecological zones and place of residence predicted induced abortion among AGYW. More importantly, the results demonstrate that AGYW residing in urban areas of the forest zones were statistically significant to report induced abortion compared to those in the rural areas. In conclusion, there is a strong association between place of residence, ecological zones and induced abortion in Ghana. Primarily, urban-dwelling women in the forest zone are more likely to report induced abortion. There is, therefore, a need to prioritize women residing in urban areas and the forest zone of Ghana. AGYW in these high-risk ecological zones should be reached with sufficient health education and sensitization about induced abortion. Given the protective factor of contraceptive use, it is recommended that the government and its health agencies strengthen campaigns to improve contraceptive use among AGYW across the country, particularly in the urban forest ecological zone.
Biophysical perspectives to understanding cancer-associated fibroblasts
Authors: Devarasou Somayadineshraj , Kang Minwoo , Shin Jennifer H.
Published: June 2024

The understanding of cancer has evolved significantly, with the tumor microenvironment (TME) now recognized as a critical factor influencing the onset and progression of the disease. This broader perspective challenges the traditional view that cancer is primarily caused by mutations, instead emphasizing the dynamic interaction between different cell types and physicochemical factors within the TME. Among these factors, cancer-associated fibroblasts (CAFs) command attention for their profound influence on tumor behavior and patient prognoses. Despite their recognized importance, the biophysical and mechanical interactions of CAFs within the TME remain elusive. This review examines the distinctive physical characteristics of CAFs, their morphological attributes, and mechanical interactions within the TME. We discuss the impact of mechanotransduction on CAF function and highlight how these cells communicate mechanically with neighboring cancer cells, thereby shaping the path of tumor development and progression. By concentrating on the biomechanical regulation of CAFs, this review aims to deepen our understanding of their role in the TME and to illuminate new biomechanical-based therapeutic strategies.
A novel method may reveal bulk metallic glass compressive ductility trends in high data rate nanoindentation
Authors: Sickle Jordan J. , Higgins Wesley H. , Wright Wendelin J. , Pharr George M. , Dahmen Karin A.
Published: June 2024

Recent methods allow novel amorphous alloy compositions to be rapidly manufactured at small scale; however, obtaining materials properties such as compressive ductility from these smaller specimens has remained a challenge. Here, we suggest a potential high-throughput nanoindentation method that may be able to rapidly characterize the relative compressive ductility between these alloys based on their serration characteristics. The properties of emergent serrations, when interpreted in a simple micromechanical stress relaxation model, may order these materials by their compressive plastic strain to failure. These results are consistent with the ordering obtained from compressed specimens as well as with model simulations, suggesting that this model may be broadly useful for interpreting compressive ductility from nanoindentation serrations. After it is validated on more materials, this new method will match the rapid pace of amorphous alloy development, thus allowing metallic glass properties to be fine-tuned for each application prior to scale prototyping.
Inverse scattering problems of the biharmonic Schrödinger operator with a first order perturbation
Authors: Xu Xiang , Zhao Yue
Published: June 2024

We consider an inverse scattering problems for the biharmonic Schrödinger operator Δ2 + A · ∇ + V in three dimensions. By the Helmholtz decomposition, we take A = ∇p + ∇ ×ψ. The main contributions of this work are twofold. First, we derive a stability estimate of determining the divergence-free part ∇ ×ψ of A by far-field data at multiple wavenumbers. As a consequence, we further derive a quantitative stability estimate of determining −12∇⋅A+V. Both the stability estimates improve as the upper bound of the wavenumber increases, which exhibit the phenomenon of increased stability. Second, we obtain the uniqueness of recovering both A and V by partial far-field data. The analysis employs scattering theory to obtain an analytic domain and an upper bound for the resolvent of the fourth order elliptic operator. Notice that due to an obstruction to uniqueness, the corresponding results do not hold in general for the Laplacian, i.e., Δ + A · ∇ + V. This can be explained by the fact that the resolvent of the biharmonic operator enjoys a faster decay estimate with respect to the wavenumber compared with the Laplacian.
Coherent control of terahertz-scale spin resonances using optical spin–orbit torques
Authors: Hintermayr Julian , van Kuppevelt Paul M. P. , Koopmans Bert
Published: June 2024

Using optically generated spin–orbit torques induced by the heavy metal Pt, we demonstrate coherent control of GHz ferromagnetic resonances in Pt/Co/Pt multilayers as well as sub-THz exchange resonances in [Gd/Co]2 multilayers. Employing a double-pump setup, we show that depending on the helicities of the pump pulses, spin resonances can either be coherently amplified or suppressed if the time delay between the arrival of the pump beams is chosen appropriately. Furthermore, by investigating the phase and amplitude of the exchange-driven modes, we identify features that challenge the current understanding of optically generated spin–orbit torques and discuss possible explanations.
Experimental and model investigation of spreading characteristics of the liquid sheet formed by jet impinging on a circular plane
Authors: Kang Tianyu , Yu Qingbo , Liu Zhongyuan , Tao Shengkai
Published: June 2024

The focus of this paper is on the spreading characteristics of the liquid sheet formed by jet impinging on a circular plane. The liquid sheet is studied in two parts: the liquid film that spreads radially on the circular plane, and the free liquid sheet after leaving the circular plane, the former determines the initial thickness and velocity of the latter. Experimental results show that, for the liquid film on the circular plane part, as the jet velocity increases, the liquid film thickness increases due to the film velocity loss caused by the inelastic collision. The liquid film thickness is positively correlated with the jet radius and negatively correlated with the circular plane radius. Liquid viscosity slows the spreading of liquid film, forms the boundary layer, and thickens the liquid film. The surface tension inhibits the velocity loss due to the inelastic collision. For the free liquid sheet part, surface tension and gravity promote the bending of the liquid sheet. The larger the initial momentum of the liquid sheet leaving the circular plane, the larger the maximum spreading range of free liquid sheet reaching the equator. As for the theoretical model, a film velocity correction coefficient reflecting collision loss is introduced to improve the radial spreading theory of the liquid film on a solid surface, and a streamline function is assumed to solve the momentum integral equation of free liquid sheet. The predicted streamline agrees well with the experimental data.
Magneto-acousto-electric effects based on focused acoustic-vortex beams in a coaxial magnetic field
Authors: Liu Runquan , Hu Gaorui , Li Peixia , Guo Gepu , Tu Juan , Zhang Dong , Ma Qingyu
Published: June 2024

As an innovative neural modulation technique, the transcranial magneto-acousto-electric (MAE) stimulation (TMAES) realizes the synergistic regulation of neuronal discharge through the ultrasonic mechanical and inductive electric effects, offering significant prospects in biomedical applications. However, the stimulation accuracy is still limited by the unidirectional distribution of MAE field intensity. A method of constructing center-converging MAE field by coupling the helical wave fronts of focused acoustic-vortex (FAV) beams with a coaxial magnetic field is proposed. By describing FAVs with Laguerre–Gaussian functions, the theory of MAE field construction is derived in explicit formulae and the spatiotemporal characteristics of MAE fields in the focal region are analyzed. It is theoretically and experimentally demonstrated that the MAE field generated by the FAV of lth order is determined by those of (l − 1)th and (l + 1)th orders. The center-converging phase-rotating MAE field can only be generated by the FAV of first order, maintaining a constant peak intensity at the vortex center. Experimental distributions of MAE fields for FAVs of different orders show good agreements with numerical simulations. With the peak pressure of 0.86 MPa and the magnetic intensity of 0.3 T, the peak intensity of 62.1 mV/m reaching the electric stimulation threshold is achieved. The center-converging MAE field constructed by FAV may develop a new synergistic neural modulation scheme for TMAES with enhanced precision and flexibility while ensuring safety and efficacy, thereby exhibiting significant scientific and practical implications.
Unsaturation effects on lipid transmembrane asymmetry
Authors: Ma Yong-Hao , Li Bolin , Wang Chu , Yang Jingjing , Han Xiaofeng , Lu Xiaolin
Published: June 2024

Within cell plasma membranes, unsaturated lipids are asymmetrically distributed over the inner and outer leaflets, offering an attractive local structural feature. However, the mechanism to keep lipid transmembrane asymmetry and the closely related transmembrane movement (flip-flop) for unsaturated lipids remain poorly understood. Here, we applied sum frequency generation vibrational spectroscopy to investigate this lipid transmembrane asymmetry upon mimicking the cell membrane homeostatic processes. On the one hand, unsaturated lipids were found to hinder the flip-flop process and preserve lipid transmembrane asymmetry in model cell membranes, owing to the steric hindrance caused by their bent tails. On the other hand, local unsaturated lipids in the mixed unsaturated/saturated lipid bilayer were conducive to the formation of the local asymmetry. Therefore, lipid unsaturation can be recognized as an intrinsic key factor to form and maintain lipid transmembrane asymmetry in cell membranes.
Physics-informed neural networks for fully non-linear free surface wave propagation
Authors: Lu Haocheng , Wang Qian , Tang Wenhao , Liu Hua
Published: June 2024

This study proposed fully nonlinear free surface physics-informed neural networks (FNFS-PINNs), an advancement within the framework of PINNs, to tackle wave propagation in fully nonlinear potential flows with the free surface. Utilizing the nonlinear fitting capabilities of neural networks, FNFS-PINNs offer an approach to addressing the complexities of modeling nonlinear free surface flows, broadening the scope for applying PINNs to various wave propagation scenarios. The improved quasi-σ coordinate transformation and dimensionless formulation of the basic equations are adopted to transform the time-dependent computational domain into the stationary one and align variable scale changes across different dimensions, respectively. These innovations, alongside a specialized network structure and a two-stage optimization process, enhance the mathematical formulation of nonlinear water waves and solvability of the model. FNFS-PINNs are evaluated through three scenarios: solitary wave propagation featuring nonlinearity, regular wave propagation under high dispersion, and an inverse problem of nonlinear free surface flow focusing on the back-calculation of an initial state from its later state. These tests demonstrate the capability of FNFS-PINNs to compute the propagation of solitary and regular waves in the vertical two-dimensional scenarios. While focusing on two-dimensional wave propagation, this study lays the groundwork for extending FNFS-PINNs to other free surface flows and highlights their potential in solving inverse problems.
Hydrated cation–π interactions of π-electrons with hydrated Mg2+ and Ca2+ cations
Authors: Mu Liuhua , Shi Guosheng , Fang Haiping
Published: June 2024

Hydrated cation–π interactions at liquid–solid interfaces between hydrated cations and aromatic ring structures of carbon-based materials are pivotal in many material, biological, and chemical processes, and water serves as a crucial mediator in these interactions. However, a full understanding of the hydrated cation–π interactions between hydrated alkaline earth cations and aromatic ring structures, such as graphene remains elusive. Here, we present a molecular picture of hydrated cation–π interactions for Mg2+ and Ca2+ by using the density functional theory methods. Theoretical results show that the graphene sheet can distort the hydration shell of the hydrated Ca2+ to interact with Ca2+ directly, which is water–cation–π interactions. In contrast, the hydration shell of the hydrated Mg2+ is quite stable and the graphene sheet interacts with Mg2+ indirectly, mediated by water molecules, which is the cation–water–π interactions. These results lead to the anomalous order of adsorption energies for these alkaline earth cations, with hydrated Mg2+–π < hydrated Ca2+–π when the number of water molecules is large (n ≥ 6), contrary to the order observed for cation–π interactions in the absence of water molecules (n = 0). The behavior of hydrated alkaline earth cations adsorbed on a graphene surface is mainly attributed to the competition between the cation–π interactions and hydration effects. These findings provide valuable details of the structures and the adsorption energy of hydrated alkaline earth cations adsorbed onto the graphene surface.
Fabrication and evaluation of figures of merit of ZnO polymer-based hybrid UV photodiodes
Authors: Nagpal Keshav , Rauwel Erwan , Ducroquet Frédérique , Gélard Isabelle , Rauwel Protima
Published: June 2024

This work reports on the fabrication of ZnO polymer-based hybrid ultraviolet (UV) photodiodes with a configuration of ITO/ZnO-nanorod/F8BT/PEDOT:PSS/Ag. The diode was fabricated by spin-coating p-type F8BT and PEDOT:PSS polymers on hydrothermally grown n-type ZnO nanorods. The growth of ZnO nanorods was carried out by varying seed layer alcohols, viz., methanol, ethanol, isopropanol, and aqueous ethanol (70% alcohol). These solvents influenced the nanorod diameter, surface coverage, and surface defects. Herein, we demonstrate that the uniformity and defects in ZnO nanorods govern the electrical properties, photoresponse, and figures of merit of the photodiodes. In particular, the photodiodes are evaluated on their rectification ratio, ideality factor (η), responsivity (R), external quantum efficiency (EQE), and response time (Tdecay). The photodiode fabricated with ZnO nanorods grown on the methanol seeding layer has demonstrated the best performance, owing to the uniform surface coverage of the nanorods. It also presented the highest rectification ratio of ∼640, a Tdecay of 108 s, a η of 2, an EQE of ∼2760%, and an R of ∼8.14 A/W at −2 V.
The anion photoelectron spectrum and diabatization of tetrazolyl
Authors: Avanessian Chris , Yarkony David R.
Published: June 2024

The potential energy surface of tetrazolyl [cyclic (N4CH)] has a conical intersection seam between the two lowest-energy electronic states near the ground state minimum geometry. This work treats that molecule. The potential energy surfaces used in this study are based on a least-squares fitting procedure that includes ab initio energies, energy gradients, and derivative couplings described using polynomials up to fourth-order and ab initio data obtained from multireference configuration interaction wave functions. A five-electronic-state description was generated with a root mean square absolute energy error of 9.6 cm–1, compared to 326.8 cm–1 when only second-order terms were used. The time-independent multimode vibronic coupling in the KDC approximation was used to simulate and analyze the anion ultraviolet photoelectron spectrum of tetrazolide.
Quantitative analysis of ITER Poloidal Field joints through rigorous resistivity parameterization
Authors: Huang J , Ilyin Y , Zhai Y , ten Kate H H J , Nijhuis A
Published: June 2024

The lap-type twin-box joints are integral components in International Thermonuclear Experimental Reactor (ITER) fusion magnets, with profound implications for magnet stability based on their electro-magnetic, thermal, and mechanical properties. Throughout the extensive R&D process, rigorous qualification tests are conducted to meet stringent standards. However, existing tests often prioritize global performance, which lack of strand-level details due to inherent limitations in test setups. Furthermore, as the referencing test facility of SULTAN falls short in replicating relevant ITER operating conditions, numerical methods that offer both accuracy and the requisite level of detail for comprehensive magnet and component analysis and development are necessary. This paper introduces the utilization of the JackPot-AC/DC code, developed at the University of Twente, as a fundamental tool for achieving strand-level precision in handling CICCs and joints, which encompasses copper and solder components. The primary focus of this study is to obtain precise input parameters, emphasizing their role in conducting a quantitative analysis using JackPot-AC/DC. The investigation centers on an ITER PF5 joint (PFJEU6), where contact resistances and AC losses were measured under parallel magnetic fields. Given the constraints in the measured results, an enhanced parameterization is performed to derive precise resistivity and solder-related parameters. Additionally, sensitivity analyses of individual parameters and cable compact configurations are thoughtfully evaluated. With the optimal input parameters acquired, systematic simulations of the joint exposed to transverse magnetic fields, mimicking SULTAN and ITER operating conditions, are processed and validated against experimental results. This research establishes a comprehensive foundation for the analysis of lap-type twin-box joints, including DC, AC, and stability properties. The outcomes will significantly contribute to advancing the understanding of the intricate behavior of these joints in the context of fusion magnet applications.
The wildfire impacts of the 2017-2018 precipitation whiplash event across the Southern Great Plains
Authors: Puxley B L , Martin E R , Basara J B , Christian J I
Published: June 2024

The Southern Great Plains of the United States is a region with a sharp zonal precipitation gradient that is prone to rapid transitions in precipitation extremes. Transitions from pluvial to drought conditions can lead to the green-up of vegetation during extreme rainfall, posing a considerable fire risk as the region rapidly transitions into drought. Such transitions have been studied in depth across regions such as California; however, limited studies have examined their impacts across the Southern Great Plains. The aim of this study was to examine the role of preceding precipitation whiplash events in providing fuel for wildfires, with 2017–2018 investigated as a case study. This study specifically demonstrates the relationship between precipitation, vegetation, and wildfires for the first time across the Southern Great Plains. Lag correlation analysis of historical data at our study site showed anomalously high precipitation 8 months prior to Spring wildfires, resulting in a significantly higher number of wildfires and acres burned. In particular, this study examined a highly impactful precipitation whiplash event that occurred during the Fall of 2017 across the Oklahoma and Texas panhandles, which preceded a mega-fire event in the Spring of 2018. Precipitation anomalies that were 137% of normal during the 2017 growing season rapidly cascaded into drought conditions with precipitation anomalies 21% of normal throughout the cool winter season. Excessive precipitation supported vigorous vegetation recovery and growth, with vegetation indices peaking at approximately 1 standard deviation above average during August 2017. However, the subsequent drought period rapidly desiccated the terrestrial surface. As a result, dozens of wildfires burned a total of 556 347 acres during March and April 2018, resulting in at least two fatalities, dozens of homes destroyed, and over 500 personnel dispatched to fight and mitigate the fires. Overall, this study highlights the significant role of preceding Fall precipitation whiplash events in fueling Spring wildfires across the Southern Great Plains, particularly exemplified by the impactful 2017–2018 case, highlighting the complex dynamics between extreme precipitation, vegetation growth, and subsequent fire risks in the region.
Entanglement Hamiltonian for inhomogeneous free fermions
Authors: Bonsignori Riccarda , Eisler Viktor
Published: June 2024

We study the entanglement Hamiltonian for the ground state of one-dimensional free fermions in the presence of an inhomogeneous chemical potential. In particular, we consider a lattice with a linear, as well as a continuum system with a quadratic potential. It is shown that, for both models, conformal field theory predicts a Bisognano–Wichmann form for the entanglement Hamiltonian of a half-infinite system. Furthermore, despite being nonrelativistic, this result is inherited by our models in the form of operators that commute exactly with the entanglement Hamiltonian. After appropriate rescaling, they also yield an excellent approximation of the entanglement spectra, which becomes asymptotically exact in the bulk of the trapped Fermi gas. For the gradient chain, however, the conformal result is recovered only after taking a proper continuum limit.
Effect of interlayer thickness and gap distance on vaporizing foil actuator welding of 5A06 aluminium alloy and 321 stainless steel
Authors: Su Shan , Wu Yuanyuan , Shao Fei , Gu Xiaoya , Liu Xiaoyu , Wang Ruichen
Published: June 2024

The composite structure of aluminium alloy and stainless steel provides a wide range of comprehensive advantages, encompassing properties such as lightweight, high strength, and corrosion resistance. These advantages make composite structure particularly suitable for various applications in industries such as transportation and chemicals. One innovative solid-phase welding technology that is well suited for joining dissimilar materials is vaporizing foil actuator welding. This technology allows for the welding of composite structures made of aluminium and stainless steel, despite the significant differences in physical and chemical properties. To enhance the vaporizing welding process, this paper proposes the introduction of an interlayer between the dissimilar materials. The interlayer consists of a third material that is added to bridge the gap between materials with differing hardness and plasticity. The main objective of introducing the interlayer is to minimise performance disparities and reduce the formation of intermetallic compounds at the interface. By examining the vaporizing foil actuator welding process of aluminium alloy and stainless steel with the interlayer, it aims to analyse the characteristics of the interface morphology. Additionally, this study investigates the energy conversion mechanism of the aluminium foil gasification process and explore the influence of the interlayer on the microstructure and mechanical properties of the interface between aluminium alloy and stainless-steel joints.
The burden of heat in arid regions of the Middle East: an analysis from Jordan and Kuwait
Authors: Alwadi Yazan , Alahmad Barrak
Published: June 2024

The Middle East, with its vast arid landscape, is facing escalating health risks due to intensifying heat under climate change. Kuwait and Jordan, two representative countries from the region, have no heat action plan in place. This study aims to (1) quantify the mortality burden of extreme heat in these countries, and hence (2) identify critical temperature thresholds. We collected 17 years of daily mortality records from 2000 to 2016 in Amman, Jordan, and the entire state of Kuwait. We fitted a time series design restricted to the summer months (June–August) for each location. We used distributed lag non-linear models to estimate non-linear associations and lagged effects of temperature on mortality. We then calculated attributable mortality for a range of temperature percentiles. We analyzed a total of 56 654 (39 996 all-cause deaths in Amman and 16 658 non-accidental deaths in Kuwait). Kuwait’s average summer temperature (38.7 °C) was higher than Amman (26.5 °C). In Kuwait, 202.1 (95% eCI: 17.7, 344.8) attributable heat deaths occurred over 79 d at temperatures above 41.9 °C (>95th percentile), averaging 2.6 heat deaths per day. Amman experienced 500.7 (95% eCI: 17.7, 344.8) attributable heat deaths over 77 d at temperatures above 30.75 °C, with an average of 6.5 deaths per day. This study equips Kuwait and Jordan with critical data to develop and implement targeted heat action plans. The two Middle Eastern countries face extreme heat challenges and are undergoing serious demographic changes with an influx of migrant workers and refugees. We provide an essential quantification of the mortality burden attributable to extreme heat in Kuwait and Jordan, two countries in the Middle East facing unprecedented heat and yet without existing heat action plans. Policymakers face the question of which thresholds represent negligible risk and which cannot be ignored. By analyzing 56 654 deaths, we reveal the number of deaths per day attributable to specific temperatures. This study presents the first step towards establishing targeted heat action plans to mitigate the health risks posed by intensifying heat. The methods used for Kuwait and Amman can be replicated in similar Middle Eastern countries.
Development and evaluation of two educational sessions on take-home lead exposure prevention for construction workers and their families
Authors: Tore Grant , Green Jennifer Greif , Noguchi Julia , Echevarría-Ramos Mariangelí , Peters Junenette L , Levy Jonathan I , Botana Martinez Maria Pilar , Ceballos Diana M
Published: June 2024

Take-home exposures occur when workers accidentally bring workplace contaminants home. Regular job responsibilities may expose construction workers to lead, which extends to their households via the take-home pathway. The present study aimed to develop and evaluate 2 educational sessions addressing take-home lead exposure tailored to construction workers and their families. Educational materials on take-home lead exposure and prevention strategies were designed following guidance from US government institutions and experts on construction work, lead exposure, and educational interventions. The educational materials were pilot-tested with construction workers and their family members during in-person or online sessions in English or Spanish. Changes in knowledge of take-home lead exposure were assessed through pre- and post-testing and open-ended feedback was collected from both participants and session facilitators. The study sample comprised 44 participants, including 33 workers and 11 family members. Among all participants, 81% were male, 46% were Hispanic or Latino, and the average age was 29 years. Post-test scores (µ = 93%, SD = 10%) were higher than pre-test scores (µ = 82%, SD = 19%), and younger participants (<30 years) were more likely to have a lower pre-test score compared to older participants (≥30 years). Overall, feedback from participants and facilitators was positive, indicating appropriate duration, appealing visuals, and ease of engagement through the training activities. Effective public health education for lead-exposed construction workers and their families is needed to reduce lead exposure disparities, especially among children of workers. Interventions must recognize that take-home exposures are not isolated to occupational or home environments.
Adoption, orchestration, and deployment of artificial intelligence within the National Health Service—facilitators and barriers: an expert roundtable discussion
Authors: Lip Gerald , Novak Alex , Goyen Mathias , Boylan Katherine , Kumar Amrita
Published: June 2024

Clinical care, workflow, and patient outcomes within National Health Service (NHS) radiology services will potentially benefit significantly in coming years with the integration of artificial intelligence (AI) into various specialty areas. This article summarizes an expert roundtable discussion, convened by the British Institute of Radiology, comprised experts from clinical, NHS management and industry backgrounds. Facilitators and barriers to both implementation and integration of AI platforms into daily practice are discussed alongside examples including AI in emergency care and breast screening. Issues addressed include the need to generate more real-world evidence that helps developers and service providers to determine the optimal way for patients to reap the benefits of AI with faster reporting turnaround time, faster diagnoses, and treatment times, for example. To ensure the effective and timely wide-scale implementation, adoption requires a national policy drive and national level coordination but specific, local needs of NHS Trusts and any particular service within Trusts will also need to be met. By embedding AI-capabilities into scanners, ultrasound-devices, X-ray equipment, and Picture archiving and communication system (PACS), local services will benefit, while AI applications can streamline workflows across and between departments and potentially Trusts. AI predictive analytics and systems engineering can be used to better manage patient volume and movement. In the short term, education, training, and confidence in adapting and adopting AI in radiology require dedicated local, national, and governmental effort but the future benefits promise to justify the means.
Ligation of intersphincteric fistula tract (LIFT) for trans-sphincteric cryptoglandular anal fistula: long-term impact on faecal continence
Authors: van Oostendorp Justin Y , Verkade Carolien , Han-Geurts Ingrid J M , van der Mijnsbrugge Grietje J H , Wasowicz-Kemps Dareczka K , Zimmerman David D E
Published: June 2024

Background

The ligation of intersphincteric fistula tract is a surgical technique designed to treat trans-sphincteric anal fistulas aiming to preserve sphincter integrity. Recent studies suggest its efficacy in short-term fistula healing with limited impact on continence. However, comprehensive prospective data on long-term outcomes, including recurrence and bowel continence, are limited. The present study aims to report on the long-term functional outcomes.

Methods

Patients who underwent the ligation of intersphincteric fistula tract procedure for trans-sphincteric cryptoglandular anal fistulas between July 2012 and October 2018 at two Dutch referral centres were retrospectively reviewed. The primary outcome of interest was the long-term bowel continence after the ligation of intersphincteric fistula tract procedure, using the faecal incontinence severity index. Short-term data (collected in 2018) and long-term data (collected in 2023) on bowel continence, healing rates and recurrences were obtained through electronic records and Rockwood questionnaires. Sankey diagrams were used to visually represent individual variations in continence status (preoperative versus follow-up).

Results

Among 110 patients included (50% female, median follow-up 92 months), 101 patients (92%) were treated with previous surgeries (median 2, range 0–6) and 80% had previous seton drainage. Preligation of intersphincteric fistula tract, 16% of the patients reported incontinence (mean(s.d.) faecal incontinence severity index: 2.4(7.5), increasing to 18% after ligation of intersphincteric fistula tract at short-term follow-up, including 11% newly induced cases. Long-term follow-up collected using Rockwood questionnaires (63% response rate) in 69 patients uncovered a 74% incontinency rate (mean(s.d.) faecal incontinence severity index: 9.22(9.5). In those patients without subsequent surgery 49% (17 of 35) reported incontinence at long-term follow-up. Primary fistula healing after ligation of intersphincteric fistula tract was 28%. Preoperative seton drainage significantly improved healing rates (33% versus 9%). Notably, 43% (34 of 79) of unhealed fistulas transitioned into intersphincteric tracts; in these patients, 19 were treated with subsequent fistulotomy achieving cure in 18 cases.

Conclusions

Ligation of intersphincteric fistula tract healing rates fell below recent literature standards. Although the immediate impact on postoperative continence appears minimal, long-term incontinence rates are concerning. In recognizing the deterioration of individual continence, we advocate for a patient-centered approach and urge fellow researchers and clinicians to collect comprehensive prospective continence data.
CipherTrace: automatic detection of ciphers from execution traces to neutralize ransomware
Authors: Hassanin Mostafa AbdelMoez , Martinovic Ivan
Published: June 2024

In 2021, the largest US pipeline system for refined oil products suffered a 6-day shutdown due to a ransomware attack [1]. In 2023, the sensitive systems of the US Marshals Service were attacked by a ransomware [2]. One of the most effective ways to fight ransomware is to extract the secret keys. The challenge of detecting and identifying cryptographic primitives has been around for over a decade. Many tools have been proposed, but the vast majority of them use templates or signatures, and their support for different operating systems and processor architectures is rather limited; neither have there been enough tools capable of extracting the secret keys. In this paper, we present CipherTrace, a generic and automated system to detect and identify the class of cipher algorithms in binary programs, and additionally, locate and extract the secret keys and cryptographic states accessed by the cipher. We focus on product ciphers, and evaluate CipherTrace using four standard cipher algorithms, four different hashing algorithms, and five of the most recent and popular ransomware specimens. Our results show that CipherTrace is capable of fully dissecting Fixed S-Box block ciphers (e.g. AES and Serpent) and can extract the secret keys and other cryptographic artefacts, regardless of the operating system, implementation, or input- or key-size, and without using signatures or templates. We show a significant improvement in performance and functionality compared to the closely related works. CipherTrace helps in fighting ransomware, and aids analysts in their malware analysis and reverse engineering efforts.
DRGKB: a knowledgebase of worldwide diagnosis-related groups’ practices for comparison, evaluation and knowledge-guided application
Authors: Ren Shumin , Yang Lin , Du Jiale , He Mengqiao , Shen Bairong
Published: June 2024

As a prospective payment method, diagnosis-related groups (DRGs)’s implementation has varying effects on different regions and adopt different case classification systems. Our goal is to build a structured public online knowledgebase describing the worldwide practice of DRGs, which includes systematic indicators for DRGs’ performance assessment. Therefore, we manually collected the qualified literature from PUBMED and constructed DRGKB website. We divided the evaluation indicators into four categories, including (i) medical service quality; (ii) medical service efficiency; (iii) profitability and sustainability; (iv) case grouping ability. Then we carried out descriptive analysis and comprehensive scoring on outcome measurements performance, improvement strategy and specialty performance. At last, the DRGKB finally contains 297 entries. It was found that DRGs generally have a considerable impact on hospital operations, including average length of stay, medical quality and use of medical resources. At the same time, the current DRGs also have many deficiencies, including insufficient reimbursement rates and the ability to classify complex cases. We analyzed these underperforming parts by domain. In conclusion, this research innovatively constructed a knowledgebase to quantify the practice effects of DRGs, analyzed and visualized the development trends and area performance from a comprehensive perspective. This study provides a data-driven research paradigm for following DRGs-related work along with a proposed DRGs evolution model. Availability and implementation: DRGKB is freely available at http://www.sysbio.org.cn/drgkb/.

Database URL: http://www.sysbio.org.cn/drgkb/
Cardiovascular medications, high-sensitivity cardiac troponin T concentrations, and long-term outcome in non-ST segment elevation acute coronary syndrome
Authors: Eggers Kai M , Lindhagen Lars , Lindahl Bertil
Published: June 2024

Aims

Cardiac troponin plays an essential role in the management of non-ST segment elevation acute coronary syndrome (NSTE-ACS). However, it is not clear whether troponin concentrations provide guidance regarding the initiation of prognostically beneficial cardiovascular medications [i.e. betablockers, renin–angiotensin–aldosterone system (RAAS) inhibitors, and statins] in NSTE-ACS.

Methods and results

Registry-based study investigating three NSTE-ACS cohorts (n = 43 075, 40 162, and 46 698) with elevated high-sensitivity cardiac troponin concentrations >14 ng/L. Cox proportional regression models with the addition of interaction terms were used to analyse the interrelations of high-sensitivity cardiac troponin T (hs-cTnT) concentrations, new initiated medications with the respective three drug classes, and long-term risk of all-cause mortality and major adverse events (MAE). Betablockers were associated with risk reductions of 8 and 5% regarding all-cause mortality and MAE, respectively. There was no evidence of an interaction with hs-cTnT concentrations. RAAS inhibitors were associated with 13 and 8% risk reductions, respectively, with a weak interaction between hs-cTnT and MAE (Pinteraction = 0.016). However, no increasing prognostic benefit was noted at hs-cTnT concentrations >100 ng/L. Statins were associated with 38 and 32% risk reductions, respectively, with prognostic benefit across the entire range of hs-cTnT concentrations, and with a weak interaction regarding MAE (Pinteraction = 0.011).

Conclusion

Cardiovascular medications provide different prognostic benefit in patients with NSTE-ACS with elevated hs-cTnT, and there was some evidence of greater treatment effects regarding MAE along with higher hs-cTnT concentrations. However, hs-cTnT appears only to have limited value overall for customizing such treatments.