bluuebunny/crossref_metadata_2025 huggingface dataset:
The Milky Way as seen by classical Cepheids II: Spiral structure
Authors: Drimmel R. , Khanna S. , Poggio E. , Skowron D.M.
Published: December 2024

As a relatively young and bright population and the archetype of standard candles, classical Cepheids are an ideal population on which to trace the non-axisymmetric structure in the young stellar disk to large distances. We used the new distances derived in Paper I based on mid-IR WISE photometry for a selected sample of 2857 dynamically young Cepheids to trace the spiral arms of the Milky Way.
The Perseus and Sagittarius-Carina arms are clearly evident in the third and fourth Galactic quadrants, while the Local and Scutum arms are much weaker, and extinction severely limits our view of the latter innermost spiral arm. Pitch angles were derived for each arm over various ranges of Galactic azimuth, each covering at least 90 in azimuth. Our method of detecting spiral arms and deriving pitch angles does not rely on pre-assigning sources to specific arms. While the spiral structure in the first and second quadrant is not obvious in part because of extinction effects, it is not inconsistent with the structure seen in the third and fourth quadrants. In summary, the Cepheids allow us to map spiral structure in the third and fourth Galactic quadrants where currently few masers have astrometric parallaxes, significantly extending our understanding of the Milky Way at large scales.
Tracing the Milky Way spiral arms with 26Al
Authors: Vasini A. , Spitoni E. , Matteucci F. , Cescutti G. , Della Valle M.
Published: December 2024

Context. Massive stars are one of the most important and investigated astrophysical production sites of 26Al, a short-lived radioisotope with an ~1 Myr half-life. Its short lifetime prevents us from observing its complete chemical history, and only the 26Al that was recently produced by massive stars can be observed. Hence, it is considered a tracer of star formation rate (SFR). However, important contributions to 26Al come from nova systems that pollute the interstellar medium with a large delay, thus partly erasing the correlation between 26Al and SFR.

Aims. In this work, we aim to describe the 2D distribution of the mass of 26Al as well as that of massive stars and nova systems in the Milky Way (MW), to investigate their relative contributions to the production of 26Al.

Methods. We used a detailed 2D chemical evolution model where the SFR is azimuthally dependent and is required to reproduce the spiral arm pattern observed in the MW. We tested two different models, one where the 26Al comes from massive stars and novae, and one with massive stars only. We then compared the predictions to the ~2 M⊙ of 26Al mass observed by the surveys of the Compton Telescope (COMPTEL) and International Gamma-Ray Laboratory (INTEGRAI).

Results. The results show that novae do not trace SFR and, in the solar vicinity, they concentrate in its minima. The effect of novae on the map of the 26Al mass consists in damping the spiral pattern by a factor of five. Regarding the nucleosynthesis, we find that ~75% of the 26Al is produced by novae and the ~25% by massive stars.

Conclusions. We conclude that novae cannot be neglected as 26Al producers since the observations can only be reproduced by including their contribution. Moreover, we suggest that bulge novae should eject around six times more material than the disc ones to well reproduce the observed mass of 26Al.
Die Zukunft der Medizin: ein informierter Blick in die „Glaskugel“
Authors: Grgic Ivica
Published: December 2024

Dieser Artikel beleuchtet mögliche zukünftige Szenarien für die Medizin auf Basis aktueller Entwicklungen, technologischer Innovationen und gesellschaftlicher Dynamiken. Durch die Untersuchung von Fortschritten in den Bereichen Künstliche Intelligenz, immersive Technologien, Genomik und digitaler Gesundheitsinfrastruktur entwirft der Beitrag eine Vision eines Gesundheitssystems im Wandel. Die potenzielle Rolle der KI als digitaler Assistent in Diagnostik, Ressourcenmanagement und personalisierter Medizin wird hervorgehoben, ebenso wie die Auswirkungen auf klinische Arbeitsabläufe. Immersive Technologien wie VR und AR versprechen Fortschritte in der medizinischen Ausbildung, der Patientenversorgung und therapeutischen Interventionen. Fortschritte in der Genomik und Gentechnologien wie CRISPR eröffnen neue Möglichkeiten für personalisierte Behandlungen und potenzielle Heilungen genetischer Erkrankungen. Gleichzeitig bringen diese Innovationen ethische Herausforderungen in Bezug auf Datenschutz, Datensicherheit und klinische Verantwortung mit sich. Der Artikel reißt auch die gesundheitlichen Auswirkungen des Klimawandels, einer alternden Bevölkerung und globaler Konflikte an und betont die Notwendigkeit von Vorsorge und Resilienz im Gesundheitssystem. Zusammenfassend wird für einen besonnenen und ausgewogenen Innovationsansatz plädiert, der ethische Überlegungen integriert, um eine Zukunft zu fördern, in der die Medizin trotz zunehmender Digitalisierung und technologischer Komplexität menschlich und empathisch bleibt.
Verbesserungen der Arbeitsumgebung gemeinsam gestalten
Authors: Thoma Jorun , von Zepelin Lyn Anne
Published: December 2024

Mitarbeitende auf Intensivstationen wollen ihre Arbeitsumgebung mitgestalten – davon profitieren dann auch die Patienten. Wie dies in Form von Verbesserungsprojekten mit Bezug zu den Kriterien für ein Magnet-Krankenhaus gelingen kann, berichten die Autorinnen am Beispiel der Uniklinik Freiburg im folgenden Beitrag.
Mit Daten überzeugen – Exzellenz sichtbar machen
Authors: Vogt Birgit
Published: December 2024

Das Universitätsklinikum Hamburg-Eppendorf macht pflegesensitive und pflegerelevante Kennzahlen in einem Live-Dashboard sichtbar. Neben dem Ziel, eine pflegestärkende Ressource bereitzustellen, wird mittels Verknüpfung und Monitoring von Daten aus der Pflegepraxis ein Beitrag geleistet, um Verbesserungspotenziale im Versorgungssystem sowie in Prozess- und Schnittstellenabläufen zu identifizieren.
The Controversy Surrounding the Arcade of Struthers: A Systematic Review of Literature
Authors: Natroshvili Tinatin , Meene Maaike van de , Szweryn Walter J. , Kemler Marius A.
Published: December 2024

The arcade of Struthers was first described by Kane et al in 1973 as a thickening of the deep investing fascia of the distal arm and superﬁcial ﬁbers of the medial head of the triceps muscle extending to the medial intermuscular septum. However, existence of anatomical structure remains disputed, lacking a unanimous consensus. This systematic review aims to provide an overview of all findings and conclusions on this subject. A literature search was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase, and Web of Science. The QUality Appraisal for Cadaveric Studies (QUACS) scale was used for quality appraisal. In total, 12 studies (including 348 arms) agreed with the existence of the arcade of Struthers and its role in ulnar nerve entrapment. One study agreed with the existence of the structure, but disagreed with its nomenclature. On the other side, five studies (describing 224 arms) were against the existence of the structure. In literature, studies can be divided into two groups. The first group agrees with the existence of the arcade of Struthers as described by Kane et al in 1973, emphasizing its role in ulnar nerve entrapment. The second group disagrees with the existence of the arcade of Struthers, and is further divided into those who believe the structure is best described as an accessory origin of the head of the triceps muscle and those who consider it a dissection artifact.
Looking to the future of energy meteorology
Authors: Thompson Avery
Published: December 2024

Bridging the fields of renewable energy and meteorology leads to better energy forecasting and technological innovation.
Probabilistic quantum cloning of three symmetric states
Authors: Wang Shou-Ya , Zhang Wen-Hai
Published: December 2024

This paper investigates the 1 → M probabilistic quantum cloning of three symmetric states, which are defined by a complex number of their inner product. First, a general transformation of the 1 → M probabilistic quantum cloning is designed, and the ancillary success states are introduced. Then, the explicit expression of the probability of successful cloning is derived, which depends on the number M and the inner product of the three symmetric states. Finally, three examples are provided to demonstrate the efficiency of our cloning transformation.
Indium-flush technique for C-band InAs/InP quantum dots
Authors: Yuan Jiajing , Dear Calum , Jia Hui , Park Jae-Seong , Hou Yaonan , El Hajraoui Khalil , Zeng Haotian , Deng Huiwen , Yang Junjie , Tang Mingchu , Chen Siming , Ramasse Quentin M. , Li Qiang , Seeds Alwyn , Liu Huiyun
Published: December 2024

High-quality InAs/InP quantum dots (QDs) emitting at 1550 nm are indispensable to realize high-performance telecom C-band lasers. In general, a longer emission (>1550 nm) with a broad spectral character has been obtained with InAs/InP QDs. Here, we proposed the use of the indium-flush (IF) method to shorten the emission and improve the optical properties of InAs/InP QDs. By exploiting IF, the full-width at half-maximum of the room-temperature QD photoluminescence spectra is narrowed from 89.2 to 47.9 meV, with a blue shift of 300 nm (from 1824 to 1522 nm). The scanning transmission electron microscopy and electron energy loss spectroscopy results reveal the atomic-level mechanism of the IF method, which uniformly modify the height of InAs/InP QDs in a controlled manner and form distinct Al-rich and In-rich regions. Finally, InAs/InP (001) QD lasers with the IF method have been demonstrated with a low threshold current density per QD layer of 106 A/cm2. We demonstrated both in terms of mechanism model and device performance that the IF method could serve as a robust strategy for the growth of high-performance C-band InAs/InP QD lasers via molecular beam epitaxy.
Chance-constrained bi-level optimal scheduling model for distribution network with thermal controllable load aggregators
Authors: Wang Jinfeng , Zhu Jie , Jiang Lin , Huang Yangjue , Huang Zhipeng , Xu Yinliang
Published: December 2024

An increasing amount of distributed renewable energy is being integrated into distribution networks to achieve decarbonization. It is essential to exploit demand-side flexible resources further to enhance system flexibility in response to the intermittency and unpredictability of renewable energy sources. This paper introduces a polytope-based aggregation method for thermostatically controlled loads (TCLs), aggregating numerous individual TCLs into a unified virtual battery via the aggregator (AGG). This approach avoids the dimensionality curse faced by the distribution system operator when directly controlling each TCL, while efficiently utilizing TCL flexibility. Subsequently, a bi-level optimization model is established, where AGGs are treated as independent stakeholders participating in the distribution network scheduling optimization through the local energy market. This model incorporates chance constraints to address the uncertainty of renewable energy sources. Finally, the distributionally robust chance constraint (DRCC) method is used to convert chance constraints into a linear form, and strong duality theory and Karush–Kuhn–Tucker conditions are applied to transform the bi-level model into a single-level model with equilibrium solutions. Case studies on the IEEE 33-bus network demonstrate that the proposed polytope-based aggregation method substantially improves computational efficiency with minimal optimality loss. Additionally, the DRCC method offers superior economic performance compared to robust and deterministic optimization approaches, while maintaining robustness.
Irreversible oxygen uptake and thermal expansion in the solid electrolyte oxygen-deficient perovskite Ca(Ti0.8Fe0.2)O3−δ
Authors: Mullens Bryce G. , Marlton Frederick P. , Bennett Caleb J. , Saura-Múzquiz Matilde , Nicholas Maria K. , Brand Helen E. A. , Kennedy Brendan J.
Published: December 2024

The efficient operation of solid oxide fuel cells for renewable energy generation requires solid electrolytes with high ionic conductivity, thermal stability, and chemical durability. Metal oxide perovskites of the form ABO3 are promising candidates, especially when doped with cations that incorporate interstitial oxygen or oxygen vacancies to enhance ionic conductivity. However, doping can lead to complex and poorly understood crystallographic structures. In this study, we investigate the effects of Fe3+ doping on the orthorhombic Pbnm CaTiO3 perovskite, forming Ca(Ti0.8Fe0.2)O3−δ, and demonstrate the complexity of its phase transitions at operational temperatures. Using synchrotron X-ray diffraction and thermogravimetric analysis, we show that this material undergoes significant oxygen uptake at elevated temperatures, leading to an irreversible expansion of the unit cell and changes in polyhedral coordination upon cooling. These structural modifications are attributed to the partial oxidation of Fe3+ to Fe4+, providing insight into the inconsistencies observed in previous studies of oxygen-deficient perovskites. Our findings highlight the critical role of thermal history and oxygen availability in determining the structural stability and long-term performance of perovskite-based solid electrolytes in solid oxide fuel cells.
Perinatal lamb survival was not reduced by grazing forage oats
Authors: Robertson Susan M. , Friend Michael A. , Allworth Bruce , Bhanugopan Marie
Published: December 2024

Context Grazing forage oats (Avena sativa) is perceived as a risk to perinatal lamb survival and grazing oats only during the lambing period has reduced lamb survival. Aims This study assessed whether perinatal lamb mortality differed for ewes grazing a legume-based pasture throughout the lambing period compared with those grazing oat forage during lambing. Methods A randomised design used two replicates each of two litter sizes (singles or twins) in two forage treatments. Mature Merino ewes were used (n = 424; 53 per group) and all groups grazed legume-based pasture from 6 weeks prior to the start of the lambing period. Control ewes remained on legume pastures, whereas Oat groups were moved to forage oats 9–11 days before lambing. A calcium, magnesium and sodium loose lick supplement was offered to all groups. Key results Ewe mortality was 1.2%, mainly in twin-bearing ewes and similar among treatments. Lamb birthweights were similar; however liveweight at marking was greater for lambs that were born on the legume pastures than for those born on the oats (13.1 ± 0.19 and 12.5 ± 0.18 kg; P = 0.041). Lamb survival did not differ (P = 0.192) between ewes grazing oats (87.3 ± 3.4%) and those grazing legume pasture (78.1 ± 3.4%), and resulted in 1.28 versus 1.14 (P = 0.143) lambs marked/ewe. Lamb survival was similar (P = 0.102) for singles (89.2 ± 3.2%) and twin lambs (76.2 ± 3.2%). Loss in condition score during the lambing period was reduced (P < 0.001) by grazing oats (−0.2 ± 0.06) compared with legume pasture (−0.6 ± 0.06). Conclusions Lamb survival was not reduced by grazing oats rather than legume pasture during the lambing period, although further replication is needed, given the large numerical difference. Any difference in survival between oats and a legume-based pasture when ewes are offered a calcium, magnesium and sodium supplement may depend on the capacity of forage to meet the energy requirements of ewes, although taller oats potentially provide shelter from wind chill. Implications Grazing forage oats during the lambing period has variable effects on lamb survival associated with the relative ability of alternative pasture to provide adequate nutrition, with positive impacts possible.
K
ATP
channel–dependent electrical signaling links capillary pericytes to arterioles during neurovascular coupling
Authors: Isaacs Dominic , Xiang Liuruimin , Hariharan Ashwini , Longden Thomas A.
Published: December 2024

The brain has evolved mechanisms to dynamically modify blood flow, enabling the timely delivery of energy substrates in response to local metabolic demands. Several such neurovascular coupling (NVC) mechanisms have been identified, but the vascular signal transduction and transmission mechanisms that enable dilation of penetrating arterioles (PAs) remote from sites of increased neuronal activity are unclear. Given the exponential relationship between vessel diameter and blood flow, tight control of arteriole membrane potential and diameter is a crucial aspect of NVC. Recent evidence suggests that capillaries play a major role in sensing neural activity and transmitting signals to modify the diameter of upstream vessels. Thin-strand pericyte cell bodies and processes cover around 90% of the capillary bed, and here we show that these cells play a central role in sensing neural activity and generating and relaying electrical signals to arterioles. We identify a K
ATP
channel–dependent neurovascular signaling pathway that is explained by the recruitment of thin-strand pericytes and we deploy vascular optogenetics to show that currents generated in individual thin-strand pericytes are sent over long distances to upstream arterioles to cause dilations in vivo. Genetic disruption of vascular K
ATP
channels reduces the arteriole diameter response to neural activity and laser ablation of thin-strand pericytes eliminates the K
ATP
-dependent component of NVC. Together, our findings indicate that thin-strand pericytes sense neural activity and transform this into K
ATP
channel–dependent electrometabolic signals that inform upstream arterioles of local energy needs, promoting spatiotemporally precise energy distribution.
Social dilemma of nonpharmaceutical interventions: Determinants of dynamic compliance and behavioral shifts
Authors: Glaubitz Alina , Fu Feng
Published: December 2024

In fighting infectious diseases posing a global health threat, ranging from influenza to Zika, nonpharmaceutical interventions (NPI), such as social distancing and face covering, remain mitigation measures public health can resort to. However, the success of NPI lies in sufficiently high levels of collective compliance, otherwise giving rise to recurrent infections that are not only driven by pathogen evolution but also changing vigilance in the population. Here, we show that compliance with each NPI measure can be highly dynamic and context-dependent during an ongoing epidemic, where individuals may prefer one to another or even do nothing, leading to intricate temporal switching behavior of NPI adoptions. By characterizing dynamic regimes through the perceived costs of NPI measures and their effectiveness in particular regarding face covering and social distancing, our work offers insights into overcoming barriers in NPI adoptions.
Electrocatalytic nitrate reduction using iron single atoms for sustainable ammonium supplies to increase rice yield
Authors: Liu Chunlei , Ma Jingchen , Wang Manting , Xu Jingru , Zhu Chao , Zhu Guibing
Published: December 2024

Increasing food production and ensuring drinking water safety have always been a focus of attention, especially for people in underdeveloped regions of the world. Traditional excessive fertilizer applications have increased crop yield but also caused groundwater nitrate pollution. Agricultural irrigating water is an important reservoir for nitrogen (N) (e.g., nitrate) accumulation after fertilization. Ammonium (NH
4
+
-N) is a more readily absorbed N form by rice than nitrate (NO
3
−
-N). In this study, we proposed a strategy using iron single-atom catalysts (Fe-SAC) to selectively reduce NO
3
−
-N to NH
4
+
-N from the real paddy field irrigating water to provide sustainable NH
4
+
-N supplies for rice uptakes, thereby highlighting decreasing N fertilizer applications and mitigating NO
3
−
-N pollution. Then, we constructed a solar-energy-driven electrochemical reactor for NO
3
−
-N reduction, with the Fe single atom as the core catalyst, and achieved an average NH
4
+
-N selectivity of 80.2 ± 2.6% with no additional energy input. Sustainable NH
4
+
-N supplies resulted in a 30.4 % increase in the 100-grain weight of the cultivated rice and a 50% decrease of fertilizer application than those of the fertilization group in the pot experiment, which were one of the best values ever reported. Furthermore, the
15
N isotope tracing results indicated a N use efficiency (NUE) from
15
NO
3
−
-N of 71.2 ± 3.2%. Sustainable NH
4
+
-N supplies played a key role in promoting rice root development which contributed to the high NUE. Our study shares unique insights in increasing grain yield, reducing fertilizer applications, and preventing nitrate leaching into groundwater.
An integrated picture of the structural pathways controlling the heart performance
Authors: Morotti Ilaria , Caremani Marco , Marcello Matteo , Pertici Irene , Squarci Caterina , Bianco Pasquale , Narayanan Theyencheri , Piazzesi Gabriella , Reconditi Massimo , Lombardi Vincenzo , Linari Marco
Published: December 2024

The regulation of heart function is attributed to a dual filament mechanism: i) the Ca
2+
-dependent structural changes in the regulatory proteins of the thin, actin-containing filament making actin available for myosin motor attachment, and ii) the release of motors from their folded (OFF) state on the surface of the thick filament allowing them to attach and pull the actin filament. Thick filament mechanosensing is thought to control the number of motors switching ON in relation to the systolic performance, but its molecular basis is still controversial. Here, we use high spatial resolution X-ray diffraction data from electrically paced rat trabeculae and papillary muscles to provide a molecular explanation of the modulation of heart performance that calls for a revision of the mechanosensing hypothesis. We find that upon stimulation, titin-mediated structural changes in the thick filament switch motors ON throughout the filament within ~½ the maximum systolic force. These structural changes also drive Myosin Binding Protein-C (MyBP-C) to promote first motor attachments to actin from the central 1/3 of the half-thick filament. Progression of attachments toward the periphery of half-thick filament with increase in systolic force is carried on by near-neighbor cooperative thin filament activation by attached motors. The identification of the roles of MyBP-C, titin, thin and thick filaments in heart regulation enables their targeting for potential therapeutic interventions.
Kazuyo Moro: Building relationships is essential for gaining both speed and opportunities in research
Authors: Cols Montserrat
Published: December 2024

Professor Kazuyo Moro holds dual appointments as a team leader for the Laboratory for Innate Immune Systems at RIKEN IMS as well as Osaka University Graduate School of Medicine. Her lab conducts multifaceted research on type 2 innate lymphoid cells (ILC2), from ILC2 differentiation, activation, suppression, and transcriptional control mechanisms, as well as basic research and drug discovery. The research from Prof. Moro lab aims to build new models and therapies for related immune diseases such as allergies, fibrosis, and metabolic diseases.
Linear control of lift in dragonfly vertical flight
Authors: Zhang Kaixuan , Su Xiaohui , Zhao Yong
Published: December 2024

The lift generation mechanisms of dragonflies have been extensively and deeply studied. As research advances, controlling the lift coefficient faces significant challenges. How the lift coefficient varies and whether a unified model can predict lift tendency remains unresolved. In this study, we propose a flapping amplitude partial advanced model (FAPAM) to control the linear variation of lift in dragonfly vertical flight. The FAPAM model can predict the average lift coefficient by the spatial plane and control the dragonfly lift coefficient over a large range. In this model, the maximum lift coefficient is 2.01 times higher than the weight of a dragonfly. The control parameters of the FAPAM are flapping amplitude (FA) and partial lead percent (PLP). Any linear combination of FA and PLP ensures a linear variation of the average lift coefficient. When FA and advanced rotation angle (ARA) increase by one degree, respectively, the increased lift coefficient of FA is 5.38–9.52 times higher than that of ARA, which is closely related to the leading-edge vortex, trailing edge vortex, and positive pressure zone. The FAPAM model seamlessly integrates vertical ascending mode and vertical climbing mode by introducing transition mode. Additionally, FAPAM can effectively simulate the lift coefficient required for the vertical undulating motion of dragonflies during their oviposition process on water. Most importantly, the FAPAM model can maximize the energy efficiency of different motion modes.
Scenario-based simulation training for incident management: for whom and how
Authors: See Pei Jun , Ong Charlene , Poon Ngee , Soh Kee Hean , Tan Siew Ghim , Singh Dhaliwal Satvinder
Published: December 2024

As policing involves high-stakes situations, scenario-based simulation training (SBST) helps officers develop decision-making skills in stressful environments. Virtual simulations offer a cost-effective way to replicate real-life incidents. This study explores how police officers perceive SBST in a virtual environment. This research aims to find if fidelity is important when creating scenarios and understand officers’ expectations and perceptions of SBST. The findings indicate that officers’ demographics and prior work experiences influence how they perceive those exercises. Officers who have spent a large proportion of their years in service found SBST to be able to meet the intended learning objectives. Future research could explore whether similar demographic effects are present in other law enforcement agencies to improve the design of effective simulations.
Preexposure Prophylaxis and Intimate Partner Violence Among Gay, Bisexual, and Other Men Who Have Sex With Men: A Global Scoping Review of the Literature
Authors: Goswami Swarnali , Canedo Joanne , Veeramachaneni Sai , Siddiqua Cynthia , Holmes Erin , Barnard Marie
Published: December 2024

Men who have sex with men (MSM) experience intimate partner violence (IPV) and are at an elevated risk of HIV acquisition. Preexposure prophylaxis (PrEP) is an effective preventative measure against HIV. However, its adoption and consistent use among MSM, especially those experiencing IPV, is low. This scoping review summarizes literature relevant to HIV PrEP, focusing on MSM who experience IPV. Of the 110 studies identified, eight eligible studies met the inclusion and exclusion criteria. Most of these were conducted in the United States, focusing exclusively on adult MSM. Most studies evaluated daily oral PrEP. The studies assessed the impact of IPV on respondent's knowledge, willingness, preference, and PrEP use and revealed varying levels of association between IPV and PrEP. Future research is essential to develop practice guidelines and policy to enhance PrEP uptake in this vulnerable population.
Understanding document statistics: An approach to enhance the author's work
Authors: Hicks Rodney W.
Published: December 2024

The document statistics tool, which authors use to review their work before submission, is explained. The tool yields readability statistics, which assess the document's ease of reading. Authors are encouraged to take advantage of its features, which are described in full.
The Cost Evaluation of Day-Case Compared With Inpatient Stapes Surgery for Otosclerosis: Subanalysis of a Randomized Controlled Trial
Authors: Derks Laura S.M. , Kamalski Digna M.A. , Thomeer Hans G.X.M. , Grolman Wilko , Stokroos Robert J. , Wegner Inge
Published: December 2024

Objective

To evaluate the difference in overall, hospital, and out-of-hospital cost difference of day-case stapes surgery, compared with inpatient stapes surgery, while maintaining equal hearing outcomes and quality of life (QoL).

Study design

A single-center, nonblinded, randomized controlled trial in a tertiary referral center.

Methods

A total of 112 adult patients planned for primary or revision stapes surgery for clinically suspected otosclerosis were randomly assigned to either the day-case or inpatient treatment group. An evaluation was performed of the difference in total health care–related costs (hospital and out-of-hospital costs) from a hospital and patient perspective over the course of 1 year. Audiometric measurements included pure-tone audiometric measurements and speech audiometry measured at 2 months and 1 year postoperatively. QoL was assessed at 3 months and 1 year postoperatively, using the EQ-5D and HUI3 questionnaires.

Results

A total of 109 cases (100 patients) were analyzed due to three dropouts. The total health care–related costs were €16,586 in the inpatient group (n = 54) and €16,904 in the day-case group (n = 55). The mean postoperative hospital stay was 0.9 days (mean costs of €854) in the inpatient group and 0.5 days (mean costs of €561) in the day-case group (both mean differences statistically significant), with a crossover rate from day-case to the inpatient group of 36% (n = 20) and a crossover rate from inpatient to the day-case group of 11% (n = 6). There were no differences in postoperative complications and objective hearing outcomes. Besides an increased number (0.2) of postoperative telephone consultations in the day-case group, there were no statistically significant differences in postoperative hospital and out-of-hospital costs or visits. The QoL showed no statistically significant differences.

Conclusion

A day-case approach in primary or revision stapes surgery does not result in a statistically significant reduction of health care–related hospital and out-of-hospital costs compared with an inpatient approach. It also does not affect the surgical outcome (objective audiometric measurements and complication rate), QoL, and postoperative course (number of postoperative hospital and out-of-hospital visits).

Level of evidence: 1.
Contribution of point-of-care ultrasound in the prehospital management of patients with non-trauma acute dyspnea: a systematic review and meta-analysis
Authors: Taheri Omide , Samain Julie , Mauny Frédéric , Puyraveau Marc , Desmettre Thibaut , Marx Tania
Published: December 2024

Acute dyspnea is a common symptom whose management is challenging in prehospital settings. Point-of-care ultrasound (POCUS) is increasingly accessible because of device miniaturization. To assess the contribution of POCUS in the prehospital management of patients with acute nontraumatic dyspnea, we performed a systematic review on nontrauma patients of any age managed in the prehospital setting for acute dyspnea and receiving a POCUS examination. We searched seven databases and gray literature for English-language studies published from January 1995 to November 2023. Two independent reviewers completed the study selection, data extraction, and risk of bias assessment. The primary outcome was the assessment of the contribution of POCUS to feasibility, diagnostic, therapeutic, prognosis, patient referral, and transport vector modification. Twenty-three studies were included. The risk of bias assessment identified 3 intermediate-risk, 18 serious-risk, and 2 critical-risk studies. Three studies reported moderate to excellent feasibility for lung POCUS, and three studies reported poor to mediocre feasibility for cardiac POCUS. The median duration of the POCUS examination was less than 5 minutes (six studies). POCUS improved diagnostic identification (seven studies). The diagnostic accuracy of POCUS was excellent for pneumothorax (sensitivity = 100%, specificity = 100%, two studies), very good for acute heart failure (sensitivity = 71–100%, specificity = 72–95%, eight studies), good for pneumonia (sensitivity = 88%, specificity = 59%, one study), and moderate for pleural effusion (sensitivity = 26–53%, specificity = 83–92%, two studies). Treatment was modified in 11 to 54% of the patients (seven studies). POCUS had no significant effect on patient prognosis (two studies). POCUS contributed to patient referrals and transport vectors in 51% (four studies) and 25% (three studies) of patients, respectively. The evidence supports the use of POCUS for managing acute nontraumatic dyspnea in the prehospital setting in terms of feasibility, overall diagnostic contribution, and, particularly, lung ultrasound for acute heart failure diagnosis. Moreover, POCUS seems to have a therapeutic contribution. There is not enough evidence supporting the use of POCUS for pneumonia, pleural effusion, pneumothorax, chronic obstructive pulmonary disease, or asthma exacerbation diagnosis, nor does it support prognostic, patient referral, and transport vector contribution. A high level of evidence is lacking and needed.
Methicillin-Resistant Staphylococcus aureus Nasal Screening With Polymerase Chain Reaction for Early De-escalation of Empiric Vancomycin in the Treatment of Suspected/Confirmed Respiratory Infection in Critically Ill Patients
Authors: Lin Amanda , Luo Evelyn , Gottesman Eric , LeDoux David , Saunders-Hao Patricia , Jain Sumeet , Stefanov Dimitre G. , Butzko Ryan , Wong Kelvin , Barrera Maldonado Christian Daniel , Gautam-Goyal Pranisha
Published: December 2024

Background:

Vancomycin empirically for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia coverage often is prolonged. With high negative predictive value for MRSA pneumonia, we evaluated the efficacy of MRSA nasal screening with polymerase chain reaction for early de-escalation of empiric vancomycin for treatment of respiratory infections in patients admitted to the intensive care units.

Study Question:

The impact of MRSA nasal screening on early de-escalation of vancomycin for respiratory infections.

Study Design:

A retrospective, single-center cohort study was conducted to evaluate the outcomes of vancomycin therapy in patients admitted to the intensive care units with diagnosis of pneumonia before (control group) and after (study group) implementation of MRSA nasal screening.

Measures and Outcomes:

The primary end point was the difference in duration of vancomycin drug therapy in patients with suspected/confirmed pneumonia between the control and study groups. Secondary end points included the number of vancomycin trough levels obtained, discordance between polymerase chain reaction and sputum culture results, and clinical outcomes.

Results:

In total, 123 patients (control: n = 76; study: n = 47) were included. The median vancomycin duration in the control group and the study group was 73.3 hours (54.3–110.6) and 30.2 hours (20.3–39.7), respectively, P < 0.0001. The control group had 2.73 times (95% CI: 2.15–3.45, P < 0.0001) longer vancomycin duration than the study group. There was a significant difference in the number of trough levels obtained between the 2 groups. The median in the control and study groups were 1 (1–3) and 1 (0–1), respectively, P < 0.0001. There was no difference between groups for length of stay, 30-day readmission for MRSA infection, reinitiation of anti-MRSA therapy for infection, vancomycin-resistant enterococci infection within 30 days, acute kidney injury, and in-hospital all-cause mortality.

Conclusion:

The implementation of a MRSA nasal screening for critically ill patients treated with vancomycin for pneumonia resulted in a significantly shorter duration of vancomycin treatment without negatively affecting patient outcomes.
Ensuring equity in psychosocial risk assessment for solid organ transplantation: a review
Authors: Obayemi Joy E. , Shaw Brian I. , Greenberg Goni-Katz , Henson Jackie , McElroy Lisa M.
Published: December 2024

Purpose of review

This review summarizes the different instruments for evaluating the psychosocial health of transplant candidates, the evidence demonstrating how these instruments relate to probability of transplant waitlisting and transplant outcomes, and the critical knowledge gaps that exist in the causal pathway between psychosocial health and clinical transplant trajectory.

Recent findings

The current literature reveals that psychosocial assessments are a common reason for racial and ethnic minorities to be denied access to the transplant list. Given evidence that a lack of clinician consensus exists regarding the definition of, importance of, and reproducibility of psychosocial support evaluations, this facet of the holistic evaluation process may create a unique challenge for already vulnerable patient populations. Though recent evidence shows that psychosocial evaluation scores predict select transplant outcomes, these findings remain inconsistent.

Multiple instruments for psychosocial transplant evaluation exist, though the utility of these instruments remains uncertain. As equity becomes an increasingly urgent priority for the transplant system, rigorous interrogation of the causal pathway between psychosocial health and transplant longevity is still needed.
Caring for Patients With Injection Drug Use–Associated Infective Endocarditis at the End of Life
Authors: Todt Kendrea
Published: December 2024

Admissions for patients with injection drug use–associated infective endocarditis are increasing. Injection drug use–associated infective endocarditis is a serious and often fatal cardiac infection. Nurses are often frustrated when caring for these patients because these care assignments are physically and emotionally demanding. Nurses feel helpless, as they disposition young patients to a funeral homes, morgue, or hospice, or send them home to die, and yet a dearth of information regarding end-of-life care for injection drug use–associated infective endocarditis patients remains. This study explored the lived experiential impact these experiences have on nurses. The method was interpretive and participatory, a modified photo-elicitation phenomenological design. Twenty-nine nurses recruited by purposive sampling took photographs and wrote reflections, with 5 participating in an optional unstructured interview conducted by the author. Three themes emerged from the data that elucidated these experiences as (1) a “heartbreaking” experience to witness, (2) an “exhausting” experience to endure, and (3) a practice-altering experience that transforms. Data analysis reveals that nurses experience intense pain, exhaustion, and, yet, transformation, both negative and positive. Implications for nurses include the need for end-of-life education, formal debriefing process to mitigate turnover, and future research into nature-based therapies to help nurses process trauma, as a form of self-care.
A Review of Network Models for HIV Spread
Authors: Mattie Heather , Goyal Ravi , De Gruttola Victor , Onnela Jukka-Pekka
Published: December 2024

Background:

HIV/AIDS has been a global health crisis for over 4 decades. Network models, which simulate human behavior and intervention impacts, have become an essential tool in guiding HIV prevention strategies and policies. However, no comprehensive survey of network models in HIV research has been conducted. This article fills that gap, offering a summary of past work and future directions to engage more researchers and inform policy related to eliminating HIV.

Setting:

Network models explicitly represent interactions between individuals, making them well-suited to study HIV transmission dynamics. Two primary modeling paradigms exist: a mechanistic approach from applied mathematics and a statistical approach from the social sciences. Each has distinct strengths and weaknesses, which should be understood for effective application to HIV research.

Methods:

We conducted a systematic review of network models used in HIV research, detailing the model types, populations, interventions, behaviors, datasets, and software used, while identifying potential future research directions.

Results:

Network models are particularly valuable for studying behaviors central to HIV transmission, such as partner selection and treatment adherence. Unlike traditional models, they focus on individual behaviors, aligning them with clinical practice. However, more accurate network data are needed for better model calibration and actionable insights.

Conclusions:

This article serves as a point of reference for HIV researchers interested in applying network models and understanding their limitations. To our knowledge, this is the most comprehensive review of HIV network models to date.
Advances in Research on Meningeal Lymphatic Vessels in Central Nervous System Diseases
Authors: Shen Huimin , Zhu Bingrui , Qian Yajun , Jin Jiancheng , Zhou Jiankuai , Peng Guotao , Mo Jun
Published: December 2024

Meningeal lymphatic vessels (mLVs), located around the dural sinuses, are considered significant participants in cerebrospinal fluid (CSF) circulation. Meningeal lymphatic vessels not only drain fluids and metabolic waste from the brain into deep cervical lymph nodes (dCLNs) but also transport immune cells from the brain to dCLNs, thus regulating the interaction between the central and peripheral immune systems. These vessels play a crucial role in maintaining normal physiological functions of the central nervous system (CNS). Meningeal lymphatic vessels are involved in the pathophysiological processes of various CNS diseases, including neurodegenerative diseases, cerebrovascular diseases, and brain tumors. In aging and various CNS diseases, damage and dysfunction of mLVs have been observed, leading to the abnormal accumulation of toxic substances and exacerbating neural damage. By transporting antigen-presenting cells that have taken up antigens within the brain to dCLNs, mLVs modulate the activation of peripheral immune cells and their migration and infiltration into brain lesions. Certain drug interventions or physical therapies can modulate the drainage function of mLVs, effectively improving the prognosis of CNS diseases. This review provides a detailed introduction to the anatomic structure, physiological roles, and research advances of mLVs in CNS diseases. In addition, we propose new strategies for targeting mLVs in the treatment of CNS diseases.
The Coexistence of Accessory Anterior Cerebral and Anterior Communicating Arteries
Authors: Triantafyllou George , Papadopoulos-Manolarakis Panagiotis , Tsakotos George , Piagkou Maria
Published: December 2024

Variations in the cerebral artery circle are more prevalent than one might expect. This imaging report outlines the variability observed in the anterior circulation of a 47-year-old female patient, analyzed using a computed tomography angiogram. The first segments (A1) of the anterior cerebral arteries (ACAs) on the left and right side emanate from the internal carotid artery. The authors identified 2 anterior communicating arteries (AComAs) standing 1.4 mm apart. The left and right second segments (A2) of the ACAs were typically present, and authors discovered an accessory A2 branching from the second AComA, also referred to as the median artery of the corpus callosum. Consequently, the patient exhibited both accessories ACA and AComA. These morphological variants in the anterior cerebral circulation are particularly significant due to the increased risk of aneurysms in this area.
Linguistic and clinical validation of the Chinese version of the Acute Cystitis Symptom Score (ACSS) questionnaire in Taiwanese women with uncomplicated acute cystitis
Authors: Chou Yi-Ju , Chang Shang-Jen , Alidjanov Jakhongir F. , Naber Kurt G. , Yang Stephen Shei-Dei
Published: December 2024

Purpose:

The Acute Cystitis Symptom Score (ACSS) questionnaire is designed to diagnose acute cystitis in women. By quantifying the severity of symptoms, ACSS provides objective diagnostic criteria. The aim of this study is to translate the ACSS questionnaire into a Chinese version and validate its clinical use for diagnosing acute cystitis in Taiwanese women.

Materials and methods:

After rigorously translating the ACSS questionnaire into traditional Chinese used by the Mandarin-speaking Taiwanese people, it was clinically validated. Women aged 20 and above with suspected acute cystitis were recruited as the patients, and healthy women undergoing health check-ups as controls. Discriminative ability was assessed by comparing ACSS scores between the 2 groups, and the optimal diagnostic cutoff was determined using receiver operating characteristics analysis. In the patient group, treatment response was evaluated as patient-reported outcome by comparing ACSS scores pretreatment and posttreatment.

Results:

A total of 89 and 43 participants were recruited for the patient and control groups, respectively. The total score of typical symptoms between the patient and the control groups was significantly different (P < 0.001). After antibiotic treatment, the total score of typical symptoms in the patient group significantly decreased (P < 0.001). Using receiver operating characteristics curve analysis, the best cutoff score for diagnosing acute cystitis was 4, with a sensitivity and a specificity of 75.3% and 95.3%, respectively.

Conclusion:

After clinical validation, the Chinese version of the ACSS questionnaire can now be used as a symptom-oriented diagnostic and patient-reported outcome tool for acute cystitis in the Mandarin-speaking female population in Taiwan.
Dazzle camouflage: benefits and problems revealed
Authors: Lovell P. George , Sharman Rebecca J. , Meese Tim S.
Published: December 2024

During WWI, ships were painted in high-contrast 'dazzle' patterns believed to distort, among other things, submariners' perceptions of direction when aiming their torpedoes, but was this strategy effective? Here, we investigated the effects of different camouflage patterns, including versions used in the war, on the perceived direction of travel for a three-dimensional computer model of the RMS Mauretania. The results of this study showed that texture gradients ‘twisted’ the perceived direction of the ship, the effect being ~10° for a regular pattern of circles. We also found a second, larger effect, 'hysteresis', that biased perceived target directions to parallel the horizon for directions of travel within approximately ±30° of 90° (left–right). Hysteresis persisted outside this central plateau, causing perceived directions to be offset from veridical. The twist and hysteresis effects combined linearly and were constructive (enhancing protection) or destructive (diminishing protection) depending on the directions of (i) travel and (ii) the 'twisting' texture gradients. However, the strength of hysteresis reduced as a function of experience. Our simulated torpedo attacks suggest that systematic perceptual distortion of direction by dazzle might have been effective only where submariners had low hysteresis and ships were fast enough to benefit from the perceptual error imposed by twist.